Nokea
A nurse is providing care to several neonates. In giving the infants prophylactic medication to prevent ophthalmia neonatorum
- A. which ordered medication should the nurse question giving?
- B. Erythromycin (Eyemycin)
- C. Penicillin
- D. Silver nitrate (Dey-Drops)
Correct Answer: b
Rationale: Penicillin is not used for prophylaxis against ophthalmia neonatorum. The other medications are appropriate.
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What steps are included in the QSEN steps for rewarming a neonate at risk for cold stress? Select all that apply.
- A. placing the neonate under the radiant warmer
- B. putting a pulse oximeter on the neonate
- C. assessing a blood glucose level
- D. calling the NICU team for assessment
Correct Answer: A
Rationale: Steps include placing the neonate under a radiant warmer and assessing blood glucose levels.
The nurse notices that a 6-hour-old newborn patient's urethral opening is on the dorsal side of the penis. The nurse knows that this is called what?
- A. hypospadias
- B. epispadias
- C. phimosis
- D. unispadias
Correct Answer: B
Rationale: The correct answer is B: epispadias. In epispadias, the urethral opening is located on the dorsal side of the penis. This condition is a congenital anomaly where the urethra fails to fully close during fetal development. Hypospadias (choice A) is when the urethral opening is on the underside of the penis. Phimosis (choice C) is the inability to retract the foreskin. Unispadias (choice D) is not a recognized medical term. Therefore, the nurse correctly identifies the condition as epispadias due to the specific presentation of the urethral opening on the dorsal side of the penis in the 6-hour-old newborn patient.
The nurse is explaining to a mother that her newborn's blood test indicates a high level of unconjugated bilirubin, which causes jaundice. Which information doesn't the nurse present to the mother?
- A. The blood test does not indicate a pathological disease.
- B. The newborn's liver converts bilirubin to a water-soluble substance.
- C. An abundance of RBCs and RBC short life span contributes to the condition.
- D. The newborn's condition is also referred to as hyperbilirubinemia.
Correct Answer: D
Rationale: The correct answer is D because the nurse does not mention the term "hyperbilirubinemia" to the mother. Instead, the nurse focuses on explaining the high level of unconjugated bilirubin causing jaundice.
A: The nurse likely mentioned that the blood test does not indicate a pathological disease to reassure the mother that jaundice is a common condition in newborns.
B: The nurse would have explained that the newborn's liver converts bilirubin to a water-soluble substance as part of the discussion on how bilirubin is processed in the body.
C: An abundance of RBCs and their short lifespan contributing to jaundice would be relevant information that the nurse would provide to explain the underlying causes of the condition.
An infant at term was born at 0105 hours. The nurse is developing a plan of care for the newborn. During which time range will the nurse plan on performing the assessment to determine a Ballard score?
- A. 0115 to 0130
- B. 0200 to 0600
- C. 1400 to 1800
- D. 2000 to 2300
Correct Answer: B
Rationale: The correct answer is B (0200 to 0600) because the Ballard score is typically assessed within the first 12-24 hours of life. Given that the infant was born at 0105 hours, the nurse should plan on performing the assessment between 0200 to 0600. This time frame falls within the recommended window for assessing the Ballard score accurately. Choices A, C, and D are incorrect because they fall outside the optimal time range for conducting the assessment. Option A (0115 to 0130) is too soon after birth, and options C (1400 to 1800) and D (2000 to 2300) are too late for the initial assessment as per standard practice.
The labor and delivery nurse understands that some neonates spontaneously take a breath once the head and chest is delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe?
- A. Oxygen is applied immediately to start respirations.
- B. Carbon dioxide is administered in small doses.
- C. Mild hypoxia and decreased pH stimulates the brain.
- D. Suctioning is used to stimulate breathing efforts.
Correct Answer: C
Rationale: Step 1: Mild hypoxia and decreased pH stimulate the brain to initiate breathing in neonates.
Step 2: This chemical stimuli trigger the respiratory centers in the brainstem.
Step 3: Oxygen administration may not be necessary as the neonate's own respiratory drive is initiated by chemical stimuli.
Step 4: Carbon dioxide administration is not needed as high levels can be harmful.
Step 5: Suctioning is not used to stimulate breathing but to clear airways if necessary.
Summary: Choice C is correct as it aligns with the physiological response of neonates to chemical stimuli for breathing, while the other choices are not relevant or could be potentially harmful.