ATI COMPREHENSIVE exit exam A

ATI COMPREHENSIVE exit exam A 1. A client who is 8 hr postpartum asks the nurse if she will need to receive Rh immune globulin. The client is gravida 2, para 2, and her blood type is AB negative. The newborns blood type is B positive. Which of the following statements is appropriate? a. You only need to receive Rh immune globulin if you have a positive blood type." b. You should receive Rh immune globulin within 72 hours of delivery." c. "Both you and your baby should receive Rh immune globulin at your -week appointment." d. "immune globulin is not necessary since this is your second pregnancy." 2. A nurse in a prenatal Clinic is teaching a client about non pharmacological pain management during labor. Which of the following statements by the client indicates an understanding of the teaching? a. My nurse can teach me biofeedback at the beginning of labor- biofeedback would be taught earlier to control other pain, not pain of labor b. A transcutaneous electrical nerve stimulator will help with pelvic pressure- This would mess with the readings of the pt and baby c. The nurse will initiate acupuncture when I arrive at the unit - Needles during labor no. d. I can use my ultrasound picture as a focal point during contractions 3. Nurses caring for client was in end-stage osteoporosis and is reporting severe pain. Clients respiratory rate is 14 per minute. Which of the following medications should the nurse expect to be the highest priority to administer to the client? a. Promethazine b) Hydromorphone c) Ketorolac d) Amitriptyline 4. A nurse is caring for a client who has DVT. Which of the following instructions the nurse include in the plan of care? a. Live with the clients fluid intake to 1500 mL per day b. Massage place affected extremity to relieve pain c. Apply cold packs of clients affected extremity d. Elevate the client’s affected extremity when in bed 5. A nurse is caring for a client who is receiving oxytocin IV for augmentation of labor. The client’s contractions are occurring every 45 seconds with a nine seconds duration in the fetal heart rate is 170 to 180/minute. Which of the following actions should nurse take? a. Discontinue oxytocin infusion b. Increased oxytocin infusion c. Decreased oxytocin infusion d. Maintain oxytocin infusion