A nurse is caring for a newborn.
Drag words from the choices below to fill in each blank in the following sentence.
The client is at risk for developing
The Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}
The client is at risk for developing transient tachypnea of the newborn and hypoglycemia.
Rationale:
Target 1: Transient Tachypnea of the Newborn (TTN): The newborn has progressively increasing respiratory rates (68 → 72 → 76 breaths/min) along with grunting and mild intercostal retractions. Cesarean birth is a major risk factor for TTN because the absence of labor contractions delays the clearance of fetal lung fluid. TTN typically presents within the first few hours of life with tachypnea and mild respiratory distress, resolving within 24–72 hours.
Target 2: Hypoglycemia: The newborn weighs 4200 g (9 lb 4 oz), indicating macrosomia.
Large-for-gestational-age (LGA) infants are at higher risk for hypoglycemia due to increased insulin production in response to maternal hyperglycemia. Tachypnea can also be a sign of hypoglycemia in neonates.
Incorrect Options:
Tachycardia: The newborn’s heart rate is elevated (154–156 bpm), but mild tachycardia is expected in newborns and is not the primary concern compared to respiratory distress and hypoglycemia risk.
Bronchopulmonary Dysplasia (BPD): BPD is a chronic lung condition primarily seen in preterm infants who require prolonged mechanical ventilation and oxygen therapy. This newborn was term, had clear amniotic fluid, and no intubation, making BPD unlikely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. A heart rate of 90/min is within normal limits.
B. Discomfort at the insertion site is expected and should be managed appropriately.
C. Bounding pulses in the affected extremity can occur due to arterial flow after catheterization but are not necessarily abnormal unless accompanied by other concerning findings.
D. A hematoma at the catheter insertion site may indicate bleeding or vascular injury and should be reported promptly.
Correct Answer is B
Explanation
A. Incorrect – Dabigatran should be replaced every 4 months, not 6 months, once the bottle is opened to ensure potency.
B. Correct – Dabigatran is sensitive to moisture and should be stored in its original container with the desiccant to maintain effectiveness.
C. Incorrect – Dabigatran capsules should not be crushed, chewed, or opened, as this can increase drug absorption and risk of bleeding.
D. Incorrect – Dabigatran should be stored at room temperature, not in the refrigerator, to prevent moisture exposure.
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