A nurse is caring for a preterm newborn who has a nasogastric tube and who recently began intermittent gavage feedings of formula. The nurse notes increased abdominal distention, lethargy, bloody stools, and increasing gastric residuals before feedings. The nurse should suspect which of the following?

Intraventricular hemorrhage

Need for placement of a gastrostomy tube

Overstimulation

Necrotizing enterocolitis

Answer and Explanation

The Correct Answer is D

A. Intraventricular hemorrhage presents with neurological signs like apnea or seizures, not primarily gastrointestinal symptoms.
B. Increased gastric residuals alone may indicate a need for tube placement, but the full symptom set suggests NEC.
C. Overstimulation may cause irritability but does not typically result in bloody stools or abdominal distension.
D. NEC is a life-threatening gastrointestinal disorder in preterm infants characterized by intestinal inflammation, abdominal distension, lethargy, bloody stools, and increased gastric residuals. Immediate intervention is necessary.

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Correct Answer is C

Explanation

A. Placing the baby under a warmer can be done if skin-to-skin is not effective.

B. CPR is unnecessary as the newborn’s vital signs are within normal limits for this age.

C. Skin-to-skin contact is the best initial intervention to stabilize temperature and promote bonding, which may also regulate respiratory and heart rates.

D. Oxygen is not indicated as the respiratory rate and oxygenation appear adequate.

A. Explain what colostrum is and offer to assist with latch. B. Call the physician for a prescription for formula. C. Obtain consent from her to use donor breast milk. D. Instruct her to burp after the baby eats 1/2 ounce.

Correct Answer is A

Explanation

A. Colostrum, the first form of breast milk, is produced in small amounts and is rich in nutrients and antibodies. Many new mothers are unaware of this and need reassurance.
B. Formula is not necessary unless medically indicated or the mother persists after being educated.
C. Donor breast milk is typically reserved for medically fragile infants.
D. Burping after feeding is important but does not address the client’s concern about milk supply.

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a 4-hour old newborn. The nurse's findings include an irregular respiratory rate at 58, heart rate of 138 with a regular rhythm, and axillary temperature of 97.4 °F. Based on these assessments which intervention(s) should the nurse perform first?

Correct Answer is C

Explanation

The nurse is caring for a 1-day postpartum client that is breastfeeding a healthy full-term newborn. The client requests a bottle of formula and verbalizes that she does "not have any milk". What is the most appropriate response?

Correct Answer is A

Explanation

A nurse is reinforcing teaching about newborn care with a postpartum client. Which of the following statements by the client indicates a need for further teaching?

A 2-day old newborn is observed to be restless, irritable, sucking on its fist, and crying. What action should the nurse take first?

A nurse is assisting a healthcare provider during an infant's circumcision. Which action by the nurse demonstrates the nurse is acting as the infant's client care advocate?

The nurse completing a gestational exam using the Ballard assessment tool understands that this assesses which two maturity components?

A breastfeeding mother is planning to return to work 3 months after her baby is born. The mother is planning to use an electric breast pump and freeze some breast milk for use later. Which information does the nurse need to provide?

The nurse is providing education to a mother of an uncircumcised male infant. What hygiene education would be the most appropriate for the nurse to provide?

The nurse is instructing a new parent on appropriate circumcision care. Which statement by the parent demonstrates effective teaching?