Nokea
The labor and delivery nurse understands that some neonates spontaneously take a breath once the head and chest is delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe?
- A. Oxygen is applied immediately to start respirations.
- B. Carbon dioxide is administered in small doses.
- C. Mild hypoxia and decreased pH stimulates the brain.
- D. Suctioning is used to stimulate breathing efforts.
Correct Answer: C
Rationale: Step 1: Mild hypoxia and decreased pH stimulate the brain to initiate breathing in neonates.
Step 2: This chemical stimuli trigger the respiratory centers in the brainstem.
Step 3: Oxygen administration may not be necessary as the neonate's own respiratory drive is initiated by chemical stimuli.
Step 4: Carbon dioxide administration is not needed as high levels can be harmful.
Step 5: Suctioning is not used to stimulate breathing but to clear airways if necessary.
Summary: Choice C is correct as it aligns with the physiological response of neonates to chemical stimuli for breathing, while the other choices are not relevant or could be potentially harmful.
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The nurse is assisting a newborn's primary care provider with the performance of a circumcision. Which intervention is used to manage the neonate's pain?
- A. A Velcro tourniquet is loosely wrapped around the penis.
- B. The neonate is breastfed first to promote a sense of calmness.
- C. A sucrose-dipped pacifier is offered during the nerve block.
- D. The foreskin is numbed with ice before the nerve block.
Correct Answer: C
Rationale: The correct answer is C because offering a sucrose-dipped pacifier during the nerve block procedure can help manage the newborn's pain by providing comfort and distraction through the sweet taste and sucking motion. Sucrose has been shown to have analgesic effects in newborns. Choice A is incorrect as a tourniquet is not recommended for circumcision. Choice B may help with calming but not specifically with pain management. Choice D is incorrect as numbing with ice before the nerve block may not be effective in providing adequate pain relief during the procedure.
Which statement is the most accurate regarding suctioning of the oral and nasal passages of a newborn?
- A. The bulb syringe should be compressed after it is inserted into the baby's nose to suction.
- B. Suction the nose and then the mouth of the newborn to prevent aspiration.
- C. Saline should be placed in the baby's nose and mouth prior to suctioning.
- D. Place the bulb syringe on the side of the infant's cheek while suctioning the mouth.
Correct Answer: B
Rationale: The correct answer is B: Suction the nose and then the mouth of the newborn to prevent aspiration. This is the most accurate statement because suctioning the nose first prevents any mucus or secretions from being pushed into the mouth during suctioning. Aspiration can occur if the baby inhales any secretions. Suctioning the mouth after the nose ensures that any remaining secretions are cleared.
Choice A is incorrect because compressing the bulb syringe after insertion can cause trauma to the delicate nasal passages. Choice C is incorrect as using saline before suctioning is not necessary and may increase the risk of aspiration. Choice D is incorrect as placing the bulb syringe on the side of the infant's cheek is not an effective method for suctioning the mouth or nose.
What steps are included in the QSEN steps for rewarming a neonate at risk for cold stress? Select all that apply.
- A. placing the neonate under the radiant warmer
- B. putting a pulse oximeter on the neonate
- C. assessing a blood glucose level
- D. calling the NICU team for assessment
Correct Answer: A
Rationale: Steps include placing the neonate under a radiant warmer and assessing blood glucose levels.
What does the nursing process describe?
- A. what nurses do
- B. how nurses think
- C. where nurses provide care
- D. who nurses care for
Correct Answer: A
Rationale: The nursing process outlines the systematic approach to providing patient care, focusing on what nurses do—assess, diagnose, plan, implement, and evaluate.
In preparing a family for discharge from the perinatal unit, which method of nail care does the nurse teach as the preferred method?
- A. Cutting the nails with sharp scissors
- B. Filing the nails with a fine emery board
- C. Letting the nails break off naturally
- D. Wrapping the infant's hands in mittens
Correct Answer: B
Rationale: Several options exist for nail care to keep the infant from scratching her face. The nails can be cut, but there is a risk of damaging the delicate skin around the nail. This is best done while the baby sleeps. Letting the nails break off is not a good option, as the child may injure herself before they break. Covering the hands with mittens or a tee shirt is a possible option, but does not allow the child to suck on the fingers for self-soothing. The best option is to file the nails gently with a fine-grained emery board.