A mother of a preterm baby is performing skin-to-skin contact in the neonatal nursery. Which of the following responses would the nurse evaluate as a positive neonatal outcome?
Respiratory rate of 75.
Temperature of 96.5°F.
Sucking or licking of mother’s nipples.
Flaring of the baby’s nares.
The Correct Answer is C
Choice A rationale
A respiratory rate of 75 breaths per minute exceeds the normal range of 30 to 60 breaths per minute in neonates. Tachypnea indicates distress, which necessitates immediate intervention to prevent complications.
Choice B rationale
A temperature of 96.5°F is below the normal neonatal range of 97.7°F to 99.5°F, suggesting hypothermia. This can impair enzyme activity, oxygen delivery, and thermoregulatory functions, requiring prompt warming measures.
Choice C rationale
Sucking or licking of the nipples reflects a positive response in kangaroo care, indicative of improved thermoregulation and bonding. This natural behavior also suggests a healthy neonate capable of initiating feeding.
Choice D rationale
Nasal flaring is a sign of respiratory distress, typically indicating increased effort to meet oxygen demands. This would not be considered a positive outcome and requires immediate evaluation and intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Postpartum depression does not resolve without intervention. It requires medical or psychological treatment to address underlying hormonal, emotional, and environmental factors contributing to the condition.
Choice B rationale
Postpartum depression is distinct from baby blues, which are transient and resolve without treatment. PPD involves more severe symptoms requiring medical or psychological intervention for effective management.
Choice C rationale
Postpartum depression is not limited to older Caucasian women. It affects women of all ages, ethnicities, and socioeconomic backgrounds, influenced by hormonal, genetic, and environmental factors.
Choice D rationale
Postpartum depression is characterized by severe anxiety, irritability, and panic attacks, distinguishing it from baby blues. These symptoms interfere with daily functioning and require medical or psychological treatment.
Correct Answer is B
Explanation
Choice A rationale
Surgical intervention is not the initial step for uterine atony as conservative measures, such as fundal massage, are prioritized to encourage uterine contraction and reduce bleeding.
Choice B rationale
Fundal massage stimulates uterine contraction by mechanically compressing the myometrium, which helps to constrict the spiral arteries and reduce hemorrhage caused by uterine atony.
Choice C rationale
Establishing venous access is critical for fluid resuscitation but does not directly address the underlying cause of hemorrhage, which requires mechanical or pharmacological uterine contraction.
Choice D rationale
Catheterizing the bladder can prevent displacement of the uterus but does not directly address uterine atony. An empty bladder supports fundal massage by allowing proper uterine positioning.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
