NURS 431 Maternal newborn practice

a nurse at a prenatal clinic is caring for a client who suspects she may be pregnant and asks the nurse how the provider will confirm her pregnancy, the nurse should inform the client that which lab tests would confirm pregnancy?

A urine test for the presence of human chorionic gonadotropin

3 multiple choice options

a nurse is teaching a client who is 8 weeks of gestation and has a uterine fibroid about potential effects of the fibroid during pregnancy, which of the following info should the nurse include?

"The fibroid can increase the risk for postpartum hemorrhage."

3 multiple choice options

a nurse is assessing a client who is at 12 weeks gestation and has a hydatidiform mole, which should the nurse expect

Dark brown vaginal discharge

1 multiple choice option

a nurse is caring for a client who is in the latent phase of labor and is experiencing low back pain. which of the following actions should the nurse take?

Apply pressure to the client's sacral area during contractions.

3 multiple choice options

a nurse is caring for a client who is at 32 weeks of gestation and is experiencing preterm labor, which med should the nurse administer

Betamethasone

3 multiple choice options

a nurse is caring for a client who has oligohydramnios, which of the following fetal anomalies should the nurse expect

Renal agenesis

2 multiple choice options

a nurse is caring for a client who has oligohydramnios, which of the following fetal anormalies should the nurse see

Uteroplacental insufficiency

3 multiple choice options

a nurse is caring for a client whos LMP began July 8, using nageles rule, what is her EDD?

April 15

3 multiple choice options

a nurse is caring for a client who is 35 weeks gestation and has severe pre-eclampsia, which assessment provides most accurate info regarding client weight and electrolyte status

daily weight

2 multiple choice options

a nurse is reviewing the medical record of a client who is 33 weeks gestation and has placenta previa and bleeding, which prescription should the nurse clarify with the provider

Perform a vaginal examination.

a nurse is admitting a client who is in labor and experiencing mod bright red vaginal bleeding, which should the nurse take

Obtain blood samples for baseline laboratory values.

a nurse is providing teaching to a client who is at 8 weeks of gestation about manifestations to report to the provider during pregnancy. which of the following info should the nurse include

Blurred or double vision

a nurse is caring for a client who believes she may be pregnant, which of the following findings should the nurse identify as a positive sign of pregnancy

Palpable fetal movement

a nurse is caring for a client who is at 38 weeks of gestation and reports no fetal movement for 24 hours, which should you take

Auscultate for a fetal heart rate.

a nurse is teaching a client who is at 12 weeks gestation and has HIV, which should the nurse include

"You should continue to take zidovudine throughout the pregnancy."

a nurse is teaching a client who is at 12 weeks gestation about manifestations of potential complications she should report, which would she include?

Swelling of the face

a nurse is teaching a client who is 10 weeks gestation about an abdominal ultrasound in the first trimester, which should the RN include

"You will need to have a full bladder during the ultrasound."

3 multiple choice options

a nurse is caring for a client who is 37 weeks gestation and is undergoing a nonstress test, the FHR is 130/min without accelerations for the past 10 min, which should they include?

Use vibroacoustic stimulation on the client's abdomen for 3 seconds.

a nurse is assessing a client who is at 35 weeks gestation and is receiving magnesium sulfate via continuous IV infusion for severe pre-eclampsia, which of the following should the nurse report

Urinary output 20 mL/hr

a nurse is teaching a client who is at 30 weeks of gestation about warning signs of complications that she should report to her provider, which of the following findings should the nurse include

Vaginal bleeding

1 multiple choice option

a nurse is assessing a client who is at 37 weeks gestation and has a suspected pelvic fracture due to blunt abdominal trauma, which of the following should the nurse expect

Uterine contractions

3 multiple choice options

a nurse is caring for a client who is 26 weeks of gestation and reports constipation, which is appropriate

"You should walk for at least 30 minutes every day."

3 multiple choice options

a nurse is teaching a client who is 13 weeks gestation about the treatment of incompetent cervix with cervical cerclage, which insludes an understanding?

"I should go to the hospital if I think I may be in labor."

3 multiple choice options

a nurse is reviewing the lab results for a client 37 weeks gestation, the client is rubella non-immune, positive for group A beta-hemolytic streptoccoi, and has a blood type of O negative, which of the following should the nurse take?

Instruct the client to obtain a rubella immunization after delivery.

