Nokea
At 38 weeks' gestation, a primigravid client with poorly controlled diabetes and severe preeclampsia is admitted for a cesarean delivery. The nurse explains to the client that delivery helps to prevent which of the following?
- A. Neonatal hyperbilirubinemia.
- B. Congenital anomalies.
- C. Perinatal asphyxia.
- D. Stillbirth.
Correct Answer: D
Rationale: Delivery helps prevent stillbirth in high-risk pregnancies.
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Three days after admission of a neonate delivered at 30 weeks' gestation, the neonatologist plans to assess the neonate for periventricular-intraventricular hemorrhage (PIVH). The nurse should plan to assist the neonatologist by preparing the neonate for which of the following?
- A. Computed tomography scan.
- B. Arterial blood specimen collection.
- C. Radiographs of the skull.
- D. Complete blood count specimen collection.
Correct Answer: A
Rationale: A computed tomography scan is used to assess for PIVH, as it visualizes bleeding in the brain.
A laboring client with preeclampsia is prescribed magnesium sulfate 2 g/hour I.V. piggyback. The pharmacy sends the I.V. to the unit labeled magnesium sulfate 20 g/500 mL normal saline. To deliver the correct dose, the nurse should set the pump to deliver how many milliliters per hour?
Correct Answer: 50
Rationale: To calculate the correct dose: (2 g/hour * 500 mL) / 20 g = 50 mL/hour.
When caring for a neonate born at 30 weeks' gestation who is in an isolette and receiving continuous oxygen, which of the following would the nurse use as the best method to determine the effectiveness of this treatment?
- A. Evidence of cyanosis on mouth, hands, and feet.
- B. Continuous pulse rate monitoring.
- C. Arterial blood gas levels.
- D. Percentage of oxygen delivered.
Correct Answer: C
Rationale: Arterial blood gas levels provide the most accurate assessment of oxygenation and ventilation status, indicating the effectiveness of oxygen therapy.
A neonate at 37 weeks' gestation is delivered by cesarean delivery because of placenta previa. Which of the following would the circulating nurse do first as soon as the neonate is delivered?
- A. Stimulate the neonate to cry vigorously.
- B. Aspirate mucus from the mouth with a bulb syringe.
- C. Begin resuscitation procedures with a bag and mask.
- D. Hold the neonate upright for the mother to view.
Correct Answer: B
Rationale: Aspirating mucus from the mouth with a bulb syringe clears the airway, which is the first priority to ensure breathing.
A primigravid client with insulin-dependent diabetes tells the nurse that the contraction stress test performed earlier in the day was suspicious. The nurse interprets this test result as indicating that the fetal heart rate pattern showed which of the following?
- A. Frequent late decelerations.
- B. Decreased fetal movement.
- C. Inconsistent late decelerations.
- D. Lack of fetal movement.
Correct Answer: C
Rationale: Suspicious results indicate inconsistent late decelerations.