CHAMBERLAIN UNIVERSITY
NR 327 MATERNAL CHILD NURSING
QUIZ 1
(DETAILED ANSWERS & RATIONALES)
1. A woman gave birth to a healthy 7-pound, 13-ounce infant girl. The nurse suggests that the woman place the infant to her breast within 15 minutes after birth. The nurse knows that breastfeeding is eff...
CHAMBERLAIN UNIVERSITY
NR 327 MATERNAL CHILD NURSING
QUIZ 1 (DETAILED ANSWERS & RATIONALES )
1.A woman gave birth to a healthy 7-pound, 13-ounce infant girl. The nurse suggests that the woman place the infant to her breast within 15 minutes after birth. The nurse knows that breastfeeding is effective during the first 30 minutes after birth because this is the: a. Transition period. b. First period of reactivity. c. Organizational stage.
d. Second period of reactivity.
ANS: B
The first period of reactivity is the first phase of transition and lasts up to 30 minutes after birth. The infant is highly alert during this phase. The transition period is the phase between intrauterine and extra uterine existence. There is no such phase as the organizational stage. The second period of reactivity occurs roughly between 4 and 8 hours after birth, after a period of prolonged sleep. 2.Part of the health assessment of a newborn is observing the infant’s breathing pattern. A full-term newborn’s breathing pattern is predominantly: a. Abdominal with synchronous chest movements.
b. Chest breathing with nasal flaring.
c. Diaphragmatic with chest retraction.
d. Deep with a regular rhythm. ANS: A
In normal infant respiration the chest and abdomen rise synchronously, and breaths are shallow and irregular. Breathing with nasal flaring is a sign
of respiratory distress. Diaphragmatic breathing with chest retraction is a sign of respiratory distress. Infant breaths are not deep with a regular rhythm. 3.TRUE/FALSE
One reason hyperthermia develops more rapidly in the newborn than in the adult is that sweat glands have not formed yet. ANS: FALSE
Newborns have six times as many sweat glands per unit area as adults, but
they do not function.
4.A collection of blood between the skull bone and its periosteal is known as a cephalhematoma. To reassure the new parents whose infant develops such a soft bulge, it is important that the nurse be aware that this condition:
a. May occur with spontaneous vaginal birth.
b. Only happens as the result of a forceps or vacuum delivery.
c. Is present immediately after birth.
d. Will gradually absorb over the first few months of life.
ANS: A
Bleeding may occur during a spontaneous vaginal delivery as a result of the pressure against the maternal bony pelvis. The soft, irreducible fullness
does not pulsate or bulge when the infant cries. Low forceps and other difficult extractions may result in bleeding. However, these can also occur spontaneously. The swelling may appear unilaterally or bilaterally and is usually minimal or absent at birth. It increases over the first 2 to 3 days of life. Cephalhematomas disappear gradually over 2 to 3 weeks. A less common condition results in calcification of the hematoma, which may persist for months. 5.During life in utero oxygenation of the fetus occurs through Trans placental gas exchange. When birth occurs, four factors combine to stimulate the respiratory center in the medulla. The initiation of respiration then follows. Which is NOT one
of these essential factors?
a. Chemical b. Mechanical c. Thermal
d. Psychological ANS: D
A psychological factor is not one of the essential factors in the initiation of breathing; the fourth factor is sensory. The sensory factors include handling by the provider, drying by the nurse, lights, smells, and sounds. Chemical factors are essential for the initiation of breathing. During labor decreased levels of oxygen and increased levels of carbon dioxide seem to
have a cumulative effect that is involved in the initiation of breathing. Clamping of the cord may also contribute to the start of respirations. Prostaglandins are known to inhibit breathing. Clamping of the cord results
in a drop in the level of prostaglandins. Mechanical factors also are necessary to initiate respirations. As the infant passes through the birth canal, the chest is compressed. With birth the chest is relaxed, which allows for negative intra-thoracic pressure that encourages air to flow into the lungs. The profound change in temperature between intrauterine and extra uterine life stimulates receptors in the skin to communicate with the receptors in the medulla. This also contributes to the initiation of breathing. 6.The nurse caring for the newborn should be aware that the sensory system least mature at the time of birth is: a. Vision. b. Hearing.
c. Smell. d. Taste.
ANS: A
The visual system continues to develop for the first 6 months. As soon as the amniotic fluid drains from the ear (minutes), the infant’s hearing is similar to that of an adult. Newborns have a highly developed sense of smell. The newborn can distinguish and react to various tastes. 7.One reason the brain is vulnerable to nutritional deficiencies and trauma in early infancy is the: a. incompletely developed neuromuscular system.
b. Primitive reflex system.
c. Presence of various sleep-wake states.
d. Cerebellum growth spurt. ANS: D
The vulnerability of the brain likely is to the result of the cerebellum growth
spurt. The neuromuscular system is almost completely developed at birth.
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