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Nurses' Notes
3 weeks old:
Follow up newborn weight check. Parent is smoking a cigarette in the living room while infant sleeps. Parent reports the newborn is breastfeeding well. The newborn is asleep in their bassinet in the living room. Newborn currently asleep in prone position. Parent reports that the newborn sleeps in their bassinet in the parents' bedroom overnight.
Vital Signs
3 weeks old:
Temperature 36.9° C (98.4" F)
Heart rate 138/min
Respiratory rate 42/min
Parent is smoking a cigarette in the living room while infant sleeps
Newborn currently asleep in prone position
Parent reports that the newborn sleeps in their bassinet in the parents' bedroom overnight
Temperature 36.9° C (98.4" F)
Heart rate 138/min
Respiratory rate 42/min
The Correct Answer is ["A","B"]
- Parent smoking around the infant exposes the newborn to secondhand smoke, increasing the risk of respiratory infections and sudden infant death syndrome (SIDS). Smoking should be avoided in the infant’s environment.
- The prone sleeping position raises the risk of SIDS; current guidelines recommend placing infants to sleep on their backs (supine position) to reduce this risk.
Rationale for Incorrect Findings:
- The newborn’s vital signs are within normal limits for a 3-week-old: temperature 36.9° C (98.4° F), heart rate 138/min, respiratory rate 42/min. These values indicate stable cardiopulmonary status and do not require intervention.
- The newborn sleeping in a bassinet, particularly in the parents’ bedroom, follows safe sleep recommendations that reduce SIDS risk by promoting a separate, firm sleeping surface close to caregivers. This is an appropriate practice and does not require intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The presence of community members smoking reflects individual lifestyle choices, as smoking is a personal behavior that directly affects health. Observing such behavior can help the nurse identify trends in health practices and target interventions like smoking cessation programs.
B. The presence of a community health clinic represents an available resource for healthcare access, which is a structural or systemic factor rather than an individual lifestyle choice. It reflects the healthcare infrastructure in the area.
C. The presence of a manufacturing facility is related to the economic and environmental conditions of the community. While it may influence occupational health, it is not an indicator of personal health choices made by individuals.
D. The presence of high-speed internet is an infrastructural advantage that may support health education and access to services, but it is not a direct observation of personal health behavior or lifestyle decisions.
Correct Answer is ["B","C"]
Explanation
Rationale for Correct Choices:
- Teach healthcare workers how to distinguish the disease from chickenpox: Smallpox and chickenpox may initially present with similar rash-like symptoms. Rapid and accurate recognition by healthcare workers is critical to implement isolation protocols and prevent further transmission in a bioterrorism event.
- Vaccinate laboratory workers against the disease: Laboratory workers who may handle specimens suspected of containing smallpox virus are at high occupational risk. Pre-exposure vaccination is appropriate for these individuals to protect them during diagnostic and investigative procedures.
Rationale for Incorrect Choices:
- Obtain standing orders to treat infected individuals with ciprofloxacin: Ciprofloxacin is not effective against smallpox, which is caused by a virus. Using an antibiotic would not provide benefit unless there were bacterial complications. The preferred antiviral agent for smallpox is tecovirimat (TPOXX).
- Perform routine screening to identify infected animals: Smallpox does not occur in animals; it has no animal reservoir. Screening animals would not contribute to disease surveillance or prevention and is not a necessary step in smallpox preparedness.
- Implement routine vaccination for the disease for the general public population: Routine smallpox vaccination was stopped decades ago after global eradication. In a bioterrorism scenario, targeted vaccination (ring vaccination) would be used rather than mass immunization.
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