A nurse is teaching about car seat safety to the parents of a newborn who was delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching?

"My baby will need a car seat challenge test before discharge."

"I can use a sleep sack to keep my baby warm in the car seat."

"When my baby is 1 year old, I can turn their car seat facing forward."

"The car seat should be positioned in the car at a 45-degree angle."

Answer and Explanation

The Correct Answer is D

Explanation.

Choice A Reason:

"My baby will need a car seat challenge test before discharge." This statement is inappropriate. While some preterm infants may require a car seat challenge test before discharge to assess their cardiorespiratory stability while seated in a car seat, this is not a universal requirement for all newborns. The need for a car seat challenge test depends on the infant's gestational age, medical condition, and hospital policies.

Choice B Reason:

"I can use a sleep sack to keep my baby warm in the car seat." This statement is inappropriate. Using a sleep sack or any other bulky clothing or accessories in the car seat is not recommended as it can interfere with the proper harness fit and compromise the safety of the baby. Bulky clothing can compress in a crash, creating space between the baby and the harness, increasing the risk of ejection or injury.

Choice C Reason:

"When my baby is 1 year old, I can turn their car seat facing forward." This statement is inappropriate. Turning the car seat forward-facing at 1 year of age is an outdated guideline. Current recommendations from the American Academy of Pediatrics (AAP) advise keeping infants in rear-facing car seats until they reach the maximum weight or height limit recommended by the car seat manufacturer, which is typically around 2 years of age or older. Rear-facing car seats provide better protection for the baby's head, neck, and spine in the event of a crash compared to forward-facing seats.

Choice D Reason:

"The car seat should be positioned in the car at a 45-degree angle." This statement is appropriate. Positioning the car seat at a 45-degree angle is recommended for newborns and young infants. This angle helps keep the baby's airway open and prevents their head from flopping forward, reducing the risk of breathing difficulties and oxygen desaturation.

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Correct Answer is C

Explanation

To calculate the estimated date of delivery using Angele’s Rule, you start with the first day of the last menstrual period (LMP), subtract three months, and then add seven days.

For this client:

First day of last menstrual period (LMP): August 10

Subtract three months: August - 3 months = May

Add seven days: May + 7 days = May 17

So, the client's estimated date of delivery is May 17.

Therefore, the correct answer is:

C. May 17

A. Report the guardian's refusal of the medication to social services. B. Document the guardian's refusal of the medication. C. Inform the guardian that the medication can be given after discharge. D. Notify the facility's ethics committee about the guardian's medication refusal.

Correct Answer is B

Explanation

Choice A Reason:

Reporting the guardian's refusal of the medication to social services is incorrect. Refusing a medication for a newborn, especially one that is standard practice like erythromycin ophthalmic ointment, does not automatically warrant reporting to social services. Reporting to social services should only occur in cases where there are concerns for the safety or well-being of the newborn.

Choice B Reason:

Documenting the guardian's refusal of the medication. Is correct. When a guardian refuses a prescribed medication for a newborn, the nurse's immediate responsibility is to document this refusal accurately in the medical record. Documentation ensures that the refusal is well-documented for future reference and legal purposes.

Choice C Reason:

Informing the guardian that the medication can be given after discharge is incorrect. While it's important to educate the guardian about the purpose and benefits of the medication, informing them that it can be given after discharge may not address the immediate need for prophylaxis against ophthalmia neonatorum, which is the infection erythromycin ophthalmic ointment is intended to prevent.

Choice D Reason:

Notifying the facility's ethics committee about the guardian's medication refusal is incorrect. In most cases, notifying the ethics committee would be an overreaction to a guardian's refusal of a standard prophylactic medication. Ethics committees are typically reserved for complex ethical dilemmas that require deliberation and guidance beyond standard practice.

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A nurse is teaching about car seat safety to the parents of a newborn who was delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is calculating the estimated date of delivery for a client who reports that the first day of her last menstrual period was August 10. Using Angele’s Rule, which of the following is the client's estimated date of delivery?

Correct Answer is C

Explanation

A nurse is caring for a newborn immediately following birth who has a prescription for erythromycin ophthalmic ointment. The guardian refuses the medication. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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