Deck 25: Physiological Adaptations of the Newborn

Question 1

An African-Canadian woman notices some bruises on her newborn girl's buttocks.She asks the nurse who spanked her daughter.The nurse explains that these marks are referred to as what?

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

Answer 1

Mongolian spots

Question 2

Part of the health assessment of a newborn is observing the infant's breathing pattern.What is a full-term newborn's predominant breathing pattern?

A) Abdominal with synchronous chest movements
B) Chest breathing with nasal flaring
C) Diaphragmatic with chest retraction
D) Deep with a regular rhythm

Answer 2

Abdominal with synchronous chest movements

Question 3

While examining a newborn,the nurse notes uneven skin folds on the buttocks and a click when performing the Ortolani manoeuvre.The nurse recognize these findings as an indication of what?

A) Polydactyly
B) Clubfoot
C) Hip dysplasia
D) Webbing

Answer 3

Hip dysplasia

Question 4

What is the most critical physiological change required of the newborn?

A) Closure of fetal shunts in the circulatory system
B) Full function of the immune defence system at birth
C) Maintenance of a stable temperature
D) Initiation and maintenance of respirations

Question 5

While evaluating the reflexes of a newborn,the nurse notes that with a loud noise the newborn symmetrically abducts and extends his arms,his fingers fan out and form a C with the thumb and forefinger,and he has a slight tremor.How would the nurse document this positive finding?

A) Tonic neck reflex
B) Glabellar (Myerson)reflex
C) Babinski reflex
D) Moro reflex

Question 6

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.What is the basis for the nurses' response?

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

Question 7

What should the nurse be aware of with regard to the respiratory development of the newborn?

A) The positive pressure created by crying aids in keeping the alveoli open.
B) Newborns must expel the fluid from the respiratory system within a few minutes of birth.
C) Newborns are instinctive mouth breathers.
D) Seesaw respirations are no cause for concern in the first hour after birth.

Question 8

Which is true about the neonatal period?

A) It consists of four phases,two reactive and two of decreased responses.
B) It lasts from birth to day 28 of life.
C) It applies to full-term births only.
D) It varies by socioeconomic status and the mother's age.

Question 9

Which is the newborn period that lasts about 30 minutes and happens immediately after birth?

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

Question 10

What would the nurse be aware of with regard to the functioning of the renal system in newborns?

A) The pediatrician should be notified if the newborn has not voided in 24 hours.
B) Breastfed infants likely will void more often during the first days after birth.
C) "Brick dust" or blood on a diaper is always cause to notify the physician.
D) Weight loss from fluid loss and other normal factors should be made up in 4 to 7 days.

Question 11

A newborn is placed under a radiant heat warmer,and the nurse evaluates the infant's body temperature every hour.Maintaining the newborn's body temperature is important to prevent which event from happening?

A) Respiratory depression
B) Cold stress
C) Tachycardia
D) Vasoconstriction

Question 12

While assessing the newborn,the nurse should be aware that which is the average range of expected apical pulse findings of a full-term,quiet,alert newborn?

A) 80 to 100 beats/min
B) 100 to 120 beats/min
C) 110 to 160 beats/min
D) 150 to 180 beats/min

Question 13

While assessing the integument of a 24-hour-old newborn,the nurse notes a pink,papular rash with vesicles superimposed on the thorax,back,and abdomen.What should the nurse do?

A) Notify the physician immediately.
B) Move the newborn to an isolation nursery.
C) Document the finding as erythema toxicum.
D) Take the newborn's temperature and obtain a culture of one of the vesicles.

Question 14

What should the nurse know about variations in infants' blood count to explain to new parents?

A) A somewhat lower than expected red blood cell (RBC)count could be the result of delay in clamping the umbilical cord.
B) The early high white blood cell (WBC)count 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 ability of the blood to clot properly.

Question 15

Which statement is an inaccurate description of the first phase of the transition period?

A) It lasts no longer than 30 minutes.
B) It is marked by spontaneous tremors,crying,and head movements.
C) It often includes the passage of meconium.
D) It may involve the infant suddenly sleeping briefly.

Question 16

What should the nurse be aware of with regard to the newborn's developing cardiovascular system?

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 17

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?" What is the basis for the nurse's response?

A) It is meconium and is a baby's first stool.
B) It is a transitional stool
C) It is a sign of internal bleeding.
D) Tell the parent not to worry about the colour of the stool.

Question 18

What infant response to cool environmental conditions is protective?

