The parents of a male newborn ask the nurse whether they should have their son circumcised. The nurse ‘s most appropriate response would be:

Correct Answer: D

Rationale: The correct answer is option D: "I'm sure you have discussed this with your doctor, but let's review the benefits and risks of circumcision." This response is the most appropriate because it acknowledges the parents' previous discussions with their doctor while also promoting an informed decision-making process through an open dialogue about the benefits and risks of circumcision. Option A is incorrect because although some studies suggest a reduced risk of penile cancer with circumcision, the evidence is not strong enough to recommend routine circumcision solely for this reason. Option B is not the best choice as it does not provide the parents with valuable information or guidance to make an informed decision. Option C is incorrect because it misrepresents the current stance of the American Academy of Pediatrics, which recognizes that the decision to circumcise is a personal one and should be made by the parents after receiving accurate and unbiased information. In an educational context, it is crucial for nurses to approach discussions about circumcision with sensitivity, respect, and a focus on providing evidence-based information to empower parents to make informed decisions about their child's health. By engaging in open and non-judgmental conversations, nurses can support parents in navigating the complex decision-making process surrounding circumcision, ultimately promoting the well-being of both the newborn and the family.

Correct Answer: B

Rationale: In maternal and reproductive health nursing, understanding correct breastfeeding attachment is crucial for promoting successful breastfeeding outcomes. The best indication that correct attachment to the breast has occurred is when the baby's mouth covers most of the areolar surface (Option B). This is because proper latch and attachment ensure effective milk transfer, prevent nipple soreness, and promote adequate stimulation for milk production. Option A (Baby's tongue is securely on top of the nipple) is incorrect because the baby's tongue should be under the nipple, not on top of it, to effectively compress the milk sinuses and extract milk. Option C (Baby makes frequent loud clucking sounds while nursing at each breast) is incorrect as it does not indicate correct attachment but may suggest poor latch or swallowing issues. Option D (Baby sucks each breast vigorously for five minutes before falling asleep) is incorrect as the duration of sucking alone does not determine correct attachment; it is the positioning and mouth coverage that are key. Educationally, nurses should teach mothers the signs of correct attachment, such as observing the baby's mouth covering most of the areola, hearing audible swallowing, and noting comfort and relaxed body language in the baby. Providing hands-on support and guidance to ensure proper latch can significantly impact breastfeeding success and maternal-infant bonding. Regular assessment and reinforcement of correct attachment techniques are essential to support breastfeeding initiation and maintenance.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Respiratory distress. Infants born to mothers with diabetes, especially those with large birth weights like the 9-pound 10 oz. baby in this case, are at higher risk for respiratory distress syndrome due to factors such as delayed lung maturation and surfactant deficiency. Option A) Meconium ileus is incorrect as it is a condition related to cystic fibrosis, not maternal diabetes. Option C) Physiologic jaundice is a common occurrence in newborns and is not specifically associated with maternal diabetes. Option D) Increased intracranial pressure is not typically a direct concern in infants born to mothers with diabetes unless there are other underlying issues present. In an educational context, understanding the potential complications for infants born to mothers with diabetes is crucial for nurses working in maternal and reproductive health. This knowledge allows nurses to provide appropriate care, closely monitor for potential issues such as respiratory distress, and intervene promptly to ensure the well-being of both the mother and the infant.

Correct Answer: B

Rationale: In the context of maternal and reproductive health nursing, understanding the rationale behind phototherapy for neonatal jaundice is crucial. The correct answer is option B: Phototherapy breaks down the unconjugated bilirubin in the skin to a conjugated form, which can then be excreted from the body. This process helps to reduce the levels of bilirubin in the blood, alleviating jaundice in preterm neonates. Option A is incorrect because phototherapy does not activate the liver to dispose of bilirubin. The liver is still developing in preterm neonates and may not be able to efficiently process bilirubin on its own. Option C is incorrect because phototherapy does not activate Vitamin K to facilitate bilirubin excretion. Vitamin K is primarily involved in blood clotting and does not play a direct role in bilirubin metabolism. Option D is incorrect because phototherapy does not dissolve bilirubin. Instead, it alters the structure of bilirubin in the skin to make it easier for the body to eliminate. Educationally, this question highlights the importance of understanding the mechanisms of phototherapy in managing neonatal jaundice, a common issue in preterm infants. Nurses need to grasp the specific actions of phototherapy to provide safe and effective care for these vulnerable newborns.

Correct Answer: A

Rationale: In maternal and reproductive health nursing, understanding the nutritional needs of pre-term neonates is crucial for providing optimal care. The correct answer is A) Poor sucking reflex. Pre-term neonates often have underdeveloped sucking reflexes, which can impede their ability to effectively latch onto a nipple or bottle for feeding. This can lead to inadequate intake of nutrients, resulting in a potential nutritional problem. Option B) A decreased metabolic rate is incorrect because pre-term neonates actually have higher metabolic rates compared to full-term infants due to their need to support growth and development outside the womb. Option C) Decreased caloric requirement is incorrect because pre-term neonates typically have higher caloric requirements to support their rapid growth and development compared to full-term infants. Option D) Increased absorption of nutrients is incorrect because pre-term neonates may actually have challenges with nutrient absorption due to their immature gastrointestinal systems. Educationally, it is important for nurses to be able to recognize the unique nutritional challenges faced by pre-term neonates to provide appropriate interventions and support for optimal growth and development. By understanding the impact of poor sucking reflexes on nutritional intake, nurses can implement strategies such as alternative feeding methods or nutritional supplementation to address these challenges effectively.