Nokea
Which instruction should the nurse provide about newborn feeding?
- A. Feed on a strict schedule
- B. Breastfeed or formula-feed on demand
- C. Avoid feeding at night
- D. Offer water between feedings
Correct Answer: B
Rationale: Feeding on demand supports the newborn's nutritional needs and promotes bonding and growth.
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Which response by the nurse is best?
- A. Any alcohol consumption during pregnancy will cause the child to have complications later in life.
- B. The minimal safe amount of alcohol consumption during pregnancy has not yet been determined.
- C. Alcohol consumption has a harmful effect on the baby only if consumed during the first trimester of pregnancy.
- D. Occasional intake of a small amount of alcohol during pregnancy will not adversely affect the unborn baby.
Correct Answer: B
Rationale: No safe level of alcohol consumption during pregnancy has been established, as it may cause fetal alcohol spectrum disorders.
Which information about shortness of breath during pregnancy is correct?
- A. It is not common during pregnancy and may indicate a blood clot in the lungs.
- B. It is probably the result of anxiety about the baby's impending delivery.
- C. It is probably caused by the enlarged uterus pressing against the diaphragm.
- D. It is probably caused by decreased oxygen secondary to slow venous circulation.
Correct Answer: C
Rationale: Shortness of breath is common in late pregnancy due to the enlarged uterus pressing against the diaphragm, limiting lung expansion.
The nurse is caring for the pregnant client whose FHR tracing reveals a reduction in variability over the last 40 minutes. The client has had occasional decelerations after the onset of a contraction that did not resolve until the contraction was over. The client suddenly has a prolonged deceleration that does not resolve, and the nurse immediately intervenes by calling for assistance. Place the nurse’s interventions in the sequence that they should occur.
- A. Administer oxygen via facemask
- B. Have the HCP paged if the prolonged decelerations have not resolved.
- C. Place an indwelling urinary catheter in anticipation of emergency cesarean birth if the heart rate remains low.
- D. Increase the rate of the intravenous (IV) fluids
- E. Assist the client into a different position
- F. Prepare for a vaginal examination and fetal scalp stimulation
Correct Answer: E,A,D,B,F,C
Rationale: Assist the client into a different position should be first. Repositioning is an attempt to increase the FHR in case of cord obstruction. Administer oxygen via facemask is next to increase oxygenation to the fetus. Increase the rate of the IV fluids next to treat possible hypotension, the most common cause of fetal bradycardia. Have the HCP paged if the prolonged decelerations have not resolved. The immediate focus should be on attempting to relieve the prolonged decelerations. Prepare for a vaginal examination and fetal scalp stimulation. This is performed to rule out cord prolapse and to provide stimulation to the fetal head. Place an indwelling urinary catheter in anticipation of emergency cesarean birth if the HR remains low.
The client who is actively bleeding due to a spontaneous abortion asks the nurse why this is happening. The nurse advises the client that the majority of first-trimester losses are related to which problem?
- A. Cervical incompetence
- B. Chronic maternal disease
- C. Poor implantation
- D. Chromosomal abnormalities
Correct Answer: D
Rationale: Chromosomal abnormalities account for the majority of first-trimester spontaneous abortions. Cervical incompetence can result in spontaneous abortion but does not account for the majority. Chronic maternal disease can result in spontaneous abortion but does not account for the majority. Poor implantation can result in spontaneous abortion but does not account for the majority.
Which response by the nurse addresses the client's anxiety about childbirth?
- A. Your anxiety is normal, and we can discuss coping strategies like breathing exercises.
- B. You should not be anxious; childbirth is a natural process.
- C. Anxiety will harm your baby, so you need medication.
- D. Ignore your anxiety; it will go away after delivery.
Correct Answer: A
Rationale: Acknowledging anxiety as normal and offering coping strategies like breathing exercises supports the client emotionally.