OB HESI EAQ - Care of Newborn
While inspecting her newborn a mother asks the nurse whether her baby has flat feet. How should the nurse respond? "Flat feet are more common in children than adults." "That's hard to assess because the feet are so small." "There may be a bone defect that needs further assessment." "Infants' feet appear flat because the arch is covered with a fat pad."
"Infants' feet appear flat because the arch is covered with a fat pad."
A new mother exclaims to the nurse, "My baby looks like a Conehead!" How should the nurse respond? "Are you disappointed in how your baby looks?" "Don't worry—your baby's head will be round in a few days." "Is there anyone in your family whose head shape is similar to your baby's?" "This often happens as the baby's head moves down the birth canal—the bones move for easier passage."
"This often happens as the baby's head moves down the birth canal—the bones move for easier passage."
A nurse reviews the prescribed treatment with the parents of an infant born with bilateral clubfeet. Which parental statement indicates to the nurse that further education is required? "We'll have to start serial casting right away." "The casts will have to be changed every week." "The baby may have to have surgery if the problem is not fixed in a few months." "We'll have to have the baby fitted with prosthetic devices before the baby is able to walk."
"We'll have to have the baby fitted with prosthetic devices before the baby is able to walk."
A nurse is assessing a newborn with suspected retention of a fetal structure that will result in a congenital heart defect. Which fetal structures should undergo change after birth? Select all that apply. Mitral valve Foramen ovale Pulmonary veins Ductus arteriosus Pulmonary arteries
Foramen ovale, Ductus arteriosus
What is an appropriate nursing intervention for a neonate with respiratory distress syndrome (RDS)? Avoid handling the infant to conserve energy Position the infant to promote respiratory efforts Assess the infant for congenital birth defects to enable early treatment Set the incubator thermostat 10° F (12° C) below body temperature to prevent shivering
Position the infant to promote respiratory efforts
While performing a newborn assessment after a vaginal birth, a student nurse observes a swelling on one side of the top of the head that does not cross the suture line. The student nurse has identified what clinical manifestation? A bulging fontanel A cephalhematoma Caput succedaneum Normal molding pattern
A cephalhematoma
What is the most important parameter for the nurse to monitor during the first 24 hours after the birth of an infant at 36 weeks' gestation? Duration of cry Respiratory distress Frequency of voiding Decreased temperature
Respiratory distress
While assessing a newborn the nurse notes the following findings: arms and legs slightly flexed; smooth, transparent skin; abundant lanugo on the back; slow recoil of the pinnae; and few sole creases. What complication does the nurse anticipate in light of these findings? Polycythemia Hyperglycemia Postmaturity syndrome Respiratory distress syndrome
Respiratory distress syndrome
A nurse is teaching a prenatal class regarding infant safety. After the class several of the students are heard discussing what they have learned. The nurse determines that the teaching has been effective when one of the future parents makes which statement? "My mother has already made the cutest pillowcases for the baby's pillows." "I just bought a new baby seat that can be strapped into the front seat of the car." "My mother can't believe that babies are supposed to sleep on their backs, not their stomachs." "At my shower I was given a baby tub that has a special safety strap that lets me leave the baby alone in it."
"My mother can't believe that babies are supposed to sleep on their backs, not their stomachs."
A new mother asks the nurse administering erythromycin ophthalmic ointment to her newborn why her baby must be subjected to this procedure. What is the best response by the nurse? "It will keep your baby from going blind." "This ointment will protect your baby from bright lights." "There is a law that newborns must be given this medicine." "This antibiotic helps keep babies from contracting eye infections."
"This antibiotic helps keep babies from contracting eye infections."
While a mother is inspecting her newborn she expresses concern that her baby's eyes are crossed. How should the nurse most appropriately respond? "Take another look. They seem fine to me." "It's all right. Most babies have crossed eyes." "This is expected. Your baby is trying to focus." "You're right. I'll contact your health care provider."
"This is expected. Your baby is trying to focus."
