A nurse is reinforcing teaching with new parents about the provider's prescription for a serum bilirubin test. Which of the following statements should the nurse include in the explanation?

"Your baby is at a higher risk because they were born with congenital dermal melanocytosis.”

"This is because your baby is breastfed. You should start supplementing with formula."

"Your baby is at a higher risk because they have had four bowel movements in the first day of life.”

"This is because your baby's liver is not yet efficient at breaking down red blood cells."

Answer and Explanation

The Correct Answer is D

A. "Your baby is at a higher risk because they were born with congenital dermal melanocytosis.": Congenital dermal melanocytosis, also known as Mongolian spots, are harmless pigmented birthmarks and are unrelated to bilirubin levels or jaundice risk in newborns.

B. "This is because your baby is breastfed. You should start supplementing with formula.": Breastfeeding itself is not a reason to stop or supplement with formula unless medically necessary. Breastfeeding jaundice can occur, but proper feeding techniques and frequency usually manage it without needing supplementation.

C. "Your baby is at a higher risk because they have had four bowel movements in the first day of life.": Frequent bowel movements actually help lower bilirubin levels by aiding in the excretion of bilirubin through stool, so this would not increase jaundice risk.

D. "This is because your baby's liver is not yet efficient at breaking down red blood cells.": Newborns often experience physiological jaundice because their immature livers cannot efficiently process the breakdown products of red blood cells, leading to elevated bilirubin levels in the blood.

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Correct Answer is A

Explanation

A. Inject 15 units of air into the regular insulin vial: After injecting air into the NPH vial without drawing up the medication, the next step is to inject air into the regular insulin vial. This maintains the correct order and prevents contamination of the regular insulin with the cloudy NPH insulin.

B. Withdraw 10 units of NPH insulin: NPH insulin should not be withdrawn first because it is cloudy and could contaminate the regular insulin if mixed incorrectly. Regular insulin, which is clear, should always be drawn up before NPH when mixing in the same syringe.

C. Verify the dosage with another nurse: Verifying insulin doses with another nurse is necessary but is typically done after the insulin is prepared and drawn up. At this stage, the immediate step is to complete proper air injection into both vials before drawing any insulin.

D. Place the cap over the needle: Recapping needles increases the risk of accidental needlestick injuries and should be avoided unless absolutely necessary. There is no need to recap at this stage in the insulin preparation process.

A. "I have switched from tobacco cigarettes to electronic cigarettes.” B. "Sometimes I am exposed to toxic chemicals at my workplace, but not any that have harmed me." C. "Two of my grandparents had diabetes, so I try to eat a healthy diet." D. "My job and home life are both very stressful, but I haven't been able to do anything about that.”

Correct Answer is C

Explanation

A. "I have switched from tobacco cigarettes to electronic cigarettes.": Although electronic cigarettes may reduce exposure to certain harmful chemicals found in tobacco smoke, they still pose significant health risks. This change does not reflect truly limiting risky behavior but rather substituting one form of risk for another.

B. "Sometimes I am exposed to toxic chemicals at my workplace, but not any that have harmed me.": Exposure to toxic chemicals, even without immediate harm, still represents ongoing risk. A proactive approach would involve using protective equipment or seeking safer work conditions.

C. "Two of my grandparents had diabetes, so I try to eat a healthy diet.": Actively modifying diet in response to a family health history shows a positive, preventative approach and reflects conscious efforts to limit risk-taking behaviors and promote long-term health.

D. "My job and home life are both very stressful, but I haven't been able to do anything about that.": Chronic unmanaged stress is a health risk, and acknowledging stress without taking steps to manage it indicates that the client is not effectively limiting risk behaviors.

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A nurse is reinforcing teaching with new parents about the provider's prescription for a serum bilirubin test. Which of the following statements should the nurse include in the explanation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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