Deck 4: Newborn

Question 1

A 25-year-old female has just given birth to an eight-pound baby boy. Suctioning of the neonate is required. The first action of the nurse midwife when suctioning a neonate immediately after birth is to:

A)Suction the mouth.
B)Suction the nose.
C)Turn the neonate on his side to drain the secretions.
D)Gently flick the neonate's soles.

Answer 1

Suction the mouth.

Question 2

Which of the following actions by a nurse midwife is the least appropriate when giving respiratory care to a healthy, full-term newborn?

A)Assess the newborn's respiratory rate every 15 minutes during the first hour of life.
B)Suction the newborn's mouth first using a bulb syringe before suctioning the nose.
C)Change the newborn's position frequently.
D)Position the newborn with the head up and on one side.

Answer 2

Position the newborn with the head up and on one side.

Question 3

A 38-week newborn is born to a 30-year-old through vaginal birth. A minute after birth, a nurse midwife obtains the newborn's APGAR score with the following assessment findings: flexed arms and legs with some active movement, a pulse rate of 110 beats per minute, grimace after inserting a tube through a nostril, pink skin tone except for the hands and feet and regular breathing pattern with a good cry. What is the newborn's APGAR score?

A)6
B)7
C)8
D)9

Answer 3

7

Question 4

A 37-week female newborn is born to a 28-year-old female through cesarean birth. A nurse midwife assesses the newborn a minute after birth for APGAR scoring. The following assessment findings are obtained: flexed arms and legs with limited active movement; a pulse rate of 90 beats per minute; grimacing observed after inserting a tube through one of the nostrils; bluish skin tone, including the extremities; and slow, irregular breaths. Which of the following is the next action of the nurse midwife?

A)Initiate immediate resuscitation.
B)Change the newborn's position and wrap her loosely with a warm blanket.
C)Initiate clearing of the airways and oxygen therapy.
D)Obtain another APGAR score in 5 minutes.

Question 5

A female client at 32 weeks' gestation gives birth to a baby girl. The newborn weighs 1400 grams. When managing the newborn's nutritional needs, which of the following actions by the nurse midwife is the most appropriate?

A)Feed the newborn every 4 to 6 hours.
B)Prepare the newborn for gavage feeding.
C)Prepare the newborn for parenteral hyperalimentation.
D)Bottle feed the newborn with special pre-term formula milk using a preemie nipple.

Question 6

A nurse midwife is assessing a mature female neonate born to a 21-year-old G3P2 client. Which of the following findings suggests that further evaluation and notification of the physician are necessary?

A)Birth length = 53 cm
B)Head circumference = 35 cm
C)Birth weight = 11 pounds
D)Chest circumference is 2 cm less than the head circumference.

Question 7

After birth, the nurse midwife immediately dries a male neonate's face and hair with a clean, pre-warmed towel. After drying, the nurse midwife covers the neonate's hair with a cap. The purpose of these actions is to prevent heat loss through:

A)Convection.
B)Conduction.
C)Evaporation.
D)Radiation.

Question 8

A nurse midwife is assessing the gastrointestinal system of a 3-day-old newborn. Which of the following findings indicates that further tests are required?

A)The newborn passed the meconium stool 48 hours after birth.
B)The newborn easily regurgitates.
C)The newborn passed loose green stools on the third day of life.
D)The newborn passed blood-flecked stools.

Question 9

Which of the following statements about the tonic-clonic reflex is not accurate?

A)Unlike other reflexes, the tonic-clonic reflex does not have a function.
B)The movement is most evident in the arms.
C)The arm and leg on the side to which the head turns extend, and the opposite arm and leg contract.
D)It disappears on the 6th month of life.

Question 10

A newborn has difficulty breathing and experiences severe coughing spells during breastfeeding. The newborn is diagnosed with a tracheoesophageal fistula. Without proper management, the newborn is most likely to lose which reflex?

A)Sucking reflex
B)Swallowing reflex
C)Rooting reflex
D)Extrusion reflex

Question 11

When a substance is placed on the anterior portion of the newborn's tongue, the newborn extrudes the substance. The nurse midwife knows that this reflex disappears at about:

A)6 weeks of life
B)8 months of life
C)12 months of life
D)4 months of life

Question 12

On assessment, the nurse midwife notes that a female newborn has pink patches at the nape of the neck. The nurse midwife informs the mother that these patches:

A)Occur more often in males than in females.
B)Are caused by an injury during labor.
C)Do not fade.
D)Disappear by school age without treatment.

Question 13

A nurse midwife is monitoring the newborns for jaundice. Which of the following newborns has the least risk of developing jaundice caused by extensive bruising?

A)A newborn with cephalhematoma.
B)A newborn with a birth weight of 8 pounds.
C)An infant born to a mother through vaginal breech delivery.
D)An infant born at 32 weeks' gestation.

Question 14

A nurse midwife observes that a full-term newborn has yellowish skin and sclera of the eyes on the second day of life. Total serum bilirubin level is determined at 15 mg/dL. Which of the following interventions are appropriate for the newborn?
I.Early feeding
II.Exchange transfusion
III.Phototherapy
IV.Supplemental feedings with additional formula

A)I and III
B)I, III and IV
C)III and IV
D)All of the interventions are appropriate.

Question 15

A newborn with physiological jaundice is placed on phototherapy. Which of the following actions of the nurse midwife are appropriate for the newborn on phototherapy?
I.Maintain eye dressings during breastfeeding.
II.Place the lights 30 inches above the newborn.
III.Monitor axillary temperature of the newborn.
IV.Undress the infant, except for the diaper, when exposed to the light.

A)I, II and III
B)II, III and IV
C)I, III and IV
D)All of the actions are appropriate.

Question 16

A nurse midwife is assessing a client and her infant one week after delivery. The infant's birth weight was 7.5 pounds. Which of the following findings indicate that the infant is getting enough milk?
I.The mother reports that the infant is wetting 6 to 8 diapers a day.
II.The mother informs the nurse midwife that the infant appears content between feedings.
III.The infant's weight is 6.8 pounds.
IV.The mother reports that the infant quietly swallows during breastfeeds.

A)I and II
B)I, II and III
C)I, II and IV
D)All of the findings indicate sufficient milk intake.

Question 17

A mother who gave birth a week ago comes to the facility complaining of a cracked and fissured nipple on her right breast. The mother is diagnosed with mastitis. Which of the following teachings is the most effective when managing a client with mastitis?

A)Instruct the client to discontinue breastfeeding until antibiotic therapy is completed.
B)Instruct the client to start breastfeeding on the left breast.
C)Offer formula milk if the breasts are too painful when breastfeeding.
D)Instruct the client to avoid wearing bras until the pain is tolerable.