Chapter 28 The Normal Newborn: Needs and Care
1) The parents of a newborn male ask the nurse whether they should
circumcise their son. What is the best response by the nurse?
1. Circumcision should be undertaken to prevent problems in the future.
2. Circumcision might decrease the childs risk of developing a urinary tract
infection.
3. Circumcision can sometimes cause complications. What questions do you
have?
4. Circumcision is painful, and should be avoided unless you are Jewish.
Answer: 3
Explanation: 3. Asking this question allows the nurse to determine what the
parents concerns are, then address them specifically.
Page Ref: 715
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, culture,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
Centered Care: Communicate information effectively; listen openly and
cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4 Discuss the common concerns of families regarding
their newborns.
,MNL LO: 4.3.1 Implement strategies for promoting newborn health and
parental teaching.
1
Copyright 2016 Pearson Education, Inc.
2) The nurse tells a mother that the doctor is preparing to circumcise her
newborn. The mother expresses concern that the infant will be uncomfortable
during the procedure. The nurse explains that the physician will numb the
area before the procedure. Additional methods of comfort often used during the
procedure include which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Providing a pacifier
2. Stroking the head
3. Restraining both arms and legs
4. Talking to the infant
5. Giving the infant a sedative before the procedure
Answer: 1, 2, 4
Explanation: 1. Providing a pacifier is an accepted method of soothing during
the circumcision.
2. Stroking the head is an accepted method of soothing during the
circumcision.
4. Talking to the infant is an accepted method of soothing during the
circumcision.
Page Ref: 716
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 7. Initiate effective treatments to
relieve pain and suffering in light of patient values, preferences, and
expressed needs. | AACN Essentials Competencies: IX. 5. Deliver
,compassionate, patient-centered, evidence-based care that respects patient
and family preferences. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4 Discuss the common concerns of families regarding their
newborns.
MNL LO: 4.3.1 Implement strategies for promoting newborn health and
parental teaching.
2
Copyright 2016 Pearson Education, Inc.
3) The nurse is caring for four newborns who have recently been admitted to
the newborn nursery. Which labor event puts the newborn at risk for an
alteration of health?
1. The infants mother has group B streptococcal (GBS) disease.
2. The infants mother had an IV of lactated Ringers solution.
3. The infants mother had a labor that lasted 12 hours.
4. The infants mother had a cesarean birth with her last child.
Answer: 1
Explanation: 1. A common cause of neonatal distress is early-onset group B
streptococcal (GBS) disease. Infected mothers transmit GBS infection to their
infants during labor and birth. All infants of mothers identified as at risk should
be assessed and observed for signs and symptoms of sepsis.
Page Ref: 711
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: V. B. 4. Communicate observations or
concerns related to hazards and errors to patients, families, and the health
care team. | AACN Essentials Competencies: IX. 1. Conduct comprehensive
and focused physical, behavioral, psychological, spiritual, socioeconomic,
and environmental assessments of health and illness parameters in patients,
using developmentally and culturally appropriate approaches. | NLN
, Competencies: Relationship-Centered Care: Factors that contribute to or
threaten health. | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 1 Summarize the essential areas of information to be
obtained about a newborns birth experience and immediate postnatal period.
MNL LO: 4.3.2 Determine the nursing care provided to the newborn during
early transition to extrauterine life.
3
Copyright 2016 Pearson Education, Inc.
4) The nurse initiates newborn admission procedures and evaluates the
newborns need to remain under observation by assessing which of the
following?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Respiratory rate
2. Skin texture
3. Airway clearance
4. Ability to feed
5. Head weight
Answer: 1, 3, 4
Explanation: 1. The nurse initiates newborn admission procedures and
evaluates the newborns need to remain under observation by assessing vital
signs (body temperature, heart rate, respiratory rate).
3. The nurse initiates newborn admission procedures and evaluates the
newborns need to remain under observation by assessing airway clearance.
4. The nurse initiates newborn admission procedures and evaluates the
newborns need to remain under observation by assessing ability to feed.
