CHAPTER 7: GROWTH AND DEVELOPMENT OF THE NEWBORN My Nursing Test Banks

CHAPTER 7: GROWTH AND DEVELOPMENT OF THE NEWBORN

MULTIPLE CHOICE

1.The neonatal or newborn period of life is defined as the first:

a.

24 hours

c.

7 days

b.

48 hours

d.

28 days

ANS: D

Feedback

A

Incorrect. The neonatal or newborn period of life is not defined as the first 24 hours.

B

Incorrect. The neonatal or newborn period of life is not defined as the first 48 hours.

C

Incorrect. The neonatal or newborn period of life is not defined as the first 7 days.

D

Correct. The neonatal or newborn period of life is not defined as the first 28 days.

PTS: 1 REF: p. 192 Growth and Development of the Newborn

OBJ: Cognitive Level: Knowledge

2.In fetal circulation, most blood will bypass the fetal lungs via the:

a.

inferior vena cava

c.

foramen ovale

b.

ductus venosus

d.

ductus arteriosus

ANS: C

Feedback

A

Incorrect. In fetal circulation, most blood will not bypass the fetal lungs via the inferior vena cava, instead most of the blood from the placenta enters the inferior vena cava on the way directly to the heart, thus bypassing the lungs.

B

Incorrect. In fetal circulation, most blood will not bypass the fetal lungs via the ductus venosus; 60% of the blood from the placenta passes through the ductus venosus directly into the inferior vena cava.

C

Correct. In fetal circulation, most blood will bypass the fetal lungs via the foramen ovale, an opening between the right and left atria of the fetal heart.

D

Incorrect. In fetal circulation, most blood will not bypass the fetal lungs via the ductus arteriosus, however, a large amount of blood from the placenta travels through the ductus arteriosus (channel between the main pulmonary artery and the aorta).

PTS: 1 REF: p. 192 Growth and Development of the Newborn

OBJ: Cognitive Level: Knowledge

3.When the fetus makes the transition to becoming a newborn and extrauterine life begins, there occurs a series of changes, including decreased pulmonary vascular resistance, increased pulmonary blood flow, increased pressure of the left atrium, decreased pressure of the right atrium, and closure of which of the following structures?

a.

foramen ovale

c.

inferior vena cava

b.

ductus venosus

d.

superior vena cava

ANS: A

Feedback

A

Correct. The transition to extrauterine life requires the lungs to initiate respirations and the PaO2 levels increase. The opening between the left and right atria, the foramen ovale, closes shortly after birth.

B

Incorrect. The ductus venosus closes more gradually, usually within 2 weeks of birth.

C

Incorrect. The inferior vena cava must remain open for life to persist.

D

Incorrect. The superior vena cava must remain open for life to persist.

PTS: 1 REF: p. 192 Growth and Development of the Newborn

OBJ: Cognitive Level: Knowledge

4.After a long labor, the mother is concerned about the swelling of her babys scalp. The newborn is 24 hours old. The nurse palpates the scalp and finds swelling that extends across the suture lines. In addition to explaining the probable cause of the swelling and the time of resolution, the nurse explains that the term for this condition is:

a.

cephalhematoma

c.

molding

b.

caput succedaneum

d.

crepitation

ANS: B

Feedback

A

Incorrect. Cephalhematoma will usually develop after 24 hours, indicates rupture of blood vessels and bleeding, but does not extend across the suture lines.

B

Correct. Caput succedaneum is often evident after long labor, is swelling of the soft tissues of the scalp. The edema extends across the suture lines, and presents within the first 24 hours following birth.

C

Incorrect. Molding describes the misshapen appearance of the head following live birth.

D

Incorrect. Crepitation is the noisy discharge of gas from the intestine through the anus.

PTS: 1 REF: p. 193 Extrauterine Transition OBJ: Cognitive Level: Knowledge

5.The umbilical cord, which connects the fetus to the placenta, contains:

a.

one vein and one artery

c.

one artery and two veins

b.

two veins and two arteries

d.

two arteries and one vein

ANS: D

Feedback

A

Incorrect. The umbilical cord, which connects the fetus to the placenta, does not contain one vein and one artery.

B

Incorrect. The umbilical cord, which connects the fetus to the placenta, does not contain two veins and two arteries.

C

Incorrect. The umbilical cord, which connects the fetus to the placenta, does not contain one artery and two veins.

D

Correct. The umbilical cord, which connects the fetus to the placenta, does contains two arteries and one vein.

PTS: 1 REF: p. 206 Cognitive Development OBJ: Cognitive Level: Knowledge

6.The nurse instructing the mother on how to care for the umbilical cord of the newborn would direct the mother to:

a.

wash the cord only with warm water and gently dry it

b.

apply 70% isopropyl alcohol or hydrogen peroxide to the base next to the skin and to the cord with each diaper change

c.

use a solution of baby shampoo and water on the cord, rinse, and dry carefully

d.

wash the cord with a solution of Ivory soap and water, dry, air for 30 minutes, and apply triple antibiotic ointment after baths and diaper changes

ANS: B

Feedback

A

Incorrect. The nurse instructing the mother on how to care for the umbilical cord of the newborn would not direct the mother to wash the cord only with warm water and gently dry it; will not protect against infection.

