Nokea
Although circumcision continues to be a controversial procedure, many parents in the United States elect to have this surgery performed on their newborn sons. It is believed that newborns do not feel pain; therefore, this is the optimum time for the procedure to be done and no anesthesia is required.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Newborns do feel pain, and current guidelines recommend using analgesia during circumcision.
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A newborn's birth was prolonged because the shoulders were very wide. The nurse performing the assessment would be particularly observant for a problem with the:
- A. Moro reflex
- B. Plantar reflex
- C. Babinski reflex
- D. Stepping reflex
Correct Answer: A
Rationale: The Moro reflex is a normal infantile reflex that is typically present at birth and disappears around 4-6 months of age. This reflex is triggered by a sudden loss of support or a loud noise, causing the infant to throw back the head and extend the arms in a gesture as if trying to grab something. In a situation where the newborn's birth was prolonged due to wide shoulders, there is a higher risk of injury to the brachial plexus (nerves that control arm movement) during delivery. Damage to the brachial plexus can result in weakness or paralysis of the affected arm, and this may impact the Moro reflex as it involves the arms' movement. Therefore, the nurse would be particularly observant for any abnormality or lack of response in the Moro reflex as it may indicate potential nerve injury related to the difficult birth.
A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first?
- A. A client who experienced a cesarean birth 4 hr ago and reports pain
- B. A client who has preeclampsia with a BP of 138/90 mm Hg
- C. A client who experienced a vaginal birth 24 hr ago and reports no bleeding
- D. A client who is scheduled for discharge following a laparoscopic tubal ligation Which of the following findings indicates that it is safe for the nurse to continue the infusion? .
Correct Answer: A
Rationale: The client who experienced a cesarean birth 4 hours ago and is reporting pain should be seen first by the nurse. Pain assessment and management are crucial following a cesarean birth to ensure the client's comfort and well-being. Uncontrolled pain can lead to complications and affect the client's recovery process. Addressing the client's pain promptly is a priority to promote their comfort and facilitate their recovery.
After delivery it is determined there is a placental accreta, what intervention should the nurse anticipate?
- A. Hysterectomy
- B. IV antibiotic
- C. IV Pitocin
- D. 2L oxygen by mask
Correct Answer: A
Rationale: In the case of placental accreta, where the placenta is abnormally attached to the uterine wall, it can be very difficult to detach the placenta without significant bleeding. In severe cases, the safest intervention to prevent life-threatening hemorrhage is a hysterectomy, which involves the removal of the uterus. This is a serious surgical procedure that may be necessary to save the mother's life. Other interventions mentioned in the options (IV antibiotic, IV Pitocin, 2L oxygen by mask) may be part of the management plan but would not address the underlying issue of placental accreta like a hysterectomy would.
The nurse assess that a newborn is in respiratory distress when the infant exhibits:
- A. Apnea, grunting, wheezing, and crackles
- B. Wheezing, cyanosis, hiccups, and crackles
- C. Cyanosis, retraction, wheezing, and hiccups
- D. Tachypnea, retraction, grunting, and cyanosis
Correct Answer: D
Rationale: These are classic signs of respiratory distress.
What actions should the nurse advise women to take when educating them on breast self-examination (BSE)?
- A. Use the fingertips of their index, middle, and ring fingers.
- B. Use pressure in two intensities, light and deep.
- C. Look for dimpling while bending forward from the waist.
- D. Feel for lumps while encircling the breast from nipple outward.
Correct Answer: A
Rationale: Proper technique ensures accurate detection of abnormalities.