Nokea
On admission to the labor and delivery suite, the nurse assesses the discharge needs of a primipara who will be discharged home 4 days after a cesarean delivery. Which of the following questions should the nurse ask the client?
- A. Have you ever had anesthesia before?
- B. Do you have any allergies?
- C. Do you scar easily?
- D. Are there many stairs in your home?
Correct Answer: D
Rationale: Home environment impacts recovery.
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A couple, accompanied by their 5-year-old daughter, have been notified that their 32-week-gestation fetus is dead. The father is yelling at the staff. The mother is crying uncontrollably. The 5-year-old is banging the head of her doll on the floor. Which of the following nursing actions is appropriate at this time?
- A. Tell the father that his behavior is inappropriate.
- B. Sit with the family and quietly communicate sorrow at their loss.
- C. Help the couple to understand that their daughter is acting inappropriately.
- D. Encourage the couple to send their daughter to her grandparents.
Correct Answer: B
Rationale: Supportive presence is key.
A nurse notes that a 6-hour-old neonate has cyanotic hands and feet. Which of the following actions by the nurse is appropriate?
- A. Place child in an isolette.
- B. Administer oxygen.
- C. Swaddle baby in a blanket.
- D. Apply pulse oximeter.
Correct Answer: C
Rationale: Cyanosis in extremities is normal in the first few hours due to peripheral vasoconstriction; swaddling provides warmth without unnecessary intervention.
A client is being discharged on Coumadin (warfarin) post-pulmonary embolism after a cesarean delivery. Which of the following laboratory values indicates that the medication is effective?
- A. PT (prothrombin time): 12 sec (normal is 10-13 seconds).
- B. INR (international normalized ratio): 2.5 (normal is 1.0-1.4).
- C. Hematocrit 55%.
- D. Hemoglobin 10 g/dL.
Correct Answer: B
Rationale: An INR of 2.5 indicates therapeutic anticoagulation.
To promote bonding and attachment immediately after birth, which action should the nurse take?
- A. Assist the mother in feeding her baby.
- B. Allow the mother quiet time with her infant.
- C. Teach the mother about the concepts of bonding and attachment.
- D. Assist the mother in assuming an en face position with her newborn.
Correct Answer: D
Rationale: The correct answer is D because assuming an en face position (face-to-face) with the newborn promotes bonding and attachment by facilitating eye contact, skin-to-skin contact, and mutual recognition between the mother and baby. This physical closeness immediately after birth helps establish a strong emotional connection.
A: Assisting with feeding is important but does not specifically address bonding and attachment immediately after birth.
B: Allowing quiet time is beneficial but may not actively promote bonding and attachment.
C: Teaching about bonding and attachment is valuable but does not directly facilitate the immediate connection between mother and baby.
A client, G1 P0000, is PP1 from a normal spontaneous delivery of a baby boy, Apgar 5/6. Because the client exhibited addictive behaviors, a toxicology assessment was performed; the results were positive for alcohol and cocaine. Which of the following interventions is appropriate for the nurse to perform for this postpartum client?
- A. Strongly advise the client to breastfeed her baby.
- B. Perform hourly incentive spirometer respiratory assessments.
- C. Suggest that the nursery nurse feed the baby in the nursery.
- D. Provide the client with supervised instruction on baby-care skills.
Correct Answer: D
Rationale: Supervised instruction ensures safe infant care.