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For which of the following should the nurse be especially alert when caring for a term neonate, who weighed 10 lb at birth, 1 hour after a vaginal delivery?
- A. Hypoglycemia.
- B. Hypercalcemia.
- C. Hypermagnesemia.
- D. Hyperbilirubinemia.
Correct Answer: A
Rationale: The neonate would be considered large for gestational age (LGA) because the neonate weighs more than 4,000 g (90th percentile). Hypoglycemia is a problem for the LGA neonate because glycogen stores are quickly used to maintain the weight. Other complications like hyperbilirubinemia may occur, but hypoglycemia is the priority concern within the first hour.
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An infusion of lidocaine hydrochloride (Xylocaine) is running at 30 mL/hour. The dilution is 1,000 mg/250 mL. What dosage is the client receiving per minute?
Correct Answer: 2 mg/minute.
Rationale: Calculate: 1,000 mg in 250 mL = 4 mg/mL. At 30 mL/hour, that's 30 mL × 4 mg/mL = 120 mg/hour. Per minute: 120 mg ÷ 60 min = 2 mg/minute.
The nurse is assessing the perineal changes of a woman in the second stage of labor. The nurse expects to see which of the following changes?
- A. Anterior-posterior slit.
- B. Oval opening.
- C. Circular shape.
- D. Crowning.
Correct Answer: D
Rationale: Crowning, when the fetal head is visible at the vaginal opening, is the expected perineal change in the second stage of labor, indicating imminent delivery.
A tour bus has overturned on an exit ramp. Many passengers are injured, but there are no fatalities. While the emergency department nurse prepares for treating the injured, the nurse also calls the crisis nurse based on the understanding about which of the following?
- A. The accident victims will be experiencing grief and mourning.
- B. Many of the passengers may be experiencing feelings of victimization.
- C. There is a need for someone to coordinate calls from relatives about the passengers.
- D. Some of the passengers will need psychiatric hospitalization.
Correct Answer: B
Rationale: A crisis nurse can address feelings of victimization, a common psychological response to traumatic accidents, providing emotional support.
Which of these statements related to information technology is accurate?
- A. Social networks and cell phone cameras pose low risk in terms of information technology security and confidentiality.
- B. The security of technological data and information in healthcare environments is most often violated by those who work there.
- C. The security of technological data and information in healthcare environments is most often violated by computer hackers.
- D. Computer data deletion destroys all evidence of the data.
Correct Answer: B
Rationale: The most common breaches of healthcare data security occur internally by staff , through actions like unauthorized access or improper handling of information, rather than external hackers or low-risk social media . Data deletion does not always destroy all evidence.
A nurse is administering indomethacin to a neonate. To ensure that the nurse has identified the neonate correctly, the nurse should do which of the following? Select all that apply.
- A. Ask the parents to confirm that this is their baby.
- B. Ask another nurse to confirm that this is the neonate for whom the medication has been prescribed.
- C. Check the neonate's identification band against the medical record number.
- D. Verify the date of birth from the medical record with the date of birth on the client's identification band.
- E. Compare the number on the crib with the number on the client's identification band.
Correct Answer: A, C, D
Rationale: Correct identification involves checking the ID band against the medical record and date of birth, and confirming with parents.