Nokea
A nurse is providing teaching to the parents of a newborn about the plastibell circumcision technique.
- A. The plastibell will be removed 4 hours after the procedure
- B. Notify the provider if the end of the penis appears dark red
- C. Make sure the newborn's diaper is snug
- D. Yellow exudate will form at the surgical site in 24 hours
Correct Answer: B
Rationale: The correct answer is B: Notify the provider if the end of the penis appears dark red. This is because dark red coloration at the end of the penis could indicate infection or compromised blood flow, requiring immediate medical attention. Choice A is incorrect as the plastibell is typically left in place for about a week, not 4 hours. Choice C is incorrect as a snug diaper can cause discomfort and hinder healing. Choice D is incorrect because yellow exudate is a normal part of the healing process, usually appearing within 24-48 hours post-circumcision.
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A nurse is caring for four newborns. Which of the following newborns should the nurse assess first?
- A. newborn who has nasal flaring
- B. newborn who has subconjunctival hemorrhage of the left eye
- C. A newborn who has overlapping suture lines
- D. A newborn who has not rust-stained urine
Correct Answer: A
Rationale: The correct answer is A: newborn who has nasal flaring. Nasal flaring indicates respiratory distress, which is a priority concern in newborns as it can lead to hypoxia. The nurse should assess this newborn first to ensure adequate oxygenation.
B: Subconjunctival hemorrhage is common and not an urgent issue.
C: Overlapping suture lines are normal in newborns and do not require immediate attention.
D: Not passing rust-stained urine could indicate a metabolic issue but is not as urgent as respiratory distress.
A nurse is assessing a newborn immediately following a vaginal birth. For which of the following findings should the nurse intervene?
- A. Molding
- B. Vernix Caseosa
- C. Acrocyanosis
- D. Sternal retractions
Correct Answer: D
Rationale: The correct answer is D: Sternal retractions. Sternal retractions in a newborn indicate respiratory distress, potentially due to a blocked airway or difficulty breathing. The nurse should intervene immediately to ensure the newborn's airway is clear and that they are able to breathe properly.
A: Molding is the overlapping of cranial bones during birth, a common and temporary finding.
B: Vernix Caseosa is a protective coating on the newborn's skin and is normal.
C: Acrocyanosis is the bluish discoloration of the hands and feet, a common finding in newborns due to immature circulation.
A nurse is providing teaching to a client who is receiving medroxyprogesterone IM for contraception. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should discontinue this medication if I experience spotting
- B. I will need to return to the clinic in the next eight weeks for my next injection
- C. I should increase my calcium intake while taking this medication
- D. I will get two shots each time I receive this medication
Correct Answer: B
Rationale: The correct answer is B. Returning to the clinic in 8 weeks for the next injection indicates an understanding of the medication schedule. Medroxyprogesterone is typically given every 11 to 13 weeks, so returning in 8 weeks would align with the correct timing for the next injection. This demonstrates the client's comprehension of the dosing regimen.
Incorrect choices:
A: Discontinuing the medication if spotting occurs is not correct as spotting can be a common side effect of medroxyprogesterone.
C: Increasing calcium intake is not specifically related to medroxyprogesterone IM for contraception.
D: Getting two shots each time is incorrect as typically only one injection is given.
Overall, choice B is the correct answer based on the medication's dosing schedule, while the other choices do not align with the appropriate understanding of medroxyprogesterone IM for contraception.
A nurse is planning care for a newborn who is scheduled to start phototherapy using a lamp. Which of the following actions should the nurse include in the plan?
- A. Apply a thin layer of lotion to the newborn skin every 8 hrs.
- B. Give the newborn 1oz of glucose water every 4 hrs
- C. Ensure the newborn eyes are closed beneath the shield.
- D. Dress the newborn in a thin layer of clothing during therapy
Correct Answer: C
Rationale: Rationale: Choice C is correct because ensuring the newborn's eyes are closed beneath the shield during phototherapy prevents potential eye damage from the bright light. Closing the eyes protects the delicate eye tissues from exposure to the intense light. This action is crucial in preventing eye injury and promoting the safety and well-being of the newborn.
Incorrect Choices:
A: Applying lotion to the skin can intensify the effects of the light and should be avoided.
B: Giving glucose water is unnecessary and not related to phototherapy.
D: Dressing the newborn in clothing can interfere with the effectiveness of the light therapy.
A nurse is caring for a client who is 36 weeks gestation and has MRSA. Which of the following isolation precautions should the nurse initiate?
- A. Droplet
- B. Contact
- C. Airborne
- D. Protective environment
Correct Answer: B
Rationale: The correct answer is B: Contact isolation. This is because MRSA is primarily spread through direct physical contact with the infected individual or contaminated surfaces. By implementing contact precautions, the nurse can prevent the spread of MRSA to other patients and healthcare workers. Droplet precautions (choice A) are used for diseases spread through large respiratory droplets, such as influenza. Airborne precautions (choice C) are for diseases transmitted through small respiratory droplets that remain suspended in the air, like tuberculosis. Protective environment (choice D) is used for immunocompromised patients to protect them from environmental pathogens. Therefore, the most appropriate precaution for a client with MRSA at 36 weeks gestation is contact isolation.