A nurse is performing a physical assessment of a newborn whose mother used cocaine throughout the pregnancy.
Which of the following findings should the nurse expect?
Irritability.
Hypotonicity.
Decreased auditory startle response.
Increased head circumference.
The Correct Answer is A
Choice A rationale:
Irritability is a common withdrawal symptom in newborns exposed to cocaine during pregnancy. Cocaine exposure can lead to irritability, restlessness, and difficulty in consoling the newborn.
Choice B rationale:
Hypotonicity, or decreased muscle tone, is not a common finding associated with cocaine exposure in newborns. Cocaine exposure more commonly results in hypertonicity, where the muscles are tense and rigid.
Choice C rationale:
Decreased auditory startle response is not a typical finding associated with cocaine exposure. Newborns exposed to cocaine may have an exaggerated startle response, which is the opposite of the expected finding in this case.
Choice D rationale:
Increased head circumference is not a characteristic finding associated with cocaine exposure. Cocaine exposure is more likely to cause growth restriction, low birth weight, and microcephaly (small head size) in newborns.
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Correct Answer is A
Explanation
Choice A rationale:
The nurse should suggest, "Give your son a little gift from his new sister," as a strategy to help the preschool-age son adjust to having a new sibling. This approach involves a small token or gift given from the newborn to the older sibling. It helps create a positive association and fosters a sense of connection and acceptance between the siblings. The gift symbolizes the new baby's arrival and can help the older child feel special and valued during this transition.
Choice B rationale:
While spending alone time with the new sister is important, the statement, "Give your son plenty of 'alone time' with his sister," does not address the initial meeting concerns. Alone time is relevant once the siblings have established a bond, but the initial introduction requires a more structured approach to ensure a smooth transition.
Choice C rationale:
Planning for the son to meet his sister for the first time at home is not the most suitable strategy. Hospitals provide a controlled environment with healthcare professionals available, ensuring the safety and well-being of both the mother and the newborn. The initial meeting should occur in a setting where medical assistance is readily accessible in case of any unforeseen circumstances.
Choice D rationale:
Holding the daughter when the son first meets her is a common and natural practice but does not actively involve the son in the process. Providing a gift from the baby to the older sibling fosters a sense of participation and inclusion, making the older child feel more involved and excited about the new sibling's arrival.
Correct Answer is A
Explanation
Choice A rationale:
The nurse should include the statement, "Use a product with DEET on your skin and clothes when you are walking in a wooded area," in the educational program on Lyme disease. DEET is a widely used insect repellent effective against ticks. It is recommended to prevent tick bites in wooded and grassy areas. The rationale behind this choice is to educate the public about practical measures to reduce the risk of Lyme disease. DEET repels ticks, reducing the chances of tick attachment and, consequently, the transmission of Lyme disease.
Choice B rationale:
The statement, "Symptoms of Lyme disease appear 2 days after being bitten by an infected tick," is incorrect. The incubation period for Lyme disease can vary from 3 to 30 days after the tick bite. Symptoms usually appear within 3 to 14 days but can take longer to manifest. Providing inaccurate information can lead to misunderstanding and inadequate preventive measures.
Choice C rationale:
The statement, "Remove embedded ticks by squeezing the body with tweezers," is incorrect. Improper removal of ticks, such as squeezing the body, can lead to the injection of tick fluids into the host, increasing the risk of disease transmission. The correct method for tick removal is to use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible and pull upward with steady, even pressure. This helps ensure the tick is removed entirely and reduces the risk of infection.
Choice D rationale:
The statement, "If bitten by a tick, testing for Lyme disease should occur within 2 weeks," is incorrect. Testing for Lyme disease immediately after a tick bite is not recommended because it takes time for the body to produce antibodies detectable by the tests. Testing too early can yield false-negative results. Healthcare providers may recommend testing if symptoms develop, but waiting for a few weeks after the bite increases the accuracy of the test results.
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