Deck 7: Health Promotion of the Newborn and Family

Question 1

The nurse notes the first stool of a newborn is black and tarry. Which term is used to describe this type of stool?

A) Meconium
B) Transitional
C) Miliaria
D) Milk stool

Answer 1

Meconium

Question 2

Which is the name of the suture separating the parietal bones at the top center of a newborn's head?

A) Frontal
B) Coronal
C) Sagittal
D) Occipital

Answer 2

Sagittal

Question 3

Stroking the newborn's cheek along the side of the mouth causes the newborn to turn the head toward that side and begin to suck. This is which reflex?

A) Perez
B) Sucking
C) Rooting
D) Extrusion

Answer 3

Rooting

Question 4

A nurse is palpating a newborn's fontanels. The nurse documents the anterior fontanel is which shape?

A) Circle
B) Triangle
C) Square
D) Diamond

Question 5

At the time of birth, what is the grayish white, cheeselike substance that normally covers the newborn's skin called?

A) Miliaria
B) Meconium
C) Amniotic fluid
D) Vernix caseosa

Question 6

A nurse has determined that a newborn's respiratory breathing is within a normal range. How should the nurse document this finding?

A) Irregular, abdominal, 30 to 60 breaths/min
B) Regular, abdominal, 25 to 35 breaths/min
C) Regular, noisy, 35 to 45 breaths/min
D) Irregular, quiet, 45 to 55 breaths/min

Question 7

The nurse should expect the apical heart rate of a stabilized newborn to be in which range?

A) 60 to 80 beats/min
B) 80 to 100 beats/min
C) 120 to 140 beats/min
D) 160 to 180 beats/min

Question 8

Which is the most critical physiologic change required of the newborn?

A) Closure of fetal shunts in the heart
B) Stabilization of fluid and electrolytes
C) Body-temperature maintenance
D) Onset of breathing

Question 9

Which characteristic is representative of the newborn's gastrointestinal tract?

A) Stomach capacity is approximately 90 ml.
B) Peristaltic waves are relatively slow.
C) Overproduction of pancreatic amylase occurs.
D) Intestines are shorter in relation to body size.

Question 10

The nurse observes that a new mother avoids making eye contact with her newborn. The nurse should perform which action?

A) Examine newborn's eyes for ability to focus.
B) Assess for other attachment behaviors.
C) Recognize this as a common reaction in new mothers.
D) Ask mother why she won't look at newborn.

Question 11

Which statement best represents the first stage of the first period of reactivity in the newborn?

A) It begins when the newborn awakes from a deep sleep.
B) It ends when the amount of respiratory mucus has decreased.
C) It is an excellent time to acquaint the parents with the newborn.
D) It is an excellent time for mother to sleep and recover.

Question 12

A nurse is doing an assessment on a newborn. Which is characteristic of a newborn's vision at birth and an expected finding during the assessment?

A) Ciliary muscles are mature.
B) Blink reflex is absent.
C) Tear glands function.
D) Pupils react to light.

Question 13

Why are rectal temperatures not recommended in the newborn?

A) They are inaccurate.
B) They do not reflect core body temperature.
C) They can cause perforation of rectal mucosa.
D) They take too long to obtain an accurate reading.

Question 14

A nurse notes that a 12-hour-old newborn has not had the first meconium stool. The nurse documents this finding and continues to monitor the newborn because, in term newborns, the first meconium stool occurs within how many hours of birth?

A) 6 to 8
B) 8 to 12
C) 12 to 24
D) 24 to 48

Question 15

When doing the first assessment of a male newborn, the nurse notes that the scrotum is large, edematous, and pendulous. This should be interpreted as a(n):

A) normal finding.
B) hydrocele.
C) absence of testes.
D) inguinal hernia.

Question 16

In a newborn's eyes, strabismus is a normal finding because of:

A) congenital cataracts.
B) lack of binocularity.
C) absence of red reflex.
D) inability of pupil to react to light.

Question 17

The Apgar score of a newborn 5 minutes after birth is 8. Which is the nurse's best interpretation of this?

