A nurse is caring for a newborn and assessing newborn reflexes.To elicit the Moro (or startle) reflex, the nurse should take which of the following actions?
Turn the newborn's head quickly to one side.
Perform a sharp hand clap near the infant.
Stroke the outer edge of the sole of the foot from near the heel up toward the toes.
Place a finger at the base of the newborn's toes.
The Correct Answer is B
Choice A rationale
Turning the newborn's head quickly to one side elicits the tonic neck reflex, not the Moro reflex. The tonic neck reflex involves the newborn's arm extending on the side where the head is turned and the opposite arm bending at the elbow, resembling a fencing position.
Choice B rationale
Performing a sharp hand clap near the infant elicits the Moro (startle) reflex, which is characterized by the infant throwing their arms outward, opening their hands, and then bringing the arms back in. This is a response to sudden stimuli and is a normal reflex in newborns.
Choice C rationale
Stroking the outer edge of the sole of the foot from near the heel up toward the toes elicits the Babinski reflex, not the Moro reflex. The Babinski reflex is characterized by the big toe moving upward or toward the top surface of the foot and the other toes fanning out.
Choice D rationale
Placing a finger at the base of the newborn's toes elicits the plantar grasp reflex, not the Moro reflex. The plantar grasp reflex involves the toes curling around the finger or object placed at the base of the toes. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A rationale
Postpartum blues typically resolve within the first two weeks postpartum and involve mild symptoms like mood swings and irritability. In contrast, postpartum depression can persist longer and requires treatment.
Choice B rationale
Symptoms of postpartum blues usually disappear without medical intervention, whereas postpartum depression often needs professional treatment to manage the more severe and persistent symptoms.
Choice C rationale
Postpartum depression can impair a mother's ability to care for herself and her baby safely, requiring intervention to prevent harm. Postpartum blues do not typically cause such severe functional impairment.
Choice D rationale
Postpartum depression may require antidepressants for treatment due to its severity. Postpartum blues generally do not necessitate such interventions and are managed through support and reassurance.
Choice E rationale
Postpartum depression can occur at any time within the first 12 months after delivery, while postpartum blues are usually confined to the initial two weeks postpartum.
Correct Answer is C
Explanation
Choice A rationale
Male condoms are effective in preventing pregnancy and sexually transmitted infections, but their reliability can be compromised by improper use or breakage.
Choice B rationale
Vaginal rings provide hormonal contraception and are effective, but they may be less reliable compared to implants due to potential for incorrect use.
Choice C rationale
Hormonal implants are highly reliable because they provide continuous contraception over an extended period (up to 3-5 years) with minimal user intervention.
Choice D rationale
Oral contraceptives are effective when taken correctly, but their reliability can be reduced by missed doses or incorrect use.
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