Nokea
A nurse is caring for a newborn immediately following birth. For which of the following reasons should the nurse delay the instillation of antibiotic ophthalmic ointment?
- A. To allow manifestations of infection to be identified
- B. The newborn weighs less than 2.5 kg (5.5 lb)
- C. The newborn was delivered via cesarean birth
- D. To facilitate bonding between the newborn and parent
Correct Answer: D
Rationale: The correct answer is D: To facilitate bonding between the newborn and parent. Delaying the instillation of antibiotic ointment allows for immediate skin-to-skin contact and bonding between the newborn and parent, promoting attachment and emotional connection. This is a crucial aspect of postnatal care and has long-term benefits for the newborn's emotional and psychological development. Choices A, B, and C are incorrect because delaying antibiotic ointment instillation for reasons such as identifying infection, low birth weight, or mode of delivery could potentially result in harm to the newborn by not providing immediate protection against eye infections, which can be serious and lead to vision impairment.
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What is the function of the amniotic fluid during fetal development?
- A. To cushion and protect the fetus from trauma
- B. To provide a medium for fetal movement and growth
- C. To regulate fetal temperature
- D. All of the above
Correct Answer: D
Rationale: Amniotic fluid serves multiple functions including cushioning the fetus allowing movement and regulating temperature. These roles are essential for healthy fetal development.
Which of the following is a potential legal issue related to maternal and newborn healthcare?
- A. Medical negligence
- B. Patient confidentiality
- C. Informed consent
- D. All of the above
Correct Answer: D
Rationale: Legal issues in maternal and newborn healthcare include medical negligence, patient confidentiality, and informed consent.
A nurse is caring for a client who is in labor and requires augmentation of labor. Which of the following conditions should the nurse recognize as a contraindication to the use of oxytocin?
- A. Post-term with oligohydramnios.
- B. Chorioamnionitis
- C. Shoulder presentation
- D. Diabetes mellitus
Correct Answer: C
Rationale: Shoulder presentation is a contraindication for oxytocin use because it can lead to complications like umbilical cord prolapse or fetal distress.
A nurse is caring for a client who becomes unresponsive upon delivery of the placenta. Which of the following actions should the nurse take first?
- A. Determine respiratory function.
- B. Increase the IV fluid rate.
- C. Access emergency medications from the cart.
- D. Collect a maternal blood sample for coagulopathy studies.
Correct Answer: A
Rationale: Determining respiratory function is the first priority in an unresponsive client to ensure that the airway is patent and the client is breathing.
A nurse is caring for a client who is in active labor with a fetus in the occipitoposterior position. The nurse assists the client into a hands-and-knees position. Which of the following questions should the nurse ask to evaluate the effectiveness of this intervention?
- A. Does that lessen your suprapubic pain?
- B. Are you feeling relief from your pelvic pressure?
- C. Do your contractions feel further apart?
- D. Has your back labor improved?
Correct Answer: D
Rationale: The correct answer is D: "Has your back labor improved?" This question is appropriate because the occipitoposterior position often leads to back labor due to the baby's position pressing on the mother's spine. By asking if the back labor has improved, the nurse can assess the effectiveness of the hands-and-knees position in helping relieve pressure on the mother's back.
Choice A: "Does that lessen your suprapubic pain?" is incorrect because the hands-and-knees position is more effective for back pain relief, not suprapubic pain.
Choice B: "Are you feeling relief from your pelvic pressure?" is incorrect because the hands-and-knees position is more effective for addressing back pain, not pelvic pressure.
Choice C: "Do your contractions feel further apart?" is incorrect as the position change is unlikely to affect the timing of contractions significantly.
In summary, the correct question (Choice D) directly addresses the main issue associated with occipitoposterior