Nokea
The nurse notices that a 6-hour-old newborn patient’s urethral opening is on the dorsal side of the penis. The nurse knows that this is called what?
- A. hypospadias
- B. epispadias
- C. phimosis
- D. unispadias
Correct Answer: B
Rationale: Epispadias is a congenital condition where the urethral opening is located on the dorsal side of the penis.
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Which technique should the nurse recommend to the postpartum patient in order to prevent nipple trauma?
- A. Assess the nipples before each feeding.
- B. Limit the feeding time to less than 5 minutes.
- C. Wash the nipples daily with mild soap and water.
- D. Position the infant so the nipple is far back in the mouth.
Correct Answer: D
Rationale: The correct answer is D: Position the infant so the nipple is far back in the mouth. This technique helps prevent nipple trauma by ensuring that the baby latches onto the breast correctly, with a deep latch that prevents excessive pressure and friction on the nipple. By positioning the nipple far back in the baby's mouth, the baby can effectively suckle and draw milk without causing damage to the nipple.
Choice A is incorrect because simply assessing the nipples before each feeding does not actively prevent trauma. Choice B is incorrect as limiting feeding time to less than 5 minutes can lead to inadequate milk transfer and potential nipple trauma due to improper latch. Choice C is incorrect as washing the nipples daily with soap and water can actually strip the skin of natural oils and increase the risk of dryness and cracking, leading to trauma.
Which method is correct for obtaining a blood glucose reading on a newborn?
- A. Placing a tourniquet on the newborn's wrist and obtaining a blood sample from a venipuncture to be sent to the laboratory.
- B. Warming the hand and obtaining a sample from the thumb.
- C. Warm the foot, clean it with an alcohol pad, and puncture the side of the heel.
- D. Elevate the foot and obtain a blood sample from the heel.
Correct Answer: C
Rationale: The correct method is C because newborns have delicate blood vessels in their feet, making it easier to obtain a blood sample. Step-by-step rationale: 1. Warm the foot to increase blood flow. 2. Clean with an alcohol pad to prevent infection. 3. Puncture the side of the heel as it has a good blood supply and less painful. Other choices are incorrect: A is invasive and not suitable for newborns. B is not recommended as thumb samples may be inaccurate. D does not specify the heel's side, which is crucial for newborns' safety.
Why is the Dubowitz/Ballard assessment tool used on newborns following delivery?
- A. To determine whether the infant is transitioning to extrauterine life
- B. To predict any growth and development problems that the infant may have
- C. To determine the neuromuscular and physical maturity of the infant
- D. To compare the newborn with other newborns born at the same gestational age
Correct Answer: C
Rationale: The Dubowitz/Ballard assessment tool is used to determine the neuromuscular and physical maturity of the newborn. This tool assesses various physical and neuromuscular characteristics to estimate the gestational age of the infant accurately. By evaluating factors such as skin texture, lanugo, ear formation, and posture, healthcare providers can assess the infant's developmental stage. This assessment helps in determining if the infant is born prematurely or post-term, guiding appropriate care and interventions. The other choices are incorrect because the tool is not primarily used for those purposes.
At birth, a newborn weighed 6 pounds, 12 ounces. Three days later, the newborn weighs 5 pounds, 10 ounces. What conclusion should the nurse draw regarding this newborn’s weight?
- A. This weight loss is within normal limits.
- B. This weight gain is within normal limits.
- C. This weight loss is excessive.
- D. This weight gain is excessive.
Correct Answer: A
Rationale: A weight loss of up to 10% in the first few days is considered normal.
The nurse determines the gestational age of an infant to be 40 weeks. Which characteristics are most likely to be observed? (Select all that apply.)
- A. Testes are pendulous, and the scrotum has deep rugae
- B. Plantar creases over entire sole
- C. Lanugo abundant over shoulders and back
- D. Vernix well distributed over entire body
Correct Answer: A
Rationale: Full-term infants typically exhibit pendulous testes, deep scrotal rugae, and plantar creases over the entire sole. Lanugo is usually minimal, and vernix tends to be localized rather than widespread.