Page Ref: 707
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: V. B. 4. Communicate observations or
1) The parents of a newborn male ask the nurse whether they should
circumcise their son. What is the best response by the nurse?
1. Circumcision should be undertaken to prevent problems in the future.
2. Circumcision might decrease the childs risk of developing a urinary tract
infection.
3. Circumcision can sometimes cause complications. What questions do you
have?
4. Circumcision is painful, and should be avoided unless you are Jewish.
Answer: 3
Explanation: 3. Asking this question allows the nurse to determine what the
parents concerns are, then address them specifically.
Page Ref: 715
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, culture,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
Centered Care: Communicate information effectively; listen openly and
cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4 Discuss the common concerns of families regarding
their newborns.
,MNL LO: 4.3.1 Implement strategies for promoting newborn health and
parental teaching.
1
Copyright 2016 Pearson Education, Inc.
2) The nurse tells a mother that the doctor is preparing to circumcise her
newborn. The mother expresses concern that the infant will be uncomfortable
during the procedure. The nurse explains that the physician will numb the
area before the procedure. Additional methods of comfort often used during the
procedure include which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Providing a pacifier
2. Stroking the head
3. Restraining both arms and legs
4. Talking to the infant
5. Giving the infant a sedative before the procedure
Answer: 1, 2, 4
Explanation: 1. Providing a pacifier is an accepted method of soothing during
the circumcision.
2. Stroking the head is an accepted method of soothing during the
circumcision.
4. Talking to the infant is an accepted method of soothing during the
circumcision.
Page Ref: 716
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 7. Initiate effective treatments to
relieve pain and suffering in light of patient values, preferences, and
expressed needs. | AACN Essentials Competencies: IX. 5. Deliver
,compassionate, patient-centered, evidence-based care that respects patient
and family preferences. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4 Discuss the common concerns of families regarding their
newborns.
MNL LO: 4.3.1 Implement strategies for promoting newborn health and
parental teaching.
2
Copyright 2016 Pearson Education, Inc.
3) The nurse is caring for four newborns who have recently been admitted to
the newborn nursery. Which labor event puts the newborn at risk for an
alteration of health?
1. The infants mother has group B streptococcal (GBS) disease.
2. The infants mother had an IV of lactated Ringers solution.
3. The infants mother had a labor that lasted 12 hours.
4. The infants mother had a cesarean birth with her last child.
Answer: 1
Explanation: 1. A common cause of neonatal distress is early-onset group B
streptococcal (GBS) disease. Infected mothers transmit GBS infection to their
infants during labor and birth. All infants of mothers identified as at risk should
be assessed and observed for signs and symptoms of sepsis.
Page Ref: 711
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: V. B. 4. Communicate observations or
concerns related to hazards and errors to patients, families, and the health
care team. | AACN Essentials Competencies: IX. 1. Conduct comprehensive
and focused physical, behavioral, psychological, spiritual, socioeconomic,
and environmental assessments of health and illness parameters in patients,
using developmentally and culturally appropriate approaches. | NLN
, Competencies: Relationship-Centered Care: Factors that contribute to or
threaten health. | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 1 Summarize the essential areas of information to be
obtained about a newborns birth experience and immediate postnatal period.
MNL LO: 4.3.2 Determine the nursing care provided to the newborn during
early transition to extrauterine life.
3
Copyright 2016 Pearson Education, Inc.
4) The nurse initiates newborn admission procedures and evaluates the
newborns need to remain under observation by assessing which of the
following?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Respiratory rate
2. Skin texture
3. Airway clearance
4. Ability to feed
5. Head weight
Answer: 1, 3, 4
Explanation: 1. The nurse initiates newborn admission procedures and
evaluates the newborns need to remain under observation by assessing vital
signs (body temperature, heart rate, respiratory rate).
3. The nurse initiates newborn admission procedures and evaluates the
newborns need to remain under observation by assessing airway clearance.
4. The nurse initiates newborn admission procedures and evaluates the
newborns need to remain under observation by assessing ability to feed.
Page Ref: 707
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: V. B. 4. Communicate observations or
