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Exhibits

Which description(s) by the client should help confirm that the mastitis has been resolved and breastfeeding/breast health is well maintained? Select all that apply.

After a feeding, the nipple is creased.

The feelings of fatigue continue, but there are no chills, achiness, or dizziness.

The infant continues to want to nurse all the time.

The temperature taken at home is 99.0° F (37.2° C).

Pain during feeding lasts for 10 of the 20 minutes of the feed.

Pumping continues on the right side instead of breastfeeding on that side.

The red area on her right breast has resolved.

The infant is breastfeeding every 2 to 3 hours for 20 minutes in a variety of positions.

Answer and Explanation

Correct Answer : D,G,H

A.   After a feeding, the nipple is creased. A creased nipple suggests a poor latch, which can lead to ineffective milk removal and increase the risk of recurrent mastitis. A proper latch should be deep, with the baby covering a large portion of the areola, ensuring effective drainage of the breast.
B.   The feelings of fatigue continue, but there are no chills, achiness, or dizziness. While the absence of chills, achiness, and dizziness indicates improvement, persistent fatigue may suggest anemia, inadequate hydration, or continued recovery from infection. Fatigue alone does not confirm complete resolution of mastitis.
C.   The infant continues to want to nurse all the time. Cluster feeding can be normal during growth spurts, but persistent frequent feeding beyond 2–3 hours may indicate poor milk transfer, low supply, or ineffective latch. Mastitis resolution should result in more effective milk drainage and a more predictable feeding pattern.
D.   The temperature taken at home is 99.0° F (37.2° C). A normal temperature suggests that the infection and systemic inflammation have resolved. Mastitis is characterized by fever, so its absence indicates improvement.
E.   Pain during feeding lasts for 10 of the 20 minutes of the feed. Persistent pain, especially for half the feeding duration, may indicate ongoing inflammation, nipple trauma, or unresolved infection. Resolution of mastitis should lead to pain-free or minimal discomfort during feeding.
F.   Pumping continues on the right side instead of breastfeeding on that side. If the affected breast is still too painful for direct nursing, this suggests ongoing inflammation or poor resolution of mastitis. Ideally, the mother should be able to comfortably breastfeed from both breasts.
G.   The red area on her right breast has resolved. The disappearance of redness, swelling, and warmth indicates resolution of localized inflammation and infection, confirming improvement in mastitis.
H.   The infant is breastfeeding every 2 to 3 hours for 20 minutes in a variety of positions. Effective breastfeeding frequency and positioning ensure proper milk drainage, reducing the risk of recurrence. Mastitis resolution should allow the mother to comfortably breastfeed at regular intervals with different holds to promote complete emptying of all milk ducts.

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Correct Answer is B

Explanation

A. Weight gain. While albumin administration increases intravascular volume, leading to temporary fluid retention, the goal in nephrotic syndrome is to shift fluid from the interstitial spaces back into circulation. The expected outcome is a reduction in edema, not an overall weight gain. A persistent increase in weight could indicate continued fluid retention rather than treatment effectiveness.
B. Reduction of edema. Nephrotic syndrome is characterized by hypoalbuminemia, which causes fluid to leak from the blood vessels into the tissues, leading to generalized edema. Albumin 25% IV works by increasing oncotic pressure, drawing fluid back into the bloodstream. Once in circulation, excess fluid is excreted by the kidneys, resulting in decreased swelling, especially in the face, abdomen, and lower extremities.
C. Improved caloric intake. Nephrotic syndrome affects fluid balance but does not typically lead to reduced appetite unless complications arise. While improved well-being may lead to better nutritional intake, this is not the primary expected outcome of albumin therapy.
D. Reduction of fever. Fever is not a direct symptom of nephrotic syndrome, though it may occur with infections due to immunosuppression from protein loss. Albumin therapy does not have antipyretic properties, so a reduction in fever would not indicate the medication’s effectiveness in managing nephrotic syndrome.

A. Obtain blood cultures. B. Administer penicillin. C. Prepare for a cesarean section. D. Cover the lesion with a dressing.

Correct Answer is C

Explanation

A. Obtain blood cultures. Blood cultures are not required for diagnosing or managing herpes simplex virus (HSV) in pregnancy. While neonatal herpes can lead to systemic infection, cultures are typically performed on the newborn only if infection is suspected after birth. The priority is preventing vertical transmission.
B. Administer penicillin. Penicillin is used for bacterial infections, such as Group B Streptococcus (GBS) or syphilis, but it is ineffective against HSV, which is a viral infection. Antiviral medications like acyclovir are used to suppress HSV outbreaks during pregnancy, but once active lesions are present at term, cesarean delivery is required.
C. Prepare for a cesarean section. Active genital herpes at the time of delivery poses a significant risk of neonatal herpes, which can cause severe complications such as encephalitis, sepsis, or death. To prevent direct contact with the virus, cesarean section is recommended if there are active lesions or prodromal symptoms at the time of labor or rupture of membranes.
D. Cover the lesion with a dressing. Covering herpes lesions does not prevent transmission during vaginal birth, as the virus can still be present in vaginal secretions. The most effective way to prevent neonatal herpes is to avoid exposure through cesarean delivery.

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Exhibits Which description(s) by the client should help confirm that the mastitis has been resolved and breastfeeding/breast health is well maintained? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Albumin 25% IV is prescribed for a child with nephrotic syndrome. Which assessment finding indicates to the nurse that the medication is having the desired effect?

Correct Answer is B

Explanation

A multiparous client with active herpes lesions is admitted to the unit with spontaneous rupture of membranes. Which action should the nurse take?

Correct Answer is C

Explanation

A nurse is speaking with a client who is addicted to heroin and who just learned that she is pregnant. The client states, "I just started taking methadone. Is there anything else I can do to make sure my baby is healthy?" Which information should the nurse provide?

Exhibits For each assessment finding, click to indicate whether findings from this client's assessment are generally associated with mastitis, endometritis, or could be a sign of both conditions. Each row must have only one response option selected.

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A newborn is delivered by cesarean section to a mother who is HIV-positive. The mother received antiretroviral therapy during pregnancy. Which intervention should the nurse implement?

Which is the most important assessment for the nurse to conduct following the administration of epidural anesthesia to a client who is at 40-weeks gestation?

The nurse is caring for a child with a unilateral long-leg cast applied for the correction of club foot. Which action is most important for the nurse to perform?

Exhibits

Which description(s) by the client should help confirm that the mastitis has been resolved and breastfeeding/breast health is well maintained? Select all that apply.