vSim Questions Newborn

Signs of Rotavirus

Rotavirus causes inflammation of a child's stomach and digestive tract, usually triggering vomiting, diarrhea, and fever and not seen in a preterm infant.

Which assessment finding within the first 24 hours of birth requires immediate health care provider notification?

The skin is jaundiced. Pathologic jaundice occurs within the first 24 hours of life and is often related to blood incompatibility.

A nurse is providing preoperative care to a female newborn client with the congenital abnormality myelomeningocele. Which intervention is the priority?

preventing infection

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

two smaller arteries and one larger vein In 0.5% of births (3.5% of twin births), there is only one umbilical artery, which can be linked to cardiac or chromosomal abnormalities.

The nurse realizes the educational session conducted on due dates was successful when a participant is overheard making which statement?

"The ability of my placenta to provide adequate oxygen and nutrients to my baby after 42 weeks' gestation is thought to be compromised." As the placenta loses its ability to nourish the fetus, the fetus uses stored nutrients to stay alive, and wasting occurs.

The nurse is caring for a client who is at her due date. The client asks. "How long is the health care provider going to let me go?" The nurse is correct to state that typical a mother should not pass how many weeks gestation?

42 weeks Going past that point, either a cesarean section or an induction would be completed. Actual dates do vary depending on the status of the fetus.

The nurse records a newborn's Apgar score at birth. A normal 1-minute Apgar score is:

7 to 10 This implies the infant is breathing well and cardiovascular adaptation is occurring.

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

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.

A preterm infant has an umbilical vessel catheter inserted so that blood can be drawn readily. Which would be most important to implement during this procedure?

Ensure that the infant is kept warm. Preterm infants must be protected from chilling during all procedures, because maintaining warmth is a major concern because of immaturity.

A common symptom that would alert the nurse that a preterm infant is developing respiratory distress syndrome is:

Expiratory grunting. It is a physiologic measure to ensure alveoli do not fully close on expiration (so they require less energy expenditure to reopen).

The nurse is explaining to new parents the various injections their newborn will receive before being discharged home. Which injection should the nurse teach the parents about that will help decrease the incidence of hepatic disease later in life?

Hep B Hep B is the vaccination against hepatitis B and recommended by the CDC. It has been found to help prevent cirrhosis and liver cancer later in life.

A woman wearing hospital scrubs comes to the nursery and states "Mrs. Smith is ready for her baby. I will be glad to take the baby to her." What will the nursery nurse do next?

Look at the woman's hospital identification badge.

A premature infant in the neonatal intensive care unit exhibits worsening respiratory distress and is noted to have abdominal distention, absent bowel sounds, and frequent diarrhea stools that are positive for hemoccult. What diagnosis would be most likely to correlate with the symptoms?

Necrotizing enterocolitis (NEC)

The primipara tells the nurse, "My baby jumps every time I pick her up. Is she afraid that I will drop her?" Which response by the nurse would be best?

No, it is the Moro reflex (startle reflex) A startled newborn will extend the arms and legs away from the body and to the side. Then the arms come back toward each other with the fingers spread in a "C" shape. The arms look as if the newborn is trying to embrace something. The Moro reflex should be symmetrical.

How long is the neonatal period for a newborn?

The neonatal period is the first 28 days of life

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

The nurse should expect the newborn who is breastfed or formula-fed to lose 5% to 10% of birth weight in the first few days of life.

When documenting the newborn's weight on a growth chart, the nurse recognizes the newborn is large-for-gestational-size based on which percentile on growth charts?

above 90th percentile A newborn whose weight is above the 90th percentile on growth charts is defined as large-for-gestational-age.

During the newborn's assessment, which finding would lead the nurse to suspect that a large-for-gestational-age newborn has experienced birth trauma?

asymmetrical movement A birth injury is typically characterized by asymmetrical movement.

A nurse is providing care to a 3-hour-old neonate. The nurse ensures that her hands are warm prior to touching the neonate to prevent heat loss by which mechanism?

conduction heat loss from direct contact to a cool surface such as cold hands

Signs of hypoglycemia in newborn

lethargy and hypotonia; jitteriness; twitching; poor feeding; temperature instability; apnea; respiratory distress; seizures

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 Typically, a newborn's blood glucose levels are assessed with use of a heel stick sample of blood on admission to the nursery, not 4 or 24 hours after admission to the nursery. It is also not necessary or even reasonable to check the glucose level only after the newborn has been fed

When does physiologic jaundice occur?

physiologic jaundice occurs 48 hours or more after birth, peaks at the 5th to 7th day, and disappears between the 7th and 10th day postpartum.

Advantages to circumcision

reduced risk of penile cancer, and fewer complications than if circumcised later in life