A nurse is caring for a newborn who is placed in a neutral thermal environment.What is the desired outcome of this measure?
To minimize the patient’s oxygen needs.
To facilitate the conversion of glucose to lactic acid.
To decrease the absorption of surfactant from the alveoli.
To increase the patient’s ability to metabolize brown fat stores.
The Correct Answer is A
The correct answer is choice A: To minimize the patient’s oxygen needs.
A neutral thermal environment is an environment in which a neonate maintains a normal body temperature while minimizing energy expenditure and oxygen consumption. This is important for the wellbeing of neonates, especially those who are preterm or have respiratory insufficiency.
Choice B is wrong because the conversion of glucose to lactic acid is not a desired outcome of a neutral thermal environment. This conversion occurs when there is inadequate oxygen supply to the tissues, resulting in anaerobic metabolism and metabolic acidosis.
Choice C is wrong because the absorption of surfactant from the alveoli is not affected by a neutral thermal environment.
Surfactant is a substance that reduces surface tension and prevents alveolar collapse. It is produced by type II alveolar cells and secreted into the alveoli.
Choice D is wrong because the metabolism of brown fat stores is not a desired outcome of a neutral thermal environment.
Brown fat is a specialized tissue that generates heat by nonshivering thermogenesis in response to cold stress.
It is located in the nape of the neck, between the scapulae, and around the kidneys and adrenals. It increases the metabolic rate and oxygen consumption of neonates.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D. Apply petrolatum to the patient’s perineum.This is because petrolatum can help soothe and protect the perineal area, which may be swollen, bruised, or have stitches after a vaginal delivery.Applying petrolatum can also prevent the pad from sticking to the wound and causing more pain.
Choice A is wrong because observing the patient for vaginal discharge of bright red blood is not a specific action for perineal care.Bright red blood may indicate postpartum hemorrhage, which requires immediate medical attention.
Choice B is wrong because assessing the patient’s vaginal tone is not a priority action for perineal care.Vaginal tone may be reduced after childbirth due to stretching of the pelvic floor muscles, but this can improve with time and exercises.
Choice C is wrong because massaging the patient’s perineum is not recommended for perineal care.Massaging the perineum may cause more trauma and discomfort to the area, especially if there are stitches or hemorrhoids.Massaging the fundus (the top of the uterus) may be done to help it contract and prevent bleeding, but this is different from massaging the perineum.
Correct Answer is B
Explanation
A transverse lie means that the baby is lying sideways across the uterus, instead of head-down or breech.
This position makes vaginal delivery impossible and increases the risk of umbilical cord prolapse, which can compromise fetal oxygen supply.Therefore, a cesarean delivery is indicated for a fetus in a transverse lie.
Choice A is wrong because having extremely slender hips does not necessarily mean that a woman cannot deliver vaginally.
The size and shape of the pelvis, not the external appearance, determines the adequacy of the birth canal.A trial of labor may be attempted for women with borderline pelvic measurements.
Choice C is wrong because fetal hyperactivity is not a reason for a cesarean delivery.
Fetal movements may vary depending on the time of day, maternal activity, maternal blood sugar level, and other factors.Fetal well-being can be assessed by fetal heart rate monitoring and biophysical profile.
Choice D is wrong because having a posterior cervix does not indicate the need for a cesarean delivery.
A posterior cervix means that the cervix is tilted toward the back of the uterus, which may make cervical dilation slower and more painful.However, with adequate contractions and maternal pushing, the cervix can move to an anterior position and allow vaginal delivery.
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