O'Meara Prep U Ch: 18

A new mother who is breastfeeding her newborn asks the nurse, "How will I know if my baby is drinking enough?" Which response by the nurse would be most appropriate

"He should wet between 6 to 10 diapers each day."

A nursing mother calls the nurse and is upset. She states that her newborn son just bit her when he was nursing. Upon examining the newborn's mouth, two precocious teeth are noted on the lower central portion of the gums. What would be the nurse's best response

"Precocious teeth can occur at birth but we may need to remove them to prevent aspiration."

A nurse is describing the advantages and disadvantages of circumcision to a group of expectant parents. Which statement by the parents indicates effective teaching

"The rate of penile cancer is less for circumcised males."

The nurse assesses a newborn's Apgar score at birth and documents that it is normal. Which score did the nurse most likely record

8

The parents of a newborn male are questioning the nurse concerning the pros and cons of a circumcision. Which disadvantage should the nurse point out to these parents

Anesthetic may not be effective during the procedure

A 30-minute-old newborn starts crying in a high-pitched manner and cannot be consoled by the mother. Which action should the nurse prioritize if jitteriness is also noted and the infant is unable to breastfeed

Check blood glucose.

The nurse is teaching a prenatal class illustrating the steps that are used to keep families safe. The nurse determines the session is successful when the parents correctly choose which precaution to follow after the birth of their infant

Check the identification badge of any health care worker before releasing baby from room.

The nurse is preparing discharge instructions for the parents of a male newborn who is to be circumcised before discharge. Which instruction should the nurse prioritize

Cover the glans generously with petroleum jelly.

A new mother voices concerns about breastfeeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are

prolactin and oxytocin.

A nurse is assessing a newborn. What gestational age assessment findings indicate that the newborn has reached term

Flexible wrist with a small angle at a range of 15 degrees

The nurse documents that a newborn has a normal head-to-body proportion. What did the nurse document in the baby's medical record

Head one fourth of total length

Assessment of a newborn reveals a heart rate of 180 beats per minute. To determine whether this finding is a common variation rather than a sign of distress, what else does the nurse need to know

How many hours old is this newborn?

A client who has a breastfeeding newborn reports sore nipples. Which intervention can the nurse suggest to alleviate the client's condition

Offer suggestions based on observation to correct positioning or latching.

According to Brazelton's Neonatal Behavioral Assessment Scale, a newborn would be in what state if the eyes are open and looking at people nearby, and the newborn has minimal activity or body movement

Quiet alert

The nurse is inspecting a male newborn's genitalia. Which action should the nurse avoid when conducting this assessment

Retracting the foreskin over the glans to assess for secretions

A nurse working as a member of a genetic counseling team understands that her careful assessment of which body areas in a newborn may provide important indications for structural genetic disorders

Space between the eyes, the shape of the ears, and the numbers of fingers and toes

A nurse determines that a newborn has a 1-minute Apgar score of 5 points. What conclusion would the nurse make from this finding

The infant is experiencing moderate difficulty in adjusting to extrauterine life.

When assessing the newborn's umbilical cord, what should the nurse expect to find

two smaller arteries and one larger vein

A nurse is teaching a newborn's caregivers how to change a diaper correctly. Which statement by the caregiver best indicates the nurse's teaching was effective

"We will fold down the front of her diaper under the umbilical cord until it falls off."

A parent asks the nurse how to swaddle the newborn because the parent heard that it helps newborns calm down. Which statement will the nurse include in the teaching

"Wrapping the newborn too tightly can impair breathing."

A mother is upset because her newborn has lost 6 ounces since birth 2 days ago. The nurse informs the mother that it is normal for a newborn to lose which percentage of their birth weight within the first week of life

5% to 10% of their birth weight

When teaching a class of new parents about the needs of their newborn, the nurse explains that the newborn's voiding is a good indicator that he or she is getting enough fluids. The nurse determines that the teaching was successful when the parents state which number of voidings per day is a good indicator of adequate fluids

6 to 8

The nurse is noting a collection of blood under the scalp on a newborn being discharged to home. The nurse is correct to prepare teaching instructions of which topic

A cephalohematoma

What supplies would the nursery nurse collect in preparation for bathing a newborn infant? Select all that apply

A washcloth Warm tub of water Thermometer

The nurse has completed an assessment on a 1-day-old newborn. Which finding should the nurse prioritize

Blood sugar 42 mg/dL

The nurse notices that there is no vitamin K administration recorded on a newborn's medical record upon arrival to the newborn nursery. What would be the nurse's first action

Call the Labor and Delivery nurse who cared for the newborn to inquire about why the medication was not documented.