B

Correct. The nurse instructing the mother on how to care for the umbilical cord of the newborn would direct the mother to apply 70% isopropyl alcohol or hydrogen peroxide to the base next to the skin and to the cord with each diaper change.

C

Incorrect. The nurse instructing the mother on how to care for the umbilical cord of the newborn would not direct the mother to use a solution of baby shampoo and water on the cord, rinse, and dry carefully.

D

Incorrect. The nurse instructing the mother on how to care for the umbilical cord of the newborn would not direct the mother to wash the cord with a solution of Ivory soap and water, dry, air for 30 minutes, and apply triple antibiotic ointment after baths and diaper changes.

PTS:1REF:p. 194 Physiological Development

OBJ: Cognitive Level: Comprehension

7.The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is to:

a.

allow visualization at all times

c.

remind the caregivers to do cord care

b.

keep the diaper from rubbing the cord

d.

provide air circulation for the cord

ANS: D

Feedback

A

Incorrect. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is not to allow visualization at all times.

B

Incorrect. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is not to keep the diaper from rubbing the cord.

C

Incorrect. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is not to remind the caregivers to do cord care.

D

Correct. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is to provide air circulation for the cord.

PTS:1REF:p. 195 Physiological Development

OBJ: Cognitive Level: Knowledge

8.The nurse is assessing neonatal reflexes. As the nurse moves the neonates head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is called:

a.

cats eye

c.

dolls eye

b.

head lag reflex

d.

eye delay

ANS: C

Feedback

A

Incorrect. As the nurse moves the neonates head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is not called cats eye.

B

Incorrect. As the nurse moves the neonates head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is not called head lag reflex.

C

Correct. As the nurse moves the neonates head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is called dolls eye.

D

Incorrect. As the nurse moves the neonates head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is not called eye delay.

PTS:1REF:p. 197 Physiological Development

OBJ: Cognitive Level: Knowledge

9.The rooting reflex of an infant disappears at approximately how many months of age?

a.

1

c.

4

b.

2

d.

6

ANS: C

Feedback

A

Incorrect. The rooting reflex of an infant does not disappear at approximately 1 month of age.

B

Incorrect. The rooting reflex of an infant does not disappear at approximately 2 months of age.

C

Correct. The rooting reflex of an infant does disappear at approximately 4 months of age.

D

Incorrect. The rooting reflex of an infant does not disappear at approximately 6 months of age.

PTS:1REF:p. 197 Physiological Development

OBJ: Cognitive Level: Knowledge

10.The stomach capacity of the newborn is approximately how many mL?

a.

30

c.

60

b.

40

d.

80

ANS: C

Feedback

A

Incorrect. The stomach capacity of the newborn is not approximately 30 mL?

B

Incorrect. The stomach capacity of the newborn is not approximately 40 mL?

C

Correct. The stomach capacity of the newborn is approximately 60 mL?

D

Incorrect. The stomach capacity of the newborn is not approximately 80 mL?

PTS:1REF:p. 199 Physiological Development

OBJ: Cognitive Level: Knowledge

11.The newborn is less capable of absorbing fat than older children and adults because of:

a.

natural allergies to fat

b.

lack of stomach acid

c.

shorter large and small intestines with shorter emptying time

d.

reduced bile salt secretion and less efficient pancreas

ANS: D

Feedback

A

Incorrect. The newborn is less capable of absorbing fat than older children and adults not because of natural allergies to fat.

B

Incorrect. The newborn is less capable of absorbing fat than older children and adults not because of lack of stomach acid.

C

Incorrect. The newborn is less capable of absorbing fat than older children and adults not because of shorter large and small intestines with shorter emptying time.

D

Correct. The newborn is less capable of absorbing fat than older children and adults because of reduced bile salt secretion from the liver and less efficient pancreas.

PTS:1REF:p. 200 Physiological Development

OBJ: Cognitive Level: Knowledge

12.The nurse is working with a newborn who has elevated bilirubin levels that are fast approaching the toxic level. The nurse is most concerned about which of the following conditions?

a.

ketolysis

c.

kernicterus

b.

bilharziasis

d.

biliverdin

ANS: C

Feedback

A

Incorrect. Elevated bilirubin levels approaching toxicity is not ketolysis.

B

Incorrect. Bilharziasis, more commonly known as schistosomiasis, is a parasitic infection second only to malaria in the number of people affected.

C

Correct. Kernicterus is the chronic and permanent accumulation of bilirubin in central nervous system tissues.

D

Incorrect. Biliverdin is the green bile pigment that becomes bilirubin.

PTS:1REF:p. 200 Physiological Development

OBJ: Cognitive Level: Comprehension

13.Which of the following statements best describes the purpose of phototherapy?

a.

reducing serum bilirubin level and preventing brain damage

b.

raising the body temperature of a neonate with a subnormal temperature

c.

producing X-rays of the internal organs of the body

d.

reducing pain in the muscles and joints of the body

ANS: A

Feedback

A

Correct. Phototherapy is the use of special high-intensity fluorescent lights as a method of reducing serum bilirubin level and preventing brain damage.

B

Incorrect. Raising the body temperature of a neonate with a subnormal temperature does not best describe the purpose of phototherapy.

