Nokea
A client comes to the clinic to confirm that she is pregnant. Her last menstrual period was January 31st. According to Naegele's rule, when should the client expect to deliver?
- A. November 31
- B. December 7
- C. November 7
- D. December 24
Correct Answer: C
Rationale: The correct answer is C: November 7. Naegele's rule estimates the due date by adding 7 days to the first day of the last menstrual period (LMP), subtracting 3 months, and adding 1 year. LMP is January 31, so adding 7 days gives February 7. Subtracting 3 months gives November 7. Other choices are incorrect as there is no November 31, December 7 is too far ahead, and December 24 is also too far from the estimated due date.
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A nurse is caring for a 4-year-old child diagnosed with leukemia who is admitted with myelosuppression.
- A. "Provide a diet high in carbohydrates."'
- B. "Monitor rectal temperature every 4 hr."'
- C. "Use lemon or glycerin swabs for oral care."'
- D. "Inspect the skin daily for lesions."'
Correct Answer: D
Rationale: The correct answer is D: "Inspect the skin daily for lesions." This is important because myelosuppression can lead to decreased platelets, increasing the risk of skin lesions and bleeding. Monitoring the skin daily can help detect any lesions early and prevent complications.
A: Providing a high-carbohydrate diet is not directly related to managing myelosuppression.
B: Monitoring rectal temperature is important but not directly related to skin lesion detection.
C: Using lemon or glycerin swabs for oral care is important for mucositis, not skin lesions.
With routine prenatal screening, a woman in the second trimester of pregnancy is confirmed to have gestational diabetes. How may the nurse explain the role of diet and insulin in the management of blood sugar during pregnancy?
- A. You will need to take an oral hypoglycemic, which is a pill to lower your blood sugar.
- B. Insulin lowers an elevated blood sugar during pregnancy to meet the increased metabolic needs of the baby.
- C. There is a good possibility you will be taking insulin for the rest of your life.
- D. You should eat three large meals per day to maintain steady glucose load.
Correct Answer: B
Rationale: The correct answer is B: Insulin lowers an elevated blood sugar during pregnancy to meet the increased metabolic needs of the baby. During pregnancy, the placenta produces hormones that can make it difficult for insulin to work effectively, leading to gestational diabetes. Insulin helps to lower blood sugar levels in the mother, which in turn provides the necessary glucose for the developing baby's growth and development. The other choices are incorrect because: A) Oral hypoglycemics are not typically prescribed during pregnancy due to potential risks to the baby. C) Gestational diabetes usually resolves after delivery and does not require lifelong insulin use. D) Eating three large meals per day can cause blood sugar spikes and is not recommended for managing gestational diabetes.
A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching?
- A. Obtain an informed consent prior to obtaining the specimen
- B. Collect at least milliliter of the urine for the test
- C. Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen.
- D. Premature newborns may have false negative tests due to immature development of liver enzymes.
Correct Answer: C
Rationale: The correct answer is C: Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen. This is important because certain metabolic disorders can only be detected if the baby has been feeding normally. Without proper feeding, the test results may not be accurate.
Choice A is incorrect because informed consent is not required for universal newborn screening; it is a routine procedure. Choice B is incorrect as urine is not typically used for the universal newborn screening. Choice D is incorrect because premature newborns may have false positive tests, not false negative tests, due to immature liver enzyme development.
A nurse is talking to the parents of a 3-year-old child about water safety precautions. Which of the following statements made by the parents indicates a need for clarification?
- A. We keep the toilet seat down at all times.
- B. We don't answer the phone during bath time.
- C. We empty all buckets filled with water.
- D. We have our child in swimming lessons.
Correct Answer: D
Rationale: The correct answer is D because enrolling a 3-year-old child in swimming lessons does not necessarily prevent drowning incidents. It is crucial for parents to understand that even with swimming lessons, active supervision around water is essential to prevent accidents. Keeping the toilet seat down (A), avoiding distractions during bath time (B), and emptying buckets filled with water (C) are all important water safety precautions to prevent drowning incidents. Swimming lessons are beneficial, but they should not replace vigilant supervision.
A woman in active labor receives a narcotic analgesic for pain control. If the narcotic is given a half an hour before delivery, which effect will the medication have on the infant?
- A. It will cause the infant's blood sugar to fall.
- B. It will cause the infant's respiratory rate to decrease.
- C. It will cause the infant's heart rate to increase.
- D. It will cause the infant's movements to be hyperactive.
Correct Answer: B
Rationale: The correct answer is B: It will cause the infant's respiratory rate to decrease. Narcotic analgesics can cross the placenta and affect the baby. These medications can depress the respiratory drive of the newborn, leading to decreased respiratory rate. This effect is particularly pronounced if the narcotic is given shortly before delivery when the drug levels in the infant's system are highest. The other choices are incorrect because: A) Narcotics are not known to directly affect blood sugar levels in infants. C) Narcotics typically cause a decrease, rather than an increase, in heart rate. D) Narcotics are more likely to cause sedation and decreased movements rather than hyperactivity in newborns.