The nurse is performing a newborn assessment. Which symptom, if present in a newborn, would indicate respiratory distress?

Flaring of the nares

Shallow and irregular respirations

Respiratory rate of 50 breaths per minute

Abdominal breathing with synchronous chest movement

Answer and Explanation

The Correct Answer is A

A. Flaring of the nares:
Flaring of the nares is a clinical sign of respiratory distress in newborns. It indicates that the infant is working harder to breathe and is attempting to increase the size of the nostrils to get more air.

B. Shallow and irregular respirations:
Shallow and irregular respirations can be a sign of respiratory distress, but flaring of the nares is a more specific and immediate indication.

C. Respiratory rate of 50 breaths per minute:
While a respiratory rate of 50 breaths per minute might be within the normal range for a newborn, the overall clinical picture, including other signs of distress, should be considered.

D. Abdominal breathing with synchronous chest movement:
Abdominal breathing with synchronous chest movement is not a normal pattern for a newborn and could indicate respiratory distress.

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Correct Answer is B

Explanation

A. Monitor blood pressure, pulse, and respirations every 4 hours: Monitoring vital signs is important, especially in a client with eclampsia. However, the frequency of monitoring may need to be increased, particularly if the client's condition is unstable.

B. Keep an airway at the bedside: This is a crucial intervention. Eclampsia can lead to seizures, and having airway management equipment readily available is essential to ensure the client's safety during and after a seizure.

C. Allow liberal family visitation: While family support is important, the priority in eclampsia management is the safety and well-being of the client. Family visitation should be allowed, but it may need to be balanced with the need for a controlled and safe environment.

D. Assess temperature every hour: While monitoring temperature is a part of routine care, it may not be the highest priority in the context of eclampsia. Monitoring for signs of imminent seizure activity and maintaining a safe environment take precedence.

Preeclampsia & eclampsia: Video, Anatomy & Definition | Osmosis

A. Strawberries B. Collard greens. C. Whole milk D. Yogurt

Correct Answer is A

Explanation

A. Strawberries:
Strawberries contain a moderate amount of folic acid, providing a good alternative source for the client. While not as high as some vegetables, they still offer a reasonable amount of this essential nutrient. This could be a suitable option considering the client's dislike for green leafy vegetables and allergy to soy.

B. Collard greens:
Collard greens are an excellent source of folic acid. However, since the client dislikes green leafy vegetables, recommending collard greens might not align with her preferences.

C. Whole milk:
Whole milk doesn't contain significant amounts of folic acid. While it's a source of other nutrients, it isn't a primary choice for obtaining folic acid.

D. Yogurt:
Similar to whole milk, yogurt doesn't contain a substantial amount of folic acid. While it offers various health benefits due to its probiotics and nutrients, it's not a significant source of folic acid.

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The nurse is performing a newborn assessment. Which symptom, if present in a newborn, would indicate respiratory distress?

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Naxlex Comprehensive Predictor Exams

A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis of eclampsia. She is not presently convulsing Which intervention should the nurse plan to include in this client's nursing care plan?

Correct Answer is B

Explanation

After two miscarriages, a client is instructed to increase her daily intake of foods that includes folic acid. The client does not like green leafy vegetables and states she is allergic to soy. Which food should the nurse suggest that the client eat to obtain folic acid?

Correct Answer is A

Explanation

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The nurse is performing a newborn assessment. Which symptom, if present in a newborn, would indicate respiratory distress?

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