Nurs201 - Exam #1

The nurse is teaching nursing students about the risks that late preterm infants may experience. The nurse feels confident learning has taken place when the students make which statement? "Late preterm infant complications are considered minor compared to the preterm newborn." "The late preterm infant is more mature and able to cope as well as a full-term infant." "Late preterm newborns have fewer clinical problems leading to shorter hospital stays." "A late preterm newborn may have more clinical problems compared with full-term newborns."

"A late preterm newborn may have more clinical problems compared with full-term newborns."

The nurse should give which discharge instructions about thermal injury to a client with peripheral vascular disease? Select all that apply. "Warm the fingers or toes by using an electric heating pad." "Avoid sunburn during the summer." "Wear extra socks in the winter." "Choose loose, soft, cotton socks." "Use an electric blanket when you are sleeping."

"Avoid sunburn during the summer." "Wear extra socks in the winter." "Choose loose, soft, cotton socks."

The nurse is discussing fever with the parents of a child who is in the emergency department with a temperature of 101 degrees Fahrenheit. Which statement by a parent indicates an understanding about fevers and their management in the ill child? "We've been giving him a little extra acetaminophen to help bring his fever down." "We've had to wake him up in the night to give him more medicine to reduce his temperature." "My wife and I have been using cold water and washcloths on him because of the fever." "Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection."

"Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection."

The nurse is collecting data on an 18-month-old child admitted with a diagnosis of possible seizures. When interviewing the caregivers, which questions would be most important for the nurse to ask? "Is your child up to date on his immunizations?" "Has anyone in your family been sick recently" "What type of activities was your child doing today?" "Have you checked your child's temperature?"

"Have you checked your child's temperature?"

You are the hospice nurse caring for a client with pulmonary fibrosis who wants to die at home. The client is having difficulty breathing. The family asks why it is so hard for the client to breathe. What would be the nurse's best response? "The dying no longer have the energy to breathe." "This is normal when a person is near the end of their life." "The fibrosis of the lungs makes the lungs stiff, which makes it harder to breathe. "The disease is making your loved one retain carbon dioxide, so there is not enough room in the blood for adequate oxygen."

"The fibrosis of the lungs makes the lungs stiff, which makes it harder to breathe."

The nurse has just measured an adult client's oral temperature and obtained a result of 102.4ºF (39.1ºC). The client states, "I just finished my coffee right before you came in. Can I have another cup?" Which response by the nurse is most appropriate? "I will bring you another cup when I return in 30 minutes to reassess your temperature. Please do not drink any other beverages until I return." "You will need to remain n.p.o. until I notify your primary health care provider about your increased temperature." "Before you drink another hot beverage, drink some cool water so I can obtain an accurate oral temperature." "I'll be right back with your coffee and a different thermometer. I'm not sure this one measured your temperature correctly."

"I will bring you another cup when I return in 30 minutes to reassess your temperature. Please do not drink any other beverages until I return."

The father of a toddler tells the nurse that his child had a fever the previous night. During the assessment, which statement by the father indicates further discussion is necessary regarding temperature measurement? "I used one of those thermometers that goes in the ear, but I don't think it was accurate." "We have an electronic oral thermometer. It seemed to match our child's symptoms of fever better." "My mother said she always used a glass thermometer when I was a kid and it was very accurate. Maybe that would be better." "I know rectal temperature is pretty accurate but I didn't see that it was necessary to cause the discomfort of that route."

"My mother said she always used a glass thermometer when I was a kid and it was very accurate. Maybe that would be better."

A pregnant woman enjoys exercising at a local health spa once a week. Which comment would lead the nurse to believe she needs additional health teaching? "I limit exercising to low-impact aerobics." "Nothing feels nicer than a hot sauna after exercise." "I'm learning to play table tennis." "The gym gets hot and stuffy by midmorning."

"Nothing feels nicer than a hot sauna after exercise."

