A nurse is caring for a couple who experienced a fetal death at 37 weeks of gestation. Which of the following responses by the nurse is therapeutic?
"I think you should call your minister. He can help comfort you."
"It must be very difficult for you both. I will be available if you need anything."
"You are both young and can have other children."
"Did you have any complications during your pregnancy?"
The Correct Answer is B
Choice A rationale: This response assumes that the couple's religious beliefs are relevant to them, which may not be the case. It is not appropriate for the nurse to suggest involving their minister without knowing their preferences or beliefs.
Choice B rationale: This response acknowledges the couple's emotional experience and shows empathy toward their grief. It offers support and reassurance that the nurse will be available to help them through this difficult time.
Choice C rationale: While this statement may be factually true, it is not empathetic or supportive of the couple's current emotional state. It may come across as dismissive of their feelings and minimize their grief.
Choice D rationale: While gathering information about the pregnancy is essential for the medical record, this question does not address the couple's emotional needs. It is more appropriate to focus on offering emotional support and assistance rather than immediately delving into clinical details.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Elevating the client's legs is not the first action to address late decelerations. Positioning the client on her side is the priority intervention.
Choice B rationale:
Administering oxygen via a face mask is an appropriate intervention for late decelerations, but it is not the first action. Positioning the client on her side is the priority.
Choice C rationale:
Positioning the client on her side can relieve pressure on the vena cava and improve fetal oxygenation, which is crucial in managing late decelerations.
Choice D rationale:
Increasing the infusion rate of the IV fluid may not directly address the cause of late decelerations and is not the first action to take in this situation.
Correct Answer is A
Explanation
Choice A rationale: The rooting reflex is a natural reflex in newborns that helps them find the nipple for feeding. When the baby's cheek is touched or stroked, they will turn their head in that direction and open their mouth, searching for the breast or bottle.
Choice B rationale: The Babinski reflex is a different reflex, which involves the fanning and curling of the toes when the sole of the foot is stroked. It is not related to sucking or feeding.
Choice C rationale: The Moro reflex, also known as the startle reflex, occurs when a newborn is startled by a sudden noise or movement. The baby reacts by extending their arms and legs and then bringing them back toward the center of their body. It is not related to sucking or feeding.
Choice D rationale: The stepping reflex is observed when a newborn is held upright with their feet touching a solid surface. The baby will make stepping movements, but it is not related to sucking or feeding.
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