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
Related Questions
Correct Answer is D
Explanation
DDH refers to an abnormal development or alignment of the hip joint, which can lead to instability or dislocation of the hip. An asymmetric thigh fold is a common physical finding in DDH, where there is a difference in the skin fold between the affected and unaffected sides of the thigh. This occurs due to the malposition or displacement of the femoral head within the acetabulum.
While other findings may also be present in DDH, such as an inwardly turned foot on the affected side (also known as a positive Ortolani or Barlow test), absent plantar reflexes, or a lengthened thigh on the affected side, the asymmetric thigh fold is a key indicator of hip dysplasia in a newborn.
Correct Answer is D
Explanation
At this age, children have developed the physical coordination and balance necessary to navigate stairs with more control and safety. They may still require support from holding onto the railing for added stability and security. As children grow older, they continue to refine their motor skills, balance, and coordination, and by the age of 4, 5, and 6 years, they typically demonstrate more advanced stair-descending skills, such as alternating feet and using the railing less for support.
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