ATI RN Maternal Newborn Online Practice 2019 B with NGN

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A nurse is teaching a client who is at 24 weeks of gestation regarding a 1-hr glucose tolerance test. Which of the following statements should the nurse include in the teaching ?

"A blood glucose of 130 to 140 is considered a positive screening result." The nurse should teach the client that a blood glucose level of 130 to 140 mg/dL is considered a positive screening. If the client receives a positive result, she will need to undergo a 3-hr glucose tolerance test to confirm if she has gestational diabetes mellitus.

A nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

"I will continue taking my insulin if I experience nausea and vomiting" The nurse is teaching a client to continue to take her insulin as prescribed her illness to prevent hypoglycemic and hyperglycemic episodes

A nurse is teaching a client who is in preterm labor about terbutaline. Which of the following statements by the client indicates an understanding of the teaching?

"I will have blood tests because my potassium might decrease." An adverse effect of terbutaline is hypokalemia.

A nurse is teaching a client who is Rh negative about Rh0(D) immune globulin. Which of the following statements by the client indicates an understanding of the teaching

"I will need this medication if I have an amniocentesis." Rho(D) immune globulin is given to clients who are Rh negative following an amniocentesis because of the potential of fetal RBCs entering the maternal circulation.

A nurse is caring for a client who is experiencing preterm labor at 29 weeks of gestation and has a prescription for betamethasone. Which of the following statements should the nurse make about the indication for medication administration?

"This medication stimulates fetal lung maturity." The nurse should inform the client that betamethasone is a glucocorticoid that enhances fetal lung maturity by promoting the release of enzymes that release lung surfactant.

A nurse in a prenatal clinic is caring for a client who reports that her menstrual period is 2 weeks late. The client appears anxious and asks the nurse if she is pregnant. Which of the following responses should the nurse make?

"You can miss your period for several other reasons. Describe your typical menstrual cycle." Amenorrhea is a presumptive sign of pregnancy, not a positive sign. Therefore, the nurse should explore the client's menstrual cycle to determine other necessary interventions.

A nurse is providing teaching about family planning to a client who has a new prescription for a diaphragm. Which of the following statements should the nurse include in the teaching?

"You should leave the diaphragm in place for at least 6 hours after intercourse." The client should keep the diaphragm in place for at least 6 hr after intercourse to provide protection against pregnancy.

A school nurse is providing teaching to an adolescent about levonorgestrel contraception. Which of the following information should the nurse include in the teaching ?

"You should take the medication within 72 hours following unprotected sexual intercourse." Levonorgestrel is an emergency contraceptive which inhibits ovulation to prevent conceptionThe nurse should instruct the adolescent to take this medication as soon as possible within 72 hr after unprotected sexual intercourse

A nurse is teaching a new parent of a newborn safety. Which of the following instructions should the nurse include in the teaching?

"you can share your room with your baby for the next few weeks" The nurse should recommend room-sharing during the first few weeks. This allows the parent to be readily available to the newborn and learn the newborn's cuesHowever, the nurse should instruct the parent to avoid placing the newborn in their bed as it increases the risk for sudden infant death syndrome .

A nurse is preparing to administer azithromycin to a client who is at 16 weeks of gestation and has a positive chlamydia culture. The prescription states "Administer azithromycin 1 g orally now.Available is 250 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number . Use a leading zero if it applies . Do not use a trailing zero.)

4 tablets

A nurse at a providers office is caring for a client who is 28 years of age. Select 3 findings that require immediate follow up.

Abdomen assessment is correct. The client reports dull abdominal pain and rates it as 2 on 0 to 10 pain scale. The nurse noted right lower quadrant abdominal tenderness during their assessmentwhich is an unexpected finding that requires immediate follow up. Vaginal spotting is correct. Spotting is defined as a scant amount of vaginal bleeding. The client reports spotting along with a late menstrual period, which are unexpected findings that require immediate follow up . Menstrual period is correct. The client reports a usual regular menstrual period: however it is currently late by 2 weeks. This is an unexpected finding that requires immediate follow up.

