Deck 23: Physiologic and Behavioral Adaptations of the Newborn

Question 1

A new mother states that her infant must be cold because the baby's hands and feet are blue.This common and temporary condition is called what?

A) Acrocyanosis
B) Erythema toxicum neonatorum
C) Harlequin sign
D) Vernix caseosa

Answer 1

Acrocyanosis

Question 2

While assessing the integument of a 24-hour-old newborn,the nurse notes a pink papular rash with vesicles superimposed on the thorax,back,and abdomen.What action is the highest priority for the nurse to take immediately?

A) Immediately notify the health care professional.
B) Move the newborn to an isolation nursery.
C) Document the finding as erythema toxicum neonatorum.
D) Take the newborn's temperature and obtain a culture of one of the vesicles.

Answer 2

Document the finding as erythema toxicum neonatorum.

Question 3

The nurse caring for a newborn checks the record to note clinical findings that occurred last shift.Which finding related to the renal system would be of increased significance and require further action?

A) The newborn has not voided in 24 hours.
B) The breastfed infant voided more often than a formula feed infant.
C) Brick dust was noted on several diapers.
D) Weight loss from fluid loss and other normal factors has yet to be regained.

Answer 3

The newborn has not voided in 24 hours.

Question 4

While examining a newborn,the nurse notes uneven skinfolds on the buttocks and a clunk when performing the Ortolani maneuver.These findings are likely indicative of what?

A) Polydactyly
B) Clubfoot
C) Hip dysplasia
D) Webbing

Question 5

Which information about variations in the infant's blood counts is important for the nurse to explain to the new parents?

A) A somewhat lower-than-expected red blood cell count could be the result of a delay in clamping the umbilical cord.
B) An early high white blood cell (WBC)count is normal at birth and should rapidly decrease.
C) Platelet counts are higher in the newborn than in adults for the first few months.
D) Even a modest vitamin K deficiency means a problem with the blood's ability to properly clot.

Question 6

Which infant response to cool environmental conditions is either not effective or not available to them?

A) Constriction of peripheral blood vessels
B) Metabolism of brown fat
C) Increased respiratory rates
D) Unflexing from the normal position

Question 7

Which information related to the newborn's developing cardiovascular system should the nurse fully comprehend?

A) The heart rate of a crying infant may rise to 120 beats per minute.
B) Heart murmurs heard after the first few hours are a cause for concern.
C) The point of maximal impulse (PMI)is often visible on the chest wall.
D) Persistent bradycardia may indicate respiratory distress syndrome (RDS).

Question 8

What is the correct term for the cheeselike,white substance that fuses with the epidermis and serves as a protective coating?

A) Vernix caseosa
B) Surfactant
C) Caput succedaneum
D) Acrocyanosis

Question 9

A first-time father is changing the diaper of his 1-day-old daughter.He asks the nurse,"What is this brown,sticky stuff in her diaper?" What is the nurse's best response?

A) "That's meconium,which is your baby's first stool.It's normal."
B) "That's transitional stool."
C) "That means your baby is bleeding internally."
D) "Oh,don't worry about that.It's okay."

Question 10

What marks on a baby's skin may indicate an underlying problem that requires notification of a physician?

A) Mongolian spots on the back
B) Telangiectatic nevi on the nose or nape of the neck
C) Petechiae scattered over the infant's body
D) Erythema toxicum neonatorum anywhere on the body

Question 11

Part of the health assessment of a newborn is observing the infant's breathing pattern.What is the predominate pattern of newborn's breathing?

A) Abdominal with synchronous chest movements
B) Chest breathing with nasal flaring
C) Diaphragmatic with chest retraction
D) Deep with a regular rhythm

Question 12

The nurse is assessing a full term,quiet,and alert newborn.What is the average expected apical pulse range (in beats per minute)?

A) 80 to 100
B) 100 to 120
C) 120 to 160
D) 150 to 180

Question 13

An African-American woman noticed some bruises on her newborn daughter's buttocks.The client asks the nurse what causes these.How would the nurse best explain this integumentary finding to the client?

A) Lanugo
B) Vascular nevus
C) Nevus flammeus
D) Mongolian spot

Question 14

A client is warm and asks for a fan in her room for her comfort.The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on high.The nurse instructs the mother that the fan should not be directed toward the newborn and that the newborn should be wrapped in a blanket.The mother asks why.How would the nurse respond?

A) "Your baby may lose heat by convection,which means that he will lose heat from his body to the cooler ambient air.You should keep him wrapped and should prevent cool air from blowing on him."
B) "Your baby may lose heat by conduction,which means that he will lose heat from his body to the cooler ambient air.You should keep him wrapped and should prevent cool air from blowing on him."
C) "Your baby may lose heat by evaporation,which means that he will lose heat from his body to the cooler ambient air.You should keep him wrapped and should prevent cool air from blowing on him."
D) "Your baby will easily get cold stressed and needs to be bundled up at all times."

Question 15

A newborn is placed under a radiant heat warmer.The nurse understands that thermoregulation presents a problem for the newborn.What is the rationale for this difficulty?

A) The renal function of a newborn is not fully developed,and heat is lost in the urine.
B) The small body surface area of a newborn favors more rapid heat loss than does an adult's body surface area.
C) Newborns have a relatively thin layer of subcutaneous fat that provides poor insulation.
D) Their normal flexed posture favors heat loss through perspiration.

