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A nurse is preparing to administer an IM injection to a newborn. Which of the following sites should the nurse select?
- A. Vastus lateralis
- B. Dorsogluteal
- C. Deltoid
- D. Rectus femoris
Correct Answer: A
Rationale: The correct answer is A: Vastus lateralis. For newborns, the vastus lateralis muscle is the preferred site for intramuscular injections due to its larger muscle mass and reduced risk of injury to nerves and blood vessels. It is located on the thigh, making it easily accessible and safe for administration. The deltoid muscle (choice C) is not recommended for newborns due to insufficient muscle mass. The dorsogluteal site (choice B) is not recommended for infants due to the proximity to the sciatic nerve. The rectus femoris (choice D) is not typically used for IM injections in newborns.
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A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)
- A. Labor induction with oxytocin
- B. Newborn weight 2.948 kg (6 lb 8 oz)
- C. Vacuum-assisted delivery
- D. History of uterine atony
- E. History of human papillomavirus
Correct Answer: A,C,D
Rationale: The correct answers are A, C, and D.
A: Labor induction with oxytocin can lead to uterine hyperstimulation, increasing the risk of postpartum hemorrhage.
C: Vacuum-assisted delivery can cause trauma to the birth canal, leading to increased bleeding.
D: History of uterine atony indicates a weak uterine muscle tone, which can result in excessive bleeding after delivery.
B: Newborn weight is not directly related to postpartum hemorrhage risk.
E: History of human papillomavirus does not increase the risk of postpartum hemorrhage.
Which hormone is responsible for triggering milk ejection during breastfeeding?
- A. Progesterone
- B. Estrogen
- C. Prolactin
- D. Oxytocin
Correct Answer: D
Rationale: The correct answer is D: Oxytocin. Oxytocin is responsible for triggering milk ejection during breastfeeding by causing the contraction of muscles around the milk-producing cells, facilitating the release of milk. Progesterone and estrogen are involved in preparing the body for pregnancy and maintaining the uterine lining, not milk ejection. Prolactin stimulates milk production but not milk ejection directly. Therefore, the correct choice is oxytocin as it specifically triggers the release of milk during breastfeeding.
What is the recommended method of pain relief during labor for a woman who desires regional anesthesia?
- A. Epidural block
- B. Spinal block
- C. Combined spinal-epidural block
- D. All of the above
Correct Answer: D
Rationale: Regional anesthesia options include epidural, spinal, and combined spinal-epidural blocks.
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:
Which of the following is a potential complication of a retained placenta?
- A. Preeclampsia
- B. Postpartum hemorrhage
- C. Gestational diabetes
- D. All of the above
Correct Answer: B
Rationale: The correct answer is B: Postpartum hemorrhage. A retained placenta can lead to postpartum hemorrhage due to incomplete delivery of the placenta, causing excessive bleeding. Preeclampsia and gestational diabetes are not directly related to a retained placenta. Therefore, the correct answer is B.