PN Maternal Newborn Final Exam : Maternal Newborn Final Exam: Questions & Answers: Well Elaborated

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? (Ans- Pelvic Inflammatory Disease. An ectopic pregnancy occurs when the fertilized egg implants in tissue outside of the uterus, and the placenta and fetus begin to develop there. The most common site is within a fallopian tube, but ectopic pregnancies can occasionally occur in the ovary or the abdomen. Most cases are a result of scarring caused by a previous tubal infection or tubal surgery. Therefore, pelvic inflammatory disease (PID) places the client at risk for an ectopic pregnancy. A nurse is collecting data for a NB who is 12 hr old and notes mild jaundice of the face and trunk. Which of the following should the nurse take? (Ans- Obtain a stat prescription for a bilirubin level. Jaundice in the first 24 hr of life is pathologic. The nurse should notify the provider and obtain a stat prescription for a bilirubin level. A nurse is caring for four newborns. Which of the following findings should the nurse report to the provider? (Ans- A 12-hr old newborn who has a heart rate of 70/min while sleeping. An average heart rate for a newborn is 80 to 100/min while sleeping. A newborn's heart rate can increase to 180/min during episodes of crying. A heart rate less than 80/min is bradycardia and should be reported to the provider. A nurse is caring for a client who has trichomoniasis and a prescription for metronidazole. Which of the following instructions should the nurse reinforce with the client about the treatment plan? (Ans- "You and your partner need to take the medication and use a condom during intercourse until cultures are negative." Trichomonas vaginalis is the organism that causes the sexually transmitted infection trichomoniasis. Both men and women can be infected with trichomoniasis. Clinical findings include yellowish to greenish, frothy, mucopurulent, copious discharge with an unpleasant odor, as well as itching, burning, or redness of the vulva and vagina. Trichomoniasis can be treated easily with metronidazole. However, for the treatment to work, it is important to make sure both sexual partners receive treatment to prevent reinfection. Instruct the client to use condoms during sexual intercourse while being treated. A nurse is assisting the plan of care for a client who is pregnant and is Rf-negative. In which of the following situations should the nurse administer Rh(D)Immune Globulin? (Ans- At 28 weeks of gestation. The nurse should administer Rh(D) Immune Globulin to a client who is pregnant and has Rh-negative blood at 28 weeks of gestation. Rh(D) Immune Globulin consists of passive antibodies against the Rh factor, which will destroy any fetal RBCs in the maternal circulation and blocks maternal antibody production. A nurse is caring for a client who desires an intrauterine device (IUD) for contraception. Which of the following findings is a contraindication for the use of this device? (Ans- Menorrhagia. An IUD is a small plastic or copper device placed inside the uterus that changes the uterine environment to prevent pregnancy. An IUD is contraindicated for women who have menorrhagia, severe dysmenorrhea, or have a history of ectopic pregnancy. A nurse is assisting with 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? (Ans- Nonreacttive nonstress test. The nurse should apply the urgent versus non-urgent priority-setting framework. Using this framework, the nurse should consider urgent needs to be the priority need because they pose more of a threat to the client. Using the urgent vs nonurgent approach to client care, the nurse determines that the priority finding is a nonreactive nonstress test. A nonstress test measures fetal heart rate (FHR) accelerations with normal movement. A fetal acceleration is a positive sign. It is present when the FHR increases 15/min and lasts 15 seconds. In a nonreactive nonstress test, there are no accelerations. The absence of FHR accelerations suggests that the fetus may be going into distress. The nurse might also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. 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? (Ans- " A weight gain of about 25 to 35 pounds is good." A weight gain of 25 to 35 lb is associated with good fetal outcome. A gain of 4 lb in the first trimester and 12 lb each for the second and third trimester is recommended. SHOW HINT A nurse is assisting in the plan of care for a newborn who requires phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan of care? (Ans- Ensure the newborn's eyes are closed before applying the eye shield. 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 is caring for who is at 34 weeks of gestation and has a prescription for terbutaline for preterm labor. Which of the following statements bythe client is the nurse's priority? (Ans- "My heart feels as if it is racing." The nurse should apply the urgent versus nonurgent priority-setting framework. Using this framework, the nurse should consider urgent needs to be the priority need because they pose more of a threat to the client. Using the urgent vs nonurgent framework, the nurse should assess the client's heart rate. If the pulse is greater than 130/min, the terbutaline needs to be held until the provider is notified. The nurse might also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent.