Nokea
What is the nurse's role when preparing a mother for epidural anesthesia?
- A. Monitor the mother's contractions
- B. Ensure the mother has an empty bladder
- C. Ensure the mother is in a supine position
- D. Administer a test dose of the epidural medication
Correct Answer: C
Rationale: Ensuring the bladder is empty helps prevent complications during epidural anesthesia.
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Before giving a client oral combination contraceptives, which side effects should the nurse tell the patient to be aware of? Select all that apply.
- A. Irregular bleeding
- B. Thick vaginal discharge
- C. Nausea
- D. Breast tenderness
Correct Answer: B
Rationale: Common side effects of oral combination contraceptives include irregular bleeding, nausea, and breast tenderness. Choice B, thick vaginal discharge, is not typically associated with oral contraceptives.
A neonate is being discharged home with a fiber-optic blanket for treatment of physiologic jaundice. What is important for the nurse to include in the discharge instructions?
- A. Cover the infant's eyes during the treatment.
- B. Reduce the daily number of formula feedings.
- C. Encourage frequent feeding to increase intake.
- D. Expect a constipated stool until jaundice clears.
Correct Answer: C
Rationale: Frequent feeding aids in bilirubin excretion.
Which congenital defects in a newborn are associated with long-term parenting problems? (Select all that apply.)
- A. Polydactyl
- B. Cleft lip and palate
- C. Ventral septal defect
- D. Ambiguous genitalia
Correct Answer: B
Rationale: 1. Cleft lip and palate: Parents of a newborn with a cleft lip and palate may face challenges related to feeding difficulties, speech development issues, and concerns about their child's appearance. These issues can require additional medical interventions and support, leading to long-term parenting stress and psychological strain.
A newborn's birth was prolonged because the shoulders were very wide. The nurse performing the assessment would be particularly observant for a problem with the:
- A. Moro reflex
- B. Plantar reflex
- C. Babinski reflex
- D. Stepping reflex
Correct Answer: A
Rationale: The Moro reflex is a normal infantile reflex that is typically present at birth and disappears around 4-6 months of age. This reflex is triggered by a sudden loss of support or a loud noise, causing the infant to throw back the head and extend the arms in a gesture as if trying to grab something. In a situation where the newborn's birth was prolonged due to wide shoulders, there is a higher risk of injury to the brachial plexus (nerves that control arm movement) during delivery. Damage to the brachial plexus can result in weakness or paralysis of the affected arm, and this may impact the Moro reflex as it involves the arms' movement. Therefore, the nurse would be particularly observant for any abnormality or lack of response in the Moro reflex as it may indicate potential nerve injury related to the difficult birth.
Parents who recently experienced the death of their unborn child ask the nurse, 'What is a fetal death?' What is the nurse's best response?
- A. Fetal deaths occur later in pregnancy after 20 weeks' gestation.
- B. It refers to the intrauterine fetal death at any time during pregnancy.
- C. Fetal deaths occur earlier in pregnancy before 20 weeks' gestation.
- D. Fetal death occurs only at the birth of the newborn.
Correct Answer: B
Rationale: Fetal death refers to the spontaneous intrauterine death of a fetus at any time during pregnancy. Fetal deaths later in pregnancy (after 20 weeks of gestation) are referred to as stillbirths, and deaths earlier than 20 weeks are referred to as a miscarriage.