3 multiple choice options

a nurse is reviewing the medical record of a client who is 39 weeks gestation and has polyhydramnios, which should the RN report

Fetal gastrointestinal anomaly

3 multiple choice options

a nurse is assessing a client who is 34 weeks and has mild placental abruption, which should you expect

Dark red vaginal bleeding

3 multiple choice options

a nurse is teaching a client who has pre-eclampsia and is to receive Mg sulfate continuous IV infusion about expected adverse effect, which include

Feeling of warmth

3 multiple choice options

a nurse is caring for a client in active labor and has meconium staining of amniotic fluid, the nurse notes reassuring FHR, which take next

Prepare equipment needed for newborn resuscitation.

3 multiple choice options

a nurse is assessing a client who is 35 weeks gestation and has preeclampsia without severe featiures, which is a priroity

480 mL urine output in 24 hr

3 multiple choice options

a nurse is caring for a client who is in latent phase of labor and is receiving oxytocin via continuous IV infusion, the nurse notes the client is having contractions every 2 min which last 100-110 seconds and FHR is reassuring, which take next

Decrease the dose of oxytocin by half.

3 multiple choice options

a nurse is caring for a client who reports intestinal gas pain following c-section, which should the nurse take

Assist the client to ambulate in the hallway.

3 multiple choice options

a nurse is caring for a newborn who is premature in neonatal intensive care unit, which action promotes development

Position the naked newborn on the parent's bare chest.

3 multiple choice options

a nurse is providing teaching to a client who is postpartum and doses not plan to breastfeed her newborn. which insturctions include.

Place ice packs on your breasts.

2 multiple choice options

a nurse is planning care for a client who is postpartum and has cardiac disease, which prescriptions clarify

Monitor the client's weight weekly.

3 multiple choice options

a nurse is assisting a client 4 hr postpartum to get out of bed for the first time, the client becomes frightened when she has a gush of dark red blood from her vagina, which statement make

"Blood pools in the vagina when you are lying in bed."

3 multiple choice options

a nurse is assessing a newborn 1 hr after birth, which assessment findings report

Jaundice of the sclera

3 multiple choice options

a nurse is assessing a 4 hour old newborn who is to breastfeed and notes hands/feet cool and blue, which action take

Place the naked newborn on the mother's bare chest and cover both with a blanket.

3 multiple choice options

a nurse is administering rubella vaccine to a client 2 days postpartum, which statement indicates need further instruction

"I can conceive any time I want after 10 days."

3 multiple choice options

a nurse is providing teaching to a client who is planning to breastfeed her newborn, which indicates an understanding

it is normal for my baby to sometimes feed every hr for several hours in a row

3 multiple choice options

A nurse is testing the reflexes of a newborn to assess neurologic maturity. What reflexes is the nurse assessing when she quickly and gently turns the newborn's head to one side?

tonic neck

3 multiple choice options

A nurse is caring for a client who is receiving mag sulfate by continuous IV. What meds should the nurse have available at bedside?

calcium gluconate

2 multiple choice options

A nurse is assessing a newborn who was born at 39 wks gestation. What finding should the nurse expect?

symmetric rib cage

1 multiple choice option

A nurse is caring for a client who has a soft uterus and increased lochia. What meds should the nurse plan to administer to promote uterine contractions?

methylergonovine

2 multiple choice options

A nurse is assessing a newborn 1 min after birth andnotes a hr of 136/min, resp 36, well flexed extremities, responding to stimuli with a cry, blue hands and feet. What Apgar score should the nurse assign to the newborn?

9

3 multiple choice options

A nurse is providing teaching to the parents of a newborn about how to care for his circumcision at home. What instructions should the nurse include in the teaching?

Encourage nonnutritive sucking for pain relief.

2 multiple choice options

A nurse is caring for a client who is to receive a continuous IV infusion of oxytocin following a vaginal birth. What assessment findings should the nurse monitor to evaluate the effectiveness of the med?

fundal consistency

2 multiple choice options

A nurse is assessing a client who is postpartum following a vacuum-assisted birth. For what finding should the nurse monitor to identify a cervical laceration?

slow trickle of bright vaginal bleeding and a firm fundus

2 multiple choice options

A nurse is planning care for a newborn who is receiving phototherapy for an elevated bilirubin level. What action should the nurse take?

use photometer to monitor the lamp's energy

2 multiple choice options

A nurse is caring for a newborn directly after birth. What medications should the nurse administer to the newborn within 1-2 hr of delivery?

