Nursing Board Exam Bullets

• If the neonate is stable, the mother should be allowed to breast-feed within the neonate’s first hour of life.
• The nurse should check the neonate’s temperature every 1 to 2 hours until it’s maintained within normal limits.
• At birth, a neonate normally weighs 5 to 9 lb (2 to 4 kg), measures 18″ to 22″ (45.5 to 56 cm) in length, has a head circumference of 13½” to 14″ (34 to 35.5 cm), and has a chest circumference that’s 1″ (2.5 cm) less than the head circumference.
• In the neonate, temperature normally ranges from 98° to 99° F (36.7° to 37.2° C), apical pulse rate averages 120 to 160 beats/minute, and respirations are 40 to 60 breaths/minute.
• The diamond-shaped anterior fontanel usually closes between ages 12 and 18 months. The triangular posterior fontanel usually closes by age 2 months.
• In the neonate, a straight spine is normal. A tuft of hair over the spine is an abnormal finding.
• Prostaglandin gel may be applied to the vagina or cervix to ripen an unfavorable cervix before labor induction with oxytocin (Pitocin)
• Supernumerary nipples are occasionally seen on neonates. They usually appear along a line that runs from each axilla, through the normal nipple area, and to the groin.
• Meconium is a material that collects in the fetus’s intestines and forms the neonate’s first feces, which are black and tarry.
• The presence of meconium in the amniotic fluid during labor indicates possible fetal distress and the need to evaluate the neonate for meconium aspiration.
• To assess a neonate’s rooting reflex, the nurse touches a finger to the cheek or the corner of the mouth. Normally, the neonate turns his head toward the stimulus, opens his mouth, and searches for the stimulus.
• Harlequin sign is present when a neonate who is lying on his side appears red on the dependent side and pale on the upper side.
• Mongolian spots can range from brown to blue. Their color depends on how close melanocytes are to the surface of the skin. They most commonly appear as patches across the sacrum, buttocks, and legs.
• Mongolian spots are common in non-white infants and usually disappear by age 2 to 3 years.
• Vernix caseosa is a cheeselike substance that covers and protects the fetus’s skin in utero. It may be rubbed into the neonate’s skin or washed away in one or two baths.
• Caput succedaneum is edema that develops in and under the fetal scalp during labor and delivery. It resolves spontaneously and presents no danger to the neonate. The edema doesn’t cross the suture line.
• Nevus flammeus, or port-wine stain, is a diffuse pink to dark bluish red lesion on a neonate’s face or neck.
• The Guthrie test (a screening test for phenylketonuria) is most reliable if it’s done between the second and sixth days after birth and is performed after the neonate has ingested protein.
• To assess coordination of sucking and swallowing, the nurse should observe the neonate’s first breast-feeding or sterile water bottle-feeding.
• To establish a milk supply pattern, the mother should breast-feed her infant at least every 4 hours. During the first month, she should breast-feed 8 to 12 times daily (demand feeding).
• To avoid contact with blood and other body fluids, the nurse should wear gloves when handling the neonate until after the first bath is given.
• If a breast-fed infant is content, has good skin turgor, an adequate number of wet diapers, and normal weight gain, the mother’s milk supply is assumed to be adequate.
• In the supine position, a pregnant patient’s enlarged uterus impairs venous return from the lower half of the body to the heart, resulting in supine hypotensive syndrome, or inferior vena cava syndrome.
• Tocolytic agents used to treat preterm labor include terbutaline (Brethine), ritodrine (Yutopar), and magnesium sulfate.
• A pregnant woman who has hyperemesis gravidarum may require hospitalization to treat dehydration and starvation.
• Diaphragmatic hernia is one of the most urgent neonatal surgical emergencies. By compressing and displacing the lungs and heart, this disorder can cause respiratory distress shortly after birth.
• Common complications of early pregnancy (up to 20 weeks’ gestation) include fetal loss and serious threats to maternal health.
• Fetal embodiment is a maternal developmental task that occurs in the second trimester. During this stage, the mother may complain that she never gets to sleep because the fetus always gives her a thump when she tries.
• Visualization in pregnancy is a process in which the mother imagines what the child she’s carrying is like and becomes acquainted with it.
• Hemodilution of pregnancy is the increase in blood volume that occurs during pregnancy. The increased volume consists of plasma and causes an imbalance between the ratio of red blood cells to plasma and a resultant decrease in hematocrit.
• Mean arterial pressure of greater than 100 mm Hg after 20 weeks of pregnancy is considered hypertension.
• The treatment for supine hypotension syndrome (a condition that sometimes occurs in pregnancy) is to have the patient lie on her left side.
• A contributing factor in dependent edema in the pregnant patient is the increase of femoral venous pressure from 10 mm Hg (normal) to 18 mm Hg (high).

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