C

Incorrect. Producing X-rays of the internal organs of the body does not best describe the purpose of phototherapy.

D

Incorrect. Reducing pain in the muscles and joints of the body does not best describe the purpose of phototherapy.

PTS:1REF:p. 200 Physiological Development

OBJ: Cognitive Level: Knowledge

14.The nurse administering phototherapy ordered by the primary care provider must take special safety precautions and:

a.

check the babys blood glucose before therapy

b.

cover the baby with a sheet during therapy

c.

shield the babys eyes and protect the gonads

d.

apply a special sunscreen prior to the treatment

ANS: C

Feedback

A

Incorrect. Special safety precautions when administering phototherapy is not to check the babys blood glucose before therapy.

B

Incorrect. Special safety precautions when administering phototherapy is not to cover the baby with a sheet during therapy.

C

Correct. Special safety precautions when administering phototherapy requires the nurse to shield the babys eyes (prevent retinal damage) and protect the gonads since maximum exposure is accomplished when the newborn is unclothed.

D

Incorrect. Special safety precautions when administering phototherapy is not to apply a special sunscreen prior to the treatment.

PTS:1REF:p. 200 Physiological Development

OBJ: Cognitive Level: Comprehension

15.To best assess the effectiveness of the phototherapy treatment, the nurse will monitor which of the following?

a.

skin color of the newborn

c.

serial serum bilirubin levels

b.

pulse oximetry

d.

activity level of the baby

ANS: C

Feedback

A

Incorrect. To best assess the effectiveness of the phototherapy treatment, the nurse will not rely upon the skin color of the newborn.

B

Incorrect. To best assess the effectiveness of the phototherapy treatment, the nurse will not rely upon the oxygen level in the blood.

C

Correct. To best assess the effectiveness of the phototherapy treatment, the nurse will rely upon serial serum bilirubin levels.

D

Incorrect. To best assess the effectiveness of the phototherapy treatment, the nurse will not rely upon the activity level of the baby.

PTS:1REF:p. 200 Physiological Development

OBJ: Cognitive Level: Application

16.At what age is the infant able to concentrate urine completely?

a.

birth

c.

3 months

b.

1 week

d.

1 year

ANS: C

Feedback

A

Incorrect. An infant is not able to concentrate urine completely at birth.

B

Incorrect. An infant is not able to concentrate urine completely at 1 week.

C

Correct. An infant is able to concentrate urine completely at 3 months.

D

Incorrect. An infant unable to concentrate urine completely at 1 year is in a lot of trouble.

PTS:1REF:p. 201 Physiological Development

OBJ: Cognitive Level: Knowledge

17.The normal value of the specific gravity of a newborns urine is:

a.

0.008-0.009

c.

1.1-1.7

b.

1.001-1.02

d.

1.8-1.9

ANS: B

Feedback

A

Incorrect. Water has a specific gravity of 1.0, so the value of 0.008-0.009 is way too low.

B

Correct. The normal value of the specific gravity of a newborns urine is close to the specific gravity of water, as their kidneys are not able to concentrate urine immediately after birth.

C

Incorrect. The normal value of the specific gravity of human urine is never as high as 1.1-1.7.

D

Incorrect. The normal value of the specific gravity of human urine is never as high as 1.8-1.9.

PTS:1REF:p. 201 Physiological Development

OBJ: Cognitive Level: Knowledge

18.The nurse uses what equipment to check for fluid between the parietal and visceral layers of the tunica vaginalis, the outermost covering of the testes?

a.

transilluminator

c.

manometer

b.

30 cc syringe

d.

fluid meter

ANS: A

Feedback

A

Correct. The use of the transilluminator may reveal a hydrocele or a collection of fluid between the parietal and visceral layers of the tunica vaginalis, the outermost covering of the testes.

B

Incorrect. The use of a 30 cc syringe would not be used to reveal the presence of a hydrocele.

C

Incorrect. The use of a manometer would not be used to reveal the presence of a hydrocele.

D

Incorrect. The use of a fluid meter would not be used to reveal the presence of a hydrocele.

PTS:1REF:p. 202 Physiological Development

OBJ: Cognitive Level: Knowledge

19.A collection of fluid between the parietal and visceral layers of the tunica vaginalis is called:

a.

spermatocele

c.

glandulitis

b.

hydrocele

d.

epididymitis

ANS: B

Feedback

A

Incorrect. A collection of fluid between the parietal and visceral layers of the tunica vaginalis is not called a spermatocele.

B

Correct. A collection of fluid between the parietal and visceral layers of the tunica vaginalis is called a hydrocele.

C

Incorrect. A collection of fluid between the parietal and visceral layers of the tunica vaginalis is not called glandulitis.

D

Incorrect. A collection of fluid between the parietal and visceral layers of the tunica vaginalis is not called epididymitis.

PTS:1REF:p. 202 Physiological Development

OBJ: Cognitive Level: Knowledge

20.When the nurse detects a hydrocele on a newborn, the nurse will talk with the caregivers and get them to:

a.

sign the surgical permit after a full explanation of the surgical procedure

b.

express their feelings about this abnormality in their newborn son

c.

decide on a specialist to correct this deformity in their newborn

d.

reassure them that this usually disappears within the first year of life

ANS: D

Feedback

A

Incorrect. No treatment is usually necessary for a hydrocele, hence the nurse will not talk with the caregivers and get them to sign the surgical permit after a full explanation of the surgical procedure.

