Nokea
In which condition is breastfeeding contraindicated?
- A. Triplet birth
- B. Flat or inverted nipples
- C. Human immunodeficiency virus infection
- D. Inactive, previously treated tuberculosis
Correct Answer: C
Rationale: The correct answer is C: Human immunodeficiency virus infection. Breastfeeding is contraindicated in this condition due to the risk of vertical transmission of the virus to the infant through breast milk. HIV can be present in breast milk, increasing the risk of infection to the baby. This is supported by guidelines from organizations such as WHO.
Choices A, B, and D are incorrect:
A: Triplet birth is not a contraindication for breastfeeding; it may require additional support but is not a direct contraindication.
B: Flat or inverted nipples may pose initial challenges but can be addressed with proper latch techniques or the use of aids like nipple shields.
D: Inactive, previously treated tuberculosis does not contraindicate breastfeeding as long as the mother has completed treatment and is not actively infectious.
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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: The correct answer is C: magnesium sulfate for treatment of preeclampsia. Magnesium sulfate is commonly used to manage preeclampsia in pregnant women. Neonates born to mothers who received magnesium sulfate may exhibit 'frog-like' posturing due to the effects of the medication crossing the placenta. The other choices, A: fentanyl in the epidural, B: penicillin for treatment of group B strep infection, and D: prenatal vitamins, are not associated with causing 'frog-like' posturing in newborns. Fentanyl in the epidural is a pain medication, penicillin is an antibiotic, and prenatal vitamins are supplements that do not typically cause this specific posturing.
The nurse is receiving shift report on her mother-baby couplet assignment. Which infant should the nurse evaluate first?
- A. 38-weeks' gestation female newborn with a blood sugar level of 60 mg/dL
- B. Term male newborn with a noted axillary temperature of 37.2°C (99°F)
- C. 40-weeks' gestation female newborn with reported poor feed at last attempt
- D. 39-weeks' gestation male newborn who has been crying prior to initial bath
Correct Answer: C
Rationale: The correct answer is C, to evaluate the 40-weeks' gestation female newborn with reported poor feed at the last attempt first. This choice should be prioritized as poor feeding in a newborn can be a sign of potential serious issues such as inadequate nutrition, dehydration, or underlying medical conditions. Addressing this concern promptly is crucial for the infant's well-being.
Option A can be considered as the blood sugar level of 60 mg/dL in the 38-weeks' gestation female newborn is slightly low, but it is not an immediate priority compared to poor feeding. Option B's axillary temperature of 37.2°C is within the normal range for a newborn, so it can be assessed after addressing the concern of poor feeding. Option D, a 39-weeks' gestation male newborn crying prior to the initial bath, can also be evaluated after addressing the more urgent issue of poor feed.
What assessment findings doesn't indicate abnormal transition in a neonate?
- A. prolonged apneic episodes
- B. marked pallor
- C. blue hands and feet oral secretions
- D. crackles upon auscultation
Correct Answer: C
Rationale: The correct answer is C: blue hands and feet oral secretions. This choice doesn't indicate an abnormal transition in a neonate because blue hands and feet and oral secretions are common normal findings in newborns due to immature circulatory and respiratory systems. Prolonged apneic episodes (A) can indicate respiratory distress, marked pallor (B) can indicate anemia or poor perfusion, and crackles upon auscultation (D) can indicate respiratory issues. Therefore, C is the correct answer as it is a normal finding in neonates.
The nurse is completing an initial assessment of the newborn. The newborn’s ears appear to be parallel to the outer and inner canthus of the eye. How does the nurse document the ear placement?
- A. low set
- B. high set
- C. a normal position
- D. facial paralysis
Correct Answer: C
Rationale: Ears positioned parallel to the outer and inner canthus are considered normal.
The nurse is assessing a term neonate delivered to a mother with a history of drug and alcohol abuse. Which finding does the nurse relate to the mother's history?
- A. Chest circumference is less than the head circumference.
- B. The neonate's pulse rate increases when the neonate cries.
- C. When crying, the neonate exhibits an absence of tear production.
- D. Head circumference is below the 10th percentile of normal for gestational age.
Correct Answer: D
Rationale: The correct answer is D because a head circumference below the 10th percentile for gestational age can be indicative of intrauterine growth restriction (IUGR), which is commonly seen in infants of mothers with a history of drug and alcohol abuse. This is due to restricted fetal growth caused by maternal substance abuse.
A, B, and C are incorrect:
A: Chest circumference being less than head circumference is not directly related to maternal drug and alcohol abuse.
B: The neonate's pulse rate increasing when crying is a normal physiological response and is not specific to the mother's history of substance abuse.
C: Absence of tear production when crying is not a typical finding related to maternal drug and alcohol abuse.