Nokea
The nurse is caring for a client in labor with an epidural. What assessment is most important immediately after placement?
- A. Monitor maternal temperature.
- B. Assess for lower extremity weakness.
- C. Monitor maternal blood pressure.
- D. Check fetal presentation.
Correct Answer: C
Rationale: Maternal blood pressure monitoring is essential to detect and manage hypotension caused by epidural anesthesia.
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The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by
- A. Proper breastfeeding techniques
- B. Washing with mild soap and water once a day
- C. Wearing a supportive bra 24h
- D. Wearing a nipple shield first few days of breastfeeding
Correct Answer: A
Rationale: Acute mastitis is inflammation of the breast tissue that may result from milk stasis, inadequate milk removal, or bacteria entering the breast tissue through cracks in the nipple. One of the key ways to prevent acute mastitis is by ensuring proper breastfeeding techniques. This includes ensuring a good latch to allow for effective milk removal, practicing frequent and complete emptying of the breasts, and alternating the position of the baby during feeding to ensure all parts of the breast are drained. Proper breastfeeding techniques help to prevent milk stasis and reduce the risk of developing mastitis.
What is the theory that supports HypnoBirthing?
- A. the fear-tension-pain theory
- B. the theory that pain is productive in labor
- C. the idea that self-hypnosis always works if you try hard enough
- D. the theory that when hypnotized during labor, the environment does not matter because the person is not aware of the surroundings
Correct Answer: A
Rationale: HypnoBirthing is based on the fear-tension-pain theory, which links fear to increased tension and pain.
A mother's laboratory results indicate the presence of cocaine and alcohol. The characteristic in her newborn that would indicate to the nurse that the baby has been affected with fetal alcohol syndrome would be:
- A. Cleft lip
- B. Polydactyly
- C. Umbilical Hernia
- D. Small upturned nose neonate weighs 3.2 kg, The health care provider prescribes the following orders for the neonate and signs the order sheet. Which order would the nurse question? Progress Notes: 12/01/22- 10am ï‚· Acetaminophen (Tylenol) 10mg/kg per rectum every 4-6 hours prn for pain ï‚· Ampicillin 200mg/kg IV every 6 hours in D5.45 NSSIV @ 125ml/hr. ï‚· Mom may breastfeed ad lib ï‚· Draw blood cultures x 3 in A.M. ï‚· Urine C&S in A.M.
Correct Answer: D
Rationale: The order that the nurse should question is "Ampicillin 200mg./kg IV every 6 hours." The usual dosage for ampicillin is 200-300 mg/kg/day divided into 4-6 doses, not every 6 hours. Administering ampicillin every 6 hours at 200mg/kg could potentially lead to overdose for the neonate. It is important to clarify this dosage with the health care provider before administering the medication to ensure the safety of the newborn.
Pregnant Black people have more complications resulting from epigenetic changes caused by prolonged stress due to racism and discrimination. What complication could arise because of this history?
- A. postterm pregnancy
- B. preeclampsia
- C. liver disease
- D. cholestasis of pregnancy
Correct Answer: B
Rationale: Prolonged stress and systemic racism contribute to higher rates of preeclampsia in Black pregnant individuals.
A nurse is providing dietary teaching for a client who is at 29 weeks of gestation and has phenylketonuria. Which of the following suggested foods should the nurse include in the teaching?
- A. A peanut butter sandwich on wheat bread.
- B. A sliced apple and red grapes.
- C. A chocolate chip cookie with a glass of skim milk.
- D. A scrambled egg with cheddar cheese.
Correct Answer: B
Rationale: Phenylketonuria (PKU) is a genetic disorder where the body cannot metabolize phenylalanine, an amino acid found in protein-containing foods. Patients with PKU need to follow a strict low-phenylalanine diet to prevent the buildup of phenylalanine in the body. Fruits like apples and grapes are low in protein and contain minimal phenylalanine, making them suitable choices for individuals with PKU. The other options listed contain higher amounts of protein and phenylalanine, such as peanut butter, chocolate chip cookies, milk, scrambled eggs, and cheese, which should be avoided by individuals with PKU.