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A nurse is teaching a newly licensed nurse about neonatal abstinence syndrome.
Which of the following statements by the newly licensed nurse indicate understanding of the teaching?

A.

"The newborn will have decreased muscle tone.”.

B.

"The newborn will have a continuous high-pitched cry.”.

C.

"The newborn will sleep for 2 to 3 hours after a feeding.”.

D.

"The newborn will have mild tremors when disturbed.”.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Decreased muscle tone is not typically associated with neonatal abstinence syndrome (NAS). Instead, NAS often presents with hypertonia or increased muscle tone due to

withdrawal symptoms.

 

Choice B rationale

A continuous high-pitched cry is a hallmark sign of NAS, indicating the newborn is experiencing withdrawal and discomfort. This symptom results from the overstimulation of the

central nervous system.

 

Choice C rationale

Newborns with NAS often have difficulty sleeping and may sleep for shorter periods due to irritability and discomfort. Prolonged sleep after feeding is not characteristic of NAS.

 

Choice D rationale

Tremors in newborns with NAS are usually pronounced and continuous, not just when disturbed. These tremors are a result of withdrawal effects on the nervous system.


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Correct Answer is C

Explanation

Choice A rationale

While maternal lacerations are a risk during childbirth, they are not the greatest risk in cases of fetal dystocia. The focus is primarily on fetal wellbeing.

Choice B rationale

Fetal injury such as bruising can occur with dystocia, but the primary concern is the potential for severe, life-threatening complications.

Choice C rationale

Neonatal asphyxia related to prolonged labor is the greatest risk with fetal dystocia. Prolonged labor can lead to decreased oxygen supply to the fetus, causing asphyxia and

potential brain injury.

Choice D rationale

Increased consideration for a cesarean delivery is a possible outcome of fetal dystocia, but it is a management decision rather than a direct risk to the baby’s immediate health.

Correct Answer is D

Explanation

Choice A rationale

Placental abruption involves the detachment of the placenta from the uterine wall before delivery, causing bleeding, abdominal pain, and uterine tenderness. It does not typically cause dyspnea, hypotension, frothy sputum, or loss of consciousness.

Choice B rationale

Uterine rupture is a tear in the uterine wall, often in a scarred uterus. Symptoms include severe abdominal pain, abnormal fetal heart rate, and vaginal bleeding. It can cause shock, but not frothy sputum or sudden dyspnea.

Choice C rationale

Uterine inversion occurs when the uterus turns inside out, often during placental delivery. It leads to pain, hemorrhage, and shock. Like uterine rupture, it does not cause frothy sputum or sudden dyspnea.

Choice D rationale

Anaphylactoid syndrome (amniotic fluid embolism) occurs when amniotic fluid enters the maternal circulation, causing an anaphylactic reaction. Symptoms include sudden dyspnea, hypotension, frothy sputum, and loss of consciousness, fitting the scenario described.

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