Chapter 18: Nursing Management of the Newborn Flashcards

Question

A newborn’s heart rate is absent during the first Apgar assessment. What score should be assigned for heart rate? A. 0 B. 1 C. 2 D. 3

Answer 1

A. 0 Rationale: An absent heart rate (0 bpm) results in a score of 0 for heart rate.

Answer 2

C. 2 Rationale: Regular respirations (30-60 breaths/min), strong, good cry are indicative of a score of 2 for respiratory effort.

Answer 3

B. 1 Rationale: Some flexion with limited resistance to extension earns 1 point for muscle tone.

Answer 4

C. 2 Rationale: A vigorous cry in response to suctioning indicates a score of 2 for reflex irritability.

Answer 5

C. 2 Rationale: A completely appropriate color (pink trunk and extremities) earns 2 points for skin color.

Answer 6

B. 1 Rationale: Some flexion with limited resistance to extension results in 1 point for muscle tone.

Answer 7

A. 0 Rationale: No respiratory effort (apnea) results in a score of 0 for respiratory effort.

Answer 8

C. 2 Rationale: A heart rate greater than 100 bpm earns 2 points for heart rate.

Answer 9

A. 0 for both muscle tone and reflex irritability Rationale: No movement or response to stimuli would result in a score of 0 for both muscle tone and reflex irritability.

Answer 10

B. 1 Rationale: Irregular, shallow respirations with occasional crying would earn 1 point for respiratory effort.

Answer 11

D. Sticky, transparent skin with some peeling Rationale: Sticky and transparent skin with some peeling is characteristic of a preterm newborn. Full-term newborns usually have smoother skin with more developed features.

Answer 12

A. Lanugo is absent Rationale: Lanugo is typically absent in preterm newborns. It begins to appear with gestational maturity and may disappear with postmaturity.

Answer 13

B. Full term Rationale: Plantar creases covering the entire sole are indicative of a full-term newborn. The more creases, the greater the gestational maturity.

Answer 14

D. Full, budding breast tissue with visible areola Rationale: Full-term newborns have full, budding breast tissue with visible areolas, which are indicative of more developed maturity.

Answer 15

A. Preterm Rationale: Fused eyelids and minimal ear cartilage development suggest prematurity, as these features are more developed in full-term and postmature newborns.

Answer 16

A. Preterm Rationale: A smooth scrotum with no evidence of testicular descent is characteristic of a preterm male newborn. Full-term newborns generally have more developed genitals.

Answer 17

C. A clitoris covered by labia Rationale: In postmature females, the clitoris is usually covered by the labia, indicating greater maturity compared to a prominent clitoris with flat labia, which suggests prematurity.

Answer 18

C. Postmature Rationale: Significant cracking and wrinkling of the skin, along with well-developed ear cartilage, suggests a postmature newborn, indicating higher gestational maturity.

Answer 19

B. Open eyelids and firm ear cartilage Rationale: Full-term newborns typically have open eyelids and firm ear cartilage, which indicate more advanced development compared to preterm newborns.

Answer 20

A. Smooth scrotum with no testicular descent Rationale: A smooth scrotum with no evidence of testicular descent is characteristic of a male preterm newborn. Full-term and postmature newborns usually have rugae-covered scrotums and descended testicles.

Answer 21

B. Full flexion of arms and legs Rationale: Full flexion of arms and legs demonstrates the highest degree of neuromuscular maturity, with greater flexion indicating greater maturity.

Answer 22

C. Postmature Rationale: A square window angle of 0 degrees indicates postmaturity, as this suggests high neuromuscular maturity.

Answer 23

D. 4 points Rationale: A greater recoil (less than a 90-degree angle) indicates higher neuromuscular maturity and is scored as 4 points.

Answer 24

A. Lower neuromuscular maturity Rationale: A popliteal angle of 180 degrees indicates low neuromuscular maturity. Newborns with greater maturity typically have a popliteal angle of less than 90 degrees.

Answer 25

D. –1 point Rationale: If the elbow reaches the opposite shoulder, it indicates lesser neuromuscular maturity, which is scored as –1 point.

Answer 26

B. The feet are not able to reach the ears Rationale: Lesser flexibility (feet not reaching the ears) indicates greater neuromuscular maturity. More flexibility suggests lower maturity.

Answer 27

C. Full-term status Rationale: A popliteal angle of less than 90 degrees indicates full-term status and greater neuromuscular maturity, as more flexion demonstrates a higher degree of maturity.

Answer 28

B. –1 point Rationale: A square window angle greater than 90 degrees indicates a lower level of maturity and is scored as –1 point.

Answer 29

A. Scarf sign where the elbow reaches the midline Rationale: A scarf sign where the elbow reaches the midline indicates lower neuromuscular maturity, as it suggests the arms are not flexed sufficiently.

Answer 30

C. Postmature Rationale: The combination of full flexion, a square window angle of 0 degrees, and limited ability to move the feet toward the ears is characteristic of a postmature newborn.

Answer 31

B. To promote the synthesis of prothrombin for blood clotting Rationale: Vitamin K promotes blood clotting by increasing the synthesis of prothrombin by the liver. This is essential for preventing hemorrhage in newborns.

Answer 32

D. “Without vitamin K supplementation, your baby is at risk for vitamin K deficiency bleeding (VKDB).” Rationale: Newborns are at risk for VKDB because their intestines are sterile and do not produce vitamin K until after the first feeding. Vitamin K supplementation is necessary to prevent bleeding.

Answer 33

A. Increased risk of bleeding C. Vitamin K deficiency bleeding (VKDB) D. Delayed clotting ability Rationale: Without vitamin K, newborns are at increased risk for bleeding, including VKDB, due to delayed clotting ability caused by a deficiency in vitamin K-dependent coagulation factors.

Answer 34

B. 0.5 to 1 mg Rationale: The AAP recommends a single IM dose of 0.5 to 1 mg of vitamin K for newborns to prevent vitamin K deficiency bleeding (VKDB).

Answer 35

B. Educate the parents about the risks of not administering vitamin K and offer information on VKDB. Rationale: The first step should be to educate the parents about the risks of not administering vitamin K and the benefits of prophylaxis, ensuring they have all the information to make an informed decision.

Answer 36

C. To ensure immediate blood clotting and prevent VKDB Rationale: Vitamin K is given shortly after birth to promote immediate blood clotting and prevent vitamin K deficiency bleeding (VKDB), as newborns are at risk due to a lack of intestinal bacteria to produce vitamin K.

Answer 37

A. “Vitamin K is critical in preventing bleeding in your newborn.” B. “Vitamin K supplementation has been proven safe with no significant side effects.” C. “Refusal of vitamin K places your baby at a significant risk of bleeding.” Rationale: Vitamin K is essential in preventing VKDB and is safe with no significant side effects. Refusal of vitamin K increases the newborn’s risk of bleeding, and delaying it can be dangerous.

Answer 38

A. Early onset of vitamin K deficiency bleeding (VKDB) Rationale: The most significant outcome of not receiving vitamin K prophylaxis is the risk of early onset vitamin K deficiency bleeding (VKDB).

Answer 39

A. Vitamin K should be given within the first 24 hours after birth. Rationale: Vitamin K should be administered within the first hours after birth to be effective in preventing VKDB.

