Deck 21: Care of the Normal Newborn

Question 1

Which statement made by a new mother should be a cause of concern to the nurse?

A) "I will start my baby on solid foods at 5 months."
B) "I usually keep the temperature in my house at 22.2°C (72°F)."
C) "I plan to position my infant on his back when sleeping."
D) "I don't intend to spoil my baby by picking him up every time he cries."

Answer 1

"I don't intend to spoil my baby by picking him up every time he cries."

Question 2

In providing and teaching cord care, which guidance is most appropriate?

A) Cord care is done only to control bleeding.
B) Alcohol is the only agent used for cord care.
C) It takes a minimum of 24 days for the cord to separate.
D) Keeping the cord dry will decrease bacterial growth.

Answer 2

Keeping the cord dry will decrease bacterial growth.

Question 3

In which position should the parents be instructed to place their newborn for sleep?

A) On the back
B) On the left side
C) On the right side
D) On the abdomen

Answer 3

On the back

Question 4

The nurse is evaluating a newborn's circumcision 30 minutes after the procedure. The nurse notes excessive bleeding coming from the circumcised area. Which priority intervention should the nurse implement at this time?

A) Apply pressure to the site.
B) Continue to observe for another 30 minutes.
C) Apply the diaper tightly over the circumcised area.
D) Apply petroleum jelly to the site with a small piece of gauze.

Question 5

An infant who eats very rapidly may experience problems with swallowing excessive air. What should the mother be instructed to do?

A) Use a nipple with a smaller hole.
B) Place the infant on the abdomen after feeding.
C) Provide the infant with water between feedings.
D) Begin the feeding before the infant becomes too hungry.

Question 6

A 38 weeks' gestation fetus is delivered via cesarean birth and transported to the newborn nursery in an isolette. Apgar scores were 8, 9, and 10. At this time, the infant is receiving an initial assessment in the newborn nursery. Which is the priority nursing diagnosis?

A) Risk for injury related to potential equipment malfunction of radiant warmer
B) Altered tissue perfusion related to use of medications during delivery process
C) Ineffective airway clearance due to mode of delivery and use of anesthetics
D) Risk for ineffective thermoregulation related to gestational age

Question 7

Which statement made by a parent indicates a need for the nurse to provide instruction on safety and accident prevention?

A) "I always take the phone off the hook when I give my baby a bath so I won't be disturbed."
B) "I'm going to buy a backpack for my 2-week-old baby so I can carry her in it whenever she gets fussy."
C) "I've been reading about what new things my baby will be learning to do in the next month or two, so I'll know what to expect."
D) "I make sure I always place the baby in her own crib after feeding her in my bed."

Question 8

Which of the following guidelines should the nurse implement to prevent the abduction of a newborn from the hospital?

A) Restricting the amount of time infants are out of the nursery
B) Questioning anyone who is seen walking in the hallways carrying an infant
C) Allowing no visitors in the maternity area except those who have identification bracelets
D) Instructing the parents not to give the baby to anyone except the nurse assigned that day

Question 9

Which intervention will be most helpful to parents in identifying problems with an infant car seat?

A) Questioning the parents about the instructions
B) Providing the parents with current laws on infant and child safety
C) Asking the parents to demonstrate how to secure the infant in the car seat
D) Allowing the parents to ask questions and express feelings about infant restraint

Question 10

A nursing student has been caring for a patient and newborn all morning. After taking the newborn to the nursery for hearing screening, the student is returning the infant to his mother. Which procedure is correct for identifying the newborn?

A) Ask the mother to state her name and the name of her infant.
B) Call out the mother's full name before leaving the infant with her.
C) Have the mother read her printed band number and verify that it matches the infant's number.
D) Return the infant with no special procedure because the student knows the mother and infant.

Question 11

Which of the following is the appropriate treatment for miliaria?

A) Application of oil
B) Removal of wet clothing
C) Removal of excess clothing
D) Application of soothing lotion

Question 12

Which information should the nurse teach to new parents regarding the use of a bulb syringe?

A) Use it only once per day.
B) Suction the back of the throat vigorously.
C) Insert the syringe into the sides of the mouth.
D) Always suction the mouth before suctioning the nose.

Question 13

The nurse is explaining the procedure of newborn screening to parents prior to discharge. Which statement by the parents indicates a need for further teaching?

A) "We understand the tests are performed at 24 to 48 hours."
B) "We're glad all the tests can be done on one blood sample."
C) "We wish the tests would screen for congenital hypothyroidism, it runs in our family."
D) "We know that if the tests are done before 24 hours, the tests will need to be repeated at 1 to 2 weeks."

