The birth weight of an infant delivered by a woman with gestational diabetes is 10.1 pounds (4,581 grams). The infant is jitery and has a heel stick glucose level of 40 mg/dL (2.2 mmol/L) 30 minutes after birth. Based on this information, which intervention should the practical nurse (PN) implement first?

Reference range:

Blood glucose neonate: [30 to 60 mg/dL or 1.7 to 3.3 mmol/L]

Oﬀer nipple feedings of 10% dextrose.

Begin frequent feedings of breast milk or formula

Repeat the heel stick for glucose in one hour

Assess for signs of hypocalcemia

Answer and Explanation

The Correct Answer is B

b. Begin frequent feedings of breast milk or formula.

The infant has hypoglycemia, which is a low blood glucose level that can cause jiteriness, lethargy, seizures, or coma. Hypoglycemia is common in infants of mothers with gestational diabetes, as they produce excess insulin in response to high maternal glucose levels. The PN should begin frequent feedings of breast milk or formula, as this can provide a source of glucose and stimulate the infant's own glucose production.

The other options are not correct because:

a. Oﬀering nipple feedings of 10% dextrose may be indicated in some cases of severe hypoglycemia, but it is not the first intervention. The PN should try oral feedings of breast milk or formula first, as they are more natural and less invasive.

c. Repeating the heel stick for glucose in one hour may be necessary to monitor the infant's glucose level, but it is not the first intervention. The PN should treat the hypoglycemia first, as it can have serious consequences if left untreated.

d. Assessing for signs of hypocalcemia may be important, as hypocalcemia is another possible complication in infants of mothers with gestational diabetes, but it is not the first intervention. The PN should address the hypoglycemia first, as it is more urgent and more likely to cause jiteriness.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

A. Explaining the examination and asking the client to sign the consent form is not within the PN's scope of practice. It is the responsibility of the healthcare provider performing the procedure to explain the risks, benefits, and alternatives of the exam and to obtain informed consent from the client.

B. Checking the medical record for the correct signed consent form prior to the examination is an essential role for the practical nurse. It ensures that informed consent has been obtained and documented before proceeding with any invasive procedure, aligning with the PN's responsibility to verify necessary documentation.

C. Explaining to a family member and obtaining their signature on the consent form may be appropriate only if the client is unable to provide consent and has a legal representative. However, obtaining consent and explaining the procedure is still the responsibility of the healthcare provider, not the PN.

D. Asking if the client understands the exam and why the consent form must be signed is part of the PN's role in ensuring that the client is informed, but the PN cannot assume responsibility for explaining the procedure in detail. This should be done by the healthcare provider who will perform the exam.

A. Absence of coarse crackles. B. Increase in respiratory rate. C. Increase in breath sounds. D. Absence of fine crackles.

Correct Answer is A

Explanation

A) Correct - The absence of coarse crackles indicates that the airway has been cleared of secretions effectively, and the lung sounds are clearer.
B) Incorrect - An increase in respiratory rate could indicate distress rather than the effectiveness of the intervention.
C) Incorrect - An increase in breath sounds may not necessarily indicate the effectiveness of the intervention, as the quality of breath sounds matters more than the increase.
D) Incorrect - The absence of fine crackles might not directly indicate the effectiveness of the intervention, as other factors can influence lung sounds.

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Naxlex Comprehensive Predictor Exams

Prior to an invasive examination of a hospitalized client, a consent form should be obtained. Which action best describes the responsibility of the practical nurse (PN)?

Correct Answer is B

Explanation

The nurse is performing tracheostomy care for a client who underwent a laryngectomy for laryngeal cancer. During the procedure, the client begins to cough and is unable to clear the secretions. After the nurse suctions the airway, which finding indicates the intervention was effective?

Correct Answer is A

Explanation

An oil retention enema is prescribed for a hospitalized client. The practical nurse (PN) should administer the enema solution at which temperature?

At a prenatal visit, a primigravida client confides to the practical nurse (PN) that her partner is abusive. Which information should the PN provide?

The practical nurse (PN) observes two unlicensed assistive personnel (UAP) turning an older client who had a hip arthroplasty with prosthesis placement four hours ago. Which observation by the PN indicates that the UAPs need additional information about the turning procedure?

A client with chronic kidney disease reports to the nurse of feeling increasingly tired. The client receives injections for epoetin alfa three times a week. Which laboratory value should the nurse review?

When gathering data about a client with dark skin tones, which site should the practical nurse (PN) observe?

Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?