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A client comes to the clinic for her first prenatal visit and reports that July 10 was the first day of her last menstrual period. Using Nagele's Rule, the nurse calculates the estimated date of birth for the client to be _________.
- A. 4/17.
- B. 4/10.
- C. 5/10.
- D. 5/17.
Correct Answer: A
Rationale: Nagele's Rule is a common method used to estimate the due date. To calculate it, subtract 3 months and add 7 days to the first day of the last menstrual period. In this case, if the last menstrual period started on July 10, subtracting 3 months (April) and adding 7 days gives an estimated due date of April 17. This is the correct answer. Choices B, C, and D are incorrect because they do not follow the Nagele's Rule calculation method.
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What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy?
- A. Assessing FHR and maternal vital signs.
- B. Performing a venipuncture for hemoglobin and hematocrit levels.
- C. Placing clean disposable pads to collect any drainage.
- D. Monitoring uterine contractions.
Correct Answer: A
Rationale: The highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to assess the fetal heart rate (FHR) and maternal vital signs. This assessment is crucial in determining the extent of blood loss and its impact on both the mother and the fetus. Ensuring the well-being of both the mother and the fetus is the top priority in this situation. While obtaining hemoglobin and hematocrit levels is important, it can be done after the initial assessment. Placing clean disposable pads is necessary for managing any drainage but does not take precedence over assessing vital signs. Monitoring uterine contractions is important but is not the highest priority when compared to assessing the FHR and maternal vital signs.
A new parent is receiving discharge teaching about car seat safety from a nurse. Which statement by the parent indicates an understanding of the teaching?
- A. "I should position my baby's car seat at a 45-degree angle in the car."
- B. "I should place the car seat rear-facing until my baby is 12 months old."
- C. "I should place the harness snugly in a slot above my baby's shoulders."
- D. "I should position the retainer clip at the top of my baby's abdomen."
Correct Answer: A
Rationale: The correct answer is A. Positioning the car seat at a 45-degree angle is crucial to prevent the baby's head from falling forward, which can obstruct the airway. Choice B is incorrect because the recommendation is to keep the car seat rear-facing until the baby reaches the height or weight limit set by the car seat manufacturer, typically beyond 12 months. Choice C is incorrect as the harness should be snugly placed at or below the baby's shoulders, not above. Choice D is incorrect as the retainer clip should be positioned at armpit level to secure the harness straps properly.
A newborn is being assessed following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of the birth method?
- A. Hypoglycemia
- B. Polycythemia
- C. Facial Palsy
- D. Bronchopulmonary dysplasia
Correct Answer: C
Rationale: Facial palsy is a known complication of forceps-assisted birth. During forceps delivery, pressure applied to the facial nerve can result in facial palsy. The newborn may present with weakness or paralysis of the facial muscles on one side. Hypoglycemia (Choice A) is not directly related to forceps-assisted birth. Polycythemia (Choice B) is a condition characterized by an increased number of red blood cells and is not typically associated with forceps delivery. Bronchopulmonary dysplasia (Choice D) is a lung condition that primarily affects premature infants who require mechanical ventilation and prolonged oxygen therapy, not a direct outcome of forceps-assisted birth.
A client with preeclampsia is receiving magnesium sulfate by continuous IV infusion. Which finding should the nurse report to the provider?
- A. Blood pressure 148/94 mm Hg
- B. Respiratory rate 14/min
- C. Urinary output 20 mL/hr
- D. 2+ deep tendon reflexes
Correct Answer: C
Rationale: In a client with preeclampsia receiving magnesium sulfate, a urinary output of 20 mL/hr is a concerning finding as it may indicate renal impairment or magnesium toxicity. Adequate urinary output is crucial for eliminating excess magnesium and preventing toxicity. The nurse should report this finding to the provider for further evaluation.
A blood pressure of 148/94 mm Hg is elevated but expected in a client with preeclampsia. A respiratory rate of 14/min is within the normal range. 2+ deep tendon reflexes are a common finding in clients receiving magnesium sulfate and are not a cause for concern unless they progress to hyperreflexia or clonus.
The healthcare provider is preparing to administer phytonadione (vitamin K) to a newborn. Which statement made by the parents indicates understanding why the healthcare provider is administering this medication?
- A. Improve insufficient dietary intake
- B. Stimulate the immune system
- C. Help an immature liver
- D. Prevent hemorrhagic disorders
Correct Answer: D
Rationale: The correct answer is D because phytonadione (vitamin K) is administered to newborns to prevent hemorrhagic disease due to their low levels of vitamin K, which is essential for blood clotting. Choice A is incorrect as vitamin K administration is not related to improving dietary intake. Choice B is incorrect as vitamin K doesn't stimulate the immune system. Choice C is incorrect as vitamin K is not given to help an immature liver, but rather to prevent hemorrhagic disorders.