Nokea
The nurse recommends skin-to-skin contact immediately following the birth of a newborn because it reduces what type of heat loss?
- A. radiation
- B. convection
- C. conduction
- D. evaporation
Correct Answer: D
Rationale: The correct answer is D: evaporation. Skin-to-skin contact reduces evaporative heat loss by preventing the newborn's skin from losing heat through evaporation of amniotic fluid. This is effective in helping the baby maintain a stable body temperature. Radiation (A), convection (B), and conduction (C) are other types of heat loss that are not specifically addressed by skin-to-skin contact immediately after birth.
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Which assessment finding of a newborn requires prompt action by the nurse?
- A. Respiratory rate of 50 breaths per minute
- B. Cyanosis of the extremities
- C. Pause in breathing lasting 20 seconds
- D. Pause in breathing for 15 seconds followed by rapid respirations
Correct Answer: C
Rationale: The correct answer is C: Pause in breathing lasting 20 seconds. This finding indicates a potential apnea episode in the newborn, which requires immediate attention to prevent further complications like hypoxia. The pause in breathing lasting 20 seconds exceeds the normal range for apnea in newborns, typically defined as a pause lasting more than 15 seconds. Prompt action is necessary to assess and address the underlying cause of the apnea episode.
Choice A (Respiratory rate of 50 breaths per minute) is within the normal range for newborns (30-60 breaths per minute) and does not require immediate action. Choice B (Cyanosis of the extremities) may indicate poor circulation but is not as urgent as a prolonged pause in breathing. Choice D (Pause in breathing for 15 seconds followed by rapid respirations) is incorrect as it does not meet the criteria for apnea in newborns and does not require immediate action.
What condition can result from a long, difficult labor and is characterized by a localized, soft area on the newborn’s head?
- A. caput succedaneum
- B. molding
- C. depressed fontanelles
- D. cephalohematoma
Correct Answer: A
Rationale: Caput succedaneum refers to swelling of the soft tissues of the scalp due to prolonged pressure during labor.
Which diagnosis is most appropriate for a newborn who has not voided within 24 hours after delivery?
- A. Hypovolemia related to insufficient fluid intake
- B. Altered growth and development related to gestational age of 36 weeks
- C. Altered nutrition, less than body requirements related to failure to properly latch onto the breast
- D. Constipation related to failure to pass a meconium stool and possible bowel obstruction
Correct Answer: A
Rationale: The correct answer is A: Hypovolemia related to insufficient fluid intake. In a newborn, the inability to void within 24 hours after birth can indicate dehydration and hypovolemia due to insufficient fluid intake. Newborns need to pass urine within the first 24 hours of life to show adequate hydration. Altered growth and development (choice B) is not relevant to the immediate concern of no voiding. Altered nutrition (choice C) is unlikely to cause the absence of urine output. Constipation (choice D) is less likely in a newborn and is not the primary concern when a newborn fails to void.
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.
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: The correct answer is B: epispadias. In epispadias, the urethral opening is located on the dorsal side of the penis. This condition is a congenital anomaly where the urethra fails to fully close during fetal development. Hypospadias (choice A) is when the urethral opening is on the underside of the penis. Phimosis (choice C) is the inability to retract the foreskin. Unispadias (choice D) is not a recognized medical term. Therefore, the nurse correctly identifies the condition as epispadias due to the specific presentation of the urethral opening on the dorsal side of the penis in the 6-hour-old newborn patient.