Chapter 25 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 25 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 25_LO01_Q01

The nurse is using the New Ballard Score to assess the gestational age of a newborn delivered 4 hours ago. The infant is 33 weeks by early ultrasound and last menstrual period. The nurse expects the infant to exhibit:

1. Full sole creases, nails extending beyond the fingertips, scarf sign shows the elbow beyond the midline.
2. Testes located deep in the scrotum, rugae cover the scrotum, vernix covering the entire body.
3.  Ear cartilage remains folded over, lanugo present over much of the body, some flexion of arms and legs at rest,
4. 1cm breast bud, peeling skin and veins not visible, rapid recoil of legs and arms to extension.

Correct Answer: 3

Rationale:

1. Full sole creases and nails beyond the fingertips will be seen in term infants; scarf sign beyond the midline is an indication of a preterm infant.
2. Deep testes and rugae-covered scrotum are seen in term infants; vernix covering the body is an indication of a preterm infant.
3. All of these characteristics are indications of a preterm infant.
4. 1cm breast bud, peeling skin, the presence of adipose so that veins are not visible, and rapid recoil of the legs and arms are all indications of term–to–post-term infants.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 25.1 Describe the physical and neuromuscular maturity characteristics assessed to determine gestational age of the newborn.

Chapter 25_LO02 _Q02

The nurse is working with a student nurse during assessment of a 2-hour-old newborn. Which action indicates that the student nurse understands neonatal assessment? The student nurse:

1. Listens to bowel sounds then assesses the head for skull consistency, and size and tension of fontanels.
2. Checks for Ortolani’s sign, then palpates femoral pulse, then assesses respiratory rate.
3. Determines skin color, then describes shape of the chest and looks at structures and flexion of the feet.
4. Counts the number of cord vessels, then assess genitals, then sclera color and eyelids.

Correct Answer: 3

Rationale:

1. The assessment should proceed in a head-to-toe order; the head should be assessed before the bowel sounds.
2. The assessment should proceed in a head-to-toe order; the respiratory rate should be assessed first, when the infant is at rest and undisturbed.
3. This assessment proceeds in a head-to-toe fashion.
4. The assessment should proceed in a head-to-toe order; the sclera and eye assessment should be done prior to assessing genitals.

Cognitive level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 25.2 Explain the components and methods of a systematic physical assessment of the newborn.

Chapter 25_LO03 _Q03

The nurse is preparing new parents to be discharged with their newborn. The father asks the nurse why the baby’s head is so pointed and puffy-looking. The best response by the nurse is:

1. “His head is molded from fitting through the birth canal. It will become more round.”
2. “We refer to that as ‘cone head,’ which is a temporary condition that goes away.”
3. “It might mean that your baby sustained brain damage during birth, and could have delays.”
4. “I think he looks just like you. Your head is much the same shape as your baby’s.”

Correct Answer: 1

Rationale:

1. This statement is accurate, and directly answers the father’s question.
2. Although nursing staff might refer to molding as looking like a ‘cone head,’ and the shape is temporary, it is better to be more specific in describing why the head is shaped as it is. In addition, this answer does not answer the question “why” as stated by the father.
3. A molded head shape does not indicate brain damage. Molding is normal and transient.
4. Although this might be true, it is better to give a factual answer that does not imply that you think the father’s head is abnormally shaped. This answer could be perceived as insulting by the father.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome: 25.3 Describe the normal physical characteristics and normal variations of the newborn considered in a newborn assessment.

Chapter 25_LO04_Q04

The nurse is assessing a newborn a few minutes after birth. The neonate has overlapping anterior fontanelles and suture lines. The best nursing action is to:

1. Contact the physician immediately.
2. Verify the presence of lanugo.
3. Document the findings.
4. Assess for rectal patency.

Correct Answer: 3

Rationale:

1. There is no need to contact the physician. Overlapping fontanels and sutures are a common variation of normal.
2. Lanugo is not related to overlapping fontanels and sutures, which are a common variation of normal.
3. Because overlapping fontanels and sutures are a common variation of normal, documenting the findings is appropriate.
4. Rectal patency is not related to overlapping fontanels and sutures, which are a common variation of normal.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Planning

Learning Outcome: 25.4 Compare abnormal findings in a newborn physical assessment to possible causes and nursing responses.