B

Incorrect. No treatment is usually necessary for a hydrocele, hence the nurse will not talk with the caregivers and get them to express their feelings about this abnormality in their newborn son.

C

Incorrect. No treatment is usually necessary for a hydrocele, hence the nurse will not talk with the caregivers and get them to decide on a specialist to correct this deformity in their newborn.

D

Correct. When the nurse detects a hydrocele on a newborn, the nurse will talk with the caregivers and reassure them that this usually disappears within the first year of life.

PTS:1REF:p. 202 Physiological Development

OBJ: Cognitive Level: Knowledge

21.The nurse is teaching the caregivers about the immediate care of the newborn circumcised utilizing the plastibell. The nurse would instruct the caregivers to:

a.

gently lift the ring and squeeze warm water from a cotton ball onto the tip of the penis when changing the diaper

b.

take the bell off when the baby is awake, active, and likely to pull on the bell and dislodge it

c.

pull the ring off in 5 to 7 days when the circumcision is near or completely healed

d.

wash the bell and the penis with alcohol several times a day

ANS: A

Feedback

A

Correct. The nurse is teaching the caregivers about the immediate care of the newborn circumcised utilizing the plastibell. The nurse would instruct the caregivers to gently lift the ring and squeeze warm water from a cotton ball onto the tip of the penis when changing the diaper.

B

Incorrect. The nurse is teaching the caregivers about the immediate care of the newborn circumcised utilizing the plastibell. The nurse would not instruct the caregivers to take the bell off when the baby is awake, active, and likely to pull on the bell and dislodge it.

C

Incorrect. The nurse is teaching the caregivers about the immediate care of the newborn circumcised utilizing the plastibell. The nurse would not instruct the caregivers to pull the ring off in 5 to 7 days when the circumcision is near or completely healed.

D

Incorrect. The nurse is teaching the caregivers about the immediate care of the newborn circumcised utilizing the plastibell. The nurse would not instruct the caregivers to wash the bell and the penis with alcohol several times a day.

PTS:1REF:p. 204 Physiological Development

OBJ: Cognitive Level: Comprehension

22.The nurse is teaching the caregivers about the immediate care of the newborn circumcised without a plastibell. The nurse would teach the caregivers to:

a.

apply a thin layer of petroleum jelly to the circumcision

b.

remove any yellow exudate that accumulates on the penis about the second day after circumcision

c.

apply powder to the area of the circumcision

d.

use hydrogen peroxide to wash the circumcision area after each voiding

ANS: A

Feedback

A

Correct. If the plastibell is not used, there will be an open cut that will adhere to diapers. A thin layer of petroleum jelly applied to the circumcision will keep the diapers from sticking.

B

Incorrect. The yellow exudate is a granulation issue, and should not be removed.

C

Incorrect. It is more important to change diapers often so urine and stool do not irritate the site; powder is nice, but keeping the site clean is most important.

D

Incorrect. The use of hydrogen peroxide is not necessary after each diaper change, just keep the site clean.

PTS:1REF:p. 204 Physiological Development

OBJ: Cognitive Level: Comprehension

23.The nurse is teaching the caregivers about the care of their uncircumcised son. The nurse tells the caregivers that the foreskin may not be retractable in some children until around how many years of age?

a.

3

c.

6

b.

4

d.

8

ANS: A

Feedback

A

Correct. The foreskin of the uncircumcised son may not be retractable until age 3.

B

Incorrect. The foreskin of the uncircumcised son will be retractable after age 3.

C

Incorrect. The foreskin of the uncircumcised son will be retractable after age 3.

D

Incorrect. The foreskin of the uncircumcised son will be retractable after age 3.

PTS:1REF:p. 204 Physiological Development

OBJ: Cognitive Level: Knowledge

24.The mother asks the nurse to explain smegma to her. This is a term she heard the doctor mention. The nurse replies that smegma is:

a.

the oil used in the nursery to lubricate the babys skin after birth

b.

a collection of dead cells under the fingernails of the newborn infant

c.

a collection of cells that shed from the outer layer of skin and gathered under the foreskin

d.

the hormonal reaction to withdrawal from the maternal placental support

ANS: C

Feedback

A

Incorrect. Smegma is not the oil used in the nursery to lubricate the babys skin after birth.

B

Incorrect. Smegma is not a collection of dead cells under the fingernails of the newborn infant.

C

Correct. Smegma is a collection of cells that shed from the outer layer of skin and gather under the foreskin. Odor and infection may develop if the smegma is not removed.

D

Incorrect. Smegma is not the hormonal reaction to withdrawal from the maternal placental support.

PTS:1REF:p. 204 Physiological Development

OBJ: Cognitive Level: Knowledge

25.Male Jewish newborns are typically circumcised in a religious ceremony on what day of life?

a.

3rd

c.

8th

b.

5th

d.

12th

ANS: C

Feedback

A

Incorrect. Male Jewish newborns are typically not circumcised in a religious ceremony on the 3rd day of life.

