A nurse in a prenatal clinic is caring for a client.

Using Leopold maneuvers, the nurse palpates a round, firm, movable part in the fundus of the uterus and a long, smooth surface on the client’s right side.

In which abdominal quadrant should the nurse expect to auscultate fetal heart tones?

Left lower

Right upper

Left upper

Right lower

Answer and Explanation

The Correct Answer is D

Choice A rationale
The left lower quadrant is not the most likely location to auscultate fetal heart tones if the nurse palpates a round, firm, movable part in the fundus of the uterus and a long, smooth surface on the client’s right side. These findings suggest that the fetus is in a breech position with its back on the left side, which would place the fetal chest, and thus the heart tones, in the right lower quadrant.
Choice B rationale
The right upper quadrant is not the most likely location to auscultate fetal heart tones if the nurse palpates a round, firm, movable part in the fundus of the uterus and a long, smooth surface on the client’s right side. These findings suggest that the fetus is in a breech position with its back on the left side, which would place the fetal chest, and thus the heart tones, in the right lower quadrant.
Choice C rationale
The left upper quadrant is not the most likely location to auscultate fetal heart tones if the nurse palpates a round, firm, movable part in the fundus of the uterus and a long, smooth surface on the client’s right side. These findings suggest that the fetus is in a breech position with its back on the left side, which would place the fetal chest, and thus the heart tones, in the right lower quadrant.
Choice D rationale
The right lower quadrant is the most likely location to auscultate fetal heart tones if the nurse palpates a round, firm, movable part in the fundus of the uterus and a long, smooth surface on

the client’s right side. These findings suggest that the fetus is in a breech position with its back on the left side, which would place the fetal chest, and thus the heart tones, in the right lower quadrant.

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Correct Answer is D

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.

A. A newborn who is 24 hours post-delivery and has not voided B. A newborn who is 18 hours post-delivery and has acrocyanosis C. A newborn who is 12 hours post-delivery and has a temperature of 37.5°C (99.5°F) D. A newborn who is 24 hours post-delivery and has not passed meconium

Correct Answer is D

Explanation

Choice A rationale
A newborn typically begins to void within 24 hours after birth, so not voiding within this time frame is not immediately concerning.
Choice B rationale

Acrocyanosis, or bluish discoloration of the hands and feet, is common in newborns, especially within the first few hours after birth. It is a normal finding and does not require immediate intervention.
Choice C rationale
A temperature of 37.5°C (99.5°F) is within the normal range for a newborn. Therefore, this does not require immediate attention.
Choice D rationale
Newborns typically pass meconium, the first stool, within 24 to 48 hours after birth. If a newborn has not passed meconium within 24 hours, it could indicate a problem such as meconium ileus, a complication of cystic fibrosis, or other conditions that might obstruct the bowel. This situation requires immediate attention and intervention.

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A nurse in a prenatal clinic is caring for a client. Using Leopold maneuvers, the nurse palpates a round, firm, movable part in the fundus of the uterus and a long, smooth surface on the client’s right side. In which abdominal quadrant should the nurse expect to auscultate fetal heart tones?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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A nurse in a prenatal clinic is caring for a client.

Using Leopold maneuvers, the nurse palpates a round, firm, movable part in the fundus of the uterus and a long, smooth surface on the client’s right side.

In which abdominal quadrant should the nurse expect to auscultate fetal heart tones?