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A nurse is reinforcing teaching about outpatient resources for a client who is recovering from a molar pregnancy.
Which of the following statements by the client indicates an understanding of the teaching?
- A. I will need to start chemotherapy immediately.
- B. I will need to attend a support group when I get home.
- C. I will need an amniocentesis within 1 month.
- D. I will need home palliative services after I am discharged from the hospital.
Correct Answer: B
Rationale: Attending a support group provides emotional support and coping strategies post-molar pregnancy, reflecting an understanding of the psychosocial resources available.
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A nurse is assisting with the admission of a client who has hyperemesis gravidarum.
Which of the following laboratory tests is the priority to complete?
- A. Serum bilirubin
- B. Liver enzymes
- C. Urinalysis for ketones
- D. CBC
Correct Answer: C
Rationale: Urinalysis for ketones is the priority to assess dehydration and ketosis from severe vomiting in hyperemesis gravidarum, guiding immediate treatment to prevent complications.
A nurse is reinforcing teaching with a client who is pregnant and reports frequent heartburn.
Which of the following recommendations should the nurse include in the teaching?
- A. Lie in a left side lying position for 30 min after meals
- B. Drink a cup of black coffee before breakfast
- C. Take sips of milk between meals
- D. Eat three large meals per day
Correct Answer: C
Rationale: Taking sips of milk between meals can help neutralize stomach acid and provide temporary relief from heartburn symptoms. However, it's essential to avoid drinking large quantities of milk at once, as this can lead to increased stomach acid production.
A nurse is reinforcing discharge instructions about breastfeeding with a client. Which of the following statements should the nurse make?
- A. You should recognize that your baby sucking on his hands is a hunger cue.
- B. You should feed your baby for 10 minutes on each breast.
- C. You should feed your baby six times a day.
- D. You should wake your baby at least every 6 hours at night for feedings.
Correct Answer: A
Rationale: Recognizing that sucking on hands is a hunger cue helps ensure timely feeding, supporting a successful breastfeeding routine and adequate nutrition for the baby.
A nurse is checking the reflexes of a newborn.
Which of the following actions should the nurse use to elicit the Babinski reflex?
- A. Touch the corner of the newborn's mouth.
- B. Place the newborn supine and apply pressure to the soles of the feet.
- C. Stroke upward on the lateral aspect of the sole of the newborn's foot
- D. Pull the newborn up by the wrist from a supine position.
Correct Answer: C
Rationale: Stroking upward on the lateral sole elicits the Babinski reflex, where toes fan and extend, a normal newborn response indicating neurological health.
A nurse is reviewing the facility protocol about newborn identification and safety with a new parent. Which of the following information should the nurse include?
- A. You should check the identity of individuals who come to remove your baby from the room
- B. We will scan your baby's identification bracelet each time check on him
- C. We will match the bracelet on your baby with his footprint record each shift
- D. Your baby will wear an electronic bracelet when he is out of your room
Correct Answer: A
Rationale: It's crucial for parents to verify the identity of anyone who comes to take their baby out of the room. This helps ensure the baby's safety and prevents unauthorized individuals from taking the baby. Hospital staff usually wear identification badges, and parents should be encouraged to ask for and verify this identification.