Week 1 Practice Questions
A patient in the early postpartum period asks, "How do I know if my baby is getting enough breast milk? I don't feel anything there." What are the desirable outcomes?
"A good way to tell if your baby is taking in enough breast milk is if you continue to see enough wet and soiled diapers." Monitoring newborn output is an important component when assessing whether intake is adequate. "If your baby is gaining weight with each checkup at the pediatrician, it usually means your baby is getting enough breast milk." Adequate weight gain is the single most important consideration when determining whether breastfeeding is successful. "If your baby actively participates in a feeding, you can hear swallowing and your baby seems content in between feeding. These are all signs that your baby is satisfied with the quantity of breast milk your body is producing." Swallowing and satiation are signs that the newborn is effectively transferring milk from the breast with feeding. "When your milk comes in, your breasts will feel full and most women will feel a milk letdown. This is a good sign that your body is producing enough breast milk for your baby." Feelings of fullness in the breast and the sensation of letdown occur when mature milk forms in the breasts. These are signs that breastfeeding is going well and that milk supply is likely adequate.
Which parental statement indicates a need for further sleep safety education?
"I cover my baby with a warm quilt at night." Babies should not use heavy quilts or blankets due to the risk for suffocation. This statement indicates a need for further education.
Which parental statement would the nurse interpret as indicating a need for further education about newborn body processes?
"I will check my baby's temperature in his bottom when he is sick." Rectal temperatures are not the preferred method of measuring temperature because there is a risk for injury. Parents should measure their baby's temperature by placing the thermometer high in the armpit (without causing pain) and holding the arm down. This parental statement indicates to the nurse that further education is needed.
Which parental statements about umbilical cord care would the nurse interpret as indicating a need for further education?
"I will pull off the stump in a few days to keep it from getting infected." The stump should not be pulled off; it will fall off without assistance within 10 to 14 days. The nurse would interpret this statement as indicating a need for more education. "I need to apply petroleum jelly to the cord with every diaper change." Petroleum jelly should not be applied to the umbilical cord. The nurse would interpret this statement as indicating a need for more education. "I should buy diapers one size larger to prevent irritation around the cord." Parents should be taught to fold appropriately sized diapers to prevent contaminating the cord with urine. The nurse would interpret this statement as indicating a need for more education. "I need to clean around the cord with alcohol swabs whenever I change the diaper." The cord should be cleaned at the base (where it meets the skin) with water daily. The nurse would interpret this statement as indicating a need for more education.
A patient with nipple soreness asks the mother-baby nurse what she can do to help alleviate the discomfort. Which solution would the nurse generate to help this patient?
"Some women find that lanolin cream is helpful for soreness. You apply the cream following a feed. You can also leave your nipples open to air when you're not feeding." Lanolin cream is an evidence-based remedy for sore nipples. Leaving the breasts open to air between feeds also has been shown to alleviate discomfort and promote nipple healing.
Which recommendations would the nurse make to the family whose newborn falls asleep after 2 to 3 minutes of breastfeeding?
"The baby needs to be awakened, so unwrap the newborn and gently stroke his palms or soles." Newborns who fall asleep shortly after beginning the feeding need to be woken up to feed properly. Unwrapping and gently stroking the newborn will help to awaken for feeding. "Change the newborn's diaper to wake your newborn up." Changing the diaper is a useful strategy for awakening a sleepy newborn for feeding.
Which education would the nurse provide a mother who reports latch difficulty with breastfeeding?
"Wait until the mouth is open wide to insert the nipple into the newborn's mouth." The mother should be taught that if the mouth is not open wide before the nipple is inserted, it is more difficult for the newborn to get sufficient milk and can cause nipple pain.
Which education would the nurse provide the mother of a newborn and 2-year-old who expresses concern about the baby's sleep schedule?
"Your baby will not be disturbed by other children during quiet sleep." During quiet sleep, the newborn is not disturbed by noise.
Match the phases of lactogenesis with the description of the type of milk produced during that phase: Lactogenesis III
20 kcal/oz with nutrients sufficient to meet newborn's needs
The nurse would anticipate _____ number of feedings for a 5-day-old breastfed baby to have in 24 hours.
