Nokea
When teaching a primiparous client who used cocaine during pregnancy how to comfort her fussy neonate, the nurse can advise the mother to:
- A. Tightly swaddle the neonate.
- B. Feed the neonate extra, high-calorie formula.
- C. Keep the neonate in a brightly lit environment.
- D. Touch the baby only when he is crying.
Correct Answer: A
Rationale: Tightly swaddling the neonate provides comfort and reduces overstimulation in cocaine-exposed neonates.
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The health care provider has performed an amniotomy on a laboring client. Which of the following details must be included in the documentation of this procedure? Select all that apply.
- A. Time of rupture.
- B. Color and clarity of fluid.
- C. Fetal heart rate (FHR) and pattern before and after the procedure.
- D. Size of amnio-hook used during the procedure.
- E. Odor and amount of fluid.
Correct Answer: A,B,C,E
Rationale: Documentation of an amniotomy includes the time, fluid characteristics (color, clarity, odor, amount), and fetal heart rate before and after to assess fetal response. The size of the amnio-hook is not clinically relevant.
As the nurse enters the room of a newly admitted primigravid client diagnosed with severe preeclampsia, the client begins to experience a seizure. The nurse should do which in order of priority from first to last?
- A. Call for immediate assistance.
- B. Turn the client to her side.
- C. Note the time when the seizure began.
- D. Maintain airway.
Correct Answer: A,D,B,C
Rationale: Call for help, ensure the airway is clear, turn the client to prevent aspiration, and document the seizure duration.
When instilling erythromycin ointment into the eyes of a neonate 1 hour old, the nurse would explain to the parents that the medication is used to prevent which of the following?
- A. Chorionetinitis from cytomegalovirus.
- B. Blindness secondary to gonorrhea.
- C. Cataracts from beta-hemolytic streptococcus.
- D. Strabismus resulting from neonatal maturation.
Correct Answer: B
Rationale: Erythromycin ointment is used prophylactically to prevent ophthalmia neonatorum, which can lead to blindness due to gonorrhea exposure during delivery.
During a home visit on the fourth postpartum day, a primiparous client tells the nurse that she has been experiencing breast engorgement. To relieve engorgement, the nurse teaches the client that before nursing her baby, the client should do which of the following?
- A. Apply an ice cube to the nipples.
- B. Rub her nipples gently with lanolin cream.
- C. Express a small amount of breast milk.
- D. Offer the neonate a small amount of formula.
Correct Answer: C
Rationale: Expressing a small amount of milk softens the breast, making it easier for the neonate to latch.
A client is admitted with a suspected abruptio placentae. The nurse should assess the client for which of the following signs and symptoms? Select all that apply.
- A. A bleeding that is concealed or apparent.
- B. Abdominal rigidity.
- C. Painful abdomen.
- D. Painless bleeding.
- E. Large placenta.
- F. Bleeding that stops spontaneously.
Correct Answer: A,B,C
Rationale: Abruptio placentae involves placental separation, causing concealed or apparent bleeding, abdominal rigidity, and pain due to uterine irritation. Painless bleeding is characteristic of placenta previa, and large placenta or spontaneous cessation are not typical.