Question 1

The nurse is providing care for a neonate during the fourth stage of labor. Which action does the nurse take during this stage?

Accepted Answer

The fourth stage of labor is the immediate postpartum period, during which the nurse should dry the neonate immediately to prevent hypothermia. Neonate assessment should be completed within the first 5-15 minutes after birth, not within 1 hour. Blood glucose levels are not typically obtained during the immediate postpartum period. Apgar screening is usually performed at 1 and 5 minutes after birth, not until scores are 7.

Question 2

Postnatal nurses expressed concern about neonatal pain management during painful interventions. Using evidence-based practice from research performed by Thakkar, Arora, Das, Javadekar, and Panigrahi (2016), which method of pain control will be used for heel sticks?

Accepted Answer

The combination of stimulated sucking and receiving sucrose orally has been shown to be effective in reducing pain during heel sticks in neonates (Thakkar et al., 2016). This method provides both non-pharmacological and pharmacological pain relief. Applying an anesthetic gel before the stick may cause delayed onset of the anesthetic effect and breastfeeding during the stick may not provide sufficient pain relief. Having the mother and neonate en face may offer some comfort, but it does not provide effective pain relief during the procedure.

Question 3

The nurse is assisting a newborn's primary care provider with the performance of a circumcision. Which intervention is used to manage the neonate's pain?

Accepted Answer

Sucrose has been shown to have analgesic effects in newborns and is often used during painful procedures like circumcision. Offering a sucrose-dipped pacifier can help manage the neonate's pain during the nerve block.

Question 4

The nurse works in a postnatal nursery and is required by hospital policy to perform a gestational age assessment on specified neonates. On which neonate is the nurse most likely to perform this assessment?

Accepted Answer

Neonates with a birth weight significantly above or below the average, such as 4,100 g, are often assessed for gestational age to determine if their size is appropriate for their gestational age.

Question 5

The nurses in a postnatal unit are aware of the fears of new parents with regard to infant abduction. Which interventions by the nurse will alleviate the concerns of the parents? Select all that apply.

Accepted Answer

All of the interventions listed can alleviate the concerns of parents with regard to infant abduction. Allowing only visitors with identification to enter the unit ensures that only authorized personnel are present. Using the hospital abduction alarm system adds an extra layer of security. Requiring unit personnel to wear specific name tags allows parents to easily identify hospital staff. Taking footprints and a photo of the newborn for identification purposes is a common practice in hospitals. Encouraging parents to accompany persons transporting the newborn ensures that the infant is never left alone with an unauthorized person.

Question 6

The postpartum nurse notices that a new mother has her neonate unwrapped and undressed "to check out the baby." For which reason does the nurse conclude the neonate is at risk for cold stress?

Accepted Answer

The answer of The postpartum nurse notices that a new...

Question 7

A patient delivers a term neonate and expresses concern about the reason for giving the neonate an injection. Which information from the nurse is accurate?

Accepted Answer

Vitamin K is necessary for the activation of clotting factors in the blood, which helps prevent excessive bleeding. Neonates have low levels of vitamin K and are at risk of hemorrhage if not given a vitamin K injection shortly after birth. While breast milk does contain some vitamin K, it is not enough to prevent hemorrhage in neonates. Additionally, while mothers can pass some vitamin K to their fetus, it is not enough to meet the newborn's needs.

Question 8

The nurse is explaining to the new breastfeeding mother the types of neonatal stools the mother can expect. Which examples does the nurse provide? Select all that apply.

Accepted Answer

Golden yellow, pasty consistency, and sour odor are typical of breastfed babies' stools. The neonate's first stool, meconium, is usually passed within the first 24 to 48 hours after birth.

Question 9

The nurse is presenting information to new parents regarding screening of their newborn. Which information does the nurse identify as being most important to the parents?

Accepted Answer

Screenings are for infections, genetic diseases, and inherited disorders.

Question 10

The nurse is preparing a talk with new parents about immunity and their newborns. Which factual information will the nurse present? Select all that apply.

Accepted Answer

A) A vaccination is an example of acquired immunity; it is not present at birth and must be acquired through exposure to a pathogen or vaccine.
C) Placental transfer is how newborns receive natural passive immunity from their mothers, as certain antibodies can cross the placenta during pregnancy.
E) Natural passive immunity is protective for a limited time after birth, as it is based on the transfer of antibodies from the mother to the baby.

Question 11

The nurse in the neonate nursery notices a neonate, born 45 minutes ago, is unresponsive to external stimuli, and has a respiratory and heart rate below normal range. Which action does the nurse take?

Accepted Answer

The answer of The nurse in the neonate nursery notices...

Question 12

During the fourth stage of labor, which actions by the nurse will promote parent-newborn attachment? Select all that apply.

Accepted Answer

These actions promote parent-newborn attachment by allowing the parents to bond with their newborn immediately after birth.

Question 13

A neonate is born after 37 weeks gestation, and the nurse is concerned about avoiding cold stress after discharge. Which suggestions does the nurse give the mother to keep the baby safe? Select all that apply.

Accepted Answer

A) Keeping the baby wrapped in a warm blanket helps to maintain the infant's body temperature, which decreases the risk of cold stress.
C) Positioning the baby away from vents and drafts helps prevent heat loss and maintain body temperature.
D) Placing a stocking cap on the neonate's head helps to keep the baby's head warm, which is an area where heat loss can occur.
E) Changing wet clothing immediately prevents heat loss and keeps the baby dry, which is essential for maintaining body temperature. Bathing in a warm location is not mentioned as a suggestion and may actually increase the risk of heat loss during the bath. Therefore, the answer does not include choice B.

Question 14

A new mother states, "I don't want anyone around my baby. I need to protect him from getting sick." Which statement by the nurse will help the mother to understand neonatal immunity? Select all that apply.

Accepted Answer

The answer of A new mother states, "I don't want...

Question 15

The nurse is assessing a newborn's reflexes. Which response will cause the nurse concern?

Accepted Answer

D  An asymmetrical Moro reflex may indicate a neurological issue or injury, and the absence of rooting or sucking reflexes can indicate neurological problems or developmental delays.

Question 16

The nurse is explaining to a mother that her newborn's blood test indicates a high level of unconjugated bilirubin, which causes jaundice. Which information does the nurse present to the mother? Select all that apply.

Accepted Answer

The answer of The nurse is explaining to a mother...

Question 17

The labor and delivery nurse understands that some neonates spontaneously take a breath once the head and chest is delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe?

Accepted Answer

Mild hypoxia (low oxygen levels) and decreased pH (acidic conditions) stimulate the respiratory center in the brain, which triggers the reflex to take a breath. This is known as the chemical stimuli for breathing in neonates. Oxygen administration, carbon dioxide administration, and suctioning are not typically used as chemical stimuli for breathing in neonates.

Question 18

The nurse is assessing a term neonate delivered to a mother with a history of drug and alcohol abuse. Which finding does the nurse relate to the mother's history?

Accepted Answer

Neonates born to mothers with a history of drug and alcohol abuse are at risk for intrauterine growth restriction, which can result in a smaller head circumference, placing it below the 10th percentile for gestational age.

Question 19

The nurse is providing information to a postpartum mother about circumcision of her neonate. The neonate's father states, "We have never done that to any baby boy in my family." Which statement is best for the nurse to make?

Accepted Answer

The best statement is D because it acknowledges and respects the family's cultural and personal beliefs without imposing judgment or unsolicited advice. This approach fosters a respectful and understanding relationship between the healthcare provider and the family.

Quiz 15: Physiological and Behavioral Responses of the Neonate