Chapter 23 Physiologic and Behavioral Adaptations of the Newborn

Chapter 23  Physiologic and Behavioral Adaptations of the Newborn

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A woman gave birth to a healthy 7-pound, 13-ounce infant girl. The nurse suggests that the client place the infant to her breast within 15 minutes after birth. The nurse is aware that the initiation of breastfeeding is most effective during the first 30 minutes after birth. What is the correct term for this phase of alertness?
a.
Transition period
b.
First period of reactivity
c.
Organizational stage
d.
Second period of reactivity

ANS: B
The first period of reactivity is the first phase of transition and lasts up to 30 minutes after birth. The infant is highly alert during this phase. The transition period is the phase between intrauterine and extrauterine existence. An organizational stage is not a valid stage. The second period of reactivity occurs approximately between 4 and 8 hours after birth, after a period of sleep.

DIF: Cognitive Level: Understand REF: p. 523 TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance

2. Part of the health assessment of a newborn is observing the infant’s breathing pattern. What is the predominate pattern of newborn’s breathing?
a.
Abdominal with synchronous chest movements
b.
Chest breathing with nasal flaring
c.
Diaphragmatic with chest retraction
d.
Deep with a regular rhythm

ANS: A
In a normal infant respiration, the chest and abdomen synchronously rise and infant breaths are shallow and irregular. Breathing with nasal flaring is a sign of respiratory distress. Diaphragmatic breathing with chest retraction is also a sign of respiratory distress.

DIF: Cognitive Level: Understand REF: p. 524
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

3. The nurse is assessing a full term, quiet, and alert newborn. What is the average expected apical pulse range (in beats per minute)?
a.
80 to 100
b.
100 to 120
c.
120 to 160
d.
150 to 180

ANS: C
The average infant heart rate while awake is 120 to 160 beats per minute. The newborn’s heart rate may be approximately 85 to 100 beats per minute while sleeping and typically a little higher than 100 to 120 beats per minute when alert but quiet. A heart rate of 150 to 180 beats per minute is typical when the infant cries.

DIF: Cognitive Level: Understand REF: p. 523
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

4. A newborn is placed under a radiant heat warmer. The nurse understands that thermoregulation presents a problem for the newborn. What is the rationale for this difficulty?
a.
The renal function of a newborn is not fully developed, and heat is lost in the urine.
b.
The small body surface area of a newborn favors more rapid heat loss than does an adult’s body surface area.
c.
Newborns have a relatively thin layer of subcutaneous fat that provides poor insulation.
d.
Their normal flexed posture favors heat loss through perspiration.

ANS: C
The newborn has little thermal insulation. Furthermore, the blood vessels are closer to the surface of the skin. Changes in environmental temperature alter the temperature of the blood, thereby influencing temperature regulation centers in the hypothalamus. Heat loss does not occur through urination. Newborns have a higher body surface-to-weight ratio than adults. The flexed position of the newborn helps guard against heat loss, because it diminishes the amount of body surface exposed to the environment.

DIF: Cognitive Level: Understand REF: p. 528 TOP: Nursing Process: Planning
MSC: Client Needs: Physiologic Integrity

5. An African-American woman noticed some bruises on her newborn daughter’s buttocks. The client asks the nurse what causes these. How would the nurse best explain this integumentary finding to the client?
a.
Lanugo
b.
Vascular nevus
c.
Nevus flammeus
d.
Mongolian spot

ANS: D
A Mongolian spot is a bluish-black area of pigmentation that may appear over any part of the exterior surface of the infant’s body and is more commonly noted on the back and buttocks and most frequently observed on infants whose ethnic origins are Mediterranean, Latin American, Asian, or African. Lanugo is the fine, downy hair observed on a term newborn. A vascular nevus, commonly called a strawberry mark, is a type of capillary hemangioma. A nevus flammeus, commonly called a port wine stain, is most frequently found on the face.

DIF: Cognitive Level: Apply REF: p. 535 TOP: Nursing Process: Diagnosis
MSC: Client Needs: Health Promotion and Maintenance