Nokea
A postpartum nurse is providing instructions to the mother of a newborn infant with hyperbilirubinemia who is being breastfed. The nurse provides which most appropriate instructions to the mother?
- A. Switch to bottle feeding the baby for 2 weeks
- B. Stop the breast feedings and switch to bottle-feeding permanently
- C. Feed the newborn infant less frequently
- D. Continue to breastfeed every 2-4 hours.
Correct Answer: D
Rationale: The most appropriate instruction for a mother of a newborn infant with hyperbilirubinemia who is being breastfed is to continue to breastfeed every 2-4 hours. Breastfeeding should be initiated within 2 hours after birth and continued every 2-4 hours thereafter. Breast milk helps to promote the passage of meconium (the dark green stools of the newborn) and reduce the risk of hyperbilirubinemia. It is important to continue breastfeeding to establish and maintain a good milk supply, promote bonding between mother and baby, and provide important nutrients to the newborn. Switching to bottle feeding or feeding the newborn infant less frequently is not recommended in this case.
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A nurse is performing a gestational age assessment on a newborn. The nurse determines that the newborn is "term" if which findings are assessed? (Select all that apply.)
- A. Posture with fully flexed arms and legs
- B. Arm recoil brisk
- C. Square window at 90 degrees
- D. Scarf sign of elbow crossing over the midline
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What is an appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler?
- A. Provide for privacy
- B. Encourage parents to room in
- C. Explain procedures and routines
- D. Encourage contact with children the same age
Correct Answer: B
Rationale: Encouraging parents to room in with the hospitalized toddler is an appropriate nursing intervention to minimize separation anxiety. This allows the child to maintain a sense of security and familiarity by having their primary caregivers close by. Having parents present can provide comfort, reassurance, and emotional support for the child during their hospital stay, which can help alleviate separation anxiety. Additionally, parents can continue to provide their usual care and routines for the child, further promoting a sense of stability and security.
A 62-year old client diagnosed with pyelonephritis and possible septicemia has had five urinary tract infections over the past 2 years. She's fatigued from lack of sleep; urinates frequently, even during the night, and has lost weight recently. Tests reveal the following: sodium level 152mEq/L, osmolarity 340mOsm/L, glucose level 125mg/dl, and potassium level of 3.8mEq/L. Which of the following nursing diagnoses is most appropriate for this client?
- A. Deficient fluid volume related to inability to conserve water
- B. Imbalanced nutrition: Less than body requirements related to hypermetabolic state
- C. Deficient fluid volume related to osmotic diuresis induced by hypernatremia
- D. Imbalanced nutrition: Less than body requirements related to catabolic effects of insulin deficiency
Correct Answer: C
Rationale: The client's elevated sodium level of 152 mEq/L indicates hypernatremia, which can lead to osmotic diuresis, causing excessive urination and subsequent fluid loss. This fluid loss can result in deficient fluid volume. The client's symptoms of frequent urination, fatigue from lack of sleep, and weight loss are indicative of dehydration due to the osmotic diuresis. Therefore, the most appropriate nursing diagnosis for this client is Deficient fluid volume related to osmotic diuresis induced by hypernatremia.
Which of the following would the nurse identify as an abnormal finding?
- A. Red blood cells (RBCs): 4.9million/ul
- B. Hematocrit: 45%
- C. Platelets: 115,000/ul
- D. None of the above
Correct Answer: C
Rationale: The normal range for platelets in adults is typically between 150,000 to 400,000 platelets per microliter of blood. A platelet count of 115,000/ul would be considered low, a condition known as thrombocytopenia. Thrombocytopenia can result in difficulty with blood clotting and may lead to increased risk of bleeding. Therefore, a platelet count of 115,000/ul would be identified as an abnormal finding by the nurse.
Which screening test is a neonatal nurse likely to use to detect developmental dysplasia of the hip (DDH)?
- A. Barlow's maneuver
- B. Pavlik's maneuver
- C. Gower's maneuver
- D. Allis's maneuver
Correct Answer: B
Rationale: Neonatal nurses are likely to use Pavlik's maneuver to detect developmental dysplasia of the hip (DDH) in newborns. Pavlik's maneuver is a technique used to diagnose, treat, and manage DDH in infants. It involves positioning the infant's hips in a flexed and abducted position to help stabilize the hip joint and promote proper development. This technique is gentle and non-invasive, making it suitable for screening infants for hip dysplasia. Other maneuvers listed, such as Barlow's, Gower's, and Allis's maneuvers, are different techniques used to assess hip stability or alignment and are not specific to DDH screening in newborns.