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The physician orders betamethasone (Celestone) for a 34-year-old multigravid client at 32 weeks' gestation who is experiencing preterm labor. Previously, the client has experienced one infant death due to preterm birth at 28 weeks' gestation. The nurse explains that this drug is given for which of the following reasons?
- A. To enhance fetal lung maturity.
- B. To counter the effects of tocolytic therapy.
- C. To treat chorioamnionitis.
- D. To decrease neonatal production of surfactant.
Correct Answer: A
Rationale: Betamethasone enhances fetal lung maturity.
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A multigravid client in active labor at 39 weeks' gestation has a history of smoking one to two packs of cigarettes daily. For which of the following should the nurse be alert when assessing the client's neonate?
- A. Hyperirritability.
- B. Hyperbilirubinemia.
- C. Low birth weight.
- D. Hypocalcemia.
Correct Answer: C
Rationale: Maternal smoking is strongly associated with low birth weight due to placental insufficiency and reduced fetal growth. Hyperirritability, hyperbilirubinemia, and hypocalcemia are less directly linked.
The nurse on the postpartum mother-baby unit is assigned to take care of four couplets and a new couplet will be admitted within the next 30 minutes. All assessments are complete. The nurse can delegate care for which couplet to the unlicensed nursing personnel?
- A. A G1 P1 with gestational diabetes who is 12 hours postpartum and who still requires insulin.
- B. A G4 P4 who is breast-feeding an 8 lb infant without difficulty.
- C. A G3 P3 postpartum client who is receiving Magnesium Sulfate and whose infant has a respiratory rate of 20.
- D. A G2 P2 who delivered vaginally 2 days ago with an infant having low blood glucose levels the first 24 hours post delivery.
Correct Answer: B
Rationale: The G4 P4 client with stable breastfeeding is appropriate for UAP delegation, as no complex medical needs are present.
An infant born premature at 34 weeks is receiving gavage feedings. The client holding her infant asks why the nurse places a pacifier in the infant's mouth during these feedings. The nurse replies that the pacifier helps in what ways? Select all that apply.
- A. Teaches the infant to suck and swallow.
- B. Provides oral stimulation.
- C. Keeps oral mucus membranes moist while the tube is in place.
- D. Reminds the infant how to suck.
- E. Stimulates secretions that help gastric emptying.
Correct Answer: B,D
Rationale: The pacifier provides oral stimulation and reminds the infant how to suck, promoting oral motor development.
The physician orders 1000 mL of Ringer's Lactate intravenously over an 8-hour period for a 29-year-old primigravid client at 16 weeks' gestation with hyperemesis. The drip factor is 12 gtts/mL. The nurse should administer the IV infusion at how many drops per minute?
- A. 25 gtts/minute.
- B. 30 gtts/minute.
- C. 35 gtts/minute.
- D. 40 gtts/minute.
Correct Answer: A
Rationale: Calculation: (1000 mL * 12 gtts/mL) / (8 hours * 60 minutes) = 25 gtts/minute.
The nurse is explaining to a primagravida in labor that her baby is in a breech presentation, with the baby’s presenting part in a left, sacrum, posterior (LSP) position. Which illustration should the nurse use to help the client understand how her baby is positioned?
- A. primagravida-1.png
- B. primagravida-2.png
- C. primagravida-3.png
- D. primagravida-4.png
Correct Answer: A
Rationale: This figure shows the client’s baby in a breech presentation with the baby facing the pelvis on the left, the sacrum as the presenting part, and the presenting part (sacrum) is posterior in the pelvis. Figure 2 shows a vertex presentation with the baby in a left, occiput, anterior position (LOA). Figure 3 shows a vertex presentation, left, occipit, posterior (LOP). Figure 4 shows a face position with the babyin a left, mentum, transverse position (LMT).