A newborn was admitted to the hospital with vomiting and dehydration. The newborn's heart rate is 170, respiratory rate is 44, blood p 85/52, and temperature is 99 Degree F (37.2 Degree C). What is the nurse's best response to the parents who ask if the vital signs are normal?
"The blood pressure is elevated, but the other vital signs are within normal limits”
"The heart rate is elevated, but the other vital signs are within normal limits"
"The temperature is elevated, but the other vital signs are within normal limits"
“The respiratory rate is elevated, but the other vital signs are within normal limits"
The Correct Answer is B
While the newborn's heart rate of 170 bpm is elevated, the respiratory rate of 44 breaths/min, blood pressure of 85/52 mmHg, and temperature of 99°F (37.2°C) are within the normal range for a newborn.
It is important for the nurse to explain to the parents that the newborn's heart rate may be elevated due to the vomiting and dehydration and that healthcare providers will monitor the vital signs closely to ensure the newborn's stability.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
The influenza LAV is typically produced using egg-based methods, which may pose a risk for individuals with an allergy to eggs. Although the risk of a severe allergic reaction to the influenza vaccine is low, it is recommended to avoid the influenza LAV in individuals with a known severe allergy to eggs. Inactivated poliovirus (PV), Haemophilus influenza type b (Hib), and Hepatitis (Hepi) vaccines do not contain egg proteins and can generally be safely administered to individuals with an egg allergy.
Correct Answer is A
Explanation
The nurse should include information that growth spurts in height occur toward the end of mid puberty. Gynecomastia is not a common change in boys during puberty, but it might occur in some cases. Changes in the voice and pubic hair growth signal the beginning of puberty. If scrotal changes have not occurred by the age of 14 years, puberty might be considered delayed.
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