A nurse is caring for a client who is receiving magnesium sulfate for treatment of preterm labor

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    Terms in this set (40)

    nurse is planning care for a requires phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include inthe plan of care

    Ensure the newborns eyes are closed before applying the eye shield

    A nurse is caring for a client at 34 weeks gestation and has a prescription for terbutaline for preterm labor. Which of the following statements by the patient is the priority?

    "My heart feels as if it is racing."

    A nurse is planning care for a client who is pregnant and is Rh-negative. In which of the following situations should the nurse administer Rh(D) Immune Globulin?

    At 28 weeks of gestation

    A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. Which of the following actions should the nurse include in the plan of care?

    Check the cervix prior to analgesic administration.

    A nurse is planning care for a client who is at 35 weeks of gestation. Which of the following lab tests should the nurse obtain?

    Group B streptococcus Beta-hemolytic (GBS)

    A nurse is caring for a newborn whose mother received magnesium sulfate to treat preterm labor. Which of the following clinical manifestations is the newborn indicates toxicity due to the magnesium sulfate therapy?

    Respiratory depression

    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?

    hypotension

    A nurse is caring for a client who has trichomoniasis and a prescription for metronidazole. Which of the following instructions should the nurse provide to the client about the treatment plan?

    "You and your partner need to take the medication and use a condom during intercourse until cultures are negative."

    A nurse in a prenatal clinic is caring for a client who is within the recommended 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 weight gain of 25 - 35 lbs is good

    A nurse is caring for a client who has a prescription for naloxone. Which of the following is the intended action of the med in relation to the CNS?

    Block effects of narcotics on the CNS

    A nurse is discussing diaphragm use with a client. Which of the following statements by client indicates an understanding of the teaching?

    I should replace my diaphragm every 2 years

    A nurse is teaching a client about a nonstress test. Which of the following statements by the client indicates an understanding of the teaching?

    I should press the button on the handheld marker when my baby moves

    A nurse is caring for a client who is 2 hr postpartum. The nurse notes the client's perineal pad has a large amount of lochia rubra with several clots. Which of the following actions should the nurse take first?

    Massage the fundus

    A nurse is caring for a preterm newborn who is receiving oxygen therapy. Which of the following findings should the nurse identify as a potential complication from the oxygen therapy?

    retinopathy

    A nurse is caring for a client who is receiving oxytocin for induction of labor. Which of the following actions should the nurse take?

    Perform continuous fetal heart rate monitoring

    A nurse is assessing a client on the first postpartum day. Findings include fundus firm and 1 fingerbreadth above and to the right of the umbilicus, moderate lochia rubra with small clots, temp 37.3 and pulse 52. Which of the following actions should the nurse take?

    Ask the pt when she last voided

    A nurse is assessing a newborn who is 12 hr old and notes mild jaundice of face and trunk. Which of the following actions should the nurse take?

    obtain stat prescription for a bilirubin level

    A nurse is speaking with an expectant father who says that he feels resentful of the added attention others are giving to his wife since the pregnancy was announced. Which of the following responses should the nurse make?

    These feeling are common for expectant fathers in early pregnancy

    A nurse is caring for a client who is at 36 weeks of gestation and has pre-eclampsia. Which of the following findings should the nurse identify as the priority?

    nonreactive nonstress test

    A nurse is caring for a client who is at 8 weeks of gestation with twins and primigravida. The client states that even though she and her husband planned this pregnancy, she is experiencing many ambivalent feelings about it. Which of the following responses should the nurse make?

    These feelings are quite normal at the beginning of pregnancy

    A nurse receives report on a client who is in labor and is experiencing contractions 4 min apart. Which of the following patterns should the nurse expect on the fetal monitoring tracing?

    Contractions that last for 60 seconds each with a 3 min rest between contractions

    A nurse is discussing epidural anesthesia with a client who is receiving oxytocin for induction of labor. Which of the following statements should the nurse make?

    an epidural given too early can prolong labor

    A nurse is caring for a newborn who was born to a client with a narcotic use disorder. Which of the following nursing actions is a contraindication for the care of the newborn?

    frequent stimulation

    A nurse is preparing to administer naloxone to a newborn. Which of the following conditions can require administration of the medication?

    IV narcotics administered to the mother during labor

    A nurse is planning care for a client who has a prescription for oxytocin. Which of the following is a contraindication for the use of
    this medication?

    active genital herpes

    A nurse is caring for a client who desires an intrauterine device for contraception. Which of the following findings is a contraindication for the use of this device?

    menorrhagia

    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?

    Instruct the client about vena cava syndrome and measures to prevent it

    A nurse is caring for a newborn who has irregular respirations of 52/min with several periods of apnea lasting approx. 5 seconds.
    The newborn is pink with acrocyanosis. Which of the following actions should the nurse take?

    continue to routinely monitor the newborn

    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?

    do not become pregnant for at least 1 yr

    A nurse is assessing a client recieving magnesium sulfate as treatment for preeclampsia. which of the following clinical findings is the nurse's priority?

    urinary output 40ml in 2 hrs

    A nurse is caring for a client whose membranes have ruptured and is in active labor. the fetal monitor tracing reveals late decels. Which of the following actions should the nurse take first?

    Turn the client onto her left side

    A nurse is caring for a client who is at 16 weeks of gestation and has severe iron-deficiency anemia. The provider prescribes and injection of iron dextran IM. Which of the following methods should the nurse use to administer the medication?

    Use a 20 gauge needle and use the Z track method

    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?

    decreased blood glucose

    A nurse is caring for four newborns. Which of the newborns is at greatest risk for hypoglycemia?

    a newborn who is large for gestational age

    A nurse is caring for a client who is in labor. The client questions the application of an internal fetal scalp monitor. Which of the following responses should the nurse make?

    we need to observe your baby more closely

    A nurse is teaching a client who has active genital herpes simplex virus, type 2. Which of the following statements should the nurse include in the teaching?

    You will have a c section prior to the onset of labor

    A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following clinical findings should the nurse expect?

    exaggerated reflexes

    A nurse is caring for a client who is in labor. A vaginal exam reveals this info. 2cm, 50%, +1, right occiput anterior (ROA). Based on this info, which of the following fetal positions should the nurse document in the medical record?

    vertex

    A nurse is caring for a client who has clinical manifestations of an ectopic pregnancy. Which of the following findings is a risk factor for an ectopic pregnancy?

    pelvic inflammatory disease (PID)

    A nurse is caring for a client who is pregnant and reports nausea and vomiting. Which of the following instructions should the nurse provide the client?

    Eat some crackers before rising from bed in the morning

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