Provide rationale for why each answer is correct andwhy the wrong answers are incorrect.
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1 A nurse is assisting in the care of a newborn immediately after birth. At 5 min after birth, the newborn has acrocyanosis, flexed extremities, a grimace when suctioned, a heart rate of 130/min, and a lusty cry with tactile stimulation What should the nurse document as the newborn’s 5-min Apgar score? a. 8 b. 6 7 d. 9 2. A nurse is assisting with the care of a client who is in labor and has an external electronic fetal monitor The nurse observes that the fetal heart rate begins to decelerate after the contraction has started with the lowest point of the deceleration occurring after the peak of the contraction which of the following actions should the nurse take first? ਹੈ। b. c. d. Place the client in the lateral position Increase the rate of the maintenance IV infusion Elevate the client’s legs Administer oxygen using a nonrebreather mask 3. A nurse is reinforcing teaching with a parent about using an iron fortified formula to feed her newborn Which of the following information should the nurse include in the teaching? b Iron will facilitate eyesight development Iron will facilitate bone growth The newborn’s iron source will start to deplete. Newborns do not metabolize iron adequately. C d 4. A nurse is assisting in the care of a newborn immediately following birth. The nurse notes mucus bubbling out of the newborn’s mouth and nose. Which of the following actions should the nurse take first? a. Perform deep suctioning of the newborn’s trachea with an endotracheal tube b. Suction the newborn’s mouth with a bulb syringe c. Administer saline drops into the newborn’s nares. d. Place the newborn in Trendelenburg position. 5. A nurse is caring for a newborn immediately after birth. Which of the following actions by the nurse reduces evaporative heat loss by the newborn? a. Placing the newborn on a warm surface b. Preventing air drafts c Drying the newborn’s skin thoroughly d. Maintaining ambient room temperature at 24°C (75* F.)
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