Nokea
The nurse encourages the patient to begin taking folate prior to trying to conceive. Why would the nurse encourage folate intake?
- A. Taking folate increases the chances of conceiving.
- B. Folate helps prevent neural tube defects.
- C. The nurse is preparing the patient to take vitamins during pregnancy.
- D. Folate decreases miscarriage.
Correct Answer: B
Rationale: The correct answer is B: Folate helps prevent neural tube defects. Folate is crucial for fetal development, particularly in preventing neural tube defects like spina bifida. It should be taken before conception to ensure adequate levels early in pregnancy. A: Taking folate does not directly increase the chances of conceiving. C: The nurse is not preparing the patient to take vitamins during pregnancy, but to prevent birth defects. D: Folate may reduce the risk of certain pregnancy complications but does not directly decrease miscarriage rates.
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During the assessment of a newborn, it is most important for the nurse to report a:
- A. Temperature of 97.7 degrees Fahrenheit
- B. Pale pink, rust-colored stain in the diaper
- C. Heart rate that drops to 120 beats/min
- D. Breathing pattern that is diaphragmatic with sternal retractions
Correct Answer: D
Rationale: The correct answer is D because a breathing pattern that is diaphragmatic with sternal retractions indicates respiratory distress in a newborn, which is a critical condition requiring immediate attention. Staying logical, let's assess the other choices:
A: Temperature of 97.7 degrees Fahrenheit is within the normal range for a newborn and does not indicate an urgent issue.
B: A pale pink, rust-colored stain in the diaper could be due to various factors such as diet and is not an immediate concern.
C: A heart rate dropping to 120 beats/min in a newborn is generally within the normal range and does not signify a critical issue.
A nurse is caring for a client who is 1 hr postpartum and observes a large amount of lochia rubra and several small clots on the client's perineal pad. The fundus is midline and firm at the umbilicus. Which of the following actions should the nurse take?
- A. Document the findings and continue to monitor the client.
- B. Notify the client's provider.
- C. Increase the frequency of fundal massage.
- D. Encourage the client to empty her bladder.
Correct Answer: A
Rationale: The correct answer is A: Document the findings and continue to monitor the client. This is the appropriate action because the client's fundus is midline and firm, indicating good uterine tone. Lochia rubra and small clots are expected findings in the immediate postpartum period. The nurse should document these findings for future reference and continue to monitor the client's condition.
Choice B (Notify the client's provider) is incorrect because there are no concerning signs that warrant immediate provider notification, as the fundus is firm and midline.
Choice C (Increase the frequency of fundal massage) is unnecessary since the fundus is already firm at the umbilicus, indicating good uterine tone.
Choice D (Encourage the client to empty her bladder) is not the priority in this scenario, as the client's fundal assessment and lochia observations take precedence.
A nurse is reviewing signs of effective breathing with a client who is 5 days postpartum. Which of the following information should the nurse include in the teaching?
- A. "You should feel a tugging sensation when the baby is sucking.
- B. You should expect your baby to have two to three wet diapers in 24hour period
- C. "Your baby's urine should appear dark and concentrated".
- D. "Your breast should stay firm after the baby breastfeeds".
Correct Answer: B
Rationale: Rationale: Choice B is correct because a newborn should have at least 6-8 wet diapers in a 24-hour period, indicating adequate hydration and effective breastfeeding. This frequency of wet diapers is a sign of adequate milk intake and hydration for the baby, which is crucial for their growth and development. Choices A, C, and D are incorrect because feeling a tugging sensation, dark and concentrated urine, and firm breasts are not indicators of effective breathing or breastfeeding in a newborn.
The nurse is caring for a client in labor with ruptured membranes. What finding suggests umbilical cord prolapse?
- A. Clear amniotic fluid.
- B. Variable decelerations on the fetal monitor.
- C. Contractions every 2 minutes.
- D. Maternal blood pressure of 110/70 mmHg.
Correct Answer: B
Rationale: The correct answer is B: Variable decelerations on the fetal monitor. This finding suggests umbilical cord prolapse because the cord can become compressed during contractions, leading to variable decelerations. It is a serious complication that requires immediate intervention to prevent fetal distress.
A: Clear amniotic fluid is a normal finding after rupture of membranes.
C: Contractions every 2 minutes may indicate tachysystole, but not specifically cord prolapse.
D: Maternal blood pressure is not directly related to cord prolapse.
Which assessment finding indicates uterine rupture?
- A. Contractions abruptly stop during labor
- B. Decreased maternal heart rate
- C. Gradual onset of mild pain during contractions
- D. Uterus becomes firm between contractions
Correct Answer: A
Rationale: The correct answer is A: Contractions abruptly stop during labor. Uterine rupture is a serious obstetric emergency where the integrity of the uterus is compromised, leading to potential life-threatening complications for both the mother and the fetus. When the uterus ruptures, contractions may abruptly stop due to the loss of muscle tone and coordination. This sudden cessation of contractions is a red flag indicating uterine rupture.
Choice B, decreased maternal heart rate, is not typically associated with uterine rupture. Choice C, gradual onset of mild pain during contractions, is more indicative of a normal labor process rather than uterine rupture. Choice D, uterus becomes firm between contractions, is not a specific sign of uterine rupture as it can occur in normal labor as well.