Ati Maternal Newborn Practice A Quiz

A nurse is demonstrating to a client how to bathe their newborn. In which order should the nurse perform the following actions?

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A client who is at 11 weeks of gestation and reports abdominal cramping
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Evidence-based practice indicates the nurse should perform this step first when performing Leopold maneuvers. During this step, the nurse palpates the client's abdomen with the palms to determine which fetal part is in the uterine fundus. This step also identifies the lie (transverse or longitudinal) and presentation (cephalic or breech) of the fetus.
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"The person who comes to take my baby's pictures will be wearing a photo identification badge."
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The nurse should demonstrate how to bathe a newborn by using a head to toe, clean to dirty, approach. Therefore, the nurse should first wipe the newborn's eyes from the inner canthus outward using plain water. The nurse should then wash the newborn's neck by lifting the newborn's chin. Next, the nurse should cleanse the skin around the umbilical cord stump followed by washing the newborn's legs and feet. The last step of the bath should be to clean the newborn's diaper area.

A nurse is performing a physical assessment of a newborn upon admission to the nursery. Which of the following manifestations should the nurse expect? (Select all that apply.)a) Yellow sclerab) Acrocyanosisc) Posterior fontanel larger than the anterior fontaneld) Positive Babinski reflexe) Two umbilical arteries visible

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Heart rate 154/minRespiratory rate 58/minWeight 2,600 g (5 lb 12 oz)The expected reference range for a newborn's heart rate is from 110/min to 160/min while awake.A healthy newborn's temperature averages 37° C (98.6° F), with a range of 36.5° to 37.5° C (97.7° to 99.5° F).The expected reference range for a newborn's respiratory rate is from 30/min to 60/min.The expected reference range for a newborn's length is from 45 to 55 cm (17.7 to 21.7 in).The expected reference range for a newborn's weight is from 2,500 to 4,000 g (5.5 lb to 8.8 lb).
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b, d,eeYellow sclera is incorrect. Yellow sclera is an indication of hyperbilirubinemia and is not an expected manifestation. Acrocyanosis is correct. Acrocyanosis is an expected finding for at least the first 24 hr following birth. Poor peripheral perfusion leads to bluish discoloration in the newborn's hands and feet.Posterior fontanel larger than the anterior fontanel is incorrect. The posterior fontanel is located on the back of the newborn's head and is a small triangular shape. The anterior fontanel is diamond shaped and approximately 5 cm (2 in) long. It is located on the top of the newborn's head and is larger than the posterior fontanel.Positive Babinski reflex is correct. Newborns should exhibit a positive Babinski sign following birth. The nurse should stroke the newborn's foot upward from the heel to the toes. The toes should hyperextend, and dorsal flexion of the big toe should occur. The absence of this finding requires neurological evaluation. The Babinski reflex is no longer present after 1 year of age.Two umbilical arteries visible is correct. The nurse should observe two arteries and one vein in the umbilical cord. The presence of only one artery can indicate a renal anomaly.
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d) Monitor the FHR.
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d) A newborn who is 18 hr old and has an axillary temperature of 37.7° C (99.9° F)

A nurse is preparing to administer magnesium sulfate 2 g/hr to a client who is in preterm labor. Available is 20 g magnesium sulfate in 500 mL of dextrose 5% in water (D5W). The nurse should set the IV infusion pump to administer how many mL/hr?

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Obtain a gift from the newborn to present to the sibling.
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Hemoglobin 10 g/dL
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50 mL/hr20 g/ 500 mL = 2 g/X mLX mL = 50 mL
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"I will likely need to use alternative positions for sexual intercourse."

A nurse is performing a physical assessment of a newborn. Which of the following clinical findings should the nurse expect? (Select all that apply.)Heart rate 154/minAxillary temperature 36° C (96.8° F)Respiratory rate 58/minLength 43 cm (16.9 in)Weight 2,600 g (5 lb 12 oz)

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Obtain a gift from the newborn to present to the sibling.
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Respiratory rate 10/min
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Heart rate 154/minRespiratory rate 58/minWeight 2,600 g (5 lb 12 oz)The expected reference range for a newborn's heart rate is from 110/min to 160/min while awake.A healthy newborn's temperature averages 37° C (98.6° F), with a range of 36.5° to 37.5° C (97.7° to 99.5° F).The expected reference range for a newborn's respiratory rate is from 30/min to 60/min.The expected reference range for a newborn's length is from 45 to 55 cm (17.7 to 21.7 in).The expected reference range for a newborn's weight is from 2,500 to 4,000 g (5.5 lb to 8.8 lb).
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"Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen."

A nurse is demonstrating to a client how to bathe their newborn. In which order should the nurse perform the following actions?

A nurse is preparing to administer magnesium sulfate 2 g/hr to a client who is in preterm labor. Available is 20 g magnesium sulfate in 500 mL of dextrose 5% in water (D5W). The nurse should set the IV infusion pump to administer how many mL/hr?

A nurse is performing a physical assessment of a newborn. Which of the following clinical findings should the nurse expect? (Select all that apply.)Heart rate 154/minAxillary temperature 36° C (96.8° F)Respiratory rate 58/minLength 43 cm (16.9 in)Weight 2,600 g (5 lb 12 oz)

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