Deck 31: The Normal Newborn: Needs and Care

Question 1

In planning care for a new family immediately after birth, which procedure would the nurse most likely withhold for 1 hour to allow time for the family to bond with the newborn?

A) Eye prophylaxis medication
B) Drying the newborn
C) Vital signs
D) Vitamin K injection

Answer 1

Eye prophylaxis medication

Question 2

The nurse is caring for a patient who was given meperidine (Demerol) during labor. In planning care for the patient's newborn, the nurse should closely assess the newborn for:

A) Body temperature.
B) Stool pattern.
C) Bilirubin level.
D) Urine output.

Answer 2

Body temperature.

Question 3

The nurse is administering erythromycin (Ilotycin) ointment to a newborn. What factors are associated with administration of this medication?

A) The medication should be instilled in the lower conjunctival sac of each eye.
B) The eyelids should be massaged gently to distribute the ointment.
C) The medication must be given immediately after delivery.
D) The medication does not cause any discomfort to the infant.
E) The medication can interfere with the baby's ability to focus.

Answer 3

The medication should be instilled in the lower conjunctival sac of each eye.
The eyelids should be massaged gently to distribute the ointment.
The medication can interfere with the baby's ability to focus.

Question 4

The nurse has instructed a new mother on quieting activities for her newborn. The nurse knows that the mother understands when she overhears the mother telling the father to:

A) Hold the newborn in an upright position.
B) Massage the hands and feet.
C) Swaddle the newborn in a blanket.
D) Make eye contact while talking to the newborn.

Question 5

The normal newborn nursery nurse is preparing to receive four term newborns who delivered a few minutes ago. What labor characteristic will most likely require action by the nurse?

A) Multip experienced a precipitous delivery of a 7 pound, 3 ounce female.
B) Mother received IV narcotics 30 minutes prior to birth.
C) Maternal temperature of
D) Infant delivered in a face presentation mentum anterior

Question 6

A nurse is instructing nursing students about the procedure for vitamin K administration. What information should be included?

A) Gently massage the site after injection.
B) Use a 22-gauge 1-inch needle.
C) Inject in the vastus lateralis muscle.
D) Cleanse the site with alcohol prior to injection.
E) Inject at a 45-degree angle.

Question 7

The nurse is caring for a newborn who was recently circumcised. Which nursing intervention is appropriate following the procedure?

A) Keep the infant NPO for 4 hours following the procedure.
B) Observe for urine output.
C) Wrap dry gauze tightly around the penis.
D) Keep the newborn in the nursery for the next 4 hours.

Question 8

The nurse teaches the parents of an infant who recently was circumcised to observe for bleeding. What should the parents be taught to do if bleeding does occur?

A) Wrap the diaper tightly.
B) Remove the petroleum ointment dressing, and observe in 1 hour.
C) Apply gentle pressure to the site with gauze.
D) Apply a new petroleum ointment gauze dressing.

Question 9

A newborn delivered at term is being discharged. The parents ask the nurse how to keep their baby warm. The nurse knows additional teaching is necessary if a parent states:

A) "A quick cool bath will help wake up my son for feedings."
B) "I can check my son's temperature under his arm."
C) "My baby should be dressed warmly, with a hat."
D) "Cuddling my son will help to keep him warm."

Question 10

The nurse tells a mother that the doctor is preparing to circumcise her newborn. The mother expresses concern that the infant will be uncomfortable during the procedure. The nurse explains that the physician will numb the area before the procedure. Additional methods of comfort often used during the procedure include: Note: Credit will be given onlyif all correct choices and no incorrect choices are selected. Standard Text:

A) Providing a pacifier.
B) Stroking the head.
C) Restraining both arms and legs.
D) Talking to the infant.
E) Giving the infant a sedative before the procedure.

Question 11

The nurse is teaching a parenting class for pregnant couples who will deliver soon. Which statement by a mother-to-be indicates that additional information is needed?

A) "Baby girls sometimes have a little bloody mucus in their diapers as a reaction to the high estrogen level in the mother."
B) "Genitals of babies look swollen and enlarged at birth as a result of the hormones in the mother's circulation."
C) "We can call the nurse help line any time of day or night if we have questions about our baby after we get home."
D) "Car seats are installed the same way in different models of cars. Our friends can show us how to install it."

