A nurse is preparing to collect a blood specimen from a newborn via heelstick. Which of the following actions should the nurse take? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
Place a heel warmer on the newborn's heel.
Confirm the identity of the newborn.
Apply pressure to the puncture site with a dry gauze pad.
Label the specimen per facility protocol.
Clean the puncture site with an antiseptic cleanser.
The Correct Answer is B, A, E, C, D
This sequence ensures proper identification, infection control, specimen collection, and safety for the newborn.
Choice A rationale:
The nurse should place a heel warmer on the newborn's heel for 3 to 5 minutes before the heelstick to increase blood flow and facilitate collection.
Choice B rationale:
The nurse should confirm the identity of the newborn before collecting any specimen to ensure patient safety and avoid errors.
Choice C rationale:
The nurse should apply pressure to the puncture site with a dry gauze pad to stop bleeding and promote clotting.
Choice D rationale:
The nurse should label the specimen per facility protocol to ensure accurate identification and processing.
Choice E rationale:
The nurse should clean the puncture site with an antiseptic cleanser to prevent infection and reduce contamination of the specimen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Newborns typically lose some weight after birth, but 15 percent loss would be excessive and concerning. A normal weight loss range is about 5 to 10 percent.
Choice B rationale:
Newborns should be fed on demand rather than adhering to strict schedules to ensure they are adequately nourished.
Choice C rationale:
Breastfeeding requires additional energy, and mothers are generally advised to consume around 500 extra calories a day to support milk production and their own energy needs.
Choice D rationale:
Offering a pacifier before sleep can reduce the risk of sudden infant death syndrome (SIDS), but this recommendation usually starts at around 1 to 2 months of age.
Correct Answer is A
Explanation
Choice A rationale:
Sertraline is an antidepressant medication known as a selective serotonin reuptake inhibitor (SSRI). One of the potential side effects of SSRIs is sexual dysfunction, including erectile dysfunction.
Choice B rationale:
Vancomycin is an antibiotic and is not typically associated with erectile dysfunction.
Choice C rationale:
Topiramate is an anticonvulsant medication and is not typically associated with erectile dysfunction.
Choice D rationale:
Polyethylene glycol is a laxative and is not typically associated with erectile dysfunction.
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