Question 6031)
What is the safest position for a woman in labor when a nurse observes a prolapsed cord?
A. Prone
B. Fowler
C. Lithotomy
D. Trendelenburg
Answer: D
Explanation: A position in which the mother's head is below the level of the hips helps decrease compression of the cord and therefore maintains the blood supply to the fetus.
Question 6032)
What should a nurse anticipate about the insulin requirements of a client with diabetes on her first postpartum day?
A. A rapid increase
B. Will remain unchanged
C. A sharp and sudden decrease
D. Will decrease slowly and steadily
Answer: C
Explanation: Insulin requirements may fall suddenly during the first 24 to 48 postpartum hours because the endocrine changes of pregnancy are reversed.
Question 6033)
How should a nurse screen a newborn of a diabetic mother for hypoglycemia?
A. Test for glucose tolerance.
B. Draw blood for a serum glucose level.
C. Arrange for a fasting blood glucose level.
D. Test heel blood with a glucose-oxidase strip.
Answer: D
Explanation: Glucose-oxidase strips are used by nurses to screen infants for hypoglycemia.
Question 6034)
An infant is born with a bilateral cleft palate. Plans are made to begin reconstruction immediately. What nursing intervention should be included to promote parentinfant attachment?
A. Demonstrating a positive acceptance of the infant
B. Placing the infant in a nursery away from view of the general public
C. Explaining to the parents that the infant will look normal after the surgery
D. Encouraging the parents to limit contact with the infant until after the surgery
Answer: A
Explanation: By demonstrating acceptance of the infant, without regard for the defect, the nurse acts as a role model for the patents, thus enhancing their acceptance.
Question 6035)
A nurse who is assessing a newborn 3 minutes after birth takes into consideration that the heart rate of a healthy, alert neonate may range between:
A. 120 and 180 beats/min.
B. 130 and 170 beats/min.
C. 110 and 160 beats/min.
D. 100 and 130 beats/min.
Answer: C
Explanation: The newborn's heart rate varies with activity, crying can increase it to 180 beats/min., whereas deep sleep may lower it to 80 to 100 beats/min., a rate between 110 and 160 beats/min is the average.
Question 6036)
At the beginning of the first formula feeding a newborn begins to cough and choke, and the lips become cyanotic. What is the immediate nursing action?
A. Stimulate crying.
B. Suction and then oxygenate.
C. Substitute the formula with sterile water.
D. Stop the feeding momentarily and then restart.
Answer: B
Explanation: Cyanosis, choking and coughing are signs of aspiration and hypoxia. Suctioning and oxygenation are needed.
Question 6037)
Which behavior should a nurse identify as the Moro reflex response?
A. Extension and adduction of the arms
B. Abduction and then adduction of the arms
C. Adduction of the arms and fanning of the toes
D. Extension of the arms and curling of the fingers
Answer: B
Explanation: The Moro reflex is a sudden extension and abduction of the arms at the shoulders and spreading of the fingers. This is followed by flexion and adduction of the arms with the index finger and thumb forming the letter "C", the infant may cry.
Question 6038)
An infant's intestines are sterile at birth, thus lacking the bacteria necessary for the synthesis of:
A. bilirubin
B. bile salts
C. prothrombin
D. intrinsic factor
Answer: C
Explanation: Bacteria, especially Escherichia coli, produce substances necessary to synthesize prothrombin.
Question 6039)
A nurse teaches a group of postpartum clients that all their newborns will be screened for phenylketonuria (PKU)to :
A. assess protein metabolism.
B. reveal potential retardation.
C. detect chromosomal damage.
D. identify thyroid insufficiency.
Answer: A
Explanation: Phenylalanine is an essential amino acid necessary for growth that may be absent in infants with phenylketonuria (PKU), testing is done on all neonates born in the United States.
Question 6040)
Which newborn assessment identified immediately after birth will probably necessitate prolonged follow-up care?
A. Apgar score of 5
B. Weight of 3500 grams
C. Blood glucose level of 50 mg/dL
D. Umbilical cord with 2 blood vessels
Answer: D
Explanation: The congenital absence of a blood vessel in the umbilical cord is often associated with life-threatening congenital anomalies. There should be two arteries and one vein.
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