Saturday, 29 December 2012

problems encountered in breadst feeding

Problems Encountered With Breastfeeding


¦ Breasts are swollen, hard, hot, tender, and may be dry and red due to
vascular congestion before secreting milk (lactation); usually occurs
3–5 days postpartum

¦ Nursing:
¦ Breastfeed q2h and empty breasts entirely by pumping (back pressure
on full milk glands .milk production)
¦ Apply ice between feedings 15min on and 45min off (heat .vascular


¦ Nipples are below surface of surrounding skin

¦ Nursing:
¦ Wear breast shield to draw nipple out
¦ Use electric breast pump before attempting latching-on
¦ Apply ice and tug and roll nipple with hands before feeding


¦ Nipple irritation resulting in discomfort

¦ Nursing:
¦ Alternate infant position
¦ Ensure infant is on areola and not just the nipple
¦ Apply ice before feeding to .nipple erectness and .soreness OR breast
massage and warm compress before feeding to .let-down reflex
¦ Analgesic 1hr before feeding to .soreness
¦ Use less sore nipple first
¦ Use breast shield. At end of feeding apply breast milk to nipples and



1. The most common pathogenic mechanism of acute pancreatitis is –
Auto digestion of the pancreas.

2. What does the nurse monitors for, in a patient with Acute Renal Failure?
Pulmonary edema and ECG changes.

3. A disease caused by Treponema pallidum is –

4. Which of the following is an important nursing intervention for a patient with Cushing Syndrome?
(a) Left Middle Cerebral Artery (b) Observe for hypotension
(c) Protect from infection (d) Restrict carbohydrate intake.

Ans: Protect from infection.

5. Involvement of which of the following structures will lead to right-sided hemiplegia and aphasia?
(a) Left Middle Cerebral Artery (b) Vertebral Artery (c) Brain stem
(d)Right Middle Cerebral Artery.

Ans: Left Middle Cerebral Artery

6. Which one of the following is a common response expected in a patient with stroke, to the change in body image?
(a)Denial (b) Dis association (c) Delusion (d) Depression.
Ans: Depression.

7. A patient with early osteoporosis must be advised to-
Stop smoking

8. For doing nasotracheal suctioning, during which of the following patient activities, the catheter should be inserted?
(a)Swallowing (b) Inhaling (c) Exhaling (d) Retching
Ans: Inhaling

9. The simple most effective method for reducing the risks of stasis of pulmonary secretions is-
Two hourly position change.

10. What is cyanosis?
Blue discoloration of skin.

11. The period from conception to birth is denoted as –

12. Role of nursing is “having charge of somebody’s health” Whose vision is this?
Florence Nightingale

13. Which of the following developmental stage corresponds to infancy?
(A) Trust Vs Mistrust (b) Autonomy Vs Shame (c) Initiative Vs Guilt (d) Industry Vs Inferiority.

Ans: Trust Vs Mistrust

14. Who proposed the nursing theory of self-care deficit?
Dorothea orem

15. The head circumference of a normal infant is –
33-35 cm

16. The leading cause of death in adolescence is –
17. The legal definition of ‘death’ that facilitates organ donation is, cessation of –
Function of brain

18. The body temperature at which tissues and cells can best function is –
36-38o C

19. Men have a higher Basal Metabolic Rate because, their body contains more-

20. The mechanism by which body loses heat to the environment, without having direct contact is --?

21. Which of the following structures controls heat loss?
(a) Anterior pituitary (b) Posterior pituitary (c) Posterior hypothalamus (d) Anterior hypothalamus
22. Exposure of the body to subnormal temperature can lead to …

23. What is the effect of an antipyretic?
Reduce fever

24. The volume of blood pumped by the heart during one minute is called….
Cardiac output

25. What is the normal pulse rate of an infant?
26. The phase of respiration in which gases move in and out of the lungs is ….

27. What is the normal partial pressure of carbon dioxide in arterial blood? (mm Hg)

28. What is the equipment that indirectly measures arterial oxygen saturation?
Pulse Oximeter

29. What is the term used to denote regular, abnormally slow respirations?

30. What technique of assessment helps to determine ketoacidosis?

31. Inflammation of skin at base of nail is?

32. The condition in which both eyes do not focus on an object simultaneously is known as?
33. The most effective way to break the chain of infection is by?
Hand hygiene

34. How many drops in a standard drip set makes one ml.?

35. The prescription orders 0.125 mg digoxin orally. Tablets containing 0.25 mg is available. How many tablets will you administer?

