Newborn Care (31 Questions)

1. You are preparing for the discharge of Mme Laporte and her newborn son, born at 39 weeks of gestation. The infant weighs 3.4 kg. M. Laporte brings the car seat into the room and places the infant inside so you can verify the safety before they leave the hospital. You observe that the car seat is rear-facing, the harness straps are threaded through the slots at the level of the shoulders, and the chest clip is positioned over the infant’s umbilical area. The father asks, "Is he ready to go?"

Question:
What is the nurse’s priority action? *
2. Mme Dubois, a 24-year-old primipara, delivered a healthy female infant 6 hours ago. During your assessment, Mme Dubois states, "My sister formula fed her baby and he is fine. I don't see why I should struggle with breastfeeding if the formula has all the same vitamins." She appears hesitant to attempt the next feed.

Question:
Which response best explains the specific physiological advantage of breast milk relevant to the newborn’s immune system? *
3. You are working in the postpartum clinic. Mme Giroux brings in her 2-month-old son for his well-baby checkup. The physician has ordered the routine 2-month immunizations (DTaP-IPV-Hib and Pneumococcal). Mme Giroux seems anxious and says, "I read on a blog that these shots overload the immune system and trigger autism. I think we should skip them."

Question:
What is the most appropriate, evidence-based therapeutic response? *
4. Mme Vachon is reading the information sheet for the Rotavirus vaccine. She tells the nurse, "It says here my baby could get intussusception (bowel blockage) from this vaccine. That sounds terrifying. Why would I risk that?"

Question:
How should the nurse explain the risk-benefit analysis? *
5. Mme Levesque is 3 days postpartum and plans to return to work in 3 months. She asks for specific instructions on building a "milk stash." She has a standard refrigerator with a freezer compartment at home.

Question:
Which instruction regarding milk storage safety is accurate? *
6. You are performing a home visit for Baby Bernier, who is 4 days old. The parents are nervous about the umbilical cord stump. You observe the stump is turning black and is slightly moist at the base, but there is no redness on the surrounding skin and no foul odor. M. Bernier asks, "Should we be cleaning this with alcohol to dry it out faster?"

Question:
What is the current standard of nursing care for the umbilical cord? *
7. Baby Gagnon was born 45 minutes ago via spontaneous vaginal delivery. The newborn assessment is normal. You are preparing to administer the medications ordered by the physician: "Erythromycin 0.5% ophthalmic ointment OU" and "Phytonadione (Vitamin K) 1.0 mg IM." The father interrupts you and asks, "Why does he need a needle? He isn't sick."

Question:
What is the best physiological explanation for the Vitamin K injection? *
8. You have obtained consent to administer the Vitamin K injection to Baby Gagnon (from the previous scenario). The infant is swaddled, and you have exposed the leg. You are holding a 1 mL syringe with a 25-gauge, 5/8-inch needle.

Question:
Which anatomical landmark describes the correct injection site? *
9. Mme Tessier calls the CLSC (health clinic) 5 days postpartum. She is exclusively breastfeeding her daughter. She sounds distressed and says, "My baby seems fussy, and my breasts don't feel as hard as they did yesterday. I'm afraid she is starving."

Question:
Which question is most critical for the nurse to ask to assess the adequacy of intake? *
10. You are weighing Baby Marchand at the 48-hour discharge check. The birth weight was 3800 g. The current weight is 3575 g. The mother sees the number and says, "Oh no, he lost weight! I knew I didn't have enough milk. Should I give him a bottle of formula?"

Question:
What is the nurse’s correct analysis and intervention? *
11. Baby Roy, born at 38 weeks, requires a heel stick for a serum bilirubin check. The standing order allows for "Sucrose 24% oral solution for procedural pain." The infant is currently awake and calm in the bassinet.

Question:
To achieve the maximum analgesic effect, when and how should the nurse administer the sucrose? *
12. You are caring for Mme Cloutier, a G1P1 who had an emergency C-section 24 hours ago. She is recovering in bed. You bring her son to her for skin-to-skin time.

Question:
Which observation by the nurse indicates positive maternal-infant attachment (bonding)? *
13. You are conducting a home visit for Mme Plante. She excitedly shows you the nursery. You observe the crib: the mattress is firm, the sheet is fitted, but there are bumper pads tied to the rails, a fluffy duvet folded at the foot of the bed, and a positioning wedge to keep the baby on his side.

Question:
Which item represents a safety hazard regarding Sudden Infant Death Syndrome (SIDS) and suffocation? *
14. Baby Bedard is 36 hours old. The transcutaneous bilirubin screening indicates a level in the "Low-Intermediate Risk" zone. The physician’s order is: "Encourage frequent breastfeeding q2-3h. Repeat bilirubin in 12 hours." Mme Bedard asks, "Why does eating help the yellow color go away?"

