Nokea
You are the clinician on duty at Rabuor health centre when a mother is brought by relatives having delivered at home 2 days ago. When you examine the baby you find a tiny infant weighing $1800 \mathrm{~g}$. The baby is cold with bluish lips and a weak cry. List 4 signs of prematurity. What is one sign?
- A. Low birth weight (<2500 g)
- B. High birth weight (>4000 g)
- C. Thick skin with vernix
- D. Strong sucking reflex
Correct Answer: A
Rationale: Low birth weight (<2500 g) is a hallmark sign of prematurity, consistent with this baby’s 1800 g weight.
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How many hours of hospital stay does legislation currently allow for a postpartum patient who has delivered vaginally without complications?
- A. 24
- B. 48
- C. 36
- D. 72
Correct Answer: B
Rationale: Postpartum patients who deliver vaginally stay in the hospital for an average of 48 hours; patients who have had a cesarean delivery usually stay 4 days.
In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart rate (FHR) has dropped to 120 beats/min from a rate of 160 beats/min earlier in the pregnancy. What is the nurses first action?
- A. Ask if the patient has taken a sedative.
- B. Notify the physician.
- C. Turn the patient to her right side.
- D. Record the rate as a normal finding.
Correct Answer: D
Rationale: The FHR at term ranges from a low of 110 to 120 beats/min to a high of 150 to 160 beats/min. This should be recorded as normal. The FHR drops in the late stages of pregnancy.
A child breaks out with the varicella infection (chickenpox) while hospitalized for a minor surgical procedure. Which interventions should the nurse implement? (Select one that does not apply.).
- A. Place a mask on the child before transporting the child outside the room.
- B. Immunize exposed family members with the varicella vaccine.
- C. Place the child in strict isolation to prevent an outbreak on the unit.
- D. Determine which staff have had varicella before making assignments.
Correct Answer: B
Rationale: Varicella is airborne; a mask during transport, strict isolation (negative pressure room), and staff immunity checks prevent spread. Vaccine is post-exposure prophylaxis but not immediate nursing action.
The nurse is reading a pregnant patients history and physical. What information does the nurse recognize might indicate the need for a cesarean delivery? (Select one that does not apply.)
- A. History of childhood rickets
- B. Immobile coccyx
- C. Prepregnant weight of 100 pounds
- D. Pelvic Fracture
Correct Answer: C
Rationale: Pelvic conditions that may predispose to a cesarean delivery are childhood rickets, pelvic fracture, and immobile coccyx. 'E' refers to pelvic fracture 3 years ago.
An urban area has been reported to have a high perinatal mortality rate. What information does this provide?
- A. Maternal and infant deaths per 100,000 live births per year
- B. Deaths of fetuses weighing more than $500 \mathrm{~g}$ per 10,000 births per year
- C. Deaths of infants up to 1 year of age per 1000 live births per year
- D. Fetal and neonatal deaths per 1000 live births per year
Correct Answer: D
Rationale: The perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year.