Nokea
Which of the following is a potential ethical issue in maternal and newborn healthcare?
- A. Informed consent
- B. Patient confidentiality
- C. End-of-life decision-making
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. In maternal and newborn healthcare, ethical issues can arise in various aspects such as obtaining informed consent for procedures, ensuring patient confidentiality, and making difficult end-of-life decisions. Informed consent is crucial to respect patient autonomy. Patient confidentiality is vital to maintain trust and privacy. End-of-life decision-making involves complex ethical considerations. Choosing D is correct as all these issues are potential ethical concerns in this specific healthcare context. Choices A, B, and C alone are not comprehensive enough to cover the range of ethical issues that can arise in maternal and newborn healthcare.
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A nurse is assessing a client who gave birth vaginally 12 hr ago and palpates their uterus to the right above the umbilicus. Which of the following interventions should the nurse perform?
- A. Reassess the client in 2 hr.
- B. Administer simethicone.
- C. Assist the client to empty their bladder.
- D. Instruct the client to lie on their right side.
Correct Answer: C
Rationale: Correct Answer: C - Assist the client to empty their bladder.
Rationale: The client's uterus palpated to the right above the umbilicus indicates a full bladder displacing the uterus. A distended bladder can prevent the uterus from contracting effectively, leading to increased risk of postpartum hemorrhage. Emptying the bladder helps the uterus contract properly, reducing the risk of complications. This intervention directly addresses the underlying issue.
Incorrect Choices:
A: Reassessing in 2 hours does not address the immediate concern of a full bladder causing uterine displacement.
B: Simethicone is used for gas relief and is not relevant in this situation.
D: Instructing the client to lie on their right side does not address the bladder distention issue.
E, F, G: Irrelevant as they do not address the specific problem of a full bladder causing uterine displacement.
Select the 5 actions the nurse should take
- A. Increase the flow rate of the maintenance IV fuid
- B. Have the charge nurse notify the provider
- C. Place the client in a Trendelenburg position
- D. Exert upward pressure on the presenting part.
- E. Attempt to push the umbilical cord back into the cervix
- F. Administer oxygen at 10 L/mm via nonrebreather face mask
Correct Answer: A,B,C,D,F
Rationale: A prolapsed umbilical cord is a life-threatening emergency requiring immediate intervention to relieve cord compression and restore fetal oxygenation. The priority actions are:
Notify the provider
Reposition the client (Trendelenburg or knee-chest)
Manually relieve pressure on the cord
Administer oxygen
Increase IV fluids for better circulation
What is the primary legal responsibility of a nurse or midwife in maternal and newborn healthcare?
- A. Ensuring patient safety
- B. Maintaining patient confidentiality
- C. Providing appropriate care and treatment
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. A nurse or midwife's primary legal responsibility in maternal and newborn healthcare is to ensure patient safety by providing appropriate care and treatment while also maintaining patient confidentiality. Patient safety is paramount in healthcare to prevent harm or injury. Maintaining confidentiality is crucial to protect patient privacy and uphold ethical standards. Providing appropriate care and treatment involves assessing, planning, implementing, and evaluating care to meet the unique needs of each patient. Choosing D encompasses all these critical aspects, ensuring comprehensive legal responsibility is upheld.
Which of the following is a potential complication of neonatal hyperbilirubinemia?
- A. Hypoglycemia
- B. Kernicterus
- C. Respiratory distress syndrome
- D. All of the above
Correct Answer: B
Rationale: The correct answer is B: Kernicterus. Neonatal hyperbilirubinemia can lead to kernicterus, a condition characterized by bilirubin accumulation in the brain, causing irreversible neurological damage. Hypoglycemia (choice A) and respiratory distress syndrome (choice C) are not direct complications of hyperbilirubinemia. Choice D, "All of the above," is incorrect as only kernicterus is a potential complication of neonatal hyperbilirubinemia.
A nurse is developing a plan of care for a newborn whose mother tested positive for heroin during pregnancy. The newborn is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse include in the plan?
- A. Administer naloxone to the newborn.
- B. Swaddle the newborn with his legs extended.
- C. Maintain eye contact with the newborn during feedings
- D. Minimize noise in the newborn's environment.
Correct Answer: D
Rationale: Minimizing noise in the newborn's environment helps reduce overstimulation, which can exacerbate symptoms of neonatal abstinence syndrome. Naloxone is not used for this condition, and swaddling with legs extended is incorrect as it should be snug to provide comfort.