8-12 Nurses need to understand typical feeding frequency and volume for breastfed infants. Breastfed infants would be fed approximately every 2-3 hours (8-12 feedings per 24 hours).
Which statements regarding the assessment of newborn vital signs are accurate?
A heart rate of 146 beats/min is normal. The normal newborn heart rate ranges from 120 to 160 beats/min. A blood pressure of 70/48 is normal. While not routinely measured, normal newborn blood pressure ranges from systolic 65 to 95 mm Hg and diastolic 30 to 60 mm Hg. Respiratory rate and heart rate are assessed for a full minute. Respiratory rate and heart rate are routinely assessed for a full minute to account for variability.
Which characteristic of newborns necessitates the administration of vitamin K at birth?
Absence of intestinal flora Intestinal flora needed to produce vitamin K are absent in the first week after birth. Vitamin K is administered at birth to activate clotting factors and decrease the risk for hemorrhagic disease.
Match the infant state with the description of interactions that parents might expect: Signaling for a change, consider feeding or repositioning
Active alert
Match the infant state with the description of interactions that parents might expect: Easy to awaken, feeding likely unsuccessful
Active sleep
Which intervention would the nurse implement for a 10-minute-old healthy newborn?
Administer vitamin K. Newborns are born without clotting factors. Vitamin K is necessary for clotting factor production to prevent bleeding disorders. The nurse would administer the vitamin K first to prevent excessive bleeding.
Which nursing intervention is aimed at preventing ophthalmia neonatorum?
Administration of erythromycin ointment Erythromycin ophthalmic ointment is administered to newborns as prophylaxis against Neisseria gonorrhoeae, which may cause ophthalmia neonatorum.
Which assessments would the nurse include during the initial assessment of a newborn after birth?
Airway patency The nurse would assess the airway patency of the newborn; if the airway is not patent, resuscitation or immediate intervention is needed. Heart sounds The nurse would assess the heart sounds of the newborn (heart rate, rhythm, and whether murmur is present) to determine whether resuscitation or immediate intervention is needed. Color The nurse would assess the color of the infant. If not pink, the infant may require resuscitation or immediate intervention.
Which care would the nurse provide for an infant with macrosomia?
Assess for birth trauma. Macrosomia, or an infant who is large-sized, increases the likelihood of birth trauma such as clavicle fracture or brachial plexus injury; therefore the nurse would assess for such injuries. Monitor thermoregulation. Infants with macrosomia are at risk for thermal dysregulation due to large body surface area. Educate families on proper handling. The infant may be large but is also physiologically immature; therefore the nurse educates families on proper handling.
Which action would the nurse take first when caring for a newborn with poor muscle tone, low temperature, and lethargy?
Assess the newborn's blood glucose. Poor muscle tone, low temperature, and lethargy are signs of hypoglycemia. The nurse should assess the blood glucose and send findings to the health care provider.
Which nursing interventions would the nurse perform immediately after birth to support the healthy newborn's respiration and thermoregulation?
Skin-to-skin contact Placing the infant on the mother's bare chest or abdomen promotes airway patency and thermoregulation. Clear secretions Clearing secretions (wiping and/or suctioning if needed) helps support respiration. Drying Drying the infant's skin with vigorous rubbing promotes thermoregulation by preventing evaporative heat loss. It also promotes respiration through tactile stimulation. Warming Placing a hat on the newborn and covering the mother and newborn with a warm blanket promote thermoregulation.
Which neonatal infection would the nurse suspect in a neonate with vesicular or pustular lesions?
Staphylococcus aureus Staphylococcus aureus is associated with vesicular or pustular lesions. Bullae may develop with clear or purulent fluid.
Match the reflex being assessed with the picture: Babinski
Stroke lateral sole of foot from heel to across base of toes. Toes flare with dorsiflexion of the big toe.
Which infant actions are common cues indicating a readiness to feed?
Sucking Sucking is a common feeding cue. Rooting The rooting reflex is a common feeding cue characterized by the newborn turning and rooting with the mouth when the cheek or lip is touched. Mouthing Mouthing is a common feeding cue characterized by the newborn sucking when the mouth is stimulated. Hand-to-mouth movements Hand-to-mouth movements are a common feeding cue characterized by bringing hand(s) to the mouth.
