Nokea
What newborn blood test determines blood type and testing for Rh incompatibility?
- A. direct bilirubin level
- B. indirect bilirubin level
- C. RBC count with type and cross match
- D. Coombs test
Correct Answer: D
Rationale: The Coombs test detects antibodies against red blood cells, indicating Rh incompatibility.
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A mother brings her 4-week-old newborn into the clinic for a well-child check. She reports to the nurse that the newborn developed small white marks on her nose. What are these small white marks commonly called?
- A. Milia
- B. Mongolian spots
- C. Erythema toxicum
- D. Port-wine stain
Correct Answer: A
Rationale: The correct answer is A: Milia. Milia are tiny, white, pearly bumps that commonly appear on a newborn's face, including the nose, due to blocked oil glands. They are harmless and typically disappear on their own.
Explanation:
1. Milia are common in newborns, appearing as small white bumps on the nose and face.
2. They result from blocked oil glands and are not harmful.
3. Mongolian spots are bluish-gray birthmarks usually on the lower back or buttocks.
4. Erythema toxicum presents as red blotches on the skin shortly after birth.
5. Port-wine stain is a vascular birthmark that appears as a pink or red mark on the skin.
The nurse is explaining to the new breastfeeding mother the types of neonatal stools the mother can expect. Which examples does the nurse provide? Select all that apply.
- A. Residual meconium is passed as loose watery stool.
- B. Sticky, thick, black stools indicate a presence of blood.
- C. Stools will eventually become drier and more formed.
- D. Golden yellow, a pasty consistency, and sour odor is expected.
Correct Answer: D
Rationale: The correct answer is D because in the early days after birth, newborn stools transition from meconium to a yellow, seedy consistency with a sour odor. This is known as transitional stool. Residual meconium is not passed as loose watery stool (A) but as a sticky, tar-like substance. Sticky, thick, black stools do not necessarily indicate blood (B) but could be meconium. Stools do not become drier and more formed (C) until later in the infant's life.
A mother is attempting to breastfeed her infant in the hospital setting. The infant is sleepy and displays some audible swallowing, the maternal nipples are flat, and the breasts are soft. The nurse has attempted to teach the mother positioning on one side, and now the mother wants to place the infant to the breast on the other side. Based on LATCH scores, what score would the nurse assign to this feeding session?
- A. 10 and document findings in the chart.
- B. 6 and further teach and assist the mother in feeding activities.
- C. 5 and tell the mother to discontinue feeding attempts at this time because the infant is too sleepy.
- D. 8 and no further assistance is needed for feeding.
Correct Answer: B
Rationale: The correct answer is B: 6 and further teach and assist the mother in feeding activities.
Rationale:
1. LATCH scoring system assesses breastfeeding effectiveness.
2. A score of 6 indicates some difficulty and need for further teaching.
3. Signs of difficulty in this scenario: sleepy infant, flat nipples, soft breasts.
4. Audible swallowing is a positive sign but not enough to warrant a perfect score.
5. Further teaching and assistance can improve latch and feeding success.
6. Other options are incorrect as they do not address the need for additional teaching and support.
A new mother and father are inspecting their baby after the nurse brings the infant to them. The mother wants to know why her baby has bruises on the buttocks area. Which statement should be made by the nurse?
- A. Bruises are common after a traumatic delivery. I will ask the physician to come discuss the delivery.'
- B. These areas are called blue/gray macules and are common in certain ethnic groups, but will disappear around 3 years of age.'
- C. These are not bruises; these spots are birthmarks and are usually a permanent impairment.'
- D. The previous nurse did not report these findings. Who else has been in the room with the baby?'
Correct Answer: B
Rationale: The correct answer is B because blue/gray macules, also known as Mongolian spots, are common in certain ethnic groups, especially in babies with darker skin tones. These marks typically appear on the buttocks and lower back and usually fade away by around 3 years of age. This explanation reassures the parents that the marks are not bruises from trauma but rather a normal and harmless skin pigmentation variation.
Choices A, C, and D are incorrect because:
A: This statement implies a traumatic delivery, which may cause unnecessary worry for the parents. It also deflects responsibility by suggesting involving the physician without providing a clear explanation.
C: This statement misidentifies the marks as birthmarks, which are different from Mongolian spots. It also incorrectly suggests they are a permanent impairment, causing unnecessary concern.
D: This statement is confrontational and shifts the focus away from addressing the parents' concerns. It does not provide any explanation or reassurance about the baby's condition.
The perinatal nurse notes that a newborn does not seem to have an opening inside the anal ring. Which action by the nurse takes priority?
- A. Ask the mother how well the infant is eating.
- B. Assess the abdomen and notify the physician.
- C. Facilitate laboratory studies for kidney function.
- D. Reassure the parents that this is a normal deviation.
Correct Answer: B
Rationale: This infant may have an imperforate anus, a condition that is an emergency, as the infant cannot pass stool. The nurse should quickly assess the baby's abdomen for distention and firmness and notify the physician or health-care provider. The other actions are not warranted.