Nokea
The pathological retraction ring of Bandl is associated with:
- A. Preterm labour.
- B. Obstructed labour.
- C. Precipitate labour.
- D. Abruptio placenta.
- E. Chorioamnionitis.
Correct Answer: B
Rationale: Bandl’s ring a pathological retraction ring forms in obstructed labor due to prolonged intense uterine contractions leading to a visible ridge between the upper and lower uterine segments.
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The nurse evaluates a preterm infant after a gavage feeding. The nurse determines that feeding intolerance has developed when which finding is noted during assessment?
- A. The infant immediately falls asleep after feeding.
- B. The gastric residual is zero prior to the next feeding.
- C. The infant’s abdominal girth has increased in size.
- D. The infant is having soft,loose stools.
Correct Answer: C
Rationale: Increased abdominal girth indicates feeding intolerance suggesting issues like paralytic ileus or NEC. Sleeping zero residual and loose stools are normal.
The nurse has just assisted with the birth of a full-term infant. The nurse should take which measures immediately to promote parent-infant attachment? Select all that apply.
- A. Have the mother nap before interacting with her newborn.
- B. Dim the lights in the birthing room.
- C. Place the newly delivered infant on the mother’s abdomen.
- D. Delay instilling the ophthalmic antibiotic for an hour.
- E. Play loud music to keep the infant stimulated.
- F. Ask the parents to delay phone calls for an hour after birth.
Correct Answer: B,C,D,F
Rationale: Dimming lights encourages eye contact skin-to-skin contact improves interaction delaying antibiotic ointment prevents blurred vision and delaying phone calls maximizes bonding time. Napping misses the alert period and loud music is overstimulating.
Which nursing action would best help the child to cope with the effects of the chemotherapy?
- A. Serve the child a well-balanced meal before beginning the chemotherapy.
- B. Give the child an antiemetic before beginning the chemotherapy.
- C. Encourage the child to get plenty of rest before beginning the chemotherapy.
- D. Give the child pain medication before beginning the chemotherapy.
Correct Answer: B
Rationale: Chemotherapy often causes nausea and vomiting. Administering an antiemetic prophylactically manages these side effects, improving the child's comfort and coping.
When caring for a child with measles, which precaution is most appropriate for the nurse to implement?
- A. Standard precautions
- B. Droplet precautions
- C. Contact precautions
- D. Airborne precautions
Correct Answer: D
Rationale: Measles is highly contagious and spreads via airborne transmission, requiring airborne precautions, including a negative-pressure room and N95 respirator use.
The nurse is caring for the client who has just given birth to a baby boy. The mother is O negative. The nurse should assess for ABO incompatibility and hyperbilirubinemia if the infant’s blood type is which type?
- A. O positive
- B. O negative
- C. A negative
- D. Any type
Correct Answer: C
Rationale: ABO incompatibility occurs when a mother with type O blood (no antigens A/B antibodies) has an infant with A or B blood (e.g. A negative) leading to hemolysis and hyperbilirubinemia. O blood types are compatible.