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A nurse is providing prenatal teaching to a client who practices a vegan diet and is trying to increase intake of vitamin B12. Which of the following foods should the nurse recommend?
- A. Fortified soy milk
- B. Raw carrots
- C. Fresh citrus fruits
- D. Brown rice
Correct Answer: A
Rationale: The correct answer is A: Fortified soy milk. Vegans often have difficulty obtaining enough vitamin B12, which is primarily found in animal products. Fortified soy milk is a good source of vitamin B12 for vegans. Raw carrots (B), fresh citrus fruits (C), and brown rice (D) do not contain significant amounts of vitamin B12. Raw carrots and fresh citrus fruits are good sources of vitamin C, while brown rice is a source of carbohydrates and fiber.
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Which of the following actions should the nurse plan to implement? For each potential nursing action, click to specify if the intervention is indicated or contraindicated for the newborn.
- A. Educate the parents to begin range of motion exercises on the affected arm after 1 week.
- B. Assess for grasp reflex in the affected extremity.
- C. Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt.
- D. Instruct parents to limit physical handling for 2 weeks.
Correct Answer:
Rationale: Educate the parents to begin range of motion exercises on the affected arm after 1 week is indicated. Passive ROM exercises of the arm are indicated to restore function of the extremity. The initiation of these exercises is delayed for approximately 1 week to prevent additional injury to the brachial plexus. Assess for grasp reflex in the affected extremity is indicated. With Erb-Duchenne paralysis, only the upper arm is affected. The function of the wrists and fingers should be unaffected; the nurse should assess for a palmar grasp reflex.Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt is indicated. Intermittent immobilization of the affected arm across the newborn's abdomen can be achieved by pinning the sleeve to the shirt.Instruct parents to limit physical handling for 2 weeks is contraindicated. Parents and guardians should participate in the physical care of their newborn to increase parental-infant attachment. Providing education and practice opportunities for the parents will decrease their fears of injuring the newborn and increase confidence and bonding.
Which of the following tests is used to assess fetal lung maturity?
- A. Non-stress test
- B. Biophysical profile
- C. Amniocentesis
- D. Lecithin-sphingomyelin (L/S) ratio
Correct Answer: D
Rationale: The correct answer is D: Lecithin-sphingomyelin (L/S) ratio. This test is used to assess fetal lung maturity by measuring the ratio of two substances found in the amniotic fluid. An L/S ratio greater than 2:1 is indicative of mature fetal lungs. This test is crucial in determining if a baby can breathe adequately after birth. The other choices are incorrect because: A) Non-stress test monitors fetal heart rate and movements, B) Biophysical profile assesses fetal well-being, and C) Amniocentesis is a procedure to collect amniotic fluid for genetic testing.
Which of the following is a potential complication of a forceps-assisted delivery?
- A. Shoulder dystocia
- B. Hemorrhage
- C. Birth trauma
- D. All of the above
Correct Answer: C
Rationale: The correct answer is C: Birth trauma. Forceps-assisted delivery can result in birth trauma due to the application of forceps on the baby's head, leading to injuries such as facial bruising or lacerations. Shoulder dystocia (choice A) is a complication during natural delivery, not specific to forceps. Hemorrhage (choice B) can occur post-delivery and is not directly related to forceps. Choice D is incorrect as not all complications listed are directly associated with forceps-assisted delivery.
A nurse is caring for a client who is 12 hr postpartum and has a third-degree perineal laceration. The client reports not having a bowel movement for 4 days. Which of the following medications should the nurse administer?
- A. Bisacodyl 10 mg rectal suppository
- B. Magnesium hydroxide 30 mL PO
- C. Famotidine 20 mg PO
- D. Loperamide 4 mg PO
Correct Answer: A
Rationale: A rectal suppository like bisacodyl is appropriate for relieving constipation in a postpartum client with a perineal laceration, as it avoids straining. Loperamide is an antidiarrheal and not indicated here.
Which of the following is a potential ethical issue related to maternal request for cesarean delivery?
- A. Autonomy versus beneficence
- B. Allocation of resources
- C. Informed consent
- D. All of the above
Correct Answer: A
Rationale: The ethical issue of autonomy versus beneficence arises when a mother's request for a cesarean delivery conflicts with medical recommendations. Respecting patient autonomy while ensuring beneficence (doing what is best for the patient) can create ethical dilemmas.