OB/PEDS (Pre-Quiz) 17 & 18

The nurse is teaching a new mother about the changes in her newborn's gastrointestinal tract. The nurse determines that additional teaching is needed when the mother makes which statement?

"His stomach can hold approximately 10 ounces"

The parents of a 2-day-old newborn are getting ready to go home with their baby. The mother is breastfeeding the newborn. In preparation for discharge, the nurse obtains the newborn's weight. The newborn weighs 7 lb (3180 g) this morning. The parents voice concern, saying, "Our newborn lost weight since being born. Our newborn was 7 lb 8 oz (3404 g) and now our newborn is less. What is going on?" Which response by the nurse would be most appropriate?

"I understand your concern. It is normal for this to happen but your newborn will gain it back quickly"

New parents are upset their newborn has lost weight since birth. The nurse explains that newborns typically lose how much of their birth weight by 3 to 4 days of age?

10%

A newborn develops physiologic jaundice, and the mother asks the nurse why this happened. Which response by the nurse would be most accurate?

"because his liver is a bit immature, the baby can't break down the bilirubin as fast as needed"

A nurse is making a home visit to a new mother with a 5-day-old newborn. The mother tells the nurse that the baby is fussy and she does not know how to calm her. Which suggestions would be most appropriate for the nurse to make? Select all that apply.

"encourage her to suck" "try shushing her loudly" "try swaddling her nice and snuggly"

A nurse is assessing the congenital reflexes of a newborn. The newborn's parent is watching the nurse and asks, "Why are you testing these things?" Which response by the nurse would be appropriate?

"it is a way for us to check your newborn's brain and nerve function"

A nurse is preparing to weigh a newborn just admitted to the nursery. Place the steps listed below in the order that the nurse would complete them. Use all options.

1)Balance the scale. 2)Cover the scale with a warmed cloth. 3)Recalibrate the scale to zero. 4)Place the unclothed newborn in the center of the scale.

A nurse is teaching new parents how to bathe their newborn once the bring the baby home. Place the body areas listed below in the order that the parents clean the newborn's body. Use all options.

1)Eyes 2)Face 3)Hair 4)Extremities 5)Diaper area

A nurse is developing a plan of care for a newborn to minimize the risk for heat loss. The nurse prioritizes potential interventions based on which mechanism is responsible. Place the interventions listed below in the order the nurse would address them based on the mechanism accounting for the greatest to least amount of heat loss. Use all options.

1)Placing the newborn under a radiant warmer during a procedure 2)Using a warmed isolette to transfer a newborn to the nursery 3)Drying the newborn after giving the newborn a bath 4)Encouraging skin-to-skin contact with the mother

A nurse is explaining to new parents how a newborn adapts to extrauterine life. When discussing the physiologic changes that occur, the nurse would explain that this transition usually occurs within the first:

6-10 hours of life

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?

6-8

A newborn has a heart rate of 90 beats per minute, a regular respiratory rate of 40 breaths per minute, tight flexion of the extremities, a grimace when stimulated, and acrocyanosis. The nurse assigns an Apgar score of:

7

A nurse is assessing a newborn's temperature. Which reading would the nurse document as normal

98.6

While teaching a newborn nutrition class to a group of pregnant women, the nurse encourages breastfeeding because it is a major source of which immunoglobulin?

IgA

A nurse is teaching new parents about keeping follow-up appointments and calling their health care provider if they notice signs of illness in their newborn. The nurse determines that the teaching was successful when the parents identify which signs as needing to be reported? Select all that apply.

abdominal distention, refuse feeding, temperature of 101 or higher

A new dad appears very concerned that his newborn's head looks too big. The nurse assures him there is no need for concern, explaining that the head circumference should typically be:

approximately one-fourth of the length

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

asymmetrical chest movement

A nurse is caring for an infant with an elevated bilirubin level who is under phototherapy. What evaluation data would best indicate that the newborn's jaundice is improving?

bilirubin level went from 15 to 11

The ability of the nurse to identify irregular findings during a physical assessment aids in rapid diagnosis and treatment of possible complications. The nurse assesses a newborn and notes tachycardia. The nurse notifies the health care provider based on the understanding that further assessment is necessary for which condition?

drug withdrawal

The nurse is describing fetal circulation to new parents and how the circulation changes after birth. The nurse describes a structure that allows the pulmonary circulation to be bypassed, but that shortly after birth this structure should close. Which structure is the nurse describing?

ductus arteriosus

A nurse is observing a new parent bottle feeding the newborn. The nurse notices that the newborn begins to get fussy during the feeding. Which action by the nurse would be appropriate?

encourage the parent to burp the newborn to get rid of air

The nurse is inspecting the mouth of a newborn and finds small, white cysts on the gums and hard palate. The nurse documents this finding as:

epstein pearls

In an effort to decrease complications for the infant right after birth, the nurse would expect to administer which medication for prophylaxis of potential eye conditions?

erythromycin ophthalmic ointment

A nurse is conducting a class for expectant parents about newborns and the changes that they experience after birth. The nurse discusses the neonatal period, describing it as which time frame?

first 28 days of life

A new mother is concerned that the infant is not eating enough and will not have enough energy. The nurse explains that storage of which substance will provide energy for the first 24 hours after birth?

glucose

One of the nurse's responsibilities is to educate new parents on the best method to prevent infections in the newborn environment. Which method would the nurse identify as best to control infection?

