A nurse is planning care for a newborn who has spinal bifida. Which of the following actions should be included in the plan of care?

Obtain rectal temperatures.

Cover the lesion with a dry dressing

Apply snug, clean diapers.

Place the newborn in the prone position.

Answer and Explanation

The Correct Answer is D

The newborn should be placed in prone position to prevent pressure to the lesion which may lead to damage to the contents of the sac. It should be covered with a sterile, wet gauze to maintain the integrity of the sac.

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Correct Answer is ["B","D"]

Explanation

B. This statement indicates the client understands the importance of monitoring the incision site for any signs of infection, such as discharge, and knows to seek medical attention if these signs occur.
D. This statement indicates the client understands that while some discomfort is normal after a cesarean birth, unrelieved or severe pain could be a sign of complications and should be addressed promptly.
A. Resting in a recliner may not provide adequate support or promote proper healing of the incision site.
C. While continuing prenatal vitamins may be beneficial for overall health, it is not directly related to the cesarean birth recovery process.
E. A fever during the first week at home is not a typical occurrence and may indicate an infection, which should be evaluated by a healthcare provider. Therefore, it is not accurate to expect a fever during this time.

A. Have the client pant during the next contractions. B. Assist the client into a comfortable position. C. Help the client to the bathroom to void. D. Observe the perineum for signs of crowning

Correct Answer is A

Explanation

A Panting helps the client manage the urge to push and prevents premature pushing, which can cause cervical swelling or injury. This technique helps delay pushing until full dilation is achieved, ensuring a safer delivery process.
B. Helping the client into a comfortable position can facilitate labor progress. However, it may not be the most urgent action given the potential imminent delivery.

C. Voiding is a common suggestion during labor, but if the client feels the urge to push, it may be an indication that the baby is descending and delivery is imminent.
D. The client's urge to push indicates that the baby is descending, and birth is imminent. It would not be safe to have the client walk to the bathroom at this stage, as she may deliver the baby during the process, increasing the risk of an unattended birth.

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A nurse is planning care for a newborn who has spinal bifida. Which of the following actions should be included in the plan of care?

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who is 3 days postoperative following a cesarean birth. Which of the following client statements should indicate to the nurse the teaching is effective? (Select all that apply.)

Correct Answer is ["B","D"]

Explanation

A nurse is caring for a client who is in active labor with 7 cm of cervical dilation and 100% effacement. The fetus is at 1+ station, and the client's amniotic membranes are intact. The client suddenly states that she needs to push. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is planning care for a newborn who has spinal bifida. Which of the following actions should be included in the plan of care?

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