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A nurse is caring for a newborn and assessing newborn reflexes. To elicit the Babinski reflex, the nurse should take which of the following actions?

A.

Tickle the outer edge of the sole of the newborn’s foot moving up toward the toes.

B.

Turn the newborn’s head quickly to one side.

C.

Hold the newborn vertically allowing one foot to touch the table surface.

D.

Clap near the crib and make a loud noise.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

The Babinski reflex is elicited by stroking the outer edge of the sole of the newborn’s foot, moving up toward the toes. This causes the big toe to move upward and the other toes to fan out.

 

Choice B rationale

 

Turning the newborn’s head quickly to one side is used to elicit the tonic neck reflex, not the Babinski reflex.

 

Choice C rationale

 

Holding the newborn vertically and allowing one foot to touch the table surface is used to elicit the stepping reflex, not the Babinski reflex.

 

Choice D rationale

 

Clapping near the crib and making a loud noise is used to elicit the startle (Moro) reflex, not the Babinski reflex.


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Correct Answer is A

Explanation

Choice A rationale

Given the neonate’s symptoms and critically low blood glucose level (30 mg/dL), the most urgent action is to address the hypoglycemia. Therefore, the nurse shouldadminister a bolus of intravenous glucose (Option A). This immediate intervention is crucial to stabilize the neonate and prevent further complications associated with hypoglycemia.

Choice B rationale

While monitoring blood glucose levels is important, waiting 30 minutes to reassess without immediate intervention could allow the hypoglycemia to worsen, potentially leading to severe complications such as seizures or brain damage. Immediate treatment is necessary to stabilize the neonate.

Choice C rationale

Although feeding can help increase blood glucose levels, the neonate’s current symptoms (jitteriness, poor feeding, weak cry, and irritability) suggest that they may not be able to effectively feed. Additionally, the blood glucose level is critically low and requires more rapid correction than feeding alone can provide.

Choice D rationale

While maintaining an appropriate body temperature is important, the neonate’s temperature (36.1°C) is not critically low. The primary concern here is the hypoglycemia, which needs to be addressed immediately. Placing the neonate under a radiant warmer does not directly address the low blood glucose level.

Correct Answer is B

Explanation

Choice A rationale

Erythema toxicum is a common, benign rash seen in newborns. It appears as red patches with small white or yellow pustules in the center. It is not characterized by small raised pearly white spots on the nose and chin.

Choice B rationale

Milia spots are small raised pearly white spots that commonly appear on the nose, chin, and cheeks of newborns. They are caused by trapped keratin and are harmless, usually resolving on their own within a few weeks.

Choice C rationale

Mongolian spots are flat, blue-gray patches commonly found on the lower back and buttocks of newborns, especially those with darker skin. They are not raised and do not appear on the nose and chin.

Choice D rationale

Epstein’s pearls are small white or yellow cysts found on the gums or roof of the mouth in newborns. They are not found on the nose and chin. .

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