Nokea
The nurse knows that during the motoric process, the newborn will be rated poorly if they do what?
- A. They have good reflexes.
- B. They have hyper- or hypotonic movements.
- C. They have good head control.
- D. They have moderate activity levels.
Correct Answer: B
Rationale: Hyper- or hypotonic movements indicate poor motoric development.
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What is the proper method for cleaning the bulb syringe?
- A. Boil the syringe after each use
- B. Microwave in warm water for 1 minute after use
- C. Wash in warm soapy water daily or after each use
- D. Wipe with alcohol prep each day and after each use
Correct Answer: C
Rationale: The correct answer is C: Wash in warm soapy water daily or after each use. This method is recommended as it effectively removes any residue, dirt, or bacteria from the bulb syringe. Cleaning the syringe daily or after each use helps prevent the growth of harmful bacteria and ensures it remains hygienic for future use. Boiling the syringe (choice A) may damage the materials and is not necessary after every use. Microwaving in warm water (choice B) may not effectively clean the syringe. Wiping with alcohol prep (choice D) may not be sufficient to remove all contaminants.
A breastfeeding patient who was discharged yesterday calls to ask about a tender hard area on her right breast. What should the nurse's first response be?
- A. This is a normal response in breastfeeding mothers.'
- B. Notify your doctor so he can start you on antibiotics.'
- C. Stop breastfeeding because you probably have an infection.'
- D. Try massaging the area and apply heat; it is probably a plugged duct.'
Correct Answer: D
Rationale: The correct response is D because a tender, hard area on the breast is likely a plugged duct, which can be relieved by massaging the area and applying heat to promote milk flow. This approach helps prevent further complications and encourages continued breastfeeding.
Choice A is incorrect as it dismisses the patient's concern without providing helpful guidance. Choice B is incorrect because antibiotics are not typically necessary for a plugged duct unless it progresses to mastitis. Choice C is incorrect as stopping breastfeeding can worsen the condition and may lead to engorgement or mastitis.
During an assessment of a 12-hour-old newborn, the nurse notices pale pink spots on the nape of the neck. How does the nurse document this finding?
- A. nevus vasculosus
- B. Mongolian spots
- C. nevus flammeus
- D. telangiectatic nevi
Correct Answer: D
Rationale: The correct answer is D: telangiectatic nevi. These are also known as "stork bites" or "angel kisses." The rationale for this choice is that telangiectatic nevi are pale pink spots commonly found on the nape of the neck in newborns, which typically fade over time.
A: Nevus vasculosus is a different type of birthmark characterized by a red or purple color due to an overgrowth of blood vessels.
B: Mongolian spots are bluish-gray birthmarks usually found on the lower back or buttocks.
C: Nevus flammeus, also known as a port-wine stain, presents as a flat, pink, or red mark on the skin.
In summary, the correct answer, telangiectatic nevi, is the most appropriate choice based on the description of the finding on the newborn's nape of the neck, while the other options describe different types of birthmarks with distinct characteristics.
What characteristics are directly related to the newborn’s decreased ability to maintain thermal stability?
- A. A neonate has decreased subcutaneous fat and a large body surface-to-weight ratio.
- B. The blood vessels in the neonate are farther from the skin than those of an adult.
- C. Newborns are unable to rely on brown adipose tissue for heat production.
- D. The newborn prefers to be in constant motion, increasing the surface area exposed to the environment.
Correct Answer: A
Rationale: Newborns have less subcutaneous fat and a higher surface-to-weight ratio, making thermoregulation challenging.
Infants who develop cephalohematoma are at an increased risk for
- A. infection.
- B. jaundice.
- C. caput succedaneum.
- D. erythema toxicum.
Correct Answer: B
Rationale: The correct answer is B: jaundice. Cephalohematoma is a collection of blood between the skull and periosteum of a newborn, often caused by birth trauma. This blood breakdown can lead to an increase in bilirubin levels, causing jaundice. Infection (choice A) is not directly associated with cephalohematoma. Caput succedaneum (choice C) is a scalp swelling that resolves on its own and is not linked to cephalohematoma. Erythema toxicum (choice D) is a benign rash common in newborns and is not related to cephalohematoma or jaundice.