OB/Maternity HESI Assignment exam Accurate 100%

At 10-weeks gestation, a high-risk multiparous client with a family history of Down syndrome is admitted for observation following a chorionic villi sampling (CVS) procedure. What assessment finding requires immediate intervention? - ANSWER A. Uterine cramping A client states, "During the three months I've been pregnant, it seems like I have had to go to the bathroom every five minutes." Which explanation should the nurse provide to this client? - ANSWER D. The growing uterus is putting pressure on the bladder. The nurse assesses a male newborn and determines that he has the following vital signs: axillary temperature 95.1 F, heart rate 136 beats/minute, and a respiratory rate 48 breaths/minute. Based on these findings, which action should the nurse take first? - ANSWER C. Assess the infant's blood glucose level An infant in respiratory distress is placed on pulse ox. The O2 sat is 85%. What is the priority nursing intervention? - ANSWER B. Begin humidified oxygen via hood When assessing a newborn infant's heart rate, which technique is most important for the nurse to use? - ANSWER C. Count the heart rate for at least one full minute The nurse prepares to administer an injection of vitamin K to a newborn infant. The mother tells the nurse, "Wait! I don't want my baby to have a shot." Which response would be best for the nurse to make? - ANSWER B. Explore the mother's concerns about the infant receiving an injection of vitamin K The nurse is teaching a new mother about diet and breastfeeding. Which instruction is most important to include in the teaching plan? - ANSWER A. Avoid alcohol because it is excreted in breast milk Which nursing intervention best enhances maternal-infant bonding during the fourth stage of labor? - ANSWER D. Encourage early initiation of breast of formula feeding A client at 8-weeks gestation asks the nurse about the risk fora congenital heart defect (CHD) in her baby. Which response best explains when a CHD may occur? - ANSWER D. The heart develops in the third to fifth weeks after conception A client at 8-months gestation tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. What information should the nurse provide? - ANSWER B. The fetus in utero is capable of hearing and does respond to the mother's voice