Chapter 7: Newborn and Infants My Nursing Test Banks

Chapter 7: Newborn and Infants

Multiple Choice

  1. 1. A mother brings her 9 month infant in for a routine visit. What milestone would be appropriate for the doctor to ask if the infant is meeting?

1. Walking

2. Speaking in two word phrases

3.  Rolls back to stomach and stomach to back

4.  All of the above

ANS: 3

Feedback
1. Between 1012 months of age, an infant can walk
2. Between 1416 months of age, an infant can speak two word phrases
3. Between 6 and 9 months of age, an infant can roll from back to stomach and stomach to back.
4. Many infants will not be walking at this age. It is too soon for word phrases to be developed.  The child should be rolling.

KEY: Content Area: Growth and Development| Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

  1. 2. A 5 day old infant comes in for a newborn checkup. On assessment of the newborn, you note that the skin is jaundice in color. The anterior fontanel is slightly sunken. Per mom, the infant has only had 2 diapers today. The infant is strictly breastfed and this is moms first child. She states baby is having trouble latching on. A bilirubin level is sent and comes back at 18. You identify this newborn to be dehydrated and is most likely to have breast milk jaundice. Which nursing intervention(s) will be required for this baby?
  1. 1. Phototherapy
  2. 2. Providing support and education for the lactating mother
  3. 3. Strict monitoring of intake and output
  4. 4. All of the above

ANS 4

Feedback
1. Phototherapy will be required to help decrease the level of bilirubin.
2. It is important to provide the mother with support and education and offer a lactation specialist.
3. This infant is dehydrated so it will be necessary to monitor strict I & Os.
4. Breast Milk Jaundice occurs in 12% of breastfed babies. At early onset there are poor feeding patterns and bilirubin levels may spike to 19. It is important to provide the mother with support and education and offer a lactation specialist. This infant is dehydrated so it will be necessary to monitor strict I & Os.  Phototherapy will be required to help decrease the level of bilirubin.

KEY: Content Area: Hyperbilirubinemia| Integrated Processes: Nursing Process | Client Need: Physiological integrity | Cognitive Level: Application| REF: Chapter 7 | Type: Multiple Choice

  1. 3. Apgar scores measure heart rate, respiratory rate, reflex irritability, color and :
  1. 1. Rigidity
  2. 2. Muscle tone
  3. 3. Birth weight
  4. 4. Capillary refill

ANS: 2

Feedback
1. Not assessed  for the APGAR score
2. Apgar scores measure 5 areas: respiratory rate, heart rate, muscle tone, color and reflex irritability. The higher score indicates adequate adaptation. Scores are done at 1 minute and 5 minutes after birth.
3. Not assessed for the APGAR score
4. Not assessed the APGAR score

KEY: Content Area: Physiology | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

  1. 4. A mother on the postpartum unit asked to have her infant back from the nursery so that she can breastfeed. The nurse brings the newborn to the room and hands the baby to the mother. She asks the mother to let her know how long the baby feeds.  What vital step did the nurse forget to take before giving the baby to the mother?
  1. 1. The nurse should have made sure that the baby was latching correctly
  2. 2. The nurse should have identified the babys ID band with the mothers
  3. 3. The nurse should have the mother speak with a lactation consultant
  4. 4. The nurse should have asked the mother how long she planned to feed

ANS: 2

Feedback
1. It is vital that ID bands are checked with baby and mother before leaving the infant.
2. It is vital that ID bands are checked with baby and mother before leaving the infant.
3. Safety of the baby is the first priority
4. Safety of the baby is the first priority

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Analysis | REF: Chapter 7 | Type: Multiple Choice

5. Excessive heat loss results in which of these?

1. RDS

2. Depletion of glucose levels

3. Jaundice

4. Increase in surfactant levels

ANS: 2

Feedback
1. Cold stress is excessive heat loss resulting in an increase in heart rate, respiratory rate, oxygen consumption, metabolic acidosis, depletion of glucose levels, and surfactant levels
2. Cold stress is excessive heat loss resulting in an increase in heart rate, respiratory rate, oxygen consumption, metabolic acidosis, depletion of glucose levels, and surfactant levels
3. Cold stress is excessive heat loss resulting in an increase in heart rate, respiratory rate, oxygen consumption, metabolic acidosis, depletion of glucose levels, and surfactant levels
4. Surfactant levels decrease

KEY: Content Area: Physiology| Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

6. A mother has just delivered her new baby a few hours ago. She asks the nurse if she can bathe the baby because he has blood on him. The best response from the nurse would be.

