Deck 17: Assessment and Care of the Newborn and Family

Question 1

As part of Standard Precautions, nurses wear gloves when handling the newborn. The chief reason is:

A) To protect the baby from infection.
B) That it is part of the Apgar protocol.
C) To protect the nurse from contamination by the newborn.
D) Because the nurse has primary responsibility for the baby during the first 2 hours.

Answer 1

To protect the nurse from contamination by the newborn.

Question 2

A mother expresses fear about changing her infant's diaper after he is circumcised. What does the woman need to be taught to take care of the infant when she gets home?

A) Cleanse the penis with prepackaged diaper wipes every 3 to 4 hours.
B) Apply constant, firm pressure by squeezing the penis with the fingers for at least 5 minutes if bleeding occurs.
C) Cleanse the penis gently with water and put petroleum jelly around the glans after each diaper change.
D) Wash off the yellow exudate that forms on the glans at least once every day to prevent infection.

Answer 2

Cleanse the penis gently with water and put petroleum jelly around the glans after each diaper change.

Question 3

At 1 minute after birth the nurse assesses the infant and notes: a heart rate of 80 beats/min, some flexion of extremities, a weak cry, grimacing, and a pink body but blue extremities. The nurse would calculate an Apgar score of:

A) 4.
B) 5.
C) 6.
D) 7.

Answer 3

5.

Question 4

An Apgar score of 10 at 1 minute after birth would indicate:

A) An infant having no difficulty adjusting to extrauterine life and needing no further testing.
B) An infant in severe distress that needs resuscitation.
C) A prediction of a future free of neurologic problems.
D) An infant having no difficulty adjusting to extrauterine life but who should be assessed again at 5 minutes after birth.

Question 5

A new father wants to know what medication was put into his infant's eyes and why it is needed. The nurse explains to the father that the purpose of the Ilotycin ophthalmic ointment is to:

A) Destroy an infectious exudate caused by Staphylococcus that could make the infant blind.
B) Prevent gonorrheal and chlamydial infection of the infant's eyes potentially acquired from the birth canal.
C) Prevent potentially harmful exudate from invading the tear ducts of the infant's eyes, leading to dry eyes.
D) Prevent the infant's eyelids from sticking together and help the infant see.

Question 6

Pain should be assessed regularly in all newborn infants. If the infant is displaying physiologic or behavioral cues indicating pain, measures should be taken to manage the pain. Examples of nonpharmacologic pain management techniques include (choose all that apply):

A) Swaddling.
B) Nonnutritive sucking.
C) Skin-to-skin contact with the mother.
D) Sucrose.
E) Acetaminophen.

Question 7

As part of their teaching function at discharge, nurses should tell parents that the baby's respiration should be protected by all of the following procedures except:

A) Preventing exposure to people with upper respiratory tract infections.
B) Keeping the infant away from secondhand smoke.
C) Avoiding loose bedding, water beds, and beanbag chairs.
D) Not letting the infant sleep on his or her back.

Question 8

The nurse is using the Ballard scale to determine the gestational age of a newborn. Which assessment finding is consistent with a gestational age of 40 weeks?

A) Flexed posture
B) Abundant lanugo
C) Smooth, pink skin with visible veins
D) Faint red marks on the soles of the feet

Question 9

A newborn is jaundiced and receiving phototherapy via ultraviolet bank lights. An appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy by this method would be to:

A) Apply an oil-based lotion to the newborn's skin to prevent drying and cracking.
B) Limit the newborn's intake of milk to prevent nausea, vomiting, and diarrhea.
C) Place eye shields over the newborn's closed eyes.
D) Change the newborn's position every 4 hours.

Question 10

Nurses can help parents deal with the issue and fact of circumcision if they explain:

A) The pros and cons of the procedure during the prenatal period.
B) That the American Academy of Pediatrics (AAP) recommends that all newborn males be routinely circumcised.
C) That circumcision is rarely painful and any discomfort can be managed without medication.
D) That the infant will likely be alert and hungry shortly after the procedure.

Question 11

An infant boy was born just a few minutes ago. The nurse is conducting the initial assessment. Part of the assessment includes the Apgar score. The Apgar assessment is performed:

A) Only if the newborn is in obvious distress.
B) Once by the obstetrician, just after the birth.
C) At least twice, 1 minute and 5 minutes after birth.
D) Every 15 minutes during the newborn's first hour after birth.

Question 12

In the classification of newborns by gestational age and birth weight, the appropriate for gestational age (AGA) weight would:

A) Fall between the 25th and 75th percentiles for the infant's age.
B) Depend on the infant's length and the size of the head.
C) Fall between the 10th and 90th percentiles for the infant's age.
D) Be modified to consider intrauterine growth restriction (IUGR).

Question 13

A 3.8-kg infant was delivered vaginally at 39 weeks after a 30-minute second stage. There was a nuchal cord. After birth the infant is noted to have petechiae over the face and upper back. Information given to the infant's parents should be based on the knowledge that petechiae:

A) Are benign if they disappear within 48 hours of birth.
B) Result from increased blood volume.
C) Should always be further investigated.
D) Usually occur with forceps delivery.

Question 14

When preparing to administer a hepatitis B vaccine to a newborn, the nurse should:

A) Obtain a syringe with a 25-gauge, -inch needle.
B) Confirm that the newborn's mother has been infected with the hepatitis B virus.
C) Assess the dorsogluteal muscle as the preferred site for injection.
D) 5/8 Confirm that the newborn is at least 24 hours old.

Question 15

Early this morning, an infant boy was circumcised using the PlastiBell method. The nurse tells the mother that she and the infant can be discharged after:

A) The bleeding stops completely.
B) Yellow exudate forms over the glans.
C) The PlastiBell rim falls off.
D) The infant voids.

Question 16

The normal term infant has little difficulty clearing its airway after birth. Most secretions are brought up to the oropharynx by the cough reflex. However, if the infant has excess secretions, the mouth and nasal passages can be cleared easily with a bulb syringe. When instructing parents on the correct use of this piece of equipment, it is important that the nurse teach them to:

A) Avoid suctioning the nares.
B) Insert the compressed bulb into the center of the mouth.
C) Suction the mouth first.
D) Remove the bulb syringe from the crib when finished.