Nokea
A gestational diabetic client, who delivered yesterday, is currently on the postpartum unit. Which of the following statements is appropriate for the nurse to make at this time?
- A. Monitor your blood glucose five times a day until your 6-week checkup.
- B. I will teach you how to inject insulin before you are discharged.
- C. Daily exercise will help to prevent you from becoming diabetic in the future.
- D. Your baby should be assessed every 6 months for signs of juvenile diabetes.
Correct Answer: A
Rationale: Gestational diabetes often resolves after delivery, but monitoring is still important.
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Which assessment finding 24 hours after vaginal birth would indicate a need for further intervention?
- A. Pain level 5 on scale of 0 to 10
- B. Saturated pad over a 2-hour period
- C. Urinary output of 500 mL in one voiding
- D. Uterine fundus 2 cm above the umbilicus
Correct Answer: B
Rationale: The correct answer is B because a saturated pad over a 2-hour period 24 hours after vaginal birth could indicate postpartum hemorrhage, a serious complication requiring immediate intervention. Excessive bleeding can lead to hypovolemic shock and endanger the mother's life. Monitoring and managing postpartum bleeding is crucial to prevent complications.
A: Pain level of 5 is subjective and may vary among individuals. It does not necessarily indicate a need for immediate intervention.
C: Urinary output of 500 mL in one voiding is within the normal range for postpartum women and does not suggest an immediate need for intervention.
D: Uterine fundus 2 cm above the umbilicus is within the expected range for 24 hours postpartum and does not indicate a need for immediate intervention.
The nursery nurse is careful to wear gloves when admitting neonates into the nursery. Which of the following is the scientific rationale for this action?
- A. Meconium is filled with enteric bacteria.
- B. Amniotic fluid may contain harmful viruses.
- C. The high alkalinity of fetal urine is caustic to the skin.
- D. The baby is high risk for infection and must be protected.
Correct Answer: A
Rationale: Meconium contains enteric bacteria, making it important to use gloves to prevent contamination.
Which of the following are nursing measures that can promote parent-infant bonding and attachment? (Select all that apply.)
- A. Provide comfort and ample time for rest.
- B. Keep the baby wrapped to avoid cold stress.
- C. Position the infant face to face with the mother.
- D. Point out the characteristics of the infant in a positive way.
Correct Answer: A
Rationale: Rationale:
A: Providing comfort and ample time for rest helps parents feel less stressed, promoting bonding.
B: Keeping the baby wrapped is important for warmth but does not directly impact bonding.
C: Positioning face to face can enhance bonding, but it is not a nursing measure.
D: Pointing out characteristics positively can boost parent's confidence but does not directly promote bonding.
To assess fundal contraction 6 hours after cesarean birth, which technique should the nurse utilize?
- A. Assess lochial flow rather than palpating the fundus.
- B. Palpate forcefully through the abdominal dressing.
- C. Place hands on both sides of the abdomen and press downwar
- D. Gently palpate, applying the same technique used for vaginal deliveries.
Correct Answer: D
Rationale: The correct answer is D. Gently palpating the fundus is the appropriate technique after cesarean birth to assess fundal contraction. This technique is recommended to prevent causing discomfort or dislodging the uterus. Assessing lochial flow (A) does not directly evaluate fundal contraction. Palpating forcefully through the abdominal dressing (B) can be painful and may not provide an accurate assessment. Placing hands on both sides of the abdomen and pressing downward (C) is not a recommended technique as it can potentially cause uterine displacement.
Four newborns are in the neonatal nursery, none of whom is crying or in distress. Which of the babies should the nurse report to the neonatologist?
- A. 16-hour-old baby who has yet to pass meconium.
- B. 16-hour-old baby whose blood glucose is 50 mg/dL.
- C. 2-day-old baby who is breathing irregularly at 70 breaths per minute.
- D. 2-day-old baby who is excreting a milky discharge from both nipples.
Correct Answer: C
Rationale: Irregular breathing at 70 breaths per minute could indicate respiratory distress and requires further evaluation.