Deck 24: The Physiologic Responses of the Newborn to Birth

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?

A)"I measured the newborn's blood pressure using the Doppler technique."
B)"I auscultated the infant's heart tones for one minute."
C)"I palpated peripheral pulses in all the newborn's extremities."
D)"I obtained the infant's heart rate by observing the cardiac monitor."

Answer 1

"I obtained the infant's heart rate by observing the cardiac monitor."

Question 2

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

A)"I can't believe he can already digest fats, carbohydrates, and proteins."
B)"It is amazing that his whole digestive tract moves things along at birth."
C)"Incredibly, his stomach capacity is already a cupful when he was born."
D)"He will lose some weight but then miraculously regain it by about 10 days."

Answer 2

"Incredibly, his stomach capacity is already a cupful when he was born."

Question 3

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

A)24-hour-old term male with total bilirubin level of 2.0
B)3-day-old term bottle-fed female with bilirubin of 11.0
C)2-week-old post-term breastfed male with bilirubin of 10.0
D)12-hour-old preterm female exhibiting icterus and lethargy

Answer 3

12-hour-old preterm female exhibiting icterus and lethargy

Question 4

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

A)Respiratory rate 60, crackles present bilaterally
B)Pulse rate 145, systolic murmur heard
C)Mean blood pressure 55 mm Hg
D)Pauses in respiration lasting 30 seconds

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?

A)Stool characteristics
B)Fluid intake
C)Skin color
D)Bilirubin level

Question 6

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

A)"We should make sure that we keep our home air-conditioned so the baby doesn't overheat."
B)"It is important that we dry the baby off as soon as we give him a bath or shampoo his hair."
C)"When we change the baby's diaper, we should change any wet clothing or blankets, too."
D)"If the baby's body temperature gets too low, he will warm himself up without any shivering."
E)"Our baby will have a much faster rate of breathing if he is not dressed warmly enough."

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?

A)"Our baby was born with kidneys that are too small."
B)"A baby's kidneys don't concentrate urine well for several months."
C)"Feeding our baby frequently will help the kidneys function."
D)"Kidney function in an infant is very different from in an adult."

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:

A)"Take your newborn to the pediatrician."
B)"There may be a possible food allergy."
C)"Your newborn has diarrhea."
D)"This is a normal occurrence."

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?

A)Maternal-fetal transfer of IgM while in utero
B)Placental leakage
C)Intrauterine exposure to syphilis
D)Intrauterine exposure to TORCH syndrome

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:

A)"Newborns have immature immune function at birth, and illness is very hard to detect."
B)"Your mothering skills will improve with time.You should take the newborn class."
C)"Your baby didn't get enough active acquired immunity from you during the pregnancy."
D)"The immunity your baby gets in utero doesn't start to function until he is 4 to 8 weeks of age."

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?

A)Newborns can eliminate excess fluid as quickly as an adult.
B)The kidneys are fully functional by 30 weeks' gestation.
C)Neonates have a tendency to become dehydrated.
D)Sugar is rarely present in the urine of a newborn.

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?

A)Placing the newborn away from air currents
B)Pre-warming the examination table
C)Drying the newborn thoroughly
D)Removing wet linens from the isolette

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?

A)Cord clamping delayed until pulsation ceased
B)CBC drawn from the anterior surface of the left hand
C)Placental abruption noted to be 80% at time of delivery
D)Infant is breastfed 15-20 minutes every three hours

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:

A)"The liver of an infant is not fully mature and doesn't conjugate the bilirubin for excretion."
B)"The infant received too many red blood cells after delivery because the cord was not clamped immediately."
C)"The yellow color of your baby's skin indicates that you are breastfeeding too often."
D)"This is an abnormal finding related to your baby's bowels not excreting bilirubin as they should."

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:

A)"Will be able to hear very well immediately after she is born."
B)"Should be trained to breastfeed by being encouraged to suck on a pacifier before feedings."
C)"Will have difficulty seeing me close up in the hours right after delivery."
D)"Should be discouraged form sucking on a pacifier if he is bottle feeding."