Chapter 22 - Physiologic & Behavioral Adaptations of
the Newborn (Maternity) EAQ's
The nurse observes that a newborn is passing stool through the vagina. What does the nurse infer that
the newborn has from this observation?
1
Epispadias
2
Hypospadias
3
Vaginal agenesis
4
Rectovaginal fistula
4 - Rectovaginal fistula
pg 543 - Fecal discharge from the vagina indicates a rectovaginal fistula. Hypospadias or epispadias are
abnormalities of the male genitalia. All female infants are born with hymenal tags; absence of such tags
can indicate vaginal agenesis and is associated with adrenal hyperplasia.
After performing an Ortolani test, the nurse observes that a newborn has asymmetric gluteal and thigh
skinfolds and uneven knee levels. What does the nurse infer that the infant had from this assessment?
1
A low birth weight
2
A vertex presentation at birth
3
Amniotic prolapse before birth
4
A breech presentation at birth
,4 - A breech presentation at birth
pg 544 - The newborn was found to have asymmetric gluteal and thigh skinfolds and uneven knee levels,
which indicate a positive Ortolani test. The test reveals that the infant has developmental dysplasia of
the hips (DDH). DDH occurs more often in female infants with breech presentation at birth. Therefore
the newborn had breech presentation before birth. Low birth weight may be due to gestational diabetes
and preterm deliveries; however, low birth weight is unrelated to developmental dysplasia of the hips.
Amniotic prolapse is not associated with uneven knee lengths and asymmetric gluteal and thigh
skinfolds. Vertex presentation of the newborn is an edematous area that is present at birth, extends
across suture lines of the skull, and usually disappears spontaneously within 3 to 4 days after birth.
The nurse examines a 6-day-old newborn and observes that the infant's skin color and sclera appear
yellowish. What would the nurse expect to find in the laboratory reports of the infant?
1
Platelet count less than 150,000/mm3
2
Blood glucose levels less than 40 mg/dL
3
Free bilirubin levels greater than 20 mg/dL
4
Leukocyte count less than 12,000/ mm3
3 - Free bilirubin levels greater than 20 mg/dL
pg 538 - The infant's skin color and sclera of eyes appear yellow due to jaundice, which is caused by
elevated unconjugated (free) bilirubin levels in the serum that is greater than 20 mg/dL
(hyperbilirubinemia). Yellowing of the skin, or jaundice, is not caused by abnormal levels of platelets,
blood glucose levels, or leukocytes. A platelet count of less than 150,000/mm3 indicates vitamin K
deficiency, which can lead to severe hemorrhage. Blood glucose levels that are less than 40 mg/dL
indicate hypoglycemia, and a leukocyte count of less than 12,000/mm3 indicates that the newborn has
sepsis.
,Why is vitamin K given to the newborn?
1
To reduce bilirubin levels
2
To increase the production of red blood cells
3
To enhance ability of blood to clot
4
To stimulate the formation of surfactant
3 - To enhance ability of blood to clot
pg 539 - Vitamin K is required for the production of certain clotting factors. Vitamin K does not reduce
bilirubin levels. Vitamin K does not increase the production of red blood cells. Newborns have a
deficiency of vitamin K until intestinal bacteria that produce vitamin K are formed. Vitamin K does not
stimulate the formation of surfactant.
The nurse is caring for a baby who is 4 weeks old. The nurse finds that the newborn is breathing through
the mouth. What does the nurse expect to be the most likely clinical condition for this observation?
1
Hypoxemia
2
Cardiac disorder
3
, Nasal obstruction
4
Laryngeal obstruction
3 - Nasal obstruction
pg 530 - Newborns are generally nose breathers. After 3 weeks of age, newborns develop a reflex
response that allows them to use their mouths for breathing at times of nasal obstruction. If the
newborn has hypoxemia, the infant would breathe deeply through nose and not through the mouth.
Mouth breathing in infants is a normal finding and does not indicate a cardiac problem. If the infant has
laryngeal obstruction, the infant would be unable to breathe. This is a life-threatening condition.
Upon assessing a newborn, the nurse finds that the baby has swelling in the breast and thin milky
discharge from the nipples. What does the nurse expect to be the reason for this finding?
1
Low levels of bilirubin during pregnancy
2
High levels of estrogen during pregnancy
3
Low levels of progesterone during pregnancy
4
High levels of catecholamines during pregnancy
2 - High levels of estrogen during pregnancy
pg 542 - Some infants have a swelling in the breast with a thin milky discharge from the nipples due to
high estrogen levels during pregnancy (hyperestrogenism of pregnancy). It has no critical significance
and no treatment is required. During pregnancy, estrogen and progesterone levels are always elevated.
