Nokea
The client with oligohydramnios and possible intrauterine growth restriction gives birth. The newborn’s 1-minute Apgar score was 6,and the 5-minute Apgar score is 7. Which conclusion should the nurse make from this information?
- A. A low Apgar score at 1 minute correlates with infant mortality.
- B. The 5-minute Apgar score of 7 is within normal parameters.
- C. Neurological problems are unlikely with a 5-minute score of 7.
- D. Oligohydramnios would not have affected the Apgar score.
Correct Answer: B
Rationale: A 5-minute Apgar score at or above 7 is considered normal. A low 1-minute score is not associated with mortality but a low 5-minute score is. Apgar scores are poor predictors of neurological outcomes and oligohydramnios can affect scores.
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What percentage of Polyhydramnios is associated with congenital malformations:
- A. Less than 1%.
- B. 5-10%.
- C. 20-30%.
- D. 50-60%.
- E. 90-100%.
Correct Answer: C
Rationale: Approximately 20-30% of polyhydramnios cases are associated with congenital malformations such as gastrointestinal or neural tube defects which impair fetal swallowing or increase fluid production.
The parents are visiting their newborn,who is in the neonatal intensive care unit (NICU) after being diagnosed with a terminal cardiac condition. Which statement best reflects the nurse’s judgment about interventions to promote parental attachment?
- A. Interventions should be delayed until it is certain that the newborn will live.
- B. The parents should be encouraged to provide as much care as possible.
- C. The parents should only be encouraged to touch and name their newborn.
- D. The parents should be assured that they did not do anything to cause this condition.
Correct Answer: B
Rationale: Encouraging parents to provide care promotes attachment aiding coping if the infant dies. Delaying interventions limiting to touch/naming or assuming guilt are less supportive.
Which nursing action is most appropriate when caring for a school-age child who is experiencing a nosebleed?
- A. Tilt the child's head backward, and apply an ice pack to the nose.
- B. Position the child's head forward while gently pinching the nostrils.
- C. Pack the affected nostril with a small amount of clean cotton.
- D. Clean the affected nostril, and instill saline nose drops.
Correct Answer: B
Rationale: Positioning the head forward and pinching the nostrils applies pressure to stop bleeding while preventing blood from flowing down the throat, which could cause choking or nausea.
Thyrotoxicosis is pregnancy is treated with:
- A. Partial thyroidectomy in first trimester.
- B. Radioiodine ablation of thyroid gland.
- C. With neomercazole.
- D. Surgery on thyroid gland in 3rd trimester.
- E. With iodine drops and β-blockers.
Correct Answer: C
Rationale: Neomercazole (carbimazole) is used to treat thyrotoxicosis in pregnancy as it controls thyroid hormone production safely. Radioiodine is contraindicated and surgery is avoided unless absolutely necessary.
Which statement by the parents best indicates that the nurse's teaching has been effective?
- A. We'll give our child the penicillin for the full 10 days.
- B. We will keep our child at home until fully recovered.
- C. We will make sure that our child stays out of the sun with being treated.
- D. We'll notify the physician if our child has a sore throat.
Correct Answer: D
Rationale: Effective teaching about rheumatic fever emphasizes preventing recurrent streptococcal infections, which can trigger relapse. Notifying the physician about a sore throat ensures prompt treatment of potential streptococcal infections, reducing recurrence risk.