Maternal Newborn Online Practice 2020 B full q

a nurse is caring for a client who is 48 hours postpartum following a vaginal birth. Which of the following findings should the nurse report to the provider? Warm, tender area on the calf Orthostatic hypotension Moderate lochia rubra Dysuria Cracked nipples

Warm, tender area on the calf Dysuria Cracked nipples

a nurse is planning to perform a blood collection via heel stick on a newborn. After performing hand hygiene and donning gloves, which of the following actions should the nurse plan to take next? Cleanse the newborn's heel with antiseptic and allow it to dry. Wrap the newborn's heel with a cloth moistened with warm water. Cuddle and comfort the newborn. Apply pressure to the newborn's heel by using a dry gauze square.

Wrap the newborns heel with a cloth moistened with warm water

A nurse is reinforcing education about the prevention of newborn abduction with a client who recently gave birth. Which of the following statements should the nurse identify as an indication that the client understands the instructions? "I can carry my baby back to the nursery in my arms." "An alarm will sound if someone removes my baby's safety device." "The nurse is not required to show their identification when taking my baby back to the nursery." "I can leave my baby in the bassinet while I take a shower."

An alarm will sound if someone removes my baby's safety device

Tonic neck reflex

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A nurse is assisting in the care of a client during the active phase of labor. Which of the following actions should the nurse take to promote the clients comfort? Prepare the client for a pudendal nerve block. Administer a sedative to the client. Encourage the client to push. Have the client perform relaxing breathing techniques.

Have the client perform relaxing breathing techniques.

A nurse is assisting with the care of a client who is pregnant and has preeclampsia. While the nurse is collecting data, the client has a seizure. Which of the following actions should the nurse take first? Monitor fetal heart tones. Measure the client's blood pressure. Insert indwelling urinary catheter. Turn the client on their side.

Turn the client on their side

a nurse in an antepartum clinic is reviewing laboratory test results for a group of clients. The nurse should notify the provider of which results? Hemoglobin 14 g/dL WBC count 14,000/mm3 Hematocrit 31% Platelets 200,000/mm3

Hematocrit 31%

a nurse is collecting data from a client who is receiving magnesium sulfate IV for preeclampsia. The nurse should identify which of the following findings as an indication of toxicity to report to the provider? Tinnitus Proteinuria 3+ Increased urine output Respiratory rate 10/min

Respiratory rate of 10/minute

a nurse is reinforcing teaching with a client who is pregnant and will undergo a 1 hour oral glucose tolerance test. Which of the following instructions should the nurse include? Provide a urine sample at the start of the test. Fast for 12 hr before the test. Avoid caffeine the morning of the test. Eat a low-carbohydrate diet 24 hr prior to the test.

avoid caffeine the morning of the test

a nurse is collecting data from a client who is at 37 weeks of gestation. Which of the following findings should the nurse report to the provider? Leukorrhea Nonpitting ankle edema Tingling in fingers Blurred vision

blurred vision

a nurse is collecting data from a client who is primigravida and has hyperthyroidism. Which of the following findings should the nurse expect? Lethargy Hoarseness Diaphoresis Cold intolerance

diaphoresis

A nurse is reinforcing teaching about breastfeeding with a client who has a 12- hour old newborn. Which of the following statements should the nurse identify as an indication that the client understands the instructions? "I will wipe the colostrum off my nipple before my baby feeds." "I should wake up my baby to feed during the night." "Since I am breastfeeding, I won't need to give my baby iron supplements until he's a year old." "I should start to pump my breasts after each feeding when I get home."

I should wake my baby up o feed during the night.

A nurse is reinforcing teaching about car safety with the guardian of a newborn. Which of the following statements by the guardian indicates an understanding of the teaching? "I will place the baby's car seat in a rear-facing position until she is 1 year old." "I will position the retainer clip at the level of the baby's armpits." "I will place the shoulder harness straps in a slot 2 inches above the baby's shoulders." "I will position the baby at a 60-degree angle in the car seat."

I will position the retainer clip at the level of my baby's armpits

A nurse is reinforcing teaching about newborn umbilical cord care with a client who is postpartum. Which of the following statements should the nurse identify as an indication that the client understands the instructions? "I will report any drainage from my baby's umbilical cord." "I will wash my baby's umbilical cord with soapy water." "I will expect my baby's umbilical cord to fall off in 2 to 3 days." "I will secure the diaper over my baby's umbilical cord."

