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Which of the following would the nurse expect as a common finding for a multiparous client delivering a viable neonate at 41 weeks' gestation with the aid of a vacuum extractor?
- A. Caput succedaneum.
- B. Cephalohematoma.
- C. Maternal lacerations.
- D. Neonatal intracranial hemorrhage.
Correct Answer: A
Rationale: Vacuum extraction commonly causes caput succedaneum, a soft tissue swelling on the neonate's scalp due to pressure, which resolves spontaneously. Cephalohematoma, lacerations, or hemorrhage are less common or more serious.
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Three days after admission of a neonate delivered at 30 weeks' gestation, the neonatologist plans to assess the neonate for periventricular-intraventricular hemorrhage (PIVH). The nurse should plan to assist the neonatologist by preparing the neonate for which of the following?
- A. Computed tomography scan.
- B. Arterial blood specimen collection.
- C. Radiographs of the skull.
- D. Complete blood count specimen collection.
Correct Answer: A
Rationale: A computed tomography scan is used to assess for PIVH, as it visualizes bleeding in the brain.
A nurse is teaching a client about the use of the contraceptive patch. Which of the following instructions should the nurse include?
- A. Apply the patch to the genital area.
- B. Change the patch weekly for three weeks, then have a patch-free week.
- C. Wear the patch for one month without changing.
- D. Apply a new patch daily.
Correct Answer: B
Rationale: The contraceptive patch is changed weekly for three weeks, followed by a patch-free week to allow a withdrawal bleed. It is not applied to the genital area, worn for a month, or changed daily.
The nurse in the labor and delivery area receives a telephone call from the emergency room announcing that a multigravid client in active labor is being transferred to the labor area. The client has been successful care, when the client arrives by stretcher, she says, 'I think the baby's coming ... Help!' The fetal skull is crowning. The nurse should obtain which of the following information first?
- A. Estimated date of delivery.
- B. Amniotic fluid status.
- C. Gravida and parity.
- D. Prenatal history.
Correct Answer: A
Rationale: With crowning, delivery is imminent, and confirming the estimated date of delivery ensures the neonate's gestational age is known for resuscitation planning. Fluid status, gravida/parity, and prenatal history are secondary.
After teaching the parents of a neonate born with a cleft lip and cleft palate about appropriate feeding techniques, the nurse determines that the mother needs further instruction when the mother says which of the following?
- A. I should clean her mouth with soapy water after feeding.'
- B. I should feed her in an upright position.'
- C. I need to remember to burp her often.'
- D. I may need to use a special nipple for feeding.'
Correct Answer: A
Rationale: Cleaning the mouth with soapy water is inappropriate and could irritate the cleft, indicating a need for further instruction.
Assessment of a 16-year-old nulligravid client who visits the clinic and asks for information on contraceptives reveals a menstrual cycle of 28 days. The nurse formulates a nursing diagnosis of Deficient knowledge related to ovulation and fertility management. Which of the following would be important to include in the teaching plan for the client?
- A. The ovum survives for 96 hours after ovulation, making conception possible during this time.
- B. The basal body temperature falls at least 0.2°F after ovulation has occurred.
- C. Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle.
- D. Most women can tell they have ovulated because of severe pain and thick, scant cervical mucus.
Correct Answer: C
Rationale: Ovulation typically occurs around day 14 (plus or minus 2 days) before the next menstrual cycle in a 28-day cycle, which is critical for understanding fertility windows. The ovum survives for about 12-24 hours, not 96 hours, and basal body temperature rises after ovulation.