Davis Chapter 06 Normal Newborn exam with complete solutions.
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Course
NUR
Institution
NUR
The nurse is discussing the neonatal blood screening test with a new mother. The nurse knows that the teaching was successful when the mother states that the test screens for the presence in the newborn of which of the following diseases? Select all that apply.
1. Hypothyroidism.
2. Sickle cell d...
Davis Chapter 06 Normal Newborn exam
with complete solutions
The nurse is discussing the neonatal blood screening test with a new mother. The nurse
knows that the teaching was successful when the mother states that the test screens for
the presence in the newborn of which of the following diseases? *Select all that apply.*
1. Hypothyroidism.
2. Sickle cell disease.
3. Galactosemia.
4. Cerebral palsy.
5. Cystic fibrosis. - ANSWER-1. Hypothyroidism.
2. Sickle cell disease.
3. Galactosemia.
5. Cystic fibrosis.
The nursery nurse is careful to wear gloves when admitting neonates into the nursery.
Which of the following is the scientific rationale for this action?
1. Meconium is filled with enteric bacteria.
2. Amniotic fluid may contain harmful viruses.
3. The high alkalinity of fetal urine is caustic to the skin.
4. The baby is at high risk for infection and must be protected. - ANSWER-2. Amniotic
fluid may contain harmful viruses.
A full-term newborn was just born. Which nursing intervention is important for the nurse
to perform *first*?
1. Remove wet blankets.
2. Assess Apgar score.
3. Insert eye prophylaxis.
,4. Elicit the Moro reflex. - ANSWER-1. Remove wet blankets.
To reduce the risk of hypoglycemia in a full-term newborn weighing 2,900 grams, what
should the nurse do?
1. Maintain the infant's temperature above 97.7°F/36.5°C.
2. Feed the infant glucose water every 3 hours until breastfeeding well.
3. Assess blood glucose levels every 3 hours for the first twelve hours.
4. Encourage the mother to breastfeed every 4 hours. - ANSWER-1. Maintain the
infant's temperature above 97.7°F/36.5°C.
A mother asks the nurse to tell her about the responsiveness of neonates at birth.
Which of the following answers is appropriate? *Select all that apply.*
1. "Babies have a poorly developed sense of smell until they are 2 months old."
2. "Babies respond to all forms of taste well, but they prefer to eat sweet things
like breast milk."
3. "Babies are especially sensitive to being touched and cuddled."
4. "Babies are nearsighted with blurry vision until they are about 3 months of
age."
5. "Babies respond to many sounds, especially to the high-pitched tone of the
female voice." - ANSWER-2. "Babies respond to all forms of taste well, but they prefer
to eat sweet things
like breast milk."
3. "Babies are especially sensitive to being touched and cuddled."
5. "Babies respond to many sounds, especially to the high-pitched tone of the
female voice."
A mother, 1 day postpartum from a 3-hour labor and a spontaneous vaginal delivery,
questions the nurse because her baby's face is "purple." Upon examination, the nurse
notes petechiae over the scalp, forehead, and cheeks of the baby. The nurse's
response should be based on which of the following?
1. Petechiae are indicative of severe bacterial infections.
2. Rapid deliveries can injure the neonatal presenting part.
3. Petechiae are characteristic of the normal newborn rash.
4. The injuries are a sign that the child has been abused. - ANSWER-2. Rapid deliveries
can injure the neonatal presenting part.
,A 2-day-old breastfeeding baby born via normal spontaneous vaginal delivery has just
been weighed in the newborn nursery. The nurse determines that the baby has lost
3.5% of the birth weight. Which of the following nursing actions is appropriate?
1. Do nothing because this is a normal weight loss.
2. Notify the neonatologist of the significant weight loss.
3. Advise the mother to bottle feed the baby at the next feed.
4. Assess the baby for hypoglycemia with a glucose monitor. - ANSWER-1. Do nothing
because this is a normal weight loss.
Four newborns are in the neonatal nursery, none of whom is crying or in distress. Which
of the babies should the nurse report to the neonatologist?
1. 16-hour-old baby who has yet to pass meconium.
2. 16-hour-old baby whose blood glucose is 50 mg/dL.
3. 2-day-old baby who is breathing irregularly at 70 breaths per minute.
4. 2-day-old baby who is excreting a milky discharge from both nipples. - ANSWER-3.
2-day-old baby who is breathing irregularly at 70 breaths per minute.
The pediatrician has ordered vitamin K 0.5 mg IM for a newborn. The medication is
available as 2 mg/mL. How many milliliters (mL) should the nurse administer to the
baby? *Calculate to the nearest hundredth.*
______ mL - ANSWER-0.25 mL
A nurse is doing a newborn assessment on a new admission to the nursery. Which of
the following actions should the nurse make when evaluating the baby for
developmental dysplasia of the hip (DDH)? *Select all that apply.*
1. Grasp the baby's legs with the thumbs on the inner thighs and forefingers on
the outer thighs.
2. Gently adduct and abduct the baby's thighs.
3. Palpate the trochanter during hip rotation.
4. Place the baby in a fetal position.
5. Compare the lengths of the baby's legs. - ANSWER-1. Grasp the baby's legs with the
thumbs on the inner thighs and forefingers on
the outer thighs.
2. Gently adduct and abduct the baby's thighs.
3. Palpate the trochanter during hip rotation.
5. Compare the lengths of the baby's legs.
, A nurse notes that a 6-hour-old neonate has cyanotic hands and feet. Which of the
following actions by the nurse is appropriate?
1. Place the child in an isolette.
2. Administer oxygen.
3. Swaddle the baby in a blanket. 4. Apply pulse oximeter. - ANSWER-3. Swaddle the
baby in a blanket.
A couple is asking the nurse whether or not their son should be circumcised. On which
fact should the nurse's response be based?
1. Boys should be circumcised for them to establish a positive self-image.
2. Boys should not be circumcised because there is no medical rationale for the
procedure.
3. Experts from the Centers for Disease Control and Prevention (CDC) argue that
circumcision is desirable.
4. A statement from the American Academy of Pediatrics (AAP) asserts that
circumcision is optional. - ANSWER-4. A statement from the American Academy of
Pediatrics (AAP) asserts that
circumcision is optional.
A baby boy is to be circumcised by the mother's obstetrician. Which of the following
actions shows that the nurse is being a patient advocate?
1. Before the procedure, the nurse prepares the sterile field for the physician.
2. The nurse refuses to unclothe the baby until the doctor orders something for
pain.
3. The nurse holds the feeding immediately before the circumcision.
4. After the procedure, the nurse monitors the site for signs of bleeding. - ANSWER-2.
The nurse refuses to unclothe the baby until the doctor orders something for
pain.
Using the Neonatal Infant Pain Scale (NIPS), a nurse is assessing the pain response of
a newborn who has just had a circumcision. The nurse is assessing a change in which
of the following signs/symptoms? Select all that apply.
1. Heart rate.
2. Blood pressure.
3. Temperature.
4. Facial expression.
5. Breathing pattern. - ANSWER-4. Facial expression.
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