B

Incorrect. Male Jewish newborns are typically not circumcised in a religious ceremony on the 5th day of life.

C

Correct. Male Jewish newborns are typically circumcised in a religious ceremony on the 8th day of life.

D

Incorrect. Male Jewish newborns are typically not circumcised in a religious ceremony on the 12th day of life.

PTS:1REF:p. 204 Physiological Development

OBJ: Cognitive Level: Knowledge

26.The mother observes traces of blood on the diaper of her newborn daughter and calls this to the attention of the nurse. The nurses best reply would be which of the following?

a.

I suspect this is from a urinary tract infection, a condition common in newborns when the bladder is not completely developed.

b.

This is probably caused by the baby not getting maternal hormones from the placenta. It will probably go away soon.

c.

This is probably from the trauma of the birth and will disappear in time.

d.

This is some placental blood we missed when bathing the baby at birth.

ANS: B

Feedback

A

Incorrect. The usual cause of small traces of blood on the female newborns diaper is from the withdrawal of maternal hormones, not from a urinary tract infection.

B

Correct. The usual cause of small traces of blood on the female newborns diaper is from the withdrawal of maternal hormones, called pseudomenstruation, and caregivers may need reassurance that this is normal and will soon disappear.

C

Incorrect. The usual cause of small traces of blood on the female newborns diaper is from the withdrawal of maternal hormones, not from the trauma of birth..

D

Incorrect. The usual cause of small traces of blood on the female newborns diaper is from the withdrawal of maternal hormones, not from placental blood we missed when bathing the baby at birth.

PTS:1REF:p. 202 Physiological Development

OBJ: Cognitive Level: Application

27.In assessing flexion of the elbows of the newborn, the nurse would flex them by holding for 5 seconds and when extending them. The elbows of a term newborn will form an angle of:

a.

120 degrees with an extended position following the angle

b.

100 degrees with a semiflexed position

c.

less than 90 degrees with a rapid recoil back to an extended position

d.

less than 90 degrees and rapidly recoil back to a flexed position

ANS: D

Feedback

A

Incorrect. The newborns elbow is by definition less than 120 degrees.

B

Incorrect. The newborns elbow is by definition less than 100 degrees

C

Incorrect. Though true the newborns elbow is less than 90 degrees, they recoil back to a flexed position, not an extended position.

D

Correct. In assessing flexion of the elbows of the newborn, the nurse would flex them by holding for 5 seconds and when extending them. The elbows of a term newborn will form an angle of less than 90 degrees and rapidly recoil back to a flexed position.

PTS:1REF:p. 203 Physiological Development

OBJ: Cognitive Level: Knowledge

28.The transitional stool of the newborn usually occurs by the 3rd day and is:

a.

green brown-yellow brown

c.

grayish

b.

clay color

d.

light yellow-light green

ANS: A

Feedback

A

Correct. The transitional stool of the newborn usually occurs by the 3rd day and is green brown-yellow brown.

B

Incorrect. The transitional stool of the newborn usually occurs by the 3rd day and is not clay color.

C

Incorrect. The transitional stool of the newborn usually occurs by the 3rd day and is not grayish.

D

Incorrect. The transitional stool of the newborn usually occurs by the 3rd day and is not light yellow-light green.

PTS: 1 REF: p. 210 Anticipatory Guidance OBJ: Cognitive Level: Knowledge

29.The mother of a breastfed newborn tells the nurse that the babys stool is golden yellow, is pasty instead of firm, and has a sour milk odor. The best response on the part of the nurse would be which of the following?

a.

You probably need to feed this baby some cereal to firm up the stool.

b.

Cut back on your fluid intake and be careful what you eat, as you pass this on to the baby.

c.

I need to check your temperature and your breasts to determine if you have a breast abscess.

d.

This is a normal stool for a newborn that is breastfed. Do not change anything about your breastfeeding.

ANS: D

Feedback

A

Incorrect. When the babys stool is golden yellow, is pasty instead of firm, and has a sour milk odor, you will not advise the mother to change anything.

B

Incorrect. When the babys stool is golden yellow, is pasty instead of firm, and has a sour milk odor, you will not advise the mother to change anything.

C

Incorrect. When the babys stool is golden yellow, is pasty instead of firm, and has a sour milk odor, you will not suspect a problem with the mothers temperature or assess for a breast abscess..

D

Correct. When the babys stool is golden yellow, is pasty instead of firm, and has a sour milk odor, it is normal if the mother is breastfeeding.

PTS:1REF:p. 210 Anticipatory Guidance

OBJ: Cognitive Level: Application

30.The nurse is assessing a newborn and finds a rash that has a red macular base with a white vesicular center. This rash is most likely which of the following conditions?

a.

desquamation

c.

petechiae

b.

telangiectatic nevi

d.

erythema toxicum

ANS: D

Feedback

A

Incorrect. Desquamation is the normal process by which the skin is sloughed in fine scales, commonly referred to as peeling of the skin.

B

Incorrect. Telangiectatic nevi are capillary hemangiomas commonly called stork bites.

C

Incorrect. Petechiae are small, pinpoint, nonraised, perfectly round, purplish red spots, which are a result of an intradermal or submucosal hemorrhage. May or may not be normal.

