Nokea
Which measure helps reduce nipple soreness associated with breastfeeding?
- A. Feeding the baby during the first 48 hours after delivery
- B. Placing a finger between the baby's mouth and the breast to break suction after feeding
- C. Applying warm, moist soaks to the breast several times per day
- D. Wearing a support bra during the day
Correct Answer: B
Rationale: Breaking suction by placing a finger between the baby’s mouth and the breast prevents trauma to the nipple, reducing soreness. Feeding early promotes latch but doesn’t address soreness directly, warm soaks may increase inflammation, and a bra supports but doesn’t prevent nipple trauma.
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A client with a history of a hiatal hernia is being discharged. The nurse should teach the client to:
- A. Avoid heavy lifting
- B. Eat large meals
- C. Sleep flat in bed
- D. Increase spicy food intake
Correct Answer: A
Rationale: Heavy lifting increases abdominal pressure, worsening hiatal hernia symptoms. Small meals, sleeping upright, and avoiding spicy foods are also recommended.
The nurse is caring for a client with a history of sickle cell anemia. Which intervention is most important during a sickle cell crisis?
- A. Administer oxygen
- B. Apply cold packs to joints
- C. Encourage bed rest
- D. Administer antibiotics
Correct Answer: A
Rationale: Sickle cell crisis causes vaso-occlusion, reducing tissue oxygenation. Administering oxygen is the priority to prevent hypoxia. Cold packs worsen vasoconstriction, rest is secondary, and antibiotics are for infections.
A client with AIDS has impaired nutrition due to diarrhea. The nurse teaches the client about the need to avoid certain foods.
- A. Tossed salad
- B. Baked chicken
- C. Broiled fish
- D. Steamed rice
Correct Answer: A
Rationale: Raw foods like tossed salad (A) can harbor pathogens, risky for AIDS patients with diarrhea. Baked chicken (B), broiled fish (C), and steamed rice (D) are cooked and safer, indicating further teaching is needed for A.
A 29-year-old client is admitted for a hysterectomy. She has repeatedly told the nurses that she is worried about having this surgery, has not slept well lately, and is afraid that her husband will not find her desirable after the surgery. Shortly into the preoperative teaching, she complains of a tightness in her chest, a feeling of suffocation, lightheadedness, and tingling in her hands. Her respirations are rapid and deep. Assessment reveals that the client is:
- A. Having a heart attack
- B. Wanting attention from the nurses
- C. Suffering from complete upper airway obstruction
- D. Hyperventilating
Correct Answer: D
Rationale: Classic symptoms of a heart attack include heaviness or squeezing pain in the chest, pain spreading to the jaw, neck, and arm. Nausea and vomiting, sweating, and shortness of breath may be present. The client does not exhibit these symptoms. Clients suffering from anxiety or fear prior to surgical procedures may develop hyperventilation. This client is not seeking attention. Symptoms of complete airway obstruction include not being able to speak, and no airflow between the nose and mouth. Breath sounds are absent. Tightness in the chest; a feeling of suffocation; lightheadedness; tingling in the hands; and rapid, deep respirations are signs and symptoms of hyperventilation. This is almost always a manifestation of anxiety.
A new mother tells the nurse that she is getting a new microwave so that her husband can help prepare the baby's feedings. The nurse should:
- A. Explain that a microwave should never be used to warm the baby's bottles.
- B. Tell the mother that microwaving is the best way to prevent bacteria in the formula.
- C. Tell the mother to shake the bottle vigorously for one minute after warming in the microwave.
- D. Instruct the parents to always leave the top of the bottle open while microwaving so heat can escape.
Correct Answer: A
Rationale: Microwaving baby bottles can cause uneven heating, leading to burns, so it should be avoided; warming under running water or in a bottle warmer is safer.