A newborn in the nursery is exhibiting signs of intrauterine drug exposure. Which of the following signs/symptoms is the nurse observing? (Select all that apply)
Calm, easy to comfort
Tremors
Persistent shrill cry
Difficult to console
Correct Answer : B,C,D
Choice A) Calm, easy to comfort is incorrect because this is not a sign of intrauterine drug exposure, but rather a sign of normal or healthy newborn behavior. Newborns who are calm and easy to comfort are usually well-adjusted and have a good temperament. They respond positively to soothing techniques such as holding, rocking, or singing.
They do not show signs of distress or withdrawal, which are common in newborns who are exposed to drugs in utero. Therefore, this response is irrelevant and inaccurate.
Choice B) Tremors is correct because this is a sign of intrauterine drug exposure that can indicate neurological damage or withdrawal syndrome. Tremors are involuntary shaking or quivering movements of the body or limbs that occur due to abnormal electrical activity in the brain or nervous system. Newborns who are exposed to drugs such as opioids, cocaine, or alcohol in utero may develop tremors as a result of brain injury, hypoxia, hypoglycemia, or seizures. They may also experience tremors as a symptom of neonatal abstinence syndrome (NAS), which is a condition that occurs when the newborn stops receiving the drug from the mother and goes through withdrawal. NAS can cause various physical and behavioral problems in the newborn, such as irritability, poor feeding, vomiting, diarrhea, sweating, fever, or seizures. Therefore, this response is clear and accurate.
Choice C) Persistent shrill cry is correct because this is a sign of intrauterine drug exposure that can indicate pain or discomfort in the newborn. Crying is a normal and natural way for newborns to communicate their needs and feelings. However, some newborns who are exposed to drugs such as opioids, cocaine, or alcohol in utero may cry more often, louder, or longer than usual. They may have a high-pitched or piercing cry that is difficult to soothe or stop. This may be due to various factors such as hunger, colic, infection, injury, or withdrawal. A persistent shrill cry can also affect the bonding and attachment between the newborn and the parents or caregivers. Therefore, this response is clear and accurate.
Choice D) Difficult to console is correct because this is a sign of intrauterine drug exposure that can indicate emotional or behavioral problems in the newborn. Newborns who are difficult to console are usually unhappy and restless. They do not respond well to soothing techniques such as holding, rocking, or singing. They may have trouble sleeping, feeding, or interacting with others. They may also show signs of agitation, anxiety, or depression. These problems may be caused by exposure to drugs such as opioids, cocaine, or alcohol in utero, which can affect the development and function of the brain and nervous system. They may also be influenced by the environment and relationship of the newborn with the parents or caregivers. Therefore, this response is clear and accurate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A) Placenta previa is incorrect because this is not a likely complication for a client who has gestational hypertension and reports continuous abdominal pain and vaginal bleeding. Placenta previa is a condition where the placenta covers part or all of the cervix, preventing normal delivery. It can cause painless, bright red bleeding in the third trimester, especially after intercourse or a pelvic exam. However, it does not cause abdominal pain, as the bleeding is not associated with uterine contractions or separation. Moreover, it is not related to gestational hypertension, which is a condition that causes high blood pressure during pregnancy. Therefore, this response is irrelevant and inaccurate.
Choice B) Incompetent cervix is incorrect because this is not a possible complication for a client who is at 36 weeks of gestation and has gestational hypertension and reports continuous abdominal pain and vaginal bleeding.
Incompetent cervix is a condition where the cervix is weak and unable to hold the pregnancy, leading to premature dilation and delivery. It can cause painless, watery vaginal discharge or spotting in the second trimester, followed by rupture of membranes and labor. However, it does not cause abdominal pain or heavy bleeding, as the cervix does not tear or detach from the uterus. Moreover, it is not related to gestational hypertension, which is a condition that causes high blood pressure during pregnancy. Therefore, this response is irrelevant and inaccurate.
Choice C) Prolapsed cord is incorrect because this is not a common complication for a client who has gestational hypertension and reports continuous abdominal pain and vaginal bleeding. Prolapsed cord is a condition where the umbilical cord slips through the cervix and into the vagina before the baby, compressing the cord and cutting off the blood supply and oxygen to the baby. It can cause variable or prolonged fetal heart rate decelerations, visible or palpable cord in the vagina, or fetal distress. However, it does not cause abdominal pain or bleeding, as the cord does not rupture or bleed. Moreover, it is not related to gestational hypertension, which is a condition that causes high blood pressure during pregnancy. Therefore, this response is irrelevant and inaccurate.
Choice D) Abruptio placentae is correct because this is a probable complication for a client who has gestational hypertension and reports continuous abdominal pain and vaginal bleeding. Abruptio placentae is a condition where the placenta separates from the uterine wall before delivery, causing hemorrhage and hypoxia for the mother and the baby. It can cause severe, constant abdominal pain, dark red bleeding, uterine tenderness or rigidity, fetal distress or demise, or maternal shock or coagulopathy. It can be triggered by gestational hypertension, which is a condition that causes high blood pressure during pregnancy and increases the risk of placental abruption by 25%. Therefore, this response is relevant and accurate.
Correct Answer is D
Explanation
Choice a) A phase of the female menstrual cycle that involves the release of an egg (ovum) from one of the ovaries is incorrect because this is not the definition of Mittelschmerz, but rather the definition of ovulation. Ovulation is the process by which one or more eggs are released from the ovaries and travel to the fallopian tubes, where they can be fertilized by sperm. Ovulation usually occurs around the middle of the menstrual cycle, which is typically 28 days long, but can vary from person to person. Ovulation can be detected by changes in basal body temperature, cervical mucus, or hormone levels. Therefore, this response is inaccurate and misleading.
Choice B) A female reproductive organ in which ova or eggs are produced is incorrect because this is not the definition of Mittelschmerz, but rather the definition of ovary. The ovary is a paired organ that is located on either side of the uterus in the lower abdomen. The ovary contains thousands of follicles, which are sacs that contain immature eggs. Each month, one or more follicles mature and release an egg during ovulation. The ovary also produces hormones such as estrogen and progesterone, which regulate the menstrual cycle and pregnancy. Therefore, this response is irrelevant and inaccurate.
Choice C) The regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina is incorrect because this is not the definition of Mittelschmerz, but rather the definition of menstruation. Menstruation is the process by which the endometrium, which is the tissue that lines the uterus and prepares for implantation of a fertilized egg, is shed and expelled through the vagina if pregnancy does not occur. Menstruation usually occurs once a month and lasts for about 3 to 7 days, but can vary from person to person. Menstruation can be accompanied by symptoms such as cramps, bloating, mood swings, or headaches. Therefore, this response is irrelevant and inaccurate.
Choice D) One-sided, lower belly pain associated with normal ovulation. Usually occurs about 14 days before the next menstrual period is correct because this is the definition of Mittelschmerz. Mittelschmerz is a German word that means "middle pain". It refers to a mild to moderate pain or discomfort that some women experience in their lower abdomen around the time of ovulation. The pain may last for a few minutes to a few hours and may switch sides from month to month depending on which ovary releases an egg. The pain may be caused by irritation or stretching of the ovarian or abdominal wall by the maturing follicle or by fluid or blood released during ovulation.
Mittelschmerz is not a sign of any disease or problem and does not require any treatment. However, it can be confused with other conditions that cause pelvic pain, such as appendicitis, ectopic pregnancy, or ovarian cysts. Therefore, women who have severe or persistent pain should consult their doctor for diagnosis and treatment. Therefore, this response is clear and accurate.
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