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
Bone marrow aspiration and biopsy is the definitive diagnostic test for leukemia. This procedure involves extracting a small sample of the bone marrow, typically from the iliac crest in children, to analyze the type and percentage of immature blood cells (blasts) that characterize leukemia, thus confirming the diagnosis accurately.
Choice B rationale
A Computed Tomography (CT) scan uses X-rays to create cross-sectional images of the body. While useful for assessing solid tumors or detecting intracranial or chest disease complications of leukemia, it is not the primary or definitive diagnostic test for the condition itself, which is a cancer of the blood and bone marrow.
Choice C rationale
A Complete Blood Cell Count (CBC) is a crucial screening tool that often suggests the presence of leukemia by revealing abnormal white blood cell counts (often high or very low) and possibly anemia or thrombocytopenia. However, the CBC alone cannot confirm the diagnosis; it only indicates the need for definitive testing.
Choice D rationale
A Lumbar Puncture (spinal tap) is performed to collect cerebrospinal fluid (CSF) to check for the presence of leukemic cells that may have infiltrated the central nervous system, which is essential for staging and treatment planning, but it does not confirm the initial diagnosis of leukemia in the bone marrow.
Correct Answer is C
Explanation
Choice A rationale
Unlicensed Assistive Personnel (UAP) are generally not permitted to perform invasive procedures or tasks that require specialized nursing knowledge, sterile technique, or clinical judgment, such as accessing or drawing blood from a central venous catheter. This procedure carries risks of infection and occlusion, requiring a licensed nurse.
Choice B rationale
Counseling, patient education, and support group referrals for complex medical conditions like leukemia require the specialized knowledge and judgment of a Registered Nurse (RN). A Licensed Practical Nurse (LPN) may reinforce teaching but initiating contact and providing detailed support information is outside their typical scope of practice for an oncology patient.
Choice C rationale
Administration of chemotherapeutic agents is a high-risk intervention that requires specialized certification and extensive training due to the potent nature of the drugs and the serious potential for adverse effects. This task is most appropriate for a chemotherapy-certified Registered Nurse to ensure patient safety and adherence to strict protocols.
Choice D rationale
A dietitian's role is to assess and manage nutritional status. Checking meal trays for intake is a routine assessment that can be completed by any member of the care team, including a UAP or nurse. However, the primary responsibility for complex nutritional assessment belongs to the dietitian, making this a fitting assignment for them.
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