Nokea
A nurse is caring for a client who is receiving oxytocin via continuous IV infusion and is experiencing persistent late decelerations in the FHR. After discontinuing the infusion, which of the following actions should the nurse take?
- A. Instruct the client to bear down and push with contractions.
- B. Administer oxygen at 10 L/min via nonrebreather facemask.
- C. Place the client in a supine position.
- D. Initiate an amnioinfusion.
Correct Answer: B
Rationale: The correct answer is B: Administer oxygen at 10 L/min via nonrebreather facemask. Late decelerations in FHR during oxytocin infusion indicate uteroplacental insufficiency. Administering oxygen helps improve oxygenation to the fetus, potentially alleviating the late decelerations. This action addresses the underlying cause and supports fetal oxygenation. In contrast, option A may increase intrauterine pressure, worsening fetal distress. Option C (supine position) can further compromise placental perfusion. Option D (amnioinfusion) is used for variable decelerations, not late decelerations.
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What is the primary goal of interprofessional collaboration in maternal and newborn healthcare?
- A. To improve communication and coordination of care
- B. To decrease healthcare costs
- C. To increase patient satisfaction
- D. All of the above
Correct Answer: A
Rationale: The primary goal of interprofessional collaboration is to improve communication and coordination of care.
A nurse is caring for a client who is at 22 weeks of gestation and is HIV positive. Which of the following actions should the nurse take?
- A. Administer penicillin G 2.4 million units IM to the client.
- B. Instruct the client to schedule an annual pelvic examination.
- C. Tell the client they will start medication for HIV immediately after delivery.
- D. Report the client’s condition to the local health department.
Correct Answer: D
Rationale: The correct answer is D: Report the client’s condition to the local health department. This action is important to ensure proper follow-up care, contact tracing, and prevention of HIV transmission. Administering penicillin G (A) is not indicated for HIV, scheduling an annual pelvic exam (B) is routine and not specific to the client's HIV status, and starting medication post-delivery (C) delays necessary treatment.
A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
- A. Identify the attitude of the head.
- B. Palpate the fundus to identify the fetal part.
- C. Determine the location of the fetal back.
- D. Palpate for the fetal part presenting at the inlet.
Correct Answer: B, C, D, A
Rationale: Leopold maneuvers should be performed in the following sequence: palpate the fundus, determine the location of the fetal back, palpate for the fetal part presenting at the inlet, and identify the attitude of the head.
A nurse is developing a plan of care for a newborn whose mother tested positive for heroin during pregnancy. The newborn is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse include in the plan?
- A. Administer naloxone to the newborn.
- B. Swaddle the newborn with his legs extended.
- C. Maintain eye contact with the newborn during feedings
- D. Minimize noise in the newborn's environment.
Correct Answer: D
Rationale: Minimizing noise in the newborn's environment helps reduce overstimulation, which can exacerbate symptoms of neonatal abstinence syndrome. Naloxone is not used for this condition, and swaddling with legs extended is incorrect as it should be snug to provide comfort.
Which of the following is a potential barrier to providing culturally competent care in maternal and newborn healthcare?
- A. Lack of awareness of cultural differences
- B. Bias and prejudice
- C. Limited access to resources
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Lack of awareness of cultural differences can lead to misunderstandings and miscommunication in healthcare. Bias and prejudice can hinder the ability to provide equitable care to individuals from diverse backgrounds. Limited access to resources can restrict healthcare providers from offering culturally appropriate services. Therefore, all these factors can act as potential barriers to providing culturally competent care in maternal and newborn healthcare. Choices A, B, and C are incorrect because each of them individually contributes to the overall challenge of achieving cultural competence in healthcare.