The nurse is about to administer phytonadione to a newborn.
Which statement by the parents shows they understand why this medication is being given?

It stimulates the immune system.

It aids an immature liver.

It prevents hemorrhagic disorders.

It compensates for insufficient dietary intake.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While it’s true that phytonadione, also known as vitamin K, plays a role in the immune system, this is not the primary reason it is given to newborns. Therefore, this statement does not show an understanding of why the medication is being given.

Choice B rationale

Phytonadione does not aid an immature liver. It is necessary for the synthesis of certain proteins required for blood clotting. However, it does not directly aid the liver’s function.

Choice C rationale

This is the correct statement. Phytonadione is given to newborns to prevent hemorrhagic disorders, specifically vitamin K deficiency bleeding (VKDB). Newborns are at risk for VKDB because their gut does not yet have the bacteria necessary to produce vitamin K5.

Choice D rationale

While it’s true that vitamin K is obtained from dietary intake, newborns do not receive phytonadione to compensate for insufficient dietary intake. They receive it to prevent VKDB, a bleeding disorder caused by vitamin K deficiency.

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Correct Answer is D

Explanation

Choice A rationale

The eye ointment used in newborns is not intended to clear the infant’s vision.

Choice B rationale

The purpose of the eye ointment is not to dilate the pupil for visualization of the red reflex.

Choice C rationale

While the ointment does help prevent infections, it is not specifically targeted against herpes.

Choice D rationale

The primary purpose of the eye ointment is to prevent eye infections in newborns. This is particularly important as mothers who have a sexually transmitted infection (STI) can pass it to their newborns during childbirth, putting them at risk for an eye infection known as ophthalmia neonatorum (ON)1.

A. Insert a straight urinary catheter to drain the bladder. B. Scan the bladder for urinary retention. C. Test the fluid with a nitrazine strip. D. Palpate the suprapubic area for fetal head position.

Correct Answer is C

Explanation

Choice A rationale

Inserting a straight urinary catheter to drain the bladder is not the appropriate technique to evaluate fluid leakage in a pregnant woman. This procedure is invasive and can potentially introduce bacteria into the urinary tract, leading to infection.

Choice B rationale

Scanning the bladder for urinary retention is not the appropriate technique to evaluate fluid leakage in a pregnant woman. While ultrasound can be used to assess the amount of fluid in the bladder, it does not provide information about the nature of the fluid leakage.

Choice C rationale

Testing the fluid with a nitrazine strip is the appropriate technique to evaluate fluid leakage in a pregnant woman. Amniotic fluid has a higher pH than normal vaginal secretions and urine, and will turn a nitrazine strip blue. This test can help determine whether the fluid leakage is amniotic fluid, which could indicate rupture of membranes.

Choice D rationale

Palpating the suprapubic area for fetal head position is not the appropriate technique to evaluate fluid leakage in a pregnant woman. While this can provide information about the position of the fetus, it does not provide information about the nature of the fluid leakage.

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The nurse is about to administer phytonadione to a newborn.Which statement by the parents shows they understand why this medication is being given?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A father watching the admission of his newborn to the nursery notices that eye ointment is placed in the infant’s eyes. He asks the nurse what is the purpose of the ointment.The nurse would be correct in stating that the purpose for using the ointment is to:

Correct Answer is D

Explanation

During a routine prenatal health assessment for a client in her third trimester, the client reports that she had fluid leakage on her way to the appointment.Which technique should the nurse implement to evaluate the leakage?

Correct Answer is C

Explanation

The nurse is caring for a postpartum client who is experiencing severe pain and a sensation of pressure in her perineum.Her uterus is firm, and she has a moderate flow of lochia.Upon inspection, the nurse discovers that a perineal hematoma is starting to form. What should the nurse assess first?

A client who is at 10-weeks gestation calls the clinic because she has been vomiting for the past 24 hours. The nurse determines that the client has no fever.What instruction should the nurse give to this client?

Which signs of postpartum depression require additional attention from the nurse? (Select all that apply.)

A client, who is three days postpartum and formula feeding her newborn, reports experiencing painful, hard, and full breasts to the nurse.What recommendation should the nurse provide?

A client at 35 weeks gestation complains of pain whenever the baby moves.The nurse notes the client’s temperature to be 101.20 F (38.4° C), with severe abdominal or uterine tenderness on palpation.What condition do these findings suggest?

One day after vaginal delivery of a full-term baby, a postpartum client’s white blood cell count is 15,000/mm (15 x 109/L). What action should the nurse take first?

A multiparous client with active herpes lesions has been admitted to the unit due to spontaneous rupture of membranes.What action should the nurse take?

The nurse observes on the fetal monitor that a laboring client has a variable deceleration. What action should the nurse implement first?

The nurse is about to administer phytonadione to a newborn.
Which statement by the parents shows they understand why this medication is being given?