Answer 40

A. Newborns do not have sufficient intestinal bacteria to produce vitamin K until after their first feeding. Rationale: Newborns do not have intestinal bacteria to produce vitamin K immediately after birth, making supplementation necessary until the body can produce adequate amounts.

Answer 41

A. Oral vitamin K requires multiple doses to be effective. C. Oral vitamin K has been used effectively in other parts of the world. Rationale: Oral vitamin K is used in some parts of the world but requires multiple doses to be effective. In the United States, the standard of care is IM vitamin K.

Answer 42

B. Risk of vitamin K deficiency bleeding (VKDB) Rationale: Refusal of vitamin K increases the risk of vitamin K deficiency bleeding (VKDB), as the newborn will not have adequate vitamin K until after the intestines begin producing it.

Answer 43

B. Concerns over the safety and long-term effects of vitamin K Rationale: Some parents refuse vitamin K because of concerns about its safety and long-term effects, despite the evidence supporting its benefits and safety in preventing VKDB.

Answer 44

B. “All newborns, regardless of birth weight, need vitamin K to prevent bleeding.” Rationale: All newborns, including premature infants, need vitamin K prophylaxis to prevent vitamin K deficiency bleeding, as their intestines do not produce vitamin K until after feeding.

Answer 45

A. It reduces the risk of vitamin K deficiency bleeding (VKDB). C. It helps with the synthesis of clotting factors. Rationale: Vitamin K helps with the synthesis of clotting factors and reduces the risk of VKDB. It does not prevent jaundice or provide long-term protection against bleeding disorders beyond the immediate newborn period.

Answer 46

B. To prevent ophthalmia neonatorum and neonatal blindness Rationale: The primary purpose of eye prophylaxis in newborns is to prevent ophthalmia neonatorum, a serious eye infection that can cause neonatal blindness.

Answer 47

A. Gonorrhea and chlamydia Rationale: Ophthalmia neonatorum is most commonly contracted when a newborn is exposed to gonorrhea and chlamydia during vaginal delivery.

Answer 48

D. Erythromycin 0.5% ophthalmic ointment Rationale: Erythromycin 0.5% ophthalmic ointment is the only FDA-approved drug for the prophylaxis of gonococcal ophthalmia neonatorum in the United States.

Answer 49

A. It must be administered within the first hour or two of life. B. It is mandatory in all 50 states to prevent ophthalmia neonatorum. C. It can be delayed to allow for bonding time between mother and baby. Rationale: Eye prophylaxis must be administered within the first hour or two of life to prevent ophthalmia neonatorum. It is legally required in all 50 states and can be delayed to allow for bonding, but it must be administered as soon as possible.

Answer 50

B. The prophylactic agent should be administered within the first hour or two after birth. Rationale: Regardless of the method of delivery, the prophylactic agent must be administered within the first hour or two after birth to prevent ophthalmia neonatorum.

Answer 51

B. Red, swollen eyelids with purulent discharge Rationale: Ophthalmia neonatorum typically presents with red, swollen eyelids and purulent discharge within the first 10 days of life.

Answer 52

A. The medication should be instilled in the conjunctival sac of each eye. B. The newborn’s eyelids should be gently closed after the medication is applied. Rationale: The prophylactic agent should be applied to the conjunctival sac of each eye, and the eyelids should be gently closed after application to ensure the ointment is distributed. Bonding is important but should not delay the administration.

Answer 53

C. Within the first 1 to 2 hours of life Rationale: Eye prophylaxis should be administered within the first 1 to 2 hours of life to prevent ophthalmia neonatorum.

Answer 54

B. Administer the medication as soon as the newborn reaches the nursery for observation. Rationale: If eye prophylaxis is delayed, it should be administered as soon as the newborn reaches the nursery for observation and assessment to prevent ophthalmia neonatorum.

Answer 55

A. Increased risk of visual impairment or blindness due to ophthalmia neonatorum Rationale: If eye prophylaxis is not administered, newborns are at significant risk of developing ophthalmia neonatorum, which can lead to visual impairment or blindness due to infection.

Answer 56

C. Ophthalmia neonatorum, leading to potential blindness Rationale: If erythromycin eye prophylaxis is not administered, the newborn is at risk for ophthalmia neonatorum, which can lead to neonatal blindness.

Answer 57

A. The ointment is applied to the lower eyelid. D. It should be applied as soon as possible after birth, ideally within one to two hours. Rationale: Erythromycin ointment should be applied to the lower eyelid within one to two hours of birth to prevent ophthalmia neonatorum.

Answer 58

B. To prevent the development of gonococcal ophthalmia neonatorum Rationale: Erythromycin ointment is used to prevent gonococcal ophthalmia neonatorum, a bacterial eye infection that can cause blindness if left untreated.

Answer 59

C. It must be administered within one to two hours of birth. Rationale: Eye prophylaxis should be administered within one to two hours of birth to prevent ophthalmia neonatorum.

Answer 60

D. Intramuscular injection in the vastus lateralis Rationale: Vitamin K is administered via an intramuscular injection in the vastus lateralis muscle to prevent hemorrhagic disease in newborns.

Answer 61

A. To prevent ophthalmia neonatorum Rationale: Erythromycin ointment is used to prevent ophthalmia neonatorum, a bacterial eye infection that can lead to blindness if untreated.

Answer 62

A. The injection is given in the vastus lateralis muscle. C. The medication should be given immediately after birth to prevent hemorrhagic disease. Rationale: Vitamin K is administered intramuscularly in the vastus lateralis muscle immediately after birth to prevent hemorrhagic disease.

Answer 63

C. It is a capillary angioma that is flat, purple-red, and does not fade over time. Rationale: Nevus flammeus (port wine stain) is a permanent capillary angioma that appears flat and purple-red. It is most often found on the face or neck and does not fade over time. It may be associated with certain syndromes and requires monitoring.

Answer 64

A. Harlequin sign Rationale: Harlequin sign is a transient condition in which blood vessels on one side of the body dilate, resulting in a red appearance, while the opposite side remains pale. It is caused by immature autoregulation of blood flow and usually resolves within 20 minutes.

Answer 65

B. Erythema toxicum Rationale: Erythema toxicum is a benign, idiopathic rash that resolves on its own within a few days, with no need for medical treatment.

Answer 66

D. Document the finding and provide reassurance, as it is a common and expected result from the use of the fetal scalp electrode. Rationale: A small puncture mark caused by the use of a fetal scalp electrode is a common and expected result of this monitoring technique. It typically does not require intervention, though it should be documented and reassured to the parents.

Answer 67

A. These are Mongolian spots, which are common in darker-skinned newborns and will disappear in the first few years of life. Rationale: Mongolian spots are benign blue or purple splotches that appear on the lower back and buttocks of newborns, especially in darker-skinned newborns, and they typically disappear within the first few years of life.

Answer 68

D. Erythema toxicum Rationale: Erythema toxicum is a benign, idiopathic rash that commonly appears during the first week of life and consists of small, papular pustules. It typically resolves within a few days and does not require treatment.