Which factors are likely to support breastfeeding as the family's feeding method choice?
Support from family Support and encouragement from family and friends is a major influence on feeding method choice and has been shown to increase breastfeeding choice. Cultural practices Cultural practices are highly influential on feeding method choice. Duration of breastfeeding is also highly influenced by culture. Health care provider knowledge Health care provider breastfeeding knowledge is highly influential on the choice to breastfeed because the health care provider may assist with establishing breastfeeding, troubleshooting common challenges, and sharing advantages of breastfeeding.
Which safety education would the nurse provide the parent of a newborn?
Support the newborn's head by keeping a hand behind the head and neck when holding. Newborns have underdeveloped neck muscles and require continuous head support.
Which action would the nurse take for a breastfeeding mother who is afebrile but reports erythema and tenderness over her right breast?
Teach breast massage technique. The patient's symptoms indicate a plugged mammary duct. The nurse would teach the mother to massage the breast to relieve pain and unplug the milk duct.
Which cue would the nurse explain is given by nonnutritive sucking during breastfeeding?
The breast is empty. The nurse would explain that nonnutritive sucking indicates the breast is empty. Families would be taught to remove the infant from the breast, burp, and consider switching to the other breast.
Which interventions would the nurse implement for a breastfed newborn who has lost 8% of his or her birth weight?
Weigh the infant daily using same scale. Weighing the infant daily at the same time of day with the same scale ensures accurate measurement and tracking of weight loss. Evaluate feeding technique and positioning. The nurse would evaluate the mother's feeding technique and positioning to assist with establishing effective feeding. Demonstrate waking techniques for feeding a sleepy baby. The nurse would demonstrate techniques for waking a sleepy baby to encourage effective breastfeeding. Evaluate the newborn suck and latch. The nurse would evaluate the newborn suck and latch to ensure effective breastfeeding.
When teaching about infant feeding cues in the first days of life, which solution can the nurse consider to encourage the best time to initiate breastfeeding?
When the infant is in the quiet alert state During the quiet alert state, the newborn is observing the world, and the newborn is calm and relaxed. This is an optimal time to initiate a feeding.
In which way does breast milk composition vary from formula?
Whey-to-casein ratio is 70:30 Breast milk has a ratio of whey-to-casein of 70:30 whereas formula has a ratio of 80:20; the whey-to-casein ratio in breast milk leads to easier digestion and softer stools compared to formula.
Which newborn assessment finding is considered a normal variant?
Caput succedaneum Caput succedaneum is an area of edema to the newborn's head as a result of labor; it is considered a normal variant.
Match the nutrient to its description with respect to breast milk or formula: Lactose is the primary source
Carbohydrate
Which nursing interventions are appropriate for an infant experiencing withdrawal?
Cluster care to minimize handling. Clustered care to minimize handling is an appropriate intervention for an infant experiencing withdrawal; infants are easily startled and distressed. Reduce environmental stimuli. Reduction of environmental stimuli, such as lights or noise, is appropriate to avoid startling or distressing the infant experiencing withdrawal. Offer nonnutritive sucking. Nonnutritive sucking is appropriate because it is soothing for infants experiencing withdrawal.
Which type of commercial formula requires dilution with equal parts water?
Concentrate Concentrate formula requires dilution with equal parts of formula and water.
Match the method of heat loss with the nursing action that would prevent it: Place a blanket between the newborn and the examination table.
Conduction
Match the method of neonatal heat loss with its description: Heat loss from direct contact with cool surfaces
Conduction
Match the phases of lactogenesis with the description of the type of milk produced during that phase: Lactogenesis II
Contains mix of colostrum and mature milk
Match the method of heat loss with the nursing action that would prevent it: Move the crib away from air vents
Convection
Match the method of neonatal heat loss with its description: Heat loss from body surface exposure to cooler ambient air
Convection
Which type of commercial infant formula is recommended for most infants?
Cow's milk-based formula Iron-fortified cow's milk-based formulas are recommended for the majority of infants who will receive commercial infant formula.
