When observing a drug-exposed newborn, what symptom suggests that the newborn may be exhibiting withdrawal symptoms?

Choice A reason:

Drowsy. This is not the best state for feeding a newborn, because the baby may fall asleep before finishing the feed or may not latch on well. A drowsy baby may also have trouble swallowing or coordinating sucking and breathing. •

Choice B reason:

Crying. This is also not a good state for feeding a newborn, because crying is a late sign of hunger and indicates that the baby is already distressed. A crying baby may have difficulty calming down enough to feed or may gulp air and become gassy. •

Choice C reason:

Active alert. This is a possible state for feeding a newborn, but not the most optimal one. An active alert baby may be easily distracted by noises or movements around them or may become fussy or overstimulated if they are not fed quickly enough. •

Choice D reason:

Alert. This is the best state for feeding a newborn because the baby is awake, calm, and attentive to their surroundings. An alert baby will show signs of hunger such as rooting, smacking their lips, or sucking their fingers, and will be ready to latch on and feed well.

Choice A reason:

Intermittent abdominal pain following passage of bloody mucus is not a sign of placenta previa, but rather of bloody show, which is a normal occurrence in late pregnancy as the cervix begins to dilate and efface.

Choice B reason:

Abdominal pain with minimal red vaginal bleeding is not a sign of placenta previa, but rather of abruptio placentae, which is a serious complication where the placenta detaches from the uterine wall before delivery.

Choice C reason:

A large amount of bright red vaginal bleeding without pain is a sign of placenta previa, which is a condition where the placenta covers part or all of the cervical opening. This can cause bleeding when the cervix dilates or contracts, especially in the third trimester. This is a medical emergency that requires immediate attention.

Choice D reason:

Severe abdominal pain with increasing fundal height is not a sign of placenta previa, but rather of uterine rupture, which is a rare but life-threatening complication where the uterus tears open along the scar line from a previous cesarean delivery or other uterine surgery. This can cause severe bleeding, fetal distress, and shock.