Nokea
After the delivery of fetus,placenta should be removed by:
- A. Fundal pressure.
- B. D & C.
- C. Brandt-Andrews method.
- D. Manual removal.
- E. C-section.
Correct Answer: C
Rationale: The Brandt-Andrews method using controlled cord traction is the standard technique for delivering the placenta in the third stage of labor. Other methods are used only in complications.
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23 years old primigravida presents to you at fourteen weeks of gestation. She is concerned about normality of fetus. At what time you will advice her detailed fetal anomaly scan:
- A. 22-24 weeks.
- B. 14-16 weeks.
- C. 18-22 weeks.
- D. 10-14 weeks.
- E. 24-28 weeks.
Correct Answer: C
Rationale: A detailed fetal anomaly scan is typically performed between 18-22 weeks of gestation as this is the optimal time to visualize fetal anatomy clearly. Earlier scans (10-14 weeks) are for nuchal translucency and later scans may miss the window for detailed structural assessment.
The postpartum client (G2P2) asks the nurse for suggestions to help facilitate her 3-year-old’s attachment and acceptance of their newborn. Which action should the nurse suggest?
- A. Provide a doll for the 3-year-old to care for and nurture.
- B. Avoid bringing the 3-year-old to the “scary” hospital.
- C. Plan that dad cares for the 3-year-old and mom cares for the baby.
- D. Encourage the child to be “grown up” and accept the newborn.
Correct Answer: A
Rationale: Providing a doll encourages the 3-year-old to mimic parental care reducing jealousy. Hospital visits shared parental attention and accepting regression promote bonding.
The nurse meets the frantic father at an ED door. He says he just delivered his wife’s full-term newborn in the car when the temperature outside is only 10°F (—12.2°C). In response to the cold environment,the nurse knows that the infant’s body will immediately begin to produce heat by which mechanism?
- A. Shivering
- B. Metabolizing body fat
- C. Dilating surface blood vessels
- D. Decreasing flexion of the extremities
Correct Answer: B
Rationale: When skin receptors of full-term newborns perceive a drop in environmental temperature the sympathetic nervous system is stimulated. This in turn stimulates metabolism of brown fat thus producing heat that is transferred to the peripheral circulation. Shivering is rarely seen in newborns and it does little to produce heat. Newborns conserve heat by constricting not dilating blood vessels. Decreasing flexion promotes heat loss by exposing more skin surface.
The nurse is assessing the full-term Caucasian infant who is 40 hours old. Which technique should the nurse use to evaluate the infant for jaundice?
- A. Remove the infant’s diaper and look at the color of the genitalia.
- B. Apply pressure on the forehead for 3 seconds,release and evaluate the skin color.
- C. Assess the color of the palms and compare that skin color to the color of the soles.
- D. Open the infant’s mouth to assess the color of the infant’s tongue and palate.
Correct Answer: B
Rationale: To differentiate jaundice from normal skin color apply pressure over a bony area like the forehead. A yellow blanched area indicates jaundice. Genitalia palms soles or oral mucosa are less reliable due to slower progression or darker pigmentation.
Which intervention is most appropriate for a child with a musculoskeletal disability using a wheelchair?
- A. Encourage competitive sports to build strength.
- B. Provide a firm mattress to prevent bedsores.
- C. Teach the child to avoid all physical activity.
- D. Limit the child's interaction with peers.
Correct Answer: B
Rationale: A firm mattress helps distribute weight evenly, reducing the risk of pressure ulcers in a child with limited mobility due to a musculoskeletal disability.