The nurse would assess respirations in a 9-month-old infant when the client is:
Playing in the playroom.
Crying.
Sleeping.
Laughing.
The Correct Answer is C
Choice A rationale
Playing might cause irregular breathing patterns due to excitement or activity, making it hard to get an accurate respiratory rate.
Choice B rationale
Crying can alter the normal breathing rate and pattern, resulting in an inaccurate assessment of respirations.
Choice C rationale
Sleeping provides the most accurate assessment of respirations, as the infant’s breathing will be at its natural, resting rate.
Choice D rationale
Laughing, similar to crying, causes irregular breathing patterns due to physical exertion and emotions, affecting accuracy.
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View Related questions
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Keeping the diaper loose in the front helps avoid pressure on the circumcision site, promoting healing and reducing discomfort for the infant.
Choice B rationale
A yellow crust or exudate forming on the circumcision site is a normal part of the healing process and should not be a cause for alarm. It is not an indication to call the doctor immediately unless other signs of infection or complications are present.
Choice C rationale
Notifying the healthcare provider in the case of significant bleeding is crucial. Excessive bleeding can indicate a complication that requires prompt medical attention to ensure the infant's safety and proper healing.
Choice D rationale
Applying petroleum jelly with each diaper change helps to protect the circumcision site from sticking to the diaper, promoting healing and reducing discomfort.
Correct Answer is A
Explanation
Choice A rationale
Monitoring for hypoglycemia is critical in newborns born to mothers with gestational diabetes, as they can experience significant drops in blood sugar levels post-birth due to the
sudden discontinuation of the high glucose supply from the mother.
Choice B rationale
Physiological jaundice is common in many newborns but does not represent the most immediate threat. It typically resolves within a few days with appropriate monitoring and care.
Choice C rationale
Hyperthermia can be a concern for newborns, but it is not the primary immediate complication in newborns born to gestational diabetic mothers. Hypoglycemia poses a greater
immediate risk.
Choice D rationale
Development of rash is generally a less critical concern and does not represent an immediate threat to the newborn’s well-being in comparison to hypoglycemia.