Nokea
A client is to receive oxytocin to augment labor. Which finding contraindicates the initiation of the oxytocin infusion and should be reported to the provider?
- A. Late decelerations
- B. Moderate variability of the FHR
- C. Cessation of uterine dilation
- D. Prolonged active phase of labor
Correct Answer: A
Rationale: The correct answer is A. Late decelerations indicate fetal distress, suggesting compromised oxygenation. Starting oxytocin can further stress the fetus, worsening decelerations. Report to prevent harm. B is incorrect as moderate variability is a reassuring sign of fetal well-being. C is incorrect as cessation of uterine dilation may indicate uterine hyperstimulation, not fetal distress. D is incorrect as prolonged active labor phase alone doesn't necessarily contraindicate oxytocin, but it may require monitoring.
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When teaching a new mother how to use a bulb syringe to suction her newborn's secretions, which of the following instructions should the nurse include?
- A. Insert the syringe tip after compressing the bulb.
- B. Suction each nare before suctioning the mouth.
- C. Insert the tip of the syringe at the center of the newborn's mouth.
- D. Stop suctioning when the newborn's cry sounds clear.
Correct Answer: D
Rationale: The correct answer is D because it is important to stop suctioning when the newborn's cry sounds clear to avoid causing unnecessary discomfort or injury. Step 1: Gently compress the bulb syringe. Step 2: Insert the tip into the nostril, not the mouth. Step 3: Release the bulb to suction out the secretions. Step 4: Repeat in the other nostril. Incorrect choices: A is incorrect because you should insert the syringe tip before compressing the bulb. B is incorrect as you should suction the mouth before the nose. C is incorrect as you should not insert the syringe tip in the center of the mouth.
A client with pregestational type 1 diabetes mellitus is being taught by a nurse about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should aim to maintain my fasting blood glucose between 100 and 120.
- B. I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or higher.
- C. I will continue taking my insulin if I experience nausea and vomiting.
- D. I will avoid exercise if my blood glucose exceeds 250.
Correct Answer: C
Rationale: The correct answer is C because continuing to take insulin during nausea and vomiting is crucial for maintaining blood glucose control in clients with diabetes. Nausea and vomiting can lead to decreased food intake, risking hypoglycemia if insulin is not adjusted.
Choice A is incorrect because fasting blood glucose levels should ideally be maintained between 60-90 mg/dL in pregnant clients with diabetes for optimal outcomes, not 100-120 mg/dL.
Choice B is incorrect because engaging in moderate exercise when blood glucose is high (250 or higher) can exacerbate hyperglycemia rather than help in lowering blood glucose levels.
Choice D is incorrect because avoiding exercise when blood glucose exceeds 250 is not recommended. Exercise can help lower blood glucose levels and improve insulin sensitivity.
A healthcare professional in a provider's office is reviewing the medical record of a client who is in her first trimester of pregnancy. Which of the following findings should the healthcare professional identify as a risk factor for the development of preeclampsia?
- A. Singleton pregnancy
- B. BMI of 20
- C. Maternal age of 32 years
- D. Pregestational diabetes mellitus
Correct Answer: D
Rationale: The correct answer is D: Pregestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine during pregnancy. Pregestational diabetes is a known risk factor for developing preeclampsia due to the underlying vascular and inflammatory changes associated with diabetes. In contrast, choices A, B, and C are not typically considered risk factors for preeclampsia. A singleton pregnancy (choice A) is a normal occurrence and not a risk factor for preeclampsia. A BMI of 20 (choice B) falls within the healthy weight range and is not a known risk factor for preeclampsia. Maternal age of 32 years (choice C) is also not considered a significant risk factor for preeclampsia in the absence of other factors.
A caregiver is learning about newborn safety. Which of the following statements by a parent indicates an understanding of the teaching?
- A. I will dress my baby in flame-retardant clothing.
- B. I will ensure a bib on my baby at night to keep her clothing dry.
- C. I will warm my baby's formula using the lowest setting in the microwave.
- D. I will cover the crib mattress with plastic to prevent staining.
Correct Answer: A
Rationale: The correct answer is A because dressing the baby in flame-retardant clothing is a safety measure to reduce the risk of burns. Flame-retardant clothing can help protect the baby in case of accidental exposure to fire or heat sources.
Choice B is incorrect because putting a bib on the baby at night can pose a suffocation hazard. Choice C is incorrect because warming formula in the microwave can create hot spots that may burn the baby's mouth. Choice D is incorrect because covering the crib mattress with plastic can increase the risk of suffocation and overheating for the baby.
A healthcare professional is preparing to administer magnesium sulfate 2 g/hr IV to a client who is in preterm labor. Available is 20 g of magnesium sulfate in 500 mL of dextrose 5% in water (D5W). How many mL/hr should the IV infusion pump be set to administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
- A. 60
- B. 30
- C. 50
- D. 80
Correct Answer: C
Rationale: To calculate the mL/hr for the IV infusion pump, we need to use the formula: (Desired dose in mg/hr * Volume of solution in mL) / Concentration of solution in mg/mL.
Given:
Desired dose = 2 g/hr = 2000 mg/hr
Volume of solution = 500 mL
Concentration of solution = 20 g in 500 mL = 20,000 mg in 500 mL = 40 mg/mL
Now, plug these values into the formula:
(2000 mg/hr * 500 mL) / 40 mg/mL = 25,000 mL/hr
Round this to the nearest whole number, which is 25,000 mL/hr ≈ 50 mL/hr. Therefore, the IV infusion pump should be set to administer 50 mL/hr, making choice C the correct answer.
Option A (60 mL/hr) and Option D (80 mL/hr) are incorrect as they do not match the calculated value. Option