A nurse decides on a teaching plan for a new mother and her infant. What should the plan include? A schedule for teaching infant care A demonstration and explanation of infant care A discussion of mothering skills presented in a nonthreatening manner Emotional support that will foster dependence on the nurse's expertise
A demonstration and explanation of infant care
A client expresses a desire to breastfeed her preterm infant, who is being cared for in the neonatal intensive care unit. How should the nurse respond to this client's request? By telling the client that this is not possible because the infant will be fed by means of gavage By discouraging the client because of the time and effort it will take to pump her breasts By supporting the client's decision and explaining that her infant may be unable to finish breastfeeding due to exhaustion By explaining to the client that breast milk is inadequate for a preterm infant because it does not contain all the necessary nutrients
By supporting the client's decision and explaining that her infant may be unable to finish breastfeeding due to exhaustion
A newborn is circumcised prior to discharge from the hospital. What should the immediate postoperative care include? Keeping the infant NPO for 4 hours to prevent vomiting Encouraging the intake of alkaline fluids to reduce urine acidity Changing the dressing using dry, sterile gauze to maintain cleanliness Encouraging the mother to cuddle her baby to provide emotional support
Encouraging the mother to cuddle her baby to provide emotional support
An infant is born precipitously in the emergency department. What should the nurse's initial action be? Tie and cut the umbilical cord Establish an airway for the newborn Ascertain the condition of the uterine fundus Arrange transport for mother and infant to the birthing unit
Establish an airway for the newborn
Which factor does the nurse conclude is directly related to an infant's survival in the neonatal period? Gestational age and birth weight Reproductive history of the mother Parental health habits and social class Adequacy of the mother's prenatal care
Gestational age and birth weight
Which characteristic that may pose a potential nutrition problem should the nurse identify in a preterm neonate? Inadequate sucking reflex Diminished metabolic rate Rapid digestion of formula Increased absorption of nutrients
Inadequate sucking reflex
A newborn who has remained in the hospital because the mother had a cesarean birth is to be tested for phenylketonuria (PKU) on the morning of discharge. How should the nurse explain the purpose of PKU testing to this mother? It detects thyroid deficiency It reveals possible brain damage It identifies chromosomal damage It is used to measure protein metabolism
It is used to measure protein metabolism
A primipara tells the nurse that her baby is breathing very rapidly and that the breaths are irregular. She expresses fear that her baby may be sick and will have to remain in the hospital. What is the nurse's initial action? Assessing the infant and telling the mother that her baby is fine Picking up the infant and telling the mother that the nurses will watch her baby closely Observing the infant's respirations and telling the mother that these respirations are expected Taking the infant to the nursery and returning to tell the mother that the health care provider has been notified
Observing the infant's respirations and telling the mother that these respirations are expected
The nurse is planning to use a newborn's foot to obtain blood for the required newborn metabolic testing. Which part of the foot is the best site to use for the puncture? Big toe Foot pad Inner sole Outer heel
Outer heel
During the second reactive period a newborn becomes more alert and responsive and there is an increase in mucus production and gagging. What should the nurse's initial intervention be? Report this finding Administer nasal oxygen Lower the head of the bassinette Remove secretions from the pharynx
Remove secretions from the pharynx
What is the most common complication for which a nurse must monitor preterm infants? Hemorrhage Brain damage Respiratory distress Aspiration of mucus
Respiratory distress
The primary healthcare provider tells a mother that her newborn has multiple visible birth defects. The mother seems composed and asks to see her baby. What nursing action will be most helpful in easing the mother's stress when she sees her child for the first time? Bringing the infant as requested before she changes her mind Describing how the infant looks before bringing the infant to her Staying with her after bringing the infant to help her verbalize her feelings Showing the mother pictures of the birth defects, then bringing the infant to her
Staying with her after bringing the infant to help her verbalize her feelings
The newborn's total body response to noise or movement is often distressing to the parents. What should the nurse explain about this response? This automatic response probably signifies hunger. This reflexive response is an expected part of development. It is an involuntary response that will remain for the first year of life. It is a voluntary response that indicates insecurity in a new environment.