1. Sure, let me get you some soap and washcloths

2. Why dont you get some rest, there will be lots of time for bathing

3. Its important that we not bathe the baby too soon after birth.  Lets wait till later in the day.

4. Sure, but why dont you feed the baby

ANS: 3

Feedback
1. A nursing intervention to prevent hypothermia is to delay the first bath until the infant has regulated and stabilized core body temperature.
2. Avoids the mothers question and an explanation should occur
3. A nursing intervention to prevent hypothermia is to delay the first bath until the infant has regulated and stabilized core body temperature.
4. Avoids the mothers question and an explanation should occur

KEY: Content Area: Physiological| Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

7. A 4 week old infant is brought to the ED. Mom states that the baby hasnt been eating well and has had decreased diapers for 2 days. The baby has been sleeping more and has been hard to wake up. On assessment, you find that the baby is difficult to arouse, is hypotonic and temperature is 35.4 rectally. What is an important lab value to check? Choose the best answer.

1. Complete metabolic panel

2. Liver panel

3. Blood glucose

4. PTT

ANS: 3

Feedback
1. Not the first choice due to the length of time to have results for  a CPM
2. The signs and symptoms do not indicate the need for a liver panel
3. Lethargy, poor feeding, hypotonic and temperature instability are all signs of hypoglycemia
4. The sign and symptoms do not indicate a need for a PTT

KEY: Content Area: Physiology| Integrated Processes: Nursing Process | Client Need: Physiology Integrity | Cognitive Level: Application | REF: Chapter 7 | Type: Multiple Choice

8. A pregnant woman with a history of a clotting disorder is required to self-administer heparin during her pregnancy. After delivery, the infant will be at greater risk for:

1. Low blood sugar

2. Decrease Vitamin K

3. Increased Vitamin K

4. High blood sugar

ANS: 2

Feedback
1. Anticoagulants do not effect blood sugar
2. An infant of a mother who is treated with anticoagulants are at risk for decreased vitamin K levels
3. Anticoagulants have the opposite effect on vitamin K
4. Anticoagulants do not effect blood sugar

KEY: Content Area: Pharmacology| Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 7 | Type: Multiple Choice

9. A part of injury prevention is making and keeping infant appointments. The required checkups and vaccinations are at:

1. 3 months, 6 months, 9 months

2. 2 months, 4 months, 6 months and 1 year

3. 2 months, 4 months, 6 month, 9 months and 1 year

4. 2 months, 4 months, 9 months and 1 year

ANS: 3

Feedback
1. It is recommended that a routine check-up with vaccinations be done at 2 months, 4 months, 6 months, 9 months and 1 year of age.
2. It is recommended that a routine check-up with vaccinations be done at 2 months, 4 months, 6 months, 9 months and 1 year of age.
3. It is recommended that a routine check-up with vaccinations be done at 2 months, 4 months, 6 months, 9 months and 1 year of age.
4. It is recommended that a routine check-up with vaccinations be done at 2 months, 4 months, 6 months, 9 months and 1 year of age.

KEY: Content Area: Growth| Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

10. You are taking care of an infant who was admitted with dehydration. His weight is 6kg. You have been watching his I & Os. What would you expect the infants urinary output to be in order to maintain adequate hydration?

1. 0.52 ml/kg/hr

2. 0.52.5 ml/kg/hr

3. 13 ml/kg/hr

4. As long as he is having wet diapers it doesnt matter

ANS: 3

Feedback
1. Urine output is not in normal range
2. Urine output is not in normal range
3. Urine output for the newborn/infant should be 13 cc/kg/hr, in the hospital, to maintain adequate fluid maintenance
4. Measuring I & O is important to assess kidney function in a dehydrated patient

KEY: Content Area: Renal/Urinary| Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge |  REF: Chapter 7 | Type: Multiple Choice

11. A mother brings her newborn daughter to the ER with concerns that she is having vaginal bleeding. You know this is normal and called what?

