Nokea
A student nurse asks the newborn nursery nurse why so many babies prefer to be in a flexed position. What answer by the nurse is best?
- A. Flexion keeps their limbs symmetrical.
- B. It keeps their body temperature normal.
- C. Its very familiar to them from being in utero.
- D. They dont have the strength for extension.
Correct Answer: C
Rationale: Newborns naturally keep themselves in flexion
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A neonates 5-minute Apgar assessment reveals the following: active motion; pulse
- A. 126 beats/minute; grimace and coughing during suctioning; appearance
- B. good color all over; and respirations slightly irregular with weak cry. What action by the nurse is most appropriate?
- C. Assess oxygen saturation and administer oxygen if needed.
- D. Document the findings in the chart and begin the identification process.
Correct Answer: A
Rationale: The babys 5-minute Apgar score is 8 (motion 2; pulse 2; grimace 2; appearance 1; respirations 1). If a 5-minute Apgar score is less than 9 the nurse should stabilize the infant instead of leaving the baby with the parents in the birthing unit. Because it appears that this babys problems are related to either oxygenation or perfusion the nurse should assess the oximetry reading and administer oxygen if needed.
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: Epispadias is a congenital condition where the urethral opening is located on the dorsal side of the penis.
The nurse is assisting a newborn's primary care provider with the performance of a circumcision. Which intervention is used to manage the neonate's pain?
- A. A Velcro tourniquet is loosely wrapped around the penis.
- B. The neonate is breastfed first to promote a sense of calmness.
- C. A sucrose-dipped pacifier is offered during the nerve block.
- D. The foreskin is numbed with ice before the nerve block.
Correct Answer: C
Rationale: The correct answer is C because offering a sucrose-dipped pacifier during the nerve block procedure can help manage the newborn's pain by providing comfort and distraction through the sweet taste and sucking motion. Sucrose has been shown to have analgesic effects in newborns. Choice A is incorrect as a tourniquet is not recommended for circumcision. Choice B may help with calming but not specifically with pain management. Choice D is incorrect as numbing with ice before the nerve block may not be effective in providing adequate pain relief during the procedure.
The nurse completes an initial newborn examination. The nurses findings include the following: heart rate 136 beats/minute; respiratory rate 64 breaths/minute; temperature 98.2F (36.8C). The nurse also documents a heart murmur,absence of bowel sounds symmetry of ears and eyes no grunting or nasal flaring and full range of movement of all extremities. Which finding requires immediate consultation with the health-care provider?
- A. Absent bowel sounds
- B. Heart murmur
- C. Respiratory rate
- D. Temperature
Correct Answer: A
Rationale: Bowel obstruction in the neonate is often first identified by an absence of bowel sounds in a small
Transient tachypnea of the neonate develops due to what pathophysiologic phenomenon?
- A. failure to clear lung fluid by the usual mechanism
- B. failure of the patent ductus arteriosus to close
- C. insufficient surfactant production
- D. aspiration of meconium during vaginal or cesarean birth that interferes with surfactant activity
Correct Answer: A
Rationale: TTN occurs when there is delayed reabsorption of fetal lung fluid after birth.