A nurse is preparing to administer vitamin
K. Which of the following muscles should the nurse consider for the injection?

Deltoid

Vastus lateralis

Ventrogluteal

Dorsogluteal .

Answer and Explanation

The Correct Answer is B

Choice A rationale
The deltoid muscle is not typically used for intramuscular injections in infants due to its small size.

Choice B rationale
The vastus lateralis muscle is one of the preferred sites for intramuscular injections in infants, including the vitamin K injection. This muscle is large enough to absorb the medication, and injections here carry less risk of hitting a nerve or blood vessel.
Choice C rationale
The ventrogluteal muscle is not typically used for intramuscular injections in infants. This site is often used in older children and adults.
Choice D rationale
The dorsogluteal site is not recommended for intramuscular injections due to the risk of damaging the sciatic nerve.

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Correct Answer is D

Explanation

Choice A rationale

Monitoring weight is important for a newborn who is small for gestational age (SGA), but it is not the priority intervention. Weight can provide information about the newborn’s growth and development, but it does not address immediate physiological needs.
Choice B rationale
Monitoring I&O (Intake and Output) is crucial in assessing the newborn’s hydration status and kidney function. However, it is not the priority intervention for an SGA newborn.
Choice C rationale
Monitoring axillary temperature is important to maintain the newborn’s thermal regulation. However, it is not the priority intervention. Newborns, especially those who are SGA, are at risk for hypothermia due to their high body surface area to volume ratio and lack of subcutaneous fat.
Choice D rationale
Monitoring blood glucose levels is the priority intervention for an SGA newborn. SGA newborns are at risk for hypoglycemia because they have fewer glycogen stores. Hypoglycemia can lead to serious complications such as seizures, hence the need for close monitoring

A. There is an increased risk of introducing infection. B. This could initiate preterm labor. C. This could result in profound bleeding. D. There is an increased risk of rupture of the membranes.

Correct Answer is C

Explanation

Choice A rationale
While it’s true that any internal examination carries a risk of introducing infection, this is not the primary reason to avoid an internal examination in a client with placenta previa.
Choice B rationale
Initiating preterm labor is a concern with any internal examination, but it’s not the primary reason to avoid an internal examination in a client with placenta previa.
Choice C rationale
This is the correct answer. In a client with placenta previa, an internal examination could disturb the placenta and cause severe, potentially life-threatening bleeding.
Choice D rationale
While rupture of the membranes is a risk associated with internal examinations, it’s not the primary reason to avoid an internal examination in a client with placenta previa.

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A nurse is preparing to administer vitamin K. Which of the following muscles should the nurse consider for the injection?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is formulating a care plan for a newborn who is small for gestational age (SGA). Which of the following should be the priority intervention in the newborn’s care plan?

Correct Answer is D

Explanation

A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination.Which of the following explanations of the primary reason should the nurse provide?

Correct Answer is C

Explanation

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A nurse is preparing to administer vitamin
K. Which of the following muscles should the nurse consider for the injection?