Nokea
When giving a newborn a bath, what is a concern for the nurse (or caregiver)?
- A. hyperbilirubinemia
- B. hypoglycemia
- C. thermoregulation
- D. contact dermatitis
Correct Answer: C
Rationale: Maintaining thermoregulation is critical during bathing to prevent hypothermia.
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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.
The nurse is completing an initial assessment of the newborn. The newborn's ears appear to be parallel to the outer and inner canthus of the eye. How does the nurse document the ear placement?
- A. low set
- B. high set
- C. a normal position
- D. facial paralysis
Correct Answer: C
Rationale: Step 1: Observe the newborn's ears are parallel to the outer and inner canthus of the eye.
Step 2: Compare the observed ear placement to the standard positioning.
Step 3: If the ears align with the eye canthus, document as "a normal position" (Choice C).
Rationale: Parallel ear position indicates normal development. Low set (Choice A) or high set (Choice B) ears suggest abnormalities. Facial paralysis (Choice D) is not related to ear placement in this context.
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 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.
The nurse is completing a gestational assessment on a newborn whose parent was treated for preeclampsia during labor. The neonate is demonstrating 'frog-like' posturing. The nurse knows this is likely due to what medication during labor?
- A. fentanyl in the epidural
- B. penicillin for treatment of group B strep infection
- C. magnesium sulfate for treatment of preeclampsia
- D. prenatal vitamins
Correct Answer: C
Rationale: The correct answer is C: magnesium sulfate for treatment of preeclampsia. Magnesium sulfate is commonly used to manage preeclampsia in pregnant women. Neonates born to mothers who received magnesium sulfate may exhibit 'frog-like' posturing due to the effects of the medication crossing the placenta. The other choices, A: fentanyl in the epidural, B: penicillin for treatment of group B strep infection, and D: prenatal vitamins, are not associated with causing 'frog-like' posturing in newborns. Fentanyl in the epidural is a pain medication, penicillin is an antibiotic, and prenatal vitamins are supplements that do not typically cause this specific posturing.