The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone. What approach should the nurse take when performing the test to prevent this complication?

Lancet should penetrate the ball of the foot.

Lancet should penetrate at the outer aspect of the heel.

Lancet should penetrate the area just below the fifth toe.

Lancet should penetrate the walking surface of the heel.

Answer and Explanation

The Correct Answer is B

A.   The ball of the foot is not recommended for heelstick procedures.
B.   The outer aspect of the heel is the preferred site. This area has fewer nerve endings and less risk of damaging the bone or cartilage.
C. The area below the fifth toe is not a standard site for a heelstick.
D.   The walking surface of the heel should be avoided since it is prone to infection, more sensitive, and may interfere with walking.

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Correct Answer is ["A","D","E"]

Explanation

A. Hepatitis B immunization is typically administered soon after birth for protection.
B. Hib immunization is usually given later and not immediately after birth.
C. Lidocaine gel is not routinely used on the umbilical stump.
D. Vitamin K injection is commonly given to prevent bleeding disorders in newborns.
E. Antibiotic ointment to both eyes prevents eye infections that can be caused by bacteria transmitted from the mother during delivery.

A. 110/min B. 100/min C. 22/min D. 48/min

Correct Answer is D

Explanation

A. A respiratory rate of 110/min is too high for a newborn and may indicate respiratory distress.
B. A respiratory rate of 100/min is too high for a newborn and may indicate respiratory distress.
C. A respiratory rate of 22/min is too low for a newborn.
D. A normal respiratory rate for a newborn is between 40 and 60 breaths per minute.

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The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone. What approach should the nurse take when performing the test to prevent this complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a newborn immediately following birth. Which of the following medications should the nurse anticipate administering? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

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Correct Answer is D

Explanation

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