A nurse is assisting with the care of a newborn who has neonatal abstinence syndrome. Which of the following actions should the nurse take first?
Weigh the newborn's wet diaper.
Auscultate the newborn's bowel sounds.
Determine the newborn's respiratory rate.
Swaddle the newborn in blankets.
The Correct Answer is C
A. weighing the newborn's wet diaper, is a routine part of newborn care but is not the first priority in this situation.
B. auscultating the newborn's bowel sounds, is important for assessing gastrointestinal function but is not the first priority when the baby is at risk for respiratory distress.
C. Neonatal abstinence syndrome (NAS) is a condition that occurs in newborns who were exposed to addictive substances in utero. One of the key concerns in NAS is respiratory distress, so determining the newborn's respiratory rate is the first priority.
D. swaddling the newborn in blankets, is a comfort measure but does not address the immediate concern of assessing respiratory status in a baby with suspected NAS.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. 2+ ketonuria indicates an elevated level of ketones in the urine, which can be a sign of inadequate nutrition or metabolism. This should be reported to the provider for further evaluation.
B. A urine specific gravity of 1.030 is within normal range during pregnancy.
C. A hematocrit (Hct) of 38% is within the normal range for a pregnant individual.
D. A fasting blood glucose level of 70 mg/dL is within the normal range.
Correct Answer is A
Explanation
A. The nurse's role is to provide education and information about available methods of contraception without imposing personal beliefs or preferences.
B. It is not the nurse's role to select the method of contraception for the client. The decision should be made by the client based on their individual preferences and health considerations.
C. While assessing the client's socioeconomic status may be relevant for some aspects of care, it is not directly related to providing information about contraception.
D. Collecting a dietary history is not relevant to a client's inquiry about contraception.
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