erythromycin ophthalmic ointment

2 multiple choice options

A nurse is caring for a newborn immediately following delivery. What actions should the nurse take first?

place the newborn directly on the client's chest

3 multiple choice options

A nurse is providing teaching to the parents of a newborn about bottle feeding. What instructions should the nurse include?

boil water for powdered formula for 1-2 min

3 multiple choice options

A nurse is assessing a client who is 14 hr postpartum and has a 3rd degree perineal laceration. The client's temp is 37.8 C (100F), her fundus is firm and slightly deviated to the right. The client reports a gush of blood when she ambulates and no bm since delivery. What action should the nurse take?

assist the client to empty her bladder

2 multiple choice options

A nurse is caring for a postpartum client 8hrs after delivery. What factors place the client at risk for uterine atony? select all

prolonged labor

mag sulfate infusion

distended bladder

1 multiple choice option

A nurse is caring for a newborn who is premature at 30 wks gestation. What finding should the nurse expect?

abundant lanugo

3 multiple choice options

A nurse is assessing a newborn for congenital hip dysplasia. What finding should the nurse expect?

limited abduction of one hip

2 multiple choice options

A nurse is assessing a 2 day old newborn and notes an egg-shaped, edematous, bluish discoloration that does not cross the suture line. What pieces of info should the nurse provide to the mother when she inquires about the finding?

this will resolve within 3-6 wks without treatment

3 multiple choice options

A nurse is providing teaching to the parents of a newborn about home safety. What statement by the parents indicates an understanding of the teaching?

I will place my baby on his back when it is time for him to sleep

2 multiple choice options

A nurse is assessing a 12 hr old newborn and notes a resp rate of 44 with shallow respirations and periods of apnea lasting up to 10 seconds. What action should the nurse take?

continue routine monitoring

1 multiple choice option

nurse is planning care for a requires phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include inthe plan of care

Ensure the newborns eyes are closed before applying the eye shield

A nurse is caring for a client at 34 weeks gestation and has a prescription for terbutaline for preterm labor. Which of the following statements by the patient is the priority?

"My heart feels as if it is racing."

A nurse is planning care for a client who is pregnant and is Rh-negative. In which of the following situations should the nurse administer Rh(D) Immune Globulin?

At 28 weeks of gestation

A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. Which of the following actions should the nurse include in the plan of care?

Check the cervix prior to analgesic administration.

A nurse is planning care for a client who is at 35 weeks of gestation. Which of the following lab tests should the nurse obtain?

Group B streptococcus Beta-hemolytic (GBS)

A nurse is caring for a newborn whose mother received magnesium sulfate to treat preterm labor. Which of the following clinical manifestations is the newborn indicates toxicity due to the magnesium sulfate therapy?

Respiratory depression

A nurse is caring for a client who is in labor and has an epidural for pain relief. Which of the following is a complication from the epidural block?

hypotension

A nurse is caring for a client who has trichomoniasis and a prescription for metronidazole. Which of the following instructions should the nurse provide to the client about the treatment plan?

"You and your partner need to take the medication and use a condom during intercourse until cultures are negative."

A nurse in a prenatal clinic is caring for a client who is within the recommended guideline for weight. The client asks the nurse how much weight is safe for her to gain during her pregnancy. Which of the following responses should the nurse make?

A weight gain of 25 - 35 lbs is good

A nurse is caring for a client who has a prescription for naloxone. Which of the following is the intended action of the med in relation to the CNS?

Block effects of narcotics on the CNS

A nurse is discussing diaphragm use with a client. Which of the following statements by client indicates an understanding of the teaching?

I should replace my diaphragm every 2 years

A nurse is teaching a client about a nonstress test. Which of the following statements by the client indicates an understanding of the teaching?

I should press the button on the handheld marker when my baby moves

A nurse is caring for a client who is 2 hr postpartum. The nurse notes the client's perineal pad has a large amount of lochia rubra with several clots. Which of the following actions should the nurse take first?

Massage the fundus

A nurse is caring for a preterm newborn who is receiving oxygen therapy. Which of the following findings should the nurse identify as a potential complication from the oxygen therapy?

retinopathy

A nurse is caring for a client who is receiving oxytocin for induction of labor. Which of the following actions should the nurse take?

Perform continuous fetal heart rate monitoring

A nurse is assessing a client on the first postpartum day. Findings include fundus firm and 1 fingerbreadth above and to the right of the umbilicus, moderate lochia rubra with small clots, temp 37.3 and pulse 52. Which of the following actions should the nurse take?

