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A nurse is assessing a newborn whose mother had gestational diabetes mellitus. The nurse should monitor for which of the following findings as a manifestation of hypoglycemia?
- A. Abdominal distention
- B. Petechiae
- C. Increased muscle tone
- D. Jitteriness
Correct Answer: D
Rationale: The correct answer is D: Jitteriness. In newborns of mothers with gestational diabetes mellitus, hypoglycemia can occur due to the abrupt cessation of the maternal glucose supply. Jitteriness is a common manifestation of hypoglycemia in newborns. This is because the brain is highly dependent on glucose for energy, and low blood sugar levels can affect neurological function, leading to symptoms like jitteriness. Abdominal distention, petechiae, and increased muscle tone are not typical manifestations of hypoglycemia in newborns with a history of maternal gestational diabetes mellitus.
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A nurse is preparing to assess fetal heart tones for a client who is at 12 weeks of gestation. Which of the following actions should the nurse take?
- A. Place the client in a side-lying position prior to assessing the fetal heart rate
- B. Measure the fundal height to determine the placement of the ultrasound stethoscope.
- C. Position the ultrasound stethoscope above the symphysis pubis to assess the fetal heart rate.
- D. Perform Leopold maneuvers prior to auscultating the fetal heart rate.
Correct Answer: C
Rationale: At 12 weeks of gestation, the fetal heart rate is best assessed by placing the ultrasound stethoscope above the symphysis pubis, where the uterus is located.
Which of the following is a potential ethical issue related to pain management in maternal and newborn healthcare?
- A. Undertreatment of pain
- B. Overtreatment of pain
- C. Use of alternative therapies without informed consent
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Undertreatment of pain can lead to unnecessary suffering, while overtreatment can result in adverse effects for the mother and newborn. Additionally, using alternative therapies without informed consent violates the principle of autonomy. These issues highlight the importance of balancing pain management strategies to ensure optimal care and ethical practice in maternal and newborn healthcare. Choices A, B, and C each represent distinct ethical concerns that may arise in pain management, emphasizing the need for a comprehensive approach to address these complexities.
What is the recommended method of administering vitamin D to a breastfed newborn?
- A. Intramuscular injection
- B. Oral drops
- C. Topical application
- D. Subcutaneous injection
Correct Answer: B
Rationale: Oral drops are the recommended method for administering vitamin D to breastfed newborns.
Which of the following is a potential complication of a vaginal birth after cesarean (VBAC)?
- A. Uterine rupture
- B. Postpartum hemorrhage
- C. Maternal infection
- D. All of the above
Correct Answer: A
Rationale: Uterine rupture is a potential complication of VBAC.
Select the 5 findings that require follow-up by the nurse.
- A. Lower extremity assessment
- B. Fetal heart tracing
- C. Weight assessment
- D. Blood pressure
- E. Nausea
- F. Respiratory assessment
- G. DTR
Correct Answer: A,C,D,E,G
Rationale: Administer oxygen