ATI - Preterm Labor, Preeclampsia, and Gestational Diabetes

Nurse Darla is planning to administer magnesium sulfate to Ms. Goodwin. Which of the following indicate magnesium sulfate toxicity? Select all that apply. a) altered level of consciousness b) respiratory rate less than 12/min c) deep tendon reflexes 3+ d) urinary output less than 30 mL/hr e) muscle rigidity

A, B, and D

Nurse Ellen is explaining the risk factors for developing gestational diabetes to Ms. Anderson. Which of the following should Ellen include? Select all that apply. a) obesity b) history of smoking c) maternal age over 30 d) family history of diabetes mellitus e) first pregnancy

A, C, and D

Nurse Morgan is preparing to administer hydralazine (Apresoline) 5 mg IV bolus. Available is hydralazine 20 mg/mL. How many mL should Morgan administer? Round the answer to the nearest hundredth

0.25

Nurse Darla confirms uterine contractions are occurring on the fetal monitor. Which of the following is the priority nursing intervention? a) obtain a clean catch, mid-stream urine sample b) evaluate the concentration of Ms. Goodwin's urine c) check for effacement and cervical dilation d) assess vaginal discharge

C

Nurse Ellen is converting Ms. Anderson's weight to pounds. If Ms. Anderson weighs 113 kg, how many pounds does she weigh? Round to the nearest tenth.

248.6

Nurse Darla completed a vaginal examination on Ms. Goodwin and notified the provider of her findings. Which of the following actions is the highest priority? a) administer nifedipine (procardia) b) obtain a cervical culture c) communicate the plan of care with Ms. Goodwin d) administer betamethasone (celestone)

A

Nurse Darla is planning care for Ms. Goodwin after Ms. Goodwin experienced a gush of fluid. Which of the following is the priority action at this time? a) evaluate the fetal heart rate b) perform a vaginal examination c) collect a sample of the fluid to test for ferning d) use a nitrazine strip to test the pH of the fluid

A

Nurse Ellen is calculating Ms. Anderson's estimated date of delivery. Which of the following is an appropriate response by Ellen? a) your estimated date of delivery is April 20th b) your estimated date of delivery is May 13th c) your estimated date of delivery is April 13th d) your estimated date of delivery is May 20th

A

Nurse Jill is discussing the treatment of hypoglycemia with Ms. Anderson. Which of the following should Jill include in the teaching? a) drink 4 oz regular non-caffeinated soft drink b) drink 8 oz fruit juice c) consume three hard candies d) consume two glucose tablets

A

Nurse Jill is explaining the unexpected results of the 3-hr oral glucose tolerance test to Ms. Anderson. Which of the following is an appropriate statement by Jill? a) you will have a diagnosis of gestational diabetes if two blood glucose levels are elevated b) you will have a diagnosis of gestational diabetes if three blood glucose levels are elevated c) you will have a diagnosis of gestational diabetes if one blood glucose level is elevated d) you will have a diagnosis of gestational diabetes if four blood glucose levels are elevated

A

Nurse Jill is preparing to educate Ms. Anderson regarding self-administering regular insulin (Humulin R). Which of the following should Jill include in the teaching? a) rotate the administration of insulin with one site for a week b) store the insulin vials in the refrigerator between injections c) administer the insulin 15 min prior to meals d) gently shake the insulin vials before drawing up the dose

A

Nurse Morgan completes an admission assessment for Ms. Klein. Based on the assessment, which of the following is the priority nursing intervention at this time? a) initiate seizure precautions b) inset an indwelling urinary catheter c) monitor Ms. Klein's I&O d) apply antiembolism stockings

A

Nurse Morgan is administering IV magnesium sulfate to Ms. Klein. Which of the following manifestations indicates Ms. Klein is experiencing magnesium toxicity? a) respirations 11/min b) 4+ deep tendon reflexes c) skin pallor d) urinary output of 60 mL/hr

A

Nurse Morgan is preparing to administer magnesium sulfate IV at 2 g/ hr. Available is magnesium sulfate 40 g/1,000 mL lactated Ringer's. Morgan should set the IV pump to deliver how many mL/hr? Round the answer to the nearest whole number. a) 50 mL/hr b) 75 mL/hr c) 100 mL/hr d) 125 mL/hr