I will report any drainage from my baby's umbilical cord.

a nurse is preparing to to administer phytonadine to a newborn. The nurse should plan to administer this medication by which of the following routes? Ophthalmic Intramuscular Subcutaneous Rectal

Intramuscular

a nurse is assisting with the admission of a newborn who has respiratory distress. While collecting data, which of the following should the nurse report to the provider? Nasal flaring Respiratory rate 60/min Intercostal retractions Grunting Heart rate 120/min

Nasal flaring Intercostal retractions Grunting

A nurse in a providers office is reinforcing teaching with a client. Which of the following statements should the nurse include? Provider Prescriptions: Norgestrel 0.075 mg PO dailyMetronidazole 500 mg PO twice a day for 7 days History and Physical: Spontaneous vaginal birth 6 months agoHistory of hypertensionClient reports vaginal discharge with a fish-like odorThin, watery vaginal secretions noted on pelvic examination Diagnostic Results: pH 5.0Whiff test positivePositive microscopic screening for bacterial vaginosis options: -"You should discontinue your medication if your urine appears dark in color." -"You should douche every other day for 1 week while taking your medication." -"You might experience a metallic taste in your mouth while taking your medication." -"Your partner will require medication treatment for this condition as well."

You might experience a metallic taste in your mouth while taking your medication A metallic taste in the mouth is a common adverse effect of metronidazole and does not warrant notification of the provider.

A nurse is reinforcing teaching about home safety precautions with a group of guardians. Which of the following instructions should the nurse include? "You should be able to place three fingers between the mattress and the sides of the crib." "You should ensure that crib slats are no more than 2.25 inches apart." "You should attach a pacifier to your baby's clothing." "You should set your water heater at 130 degrees Fahrenheit."

You should ensure that crib slats are no more than 2.25 inches apart

a nurse is reinforcing teaching about a nonstress test with a client who is at 33 weeks of gestation. Which of the following statements should the nurse include? "You will receive IV fluids throughout the test." "You will press a button when you feel the baby move." "You will need to avoid eating for 4 hours prior to the test." "You will be prompted to massage your nipples for the test."

You will press a button when you feel the baby move

A nurse is caring for a client following a cesarean birth. Which of the following actions should the nurse take to decrease the client's risk of developing thrombophlebitis? Have the client ambulate several times each day. Administer aspirin 80 mg orally once per day. Tell the client to expect leg pain for 48 hr. Apply warm compresses to the client's legs.

have the client ambulate several times a day

A nurse is reinforcing teaching with a client who is trying to become pregnant. Which of the following foods should the nurse recommend as the best source of folate? 1 cup cooked spinach One medium apple 240 mL (8 oz) 2% milk One large hard-boiled egg

1 cup cooked spinach

A nurse is collecting data from a client who gave birth 18 hours ago. Which of the following findings should the nurse identify as an indication of a postpartum complication? Fundus is palpable at 2 cm above the umbilicus. Temperature is 38° C (100.4° F). Lochia increases after breastfeeding. The perineal pad contains several small blood clots.

Fundus is palpable at 2cm above the umbilicus

a nurse in postpartum unit is caring for a client who has endometriosis and is 48 hours postpartum following a cesarean birth. Which of the following findings should the nurse anticipate? WBC 8,000/mm3 Erythrocyte sedimentation rate 15 mm/hr Respiratory rate 18/min Heart rate 110/min

Heart rate of 110

A nurse is contributing to the plan of care for a client who has hyperemesis gravidarum. Which of the following interventions should the nurse recommend? Encourage fluids with meals. Obtain a specimen for a uric acid level. Initiate a high-fat and low-protein diet. Monitor intake and output.

Monitor intake and output

A nurse is reinforcing teaching about formula preparation with the parent of a newborn. Which of the following information should the nurse include? Warmed formula can increase spitting up. Overdiluted formula can result in inadequate growth. The water used to prepare the formula must be sterile. Formula left in the bottle can be given at the next feeding.

