Nokea
Which characteristic is representative of a full-term newborns gastrointestinal tract?
- A. Transit time is diminished.
- B. Peristaltic waves are relatively slow.
- C. Pancreatic amylase is overproduced.
- D. Stomach capacity is very limited.
Correct Answer: D
Rationale: Newborns require frequent small feedings because their stomach capacity is very limited. A newborns colon has a relatively small volume and resulting increased bowel movements. Peristaltic waves are rapid. A deficiency of pancreatic lipase limits the absorption of fats.
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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.
Which term is used to describe a newborns first stool?
- A. Milia
- B. Milk stool
- C. Meconium
- D. Transitional
Correct Answer: C
Rationale: Meconium is composed of amniotic fluid and its constituents, intestinal secretions, shed mucosal cells, and possibly blood. It is a newborns first stool. Milia involves distended sweat glands that appear as minute vesicles, primarily on the face. Milk stool usually occurs by the fourth day. The appearance varies depending on whether the newborn is breast or formula fed. Transitional stools usually appear by the third day after the beginning of feeding. They are usually greenish brown to yellowish brown, thin, and less sticky than meconium.
Which is true regarding an infants kidney function?
- A. Conservation of fluid and electrolytes occurs.
- B. Urine has color and odor similar to the urine of adults.
- C. The ability to concentrate urine is less than that of adults.
- D. Normally, urination does not occur until 24 hours after delivery.
Correct Answer: C
Rationale: At birth, all structural components are present in the renal system, but there is a functional deficiency in the kidneys ability to concentrate urine and to cope with conditions of fluid and electrolyte stress such as dehydration or a concentrated solute load. Infants urine is colorless and odorless. The first voiding usually occurs within 24 hours of delivery. Newborns void when the bladder is stretched to 15 ml, resulting in about 20 voidings per day.
The nurse is assessing the reflexes of a newborn. Stroking the outer sole of the foot assesses which reflex?
- A. Grasp
- B. Perez
- C. Babinski
- D. Dance or step
Correct Answer: C
Rationale: This is a description of the Babinski reflex. Stroking the outer sole of the foot upward from the heel across the ball of the foot causes the big toes to dorsiflex and the other toes to hyperextend. This reflex persists until approximately age 1 year or when the newborn begins to walk. The grasp reflex is elicited by touching the palms or soles at the base of the digits. The digits will flex or grasp. The Perez reflex involves stroking the newborns back when prone; the child flexes the extremities, elevating the head and pelvis. This disappears at ages 4 to 6 months. When the newborn is held so that the sole of the foot touches a hard surface, there is a reciprocal flexion and extension of the leg, simulating walking. This reflex disappears by ages 3 to 4 weeks.
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.