Nokea
The blood glucose of a client with type 1 diabetes 12 hours after delivery is 96 mg/dL. The client has received no insulin since delivery. The drop in serum levels of which of the following hormones of pregnancy is responsible for the glucose level?
- A. Estrogen.
- B. Progesterone.
- C. Human placental lactogen (hPL).
- D. Human chorionic gonadotropin (hCG).
Correct Answer: C
Rationale: hPL influences glucose metabolism.
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The nurse is developing a plan of care for the patient’s fourth stage of labor. One nursing intervention is to promote bonding. Specifically, which nursing action will facilitate the bonding process?
- A. Encourage the patient to call the baby by his or her first name
- B. Stimulate the grasp reflex by placing the patient’s finger in the infant’s palm.
- C. Ask the patient if she wants her baby placed on her chest immediately after birth.
- D. Assess for familial characteristics and remark on the resemblance to the patient or the father
Correct Answer: C
Rationale: Rationale: Choice C is correct because immediate skin-to-skin contact promotes bonding by facilitating the release of oxytocin, the bonding hormone. This close physical contact also helps regulate the baby's temperature and promotes breastfeeding initiation. Choices A, B, and D do not directly facilitate bonding as effectively as immediate skin-to-skin contact. Encouraging the baby's name or assessing for familial characteristics may be important but do not have the same immediate bonding impact as skin-to-skin contact. Placing the patient's finger in the infant's palm may stimulate reflexes but does not directly promote bonding as effectively as skin-to-skin contact.
A client received general anesthesia during her cesarean section 4 hours ago. Which of the following postpartum nursing interventions is important for the nurse to make?
- A. Place the client flat in bed.
- B. Assess for dependent edema.
- C. Auscultate lung fields.
- D. Check patellar reflexes.
Correct Answer: C
Rationale: General anesthesia can impair lung function, necessitating lung auscultation.
Four newborns are in the neonatal nursery, none of whom is crying or in distress. Which of the babies should the nurse report to the neonatologist?
- A. 16-hour-old baby who has yet to pass meconium.
- B. 16-hour-old baby whose blood glucose is 50 mg/dL.
- C. 2-day-old baby who is breathing irregularly at 70 breaths per minute.
- D. 2-day-old baby who is excreting a milky discharge from both nipples.
Correct Answer: C
Rationale: Irregular breathing at 70 breaths per minute could indicate respiratory distress and requires further evaluation.
A breastfeeding client calls her obstetrician stating that her baby was diagnosed with thrush and that her breasts have become infected as well. Which of the following organisms has caused the baby's and mother's infection?
- A. Staphylococcus aureus.
- B. Streptococcus pneumoniae.
- C. Escherichia coli.
- D. Candida albicans.
Correct Answer: D
Rationale: Candida causes thrush.
A 40-week-gestation neonate is in the first period of reactivity. Which of the following actions should the nurse take at this time?
- A. Encourage the parents to bond with their baby.
- B. Notify the neonatologist of the finding.
- C. Perform the gestational age assessment.
- D. Place the baby under the overhead warmer.
Correct Answer: A
Rationale: Bonding is encouraged during periods of reactivity.