A nurse is assessing a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect?

Excessive crying

Decreased muscle tone

Absent Moro reflex

Diminished deep tendon reflexes

Answer and Explanation

The Correct Answer is A

Rationale:

A. Excessive crying:

Correct answer. Neonatal abstinence syndrome (NAS) often presents with irritability, inconsolable crying, and difficulty soothing.

B. Decreased muscle tone: NAS can cause hypertonia or increased muscle tone rather than decreased muscle tone.

C. Absent Moro reflex: NAS may cause hyperactive Moro reflex rather than absent.

D. Diminished deep tendon reflexes: NAS can cause hyperactive deep tendon reflexes rather than diminished.

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Correct Answer is C

Explanation

Rationale:

A. Administering methylergonovine is not appropriate for a fourth-degree perineal laceration.

Methylergonovine is typically used to prevent or treat postpartum hemorrhage by promoting uterine contractions.

B. Applying povidone-iodine to the client's perineum is not indicated for the management of a perineal laceration. Povidone-iodine is an antiseptic solution used for wound cleansing, but it may be too harsh for the perineal area.

C. Providing the client with a cool sitz bath is appropriate for managing discomfort and promoting healing after a fourth-degree perineal laceration. A sitz bath helps to soothe the perineal area and reduces inflammation.

D. Applying a moist, warm compress to the perineum is not recommended for a fourth-degree perineal laceration, as it may increase the risk of infection and discomfort.

A. Position the client supine with knees flexed and place a small rolled towel under one of their hips. B. Palpate the fetal part positioned in the fundus. C. Instruct the client to empty their bladder. D. Palpate the fetal parts along both sides of the uterus. E. Palpate the fetal part positioned above the symphysis pubis.

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

Explanation

C. Instruct the client to empty their bladder.

A. Position the client supine with knees flexed and place a small rolled towel under one of their hips.
B. Palpate the fetal part positioned in the fundus.

D. Palpate the fetal parts along both sides of the uterus.

E. Palpate the fetal part positioned above the symphysis pubis.

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A nurse is assessing a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 12 hr postpartum and has a fourth-degree laceration of the perineum. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

31. A nurse is preparing to perform Leopold maneuvers on a client who is at 36 weeks of gestation. Identify the sequence of actions the nurse should take. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps)

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

Explanation

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