Nokea
What do ineffective parenting practices put the newborn at risk for?
- A. sleeplessness
- B. reflux
- C. lack of attachment
- D. NICU admission
Correct Answer: C
Rationale: Ineffective parenting practices can lead to a lack of emotional bonding and attachment which can impact the child's development.
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What assessment data increases the risk of postpartum infection?
- A. precipitous labor
- B. urinary retention
- C. breast-feeding
- D. intact perineum
Correct Answer: A
Rationale: The correct answer is A: precipitous labor. Precipitous labor can cause trauma to the birth canal, leading to increased risk of infection. Urinary retention (B) may lead to urinary tract infections but not necessarily postpartum infections. Breastfeeding (C) and intact perineum (D) are not direct risk factors for postpartum infections.
The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt?
- A. Large doses of vitamin C during pregnancy
- B. Prophylactic antibiotics
- C. Strict aseptic technique, including hand washing, by all health care personnel
- D. Limited protein and fat intake
Correct Answer: C
Rationale: Rationale:
Choice C is correct because strict aseptic technique, including hand washing, is crucial in preventing puerperal infection by minimizing the transmission of pathogens. Proper hand hygiene is a fundamental practice in infection control. Choices A, B, and D are incorrect because large doses of vitamin C, prophylactic antibiotics, and limited protein and fat intake do not directly address the primary mode of infection transmission and prevention for puerperal infection. Vitamin C, antibiotics, and dietary restrictions are not the primary strategies in preventing puerperal infections compared to the importance of proper hand hygiene and aseptic technique.
The nurse is admitting a 38-year-old patient to triage in early labor with ruptured membranes. Her history includes a previous vaginal delivery 4 years ago and the presence of a uterine fibroid. What interventions are appropriate based on the hemorrhage risk for this patient?
- A. The patient is a moderate hemorrhage risk, so a type and screen should be ordered.
- B. The patient is a high hemorrhage risk, so 4 units of packed red blood cells should be ordered.
- C. The patient is a low hemorrhage risk, so a hold tube should be drawn.
- D. The patient is a moderate hemorrhage risk, but blood is not drawn at this time.
Correct Answer: A
Rationale: Step 1: The patient is in early labor with ruptured membranes, which increases the risk of hemorrhage.
Step 2: The presence of a uterine fibroid also contributes to the hemorrhage risk.
Step 3: Previous vaginal delivery 4 years ago does not significantly alter the hemorrhage risk.
Step 4: Ordering a type and screen will allow for rapid access to blood products if needed in case of hemorrhage.
Step 5: This is a moderate hemorrhage risk situation, warranting the need for preparing for potential blood transfusion.
Summary:
- Choice B is incorrect as ordering 4 units of packed red blood cells is excessive for a moderate hemorrhage risk.
- Choice C is incorrect as a hold tube will not provide immediate access to blood products in case of hemorrhage.
- Choice D is incorrect as blood should be drawn to be prepared for potential hemorrhage in a moderate risk situation.
The nurse is assessing a patient who is 12 hours postpartum. The uterus is firm to palpation, at midline, and is 1 cm below the umbilicus with continuous heavy vaginal bleeding. What is the nurse’s first action?
- A. Massage the uterus and resume the IV Pitocin drip.
- B. Change the peri-pad and reassess the bleeding.
- C. Call the provider to check for a cervical laceration.
- D. Administer the ordered iron supplement and ibuprofen.
Correct Answer: A
Rationale: The nurse must address the uterine tone and bleeding immediately by massaging the uterus and resuming Pitocin to prevent hemorrhage.
A client has been transferred to the post -anesthesia care unit from a cesarean delivery. The client had spinal anesthesia for the surgery. Which of the following interventions should the nurse perform at this time?
- A. Assess the level of the anesthesia.
- B. Encourage the client to urinate in a bedpan.
- C. Provide the client with the diet of her choice.
- D. Check the incision for signs of infection.
Correct Answer: A
Rationale: After spinal anesthesia, it's important to assess the level of anesthesia to monitor for any complications, such as a block or insufficient motor return, which can affect mobility and pain management.