Low bilirubin levels indicate that the infant will not have jaundice after birth. However, high
the Newborn (Maternity) EAQ's
The nurse observes that a newborn is passing stool through the vagina. What does the nurse infer that
the newborn has from this observation?
1
Epispadias
2
Hypospadias
3
Vaginal agenesis
4
Rectovaginal fistula
4 - Rectovaginal fistula
pg 543 - Fecal discharge from the vagina indicates a rectovaginal fistula. Hypospadias or epispadias are
abnormalities of the male genitalia. All female infants are born with hymenal tags; absence of such tags
can indicate vaginal agenesis and is associated with adrenal hyperplasia.
After performing an Ortolani test, the nurse observes that a newborn has asymmetric gluteal and thigh
skinfolds and uneven knee levels. What does the nurse infer that the infant had from this assessment?
1
A low birth weight
2
A vertex presentation at birth
3
Amniotic prolapse before birth
4
A breech presentation at birth
,4 - A breech presentation at birth
pg 544 - The newborn was found to have asymmetric gluteal and thigh skinfolds and uneven knee levels,
which indicate a positive Ortolani test. The test reveals that the infant has developmental dysplasia of
the hips (DDH). DDH occurs more often in female infants with breech presentation at birth. Therefore
the newborn had breech presentation before birth. Low birth weight may be due to gestational diabetes
and preterm deliveries; however, low birth weight is unrelated to developmental dysplasia of the hips.
Amniotic prolapse is not associated with uneven knee lengths and asymmetric gluteal and thigh
skinfolds. Vertex presentation of the newborn is an edematous area that is present at birth, extends
across suture lines of the skull, and usually disappears spontaneously within 3 to 4 days after birth.
The nurse examines a 6-day-old newborn and observes that the infant's skin color and sclera appear
yellowish. What would the nurse expect to find in the laboratory reports of the infant?
1
Platelet count less than 150,000/mm3
2
Blood glucose levels less than 40 mg/dL
3
Free bilirubin levels greater than 20 mg/dL
4
Leukocyte count less than 12,000/ mm3
3 - Free bilirubin levels greater than 20 mg/dL
pg 538 - The infant's skin color and sclera of eyes appear yellow due to jaundice, which is caused by
elevated unconjugated (free) bilirubin levels in the serum that is greater than 20 mg/dL
(hyperbilirubinemia). Yellowing of the skin, or jaundice, is not caused by abnormal levels of platelets,
blood glucose levels, or leukocytes. A platelet count of less than 150,000/mm3 indicates vitamin K
deficiency, which can lead to severe hemorrhage. Blood glucose levels that are less than 40 mg/dL
indicate hypoglycemia, and a leukocyte count of less than 12,000/mm3 indicates that the newborn has
sepsis.
,Why is vitamin K given to the newborn?
1
To reduce bilirubin levels
2
To increase the production of red blood cells
3
To enhance ability of blood to clot
4
To stimulate the formation of surfactant
3 - To enhance ability of blood to clot
pg 539 - Vitamin K is required for the production of certain clotting factors. Vitamin K does not reduce
bilirubin levels. Vitamin K does not increase the production of red blood cells. Newborns have a
deficiency of vitamin K until intestinal bacteria that produce vitamin K are formed. Vitamin K does not
stimulate the formation of surfactant.
The nurse is caring for a baby who is 4 weeks old. The nurse finds that the newborn is breathing through
the mouth. What does the nurse expect to be the most likely clinical condition for this observation?
1
Hypoxemia
2
Cardiac disorder
3
, Nasal obstruction
4
Laryngeal obstruction
3 - Nasal obstruction
pg 530 - Newborns are generally nose breathers. After 3 weeks of age, newborns develop a reflex
response that allows them to use their mouths for breathing at times of nasal obstruction. If the
newborn has hypoxemia, the infant would breathe deeply through nose and not through the mouth.
Mouth breathing in infants is a normal finding and does not indicate a cardiac problem. If the infant has
laryngeal obstruction, the infant would be unable to breathe. This is a life-threatening condition.
Upon assessing a newborn, the nurse finds that the baby has swelling in the breast and thin milky
discharge from the nipples. What does the nurse expect to be the reason for this finding?
1
Low levels of bilirubin during pregnancy
2
High levels of estrogen during pregnancy
3
Low levels of progesterone during pregnancy
4
High levels of catecholamines during pregnancy
2 - High levels of estrogen during pregnancy
pg 542 - Some infants have a swelling in the breast with a thin milky discharge from the nipples due to
high estrogen levels during pregnancy (hyperestrogenism of pregnancy). It has no critical significance
and no treatment is required. During pregnancy, estrogen and progesterone levels are always elevated.
Low bilirubin levels indicate that the infant will not have jaundice after birth. However, high
