The nurse is assessing a term neonate delivered to a mother with a history of drug and alcohol abuse. Which finding does the nurse relate to the mother's history?

Correct Answer: D

Rationale: The correct answer is D because a head circumference below the 10th percentile for gestational age can be indicative of intrauterine growth restriction (IUGR), which is commonly seen in infants of mothers with a history of drug and alcohol abuse. This is due to restricted fetal growth caused by maternal substance abuse. A, B, and C are incorrect: A: Chest circumference being less than head circumference is not directly related to maternal drug and alcohol abuse. B: The neonate's pulse rate increasing when crying is a normal physiological response and is not specific to the mother's history of substance abuse. C: Absence of tear production when crying is not a typical finding related to maternal drug and alcohol abuse.

Correct Answer: C

Rationale: The correct answer is C, a combination of stimulated sucking and receiving sucrose orally. Thakkar et al. (2016) found that this method effectively reduced pain response during heel sticks in neonates. Stimulated sucking triggers the release of endorphins, providing natural pain relief, while sucrose activates sweet taste receptors, further reducing pain perception. This dual approach addresses both physiological and psychological aspects of pain management in neonates. Choice A (anesthetic gel) may not be as effective for heel sticks as it takes time to work and may not provide comprehensive pain relief. Choice B (breastfeeding) may distract the neonate but does not directly address pain management. Choice D (en face positioning) may promote bonding but does not offer a specific pain management strategy. Overall, choice C is supported by research and provides a holistic approach to neonatal pain control during heel sticks.

Correct Answer: D

Rationale: The correct answer is D because in the early days after birth, newborn stools transition from meconium to a yellow, seedy consistency with a sour odor. This is known as transitional stool. Residual meconium is not passed as loose watery stool (A) but as a sticky, tar-like substance. Sticky, thick, black stools do not necessarily indicate blood (B) but could be meconium. Stools do not become drier and more formed (C) until later in the infant's life.

Correct Answer: C

Rationale: The correct answer is C: Human immunodeficiency virus infection. Breastfeeding is contraindicated in this condition due to the risk of vertical transmission of the virus to the infant through breast milk. HIV can be present in breast milk, increasing the risk of infection to the baby. This is supported by guidelines from organizations such as WHO. Choices A, B, and D are incorrect: A: Triplet birth is not a contraindication for breastfeeding; it may require additional support but is not a direct contraindication. B: Flat or inverted nipples may pose initial challenges but can be addressed with proper latch techniques or the use of aids like nipple shields. D: Inactive, previously treated tuberculosis does not contraindicate breastfeeding as long as the mother has completed treatment and is not actively infectious.

Correct Answer: B

Rationale: The correct answer is B: Prolactin. Prolactin is the hormone essential for milk production in the mammary glands. It stimulates the production of milk by the alveoli in the breast tissue. Estrogen and progesterone are involved in the preparation of breast tissue during pregnancy, but they do not directly stimulate milk production. Lactogen is another name for human placental lactogen, which is not directly involved in milk production but plays a role in regulating maternal metabolism during pregnancy.