Deck 2: Neonatal

Question 1

Julia gave birth to a baby girl who is 2,930 grams in weight. The baby was admitted at the NICU due to a low APGAR score because her mother had a prolonged second stage of labor. As a result, the neonate had asphyxia. Which of the following would a nurse expect to find in a newborn with asphyxia?

A)Hypocapnia
B)Ketosis
C)Acidosis
D)Hyperoxemia

Answer 1

Acidosis

Question 2

Sixteen hours after birth, the nurse noticed that the neonate is jittery, hyperactive, sneezes frequently, produces a high-pitched cry, and is having difficulty sucking. Evaluation reveals that the neonate has increased deep tendon reflexes and a decreased Moro reflex. The nurse should suspect a case of:

A)Syphilis in the neonate
B)Cerebral palsy
C)Fetal alcohol syndrome
D)Opiod withdrawal

Answer 2

Opiod withdrawal

Question 3

Baby Boy Mcintosh was immediately transferred from the birthing center to the neonatal intensive care unit because of myelomeningocele. The nurse assigned at the unit should immediately:

A)Provide newborn care
B)Start the prophylaxis (antibiotic)
C)Apply a sterile saline dressing
D)Assess for any signs of paralysis

Answer 3

Apply a sterile saline dressing

Question 4

During the assessment, the nurse noticed that one of the admitted neonates, who is small-for-gestational-age, is jittery, has a high-pitched cry, and has irregular respirations. The nurse must be aware that these signs could be an indication of:

A)Hypercalcemia
B)Hypovolemia
C)Hypoglycemia
D)Hypothyroidism

Question 5

Nurse Dolores is caring for a fifteen-day-old neonate who has a necrotizing enterocolitis (NEC). What nursing care plan should be included for the neonate?

A)Measure abdominal girth at least every two hours
B)Dilute the milk formula as ordered
C)Hyperventilate the neonate before each feeding
D)Introduce formula feeding by lavage

Question 6

A neonate was admitted at the hospital due to hydrocephalus. After the insertion of a shunt to treat the disease, the nurse should evaluate the function of the shunt by:

A)Palpation of the anterior fontanel
B)Notation of the frequency of voiding
C)Assessment of periorbital edema
D)Observation of symmetric Moro reflex

Question 7

A one-week-old infant was admitted at the neonatal intensive care unit after surgery to treat esophageal atresia. What would be an immediate postoperative nursing priority for this patient?

A)Administering oral milk feeding slowly
B)Observing for signs of infection at the incision site
C)Reporting episodes of vomiting to the physician
D)Checking for the patency of nasogastric tube

Question 8

A nurse is caring for a pregnant patient and is assessing the fetal heart rate. The nurse notes that the fetal heart rate is abnormal for the third time; this is made known to the physician to order a fetal scalp pH sample. The nurse is aware that the fetus may be compromised if the fetal pH is:

A)7)17
B)7)22
C)7)30
D)7)34

Question 9

The nurse is caring for several infants who are forty-eight hours old. Among the following infants, which should be given highest priority by the nurse?

A)A bottle-fed infant who takes 1-ounce of milk every three to five hours
B)A breastfed infant who lost 0.5 ounce of his weight
C)A bottle-fed infant who takes two to three ounces of milk every two to four hours
D)A breastfed infant who feeds every two to four hours

Question 10

When caring for a neonate in acute respiratory distress from laryngotracheobronchitis who has a body temperature of 38.7 ºC, the nurse should give priority to:

A)Monitor the neonate's respiratory status continuously
B)Deliver 40% humidified oxygen
C)Provide support to decrease apprehension
D)Initiate measures to decrease fever

Question 11

The nurse is checking for cervical dilation of a patient who is in labor, when the nurse observes that the umbilical cord has prolapsed. The nurse's initial action would be to:

A)Obtain the fetal heart rate
B)Cover the cord with sterile saline soaks
C)Position the patient on her side
D)Place the patient in Trendelenburg's position

Question 12

A clinical nurse specialist is monitoring the blood glucose level of a neonate who was born to a diabetic mother. The nurse determined that the blood glucose level is 50 mg/dL. What would be the action of the nurse?

