Nokea
What is the recommended method of feeding for a newborn with phenylketonuria (PKU)?
- A. Breastfeeding
- B. Formula feeding
- C. Lowphenylalanine formula feeding
- D. All of the above
Correct Answer: C
Rationale: Lowphenylalanine formula feeding is recommended for newborns with PKU.
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Which of the following is a potential complication of a cesarean delivery?
- A. Hemorrhage
- B. Infection
- C. Uterine rupture
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. A cesarean delivery can lead to hemorrhage due to the incision and removal of the placenta. Infection can occur at the incision site or in the uterus post-surgery. Uterine rupture is a rare but serious complication where the uterus tears open. Choosing D is correct as all these complications can potentially arise after a cesarean delivery. Options A, B, and C are incorrect as they do not encompass all possible complications of a cesarean delivery.
A nurse in a prenatal clinic is assessing a group of clients. Which of the following clients should the nurse see first?
- A. A client who is at 11 weeks of gestation and reports abdominal cramping.
- B. A client who is at 15 weeks of gestation and reports tingling and numbness in right hand.
- C. A client who is at 20 weeks of gestation and reports constipation for the past 4 days.
- D. A client who is at 8 weeks of gestation and reports having three bloody noses in the past week.
Correct Answer: A
Rationale: Abdominal cramping in early pregnancy can be a sign of a miscarriage or ectopic pregnancy, both of which require immediate evaluation and intervention.
Which of the following nursing actions should the nurse plan to take? For each potential nursing action, click to specify it the intervention is indicated or contraindicated for the client.
- A. Insert a large bore intravenous catheter.
- B. Assess cervical dilation.
- C. Weigh perineal pads.
- D. Administer methotrexate.
Correct Answer: A, C
Rationale: Inserting a large bore IV catheter is indicated to manage potential hemorrhage. Weighing perineal pads helps quantify blood loss. Assessing cervical dilation is contraindicated as it may exacerbate bleeding. Administering methotrexate is not relevant in this context.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing. 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
- A. Place newborn skin to skin on birthing parents chest, Encourage birthing parents to breastfeed, Obtain prescription for arterial blood gases, Plan to initiate phototherapy, Perform neonatal abstinence system scoring
- B. Cold stress, Acute bilirubin encephalopathy, Respiratory distress syndrome, Neonatal abstinence syndrome (NAS)
- C. Stool output, Temperature, Lung sounds, Blood glucose level, Bilirubin level
Correct Answer:
Rationale: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, E.
Rationale:
The correct actions to take are to place newborn skin to skin on birthing parent's chest and encourage breastfeeding, as these promote bonding and breastfeeding, crucial for newborn well-being. The potential condition the client is most likely experiencing is Cold stress, indicated by the need for phototherapy. The parameters to monitor are Temperature (to track for hypothermia due to cold stress) and Bilirubin level (to assess for jaundice, common in newborns with cold stress).
A nurse is admitting a client to the labor and delivery unit when the client states, 'My water just broke.' Which of the following interventions is the nurse's priority?
- A. Perform Nitrazine testing.
- B. Assess the fluid.
- C. Check cervical dilation.
- D. Begin FHR monitoring.
Correct Answer: D
Rationale: The correct answer is D: Begin FHR monitoring. This is the priority because it assesses the well-being of the fetus immediately after the client's water breaks, ensuring timely detection of any fetal distress. Performing Nitrazine testing (A) or checking cervical dilation (C) can wait until after FHR monitoring. Assessing the fluid (B) may be important but not as urgent as monitoring the FHR.