OB Test 2 Practice Questions
The newborn HR is 120, has a weak cry, muscle tone is flaccid, grimaces w bulb suction, and body is pink with blue extremities. APGAR? a) 8 b) 7 c) 6 d) 5
5 [2+1+0+1+1]
A baby born 28 hours ago has yellowish skin, a temperature of 97.3, a respiratory rate of 67, and acrocyanosis. what nursing intervention would the nurse do first? a) Wrap baby in blanket, put cap on head and monitor temperature in 30 minutes b) Initiate feedings c) Give supplemental oxygen d) Call the HCP for indication of pathologic jaundice
a
Which of the following signs would require nursing intervention? a) glucose of 32 b) hands and feet appear blue 2 hours postpartum c) temperature is 99.1 d) blue-black skin discoloration on sacral area
a
Which patient should the nurse see first? a) A 26 hour old neonate who has not yet had a wet diaper b) A 6 minute old baby with an O2sat of 88% c) A 3 day old baby whose birth weight was 3600 g and is now 3250g d) A 16 hour old baby with bluish discoloration of the hands and feet
a
While caring for the newborn, the nurse must be alert for any signs of cold stress. Which finding should the nurse anticipate? a) Increased respiratory rate b) Decreased activity level c) Hyperglycemia d) Shivering
a
A nurse is reviewing contraindications for circumcision with a newly hired nurse. Which of the following conditions are CI's? (SATA) a) hypospadias b) hydrocele c) family Hx of hemophilia d) hyperbilirubinemia e) epispadias
a, c, e
The nurse is assisting a breastfeeding client when she asks how she will know if her baby is getting any milk. Which statements are the priority? SATA a) an audible sound will be heard as your baby is swallowing breast milk b) appears content after feeding and sleeps 4 hours between feedings c) burps loudly once or twice between breasts and when finished d) finishing the feeding in 5 minutes on each breast e) urinates 6-8x/day and has 1-3 bowel movements after day 4
a, e
A 3.8-kg infant was delivered vaginally at 39 weeks after a 30-minute second stage. There was a nuchal cord. After birth the infant is noted to have petechiae over the face and upper back. What information should the nurse provide to the parents regarding the presence of petechiae? a) Should always be further investigated. b) Are benign if they disappear within 48 hours of birth. c) Usually occur with forceps delivery. d) Result from increased blood volume.
b
Following a vaginal delivery, the client tells the nurse that she intends to breastfeed her infant but she is very concerned about returning to her prepregnancy weight. On the basis of this interaction, the nurse would advise the client that: (Select all that apply.) a) She should join Weight Watchers as soon as possible to ensure adequate weight loss. b) Even though more calories are needed for lactation, typically women who breastfeed lose weight more rapidly than women who bottle feed in the postpartum period. c) If breastfeeding, she should regulate her fluid consumption in response to her thirst level. d) If she decreases her calorie intake by 100-200 calories a day she will lose weight more quickly. e) Weight loss diets are not recommended for women who breastfeed.
b, c, e
When a mother is considering breastfeeding, the nurse would educate the patient on which of the following benefits? a) Decreased acne in mother b) Reduced risk of SIDS c) Reduced risk of Type II Diabetes and increased weight loss for the mother d) Reduced risk of developing autism in child e) Reduced risk of clinical asthma for the child
b, c, e
A new client asks, "Why are you doing a gestational age assessment on my baby?" The nurse's best response is: a. "It was ordered by your physician." b. "This is done to accurately determine the gestational age of your newborn" c. "It helps us identify infants who are at risk for any problems." d. "The gestational age determines how long the infant will be hospitalized."
