Chapter 18 Caring for the Normal Newborn

Chapter 18  Caring for the Normal Newborn

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse is assessing the neonate’s skin and notes the presence of small irregular red patches on the cheeks that turn into single yellow pimples on the baby’s chest. What treatment and care does the nurse recommend to the parents to help resolve this rash?
A.
Apply aloe vera lotion to lesions and skin.
B.
Apply hormonal skin cream twice a day.
C.
None; it will disappear within about a month.
D.
Vigorously wash and cleanse the baby’s skin.

ANS: C
Erythema toxicum is a newborn rash that consists of small, irregular flat red patches on the cheeks that develop into singular, small yellow pimples appearing on the chest, abdomen, and extremities. The etiology is unknown and it may persist for up to a month before resolving on its own.

Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Moderate

PTS: 1

2. The nurse completes an initial newborn examination. The nurse’s findings include the following: heart rate, 136 beats/minute; respiratory rate, 64 breaths/minute; temperature, 98.2°F (36.8°C). The nurse also documents a heart murmur, absence of bowel sounds, symmetry of ears and eyes, no grunting or nasal flaring, and full range of movement of all extremities. Which finding requires immediate consultation with the health-care provider?
A.
Absent bowel sounds
B.
Heart murmur
C.
Respiratory rate
D.
Temperature

ANS: A
Bowel obstruction in the neonate is often first identified by an absence of bowel sounds in a small, distinct section of the intestines; therefore, this finding should be reported. The other findings are normal (it is not uncommon to hear murmurs in infants less than 24 hours old).

Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Nursing Process: Assessment
Difficulty: Difficult

PTS: 1

3. The nursery nurse notes the presence of diffuse edema on a newborn baby’s head. Review of the birth record indicates that her mother experienced a prolonged labor and difficult childbirth. What action by the nurse is best?
A.
Document the findings in the infant’s chart.
B.
Measure head circumference every 12 hours.
C.
Prepare to administer IV osmotic diuretics.
D.
Transfer the baby to the NICU for monitoring .

ANS: A
Caput succedaneum is diffuse edema that crosses the cranial suture lines and disappears without treatment during the first few days of life. It often is the result of a traumatic or difficult birth. The nurse should document the findings. No other action is needed.

Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Communication and Documentation
Difficulty: Moderate

PTS: 1

4. The perinatal nurse teaches new parents that the best sleeping position for infants is which of the following?
A.
Prone
B.
Side-lying
C.
Side-lying with a blanket roll behind the infant’s back
D.
Supine

ANS: D
The nurse should teach the parents that all newborns should be placed on their backs (supine) for sleep by every caregiver for the first year of life.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Teaching/Learning
Difficulty: Easy

PTS: 1

5. A student nurse is verbalizing disappointment in a new mother’s seeming lack of interest in her newborn baby. The student complains to the registered nurse that the mother just wants to sleep and have someone else care for the infant. What response by the registered nurse is best?
A.
“Assess closely; we may need to call social work.”
B.
“Don’t judge other people until you have had a baby.”
C.
“The mother may be completely exhausted from the childbirth experience.”
D.
“We have to accept that everyone’s experience is different.”

ANS: C
Each option has an element of an appropriate response to the student. A definitive lack of bonding may call for a social work consult. Nurses should not judge other people’s responses. Every mother’s experience is different. However, the best response is the one that gives the student definitive information that can clarify the situation. After a long and possibly difficult birth, the mother may be too exhausted and too overwhelmed to assume an active role in parenting at this point. The student should show acceptance, reinforce previously taught information, allow the mother rest, and assist with bonding as opportunities present themselves, praising the mother for her efforts.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Psychosocial Integrity
Integrated Process: Caring
Difficulty: Easy

PTS: 1