Question:
What is the correct nursing explanation? *
15. Baby Savard was born at 41 weeks gestation and weighs 4.5 kg (LGA – Large for Gestational Age). The mother had Gestational Diabetes. At 1 hour of life, you notice the baby is jittery and has a weak cry.

Question:
What is the priority nursing intervention based on these risk factors and symptoms? *
16. Mme Lavoie is 12 hours postpartum. Her newborn is sleepy and struggling to latch onto the breast. Mme Lavoie is anxious but successfully manually expresses 3 mL of colostrum into a sterile container. She asks, "How can I get this into him without using a bottle? I don't want him to get confused."

Question:
What is the most appropriate method for the nurse to suggest for administering this small volume of colostrum? *
17. Mme Coté is a primipara preparing to breastfeed. She had an uncomplicated vaginal delivery and is sitting up in bed. She says, "I want to hold him in the traditional way, in my arms." You proceed to assist her with the Madonna Hold.

Question:
Which description accurately reflects the correct alignment for this position? *
18. Baby Tanguay, 3 days old, is being discharged. The physician has prescribed a liquid multivitamin supplement: "Administer 0.5 mL PO daily." The parents ask what they should use to give the medicine to ensure the dose is right.

Question:
What is the safest and most accurate item for the nurse to recommend? *
19. You are performing a skin assessment on Baby Lemieux, who is 24 hours old. You note tiny, white, pinhead-sized papules on the bridge of the nose and chin. The father asks, "Is that acne? Should we squeeze them?"

Question:
What is the correct nursing identification and teaching? *
20. Mme Poirier calls the nurse to the diaper changing station on Day 2 of life. She shows you a diaper with a dark, reddish-orange stain. She is terrified and says, "There is blood in his diaper! Is he bleeding internally?"

Question:
How should the nurse interpret this finding? *
21. Baby Rioux regurgitates a large amount of formula and begins to gag and turn dusky (cyanotic). You grab the bulb syringe to clear the airway.

Question:
What is the correct sequence of action? *
22. Mme Bédard is reading a book while her newborn sleeps in the bassinet. The baby begins to stir, opens his mouth, and turns his head side to side (rooting). Mme Bédard says, "He's moving, but I'll wait until he cries so I know he's really hungry."

Question:
What is the best nursing guidance regarding hunger cues? *
23. Baby Michaud is 6 days old. The parents bring him to the clinic because the umbilical cord has not fallen off yet. Upon assessment, you note the cord stump is moist, the skin around the umbilicus is red and warm to the touch, and there is a foul, purulent odor.

Question:
What condition do these signs suggest? *
24. Mme Landry notices that her newborn, Baby Landry, has long fingernails and has scratched his face. She asks, "Can I cut his nails with the clippers I have at home?"

Question:
What is the safest recommendation for nail care in the first week of life? *
25. Baby Tremblay was born 2 hours ago at 37 weeks gestation. His axillary temperature is 36.4°C. He is alert and sucking on his hand. Mme Tremblay is resting in bed and asks, "He feels a little cool. Should you put him under the heater warmer, or can I hold him?"

Question:
What is the nurse’s best recommendation to promote thermoregulation? *
26. You are completing the discharge assessment for Baby Gagnon, who is 48 hours old. The parents are packed and ready to leave. You notice blotchy red spots with small white/yellow papules in the center on the baby's trunk and back. The father sees them and says, "Wait! Look at these spots. Is he sick? We can't take him home if he has an infection."

Question:
What is the nurse’s correct response? *
27. Mme Roy calls the clinic stating her 3-week-old infant has a cold and is congested. She says, "He sounds so snuffly when he breathes, and he is having trouble sucking on the bottle because his nose is blocked." The baby has no fever and is pink.

Question:
What teaching should the nurse provide regarding airway clearance at home? *
28. Mme Leclerc is exclusively breastfeeding but must return to work in 6 weeks. She wants to continue providing breast milk for her baby while she is at the office. She asks, "How do I make sure I keep making enough milk when I'm not with the baby?"

Question:
What is the fundamental principle of lactation management the nurse should explain? *
29. Mme Bouchard is being discharged. She plans to breastfeed but has flat nipples and requires a breast pump to help stimulate milk flow initially. She tells you, "I looked online, and electric pumps cost hundreds of dollars. I can't afford that right now."

Question:
What resource should the nurse suggest to facilitate access to equipment? *
30. You are assessing Baby Caron, who is 4 hours old. You observe that the baby's trunk and lips are pink, but the hands and feet are a deep blue color. The respiratory rate is 45 breaths/min and unlabored. The heart rate is 140 bpm.

Question:
What is the appropriate nursing intervention? *
31. Mme Fortin asks what she can do to prevent her baby from getting a diaper rash. She says, "My friend uses baby powder, should I buy that?"

Question:
What is the most up-to-date safety teaching regarding diaper area care? *