Over-diluted formula can result in inadequate growth

A nurse is caring for a client who delivered vaginally 6 hours ago. Which of the following findings should the nurse report to the provider? Labial edema Fundus firm at the umbilicus WBC count 15,000/mm3 Perineal pad soaked in 15 min

Perineal pad soaked in 15 minutes

a nurse is caring for a 12 hr old male newborn who was delivered from a breech position. Which of the following findings should the nurse report to the charge nurse? Scrotum appears edematous. Skin appears jaundiced. Voiding has not occurred. The umbilical cord contains two arteries and one vein.

Skin appears jaundiced The nurse should report jaundice within the first 24 hr of life to the charge nurse. Pathologic jaundice can lead to severe neurologic disorders.

a nurse is collecting data from a client who is one day postpartum. Which of the following findings should the nurse identify as an indication of infection? BUN 15 mg/dL WBC 35,000/mm3 Urine specific gravity 1.025 Hgb 10 g/dL

WBC 35,000/mm3

a nurse is collecting data from a client who is 38 weeks of gestation. Which of the following findings should the nurse report to the provider? Glycosuria Leg cramps Insomnia Leukorrhea

glycosuria Glycosuria is a potential complication of gestational diabetes mellitus and the nurse should report this finding to the provider.

A nurse is assisting with the care of a client who is postpartum and is receiving lactated ringers 1,500 ml IV to infuse over 10 hours. The nurse should verify that the IV pump's settings will deliver how many mL/hour?

150mL/hr

a nurse is contributing to the plan of care for a client who has eclampsia. Which of the following interventions should the nurse plan to include as the priority immediately following a seizure? Initiate an IV line with an 18-gauge needle. Insert an indwelling urinary catheter. Administer oxygen via facemask at 10 L/min. Monitor the client during magnesium sulfate therapy.

Administer oxygen via face mask at 10L/min

A nurse is collecting data from the parent of a newborn immediately following birth. The parent states "she is so tiny we don't know how to pick her up without hurting her" which of the following actions should the nurse take first to promote parent-newborn attachment? Encourage rooming-in with the newborn during the hospital stay. Reinforce the need for all adult family members to engage in newborn care. Demonstrate to the parent how to hold the newborn. Provide privacy for the parent to examine the newborn.

Demonstrate to the parent how to hold the newborn

A nurse is contributing to the plan of care for a client who is pregnant and has intermittent constipation. Which of the following interventions should the nurse recommend in the plan? Take two docusate calcium capsules each evening. Use a hypertonic enema when episodes occur. Consume 10 mL (2 tsp) of mineral oil each morning. Drink 2 L of water per day.

Drink 2L of water per day

A nurse is reinforcing discharge teaching about home care with the patient of a newborn. Which of the following instructions should the nurse include? "Dress your newborn with two extra layers for the first week at home." "Give your newborn a bath once a day in the morning." "Cover your newborn with a lightweight blanket during naps." "Ensure the water temperature during your newborn's bath is maintained at 100 degrees Fahrenheit."

Ensure the water temperature during your newborns bath is maintained at 100 degrees Fahrenheit

A nurse is caring for a client who is in preterm labor and receiving betamethasone. Which of the following actions should the nurse take? Check the client's blood pressure every 15 min for 1 hr after administration. Monitor the client's magnesium level. Inject the medication into the client's vastus lateralis muscle. Inform the client that the medication can cause dizziness.

inject the medication into the vastus lateralis is muscle

a nurse is planning to reinforce discharge teaching about formula feeding with the guardian of a newborn. Which of the following instructions should the nurse plan to include? Provide the newborn with six to eight feedings during a 24-hr period. Ensure that the newborn receives 45 to 60 mL of formula per feeding during the first 48 hr. Offer water to the newborn between feedings. Delay burping the newborn until the feeding is complete.

provide the newborn with six to eight feedings during a 24 hour period

a nurse is assisting with monitoring a client after an amniocentesis. Which of the following findings should the nurse expect? FHR 120/min Vaginal bleeding Temperature of 39° C (102.2° F) Leakage of amniotic fluid

FHR 120/min

A nurse is collecting data from a 28 year old client who is requesting a prescription for an oral contraceptive. Which of the following information in the clients history should the nurse identify as a contraindication for the use of oral contraceptives? History of mononucleosis 1 year ago Frequent headaches with visual changes Reports of occasional heartburn in the evening Irregular menstrual cycles with dysmenorrhea

Frequent headaches with visual changes

A nurse is contributing to the plan of care for a newborn following a vaginal birth. Which of the following information should the nurse include when helping to develop the newborns plan of care? Maternal group B streptococcus (GBS) status Apgar score Maternal urinary output Type of birth Maternal weight

GBS Apgar score Type of birth

A nurse is contributing to the plan of care for a client who is at 18 weeks gestation and has just learned that the fetus has a trisomy 21. Which of the following resources should the nurse recommend for the client?

