Answer to Question 1
1
Rationale:
1. To soothe a newborn during assessment or other procedures, place a gloved finger into the newborn's mouth.
2. Crying will increase heart rate and respiratory rate, so vitals should not be taken when the newborn is crying.
3. However, assessment of vitals needs to be done at regularly timed intervals, so waiting until the newborn stops crying might cause too long of a delay.
4. A hot water bottle should not be placed next to the newborn, because of a potential risk for burns.
Answer to Question 2
2
Rationale:
1. This is unnecessary, and might frighten the client. The client is describing fibrocystic breast changes.
2. The client is describing fibrocystic breast changes. A salt restriction with a mild diuretic taken the week before menstrual bleeding often improves the condition.
3. The client is describing fibrocystic breast changes, not a serious condition. The absence or presence of nipple discharge is not an indicator of seriousness of a breast condition.
4. The client is describing fibrocystic breast changes. Research is inconclusive as to whether eliminating methylxanthines from the diet is effective at reducing fibrocystic breast symptoms.
