NUR 2633 TEST BANK EXAM QUESTIONS AND ACCURATE
ANSWERS WITH RATIONALE|VERIFIED BY EXPERTS|(100%
PASS GUARANTEED) A GRADED |LATEST UPDATE
2024/2025.
A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm.
How might the nurse respond to this information?
A) "This is a primitive reflex known as the plantar grasp."
B) "This is a primitive reflex known as the palmar grasp."
C) "This is a protective reflex known as rooting."
D) "This is a protective reflex known as the Moro reflex." - CORRECT ANSWER Ans: B
Feedback:
Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes
present at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step,
and Babinski. During the palmar grasp, the infant reflexively grasps when the palm is touched.
The plantar grasp occurs when the infant reflexively grasps with the bottom of the foot when
pressure is applied to the plantar surface. The root reflex occurs when the infant's cheek is
stroked and the infant turns to that side, searching with mouth. The Moro reflex is displayed
when with sudden extension of the head, the arms abduct and move upward and the hands form a
"C."
Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned?
A) Plantar grasp
B) Step
C) Babinski
D) Neck righting - CORRECT ANSWER Ans: B
Feedback:
Appropriate appearance and disappearance of primitive reflexes, along with the development of
protective reflexes, indicates a healthy neurologic system. The step reflex is a primitive reflex
that appears at birth and disappears at 4 to 8 weeks of age. The plantar grasp reflex is a primitive
reflex that appears at birth and disappears at about the age of 9 months. The Babinski reflex is a
primitive reflex that appears at birth and disappears around the age of 12 months. The neck
righting reflex is a protective reflex that appears around the age of 4 to 6 months and persists.
A new mother expresses concern to the nurse that her baby is crying and grunting when passing
stool. What is the nurse's best response to this observation?
A) "This is normal behavior for infants unless the stool passed is hard and dry."
B) "This is normal behavior for infants due to the immaturity of the gastrointestinal system."
C) "This indicates a blockage in the intestine and must be reported to the physician."
D) "This is normal behavior for infants unless the stool passed is black or green." - CORRECT
ANSWER Ans: A
Feedback:
Due to the immaturity of the gastrointestinal system, newborns and young infants often grunt,
strain, or cry while attempting to have a bowel movement. This is not of concern unless the stool
,is hard and dry. Stool color and texture may change depending on the foods that the infant is
ingesting. Iron supplements may cause the stool to appear black or very dark green.
The neonatal nurse assesses newborns for iron-deficiency anemia. Which of the following
newborns is at highest risk for this disorder?
A) A postterm newborn
B) A term newborn with jaundice
C) A newborn born to a diabetic mother
D) A premature newborn - CORRECT ANSWER Ans: D
Feedback:
Maternal iron stores are transferred to the fetus throughout the last trimester of pregnancy.
Infants born prematurely miss all or at least a portion of this iron store transfer, placing them at
increased risk for iron-deficiency anemia compared with term infants. An infant having jaundice,
having been born to a mother with diabetes, or have been born postterm does not significantly
place the infant at risk for iron-deficiency anemia.
The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross
motor skills over the first 12 months of life. Which of the following statements accurately
describe the typical infant's achievement of these milestones? Select all answers that apply.
A) At 1 month the infant lifts and turns the head to the side in the prone position.
B) At 2 months the infant lifts head and looks around.
C) At 6 months the infant pulls to stand up.
D) At 7 months the infant sits alone with some use of hands for support.
E) At 9 months the infant crawls with the abdomen off the floor.
F) At 12 months the infant walks independently. - CORRECT ANSWER Ans: A, D, E, F
Feedback:
At 1 month the infant lifts and turns the head to the side in the prone position. At 7 months the
infant sits alone with some use of hands for support. At 9 months the infant crawls with the
abdomen off the floor. At 12 months the infant walks independently. At 4 months the infant lifts
the head and looks around. At 10 months the infant pulls to stand up.
At which age would the nurse expect to find the beginning of object permanence?
A) 1 month
B) 4 months
C) 8 months
D) 12 months - CORRECT ANSWER Ans: B
Feedback:
Object permanence begins to develop between 4 and 7 months of age and is solidified by
approximately age 8 months. By age 12 months, the infant knows he or she is separate from the
parent or caregiver.
The nurse is teaching a new mother about the development of sensory skills in her newborn.
Which of the following would alert the mother to a sensory deficit in her child?
A) The newborn's eyes wander and occasionally are crossed.
B) The newborn does not respond to a loud noise.
C) The newborn's eyes focus on near objects.
,D) The newborn becomes more alert with stroking when drowsy. - CORRECT ANSWER Ans:
B
Feedback:
Though hearing should be fully developed at birth, the other senses continue to develop as the
infant matures. The newborn should respond to noises. Sight, smell, taste, and touch all continue
to develop after birth. The newborn's eyes wander and occasionally cross, and the newborn is
nearsighted, preferring to view objects at a distance of 8 to 15 inches. Holding, stroking, rocking,
and cuddling calm infants when they are upset and make them more alert when they are drowsy.
