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A nurse is reinforcing teaching with a client who is at 24 weeks of gestation and has opioid use disorder.
Which of the following statements should the nurse make?
- A. You will be prescribed methadone.
- B. You will be prescribed aripiprazole.
- C. You will be prescribed diazepam.
- D. You will be prescribed naloxone.
Correct Answer: A
Rationale: Methadone is commonly prescribed for opioid use disorder in pregnancy, safely managing withdrawal and reducing relapse risk for mother and fetus.
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A nurse is reinforcing teaching about travel with a client who is pregnant.
Which of the following instructions should the nurse include?
- A. Take a break and walk at least once every hour.
- B. Wear the shoulder harness snug across your shoulder.
- C. Position the lap belt across your hips.
- D. Move your car seat forward, close to the steering wheel.
Correct Answer: A
Rationale: Taking breaks and walking hourly during travel improves circulation, reducing the risk of blood clots, a key concern during pregnancy.
A nurse is collecting data from a newborn.
The nurse should recognize that which of the following images demonstrates a positive Babinski reflex?
- A. Image showing toes fanning out when the sole is stroked.
- B. Image showing the newborn grasping a finger when the palm is touched.
- C. Image showing the newborn turning the head when the cheek is stroked.
- D. Image showing the newborn making stepping movements when held upright.
Correct Answer: A
Rationale: The image showing toes fanning out when the sole of the foot is stroked demonstrates a positive Babinski reflex, a normal newborn response indicating immature nervous system development.
A nurse is checking the reflexes of a newborn.
Which of the following actions should the nurse use to elicit the Babinski reflex?
- A. Place the newborn supine and apply pressure to the soles of the feet.
- B. Pull the newborn up by the wrist from a supine position.
- C. Touch the corner of the newborn's mouth.
- D. Stroke upward on the lateral aspect of the sole of the newborn's foot.
Correct Answer: D
Rationale: Stroking upward on the lateral sole elicits the Babinski reflex, causing toes to fan out, a normal newborn response.
History and Physical: The client reports a history of one previous cesarean section due to breech presentation. She smokes half a pack of cigarettes daily and has a BMI greater than 30. The client denies leakage of amniotic fluid and describes positive fetal movement. Vital Signs: Temperature: 98.6°F (37°C), Pulse: 88 beats/min, Respiratory Rate: 16 breaths/min, Blood Pressure: 128/78 mmHg, Oxygen Saturation: 98% on room air. Nurses' Notes (0830 and 0845): 0830: The client is grimacing and reports discomfort. Fetal heart rate is 148 beats per minute. Fundal height measures 28 cm. 0845: Uterine contractions every 2 to 3 minutes, moderate in intensity, lasting 60 seconds.
The nurse should recommend to first address the client's ___, followed by the client's ___.
- A. Uterine contraction frequency
- B. History of cesarean delivery
Correct Answer: A,B
Rationale: Frequent contractions indicate preterm labor risk at 30 weeks; prior cesarean increases uterine rupture risk, both needing prompt attention.
Nurses' Notes: The client, who is 28 weeks gestation, gravida 4, para 3, reports a history of vaginal bleeding for the past 2 hours. She states, 'I started bleeding a couple of hours ago, but now I am saturating pads with bright red blood. I’m scared something is going to happen to my baby.' Blood is trickling down her legs. She denies abdominal pain. A perineal pad is saturated with bright red vaginal bleeding. Physical Examination Results: Fundal height is 27 cm. No uterine contractions or irritability. Fetal heart rate: 170/min, minimal variability, no decelerations. Diagnostic Results: Urine: Leukocyte esterase positive, Nitrites positive, Red blood cells: 6.
Complete the diagram by dragging from the choices below to specify: Potential Condition, Actions to Take (Select 2), Parameters to Monitor (Select 2). Potential Condition Choices: A. Placenta previa, B. Abruptio placentae, C. Preterm labor, D. Uterine rupture. Actions: A. Administer methotrexate, B. Administer broad-spectrum antibiotics, C. Prepare for an emergency cesarean birth, D. Reinforce bed rest and maintain IV access, E. Encourage ambulation. Parameters: A. Fetal heart rate, B. Maternal oxygen saturation, C. WBC count, D. Urine output, E. Uterine contractions.
- A. Placenta previa
- B. Prepare for an emergency cesarean birth
- C. Reinforce bed rest and maintain IV access
- D. Fetal heart rate
- E. Maternal oxygen saturation
Correct Answer: A,C,D,A,B
Rationale: Painless bleeding suggests placenta previa; cesarean and bed rest manage it; fetal heart rate and oxygen saturation monitor stability.