Although circumcision continues to be a controversial procedure, many parents in the United States elect to have this surgery performed on their newborn sons. It is believed that newborns do not feel pain; therefore, this is the optimum time for the procedure to be done and no anesthesia is required.

Correct Answer: B

Rationale: The correct answer is B) FALSE. It is crucial to provide anesthesia during circumcision for newborns as they do experience pain. Infants have a well-developed nervous system and can feel pain even though they may not express it in the same way as adults. Failing to use anesthesia during circumcision can lead to significant physiological stress, behavioral changes, and long-term negative effects on pain perception and stress responses in the infant. Choosing option A) TRUE would be incorrect because newborns do feel pain, and it is unethical to perform a procedure like circumcision without providing adequate pain relief. This misconception highlights the importance of ongoing education and awareness among healthcare providers and parents regarding the need for pain management in newborn procedures. In the field of maternal newborn nursing, it is essential to prioritize the well-being and comfort of newborns. By ensuring that appropriate pain management practices are followed during procedures like circumcision, healthcare providers can promote positive outcomes and establish trust with families. Educating parents about the importance of pain management for their newborns can empower them to make informed decisions and advocate for their child's health and safety.

Correct Answer: D

Rationale: In maternal newborn nursing, promoting infant feeding in a breastfed baby is crucial for the health and well-being of both the mother and the child. The correct answer is D) Maintain on-demand breastfeeding for the first 4 weeks. This is because on-demand breastfeeding helps establish a good milk supply, promotes bonding between mother and baby, and allows the baby to feed according to their hunger cues, promoting healthy weight gain. Option A) Feed the baby on a 3- to 4-hour schedule is incorrect because scheduled feedings can interfere with establishing a good milk supply and responding to the baby's hunger cues, leading to potential issues with weight gain and milk production. Option B) Alternate breast milk and formula for each feeding is incorrect as it can interfere with establishing exclusive breastfeeding, which is recommended for the first 6 months of life to provide optimal nutrition and health benefits to the baby. Option C) Stop breastfeeding if her nipples get sore is incorrect because sore nipples are common in the early stages of breastfeeding and can often be addressed with proper positioning and latching techniques, continuing to breastfeed is important for maintaining milk supply and promoting infant health. Educationally, it is important for nurses to provide evidence-based information to mothers to support successful breastfeeding, emphasizing the benefits of on-demand feeding, exclusive breastfeeding, and strategies to address common challenges like sore nipples. This empowers mothers to make informed decisions and promotes the best outcomes for both mother and baby.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A: Instructing the parents on how to observe for signs of jaundice. Jaundice is a common condition in newborns and can be more prevalent in infants with cephalhematoma. It is essential for parents to monitor their newborn for signs of jaundice, such as yellowing of the skin or eyes, as it can indicate a potential issue with the baby's liver function. Early detection and management of jaundice are crucial to prevent complications. Option B, assessing the fontanels for tenseness, is not the priority in this case as cephalhematoma does not typically affect the fontanels. While fontanels should be assessed for normalcy, it is not the immediate concern in this situation. Option C, increasing the infant's feeding to every 3 hours, is not the priority intervention at the time of discharge for a newborn with cephalhematoma. Feeding frequency is important, but monitoring for jaundice takes precedence in this case. Option D, recording the number of wet diapers in 24 hours, is important for monitoring the newborn's hydration status but is not the priority over watching for signs of jaundice, which can have more immediate health implications. In the context of maternal newborn nursing education, it is crucial to prioritize teaching parents about common newborn conditions and associated signs and symptoms. By educating parents on how to recognize signs of jaundice early, nurses can empower them to seek timely medical intervention if needed, promoting the health and well-being of the newborn.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Encourage frequent feeding to increase intake. Physiologic jaundice is common in newborns due to the breakdown of excess red blood cells. Increased feeding helps to promote bowel movements, aiding in the excretion of bilirubin which causes jaundice. Encouraging frequent feeding also ensures adequate hydration and nutrition for the neonate, supporting overall well-being. Option A) Cover the infant's eyes during the treatment is incorrect as the fiber-optic blanket does not require eye protection. This distracts from the main focus of promoting feeding. Option B) Reduce the daily number of formula feedings is incorrect because reducing feedings can lead to decreased bilirubin excretion, exacerbating jaundice. Maintaining or increasing feedings is crucial for neonates with jaundice. Option D) Expect a constipated stool until jaundice clears is incorrect. Constipation is not a typical symptom of physiologic jaundice, and this statement does not provide helpful guidance for managing the condition. Educationally, it's important to understand the rationale behind the treatment of physiologic jaundice in newborns. Teaching the importance of frequent feeding not only helps in clearing jaundice but also underscores the significance of nutrition and hydration in neonatal care. This knowledge equips nurses to provide comprehensive support to both newborns and their families during the transition from hospital to home care.

Correct Answer: D

Rationale: In this scenario, the correct interpretation by the nurse is "D) Respiratory Distress." The newborn's respiratory rate of 80 breaths/min, nasal flaring, sternal retractions, along with the low oxygen saturation of <87%, indicate respiratory distress. Respiratory distress in newborns can be caused by various conditions such as respiratory infections, meconium aspiration, or transient tachypnea of the newborn. Option A, "Cardiac distress," is incorrect as the symptoms presented are more indicative of respiratory rather than cardiac issues. Option B, "Respiratory Alkalosis," does not fit the clinical picture presented by the newborn. Option C, "Bronchial pneumonia," could be a consideration due to the respiratory symptoms, but the overall presentation is more indicative of generalized respiratory distress rather than a specific diagnosis like pneumonia. Educationally, it is crucial for nurses to recognize the signs and symptoms of respiratory distress in newborns as prompt intervention is essential to prevent further complications. Understanding the assessment findings and their implications helps nurses provide timely and appropriate care to newborns in distress.