Nokea
A client has experienced a fetal demise following a vaginal delivery at term. What should the nurse advise the client?
- A. "You can bathe and dress your baby if you'd like to."
- B. "If you don't hold the baby, it will make letting go much harder."
- C. "You should name the baby so he/she can have an identity."
- D. "I'm sure you will be able to have another baby when you're ready."
Correct Answer: A
Rationale: After a fetal demise, allowing the parents to bathe and dress their baby can offer them a sense of closure and help them in their grieving process. This act can provide a tangible way for the parents to bond with their baby and create lasting memories. Option B is incorrect because each individual may have different emotional needs and holding the baby may not be appropriate or helpful for everyone. Option C, while well-intentioned, may not be suitable for all parents as naming the baby could be emotionally challenging. Option D is insensitive as it overlooks the grieving process of losing a baby by suggesting a replacement.
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A primiparous woman presents in labor with the following labs: hemoglobin 10.9 g/dL, hematocrit 29%, hepatitis surface antigen positive, Group B Streptococcus positive, and rubella non-immune. Which intervention should the nurse implement?
- A. Transfuse 2 units of packed red blood cells.
- B. Give measles, mumps, rubella vaccine 0.5 mL.
- C. Administer ampicillin 2 grams intravenously.
- D. Inject hepatitis B immune globulin 0.5 milliliters.
Correct Answer: C
Rationale: The correct intervention in this scenario is to administer ampicillin 2 grams intravenously. This is crucial to prevent Group B Streptococcus infection in the newborn during delivery. Option A, transfusing packed red blood cells, is not indicated based on the hemoglobin and hematocrit levels provided. Option B, giving measles, mumps, rubella vaccine, is not necessary at this time. Option D, injecting hepatitis B immune globulin, is not appropriate for the conditions presented in the question.
The nurse is providing care for a newborn who was delivered vaginally assisted by forceps. The nurse observes red marks on the head with swelling that does not cross the suture line. Which condition should the nurse document in the medical record?
- A. Caput succedaneum
- B. Hydrocephalus
- C. Cephalhematoma
- D. Microcephaly
Correct Answer: C
Rationale: The correct answer is Cephalhematoma. Cephalhematoma is a collection of blood between the skull bone and periosteum that does not cross the suture line. It often occurs due to birth trauma, such as forceps delivery, leading to localized swelling. Caput succedaneum (Choice A) is diffuse swelling of the scalp that may cross suture lines and is typically present at birth. Hydrocephalus (Choice B) is an abnormal accumulation of cerebrospinal fluid within the brain's ventricles. Microcephaly (Choice D) is a condition characterized by a smaller than average head size and may be present at birth or develop later in infancy.
Which of the following statements is true of mutations?
- A. Mutations can only occur by chance.
- B. Mutations produce sperm and ova cells.
- C. Mutations occur through radiation or other environmental influences.
- D. Mutations help adenine combine with guanine to form the single spiral structure of DNA.
Correct Answer: C
Rationale: The correct answer is C. Mutations can occur due to environmental influences such as radiation, chemicals, or other external factors, leading to changes in the DNA sequence. Choice A is incorrect because mutations can also occur due to errors in DNA replication, not solely by chance. Choice B is incorrect as mutations affect the DNA sequence itself, not the production of specific cells. Choice D is incorrect because mutations involve changes in the DNA sequence and do not specifically involve the formation of the DNA structure.
When does the fetus typically begin to turn and respond to external stimulation during pregnancy?
- A. During the second or third week
- B. After the first trimester
- C. Sometimes
- D. Never
Correct Answer: B
Rationale: The correct answer is B. The fetus typically begins to respond to external stimulation much later in pregnancy, usually after the first trimester. During the second or third week of pregnancy, the fetus is still in the early stages of development and is not yet capable of turning or responding to external stimuli. Choices A, C, and D are incorrect because they do not accurately reflect the timeline of fetal development when it comes to responding to external stimulation.
Preconception counseling is crucial for the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy?
- A. Frequent episodes of maternal hypoglycemia
- B. Congenital anomalies in the fetus
- C. Hydramnios
- D. Hyperemesis gravidarum
Correct Answer: B
Rationale: Preconception counseling is essential as strict metabolic control before conception and in the early weeks of gestation helps reduce the risk of congenital anomalies. Frequent episodes of maternal hypoglycemia usually occur during the first trimester due to hormonal changes, affecting insulin production and use, rather than before conception. Hydramnios is more common in diabetic pregnancies, typically seen in the third trimester, not during early pregnancy. Hyperemesis gravidarum, although it may lead to hypoglycemic events, is related to decreased food intake and glucose transfer to the fetus, exacerbating hypoglycemia rather than being directly associated with poor glycemic control before and during early pregnancy.