A student nurse is working with a client who is diagnosed with head trauma. The nurse has documented Cheyne-Stokes respirations. The student would expect to see which of the following? Regular breathing where the rate and depth increase, then decrease Periods of normal breathing followed by periods of apnea Irregular breathing at 14 to 18 breaths per minute Period of cessation of breathing

Regular breathing where the rate and depth increase, then decrease

A female client comes to the clinic and asks the nurse what would be the most cost effective method for her to determine her ovulation patterns. What is the best response by the nurse? "The least costly method to determine ovulation patterns is to record the basal body temperature for at least 4 months." "The least costly method would be a surgical procedure to determine if your fallopian tubes are blocked." "The least costly method would be to purchase a commercial kit from the store to assess the upsurge of LH that occurs just after ovulation." "The least costly method would be to purchase an at-home testing kit for sperm motility."

"The least costly method to determine ovulation patterns is to record the basal body temperature for at least 4 months."

A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed? "We can stop the penicillin when her symptoms disappear." "If she needs dental surgery, we might need additional medication." "She needs to take the drug for the full 14 days." "To prevent another episode, she'll need preventive antibiotic therapy for at least 5 years."

"We can stop the penicillin when her symptoms disappear."

When assessing an infant's axillary temperature, it will be: 1°F (0.5°C) lower than an oral temperature. 1°F (0.5°C) higher than a rectal temperature. 1°F (0.5°C) higher than an oral temperature. The same as the tympanic temperature.

1°F (0.5°C) lower than an oral temperature.

The nurse is caring for a 7-month-old female infant diagnosed with a urinary tract infection (UTI). The parents are upset as this is the infant's second UTI with a fever. Which instruction is most helpful? Select all that apply. UTI's are common in male infants at this age. A fever is commonly noted with a UTI. Change diapers promptly, especially after bowel movements. After 3 days on antibiotics, the infection is clear. Female urethras are shorter and straighter than males.

A fever is commonly noted with a UTI. Change diapers promptly, especially after bowel movements. Female urethras are shorter and straighter than males.

The nurse is caring for a client who is in respiratory distress. The physician orders arterial blood gases (ABGs) to determine various factors related to blood oxygenation. What site can ABGs be obtained from? The trachea and bronchi A catheter in the arm vein The pleural surfaces A puncture at the radial artery

A puncture at the radial artery

The nurse is caring for a client in septic shock. The nurse knows to closely monitor the client. What finding would the nurse observe when the client's condition is in its initial stages? A rapid, bounding pulse A slow but steady pulse A weak and thready pulse A slow and imperceptible pulse

A rapid, bounding pulse

The perioperative nurse is caring for a client who is undergoing abdominal surgery with the inclusion of succinylcholine in the client's anesthesia. The anesthesiologist tells the team that the client is exhibiting signs and symptoms suggestive of malignant hyperthermia. What is the nurse's best action? Anticipate IV administration of dantrolene Initiate resuscitation Prepare to administer acetylcysteine IV Administer naloxone IV as per facility protocol

Anticipate IV administration of dantrolene

A client postoperative from an appendectomy reports feeling cold and has a temperature of 96.2°F (35.7°C). Which action should the nurse perform first? Check the client's blood pressure. Apply an oxygen saturation monitor. Apply warm blankets to the client. Notify the health care provider.

Apply warm blankets to the client.

The nurse is working in collaboration with a nurse anesthetist to assess a preoperative client. When addressing the client's risk for malignant hyperthermia as a result of neuromuscular junction blockers, what assessment should be prioritized? Assessing for a family history of malignant hyperthermia Assessing for a history of febrile seizures in childhood Assessing for any history of cytochrome P450 dysfunction Assessing the client's allergy status

Assessing for a family history of malignant hyperthermia

A homeless client presents to the ED. Upon assessment, the client is experiencing hypothermia. The nurse will plan to complete which priority intervention during the rewarming process? Attach a cardiac monitor Insert a Foley urinary catheter Assist with endotracheal intubation Administer inotropic drugs

