Newborn

The nurse is providing care for a neonate during the fourth stage of labor. Which action does the nurse take during this stage? A. Dry the neonate immediately B. Compete neonate assessment within 1 hour C. Obtain neonate blood glucose levels D. Perform Apgar screening until scores are 7.

A. Dry the neonate immediately This is correct because the fourth stage is from the birth of the fourth stage is after the birth of the baby. The nurse is to dry the neonate immediately to aid with thermoregulation and to prevent cold stress.

A neonate is born after 37 weeks gestation, and the nurse is concerned about avoiding cold stress after discharge. Which suggestions does the nurse give the mother to keep the baby safe? *Select all that apply: A. Keep the baby wrapped in a warm blanket. B. Perform the daily bath in a warm location. C. Position the baby away from vents and drafts. D. Place a stocking cap on the neonate's head. E. Change wet clothing immediately.

A. Keep the baby wrapped in a warm blanket. C. Position the baby away from vents and drafts. D. Place a stocking cap on the neonate's head. E. Change wet clothing immediately. Baths should not be given daily to newborns. Swaddling in blankets decreases heat loss due to convection and radiation. Placing away from vents and drafts decreases heat loss due to convection. Hat or stocking on head helps to decrease heat loss by radiation and convection. Removing wet clothing should decrease heat loss due to radiation, evaporation, and conduction.

The nurse is providing care for a premature neonate born at 28 weeks gestation who is experiencing respiratory distress syndrome [RDS]. Which assessment finding indicates to the nurse that the neonate's respiratory status is deteriorating? A. Pao2 is 48 and Paco2 is 55mm HG on 90% oxygen. B. RR is 58 C. Breath sounds upon auscultation are decreased. D. Heart rate is 162

A. Pao2 is 48 and Paco2 is 55mm HG on 90% oxygen. A sign that neonate's respiratory status is deteriorating is if increased oxygen levels fail to maintain a Pao2 and Paco2 within normal limits [Pao2 60-70 mm, Paco2 35-45mm]. The neonate is unable to maintain a normal range on 90 % oxygen which is a sign of deterioration.

The nurses in a postnatal unit are aware of the fears of new parents with regard to infant abduction. Which interventions by the nurse will alleviate the concerns of the parents? *Select all that apply: A. Allow only visitors with identification to enter the unit. B. Use the hospital abduction alarm system. C. Require unit personnel to wear specific name tags. D. Footprints and a photo of the neonate are taken for identification purposes. E. Encourage parents to accompany persons transporting the newborn.

All are correct!

The nurse is concerned about the number of infants in the community who die from SIDS even with teaching about "back to sleep" being provided. On which additional preventive measures will the nurse focus? *Select all that apply: A. During pregnancy, women should not smoke, drink alcohol, or use illegal drugs. B. Infants need to be dressed to prevent infants from overheating during sleep. C. Mothers need to be informed that breastfeeding reduces the risk of SIDS D. Parents should not smoke or allow smoking around their baby. E. Parents need to avoid products that claim to reduce the risks of SIDS

All of these statements are correct

The postpartum nurse is preparing to present infant care information to a couple who expresses concern about when to bathe their newborn. Which behaviors will the nurse present as general guidelines? *Select all that apply: A. Bathing is best after a feeding when newborn is relaxed. B. Daily bathing with soap is not necessary for the newborn. C. Use a mild preservative-free soap with a neutral pH. D. Avoid the use of soap on the face of the newborn. E. Genital and rectal areas should be cleaned at each diaper change

B. Daily bathing with soap is not necessary for the newborn. C. Use a mild preservative-free soap with a neutral pH. D. Avoid the use of soap on the face of the newborn. The rationales for this question are about breastfeeding and are not r/t this question.

The labor and delivery nurse understands that some neonates spontaneously take a breath once the head and chest are delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe? A. Oxygen is applied immediately to start respiration. B. Carbon dioxide is administered in small doses. C. Mild hypoxia and decreased pH stimulates the brain

C. Mild hypoxia and decreased pH stimulates the brain. This is correct because the essence of chemical stimuli to initiate neonates breathing is the mild hypoxia that occurs when placental blood flow stops. Hypoxia causes an increase in carbon dioxide and a decrease in blood pH, a chemical reaction that stimulates the respiratory center in the medulla.

