A nurse is contributing to the care of a newborn who is experiencing hyperbilirubinemia and is receiving phototherapy.
Which of the following findings indicate that the phototherapy is effective?
Serum bilirubin level has increased from 6 hours ago.
Hemoglobin and hematocrit have increased.
Transcutaneous bilirubin (TcB) level has decreased from 6 hours ago.
Jaundice moves from chest to groin level.
The Correct Answer is C
Choice A rationale
An increase in serum bilirubin levels indicates worsening hyperbilirubinemia rather than improvement. Effective phototherapy should result in a decrease in bilirubin levels as it helps break down bilirubin into a form that can be excreted.
Choice B rationale
Hemoglobin and hematocrit levels are not directly affected by phototherapy. These values are more related to red blood cell count and do not indicate the effectiveness of phototherapy for treating hyperbilirubinemia.
Choice C rationale
A decrease in transcutaneous bilirubin (TcB) levels from 6 hours ago indicates effective phototherapy. Phototherapy reduces bilirubin levels in the blood by converting it to a water-soluble form that can be eliminated from the body.
Choice D rationale
Jaundice typically moves from the head to the lower body as bilirubin levels decrease. Movement from chest to groin level without a corresponding decrease in bilirubin levels does not necessarily indicate effective phototherapy. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Abruptio placentae involves the premature separation of the placenta from the uterine wall, causing continuous abdominal pain and vaginal bleeding. This condition is a medical emergency that can compromise fetal and maternal health.
Choice B rationale
Premature rupture of membranes is characterized by the leaking or gushing of amniotic fluid, not continuous abdominal pain and vaginal bleeding. It usually doesn't present with severe pain unless there are complications like infection.
Choice C rationale
Placenta previa is where the placenta covers the cervical opening, causing painless vaginal bleeding. It typically does not involve continuous abdominal pain, distinguishing it from abruptio placentae.
Choice D rationale
Prolapsed cord occurs when the umbilical cord slips ahead of the baby during delivery, which is a different obstetric emergency. It does not present with continuous abdominal pain and vaginal bleeding.
Correct Answer is D
Explanation
Choice A rationale
A longitudinal fetal lie, where the baby is aligned vertically with the mother’s spine, is the normal and optimal position for labor. It typically does not cause prolonged or difficult labor.
Choice B rationale
A gynecoid pelvis is considered the most favorable pelvic shape for vaginal delivery. It is roomy and allows for the easiest passage of the baby through the birth canal, reducing the likelihood of prolonged labor.
Choice C rationale
General flexion, where the baby’s chin is tucked to its chest and the limbs are flexed, is the optimal fetal attitude for birth. This position facilitates a smoother and shorter labor process.
Choice D rationale
Persistent occiput posterior (OP) position, where the baby’s head is down but facing the mother’s front, can result in a difficult and prolonged labor. This position often leads to severe back pain for the mother and may complicate the labor process.
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