After teaching an in-service program to a group of nurses working in newborn nursery about a neutral thermal environment, the nurse determines that the teaching was successful when the group identifies which process as the newborn's primary method of heat production?
nonshivering thermogenesis
cold stress
convection
bilirubin conjugation
The Correct Answer is A
A. Nonshivering thermogenesis is the primary method of heat production in newborns. Unlike adults, newborns do not generate heat through shivering. Instead, they rely on the metabolism of brown adipose tissue (brown fat) to produce heat. This process is triggered by exposure to cold and helps maintain body temperature.
B. Cold stress is a condition, not a heat production mechanism. It occurs when the newborn is exposed to cold temperatures, leading to increased oxygen and energy demands as the body attempts to produce heat — which can be dangerous.
C. Convection is a method of heat loss, not production. It occurs when heat is lost from the body surface to cooler surrounding air (e.g., drafts in the room).
D. Bilirubin conjugation is related to the liver's processing of bilirubin and has nothing to do with thermoregulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Short duration of labor is not typically associated with subinvolution. In fact, prolonged labor (not short) can be a risk factor due to increased uterine fatigue.
B. Use of anesthetics is correct. The use of certain anesthetics during labor, especially those that affect uterine tone (like general anesthesia or high doses of regional anesthesia), can contribute to uterine atony, which may lead to subinvolution—a condition where the uterus does not return to its normal size after childbirth.
C. Early ambulation actually promotes uterine involution and prevents complications like thrombophlebitis, making it a protective factor, not a contributing one.
D. Breastfeeding stimulates the release of oxytocin, which causes uterine contractions and promotes involution, making it a helpful factor in preventing subinvolution.
Correct Answer is C
Explanation
A. Two fingerbreadths above the umbilicus would be abnormal and may indicate uterine distension due to retained placental fragments or a full bladder, especially this long after delivery.
B. Two fingerbreadths below the umbilicus is typically expected 24 hours or more after delivery, not at 12 hours postpartum.
C. At the level of the umbilicus is normal and expected at about 12 hours postpartum. After delivery, the uterus rises slightly and is generally found at or near the umbilicus before it begins to descend (involute) by about 1 fingerbreadth per day.
D. Four fingerbreadths below the umbilicus would be expected several days postpartum, not within the first 12 hours.
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