A nurse is caring for a client who just delivered a newborn. Following the delivery, which nursing action should be done first to care for the newborn?

Dry the infant off and cover the head.

Stimulate the infant to cry.

Clear the respiratory tract.

Cut the umbilical cord.

None

Answer and Explanation

The Correct Answer is C

This action is important as it helps to prevent hypothermia, which newborns are particularly susceptible to. However, while drying the infant is essential, it should not be the very first action taken immediately after birth.

Stimulating the infant to cry can help establish normal respiratory function and is important for transitioning to extrauterine life. However, it may not be the first action if the infant is not breathing or appears to need immediate airway clearance.

This is a critical first step, especially if the newborn is not breathing adequately. Clearing the airway (using suction if necessary) is vital to ensure that the infant can breathe properly and transition well after birth. If there are any signs of airway obstruction or if the infant is not crying, this action takes precedence.

While cutting the umbilical cord is a standard procedure, it is typically performed after ensuring the infant is stable. Current guidelines suggest delaying cord clamping for a short period unless there are complications that require immediate action.

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Correct Answer is B

Explanation

53. A nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks of gestation. An ectopic pregnancy occurs when the fertilized egg implants outside the uterus, most commonly in the fallopian tube. One of the hallmark symptoms of an ectopic pregnancy is unilateral, cramp-like abdominal pain depending on the location of the pregnancy.
A. Uterine enlargement greater than expected for gestational age is not expected in an ectopic pregnancy because the fertilized egg implants outside the uterus, so there is no uterine enlargement.
C. Severe nausea and vomiting are more commonly associated with conditions such as hyperemesis gravidarum or early pregnancy symptoms but are not specific to ectopic pregnancy.
D. A large amount of vaginal bleeding may occur in some cases of ectopic pregnancy, but it is not a consistent or defining characteristic.

A. "Preterm newborns have a smaller body surface area than normal newborns." B. "Preterm newborns lack adequate temperature control mechanisms." C. "The heat in the incubator rapidly dries the sweat of preterm newborns." D. "The added brown fat layer in a preterm newborn reduces his ability to generate heat.

Correct Answer is B

Explanation

Preterm newborns have immature physiological mechanisms to regulate their body temperature effectively which include subcutaneous fat deposition, fully developed sweat glands, and the ability to shiver. They also have a large surface area increasing heat loss. As a result, preterm

infants are at a higher risk of hypothermia. Incubator care assist in the control of body temperature in the premature neonates.

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A nurse is caring for a client who just delivered a newborn. Following the delivery, which nursing action should be done first to care for the newborn?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks of gestation. Which of the following manifestations should the nurse expect to identify as consistent with the diagnosis?

Correct Answer is B

Explanation

A nurse is caring for a preterm newborn who is in an incubator to maintain a neutral thermal environment. The father of the newborn asks the nurse why this is necessary. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

A nurse is assessing a client who is receiving magnesium sulfate to treat pre-eclampsia. Which of the following findings should the nurse report to the provider?

A nurse in a prenatal clinic is caring for a client who is suspected of having a hydatidiform mole. Which of the following findings should the nurse expect to observe in this client?

A nurse is preparing to assess a newborn who is postmature. Which of the following findings should the nurse expect? (Select all that apply.)

A nurse is preparing to administer magnesium sulfate IV to a client who is experiencing preterm labor. Which of the following is the priority nursing assessment for this client?

A nurse is assessing a client who is in active labor and notes that the presenting part is at 0 station. Which of the following is the correct interpretation of this clinical finding?

A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not." Which of the following should the nurse recognize as a sign of true labor?