Nokea
In term newborns, the first meconium stool should occur no later than within how many hours after birth?
- A. 6
- B. 8
- C. 12
- D. 24
Correct Answer: D
Rationale: The first meconium stool should occur within the first 24 hours. It may be delayed up to 7 days in very low birth-weight newborns.
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Which statement best represents the first period of reactivity in the infant?
- A. Begins when the newborn awakes from a deep sleep
- B. Is an excellent time to acquaint the parents with the newborn
- C. Ends when the amounts of respiratory mucus have decreased
- D. Provides time for the mother to recover from the childbirth process
Correct Answer: B
Rationale: During the first period of reactivity, the infant is alert, cries vigorously, may suck his or her fist greedily, and appears interested in the environment. The infants eyes are usually wide open, suggesting that this is an excellent opportunity for mother, father, and infant to see each other. The second period of reactivity begins when the infant awakes from a deep sleep and ends when the amounts of respiratory mucus have decreased. The mother should sleep and recover during the second stage, when the infant is sleeping.
Which term is used to describe a newborns first stool?
- A. Milia
- B. Milk stool
- C. Meconium
- D. Transitional
Correct Answer: C
Rationale: Meconium is composed of amniotic fluid and its constituents, intestinal secretions, shed mucosal cells, and possibly blood. It is a newborns first stool. Milia involves distended sweat glands that appear as minute vesicles, primarily on the face. Milk stool usually occurs by the fourth day. The appearance varies depending on whether the newborn is breast or formula fed. Transitional stools usually appear by the third day after the beginning of feeding. They are usually greenish brown to yellowish brown, thin, and less sticky than meconium.
The nurse is assessing the reflexes of a newborn. Stroking the outer sole of the foot assesses which reflex?
- A. Grasp
- B. Perez
- C. Babinski
- D. Dance or step
Correct Answer: C
Rationale: This is a description of the Babinski reflex. Stroking the outer sole of the foot upward from the heel across the ball of the foot causes the big toes to dorsiflex and the other toes to hyperextend. This reflex persists until approximately age 1 year or when the newborn begins to walk. The grasp reflex is elicited by touching the palms or soles at the base of the digits. The digits will flex or grasp. The Perez reflex involves stroking the newborns back when prone; the child flexes the extremities, elevating the head and pelvis. This disappears at ages 4 to 6 months. When the newborn is held so that the sole of the foot touches a hard surface, there is a reciprocal flexion and extension of the leg, simulating walking. This reflex disappears by ages 3 to 4 weeks.
Which characteristic is representative of a full-term newborns gastrointestinal tract?
- A. Transit time is diminished.
- B. Peristaltic waves are relatively slow.
- C. Pancreatic amylase is overproduced.
- D. Stomach capacity is very limited.
Correct Answer: D
Rationale: Newborns require frequent small feedings because their stomach capacity is very limited. A newborns colon has a relatively small volume and resulting increased bowel movements. Peristaltic waves are rapid. A deficiency of pancreatic lipase limits the absorption of fats.
The nurse should expect the apical heart rate of a stabilized newborn to be in which range?
- A. 60 to 80 beats/min
- B. 80 to 100 beats/min
- C. 120 to 140 beats/min
- D. 160 to 180 beats/min
Correct Answer: C
Rationale: The pulse rate of the newborn varies with periods of reactivity. Usually the pulse rate is between 120 and 140 beats/min. Sixty to 100 beats/min is too slow for a newborn, and 160 to 180 beats/min is too fast for a newborn.