Nokea
Abnormal FHR patterns can result in which condition?
- A. Acidemia.
- B. Hypoxia.
- C. Hypoglycemia.
- D. Meconium stool.
- E. Maternal hypotension.
Correct Answer: A,B,D,E
Rationale: Abnormal FHR patterns can lead to acidemia, hypoxia, meconium passage, and maternal hypotension effects, but not directly hypoglycemia.
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A primiparous client was induced at 41-weeks gestation with misoprostol and oxytocin. She gave birth vaginally 4 days ago, and her prenatal course and delivery were uncomplicated. She was discharged home on day two with her newborn and has been breastfeeding around the clock. Discharge prescription included ferrous sulfate 325 mg PO twice daily. Client called her healthcare provider (HCP) this morning with fatigue, new onset of headache that was not relieved with ibuprofen, nausea, dizziness, weakness, and seeing “flashing lights.â€. Client was instructed to come to the hospital for evaluation. Based on the client's symptoms, the nurse determines additional assessments are needed. Select the 4 assessments the nurse should perform.
- A. Fingerstick hemoglobin.
- B. Urine for protein.
- C. Perineal assessment.
- D. Vision test.
- E. Skin turgor.
- F. Deep tendon reflexes.
- G. Lung sounds.
Correct Answer: B,D,F,G
Rationale: Urine protein, vision test, deep tendon reflexes, and lung sounds assess preeclampsia indicators like proteinuria, visual disturbances, CNS irritability, and pulmonary edema.
A client receiving a solution of magnesium sulfate suddenly develops right upper quadrant pain. After reviewing abnormal laboratory results, what action should the nurse implement? (Select all that apply)
- A. Evaluate fetal heart rate and contraction patterns.
- B. Obtain prescription to repeat hepatic panel.
- C. Monitor for evidence of seizure activity.
- D. Check the urinary output in hourly urinometer.
- E. Inspect the perineum for vaginal bleeding.
Correct Answer: A,B,C,D
Rationale: Monitoring fetal heart rate, repeating hepatic panel, checking for seizures, and assessing urinary output address potential HELLP syndrome and renal function in preeclampsia.
A client whose labor is being augmented with an oxytocin infusion requests an epidural for pain control. Findings of the last vaginal exam, performed 1 hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station. Which action should the nurse implement first?
- A. Request placement of the epidural.
- B. Give a bolus of intravenous fluids.
- C. Decrease the oxytocin infusion rate.
- D. Determine current cervical dilation.
Correct Answer: D
Rationale: Assessing current cervical dilation ensures labor progress is suitable for epidural placement, preventing complications like slowed labor.
A client at 9 weeks gestation tells the nurse that while she has cut down, she still has at least one alcoholic drink every evening before bedtime. Which intervention should the nurse implement?
- A. Notify child protective services of the client's illicit drug use and probable child endangerment.
- B. Praise the client for her actions and offer to discuss ways to decrease consumption even more.
- C. Refer the client to an outpatient alcohol abuse program for disulfiram therapy.
- D. Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit.
Correct Answer: B
Rationale: Praising reduced alcohol intake encourages further reduction, while offering support fosters a collaborative approach to minimize fetal alcohol exposure.
A newborn is delivered by cesarean section to a mother who is HIV-positive. The mother received antiretroviral therapy during pregnancy. Which intervention should the nurse implement?
- A. Encourage breastfeeding every 2 to 3 hours.
- B. Give zidovudine 6 to 12 hours after birth.
- C. Administer antibiotics for 7 to 10 days.
- D. Delay the initial bath for 1 to 2 days.
Correct Answer: B
Rationale: Zidovudine within 6-12 hours reduces HIV transmission risk in newborns of HIV-positive mothers, unlike breastfeeding, which is contraindicated, or antibiotics and delayed bathing, which are irrelevant.