A nurse at a community health clinic is planning care for an adolescent who recently learned that she is pregnant and is concerned about her ability to afford and care for her baby. Which of the following actions should the nurse take?
Contact the adolescent’s parent for assistance.
Assist the adolescent in applying for Medicaid.
Refer the adolescent to a local mental health clinic.
Advise the adolescent to place the newborn for adoption.
The Correct Answer is B
The correct answer is B.
Assist the adolescent in applying for Medicaid.
This action demonstrates the nurse’s role as an advocate and a resource person for the client, who might be eligible for financial assistance and health care coverage during her pregnancy and postpartum period. Medicaid is a federal and state program that provides health insurance for low-income individuals and families.
Choice A is wrong because contacting the adolescent’s parent for assistance might violate the client’s confidentiality and autonomy, especially if the parent is not aware of or supportive of the pregnancy. The nurse should respect the client’s right to privacy and self-determination, unless there is a risk of harm to the client or the fetus.
Choice C is wrong because referring the adolescent to a local mental health clinic might imply that the client has a mental disorder or needs psychological counseling, which could be stigmatizing and discouraging.
The nurse should assess the client’s emotional state and coping skills, and provide supportive and nonjudgmental care. The nurse can also offer referrals to other community resources, such as prenatal education, parenting classes, or social services, that might benefit the client.
Choice D is wrong because advising the adolescent to place the newborn for adoption might interfere with the client’s decision-making process and personal values.
The nurse should not impose his or her own opinions or beliefs on the client, but rather explore the client’s feelings and preferences about her pregnancy options. The nurse should provide factual information and education about adoption, abortion, or parenting, and help the client weigh the benefits and risks of each option.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason
Administering naloxone to the newborn is not appropriate. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose in adults. It is not typically used for newborns with neonatal abstinence syndrome. The management of NAS is primarily supportive, and medications may be prescribed to help manage specific withdrawal symptoms, but naloxone is not a standard treatment for NAS.
Choice B reason:
Minimizing noise in the newborn's environment is a crucial action in the plan of care is the correct action to be included. Newborns experiencing NAS can be easily overstimulated, and loud noises can exacerbate their withdrawal symptoms and distress. Creating a calm and quiet environment helps reduce agitation and promotes better sleep and overall comfort.
Choice C reason
Swaddling the newborn with his leg extended is not appropriate in this case. Swaddling can be beneficial for some newborns, but the specific positioning and swaddling techniques should be individualized based on the newborn's needs and preferences. Extending the newborn's legs may not necessarily be the best approach, as it may not provide comfort or address the symptoms associated with NAS.
Choice D reason:
Maintaining eye contact with the newborn during feedings is not appropriate in this case. While maintaining eye contact during feedings is an essential aspect of bonding and promoting parent-newborn attachment, it may not be the primary focus in managing neonatal abstinence syndrome. The plan of care for a newborn with NAS would primarily involve managing withdrawal symptoms, providing comfort measures, and addressing the newborn's unique needs during this challenging period.
Correct Answer is C
Explanation
Choice A reason:
"This test will be repeated when your baby is 2 months old. “This is a false statement. Newborn genetic screening is usually performed shortly after birth. The test is not typically repeated when the baby is 2 months old, as it is meant to detect conditions early on, allowing for prompt intervention and management if necessary.
Choice B reason:
"Your baby will be given 2 ounces of water to drink prior to the test."This is a false statement. The baby does not need to drink water before the newborn genetic screening test. The test is usually performed by collecting a small blood sample from the baby's heel, and there is no need for the baby to drink water beforehand.
Choice C reason:
"This test should be performed after your baby is 24 hours old. “This is the appropriate statement. The nurse should include the statement that newborn genetic screening should be performed after the baby is 24 hours old. Newborn genetic screening, also known as newborn screening or heel prick test, is a standard test performed on newborns to detect certain genetic, metabolic, and congenital disorders early on. The test is typically done by pricking the baby's heel to collect a small sample of blood, which is then analysed in a laboratory.
Choice D reason:
"A nurse will draw blood from your baby's inner elbow. “This is a false statement. The correct location for collecting the blood sample for newborn genetic screening is the baby's heel. The nurse will prick the baby's heel to obtain a few drops of blood, which will then be collected on a special filter paper for laboratory analysis.
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