Question 1

During a post conference, nursing students are simulating physical assessment of the newborn using a model. Throughout the simulated assessment, students describe each of their actions. Which nursing student's statement indicates the need for further teaching?

Accepted Answer

It is not appropriate to obtain a newborn's heart rate by observing the cardiac monitor. Newborns should have their heart rate assessed by auscultating their heart tones directly with a stethoscope.

Question 2

A new grandfather is marveling over his 12-hour-old newborn grandson. Which statement indicates that the grandfather needs additional education?

Accepted Answer

A newborn's stomach capacity is only about the size of a cherry at birth, not a cupful. The other statements are correct and indicate a good understanding of newborn development.

Question 3

The nurse is reviewing charts of newborns. Which infant requires immediate intervention?

Accepted Answer

Preterm infants are at higher risk for hyperbilirubinemia and the presentation of icterus and lethargy suggests significant jaundice requiring immediate intervention. The other infants have bilirubin levels within the normal range or slightly elevated and may require monitoring and further evaluation, but not immediate intervention.

Question 4

The nurse is assessing a newborn at 1 hour of age. Which finding requires an immediate intervention?

Accepted Answer

Pauses in respiration lasting 30 seconds are not normal for newborns and require immediate intervention. This could be a sign of a serious respiratory issue such as apnea or respiratory distress syndrome. The other options may require further assessment or monitoring, but they do not indicate an immediate need for intervention.

Question 5

A telephone triage nurse gets a call from a postpartum patient who is concerned about jaundice. The patient's newborn is 37 hours old. What data should the nurse gather first?

Accepted Answer

Skin color is the most important data to gather in this situation as jaundice causes a yellowing of the skin. This will help determine the severity of the jaundice and whether further evaluation or treatment is necessary. The other options may be important to gather as well, but skin color is the priority. Bilirubin level cannot be determined over the phone and requires a blood test.

Question 6

The nurse is teaching new parents how to dress their newborn. Which statements indicate that teaching has been effective?

Accepted Answer

The answer of The nurse is teaching new parents how...

Question 7

The parents of a newborn are receiving discharge teaching. The nurse explains that the infant should have several wet diapers per day. Which statement by the parents indicates that further education is necessary?

Accepted Answer

The statement "Our baby was born with kidneys that are too small" indicates a lack of understanding about normal kidney development in newborns. It may warrant further education by the nurse. The other statements demonstrate understanding about normal kidney function in infants.

Question 8

A postpartum patient calls the nursery to report that her 3-day-old newborn has passed a bright green stool. The nurse's best response is:

Accepted Answer

Passing a bright green stool is a normal occurrence in newborns, as it can be due to the meconium transitioning to regular stools. There is no need for alarm unless accompanied by other symptoms like fever, lethargy, or poor feeding.

Question 9

When reviewing laboratory results for a 1-day-old infant, the nurse notes that the infant's IgM antibodies are elevated. Which is the least likely cause of the infant's IgM antibody level elevation?

Accepted Answer

IgM antibodies are too large to cross the placenta, so maternal-fetal transfer of IgM in utero is not possible. Elevated IgM in a newborn suggests an in utero infection, as IgM is produced by the fetus in response to an antigen.

Question 10

The mother of a 2-day-old male has been informed that her child has sepsis. The mother is distraught and says, "I should have known that something was wrong. Why didn't I see that he was so sick?" The best reply is:

Accepted Answer

Newborns have immature immune function at birth, making it difficult to detect illness. It is not the mother's fault that the baby has sepsis, as it can happen even with proper care. This response acknowledges the mother's concerns while providing reassurance and education about neonatal immune function.

Question 11

The nurse manager of the neonatal intensive care unit is preparing a handout for parents of ill newborns. Which statement should the nurse include?

Accepted Answer

Neonates have a higher risk for becoming dehydrated due to their smaller fluid reserves and increased fluid needs. They also have immature kidneys, making it more difficult for them to regulate their fluid balance. Option A is not accurate as newborns cannot eliminate fluid as quickly as an adult. Option B is not entirely accurate as kidney function varies among individuals and premature infants may have less functional kidneys. Option D is not accurate as a small amount of sugar in the urine of a newborn is normal.

Question 12

The nurse is planning the care of a 1-day-old infant. Which of the following nursing interventions would protect the newborn from heat loss by convection?

Accepted Answer

Heat loss by convection occurs when heat is lost from the body to surrounding cool air currents. Placing the newborn away from air currents would protect the infant from heat loss by convection. Pre-warming the examination table would prevent heat loss by conduction, not convection. Drying the newborn thoroughly and removing wet linens from the isolette would protect the infant from heat loss by evaporation, not convection.

Question 13

The newborn at 24 hours of age has a red blood cell count of 5.4 million per ml. Which of the following entries would the nurse expect to find in the newborn's chart?

Accepted Answer

Delayed cord clamping allows for more blood to flow from the placenta to the baby, increasing the baby's red blood cell count.

Question 14

The home care nurse is examining a 3-day-old infant. The skin on the child's sternum is yellow when blanched with a finger. The parents ask the nurse why jaundice occurs. The best response from the nurse is:

Accepted Answer

Jaundice occurs in newborns because their liver is not fully mature and cannot conjugate the bilirubin for excretion. This causes a buildup of bilirubin in the blood, which leads to a yellowing of the skin (jaundice). Breastfeeding does not cause jaundice, and it is not related to bowel function. While delayed clamping of the umbilical cord can contribute to jaundice, it is not the only cause.

Question 15

During a community health class, the nurse is educating prenatal patients and their partners about normal newborn behavior. Which attendee's statement indicates that teaching was effective? "I can expect that my newborn baby:

Accepted Answer

The statement "Will be able to hear very well immediately after she is born" indicates that the attendee has learned that newborns are born with a fully functioning auditory system. Option B is incorrect because newborns should not be encouraged to suck on a pacifier before feedings as it can interfere with breastfeeding. Option C is incorrect because newborns are born with the ability to see close up, although their vision may be blurry at first. Option D is incorrect because pacifiers should only be used for soothing purposes, not as a regular part of bottle feeding.

Quiz 24: The Physiologic Responses of the Newborn to Birth