Nokea
A breastfeeding mother and her baby are being discharged home after delivery. The nurse is providing anticipatory guidance about what signs to expect the baby to exhibit every 24 hours by the end of the first week. Which of the following should the nurse include in his/her instructions?
- A. The baby will have at least 6 wet diapers.
- B. The baby will have at least 6 pasty stools.
- C. The baby will breastfeed at least 6 times.
- D. The baby will gain at least 6 ounces.
Correct Answer: A
Rationale: Adequate wet diapers indicate proper hydration and milk intake.
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A baby is born addicted to crack cocaine. Which of the following signs/symptoms would the nurse expect to see?
- A. Hyperreflexia.
- B. Anorexia.
- C. Constipation.
- D. Hypokalemia.
Correct Answer: A
Rationale: Neonates born addicted to crack cocaine often exhibit hyperreflexia, irritability, and other signs of withdrawal.
A client with diabetes mellitus is at 37 weeks gestation. She has had weekly NSTs for the last 3 weeks, and the results have been reactive. This week, the NST was nonreactive after 40 minutes. The nurse anticipates which of the following will be performed for the client based on these results?
- A. Scheduled for an immediate ultrasound
- B. Scheduled for a biophysical profile
- C. Admitted to the hospital for induction of labor
- D. Scheduled for a follow-up appointment for NST in 2 days
Correct Answer: B
Rationale: The correct answer is B: Scheduled for a biophysical profile. At 37 weeks gestation, a nonreactive NST after 40 minutes indicates a need for further evaluation with a biophysical profile to assess fetal well-being comprehensively. This test includes NST along with ultrasound evaluation of amniotic fluid volume, fetal tone, fetal breathing movements, and gross body movements. Biophysical profile provides a more detailed assessment of fetal status compared to NST alone.
Choice A is incorrect because an immediate ultrasound is not the next step after a nonreactive NST. Choice C is incorrect because hospital admission for labor induction is premature based on one nonreactive NST result. Choice D is incorrect because waiting for 2 days for a follow-up NST is not recommended due to the urgency of assessing fetal well-being promptly.
The nurse has received change of shift report on the following four clients. Which of the clients should the nurse assess first?
- A. G1 P0000, 9 weeks’ gestation, hyperemesis gravidarum, vomited twice during the last shift.
- B. G2 P0101, 24 weeks’ gestation, receiving terbutaline po q 2 h for preterm labor, no complaints of cramping during last shift.
- C. G1 P0000, 1 day postpartum, vacuum extraction, for bilateral tubal ligation during this shift.
- D. G2 P0101, 2 days postpartum, spontaneous delivery, had asthma attack during last shift.
Correct Answer: D
Rationale: The client who had an asthma attack during the last shift should be assessed first due to the potential for respiratory complications.
A nurse is following the PDSA cycle for quality improvement. Which action will the nurse take for the letter “A”?
- A. Act
- B. Alter
- C. Assess
- D. Approach
Correct Answer: A
Rationale: There are many models for quality improvement and performance improvement. One model is the PDSA cycle: plan, do, study, and act.
A birth plan is being developed by a pregnant couple. Which of the following items should be included in the plan?
- A. The method of infant feeding the mother plans on using.
- B. The name and address of her health care insurance company.
- C. The couple's baby name preferences.
- D. The couple's cell phone numbers.
Correct Answer: A
Rationale: A birth plan typically includes the mother's preferences for labor, delivery, and postpartum care, including infant feeding methods.