Nokea
The nurse is providing preconception counseling. Which supplement should the nurse recommend to help prevent the occurrence of anencephaly?
- A. Folic acid.
- B. Iron.
- C. Vitamin D.
- D. Calcium.
Correct Answer: A
Rationale: Folic acid (400-800 mcg daily) prevents neural tube defects like anencephaly by supporting neural tube closure.
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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.
The nurse is caring for an infant admitted with dehydration, irritability, signs of extreme hunger, and a palpable olive-like mass in the upper right abdominal quadrant. When feeding the infant, the nurse should monitor for which development?
- A. Arched back.
- B. Coffee-ground emesis.
- C. Projectile vomiting.
- D. Frequent pauses.
Correct Answer: C
Rationale: Projectile vomiting is characteristic of pyloric stenosis, indicated by the olive-like mass, hunger, and dehydration.
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.
A nurse is speaking with a client who is addicted to heroin and who just learned that she is pregnant. The client states, 'I just started taking methadone. Is there anything else I can do to make sure my baby is healthy?' Which information should the nurse provide?
- A. Describe genetic testing protocols.
- B. Sign up for group therapy sessions.
- C. Start a prenatal care plan as soon as possible.
- D. Discontinue the methadone right away.
Correct Answer: C
Rationale: Early prenatal care monitors methadone effects, fetal development, and complications like neonatal abstinence syndrome, ensuring a healthy pregnancy.
Based on the assessment findings, the priority diagnosis suspected is... This diagnosis places the client at risk of...
- A. Mastitis
- B. Engorgement
- C. Blocked milk duct
- D. Inflammatory breast cancer
- E. Abscess
- F. Breastfeeding intolerance
- G. Nipple thrush
Correct Answer: A
Rationale: Mastitis, indicated by fever, localized breast symptoms, and systemic signs, is the priority diagnosis. It risks progressing to an abscess if untreated, requiring prompt intervention.