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?

Accepted Answer

Eye prophylaxis medication is routinely given to newborns to prevent ophthalmia neonatorum, but it can be delayed for up to an hour after birth to allow the family to bond with the newborn. Drying the newborn, taking vital signs, and giving a vitamin K injection are all important procedures that should be done shortly after birth to ensure the newborn's health and well-being. Delaying these procedures could put the newborn at risk for complications.

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:

Accepted Answer

Meperidine (Demerol) can cause neonatal respiratory depression, which in turn can affect the newborn's ability to regulate body temperature. Close monitoring of the newborn's body temperature is essential to ensure the infant does not develop hypothermia as a result of respiratory depression or other side effects of opioid exposure.

Question 3

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

Accepted Answer

Erythromycin ointment is instilled in the lower conjunctival sac (A) and the eyelids are gently massaged to distribute it (B). It can cause temporary blurred vision, interfering with the baby's ability to focus (E). It is typically given within an hour or two after birth, not immediately (C), and it can cause mild discomfort (D).

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:

Accepted Answer

Swaddling the newborn in a blanket can provide a feeling of security and comfort, which can help to calm the baby's initial episodes of crying and fussiness. Holding the newborn in an upright position, massaging the hands and feet, and making eye contact while talking to the newborn can also be calming strategies, but they may not necessarily be the best choices for all babies in every situation.

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?

Accepted Answer

The administration of IV narcotics to the mother shortly before birth can affect the newborn, potentially causing respiratory depression or altered neurological function, requiring monitoring and possible intervention by the nurse.

Question 6

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

Accepted Answer

The answer of A nurse is instructing nursing students about...

Question 7

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

Accepted Answer

After circumcision, it is important to observe the newborn for urine output to ensure that there is no urinary retention or obstruction. Keeping the infant NPO is not necessary, and tight wrapping of gauze can cause irritation and interfere with healing. Keeping the newborn in the nursery is not necessary as long as he is stable and there are no complications.

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?

Accepted Answer

If bleeding occurs, the parents should be taught to apply gentle pressure to the site with gauze. This helps to stop the bleeding and promote clotting. Wrapping the diaper tightly or applying a new petroleum ointment dressing may cause further irritation or discomfort. Removing the dressing should be avoided in case it tears the clot and causes more bleeding.

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:

Accepted Answer

A quick cool bath is not recommended for newborns as it can cause them to lose body heat and become cold, leading to potential complications such as hypothermia.

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:

Accepted Answer

These methods (providing a pacifier, stroking the head, and talking to the infant) are non-pharmacological comfort measures that can help soothe and distract the infant during minor procedures like circumcision. They are commonly used to provide comfort and reduce stress without the need for medication.

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?

Accepted Answer

While the other options demonstrate an understanding of newborn care, choice D indicates that the mother-to-be may not have adequate information about the importance of properly installing a car seat. It is important to provide additional information and resources to ensure the safety of the newborn.

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:

Accepted Answer

It is within normal limits for a newborn to lose up to 10% of their birth weight in the first few days after birth. In this case, the newborn has lost approximately 5.2% of their birth weight, which is considered normal.

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:

Accepted Answer

Prolonged rupture of membranes (more than 18-24 hours) increases the risk of infection for the newborn. This is because the protective amniotic fluid is no longer present, and bacteria can travel into the uterus and infect the baby. The other options listed do not necessarily increase the risk of health alterations for the newborn.

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:

Accepted Answer

Passage of the first stool within 48 hours is considered normal for a newborn. It is not uncommon for a newborn to have their first stool up to 3 days after birth. It is important to educate the mother on the normal bowel patterns for her newborn and reassure her that there is no immediate cause for concern. Calling the pediatrician or assuming the newborn is dehydrated is not appropriate without further assessment.

Question 15

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

Accepted Answer

Checking the identification of all personnel who transport the newborn ensures that only authorized individuals are handling the infant, reducing the risk of abduction or accidental mix-up. Keeping the baby in the room at all times (A) and placing a "No Visitors" sign on the door (C) may limit access to the baby but does not address the issue of unauthorized personnel. Keeping the baby in the nursery at all times (D) may also limit access but does not involve the parents in the care of the baby, which is important for bonding and breastfeeding.

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:

Accepted Answer

The best response would be to provide factual information and address the potential risks and benefits, as well as any concerns the parents may have. Option A is not entirely accurate, as circumcision is not necessary to prevent problems. Option B is partially true, but the benefits are relatively small and may not be significant enough to justify the procedure. Option D is biased and unprofessional, as it is not appropriate for the nurse to impose their personal beliefs on the parents. Therefore, option C is the best choice as it addresses the importance of informed decision-making and encourages the parents to ask questions to make an informed decision.

Question 17

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

Accepted Answer

Folding the diaper down prevents irritation and promotes drying. Keeping the stump clean and dry helps prevent infection. Observing for signs of infection is crucial for early intervention.

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?

Accepted Answer

Infectious disease screening results, maternal history of gestational diabetes, and prolonged rupture of the membranes are pertinent as they can directly affect the newborn's health and transition to the extrauterine environment.

Question 19

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

Accepted Answer

Massaging eyelids gently following the application helps to distribute the ointment and ensures proper coverage of the affected area. Irrigating the eyes after instillation or preceding instillation with irrigation is not appropriate for the application of erythromycin ophthalmic ointment. Using a syringe to apply ointment may not be necessary as most ophthalmic ointments come with a sterile applicator tip.

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:

Accepted Answer

The behaviors described are indicative of respiratory distress in a newborn, which is a serious concern and requires immediate attention. Nasal flaring and facial grimacing are signs that the baby is struggling to breathe, and excessive mucus can block their airways. Neonatal jaundice, polycythemia, and neonatal hyperthermia are also important to monitor, but they do not have the same urgency as respiratory distress.

Quiz 31: The Normal Newborn: Needs and Care