A nurse is planning discharge for a client who is 3 days postpartum. Which of the following nonpharmacological interventions should the nurse include in the plan of care for lactation suppression?

Apply cabbage leaves to the breasts. Plant sterols and salicylates from cabbage leaves can help to relieve swelling and discomfort caused by breast engorgement.

A nurse is caring for a client who is in labor and whose fetus is in the right occiput posterior position. The client is dilated to 8 cm and reports back pain. Which of the following actions should the nurse take?

Apply sacral counterpressure. The nurse should apply sacral counterpressure to assist in relieving back labor pain related to fetal posterior position.

A nurse is assessing a client who gave birth vaginally 12 hr ago and palpates her uterus to the right above the umbilicus. Which of the following interventions should the nurse perform?

Assist the client to empty her bladder. The nurse should assist the client to empty her bladder because the assessment findings indicate that the client's bladder is distended. This can prevent the uterus from contracting, resulting in increased vaginal bleeding or postpartum hemorrhage.

A nurse is reviewing laboratory results of a newborn who is 4 hr old. Which of the following findings should the nurse report to the provider?

Bilirubin 9 mg/dL A bilirubin level of 9 mg/dL is above the expected reference range for a newborn who is 4 hr old. The expected reference range for a newborn who is less than 24 hr old is 2 to 6 mg/dL. The nurse should report this finding to the provider.

A nurse is caring for a client who is at 41 weeks of gestation and has a positive contraction stress test . For which of the following diagnostic test should the nurse prepare the client ?

Biophysical profile (BPP) The nurse should prepare the client for a BPP to further assess fetal well-beingA positive contraction stress test indicates there is potential uteroplacental insufficiency. A BPP uses a real time ultrasound to visualize physical and physiological characteristics of the fetus and observe for fetal biophysical responses to

A nurse is reviewing the laboratory report of a newborn who is 24 hr old. Which of the following results should the nurse report to the provider?

Blood glucose 30 mg/dL Newborns less than 24 hr old should have a blood glucose of 40 to 60 mg/dL. Newborns who are greater than 24 hr old should have a blood glucose of 50 to 90 mg/dL. A blood glucose level of 30 mg/dL is below the expected reference range for a newborn who is 24 hr old and should be reported to the provider.

A nurse is performing an assessment on the client. Which of the following findings should the nurse report to the provider? Select all that apply.

Blood pressure 152/110 mm Hg is correct. The client's blood pressure is above the expected reference range. An elevated blood pressure can be an indication of anxiety or preeclampsiatherefore, the nurse should report this finding to the provider. +2 pitting edema is correct. The client has +2 pitting edema, which may not be indicative of any disorder but should be investigated, especially if it is occurring with other manifestations; therefore, the nurse should report this finding to the provider Headache is correct. The client reports a headache that began 1 hr ago. A headache that coincides with an elevated blood pressure might be an indication of preeclampsia therefore, the nurse should report this finding to the provider. Heartburn is correct. The client reports heartburn that began 1 hr ago. Although heartburn can occur after eatingthe client is also experiencing other manifestations along with the heartburntherefore, the nurse should report this finding to the provider

A nurse is assessing a newborn following a circumcision. Which of the following findings should the nurse identify as an indication that the newborn is experiencing pain?

Chin quivering Behavioral responses to a newborn's pain include facial expressions such as chin quivering, grimacing, and furrowing of the brow.

The nurse has reviewed the recent nurses notes and diagnostic results. Click to highlight the findings that indicate the current condition is not improving

