Chapter 23: Physiologic and Behavioral Adaptations of the Newborn

Chapter 23: Physiologic and Behavioral Adaptations of the Newborn

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A woman gave birth to a healthy 7-pound, 13-ounce infant girl. The nurse suggests that the client place the infant to her breast within 15 minutes after birth. The nurse is aware that the initiation of breastfeeding is most effective during the first 30 minutes after birth. What is the correct term for this phase of alertness?

ANS:  B

The first period of reactivity is the first phase of transition and lasts up to 30 minutes after birth. The infant is highly alert during this phase. The transition period is the phase between intrauterine and extrauterine existence. An organizational stage is not a valid stage. The second period of reactivity occurs approximately between 4 and 8 hours after birth, after a period of sleep.

DIF:    Cognitive Level: Understand            REF:   p. 523             TOP:   Nursing Process: Planning

MSC:  Client Needs: Health Promotion and Maintenance

2. Part of the health assessment of a newborn is observing the infant’s breathing pattern. What is the predominate pattern of newborn’s breathing?

ANS:  A

In a normal infant respiration, the chest and abdomen synchronously rise and infant breaths are shallow and irregular. Breathing with nasal flaring is a sign of respiratory distress. Diaphragmatic breathing with chest retraction is also a sign of respiratory distress.

DIF:    Cognitive Level: Understand            REF:   p. 524

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiologic Integrity

3. The nurse is assessing a full term, quiet, and alert newborn. What is the average expected apical pulse range (in beats per minute)?

ANS:  C

The average infant heart rate while awake is 120 to 160 beats per minute. The newborn’s heart rate may be approximately 85 to 100 beats per minute while sleeping and typically a little higher than 100 to 120 beats per minute when alert but quiet. A heart rate of 150 to 180 beats per minute is typical when the infant cries.

DIF:    Cognitive Level: Understand            REF:   p. 523

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

4. A newborn is placed under a radiant heat warmer. The nurse understands that thermoregulation presents a problem for the newborn. What is the rationale for this difficulty?

ANS:  C

The newborn has little thermal insulation. Furthermore, the blood vessels are closer to the surface of the skin. Changes in environmental temperature alter the temperature of the blood, thereby influencing temperature regulation centers in the hypothalamus. Heat loss does not occur through urination. Newborns have a higher body surface-to-weight ratio than adults. The flexed position of the newborn helps guard against heat loss, because it diminishes the amount of body surface exposed to the environment.

DIF:    Cognitive Level: Understand            REF:   p. 528             TOP:   Nursing Process: Planning

MSC:   Client Needs: Physiologic Integrity