A nursery nurse is caring for a newborn who was born 2 hours ago.
Upon review of the prenatal records, the nurse notes the following prenatal panel results: A positive, Hepatitis B positive, RPR negative, Rubella immune, HIV negative, GBS positive.
In addition to Vitamin K and Erythromycin ophthalmic ointment, what injection(s) should the newborn receive?

Hepatitis B vaccine only, administered within 1 hour of birth.

Hepatitis B vaccine and Hepatitis B immunoglobulin administered within 12 hours of delivery.

Hepatitis B immunoglobulin (HBIG) only, administered within 12 hours of birth.

Hepatitis B immunoglobulin (HBIG) within 12 hours, followed by hepatitis B vaccine monthly for 12 months.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Administering only the Hepatitis B vaccine within 1 hour of birth is not sufficient for a newborn born to a Hepatitis B positive mother. The newborn also needs Hepatitis B immunoglobulin (HBIG) to provide immediate passive immunity.

Choice B rationale

Administering both the Hepatitis B vaccine and Hepatitis B immunoglobulin (HBIG) within 12 hours of delivery is the recommended practice for newborns born to Hepatitis B positive mothers. This provides both active and passive immunity.

Choice C rationale

Administering only Hepatitis B immunoglobulin (HBIG) within 12 hours of birth is not sufficient. The newborn also needs the Hepatitis B vaccine to develop long-term immunity.

Choice D rationale

Administering Hepatitis B immunoglobulin (HBIG) within 12 hours, followed by monthly Hepatitis B vaccines for 12 months, is not the standard practice. The newborn should receive the Hepatitis B vaccine series according to the recommended schedule. .

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Correct Answer is D

Explanation

Choice A rationale

Newborns are not born with fully developed immune responses. Their immune system is immature and continues to develop after birth. They rely on maternal antibodies for initial protection.

Choice B rationale

Newborns do not have a mature gut microbiome immediately after birth. The gut microbiome develops over time and is influenced by factors such as breastfeeding and exposure to the environment.

Choice C rationale

Newborns do not rely solely on their innate immune system. They receive passive immunity from maternal antibodies transferred through the placenta and colostrum, which provides initial protection against infections.

Choice D rationale

Newborns receive passive immunity through the placenta and colostrum, but their own immune system is not fully functional until several months of age. This passive immunity helps protect them from infections during the early months of life.

A. Flexion of arms. B. Caput succedaneum. C. Heart rate 158 bpm. D. Respiratory rate 66/min. E. Acrocyanosis. F. Subcostal retractions. G. Nasal flaring. H. Grunting.

Correct Answer is ["D","F","G","H"]

Explanation

Choice A rationale

Flexion of arms is a normal finding in newborns and does not indicate respiratory distress.

Choice B rationale

Caput succedaneum is a common condition where the scalp swells due to pressure during delivery. It does not indicate respiratory distress.

Choice C rationale

A heart rate of 158 bpm is within the normal range for newborns and does not indicate respiratory distress.

Choice D rationale

A respiratory rate of 66/min is above the normal range (30-60 breaths per minute) and indicates respiratory distress.

Choice E rationale

Acrocyanosis is common in newborns and does not indicate respiratory distress.

Choice F rationale

Subcostal retractions indicate increased work of breathing and are a sign of respiratory distress.

Choice G rationale

Nasal flaring is a sign of respiratory distress as it indicates increased effort to breathe.

Choice H rationale

Grunting is a sign of respiratory distress as it indicates difficulty in maintaining lung expansion.

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Naxlex Comprehensive Predictor Exams

Which of the following statements accurately describes a characteristic of the newborn immune system?

Correct Answer is D

Explanation

The nurse is caring for a newborn one hour after delivery.Which of the following assessment findings does the nurse identify as signs of respiratory distress? (Select all that apply)

Correct Answer is ["D","F","G","H"]

Explanation

A nurse is caring for a newborn and assessing newborn reflexes.To elicit the Babinski reflex, the nurse should take which of the following actions?

A nurse is caring for a newborn who was born at 39 weeks gestation and weighs 3350 g. Based on the weight and gestational age, what is the most appropriate way to document the findings?

A nurse in the newborn nursery is caring for a group of newborns.Which of the following newborns requires immediate intervention?

A nurse is completing a newborn assessment and notes small raised pearly white spots on the nose and chin.This finding is characteristic of which of the following?

The nursery nurse is receiving a report on her assigned 4 neonates.Which of the following conditions is high risk for unconjugated bilirubin and jaundice?

A nurse is assessing a newborn 1 hour after birth.Which of the following respiratory rates is within the expected reference range for a newborn?

A nurse is caring for a newborn delivered by vaginal birth after 3 hours of pushing.The newborn’s mother asks about the swollen area on her son’s head.After palpation and identification that the swelling does cross the suture line, which of the following is an appropriate response by the nurse?

A nurse is preparing to administer 1 mg Phytonadione to a neonate. The medication is available in 1 mg/0.5 mL. How much should the nurse administer? (Round to the nearest tenth. Use a leading zero when applicable. Do not use a trailing zero.)