Nokea
Whose theoretical model describes how clinical judgment evolves with experience?
- A. Benner
- B. Tanner
- C. Lasater
- D. Nightingale
Correct Answer: A
Rationale: Patricia Benner's theoretical model explains how clinical judgment develops through stages of novice to expert based on experience.
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The nurse is completing a gestational assessment on a newborn whose parent was treated for preeclampsia during labor. The neonate is demonstrating “frog-like” posturing. The nurse knows this is likely due to what medication during labor?
- A. fentanyl in the epidural
- B. penicillin for treatment of group B strep infection
- C. magnesium sulfate for treatment of preeclampsia
- D. prenatal vitamins
Correct Answer: C
Rationale: Magnesium sulfate administered to treat preeclampsia can cause hypotonia and 'frog-like' posturing in the newborn.
What characteristics are directly related to the newborn’s decreased ability to maintain thermal stability?
- A. A neonate has decreased subcutaneous fat and a large body surface-to-weight ratio.
- B. The blood vessels in the neonate are farther from the skin than those of an adult.
- C. Newborns are unable to rely on brown adipose tissue for heat production.
- D. The newborn prefers to be in constant motion, increasing the surface area exposed to the environment.
Correct Answer: A
Rationale: Newborns have less subcutaneous fat and a higher surface-to-weight ratio, making thermoregulation challenging.
The mother-baby nurse is providing care to a patient and her newborn 2 hours after delivery. On review of the newborn's chart, the nurse sees a notation of caput succedaneum. What will the nurse expect to find in the mother's chart?
- A. Race: non-White
- B. A longer than usual labor
- C. Administration of an epidural
- D. Delivery by cesarean birth
Correct Answer: B
Rationale: The correct answer is B: A longer than usual labor. Caput succedaneum is swelling of the baby's scalp due to pressure during labor. This indicates a longer labor duration.
A: Race is not a factor in the development of caput succedaneum.
C: Administration of an epidural does not directly cause caput succedaneum.
D: Delivery by cesarean birth is not associated with caput succedaneum.
The nurse is providing care for a neonate during the fourth stage of labor. Which action does the nurse take during this stage?
- A. Dry the neonate immediately.
- B. Compete neonate assessment within 1 hour.
- C. Obtain neonate blood glucose levels.
- D. Perform Apgar screening until scores are 7.
Correct Answer: A
Rationale: The correct answer is A: Dry the neonate immediately. This is crucial during the fourth stage of labor to prevent hypothermia in the neonate. Drying the neonate helps maintain body temperature and reduce heat loss. Choice B is incorrect because a complete neonate assessment should be done within the first 1-2 minutes, not within 1 hour. Choice C is incorrect as obtaining neonate blood glucose levels is not typically done during the immediate post-birth period unless indicated. Choice D is incorrect as Apgar screening is typically done at 1 and 5 minutes after birth, not until the scores are 7.
Which interventions should the nurse perform following the delivery of the newborn?
- A. Place the infant on the mother's chest after wrapping in a sterile blanket
- B. Measure the Apgar score at 5 and 10 minutes after delivery, report findings to the physician
- C. Remove vernix caseosa that is covering the infant's body while stimulating the infant to cry
- D. Transfer the infant to the newborn nursery after securing in warm blankets and an open crib
Correct Answer: B
Rationale: The correct answer is B because measuring the Apgar score at 5 and 10 minutes after delivery is a standard practice to assess the newborn's overall well-being. This helps to identify any immediate medical intervention needed and ensures the newborn's health is monitored closely.
A is incorrect because placing the infant on the mother's chest is important for bonding, but not a critical intervention immediately following delivery.
C is incorrect because removing vernix caseosa and stimulating crying can be done later and are not immediate priorities.
D is incorrect because transferring the infant to the nursery without assessing the Apgar score can delay necessary medical interventions if needed.