Answer 69

C. It is caused by a concentration of immature blood vessels and will fade within the first year of life. Rationale: Stork bites, or salmon patches, are caused by a concentration of immature blood vessels and are a normal variant. These marks typically fade within the first year of life.

Answer 70

A. They are benign blue or purple spots that appear on the newborn’s lower back and buttocks. D. These spots typically disappear within the first 4 years of life. Rationale: Mongolian spots are benign blue or purple spots that appear on the lower back and buttocks of newborns, especially in darker-skinned infants. They generally disappear within the first 4 years of life.

Answer 71

C. The lesion is benign and will disappear within the first 4 years of life. Rationale: Mongolian spots are benign, dark blue or purple lesions commonly found on the lower back and buttocks. They are especially prevalent in certain racial and ethnic groups and typically disappear by age 4 without any intervention.

Answer 72

B. Nevus vasculosus Rationale: Nevus vasculosus (strawberry hemangioma) is a benign capillary hemangioma that is raised, rough, and dark red. It is most commonly found on the head and may increase in size initially but typically resolves by age 3.

Answer 73

B. Document the finding as a nevus vasculosus (strawberry hemangioma) and reassure the parents that it will resolve by age 3. Rationale: Nevus vasculosus (strawberry hemangioma) is a benign lesion that is typically bright red and raised. It usually resolves by age 3 without the need for surgical intervention or steroids. Parents should be reassured that the condition is temporary.

Answer 74

A. Erythema toxicum Rationale: Erythema toxicum is a common, benign, and transient rash that presents with papules or pustules, often mistaken for flea bites. It is common in the first week of life and disappears without treatment. The lack of a distinct pattern is a key characteristic.

Answer 75

A. Milia B. Mongolian spots D. Erythema toxicum Rationale: Milia, Mongolian spots, and erythema toxicum typically resolve on their own without the need for medical treatment. Nevus vasculosus may require monitoring but usually resolves by age 3.

Answer 76

C. Stork bites Rationale: Stork bites (salmon patches) are caused by a concentration of immature blood vessels and are most commonly found on the nape of the neck. These are typically benign and fade within the first year of life.

Answer 77

D. A pattern of rash that mimics flea bites Rationale: Erythema toxicum is characterized by small papules or pustules that resemble flea bites, typically on the face, chest, and back. It lacks a specific pattern and resolves within a few days.

Answer 78

A. They are permanent lesions that do not fade over time. B. They are associated with certain cancers, bony malformations, and neurologic issues. D. Port wine stains are commonly located on the head and neck. Rationale: Port wine stains (nevus flammeus) are permanent, often located on the head and neck, and can be associated with bony malformations, structural abnormalities, and cancer. Treatment may be considered for cosmetic reasons but is not immediately necessary.

Answer 79

B. Reassure the parents that the condition is common and resolves on its own. Rationale: Harlequin sign is a transient condition caused by immature blood flow regulation. It typically resolves on its own within 20 minutes and does not require medical intervention.

Answer 80

A. The lesion will likely fade by age 3, and no treatment is necessary. Rationale: Nevus vasculosus (strawberry hemangiomas) typically resolve by age 3 without treatment. Parents should be educated on monitoring but no intervention is required unless complications occur.

Answer 81

D. The rash will resolve on its own within a few days and does not require any medical treatment. Rationale: Erythema toxicum is a benign rash that typically resolves on its own within a few days and does not require any medical treatment.

Answer 82

B. Stork bites Rationale: Stork bites (salmon patches) are caused by a concentration of immature blood vessels and are often seen on the eyelids and nape of the neck. These lesions typically fade within the first year of life.

Answer 83

A. Nevus vasculosus C. Nevus flammeus Rationale: Nevus vasculosus and nevus flammeus may require referral if there are complications such as recurrent bleeding, infection, or if the parents express concern about the lesions. Erythema toxicum and milia do not typically require intervention.

Answer 84

A. Milia Rationale: Milia are small, pearly white lesions commonly found on a newborn’s nose, chin, and forehead. These are unopened sebaceous glands and typically disappear within the first few weeks of life.

Answer 85

A. The condition involves a marked red color on one side of the body and a pale color on the opposite side. B. The condition is usually seen in low-birth-weight newborns and results from immature blood flow regulation. D. It resolves spontaneously within a short period, typically 20 minutes. Rationale: Harlequin sign involves a distinct color pattern on one side of the body, with redness on the dependent side and paleness on the nondependent side. It is caused by immature autoregulation of blood flow and resolves spontaneously within about 20 minutes.

Answer 86

A. Nevus vasculosus Rationale: Nevus vasculosus, also known as a strawberry hemangioma, is a benign capillary hemangioma that appears as a raised, dark red lesion, commonly on the head. It is typically present within the first few weeks of life.

Answer 87

B. The lesion will resolve by age 3 without any treatment. Rationale: Nevus vasculosus (strawberry hemangiomas) typically resolve by age 3 without the need for treatment, although they may grow in size during the first few months.

Answer 88

B. It is commonly mistaken for a staphylococcal infection. C. It is a benign rash that often appears during the first week of life. D. The rash will disappear within a few days without the need for any treatment. Rationale: Erythema toxicum is a benign rash that appears during the first week of life, often mistaken for a staphylococcal infection. It resolves on its own within a few days without the need for treatment.

Answer 89

C. Educating the parents that the lesion is permanent and will not fade. Rationale: Nevus flammeus (port wine stains) are permanent and do not fade. Parents should be educated about the nature of the lesion, but it typically does not require immediate treatment unless associated with other concerns.

Answer 90

D. The lesion is likely to grow in size during the first few months but will resolve by age 3. Rationale: Nevus vasculosus (strawberry hemangiomas) may grow during the first few months but typically resolve by age 3 without treatment.

Answer 91

A. Stork bites C. Erythema toxicum D. Mongolian spots Rationale: Stork bites, erythema toxicum, and Mongolian spots typically fade within the first year of life. Nevus flammeus (port wine stain) is permanent and does not fade.

Answer 92

C. A referral for periodic eye examinations and neurologic imaging may be necessary, as this lesion is associated with other malformations. Rationale: Nevus flammeus (port wine stain) is a permanent lesion, and although it does not grow, it may be associated with other structural malformations and requires periodic monitoring for possible complications, such as childhood cancer.

Answer 93

B. Elongation of the fetal head to accommodate the passage through the birth canal Rationale: Molding is the elongation of the fetal head that occurs during a vaginal birth, accommodating the passage through the birth canal. It resolves naturally within a week without intervention.

Answer 94

D. Caput succedaneum Rationale: Caput succedaneum is localized edema that crosses suture lines and is typically seen after prolonged labor. It resolves within 3 days without treatment.

Answer 95

C. Cephalhematoma Rationale: Cephalhematoma is a subperiosteal collection of blood that is confined to one cranial bone. It does not cross suture lines and is often seen in newborns following traumatic delivery.

Answer 96

A. It typically closes between 6 and 12 weeks after birth. Rationale: The posterior fontanelle typically closes between 6 and 12 weeks after birth and is smaller than the anterior fontanelle.

Answer 97

D. The swelling is firm and does not have overlying skin discoloration. Rationale: Cephalhematomas are firm, localized, and do not cross suture lines. They usually resolve over weeks to months.

