Question

The nurse admits a newborn to the admission nursery and prepares to bathe the baby for the first time after assessing which of the following?

Answer 1

Correct Answers:

Stable temperature for 2 hours.

Rationale :

🌡️ A stable temperature for at least 2 hours is essential before bathing a newborn to prevent hypothermia.

🌡️ Newborns have immature thermoregulation and are highly susceptible to rapid heat loss after birth.

🌡️ Ensuring a consistent, normal temperature ensures that the baby can handle the bath safely without becoming cold-stressed.

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Answer 2

Correct Answers:

Tummy time.

Rationale :

🐾 Tummy time promotes muscle development and prevents positional plagiocephaly (flat spots on the head) by reducing constant pressure on the back of the skull.

🐾 Supervised tummy time also strengthens neck, shoulder, and arm muscles important for motor development.

🐾 Safe sleeping still requires placing infants on their backs, but awake, supervised tummy time is key during the day.

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Answer 3

Correct Answers:

"This is a caput succedaneum, which is a collection of fluid from pressure of the vacuum extractor.".

Rationale :

💦 Caput succedaneum is a soft, puffy swelling that crosses suture lines, caused by pressure against the cervix or vacuum extraction.

💦 It is benign, typically resolving within a few days without intervention.

💦 Educating parents about its harmless nature reassures them and prevents unnecessary anxiety.

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Answer 4

Correct Answers:

The infant is overstimulated.

Rationale :

🔊 Overstimulation in newborns can occur from excessive noise, light, handling, or cold exposure, leading to irritability and exhaustion.

🔊 Signs include crying, kicking, followed by sudden tiredness — as described in the scenario.

🔊 Overstimulation can lead to metabolic acidosis if not corrected, making this a priority concern to address immediately.

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Answer 5

Correct Answers:

"My baby will be placed under special lights if the test is elevated.".

Rationale :

🚫💡 Phototherapy lights are used for hyperbilirubinemia, not for elevated PKU levels.

🚫💡 Phenylketonuria (PKU) is a metabolic disorder requiring dietary management, not light therapy.

🚫💡 Misunderstanding this indicates the parent needs further teaching about newborn screenings and genetic conditions.

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Answer 6

Correct Answers:

Nipple line.

Rationale :

🎯 Chest circumference in newborns should be measured at the nipple line, which provides a consistent and accurate assessment point.

🎯 Measuring at other locations like the axilla or rib border could give inaccurate readings.

🎯 Accurate chest circumference helps assess growth patterns and respiratory development.

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Answer 7

Correct Answers:

Rooting.

Rationale :

👄 The rooting reflex prompts the newborn to turn the head toward touch on the cheek or mouth, initiating sucking behavior.

👄 This reflex helps newborns find the breast or bottle for feeding.

👄 It is vital for successful breastfeeding and typically fades by around 4 months of age.

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Answer 8

Correct Answers:

Fetal circulation is no longer effective at birth.

Rationale :

❌🩸 At birth, major changes occur: the foramen ovale, ductus arteriosus, and ductus venosus begin to close as the newborn breathes air and circulatory patterns change.

❌🩸 Fetal circulation is ineffective after birth because the newborn must now oxygenate blood via the lungs, not the placenta.

❌🩸 Persistent fetal circulation after birth leads to serious complications like persistent pulmonary hypertension.

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Answer 9

Correct Answers:

A blood glucose fingerstick of 40 mg/dL for an infant who is 1 -hr old.

Rationale :

🌕🚨 Jaundice appearing within the first 24 hours is considered pathologic and may indicate serious conditions like hemolysis or infection.

🌕🚨 Immediate reporting and evaluation are necessary to prevent complications like kernicterus (brain damage from high bilirubin).

🌕🚨 Physiologic jaundice typically appears after 24 hours — early jaundice needs urgent assessment.

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Answer 10

Correct Answers:

rooting,
stepping.
moro.
Babinski.

Rationale :

👄 Rooting Reflex

👄 The rooting reflex helps the infant locate food by turning their head toward the stimulus when the cheek or lip is touched.

👄 It is essential for successful breastfeeding and generally disappears by about 4 months of age.

👄 Its presence confirms healthy neurological development.

🚶 Stepping Reflex

🚶 The stepping reflex is observed when holding the newborn upright with feet touching a surface, leading to stepping movements.

