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How can a nurse reduce the risk of infection in a newborn in the NICU?
- A. Maintain strict hand hygiene
- B. Limit visitors and monitor closely for signs of infection
- C. Ensure proper sterilization of equipment
- D. Administer prophylactic antibiotics
Correct Answer: B
Rationale: Rationale for Correct Answer (B): Limiting visitors and monitoring closely for signs of infection in a newborn in the NICU is crucial because newborns are highly vulnerable to infections. By restricting visitors, the risk of introducing pathogens is reduced. Close monitoring allows for early detection of any signs of infection, enabling prompt intervention to prevent complications.
Summary of Other Choices:
A: While maintaining strict hand hygiene is important, it alone is not sufficient to reduce the risk of infection in a newborn in the NICU.
C: Proper sterilization of equipment is essential but may not directly address the risk of infection transmission from visitors or other sources.
D: Administering prophylactic antibiotics is not recommended as a routine measure due to the potential for antibiotic resistance and adverse effects in newborns. Monitoring and prevention are preferred over indiscriminate antibiotic use.
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The nurse is assessing a client in active labor with variable decelerations on the fetal monitor. What is the priority intervention?
- A. Increase oxytocin infusion.
- B. Reposition the client.
- C. Administer oxygen at 10 L/min.
- D. Perform a vaginal examination.
Correct Answer: B
Rationale: The correct answer is B: Reposition the client. Variable decelerations can indicate umbilical cord compression. Repositioning the client can help relieve the compression, improving fetal oxygenation. Increasing oxytocin (A) could worsen the situation. Administering oxygen (C) may be needed but repositioning is the priority. Performing a vaginal examination (D) is not indicated for variable decelerations.
What component of a health history for a wellness exam includes information on lifestyle factors, such as diet, exercise habits, tobacco use, alcohol consumption, and recreational drug use?
- A. chief complaint/reason for visit
- B. gynecologic history
- C. medications and supplements
- D. social history
Correct Answer: D
Rationale: The correct answer is D: social history. This component of a health history focuses on lifestyle factors that can impact a person's overall health and well-being. It includes information on diet, exercise habits, tobacco use, alcohol consumption, and recreational drug use. By understanding these factors, healthcare providers can assess potential risks, provide appropriate counseling, and tailor interventions to promote health.
A: Chief complaint/reason for visit is not the correct answer as it pertains to the specific reason why the patient is seeking medical attention.
B: Gynecologic history is focused on a specific aspect of health related to female reproductive health and is not inclusive of overall lifestyle factors.
C: Medications and supplements focus on the use of medications and supplements and do not cover lifestyle factors such as exercise habits or recreational drug use.
The nurse is counseling a client on the proper con- admitted to the labor and delivery unit complaining sumption of fish and fish products while pregnant. of mild contractions that are 10 minutes apart. How much fish should the nurse instruct the client After performing Leopold's maneuvers, the nurse to eat? determines that a hard round object is in the uterine
- A. 8 to 12 ounces of a variety of fish every week fundus. What should the nurse do if green fluid is
- B. 8 to 12 ounces of a variety of fish every month noted after rupture of the fetal membranes?
- C. 12 to 16 ounces of a variety of fish every week A.Observe the fetal monitor for variable decelerations
- D. 12 to 16 ounces of a variety of fish every month
Correct Answer: C
Rationale: The correct answer is C: 12 to 16 ounces of a variety of fish every week. During pregnancy, fish is a good source of protein and omega-3 fatty acids which are beneficial for fetal development. Consuming 12 to 16 ounces per week is recommended by health authorities for pregnant women to get essential nutrients without excessive mercury intake. Choice A (8 to 12 ounces of fish every week) is not enough for optimal nutrition during pregnancy. Choice B (8 to 12 ounces of fish every month) is too infrequent for consistent nutrient intake. Choice D (12 to 16 ounces of fish every month) is also inadequate as the frequency is not sufficient for optimal fetal development. Therefore, choice C is the best option for ensuring adequate nutrient intake while minimizing risks associated with mercury consumption.
After being in labor several hours with no progress the patient diagnosed with CPD and must have a c/s. the patient is worried that she will not be able to have any future children vaginally. After sharing this info with her care provider, the nurse would anticipate should would receive what type of incision?
- A. Transverse
- B. Vertical
- C. Low vertical
- D. Pfannenstiel
Correct Answer: B
Rationale: The correct answer is B: Vertical incision. In cases of CPD (cephalopelvic disproportion) where labor is not progressing and a cesarean section is necessary, a vertical incision is typically performed. This type of incision allows for better access to the uterus and is preferred in emergency situations like CPD. A transverse incision (choice A) is commonly used in elective c-sections but may not provide enough access in cases of CPD. Low vertical (choice C) is not ideal for CPD as it limits visibility and access. Pfannenstiel incision (choice D) is a horizontal incision placed low on the abdomen and is typically used in elective c-sections, not specifically for CPD cases.
A client at 36 weeks' gestation reports severe itching without a rash. What condition should the nurse suspect?
- A. Cholestasis of pregnancy.
- B. Preeclampsia.
- C. Gestational diabetes.
- D. Intrauterine growth restriction.
Correct Answer: A
Rationale: The correct answer is A: Cholestasis of pregnancy. Severe itching without a rash in a pregnant client at 36 weeks' gestation is often indicative of cholestasis of pregnancy, a liver condition that can occur during pregnancy. This condition is characterized by reduced bile flow, leading to the accumulation of bile acids in the blood, resulting in itching, especially on the palms and soles of the feet. Other choices (B) Preeclampsia, (C) Gestational diabetes, and (D) Intrauterine growth restriction are not typically associated with severe itching without a rash in the absence of other specific symptoms. Preeclampsia presents with hypertension and proteinuria, gestational diabetes with high blood sugar levels, and intrauterine growth restriction with poor fetal growth.