Nokea
The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor?
- A. My first child has cerebral palsy.
- B. My first child has hypertension.
- C. My first child has asthma.
- D. My first child has cystic fibrosis.
Correct Answer: D
Rationale: Cystic fibrosis is a genetic condition, and a history of it in a previous child would warrant a referral to a genetic counselor. Cerebral palsy, hypertension, and asthma are not typically genetic conditions.
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A nurse is assessing a laboring person who is receiving oxytocin for labor induction. What is the most important intervention to prevent uterine hyperstimulation?
- A. monitor fetal heart rate
- B. increase fetal monitoring
- C. administer an epidural
- D. monitor contractions
Correct Answer: B
Rationale: The correct answer is B: increase fetal monitoring. Monitoring the fetus closely is crucial to detect signs of uterine hyperstimulation, such as non-reassuring fetal heart rate patterns. This allows for timely interventions to prevent fetal distress or hypoxia. Monitoring contractions (choice D) is important but does not directly address fetal well-being. Administering an epidural (choice C) may help manage pain but does not prevent uterine hyperstimulation. While monitoring fetal heart rate (choice A) is important, increasing the frequency of monitoring (choice B) is more specific to detecting complications related to oxytocin-induced uterine hyperstimulation.
A nurse is educating a postpartum person about newborn care. What is the best way to prevent diaper rash?
- A. frequent diaper changes
- B. use of a barrier cream
- C. apply petroleum jelly to the skin
- D. change diapers frequently
Correct Answer: C
Rationale: The correct answer is C: apply petroleum jelly to the skin. Petroleum jelly acts as a barrier, protecting the baby's skin from moisture and irritants in the diaper. It helps maintain the skin's natural moisture and prevents diaper rash.
Rationale:
1. Petroleum jelly creates a protective barrier on the skin, preventing direct contact with moisture and irritants.
2. It helps to keep the skin moisturized, reducing the risk of irritation.
3. Petroleum jelly is safe and gentle on the baby's skin.
4. It is particularly effective for preventing diaper rash compared to other options.
Summary:
A: Frequent diaper changes are important but may not provide enough protection against moisture and irritants.
B: Barrier creams can be effective, but petroleum jelly is a more commonly recommended option.
D: Changing diapers frequently is essential, but applying petroleum jelly as an additional protective measure is more effective in preventing diaper rash.
A nurse is assisting a postpartum person with breastfeeding. What is the best intervention to help relieve nipple pain?
- A. apply lanolin cream
- B. administer analgesics
- C. apply a warm compress
- D. apply cold compresses
Correct Answer: A
Rationale: The correct answer is A: apply lanolin cream. Lanolin cream helps to soothe and moisturize the nipples, reducing pain and promoting healing. It is safe for the baby and does not need to be removed before breastfeeding. Applying analgesics (B) is not recommended as they can be harmful to the baby. Warm compresses (C) may not provide the same level of relief for nipple pain as lanolin cream. Cold compresses (D) are not suitable for relieving nipple pain as they can further exacerbate discomfort. Therefore, applying lanolin cream is the best intervention for relieving nipple pain during breastfeeding.
A patient in labor who is 7 cm dilated requests pain relief. What is the most appropriate intervention at this time?
- A. Administer an epidural block
- B. Provide non-pharmacological pain relief methods
- C. Administer narcotic analgesics
- D. Encourage the patient to push with each contraction
Correct Answer: A
Rationale: The correct answer is A: Administer an epidural block. At 7 cm dilation, the patient is in active labor and an epidural can provide effective pain relief without affecting the ability to push during the second stage of labor. Epidural blocks work by numbing the lower part of the body, reducing pain sensation while allowing the patient to remain alert and able to push effectively when the time comes. Non-pharmacological methods (B) may not provide sufficient relief at this stage. Narcotic analgesics (C) can pass through the placenta and affect the baby. Encouraging the patient to push (D) prematurely can lead to exhaustion and prolonged labor.
The blood of a pregnant client was initially assessed at 10 weeks’ gestation and reassessed at 38 weeks’ gestation.
- A. Rise in hematocrit from 34% to 38%.
- B. Rise in white blood cells from 5 000 cells/mm3 to 15 000 cells/mm3.
- C. Rise in potassium from 3.9 mEq/L to 5.2 mEq/L.
- D. Rise in sodium from 137 mEq/L to 150 mEq/L.
Correct Answer: B
Rationale: White blood cell count increases during pregnancy due to physiological stress and immune system changes. Hematocrit levels typically decrease due to plasma expansion, while potassium and sodium levels remain stable.