which action should the nurse take if an infant who was born yesterday weighing 75 lbs 3402 grams weighs 7 lbs 3175 grams today which action should the nurse take if an infant who was born yesterday weighing 75 lbs 3402 grams weighs 7 lbs 3175 grams today
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Maternity HESI 2023 Quizlet

1. What action should the nurse take if an infant, who was born yesterday weighing 7.5 lbs (3,402 grams), weighs 7 lbs (3,175 grams) today?

Correct answer: A

Rationale: The correct action for the nurse to take in this situation is to inform and assure the mother that this weight loss is normal. Newborns can lose up to 10% of their birth weight in the first few days after birth, which is attributed to fluid loss and adjustment to life outside the womb. This weight loss is typically regained within the first two weeks of life. It is crucial for the nurse to educate and provide reassurance to the mother about this common occurrence in newborns.

2. The nurse is conducting intake interviews of children at a city clinic. Which child is most susceptible to lead poisoning?

Correct answer: B

Rationale: The correct answer is B. Young children, like the 2-year-old playing on aging playground equipment, are at higher risk of lead poisoning due to their hand-to-mouth behavior and exploration of their environment. Aging playground equipment may have lead-based paint that can be ingested by the child. While children living in housing projects are also at risk due to lead-based paint in older buildings, the 2-year-old child playing on potentially lead-contaminated playground equipment is the most susceptible in this scenario. The adolescent working in a paint factory may face occupational hazards related to lead exposure, but the immediate risk from environmental sources is higher for the 2-year-old. Type 1 diabetes in a 10-year-old is not directly linked to an increased susceptibility to lead poisoning.

3. The endometrium is shed up to the basal layer during this phase of the menstrual cycle:

Correct answer: D

Rationale: The correct answer is D. During the menstrual phase of the menstrual cycle, the endometrium is shed up to the basal layer. This shedding occurs as a result of decreased levels of estrogen and progesterone, leading to the breakdown and subsequent shedding of the endometrial lining. Choice A, ovulation, is incorrect as ovulation is the release of an egg from the ovary, which occurs during the mid-cycle. Choice B, regenerative, is incorrect as it does not specifically refer to the phase where the shedding of the endometrium occurs. Choice C, secretory, is incorrect as it refers to the phase where the endometrium thickens in preparation for possible implantation of a fertilized egg, not shedding.

4. In which chromosome pattern is Duchenne disease inherited?

Correct answer: C

Rationale: Duchenne disease is caused by a mutation in the DMD gene located on the X chromosome, leading to an X-linked recessive inheritance pattern. Males are typically affected by this disorder as they have only one X chromosome, while females are carriers with one normal and one affected X chromosome.

5. A client is receiving levothyroxine for hypothyroidism. Which of the following findings would indicate that the medication is effective?

Correct answer: C

Rationale: The correct answer is C: Increased energy levels. When a client with hypothyroidism is receiving levothyroxine, increased energy levels indicate that thyroid hormone levels are being normalized, which is a positive response to treatment. This improvement reflects the effectiveness of the medication in addressing the underlying hypothyroidism. Choices A, B, and D are incorrect. Decreased heart rate and decreased appetite may be symptoms of hypothyroidism and would not necessarily indicate the effectiveness of levothyroxine. Increased weight could also be a symptom of hypothyroidism and does not directly reflect the medication's effectiveness.

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