A)Feed the baby orally with 10% dextrose in water
B)Monitor the neonate continuously for the next twenty-four hours
C)Alert the physician and request an order of glucose 50%
D)Assess the cord serum glucose level

Question 13

A nurse is caring for a patient who is receiving magnesium sulfate therapy intravenously for preeclampsia. The patient gives birth to a baby weighing 4.2 pounds in the 36?? week of gestation. The nurse is aware that a finding in the newborn that may indicate magnesium sulfate toxicity is:

A)Tachycardia
B)Pallor
C)Hypotonia
D)Tremors

Question 14

A clinical nurse specialist is caring for a neonate who develops hyperbilirubinemia. The physician ordered phototherapy BID. During the therapy, the nurse should include which plan of care:

A)Keep the eye shield on continuously
B)Cover the patient with a blanket made of light material
C)Take the vital signs every hour
D)Give fluids at least every two hours

Question 15

Prior to discharge from the newborn nursery at forty-eight hours old, the nurse knows that murmurs are frequently assessed and are most often due to which factor?

A)A ventricular septal defect
B)Transition from fetal to pulmonic circulation
C)Heart disease of the newborn period
D)Cyanotic heart disease

Question 16

A clinical nurse specialist is planning a nursing care for a pregnant patient who is admitted with a diagnosis of abruption placenta. The nurse should include a careful observation for signs and symptoms of:

A)Seizure
B)Jaundice
C)Hypovolemic shock
D)Hypertension

Question 17

A neonate with cardiac disease has been admitted to the nursery from the delivery room. Which finding helps the nurse to differentiate between a cyanotic and an acyanotic defect?

A)Neonates with cyanotic heart disease feed poorly
B)The pulse oximeter does not read above 93%
C)Cyanotic heart disease causes high fevers
D)Neonates with cyanotic heart disease usually go directly to the operating room

Question 18

A child ingested twenty maximum strength acetaminophen tablets thirty minutes ago and is seen at the emergency department. The ER nurse calls one of the staff nurses at the NICU to identify which physician's order should be done first. The NICU nurse should state that it must be:

A)Gastric lavage PRN
B)Acetylcesteine for age per pharmacy
C)Activated charcoal per pharmacy
D)Start IV dextrose 5% with 0.33% normal saline KVO

Question 19

A newborn was admitted to the neonatal intensive care unit. His diagnosis is febrile seizures. In preparing for his admission, which of the following is the most important nursing action?

A)Request an order of a stat admission CBC
B)Place a urine collection bag and specimen cup at the bedside
C)Place a cooling mattress on his bed
D)Pad the side rails of his bed

Question 20

A nurse is caring for a neonate with a suspected diagnosis of rheumatic fever. The nurse reviews the laboratory results, knowing that which laboratory study would assist in confirming the diagnosis?

A)Immunoglobulin
B)RBC count
C)WBC count
D)Antistreptolysin O titer

Question 21

A nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which likely sign of this condition documented in the record?

A)Increased crying
B)Coughing at nighttime
C)Choking with feedings
D)Severe projectile vomiting

Question 22

A nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On admission assessment, which data would the nurse expect to obtain when asking the mother about the child's symptoms?

A)Diarrhea
B)Projectile vomiting
C)Increased urine output
D)Vomiting large amounts of bile

Question 23

A nurse is preparing to care for an infant with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which symptom of this disorder documented?

A)Diarrhea
B)Ribbon-like stools
C)Profuse projectile vomiting
D)Bright red blood and mucus in the stools

Question 24

A sweat test is performed on an infant with a suspected diagnosis of cystic fibrosis. The nurse reviews the test results and determines that which of the following is a positive result for cystic fibrosis?

A)Chloride level of 20 mEq/L
B)Chloride level of 30 mEq/L
C)Chloride level of 40 mEq/L
D)Chloride level of 70 mEq/L

Question 25

A mother arrives in an emergency room with her infant and the mother states that the child fell off a bunk bed. A head injury is suspected and a nurse is assessing the child continuously for signs of increased intracranial pressure (ICP). Which of the following is a late sign of increased ICP in this child?

A)Nausea
B)Bradycardia
C)Bulging fontanel
D)Dilated scalp veins

Question 26

A nurse is performing an admission assessment on a newborn infant with a diagnosis of spina bifida (myelomeningocele). A priority nursing assessment for this newborn is:

A)Pulse rate
B)Palpation of the abdomen
C)Specific gravity of the urine
D)Head circumference measurement

Question 27

A lumbar puncture is performed on an infant suspected of having bacterial meningitis and cerebrospinal fluid (CSF) is obtained for analysis. A nurse reviews the results of the CSF analysis and determines that which of the following results would verify the diagnosis?

