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When advising a woman considering pregnancy on nutritional needs to reduce the risk of giving birth to a newborn with a neural tube defect, what information should the nurse include?
- A. Limit alcohol consumption.
- B. Increase intake of iron-rich foods.
- C. Consume foods fortified with folic acid.
- D. Avoid foods containing aspartame.
Correct Answer: C
Rationale: The correct answer is C: Consume foods fortified with folic acid. Folic acid plays a crucial role in preventing neural tube defects in newborns. It is recommended that women of childbearing age consume 400 mcg of folic acid daily to reduce the risk. Foods fortified with folic acid include cereals, bread, and pasta.
A: Limit alcohol consumption - While important for overall health, alcohol consumption is not directly related to preventing neural tube defects.
B: Increase intake of iron-rich foods - Iron is essential during pregnancy, but it is not specifically linked to reducing the risk of neural tube defects.
D: Avoid foods containing aspartame - Aspartame is a sweetener and does not have a direct impact on neural tube defects prevention.
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When monitoring uterine contractions in a client in the active phase of the first stage of labor, which finding should the nurse report to the provider?
- A. Contractions lasting longer than 90 seconds
- B. Contractions occurring every 3 to 5 minutes
- C. Contractions are strong in intensity
- D. Client reports feeling contractions in the lower back
Correct Answer: A
Rationale: Rationale: Contractions lasting longer than 90 seconds can indicate uterine hyperstimulation, which can lead to decreased oxygenation of the fetus. This finding should be reported to the provider for further assessment and intervention. Contractions occurring every 3 to 5 minutes (choice B) are normal in the active phase of labor. Strong contractions (choice C) are also expected during this phase. Feeling contractions in the lower back (choice D) is common and not typically a cause for concern. Reporting contractions lasting longer than 90 seconds is crucial to ensure the safety of both the mother and the baby.
A parent of a newborn is being taught about crib safety. Which statement by the client indicates understanding of the teaching?
- A. I will place my baby on his stomach when he is sleeping.
- B. I should remove extra blankets from my baby's crib.
- C. I should pad the mattress in my baby's crib so that he will be more comfortable when he sleeps.
- D. I should place my baby's crib next to the heater to keep him warm during the winter.
Correct Answer: B
Rationale: The correct answer is B because removing extra blankets from the baby's crib reduces the risk of suffocation and Sudden Infant Death Syndrome (SIDS). Placing the baby on the stomach (Option A) increases the risk of SIDS. Padding the mattress (Option C) can also increase the risk of suffocation. Placing the crib next to a heater (Option D) can lead to overheating and poses a fire hazard. Removing extra blankets ensures a safe sleep environment for the baby.
A client in active labor is being prepared for epidural analgesia. Which of the following actions should the nurse take?
- A. Have the client sit upright on the bed with legs crossed.
- B. Administer a 500 mL bolus of lactated Ringer's solution prior to induction.
- C. Inform the client that the anesthetic effect will last for approximately 2 hours.
- D. Obtain a 30-minute electronic fetal monitoring (EFM) strip prior to induction.
Correct Answer: D
Rationale: The correct answer is D: Obtain a 30-minute electronic fetal monitoring (EFM) strip prior to induction. This is important to assess the fetal well-being and baseline status before initiating epidural analgesia. It helps in detecting any fetal distress or abnormalities that may be exacerbated by the epidural.
A: Having the client sit upright with legs crossed is not recommended as it may interfere with the procedure and comfort of the client.
B: Administering a 500 mL bolus of lactated Ringer's solution is not directly related to preparing for epidural analgesia.
C: Informing the client about the duration of anesthetic effect is important, but ensuring fetal well-being through EFM monitoring is a priority before the procedure.
A client is in the first trimester of pregnancy and lacks immunity to rubella. When should the client receive rubella immunization?
- A. Shortly after giving birth
- B. In the third trimester
- C. Immediately
- D. During the next attempt to get pregnant
Correct Answer: A
Rationale: The correct answer is A. Rubella immunization should be given shortly after giving birth to prevent any potential harm to the fetus during pregnancy. Immunization during pregnancy is contraindicated to avoid any risk of harm to the developing baby. Option B is incorrect as immunization in the third trimester can still pose a risk to the fetus. Option C is incorrect as immediate immunization during pregnancy is not recommended. Option D is incorrect as waiting until the next attempt to get pregnant does not protect the current fetus.
During the admission assessment of a newborn, which anatomical landmark should be used for measuring the newborn's chest circumference?
- A. Sternal notch
- B. Nipple line
- C. Xiphoid process
- D. Fifth intercostal space
Correct Answer: B
Rationale: The correct answer is B: Nipple line. This landmark is used for measuring newborn chest circumference as it ensures consistency in measurement and is a reliable reference point. The nipple line is anatomically consistent and easily identifiable, making it the ideal landmark for accurate measurements.
Rationale:
A: Sternal notch is not recommended for chest circumference measurement in newborns as it is not a consistent landmark and may vary among individuals.
C: Xiphoid process is not suitable for chest circumference measurement as it is located at the lower end of the sternum and not commonly used for this purpose.
D: Fifth intercostal space is not a recommended landmark for chest circumference measurement in newborns as it is not as reliable and consistent as the nipple line.