L&P nclex review questions
At what gestational age should a primigravida expect to start feeling quickening?
18-20 weeks
A mother's household consists of her husband, his mother, and another child. She is living in a/an: A. Extended family. B. Single-parent family. C> Married-blended family. D. Trinuclear family.
A.
Practices such as providing recommended immunizations, infant car seats, and school health education are part of: A. Primary preventive care. B. Secondary preventive care. C. Tertiary preventive care. D. Primordial preventive care.
A. Primary preventive care
what is accountability?
Accountability refers to legal and professional responsibility for practice.
Which time span delineates the appropriate length for a normal pregnancy? A. 9 lunar months, 8.5 calendar months, 39 weeks, 272 days B. 10 lunar months, 9 calendar months, 40 weeks, 280 days C. 9 calendar months, 10 lunar months, 42 weeks, 294 days D. 9 calendar months, 38 weeks, 266 days
B.
Providing treatment and rehabilitation for people who have developed disease is part of: Primary preventive care. Secondary preventive care. C. Tertiary preventive care. Correct Primordial preventive care.
C. rational: Primary preventive care involves promoting healthy lifestyles. Secondary preventive care involves targeting populations at risk. Tertiary preventive care is the treatment or rehabilitation of those who already have a specific disease. Primordial preventive care refers to prevention of the risk factors themselves at either the social or environmental level.
The perinatal continuum of care begins with: A The diagnosis of pregnancy. BThe interval just before birth. C Identification of a pregnant woman as high risk. D Family planning and preconception care.
D
what is ethics?
Ethics refers to a code to guide practice
what is a biophysical profile?
is a method of biophysical assessment of fetal well-being in the third trimester.
A client is told that she needs to have a nonstress test to determine fetal well-being. After 20 minutes of monitoring, the nurse reviews the strip and finds two 15-beat accelerations that lasted for 15 seconds. What should the nurse do next?
*Inform the physician and prepare for discharge; this client has a normal strip. Fetal well-being is determined during a nonstress test by two accelerations occurring within 20 minutes that demonstrate a rise in heart rate of at least 15 beats.
When should clear liquids be stopped before scheduled surgery
*Varies according to the surgical procedure to be done Each surgical procedure may have a different requirement for when nothing by mouth (NPO) status should be initiated. The nurse should follow the surgeon's or anesthesiologist's order as to when clear liquids should be stopped. Although 2 hours before surgery is a common time for stopping clear liquids to reduce the risk of pulmonary aspiration in healthy patients, the timing may vary. Therefore, it should be clarified with the surgeon or anesthesiologist. Although a 6-hour time frame is often used for stopping milk and milk products before surgery, the timing may vary. Therefore, it should be clarified with the surgeon or anesthesiologist. Stopping clear liquids by midnight may be too long a period before surgery. Therefore, the timing should be clarified with the surgeon or anesthesiologist
What is not a trend in the delivery of health care in the United States? A. Greater emphasis has been placed on curing disease and disability than on preventing them. Correct B. Hospital stays for many conditions have been shortened. C. Acute care is increasingly provided through home-based services. D. Hospital-based nurses are increasingly involved in follow-up care after discharge.
A
From the nurse's perspective, what measure should be the focus of the health care system in order to reduce the rate of infant mortality further? A. Implementing programs to ensure women's early participation in ongoing prenatal care Correct B> Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days C> Expanding the number of neonatal intensive care units (NICUs) Incorrect D> Mandating that all pregnant women receive care from an obstetrician
A rational; Early prenatal care allows for early diagnosis and appropriate interventions to reduce the rate of infant mortality. An increased length of stay has been shown to foster improved self-care and parental education; however, it does not affect the incidences of leading causes of infant mortality, such as low birth weight. Early prevention and diagnosis reduce the rate of infant mortality. NICUs offer care to high-risk infants after they are born. Expanding the number of NICUs would offer better access for high-risk care, but this is not the primary focus for further reduction of infant mortality rates. A mandate that all pregnant women receive obstetrician care would be nearly impossible to enforce. Furthermore, certified nurse-midwives (CNMs) have been demonstrated to provide reliable, safe care for pregnant women.
Which of the following conditions has not contributed to an increase in maternity-related health care costs? A. Early postpartum discharges Correct B. Maternal medical risk factors, such as diabetes C. The use of high-tech equipment D. The cost of care for low-birth-weight (LBW) infants
A. Early postpartum discharges are associated with decreased health care costs. High-risk factors and high-tech equipment both increase such costs. Clinical evidence indicates that maternity-related health care costs are increased for LBW and high-risk infants.