c
A nurse is assessing a client who is 12 hours postpartum. Which finding would be a source of concern if observed by the nurse? a) Bradycardia—pulse rate of 55 beats/min b) Postural hypotension c) Pain in left calf with dorsiflexion of left foot d) Temperature of 38° C
c
G8 P4 client just delivered baby Charlie at 0623. What is the nurse's initial action? a) clamp and cut the cord b) apply erythromycin ointment to both eyes c) dry and place a cap on his head d) obtain hand and foot prints
c
Who would the nurse see first after receiving report? a) a 27 hr old baby boy who has just developed jaundice b) A 1 day old baby who has a glucose of 45 c) A baby that has blue tint to the chest and lips d) A baby who turns their head when a person touches their cheek
c
A 3 hour old baby who was born at term has a respiratory rate of 64. At this time, what other findings might be present? a) meconium hasn't. passed yet b) HR of 85 c) increased muscle tone d) decreased mucous production
c (this is the 2nd period of reactivity)
The nurse has received a shift report on a group of newborns. The nurse should make rounds on which client first? a) Newborn who is LGA and needs a repeat BG prior to the next feeding in 15 mins b) Neonate born at 36 wks gestation weighing 5 lb and due to breastfeed for the first time in 15 mins c) neonate born 24 hrs ago by c/s and had a RR of 64 approximately 30 mins ago d) newborn who had a Temp of 97.6F and was double wrapped with a hat on 30 mins ago to bring up the temperature
c - abnormal RR. answer using ABC's
Which of the following would effect a mother's ability to breastfeed? a) current pregnancy b) breast size c) breast cancer d) breast reduction e) obesity
c, d, e
A 1 wk postpartum mother calls the unit to inquire about a tender, hard area on her left breast. What is the nurse's initial response? a) this is a normal response at 1-week b) notify the HCP c) stop breastfeeding because you probably have an infection d) try massaging the area and applying heat packs before feeding, and cold packs after
d
A 24 week, 7 hour old pre-term infant is in the second stage of reactivity. The infant's mother is concerned that her child has not yet passed a meconium stool. What is the proper response of the nurse? a) Reassure mom that this usually does not occur until 3 days - everything is fine. b) The baby probably has Hirschsprung's disease - we need a STAT rectal biopsy c) Tell the mother that she will call the HCP as this is abnormal d) Reassure the mother that since her infant is premature that he may not experience this phase
d
On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. What is the first action to be taken by the nurse? a) Call the woman's primary health care provider. b) Begin an IV infusion of Ringer's lactate solution. c) Assess the woman's vital signs. d) Massage the woman's fundus.
d
While evaluating the reflexes of a male newborn, the nurse notes that with a loud noise, the newborn symmetrically abducts and extends his arms, his fingers fan out and form a "C" with the thumb and forefinger, and he has a slight tremor. The nurse documents this finding as a positive: a) Glabellar (Myerson) reflex response b) Babinski reflex response c) Tonic neck reflex response d) Moro reflex response
d
A client is concerned because her 1 day old son. who was very alert at birth is now sleeping most of the time. The best nursing response would be: a) most infants are alert at birth and then require deep sleep to recover from the birth experience b) your son's behavior is slightly abnormal and bears careful observation c) would you like the pediatrician to check him to ease your mind? d) your son's behavior is definitely abnormal and we should keep him in the nursery
a
When developing a nursing care plan for an infant receiving phototherapy, the nurse should include what information? (SATA) a) adequate skin exposure to phototherapy b) allowing mother to hold infant as much as she wishes c) eye protection d) supplemental water between feedings e) thermoregulation f) supplement formula for breastmilk
a, c, e
A client has just delivered a healthy 7 lb baby boy. The physician instructs the nurse to suction the baby. The procedure the nurse uses is to: a) suction the nose first b) suction the mouth first c) suction neither the nose nor mouth until the physician gives further instructions d) turn the baby on his side so mucus will drain out before suctioning
b
When would be appropriate to complete baby Charlie's first physical exam? a) at one hour of age, as soon as immediate care is completed b) at 4 hours of age with an axillary temp of 98.8F c) at 36 hours of age upon discharge d) at 4 weeks old
b
A nurse is discussing with an obese client potential long-term consequences of infant feeding practices. Which method should the nurse identify to the client as having a decreased risk for the development of childhood obesity for the infant? a) Lower-calorie infant formula. b) An on-demand feeding schedule. c) Breastfeeding. d). Smaller, more frequent feedings.
c
A nurse is examining a newborn male, who is estimated to be 39 weeks of gestation. Which physical finding should the nurse anticipate to be present? a) Abundant lanugo over his entire body. b) Ability to move his elbow past his sternum. c) Testes descended into the scrotum. d) Extended posture when at rest.
