Nokea
A breastfeeding patient who was discharged yesterday calls to ask about a tender hard area on her right breast. What should the nurse's first response be?
- A. This is a normal response in breastfeeding mothers.'
- B. Notify your doctor so he can start you on antibiotics.'
- C. Stop breastfeeding because you probably have an infection.'
- D. Try massaging the area and apply heat; it is probably a plugged duct.'
Correct Answer: D
Rationale: The correct response is D because a tender, hard area on the breast is likely a plugged duct, which can be relieved by massaging the area and applying heat to promote milk flow. This approach helps prevent further complications and encourages continued breastfeeding.
Choice A is incorrect as it dismisses the patient's concern without providing helpful guidance. Choice B is incorrect because antibiotics are not typically necessary for a plugged duct unless it progresses to mastitis. Choice C is incorrect as stopping breastfeeding can worsen the condition and may lead to engorgement or mastitis.
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The nurse teaching a family about bonding with their infant describes touch as an important facet of this process. What does the nurse understand is most important about touch and bonding?
- A. All newborn care must be completed through touch.
- B. Parental recognition occurs through touch.
- C. The neonate learns exclusively through touch.
- D. Touch accustoms the parent to the infant's body.
Correct Answer: C
Rationale: All options are at least partially correct. However, the most important point about touch and bonding is that all the infant learns during the neonatal period is conveyed through touch. Touch conveys warmth, love, pleasure, comfort, and security to the neonate.
Whose theoretical model describes how clinical judgment evolves with experience?
- A. Benner
- B. Tanner
- C. Lasater
- D. Nightingale
Correct Answer: A
Rationale: Patricia Benner's theoretical model explains how clinical judgment develops through stages of novice to expert based on experience.
What assessment findings indicate abnormal transition in a neonate? Select all that apply.
- A. prolonged apneic episodes
- B. marked pallor
- C. excessive oral secretions
- D. crackles upon auscultation
Correct Answer: C
Rationale: Abnormal transition signs include prolonged apnea, marked pallor, excessive secretions, and crackles.
The perinatal nurse notes that a newborn does not seem to have an opening inside the anal ring. Which action by the nurse takes priority?
- A. Ask the mother how well the infant is eating.
- B. Assess the abdomen and notify the physician.
- C. Facilitate laboratory studies for kidney function.
- D. Reassure the parents that this is a normal deviation.
Correct Answer: B
Rationale: This infant may have an imperforate anus, a condition that is an emergency, as the infant cannot pass stool. The nurse should quickly assess the baby's abdomen for distention and firmness and notify the physician or health-care provider. The other actions are not warranted.
The newborn nursery nurse walks into the mother's room and notices the patient next to the window. What is the nurse's next course of action?
- A. Ask the mom to hold the infant using skin-to-skin contact.
- B. Nothing; infants are encouraged to be near the windows for sun exposure.
- C. Place the infant near the door on the other side of the room.
- D. Position the baby on the baby scale to obtain a weight.
Correct Answer: A
Rationale: The correct answer is A: Ask the mom to hold the infant using skin-to-skin contact. This is because skin-to-skin contact between the mother and newborn is important for bonding, regulating the baby's temperature, promoting breastfeeding, and comforting the baby. It also helps establish trust and promote attachment.
Choice B is incorrect because newborns should not be exposed to direct sunlight for long periods due to the risk of sunburn and overheating.
Choice C is incorrect because there is no specific benefit to placing the infant near the door, and it does not address the importance of skin-to-skin contact.
Choice D is incorrect because obtaining the baby's weight is not the immediate priority when entering the room, especially when the opportunity for skin-to-skin contact is present.