The nurse is assessing a newborn who was born vaginally. The newborn was in the vertex position. The nurse notes that the newborn has some localized scalp edema primarily over the presenting part of the head. There is some bruising and edema that crosses the suture line. The nurse documents this finding as which of the following

Caput succedaneum

A nurse needs to monitor the blood glucose levels of a newborn under observation at a health care facility. When should the nurse check the newborn's initial glucose level

On admission to the nursery

The nurse is assessing a newborn by auscultating the heart and lungs. Which natural phenomenon will the nurse explain to the parents is happening in the cardiovascular system

Pressure changes occur and result in closure of the ductus arteriosus.

Which factor might result in a decreased supply of breast milk in a postpartum client

Supplemental feedings with formula

The nurse is assessing a 2-hour-old newborn and notes that the infant has irregular patterns of breathing rate, depth, and rhythm. Which is the best action made by the nurse

Taking no action because these are normal findings in a newborn

What physiologic changes occur after birth when the cord is cut and clamped

The infant takes its first breath and the lungs expand to increase blood oxygen levels.

The nurse is looking over a newborn's plan of care regarding expected outcomes. Which outcome would not be appropriate according to a newborn's nursing care

The newborn will experience no bleeding episodes lasting more than 5 minutes.

Upon assessing the newborn's respirations, which finding would cause the nurse to notify the primary care provider

a respiratory rate of 15 breaths per minute with nasal flaring

While assessing a full-term neonate, which symptom would cause the nurse to suspect a neurologic impairment

a weak sucking reflex

The nurse institutes measures to maintain thermoregulation based on the understanding that newborns have limited ability to regulate body temperature because they

are unable to shiver effectively to increase heat production.

The nurse is assessing a woman who had a forceps-assisted birth for complications. Which condition would the nurse assess in the fetus

caput succedaneum

While performing a physical assessment of a newborn boy, the nurse notes diffuse edema of the soft tissues of his scalp that crosses suture lines. The nurse documents this finding as

caput succedaneum.

The nurse places a warmed blanket on the scale when weighing a newborn to minimize heat loss via which mechanism

conduction

When discussing heat loss in newborns, placing a newborn on a cold scale would be an example of what type of heat loss

conduction

A nurse is assessing the fluid status of a preterm newborn. Which parameter would be mostappropriate for the nurse to assess

fontanels

The nurse is explaining to new parents that a potential complication of a cesarean birth is transient tachypnea. The nurse explains that this is due to which occurrence

lack of thoracic compressions during birth

Assessment of a newborn reveals rhythmic spontaneous movements. The nurse interprets this as indicating

motor maturity.

After teaching an in-service program to a group of nurses working in newborn nursery about a neutral thermal environment, the nurse determines that the teaching was successful when the group identifies which process as the newborn's primary method of heat production

nonshivering thermogenesis

The Ballard scoring system evaluates newborns on which two factors

physical maturity and neuromuscular maturity

In a class for expectant parents, the nurse discusses the various benefits of breastfeeding. However, the nurse also describes that there are situations involving certain women who should not breastfeed. Which examples would the nurse cite? Select all that apply

women on antithyroid medications women on antineoplastic medications women using street drugs

The nurse observes the stool of a newborn who has begun to breastfeed. Which finding would the nurse expect

yellowish-brown, seedy stool

The nurse is preparing new parents and their infant for discharge by answering questions and presenting basic discharge instruction. Which explanation should the nurse provide when questioned about the infant's yellow hue

The tint is due to jaundice.

What is the expected range for respirations in a newborn

30 to 60 breaths per minute

A nurse is providing care to a newborn and places a warm towel on a cold scale to prevent heat loss by which mechanism

Conduction