A nurse is assessing a newborn and hears bowel sounds in the ...

[DyllonKazuo]

A nurse is assessing a newborn and hears bowel sounds in the infant's chest area. What other finding should the nurse specifically assess for?
 
  A.
  Clubbed fingernails
  B.
  Cyanosis
  C.
  Genital abnormalities
  D.
  Normal stools

Question 2

A nurse is seeing a baby with a diagnosed cleft lip. What assessment finding indicates to the nurse that a priority outcome has been met?
 
  A.
  Absence of infection
  B.
  Appropriate weight gain
  C.
  Interacts at developmental age
  D.
  Normal cranial nerve function

[Joy Chen]

Answer to Question 1

ANS: B
Bowel sounds in the thoracic cavity could indicate a congenital diaphragmatic hernia. The nurse should assess for other signs, including cyanosis, bradycardia, barrel chest, and scaphoid abdomen. The other findings are not related to this condition.

Answer to Question 2

ANS: B
Maintaining adequate nutrition is a priority concern in a child with cleft lip or palate, because these defects interfere with feeding. An appropriate weight gain signifies that feeding is adequate. Infection would be a concern in a recent defect repair. Interacting appropriately and having normal cranial nerve function are not specifically related to this defect.

[DyllonKazuo]

TYSM

[juliaf]

Excellent