Nokea
The nurse is assessing the infant who may have FAS. Which findings,if observed,should the nurse associate with FAS? Select all that apply.
- A. Broad nasal bridge and flat midface
- B. Growth deficit in weight and length
- C. Excessive irritability and hypotonia
- D. Poor feeding and persistent vomiting
- E. Large jaw and overdeveloped maxilla
Correct Answer: A,B,C,D
Rationale: FAS features include broad nasal bridge flat midface growth deficits irritability hypotonia and poor feeding/vomiting due to alcohol’s effects. The jaw is small not large.
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A 30 years old G5P4 is admitted in labor room with H/O 32 weeks gestation,mild vaginal bleeding and abdominal pain. O/E her blood pressure 140/100 mm Hg abdomen is tense tender and hard. Fetal heart sounds are not audible. What is the most likely diagnosis:
- A. Placenta praevia.
- B. Abruptio placenta.
- C. Preterm labour.
- D. Urinary tract infection.
- E. Vasa praevia.
Correct Answer: B
Rationale: Abruptio placenta presents with vaginal bleeding abdominal pain a tense uterus and fetal distress (absent heart sounds) often with hypertension. Placenta previa typically causes painless bleeding and other options do not match the clinical picture.
The nurse finds documentation in the 4-hour-old newborn’s medical record that states,“Clamping of the umbilical cord was delayed until cord pulsations ceased.” When assessing and collecting additional information about the newborn,what effect should the nurse find as a result of the delayed cord clamping?
- A. More rapid expulsion of meconium by the newborn
- B. Increased level of newborn alertness after birth
- C. An increase in the newborn’s initial temperature
- D. An increase in the newborn’s hemoglobin and hematocrit
Correct Answer: D
Rationale: Newborn Hgb and Hct values will be higher when placental transfusion accomplished through delayed cord clamping occurs at birth. Blood volume increases by up to 50% with delayed cord clamping. Meconium passage alertness and temperature are not affected by delayed clamping.
The nurse is discharging the 3-day-old term newborn with a right-sided cephalohematoma. The nurse should instruct the parents to observe their infant closely over the next week for the development of which problem associated with the cephalohematoma?
- A. Jaundice
- B. Difficulty feeding
- C. Pale extremities
- D. Bulging on the right side of the head with crying
Correct Answer: A
Rationale: Cephalohematoma resolution causes RBC hemolysis leading to jaundice. It doesn’t affect feeding cause paleness or bulge with crying.
The nurse and student nurse are caring for the postpartum client who delivered a term newborn 24 hours previously. The nurse recognizes that the student needs more information on newborn nutrition when making which statement?
- A. About half of the baby’s calorie needs are met by the fat in breast milk or formula.
- B. Lactose is the primary source of carbohydrates in breast milk and formula.
- C. Calcium supplements are not needed for the newborn regardless of the feeding method.
- D. Supplemental water should be given to all infants daily,regardless of feeding method.
Correct Answer: D
Rationale: Breast milk and formula (~90% water) meet infant water needs. Supplemental water risks hyponatremia. Fat (~50% calories) lactose and adequate calcium are correct.
Which instruction should the nurse include when teaching the parents about the administration of oral penicillin to their child?
- A. Give the medication with a full glass of orange juice.
- B. Give the medication after a large meal.
- C. Continue the medication even if the child develops a rash.
- D. Continue the medication for the full course of therapy.
Correct Answer: D
Rationale: Completing the full course of penicillin therapy eradicates the infection and prevents recurrence or resistance, especially for streptococcal infections.