Question 1

The condition during which infants are at an increased risk for subgaleal hemorrhage is called what?

Accepted Answer

A)  Infection 
B)  Jaundice 
C)  Caput succedaneum 
D)  Erythema toxicum neonatorum

Question 2

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 3

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 positive _____ reflex.

Accepted Answer

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

Question 4

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 5

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?

Accepted Answer

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 6

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

Accepted Answer

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 7

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 8

Which statements describe the first stage of the neonatal transition period?
(Select all that apply).

Accepted Answer

A)  The neonatal transition period lasts no longer than 30 minutes. 
B)  It is marked by spontaneous tremors, crying, and head movements. 
C)  Passage of the meconium occurs during the neonatal transition period. 
D)  This period may involve the infant suddenly and briefly sleeping. 
E)  Audible grunting and nasal flaring may be present during this time.

Question 9

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 10

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 11

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."

Question 12

The healthy infant must accomplish both behavioral and biologic tasks to develop normally. Behavioral characteristics form the basis of the social capabilities of the infant. Newborns pass through a hierarchy of developmental challenges as they adapt to their environment and caregivers. This progression in behavior is the basis for the Brazelton Neonatal Behavioral Assessment (NBAS). Match the cluster of neonatal behaviors with the correct level on the NBAS scale.

-Signs of stress related to homeostatic adjustment

Accepted Answer

A) Habituation 
B) Orientation 
C) Range of state 
D) Autonomic stability 
E) Regulation of state

Question 13

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

Accepted Answer

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 14

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 at this time?

Accepted Answer

A)  Immediately notify the physician. 
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.

Question 15

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 16

A nursing student is helping the nursery nurses with morning vital signs.A baby born 10 hours ago by cesarean section is found to have moist lung sounds.What is the best interpretation of these data?

Accepted Answer

A)  The nurse should immediately notify the pediatrician for this emergency situation. 
B)  The neonate must have aspirated surfactant. 
C)  If this baby was born vaginally, then a pneumothorax could be indicated. 
D)  The lungs of a baby delivered by cesarean section may sound moist during the first 24 hours after childbirth.

Question 17

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

Accepted Answer

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

Question 18

The brain is vulnerable to nutritional deficiencies and trauma in early infancy.What is the rationale for this physiologic adaptation in the newborn?

Accepted Answer

A)  Incompletely developed neuromuscular system 
B)  Primitive reflex system 
C)  Presence of various sleep-wake states 
D)  Cerebellum growth spurt

Question 19

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 20

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

Exam 23: Physiologic and Behavioral Adaptations of the Newborn