handwashing

While assessing a newborn, the nurse notes that half the body appears red while the other half appears pale. The nurse interprets this finding as:

harlequin sign

Screening for this most common birth defect is required by law in most states. Each nurse should know the law for his or her state and the requirements for screening. The nurse would expect a newborn to be screened for which defect as the most common?

hearing

Assessment of a newborn reveals microcephaly. The nurse develops a teaching plan for the parents about the need for follow-up care based on the understanding that the newborn is at risk for developing which complication(s)? Select all that apply.

hearing disorders cerebral palsy epilepsy

Which laboratory test results would the nurse consider as a normal finding in a newborn soon after birth?

hemoglobin: 17.5 g/dl

When the nurse is describing the events that occur in a newborn when he or she experiences a cold environment, which event would the nurse identify as occurring first?

increased release of norepinephrine

A nurse is preparing to administer Vitamin K to a newborn. The nurse would administer the drug:

intramuscularly

During an initial newborn assessment, the nurse recognizes certain signs need to be reported to the primary care provider as they indicate potential problems. Which finding(s) would the nurse report? Select all that apply.

labored breathing, flaccid body posture, generalized cyanosis

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

When conducting an assessment, the nurse observes fine, downy hair covering the newborn's shoulders and back. The nurse documents this finding as:

lanugo

A nurse is assessing a newborn's gestational age. Which parameter would the nurse evaluate to assess physical maturity? Select all that apply.

lanugo, genitals

The nurse is aware that the infant's circulatory dynamics during transition can be greatly affected by which action?

late clamping of the umbilical cord after 3 minutes

The nurse is completing an assessment of a newborn. 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 at the fourth intercostal space

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

limited voluntary muscle activity

A nurse is describing the many changes a newborn will go through during his or her first couple of weeks after birth. The nurse explains how the functions of the placenta are taken over by which organ?

liver

A nurse is reviewing the history and physical examination findings of a postpartum woman and her female neonate. The neonate was healthy at birth but is now exhibiting signs of jaundice. Which factor(s) would the nurse assess to help identify the neonate suffers from jaundice? Select all that apply.

maternal TORCH infection maternal gestational diabetes use of oxytocin during labor

ssessment of a newborn reveals tiny white pinpoint papules on a newborn's nose. The nurse documents this finding as:

milia

A nurse is aware that the newborn's neuromuscular maturity assessment is typically completed within 24 hours after birth. Which assessment would the nurse be least likely to complete to determine the newborn's degree of maturity?

moro reflex

A nurse is assessing a newborn and observes the newborn bringing his hand up to his mouth. The nurse interprets this finding as which behavioral response?

motor maturity

The majority of skin variations are transient and fade or disappear with time. The nurse assesses a permanent skin variation in a newborn and counsels the parents to monitor it because of its link to potential childhood cancer. The nurse implements this counseling based on which finding?

nevus flammeus

The nurse is teaching new parents the best way to prevent hypothermia. Which mechanism would the nurse include when explaining about the newborn's primary method of heat production?

nonshivering thermogenesis

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

over the liver

A nurse is explaining to new parents about the numerous changes that occur shortly after birth to the newborn. When describing how the ductus arteriosus closes, the nurse explains that which factor is most important to assist in its closure?

oxygen

A nurse is assessing a newborn with the parents. The nurse explains that which aspect of newborn behavior is an important indication of neurologic development and function?

reflex

Assessment of a newborn reveals the following findings: Length, 48 cm; weight, 2900 g; apical pulse, 150 beats/min; respirations, 24 breaths/min; head circumference, 31cm; chest circumference, 32 cm; temperature 97.9°F (36.6°C). After reviewing these findings, the nurse would notify the provider about which one(s)? Select all that apply.

respirations head circumference

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

right upper abdominal quadrant

A nurse is assessing a newborn's gestational age, When determining neuromuscular maturity, which parameters would the nurse assess? Select all that apply.

scarf sign, arm recoil, posture

When conducting a class for new parents, the nurse explains that newborns demonstrate several predictable responses when interacting with their environment. Which behavioral responses would the nurse integrate into the discussion? Select all that apply.

self-quieting ability orientation habituation

Circumcision is a very personal decision for parents, and the nurse's major responsibility is to inform the parents of the risks and benefits of the procedure. The nurse needs to recognize that this is mainly which type of decision?

social decision

The mother has given birth to a premature infant at 30 weeks. To ensure the alveoli can function properly, the infant needs to be evaluated for:

surfactant

The newborn should have the neurologic status evaluated to determine its maturity and to identify any potential problems. The nurse tests the newborn's Babinski reflex. Which response would the nurse interpret as normal for the newborn?

toes fan out when sole of foot is stroked

The nurse is assessing the abdomen of the neonate. When inspecting the umbilical cord area of a newborn, the nurse would expect which finding?

two arteries and one vein

After completing a class for new parents, the nurse notes the session is successful when the class recognizes the newborn should be bathed how often?

two or three times per week

A nurse is conducting a physical examination of a newborn. The nurse documents which finding as within normal parameters? Select all that apply.

weight of 3,300 grams temperature of 98.6 length of 54 cm

The nurse describes the changes in stool that a new mother would see when feeding her newborn formula. Which description best indicates what the mother would observe after several days?

yellow-green, pasty, unpleasent-smelling stool