Questions 20

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Wong's Essentials of Pediatric Nursing 11th Edition Test Bank

Chapter 7 Questions

Question 1 of 5

The Apgar score of an infant 5 minutes after birth is 8. Which is the nurses best interpretation of this?

Correct Answer: B

Rationale: The Apgar reflects an infants status in five areas: heart rate, respiratory effort, muscle tone, reflex irritability, and color. A score of 8 to 10 indicates an absence of difficulty adjusting to extrauterine life. Scores of 0 to 3 indicate severe distress, and scores of 4 to 7 indicate moderate difficulty. All infants are rescored at 5 minutes of life, and a score of 8 is not indicative of distress; the newborn does not have a low score. The Apgar score is not used to determine the infants need for resuscitation at birth.

Question 2 of 5

The nurse should expect the apical heart rate of a stabilized newborn to be in which range?

Correct Answer: C

Rationale: The pulse rate of the newborn varies with periods of reactivity. Usually the pulse rate is between 120 and 140 beats/min. Sixty to 100 beats/min is too slow for a newborn, and 160 to 180 beats/min is too fast for a newborn.

Question 3 of 5

Which is true regarding an infants kidney function?

Correct Answer: C

Rationale: At birth, all structural components are present in the renal system, but there is a functional deficiency in the kidneys ability to concentrate urine and to cope with conditions of fluid and electrolyte stress such as dehydration or a concentrated solute load. Infants urine is colorless and odorless. The first voiding usually occurs within 24 hours of delivery. Newborns void when the bladder is stretched to 15 ml, resulting in about 20 voidings per day.

Question 4 of 5

Which finding in the newborn is considered abnormal?

Correct Answer: B

Rationale: Profuse drooling and salivation are potential signs of a major abnormality. Newborns with esophageal atresia cannot swallow their oral secretions, resulting in excessive drooling. Nystagmus is an involuntary movement of the eyes. This is a common variation in newborns. Meconium, the first stool of newborns, is dark green or black. A pseudomenstruation may be present in normal newborns. This is a blood-tinged or mucoid vaginal discharge.

Question 5 of 5

What is the grayish white, cheeselike substance that covers the newborns skin?

Correct Answer: D

Rationale: The vernix caseosa is the grayish white, cheeselike substance that covers a newborns skin.

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