c
A nurse is placing a newborn under a radiant heat warmer for temperature stabilization. Which action should the nurse include during this procedure? a) Cover the probe with a non-reflective material. b) Recheck temperature by periodically taking a rectal temperature. c) Perform all examinations and activities under the warmer. d) Place the thermistor probe on the left side of the chest.
c
Baby boy Tiger was delivered at 1012 am. After reviewing the EHR, what is the nurse's initial action?? EHR 1012 am: spontaneous vaginal delivery of viable male infant. Infant umbilical cord clamped and cut per HCP. Infant placed on a warm blanket on mother's chest. a) suction the nose b) take the infant to the overhead warmer c) begin chest compressions d) vigorously dry the infant
d
What statement from the mom indicates proper education on cord care? SATA a) "I will give my baby a bath every day" b) "I will fully submerge my baby in the sink during bath time." c) "I will use mild soap and water to wash my baby's cord." d) "I will call the doctor if I notice any drainage from the cord" e) "I will completely dry the cord after bathing my baby."
c, d, e
A nurse is completing an assessment. Which of the following data indicate the newborn is adapting well to extrauterine life? (SATA) a) expiratory grunting b) inspiratory nasal flaring c) apnea for 10-second periods d) obligatory nose breathing e) crackles and wheezing f) bluish color to lips g) RR of 52
c, d, g
A group of nursing students are reviewing the process of bathing for a newborn. Which statement should the nursing students identify as being incorrect? a) Tub baths may be given before the infant's umbilical cord falls off and the umbilicus is healed. b) Only plain warm water should be used to preserve the skin's acid mantle. c) Powders are not recommended because the infant can inhale powder. d) Newborns should be bathed every day, for the bonding as well as the cleaning.
d
A nurse caring for a newborn should be aware that the sensory system least mature at the time of birth is: a) Hearing. b) Taste. c) Smell. d) Vision.
d
A nurse is monitoring a healthy newborn's blood glucose level 90 minutes after birth. Which result should the nurse anticipate in terms of mg/dL? a) 80 to 100 b) 60 to 70 c) Less than 40 d) 55 to 60
d
On assessment of a post c-section neonate, the nurse notes fine crackles when listening to the baby's lungs. What should the nurse's next action be? a) bulb suction mouth and nose b) provide supplemental oxygen c) notify the health care provider d) document the finding and continue to monitor the neonate
d
When the mother of a new baby asks the nurse to feed her baby the most appropriate response is to say: a) ill feed him today. maybe tomorrow you can try b) its not difficult at all. He is just like a normal baby, only smaller c) you can learn to feed him as well as I can; i wasn't good when I first fed a premature infant either d) its frightening sometimes to feed an infant this small, but ill stay with you to help
d
when assessing a neonate 1 hour after birth, the nurse notes acrocyanosis of both feet and hands, measures an axillary temp of 95.5 F, an apical pulse of 110 bpm, and a RR of 64. Which assessment would be the most concerning for the nurse? a) bradypnea b) tachycardia c) hypoxia d) hypothermia
d
A mother expresses fear about changing her infant's diaper after he is circumcised. What should the nurse teach the mother about providing caring for the infant upon discharge? a) Cleanse the penis gently with water and put petroleum jelly around the glans after each diaper change. b) Apply constant, firm pressure by squeezing the penis with the fingers for at least 5 minutes if bleeding occurs. c) Cleanse the penis with prepackaged diaper wipes every 3 to 4 hours. d) Wash off the yellow exudate that forms on the glans at least once every day to prevent infection.
a
A nurse is preparing to weight a newborn. Which action should the nurse include as part of the procedure? a) Weigh the newborn at the same time each day for accuracy. b) Place a sterile scale paper on the scale for infection control. c) Keep a hand on the newborn's abdomen for safety. d) Leave its diaper on for comfort.
a
A nurse is reviewing best practice for placing an infant to breast following birth. What timeframe should the nurse identify as representing a Baby-friendly hospital mandate? a) 1 hour b) 30 minutes c) 4 hours d) 2 hours
a
A nurse must administer erythromycin ophthalmic ointment to a newborn after birth. Which action should the nurse include when administering the medication? a) Cleanse eyes from inner to outer canthus before administration if necessary. b) Flush eyes 10 minutes after installation to reduce irritation. c) Apply directly over the cornea. d) Instill within 15 minutes of birth for maximum effectiveness.
