Nursing Elites

1. When reinforcing teaching with a group of new parents about proper techniques for bottle feeding, which of the following instructions should be provided?

• A. Burp the newborn at the end of the feeding
• B. Hold the newborn close in a supine position
• C. Keep the nipple full of formula throughout the feeding
• D. Refrigerate any unused formula

Correct answer: C

Rationale: The correct technique for bottle feeding includes keeping the nipple full of formula throughout the feeding to prevent air from entering the baby's stomach. This helps reduce the risk of the baby swallowing air, which can lead to discomfort and colic. Therefore, maintaining a full nipple during feeding is essential for the baby's comfort and digestion. Option A is incorrect as burping should be done during the feeding to prevent excessive air intake. Option B is incorrect as the baby should be held semi-upright, not in a supine position, to reduce the risk of choking and ear infections. Option D is irrelevant to the feeding process and does not contribute to the baby's well-being.

2. A client who is breastfeeding and has mastitis is receiving teaching from the nurse. Which of the following responses should the nurse make?

• A. Limit the amount of time the infant nurses on each breast.
• B. Nurse the infant only on the unaffected breast until resolved.
• C. Completely empty each breast at each feeding or use a pump.
• D. Wear a tight-fitting bra until lactation has ceased.

Correct answer: C

Rationale: The correct response is to completely empty each breast at each feeding or use a pump to prevent milk stasis, which can exacerbate mastitis. By ensuring proper drainage of the affected breast, the client can help alleviate symptoms and promote healing. Choice A is incorrect because limiting feeding time can lead to inadequate drainage, potentially worsening the condition. Choice B is incorrect as it can cause engorgement in the unaffected breast, leading to further complications. Choice D is incorrect as wearing a tight-fitting bra can worsen symptoms by putting pressure on the affected breast, hindering proper drainage and exacerbating mastitis.

3. A client at 40 weeks of gestation is experiencing contractions every 3 to 5 minutes, becoming stronger. A vaginal exam by the registered nurse reveals the client's cervix is 3 cm dilated, 80% effaced, and -1 station. The client requests pain medication. Which of the following actions should the nurse prepare to take? (Select all that apply)

• A. Provide ice chips.
• B. Insert an indwelling urinary catheter.
• C. Administer opioid analgesic medication.
• D. Provide ice chips.

Correct answer: C

Rationale: During labor, effective pain management is crucial. The nurse should assist the client with patterned breathing techniques to help manage pain and administer opioid analgesic medication as ordered. Providing ice chips is a comfort measure but does not directly address pain relief. Inserting a urinary catheter is not typically indicated at this stage of labor unless there are specific medical indications, such as the need to closely monitor urine output. Therefore, the correct action for the nurse to prepare to take in this scenario is to administer opioid analgesic medication.

4. A nurse in a prenatal clinic overhears a newly licensed nurse discussing conception with a client. Which of the following statements by the newly licensed nurse requires intervention by the nurse?

• A. Fertilization takes place in the outer third of the fallopian tube.
• B. Implantation occurs between 6 to 10 days after conception.
• C. Sperm remain viable in the woman's reproductive tract for 2 to 3 days.
• D. Bleeding or spotting can accompany implantation.

Correct answer: B

Rationale: The correct answer is B because implantation typically occurs between 6 to 10 days after conception, not 2 to 3 days. It is crucial for the nurse to intervene and provide accurate information to ensure the client receives correct education about conception. Choice A is correct as fertilization does occur in the outer third of the fallopian tube. Choice C is also accurate as sperm can remain viable in the woman's reproductive tract for 2 to 3 days. Choice D is correct as bleeding or spotting can indeed accompany implantation.

5. A client who is 2 hours postpartum is in the taking-hold phase. Which intervention should the nurse plan to implement during this phase of postpartum behavioral adjustment?

• A. Discuss contraceptive options with the client and her partner.
• B. Repeat information to ensure client understanding.
• C. Listen to the client and her partner as they reflect upon the birth experience.
• D. Demonstrate to the client how to perform a newborn bath.

Correct answer: D

Rationale: During the taking-hold phase of postpartum behavioral adjustment, the new mother starts taking a stronger interest in her new role as a mother. This phase involves the mother focusing on the care of her newborn and acquiring parenting skills. Demonstrating how to perform a newborn bath is an appropriate intervention during this phase as it helps the mother actively engage in caring for her baby, which aligns with the developmental tasks of this phase. Choices A, B, and C are incorrect as they do not specifically address the mother's need to actively engage in caring for her newborn during the taking-hold phase. Discussing contraceptive options, repeating information, and listening to reflections on the birth experience are more relevant to other phases of postpartum adjustment.

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