When changing a diaper on a 2-day-old infant, the practical nurse (PN) observes that the baby's legs are flexed with limited abduction. Based on this finding, what action should the PN take next?
Perform range of motion to the joint.
Continue care since this is a normal finding.
Notify the healthcare provider.
Document the finding in the record.
The Correct Answer is C
Limited abduction of the legs in a newborn can be a sign of developmental dysplasia of the hip (DDH), a condition in which the hip joint is not properly formed. The practical nurse (PN) should notify the healthcare provider of this finding so that further assessment and appropriate intervention can be initiated.
Performing range of motion to the joint (A) is not appropriate without a healthcare provider's order. Continuing care as if this is a normal finding (B) is not appropriate because limited abduction of the legs in a newborn can be a sign of DDH. While documenting the finding in the record (D) is important, notifying the healthcare provider is the most important action for the PN to take next.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The priority goal for the practical nurse (PN) in the antepartum clinic is to ensure that the client recognizes the dangers of alcohol use during pregnancy. Alcohol consumption during pregnancy can lead to fetal alcohol syndrome and other developmental disorders. It is important for the client to understand the risks associated with alcohol use and to avoid it during pregnancy. The other goals are also important but recognizing the dangers of alcohol use takes priority.
Correct Answer is B
Explanation
Based on the assessment findings, the infant is at the greatest risk for developing anemia due to a lack of iron. Infants should begin eating solid foods that are rich in iron at around 6 months of age to ensure they are getting enough of this important nutrient. Drinking whole milk from a bottle can displace other foods that are rich in iron and contribute to the development of anemia.
Option A, allergies related to whole milk, is a possibility but not the greatest risk in this situation.
Option C, obesity due to increased calorie count, is also a possibility but not the greatest risk.
Option D, lactose intolerance due to whole milk, is a possibility but not the greatest risk in this situation.
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