When teaching a new mother how to use a bulb syringe to suction her newborn's secretions, which of the following instructions should the nurse include?

Correct Answer: D

Rationale: The correct answer is D because it is important to stop suctioning when the newborn's cry sounds clear to avoid causing unnecessary discomfort or injury. Step 1: Gently compress the bulb syringe. Step 2: Insert the tip into the nostril, not the mouth. Step 3: Release the bulb to suction out the secretions. Step 4: Repeat in the other nostril. Incorrect choices: A is incorrect because you should insert the syringe tip before compressing the bulb. B is incorrect as you should suction the mouth before the nose. C is incorrect as you should not insert the syringe tip in the center of the mouth.

Correct Answer: B

Rationale: The correct answer is B. The blotchy hyperpigmentation on the client's forehead is likely melasma, a common occurrence during pregnancy. This is due to hormonal changes causing increased melanin production. The nurse should educate the client that this is an expected occurrence during pregnancy and reassure her that it is usually temporary and will fade postpartum. Choice A (Tell the client to follow up with a dermatologist) is incorrect because dermatological consultation is not typically necessary for melasma during pregnancy. Choice C (Instruct the client to increase her intake of vitamin D) is incorrect because vitamin D deficiency is not typically associated with blotchy hyperpigmentation on the forehead during pregnancy. Choice D (Inform the client she might have an allergy to her skin care products) is incorrect because melasma is not caused by allergies to skincare products.

Correct Answer: A

Rationale: The estimated date of delivery (EDD) is calculated by adding 280 days to the first day of the last menstrual period (LMP). In this case, April 1st + 280 days = January 8, which is the correct EDD. Choice A is correct. Choices B, C, and D are incorrect because they do not account for the 280-day gestation period from the LMP.

Correct Answer: B

Rationale: The correct answer is B: Urine ketones present. Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy, leading to dehydration and ketonuria. Presence of urine ketones indicates fat breakdown due to inadequate calorie intake. Option A is within normal range for hemoglobin. Option C is within normal range for alanine aminotransferase. Option D is within normal range for blood glucose. Thus, the presence of urine ketones is the most indicative finding for hyperemesis gravidarum.

Correct Answer: C

Rationale: The correct answer is C: Attention-focusing. At 40 weeks gestation with a platelet count of 75,000/mm3, epidural analgesia is contraindicated due to the risk of epidural hematoma. Naloxone hydrochloride is an opioid antagonist used for opioid overdose, not for labor pain relief. Pudendal nerve block is used for local anesthesia during the second stage of labor, not for early labor pain relief. Attention-focusing techniques can help the client manage pain without pharmacological interventions, ensuring safety for both the client and the baby.

Correct Answer: A

Rationale: The correct answer is A: Eat crackers or plain toast before getting out of bed. This recommendation helps alleviate morning sickness by providing a small, easily digestible snack to settle the stomach before getting up. It helps stabilize blood sugar levels and prevent an empty stomach exacerbating nausea. Explanation for why B, C, and D are incorrect: B: Awakening during the night to eat a snack can disrupt sleep patterns and is not necessary for managing morning sickness. C: Skipping breakfast and waiting until lunch may lead to prolonged nausea and low blood sugar levels, worsening symptoms. D: Eating a large evening meal can increase the likelihood of acid reflux and indigestion, making morning sickness worse.

Correct Answer: C

Rationale: To calculate the mL/hr for the IV infusion pump, we need to use the formula: (Desired dose in mg/hr * Volume of solution in mL) / Concentration of solution in mg/mL. Given: Desired dose = 2 g/hr = 2000 mg/hr Volume of solution = 500 mL Concentration of solution = 20 g in 500 mL = 20,000 mg in 500 mL = 40 mg/mL Now, plug these values into the formula: (2000 mg/hr * 500 mL) / 40 mg/mL = 25,000 mL/hr Round this to the nearest whole number, which is 25,000 mL/hr ≈ 50 mL/hr. Therefore, the IV infusion pump should be set to administer 50 mL/hr, making choice C the correct answer. Option A (60 mL/hr) and Option D (80 mL/hr) are incorrect as they do not match the calculated value. Option

Correct Answer: B

Rationale: The correct answer is B: Lecithin/sphingomyelin (L/S) ratio. This test is used to assess fetal lung maturity by determining the ratio of two substances present in amniotic fluid. An L/S ratio of 2:1 or higher indicates mature fetal lungs, reducing the risk of respiratory distress syndrome in preterm infants. A: Alpha-fetoprotein (AFP) is used to screen for neural tube defects, not fetal lung maturity. C: Kleihauer-Betke test is used to detect fetal-maternal hemorrhage. D: Indirect Coombs' test is used to detect antibodies in maternal blood that may attack fetal red blood cells, not assess fetal lung maturity. In summary, the L/S ratio test is the most appropriate choice to assess fetal lung maturity during preterm labor, as it directly correlates with the development of the fetal lungs.

Correct Answer: C

Rationale: The correct answer is C: Perform the pelvic rock exercise every day. This exercise helps strengthen the core muscles, which can alleviate backache during pregnancy. It also promotes flexibility in the lower back and pelvis. Avoiding any lifting (A) is not a practical measure as some lifting may be necessary in daily activities. Performing Kegel exercises (B) strengthens pelvic floor muscles but does not directly address backache. Avoiding standing for prolonged periods (D) can help reduce backache but is not as effective as specific exercises targeting the back muscles like the pelvic rock exercise.