Nokea
A breastfeeding mother reports to the nurse that her newborn nurses every hour and never seems satisfied. Which advice should the nurse provide?
- A. Supplement breastfeeding with formula after each nursing session.
- B. Allow the newborn to nurse on each breast for at least 20 minutes.
- C. Reduce the number of nursing sessions to every 2-3 hours.
- D. Ensure the newborn has a proper latch and is effectively nursing.
Correct Answer: D
Rationale: The nurse should ensure that the newborn has a proper latch and is effectively nursing. Sometimes, newborns nurse frequently for comfort even when they are effectively latched. It is essential to address the latch first before considering other interventions. Supplementing with formula (Choice A) may decrease the mother's milk supply. Allowing the newborn to nurse for a set time (Choice B) may not address the underlying latch issue. Reducing nursing sessions (Choice C) may lead to decreased milk production and does not address the latch problem.
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During the initial assessment of the newborn, which of the following data would be considered normal?
- A. Chest circumference 31.5 cm, head circumference 33.5 cm
- B. Chest circumference 30 cm, head circumference 29 cm
- C. Chest circumference 38 cm, head circumference 31.5 cm
- D. Chest circumference 32.5 cm, head circumference 36 cm
Correct Answer: A
Rationale: The correct answer is A. During the initial assessment of a newborn, the average head circumference at birth is 32 to 37 cm, while the average chest circumference ranges from 30 to 35 cm. Normally, the head's circumference is about 2 cm greater than the chest circumference at birth. Choice A provides measurements of chest circumference 31.5 cm and head circumference 33.5 cm, both falling within the normal range in terms of actual size and relative size. Choices B, C, and D do not align with the typical measurements seen in a healthy newborn. Choice B has both circumferences below the average range, choice C has the chest circumference above the average, and choice D has the head circumference notably higher than the chest circumference, which is not typical for a newborn.
Which of the following is not an infectious cause of diarrhea?
- A. Allergy
- B. Bacteria
- C. Parasite
- D. Virus
Correct Answer: A
Rationale: The correct answer is A: Allergy. Allergy is not an infectious cause of diarrhea. Diarrhea caused by bacteria, parasites, and viruses is due to infection, while an allergy triggers an immune response that can lead to diarrhea but is not caused by an infectious agent. Choices B, C, and D are incorrect because bacteria, parasites, and viruses are known infectious causes of diarrhea, resulting from infections by these microorganisms.
A postpartum client who delivered a healthy newborn is being assessed by a nurse. Which finding would indicate a complication during the early postpartum period?
- A. Moderate lochia rubra
- B. Bradycardia
- C. Elevated blood pressure
- D. Uterine contraction
Correct Answer: C
Rationale: An elevated blood pressure in the postpartum period may indicate the onset of preeclampsia, a serious complication that requires immediate medical attention. Preeclampsia is characterized by high blood pressure, protein in the urine, and sometimes swelling in the hands and face. If left untreated, preeclampsia can lead to serious complications for both the mother and the baby. Therefore, it is crucial for healthcare providers to closely monitor blood pressure levels in postpartum clients to promptly address any signs of preeclampsia. Choices A, B, and D are not indicative of a complication during the early postpartum period. Moderate lochia rubra is a normal finding as it indicates the normal discharge of blood and tissue from the uterus after childbirth. Bradycardia, a slow heart rate, is not typically a concern in the absence of other symptoms or signs of distress. Uterine contractions are essential for involution and are expected in the postpartum period.
The healthcare provider is assessing a newborn who had undergone vaginal delivery. Which of the following findings is least likely to be observed in a normal newborn?
- A. (+) Moro reflex
- B. Heart rate is 80 bpm
- C. Respirations are irregular
- D. Uneven head shape
Correct Answer: B
Rationale: A heart rate of 80 bpm is least likely to be observed in a normal newborn. The normal heart rate range for a newborn is usually higher than 80 bpm, typically ranging from 120-160 bpm. The Moro reflex (choice A) is a normal newborn reflex, respirations being irregular (choice C) are expected due to the immature respiratory control center, and an uneven head shape (choice D) is common due to molding during vaginal delivery.
The healthcare provider assesses the newborn's ears to be parallel to the outer and inner canthus of the eye. The healthcare provider documents this finding to be which of the following?
- A. A normal position
- B. A possible chromosomal abnormality
- C. Facial paralysis
- D. Prematurity
Correct Answer: A
Rationale: When the top of the ear (pinna) is parallel to the outer and inner canthus of the eye, it is considered a normal position in a newborn. This alignment is an important assessment to ensure normal development and anatomy. Choices B, C, and D are incorrect because the parallel alignment of the ears to the outer and inner canthus of the eye is not indicative of a possible chromosomal abnormality, facial paralysis, or prematurity. It is simply a normal anatomical finding in a newborn.