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A nurse is caring for a newborn who was born prematurely at 26 weeks. Which of the following interventions should the nurse take to decrease the newborn's risk of increased intracranial pressure?

Elevate the head of the bed 15° to 20°.

Stimulate the newborn every 2 hr.

Place the newborn in a radiant warmer.

Administer hypertonic solution.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Elevating the head of the bed can help prevent intracranial pressure by promoting venous drainage from the head.

Choice B rationale:

Premature newborns need to rest and conserve energy, so excessive stimulation every 2 hours is not recommended.

Choice C rationale:

Placing the newborn in a radiant warmer helps maintain a stable body temperature, but it does not directly address intracranial pressure.

Choice D rationale:

Administering hypertonic solution is not a standard intervention for decreasing intracranial pressure in a premature newborn.

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Correct Answer is A

Explanation

Choice A rationale:

Absent deep tendon reflexes can be a sign of magnesium toxicity, which is a potential adverse effect of magnesium sulfate infusion.

Choice B rationale:

A fetal heart rate of 120/min is within a normal range and is not concerning.

Choice C rationale:

Blood pressure of 150/92 mm Hg is elevated but is expected in a client with preeclampsia.

Choice D rationale:

Facial flushing can be a common side effect of magnesium sulfate and is not a priority finding to report.

A. "The amount of food I eat could affect my menstrual cycle." B. "I am gaining about 2 pounds per week." C. "I realize my body will never be perfect." D. "I took a laxative for constipation yesterday."

Correct Answer is B

Explanation

Choice A rationale:

Understanding the relationship between food intake and the menstrual cycle is a relevant topic for individuals with anorexia nervosa.

Choice B rationale:

Rapid weight gain of 2 pounds per week can be concerning and may indicate an unhealthy pattern or behaviors related to the eating disorder.

Choice C rationale:

Recognizing that the body will never be perfect is a positive and realistic perspective that can contribute to a healthier mindset in individuals with anorexia nervosa.

Choice D rationale:

Taking a laxative for constipation is not uncommon among individuals with eating disorders, but the statement doesn't necessarily raise immediate concern compared to the rapid weight gain mentioned in choice B.

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A nurse is caring for a newborn who was born prematurely at 26 weeks. Which of the following interventions should the nurse take to decrease the newborn's risk of increased intracranial pressure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has preeclampsia and is receiving magnesium sulfate via continuous IV infusion. Which of the following findings should the nurse report to the provider?

Correct Answer is A

Explanation

A nurse is facilitating a support group for clients who have anorexia nervosa. Which of the following client statements should the nurse investigate further?

Correct Answer is B

Explanation

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