Nokea
A first-time mother brings in her 5-day-old baby for a well-child visit. The baby weighs 7 lb 5 oz, down from 7 lb 10 oz at discharge. The nurse's best response is:
- A. I will notify the doctor about this weight loss.
- B. Newborns can lose up to 10% of their birth weight and regain it by 2 weeks of age.
- C. I can tell you are a first-time mother; don't worry.
- D. Maybe the baby isn't getting enough milk. How often are you feeding?
Correct Answer: B
Rationale: A small weight loss is normal in the first week of life; infants typically regain their birth weight by 2 weeks.
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A 3-week-old neonate is brought to the emergency department because of a three-day history of intermittent vomiting. His mother reports that he has not urinated for eight hours. On physical examination, his eyes are sunken. Which of the following will MOST likely require correction before surgery is performed?
- A. Hypochloremia
- B. Hyperkalemia
- C. Hypernatremia
- D. N/A
Correct Answer: A
Rationale: Hypochloremia is often associated with dehydration and metabolic alkalosis, which may need correction before surgery.
The LEAST important advice for a 2-month-old baby with excessive crying is
- A. master the situation in relaxed manner
- B. adhere to precry cues
- C. change milk formula
- D. avoid sensory overstimulation
Correct Answer: C
Rationale: Changing formula is less critical if the baby is gaining weight adequately.
A first-time mother brings in her 5-day-old baby for a well-child visit. The baby weighs 7 lb 5 oz, down from 7 lb 10 oz at discharge. The nurse's best response is:
- A. I will notify the doctor about this weight loss.
- B. Newborns can lose up to 10% of their birth weight and regain it by 2 weeks of age.
- C. I can tell you are a first-time mother; don't worry.
- D. Maybe the baby isn't getting enough milk. How often are you feeding?
Correct Answer: B
Rationale: A small weight loss is normal in the first week of life; infants typically regain their birth weight by 2 weeks.
Which vitamin is recommended for all women of childbearing age to reduce the risk of neural tube defects such as spina bifida?
- A. A
- B. C
- C. Niacin
- D. Folic acid
Correct Answer: D
Rationale: Folic acid is the correct answer. All women of childbearing age are recommended to take folic acid to reduce the risk of neural tube defects such as spina bifida in their offspring. Neural tube defects occur in the early stages of pregnancy, often before a woman even knows she is pregnant, which is why it is important for all women of childbearing age to ensure they have adequate folic acid intake. Folic acid is a B vitamin that helps the body make new cells and plays a crucial role in the development of the baby's neural tube, which eventually becomes the brain and spinal cord. Adequate folic acid intake before and during pregnancy can significantly reduce the risk of neural tube defects. That's why it is recommended for all women of childbearing age to take a daily folic acid supplement or consume foods fortified with folic acid.
A nurse in the newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs if noted in the newborn infant would alert the nurse to the possibility of this syndrome?
- A. Hypotension and Bradycardia
- B. Tachypnea and retractions
- C. Acrocyanosis and grunting
- D. The presence of a barrel chest with grunting
Correct Answer: B
Rationale: Respiratory distress syndrome (RDS), also known as hyaline membrane disease, is a condition commonly seen in preterm newborn infants. The two classic signs of RDS are tachypnea (rapid breathing) and retractions. Tachypnea is defined as a respiratory rate greater than 60 breaths per minute in newborn infants. Retractions refer to visible indrawing of the chest wall with each breath, indicating increased work of breathing. These signs are indicative of the infant's struggle to breathe and can suggest the presence of RDS. While acrocyanosis (bluish discoloration of the extremities) and grunting may also be present in infants with RDS, tachypnea and retractions are more specific indicators of respiratory distress. Hypotension and bradycardia are not common signs of RDS. The presence of a barrel chest with grunting is not specific