OB Exam 3 Actual Questions And Correctly Well Defined Answers.

The nurse knows that thermoregulation presents a problem for newborns because: A. Their renal function is not fully developed, and heat is lost in the urine. B. Their small body surface area favors more rapid heat loss than does an adult's body surface area. C. They have a relatively thin layer of subcutaneous fat that provides poor insulation. D. Their normal flexed posture favors heat loss through perspiration. - correct answers They have a relatively thin layer of subcutaneous fat that provides poor insulation. The nurse administers vitamin K to the newborn for which reason? a. Most mothers have a diet deficient in vitamin K, which results in the infant being deficient. b. Vitamin K prevents the synthesis of prothrombin in the liver and must be given by injection. c. Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract. d. The supply of vitamin K is inadequate for at least 3 to 4 months, and the newborn must be supplemented. - correct answers Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract. A new mother recalls from prenatal class that she should try to feed her newborn daughter when she exhibits feeding readiness cues rather than waiting until the baby is frantically crying. Which feeding cue would indicate that the baby is ready to eat? a. Waves her arms in the air b. Makes sucking motions c. Has the hiccups d. Stretches out her legs straight - correct answersMakes sucking motions Necrotizing enterocolitis (NEC) is an acute inflammatory disease of the gastrointestinal (GI) mucosa that can progress to perforation of the bowel. Care is supportive; however, risk factors may increase the risk of NEC. In order to develop an optimal plan of care for this infant, the nurse must understand that which intervention has the greatest effect on lowering the risk of NEC? a. Early enteral feedings b. Breastfeeding c. Exchange transfusion d. Prophylactic probiotics - correct answersBreastfeeding Rationale: A Incorrect: Early enteral feedings of formula or hyperosmolar feedings are known to contribute to the development of NEC. The mother should be encouraged to pump or feed breast milk exclusively. B Correct: A decrease in the incidence of NEC is directly correlated with exclusive breastfeeding. Breast milk enhances maturation of the GI tract and contains immune factors that contribute to a lower incidence or severity of NEC, Crohn's disease, and celiac illness. The neonatal intensive care unit (NICU) nurse can be very supportive of the mother in terms of providing her with equipment to pump, ensuring privacy, and encouraging skin-to-skin contact. C Incorrect: Exchange transfusion may be necessary; however, it is a known risk factor for the development of NEC. D Incorrect: Although still early, a study in 2005 found that the introduction of prophylactic probiotics appeared to enhance the normal flora of the bowel and therefore decrease the severity of NEC when it did occur. This treatment modality is not as widespread as the encouragement of breastfeeding; however, it is another strategy that the health care providers of these extremely fragile infants may have at their disposal. With regard to the classification of neonatal bacterial infection, nurses should be aware of which of the following? a. Congenital infection progresses slower than health care-associated infection b. Health care-associated infection can be prevented by effective handwashing; early-onset infections cannot c. Infections occur with about the same frequency in boy and girl infants, although female mortality is higher d. The clinical sign of a rapid, high fever makes infection easier to diagnose. - correct answersHealth care-associated infection can be prevented by effective handwashing; early-onset infections cannot Rationale: - A Incorrect: Congenital (early-onset) infections progress more rapidly than nosocomial (late-onset) infections. - B Correct: Handwashing is an effective preventive measure for late-onset (health care-associated) infections because these infections come from the infant's environment. Early-onset, or congenital, infections are caused by the normal flora at the maternal vaginal tract. Congenital infections progress more rapidly than health care-associated infections. - C Incorrect: Infection occurs about twice as often in boys and results in higher mortality. Congenital infections progress more rapidly than health care-associated infections. - D Incorrect: Clinical signs of neonatal infection are nonspecific and similar to noninfectious problems, making diagnosis difficult. Congenital infections progress more rapidly than health care-associated infections. Which statement, if made by the parents of a newborn with an esophageal atresia, indicates to the nurse that the parents understand the condition? a. "The muscles around the stomach are too tight." b. "The esophagus doesn't lead to the stomach." c. "There is a hole in the roof of the baby's mouth." d. "Part of the bowel is outside the stomach" - correct answers"The esophagus doesn't lead to the stomach." Rationale: A Incorrect: This comment indicates poor understanding and is a more accurate description of pyloric stenosis. B Correct: This statement indicates understanding by the parents. Esophageal atresia is a congenital anomaly in which the esophagus ends in a blind pouch, thus failing to form a continuous passageway to the stomach. C Incorrect: A cleft in the baby's hard or soft palate would lead the parents to make this statement. This parent requires further explanation of the newborn's condition. D Incorrect: Gastroschisis is the herniation of the bowel through a defect in the abdominal wall. This statement does not imply understanding.