A nurse is collecting data from a late-preterm newborn.
Which of the following findings should the nurse expect?

Thermal instability.

Leathery skin.

Hyperglycemia.

Alert wide-eyed appearance.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Late-preterm newborns, born between 34 weeks 0 days and 36 weeks 6 days of gestation, have immature physiological systems. Their underdeveloped thermoregulatory centers and reduced subcutaneous fat make them highly susceptible to heat loss, leading to thermal instability and hypothermia risk.

Choice B rationale

Leathery skin is characteristic of a post-term newborn, typically born at 42 weeks of gestation or beyond. This is due to prolonged exposure to amniotic fluid, resulting in desiccation, cracking, and peeling, a sign of post-maturity, not late-preterm status.

Choice C rationale

Late-preterm newborns are more prone to hypoglycemia, not hyperglycemia. Their immature liver glycogen stores, increased metabolic demands, and inefficient gluconeogenesis make them vulnerable to low blood glucose levels, particularly during periods of stress or inadequate feeding.

Choice D rationale

An alert, wide-eyed appearance is more characteristic of a full-term or post-term newborn. Late-preterm newborns often exhibit less mature neurological development, appearing sleepier, less alert, and demonstrating weaker sucking reflexes due to their developmental immaturity.

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Correct Answer is ["A","B","C","D","F"]

Explanation

Choice A rationale: Transient hypoglycemia is a common physiologic occurrence in term newborns during the first few hours after birth due to the abrupt cessation of maternal glucose supply. The newborn must transition to endogenous glucose production through glycogenolysis and gluconeogenesis. This transitional dip typically resolves with feeding and thermoregulation, making this statement scientifically accurate and reflective of normal neonatal adaptation.

Choice B rationale: Skin-to-skin contact enhances thermoregulation by reducing heat loss through conduction and evaporation. Maintaining a stable body temperature reduces metabolic demands and conserves glucose stores. Additionally, skin-to-skin contact promotes early breastfeeding, which provides exogenous glucose. These combined effects help stabilize neonatal blood glucose levels, making this an evidence-based intervention for hypoglycemia prevention and management.

Choice C rationale: Clamping the umbilical cord terminates the placental transfer of maternal glucose, which is the fetus’s primary energy source in utero. After birth, the newborn must rely on hepatic glycogen stores and initiate gluconeogenesis to maintain glucose homeostasis. This sudden metabolic shift can lead to transient hypoglycemia, especially in infants with increased glucose demands or limited glycogen reserves.

Choice D rationale: Persistent hypoglycemia, particularly glucose levels consistently below 50 mg/dL despite adequate feeding, may necessitate intravenous glucose administration to prevent neurologic injury. IV dextrose provides immediate correction of hypoglycemia when oral intake is insufficient or symptoms are severe. This intervention is especially critical in symptomatic infants or those at high risk, such as macrosomic newborns or infants of diabetic mothers.

Choice E rationale: The lower limit of normal blood glucose in neonates is generally considered to be 40 mg/dL in the first 4 hours and 45 mg/dL after that. However, stating that 40 to 45 mg/dL is the normal lower limit for up to 72 hours is imprecise. Glucose thresholds vary slightly by institution and age in hours, and levels should ideally rise above 50 mg/dL with feeding. Therefore, this statement lacks full accuracy.

Choice F rationale: Frequent breastfeeding provides a consistent source of glucose and stimulates endogenous insulin regulation. Early and effective feeding is the primary intervention for asymptomatic hypoglycemia in term infants. Breast milk contains lactose, which is metabolized into glucose and galactose, supporting energy needs. Therefore, this statement correctly reflects the role of frequent feeding in stabilizing neonatal glucose levels.

A. "I will increase my intake of vitamin K.”. B. "I will increase my potassium intake while breastfeeding.”. C. "I will maintain the same caloric intake as during pregnancy.”. D. "I will maintain adequate fluid intake to quench my thirst.”. . . .

Correct Answer is D

Explanation

Choice A rationale

While vitamin K is important for coagulation and is often supplemented in newborns, increasing maternal intake of vitamin K during breastfeeding is not a primary nutritional recommendation for the mother. The focus for maternal nutrition during lactation is generally on overall caloric and fluid intake, and specific macronutrients and micronutrients that support milk production.

Choice B rationale

While potassium is an essential electrolyte, and maintaining appropriate levels is crucial for overall health, there isn't a specific recommendation to significantly increase potassium intake beyond general dietary guidelines for a breastfeeding mother. The emphasis is typically on adequate fluid and overall balanced nutrition rather than targeted potassium supplementation for lactation.

Choice C rationale

Breastfeeding significantly increases a mother's energy expenditure due to the metabolic demands of milk production. Therefore, maintaining the same caloric intake as during pregnancy would be insufficient to meet these increased energy needs, potentially leading to maternal fatigue and weight loss. An increase of approximately 330-400 additional calories per day is typically recommended.

Choice D rationale

Adequate fluid intake is crucial for successful lactation. Breast milk is approximately 87% water, and the process of milk synthesis requires a substantial fluid volume. Maintaining adequate hydration, guided by thirst, ensures sufficient substrate for milk production and prevents maternal dehydration, which can negatively impact milk supply and overall well-being. .

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A nurse is collecting data from a late-preterm newborn. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse on the labor and delivery unit is assisting in the care of a newborn at 1 hour old. Exhibits The nurse reinforces teaching regarding newborn hypoglycemia. Which of the following client statements indicate understanding of newborn hypoglycemia? Select all that apply.

Correct Answer is ["A","B","C","D","F"]

Explanation

A nurse is reinforcing discharge instructions with a postpartum client about breastfeeding. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

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A nurse is collecting data from a late-preterm newborn.
Which of the following findings should the nurse expect?