Deck 7: Growth and Development of the Newborn

Question 1

The neonatal or newborn period of life is defined as the first:

A) 24 hours
B) 48 hours
C) 7 days
D) 28 days

Answer 1

28 days

Question 2

In fetal circulation, most blood will bypass the fetal lungs via the:

A) inferior vena cava
B) ductus venosus
C) foramen ovale
D) ductus arteriosus

Answer 2

foramen ovale

Question 3

When the fetus makes the transition to becoming a newborn and extrauterine life begins, there occurs a series of changes, including decreased pulmonary vascular resistance, increased pulmonary blood flow, increased pressure of the left atrium, decreased pressure of the right atrium, and closure of which of the following structures?

A) foramen ovale
B) ductus venosus
C) inferior vena cava
D) superior vena cava

Answer 3

foramen ovale

Question 4

After a long labor, the mother is concerned about the swelling of her baby's scalp. The newborn is 24 hours old. The nurse palpates the scalp and finds swelling that extends across the suture lines. In addition to explaining the probable cause of the swelling and the time of resolution, the nurse explains that the term for this condition is:

A) cephalhematoma
B) caput succedaneum
C) molding
D) crepitation

Question 5

The umbilical cord, which connects the fetus to the placenta, contains:

A) one vein and one artery
B) two veins and two arteries
C) one artery and two veins
D) two arteries and one vein

Question 6

The nurse instructing the mother on how to care for the umbilical cord of the newborn would direct the mother to:

A) wash the cord only with warm water and gently dry it
B) apply 70% isopropyl alcohol or hydrogen peroxide to the base next to the skin and to the cord with each diaper change
C) use a solution of baby shampoo and water on the cord, rinse, and dry carefully
D) wash the cord with a solution of Ivory soap and water, dry, air for 30 minutes, and apply triple antibiotic ointment after baths and diaper changes

Question 7

The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is to:

A) allow visualization at all times
B) keep the diaper from rubbing the cord
C) remind the caregivers to do cord care
D) provide air circulation for the cord

Question 8

The nurse is assessing neonatal reflexes. As the nurse moves the neonate's head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is called:

A) cat's eye
B) head lag reflex
C) doll's eye
D) eye delay

Question 9

The rooting reflex of an infant disappears at approximately how many months of age?

A) 1
B) 2
C) 4
D) 6

Question 10

The stomach capacity of the newborn is approximately how many mL?

A) 30
B) 40
C) 60
D) 80

Question 11

The newborn is less capable of absorbing fat than older children and adults because of:

A) natural allergies to fat
B) lack of stomach acid
C) shorter large and small intestines with shorter emptying time
D) reduced bile salt secretion and less efficient pancreas

Question 12

The nurse is working with a newborn who has elevated bilirubin levels that are fast approaching the toxic level. The nurse is most concerned about which of the following conditions?

A) ketolysis
B) bilharziasis
C) kernicterus
D) biliverdin

Question 13

Which of the following statements best describes the purpose of phototherapy?

A) reducing serum bilirubin level and preventing brain damage
B) raising the body temperature of a neonate with a subnormal temperature
C) producing X-rays of the internal organs of the body
D) reducing pain in the muscles and joints of the body

Question 14

The nurse administering phototherapy ordered by the primary care provider must take special safety precautions and:

A) check the baby's blood glucose before therapy
B) cover the baby with a sheet during therapy
C) shield the baby's eyes and protect the gonads
D) apply a special sunscreen prior to the treatment

Question 15

To best assess the effectiveness of the phototherapy treatment, the nurse will monitor which of the following?

A) skin color of the newborn
B) pulse oximetry
C) serial serum bilirubin levels
D) activity level of the baby

Question 16

At what age is the infant able to concentrate urine completely?

A) birth
B) 1 week
C) 3 months
D) 1 year

Question 17

The normal value of the specific gravity of a newborn's urine is:

A) 0.008-0.009
B) 1.001-1.02
C) 1.1-1.7
D) 1.8-1.9

Question 18

The nurse uses what equipment to check for fluid between the parietal and visceral layers of the tunica vaginalis, the outermost covering of the testes?

