Newborn PrepU

When auscultating the newborn's heart, the nurse would place the stethoscope at which area to auscultate the point of maximal impulse?

Lateral to the midclavicular line at the fourth intercostal space

What should the nurse consider when checking results of blood work done on a newborn?

Leukocytosis is usually present.

The nurse is preparing a teaching plan for new parents about why newborns experience heat loss. Which of the following would the nurse include?

Limited voluntary muscle activity

A patient who gave birth 2 hours ago expresses concern about her baby developing jaundice. How should the nurse respond? Choose the best response.

"I understand your concern because as many as 50% of babies can develop jaundice."

A mother is concerned because her daughter has lost 8 ounces 3 days after birth. What response by the nurse is appropriate?

"This is a normal and expected finding."

When instructing a new mom on providing skin care to her newborn, which of the following should NOT be included in the teaching?

"Use talc powders to prevent diaper rash."

Which of the following statements by the parents of a newborn indicate that they understand how to soothe their newborn if he becomes upset?

"We'll turn the mobile on that's hanging above his head in his crib."

A patient expresses concern to the nurse that her baby is dehydrated and is not getting enough milk from breastfeeding. What is the best response from the nurse?

"You can tell that your baby is adequately hydrated because he is making 8 wet diapers a day."

What should the nurse expect for a full-term newborn's weight during the first few days of life?

Loss of 5% to 10% of birth weight in formula-fed and breastfed newborns

The heart rate of the newborn in the first few minutes after birth will be in which of the following ranges?

120-180 bpm

How long is the neonatal period for a newborn?

28

How long is the neonatal period for a newborn?

28 days

The nurse has completed the initial assessment and vital signs for an infant born at 12 noon. The assessment and vital signs were completed at 1:30pm. What time will the nurse plan to complete the next set of vital signs?

2:00pm

What is the expected range for respirations in a newborn?

30-60 breaths per minute

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 of the following within the first week of life?

5-10% of their weight

You record a newborn's Apgar score at birth. A normal 1-minute Apgar score is

7-10

Which of the following would alert the nurse to suspect that a newborn is experiencing respiratory distress?

Asymmetrical chest movement

A nurse tests a newborn's nervous functioning by stroking the sole of the baby's foot in an inverted "J" curve from the heel upward. The baby responds by fanning his toes. Which reflex has just been demonstrated?

Babinski Reflex

Which is NOT a cause of jaundice in the newborn?

Bilirubin hyperexcretion

You are admitting a 10-pound newborn to the nursery. You know that it will be important to monitor what during the transition period?

Blood sugar

Ophthalmia neonatorum is contracted when a mother has which sexually transmitted infection(s)?

Both A and B

A nurse teaches new parents that the best way to help prevent infections in the newborn is which of the following?

Breastfeed

A newborn's primary method of heat production is through nonshivering thermogenesis. This process oxidizes which of the following in response to cold exposure?

Brown fat

What is the primary mechanism for temperature regulation in a newborn infant?

Brown fat store usage

What is the term for a small collection of blood that forms underneath the skull as a result of birth trauma?

Cephalhematoma

What is the term for a small collection of blood that forms underneath the skull as a result of birth trauma?

Cephalohematoma

What is the most important thing the nurse can teach the family of a newborn to prevent abduction while the baby is in the hospital?

Check the identification badge of any health care worker before he or she takes the baby from the room.

A newborn is challenged to maintain an adequate body temperature. If a baby is placed too close to a cold air vent, the nurse can assume that the infant will lose heat by which mechanism?

Convection

Eliminating drafts in the delivery room and in the nursery will help to prevent heat loss in a newborn through which mechanism?

Convection

The nurse notices while holding him upright that a day-old newborn has a significantly indented anterior fontanelle. She immediately brings it to the attention of the physician. What does this finding most likely indicate?

Dehydration

You are the oncoming nursery nurse caring for a 3-hour-old newborn boy. You make your initial assessment and find the following: Respiratory rate 30 bpm, B/P 60/40 mm/Hg, heart rate 155, temperature (Axillary) 36.8 °C. You assess that the newborn is in a state of quiet alert. What would you do?

Document that data

You are the oncoming nursery nurse caring for a 3-hour-old newborn boy. You make your initial assessment and find the following: Respiratory rate 30 bpm, B/P 60/40 mm/Hg, heart rate 155, temperature (Axillary) 36.8 °C. You assess that the newborn is in a state of quiet alert. What would you do?

