Chapter 17 Newborn Transitioning

Chapter 17 Newborn Transitioning Test Bank for Maternity and Pediatric Nursing, 4th Edition by Ricci, Kyle, And Carman

1. A nurse is explaining to a group of new parents about the changes that occur in the neonate to sustain extrauterine life, describing the cardiac and respiratory systems as undergoing the most changes. Which information would the nurse integrate into the exapbilrba.ncoamti/otenst to support this description? A. The cardiac murmur heard at birth disappears by 48 hours of age. B. Pulmonary vascular resistance (PVR) is decreased as lungs begin to function. C. Heart rate remains elevated after the first few moments of birt ah b . irb D. Breath sounds will have rhonchi for at least the first day of life as fluid is absorbed. Answer: B Rationale: Although all the body systems of the newborn undergo changes, respiratory gas exchange along with circulatory modifications must occur immediately to sustain extrauterine life. With the first breath, PVR decreases, and the heart rate initia a l b l iy rb. i cn omcr/te ea stses but then decreases to 120 to 130 bpm after a few minutes. The ductal murmur will go away in 80+% of infants by 48 hours. Rhonchi caused by retained amniotic fluid is an abnormal finding and would not be expected. Question format: Multiple Choice Chapter 17: Newborn Adaptation Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 579 2. A new mother reports that her newborn often spits up after feeadbiirnbg.c.omA/tsesset ssment reveals regurgitation. Which factor would the nurse integrate into the response? A. newborn being placed prone after feeding B. limited ability of digestive enzymes C. underdeveloped pyloric sphincter D. relaxed cardiac sphincter Answer: D Rationale: The cardiac sphincter and nervous control of the stomach is immature, which may lead to uncoordinated peristaltic activity and frequent regurgitation. Placement of the newborn is unrelated to regurgitation. Most digestive enzymes are available aa b t i rb b. i c r o t mh,/t eb su t t they are limited in their ability to digest complex carbohydrates and fats; this results in fatty stools, not regurgitation. Immaturity of the pharyngoesophageal sphincter and absence of lower esophageal peristaltic waves, not an underdeveloped pyloric sphincter, also caobinrbt.rciobmu/tteestto the reflux of gastric contents. Question format: Multiple Choice Chapter 17: Newborn Adaptation Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 590 3. Twenty minutes after birth, a baby begins to move his head froambirbs.ciodme/tteost side, making eye contact with the mother, and pushes his tongue out several times. The nurse interprets this as: A. a good time to initiate breast-feeding. B. the period of decreased responsiveness preceding sleep. C. a sign that the infant is being overstimulated. D. evidence that the newborn is becoming chilled. Answer: A Rationale: The newborn is demonstrating behaviors indicating the first period of reactivity, which usually begins at birth and lasts for the first 30 minutes. Thabiisrbi.scoam /gteosot d time to initiate breastfeeding. Decreased responsiveness occurs from 30 to 120 minutes of age and is characterized by muscle relaxation and diminished responsiveness to outside stimuli. None of the behaviors indicate overstimulation. Chilling would be evidenced by tachypnea, decreased activity, and hypotonia. Question format: Multiple Choice Chapter 17: Newborn Adaptation Cognitive Level: Apply