Nokea
A postpartum nurse is teaching umbilical cord care to new parents as part of discharge teaching. The nurse would be sure to include which information in her teaching?
- A. Apply rubbing alcohol to the cord with each diaper change to help it dry out.
- B. Cover the cord with bacitracin after bathing to prevent infection.
- C. Keep the cord dry and open to the air.
- D. Wash the cord with soap and water each day during a tub bath.
Correct Answer: C
Rationale: Keeping the cord dry and exposed to air aids in proper healing.
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The nurse is performing a gestational age assessment on a newborn. Which characteristic indicates the greatest gestational maturity?
- A. The infant's arms and legs are extended.
- B. There is some peeling and cracking of the skin.
- C. There are few rugae on the scrotum and the testes are high in the scrotum.
- D. The arm can be positioned with the elbow beyond the midline of the chest.
Correct Answer: B
Rationale: The correct answer is B because peeling and cracking of the skin, known as desquamation, is characteristic of a newborn born at term or post-term. This indicates the skin has been in contact with amniotic fluid for an extended period, typical of a more mature gestational age. Choices A, C, and D are incorrect as they do not specifically indicate gestational maturity. Arms and legs extended (A) can be seen in preterm infants. Few rugae on the scrotum and high testes (C) can be normal variations in newborns. The arm positioning (D) does not provide a direct indicator of gestational age.
An infant was born with anencephaly and was taken immediately to the NICU. The parents are about to visit for the first time. What action by the nurse is most appropriate?
- A. Call the hospital chaplain to visit the parents.
- B. Obtain informed consent for emergency surgery.
- C. Prepare the parents for how the infant will look.
- D. Show the parents proper gowning and gloving.
Correct Answer: C
Rationale: Infants born with anencephaly (incomplete closure of the anterior portion of the neural tube) are often missing parts of the brain, forehead, skull, and occiput. The nurse must be very sensitive in working with the parents of such children and needs to prepare the parents for how the child will look. Well-prepared parents have a better chance of being able to bond with their child. A visit from the chaplain may or may not be welcomed. Emergency surgery is not performed. Proper gowning and gloving are not needed unless the infant is in isolation.
Developing a plan to achieve patient outcomes is included in which step of the CJMM?
- A. prioritizing hypotheses
- B. generating solutions
- C. taking action
- D. evaluating outcomes
Correct Answer: B
Rationale: Generating solutions involves creating strategies to address identified problems, which includes developing plans to achieve desired patient outcomes.
Which interventions should the nurse perform following the delivery of the newborn?
- A. Place the infant on the mother's chest after wrapping in a sterile blanket
- B. Measure the Apgar score at 5 and 10 minutes after delivery, report findings to the physician
- C. Remove vernix caseosa that is covering the infant's body while stimulating the infant to cry
- D. Transfer the infant to the newborn nursery after securing in warm blankets and an open crib
Correct Answer: B
Rationale: The correct answer is B because measuring the Apgar score at 5 and 10 minutes after delivery is a standard practice to assess the newborn's overall well-being. This helps to identify any immediate medical intervention needed and ensures the newborn's health is monitored closely.
A is incorrect because placing the infant on the mother's chest is important for bonding, but not a critical intervention immediately following delivery.
C is incorrect because removing vernix caseosa and stimulating crying can be done later and are not immediate priorities.
D is incorrect because transferring the infant to the nursery without assessing the Apgar score can delay necessary medical interventions if needed.
The mother-baby nurse is providing care to a patient and her newborn 2 hours after delivery. On review of the newborn's chart, the nurse sees a notation of caput succedaneum. What will the nurse expect to find in the mother's chart?
- A. Race: non-White
- B. A longer than usual labor
- C. Administration of an epidural
- D. Delivery by cesarean birth
Correct Answer: B
Rationale: The correct answer is B: A longer than usual labor. Caput succedaneum is swelling of the baby's scalp due to pressure during labor. This indicates a longer labor duration.
A: Race is not a factor in the development of caput succedaneum.
C: Administration of an epidural does not directly cause caput succedaneum.
D: Delivery by cesarean birth is not associated with caput succedaneum.