A nurse is assisting with the care of a newborn who has neonatal abstinence syndrome. Which of the following actions should the nurse take first?

Weigh the newborn's wet diaper.

Auscultate the newborn's bowel sounds.

Determine the newborn's respiratory rate.

Swaddle the newborn in blankets.

Answer and Explanation

The Correct Answer is C

A.   weighing the newborn's wet diaper, is a routine part of newborn care but is not the first priority in this situation.
B.   auscultating the newborn's bowel sounds, is important for assessing gastrointestinal function but is not the first priority when the baby is at risk for respiratory distress.
C.   Neonatal abstinence syndrome (NAS) is a condition that occurs in newborns who were exposed to addictive substances in utero. One of the key concerns in NAS is respiratory distress, so determining the newborn's respiratory rate is the first priority.
D.   swaddling the newborn in blankets, is a comfort measure but does not address the immediate concern of assessing respiratory status in a baby with suspected NAS.

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Correct Answer is B

Explanation

A. If both the mother and the newborn are Rh-negative, there is no need for Rh (D. immune globulin.
B. An Rh-negative mother carrying an Rh-positive baby is at risk for Rh incompatibility. She should receive Rh (D. immune globulin to prevent sensitization.
C. If both the mother and the newborn are Rh-positive, there is no need for Rh (D. immune globulin.
D. If the mother is Rh-positive and the newborn is Rh-negative, there is no need for Rh (D. immune globulin.

A. Recurrent variable deceleration of the FHR B. Uterine contractions every 6 min C. Uterine contractions lasting 30 to 45 seconds D. Moderate variability of the FHR

Correct Answer is A

Explanation

A. Recurrent variable decelerations of the fetal heart rate (FHR) are concerning and can indicate fetal distress.
B. Uterine contractions every 6 minutes may not provide effective progress in labor, but it is not indicative of fetal distress.
C. Uterine contractions lasting 30 to 45 seconds are within the normal range for labor.
D. Moderate variability of the FHR is a reassuring sign and indicates that the fetus is tolerating labor well.

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A nurse is assisting with the care of a newborn who has neonatal abstinence syndrome. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

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