A nurse is caring for a client who asks why her newborn is receiving a phytonadione injection. Which of the following statements should the nurse make?
This medication prevents your baby from developing bleeding problems."
"This medication enhances regulation of your baby's temperature."
"This medication enhances your baby's immune response."
"This medication prevents your baby from developing jaundice
The Correct Answer is A
Choice A Reason:
"This medication prevents your baby from developing bleeding problems." This is the correct statement. Phytonadione is given to newborns to prevent neonatal vitamin K deficiency bleeding (VKDB), which can lead to serious bleeding problems, including intracranial hemorrhage.
Choice B Reason:
"This medication enhances regulation of your baby's temperature." Phytonadione does not have any direct impact on the regulation of a baby's temperature. Its primary purpose is to prevent bleeding issues.
Choice C Reason:
"This medication enhances your baby's immune response. Phytonadione does not enhance a baby's immune response. It primarily addresses vitamin K deficiency and associated bleeding risks.
Choice D Reason:
"This medication prevents your baby from developing jaundice." Phytonadione is not used to prevent jaundice. Jaundice is typically related to bilirubin levels and is managed separately from vitamin K supplementation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
d. Prothrombin time.
Explanation:
Warfarin is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver. Therefore, it is important to monitor the client's clotting ability to ensure that the medication is working properly and not causing any adverse effects.
The laboratory test that is used to monitor warfarin therapy is the prothrombin time (PT), which measures the time it takes for the blood to clot. The nurse should monitor the client's PT regularly and adjust the dosage of warfarin as necessary to maintain the therapeutic range.
Option a (Triiodothyronine) is a thyroid hormone and is not directly related to warfarin therapy.
Option b (Blood urea nitrogen) is a measure of kidney function and is also not directly related to warfarin therapy.
Option c (Arterial blood gases) is a measure of oxygen and carbon dioxide levels in the blood and is not related to warfarin therapy.
Correct Answer is C
Explanation
Choice A Reason:
The cause of death is determined and documented by the physician or medical examiner, not the nurse. Including this in the postmortem documentation by the nurse would be inappropriate as it is not within the nurse's scope of practice to make this determination.
Choice B Reason:
While the nurse may document the last set of vital signs before death, this is typically recorded in the patient's medical record at the time the vital signs are taken, not specifically in postmortem documentation. The focus of postmortem documentation is on the events and conditions after the death has been confirmed.
Choice C Reason:
The location of the identification tag is crucial in postmortem documentation to ensure proper identification of the deceased. This information helps in maintaining the integrity and identification of the body during transportation and handling by the mortuary or funeral home.
Choice D Reason:
Advance directives are part of the client's medical record and are used to guide care decisions while the client is alive. They are not typically included in postmortem documentation, as they pertain to the client's wishes regarding treatment prior to death, not after. The original documents should remain in the client's file.
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