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A nurse is assessing a newborn who was born postterm. Which of the following findings should the nurse expect?
- A. Large deposits of subcutaneous fat
- B. Thin covering of fine hair on shoulders and back
- C. Nails extending over tips of fingers
- D. Pale, translucent skin
Correct Answer: C
Rationale: The correct answer is C: Nails extending over tips of fingers. This is expected in postterm newborns due to prolonged intrauterine growth. The nails continue to grow in utero, leading to longer nails at birth. Large deposits of subcutaneous fat (option A) are typically seen in term newborns, not postterm. Thin covering of fine hair on shoulders and back (option B) is known as lanugo, which is more common in premature infants. Pale, translucent skin (option D) is also more common in premature infants due to decreased subcutaneous fat. Therefore, the correct answer is C, nails extending over tips of fingers, as it is a characteristic finding in postterm newborns.
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Which of the following is a professional standard for nursing practice in maternal and newborn healthcare?
- A. Promotion of health equity
- B. Provision of patient-centered care
- C. Advocacy for social justice
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D. "All of the above" is the professional standard for nursing practice in maternal and newborn healthcare because it encompasses all three essential aspects: promotion of health equity, provision of patient-centered care, and advocacy for social justice. Nurses must address health disparities, prioritize individualized care for patients, and advocate for fair and equitable healthcare practices. Choosing A, B, or C individually would be limiting, as they are all interconnected and crucial in providing comprehensive care. Therefore, selecting D ensures that nurses adhere to all professional standards essential in maternal and newborn healthcare.
A nurse is preparing to administer oxytocin to a client who is postpartum. Which of the following findings is an indication for the administration of the medication? (Select all that apply.)
- A. Flaccid uterus
- B. Cervical laceration
- C. Excess vaginal bleeding
- D. Increased afterbirth cramping
Correct Answer: A,C
Rationale: The correct answers are A and C. A flaccid uterus indicates poor uterine tone, which can lead to postpartum hemorrhage. Oxytocin is given to enhance uterine contractions and tone, helping prevent excessive bleeding. Excess vaginal bleeding is also an indication for oxytocin administration as it can help control bleeding by promoting uterine contractions. Choices B, D, and other options are incorrect as they do not directly relate to the need for oxytocin administration in this scenario. Cervical laceration and increased afterbirth cramping may require other interventions, but they do not specifically indicate the need for oxytocin administration to address postpartum bleeding.
A nurse is caring for a client who is at 10 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Frequent vomiting with weight loss of 3 lb in 1 week
- B. Reports of mood swings
- C. Nosebleeds occurring approximately 3 times per week
- D. Increased vaginal discharge
Correct Answer: A
Rationale: The correct answer is A. Frequent vomiting with weight loss of 3 lb in 1 week is concerning during the first trimester as it may indicate hyperemesis gravidarum, a severe form of morning sickness that can lead to dehydration and malnutrition, posing risks to both the mother and the fetus. The nurse should report this finding to the provider for further evaluation and intervention.
Incorrect choices:
B: Reports of mood swings are common during pregnancy due to hormonal changes and are not typically a cause for concern at 10 weeks of gestation.
C: Nosebleeds are common in pregnancy due to increased blood volume and hormonal changes and are usually not serious unless severe or frequent.
D: Increased vaginal discharge is a normal pregnancy symptom caused by hormonal changes and increased blood flow to the pelvic area.
A nurse is performing an initial assessment of a newborn. Which of the following actions should the nurse take to prevent any heat loss through conduction?
- A. Cover the scale with a warmed blanket before weighing the baby
- B. Evaluate respirations by observing the newborn's uncovered chest for 1 min.
- C. Place the newborn's crib away from of an air vent to perform the assessment.
- D. Perform the assessment immediately after birth before removing amniotic fluid.
Correct Answer: A
Rationale: Covering the scale with a warmed blanket prevents heat loss through conduction, which occurs when the newborn comes into contact with a cold surface.
What is the function of the amniotic fluid during pregnancy?
- A. To protect the fetus from infection
- B. To cushion the fetus from physical trauma
- C. To regulate fetal temperature
- D. All of the above
Correct Answer: D
Rationale: Amniotic fluid protects the fetus from infection, cushions it from trauma, and helps regulate temperature.