Nokea
The nurse is caring for a multiparous client after vaginal delivery of a set of male twins 2 hours ago. The nurse should encourage the mother and husband to:
- A. Bottle-feed the twins to prevent exhaustion and fatigue.
- B. Plan for each parent to spend equal amounts of time with each twin.
- C. Avoid assistance from other family members until attachment occurs.
- D. Relate to each twin individually to enhance the attachment process.
Correct Answer: D
Rationale: Relating to each twin individually fosters unique bonding and attachment.
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A newborn weighing 6½ lb is to be given naloxone hydrochloride (Narcan) due to respiratory depression caused by a narcotic administered to the mother shortly before delivery. The dosage is 0.01 mg/kg, administered into the umbilical vein. The vial is labeled 0.4 mg/mL.. How many milligrams would the newborn receive? Round to two decimals.
Correct Answer: 0.03 mg
Rationale: The neonate weighs 6.5 lb (2.95 kg). The dose is 0.01 mg/kg, so 0.01 mg/kg × 2.95 kg = 0.0295 mg, rounded to 0.03 mg.
As the nurse enters the room of a newly admitted primigravid client diagnosed with severe preeclampsia, the client begins to experience a seizure. The nurse should do which in order of priority from first to last?
- A. Call for immediate assistance.
- B. Turn the client to her side.
- C. Note the time when the seizure began.
- D. Maintain airway.
Correct Answer: A,D,B,C
Rationale: Call for help, ensure the airway is clear, turn the client to prevent aspiration, and document the seizure duration.
A multigravid client in active labor at term is diagnosed with polyhydramnios. The physician has instructed the client about possible neonatal complications related to the polyhydramnios. The nurse determines that the client has understood the instructions when the client states that polyhydramnios is associated with which of the following in the fetus or neonate?
- A. Renal dysfunction.
- B. Intrauterine growth retardation.
- C. Pulmonary hypoplasia.
- D. Gastrointestinal disorders.
Correct Answer: D
Rationale: Polyhydramnios is associated with fetal gastrointestinal disorders (e.g., esophageal atresia) that impair amniotic fluid absorption. Renal dysfunction, growth retardation, or pulmonary hypoplasia are more linked to oligohydramnios.
A nurse is counseling a client about the use of spermicides. Which of the following instructions should the nurse include?
- A. Apply spermicide 10-30 minutes before intercourse.
- B. Use spermicide alone for maximum effectiveness.
- C. Leave spermicide in place for at least 24 hours.
- D. Apply spermicide after intercourse.
Correct Answer: A
Rationale: Spermicide should be applied 10-30 minutes before intercourse for optimal effectiveness. It is not most effective alone, should not be left for 24 hours, and is applied before, not after, intercourse.
A nurse is teaching a client about the use of the contraceptive injection. Which of the following instructions should the nurse include?
- A. The injection is given every 6 months.
- B. The injection may cause a delay in return to fertility.
- C. The injection protects against STIs.
- D. The injection is taken orally daily.
Correct Answer: B
Rationale: The contraceptive injection (Depo-Provera) may cause a delay in return to fertility, sometimes up to 18 months. It is given every 3 months, does not protect against STIs, and is not taken orally.