Nokea
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.
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Upon assessment, the RN notices that the newborn remains red at rest. Which laboratory value is most important for the nurse to evaluate?
- A. Glucose
- B. Bilirubin
- C. Sodium
- D. Hematocrit
Correct Answer: D
Rationale: The correct answer is D: Hematocrit. A red newborn at rest may indicate polycythemia, which increases the risk of hyperviscosity and complications. Hematocrit measures the percentage of red blood cells in the blood, so evaluating it can help determine if the newborn has polycythemia. Glucose (A) is important but not directly related to the newborn's redness. Bilirubin (B) is crucial for evaluating jaundice, not redness. Sodium (C) levels are not typically associated with a red newborn at rest.
Which of the following findings would be most concerning to the infant nursery nurse performing an initial assessment on an infant born minutes ago?
- A. Umbilical cord with one artery and two veins
- B. Respiratory rate of 35 breaths per minute
- C. Pink body, blue extremities
- D. No retractions of grunting
Correct Answer: A
Rationale: The correct answer is A because an umbilical cord with one artery and two veins is indicative of a congenital anomaly, which can lead to serious health issues such as heart defects or kidney problems. The umbilical cord normally has two arteries and one vein. Option B, a respiratory rate of 35 breaths per minute, is within the normal range for a newborn. Option C, pink body with blue extremities, is a common finding in newborns due to their immature circulatory system. Option D, no retractions or grunting, is a positive sign as retractions and grunting can indicate respiratory distress.
A neonate has difficulty maintaining a normal temperature. A student nurse prepares to place the infant under a radiant warmer. What action by the student leads the faculty member to intervene?
- A. Assesses the surrounding area for drafts
- B. Ensures the infant is dried off completely
- C. Observes the respiratory rate at the same time
- D. Wraps the baby in a warmed blanket
Correct Answer: D
Rationale: Radiant heater units warm only the outer surface of objects in them so it is counterproductive to dress the baby or cover the baby with blankets. The other actions are appropriate.
A nurse is assessing an infant who has a large bruise around his neck and face from a nuchal cord. What other assessment finding correlates with this condition?
- A. Elevated serum bilirubin
- B. Irritability with gentle handing
- C. Large-for-gestational-age measurements
- D. Obvious vertebral defects
Correct Answer: A
Rationale: Infants born with a nuchal cord often demonstrate significant bruising to the face and neck. This may be upsetting to the parents. Irritability with handling might be related to damage from birth trauma. Large-for-gestational-age infants often have bruising related to extraction techniques during a difficult birth. Obvious vertebral defects are associated with neural tube anomalies and can be seen in children with hairy pigmented skin lesions and hairy nevi located in the posterior midline area near the spinal column.
The nurse is providing care for a neonate during the fourth stage of labor. Which action does the nurse take during this stage?
- A. Dry the neonate immediately.
- B. Compete neonate assessment within 1 hour.
- C. Obtain neonate blood glucose levels.
- D. Perform Apgar screening until scores are 7.
Correct Answer: A
Rationale: The correct answer is A: Dry the neonate immediately. This is crucial during the fourth stage of labor to prevent hypothermia in the neonate. Drying the neonate helps maintain body temperature and reduce heat loss. Choice B is incorrect because a complete neonate assessment should be done within the first 1-2 minutes, not within 1 hour. Choice C is incorrect as obtaining neonate blood glucose levels is not typically done during the immediate post-birth period unless indicated. Choice D is incorrect as Apgar screening is typically done at 1 and 5 minutes after birth, not until the scores are 7.