A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?

Monitor the rectal temperature every 4 hr.

Administer broad-spectrum antibiotics.

Cleanse the site with povidone-iodine.

Prepare for surgical closure after 72hr.

Answer and Explanation

The Correct Answer is C

The priority action in this scenario is to prevent infection. Cleansing the site with povidone-iodine can help reduce the risk of infection. Rectal temperature monitoring and administration of antibiotics may be necessary if infection is suspected, but preventing infection is the priority. Surgical closure may be necessary, but this is not an immediate concern.

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Correct Answer is D

Explanation

Broccoli is an excellent source of calcium, with one cup of cooked broccoli providing approximately 62 milligrams of calcium. In comparison, one medium potato provides only around 10 milligrams of calcium, 1/2 cup cubed avocado provides around 11 milligrams of calcium, and one large banana provides only around 6 milligrams of calcium.

Therefore, the nurse should encourage the client to consume foods that are rich in calcium such as leafy greens, tofu, fortified plant-based milk, fortified plant-based yogurt, and other fortified foods. Additionally, the nurse may recommend the client to take calcium supplements as needed to ensure adequate calcium intake during pregnancy.

A. Administer 70% nitrous oxide mixed with oxygen. B. Ambulate the client in the hallway. C. Apply counterpressure to the sacral area. D. Have the client sit in a tub of warm water. E. Perform Leopold maneuvers

Correct Answer is ["A","C","D"]

Explanation

Administering 70% nitrous oxide mixed with oxygen is a common pain management option for laboring clients.

Applying counterpressure to the sacral area can help alleviate back pain during labor. Sitting in a tub of warm water, also known as hydrotherapy, can help reduce pain and promote relaxation during labor.

Ambulating the client may not be feasible or safe during the latent phase of labor when contractions are less frequent and intense.

Performing Leopold maneuvers, which involve palpating the mother's abdomen to determine the position of the fetus, does not directly address pain management.

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A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?

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Naxlex Comprehensive Predictor Exams

A nurse is providing nutritional guidance to a client who is pregnant and follows a vegan diet. The client asks the nurse which foods she should eat to ensure adequate calcium intake. The nurse should instruct the client that which of the following foods has the highest amount of calcium?

Correct Answer is D

Explanation

A nurse is caring for a client who is in the latent phase of the first stage of labor and is in pain. Which of the following nursing interventions are appropriate to reduce pain? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

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