NCLEX-PN › Infant and Postpartum Care
How long with the umbilical cord stump generally remain on a newborn?
2-3 weeks
1 week
2-5 days
4 weeks
The stump of the umbilical cord will generally remain for 2-3 weeks after delivery. During that time the stump's coloration will change from blue to black as it dries. Eventually it will fall off much like a healing scab, leaving behind the umbilicus (navel).
Which of the following might be signs of an umbilical cord stump infection?
Pus and swelling around the umbilicus
Blackening of the umbilical cord stump
Bleeding as the stump falls off
Frequent crying
An umbilical cord stump will normally turn black and may bleed slightly when it falls off. These are not signs of infection. If, however, there is pus or swelling around the umbilicus, this may be signs of infection and should be further evaluated by a pediatrician. Newborns cry for many different reasons - this is not necessarily a sign of physical illness or infection.
By five months of age, what change would be expected in an infant's weight?
Double
Triple
Increase by at least 50%
Increase by at least 70%
An infant would be expected to double it's birth weight by five months. Some infants may double their birth weight by three to four months. An infant that has surpassed five months without approaching twice their birth weight may need to be evaluated for feeding difficulties or failure to thrive.
A young couple presents to a clinic with a seven year old who has varicella (chicken pox). The child is not in any distress and the virus seems to be progressing normally. They are concerned, however, because one of them is currently pregnant with their second child. They are at 31 weeks of gestation. The carrying mother had chicken pox when she was 2 years old. They ask the nurse if they should be concerned for the health of the unborn child. Which of the following is the most appropriate response?
There is no need for concern
There is mild need for concern - fetal monitoring is recommended
The mother should not be in contact with the 7 year old till the last lesion is scabbed over
Frequent hand washing is recommended to prevent passing of the viral load to the fetus
As long as the carrying mother has had varicella, she will be able to pass the antibodies to the virus through the placenta to the unborn child. This will confer passive immunity to the fetus. This immunity lasts for the first few months after birth, so newborns delivered by mothers with immunity to varicella will remain immune for some time even after delivery. Increased immunity to this and other pathogens is conferred by breast milk, which contains maternal antibodies (mostly IgA).
What is a normal heart rate for a newborn two hours postpartum?
110-160 bpm
60-90 bpm
80-110 bpm
140-190 bpm
A newborn's heart rate is significantly higher than that of an adult. Normal heart rate for a newborn two hours postpartum is 110-160 beats per minute. Heart rate decreases in the first year of life to 80-140 beats per minute.
At what age does an infant develop the grasping response?
0-3 months
3-4 months
4-6 months
6-8 months
The grasping reflex is the earliest reflex developed by the infant. It is often present at birth: the infant will grasp at objects such as a finger placed into their open palm.
At what age will an infant develop an inferior pincer grasp?
6-9 months
2-4 months
4-5 months
9-12 months
The inferior pincer grasp is the ability to pick up small objects such as by resting the forearm on a surface and pinching using the sides of the thumb and the index finger. It is an important milestone in the development of fine motor skills.
Which of the following behaviors would be under the category "grimace" in the APGAR score?
All of these
Pulling away
Sneezing
Coughing
The "grimace" category of the APGAR score actually refers to a wide variety of reflexive behavior. These include sneezing and coughing, crying on stimulation, pulling away, and facial expression.
At what time does molding (the elongation of the baby's head as it passes through the birth canal) resolve in a newborn?
1-5 days
10-14 days
2-3 weeks
Less than 24 hours
Molding, or the elongation of the infants head during labor and delivery, is a normal adaptation allowing the relatively large skull to traverse the narrow space of the birth canal. It generally resolves in 1-5 days.
At what age does an infant learn object permanence?
5-6 months
2-4 months
3-5 months
6-8 months
Object permanence is the understanding that an object still exists even when it can not be seen, heard, or touched. It is often tested by placing an object on a surface, then covering that object and allowing the infant to attempt to uncover it, thus demonstrating a knowledge that the object remains present though it is hidden.