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A nurse is caring for a newborn who is 5 days old.
Medical History

History of maternal opioid use prior to pregnancy and prescribed methadone use during pregnancy. Maternal and neonatal positive urine drug screens for methadone. Newborn is exhibiting clinical findings of neonatal abstinence syndrome (NAS).

Which of the following actions should the nurse take? Select all that apply.

Maintain a low stimulation environment.

Plan to administer naloxone.

Instruct the parent to avoid breastfeeding

Instruct the parent to avoid eye contact with the newborn during feeding

Perform Ballard newborn screening each shift.

Weigh the newborn daily.

Swaddle the newborn with flexed extremities

Answer and Explanation

Correct Answer : A,C,E,F,G

Rationale:

A. Newborns with neonatal abstinence syndrome (NAS) are often irritable and hypersensitive to stimuli. Keeping the environment calm and quiet can help minimize their discomfort.

B. Naloxone is not routinely used in the management of NAS unless there is evidence of severe respiratory depression or opioid overdose, which is not indicated in this scenario.

C. Maternal opioid use and positive urine drug screens for methadone may contraindicate breastfeeding due to the potential transmission of opioids to the infant through breast milk. It's essential to consult with healthcare providers regarding the safest feeding option for the newborn.

D. Eye contact during feeding is essential for bonding between the parent and the newborn and should not be discouraged unless medically necessary.

E. Ballard newborn screening helps assess the newborn's gestational age and guide appropriate care for neonates with NAS, as they may require specialized management.

F. Daily weighing helps monitor the newborn's hydration status and overall well-being, which is crucial in managing NAS and ensuring adequate nutrition.

G. Swaddling can provide comfort to newborns with NAS by mimicking the womb environment and reducing their agitation.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Rationale:

A. Limiting the length of breastfeeding to 5 minutes per breast is not recommended and may lead to inadequate milk transfer and supply issues.

B. Instructing the client to wait 4 hours between daytime feedings may result in insufficient milk intake for the newborn and could impact breastfeeding success.

C. Offering supplemental formula between feedings may interfere with establishing breastfeeding and could decrease the client's milk supply.

D. Assessing the newborn's latch while breastfeeding is the appropriate action for addressing sore nipples. Poor latch is a common cause of nipple soreness in breastfeeding mothers. Ensuring the newborn has a proper latch can help alleviate discomfort and prevent further nipple trauma.

A. Maintain a low stimulation environment. B. Plan to administer naloxone. C. Instruct the parent to avoid breastfeeding D. Instruct the parent to avoid eye contact with the newborn during feeding E. Perform Ballard newborn screening each shift. F. Weigh the newborn daily. G. Swaddle the newborn with flexed extremities

Correct Answer is ["A","C","E","F","G"]

Explanation

Rationale:

A. Newborns with neonatal abstinence syndrome (NAS) are often irritable and hypersensitive to stimuli. Keeping the environment calm and quiet can help minimize their discomfort.

B. Naloxone is not routinely used in the management of NAS unless there is evidence of severe respiratory depression or opioid overdose, which is not indicated in this scenario.

D. Eye contact during feeding is essential for bonding between the parent and the newborn and should not be discouraged unless medically necessary.

E. Ballard newborn screening helps assess the newborn's gestational age and guide appropriate care for neonates with NAS, as they may require specialized management.

F. Daily weighing helps monitor the newborn's hydration status and overall well-being, which is crucial in managing NAS and ensuring adequate nutrition.

G. Swaddling can provide comfort to newborns with NAS by mimicking the womb environment and reducing their agitation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 1 day postpartum and breastfeeding her newborn. The client reports sore nipples. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

Correct Answer is ["A","C","E","F","G"]

Explanation

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