Attach a cardiac monitor

The client has been brought to the emergency department by their caregiver. The caregiver says that she found the client diaphoretic, nauseated, flushed and complaining of a pounding headache when she came on shift. What are these symptoms indicative of? Concussion Autonomic dysreflexia Spinal shock Contusion

Autonomic dysreflexia

A nurse is performing a physical examination on a newborn. Which assessment should she include? Axillary temperature, femoral pulse, head circumference Rectal temperature, femoral pulse, head circumference Temporal temperature, blood pressure, reflexes Oral temperature, blood pressure, head circumference

Axillary temperature, femoral pulse, head circumference

A nurse is about to give a full-term neonate his first bath. How should the nurse proceed? Bathe the neonate only after his vital signs have stabilized. Clean the neonate with medicated soap. Scrub the neonate's skin to remove the vernix caseosa. Wash the neonate from feet to head.

Bathe the neonate only after his vital signs have stabilized.

When caring for a client who is post-intracranial surgery what is the most important parameter to monitor? Extreme thirst Intake and output Nutritional status Body temperature

Body temperature

It is discovered that a new mother has developed a puerperal infection. What is the most likely expected outcome that the nurse will identify for this client related to this condition? Client's temperature remains below 100.4° F or 38° C orally. Fundus remains firm and midline with progressive descent. Client maintains a urinary output greater than 30 mL per hour. Lochia discharge amount is 6 inches or less on a perineal pad in 1 hour.

Client's temperature remains below 100.4° F or 38° C orally.

A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer? Botulinum toxin type B Dantrolene Baclofen Methocarbamol

Dantrolene

A patient develops malignant hyperthermia after receiving a NMJ blocker. Which would the nurse expect to be given? Dantrolene Succinylcholine Naloxone Protamine sulfate

Dantrolene

A patient is having surgery to repair a ruptured Achilles tendon. The patient develops severe muscle contractions and hyperthermia. Which medications will be administered? Dantrolene sodium (Dantrium) Baclofen (Lioresal) Carisoprodol (Soma) Cyclobenzaprine (Flexeril)

Dantrolene sodium (Dantrium)

A 6-month-old is admitted to the hospital because of a fever. When you obtain a health history, what data would you obtain first? Details about the fever Family profile History of past illnesses Review of systems

Details about the fever

While conducting the physical examination during assessment of the respiratory system, which conditions does the nurse assess by inspecting and palpating the trachea? Evidence of exudate Evidence of muscle weakness Color of the mucous membranes Deviation from the midline

Deviation from the midline

The nurse enters the room of a client who is being monitored with pulse oximetry. Which of the following factors may alter the oximetry results? Increased temperature of the room Placement of the probe on an earlobe Diagnosis of peripheral vascular disease Reduced lighting in the room

Diagnosis of peripheral vascular disease

For air to enter the lungs (process of ventilation), the intrapulmonary pressure must be less than atmospheric pressure so air can be pulled inward. Select the movement of respiratory muscles that makes this happen during inspiration. Anteroposterior rib diameter decreases. Intercostals muscles relax to allow for expansion. Lungs are pulled up and pushed back against the thoracic cage. Diaphragm contracts and elongates the chest cavity.

Diaphragm contracts and elongates the chest cavity

Which of the following clinical manifestations should a nurse monitor for during a pulmonary angiography, which indicates an allergic reaction to the contrast medium? Hematoma Difficulty in breathing Urge to cough Absent distal pulses

Difficulty in breathing

A client informs the nurse that a mercury thermometer is used at home to take the temperature of her children when they are sick. What health education by the nurse is most appropriate? Educate the client about safety related to accidental breakage of the thermometer. Encourage the client to dispose of the thermometer in the trash and buy a new type. Encourage the client to use an alternative type of thermometer to assess temperature in the home. Instruct the client that mercury thermometers should be used only in a hospital setting with appropriate safeguards.

Encourage the client to use an alternative type of thermometer to assess temperature in the home.

A preterm infant has an umbilical vessel catheter inserted so that blood can be drawn readily. Which would be most important to implement during this procedure? Prevent the infant from crying. Ensure that the infant is kept warm. Assess the infant's cranial vascular tension. Evaluate the infant's urinary output.

