the appropriate order of steps in active management of the third stage of labor includes
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Community Health HESI Test Bank 2023

1. The appropriate order of steps in active management of the third stage of labor includes:

Correct answer: C

Rationale: The correct sequence of steps in active management of the third stage of labor includes intramuscular injection of oxytocin to prevent postpartum hemorrhage, controlled cord traction with counter traction to the uterus to facilitate placental delivery, and uterine massage to aid in uterine contraction and prevent excessive bleeding. Choice A is incorrect because ergometrine administration is not routinely recommended in active management. Choice B is incorrect as intravenous oxytocin is not the preferred route of administration. Choice D is incorrect as the order of steps is not accurate.

2. The Food Fortification Act of 2000 provides for the mandatory fortification of staple foods, which includes:

Correct answer: A

Rationale: The correct answer is A: Flour with iron. The Food Fortification Act of 2000 mandates the fortification of flour with iron to address iron deficiency in the population. Refined sugar is not typically fortified with iron, making choice B incorrect. While cooking oil fortification with vitamin A is common in some regions, it is not specified under the Food Fortification Act of 2000, rendering choice C incorrect. Similarly, rice fortification with vitamin A is not included in the mandatory fortification list according to the act, making choice D incorrect.

3. Building a healthy community is based on the following basic principles except:

Correct answer: D

Rationale: Building a healthy community is indeed based on principles like concreteness, group dynamics, and focusing on community-level change. However, stating that environmental factors are more basic than institutional factors is incorrect. Both environmental and institutional factors play crucial roles in community health. Environmental factors like access to healthcare, clean water, and safe housing are vital, while institutional factors such as healthcare systems, education, and governance also significantly impact community health. Therefore, the correct answer is D, as environmental factors are not more basic than institutional factors.

4. A Hispanic client confides in the nurse that she is concerned that staff may give her newborn the 'evil eye.' The nurse should communicate to other personnel that the appropriate approach is to

Correct answer: A

Rationale: In some Hispanic cultures, touching the baby after looking at them is believed to prevent the 'evil eye.' Respecting this cultural belief can help build trust and comfort with the client. Choices B, C, and D are incorrect as they do not address the specific cultural concern raised by the client. Talking slowly or avoiding touching the child does not relate to the belief in the 'evil eye.' Similarly, focusing only on the parents does not address the client's worry about the newborn receiving the 'evil eye.'

5. After 3 days, the nurse notes that James has chest indrawing and stridor. His mother returned him to the health center immediately. The nurse should:

Correct answer: C

Rationale: Chest indrawing and stridor are signs of severe respiratory distress. In this situation, immediate referral is essential. Giving the first dose of antibiotics before referral can help initiate treatment, but urgent referral for further evaluation and management is crucial. Choice A is incorrect because simply changing the antibiotic without assessing the severity of the symptoms and providing urgent care is not appropriate. Choice B is incorrect as advising the mother to observe the child and continue antibiotics delays necessary intervention for a potentially life-threatening condition. Choice D is incorrect as observing the child at the center is not sufficient when signs of severe illness are present.

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