a
A primigravida patient is 36hrs post-partum and is complaining that she does not feel like she is producing enough breast milk. What should the nurse tell the patient? a) Schedule a lactation consult b) Inform her this is normal c) Tell her to bottle feed with formula d) Assess newborn for tongue-tie and rooting reflex
a
A well baby nurse is assigned three patients, which one should she see first? a) 36 hour old C/S neonate with a high pitched cry b) 2 hour old neonate with a respiratory rate of 60 c) 6 hour old neonate with a temperature of 99.0 d) 24 hour old neonate with acrocyanosis
a
EHR: APGAR 9/10. Excessive saliva noted, infant mouth and nose suctioned with bulb syringe. Temp: 97.8F, pulse 156 and then 168. RR 48 and then 52. O2 sat 72% and then 89%. Based on the EHR, what is the nurse's priority action? a) allow mother and infant to bond b) give infant O2 at 10 L/min c) administer vitamin K injection d) perform oropharyngeal suctioning
a
Following birth, the nurse assigns an Apgar score of 10 at 1 minute to a newborn. How would the nurse explain this score? a) An infant having no difficulty adjusting to extrauterine life but who should be assessed again at 5 minutes after birth. b) An infant having no difficulty adjusting to extrauterine life and needing no further testing. c) A prediction of a future free of neurologic problems. d) An infant in severe distress that needs resuscitation.
a
The maternity nurse must be cognizant that cultural practices have significant influence on infant feeding methods. Which statement should the maternity identify as correct? a) A common practice among Mexican women is known as las dos cosas. b) Muslim cultures do not encourage breastfeeding because of modesty concerns. c) Latino women born in the United States are more likely to breastfeed. d). East Indian and Arab women believe that cold foods are best for a new mother.
a
The mother is inquiring about how long and how frequent she should be breast feeding her 24 hour old infant. What is the nurses best response? a) The newborn should be fed every 2-3 hours for at least 15 minutes b) Smaller breasted women should feed their infants longer than larger breasted women. c) The newborn should be fed every 4 hours for as long as it is still feeding. d) The newborn should only be fed when showing cues of hunger.
a
The nurse examines a woman 1 hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. What is the nurse's initial action? a) Massage her fundus b) Place her on a bedpan to empty her bladder c) Administer methylergonovine (Methergine), 0.2 mg IM, which has been ordered prn d) Call the physician
a
The nurse is assessing the respiratory system of a newborn. Which statement should the nurse be aware of with regard to the respiratory development of the newborn? a) Crying increases the distribution of air in the lungs. b) Seesaw respirations are no cause for concern in the first hour after birth. c) Newborns must expel the fluid at uterine life from the respiratory system within a few minutes of birth. d) Newborns are instinctive mouth breathers.
a
The nurse is providing discharge instructions related to the baby's respiratory system. Which statement should the nurse not include as part of discharge teaching? a) Don't let the infant sleep on his or her back. b) Avoid loose bedding, waterbeds, and beanbag chairs. c) Prevent exposure to people with upper respiratory tract infections. d) Keep the infant away from secondhand smoke.
a
Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. What clinical finding should the nurse expect? a) Hematoma formation b) Uterine atony c) Constipation d) Bladder distention
a
Upon assessment, the nurse finds that the neonate's temperature is 97.3 F and respirations are 70. Which of the next following findings would be the most concerning? a) Glucose of 22 b) Baby having 2 bowel movements in the last 24 hours c) Baby showing hunger cues to breastfeed every 2 hours d) HR of 130 bpm
a
The nurse is observing a postpartum client who has been bleeding excessively during the first hour, saturating multiple pads. Which interventions would the nurse anticipate that the physician would order? (Select all that apply.) a) Administer oxygen via nonrebreather mask @ 10 L/minute b) Insert a secondary intravenous line access c) Document findings in the health care record d) Type & screen for 2 units of blood e) Decrease flow rate for intravenous fluid administration
a, b
Which of the following are true regarding breastfeeding? Select all that apply. a) Feedings should last 15-20 minutes per breast b) The infant should be fed every 2-3 hours. c) It is okay for the mother to have a moderate amount of caffeine while breastfeeding. d) The mother cannot breastfeed within 90 minutes of smoking. e) The mother should make her first attempt at breastfeeding 90 minutes after birth.