Ensure that the infant is kept warm.

A 28-year-old patient has a history of malignant hyperthermia following anesthesia. Today, this patient is on the operating room schedule for a D&C;. Which method of anesthesia would not be acceptable for this patient? General anesthesia with an inhalation agent Epidural anesthesia Spinal anesthesia Local anesthesia

General anesthesia with an inhalation agent

A patient develops malignant hyperthermia. Which of the following most likely would be the first indicator of this complication? Body temperature rise of 2 degrees F Tentanus-like jaw movements Generalized muscle rigidity Heart rate over 150 beats per minute

Heart rate over 150 beats per minute

A nurse is assessing a 1-hour-old neonate in the special care nursery. Which assessment finding indicates a metabolic response to cold stress? Arrhythmia Hyperglycemia Hypoglycemia Hypertension

Hypoglycemia

A 25-year-old young female client arrives at the community clinic reporting changes in her eating habits. She reports a sudden loss of appetite with no apparent reason. The nurse understands that which part of the brain could be responsible for the client's condition? Cerebellum Limbic system Hypothalamus Medulla

Hypothalamus

A client in the operating room goes into malignant hyperthermia due to an abnormal reaction to the anesthetic. The nurse knows that the area of the brain that regulates body temperature is what? Cerebellum Thalamus Hypothalamus Midbrain

Hypothalamus

What would be found in the midbrain? Reticular activating system Respiratory control center Hypothalamus Swallowing center

Hypothalamus

Which of the following areas of the brain are responsible for temperature regulation? Hypothalamus Thalamus Pons Medulla

Hypothalamus

A nurse is concerned that a client may develop postoperative atelectasis. Which nursing diagnosis would be most appropriate if this complication occurs? Decreased cardiac output Impaired spontaneous ventilation Ineffective airway clearance Impaired gas exchange

Impaired gas exchange

A nurse is monitoring a client post cardiac surgery. What action would help to prevent cardiovascular complications for this client? Position the client in bed with pillows placed under his knees to hasten venous return. Keep the client from ambulating until the day after surgery. Implement leg exercises and turn the client in bed every 2 hours. Keep the client cool and uncovered to prevent elevated temperature.

Implement leg exercises and turn the client in bed every 2 hours.

Which is associated with an increase in gonadotropin-releasing hormone secretion? Stress Starvation Extreme exercise Increased light exposure

Increased light exposure

The nurse is in the radiology unit of the hospital. The nurse is caring for a client who is scheduled for a lung scan. The nurse knows that lung scans need the use of radioisotopes and a scanning machine. Before the perfusion scan, what must the client be assessed for? Bleeding Dysrhythmias Iodine allergy Inflammation

Iodine allergy

A physician has ordered that a client with suspected lung cancer undergo magnetic resonance imaging (MRI). The nurse explains the benefits of this study to the client. Included in teaching would be which of the following regarding the MRI? Lung blood flow can be viewed after a radiopaque agent is injected. Narrow-beam x-ray can scan successive lung layers. MRI can view soft tissues and can help stage cancers. Tumor densities can be seen with radiolucent images.

MRI can view soft tissues and can help stage cancers.

What can the nurse educate a subfertile couple about to avoid the problem with lower sperm counts in the male partner? Avoid exercise regimens. Minimize actions that increase scrotal heat. Sit in a hot bath twice daily to increase the scrotal heat. Use the sauna after an exercise regimen to "sweat out" the toxins.

Minimize actions that increase scrotal heat.

