Nursing Elites

1. A nurse is caring for a newborn who is large for gestational age (LGA). Which of the following findings should the nurse expect?

• A. Hyperbilirubinemia
• B. Hypoglycemia
• C. Hypercalcemia
• D. Hypothermia

Correct answer: B

Rationale: Newborns who are large for gestational age (LGA) are at risk for hypoglycemia due to increased insulin production. Hyperbilirubinemia (Choice A) is more commonly associated with ABO or Rh incompatibility. Hypercalcemia (Choice C) is not a common finding in LGA newborns. Hypothermia (Choice D) may occur in newborns who are small for gestational age (SGA) due to a lack of subcutaneous fat for insulation, but it is not typically associated with LGA newborns.

2. A nurse is caring for a newborn who is 2 days old and has a total serum bilirubin level of 18 mg/dL. Which of the following interventions should the nurse implement?

• A. Administer 1 oz of glucose water every 2 hours
• B. Feed the newborn 60 mL of formula every 4 hours
• C. Offer sterile water between feedings
• D. Initiate phototherapy

Correct answer: D

Rationale: The correct answer is D: Initiate phototherapy. Phototherapy is the primary treatment for a newborn with hyperbilirubinemia, as it helps to break down excess bilirubin in the skin. Administering glucose water (choice A) is not indicated for treating hyperbilirubinemia. Feeding the newborn formula (choice B) or offering sterile water (choice C) will not directly address the elevated bilirubin levels in the newborn.

3. A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following actions should the nurse take?

• A. Swaddle the newborn tightly
• B. Provide frequent tactile stimulation
• C. Position the newborn in a prone position
• D. Offer large feedings every 4 hours

Correct answer: A

Rationale: The correct action for the nurse to take when caring for a newborn with neonatal abstinence syndrome is to swaddle the newborn tightly. Swaddling helps to provide comfort and reduce irritability in these newborns. Choice B, providing frequent tactile stimulation, may exacerbate the symptoms of neonatal abstinence syndrome by overstimulating the newborn. Choice C, positioning the newborn in a prone position, is not recommended as it increases the risk of sudden infant death syndrome (SIDS). Choice D, offering large feedings every 4 hours, is not appropriate as newborns with neonatal abstinence syndrome may have feeding difficulties and need smaller, more frequent feedings.

4. A nurse is assessing a client who is at 32 weeks of gestation. Which of the following findings should the nurse report to the provider?

• A. Client reports constipation
• B. Client reports swelling in the face
• C. Client reports heartburn
• D. Client reports frequent urination

Correct answer: B

Rationale: The correct answer is B because facial swelling can indicate preeclampsia, a serious condition during pregnancy that requires immediate medical attention. Constipation (choice A), heartburn (choice C), and frequent urination (choice D) are common discomforts during pregnancy and are not typically indicative of a serious complication like preeclampsia at 32 weeks of gestation.

5. A healthcare provider is assessing a newborn who is 12 hours old. Which of the following findings should the provider report?

• A. Respiratory rate 50/min
• B. Blood glucose 30 mg/dL
• C. Blood pressure 60/40 mm Hg
• D. Heart rate 140/min

Correct answer: B

Rationale: A blood glucose level of 30 mg/dL in a newborn is significantly low and indicates hypoglycemia, which can be dangerous in a newborn. Hypoglycemia in a newborn can lead to neurological issues and requires immediate attention. The other findings provided, such as a respiratory rate of 50/min, blood pressure of 60/40 mm Hg, and a heart rate of 140/min, are within normal ranges for a newborn and do not require immediate reporting unless accompanied by clinical signs of distress.

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