A nurse is caring for a client who is 1 day postpartum. The client tells the nurse, "The baby has been breathing funny, fast and slow, off and on." Which of the following responses should the nurse make?
"There's absolutely nothing for you to worry about. Newborns often breathe like this."
"I'll sit here while you feed him and we'll check out his breathing."
"You are going to be a very good, responsible mother to this baby."
"All new mothers feel a bit anxious about things like this."
The Correct Answer is B
Choice A rationale: While it's true that newborns can have irregular breathing patterns, this response may come across as dismissive and not addressing the client's concerns.
Choice B rationale: The nurse should respond by actively listening to the client's concerns and offering to assess the newborn's breathing while they are feeding. Newborns can have irregular breathing patterns, including periods of rapid breathing (tachypnea) and pauses in breathing (periodic breathing). These patterns are generally normal and related to the baby's immature respiratory system adjusting to life outside the womb.
Choice C rationale: This response does not address the client's concern about the baby's breathing and instead focuses on the client's potential as a mother.
Choice D rationale: This response may minimize the client's concerns and does not address the baby's breathing issue. It's essential to acknowledge and assess the newborn's breathing pattern to ensure it is within the normal range.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: During phototherapy, it is essential to maintain adequate hydration and nutrition for the newborn. Encouraging frequent breastfeeding helps provide the baby with essential nutrients and fluids, which can be lost due to increased stooling caused by phototherapy.
Choice B rationale: The use of lotion on the newborn's skin during phototherapy is not recommended, as it may interfere with the effectiveness of the light therapy. The skin needs to be exposed to the light for the treatment to work.
Choice C rationale: Monitoring the newborn's blood glucose level is not directly related to phototherapy. Blood glucose monitoring may be necessary for specific medical reasons, but it is not a standard intervention during phototherapy.
Choice D rationale: During phototherapy, the newborn is usually placed in a supine (face-up) position to ensure maximum exposure of the skin to the phototherapy lights. The prone position is not recommended during phototherapy as it may reduce the effectiveness of the treatment.
Correct Answer is D
Explanation
Choice A rationale: Eight months is too early to transition to whole milk. At this age, infants still need the complete nutrition provided by breast milk or formula.
Choice B rationale: Ten months is still too early for transitioning to whole milk. Breast milk or formula should be the primary source of nutrition until around 12 months of age.
Choice C rationale: At 6 months of age, infants are usually just starting to introduce solid foods, but breast milk or formula remains the primary source of nutrition. Transitioning to whole milk at this age is not recommended.
Choice D rationale: The American Academy of Pediatrics (AAP) recommends transitioning from breast milk or formula to whole cow's milk at around 12 months of age. Before that age, breast milk or formula provides essential nutrients for the baby's growth and development.
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