The instructor of the pre-nursing physiology class is explaining respiration to the class. What does the instructor explain is the main function of respiration? To exchange atmospheric air between the blood and the cells To move O2 out of the atmospheric air and into the retained air To exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells To move CO2 out of the atmospheric air and into the expired air

To exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells

Upon palpation of the sinus area, what would the nurse identify as a normal finding? No sensation during palpation Pain sensation behind the eyes Light not going through the sinus cavity Tenderness during palpation

No sensation during palpation

A child who is 15 years of age is hospitalized with bacterial meningitis. At 1730, the client's mother reports her child is "burning up." The nurse is reviewing the client's medication administration records in the medical record. The health care provider (HCP) has ordered ibuprofen 325 mg every 3 to 4 hr for temperature over 99° F (37.2° C). The child's temperature at 1730 is 102.5° F (39.1° C). What should the nurse do first? Notify the HCP. Initiate tepid sponge bath. Institute seizure precautions. Administer another dose of aspirin.

Notify the HCP.

A nurse practitioner diagnosed a patient with an infection in the maxillary sinuses. Select the area that the nurse palpated to make that diagnosis. On the cheeks below the eyes Between the eyes and behind the nose Above the eyebrows Behind the ethmoid sinuses

On the cheeks below the eyes

The nurse is performing an assessment for a patient with congestive heart failure. The nurse asks if the patient has difficulty breathing in any position other than upright. What is the nurse referring to? Tachypnea Bradypnea Dyspnea Orthopnea

Orthopnea

When assessing a client, which adaptation indicates the presence of respiratory distress? Respiratory rate of 14 breaths per minute Sore throat Productive cough Orthopnea

Orthopnea

The nurse in the newborn nursery is placing a 30-minute-old newborn on a radiant warmer for thermoregulation. Where should she apply the temperature probe to be most accurate? Over the upper chest Over the liver on the abdomen On the upper thigh On the scalp

Over the liver on the abdomen

When the physician looks in a child's mouth during a sick-visit exam, the mother exclaims: "Her tongue is bright red! It was not like that yesterday." The physician would most likely order which medication based on the probable diagnosis of scarlet fever? Steroids to decrease the inflammation Acetaminophen to decrease the throat pain Penicillin to prevent acute glomerulonephritis Erythromycin to prevent the spread to siblings

Penicillin to prevent acute glomerulonephritis

A 9-month-old baby is scheduled for heart surgery. When preparing this client for surgery, the nurse should consider which surgical risk associated with infants? Prolonged wound healing Potential for hypothermia or hyperthermia Congestive heart failure Gastrointestinal upset

Potential for hypothermia or hyperthermia

Which term indicates a potentially serious client condition? Pyrexia Pulse pressure Eupnea Afebrile

Pyrexia

T / F: During measurement of a rectal temperature, the thermometer probe should be inserted about 1.5 inches (3.8 cm) in an adult and 0.5 inches (1.3 cm) in an infant.

True

Just after delivery, a nurse measures a neonate's axillary temperature at 94.1°F (34.5°C). What should the nurse do? Rewarm the neonate gradually. Give the baby a bath. Observe the neonate hourly. Notify the physician when the neonate's temperature is normal.

Rewarm the neonate gradually.

A client is receiving hypothermic treatment for uncontrolled fever related to increased intracranial pressure (ICP). Which assessment finding requires immediate intervention? Capillary refill of 2 seconds Shivering Cool, dry skin Urine output of 100 mL/hr

Shivering

Which ventilation-perfusion ratio is exhibited by acute respiratory distress syndrome (ARDS)? Normal ratio of perfusion to ventilation Low ventilation-perfusion ratio Dead space Silent unit

Silent unit

The nurse is preparing the delivery room before the birth occurs. What supplies would the nurse have available to care for the newborn? Select all that apply. Warmer bed Glucose water Suction equipment Identification bands Ophthalmoscope

Suction equipment Identification bands Warmer bed

A nurse assesses a client's respiratory status. Which observation indicates that the client is having difficulty breathing? Use of accessory muscles Controlled breathing Diaphragmatic breathing Pursed-lip breathing

Use of accessory muscles

A nurse is concerned that a 1-day-old newborn is becoming ill and may be septic. What signs of distress would validate the nurse's concerns? Respiratory rate of 40 Temperature instability Heart rate of 152 Erythema toxicum

Temperature instability

For which reason does gas exchange decrease in older adults? The alveolar walls contain fewer capillaries. The elasticity of the lungs increases with age. The number of alveoli decreases with age. The alveolar walls become thicker.

