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What is a function of brown adipose tissue (BAT) in newborns?
- A. Generates heat for distribution to other parts of body
- B. Provides ready source of calories in the newborn period
- C. Protects newborns from injury during the birth process
- D. Insulates the body against lowered environmental temperature
Correct Answer: A
Rationale: Brown fat is a unique source of heat for newborns. It has a larger content of mitochondrial cytochromes and a greater capacity for heat production through intensified metabolic activity than does ordinary adipose tissue. Heat generated in brown fat is distributed to other parts of the body by the blood. It is effective only in heat production. Brown fat is located in superficial areas such as between the scapulae, around the neck, in the axillae, and behind the sternum. These areas should not protect the newborn from injury during the birth process. The newborn has a thin layer of subcutaneous fat, which does not provide for conservation of heat.
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The Apgar score of an infant 5 minutes after birth is 8. Which is the nurses best interpretation of this?
- A. Resuscitation is likely to be needed.
- B. Adjustment to extrauterine life is adequate.
- C. Additional scoring in 5 more minutes is needed.
- D. Maternal sedation or analgesia contributed to the low score.
Correct Answer: B
Rationale: The Apgar reflects an infants status in five areas: heart rate, respiratory effort, muscle tone, reflex irritability, and color. A score of 8 to 10 indicates an absence of difficulty adjusting to extrauterine life. Scores of 0 to 3 indicate severe distress, and scores of 4 to 7 indicate moderate difficulty. All infants are rescored at 5 minutes of life, and a score of 8 is not indicative of distress; the newborn does not have a low score. The Apgar score is not used to determine the infants need for resuscitation at birth.
What is most descriptive of the shape of the anterior fontanel in a newborn?
- A. Circle
- B. Square
- C. Triangle
- D. Diamond
Correct Answer: D
Rationale: The anterior fontanel is diamond shaped and measures from barely palpable to 4 to 5 cm. The shape of the posterior fontanel is a triangle. Neither of the fontanels is a circle or a square.
When doing the first assessment of a male newborn, the nurse notes that the scrotum is large, edematous, and pendulous. What should this be interpreted as?
- A. A hydrocele
- B. An inguinal hernia
- C. A normal finding
- D. An absence of testes
Correct Answer: C
Rationale: A large, edematous, and pendulous scrotum in a term newborn, especially in those born in a breech position, is a normal finding. A hydrocele is fluid in the scrotum, usually unilateral, which usually resolves within a few months. An inguinal hernia may or may not be present at birth. It is more easily detected when the child is crying. The presence or absence of testes should be determined on palpation of the scrotum and inguinal canal. Absence of testes may be an indication of ambiguous genitalia.
Which statement reflects accurate information about patterns of sleep and wakefulness in the newborn?
- A. States of sleep are independent of environmental stimuli.
- B. The quiet alert stage is the best stage for newborn stimulation.
- C. Cycles of sleep states are uniform in newborns of the same age.
- D. Muscle twitches and irregular breathing are common during deep sleep.
Correct Answer: B
Rationale: During the quiet alert stage, the newborns eyes are wide open and bright. The newborn responds to the environment by active body movement and staring at close-range objects. Newborns ability to control their own cycles depend on their neurobehavioral development. Each newborn has an individual cycle. Muscle twitches and irregular breathing are common during light sleep.
In term newborns, the first meconium stool should occur no later than within how many hours after birth?
- A. 6
- B. 8
- C. 12
- D. 24
Correct Answer: D
Rationale: The first meconium stool should occur within the first 24 hours. It may be delayed up to 7 days in very low birth-weight newborns.