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A nurse is caring for a client who is in labor and receiving oxytocin. Which of the following findings indicates that the nurse should increase the rate of infusion?
- A. Contractions every 5 min that last 30 seconds
- B. Montevideo units consistently 300 mm Hg
- C. Urine output of 20 mL/hr
- D. FHR pattern with absent variability
Correct Answer: A
Rationale: Contractions every 5 minutes lasting 30 seconds are inadequate for labor progression, indicating the need to increase oxytocin infusion to strengthen contractions.
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A nurse is caring for a client who is at 10 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Frequent vomiting with weight loss of 3 lb in 1 week
- B. Reports of mood swings
- C. Nosebleeds occurring approximately 3 times per week
- D. Increased vaginal discharge
Correct Answer: A
Rationale: Frequent vomiting with significant weight loss may indicate hyperemesis gravidarum, a condition that requires medical intervention to prevent dehydration and nutritional deficiencies.
Which of the following is a professional standard for nursing practice in maternal and newborn healthcare?
- A. Collaboration with interdisciplinary team members
- B. Advocacy for patients and families
- C. Incorporation of evidence-based practice
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, all of the above. Collaboration with interdisciplinary team members is crucial in providing holistic care in maternal and newborn healthcare. Advocacy for patients and families ensures their rights and preferences are respected. Incorporation of evidence-based practice ensures that nursing care is based on the best available research and clinical expertise. Therefore, selecting all of the above options is essential to uphold professional standards in nursing practice in maternal and newborn healthcare.
A nurse in a prenatal clinic is assessing a group of clients. Which of the following clients should the nurse see first?
- A. A client who is at 11 weeks of gestation and reports abdominal cramping.
- B. A client who is at 15 weeks of gestation and reports tingling and numbness in right hand.
- C. A client who is at 20 weeks of gestation and reports constipation for the past 4 days.
- D. A client who is at 8 weeks of gestation and reports having three bloody noses in the past week.
Correct Answer: A
Rationale: Abdominal cramping in early pregnancy can be a sign of a miscarriage or ectopic pregnancy, both of which require immediate evaluation and intervention.
What is the primary intervention for postpartum hemorrhage?
- A. Oxytocin infusion
- B. Methylergonovine injection
- C. Misoprostol administration
- D. Blood transfusion
Correct Answer: A
Rationale: The correct answer is A: Oxytocin infusion. Oxytocin is the first-line medication for postpartum hemorrhage as it helps to contract the uterus, reducing bleeding. It stimulates uterine contractions, which helps to control bleeding by compressing blood vessels. Methylergonovine (B) is contraindicated in hypertensive disorders, Misoprostol (C) is an alternative if oxytocin is not available, and Blood transfusion (D) is a supportive measure after the bleeding is controlled.
A nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will need to increase my insulin doses during the first trimester.
- B. I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or greater.
- C. I will continue taking my insulin if I experience nausea and vomiting.
- D. I will ensure that my bedtime snack is high in refined sugar.
Correct Answer: C
Rationale: Continuing to take insulin as prescribed, even when experiencing nausea and vomiting, is essential for maintaining blood glucose control during pregnancy.