A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include?
- A. You should use an oil based vaginal lubricant when inserting your diaphragm
- B. You should store your diaphragm in sterile water after each use
- C. You should keep the diaphragm in place for at least 4 hours after intercourse
- D. You should have your provider refit you for a new diaphragm
Correct Answer: D
Rationale: The correct answer is D: You should have your provider refit you for a new diaphragm. This is important because postpartum changes, such as weight gain or loss, can affect the fit of the diaphragm. A proper fit is crucial for effective contraception. Storing the diaphragm in sterile water (B) is incorrect as it can damage the device. Using oil-based lubricants (A) is not recommended as they can weaken the diaphragm. Keeping the diaphragm in place for 4 hours after intercourse (C) is unnecessary and may increase the risk of infection.
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A nurse is using Niagele9s rule to calculate the expected delivery date of a client who reports the first day of the last menstrual cycle was July 28th. Which of the following dates should the nurse document as a client expected delivery date? 07/28
- A. April 21st
- B. April 4th
- C. May 5th
- D. May 21st
Correct Answer: C
Rationale: The correct answer is C: May 5th. To calculate the expected delivery date using Naegele's rule, add 7 days to the first day of the last menstrual period (July 28th), then subtract 3 months, and add 1 year. July 28th + 7 days = August 4th. Subtract 3 months = May 4th. Add 1 year = May 5th. Choice A is incorrect as it is too early. Choice B is incorrect as it is also too early. Choice D is incorrect as it is too late.
A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include?
- A. Expect 2 to 4 wet diapers every 24 hours
- B. Allow the baby to feed at least every 3 hours
- C. Offer the newborn 30 ml (1 oz.) a water between feedings
- D. Feed the newborn 5 to 10 minutes per breast
Correct Answer: B
Rationale: Correct Answer: B - Allow the baby to feed at least every 3 hours.
Rationale:
1. Breastfeeding frequency is crucial for establishing a good milk supply and ensuring the baby receives adequate nutrition.
2. Newborns typically need to breastfeed at least 8-12 times in 24 hours to meet their nutritional needs.
3. Feeding every 3 hours helps maintain the baby's hydration, energy levels, and growth.
4. Regular feeding also helps prevent issues like engorgement for the mother and ensures the baby gets enough hindmilk for proper growth.
Summary of Incorrect Choices:
A: Wet diapers may vary, but newborns should ideally have 8-12 wet diapers a day.
C: Offering water between feedings is unnecessary and may fill up the baby's stomach, reducing milk intake.
D: Limiting feeding time per breast may not allow the baby to get enough hindmilk, essential for growth and development.
A nurse is assessing a full-term newborn arm admission to the nursery. Which of the following clinical findings should the nurse report to the provider?
- A. Transient circumoral cyanosis - i think this is referring to acrocyanosis which is normal
- B. Single Palmar creases - down syndrome - p.27
- C. Subconjunctival hemorrhage - expected
- D. Rust stain urine - expected
Correct Answer: B
Rationale: The correct answer is B: Single Palmar creases - down syndrome. This finding should be reported to the provider because it is a physical characteristic associated with Down syndrome. The presence of a single palmar crease can indicate a chromosomal abnormality and requires further evaluation.
A: Transient circumoral cyanosis is a common finding in newborns and is typically related to acrocyanosis, which is considered normal in the immediate postnatal period.
C: Subconjunctival hemorrhage is a common occurrence during the birth process and is often benign, resolving on its own without intervention.
D: Rust stain urine may be a result of uric acid crystals and is considered expected in newborns due to the metabolism of fetal hemoglobin. It does not typically require immediate reporting to the provider.
In summary, the other choices are considered normal or expected in newborns, while the presence of a single palmar crease requires further assessment due to its association with Down syndrome.
A nurse is reviewing the laboratory results of a newborn. Which of the following findings should the nurse report to the provider?
- A. Blood glucose 58 mg / DL
- B. Hematocrit 48%
- C. Platelets 100,000/ mm 3
- D. Hemoglobin 16 G / DL
Correct Answer: C
Rationale: The correct answer is C: Platelets 100,000/mm3. This finding is abnormal in a newborn and could indicate a potential bleeding disorder or thrombocytopenia, which requires immediate attention from the provider to assess and manage appropriately. Choice A (Blood glucose 58 mg/dL) is within normal range for a newborn. Choice B (Hematocrit 48%) and D (Hemoglobin 16 g/dL) are also within normal limits for a newborn and do not require immediate reporting.
A client who is 16 weeks of gestation asks the nurse how to prepare her father to a younger sibling. Statements should the nurse make?
- A. You should hold your newborn in your arms when you introduce him to your toddler
- B. You should give your toddler a gift from the baby when she visits
- C. You should move your toddler out of her crib 2 weeks prior to your due date
- D. You should place your toddler in timeout if she exhibits regressive Behavior after the baby is born
Correct Answer: B
Rationale: Correct Answer: B - You should give your toddler a gift from the baby when she visits.
Rationale: Giving a gift from the baby to the toddler helps create a positive association and bond between the siblings from the beginning. It can also help the toddler feel special and included in the new family dynamic. This gesture can promote a sense of love and acceptance, easing the transition for both the toddler and the newborn.
Incorrect Choices:
A: Holding the newborn when introducing to the toddler may cause the toddler to feel overwhelmed or jealous.
C: Moving the toddler out of her crib close to the due date may disrupt her routine and lead to feelings of insecurity.
D: Placing the toddler in timeout for regressive behavior can create negative associations with the new sibling and cause emotional distress.