The process by which people retain some of their own culture while adopting the practices of the dominant society is known as: A. Acculturation. Correct B.Assimilation. C. Ethnocentrism. D. Cultural relativism.
A. rational: Acculturation is the process by which people retain some of their own culture while adopting the practices of the dominant society. This process takes place over the course of generations. Assimilation is a loss of cultural identity. Ethnocentrism is the belief in the superiority of one's own culture over the cultures of others. Cultural relativism recognizes the roles of different cultures.
The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool useful in confirming the diagnosis? A.Doppler blood flow analysis B. Contraction stress test (CST) C Amniocentesis D. Daily fetal movement counts
A. rational: Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the fetus and the placenta. It is a helpful tool in the management of high risk pregnancy due to intrauterine growth restriction (IUGR), diabetes mellitus, multiple fetuses, or preterm labor. Because of the potential risk of inducing labor and causing fetal distress, a CST is not performed in a woman whose fetus is preterm. Indications for an amniocentesis include diagnosis of genetic disorders or congenital anomalies, assessment of pulmonary maturity, and the diagnosis of fetal hemolytic disease, not IUGR. Fetal kick count monitoring is performed to monitor the fetus in pregnancies complicated by conditions that may affect fetal oxygenation. Although it may be a useful tool at some point later in this woman's pregnancy, it is not used to diagnose IUGR.
Which action taken made by the nurse would indicate that he or she is practicing appropriate family-centered care techniques? A The nurse encourages the mother and father to make choices whenever possible. Correct B The nurse updates the family about what is going to happen but instructs the client's sister that she cannot be present in the room during the birth. C. The nurse believes that he or she is acting in the best interest of the client and commands her what to do throughout labor. D. The father is discouraged from accompanying his wife during a cesarean birth.
A. rational: With family-centered maternity care (FCMC), it is important to allow for choices for the couple and to include the partner in the care process. Also, FCMC involves collaboration between the health care team and the client. Unless there is an institutional policy prohibiting the number of attendees at a birth, the client should be allowed to have whomever she desires with her. In a family-centered care model, the partner or even a grandparent may be present for a cesarean birth (unless of course the birth is an emergency, for which guests may be requested to leave).
The two most frequently reported maternal medical risk factors are: A. Hypertension associated with pregnancy and diabetes. B. Drug use and alcohol abuse. C. Homelessness and lack of insurance. D. Behaviors and lifestyles.
A. rational: Hypertension and diabetes are the most frequently reported maternal risk factors. Both are associated with obesity. Approximately 20% of U.S. women who give birth are obese. Obesity in pregnancy is associated with the use of more health care services and longer hospital stays. Both drug use and alcohol abuse continue to increase in the maternal population; they are associated with low-birth-weight infants, mental retardation, and birth defects. The number of clients who are homeless or lack health care insurance is increasing; however, these are not the most common risks. Behavior and lifestyle choices do contribute to the health of the mother and fetus.
The term used to describe professional interaction among health care providers in the clinical nursing practice is: A. Collegiality B. Ethics C. Evaluation D. Accountability
A. rational; Collegiality refers to a working relationship with one's colleagues. Evaluation refers to examination of the effectiveness of interventions in relation to expected outcomes. Accountability refers to legal and professional responsibility for practice.
A maternity nurse should be aware of which fact about the amniotic fluid? A. It serves as a source of oral fluid and as a repository for waste from the fetus. B. The volume remains about the same throughout the term of a healthy pregnancy. C. A volume of less than 300 ml is associated with gastrointestinal malformations. D. A volume of more than 2 L is associated with fetal renal abnormalities.
A. It serves as a source of oral fluid and as a repository for waste from the fetus. Amniotic fluid also cushions the fetus and helps maintain a constant body temperature. Its volume changes constantly; too little fluid (oligohydramnios) is associated with renal abnormalities, and too much fluid (polyhydramnios) is associated with gastrointestinal and other abnormalities.
