a nurse is caring for a client who is 6 hr postpartum the client is rh negative and her newborn is rh positive the client asks why an indirect coombs
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ATI Maternal Newborn Proctored

1. A client who is 6 hours postpartum and Rh-negative has an Rh-positive newborn. The client asks why an indirect Coombs test was ordered. Which of the following is an appropriate response by the healthcare provider?

Correct answer: C

Rationale: The indirect Coombs test is performed to detect Rh-positive antibodies in the mother's blood. In cases where the mother is Rh-negative and the baby is Rh-positive, the mother may develop antibodies against the baby's blood cells, which can lead to hemolytic disease of the newborn. Choice A is incorrect because kernicterus is a complication of severe jaundice, not directly assessed by the indirect Coombs test. Choice B is incorrect as the test aims to detect Rh-positive antibodies, not Rh-negative antibodies in the newborn's blood. Choice D is incorrect as the test is focused on detecting antibodies in the mother's blood, not the newborn's.

2. A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow.

Correct answer: D

Rationale: The correct sequence for the nurse to follow when performing Leopold maneuvers is as follows: first, palpate the client's fundus to identify the fetal part, second, determine the location of the fetal back, third, palpate for the fetal part presenting at the inlet, and finally, palpate the cephalic prominence to identify the attitude of the head. Therefore, option D, 'All of the Above,' is the correct answer as it includes all the steps in the correct sequence. Choices A, B, and C are incorrect as they do not represent the complete sequence required for performing Leopold maneuvers.

3. A client has severe preeclampsia and is receiving magnesium sulfate IV. Which of the following findings should the nurse identify and report as signs of magnesium sulfate toxicity? (Select all that apply)

Correct answer: D

Rationale: Signs of magnesium sulfate toxicity include respirations less than 12/min, urinary output less than 25 mL/hr, and decreased level of consciousness. These signs indicate potential overdose of magnesium sulfate and require immediate attention to prevent further complications. Reporting these signs promptly is crucial to ensure the client's safety and well-being. Choice D, 'All of the above,' is the correct answer as all the listed findings are indicative of magnesium sulfate toxicity. Choices A, B, and C individually represent different signs of toxicity, making them incorrect on their own. Therefore, the nurse should be vigilant in identifying and reporting all these signs to prevent adverse outcomes.

4. A client who is at 12 weeks of gestation is reviewing a new prescription of ferrous sulfate. Which of the following statements by the client indicates understanding of the teaching?

Correct answer: C

Rationale: The correct answer is C. Taking iron supplements with orange juice, which contains vitamin C, enhances the absorption of iron, making the treatment more effective. Choices A, B, and D are incorrect because taking ferrous sulfate with milk, calcium-rich foods, or breakfast may hinder iron absorption due to interactions with calcium or other substances that compete with iron absorption.

5. Which of the following medications should the provider prescribe for a client with gonorrhea?

Correct answer: A

Rationale: Ceftriaxone is the preferred medication to treat gonorrhea, a bacterial infection. It is essential to promptly treat gonorrhea to prevent complications such as pelvic inflammatory disease, infertility, and the spread of the infection to others. Fluconazole is used for fungal infections, Metronidazole treats certain bacterial and parasitic infections, and Zidovudine is an antiretroviral medication used in HIV treatment; none of these are appropriate for gonorrhea.

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