Nokea
Upon discharge, parents of a newborn reveal their plans to take their newborn to the beach with them on a vacation when the newborn is 3 months old. Which statement by the nurse is the most appropriate?
- A. Newborns are encouraged to get at least 2 hours of sun each day for vitamin D synthesis.'
- B. You should make plans to leave your newborn with a relative or a babysitter while you are on vacation.'
- C. Sunscreen should be applied to your newborn every hour to prevent sunburn.'
- D. It is best to place your newborn in lightweight clothing and in the shade when outdoors.'
Correct Answer: D
Rationale: The correct answer is D because newborns have delicate skin that is highly susceptible to sunburn and heat-related issues. Placing the newborn in lightweight clothing and in the shade helps protect their sensitive skin from harmful UV rays. This approach minimizes the risk of sunburn and overheating.
A is incorrect because newborns should not be exposed to direct sunlight for prolonged periods. B is inappropriate as it is important for newborns to be with their parents for bonding and care. C is incorrect as sunscreen is not recommended for infants under 6 months of age due to potential skin irritation and absorption concerns.
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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: C
Rationale: The correct answer is C: This weight loss is excessive. The newborn's weight decreased from 6 lbs 12 oz to 5 lbs 10 oz in just three days, indicating a significant loss. A newborn typically loses around 5-10% of their birth weight in the first few days. This weight loss exceeds the expected range, suggesting potential issues like inadequate feeding or dehydration. Choices A and B are incorrect because the weight loss is not within normal limits, and weight gain is not observed. Choice D is incorrect as there is no weight gain, let alone excessive weight gain.
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.
A student nurse is verbalizing disappointment in a new mothers seeming lack of interest in her newborn baby. The student complains to the registered nurse that the mother just wants to sleep and have someone else care for the infant. What response by the registered nurse is best?
- A. Assess closely; we may need to call social work.
- B. Dont judge other people until you have had a baby.
- C. The mother may be completely exhausted from the childbirth experience.
- D. We have to accept that everyones experience is different.
Correct Answer: C
Rationale: After a long and possibly difficult birth
A 29-year-old Chinese American patient is admitted for IUFD. Her blood pressure (BP) is 90/60, body mass index (BMI) is 41, and the medical and surgical history is noncontributory. She does not smoke or have substance use disorder. What part of her history places her at risk for IUFD?
- A. age
- B. obesity
- C. hypotension
- D. ethnicity
Correct Answer: B
Rationale: Obesity is a recognized risk factor for intrauterine fetal death (IUFD).
A nurse is preparing to discharge an infant who has developmental dysplasia of the hip (DDH). What discharge instruction would be most important?
- A. How to correctly perform Ortolani's maneuver
- B. How to properly use the Pavlik harness
- C. When to return for corrective surgery
- D. Where to take the baby to be fit for corrective shoes
Correct Answer: B
Rationale: A baby with DDH will be placed in a special splint, most often the Pavlik harness, to keep the legs in a position of abduction. The harness is worn continuously for 3-6 months, during which time bone growth helps create a normal hip joint. Ortolani's maneuver is an assessment for DDH. Surgery may be required, but not until it has been determined that bone growth is not creating a normally shaped hip joint. Corrective shoes are not needed.