Deck 24: Nursing Care of the Newborn and Family

Question 1

During the complete physical examination 24 hours after birth:

A)The parents are excused to reduce their normal anxiety
B)The nurse can gauge the neonate's maturity level by assessing his or her general appearance
C)Once often neglected,blood pressure is now routinely checked
D)When the nurse listens to the heart,the S1 and S2 sounds can be heard;the first sound is somewhat higher in pitch and sharper than the second

Answer 1

The nurse can gauge the neonate's maturity level by assessing his or her general appearance

Question 2

A newborn is jaundiced and is receiving phototherapy via ultraviolet bank lights.An appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy by this method is to:

A)Apply an oil-based lotion to the newborn's skin to prevent dying and cracking
B)Limit the newborn's intake of milk to prevent nausea,vomiting,and diarrhea
C)Place eye shields over the newborn's closed eyes
D)Change the newborn's position every 4 hours

Answer 2

Place eye shields over the newborn's closed eyes

Question 3

The nurse is using the New Ballard Scale to determine the gestational age of a newborn.Which assessment finding is consistent with a gestational age of 40 weeks?

A)Flexed posture
B)Abundant lanugo
C)Smooth,pink skin with visible veins
D)Faint red marks on the soles of the feet

Answer 3

Flexed posture

Question 4

As part of Standard Precautions,nurses wear gloves when handling the newborn.The chief reason is:

A)To protect the baby from infection
B)It is part of the Apgar protocol
C)To protect the nurse from contamination by the newborn
D)Because the nurse has primary responsibility for the baby during the first 2 hours

Question 5

A nurse is assessing a newborn girl who is 2 hours old.What finding warrants a call to the physician?

A)Blood glucose of 45 mg/dl using a Dextrostix
B)Heart rate of 160 beats/min after crying vigorously
C)A crepitant-like feeling when assessing the clavicles
D)Passage of a dark black-green substance from the rectum

Question 6

An infant boy was born a few minutes ago.The nurse is conducting the initial assessment.Part of the assessment includes the Apgar score.The Apgar assessment is performed:

A)Only if the newborn is in obvious distress
B)Once by the obstetrician,just after the birth
C)At least twice,1 minute and 5 minutes after birth
D)Every 15 minutes during the newborn's first hour after birth

Question 7

Early this morning an infant boy was circumcised using the PlastiBell method.The nurse tells the mother that she and the infant can be discharged after:

A)The bleeding stops completely
B)Yellow exudate forms over the glans
C)The PlastiBell rim falls off
D)The infant voids

Question 8

In the classification of newborns by gestational age and birth weight,the appropriate-for- gestational age (AGA)weight:

A)Falls between the 25th and 75th percentiles for the infant's age
B)Depends on the infant's length and the size of the head
C)Falls between the 10th and 90th percentiles for the infant's age
D)Is modified to consider intrauterine growth restriction (IUGR)

Question 9

With regard to lab tests and diagnostic tests in the hospital after birth,nurses should be aware that:

A)All states test for phenylketonuria (PKU),hypothyroidism,cystic fibrosis,and sickle cell diseases
B)Federal law prohibits newborn genetic testing without parental consent
C)If genetic screening is done before the infant is 24 hours old,it should be repeated at age 1 to 2 weeks
D)Hearing screening is now mandated by federal law

Question 10

When preparing to administer a hepatitis B vaccine to a newborn,the nurse should:

A)Obtain a syringe with a 25-gauge,5/8-inch needle
B)Confirm that the newborn's mother has been infected with the hepatitis B virus
C)Assess the dorsogluteal muscle as the preferred site for injection
D)Confirm that the newborn is at least 24 hours old

Question 11

Although most blood specimens are drawn by laboratory technicians,nurses may be required to perform heelsticks to obtain blood for glucose monitoring or newborn screening.The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone.To prevent this problem the stick should be made:

A)At the outer aspect of the heel
B)On the walking surface of the heel
C)In the ball of the foot
D)In the area just below the fifth toe

Question 12

The nurse is performing a gestational age and physical assessment on the newborn.The infant appears to have an excessive amount of saliva.The nurse recognizes that this finding:

A)Is normal
B)Indicates that the infant is hungry
C)May indicate that the infant has a tracheoesophageal fistula or esophageal atresia
D)May indicate that the infant has a diaphragmatic hernia

Question 13

At 1 minute after birth a nurse assesses an infant and notes a heart rate of 80 beats/min,some flexion of extremities,a weak cry,grimacing,and a pink body but blue extremities.The nurse calculates an Apgar score of:

A)4
B)5
C)6
D)7

Question 14

Nurses can help parents deal with the issue and fact of circumcision if they explain:

A)The pros and cons of the procedure during the prenatal period
B)That the American Academy of Pediatrics (AAP)recommends that all newborn males be routinely circumcised
C)That circumcision is rarely painful and that any discomfort can be managed without medication
D)That the infant will likely be alert and hungry shortly after the procedure

Question 15

The nurse administers vitamin K to the newborn for what reason?

