Nokea
A neonate is delivered by primary cesarean section at 36 weeks' gestation. The temperature in the delivery room is 70F. To prevent heat loss from convection, which action should the nurse take?
- A. Dry the neonate quickly after delivery.
- B. Keep the neonate away from air conditioning vests.
- C. Place the neonate away from outside windows.
- D. Phewarm the bed.
Correct Answer: B
Rationale: The neonate should be kept away from drafts, such as from air conditioning vents, which may cause heat loss by convection. Convection involves heat loss due to air movement, and avoiding drafts is the most effective action.
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A 30-year-old multigravid client at 8 weeks' gestation has a history of insulin-dependent diabetes since age 20. When explaining about the importance of blood glucose control during pregnancy, the nurse should tell the client that which of the following will occur regarding the client's insulin needs during the first trimester?
- A. They will increase.
- B. They will decrease.
- C. They will remain constant.
- D. They will be unpredictable.
Correct Answer: B
Rationale: Insulin needs typically decrease in the first trimester due to increased insulin sensitivity.
The nurse assesses a primiparous client in labor for 20 hours. The nurse identifies late decelerations on the monitor and initiates standard procedures for the labor client with this wave pattern. Which intravenous should the nurse perform? Select all that apply.
- A. Administering oxygen via mask to the client.
- B. Questioning the client about the effectiveness of pain relief.
- C. Placing the client on her side.
- D. Readjusting the monitor to a more comfortable position.
- E. Applying an internal fetal monitor to help identify the cause of the decelerations.
Correct Answer: A,C
Rationale: Late decelerations indicate uteroplacental insufficiency. Standard interventions include administering oxygen to improve fetal oxygenation and placing the client on her side to enhance uterine perfusion. Questioning pain relief or readjusting the monitor does not address the issue, and internal monitoring may be considered but is not the first step.
When developing the plan of care for a primiparous client during the first 12 hours after vaginal delivery, which of the following concerns of the client should be the nurse's primary focus of care?
- A. The neonate.
- B. The family.
- C. The client's own comfort.
- D. The client's significant other.
Correct Answer: C
Rationale: In the first 12 hours postpartum, the nurse's primary focus is the client's physical and emotional comfort to promote recovery and prevent complications.
Which of the following measures would the nurse expect to include in the teaching plan for a multiparous client who delivered 24 hours ago and is receiving intravenous antibiotic therapy for cystitis?
- A. Limiting fluid intake to 1 L daily to prevent overload.
- B. Catheterizing the bladder every 2 to 4 hours while awake.
- C. Washing the perineum with povidone iodine (Betadine) after voiding.
- D. Avoiding the intake of acidic fruit juices until the treatment is discontinued.
Correct Answer: D
Rationale: Avoiding acidic juices reduces bladder irritation during cystitis treatment.
A multiparous client who has a neonate diagnosed with hemolytic disease of the newborn asks the nurse why the neonate has developed this problem. Which of the following responses by the nurse should be most appropriate?
- A. You are Rh-positive and the neonate's father is Rh-negative.'
- B. You and the neonate's father are both Rh-negative.'
- C. You are Rh-negative and the neonate's father is Rh-positive.'
- D. The fetus is Rh-negative and you are Rh-positive.'
Correct Answer: C
Rationale: Hemolytic disease of the newborn occurs when an Rh-negative mother carries an Rh-positive fetus, leading to maternal antibody production against fetal red blood cells.