Answer 98

C. Pitting edema and skin discoloration Rationale: Caput succedaneum involves pitting edema, skin discoloration, and swelling that crosses suture lines. It resolves within a few days.

Answer 99

B. Use of vacuum extraction or forceps during delivery Rationale: Cephalhematomas are most commonly associated with traumatic delivery, such as the use of forceps or vacuum extraction.

Answer 100

B. Within a few days Rationale: Caput succedaneum typically resolves within 3 days without any treatment.

Answer 101

B. Observation and reassurance as it will resolve on its own Rationale: Cephalhematomas resolve on their own without intervention, and aspiration is not recommended due to the risk of infection.

Answer 102

C. Observing for asymmetry in head size and shape Rationale: It is essential to assess for any asymmetry in head size and shape, as variations like molding, caput succedaneum, or cephalhematoma can cause changes in head appearance.

Answer 103

A. Normal, as it should measure 0.5 to 1 cm Rationale: The posterior fontanelle typically measures 0.5 to 1 cm and should be soft, flat, and open at birth, gradually closing by 6 to 12 weeks.

Answer 104

C. The elongated shaping of the fetal head to fit through the birth canal Rationale: Molding is the elongated shaping of the fetal head, which occurs during a vaginal birth as the head fits through the birth canal.

Answer 105

D. Cephalhematoma Rationale: Cephalhematoma is a firm, localized swelling that is confined to one cranial bone and does not cross suture lines.

Answer 106

C. It involves only one cranial bone. Rationale: Cephalhematoma is confined to one cranial bone, unlike caput succedaneum, which crosses suture lines and is soft and edematous.

Answer 107

B. Hyperbilirubinemia from the breakdown of red blood cells in the hematoma Rationale: The breakdown of red blood cells in the cephalhematoma can lead to hyperbilirubinemia, which typically occurs later than classic physiologic jaundice.

Answer 108

C. It closes by 18 months of age. Rationale: The anterior fontanelle typically closes by 18 months of age.

Answer 109

B. Caput succedaneum Rationale: Caput succedaneum is swelling caused by pressure during birth that crosses suture lines and resolves within a few days.

Answer 110

D. It does not cross suture lines. Rationale: Cephalhematoma is a blood collection under the periosteum that does not cross suture lines and typically resolves within weeks.

Answer 111

A. Molding Rationale: Molding refers to the elongation of the fetal head due to the pressure of the birth canal, which resolves within a few days.

Answer 112

D. Cephalhematoma Rationale: Cephalhematoma is characterized by a blood collection beneath the periosteum that does not cross suture lines and may lead to jaundice due to the breakdown of red blood cells.

Answer 113

C. Anocutaneous reflex Rationale: The anocutaneous reflex (anal wink) is associated with the S4-S5 innervations and is elicited by stimulating the perianal skin.

Answer 114

C. Truncal incurvation reflex Rationale: The truncal incurvation (Galant reflex) disappears by 4 weeks of age and is elicited by stimulating the side of the spine.

Answer 115

B. Babinski reflex Rationale: The Babinski reflex is characterized by the toes fanning out when the sole of the newborn’s foot is stroked.

Answer 116

C. Truncal incurvation reflex Rationale: The truncal incurvation (Galant reflex) is tested by applying pressure along the side of the spine in a prone position.

Answer 117

C. Babinski reflex Rationale: The Babinski reflex is present at birth and disappears by 1 year of age.

Answer 118

A. They may indicate a neurologic pathology Rationale: Absent or abnormal reflexes, or persistence of reflexes beyond the usual time frame, may indicate neurologic pathology.

Answer 119

C. By lifting the newborn’s arms and then releasing them suddenly Rationale: The Moro reflex is elicited by supporting the newborn’s upper body, lifting it slightly, and then releasing the arms suddenly.

Answer 120

A. A fencer’s stance Rationale: The tonic neck reflex, also known as the fencing reflex, resembles the stance of a fencer with one arm extended and the other flexed.

Answer 121

B. When the newborn’s cheek is stroked Rationale: The rooting reflex is elicited by stroking the newborn’s cheek, causing the newborn to turn toward the side and make sucking movements.

Answer 122

B. Babinski reflex Rationale: The Babinski reflex is elicited by stroking the lateral sole of the newborn’s foot from heel to ball, causing the toes to fan out.

Answer 123

A. Palmar grasp reflex Rationale: The palmar grasp reflex is elicited by placing a finger on the newborn’s open palm, causing the hand to close around the finger.

Answer 124

B. Palmar grasp reflex Rationale: The plantar grasp reflex is similar to the palmar grasp reflex, where the toes curl over a finger placed just below the newborn’s toes.

Answer 125

D. The external sphincter constricts Rationale: The anocutaneous reflex causes the external sphincter to constrict (wink) immediately with stimulation of the perianal skin.

Answer 126

D. Truncal incurvation reflex Rationale: The truncal incurvation reflex (Galant reflex) is assessed by applying pressure along the side of the spine when the newborn is in a prone position.

Answer 127

B. The newborn performs alternating flexion and extension of the legs Rationale: The stepping reflex involves alternating flexion and extension of the legs, resembling walking movements when the newborn’s feet touch a surface.

Answer 128

B. Stepping reflex Rationale: The stepping reflex is tested by holding the newborn upright and inclined forward with their feet touching a flat surface.

Answer 129

D. Gag reflex Rationale: The gag reflex is a protective reflex elicited by swallowing an irritant or suctioning, causing the newborn to gag or cough.

Answer 130

A. To evaluate the newborn’s development and neurologic function Rationale: Reflex assessments help evaluate a newborn’s neurologic function and development.

Answer 131

A. Moro reflex Rationale: The Moro reflex should typically disappear by the 4-6 month mark. If it persists, it may indicate a neurologic issue.

Answer 132

B. Neurologic pathology Rationale: The return of an infantile reflex in an older child or adult suggests a possible neurologic pathology.

Answer 133

C. Sucking reflex Rationale: The sucking reflex is elicited by gently stimulating the newborn’s lips.

Answer 134

A. The newborn’s arms extend and then flex back into a “C” shape Rationale: The Moro reflex involves the newborn extending their arms outward and flexing the knees, followed by the arms returning to the chest in a “C” shape.

Answer 135

C. Truncal incurvation reflex Rationale: The truncal incurvation (Galant reflex) tests T2-S1 innervation when the pelvis flexes toward the side of stimulation.

Answer 136

B. By 1-2 months of age Rationale: The tonic neck reflex typically disappears by 1-2 months of age.

Answer 137

D. Rooting reflex Rationale: The rooting reflex is observed when the newborn turns toward the side of the cheek that was stroked and begins sucking movements.

Answer 138

C. “Transitional stools appear on day 3 and are typically brown to green.” Rationale: Transitional stools typically appear by day 3 after initiation of feeding and are brown to green in color, becoming less sticky than meconium.

Answer 139

A. Six wet diapers a day Rationale: Newborns should soak 6 to 12 diapers a day, indicating adequate hydration.

Answer 140

B. “Fold the top of the diaper down below the umbilical cord area.” Rationale: The top of the diaper should be folded below the umbilical area to prevent irritation and promote healing.