A)Most mothers have a diet deficient in vitamin K,which results in the infant being deficient.
B)Vitamin K prevents the synthesis of prothrombin in the liver and must be given by injection.
C)Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract.
D)The supply of vitamin K is inadequate for at least 3 to 4 months,and the newborn must be supplemented.

Question 16

An assessment tool for pain in newborns uses the acronym CRIES to identify behavioral indicators of pain.In the acronym:

A)R stands for requiring more medication
B)I stands for increased vital signs
C)E stands for elimination
D)S stands for sleepiness

Question 17

A mother is changing the diaper of her newborn son.She notices that his scrotum appears large and swollen.She asks the nurse,"What is that?" The best response from the nurse is:

A)"That is a hydrocele,which is a common finding in newborn males.The swelling usually decreases without intervention."
B)"I don't know,but I'm sure it is nothing."
C)"Your baby might have testicular cancer."
D)"Your baby's urine is backing up into his scrotum."

Question 18

The normal term infant has little difficulty clearing its airway after birth.Most secretions are brought up to the oropharynx by the cough reflex.However,if the infant has excess secretions,the mouth and nasal passages can easily be cleared with a bulb syringe.When instructing parents on the correct use of this piece of equipment,it is important that the nurse teach them to:

A)Avoid suctioning the nares
B)Insert the compressed bulb into the center of the mouth
C)Suction the mouth first
D)Remove the bulb syringe from the crib when finished

Question 19

A new father wants to know what medication was put into his infant's eyes and why it is needed.The nurse explains to the father that the purpose of the erythromycin (Ilotycin)ophthalmic ointment is to:

A)Destroy an infectious exudate caused by Staphylococcus that could make the infant blind
B)Prevent gonorrheal and chlamydial infection of the infant's eyes potentially acquired from the birth canal
C)Prevent potentially harmful exudate from invading the tear ducts of the infant's eyes,leading to dry eyes
D)Prevent the infant's eyelids from sticking together and help the infant see

Question 20

As part of the infant discharge teaching,the nurse is reviewing the use of the infant car safety seat.The nurse is teaching that:

A)Infant carriers are fine until an infant car safety seat can be purchased
B)For traveling on airplanes,buses,and trains,infant carriers are satisfactory
C)Infant car safety seats are used for infants only from birth to 15 pounds
D)Infant car seats should be rear facing and placed in the back seat of the car

Question 21

Nurses can help the family develop useful day-night routines (i.e.,help the infant tell the difference between day and night)by suggesting all of these interventions except:

A)Save the crib or bassinet for nighttime sleep
B)Feed the baby for the last evening time around 11 PM
C)Keep a small night-light on to avoid turning on bright lights
D)Play with the baby during nighttime feedings to tire out the infant,for more and longer sleep

Question 22

Parents lost their first child to sudden infant death syndrome (SIDS).Therefore,you are teaching them infant cardiopulmonary resuscitation (CPR).You know they are knowledgeable when they demonstrate infant CPR compressions of _____ per minute.

A)50
B)75
C)100
D)125

Question 23

As recently as 2005,the American Academy of Pediatrics (AAP)revised safe sleep practices to assist in the prevention of sudden infant death syndrome.The nurse should model these practices in the hospital and incorporate this information into the teaching for new parents.They include (choose all that apply):

A)Fully supine position for all sleep
B)Side-sleeping position as an acceptable alternative
C)"Tummy time" for play
D)Infant sleep sacks or buntings
E)A soft mattress

Question 24

Sucking is an infant's chief pleasure.Sucking that is not satisfied by either breastfeeding or a bottle is referred to as ____________________ sucking.

Question 25

Pain should be assessed regularly in all newborn infants.If the infant is displaying physiologic or behavioral cures indicating pain,measures should be taken to manage the pain.Examples of nonpharmacologic pain management techniques include (choose all that apply):

A)Swaddling
B)Nonnutritive sucking
C)Skin-to-skin contact with the mother
D)Sucrose
E)Acetaminophen

Question 26

A nurse is responsible for teaching new parents about the hygienic care of their newborn.The nurse should tell the parents to:

A)Avoid washing the head for at least 1 week to prevent heat loss
B)Sponge bathe only until the cord has fallen off
C)Cleanse the ears and nose with cotton-tipped swabs,such as Q-tips
D)Create a draft-free environment of at least 75° F (24° C)when bathing the infant

Question 27

When teaching new parents about infant quieting techniques,the nurse should include what activities as suggestions? Choose all that apply.

A)Carry your infant in a front pack or backpack.
B)Swaddle your infant snugly in a receiving blanket.
C)Place a heating pad in your infant's crib while he or she sleeps.
D)Rhythmic,monotonous flashing lights may soothe the infant.
E)Movement such as rocking often helps quiet an infant.

Question 28

A nurse is discussing infant care as part of a mother-infant's couplet discharge planning.The mother asks the nurse,"When will my baby's cord fall off?" The nurse responds,"Your baby's cord should fall off by ____________________ (weeks/days)after birth."