1. Pseudomenstruation

2. Milia

3. Vernix caseosa

4. Toxicum

ANS: 1

Feedback
1. Pseudomenstruation is thin white or blood tinged mucus that may be present due to maternal withdrawal of hormones.
2. Incorrect term
3. Incorrect term
4. Incorrect term

KEY: Content Area: Physical Assessment| Integrated Processes: Nursing Process | Client Need: Physiological Assessment | Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

12. While interviewing the mother of an infant, you note that the mother gets frustrated as she explains that her baby has been up all night crying at least 3 times a week for the last 2 weeks.  She states that she has tried everything and feels hopeless. What would be the BEST response from you as the nurse?

1. Believe me, I know. I have a newborn too.

2. Have you tried warm milk?

3. Its ok to be frustrated and feel overwhelmed.

4. You are doing nothing wrong. This can be a common occurrence in infants and you should not feel guilty.

ANS: 4

Feedback
1.  It is important that education is provided to the mother or caregiver so that they know the irritability is not a reflection of their parenting skills.
2. Infants do not have the enzyme to absorb milk thus would cause more stomach upset
3. Acknowledgement of the mothers feelings is important. Mother needs educated about Infant Colic.
4. The mother is describing Infant Colic. This can be very frustrating for mothers. They can feel helpless, hopeless and like a terrible mother. It is important that education is provided to the mother or caregiver so that they know the irritability is not a reflection of their parenting skills.

KEY: Content Area: Physiological| Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 7 | Type: Multiple Choice

13. The benefits of breast-feeding are

1. Decreased risk of obesity

2. Convenience

3. Promotes positive bonding with infant and mother

4. All of the above

ANS: 4

Feedback
1. Improves nutritional outcomes for the infant
2. Breastfeeding requires no bottle preparation
3. Positive bonding occurs in breastfeeding
4. Breastfeeding is the optimal method of feeding because it provides all nutrients, minerals, and vitamins needed.  There is no bottle required and baby and mother can bond.

KEY: Content Area: Nutrition| Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

14. The AAPs recommendations for length of breastfeeding is

1. 6 months

2. 6 months with the first child

3. 1 year

4. 9 month

ANS: 3

Feedback
1. The American Academy of Pediatrics recommends breastfeeding for a full year. It reduces cost and preparation time, is on demand and has been shown to decrease obesity.
2. The American Academy of Pediatrics recommends breastfeeding for a full year. It reduces cost and preparation time, is on demand and has been shown to decrease obesity.
3. The American Academy of Pediatrics recommends breastfeeding for a full year. It reduces cost and preparation time, is on demand and has been shown to decrease obesity.
4. The American Academy of Pediatrics recommends breastfeeding for a full year. It reduces cost and preparation time, is on demand and has been shown to decrease obesity.

KEY: Content Area: Nutrition| Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

15. When interviewing the mother of an infant the nurse asks some questions about how the baby is fed. What statement tells you that the mother will need further education?

1. I always use the ready to feed because it is easier.

2. I burp Junior at the end of his bottle.

3. I rock him while he feeds.

4. I just bought this great bottle warmer.

ANS: 2

Feedback
1. The mother has found a feeding technique that fits her lifestyle and gives adequate nutrition to the infant.
2. It is important to burp the infant frequently (about every ounce) to prevent emesis d/t swallowed air.
3. Rocking can be a comfort measure for feeding
4. The mother understands about warming the bottle prior to feeding

KEY: Content Area: Nutrition| Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 7 | Type: Multiple Choice

16. The physician is discussing feeding habits and schedule with a mother of a 4 month old. Which statement from the mother would warrant the need for further teaching and education?