Question 14

Most newborns receive a prophylactic injection of vitamin K soon after birth. Which site is optimal for the newborn?

A) Deltoid muscle
B) Gluteal muscle
C) Rectus femoris muscle
D) Vastus lateralis muscle

Question 15

When an infant's temperature drops from (37 to 36.3°C) 98.7 to 97.4°F, the nurse should

A) instruct parents on the risks of cold stress.
B) determine the time and amount of last feeding.
C) increase the temperature in the mother's room.
D) evaluate infant for the presence of a blood sugar level higher than 50 mg/dL.

Question 16

An infant's temperature is recorded at 36°C (96.8°F) during the morning assessment. Which action should the nurse take?

A) Note the findings in the electronic health record (EHR).
B) Unwrap the infant and inspect for abnormalities.
C) Provide the infant with glucose water.
D) Make sure that the infant is wrapped securely with a blanket and recheck temperature in 15 minutes.

Question 17

Which newborn assessment finding requires the nurse to take immediate action?

A) Glucose level of 40 mg/dL
B) Axillary temperature of 37°C (98.6°F)
C) Mild yellow tinge to skin at 32 hours of age
D) Mild inflammation of conjunctiva after eye prophylaxis

Question 18

A yellow crust has formed over the circumcision site. The mother calls the hotline at the local hospital 5 days after her son was circumcised. She is very concerned. Which response by the nurse is most appropriate?

A) The yellow crust should not be removed.
B) This yellow crust is an early sign of infection.
C) Discontinue the use of petroleum jelly to the tip of the penis.
D) After circumcision, the diaper should be changed frequently and fastened snugly.

Question 19

Administration of medications after birth is the topic of discussion during a prenatal education class. Which statement indicates to the nurse that the pregnant patient understands the primary indication for the administration of vitamin K?

A) "The nurse will draw blood to determine if vitamin K is needed."
B) "Vitamin K prevents the possibility of bleeding problems in my baby."
C) "My baby will receive medication by mouth when the nurse administers the vitamin K."
D) "Vitamin K will be administered shortly after birth, generally within the first hour."

Question 20

An hour after birth, the nurse assesses a newborn's temperature and notes that it is 36.2°C (97.2°F). The next activity planned for the newborn is the bath, and the new mother and father are invited to participate in the procedure. What is the nurse's next action?

A) Take the infant's temperature rectally.
B) Ask the father to test the water to determine if it is too hot.
C) Delay the bath until the newborn's temperature is above 36.7°C (98°F).
D) Explain to the new parents that no soap should be used to cleanse the eyes.

Question 21

Which statement by a parent suggests that the nurse intervene with further teaching?

A) "I put my newborn baby on her back when she goes to sleep. I understand this is the best position."
B) "Jennifer's eyes sometimes cross, but I know that this is normal in 1-month-old babies."
C) "My 5-month-old infant has been drooling, biting, and running a fever for the past few days. I think he's teething."
D) "My neighbor has been giving her baby solids since he was 8 weeks old. I think I'll wait until my baby is about 5 months old."

Question 22

Which statement is true regarding growth and development during the first 6 months?

A) The infant will grow 1 cm in length per month.
B) The infant will gain about 2 lb per month.
C) The infant will regain weight lost after birth within 1 week.
D) The infant will have a 1-inch increase in head circumference per month.

Question 23

Parents ask the nurse, "How many wet diapers a day should we expect and how will we know the baby's stools are normal?" Which response should the nurse make if the infant is being formula fed? (Select all that apply.)

A) The stools should be watery.
B) The stools should be dry and hard.
C) The infant should have at least one stool a day.
D) The infant should have at least six wet diapers a day.
E) The infant will only have a bowel movement every other day.

Question 24

The nurse has just completed discharge teaching to parents on newborn bathing. Which statement made by the parents indicates a further need for teaching? (Select all that apply.)

A) "We will clean the diaper area last."
B) "We will use cotton-tipped swabs to clean the ears."
C) "We will use an antibacterial soap during the sponge bath."
D) "We can submerge the baby in a tub of water after the cord falls off."
E) "We will shampoo the baby's head using a football hold before unwrapping."

Question 25

Infant immunizations should begin at which age?

A) Birth
B) 2 months
C) 3 months
D) 4 months

Question 26

A new mother asks, "Why should I bring my baby in for a checkup? He is not sick." Which is the nurse's best response?

A) "Please ask your pediatrician to explain this to you."
B) "He may have a problem that you haven't identified."
C) "These visits are required by law to identify communicable diseases."
D) "Well-baby visits allow the doctor to determine whether your baby is growing and developing normally."

