NRSG 408 TEST 3 QUESTIONS WITH CORRECT DETAILED ANSWERS
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Course
NRSG 408
Institution
NRSG 408
NRSG 408 TEST 3 QUESTIONS WITH CORRECT DETAILED ANSWERS
The nurse is caring for a pregnant client diagnosed with mitral valve stenosis. Which position would the nurse suggest to the client to ensure a safe labor?
a. Supine
b. Standing
c. Lithotomy
d. Side-lying - Answer-d. Side-lying
R...
NRSG 408 TEST 3 QUESTIONS WITH
CORRECT DETAILED ANSWERS
The nurse is caring for a pregnant client diagnosed with mitral valve stenosis. Which
position would the nurse suggest to the client to ensure a safe labor?
a. Supine
b. Standing
c. Lithotomy
d. Side-lying - Answer-d. Side-lying
Rationale: Mitral valve stenosis occurs for various reasons, such as a stiffening of the
valve leaflets resulting from rheumatic heart disease. During labor, it is very important to
have adequate pain control to prevent tachycardia in these clients. A side-lying position
is desired to prevent tachycardia. A supine position would not provide comfort; rather, it
may cause supine hypotension. A standing position is not preferred in clients with mitral
valve stenosis. The lithotomic position may increase the risk of pulmonary edema in
clients with mitral valve stenosis.
When assessing a pregnant client with heart disease, the nurse knows that which form
of heart disease in women of childbearing years usually has a benign effect on
pregnancy?
a. Cardiomyopathy
b. Mitral valve prolapse
c. Rheumatic heart disease
d. Congenital heart disease - Answer-b. Mitral valve prolapse
Rationale: Mitral valve prolapse is a benign condition that is usually asymptomatic.
Cardiomyopathy produces congestive heart failure during pregnancy. Rheumatic heart
disease can lead to heart failure during pregnancy. Some congenital heart diseases will
produce pulmonary hypertension or endocarditis during pregnancy.
Which nursing actions are included in the primary survey for a client at 19 weeks of
gestation who has experienced a stab wound to the upper right abdominal quadrant and
is not breathing? Select all that apply.
a. Initiating an intravenous line
b. Administering oxygen
c. Performing an ultrasound examination
,d. Evaluating the fetal heart rate
e. Using a jaw thrust to establish an airway - Answer-a. Initiating an intravenous line
b. Administering oxygen
e. Using a jaw thrust to establish an airway
Rationale: Included in the primary survey for an obstetric client who is not breathing is
initiating an intravenous line, administering oxygen, and using a jaw thrust to establish
an airway. Performing an ultrasound examination and evaluating the fetal heart rate are
included in the secondary survey.
The nurse is caring for a pregnant client who is on antibiotic therapy to treat a urinary
tract infection (UTI). Which dietary changes would the nurse suggest for this client?
a. "Include yogurt, cheese, and milk in your diet."
b. "Avoid folic acid supplements until the end of therapy."
c. "Include vitamins C and E supplementation in your diet."
d. "Reduce your dietary fat intake by 40 to 50 grams per day." - Answer-a. "Include
yogurt, cheese, and milk in your diet."
A pregnant client reports abdominal pain in the right lower quadrant, along with nausea
and vomiting. The urinalysis report shows an absence of urinary tract infection. A chest
x-ray also rules out lower-lobe pneumonia. Which client condition would the nurse
suspect?
a. Appendicitis
b. Cholelithiasis
c. Placenta previa
d. Uterine rupture - Answer-a. Appendicitis
Note:
- Cholelithiasis: RUQ pain
- Placenta previa: when the placenta is implanted in the lower uterine segment covering
the cervix, which causes bleeding when the cervix dilates.
- Uterine rupture: a result of trauma, which may cause fetal death.
A client who recently had a heart transplant with no evidence of rejection asks the nurse
about the safety of conceiving a child. Which is the most accurate response by the
nurse?
a. "A heart transplant does not tolerate pregnancy."
b. "You may conceive 1 year after the transplant."
c. "The newborn may have congenital heart disease."
d. "You may need to terminate pregnancy at any time." - Answer-b. "You may conceive
1 year after the transplant."
