Chapter 17: Newborn Transitioning

D

A nurse is developing a teaching plan for the parents of a newborn. When describing the neurologic development of a newborn to the parents, the nurse would explain that the development occurs in which fashion? A) toe-to-head B) lateral-to-medial C) outward-to-inward D) center to outsie

B

A nurse is reviewing the laboratory test results of a newborn. Which result would the nurse identify as a cause for concern? A) hemoglobin 19 g/dL B) platelets 75,000/uL C) white blood cells 20,000/mm3 D) hematocrit 52%

A

When counseling a mother about the immunologic properties of breast milk, the nurse would emphasize breast milk as a major source of which immunoglobulin? A) IgA B) IgG C) IgM D) IgE

A

A client expresses concern that her 2-hour-old newborn is sleepy and difficult to awaken. The nurse explains that this behavior indicates: A) normal progression of behavior. B) probable hypoglycemia. C) physiological abnormality. D) inadequate oxygenation

C

A group of nurses are reviewing information about the changes in the newborn's lungs that must occur to maintain respiratory function. The nurses demonstrate understanding of this information when they identify which event as occurring first? A) expansion of the lungs B) increased pulmonary blood flow C) initiation of respiratory movement D) redistribution of cardiac output

A

A new mother asks the nurse, "Why has my baby lost weight since he was born?" The nurse integrates knowledge of which cause when responding to the new mother? A) insufficient calorie intake B) shift of water from extracellular space to intracellular space C) increase in stool passage D) overproduction of bilirubin

B

A new mother is changing the diaper of her 12-hour-old newborn and asks why the stool is black and sticky. Which response by the nurse would be most appropriate? A) "You probably took iron during your pregnancy and that is what causes this type of stool." B) "This is meconium stool and is normal for a newborn." C) "I'll take a sample and check it for possible bleeding." D) "This is unusual, and I need to report this to your pediatrician. "

D

A new mother reports that her newborn often spits up after feeding. Assessment reveals regurgitation. The nurse responds integrating understanding that this most likely is due to which factor? A) placing the newborn prone after feeding B) limited ability of digestive enzymes C) underdeveloped pyloric sphincter D) relaxed cardiac sphincter

A C E

A newborn is experiencing cold stress. Which findings would the nurse expect to assess? Select all that apply. A) respiratory distress B) decreased oxygen needs C) hypoglycemia D) metabolic alkalosis E) jaundice

D

A nurse is assessing a newborn and observes the newborn moving his head and eyes toward a loud sound. The nurse interprets this as which behavior? A) habituation B) motor maturity C) social behavior D) orientation

B C

A nurse is assessing a newborn who is about 4 1/2 hours old. The nurse would expect this newborn to exhibit which behavior? Select all that apply. A) sleeping B) interest in environmental stimuli C) passage of meconium D) difficulty arousing the newborn E) spontaneous Moro reflexes

D

A nurse is assessing a newborn. Which finding would alert the nurse to the possibility of respiratory distress in a newborn? A) symmetrical chest movements B) periodic breathing C) respirations of 40 breaths/minute D) sternal retractions

B

A nurse is conducting a refresher in-service program for a group of neonatal nurses. Afterteaching the group about hepatic system adaptations after birth, the nurse determines that the teaching was successful when the group identifies which process as reflective of the change of bilirubin from a fat-soluble product to a water-soluble product? A) hemolysis B) conjugation C) jaundice D) hyperbilirubinemia

B

A nurse is explaining to a group of new parents about the changes that occur in the neonateto sustain extrauterine life, describing the cardiac and respiratory systems as undergoing the most changes. Which information would the nurse integrate into the explanation to support this description? A) The cardiac murmur heard at birth disappears by 48 hours of age. B) Pulmonary vascular resistance (PVR) is decreased as lungs begin to function. C) Heart rate remains elevated after the first few moments of birth. D) Breath sounds will have rhonchi for at least the first day of life as fluid is absorbed.

