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When the nurse determines they have a high-risk newborn and birthing person in their care, what can they do to mitigate the situation?
- A. Document in the chart.
- B. Reassure the parent that everything will be fine.
- C. Refer the couplet to social work for early intervention.
- D. Refer to a pediatric health-care provider for well-baby checkup.
Correct Answer: C
Rationale: The correct answer is C: Refer the couplet to social work for early intervention. This is the best course of action as social work can provide support and resources to address the high-risk situation. Documenting in the chart (A) is important but not sufficient for immediate intervention. Reassuring the parent (B) may be helpful, but it doesn't address the risk factor. Referring to a pediatric provider (D) is important but social work intervention can provide more comprehensive support in this specific situation.
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Why is the Dubowitz/Ballard assessment tool used on newborns following delivery?
- A. To determine whether the infant is transitioning to extrauterine life
- B. To predict any growth and development problems that the infant may have
- C. To determine the neuromuscular and physical maturity of the infant
- D. To compare the newborn with other newborns born at the same gestational age
Correct Answer: C
Rationale: The Dubowitz/Ballard assessment tool is used to determine the neuromuscular and physical maturity of the newborn. This tool assesses various physical and neuromuscular characteristics to estimate the gestational age of the infant accurately. By evaluating factors such as skin texture, lanugo, ear formation, and posture, healthcare providers can assess the infant's developmental stage. This assessment helps in determining if the infant is born prematurely or post-term, guiding appropriate care and interventions. The other choices are incorrect because the tool is not primarily used for those purposes.
Which woman is most likely to continue breastfeeding beyond 6 months?
- A. A woman who avoids using bottles.
- B. A woman who uses formula for every other feeding.
- C. A woman who offers water or formula after breastfeeding.
- D. A woman whose infant is satisfied for 4 hours after the feeding.
Correct Answer: A
Rationale: The correct answer is A because avoiding bottles helps maintain the baby's preference for breastfeeding, leading to a higher likelihood of continuing beyond 6 months. Using formula for every other feeding (choice B) introduces a different feeding method, potentially reducing breastfeeding duration. Offering water or formula after breastfeeding (choice C) can reduce the baby's interest in breastfeeding exclusively. A satisfied baby for 4 hours after feeding (choice D) does not necessarily indicate a longer breastfeeding duration as other factors like feeding frequency play a role.
The nurse is watching new parents suction their newborn. The baby begins gagging. What action should the nurse demonstrate to the parents?
- A. Pick the baby up and comfort her.
- B. Place the baby on her back.
- C. Turn the babys head to the side.
- D. Wipe secretions out with a cloth.
Correct Answer: C
Rationale: If the baby begins gagging or vomitingIf the baby begins gagging or vomiting the parents (or nurse) should position the infants head to the side or downward to prevent aspiration. The other actions are not appropriate.
Blood flow connection between the systemic, aorta, pulmonary blood flow, and pulmonary artery is which fetal shunt?
- A. ductus venosus
- B. foramen ovale
- C. ductus arteriosus
- D. foramen venosus
Correct Answer: C
Rationale: The ductus arteriosus connects the pulmonary artery to the descending aorta, allowing most fetal blood to bypass the lungs.
Which finding should be most concerning immediately following delivery of a newborn?
- A. Capillary refill time of 3 seconds
- B. Heart rate of 180 bpm
- C. Respiratory rate of 65 breaths per minute
- D. Apgar score of 8 at 5 minutes
Correct Answer: B
Rationale: The correct answer is B: Heart rate of 180 bpm. A high heart rate in a newborn is concerning as it could indicate distress or a medical condition. A heart rate of 180 bpm is significantly above the normal range for a newborn (120-160 bpm), requiring immediate attention to assess and address the underlying cause, such as infection or cardiac issues.
A: Capillary refill time of 3 seconds is within the normal range (less than 3 seconds is normal).
C: Respiratory rate of 65 breaths per minute is slightly elevated but not as critical as a high heart rate.
D: Apgar score of 8 at 5 minutes is a good score, indicating the baby is in overall good condition, but it does not address the immediate concern of a high heart rate.