Nursing Elites

1. Using Nägele's rule, what is the estimated date of delivery for a pregnant client who reports that the first day of her last menstrual period was August 2, 2006?

• A. April 25, 2007.
• B. May 9, 2007.
• C. May 29, 2007.
• D. June 2, 2007.

Correct answer: B

Rationale: Nägele's rule is used to estimate the date of delivery. It involves adding 7 days to the first day of the last menstrual period (August 2), which gives August 9. Then, subtracting 3 months from August 9, we arrive at May 9 of the following year as the estimated date of delivery. This makes choice B, 'May 9, 2007,' the correct answer. Choices A, C, and D are incorrect as they do not follow the correct calculation based on Nägele's rule.

2. Which physical assessment data should the nurse consider a normal finding for a primigravida client who is 12 hours postpartum?

• A. Unilateral lower leg pain.
• B. Saturating two perineal pads per hour.
• C. Pulse rate of 56 bpm.
• D. Soft, spongy fundus.

Correct answer: C

Rationale: A pulse rate of 56 bpm is a normal finding for a primigravida client who is 12 hours postpartum. Bradycardia (pulse rate 50-70 bpm) can be a normal postpartum occurrence due to increased stroke volume and decreased cardiac output after delivery. Unilateral lower leg pain and saturating two perineal pads per hour are not normal findings and require further assessment. A soft, spongy fundus could indicate uterine atony, which is abnormal postpartum.

3. Just after delivery, a new mother tells the nurse, 'I was unsuccessful breastfeeding my first child, but I would like to try with this baby.' Which intervention is best for the LPN/LVN to implement first?

• A. Assess the husband's feelings about his wife's decision to breastfeed their baby.
• B. Ask the client to describe why she was unsuccessful with breastfeeding her last child.
• C. Encourage the client to develop a positive attitude about breastfeeding to help ensure success.
• D. Provide assistance to the mother to begin breastfeeding as soon as possible after delivery.

Correct answer: D

Rationale: The correct intervention is to provide immediate assistance to the mother to begin breastfeeding as soon as possible after delivery. This approach helps initiate bonding and successful breastfeeding. Taking action promptly can address the mother's desire to breastfeed and promote positive outcomes for both the mother and the newborn.

4. When preparing a class on newborn care for expectant parents, what content should be taught concerning the newborn infant born at term gestation?

• A. Milia are white marks caused by sebaceous glands and typically resolve within 2 to 4 weeks.
• B. Meconium is the first stool and is typically dark green or black in color.
• C. Vernix caseosa is a white, cheesy substance mainly found in skin folds, providing a protective layer.
• D. Pseudostrabismus in newborns usually self-resolves without the need for intervention.

Correct answer: C

Rationale: Vernix caseosa is a white, cheesy substance that acts as a protective barrier on the skin of newborns, particularly present in skin folds. It helps to prevent dehydration and protect the delicate skin of the newborn from the amniotic fluid in utero. Educating expectant parents about the presence and function of vernix caseosa can help them understand the importance of its preservation during the immediate postnatal period. Choices A, B, and D are incorrect as they do not directly relate to the protective function of vernix caseosa in newborns. Milia are small, white bumps on the skin due to blocked oil glands, meconium is the first stool of a newborn and is typically dark green or black in color, and pseudostrabismus refers to false appearance of misalignment of the eyes, which usually resolves on its own without intervention.

5. The LPN/LVN is providing discharge teaching for a client who is 24 hours postpartum. The nurse explains to the client that her vaginal discharge will change from red to pink and then to white. The client asks, 'What if I start having red bleeding after it changes?' What should the nurse instruct the client to do?

• A. Reduce activity level and notify the healthcare provider.
• B. Go to bed and assume a knee-chest position.
• C. Massage the uterus and go to the emergency room.
• D. Do not worry as this is a normal occurrence.

Correct answer: A

Rationale: If the client experiences a return to red bleeding after transitioning to pink and white, it may indicate possible complications like hemorrhage or retained placental fragments. Instructing the client to reduce activity level and promptly notify the healthcare provider is crucial for timely evaluation and management of these potentially serious postpartum complications. Choice B is incorrect as assuming a knee-chest position is not the appropriate action for red bleeding postpartum. Choice C is incorrect as massaging the uterus without professional assessment can be dangerous. Choice D is incorrect because red bleeding after transitioning is not normal and should be evaluated promptly.

Similar Questions