🚶 This primitive reflex suggests intact spinal cord and brainstem function.

🚶 It disappears typically by 2 months of age.

😮 Moro Reflex

😮 The Moro reflex (startle reflex) occurs when the infant is startled by a loud noise or sudden movement, leading to extension and then flexion of the arms and legs.

😮 This reflex indicates normal brainstem activity and is typically gone by 6 months.

😮 Absence may indicate neurological or musculoskeletal injury.

🦶 Babinski Reflex

🦶 The Babinski reflex involves fanning of the toes when the lateral aspect of the sole is stroked.

🦶 In newborns, it is a normal finding and indicates a healthy corticospinal tract.

🦶 Persistence beyond 2 years of age suggests neurologic dysfunction.

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QLexNursing

1 :
The nurse admits a newborn to the admission nursery and prepares to bathe the baby for the first time after assessing which of the following?

2 :
How do you prevent flat spots on the back of a babys head?

3 :
A nurse is caring for a newborn who was delivered by vacuum extraction and has swelling on his head that crosses the suture line. The newborn's mother asks about the swelling on her newborn's head. Which of the following responses should the nurse make?

4 :
The nurse enters the room and notices that the room feels cold. The mother says, "He has been crying and kicking and now he seems very tired.". What is the nurse's priority concern?

5 :
A nurse is reinforcing teaching about phenylketonuria (PKU) testing with the parent of a newborn. Which of the following statements by the parent indicates a need for further teaching?

6 :
A nurse is collecting data from a newborn. Which of the following anatomical landmarks should the nurse use to measure chest circumference?

7 :
A nurse is assisting a client with breastfeeding her newborn. The nurse should explain that which of the following reflexes will initiate sucking?

8 :
Which statement about fetal circulation is true?

9 :
A nurse is caring for several newborn clients. For which of the following findings should the nurse notify the charge nurse?

10 :
The names of the newborn reflexes are? Select all that apply.

QLexNursing

1 : The nurse admits a newborn to the admission nursery and prepares to bathe the baby for the first time after assessing which of the following?

2 : How do you prevent flat spots on the back of a babys head?

3 : A nurse is caring for a newborn who was delivered by vacuum extraction and has swelling on his head that crosses the suture line. The newborn's mother asks about the swelling on her newborn's head. Which of the following responses should the nurse make?

4 : The nurse enters the room and notices that the room feels cold. The mother says, "He has been crying and kicking and now he seems very tired.". What is the nurse's priority concern?

5 : A nurse is reinforcing teaching about phenylketonuria (PKU) testing with the parent of a newborn. Which of the following statements by the parent indicates a need for further teaching?

6 : A nurse is collecting data from a newborn. Which of the following anatomical landmarks should the nurse use to measure chest circumference?

7 : A nurse is assisting a client with breastfeeding her newborn. The nurse should explain that which of the following reflexes will initiate sucking?

8 : Which statement about fetal circulation is true?

9 : A nurse is caring for several newborn clients. For which of the following findings should the nurse notify the charge nurse?

10 : The names of the newborn reflexes are? Select all that apply.

1 :
The nurse admits a newborn to the admission nursery and prepares to bathe the baby for the first time after assessing which of the following?

2 :
How do you prevent flat spots on the back of a babys head?

3 :
A nurse is caring for a newborn who was delivered by vacuum extraction and has swelling on his head that crosses the suture line. The newborn's mother asks about the swelling on her newborn's head. Which of the following responses should the nurse make?

4 :
The nurse enters the room and notices that the room feels cold. The mother says, "He has been crying and kicking and now he seems very tired.". What is the nurse's priority concern?

5 :
A nurse is reinforcing teaching about phenylketonuria (PKU) testing with the parent of a newborn. Which of the following statements by the parent indicates a need for further teaching?

6 :
A nurse is collecting data from a newborn. Which of the following anatomical landmarks should the nurse use to measure chest circumference?

7 :
A nurse is assisting a client with breastfeeding her newborn. The nurse should explain that which of the following reflexes will initiate sucking?

8 :
Which statement about fetal circulation is true?

9 :
A nurse is caring for several newborn clients. For which of the following findings should the nurse notify the charge nurse?

10 :
The names of the newborn reflexes are? Select all that apply.