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The physiology of newborns is fundamentally different than the physiology of older children and adults. Maybe the reason that it is different is it constantly changes, with the biggest change going out from the intrauterine and entering the extrauterine life. Newborn health is so important to families that the 2020 National Health Goals related to newborn health have been revised. Nurses play a major role in achieving these goals because nurses are uniquely suited to give care to newborns and newborn instruction to parents. Read and analyze each question carefully and chose the best answer/s from the choices provided. At the end of these practice tests, correct answers along with the explanation are given. Newborn Nursing NCLEX-RN Practice Questions1. The nurse is caring for a newborn immediately after delivery. Which action by the nurse shows an understanding of the newborn’s thermoregulatory ability? A. Suctions the newborn’s nostrils with a bulb syringe 2. During the assessment, the nurse notes a reddish stain on the diaper of a newborn. Which statement by the nurse shows an understanding of the cause of the stain? A. “A newborn excretes excess bilirubin through
their urine.” 3. The nurse is assessing the newborn’s heart rate while the newborn is asleep. Which result does the nurse consider a normal finding? A. 100 beats per minute 4. A parent brings a newborn into the healthcare clinic for a well-baby check-up. During the assessment of fontanelles, which findings by the nurse show a normal finding? A. A bulging anterior fontanel; a sunken posterior fontanel 5. The nurse assesses a newborn’s reflexes. Which reflex can be assessed after birth and remain until adulthood? A. Rooting reflex 6. The nurse observes that the newborn demonstrates the Babinski reflex. Which actions describe this reflex? A. Dorsiflexion of the big toe and the foot 7. After birth, the nurse wants to maintain a neutral environment for the newborn. Which action is least effective to maintain a neutral environment? A. Cover the weighing scale with a warmed blanket before weighing. 8. Assessment of a newborn reveals an asymmetrical Moro reflex. Which action by the nurse is next? A. Assess for increased
intracranial pressure. 9. The nurse is caring for a newborn who underwent circumcision. During the first four hours after the procedure, which nursing action is a priority? A. Assessing for signs of hemorrhage. 10. Immediately after birth, the nurse observes that the newborn exhibits flaring nostrils, mild intercostal retractions, and grunting at the end of expiration. The newborn’s vital signs show that the respirations are 80 breaths per minute and a heart rate of 160 beats per minute. Which nursing action is appropriate for the assessment findings? A. Administer oxygen at 2L/min via nasal cannula. 11. The nurse provides discharge instructions to a mother about umbilical cord care. Which statement by the mother indicates effective health teaching? A. “My child can have a tub bath every day.” 12. The nurse is caring for a newborn who weighs 3800 grams and feeds every four hours. The newborn needs 110 kilocalories per kg of body weight every 24 hours. How many ounces of 20 kilocalories/oz formula does the nurse prepare for each feeding? A. 3 ounces 13. The nurse observes that the post-term newborn has meconium-stained amniotic fluid. Which nursing action is essential for this newborn? A. Monitor the newborn’s bowel sounds. 14. The nurse prepares to administer vitamin K to a newborn. Which action by the nurse is correct? A. Administers on the vastus lateralis muscle 15. A 2-day-old neonate is receiving phototherapy for jaundice. Which action is essential for the nurse to implement for this client? A. Monitor the temperature carefully. 16. The nurse suddenly bumps the bassinet of a newborn, eliciting the startle reflex. Which actions by the newborn show this reflex? A. The big toe dorsiflexes, followed by fanning of the other toes. 17. The nurse is caring for a newborn who underwent circumcision. During the assessment, the nurse notes a 2-cm circle of bright red bleeding in the newborn’s diaper. Which action by the nurse is next? A. Inform the newborn’s healthcare provider immediately. 18. A mother states, “I think my baby likes to hear me talk.” Which response by the nurse is best? A. “Babies are stimulated by low-pitched, monotonous sounds.” 19. After delivery, a newborn is transported to the nursery. The nurse prepares to prevent hypothermia in the newborn. Which action increases radiant heat loss? A. Avoid covering the weighing scale with a blanket or towel. 20. The nurse assesses the mother of a newborn who is breastfeeding. Which assessment finding indicates ineffective breastfeeding of the newborn? A. The newborn’s mouth grasps the mother’s nipple with the tongue down. 21. The nurse educates expectant parents regarding eye prophylaxis for the newborn. A father asks, “Which infectious diseases could be prevented by this treatment?” Which response by the nurse is best A. “Prophylactic eye treatment for newborns helps prevent syphilis.” 22. The nurse observes a mother breastfeeding her newborn and sees that the newborn is making frantic rooting motions but will not grasp the nipple. Which action by the nurse is best? A. Instruct the mother to pause feeding and comfort the newborn. 23. After a vaginal delivery, the nurse assesses a large-for-gestational-age (LGA) newborn and finds that the axillary temperature is 96℉ (35.6℃) and the newborn’s lips and hands are trembling. Which action by the nurse is next? A. Wrap the newborn in warm blankets. 24. The nurse educates a mother regarding the limitations of breastfeeding her newborn. Which statement by the mother indicates an understanding of the teaching? A. “I may drink alcohol a few hours before breastfeeding my baby.” 25. During the assessment of a 14-month-old infant, the nurse notes that the anterior fontanel is still open. Which action by the nurse is best? A. Switch to an intensive neurological examination. 26. The nurse is providing health education to a mother regarding the introduction of solid foods to their infant. Which age will it be most appropriate to start with solid foods? A. 2 months 27. The nurse is caring for a newborn of a substance-abusing mother. Which developmental concern will the infant most likely develop? A. Guilt 28. A mother asks the nurse about appropriate toys for their 5-month-old infant. Which response by the nurse is best? A. “Your baby would appreciate playing with a
teddy with colorful, button eyes.” 29. A mother states to the nurse, “Every time I pick up my crying infant, I worry that I am spoiling her too much.” Which response by the nurse is best? A.
“Comforting a crying baby does not spoil her; they need to be held and cuddled.” 30. The nurse is performing a neurodevelopmental assessment on a three-month-old infant. Which assessment finding does not nurse expect? A. A strong rooting
reflex Answers and RationaleWhich action should the nursery nurse take first in caring for the infant dry the infant quickly with warm blankets?Which action should the nursery nurse take first in caring for the infant? Dry the infant quickly with warm blankets. Drying the infant is a priority to prevent evaporative heat loss.
When assessing a newborn infant's heart rate what is most important for the nurse to do?Heart rate is evaluated by stethoscope. This is the most important assessment: If there is no heartbeat, the infant scores 0 for heart rate. If heart rate is less than 100 beats per minute, the infant scores 1 for heart rate.
Which nonpharmacologic interventions should the nurse implement to provide the most effective response in decreasing procedural pain in a neonate?Standardized pain scales allow for consistency between providers and individualized treatment plans for neonates. The use of non-pharmacological treatments such as, nonnutritive sucking, facilitated tucking, kangaroo care, swaddling and heel warming may all be beneficial in alleviating a neonate's pain.
Which of the following signs would lead the nurse to suspect that the newborn who is large for gestational age is experiencing hypoglycemia?Question 5 Explanation: The features indicating hypoglycemia in LGA infants include lethargy, stupor and fretfulness, respiratory difficulty and central cyanosis. The other features include poor feeding in a previously well feeding infant and weak whimpering cry.
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