Question 1

Which range,in g/L,represents the normal hemoglobin of a healthy full-term infant?

Accepted Answer

The normal range of hemoglobin in a term newborn is 166 to 175 g/L.

Question 2

What would an Apgar score of 10 at 1 minute after birth indicate?

Accepted Answer

An initial Apgar score of 10 is a good sign of healthy adaptation; however,it must be repeated at the 5-minute mark.

Question 3

A new father wants to know what medication was put into his infant's eyes and why it is needed.What does the nurse explain to the father about the purpose of the Ilotycin ophthalmic ointment?

Accepted Answer

The purpose of the erythromycin ophthalmic ointment is to prevent gonorrheal and chlamydial infection of the infant's eyes that is potentially acquired from the birth canal.Prophylactic ophthalmic ointment is instilled in the eyes of all neonates to prevent gonorrheal or chlamydial infection.Prophylactic ophthalmic ointment is not instilled to prevent dry eyes.Prophylactic ophthalmic ointment has no bearing on vision other than to protect against infection that may lead to vision problems.

Question 4

The normal term infant has little difficulty clearing the airway after birth.Most secretions are brought up to the oropharynx by the cough reflex.However,if the infant has excess secretions,the mouth and nasal passages can be cleared easily with a bulb syringe.When instructing parents on the correct use of this piece of equipment,it is important that the nurse teach them to do which of the following?

Accepted Answer

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.After compression of the bulb it should be inserted into one side of the mouth.If it is inserted into the centre of the mouth,the gag reflex is likely to be initiated.When the infant's cry no longer sounds as though it is through mucus or a bubble,suctioning can be stopped.The bulb syringe should remain in the crib so that it is easily accessible if needed again.

Question 5

Nurses can help parents deal with the issue and fact of circumcision if they explain which of the following?

Accepted Answer

Many parents find themselves making the decision during the pressure of labour.The CPS and other professional organizations note the benefits but stop short of recommendation for routine circumcision.Circumcision is painful and must be managed with environmental,nonpharmacological,and pharmacological measures.After the procedure the infant may be fussy for several hours,or he may be sleepy and difficult to awaken for feeding.

Question 6

A mother expresses fear about changing her infant's diaper after he is circumcised.What does the woman need to be taught,in order to take care of the infant when she gets home?

Accepted Answer

CleAnswering the penis gently with water and putting petroleum jelly around the glAnswer after each diaper change is appropriate when caring for an infant who has had a circumcision.With each diaper change,the penis should be washed off with warm water to remove any urine or feces.If bleeding occurs,the nurse should apply gentle pressure to the site of the bleeding with a sterile gauze square.Yellow exudates cover the glAnswer penis within 24 hours after the circumcision.This is part of normal healing and not an infective process.The exudates should not be removed.

Question 7

Which statement applies to a complete physical examination within 24 hours after birth?

Accepted Answer

The nurse will be looking at skin colour,alertness,cry,head size,and other features.The parents' presence actively involves them in child care and gives the nurse a chance to observe interactions.The complete exam is not done immediately at birth; the infant's temperature must be stabilized.The second sound is higher and sharper than the first.

Question 8

What should the nurse be aware of with regard to umbilical cord care?

Accepted Answer

The cord stump is an excellent medium for bacterial growth.The nurse should first check the clamp (or tie)and apply a second one.If the bleeding does not stop,the nurse should call for assistance.The cord clamp is removed after 24 hours when it is dry.The average cord separation time is 10 to 14 days.

Question 9

In the classification of newborns by gestational age and birth weight,the appropriate for gestational age ( AGA )weight would be which of the following?

Accepted Answer

The AGA range is a large one: between the 10th and the 90th percentiles for infant age.The infant's length and size of the head are measured,but do not affect the normal weight designation.IUGR applies to the fetus,not the newborn's weight.

Question 10

What is the main reason that nurses wear gloves when handling the newborn at birth?

Accepted Answer

Gloves are worn to protect the nurse from infection until the blood and amniotic fluid are cleaned off the newborn.

Question 11

As part of their teaching function at discharge,nurses should tell parents that the baby's respiration will not be protected by which one of the following procedures?