Question 27

Which intervention should be included in the home care of a high-risk infant?

A) Feeding the infant on a strict schedule
B) Keeping the infant in the supine or prone position
C) Providing continued respiratory support and oxygen
D) Cleaning the umbilical cord several times daily with alcohol

Question 28

Which clinical finding indicates a sign of illness in the newborn?

A) A yellow scaly lesion on the scalp
B) More than two soft stools per day
C) Regurgitating a small amount of feeding
D) An axillary temperature greater than 38°C (100.4°F)

Question 29

The nurse is teaching new parents how to avoid and treat newborn diaper rash. Which should the nurse include in the teaching session? (Select all that apply.)

A) Keep the diaper area clean and dry.
B) Do not use talc-based powders in the diaper area.
C) Cleanse the diaper area with a scrubbing motion.
D) Apply a thick layer of zinc oxide to prevent further outbreaks.
E) Remove the diaper and expose the perineum to warm air if a rash develops.

Question 30

As the nurse assists a newly discharged patient and her infant to the waiting car, the nurse notes that the infant seat is in the front seat of the car facing the front and secured by the seat belt. The nurse should explain to the parents that the car seat should be placed

A) in an upright position.
B) at a 30-degree angle.
C) not secured by the seat belt.
D) in the back seat facing the rear of the car.

Question 31

Which infant should be seen immediately by a health care provider?

A) A 1-week-old infant with a diaper rash
B) A 1-month-old infant with an axillary temperature of 37.7°C (99.8°F)
C) A 3-week-old breast-fed infant who has had two loose stools
D) A 2-week-old infant with nasal congestion and respirations of 64 breaths per minute

Question 32

A new mother asks what she can do to help her infant sleep through the night. Which should the nurse suggest?

A) Bring the infant into a well-lit room for the feeding.
B) Avoid talking to the infant and keep the room quiet during night feedings.
C) Play with the infant after the feeding before putting the infant back into the crib.
D) Change the infant's diaper after the feeding to prevent waking the infant later in the night.

Question 33

The nurse is calling a new mother to schedule a routine home visit planned for 48 to 72 hours after discharge. What is the nurse's priority question to help determine the best time for the visit?

A) "When will the baby's father be home?"
B) "Do you plan on having any visitors in the day or two?"
C) "At approximately what time do you think you will be nursing your baby?"
D) "When will your home be presentable enough for me to come and visit?"

Question 34

During the first 6 months of life, the infant should have well-baby checkups at which interval?

A) 1 to 2 weeks
B) 2 to 4 weeks
C) 1 to 2 months
D) 3 to 4 months

Question 35

A new mother is preparing for discharge from the birthing center and relays to the nurse her concerns about how she will handle the baby's episodes of crying. What is the nurse's best response?

A) "I hear your concern. Is there someone in the household who cannot tolerate hearing a baby cry?"
B) "It is okay to just let the baby cry from time to time. You don't want to risk spoiling the baby too soon."
C) "Infants only cry when they are hungry or if they have gas. If you don't eat any gas-producing food, your baby will cry less."
D) "Crying is the way your baby communicates with you. It is important for you to meet your baby's needs consistently and promptly."

Question 36

The nurse is teaching new parents strategies to help with newborn colic. Which interventions should the nurse suggest? (Select all that apply.)

A) Increase the number of feedings.
B) Feed the infant in an upright position.
C) Burp the infant frequently during feedings.
D) Allow the infant to cry for a period of time.
E) Increase carrying time by use of a front carrier pack.

Question 37

The nurse is preparing a newborn for a circumcision. Which prescribed interventions should the nurse implement to alleviate pain? (Select all that apply.)

A) Oral sucrose during the procedure
B) Bright lights after the procedure
C) Adequate stimulation before and after the procedure
D) Acetaminophen (Tylenol) postprocedure, as needed
E) EMLA cream (eutectic mixture of local anesthetics) before the procedure

Question 38

Which statement by the parents indicates the need for further education with regard to pacifier use?

A) "We will discard the pacifier if it becomes torn."
B) "We will replace the pacifier every 1 to 2 months."
C) "We will be sure to cleanse the pacifier frequently."
D) "We will keep track of the pacifier by tying it to a string around the baby's neck."

Question 39

During a prenatal education class regarding infant home care, the nurse is reviewing the simulated setting created by new mothers for putting the baby to bed. Which observation indicates to the nurse that the new mothers understood the nurse's teaching about infant safety?

A) The crib is lined with a bumper pad.
B) Stuffed animals are placed in the crib.
C) The baby mannequin is in the supine position.
D) The baby mannequin is covered with a handmade quilt.