A nurse is caring for a newborn following a circumcision. Which of the following manifestations indicates the newborn is experiencing pain?

Lip smacking

Diaphoresis

Hypoglycemia

Transient strabismus

Answer and Explanation

The Correct Answer is B

A. Incorrect. Lip smacking is not typically associated with pain in newborns and may indicate hunger or a self-soothing behavior.
B. Correct. Diaphoresis, or sweating, can be a sign of pain in newborns following circumcision. C. Incorrect. Hypoglycemia refers to low blood glucose levels and is not a direct manifestation of pain.
D. Incorrect. Transient strabismus, or crossed eyes, is not typically associated with pain in newborns and may be a normal variation.

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Correct Answer is D

Explanation

A. A warm extremity is not typically associated with compartment syndrome. Compartment syndrome may present with coolness due to compromised circulation.

B. Moderate pain on the ankle may be present in compartment syndrome due to increased pressure within the compartment, but it is not a specific manifestation.
C. Blanch time of 2 seconds in the toenail beds indicates normal capillary refill, which is not consistent with compartment syndrome. In compartment syndrome, capillary refill may be delayed.
D. Palpation of a weak or absent dorsalis pedis pulse is a concerning finding indicative of compromised circulation, a hallmark sign of compartment syndrome.

A. Suggest the family persuade the client to take the medication. B. Recommend that the medication be delivered intramuscularly. C. Remind the newly licensed nurse that the client has a right to refuse medication. D. Suggest the newly licensed nurse contact the pharmacy to inquire about compatible foods.

Correct Answer is C

Explanation

A. Suggest the family persuade the client to take the medication: This option involves coercion, which is not ethically appropriate. Clients have the right to refuse medication, and persuasion from family members should not be used to override this right.
B. Recommend that the medication be delivered intramuscularly: Administering medication against a client's will through an invasive route like intramuscular injection is not appropriate and may constitute assault.
C. Remind the newly licensed nurse that the client has a right to refuse medication: This response upholds the client's autonomy and right to refuse treatment. Nurses must respect a client's decision to decline medication, provided they are competent to make that decision.
D. Suggest the newly licensed nurse contact the pharmacy to inquire about compatible foods: This response does not address the ethical issue of respecting the client's autonomy and right to refuse medication.

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A nurse is caring for a newborn following a circumcision. Which of the following manifestations indicates the newborn is experiencing pain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data on a client who has swelling of the lower leg. The nurse should identify that which of the following findings is a manifestation of compartment syndrome?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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