This reflexive response is an expected part of development.
Phototherapy is prescribed for a preterm neonate with hyperbilirubinemia. Which nursing intervention is appropriate to reduce the potentially harmful side effects of the phototherapy? Covering the trunk to prevent hypothermia Using shields on the eyes to protect them from the light Massaging vitamin E oil into the skin to minimize drying Turning after each feeding to reduce exposure of each surface area
Using shields on the eyes to protect them from the light
At 10 hours of age a newborn has a large amount of mucus in the nasopharynx and becomes cyanotic. What is the nurse's initial action? Suctioning the mouth Administering oxygen Notifying the practitioner Inserting an endotracheal tube
Suctioning the mouth
The health care provider hands a neonate to a nurse immediately after birth. Which is the most appropriate action for the nurse to take next for this newborn? Perform an abbreviated physical assessment Administer oxygen until cyanosis disappears Cut the umbilical cord and attach an umbilical clip Dry the infant and provide skin-to-skin contact with the mother
Dry the infant and provide skin-to-skin contact with the mother
A client is rooming in with her newborn. The nurse observes the infant lying quietly in the bassinet with the eyes open wide. What action should the nurse take in response to the infant's behavior? Brightening the lights in the room Encouraging the mother to talk to her baby Wrapping and then turning the infant to the side Beginning physical and behavioral assessments
Encouraging the mother to talk to her baby
Fetal heart rate tracing abnormalities are observed on the fetal monitor when a client in active labor turns to the supine position. Which nursing action is most beneficial at this time? Helping the client change her position Informing the client of the problem with the fetus Administering oxygen by mask to the client at 2 L/min Readjusting placement of the fetal monitor on the client's abdomen
Helping the client change her position
A nurse performing a newborn assessment elicits the Babinski reflex. What does the nurse conclude that this finding indicates? Hypoxia during labor Neurological injury during birth Hyperreflexia of the muscular system Immaturity of the central nervous system (CNS)
Immaturity of the central nervous system (CNS)
The nurse is performing the nursery intake assessment of a 1-hour-old newborn. The assessment reveals that the newborn's hands and feet are cyanotic, and there is circumoral pallor when the infant cries or feeds. What action should the nurse perform based on these findings? Notify the practitioner, because circumoral pallor may indicate cardiac problems Notify the practitioner, because both signs are indicative of increased intracranial pressure Take no specific action, because both signs are expected in a newborn until 2 weeks of age Take no specific action, because circumoral pallor is an expected finding during feedings and periods of crying
Notify the practitioner, because circumoral pallor may indicate cardiac problems
A nurse who is assessing a full-term newborn elicits the Moro reflex. Which method would the nurse utilize to best elicit this reflex? Touching the infant's cheek Striking the surface of the infant's crib suddenly Allowing the infant's feet to touch the surface of the crib Stroking the sole of the foot along the outer edge from the heel to the toe
Striking the surface of the infant's crib suddenly
A newborn with a myelomeningocele is being transferred immediately from the birthing room to the neonatal intensive care unit (NICU). What is the initial nursing intervention? Start antibiotic prophylaxis Provide routine newborn care Apply a sterile saline dressing Assess the infant for paralysis
Apply a sterile saline dressing
An infant has had surgery for repair of a myelomeningocele. For which early sign of impending hydrocephalus should the nurse monitor the infant? Frequent crying Bulging fontanels Change in vital signs Difficulty with feeding
Bulging fontanels
A client expresses a desire to breast-feed her preterm neonate, who is in the neonatal intensive care unit (NICU). The client states that she will pump her breasts until her baby is ready to breast-feed. The infant has been sucking on a pacifier for 1 week in accordance with protocol. How should the nurse respond to the mother's request? By telling the client that this is unnecessary because the infant is being fed by gavage By discouraging the client because of the time and effort it will take to pump her breasts By instructing the client that breast milk is inadequate because it does not contain the necessary nutrients By supporting the client's decision and explaining that the infant may lie close to her breast for nippling as desired