Answer 141

D. Plain water or special cleansing wipes Rationale: Meconium can be difficult to remove, and plain water or special cleansing wipes should be used to clean the area.

Answer 142

C. The environmental impact of cloth and disposable diapers should be considered. Rationale: The nurse should discuss the pros and cons of both cloth and disposable diapers, including their environmental impact, to help parents make an informed choice.

Answer 143

B. Wipe from front to back to avoid urinary tract infections. Rationale: Wiping from front to back helps prevent urinary tract infections in female newborns.

Answer 144

C. Change the diaper frequently, especially after bowel movements. Rationale: Frequent diaper changes, especially after bowel movements, help prevent diaper rash.

Answer 145

B. Barrier cream such as A&D ointment or Desitin Rationale: Barrier creams protect the skin from moisture and irritation and are useful for preventing diaper rash.

Answer 146

B. Brown to green Rationale: Transitional stools are typically brown to green and less sticky than meconium.

Answer 147

A. Keep all supplies within reach before beginning the diaper change. Rationale: The nurse should instruct parents to have all diapering supplies within reach to ensure a smooth and efficient diaper change.

Answer 148

C. Both types have advantages and disadvantages. Rationale: Both cloth and disposable diapers have pros and cons regarding convenience, environmental impact, and cost.

Answer 149

C. Notify the healthcare provider, as the rash may be fungal in origin. Rationale: A persistent rash for more than 3 days may indicate a fungal infection and requires medical evaluation.

Answer 150

D. Wash hands thoroughly Rationale: Handwashing should always be performed before and after changing a newborn’s diaper to prevent contamination.

Answer 151

D. Mustard-colored with a seedy consistency Rationale: Breast-fed newborn stools are typically mustard-colored with a seedy consistency.

Answer 152

C. Clean the genital area with mild soap and water or wipes. Rationale: Mild soap and water or wipes should be used to gently clean the genital area to prevent irritation.

Answer 153

B. Expose the newborn’s bottom to air several times a day. Rationale: Air exposure helps keep the skin dry and reduces the likelihood of diaper rash.

Answer 154

C. Use water or special cleansing wipes to remove meconium. Rationale: Meconium can be sticky, and water or special cleansing wipes are most effective in removing it.

Answer 155

B. After every feeding Rationale: Parents should check the diaper after every feeding to ensure the baby’s needs are met and to prevent discomfort.

Answer 156

D. To prevent diaper rash by creating a protective layer Rationale: Barrier creams create a protective layer on the skin to prevent irritation from urine and stool.

Answer 157

D. “You should clean the cord stump with soap and water and apply an appropriate agent as needed.” Rationale: Cleaning the cord stump with soap and water and using the appropriate cleaning agent (e.g., alcohol or antimicrobial) is necessary to prevent infection while promoting proper healing.

Answer 158

C. “The cord should fall off within 7 to 10 days, so I will report this to the healthcare provider.” Rationale: The cord stump usually falls off within 7-10 days. If it has not fallen off by this time, the healthcare provider should be notified to rule out any complications.

Answer 159

A. Keep the cord clamp in place and ensure referral to home health care. Rationale: If the cord is still moist, the clamp should remain in place to prevent infection, and a referral to home health care is necessary for proper removal after discharge.

Answer 160

A. “We will avoid touching the cord stump to keep it from getting infected.” Rationale: Parents should be instructed to handle the cord stump appropriately, as cleaning and proper care are essential. Avoiding contact altogether is not advisable.

Answer 161

B. Document the finding as part of the normal healing process. Rationale: The blackening and shriveling of the cord stump are normal as it dries and prepares to slough off in 7-10 days.

Answer 162

D. The cord stump has a foul odor and drainage. Rationale: Foul odor and drainage are signs of infection, which require immediate intervention to prevent complications.

Answer 163

A. Fold the diaper below the cord stump to allow air circulation. Rationale: Folding the diaper below the cord stump promotes drying and prevents contamination, essential for proper healing.

Answer 164

C. Leave the clamp in place and inform the healthcare provider for further instructions. Rationale: The cord clamp should remain in place if the stump is moist, and the healthcare provider should be informed to determine the next steps.

Answer 165

B. Clean the cord stump with soap and water to prevent contamination. Rationale: Keeping the cord stump clean with soap and water helps prevent infection, while exposing it to air helps promote healing.

Answer 166

C. The policy may change based on new research findings regarding infection prevention. Rationale: The nurse should be aware that research advancements may influence the facility’s policies on cord care to enhance infection prevention.

Answer 167

B. Leave the clamp in place and notify the healthcare provider for further instructions. Rationale: If the cord is still moist, the clamp should remain in place, and the healthcare provider should be notified to decide on the next steps, as it should be dry before removal.

Answer 168

C. “I will wait until the cord stump falls off before giving the baby a tub bath.” Rationale: Parents should avoid tub baths until the cord stump falls off to prevent infection and ensure proper healing.

Answer 169

B. Fold the diaper below the level of the cord stump to promote air circulation. Rationale: Folding the diaper below the cord stump allows for air-drying, which helps prevent contamination and promotes healing.

Answer 170

B. The cord is undergoing normal healing and is expected to slough off. Rationale: The normal progression of healing includes the cord changing from yellow to brown to black before it naturally sloughs off.

Answer 171

C. “Expose the cord stump to air as much as possible to promote healing.” Rationale: Exposing the cord stump to air promotes air-drying, which aids in the healing process.

Answer 172

D. “I will pull on the cord gently if it seems to be taking too long to fall off.” Rationale: The cord should never be pulled or loosened. It will fall off naturally, and attempts to pull it can cause injury or infection.

Answer 173

A. Report the findings to the newborn’s primary care provider immediately. Rationale: Redness and foul odor indicate a possible infection, which requires immediate reporting to the healthcare provider for proper treatment.

Answer 174

8 - 12 times a day

Answer 175

C. Check for abdominal distention and patency of the anus. Rationale: Before feeding, the newborn’s ability to digest food and eliminate waste should be confirmed by assessing bowel sounds, abdominal distention, and anal patency.

Answer 176

B. The newborn places their fingers or fist in their mouth. Rationale: Hunger cues include rooting, sucking, and placing fingers or a fist in the mouth. Crying is often a late sign of hunger.

Answer 177

B. Breastfeed every 2 to 3 hours or when the newborn shows hunger cues. Rationale: Breastfed newborns typically nurse every 2 to 3 hours, and feeding should be based on hunger cues rather than a strict schedule.

Answer 178

B. No, the newborn should consume at least 9 oz daily. Rationale: Formula intake should be 1.5 to 2 oz per pound of body weight. For a 6-lb newborn, this equates to 9 to 12 oz per day.

Answer 179

C. The newborn wets 6 to 10 diapers daily and is gaining weight. Rationale: Adequate hydration and nutrition are indicated by 6 to 10 wet diapers, regular stools, and appropriate weight gain.

Answer 180

D. Frequently burp the newborn during the feeding. Rationale: Burping during feedings helps release swallowed air, reducing discomfort and fussiness.

Answer 181

A. The parent supports the newborn’s head while holding them upright. Rationale: Proper head support and an upright position are key to effective burping.

