Exam (elaborations) HESI practice OB

At ten weeks gestation, a high risk multiparous client with a Fhx of downs syndrome is admitted for observation following a CVS. What assessment findings requires immediate action? A) Uterine Cramping B) Systolic BP 100 C) Abdominal tenderness D) Intermittent Nausea - ANSWER A A nurse assesses a male newborn and determines that he has the following vital signs: Axillary temp of 95.1 F, HR of 136, RR of 48. Based on these findings, which action should the nurse take first? A) Check the infants ABG B) Notify the pediatrician of the vital signs C) Encourage the infant to breastfeed or drink sugar water D) Assess the infant's glucose level - ANSWER D An infant in respiratory distress is placed on pulse ox. The O2 sat is 85%. What is the priority nursing intervention? A) Begin humidified oxygen B) Place the infant under a radiant warmer C) Evaluate the blood pH D) Stimulate infant to cry - ANSWER A When assessing a newborn infant's HR, what technique is most important for the nurse to use? A) palpate the umbilical cord B) Count the HR for at least one full minute C) Quiet the infant before counting HR D) Listen at the apex of the heart - ANSWER B 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? A) Explain that the Vit K shot is required by state law and compliance is mandatory B) inform the mother that the injection was prescribed by the Dr. C) Explore the mother's concerns about the infant receiving the shot. D) Remind the mother that all babies receive this shot and it is relatively painless. - ANSWER C