ATI PN NURSING CARE OF CHILDREN ONLINE PRACTICE 2020 A WITH NGN QUESTIONS AND ANSWERS

A nurse is caring for a client who is at 24 weeks of gestation and has a suspected placental abruption. Which of the following laboratory tests should the nurse expect the provider to prescribe? A. Kleihauer-Betke test B. Progesterone serum level C. Lecithin/sphingomyelin (L/S) ratio D. Maternal Alpha-fetoprotein (AFP) A. Kleihauer-Betke test The nurse should expect the provider to prescribe a Kleihauer-Betke test for a client who has suspected placental abruption to determine if fetal blood is in maternal circulation. This test is useful to determine if Rho-(D) immune globulin therapy should be administered to a client who is Rh-negative. A nurse is demonstrating to a client how to bathe their newborn. In which order should the nurse perform the following actions? (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.) A. Clean the newborn's diaper area. B. Wash the newborn's neck by lifting the newborn's chin. C. Wipe the newborn's eyes from the inner canthus outward. D. Cleanse the skin around the newborn's umbilical cord stump. E. Wash the newborn's legs and feet. C. Wipe the newborn's eyes from the inner canthus outward. B. Wash the newborn's neck by lifting the newborn's chin. D. Cleanse the skin around the newborn's umbilical cord stump. E. Wash the newborn's legs and feet. A. Clean the newborn's diaper area. The nurse should demonstrate how to bathe a newborn by using a head to toe, clean to dirty, approach. Therefore, the nurse should first wipe the newborn's eyes from the inner canthus outward using plain water. The nurse should then wash the newborn's neck by lifting the newborn's chin. Next, the nurse should cleanse the skin around the umbilical cord stump followed by washing the newborn's legs and feet. The last step of the bath should be to clean the newborn's diaper area. A nurse is caring for a client who has hyperemesis gravidarum and is receiving IV fluid replacement. Which of the following findings should the nurse report to the provider? A. BUN 25 mg/dL B. Serum creatinine 0.8 mg/dL C. Urine output of 280 mL within 8 hr D. Urine negative for ketones A. BUN 25 mg/dL The nurse should report an elevated BUN to the provider since it can indicate dehydration. A nurse is assessing a client who is at 38 weeks of gestation during a weekly prenatal visit. Which of the following findings should the nurse report to the provider? A. Blood pressure 136/88 mm Hg B. Report of insomnia C. Weight gain of 2.2 kg (4.8 lb) D. Report of Braxton Hicks contractions C. Weight gain of 2.2 kg (4.8 lb) A weight gain of 2.2 kg (4.8 lb) in a week is above the expected reference range and could indicate complications. Therefore, this finding should be reported to the provider. A nurse is providing teaching for a client who gave birth 2 hr ago about the facility policy for newborn safety. Which of the following client statements indicates an understanding of the teaching? A. "My sister will be able to carry my baby from the nursery to my room when she arrives." B. "The nurse will match my wrist band to my baby's crib card when they bring him to me." C. "The person who comes to take my baby's pictures will be wearing a photo identification badge." D. "My baby doesn't n C. "The person who comes to take my baby's pictures will be wearing a photo identification badge." All personnel working on the unit should be wearing a photo identification badge. The nurse should instruct the parent to never allow anyone who is not wearing an identification badge to come in contact with the newborn. A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching? A. "Obtain an informed consent prior to obtaining the specimen." B. "Collect at least 1 milliliter of urine for the test." C. "Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen." D. "Premature newborns may have false negative tests due to immature development of liver C. "Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen." The nurse should ensure that the newborn has been receiving regular feedings for at least 24 hr prior to testing. A nurse is preparing to administer magnesium sulfate 2 g/hr IV to a client who is in preterm labor. Available is 20 g magnesium sulfate in 500 mL of dextrose 5% in water (D5W). The nurse should set the IV infusion pump to administer how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 50 mL/hr 2 g/hr x 500 mL = 1,000 mL/g/hr 1,000 mL/g/hr / 20g = 50 mL/hr A nurse is caring for a prenatal client who has parvovirus B19 (fifth disease). Which of the following actions should the nurse take? A. Administer antiviral medication. B. Schedule an ultrasound examination. C. Administer Haemophilus influenzae type b vaccine. D. Schedule an indirect Coombs' test. B. Schedule an ultrasound examination. The nurse should schedule serial ultrasound examinations to monitor the fetus during the pregnancy to detect the possible development of fetal hydrops. Also, the virus can cause miscarriage, intrauterine growth restriction, fetal anemia, or stillbirth. A nurse is performing a routine assessment on a client who is at 18 weeks of gestation. Which of the following findings should the nurse expect? A. Deep tendon reflexes 4+ B. Fundal height 14 cm C. Urine protein 2+ D. FHR 152/min D. FHR 152/min The expected range for the FHR is 110/min to 160/min. The FHR is higher earlier in gestation with an average of approximately 160/min at 20 weeks of gestation. Therefore, this is an expected finding by the nurse. A nurse is providing education about family bonding to parents who recently adopted a newborn. The nurse should make which of the following suggestions to aid the family's 7-year-old child in accepting the new family member? A. Allow the sibling to hold the newborn during a bath. B. Make sure the sibling kisses the newborn each night. C. Obtain a gift from the newborn to present to the sibling. D. Switch the sibling's room with the nursery. C. Obtain a gift from the newborn to present to the sibling. Presenting a gift from the newborn to the sibling is a strategy to facilitate a school-age sibling's acceptance of a new family member. This ensures that the sibling does not feel left out and that they understand their role in the family. A nurse is caring for a client who is at 30 weeks of gestation and has a prescription for magnesium sulfate IV to treat preterm labor. The nurse should notify the provider of which of the following adverse effects? A. Client reports nausea B. Urinary output of 40 mL/hr C. Respiratory rate 10/min D. Client reports feeling flushed C. Respiratory rate 10/min The nurse should report a respiratory rate of less than 12/min to the provider, because this is a manifestation of magnesium toxicity. The nurse should ensure that the antidote, calcium gluconate, is readily available. A nurse is caring for a client who is anemic at 32 weeks of gestation and is in preterm labor. The provider prescribed betamethasone 12 mg IM. Which of the following outcomes should the nurse expect? A. Decreased uterine contractions B. An increase in the client's hemoglobin levels C. A reduction in respiratory distress in the newborn D. Increased production of antibodies in the newborn C. A reduction in respiratory distress in the newborn Betamethasone is a glucocorticoid that is given to stimulate fetal lung maturity and prevent respiratory distress. A nurse is caring for a newborn who is 70 hr old. Which of the following findings should the nurse report to the provider? Select all that apply. Medical History Newborn delivered by repeat cesarean birth at 40 weeks of gestation. Birth weight 7 lb 12 oz (3,515 g) Apgar scores 8 at 1 min and 9 at 5 min Maternal history of methadone use during pregnancy. Vital Signs 0700: Heart rate 156/minRespiratory rate 58/minTemperature 37.2° C (98.9° F) Oxygen saturation 98% on room air 1100: Heart rat D. Central nervous system findings The newborn is displaying inconsolability, high-pitched cry, increased muscle tone, tremors, hyperactive Moro reflex, and excessive sucking. These findings are manifestations of NAS and should be reported to the provider. E. Gastrointestinal findings The newborn is displaying poor feeding and loose stools. These findings are manifestations of NAS and should be reported to the provider. A nurse is performing a physical assessment of a newborn upon admission to the nursery. Which of the following manifestations should the nurse expect? (Select all that apply.) A. Yellow sclera B. Acrocyanosis C. Posterior fontanel larger than the anterior fontanel D. Positive Babinski reflex E. Two umbilical arteries visible B. Acrocyanosis Acrocyanosis is an expected finding for at least the first 24 hr following birth. Poor peripheral perfusion leads to bluish discoloration in the newborn's hands and feet.