A) transilluminator
B) 30 cc syringe
C) manometer
D) fluid meter

Question 19

A collection of fluid between the parietal and visceral layers of the tunica vaginalis is called:

A) spermatocele
B) hydrocele
C) glandulitis
D) epididymitis

Question 20

When the nurse detects a hydrocele on a newborn, the nurse will talk with the caregivers and get them to:

A) sign the surgical permit after a full explanation of the surgical procedure
B) express their feelings about this abnormality in their newborn son
C) decide on a specialist to correct this deformity in their newborn
D) reassure them that this usually disappears within the first year of life

Question 21

The nurse is teaching the caregivers about the immediate care of the newborn circumcised utilizing the plastibell. The nurse would instruct the caregivers to:

A) gently lift the ring and squeeze warm water from a cotton ball onto the tip of the penis when changing the diaper
B) take the bell off when the baby is awake, active, and likely to pull on the bell and dislodge it
C) pull the ring off in 5 to 7 days when the circumcision is near or completely healed
D) wash the bell and the penis with alcohol several times a day

Question 22

The nurse is teaching the caregivers about the immediate care of the newborn circumcised without a plastibell. The nurse would teach the caregivers to:

A) apply a thin layer of petroleum jelly to the circumcision
B) remove any yellow exudate that accumulates on the penis about the second day after circumcision
C) apply powder to the area of the circumcision
D) use hydrogen peroxide to wash the circumcision area after each voiding

Question 23

The nurse is teaching the caregivers about the care of their uncircumcised son. The nurse tells the caregivers that the foreskin may not be retractable in some children until around how many years of age?

A) 3
B) 4
C) 6
D) 8

Question 24

The mother asks the nurse to explain smegma to her. This is a term she heard the doctor mention. The nurse replies that smegma is:

A) the oil used in the nursery to lubricate the baby's skin after birth
B) a collection of dead cells under the fingernails of the newborn infant
C) a collection of cells that shed from the outer layer of skin and gathered under the foreskin
D) the hormonal reaction to withdrawal from the maternal placental support

Question 25

Male Jewish newborns are typically circumcised in a religious ceremony on what day of life?

A) 3rd
B) 5th
C) 8th
D) 12th

Question 26

The mother observes traces of blood on the diaper of her newborn daughter and calls this to the attention of the nurse. The nurse's best reply would be which of the following?

A) "I suspect this is from a urinary tract infection, a condition common in newborns when the bladder is not completely developed."
B) "This is probably caused by the baby not getting maternal hormones from the placenta. It will probably go away soon."
C) "This is probably from the trauma of the birth and will disappear in time."
D) "This is some placental blood we missed when bathing the baby at birth."

Question 27

In assessing flexion of the elbows of the newborn, the nurse would flex them by holding for 5 seconds and when extending them. The elbows of a term newborn will form an angle of:

A) 120 degrees with an extended position following the angle
B) 100 degrees with a semiflexed position
C) less than 90 degrees with a rapid recoil back to an extended position
D) less than 90 degrees and rapidly recoil back to a flexed position

Question 28

The transitional stool of the newborn usually occurs by the 3rd day and is:

A) green brown-yellow brown
B) clay color
C) grayish
D) light yellow-light green

Question 29

The mother of a breastfed newborn tells the nurse that the baby's stool is golden yellow, is pasty instead of firm, and has a sour milk odor. The best response on the part of the nurse would be which of the following?

A) "You probably need to feed this baby some cereal to firm up the stool."
B) "Cut back on your fluid intake and be careful what you eat, as you pass this on to the baby."
C) "I need to check your temperature and your breasts to determine if you have a breast abscess."
D) "This is a normal stool for a newborn that is breastfed. Do not change anything about your breastfeeding."

Question 30

The nurse is assessing a newborn and finds a rash that has a red macular base with a white vesicular center. This rash is most likely which of the following conditions?

A) desquamation
B) telangiectatic nevi
C) petechiae
D) erythema toxicum

Question 31

The nurse will assess the newborn for passage of stool and will expect the newborn to pass which of the following stools:

A) a pasty yellow stool by 24 hours
B) firm, pale yellow stool by 18 hours
C) a meconium stool by 24 hours
D) a meconium stool by 72 hours

Question 32

The nurse is instructing the caregivers in changing the diaper of their newborn daughter. The nurse will instruct the caregivers to wipe the baby from:

A) back to front using a wipe designed for a baby
B) front to back using plain water and absorbent cotton or a fresh washcloth
C) from the vagina forward and then from the vagina to the rectum
D) from the vagina forward and then from the vagina to the rectum.

