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 client who are prescribed methadone to breastfeed.
-The nurse should encourage clients who are prescribed methadone during
pregnancy to breastfeed their newborns to help with withdrawal symptoms.
A nurse is caring for a client who received terbutaline subcutaneously. Which of
the following findings is an indication the medication was effective?
Decreased frequency of contractions.
-Terbutaline is a tocolytic medication that is used to halt preterm labor.
Terbutalinecause relaxation of smooth muscle, which decrease uterine activity.
Therefore, the nurse should identify that a decrease in frequency of contractions
is an indication that terbutaline was effective.
00:02 01:50
A charge nurse is discussing care of clients who are in labor with a newly
licensed nurse. Which of the following actions should the charge nurse include
in the teaching regarding situations requiring an amniotomy?
Placing a fetal scalp electrode.
-A fetal scalp electrode is attached to the presenting part of the fetus in order to
provide accurate continuous monitoring of the fetal heart rate. If the client's
membranes are intact, the amniotic sac must be artificially ruptured prior to
attaching the electrode to enable access to the presenting part.
,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?
Heart rate 54/min
-The nurse should identify that a heart rate of 54/min is below the expected
reference range of 60 to 100/min. During pregnancy, the heart rate increases 10
to15/min due to increased blood volume and increase tissue demands for
oxygen.
Bradycardia is a contraindication for the administration of labetalol, an
antihypertensive medication. Therefore, the nurse should withhold the medication
and notify the provider.
A nurse is caring for a client who is at 30 weeks of gestation and observes the
client choking while eating lunch. The client is unable to speak or cough.
Identifythe sequence of steps the nurse should take to clear the airway
obstruction.
• Stand posterior to the client.
• Position arms under the client's axilla and across the client's chest.
• Place thumb-side of a clenched fist to the client's mid-sternum area.
• Initiate chest thrust to the client using a backward motion.
-If the client becomes unconscious, the nurse should perform CPR and activate
emergency medical services.
A nurse is preparing to administer an opioid analgesic to a client who is in
active labor. Which of the following assessments should the nurse perform?
(SATA)
Maternal blood pressure.
-Opioid analgesic can cause hypotension. The nurse should assess the clients
bloodpressure before and after administering opioids.
Pain level.
-The nurse should assess the clients baseline pain level prior to administering pain
medication and again after administering pain medication to determine the
effectiveness of the medication. Opioid analgesic are indicated for the relief of
moderate to sever labor pain.
Fetal heart rate.
, -Opioid analgesics can cause fetal bradycardia and changes in variability. The
nurse should assess the fetal heart rate prior to administering an opioid analgesic
toensure the rate is within the expedited reference range and to have a baseline
for future assessments. The nurse should provide ongoing assessments of fetal
heart rate throughout labor according to facility protocol.
A nurse is reviewing the medical records of a client who is at 8 wks. of
gestation. Which of the following findings should the nurse identify as a risk
factor for developing preeclampsia?
Rheumatoid Arthritis.
-The presence of a connective tissue disease, such as rheumatoid arthritis or
systemic lupus erythematosus, increase a clients risk for developing
preeclampsia.
A nurse is reviewing the laboratory results for a postpartum client who is receiving
warfarin for deep-vein thrombosis. Which of the following laboratory tests should
the nurse monitor?
International normalized ratio (INR).
-The nurse should monitor the INR of a client who is taking warfarin.
Prothrombintime(PT) is also measure to regulate warfarin therapy. However, PT
values are more difficult to interpret. INR determined by multiplying the PT by a
correction factor based on the specific thromboplastin preparation used for the
test, as a way of equalizing laboratory to laboratory variations.
A nurse is monitoring a client who is in the active phase of labor and has an
intrauterine pressure catheter and fetal scalp electrode. Which of the
followingfindings should the nurse expect?
Montevideo units (MVU) of 220 mm Hg.
- The nurse should identify that an MVU of 220 mm Hg is within the expected
range during the active phase of labor. MVUs generally range between 100 to
250 mm Hg during the first stage of labor and increase to 300 to 400 mm Hg
during thesecond stage of labor. MVUs are calculated by subtracting the baseline
uterine pressure from the peak contraction pressure for every contraction that
occurs during a 10-min period. The nurse then adds the pressure produced by
each contraction during that time to determine the MVUs.
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