The nurse is assessing a 4-month-old boy during a scheduled visit. Which of the following
findings might suggest a developmental problem?
A) The child does not coo or gurgle.
B) The child does not babble or laugh.
C) The child never squeals or yells.
D) The child does not say dada or mama. - CORRECT ANSWER Ans: B
Feedback:
The fact that the child does not babble or laugh might suggest a developmental problem. At 4 to
5 months of age most children are making simple vowel sounds, laughing aloud, doing
raspberries, and vocalizing in response to voices. The child should have developed past cooing or
gurgling, but is too young to squeal, yell, or say dada or mama.
The nurse observes an infant interacting with his parents. Which of the following are normal
social behavioral developments for this age group? Select all answers that apply.
A) Around 5 months the infant may develop stranger anxiety.
B) Around 2 months the infant exhibits a first real smile.
C) Around 3 months the infant smiles widely and gurgles when interacting with the caregiver.
D) Around 3 months the infant will mimic the parent's facial movements, such as sticking out the
tongue.
E) Around 3 to 6 months of age the infant may enjoy socially interactive games such as patty-
cake and peek-a-boo.
F) Separation anxiety may also start in the last few months of infancy. - CORRECT ANSWER
Ans: B, C, D, F
Feedback:
The infant exhibits a first real smile at age 2 months. By about 3 months of age the infant will
start an interaction with a caregiver by smiling widely and possibly gurgling. The 3- to 4-month-
old will also mimic the parent's facial movements, such as widening the eyes and sticking out the
tongue. Separation anxiety may also start in the last few months of infancy. Around the age of 8
months the infant may develop stranger anxiety. At 6 to 8 months of age the infant may enjoy
socially interactive games such as patty-cake and peek-a-boo.
The nurse is performing a health assessment of a 3-month-old Black American boy. For what
condition should this infant be monitored based on his race?
A) Jaundice
B) Iron deficiency
C) Lactose intolerance
D) Gastroesophageal reflux disease (GERD) - CORRECT ANSWER Ans: C
, Feedback:
Many dietary practices are affected by culture, both in the types of food eaten and in the
approach to progression of infant feeding. Some ethnic groups tend to be lactose intolerant
(particularly blacks, Native Americans, and Asians); therefore, alternative sources of calcium
must be offered. Jaundice, iron deficiency, and GERD are not seen at a significantly higher rate
in African American infants.
The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl.
Which of the following is the most effective anticipatory guidance?
A) Encouraging breastfeeding until the sixth month
B) Advocating iron supplements with bottle-feeding
C) Advising fluid intake per feeding of 5 or 6 ounces
D) Discouraging the addition of fruit juice to the diet - CORRECT ANSWER Ans: D
Feedback:
Discouraging the addition of fruit juice to the child's diet is the most effective anticipatory
guidance. Fruit juice can displace important nutrients from breast milk or formula. Encouraging
breastfeeding until the sixth month is only halfway to the Healthy People goal of breastfeeding
for the first year. Advising fluid intake per feeding of 5 or 6 ounces is too much for this neonate,
but is typical for an infant 4 to 6 months of age. Advocating iron supplements with bottle-feeding
is unnecessary so long as the formula is fortified with iron.
The nurse is teaching a new mother the proper techniques for breastfeeding her newborn. Which
of the following is a recommended guideline that should be implemented?
A) Wash the hands and breasts thoroughly prior to breastfeeding.
B) Stroke the nipple against the baby's chin to stimulate wide opening of the baby's mouth.
C) Bring the baby's wide-open mouth to the breast to form a seal around all of the nipple and
areola.
D) When finished the mother can break the suction by firmly pulling the baby's mouth away
from the nipple. - CORRECT ANSWER Ans: C
Feedback:
Before each breastfeeding session, mothers should wash their hands, but it is not necessary to
wash the breast in most cases. The mother should then stroke the nipple against the baby's cheek
to stimulate opening of the mouth and bring the baby's wide-open mouth to the breast to form a
seal around all of the nipple and areola When the infant is finished feeding, the mother can break
the suction by inserting her finger into the baby's mouth.
The nurse is providing discharge teaching regarding formula preparation for a new mother.
Which of the following guidelines would the nurse include in the teaching plan?
A) Always wash bottles and nipples in hot soapy water and rinse well; do not wash them in the
dishwasher.
B) Store tightly covered ready-to-feed formula can after opening in refrigerator for up to 24
hours.
C) Warm bottle of formula by placing bottle in a container of hot water, or microwaving
formula.
