A nurse is collecting data from a late-preterm newborn.
Which of the following findings should the nurse expect?
Thermal instability.
Leathery skin.
Hyperglycemia.
Alert wide-eyed appearance.
The Correct Answer is A
Choice A rationale
Late-preterm newborns, born between 34 weeks 0 days and 36 weeks 6 days of gestation, have immature physiological systems. Their underdeveloped thermoregulatory centers and reduced subcutaneous fat make them highly susceptible to heat loss, leading to thermal instability and hypothermia risk.
Choice B rationale
Leathery skin is characteristic of a post-term newborn, typically born at 42 weeks of gestation or beyond. This is due to prolonged exposure to amniotic fluid, resulting in desiccation, cracking, and peeling, a sign of post-maturity, not late-preterm status.
Choice C rationale
Late-preterm newborns are more prone to hypoglycemia, not hyperglycemia. Their immature liver glycogen stores, increased metabolic demands, and inefficient gluconeogenesis make them vulnerable to low blood glucose levels, particularly during periods of stress or inadequate feeding.
Choice D rationale
An alert, wide-eyed appearance is more characteristic of a full-term or post-term newborn. Late-preterm newborns often exhibit less mature neurological development, appearing sleepier, less alert, and demonstrating weaker sucking reflexes due to their developmental immaturity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Discussing a desire for more children is a normal manifestation of a positive postpartum adjustment. This indicates a healthy attachment to the current child and an optimistic outlook on future family expansion, reflecting psychological well-being and a positive coping mechanism in the postpartum period, not a concern.
Choice B rationale
Fatigue and a desire to sleep are common physiological and psychological responses to the physical demands of labor, delivery, and the initial postpartum period, as well as the demands of newborn care. This is a normal physiological recovery process and not indicative of a psychosocial concern.
Choice C rationale
Acknowledging similarities between the newborn and oneself as an infant indicates a healthy process of identification and bonding. This self-referential observation fosters a sense of connection and continuity within the family unit, signifying normal maternal-infant attachment and psychological integration, not a concern.
Choice D rationale
A client's reluctance to feed the newborn can be a significant indicator of potential psychosocial concerns such as postpartum depression, anxiety, or difficulties with maternal-infant bonding. This behavior may suggest a diminished capacity for engaging in essential caregiving activities, warranting further assessment and intervention.
Correct Answer is B
Explanation
Choice A rationale
Soft bumper pads in a crib are generally discouraged due to the risk of suffocation or strangulation for newborns. The American Academy of Pediatrics recommends a bare crib environment to reduce the risk of sudden infant death syndrome (SIDS). Airflow around the infant is paramount.
Choice B rationale
Setting the water heater temperature to 48.8° C (120° F) is a recommended safety precaution to prevent accidental scalding in infants and young children. Water temperatures higher than this can cause full-thickness burns very rapidly, as a newborn's skin is much more delicate and thinner than an adult's.
Choice C rationale
Washing a newborn's face with a warm, soapy washcloth is generally not recommended for daily care. Plain warm water is usually sufficient for cleansing a newborn's delicate skin. Soaps, especially perfumed ones, can be drying and irritating, potentially disrupting the natural skin barrier and leading to dermatitis.
Choice D rationale
Placing a pillow under a newborn's head during naps increases the risk of suffocation and SIDS. Pillows can obstruct the airway and pose a rebreathing hazard. The safest sleep environment for an infant is on their back on a firm, flat surface without pillows, blankets, or toys.
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