Nursing Elites

1. A healthcare professional is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the professional use to help minimize the pain of the procedure for the newborn?

• A. Apply a cool pack to the heel for 10 minutes prior to the puncture.
• B. Request a prescription for IM analgesic.
• C. Use a manual lancet to pierce the skin.
• D. Place the newborn skin-to-skin on the mother's chest.

Correct answer: D

Rationale: Placing the newborn skin-to-skin on the mother's chest is an effective technique to significantly decrease the newborn's pain level and anxiety during a heel stick procedure. This approach provides comfort, warmth, and familiarity to the newborn, promoting a sense of security and reducing distress. It is important for the healthcare professional to implement this technique before, during, and after the procedure to optimize pain management and support newborn well-being. The other options, such as applying a cool pack, requesting an IM analgesic prescription, and using a manual lancet, are not appropriate for minimizing pain in a newborn during a heel stick procedure. Applying a cool pack may cause vasoconstriction and increase pain, requesting an IM analgesic for a routine heel stick is excessive, and using a manual lancet without additional comforting measures may not adequately address the newborn's pain and anxiety.

2. While observing the electronic fetal heart rate monitor tracing for a client at 40 weeks of gestation in labor, a nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?

• A. Early decelerations
• B. Accelerations
• C. Late decelerations
• D. Variable decelerations

Correct answer: D

Rationale: Variable decelerations can indicate umbilical cord compression, which is a concern that may arise due to the umbilical cord being compressed during labor. This compression can lead to reduced blood flow and oxygen delivery to the fetus, necessitating close monitoring and potentially interventions to alleviate the pressure on the cord. Early decelerations are typically benign and mirror the contractions, indicating fetal head compression. Accelerations are reassuring patterns that show a healthy response to fetal movement. Late decelerations are concerning as they suggest uteroplacental insufficiency, indicating potential oxygen deprivation to the fetus.

3. A client is exhibiting tearfulness, insomnia, lack of appetite, and a feeling of letdown after childbirth. Which of the following conditions is associated with these manifestations?

• A. Postpartum fatigue
• B. Postpartum psychosis
• C. Letting-go phase
• D. Postpartum blues

Correct answer: D

Rationale: The correct answer is D, Postpartum blues. Postpartum blues, also known as baby blues, are common after childbirth and are characterized by symptoms like tearfulness, insomnia, lack of appetite, and a feeling of letdown. This condition is typically self-limiting and resolves without specific treatment. Postpartum fatigue (choice A) refers to extreme tiredness after childbirth but does not typically include symptoms like tearfulness and insomnia. Postpartum psychosis (choice B) is a severe condition that includes symptoms such as hallucinations and delusions, which are not present in the scenario. The letting-go phase (choice C) does not represent a specific postpartum condition related to the symptoms described.

4. A client who is 3 days postpartum is receiving education on effective breastfeeding. Which of the following information should the nurse include?

• A. Your milk will replace colostrum in about 10 days.
• B. Your breasts should feel firm after breastfeeding.
• C. Your newborn should urinate at least 10 times per day.
• D. Your newborn should appear content after each feeding.

Correct answer: D

Rationale: The correct answer is D. The nurse should inform the client that a baby who is sated will appear content after feedings. This indicates that the baby is effectively emptying the breasts during feedings. Choices A, B, and C are incorrect because: A) Breast milk replaces colostrum within a few days, not 10 days. B) Breasts feeling firm after breastfeeding may indicate engorgement or plugged ducts, not necessarily effective breastfeeding. C) While the frequency of urination is important, it is not directly related to effective breastfeeding.

5. A client who is postpartum has a slightly boggy and displaced fundus to the right. Which of the following actions should the nurse take based on these findings?

• A. Encourage the client to perform Kegel exercises.
• B. Encourage the client to move to the left lateral position.
• C. Ask the client to rate her pain.
• D. Assist the client to the bathroom to void.

Correct answer: D

Rationale: A displaced and boggy fundus in a postpartum client typically indicates a full bladder, which can impede uterine contractions and increase the risk of postpartum hemorrhage. Assisting the client to the bathroom to void helps ensure the bladder is empty, aiding the fundus to contract and reducing the risk of complications. Encouraging Kegel exercises, changing positions, or assessing pain would not directly address the issue of the boggy fundus caused by a full bladder.

Similar Questions