Chapter 18: Nursing Management of
the Newborn Exam || Latest Exam
The newborn has been placed in skin-to-skin contact with his mother. A blanket covers
all of his body except his head. His hair is still wet with amniotic fluid, etc. What is the
most likely type of heat loss this baby may experience?
-Conductive
-Convective
-Evaporative
-Radiating -CORRECT ANSWER Evaporative
Evaporative heat loss occurs with the evaporation of fluid from the infant.
A nurse is preparing to administer Vitamin K to a newborn. The nurse would administer
the drug:
-orally.
-subcutaneously.
-intramuscularly.
-intravenously. -CORRECT ANSWER intramuscularly.
The American Academy of Pediatrics recommends that vitamin K be administered to all
newborns soon after birth in a single intramuscular dose of 0.5 to 1 mg. An oral vitamin
K preparation is also being given to newborns outside the United States, but at least
three doses are needed over a one month period. It is not given subcutaneously or
intravenously.
The parents are bonding with their newborn when the nurse notes the infant's axillary
temperature is 97.2oF (36.2oC) an hour after birth. Which intervention should the nurse
prioritize for this family?
-Help the mother provide skin-to-skin (kangaroo) care.
-Place a second stockinette on the baby's head.
-Administer a warm bath with temperature slightly higher than usual.
-Place the infant under a radiant warmer. -CORRECT ANSWER Help the mother
provide skin-to-skin (kangaroo) care.
The nurse should encourage bonding to continue. One way to help the infant get warm
is to help the parents provide kangaroo care, which involves skin-to-skin contact and
parent/baby coverage with blankets. Once the infant is taken for the initial assessment,
,placement under the radiant heater would then be appropriate. Placing a second
stockinette is a potential option; however, it would not be as effective as the skin-to-skin
contact. The bath would not be undertaken until the infant's temperature is stabilized
within the normal range.
The nursery nurse notes that one of the newborn infants has white patches on his
tongue that look like milk curds. What action would be appropriate for the nurse to take?
-Wipe the tongue off vigorously to remove the white patches.
-Rinse the tongue off with sterile water and a cotton swab.
-Since it looks like a milk curd, no action is needed.
-Report the finding to the pediatrician. -CORRECT ANSWER Report the finding to the
pediatrician.
Although the finding looks like a milk curd, if the white patch remains after feeding, the
pediatrician needs to be notified. The likely cause of the white patch on the tongue is a
fungal infection called Candida albicans, which the newborn probably contracted while
passing through the birth canal. The nurse should not try to remove the patches.
A woman who is about to be discharged after a vaginal birth notices a flea-like rash on
her newborn's chest that consists of tiny red lesions all across the nipple line. What is
the best response from the nurse when explaining this to the woman?
-"It is a normal skin finding in a newborn."
-"It is a sign of a group B streptococcus skin infection. "
-"It is an indication that the woman has mistreated her newborn."
-"It is a self-limiting virus that does not require treatment." -CORRECT ANSWER "It is a
normal skin finding in a newborn."
This most likely is erythema toxicum, also known as newborn rash, and is a common
finding that will gradually disappear and not need any treatment. This is often mistaken
for staphylococcal pustules. This is not a sign of mistreatment by the woman, nor is it
caused by a virus or group B streptococcal (GBS) infection.
The mother of a newborn observes a diaper rash on her newborn's skin. Which
intervention should the nurse instruct the parent to implement to treat the diaper rash?
-Expose the newborn's bottom to air several times a day.
-Use only baby wipes to cleanse the perianal area.
-Use products such as talcum powder with each diaper change.
-Place the newborn's buttocks in warm water after each void or stool. -CORRECT
ANSWER Expose the newborn's bottom to air several times a day.
The nurse should instruct the parent to expose the newborn's bottom to air several
times per day to treat and prevent diaper rashes. Use of baby wipes and products such
, as powder should be avoided. The parent should be instructed to place the newborn's
buttocks in warm water after having had a diaper on all night but not with every diaper
change.
