Chapter 22 The Normal Newborn: Nursing Care

Chapter 22  The Normal Newborn: Nursing Care

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 her reply?
a. After circumcision, the diaper should be changed frequently and fastened snugly.
b. This yellow crust is an early sign of infection.
c. The yellow crust should not be removed.
d. Discontinue the use of petroleum jelly to the tip of the penis.

ANS: C
Crust is a normal part of healing and should not be removed. The diaper should be fastened
loosely to prevent rubbing or pressure on the incision site. 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.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 472 | Patient-Centered Teaching Box
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

2. A new father wants to know what medication was put into his infant’s eyes and why it is

needed. The nurse explains to the father that the purpose of the ophthalmic ointment is to
a. destroy an infectious exudate caused by Staphylococcus that could make the infant

blind.
b. prevent gonorrheal and chlamydial infection of the infant’s eyes potentially

acquired from the birth canal.
c. prevent potentially harmful exudate from invading the tear ducts of the infant’s

eyes, leading to dry eyes.
d. prevent the infant’s eyelids from sticking together and help the infant see.

ANS: B
The ointment is used to prevent potential gonorrheal and chlamydial infection of the infant’s
eyes.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 462 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Physiologic Integrity

3. When instructing parents on the correct use of a bulb syringe it is important include what

information?
a. Avoid suctioning the nares.
b. Insert the compressed bulb into the center of the mouth.
c. Suction the mouth first.
d. Remove the bulb syringe from the crib when finished.

ANS: C

The mouth should be suctioned first to prevent the infant from inhaling pharyngeal
secretions by gasping as the nares are suctioned. The nasal passages should be suctioned one
nostril at a time. The mouth should always be suctioned first. After compression of the bulb
it should be inserted into one side of the mouth. If it is inserted into the center of the mouth,
the gag reflex is likely to be initiated. The bulb syringe should remain in the crib so that it is
easily accessible if needed again.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 463 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

4. In providing and teaching cord care, what is an important principle?

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. The process of 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 to prevent infection and add 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: Comprehension/Understanding
REF: p. 468 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

5. The nurse’s initial action when caring for an infant with a slightly decreased temperature is

to
a. notify the physician immediately.
b. place a cap on the infant’s head.
c. Keep the infant in the nursery for the next 4 hours.
d. Assess for other signs of inaccurate gestational age.

ANS: B
A cap will prevent further heat loss from the head, and having the mother place the infant
skin-to-skin should increase the infant’s temperature. Nursing actions are needed first to
correct the problem. If the problem persists after interventions, notification may then be
necessary. A slightly decreased temperature can be treated in the mother’s room. This would
be an excellent time for parent teaching on prevention of cold stress. There is no need for
another gestational age assessment.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 464 OBJ: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity