VATI RN Maternal Newborn 2019

1. A charge nurse is teaching a newly li- censed nurse about substance use disor- ders during pregnan- cy. Which of the follow- ing statements by the newly licensed nurse indicates an under- standing of the teach- ing? 2. A nurse is caring for a client who received terbutaline subcuta- neously. Which of the following findings is an indication the med- ication was effective? 3. A charge nurse is dis- cussing care of clients who are in labor with a newly licensed nurse. Which of the follow- ing actions should the charge nurse include in the teaching regard- ing situations requir- ing an amniotomy? 4. A nurse is review- ing the medical record of a client who has preeclampsia pri- or to administering la- betalol. For which of the following findings Encourage client who are prescribed methadone to breastfeed. -The nurse should encourage clients who are pre- scribed methadone during pregnancy to breastfeed their newborns to help with withdrawal symptoms. Decreased frequency of contractions. -Terbutaline is a tocolytic medication that is used to halt preterm labor. Terbutaline cause relaxation of smooth muscle, which decrease uterine activity. Therefore, the nurse should identify that a decrease in frequency of contractions is an indication that terbutaline was effective. Placing a fetal scalp electrode. -A fetal scalp electrode is attached to the present- ing part of the fetus in order to provide accurate continuous monitoring of the fetal heart rate. If the client's membranes are intact, the amniotic sac must be artificially ruptured prior to attaching the electrode to enable access to the presenting part. Heart rate 54/min -The nurse should identify that a heart rate of 54/min is below the expected reference range of 60 to 100/min. During pregnancy, the heart rate increases 10 to 15/min due to increased blood volume and increase tissue demands for oxygen. Bradycardia is a contraindication for the administration of la- betalol, an antihypertensive medication. Therefore, should the nurse with- hold the medication? 5. A nurse is caring for a client who is at 30 weeks of ges- tation and observes the client choking while eating lunch. The client is unable to speak or cough. Identify the sequence of steps the nurse should take to clear the airway obstruc- tion. the nurse should withhold the medication and notify the provider. 1. Stand posterior to the client. 2. Position arms under the client's axilla and across the client's chest. 3. Place thumb-side of a clenched fist to the client's mid-sternum area. 4. Initiate chest thrust to the client using a backward motion. -If the client becomes unconscious, the nurse should perform CPR and activate emergency medical ser- vices. 6. A nurse is preparing to Maternal blood pressure. administer an opioid analgesic to a client who is in active labor. Which of the following assessments should the nurse perform? (SATA) 7. -Opioid analgesic can cause hypotension. The nurse should assess the clients blood pressure before and after administering opioids. Pain level. -The nurse should assess the clients baseline pain level prior to administering pain medication and again after administering pain medication to deter- mine the effectiveness of the medication. Opioid analgesic are indicated for the relief of moderate to sever labor pain. Fetal heart rate. -Opioid analgesics can cause fetal bradycardia and changes in variability. The nurse should assess the fetal heart rate prior to administering an opioid anal- gesic to ensure the rate is within the expedited refer- ence range and to have a baseline for future assess- ments. The nurse should provide ongoing assess- ments of fetal heart rate throughout labor according to facility protocol.