a, b, c *first attempt should be made w/in an hour after birth *mom should not BF w/in 2 hours after smoking, not 90 mins
A graduate nurse is explaining how to assess newborn jaundice and the effects of phototherapy. Which statements are correct? (SATA) a) phototherapy treatment can increase the risk of dehydration b) it is best to observe for jaundice in the conjunctival sac or oral mucosa c) the neonate will be irritable from the elevated bilirubin in the system d) i will monitor the unconjugated bilirubin carefully as it is the dangerous one e) i will carefully record the neonates intake as limiting fluids is helpful
a, b, d
Despite placing a newborn skin-to-skin on the mother at delivery, the infant's temp is 96.4F. Which initial actions should be implemented? (SATA) a) placing a knit hat on the baby b) drying the baby well c) place the baby in an incubator d) use an overbed warmer e) wrap the infant in warmed blankets f) provide warmed IV fluids
a, b, e
The pediatric nurse is being pulled to the nursery for the day. Which three neonates are the best client care assignment for the pediatric nurse? (Select all that apply) a) a 4 hr old with a bluish appearance of the hands and feet b) a recent admission with APGAR score of 8 & 10 c) a 2 day old who has not passed a meconium stool d) a 1 day old with cleft palate and lip e) an 18 hour postterm breastfed neonate with jaundice f) a 1 day old with caput succedaneum
a, b, f
The nurse is providing discharge planning to a primipara patient with a 4 day old baby. What should the nurse tell the patient that warrants a call to her healthcare provider? Select all that apply. a) 2 consecutive green watery stools b) one stool a day while formula feeding c) high pitched cry d) 7 wet diapers per day e) forceful regurgitation after feedings f) axillary temperature of 98.0F
a, c, e
A mother who is HIV positive is really excited to breastfeed and is asking when she can begin. What is the nurse's best response? a) Why would you ask me that? You don't want to infect your baby do you? b) Due to your HIV positive diagnosis, it is unsafe for you to breastfeed. Formula feeding is a great alternative. c) Immediately! The baby needs to feed within an hour after birth d) Once you're established on your HIV medication therapy, then you can breastfeed.
b
A nurse administers Vitamin K to the newborn post delivery. The nurse understands that the reason for this medication to be given is? a) Reduce bilirubin levels. b) Enhance the ability of blood to clot. c) Stimulate the formation of surfactant. d) Increase the production of red blood cells.
b
A nurse examining a newborn infant notes that the infant is jaundiced. Which observation would lead the nurse to continue to monitor but not to intervene and contact the physician? a) Infant is being bottle fed and within the first 24 hours of life. b) Jaundice appeared on the third day of life. c) Jaundice appeared within the first 24 hours of life. d) Preterm infant who is 12 hours old.
b
A nurse is providing umbilical cord care to a newly delivered infant. What information should the nurse be aware of? a) The cord clamp is removed at cord separation. b) The stump can easily become infected. c) The average cord separation time is 5 to 7 days. d) A nurse noting bleeding from the vessels of the cord should immediately call for assistance.
b
A nurse is reviewing the concept of weaning with regard to infant care. Which statement should the nurse identify as correct? a) Abrupt weaning is easier than gradual weaning. b) Weaning can be mother or infant initiated. c) Weaning should proceed from breast to bottle to cup. d) The feeding of most interest should be eliminated first.
b
A nursing student is reviewing concepts related to infant feeding. Which statement should the nurse identify as being correct concerning tandem feeding? a) Supplementing breastfeeding with bottle feeding to maintain adequate weight gain. b). Breastfeeding an infant and an older sibling during the same period. c) Using both breasts to nurse the baby. d) Adequate nutritional stores for the mother and infant.
