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1. A first-time father is changing the diaper of his 1-day-old daughter. He asks the nurse, What is this black, sticky
stuff in her diaper? The nurses best response is:
a) That means your baby is bleeding internally.
b) Oh, dont worry about that. Its okay.
c) Thats meconium, which is your babys first stool. Its normal.
d) Thats transitional stool.
2. A new mother states that her infant must be cold because the babys hands and feet are blue. The nurse explains
that this is a common and temporary condition called:
a) Vernix caseosa
b) Acrocyanosis.
c) Harlequin color.
d) Erythema neonatorum
3. A woman gave birth to a healthy 7-pound, 13-ounce infant girl. The nurse suggests that the woman place the
infant to her breast within 15 minutes after birth. The nurse knows that breastfeeding is effective during the first
30 minutes after birth because this is the:
a) First period of reactivity
b) Transition period.
c) Organizational stage.
d) Second period of reactivity
4. An African-American woman noticed some bruises on her newborn girls buttocks. She asks the nurse who
spanked her daughter. The nurse explains that these marks are called
a) Lanugo.
b) Vascular nevi
c) Mongolian spots.
d) Nevus flammeus.
5. A collection of blood between the skull bone and its periosteum is known as a cephalhematoma. To reassure the
new parents whose infant develops such a soft bulge, it is important that the nurse be aware that this condition:
a) Will rapidly absorb over the first few days of life.
b) Is present immediately after birth.
c) Only happens as the result of a forceps or vacuum delivery.
d) May occur with spontaneous vaginal birth
6. The cheeselike, whitish substance that fuses with the epidermis and serves as a protective coating is called:
a) Caput succedaneum
b) Vernix caseosa
c) Acrocyanosis
d) Surfactant
7. A client is warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother
and her infant and finds the infant unwrapped in his crib with the fan blowing over him on high. The nurse
instructs the mother that the fan should not be directed toward the newborn and the newborn should be wrapped in
a blanket. The mother asks why. The nurses best response is:
a) Your baby may lose heat by evaporation, which means that he will lose heat from his body to the cooler
ambient air. You should keep him wrapped and prevent cool air from blowing on him.
b) Your baby may lose heat by conduction, which means that he will lose heat from his body to the cooler
ambient air. You should keep him wrapped and prevent cool air from blowing on him.
c) Your baby may lose heat by convection, which means that he will lose heat from his body to the
cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him.
d) Your baby will get cold stressed easily and needs to be bundled up at all times.
8. During life in utero oxygenation of the fetus occurs through transplacental gas exchange. When birth occurs, four
factors combine to stimulate the respiratory center in the medulla. The initiation of respiration then follows.
Which is NOT one of these essential factors?
a) Thermal
b) Chemical
c) Mechanical
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d) Psychologic
All of these statements about physiologic jaundice are true EXCEPT:
a) Neonatal jaundice is common, but kernicterus is rare.
b) The appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic process
c) Because jaundice may not appear before discharge, parents need instruction on how to assess it and when
to call for medical help.
d) Breastfed babies have a lower incidence of jaundice.
What marks on a babys skin may indicate an underlying problem that requires notification of a physician?
a) Erythema toxicum anywhere on the body
b) Petechiae scattered over the infants body
c) Telangiectatic nevi on the nose or nape of the neck
d) Mongolian spots on the back
The nurse assessing a newborn knows that the most critical physiologic change required of the newborn is:
a) Initiation and maintenance of respirations
b) Maintenance of a stable temperature
c) Closure of fetal shunts in the circulatory system
d) Full function of the immune defense system at birth
A newborn is placed under a radiant heat warmer, and the nurse evaluates the infants body temperature every
hour. Maintaining the newborns body temperature is important for preventing:
a) Cold stress
b) Tachycardia.
c) Respiratory depression
d) Vasoconstriction
While assessing the newborn, the nurse should be aware that the average expected apical pulse range of a fullterm, quiet, alert newborn is:
a) 150 to 180 beats/min.
b) 80 to 100 beats/min.
c) 100 to 120 beats/min
d) 120 to 160 beats/min.
Part of the health assessment of a newborn is observing the infants breathing pattern. A full-term newborns
breathing pattern is predominantly:
a) Diaphragmatic with chest retraction.
b) Abdominal with synchronous chest movements
c) Chest breathing with nasal flaring.
d) Deep with a regular rhythm.
