The nurse is assigned to the postpartum room of a 12-hour-old neonate, and the EHR has a task reminder prompting the nurse to complete a Brazelton assessment on the newborn. Why is this not appropriate?
- A. This newborn has been born to a person who is placing the infant up for adoption.
- B. This newborn has been born to a person who birthed by cesarean section.
- C. This newborn is only 12 hours old.
- D. This newborn is experiencing pathologic jaundice.
Correct Answer: C
Rationale: The correct answer is C because performing a Brazelton assessment on a newborn who is only 12 hours old is not appropriate. The Brazelton assessment is typically done within the first 24-36 hours of life. Performing it too early may yield inaccurate results as the newborn is still transitioning and adapting to life outside the womb.
Choice A is not relevant to the appropriateness of the assessment timing. Choice B also does not impact the timing of the assessment. Choice D is also irrelevant to the timing of the assessment and would not affect the decision to delay performing the Brazelton assessment.
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What is a routine health provider visiting schedule for a newborn in their first year of life, beginning at 1 month of age?
- A. 1 month, 2 months, 4 months, 6 months, 9 months, and 12 months of age
- B. 1 month to 12 months, visiting once each month
- C. 1 month, 3 months, 6 months, 9 months, and 12 months
- D. 1 month, 3 months, 6 months, 12 months
Correct Answer: A
Rationale: Routine visits occur at 1, 2, 4, 6, 9, and 12 months.
A nurse is planning discharge needs to a family whose baby has just been born. Which statement is the most accurate regarding care of the umbilical cord?
- A. Wash the newborn every day in a shallow tub of water.
- B. Rinse the umbilical cord with water and soap until it falls off.
- C. Notify the practitioner if the umbilical cord is still in place after 1 week.
- D. Swab the umbilical cord with alcohol or water daily until it falls off.
Correct Answer: D
Rationale: The correct answer is D. Swabbing the umbilical cord with alcohol or water daily until it falls off is the recommended care to prevent infection. Alcohol helps dry out the cord stump, promoting faster healing.
- A: Washing the newborn every day in water can introduce bacteria and moisture to the cord, increasing infection risk.
- B: Using soap on the umbilical cord can irritate the skin and delay healing.
- C: It's normal for the umbilical cord to fall off within 1-2 weeks, so there's no need to notify the practitioner unless there are signs of infection.
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.
A nurse is providing discharge teaching to parents of a newborn. The baby had no medical problems and is healthy other than having failed an automated auditory brainstem response (AABR) hearing test conducted in the nursery. What information does the nurse provide?
- A. AABR tests are conclusive and the baby is deaf.
- B. Background noise may have interfered with the test.
- C. The babys hearing should be retested within 1 month.
- D. The baby should have another hearing test next week.
Correct Answer: C
Rationale: Babies who fail a hearing screening test at birth should have a follow-up test within a month. The AARB test can be conducted in the presence of background noise. The results are not conclusive (it is a screening device)
Transient tachypnea of the neonate develops due to what pathophysiologic phenomenon?
- A. failure to clear lung fluid by the usual mechanism
- B. failure of the patent ductus arteriosus to close
- C. insufficient surfactant production
- D. aspiration of meconium during vaginal or cesarean birth that interferes with surfactant activity
Correct Answer: A
Rationale: The correct answer is A because transient tachypnea of the neonate is primarily caused by the failure to clear lung fluid by the usual mechanism. During birth, the baby may not expel the lung fluid properly, leading to respiratory distress. This results in rapid breathing (tachypnea) due to the retained fluid in the lungs. The other choices are incorrect as they do not directly relate to the pathophysiology of transient tachypnea. Choice B involves the heart (patent ductus arteriosus), choice C relates to insufficient surfactant production seen in respiratory distress syndrome, and choice D mentions meconium aspiration syndrome, which is a different condition caused by the aspiration of meconium into the lungs, not related to the failure to clear lung fluid.
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