Chapter 19 Normal Newborn: Processes of Adaptation

Chapter 19  Normal Newborn: Processes of Adaptation

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A nursing student is helping the nursery nurse with morning vital signs. A baby born 10 hours ago via cesarean section is found to have moist lung sounds. Which is the best interpretation of this information?
a.
This is an emergency situation.
b.
The neonate must have aspirated surfactant.
c.
If this baby was born vaginally, it could indicate a pneumothorax.
d.
The lungs of a baby delivered by cesarean section may sound moist for 24 hours after birth.

ANS: D
The condition will resolve itself within a few hours. For this common condition of newborns, surfactant acts to keep the expanded alveoli partially open between respirations. In vaginal births, absorption of remaining lung fluid is accelerated by the process of labor and birth. Remaining lung fluid will move into interstitial spaces and be absorbed by the circulatory and lymphatic systems. This is a common condition for infants delivered by cesarean section. Surfactant is produced by the lungs, so aspiration is not a concern. It is common to have some fluid left in the lungs; this will be absorbed within a few hours.

PTS: 1 DIF: Cognitive Level: Analysis REF: 368
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

2. Which organs are nonfunctional during fetal life?
a.
Eyes and ears
b.
Lungs and liver
c.
Kidneys and adrenals
d.
Gastrointestinal system

ANS: B
Most of the fetal blood flow bypasses the nonfunctional lungs and liver. Near term, the eyes are open and the fetus can hear. Kidneys and adrenals function during fetal life. The fetus continuously swallows amniotic fluid, which is filtered through the kidneys. The gastrointestinal system functions during fetal life.

PTS: 1 DIF: Cognitive Level: Understanding REF: 370
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

3. Which method of heat loss may occur if a newborn is placed on a cold scale or touched with cold hands?
a.
Radiation
b.
Conduction
c.
Convection
d.
Evaporation

ANS: B
Conduction occurs when the infant comes in contact with cold objects. Radiation is the transfer of heat to a cooler object that is not in direct contact with the infant. Convection occurs when heat is transferred to the air surrounding the infant. Evaporation can occur during birth or bathing as a result of wet linens or clothes, or insensible heat loss.

PTS: 1 DIF: Cognitive Level: Understanding REF: 372
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Physiologic Integrity

4. How can nurses prevent evaporative heat loss in the newborn?
a.
Placing the baby away from the outside wall and the windows
b.
Keeping the baby out of drafts and away from air conditioners
c.
Drying the baby after birth and wrapping the baby in a dry blanket
d.
Warming the stethoscope and nurse’s hands before touching the baby

ANS: C
Wet linens or wet clothes can cause heat loss by evaporation. If the heat loss is caused by placing the baby near cold surfaces or equipment, it is termed a radiation heat loss. Heat loss by convection occurs when drafts come from open doors and air currents created by people moving around. Conduction heat loss occurs when the baby comes into contact with cold objects or surfaces.

PTS: 1 DIF: Cognitive Level: Application REF: 372
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Physiologic Integrity

5. The nurse is explaining how a newly delivered baby initiates respirations. Which statement explains this process?
a.
Drying off the infant
b.
Chemical, thermal, and mechanical factors
c.
An increase in the PO2 and a decrease in the PCO2
d.
The continued functioning of the foramen ovale

ANS: B
A variety of these factors are responsible for initiation of respirations. Tactile stimuli aid in initiating respirations but are not the main cause. The PO2 decreases at birth and the PCO2 increases. The foramen ovale closes at birth.

PTS: 1 DIF: Cognitive Level: Application REF: 369
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Physiologic Integrity