A nurse receives a handoff report.
Which newborn should the nurse assess first?

Choice A rationale

Thoroughly cooking meat to an internal temperature of 160°F (71°C) kills the Toxoplasma gondii parasite, thus preventing transmission through ingestion of contaminated meat. This is a crucial preventive measure recommended for pregnant women.

Choice B rationale

Drinking unpasteurized milk poses a risk of toxoplasmosis, as well as other foodborne illnesses like listeriosis and brucellosis. Pasteurization is a process that heats milk to a specific temperature for a set time, killing harmful bacteria and parasites, including Toxoplasma gondii. Therefore, this statement indicates a need for further instruction, as pregnant women should consume only pasteurized dairy products.

Choice C rationale

Cat feces can contain oocysts of Toxoplasma gondii, which can become infectious after a period of sporulation. Avoiding contact with materials possibly contaminated with cat feces, such as litter boxes and garden soil, is an important measure to prevent toxoplasmosis.

Choice D rationale

Handling raw meat can expose a person to Toxoplasma gondii cysts. Avoiding touching mucous membranes of the mouth or eyes after handling raw meat and washing hands thoroughly reduces the risk of self-inoculation with the parasite.

Choice A rationale: Weight loss

Weight loss during pregnancy, especially in the second trimester, is unexpected unless there is a medical condition such as hyperemesis gravidarum or other nutritional deficiencies. While mild weight fluctuations can occur, a consistent loss of weight rather than gradual gain suggests inadequate caloric intake due to persistent vomiting and dehydration.

Choice B rationale: Breast tenderness

Breast tenderness is a common and expected physiological change during pregnancy due to hormonal fluctuations, particularly increased estrogen and progesterone levels. It is not considered abnormal or unexpected at this stage of pregnancy.

Choice C rationale: Heart rate

A heart rate of 116/min is unexpected, as it is above the normal range for adults (typically 60–100/min). Pregnancy can cause a mild increase in heart rate, but tachycardia above 110/min may indicate dehydration, anemia, or electrolyte imbalance, all of which can stem from excessive vomiting and fluid loss.

Choice D rationale: Vomiting

While occasional nausea and vomiting (morning sickness) can be expected in early pregnancy, persistent vomiting up to eight times daily and symptoms of dehydration (dry mucosa, poor skin turgor, positive ketones in urine) raise concern for hyperemesis gravidarum, a more severe form of pregnancy-related nausea and vomiting.

Choice E rationale: Nasal congestion

Nasal congestion is common during pregnancy due to increased blood volume and vascular changes affecting the nasal mucosa. It is not unexpected and does not indicate a complication.

Choice F rationale: Respiratory rate

A respiratory rate of 20/min falls within the normal range for adults (typically 12–20/min), making it an expected finding.