Nokea
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: Correct Answer: C - The car seat should be positioned in the car at a 45-degree angle.
Rationale: Placing the car seat at a 45-degree angle helps protect a newborn's airway and prevents slumping, ensuring optimal safety during travel. This position aligns the baby's head with the neck and spine, reducing the risk of suffocation and injury in the event of sudden stops or accidents. A 45-degree angle also supports proper breathing and oxygenation for the newborn. Therefore, this statement indicates the parent understands the importance of correctly positioning the car seat for their baby's safety.
Summary of Incorrect Choices:
A: Incorrect - Using a sleep sack in the car seat can lead to overheating and compromise the baby's safety by interfering with the car seat's harness system.
B: Incorrect - A car seat challenge test is typically done for premature infants, not a newborn delivered at 38 weeks of gestation.
D: Incorrect - Turning a baby's car seat forward-facing
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A nurse is assessing a client who is 6 hr postpartum and has endometritis. Which of the following findings should the nurse expect?
- A. Temperature 37.4°C (99.3°F)
- B. WBC count 9,000/mm3
- C. Uterine tenderness
- D. Scant lochia
Correct Answer: C
Rationale: The correct answer is C: Uterine tenderness. Endometritis is an infection of the uterine lining that can occur postpartum. Uterine tenderness is a common finding in clients with endometritis due to inflammation and infection. A: A temperature of 37.4°C (99.3°F) is within normal range and may not specifically indicate endometritis. B: A WBC count of 9,000/mm3 is also within normal limits and may not be specific to endometritis. D: Scant lochia may be seen in clients with endometritis, but it is not a defining characteristic.
A nurse is preparing to perform Leopold maneuvers on a client who is at 36 weeks of gestation. Identify the sequence of actions the nurse should take.
- A. Instruct the client to empty their bladder.
- B. Position the client supine with knees flexed and place a small, rolled towel under one of their hips.
- C. Palpate the fetal part positioned in the fundus.
- D. Palpate the fetal parts along both sides of the uterus.
Correct Answer: A, B, C, D
Rationale: The correct order for performing Leopold maneuvers on a client at 36 weeks gestation is A, B, C, D. Firstly, instructing the client to empty their bladder (A) allows for better visualization and palpation of the fetus. Secondly, positioning the client supine with knees flexed and placing a small, rolled towel under one hip (B) helps relax the abdominal muscles and provides easier access to the uterus. Next, palpating the fetal part positioned in the fundus (C) helps determine the fetal presentation and position. Finally, palpating the fetal parts along both sides of the uterus (D) allows for further assessment of the fetal position and presentation. Choices E, F, and G are incorrect as they do not align with the sequential steps required for conducting Leopold maneuvers effectively.
A nurse is assessing a full-term newborn upon admission to the nursery. Which of the following clinical findings should the nurse report to the provider?
- A. Single palmar creases (p200
- B. Down Syndrome)
- C. Rust-stained urine
- D. Transient circumoral cyanosis
- E. Subconjunctival hemorrhage
Correct Answer: A
Rationale: The correct answer is A: Single palmar creases. This finding could indicate potential chromosomal abnormalities like Down Syndrome. It is crucial to report this to the provider for further evaluation and appropriate management. Rust-stained urine (C), transient circumoral cyanosis (D), and subconjunctival hemorrhage (E) are common findings in newborns and usually resolve spontaneously without causing harm. Reporting these would not be necessary unless they persist or worsen.
A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect?
- A. Telangiectatic nevi
- B. Facial petechiae
- C. Periauricular papillomas
- D. Erythema toxicum
Correct Answer: B
Rationale: The correct answer is B: Facial petechiae. When a newborn is delivered with a nuchal cord (around the neck), it can cause pressure on the baby's face during delivery, leading to tiny broken blood vessels called petechiae. This is a common finding in newborns with nuchal cords due to the pressure exerted on the face. Telangiectatic nevi (A), periauricular papillomas (C), and erythema toxicum (D) are not typically associated with nuchal cords. Petechiae is the most likely finding in this scenario.
Select the 3 findings that require immediate follow-up.
- A. Lateral deviation of the uterus
- B. Deep tendon reflexes 1+
- C. Pain rating of 3 on a scale of 0 to 10 (increased)
- D. Peripheral edema 2+ bilateral lower extremities
- E. Uterine tone soft
- F. Large amount of lochia rubra
- G. Blood pressure 136/86 mm Hg
Correct Answer: A,B,C
Rationale: The correct choices for immediate follow-up are A, B, and C. A lateral deviation of the uterus could indicate a possible complication like uterine atony or retained products of conception. Deep tendon reflexes of 1+ could suggest hyporeflexia or neurological issues. A pain rating of 3 on a scale of 0 to 10, especially if it has increased, may indicate worsening pain or a new issue. Choices D, E, F, and G do not present immediate concerns that require urgent follow-up compared to choices A, B, and C. Peripheral edema 2+ in bilateral lower extremities, soft uterine tone, large amount of lochia rubra, and a blood pressure of 136/86 mm Hg are important findings but do not necessitate immediate intervention or follow-up.