Question 12

At birth, an infant weighed 8 pounds 4 ounces. Three days later, the newborn is being discharged. The parents note that the baby now weighs 7 pounds 15 ounces. The nurse explains that the change in the newborn's weight is:

A) Excessive.
B) Within normal limits.
C) Less than expected.
D) Unusual.

Question 13

The nurse is caring for four newborns who have recently been admitted to the newborn nursery. Which labor event puts the newborn at risk for an alteration of health? The infant's mother had:

A) Ruptured membranes for 36 hours.
B) An IVof lactated Ringer's solution.
C) A labor that lasted 12 hours.
D) A cesarean birth with her last child.

Question 14

A postpartum mother is concerned that her newborn has not had a stool since birth. The newborn is 18 hours old. The nurse's best response is:

A) "I will call your pediatrician immediately."
B) "Passage of the first stool within 48 hours is normal."
C) "Your newborn might not have a stool until the third day."
D) "Your newborn must be dehydrated."

Question 15

To promote infant security in the hospital, the nurse instructs the parents of a newborn to:

A) Keep the baby in the room at all times.
B) Check the identification of all personnel who transport the newborn.
C) Place a "No Visitors" sign on the door.
D) Keep the baby in the nursery at all times.

Question 16

The parents of a newborn male ask the nurse whether they should circumcise their son. The best response by the nurse is "Circumcision:

A) "Should be undertaken to prevent problems in the future."
B) "Might decrease the child's risk of developing a urinary tract infection."
C) "Can sometimes cause complications. What questions do you have?"
D) "Is painful, and should be avoided unless you are Jewish."

Question 17

Which instructions should the nurse include when teaching parents of a newborn about caring for the umbilical cord?

A) Use triple-dye to cleanse the umbilical cord at home.
B) Fold the diaper down to prevent covering the cord stump.
C) Keep the umbilical stump clean and dry to avoid infection.
D) Observe for signs of infection such as foul smell, redness, and drainage.
E) Begin tub baths to help cleanse the cord stump at home.

Question 18

Prior to conducting the initial assessment of a newborn, the nurse reviews the mother's prenatal record and the delivery record to obtain information concerning possible risk factors for the infant and to anticipate the impact of these factors on the infant's ability to successfully transition to the extrauterine environment. Which information is pertinent to this assessment?

A) Drug or alcohol use by the father
B) Infectious disease screening results
C) Maternal history of gestational diabetes
D) Prolonged rupture of the membranes
E) Maternal use of prenatal vitamins

Question 19

Appropriate nursing interventions for the application of erythromycin ophthalmic ointment (Ilotycin) include:

A) Massaging eyelids gently following application.
B) Irrigating eyes after instillation.
C) Using a syringe to apply ointment.
D) Preceding instillation with irrigation.

Question 20

The nurse assesses the newborn and notes the following behaviors: nasal flaring, facial grimacing, and excessive mucus. The nurse is most concerned about:

A) Neonatal jaundice.
B) Polycythemia.
C) Neonatal hyperthermia.
D) Respiratory distress.

Question 21

When teaching new parents how to enhance attachment to their newborn, which topics should the nurse include?

A) Periods of reactivity and expected newborn responses
B) Abnormal physical characteristics of the newborn, and referral resources
C) Gradual development and reciprocal interactive nature of the bonding process
D) Demonstration and return demonstration of comforting techniques
E) Infant's capacity for interaction, such as nonverbal communication

Question 22

A mother and her newborn are being discharged 2 days after delivery. The general discharge instructions provided by the nurse include:

A) Always place the infant in a supine position in the crib.
B) Support the infant's head when carrying for the first week or two.
C) Do not allow the baby to fall asleep in someone's arms.
D) Do not cover the cord stump with a bandage.
E) Use a bulb syringe to suction mucus from the infant's nostrils as necessary.

Question 23

A postpartum patient calls the nursery to report that her newborn's umbilical cord stump is draining, and has a foul odor. The nurse's best response is:

A) "Take your newborn to the pediatrician."
B) "Cover the cord stump with gauze."
C) "Apply Betadine around the cord stump."
D) "This is normal during healing."

Question 24

New parents decide not to have their newborn circumcised. What should the nurse teach regarding care for the uncircumcised infant?