Answer 182

C. “Crying is a late hunger cue; look for earlier signs such as rooting or sucking.” Rationale: Crying is a late hunger cue, and parents should be taught to recognize earlier cues like rooting or sucking behaviors.

Answer 183

B. Within 30 minutes Rationale: Bottle feedings should typically take 30 minutes or less to prevent overfeeding and fatigue.

Answer 184

A. Maintaining eye contact and speaking softly to the newborn. Rationale: Feeding time fosters bonding through eye contact, soft speech, and physical closeness.

Answer 185

A. “Breast milk is digested more quickly than formula, so breastfed babies feed more often.” Rationale: Breast milk is more easily digested than formula, leading to more frequent feeding in breastfed newborns.

Answer 186

B. Ensure the newborn is burped frequently during feedings. Rationale: Burping frequently during feedings helps prevent gas buildup in newborns.

Answer 187

D. “I will prepare bottles in advance and store them at room temperature.” Rationale: Formula should not be stored at room temperature to prevent bacterial growth.

Answer 188

D. “We will feed our baby on demand, responding to hunger cues.” Rationale: Feeding on demand allows the newborn to regulate intake based on hunger and fullness.

Answer 189

B. Propping the bottle on a pillow and stepping away. Rationale: Bottle propping increases the risk of aspiration and does not promote bonding or safety during feeding.

Answer 190

110–120 kcal/kg/day

Answer 191

A. Promotes maternal milk production C. Enhances newborn weight gain E. Facilitates maternal-infant bonding Rationale: Unrestricted feeding supports milk production, improves newborn nutrition, and strengthens bonding.

Answer 192

B. Rooting around with their mouth C. Placing a fist in their mouth E. Sucking movements Rationale: Hunger cues include rooting, hand-to-mouth movements, and sucking motions. Crying is a late sign of hunger.

Answer 193

C. Stabilizes the newborn’s temperature Rationale: Skin-to-skin contact stabilizes the newborn’s temperature, respiratory rate, and blood glucose level while also fostering bonding and maternal oxytocin production.

Answer 194

A. Causes the uterus to contract and reduce bleeding B. Enhances bonding between mother and newborn C. Stimulates the let-down reflex for milk ejection Rationale: Oxytocin helps the uterus contract, enhances bonding, and triggers the milk ejection reflex during breast-feeding.

Answer 195

B. Positioning and latch effectiveness Rationale: The LATCH scoring tool evaluates how well the infant latches, audible swallowing, nipple type, mother’s comfort, and holding/help required.

Answer 196

A. Placing the newborn skin-to-skin with the mother C. Encouraging breast-feeding within one hour of birth D. Assisting with newborn positioning and latch-on Rationale: Skin-to-skin contact, early initiation, and assistance with positioning all promote successful breast-feeding.

Answer 197

D. Encourages milk ejection from the breasts Rationale: Oxytocin facilitates the let-down reflex, allowing milk to be ejected from the breasts during feeding.

Answer 198

A. Audible swallowing C. Six to ten wet diapers daily E. Content behavior after feeding Rationale: Effective feeding is evidenced by audible swallowing, adequate diaper output, and content behavior after feeding.

Answer 199

C. Waking up hungry eight times in 24 hours Rationale: Hunger cues, regular feedings, and six to ten wet diapers daily are signs of adequate intake.

Answer 200

A. Provide unrestricted periods of breast-feeding C. Keep the newborn with the mother throughout the hospital stay D. Initiate breast-feeding within the first hour of life Rationale: Unrestricted breast-feeding, early initiation, and rooming-in support successful breast-feeding.

Answer 201

A. Increasing fluid intake Rationale: Increased fluid intake helps maintain hydration, which is necessary for optimal milk production.

Answer 202

B. Ensure the newborn’s lips form a seal around the nipple and areola D. Wait for the newborn to open their mouth wide before latching E. Position the newborn’s body close to the mother Rationale: Proper latch includes ensuring the newborn’s lips seal around the areola, waiting for a wide mouth, and positioning the newborn close to the mother.

Answer 203

A. “It stimulates milk production in both breasts.” Rationale: Feeding from both breasts ensures milk production is stimulated equally.

Answer 204

C. Fewer than six wet diapers per day Rationale: Fewer than six wet diapers per day indicates inadequate milk intake.

Answer 205

D. “Seek guidance from a lactation consultant for support.” Rationale: Lactation consultants can provide valuable assistance with latching and breast-feeding techniques.

Answer 206

B. Rich in antibodies Rationale: Colostrum is rich in antibodies, providing passive immunity and serving as the newborn’s “first immunization.”

Answer 207

C. Eight to twelve times Rationale: Breast-fed newborns typically feed 8–12 times in 24 hours, as per their on-demand feeding schedule.

Answer 208

A. Audible swallowing is absent Rationale: Audible swallowing is a critical indicator of effective milk transfer during breast-feeding.

Answer 209

C. Ensure the newborn latches properly Rationale: Proper latch-on is essential to prevent nipple pain, cracking, and ineffective feeding.

Answer 210

B. Within the first hour after birth Rationale: Breast-feeding should ideally be initiated within the first hour after birth to take advantage of the newborn’s natural alertness.

Answer 211

A. Provides passive immunity D. Acts as a natural laxative E. Reduces the risk of infection Rationale: Colostrum is rich in antibodies, acts as a natural laxative, and reduces the newborn’s risk of infection.

Answer 212

C. Incorrect latch-on technique Rationale: Nipple discomfort is often due to poor latch-on, which may cause pain or nipple trauma.

Answer 213

A. “Avoid using pacifiers, as they can interfere with latch-on.” Rationale: Using pacifiers early on can cause nipple confusion, interfering with breast-feeding success.

Answer 214

B. Assist in positioning the newborn for proper latch C. Encourage skin-to-skin contact E. Observe and score using the LATCH tool Rationale: Assistance with latch, promoting skin-to-skin contact, and using the LATCH tool are all appropriate during the first breast-feeding session.

Answer 215

B. Holding the baby close and maintaining eye contact Rationale: Bonding is enhanced when the mother holds the baby close and maintains eye contact during feeding.

Answer 216

D. Provide passive immunity and essential nutrients Rationale: Colostrum is nutrient-rich and contains antibodies to boost the newborn’s immunity.

Answer 217

A. “Frequent feeding ensures adequate milk production and nutrition.” Rationale: Newborns feed frequently to meet their nutritional needs and stimulate milk production.

Answer 218

A. Nurse frequently and on demand C. Encourage relaxation during feedings E. Increase fluid intake to support lactation Rationale: Frequent nursing, relaxation, and adequate hydration promote effective milk production.

Answer 219

B. Steady weight gain after the first week is an indicator of adequate milk intake. Rationale: Steady weight gain and other signs like wet diapers and contentment after feedings are indicators of sufficient milk intake.

Answer 220

D. Correct positioning and latching on Rationale: Proper positioning and latch-on are critical for effective milk transfer and successful breast-feeding.

Answer 221

B. “Feed on demand every 2 to 3 hours for 8 to 12 feedings in 24 hours.” Rationale: Feeding on demand ensures the newborn receives adequate nourishment and stimulates milk production.

Answer 222

D. Crying and squirming Rationale: Crying is considered a late hunger cue. Earlier cues include rooting and hand-to-mouth movements.

