A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician of what conditions occur. (Select all that apply.).
Respiratory rate of 36 breaths/minute at rest.
Appetite slowly increasing.
Temperature above 37.7° C (100° F).
New, frequent coughing.
Turning blue or bluer than normal.
Correct Answer : A,C,D,E
The correct answer is choices A, C, D, and E.
Choice A rationale:
A respiratory rate of 36 breaths/minute at rest is concerning in a pediatric client, as it may indicate respiratory distress or an underlying respiratory condition.
Choice B rationale:
An increasing appetite is generally a positive sign and not typically concerning unless accompanied by other symptoms.
Choice C rationale:
A temperature above 37.7° C (100° F) is concerning as it indicates fever, which could be a sign of infection or other medical conditions.
Choice D rationale:
New, frequent coughing is concerning as it may indicate respiratory infections, asthma, or other respiratory issues.
Choice E rationale:
Turning blue or bluer than normal (cyanosis) is a serious symptom indicating inadequate oxygenation and requires immediate medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
C. Hepatitis B, and E. HIV/AIDS.
Choice A rationale:
Diabetes. Diabetes is not an infectious disease but a metabolic disorder characterized by high blood sugar levels. It does not pose a risk of maternal complications due to infection and is not a risk factor for infectious diseases during the preconception phase.
Choice B rationale:
Rubella. Rubella is a viral infection that can cause serious complications during pregnancy, including congenital rubella syndrome, which can lead to developmental abnormalities in the fetus. It is crucial for women to be immune to rubella before conception to prevent these complications.
Choice C rationale:
Hepatitis B. Hepatitis B is a viral infection that can lead to liver inflammation and potentially serious complications. Pregnant women with hepatitis B can transmit the virus to their newborns during childbirth. Proper screening, vaccination, and medical management are necessary to prevent transmission and maternal complications.
Choice D rationale:
Anemia. Anemia is a condition characterized by a deficiency of red blood cells or hemoglobin in the blood. While anemia can have various causes, it is not an infectious disease and does not directly increase the risk of maternal complications due to infection during the preconception phase.
Choice E rationale:
HIV/AIDS. HIV/AIDS is a viral infection that weakens the immune system, making individuals more susceptible to
Correct Answer is D
Explanation
Choice A rationale:
Limiting the time spent on exploration of intimate topics may result in incomplete information, leading to potential gaps in the patient's health history. It's essential to create a safe and supportive environment, allowing the patient to share necessary information freely.
Choice B rationale:
Avoiding questions that may embarrass the patient could prevent the nurse from gathering crucial information related to the patient's reproductive health. Sensitivity and non-judgmental communication are essential, enabling the patient to openly discuss sensitive topics.
Choice C rationale:
Using accepted medical terminology is important, but it should be balanced with clear communication. Complex medical terms might confuse the patient. It's essential to use language that the patient can understand, ensuring effective communication and a better understanding of their health.
Choice D rationale:
This statement indicates a correct understanding of the best approach when obtaining a reproductive health history. Explaining the purpose for the questions asked and how the information will be used builds trust and helps the patient feel more comfortable sharing sensitive information. It also ensures that the patient understands the relevance of the questions, fostering open communication between the patient and the healthcare provider.
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