The nurse receives 2 newborns within the first minutes after a vaginal delivery and intervenes to establish adequate respirations.
What is the priority issue that the nurse should address to ensure the newborn’s survival?
Hypoglycemia.
Bleeding tendencies.
Heat loss.
Fluid balance.
The Correct Answer is C
Choice A rationale
Hypoglycemia, or low blood sugar, is a concern in newborns, but it is not the most immediate concern within the first minutes after delivery.
Choice B rationale
While newborns do have certain bleeding tendencies due to immature clotting mechanisms, this is not the immediate priority in the first minutes after birth.
Choice C rationale
The priority issue that the nurse should address to ensure the newborn’s survival is heat loss.
Newborns are at high risk of heat loss and maintaining their body temperature is crucial. This is because they have a large body surface area relative to their weight and their temperature regulation mechanism is not fully developed.
Choice D rationale
Fluid balance is important in newborns, but it is not the immediate concern in the first minutes after birth. The initial focus is on establishing respiration and maintaining body temperature.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is A. Praise the client for her actions and offer to discuss ways to decrease consumption even more.
Why? During pregnancy, any amount of alcohol poses a risk to the developing fetus, but abruptly shaming or forcing action may not be effective. The best approach is motivational interviewing, which involves acknowledging the client's reduction while encouraging further progress. A supportive conversation can help guide the client toward complete cessation of alcohol use.
Here’s why the other options are incorrect:
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B. Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit – While alcohol cessation is the goal, forcing the client without a supportive approach can lead to resistance. Routine blood alcohol testing is not standard unless substance dependence is suspected.
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C. Notify child protective services of the client’s illicit drug use and probable child endangerment – Alcohol is not classified as an illicit drug, and reporting at this stage would be premature unless clear evidence of abuse or harm to the fetus exists.
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D. Refer the client to an outpatient alcohol abuse program for disulfiram therapy – Disulfiram (Antabuse) is not recommended in pregnancy, as it may cause adverse effects. Instead, behavioral counseling and support groups are preferred interventions.
Correct Answer is ["25"]
Explanation
Answer and explanation
Step 1 is to convert the child’s weight from pounds to kilograms since the dosage is prescribed in mg/kg. We know that 1 kg is approximately 2.2 lbs. So, the child’s weight in kg is 55 lbs ÷ 2.2 = 25 kg (rounded to the nearest whole number for simplicity).
Step 2 is to calculate the total daily dosage. The prescription is for isoniazid 10 mg/kg/day. So, the total daily dosage in mg is 10 mg/kg/day × 25 kg = 250 mg/day.
Step 3 is to calculate the volume of the oral solution to administer. The bottle is labeled, “Isoniazid Oral Solution, USP 50 mg per 5 mL.”. So, the volume in mL to administer is (250 mg/day ÷ 50 mg) × 5 mL = 25 mL. Therefore, the nurse should administer 25 mL of the Isoniazid Oral Solution, USP 50 mg per 5 mL, once a day.
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