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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 D

Explanation

Choice A rationale

Newborns are not born with fully developed immune responses. Their immune system is immature and continues to develop after birth. They rely on maternal antibodies for initial protection.

Choice B rationale

Newborns do not have a mature gut microbiome immediately after birth. The gut microbiome develops over time and is influenced by factors such as breastfeeding and exposure to the environment.

Choice C rationale

Newborns do not rely solely on their innate immune system. They receive passive immunity from maternal antibodies transferred through the placenta and colostrum, which provides initial protection against infections.

Choice D rationale

Newborns receive passive immunity through the placenta and colostrum, but their own immune system is not fully functional until several months of age. This passive immunity helps protect them from infections during the early months of life.

Correct Answer is ["A","B","C","E"]

Explanation

Choice A rationale

Sucking on their fingers is an early hunger cue in infants. It indicates that the baby is ready to feed.

Choice B rationale

Smacking their lips is another early hunger cue. It shows that the baby is thinking about feeding.

Choice C rationale

Extending their tongue is also an early hunger cue. It indicates that the baby is ready to latch onto the breast or bottle.

Choice D rationale

Crying is a late hunger cue. It is better to feed the baby before they start crying to make feeding easier.

Choice E rationale

Rooting is an early hunger cue. It involves the baby turning their head towards the breast or bottle, indicating they are ready to feed. .

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