A)Clear CSF, elevated protein, and deceased glucose level
B)Clear CSF, decreased pressure, and elevated protein level
C)Cloudy CSF, elevated protein, and decrease glucose level
D)Cloudy CSF, decreased protein, and decreased glucose level

Question 28

A nurse is planning care for a newborn of a diabetic mother. A priority nursing diagnosis for this infant would be:

A)Hyperthermia related to excess fat and glycogen
B)Risk for injury related to low blood glucose levels
C)Risk for delayed development related to excessive size
D)Risk for aspiration related to impaired suck and swallow

Question 29

A nurse in a newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs, if noted in the newborn infant, would alert the nurse to the possibility of this syndrome?

A)Tachypnea and retractions
B)Acrocyanosis and grunting
C)Hypotension and bradycardia
D)Presence of a barrel chest with acrocyanosis

Question 30

A nurse in a newborn nursery is caring for a neonate. On assessment, the infant is exhibiting signs of cyanosis, tachypnea, nasal flaring, and grunting. Respiratory distress syndrome is diagnosed and the physician prescribes surfactant replacement therapy. The nurse prepares to administer this therapy by:

A)Intravenous
B)Subcutaneous
C)Intramuscular
D)Instillation of the preparation into the lung through an endotracheal tube

Question 31

A nurse notes hypotonia, irritability, and a poor sucking reflex in a full-term newborn infant on admission to the nursery. The nurse suspects fetal alcohol syndrome and is aware that which additional sign would be consistent with fetal alcohol syndrome?

A)Length of nineteen inches
B)Abnormal palmar creases
C)Birth weight of 6 lb. 14 oz
D)Head circumference appropriate for gestational age

Question 32

A ten-year-old patient who has been diagnosed with scoliosis is to be treated with a Milwaukee brace. To which of the following nursing diagnoses would a nurse give priority?

A)Self-care deficit
B)Sleep pattern disturbance
C)Skin integrity
D)Impaired gas exchange

Question 33

A nurse is caring for an infant after corrective surgery for Tetralogy of Fallot. The mother reports that the child has suddenly begun seizing. The nurse recognizes this problem is probably due to:

A)A cerebral vascular accident
B)Postoperative meningitis
C)Medication reaction
D)Metabolic alkalosis

Question 34

A preterm neonate, born at thirty-one weeks gestation, is receiving an intravenous electrolyte solution at a rate of 20-22 mL/hr via an umbilical arterial line. At the hourly intake measurement, the nurse determines that 45 mL have infused in the past hour. The most appropriate initial nursing action is to:

A)Check the physician's order
B)Set the infusion rate to 10-11 mL/hr on the next two hours
C)Take the vital signs
D)Compare the intake with the output

Question 35

A physician offers a nurse to suture wounds of a neonate patient. The physician tells the nurse that minor wounds can be sutured by a nurse without any supervision. The nurse should:

A)Proceed with the procedure in the physician's presence
B)Refuse to suture the wound
C)Call the State Board of Nursing and report the situation
D)Follow the instructions given by the physician

Question 36

After speaking with the parents of a child dying from acute lymphocytic leukemia, the physician gives a verbal order of DNR, but refuses to put it in writing. The nurse should:

A)Follow the instructions as given by the physician
B)Refuse to follow the order unless the nurse manager approves it
C)Ask the physician to put it in writing using a pencil before leaving
D)Determine whether the family is in accord with the physician while following hospital policy

Question 37

Which of the following reasons, given by a mother who permits her baby girl to sleep in the same bed as the parents, requires further investigation by the nurse?

A)"I am too tired to get up at night to check on the baby in the other room."
B)"This promotes bonding between us and our child."
C)"I slept with my parents when I was a child."
D)I can be certain that my husband is not being inappropriate."

Question 38

The best nursing approach to parents who are displaying anxiety and guilt when their baby is hospitalized is to:

A)Explain the dangers of excess anxiety and guilt
B)Distract their attention to something less painful
C)Anticipate their emotional responses and acknowledge them
D)Give personal examples that are similar to their situation

Question 39

A nurse notices the mother of a hospitalized twenty-five-day-old infant boy sitting and talking on the telephone while the infant lies in the crib crying. Which of the following statements by the nurse would be most appropriate?

A)"Your son is crying and needs your attention now."
B)"Let us check your son together to see what he needs."
C)"Why do you think your son is crying right now?"
D)"When did you last feed your baby?"

