A nurse is reviewing the safety plan for preventing newborn abduction with newly licensed nurses. Which of the following information should the nurse include in the teaching?
Instruct the client to carry the newborn in their arms when going to the nursery.
Remove the electronic security sensor when the newborn is in the client's room.
Apply identification bands after the newborn's first bath.
Discourage family from posting photos of the newborn on social media.
The Correct Answer is D
Rationale:
A. Instruct the client to carry the newborn in their arms when going to the nursery: Carrying a newborn to the nursery without security measures increases the risk of abduction. Infants should always be transported in a secure bassinet or by authorized staff using the hospital’s safety protocols.
B. Remove the electronic security sensor when the newborn is in the client's room: The electronic security sensor is essential for monitoring the newborn’s location within the hospital. Removing it defeats the purpose of the abduction prevention system and is unsafe.
C. Apply identification bands after the newborn's first bath: Identification bands should be applied immediately after birth to ensure accurate identification from the start. Waiting until after the first bath delays verification and increases risk for misidentification or abduction.
D. Discourage family from posting photos of the newborn on social media: Sharing identifiable information or images online can inadvertently alert potential abductors to the newborn’s presence. Families should be advised to limit social media exposure until the infant’s safety can be ensured.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","F","G","H"]
Explanation
Rationale:
A. Hemoglobin and hematocrit: The client’s hemoglobin (9.1 g/dL) and hematocrit (27%) are significantly below normal, indicating anemia, likely from gastrointestinal bleeding. This finding requires immediate follow-up to prevent further hemodynamic compromise and assess for ongoing blood loss.
B. Stool results: The client reports dark, tarry stool, which is indicative of melena and gastrointestinal bleeding. Positive hemoccult (if confirmed) further supports active bleeding. Prompt evaluation is necessary to identify the source and prevent severe anemia or shock.
C. Temperature: The client’s temperature is 37.5°C (99.5°F), which is mildly elevated but not critically high. It does not indicate an immediate life-threatening condition, though it should be monitored as part of ongoing assessment for infection.
D. WBC count: The WBC is 6,700/mm³, which is within normal limits. There is no indication of acute infection requiring immediate intervention at this time.
E. Respiratory rate: The respiratory rate of 18/min is within normal limits and does not require immediate follow-up.
F. Heart rate: The client’s heart rate is 118/min, which is tachycardic and may indicate hypovolemia from blood loss. Immediate monitoring and intervention are warranted to prevent cardiovascular compromise.
G. Blood pressure: The client’s blood pressure is 90/50 mm Hg, which is hypotensive. This may result from fluid loss due to bleeding and requires urgent assessment and stabilization to prevent shock.
H. Current medications: The client is taking high-dose ibuprofen (800 mg three times daily), a nonsteroidal anti-inflammatory drug (NSAID), which increases the risk of gastrointestinal bleeding and ulcer formation. This directly relates to the client’s presenting symptoms and requires immediate review and discontinuation.
Correct Answer is B
Explanation
Rationale:
A. "Taking disulfiram is an alternate therapy instead of joining Alcoholics Anonymous.": Disulfiram is a pharmacologic aid and should be used in combination with counseling or support groups like Alcoholics Anonymous. It is not a standalone treatment and does not replace behavioral therapies.
B. "I should avoid products containing alcohol, like mouthwash, while taking this medication.": Disulfiram causes a severe reaction when alcohol is ingested, even in small amounts found in products like mouthwash or cough syrup. Avoiding all alcohol-containing products demonstrates correct understanding of safety precautions while taking this medication.
C. "Disulfiram is mainly used for people who are at a high risk for a relapse of drinking alcohol.": Disulfiram is primarily used to maintain abstinence by causing unpleasant reactions with alcohol, but it is not limited to clients at high risk of relapse. It is important for all clients on disulfiram to understand adherence and alcohol avoidance.
D. "My sensitivity to alcohol will go away 24 hours after I stop taking this medication.": Disulfiram’s effects persist for up to 14 days after discontinuation, not just 24 hours. The client must continue to avoid alcohol for a longer period even after stopping the medication to prevent adverse reactions.
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