A nurse is assessing a pre-term newborn who has retinopathy of prematurity (ROP).
Which of the following manifestations should the nurse expect to observe?
Leukocoria (white pupils)
Strabismus (crossed eyes)
Nystagmus (involuntary eye movements)
All of the above
The Correct Answer is A
Leukocoria (white pupils) is a symptom of retinopathy of prematurity (ROP), an eye disease that can happen in premature babies. ROP happens when abnormal blood vessels grow on the retina, the light-sensitive layer of tissue in the back of the eye.
Choice B is wrong because strabismus (crossed eyes) is not a symptom of ROP, but a possible complication that can occur later in life.
Choice C is wrong because nystagmus (involuntary eye movements) is not a symptom of ROP, but another possible complication that can occur later in life.
Choice D is wrong because it includes choices B and C, which are incorrect.
Normal ranges for gestational age and birth weight are 38 to 42 weeks and 5.5 to 10 pounds, respectively. Babies born before 31 weeks or weighing less than 3 pounds are at risk for ROP.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","E"]
Explanation
Magnesium sulfate IV infusion can cause various adverse effects such asflushing,headache,nauseaanddrowsiness.
These are common and expected side effects of this medication.
Choice A is wrong because magnesium sulfate IV infusion does not causediarrhea.Diarrhea is a possible side effect of oral magnesium sulfate, which is used as a laxative.
However, oral magnesium sulfate is not used to treat pre-term labor or prevent seizures.
Normal ranges of magnesium in the blood are 1.7 to 2.2 mg/dL for adults.
Magnesium sulfate IV infusion is used to treat hypomagnesemia (low levels of magnesium in the blood) or to prevent seizures in pregnant women with pre-eclampsia, eclampsia or toxemia.
Correct Answer is C
Explanation
This is because assessing fetal heart rate is the most important action to take first when a client has prelabor rupture of membranes (PROM) at 34 weeks of gestation and oligohydramnios.Fetal heart rate can indicate fetal well-being, distress, or infection.Oligohydramnios can increase the risk of umbilical cord compression and fetal hypoxia.
Choice A is wrong because administering IV fluids is not the first priority in this situation.IV fluids may be given to prevent dehydration, enhance uterine blood flow, or augment labor, but they are not as urgent as assessing fetal heart rate.
Choice B is wrong because obtaining a urine specimen is not the first priority in this situation.A urine specimen may be obtained to check for infection, proteinuria, or glucose levels, but they are not as urgent as assessing fetal heart rate.
Choice D is wrong because inserting an indwelling urinary catheter is not the first priority in this situation.An indwelling urinary catheter may be inserted to monitor fluid balance, prevent bladder distension, or reduce the risk of infection, but they are not as urgent as assessing fetal heart rate.
Normal ranges for fetal heart rate are 110 to 160 beats per minute.Oligohydramnios is defined as an amniotic fluid index of less than 5 cm.
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