Keenan-Lindsay: Leifer’s Introduction to Maternity and Pediatric Nursing in Canada, 1st Edition
MULTIPLE CHOICE
1. The mother of a 2-week-old infant tells a nurse that she thinks he is sleeping too much.
What is the most appropriate nursing response to this mother?
a. “Tell me how many hours per day your baby sleeps.”
b. “It is normal for newborns to sleep most of the day.”
c. “Newborns generally sleep 12 to 15 hours per day.”
d. “You will find as the baby gets older, he sleeps less.”
ANS: A
Although it is true that newborns sleep a great deal of any 24-hour period, the nurse
must find out what the mother means by “too much” before giving any information.
DIF: Cognitive Level: Application REF: 275 OBJ: 10
TOP: Discharge Planning KEY: Nursing Process Step:
Implementation
2. Which statement indicates parents of a 2-week-old breastfed infant understand when to
contact the primary health care provider?
a. Infant refuses a feeding.
b. Infant has an axillary temperature of 36.1° C (97 F).
c. Infant has three seedy yellow stools in 24 hours.
d. Infant’s diaper is not wet after 8 hours.
ANS: D
Decreased or lack of voiding by the newborn should be reported to the health care
provider to prevent dehydration.
DIF: Cognitive Level: Comprehension REF: 287 OBJ: 8
TOP: Discharge Planning KEY: Nursing Process Step: Evaluation
, 3. A mother asks a nurse, “Do you think my baby recognizes my voice?” The nurse should
consider which correct information when responding?
a. Voice recognition is delayed because the ears are not well developed at birth.
b. Infants respond to voice by increasing movements and sucking.
c. Infants initially respond to low-pitched voices.
d. Newborns can distinguish a mother’s voice from other sounds in the first days of
life.
ANS: D
The ability to discriminate between a mother’s voice and other voices may occur as
early as in the first 3 days of life.
DIF: Cognitive Level: Knowledge REF: 274 OBJ: 4 | 10
TOP: Newborn Assessment—Hearing KEY: Nursing Process Step:
Implementation
4. A nurse compares the birth weight of a 3-day-old with her current weight and determines
the infant has lost 8% of the birth weight. What is the most appropriate intervention by
the nurse?
a. Assess feeding behaviour.
b. Report the discrepancy to the primary health care provider immediately.
c. Decrease the interval between the infant’s feedings.
d. Try feeding the infant formula between feeds.
ANS: A
It is typical for the newborn to lose 7 to 10% of their birth weight in the first 3 to 4
days of life. A nurse would assess the feeding behaviour to determine if newborn is
feeding well. Usually no change in the plan of care is needed.
DIF: Cognitive Level: Application REF: 269 OBJ: 4
TOP: Newborn Assessment—Weight KEY: Nursing Process Step:
Implementation
5. Parents express concern about the milia on the face and nose of their infant. What is a
nurse’s most helpful response when instructing the parents?
a. “Contact a pediatric dermatologist for topical medication.”
MULTIPLE CHOICE
1. The mother of a 2-week-old infant tells a nurse that she thinks he is sleeping too much.
What is the most appropriate nursing response to this mother?
a. “Tell me how many hours per day your baby sleeps.”
b. “It is normal for newborns to sleep most of the day.”
c. “Newborns generally sleep 12 to 15 hours per day.”
d. “You will find as the baby gets older, he sleeps less.”
ANS: A
Although it is true that newborns sleep a great deal of any 24-hour period, the nurse
must find out what the mother means by “too much” before giving any information.
DIF: Cognitive Level: Application REF: 275 OBJ: 10
TOP: Discharge Planning KEY: Nursing Process Step:
Implementation
2. Which statement indicates parents of a 2-week-old breastfed infant understand when to
contact the primary health care provider?
a. Infant refuses a feeding.
b. Infant has an axillary temperature of 36.1° C (97 F).
c. Infant has three seedy yellow stools in 24 hours.
d. Infant’s diaper is not wet after 8 hours.
ANS: D
Decreased or lack of voiding by the newborn should be reported to the health care
provider to prevent dehydration.
DIF: Cognitive Level: Comprehension REF: 287 OBJ: 8
TOP: Discharge Planning KEY: Nursing Process Step: Evaluation
, 3. A mother asks a nurse, “Do you think my baby recognizes my voice?” The nurse should
consider which correct information when responding?
a. Voice recognition is delayed because the ears are not well developed at birth.
b. Infants respond to voice by increasing movements and sucking.
c. Infants initially respond to low-pitched voices.
d. Newborns can distinguish a mother’s voice from other sounds in the first days of
life.
ANS: D
The ability to discriminate between a mother’s voice and other voices may occur as
early as in the first 3 days of life.
DIF: Cognitive Level: Knowledge REF: 274 OBJ: 4 | 10
TOP: Newborn Assessment—Hearing KEY: Nursing Process Step:
Implementation
4. A nurse compares the birth weight of a 3-day-old with her current weight and determines
the infant has lost 8% of the birth weight. What is the most appropriate intervention by
the nurse?
a. Assess feeding behaviour.
b. Report the discrepancy to the primary health care provider immediately.
c. Decrease the interval between the infant’s feedings.
d. Try feeding the infant formula between feeds.
ANS: A
It is typical for the newborn to lose 7 to 10% of their birth weight in the first 3 to 4
days of life. A nurse would assess the feeding behaviour to determine if newborn is
feeding well. Usually no change in the plan of care is needed.
DIF: Cognitive Level: Application REF: 269 OBJ: 4
TOP: Newborn Assessment—Weight KEY: Nursing Process Step:
Implementation
5. Parents express concern about the milia on the face and nose of their infant. What is a
nurse’s most helpful response when instructing the parents?
a. “Contact a pediatric dermatologist for topical medication.”