A patient who is at 41 weeks gestation is concerned when the primary care provider decides to induce labor. Which reason does the nurse explain as the most important need for this procedure? A. Increasing size of the neonate. B. Ability to deliver vaginally. C. Risk for placental dysfunction. D. Likelihood of meconium aspiration.

C. Risk for placental dysfunction. With the post mature fetus, the greatest reason to induce labor is to minimize complications related to placental dysfunction. With post maturity, placental function decreases, resulting in altered oxygenation and nutrient transport, which increases the risk for hypoxia and hypoglycemia at the onset of labor. This is the most important reason for labor induction.

The postpartum nurse notices that a new mother has her neonate unwrapped and undressed to "check out the baby". For which reason does the nurse conclude the neonate is at risk for cold stress? A. The neonate has an increased metabolic rate B. The neonate's respiratory rate has dropped C. The neonate is moving extremities about D. The neonate's skin is cool and clammy

C. The neonate is moving extremities about This is correct because a visible manifestation that indicates the neonate may be approaching cold stress is movement of the extremities in an effort to produce body heat.

The nurse is presenting information to new parents regarding screening of their newborn. Which information does the nurse identify as being most important to the parents? A. All babies born in the United States are screened for specific conditions. B. Newborn screenings consist of a blood test and a hearing test. C. Each state has statues or regulations on newborn screenings. D. Screenings are for infections, genetic diseases, and inherited disorders.

D. Screenings are for infections, genetic diseases, and inherited disorders This is correct because the parents are going to want to know that information.

A mother who is 2 weeks postpartum asks the nurse lactation specialist how she knows if her baby is hungry. Which hunger indicator does the nurse discuss? A. Crying when all other physical needs are met. B. If 2 to 3 hours have passed since feeding. C. When the mother experiences a let-down sensation. D. When the neonate opens the mouth in response to tactile stimulation.

D. When the neonate opens the mouth in response to tactile stimulation. This is the best way to determine if a baby is hungry; the rooting reflex is not solicited in a baby who is not hungry.

A patient in the second trimester of pregnancy is discussing breastfeeding and other options with the nurse. Which question is most important for the nurse to ask? A. "How does your partner feel about you breastfeeding?" B. "Do you have family members who have breastfed their babies?" C. "At what point after childbirth do you plan to return to work?" D. "Why do you want to breastfeed?"

A. "How does your partner feel about you breastfeeding?" The woman's partner plays a significant role in her choice to breastfeed and to continue breastfeeding. Her feelings about and success at breastfeeding are enhanced by her partner's support.

The nurse is preparing a talk with new parents about immunity and their newborns. Which factual information will the nurse present? *Select all that apply: A. A vaccination is an example of acquired immunity. B. Antigens are produced as part of natural immunity. C. Placental transfer is how newborns get natural passive immunity. D. Gamma globulin is an example of artificial active immunity. E. Natural passive immunity protects the baby for a few months after birth.

A. A vaccination is an example of acquired immunity. C. Placental transfer is how newborns get natural passive immunity. E. Natural passive immunity protects the baby for a few months after birth. Vaccinations are correct examples of acquired immunity, Placental transfers is how the mother passes on natural passive immunity, and the last statement is a true statement.

The nurse is preparing to teach a class on the benefits of breastfeeding for infants. Which benefits will the nurse include in the presentation? *Select all that apply: A. Decreased incidence of SIDS B. Fewer cases of necrotizing enterocolitis. C. Less likely to become obese adults. D. Decreased risk for developing otitis media. E. Immunity to respiratory syncytial virus.

A. Decreased incidence of SIDS B. Fewer cases of necrotizing enterocolitis. D. Decreased risk for developing otitis media. All of these statements are true

During the fourth stage of labor, which actions by the nurse will promote parent-newborn attachment? *Select all that apply: A. Delay administration of eye ointment until parents have held newborns. B. Stay close with the couple and neonate in case of emergency. C. Space out necessary assessments to prevent prolonged interruptions. D. Initiate skin-to-skin contact with a warm blanket over the neonate and parent. E. Explain expected neonatal characteristics such as molding, milia, and lanugo.

A. Delay administration of eye ointment until parents have held newborns. D. Initiate skin-to-skin contact with a warm blanket over the neonate and parent. E. Explain expected neonatal characteristics such as molding, milia, and lanugo. Once ointment is on the neonates eyes mother and baby will not be able to bond and see each other. Skin-to-skin should be initiated when a warm blanket Understanding special characteristics can aide in bonding.

