when is it most appropriate to clamp and cut the umbilical cord

ATI LPN

LPN Pediatrics

1. When is it MOST appropriate to clamp and cut the umbilical cord?

A. Before the newborn has taken its first breath
B. After the placenta has completely delivered
C. As soon as the cord has stopped pulsating
D. Immediately following delivery of the newborn

Correct answer: C

Rationale: The ideal time to clamp and cut the umbilical cord is when it has stopped pulsating. This allows for the transfer of remaining blood from the placenta to the newborn, which can be beneficial for the baby's health and iron stores. Clamping the cord too early can deprive the newborn of this essential blood volume. Waiting for the pulsations to cease ensures that the baby receives the maximum benefits from delayed cord clamping.

2. What is the pattern of fever in enteric fever?

A. Intermittent fever
B. Relapsing fever
C. Pel-Ebstein fever
D. Continuous fever

Correct answer: D

Rationale: Enteric fever, caused by Salmonella typhi or paratyphi, is characterized by a continuous fever pattern. The fever typically persists without significant fluctuations, distinguishing it from diseases with intermittent or relapsing fever patterns. Pel-Ebstein fever, a cyclic pattern of fever seen in Hodgkin's lymphoma, is not associated with enteric fever. Relapsing fever is a characteristic of diseases like Borrelia recurrentis infection. Intermittent fever is seen in conditions like malaria.

3. What are the MOST important initial steps in assessing and managing a newborn?

A. Drying and warming the infant, obtaining an APGAR score.
B. Clearing the airway, keeping the infant warm.
C. Suctioning the airway, obtaining a heart rate.
D. Keeping the infant warm, counting respirations.

Correct answer: B

Rationale: The most crucial initial steps in assessing and managing a newborn involve clearing the airway to ensure proper breathing and keeping the infant warm to maintain body temperature. Airway clearance helps prevent respiratory distress, while warmth is essential to prevent hypothermia, a common issue in newborns. These steps are vital in the immediate care of a newborn to support their transition to extrauterine life and ensure their well-being. Choice A is incorrect because obtaining an APGAR score is important but not as critical as clearing the airway. Choice C is incorrect as suctioning the airway is not always necessary and obtaining a heart rate is secondary to ensuring a clear airway and warmth. Choice D is incorrect because counting respirations is not as immediate and crucial as clearing the airway.

4. Kobby, who is diagnosed with diabetes mellitus type 1, displays symptoms of hypoglycemia; which of the following actions should the nurse instruct the parents to take?

A. Give the child honey (simple sugar)
B. Give the child milk (complex sugar)
C. Contact the healthcare provider before doing anything
D. Give the child nothing by mouth

Correct answer: A

Rationale: During hypoglycemia, it is crucial to quickly raise blood glucose levels. Giving a simple sugar like honey is recommended as it can rapidly increase blood sugar levels and alleviate the symptoms of hypoglycemia in individuals with diabetes mellitus type 1. Milk, being a complex sugar, will not act as quickly as honey in raising blood sugar levels. Contacting the healthcare provider may lead to a delay in treatment, as immediate action is necessary during hypoglycemia. Withholding food or drink (choice D) is not appropriate when dealing with hypoglycemia as it can worsen the condition.

5. During transport of a woman in labor, the patient tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. What should you do?

A. Ask the mother to take short, quick breaths until you arrive at the hospital.
B. Allow the head to deliver and check for the location of the cord.
C. Apply gentle pressure to the baby's head and notify the hospital immediately.
D. Advise your partner to stop the ambulance and assist with the delivery.

Correct answer: D

Rationale: When the top of the baby's head is visible (crowning) during transport, it indicates imminent delivery. In this situation, it is crucial to stop the ambulance and assist with the delivery. This ensures a safe delivery process for the mother and the baby. Waiting to arrive at the hospital or attempting to apply pressure to the baby's head can lead to complications. Allowing the head to deliver and checking for the cord's location is a necessary step during the delivery process, but the immediate priority is to assist in the safe delivery of the baby.