What would a breastfeeding mother who is concerned that her baby is not getting enough to eat find most helpful and most cost-effective on the day after discharge? A Visiting a pediatric screening clinic at the hospital B Placing a call to the hospital nursery warm line C Calling the pediatrician for a lactation consult referral Requesting a home visit
B
When providing health education to the client, the nurse understands that an example of the secondary level of prevention is: A. Approved infant car seats. B. Breast self-examination (BSE). C> Immunizations. D. Support groups for parents of children with Down syndrome.
B rational: Infant car seats and immunizations are examples of primary prevention. BSE is an example of secondary prevention, which includes health screening measures for early detection of health problems. Support groups are an example of tertiary prevention, which follows the occurrence of a defect or disability (e.g., Down syndrome
A patient has undergone an amniocentesis for evaluation of fetal well-being. Which intervention would be included in the nurse's plan of care after the procedure? (Select all that apply.) A.Perform ultrasound to determine fetal positioning. B. Observe the patient for possible uterine contractions. C. Administer RhoGAM to the patient if she is Rh negative. D. Perform a minicatheterization to obtain a urine specimen to assess for bleeding. Incorrect
B, C rational: Ultrasound is used prior to the procedure as a visualization aid to assist with insertion of transabdominal needle. There is no need to assess the urine for bleeding as this is not considered to be a typical presentation or complication.
A nurse is providing instruction for an obstetrical patient to perform a daily fetal movement count (DFMC). Which instructions could be included in the plan of care? (Select all that apply.) A. The fetal alarm signal is reached when there are no fetal movements noted for 5 hours. Incorrect B. The patient can monitor fetal activity once daily for a 60-minute period and note activity. Correct C. Monitor fetal activity two times a day either after meals or before bed for a period of 2 hours or until 10 fetal movements are noted. Correct D. Count all fetal movements in a 12-hour period daily until 10 fetal movements are noted. Correct
B, C, D rational: The fetal alarm signal is reached when no fetal movements are noted for a period of 12 hours.
In reviewing the history of a woman who wants to become pregnant, which medication profile would indicate a potential concern relative to toxic exposure? (Select all that apply.) A. Tylenol OTC occasionally for a headache; twice last week B. Anticonvulsant for seizure disorder Correct C. Lithium for bipolar disorder Correct D. Coumadin for atrial fibrillation Correct E. Multivitamins once a day
B, C, D patient being treated with an anticonvulsant or lithium is at risk for toxic effects during pregnancy. Warfarin (Coumadin) can put a patient at risk during pregnancy. Although acetaminophen (Tylenol) can have toxic effects on the liver, the reported frequency is not a concern at this time. Taking multivitamins is a healthy recommended option.
A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate? A. "Many women imagine what their baby is like." B. "A baby in utero does respond to the mother's voice." \ C. "You'll need to ask the doctor if the baby can hear yet." D. "Thinking that your baby hears will help you bond with the baby."
B. Fetuses respond to sound by 24 weeks. The fetus can be soothed by the sound of the mother's voice, and the nurse should instruct the mother so. Although statement A is accurate, it is not the most appropriate response. Statement D is not appropriate because it gives the mother impression that her baby cannot hear her and belittles her interpretation of her fetus's behaviors
What is an appropriate indicator for performing a contraction stress test? A. Increased fetal movement and small for gestational age B. Maternal diabetes mellitus and postmaturity C. Adolescent pregnancy and poor prenatal care D. History of preterm labor and intrauterine growth restriction
B. rational: Decreased fetal movement is an indicator for performing a contraction stress test; the size (small for gestational age) is not an indicator. Although adolescent pregnancy and poor prenatal care are risk factors for poor fetal outcomes, they are not indicators for performing a contraction stress test. Intrauterine growth restriction is an indicator; history of a previous stillbirth, not preterm labor, is another indicator.
Which personal safety precaution should guide the nurse working in home care? A Do not carry personal items, such as extra car keys or a cellular phone. B Avoid making a visit with another nurse. C Schedule visits during daylight hours. Correct D, Never wear a name tag.
C
When would the best timeframe be to establish gestational age based on ultrasound? A.At term B. 8 weeks C. Between 14 and 22 weeks D. 36 weeks
C rational: Ultrasound determination of gestational age dating is best done between 14 and 22 weeks. It is less reliable after that period because of variability in fetal size. Standard sets of measurements relative to gestational age are noted around 10 to after 12 weeks and include crown-rump length (after 10), biparietal diameter (after 12), femur length, and head and abdominal circumferences.
