Nokea
A newborn is suspected of having substance abuse instructions? exposure. Which of the following assessment findings
- A. Exercise will decrease my metabolism and should the nurse expect? Select all that apply.
- B. Increased weight gain
- C. Starting on Glucophage will take the place of
- D. Seizures
Correct Answer: D
Rationale: The correct answer is D: Seizures. Substance abuse exposure in a newborn can lead to withdrawal symptoms, including seizures. This is because the newborn's central nervous system may have been affected by the substances. Seizures are a serious medical emergency and require immediate attention.
Explanation for why other choices are incorrect:
A: Exercise and metabolism are not directly related to substance abuse exposure in a newborn.
B: Increased weight gain is not a typical assessment finding for newborns with substance abuse exposure.
C: Glucophage is a medication used to treat diabetes, and it does not relate to substance abuse exposure in a newborn.
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A postpartum client calls the pediatric clinic to report that her 4-day old female newborn has a spot of blood on her diaper. Which of the following statements made by the nurse is most appropriate?
- A. Your newborn may have a urinary infection, continue to breastfeed frequently
- B. Your newborn has jaundice so it may need phototherapy
- C. This is a normal finding due to withdrawal of maternal hormones
- D. Your baby has an immature immune system, continue to breastfeed frequently
Correct Answer: C
Rationale: The correct answer is C because the spot of blood on the diaper of a 4-day old female newborn is a normal finding due to the withdrawal of maternal hormones. During pregnancy, the baby is exposed to maternal hormones, and after birth, the sudden decrease in these hormones can cause a temporary withdrawal bleeding. This is known as pseudomenstruation and is common in newborn girls. It is important for the nurse to reassure the mother that this is a normal and harmless occurrence.
Choice A is incorrect because urinary infection is not typically the cause of blood on the diaper in a newborn. Choice B is incorrect because jaundice does not typically present with blood in the diaper. Choice D is incorrect because while breastfeeding is important for the baby's immune system, it is not directly related to the presence of blood on the diaper in this case.
The nurse is teaching a client about morning sickness. What recommendation should the nurse provide?
- A. Eat large meals three times a day.
- B. Drink fluids with meals.
- C. Consume dry crackers before getting out of bed.
- D. Avoid eating before bedtime.
Correct Answer: C
Rationale: The correct answer is C: Consume dry crackers before getting out of bed. This recommendation helps alleviate morning sickness by providing a bland and easily digestible snack to settle the stomach before getting up. By consuming dry crackers, the client can avoid an empty stomach, which can contribute to nausea. Eating large meals three times a day (A) can worsen morning sickness due to heavy digestion, while drinking fluids with meals (B) may exacerbate nausea. Avoiding eating before bedtime (D) is generally recommended, but it does not specifically address morning sickness.
How can a nurse best prevent heat loss in a newborn during the first hour of life?
- A. Place the newborn under a radiant warmer
- B. Dry the newborn and cover with a warm blanket
- C. Place the newborn in a skin-to-skin position with the mother
- D. Keep the newborn wrapped in a wet blanket
Correct Answer: A
Rationale: The correct answer is A: Place the newborn under a radiant warmer. This method is the most effective in preventing heat loss in a newborn as radiant warmers provide a consistent heat source to maintain the newborn's body temperature. This is crucial during the first hour of life when newborns are at a higher risk of hypothermia.
Choice B is not as effective as using a radiant warmer as it may not provide enough warmth to prevent heat loss. Choice C, placing the newborn in a skin-to-skin position with the mother, is beneficial for bonding and regulating the newborn's temperature in the long term but may not be as effective as a radiant warmer in the immediate post-birth period.
Choice D, keeping the newborn wrapped in a wet blanket, is incorrect as wet blankets can further contribute to heat loss through evaporative cooling. In summary, using a radiant warmer is the best option for preventing heat loss in a newborn during the critical first hour of life.
Which statement by the client would alert the nurse that she should not take oral contraceptives?
- A. I drink one to two alcohol drinks a few times a week.
- B. I am slightly overweight and have a difficult time fitting exercise into my schedule.
- C. I am trying to limit cigarettes to one pack a week.
- D. I try to have my boyfriend wear a condom every time we have sex.
Correct Answer: C
Rationale: The correct answer is C because smoking while taking oral contraceptives increases the risk of blood clots, stroke, and heart attack. Smoking and oral contraceptives together pose a higher risk than either alone. Choices A, B, and D are not direct contraindications for taking oral contraceptives. A: Moderate alcohol consumption is generally not contraindicated. B: Being slightly overweight and having difficulty with exercise are not absolute contraindications. D: Using condoms is a good practice but does not specifically indicate a reason not to take oral contraceptives.
The nurse is assessing a client in labor and notes persistent late decelerations on the monitor. What is the priority action?
- A. Reposition the client to her left side.
- B. Administer oxygen via face mask.
- C. Increase IV fluids.
- D. Notify the healthcare provider.
Correct Answer: A
Rationale: The correct answer is A: Reposition the client to her left side. This is the priority action because late decelerations indicate uteroplacental insufficiency, possibly due to compression of the umbilical cord. Repositioning the client to her left side can help improve blood flow to the placenta by reducing pressure on the vena cava, thus optimizing fetal oxygenation. Administering oxygen (B) is important but not the immediate priority. Increasing IV fluids (C) may not directly address the cause of late decelerations. Notifying the healthcare provider (D) is important but should come after immediate interventions.