Nokea
A postpartum person is breastfeeding her newborn. What is the most important factor for successful breastfeeding in the early postpartum period?
- A. encourage frequent feeding
- B. encourage skin-to-skin contact
- C. support the baby's latch
- D. support early initiation of breastfeeding
Correct Answer: B
Rationale: The correct answer is B: encourage skin-to-skin contact. Skin-to-skin contact in the early postpartum period promotes bonding, regulates the baby's body temperature, and encourages successful breastfeeding by stimulating the baby's natural feeding instincts. It also helps in establishing a strong emotional connection between the parent and the newborn. Encouraging frequent feeding (choice A) is important, but skin-to-skin contact is crucial for successful breastfeeding initiation. Supporting the baby's latch (choice C) is essential, but skin-to-skin contact precedes and aids in achieving a proper latch. While supporting early initiation of breastfeeding (choice D) is beneficial, skin-to-skin contact enhances the initiation process and overall breastfeeding success.
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In a low-risk laboring person who is not receiving oxytocin, how often should the nurse assess the fetal heart rate during the second stage of labor?
- A. every 5 minutes with contractions
- B. at least every 30 minutes
- C. every 5–15 minutes
- D. only when the physician orders assessment
Correct Answer: C
Rationale: The correct answer is C: every 5-15 minutes. During the second stage of labor, frequent assessment of the fetal heart rate is crucial to monitor fetal well-being and detect any signs of distress promptly. Assessing every 5-15 minutes allows the nurse to closely monitor the fetal heart rate pattern and response to uterine contractions, ensuring timely interventions if needed. Option A (every 5 minutes with contractions) may be too frequent and unnecessary, causing patient discomfort. Option B (at least every 30 minutes) is too infrequent and may miss important changes in fetal status. Option D (only when the physician orders assessment) is incorrect as nurses should proactively monitor fetal well-being without waiting for physician orders.
Which is equivalent to a 2 oz protein serving?
- A. 4 tbsp peanut butter
- B. 2 eggs
- C. 1 cup cooked lima beans
- D. 2 ounces mixed nuts
Correct Answer: B
Rationale: Two eggs are equivalent to a 2 oz protein serving, providing approximately 12 grams of protein.
A nurse is caring for a laboring person and is monitoring for signs of fetal distress. Which finding is the most concerning in this situation?
- A. Late decelerations
- B. Bradycardia
- C. Tachycardia
- D. Variable decelerations
Correct Answer: A
Rationale: The correct answer is A: Late decelerations. Late decelerations indicate uteroplacental insufficiency, which can lead to fetal hypoxia and distress. This is the most concerning finding as it indicates a problem with oxygen delivery to the fetus. Bradycardia (B) and Tachycardia (C) can also be concerning, but late decelerations are more specific to fetal distress. Variable decelerations (D) are caused by cord compression and are concerning but not as indicative of fetal distress as late decelerations.
A nurse is caring for a laboring person who is in the third stage of labor. What is the most appropriate nursing intervention during this stage?
- A. assist with the delivery of the placenta
- B. prepare for a vaginal birth
- C. administer oxytocin
- D. apply gentle pressure to the uterus
Correct Answer: A
Rationale: The correct answer is A: assist with the delivery of the placenta. During the third stage of labor, the placenta needs to be delivered. This is done by gently applying traction to the umbilical cord while supporting the uterus to facilitate the expulsion of the placenta. This step is crucial to prevent postpartum hemorrhage.
Choice B (prepare for a vaginal birth) is incorrect because the person is already in the third stage of labor, which means the baby has been delivered and they are now focusing on delivering the placenta.
Choice C (administer oxytocin) is incorrect because while oxytocin may be used to help control bleeding after the placenta is delivered, it is not the most appropriate intervention during the third stage of labor.
Choice D (apply gentle pressure to the uterus) is incorrect because direct pressure to the uterus is not the primary intervention during the third stage of labor; assisting with the delivery of the placenta takes precedence.
A woman in labor begins to experience a sudden increase in vaginal bleeding and the fetal heart rate decelerates. What is the likely cause of these symptoms?
- A. Placenta previa
- B. Placental abruption
- C. Uterine rupture
- D. Cervical laceration
Correct Answer: B
Rationale: The correct answer is B: Placental abruption. Placental abruption is the premature separation of the placenta from the uterine wall, leading to vaginal bleeding and fetal distress. The sudden increase in bleeding and fetal heart rate deceleration are hallmark signs of placental abruption. Placenta previa (choice A) involves bleeding without fetal distress. Uterine rupture (choice C) typically presents with severe abdominal pain and shock. Cervical laceration (choice D) would not cause fetal heart rate deceleration.