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Three hours after birth, a newborn of a mother with diabetes becomes jittery, has weak, high-pitched cry , and exhibits irregular respirations. The nurse recognizes that these signs are often associated with:
- A. Hypovolemia
- B. Hypocalcemia
- C. Hypoglycemia
- D. Hyperglycemia
Correct Answer: C
Rationale: Hypoglycemia is common in infants of diabetic mothers.
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The nurse is performing Leopold's maneuvers. What is the primary goal?
- A. Determine fetal well-being.
- B. Assess fetal position and presentation.
- C. Measure amniotic fluid volume.
- D. Evaluate uterine contractions.
Correct Answer: B
Rationale: Leopold's maneuvers are used to assess fetal position, presentation, and engagement.
A new mother asks the nurse why newborns receive an injection of vit. K after delivery. What will be the best response from the nurse?
- A. Newborns are given vit K to help with the digestion to help them absorb fat soluble vitamins
- B. Newborns are given vit K and erythromycin ointment to help prevent ophthalmia neonatorum
- C. Newborns lack the intestinal flora needed to produce vit K, so it is given to prevent bleeding episodes
- D. This vitamin substitutes for vitamin C and newborns will strengthen their immune system
Correct Answer: C
Rationale: Vitamin K is essential for clotting and prevents hemorrhagic disease.
The nurse is teaching a prenatal class about breastfeeding. What is a key benefit of colostrum?
- A. It increases the baby’s birth weight.
- B. It provides antibodies that protect against infection.
- C. It eliminates the need for formula supplementation.
- D. It reduces maternal fatigue.
Correct Answer: B
Rationale: Colostrum is rich in antibodies, which provide passive immunity and protect the newborn from infections.
What contraceptive method is best suited for a single, perimenopausal woman with four sex partners who smokes 1 pack of cigarettes per day?
- A. Male condom.
- B. Intrauterine device.
- C. NuvaRing.
- D. Oral contraceptives.
Correct Answer: A
Rationale: Male condoms provide dual protection against pregnancy and STIs.
The nurse is monitoring a client with severe preeclampsia. What assessment finding requires immediate intervention?
- A. Blood pressure of 150/90 mmHg.
- B. Urine output of 25 mL/hr.
- C. Headache relieved by acetaminophen.
- D. Deep tendon reflexes +2.
Correct Answer: B
Rationale: Oliguria (urine output <30 mL/hr) may indicate worsening renal function or severe complications in preeclampsia.