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Upon delivery of the newborn, the nursing intervention that most promotes parental attachment is:
- A. Placing the infant under the radiant warmer
- B. Allowing the mother to rest immediately after delivery
- C. Placing the newborn on mother's chest and abdomen
- D. Taking the newborn to the nursery for the initial assessment
Correct Answer: C
Rationale: The correct answer is C: Placing the newborn on mother's chest and abdomen. This promotes parental attachment through skin-to-skin contact, facilitating bonding and emotional connection. It also helps regulate the baby's temperature and encourage breastfeeding. Placing the infant under the radiant warmer (A) may disrupt immediate bonding. Allowing the mother to rest (B) is important, but promoting attachment should be prioritized. Taking the newborn to the nursery (D) can delay the crucial bonding process.
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The nurse encourages the patient to begin taking folate prior to trying to conceive. Why would the nurse encourage folate intake?
- A. Taking folate increases the chances of conceiving.
- B. Folate helps prevent neural tube defects.
- C. The nurse is preparing the patient to take vitamins during pregnancy.
- D. Folate decreases miscarriage.
Correct Answer: B
Rationale: The correct answer is B: Folate helps prevent neural tube defects. Folate is crucial for fetal development, particularly in preventing neural tube defects like spina bifida. It should be taken before conception to ensure adequate levels early in pregnancy. A: Taking folate does not directly increase the chances of conceiving. C: The nurse is not preparing the patient to take vitamins during pregnancy, but to prevent birth defects. D: Folate may reduce the risk of certain pregnancy complications but does not directly decrease miscarriage rates.
The nurse is educating a pregnant client about foods high in iron. Which food should be recommended?
- A. Milk.
- B. Chicken.
- C. Spinach.
- D. Bananas.
Correct Answer: C
Rationale: The correct answer is C: Spinach.
1. Spinach is high in iron, which is important for pregnant women to prevent anemia.
2. Milk (A) does not contain a significant amount of iron.
3. Chicken (B) is a good source of protein but not as high in iron as spinach.
4. Bananas (D) are rich in potassium but not iron, making them a less suitable choice for iron supplementation during pregnancy.
The nurse is assessing a client with suspected chorioamnionitis. What is the priority nursing assessment?
- A. Assess for foul-smelling vaginal discharge.
- B. Monitor maternal blood pressure.
- C. Evaluate fetal heart rate.
- D. Check maternal glucose levels.
Correct Answer: C
Rationale: The correct answer is C: Evaluate fetal heart rate. In chorioamnionitis, fetal distress can occur due to infection and inflammation of the fetal membranes. Monitoring fetal heart rate is crucial to assess the well-being of the baby. Assessing for foul-smelling discharge (A) is important but not the priority. Monitoring maternal blood pressure (B) and checking glucose levels (D) are relevant assessments but do not address the immediate risk of fetal distress in chorioamnionitis.
What is the term for integrating a person's cultural beliefs into their health care?
- A. cultural integrity
- B. culturally responsive care
- C. holistic care
- D. integrative care
Correct Answer: B
Rationale: The correct answer is B: culturally responsive care. This term specifically refers to integrating a person's cultural beliefs into their health care. Culturally responsive care acknowledges and respects the diversity of beliefs and practices among patients. The other choices are incorrect because:
A: cultural integrity does not specifically address the integration of cultural beliefs in health care.
C: holistic care focuses on treating the whole person but does not specifically address cultural beliefs.
D: integrative care typically refers to combining conventional and complementary approaches to health care, not necessarily cultural beliefs integration.
A couple comes in for an infertility workup, having attempted to get pregnant for 2 years. The woman, 37, has always had irregular menstrual cycles but is otherwise healthy. The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the sperm seem to be clumped together. What additional test is needed?
- A. FSH level
- B. Antisperm antibodies
- C. Testicular biopsy
- D. Test of testicular infection
Correct Answer: B
Rationale: The correct answer is B: Antisperm antibodies. In this case, the man's history of vasectomy reversal and normal semen analyses with clumped sperm suggest a possible presence of antisperm antibodies. These antibodies can cause sperm agglutination, affecting fertility. Testing for antisperm antibodies can provide valuable information on potential immune-related infertility issues.
A: FSH level is not the most appropriate test in this scenario as the man's semen analyses were normal, indicating potential issues with sperm-egg interaction rather than hormonal imbalances.
C: Testicular biopsy is invasive and not necessary at this stage when the issue seems to be related to sperm clumping rather than a structural problem within the testes.
D: Test of testicular infection is unlikely as the man's semen analyses were normal, and there are no indications of infection based on the information provided.