Which actions would the nurse take to promote parent-infant bond?
Encourage rooming-in after birth. Rooming-in after birth promotes parent-infant interaction and bonding. Encourage skin-to-skin contact for birth and nonbirth parents. Skin-to-skin opportunities for the birth and nonbirth parents (if appropriate) promotes parent-infant bond. Recommend breastfeeding in the first 1 to 2 hours after birth. Breastfeeding within the first 1 to 2 hours after birth promotes parent-infant bond.
Match the method of heat loss with the nursing action that would prevent it: Keep the newborn dry and covered.
Evaporation
Match the method of neonatal heat loss with its description: Heat loss from moisture leaving skin
Evaporation
Which factors contribute to the severity of withdrawal symptoms in neonatal abstinence syndrome?
Exposure amount The exposure amount is associated with the severity of withdrawal symptoms in neonatal abstinence syndrome; greater exposure leads to worsened withdrawal symptoms. Exposure duration The duration of exposure is associated with the severity of withdrawal symptoms in neonatal abstinence syndrome; longer duration leads to worsened withdrawal symptoms. Exposure timing The timing of exposure is associated with the severity of withdrawal symptoms in neonatal abstinence syndrome; exposure close to birth increases the severity of withdrawal but delays the onset of symptoms.
Match the nutrient to its description with respect to breast milk or formula: It supplies 50% of calories, though highly variable across individuals.
Fat
Which health care provider prescription would the nurse anticipate for a newborn whose heelstick reveals a glucose reading of 49 mg/dL?
Feed the newborn breast milk or formula. A serum glucose of 49 mg/dL is considered hypoglycemia in most agencies; feeding the newborn is the most common intervention for stable hypoglycemia.
Which intervention would a nurse take to prevent infection of the umbilical cord?
Fold the diaper below the umbilical cord. Folding the diaper below the cord avoids urine contamination and potential infection.
Which breastfeeding position would the nurse recommend for a mother with an abdominal incision?
Football The nurse would teach the mother that the football hold avoids pressure against an abdominal incision because the baby is held along the mother's side.
Match the fetal cardiac shunts with the description of their adaptation after birth: Increased pulmonary blood flow promotes closure.
Foramen ovale
Match the gestational classifications with their definition: 39 0/7 through 40 6/7 weeks
Full term
Match the reflex being assessed with the picture: Tonic neck "Fencing"
Gently turn head to one side while newborn is supine. Newborn extends extremities on side to which head is turned, with flexion on opposite side.
Which signs are included in the Apgar assessment completed at 1 and 5 minutes after birth?
Heart rate Heart rate is assessed by auscultation or palpation of the umbilical cord. Respiratory effort Respiratory effort is assessed by chest wall movement. Muscle tone Muscle tone is assessed by degree of flexion and movement of extremities. Response to catheter Reflex irritability is assessed by response to suctioning of nares or nasopharynx. Color Color is described as blue or pale, pink body with blue extremities, or completely pink.
For which TORCH infections would the nurse anticipate administering immune globulin?
Hepatitis B virus Hepatitis B immune globulin may be administered to infants of HBsAg mothers. Varicella zoster Varicella zoster immune globulin may be administered to infants with varicella zoster.
Which TORCH infections may be transmitted perinatally?
Herpes simplex virus Herpes simplex virus may be transmitted transplacentally, perinatally, or after birth. Gonorrhea Gonorrhea is transmitted perinatally, although last trimester ascending infection may occur. Varicella zoster Varicella zoster is transmitted transplacentally, perinatally, or after birth. Cytomegalovirus Cytomegalovirus may be transmitted transplacentally, perinatally, or after birth.
Exposure to contaminated equipment or medications is an example of which mode of transmission of infection in a newborn?
Horizontal Horizontal transmission is an infection acquired after birth from contact with contaminated equipment, products (e.g., medications), or individuals.
Which advantages are associated with human milk (expressed and/or donor milk) feeding?
Improved infant immunity Improved infant immunity is an advantage of human milk feeding and exclusive breastfeeding. Ability to track amount of milk consumed Human milk feeding allows for the tracking of the amount of milk consumed because the infant is fed expressed breast milk from a bottle. Others able to feed infant An advantage of human milk feeding is that others are able to feed the infant because the infant receives expressed breast milk.