D) Do not add cereal to the formula in the bottle or sweeten the formula with honey. -
CORRECT ANSWER Ans: D
ANSWERS WITH RATIONALE|VERIFIED BY EXPERTS|(100%
PASS GUARANTEED) A GRADED |LATEST UPDATE
2024/2025.
A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm.
How might the nurse respond to this information?
A) "This is a primitive reflex known as the plantar grasp."
B) "This is a primitive reflex known as the palmar grasp."
C) "This is a protective reflex known as rooting."
D) "This is a protective reflex known as the Moro reflex." - CORRECT ANSWER Ans: B
Feedback:
Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes
present at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step,
and Babinski. During the palmar grasp, the infant reflexively grasps when the palm is touched.
The plantar grasp occurs when the infant reflexively grasps with the bottom of the foot when
pressure is applied to the plantar surface. The root reflex occurs when the infant's cheek is
stroked and the infant turns to that side, searching with mouth. The Moro reflex is displayed
when with sudden extension of the head, the arms abduct and move upward and the hands form a
"C."
Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned?
A) Plantar grasp
B) Step
C) Babinski
D) Neck righting - CORRECT ANSWER Ans: B
Feedback:
Appropriate appearance and disappearance of primitive reflexes, along with the development of
protective reflexes, indicates a healthy neurologic system. The step reflex is a primitive reflex
that appears at birth and disappears at 4 to 8 weeks of age. The plantar grasp reflex is a primitive
reflex that appears at birth and disappears at about the age of 9 months. The Babinski reflex is a
primitive reflex that appears at birth and disappears around the age of 12 months. The neck
righting reflex is a protective reflex that appears around the age of 4 to 6 months and persists.
A new mother expresses concern to the nurse that her baby is crying and grunting when passing
stool. What is the nurse's best response to this observation?
A) "This is normal behavior for infants unless the stool passed is hard and dry."
B) "This is normal behavior for infants due to the immaturity of the gastrointestinal system."
C) "This indicates a blockage in the intestine and must be reported to the physician."
D) "This is normal behavior for infants unless the stool passed is black or green." - CORRECT
ANSWER Ans: A
Feedback:
Due to the immaturity of the gastrointestinal system, newborns and young infants often grunt,
strain, or cry while attempting to have a bowel movement. This is not of concern unless the stool
,is hard and dry. Stool color and texture may change depending on the foods that the infant is
ingesting. Iron supplements may cause the stool to appear black or very dark green.
The neonatal nurse assesses newborns for iron-deficiency anemia. Which of the following
newborns is at highest risk for this disorder?
A) A postterm newborn
B) A term newborn with jaundice
C) A newborn born to a diabetic mother
D) A premature newborn - CORRECT ANSWER Ans: D
Feedback:
Maternal iron stores are transferred to the fetus throughout the last trimester of pregnancy.
Infants born prematurely miss all or at least a portion of this iron store transfer, placing them at
increased risk for iron-deficiency anemia compared with term infants. An infant having jaundice,
having been born to a mother with diabetes, or have been born postterm does not significantly
place the infant at risk for iron-deficiency anemia.
The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross
motor skills over the first 12 months of life. Which of the following statements accurately
describe the typical infant's achievement of these milestones? Select all answers that apply.
A) At 1 month the infant lifts and turns the head to the side in the prone position.
B) At 2 months the infant lifts head and looks around.
C) At 6 months the infant pulls to stand up.
D) At 7 months the infant sits alone with some use of hands for support.
E) At 9 months the infant crawls with the abdomen off the floor.
F) At 12 months the infant walks independently. - CORRECT ANSWER Ans: A, D, E, F
Feedback:
At 1 month the infant lifts and turns the head to the side in the prone position. At 7 months the
infant sits alone with some use of hands for support. At 9 months the infant crawls with the
abdomen off the floor. At 12 months the infant walks independently. At 4 months the infant lifts
the head and looks around. At 10 months the infant pulls to stand up.
At which age would the nurse expect to find the beginning of object permanence?
A) 1 month
B) 4 months
C) 8 months
D) 12 months - CORRECT ANSWER Ans: B
Feedback:
Object permanence begins to develop between 4 and 7 months of age and is solidified by
approximately age 8 months. By age 12 months, the infant knows he or she is separate from the
parent or caregiver.
The nurse is teaching a new mother about the development of sensory skills in her newborn.
Which of the following would alert the mother to a sensory deficit in her child?
A) The newborn's eyes wander and occasionally are crossed.
B) The newborn does not respond to a loud noise.
C) The newborn's eyes focus on near objects.
,D) The newborn becomes more alert with stroking when drowsy. - CORRECT ANSWER Ans:
B
Feedback:
Though hearing should be fully developed at birth, the other senses continue to develop as the
infant matures. The newborn should respond to noises. Sight, smell, taste, and touch all continue
to develop after birth. The newborn's eyes wander and occasionally cross, and the newborn is
nearsighted, preferring to view objects at a distance of 8 to 15 inches. Holding, stroking, rocking,
and cuddling calm infants when they are upset and make them more alert when they are drowsy.
