Nokea
What is the recommended method of administering hepatitis B vaccine to a newborn?
- A. Intramuscular injection
- B. Oral administration
- C. Topical application
- D. Subcutaneous injection
Correct Answer: A
Rationale: The correct answer is A: Intramuscular injection. Administering hepatitis B vaccine via intramuscular injection ensures proper absorption and immune response. Injecting into the muscle allows for efficient delivery to the bloodstream. Oral administration (B) is not effective as the vaccine may be degraded in the digestive system. Topical application (C) and subcutaneous injection (D) are not recommended for hepatitis B vaccine due to inadequate absorption and immune response.
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Which of the following is a potential complication of a cesarean delivery?
- A. Postpartum hemorrhage
- B. Infection
- C. Deep vein thrombosis (DVT)
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Postpartum hemorrhage can occur due to surgical trauma, infection can develop at the incision site, and deep vein thrombosis (DVT) can result from immobility post-surgery. Choosing A, B, or C alone would be incorrect as cesarean delivery carries risks of all these complications. Selecting E, F, or G is incorrect due to lack of relevance to cesarean delivery complications.
A nurse is caring for a client who has preeclampsia and is receiving a continuous infusion of magnesium sulfate IV. Which of the following actions should the nurse take?
- A. Restrict hourly fluid intake to 150 mL/hr.
- B. Have calcium gluconate readily available.
- C. Assess deep tendon reflexes every 6 hr.
- D. Monitor intake and output every 4 hr.
Correct Answer: B
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity and should be readily available in case the client shows signs of toxicity, such as respiratory depression or loss of deep tendon reflexes.
A nurse is teaching a postpartum client about steps the nurses will take to promote the security and safety of the client's newborn. Which of the following statements should the nurse make?
- A. "The nurse will carry your baby in their arms to the nursery for scheduled procedures."
- B. "We will document the relationship of visitors in your medical record."
- C. "It's okay for your baby to sleep in the bed with you while in the hospital."
- D. "Staff members who take care of your baby will be wearing a photo identification badge."
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. Staff wearing photo ID badges ensures proper identification for security.
2. Visual verification protects against unauthorized individuals caring for the baby.
3. ID badges indicate staff members have been vetted and authorized to care for newborns.
4. Promotes safety by ensuring only qualified individuals handle the baby.
Summary:
A: Carrying the baby to the nursery poses security risks and disrupts mother-infant bonding.
B: Documenting visitor relationships is important but does not directly address newborn security.
C: Co-sleeping with the baby in the hospital increases the risk of accidental suffocation.
D: Correct choice, as it directly addresses security and safety measures for the newborn.
E:
F:
G:
A nurse is observing a new guardian caring for their crying newborn who is bottle feeding. Which of the following actions by the guardian should the nurse recognize as a positive parenting behavior?
- A. Lays the newborn across their lap and gently sways.
- B. Places the newborn in the crib in a prone position.
- C. Offers the newborn a pacifier dipped in formula.
- D. Prepares a bottle of formula mixed with rice cereal.
Correct Answer: A
Rationale: Laying the newborn across the lap and gently swaying is a positive parenting behavior that can help soothe the newborn and promote bonding.
A nurse is assessing a newborn who is 16 hr old. Which of the following findings should the nurse report to the provider?
- A. Substernal retractions
- B. Acrocyanosis
- C. Overlapping suture lines
- D. Head circumference 33 cm (13 in)
Correct Answer: A
Rationale: The correct answer is A: Substernal retractions. Substernal retractions in a newborn can indicate respiratory distress, which is a critical finding that requires immediate attention from the provider to prevent complications. Acrocyanosis (B) is a common finding in newborns and usually resolves on its own. Overlapping suture lines (C) can be normal in newborns due to the molding process during birth. The head circumference of 33 cm (13 in) (D) is within the normal range for a newborn.