A) Resuscitation is likely to be needed.
B) Adjustment to extrauterine life is adequate.
C) Additional scoring in 5 more minutes is needed.
D) Maternal sedation or analgesia contributed to the low score.

Question 18

The nurse is assessing a 3-day-old, breastfed newborn who weighed 7 pounds, 8 ounces at birth. The newborn's mother is now concerned that the newborn weighs 6 pounds, 15 ounces. Which is the most appropriate nursing intervention?

A) Recommend supplemental feedings of formula.
B) Explain that this weight loss is within normal limits.
C) Assess child further to determine cause of excessive weight loss.
D) Encourage mother to express breast milk for bottle feeding the newborn.

Question 19

Which is a function of brown adipose tissue (BAT) in the newborn?

A) Provides ready source of calories in the newborn period
B) Insulates the body against lowered environmental temperature
C) Protects the newborn from injury during the birth process
D) Generates heat for distribution to other parts of body

Question 20

The nurse is presenting an in-service session on assessing gestational age in newborns. Which information should be included?

A) The newborn's length and weight are the most accurate indicators of gestational age.
B) The newborn's Apgar score and the mother's estimated date of confinement (EDC) are combined to determine gestational age.
C) The newborn's posture at rest and arm recoil are two physical signs used to determine gestational age.
D) The newborn's chest circumference compared to the head circumference is the determinant for gestational age.

Question 21

The nurse observes flaring of nares in a newborn. This should be interpreted as:

A) nasal occlusion.
B) sign of respiratory distress.
C) common response to sneezing.
D) snuffles of congenital syphilis.

Question 22

In the newborn, intramuscular phytonadione (vitamin K) is administered into which muscle?

A) Deltoid
B) Dorsogluteal
C) Vastus medialis
D) Vastus lateralis

Question 23

On what is successful breastfeeding most dependent?

A) Mother's socioeconomic level
B) Size of mother's breasts
C) Mother's desire to breastfeed
D) Birth weight of newborn

Question 24

A new mother wants to be discharged with her newborn as soon as possible. What should be done prior to discharge?

A) Newborn has voided at least once
B) Newborn does not spit up after feeding
C) Jaundice, if present, appeared before 24 hours
D) Appointment is made for home care or a primary care practitioner office visit within next 2 or 3 days

Question 25

What should a nursing intervention to promote parent-newborn attachment include?

A) Delaying parent-newborn interactions until the second period of reactivity
B) Explaining individual differences among newborns to the parents
C) Alleviating stress for parents by decreasing their participation in the newborn's care
D) Allowing a newborn to fuss for a period of time before soothing by holding

Question 26

A nurse is assessing the presence of expected reflexes in a newborn. Which figure depicts the elicitation of the tonic neck reflex?

A)
B)
C)
D)

Question 27

A newborn is being discharged at age 48 hours. The parents ask how the newborn should be bathed this first week home. How should the nurse recommend to bathe the newborn?

A) Daily with mild soap
B) Daily with an alkaline soap
C) Two or three times this week with plain water
D) Two or three times this week with mild soap

Question 28

The parents of a newborn plan to have him circumcised. They ask the nurse about pain associated with this procedure. What knowledge should the nurse's response be based on?

A) Experience pain with circumcision
B) Do not experience pain with circumcision
C) Quickly forget about the pain of circumcision
D) Are too young for anesthesia or analgesia

Question 29

The stump of the umbilical cord usually separates in how many days?

A) 3
B) 10 to 14
C) 16 to 20
D) 28

Question 30

What are distended sebaceous glands that appear as tiny white papules on cheeks, chin, and nose in the newborn period called?

A) Milia
B) Lanugo
C) Mongolian spots
D) Cutis marmorata

Question 31

Early this morning, a baby boy was circumcised by using the Plastibell method. When should the nurse tell the mother that the baby can be discharged?

A) The newborn voids
B) Receiving vitamin K
C) Yellow exudate forms over glans
D) The Plastibell rim falls off

Question 32

Where would nonpathologic cyanosis normally be present in the newborn shortly after birth?

