1. A nurse is assessing a client who has gestational diabetes and is
experiencinghyperglycemia. Which of the following findings should the
nurse expect?
a. Reports increased urinary output
b. Diaphoresis
c. Reports blurred vision
d. Shallow respirations
2. A nurse is caring for a client who ...
ATI MATERNAL NEWBORN PROCTORED EXAM 1. A nurse is assessing a client who has gestational diabetes and is experiencinghyperglycemia. Which of the following findings should the nurse expect? a. Reports increased urinary output b. Diaphoresis c. Reports blurred vision d. Shallow respirations 2. A nurse is caring for a client who is at 22 weeks of gestation and is HIV positive. Which of the following actions should the nurse take? a. Administer penicillin G 2.4 million units IM to the client b. Instruct the client to schedule an annual pelvic examination c. Tell the client she will start medication for HIV immediately after delivery d. Report the client’s condition to the local health department 3. A nurse is providing teaching for a client who has a new prescription for combined oral contraceptives. Which of the following findings should the nurse include as an adverseeffect of this medication? a. Depression b. Polyuria c. Hypotension d. Urticaria 4. A nurse is providing teaching to a client who is at 40 weeks of gestation and has a newprescription for misoprostol. Which of the following instructions should the nurse include in the teaching? a. “I can administer oxytocin 4 hours after the insertion of the medication” b. “You will need a full bladder prior to the insertion of the medication” - no need toempty bladder first c. “Remain in a side-lying position for 15 minutes after the medication is inserted” d. “An antacid will be given 20 minutes prior to the insertion of the medication” 5. 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 influenza type b vaccine d. Schedule an indirect Coombs’ test 6. A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Whichof the following techniques should the nurse use to help minimize the pain of the procedure for the newborn? a. Apply a cool back for 10 minutes to the heel prior to the puncture b. Request a prescription for IM analgesic c. Use a manual lace blade to pierce the skin d. Place the newborn skin to skin on the mother’s chest 7. A nurse is performing a vaginal examination on a client who is in labor and observes theumbilical cord protruding from the vagina. After calling for assistance, which of the following actions should the nurse take? a. Insert two gloved fingers into the vagina and apply upward pressure to thepresenting part b. Wrap the visible cord tightly with sterile, dry gauze c. Apply oxygen to the client at 2 L/min via nasal cannula d. Place the client in the lithotomy position and apply fundal pressure 8. 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 theprovider to prescribe? a. Kleihauer -Betke test b. Progesterone serum level c. Lecithin/sphingomyelin (L/S) ration d. Maternal Alpha -fetoprotein (AFP) 9. A nurse is admitting a client who is in labor. The client admits to recent cocaine use. Forwhich of the following complications should the nurse assess? a. Abruptio placenta b. Placenta previa c. Preeclampsia d. Maternal bradycardia 10. A nurse is assessing a client who has severe preeclampsia. Which of the following manifestations should the nurse expect? a. 2+ deep tendon reflex b. Proteinuria of 200mg in a 24-hr specimen c. Polyuria d. Blurred vision 1. Two days after delivery, a postpartum client prepares for discharge. What should the nurse teach her about lochia flow? Incorrect: Lochia does change color but goes from lochia rubra (bright red) on days 1-3, to lochia serosa (pinkish brown) on days 4-9, to lochia alba (creamy white) days 10-21. Incorrect: Numerous clots are abnormal and should be reported to the physician. Incorrect: Saturation of the perineal pad is considered abnormal and may indicate postpartum hemorrhage. Correct: Lochia normally lasts for about 21 days, and changes from a bright red, topinkish brown, to creamy white. The color of the lochia changes from a bright red to white after four days Numerous large clots are normal for the next three to four days Saturation of the perineal pad with blood is expected when getting up from the bed Lochia should last for about 3 weeks, changing color every few days 2. A nurse monitors fetal well -being by means of an external monitor. At the peak of the contractions, the fetal heart rate has repeatedly dropped 30 beats/min below the baseline. Late decelerations are suspected and the nurse notifies the physician. Which is the rationale for this action?
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