1. 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.
2. 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.
3. 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.
4. 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.
5. 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 need to wear the electronic security bracelet when he's in
my room.": 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.
6. 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?