Answer to Question 1
D
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A Incorrect. Capillary refill is not within the normal range if it is less than 6 seconds.
B Incorrect. Capillary refill is not within the normal range if it is less than 5 seconds.
C Incorrect. Capillary refill is not within the normal range if it is less than 4 seconds.
D Correct. Capillary refill is within the normal range if it is less than 3 seconds.
Answer to Question 2
C
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A Incorrect. Taking the temperature of a newborn, the nurse gets a reading of 37.7 degrees C (99.6 degrees F). The nurse does not interpret this temperature as very high for a newborn and does not call the health care practitioner.
B Incorrect. Taking the temperature of a newborn, the nurse gets a reading of 37.7 degrees C (99.6 degrees F). The nurse does not interpret this temperature as high for an infant of this age and does not decide to retake it in 20 minutes.
C Correct. Taking the temperature of a newborn, the nurse gets a reading of 37.7 degrees C (99.6 degrees F). The nurse interprets this temperature as normal and proceeds to chart the temperature in the infant's record.
D Incorrect. Taking the temperature of a newborn, the nurse gets a reading of 37.7 degrees C (99.6 degrees F). The nurse does not interpret this temperature as below normal and does not add a warmed blanket to the infant's crib.
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