Nokea
A family is concerned about how their 2-year-old son is going to react to the new baby. Which intervention would help facilitate sibling attachment?
- A. Have the mother and father spend individual time with their son to allay potential anxiety over the new baby coming in and displacing his position in the family as the only child.
- B. Make sure that their son is supervised at all times when the baby is brought home
- C. Include the son in helping to take care of the baby and reinforce the label of “big brother” as a special role.
- D. Observe the son’s reaction to the baby and let him decide when he wants to be
Correct Answer: C
Rationale: The correct answer is C because involving the 2-year-old son in caring for the new baby and reinforcing his role as a "big brother" can help facilitate sibling attachment. This intervention promotes bonding, fosters a sense of responsibility, and helps the son feel included in the family dynamic. It also allows the son to feel special in his new role, leading to positive feelings towards the new baby.
Choice A is incorrect as just spending individual time with the son may not address his concerns about the new baby and could potentially reinforce any feelings of displacement. Choice B is incorrect as constant supervision may not necessarily facilitate sibling attachment and could lead to feelings of restriction or resentment. Choice D is incorrect as it puts the onus solely on the son without providing clear guidance or support in navigating the new family dynamic.
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What type of lochia is bright to dark red and occurs on days 1–3 postpartum?
- A. rubra
- B. serosa
- C. placental
- D. alba
Correct Answer: A
Rationale: The correct answer is A: rubra. Lochia rubra is bright to dark red, typically occurring on days 1-3 postpartum. This is due to the presence of blood and decidual tissue. Serosa (B) is pinkish-brown and occurs around days 4-10, representing a mix of blood and mucus. Placental (C) is typically expelled within 30 minutes postpartum and consists of dark red blood. Alba (D) is whitish-yellow, appearing around day 10 and lasting up to 6 weeks, indicating the final stage of lochia consisting of leukocytes and decidual tissue.
The nurse is caring for a birth mother who is relinquishing her newborn. What intervention is appropriate for the nurse?
- A. Use words like “giving away your child” or “giving up for adoption.”
- B. Tell the person not to hold the baby.
- C. Ask the person why she is giving up her baby.
- D. Ask about the patient’s expectations for having newborn photos or video.
Correct Answer: D
Rationale: The correct answer is D because asking about the patient's expectations for newborn photos or video shows empathy and support for the mother's emotional needs during this difficult time. It allows the nurse to provide personalized care and helps the mother create lasting memories.
A: Using phrases like "giving away your child" is insensitive and can be hurtful to the mother.
B: Discouraging the mother from holding the baby can be emotionally damaging and is not supportive.
C: Asking why she is giving up her baby can be intrusive and may not be helpful at this moment.
Which should the nurse do to provide support to a patient who must return to full-time employment 6 weeks after a vaginal birth?
- A. Discuss child care arrangements with her.
- B. Allow her to solve the problem on her own.
- C. Reassure her that she’ll get used to leaving her baby.
- D. Allow her to express her positive and negative feelings freely.
Correct Answer: A
Rationale: The correct answer is A because discussing child care arrangements with the patient is essential for addressing her concerns and ensuring a smooth transition back to full-time employment. By discussing child care options, the nurse can help the patient make informed decisions and feel more confident about returning to work. This step shows support and helps the patient plan ahead for her baby's care while she's at work.
Choices B, C, and D are incorrect because they do not actively address the patient's needs or provide practical support. Allowing the patient to solve the problem on her own (B) may leave her feeling overwhelmed and unsupported. Reassuring her that she'll get used to leaving her baby (C) minimizes her feelings and does not offer concrete assistance. Allowing her to express feelings (D) is important but may not directly address the practical aspect of arranging child care, which is crucial for her successful return to work.
A client is being discharged on Coumadin (warfarin) post-pulmonary embolism after a cesarean delivery. Which of the following laboratory values indicates that the medication is effective?
- A. PT (prothrombin time): 12 sec (normal is 10-13 seconds).
- B. INR (international normalized ratio): 2.5 (normal is 1.0-1.4).
- C. Hematocrit 55%.
- D. Hemoglobin 10 g/dL.
Correct Answer: B
Rationale: An INR of 2.5 indicates therapeutic anticoagulation.
A postpartum patient calls the clinic and reports to the nurse feelings of fatigue, tearfulness, and anxiety. What is the nurse’s most appropriate response at this time?
- A. “When did these symptoms begin?”
- B. “Sounds like normal postpartum depression.”
- C. “Are you having trouble getting enough sleep?”
- D. “Are you able to get out of bed and provide care for your baby?”
Correct Answer: A
Rationale: The correct answer is A: "When did these symptoms begin?" The nurse's response should address the patient's concerns and gather more information to assess the situation accurately. By asking when the symptoms began, the nurse can determine the duration and severity of the symptoms, enabling appropriate intervention.
Choice B is incorrect because assuming the symptoms are due to "normal postpartum depression" without further assessment is premature and may overlook other potential causes. Choice C focuses solely on sleep and may not address the underlying issues causing the patient's symptoms. Choice D assumes the patient's ability to provide care for the baby without first addressing the patient's emotional well-being.