Which of the following actions, if demonstrated by a nursing student, could lead to dismissal from the health program? (Select all that apply.) A. A student nurse offers her phone number to a patient so that they can remain in touch. B. Nursing students go out for lunch following a clinical rotation to a local restaurant while still in uniform. C. A nursing student posts pictures of clinical site experiences on her Facebook page. D. Student nurses share their thoughts about their clinical site experiences on Twitter.
C, D rational: Although a nursing student can provide a phone number to a patient so that they remain in touch, the student should be aware of the limits of the relationship while in nursing school. Nursing students going out to lunch following a clinical experience while in uniform would not pose a problem as long as they maintained their professional demeanor and did not discuss clinical events. Posting of images related to clinical experiences on a Facebook page would make the student liable for violation of privacy. Sharing of thoughts related to clinical experiences on social media may result in dismissal from a health program if a student nurse provides information that results in violation of the HIPAA (Health Insurance Portability and Accountability Act) Privacy Rule.
In the past, factors to determine whether a woman was likely to have a high risk pregnancy were evaluated primarily from a medical point of view. A broader, more comprehensive approach to high risk pregnancy has been adopted. There are now four categories based on threats to the health of the woman and the outcome of pregnancy. Which of the options listed here is not included as a category? A. Biophysical B> Psychosocial C. Geographic D. Environmental
C, geographic rational The fourth category is correctly referred to as the sociodemographic risk category. The factors stem from the mother and her family. Ethnicity may be one of the risks to pregnancy; however, it is not the only factor in this category. Low income, lack of prenatal care, age, parity, and marital status are included. Biophysical is one of the broad categories used for determining risk. It includes genetic considerations, nutritional status, and medical and obstetric disorders. Psychosocial risks include smoking, caffeine, drugs, alcohol, and psychologic status. All of these adverse lifestyles can have a negative effect on the health of the mother or fetus. Environmental risks are those that can affect fertility and fetal development. They include infections, chemicals, radiation, pesticides, illicit drugs, and industrial pollutants.
A pregnant woman has been diagnosed with oligohydramnios. Which presentation would the nurse suspect to find on physical examination? A. Fetus is in a breech position B. FHR baseline is within normal range C. Fetus with possible renal problems D. Increased fundal height
C. Oligohydramnios reflects a decrease in the amount of amniotic fluid and is associated with renal abnormalities in the fetus and compromised fetal well-being. The position of the fetus is due to gestational age and the maternal uterine environment. FHR may be within normal range because it is affected by gestational age and fetal well-being. An increase in fundal height would be associated with polyhydramnios and/or gestational age assessment.
When caring for pregnant women, the nurse should keep in mind that violence during pregnancy: A. Affects more than 25% of pregnant women in the United States. Incorrect B. Increases a pregnant woman's risk for gestational hypertension. C.May be associated with substance abuse by both the pregnant woman and her partner. Correct D. Has decreased in incidence as a result of better assessment techniques and record-keeping.
C. rational Approximately 8% of pregnant women are battered; the incidence of battering increases during pregnancy. Violence itself has no correlation with the incidence of gestational hypertension. Alcoholism and substance abuse by the woman or her abuser are associated with violence. The rates of violence have actually increased, possibly because of better assessment and reporting mechanisms.
A nurse providing care for the antepartum woman should understand that the contraction stress test (CST): A.Sometimes uses vibroacoustic stimulation. B. Is an invasive test; however, contractions are stimulated. C. Is considered to have a negative result if no late decelerations are observed with the contractions. D. Is more effective than nonstress test (NST) if the membranes have already been ruptured.
C. rational: No late decelerations indicate a positive CST result. Vibroacoustic stimulation is sometimes used with NST. CST is invasive if stimulation is performed by IV oxytocin but not if by nipple stimulation. CST is contraindicated if the membranes have ruptured.
In which culture is the father more likely to be expected to participate in the labor and delivery? Asian-American African-American C. European-American Hispanic
C. European americans rational: Asian-American fathers do not actively participate in labor or birth. African-American men view pregnancy as a sign of virility; however, they may be less likely to participate actively in labor or birth. European-Americans expect the father to take a more active role in the labor and delivery than the other cultures. Hispanic men often view labor and birth as a female affair.
The nurse understands the importance of a walking survey because this tool: Determines how much exercise expectant mothers have been getting, to help inform client care decisions. Usually takes place on the maternity ward but can be expanded to other areas of the hospital. C. Is a method of observing the resources and health-related environment of the community. Is performed by government census takers as part of their canvas.
