Nokea
An antepartal client is Rh negative and understands that she will receive a RhoGAM injection during her pregnancy. The client asks the nurse if she will also receive a RhoGAM injection after the birth of her baby. The client will receive RhoGAM after the birth if blood tests are:
- A. Mother Rh positive; baby Rh negative
- B. Mother Rh negative; Coombs positive; baby Rh negative
- C. Mother Rh positive; Coombs negative; baby Rh positive
- D. Mother Rh negative; Coombs negative; baby Rh positive
Correct Answer: D
Rationale: If the baby is Rh positive and the mother is Rh negative, the mother may develop antibodies against the baby's blood. RhoGAM is administered to prevent the mother's immune system from becoming sensitized to Rh-positive blood.
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A postpartum complication a client is at risk for is deep-vein thrombosis. Which of the following is a factor strongly associated with this postpartum complication?
- A. Cesarean birth
- B. Vaginal birth
- C. Anemia
- D. Multiparity
Correct Answer: A
Rationale: Cesarean birth doubles the risk for deep-vein thrombosis (DVT) due to immobility and vascular changes associated with surgery. Other risk factors include smoking, obesity, and a history of thromboembolism.
A nurse is admitting a client who is at 33 weeks of gestation and has preeclampsia with severe features. Which of the following actions should the nurse take?
- A. Restrict protein intake to less than 40 g/day
- B. Initiate seizure precautions for the client
- C. Initiate an infusion of 0.9% sodium chloride at 150 mL/hr
- D. Encourage the client to ambulate twice per day
Correct Answer: B
Rationale: The nurse should initiate seizure precautions because severe preeclampsia poses a high risk for seizures (eclampsia), ensuring the safety of the client.
A nurse is caring for a client in active labor. The nurse notes variable decelerations in the fetal heart rate. Which of the following is the priority nursing action?
- A. Administer oxygen
- B. Reposition the client
- C. Prepare for delivery
- D. Increase IV fluids
Correct Answer: B
Rationale: Variable decelerations are often caused by umbilical cord compression. Repositioning the client can help alleviate pressure on the cord and improve fetal oxygenation.
A nurse is caring for a client who is at 14 weeks of gestation and has hyperemesis gravidarum. Which of the following medications should the nurse plan to administer?
- A. Digoxin
- B. Calcium gluconate
- C. Vitamin B6
- D. Propranolol
Correct Answer: C
Rationale: Vitamin B6 (pyridoxine) is often used to treat nausea and vomiting in pregnancy, including hyperemesis gravidarum, and is considered safe for use in pregnant clients.
A nurse is providing teaching to a client who is 32 weeks pregnant and has a diagnosis of placenta previa. Which of the following instructions should the nurse include?
- A. Limit physical activity
- B. Monitor fetal movements daily
- C. Call the healthcare provider if contractions begin
- D. All of the above
Correct Answer: D
Rationale: Clients with placenta previa are at increased risk for bleeding and preterm labor. They should limit physical activity, monitor fetal movements, and notify their provider if they experience any contractions or signs of labor.