Nokea
A new mother who is breastfeeding her 4-week-old infant and has type 1 diabetes, reports that her insulin needs have decreased since the birth of her child. Which action should the nurse implement?
- A. Schedule an appointment for the client with the diabetic nurse educator.
- B. Counsel her to increase her caloric intake
- C. Inform her that a decreased need for insulin occurs while breastfeeding
- D. Advise the client to breastfeed more frequently
Correct Answer: C
Rationale: Breastfeeding can lower insulin requirements due to increased energy expenditure, and informing the client of this normal change is appropriate.
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The nurse is preparing to administer magnesium sulfate to a laboring client whose blood pressure has increased from 110/60 mmHg to 140/90 mmHg Which nursing protocol has the highest priority?
- A. Insert a Foley catheter with a urimeter to monitor hourly output
- B. Have calcium gluconate immediately available
- C. Provide a quiet environment with subdued lighting.
- D. Assess deep tendon reflexes (DTRS) every 4 hours.
Correct Answer: B
Rationale: Magnesium sulfate toxicity can cause neuromuscular blockade, making calcium gluconate, the antidote, critical to have immediately available in case of toxicity signs like loss of deep tendon reflexes.
A father watching the admission of his newborn to the nursery notices that eye ointment is placed in the infant's eyes. He asks the nurse what is the purpose of the ointment. The nurse would be correct in stating that the purpose for using the ointment is to
- A. dilate the pupil so the red reflex can be visualized
- B. prevent herpes infection.
- C. prevent eye infections
- D. clear the infant's vision
Correct Answer: C
Rationale: Antibiotic eye ointment, typically erythromycin, is applied to prevent neonatal conjunctivitis, particularly from gonorrhea or chlamydia, which can be transmitted during birth.
A client is admitted to the postpartum unit and tells the nurse she had rheumatic fever as a child, which resulted in some 'heart damage.' The nurse knows that this client is at particular risk for developing heart failure during the immediate postpartum period. Based on this client's history, which nursing problem has the highest priority?
- A. Sleep deprivation.
- B. Fluid volume excess
- C. Nausea and vomiting
- D. Risk for infection.
Correct Answer: B
Rationale: Heart damage from rheumatic fever increases the risk of heart failure, particularly postpartum due to fluid shifts. Managing fluid volume excess is the priority.
During a routine first trimester prenatal exam, a pregnant client tells the nurse that she has noticed an increase in vaginal discharge that is white, thin, and watery. Which action should the nurse implement?
- A. Notify the healthcare provider of the complaint
- B. Recommend an over-the-counter yeast medication
- C. Inform her that this is a normal physiological change.
- D. Prepare the client for a sterile speculum exam
Correct Answer: C
Rationale: Increased white, thin, watery discharge (leukorrhea) is a normal physiological change in pregnancy due to hormonal shifts, requiring no immediate intervention.
A nurse is speaking with a client who is addicted to heroin and who just learned that she is pregnant. The client states, 'I just started taking methadone. Is there anything else I can do to make sure my baby is healthy?' Which information should the nurse provide?
- A. Describe genetic testing protocols
- B. Discontinue the methadone right away
- C. Sign up for group therapy sessions
- D. Start a prenatal care plan as soon as possible
Correct Answer: D
Rationale: Early prenatal care is critical for monitoring maternal and fetal health, managing opioid addiction with methadone under medical supervision, and addressing potential complications.