D

Correct. Some newborns may experience a transient newborn rash that is characterized by a red macular base with a white vesicular center. This rash is referred to as erythema toxicum.

PTS:1REF:p. 205 Physiological Development

OBJ: Cognitive Level: Knowledge

31.The nurse will assess the newborn for passage of stool and will expect the newborn to pass which of the following stools:

a.

a pasty yellow stool by 24 hours

c.

a meconium stool by 24 hours

b.

firm, pale yellow stool by 18 hours

d.

a meconium stool by 72 hours

ANS: C

Feedback

A

Incorrect. The newborn stool that is pasty yellow indicates the infant is being breastfed, but does not occur until the meconium and the transitional stool have occurred.

B

Incorrect. The newborn stool that is firm, pale yellow indicates the infant is being breastfed, but does not occur until the meconium and the transitional stool have occurred, not by 18 hours.

C

Correct. The nurse will assess the newborn for passage of stool and will expect the newborn to pass a meconium stool within 24-48 hours of birth.

D

Incorrect. The transitional stool will be passed by the 3rd day after birth.

PTS: 1 REF: p. 206 Cognitive Development OBJ: Cognitive Level: Knowledge

32.The nurse is instructing the caregivers in changing the diaper of their newborn daughter. The nurse will instruct the caregivers to wipe the baby from:

a.

back to front using a wipe designed for a baby

b.

front to back using plain water and absorbent cotton or a fresh washcloth

c.

from the vagina forward and then from the vagina to the rectum

d.

from the vagina forward and then from the vagina to the rectum

ANS: B

Feedback

A

Incorrect. The nurse will instruct the caregivers to not wipe the baby from back to front using a wipe designed for a baby.

B

Correct. When changing the diaper of a female, instruct caregivers to wipe from front to back. This will control feces contamination of the vaginal area. The AAP recommends using plain water and absorbent cotton or fresh washcloth.

C

Incorrect. The nurse will instruct the caregivers to not wipe the baby from the vagina forward and then from the vagina to the rectum.

D

Incorrect. The nurse will instruct the caregivers to not wipe the baby from the vagina forward and then from the vagina to the rectum.

PTS: 1 REF: p. 212 Anticipatory Guidance OBJ: Cognitive Level: Knowledge

33.The normal newborn uses what behavior or ability to protect him- or herself from overstimulation and to free energy to meet physiologic demands?

a.

deep sleeping

c.

constitution

b.

crying

d.

habituation

ANS: D

Feedback

A

Incorrect. The normal newborn does not use deep sleeping to protect himself from overstimulation.

B

Incorrect. The normal newborn does not use crying to protect himself from overstimulation.

C

Incorrect. The normal newborn does not use the constitution to protect himself from overstimulation.

D

Correct. Habituation, the ability to decrease responses to disturbing stimuli, is a defensive state that the newborn may enter to protect him- or herself from over\-stimulation and to free energy to meet physiologic demands.

PTS:1REF:p. 205 Physiological Development

OBJ: Cognitive Level: Knowledge

34.Which of the following best describes habituation?

a.

ability to decrease responses to disturbing stimuli

b.

staying still for longer periods of time

c.

breathing more slowly than usual

d.

adjusting to temperature increases and decreases

ANS: A

Feedback

A

Correct. The ability to decrease responses to disturbing stimuli best describes the term, habituation.

B

Incorrect. Staying still for longer periods of time does not best describe the term, habituation.

C

Incorrect. Breathing more slowly than usual does not best describes the term, habituation.

D

Incorrect. Adjusting to temperature increases and decreases does not best describe the term, habituation.

PTS:1REF:p. 205 Physiological Development

OBJ: Cognitive Level: Knowledge

35.According to child psychoanalyst Erik Erikson, newborns develop basic trust when:

a.

they reach the age of 1 month

b.

the mind matures sufficiently to conceptualize

c.

caregivers meet the needs of the newborn

d.

more needs are met than not met

ANS: C

Feedback

A

Incorrect. Eriksons theory of development does not say that the newborn develops basis trust when they reach the age of 1 month.

B

Incorrect. Eriksons theory of development does not say that the newborn develops basis trust when the mind matures sufficiently to conceptualize.

C

Correct. According to child psychoanalyst Erik Erikson, newborns develop basic trust when caregivers meet the needs of the newborn, trust versus mistrust.

D

Incorrect. Eriksons theory of development does not say that the newborn develops basis trust when more needs are met than not met.

PTS:1REF:p. 207 Cognitive Development

OBJ: Cognitive Level: Comprehension

36.Prior to discharge from the hospital, the newborn most often will receive a screening blood test to rule out which of the following conditions?

a.

Addisons disease and pituitary dysfunction

b.

Down syndrome and autism

c.

phenylketonuria and hypothyroidism

d.

Marfans syndrome and cerebral palsy

ANS: C

Feedback

A

Incorrect. The newborn, prior to discharge from the hospital, does not most often receive a screening blood test to rule out Addisons disease and pituitary dysfunction.

B

Incorrect. The newborn, prior to discharge from the hospital, does not most often receive a screening blood test to rule out Down syndrome and autism.

C

Correct. The newborn, prior to discharge from the hospital, does most often receive a screening blood test to rule out phenylketonuria and hypothyroidism.

