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What is the priority nursing intervention for a newborn with a low Apgar score of 4 at 1 minute?
- A. Place the baby in skin-to-skin contact with the mother
- B. Administer oxygen and stimulate the baby
- C. Delay interventions and reassess in 5 minutes
- D. Begin chest compressions immediately
Correct Answer: B
Rationale: A low Apgar score indicates poor adaptation; oxygen improves function.
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When teaching a parenting class on childhood discipline, the nurse is asked by a parent, 'How long do I place my child in time-out?' How should the nurse best respond?
- A. Use the amount of time it takes to elicit a behavior change.
- B. Use 1 minute per year of age, but do not exceed 5 minutes.
- C. Use as much time as is needed to control the behavior.
- D. Use 1 minute per year of the child's age as needed.
Correct Answer: B
Rationale: When using time-out, use 1 minute per year of the child's age (a 3-year-old would have time-out for 3 minutes). Do not exceed 5 minutes.
When should a man with a chlamydial infection expect to experience pain?
- A. When urinating.
- B. When ejaculating.
- C. When the penis becomes erect.
- D. When the testicles are touched.
Correct Answer: A
Rationale: Chlamydia often causes painful urination.
The primiparous patient that's 40 weeks' gestation reports to the nurse that she has increased pelvic pressure and increased urinary frequency. Which response by the nurse is best?
- A. This symptom usually means the baby's head has descended further
- B. Unless you have pain with urination, we don't need to worry it
- C. Come in for an appointment today and we'll check out everything
- D. This might indicate that the baby is no longer in a head down position
Correct Answer: A
Rationale: The best response by the nurse is to reassure the primiparous patient that her increased pelvic pressure and urinary frequency could mean that the baby's head has descended further into the pelvis. This can indicate that labor is approaching, as the baby is getting into position for birth. It is important for the nurse to provide this information to ease the patient's concerns and help her understand the potential significance of these symptoms at 40 weeks' gestation.
The nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which is noted on the external monitor tracing during a contraction?
- A. Variability
- B. Accelerations
- C. Early decelerations
- D. Variable decelerations
Correct Answer: D
Rationale: Variable decelerations are a hallmark sign of umbilical cord compression, requiring immediate monitoring and intervention.
Before discharge, what health teaching should the nurse provide to a woman diagnosed with pelvic inflammatory disease (PID)?
- A. Endometriosis.
- B. Menopause.
- C. Ovarian hyperstimulation.
- D. Sexually transmitted infections.
Correct Answer: D
Rationale: PID is often caused by untreated STIs, so education about STIs is crucial.