A nurse is caring for a new mother who is breastfeeding her term newborn. The newborn weighed 3.4 kg (7.5 lb) at birth and weighed 3.3 kg (7.3 lb) on the second day of life. The mother expresses concern about the weight loss and asks the nurse about the amount of her breast milk. Which of the following responses by the nurse is appropriate?

"A healthy newborn can lose 6% of his birth weight before starting to gain weight."

"Why don't you switch to formula to make sure your baby is eating enough?"

"It is common for new mothers to worry that they are not making enough milk for their baby."

"Your newborn will need to remain in the hospital so his weight can be monitored."

Answer and Explanation

The Correct Answer is A

Choice A rationale: Weight loss in the first few days after birth is normal for newborns, and a weight loss of up to 7-10% of the birth weight is considered within the expected range. A 6% weight loss is within normal limits, and it is reassuring to inform the mother that this is typical.
Choice B rationale: Suggesting switching to formula is not necessary based on the weight loss described. Breastfeeding provides adequate nutrition for most newborns, and early weight loss is typical and not a cause for alarm.
Choice C rationale: While it is true that new mothers may worry about breastfeeding and milk supply, this response does not address the specific weight loss concern and might not fully reassure the mother.
Choice D rationale: A 6% weight loss is within the expected range for a newborn and does not warrant hospitalization. It is a normal finding, and most newborns will start to regain their birth weight within a few days of life.

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Correct Answer is A

Explanation

Choice A rationale: Auscultating fetal heart tones in the right upper quadrant is not appropriate based on the information provided by Leopold maneuvers, which indicates the fetal back is on the right side of the mother's abdomen, and the fetal head is in the fundal portion of the uterus.
Choice B rationale: During Leopold maneuvers, the nurse palpated a round, firm, movable part in the fundal portion of the uterus. This finding corresponds to the fetal head, which is typically located at the top of the uterus (fundus). Additionally, the nurse palpated a long, smooth surface on the mother's right side. This finding indicates the fetal back, which typically lies along the right side of the mother's abdomen, suggesting that the fetus's back is positioned anteriorly (toward the mother's front). The location of the fetal heart is typically best heard over the back of the fetus. Therefore, the nurse should auscultate the fetal heart tones in the maternal quadrant corresponding to the back of the fetus, which is the left lower quadrant.
Choice C rationale: The information from Leopold maneuvers does not indicate the fetal back is in the right lower quadrant. The nurse should not auscultate fetal heart tones in this area.
Choice D rationale: Auscultating fetal heart tones in the left upper quadrant is not appropriate based on the information provided by Leopold maneuvers, which indicates the fetal head is in the fundal portion of the uterus and the fetal back is on the right side of the mother's abdomen. The fetal heart is usually best heard over the back of the fetus, which is not in the left upper quadrant.

A. Gender of the fetus B. Anatomic abnormalities C. Maturity of lungs D. Weeks of gestation

Correct Answer is C

Explanation

Choice A rationale: The gender of the fetus is not determined through amniocentesis. Fetal gender determination can be achieved through ultrasound or other specialized genetic tests if needed.
Choice B rationale: While amniocentesis can provide information about certain chromosomal abnormalities and genetic conditions, it is not the primary procedure used to detect anatomic abnormalities. Detailed ultrasound and other specialized imaging techniques are used for this purpose.
Choice C rationale: Amniocentesis is a prenatal diagnostic procedure in which a small amount of amniotic fluid is withdrawn from the uterus. The amniotic fluid contains fetal cells and biochemical substances that can provide valuable information about the fetus's health and development. One of the essential pieces of information obtained from amniocentesis is the maturity of the lungs. This is crucial in preterm labor to assess whether the lungs are mature enough to support breathing if the baby is born prematurely.
Choice D rationale: The gestational age is determined through other methods, such as ultrasound measurements and the last menstrual period. Amniocentesis is not primarily used to determine the weeks of gestation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is assisting with the care of a client who is experiencing preterm labor and is scheduled to undergo amniocentesis. The client needs an amniocentesis to determine which of the following findings?

Correct Answer is C

Explanation

A nurse is caring for a client who is pregnant and undergoing a nonstress test. The nurse records the FHR as 130 to 150/min, with no fetal movement for 15 min. Which of the following actions should the nurse take?

A nurse is reinforcing teaching with a client who is at 15 weeks of gestation and is about to undergo an amniocentesis. The nurse should reinforce that this test can identify which of the following traits or problems? (Select all that apply.)

A nurse is assisting in the care of a client who is in active labor. The nurse notes late decelerations on the fetal monitor tracing. Which of the following actions should the nurse take first?

A nurse is updating the plan of care for a newborn who is undergoing phototherapy. Which of the following actions should the nurse include in the plan?

A nurse is assisting a client with breastfeeding her newborn. The nurse should explain that which of the following reflexes will initiate sucking

A nurse is assisting in collecting data for a gestational age assessment on a newborn. Which of the following should the nurse check during a neuromuscular assessment? (Select all that apply.)

A nurse is reviewing laboratory results from a client who is at 28 weeks of gestation and has gestational diabetes. The nurse notes that blood glucose levels taken 1 hour following a meal range from 145 mg/dL to 162 mg/dL over the past week. Which of the following actions should the nurse take?

A nurse is reinforcing teaching with a client about how to reduce the risk of giving birth to a newborn who has a neural tube defect. Which of the following instructions should the nurse include in the teaching?