Which soft-tissue birth injury would the nurse immediately report to the health care provider?
Increased head circumference Increased head circumference, boggy scalp, and pallor tachycardia are all signs of possible subgaleal hemorrhage, a serious injury that requires prompt report to the health care provider, evaluation, and treatment.
Which care would the nurse anticipate providing an infant with a brachial plexus injury?
Intermittent immobilization Intermittent immobilization is used to minimize discomfort and allow for healing in an infant with a brachial plexus injury. Range-of-motion exercises Range-of-motion exercises are performed to promote range of motion in an infant with a brachial plexus injury, but they are typically delayed until 1 week after the injury to prevent additional injury. Gentle manipulation Gentle manipulation is indicated to prevent pain for the infant with brachial plexus injury.
Which statement explains how intrathoracic pressure contributes to newborn respiratory adaptation?
It forces fetal lung fluid out of the alveoli and into interstitial spaces. Pressure changes in the lungs force fetal lung fluid out of the alveoli to allow air into the lungs.
While caring for a formula-fed 2-day-old, which nursing interventions promote safe sleep?
Keeping bassinet free of toys and supplies To avoid suffocation, the bassinet should be free of blankets, pillows, toys, and supplies. Offering a pacifier during sleep Pacifier use may decrease SIDS, though use may be delayed for the first month until breastfeeding is established. Dressing the newborn in a sleep sack Dressing the newborn in a sleep sack or one-piece sleeper is recommended to maintain warmth. Blankets and quilts should be avoided due to the risk for suffocation.
Which characteristics predispose the newborn to heat loss?
Large body surface to mass ratio Newborns have a large skin surface in proportion to their size, increasing the risk for heat loss. Thin subcutaneous fat layer Newborns have inadequate stores of brown fat and are at a higher risk for heat loss due to thin layers of subcutaneous fat. Superficial blood vessels Because of the lack of subcutaneous tissue, newborn blood vessels are closer to the surface, leading to increased insensible heat loss.
Match the gestational classifications with their definition: 34 0/7 through 36 6/7 weeks
Late preterm
Match the gestational classifications with their definition: 41 0/7 through 41 6/7 weeks
Late term
Which criterion is used to classify an infant as small-for-gestational-age (SGA)?
Less than 10th percentile for weight SGA infants are less than the 10th percentile for weight.
Which interventions would the nurse implement when caring for a newborn postcircumcision?
Loosely attach diaper. The nurse would attach the diaper loosely to prevent pressure to the circumcision site. Carefully document urinary output. The nurse would document urinary output, which is an indicator of healing and normal urinary function. Monitor for bleeding and signs of infection The nurse would monitor for bleeding and/or signs of infection (redness, swelling, purulent drainage). Should these occur, the nurse would contact the health care provider.
For which breastfeeding concern would the nurse teach families to seek medical attention?
Mastitis Mastitis requires antibiotics; therefore the nurse would teach the family to seek medical attention. The nurse would teach families about signs of mastitis, including pain, fever, and generalized malaise.
Which factor contributes to the development of respiratory distress syndrome in infants of mothers with diabetes?
Maternal hyperglycemia Maternal hyperglycemia delays fetal synthesis of surfactant, contributing to the development of respiratory distress syndrome.
Which factors are associated with the development of complications in infants of mothers with diabetes?
Metabolic control before conception Metabolic control before conception and throughout pregnancy is a risk factor contributing to the development of complications in infants of mothers with diabetes; mothers with poor control are more likely to have infants with complications. Severity of mother's diabetes Infants of mothers with more severe diabetes have higher rates of complications, including congenital anomalies, macrosomia, hypoglycemia, and respiratory distress syndrome. Age of diabetes onset Mothers with a longer duration of diabetes before pregnancy are more likely to have infants with complications.
Through which mechanism does nonshivering thermogenesis generate heat in a newborn?
Metabolism of brown fat Nonshivering thermogenesis increases the newborn's body temperature by metabolizing brown fat.