Answer 223

A. Insert a clean finger into the baby’s mouth. Rationale: Inserting a finger breaks suction safely without causing nipple trauma.

Answer 224

C. Six wet diapers and two to five loose yellow stools daily Rationale: These are key indicators that the newborn is well-nourished and hydrated.

Answer 225

B. Facing the breast with ear, shoulder, and hip in alignment Rationale: Proper alignment ensures effective latch-on and milk transfer.

Answer 226

C. Vary feeding positions and ensure proper latch-on. Rationale: Varying positions and proper latch-on help reduce nipple trauma and soreness.

Answer 227

B. Supplemental feeding reduces milk production. Rationale: Supplemental feedings reduce the baby’s demand for breast milk, leading to decreased milk supply.

Answer 228

A. Listening to soothing music during feedings Rationale: Relaxation techniques, such as listening to music, help promote the letdown reflex.

Answer 229

A. To remove excess gas from the stomach Rationale: Burping helps release trapped air, which can cause discomfort in the infant.

Answer 230

A. Breast-feeding on demand C. Using a quiet and relaxed environment D. Ensuring correct latch-on technique E. Alternating the breast offered first Rationale: Feeding on demand, a relaxed environment, proper latch-on, and alternating breasts all promote successful breast-feeding.

Answer 231

A. Wide-open mouth with much of the areola in the mouth B. Lips rolled outward D. Jaw movement and rhythmic sucking Rationale: Proper latch-on includes a wide-open mouth, lips rolled outward, and rhythmic sucking with jaw movement.

Answer 232

A. Rooting reflex B. Smacking lips D. Placing hands in the mouth Rationale: Rooting, smacking lips, and hand-to-mouth movements are early hunger cues.

Answer 233

A. Nursing the newborn frequently B. Drinking plenty of fluids C. Relaxing during feeding sessions E. Alternating breasts at each feeding Rationale: Frequent nursing, adequate hydration, relaxation, and alternating breasts stimulate milk production.

Answer 234

A. Inadequate knowledge about breast-feeding B. Judgmental attitudes from health care providers C. Lack of proper positioning and latch-on E. Distractions during feeding sessions Rationale: Knowledge deficits, poor support, improper technique, and distractions contribute to breast-feeding challenges.

Answer 235

B. Assess latch-on and positioning, and provide supportive guidance. Rationale: Assessing and improving latch-on and positioning are essential for successful breastfeeding, and supportive guidance is crucial.

Answer 236

D. Insert a clean finger into the baby’s mouth to break the suction. Rationale: Breaking suction gently by inserting a finger helps prevent nipple trauma.

Answer 237

A. At least six wet diapers per day D. Rhythmic sucking with audible swallowing E. Pale yellow urine Rationale: Wet diapers, rhythmic sucking with swallowing, and pale yellow urine indicate sufficient milk intake.

Answer 238

A. Wash her hands thoroughly Rationale: Handwashing is crucial to prevent contamination of breast milk.

Answer 239

C. Use milk within 24 hours after refrigeration Rationale: Expressed milk should be used within 24 hours after being refrigerated to ensure safety.

Answer 240

D. 3 months Rationale: Frozen breast milk should be used within 3 months to maintain its nutritional quality.

Answer 241

B. Using a microwave oven Rationale: Microwaving breast milk can create hot spots and destroy essential nutrients.

Answer 242

A. To prevent contamination from multiple uses Rationale: Storing milk in small quantities reduces the risk of contamination from repeated openings.

Answer 243

B. Discard it Rationale: Breast milk that has been refrigerated for more than 24 hours should be discarded for safety.

Answer 244

C. They are most beneficial for mothers who experience lengthy separations from their infant Rationale: Electric pumps are designed for regular use, particularly for mothers who are separated from their babies for extended periods.

Answer 245

A. Discard it Rationale: Once thawed, breast milk should not be refrozen and must be discarded after use.

Answer 246

C. In a sealed container in the freezer Rationale: Breast milk should be stored in sealed containers in the freezer for long-term preservation.

Answer 247

C. Express milk in a quiet and clean environment Rationale: A calm, clean environment promotes successful milk expression and reduces contamination risks.

Answer 248

D. Use an electric breast pump for regular expression Rationale: An electric pump is ideal for mothers who need to pump frequently, such as during work hours.

Answer 249

D. Never refreeze milk once it has been thawed Rationale: Refreezing breast milk after thawing can compromise its quality and safety.

Answer 250

B. It is best for mothers who occasionally need an extra bottle Rationale: Manual pumps are more suitable for occasional use, such as when a mother needs one extra bottle.

Answer 251

C. Make sure the pump is clean before use Rationale: Cleaning the pump properly before use is essential to prevent contamination of expressed milk.

Answer 252

D. Thaw milk in warm water before using it Rationale: Thawing milk in warm water is the safest method to maintain the milk’s nutritional value.

Answer 253

B. 4 hours Rationale: Breast milk should be stored at room temperature for no longer than 4 hours to maintain its safety and quality.

Answer 254

B. 4 days Rationale: Breast milk can be safely stored in the refrigerator for up to 4 days.

Answer 255

B. 3 months Rationale: Breast milk can be stored in a freezer for up to 3 months to maintain its nutritional value and safety.

Answer 256

B. Nutritional imbalances or digestive issues Rationale: Mistakes in formula preparation or measurement errors can result in nutritional imbalances, leading to digestive issues or inadequate nutrition for the infant.

Answer 257

A. By testing it on the inside of their wrist Rationale: Parents should test the temperature of the formula by letting a few drops fall on the inside of their wrist to ensure it is comfortably warm.

Answer 258

A. Cool it in cold water Rationale: If the formula is too hot, it should be cooled in cold water before feeding to the infant to avoid burns.

Answer 259

C. Discard it Rationale: Leftover formula should be discarded because the infant’s saliva has mixed with it, which could lead to bacterial growth.

Answer 260

D. By placing it in hot water or using an electric bottle warmer Rationale: Refrigerated formula should be warmed by placing the bottle in hot water or using an electric bottle warmer to ensure safety and prevent overheating.

Answer 261

D. Iron-fortified formula Rationale: Infants are generally recommended to receive iron-fortified formula until the age of 1 year to support healthy growth and development.

Answer 262

C. Signs of formula intolerance or lactose intolerance Rationale: If the infant shows signs of a reaction or lactose intolerance, a different formula type is recommended.

Answer 263

C. Ready-to-feed formula Rationale: Ready-to-feed formula is the most expensive as it can be directly poured into a bottle without mixing.

Answer 264

B. Sets minimum and maximum levels of nutrients Rationale: The FDA regulates the nutrients in infant formula to ensure it meets the nutritional needs of infants.

Answer 265

A. Natural components of breast milk Rationale: DHA and ARA are two natural components found in breast milk that are added to formula to mimic the nutritional benefits of breast milk.

Answer 266

D. Both B and C Rationale: Powdered formula and concentrated formula require mixing with water before they can be fed to the infant.

Answer 267

C. A bottle brush Rationale: A bottle brush is essential for cleaning bottles and nipples used in formula feeding.

Answer 268

C. By turning the bottle upside down and observing the flow rate Rationale: Turning the bottle upside down allows parents to observe the flow rate of formula and check if it is appropriate for the infant.

