Maternal Newborn Final Exam - Questions, Answers and Rationales A nurse in a prenatal clinic is caring for a client who is within the recommended
... [Show More] guideline for weight. The client asks the nurse how much weight is safe for her to gain during her pregnancy. Which of the following responses should the nurse make? A. your provider can discuss an appropriate amount of weight gain with you B. a weight gain of about 14 pounds each trimester is suggested C. if you eat nutritious food when you feel hungry, the amount of weight gain is insignificant D. a weight gain of about 25-35 pounds is good A weight gain of 25-35 lbs is associated with good fetal outcome. A gain of 4 lb in the first trimester and 12 lb for the second and third trimester is recommended A nurse is caring for a client who is in labor and has an epidural for pain relief. Which of the following is a complication from the epidural block? A. n/v B. tachycardia C. hypotension D. respiratory depression Maternal hypotension is an adverse effect of epidural anesthesia. The nurse should administer an IV fluid bolus prior to the placement of epidural anesthesia in order to decrease the likelihood of this complication A nurse is providing discharge teaching to a client following the removal of a hydatidiform mole. Which of the following statements should the nurse include in the teaching? A. do not become pregnant for at least 1 year B. seek genetic counseling for yourself and your partner prior to getting pregnant again C. you should have an hCG level drawn in 6 weeks D. have your blood pressure checked weekly for the next month Hydatidiform moles are uncontrolled growths in the uterus arising from placental or fetal tissue in early pregnancy. There is increased incidence of choriocarcionma associated with molar pregnancies. Pregnancy must be avoided for 1 year so the client can be closely monitored for manifestations of the condition. A baseline hCG level should be obtained following evacuation of the mole and then weekly until levels are normal for 3 consecutive weeks. Additional hCG levels should be obtained every 4 weeks for the next 6-12 months A nurse is planning care for a client who is at 35 weeks of gestation. Which of the following laboratory tests should the nurse obtain? A. rubella titer B. blood type C. group B strep B-hemolytic D. 1-hour glucose tolerance test Should obtain a vaginal/anal GBS culture at 35-37 weeks of gestation to screen for infection. Prophylactic antibiotics should be given during labor to the client who is positive for GBS. Rubella titer at first prenatal visit Blood type and Rh factor at first prenatal visit to determine if Rhogam is given at 28 weeks 1 hr GTT at 24-28 weeks to screen for gestational diabetes A nurse is caring for a client who is at 34 weeks of gestation and has a prescription for terbutaline for preterm labor. Which of the following statements by the client is the priority? A. my ankles are swollen at the end of the day B. I can feel the baby kicking my ribs, and it is very uncomfortable C. I’m growing more and more worried every day D. my heart feels as if it is racing The primary action of terbutaline is to cause bronchodilation and relax smooth muscle. However, an adverse effect is tachycardia. If the pulse is greater than 130/min, the terbutaline needs to be held until the provider is notified. A nurse is planning care for a newborn who requires phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan of care? A. swaddle the newborn in a receiving blanket during the treatment B. maintain NPO status until the newborn's bilirubin is within the expected reference range C. ensure the newborn's eyes are closed before applying the eye shield D. apply lotion to the newborn's skin twice per day Overexposure to the lights during treatment can cause damage to the newborn's corneas. Therefore, the nurse should gently close the newborn's eyes prior to applying the eye shield. A nurse administers betamethasone to a client who is at 33 weeks of gestation to stimulate fetal lung maturity. When planning care for the newborn, which of the following conditions should the nurse identify as an adverse effect of this medication? A. hyperthermia B. decreased blood glucose C. rapid pulse rate D. irritability Betametasone causes hyperglycemia, which predisposes the newborn to hypoglycemia in the first hours after delivery. It is important to assess the newborn's blood glucose level within the first hour following birth and frequently thereafter until blood glucose levels are stable. Does not have an effect on the newborn's vital signs A nurse is caring for a client who is at 16 weeks of gestation and has severe iron-deficiency anemia. The provider prescribes an injection of iron dextran IM. Which of the following methods should the nurse use to administer the medication? A. 20-gauge needle, administer using z-track method B. 22-gauge needle, administer deep into the thigh C. use a 25-gauge needle, administer into deltoid muscle D. 18-gauge needle, administer into rectus femoris muscle The nurse should administer iron using the z-track method to prevent staining of the tissue. 20-gauge needle is the correct size. Use ventrogluteal muscle. A 22-gauge needle is too small for iron injections. The nurse should administer the iron into the ventrogluteal muscle, not the thigh. A 25-gauge needle is very small and is not suitable for iron because iron is thicker than this gauge allows. This needle is short and typically only used for subcutaneous injections. The nurse should administer iron deep into the muscle. In addition, iron is never given in the deltoid, only the ventrogluteal muscle, as this is a larger muscle mass. An 18-gauge needle is too large. The nurse should administer the iron using the Z-track method into the ventrogluteal muscle. A nurse in an antepartum clinic answers a phone call from a client who is at 37 weeks of gestation and reports, "I became very dizzy while lying in bed this morning, but the feeling went away when I turned on my side." Which of the following actions should the nurse take? A. instruct the client about vena cava syndrome and measures to prevent it B. arrange for the client to come to the clinic for assessment C. check the client's chart for gestational diabetes mellitus D. schedule a NST A nurse is teaching a client about a nonstress test. Which of the following statements by the client indicates an understanding of the teaching? A. I know not to eat anything after midnight B. I will have medication given to me to cause contractions C. I should press the button on the handheld marker when my baby moves D. I will stimulate my breast to cause contractions [Show Less]