A nurse is preparing to give change-of-shift report to the oncoming nurse. Which of the following information should the nurse include?

Medical diagnosis.

Number of visitors.

Routine care.

Expected laboratory results.

Answer and Explanation

The Correct Answer is A

A. Medical diagnosis:
This provides context for the patient’s condition and guides the next nurse in understanding care priorities.

B. Number of visitors:
This is not essential clinical information for continuity of care.

C. Routine care:
Routine care (like scheduled hygiene or linen changes) is generally not included unless there was a deviation or issue.

D. Expected laboratory results:
Only actual or pending critical results should be reported. “Expected” values are not useful unless they have been received and are relevant.

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Correct Answer is C

Explanation

The nurse should explain that the injection is administered in order to prevent vitamin K deficiency bleeding (VKDB) in the newborn. Vitamin K is needed for blood clotting, but newborn babies have very low levels of vitamin K in their bodies at birth because only small amounts of the vitamin pass through the placenta and breast milk. VKDB can cause life-threatening bleeding in various parts of the body, such as the brain, intestines, or skin. VKDB can be classified into early-onset, classic, or late- onset depending on the time of presentation after birth. The most effective way to prevent VKDB is to give a single intramuscular dose of 0.5 to 1 mg of vitamin K to all newborn infants within 6 hours of birth.

Choice A is wrong because sepsis is not caused by vitamin K deficiency, but by bacterial infection.

Choice B is wrong because tachypnea is not caused by vitamin K deficiency, but by respiratory distress or other conditions.

Choice D is wrong because jaundice is not caused by vitamin K deficiency, but by high levels of bilirubin in the blood.

A. Homocysteine. B. Indirect Coombs. C. Erythropoietin. D. aPTT.

Correct Answer is B

Explanation

The indirect Coombs test is used to detect antibodies against foreign red blood cells in the maternal serum. This test can help identify maternal-fetal blood incompatibility, which can cause hemolytic disease of the newborn.

Choice A is wrong because homocysteine is a type of amino acid and is not related to blood compatibility.

Choice C is incorrect because erythropoietin is a hormone that regulates red blood cell production and is not a specific test for detecting maternal-fetal blood incompatibility.

Choice D is not the correct answer as aPTT (activated partial thromboplastin time) is a test used to evaluate blood clotting factors and is not directly related to monitoring maternal-fetal blood incompatibility.

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A nurse is preparing to give change-of-shift report to the oncoming nurse. Which of the following information should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postpartum and asks the nurse why her newborn received a vitamin K injection. The nurse should explain that the injection is administered in order to prevent which of the following complications in the newborn?

Correct Answer is C

Explanation

A nurse is caring for a client who is pregnant and Rh-negative. The nurse should plan to monitor which of the following maternal laboratory test results to determine maternal-fetal blood incompatibility?

Correct Answer is B

Explanation

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