A nurse is speaking on the phone to a client on the phone who is pregnant and taking iron supplements for iron-deficiency anemia. The client reports that her stools are black but she has no abdominal pain or cramping. Which of the following responses by the nurse is appropriate?

"Go to the emergency room and your provider will meet you the

"Come to the office and we will check things out."

"What else have you been eating?"

"This is expected because of the way iron is broken down during digestion."

Answer and Explanation

The Correct Answer is D

Choice A rationale:
Going to the emergency room for black stools without abdominal pain or cramping is not warranted in this situation.
Choice B rationale:
Having the client come to the office to check things out may not be necessary since black stools can be an expected side effect of iron supplements and do not necessarily indicate a problem.
Choice C rationale:
Asking about the client's diet is a valid question, but the black stools are likely due to iron supplements' effects and not related to dietary choices.
Choice D rationale:
Black stools are a known side effect of iron supplements. When iron is broken down during digestion, it can cause the stools to appear black or dark. As the client has no other concerning symptoms like abdominal pain or cramping, this response by the nurse reassures the client that the finding is expected and not a cause for alarm.

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Correct Answer is B

Explanation

The correct answer is Choice B, the nipple line.

Choice A rationale: The axillae, or underarms, are not used to measure chest circumference in a newborn. This area does not provide an accurate or consistent measurement of chest size due to the positioning and movement of the baby’s arms.

Choice B rationale: The nipple line is the correct anatomical landmark to use when measuring chest circumference in a newborn. This line is typically used because it provides a consistent and accurate measurement. It is located at the level of the nipples, which is approximately at the mid-chest level. This location allows for a measurement that is representative of the chest size, as it is at the broadest part of the chest.

Choice C rationale: The lower ribcage border is not the correct landmark for measuring chest circumference in a newborn. This area is too low and would not provide an accurate representation of the chest size. The measurement taken at this location would be smaller than the actual chest size, as it is below the broadest part of the chest.

Choice D rationale: The sternal notch is not an appropriate landmark for measuring chest circumference in a newborn. The sternal notch is located at the top of the sternum, near the base of the neck. A measurement taken at this location would not accurately represent the size of the chest, as it is above the broadest part of the chest.

A. Place the newborn in the Trendelenburg position. B. Administer saline drops into the newborn's nares. C. Suction the newborn's mouth with a bulb syringe. D. Perform deep suctioning of the newborn's trachea with an endotracheal tube.

Correct Answer is C

Explanation

Choice A rationale: Placing the newborn in the Trendelenburg position (head down, feet up) is not recommended in this situation and can potentially cause harm.
Choice B rationale: While saline drops can help clear nasal congestion, the bubbling mucus is coming from the mouth and nose, and suctioning is more appropriate.
Choice C rationale: The bubbling mucus indicates the presence of mucus and amniotic fluid in the baby's airway, which could interfere with breathing. The first action should be to suction the newborn's mouth to clear the airway.
Choice D rationale: Performing deep suctioning with an endotracheal tube is an invasive procedure and is not necessary for clearing mucus from the newborn's mouth and nose.

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A nurse is speaking on the phone to a client on the phone who is pregnant and taking iron supplements for iron-deficiency anemia. The client reports that her stools are black but she has no abdominal pain or cramping. Which of the following responses by the nurse is appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a newborn. Which of the following anatomical landmarks should the nurse use to measure chest circumference?

Correct Answer is B

Explanation

A nurse is assisting in the care of a newborn immediately following birth. The nurse notes mucus bubbling out of the newborn's mouth and nose. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

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