b
EHR: 4 hour old neonate. RN at bedside. Newborn skin appears pale. O2 sat 75%, BG 35 Based on the EHR, what should the nurse do? a) increase IV rate b) provide supplemental O2 c) record the finding on the medical record and repeat the reading in 30 mins d) wrap the neonate to increase body temperature
b
EHR: Rn at bedside. Newborn noted to have expiratory grunting, occasional nasal flaring, and acrocyanosis. Client asks, "Do you think my membranes being ruptured 26 hours before birth has to do with him acting like this?" Vital signs: Temp: 98F, RR: 66; The infant is 20 hours old, 7lbs 1 oz After reading the EHR, what nursing actions are most indicated? a) continue recording vitals, voiding, stooling, and eating patterns q.4 hrs b) place a pulse ox and contact the HCP for a Rx to draw blood cultures c) arrange a transfer to the NICU with a diagnosis of possible sepsis d) draw a CBC with differential and feed the infant
b
EHR: spontaneous vaginal delivery of viable male infant. Infant umbilical cord clamped and cut per HCP. Infant placed on warm blanket on mother's chest. RN vigorously dries infant with warm blanket. Infant noted to have a strong cry, good flexion of extremities, cries when using bulb suctioning, blue, pale. APGAR 8/10. Cap and diaper placed on infant. Infant...__________________________________ Fill in the blank based on the EHR a) wrapped in warm blankets and given to partner b) placed skin to skin on mother's chest c) taken to overhead warmer for physical assessment d) placed in bassinet and taken to well baby nursery
b
Of these 4 babies born at full-term and healthy, which has the best chance of not getting sick? a) baby Will who is fed infant formula by bottle exclusively b) baby Baylee who is breastfed and never given other liquids c) baby Hannah who is breastfed and given sips of herbal tea d) baby Evie who is breastfed with formula supplementation
b
The birth weight of a breastfed newborn was 8 lb, 4 oz. On the third day the newborn's weight is 7 lb, 12 oz. Which action should the nurse take based on this finding? a) Notify the physician because the newborn is being poorly nourished. b) Encourage the mother to continue breastfeeding because it is effective in meeting the newborn's nutrient and fluid needs. c) Suggest that the mother switch to bottle feeding because breastfeeding is ineffective in meeting newborn needs for fluid and nutrients. d) Refer the mother to a lactation consultant to improve her breastfeeding technique.
b
The newborn infant was discharged 9 days ago. The child was born at 39 weeks and weight 8 pounds. when should mom call the pediatrician? a) Infant is spitting up after eating and burping b) umbilical cord area is red with purulent drainage after bathing the baby c) Infant is having 7 wet diapers per day d) Stool is mustard colored with a cottage cheese consistency.
b
The nurse is assigned to care for a 2 hour old newborn in an isolette. she checks the temp of the isolette knowing the temp is too high if the infant: a) pulse is decreased b) temperature is 101 F rectally c) temperature is 99.4F rectally d) respirations are decreased
b
The nurse is speaking with a new mom about breastfeeding. Which statement from the mother indicates understanding? a) "I should stop breastfeeding when my baby decides that it is time." b) "If my nipples become cracked or start bleeding, I should consult a lactation consultant." c) "I should begin feeding when my baby starts crying." d) "I need to use both breastmilk and formula in order for my baby to grow."
b
Which infant is at greatest risk to develop cold stress? a) full term infant delivered vaginally w/o complications b) 36 wk infant w Apgar score of 7 at 5 mins c) 38-week female infant delivered via c/s because of cephalopelvic disproportion d) term infant delivered vaginally with epidural anesthesia
b
After receiving change of shift report in the newborn nursery, the nurse should see which neonate first? a) 3 hr old w increased respiratory secretions b) 6 hr old with BG of 25 c) 12 hr old w temperature of 97.4F d) 24 hr old with no urine output for the past 12 hrs
b normal: 40-60 *c - anything below 97.6 is concerning, but the BG is more concerning *d - we dont know # of wet diapers before this
Based on periods of reactivity, what should the nurse encourage the mother of a term neonate to do approximately 90 minutes after birth? a) feed the neonate b) allow the neonate to sleep c) get to know the neonate d) change the neonates diaper
b - at this point they are most likely in the period of decreased responsiveness *baby should be fed w/in 1 hour of age
The nurse assesses a 15-hour-old infant and finds jaundice. What is the priority action the nurse needs to take? a) continue with the normal newborn exam b) notify the HCP of the finding c) provide an extra feeding for the infant d) wait and assess skin color when the infant is over 24 hours old
b - pathologic jaundice
A nurse is reviewing possible etiologies for hyperbilirubinemia in the newborn. Which findings would the nurse expect to lead to increased bilirubin levels in the newborn? (Select all that apply.) a) Cord clamped immediately following delivery of newborn b) Initiation of newborn feedings delayed following birth c) Twin-to-twin transfusion syndrome d) Hyperglycemia e) Meconium passed after 24 hours
b, c, e
Which mom should we instruct not to breastfeed? Select all that apply. a) Mom that just found out she is pregnant b) Mom with HIV positive c) Mom with multiples d) Mom with extremely small breasts e) Mom with active TV, whose undergoing treatment f) Mom who had a bottle of wine an hour ago.
