Nokea
A neonate is being admitted to the well-baby nursery. Which of the following findings should be reported to the neonatologist?
- A. Umbilical cord with three vessels.
- B. Diamond-shaped anterior fontanelle.
- C. Cryptorchidism.
- D. Café au lait spot.
Correct Answer: C
Rationale: Cryptorchidism (undescended testes) requires medical evaluation.
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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.
A 2-day-old, exclusively breastfed baby is to be discharged home. Under what conditions should the nurse teach the parents to call the pediatrician?
- A. If the baby feeds 8 to 12 times each day.
- B. If the baby urinates 6 to 10 times each day.
- C. If the baby has stools that are watery and bright yellow.
- D. If the baby has eyes and skin that are tinged yellow.
Correct Answer: D
Rationale: Jaundice may indicate hyperbilirubinemia.
Which vaccinations are indicated for the postpartum patient if she does not have immunity? (Select all that apply.)
- A. Pertussis
- B. Rubella
- C. Diphtheria, tetanus (Tdap)
- D. RhoGAM
Correct Answer: A
Rationale: Rationale:
1. Pertussis vaccine is recommended in the postpartum period to protect the newborn from whooping cough.
2. Rubella vaccine is usually given preconception or postpartum if the mother is not immune.
3. Tdap vaccine (Diphtheria, Tetanus, Pertussis) is recommended during pregnancy, not specifically postpartum.
4. RhoGAM is given to Rh-negative mothers to prevent hemolytic disease in the newborn, not for general immunity.
What physiologic postpartum change occurs because the uterus shrinks in size, resulting in an increase in blood flow?
- A. Edema increases.
- B. Cardiac output increases.
- C. Temperature rises.
- D. Lochia increases.
Correct Answer: B
Rationale: The correct answer is B: Cardiac output increases. As the uterus shrinks in size postpartum, it stimulates an increase in blood flow to the area, leading to an increase in cardiac output to meet the demands. This is a normal physiologic response that helps to prevent excessive bleeding and promote healing. Edema increasing (A) is not directly related to the shrinking uterus. Temperature rising (C) is not a typical postpartum change due to uterine involution. Lochia increasing (D) is not a direct result of uterine shrinkage, but rather a normal discharge after childbirth.
If the rubella vaccine is indicated for a postpartum patient, which instructions should be provided?
- A. No specific instructions
- B. Drinking plenty of fluids to prevent fever
- C. Recommendation to stop breastfeeding for 24 hours after the injection
- D. Explanation of the risks of becoming pregnant within 28 days following injection
Correct Answer: D
Rationale: The correct answer is D because the rubella vaccine contains live virus and poses a risk to the fetus if the patient becomes pregnant within 28 days of receiving the vaccine. Providing instructions about the risks of pregnancy after vaccination is crucial to prevent potential harm to the fetus.
A: Incorrect - Specific instructions are necessary due to the live virus in the vaccine.
B: Incorrect - Drinking fluids does not address the specific risks associated with pregnancy after vaccination.
C: Incorrect - Stopping breastfeeding is not necessary after receiving the rubella vaccine.