Nokea
A breast-feeding primiparous client reports leaking breasts between feedings on day 3 postpartum. The nurse explains this is due to:
- A. Overproduction of milk.
- B. Poor latch technique.
- C. Milk supply adjusting to demand.
- D. Inadequate feeding frequency.
Correct Answer: C
Rationale: Leaking breasts on day 3 indicate the milk supply is adjusting to the neonate's demand as lactation establishes.
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At 38 weeks' gestation, a primigravid client with poorly controlled diabetes and severe preeclampsia is admitted for a cesarean delivery. The nurse explains to the client that delivery helps to prevent which of the following?
- A. Neonatal hyperbilirubinemia.
- B. Congenital anomalies.
- C. Perinatal asphyxia.
- D. Stillbirth.
Correct Answer: D
Rationale: Delivery helps prevent stillbirth in high-risk pregnancies.
A newly delivered primiparous client asks the nurse, "Can my baby see?" Which of the following statements about neonatal vision should the nurse include in the explanation?
- A. Neonates primarily focus on moving objects.
- B. They can see objects up to 12 inches away.
- C. Usually they see clearly by about 2 days after birth.
- D. Neonates primarily distinguish light from dark.
Correct Answer: B
Rationale: Neonates can focus on objects about 8-12 inches away, which is optimal for bonding during feeding.
The cervix of a 15-year-old primigravid client admitted to the labor area is 2 cm dilated and 50% effaced. Her membranes are intact, and contractions are occurring every 5 to 6 minutes. Which of the following should the nurse recommend at this time?
- A. Resting in the right lateral recumbent position.
- B. Using in the left lateral recumbent position.
- C. Walking around in the hallway.
- D. Sitting in a comfortable chair for a period of time.
Correct Answer: C
Rationale: In early labor (2 cm dilation), ambulation (walking) promotes labor progression by using gravity to encourage fetal descent and enhance contractions. Lateral positions are better for rest or later stages, and sitting may not aid progression as effectively.
A client is considering a hormonal IUD. Which of the following benefits should the nurse highlight?
- A. It provides protection against STIs.
- B. It can reduce menstrual bleeding over time.
- C. It requires replacement every year.
- D. It is suitable for women with heavy menstrual bleeding.
Correct Answer: B
Rationale: A hormonal IUD, like Mirena, can reduce menstrual bleeding over time, often leading to lighter periods or amenorrhea. It does not protect against STIs, lasts 3-7 years depending on the type, and is suitable for heavy bleeding, but B is the primary benefit.
A nurse is reviewing a client's maternal prenatal record and notes that the mother used narcotics during her pregnancy. A primary nursing intervention when caring for a drug-exposed neonate is to:
- A. Assess vital signs including blood pressure every hour.
- B. Minimize environmental stimuli.
- C. Place the infant in a well-lighted area for observation.
- D. Provide stimulation to increase adaptation to the environment.
Correct Answer: B
Rationale: Minimizing environmental stimuli reduces stress and overstimulation in drug-exposed neonates, who are often hypersensitive.