A nurse is assisting with the care of a newborn 1 hr after birth.
Select the 5 findings that the nurse should report to the provider.
Temperature
Respiratory findings
Serum glucose
Hematocrit
White blood cell count
Hemoglobin
Heart rate
Correct Answer : B,F,G
Choice A:
Temperature. The newborn's temperature is within the normal range of 36.5°C to 37.5°C (97.7°F to 99.5°F) for axillary measurement. Therefore, this finding does not need to be reported to the provider.
Choice B:
Respiratory findings. The newborn's respiratory rate is above the normal range of 30 to 60 breaths per minute. The newborn also has a low oxygen saturation of 96%, which indicates possible respiratory distress. Therefore, this finding should be reported to the provider.
Choice C:
Serum glucose. The question does not provide any information about the newborn's serum glucose level, so this choice is irrelevant and does not need to be reported to the provider.
Choice D:
Hematocrit. The question does not provide any information about the newborn's hematocrit level, so this choice is irrelevant and does not need to be reported to the provider.
Choice E:
White blood cell count. The question does not provide any information about the newborn's white blood cell count, so this choice is irrelevant and does not need to be reported to the provider.
Choice F:
Hemoglobin. The question does not provide any information about the newborn's hemoglobin level, but it is known that newborns have higher hemoglobin levels than adults due to fetal hemoglobin. A high hemoglobin level can increase the risk of polycythemia, which can cause hyperviscosity, hypoxia, and hyperbilirubinemia. Therefore, this finding should be reported to the provider.
Choice G:
Heart rate. The newborn's heart rate is above the normal range of 110 to 160 beats per minute. A high heart rate can indicate tachycardia, which can be caused by various factors such as fever, dehydration, anemia, infection, or congenital heart defects. Therefore, this finding should be reported to the provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A reason:
Swimming is one of the best exercises for pregnant women because it provides moderate aerobic conditioning with minimal stress on your joints. It also supports your increased weight and helps you stay cool and comfortable.
Choice B reason:
Scuba diving is not a safe exercise for pregnant women because it poses a high risk of injury to the baby. The baby has no protection against decompression sickness and gas embolism, which are caused by changes in pressure underwater.
Choice C reason:
Walking is a great exercise for beginners and can be done throughout pregnancy. It improves your cardiovascular fitness, strengthens your muscles and bones, and helps prevent excessive weight gain and gestational diabetes.
Choice D reason:
Yoga can be beneficial for pregnant women as it can improve flexibility, balance, posture, breathing and relaxation. It can also reduce stress, anxiety and back pain. However, some yoga poses may not be suitable for pregnancy, so it is advisable to join a prenatal yoga class or consult a qualified instructor.
Choice E reason:
Snow skiing is not recommended for pregnant women because it involves a high risk of falling and affecting your balance. Falls can cause damage to your baby or placenta, especially in the second and third trimesters.
Correct Answer is ["A","B","C","E"]
Explanation
A. Discard unused formula in used bottle after 2 hours:Once a baby has started drinking from a bottle, bacteria from the baby’s mouth can contaminate the formula. Any leftover formula should be discarded after 2 hours to prevent bacterial growth and reduce the risk of infection.
B. Never prop a bottle:Propping a bottle can lead to choking, ear infections, and dental issues (such as baby bottle tooth decay). Babies should always be held upright during feedings.
C. Formula is available in three forms:Infant formula is available in three types:Ready-to-feed (no mixing needed),Liquid concentrate (mix with water),Powdered formula (mix with water).
E. Store prepared bottles in the refrigerator:If formula is prepared in advance, it must be stored in the refrigerator (≤ 4°C or 40°F) and used within 24 hours to prevent bacterial growth.
Incorrect Answer:
D. Warm the bottle in the microwave:Microwaving heats unevenly, creating hot spots that can burn the baby’s mouth. Instead, warm bottles by placing them in warm water for a few minutes and always test the temperature on the wrist before feeding.
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