Nokea
What is the primary ethical principle guiding nursing practice in maternal and newborn healthcare?
- A. Autonomy
- B. Non-maleficence
- C. Beneficence
- D. Justice
Correct Answer: C
Rationale: The correct answer is C: Beneficence. In maternal and newborn healthcare, beneficence is the primary ethical principle guiding nursing practice. This principle emphasizes the nurse's duty to promote the well-being and best interests of both the mother and the newborn. Nurses must act in a way that benefits their patients and ensures their safety and health. Autonomy (A) focuses on respecting the patient's right to make their own decisions, which is important but not the primary principle in this context. Non-maleficence (B) involves avoiding harm, which is essential but not the primary guiding principle here. Justice (D) pertains to fairness in healthcare access and resource allocation, which is also crucial but not the primary ethical principle for maternal and newborn healthcare.
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A nurse is preparing to perform Leopold maneuvers on a client who is at 36 weeks of gestation. Identify the sequence of actions the nurse should take.
- A. Instruct the client to empty their bladder.
- B. Position the client supine with knees flexed and place a small, rolled towel under one of their hips.
- C. Palpate the fetal part positioned in the fundus.
- D. Palpate the fetal parts along both sides of the uterus.
Correct Answer: A, B, C, D
Rationale: The correct order is A, B, C, D. First, instructing the client to empty their bladder ensures better visualization and palpation of the uterus. Second, positioning the client supine with knees flexed and a small towel under the hip optimizes comfort and facilitates proper examination. Third, palpating the fetal part in the fundus helps determine the fetal presentation. Finally, palpating the fetal parts along both sides of the uterus assists in identifying the position and engagement of the fetus. Choices E, F, and G are not relevant to the Leopold maneuvers sequence and do not contribute to the accurate assessment of fetal position and presentation.
Which hormone is responsible for stimulating milk production in the breasts?
- A. Progesterone
- B. Estrogen
- C. Prolactin
- D. Oxytocin
Correct Answer: C
Rationale: The correct answer is C: Prolactin. Prolactin is the hormone responsible for stimulating milk production in the breasts. It is produced by the pituitary gland and plays a crucial role in lactation. Progesterone and estrogen are involved in preparing the breasts for milk production but do not directly stimulate it. Oxytocin is responsible for the ejection of milk from the breast but not for its production.
A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?
- A. Administer broad-spectrum antibiotics.
- B. Monitor the rectal temperature every 4 hr.
- C. Cleanse the site with povidone-iodine.
- D. Prepare for surgical closure after 72 hr.
Correct Answer: A
Rationale: The correct answer is A: Administer broad-spectrum antibiotics. This is crucial in preventing infection, as the leaking cerebrospinal fluid puts the newborn at risk for meningitis. Antibiotics help reduce the risk of infection until surgical closure can be performed. Monitoring rectal temperature (B) is important but not the priority. Cleansing the site with povidone-iodine (C) may further irritate the area. Planning for surgical closure after 72 hr (D) is important, but immediate infection prevention is the priority.
A nurse is caring for a client who is receiving oxytocin via continuous IV infusion and is experiencing persistent late decelerations in the FHR. After discontinuing the infusion, which of the following actions should the nurse take?
- A. Instruct the client to bear down and push with contractions.
- B. Administer oxygen at 10 L/min via nonrebreather facemask.
- C. Place the client in a supine position.
- D. Initiate an amnioinfusion.
Correct Answer: B
Rationale: The correct answer is B: Administer oxygen at 10 L/min via nonrebreather facemask. Late decelerations in FHR during oxytocin infusion indicate uteroplacental insufficiency. Administering oxygen helps improve oxygenation to the fetus, potentially alleviating the late decelerations. This action addresses the underlying cause and supports fetal oxygenation. In contrast, option A may increase intrauterine pressure, worsening fetal distress. Option C (supine position) can further compromise placental perfusion. Option D (amnioinfusion) is used for variable decelerations, not late decelerations.
A nurse in a clinic is caring for a 16-year-old adolescent. Which of the following findings should the nurse report to the provider? (Select all that apply.)
- A. Abdominal assessment
- B. Vaginal discharge
- C. Heart rate
- D. Temperature
- E. Dyspareunia
- F. Condom usage
Correct Answer: A,B,D,E,F
Rationale: The correct findings to report to the provider are A, B, D, E, and F. Abdominal assessment (A) is important to assess for any underlying issues. Vaginal discharge (B) could indicate infection. Temperature (D) may suggest infection or illness. Dyspareunia (E) could indicate underlying gynecological issues. Condom usage (F) is important for assessing sexual activity and risk. Heart rate (C) is a normal vital sign and doesn't necessarily require immediate reporting.