A nurse is providing care for a pregnant patient.

The patient’s medical history includes Gravida 4 Para 3, 32 weeks of gestation, and a BMI of 32. The patient has a history of two newborns weighing over 4.5 kg (10 lb) and a family history of type one diabetes mellitus (maternal). The fetal heart tones are 140/min via doppler.

Which of the following provider prescriptions should the nurse plan to implement? Select the three actions the nurse should plan to take.

Conduct a non-stress test twice per week.

Encourage the patient to limit carbohydrate intake to 40% of their daily calories.

Instruct the patient to check a random blood glucose level once daily.

Anticipate a prescription for metformin.

Answer and Explanation

Correct Answer : A,B,D

Choice A rationale

A nonstress test (NST) is a test during pregnancy that measures the baby’s heart rate and response to movement. It is designed to ensure the baby is doing well and getting enough oxygen. Your provider might order it during the third trimester if you’re experiencing certain complications.

Choice B rationale

During pregnancy, women need nutrient-rich sources of carbohydrate, in the right amounts. Restriction of simple carbohydrates has been shown to reduce postprandial hyperglycemia, fetal glucose exposure, and fetal overgrowth. Therefore, encouraging the patient to limit carbohydrate intake to 40% of their daily calories could be beneficial.

Choice C rationale

Checking a random blood glucose level once daily is not typically recommended during pregnancy. Instead, blood glucose levels are usually checked at specific times, such as fasting (before breakfast), before other meals, and 1 hour after meals. This helps to provide more accurate information about how the body is managing blood glucose levels throughout the day.

Choice D rationale

Metformin is generally considered safe for use during pregnancy. It can also be used to treat women with gestational diabetes mellitus (diabetes that develops during pregnancy)7. Given the patient’s history and risk factors, it would be reasonable to anticipate a prescription for metformin.

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Correct Answer is A

Explanation

Choice A rationale

Applying lotion to the newborn’s skin during phototherapy is not recommended. Lotion can block the light from reaching the skin and reduce the effectiveness of the treatment.

Choice B rationale

Covering the newborn’s eyes with a mask during phototherapy is a standard practice. This is done to protect the newborn’s eyes from the intense light used in phototherapy.

Choice C rationale

An increase in stool frequency is expected during phototherapy. This is because phototherapy helps to break down bilirubin, which is then excreted in the stool.

Choice D rationale

A pink rash on the newborn’s trunk does not require intervention during phototherapy. It could be a common newborn rash that will resolve on its own.

A. The client reports profuse itching. B. Temperature 38.2°C (100.8°F). C. Blood pressure 80/56 mm Hg. D. The client reports weakness of the lower extremities.

Correct Answer is C

Explanation

Choice A rationale

While itching can be a side effect of opioid analgesics, it is not the priority observation. Itching can be uncomfortable for the client, but it is not life-threatening.

Choice B rationale

A temperature of 38.2°C (100.8°F) indicates a low-grade fever. While this should be monitored, it is not the priority observation in this situation.

Choice C rationale

The priority observation is the client’s blood pressure. Opioid epidural analgesia can cause hypotension, which can lead to inadequate perfusion to the mother and the fetus. Therefore, the nurse should prioritize monitoring the client’s blood pressure.

Choice D rationale

Weakness of the lower extremities can be a side effect of epidural analgesia, but it is not the priority observation. The nurse should monitor for this, but it is not as critical as monitoring the client’s blood pressure.

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Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an infant who is receiving phototherapy. Which of the following findings requires intervention by the nurse?

Correct Answer is A

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

A nurse is attending to a client who is receiving opioid epidural analgesia during labor. Which of the following observations should the nurse prioritize?

Correct Answer is C

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

A nurse is caring for a client who is 2 days postpartum, is breastfeeding, and reports nipple soreness. Which of the following measures should the nurse suggest to reduce discomfort during breastfeeding? (Select all that apply.)

A nurse is providing discharge instructions to a client who is 3 days postoperative following a cesarean birth. Which of the following statements from the client indicates that the teaching has been effective? (Select all that apply.)

A home health nurse is teaching a client who is breastfeeding about managing breast engorgement. Which of the following client statements indicates understanding of the teaching?

A nurse is preparing to measure the fundal height of a client who is at 22 weeks of gestation. At which location should the nurse expect to palpate the fundus?

A nurse is caring for a client who has just delivered a newborn. The nurse notices secretions bubbling out of the newborn’s nose and mouth. Which of the following actions should the nurse prioritize?

A nurse is preparing to assess a newborn who is postmature. Which of the following findings should the nurse expect?

A nurse is caring for a client who is in active labor and notes late decelerations in the FHR. Which of the following actions should the nurse take first?