ATI Proctored exam maternal newborn 2019

A nurse is caring for a client who is 2 weeks postpartum following a cesarean birth. Which of the following clinical fndings should the nurse identify as an indication of postpartum infection? a. Unilateral breast pain ...

A nurse is caring for a client who is 2 weeks postpartum following a cesarean birth. Which of the following clinical fndings should the nurse identify as an indication of postpartum infection? a. Unilateral breast pain b. Persistent abdominal striae c. Lochia alba d. WBC count 12,000/mm3 - ANS a. Unilateral breast pain A nurse is assessing client who has preeclampsia during a prenatal visit. Which of the following findings should the nurse report to the provider? a. Blood glucose 110 mg/dL b. Deep tendon reRexes of 2+ c. Urine protein of 3+ d. Hemoglobin 13 g/dL - ANS c. Urine protein of 3+ A nurse is providing teaching about the expected effects of magnesium sulfate to a client who is at 28 weeks of gestation and has preeclampsia. Which of the following responses by the nurse is appropriate? a. "This medication improves tissue perfusion." b. "This medication increases cardiac output." c. "This medication stabilizes the fetal heart rate." d. "This medication prevents seizures." - ANS d. "This medication prevents seizures." A nurse is teaching a prenatal class regarding false labor. Which of the following information should the nurse include? a. "You will have dilation and effacement of the cervix." b. "Your contractions will become temporarily regular." c. "You will have bloody show." d. "Your contractions will become more intense when walking." - ANS b. "Your contractions will become temporarily regular." A nurse manager is revising a maternal unit policy to ensure proper identification of newborns. Which of the following should the nurse include in the policy? a. Check the newborn's identification using the crib card. b. Replace the infant's identification band after his name has been recorded. c. Require visitors to wear an identification band. d. Obtain an imprint of the infant's feet prior to taking him to the nursery. - ANS d. Obtain an imprint of the infant's feet prior to taking him to the nursery. A nurse is caring for a client who delivered by cesarean birth 6 hr ago. The nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage. Which of the following actions should the nurse take? a. Apply an ice pack to the incision site. b. Replace the surgical dressing. c. Administer 500 mL lactated Ringer's IV bolus. d. Evaluate urinary output. - ANS d. Evaluate urinary output. . A nurse is providing discharge instructions to a client who is postpartum and has engorged breasts. Which of the following nonpharmacological comfort measures should the nurse include in the teaching?