Which observations would the nurse document as normal findings of an inspection of the newborn head?
Molding Molding is the shaping of the fetal head by overlapping of the cranial bones to facilitate movement through the birth canal during labor. This is a normal finding in newborns born during a vaginal delivery. Separation of sutures Separation of sutures is a normal finding. Sutures should be palpable with a small separation between each.
For which condition would the nurse teach the family that breastfeeding is contraindicated but feeding expressed breast milk is safe?
Mother with active tuberculosis While breastfeeding is contraindicated in mothers with active tuberculosis, expressed breast milk is considered safe. The nurse would teach this mother to feed her infant expressed breast milk.
Which patient condition is a common breastfeeding complication in the first 24 hours following delivery?
Nipple soreness Nipple soreness due to poor latch or positioning is one of the most common complaints of women who are breastfeeding in the first 24 hours following delivery.
The mother of a breastfed infant states that she is having pain when the infant latches. Which action would the nurse take next?
Observe a complete breastfeeding session to assess the latch and position of the infant. Nipple soreness is a common complaint in the hospital. It is important for the bedside nurse to observe a complete feeding to understand the cause of the soreness. Assisting with latching and positioning may help to alleviate discomfort.
Which reflex is elicited by pressing a finger against the base of the newborn's fingers?
Palmar grasp reflex The palmar grasp reflex is tested by pressing a finger against the base of the newborn's fingers. The expected response is for the fingers to curl tightly.
For which signs in a 5-day-old breastfed newborn would a nurse educate parents to contact the health care provider for further assessment?
Passage of one stool per day Breastfed newborns usually stool at least four times per day. The parents should contact the health care provider if the newborn is passing only one stool per day. Brown stool with a consistency of paste Breastfed newborns should have soft, seedy yellow stools; a brown, paste-like consistency is abnormal, and the parents should contact the health care provider should this occur.
Match the reflex being assessed with the picture: Sucking
Place nipple or gloved finger in mouth, rub against palate. Newborn begins to suck, but may be weak if recently fed.
Which education would the nurse provide the parents of a newborn born with plagiocephaly?
Plagiocephaly at birth is a positional deformity that often resolves without intervention. Plagiocephaly at birth often results from intrauterine positioning that causes asymmetry; it often self-resolves without intervention.
Which neonatal effects would the nurse anticipate in a newborn with suspected cocaine exposure in utero?
Prematurity Prematurity is a neonatal effect associated with in utero cocaine exposure. Hypersensitivity to noise Hypersensitivity to noise is a neonatal effect associated with in utero cocaine exposure. Small for gestational age Small for gestational age is a neonatal effect associated with in utero cocaine exposure.
Which predisposing factor for birth trauma is considered a maternal risk factor?
Primigravida Primigravida, age <16 or >35 years, uterine dysfunction, preterm or postterm labor, cephalopelvic disproportion, and oligohydramnios are all maternal factors that increase the risk for birth trauma.
Which interventions would the nurse implement to maintain a neutral thermal environment?
Promote skin-to-skin contact. Skin-to-skin contact promotes warmth and maintenance of body temperature. Examine under a radiant warmer. Examination under a heat panel or radiant warmer promotes a neutral thermal environment. Encourage early and frequent breastfeeding. Early and frequent breastfeeding promotes a neutral thermal environment through skin-to-skin contact.
Match the nutrient to its description with respect to breast milk or formula: Whey and casein are primary sources
Protein
Match the infant state with the description of interactions that parents might expect: Ideal time for engaging with baby, most responsive
Quiet alert
Match the infant state with the description of interactions that parents might expect: Difficult to awaken, feeding likely unsuccessful
Quiet sleep
Match the method of heat loss with the nursing action that would prevent it: Move the crib away from the window or outside wall.
Radiation
Match the method of neonatal heat loss with its description: Heat loss to a cooler surface nearby but not in direct contact
Radiation
For which disorder would the nurse expect an intrauterine transfusion to be prescribed?
Rh incompatibility Intrauterine transfusion may be used to treat maternal sensitization and fetal anemia related to Rh incompatibility.
Which maternal-infant blood type combination may lead to maternal sensitization during pregnancy?