Document the data

Which of the following would the nurse expect to administer for eye prophylaxis in the newborn?

EOO

How can the nurse be instrumental in preventing hypoglycemia in the newborn? Choose the best answer.

Encouraging early and frequent feedings

What are small unopened or plugged sebaceous glands that occur in a newborn's mouth and gums?

Epstein's Pearls

The newborn has been placed in skin-to-skin contact with his mother. A blanket covers all of his body except his head. His hair is still wet with amniotic fluid, etc. What is the most likely type of heat loss this baby may experience?

Evaporation

Neonatal red blood cells have a life span of 120 days, while those of adults last 80 to 100 days.

False

The American Academy of Pediatrics and the American Dietetic Association recommend breastfeeding exclusively for how long?

First six months

While assessing a newborn you elicit a rooting reflex. How did you do this?

Gently stroking the cheek of the newborn

The AGPAR score is based on which 5 parameters?

Heart rate, muscle tone, reflex irritability, respiratory effort, and color

The standard of care and recommendation by the Centers for Disease Control is to administer an immunization to all newborns. Which immunization is recommended to be administered prior to discharge?

Hep B

A woman who is about to be discharged after a vaginal birth notices a flea-like rash on her newborn's chest. The rash has tiny red lesions all across the nipple line. This is likely an indication of what?

It is a normal skin finding in a newborn.

While examining a 2-day old newborn, a nurse notices that the skin and sclera of the eyes appear yellow. The nurse recognizes this condition as which of the following?

Jaundice

The nurse measures a newborn's temperature immediately after birth and finds it to be 99°F. An hour later, it has dropped several degrees. The nurse understands that this heat loss can be explained in part by which of the following in the newborn?

Lack of subQ fat

A newborn is passing greenish-black stool of tarry consistency. The nursing student correctly identifies this type of stool as which of the following?

Meconium stool

An African American baby has discoloring which appears similar to bruising on his buttock after a normal vaginal delivery. This assessment should be documented as:

Mongolian spots.

A nursing student is preparing a class for new mothers about adaptations they can expect in their newborns. Which of the following about newborn vision whould the student accurately include in the presentation?

Newborns have the ability to focus only on objects in close proximity.

A nurse is observing respiratory effort in a newborn as part of Apgar scoring. Which of the following methods should he use to do this?

Observe chest movement

When applying a skin temperature probe to a newborn who is lying on his side, which location would be most appropriate?

Over the liver

A father is asking questions about the circumcision of his son. He is asking the nurse if there are any disadvantages to the procedure. How should the nurse respond?

Pain administration may not be effective

A father is asking questions about the circumcision of his son. He is asking the nurse if there are any disadvantages to the procedure. How should the nurse respond?

Pain administration may not be effective during the procedure

A father is asking questions about the circumcision of his son. He is asking the nurse if there are any disadvantages to the procedure. How should the nurse respond?

Pain administration may not be effective for this procedure

You are assisting with the circumcision of a 16-hour-old male infant. Immediately after the procedure, what kind of dressing would you apply to the surgical area?

Petrolatum gauze dressing

The New Ballard scoring system evaluates newborns on which 2 factors?

Physical maturity and neuromuscular maturity

The infant's temperature is 97.2F axillary an hour after birth. Which intervention is the appropriate for the nurse?

Place the infant under a radiant warmer or in a heated isolette.

A nursing student is aware that fetal gas exchange takes place in which of the following?

Placenta

At birth there are multiple changes in the cardiac and respiratory systems. Which of the following is one of the changes to occur at birth in the cardiovascular system?

Pressure changes occur and result in closure of the ductus arteriosus

A nurse is teaching newborn care to students. The nurse correctly identifies which of the following as the predominant form of heat loss in the newborn?

Radiation, convection, and conduction.

The nurse is preparing to apply a thermistor probe to a newborn to monitor the newborn's temperature. At which location would the nurse most likely apply the probe?

Right upper abdominal quadrant

The nurse is documenting assessment of infant reflexes. She strokes the side of the infants face and the baby turns toward the stroke. What reflex has the nurse elicited?

