A nurse is reinforcing teaching about preventing mastitis with a client who is breastfeeding. Which of the following instructions should the nurse include?

"Wear an underwire bra between feedings."

"You should use a breast pump if you plan to return to work."

"Wash your nipples with soap and water daily."

"Cover your breasts immediately after feedings."

Answer and Explanation

The Correct Answer is B

(a) "Wear an underwire bra between feedings."
Wearing an underwire bra between feedings can compress breast tissue and impede milk flow, increasing the risk of mastitis. This recommendation is incorrect and could contribute to the development of mastitis rather than preventing it.

(b) "You should use a breast pump if you plan to return to work."
Regularly expressing breast milk with a breast pump, especially if planning to return to work, helps maintain milk supply and prevents engorgement, which can lead to mastitis. This recommendation encourages appropriate breastfeeding practices to prevent mastitis.

(c) "Wash your nipples with soap and water daily."
While maintaining good breast hygiene is important, excessive washing with soap and water can strip the nipples of natural oils and increase the risk of dryness and cracking, which may predispose to mastitis. This recommendation is not the most effective strategy for preventing mastitis.

(d) "Cover your breasts immediately after feedings."
Covering the breasts immediately after feedings may trap moisture and promote bacterial growth, increasing the risk of mastitis. It is important to allow the breasts to air dry after feedings to prevent moisture buildup and promote healing of any cracked nipples. This recommendation is not appropriate for preventing mastitis.

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Correct Answer is B

Explanation

Answer: B. Determine the newborn's respiratory rate.

Rationale:

A. Weigh the newborn's wet diaper:
While monitoring fluid output is important in assessing hydration status and overall health, it is not the immediate priority. In the context of a newborn with neonatal abstinence syndrome (NAS), the respiratory status takes precedence, especially given that withdrawal can affect respiratory function.

B. Determine the newborn's respiratory rate:
Assessing the respiratory rate is crucial, as newborns with NAS may experience respiratory distress, including increased respiratory effort or apnea. Identifying any respiratory issues early allows for prompt intervention, which is vital for the newborn's safety and well-being. Ensuring adequate respiratory function is a priority in this population.

C. Auscultate the newborn's bowel sounds:
While assessing bowel sounds is relevant to monitoring gastrointestinal function and potential withdrawal symptoms, it is not the immediate priority. Changes in bowel sounds may occur due to the syndrome, but respiratory assessment should come first to ensure stability.

D. Swaddle the newborn in blankets:
Swaddling can provide comfort to a newborn with NAS; however, it is not the first action to take. Comfort measures are important, but they should follow critical assessments of the newborn's respiratory and overall clinical status to ensure safety.

A. Serum bilirubin B. Liver enzymes C. Urinalysis for ketones D. CBC

Correct Answer is C

Explanation

(a) Serum bilirubin:
While serum bilirubin can provide useful information about liver function, it is not the most immediate concern for a client with hyperemesis gravidarum. This condition primarily involves severe nausea and vomiting, which can lead to dehydration and ketosis.

(b) Liver enzymes:
Liver enzymes can be elevated in hyperemesis gravidarum, but they are not the primary concern. The immediate priority is to assess the extent of dehydration and metabolic disturbances.

(c) Urinalysis for ketones:
This test is the priority because it helps determine the extent of dehydration and ketosis. In hyperemesis gravidarum, severe vomiting can lead to significant fluid and electrolyte imbalances and ketosis, which need to be identified and corrected promptly to prevent further complications.

(d) CBC:
A complete blood count (CBC) provides useful information about overall health and can identify anemia or infection, but it is not the priority for immediate assessment of hyperemesis gravidarum. The immediate need is to evaluate hydration status and ketosis, which is best done through urinalysis for ketones.

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A nurse is reinforcing teaching about preventing mastitis with a client who is breastfeeding. Which of the following instructions should the nurse include?

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a newborn who has neonatal abstinence syndrome. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

Rationale:

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Correct Answer is C

Explanation

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