Nokea
A gravid woman who recently emigrated from mainland China is being seen at her first prenatal visit. She was never vaccinated in her home country. An injection to prevent which of the following communicable diseases should be administered to the woman during her pregnancy?
- A. Influenza.
- B. Mumps.
- C. Rubella.
- D. Varicella.
Correct Answer: A
Rationale: Influenza vaccination is safe and recommended during pregnancy to protect both the mother and fetus. Vaccines for Mumps, Rubella, and Varicella are live attenuated vaccines and are contraindicated during pregnancy.
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A nurse is caring for a postpartum person who is breastfeeding. What is the most important action to promote effective breastfeeding?
- A. assist with positioning
- B. administer analgesics
- C. administer IV fluids
- D. assist with breastfeeding positioning
Correct Answer: B
Rationale: The correct answer is B: administer analgesics. Pain management is crucial to promote effective breastfeeding as it can help the postpartum person be more comfortable and relaxed during breastfeeding sessions. This can lead to better latch and milk transfer, ultimately enhancing the breastfeeding experience.
A: assist with positioning - While positioning is important for successful breastfeeding, it is not the most crucial action compared to pain management.
C: administer IV fluids - IV fluids are not directly related to promoting effective breastfeeding. Hydration is important but not the most critical factor in this scenario.
D: assist with breastfeeding positioning - This choice is similar to option A and while important, it is not as critical as ensuring proper pain management for effective breastfeeding.
A pregnant patient is at 30 weeks gestation and is experiencing dizziness and lightheadedness when standing. What is the nurse's first priority action?
- A. Encourage the patient to drink fluids and rest for 10 minutes.
- B. Instruct the patient to lie flat on her back to restore circulation.
- C. Monitor the patient's blood pressure and check for signs of anemia.
- D. Administer oxygen and prepare for immediate delivery.
Correct Answer: A
Rationale: The correct answer is A: Encourage the patient to drink fluids and rest for 10 minutes. This is the first priority action because dizziness and lightheadedness in a pregnant patient at 30 weeks gestation could be due to orthostatic hypotension, a common issue in pregnancy. Encouraging the patient to drink fluids and rest will help increase blood volume and alleviate symptoms.
Choice B is incorrect because lying flat on her back can worsen symptoms due to supine hypotensive syndrome. Choice C is not the first priority as checking for anemia or monitoring blood pressure should come after addressing immediate symptoms. Choice D is incorrect because immediate delivery is not warranted based on the symptoms described.
A woman in her third trimester advises the nurse that she wishes to breastfeed her baby, 'but I don’t think my nipples are right.' Upon examination, the nurse notes that the client has inverted nipples. Which of the following actions should the nurse take at this time?
- A. Advise the client that it is unlikely that she will be able to breastfeed.
- B. Refer the client to a lactation consultant for advice.
- C. Call the labor room and notify them that a client with inverted nipples will be admitted.
- D. Teach the woman exercises to exert her nipples.
Correct Answer: B
Rationale: Inverted nipples can make breastfeeding challenging, but with proper guidance from a lactation consultant, many women are able to breastfeed successfully. Exercises to exert the nipples may also be helpful, but referral to a specialist is the best initial action.
A patient who was admitted to the delivery room undergoes an ultrasound, which reveals that the sacrum is the presenting part; the lie is longitudinal, with both the hips and knees in flexion. Which describes this fetal presentation?
- A. Cephalic
- B. Complete breech
- C. Frank breech
- D. Footling breech
Correct Answer: C
Rationale: The correct answer is A: Cephalic. In this presentation, the sacrum is the presenting part, indicating the baby is head down, which is characteristic of a cephalic presentation. Additionally, the lie is longitudinal, further supporting the cephalic presentation. The flexion of both hips and knees is also consistent with the normal positioning of a baby in the cephalic presentation.
Summary of other choices:
B: Complete breech - In a complete breech presentation, the baby is bottom down with both hips and knees flexed, but the sacrum would not be the presenting part.
C: Frank breech - In a frank breech presentation, the baby's buttocks are the presenting part with the legs extended and the feet near the head.
D: Footling breech - In a footling breech presentation, one or both feet are the presenting part, with the hips and knees extended, not flexed as described in the scenario.
A nurse is caring for a laboring person who is in the first stage of labor. What is the most important assessment to perform during this stage?
- A. assess fetal heart rate
- B. monitor contractions
- C. check blood pressure
- D. assist with breathing exercises
Correct Answer: A
Rationale: The correct answer is A: assess fetal heart rate. During the first stage of labor, monitoring the fetal heart rate is crucial as it indicates the well-being of the baby. Changes in fetal heart rate can signal distress and prompt intervention. Monitoring contractions is important but assessing fetal well-being takes precedence. Checking blood pressure is important but not the most critical in this stage. Assisting with breathing exercises can help manage pain, but assessing fetal heart rate is more crucial for ensuring the baby's safety.