1. A nurse is obtaining a capillary blood sample from a newborn for phenylketonuria testing. Identify the sequence of steps the nurse should follow. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Puncture the heel and collect the blood.

Apply pressure with a dry gauze pad.

Wrap a warm, moist cloth around the heel.

Cover the heel with an adhesive bandage.

Cleanse the heel with an antiseptic.

Answer and Explanation

The Correct Answer is C,E,A,B,D

1. Wrap a warm, moist cloth around the heel to dilate the blood vessels, which makes it easier to obtain the blood sample.

2. Cleanse the heel with an antiseptic to reduce the risk of infection at the puncture site.

3. Puncture the heel and collect the blood, ensuring that the sample is adequate for the test.

4. Apply pressure with a dry gauze pad to stop the bleeding from the puncture site.

5. Cover the heel with an adhesive bandage to protect the area and minimize the risk of infection.

Nursing Test Bank

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Correct Answer is D

Explanation

A. A glucose level of 60 mg/dL is within the normal range for a full-term newborn. Newborns generally have blood glucose levels between 40 and 60 mg/dL in the first few hours of life, and 60 mg/dL is considered acceptable for a 1-day-old newborn.
B. A WBC count of 10,000/mm³ is within the normal range for a newborn. Newborns can have elevated WBC counts due to the stress of birth, and this finding is not immediately concerning.
C. A platelet count of 225,000/mm³ is normal for a full-term newborn. Platelet counts in newborns generally range from 150,000 to 300,000/mm³, so this result falls within the expected range.
D. A hemoglobin level of 9.5 g/dL is low for a 1-day-old newborn. Normal hemoglobin levels for newborns are typically between 14 and 24 g/dL. Low hemoglobin may indicate anemia, which requires further evaluation and management.

A. Blurred vision B. Shortness of breath C. Non-pitting ankle edema D. Leukorrhea

Correct Answer is A

Explanation

A. Blurred vision can indicate a prenatal complication, such as preeclampsia, which is a serious condition that can develop in the later stages of pregnancy and requires immediate attention. Preeclampsia can lead to severe health issues for both the mother and baby.
B. Shortness of breath can be a normal part of late pregnancy due to the pressure on the diaphragm from the growing uterus. While it should be monitored, it is not specifically indicative of a complication compared to other symptoms.
C. Non-pitting ankle edema is common in the later stages of pregnancy and is not necessarily a sign of a complication on its own. It can occur due to the increased fluid volume and pressure from the uterus.
D. Leukorrhea, or increased vaginal discharge, is a common and normal finding in pregnancy, especially as labor approaches. It is generally not a sign of a complication unless accompanied by other concerning symptoms.

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1. A nurse is obtaining a capillary blood sample from a newborn for phenylketonuria testing. Identify the sequence of steps the nurse should follow. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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