C. Is a method of observing the resources and health-related environment of the community
A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? "We don't really know when such defects occur." "It depends on what caused the defect." C. "They occur between the third and fifth weeks of development." "They usually occur in the first 2 weeks of development."
C. They occur between the third and fifth weeks of development." The nurse would be aware of when such defects occur. Regardless of the cause, the heart is vulnerable during its period of development, the third to fifth weeks. The cardiovascular system is the first organ system to function in the developing human. Blood vessel and blood formation begins in the third week, and the heart is developmentally complete in the fifth week.
A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates that: A. The fetus is at risk for Down syndrome. B. The woman is at high risk for developing preterm labor. C. The lungs are mature. D. Meconium is present in the amniotic fluid.
C. lungs are mature The detection of the presence of pulmonary surfactants, surface-active phospholipids, in amniotic fluid has been used to determine fetal lung maturity, or the ability of the lungs to function after birth. This occurs at approximately 35 weeks of gestation. This result is unrelated to Down syndrome and in no way indicates risk for preterm labor. Meconium should not be present in the amniotic fluid.
A pregnant client asks the nurse whether she can take castor oil for her constipation. How should the nurse respond?
Castor oil can initiate premature uterine contractions and other adverse effects in pregnant women. Castor oil doesn't promote sodium retention and isn't known to increase absorption of fat-soluble vitamins.
When a nurse is unsure about how to perform a client care procedure, the best action would be to: A.Ask another nurse. B. Discuss the procedure with the client's physician. C. Look up the procedure in a nursing textbook. D. Consult the agency procedure manual and follow the guidelines for the procedure.
D
A 23-year-old African-American woman is pregnant with her first child. On the basis of the statistics for infant mortality, which plan is most important for the nurse to implement? A.Perform a nutrition assessment. Incorrect B. Refer the woman to a social worker. C Advise the woman to see an obstetrician, not a midwife. D. Explain to the woman the importance of keeping her prenatal care appointments.
D rational: Nutritional status is an important modifiable risk factor, but it is not the most important action a nurse should take in this situation. The client may need assistance from a social worker at some time during her pregnancy, but this also is not the most important aspect the nurse should address at this time. If the woman has identifiable high-risk problems, her health care may need to be provided by a physician. However, it cannot be assumed that all African-American women have high-risk issues. Additionally, this is not the most important aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to advise or manage the type of care a client is to receive. Consistent prenatal care is the best method of preventing or controlling risk factors associated with infant mortality.
Which developmental finding is accurate with regard to fetal growth? A. Heart starts beating at 12 weeks. .B. Lungs take shape by 8 weeks. C. Brain configuration is complete by 8 weeks. D. Main blood vessels form by 8 weeks.
D. The heart starts beating by 4 weeks, the lungs take shape by 12 weeks, and brain configuration is complete by 12 weeks.
Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that: A. Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis. B. Screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for neural tube defects. C. Percutaneous umbilical blood sampling (PUBS) is one of the quad-screen tests for Down syndrome. d. MSAFP is a screening tool only; it identifies candidates for more definitive procedures.
D. rational: CVS does provide a rapid result, but it is declining in popularity because of advances in noninvasive screening techniques. MSAFP screening is recommended for all pregnant women. MSAFP, not PUBS, is part of the quad-screen tests for Down syndrome. MSAFP is a screening tool, not a diagnostic tool. Further diagnostic testing is indicated after an abnormal result.
A woman who is at 36 weeks of gestation is having a nonstress test. Which statement indicates her correct understanding of the test? A. "I will need to have a full bladder for the test to be done accurately." B. "I should have my husband drive me home after the test because I may be nauseated." C. "This test will help to determine whether the baby has Down syndrome or a neural tube defect." D. "This test observes for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby." Correct
D. rational: The nonstress test is one of the most widely used techniques to determine fetal well-being and is accomplished by monitoring fetal heart rate in conjunction with fetal activity and movements. An ultrasound requires a full bladder. An amniocentesis is the test after which a pregnant woman should be driven home. A maternal serum alpha-fetoprotein test is used in conjunction with unconjugated estriol levels and human chorionic gonadotropin helps to detect Down syndrome.
