A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. The nurse locates the fetal heart tones above the client's umbilicus at midline. The nurse should suspect that the fetus is in which of the following positions?

Correct Answer: A

Rationale: When the nurse locates the fetal heart tones above the client's umbilicus at midline, it indicates that the fetus is in a cephalic position. In this position, the baby's head is facing downward towards the birth canal, which is the optimal position for a vaginal delivery. This positioning is considered normal and favorable for childbirth.

Correct Answer: A

Rationale: Positioning the infant to grasp the nipple to express milk is an essential step in helping the patient begin breastfeeding successfully. As a nurse, it is crucial to ensure that the infant is properly latched onto the breast to facilitate effective feeding and milk transfer. This involves positioning the infant in a way that allows them to effectively grasp the nipple, promoting proper suckling and milk production. By assisting the patient in positioning the infant correctly, the nurse is supporting the establishment of successful breastfeeding and ensuring optimal nutrition for the baby.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Proteinuria of +2 on a urine dipstick, which is most concerning at 32 weeks gestation. Proteinuria can indicate a potential problem with the kidneys, specifically preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. Preeclampsia can lead to complications for both the mother and the baby if not managed promptly. Option A, a blood pressure of 120/80 mmHg, falls within the normal range during pregnancy and is not typically a cause for concern. Option B, mild lower back pain, is common in pregnancy and may not signal a serious issue unless accompanied by other symptoms. Option C, a weight gain of 2 pounds in one week, can be normal in pregnancy as long as it is within recommended guidelines. Educationally, it is crucial for healthcare providers to recognize the significance of proteinuria in prenatal care as it can indicate a potentially life-threatening condition like preeclampsia. Regular monitoring of blood pressure, urine dipstick tests, and other prenatal assessments is essential to detect and manage complications early, ensuring the best possible outcomes for both the mother and the baby.

Correct Answer: B

Rationale: In educating parents about safe sleeping practices for newborns, the nurse must emphasize the importance of placing the baby on a firm mattress and avoiding loose bedding, as option B states. This recommendation aligns with the guidelines from the American Academy of Pediatrics (AAP) to reduce the risk of Sudden Infant Death Syndrome (SIDS) and suffocation. A firm mattress provides a stable sleeping surface, reducing the risk of the baby's face becoming covered by soft bedding. Loose bedding, such as blankets, pillows, and stuffed animals, can pose suffocation hazards. Options A, C, and D are incorrect and potentially dangerous practices. Placing the newborn in the prone (on the stomach) position (Option A) increases the risk of SIDS. Co-sleeping with the baby on a soft mattress (Option C) raises the risk of accidental suffocation or overlaying by the adult. Encouraging side-lying sleeping position (Option D) may also pose a risk of accidental rolling onto the stomach, increasing the risk of SIDS. Educationally, it is crucial for nurses to provide evidence-based information on safe sleep practices to prevent adverse outcomes in newborns. By explaining the rationale behind the correct choice and the potential dangers of the incorrect options, nurses can empower parents to create a safe sleep environment for their newborns, promoting infant safety and well-being.

Correct Answer: B

Rationale: In the context of newborn hearing screening, the correct response for a nurse when a mother asks about it is option B) Reassure the mother that this is a routine test. This response is appropriate because newborn hearing screening is a standard procedure recommended for all infants shortly after birth. By reassuring the mother that this is routine, the nurse can alleviate any concerns or anxieties the mother may have regarding the test. Option A) Explain that hearing screening is optional is incorrect because newborn hearing screening is considered a crucial part of early identification of hearing loss and is recommended for all infants. Option C) Inform the mother that hearing screening is mandatory is not entirely accurate as parents usually have the right to decide whether to proceed with the screening, although it is highly recommended. Option D) Provide resources for further testing if needed is not the most suitable response initially as the focus should be on reassuring the mother about the routine nature of the screening test before discussing further steps if any issues are identified. In an educational context, it is essential for nurses to understand the significance of newborn hearing screening and be able to effectively communicate with parents about the procedure to ensure timely identification and intervention in case of hearing loss, emphasizing the importance of early detection in promoting optimal developmental outcomes for the newborn.