Question 40

Jackie, an operating room nurse, calls her friend at the NICU because she was assigned to circulate for a pregnancy termination case. As her friend, you know that Jackie opposed to the abortion based on her moral principles. You should advise Jackie to:

A)Discuss her beliefs with the patient
B)Have her ask her supervisor to assign another nurse to the case
C)Have her request an ethics panel to be convened to review the case
D)Advise her to leave the room during the time the fetus is aborted

Question 41

A family of a dying patient requests that the window remain open in the patient's room. The most appropriate response by the nurse is:

A)"Open windows create a safety hazard."
B)"You want the window open?"
C)"It's too cold outside to do it."
D)"Why would you want the window open?"

Question 42

A nurse has received an order for Total Parenteral Nutrition for a patient admitted with severe malnutrition. Which of the following measures is essential?

A)A complete blood count has been obtained
B)A subclavian catheter is patent and a chest X-ray is done to confirm placement
C)Arm restraints should be in place during the catheter insertion
D)An antecubital IV catheter is started and a baseline chemistry profile has been done

Question 43

Under the Good Samaritan Act, a nurse may be held liable for a patient abandonment at the scene of an emergency in which of the following cases?

A)The nurse does not stop to provide assistance
B)The nurse begins assistance and then abruptly stops
C)The nurse does not initiate care
D)The nurse does not perform under the direct order of a physician

Question 44

To communicate effectively with the parents of a hospitalized child, the nurse should:

A)Understand that non-verbal communication is meaningful
B)Have empathy with the parents, but realize that the nurse should be in control of the situation
C)Acknowledge positive comments and ignore negative comments
D)Present policy and procedures in detail upon admission

Question 45

An infant is admitted to the nursery for observation after a motor vehicle accident. Family members are unable to stay with the patient. To provide psychological comfort, the nurse would:

A)Assign the same nurse to care for the patient
B)Follow a routine to which the patient is accustomed
C)Ensure a staff member stays with the patient
D)Have the patient listen to the parent's voice over the phone

Question 46

A nurse initiates preparation of a six-year-old boy for an infratentorial craniotomy. The nurse plans to:

A)Schedule role playing with another patient having the same surgery
B)Have the patient draw his concept of a brain and briefly clarify any misconceptions
C)Encourage a dummy play with simulated surgical equipment
D)Provide a thorough explanation of anatomy and the procedure to be performed

Question 47

While in the hospital, a male baby patient suddenly has a nosebleed that spreads blood on the play table. The nurse's initial action in this situation would be:

A)Take the patient back to his room for care
B)Call housekeeping to clean the area
C)Provide nursing care to stop his nosebleed
D)Notify the supervisor so that those in the area can be tested for HIV

Question 48

A neonate, diagnosed with asthma, is admitted to the unit after an exacerbation at home. The patient is short of breath. To facilitate breathing and to promote respiratory drainage, the nurse would place the patient in a:

A)Supine position
B)Left lateral position
C)High Fowler's position
D)Trendelenburg position

Question 49

An abdominal surgery will be performed on a two-month-old infant. Recognizing the developmental level, on the day of the surgery, the nurse should provide the patient with a:

A)Pacifier to suck
B)Music box for listening
C)Rattle to shake
D)Mobile for watching

Question 50

A two-week-old infant with hypertrophic pyloric stenosis is admitted for corrective surgery. The nurse recognizes that the primary objective of the preoperative period is to:

A)Correct fluid and electrolyte imbalances
B)Document the frequency and character of vomitus
C)Improve nutritional status
D)Stabilize vital signs

Question 51

In which room must a nurse place an infant admitted with a diagnosis of meningitis?

A)Semi-private room in the middle of the unit
B)Corner of a four-bed room next to the nurse's station
C)Private room two doors away from the nurse's station
D)Isolation room away from the activity at the end of the hall

Question 52

An infant was admitted to the unit with a tentative diagnosis of bacterial meningitis. When preparing the child for a lumbar puncture, the nurse would first:

A)Obtain a pacifier for the patient to suck on during the procedure
B)Tell the parents they may stay with their child during the procedure
C)Use doll play to demonstrate the procedure
D)Ask the parents if the procedure has been explained to them

Question 53

A nurse can best handle the answering of personal questions asked by the parents of an infant patient during the nurse-patient and family relationship by:

A)Providing brief, truthful answers and redirecting the focus of conversation
B)Offering an honest, brief expression of personal views on the subject
C)Reminding the parents gently that the nurse's feeling are not the parents' concern
D)Reviewing the positive and negative aspect of the subject

