Nokea
A family who immigrated to the United States in the past year is preparing to take their infant home with both oxygen and G-tube feeds. How does the nurse know discharge education has prepared them for success?
- A. The caregiver has been able to demonstrate a G-tube feed successfully at the correct feeding times throughout the day.
- B. The caregiver was unable to safely administer all medications at the prescribed times during the day and night.
- C. The family has cultural concerns that have not been addressed at this time regarding home-going care for the infant, but a social worker has been consulted.
- D. Oral feeding is important to the caregiver for the infant, and they continue to attempt PO feedings after both the nurse and attending physician have explained the infant’s need for G-tube feedings.
Correct Answer: A
Rationale: Successful demonstration of G-tube feeding indicates preparedness.
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The nurse is completing an initial assessment of the newborn. The newborn’s ears appear to be parallel to the outer and inner canthus of the eye. How does the nurse document the ear placement?
- A. low set
- B. high set
- C. a normal position
- D. facial paralysis
Correct Answer: C
Rationale: Ears positioned parallel to the outer and inner canthus are considered normal.
Which assessment finding of a newborn in the newborn nursery warrants further investigation and notification to the physician?
- A. Absent bowel sounds 15 minutes after delivery
- B. Bluish discoloration on the buttocks area
- C. Regurgitation of small amounts of feedings
- D. Absent meconium stool on day 2 of life
Correct Answer: D
Rationale: The correct answer is D because the absence of meconium stool on day 2 of life can indicate a potential intestinal obstruction, which requires immediate medical attention. Meconium should be passed within the first 24-48 hours of life. A: Absent bowel sounds 15 minutes after delivery are normal as the gastrointestinal system may take some time to start functioning. B: Bluish discoloration on the buttocks area can be due to vascular changes and is usually not concerning. C: Regurgitation of small amounts of feedings is common in newborns and often not indicative of a serious issue.
A newborn was prenatally diagnosed with trisomy 13 along with an unrepairable cardiac anomaly. Genetic testing and cardiac imaging after birth have confirmed both findings. What discharge planning should be included for this infant?
- A. cardiology follow-up
- B. genetic testing for the family
- C. home hospice care
- D. lactation consultant
Correct Answer: C
Rationale: Given the unrepairable cardiac anomaly, home hospice care is appropriate.
A mother brings her 4-week-old newborn into the clinic for a well-child check. She reports to the nurse that the newborn developed small white marks on her nose. What are these small white marks commonly called?
- A. Milia
- B. Mongolian spots
- C. Erythema toxicum
- D. Port-wine stain
Correct Answer: A
Rationale: The correct answer is A: Milia. Milia are tiny, white, pearly bumps that commonly appear on a newborn's face, including the nose, due to blocked oil glands. They are harmless and typically disappear on their own.
Explanation:
1. Milia are common in newborns, appearing as small white bumps on the nose and face.
2. They result from blocked oil glands and are not harmful.
3. Mongolian spots are bluish-gray birthmarks usually on the lower back or buttocks.
4. Erythema toxicum presents as red blotches on the skin shortly after birth.
5. Port-wine stain is a vascular birthmark that appears as a pink or red mark on the skin.
A nurse is discharging parents and their new infant. When assisting the family to place the infant in a car seat, which observation leads the nurse to reinforce teaching?
- A. The baby is wearing a sack-type sleeper.
- B. The baby is wearing a single layer of clothes.
- C. The parent checks the temperature of the car seat.
- D. A rear-facing car seat is in the back seat.
Correct Answer: A
Rationale: Sack-type sleepers are not recommended for wearing in a child safety seat because the straps may not fit properly. The other observations are appropriate.