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The nurse would assess respirations in a 9-month-old infant when the client is:

A.

Playing in the playroom.

B.

Crying.

C.

Sleeping.

D.

Laughing.

Answer and Explanation

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

Measles, mumps, rubella (MMR) vaccine is recommended for a 1-year-old child as it protects against these three highly contagious viral diseases. This vaccine is typically given in two doses, with the first dose administered at 12-15 months.

Choice B rationale

Tetanus, diphtheria, and pertussis (TDaP) vaccine is not typically given at 1 year of age. The primary series is given in infancy, and the TDaP booster is given at 4-6 years of age.

Choice C rationale

Inactivated polio virus (IPV) vaccine is part of the routine vaccination schedule for children. It protects against polio, a serious disease that can cause paralysis. The IPV vaccine is given in multiple doses, starting at 2 months of age.

Choice D rationale

Varicella (VAR) vaccine protects against chickenpox, a highly contagious disease. It is recommended for children at 12-15 months of age and is usually given in two doses.

Choice E rationale

Human papillomavirus (HPV) vaccine is not recommended for a 1-year-old child. It is typically given to preteens and teens to protect against HPV infections that can lead to cervical cancer and other diseases.

Correct Answer is B

Explanation

Choice A rationale

Acrocyanosis is a common and typically benign condition in newborns, characterized by bluish discoloration of the hands and feet. It is not an immediate priority.

Choice B rationale

Respiratory distress is the priority assessment for a newborn immediately following a cesarean delivery. Ensuring the newborn has a patent airway and is breathing effectively is crucial for their survival and immediate well-being.

Choice C rationale

Hypothermia is a concern for newborns, but respiratory distress takes precedence as an immediate life-threatening condition.

Choice D rationale

Accidental lacerations can occur during a cesarean delivery, but they are usually not life-threatening and can be addressed after ensuring the newborn's respiratory status is stable. .

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