A nurse is assessing a newborn who has hypoglycemia due to perinatal asphyxia.
Which of the following findings should the nurse expect? (Select all that apply.)
Irregular respirations
Cyanosis
Apnea
Eye-rolling
Lethargy
Correct Answer : A,C,D,E
The correct answer is choice A, C, D, and E. Hypoglycemia due to perinatal asphyxia can cause various neurological signs in the newborn, such as irregular respirations, apnea, eye-rolling, and lethargy.
These signs indicate inadequate oxygenation and glucose delivery to the brain. Cyanosis is not a specific sign of hypoglycemia, but rather a sign of poor oxygenation that can occur due to other causes.
Therefore, choice B is wrong.
Choice A is correct because irregular respirations can result from hypoglycemia due to perinatal asphyxia. Hypoglycemia can impair the respiratory center in the brainstem and cause irregular breathing patterns.
Choice C is correct because apnea can result from hypoglycemia due to perinatal asphyxia.
Apnea is defined as a pause in breathing
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A.Factor II, also known as prothrombin, is one of the coagulation factors that are activated by vitamin K.Vitamin K is a cofactor for the carboxylation of specific glutamic acid groups in coagulation factors II, VII, IX, and X.
This process is essential for the activation of these factors in the coagulation cascade.
Choice B is wrong because factor V is not a vitamin K-dependent coagulation factor.
Factor V is activated by thrombin and acts as a cofactor for factor Xa in the conversion of prothrombin to thrombin.
Choice C is wrong because factor VIII is not a vitamin K-dependent coagulation factor.
Factor VIII is activated by thrombin and acts as a cofactor for factor IXa in the activation of factor X.
Choice D is wrong because factor XI is not a vitamin K-dependent coagulation factor.
Factor XI is activated by factor XIIa and activates factor IX in the intrinsic pathway of coagulation.
Normal ranges for coagulation factors are:
• Factor II: 70-120% of normal activity
• Factor V: 50-150% of normal activity
• Factor VIII: 50-150% of normal activity
• Factor IX: 50-150% of normal activity
• Factor X: 70-140% of normal activity
• Factor XI: 70-150% of normal activity
Correct Answer is C
Explanation
The correct answer is choice C. Nasal flaring and grunting are signs of respiratory distress in a newborn and should alert the nurse to a potential problem.
The nurse should monitor the newborn’s respiratory rate, oxygen saturation, and chest movements, and notify the provider if the symptoms persist or worsen.
Choice A is wrong because molding of the head is a normal finding in a newborn who was delivered vaginally.
It is caused by the pressure of the birth canal on the skull bones and usually resolves within a few days.
Choice B is wrong because acrocyanosis of hands and feet is a normal finding in a newborn during the first 24 hours of life.
It is caused by poor peripheral circulation and does not indicate hypoxia or cyanosis.
Choice D is wrong because vernix caseosa on skin folds is a normal finding in a newborn.
It is a white, cheesy substance that protects the skin from amniotic fluid and helps with thermoregulation.
It usually disappears within a few days.
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