By supporting the client's decision and explaining that the infant may lie close to her breast for nippling as desired
What should be included in a plan of care to limit the development of hyperbilirubinemia in the breastfed neonate? Encouraging more frequent breastfeeding during the first 2 days Instituting phototherapy for 30 minutes every 6 hours for 3 days Substituting formula feeding for breastfeeding on the second day Supplementing breastfeeding with glucose water during the first day
Encouraging more frequent breastfeeding during the first 2 days
A nurse teaches a new mother about neonatal weight loss in the first 3 days of life. How does the nurse explain the cause of this weight loss? An allergy to formula A hypoglycemic response Ineffective feeding techniques Excretion of accumulated excess fluids
Excretion of accumulated excess fluids
A 1-day-old newborn has just expelled a thick, greenish-black stool. The nurse determines that this is the infant's first stool. What should the nurse do next? Document the stool in the infant's record. Send the stool to the laboratory per protocol. Assess the infant for an intestinal obstruction. Notify the health care provider that a tarry stool has been passed.
Document the stool in the infant's record.
A client asks the nurse what advantage breast-feeding holds over formula feeding. What major group of substances in human milk are of special importance to the newborn and cannot be reproduced in a bottle formula? Amino acids Gamma globulins Essential electrolytes Complex carbohydrates
Gamma globulins
The nurse assesses a fetal scalp monitoring site when admitting a newborn to the nursery. For which complication should the nurse monitor this newborn? Injury Infection Feeding problems Respiratory distress
Infection
A preterm neonate admitted to the neonatal intensive care nursery exhibits muscle twitching; seizures; cyanosis; abnormal respirations; and a short, shrill cry. Which complication does the nurse suspect? Tetany Spina bifida Hyperkalemia Intracranial hemorrhage
Intracranial hemorrhage
A client exhibits oligohydramnios at 36 weeks' gestation. What newborn complication should the nurse anticipate? Spina bifida Imperforate anus Tracheoesophageal fistula Intrauterine growth restriction (IUGR)
Intrauterine growth restriction (IUGR)
A mother is inspecting her newborn girl for the first time. The infant's breasts are edematous, and she has a pink vaginal discharge. How should the nurse respond when the mother asks what is wrong? "You seem very concerned. I don't see anything unusual." "Your baby appears to have a problem. I'll notify the pediatrician." "The swelling and discharge will go away. It's nothing to worry about." "The swelling and discharge are expected. They're a response to your hormones."
"The swelling and discharge are expected. They're a response to your hormones."
The nurse is assessing a newborn for developmental dysplasia of the hip (DDH). Where does the nurse look for extra skinfolds? Calf muscles Popliteal area Back of the thigh Lower portion of the abdomen
Back of the thigh
When changing her newborn's diaper a new mother notes a reddened area on the infant's buttock and reports it to the nurse. How should the nurse best address this mother's concern? Have nursery staff members change the infant's diaper. Use both lotion and powder to protect the involved area. Request that the health care provider prescribe a topical ointment. Encourage the mother to cleanse the area and change the diaper more often.
Encourage the mother to cleanse the area and change the diaper more often.
During a newborn assessment the nurse identifies the absence of the red reflex in the eyes. What should the nurse's next action be? Rinse the eyes with sterile saline Notify the primary healthcare provider Expect edema to subside within a few days Conclude that this is a result of the prescribed eye prophylaxis
Notify the primary healthcare provider
During a vertex vaginal birth the nurse notes meconium-stained amniotic fluid. What is the priority nursing intervention for the newborn? Stimulating crying Suctioning the airway Using an Ambu bag with oxygen support Placing the infant in the reverse Trendelenburg position
Suctioning the airway