Clonus positive. DTRs 4+ is correct. The nurse should identify that the client's reflex irritability has increased, and the client is now at greater risk for seizure activitytherefore, this finding indicates the client's condition is not improving Reports headache as 4 on 0 to 10 pain scale is correct. The nurse should identify that the client's headache is worsening, which indicates increased cerebral irritability and places the client at a greater risk for seizure activity therefore, this finding indicates the client's condition is not improving Platelets 95000 / m * m ^ 3 ( 150,000 to 400000 / m * m ^ 3 ) is correct. The nurse should identify that the client's platelet level is below the expected reference range which indicates that the client's preeclampsia is worseningtherefore, this finding indicates the client's condition is not improving Aspartate aminotransferase ( AST) 60 units/L (0 to 35 units/L) is correct. The nurse should identify that the client's AST level is above the expected reference range, which indicates that the client's preeclampsia is worsening therefore, this finding indicates the client's condition is not improving Alanine aminotransferase (ALT) 50 units/ L (0 to 36 /L) is correct. The nurse should identify that the client's ALT level is above the expected reference range, which indicates that the client's preeclampsia is worsening: therefore this finding indicates the client's condition is not improving

A nurse is caring for a newborn who is undergoing phototherapy to treat hyperbilirubinemia. Which of the following actions should the nurse take?

Cover the newborn's eyes while under the phototherapy light. Applying an opaque eye mask prevents damage to the newborn's retinas and corneas from the phototherapy light.

A nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura (ITP). Which of the following findings should the nurse expect?

Decreased platelet count A client who has ITP has an autoimmune response that results in a decreased platelet count.

A nurse is planning care for a client who is 2 hr postpartum. Which of the following interventions should the nurse plan to implement during the taking-hold phase of postpartum behavioral adjustment?

Demonstrate to the client how to perform a newborn bath. Demonstrating to the client how to perform a newborn bath occurs during the taking-hold phase. The new parent moves from being passively dependent to taking a stronger interest in her new role as a mother. She is now focusing on the care her newborn and acquiring parenting skills. The nurse should provide positive reinforcement during this phase to give the new parent confidence and promote maternal adjustment.

A nurse is caring for a client who becomes unresponsive upon delivery of the placenta. Which of the following actions should the nurse take first?

Determine respiratory function. The priority action the nurse should take when using the airway, breathing, circulation approach to client care is to determine respiratory function and the need for cardiopulmonary resuscitation.

A nurse in the antepartum clinic is assessing a client's adaptation to pregnancy. The client states that she is, "happy one minute and crying the next." The nurse should interpret the client's statements as an indication of which of the following?

Emotional lability The nurse should recognize and interpret the client's statement as an indication of emotional lability. Many clients experience rapid and unpredictable changes in mood during pregnancy. Intense hormonal changes may be responsible for mood changes that occur during pregnancy. Tears and anger alternate with feelings of joy or cheerfulness for little or no reason.

A nurse is caring for a client who is at 22 weeks of gestation and reports concern about the blotchy hyperpigmentation on her forehead. Which of the following actions should the nurse take?

Explain to the client this is an expected occurrence. Chloasma, also referred to as the mask of pregnancy, is a blotchy, brown hyperpigmentation of the skin over the cheeks, nose, and forehead. It is seen most often in dark-skinned women and is caused by an increase in melanotropin during pregnancy. This condition appears after 16 weeks of gestation and increases gradually until delivery for 50 to 70% of women. Therefore, the nurse should reassure the client that this is an expected occurrence which usually fades after delivery.

A nurse is preparing to administer oxytocin to a client who is postpartum. Which of the following findings is an indication for the administration of the medication?

Flaccid uterus Excess vaginal bleeding Flaccid uterus is correct. Oxytocin increases the contractility of the uterus. Excess vaginal bleeding is correct. Oxytocin enhances uterine contractility, decreasing vaginal bleeding

A nurse is reviewing the laboratory results for a client who is at 10 weeks of gestation. Which of the following laboratory findings should the nurse report to the provider?

Hemoglobin 10 g/dL A hemoglobin level of 10 g/dL is below the expected reference range of greater than 11 g/dL for a client who is pregnant. The nurse should report this laboratory finding to the provider.

A nurse at the providers office is caring for a client who is 28 years of age. The nurse is preparing the client for surgery which of the following actions should the nurse take

Inform the client to be NPO prior to surgery is correct. The nurse should inform the client to be prior to surgery. This will prevent aspiration during surgery Insert an 18-gauge peripheral IV prior to surgery is correct. The nurse should provide access prior to surgery by inserting a larger bore such as an 18- or 20-gauge. An IV is used to administer IV fluids or blood products during surgery. Obtain a complete blood count is correct. The nurse should obtain a complete blood count to establish baseline data prior to surgery Verify a consent form is signed by the client is correct. The nurse should verify that the client has signed a consent form for surgery . This is mandatory prior to any surgical procedure.

