A nurse is performing a heel stick on a newborn. Which of the following actions should the nurse take?
Puncture the heel on the inner aspect of the foot.
Use an automatic puncture device on the heel.
Cleanse the newborn's heel with an alcohol swab after the procedure.
Place an ice pack on the newborn's heel 5 min before the procedure.
The Correct Answer is B
“Use an automatic puncture device on the heel.” This is the most common and minimally invasive method to draw capillary blood from an infant for medical testing.
Choice A is incorrect because the heel should be punctured on the outer aspect of the foot to avoid damaging the calcaneus bone.
Choice C is incorrect because the heel should be cleansed with an alcohol swab
before, not after, the procedure.
Choice D is incorrect because there is no need to place an ice pack on the newborn’s heel before the procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A nurse conducting a class for a group of clients about birth control should include information about having an annual examination to assess their diaphragm.
A diaphragm should be replaced at least every 2 years and it’s important to
bring it to an annual checkup so the healthcare provider can check the fit.
Choice A is incorrect because spermicide should be used immediately before sexual intercourse, not 3 hours prior.
Choice B is incorrect because fertility can return immediately after IUD removal.
Choice C is incorrect because emergency contraception is intended for backup contraception only and not as a primary method of birth control
Correct Answer is C
Explanation
A nurse assessing the results of a nonstress test for an antepartal client at 35 weeks of gestation should indicate the need for further diagnostic testing if there are no late decelerations noted with three uterine contractions of 60 seconds in duration within a 10-min testing period.
Choice A is incorrect because an increase in fetal heart rate to 150/min above the baseline of 140/min lasting 10 seconds in response to fetal movement within a 40-min testing period is a normal result.
Choice B is incorrect because irregular contractions of 10 to 20 seconds in duration that are not felt by the client do not indicate the need for further diagnostic testing.
Choice D is incorrect because three fetal movements perceived by the client in a 20-min testing period do not indicate the need for further diagnostic testing.
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