ATI RN
Nursing Care of the Newborn Quizlet Questions
Question 1 of 5
The nurse notes swelling in the scrotum of a newborn infant. Transillumination reveals a reddish-yellow reflection. What action by the nurse is best?
Correct Answer: A
Rationale: When the nurse assesses a swollen scrotum, it is important to determine that the scrotal sac does not contain entrapped bowel or a mass. Transillumination can determine the presence of a mass when the light directed at the scrotum does not produce a reflection. A reddish-yellow reflection indicates fluid, which will be reabsorbed on its own. The nurse should document the findings and reassure the parents. No further action is needed.
Question 2 of 5
In preparing a family for discharge from the perinatal unit, which method of nail care does the nurse teach as the preferred method?
Correct Answer: B
Rationale: Several options exist for nail care to keep the infant from scratching her face. The nails can be cut, but there is a risk of damaging the delicate skin around the nail. This is best done while the baby sleeps. Letting the nails break off is not a good option, as the child may injure herself before they break. Covering the hands with mittens or a tee shirt is a possible option, but does not allow the child to suck on the fingers for self-soothing. The best option is to file the nails gently with a fine-grained emery board.
Question 3 of 5
A student nurse is caring for an infant who was just circumcised. What assessment finding should the student report to the registered nurse?
Correct Answer: A
Rationale: The nurse should assess for the first voiding after a circumcision to evaluate for urinary obstruction related to injury or swelling. Slight blood on the diaper would be expected. Some swelling may occur and does not cause concern unless it blocks the urethra. After a procedure, it is normal for an infant to wish to be held and comforted.
Question 4 of 5
The nurse is assessing an infant's extrusion reflex. To perform this correctly, what steps does the nurse take?
Correct Answer: C
Rationale: The extrusion reflex is elicited by touching the tip of the infant's tongue. The tongue should protrude outward. Palmar grasp is detected by placing a small object in the infant's hand. Stroking the side of the cheek should result in the rooting reflex. Turning the head and watching the position of the extremities is part of the tonic neck or fencing reflex.
Question 5 of 5
The newborn nursery nurse knows that infant behavior is best assessed by which of the following?
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.