A nurse is planning care for a client who is to undergo a nonstress test. Which of the following actions should the nurse include in the plan of care?

Instruct the client to press the provided button each time fetal movement is detected. Fetal movement may not be evident on the fetal monitor and tracing. Instructing the client to press the button when she detects fetal movement will ensure that the fetal movement is noted.

A nurse in a women's health clinic is providing teaching about nutritional intake to a client who is at 8 weeks of gestation. The nurse should instruct the client to increase her daily intake of which of the following nutrients?

Iron The recommendation for iron intake during pregnancy is higher than that for women who are not pregnant. For women who are pregnant, it is 27 mg/day. For women who are not pregnant, it is 15 mg/day for women younger than 19 years old and 18 mg/day for women between the ages of 19 and 50 years old.

A nurse is assessing a newborn for manifestations of hypoglycemia. Which of the following findings should the nurse expect?

Jitteriness Jitteriness, tachypnea, retractions, nasal flaring, lethargy, temperature instability, apnea, abnormal cry, poor feeding, and seizures are expected findings of hypoglycemia. Newborns who are small or large for gestational age and late preterm newborns are at an increased risk for hypoglycemia.

A nurse is caring for a client following an amniocentesis at 18 weeks of gestation. Which of the following findings should the nurse report to the provider as a potential complication?

Leakage of fluid from the vagina Leakage of fluid from the vagina could indicate premature leakage of amniotic fluid and should be reported to the provider.

A nurse is assessing fetal heart tones for a client who is pregnant. The nurse has determined the fetal position as left occipital anterior. To which of the following areas of the client's abdomen should the nurse apply the ultrasound transducer to assess the point of maximum intensity of the fetal heart?

Left lower quadrant The fetal heart tones of a fetus in the left occipital anterior position are best heard in the left lower quadrant.

A nurse on a postpartum unit is caring for a client who is experiencing hypovolemic shock. After notifying the provider, which of the following actions should the nurse take next?

Massage the client's fundus. The greatest risk to the client is hemorrhage. Therefore, the next action the nurse should take is to massage the client's fundus to expel clots and promote contractions.

A nurse is planning care for a client who is in labor and is requesting epidural anesthesia for pain controlWhich of the following actions should the nurse include in the plan of care?

Monitor the clients blood pressure every 5 min following the first dose of anesthetic solution. The nurse should plan to obtain a baseline blood pressure prior to the initiation of anesthetic solution . The nurse should then continue to monito the client's blood pressure every 5 to 10 min to assess for maternal hypotension caused by the anesthetic solution

A nurse at a providers office is caring for a client was 28 years of age. A nurse is evaluating the client following surgery. Which of the following findings indicate the client is experiencing a potential complication of the surgery that requires immediate follow up.

Neurological findings of drowsiness and easy arousal are expected postoperativelytherefore, no follow up is required by the nurse. The client's temperature is below the expected reference range, which can be an indication of hypothermia. The client's oxygen saturation is below the expected reference range which can be an indication of decreasing oxygen levels associated with anesthesia. The client's blood pressure is below the expected reference range which can be a result of anesthesia or the client's low temperature. The client's temperature, oxygen saturation, and blood pressure all require immediate follow-up by the nurse. An integumentary finding of moistcool skin is unexpected and requires follow up by the nurse. This finding might indicate hypothermia. A cardiopulmonary finding of +1 pedal pulses bilaterally requires follow up by the nurse. This indicates decreased circulation and perfusion.

A nurse is reviewing the medical record of a newly admitted client who is at 32 weeks of gestation. Which of the following conditions is an indication for fetal assessment using electronic fetal monitoring ?

