Nokea
The father of a 3-day old infant who is breastfeeding calls the postpartum help line to report that his wife is acting strangely. She is irritable, cannot cope with the baby, and frequently cries for no appeared reason. What information is most important for the nurse to provide the father?
- A. Contact the clinic if the behaviors continue for more than two weeks or becomes worse
- B. Tell the father count the newborns number of soiled diapers over the next few days.
- C. A fluctuation in hormones in the early postpartum period can cause mood changes.
- D. Recommend giving supplemental bottle feedings to the baby between breast feeding.
Correct Answer: C
Rationale: Hormonal fluctuations (C) are common causes of mood changes in the early postpartum period.
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The nurse is reviewing a list of foods high in folic acid with a patient who is considering becoming pregnant. The nurse determines that the patient understands the teaching when the patient states she will include which list of foods in her diet?
- A. Peaches, yogurt, and tofu
- B. Strawberries, milk, and tuna
- C. Asparagus, lemonade, and chicken breast
- D. Spinach, orange juice, and fortified bran flakes
Correct Answer: D
Rationale: The correct answer is D. Spinach, orange juice, and fortified bran flakes are high in folic acid, which is essential for pregnant women to prevent neural tube defects in the fetus. Spinach is rich in folate, the natural form of folic acid. Orange juice is often fortified with folic acid, and fortified bran flakes also contain high levels of folic acid.
A, B, and C are incorrect choices because they do not contain foods that are particularly high in folic acid. While peaches, yogurt, tofu, strawberries, milk, tuna, asparagus, lemonade, and chicken breast are all nutritious choices, they are not as rich in folic acid as the foods listed in option D. It is crucial for the patient to focus on foods with high folic acid content to support a healthy pregnancy.
A patient in her fifth month of pregnancy asks the nurse, 'How many more calories should I be eating daily?' What is the correct response by the nurse?
- A. 180 more calories a day
- B. 340 more calories a day
- C. 452 more calories a day
- D. 500 more calories a day
Correct Answer: B
Rationale: The correct response is B: 340 more calories a day. During the second trimester, an additional 340 calories per day is recommended for pregnant women. This ensures proper nutrition for both the mother and the developing fetus. Option A (180 more calories) may not provide enough energy for the needs of pregnancy. Options C (452 more calories) and D (500 more calories) are excessive and could lead to unnecessary weight gain, which may pose risks during pregnancy. Option B strikes a balanced approach to support the increased energy demands of pregnancy without being excessive.
The nurses assessing a 38-week gestation newborn infant immediately following a vaginal birth. Which assessment finding best indication that the infant is transitioning well to extrauterine life?
- A. Heart rate 220 beats/minute
- B. Cries vigorously when stimulated
- C. A positive Babinski reflex
- D. Flexion of all four extremities
Correct Answer: B
Rationale: Vigorous crying (B) indicates effective transition to extrauterine life.
A term multigravida, who is receiving oxytocin for labor augmentation is requesting pain medication. Review of the clients record indication that she was medicated 30 minutes ago with butorphanol (Stadol) 2 mg and promethazine (Phenergan) 25 mg IV push. Vaginal examination reveals that the client cervical dilation is 3 cm, 70% effaced, and at a 0 station. What action should the nurse implement?
- A. Discontinue the Pitocin infusion
- B. Medicate the client with an additional 1 mg of Stadol IV push
- C. Notify the healthcare provider
- D. Instruct the client to use deep breathing during contraction
Correct Answer: D
Rationale: Deep breathing techniques (D) can help manage pain without additional medication.
A client who is anovulatory and has hyperprolactinemia is being treated for infertility with metformin, menotropins (Repronex, MENOPUR®), and human chorionic gonadotropin(hCG). Which side effects should the nurse tell the client to report immediately?
- A. Episodes of headache and irritability
- B. Nausea and vomiting
- C. Rapid increase in abdominal girth
- D. Persistent daytime fatigue
Correct Answer: C
Rationale: Rapid abdominal girth increase (C) may indicate ovarian hyperstimulation syndrome, a serious complication.