Nokea
The nurse is going to assist the mother with the first breastfeeding experience. Which of the following actions should the nurse perform first?
- A. Compare mother's and baby's identification bracelets.
- B. Help the mother into a comfortable position.
- C. Teach the mother about a proper breast latch.
- D. Tickle the baby's lips with the mother's nipple.
Correct Answer: A
Rationale: Identity verification ensures correct pairing.
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The nurse is discussing the neonatal blood screening test with a new mother. The nurse knows that the teaching was successful when the mother states that the test screens for the presence in the newborn of which of the following diseases? Select one that doesn't apply
- A. Hypothyroidism.
- B. Sickle cell disease.
- C. Galactosemia.
- D. Cerebral palsy.
Correct Answer: D
Rationale: These are common conditions screened for in neonatal blood tests; cerebral palsy is not typically screened through blood tests.
A female African American baby has been admitted into the nursery. Which of the following physiological findings would the nurse assess as normal?Select one that doesn't apply
- A. Purple-colored patches on the buttocks and torso.
- B. Bilateral whitish discharge from the breasts.
- C. Bloody discharge from the vagina.
- D. Sharply demarcated dark red area on the face.
Correct Answer: D
Rationale: Transient phenomena such as mongolian spots, witch's milk, and pseudo-menstruation are normal in newborns.
A client, 1 day postpartum (PP), is being monitored carefully after a significant postpartum hemorrhage. Which of the following should the nurse report to the obstetrician?
- A. Urine output 200 mL for the past 8 hours.
- B. Weight decrease of 2 pounds since delivery.
- C. Drop in hematocrit of 2% since admission.
- D. Pulse rate of 68 beats per minute.
Correct Answer: A
Rationale: Reduced urine output indicates potential hypovolemia.
The nurse is conducting discharge teaching for a patient going home after a cesarean birth. Which signs and symptoms should the patient be taught to report? (Select all that apply.)
- A. Mild incisional pain
- B. Feeling of pelvic fullness
- C. Lochia changing from red to pink in color
- D. Frequency, urgency, or burning on urination
Correct Answer: D
Rationale: The correct answer is D because frequency, urgency, or burning on urination could indicate a urinary tract infection, a common post-cesarean complication. Reporting these symptoms promptly can prevent further complications.
A, B, and C are incorrect. A mild incisional pain is normal after a cesarean birth and is expected during the healing process. Feeling of pelvic fullness may be due to postpartum changes in the body and is not necessarily concerning. Lochia changing from red to pink is a normal progression of lochia color and does not typically indicate a problem unless there are other concerning symptoms present.
Which should the nurse do to provide support to a patient who must return to full-time employment 6 weeks after a vaginal birth?
- A. Discuss child care arrangements with her.
- B. Allow her to solve the problem on her own.
- C. Reassure her that she’ll get used to leaving her baby.
- D. Allow her to express her positive and negative feelings freely.
Correct Answer: A
Rationale: The correct answer is A because discussing child care arrangements with the patient is essential for addressing her concerns and ensuring a smooth transition back to full-time employment. By discussing child care options, the nurse can help the patient make informed decisions and feel more confident about returning to work. This step shows support and helps the patient plan ahead for her baby's care while she's at work.
Choices B, C, and D are incorrect because they do not actively address the patient's needs or provide practical support. Allowing the patient to solve the problem on her own (B) may leave her feeling overwhelmed and unsupported. Reassuring her that she'll get used to leaving her baby (C) minimizes her feelings and does not offer concrete assistance. Allowing her to express feelings (D) is important but may not directly address the practical aspect of arranging child care, which is crucial for her successful return to work.