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A new parent asks the nurse about an area of swelling on the baby's head near the posterior fontanel that lies across the suture line. How should the nurse respond?
- A. “That is called caput succedaneum. It will have to be drained.â€.
- B. “That is called a cephalhematoma. It can cause jaundice as it is absorbed.â€.
- C. “That is called a cephalhematoma. It will cause no problems.â€.
- D. “That is called caput succedaneum. It will absorb and cause no problems.â€.
- E. A couple who plan to use in-vitro fertilization with donated sperm.
Correct Answer: D
Rationale: Caput succedaneum is swelling across suture lines that resolves spontaneously, unlike cephalhematoma, which is confined and may cause jaundice.
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A client in active labor receives a prescription for oxytocin 6 milliunits/minute intravenously (IV). The IV bag contains oxytocin 10 units in lactated Ringer's 1,000 mL. How many mL/hour should the nurse program the infusion pump to deliver? (Enter numerical value only.)
Correct Answer: 36
Rationale: Calculated as: (6 milliunits/min ÷ 10,000 milliunits) × 1,000 mL = 0.6 mL/min; 0.6 mL/min × 60 min/hour = 36 mL/hour.
A nurse is conducting a preconception class for a group of parents who are anticipating having children. Which client(s) should the nurse refer for genetic counseling? (Select all that apply)
- A. A couple who express concern about birth defects after using an internet DNA testing site.
- B. A woman and her significant other who are excited about the prospect of having children.
- C. A woman planning to start a second family after the loss of an embryo following an in-vitro fertilization procedure.
- D. A man who states that his father was recently diagnosed with Huntington's disease.
- E. A couple who plan to use in-vitro fertilization with donated sperm.
Correct Answer: A,C,D,E
Rationale: Concerns about birth defects, embryo loss, Huntington's disease, and donor sperm use indicate potential genetic risks requiring counseling, unlike general excitement about having children.
What instructions should the nurse provide to a new mother regarding postpartum care and monitoring the newborn's health?
- A. You will need to set up an appointment with your obstetrician in 8 weeks.
- B. You will need to abstain from sexual activities untilå½¼æ¤, and until you see your obstetrician.
- C. Contact the pediatrician if the baby is not breastfeeding well or has fewer wet diapers and stools.
- D. The lactation nurse will be coming by to work with you and your baby.
Correct Answer: C
Rationale: Monitoring breastfeeding success and diaper output is critical for detecting newborn health issues like dehydration, unlike incorrect obstetrician visit timing or less comprehensive lactation support.
At 0600, while admitting a woman for a scheduled repeat cesarean section (C-section), the client tells the nurse that she drank a cup of coffee at 0400 because she wanted to avoid getting a headache. Which action should the nurse take first?
- A. Start prescribed IV with lactated Ringer's.
- B. Inform the anesthesia care provider.
- C. Ensure preoperative lab results are available.
- D. Contact the client's obstetrician.
Correct Answer: B
Rationale: Caffeine intake may alter anesthesia effects, and the anesthesiologist needs to be informed first to manage potential complications like increased gastric acidity and delayed gastric emptying.
History and Physical:
Nurses' Notes:
Vital Signs:
Laboratory Results:
The client is a 28-year-old primiparous female who was induced at 41 weeks gestation with misoprostol and oxytocin. She gave birth vaginally 4 days ago, and her prenatal course and delivery were uncomplicated. She was discharged home on day two with her newborn and has been breastfeeding around the clock.
A nurse is caring for a primiparous client in the postpartum unit. The client was induced at 41 weeks gestation with misoprostol and oxytocin and gave birth vaginally 4 days ago. She was discharged home on day two with her newborn and has been breastfeeding around the clock. She called her healthcare provider this morning with fatigue, new-onset headache, nausea, dizziness, weakness, and seeing "flashing lights."
The nurse reviews the client's history, physical, and flow sheet to determine the cause of the client's symptoms. Highlight the information from the history, physical, and flow sheet that require further evaluation. Select all that apply.
- A. Hemoglobin 10.4 g/dL (6.45 mmol/L)
- B. Platelets 150,000/mm³ (150 x 10â¹/L)
- C. New-onset headache
- D. Vomiting small amount of yellow fluid
- E. Right upper quadrant pain
- F. Seeing flashing lights
- G. Elevated blood pressure
Correct Answer: C,D,E,F,G
Rationale: Headache, vomiting, right upper quadrant pain, flashing lights, and elevated blood pressure suggest postpartum preeclampsia or HELLP syndrome, requiring urgent evaluation.