Nokea
A new mother asks for advice on how to quiet her fussy newborn. Which responses would be appropriate to suggest to the mother?
- A. Prewarm the crib sheets with a hot water bottle
- B. Swaddle the newborn tightly in a receiving blanket
- C. Place the baby in a larger crib or infant bed
- D. Offer a pacifier or allow the infant to suckle at the breast
- E. Take the infant for a ride in the car
Correct Answer: A,B,D,E
Rationale: Oftentimes, infants are comforted by warm sheets. Infants tend to like to be swaddled snugly. Many infants find comfort sucking a pacifier; breast-fed infants can suckle at the breast. Car rides are often soothing for infants. A large sleeping space is not soothing for infants. The opposite is true. A small sleeping space, such as a bassinette, tends to comfort a fussy baby.
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The postpartum mother with a third degree laceration tells the nurse she is afraid to have a bowel movement because of her painful episiotomy. What should the nurse do?
- A. Offer a suppository or enema.
- B. Encourage ambulation.
- C. Offer stool softeners as prescribed.
- D. Offer pain medication before defecating.
Correct Answer: C
Rationale: Stool softeners are available to ease the pain of defecation caused by hemorrhoids and birth trauma. Suppositories or enemas are contraindicated in mothers with third or fourth degree lacerations. Pain medications can often cause constipation. Ambulation may aid in defecation, but will not soften the stool.
Before initially feeding an infant what reflex should the nurse assess?
- A. Moro reflex
- B. Rooting reflex
- C. Babinski reflex
- D. Swallow reflex
Correct Answer: D
Rationale: The nurse should verify that the infant is able to swallow normally before feeding.
Which of the following measures could help prevent infant abduction?
- A. Only transport infants by carrying them.
- B. Require staff members to wear appropriate identification badges.
- C. Respond immediately when an alarm sounds.
- D. Never leave infants unattended at any time.
- E. Take all the infants to their mothers at the same time.
Correct Answer: B,C,D
Rationale: Staff members should always wear appropriate ID badges and should respond immediately when an alarm sounds. Infants should never be left unattended. Infants should always be transported in their cribs, never by carrying them. The nurse should transport only one infant at a time.
What should be included when discussing the care of a circumcised infant after discharge from the hospital?
- A. Gently remove the yellow exudate from the foreskin.
- B. Apply sterile petroleum gauze after each diaper change.
- C. Wipe the circumcision with alcohol each day.
- D. Avoid the use of cloth diapers until the foreskin has healed.
Correct Answer: B
Rationale: Wash the penis at diaper change and apply sterile petroleum gauze. The yellow exudate should not be removed as it is part of the normal healing process. The circumcised area should be cleansed gently, not with alcohol. Cloth diapers are sometimes recommended to promote healing.
The nurse identifies that the newborn is jaundiced within the first 24 hours of birth with jaundice occurring over bony prominences of the face and the mucous membrane. What type of jaundice does this represent?
- A. Physiologic
- B. Normal
- C. Pathologic
- D. Transitory
Correct Answer: C
Rationale: Jaundice that appears within the first 48 hours of life is termed pathologic jaundice and is abnormal. Pathologic jaundice indicates excessive red blood cell destruction and it should be reported. Jaundice that appears after the first 48 hours of life is known as physiologic jaundice and is considered normal.