A nurse is receiving change-of-shift report for four newborns. Which of the following newborns should the nurse attend to first?

A newborn who has blue hands and feet with an axillary temperature of 36.6°C (97.9°F)

A newborn who has lost 12% of her birth weight

A newborn who is 24 hr post-circumcision and has yellow exudate

A newborn who has a blood glucose level of 63 mg/dL

Answer and Explanation

The Correct Answer is A

A. The newborn with blue hands and feet (acrocyanosis) along with a normal axillary temperature of 36.6°C (97.9°F) could indicate a need for further assessment. While acrocyanosis can be normal in newborns, it is essential to monitor for any signs of respiratory distress or circulatory issues. Since this newborn is exhibiting a potential sign of compromised circulation, this infant should be attended to first.

B. A newborn who has lost 12% of her birth weight is concerning, as significant weight loss in newborns can indicate feeding problems or other underlying issues. However, this would not take precedence over potential acute issues like those indicated in option A.

C. A newborn who is 24 hours post-circumcision with yellow exudate is expected to have some discharge as part of the healing process. If the exudate is not foul-smelling and there are no signs of infection, this is typically a normal finding.

D. A newborn with a blood glucose level of 63 mg/dL is within the normal range for newborns, as acceptable levels are typically above 40 mg/dL. Therefore, this does not require immediate attention.

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Correct Answer is B

Explanation

A. Incorrect. While using a disposable razor is a precaution for individuals taking anticoagulants to reduce the risk of bleeding, it is not specific to warfarin.
B. Correct. Taking oral contraceptives along with warfarin can increase the risk of bleeding.

Therefore, the client should be advised not to take oral contraceptives while on warfarin.

C. Incorrect. Aspirin is not typically recommended for pain relief in individuals taking warfarin due to the increased risk of bleeding.

D. Incorrect. The duration of warfarin therapy is individualized based on the specific condition being treated. It is not a fixed 2-week period.

A. Hgb 9.5 g/dL B. Platelets 225,000/mm C. Glucose 60 mg/dL D. WBC 10,000/mm

Correct Answer is A

Explanation

- A) The normal range for hemoglobin (Hgb) in a full-term newborn is approximately 14 to 24 g/dL. A level of 9.5 g/dL is considered low and can indicate anemia, which may require further investigation and treatment.

- B) A platelet count of 225,000/mm³ is within the normal range for a full-term newborn, which typically falls between 150,000 to 450,000/mm³. Therefore, this value would not need to be reported.

- C) A glucose level of 60 mg/dL is within the normal range for a full-term newborn, which is typically 40 to 60 mg/dL shortly after birth. This level indicates that the newborn's glucose is being regulated properly.

- D) A white blood cell (WBC) count of 10,000/mm³ is within the normal range for a full-term newborn, which can range from 9,000 to 30,000/mm³. This suggests the absence of infection or inflammation.

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A nurse is receiving change-of-shift report for four newborns. Which of the following newborns should the nurse attend to first?

Nursing Test Bank

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