ATI-MN ATI Maternal Newborn Exam - Set 5 - Part 2

Correct Answer: The vastus lateralis muscle

The vastus lateralis, the large muscle on the side of the thigh, is the preferred site for newborn intramuscular injections because it is well developed and away from major nerves. Option a is incorrect because the abdomen is not an intramuscular injection site for newborn medications. Option b is incorrect because the dorsogluteal site is avoided in young children because of nerve injury risk. Option c is incorrect because the deltoid is too small and underdeveloped in a newborn for this injection.

Correct Answer: Apply from the inner to outer eye

The nurse applies the ointment in a ribbon along the lower lid from the inner to the outer corner, which prevents serious eye infection from organisms encountered at birth. Option a is incorrect because rinsing removes the medication before it can protect the eyes. Option b is incorrect because applying from outer to inner spreads ointment away from the tear duct and is not the correct technique. Option d is incorrect because prophylaxis is given to all newborns, not only when infection is visible.

Correct Answer: Use the outer aspect of the heel

The nurse uses the outer aspect of the heel to avoid injuring underlying bone, and warming the heel first improves blood flow for the sample. Option b is incorrect because the site is pressed with dry gauze, since alcohol can prolong bleeding. Option c is incorrect because puncturing the center of the heel risks injuring the bone beneath. Option d is incorrect because a warm cloth, not a cold one, is applied first to increase blood flow.

Correct Answer: It screens for disorders like phenylketonuria

The newborn metabolic screen uses a heel-stick blood sample to check for inherited disorders such as phenylketonuria, so early treatment can prevent serious complications. Option a is incorrect because blood type is determined by a different blood test, not the metabolic screen. Option c is incorrect because hearing is checked with a separate newborn hearing screening, not the metabolic test. Option d is incorrect because heart defects are evaluated with pulse oximetry and other tests, not this screen.

Correct Answer: Every 15 to 30 minutes

The nurse checks the circumcision site frequently, about every fifteen to thirty minutes during the first hour, to catch bleeding early after the procedure. Option a is incorrect because a single check is not enough during the high-risk first hour. Option b is incorrect because every four hours is too infrequent to detect early bleeding after circumcision. Option c is incorrect because the site is assessed on a schedule, not only when the diaper is soiled.

Correct Answer: Apply petroleum jelly to the site

For a clamp circumcision, applying petroleum jelly keeps the diaper from sticking and protects the healing site, and a yellowish film that forms is normal and left in place. Option a is incorrect because scrubbing with soap irritates the healing site; warm water is used gently. Option b is incorrect because tub baths are delayed until the site heals, with gentle water trickling used instead. Option d is incorrect because the yellowish film is part of healing and should not be removed.

Correct Answer: Notify the provider before the procedure

Circumcision is contraindicated with hypospadias because the foreskin may be needed for later surgical repair, so the nurse notifies the provider before proceeding. Option b is incorrect because proceeding could remove tissue needed to repair the defect later. Option c is incorrect because numbing cream does not change the contraindication to the procedure. Option d is incorrect because rescheduling does not address that circumcision should not be done with this condition.

Correct Answer: About 8 to 12 times in 24 hours

A breastfed newborn feeds about eight to twelve times in twenty-four hours, roughly every two to three hours, which supports milk supply and adequate intake. Option a is incorrect because only three feedings a day is far too few for a newborn's needs. Option c is incorrect because every six hours is too infrequent and can reduce milk supply and intake. Option d is incorrect because crying is a late hunger cue; feeding follows early cues and a regular pattern.

Correct Answer: The newborn takes in much of the areola

A correct latch has the newborn taking in much of the areola, not just the nipple, which allows effective milk transfer and prevents nipple soreness. Option a is incorrect because ongoing sharp pain signals a poor latch rather than a correct one. Option b is incorrect because sucking only the nipple tip is a poor latch that causes pain and limits milk flow. Option d is incorrect because clicking sounds suggest the newborn is losing suction and is not latched well.

Correct Answer: Six to eight wet diapers a day

About six to eight wet diapers a day, along with steady weight gain and contentment between feeds, indicates the breastfed newborn is getting enough milk. Option a is incorrect because constant crying after feeds can signal the newborn is still hungry, not well fed. Option b is incorrect because only one wet diaper a day suggests inadequate intake. Option c is incorrect because a week without stools is abnormal for a breastfed newborn and needs evaluation.

