ATI RN
Caring for a Newborn who is Experiencing Complications ATI Questions
Question 1 of 5
A newborn born 72 hours ago was diagnosed with jaundice, requiring phototherapy. Which is most important to educate the family on at this time?
Correct Answer: B
Rationale: The correct answer is B: Covering the newborn’s eyes during phototherapy. This is important because exposure to the bright lights used in phototherapy can harm the newborn’s eyes. Covering the eyes with a protective mask or eye patches helps prevent damage. Incorrect choices: A: Anticipatory guidance regarding immunization schedules is important but not the most immediate concern in this scenario. C: Proper clothing for the newborn during seasonal changes is important for general care but not as critical as protecting the eyes during phototherapy. D: How to accurately measure the newborn’s temperature is essential but not as urgent as ensuring eye protection during phototherapy. In summary, educating the family on covering the newborn’s eyes during phototherapy is crucial to prevent eye damage, making it the most important consideration in this situation.
Question 2 of 5
Which are risk factors for a newborn developing hypoglycemia? Select all that apply.
Correct Answer: D
Rationale: The correct answer is D: Breastfeeding. Newborns exclusively breastfed are at risk of hypoglycemia due to delayed milk production, inadequate feeding, and poor latching. Prematurity (A) and being large for gestational age (B) can increase the risk, but they are not primary causes. Cold stress (C) can contribute, but it's not a direct risk factor for hypoglycemia in newborns. By process of elimination and understanding the physiological effects of breastfeeding on newborn glucose levels, choice D is the most relevant risk factor.
Question 3 of 5
The RN in the newborn nursery is reviewing the newborn’s chart and notices that the bilirubin levels are elevated. What intervention should the nurse perform next?
Correct Answer: D
Rationale: The correct answer is D because elevated bilirubin levels in newborns indicate jaundice, which can lead to complications if not treated promptly. Phototherapy helps break down bilirubin and is the first-line treatment for neonatal jaundice. Applying phototherapy as per hospital protocol is essential to decrease bilirubin levels. Notifying the physician is also crucial for ongoing monitoring and management. Choice A (Place the patient NPO and notify a physician) is incorrect because NPO status is not necessary for managing neonatal jaundice, and phototherapy is the primary intervention. Choice B (Weigh the patient to see if weight loss has occurred) is incorrect because weight loss is not directly related to elevated bilirubin levels in newborns. Choice C (Take the newborn’s vital signs and report to the physician) is incorrect because while vital signs are important, the immediate intervention for elevated bilirubin levels is phototherapy to prevent complications.
Question 4 of 5
The nurse is reviewing a chart in the newborn nursery. An RN was ordered to take blood glucose (BG) recordings on a newborn delivered that morning. BG readings are as follows: 50 mg/dL at 7:00 a.m.; 57 mg/dL at 10:00 a.m.; 62 mg/dL at 12:00 p.m.; 67 mg/dL at 2:00 p.m.; and 68 at 4:00 p.m. What action should the nurse perform with these recordings?
Correct Answer: D
Rationale: The correct answer is D: Review orders for the timing of next BG reading. This is the correct action because the nurse should follow the protocol and guidelines set by the healthcare provider regarding the frequency and timing of blood glucose monitoring in newborns. By reviewing the orders, the nurse ensures that the newborn's blood glucose levels are monitored appropriately and at the right intervals. This helps in maintaining the newborn's health and identifying any potential issues promptly. Other choices are incorrect: A: Notify the physician immediately that the BG readings on this newborn are low - Premature action without assessing the situation or following protocol. B: Immediately give the newborn glucose water - Inappropriate and potentially harmful intervention without proper evaluation. C: Confirm the readings with the laboratory - Unnecessary step as the nurse can follow the established protocol without involving the laboratory unnecessarily.
Question 5 of 5
Which baby is most at risk for developing physiological jaundice?
Correct Answer: B
Rationale: The correct answer is B because a 5-day-old term newborn with bilirubin levels of 13 mg/dL and exclusively breastfeeding is at higher risk for developing physiological jaundice. Breastfeeding jaundice occurs due to inadequate milk intake leading to limited bowel movements, causing reabsorption of bilirubin. The other choices are incorrect because: A has normal bilirubin levels and is bottle feeding, which is less likely to cause jaundice. C is a premature baby with low bilirubin levels and meconium passage. D is a term newborn with high bilirubin levels but is breastfed frequently, reducing the risk of jaundice.