Deck 21: The Normal Newborn: Adaptation and Assessment

Question 1

The nurse should alert the physician when

A) The infant is dusky and turns cyanotic when crying.
B) Acrocyanosis is present at age 1 hour.
C) The infant's blood glucose is 45 mg/dL.
D) The infant goes into a deep sleep at age 1 hour.

Answer 1

The infant is dusky and turns cyanotic when crying.

Question 2

Heat loss by convection occurs when a newborn is

A) Placed on a cold circumcision board
B) Given a bath
C) Placed in a drafty area of the room
D) Wrapped in cool blankets

Answer 2

Placed in a drafty area of the room

Question 3

Nurses can prevent evaporative heat loss in the newborn by

A) Drying the baby after birth and wrapping the baby in a dry blanket
B) Keeping the baby out of drafts and away from air conditioners
C) Placing the baby away from the outside wall and the windows
D) Warming the stethoscope and nurse's hands before touching the baby

Answer 3

Drying the baby after birth and wrapping the baby in a dry blanket

Question 4

Cardiovascular changes that cause the foramen ovale to close at birth are a direct result of

A) Increased pressure in the right atrium
B) Increased pressure in the left atrium
C) Decreased blood flow to the left ventricle
D) Changes in the hepatic blood flow

Question 5

What is a result of hypothermia in the newborn?

A) Shivering to generate heat
B) Decreased oxygen demands
C) Increased glucose demands
D) Decreased metabolic rate

Question 6

A woman gave birth to a healthy 7-pound,13-ounce infant girl.The nurse suggests that the woman place the infant to her breast within 15 minutes after birth.The nurse knows that breastfeeding is effective during the first 30 minutes after birth because this is the

A) Transition period
B) First period of reactivity
C) Organizational stage
D) Second period of reactivity

Question 7

In fetal circulation,the pressure is greatest in the

A) Right atrium
B) Left atrium
C) Hepatic system
D) Pulmonary veins

Question 8

In administering vitamin K to the infant shortly after birth,the nurse understands that vitamin K is

A) Important in the production of red blood cells
B) Necessary in the production of platelets
C) Not initially synthesized because of a sterile bowel at birth
D) Responsible for the breakdown of bilirubin and prevention of jaundice

Question 9

When teaching parents about their newborn's transition to extrauterine life,the nurse explains which organs are nonfunctional during fetal life.They are the

A) Kidneys and adrenals
B) Lungs and liver
C) Eyes and ears
D) Gastrointestinal system

Question 10

A first-time dad is concerned that his 3-day-old daughter's skin looks "yellow." In the nurse's explanation of physiologic jaundice,what fact should be included?

A) Physiologic jaundice occurs during the first 24 hours of life.
B) Physiologic jaundice is caused by blood incompatibilities between the mother and infant blood types.
C) The bilirubin levels of physiologic jaundice peak between the second and fourth days of life.
D) This condition is also known as "breast milk jaundice."

Question 11

In which infant behavioral state is bonding most likely to occur?

A) Drowsy
B) Active alert
C) Quiet alert
D) Crying

Question 12

To provide competent newborn care,the nurse understands that respirations are initiated at birth as a result of

A) An increase in the PO₂ and a decrease in PCO₂
B) The continued functioning of the foramen ovale
C) Chemical, thermal, sensory, and mechanical factors
D) Drying off the infant

Question 13

Which statement is correct regarding the fluid balance in a newborn versus that in an adult?

A) The infant has a smaller percentage of surface area to body mass.
B) The infant has a smaller percentage of water to body mass.
C) The infant has a greater percentage of insensible water loss.
D) The infant has a 50% more effective glomerular filtration rate.

Question 14

A meconium stool can be differentiated from a transitional stool in the newborn because the meconium stool is

A) Seen at age 3 days
B) The residue of a milk curd
C) Passed in the first 12 hours of life
D) Lighter in color and looser in consistency

Question 15

The infant with the lowest risk of developing high levels of bilirubin is the one who

A) Was bruised during a difficult delivery
B) Developed a cephalhematoma
C) Uses brown fat to maintain temperature
D) Breastfeeds during the first hour of life

Question 16

While assessing the newborn,the nurse should be aware that the average expected apical pulse range of a full-term,quiet,alert newborn is _____ beats/min.

A) 80 to 100
B) 100 to 120
C) 120 to 160
D) 150 to 180

Question 17

A nursing student is helping the nursery nurses with morning vital signs.A baby born 10 hours ago via cesarean section is found to have moist lung sounds.What is the best interpretation of these data?

A) The nurse should notify the pediatrician stat for this emergency situation.
B) The neonate must have aspirated surfactant.
C) If this baby was born vaginally, it could indicate a pneumothorax.
D) The lungs of a baby delivered by cesarean section may sound moist for 24 hours after birth.

Question 18

The most likely interpretation of an elevated immunoglobulin M (IgM)level in a newborn is

A) The infant was breastfed during the first hours after birth
B) Transference of immune globulins from the placenta to the infant
C) An overwhelming allergic response to an antigen
D) A recent exposure to a pathogenic agent

Question 19

When the newborn infant is fed,the most likely cause of regurgitation is

A) Placing the infant in a prone position after a feeding
B) The gastrocolic reflex
C) An underdeveloped pyloric sphincter
D) A relaxed cardiac sphincter

Question 20

The process in which bilirubin is changed from a fat-soluble product to a water-soluble product is known as

A) Enterohepatic circuit
B) Conjugation of bilirubin
C) Unconjugation of bilirubin
D) Albumin binding

Question 21

With regard to the newborn's developing cardiovascular system,nurses should be aware that

A) The heart rate of a crying infant may rise to 120 beats/min.
B) Heart murmurs heard after the first few hours are cause for concern.
C) The point of maximal impulse (PMI) often is visible on the chest wall.
D) Persistent bradycardia may indicate respiratory distress syndrome (RDS).

