The nurse is teaching parents of a newborn about feeding their infant. Which instruction should the nurse include?

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Question 1 of 9

The nurse is teaching parents of a newborn about feeding their infant. Which instruction should the nurse include?

Correct Answer: A

Rationale: Rationale for Correct Answer A: 1. Using the defrost setting on microwave ovens to warm bottles is safe because it ensures even heating without creating hot spots that could burn the baby's mouth. 2. This method helps to preserve the nutrients in the breast milk or formula. 3. It is important to warm the bottle to body temperature to mimic the natural feel of breast milk for the baby's comfort. Summary of Incorrect Choices: B: Feeding the baby partially used bottles after 24 hours can increase the risk of bacterial contamination and foodborne illness. C: Mixing two parts water and one part concentrate for formula concentrate is incorrect as it may dilute the formula, leading to inadequate nutrition for the baby. D: Adding new formula to partially used bottles can alter the balance of nutrients and increase the risk of contamination, affecting the baby's health.

Question 2 of 9

What instructions should the nurse give to a client who will undergo mammography?

Correct Answer: B

Rationale: The correct answer is B: Do not use underarm deodorant. This instruction is important because deodorant can interfere with the imaging results by causing artifacts on the mammogram images. Using deodorant can lead to false positives or false negatives, affecting the accuracy of the test results. Choice A is incorrect because using underarm deodorant can negatively impact the mammogram results. Choice C is incorrect as there is no need for the client to fast before a mammogram. Choice D is also incorrect as having a friend drive you home is not a necessary instruction for a mammography appointment.

Question 3 of 9

An 85-year-old female patient is complaining about the fact that the bones in her face have become more noticeable. What explanation should the nurse provide?

Correct Answer: C

Rationale: The correct answer is C because as individuals age, there is a natural decrease in skin elasticity, subcutaneous fat, and moisture content in the skin. These factors contribute to the bones becoming more noticeable in the face. Choice A is incorrect because diets low in protein and high in carbohydrates do not directly cause enlargement of facial bones. Choice B is incorrect as the use of a specific moisturizer does not directly impact the visibility of facial bones. Choice D is incorrect because facial skin actually loses elasticity with age, leading to less taut skin and more prominent bones.

Question 4 of 9

A pregnant woman states that she is concerned about her gums because she has noticed they are swollen and have started bleeding. What would be an appropriate response by the nurse?

Correct Answer: C

Rationale: Step 1: Swollen and bleeding gums during pregnancy can be a sign of gingivitis or pregnancy gingivitis. Step 2: Dental check-ups during pregnancy are important to prevent potential complications. Step 3: Referring the woman to a dentist ensures proper evaluation and treatment. Step 4: Dental care is safe during pregnancy, so timely intervention is crucial. Step 5: Option C is correct as it addresses the concern with a proactive approach.

Question 5 of 9

A 28-year-old Aboriginal woman attending a prenatal visit describes her nutritional intake over the past 24 hours to the nurse. It includes two slices of pizza, two cans of soda, and three cookies. The nurse must:

Correct Answer: D

Rationale: The correct answer is D: discuss how the patient's food choices may affect her health and that of her baby. This is the most appropriate response because it addresses the potential impact of the patient's current diet on her health and the health of her baby during pregnancy. By discussing the implications of her food choices, the nurse can educate the patient on the importance of a balanced and nutritious diet for a healthy pregnancy. This approach promotes awareness and empowers the patient to make informed decisions for her and her baby's well-being. Incorrect choices: A: This option does not provide guidance or education on improving the patient's diet, which is crucial for a healthy pregnancy. B: Focusing on weight gain rather than nutritional content may not address the underlying issue of poor dietary choices. C: Assuming the patient's ability to cook or go grocery shopping may not address the immediate need for dietary education and guidance.

Question 6 of 9

The nurse is assessing the hearing of a 7-month-old. What would be the expected response to clapping of hands?

Correct Answer: A

Rationale: The correct answer is A because at 7 months, infants typically have developed the ability to localize sounds. When clapping hands, the expected response is for the infant to turn their head towards the sound source, indicating their ability to detect and localize the sound. This behavior reflects the normal auditory development at this age. Choice B is incorrect because by 7 months, infants should show some response to noise, such as turning their head or showing some interest. Choice C is incorrect as the startle and acoustic blink reflex typically occur in response to sudden loud noises, but at 7 months, the infant should also be able to localize the source of the sound. Choice D is incorrect as stopping all movement and appearing to listen is not a typical response expected from a 7-month-old when hearing a sound. Infants at this age are more likely to actively turn towards the sound source to investigate.

Question 7 of 9

Which assessment finding indicates a positive response to Heparin therapy?

Correct Answer: B

Rationale: The correct answer is B: increased fibrinogen. Heparin therapy works by inhibiting clot formation by enhancing the activity of antithrombin III, which leads to decreased levels of fibrinogen. Therefore, an increase in fibrinogen levels would indicate a positive response to Heparin therapy. Incorrect choices: A: increased platelet count - Heparin therapy does not typically affect platelet count, so an increase in platelet count would not indicate a positive response to Heparin therapy. C: decreased fibrin split products - Decreased fibrin split products may not necessarily indicate a positive response to Heparin therapy, as other factors can also influence their levels. D: decreased bleeding - While decreased bleeding can be a positive outcome of Heparin therapy, it is not a direct assessment finding that indicates a positive response to the therapy.

Question 8 of 9

A nurse is caring for a patient who is post-operative following abdominal surgery. The nurse should monitor for which of the following complications?

Correct Answer: D

Rationale: The correct answer is D: Atelectasis and pneumonia. Following abdominal surgery, patients are at risk for atelectasis (lung collapse) due to shallow breathing and pneumonia due to impaired lung function. A nurse should monitor for signs such as decreased oxygen saturation, increased respiratory rate, and crackles on auscultation. Wound infection (A) is a common post-operative complication but not specific to abdominal surgery. Hyperglycemia (B) may occur due to stress response but is not directly related to abdominal surgery. Dehydration (C) is a concern post-operatively, but respiratory complications like atelectasis and pneumonia are higher priority due to potential life-threatening consequences.

Question 9 of 9

A 31-year-old patient tells the nurse that he is experiencing a progressive loss of hearing. He says that it does seem to help when people speak more loudly or if he turns up the volume. The most likely cause of his hearing loss is:

Correct Answer: A

Rationale: The correct answer is A: otosclerosis. Otosclerosis is a condition where abnormal bone growth in the middle ear causes hearing loss. In this case, the patient's symptoms of progressive hearing loss improving with louder sounds suggest conductive hearing loss, which is commonly seen in otosclerosis. Other choices are incorrect because presbycusis is age-related hearing loss, trauma to the bones would typically result in sudden hearing loss, and frequent ear infections are more likely to cause temporary hearing loss rather than progressive loss.

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