A C D E

A nurse is preparing a class on newborn adaptations for a group of soon-to-be parents. When describing the change from fetal to newborn circulation, which information would the nurse most likely include? Select all that apply. A) Decrease in right atrial pressure leads to closure of the foramen ovale. B) Increase in oxygen levels leads to a decrease in systemic vascular resistance. C) Onset of respirations leads to a decrease in pulmonary vascular resistance. D) Increase in pressure in the left atrium results from increases in pulmonary blood flow. E) Closure of the ductus venosus eventually forces closure of the ductus arteriosus

B

A nurse is preparing a presentation about ways to minimize heat loss in the newborn. Which measure would the nurse include to prevent heat loss through convection? A) placing a cap on a newborn's head B) working inside an isolette as much as possible. C) placing the newborn skin-to-skin with the mother D) using a radiant warmer to transport a newborn

A

A nurse is teaching a group of new parents about their newborns' sensory capabilities. The nurse would identify which sense as being well-developed at birth? A) hearing B) touch C) taste D) vision

B

A nurse is teaching a new mother about her newborn's immune status. The nurse determines that the teaching was successful when the mother states which immunoglobulin as having crossed the placenta? A) IgA B) IgG C) IgM D) IgE

B

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? A) convection B) nonshivering thermogenesis C) cold stress D) bilirubin conjugation

A

After the birth of a newborn, which action would the nurse do first to assist in thermoregulation? A) Dry the newborn thoroughly. B) Put a hat on the newborn's head. C) Check the newborn's temperature. D) Wrap the newborn in a blanket.

B

Assessment of a newborn reveals rhythmic spontaneous movements. The nurse interprets this as indicating: A) habituation. B) motor maturity. C) orientation. D) social behaviors.

A

The nurse dries the neonate thoroughly and promptly changes wet linens. The nurse does so to minimize heat loss via which mechanism? A) evaporation B) conduction C) convection D) radiation

D

The nurse institutes measure to maintain thermoregulation based on the understanding that newborns have limited ability to regulate body temperature because they: A) have a smaller body surface compared to body mass. B) lose more body heat when they sweat than adults. C) have an abundant amount of subcutaneous fat all over. D) are unable to shiver effectively to increase heat production

D

The nurse is assessing the respirations of several newborns. The nurse would notify the health care provider for the newborn with which respiratory rate at rest? A) 38 breaths per minute B) 46 breaths per minute C) 54 breaths per minute D) 68 breaths per minute

B

The nurse is teaching a group of parents about the similarities and differences between newborn skin and adult skin. Which statement by the group indicates that additional teaching is needed? A) The newborn's skin and that of an adult are similar in thickness. B) The newborn's sweat glands function fully, just like those of an adult. C) Skin development in the newborn is not complete at birth. D) The newborn has fewer fibrils connecting the dermis and epidermis

B

The nurse observes the stool of a newborn who has begun to breast-feed. Which finding would the nurse expect? A) greenish black, tarry stool B) yellowish-brown, seedy stool C) yellow-gold, stringy stool D) yellowish-green, pasty stool

D

The nurse observes the stool of a newborn who is being bottle-fed.The newborn is 2 days old. What would the nurse expect to find? A) greenish black, tarry stool B) yellowish-brown, seedy stool C) yellow-gold, stringy stool D) yellowish-green, pasty stool

B

The nurse places a warmed blanket on the scale when weighing a newborn to minimize heat loss via which mechanism? A) evaporation B) conduction C) convection D) radiation

A

Twenty minutes after birth, a baby begins to move his head from side to side, making eye contact with the mother, and pushes his tongue out several times. The nurse interprets this as: A) a good time to initiate breast-feeding. B) the period of decreased responsiveness preceding sleep. C) a sign that the infant is being overstimulated. D) evidence that the newborn is becoming chilled

A

When describing the neurologic development of a newborn to his parents, the nurse would explain that it occurs in which fashion? A) head-to-toe B) lateral-to-medial C) outward-to-inward D) distal-caudal

C

When explaining how a newborn adapts to extrauterine life, the nurse would describe which body systems as undergoing the most rapid changes? A) gastrointestinal and hepatic B) urinary and hematologic C) respiratory and cardiovascular D) neurological and integumentary

D

When teaching new parents about the sensory capabilities of their newborn, which sense would the nurse identify as being the least mature? A) hearing B) touch C) taste D) vision

C

While observing the interaction between a newborn and the mother, the nurse notes the newborn nestling into the arms of the mother. The nurse identifies this as which behavior? A) habituation B) self-quieting ability C) social behaviors D) orientation