Nokea
A nurse provided discharge teaching to new parents on how to care for their newborn following circumcision. Which of the following statements by the parents indicates the need for further clarification?
- A. I should not remove the yellow exudate on the end of the penis.
- B. I will clean his penis with each diaper change.
- C. The circumcision will heal completely within a couple of weeks.
- D. I can give him a tub bath in two days.
Correct Answer: D
Rationale: The correct answer is D. Giving the newborn a tub bath in two days after circumcision could increase the risk of infection as the circumcision wound needs time to heal. A sponge bath is recommended until the wound is completely healed. Choice A is correct because yellow exudate is normal during the healing process. Choice B is correct as keeping the area clean is important. Choice C is correct as circumcision typically heals within a couple of weeks.
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A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching?
- A. Obtain an informed consent prior to obtaining the specimen
- B. Collect at least milliliter of the urine for the test
- C. Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen.
- D. Premature newborns may have false negative tests due to immature development of liver enzymes.
Correct Answer: C
Rationale: The correct answer is C: Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen. This is important because certain metabolic disorders can only be detected if the baby has been feeding normally. Without proper feeding, the test results may not be accurate.
Choice A is incorrect because informed consent is not required for universal newborn screening; it is a routine procedure. Choice B is incorrect as urine is not typically used for the universal newborn screening. Choice D is incorrect because premature newborns may have false positive tests, not false negative tests, due to immature liver enzyme development.
A client in active labor receives a regional anesthetic. Which is the main purpose of regional anesthetics?
- A. To relieve pain by decreasing the client's level of consciousness
- B. To provide general loss of sensation by blocking sensory nerves to an area
- C. To provide pain relief by blocking descending impulses from the central nervous system
- D. To relieve pain by decreasing the perception of pain leading to the pain centers in the brain
Correct Answer: B
Rationale: The correct answer is B: To provide general loss of sensation by blocking sensory nerves to an area. Regional anesthetics work by blocking specific nerve pathways in a targeted area, leading to loss of sensation while maintaining consciousness. This is ideal for laboring clients as it allows pain relief without affecting consciousness or motor function. Choice A is incorrect as regional anesthetics do not aim to decrease consciousness. Choice C is incorrect as regional anesthetics block sensory nerves locally, not descending impulses. Choice D is incorrect as the goal is to block sensation locally, not perception in the brain.
A breastfeeding mother complains of cramping. Which is the main cause of the client's afterpains?
- A. Infection of the suture line
- B. Constipation and bloating
- C. Contractions of the uterus
- D. Trauma during delivery
Correct Answer: C
Rationale: The correct answer is C: Contractions of the uterus. After giving birth, the uterus continues to contract to reduce in size, which can cause cramping or afterpains. This is a normal process known as involution. Infection of the suture line (A) would present with other symptoms like redness, swelling, and warmth. Constipation and bloating (B) may cause discomfort but are not directly related to afterpains. Trauma during delivery (D) could lead to pain but is not the main cause of afterpains in a breastfeeding mother.
A 35-week gestation infant was delivered by forceps. Which assessment findings should alert the nurse to a possible complication of the forceps delivery?
- A. Weak, ineffective suck, and scalp edema
- B. Molding of the head and jitteriness
- C. Shrill, high pitched cry, and tachypnea
- D. Hypothermia and hemoglobin of 12.5 g/dL
Correct Answer: A
Rationale: The correct answer is A: Weak, ineffective suck, and scalp edema. Forceps delivery can cause head trauma leading to facial nerve injury, resulting in weak suck and scalp edema. Molding of the head (choice B) is a normal finding after vaginal birth. Jitteriness (choice B) may be due to immaturity rather than a complication of forceps delivery. A shrill, high-pitched cry and tachypnea (choice C) are more indicative of respiratory distress, not specific to forceps delivery. Hypothermia and hemoglobin of 12.5 g/dL (choice D) are not directly related to complications of forceps delivery.
During an outpatient clinic visit, a 13-year-old client is diagnosed with infectious mononucleosis. The nurse should expect which of the following to be included in the client's plan of care?
- A. Take acetaminophen (Tylenol) with codeine as prescribed for pain.
- B. Encourage gargling with warm water to alleviate pain.
- C. Start a short course of ampicillin.
- D. Encourage social activity to prevent depression.
Correct Answer: B
Rationale: The correct answer is B: Encourage gargling with warm water to alleviate pain. Gargling with warm water can help soothe a sore throat, a common symptom of infectious mononucleosis. Acetaminophen with codeine (A) is not typically recommended for mononucleosis pain management in children due to the risk of respiratory depression. Starting a short course of ampicillin (C) is contraindicated in mononucleosis as it can cause a rash. Encouraging social activity (D) may not be appropriate as the client may need rest to recover.