Nokea
A nurse is caring for a client who is 12 hr postpartum and has a third-degree perineal laceration. The client reports not having a bowel movement for 4 days. Which of the following medications should the nurse administer?
- A. Bisacodyl 10 mg rectal suppository
- B. Magnesium hydroxide 30 mL PO
- C. Famotidine 20 mg PO
- D. Loperamide 4 mg PO
Correct Answer: A
Rationale: A rectal suppository like bisacodyl is effective for relieving constipation and is safe for postpartum clients with perineal lacerations.
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What is the primary ethical principle guiding nursing practice in maternal and newborn healthcare?
- A. Autonomy
- B. Non-maleficence
- C. Beneficence
- D. Justice
Correct Answer: C
Rationale: The correct answer is C: Beneficence. In maternal and newborn healthcare, beneficence is the primary ethical principle guiding nursing practice. This principle emphasizes the nurse's duty to promote the well-being and best interests of both the mother and the newborn. Nurses must act in a way that benefits their patients and ensures their safety and health. Autonomy (A) focuses on respecting the patient's right to make their own decisions, which is important but not the primary principle in this context. Non-maleficence (B) involves avoiding harm, which is essential but not the primary guiding principle here. Justice (D) pertains to fairness in healthcare access and resource allocation, which is also crucial but not the primary ethical principle for maternal and newborn healthcare.
What is the recommended method of feeding for a newborn with phenylketonuria (PKU)?
- A. Breastfeeding
- B. Formula feeding
- C. Lowphenylalanine formula feeding
- D. All of the above
Correct Answer: C
Rationale: Lowphenylalanine formula feeding is recommended for newborns with PKU.
A nurse is caring for a client who is at 10 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Frequent vomiting with weight loss of 3 lb in 1 week
- B. Reports of mood swings
- C. Nosebleeds occurring approximately 3 times per week
- D. Increased vaginal discharge
Correct Answer: A
Rationale: The correct answer is A. Frequent vomiting with weight loss of 3 lb in 1 week is concerning during the first trimester as it may indicate hyperemesis gravidarum, a severe form of morning sickness that can lead to dehydration and malnutrition, posing risks to both the mother and the fetus. The nurse should report this finding to the provider for further evaluation and intervention.
Incorrect choices:
B: Reports of mood swings are common during pregnancy due to hormonal changes and are not typically a cause for concern at 10 weeks of gestation.
C: Nosebleeds are common in pregnancy due to increased blood volume and hormonal changes and are usually not serious unless severe or frequent.
D: Increased vaginal discharge is a normal pregnancy symptom caused by hormonal changes and increased blood flow to the pelvic area.
Which of the following is a professional standard for nursing practice in maternal and newborn healthcare?
- A. Quality improvement
- B. Patient-centered care
- C. Safety
- D. All of the above
Correct Answer: D
Rationale: Quality improvement patient-centered care and safety are all fundamental professional standards in nursing practice. These standards ensure high-quality safe and compassionate care for mothers and newborns.
A nurse is reviewing laboratory findings for a client who is at 20 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Hematocrit 37% (37% to 47%)
- B. Creatinine 0.9 mg/dL (0.5 to 1 mg/dL)
- C. WBC count 11,000/mm3 (5,000 to 10,000/mm3)
- D. Fasting blood glucose 180 mg/dL (74 to 106 mg/dL)
Correct Answer: D
Rationale: The correct answer is D: Fasting blood glucose 180 mg/dL (74 to 106 mg/dL). Elevated fasting blood glucose levels during pregnancy can indicate gestational diabetes, which requires immediate attention to prevent complications for both the mother and the baby. The normal range for fasting blood glucose is 74 to 106 mg/dL; a value of 180 mg/dL is significantly elevated. The nurse should report this finding to the provider for further evaluation and management.
Choice A (Hematocrit 37%) falls within the normal range for a pregnant woman. Choice B (Creatinine 0.9 mg/dL) is within the normal range. Choice C (WBC count 11,000/mm3) is slightly elevated but not typically concerning during pregnancy. The focus should be on managing the high blood glucose level to ensure the health of the mother and baby.