A postpartum nurse instructs a new mother in how to bathe her newborn.

Which statement by the mother indicates a need for further instruction?

“I should use a clean cloth and warm water to wash around the umbilical cord.”

“I should bathe him before a feeding so he won’t spit up.”

“I should avoid getting water in his ears or eyes.”

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. “I should bathe him before a feeding so he won’t spit up.” This statement indicates a need for further instruction because it is not advisable to bathe a newborn infant before a feeding, as this may cause hypoglycemia or cold stress. The mother should bathe the infant after a feeding or between feedings when the infant is alert and comfortable.

Choice A is wrong because it is correct to use a clean cloth and warm water to wash around the umbilical cord. This helps prevent infection and promotes drying of the cord stump.

Choice C is wrong because it is correct to avoid getting water in the infant’s ears or eyes. This helps prevent ear infections and eye irritation.

Choice D is wrong because it is correct to dry the infant thoroughly and dress him warmly after bathing.

This helps prevent heat loss

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Correct Answer is A

Explanation

The correct answer is choice A. Bulging fontanelle.

A bulging fontanelle is a sign of increased intracranial pressure, which can be caused by intracranial hemorrhage.

Late-onset VKDB is a condition that occurs in infants who have low levels of vitamin K, which is essential for blood clotting.Most cases of late-onset VKDB present with intracranial hemorrhage.

Choice B. Sunken eyes is wrong because it is a sign of dehydration, not intracranial hemorrhage.

Choice C. Mottled skin is wrong because it is a sign of poor circulation or shock, not intracranial hemorrhage.

Choice D. Flaring nostrils is wrong because it is a sign of respiratory distress, not intracranial hemorrhage.

Normal ranges for vitamin K plasma concentrations are 0.2 to 3.2 ng/mL for adults and 0.15 to 1.5 ng/mL for infants.

A. “We will change his diaper every 3 to 4 hours.” B. “We will wash his penis with soap and water daily.” C. “We will apply petroleum jelly on his penis with each diaper change.” D. “We will call his doctor if we see any signs of infection.”

Correct Answer is B

Explanation

The correct answer is choice B. Washing the penis with soap and water daily can irritate the circumcision site and delay healing.

The parents should only use warm water to gently clean the area and pat it dry.

They should avoid using soap, alcohol, or peroxide on the wound.

Choice A is wrong because changing the diaper every 3 to 4 hours is recommended to prevent infection and keep the area clean and dry.

Choice C is wrong because applying petroleum jelly on the penis with each diaper change can protect the wound from sticking to the diaper and reduce friction.

Choice D is wrong because calling the doctor if they see any signs of infection, such as redness, swelling, pus, foul odor, or fever, is a correct action.

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A postpartum nurse instructs a new mother in how to bathe her newborn. Which statement by the mother indicates a need for further instruction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a newborn who has late-onset VKDB due to exclusive breastfeeding and inadequate oral vitamin K supplementation. Which of the following findings should indicate a possible intracranial hemorrhage to the nurse?

Correct Answer is A

Explanation

The nurse is teaching parents how to care for their son’s circumcision site after discharge from hospital using petroleum jelly and gauze dressing method. Which statement by parents indicates that they need further instruction?

Correct Answer is B

Explanation

A nurse is educating a group of college students about hepatitis B virus (HBV) transmission and prevention. The nurse should emphasize that the most common modes of transmission are which of the following? (Select all that apply)

A nurse is administering erythromycin eye ointment to a newborn who has a history of allergic reaction to penicillin. What should the nurse do before applying the ointment?

A nurse is caring for a newborn who has received erythromycin eye ointment as prophylaxis for ophthalmia neonatorum. What should the nurse monitor for as a potential adverse reaction to this medication?

A nurse is preparing to administer hepatitis B vaccine to a newborn whose mother is hepatitis B surface antigen negative (HBsAg-). Which of the following actions should the nurse take?

A nurse is reviewing laboratory results for a newborn who received vitamin K injection at birth. Which of the following coagulation factors should be activated by vitamin K?

A nurse is performing an initial assessment of a newborn who was delivered vaginally at term with no complications. Which of the following findings should alert the nurse to a potential problem?

A nurse is caring for a preterm newborn who has hypoglycemia due to inadequate gluconeogenesis. The nurse should understand that this condition occurs because preterm newborns have limited stores of which of the following substances?

A nurse is educating a new mother about umbilical cord care and how to prevent omphalitis, sepsis, and tetanus. Which of the following statements by the mother indicates an understanding of the teaching?

A postpartum nurse instructs a new mother in how to bathe her newborn.

Which statement by the mother indicates a need for further instruction?