Nokea
After a vaginal delivery, a preterm neonate is to receive oxygen via mask. While administering the oxygen, the nurse would place the neonate in which of the following positions?
- A. Left side, with the neck slightly flexed.
- B. Back, with the head turned to the left side.
- C. Abdomen, with the head down.
- D. Back, with the neck slightly extended.
Correct Answer: D
Rationale: Placing the neonate on their back with the neck slightly extended opens the airway, facilitating effective oxygen delivery.
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A viable male neonate delivered to a 28-year-old multiparous client by cesarean delivery because of placenta previa is diagnosed with respiratory distress syndrome. Which of the following would the nurse explain as the factor placing the neonate at the greatest risk for this syndrome?
- A. Mother's development of placenta previa.
- B. Neonate delivered preterm.
- C. Mother receiving analgesia 4 hours before delivery.
- D. Neonate with sluggish respiratory efforts after delivery.
Correct Answer: B
Rationale: Preterm delivery is the primary risk factor for RDS due to immature lung development and insufficient surfactant production.
The nurse is caring for a multigravid client who speaks little English. As the nurse enters the client's room, the nurse observes the client panting on the bed and the fetal head crowning. After calling for assistance and helping the client lie down, which of the following actions should the nurse do next?
- A. Tell the client to push between contractions.
- B. Provide gentle support to the fetal head.
- C. Apply gentle upward traction on the neonate's anterior shoulder.
- D. Massage the perineum to stretch the perineal tissues.
Correct Answer: B
Rationale: With the fetal head crowning, providing gentle support prevents rapid expulsion and perineal trauma. Pushing between contractions is incorrect, traction is for shoulder dystocia, and perineal massage is less urgent.
A client asks about the effectiveness of the contraceptive patch. Which of the following responses by the nurse is accurate?
- A. The patch is less effective than oral contraceptives.
- B. The patch is highly effective when used correctly.
- C. The patch is 100% effective in preventing pregnancy.
- D. The patch does not require a prescription.
Correct Answer: B
Rationale: The contraceptive patch is highly effective when used correctly, with a failure rate similar to oral contraceptives (about 1% with perfect use). It is not 100% effective, requires a prescription, and is not less effective than pills.
After instruction of a primigravid client at 8 weeks' gestation diagnosed with class I heart disease about self-care during pregnancy, which of the following client statements would indicate the need for additional teaching?
- A. "I should avoid being near people who have a cold."
- B. "I may be given antibiotics during my pregnancy."
- C. "I should reduce my intake of protein in my diet."
- D. "I should limit my salt intake at meals."
Correct Answer: C
Rationale: Reducing protein intake is not recommended for clients with heart disease.
A 16-year-old primigravid client, with a history of attending one prenatal visit, is admitted to the hospital in active labor at 37 weeks' gestation. Her cervix is 7 cm dilated with the presenting part at 0 station. She enters the labor unit appearing anxious and hyperventilating. Because of the hyperventilation, the nurse should assess the client for:
- A. Metabolic alkalosis.
- B. Metabolic acidosis.
- C. Respiratory alkalosis.
- D. Respiratory acidosis.
Correct Answer: C
Rationale: Hyperventilation causes excessive exhalation of carbon dioxide, leading to respiratory alkalosis (elevated blood pH). Metabolic imbalances are less likely, and respiratory acidosis occurs with hypoventilation.