Ask the pt when she last voided

A nurse is assessing a newborn who is 12 hr old and notes mild jaundice of face and trunk. Which of the following actions should the nurse take?

obtain stat prescription for a bilirubin level

A nurse is speaking with an expectant father who says that he feels resentful of the added attention others are giving to his wife since the pregnancy was announced. Which of the following responses should the nurse make?

These feeling are common for expectant fathers in early pregnancy

A nurse is caring for a client who is at 36 weeks of gestation and has pre-eclampsia. Which of the following findings should the nurse identify as the priority?

nonreactive nonstress test

A nurse is caring for a client who is at 8 weeks of gestation with twins and primigravida. The client states that even though she and her husband planned this pregnancy, she is experiencing many ambivalent feelings about it. Which of the following responses should the nurse make?

These feelings are quite normal at the beginning of pregnancy

A nurse receives report on a client who is in labor and is experiencing contractions 4 min apart. Which of the following patterns should the nurse expect on the fetal monitoring tracing?

Contractions that last for 60 seconds each with a 3 min rest between contractions

A nurse is discussing epidural anesthesia with a client who is receiving oxytocin for induction of labor. Which of the following statements should the nurse make?

an epidural given too early can prolong labor

A nurse is caring for a newborn who was born to a client with a narcotic use disorder. Which of the following nursing actions is a contraindication for the care of the newborn?

frequent stimulation

A nurse is preparing to administer naloxone to a newborn. Which of the following conditions can require administration of the medication?

IV narcotics administered to the mother during labor

A nurse is planning care for a client who has a prescription for oxytocin. Which of the following is a contraindication for the use ofthis medication?

active genital herpes

A nurse is caring for a client who desires an intrauterine device for contraception. Which of the following findings is a contraindication for the use of this device?

menorrhagia

A nurse in an antepartum clinic answers a phone call from a client who is at 37 weeks of gestation and reports, "I became very dizzy while lying in bed this morning, but the feeling went away when I turned on my side." Which of the following actions should the nurse take?

Instruct the client about vena cava syndrome and measures to prevent it

A nurse is caring for a newborn who has irregular respirations of 52/min with several periods of apnea lasting approx. 5 seconds.The newborn is pink with acrocyanosis. Which of the following actions should the nurse take?

continue to routinely monitor the newborn

A nurse is providing discharge teaching to a client following the removal of a hydatidiform mole. Which of the following statements should the nurse include in the teaching?

do not become pregnant for at least 1 yr

A nurse is assessing a client recieving magnesium sulfate as treatment for preeclampsia. which of the following clinical findings is the nurse's priority?

urinary output 40ml in 2 hrs

A nurse is caring for a client whose membranes have ruptured and is in active labor. the fetal monitor tracing reveals late decels. Which of the following actions should the nurse take first?

Turn the client onto her left side

A nurse is caring for a client who is at 16 weeks of gestation and has severe iron-deficiency anemia. The provider prescribes and injection of iron dextran IM. Which of the following methods should the nurse use to administer the medication?

Use a 20 gauge needle and use the Z track method

A nurse administers betamethasone to a client who is at 33 weeks of gestation to stimulate fetal lung maturity. When planning care for the newborn, which of the following conditions should the nurse identify as an adverse effect of this medication?

decreased blood glucose

A nurse is caring for four newborns. Which of the newborns is at greatest risk for hypoglycemia?

a newborn who is large for gestational age

A nurse is caring for a client who is in labor. The client questions the application of an internal fetal scalp monitor. Which of the following responses should the nurse make?

we need to observe your baby more closely

A nurse is teaching a client who has active genital herpes simplex virus, type 2. Which of the following statements should the nurse include in the teaching?

You will have a c section prior to the onset of labor

A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following clinical findings should the nurse expect?

exaggerated reflexes

A nurse is caring for a client who is in labor. A vaginal exam reveals this info. 2cm, 50%, +1, right occiput anterior (ROA). Based on this info, which of the following fetal positions should the nurse document in the medical record?

vertex

A nurse is caring for a client who has clinical manifestations of an ectopic pregnancy. Which of the following findings is a risk factor for an ectopic pregnancy?

PID

A nurse is caring for a client who is pregnant and reports nausea and vomiting. Which of the following instructions should the nurse provide the client?

Eat some crackers before rising from bed in the morning