A nurse is caring for a new mother who is breastfeeding her term newborn. The newborn weighed 3.4 kg (7.5 lb) at birth and weighed 3.3 kg (7.3 lb) on the second day of life. The mother expresses concern about the weight loss and asks the nurse about the amount of her breast milk. Which of the following responses by the nurse is appropriate?

"A healthy newborn can lose 6% of his birth weight before starting to gain weight."

"Why don't you switch to formula to make sure your baby is eating enough?"

"It is common for new mothers to worry that they are not making enough milk for their baby."

"Your newborn will need to remain in the hospital so his weight can be monitored."

Answer and Explanation

The Correct Answer is A

Choice A rationale: Weight loss in the first few days after birth is normal for newborns, and a weight loss of up to 7-10% of the birth weight is considered within the expected range. A 6% weight loss is within normal limits, and it is reassuring to inform the mother that this is typical.
Choice B rationale: Suggesting switching to formula is not necessary based on the weight loss described. Breastfeeding provides adequate nutrition for most newborns, and early weight loss is typical and not a cause for alarm.
Choice C rationale: While it is true that new mothers may worry about breastfeeding and milk supply, this response does not address the specific weight loss concern and might not fully reassure the mother.
Choice D rationale: A 6% weight loss is within the expected range for a newborn and does not warrant hospitalization. It is a normal finding, and most newborns will start to regain their birth weight within a few days of life.

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Correct Answer is C

Explanation

Choice A rationale: Kernicterus is a severe form of jaundice that can result from untreated hyperbilirubinemia in a newborn. The indirect Coombs test does not assess the risk of kernicterus specifically.
Choice B rationale: The indirect Coombs test detects Rh-negative antibodies in the mother's blood, not Rh-positive antibodies.
Choice C rationale: The indirect Coombs test, also known as the indirect antiglobulin test (IAT), is performed on a pregnant woman to detect the presence of Rh-negative antibodies in her blood. If the mother is Rh-negative and has been sensitized to Rh-positive blood, these antibodies can cross the placenta and attack the red blood cells of an Rh-positive fetus, potentially causing hemolytic disease of the newborn (HDN) or erythroblastosis fetalis.
Choice D rationale: The direct Coombs test (direct antiglobulin test) is used to detect the presence of maternal antibodies that have already been attached to the newborn's red blood cells. The indirect Coombs test is used to identify the presence of these antibodies in the mother's blood before they have attached to the newborn's red blood cells.

A. Prone B. Upright C. Right side D. Left side

Correct Answer is B

Explanation

Choice A rationale: Placing the infant in a prone position (lying face down) after feeding is not recommended for a baby with gastroesophageal reflux. The prone position can increase the risk of choking and is not helpful in managing reflux.
Choice B rationale: For an infant with gastroesophageal reflux, placing the baby in an upright position after feeding can help prevent or reduce reflux episodes. Keeping the infant in an upright position allows gravity to assist in keeping stomach contents down and reduces the likelihood of reflux into the esophagus.
Choice C rationale: Placing the infant on the right side after feeding is also not recommended for managing gastroesophageal reflux. The right-side position may not be as effective in preventing reflux as the upright position.
Choice D rationale: Placing the infant on the left side after feeding is not the preferred position for managing gastroesophageal reflux. The left-side position may not be as effective in preventing reflux as the upright position.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a newly licensed nurse about the purpose of an indirect Coombs test. Which of the following statements should the nurse include in the teaching?

Correct Answer is C

Explanation

A nurse is caring for an infant who has gastroesophageal reflux. The nurse should place the infant in which of the following positions after feeding?

Correct Answer is B

Explanation

A nurse is reviewing laboratory results from a client who is at 28 weeks of gestation and has gestational diabetes. The nurse notes that blood glucose levels taken 1 hour following a meal range from 145 mg/dL to 162 mg/dL over the past week. Which of the following actions should the nurse take?

Aureissisting a nurse midwife in examining a client who is a primigravida at 42 weeks of gestation and states that she thinks she is in labor. Which of the following findings confirms that the client is in labor?

A nurse is reinforcing discharge teaching about circumcision care with the parent of a newborn who had a circumcision using the Plastibell device. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

A nurse is caring for a client who is at 32 weeks of gestation and is in labor. Which of the following medications is contraindicated for this client?

A nurse is assisting a client with breastfeeding her newborn. The nurse should explain that which of the following reflexes will initiate sucking

A nurse is reinforcing teaching about formula feeding to a group of parents of newborns. Which of the following statements by one of the parents indicates a need for further teaching?

A nurse is assisting with the care of a client who is in labor. The client's labor is difficult and prolonged and she reports a severe backache. Which of the following factors is a contributing cause of difficult, prolonged labor?

A nurse is caring for a client in the prenatal clinic who has a possible ectopic pregnancy at 8 weeks of gestation. Which of the following findings should the nurse expect?