Oligohydramnios The nurse should identify that oligohydramnios requires further fetal assessment using electronic fetal monitoring. Other conditions that require further assessment include hypertensiondiabetesintrauterine growth restriction renal disease decreased fetal movement previous fetal death post-term pregnancy, systemic lupus erythematosus and intrahepatic cholestasis.

The nurse is reviewing the clients electronic medical record. Which of the following actions should the nurse take?

Place on seizure precautions is correct . The nurse should place the client on seizure precautions because the client has preeclampsia and is receiving magnesium sulfate. Administer magnesium sulfate IV bolus as prescribed is correct. The nurse should administer magnesium sulfate IV bolus as prescribed because this medication helps to prevent the client from progressing to eclampsia . Monitor the client's blood pressure every hour is incorrect . The nurse should monitor the blood pressure of a client who is receiving magnesium sulfate every 15 to 30 min. Obtain the creatinine, platelet, BUN, and liver enzymes values as prescribed is correct. The nurse should obtain baseline laboratory values to monitor progression of the client's condition. Assess for worsening headache and epigastric pain hourly and PRN is correct. The nurse should assess for worsening headache and epigastric pain to determine if the client's condition is deteriorating Monitor level of consciousness , DTRs, and visual disturbances hourly is correct. The nurse should monitor the client's level of consciousness , DTRS and visual disturbances hourly and PRN to determine if the client's condition is deteriorating

A nurse is providing discharge teaching to the parents of a newborn about car seat safety. Which of the following instructions should the nurse include?

Place the retainer clip at the level of the newborn's armpits. The nurse should instruct the parents to place the newborn in a federally approved car seat with the retainer clip snugly at the level of the newborn's armpits.

A nurse is reviewing the medical record of a client who is postpartum and has preeclampsia. Which of the following laboratory results should the nurse report to the provider?

Platelets 50,000/mm3 A platelet count of 50,000/mm3 is below the expected reference range, which can indicate disseminated intravascular coagulation. The nurse should report this result to the provider.

A nurse is calculating a client's expected date of birth using Nagele's rule. The client tells the nurse that her last menstrual cycle started on November 27th. Which of the following dates is the client's expected date of birth?

September 3rd When using Nägele's rule to calculate the estimated date of birth for a client, the nurse should subtract 3 months from the first day of the client's last menstrual cycle and then add 7 days. November 27th minus 3 months equals August 27th. August 27th plus 7 days equals September 3rd.

A nurse is teaching a postpartum client about steps the nurses will take to promote the security and safety of the client's newborn. Which of the following statements should the nurse make?

Staff members who take care of your baby will be wearing a photo identification badge. The nurse should instruct the client that all staff members that care for newborns are required to wear a photo identification badge so that the client will be reassured of the newborn's safety. Some units' staff members wear special badges or a specific color scrubs.

A nurse is teaching a new mother how to use a bulb syringe to suction her newborn's secretionsWhich of the following instructions should the nurse include?

Stop suctioning when the newborn's cry sounds clear. The nurse should instruct the client to stop suctioning when the newborn's cry no longer sounds like it is coming through a bubble of fluid or mucus

A nurse is assessing a client who is at 30 weeks of gestation during a routine prenatal visit. Which of the following findings should the nurse report to the provider?

Swelling of the face Swelling of the face, sacral area, and fingers can indicate gestational hypertension or preeclampsia. Reduction in renal perfusion leads to sodium and water retention. Fluid moves out of the intravascular compartment into the tissues, causing edema.

Based on the nurses assessment findings, which of the following conditions is the client at greatest risk for developing?

The client is at greatest risk for developing preeclampsia as evidenced by increased blood pressure Preeclampsia is correct. The client has an increased blood pressure of 152/105 mm Hgwhich is above the expected reference range. Some clients do not develop manifestations of preeclampsia until they are in the postpartum period. The client is also experiencing a headache and epigastric pain, along with an elevated blood pressure. These findings are consistent with preeclampsia and place the client at greatest risk for developing this condition. Increased blood pressure is correct. The client has an increased blood pressure of 152/105 mm Hgwhich is above the expected reference range. This finding, along with other assessment findings , is consistent with preeclampsia and places the client at greatest risk of developing this condition.

