Nokea
A nurse is providing nutritional guidance to a client who is pregnant and follows a vegan diet. The client asks the nurse which foods she should eat to ensure adequate calcium intake. The nurse should instruct the client that which of the following foods has the highest amount of calcium?
- A. ½ cup cubed avocado
- B. 1 large banana
- C. 1 medium potato
- D. 1 cup cooked broccoli
Correct Answer: D
Rationale: The correct answer is D: 1 cup cooked broccoli. Broccoli is a good source of calcium, with approximately 43 mg per cup. This is important for pregnant women, especially those following a vegan diet, as they need to ensure adequate calcium intake for fetal development and bone health. Avocado (choice A), banana (choice B), and potato (choice C) are not significant sources of calcium compared to broccoli. Avocado and banana are low in calcium, while potatoes have even less. Thus, broccoli is the best option for the client to meet her calcium needs.
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A nurse is assessing a client during her first prenatal visit. The client reports March 20th as her last menstrual period. Use Nagele's rule to calculate the estimated date of delivery.
- A. 03/20
- B. 12/27
- C. 11/27
- D. 10/03
Correct Answer: B
Rationale: The correct answer is B: 12/27. Nagele's rule calculates the estimated due date by adding 7 days to the first day of the last menstrual period, then subtracting 3 months and adding 1 year. In this case, March 20th + 7 days = March 27th. Subtracting 3 months gives us December 27th. Adding 1 year, we get December 27th of the current year as the estimated due date. Choice A is incorrect because it does not follow Nagele's rule. Choice C is incorrect as it is not 3 months subtracted from the reported last menstrual period. Choice D is incorrect as it does not account for the necessary adjustments according to Nagele's rule.
A nurse is assessing a newborn whose mother had a primary cytomegalovirus (CMV) infection during pregnancy. The newborn acquired CMV transplacentally. Which of the following findings should the nurse expect the newborn to exhibit?
- A. Urinary tract infection
- B. Hearing loss
- C. Macrosomia
- D. Cataracts
Correct Answer: B
Rationale: The correct answer is B: Hearing loss. CMV infection during pregnancy can lead to congenital CMV in newborns, resulting in various complications. Hearing loss is a common manifestation of congenital CMV infection. The virus can damage the inner ear structures, leading to sensorineural hearing loss. This complication is crucial to monitor and address early to prevent long-term consequences.
Incorrect choices:
A: Urinary tract infection - Not typically associated with congenital CMV infection.
C: Macrosomia - Excessive birth weight, not a common manifestation of congenital CMV infection.
D: Cataracts - Uncommon in congenital CMV infection; typically associated with other congenital infections like rubella.
A nurse is caring for a client following a vaginal delivery of a term fetal demise. Which of the following statement should the nurse make?
- A. “You can bathe and dress your baby if you’d like to.”
- B. “If you don’t hold the baby, it will make letting go much harder.”
- C. “You should name the baby so she can have an identity.”
- D. “I’m sure you will be able to have another baby when you’re ready.”
Correct Answer: A
Rationale: The correct answer is A, as it encourages the client to make decisions based on their preferences. By stating, "You can bathe and dress your baby if you’d like to," the nurse offers support and control to the client during a difficult time. This empowers the client to engage in meaningful rituals and take control of the situation.
Choice B is incorrect because it imposes guilt on the client by suggesting that not holding the baby will make letting go harder, which may not be the case for everyone. Choice C is incorrect as naming the baby should be a personal decision and not a directive from the nurse. Choice D is incorrect because it assumes the client's readiness for another baby, which may not be the case and can be insensitive.
A nurse is assessing a newborn upon admission to the nursery. Which of the following should the nurse expect?
- A. Bulging Fontanels
- B. Nasal Flaring
- C. Length from head to heel of 40 cm (15.7 in)
- D. Chest circumference 2 cm (0.8 in) smaller than the head circumference
Correct Answer: D
Rationale: The correct answer is D because a chest circumference smaller than the head circumference is a normal finding in a newborn due to the larger head size compared to the chest. This is known as head sparing and is essential for brain development. Bulging fontanels (choice A) are abnormal and may indicate increased intracranial pressure. Nasal flaring (choice B) is a sign of respiratory distress. A length of 40 cm (choice C) is within the average range but not a specific expectation upon admission. Therefore, choice D is the most appropriate expectation for a newborn assessment.
A nurse is planning care immediately following birth for a newborn who has myelomeningocele that is leaking cerebrospinal fluid.
- A. Administer broad-spectrum antibiotics
- B. Cleans the site with povidone-iodine
- C. Monitor the rectal temperature every 4 hours
- D. Prepare for surgical closure after 72 hours
Correct Answer: A
Rationale: The correct answer is A. Administering broad-spectrum antibiotics is crucial to prevent infection since the exposed spinal cord increases the risk. Antibiotics help reduce the risk of meningitis and sepsis. Choice B is incorrect as povidone-iodine can be irritating to the sensitive skin around the defect. Choice C is incorrect as monitoring rectal temperature is not directly related to the immediate care needed for a myelomeningocele. Choice D is incorrect because surgical closure should be done as soon as possible to prevent further complications.