36. A patient who is receiving intravenous fluids develops tenderness, warmth, erythema and pain at the infusion site. Which of the following conditions will you suspect?
(a) Sepsis (b) Infiltration (c) Fluid overload (d) Phlebitis

37. When providing oral hygiene to an unconscious patient, care must be taken to prevent?

38. What is the intrinsic rate of the normal A-V node?
40-60 per minute

39. Which of the following structures is the pacemaker of the heart?
(a) S-A node (b) Septum (c) A-V node (d) Bundle of His
Ans: S-A node

40. The prescription is for two tablespoons of milk of magnesia. How many ml. will you give?
30 ml

41. Which of the following is intravascular fluid?
(a) Lymph (b) Pleural fluid (c) Plasma (d) Synovial fluid
Ans: Plasma

42. If the serum potassium level is less than normal, the condition is known as –

43. What electrolyte abnormality is likely to develop in a patient with vomiting?

44. How much sodium is normally present in the extra cellular fluid? (in MEq/L).

45. What is the primary cause of hyperkalemia?
Renal failure

46. Which of the following is an isotonic solution?
(a)Lactated Ringers (b) Half –Normal Saline (c) One-third Normal Saline
(d) Mannitol
Ans: Lactated Ringers

47. Thousand ml. of Normal Saline is to be infused in 8 hours. What should be the rate of flow per minute?
30 drops

48. A patient admitted with vomiting, has the following arterial blood gas levels-pH 7.30; PaCO2 36 mm Hg; Pa O2 92mm Hg; and HCO3 18; what is the acid-base imbalance that is present?
Metabolic acidosis

49. Which of the following is a first-line drug used for pain management?
(a)Acetaminophen (b) Clonidine (c) Morphine (d) Ketamine
Ans: Acetaminophen

50. Which of the following is the organism that causes peptic ulcer disease?
(a) Staphylococcus (b) Coryne bacterium (c) Helicobacter pylori
(d) Streptococcus.
Ans: Helicobacter pylori

51. Which of the following nutrients helps for tissue repair?
(a)Vitamin (b) Fat (c) Carbohydrate (d) Protein
Ans: Protein

52. Microscopic examination of urine reveals elevated levels of red blood cells. What does it indicate?
Damage to Glomeruli.

53. Which of the following patient activities helps to relax the external anal sphincter, while administering enema?
(a)Separating the buttocks (b) Lubricating the catheter tip
(c)Inserting the catheter slowly (d) Breathing out through the mouth.

Ans: Breathing out through the mouth.

54. What length of the catheter tip should be inserted into the rectum, for giving enema to an adult patient?
7.5-10 cm

55. The stool discharged from an ostomy is called?

56. Which of the following is the best method to confirm placement of the nasogastric tube:
(a) Checking patient’s ability to talk (b) Aspiration of intestinal content
(c) Introducing air and auscultating (d) X-ray of chest and abdomen

Ans: X-ray of chest and abdomen

57. Which of the following is a common cause of orthostatic hypotension in a bedridden Patient?
(a)Increased autonomic response (b) Decreased circulating blood volume
(c) Increased cardiac output (d) Decreased blood pooling
Ans: Decreased circulating blood volume.

58. Which of the following body parts has a condyloid joint?

(a) Shoulder (b) Elbow (c) Wrist (d) Forearm

Ans: Wrist
59. Who was the first president of the International Council of Nurses?

60. Which of the following minerals should be taken by a child suffering from rickets?
(a)Potassium (b) Calcium (c) Sodium (d) Iron
Ans: Calcium

61. Who introduced antiseptic spray during surgery?
Joseph Lister

62. A large infection made up of several boils is known as :

63. Which of the following drugs will be administered to treat anaphylaxis?
(a) Atropine (b) Sodium bicarbonate (c) Digoxin (d) Epinephrine
Ans: Epinephrine

64. Which of the following is a vesicant drug?
(a)Dactinomycin (b) Morphine (c) Azithrocin (d) Voveran
Ans: Dactinomycin

65. Pain caused by damage to somatic tissue is known as –

66. Which of the following immunoglobulin are responsible for anaphylactic reactions?
(a) IgA (b) IgE (c) IgM (d) IgG
Ans: IgE

67. The separation and disruption of previously joined wound edges is termed as?

68. What types of dressing is Duoderm?

69. The role of the complement system in opsonization affects which response of the inflammatory process?

70. Contractures frequently occur after burn healing because of ….?
Excess fibrous tissue formation.

71. Association between HLA antigens and diseases is most commonly found in what disease conditions?
Autoimmune diseases.