A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow.

The first step the nurse should take when performing Leopold maneuvers is to palpate the client's fundus to identify the fetal part. Second, the nurse should determine the location of the fetal back. Third, the nurse should palpate for the fetal part presenting at the inlet. Finally, the nurse should palpate the cephalic prominence to identify the attitude of the head.

A nurse is caring for a client who is in labor and reports increasing rectal pressure. She is experiencing contractions 2 to 3 min apart, each lasting 80 to 90 seconds, and a vaginal examination reveals that her cervix is dilated to 9 cm. The nurse should identify that the client is in which of the following phases of labor?

Transition The nurse should identify that the client is in the transition phase of labor. This phase is characterized by a cervical dilatation of 8 to 10 cm and contractions every 2 to 3 min, each lasting 45 to 90 seconds.

A nurse at the providers office is caring for a client who is 28 years of age. The nurse is collaborating with another nurse about the clients plan of care. For each potential providers prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.

Transvaginal ultrasound is indicated . The nurse should anticipate a prescription for a transvaginal ultrasound. A transvaginal ultrasound is useful in determining the location of the ectopic pregnancy Meperidine IM is contraindicated . Clients who receive methotrexate for an ectopic pregnancy should not take analgesics stronger than acetaminophen because these medications can mask the manifestations of tubal rupture Repeat quantitative -hCG level is anticipated . The quantitative -hCG level should be repeated within 48 hr to see if the level has changed from last recording If increased levels are identified with no intrauterine pregnancy on ultrasound , this is indicative of ectopic pregnancy Methotrexate IM is anticipated . The nurse should anticipate a prescription for methotrexate IM administration to prevent further embryonic cell reproduction Blood typing is anticipated. The nurse should also anticipate potential surgical intervention for the clienttherefore, blood typing is indicated.

The nurse is planning care for the postpartum client. For each potential providers prescription click to specify if the potential prescription is anticipated or contraindicated for the client.

Urinalysis is anticipated. The nurse should anticipate a prescription for a urinalysis. A urinalysis will reveal the presence of increased levels of protein in the urinewhich might be indicative of preeclampsia . Monitor intake and output is anticipated. The nurse should anticipate a prescription for monitoring the client's intake and output. Although the client is in the postpartum period, some clients do not develop manifestations of preeclampsia until the postpartum period. Clients who experience preeclampsia are at risk for decreased urine output due to decreased renal perfusion Magnesium sulfate is anticipated . The nurse should anticipate a prescriptions for magnesium sulfate. Although the client is in the postpartum period, some clients do not develop manifestations of preeclampsia until the postpartum period. Clients who have headaches, visual disturbances, and increased DTR irritability should be administered magnesium sulfate to help prevent seizure activity in the postpartum period. Place the client on seizure precautions is anticipated. The nurse should anticipate a prescription for seizure precautionsAlthough the client is in the postpartum periodsome clients do not develop manifestations of preeclampsia until the postpartum period. The client is exhibiting manifestations of preeclampsia and could progress to eclampsia (seizures) Labetalol is contraindicated. The nurse should not anticipate a prescription for labetalol. This medication is contraindicated for clients who have asthma This client's medical history includes asthmathereforethe client should not be prescribed this medication Draw creatinine and BUN is anticipated. The nurse should anticipate a prescription for creatinine and BUN labs to be drawn. Although the client is the postpartum period, some clients do not develop manifestations of pre

A nurse is caring for a newborn who was transferred to the nursery 30 min after birth because of mild respiratory distress. Which of the following actions should the nurse take first?

Verify the newborn's identification. When using the safety/risk reduction approach to client care, the first action the nurse should take is to verify the newborn's identity upon arrival to the nursery.

A nurse is performing a vaginal examination on a client who is in labor and observes the umbilical cord protruding from the vagina. After calling for assistance, which of the following actions, should the nurse take next?

apply internal upward pressure to the presenting part using two gloved fingers. using evidence based practice the first action, the nurse should take it to apply internal upward pressure to the presenting part. Prolapse of the umbilical cord during labor can result in a decrease perfusion to the fetus which can lead to hypoxia. After calling persistence, the nurse should relieve the compression on the umbilical cord by applying upward internal pressure on the presenting part with two gloved fingers. The nurse should not move their hand.

The priority intervention the nurse should perform is

assess the clients, deep tendon reflexes, followed by assess the client for visual disturbances Assess the client's deep tendon reflexes (DTRS) is correct. The priority intervention for the nurse is to assess the client's DTRS to check the reflex irritability According to evidence-based practice, increased DTR reflex irritability places the client at a greater risk for seizure activity Assess the client for visual disturbances is correctAccording to evidence- based practice, the nurse's next priority intervention is to assess the client for visual changes, such as blurred vision and scotoma, which are caused by vasospasms and decreased amounts of blood flow to the retina. Although the client is in the postpartum period, some clients do not develop manifestations of preeclampsia until this time. The client is experiencing a headache. heartburn, and has elevated blood pressure, which can indicate preeclampsia

A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the following findings in the client's history should the nurse recognize as a contraindication to oral contraceptives? (Select all that apply)

cholecystitis, hypertension, and migraine headaches Cholecystitis is correct. A history of gallbladder disease is a contraindication for the use of oral contraceptives. Hypertension is correct. Hypertension is a contraindication for the use of oral contraceptives. Migraine headaches is correct. A history of migraine headaches is a contraindication for the use of oral contraceptives.

A nurse at the providers office is caring for a client who is 28 years of age. After reviewing a clients current assessment findings, the nurse should identify that the client is experiencing

ectopic pregnancy as evidenced by right lower quadrant, abdominal tenderness Ectopic pregnancy is correct. The client reports late menses, abdominal pain and scant dark red vaginal spotting. The assessment findings reveal right lower quadrant abdominal tenderness and scant dark red vaginal spotting on perineal pad, which are associated with ectopic pregnancy. The client also has a history of PID, which is a risk factor for ectopic pregnancy. Right lower quadrant abdominal tenderness is correct. The assessment findings reveal right lower quadrant abdominal tenderness and scant dark red vaginal spotting, which are findings associated with ectopic pregnancy

A nurse at the providers office is caring for a client who is 28 years of age. The nurse should first address

heart rate followed by the clients vaginal spotting Heart rate is correct. The nurse should first address the client's heart rate which is above the expected reference range, to establish a baseline for continued monitoring Vaginal spotting is correct. The nurse should next address the amount and characteristics of the client's vaginal spotting to establish a baseline for continued monitoring

A nurse is caring for a client who is pregnant and then at the end of her first trimester. The nurse should use the Doppler ultrasound stethoscope, in which of the following locations to begin assessing for the fetal heart tones (FTH)

just above the symphysis pubis At the end of the first trimester of pregnancy, the client's uterus is approximately the size of a grapefruit and is positioned low in the pelvis slightly above the symphysis pubis. Therefore the nurse should begin assessing for FHT just above the symphysis pubis

A nurse is teaching a client who has a new prescription for combined oral contraceptives about potential adverse effects of the medication. For which of the following findings should the nurse instruct the client to notify the provider?

shortness of breath The nurse should instruct the client to notify the provider immediately of any shortness of breath. Shortness of breath and chest pain can indicate a pulmonary embolus or myocardial infarction. Also, the nurse should instruct the client to notify the provider of other adverse effects that can indicate potential complications, including abdominal pain, sudden or persistent headaches, blurred vision, and severe leg pain.

A nurse is planning care for a client who is in labor and is to have an amniotomy. Which of the following assessment should the nurse identify as the priority?

temperature greatest risk for a client falling amniotomy is infection. Therefore the nurse should identify that the priority assessment is the clients temperature.

A nurse is assessing the newborn of a client who took a selective serotonin reputake inhibitor (SSRI) during pregnancy. Which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI

vomiting expected manifestations associated with fetal exposure to SSRIs include irritability, agitation, tremors, diarrhea, and vomitting. These manifestations typically last 2 days.


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