A nurse is caring for a newborn who requires a blood glucose test. Which of the following actions should the nurse take?

Apply a warm pack to the puncture site prior to the procedure.

Apply a mummy restraint to the newborn for the procedure.

Apply antiseptic solution to the puncture site after the procedure.

Elevate the extremity prior to the procedure.

Answer and Explanation

The Correct Answer is A

A. Applying a warm pack to the puncture site before the procedure increases blood flow to the area, which makes the blood sample collection easier and reduces discomfort for the newborn.

B. A mummy restraint may not be necessary for a routine blood glucose test. The nurse can gently hold the newborn in place during the procedure without needing to fully restrain them.

C. Antiseptic solution is typically applied before the puncture to cleanse the area. After the procedure, gentle pressure and bandaging are more appropriate to stop bleeding.

D. Elevating the extremity is unnecessary for a newborn blood glucose test, as warming the area is more effective in promoting blood flow to the puncture site.

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Correct Answer is A

Explanation

A. At 12 weeks of gestation, the uterus is typically located in the suprapubic area. The fetal heart tones can often be detected in this region as the fetus is still small enough that its heart tones can be picked up without interference from the mother's abdominal organs.
B. The umbilical area is not the optimal location at this stage; the fetal heart tones are generally not audible in this location until the uterus rises higher into the abdomen in later gestation.
C. Above the left iliac crest is not appropriate for this gestational age. The fetal heart tones would be difficult to detect in that area as the fetus is still quite low in the pelvis.
D. Below the liver border on the right abdomen is also not correct, as the fetal heart tones are unlikely to be found there at 12 weeks.

A. "You will not be able to eat or drink anything for 8 hours prior to the test." B. "You will press the provided button when you feel the baby moving during the test." C. "You will receive medication through an IV line to stimulate contractions." D. "You will be required to lie flat on your back for the duration of the test."

Correct Answer is B

Explanation

A. There is no fasting requirement for a nonstress test.
B. The client will press a button whenever they feel the baby move during the test to help correlate fetal movement with changes in the fetal heart rate.
C. A nonstress test is not meant to stimulate contractions. It monitors the fetal heart rate in response to the baby's movements.
D. While the client will be monitored, they are not required to lie flat on their back for the entire duration of the test. They may be in a semi-reclining or comfortable position.

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A nurse is caring for a newborn who requires a blood glucose test. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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