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What are signs of neonatal sepsis that a nurse should monitor for?
- A. Tachypnea, poor feeding, and temperature instability
- B. Increased alertness, reduced crying, and stable vitals
- C. Lethargy, poor perfusion, and apnea
- D. Hyperthermia, bradycardia, and cyanosis
Correct Answer: C
Rationale: The correct answer is C because lethargy, poor perfusion, and apnea are classic signs of neonatal sepsis. Lethargy indicates decreased activity and responsiveness, poor perfusion suggests inadequate blood circulation, and apnea is a serious respiratory issue. These signs indicate a systemic infection affecting multiple organs. Choices A, B, and D do not align with typical symptoms of neonatal sepsis. Tachypnea, poor feeding, and temperature instability (Choice A) are more general and can be seen in various conditions. Increased alertness, reduced crying, and stable vitals (Choice B) are not indicative of sepsis, as sepsis typically causes the opposite. Hyperthermia, bradycardia, and cyanosis (Choice D) can be present in sepsis, but they are not as specific or as common as the signs in Choice C.
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The client delivered a 4200 g fetus. The physician performed a
midline episiotomy which extended into a 3rd degree laceration. The
client asks the nurse where she tore. Which response is best?
- A. Through your rectal sphincter
- B. Through your vaginal mucosa
- C. Through your cervix
- D. Through your bladder
Correct Answer: A
Rationale: The correct answer is A: Through your rectal sphincter. A 3rd degree laceration involves the perineal body and extends through the anal sphincter muscles. This type of laceration can occur with a midline episiotomy during childbirth. The rectal sphincter is a part of the anal canal and can be torn in severe cases. Choices B, C, and D are incorrect because a 3rd degree laceration does not involve the vaginal mucosa, cervix, or bladder. The tear is specifically related to the rectal area due to the extension of the episiotomy.
The nurse is educating a client about folic acid during pregnancy. What food should the nurse recommend?
- A. Citrus fruits.
- B. Leafy green vegetables.
- C. Dairy products.
- D. Lean meats.
Correct Answer: B
Rationale: The correct answer is B: Leafy green vegetables. Folic acid is essential during pregnancy for proper fetal development. Leafy green vegetables like spinach, kale, and broccoli are rich sources of folic acid. Citrus fruits (Choice A) contain vitamin C but not as much folic acid as leafy greens. Dairy products (Choice C) provide calcium but are not significant sources of folic acid. Lean meats (Choice D) are good sources of protein but do not contain as much folic acid as leafy green vegetables. Therefore, recommending leafy green vegetables ensures the client gets an adequate intake of folic acid during pregnancy.
What statement by a health-care provider is an example of shared decision making between a health-care provider and a patient?
- A. I'm going to start this medication because it is best for your baby.
- B. Can you agree with me because I am your health-care provider?â€
- C. I understand how the hospital works, and it will be easier for you to just do what is easy for the nurses.â€
- D. Do you feel ready to make a decision after we talked about this medication?â€
Correct Answer: D
Rationale: The correct answer is D because it involves the patient in the decision-making process by asking for their readiness to make a decision after discussing the medication. This approach respects the patient's autonomy and encourages them to actively participate in their healthcare choices.
A is incorrect as it does not involve the patient in the decision-making process but rather imposes the provider's choice. B is incorrect as it uses authority to influence the patient's decision, which is not in line with shared decision making. C is incorrect as it focuses on convenience rather than involving the patient in the decision-making process.
A 45-year-old woman presents to the clinic for advice about contraception. What is the most appropriate contraception method for a woman who is nearing menopause?
- A. Oral contraceptives with estrogen
- B. Contraceptive injections
- C. IUD with progestin
- D. Barrier methods like condoms
Correct Answer: C
Rationale: The most appropriate contraception method for a woman nearing menopause is an IUD with progestin (Choice C). Progestin-containing IUDs are effective, long-lasting, and suitable for women of various ages. As women approach menopause, the hormonal changes make progestin-containing IUD a favorable option as it offers reliable contraception without the need for daily administration. Additionally, progestin can also help alleviate symptoms like heavy periods that women may experience during perimenopause.
Choices A and B are not ideal as oral contraceptives with estrogen can increase the risk of blood clots in older women, and contraceptive injections may not be as convenient for someone nearing menopause. Barrier methods like condoms (Choice D) are less effective and may not provide the level of protection needed during this stage of life.
The nurse is educating a client about gestational diabetes. What is the most important teaching point?
- A. Avoid all carbohydrates.
- B. Check your blood sugar only when symptomatic.
- C. Monitor blood sugar regularly as prescribed.
- D. Increase your physical activity significantly.
Correct Answer: C
Rationale: The correct answer is C: Monitor blood sugar regularly as prescribed. This is crucial in managing gestational diabetes to ensure blood sugar levels are within target range, preventing complications for both mother and baby. Regular monitoring helps track the effectiveness of treatment and dietary adjustments. Avoiding all carbohydrates (A) is not recommended as some are necessary for energy. Checking blood sugar only when symptomatic (B) is insufficient as it may miss important fluctuations. Increasing physical activity significantly (D) is beneficial but not the most important teaching point compared to consistent blood sugar monitoring.