The nurse is providing care for a neonate born to a mother with pre-existing diabetes mellitus. Which neonatal assessment findings do the nurse expect? *Select all that apply: A. Macrosomia B. Hyperglycemia C. Hypocalcemia D. Jaundice E. Dyspnea

A. Macrosomia C. Hypocalcemia D. Jaundice E. Dyspnea These are all expected findings for a neonate born to a mother with pre-existing diabetes mellitus.

The nurse is collecting information from a parent whose infant has frequent diaper dermatitis. Which comment by the parent indicates a possible cause of the condition? *Select all that apply: A. "I use disposable wipe to clean the diaper area." B. "I buy an antibiotic ointment specified for skin rashes." C. "I leave the diaper off while the baby is sleeping." D. "I treat any sign of a rash immediately with zinc oxide." E. "I even get up and change the baby's diaper during the night."

B. "I buy an antibiotic ointment specified for skin rashes." When an infant has diaper dermatitis, the use of antibiotic ointments, which can increase the risk of allergic skin reactions, should be avoided. This statement alerts the nurse to a possible cause of the infant's diaper dermatitis.

The nurse is teaching the mother of a neonate the benefits of kangaroo care. Which actions is explained to the mother regarding the procedure? A. The neonate is tucked into the front of a partner's shirt. B. A bare-chested neonate is held against a bare-chested parent. C. A pouch is formed from a blanket for carrying the neonate. D. The neonate is placed in a sling and placed on the parent's side.

B. A bare-chested neonate is held against a bare-chested parent. Kangaroo care is when a bare-chested neonate is held against a bare chested parent and both the neonate and parent are covered with a warm blanket.

A breastfeeding mother is planning to return to work 3 months after he baby is born. The mother is planning to use an electric beast pump and freeze some breast milk for use later. Which information does the nurse need to provide? A. Frozen breast milk can be defrosted in a microwave. B. Breast milk can be kept in a deep freezer for 6-12 months. C. The freezer door shelf decreases the chance of milk contamination. D. Breast milk can only be frozen in special plastic freezer bags.

B. Breast milk can be kept in a deep freezer for 6-12 months. Breast milk can safely be kept in a deep freezer for 6-12 months and 3-6 months in a fridge.

A mother of a premature neonate in NICU asks the nurse when her baby will begin getting oral feedings. The nurse is aware that multiple conditions are desired. Which condition is most essential? A. The neonate demonstrates proper feeding actions. B. The neonate exhibits cardiorespiratory regulation. C. The neonate is able to demonstrate hunger cues. D. The neonate is able to maintain a quiet alter state.

B. The neonate exhibits cardiorespiratory regulation. The nurse will observe for respiratory status, apnea, bradycardia, oxygenation, and feeding tolerance. The neonate needs to exhibit cardiorespiratory regulation before oral feedings are started. This is the most essential condition for oral feedings.

A patient delivers a term neonate and expresses concern about the reason for giving the neonate an injection. Which information from the nurse is accurate? A. Neonates will hemorrhage without vitamin K B. Vitamin K is needed to activate clotting factors. C. Mothers are unable to supply vitamin K D. Breastfeeding is an excellent source of vitamin K

B. Vitamin K is needed to activate clotting factors. This is correct because it is given to neonate in order to activate coagulation factors that are synthesized in the liver.

The nurse is collecting information from a new mother who is bottle-feeding her infant. Which comment, if made by the mother, requires the nurse to provide patient teaching? A. "I wish that I had tried breastfeeding because formula is expensive." B. "At least I get a break every evening when my spouse feeds the baby." C. "Sometimes I will add a little water to the formula if I am running low." D. "I get frustrated if the last bottle is fed to the baby late at night."

C. "Sometimes I will add a little water to the formula if I am running low." If the mother states a practice of diluting the baby's formula if her supply is low, the nurse needs to provide teaching. Prolonged over-dilution of formulas can cause water intoxication, as well as decrease the caloric intake by the baby.