Question 16

What is the most critical physiologic change required of the newborn after birth?

A) Closure of fetal shunts in the circulatory system
B) Full function of the immune defense system
C) Maintenance of a stable temperature
D) Initiation and maintenance of respirations

Question 17

The nurse is aware that the initiation of breastfeeding is most effective during the first 30 minutes after birth.What is the correct term for this phase of alertness?

A) Transition period
B) First period of reactivity
C) Organizational stage
D) Second period of reactivity

Question 18

The parents of a newborn ask the nurse how much the newborn can see.The parents specifically want to know what type of visual stimuli they should provide for their newborn.What information provided by the nurse would be most useful to these new parents?

A) "Infants can see very little until approximately 3 months of age."
B) "Clearest visual distance is 8 to 12 inches and they can distinguish patterns;preferring complex ones."
C) "The infant's eyes must be protected.Infants enjoy looking at brightly colored stripes."
D) "It's important to shield the newborn's eyes.Overhead lights help them see better."

Question 19

Which statement best describes the transition period between intrauterine and extrauterine existence for the newborn?

A) Consists of four phases,two reactive and two of decreased responses
B) Lasts from birth to day 28 of life
C) Applies to full-term births only
D) Varies by socioeconomic status and the mother's age

Question 20

A primiparous woman is watching her newborn sleep.She wants him to wake up and respond to her.The mother asks the nurse how much he will sleep every day.What is an appropriate response by the nurse?

A) "He will only wake up to be fed,and you should not bother him between feedings."
B) "The newborn sleeps approximately 17 hours a day,with periods of wakefulness gradually increasing."
C) "He will probably follow your same sleep and wake patterns,and you can expect him to be awake soon."
D) "He is being stubborn by not waking up when you want him to.You should try to keep him awake during the daytime so that he will sleep through the night."

Question 21

The nurse should be cognizant of which important information regarding the gastrointestinal (GI)system of the newborn?

A) The newborn's cheeks are full because of normal fluid retention.
B) The nipple of the bottle or breast must be placed well inside the baby's mouth because teeth have been developing in utero,and one or more may even be through.
C) Regurgitation during the first day or two can be reduced by burping the infant and slightly elevating the baby's head.
D) Bacteria are already present in the infant's GI tract at birth because they traveled through the placenta.

Question 22

What are the various modes of heat loss in the newborn? (Select all that apply. )

A) Perspiration
B) Convection
C) Radiation
D) Conduction
E) Urination

Question 23

While evaluating the reflexes of a newborn,the nurse notes that with a loud noise the newborn symmetrically abducts and extends his arms,his fingers fan out and form a C with the thumb and forefinger,and he has a slight tremor.The nurse would document this finding as a which positive reflex.

A) tonic neck
B) glabellar (Myerson)
C) Babinski
D) Moro

Question 24

Which cardiovascular changes cause the foramen ovale to close at birth?

A) Increased pressure in the right atrium
B) Increased pressure in the left atrium
C) Decreased blood flow to the left ventricle
D) Changes in the hepatic blood flow

Question 25

The nurse is cognizant of which information related to the administration of vitamin K?

A) Vitamin K is important in the production of red blood cells.
B) Vitamin K is necessary in the production of platelets.
C) Vitamin K is not initially synthesized because of a sterile bowel at birth.
D) Vitamin K is responsible for the breakdown of bilirubin and the prevention of jaundice.

Question 26

Which intervention can nurses use to prevent evaporative heat loss in the newborn?

A) Drying the baby after birth,and wrapping the baby in a dry blanket
B) Keeping the baby out of drafts and away from air conditioners
C) Placing the baby away from the outside walls and windows
D) Warming the stethoscope and the nurse's hands before touching the baby

Question 27

During life in utero,oxygenation of the fetus occurs through transplacental gas exchange.When birth occurs,four factors combine to stimulate the respiratory center in the medulla.The initiation of respiration then follows.What are these four essential factors? (Select all that apply. )

A) Chemical
B) Mechanical
C) Thermal
D) Psychologic
E) Sensory

Question 28

Which statements regarding physiologic jaundice are accurate? (Select all that apply. )

A) Neonatal jaundice is common;however,kernicterus is rare.
B) Appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic process.
C) Because jaundice may not appear before discharge,parents need instruction on how to assess for jaundice and when to call for medical help.
D) Jaundice is caused by reduced levels of serum bilirubin.
E) Breastfed babies have a lower incidence of jaundice.

Question 29

The nurse is circulating during a cesarean birth of a preterm infant.The obstetrician requests that cord clamping be delayed.What is the rationale for this directive?

A) To reduce the risk for jaundice
B) To reduce the risk of intraventricular hemorrhage
C) To decrease total blood volume
D) To improve the ability to fight infection

Question 30

Which newborn reflex is elicited by stroking the lateral sole of the infant's foot from the heel to the ball of the foot?

A) Babinski
B) Tonic neck
C) Stepping
D) Plantar grasp

Question 31

How would the nurse differentiate a meconium stool from a transitional stool in the healthy newborn?

A) Observed at age 3 days
B) Is residue of a milk curd
C) Passes in the first 12to 24 hours of life
D) Is lighter in color and looser in consistency

Question 32

Which component of the sensory system is the least mature at birth?

A) Vision
B) Hearing
C) Smell
D) Taste