Nokea
A client who is pregnant states that her last menstrual period was April 1st. What is the client's estimated date of delivery?
- A. January 8
- B. January 15
- C. February 8
- D. February 15
Correct Answer: A
Rationale: The estimated date of delivery (EDD) is calculated by adding 280 days to the first day of the last menstrual period (LMP). In this case, April 1st + 280 days = January 8, which is the correct EDD. Choice A is correct. Choices B, C, and D are incorrect because they do not account for the 280-day gestation period from the LMP.
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When providing care for a client in preterm labor at 32 weeks of gestation, which medication should the nurse anticipate the provider will prescribe to hasten fetal lung maturity?
- A. Calcium gluconate
- B. Indomethacin
- C. Nifedipine
- D. Betamethasone
Correct Answer: D
Rationale: Step 1: Betamethasone is a corticosteroid that promotes fetal lung maturity by stimulating the production of surfactant, essential for lung function.
Step 2: At 32 weeks, the fetus may benefit from accelerated lung development to reduce respiratory distress.
Step 3: Calcium gluconate is used for hypocalcemia, not for fetal lung maturity.
Step 4: Indomethacin is a nonsteroidal anti-inflammatory drug used to delay preterm labor, not for lung maturity.
Step 5: Nifedipine is a calcium channel blocker to prevent preterm labor, not for fetal lung maturity.
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.
A charge nurse on the postpartum unit is observing a newly licensed nurse who is preparing to administer pain medication to a client. The charge nurse should intervene when the newly licensed nurse uses which of the following secondary identifiers to identify the client?
- A. The client's room number
- B. The client's telephone number
- C. The client's birth date
- D. The client's medical record number
Correct Answer: A
Rationale: The correct answer is A: The client's room number. Using the client's room number as a secondary identifier is not appropriate as it does not uniquely identify the client and can lead to errors. The room number may change, or there could be multiple clients in the same room. Telephone number, birth date, and medical record number are more reliable secondary identifiers as they are unique to the client and less likely to be confused with another individual. It is essential to use accurate and reliable identifiers to ensure patient safety and prevent medication errors.
While caring for a newborn undergoing phototherapy to treat hyperbilirubinemia, which of the following actions should the nurse take?
- A. Cover the newborn's eyes with an opaque eye mask while under the phototherapy light.
- B. Keep the newborn in a shirt while under the phototherapy light.
- C. Apply a light moisturizing lotion to the newborn's skin.
- D. Turn and reposition the newborn every 4 hours while undergoing phototherapy.
Correct Answer: A
Rationale: Correct Answer: A - Cover the newborn's eyes with an opaque eye mask while under the phototherapy light.
Rationale:
1. Phototherapy light can cause eye damage, so covering the newborn's eyes with an opaque eye mask protects them.
2. Newborns' eyes are more sensitive to light, making eye protection crucial during phototherapy.
Summary of Incorrect Choices:
B: Keeping the newborn in a shirt won't protect the eyes from phototherapy light.
C: Applying lotion can interfere with the effectiveness of phototherapy and may cause skin irritation.
D: Turning and repositioning the newborn is important for comfort, but eye protection is the priority during phototherapy.
A client who is 12 hours postpartum has a fundus located two fingerbreadths above the umbilicus, deviated to the right of the midline, and less firm than previously noted. Which of the following actions should the nurse take?
- A. Place the client in a side-lying position.
- B. Assist the client to the bathroom to void.
- C. Obtain a prescription for IV oxytocin.
- D. Administer methylergonovine.
Correct Answer: B
Rationale: The correct answer is B: Assist the client to the bathroom to void. This action can help promote uterine contractions by relieving bladder distention, which can cause the fundus to be displaced. Voiding can help the uterus return to its normal position and firmness. Placing the client in a side-lying position (A) may be helpful for fundal massage but addressing bladder distention is the priority. Obtaining a prescription for IV oxytocin (C) or administering methylergonovine (D) are not indicated as first-line interventions for a fundus located above the umbilicus postpartum.