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A nurse is providing discharge instructions to a client who is breastfeeding her newborn.
- A. Expect 2 to 4 wet diapers every 24 hours
- B. Allow the baby to feed at least every 3 hours
- C. Offer the newborn 30 mL (1 oz.) of water between feedings
- D. Feed the newborn 5 to 10 minutes per breast
Correct Answer: B
Rationale: The correct answer is B: Allow the baby to feed at least every 3 hours. This is important for maintaining the baby's hydration, ensuring proper nutrition, and promoting successful breastfeeding. Feeding on demand helps establish a good milk supply and supports the baby's growth and development. Offering water (choice C) is unnecessary and can interfere with breastfeeding. Limiting feeding time to 5-10 minutes per breast (choice D) can prevent the baby from getting enough hindmilk, which is rich in fat and important for weight gain. Expecting 2-4 wet diapers every 24 hours (choice A) is a general guideline but not as crucial as ensuring frequent feedings for a breastfeeding newborn.
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A nurse is teaching a prenatal class regarding false labor. Which of the following information should the nurse include?
- A. your contraction will become more intense when walking
- B. you will have dilation and effacement of the cervix
- C. You will have bloody show
- D. Your contraction will become temporally regular
Correct Answer: A
Rationale: The correct answer is A: your contractions will become more intense when walking. This is because false labor contractions typically decrease in intensity or stop completely when the individual changes positions or engages in physical activity. This is a key characteristic that helps differentiate false labor from true labor. Choices B, C, and D are incorrect as they are more indicative of true labor, where there is cervical dilation, effacement, bloody show, and regular contractions. It is important for the nurse to emphasize this distinction to ensure pregnant individuals can recognize the signs of true labor and seek appropriate care.
A nurse on an antepartum unit is reviewing the medical records for four clients. Which of the following clients should the nurse assess first?
- A. A client who has diabetes mellitus and an HbA1c of 5.8%
- B. A client who has preeclampsia and a creatinine level of 1.1 mg/ dL
- C. A client who has hyperemesis gravidarum and a sodium level of 110 mEq/L
- D. A client who has placenta previa and a hematocrit of 36%
Correct Answer: C
Rationale: The correct answer is C. The nurse should assess the client with hyperemesis gravidarum and a sodium level of 110 mEq/L first. This client is at risk for severe dehydration and electrolyte imbalance, which can lead to serious complications such as metabolic acidosis or organ dysfunction. Prompt assessment and intervention are crucial to stabilize the client's condition.
Choice A is not the priority as a client with diabetes mellitus and an HbA1c of 5.8% is within the target range indicating good glycemic control. Choice B, a client with preeclampsia and a creatinine level of 1.1 mg/dL, requires monitoring but is not as urgent as the client with hyperemesis gravidarum. Choice D, a client with placenta previa and a hematocrit of 36%, also needs monitoring but is not as urgently concerning as electrolyte imbalance.
A client who is 16 weeks of gestation asks the nurse how to prepare her toddler for a younger sibling.
- A. You should hold your newborn in your arms when you introduce him to your toddler
- B. You should move your toddler out of her crib 2 weeks prior to your due date
- C. You should place your toddler in timeout if she exhibits regressive Behavior after the baby is born
- D. You should place your toddler in timeout if she exhibits regressive behavior after the baby is born
Correct Answer: B
Rationale: The correct answer is B because moving the toddler out of the crib before the baby arrives allows the toddler time to adjust to the change without associating it directly with the baby's arrival. Holding the newborn in your arms (A) may make the toddler feel left out. Placing the toddler in timeout (C, D) for regressive behavior can create negative associations with the new sibling.
A nurse is caring for a client who has placenta previa. Which of the following findings should the nurse expect?
- A. Firm rigid abdomen
- B. Painless vaginal bleeding
- C. Uterine hypertonicity
- D. Persistent headache
Correct Answer: B
Rationale: The correct answer is B: Painless vaginal bleeding. In placenta previa, the placenta partially or completely covers the cervix, leading to painless vaginal bleeding. This occurs due to separation of the placenta from the uterine wall. A firm rigid abdomen (A) is more indicative of abruptio placentae. Uterine hypertonicity (C) is seen in conditions like uterine rupture, not placenta previa. Persistent headache (D) is not typically associated with placenta previa.
A nurse in a provider’s office is assessing a client at her first antepartum visit. The client states that the first day of her last menstrual period was March 8. Use Negele’s rule to calculate the estimated date of delivery. (Use the MMDD format with four numerals and no spaces or punctuation.)
- A. December 15
- B. October 30
- C. January 15
- D. Nov 30
Correct Answer: A
Rationale: To calculate the estimated due date using Negele's rule, we add 7 days to the first day of the last menstrual period, subtract 3 months, and then add a year. March 8 + 7 days = March 15. Subtracting 3 months gives us December 15. Adding a year gives the estimated due date as December 15. This is the correct answer as it follows the standard calculation method. Other choices are incorrect as they do not follow the correct formula or have errors in calculation.