A

Nurse Jill is reviewing the components of the biophysical profile for Ms. Anderson. Nurse Jill should recognize which of the following components of a biophysical profile? Select all that apply. a) fetal tone b) fetal breathing movement c) doppler blood flow analysis d) gross body movement e) amniotic fluid volume

A, B, D, and E

Nurse Morgan is preparing to teach Ms. Klein about delivery by cesarean section. Which of the following should Morgan include in the teaching? Select all that apply. a) you will receive pain medication following the procedure b) your spouse will give informed consent c) monitoring of the fetal heart will continue d) you will receive antiemetic medications e) I will review options for anesthesia with you

A, C, and D

Nurse Darla is interviewing Ms. Goodwin about her report of a burning sensation when voiding. Which of the following clinical findings should Darla anticipate? Select all that apply. a) dysuria b) vaginal discharge c) urinary frequency d) epigastric pain e) fever

A, C, and E

Nurse Darla and the charge nurse are discussing nifedipine (Procardia). Which of the following statements by Darla indicates an understanding of the medication? a) hypertension is an expected finding of the medication b) I should assess her for facial flushing c) an adverse effect of the medication is bradycardia d) I should inspect her skin daily for bruising

B

Nurse Darla assists Ms. Goodwin to bed. Which of the following is an appropriate action for Darla to take? a) ask Ms. Goodwin to write down each time she feels a contraction b) apply a fetal monitor and tocotransducer c) palpate Ms. Goodwin's uterus d) ask Ms. Goodwin to report the kick counts over a period of 1 hr

B

Nurse Darla is teaching Ms. Goodwin about bed rest. Which of the following potential adverse effects should Darla include in the teaching? a) muscle hypertonicity b) thrombus formation c) increased Braxton-Hicks contractions d) increased cardiac output

B

Nurse Jill is teaching Ms. Anderson about a 3-hr oral glucose tolerance test to confirm a diagnosis of gestational diabetes. Which of the following should be included in the teaching? a) you should have a full bladder for the test b) the nurse will check your blood glucose level hourly during the test c) you should drink the oral glucose solution the night before d) eat a light breakfast before you come in for the test

B

Nurse Jill is teaching Ms. Anderson about clinical manifestations of hypoglycemia. Jill tells Ms. Anderson to watch for diaphoresis, headache, and shakiness. Which of the following additional manifestations should Jill include in the teaching? a) increased urination b) dizziness c) fruity breath d) constipation

B

Nurse Lance is conducting Apgar scoring on Ms. Goodwin's newborn. Which of the following is an appropriate score to assign to the newborn? a) 7 b) 5 c) 8 d) 4

B

Nurse Morgan is reviewing Ms. Kleins laboratory test results. Which of the following findings should Morgan discuss with Ms. Klein regarding her worsening condition? a) decreased uric acid b) increased proteinuria c) decreased lactate dehydrogenase (LDH) d) increased platelets

B

Nurse Morgan reviews the laboratory test results for Ms. Klein. Which of the following findings confirms a diagnosis of severe preeclampsia? a) platelets 158,000/mm3 b) aspartate aminotransferase (AST) 75 units/L c) hemoglobin 16 g/dL d) urine protein 1+

B

Nurse Jill is teaching Ms. Anderson the technique for self-blood glucose monitoring. Identify the sequence of actions Ms. Anderson should take when performing a self-blood glucose test. Place them in order of performance a) gently squeeze around the puncture site b) choose a vascular puncture site c) prick the finger using a dart-like motion d) hold the strip under the puncture site e) wipe the finger with an antiseptic swab f) apply pressure to the puncture site

B, E, C, A, D, then F

Nurse Darla is preparing to obtain a urine specimen from the urinary catheter after the catheter was clamped 5 inches above the collection port. Identify the sequence of steps Darla should take when preforming this procedure. Place in order of performance a) withdraw the specimen b) don gloves c) access the port d) unclamp the drainage tube e) disinfect the port

B, E, C, D, then A

Nurse Darla is planning care for Ms. Goodwin, who has a prolapsed cord. Which of the following is the priority action for Darla to take? a) loosely wrap the cord in a sterile towel saturated in 0.9% sodium chloride b) prepare Ms. Goodwin for cesarean birth c) apply pressure through the vaginal canal on the presenting parts d) place a rolled towel under Ms. Goodwin's hip

