Nokea
A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect?
- A. Telangiectatic nevi
- B. Facial petechiae
- C. Periauricular papillomas
- D. Erythema toxicum
Correct Answer: B
Rationale: The correct answer is B: Facial petechiae. A nuchal cord is when the umbilical cord is wrapped around the baby's neck at birth. This can cause pressure on the baby's face, leading to small red or purple spots called petechiae. This is due to burst blood vessels from the pressure. Telangiectatic nevi (choice A) are unrelated birthmarks. Periauricular papillomas (choice C) are benign skin growths that are not associated with nuchal cords. Erythema toxicum (choice D) is a common benign rash in newborns, not specifically linked to nuchal cords.
You may also like to solve these questions
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing. 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
- A. Place newborn skin to skin on birthing parents chest, Encourage birthing parents to breastfeed, Obtain prescription for arterial blood gases, Plan to initiate phototherapy, Perform neonatal abstinence system scoring
- B. Cold stress, Acute bilirubin encephalopathy, Respiratory distress syndrome, Neonatal abstinence syndrome (NAS)
- C. Stool output, Temperature, Lung sounds, Blood glucose level, Bilirubin level
Correct Answer:
Rationale: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, E.
Rationale:
The correct actions to take are to place newborn skin to skin on birthing parent's chest and encourage breastfeeding, as these promote bonding and breastfeeding, crucial for newborn well-being. The potential condition the client is most likely experiencing is Cold stress, indicated by the need for phototherapy. The parameters to monitor are Temperature (to track for hypothermia due to cold stress) and Bilirubin level (to assess for jaundice, common in newborns with cold stress).
Which of the following is a potential cause of female infertility?
- A. Polycystic ovary syndrome (PCOS)
- B. Endometriosis
- C. Pelvic inflammatory disease (PID)
- D. All of the above
Correct Answer: D
Rationale: PCOS endometriosis and PID are all common causes of female infertility. These conditions can disrupt normal reproductive function making conception difficult.
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.
Which of the following is a potential complication of a postpartum hemorrhage?
- A. Hypertension
- B. Anemia
- C. Thrombocytopenia
- D. All of the above
Correct Answer: B
Rationale: The correct answer is B: Anemia. Postpartum hemorrhage can lead to excessive blood loss, causing a drop in red blood cell count and hemoglobin levels, resulting in anemia. Hypertension is not a typical complication of postpartum hemorrhage, as it is more commonly associated with conditions like preeclampsia. Thrombocytopenia, a low platelet count, may occur in severe cases of postpartum hemorrhage but is not a common complication compared to anemia. Choice D, "All of the above," is incorrect as only anemia is a direct potential complication of postpartum hemorrhage.
A nurse is teaching a client who is at 35 weeks of gestation about manifestations of potential pregnancy complications to report to the provider. Which of the following manifestations should the nurse include?
- A. Shortness of breath when climbing stairs
- B. Swelling of feet and ankles at the end of the day.
- C. Headache that is unrelieved by analgesia
- D. Braxton Hicks contractions
Correct Answer: C
Rationale: A headache unrelieved by analgesia may indicate preeclampsia, a serious pregnancy complication requiring immediate medical attention.