Accepted Answer

The infant should be laid down to sleep on his or her back for better breathing and to prevent sudden infant death syndrome.Infants are vulnerable to respiratory infections; infected people must be kept away.Secondhand smoke can damage lungs.Infants can suffocate in loose bedding and furniture that can trap them.

Question 12

A 3800 g infant was delivered vaginally at 39 weeks after a 30-minute second stage.There was a nuchal cord.After birth,the infant had petechiae over the face and upper back.Which information would be accurate to be given to the infant's parents about petechiae?

Accepted Answer

Petechiae,or pinpoint hemorrhagic areas,acquired during birth may extend over the upper portion of the trunk and face.These lesions are benign if they disappear within 2 days of birth and no new lesions appear.Petechiae may result from decreased platelet formation.In this situation,the presence of petechiae is most likely a soft-tissue injury resulting from the nuchal cord at birth.Unless they do not dissipate in 2 days,there is no reason to alarm the family.Petechiae usually occur with a breech presentation vaginal birth.

Question 13

A newborn is jaundiced and receiving phototherapy via ultraviolet bank lights.Which is an appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy?

Accepted Answer

The infant's eyes must be protected by an opaque mask to prevent overexposure to the light.Eye shields should cover the eyes completely but not occlude the nares.Lotions and ointments should not be applied to the infant because they absorb heat,and this can cause burns.The lights increase insensible water loss,placing the infant at risk for fluid loss and dehydration.Therefore,it is important that the infant be adequately hydrated.The infant should be turned every 2 hours to expose all body surfaces to the light.

Question 14

Which type of blood should be used for genetic screening?

Accepted Answer

Genetic screening should be carried out on newborn venous or capillary blood.

Question 15

At 1 minute after birth,the nurse assesses the infant and notes a heart rate of 80 beats/min,some flexion of extremities,a weak cry,grimacing,and a pink body but blue extremities.On the basis of these data,what would the nurse calculate as the Apgar score?

Accepted Answer

Each of the five signs the nurse noted would score a 1 on the Apgar scale,for a total of 5.

Question 16

When preparing to administer a hepatitis B vaccine to a newborn,what should the nurse know?

Accepted Answer

The hepatitis B vaccine should be administered with a 25-gauge,16-mm (5/8-inch)needle.Hepatitis B vaccination is recommended for all infants.If the infant is born to an infected mother who is a chronic carrier,hepatitis vaccine and hepatitis B immune globulin should be administered within 12 hours of birth.Hepatitis B vaccine should be given in the vastus lateralis muscle.Hepatitis B vaccine can be given at birth.If the mother is a hepatitis B carrier,the vaccine should be given to the infant within 12 hours after birth.

Question 17

The nurse is using the Ballard scale to determine the gestational age of a newborn.Which assessment finding is consistent with a gestational age of 40 weeks?

Accepted Answer

Term infants typically have a flexed posture.Abundant lanugo usually is seen on preterm infants.Smooth,pink skin with visible veins is seen on preterm infants.Faint red marks usually are seen on preterm infants.

Question 18

Which principle applies to a newborn bath?

Accepted Answer

Always work from clean to dirty.Start with the face,neck,and ears first.Do not use soap on the face.CleAnswere the eyes from the inner canthus outward,using separate parts of a clean washcloth for each eye.

Question 19

Early this morning,an infant boy was circumcised using the PlastiBell method.When should the nurse tell the mother that she and her infant can be discharged?

Accepted Answer

The infant should be observed for urination after the circumcision.Bleeding is a common complication after circumcision.The nurse will check the penis for 12 hours after a circumcision to assess and provide appropriate interventions for prevention and treatment of bleeding.Yellow exudates cover the glAnswer penis within 24 hours after the circumcision.This is part of normal healing and not an infective process.The PlastiBell remains in place for about a week and falls off when healing has taken place.

Question 20

An infant boy was born just a few minutes ago and the nurse is assessing the Apgar score.When is the Apgar score performed?

Accepted Answer

Apgar scoring is performed at 1 minute and 5 minutes after birth.Scoring may continue at 5-minute intervals if the infant is in distress and requires resuscitation efforts.

Quiz 25: Nursing Care of the Newborn