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Which patient could safely be cared for by a certified nurse-midwife?
- A. Gravida 3, para 2, with no complications
- B. Gravida 1, para 0, with mild hypertension
- C. Gravida 2, para 1, with insulin-dependent diabetes
- D. Gravida 1, para 0, with borderline pelvic measurements
Correct Answer: A
Rationale: Certified nurse-midwives care for low-risk women; Gravida 3, para 2, with no complications fits this criterion.
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The nurse states to the newly pregnant patient, 'Tell me how you feel about being pregnant.' Which communication technique is the nurse using with this patient?
- A. Clarifying
- B. Paraphrasing
- C. Reflection
- D. Structuring
Correct Answer: A
Rationale: The nurse is attempting to follow up and check the accuracy of the patient's message, which is clarifying.
Which nursing intervention is an independent function of the professional nurse?
- A. Administering oral analgesics
- B. Requesting diagnostic studies
- C. Teaching the patient perineal care
- D. Providing wound care to a surgical incision
Correct Answer: C
Rationale: Teaching is an independent nursing function, whereas administering medications or requesting diagnostic studies are dependent functions requiring physician orders.
A client at 39-weeks gestation is admitted to the labor and delivery unit in active labor. The client's cervix is dilated 6 cm, 90% effaced, and the fetus is at 0 station. The client's membranes rupture spontaneously, and the fluid is clear. What action should the nurse take next?
- A. Monitor the fetal heart rate pattern.
- B. Perform a vaginal examination.
- C. Encourage the client to ambulate.
- D. Administer pain medication.
Correct Answer: A
Rationale: Monitoring the fetal heart rate pattern after membrane rupture is essential to detect any changes in fetal status.
The nurse's assessment of a preterm infant reveals decreased muscle tone, signs of respiratory difficulty, irritability, and mottled, cool skin. Which intervention should the nurse implement first?
- A. Position radiant warmer over the crib
- B. Assess the infants blood glucose level
- C. Nipple feed 1 ounce 1% glucose in water
- D. Place the infant in side-lying position
Correct Answer: A
Rationale: A radiant warmer (A) helps stabilize the infant's temperature and provides immediate warmth.
Which patient would require additional calories and nutrients?
- A. A 36-year-old female gravida 2, para 1, in her first trimester of pregnancy
- B. An 18-year-old female who delivered a 7-lb baby and is bottle feeding
- C. A 23-year-old female who had a cesarean birth and is bottle feeding
- D. A 20-year-old female who had a vaginal birth 5 months ago and is breastfeeding
Correct Answer: D
Rationale: The correct answer is D because breastfeeding requires additional calories and nutrients to support the mother's milk production and maintain her own health. Breastfeeding burns extra calories, so the mother needs to consume more to meet her body's needs. Additionally, breastfeeding mothers need to ensure they are getting enough nutrients like calcium, iron, and protein to support their own health and the production of nutritious breast milk for their baby.
Choice A is incorrect because the patient is in her first trimester of pregnancy, not breastfeeding. Choice B is incorrect because bottle feeding does not require as many additional calories and nutrients as breastfeeding. Choice C is incorrect because although the patient had a cesarean birth, the method of feeding (bottle feeding) does not require as much additional nutrition as breastfeeding.