Chapter 17 PDF

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Chapter 17- Newborn Transitioning 1. When explaining how a newborn adapts to extrauterine life, the nurse would describe which body systems as undergoing the most rapid changes? A) Gastrointestinal and hepatic B) Urinary and hematologic C) Respiratory and cardiovascular D) Neurological and integumentary 2. A new mother reports that her newborn often spits up after feeding. Assessment reveals regurgitation. The nurse responds integrating understanding that this most likely is due to which of the following? A) Placing the newborn prone after feeding B) Limited ability of digestive enzymes C) Underdeveloped pyloric sphincter D) Relaxed cardiac sphincter 3. After teaching a class about hepatic system adaptations after birth, the instructor determines that the teaching was successful when the class identifies which of the following as the process of changing bilirubin from a fat-soluble product to a water-soluble product? A) Hemolysis B) Conjugation C) Jaundice D) Hyperbilirubinemia 4. Twenty minutes after birth, a baby begins to move his head from side to side, making eye contact with the mother, and pushes his tongue out several times. The nurse interprets this as indicating which of the following? A) A good time to initiate breast-feeding B) The period of decreased responsiveness preceding sleep C) The need to be alert for gagging and vomiting D) Evidence that the newborn is becoming chilled 5. The nurse institutes measure to maintain thermoregulation based on the understanding that newborns have limited ability to regulate body temperature because they: A) Have a smaller body surface compared to body mass B) Lose more body heat when they sweat than adults C) Have an abundant amount of subcutaneous fat all over D) Are unable to shiver effectively to increase heat production 6. A new mother is changing the diaper of her 20-hour-old newborn and asks why the stool is almost black. Which response by the nurse would be most appropriate? A) “You probably took iron during your pregnancy.” B) “This is meconium stool, normal for a newborn.” C) “I’ll take a sample and check it for possible bleeding.” D) “This is unusual and I need to report this.” 7.

A client expresses concern that her 2-hour-old newborn is sleepy and difficult to awaken. The nurse explains that this behavior indicates which of the following? A) Normal progression of behavior B) Probable hypoglycemia C) Physiological abnormality D) Inadequate oxygenation 8. After the birth of a newborn, which of the following would the nurse do first to assist in thermoregulation? A) Dry the newborn thoroughly. B) Put a hat on the newborn’s head. C) Check the newborn’s temperature. D) Wrap the newborn in a blanket. 9. Assessment of a newborn reveals rhythmic spontaneous movements. The nurse interprets this as indicating: A) Habituation B) Motor maturity C) Orientation D) Social behaviors 10. After teaching new parents about the sensory capabilities of their newborn, the nurse determines that the teaching was successful when they identify which sense as being the least mature? A) Hearing B) Touch C) Taste D) Vision 11. The nurse places a warmed blanket on the scale when weighing a newborn. The nurse does so to minimize heat loss via which mechanism? A) Evaporation B) Conduction C) Convection D) Radiation 12. Which of the following would alert the nurse to the possibility of respiratory distress in a newborn? A) Symmetrical chest movements B) Periodic breathing C) Respirations of 40 breaths/minute D) Sternal retractions 13. A nurse is counseling a mother about the immunologic properties of breast milk. The nurse integrates knowledge of immunoglobulins, emphasizing that breast milk is a major source of which immunoglobulin? A) IgA B) IgG C) IgM D) IgE 14. The nurse is teaching a group of students about the similarities and differences between newborn skin and adult skin. Which statement by the group indicates that additional teaching is needed? A) The newborn’s skin and that of an adult are similar in thickness. B) The lipid composition of the skin of a newborn and adult is about the same.

C) Skin development in the newborn is complete at birth. D) The newborn has more fibrils connecting the dermis and epidermis. 15. A nurse is developing a teaching plan for the parents of a newborn. When describing the neurologic development of a newborn to his parents, the nurse would explain that the development occurs in which fashion? A) Head-to-toe B) Lateral-to-medial C) Outward-to-inward D) Distal-to-caudal 16. The nurse is assessing the respirations of several newborns. The nurse would notify the health care provider for the newborn with which respiratory rate at rest? A) 38 breaths per minute B) 46 breaths per minute C) 54 breaths per minute D) 68 breaths per minute 17. A new mother asks the nurse, “Why has my baby lost weight since he was born?” The nurse integrates knowledge of which of the following when responding to the new mother? A) Insufficient calorie intake B) Shift of water from extracellular space to intracellular space C) Increase in stool passage D) Overproduction of bilirubin 18. The nurse observes the stool of a newborn who has begun to breast-feed. Which of the following would the nurse expect to find? A) Greenish black, tarry stool B) Yellowish-brown, seedy stool C) Yellow-gold, stringy stool D) Yellowish-green, pasty stool 19. A nurse is assessing a newborn who is about 4½ hours old. The nurse would expect this newborn to exhibit which of the following? (Select all that apply.) A) Sleeping B) Interest in environmental stimuli C) Passage of meconium D) Difficulty arousing the newborn E) Spontaneous Moro reflexes 20. A nurse is assessing a newborn and observes the newborn moving his head and eyes toward a loud sound. The nurse interprets this as which of the following? A) Habituation B) Motor maturity C) Social behavior D) Orientation 21. A newborn is experiencing cold stress. Which of the following would the nurse expect to assess? (Select all that apply.) A) Respiratory distress

B) Decreased oxygen needs C) Hypoglycemia D) Metabolic alkalosis E) Jaundice 22. A group of nursing students are reviewing the changes in the newborn’s lungs that must occur to maintain respiratory function. The students demonstrate understanding of this information when they identify which of the following as the first event? A) Expansion of the lungs B) Increased pulmonary blood flow C) Initiation of respiratory movement D) Redistribution of cardiac output 23. A nurse is reviewing the laboratory test results of a newborn. Which result would the nurse identify as a cause for concern? A) Hemoglobin 19 g/dL B) Platelets 75,000/uL C) White blood cells 20,000/mm3 D) Hematocrit 52% 24. A nursing instructor is preparing a class on newborn adaptations. When describing the change from fetal to newborn circulation, which of the following would the instructor most likely include? (Select all that apply.) A) Decrease in right atrial pressure leads to closure of the foramen ovale. B) Increase in oxygen levels leads to a decrease in systemic vascular resistance. C) Onset of respirations leads to a decrease in pulmonary vascular resistance. D) Increase in pressure in the left atrium results from increases in pulmonary blood flow. E) Closure of the ductus venosus eventually forces closure of the ductus arteriosus. 25. A nursing student is preparing a presentation on minimizing heat loss in the newborn. Which of the following would the student include as a measure to prevent heat loss through convection? A) Placing a cap on a newborn’s head B) Working inside an isolette as much as possible. C) Placing the newborn skin-to-skin with the mother D) Using a radiant warmer to transport a newborn 26. After teaching a group of nursing students about a neutral thermal environment, the instructor determines that the teaching was successful when the students identify which of the following as the newborn’s primary method of heat production? A) Convection B) Nonshivering thermogenesis C) Cold stress D) Bilirubin conjugation 27. While observing the interaction between a newborn and his mother, the nurse notes the newborn nestling into the arms of his mother. The nurse identifies this behavior as which of the following? A) Habituation B) Self-quieting ability

C) Social behaviors D) Orientation...