A nurse is caring for a newborn who is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse take?

Provide frequent stimulation for the newborn.

Encourage frequent eye contact with the newborn during feedings.

Decrease the lighting levels in the nursery.

Wrap the newborn loosely in a blanket

Answer and Explanation

The Correct Answer is C

A. Provide frequent stimulation for the newborn. Excessive stimulation can worsen symptoms in newborns with neonatal abstinence syndrome (NAS), including irritability, tremors, and difficulty sleeping. These infants need a calm, low-stimulation environment to reduce neurologic stress.
B. Encourage frequent eye contact with the newborn during feedings. While bonding is important, prolonged or forced eye contact can overstimulate a newborn with NAS. These infants often have difficulty regulating sensory input and may become more irritable with excessive interaction.
C. Decrease the lighting levels in the nursery. A dim, quiet environment helps soothe infants experiencing NAS. Reducing lighting can minimize sensory overload, promote rest, and support neurologic regulation during withdrawal.
D. Wrap the newborn loosely in a blanket. Loose wrapping does not provide the security and containment that helps calm an overstimulated infant. Instead, swaddling the newborn snugly can reduce tremors, promote sleep, and offer comfort during withdrawal symptoms.

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Correct Answer is A

Explanation

A. Draw up regular insulin prior to NPH insulin. This is the correct technique when mixing short-acting (regular) and intermediate-acting (NPH) insulins in the same syringe. Drawing up regular insulin first prevents contamination of the clear insulin vial with the cloudy NPH, which could alter the action of the regular insulin.
B. Roll the syringe gently to ensure mixture of the insulins. Insulin should be mixed in the vial before drawing it into the syringe—not after. NPH insulin should be gently rolled between the hands to mix it, but the syringe itself should not be rolled after drawing both insulins, as this can introduce bubbles and affect dosing accuracy.
C. Inject into the vastus lateralis. The preferred sites for subcutaneous insulin administration are areas with sufficient subcutaneous tissue, such as the abdomen, upper outer arms, thighs, or buttocks. The vastus lateralis is more commonly used for intramuscular injections, such as vaccines.
D. Use a 15° angle for the injection. A 15° angle is appropriate for intradermal injections, not subcutaneous insulin injections. For insulin, the correct angle is typically 45° or 90°, depending on the client’s body habitus and needle length, to ensure proper subcutaneous delivery.

A. Refer the family to a chronic pain support group. B. Set up an appointment with the school nurse. C. Review the child's electronic pain diary. D. Request a change in medication from the provider.

Correct Answer is C

Explanation

A. Refer the family to a chronic pain support group. While helpful, this is a later step in the care plan. The nurse must first assess the child's specific condition and patterns of pain.
B. Set up an appointment with the school nurse. This is a supportive measure but not the priority. The nurse must gather more information before involving school personnel.
C. Review the child's electronic pain diary. This is the first action because it allows the nurse to assess the frequency, triggers, severity, and duration of the migraines. Understanding the child's pain pattern is essential for effective treatment planning.
D. Request a change in medication from the provider. This may be necessary, but the nurse should first gather complete data on the child's symptoms and current response to treatment before suggesting changes to the medication regimen.

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A nurse is caring for a newborn who is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse take?

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