A nurse is preparing to collect a specimen for newborn screening. Which of the following actions should the nurse take?

Use a lancet to puncture the inner aspect of the newborn's heel.

Leave the newborn's heel open to the air after the puncture.

Apply an antiseptic to the newborn's heel after collecting the specimen.

Warm the newborn's heel for 5 to 10 min before the puncture.

Answer and Explanation

The Correct Answer is A

A)   Correct - Newborn screening typically involves a heel stick using a lancet to collect a few drops of blood from the inner aspect of the newborn's heel.
B)   Incorrect- Leaving the newborn's heel open to the air after the puncture is not necessary; a small bandage is typically applied.
C)   Incorrect- An antiseptic is not typically applied after collecting the specimen, as it could interfere with the accuracy of the screening tests.
D)   Incorrect- Warming the newborn's heel is not a standard step before collecting a specimen for newborn screening.

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Correct Answer is B

Explanation

A) Incorrect- Foul-smelling vaginal discharge might indicate infection but is not the priority over the presence of meconium-stained amniotic fluid.
B) Correct- Fetal heart rate is important to monitor, but the presence of meconium- stained amniotic fluid has higher priority. fetal heart tones 98/min, because this indicates fetal distress and requires immediate intervention.
C) Incorrect - Amniotic fluid with meconium noted could indicate fetal hypoxia or distress, but it is not always a sign of a problem and depends on other factors such as gestational age and fetal activity.
D) Incorrect- Maternal temperature elevation might indicate infection but is not the priority over assessing the condition of the amniotic fluid and the baby.

A. A client who has a reddened area on their right calf B. A client who reports painful uterine contractions during breastfeeding C. A client who has a urinary output of 125 mL in 4 hr D. A client who reports changing their perineal pad every 2 hr

Correct Answer is C

Explanation

A) Incorrect- A reddened area on the calf might indicate a potential blood clot (deep vein thrombosis), which is important to assess but may not be the highest priority.
B) Incorrect- Painful uterine contractions during breastfeeding can be a normal response due to oxytocin release during breastfeeding and might not require immediate reporting.
C) Correct - A urinary output of 125 mL in 4 hours is significantly low and could indicate inadequate fluid intake, potential urinary retention, or other issues that need prompt attention. It is a sign of impaired renal function. This could indicate dehydration, blood loss, infection, or kidney injury. The nurse should assess the client's fluid intake and output, vital signs, urine specific gravity, and serum electrolyte levels. The nurse should also monitor the client for signs of hypovolemia, such as tachycardia, hypotension, and decreased skin turgor.
D) Incorrect- Changing a perineal pad every 2 hours is within the normal range for postpartum bleeding and might not require immediate reporting.

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A nurse is preparing to collect a specimen for newborn screening. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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