Nokea
The nurse is providing discharge instructions to the caregiver of an infant with recurrent otitis media. Which statement made by the caregiver should the nurse recognize as needing additional education about minimizing subsequent infections?
- A. Avoid any smoking inside the house.
- B. Give infant the full course of antibiotics.
- C. Schedule visit for pneumococcal vaccine.
- D. Instill benzocaine otic drops regularly.
Correct Answer: D
Rationale: Benzocaine otic drops provide pain relief but do not prevent infections. Regular use may mask symptoms, delaying treatment. Avoiding smoke, completing antibiotics, and vaccinating reduce infection risk.
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Nurses' Notes
Orders
The client is a 4-month-old female with a history of gastroesophageal reflux (GERD). Client had fundoplication surgery and will be hospitalized for several days of recovery.
Which other assessment data would the nurse want to collect before implementing pain management strategies? Select all that apply.
- A. Blood type
- B. Parents religious affiliation
- C. Blood pressure
- D. Level of consciousness
- E. Hearing acuity
- F. Heart rate
- G. Deep tendon reflexes
Correct Answer: C,D,F
Rationale: Blood pressure, level of consciousness, and heart rate assess pain intensity and guide safe pain management. Blood type, religion, hearing, and reflexes are not directly relevant.
History and Physical
Nurses' Notes
Flow Sheet
Laboratory Results
38-year-old primiparous client is seen in the outpatient obstetric office 2 weeks postpartum after a spontaneous vaginal birth of a full-term infant after rupture of membranes for 16 hours. The client was discharged on day 2, exclusively breastfeeding.
Which education by the nurse will help resolve the issue for the client? Select all that apply.
- A. Wear an underwire bra around the clock.
- B. Apply warm compresses to affected area before feeding.
- C. Pump breasts if feeding will be missed, due to absence from the infant.
- D. Pump breastmilk and feed it to infant instead of nursing.
- E. Finish antibiotics even if symptoms improve.
- F. Maintain activity due to the risk of blood clots with extra rest.
- G. Wash hands before handling the breast.
Correct Answer: B,C,E,G
Rationale: Warm compresses, pumping to prevent milk stasis, completing antibiotics, hand hygiene, starting on the unaffected side, and varying positions promote milk flow, reduce infection risk, and ensure effective breastfeeding. Underwire bras and avoiding rest are not recommended.
Following a vaginal delivery, the nurse places the neonate under the radiant warmer, provides naso-oropharyngeal suction, and dries the neonate's skin to elicit spontaneous respirations. The newborn heart rate is 100 beats/minute and remains apneic when the nurse flicks the soles of the feet. Which action should the nurse implement next?
- A. Give blow-by oxygen via cannula.
- B. Start IV infusion in a scalp vein.
- C. Assist neonatologist with intubation.
- D. Provide positive pressure ventilation.
Correct Answer: D
Rationale: Positive pressure ventilation is critical for an apneic newborn to establish breathing and ensure oxygenation, per neonatal resuscitation guidelines.
For best pain management, the nurse should give... of acetaminophen every 4 hours as scheduled.
- A. 3.3 mL
- B. 1.9 mL
- C. 5.0 mL
- D. 0.8 mL
Correct Answer: A
Rationale: For a 7 kg infant, 15 mg/kg = 105 mg. At 160 mg/5 mL, 105 mg requires 3.3 mL, providing effective pain relief without toxicity.
History and Physical
Nurses' Notes
Flow Sheet
Laboratory Results
38-year-old primiparous client is seen in the outpatient obstetric office 2 weeks postpartum after a spontaneous vaginal birth of a full-term infant after rupture of membranes for 16 hours. The client was discharged on day 2, exclusively breastfeeding.
The nurse knows that the mastitis in this scenario is most likely caused by... as evidenced by...
- A. Plugged duct
- B. Breast abscess
- C. Engorgement
- D. Nipple trauma with cracked skin
- E. Firm, red, warm area on the right breast
- F. Pus draining from the nipple
- G. Generalized swelling of the entire breast
Correct Answer: A,E
Rationale: A plugged duct, evidenced by a firm, red, warm area, is the likely cause of mastitis due to milk stasis from missed feedings. Abscess, engorgement, or nipple trauma are less likely without pus, generalized swelling, or reported cracks.