N8 Neonate Qs Ch 24-28

Wong, et al.: Maternal Child Nursing Care, 3rd Edition
Review Questions Chapter 24
1.
Which of the following would be a warning sign of ineffective adaptation to extrauterine life if noted when assessing a 24-hour-old breastfed newborn prior to discharge?

A. Apical heart rate of 90 BPM, slightly irregular, when awake and active
B. Acrocyanosis
C. Harlequin color sign
D. Weight loss representing 5% of the newborn's birthweight
2.
When caring for a newborn the nurse must be alert for signs of cold stress which would include which of the following?

A. Decreased activity level
B. Increased respiratory rate
C. Hyperglycemia
D. Shivering
3.
The nurse helps a breastfeeding mother change the diaper of her 16-hour-old newborn, after the first bowel movement. The mother expresses concern since the large amount of thick, sticky stool is very dark green, almost black in color. She asks the nurse if something is wrong. The nurse should respond to this mother's concern by:

A. Telling the mother not to worry since all breast-fed babies have this type of stool
B. Explaining to the mother that the stool is called meconium and is expected for the first few bowel movements of all newborns
C. Asking the mother what she ate at her last meal
D. Suggesting that the mother ask her pediatrician to explain newborn stool patterns to her
4.
When weighing a newborn, the nurse should:

A. Leave its diaper on for comfort
B. Place a sterile scale paper on the scale for infection control
C. Keep hand on the newborn's abdomen for safety
D. Weigh the newborn at the same time each day for accuracy
5.
Vitamin K is given to the newborn to:

A. Reduce bilirubin levels
B. Increase the production of red blood cells
C. Enhance ability of blood to clot
D. Stimulate the formation of surfactant
6.
The nurse notes that when the newborn is placed on the scale, he immediately abducts and extends his arms and his fingers fan out with the thumb and forefinger forming a "C." This response is known as a:

A. Tonic neck reflex
B. Moro reflex
C. Cremasteric reflex
D. Babinski reflex
7.
A newborn male, estimated to be 39 weeks' gestation, would exhibit:

A. Extended posture when at rest
B. Testes descended into scrotum
C. Abundant lanugo over his entire body
D. Ability to move his elbow past his sternum

Review Questions Chapter 25
1.
At one minute following birth, the newborn exhibited the following: heart rate of 155; loud, vigorous crying with active movement of all extremities; sneezing when nose is stimulated with a catheter; hands and feet bluish and cool to the touch. The Apgar score of this newborn should be recorded as:

A. 5
B. 7
C. 9
D. 10
2.
The nurse must administer erythromycin ophthalmic ointment to a newborn after birth. The nurse should

A. Instill within 15 minutes of birth for maximum effectiveness
B. Cleanse eyes from inner to outer canthus prior to administration
C. Apply directly over the cornea
D. Flush eyes 10 minutes after instillation to reduce irritation
3.
Newborns are at high risk for injury if appropriate safety precautions are not implemented. Parents should be taught to:

A. Place newborn on abdomen (prone) after feeding and for sleep
B. Avoid use of pacifiers
C. Use a rearward facing car seat until the infant weighs at least 20 pounds
D. Use a crib with side rail slats that are no more than 3 ½ inches apart
4.
A newborn has just been circumcised. The nurse's first priority would be to:

A. Assess penis for bleeding
B. Apply a lubricant such as Vaseline or KY jelly to the site at every diaper change
C. Note time of first voiding after the procedure
D. Take the newborn to his mother for comfort and feeding
5.
Following circumcision of a newborn, the nurse provides instructions to its parents regarding post-circumcision care. The nurse should tell the parents to:

A. Apply topical anesthetics with each diaper change
B. Expect a yellowish exudate to cover the glans after the first 24 hours
C. Change the diaper every 2 hours and cleanse the site with soap and water or baby wipes
D. Apply constant pressure to the site if bleeding occurs and call the physician
6.
When placing a newborn under a radiant heat warmer to stabilize temperature after birth, the nurse should:

A. Place the thermistor probe on left side of the chest
B. Cover probe with a non-reflective material
C. Recheck temperature by periodically taking a rectal temperature
D. Prewarm the radiant heat warmer and place the undressed newborn under it

Review Questions Chapter 26
1.
The birth weight of a breastfed newborn was 8 pounds, 4 ounces. On the third day the newborn's weight was 7 pounds, 12 ounces. Based on this finding, the nurse should:

A. Encourage the mother to continue breastfeeding since it is effective in meeting the newborn's nutrient and fluid needs
B. Suggest that the mother switch to bottle feeding since the breastfeeding is ineffective in meeting newborn needs for fluid and nutrients
C. Notify the physician since the newborn is being poorly nourished
D. Refer the mother to a lactation consultant to improve her breastfeeding technique
2.
Which of the following actions of a breastfeeding mother indicate the need for further instruction?

A. Holds breast with four fingers along bottom and thumb at top
B. Leans forward to bring breast toward the baby
C. Stimulates the rooting reflex then inserts nipple and areola into newborn's open mouth
D. Puts her finger into newborn's mouth before removing breast
3.
The nurse taught new parents the guidelines to follow regarding the bottle feeding of their newborn. They will be using formula from a can of concentrate. The parents would demonstrate an understanding of the nurse's instructions if they

A. Wash the top of can and can opener with soap and water before opening the can
B. Adjust the amount of water added according to weight gain pattern of the newborn
C. Add some honey to sweeten the formula and make it more appealing to a fussy newborn
D. Warm formula in a microwave oven for a couple of minutes prior to feeding

Review Questions Chapter 28
1.
Which of the following laboratory test results would be a cause for concern if exhibited by an Rh-positive newborn 12 hours after birth?

A. Direct Coombs: negative
B. Hematocrit: 58% and Hemoglobin: 18 gm/dl
C. Blood glucose level: 55 mg/dl
D. RPR/VDRL: reactive