New parents are upset their newborn has lost weight since birth. The nurse explains
that newborns typically lose how much of their birth weight by 3 to 4 days of age?
-10%
-12%
-14%
-16% -CORRECT ANSWER 10%
Newborns typically lose approximately 10% of their initial birth weight by 3 to 4 days of
age secondary to the loss of meconium, extracellular fluid, and limited food intake. This
weight loss is usually regained by the 10th day of life.
A breastfeeding mother wants to know how to help her 2-week-old newborn gain the
weight lost after birth. Which action should the nurse suggest as the best method to
accomplish this goal?
-Recommend that the mother pump her breast milk and measure it before feeding.
-Breastfeed the infant every 2 to 4 hours on demand.
-Weigh the infant daily to ensure that she is gaining 1.5 to 2 ounces (42.5 to 57 grams)
per day.
-Add cereal to the newborn's feedings twice a day. -CORRECT ANSWER Breastfeed
the infant every 2 to 4 hours on demand.
Breastfeeding the newborn every 2 to 4 hours on demand is the best way to help the
infant gain weight the fastest. Normal weight gain for this age infant is 0.66 oz to 1 oz
(19 to 28 grams) per day, not 1.5 to 2 ounces (42.5 to 57 grams). Cereal is never given
to infants this young. The mother does not need to pump her breast milk to measure it.
As long as the newborn is feeding well and has 6+ wet diapers and 3+ stools, the infant
is receiving adequate nutrition.
The nurse is teaching a prenatal class illustrating the steps that are used to keep
families safe. The nurse determines the session is successful when the parents
correctly choose which precaution to follow after the birth of their infant?
-Send a family member to accompany the infant when leaving the room.
-Check the name on the baby's identification bracelet.
-Provide a list of approved visitors who came spend time with the infant.
-Check the identification badge of any health care worker before releasing baby from
room. -CORRECT ANSWER Check the identification badge of any health care worker
before releasing baby from room.
the Newborn Exam || Latest Exam
The newborn has been placed in skin-to-skin contact with his mother. A blanket covers
all of his body except his head. His hair is still wet with amniotic fluid, etc. What is the
most likely type of heat loss this baby may experience?
-Conductive
-Convective
-Evaporative
-Radiating -CORRECT ANSWER Evaporative
Evaporative heat loss occurs with the evaporation of fluid from the infant.
A nurse is preparing to administer Vitamin K to a newborn. The nurse would administer
the drug:
-orally.
-subcutaneously.
-intramuscularly.
-intravenously. -CORRECT ANSWER intramuscularly.
The American Academy of Pediatrics recommends that vitamin K be administered to all
newborns soon after birth in a single intramuscular dose of 0.5 to 1 mg. An oral vitamin
K preparation is also being given to newborns outside the United States, but at least
three doses are needed over a one month period. It is not given subcutaneously or
intravenously.
The parents are bonding with their newborn when the nurse notes the infant's axillary
temperature is 97.2oF (36.2oC) an hour after birth. Which intervention should the nurse
prioritize for this family?
-Help the mother provide skin-to-skin (kangaroo) care.
-Place a second stockinette on the baby's head.
-Administer a warm bath with temperature slightly higher than usual.
-Place the infant under a radiant warmer. -CORRECT ANSWER Help the mother
provide skin-to-skin (kangaroo) care.
The nurse should encourage bonding to continue. One way to help the infant get warm
is to help the parents provide kangaroo care, which involves skin-to-skin contact and
parent/baby coverage with blankets. Once the infant is taken for the initial assessment,
,placement under the radiant heater would then be appropriate. Placing a second
stockinette is a potential option; however, it would not be as effective as the skin-to-skin
contact. The bath would not be undertaken until the infant's temperature is stabilized
within the normal range.
The nursery nurse notes that one of the newborn infants has white patches on his
tongue that look like milk curds. What action would be appropriate for the nurse to take?
