Nokea
A neonate with heart failure is being discharged home. In teaching the parents about the neonate's nutritional needs, the nurse should explain that:
- A. Fluids should be restricted.
- B. Decreased activity level should reduce the need to additional reduces.
- C. The formula should be low in sodium.
- D. The neonate may need a formula with higher calories per fluid ounce.
Correct Answer: D
Rationale: A neonate with heart failure may require a higher-calorie formula to meet energy needs without increasing fluid volume.
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When reviewing the prenatal history for a newly delivered neonate, the nurse notes that the mother has neurofibromatosis. The nurse should further assess the neonate for:
- A. Caffé au lait spots.
- B. Port wine nevus.
- C. Strawberry hemangiomas.
Correct Answer: A
Rationale: Neurofibromatosis is associated with café au lait spots, which are a hallmark sign to assess in the neonate.
Two hours ago, a neonate at 38 weeks' gestation and weighing 3,175 g (7 lb) was born to a primiparous client who tested positive for beta-hemolytic Streptococcus. Which of the following would alert the nurse to notify the pediatrician?
- A. Alkalosis.
- B. Increased muscle tone.
- C. Temperature instability.
- D. Positive Babinski's reflex.
Correct Answer: C
Rationale: Temperature instability can indicate early sepsis, especially in a neonate at risk due to maternal beta-hemolytic Streptococcus.
A primigravid client admitted to the labor area in the upper and lower lower than the lower was born with cystic fibrosis and she wonders if her baby will also have the disease. The nurse can tell the client that cystic fibrosis is:
- A. X-linked recessive and the disease will only occur if the baby is a boy.
- B. X-linked dominant and there is no likelihood of the baby having cystic fibrosis.
- C. Autosomal recessive and that unless the baby's father has the gene, the baby will not have the disease.
- D. Autosomal dominant and there is a 50 per cent chance of the baby having the disease.
Correct Answer: C
Rationale: Cystic fibrosis is an autosomal recessive disorder, requiring both parents to carry the gene for the child to be affected. If the father does not carry the gene, the baby cannot have the disease but may be a carrier. X-linked and dominant inheritance patterns do not apply.
A primiparous client who is bottle-feeding her neonate asks, "When should I start giving the baby solid foods?" The nurse instructs the client to introduce solid foods no sooner than at which age?
- A. 2 months.
- B. 6 months.
- C. 8 months.
- D. 10 months.
Correct Answer: B
Rationale: Solid foods are introduced around 6 months when the infant's digestive system is more mature.
The physician determines that outlet forceps are needed to assist in the delivery of a primigravid client in active labor with a large-for-gestational-size fetus. The nurse reinforces the physician's explanation for using forceps based on the understanding about which of the following concerning the location of the fetus?
- A. Fetal head at the pelvic outlet.
- B. Fetal head at the ischial spines.
- C. Fetal head above the pelvic brim.
- D. Fetal head in the false pelvis.
Correct Answer: A
Rationale: Outlet forceps are used when the fetal head is at the pelvic outlet, visible at the perineum, allowing safe assisted delivery. Higher fetal positions require different interventions.