Nokea
The client is breast-feeding and asks the nurse about nutrition and diet. Which of the following statements by the client indicate understanding of dietary needs to promote successful breastfeeding? Select all that apply.
- A. I need to increase the number of meals I eat from three to five each day.
- B. I have to add about 500 more calories to my diet while I breast-feed.
- C. I need at least two servings of protein, like meat or eggs, with each meal.
- D. I need to double my fluids from my normal three to six glasses each day.
- E. I can eat more cheese and drink orange juice with calcium to increase my calcium intake.
Correct Answer: B,E
Rationale: An additional 500 calories and increased calcium intake are correct for breastfeeding; the other statements are inaccurate or excessive.
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Assessment of a 16-year-old nulligravid client who visits the clinic and asks for information on contraceptives reveals a menstrual cycle of 28 days. The nurse formulates a nursing diagnosis of Deficient knowledge related to ovulation and fertility management. Which of the following would be important to include in the teaching plan for the client?
- A. The ovum survives for 96 hours after ovulation, making conception possible during this time.
- B. The basal body temperature falls at least 0.2°F after ovulation has occurred.
- C. Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle.
- D. Most women can tell they have ovulated because of severe pain and thick, scant cervical mucus.
Correct Answer: C
Rationale: Ovulation typically occurs around day 14 (plus or minus 2 days) before the next menstrual cycle in a 28-day cycle, which is critical for understanding fertility windows. The ovum survives for about 12-24 hours, not 96 hours, and basal body temperature rises after ovulation.
A nurse is attempting to resuscitate a neonate. After following the Neonatal Resuscitation Program guidelines, 30 seconds of chest compressions have been completed. The neonate's heart rate remains less than 60 bpm. Epinephrine is to be given. What is the expected outcome for a neonate who has received epinephrine during resuscitation?
- A. Increased urine output.
- B. A normal heart rate.
- C. Pain relief.
- D. Sedation.
Correct Answer: B
Rationale: Epinephrine is used to restore a normal heart rate during resuscitation by stimulating cardiac activity.
The nurse is caring for a multiparous client after vaginal delivery of a set of male twins 2 hours ago. The nurse should encourage the mother and husband to:
- A. Bottle-feed the twins to prevent exhaustion and fatigue.
- B. Plan for each parent to spend equal amounts of time with each twin.
- C. Avoid assistance from other family members until attachment occurs.
- D. Relate to each twin individually to enhance the attachment process.
Correct Answer: D
Rationale: Relating to each twin individually fosters unique bonding and attachment.
The nurse is caring for a primigravid client in active labor who has had two fetal blood samplings to check for fetal hypoxia. The nurse determines that the fetus is showing signs of acidosis when the scalp blood pH is below which of the following?
- A. 7.5.
- B. 7.4.
- C. 7.3.
- D. 7.2.
Correct Answer: D
Rationale: A fetal scalp blood pH below 7.2 indicates acidosis, suggesting fetal hypoxia and the need for intervention. Values above 7.25 are typically reassuring, and 7.2–7.25 may warrant close monitoring.
A 31-year-old multigravid client at 39 weeks' gestation admitted to the hospital in active labor is receiving intravenous lactated Ringer's solution and a continuous epidural anesthetic. During the first hour after administration of the anesthetic, the nurse should monitor the client for:
- A. Hypotension.
- B. Diaphoresis.
- C. Headache.
- D. Tremors.
Correct Answer: A
Rationale: Epidural anesthesia can cause sympathetic blockade, leading to hypotension, especially within the first hour. Monitoring blood pressure is critical. Diaphoresis, headache, or tremors are less common or less urgent.