Question 54

A twenty-year-old patient who is at thirty-eight weeks gestation is being prepared for an emergency cesarean birth due to an abruption placenta and severe fetal compromise. The patient received nalbuphine 10 mg IV thirty minutes ago. Because the patient is too sedated to sign the consent form, the nurse would:

A)Have the attending physician and the surgeon sign the consent form
B)Sign the consent form and have the nurse manager countersign the form
C)Call the patient's parents or husband and request a verbal consent
D)Proceed with the preparation and forgo written consent

Question 55

When a nurse is carrying a newborn to the mother's room, a visitor asks to hold the baby. The visitor is sneezing and coughing. The nurse's first action should be to:

A)Give the baby to the mother
B)Ask the visitor if the coughing and sneezing are caused by a cold
C)Request that the visitor step outside the room
D)Check the baby's identification band with the mother

Question 56

Nurse Cassie is caring for a newborn female admitted to the nursery. The patient weighs ten pounds, two ounces, which is two pounds more than the birth weight of any of her siblings. Because of the patient's weight, the nurse will:

A)Perform serial glucose readings
B)Place the patient in a heated crib
C)Document the finding
D)Delay starting oral feedings

Question 57

A mother expresses the desire to breastfeed her baby who is preterm and is admitted at the neonatal intensive care unit. The nurse should:

A)Discourage the mother because of the time and effort it will take to pump her breasts
B)Instruct the mother that breast milk is inadequate for a preterm infant because it does not contain all the necessary nutrients
C)Support the mother's decision and explain that even if her baby is able to breastfeed, the baby may easily be exhausted
D)Tell the patient that this is not permissible because the baby is being fed by gavage

Question 58

The clinical nurse specialist is caring for a preterm infant in the NICU. When assessing the patient, it is most important for the nurse to know the infant's gestational age and how it compares with the birth weight because:

A)This information must be documented on the admission record.
B)The patient will lose 12% of weight during the next few hours of life
C)The health insurance companies require evaluation and classification records
D)This data will help to identify potential problems

Question 59

The clinical nurse specialist is caring for a ten-day-old preterm infant at the NICU. During the assessment, the nurse determines that the patient is experiencing hypothermia. The nurse would:

A)Rapidly warm the patient during the next hour until the temperature is stabilized
B)Assess the patient for signs and symptoms of hyperglycemia and begin temperature stabilization
C)Gradually warm the patient during the next several hours and monitor frequently
D)Record the infant's skin temperature every hour until the temperature is stable

Question 60

A patient developed a rubella infection during the fifth month of pregnancy. At the time of the infant's birth, the nurse would place the newborn in the isolation nursery and observe:

A)Standard precautions
B)Enteric precautions
C)Droplet precautions
D)Body fluid precautions

Question 61

A nurse confers with the nutritionist about the diet of a child with decreased mobility due to a fracture. In addition to being non-constipating, the diet should be:

A)Adequate in calories and calcium
B)Low in calories and high in protein
C)High in calories and in phosphorus
D)Moderate in calories and high in protein

Question 62

A baby returns to the unit after a cardiac catheterization. Two hours later, during the change of shifts, the statement about the child's progress that should be questioned by the incoming nurse is that the child:

A)Is on bed rest with bathroom privileges
B)Has voided 100 mL since the procedure
C)Has a pressure dressing over the entry site
D)Is to have blood pressure checked every two hours

Question 63

Dana is a nurse supervisor at the neonatal intensive care unit. She is reviewing different theories of leadership and management and she came across a theory that states that the effectiveness of leadership is dependent upon the unit's situation. Which of the following leadership styles best fits a situation where the followers are self-directed, experts, and are matured individuals?

A)Democratic
B)Authoritarian
C)Laissez faire
D)Bureaucratic

Question 64

An infant was placed in a spica cast for developmental dysplasia of the hip. To employ immediate care, the nurse plans to report to the physician if the patient has developed:

A)Numbness
B)Warm toes
C)Skin desquamation
D)Generalized discomfort

Question 65

A young patient who is a mother for the first time is very anxious about her new role as a parent. With the nurse's encouragement, she has joined a new mother's support group at the local "X." This part of the plan is an example of:

A)Primary prevention
B)Secondary prevention
C)Tertiary prevention

Question 66

A clinical nurse specialist is planning a discharge conference with a patient's parents and other immediate family members. The priority nursing action that should be included in the discharge plan is:

A)Exploring what has been learned from this hospitalization
B)Discussing new issues that could be worked on at home
C)Teaching the parents about the medication to be taken
D)Obtaining a more complete family history

Question 67

A nurse tells the parents of an infant with an infected wound that a nurse epidemiologist will visit daily. The parents ask what a nurse epidemiologist does. The nurse could correctly explain the role by saying, "The nurse epidemiologist…"

A)…helps providers of care to control infection."
B)…decides what antibiotics should be prescribed for infections."
C)…works in the laboratory to identify bacteria causing infection."
D)…is responsible for collecting cultures of infections and drainages."

