A nurse in a clinic is caring for a client who is pregnant and asks how she should help her 4-year-old son prepare for the new baby. Which of the following statements should the nurse make?

"Surprise your son with a new bedroom after you bring the baby home."

"Purchase a gift to give to your son from your baby."

"Make sure you are holding your baby when your son comes to visit you in the hospital."

"Use medical terminology when teaching your son about your new baby."

Answer and Explanation

The Correct Answer is B

Rationale:

A. "Surprise your son with a new bedroom after you bring the baby home.": Sudden changes, especially without preparation, can increase feelings of insecurity or jealousy in young children. Involving the child in changes before the baby arrives helps promote acceptance and reduces anxiety.

B. "Purchase a gift to give to your son from your baby.": This strategy helps foster a positive bond between the older sibling and the newborn. It helps the child feel acknowledged and valued during a time when attention naturally shifts to the new baby.

C. "Make sure you are holding your baby when your son comes to visit you in the hospital.": Holding the baby during the first meeting can intensify feelings of displacement or jealousy in the older child. It's better to greet the child warmly and introduce the baby together to maintain emotional connection.

D. "Use medical terminology when teaching your son about your new baby.": Preschool-aged children benefit more from simple, age-appropriate explanations. Medical jargon can confuse or overwhelm them, making it harder to process the concept of a new sibling.

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

Explanation

Rationale:

A. Heart rate: Initially elevated (110/min), the client’s heart rate has decreased to 78/min by postpartum day 5, reflecting hemodynamic stability and resolution of infection-related tachycardia.

B. Temperature: Fever present on day 3 (38.6°C) has resolved by day 5 (37.1°C), indicating improved systemic response and reduced inflammation or infection.

C. WBC count: Markedly elevated at 33,000/mm³ on day 3, consistent with postpartum endometritis, has normalized to 10,000/mm³ by day 5, suggesting resolution of infection.

D. Fundal height: Uterine involution is progressing appropriately, moving from 1 cm above the umbilicus to 4 cm below by day 5, indicating the uterus is returning to its non-pregnant state.

E. Lochia: Lochia has changed from moderate, foul-smelling, dark brown on day 3 to a small amount of brownish-red with no odor by day 5, showing improvement in uterine healing and decreased infection.

F. Hemoglobin: The client’s hemoglobin has dropped from 11.1 g/dL to 10 g/dL. While still near the normal postpartum range, this decline does not represent an improvement and may indicate mild ongoing blood loss or dilutional effect.

A. 0.45% saline B. Glargine insulin C. 4.9% normal saline D. NPH insulin

Correct Answer is A

Explanation

Rationale:

A. 0.45% saline: After initial fluid resuscitation with 0.9% saline, clients with diabetic ketoacidosis (DKA) are often transitioned to 0.45% saline to provide ongoing volume replacement while avoiding sodium overload. This hypotonic solution helps correct dehydration without worsening hypernatremia.

B. Glargine insulin: Glargine is a long-acting insulin given subcutaneously and is not appropriate for continuous IV infusion. In DKA, rapid insulin action is necessary to reduce blood glucose and suppress ketogenesis quickly.

C. 4.9% normal saline: There is no such recognized concentration as 4.9% normal saline. Standard saline solutions used clinically include 0.9% (isotonic) and 0.45% (hypotonic), making this an incorrect and potentially unsafe option.

D. NPH insulin: NPH is an intermediate-acting insulin used for long-term glycemic control, not for acute management of DKA. It is given subcutaneously and has a delayed onset, making it unsuitable for continuous IV infusion.

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A nurse in a clinic is caring for a client who is pregnant and asks how she should help her 4-year-old son prepare for the new baby. Which of the following statements should the nurse make?

Nursing Test Bank

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