,The nurse is caring for a client with rheumatic heart disease (RHD). Which medication
would the primary health care provider prescribe to prevent pulmonary edema?
a. Verapamil
b. Furosemide
c. Atenolol
d. Warfarin - Answer-b. Furosemide
- Diuretics (ie. furosemide)→ used to prevent pulmonary edema.
- Calcium channel blockers (ie. verapamil)→ used to prevent atrial fibrillation and control
heart rate.
- Beta blockers (ie. atenolol) are used to prevent tachycardia.
- Anticoagulants (ie. Warfarin)→ used to prevent pulmonary embolism.
Which nursing information is recognized as part of the protocol of a perimortem
cesarean delivery?
a. The goal is to deliver the neonate in less than 5 minutes.
b. Maternal resuscitation ceases after delivery of the neonate.
c. The neonate must be delivered after 5 minutes of maternal resuscitation.
d. After 4 minutes of maternal pulselessness, the neonate must be delivered. - Answer-
d. After 4 minutes of maternal pulselessness, the neonate must be delivered.
Rationale: After 4 minutes of maternal pulselessness, the neonate must be delivered to
increase the chance of a favorable fetal outcome. The neonate would not be delivered
in less than 5 minutes unless maternal pulselessness is present. Maternal resuscitation
does not necessarily cease after delivery of the neonate. Emptying the uterine contents
may improve the outcome of maternal resuscitation. The neonate would not need to be
delivered after 5 minutes of maternal resuscitation if there is a maternal pulse.
A nurse is caring for a client with mitral stenosis who is in the active stage of labor.
Which action would the nurse take to promote cardiac function?
a. Maintain the client in a side-lying position with the head and shoulders elevated to
facilitate hemodynamics.
b. Prepare the client for cesarean delivery because this is the recommended method to
sustain hemodynamics.
c. Encourage the client to avoid the use of narcotics or epidural regional analgesia
because this alters cardiac function.
d. Promote the use of the Valsalva maneuver during pushing in the second stage to
improve diastolic ventricular filling. - Answer-a. Maintain the client in a side-lying
position with the head and shoulders elevated to facilitate hemodynamics.
, Rationale: The side-lying position with the head and shoulders elevated helps facilitate
hemodynamics during labor. A vaginal delivery is the preferred method for a client with
cardiac disease because it sustains hemodynamics better than a cesarean delivery.
The use of supportive care, medication, and narcotics or epidural regional analgesia is
not contraindicated in the client with heart disease. Using the Valsalva maneuver during
pushing in the second stage would be avoided because it reduces diastolic ventricular
filling and obstructs left ventricular outflow.
Which drug is used for treating a client with severe postpartum bleeding?
a. Nifedipine
b. Oxytocin
c. Propranolol
d. Metronidazole - Answer-b. Oxytocin
- Oxytocin: synthetic hormone used to induce labor and to control severe postpartum
bleeding by making the uterus contract.
- Nifedipine: calcium channel blocker used in tocolytic therapy for preterm labor.
- Propranolol: reverses intolerable cardiovascular effects of terbutaline.
- Metronidazole: broad-spectrum antibiotic that is used to treat chorioamnionitis after
cesarean delivery.
Which drug prevents the risk of cerebral palsy in the fetus?
a. Nifedipine
b. Propranolol
c. Dexamethasone
d. Magnesium sulfate - Answer-d. Magnesium sulfate
The nurse is administering glucocorticoids to a pregnant client in preterm labor. When
explaining the purpose of this medication to the client, which response by the nurse is
accurate?
a. To prevent fetal cerebral palsy
b. To prevent early birth of the fetus
c. To prevent gestational hypertension
d. To prevent fetal respiratory distress syndrome - Answer-d. To prevent fetal
respiratory distress syndrome
Glucocorticosteroids: used for maturation of fetal lungs (ie. Dexamethasone
(Decadron))
A pregnant client who is in preterm labor has been prescribed dexamethasone. The
nurse knows the reason for administering this drug would be to facilitate which action?
a. Maturation of fetal lungs
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