A nurse is caring for a client who is breastfeeding their newborn 1 week following delivery. Which of the following types of stool from the newborn should the nurse expect?

Sticky

Watery

Frothy

Seedy

Answer and Explanation

The Correct Answer is D

Newborn stool characteristics vary depending on feeding method and the infant’s age. In breastfed infants, stool consistency, color, and frequency reflect the digestion of human milk, which is highly digestible and well absorbed. By about 1 week of age, stools transition from early neonatal patterns to more mature breast milk stools. Recognizing normal stool patterns helps the nurse differentiate between expected findings and signs of gastrointestinal dysfunction or infection.

Rationale:
A. Sticky stools are typically associated with meconium, which is the first stool passed by a newborn within the first 24 to 48 hours of life. Meconium is thick, tar-like, and composed of amniotic fluid, mucus, and intestinal secretions. At 1 week of age, a breastfed infant should no longer be passing meconium, making this finding abnormal for this stage.

B. Watery stools may suggest diarrhea or gastrointestinal infection rather than normal breastfed infant stool. Breastfed stools can be soft, but they are not typically excessively watery or explosive. Persistent watery stools may indicate malabsorption, infection, or feeding intolerance and would require further assessment.

C. Frothy stools are more commonly associated with conditions such as lactose overload or imbalance between foremilk and hindmilk intake. This may occur if the infant is receiving mostly foremilk, which is higher in lactose and lower in fat. However, frothy stool is not the expected normal stool type for a healthy 1-week-old breastfed newborn.

D. Seedy stools are the expected finding in a breastfed newborn at 1 week of age. These stools are typically yellow to mustard-colored, soft, and contain small seed-like particles due to partially digested milk fat. This appearance reflects normal digestion and adequate intake of breast milk.

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Correct Answer is A

Explanation

Herpes simplex infection is caused by the herpes simplex virus (HSV), which spreads through direct contact with infected lesions or contaminated secretions. Infection control in healthcare settings is guided by transmission-based precautions that prevent the spread of pathogens. Because HSV is transmitted through direct skin-to-skin or mucous membrane contact, appropriate isolation measures focus on preventing contact with infectious lesions. Proper use of precautions protects both healthcare workers and other patients from transmission.

Rationale:
A. Contact precautions are required for clients with herpes simplex because the virus is transmitted through direct contact with active lesions or contaminated body fluids. This includes the use of gloves and gowns when touching the patient or contaminated surfaces. Proper hand hygiene and covering lesions help reduce transmission risk effectively.

B. Droplet precautions are used for pathogens spread through respiratory droplets, such as influenza or meningitis. Herpes simplex is not transmitted via coughing, sneezing, or respiratory secretions. Therefore, droplet precautions are not appropriate for this infection.

C. Protective environment precautions are used primarily for immunocompromised clients, such as those undergoing chemotherapy or stem cell transplantation. These measures focus on protecting the patient from environmental pathogens rather than preventing transmission from the patient. Herpes simplex does not require this type of isolation.

D. Airborne precautions are used for infections that remain suspended in the air and travel long distances, such as tuberculosis or measles. Herpes simplex virus does not spread through airborne particles. Therefore, airborne isolation is not indicated for this condition.

A. Punching the bed pillow when the staff denies the use of the telephone. B. Writing a short story depicting themselves as a superhero. C. Blaming their parent for a lack of attention received during childhood. D. Having an aggressive outburst when meal selection is unavailable.

Correct Answer is A

Explanation

Defense mechanisms are unconscious psychological strategies used to reduce anxiety and protect an individual from emotional distress. Displacement is a specific defense mechanism where an individual transfers emotional feeling from a threatening source to a safer or less threatening target. It is commonly seen in clients with anxiety disorders as a way of managing frustration or anger. Understanding defense mechanisms helps nurses interpret client behavior accurately and respond therapeutically.

Rationale:
A. Punching the bed pillow when staff denies the use of the telephone demonstrates displacement because the client redirects anger from the actual source (staff denial) onto a safer target (the pillow). This allows the expression of aggressive feelings without direct confrontation with the authority figure. It is a classic example of shifting emotional energy to a less threatening object.

B. Writing a short story depicting themselves as a superhero reflects sublimation or fantasy rather than displacement. The client is channeling emotions into creative expression or idealized thinking rather than transferring anger to another target. This defense mechanism does not involve redirecting aggression toward a substitute object.

C. Blaming their parent for lack of attention during childhood represents projection, where the individual attributes their own feelings or conflicts to another person. This is not displacement because the emotion is not redirected to a safer object but instead attributed to another individual as a source of blame.

D. Having an aggressive outburst when meal selection is unavailable reflects direct expression of frustration rather than displacement. The emotional response is directed at the immediate situation rather than being transferred to a substitute target. This indicates poor impulse control rather than use of a defense mechanism like displacement.

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Area assessed	Findings
Neurological	Drowsy but easy to arouse
Vital Signs	Temperature 35.3° C (95.5° F) Heart rate 60/min Respiratory rate 16/min Blood pressure 90/60 mm Hg Oxygen saturation 94% (oxygen at 2 L/min via nasal cannula) Rates pain as 1 on 0/10 pain scale.
Integumentary	Skin cool and moist to touch
Cardiopulmonary	Heart rate regular. Pedal pulse +1 bilateral. Lungs clear bilateral. Respirations even, nonlabored.
Abdomen	Abdomen soft, nondistended. Bowel sounds hypoactive in all four quadrants. 2x2 gauze with a clear transparent dressing intact to right lower and upper abdominal quadrant. Moderate amount of sanguineous drainage noted on the lower dressing.

A nurse is caring for a client who is breastfeeding their newborn 1 week following delivery. Which of the following types of stool from the newborn should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is contributing to the plan of care for a client who has herpes simplex. The nurse should plan to initiate which of the following isolation procedures when caring for this client?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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