A nurse is assessing a newborn who is 48 hr old and has a maternal history of methadone use during pregnancy. Which of the following manifestations should the nurse identify as an indication of neonatal abstinence syndrome?

Hyporeactivity.

Excessive high-pitched cry.

Acrocyanosis.

Respiratory rate of 50/min.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Hyporeactivity, or reduced responsiveness to stimuli, is not typically associated with neonatal abstinence syndrome (NAS) NAS is characterized by increased irritability and not reduced activity.

Choice B rationale:

An excessive high-pitched cry is a common manifestation of neonatal abstinence syndrome. Infants exposed to substances like methadone during pregnancy may experience heightened sensitivity and exhibit a high-pitched cry as a sign of withdrawal.

Choice C rationale:

Acrocyanosis, a bluish discoloration of the hands and feet, is not a specific indicator of neonatal abstinence syndrome. It is a common finding in newborns and often resolves on its own.

Choice D rationale:

A respiratory rate of 50/min is within the normal range for a newborn. It is not an indication of neonatal abstinence syndrome.

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Correct Answer is A

Explanation

Choice A rationale:

This is the correct choice. The American Academy of Pediatrics (AAP) recommends keeping children in a rear-facing car seat until they reach the age of 2 or until they reach the maximum weight and height allowed by the car seat's manufacturer. This is because rear- facing seats provide better support for a baby's head, neck, and spine during a crash, reducing the risk of injury.

Choice B rationale:

Placing the retainer clip over the upper part of the baby's abdomen is incorrect and potentially dangerous. The retainer clip should be positioned at armpit level to secure the harness straps properly.

Choice C rationale:

Placing the baby in the car seat at a 90-degree angle is not necessary. The car seat should be installed according to the manufacturer's instructions, and the angle will vary based on the specific car seat model.

Choice D rationale:

Placing the shoulder harness straps in the slots an inch above the baby's shoulders is incorrect. The straps should be positioned at or below the baby's shoulders for rear-facing car seats and at or above the shoulders for forward-facing seats.

A. Cold stress. B. Respiratory depression. C. Thermogenesis. D. Tachycardia.

Correct Answer is A

Explanation

Choice A rationale:

Placing the newborn under a radiant heat warmer is used to prevent cold stress. Newborns are at risk of losing body heat rapidly, and cold stress can lead to various complications, including respiratory distress, hypoglycemia, and metabolic acidosis. The radiant heat warmer helps maintain the baby's body temperature within the normal range, promoting overall stability and reducing the risk of cold-related issues.

Choice B rationale:

The nurse should not choose choice B, "Respiratory depression,” as the action used to prevent. Placing the newborn under a radiant heat warmer does not specifically target respiratory depression. Respiratory depression in newborns may be related to various factors, such as anesthesia exposure during delivery or certain medications, and it requires appropriate monitoring and management rather than just heat regulation.

Choice C rationale:

The nurse should not choose choice C, "Thermogenesis,” as the action used to prevent. Thermogenesis refers to the generation of heat in the body, which is essential for maintaining body temperature. While the radiant heat warmer indirectly supports thermogenesis by preventing heat loss, the main purpose of using the warmer is to prevent cold stress, as stated in choice A.

Choice D rationale:

The nurse should not choose choice D, "Tachycardia,” as the action used to prevent. Tachycardia refers to an abnormally fast heart rate, and the use of a radiant heat warmer does not specifically target this condition. The purpose of the warmer, as explained earlier, is to maintain the baby's body temperature and prevent cold stress, not to address tachycardia.

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A nurse is assessing a newborn who is 48 hr old and has a maternal history of methadone use during pregnancy. Which of the following manifestations should the nurse identify as an indication of neonatal abstinence syndrome?

Nursing Test Bank

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