Nokea
The healthcare provider prescribes magnesium sulfate 6 grams intravenously (IV) to be infused over 20 minutes for client with preterm labor. The IV bag contains magnesium sulfate 20 grams in dextrose 5% in water 500 mL. How many mL/hour should the nurse set the infusion pump? (Enter numerical value only.)
Correct Answer: 450
Rationale: To deliver 6 grams over 20 minutes from a solution of 20 grams in 500 mL, the concentration is 25 mL/g. Thus, 6 grams requires 150 mL over 20 min, which is (150 mL / 20 min) x 60 = 450 mL/hour.
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A client at 18-weeks gestation was informed this morning that she has an elevated alpha-fetoprotein (AFP) level. After the healthcare provider leaves the room, the client asks what she should do next. What information should the nurse provide?
- A. Discuss options for intrauterine surgical correction of congenital defects.
- B. Inform her that a repeat alpha-fetoprotein (AFP) should be evaluated.
- C. Reassure the client that the AFP results are likely to be a false reading.
- D. Explain that a sonogram should be scheduled for definitive results
Correct Answer: D
Rationale: An elevated AFP level is a screening indicator, not a diagnosis. A sonogram is the next step to assess for neural tube defects or other anomalies, providing definitive information.
The nurse is providing preconception counseling. Which supplement should the nurse recommend to help prevent the occurrence of anencephaly?
- A. Calcium.
- B. Iron
- C. Folic acid.
- D. Vitamin D.
Correct Answer: C
Rationale: Folic acid is essential for preventing neural tube defects, including anencephaly, and is recommended for women of childbearing age.
An unlicensed assistive personnel (UAP) reports to the charge nurse that a client who delivered a 7-pound (3,175 gram) infant 12 hours ago is reporting a severe headache. The client's blood pressure is 110/70 mm Hg, respiratory rate is 18 breaths/minute, heart rate is 74 beats/minute, and temperature is 98.6° F (37° C). The client's fundus is firm and one fingerbreadth above the umbilicus. Which action should the charge nurse implement first?
- A. Assign a practical nurse (PN) to reassess the client's vital signs.
- B. Obtain a STAT hemoglobin and hematocrit
- C. Notify the healthcare provider of the assessment findings
- D. Determine if the client received anesthesia during delivery
Correct Answer: C
Rationale: A severe headache post-delivery may indicate a post-dural puncture headache, especially if anesthesia was used, requiring immediate notification of the healthcare provider.
A nurse is speaking with a client who is addicted to heroin and who just learned that she is pregnant. The client states, 'I just started taking methadone. Is there anything else I can do to make sure my baby is healthy?' Which information should the nurse provide?
- A. Describe genetic testing protocols
- B. Discontinue the methadone right away
- C. Sign up for group therapy sessions
- D. Start a prenatal care plan as soon as possible
Correct Answer: D
Rationale: Early prenatal care is critical for monitoring maternal and fetal health, managing opioid addiction with methadone under medical supervision, and addressing potential complications.
A multiparous client with active herpes lesions is admitted to the unit with spontaneous rupture of membranes. Which action should the nurse take?
- A. Prepare for a cesarean section
- B. Cover the lesion with a dressing
- C. Obtain blood cultures
- D. Administer penicillin.
Correct Answer: A
Rationale: Active herpes lesions pose a risk of neonatal herpes transmission during vaginal delivery. Preparing for a cesarean section is the priority to minimize this risk.