The infant has Apgar scores of 7 at 1 minute and 9 at 5 minutes. What is the indication of this assessment finding?
Severe distress and absolute need of resuscitation.
Adjusting to extrauterine life.
Moderate difficulty and may need intervention.
Predicts fair neurologic future outcomes.
The Correct Answer is B
Choice A rationale
An Apgar score of 7 at 1 minute indicates that the infant is experiencing only mild difficulty with the transition to extrauterine life, and an Apgar score of 9 at 5 minutes indicates a successful adaptation. Severe distress requiring immediate, aggressive resuscitation is suggested by scores of 0 to 3, which is not the case here.
Choice B rationale
An Apgar score of 7 at 1 minute and a score of 9 at 5 minutes is the most common pattern, indicating the newborn is successfully adjusting to extrauterine life with minimal or no difficulty. The score of 7 suggests some minor, non-life-threatening depression at birth that resolved quickly by the 5-minute assessment.
Choice C rationale
Moderate difficulty and the potential need for some intervention, such as oxygen or tactile stimulation, would typically be suggested by an Apgar score in the range of 4 to 6 at 1 minute. The score of 7 suggests a better initial status than moderate difficulty, and the score of 9 confirms a successful transition.
Choice D rationale
The Apgar score is primarily an assessment of a newborn's cardiorespiratory and neurological status during the immediate transition phase, and while it is generally a good indicator of immediate neonatal well-being, it is a poor predictor of long-term neurologic future outcomes. Low scores persisting at 5 minutes are more concerning for future outcomes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Headache is a common and early manifestation of increased intracranial pressure (ICP) in a 10-year-old child because the cranial sutures are fused, preventing skull expansion, and the rise in pressure irritates pain-sensitive structures. The headache is typically worse in the morning or awakens the child from sleep due to accumulation of carbon dioxide during sleep, which causes vasodilation.
Choice B rationale
A bulging fontanel is a sign of increased ICP seen only in infants whose anterior fontanel is still open, which is usually not the case for a 10-year-old child as the fontanel typically closes between 12 and 18 months of age. Once the fontanels are closed and sutures fused, this sign is no longer a physical possibility or indicator of increased pressure.
Choice C rationale
Tachypnea, which is an abnormally rapid breathing rate, is not typically a sign of increased ICP; in fact, severe, life-threatening ICP can lead to abnormal respiratory patterns such as Cheyne-Stokes breathing or bradypnea due to pressure on the brainstem's respiratory centers. Tachypnea is more commonly associated with hypoxia or metabolic acidosis.
Choice D rationale
An increase in head circumference, or macrocephaly, is primarily seen in infants and young children before the cranial sutures fuse (about 2 years of age) to accommodate the pressure by skull expansion. In a 10-year-old child with fused sutures, the skull cannot expand, making this finding an unreliable or late indicator of acutely increased pressure.
Correct Answer is ["4.5"]
Explanation
Step 1 is: Calculate the total daily dose in milligrams by multiplying the ordered dose (3 mg/kg/day) by the weight in kilograms (3 kg). 3 mg/kg/day × 3 kg = 9 mg/day.
Step 2 is: Calculate the single dose by dividing the total daily dose (9 mg/day) by the number of doses per day (2 doses). 9 mg/day ÷ 2 doses = 4.5 mg/dose. The final calculated answer is 4.5 mg.
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