D

Incorrect. The newborn, prior to discharge from the hospital, does not most often receive a screening blood test to rule out Marfans syndrome and cerebral palsy.

PTS: 1 REF: p. 208   Health Promotion and Maintenance

OBJ: Cognitive Level: Knowledge

37.The type of heat exchange that occurs between the newborn and water during a bath or when exposed to drafts is called:

a.

convection

c.

conduction

b.

evaporation

d.

radiation

ANS: A

Feedback

A

Correct. The type of heat exchange that occurs between the newborn and water during a bath or when exposed to drafts is called convection.

B

Incorrect. Evaporation is not the type of heat exchange that occurs between the newborn and water during a bath or when exposed to drafts.

C

Incorrect. Conduction is not the type of heat exchange that occurs between the newborn and water during a bath or when exposed to drafts.

D

Incorrect. Radiation is not the type of heat exchange that occurs between the newborn and water during a bath or when exposed to drafts.

PTS: 1 REF: p. 211 Anticipatory Guidance OBJ: Cognitive Level: Knowledge

38.If a newborn is not dried thoroughly after a bath, it is most likely that the newborn will:

a.

have increased susceptibility to seizure

c.

become increasingly anxious

b.

develop a severely dried skin

d.

have a body temperature drop

ANS: D

Feedback

A

Incorrect. Improper or inadequate drying of a newborn after a bath will not most likely mean the newborn will have increased susceptibility to seizure.

B

Incorrect. Improper or inadequate drying of a newborn after a bath will not most likely mean the newborn will develop a severely dried skin.

C

Incorrect. Improper or inadequate drying of a newborn after a bath will not most likely mean the newborn will become increasingly anxious.

D

Correct. Improper or inadequate drying of a newborn after a bath will not most likely mean the newborn will have a body temperature drop as the water evaporates from the skin.

PTS: 1 REF: p. 211 Anticipatory Guidance OBJ: Cognitive Level: Knowledge

39.A type of fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn is which of the following?

a.

pure fat

c.

brown fat

b.

triglycerides

d.

glycerol

ANS: C

Feedback

A

Incorrect. Pure fat is not a type of fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn.

B

Incorrect. Triglycerides is not a type of fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn.

C

Correct. Brown fat is a type of fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn, and serves as the primary form of heat production.

D

Incorrect. Glycerol is not a type of fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn.

PTS: 1 REF: p. 211 Anticipatory Guidance OBJ: Cognitive Level: Knowledge

40.Fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn does which of the following things?

a.

protects the newborn from injury in case of falling or other trauma

b.

increases cellular metabolic rates and oxygen consumption

c.

provides a store of usable energy in case the baby does not nurse well

d.

is used in the production of hormones, especially testosterone

ANS: B

Feedback

A

Incorrect. Brown fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn does not protect the newborn from injury in case of falling or other trauma.

B

Correct. Brown fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn does increases cellular metabolic rates and oxygen consumption to produce additional heat.

C

Incorrect. Brown fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn does not provide a store of usable energy in case the baby does not nurse well.

D

Incorrect. Brown fat found primarily in the subscapular, axillary, adrenal, and mediastinal regions of the newborn is not used in the production of hormones, especially testosterone.

PTS: 1 REF: p. 211 Anticipatory Guidance OBJ: Cognitive Level: Knowledge

41.In teaching the family about caring for the newborn, you would advise the caregiver to:

a.

place the neonate directly on a scale

b.

place the newborns crib close to the window

c.

expose baby completely, bathing in as few a motions as possible

d.

block sunlight from the newborn while the newborn is in the car

ANS: D

Feedback

A

Incorrect. In teaching the family about caring for the newborn, you would not advise the caregiver to place the neonate directly on a scale.

B

Incorrect. In teaching the family about caring for the newborn, you would not advise the caregiver to place the newborns crib close to the window.

C

Incorrect. In teaching the family about caring for the newborn, you would not advise the caregiver to expose baby completely, bathing in as few a motions as possible.

D

Correct. In teaching the family about caring for the newborn, you would advise the caregiver to block sunlight from the newborn while the newborn is in the car.

PTS:1REF:p. 211 Anticipatory Guidance

OBJ: Cognitive Level: Comprehension

42.The usual recommended sleeping position for a normal newborn is which of the following positions?

a.

prone

b.

semi-Fowlers with the head elevated by a pillow

c.

supine

d.

feet elevated slightly

ANS: C

Feedback

A

Incorrect. Prone is not the usual recommended sleeping position for a normal newborn.

B

Incorrect. Semi-Fowlers with the head elevated by a pillow is not the usual recommended sleeping position for a normal newborn.

C

Correct. Supine or side-laying is the usual recommended sleeping position for a normal newborn.

D

Incorrect. Feet elevated slightly is not the usual recommended sleeping position for a normal newborn.

PTS: 1 REF: p. 211 Anticipatory Guidance OBJ: Cognitive Level: Knowledge

43.The caregivers of a newborn baby mention to the nurse that they sleep on a water bed and are planning to have the baby sleep with them. The nurse would say which of the following things to the family in her teaching?

a.

Many people believe that a family that sleeps together bonds well.

b.

This will make it more convenient to feed the baby at night.

c.