The nurse is assessing a 4-month-old boy during a scheduled visit. Which of the following
findings might suggest a developmental problem?
A) The child does not coo or gurgle.
B) The child does not babble or laugh.
C) The child never squeals or yells.
D) The child does not say dada or mama. - CORRECT ANSWER Ans: B
Feedback:
The fact that the child does not babble or laugh might suggest a developmental problem. At 4 to
5 months of age most children are making simple vowel sounds, laughing aloud, doing
raspberries, and vocalizing in response to voices. The child should have developed past cooing or
gurgling, but is too young to squeal, yell, or say dada or mama.
The nurse observes an infant interacting with his parents. Which of the following are normal
social behavioral developments for this age group? Select all answers that apply.
A) Around 5 months the infant may develop stranger anxiety.
B) Around 2 months the infant exhibits a first real smile.
C) Around 3 months the infant smiles widely and gurgles when interacting with the caregiver.
D) Around 3 months the infant will mimic the parent's facial movements, such as sticking out the
tongue.
E) Around 3 to 6 months of age the infant may enjoy socially interactive games such as patty-
cake and peek-a-boo.
F) Separation anxiety may also start in the last few months of infancy. - CORRECT ANSWER
Ans: B, C, D, F
Feedback:
The infant exhibits a first real smile at age 2 months. By about 3 months of age the infant will
start an interaction with a caregiver by smiling widely and possibly gurgling. The 3- to 4-month-
old will also mimic the parent's facial movements, such as widening the eyes and sticking out the
tongue. Separation anxiety may also start in the last few months of infancy. Around the age of 8
months the infant may develop stranger anxiety. At 6 to 8 months of age the infant may enjoy
socially interactive games such as patty-cake and peek-a-boo.
The nurse is performing a health assessment of a 3-month-old Black American boy. For what
condition should this infant be monitored based on his race?
A) Jaundice
B) Iron deficiency
C) Lactose intolerance
D) Gastroesophageal reflux disease (GERD) - CORRECT ANSWER Ans: C
, Feedback:
Many dietary practices are affected by culture, both in the types of food eaten and in the
approach to progression of infant feeding. Some ethnic groups tend to be lactose intolerant
(particularly blacks, Native Americans, and Asians); therefore, alternative sources of calcium
must be offered. Jaundice, iron deficiency, and GERD are not seen at a significantly higher rate
in African American infants.
The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl.
Which of the following is the most effective anticipatory guidance?
A) Encouraging breastfeeding until the sixth month
B) Advocating iron supplements with bottle-feeding
C) Advising fluid intake per feeding of 5 or 6 ounces
D) Discouraging the addition of fruit juice to the diet - CORRECT ANSWER Ans: D
Feedback:
Discouraging the addition of fruit juice to the child's diet is the most effective anticipatory
guidance. Fruit juice can displace important nutrients from breast milk or formula. Encouraging
breastfeeding until the sixth month is only halfway to the Healthy People goal of breastfeeding
for the first year. Advising fluid intake per feeding of 5 or 6 ounces is too much for this neonate,
but is typical for an infant 4 to 6 months of age. Advocating iron supplements with bottle-feeding
is unnecessary so long as the formula is fortified with iron.
The nurse is teaching a new mother the proper techniques for breastfeeding her newborn. Which
of the following is a recommended guideline that should be implemented?
A) Wash the hands and breasts thoroughly prior to breastfeeding.
B) Stroke the nipple against the baby's chin to stimulate wide opening of the baby's mouth.
C) Bring the baby's wide-open mouth to the breast to form a seal around all of the nipple and
areola.
D) When finished the mother can break the suction by firmly pulling the baby's mouth away
from the nipple. - CORRECT ANSWER Ans: C
Feedback:
Before each breastfeeding session, mothers should wash their hands, but it is not necessary to
wash the breast in most cases. The mother should then stroke the nipple against the baby's cheek
to stimulate opening of the mouth and bring the baby's wide-open mouth to the breast to form a
seal around all of the nipple and areola When the infant is finished feeding, the mother can break
the suction by inserting her finger into the baby's mouth.
The nurse is providing discharge teaching regarding formula preparation for a new mother.
Which of the following guidelines would the nurse include in the teaching plan?
A) Always wash bottles and nipples in hot soapy water and rinse well; do not wash them in the
dishwasher.
B) Store tightly covered ready-to-feed formula can after opening in refrigerator for up to 24
hours.
C) Warm bottle of formula by placing bottle in a container of hot water, or microwaving
formula.
D) Do not add cereal to the formula in the bottle or sweeten the formula with honey. -
CORRECT ANSWER Ans: D
