Nokea
Narcotic analgesia is administered to a laboring patient at 10am. The infant is delivered at 12:30pm. The nurse would anticipate what?
- A. Neonatal respiratory depression
- B. Increased infant alertness
- C. Decreased fetal heart rate variability
- D. No effects on the neonate
Correct Answer: A
Rationale: Narcotic analgesia, when administered to a laboring patient, can cross the placenta and affect the infant. It can cause neonatal respiratory depression in the newborn after delivery. This is because the medication can depress the respiratory drive of the infant, leading to potentially serious breathing problems. It is important for the healthcare provider to closely monitor and assess the newborn for signs of respiratory distress in such cases.
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A newborn has a respiratory rate of 80 breaths/min, nasal flaring with sternal retractions, a heart rate of 120 beats/min, temperature of 36C and a persisting oxygen saturation of <87%. The nurse interprets these findings as:
- A. Cardiac distress
- B. Respiratory Alkalosis
- C. Bronchial pneumonia
- D. Respiratory Distress
Correct Answer: D
Rationale: The newborn's presentation with a respiratory rate of 80 breaths/min, nasal flaring with sternal retractions, a heart rate of 120 beats/min, and persisting low oxygen saturation (<87%) are indicative of respiratory distress. These signs suggest that the newborn is having difficulty breathing and may not be getting enough oxygen into their system. Respiratory distress in newborns is a serious condition that requires immediate attention and intervention to support breathing and oxygenation. It is crucial for healthcare providers to recognize and address respiratory distress promptly to prevent further complications.
The nurse is assessing a client at 36 weeks' gestation who reports swelling in the hands and face. What is the priority nursing action?
- A. Check the client’s blood pressure.
- B. Reassure the client that swelling is normal.
- C. Encourage the client to reduce salt intake.
- D. Evaluate the fetal heart rate.
Correct Answer: A
Rationale: Swelling in the hands and face may indicate preeclampsia, requiring immediate blood pressure assessment.
A nurse is instructing a client who is takingan oral contraceptive about danger signs to report to her provider. The nurse determines the client understands the teaching when the client states the need to report which of the following?
- A. Reduced menstrual flow.
- B. Breast tenderness.
- C. Shortness of breath.
- D. Headaches. Maternal exam 1 from Victoria
Correct Answer: C
Rationale: Shortness of breath is a potential danger sign that should be reported to the healthcare provider when taking oral contraceptives. It could indicate a serious side effect such as a blood clot in the lungs, also known as a pulmonary embolism, which can be a life-threatening condition. Therefore, it is important for the client to seek medical attention immediately if they experience sudden shortness of breath while on oral contraceptives. Reduced menstrual flow, breast tenderness, and headaches are common side effects of oral contraceptives and are not usually considered danger signs that require immediate medical attention.
The nurse is assessing a pregnant client who reports dizziness and lightheadedness when lying on her back. What is the priority intervention?
- A. Administer oxygen via face mask.
- B. Place the client in a left lateral position.
- C. Encourage deep breathing exercises.
- D. Increase IV fluid rate.
Correct Answer: B
Rationale: Supine hypotension syndrome is relieved by positioning the client on her left side to improve blood flow.
The nurse provides education regarding female sterilization. What important information is provided?
- A. “You will need to wait 3 months before you are sterile.â€
- B. “You can have this procedure in the hospital after you give birth.â€
- C. “Fertilization will affect your milk supply for breast-feeding.â€
- D. “Tubal ligation is reversible.â€
Correct Answer: D
Rationale: The important information provided regarding female sterilization is that tubal ligation, which is a form of female sterilization, is generally considered irreversible. This means that it is a permanent method of contraception and should not be relied upon as a temporary solution. It is important for individuals considering this procedure to understand that it is meant to be permanent and should be approached as such. If there is any consideration for future fertility, alternative contraceptive options should be discussed with a healthcare provider.