Obstetric Nurse Test Obstetric Nurse Newborn Assessment and Care 5 — Questions and Answers
Question 1: Which newborn condition is best described as a collection of vernix, lanugo, and desquamated cells that may partially obstruct the colon?
- Meconium plug syndrome (Correct answer)
- Hirschsprung disease
- Necrotizing enterocolitis
- Meconium ileus
Correct answer: Meconium plug syndrome
Meconium plug syndrome involves a firm plug of concentrated meconium that delays passage and can often be relieved with a water-soluble contrast enema.
Question 2: The nurse is caring for a newborn under phototherapy for hyperbilirubinemia. Which assessment finding requires the nurse to pause therapy and notify the provider?
- Temperature of 38.5°C (101.3°F) and decreased urine output (Correct answer)
- Loose green stools and slight skin bronzing
- Macular rash under the phototherapy lamp
- Bilirubin level decreasing by 1–2 mg/dL per hour
Correct answer: Temperature of 38.5°C (101.3°F) and decreased urine output
Hyperthermia and decreased urine output during phototherapy indicate dehydration, which worsens hyperbilirubinemia and requires prompt provider notification and fluid management.
Question 3: A newborn of a mother with Type 1 diabetes is at highest risk for which immediate complication after birth?
- Hypoglycemia due to fetal hyperinsulinism (Correct answer)
- Hyperglycemia due to maternal insulin transfer
- Polycythemia from chronic hypoxia only
- Hypocalcemia as the sole metabolic risk
Correct answer: Hypoglycemia due to fetal hyperinsulinism
Infants of diabetic mothers develop fetal hyperinsulinism in response to chronic maternal hyperglycemia; after cord clamping removes the glucose supply, insulin excess causes rapid hypoglycemia.
Question 4: The nurse is demonstrating safe infant sleep practices to new parents. Which instruction is consistent with current AAP guidelines?
- Place the infant supine on a firm, flat surface in their own sleep space without loose bedding or bumper pads (Correct answer)
- Position the infant on their side to reduce aspiration risk
- Use an inclined sleeper or car seat for routine nighttime sleep
- Co-sleeping in the parental bed is acceptable if the parent is a non-smoker
Correct answer: Place the infant supine on a firm, flat surface in their own sleep space without loose bedding or bumper pads
The AAP recommends supine positioning on a firm, flat, separate sleep surface free of soft objects to reduce sudden infant death syndrome (SIDS) risk.
Question 5: The nurse performs a Dix-Hallpike-equivalent neurologic screen by holding a newborn in ventral suspension. In a term newborn, the expected response is:
- The head aligns momentarily with the plane of the body (Landau reflex) (Correct answer)
- The head drops completely below the body with arms flailing
- Immediate opisthotonus with back arching
- No response; this reflex is absent until 3 months of age
Correct answer: The head aligns momentarily with the plane of the body (Landau reflex)
In ventral suspension, a term newborn should briefly hold the head in line with the body, demonstrating the early Landau response and adequate truncal tone.
Question 6: A breastfeeding mother reports that her newborn, now 5 days old, appears more jaundiced. The nurse should first assess:
- Feeding frequency, latch quality, wet and stool diaper counts, and weight change since birth (Correct answer)
- Whether the mother has consumed any dairy products
- The newborn's ABO blood type exclusively
- Room temperature and whether the infant is being exposed to sunlight
Correct answer: Feeding frequency, latch quality, wet and stool diaper counts, and weight change since birth
Breastfeeding jaundice at day 3–5 is often caused by inadequate intake and caloric deprivation; assessing feeding effectiveness and output guides the intervention.
Question 7: During the newborn's first bath, the nurse should prioritize which action to prevent hypothermia?
- Warm the room to at least 75°F (24°C), use warm water (38°C/100°F), and dry and wrap the infant immediately (Correct answer)
- Bathe the newborn within 30 minutes of birth to remove all blood and vernix
- Use cool water to stimulate the newborn's thermoregulatory response
- Submerge the newborn fully in a tub bath to maintain even heat distribution
Correct answer: Warm the room to at least 75°F (24°C), use warm water (38°C/100°F), and dry and wrap the infant immediately
Newborns lose heat rapidly through evaporation; ensuring a warm environment, warm water, and immediate drying and swaddling are essential to prevent cold stress.
Obstetric Nurse Test Obstetric Nurse Newborn Assessment and Care 5
Which newborn condition is best described as a collection of vernix, lanugo, and desquamated cells that may partially obstruct the colon?