Nokea
A woman who has just delivered has decided to bottle feed her full term infant. Which of the following should be included in the patient teaching?
- A. It is best to heat the baby’s bottle in the microwave before feeding.
- B. You should prepare enough bottles for 24 hours of feedings.
- C. The bottle nipples should be enlarged to ease the baby’s sucking.
- D. The baby’s stools will appear bright yellow and will have a smell similar to sour milk.
Correct Answer: B
Rationale: Preparing enough bottles for 24 hours ensures convenience and hygiene. Microwaving can create hot spots, and enlarged nipples are unnecessary.
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Whose theoretical model describes how clinical judgment evolves with experience?
- A. Benner
- B. Tanner
- C. Lasater
- D. Nightingale
Correct Answer: A
Rationale: Patricia Benner's theoretical model explains how clinical judgment develops through stages of novice to expert based on experience.
As the nurse assists a new mother with breastfeeding, the mother asks, 'If formula is prepared to meet the nutritional needs of the newborn, what is in breast milk that makes it better?' The nurse's best response is that it contains
- A. more calcium.
- B. more calories.
- C. essential amino acids.
- D. important immunoglobulins.
Correct Answer: D
Rationale: The correct answer is D: important immunoglobulins. Breast milk contains immunoglobulins that provide passive immunity to the newborn, protecting them from infections. This is crucial for the newborn's developing immune system. Choice A (more calcium) is incorrect as both breast milk and formula provide adequate calcium. Choice B (more calories) is incorrect as breast milk and formula have similar calorie content. Choice C (essential amino acids) is incorrect as both breast milk and formula contain essential amino acids, but breast milk's unique composition is the presence of immunoglobulins, making it superior for newborns.
The nurse is providing care for a neonate during the fourth stage of labor. Which action does the nurse take during this stage?
- A. Dry the neonate immediately.
- B. Compete neonate assessment within 1 hour.
- C. Obtain neonate blood glucose levels.
- D. Perform Apgar screening until scores are 7.
Correct Answer: A
Rationale: The correct answer is A: Dry the neonate immediately. This is crucial during the fourth stage of labor to prevent hypothermia in the neonate. Drying the neonate helps maintain body temperature and reduce heat loss. Choice B is incorrect because a complete neonate assessment should be done within the first 1-2 minutes, not within 1 hour. Choice C is incorrect as obtaining neonate blood glucose levels is not typically done during the immediate post-birth period unless indicated. Choice D is incorrect as Apgar screening is typically done at 1 and 5 minutes after birth, not until the scores are 7.
What would be a warning sign of ineffective adaptation to extrauterine life if noted when assessing a 24-hour-old breastfed newborn before discharge?
- A. Apical heart rate of 90 beats/min, slightly irregular, when awake and active
- B. Acrocyanosis
- C. Harlequin sign
- D. Weight loss representing 5% of the newborn’s birth weight
Correct Answer: A
Rationale: A low heart rate and irregularity could indicate poor cardiac function or other underlying issues. Acrocyanosis and mild weight loss are normal findings.
A nurse has just been asked to be the baby nurse for a coworker who is working with a birthing woman at 35 weeks, 3 days. The patient has preeclampsia, has had a very hard labor with multiple decelerations on her fetal heart monitor, and her amniotic fluid had meconium when her water was broken earlier in the day. In anticipation of this birth, what resources will the nurse need to gather? Select all that apply.
- A. another baby nurse to help
- B. Neonatal Intensive Care team
- C. radiant warmer for the newborn
- D. intubation kit
Correct Answer: B
Rationale: Given the complications, additional support, NICU readiness, warming equipment, and airway management tools are necessary.