Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
What action should a nurse take when caring for a client who is 1 hr postpartum and observes a large amount of lochia rubra and several small clots on the client’s perineal pad, with the fundus midline and firm at the umbilicus?
A. Notify the client’s provider.
B. Document the findings and continue to monitor the client.
C. Increase the frequency of fundal massage.
D. Encourage the client to empty her bladder.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Nur 232 Maternity Final Proctored Exam Sp24. Take the full exam now
Full Explanation
-
Similar Questions
A nurse is caring for a client who is in active labor with 7 cm of cervical dilation and 100% effacement. The fetus is at 1+ station, and the client’s amniotic membranes are intact.
The client suddenly states that she needs to push. Which of the following actions should the nurse take?
A. Have the client pant during the next contractions.
B. Observe the perineum for signs of crowning.
C. Help the client to the bathroom to void.
D. Assist the client into a comfortable position.
Full Explanation
-
A nurse is caring for a client who is in labor.
Which of the following nursing actions reflects application of the gate control theory of pain?
A. Massage the client’s back.
B. Administer prescribed analgesic medication.
C. Turn the client onto her left side.
D. Encourage the client to rest between contractions.
Full Explanation
-
A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which of the following complications as the priority focus of care?
A. Hypomagnesemia
Hypomagnesemia is not typically a primary concern for newborns of mothers with diabetes mellitus. While it can occur in newborns, it is not directly related to macrosomia or maternal diabetes.
B. Hypocalcemia
Hypocalcemia can occur in newborns, especially preterm infants, infants of diabetic mothers, and those with perinatal asphyxia. However, it is not the primary concern in this scenario.
C. Hyperbilirubinemia
Hyperbilirubinemia can occur in newborns for a variety of reasons, including prematurity, blood group incompatibility, and other factors. While infants of diabetic mothers may have an increased risk of jaundice, it is not the primary concern in this scenario.
D. Hypoglycemia
Hypoglycemia is the correct answer. Infants of diabetic mothers are at risk for hypoglycemia after birth. During pregnancy, the fetus produces extra insulin in response to the mother’s high blood glucose levels. After birth, the newborn continues to produce extra insulin for a short time until it adjusts to normal glucose-insulin balance. This can lead to hypoglycemia, which is a primary concern and requires immediate attention.
Full Explanation
Choice A rationale
Hypomagnesemia is not typically a primary concern for newborns of mothers with diabetes mellitus. While it can occur in newborns, it is not directly related to macrosomia or maternal diabetes.
Choice B rationale
Hypocalcemia can occur in newborns, especially preterm infants, infants of diabetic mothers, and those with perinatal asphyxia. However, it is not the primary concern in this scenario.
Choice C rationale
Hyperbilirubinemia can occur in newborns for a variety of reasons, including prematurity, blood group incompatibility, and other factors. While infants of diabetic mothers may have an increased risk of jaundice, it is not the primary concern in this scenario.
Choice D rationale
Hypoglycemia is the correct answer. Infants of diabetic mothers are at risk for hypoglycemia after birth. During pregnancy, the fetus produces extra insulin in response to the mother’s high blood glucose levels. After birth, the newborn continues to produce extra insulin for a short time until it adjusts to normal glucose-insulin balance. This can lead to hypoglycemia, which is a primary concern and requires immediate attention.