Learning System PN 2.0 - Maternal Newborn Final 2022// 2023.

Nurse caring for client who desires IUD for contraception. Which finding is a contraindication for the use of this device? - HTN - Menorrhagia - Hx of multiple gestations - Hx of thromboembolic disease: Menorrhagia - an IUD is a small plastic or copper device inside uterus that changes the uterine environment to prevent pregnancy. An IUD is contraindicated for women who have menorrhagia, severe dysmenorrhea or hx of ectopic pregnancy 2. Nurse reinforcing teaching to client who is pregnant. Which instruction should nurse include? - take 600mg of ibuprofen as needed for discomfort - "You should eat soft cheeses to increase calcium intake" - "You should roll your nipples daily to ensure they are everted" - "You should use fluoride-based toothpaste to prevent dental caries.": "You should use fluoride-based toothpaste to prevent dental caries." - nausea during pregnancy can lead to poor hygiene and inflammation of the gingival tissue, which can lead to dental caries 3. Nurse assisting with the plan of care for a client who is pregnant and Rh negative. In which of the following situations should the ruse administer Rh(D) Immune Globulin - while the client is in labor - following an episode of flu during pregnancy - prior to a blood transfusion - at 28 weeks gestation: 28 weeks gestation - Rh(D) immune globulin consists of passive antibodies against the Rh factor, which will destroy any fetal RBCs in maternal circulation that blocks maternal newborn production 4. Nurse caring for a newborn who was born to a client who has narcotic use disorder. Which action should the nurse identify as a contraindication in care of newborn? - promoting maternal-newborn bonding - tight swaddling - small, frequent feedings - frequent stimulation: Frequent stimulation - newborn needs quiet environment with minimal stimulation in order to promote rest and reduce stress. Stimulating environment can trigger irritability and hyperactive behaviors 5. Nurse caring for client 35 weeks gestation Which of the following lab tests should the nurse obtain? 1 / 11 - Rubella titer - blood type - Group B strep - 1hr glucose tolerance test: Group B streptococcus B-hemolytic culture - nurse should obtain vaginal/anal GBS culture at 35 to 37 weeks of gestation to screen for infection. Prophylactic abx should be given during labor of the client with +GBS 6. Nurse assisting in plan of care for a newborn who requires phototherapy for hyperbilirubinemia. Which of the following actions should nurse include in plan of care? - swaddle the newborn in blanket - maintain NPO - ensure newborns's eyes are closed before applying eyeshield: Ensure the newborn's eyes are closed before applying the eye shield - overexposure to the lights during tx can cause damage to the newborn's corneas. Therefore the nurse should gently close the newborn's eyes prior to applying the shield 7. Caring for client 34 was gestation and has a rx for terbutaline for preterm labor. Which of the following statements is the nurse's priority? - "My ankles are swollen at the end of the day" - "I can feel the baby kicking my ribs, and it is very uncomfortable." - "I'm growing more ad more worried every day." - "My heart feels as if it is racing.": "My heart feels as if it is racing." - urgent vs nonurgent - hold med for HR 130/min and notify MD 8. A nurse is assisting with caring for a client 36 weeks gestation and has pre-eclampsia. Which should the nurse identify the priority? - +1 proteinuria - BP 140/98 - nonreactive stress test - fundal height 33cm: Nonreactive stress test - urgent vs nonurgent - nonstress test measure FHR accels with normal movement. Fetal acceleration is a positive sign. It is present when FHR increases 15/min and lasts 15 seconds. In a non- reactive stress test there are no accelerations, absence for FHR accels indicates suggests that the fetus may be going into distress 9. A nurse is caring for newborn w/ irregular respiration at 52/min with several periods of apnea lasting approx 5 secs. Newborn is pink w/ acrocyanosis. Which of the following actions should the nurse take? - administer oxygen - place newborn in an isolette - continue to monitor newborn 2 / 11 - check the newborn's glucose: continue to routinely monitor the newborn - normal resp rate and rhythm 10. A nurse is reinforcing teaching with a client who is postpartum and breastfeeding. Which of the following nutrients should the nurse include in the teaching as a nutrient for the client to increase the intake of while breasting? - Vitamin C - Iron - Folate - Calcium: Vitamin C - important for tissue formation and integrity, nurse should instruct client to consume 115-120mg of vitamin C per day, which is an increase from when the client was pregnant 11. Nurse caring for the client who reports LMP began on July 8th, based on Nagele's rule...what is the expected DOB? - April 1 - April 15 - October 15 - October 1: April 15 - count back 3 mo from the first day of LMP and add 7 days 12. Client is 2 hr postpartum. Nurse notes that the client's perineal pad has a large amount of lochia rubra with several clots. Which action should nurse take first? - Check for full bladder - Massage the fundus - VS - admin carboprost IM: Massage the fundus - safety vs. risk - primary