A nurse is reinforcing teaching about the correct use of infant car seats with the parent of a newborn.
Which of the following statements by the parent indicate an understanding of the teaching?

I should move the shoulder harness to the slots that are slightly below my baby's shoulders.

I should position the retainer clips at the level of my baby's umbilicus.

I should adjust the car seat so my baby is at a 60-degree angle while riding in the car.

I can change my baby to a forward-facing car seat when they weigh 15 pounds.

Answer and Explanation

The Correct Answer is A

Choice A rationale

The shoulder harness straps should be positioned at or slightly below the newborn's shoulders when using a rear-facing car seat. This lower placement is crucial because it directs the force of a frontal collision downward, toward the strong bones of the baby's hips and shoulders, effectively minimizing the stress on the delicate neck and spinal cord. Newborns have proportionally large heads and weak neck muscles.

Choice B rationale

The retainer or chest clip should be placed firmly across the child's mid-chest or armpits (axillary level), not the umbilicus. This specific positioning keeps the harness straps correctly aligned over the shoulders, preventing them from slipping off and ensuring that the child is secured properly, which is vital for maximum protection in the event of a crash.

Choice C rationale

A newborn's car seat should be installed at a semi-reclined angle of approximately 45 degrees (or the angle recommended by the manufacturer, usually indicated by a level or line). A 60-degree angle is too upright and could cause the newborn's head to fall forward, obstructing the airway and increasing the risk of positional asphyxia, especially in a term neonate with underdeveloped neck control.

Choice D rationale

Current safety guidelines recommend that children remain in a rear-facing car seat for as long as possible, until they reach the highest weight or height limit allowed by the car seat manufacturer. The minimum recommendation for switching to forward-facing is typically at 2 years old and having exceeded the rear-facing weight limit, which is usually higher than 15 pounds.

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Correct Answer is D

Explanation

Choice A rationale

Soft bumper pads in the crib increase the risk of suffocation or entrapment for the newborn. The current recommendation for safe sleep is a firm mattress in a crib that meets current safety standards, with only a fitted sheet. Cribs should be bare, with no soft objects, pillows, or loose bedding, to minimize the risk of Sudden Infant Death Syndrome (SIDS).

Choice B rationale

Placing a pillow under the newborn's head significantly increases the risk of suffocation or rebreathing exhaled air, which is a major risk factor for SIDS. Newborns should always be placed on their backs on a firm sleep surface for every sleep time. The head should remain uncovered, and the pillow offers no benefit, only hazard.

Choice C rationale

Using a warm, soapy washcloth on a newborn's delicate facial skin is unnecessary and may cause irritation or dryness. Newborns typically only require a plain water wash or a mild, non-soap cleanser for their face. Soap can remove the natural protective oils and disrupt the skin's barrier function.

Choice D rationale

Setting the maximum hot water temperature to 48.8°C (120°F) is a critical home safety precaution to prevent scalding burns. Water temperatures above this level can cause third-degree burns in a matter of seconds, especially in infants and young children whose skin is thinner and more vulnerable to thermal injury.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Heel warming increases capillary blood flow, improving sample accuracy and reducing hemolysis risk. Capillary glucose testing requires adequate perfusion for reliable results. Breastfeeding provides immediate glucose substrate to correct mild hypoglycemia. Normal neonatal blood glucose is >40–45 mg/dL; this newborn’s initial level of 35 mg/dL is below threshold, but responsive to feeding. Breast milk contains lactose, metabolized to glucose and galactose, supporting cerebral energy demands.

Rationale for incorrect Response 1 options: Administer glucose gel is appropriate only if feeding fails or glucose remains <25 mg/dL in asymptomatic or <40 mg/dL in symptomatic neonates. This newborn improved with feeding. Start IV fluids is reserved for persistent hypoglycemia or symptomatic neonates unresponsive to oral intake. The newborn stabilized post-breastfeeding. Phototherapy treats hyperbilirubinemia, not hypoglycemia. No bilirubin levels or jaundice signs were reported.

Rationale for incorrect Response 2 options: Supplement with formula is secondary to breastfeeding unless maternal milk is unavailable or ineffective. Breastfeeding was successful post-latch correction. Administer insulin is contraindicated; insulin lowers glucose and is used only in hyperglycemia. Monitor for jaundice is unrelated to hypoglycemia management unless bilirubin levels are elevated. No clinical jaundice was noted.

Take-home points:

Neonatal hypoglycemia is defined as glucose <40–45 mg/dL; early feeding is first-line intervention.
Macrosomic infants (birth weight >4,000 g) are at risk due to hyperinsulinemia post-placental glucose withdrawal.
Differentiate hypoglycemia from sepsis, hypothermia, and metabolic disorders—all may present with jitteriness and hypotonia.
Capillary sampling requires heel warming to ensure perfusion and accurate glucose measurement.

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A nurse is reinforcing teaching about the correct use of infant car seats with the parent of a newborn. Which of the following statements by the parent indicate an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about home safety precautions with the guardian of a newborn. Which of the following instructions should the nurse include?

Correct Answer is D

Explanation

Exhibits Question 2(B) Complete the following sentence by using the lists of options. The nurse should first dropdownbefore performing a heel stick, followed bydropdown.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

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A nurse is reinforcing teaching about the correct use of infant car seats with the parent of a newborn.
Which of the following statements by the parent indicate an understanding of the teaching?