NCLEX newborn
What is true about fontanelles select all 1. the Anterior fontanelle closes at 18 months 2. a bulging fontanelle could mean increased ICP and is serious a. depressed fontanelle could mean hypervolemia and sepsis 3. the posterior fontanelle closes at 6 months
1.anterior fontelle closes at 18 months 2. a bulging fontanelle could mean increased ICP and is serious -a depressed fontanelle could mean sepsis or hypovolemia -a posterior fontanelle closes at 8-12 weeks (2-3months)
The nurse cares for the newborn infant diagnosed with fetal alcohol syndrome. The nurse expects to see which characteristics? 1. An infant large for gestational age (LGA), craniofacial abnormalities, and hydrocephalus. 2. An infant with a small head circumference, low birth weight, and undeveloped cheekbones. 3. An infant with a large head circumference, low birth weight, and excessive rooting and sucking behaviors. 4. An infant with a normal head circumference, low birth weight, and respiratory distress syndrome.
2. small head circumference, low birth weight, underdeveloped cheeks -will see poor sucking reflex, respiratory distress, craniofacial abnormalities, hearing loss, irritability as infant, intelligence deficit
a nurse is providing discharge teaching to the parents of a newborn regarding circumcision care. Which of the following statements made by a parent indicates an understanding of the teaching? 1. "his circumcision will heal within a couple of days." 2. "i should remove the yellow mucus that will form." 3."i will clean his penis with each diaper change." 4."i will give him a tub bath within a couple of days."
3. i will clean his penis with each diaper change
which vital sign of a newborn is abnormal 1. temperature of 37 axillary 2.RR of 50 3. bp of 70/40 4. HR of 190
4. hr of 190 -HR should be 100-160
A nurse is teaching a group of new parents about proper techniques for bottle feeding. which of the following instructions should the nurse provide? A. burp the newborn at the end of the feeding. b. Hold the newborn close in a supine position. C. Keep the nipple full of formula throughout the feeding. D. refrigerate any unused formula.
C.keep the nipple full of formula throughout the feeding -this prevents the infant from sucking in air -newborn is burped after every 1/2 oz of formula
a nurse is caring for a newborn immediately following a circumcision using a gomco procedure. Which of the following actions should the nurse implement? a. apply gelfoam powder to the site. B. Place the newborn in the prone position. C. apply petroleum gauze to the site. d. avoid changing the diaper until the rst voiding.
c. apply petroleum gauze to site -prevents adhesion to diaper
what is a low birth weight
less than 2500g or less than 5lbs 8 oz
a nurse is reviewing contraindications for circumcision with a newly hired nurse. Which of the following conditions are contraindications? (select all that apply.) 1. hypospadias 2. hydrocele 3. Family history of hemophilia 4. hyperbilirubinemia 5. epispadias
1.hypospadias 3. family hx of hemophilia 5. epispadias
a nurse is reviewing care of the umbilical cord with the parent of a newborn. Which of the following instructions should the nurse include in the teaching? 1. Cover the cord with a small gauze square. 2. Trickle clean water over the cord with each diaper change. 3. apply hydrogen peroxide to the cord twice a day. 4. Keep the diaper folded below the cord.
4. keep the diaper folded below the cord -the cord should not be covered because it promotes infection -water should not be applied to cord -cord should be kept clean and dry. hydrogen peroxide not applied to cord
The newborn is diagnosed with fetal alcohol syndrome. The nurse knows which action is an important consideration for this newborn? 1. Prevent iron deficiency anemia. 2. Decrease touch to prevent over stimulation. 3. Provide feedings via gavage to decrease energy expenditure. 4. Replace vitamins depleted as a result of poor maternal diet.
4.replace vitamins depleted as a result of poor maternal diet -maternal diet is poor and infant is malnourished; adequete b vitamin is necessary for CNS
what is an acceptable APGAR score
7-10
A nurse is caring for a newborn. which of the following actions by the newborn indicates readiness to feed? A. Spits up clear mucus b. Attempts to place his hand in his mouth C. turns his head toward sounds D. Lies quietly with his eyes open
B.attempts to place his hand in his mouth -rooting, and sucking are also indications
A nurse is giving instructions to a mother about how to breastfeed her newborn. which of the following actions by the mother indicates understanding of the teaching? A. the mother places a few drops of water on her nipple before feeding. b. the mother gently removes her nipple from the infant's mouth to break the suction. C. when she is ready to breastfeed, the mother gently strokes the newborn's neck with her finger. D. when latched on, the infant's nose, cheek, and chin are touching the breast.
D. when latched on the infants nose, cheek and chin are touching her breast