Genetic counseling

A nurse is assisting with the care of a client who is in the active phase of the first stage of labor. Which of the following findings should the nurse report to the charge nurse? FHR 155/min Uterine contractions 70 seconds in duration Green fluid from the vagina Early decelerations

Green fluid from the vagina

A nurse is reinforcing teaching with a client who has a new prescription for medroxyprogesterone acetate injection for contraception. Which of the following statements by the client indicates understanding of the teaching? "I should not receive this medication while I am breastfeeding." "I will need monthly injections of this medication." "I am likely to gain weight while taking this medication." "I should limit my calcium intake while taking this medication."

I am likely to gain weight while taking this medication

A nurse is assisting in care with a client who is at 39 weeks of gestation. Which of the following statements should alert the nurse as a sign of a potential complication? "I have pain in my upper right abdomen." "My feet and ankles are swollen." "I feel like I can't breathe when I'm lying down." "I have occasional numbness in my fingers."

I have pain in my upper right abdomen

a nurse is reinforcing teaching with a client who is at 8 weeks of gestation. Which of the following responses by the client indicates an understanding of the teaching? "I should feel fetal movements by 12 weeks of pregnancy." "I should expect my pregnancy to start showing after the 20th week." "I should report occasional nausea and vomiting to the doctor immediately." "I should expect to have white vaginal discharge during pregnancy."

I should expect to have white vaginal discharge during pregnancy

a nurse is reinforcing discharge teaching with a client who has mastitis of the left breast. Which of the following instructions should the nurse include? Use a nipple shell on the unaffected breast. Formula-feed the newborn until mastitis subsides. Pump the affected breast frequently. Apply cabbage leaves to reduce pain.

Pump the affected breast immediately

A nurse on a postpartum unit is contributing to the discharge teaching plan for a client. Which of the following instructions should the nurse suggest for the plan? Apply powder to the newborn's skin after baths. Use a firm mattress in the newborn's crib. Cover the newborn with a crib comforter. Place the newborn on their stomach to sleep.

Use a firm mattress in the newborns crib

A nurse in a clinic is collecting data from a client who is at 12 weeks of gestation. Which of the following actions should the nurse take? Use an ultrasound stethoscope to listen to fetal heart tones. Obtain a blood sample for the maternal serum alpha-fetoprotein (MSAFP) screen. Collect a vaginal and an anal specimen for group B Streptococcus (GBS). Measure fundal height for gestational age.

Use an ultrasound stethoscope to listen to fetal heart tones.

a nurse is reinforcing teaching with a client who requests hydrotherapy for pain management during labor. Which of the following statements should the nurse include? "You must be at least at 37 weeks of gestation before you can use hydrotherapy." "You will receive an injection of sterile water into your lower back during hydrotherapy." "You can continue to use hydrotherapy as long as you do not develop a fever greater than 101 degrees Fahrenheit." "You should keep the water temperature above 100 degrees Fahrenheit during hydrotherapy."

You must be at least 37 weeks of gestation before you can use hydrotherapy

A nurse is reinforcing teaching about preventing urinary tract infections with a client who is at 25 weeks of gestation. Which of the following instructions should the nurse include? "You should perform Kegel exercises four times per day." "You should empty your bladder before you go to bed at night." "You should wipe from back to front after urinating." "You should wear underwear made from nylon."

You should empty your bladder before you go to bed at night. The nurse should instruct the client to urinate and empty the bladder completely before going to bed at night to prevent stasis of urine. A full bladder provides an environment that fosters bacterial growth.

a nurse is collecting data from a client who is receiving magnesium sulfate. Which of the following findings should the nurse report to the provider? Flushed skin Respiratory rate 22/min Absent deep-tendon reflexes Urinary output 35 mL/hr

absent deep tendon reflexes