A) Dilation of peripheral blood vessels
B) Shivering
C) Decreased respiratory rates
D) Flexed position

Question 19

A patient is warm and asks for a fan in her room for her comfort.The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on "high." The nurse instructs the mother that the fan should not be directed toward the newborn and the newborn should be wrapped in a blanket.The mother asks why.What is the basis of the nurse's response?

A) The baby may lose heat by convection,which means that he will lose heat from his body to the cooler ambient air.Babies should be wrapped and no cool air blowing on them.
B) The baby may lose heat by conduction,which means that he will lose heat from his body to the cooler ambient air.Babies should be wrapped and no cool air blowing on him.
C) The baby may lose heat by evaporation,which means that he will lose heat from his body to the cooler ambient air.Babies should be wrapped and no cool air blowing on him.
D) The baby will get cold stressed easily and needs to be bundled up at all times.

Question 20

A new mother states that her infant must be cold because the baby's hands and feet are blue.What is the proper term for this common and temporary condition?

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

Question 21

What marks on a baby's skin may indicate an underlying problem that requires notification of a physician?

A) Mongolian spots on the back
B) Telangiectatic nevi on the nose or nape of the neck
C) Petechiae scattered over the infant's body
D) Erythema toxicum anywhere on the body

Question 22

A collection of blood between the skull bone and its periosteum is known as a cephalhematoma.What should the nurse be aware of with regard to cephalhematoma in order to reassure the new parents whose infant develops such a soft bulge?

A) It may occur with spontaneous vaginal birth.
B) It only happens as the result of a forceps or vacuum delivery.
C) It is present immediately after birth.
D) It will gradually absorb over the first few months of life.

Question 23

What should the nurse do upon assessing unequal movement and uneven gluteal skin folds during the Ortolani manoeuvre?

A) Tell the parents that one leg may be longer than the other,but they will equal out by the time the infant is walking.
B) Alert the physician that the infant may have hip dysplasia.
C) Inform the parents and physician that moulding has not taken place.
D) Suggest that,if the condition does not change,surgery to correct vision problems might be needed.

Question 24

Which statement is true about jaundice?

A) Neonatal jaundice is not common,but kernicterus occurs frequently.
B) The appearance of jaundice during the first 24 hours indicates a pathological process.
C) Jaundice will most likely appear before discharge.
D) Breastfed babies have a lower incidence of jaundice.

Question 25

Why is the brain vulnerable to nutritional deficiencies and trauma in early infancy?

A) The infant has an incompletely developed neuromuscular system.
B) The infant has a primitive reflex system.
C) The infant experiences the presence of various sleep-wake states.
D) The infant experiences a cerebellum growth spurt.

Question 26

The nurse caring for the newborn should be aware that which sensory system is least mature at the time of birth?

A) Vision
B) Hearing
C) Smell
D) Taste

Question 27

When eliciting newborn reflexes,which is true about the Babinski reflex? Select all that apply.Express answer in small letters,followed by a comma and a space-e.g. ,a,b,c

A) Place infant prone on a flat surface and run finger down back lateral to the spine to elicit the Babinski reflex.
B) Absence of Babinski reflex requires neurological evaluation.
C) Babinski reflex usually disappears by 1 year of age.
D) Response to Babinski reflex is the trunk flexes and the pelvis swings to the stimulated side.
E) A positive Babinski is hyperextension of all toes with dorsiflexion of the big toe.
F) Lower limbs should extend when the Babinski reflex is elicited.

Question 28

What should the nurse be aware of with regard to the gastrointestinal (GI)system of the newborn?

A) The newborn's cheeks are full because of normal fluid retention.
B) The nipple of the bottle or breast must be placed well inside the baby's mouth because teeth have been developing in utero,and one or more may even be through.
C) An active rectal "wink" reflex is a sign of good sphincter control.
D) Bacteria are already present in the infant's GI tract at birth,because they traveled through the placenta.

Question 29

During life in utero,oxygenation of the fetus occurs through transplacental gas exchange.When birth occurs,four factors combine to stimulate the respiratory centre in the medulla.The initiation of respiration then follows.Which contributes to the dynamic sequence of events that occur with the infants' first breath?

A) Warm air temperature
B) Oxygen pressure increases
C) Carbon dioxide pressure decreases
D) Arterial pH decreases

Question 30

What is the term given to the cheeselike,whitish substance that fuses with the epidermis and serves as a protective coating for the fetus?

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

Question 31

What is a mode of heat loss in the newborn?

A) Perspiration
B) Diuresis
C) Urination
D) Evaporation