Correct Answer: A

Rationale: A hemoglobin level of 9.2 g/dL is below the normal range for pregnancy (11-12 g/dL in the first trimester) and indicates anemia, which can affect fetal growth and maternal health. The nurse should report this finding to the provider for further evaluation and management, such as iron supplementation.
Choice B is wrong because a fasting blood glucose of 92 mg/dL is within the normal range for pregnancy (less than 95 mg/dL) and does not indicate gestational diabetes.
Choice C is wrong because a WBC count of 10,000/mm3 is within the normal range for pregnancy (5,000-15,000/mm3) due to physiological leukocytosis.
Choice D is wrong because a platelet count of 200,000/mm3 is within the normal range for pregnancy (150,000-400,000/mm3) and does not indicate thrombocytopenia.

Correct Answer: A

Rationale: The nurse should ensure the state health department has been notified of the child's Lyme disease, as it is a reportable disease in most states. Reporting helps to monitor the incidence and prevalence of Lyme disease and to implement prevention and control measures.
Choice B is wrong because antitoxin is not used to treat Lyme disease. Antitoxin is a substance that neutralizes the effects of a toxin, such as botulism or tetanus. Lyme disease is caused by a bacterium called Borrelia burgdorferi, which can be treated with antibiotics.
Choice C is wrong because Lyme disease is not transmitted by sharing personal belongings. Lyme disease is spread to humans by the bite of infected ticks that carry the bacterium. The risk of getting Lyme disease can be reduced by avoiding tick-infested areas, wearing protective clothing, using insect repellent, and removing ticks promptly.
Choice D is wrong because skin necrosis is not a common complication of Lyme disease. Skin necrosis is the death of skin tissue due to lack of blood supply or infection. Lyme disease can cause a characteristic skin rash called erythema migrans, which is usually circular or oval and expands over time. Other possible signs and symptoms of Lyme disease include fever, headache, fatigue, joint pain, and neurological problems.

Correct Answer: B

Rationale: Monitoring liver function tests is essential for clients taking phenytoin, an anticonvulsant that can cause hepatotoxicity, leading to elevated liver enzymes or liver damage.
Choice A is incorrect because phenytoin is not commonly associated with thrombocytopenia; blood dyscrasias are rare but possible.
Choice C is incorrect because blood urea nitrogen is not directly affected by phenytoin; it is more relevant for drugs affecting renal function.
Choice D is incorrect because phenytoin can cause hyponatremia, but it is less critical than liver function monitoring, as hepatotoxicity is a more significant risk.

Correct Answer: A

Rationale: Inability to sit still for prolonged periods is a hallmark symptom of ADHD, reflecting hyperactivity and impulsivity, especially in children and some adults.
Choice B is incorrect because a persistent sad mood is more associated with depression, not ADHD.
Choice C is incorrect because recurrent intrusive thoughts are characteristic of obsessive-compulsive disorder, not ADHD.
Choice D is incorrect because hypersomnia is not typical; ADHD may cause sleep difficulties due to hyperactivity, but not excessive sleep.

Correct Answer: D

Rationale:
Choice A is wrong because the blood sample is not drawn from the baby's inner elbow, but from the heel.
Choice B is wrong because the baby does not need to drink water prior to the test, as this could dilute the blood sample and affect the results.
Choice C is wrong because the test does not need to be repeated when the baby is 2 months old, unless there is a positive or inconclusive result from the first test. Newborn genetic screening is important for early detection and intervention. This test should be performed after your baby is 24 hours old. This is because newborn genetic screening is a set of laboratory tests that detect a set of known genetic diseases that can affect a child's long-term health or survival. The test is performed on a blood sample obtained from a heel prick when the baby is two or three days old. Performing the test after 24 hours ensures that the baby has had enough time to metabolize certain substances that could interfere with the accuracy of the test.