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Work paper 3

Chapter 8: Health Promotion: Newborn


1. Which of the following is the most critical physiologic change required of the newborn?
a. Closure of fetal shunts in the heart
b. Stabilization of fluid and electrolytes
c. Body temperature maintenance
d. Onset of breathing

2. Why does thermoregulation present a problem for neonates?
a. Their renal function is not fully developed.
b. Their small body surface area favors heat loss.
c. They have a thin layer of subcutaneous fat that provides poor insulation.
d. They maintain a flexed posture that favors heat loss.

3. Which of the following is a function of brown adipose tissue (BAT) in the newborn?
a. Provides ready source of calories in the newborn period
b. Insulates the body against lowered environmental temperature
c. Protects the infant from injury during the birth process
d. Generates heat for distribution to other parts of body

4. Which of the following factors makes the neonate more prone to problems of dehydration, acidosis, and possible overhydration?
a. Placental transfer of blood is minimal.
b. Immature kidneys cannot concentrate urine.
c. Rate of fluid exchange is less than in adults.
d. Rate of metabolism is less in relation to body weight.

5. Which of the following characteristics is representative of the neonate's gastrointestinal tract?
a. Stomach capacity is approximately 90 ml.
b. Peristalic waves are relatively slow.
c. Overproduction of pancreatic amylase.
d. Transit time is diminished.

6. Which of the following terms is used to describe the newborn's first stool?
a. Meconium
b. Transitional
c. Miliaria
d. Milk stool



7. In full-term neonates, the first meconium stool should occur within how many hours of birth?
a. 6 to 8
b. 8 to 12
c. 12 to 24
d. 24 to 48

8. Which of the following is true regarding the newborn's kidney function?
a. Normally urination does not occur until 24 hours after delivery.
b. Urine has color and odor similar to urine of adults.
c. There is a decreased ability to concentrate urine compared with adults.
d. There is increased ability to concentrate urine compared with adults.

9. Which of the following statements is an accurate representation of the Apgar scoring system?
a. It is predictive of infant morbidity.
b. It is an evaluation of newborn well-being at 1 and 5 minutes.
c. It determines the need for resuscitation.
d. It determines the diagnosis of cerebral palsy.

10. The Apgar score of a neonate 5 minutes after birth is 8. Which of the following is the nurse's best interpretation of this?
a. Resuscitation is likely to be needed.
b. Adjustment to extrauterine life is adequate.
c. Additional scoring in 5 more minutes is needed.
d. Maternal sedation or analgesia contributed to low score.

11. Why are rectal temperatures not recommended in the newborn?
a. They are inaccurate.
b. They do not reflect core body temperature.
c. They can cause perforation of rectal mucosa.
d. They take too long to obtain an accurate reading.

12. The nurse should expect the apical heart rate of a stabilized neonate to be in which of the following ranges?
a. 60–80 beats/min.
b. 80–100 beats/min.
c. 120–140 beats/min.
d. 140–160 beats/min.

13. Which of the following is most descriptive of the shape of a newborn's anterior fontanel?
a. Circle
b. Triangle
c. Square
d. Diamond
14. Which of the following describes the respirations of a newborn?
a. Irregular, abdominal, 30 to 60 per minute
b. Regular, abdominal, 25 to 35 per minute
c. Regular, noisy, 35 to 45 per minute
d. Irregular, quiet, 45 to 55 per minute

15. The nurse is assessing the reflexes of a newborn. Stroking the outer sole of the foot assesses which reflex?
a. Perez
b. Babinski
c. Glabellar
d. Dance or step

16. Stroking the neonate's cheek along the side of the mouth causes the infant to turn the head toward that side and begin to suck. This is which of the following reflexes?
a. Perez
b. Sucking
c. Rooting
d. Extrusion

17. Which of the following statements best represents the first period of reactivity in the neonate?
a. Begins when the infant awakes from a deep sleep.
b. Ends when the amount of respiratory mucus has decreased.
c. Is an excellent time to acquaint the parents with the infant.
d. Is an excellent time for mother to sleep and recover.

18. At the time of birth, the grayish white, cheeselike substance that normally covers the newborn's skin is which of the following?
a. Meconium
b. Amniotic fluid
c. Vernix caseosa

19. Where would nonpathologic cyanosis normally be present in the infant shortly after birth?
a. Feet and hands
b. Bridge of nose
c. Mouth area
d. Mucous membranes

20. Which of the following findings would the nurse consider normal in assessing the anterior fontanel of a neonate?
a. Flat
b. Closed
c. Sunken
d. Bulges when infant is asleep
21. The nurse observes flaring of nares in a neonate. This should be interpreted as which of the following?
a. Nasal occlusion
b. Sign of respiratory distress
c. Common response to sneezing

22. Which of the following is the most important in the immediate care of the newborn?
a. Maintain patent airway.
b. Maintain stable body temperature.
c. Administer prophylactic eye care.
d. Establish identification of mother and baby.

23. The nurse is using a bulb syringe to suction a neonate after delivery. Which of the following is an important consideration?
a. Compress bulb after insertion.
b. Clear pharynx before nasal passages.
c. Use two bulb syringes, one for pharynx and one for nares.
d. Use bulb syringe until secretions are removed because mechanical suction is contraindicated.

24. The nurse is careful to place the incubator away from cold windows or air conditioning units. This is to conserve the neonates's body heat by preventing heat loss through which of the following methods?
a. Radiation
b. Conduction
c. Convection
d. Evaporation

25. Vitamin K is administered to the neonate to:
a. Prevent bleeding.
b. Enhance immune response.
c. Prevent bacterial infection.
d. Maintain nutritional status.

26. Nursing interventions to maintain a patent airway in a neonate should include which of the following?
a. Sleeping in the prone (on abdomen) position
b. Wrapping neonate as snugly as is possible
c. Positioning neonate on right side after feedings
d. Using bulb syringe to suction as needed, suctioning pharynx first and then nose