1. I just recently introduced table foods.

2. I feed him every 3 hours.

3. I dont wake him for feeds throughout the night if he will sleep.

4. All of the above

ANS: 1

Feedback
1. An infant is ready for solid foods around 6 months of age. All foods should be placed on a spoon not in the bottle. Baby rice cereal is usually indicated for the first solid food.
2. Feeding every three hours during the day is adequate for this age
3. A four month old does not need to be awakened during the night for feedings
4. One statement is not applicable

KEY: Content Area: | Integrated Processes: Teaching/Learning| Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 7 | Type: Multiple Choice

17. Research has shown that endogenous opioid pathways that result in calming and pain-relieving effects are activated by:

1. Tylenol

2. Kangaroo care

3. Sucrose

4. Nonnutritive sucking

5. Choice 3 and 4

ANS: 5

Feedback
1. Does not produce an endogenous response
2. While this comforts a neonate it does not have an endogenous opioid pathway
3. The administration of sucrose and the application of nonnutritive sucking are theorized to activate endogenous opioid pathways (natural pain relievers produced in the brain) with resulting calming and pain-relieving effects.
4. The administration of sucrose and the application of nonnutritive sucking are theorized to activate endogenous opioid pathways (natural pain relievers produced in the brain) with resulting calming and pain-relieving effects.
5. The administration of sucrose and the application of nonnutritive sucking are theorized to activate endogenous opioid pathways (natural pain relievers produced in the brain) with resulting calming and pain-relieving effects.

KEY: Content Area: Comfort| Integrated Processes: Caring| Client Need: Physiological Integrity | Cognitive Level: Application |  REF: Chapter 7 | Type: Multiple Choice

18. A mother of a newborn baby boy is unsure of whether or not to have her son circumcised. She asks the nurse what is recommended by the AAP. The nurse tells her that as of 1999, the AAPs recommendation is:

1. They highly recommend routine circumcisions

2. They strongly recommend circumcision only if the parents are worried about infections

3. They have no current stance

4. They do not recommend routine circumcisions

ANS: 4

Feedback
1. The current position statement issued in 1999 does not recommend routine circumcision of the newborn.
2.  The infection rate does not change with a circumcision
3. The current position statement issued in 1999 does not recommend routine circumcision of the newborn.
4. The current position statement issued in 1999 does not recommend routine circumcision of the newborn.

KEY: Content Area: Wellness| Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Ref: Chapter 7 | Type: Multiple Choice

19. Which of the following interfere with the absorption of some medications in neonates and infants?

1. Immature kidney function

2. Absence of hydrochloric acid

3. Less pancreatic enzymes

4. All of the above

Feedback
1. Immature kidney function influences absorption
2. The lack of hydrochloric acid influences absorption
3. A neonate has less pancreatic enzymes
4. In neonates there is an absence of hydrochloric acid, and in infants, less pancreatic enzymes and immature kidney function which may interfere with absorption of some medications.

KEY: Content Area: Pharmacology| Integrated Processes: Nursing Process | Client Need: Physiological Integrity| Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

20. The nurse is doing discharge teaching and instructs the parents to notify their healthcare provider with any of these important concerns regarding the newborn/infant.

1. Temperature over 99.3 degrees Fahrenheit

2. Vomiting

3. Decreased wet diapers

4. All of the above

ANS: 4

Feedback
1. A temperature greater than 99.3 degrees Fahrenheit, especially in a newborn, may be a sign of sepsis
2. Vomiting and decreased wet diapers can be a sign on dehydration
3. Vomiting and decreased wet diapers can be a sign on dehydration
4. A temperature greater than 99.3 degrees Fahrenheit, especially in a newborn, may be a sign of sepsis. Vomiting and decreased wet diapers can be a sign on dehydration. Infants and children have less reserve than adults and can become dehydrated quickly.

