Nokea
A neonate has difficulty maintaining a normal temperature. A student nurse prepares to place the infant under a radiant warmer. What action by the student leads the faculty member to intervene?
- A. Assesses the surrounding area for drafts
- B. Ensures the infant is dried off completely
- C. Observes the respiratory rate at the same time
- D. Wraps the baby in a warmed blanket
Correct Answer: D
Rationale: Radiant heater units warm only the outer surface of objects in them so it is counterproductive to dress the baby or cover the baby with blankets. The other actions are appropriate.
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The most effective time to initiate breast-feeding is in which stage of reactivity for the neonate?
- A. period of decreased reactivity
- B. first period of reactivity
- C. second period of reactivity
- D. after the end of the second period of reactivity
Correct Answer: B
Rationale: The correct answer is B: first period of reactivity. During this stage, the infant is alert and eager to suckle, making it an optimal time to initiate breastfeeding. The infant's sucking reflex is strong, and they are more likely to latch on successfully. The other choices are incorrect because during the period of decreased reactivity (A), the infant is often drowsy and less interested in feeding. The second period of reactivity (C) may involve increased activity and may not be the best time to introduce breastfeeding. After the end of the second period of reactivity (D), the infant may be more settled and not as ready to breastfeed as during the first period of reactivity.
During an assessment of a 12-hour-old newborn, the nurse notices pale pink spots on the nape of the neck. How does the nurse document this finding?
- A. nevus vasculosus
- B. Mongolian spots
- C. nevus flammeus
- D. telangiectatic nevi
Correct Answer: C
Rationale: Nevus flammeus, also known as salmon patches, are common vascular markings often seen on the nape of the neck.
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.
What assessment findings indicate abnormal transition in a neonate? Select all that apply.
- A. prolonged apneic episodes
- B. marked pallor
- C. excessive oral secretions
- D. crackles upon auscultation
Correct Answer: C
Rationale: Abnormal transition signs include prolonged apnea, marked pallor, excessive secretions, and crackles.
What newborn blood test determines blood type and testing for Rh incompatibility?
- A. direct bilirubin level
- B. indirect bilirubin level
- C. RBC count with type and cross match
- D. Coombs test
Correct Answer: D
Rationale: The Coombs test detects antibodies against red blood cells, indicating Rh incompatibility.