ATI RN
Nursing Care of the Newborn Questions
Question 1 of 5
A mother is attempting to breastfeed her infant in the hospital setting. The infant is sleepy and displays some audible swallowing, the maternal nipples are flat, and the breasts are soft. The nurse has attempted to teach the mother positioning on one side, and now the mother wants to place the infant to the breast on the other side. Based on LATCH scores, what score would the nurse assign to this feeding session?
Correct Answer: B
Rationale: The correct answer is B: 6 and further teach and assist the mother in feeding activities. Rationale: 1. LATCH scoring system assesses breastfeeding effectiveness. 2. A score of 6 indicates some difficulty and need for further teaching. 3. Signs of difficulty in this scenario: sleepy infant, flat nipples, soft breasts. 4. Audible swallowing is a positive sign but not enough to warrant a perfect score. 5. Further teaching and assistance can improve latch and feeding success. 6. Other options are incorrect as they do not address the need for additional teaching and support.
Question 2 of 5
When thinking about scoring an Apgar assessment, the nurse knows that grimace is an assessment of what in a newborn?
Correct Answer: D
Rationale: The correct answer is D because the grimace in an Apgar assessment refers to the newborn's response to stimulation, such as a gentle pinch or suctioning. This response indicates the baby's reflexes and neurological function, which are important indicators of overall health. Choices A and C are incorrect because the grimace is not specifically related to breathing or visual stimuli. Choice B is incorrect because it refers to a different aspect of the assessment (muscle tone).
Question 3 of 5
The most effective time to initiate breast-feeding is in which stage of reactivity for the neonate?
Correct Answer: B
Rationale: The correct answer is B: first period of reactivity. During this stage, the infant is alert and eager to suckle, making it an optimal time to initiate breastfeeding. The infant's sucking reflex is strong, and they are more likely to latch on successfully. The other choices are incorrect because during the period of decreased reactivity (A), the infant is often drowsy and less interested in feeding. The second period of reactivity (C) may involve increased activity and may not be the best time to introduce breastfeeding. After the end of the second period of reactivity (D), the infant may be more settled and not as ready to breastfeed as during the first period of reactivity.
Question 4 of 5
What assessment findings doesn't indicate abnormal transition in a neonate?
Correct Answer: C
Rationale: The correct answer is C: blue hands and feet oral secretions. This choice doesn't indicate an abnormal transition in a neonate because blue hands and feet and oral secretions are common normal findings in newborns due to immature circulatory and respiratory systems. Prolonged apneic episodes (A) can indicate respiratory distress, marked pallor (B) can indicate anemia or poor perfusion, and crackles upon auscultation (D) can indicate respiratory issues. Therefore, C is the correct answer as it is a normal finding in neonates.
Question 5 of 5
After birth, the nurse immediately dries a neonate's face and hair with a clean, prewarmed towel. After drying, the nurse covers the neonate's hair with a cap. What type of heat loss is the nurse preventing?
Correct Answer: C
Rationale: The correct answer is C: evaporation. After birth, drying the neonate's face and hair with a towel and covering the hair with a cap prevents heat loss through evaporation. Evaporation occurs when moisture on the skin evaporates into the air, leading to cooling of the body. By drying the neonate's hair and covering it with a cap, the nurse reduces the potential for heat loss through evaporation, helping to maintain the neonate's body temperature. Incorrect choices: A: Convection - Heat transfer through the movement of air or liquid. Drying and covering the hair do not directly impact convection heat loss. B: Conduction - Heat transfer through direct contact with a cooler surface. Drying and covering the hair with a cap do not address conduction heat loss. D: Radiation - Heat transfer through electromagnetic waves. Drying and covering the hair do not specifically target radiation heat loss.