Nokea
A primigravid client in active labor has had no anesthesia. The client's cervix is 7 cm dilated, and she is starting to feel considerable discomfort during the first 10 cm to the client's sacral client is a left side-lying position. The nurse should encourage which of the following?
- A. Rapid, shallow chest breathing.
- B. Deep chest breathing.
- C. Rapid pant-blow breathing.
- D. Slow abdominal breathing.
Correct Answer: D
Rationale: Slow abdominal breathing promotes relaxation and oxygenation, helping manage discomfort in active labor without anesthesia. Rapid or shallow breathing may lead to hyperventilation, and deep chest breathing is less effective for pain control.
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A newly delivered primiparous client asks the nurse, "Can my baby see?" Which of the following statements about neonatal vision should the nurse include in the explanation?
- A. Neonates primarily focus on moving objects.
- B. They can see objects up to 12 inches away.
- C. Usually they see clearly by about 2 days after birth.
- D. Neonates primarily distinguish light from dark.
Correct Answer: B
Rationale: Neonates can focus on objects about 8-12 inches away, which is optimal for bonding during feeding.
A multigravid client at 34 weeks' gestation visits the hospital because she suspects that her water has broken. After testing the leaking fluid with nitrazine paper, the nurse confirms that the client's membranes have ruptured when the paper turns which of the following colors?
- A. Yellow.
- B. Green.
- C. Blue.
- D. Red.
Correct Answer: C
Rationale: Nitrazine paper turns blue in the presence of amniotic fluid.
A newborn weighing 6½ lb is to be given naloxone hydrochloride (Narcan) due to respiratory depression caused by a narcotic administered to the mother shortly before delivery. The dosage is 0.01 mg/kg, administered into the umbilical vein. The vial is labeled 0.4 mg/mL.. How many milligrams would the newborn receive? Round to two decimals.
Correct Answer: 0.03 mg
Rationale: The neonate weighs 6.5 lb (2.95 kg). The dose is 0.01 mg/kg, so 0.01 mg/kg × 2.95 kg = 0.0295 mg, rounded to 0.03 mg.
When teaching a primiparous client who used cocaine during pregnancy how to comfort her fussy neonate, the nurse can advise the mother to:
- A. Tightly swaddle the neonate.
- B. Feed the neonate extra, high-calorie formula.
- C. Keep the neonate in a brightly lit environment.
- D. Touch the baby only when he is crying.
Correct Answer: A
Rationale: Tightly swaddling the neonate provides comfort and reduces overstimulation in cocaine-exposed neonates.
Shortly after birth, the nurse measures the circumference of a term neonate's head and chest. When the two measurements are compared, which of the following would the nurse expect to find about the head circumference?
- A. Equal to the chest circumference.
- B. Approximately $2 \mathrm{~cm}$ larger than the chest.
- C. About $3 \mathrm{~cm}$ smaller than the chest.
- D. Approximately $4 \mathrm{~cm}$ larger than the chest.
Correct Answer: B
Rationale: In a term neonate, the head circumference is typically about 2 cm larger than the chest circumference.