The alveolar walls contain fewer capillaries.

Which outcome does the nurse recognize as being the most appropriate for the client with a nursing diagnosis of risk for infection? The client takes the prescribed antibiotic. The client has a normal temperature and no signs and symptoms of infection. The client understands what symptoms to monitor for. The client takes his temperature daily.

The client has a normal temperature and no signs and symptoms of infection.

The nurse is applying a heating pad to a client experiencing neck pain. Which nursing action is performed correctly? The nurse uses a safety pin to attach the pad to the bedding. The nurse covers the heating pad with a heavy blanket. The nurse places the heating pad under the client's neck. The nurse keeps the pad in place for 20 to 30 minutes, assessing it regularly.

The nurse keeps the pad in place for 20 to 30 minutes, assessing it regularly.

The client is returning from the operating room following a bronchoscopy. Which action, performed by the nursing assistant, would the nurse stop if began prior to nursing assessment? The nursing assistant is pouring a glass of water to wet the client's mouth. The nursing assistant is assisting the client to a semi-Fowler's position. The nursing assistant is asking a question requiring a verbal response. The nursing assistant is assisting the client to the side of the bed to use a urinal.

The nursing assistant is pouring a glass of water to wet the client's mouth

When providing nursing care to the elderly, it is most important to provide comfort due to which of the following changes? Dementia Isolation Thermoregulation Sexuality

Thermoregulation

A client with a suspected pulmonary disorder undergoes pulmonary function tests. To interpret test results accurately, the nurse must be familiar with the terminology used to describe pulmonary functions. Which term refers to the volume of air inhaled or exhaled during each respiratory cycle? Functional residual capacity Vital capacity Tidal volume Maximal voluntary ventilation

Tidal volume

During the initial assessment, the nurse notes that the neonate's hands and feet appear blue while the neonate's torso appears pale pink. What should the nurse do next? Wrap the neonate in a warm blanket. Ask the mother to massage the neonate's hands and feet. Keep the neonate in an isolation incubator for at least 2 hours. Report the neonate's cyanosis to the primary care provider promptly.

Wrap the neonate in a warm blanket.

The nurse is assessing clients for basal metabolic rate (BMR). Which client would the nurse suspect would have an increased BMR? an older adult client a client who has a fever a client who is fasting a client who is asleep

a client who has a fever

A nurse is teaching new parents about keeping follow-up appointments and calling their health care provider if they notice signs of illness in their newborn. The nurse determines that the teaching was successful when the parents identify which signs as needing to be reported? Select all that apply. temperature of 38.3° C (101° F) or higher refuse feeding abdominal distention general fussiness approximately eight wet diapers a day

abdominal distention refuse feeding temperature of 38.3° C (101° F) or higher

A pregnant client is undergoing a fetal biophysical profile. Which parameter of the profile helps measure long-term adequacy of the placental function? amniotic fluid volume fetal heart rate fetal breathing record fetal reactivity

amniotic fluid volume

Surgery can lead to hypothermia. Which client is at greatest risk for hypothermia? a woman giving birth by C-section an adolescent for arthroscopic surgery a young adult with a fractured leg an older adult man with a fractured hip

an older adult man with a fractured hip

A toddler hospitalized with nephrotic syndrome has marked dependent edema and hypoalbuminemia. His urine is frothy. When assessing the child's vital signs, the nurse should report which finding to the primary care provider? blood pressure of 80/45 mm Hg body temperature of 102.8° F (39.3° C) pulse rate of 85 bpm respiratory rate of 28 breaths/min

body temperature of 102.8° F (39.3° C)

During the surgical procedure, the client exhibits tachycardia, generalized muscle rigidity, and a temperature of 103°F. The nurse should prepare to administer: verapamil (Isoptin) dantrolene sodium (Dantrium) potassium chloride an acetaminophen suppository

dantrolene sodium (Dantrium)

A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for: exophthalmos and conjunctival redness. flushed, warm, moist skin. systolic murmur at the left sternal border. decreased body temperature and cold intolerance.

decreased body temperature and cold intolerance.