You need to sleep on a firm mattress with the baby or give the baby a crib with a firm mattress.

d.

Some caregivers report not getting enough rest at night when they have the baby or other children sleep with them.

ANS: C

Feedback

A

Incorrect. The waterbed is to be avoided with newborns.

B

Incorrect. The waterbed is to be avoided with newborns.

C

Correct. The nurse in her family teaching will discuss the types of bedding to avoid with the newborn: soft bedding, pillows, comforters, sheepskin and waterbeds.

D

Incorrect. The waterbed is to be avoided with newborns.

PTS:1REF:p. 212 Anticipatory Guidance

OBJ: Cognitive Level: Application

44.The nurse observes the mother of a newborn and four other children feeding the newborn in the infant seat with the bottle propped. The nurse would need to:

a.

tactfully teach the mother the importance of holding and cuddling in the attachment process

b.

congratulate the mother for finding a safe place for the baby to take the bottle

c.

tell the mother that this procedure encourages independence in the newborn

d.

suggest that the mother let the older children hold the bottle for the baby in the infant seat

ANS: A

Feedback

A

Correct. Feeding time is crucial to the development of the caregiver-newborn attachment, since it is time for the newborn and caregiver to interact and learn about each other. If the newborn remains in the crib or in an infant seat with the bottle propped, the attachment process can be delayed.

B

Incorrect. If the nurse observes the mother of a newborn feeding the newborn in the infant seat with the bottle propped, it is not appropriate to congratulate the mother for finding a safe place for the baby to take the bottle.

C

Incorrect. If the nurse observes the mother of a newborn feeding the newborn in the infant seat with the bottle propped, it is not appropriate to tell the mother that this procedure encourages independence in the newborn.

D

Incorrect. If the nurse observes the mother of a newborn feeding the newborn in the infant seat with the bottle propped, it is not appropriate to suggest that the mother let the older children hold the bottle for the baby in the infant seat.

PTS:1REF:p. 210 Anticipatory Guidance

OBJ: Cognitive Level: Application

45.The current practice of feeding newborns is:

a.

to place them on a frequent feeding schedule

b.

an on-demand feed

c.

to offer five feedings a day

d.

to set up a specific schedule

ANS: B

Feedback

A

Incorrect. The current practice of feeding newborns is not best described as to place them on a frequent feeding schedule.

B

Correct. The current practice of feeding newborns is best described as an on-demand feed.

C

Incorrect. The current practice of feeding newborns is not best described as to offer five feedings a day.

D

Incorrect. The current practice of feeding newborns is not best described as to set up a specific schedule.

PTS: 1 REF: p. 210 Anticipatory Guidance OBJ: Cognitive Level: Knowledge

46.Formula-fed newborns compared to breastfeeding newborns:

a.

will go longer between feedings

b.

will feed at about the same intervals

c.

will require more frequent feedings

d.

are unpredictable in how they will compare

ANS: A

Feedback

A

Correct. Formula is digested more slowly and usually establishes a pattern of feeding every 3-4 hours, whereas a breastfed newborn may nurse every 1 1/2 3 hours.

B

Incorrect. Formula-fed newborns compared to breastfeeding newborns can go longer between feedings.

C

Incorrect. Formula-fed newborns compared to breastfeeding newborns will not require more frequent feedings.

D

Incorrect. Formula-fed newborns compared to breastfeeding newborns are predictable in how they will compare.

PTS:1REF:p. 210 Anticipatory Guidance

OBJ: Cognitive Level: Comprehension

47.The nurse teaching the new mother about breast care will advise the mother to wash the breasts:

a.

with plain water

c.

with alcohol and cotton swabs

b.

with soap and water

d.

with a peroxide-and-water solution

ANS: A

Feedback

A

Correct. The nurse teaching the new mother about breast care will advise the mother to wash the breasts with plain water.

B

Incorrect. The nurse teaching the new mother about breast care will advise the mother to wash the breasts with plain water, not with soap and water.

C

Incorrect. The nurse teaching the new mother about breast care will advise the mother to wash the breasts with plain water, not with alcohol and cotton swabs.

D

Incorrect. The nurse teaching the new mother about breast care will advise the mother to wash the breasts with plain water, not with a peroxide-and-water solution.

PTS:1REF:p. 210 Anticipatory Guidance

OBJ: Cognitive Level: Comprehension

48.In teaching the mother how to remove the newborn from the breast, the nurse would offer which of the following instructions?

a.

Gently slap the newborns cheek or hand to get him or her distracted enough to stop feeding.

b.

Pull on the babys ear that is opposite the breast there the baby is feeding.

c.

Push on the babys cheeks to open the babys mouth.

d.

Place a finger in the side of the babys mouth and between the jaws to release suction.

ANS: D

Feedback

A

Incorrect. It would not be effective to slap the newborns cheek or hand.

B

Incorrect. It would not be effective to pull on the babys ear.

C

Incorrect. It would not be effective to push on the babys cheeks to open the mouth.

D

Correct. After nursing, release the suction before removing the newborn from the breast by placing a finger in the side of the mouth and between the jaws.

PTS:1REF:p. 210 Anticipatory Guidance

OBJ: Cognitive Level: Application

Leave a Reply