C

Nurse Darla is teaching Ms. Goodwin about receiving tocolytic therapy. Which of the following statements by Ms. Goodwin indicates she understands the effects of the therapy? a) I may have difficulty sleeping at night due to the medication b) I should increase my fluid intake to 3 liters daily c) I may experience hot flashes throughout the day d) I should lie on my back as much as possible

C

Nurse Ellen is preparing to administer a 1-hr oral glucose tolerance test for Ms. Anderson. Which of the following actions should Ellen take? a) offer Ms. Anderson an additional 150 g of carbohydrates prior to ingesting the oral glucose solution b) instruct Ms. Anderson to drink the oral glucose solution over 1 hr prior to testing c) obtain a blood specimen 1 hr after Ms. Anderson ingests the oral glucose solution d) obtain a urine specimen 1 hr after Ms. Anderson ingests the oral glucose solution

C

Nurse Jill is discussing potential complications of gestational diabetes with Ms. Anderson. Gestational diabetes places the newborn at risk for which of the following? a) hypercalcemia b) infection c) hypoglycemia d) birth trauma

C

Nurse Morgan is reviewing prescriptions from Dr. Hunt. For which of the following manifestations should she plan to monitor following administration of hydralazine (Apresoline)? a) polyuria b) dry mouth c) tachycardia d) hyperglycemia

C

While evaluating the heart rate of the fetus, Nurse Darla recognizes late deceleration on the fetal monitor. Identify the sequence of steps Darla should take next. Place them in the order of performance a) apply oxygen at 8 L/min via face mask b) increase the rate of lactated Ringer's c) place Ms. Goodwin in the lateral position d) assess the frequency of uterine contractions

C, B, D, then A

Nurse Darla is preparing to administer ampicillin (Ampicin) to Ms. Goodwin. Which of the following is an appropriate action for Darla to take? a) administer the medication over 1 min b) infuse the medication over 30 min c) assess Ms. Goodwin for sensitivity to sulfonamides d) assess Ms. Goodwin for sensitivity to cephalosporin

D

Nurse Darla is preparing to administer betamethasone (Celestone) to Ms. Goodwin. Which of the following is an appropriate action for Darla to take? a) administer the medication as two separate subcutaneous injections b) administer the medication into the deltoid muscle c) administer the medication subcutaneously into the periumbilical area d) administer the medication into the ventrogluteal muscle

D

Nurse Darla is teaching Ms. Goodwin about signs of true labor. Which of the following statements by Ms. Goodwin indicates an understanding of the teaching? a) I should feel pain in my upper abdomen b) my urge to frequently urinate will decrease c) my contractions will decrease with walking d) I will experience pressure in my pelvis

D

Nurse Jill is explaining the results of the 1-hr oral glucose tolerance test to Ms. Anderson. Which of the following is an appropriate response? a) I need to obtain a urine sample for further testing b) your blood glucose level indicates you have gestational diabetes c) you will need to return tomorrow for another 1 hour oral glucose tolerance test d) you will need to have the 3 hr oral glucose tolerance test

D

Nurse Jill is preparing Ms. Anderson for a nonstress test. Which of the following actions should Jill take? a) direct Ms. Anderson to be NPO 8 hr prior to the test b) perform nipple stimulation on one of Ms. Anderson's breasts for 10 min c) continue testing until Ms. Anderson has uterine contractions every 10 min d) instruct Ms. Anderson to press the handheld marker when she feels fetal movement

D

Nurse Jill is teaching Ms. Anderson about dietary modifications for gestational diabetes. Which of the following should Jill include in the teaching? a) you should obtain 45-65% of your daily calories from carbohydrates b) you should obtain twice the amount of calories from protein that you obtain from carbohydrates c) you should limit saturated fats to 12% of your daily caloric intake d) you should consume 2,000 calories a day

D

Nurse Morgan prepares to call Dr. Hunt and give a report. Which of the following is the most important clinical data for Morgan to include in the SBAR report? a) urine protein 1+ b) epigsatric pain c) absence of vaginal bleeding d) elevated blood pressure

D

Nurse Morgan recognizes Ms. Klein is experiencing variable decelerations of the fetal heart rate. Which of the following nursing interventions should Morgan take at this time? a) administer oxygen via nasal cannula at 2 L/min b) elevate Ms. Klein's legs c) prepare Ms. Klein for immediate cesarean birth d) change Ms. Klein's position

D