A) The foreskin will be retractable at 2 months.
B) Retract the foreskin and clean thoroughly.
C) Avoid retracting the foreskin.
D) Use soap and Betadine to cleanse the penis daily.

Question 25

A postpartum client calls the clinic to report that her 3-day-old baby girl has a spot of blood on her diaper. The best explanation for the nurse to give is that this finding is due to:

A) Withdrawal of maternal hormones.
B) A urinary infection.
C) An immature immune system.
D) Physiologic jaundice.

Question 26

The nurse is working with new parents who have recently immigrated to the United States. The nurse is not familiar with the family's cultural background. Which approach is most appropriate when discussing the newborn?

A) "You appear to be Muslim. Do you want your son circumcised?"
B) "Let me explain newborn care here in the U.S."
C) "Your baby is a U.S. citizen. You must be very happy about that."
D) "Could you explain your preferences regarding childrearing?"

Question 27

At birth, an infant weighed 8 pounds, 4 ounces. Three days later, the newborn is being discharged. The parents note that the baby now weighs 7 pounds, 15 ounces. What explanation should the nurse give for the change in this newborn's weight? "His weight loss is:

A) "Excessive."
B) "Within normal limits."
C) "Less than expected."
D) "Unusual."

Question 28

The nurse is planning home visits to the homes of new parents and their newborns. Which patient should the nurse see first?

A) 3-day-old male who received hepatitis B vaccine prior to discharge
B) 4-day-old female whose parents are both hearing-impaired
C) 5-day-old male with whitish adherent discharge on the circumcision site
D) 6-day-old female with greenish discharge from the umbilical cord site

Question 29

The nurse is analyzing various teaching strategies for teaching new mothers about newborn care. To enhance learning, which teaching method should the nurse implement?

A) Select videos on various topics of newborn care.
B) Organize a class that includes first-time mothers only.
C) Have mothers return in 1 week, when they feel more rested.
D) Schedule time for one-to-one teaching in the mother's room.

Question 30

The nurse is instructing the parents of a newborn about car seat safety. Which statement indicates that the parents need additional information?

A) "The baby should be in the back seat."
B) "Newborns must be in rear-facing car seats."
C) "We need to read the owner's manual before using the car seat."
D) "How the straps go around the baby isn't that important."

Question 31

The nurse is working with an adolescent parent. The adolescent tells the nurse, "I'm really scared that I won't take care of my baby correctly. My mother says I'll probably hurt the baby because I'm too young to be a mother." The best response by the nurse is:

A) "You are very young, and parenting will be a challenge for you."
B) "Your mother was probably right. Be very careful with your baby."
C) "Mothers have instincts that kick in when they get their babies home."
D) "We can give the baby's bath together. I'll help you learn how to do it."

Question 32

The nurse is instructing a new mother on circumcision care with a Plastibell. The nurse knows the mother understands when she states that the Plastibell should fall off within:

A) 2 days.
B) 10 days.
C) 8 days.
D) 14 days.

Question 33

Which of the following activities allows the nurse to provide individualized parent teaching on the maternal-infant unit? Note: Credit will be given only if all correct choices and n o incorrect choices are selected. Standard Text:

A) Teach by example and role modeling when caring for the newborn in the mother's room.
B) Teach at every opportunity, even during the night shift, if the occasion arises.
C) Teach using newborn care videos and group classes.
D) Teach using the 24-hour educational television channels in the mother's room.
E) Teach using one-to-one instruction while in the patient's room.

Question 34

The nurse is discussing parent-infant attachment with a prenatal class. Which statement indicates that teaching was successful?

A) "I should avoid looking directly into the baby's eyes, to prevent frightening the baby."
B) "My baby will be very sleepy immediately after birth, and should go to the nursery."
C) "Newborns cannot focus their eyes, so it doesn't matter how I hold my new baby."
D) "Giving the baby his first bath can really give me a chance to get to know him."

Question 35

The nurse is providing discharge teaching to the parents of a newborn. The nurse should instruct the parents to notify the healthcare provider in case of: Standard Text:

A) More than one episode of forceful vomiting.
B) More than 6-8 wet diapers per day.
C) A bluish discoloration of the skin with or without a feeding.
D) Refusal of two feedings in a row.
E) Development of eye drainage.