A nurse is checking the reflexes of a newborn. Which of the following actions should the nurse use to elicit the Babinski reflex?
Touch the corner of the newborn's mouth.
Place the newborn supine and apply pressure to the soles of the feet.
Stroke upward on the lateral aspect of the sole of the newborn's foot
Pull the newborn up by the wrist from a supine position.
The Correct Answer is C
(a) Touch the corner of the newborn's mouth:
Touching the corner of the newborn's mouth elicits the rooting reflex, not the Babinski reflex. The rooting reflex causes the newborn to turn their head toward the touch and open their mouth, which helps with feeding.
(b) Place the newborn supine and apply pressure to the soles of the feet:
Applying pressure to the soles of the feet is not a method used to elicit the Babinski reflex. This action might influence other reflexes but not the Babinski.
(c) Stroke upward on the lateral aspect of the sole of the newborn's foot:
This is correct. The Babinski reflex is elicited by stroking upward on the lateral aspect of the sole of the newborn's foot. A positive response is the fanning and extension of the toes, which is normal in newborns.
(d) Pull the newborn up by the wrist from a supine position:
Pulling the newborn up by the wrists from a supine position is used to assess the traction response or pull-to-sit maneuver, which tests the newborn's head control and muscle tone, not the Babinski reflex.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
(A) Lie in a left side lying position for 30 min after meals:
While lying on the left side can sometimes help alleviate heartburn, it's generally recommended to elevate the head and upper body during sleep, especially if heartburn worsens at night. Lying down immediately after meals can actually exacerbate heartburn symptoms.
(B) Drink a cup of black coffee before breakfast:
Drinking black coffee can exacerbate heartburn symptoms due to its acidic nature and caffeine content. It is not recommended for individuals experiencing frequent heartburn, especially during pregnancy.
(C) Take sips of milk between meals:
Taking sips of milk between meals can help neutralize stomach acid and provide temporary relief from heartburn symptoms. However, it's essential to avoid drinking large quantities of milk at once, as this can lead to increased stomach acid production.
(D) Eat three large meals per day:
Eating large meals can increase pressure on the stomach and exacerbate heartburn symptoms. Instead of consuming three large meals, it's better to eat smaller, more frequent meals throughout the day to help prevent heartburn.
Correct Answer is D
Explanation
(A) Restrict fluids to 1,000 mL/day:
Restricting fluids may lead to dehydration, which can exacerbate nausea and other symptoms of morning sickness. It is important for pregnant individuals to stay hydrated, so fluid restriction is not recommended unless otherwise directed by a healthcare provider.
(B) Take an over-the-counter antacid:
While antacids may provide relief for heartburn or indigestion, they are not typically recommended as a first-line treatment for nausea associated with morning sickness. Antacids may have limited effectiveness in managing nausea, and their use should be guided by a healthcare provider.
(C) Increase intake of fresh fruits:
While fresh fruits are nutritious and provide essential vitamins and minerals, they may not be well-tolerated by individuals experiencing morning sickness, especially if they have strong flavors or odors. Encouraging the client to eat bland foods in the morning may be more effective in managing nausea during early pregnancy.
(D) Eat dry, bland foods in the morning:
Encouraging the client to eat dry, bland foods in the morning can help alleviate nausea associated with morning sickness. These foods are generally easier on the stomach and less likely to trigger nausea compared to richer or spicier foods. Examples include crackers, toast, or dry cereal. Eating small, frequent meals throughout the day can also help manage nausea associated with pregnancy.
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