Question 68

A cardiac monitor indicates that a patient's heart rate has increased to 160 beats per minute. Shortly after this increase, the nurse notices that the patient is in ventricular tachycardia. The nurse reports this finding to the physician because she knows that an order of which of the following is needed?

A)Intracardiac epinephrine
B)A bolus of lidocaine
C)Insertion of a pacemaker
D)Manual cardiopulmonary resuscitation

Question 69

A nurse is caring for a newborn patient in the neonatal intensive care unit. She notified the physician because she was able to assess a:

A)Body temperature of 97.7°F
B)Pale pink, rust colored stain in the diaper
C)Cardiac rate that drops to 112 beats per minute
D)Breathing pattern that is diaphragmatic with sternal retractions

Question 70

A nurse who has been named in a lawsuit can use which of these factors for the best protection in a court of law?

A)Documentation of the specific patient's record with a focus on the nursing process
B)Verification of provider's orders for the plan of care with identification of outcomes
C)Yearly evaluations and proficiency reports prepared by nurse's manager
D)Clinical specialty certification in the associated area of practice

Question 71

A patient's mother asks the nurse about a case manager, specifically the role of a case manager. The nurse should explain that the case manager:

A)Makes daily patient assignments for staff
B)Coordinates both inpatient and outpatient hospitalization and home care
C)Negotiates insurance benefits with the hospital
D)Decides what treatments are essential

Question 72

A nurse is caring for a patient who is not eating or caring and has refused to leave the house since the death of her infant a year ago. The nurse should give priority to the nursing diagnosis of:

A)Anxiety related to fear of death
B)Self-care deficit related to loss
C)Anticipatory grieving related to fear of social interaction
D)Dysfunctional grieving related to loss

Question 73

The parents of a six-month-old patient admitted with diarrhea are anxious and concerned. To involve the parents in the child's care, the nurse should first:

A)Provide literature on diarrheal causes
B)Allow the parents to record all diaper changes
C)Teach the parents how to adhere to standard precautions
D)Encourage the parents to continue the patient's usual diet

Question 74

Before returning a child who is being treated for tuberculosis to his home, the nurse consulted a community health nurse to determine:

A)Home school placement
B)Proper room ventilation
C)That all family members have been tested
D)That the child has a private room

Question 75

A patient is prescribed with chlorpropamide (Diabinese). The nurse should notify the physician if the patient reports being allergic to:

A)Penicillin
B)Sulfur
C)Iodine
D)Aspirin

Question 76

A nurse finds her patient crying because the physician has stated that the patient cannot return home alone and she does not have family nearby. After discussing the patient's concerns, the nurse should contact which of the following:

A)Hospital controller
B)Hospital chaplain
C)Case manager
D)Social worker

Question 77

A nurse calls a physician regarding an order to administer digoxin (Lanoxin) to a patient with pulse of 58 and a serum potassium level of 2.9mEq/L. The physician says to administer the medication as ordered. The nurse should best respond by stating:

A)"I will not give the medication."
B)"I think we should discuss this with the nursing supervisor."
C)"I'll give the medication, but you will still be responsible if anything goes wrong."
D)"I'm sorry, but if you want the medication given, you will have to give it yourself."

Question 78

A patient is scheduled for an intravenous pyelogram (IVP). After the contrast material is injected, which of the following patient reactions should be reported immediately to the physician?

A)Salty taste
B)Feeling warm
C)Hives
D)Face flushing

Question 79

A nurse in a newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs, if noted in the newborn infant, would alert the nurse to notify the physician to the possibility of this syndrome?

A)Tachypnea and retractions
B)Acrocyanosis and grunting
C)Hypotension and bradycardia
D)Presence of a barrel chest with acrocyanosis

Question 80

A patient in labor, who is at term, is admitted to the birthing room. Her membranes rupture spontaneously. The physician should be notified as soon as possible if the nurse notes:

A)Greenish fluid
B)Clear fluid with specks of mucus
C)Shortened intervals between contractions
D)Fetal heart rate decreases before contractions