A nurse is performing a head-to-toe assessment on a newborn. Which of the following actions should the nurse take to prevent heat loss through conduction?

Conduct the assessment before drying the newborn.

Check the newborn's rectal temperature every hr.

Place the newborn in an open crib for the initial assessment.

Cover scale with warm blankets when weighing the newborn.

Answer and Explanation

The Correct Answer is D

Rationale:
A. Conduct the assessment before drying the newborn: Performing the assessment before drying exposes the newborn’s wet skin to cooler air and surfaces, increasing heat loss through evaporation, not conduction. The newborn should always be thoroughly dried immediately after birth to conserve body heat.

B. Check the newborn's rectal temperature every hr: Frequent temperature monitoring does not prevent heat loss; it only identifies hypothermia after it occurs. Additionally, rectal temperature measurement may cause mucosal injury and is not routinely recommended for newborns.

C. Place the newborn in an open crib for the initial assessment: Placing the newborn in an open crib exposes the infant to cooler air and surfaces, increasing heat loss through convection and conduction. The initial assessment should occur under a radiant warmer to maintain thermal stability.

D. Cover scale with warm blankets when weighing the newborn: Covering the scale prevents conduction heat loss, which occurs when the newborn’s skin comes into contact with cold surfaces. Using a warm blanket or pad ensures the infant’s body heat is preserved during weighing or handling.

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Correct Answer is B

Explanation

Rationale:
A. Fibrocystic breast condition: Fibrocystic breast changes are benign and do not contraindicate oral contraceptive use. Oral contraceptives may sometimes improve symptoms, but this condition alone is not a reason to avoid them.

B. Hypertension: Oral contraceptives can elevate blood pressure and increase the risk of cardiovascular complications. Clients with uncontrolled or severe hypertension are at higher risk and should avoid combined estrogen-progestin contraceptives, making this a significant contraindication.

C. Asthma: Asthma is not a contraindication for oral contraceptive use. Hormonal contraceptives generally do not exacerbate asthma, and clients with well-controlled asthma can safely use these medications.

D. Fibromyalgia: Fibromyalgia is a chronic musculoskeletal pain disorder that does not affect cardiovascular or thrombotic risk. It is not a contraindication for oral contraceptives, and use is generally safe in these clients.

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

Rationale for Correct Choices

• Endometritis: The client’s postpartum course—cesarean delivery, prolonged rupture of membranes, and postpartum Day 3 fever—places her at high risk for endometritis, a uterine infection. Signs include uterine tenderness, boggy fundus, and foul-smelling lochia.

• Uterus and lochia assessment: The firm but tender uterus with boggy areas and moderate dark brown, foul-smelling lochia are classic indicators of endometritis. These assessment findings directly reflect the infection within the uterine cavity and help guide immediate intervention.

Rationale for Incorrect Choices

• Mastitis: While the client reports firm, warm breasts with nipple discomfort, these symptoms alone without localized redness, unilateral involvement, or systemic malaise are not sufficient to diagnose mastitis. The uterine and lochia findings are more indicative of endometritis.

• Postpartum hemorrhage: Although uterine atony can cause bleeding, the client’s fundus is firm after massage and the lochia is moderate, making hemorrhage less likely at this point. Hemoglobin remains within normal limits, further reducing the likelihood of acute postpartum hemorrhage.

• Fever: Fever is a symptom rather than a diagnosis. While present (38.2° C), it supports the presence of infection but does not specify which type, so it is not the best standalone choice for the evidence used to identify the condition.

• Elevated WBC (markedly 33,000/mm3) confirm a systemic infection, it is a general sign of infection that could apply to any source (e.g., wound or mastitis). The assessment of the uterus and lochia specifically localizes the infection to the reproductive tract.

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A nurse is performing a head-to-toe assessment on a newborn. Which of the following actions should the nurse take to prevent heat loss through conduction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is conducting a health promotion class about the use of oral contraceptives. Which of the following disorders is a contraindication for oral contraceptive use?

Correct Answer is B

Explanation

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Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

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