During the assessment of a newborn, it is most important for the nurse to report a:

Correct Answer: D

Rationale: In the assessment of a newborn, the most important finding to report is a breathing pattern that is diaphragmatic with sternal retractions (Option D). This indicates respiratory distress, which can be a critical issue in a newborn and requires immediate attention to ensure adequate oxygenation. Diaphragmatic breathing and sternal retractions suggest increased work of breathing and potential respiratory compromise, making it crucial to notify the healthcare team promptly. Option A, a temperature of 97.7 degrees Fahrenheit, falls within the normal range for a newborn and may not require immediate reporting. Option B, a pale pink, rust-colored stain in the diaper, could indicate urate crystals or mild dehydration, which are common in newborns and usually resolve without intervention. Option C, a heart rate dropping to 120 beats/min, while slightly lower than the normal range for a newborn, may not be as concerning as respiratory distress. In an educational context, understanding the significance of different assessment findings in newborns is crucial for nurses working in maternal and newborn care. Recognizing signs of respiratory distress and knowing when to escalate care is essential to ensure the well-being of the newborn. This question highlights the importance of thorough assessment skills and prompt reporting of critical findings in neonatal care.

Correct Answer: D

Rationale: In this scenario, the correct action for the nurse to take regarding a 9-year-old girl diagnosed with gonorrhea is option D: Report the girl's medical findings to child protective services. This is the appropriate course of action because gonorrhea in a prepubescent child raises concerns about possible sexual abuse, which must be reported to the appropriate authorities to ensure the child's safety and well-being. Option A is incorrect because hospital admission may not be necessary if the child's safety can be ensured in a different setting. Option B is also incorrect as discussing the need to stop future sexual encounters with a 9-year-old is not developmentally appropriate or effective in this context. Option C is irrelevant to the immediate concern of suspected child abuse. From an educational perspective, this question highlights the importance of recognizing signs of potential abuse in pediatric patients and the legal and ethical responsibilities healthcare providers have in reporting such cases to protect vulnerable children. It underscores the critical role nurses play in advocating for the health and safety of their patients, especially in cases of suspected abuse or neglect.

Correct Answer: C

Rationale: In maternal and newborn nursing, it is crucial for the nurse to consider various factors before administering medications to postpartum clients. In the case of Depo-Provera, the correct answer is C) The medicine is contraindicated if the woman has lung or esophageal cancer. This is because medroxyprogesterone acetate can potentially worsen the condition or interfere with the treatment of these cancers. Option A is incorrect because Depo-Provera is not a capsule that needs to be taken daily at the same time. Option B is irrelevant as using sunscreen is not a specific consideration for administering Depo-Provera. Option D is incorrect because it is actually recommended for clients to use an alternate form of birth control for the first two months after starting Depo-Provera to ensure effectiveness, not as a contraindication. Educationally, understanding medication contraindications is critical in providing safe and effective care to postpartum clients. Nurses need to have a comprehensive knowledge of medications, their indications, contraindications, and potential interactions to make informed decisions and prevent harm to patients. This case emphasizes the importance of thorough assessment and consideration of individual client factors before administering medications.

Correct Answer: D

Rationale: In teaching about treatment for pubic lice, it is crucial to emphasize the correct practices to ensure effective management. The correct answer, option D, stating that the pubic hair should be combed after shampoo is removed, is essential because combing helps to remove any remaining lice and nits, aiding in the eradication of the infestation. This step is integral in preventing reinfestation and ensuring treatment success. Option A, stating that antibiotics should be taken for a full 10 days, is incorrect because pubic lice are not treated with antibiotics; they are typically managed with topical medications like lice-killing shampoos or lotions. Option B, suggesting that all clothing should be pretreated with bleach before wearing, is inaccurate and potentially harmful. Bleach is not recommended for treating pubic lice infestations on clothing. It can be damaging to the skin and clothing fibers. Option C, indicating that shampoo should be applied for at least 2 hours before rinsing, is also incorrect. While timing for specific treatments may vary, prolonged application of lice-killing shampoo beyond the recommended duration can lead to skin irritation without providing additional benefits. In the educational context, it is important to highlight evidence-based practices for treating pubic lice, emphasizing the correct steps such as using recommended medications, following application instructions, and combing to remove lice and nits. By understanding and applying these principles, healthcare professionals and patients can effectively manage and prevent the spread of pubic lice infestations.

Correct Answer: A

Rationale: In maternal and newborn nursing, interpreting study results comparing the incidence of sexually transmitted diseases between populations is crucial for evidence-based practice. The correct answer, A, is that because the confidence interval (CI) of the relative risk (RR) includes the value of 1, the difference between the groups is meaningless. This indicates that there is no statistically significant difference in the incidence of sexually transmitted diseases between the two populations. Option B is incorrect because a 95% confidence interval does not automatically imply statistical significance. It is the range of values within which the true relative risk is likely to fall, not a definitive statement of significance. Option C is incorrect because a relative risk of 0.80 does not indicate power; it reflects the magnitude of the association between the exposure and outcome, with values less than 1 indicating a decreased risk. Option D is incorrect because the absence of a reported p-value for the CI does not mean that conclusions cannot be drawn. The CI itself provides information about the precision of the estimate and whether the results are statistically significant or not. Understanding how to interpret confidence intervals and relative risks is essential for nurses to make informed decisions in maternal and newborn care based on the best available evidence. It helps them assess the significance of research findings and apply them to clinical practice for better outcomes.