A Native-American woman gave birth to a baby girl 12 hours ago. The nurse notes that the woman keeps her baby in the bassinet except for bottle feeding and states that she will wait until she gets home to begin breastfeeding. The nurse recognizes that this behavior is most likely a reflection of: A. Delayed attachment. B. Embarrassment. C. Disappointment in the sex of the baby. D. A belief that babies should not be fed colostrum.
D. A belief that babies should not be fed colostrum. rational: Delayed attachment is a developmental concern, not a cultural belief. Embarrassment is likely not the cause for a delay in the initiation of breastfeeding and should be explored further by the nurse. The mother may voice her disappointment that the infant is a girl; however, this would rarely cause her to delay breastfeeding and would manifest itself in other ways. Native Americans commonly use cradleboards and avoid handling their newborns often. They also believe that infants should not be fed colostrum.
A 40-year-old woman with a high body mass index (BMI) is 10 weeks pregnant. Which diagnostic tool is appropriate to suggest to her at this time? A. Biophysical profile B. Amniocentesis C.Maternal serum alpha-fetoprotein (MSAFP) D. Transvaginal ultrasound
D. transvaginal ultrasound rational: An ultrasound is the method of biophysical assessment of the infant that is performed at this gestational age. Transvaginal ultrasound is especially useful for obese women, whose thick abdominal layers cannot be penetrated adequately with the abdominal approach. A biophysical profile is a method of biophysical assessment of fetal well-being in the third trimester. An amniocentesis is performed after the fourteenth week of pregnancy. A MSAFP test is performed from week 15 to week 22 of the gestation (weeks 16 to 18 are ideal).
when is an amniocentesis performed?
after the 14th week of pregnancy
A 40-year-old primigravid client with AB-positive blood visits the outpatient clinic for an amniocentesis at 16 weeks' gestation. The nurse determines that the most likely reason for the client's amniocentesis is to determine if the fetus has which problem?
down syndrome *
when is a transvaginal ultrasound useful?
for obese woman whose thick abdominal layers cannot be penetrated with the abdominal approach.
when is a MSAFP test performed?
from week 15 to 22.
A physiologic benefit of fever in a child is that it
increases interferon production Physiological benefits of fever include an increase in interferon, antibody production and white blood cells in addition to other chemical mediators. Fever can be present in either viral or bacterial infections. Fever does directly correlate with prognosis of a medical event.
A neonate had corrective surgery 3 days ago for esophageal atresia. The nurse notices that after gastrostomy feedings, there is often a backup of feeding into the tube. The most appropriate intervention by the nurse is to
leave the gastrostomy tube open and suspended after feedings The formula is backing up into the tube because of delayed emptying. By keeping the tube open to air, it will prevent the buildup of pressure on the operative site and the subsequent backup of feeding into the tube. The child should be positioned on the right side with the head elevated approximately 30 degrees after feeding. The child should be positioned on the right side with the head elevated approximately 30 degrees after feeding. Leaving the gastrostomy tube clamped after feedings will create pressure on the operative site and increase the risk of backup of the feedings.
A nurse is preparing to administer a gavage feeding to an infant. Which type of restraining method would be indicated?
mummy restraint For a gavage feeding, best practice would be to use a mummy restraint which would accomplish short term restriction of movement due to a procedure. Jacket restraint would be used for older children. Arm restraints would not account for the mobility of the infant's legs which could affect the procedure. A car seat restraint is used for transport.
The health care provider (HCP) prescribes a maternal blood test for alpha fetoprotein for a nulligravid client at 16 weeks' gestation. When developing the teaching plan, the nurse bases the explanations on the understanding that this test is used to detect which condition?
neural tube defects
what is the therapeutic level of magnesium for clients with preeclampsia
ranges 4 to 8 mEq/L (2 to 4 mmol/L).
A blood test for alpha fetoprotein is
recommended at 15 to 20 weeks' gestation to screen for certain chromosomal abnormalities and neural tube defects such as spina bifida
A child, age 7 years, is being treated at home and has a fever associated with a viral illness. The principal reason for treating the child's fever is
relief of discomfort
The nurse needs to start an intravenous (IV) line for an 8-year-old child to begin administering IV antibiotics. The child starts to cry and tells the nurse, "Do it later, OK?" The most appropriate action by the nurse is to
start the IV because unlimited procrastination results in heightened anxiety
when is a biophysical profile done?
third trimester
why is chorionic villi sampling done?
to detect chromosomal anomalies.
