Nokea
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.
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Which finding should be most concerning immediately following delivery of a newborn?
- A. Capillary refill time of 3 seconds
- B. Heart rate of 180 bpm
- C. Respiratory rate of 65 breaths per minute
- D. Apgar score of 8 at 5 minutes
Correct Answer: B
Rationale: The correct answer is B: Heart rate of 180 bpm. A high heart rate in a newborn is concerning as it could indicate distress or a medical condition. A heart rate of 180 bpm is significantly above the normal range for a newborn (120-160 bpm), requiring immediate attention to assess and address the underlying cause, such as infection or cardiac issues.
A: Capillary refill time of 3 seconds is within the normal range (less than 3 seconds is normal).
C: Respiratory rate of 65 breaths per minute is slightly elevated but not as critical as a high heart rate.
D: Apgar score of 8 at 5 minutes is a good score, indicating the baby is in overall good condition, but it does not address the immediate concern of a high heart rate.
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.
Which diagnosis is most appropriate for a newborn who has not voided within 24 hours after delivery?
- A. Hypovolemia related to insufficient fluid intake
- B. Altered growth and development related to gestational age of 36 weeks
- C. Altered nutrition, less than body requirements related to failure to properly latch onto the breast
- D. Constipation related to failure to pass a meconium stool and possible bowel obstruction
Correct Answer: A
Rationale: The correct answer is A: Hypovolemia related to insufficient fluid intake. In a newborn, the inability to void within 24 hours after birth can indicate dehydration and hypovolemia due to insufficient fluid intake. Newborns need to pass urine within the first 24 hours of life to show adequate hydration. Altered growth and development (choice B) is not relevant to the immediate concern of no voiding. Altered nutrition (choice C) is unlikely to cause the absence of urine output. Constipation (choice D) is less likely in a newborn and is not the primary concern when a newborn fails to void.
At birth, a newborn weighed 6 pounds, 12 ounces. Three days later, the newborn weighs 5 pounds, 10 ounces. What conclusion should the nurse draw regarding this newborn’s weight?
- A. This weight loss is within normal limits.
- B. This weight gain is within normal limits.
- C. This weight loss is excessive.
- D. This weight gain is excessive.
Correct Answer: A
Rationale: A weight loss of up to 10% in the first few days is considered normal.
Which baby is at highest risk of skin infection upon discharge?
- A. Newborn with scabs forming over heels where blood has been drawn
- B. Newborn with a new circumcision
- C. Newborn with jaundice
- D. Newborn with milia
Correct Answer: B
Rationale: The correct answer is B, a newborn with a new circumcision, as this procedure involves an incision, making the baby more susceptible to skin infections. Circumcision wounds need proper care to prevent infection.
Choice A is incorrect because scabs forming over heels where blood has been drawn do not necessarily indicate a higher risk of skin infection. Choice C, a newborn with jaundice, is incorrect as jaundice affects the liver and does not directly increase the risk of skin infection. Choice D, a newborn with milia, is incorrect because milia are harmless and do not increase the risk of skin infection.