Nokea
A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include?
- A. Feed the newborn 5 to 10 min per breast.
- B. Offer the newborn 30 mL (1 oz) of water between feedings.
- C. Expect two to four wet diapers every 24 hr.
- D. Allow the baby to feed at least every 3 hr.
Correct Answer: D
Rationale: The correct answer is D: Allow the baby to feed at least every 3 hr. Breastfeeding newborns frequently helps establish milk supply and ensures the baby receives enough nutrients. Waiting longer than 3 hours between feeds may lead to issues like dehydration or poor weight gain. Choice A is too time-specific and may not allow the baby to feed adequately. Choice B is incorrect as newborns should only be fed breastmilk, not water. Choice C is too vague and may not reflect adequate feeding.
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A nurse is providing teaching about immunizations to a client who is pregnant. Which of the following statements should the nurse include in the teaching?
- A. The immunization for varicella should be given at least 1 month prior to delivery.
- B. You can receive the rubella immunization during the third trimester of pregnancy.
- C. The hepatitis B immunization should not be obtained until after you finish breastfeeding.
- D. You can receive the immunization for influenza at any time during your pregnancy.
Correct Answer: D
Rationale: The influenza vaccine is safe and recommended during any trimester of pregnancy to protect both the mother and the baby.
A nurse is caring for a client who is 1 hr postpartum and has uterine atony. The client is exhibiting a large amount of vaginal bleeding. Which of the following actions should the nurse take?
- A. Administer betamethasone IM.
- B. Avoid performing sterile vaginal examinations.
- C. Anticipate a prescription for misoprostol.
- D. Obtain a specimen for a Kleihauer-Betke test.
Correct Answer: C
Rationale: The correct answer is C: Anticipate a prescription for misoprostol. Misoprostol is a medication used to help contract the uterus and control postpartum hemorrhage caused by uterine atony. It helps stimulate uterine contractions and reduce bleeding. Administering betamethasone (choice A) is not indicated for uterine atony and postpartum hemorrhage. Avoiding sterile vaginal examinations (choice B) does not address the underlying issue of uterine atony. Obtaining a specimen for a Kleihauer-Betke test (choice D) is used to assess the amount of fetal-maternal hemorrhage and is not an immediate intervention for uterine atony.
A nurse in a provider’s office is caring for a 20-year-old client who is at 12 weeks of gestation and requests an amniocentesis to determine the sex of the fetus. Which of the following responses should the nurse make?
- A. You cannot have an amniocentesis until you are at least 35 years of age.
- B. This procedure determines if your baby has genetic or congenital disorders.
- C. Your provider will schedule a chorionic villus sampling to determine the sex of your baby.
- D. We can schedule the procedure for later today if you’d like.
Correct Answer: B
Rationale: The correct response is B: This procedure determines if your baby has genetic or congenital disorders. Amniocentesis is a diagnostic test that involves taking a sample of the amniotic fluid, which can be analyzed for genetic abnormalities like Down syndrome. It is typically performed between 15-20 weeks of gestation, not based on maternal age. Choice A is incorrect as there is no age requirement for amniocentesis. Choice C is incorrect as chorionic villus sampling is a different procedure used for genetic testing earlier in pregnancy. Choice D is incorrect as amniocentesis is a planned procedure that requires preparation and scheduling, not something to be done on the same day.
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 teaching about home safety with a client who is 2 days postpartum. Which of the following instructions should the nurse include in the teaching?
- A. Bathe your baby immediately after a feeding.
- B. Place a bumper pad in your baby’s crib.
- C. Put a soft mattress in your baby’s crib.
- D. Wash your baby’s face with plain water.
Correct Answer: D
Rationale: The correct answer is D: Wash your baby’s face with plain water. This instruction is important as newborns have sensitive skin that can easily become irritated by harsh chemicals found in soaps. Washing the baby's face with plain water helps to keep their skin clean without causing any harm.
A: Bathing the baby immediately after a feeding can lead to discomfort and potential regurgitation.
B: Placing a bumper pad in the crib can increase the risk of suffocation or Sudden Infant Death Syndrome (SIDS).
C: Putting a soft mattress in the crib increases the risk of suffocation and poses a potential hazard to the baby's safety.
In summary, choosing option D ensures the safety and well-being of the newborn by providing gentle care for their delicate skin without introducing unnecessary risks or hazards.