b, e, f
A nurse observes a postpartum client to have excessive blood loss. Which cause should the nurse identify as being the most common cause for this finding? a) Unrepaired lacerations of the vagina or cervix. b) Vaginal or vulvar hematomas. c) Failure of the uterine muscle to contract firmly. d) Retained placental fragments.
c
The nurse completed discharge teaching with new parents who are bottle feeding newborn. Which statement by the parents indicates successful teaching? a) our baby will require feedings through the night for the first week after birth b) the baby should burp during and after each feeding with projectile vomiting c) our baby should have at least one soft, formed stool per day d) we should weigh our baby daily to make sure he is gaining weight
c
Upon discharge, a new mother is using the teach back method to explain her knowledge of breastfeeding. What statement made by the mother would indicate a need for further teaching? a) "I will alternate breasts and feed for at least 15 minutes each time" b) "Even if my baby is sleeping, I will wake my baby and feed them roughly every 2 hours" c) "I will breastfeed and use supplemental formula feedings to ensure my baby is getting enough nutrients" d) "I will support my baby's head during feedings"
c
Which neonate should the nurse see first? a) 4 day old with 5 wet diapers in a 24 hour period b) 24 hour old who has passed one stool c) 36 hour old neonate with respirations of 68 and glucose of 35 d) infant with periods of apnea for 20 seconds at a time
c
A nurse is performing a neurologic assessment on a 1 day old neonate in the nursery. Which findings indicate possible asphyxia in utero? SATA a) the neonate grasps the nurse's finger when put in the palm of the neonate's hand b) the neonate does stepping movements when held upright w the sole of the foot touching a surface c) the neonate displays weak, ineffective sucking d) the neonate does not respond when the nurse claps her hands e) the neonate turns toward the nurse's finger when touching the cheek f) the neonate's toes do not curl downward when the soles of the feet are touched
c, d
A 24-year-old primipara says, "I am worried that I will not be able to breastfeed my baby because my breasts are so small" What is the best response? a) breast milk can be enhanced by occasional formula feeding b) the woman's motivation to breastfeed is important c) because her breasts are small, she will have to feed the baby more often d) breast size poses no influence on a woman's ability to breastfeed a baby
d
In assessing a newborn infant, the nurse knows that postmature infants may exhibit: a) heavy vernix, little lanugo b) large size for gestation age c) increased subcutaneous fat, absent creases on feet d) small size for gestation age
d
The nurse helps a breastfeeding mother change the diaper of her 16-hour-old newborn after the first bowel movement. The mother expresses concern because the large amount of thick, sticky stool is very dark green, almost black. She asks the nurse whether something is wrong. Which of the following would be the best response offered by the nurse? a) Telling the mother not to worry because all breastfed babies have this type of stool. b) Asking the mother what she ate for her last meal. c) Suggesting to the mother that she ask her pediatrician to explain normal newborn stooling patterns to her. d) Explaining to the mother that this stool is called meconium and is expected for the first few bowel movements of all newborns.
d
Which infant should the nurse see first? a) A LGA baby who finished feeding 25 minutes ago b) A 48 hour old baby awaiting discharge and the mother needs education c) A baby who 30 minutes ago had a temp of 97.4 and was placed on mom's chest. d) An awake 6 hour old newborn with a respiratory rate of 26
d *if they are awake, the RR should be higher
