Newborn Nursing care NCLEX Practice Questions!

1. When teaching umbilical cord care to a new mother. the nurse would include which information?

Apply peroxide to the cord with each diaper change

Cover the cord with petroleum jelly after bathing

Keep the cord dry and open to air

Wash the cord with soap and water each day during a tub bath

Keeping the cord dry and open to air helps reduce infection and hastens drying.

Explanation

Keeping the cord dry and open to air helps reduce infection and hastens drying.

2. A mother of a term neonate asks what the thick. white. cheesy coating is on his skin. Which correctly describes this finding?

Lanugo

Milia

Nevus flammeus

Vernix

Vernix is a thick, white, cheesy coating that is commonly found on the skin of term neonates. It is a protective substance that develops in the womb and helps to protect the baby's skin from the amniotic fluid. Vernix is typically present at birth and gradually decreases over the first few days of life. It is a normal finding and does not require any treatment.

Explanation

Vernix is a thick, white, cheesy coating that is commonly found on the skin of term neonates. It is a protective substance that develops in the womb and helps to protect the baby's skin from the amniotic fluid. Vernix is typically present at birth and gradually decreases over the first few days of life. It is a normal finding and does not require any treatment.

3. The most common neonatal sepsis and meningitis infections seen within 24 hours after birth are caused by which organism?

Candida albicans

Chlamydia trachomatis

Escherichia coli

Group B beta-hemolytic streptococci

Transmission of Group B beta-hemolytic streptococci to the fetus results in respiratory distress that can rapidly lead to septic shock.

Explanation

Transmission of Group B beta-hemolytic streptococci to the fetus results in respiratory distress that can rapidly lead to septic shock.

4. A woman delivers a 3.250 g neonate at 42 weeks' gestation. Which physical finding is expected during an examination if this neonate?

Abundant lanugo

Absence of sole creases

Breast bud of 1-2 mm in diameter

Leathery. cracked. and wrinkled skin

Neonatal skin thickens with maturity and is often peeling by post term.

Explanation

Neonatal skin thickens with maturity and is often peeling by post term.

5. When attempting to interact with a neonate experiencing drug withdrawal. which behavior would indicate that the neonate is willing to interact?

Gaze aversion

Hiccups

Quiet alert state

Yawning

When caring for a neonate experiencing drug withdrawal. the nurse needs to be alert for distress signals from the neonate. Stimuli should be introduced one at a time when the neonate is in a quiet and alert state. Gaze aversion. yawning. sneezing. hiccups. and body arching are distress signals that the neonate cannot handle stimuli at that time.

Explanation

When caring for a neonate experiencing drug withdrawal. the nurse needs to be alert for distress signals from the neonate. Stimuli should be introduced one at a time when the neonate is in a quiet and alert state. Gaze aversion. yawning. sneezing. hiccups. and body arching are distress signals that the neonate cannot handle stimuli at that time.

6. When performing nursing care for a neonate after a birth. which intervention has the highest nursing priority?

Obtain a dextrostix

Give the initial bath

Give the vitamin K injection

Cover the neonates head with a cap

Covering the neonate’s head with a cap helps prevent cold stress due to excessive evaporative heat loss from the neonate’s wet head. Vitamin K can be given up to 4 hours after birth.

Explanation

Covering the neonate’s head with a cap helps prevent cold stress due to excessive evaporative heat loss from the neonate’s wet head. Vitamin K can be given up to 4 hours after birth.

7. Which neonatal behavior is most commonly associated with fetal alcohol syndrome (FAS)?

Hypoactivity

High birth weight

Poor wake and sleep patterns

High threshold of stimulation

Altered sleep patterns are caused by disturbances in the CNS from alcohol exposure in utero. Hyperactivity is a characteristic generally noted. Low birth weight is a physical defect seen in neonates with FAS. Neonates with FAS generally have a low threshold for stimulation.

Explanation

Altered sleep patterns are caused by disturbances in the CNS from alcohol exposure in utero. Hyperactivity is a characteristic generally noted. Low birth weight is a physical defect seen in neonates with FAS. Neonates with FAS generally have a low threshold for stimulation.

8. Which condition or treatment best ensures lung maturity in an infant?

Meconium in the amniotic fluid

Glucocorticoid treatment just before delivery

Lecithin to sphingomyelin ratio more than 2:1

Absence of phosphatidylglycerol in amniotic fluid

Lecithin and sphingomyelin are phospholipids that help compose surfactant in the lungs; lecithin peaks at 36 weeks and sphingomyelin concentrations remain stable.

Explanation

Lecithin and sphingomyelin are phospholipids that help compose surfactant in the lungs; lecithin peaks at 36 weeks and sphingomyelin concentrations remain stable.

9. When performing an assessment on a neonate. which assessment finding is most suggestive of hypothermia?

Bradycardia

Hyperglycemia

Metabolic alkalosis

Shivering

Hypothermic neonates become bradycardic proportional to the degree of core temperature. Hypoglycemia is seen in hypothermic neonates.

Explanation

Hypothermic neonates become bradycardic proportional to the degree of core temperature. Hypoglycemia is seen in hypothermic neonates.

10. A nurse is performing an initial assessment on a newborn. Which of the following findings would require immediate intervention?

Heart rate of 140 beats per minute

Respiratory rate of 50 breaths per minute

Bluish discoloration of the hands and feet

Nasal flaring and grunting

Nasal flaring and grunting in a newborn are signs of respiratory distress and require immediate intervention. These symptoms indicate that the newborn is having difficulty breathing, which can be life-threatening if not addressed promptly. The other options—heart rate of 140 beats per minute, respiratory rate of 50 breaths per minute, and bluish discoloration of the hands and feet (acrocyanosis)—are normal findings in a newborn and do not require immediate intervention.

Explanation

Nasal flaring and grunting in a newborn are signs of respiratory distress and require immediate intervention. These symptoms indicate that the newborn is having difficulty breathing, which can be life-threatening if not addressed promptly. The other options—heart rate of 140 beats per minute, respiratory rate of 50 breaths per minute, and bluish discoloration of the hands and feet (acrocyanosis)—are normal findings in a newborn and do not require immediate intervention.