Nokea
A nurse is assessing a newborn whose mother had gestational diabetes. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?
- A. Hypertonia
- B. Jitteriness
- C. Acrocyanosis
- D. Generalized petechiae
Correct Answer: B
Rationale: Jitteriness is a common sign of neonatal hypoglycemia and should be addressed promptly.
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A nurse is reviewing the laboratory results for a client who is at 29 weeks of gestation. Which of the following results should the nurse report to the provider?
- A. WBC count 11,000/mm3
- B. Hgb 11.2 g/dL
- C. Hct 34%
- D. Platelets 140,000/mm3
Correct Answer: D
Rationale: A platelet count of 140,000/mm³ is concerning as it is on the lower end of normal and could indicate thrombocytopenia, increasing the risk of bleeding.
A woman is 16 weeks pregnant and has elected to terminate her pregnancy. Which is the most common technique used for the termination of a pregnancy in the second trimester?
- A. Dilation and evacuation (D&E)
- B. Methotrexate administration
- C. Prostaglandin administration
- D. Vacuum aspiration
Correct Answer: A
Rationale: Dilation and evacuation (D&E) is the most common method used for termination in the second trimester, typically performed between 13 and 16 weeks.
The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge, called lochiWhich statement is the most appropriate?
- A. Lochia is similar to a light menstrual period for the first 6 to 12 hours.
- B. It is usually greater after cesarean births.
- C. Lochia will usually decrease with ambulation and breastfeeding.
- D. It should smell like normal menstrual flow unless an infection is present.
Correct Answer: D
Rationale: Lochia should smell like normal menstrual flow; an offensive odor usually indicates an infection.
The patient makes the statement: “I’m afraid to take the baby home tomorrow.” Which response by the nurse would be the most therapeutic?
- A. “You’re afraid to take the baby home?”
- B. “Don’t you have a mother who can come and help?”
- C. “You should read the literature I gave you before you leave.”
- D. “I was scared when I took my first baby home, but everything worked out.”
Correct Answer: D
Rationale: The best response by the nurse in this situation would be D. By sharing a personal experience of feeling scared when taking their first baby home, the nurse is empathizing with the patient and offering reassurance that everything worked out in the end. This can help the patient feel understood and less alone in their fear, while also providing hope that things will be okay. It validates the patient's feelings and offers a positive perspective, which can be therapeutic in this situation.
The nurses working at a newly established birthing center have begun to compare their performance in providing maternal-newborn care against clinical standards. This comparison process is most commonly known as what?
- A. Best practices network
- B. Clinical benchmarking
- C. Outcomes-oriented practice
- D. Evidence-based practice
Correct Answer: C
Rationale: Outcomes-oriented practice measures the effectiveness of interventions and quality of care against benchmarks or standards.