Nokea
A client is postpartum and has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect?
- A. Decreased platelet count
- B. Increased erythrocyte sedimentation rate (ESR)
- C. Decreased megakaryocytes
- D. Increased WBC
Correct Answer: A
Rationale: Step 1: In idiopathic thrombocytopenic purpura (ITP), there is a decreased platelet count due to immune-mediated destruction of platelets.
Step 2: This leads to an increased risk of bleeding and bruising in the postpartum client.
Step 3: Other choices are incorrect because in ITP, there is no increase in ESR or WBC. Also, megakaryocytes may be normal or increased due to compensatory production.
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A client who is at 12 weeks of gestation is reviewing a new prescription of ferrous sulfate. Which of the following statements by the client indicates understanding of the teaching?
- A. I will take this pill with my breakfast.
- B. I will take this medication with a glass of milk.
- C. I plan to drink more orange juice while taking this pill.
- D. I plan to add more calcium-rich foods to my diet while taking this medication.
Correct Answer: C
Rationale: The correct answer is C: "I plan to drink more orange juice while taking this pill." Orange juice is rich in vitamin C, which enhances the absorption of iron from ferrous sulfate, helping to combat iron deficiency anemia during pregnancy. Taking the pill with a vitamin C source is important for optimal absorption.
A: Taking the pill with breakfast may not provide enough vitamin C for optimal absorption.
B: Milk may inhibit iron absorption due to its calcium content, so it is not ideal to take with ferrous sulfate.
D: While increasing calcium-rich foods is important during pregnancy, it is not directly related to enhancing iron absorption from ferrous sulfate.
A client at 42 weeks of gestation is having an ultrasound. For which of the following conditions should the nurse prepare for an amnioinfusion? (Select all that apply)
- A. Oligohydramnios
- B. Hydramnios
- C. Fetal cord compression
- D. Polyhydramnios
Correct Answer: A
Rationale: Rationale: A client at 42 weeks of gestation is at risk for oligohydramnios, which is associated with decreased amniotic fluid levels. Amnioinfusion can be used to increase amniotic fluid volume to prevent fetal cord compression and facilitate fetal movement during labor.
Summary:
- B: Hydramnios (excessive amniotic fluid) does not require amnioinfusion.
- C: Fetal cord compression is a reason for amnioinfusion, not a condition to prepare for.
- D: Polyhydramnios (excessive amniotic fluid) does not typically require amnioinfusion unless there are complicating factors.
A newborn was transferred to the nursery 30 min after delivery. What should the nurse do first?
- A. Confirm the newborn's identification.
- B. Verify the newborn's identification.
- C. Administer vitamin K to the newborn.
- D. Determine obstetrical risk factors.
Correct Answer: B
Rationale: The correct answer is B because verifying the newborn's identification ensures the right baby is in the nursery. It is crucial for patient safety and prevents mix-ups. Confirming identification (choice A) is important but comes after verification. Administering vitamin K (choice C) is a necessary procedure but not the first priority. Determining obstetrical risk factors (choice D) is important but not as immediate as verifying identification. Thus, verifying the newborn's identification should be done first to prevent errors and ensure proper care.
A healthcare professional is assessing four newborns. Which of the following findings should the professional report to the provider?
- A. A newborn who is 26 hours old and has erythema toxicum on their face
- B. A newborn who is 32 hours old and has not passed meconium stool
- C. A newborn who is 12 hours old and has pink-tinged urine
- D. A newborn who is 18 hours old and has an axillary temperature of 37.7° C (99.9° F)
Correct Answer: D
Rationale: The correct answer is D because an axillary temperature of 37.7°C (99.9°F) in a newborn is above the normal range and could indicate a fever, which is a significant concern in newborns due to their immature immune systems. Fever in newborns can be a sign of serious infections that require immediate medical attention.
A: Erythema toxicum is a common rash in newborns and typically resolves on its own without medical intervention.
B: Failure to pass meconium stool by 48 hours may be a concern but not as urgent as a fever.
C: Pink-tinged urine in the first few days of life is likely due to uric acid crystals and is considered normal in newborns.
During a nonstress test for a pregnant client, a nurse uses an acoustic vibration device. The client inquires about its purpose. Which response should the nurse provide?
- A. It is used to stimulate uterine contractions.
- B. It will decrease the incidence of uterine contractions.
- C. It lulls the fetus to sleep.
- D. It awakens a sleeping fetus.
Correct Answer: D
Rationale: The correct answer is D because the acoustic vibration device is used during a nonstress test to wake up a sleeping fetus, ensuring that the baby is active and responsive during the test. This helps to assess the baby's well-being and monitor its heart rate patterns. Choice A is incorrect as the device does not stimulate uterine contractions. Choice B is incorrect as it does not decrease the incidence of contractions. Choice C is incorrect as the device does not lull the fetus to sleep, but rather ensures the fetus is awake and moving during the test.