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A nurse is teaching about car seat safety to the parents of a newborn who was delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching?
- A. I can use a sleep sack to keep my baby warm in the car seat.'
- B. My baby will need a car seat challenge test before discharge.'
- C. The car seat should be positioned in the car at a 45-degree angle.'
- D. When my baby is 1 year old, I can turn their car seat facing forward.'
Correct Answer: C
Rationale: The correct answer is C: The car seat should be positioned in the car at a 45-degree angle. This statement demonstrates understanding because newborns who were born at 38 weeks of gestation may have poor muscle tone and need their car seat reclined at a 45-degree angle to keep their airway open. This position helps prevent the baby's head from falling forward and potentially obstructing their breathing.
Choice A is incorrect because using a sleep sack in a car seat can interfere with the proper fit and function of the harness system. Choice B is incorrect because a car seat challenge test is typically done for preterm infants to assess their ability to sit safely in a car seat, not for full-term newborns. Choice D is incorrect because current guidelines recommend keeping infants in a rear-facing car seat until at least 2 years of age, not turning it forward-facing at 1 year old.
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A nurse is transporting a newborn back to the parent's room following a procedure. Which of the following actions should the nurse take prior to leaving the newborn with their parent?
- A. Ensure that the parent's identification band number matches the newborn's identification band number.
- B. Ask the parent to verify their name and date of birth.
- C. Check the newborn's security tag number to ensure it matches the newborn's medical record.
- D. Match the newborn's date and time of birth to the information in the parent's medical record.
Correct Answer: A
Rationale: The correct answer is A: Ensure that the parent's identification band number matches the newborn's identification band number. This is crucial for patient safety and identification to prevent mix-ups. Matching the identification band numbers ensures that the newborn is returned to the correct parent. Checking the parent's identification ensures that the parent is indeed the one authorized to receive the newborn. Choices B, C, and D do not directly address the vital step of verifying the parent-newborn match through identification band numbers, making them incorrect.
A nurse is reviewing the prescriptions for a client who is pregnant and is taking digoxin. Which of the following actions should the nurse take to best evaluate the client’s medication adherence?
- A. Ask the client if they are taking the medication as prescribed.
- B. Assess the client’s kidney function.
- C. Determine the client’s apical pulse rate.
- D. Check the client’s serum medication level.
Correct Answer: D
Rationale: The correct answer is D: Check the client's serum medication level. This is the best way to evaluate medication adherence for a client taking digoxin. Digoxin has a narrow therapeutic range, so checking the serum level helps determine if the client is taking the medication as prescribed. If the level is within the therapeutic range, it indicates adherence. Asking the client if they are taking the medication (A) relies on self-reporting, which may not be accurate. Assessing kidney function (B) and determining apical pulse rate (C) are important for monitoring digoxin therapy but do not directly assess medication adherence. Checking the serum medication level provides objective data to confirm adherence.
A nurse is providing teaching about increasing dietary fiber to an antepartum client who reports constipation. Which of the following food selections has the highest fiber content per cup?
- A. Oatmeal
- B. Cabbage
- C. Asparagus
- D. Lentils
Correct Answer: D
Rationale: The correct answer is D, Lentils. Lentils have the highest fiber content per cup compared to the other options. Lentils provide approximately 15.6 grams of fiber per cup, making them an excellent choice to alleviate constipation. Oatmeal, while a good source of fiber, typically contains around 4 grams per cup. Cabbage and asparagus have lower fiber content compared to lentils. In summary, lentils are the best choice for increasing dietary fiber due to their high fiber content per cup, which can effectively help relieve constipation in the antepartum client.
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 potential inability of the uterus to contract effectively, increasing the risk of postpartum hemorrhage.
B: Newborn weight and history of human papillomavirus are not directly related to postpartum hemorrhage.
A nurse is collecting data from a client who is at 30 weeks of gestation. Which of the following findings should the nurse identify as a manifestation of pyelonephritis?
- A. Epigastric discomfort
- B. Flank pain
- C. Temperature 37.7°C (99.8°F)
- D. Abdominal cramping
Correct Answer: B
Rationale: The correct answer is B: Flank pain. Pyelonephritis is an infection of the kidneys commonly characterized by flank pain. At 30 weeks of gestation, the uterus enlarges and can lead to obstruction of the ureters, increasing the risk of urinary stasis and infection. Epigastric discomfort (choice A) is more indicative of issues like preeclampsia. Temperature elevation (choice C) can be a sign of infection but is not specific to pyelonephritis. Abdominal cramping (choice D) is more likely related to uterine contractions or gastrointestinal issues.