A nurse on the labor and delivery unit is caring for a full-term newborn immediately following birth. Which of the following actions should the nurse take first?
Assign an Apgar score to the newborn.
Dry the newborn.
Weigh the newborn.
Place an identification bracelet on the newborn.
The Correct Answer is B
Choice A rationale:
Assigning an Apgar score is important, but drying the newborn and promoting warmth are immediate priorities.
Choice B rationale:
Drying the newborn and providing warmth help prevent heat loss and maintain the newborn's body temperature, which is essential for their well-being.
Choice C rationale:
Weighing the newborn is important, but maintaining their body temperature takes precedence immediately after birth.
Choice D rationale:
Placing an identification bracelet on the newborn is important for proper identification, but ensuring the newborn's immediate well-being and comfort is the priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Monitoring the client for a period of time after meals helps prevent behaviors such as purging or excessive exercise, which individuals with anorexia nervosa might engage in to compensate for food intake.
Choice B rationale:
Encouraging a specific weight gain is not the initial priority. Weight restoration should be approached carefully and gradually to avoid refeeding syndrome.
Choice C rationale:
Allowing the client to exercise for less than 1 hr per day is a potential intervention, but the priority is to observe the client after meals to prevent harmful behaviors.
Choice D rationale:
Weighing the client in the morning every other day is an important monitoring step, but it is not the initial intervention during admission.
Correct Answer is B
Explanation
Choice A rationale:
Expressing feelings of guilt and survivor's guilt is a common aspect of processing traumatic experiences and can be an important step in healing.
Choice B rationale:
Rationale: This statement indicates that the client is acknowledging and discussing the flashbacks related to the traumatic event. Progression toward positive outcomes in posttraumatic stress disorder (PTSD) often involves recognizing and addressing distressing symptoms.
Choice C rationale:
The preference for independence may indicate resistance to seeking support, which can hinder progress in addressing and managing PTSD symptoms.
Choice D rationale:
Recognizing that the traumatic experience has affected the ability to trust others reflects insight into the impact of the trauma on relationships, which is a step toward positive outcomes.
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