Question 33

The normal newborn uses what behavior or ability to protect him- or herself from overstimulation and to free energy to meet physiologic demands?

A) deep sleeping
B) crying
C) constitution
D) habituation

Question 34

Which of the following best describes habituation?

A) ability to decrease responses to disturbing stimuli
B) staying still for longer periods of time
C) breathing more slowly than usual
D) adjusting to temperature increases and decreases

Question 35

According to child psychoanalyst Erik Erikson, newborns develop basic trust when:

A) they reach the age of 1 month
B) the mind matures sufficiently to conceptualize
C) caregivers meet the needs of the newborn
D) more needs are met than not met

Question 36

Prior to discharge from the hospital, the newborn most often will receive a screening blood test to rule out which of the following conditions?

A) Addison's disease and pituitary dysfunction
B) Down syndrome and autism
C) phenylketonuria and hypothyroidism
D) Marfan's syndrome and cerebral palsy

Question 37

The type of heat exchange that occurs between the newborn and water during a bath or when exposed to drafts is called:

A) convection
B) evaporation
C) conduction
D) radiation

Question 38

If a newborn is not dried thoroughly after a bath, it is most likely that the newborn will:

A) have increased susceptibility to seizure
B) develop a severely dried skin
C) become increasingly anxious
D) have a body temperature drop

Question 39

A type of fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn is which of the following?

A) pure fat
B) triglycerides
C) brown fat
D) glycerol

Question 40

Fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn does which of the following things?

A) protects the newborn from injury in case of falling or other trauma
B) increases cellular metabolic rates and oxygen consumption
C) provides a store of usable energy in case the baby does not nurse well
D) is used in the production of hormones, especially testosterone

Question 41

In teaching the family about caring for the newborn, you would advise the caregiver to:

A) place the neonate directly on a scale
B) place the newborn's crib close to the window
C) expose baby completely, bathing in as few a motions as possible
D) block sunlight from the newborn while the newborn is in the car

Question 42

The usual recommended sleeping position for a normal newborn is which of the following positions?

A) prone
B) semi-Fowler's with the head elevated by a pillow
C) supine
D) feet elevated slightly

Question 43

The caregivers of a newborn baby mention to the nurse that they sleep on a water bed and are planning to have the baby sleep with them. The nurse would say which of the following things to the family in her teaching?

A) "Many people believe that a family that sleeps together bonds well."
B) "This will make it more convenient to feed the baby at night."
C) "You need to sleep on a firm mattress with the baby or give the baby a crib with a firm mattress."
D) "Some caregivers report not getting enough rest at night when they have the baby or other children sleep with them."

Question 44

The nurse observes the mother of a newborn and four other children feeding the newborn in the infant seat with the bottle propped. The nurse would need to:

A) tactfully teach the mother the importance of holding and cuddling in the attachment process
B) congratulate the mother for finding a safe place for the baby to take the bottle
C) tell the mother that this procedure encourages independence in the newborn
D) suggest that the mother let the older children hold the bottle for the baby in the infant seat

Question 45

The current practice of feeding newborns is:

A) to place them on a frequent feeding schedule
B) an on-demand feed
C) to offer five feedings a day
D) to set up a specific schedule

Question 46

Formula-fed newborns compared to breastfeeding newborns:

A) will go longer between feedings
B) will feed at about the same intervals
C) will require more frequent feedings
D) are unpredictable in how they will compare

Question 47

The nurse teaching the new mother about breast care will advise the mother to wash the breasts:

A) with plain water
B) with soap and water
C) with alcohol and cotton swabs
D) with a peroxide-and-water solution

Question 48

In teaching the mother how to remove the newborn from the breast, the nurse would offer which of the following instructions?

A) Gently slap the newborn's cheek or hand to get him or her distracted enough to stop feeding.
B) Pull on the baby's ear that is opposite the breast there the baby is feeding.
C) Push on the baby's cheeks to open the baby's mouth.
D) Place a finger in the side of the baby's mouth and between the jaws to release suction.