A postpartum nurse is conducting a newborn screening for a 36-hour old baby.
The parents inquire about the purpose of this test since the baby is not showing any signs of illness.
What would be the nurse’s best response?
“This is a blood test to determine blood type.”
“This is a diagnostic test that will confirm whether your baby has one of these diseases.”
“This is a routine test to detect who may be at risk for developing one of these diseases.”
“Since you are a carrier for a disease, we will find out if it has been passed down.”
The Correct Answer is C
Choice A rationale:
This response is incorrect because newborn screening tests do not determine blood type. Blood type is typically determined through a separate blood test, such as an ABO and Rh typing test.
While knowing a baby's blood type is important for medical reasons, it's not the primary purpose of newborn screening.
Focusing solely on blood type could mislead parents about the broader scope of conditions that newborn screening aims to identify.
Choice B rationale:
This response is incorrect because newborn screening tests are not diagnostic tests. They are screening tests, which means they identify babies who may be at risk for certain diseases, but they do not confirm whether or not a baby actually has a disease.
Diagnostic tests are typically more specific and are performed after a screening test has indicated a potential problem.
It's crucial to clarify the distinction between screening and diagnosis to avoid causing undue alarm or confusion for parents.
Choice C rationale:
This is the correct response. It accurately explains that newborn screening tests are routine procedures that are performed to detect babies who may be at risk for developing certain diseases.
The emphasis on "risk" is important because it highlights that a positive screening result does not necessarily mean that a baby has a disease, but rather that further testing is needed to confirm the diagnosis.
This response also avoids making assumptions about the parents' carrier status, which is a sensitive topic that should be addressed with care and discretion.
Choice D rationale:
This response is incorrect because it assumes that the parents are carriers for a disease, which may not be the case.
Even if the parents are carriers, newborn screening tests are not designed to specifically determine whether a disease has been passed down from parent to child.
Making such assumptions could create unnecessary anxiety or confusion for parents, and it's important to provide information that is accurate and relevant to their specific situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale for Choice A:
Encouraging the woman to rest between contractions can promote relaxation and help conserve energy, but it does not directly address the mechanisms of pain transmission as explained by the gate-control theory. Rest can have indirect benefits for pain management, but it does not directly interfere with pain signals in the same way that massage does.
Rationale for Choice B:
Administering prescribed medication can effectively block pain signals, but it does not rely on the principles of the gatecontrol theory. Medications typically work through pharmacological mechanisms that target pain receptors or neurotransmitters, rather than by competing with pain signals at the spinal cord level.
Rationale for Choice D:
Changing the woman's position can sometimes alleviate discomfort by shifting pressure or encouraging fetal movement, but it does not directly apply the gate-control theory either. Position changes can offer some physical relief, but they do not directly modulate the transmission of pain signals.
Rationale for Choice C:
Massaging the woman's back directly aligns with the gate-control theory of pain management. This theory proposes that nonpainful sensory input can effectively compete with pain signals, preventing them from reaching the brain. The following mechanisms explain how massage applies this theory:
Stimulation of non-painful nerve fibers: Massage activates large-diameter nerve fibers that transmit touch, pressure, and vibration sensations. These signals travel faster than pain signals and can effectively "close the gate" at the spinal cord, preventing pain signals from ascending to the brain.
Release of endorphins: Massage can stimulate the release of endorphins, the body's natural pain relievers. Endorphins bind to opioid receptors in the brain and spinal cord, reducing the perception of pain.
Reduction of muscle tension: Labor pain often involves muscle tension and spasms. Massage can help relax tense muscles, which can indirectly reduce pain by decreasing muscle ischemia and the release of pain-provoking substances.
Promotion of relaxation and distraction: Massage can induce a state of relaxation and provide a distraction from pain. This psychological effect can further contribute to pain relief by reducing anxiety and focusing attention on pleasant sensations.
Conclusion:
Massage offers a non-pharmacological, evidence-based approach to pain management that directly aligns with the gate-control theory. By stimulating non-painful sensory input, promoting relaxation, and releasing endorphins, massage effectively interrupts pain signals and provides significant relief for women in labor.
Correct Answer is ["A","D"]
Explanation
Choice A rationale:
Prostaglandins:
Mechanism of action: Prostaglandins are hormone-like substances that play a crucial role in labor initiation. They act by softening and ripening the cervix, stimulating uterine contractions, and rupturing the amniotic sac.
Types: Prostaglandins used for labor induction include:
Dinoprostone (Cervidil, Prepidil): Inserted into the vagina as a gel or pessary.
Misoprostol (Cytotec): Administered orally or vaginally.
Effectiveness: Generally effective in initiating labor within 24 hours, with success rates ranging from 60-85%.
Advantages:
Can be used when the cervix is unfavorable (not ripe).
Can be administered in a variety of ways to suit the patient's preferences.
May have a lower risk of uterine hyperstimulation compared to oxytocin.
Disadvantages:
Can cause side effects such as nausea, vomiting, diarrhea, and fever.
May increase the risk of uterine rupture, especially in women with a history of cesarean delivery.
Choice D rationale:
Amnioinfusion:
Procedure: Involves the infusion of sterile saline solution into the amniotic sac through a small catheter.
Mechanism of action: Not fully understood, but it's thought to work by:
Increasing amniotic fluid volume, which can help to stimulate contractions.
Stretching the uterine walls, which may trigger the release of prostaglandins.
Reducing pressure on the umbilical cord, which can improve fetal oxygenation.
Effectiveness: Usually used in conjunction with other induction methods, such as oxytocin or prostaglandins. Has a success rate of about 50-60% in initiating labor within 24 hours.
Advantages:
May be helpful in cases of low amniotic fluid (oligohydramnios).
Can decrease the risk of umbilical cord compression.
Disadvantages:
Requires the insertion of a catheter into the uterus, which carries a small risk of infection.
May cause discomfort for the mother.
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