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A nurse is assessing a client who is at 6 weeks of gestation and adheres to a vegan diet. Which of the following questions should the nurse ask to assess the client’s dietary intake?
- A. How much protein do you eat in a day?
- B. Are you taking a Vitamin C supplement?
- C. Have you considered eating shellfish?
- D. When was the last time you ate meat?
Correct Answer: A
Rationale: The correct answer is A: "How much protein do you eat in a day?" This question is important because as a vegan, the client may have a higher risk of protein deficiency due to the lack of animal protein in their diet. By asking about their protein intake, the nurse can assess if the client is meeting their protein needs for a healthy pregnancy.
Choice B, asking about a Vitamin C supplement, is incorrect as Vitamin C deficiency is not typically a concern for vegans and is not specifically related to gestational nutrition. Choice C, suggesting shellfish, is incorrect as it goes against the client's vegan dietary preferences. Choice D, asking about the last time the client ate meat, is also incorrect as it is not relevant to assessing their current dietary intake as a vegan.
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For each potential assessment finding, click to specity if the assessment finding Is consistent with mastitis or endometritis. Each finding may support more than 1 disease process.
- A. Foul-smelling lochia
- B. Painful, tender breast
- C. Temperature
- D. Chilis
Correct Answer:
Rationale:
A nurse is planning care for a toddler who has epiglottitis. which of the following interventions should the nurse include.
- A. Offer a high-calorie, high-protein diet.
- B. Administer pancreatic enzymes with meals.
- C. Initiate droplet precautions.
- D. Carefully suction the child's oropharynx to remove secretions
Correct Answer: C
Rationale: Epiglottitis is a medical emergency, and droplet precautions are necessary to prevent the spread of infection. Suctioning the oropharynx can worsen airway obstruction and is not recommended.
A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)
- A. Labor induction with oxytocin
- B. Newborn weight 2.948 kg (6 lb 8 oz)
- C. Vacuum-assisted delivery
- D. History of uterine atony
- E. History of human papillomavirus
Correct Answer: A,C,D
Rationale: The correct answers are A, C, and D.
A: Labor induction with oxytocin can lead to uterine hyperstimulation, increasing the risk of postpartum hemorrhage.
C: Vacuum-assisted delivery can cause trauma to the birth canal, leading to increased bleeding.
D: History of uterine atony indicates a weak uterine muscle tone, which can result in excessive bleeding after delivery.
B: Newborn weight is not directly related to postpartum hemorrhage risk.
E: History of human papillomavirus does not increase the risk of postpartum hemorrhage.
A nurse is preparing to administer an IM injection to a newborn. Which of the following sites should the nurse select?
- A. Vastus lateralis
- B. Dorsogluteal
- C. Deltoid
- D. Rectus femoris
Correct Answer: A
Rationale: The correct answer is A: Vastus lateralis. For newborns, the vastus lateralis muscle is the preferred site for intramuscular injections due to its larger muscle mass and reduced risk of injury to nerves and blood vessels. It is located on the thigh, making it easily accessible and safe for administration. The deltoid muscle (choice C) is not recommended for newborns due to insufficient muscle mass. The dorsogluteal site (choice B) is not recommended for infants due to the proximity to the sciatic nerve. The rectus femoris (choice D) is not typically used for IM injections in newborns.
Which of the following is a potential barrier to patient-centered care in maternal and newborn healthcare?
- A. Lack of cultural competence
- B. Provider bias
- C. Limited resources
- D. All of the above
Correct Answer: D
Rationale: Barriers to patient-centered care include lack of cultural competence, provider bias, and limited resources.