Chapter 21 Care of the Normal Newborn

Chapter 21  Care of the Normal Newborn

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A yellow crust has formed over the circumcision site. The mother calls the hotline at the local hospital 5 days after her son was circumcised. She is very concerned. On which rationale should the nurse base a reply?
a.
The yellow crust should not be removed.
b.
This yellow crust is an early sign of infection.
c.
Discontinue the use of petroleum jelly to the tip of the penis.
d.
After circumcision, the diaper should be changed frequently and fastened snugly.

ANS: A
Crust is a normal part of healing. The normal yellowish exudate that forms over the site should be differentiated from the purulent drainage of infection. The only contraindication for petroleum jelly is the use of a PlastiBell. The diaper should be fastened loosely to prevent rubbing or pressure on the incision site.

PTS: 1 DIF: Cognitive Level: Application REF: 427
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Health Promotion and Maintenance

2. Most newborns receive a prophylactic injection of vitamin K soon after birth. Which site is appropriate for the newborn?
a.
Deltoid muscle
b.
Gluteal muscles
c.
Rectus femoris muscle
d.
Vastus lateralis muscle

ANS: D
The vastus lateralis muscle is located away from the sciatic nerve and femoral blood vessels. Gluteal muscles are not used until a child has been walking for at least 1 year to develop these muscles. The rectus femoris is used only if absolutely necessary because this muscle is located closer to the sciatic nerve and blood vessels, which poses a greater danger. The deltoid is not a recommended site for newborn injections.

PTS: 1 DIF: Cognitive Level: Understanding REF: 416
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Health Promotion and Maintenance

3. What should the nurse teach to parents about using a bulb syringe?
a.
Use it only once a day.
b.
Suction the back of the throat vigorously.
c.
Insert the syringe into the sides of the mouth.
d.
Always suction the mouth before suctioning the nose.

ANS: C
The syringe should be inserted into the sides of the mouth rather than the back of the throat to avoid a vagal response and bradycardia. Suction can occur as needed. Vigorous suction of the back of the throat may stimulate the vagal nerve and produce bradycardia. The mouth should be suctioned first to prevent aspiration.

PTS: 1 DIF: Cognitive Level: Application REF: 417
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Health Promotion and Maintenance

4. Which principle is important in providing and teaching cord care?
a.
Cord care is done only to control bleeding.
b.
Alcohol is the only agent used for cord care.
c.
It takes a minimum of 24 days for the cord to separate.
d.
Keeping the cord dry will decrease bacterial growth.

ANS: D
Bacterial growth increases in a moist environment, so keeping the umbilical cord dry impedes bacterial growth. Cord care is done to prevent infection and aid in the drying of the cord. No agents are necessary to facilitate drying of the cord. The cord will fall off within 10 to 14 days.

PTS: 1 DIF: Cognitive Level: Understanding REF: 422
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Health Promotion and Maintenance

5. Which is the purpose of state-required newborn screening?
a.
Keep the state records updated.
b.
Document the number of births.
c.
Allow for accurate statistical information.
d.
Recognize and treat newborn disorders early.

ANS: D
Early treatment of disorders will prevent morbidity associated with some common newborn disorders. Keeping state records and documenting the number of births are not the purposes of newborn screening. The number of births is not indicated by the newborn screening test.

PTS: 1 DIF: Cognitive Level: Understanding REF: 432, 433
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity