Question 1

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?

Accepted Answer

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." A

Question 2

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

Accepted Answer

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 C

Question 3

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

Accepted Answer

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 A

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?

Accepted Answer

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

Question 5

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.

Accepted Answer

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

Question 6

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. )

Accepted Answer

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

Question 7

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

Accepted Answer

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

Question 8

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?

Accepted Answer

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

Question 9

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

Accepted Answer

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

Question 10

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?

Accepted Answer

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

Question 11

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

Accepted Answer

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

Question 12

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

Accepted Answer

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

Question 13

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

Accepted Answer

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

Question 14

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

Accepted Answer

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 15

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

Accepted Answer

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 16

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

Accepted Answer

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

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

Accepted Answer

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 (WB
C)  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 18

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?

Accepted Answer

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 19

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?

Accepted Answer

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.

Question 20

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

Accepted Answer

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

Exam 23: Physiologic and Behavioral Adaptations of the Newborn