A neonate weighing 1,870 g with a respiratory rate of 46 breaths/minute, a pulse rate of 175 bpm, and a serum pH of 7.11 has received sodium bicarbonate intravenously. The drug has been effective if the neonate: does not become edematous. is not dehydrated. does not go into metabolic acidosis. develops respiratory alkalosis.

does not go into metabolic acidosis.

The LVN/LPN will be assessing a postpartum client for danger signs after a vaginal birth. What assessment finding would the nurse assess as a danger sign for this client? presence of lochia rubra fever more than 100.4° F (38° C) fundus is above the umbilicus fundus is firm

fever more than 100.4° F (38° C)

A client who just gave birth to her first baby is preparing for discharge and states that she does not know how to bathe the infant. The best response by the nurse is to demonstrate how to bathe the infant and: recommend newborn care classes. have the client return demonstrate how to bathe the infant. assess if the client has questions. refer the client to the hospital's newborn care booklet.

have the client return demonstrate how to bathe the infant.

What is a consequence of hypothermia in a newborn? respirations of 46 heart rate of 126 holds breath 25 seconds skin pink and warm

holds breath 25 seconds

When the nurse is describing the events that occur in a newborn when he or she experiences a cold environment, which event would the nurse identify as occurring first? breakdown of triglycerides increased cardiac output increased blood flow through brown fat increased release of norepinephrine

increased release of norepinephrine

A client has been newly diagnosed with emphysema. The nurse should explain to the client that by definition, ventilation: is when the body changes oxygen into CO2. is breathing air in and out of the lungs. provides a blood supply to the lungs. helps people who cannot breathe on their own.

is breathing air in and out of the lungs

A 2-month-old infant is admitted to a local health care facility with an axillary temperature of 96.8° F (36° C). Which observed manifestation would confirm the occurrence of cold stress in this client? increased appetite increase in the body temperature lethargy and hypotonia hyperglycemia

lethargy and hypotonia

A client experiencing alcohol withdrawal exhibits tremors, diaphoresis, and hyperactivity. Blood pressure is 190/87 mm Hg, and pulse is 92 bpm. Which medication should the nurse expect to administer? haloperidol lorazepam benztropine naloxone

lorazepam

The nurse answers a client's call light. The client reports an irritating tickling sensation in the throat, a salty taste, and a burning sensation in the chest. Upon further assessment, the nurse notes a tissue with bright red, frothy blood at the bedside. The nurse can assume the source of the blood is likely from the rectum. stomach. nose. lungs.

lungs

Which finding is indicative of hypothermia of the preterm infant? regular respirations oxygen saturation of 95% pink skin nasal flaring

nasal flaring

The nurse auscultates the lung sounds of a client during a routine assessment. The sounds produced are harsh and cracking, sounding like two pieces of leather being rubbed together. The nurse would be correct in documenting this finding as sibilant wheezes. crackles. sonorous wheezes. pleural friction rub.

pleural friction rub

A nurse is teaching a client with multiple sclerosis (MS). When teaching the client how to reduce fatigue, the nurse should tell the client to: take a hot bath. rest in an air-conditioned room. increase the dose of muscle relaxants. avoid naps during the day.

rest in an air-conditioned room.

Two hours ago, a neonate at 38 weeks' gestation and weighing 3,175 g (7 lb) was born to a primiparous client who tested positive for beta-hemolytic Streptococcus. Which finding would alert the nurse to notify the health care provider (HCP)? alkalosis increased muscle tone temperature instability positive Babinski's reflex

temperature instability

Which hollow tube transports air from the laryngeal pharynx to the bronchi? pharynx trachea bronchioles larynx

trachea

Millions of alveoli form most of the pulmonary mass. The squamous epithelial cells lining each alveolus consist of different types of cells. Which type of alveolar cells produce surfactant? type III cells type IV cells type I cells type II cells

type II cells