A charge nurse is teaching a newly licensed nurse about substance use disorders during pregnancy.
Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Encourage clients who are prescribed methadone to breastfeed.

Methamphetamine use during pregnancy is associated with fetal macrosomia.

Environmental stimuli should be increased during the neonatal period.

Increased head circumference is an expected finding in a newborn who has fetal alcohol syndrome.

Answer and Explanation

The Correct Answer is A

Choice A rationale

For clients prescribed methadone during pregnancy, breastfeeding is generally encouraged due to the benefits of breast milk for the infant. Methadone excretion into breast milk is minimal and not considered harmful, and it can help to reduce the severity of neonatal abstinence syndrome.

Choice B rationale

Methamphetamine use during pregnancy is associated with several adverse fetal outcomes, but fetal macrosomia (abnormally large baby) is not typically one of them. Instead, it is more commonly linked to intrauterine growth restriction, preterm birth, and small for gestational age infants due to vasoconstrictive effects.

Choice C rationale

For newborns experiencing neonatal abstinence syndrome due to prenatal substance exposure, environmental stimuli should be decreased, not increased. Reducing stimuli like bright lights, loud noises, and excessive handling helps to minimize agitation, irritability, and seizures in these vulnerable infants.

Choice D rationale

Increased head circumference is not an expected finding in a newborn with fetal alcohol syndrome (FAS). In fact, microcephaly (abnormally small head circumference) is a characteristic diagnostic criterion for FAS, reflecting the detrimental effects of alcohol on fetal brain development.

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Correct Answer is D

Explanation

Choice A rationale

A negative contraction stress test (CST) indicates that the fetus tolerates uterine contractions well, with no evidence of late decelerations, implying adequate uteroplacental function. Repeating the test in 20 minutes is unnecessary as a negative result signifies fetal well-being and is a favorable outcome.

Choice B rationale

Administering an intravenous fluid bolus is often used in situations like non-reassuring fetal heart rate patterns or to improve uteroplacental perfusion, such as during a non-reactive non-stress test or before an oxytocin challenge. A negative CST indicates a healthy fetus, so a fluid bolus is not indicated.

Choice C rationale

Preparing for a cesarean birth is indicated when there is evidence of fetal distress or a high risk of adverse outcomes, such as with a positive CST (late decelerations present). A negative CST indicates a reassuring fetal status, making a cesarean birth unnecessary based solely on these test results.

Choice D rationale

A negative CST indicates a healthy fetus with good uteroplacental reserve, suggesting that the fetus will likely tolerate the stress of labor. Therefore, allowing the labor to progress naturally is the appropriate action, as there are no indications of fetal compromise.

A. Routine use of intubation equipment during birth. B. Delay in initiating breastfeeding. C. Advantage of early ambulation post-surgical procedure. D. Management of postpartum pain. E. The need for an indwelling urinary catheter.

Correct Answer is ["C","D","E"]

Explanation

Choice A rationale

Routine use of intubation equipment during a cesarean birth is not standard practice. Intubation is typically reserved for general anesthesia or respiratory compromise. Most cesarean births are performed under regional anesthesia, such as a spinal or epidural block, which allows the mother to remain awake and avoid the need for invasive airway management, minimizing associated risks.

Choice B rationale

Delay in initiating breastfeeding after a cesarean birth is not a universal or recommended practice. While there may be a slight delay due to recovery from anesthesia, early skin-to-skin contact and breastfeeding are encouraged as soon as the mother is stable and alert. This promotes maternal-infant bonding and successful lactation establishment, supporting newborn nutrition and development.

Choice C rationale

Early ambulation post-surgical procedure, including cesarean birth, is highly advantageous for preventing complications such as deep vein thrombosis and promoting recovery. Movement stimulates circulation, reduces gas accumulation in the intestines, and aids in the restoration of normal bowel function. This active recovery approach significantly improves patient outcomes and comfort.

Choice D rationale

Management of postpartum pain is a critical topic for clients undergoing a cesarean birth. Effective pain control is essential for the mother's comfort, ability to ambulate, and capacity to care for her newborn. Education should cover various pharmacological and non-pharmacological pain relief methods, including medication schedules, side effects, and when to request additional pain relief.

Choice E rationale

The need for an indwelling urinary catheter is a common aspect of cesarean birth. A catheter is typically inserted before the procedure to keep the bladder empty, reducing the risk of bladder injury during surgery and allowing for accurate monitoring of urine output post-operatively. It is usually removed within 12 to 24 hours postpartum as ambulation is initiated.

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A charge nurse is teaching a newly licensed nurse about substance use disorders during pregnancy. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is performing a contraction stress test (CST) on a client who is at 40 weeks of gestation. The results of the test indicate a negative CST. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is teaching a class to clients who are pregnant. Which of the following topics should the nurse include in the discussion about cesarean birth? (Select all that apply.)

Correct Answer is ["C","D","E"]

Explanation

A nurse is caring for a client who is in active labor and is scheduled to receive epidural anesthesia. Which of the following actions should the nurse take?

A nurse is caring for a client who is at 28 weeks of gestation and has received two doses of terbutaline subcutaneously. Which of the following adverse effects is the priority for the nurse to report to the provider?

A nurse is reviewing the results of a nonstress test for a client who is at 37 weeks of gestation. Which of the following findings indicates a reactive nonstress test?

A charge nurse is providing teaching to a newly licensed nurse who is caring for a client who has postpartum hemorrhagic shock. Which of the following statements should the charge nurse make?

A nurse is caring for a female client who is gravida 1 para 0 at 32 weeks of gestation in the antepartum unit. Complete the following sentence by using the list of options. The nurse should identify that ____________ and ___________ are findings that require follow-up.

A nurse is reviewing the medical record of a client who has preeclampsia prior to administering labetalol. For which of the following findings should the nurse withhold the medication?

A nurse is reviewing the laboratory results for a client who is at 29 weeks of gestation and has a history of anemia. Which of the following results should the nurse identify and report as an indication of a prenatal complication?

A nurse is caring for a female client who is gravida 1 para 0 at 32 weeks of gestation in the antepartum unit. Complete the following sentence by using the list of options. The nurse should identify that the client is at the greatest risk for _______ due to ________.

A charge nurse is teaching a newly licensed nurse about substance use disorders during pregnancy.
Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?