A new mother states, "I don't want anyone around my baby. I need to protect him from getting sick." Which statement by the nurse will help the mother to understand neonatal immunity? *Select all that apply: A. "I agree with you; the baby's sterile environment is gone." B. "The baby will have acquired immunity soon from vaccinations." C. "The baby has natural passive immunity from you for a few months." D." We will give the baby gamma globin for short-term immediate protection." E. "Neonates are first exposed to organisms from the maternal genital tract during the birthing process."

C. "The baby has natural passive immunity from you for a few months." D." We will give the baby gamma globin for short-term immediate protection." Natural passive immunity is the placental transmission of antibodies from the mother to the fetus. Gamma globulin provides immediate protection for a short time.

The nurse in the NICU is assessing a neonate delivered at 32 weeks gestation. Which pathophysiological manifestation is the nurse's greatest concern? A. Absent or weak reflexes. B. Presence of a heart murmur. C. Apnea 20 seconds or longer. D. Low hemoglobin lab level.

C. Apnea 20 seconds or longer. Apnea for 20 seconds or longer is the nurse's greatest concern. Even though this is expected in premature neonates, the nurse will still focus on the ABC's.

The nurse is assessing a newborns reflexes. Which response will cause the nurse concern? A. A fencing position when the head is turned. B. Strong Babinski reflex C. Asymmetrical Moro reflex D. Absence of rooting or sucking reflexes

C. Asymmetrical Moro reflex This is correct because asymmetrical response is noted when checking for a Moro reflex. This response may be related to temporary or permanent birth injury to clavicle, humerus, or bronchial plexus. This disappears by age 6 months.

The nurse is providing care for a premature in the NICU nursery. The neonate is diagnosed with brochopulmonary dysplasia [BPD] and patent ductus arteriosus [PDA]. Which specific intervention does the nurse expect for this neonate? A. Monitor of hemoglobin and hematocrit levels. B. Obtain blood glucose levels. C. Maintain fluid restrictions. D. Administer enteral feedings.

C. Maintain fluid restrictions. Fluid restrictions are appropriate for premature neonates with BPD, PDA, or other complications that can lead to pulmonary edema.

The nurse is providing information to a postpartum mother about circumcision of her neonate. The neonate's father states, "We have never done that to any baby boy in my family." Which statement is best for the nurse to make? A. "Most families opt for the procedure for a variety of reasons." B. "I can leave information for you to read over and then decide." C. "I personally think that boys are clearer and healthier if circumcised." D. "I understand that family culture and beliefs form our way of life."

D. "I understand that family culture and beliefs form our way of life." This is correct because the nurse should always respect the patient's culture and beliefs, even if the nurse does not agree with or share the opinions.

The nurse is explaining to the new breastfeeding mother that types of neonatal stools the mother can expect. Which examples does the nurse provide? *Select all that apply: A. Residual meconium is passed as loose watery stool. B. Sticky, thick, black stools indicate a presence of blood. C. Stools will eventually become drier and more formed. D. Golden yellow, a pasty consistency, and sour odor is expected. E. Neonate's first stool is passed within the first 24-48 hours.

D. Golden yellow, a pasty consistency, and sour odor is expected. E. Neonate's first stool is passed within the first 24-48 hours. Breast fed babies stool becomes golden yellow with a pasty consistency and a sour odor. Meconium stool beings to form during the fourth gestational month and is passed within 24-48 hours of birth.

The nurses in a NICU are concerned about the appropriate levels of oxygen therapy during the care of premature neonates. The nurses referenced an article by Newman [2014], titled "Oxygen Saturation Limits and Evidence supporting the Targets." On which evidenced-based conclusion will the nurse develop guidelines? A. Oxygen saturation limits of 85-89 are effective! B. Oxygen saturation rates of 91-95 are effective. C. Infants are with saturation limits about 75% of the time. D. Oxygen saturation limits need to be between 87-94

D. Oxygen saturation limits need to be between 87-94 This range is needed to decrease risk of ROP and neonatal death

The labor and delivery nurse is present for the delivery of a premature neonate. Which action by the nurse is most important? A. Stabilize and transfer neonate to NICU. B. Review pregnancy history for risk factors. C. Maintain fluid and electrolyte balance. D. Provide a NTE

D. Provide a NTE When attending a premature birth, the most important thing to do is provide a NTE. The premature neonate is at risk for increased loss of heat because of diminished amounts of subcutaneous fat. The nurse needs to take measures to prevent cold stress, which can be fatal.