Correct Answer: Insert a clean finger into the mouth corner

Slipping a clean finger into the corner of the newborn's mouth breaks the suction gently, which protects the nipple from trauma when ending the feeding. Option b is incorrect because pinching the nose can frighten the newborn and does not properly break suction. Option c is incorrect because pressing firmly on the chin does not safely release the suction. Option d is incorrect because pulling the newborn off while latched can injure the nipple.

Correct Answer: Thaw frozen milk in the refrigerator

Frozen breast milk is thawed in the refrigerator to preserve its protective factors, and it is gently swirled rather than shaken before feeding. Option a is incorrect because microwaving destroys protective factors and creates hot spots that can burn the newborn. Option c is incorrect because vigorous shaking can damage components of the milk; gentle swirling is used. Option d is incorrect because thawed milk should not be refrozen, as this lowers quality and safety.

Correct Answer: Breastfed newborns need vitamin D drops

Breast milk is low in vitamin D, so breastfed and partially breastfed newborns receive a daily vitamin D supplement to support bone development. Option a is incorrect because breast milk does not provide enough vitamin D, which is why a supplement is given. Option b is incorrect because the recommended vitamin D supplement is beneficial, not harmful. Option d is incorrect because the supplement is given daily year-round, not only in winter.

Correct Answer: Hold the newborn semi-upright to feed

The parent holds the newborn in a semi-upright position and keeps the nipple full of formula, which lowers the risk of choking and reduces swallowed air. Option a is incorrect because propping the bottle increases the risk of choking and ear infections. Option b is incorrect because feeding a newborn lying flat raises the risk of aspiration. Option c is incorrect because leftover formula is discarded, since it can grow bacteria after feeding.

Correct Answer: Place the newborn on the back to sleep

Placing the newborn on the back to sleep on a firm surface with nothing soft in the crib lowers the risk of sudden infant death. Option a is incorrect because pillows and other soft items raise the risk of suffocation and are kept out of the crib. Option c is incorrect because bumper pads are a suffocation hazard and are not used. Option d is incorrect because stomach sleeping increases the risk of sudden infant death.

Correct Answer: Use a rear-facing seat in the back

The newborn rides in a rear-facing car seat secured in the back seat, which provides the safest protection in the event of a crash. Option b is incorrect because the car seat is used for every trip, no matter how short. Option c is incorrect because the front seat exposes the newborn to airbag injury and is unsafe. Option d is incorrect because a forward-facing seat does not protect a newborn's head and neck properly.

Correct Answer: Keep the cord clean and dry

The cord is kept clean and dry with the diaper folded below it, and sponge baths are used until the cord falls off, which usually happens within two weeks. Option a is incorrect because a tight wrap traps moisture and can promote infection. Option b is incorrect because lotion adds moisture, which can delay drying and increase infection risk. Option d is incorrect because tub baths are avoided until the cord falls off to keep the area dry.

Correct Answer: A temperature above the expected range

A temperature above the expected range can signal infection, so parents are taught to report it along with poor feeding, lethargy, or labored breathing. Option a is incorrect because yellow seedy stools are expected in a breastfed newborn. Option b is incorrect because six wet diapers a day is a normal sign of adequate intake. Option c is incorrect because brief hiccups after feeding are common and harmless.

Correct Answer: Wipe from the inner to the outer corner

The nurse cleans each eye from the inner to the outer corner using a clean section of the cloth for each eye, which prevents spreading bacteria. Option a is incorrect because soap irritates the eyes and is not used for cleaning them. Option b is incorrect because using the same cloth area can spread organisms from one eye to the other. Option d is incorrect because wiping toward the inner corner can push debris toward the tear duct.

Correct Answer: Check the blood glucose level

Jitteriness and poor feeding can signal low blood glucose, so the nurse first checks the blood glucose level to confirm and guide prompt treatment. Option b is incorrect because swaddling and waiting delays identifying and correcting the low glucose. Option c is incorrect because cooling adds stress and lowers glucose further rather than helping. Option d is incorrect because withholding feeding worsens low glucose; feeding is part of treatment.