Nokea
A baby is exhibiting signs of neonatal abstinence syndrome. Which action would be appropriate for the nursery nurse to make?
- A. Cover the baby with at least two blankets.
- B. Stimulate the baby with rattles.
- C. Play soft classical music in the nursery.
- D. Attach a mobile to the crib.
Correct Answer: A
Rationale: Neonatal abstinence syndrome babies are sensitive to stimuli, so minimizing environmental stimulation, such as by swaddling, is important.
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A laboring woman, G4 P3003, who was 6 cm dilated 1 hour ago cries, 'Hurry. I have to go to the bathroom to have a bowel movement.' The nurse notes that there is an increase in bloody show. Which of the following actions by the nurse is appropriate?
- A. Assess cervical dilation.
- B. Help the woman to the bathroom.
- C. Ask the woman if she needs pain medicine.
- D. Check the fetal heart rate.
Correct Answer: A
Rationale: The urge to have a bowel movement and increased bloody show could indicate that the woman is entering the second stage of labor. The nurse should assess cervical dilation to confirm.
A mother questions the nurse about when the newborn screening tests for inborn diseases will be performed. Which of the following is an appropriate response by the nurse?
- A. The doctor took blood from the baby's umbilical cord at birth.
- B. A sample of the baby's first urine and first stool were sent for testing.
- C. A vial of blood was drawn and sent when the baby was admitted to the nursery.
- D. Blood from the baby's heel was sent after the baby had been fed a few times.
Correct Answer: D
Rationale: Newborn screening tests are typically done by collecting blood from the baby's heel after the baby has been fed a few times to ensure accurate results.
At the first prenatal visit, the patient informs the nurse that the first day of her last menstrual period (LMP) was February 18, 2024. Using Naegle's Rule, calculate the patient's EDD.
- A. 11-Nov-24
- B. 11-Nov-25
- C. 25-Nov-24
- D. 25-Nov-25
Correct Answer: C
Rationale: The correct answer is C: 25-Nov-24. Naegle's Rule is to add 7 days to the first day of the last menstrual period (LMP), then subtract 3 months, and finally add 1 year. In this case, LMP was February 18, 2024. Adding 7 days gives February 25, 2024. Subtracting 3 months gives November 25, 2024. Adding 1 year gives the estimated due date (EDD) of November 25, 2024. Choices A, B, and D are incorrect because they do not follow the correct calculation steps of Naegle's Rule.
A breastfeeding client asks the nurse to make sure that her newborn is positioned and latched well at the breast. Which of the following assessments would indicate that the baby is poorly latched?
- A. The baby swallows after every suckle.
- B. The baby’s body is facing the mother’s body.
- C. The baby’s lower lip is curled under.
- D. The baby is lying at the level of the mother’s breasts.
Correct Answer: C
Rationale: A curled-under lower lip indicates poor latching, which can lead to ineffective feeding and nipple damage.
A 36-week-gestation client is having an amniocentesis. For which of the following reasons is the test likely being conducted?
- A. Genetic evaluation.
- B. Assessment of intrauterine growth restriction.
- C. Assessment of fetal lung maturation.
- D. Hormonal studies.
Correct Answer: C
Rationale: Amniocentesis at 36 weeks is often performed to assess fetal lung maturity before delivery.