Rh-negative mother; Rh-positive fetus Maternal sensitization is related to Rh incompatibility, which occurs with an Rh-negative mother and Rh-positive fetus.
A breastfed newborn has lost 7% of its birth weight in the first 4 days of life. Which action would the nurse take?
Document the weight and reassure the parents that this is normal. Most newborns lose between 5% and 10% of their birth weight during the first 3 to 5 days of life. The nurse would reassure the parents and document this finding.
Match the fetal cardiac shunts with the description of their adaptation after birth: Increased oxygen levels lead to functional closure.
Ductus arteriosus
Match the fetal cardiac shunts with the description of their adaptation after birth: Umbilical cord clamping leads to functional closure.
Ductus venosus
Match the gestational classifications with their definition: 37 0/7 through 38 6/7 weeks
Early term
Which preventive intervention would the nurse implement for a newborn with numerous hyperbilirubinemia risk factors?
Encourage early feeding. Feeding stimulates the passage of bilirubin in stools; the nurse would encourage early feeding to promote bilirubin excretion.
Which nursing subspecialties are primarily responsible for ensuring that the mother and infant are successful with breastfeeding?
The labor and delivery nurse The labor and delivery nurse is responsible for helping to ensure the initial feed is uninterrupted and successful during the golden hour. This is a very important milestone for successful breastfeeding. All maternity nurses should be equipped to provide education regarding best feeding practices. The mother-baby nurse The mother-baby nurse should assess at least one full breastfeed every shift to ensure that the mother and infant are successful. All maternity nurses should be equipped to provide education regarding best feeding practices. The antenatal clinic nurse Prenatal education is essential in preparing the mother to be successful with breastfeeding. The antenatal clinic nurse should assess the patient's knowledge and provide education at each prenatal visit regarding breastfeeding.
Which factors stimulate the initiation of respirations after birth?
Thermal Abrupt temperature change from intrauterine to extrauterine environment stimulates skin sensors that send impulses to stimulate the respiratory center in the brain. Sensory Tactile stimulation from health care providers during and after birth stimulate skin sensors and initiate respiration. Chemical Fetal hypoxia related to decreased uterine blood flow during labor activates chemoreceptors that stimulate the respiratory center. Mechanical Mechanical factors, such as closure of cardiac shunts and changes in pressure in the heart and lungs, force fluid out of the lungs and stimulate respiration.
Match the phases of lactogenesis with the description of the type of milk produced during that phase: Lactogenesis I
Thick, yellow substance, high in protein, vitamins and minerals
Which noninvasive technique would the nurse use to best screen for suspected hyperbilirubinemia?
Transcutaneous bilirubinometry (TcB) TcB is the most reliable, noninvasive screening technique for hyperbilirubinemia.
Which two factors trigger cardiovascular adaptation after birth?
Umbilical cord clamping Umbilical cord clamping functionally closes the umbilical arteries, umbilical vein, and ductus venosus. Initiation of respiration Initiation of respiration inflates the lungs, decreases pulmonary vascular resistance, and stimulates increased pulmonary blood flow, leading to closure of the ductus arteriosus and foramen ovale.
Which education about positioning would the nurse provide to a family who will formula feed their newborn?
Use the cradle position while feeding. The nurse would teach the family that the cradle position, semi-upright, is preferred for formula feeding. Keep face-to-face contact during feeding. The nurse would teach the family to maintain close, face-to-face contact with the newborn during formula feeding. This promotes attachment and bonding.
Which description is associated with early-onset or congenital sepsis?
Usually acquired perinatally Early-onset or congenital sepsis is usually a consequence of infection acquired perinatally.
Which assessment finding would the nurse document as a normal variation that does not require immediate attention of the health care provider?
Vaginal bleeding Vaginal bleeding (pseudomenstruation) in a female newborn is a normal variant and results from changes in hormone levels after birth. Breast engorgement with nipple discharge Breast engorgement with nipple discharge is a normal variant and results from changes in the hormone levels after delivery. Reducible umbilical hernia A reducible umbilical hernia is a normal variant. Most umbilical hernias resolve without intervention. A nonreducible hernia, however, may require surgical correction.
