Nokea
A patient is being discharged after giving birth to a healthy baby. The nurse educates the patient about safe sleep practices for the infant. Which of the following statements by the patient indicates the need for further teaching?
- A. I will always place my baby on their back to sleep.
- B. I will let my baby sleep in the same bed with me to make sure they are safe.
- C. I will avoid placing pillows and soft bedding in my baby's crib.
- D. I will encourage tummy time when my baby is awake.
Correct Answer: B
Rationale: Correct Answer: B
Rationale: Co-sleeping increases the risk of sudden infant death syndrome (SIDS) and suffocation. Placing the baby in a separate crib reduces these risks.
Incorrect Choices:
A: Placing the baby on their back to sleep is the recommended position to reduce the risk of SIDS.
C: Avoiding pillows and soft bedding in the crib reduces the risk of suffocation.
D: Tummy time is important for infant development when the baby is awake.
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The nurse is caring for a pregnant patient at 24 weeks gestation who reports increased vaginal discharge. What should the nurse do first?
- A. Assess the characteristics of the discharge, including color and odor.
- B. Encourage the patient to rest and monitor for changes in discharge.
- C. Instruct the patient to wear a sanitary pad and track the amount of discharge.
- D. Perform a pelvic exam to check for signs of infection or complications.
Correct Answer: A
Rationale: Rationale:
Step 1: Assess characteristics of discharge - determining color and odor helps identify if it's normal or concerning.
Step 2: Based on assessment, decide next steps - presence of abnormal color or odor may indicate infection or other issues.
Step 3: Implement appropriate interventions - further evaluation or treatment as needed.
Summary:
- B: Resting and monitoring alone may not address the underlying cause of increased discharge.
- C: While tracking amount is important, it doesn't provide immediate information on potential infection.
- D: Performing a pelvic exam should come after initial assessment of discharge characteristics to guide further actions.
What is the most appropriate action when a laboring person's membranes rupture and meconium is present?
- A. notify the healthcare provider
- B. document the amount of meconium
- C. prepare the person for vacuum extraction
- D. apply pressure to the abdomen
Correct Answer: A
Rationale: The correct answer is A: notify the healthcare provider. This is the most appropriate action because the presence of meconium in the amniotic fluid indicates potential fetal distress, requiring immediate medical evaluation. Notifying the healthcare provider allows for prompt assessment and necessary interventions to ensure the well-being of both the laboring person and the baby. Documenting the amount of meconium (choice B) may be important for the medical record but is not the priority in this situation. Choices C and D, preparing for vacuum extraction and applying pressure to the abdomen, are not indicated and could potentially harm the baby or the laboring person.
A 16-year-old, G1 P0000, is being seen at her 10-week gestation visit. She tells the nurse that she felt the baby move that morning. Which of the following responses by the nurse is appropriate?
- A. That is very exciting. The baby must be very healthy.
- B. Would you please describe what you felt for me?
- C. That is impossible. The baby is not big enough yet.
- D. Would you please let me see if I can feel the baby?
Correct Answer: B
Rationale: At 10 weeks, fetal movement is unlikely to be felt. The nurse should ask the client to describe what she felt to determine if it was indeed fetal movement or another sensation.
A 32-year-old patient who is pregnant with her first child is inquiring about labor and delivery. Which of the following statements by the nurse is most appropriate?
- A. Labor usually lasts 12 to 24 hours for first-time mothers.
- B. Labor typically lasts 6 to 8 hours for first-time mothers.
- C. Labor for first-time mothers is usually much shorter than for those having their second child.
- D. Labor can be unpredictable, but it usually takes less than 12 hours for first-time mothers.
Correct Answer: A
Rationale: The correct answer is A: Labor usually lasts 12 to 24 hours for first-time mothers. This is the most appropriate response as it provides a realistic timeframe for labor in first-time mothers, which can vary but generally falls within this range. This information prepares the patient for a potentially lengthy labor and helps manage expectations.
Choice B is incorrect because stating that labor typically lasts 6 to 8 hours for first-time mothers is too short of a timeframe, which may lead to unrealistic expectations.
Choice C is incorrect because it inaccurately suggests that labor for first-time mothers is usually much shorter than for those having their second child, which is not necessarily true.
Choice D is incorrect because while labor can be unpredictable, stating that it usually takes less than 12 hours for first-time mothers is not accurate, as labor duration can vary greatly among individuals.
The glucose challenge screening test is performed at or after 24 weeks’ gestation to assess for the maternal physiological response to which of the following pregnancy hormones?
- A. Estrogen.
- B. Progesterone.
- C. Human placental lactogen.
- D. Human chorionic gonadotropin.
Correct Answer: C
Rationale: Human placental lactogen (hPL) is the hormone that affects glucose metabolism during pregnancy, making it the focus of the glucose challenge test.