Rooting

A nurse is discussing breastfeeding with a new mother and demonstrates that when she strokes the baby's cheek, the baby turns his head in that direction. This reflex is known as which of the following?

Rooting reflex

A nursing student correctly chooses which stage of behavioral adaptation in the infant to reinforce teaching about feeding, positioning for feeding, and diaper-changing techniques?

Second period of reactivity

A nurse is teaching a new mother about what to expect for bowel elimination in her newborn. Because the mother is breast-feeding, the nurse should tell her which of the following?

Stools should be yellow-gold, loose, and stringy to pasty.

Which of the following would the nurse do first after the birth of a newborn?

Suction the mouth and nose

A nurse working in the neonatal nursery anticipates the physician to order which of the following for a premature newborn having difficulty breathing?

Surfactant

When caring for a newborn who is jittery and irritable 30 minutes after birth, what should the nurse do?

Take blood, using a heel stick, to check for hypoglycemia.

A mother points out to you that following three meconium stools, her newborn has had a bright green stool. You would explain to her that

This is a normal finding

Why should a nurse monitor a newborn after cesarean birth more closely than after a vaginal birth?

The baby will have more fluid in its lungs, making respiratory adaptation more challenging.

Which is the best place to perform a heel stick on a newborn?

The fat pads on the lateral aspects of the foot

After teaching a class about the changes in the gastrointestinal system of a newborn, which of the following if stated by the class indicates the need for additional teaching?

The newborn's stomach is about 300 mL in volume

Which of the following is true regarding fetal and newborn senses?

The rooting reflex is an example that the newborn has a sense of touch.

The nurse is providing discharge education to a first time mother and father on their newborn female infant. The father notes the infant has a yellow skin color. How should the nurse explain what the father is noting?

The tint is yellow from jaundice

Following birth, a newborn is placed on the mother's abdomen for a period of skin-to-skin contact.

True

When assessing the umbilical cord of a newborn, which of the following would the nurse expect to find?

Two arteries and one vein

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

Two smaller arteries and one large vein

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

Two smaller arteries and one larger vein

What could be considered to be the best practice for the nurse to follow in giving a newborn his or her first bath?

Wash off all traces of blood and massage the vernix into the skin.

At what point should the nurse expect a healthy newborn to pass meconium?

Within 24 hours of birth

You are the oncoming nursery nurse in a normal newborn nursery. You receive report on four infants. Baby A is reported as being 16 hours old, vital signs within normal limits (WNL), bilirubin 3.5 mg/dL rooming in with mother; Baby B is 8 hours old, vital signs WNL, bilirubin 3 mg/dL, returning to nursery for night; Baby C is 19 hours old, vital signs WNL, bilirubin 4 mg/dL, rooming in with mother; Baby D is 4 hours old, vital signs WNL, bilirubin 2 mg/dL, returning to nursery for night. Which baby would you assess first?

baby C

Which of the following statements about brown fat is true?

• Brown fat makes up 2% to 6% of a term newborn's body weight. • Brown fat is brown and rich in blood vessels and nerve endings. • The newborn keeps himself warm by oxidizing brown fat in response to exposure to the cold. • Only newborns have brown fat. • The most common places to find brown fat are the scapulae, neck, mediastinum, and areas near the kidneys and adrenals

When assessing a newborn's gestational age, the nurse evaluates which of the following parameters to indicate physical maturity? Select all that apply.

• Lanugo • Genitals

A 25-year-old P3023 spontaneously ruptured clear fluid at home and has had a normal labor progression. The nurse and the midwife do not anticipate any complications. What should the nurse do to prepare for the birth? Select all that apply.

• Move the newborn warmer to the delivery area and turn it on. • Check the functionality of the oxygen source and equipment. • Document events as they are happening.

When performing Ortolani's maneuver, which of the following should occur? Select all that apply.

• The newborn should be in a supine position. • Attempt to abduct the hips 180 degrees while applying upward pressure.

A nursing instructor informs the student that the following are stimuli for initiating respirations in the newborn? (Select all that apply.)

• hypercapnia • hypoxia • acidosis

A nursing instructor informs students that recent research has shown advantages of delayed cord clamping include which of the following? (Select all that apply.)

• improving the newborn's cardiopulmonary adaptation • preventing childhood anemia • increasing blood pressure • improving oxygen transport • increasing red blood cell flow