-Wipe the tongue off vigorously to remove the white patches.
-Rinse the tongue off with sterile water and a cotton swab.
-Since it looks like a milk curd, no action is needed.
-Report the finding to the pediatrician. -CORRECT ANSWER Report the finding to the
pediatrician.
Although the finding looks like a milk curd, if the white patch remains after feeding, the
pediatrician needs to be notified. The likely cause of the white patch on the tongue is a
fungal infection called Candida albicans, which the newborn probably contracted while
passing through the birth canal. The nurse should not try to remove the patches.
A woman who is about to be discharged after a vaginal birth notices a flea-like rash on
her newborn's chest that consists of tiny red lesions all across the nipple line. What is
the best response from the nurse when explaining this to the woman?
-"It is a normal skin finding in a newborn."
-"It is a sign of a group B streptococcus skin infection. "
-"It is an indication that the woman has mistreated her newborn."
-"It is a self-limiting virus that does not require treatment." -CORRECT ANSWER "It is a
normal skin finding in a newborn."
This most likely is erythema toxicum, also known as newborn rash, and is a common
finding that will gradually disappear and not need any treatment. This is often mistaken
for staphylococcal pustules. This is not a sign of mistreatment by the woman, nor is it
caused by a virus or group B streptococcal (GBS) infection.
The mother of a newborn observes a diaper rash on her newborn's skin. Which
intervention should the nurse instruct the parent to implement to treat the diaper rash?
-Expose the newborn's bottom to air several times a day.
-Use only baby wipes to cleanse the perianal area.
-Use products such as talcum powder with each diaper change.
-Place the newborn's buttocks in warm water after each void or stool. -CORRECT
ANSWER Expose the newborn's bottom to air several times a day.
The nurse should instruct the parent to expose the newborn's bottom to air several
times per day to treat and prevent diaper rashes. Use of baby wipes and products such
, as powder should be avoided. The parent should be instructed to place the newborn's
buttocks in warm water after having had a diaper on all night but not with every diaper
change.
New parents are upset their newborn has lost weight since birth. The nurse explains
that newborns typically lose how much of their birth weight by 3 to 4 days of age?
-10%
-12%
-14%
-16% -CORRECT ANSWER 10%
Newborns typically lose approximately 10% of their initial birth weight by 3 to 4 days of
age secondary to the loss of meconium, extracellular fluid, and limited food intake. This
weight loss is usually regained by the 10th day of life.
A breastfeeding mother wants to know how to help her 2-week-old newborn gain the
weight lost after birth. Which action should the nurse suggest as the best method to
accomplish this goal?
-Recommend that the mother pump her breast milk and measure it before feeding.
-Breastfeed the infant every 2 to 4 hours on demand.
-Weigh the infant daily to ensure that she is gaining 1.5 to 2 ounces (42.5 to 57 grams)
per day.
-Add cereal to the newborn's feedings twice a day. -CORRECT ANSWER Breastfeed
the infant every 2 to 4 hours on demand.
Breastfeeding the newborn every 2 to 4 hours on demand is the best way to help the
infant gain weight the fastest. Normal weight gain for this age infant is 0.66 oz to 1 oz
(19 to 28 grams) per day, not 1.5 to 2 ounces (42.5 to 57 grams). Cereal is never given
to infants this young. The mother does not need to pump her breast milk to measure it.
As long as the newborn is feeding well and has 6+ wet diapers and 3+ stools, the infant
is receiving adequate nutrition.
The nurse is teaching a prenatal class illustrating the steps that are used to keep
families safe. The nurse determines the session is successful when the parents
correctly choose which precaution to follow after the birth of their infant?
-Send a family member to accompany the infant when leaving the room.
-Check the name on the baby's identification bracelet.
-Provide a list of approved visitors who came spend time with the infant.
-Check the identification badge of any health care worker before releasing baby from
room. -CORRECT ANSWER Check the identification badge of any health care worker
before releasing baby from room.