While assessing the integument of a 24-hour-old newborn, the nurse notes a pink, papular rash with vesicles
superimposed on the thorax, back, and abdomen. The nurse should:
a) Move the newborn to an isolation nursery
b) Take the newborns temperature and obtain a culture of one of the vesicles
c) Document the finding as erythema toxicum.
d) Notify the physician immediately
While evaluating the reflexes of a newborn, the nurse notes that with a loud noise the newborn symmetrically
abducts and extends his arms, his fingers fan out and form a C with the thumb and forefinger, and he has a
slight tremor. The nurse would document this finding as a positive:
a) Glabellar (Myerson) reflex.
b) Babinski reflex.
c) Tonic neck reflex
d) Moro reflex
The parents of a newborn ask the nurse how much the newborn can see. The parents specifically want to know
what type of visual stimuli they should provide for their newborn. The nurse responds to the parents by telling
them:
a) Infants can track their parents eyes and distinguish patterns; they prefer complex patterns.
b) The infants eyes must be protected. Infants enjoy looking at brightly colored stripes.
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d) She feels a firm tugging sensation on her nipples but not pinching or pain.
A primiparous woman is delighted with her newborn son and wants to begin breastfeeding as soon as possible.
The nurse can facilitate the infants correct latch-on by helping the woman hold the infant:
a) With his head cupped in her hand.
b) Curled up in a fetal position.
c) With his arms folded together over his chest.
d) With his head and body in alignment.
A postpartum woman telephones about her 4-day-old infant. She is not scheduled for a weight check until the
infant is 10 days old, and she is worried about whether breastfeeding is going well. Effective breastfeeding is
indicated by the newborn who:
a) Gains 1 to 2 ounces per week.
b) Has at least one breast milk stool every 24 hours.
c) Sleeps for 6 hours at a time between feedings.
d) Has at least six to eight wet diapers per day.
A breastfeeding woman develops engorged breasts at 3 days postpartum. What action would help this woman
achieve her goal of reducing the engorgement? The woman:
a) Breastfeeds her infant every 2 hours.
b) Avoids using a breast pump.
c) Reduces her fluid intake for 24 hours.
d) Skips feedings to let her sore breasts rest.
A pregnant woman wants to breastfeed her infant, but her husband is not convinced that there are any scientific
reasons to do so. The nurse can give the couple printed information comparing breastfeeding and bottle-feeding.
What statement is true? Bottle-feeding using commercially prepared infant formulas:
a) Requires that multivitamin supplements be given to the infant.
b) Helps the infant sleep through the night.
c) Increases the risk that the infant will develop allergies.
d) Ensures that the infant is getting iron in a form that is easily absorbed.
At a 2-month well-baby examination, it was discovered that a breastfed infant had only gained 10 ounces in the
past 4 weeks. The mother and the nurse agree that, to gain weight faster, the infant needs to:
a) Have a bottle of formula after every feeding.
b) Begin solid foods.
c) Add at least one extra breastfeeding session every 24 hours.
d) Start iron supplements.
In helping the breastfeeding mother position the baby, nurses should keep in mind that:
a) Women with perineal pain and swelling prefer the modified cradle position.
b) While supporting the head, the mother should push gently on the occiput.
c) The cradle position usually is preferred by mothers who had a cesarean birth.
d) Whatever the position used, the infant is belly to belly with the mother.
The best reason for recommending formula over breastfeeding is that:
a) The mother lacks confidence in her ability to breastfeed.
b) The mother sees bottle feeding as more convenient.
c) Other family members or care providers also need to feed the baby.
d) The mother has a medical condition or is taking drugs that could be passed along to the infant via
breast milk.
A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. What signs and
symptoms should the nurse include in her discussion? Choose all that apply.
a) Breast tenderness
b) A small white blister on the tip of the nipple
c) An area of redness on the breast often resembling the shape of a pie wedge
d) Fever and flulike symptoms
e) Warmth in the breast
The nurse is discussing storage of breast milk with a mother whose infant is preterm and in the special care unit.
What statement would indicate that the mother needs additional teaching?
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b)
c)
d)