Health Promotion of the Newborn and Family
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. Which is the most critical physiologic change required of the newborn?
a. Closure of fetal shunts in the heart
b. Stabilization of fluid and electrolytes
c. Body-t...
WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
Chapter 07: Health Promotion of the Newborn and Family
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. Which is the most critical physiologic change required of the newborn?
a. Closure of fetal shunts in the heart
b. Stabilization of fluid and electrolytes
c. Body-temperature maintenance
d. Onset of breathing
ANS: D
The onset of breathing is the most immediate and critical physiologic change required for
transition to extrauterine life. Factors that interfere with this normal transition increase fetal
asphyxia, which is a condition of hypoxemia, hypercapnia, and acidosis. This affects the
fetus’s adjustment to extrauterine life. Closure of fetal shunts in the heart, stabilization of fluid
and electrolytes, and body-temperature maintenance are important changes that must occur in
the transition to extrauterine life, but breathing and the exchange of oxygen for carbon dioxide
must come first.
DIF: Cognitive Level: Understand REF: p. 190
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
2. Which is a function of brown adipose tissue (BAT) in the newborn?
a. Provides ready source of calories in the newborn period
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b. Insulates the body against lowered environmental temperature
c. Protects the newborn from injury during the birth process
d. Generates heat for distribution to other parts of body
ANS: D
Brown fat is a unique source of heat for the newborn. It has a larger content of mitochondrial
cytochromes and a greater capacity for heat production through intensified metabolic activity
than does ordinary adipose tissue. Heat generated in brown fat is distributed to other parts of
the body by the blood. It is effective in heat production only. The newborn has a thin layer of
subcutaneous fat, which does not provide for conservation of heat. Brown fat is located in
superficial areas such as between the scapulae, around the neck, in the axillae, and behind the
sternum. These areas would not protect the newborn from injury during the birth process.
DIF: Cognitive Level: Understand REF: p. 191
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
3. Which characteristic is representative of the newborn’s gastrointestinal tract?
a. Stomach capacity is approximately 90 ml.
b. Peristaltic waves are relatively slow.
c. Overproduction of pancreatic amylase occurs.
d. Intestines are shorter in relation to body size.
ANS: A
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, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
Newborns require frequent small feedings because their stomach capacity is approximately 90
ml. Peristaltic waves are rapid. A deficiency of pancreatic lipase limits the absorption of fats.
Newborn’s intestines are longer in relation to body size than those of an adult.
DIF: Cognitive Level: Understand REF: p. 191
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance
4. The nurse notes the first stool of a newborn is black and tarry. Which term is used to describe
this type of stool?
a. Meconium
b. Transitional
c. Miliaria
d. Milk stool
ANS: A
Meconium is composed of amniotic fluid and its constituents, intestinal secretions, shed
mucosal cells, and possibly blood. It is the newborn’s first stool. Transitional stools usually
appear by the third day after the beginning of feeding. They are usually greenish brown to
yellowish brown, thin, and less sticky than meconium. Miliaria are distended sweat glands
that appear as minute vesicles, primarily on the face. Milk stool usually occurs by the fourth
day. The appearance varies, depending on whether the neonate is breastfed or formula-fed.
DIF: Cognitive Level: Remember REF: p. 191
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
NURSINGTB.COM
5. A nurse notes that a 12-hour-old newborn has not had the first meconium stool. The nurse
documents this finding and continues to monitor the newborn because, in term newborns, the
first meconium stool occurs within how many hours of birth?
a. 6 to 8
b. 8 to 12
c. 12 to 24
d. 24 to 48
ANS: D
The first meconium stool should occur within the first 24 to 48 hours. It may be delayed up to
7 days in very low birth weight newborns. Although it may occur earlier, the expected range
is the first 24 to 48 hours of life.
DIF: Cognitive Level: Remember REF: p. 191
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance
6. A nurse is doing an assessment on a newborn. Which is characteristic of a newborn’s vision at
birth and an expected finding during the assessment?
a. Ciliary muscles are mature.
b. Blink reflex is absent.
c. Tear glands function.
d. Pupils react to light.
ANS: D
NURSINGTB.COM
, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
Although at birth the eye is still structurally incomplete, the pupils do react to light. The
ciliary muscles are immature, limiting the eyes’ ability to focus on an object for any length of
time. The blink reflex is responsive to minimal stimulus. The tear glands do not begin to
function until ages 2 to 4 weeks.
DIF: Cognitive Level: Remember REF: p. 193
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
7. The Apgar score of a newborn 5 minutes after birth is 8. Which is the nurse’s best
interpretation of this?
a. Resuscitation is likely to be needed.
b. Adjustment to extrauterine life is adequate.
c. Additional scoring in 5 more minutes is needed.
d. Maternal sedation or analgesia contributed to the low score.
ANS: B
The Apgar reflects the newborn’s status in five areas: heart rate, respiratory effort, muscle
tone, reflex irritability, and color. Scores of 7 to 10 indicate an absence of difficulty adjusting
to extrauterine life. Scores of 0 to 3 indicate severe distress, and scores of 4 to 6 indicate
moderate difficulty. The Apgar score is not used to determine the newborn’s need for
resuscitation at birth. All newborns are rescored at 5 minutes. The newborn does not have a
low score.
DIF: Cognitive Level: Understand REF: p. 193
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
NURSINGTB.COM
8. The nurse is presenting an in-service session on assessing gestational age in newborns. Which
information should be included?
a. The newborn’s length and weight are the most accurate indicators of gestational
age.
b. The newborn’s Apgar score and the mother’s estimated date of confinement (EDC)
are combined to determine gestational age.
c. The newborn’s posture at rest and arm recoil are two physical signs used to
determine gestational age.
d. The newborn’s chest circumference compared to the head circumference is the
determinant for gestational age.
ANS: C
With the newborn quiet and in a supine position, the degree of flexion in the arms and legs
and the arm recoil can be used to help determine gestational age. Length, weight, and the
chest/head circumference reflect the newborn’s size and weight, which vary according to race
and gender. Birth weight alone is a poor indicator of gestational age and fetal maturity. The
Apgar score is an indication of the newborn’s adjustment to extrauterine life, and the mother’s
EDC is of no importance in determining gestational age.
DIF: Cognitive Level: Apply REF: p. 193
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance
NURSINGTB.COM
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