A nurse is caring for a newborn who has an order for phototherapy to treat hyperbilirubinemia. Which of the following actions should the nurse take?

Place eye covers on the newborn while under the lights.

Apply an emollient lotion to skin that is exposed to the lights.

Remove all blankets, clothing and diapers while the newborn is under lights

Keep the newborn as close to the light source as possible.

Answer and Explanation

The Correct Answer is A

Rationale:

A. Place eye covers on the newborn while under the lights: Eye protection is essential during phototherapy to prevent retinal damage from the high-intensity blue light. The covers should be properly fitted and removed only during feedings or when the therapy is paused.

B. Apply an emollient lotion to skin that is exposed to the lights: Emollients are not recommended during phototherapy because they can increase the risk of burns or interfere with light penetration. The newborn’s skin should remain clean and dry to ensure safety and effective treatment.

C. Remove all blankets, clothing and diapers while the newborn is under lights: While minimal clothing is used to expose as much skin as possible, the diaper is typically kept in place to protect the genital area and reduce the risk of contamination. Full removal is not necessary or recommended.

D. Keep the newborn as close to the light source as possible: The distance between the newborn and the phototherapy light should be within manufacturer guidelines. Moving the newborn too close can increase the risk of overheating or skin damage, so positioning must follow safety standards.

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Correct Answer is D

Explanation

Rationale:

A. "We only have to tell your parents if your test comes back positive.": Giving conditional privacy based on test results is misleading. Confidentiality in STI testing applies regardless of the outcome and is protected by law in many regions for adolescents.

B. "We need your parents' permission if you are on their insurance.": Insurance coverage does not determine the legal right to consent. While explanation of benefits forms may create confidentiality challenges, consent laws usually allow minors to access STI testing independently.

C. "We will have to get your parents' consent before testing you for STIs.": Requiring parental consent for STI testing contradicts legal protections in many areas that allow minors to access sexual and reproductive health care without parental involvement.

D. “We can test you for STIs without informing your parents.": Supporting the adolescent's autonomy and legal rights, this answer provides accurate information about confidential care and encourages open, respectful communication between the nurse and client.

A. Put a simple lock on the client's bedroom door. B. Give the client a barbiturate medication at bedtime. C. Encourage the client to take frequent walks during the day. D. Allow the client to nap for at least 1 hr during the day.

Correct Answer is C

Explanation

Rationale:

A. Put a simple lock on the client's bedroom door: Locking the client's door could pose a safety risk, especially in the event of an emergency such as a fire. It also restricts the client's autonomy and may increase confusion or agitation in clients with Alzheimer's disease.

B. Give the client a barbiturate medication at bedtime: Barbiturates are not recommended for older adults due to their sedating effects and risk of dependence, falls, and worsening cognitive function. Non-pharmacologic strategies are preferred first in managing sleep disturbances.

C. Encourage the client to take frequent walks during the day: Physical activity during the day helps reduce nighttime restlessness and improve sleep patterns. Walking can also help regulate circadian rhythms, promote relaxation, and reduce wandering behavior at night.

D. Allow the client to nap for at least 1 hr during the day: Long daytime naps may disrupt the sleep-wake cycle, worsening insomnia and nighttime wandering. Limiting daytime napping and encouraging activity is more effective in promoting restful nighttime sleep.

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A nurse is caring for a newborn who has an order for phototherapy to treat hyperbilirubinemia. Which of the following actions should the nurse take?

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