Nokea
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.
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The perinatal nurse notes that a newborn does not seem to have an opening inside the anal ring. Which action by the nurse takes priority?
- A. Ask the mother how well the infant is eating.
- B. Assess the abdomen and notify the physician.
- C. Facilitate laboratory studies for kidney function.
- D. Reassure the parents that this is a normal deviation.
Correct Answer: B
Rationale: This infant may have an imperforate anus, a condition that is an emergency, as the infant cannot pass stool. The nurse should quickly assess the baby's abdomen for distention and firmness and notify the physician or health-care provider. The other actions are not warranted.
The nurse is completing a gestational assessment on a newborn whose parent was treated for preeclampsia during labor. The neonate is demonstrating “frog-like” posturing. The nurse knows this is likely due to what medication during labor?
- A. fentanyl in the epidural
- B. penicillin for treatment of group B strep infection
- C. magnesium sulfate for treatment of preeclampsia
- D. prenatal vitamins
Correct Answer: C
Rationale: Magnesium sulfate administered to treat preeclampsia can cause hypotonia and 'frog-like' posturing in the newborn.
The nurse knows that during the organizational process, the newborn won't be rated as exceptionally good if they do what?
- A. They will remain alert.
- B. They will be highly irritable and demonstrate mood swings.
- C. They will demonstrate self-soothing and quieting techniques.
- D. The newborn will shut down body responses to stimuli when drowsy.
Correct Answer: B
Rationale: The correct answer is B because a newborn being highly irritable and demonstrating mood swings is indicative of poor adaptability and self-regulation skills, which are factors considered in rating newborns. Being irritable and having mood swings can be signs of difficulty in self-soothing and adjusting to the environment, hence not meeting the criteria for being rated exceptionally good.
A: Remaining alert is generally a positive sign of responsiveness, so it wouldn't hinder the newborn from being rated as exceptionally good.
C: Demonstrating self-soothing and quieting techniques is a positive behavior that can contribute to a newborn being rated as exceptionally good.
D: Shutting down body responses to stimuli when drowsy is a normal physiological response and does not necessarily impact the newborn's rating as exceptionally good.
An infant was born with anencephaly and was taken immediately to the NICU. The parents are about to visit for the first time. What action by the nurse is most appropriate?
- A. Call the hospital chaplain to visit the parents.
- B. Obtain informed consent for emergency surgery.
- C. Prepare the parents for how the infant will look.
- D. Show the parents proper gowning and gloving.
Correct Answer: C
Rationale: Infants born with anencephaly (incomplete closure of the anterior portion of the neural tube) are often missing parts of the brain, forehead, skull, and occiput. The nurse must be very sensitive in working with the parents of such children and needs to prepare the parents for how the child will look. Well-prepared parents have a better chance of being able to bond with their child. A visit from the chaplain may or may not be welcomed. Emergency surgery is not performed. Proper gowning and gloving are not needed unless the infant is in isolation.
Infants who develop cephalohematoma are at an increased risk for
- A. infection.
- B. jaundice.
- C. caput succedaneum.
- D. erythema toxicum.
Correct Answer: B
Rationale: The correct answer is B: jaundice. Cephalohematoma is a collection of blood between the skull and periosteum of a newborn, often caused by birth trauma. This blood breakdown can lead to an increase in bilirubin levels, causing jaundice. Infection (choice A) is not directly associated with cephalohematoma. Caput succedaneum (choice C) is a scalp swelling that resolves on its own and is not linked to cephalohematoma. Erythema toxicum (choice D) is a benign rash common in newborns and is not related to cephalohematoma or jaundice.