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A new mother asks the nurse when she should begin to breastfeed her newborn. The nurse's best response is:
- A. Within the first half-hour after birth
- B. After the newborn's first bath
- C. When the newborn begins to cry
- D. After administering vitamin K
Correct Answer: A
Rationale: Initiating breastfeeding within the first half-hour after birth is crucial for successful breastfeeding and bonding, as recommended by the World Health Organization. This early initiation helps establish breastfeeding and supports the newborn's health by providing colostrum, the nutrient-rich first milk. Choice B, 'After the newborn's first bath,' is incorrect because initiating breastfeeding should not be delayed after birth. Choice C, 'When the newborn begins to cry,' is incorrect as it does not promote timely initiation of breastfeeding. Choice D, 'After administering vitamin K,' is incorrect because breastfeeding initiation should not be delayed for this procedure.
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A 3-year-old child has been admitted to your pediatric ward. The doctor gave a provisional diagnosis of respiratory tract infection. After careful assessment and history, a final diagnosis of lower respiratory infection was made. Which of the following signs will confirm the diagnosis?
- A. Cough
- B. Fever
- C. Inability to lie supine
- D. Inability to eat
Correct Answer: C
Rationale: Inability to lie supine is a characteristic sign of lower respiratory infection. This positioning preference is often seen in patients with lower respiratory infections due to discomfort or difficulty breathing when lying flat on their back. While cough and fever are common symptoms associated with respiratory infections, they are not specific to lower respiratory infections. Inability to eat may indicate general illness or discomfort but is not a specific indicator of lower respiratory infection.
The student nurse has performed a gestational age assessment of an infant and finds the infant to be at 32 weeks. On which set of characteristics is the nurse basing this assessment?
- A. Lanugo mostly gone, little vernix remaining on the body
- B. Prominent clitoris, enlarging labia minora, patent anus
- C. Full areola, 5 to 10 mm nipple bud, pinkish-brown areola
- D. Skin opaque, cracking at wrists and ankles, no visible vessels
Correct Answer: B
Rationale: The correct answer is B. At 30 to 32 weeks' gestation, the clitoris is prominent, and the labia minora are enlarging. The labia majora are small and widely separated. As gestational age increases, the labia majora increase in size. At 36 to 40 weeks, they almost cover the clitoris. At 40 weeks and beyond, the labia majora cover the labia minora and clitoris. Choices A, C, and D do not align with the characteristic features seen at 32 weeks of gestation, making them incorrect.
When using the Ballard gestational assessment tool on a newborn, which of the following tests should be performed after the first hour of birth, allowing the newborn to recover from the stress of birth?
- A. Arm recoil
- B. Square window sign
- C. Scarf sign
- D. Popliteal angle
Correct Answer: A
Rationale: The correct answer is Arm recoil. Arm recoil is slower in healthy but fatigued newborns after birth, making it best elicited after the first hour of birth when the baby has had time to recover from the stress of birth. This assessment helps evaluate neuromuscular maturity in newborns and is more accurate when performed after the initial recovery period. The other choices, Square window sign, Scarf sign, and Popliteal angle, are not specifically assessed using the Ballard gestational assessment tool and do not relate to the recovery period after birth.
The instructor is teaching a group of new mothers about infant care. Which statement indicates that further teaching is needed?
- A. I should put my baby to sleep on their back.
- B. I can give my baby water if they seem thirsty.
- C. Breastfeeding provides all the nutrients my baby needs.
- D. I should burp my baby after each feeding.
Correct Answer: B
Rationale: The correct answer is B. Newborns do not need additional water as breast milk or formula provides all the necessary hydration. Giving water to infants can be harmful and is not recommended as it can interfere with the balance of electrolytes in their bodies. Choice A is correct as placing babies on their back for sleep is the recommended safe sleeping position. Choice C is also correct as breastfeeding does provide all the essential nutrients for babies. Choice D is correct as burping the baby after each feeding helps prevent discomfort from trapped air.
The nurse is preparing to administer vitamin K to a newborn. The mother asks why this injection is necessary. What is the nurse's best response?
- A. It helps the baby's liver function properly.
- B. It prevents bleeding disorders in the newborn.
- C. It boosts the baby's immune system.
- D. It promotes the baby's growth and development.
Correct Answer: B
Rationale: The correct answer is B. Vitamin K is administered to newborns to prevent bleeding disorders since they have low levels of vitamin K, which is essential for blood clotting. By providing this injection, the nurse ensures that the newborn has an adequate supply of vitamin K to support proper blood clotting and prevent potential bleeding complications. Choices A, C, and D are incorrect because vitamin K's primary role in newborns is related to blood clotting and preventing bleeding, not liver function, immune system, or growth and development.