Nokea
What are the characteristics of a 40-week preterm newborn male’s genitalia?
- A. scrotum empty, faint rugae
- B. testes in upper canal, rare rugae
- C. testes down, appropriate rugae
- D. testes pendulous, deep rugae
Correct Answer: B
Rationale: Preterm male infants often have testes located in the upper canal and minimal scrotal rugae.
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A new mother is preparing for discharge. She plans on bottle feeding her baby. Which statement indicates to the nurse that the mom needs more information about bottle feeding?
- A. I should encourage my baby to consume the entire amount of formula prepared for each feeding.'
- B. I can make up a 24-hour supply of formula and refrigerate the bottles so I am ready to feed my baby.'
- C. I will hold my baby in a cradle hold and alternate sides from left to right when I feed my baby.'
- D. I will generally feed my baby every 3 to 4 hours or more often as signs of hunger are displayed.'
Correct Answer: A
Rationale: The correct answer is A because it indicates a lack of understanding about infant feeding cues and responsive feeding. Encouraging a baby to consume the entire prepared amount can lead to overfeeding and disregards the baby's hunger and satiety cues. This approach may result in the baby being forced to finish the bottle, leading to potential issues such as obesity or feeding difficulties.
Choice B may seem convenient but is not recommended as formula should be prepared fresh to avoid bacterial contamination. Choice C describes a suitable feeding position but is not a crucial indicator of needing more information. Choice D reflects a good understanding of feeding frequency based on hunger cues, which aligns with responsive feeding practices.
What would be a warning sign of ineffective adaptation to extrauterine life if noted when assessing a 24-hour-old breastfed newborn before discharge?
- A. Apical heart rate of 90 beats/min, slightly irregular, when awake and active
- B. Acrocyanosis
- C. Harlequin sign
- D. Weight loss representing 5% of the newborn’s birth weight
Correct Answer: A
Rationale: A low heart rate and irregularity could indicate poor cardiac function or other underlying issues. Acrocyanosis and mild weight loss are normal findings.
When thinking about scoring an Apgar assessment, the nurse knows that grimace is an assessment of what in a newborn?
- A. Grimace is an assessment of a newborn's response to taking their first breath.
- B. Grimace is an assessment of the flexion of hips and legs in the newborn.
- C. Grimace is an assessment of the response to seeing their birthing person's face.
- D. Grimace is an assessment of the response to stimulation from the nurse.
Correct Answer: D
Rationale: The correct answer is D because the grimace in an Apgar assessment refers to the newborn's response to stimulation, such as a gentle pinch or suctioning. This response indicates the baby's reflexes and neurological function, which are important indicators of overall health. Choices A and C are incorrect because the grimace is not specifically related to breathing or visual stimuli. Choice B is incorrect because it refers to a different aspect of the assessment (muscle tone).
The nurse is assigned to the room of a 15-year-old person who gave birth to a newborn 72 hours ago. Why is this newborn a perfect candidate for the Brazelton assessment?
- A. This parent-newborn couplet is at risk for delayed attachment.
- B. The newborn is likely going home soon.
- C. The EHR is prompting her to do so.
- D. The infant is likely withdrawing from a substance.
Correct Answer: A
Rationale: The correct answer is A because the Brazelton assessment is used to evaluate the newborn's neurobehavioral development and ability to interact with the environment. In this case, the 15-year-old parent may be at risk for delayed attachment due to her age and the circumstances of giving birth. The assessment can help identify any issues early on and provide appropriate interventions.
Choice B is incorrect because the timing of when the newborn is going home is not relevant to the Brazelton assessment. Choice C is incorrect as the Electronic Health Record (EHR) prompting is not a valid reason to conduct the assessment. Choice D is incorrect as there is no indication that the infant is withdrawing from a substance.
The most effective time to initiate breast-feeding is in which stage of reactivity for the neonate?
- A. period of decreased reactivity
- B. first period of reactivity
- C. second period of reactivity
- D. after the end of the second period of reactivity
Correct Answer: B
Rationale: The correct answer is B: first period of reactivity. During this stage, the infant is alert and eager to suckle, making it an optimal time to initiate breastfeeding. The infant's sucking reflex is strong, and they are more likely to latch on successfully. The other choices are incorrect because during the period of decreased reactivity (A), the infant is often drowsy and less interested in feeding. The second period of reactivity (C) may involve increased activity and may not be the best time to introduce breastfeeding. After the end of the second period of reactivity (D), the infant may be more settled and not as ready to breastfeed as during the first period of reactivity.