Nokea
A nurse in a provider’s office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption?
- A. Cocaine use
- B. Blunt force trauma
- C. Hypertension
- D. Cigarette smoking
Correct Answer: C
Rationale: The correct answer is C: Hypertension. Hypertension is the most common risk factor for placental abruption because it can lead to reduced blood flow to the placenta, increasing the risk of separation. High blood pressure can cause damage to the blood vessels in the placenta, making it more susceptible to detachment. Cocaine use (A) and cigarette smoking (D) can also increase the risk of abruption, but they are not as common as hypertension. Blunt force trauma (B) can directly cause placental abruption but is not as prevalent as hypertension in this context.
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A nurse is completing a home visit to a mother who is 3 days postpartum and breastfeeding her newborn. The mother expresses concern about the amount of weight the newborn has lost since birth. Which of the following is a response the nurse should make?
- A. “The cause might be too short or infrequent feedings.”
- B. “It is due to the newborn’s loss of the influence of the maternal hormones.”
- C. “This might be related to your baby having 3 stools a day.”
- D. “You might want to offer water supplements between feedings.”
Correct Answer: A
Rationale: The correct answer is A because insufficient feeding can lead to excessive weight loss in newborns. Frequent and effective breastfeeding helps ensure the baby receives enough milk and nutrients. Option B is incorrect as maternal hormones do not directly affect newborn weight loss. Option C is incorrect as the number of stools is not necessarily indicative of weight loss. Option D is incorrect as newborns should only be fed breastmilk or formula, not water supplements.
A nurse in a provider’s office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse?
- A. It assists in identifying the location of the placenta and fetus.
- B. It is useful for estimating fetal age.
- C. This is a screening tool for spina bifida.
- D. This will determine if there is more than one fetus.
Correct Answer: A
Rationale: Correct Answer: A
Rationale: Prior to amniocentesis, an ultrasound is done to identify the location of the placenta and fetus. This is crucial to ensure the safety of the procedure. It helps in determining the best site for needle insertion to avoid harming the fetus or placenta. Additionally, it allows for visualization of any abnormalities that could affect the amniocentesis procedure.
Summary of other choices:
B: Estimating fetal age is not the primary purpose of the ultrasound before amniocentesis.
C: Screening for spina bifida is usually done through other specific tests, not the ultrasound before amniocentesis.
D: Determining if there is more than one fetus is not the main goal of the ultrasound before amniocentesis.
After assisting with a vaginal delivery, what would the nurse do to prevent heat loss via conduction in the newborn?
- A. Dry the newborn with a warm blanket.
- B. Close the doors to the delivery room.
- C. Wrap the newborn in a blanket.
- D. Place the newborn on a warm crib pad.
Correct Answer: D
Rationale: The correct answer is D: Place the newborn on a warm crib pad. This helps prevent heat loss via conduction by providing a warm surface for the newborn to rest on, minimizing direct contact with a colder surface. Drying the newborn with a warm blanket (choice A) can help prevent heat loss via evaporation, not conduction. Closing the doors to the delivery room (choice B) may help maintain room temperature but does not directly prevent heat loss via conduction. Wrapping the newborn in a blanket (choice C) helps prevent heat loss via radiation, not conduction.
A nurse is caring for a newborn delivered by vaginal birth with a vacuum assist. The newborn’s mother asks about the swollen area on her son’s head. After palpation to identify that the swelling crosses the suture line, which of the following is an appropriate response by the nurse?
- A. This is a cephalohematoma which can occur spontaneously.
- B. A caput succedaneum will subside in a few days.
- C. Mongolian spots can be found on the skin of many newborns.
- D. This is a telangiectatic nevus and no treatment is needed.
Correct Answer: B
Rationale: The correct answer is B: A caput succedaneum will subside in a few days. A caput succedaneum is a diffuse swelling of the scalp that occurs due to pressure on the baby's head during labor. It typically resolves on its own within a few days. In this scenario, since the swelling crosses the suture line, it is likely a caput succedaneum. Palpation of the swelling helps to differentiate it from cephalohematoma, which is confined by suture lines. Choice A is incorrect because a cephalohematoma is a collection of blood between the periosteum and skull bone, not the same as caput succedaneum. Choices C and D are incorrect as they refer to different conditions unrelated to the swelling on the newborn's head.
A nurse is preparing to assess a newborn who is post-term. Which of the following findings should the nurse expect? (Select all that apply)
- A. Vernix in the folds and creases
- B. Abundant lanugo
- C. Positive Moro reflex
- D. Cracked peeling skin
- E. Short soft fingernails
Correct Answer: A,C,D
Rationale: The correct answers are A, C, and D. A post-term newborn is born after 42 weeks of gestation, which can lead to certain physical characteristics.
A: Vernix in the folds and creases is expected in post-term newborns due to prolonged exposure to amniotic fluid.
C: Positive Moro reflex is expected as it indicates the baby's neurological maturity.
D: Cracked peeling skin is common in post-term newborns due to prolonged exposure to amniotic fluid, leading to dryness.
B: Abundant lanugo is typically seen in premature newborns rather than post-term.
E: Short soft fingernails are not specific to post-term newborns.