A nurse in a newborn nursery is receiving change-of-shift report for four newborns.
Which of the following newborns should the nurse assess first?

A newborn who is 24 hr old and has not had a meconium stool.

A newborn who has a short frenulum and is having difficulty breastfeeding.

A newborn who is 10 hr old and has onset tachypnea.

A newborn who is 30 hr old and has blood-tinged discharge in her diaper.

Answer and Explanation

The Correct Answer is C

A newborn who is 10 hr old and has onset tachypnea.
Tachypnea means rapid breathing and can be a sign of respiratory distress.
Transient tachypnea of the newborn (TTN) is a respiratory disorder usually seen shortly after delivery in babies who are born near or at term.
It is important for the nurse to assess this newborn ﬁrst to determine the cause of the tachypnea and provide appropriate care.

Choice A, a newborn who is 24 hr old and has not had a meconium stool, may
require further assessment but is not as urgent as a newborn with tachypnea.
Choice B, a newborn who has a short frenulum and is having difficulty breastfeeding, may require assistance with feeding but is not as urgent as a newborn with tachypnea.
Choice D, a newborn who is 30 hr old and has blood-tinged discharge in her diaper, may have pseudomenstruation which is normal and not a cause for concern.

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Correct Answer is C

Explanation

“This medication prevents seizures.” Magnesium sulfate is a mineral that is given intravenously to women with preeclampsia to reduce the risk of seizures or eclampsia.

Preeclampsia is a condition of high blood pressure and protein in the urine during pregnancy.

Choice A is incorrect because magnesium sulfate does not stabilize the fetal heart rate.

Choice B is incorrect because magnesium sulfate does not improve tissue perfusion.

Choice D is incorrect because magnesium sulfate does not increase cardiac output.

A. The newborn's respiratory rate is 32/min. B. The newborn's respiratory rate is irregular. C. The newborn is beginning to cough. D. The newborn's pulse oximetry is 91. E. None of the above

Correct Answer is E

Explanation

None of the choices provided indicate that suctioning of the nasopharynx is needed for a newborn.

Nasopharyngeal suctioning is performed to remove mucus or saliva from the back of the throat when a newborn is unable to cough or swallow. It is commonly used in infants with bronchiolitis.

Choice A, “The newborn’s respiratory rate is 32/min,” is not an answer because a respiratory rate of 32/min is within the normal range for a newborn.

Choice B, “The newborn’s respiratory rate is irregular,” is not an answer because irregular breathing paterns are common in newborns.

Choice C, “The newborn is beginning to cough,” is not an answer because coughing is a normal reﬂex that helps clear the airway.

Choice D, “The newborn’s pulse oximetry is 91,” is not an answer because pulse oximetry measures oxygen saturation and does not indicate the need for nasopharyngeal suctioning.

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A nurse in a newborn nursery is receiving change-of-shift report for four newborns. Which of the following newborns should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching about the expected eﬀects of magnesium sulfate to a client who is at 28 weeks of gestation and has preeclampsia. Which of the following responses by the nurse is appropriate?

Correct Answer is C

Explanation

A nurse is caring for a newborn. Which of the following assessment findings should indicate to the nurse that suctioning of the nasopharynx is needed?

Correct Answer is E

Explanation

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A nurse in a newborn nursery is receiving change-of-shift report for four newborns.
Which of the following newborns should the nurse assess first?