KEY: Content Area: Education| Integrated Processes: Nursing Process | Client Need: Physiological Integrity| Cognitive Level: Application | REF: Chapter 7 | Type: Multiple Choice

21. The nurse is assessing pain on a 1 year old. What is the appropriate pain scale to use?

1. NIPS

2. FACES

3. FLACC

4. CHOPS

ANS: 3

Feedback
1. Not recommended for this age range
2. Not recommended for this age range
3. FLACC or the Face, Legs, Activity, Cry, Consolability scale is a measurement used to assess pain for children between the ages of 2 months-7 years or until the child is able to understand the concept of pain (then the FACES scale can be used).
4. Not recommended for this age range

KEY: Content Area: Pain| Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 7 | Type: Multiple Choice

22. On assessment of a 6 month old infant you note that the anterior fontanel is flat and soft and the posterior fontanel is no longer palpable. This is an appropriate finding because the posterior fontanel closes at:

1. 6 months

2. 4 months

3. 2 months

4. 5 months

ANS: 4

Feedback
1. The posterior fontanel is triangular in shape, 12 cm and closes in the 2nd month.
2. The posterior fontanel is triangular in shape, 12 cm and closes in the 2nd month.
3. The posterior fontanel is triangular in shape, 12 cm and closes in the 2nd month.
4.  The posterior fontanel is triangular in shape, 12 cm and closes in the 2nd month.

KEY: Content Area: Growth| Integrated Processes: Nursing Process | Client Need: Physiological Integrity| Cognitive Level: Application | REF: Chapter 7 | Type: Multiple Choice

23. A mother is concerned that every time she leaves the hospital room to take a break, her 8 month old cries. The nurse explains to the mother that this is normal behavior and that her infant is experiencing

1. Safety issues

2. Separation anxiety

3. Irritability

4. Colic

ANS: 2

Feedback
1. The child is too young to know about safety issues
2. Between the ages of 6 and 9 months, infants suffer from separation anxiety and can be sensitive to caregiver cues
3. The child only cries when the mother leaves, if irritable the child would cry more often
4. The child is past the age of colic occurring

KEY: Content Area: Development| Integrated Processes: Teaching/Learning| Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 7 | Type: Multiple Choice

24. Highlights in education for promoting safety in infants involves

1. Burns and car seat safety

2. Preventing choking and poisoning

3. Safe Sleep

4. All the above

ANS: 4

Feedback
1. These 5 topics are important for parents and caregivers to be aware of when it comes to infant safety. It is helpful to provide anticipatory guidance to parents at time of discharge so that they can prepare for their childs growth.
2. These 5 topics are important for parents and caregivers to be aware of when it comes to infant safety. It is helpful to provide anticipatory guidance to parents at time of discharge so that they can prepare for their childs growth.
3. These 5 topics are important for parents and caregivers to be aware of when it comes to infant safety. It is helpful to provide anticipatory guidance to parents at time of discharge so that they can prepare for their childs growth.
4. These 5 topics are important for parents and caregivers to be aware of when it comes to infant safety. It is helpful to provide anticipatory guidance to parents at time of discharge so that they can prepare for their childs growth.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: Chapter 7 | Type: Multiple Choice

25. During her interview with the mother, the nurse asks sleep related questions. She finds out that the infant is placed on her belly for sleep. The nurse beings to explain safe sleep measures and includes:

1. Placing the infant in a side lying position after feeds

2. Placing the infant propped on a pillow for comfort

3. Placing the infant on her belly for only naps

4. Placing the infant on her back in a bare naked crib

ANS: 4

Feedback
1. AAP recommends that all infants be placed on their backs for sleep in a bare naked crib. This means just a fitted sheet, no bumpers, blankets, pillows or toys. These are all suffocation hazards. The infant should not be tightly swaddled and arms should be free. Tightly swaddled infants are at risk for overheating and at greater risk for SIDS.
2. A pillow can increase the chance for suffocation
3. The infant should only be placed on her belly when awake and supervised
4. AAP recommends that all infants be placed on their backs for sleep in a bare naked crib. This means just a fitted sheet, no bumpers, blankets, pillows or toys. These are all suffocation hazards. The infant should not be tightly swaddled and arms should be free. Tightly swaddled infants are at risk for overheating and at greater risk for SIDS.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Health Promotion an d Maintenance | Cognitive Level: Application | REF: Chapter 7 | Type: Multiple Choice

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