Nokea
A mother questions the nurse about when the newborn screening tests for inborn diseases will be performed. Which of the following is an appropriate response by the nurse?
- A. The doctor took blood from the baby's umbilical cord at birth.
- B. A sample of the baby's first urine and first stool were sent for testing.
- C. A vial of blood was drawn and sent when the baby was admitted to the nursery.
- D. Blood from the baby's heel was sent after the baby had been fed a few times.
Correct Answer: D
Rationale: Newborn screening tests are typically done by collecting blood from the baby's heel after the baby has been fed a few times to ensure accurate results.
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Which of the patient health behaviors in the first trimester would the nurse identify as a risk factor in pregnancy?
- A. Sexual intercourse two or three times weekly
- B. Moderate exercise for 30 minutes daily
- C. Working 40 hours a week as a secretary in a travel agency
- D. Relaxing in a hot tub for 30 minutes a day, several days a week
Correct Answer: D
Rationale: The correct answer is D because relaxing in a hot tub for 30 minutes a day, several days a week can increase the body temperature, which is harmful during the first trimester and can lead to birth defects. Choice A is not a risk factor as it promotes a healthy sexual relationship. Choice B is beneficial as moderate exercise is recommended during pregnancy. Choice C is not necessarily a risk factor unless it involves exposure to harmful substances or excessive stress.
A nurse is completing a minimum data set. Which area is the nurse working?
- A. Nursing center
- B. Psychiatric facility
- C. Rehabilitation center
- D. Adult day care center
Correct Answer: A
Rationale: Nurses who work in a nursing center (nursing home or nursing facility) are required to complete a minimum data set on each patient. Minimum data set is not needed for psychiatric, rehabilitation, or adult day care centers.
The nurse is caring for a client with a suspected breech presentation. When the nurse performs Leopold's maneuvers, which maneuvers determine the fetal presentation? Select all that apply.
- A. First
- B. Second
- C. Third (Pawlik's maneuver)
- D. Fourth
Correct Answer: C
Rationale: First, the nurse applies gentle pressure just above the symphysis pubis to determine the presenting part (First). Second, the nurse palpates the sides of the uterus to identify the fetal back and small parts (Second). Third, Pawlik’s maneuver involves locating the fetal head in the fundus to confirm the fetal presentation. This maneuver determines the fetal presentation definitively (Correct - C). Fourth, the nurse feels for the fetal buttocks or cephalic prominence to determine the position of the back or head (Fourth). Pawlik's maneuver is crucial in identifying the fetal presentation accurately, making it the correct answer. Other choices are incorrect as they do not directly determine the fetal presentation like Pawlik's maneuver does.
A breastfeeding client, 6 days postdelivery, calls the postpartum unit stating, “I think I am engorged. My breasts are very hard and hot and they really hurt.” Which of the following questions should the nurse ask at this time?
- A. “Have you taken a warm shower this morning?”
- B. “Do you have an electric breast pump?”
- C. “How much did you have to drink yesterday?”
- D. “When was the last time you fed the baby?”
Correct Answer: D
Rationale: Asking when the client last fed the baby helps determine if engorgement is due to infrequent feeding, which is a common cause of breast engorgement.
It is noted that a baby admitted to the nursery has translucent skin with visible veins. Because of this finding, the nurse should monitor this baby carefully for which of the following?
- A. Polycythemia.
- B. Hypothermia.
- C. Hyperglycemia.
- D. Polyuria.
Correct Answer: B
Rationale: Translucent skin with visible veins is common in preterm infants, who are at higher risk for hypothermia due to poor thermoregulation.