# Chapter 19: Normal Newborn: Processes of Adaptation practice questions

A nursing student is helping the nursery nurse with morning vital signs. A baby born 10 hours ago via cesarean section is found to have moist lung sounds. Which is the best interpretation of this information?
a. This is an emergency situation.
b. The neonate must have aspirated surfactant.
c. If this baby was born vaginally, it could indicate a pneumothorax.
d. The lungs of a baby delivered by cesarean section may sound moist for 24 hours after birth.
Click the card to flip 👆
1 / 36
Terms in this set (36)
A nursing student is helping the nursery nurse with morning vital signs. A baby born 10 hours ago via cesarean section is found to have moist lung sounds. Which is the best interpretation of this information?
a. This is an emergency situation.
b. The neonate must have aspirated surfactant.
c. If this baby was born vaginally, it could indicate a pneumothorax.
d. The lungs of a baby delivered by cesarean section may sound moist for 24 hours after birth.
ANS: D
The condition will resolve itself within a few hours. For this common condition of newborns, surfactant acts to keep the expanded alveoli partially open between respirations. In vaginal births, absorption of remaining lung fluid is accelerated by the process of labor and birth. Remaining lung fluid will move into interstitial spaces and be absorbed by the circulatory and lymphatic systems. This is a common condition for infants delivered by cesarean section. Surfactant is produced by the lungs, so aspiration is not a concern. It is common to have some fluid left in the lungs; this will be absorbed within a few hours.
ANS: B
Conduction occurs when the infant comes in contact with cold objects. Radiation is the transfer of heat to a cooler object that is not in direct contact with the infant. Convection occurs when heat is transferred to the air surrounding the infant. Evaporation can occur during birth or bathing as a result of wet linens or clothes, or insensible heat loss.
How can nurses prevent evaporative heat loss in the newborn?
a. Placing the baby away from the outside wall and the windows
b. Keeping the baby out of drafts and away from air conditioners
c. Drying the baby after birth and wrapping the baby in a dry blanket
d. Warming the stethoscope and nurse's hands before touching the baby
ANS: C
Wet linens or wet clothes can cause heat loss by evaporation. If the heat loss is caused by placing the baby near cold surfaces or equipment, it is termed a radiation heat loss. Heat loss by convection occurs when drafts come from open doors and air currents created by people moving around. Conduction heat loss occurs when the baby comes into contact with cold objects or surfaces.
ANS: B
Pressure in the fetal circulation is greatest in the right atrium, which allows right-to-left shunting that aids in bypassing the lungs during intrauterine life. The pressure increases in the left atrium after birth and will close the foramen ovale. The liver does not filter the blood during fetal life until the end. It is functioning by birth. Blood bypasses the pulmonary vein during fetal life.
Parents ask the nurse, "What makes the opening between the baby's atriums close at birth?" The nurse's response is that cardiovascular changes that cause the foramen ovale to close at birth are a direct result of:
a. changes in the hepatic blood flow.
b. increased pressure in the left atrium.
c. increased pressure in the right atrium
d. decreased blood flow to the left ventricle.
ANS: B
With the increase in the blood flow to the left atrium from the lungs, the pressure is increased, and the foramen ovale is functionally closed. The hepatic blood flow changes, but that is not the reason for the closure of the foramen ovale. The pressure in the right atrium decreases at birth. It is higher during fetal life. Blood flow increases to the left ventricle after birth.
ANS: D
Because the infant is wet with amniotic fluid and blood, heat loss by evaporation occurs quickly. Radiation occurs with the transfer of heat to a cooler object that is not in direct contact with the infant. Conduction occurs when the infant comes into contact with a cold surface. The crib should be preheated to prevent this from occurring. Convection occurs when heat is transferred to the air surrounding the infant.
The nurse is explaining the risk of hypothermia in the newborn to a group of nursing students. Which should the nurse include as an explanation of hypothermia in the newborn?
a. Newborns shiver to generate heat.
b. Newborns have decreased oxygen demands.
c. Newborns have increased glucose demands.
d. Newborns have a decreased metabolic rate.
ANS: D
The infant who is fed early will be less likely to retain meconium and resorb bilirubin from the intestines back into the circulation. Cephalohematomas will release bilirubin into the system as the red blood cells die off. Bruising will release more bilirubin into the system. Brown fat is normally used to produce heat in the newborn.
The nurse is preparing to administer a vitamin K injection to the infant shortly after birth. Which is important to understand about vitamin K?
a. It is necessary for the production of platelets.
b. It is important for the production of red blood cells.
c. It is not initially synthesized because of a sterile bowel at birth.
d. It is responsible for the breakdown of bilirubin and the prevention of jaundice.
ANS: C
The bowel is initially sterile in the newborn, and vitamin K cannot be synthesized until food is introduced into the bowel. The platelet count in term newborns is near adult levels. Vitamin K is necessary to activate prothrombin and other clotting factors. Vitamin K is important for blood clotting. Vitamin K is necessary to activate the clotting factors.