Answer 269

D. Replace the nipple Rationale: If the formula flows too fast (more than one drop per second), the nipple should be replaced to prevent choking and aspiration.

Answer 270

A. Boil it for 1 to 2 minutes Rationale: If well water is used, it should be sterilized by boiling it for 1 to 2 minutes to ensure it is safe for formula preparation.

Answer 271

B. 24 hours Rationale: Opened cans of ready-made or concentrated formula should be refrigerated and used within 24 hours.

Answer 272

D. Discard it Rationale: Any unused formula after 24 hours should be discarded to prevent the risk of contamination.

Answer 273

A. The proper technique for positioning both the baby and the bottle Rationale: Educating parents on how to correctly position both the baby and the bottle is crucial for a comfortable and successful feeding experience.

Answer 274

A. By talking and singing to the baby during feedings Rationale: Talking and singing to the baby during feedings helps to foster emotional interaction and bonding, which is essential for the newborn’s well-being.

Answer 275

A. It can make swallowing difficult Rationale: A head position that is too far back or turned can make it difficult for the newborn to swallow properly, which could lead to choking or feeding issues.

Answer 276

B. The baby should be held upright with their head in a comfortable position Rationale: The baby should be positioned upright during bottle-feeding with the head comfortably aligned to facilitate proper swallowing.

Answer 277

D. Difficulty holding both the infant and the bottle properly Rationale: Many new parents find it awkward at first to properly position both the baby and the bottle to ensure a successful feeding experience.

Answer 278

B. Maintaining proper feeding positions and emotional bonding Rationale: The process of formula feeding should mimic breast-feeding by focusing not only on nutrition but also on the emotional and interactive aspects, such as bonding with the newborn.

Answer 279

C. The head should be in a comfortable position, not too far back or turned Rationale: The baby’s head should be in a comfortable, neutral position to ensure easy swallowing during bottle-feeding.

Answer 280

C. To provide emotional interaction and bonding Rationale: Communicating with the newborn by talking and singing promotes emotional bonding during feedings, similar to the emotional components of breastfeeding.

Answer 281

B. “Make sure the room is quiet and relaxed, and avoid distractions during feedings.” Rationale: A quiet and calm environment helps both the mother and baby feel relaxed, which promotes better feeding and bonding during formula-feeding sessions.

Answer 282

D. Cradle the baby in a semi-upright position with the head slightly raised. Rationale: Cradling the baby in a semi-upright position with the head slightly raised helps prevent formula from washing back into the eustachian tubes, reducing the risk of ear infections.

Answer 283

B. The baby appears relaxed, and there is no evidence of choking or discomfort. Rationale: A proper feeding position, such as cradling the baby in a semi-upright position, will help prevent choking, improve comfort, and support bonding. The baby should appear relaxed during the feeding without signs of discomfort.

Answer 284

C. “I will hold my baby with their head tilted backward to help with swallowing.” Rationale: The baby’s head should be raised slightly during bottle-feeding to help prevent formula from washing back into the eustachian tubes, which could lead to an ear infection. Tilting the head backward may increase the risk of choking or aspiration.

Answer 285

B. The mother should ensure that the baby’s head is raised slightly during the feeding to prevent formula from washing into the ears. Rationale: Raising the baby’s head slightly during feeding helps prevent formula from washing into the eustachian tubes, reducing the risk of ear infections. It is also important to feed in a calm environment, not one with excessive noise or distractions.

Answer 286

B. Cradle the baby in a semi-upright position, keeping the head slightly raised during feeding. Rationale: Cradling the baby in a semi-upright position with the head slightly raised helps prevent formula from washing back into the eustachian tubes, reducing the risk of choking and ear infections.

Answer 287

C. The mother freezes any leftover formula to use at a later feeding. Rationale: Formula should never be frozen. Freezing formula can degrade the quality and safety of the milk.

Answer 288

C. The mother should hold the bottle like a pencil, ensuring the nipple remains filled with milk. Rationale: Holding the bottle like a pencil prevents air from entering the nipple and ensures that the milk flows correctly for the baby.

Answer 289

A. Always keep a bulb syringe close by to use if choking occurs. Rationale: Keeping a bulb syringe close by during feedings ensures that the mother can respond quickly in case the baby chokes.

Answer 290

D. Placing the bottle in a pan of hot water for a few minutes to warm. Rationale: Formula should never be heated in the microwave due to the risk of uneven heating, which can cause burns. Warming in a pan of hot water ensures a more controlled temperature.

Answer 291

A. After every few ounces of formula. Rationale: Burping the baby after every few ounces helps release any swallowed air, reducing the risk of discomfort or spitting up.

Answer 292

A. Always check the nipple for cracks or leaks before each feeding. Rationale: Checking the nipple regularly for damage or leaks is important to ensure proper formula flow and prevent choking or aspiration.

Answer 293

B. “I should discard any formula left in the bottle after each feeding.” Rationale: Formula left in the bottle after a feeding should be discarded to prevent bacterial contamination from the infant’s saliva.

Answer 294

B. Every 3 to 4 hours. Rationale: Newborns typically need to be fed every 3 to 4 hours, depending on their individual hunger cues and growth needs.

Answer 295

C. It ensures adequate iron intake for growth and development. Rationale: Iron-fortified formula provides essential nutrients for healthy growth, particularly for infants who may not receive sufficient iron from breast milk.

Answer 296

D. Whenever the infant shows signs of choking or difficulty breathing. Rationale: The bulb syringe should be used immediately if the infant shows signs of choking or difficulty breathing to clear the airway and prevent aspiration.

Answer 297

A. Mix the formula and water exactly as specified on the label. Rationale: Mixing the formula and water according to the exact instructions is essential to ensure the infant receives the correct nutritional content.

Answer 298

A. Shake a few drops of the formula on the inside of her wrist to test the temperature. Rationale: Testing the formula on the wrist ensures the formula is warm but not too hot, reducing the risk of burns.

Answer 299

D. Never allow the baby to fall asleep with a bottle. Rationale: Allowing an infant to fall asleep with a bottle increases the risk of “baby bottle tooth decay” due to prolonged contact of formula with the teeth.

Answer 300

C) To facilitate maternal infant bonding

Answer 301

A) How many hours old is this newborn?

Answer 302

B) Assess the newborn for signs of respiratory distress.

Answer 303

D) Decrease the serum bilirubin level

Answer 304

C) Nasal flaring

Answer 305

B) Mongolian spots

Answer 306

C) Caput succedaneum

Answer 307

B) Developmental hip dysplasia

Answer 308

A) Babinski

Answer 309

D) Promote blood clotting

Answer 310

C) Erythema toxicum

Answer 311

A) Cephalhematoma B) Molding D) Caput succedaneum

Answer 312

A) Limited rugae

Answer 313

D) Rooting reflex

Answer 314

C) He should wet between 6 to 12 diapers each day.

Answer 315

B) The cord stump should change from brown to yellow.

Answer 316

C) Feeding the newborn every 2 to 4 hours during the day D) Burping the newborns frequently throughout each feeding E) Using feeding time for promoting closeness