A nurse is preparing to discharge a newborn who has an atrial septal defect. The nurse should expect the provider to refer the client to which of the following interprofessional team members?

Case manager

Physical therapist

Occupational therapist

Nurse manager

Answer and Explanation

The Correct Answer is A

A. Case manager: A case manager coordinates care for clients with chronic conditions or complex health needs. For a newborn with an atrial septal defect, the case manager can arrange follow-up appointments, provide education to the family about monitoring for symptoms, and ensure access to cardiology services. This referral supports continuity of care and helps prevent complications.

B. Physical therapist: Physical therapy focuses on improving mobility, strength, and motor function. While important for certain conditions, a newborn with an atrial septal defect typically does not require routine physical therapy unless there are additional developmental or musculoskeletal concerns. It is not the primary referral for cardiac follow-up.

C. Occupational therapist: Occupational therapy helps clients develop fine motor skills and perform daily activities. For a newborn with a heart defect, OT is usually not indicated unless developmental delays or feeding difficulties are present. Cardiac management and follow-up are more urgent concerns at discharge.

D. Nurse manager: The nurse manager oversees nursing staff and unit operations rather than providing direct patient follow-up or discharge planning. Referral to the nurse manager does not address the newborn’s ongoing care needs after discharge and is not part of standard interprofessional follow-up for an atrial septal defect.

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Correct Answer is B

Explanation

A. Decreased level of consciousness: This is a late sign of hypoxia, indicating significant oxygen deprivation and possible brain involvement. Immediate intervention is required at this stage.

B. Restlessness: Restlessness is an early clinical manifestation of hypoxia. It reflects the body’s initial response to inadequate oxygenation, often presenting as anxiety, irritability, or agitation, and should prompt further assessment and intervention.

C. Circumoral cyanosis: Cyanosis around the mouth is a late sign of hypoxia, typically appearing after prolonged oxygen deprivation when oxygen saturation has significantly dropped.

D. Seizures: Seizures occur only in severe, prolonged hypoxia or hypoxemia affecting the central nervous system. This is a late and serious indicator of oxygen deprivation.

A. Test the glucose level of the client's pulmonary secretions. B. Ask the client to speak after air instillation. C. Auscultate the client's stomach during air instillation. D. Test the pH level of the client's gastric aspirate

Correct Answer is D

Explanation

A. Test the glucose level of the client's pulmonary secretions: Testing glucose in pulmonary secretions is not a reliable method for verifying NG tube placement. Pulmonary secretions may have variable glucose levels and cannot confirm gastric placement, making this method unsafe for ensuring the tube is correctly positioned.

B. Ask the client to speak after air instillation: Having the client speak after air instillation is not a valid or safe method to confirm NG tube placement. Speaking does not provide any reliable indication of whether the tube is in the stomach or lungs and could lead to a false sense of security.

C. Auscultate the client's stomach during air instillation: Listening for a “whoosh” of air over the stomach has been a traditional practice but is unreliable and not recommended as the sole method. Air may also enter the lungs, producing a similar sound and potentially causing harm if feeding is initiated in a malpositioned tube.

D. Test the pH level of the client's gastric aspirate: Measuring the pH of aspirated gastric contents is a safe and effective method to confirm NG tube placement. Gastric fluid typically has a pH of 1–5, whereas respiratory secretions are more alkaline. This provides reliable verification before initiating enteral feeding.

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A nurse is preparing to discharge a newborn who has an atrial septal defect. The nurse should expect the provider to refer the client to which of the following interprofessional team members?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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