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During a vaginal delivery of a macrosomic baby, the nurse midwife requests nursing assistance. Which of the following actions by the nurse would be appropriate?
- A. Estimate fetal length and weight.
- B. Assess intensity of contractions.
- C. Provide suprapubic pressure.
- D. Assist woman with breathing.
Correct Answer: C
Rationale: Suprapubic pressure helps guide the baby’s shoulders during delivery, reducing the risk of shoulder dystocia.
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During a postpartum examination, the nurse notes that a client’s left calf is warm and swollen. Which of the following actions by the nurse is appropriate at this time?
- A. Notify the client’s physician.
- B. Teach the client to massage her leg.
- C. Apply ice packs to the client’s leg.
- D. Encourage the client to ambulate.
Correct Answer: A
Rationale: A warm, swollen calf may indicate deep vein thrombosis (DVT), a serious condition requiring immediate medical attention.
A client, who is 6 hours post–vaginal delivery, has a BP of 150/110. Her last 4 BP readings were: 114/88, 120/80, 134/86, 140/90. Which of the following questions should the nurse ask the client at this time?
- A. Have you had a bowel movement since delivery?'
- B. Is there anything that is making you anxious about the baby?'
- C. When you last went to the bathroom were you bleeding heavily?'
- D. Do you have a headache or blurring of your vision?'
Correct Answer: D
Rationale: Headache or blurring of vision could indicate postpartum preeclampsia, a serious condition requiring immediate intervention.
A nurse is teaching a family about health care plans. Which information from the nurse indicates a correct understanding of the Affordable Care Act?
- A. A family can choose whether to have health insurance with no consequences.
- B. Primary care physician payments from Medicaid services can equal Medicare.
- C. Adult children up to age 26 are allowed coverage on the parent’s plan.
- D. Private insurance companies can deny coverage for any reason.
Correct Answer: C
Rationale: Adult children up to the age of 26, regardless of student status, are allowed to be covered under their parents’ health insurance plan.
A certified nursing assistant (CNA) is working with a registered nurse (RN) in the neonatal nursery. It would be appropriate for the nurse to delegate which of the following actions to the assistant?
- A. Admission assessment on a newly delivered baby.
- B. Patient teaching of a neonatal sponge bath.
- C. Placement of a bag on a baby for urine collection.
- D. Hourly neonatal blood glucose assessments.
Correct Answer: C
Rationale: CNAs can perform tasks such as placing a urine collection bag, which does not require advanced assessment or teaching skills. Admission assessments and blood glucose monitoring require the expertise of an RN.
A woman, who is in pain from a diagnosis of mastitis, has abruptly weaned her baby to a bottle. Her actions place the woman at high risk for which of the following?
- A. Mammary rupture.
- B. Postpartum psychosis.
- C. Supernumerary nipples.
- D. Breast abscess.
Correct Answer: D
Rationale: Abrupt weaning can lead to milk stasis, increasing the risk of a breast abscess due to bacterial infection.