A nurse in a clinic is teaching the mother of a 4-month-old infant who has been breastfed. The mother plans to switch her infant to an iron-fortified formula. Which of the following should be included in the teaching?

Iron is poorly absorbed in infants.

Iron facilitates growth of bones in infants.

Iron stores in infants begin to deplete.

Iron facilitates development of vision in infants.

Answer and Explanation

The Correct Answer is C

Choice A Reason:
Iron is not poorly absorbed in infants; in fact, infants absorb iron quite efficiently. Breast milk contains a small amount of iron, but it is highly bioavailable and well-absorbed. When switching to formula, it is important to use iron-fortified options to prevent iron deficiency anemia.

Choice B Reason:
While iron is essential for overall growth and development, including bone growth, it is not the primary reason for emphasizing iron in infant nutrition. The key concern with iron, especially when transitioning from breastfeeding, is the prevention of iron deficiency anemia, which can affect cognitive and motor development.

Choice C Reason:
This is the correct information to include in the teaching. Infants are born with a reserve of iron that begins to deplete around 4 to 6 months of age. It is crucial to introduce iron-fortified formula at this time to ensure the infant continues to receive adequate iron for development and to prevent iron deficiency anemia.

Choice D Reason:
Iron does play a role in the development of the nervous system, which can indirectly affect vision, but it is not specifically known for facilitating the development of vision in infants. The primary concern with iron intake in infants relates to its role in preventing anemia and supporting overall growth and development.

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Correct Answer is B

Explanation

Choice A reason:
Initiating pushing in a client with suspected placenta previa is contraindicated. Placenta previa is a condition where the placenta covers the cervix, and pushing could lead to severe bleeding and compromise both the mother and the fetus. The normal labor process involves pushing only after full cervical dilation, and in the case of placenta previa, this could exacerbate the condition.

Choice B reason:
Preparation for cesarean birth is the correct action when placenta previa is suspected. With placenta previa, vaginal delivery could cause significant hemorrhage due to the placenta's position over the cervical opening. A cesarean birth bypasses the cervix, thereby avoiding disruption of the placenta and preventing excessive bleeding.

Choice C reason:
Magnesium sulfate is used in obstetrics to prevent seizures in preeclampsia and to delay preterm labor, not for placenta previa. While it is important to manage the client's overall condition, magnesium sulfate would not address the immediate concern of potential hemorrhage due to placenta previa.

Choice D reason:
An examination to determine cervical status in the presence of placenta previa should be avoided unless absolutely necessary and performed under controlled conditions, such as in an operating room where a cesarean delivery can be performed if needed. Digital cervical examinations can dislodge the placenta and cause bleeding.

A. Moist skin B. Gray umbilical cord C. Wide skull sutures D. Protruded abdomen

Correct Answer is C

Explanation

Choice a reason:
Moist skin is not typically associated with SGA newborns. Newborns, in general, may have moist skin shortly after birth due to the amniotic fluid and vernix caseosa, but this is not a distinguishing characteristic of SGA infants.

Choice b reason:
A gray umbilical cord is not a finding specifically associated with SGA. The color of the umbilical cord at birth can vary, and a gray color may indicate that the cord is drying, which is a normal process after clamping and cutting the cord.

Choice c reason:
Wide skull sutures are associated with SGA infants. SGA can be a result of intrauterine growth restriction (IUGR), which can lead to underdevelopment of the skull bones, resulting in wider-than-normal sutures. This is because the skull may not have grown to its expected size due to the growth restriction experienced by the infant.

Choice d reason:
A protruded abdomen is not typically associated with SGA infants. In fact, SGA infants may have a scaphoid or sunken abdomen due to reduced subcutaneous fat and muscle mass. A protruded abdomen in a newborn could be a sign of other conditions such as organomegaly or gastrointestinal issues.

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A nurse in a clinic is teaching the mother of a 4-month-old infant who has been breastfed. The mother plans to switch her infant to an iron-fortified formula. Which of the following should be included in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is in labor at 40 weeks of gestation and reports that she has saturated two perineal pads in the past 30 minutes. The nurse suspects placenta previa. Which of the following is an appropriate nursing action?

Correct Answer is B

Explanation

A nurse is caring for a newborn who is small for gestational age (SGA). Which of the following findings is associated with this condition?

Correct Answer is C

Explanation

A nurse is assessing a client who received magnesium sulfate to treat preterm labor. Which of the following clinical findings should the nurse identify as an indication of toxicity from magnesium sulfate therapy and report to the provider?

A nurse in a provider's office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption?

A nurse is caring for a client who has preeclampsia and is being treated with magnesium sulfate. The client's respiratory rate is 10/min, and deep-tendon reflexes are absent. Which of the following actions should the nurse take?

A nurse is caring for a client who is 4 hours postpartum following a vaginal birth. The client has saturated a perineal pad within 10 minutes. Which of the following actions should the nurse take first?

A nurse is teaching about nutrition guidelines to a parent of a newborn. Which of the following statements by the parent indicates an understanding of the teaching?

A nurse is preparing to measure the fundal height of a client who is at 22 weeks of gestation. At which location should the nurse expect to palpate the fundus?

A nurse is caring for a client who is 1 hour postpartum and observes a large amount of lochia rubra and several small clots on the client's perineal pad. The fundus is midline and firm at the level of the umbilicus. Which of the following actions should the nurse take?

A nurse is caring for a newborn delivered by vaginal birth with vacuum assist. The newborn's mother asks about the swollen area on her son's head. After palpation to identify that the swelling crosses the suture line, which of the following is an appropriate response by the nurse?