A nurse is caring for a newborn who is 6 hours old and has a bedside glucometer reading of 65 mg/dL. The newborn's mother has type 2 diabetes mellitus.
Which of the following actions should the nurse take?
Feed the newborn immediately.
Administer 50 mL of dextrose solution IV.
Reassess the blood glucose level prior to the next feeding.
Obtain a blood sample for a serum glucose level.
The Correct Answer is A
A bedside glucometer reading of 65 mg/dL is within the normal range for a newborn who is 6 hours old.
Feeding the newborn can help maintain their blood glucose level.
Choice B is not an answer because administering 50 mL of dextrose solution IV is not necessary for a newborn with a normal blood glucose level.
Choice C is not an answer because reassessing the blood glucose level prior to the next feeding is not necessary for a newborn with a normal blood glucose level.
Choice D is not an answer because obtaining a blood sample for a serum glucose
level is not necessary for a newborn with a normal blood glucose level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A nurse should discontinue oxytocin if the client experiences uterine hyperkinesia, which is defined as more than 5 contractions in 10 minutes.
Choice B is not correct because contractions lasting 60 seconds are within the normal range.
Choice C is not correct because moderate variability of the fetal heart rate is a reassuring sign.
Choice D is not correct because nonrepetitive early decelerations are generally considered benign and do not require intervention.
Correct Answer is B
Explanation
The nurse should report a fundal height of 38 cm to the provider.
Fundal height is measured from the top of the pubic bone to the top of the uterus and is used to assess fetal growth.
A fundal height measurement that is larger than expected for gestational age may indicate macrosomia, which is a common complication of gestational diabetes mellitus.
Choice A is incorrect because non-pitting pedal edema is common during late pregnancy and is usually caused by physiologic edema resulting from hormone- induced sodium retention.
Choice C is incorrect because 12 fetal movements in an hour are within normal
range.
Choice D is incorrect because a fasting blood glucose level of 90 mg/dL is within normal range for a pregnant woman with gestational diabetes mellitus.
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