# Clinical context A stable term newborn weighing 3.2 kg is 20 minutes old, has not yet received vitamin K prophylaxis, and the parents ask why an intramuscular injection is recommended. Which actions are appropriate when administering phytonadione to prevent vitamin K-deficiency bleeding in a newborn? Select exactly 4 responses.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=603000&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Clinical context
A stable term newborn weighing 3.2 kg is 20 minutes old, has not yet received vitamin K prophylaxis, and the parents ask why an intramuscular injection is recommended.

Which actions are appropriate when administering phytonadione to prevent vitamin K-deficiency bleeding in a newborn? Select exactly 4 responses.

Select exactly 4 responses.

1

Verify the product, concentration, dose, and route before administration.

2

Delay intramuscular prophylaxis until after the first feeding and newborn bath to reduce procedural stress.

3

Document administration and assess the injection site and newborn response.

4

Administer the prescribed single dose within 1 hour of birth.

5

Withhold prophylaxis for exclusive breastfeeding because colostrum supplies enough vitamin K.

6

Explain that prophylaxis reduces preventable neonatal hemorrhage.

## Explanation

Safe newborn prophylaxis requires product and dose verification, timely administration, caregiver explanation, documentation, and follow-up. Preservative exposure and concentration must be checked rather than assumed.

## In-depth explanation

Quick answer
Use verify, give on time, explain, document, and reassess.

Why this is correct
Phytonadione prevents bleeding; waiting for hemorrhage defeats prophylaxis. Newborn medication selection must account for formulation and excipient exposure.

Easy analogy or mental picture
Use a family-centered medication-safety loop: verify age or pregnancy context, identify the exposure and new cue, prevent further harm, stabilize the client, and confirm the response.

Memory hook
Population, indication, dose or route, contraindication, urgent cue, protective action, and reassessment.

NCLEX decision rule
Choose the action that protects the maternal, newborn, or pediatric client from the most immediate medication-related harm while preserving authorized treatment.

Why the other choices are wrong
Options that normalize a danger sign, substitute an unapproved route or dose, or delay reassessment leave the client exposed to preventable harm.References
1DailyMed: phytonadione injectable emulsionVitamin K-deficiency bleeding prophylaxis in neonates, single dose within 1 hour of birth, response assessment, and benzyl-alcohol exposure consideration

## Clinical scenario

Clinical context
A stable term newborn weighing 3.2 kg is 20 minutes old, has not yet received vitamin K prophylaxis, and the parents ask why an intramuscular injection is recommended.

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