A nurse is caring for a newborn.
Vital Signs.
0640:. Temperature 36.7°C (98.1° F) axillary.
Heart rate 154/min.
Respiratory rate 68/min.
BP 72/48 mm Hg. 0650:. Heart rate 156/min.
Respiratory rate 72/min.
0700:. Temperature 37° C (98.6° F) axillary.
Heart rate 156/min.
Respiratory rate 76/min.
Admission Assessment.
0630:. Newborn delivered via cesarean birth under spinal anesthesia at. 0630.
Amniotic fluid clear.
0631:. 1-min Apgar score 7. 0636:. 5-min Apgar score 9. Newborn transferred to nursery.
Nurses' Notes.
0640:. Weight 4200 gm (9 Ib 4 oz), head circumference 35.5 cm (14 in). Respiratory rate 68/min, with mild grunting.
0650:. Respiratory rate 72/min, with mild grunting.
0700:. Respiratory rate 76/min, with moderate grunting and mild.
intercostal retractions.
Drag words from the choices below to fill in each blank in the following.
sentence.
The client is at risk for developing Target 1 and Target 2.
Hypoglycemia.
Bronchopulmonary dysplasia.
Transient tachypnea of the newborn.
Tachycardia.
The Correct Answer is C
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is **b. A room containing personal belongings.**
Choice A rationale:
A room without a window would not be a therapeutic environment for a cognitively impaired client. Lack of natural light and connection to the outside world can be disorienting and distressing for these patients.
Choice B rationale:
A room containing personal belongings is the most therapeutic environment for a cognitively impaired client. Familiar objects and surroundings can help provide a sense of comfort, security, and orientation. This can reduce agitation and confusion, which are common issues for cognitively impaired patients.
Choice C rationale:
A room adjacent to the nursing station may not be the most therapeutic environment. While proximity to staff can be beneficial, the increased noise and activity level near the nursing station could be overstimulating and disruptive for a cognitively impaired client.
Choice D rationale:
A room with dim lighting is not ideal for a cognitively impaired client. Adequate lighting is important to help these patients maintain orientation and avoid falls or other safety issues. Dim lighting can contribute to confusion and disorientation.
Correct Answer is D
No explanation
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