72. What is the most common cause of secondary immunodeficiencies?

73. If a person is having an acute rejection of a transplanted organ, which of the following drugs would most likely to be used?
(a)Tacrolimus (b) Cyclosporine (c) Cellcept (d) Daclizumab.

Ans: Daclizumab.

74. The primary difference between benign and malignant neoplasm is the ….
Characteristic of tissue invasiveness.

75. If the blood plasma has a higher osmolality than the fluid within a red blood cell, the mechanism involved in equalizing the fluid concentration is?

76. Which of the following symptoms should be watched for in a patient receiving a loop diuretic?
(a)Restlessness and agitation (b) Paresthesias. (c)Increased blood pressure
(d)Weak irregular pulse.

Ans: Weak irregular pulse.

77. Which of the following should be watched for in a patient who has just undergone a total thyroidectomy?
(a)Weight gain (b) Depressed reflexes (c) Positive chvostek sign (d) Personality changes.

Ans: Positive chvostek sign

78. Which of the following surgical procedures involves removal of a body organ?
(a) Tracheostomy (b) Laparotomy (c) Mammoplasty (d) Mastectomy.
Ans: Mastectomy.
79. The cause of arcus senilis is?
Cholesterol deposits.

80. What is the cause of presbyopia?
Inflexible lens.

81. The most appropriate technique to assess skin for temperature and moisture is ….

82. Complete absence of melanin pigment in patchy areas on a patient’s hand is described as …..

83. What instruction will you give to a patient after a chemical peel?
Avoid sun exposure
84. Childhood atopic dermatitis is commonly seen in which body area?
Antecubital space.

85. Which of the following parameters is commonly used to assess adequacy of fluid replacement in a patient with burns?
Urine output.

86. Which of the following is an earliest manifestation of inadequate oxygenation?
(a) Diaphoresis (b) Cyanosis (c) Restlessness (d) Hypotension

Ans: Restlessness

87. A diagnostic procedure which involves removal of pleural fluid for analysis is :


88. Which of the following helps to identify flail chest in a patient with chest trauma:
(a)Multiple rib fractures seen in X-ray. (b)Decreased movement of chest wall
(c)Tracheal deviation (d) Paradoxic chest movement during respiration.
Ans: Paradoxic chest movement during respiration.

89. Which of the following is an intervention for a patient with chronic obstructive pulmonary disease?
(a) Pursed-lip breathing (b) Chronic steroid therapy (c) High flow oxygen
(d)High Carbohydrate diet
Ans: Pursed-lip breathing

90. Which of the following is a normal finding obtained during a lymph node palpation?
(a) Hard, fixed node (b) Firm, mobile node (c) Enlarged tender nodes
(d)Hard, nontender nodes

Ans: Firm, mobile node

91. Which is the most common type of leukemia seen in older adults?
Chronic lymphocytic.

92. The blood vessel that brings blood to the right atrium is ….
Inferior Venae Cavae

93. Which of the following conditions is caused by elevated intra ocular pressure?
(a)Glaucoma (b) Cataract (c) Strabismus (d) Myopia.
Ans: Glaucoma.

94. Which of the following is the most common pathologic finding in individuals at risk for sudden cardiac death?
(a)Aortic valve disease (b) Mitral valve disease
(c) Left ventricular dysfunction (d) Atherosclerotic heart disease
Ans: Atherosclerotic heart disease

95. Which of the following is an absolute contraindication for the use of fibrinolytic therapy?
(a) Current use of anticoagulants (b) Severe liver disease
(c) Suspected aortic dissection (d) Active peptic ulcer disease
Ans: Suspected aortic dissection

96. Which of the following drugs provide relief of anxiety and decreases both preload and after load?
(a) Amrinone (b) Morphine sulphate (c) Furosemide

Ans: Morphine sulphate

97. In a normal sinus rhythm, the measurement of an S.T.segment is …..?
0.12 seconds

98. The ECG monitor of a patient admitted with myocardial infarction shows ventricular bigeminy. What is the nurse’s responsibility in this situation?
Assess the patient’s response

99. What is the usual treatment of Rayanaud’s Phenomenon?
Calcium Channel blockers.

100. A patient is admitted with a diagnosis of diarrhea with dehydration. What could be the cause of increased peristalsis resulting in diarrhea?
Parasympathetic stimulation.