Question 22

What characteristic shows the greatest gestational maturity?

A) Few rugae on the scrotum and testes high in the scrotum
B) Infant's arms and legs extended
C) Some peeling and cracking of the skin
D) The arm can be positioned with the elbow beyond the midline of the chest

Question 23

A new mother asks,"Why are you doing a gestational age assessment on my baby?" The nurse's best response is

A) "This must be done to meet insurance requirements."
B) "It helps us identify infants who are at risk for any problems."
C) "The gestational age determines how long the infant will be hospitalized."
D) "It was ordered by your doctor."

Question 24

Infants in whom cephalhematomas develop are at increased risk for

A) Infection
B) Jaundice
C) Caput succedaneum
D) Erythema toxicum

Question 25

A first-time father is changing the diaper of his 1-day-old daughter.He asks the nurse,"What is this black,sticky stuff in her diaper?" The nurse's best response is

A) "That's meconium, which is your baby's first stool. It's normal."
B) "That's transitional stool."
C) "That means your baby is bleeding internally."
D) "Oh, don't worry about that. It's okay."

Question 26

The parents of a newborn ask the nurse how much the newborn can see.The parents specifically want to know what type of visual stimuli they should provide for their newborn.The nurse responds to the parents by telling them

A) "Infants can see very little until about 3 months of age."
B) "Infants can track their parent's eyes and can distinguish patterns; they prefer complex patterns."
C) "The infant's eyes must be protected. Infants enjoy looking at brightly colored stripes."
D) "It's important to shield the newborn's eyes. Overhead lights help them see better."

Question 27

The hips of a newborn are examined for developmental dysplasia.Which sign indicates an incomplete development of the acetabulum?

A) Negative Ortolani's sign
B) Thigh and gluteal creases are asymmetric
C) Negative Barlow test
D) Knee heights are equal

Question 28

By knowing about variations in infants' blood count,nurses can explain to their patients that

A) A somewhat lower than expected red blood cell count could be the result of delay in clamping the umbilical cord.
B) The early high white blood cell count (WBC) is normal at birth and should decrease rapidly.
C) Platelet counts are higher than in adults for a few months.
D) Even a modest vitamin K deficiency means a problem with the blood's ability to clot properly.

Question 29

Plantar creases should be evaluated within a few hours of birth because

A) The newborn has to be footprinted.
B) As the skin dries, the creases will become more prominent.
C) Heel sticks may be required.
D) Creases will be less prominent after 24 hours.

Question 30

The shivering mechanism of heat production is rarely functioning in the newborn.Nonshivering _____________ is accomplished primarily by metabolism of brown fat,which is unique to the newborn,and by increased metabolic activity in the brain,heart,and liver.

Question 31

A newborn who is large for gestational age (LGA)is _____ percentile for weight.

A) Below the 90th
B) Less than the 10th
C) Greater than the 90th
D) Between the 10th and 90th

Question 32

What are modes of heat loss in the newborn? (Choose all that apply.)

A) Perspiration
B) Convection
C) Radiation
D) Conduction
E) Urination

Question 33

Which nursing action is designed to avoid unnecessary heat loss in the newborn?

A) Place a blanket over the scale before weighing the infant.
B) Maintain room temperature at 70° F.
C) Undress the infant completely for assessments so they can be finished quickly.
D) Take the rectal temperature every hour to detect early changes.

Question 34

A sign of illness in the newborn is

A) More than two soft stools per day
B) Regurgitating a small amount of feeding
C) A yellow scaly lesion on the scalp
D) An axillary temperature greater than 37.5° C

Question 35

An African-American woman noticed some bruises on her newborn girl's buttocks.She asks the nurse who spanked her daughter.The nurse explains that these marks are called

A) Lanugo
B) Vascular nevi
C) Nevus flammeus
D) Mongolian spots

Question 36

A new mother states that her infant must be cold because the baby's hands and feet are blue.The nurse explains that this is a common and temporary condition called

A) Acrocyanosis
B) Erythema neonatorum
C) Harlequin color
D) Vernix caseosa

Question 37

A maculopapular rash with a red base and a small white papule in the center is

A) Milia
B) Mongolian spots
C) Erythema toxicum
D) Cafe-au-lait spots

Question 38

The cheeselike,whitish substance that fuses with the epidermis and serves as a protective coating is called

A) Vernix caseosa
B) Surfactant
C) Caput succedaneum
D) Acrocyanosis

Question 39

What is the quickest and most common method to obtain neonatal blood for glucose screening 1 hour after birth?

A) Puncture the lateral pad of the heel.
B) Obtain a sample from the umbilical cord.
C) Puncture a fingertip.
D) Obtain a laboratory chemical determination.

Question 40

Which newborn reflex is elicited by stroking the lateral sole of the infant's foot from the heel to the ball of the foot?

A) Babinski
B) Tonic neck
C) Stepping
D) Plantar grasp

Question 41

The nurse is performing a blood glucose test every 4 hours on an infant born to a diabetic mother.This is to assess the infant's risk of hypoglycemia.The nurse becomes concerned if the infant's blood glucose concentration falls below ______ mg/dl.

Question 42

A ________ succedaneum may appear over the vertex of the newborn's head as a result of pressure against the mother's cervix while in utero.

Question 43

Part of the newborn assessment includes examination of the umbilical cord.The cord should contain 2 vessels: one vein and one artery.Is this statement true or false?

Question 44

In many facilities protocols allow the nurses to obtain transcutaneous bilirubin measurements (TcB)using a bilirubin meter,without the order of a nurse practitioner or physician.Is this statement true or false?