A nurse is caring for a newborn who is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse take?

Wrap the newborn loosely in a blanket.

Encourage frequent eye contact with the newborn during feedings.

Provide frequent stimulation for the newborn.

Decrease the lighting levels in the nursery.

Answer and Explanation

The Correct Answer is D

A. Wrap the newborn loosely in a blanket: Infants with neonatal abstinence syndrome (NAS) benefit from being swaddled snugly, not loosely. Tight swaddling helps reduce hyperactivity, self-stimulating movements, and agitation associated with withdrawal.

B. Encourage frequent eye contact with the newborn during feedings: Excessive eye contact can overstimulate an infant with NAS, increasing irritability and stress. Minimizing visual stimulation during feedings helps promote calm and successful feeding.

C. Provide frequent stimulation for the newborn: Newborns with NAS are highly sensitive to environmental stimuli. Providing frequent stimulation can exacerbate symptoms such as tremors, irritability, and high-pitched crying.

D. Decrease the lighting levels in the nursery: Reducing environmental stimuli, including dimming lights and minimizing noise, helps calm infants experiencing NAS. A low-stimulation environment is a key nonpharmacologic intervention to reduce withdrawal symptoms and support neurodevelopment.

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Free Nursing Study Resources

Correct Answer is ["A","B","D"]

Explanation

Rationale for correct choices

• Migraine headaches with aura: Combined oral contraceptives (COCs) increase the risk of ischemic stroke in individuals with migraine with aura. Estrogen-containing contraception can exacerbate cerebrovascular risk, making it a contraindication regardless of age or other vascular risk factors. Even with good glycemic control, the presence of aura elevates stroke risk significantly.

• History of deep vein thrombosis: COCs increase the risk of venous thromboembolism (VTE). A previous DVT is a strong contraindication because estrogen-containing contraceptives can trigger recurrence. Even if the event occurred years ago, the risk remains elevated, particularly in the presence of other risk factors such as immobility or hypercoagulable states.

• Diabetes mellitus (long-standing): Although the client currently has well-controlled blood sugar (HbA1c 6.7%), the duration of diabetes (24 years) significantly increases the risk of cardiovascular disease. Estrogen-containing contraceptives further elevate cardiovascular and thrombotic risk, making long-standing diabetes a relative contraindication.

Rationale for incorrect choices

• Lifetime nonsmoker / Rare alcohol use: Non-smoking status reduces cardiovascular risk, which is protective rather than contraindicating. Alcohol use in small amounts does not increase risk significantly.

A. Use a 15° angle for the injection. B. Roll the syringe gently to ensure mixture of the insulins. C. Draw up regular insulin prior to NPH insulin. D. Inject into the vastus lateralis.

Correct Answer is C

Explanation

A. Use a 15° angle for the injection: Subcutaneous insulin injections should be administered at a 90° angle for most adults and children with adequate subcutaneous tissue. A 15° angle is too shallow and may result in intradermal administration, affecting absorption.

B. Roll the syringe gently to ensure mixture of the insulins: Only the NPH insulin vial should be gently rolled between the hands to resuspend the cloudy insulin. Regular insulin is clear and should not be shaken, and the mixture occurs in the syringe after drawing up each insulin in the correct sequence.

C. Draw up regular insulin prior to NPH insulin: Drawing up regular (clear) insulin before NPH (cloudy) insulin prevents contamination of the short-acting insulin with intermediate-acting insulin, maintaining proper pharmacologic action and preventing altered onset or peak times.

D. Inject into the vastus lateralis: The preferred sites for subcutaneous insulin injections are the abdomen, upper arm, or anterior thigh. The vastus lateralis can be used in infants but is not the standard site for older children or adults.

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A nurse is caring for a newborn who is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","D"]

Explanation

A nurse is providing teaching to a client who has a new diagnosis of type I diabetes mellitus about administering NPH insulin and regular insulin together in one injection. Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

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