Nokea
The nurse manager is planning a debriefing for several of the nurses after an IPFD. What should the manager expect?
- A. The nurses will need to discuss fault in order to alleviate feelings of guilt.
- B. During the debriefing, some nurses will complain of physical tension, headache, and insomnia.
- C. The nurse caring for the patient will need to defend herself to the health-care provider.
- D. The charge nurse will discuss the nurse’s documentation to prevent a lawsuit.
Correct Answer: B
Rationale: Debriefing sessions often reveal stress-related symptoms such as physical tension, headaches, and insomnia among healthcare providers following traumatic events like IPFD. Focusing on blame or legal concerns detracts from the emotional processing necessary during these sessions.
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The nurse is explaining to a mother that her newborn's blood test indicates a high level of unconjugated bilirubin, which causes jaundice. Which information doesn't the nurse present to the mother?
- A. The blood test does not indicate a pathological disease.
- B. The newborn's liver converts bilirubin to a water-soluble substance.
- C. An abundance of RBCs and RBC short life span contributes to the condition.
- D. The newborn's condition is also referred to as hyperbilirubinemia.
Correct Answer: D
Rationale: The correct answer is D because the nurse does not mention the term "hyperbilirubinemia" to the mother. Instead, the nurse focuses on explaining the high level of unconjugated bilirubin causing jaundice.
A: The nurse likely mentioned that the blood test does not indicate a pathological disease to reassure the mother that jaundice is a common condition in newborns.
B: The nurse would have explained that the newborn's liver converts bilirubin to a water-soluble substance as part of the discussion on how bilirubin is processed in the body.
C: An abundance of RBCs and their short lifespan contributing to jaundice would be relevant information that the nurse would provide to explain the underlying causes of the condition.
A nurse is preparing to discharge an infant who has developmental dysplasia of the hip (DDH). What discharge instruction would be most important?
- A. How to correctly perform Ortolani's maneuver
- B. How to properly use the Pavlik harness
- C. When to return for corrective surgery
- D. Where to take the baby to be fit for corrective shoes
Correct Answer: B
Rationale: A baby with DDH will be placed in a special splint, most often the Pavlik harness, to keep the legs in a position of abduction. The harness is worn continuously for 3-6 months, during which time bone growth helps create a normal hip joint. Ortolani's maneuver is an assessment for DDH. Surgery may be required, but not until it has been determined that bone growth is not creating a normally shaped hip joint. Corrective shoes are not needed.
Transient tachypnea of the neonate develops due to what pathophysiologic phenomenon?
- A. failure to clear lung fluid by the usual mechanism
- B. failure of the patent ductus arteriosus to close
- C. insufficient surfactant production
- D. aspiration of meconium during vaginal or cesarean birth that interferes with surfactant activity
Correct Answer: A
Rationale: The correct answer is A because transient tachypnea of the neonate is primarily caused by the failure to clear lung fluid by the usual mechanism. During birth, the baby may not expel the lung fluid properly, leading to respiratory distress. This results in rapid breathing (tachypnea) due to the retained fluid in the lungs. The other choices are incorrect as they do not directly relate to the pathophysiology of transient tachypnea. Choice B involves the heart (patent ductus arteriosus), choice C relates to insufficient surfactant production seen in respiratory distress syndrome, and choice D mentions meconium aspiration syndrome, which is a different condition caused by the aspiration of meconium into the lungs, not related to the failure to clear lung fluid.
The nurse provides education on care after a first trimester loss. What is an example of communication with a patient that demonstrates effective aftercare education?
- A. You will need to follow up with us in several weeks. We want to make sure you are doing well.
- B. You should call us if you are bleeding and soaking 4 maxi pads in a day.
- C. Your period will return in 2 weeks.
- D. You should wait 2 months before having intercourse.
Correct Answer: A
Rationale: Follow-up care ensures the patient's physical and emotional well-being.
Which newborn reflex is elicited by stroking the lateral sole of the infant's foot from the heel to the ball of the foot?
- A. Babinski
- B. Stepping
- C. Tonic neck
- D. Plantar grasp
Correct Answer: A
Rationale: The correct answer is A: Babinski reflex. This reflex is elicited by stroking the lateral sole of the infant's foot, causing the big toe to extend and the other toes to fan out. This response is normal in infants up to 2 years old. The other choices are incorrect because:
B: Stepping reflex is the automatic movement of the legs when held upright with the feet touching a surface.
C: Tonic neck reflex occurs when an infant turns their head to one side, the arm on that side extends while the opposite arm flexes.
D: Plantar grasp reflex is when pressure is applied to the sole of the foot, causing the toes to curl.