A nurse is reviewing acid-base laboratory data on a newborn admitted to the NICU for meconium aspiration. Which laboratory values should the nurse report to the physician? (Select all that apply.)

Correct Answer: B

Rationale: In this scenario, the correct laboratory value that the nurse should report to the physician is option B) PCO2: 49. The high PCO2 value indicates respiratory acidosis, a condition commonly seen in newborns with meconium aspiration syndrome due to impaired gas exchange. This information is crucial for the physician to assess the baby's respiratory status and determine the appropriate intervention, such as initiating respiratory support or adjusting ventilator settings. The other options are incorrect: A) pH: 7.35 falls within the normal range for newborns (7.25-7.45) and does not indicate any immediate acid-base imbalance. C) HCO3-: 30 is within the normal range for newborns (22-32 mEq/L) and does not suggest a significant acid-base disturbance. D) PaO2: 96, though important for assessing oxygenation, is not the most relevant value in this case where respiratory acidosis is the primary concern. Understanding acid-base imbalances and interpreting laboratory values in neonates is crucial for nurses working in NICU settings. Recognizing abnormal values and knowing their implications is essential for providing timely and appropriate care to neonates with respiratory distress.

Correct Answer: D

Rationale: The nurse should use the Snellen letter chart to test a school-age child's vision. The Snellen chart is specifically designed to assess distance vision by having the child read rows of letters of various sizes from a specific distance. This chart is commonly used for vision screenings and has standardized letter sizes that help determine visual acuity. The other options listed - Denver Eye Screening Test, Allen picture card test, and Ishihara vision test - are not typically used for testing visual acuity in the same way the Snellen chart is.

Correct Answer: c

Rationale: The correct sequence for performing an abdominal assessment is: C) Inspection, B) Palpation, A) Auscultation, D) Percussion. 1. **Inspection (C)**: This is the initial step as it allows the healthcare provider to observe any visible abnormalities such as distension, scars, or masses. It sets the foundation for the rest of the assessment. 2. **Palpation (B)**: This step involves gently feeling the abdomen to assess for tenderness, masses, organ enlargement, and areas of pain. Palpation follows inspection as it provides more detailed information about what was observed. 3. **Auscultation (A)**: Listening to bowel sounds using a stethoscope comes next. This order is important as palpation and auscultation can stimulate bowel sounds, potentially altering the assessment if done out of sequence. 4. **Percussion (D)**: Percussion, the final step, involves tapping the abdomen to assess the density of underlying tissues. This should be done last as it can also alter bowel sounds and potentially cause discomfort to the patient if done earlier. Educationally, understanding the correct sequence ensures a systematic and comprehensive abdominal assessment, leading to accurate findings and appropriate interventions. It also highlights the importance of following a standardized approach in clinical practice to ensure consistency and thoroughness in patient care.

Correct Answer: B

Rationale: At around 2 months of age, infants typically start to show signs of recognizing familiar faces and objects, such as a feeding bottle. At this stage, their vision and cognitive abilities have developed enough for them to begin differentiating and responding to familiar stimuli in their environment. This recognition is an important developmental milestone in an infant's early cognitive and social development.

Correct Answer: A

Rationale: Option A is the most suggestive that a nurse has a nontherapeutic relationship with a patient and family because when the staff is concerned about the nurse's actions with the patient and family, it indicates that there may be issues or red flags in the nurse's interactions. This could imply that the nurse's behavior is not promoting a positive, therapeutic relationship with the patient and family, which is crucial for effective care delivery. Staff concerns may arise due to behaviors that are inappropriate, unprofessional, or lacking empathy, which can hinder the development of a therapeutic relationship and affect the quality of care provided.