a pregnant client receives rhod immune globulin after an amniocentesis the day following she reports a temperature of 998f 3767c which action should t
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HESI RN

Maternity HESI 2023 Quizlet

1. A pregnant client receives Rho(D) immune globulin after an amniocentesis. The day following, she reports a temperature of 99.8°F (37.67°C). Which action should the nurse implement?

Correct answer: C

Rationale: A mild increase in temperature post-amniocentesis is common, and encouraging the client to increase oral fluid intake is the appropriate action. Increasing fluid intake can help reduce mild fever, promote recovery, and prevent dehydration. It is important for the nurse to educate the client on the importance of staying hydrated to support her overall well-being during this time.

2. A new mother who is breastfeeding her 4-week-old infant and has type 1 diabetes reports that her insulin needs have decreased since the birth of her child. Which action should the nurse implement?

Correct answer: A

Rationale: The correct answer is A. During breastfeeding, insulin needs often decrease due to the metabolic demands of milk production. Therefore, the nurse should inform the client that this decrease in insulin requirements is a normal response to breastfeeding. Choice B is incorrect as increasing caloric intake is not directly related to the decrease in insulin needs during breastfeeding. Choice C is incorrect as advising the client to breastfeed more frequently does not address the issue of decreased insulin needs. Choice D is incorrect as scheduling an appointment with the diabetic nurse educator is not necessary at this point since the decreased need for insulin is a common physiological response to breastfeeding.

3. A client with no prenatal care arrives at the labor unit screaming, 'The baby is coming!' The nurse performs a vaginal examination that reveals the cervix is 3 centimeters dilated and 75% effaced. What additional information is most important for the LPN/LVN to obtain?

Correct answer: C

Rationale: Obtaining the date of the last normal menstrual period is crucial in estimating the gestational age of the fetus. This information helps in determining the progression of labor and the management of delivery. It also assists healthcare providers in assessing the overall health of the mother and the fetus. Choices A, B, and D are important in labor assessment, but in this scenario, the most crucial information needed is the date of the last normal menstrual period to estimate the gestational age.

4. The healthcare provider is reviewing the serum laboratory findings for a 5-day-old infant with congenital adrenal hyperplasia. Which laboratory result should be reported to the healthcare provider immediately?

Correct answer: D

Rationale: Low sodium levels in congenital adrenal hyperplasia can indicate salt-wasting crisis, which is a life-threatening emergency requiring immediate medical attention. Monitoring sodium levels is crucial to prevent complications such as dehydration and shock in these patients.

5. What should the nurse recommend to a woman with mastitis?

Correct answer: A

Rationale: The nurse should recommend applying heat to the affected area for a woman with mastitis. Heat can help reduce pain and inflammation associated with mastitis by improving blood flow to the area and promoting healing.

Similar Questions

After a client delivered vaginally 2 days ago, what information should you share with her if she wants to resume using her diaphragm for birth control?
A multiparous client is involuntarily pushing while being wheeled into the labor triage area. The nurse observes the fetal head presenting at the perineum. Which action should the nurse take?
To confirm respiratory distress syndrome (RDS) in a newborn, what should the nurse assess?
When preparing a class on newborn care for expectant parents, what content should be taught concerning the newborn infant born at term gestation?
Client teaching is an important part of the maternity nurse's role. Which factor has the greatest influence on successful teaching of the gravid client?

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