A nurse in the newborn nursery is collecting data about a newborn's Moro reﬂex. Which of the following actions should the nurse take to elicit this reﬂex?

Turn the newborn's head quickly to one side while they are sleeping.

Place a finger in the newborn's palm.

Clap hands after laying the newborn on a ﬂat surface.

Hold the newborn upright with one foot touching the crib surface.

Answer and Explanation

The Correct Answer is C

To elicit the Moro reﬂex, the nurse should clap hands after laying the newborn on a ﬂat surface. The Moro reﬂex, also known as the startle reﬂex, is an involuntary motor response that infants develop shortly after birth. Loud noises and sudden movements can trigger a baby’s Moro reﬂex.

Option a is incorrect because turning the newborn's head quickly to one side while they are sleeping may not elicit the Moro reﬂex.

Option b is incorrect because placing a finger in the newborn's palm may elicit the grasp reﬂex, not the Moro reﬂex.

Option d is incorrect because holding the newborn upright with one foot touching the crib surface may not elicit the Moro reﬂex.

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Correct Answer is B

Explanation

b. Migraines with aura.

Explanation:

Migraines with aura are considered a contraindication to the use of oral contraceptives. Auras are neurological symptoms that occur before or during migraines and can include visual disturbances, sensory changes, or speech difficulties. Women who experience migraines with aura have an increased risk of ischemic stroke when taking oral contraceptives. Therefore, it is important to identify this condition as a contraindication and explore alternative contraceptive options for the client.

The other options (a. History of renal calculus, c. BMI of 25, d. History of cholecystectomy) are not contraindications to the use of oral contraceptives.

A. Encourage strength-training exercise. B. Increase the client's fluids to 4 L per day. C. Increase protein in the diet. D. Encourage the client to have continual bed rest.

Correct Answer is C

Explanation

Answer: C

Rationale:

A) Encourage strength-training exercise: Strength-training exercises can be beneficial in building muscle mass and improving overall strength. However, for a client with leukemia experiencing chronic fatigue, this may be too strenuous and could exacerbate their fatigue rather than alleviate it. It is better to encourage light to moderate activities based on their tolerance.

B) Increase the client's fluids to 4 L per day: While adequate hydration is important, increasing fluids to 4 L per day may not be suitable for all clients and could pose risks, particularly if there are concerns about fluid balance or renal function. This recommendation should be tailored to the client's specific needs and medical condition.

C) Increase protein in the diet: Increasing protein in the diet can help improve energy levels and support the body's repair and regeneration processes. For clients with leukemia who are experiencing chronic fatigue, a high-protein diet can aid in maintaining muscle mass and overall nutritional status, helping to combat fatigue.

D) Encourage the client to have continual bed rest: Encouraging continual bed rest can lead to deconditioning and further exacerbate fatigue. It is important to balance rest with periods of gentle activity to maintain some level of physical function and avoid complications such as muscle atrophy or deep vein thrombosis.

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A nurse in the newborn nursery is collecting data about a newborn's Moro reﬂex. Which of the following actions should the nurse take to elicit this reﬂex?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a client who is requesting an oral contraceptive. Which of the following findings should the nurse identify as a contraindication to the use of oral contraceptives?

Correct Answer is B

Explanation

A nurse is contributing to the plan of care for a client who has leukemia and is experiencing chronic fatigue. Which of the following interventions should the nurse plan to include?

Correct Answer is C

Explanation

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