Nokea
The nurse is caring for a laboring client who is GBS+ (Group B streptococcus). Which immediate treatment is indicated for this client?
- A. Administration of Pitocin
- B. Artificial rupture of the membrane
- C. Amnioinfusion for the baby
- D. Administration of antibiotics
Correct Answer: D
Rationale: Antibiotics (D) are administered to GBS+ mothers to prevent neonatal infection.
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A pregnant patient's diet may not meet her need for folate. Which food choice is an excellent source of this nutrient?
- A. Chicken
- B. Cheese
- C. Potatoes
- D. Green leafy vegetables
Correct Answer: D
Rationale: The correct answer is D: Green leafy vegetables. Green leafy vegetables such as spinach, kale, and broccoli are excellent sources of folate, a crucial nutrient for pregnant women to prevent neural tube defects in the fetus. These vegetables are rich in natural folate, making them an ideal choice for meeting the increased folate requirements during pregnancy. Chicken (A), cheese (B), and potatoes (C) do not contain as high levels of folate as green leafy vegetables, making them less optimal choices for ensuring adequate intake of this essential nutrient during pregnancy.
When performing daily head to toe assessment of a 1-day old newborn the nurse observes yellow tint to the skin on the forehead, sternum, and abdomen. What action should the nurse take?
- A. Measure bilirubin levels using transcutaneous bilirubinometer
- B. Review maternal medical records for blood type and Rh factor
- C. Prepare the newborn for phototherapy
- D. Evaluate cord results
Correct Answer: A
Rationale: Measuring bilirubin levels (A) is the first step to determine if phototherapy is necessary for jaundice.
When explaining the recommended weight gain to your patient, the nurse's teaching should include which statement?
- A. All pregnant women need to gain a minimum of 25 to 35 lb.'
- B. The fetus, amniotic fluid, and placenta require 15 lb of weight gain.'
- C. Weight gain in pregnancy is based on the patient's prepregnant body mass index.'
- D. More weight should be gained in the first and second trimesters and less in the third.'
Correct Answer: C
Rationale: The correct answer is C because weight gain in pregnancy should be individualized based on the patient's prepregnant body mass index (BMI). This is important as it takes into consideration the patient's starting weight and helps to determine a healthy range of weight gain to support both maternal and fetal health. This approach is evidence-based and helps to prevent complications such as gestational diabetes and preeclampsia.
Explanation for why the other choices are incorrect:
A: This statement is incorrect because not all pregnant women need to gain the same amount of weight. Weight gain recommendations vary based on the patient's BMI.
B: This statement is incorrect as it provides a specific number for weight gain, which may not be accurate for all pregnant women. Weight gain should be individualized based on BMI.
D: This statement is incorrect because weight gain recommendations are distributed evenly across the trimesters, not necessarily more in the first and second trimesters and less in the third.
Regarding advanced roles of nursing, which statement related to clinical practice is the most accurate?
- A. Family nurse practitioners (FNPs) can assist with childbirth care in the hospital setting.
- B. Clinical nurse specialists (CNSs) provide primary care to obstetric patients.
- C. Neonatal nurse practitioners provide emergency care in the postbirth setting to high-risk infants.
- D. A certified nurse midwife (CNM) is not considered to be an advanced practice nurse.
Correct Answer: C
Rationale: Neonatal NPs provide specialized care for high-risk neonates in the birth room and NICU as needed.
A client at 40-weeks gestation is admitted to the labor and delivery unit in active labor. The client's cervix is dilated 8 cm, 100% effaced, and the fetus is at +1 station. The client begins to push forcefully with contractions. What action should the nurse take?
- A. Encourage the client to pant-blow during contractions.
- B. Assist the client to push with contractions.
- C. Prepare for an immediate delivery.
- D. Notify the healthcare provider.
Correct Answer: A
Rationale: Pant-blow breathing helps prevent premature pushing before full dilation, reducing the risk of cervical edema.