Chapter 25 Normal Newborn: Needs, Care, and Feeding

Chapter 25  Normal Newborn: Needs, Care, and Feeding

Complete Chapter Questions And Answers
 

Sample Questions

1) Which of the following actions must a nurse perform before weighing the newborn during the admission procedure? Select all that apply.
1. Clean the scale
2. Take the infant’s temperature
3. Cover the scale
4. Zero the scale
5. Wrap the infant tightly in a blanket to prevent heat loss
Answer: 1, 2, 3, 4
Explanation: 1. This action should be performed to prevent cross infection.
2. This action should be performed to monitor heat loss.
3. This action should be performed to prevent cross infection.
4. This action should be performed to ensure an accurate measurement.
5. The nurse should remove all clothing and blankets to ensure an accurate measurement. To prevent heat loss, the infant should instead be placed under a radiant warmer.
Page Ref: 484
Cognitive Level: Understanding
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care
Learning Outcome: LO 25.1-Summarize the essential information to be obtained about the prenatal period and a newborn’s birth experience and immediate postnatal period.
MNL LO: Recognize the timing and components of newborn assessment.

2) The nurse has received a shift change report on infants born within the last 4 hours. Which newborn should the nurse see first?
1. 37-week male, respiratory rate 45
2. 39-week female, pulse 150
3. Term male, grunting respirations
4. 39-week female, temperature 97.0°F
Answer: 3
Explanation: 1. A normal respiratory rate is 30-60. This infant has no unexpected findings.
2. A normal pulse is 110-160. This infant has no unexpected findings.
3. Grunting respirations are an indication of respiratory distress. This infant needs further assessment and possibly intervention immediately.
4. A normal temperature is 96.8 to 97.7°F. This infant has no unexpected findings.
Page Ref: 484
Cognitive Level: Analyzing
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care
Learning Outcome: LO 25.2-Explain how the physiologic and behavioral responses of the newborn during the first 4 hours after birth (admission and transitional period) determine the nursing care of the newborn.
MNL LO: Determine the nursing care provided to the newborn during early transition to extrauterine life.
3) The nurse assesses the following in a sleeping 1-hour-old, 39-weeks’-gestation newborn. The assessment data that would be of greatest concern would be:
1. Skin temperature 97.6°F.
2. Respirations 68/min.
3. Blood pressure 72/44.
4. Heart rate 156 beats/min.
Answer: 2
Explanation: 1. This is within the normal temperature range of 96.8 to 97.7°F.
2. Normal respiratory rate is 40 to 60 breaths/min. 68 could represent a less-than-expected transition.
3. This blood pressure is within the normal range of 90 to 60/50 to 40 mmHg.
4. This heart rate is within the normal range of 120 to 160 beats/min.
Page Ref: 484
Cognitive Level: Analyzing
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care
Learning Outcome: LO 25.2-Explain how the physiologic and behavioral responses of the newborn during the first 4 hours after birth (admission and transitional period) determine the nursing care of the newborn.
MNL LO: Determine the nursing care provided to the newborn during early transition to extrauterine life.

4) Which of the following information is not recorded as a part of the initial newborn assessment?
1. Resuscitative measures required in the birthing area
2. Blood draw for PKU screening
3. Presence or absence of meconium-stained fluid
4. Parents’ desires regarding circumcision for a male infant
Answer: 2
Explanation: 1. The condition of the newborn, including resuscitative measures required in the birthing area, should be recorded as part of the newborn assessment.
2. Blood is often drawn for laboratory testing, which should be recorded. However, blood draws for PKU screening must occur more than 24 hours after birth.
3. The labor and birth record, including the presence or absence of meconium-stained fluid, should be recorded as part of the newborn assessment.
4. Parent-newborn attachment information, including the parents’ desires regarding care, should be noted during the newborn assessment.
Page Ref: 483
Cognitive Level: Application
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care
Learning Outcome: LO 25.1-Summarize the essential information to be obtained about the prenatal period and a newborn’s birth experience and immediate postnatal period.
MNL LO: Recognize the timing and components of newborn assessment.