ATI RN
Nursing Interventions for Pediatric Respiratory Distress Questions
Question 1 of 5
To evaluate the desired response of methylergonovine (Methergine), the nurse would assess the patient's
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
The nurse is planning to conduct the initial assessment of a full-term newborn. Included in the plan is providing a neutral thermal environment. To accomplish this plan, what is the desired environmental temperature to conduct the assessment?
Correct Answer: C
Rationale: A neutral thermal environment for a full-term newborn is one in which the infant can maintain a stable body temperature with minimal oxygen need. The desired environmental temperature to conduct the assessment and provide a thermoneutral zone is 32 to 33.5°C (89.6 to 92.3°F). This range allows the infant to maintain stability without an increase in metabolic rate.
Question 3 of 5
The mother-baby nurse is providing care to a patient and her newborn 2 hours after delivery. On review of the newborn's chart, the nurse sees a notation of caput succedaneum. What will the nurse expect to find in the mother's chart?
Correct Answer: B
Rationale: Caput succedaneum is caused by pressure against the mother's cervix during labor, resulting in localized edema on the newborn's head. Therefore, the nurse would expect to find a notation of longer than usual labor in the mother's chart. This is a common occurrence related to the labor process, not related to the mother's race, use of epidural, or mode of delivery.
Question 4 of 5
The mother and infant should have identifying armbands with matching numbers. Both of these bands should be reviewed to determine that the mother has the correct infant. The other actions do not adequately verify the identities of mother and infant.
Correct Answer: C
Rationale: Having the mother read her printed band number and verifying that it matches the infant's number is the most accurate way to ensure correct identification. This procedure minimizes the risk of errors. The other options do not provide a foolproof method of verifying identities and can lead to mistakes.
Question 5 of 5
An hour after birth, the nurse assesses a newborn's temperature and notes that it is 36.2°C (97.2°F). The next activity planned for the newborn is the bath, and the new mother and father are invited to participate in the procedure. What is the nurse's next action?
Correct Answer: C
Rationale: The nurse's next action should be to delay the bath until the newborn's temperature is above 36.7°C (98°F). This is important because infants can lose heat during a bath through evaporation. Rectal temperatures should be avoided to prevent mucosal trauma, and it is the nurse's responsibility to ensure the bath water is at the appropriate temperature to prevent scalding.