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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.
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A nurse is caring for a client who has preterm labor and receiving magnesium sulfate by continuous IV infusion. Which of the following laboratory values should the nurse review during tocolytic therapy?
- A. Indirect Coombs test
- B. Liver enzymes
- C. Uric acid level
- D. Serum medication level
Correct Answer: D
Rationale: The correct answer is D: Serum medication level. The nurse should review this value during tocolytic therapy with magnesium sulfate because it is crucial to monitor the therapeutic range of magnesium to prevent toxicity. Monitoring serum levels helps ensure the medication is effective yet safe for the client and the baby.
A: Indirect Coombs test is used to detect antibodies on the surface of red blood cells, not relevant in this scenario.
B: Liver enzymes may be affected by magnesium sulfate but are not directly related to monitoring the medication's therapeutic effect.
C: Uric acid level is not typically monitored during tocolytic therapy with magnesium sulfate.
E, F, G: Irrelevant options.
A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client which of the following vaccinations? Select all the apply
- A. Varicella
- B. human papillomavirus
- C. Diphtheria - acellular pertussis
- D. inactivated influenza
- E. measles, mumps, and rubella
Correct Answer: C,D
Rationale: The correct answers are C (Diphtheria - acellular pertussis) and D (inactivated influenza) for a client at 30 weeks gestation. These vaccines are safe during pregnancy and provide protection to both the mother and the developing fetus. Diphtheria and pertussis can cause severe complications for newborns, so vaccinating the mother during pregnancy helps pass on immunity. Influenza vaccination is recommended to reduce the risk of severe illness in pregnant women and their babies. Choices A, B, and E are contraindicated during pregnancy due to potential harm to the fetus.
A nurse is providing teaching to the parents of a newborn about the plastibell circumcision technique. Which of the following? - p170-171 - postprocedure bottom of 170 and goes into top of 171.
- A. The plastibell will be removed 4 hours after the procedure
- B. Notify the provider is the end of your penis appears dark red
- C. Make sure the newborn's diaper is snug
- D. Yellow exudate will form at the surgical site in 24 hours
Correct Answer: D
Rationale: The correct answer is D. Yellow exudate forming at the surgical site in 24 hours is expected after plastibell circumcision due to the healing process. This exudate consists of dead cells and is a normal part of wound healing. It is important for the parents to be aware of this so they do not mistake it for an infection or abnormality.
Explanation for other choices:
A: The plastibell is not removed after 4 hours; it falls off on its own in about 5-10 days.
B: Dark red appearance at the end of the penis could indicate a potential issue, but immediate notification of the provider is not necessary.
C: Ensuring the newborn's diaper is snug is unrelated to the circumcision technique.
E, F, G: No information provided.
A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions Should the nurse include in the plan of care?
- A. Use a fetal scalp electrode during labor and delivery
- B. Bathe the newborn before initiating skin to skin contact
- C. Instruct the client to stop taking the antiretroviral medication at 32 weeks of gestation
- D. Administer pneumococcal immunization to the newborn within 4 hours following birth
Correct Answer: B
Rationale: The correct answer is B: Bathe the newborn before initiating skin to skin contact. This action is crucial to reduce the risk of HIV transmission from the mother to the newborn. By bathing the newborn before skin-to-skin contact, the nurse can remove any potential HIV-infected fluids from the baby's skin, reducing the risk of transmission. This step helps to protect the newborn while still allowing for important bonding through skin-to-skin contact after bathing.
Choice A is incorrect as the use of a fetal scalp electrode during labor and delivery is unrelated to preventing HIV transmission from mother to newborn. Choice C is incorrect as stopping antiretroviral medication can significantly increase the risk of HIV transmission to the newborn. Choice D is incorrect as administering pneumococcal immunization is important but not within 4 hours following birth in the context of preventing HIV transmission.
A nurse is providing discharge teaching to a postpartum client about caring for her five-year 5day old male newborn at home. Which of the following statements should the nurse make to the client?
- A. Retract the foreskin to clean your baby's penis during each bath
- B. Use triple antibiotic ointment on your baby's umbilical cord twice per day
- C. Swaddle your baby tightly with legs extended before laying him down to sleep
- D. Notify your baby's pediatrician if he urinates less than 6 times per day
Correct Answer: D
Rationale: The correct answer is D: Notify your baby's pediatrician if he urinates less than 6 times per day. This is important as decreased urine output can indicate dehydration in a newborn, which is a serious concern. It is crucial to monitor the baby's hydration status closely in the early days of life.
A: Retracting the foreskin to clean the baby's penis is not recommended as it can cause harm and is not necessary at this age.
B: Using triple antibiotic ointment on the umbilical cord is not recommended as it can delay the natural healing process.
C: Swaddling the baby tightly with legs extended is not recommended as it can increase the risk of hip dysplasia.
In summary, the other choices are incorrect because they may cause harm or are not recommended practices for caring for a newborn.