/*! This file is auto-generated */ .wp-block-button__link{color:#fff;background-color:#32373c;border-radius:9999px;box-shadow:none;text-decoration:none;padding:calc(.667em + 2px) calc(1.333em + 2px);font-size:1.125em}.wp-block-file__button{background:#32373c;color:#fff;text-decoration:none} Problem 788 The nurse is assessing a newborn... [FREE SOLUTION] | 91Ó°ÊÓ

91Ó°ÊÓ

The nurse is assessing a newborn. A sudden noise causes the newborn infant to extend and then flex the arms and fingers. The nurse would document this as a positive: A. Moro reflex B. Gag reflex C. Babinski reflex D. Tonic neck reflex

Short Answer

Expert verified
The nurse would document the newborn infant's reaction as a positive Moro reflex.

Step by step solution

01

Understand the Reflex Described

Recognize that the reflex behavior described is the infant's response to a sudden noise which involves extending and then flexing the arms and fingers.
02

Identify the Reflexes

Review and differentiate between the options given; Moro reflex, Gag reflex, Babinski reflex, and Tonic neck reflex, to identify which reflex corresponds to the response described in the question.
03

Match the Reflex to the Description

Determine that the Moro reflex is the correct answer as it is the reflex seen in infants where a sudden noise or loss of support causes them to extend their arms and legs, spread their fingers, and then retract their arms and legs.

Unlock Step-by-Step Solutions & Ace Your Exams!

  • Full Textbook Solutions

    Get detailed explanations and key concepts

  • Unlimited Al creation

    Al flashcards, explanations, exams and more...

  • Ads-free access

    To over 500 millions flashcards

  • Money-back guarantee

    We refund you if you fail your exam.

Over 30 million students worldwide already upgrade their learning with 91Ó°ÊÓ!

Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Moro Reflex
The Moro reflex, commonly known as the startle reflex, is an automatic response to a sudden change in sensory stimuli – like a loud noise or a sensation of falling. When infants exhibit the Moro reflex, their arms and legs abruptly extend outwards and then curl back in towards their body. It's an important indicator that the newborn's nervous system is developing appropriately.

For nurses and other healthcare professionals, understanding and identifying the Moro reflex is essential for assessing the neurological maturity and health of a newborn. A positive Moro reflex typically presents within the first few months of life and diminishes around 4 to 6 months of age. An absence or asymmetry of this reflex can indicate underlying neurological issues that may require further investigation.
Infant Reflex Response
Infant reflex responses are involuntary movements or actions that newborns automatically perform in response to certain stimuli. These reflexes are crucial for a health provider to assess because they can provide significant cues to the infant's central nervous system health and development stage.

Common reflexes observed in infants include:
  • The rooting reflex, where an infant turns their head toward a touch on the cheek, crucial for feeding.
  • The suckling reflex, which facilitates breastfeeding as the infant instinctively knows how to suck when the roof of their mouth is touched.
  • The grasp reflex, seen when the infant's palm curls around a finger when it's placed in their hand.
These reflexes are integral to a newborn's survival in the early stages of life but will gradually diminish as the child grows and starts to take voluntary control over their movements.
NCLEX-RN Examination Preparation
Preparing for the NCLEX-RN examination is a critical step for nursing graduates who wish to become licensed registered nurses. The exam assesses a candidate's competency to practice nursing at an entry-level and includes a variety of topics, including the assessment of newborn reflexes.

To prepare effectively, future nurses should:
  • Understand the format of the exam and the types of questions that will be asked.
  • Review nursing content comprehensively, with a focus on core subjects like pediatrics, obstetrics, and medical-surgical nursing.
  • Regularly take practice tests to become familiar with the question styles and rigor of the actual exam.
  • Develop test-taking strategies to manage time efficiently and to handle difficult questions or situations where they are unsure of the answer.
  • Study regularly and join study groups for collaborative learning and support.
Preparation typically involves a combination of book study, online resources, and NCLEX-RN review courses.

One App. One Place for Learning.

All the tools & learning materials you need for study success - in one app.

Get started for free

Most popular questions from this chapter

Which is a step in the assessment of jugular venous pressure? A. Assist the client to a right side lying position. B. Raise the head of the bed 10–15 degrees. C. Shine a light across the client’s neck. D. Measure the horizontal distance from the sternal angle to the meniscus of the internal jugular vein.

Which parameters would the nurse assess as part of a complete neurological assessment? (Mark all that apply.) ___ A. Deep tendon reflexes ___ B. Shape of the head ___ C. Cranial nerves ___ D. Sensory perception ___ E. Coordination ___ F. Skin ___ G. Heart

While visiting the area from another state, a client presents to the emergency room with severe pain secondary to a kidney stone. The physician orders an IV line started with \(125 \mathrm{ml}\) per hour of D5 \(1 / 4\) NS and morphine for pain. The client shows the nurse his chest where he states he has a Subcutaneous venous port and asks the nurse to start the IV there. Prior to starting an IV line in this port, the nurse would need to verify that the: A. Brand of subcutaneous port. B. Medications can be given by central line. C. Port internal tip lies in the superior vena cava. D. Intravenous fluids can be administered by central line.

Your client has an external fixator to the right lower extremity to stabilize an open fracture of the tibia and fibia with extensive soft tissue damage. The client is complaining of a tingling sensation in the foot. Which is the priority nursing action in response to the client's new complaint? A. Administer pain medication B. Assess pain level using a pain scale C. Notify physician of client's status D. Perform neurovascular assessment

A child has been diagnosed with scabies. In addition to washing the child with the prescribed medication, the nurse would instruct the mother to: A. wash all bed linens in hot soapy water. B. wash all fruits and vegetables before use. C. have the family's dog checked for evidence of infestation. D. discard all of the child's clothing and replace with new clothing.

See all solutions

Recommended explanations on Biology Textbooks

View all explanations

What do you think about this solution?

We value your feedback to improve our textbook solutions.

Study anywhere. Anytime. Across all devices.