A) Feet and hands
B) Bridge of nose
C) Circumoral area
D) Mucous membranes

Question 33

Recommendations for hepatitis B (HBV) vaccine include which statement?

A) First dose is given between birth and age 2 days.
B) First dose is given between ages 12 and 15 months.
C) It is not recommended for neonates who are at low risk for hepatitis B.
D) It is not recommended for neonates whose mothers are positive for HBV surface antigen.

Question 34

What term describes irregular areas of deep blue pigmentation seen predominantly in newborns of African, Asian, Native American, or Hispanic descent?

A) Acrocyanosis
B) Erythema toxicum
C) Mongolian spots
D) Harlequin color changes

Question 35

What does the American Academy of Pediatrics recommend as the best form of newborn nutrition?

A) Exclusive breastfeeding until age 2 months.
B) Exclusive breastfeeding until age 6 months.
C) Commercially prepared newborn formula for 1 year.
D) Commercially prepared newborn formula until age 4 to 6 months.

Question 36

What should nursing interventions to maintain a patent airway in a newborn include?

A) Sleeping in the prone (on abdomen) position
B) Wrapping neonate as snugly as possible
C) Positioning neonate supine while sleeping
D) Using bulb syringe to suction as needed, suctioning nose first, and then pharynx

Question 37

The nurse is careful to place the incubator away from cold windows or air-conditioning units. This is to conserve the newborn's body heat by preventing heat loss through:

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

Question 38

A nurse has completed an assessment on a newborn. Which finding is considered abnormal?

A) Nystagmus
B) Profuse drooling
C) Dark green or black stools
D) Slight vaginal reddish discharge

Question 39

Parents of a newborn ask the nurse why vitamin K is being administered. The nurse accurately responds by explaining phytonadione (vitamin K) is administered to the newborn to:

A) prevent bleeding.
B) enhance immune response.
C) prevent bacterial infection.
D) maintain nutritional status.

Question 40

Which is most important in the immediate care of the newborn?

A) Maintain patent airway.
B) Maintain stable body temperature.
C) Administer prophylactic eye care.
D) Establish identification of mother and baby.

Question 41

A nurse is preparing to administer a prescribed phytonadione (vitamin K) injection 0.5 mg intramuscularly to a newborn. The phytonadione (vitamin K) ampule is labeled 1 mg equals 0.5 ml. How many milliliters will the nurse administer? Record your answer using two decimal places.

Question 42

A nurse is planning a teaching session for parents of a newborn who plan to bottle-feed. Which should the nurse include in the teaching session? (Select all that apply.)

A) Limiting the feeding to 15 minutes
B) Propping the bottle for night feedings is acceptable
C) Proper technique for cleansing the bottles and nipples
D) Feeding infant on alternate sides of the lap
E) Use of bottled water without fluoride should be avoided to mix powdered formula.

Question 43

A nurse is conducting discharge teaching for parents of a newborn. The nurse instructs the parents on which method of care for the umbilical cord? (Select all that apply.)

A) Covering the cord with the diaper
B) Cleansing the cord with water daily
C) Keeping the cord area free of urine and stool
D) Monitoring for signs of infection
E) Applying bacitracin ointment to the cord daily

Question 44

A nurse is performing a 1-minute Apgar on a newborn. The nurse assesses that the newborn has a heart rate over 100, a good strong cry, some flexion of extremities, sneezes, and has a pink body with blue extremities. The nurse records what number as the Apgar? Record your answer in a whole number.

Question 45

A nurse is teaching a class on breastfeeding to expectant parents. Which are contraindications for breastfeeding? (Select all that apply.)

A) Human immunodeficiency virus (HIV) in mother
B) Mastitis
C) Inverted nipples
D) Maternal cancer therapy
E) Twin births

Question 46

A nurse is performing a gestational age assessment on a newborn. The nurse determines that the newborn is "term" if which findings are assessed? (Select all that apply.)

A) Posture with fully flexed arms and legs
B) Arm recoil brisk
C) Square window at 90 degrees
D) Scarf sign of elbow crossing over the midline
E) Popliteal angle less than 90 degrees