Nokea
The nurse is preparing new parents for discharge with their newborn. The father asks the nurse why the baby's head is so pointed and puffy-looking. What is the best response by the nurse?
- A. His head is molded from fitting through the birth canal. It will become more round.
- B. We refer to that as 'cone head,' which is a temporary condition that goes away.
- C. It might mean that your baby sustained brain damage during birth, and could have delays.
- D. I think he looks just like you. Your head is much the same shape as your baby's.
Correct Answer: A
Rationale: The corrected response 'His head is molded from fitting through the birth canal. It will become more round.' is the best answer as it explains the physiological reason for the baby's appearance after birth. It reassures the father that the pointed and puffy-looking head is a normal part of the birthing process and will resolve on its own. Choice B is incorrect because while 'cone head' is a term used colloquially, it does not provide a detailed explanation. Choice C is incorrect and should be avoided as it introduces unnecessary worry by suggesting brain damage. Choice D is not an appropriate response as it doesn't address the father's concern or provide accurate information about newborn physiology.
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When assessing a newborn for jaundice, which area should be examined?
- A. Legs and feet
- B. Chest and abdomen
- C. Face and sclera
- D. Back and buttocks
Correct Answer: C
Rationale: When assessing a newborn for jaundice, the healthcare provider should examine the face and sclera. Jaundice is often first noticeable in these areas due to the buildup of bilirubin, causing a yellowish discoloration of the skin and eyes. Examining the legs and feet (Choice A) is not the most appropriate area for identifying jaundice in newborns. Similarly, the chest and abdomen (Choice B) are not the primary areas where jaundice is usually observed. Checking the back and buttocks (Choice D) is also not as useful as examining the face and sclera when assessing for jaundice in newborns.
A new mother asks the nurse when she should begin to breastfeed her newborn. The nurse's best response is:
- A. Within the first half-hour after birth
- B. After the newborn's first bath
- C. When the newborn begins to cry
- D. After administering vitamin K
Correct Answer: A
Rationale: Initiating breastfeeding within the first half-hour after birth is crucial for successful breastfeeding and bonding, as recommended by the World Health Organization. This early initiation helps establish breastfeeding and supports the newborn's health by providing colostrum, the nutrient-rich first milk. Choice B, 'After the newborn's first bath,' is incorrect because initiating breastfeeding should not be delayed after birth. Choice C, 'When the newborn begins to cry,' is incorrect as it does not promote timely initiation of breastfeeding. Choice D, 'After administering vitamin K,' is incorrect because breastfeeding initiation should not be delayed for this procedure.
The instructor is teaching a group of new mothers about infant care. Which statement indicates that further teaching is needed?
- A. I should put my baby to sleep on their back.
- B. I can give my baby water if they seem thirsty.
- C. Breastfeeding provides all the nutrients my baby needs.
- D. I should burp my baby after each feeding.
Correct Answer: B
Rationale: The correct answer is B. Newborns do not need additional water as breast milk or formula provides all the necessary hydration. Giving water to infants can be harmful and is not recommended as it can interfere with the balance of electrolytes in their bodies. Choice A is correct as placing babies on their back for sleep is the recommended safe sleeping position. Choice C is also correct as breastfeeding does provide all the essential nutrients for babies. Choice D is correct as burping the baby after each feeding helps prevent discomfort from trapped air.
A breastfeeding mother complains of sore nipples. Which intervention should the nurse suggest?
- A. Use a breast pump until nipples heal
- B. Apply lanolin cream after each feeding
- C. Wash nipples with soap and water before and after each feeding
- D. Reduce the frequency of breastfeeding
Correct Answer: B
Rationale: The correct intervention for sore nipples in a breastfeeding mother is to suggest applying lanolin cream after each feeding. Lanolin cream can help soothe and protect the nipples, promoting healing and reducing discomfort. Using a breast pump may not address the underlying issue causing soreness. Washing nipples with soap and water excessively can lead to dryness and further irritation. Reducing breastfeeding frequency may impact milk supply and bonding. Therefore, recommending lanolin cream is the most appropriate intervention to alleviate soreness in this situation.
Which pain assessment tool is most appropriate for a 3-month-old hospitalized with a fractured femur?
- A. FLACC scale
- B. Poker chip tool
- C. Number scale
- D. Visual analog scale
Correct Answer: A
Rationale: The FLACC scale, which stands for Face, Legs, Activity, Cry, and Consolability, is specifically designed for nonverbal patients like infants and young children. It assesses pain based on observable behaviors such as facial expressions, leg movement, activity level, cry, and the ability to be consoled. In this case, a 3-month-old infant who is unable to communicate verbally would best be assessed using the FLACC scale to determine the level of pain experienced due to a fractured femur. The Poker chip tool, Number scale, and Visual analog scale are not suitable for nonverbal infants and young children as they rely on self-reporting or cognitive abilities that are not yet developed at this age.