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A nurse is assessing a newborn who was born postterm. Which of the following findings should the nurse expect?
- A. Large deposits of subcutaneous fat
- B. Thin covering of fine hair on shoulders and back
- C. Nails extending over tips of fingers
- D. Pale, translucent skin
Correct Answer: C
Rationale: The correct answer is C: Nails extending over tips of fingers. Postterm newborns tend to have longer nails due to the prolonged gestation period. This is because the nails continue to grow during the extra time in the womb. Large deposits of subcutaneous fat (A) are more common in preterm infants. Thin covering of fine hair on shoulders and back (B) is characteristic of lanugo, which is typically shed before birth. Pale, translucent skin (D) is more commonly seen in premature babies.
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A nurse is caring for a newborn who has jaundice and a new prescription for phototherapy. Which of the following actions should the nurse take?
- A. Provide the newborn with 15 mL glucose water after each feeding.
- B. Turn the newborn every 4 hr.
- C. Apply hydrating lotion to the newborn’s skin prior to treatment.
- D. Close the newborn's eyes before applying eyepatches.
Correct Answer: D
Rationale: The correct answer is D: Close the newborn's eyes before applying eyepatches. This is important to prevent damage to the eyes from the bright light used in phototherapy. Infants' eyes are sensitive, and prolonged exposure can lead to eye damage. Option A is incorrect as glucose water is not indicated for jaundice treatment. Option B is incorrect as turning the newborn every 4 hours is not specific to phototherapy treatment. Option C is incorrect as hydrating lotion is not necessary for phototherapy. Therefore, the crucial step of closing the newborn's eyes before applying eyepatches is essential for protecting the eyes during phototherapy.
A nurse is caring for an infant who has signs of neonatal abstinence syndrome. Which of the following actions should the nurse take?
- A. Monitor blood glucose level every hr.
- B. Place the infant on his back with legs extended.
- C. Initiate seizure precautions.
- D. Provide a stimulating environment.
Correct Answer: C
Rationale: The correct answer is C: Initiate seizure precautions. Neonatal abstinence syndrome can result in neurological symptoms, including seizures. Initiating seizure precautions involves ensuring a safe environment, padding the crib, and closely monitoring the infant for any signs of seizure activity. Monitoring blood glucose every hour (A) is not typically indicated for neonatal abstinence syndrome. Placing the infant on his back with legs extended (B) is a standard safe sleep practice but is not specific to managing neonatal abstinence syndrome. Providing a stimulating environment (D) can exacerbate symptoms of withdrawal and should be avoided.
A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include?
- A. Feed the newborn 5 to 10 min per breast.
- B. Offer the newborn 30 mL (1 oz) of water between feedings.
- C. Expect two to four wet diapers every 24 hr.
- D. Allow the baby to feed at least every 3 hr.
Correct Answer: D
Rationale: The correct answer is D: Allow the baby to feed at least every 3 hours. This is crucial for maintaining the baby's nutrition and ensuring an adequate milk supply. Breastfeeding on demand helps establish a healthy feeding pattern and promotes bonding between the mother and baby. Option A is incorrect because newborns should feed until they are satisfied, not based on time. Option B is incorrect as newborns should not be given water as it can interfere with breastfeeding and lead to water intoxication. Option C is incorrect as newborns should have at least 6-8 wet diapers a day.
A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include?
- A. You should have your provider refit you for a new diaphragm.'
- B. You should use an oil-based vaginal lubricant when inserting your diaphragm.'
- C. You should keep the diaphragm in place for at least 4 hours after intercourse.'
- D. You should store your diaphragm in sterile water after each use.'
Correct Answer: A
Rationale: Correct Answer: A) You should have your provider refit you for a new diaphragm.
Rationale: Postpartum changes in the body, such as weight fluctuations and pelvic floor tone, can affect the fit and effectiveness of a diaphragm. It is important for the client to be refitted by a healthcare provider to ensure proper sizing and optimal contraceptive efficacy.
Summary:
B) Using an oil-based vaginal lubricant can weaken the diaphragm material and increase the risk of breakage.
C) Keeping the diaphragm in place for an extended period after intercourse is not necessary and may increase the risk of toxic shock syndrome.
D) Storing the diaphragm in sterile water is not recommended as it can lead to contamination and infections.
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 a vegan diet may lack sufficient protein, which is crucial for fetal development. Protein intake is a key concern for pregnant vegans to ensure adequate nutrition for both the mother and the developing fetus.
Choice B is incorrect because Vitamin C deficiency is not typically a major concern for pregnant vegans. Choice C is incorrect as shellfish is not suitable for a vegan diet. Choice D is incorrect as asking about eating meat is not relevant to someone following a vegan diet.