On her second postpartum day, the mother of a newborn says, “The doctor says the baby has physiologic jaundice.
Even though it is supposed to be normal, I don’t understand why it occurs.” Which fact regarding physiologic jaundice should form the basis of the nurse’s response?

It is caused by an increase in neonatal metabolism.

It is related to the destruction of fetal red blood cells.

It is caused by an antigen-antibody reaction.

It is related to the immaturity of the reticuloendothelial system.

Answer and Explanation

The Correct Answer is B

Neonatal Jaundice | Geeky Medics

Physiologic jaundice is a common condition in newborns that occurs when the baby’s blood contains an excess of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells.In the womb, the mother’s liver removes bilirubin for the baby, but after birth the baby’s own liver must take over this function.Because the baby has more red blood cells than an adult and their liver is still immature, they may not be able to process all the bilirubin and it may build up in their skin and eyes, causing a yellowish appearance.

Choice A is wrong because it is not an increase in neonatal metabolism that causes physiologic jaundice, but rather a decrease in hepatic metabolism of bilirubin.

Choice C is wrong because it describes a different type of jaundice called hemolytic jaundice, which occurs when there is an incompatibility between the blood types of the mother and the baby, leading to an immune reaction that destroys the baby’s red blood cells faster than they can be replaced.

Choice D is wrong because it confuses the reticuloendothelial system with the hepatic system.

The reticuloendothelial system is a network of cells and tissues that are involved in immune responses and phagocytosis (the ingestion of foreign particles or cells).

The hepatic system is the system of organs and structures that are involved in liver functions, such as bile production and detoxification.

Normal ranges for bilirubin levels in newborns are 1 to 12 mg/dL (17 to 205 micromol/L) for total bilirubin and 0.2 to 1.4 mg/dL (3 to 24 micromol/L) for direct bilirubin.

Physiologic jaundice usually peaks at 3 to 5 days after birth and resolves by 2 weeks of age.

It does not require treatment unless the bilirubin levels are very high or rising rapidly, which may indicate a more serious condition or a risk of brain damage.

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Correct Answer is A

Explanation

The correct answer is choice A and it indicates fetal distress because it is a sign oflate deceleration.Late decelerations are due touteroplacental insufficiencyas the result of decreased blood flow and oxygen to the fetus during the uterine contractions.This causeshypoxemiaand can lead to fetal acidosis and neurological damage.

Choice B is wrong because it indicates anormal variabilityin the fetal heart rate, which reflects a healthy autonomic nervous system.A normal fetal heart rate is 120-160 beats per minute.

Choice C is wrong because it indicates anearly accelerationin the fetal heart rate, which is a benign finding that may occur with fetal movement or stimulation.

Choice D is wrong because it indicates anearly decelerationin the fetal heart rate, which is a normal response to fetal head compression during contractions.

It does not indicate fetal distress.

Normal ranges for fetal heart rate patterns are:

• Baseline: 120-160 beats per minute

• Variability: 6-25 beats per minute

• Accelerations: at least 15 beats per minute above baseline for at least 15 seconds

• Decelerations: none or early (mirror contractions)

A. She lives with two dogs at home. B. She works as a part-time oncology nurse. C. She is lacto-ova vegetarian. D. She commutes to work on a train.

Correct Answer is B

Explanation

The correct answer is choice B. She works as a part-time oncology nurse.This is because oncology nurses are exposed toteratogenic agents, which are substances that can cause abnormalities in an exposed fetus.Teratogenic agents can cross the placenta and alter fetal morphology or function.Examples of teratogenic agents are lead, methyl mercury, polychlorinated biphenyls, lithium, vitamin K antagonists, tobacco, rubella, cytomegalovirus, ionizing agents, hyperthermia, diabetes, and some drugs.

Choice A is wrong because living with two dogs at home does not pose a high risk for exposure to teratogenic agents.Dogs can be beneficial for pregnant women as they provide companionship and exercise.

Choice C is wrong because being a lacto-ova vegetarian does not pose a high risk for exposure to teratogenic agents.Lacto-ova vegetarians can get adequate nutrition from plant-based foods, dairy products, and eggs.

Choice D is wrong because commuting to work on a train does not pose a high risk for exposure to teratogenic agents.Trains are a safe and convenient mode of transportation for pregnant women.

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On her second postpartum day, the mother of a newborn says, “The doctor says the baby has physiologic jaundice. Even though it is supposed to be normal, I don’t understand why it occurs.” Which fact regarding physiologic jaundice should form the basis of the nurse’s response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse caring for a patient in labor is evaluating the fetal heart monitor.Which finding would indicate fetal distress?

Correct Answer is A

Explanation

A patient comes to the antepartal clinic for her visit and provides the nurse with information. What piece of information places this patient at high risk for exposure to teratogenic agents?

Correct Answer is B

Explanation

A patient who is 33 weeks pregnant has been experiencing Braxton-Hicks contractions.Which information should the nurse include in responding to this patient?

A patient had a cesarean delivery due to placenta previa.Which statement by the patient would indicate that she understands why she had the cesarean delivery?

A patient’s amniotic fluid is meconium-stained. Which action should the nurse plan to take?

A nurse is caring for a primigravida whose cervix is 2 cm dilated, 75% effaced, and the fetal presenting part is at +2 station. The patient says to the nurse, “I want an epidural now.Why won’t someone give me an epidural?” Which response is most appropriate for the nurse to make?

The nurse at the antepartal clinic reviews four patients’ charts. Which patient is at increased risk for an ectopic pregnancy?

A 23-year-old primigravida who appears to be in her third trimester of pregnancy comes to the labor and delivery unit reporting acute abdominal pain. She has had no prenatal care. Which assessment should the nurse do first?

The nurse instructs a postpartum patient in the use of a sitz bath. Which action by the patient indicates that the teaching was effective?

On her second postpartum day, the mother of a newborn says, “The doctor says the baby has physiologic jaundice.
Even though it is supposed to be normal, I don’t understand why it occurs.” Which fact regarding physiologic jaundice should form the basis of the nurse’s response?