A nurse is contributing to the care of a newborn who is experiencing hyperbilirubinemia and is receiving phototherapy.
Which of the following findings indicate that the phototherapy is effective?
Serum bilirubin level has increased from 6 hours ago.
Hemoglobin and hematocrit have increased.
Transcutaneous bilirubin (TcB) level has decreased from 6 hours ago.
Jaundice moves from chest to groin level.
The Correct Answer is C
Choice A rationale
An increase in serum bilirubin levels indicates worsening hyperbilirubinemia rather than improvement. Effective phototherapy should result in a decrease in bilirubin levels as it helps break down bilirubin into a form that can be excreted.
Choice B rationale
Hemoglobin and hematocrit levels are not directly affected by phototherapy. These values are more related to red blood cell count and do not indicate the effectiveness of phototherapy for treating hyperbilirubinemia.
Choice C rationale
A decrease in transcutaneous bilirubin (TcB) levels from 6 hours ago indicates effective phototherapy. Phototherapy reduces bilirubin levels in the blood by converting it to a water-soluble form that can be eliminated from the body.
Choice D rationale
Jaundice typically moves from the head to the lower body as bilirubin levels decrease. Movement from chest to groin level without a corresponding decrease in bilirubin levels does not necessarily indicate effective phototherapy. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Painless, bright red vaginal bleeding at 36 weeks gestation is a classic sign of placenta previa, where the placenta is abnormally implanted in the lower uterine segment, covering the cervix, and causing bleeding without pain.
Choice B rationale
Threatened abortion is characterized by vaginal bleeding before 20 weeks of gestation with or without abdominal pain. At 36 weeks, the term would be inappropriate, and the symptoms do not match.
Choice C rationale
Abruptio placentae involves painful vaginal bleeding due to premature placental separation. The presence of pain differentiates it from placenta previa.
Choice D rationale
Preterm labor may present with contractions, cervical changes, and possible bleeding, but the key feature distinguishing it from placenta previa is the presence of uterine contractions and pain, which are absent in this scenario.
Correct Answer is B
Explanation
Choice A rationale
Placing a newborn on the parent's stomach and covering with a warm blanket helps to regulate body temperature through skin-to-skin contact, which is essential for newborns, especially shortly after birth.
Choice B rationale
Rectal temperature checks are not recommended for newborns due to the risk of rectal perforation. Newborn temperatures are typically monitored using axillary (underarm) methods.
Choice C rationale
Keeping a newborn’s head covered helps to prevent heat loss, as a significant amount of body heat can be lost through the head. This practice is crucial in maintaining the newborn's body temperature.
Choice D rationale
Newborns should be kept away from drafts, including fans and air conditioning vents, to prevent them from becoming too cold. Keeping the bassinet away from these can help maintain a stable temperature.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.