The newborn with severe jaundice is at risk for developing:
- A. encephalopathy.
- B. bullous impetigo.
- C. respiratory distress.
- D. blood incompatibility.
Correct Answer: A
Rationale: Severe jaundice in a newborn puts them at risk for developing encephalopathy, which is a condition where bilirubin levels are significantly elevated and can lead to central nervous system dysfunction. If untreated or not managed promptly, high levels of bilirubin can potentially lead to brain damage. It is crucial to monitor and treat severe jaundice in newborns to prevent neurological complications like encephalopathy. Options B, C, and D are not directly associated with severe jaundice in newborns.
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A 36 y.o. woman who has had no prenatal care comes into the hospital in active labor for her fourth child. She has vesicles evident on her perineum. The following nursing actions are appropriate to protect the unborn baby and the staff, EXCEPT:
- A. Maintain standard precautions
- B. Prepare for the possibility that the baby may be delivered by CS.
- C. Notify the obstetrician and nurse midwife about the vesicles as soon as possible.
- D. Apply antibiotic ointment to the vesicles and place the mother in reverse isolation
Correct Answer: D
Rationale: When a woman with vesicles on her perineum comes into the hospital in active labor, it is important to take precautions to protect the unborn baby and the staff. However, applying antibiotic ointment to the vesicles and placing the mother in reverse isolation is not appropriate in this situation. This is because her condition is most likely due to herpes simplex virus (HSV) infection, which can be transmitted to the baby during birth leading to severe complications. Placing the mother in reverse isolation can increase the risk of transmission to the healthcare staff as well. Instead, notifying the obstetrician and nurse midwife about the vesicles as soon as possible is crucial for proper management and preparing for the possibility that the baby may be delivered by cesarean section is important to reduce the risk of transmission during vaginal birth. Maintaining standard precautions is essential to prevent the spread of infection.
Which term refers to a newborn born before completion of week 37 of gestation, regardless of birth weight?
- A. Postterm
- B. Preterm
- C. Low birth weight
- D. Small for gestational age
Correct Answer: B
Rationale: The term "preterm" refers to a newborn born before completion of week 37 of gestation, regardless of birth weight. Preterm birth can lead to various health issues for the newborn, as they may not have fully developed before being born. It is important for healthcare providers to closely monitor preterm infants to ensure they receive the proper care and support for their development.
The major pharmacologic action of albuterol sulfate (Proventil HFA) is:
- A. decreasing airway reactivity.
- B. decreasing inflammation and airway obstruction.
- C. improving the action of cilia to sweep trapped mucous upward.
- D. relaxing constricted bronchial smooth muscle.
Correct Answer: D
Rationale: Albuterol acts as a beta-2 agonist, relaxing bronchial smooth muscle to relieve airway constriction.
When caring for the child with Kawasaki disease, the nurse should know which information?
- A. A child's fever is usually responsive to antibiotics within 48 hours.
- B. The principal area of involvement is the joints.
- C. Aspirin is contraindicated.
- D. Therapeutic management includes administration of gamma globulin and aspirin.
Correct Answer: D
Rationale: Kawasaki disease is an acute febrile illness that primarily affects children. The therapeutic management of Kawasaki disease includes the administration of gamma globulin and aspirin. Intravenous immunoglobulin (IVIG) or gamma globulin is given as a single dose to reduce the risk of coronary artery abnormalities, while aspirin is used for its anti-inflammatory effects. It is important to note that aspirin should not be given to children with viral infections due to the risk of Reye syndrome. Therefore, option D is the correct choice in this case.
A newborn begins to cough, choke, and becomes cyanotic while feeding. What is the nurse's immediate action?
- A. Inform the physician.
- B. Have the mother stop feeding and observe.
- C. Remove the infant from the mother, place the infant in the crib for assessment, obtain oxygen saturation, and administer blow-by oxygen immediately.
- D. Continue feeding while monitoring.
Correct Answer: C
Rationale: Immediate removal from the feeding situation and rapid assessment with oxygen support is critical for airway safety.