Chapter 09: Newborns

Garzon Maaks: Burns’ Pediatric Primary Care, 7th Edition

MULTIPLE RESPONSE

1. Which interventions are recommendations suggested as preventive services for neonates?

(Select all that apply.)
a. Breastfeeding
b. Screening neonates for sickle hemoglobinopathies
c. Newborns screened for phenylketonuria (PKU) before being 24 hours old should
be rescreened by 2 weeks old
d. Screening for developmental hip dysplasia
e. Screening for congenital hyperthyroidism within the first 4 days of life
ANS: A, B, C, D
Options related to breastfeeding and screening for sickle hemogplobinopathies, PKU, and hip
dysplasia are recommended. Screening for hypothyroidism is recommended.

2. When providing post delivery information regarding her infant, the nurse will confirm to the
mother that which fetal cardiac structures have no function after her child is born? (Select all
that apply.)
a. Mitral valve
b. Foramen ovale
c. Cardiac septum
d. Ductus arteriosus
e. Pulmonary vein
ANS: B, D
The foramen ovale and ductus arteriosus are no longer necessary and close. All the other
options are represented in post delivery cardiac function. Select all that apply.

3. The nurse will contribute which neonate characteristics noted in the first period of reactivity to
sympathetic system changes? (Select all that apply.)
a. Transient rales
b. Tachycardia
c. Presence of oral mucus
d. Passage of meconium
e. Alertness
ANS: A, B, E
The first period of reactivity includes sympathetic system changes, such as tachycardia, rapid
respirations, transient rales, grunting, flaring and retractions, a falling body temperature,
hypertonus, and alertness. Parasympathetic system changes during the first period of reactivity
include the initiation of bowel sounds and the production of oral mucus. After an interval of
sleep, the newborn enters the second period of reactivity. During this time, the oral mucus
production again becomes evident, the heart rate becomes labile, the newborn becomes more
responsive to endogenous and exogenous stimuli, and meconium is often passed.

4. Which assessment factors are included in a 5-minute APGAR score? (Select all that apply.)
a. Heart rate
 b. Respiratory rate
c. Skin color
d. Muscle tone
e. Crying
ANS: A, B, C, D
Heart and respiratory rates, skin color and muscle tone are assessed at both the 1 and 5 minute
APGAR scoring. While crying has a positive affect on respirations, crying is not a focus of the
assessment

MULTIPLE CHOICE

1. Which assessment findings suggest that the neonate is demonstrating stabilization of

physiological functions?
a. Temperature: 97.7° F
b. Heart rate: 200 bpm
c. Systolic pressure: 100 mm Hg
d. Respiratory rate: 28 breaths/minute
ANS: A
Temperature is considered stable when between (97.7° to 99.3° F [36.5° to 37.4° C]) in open
crib after birth. Heart rate is normally 100 to 190 bpm. Systolic blood pressures greater than
96 mm Hg are considered significant hypertension in the newborn. Unlabored respirations at a
rate of 30 to 60 breaths/minute is considered normal.