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The Apgar score of an infant 5 minutes after birth is 8. Which is the nurses best interpretation of this?
- A. Resuscitation is likely to be needed.
- B. Adjustment to extrauterine life is adequate.
- C. Additional scoring in 5 more minutes is needed.
- D. Maternal sedation or analgesia contributed to the low score.
Correct Answer: B
Rationale: The Apgar reflects an infants status in five areas: heart rate, respiratory effort, muscle tone, reflex irritability, and color. A score of 8 to 10 indicates an absence of difficulty adjusting to extrauterine life. Scores of 0 to 3 indicate severe distress, and scores of 4 to 7 indicate moderate difficulty. All infants are rescored at 5 minutes of life, and a score of 8 is not indicative of distress; the newborn does not have a low score. The Apgar score is not used to determine the infants need for resuscitation at birth.
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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.
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.
What is the grayish white, cheeselike substance that covers the newborns skin?
- A. Milia
- B. Meconium
- C. Amniotic fluid
- D. Vernix caseosa
Correct Answer: D
Rationale: The vernix caseosa is the grayish white, cheeselike substance that covers a newborns skin.
Which statement reflects accurate information about patterns of sleep and wakefulness in the newborn?
- A. States of sleep are independent of environmental stimuli.
- B. The quiet alert stage is the best stage for newborn stimulation.
- C. Cycles of sleep states are uniform in newborns of the same age.
- D. Muscle twitches and irregular breathing are common during deep sleep.
Correct Answer: B
Rationale: During the quiet alert stage, the newborns eyes are wide open and bright. The newborn responds to the environment by active body movement and staring at close-range objects. Newborns ability to control their own cycles depend on their neurobehavioral development. Each newborn has an individual cycle. Muscle twitches and irregular breathing are common during light sleep.
Which is the name of the suture separating the parietal bones at the top of a newborns head?
- A. Frontal
- B. Sagittal
- C. Coronal
- D. Occipital
Correct Answer: B
Rationale: The sagittal suture separates the parietal bones at the top of the newborns head. The frontal suture separates the frontal bones. The coronal suture is said to crown the head. The lambdoid suture is at the margin of the parietal and occipital.