A nurse is caring for a 34-year-old female client who is at 34 weeks of gestation in the antepartum unit.

Exhibits

What is the most appropriate action the nurse should take next?

Administer Rh immunoglobulin (Rho(D) immune globulin)

Perform a continuous fetal heart rate monitoring

Prepare for emergent delivery

Administer a corticosteroid to enhance fetal lung maturity

Answer and Explanation

The Correct Answer is D

A. Administer Rh immunoglobulin (Rho(D) immune globulin): This is important if the mother is Rh-negative, but there is no indication of Rh incompatibility in this scenario.

B. Perform continuous fetal heart rate monitoring: This is essential for ongoing assessment of fetal well-being but may not be the very first immediate action.

C. Prepare for emergent delivery: This would only be necessary if there were signs of fetal or maternal distress, which are not currently indicated.

D. Administer a corticosteroid to enhance fetal lung maturity: Administering corticosteroids like betamethasone or dexamethasone is crucial between 24 and 34 weeks of gestation to enhance lung maturity and reduce the risk of neonatal respiratory distress syndrome.

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Correct Answer is A

Explanation

Choice A rationale

High blood glucose levels in early pregnancy increase the risk of congenital heart defects in the baby.

Choice B rationale

Hip dysplasia is not directly associated with maternal diabetes but can be a congenital condition regardless of maternal glucose control.

Choice C rationale

Necrotizing enterocolitis is more related to prematurity and not directly linked to maternal diabetes.

Choice D rationale

Port wine stains are vascular birthmarks and are not associated with maternal blood glucose levels. .

A. Urgent: Maternal fever due to chorioamnionitis. B. Non-urgent: Compression due to lack of amniotic fluid. C. Urgent: Umbilical cord prolapse due to head not being engaged in the pelvic cavity. D. Non-urgent: Progression of the fetal head through the vaginal canal.

Correct Answer is C

Explanation

Choice A rationale

Maternal fever due to chorioamnionitis would show maternal signs of infection and not directly indicate fetal heart rate changes typical of umbilical cord prolapse.

Choice B rationale

Compression due to lack of amniotic fluid (oligohydramnios) typically shows variable decelerations on the fetal monitoring strip but is not urgent without other symptoms.

Choice C rationale

Umbilical cord prolapse is an urgent condition where the umbilical cord slips ahead of the fetus and can be indicated by sudden severe variable decelerations on the fetal monitor strip, requiring immediate intervention.

Choice D rationale

Progression of the fetal head through the vaginal canal shows a gradual change in the fetal heart rate and not the sudden pattern seen with cord prolapse.

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A nurse is caring for a 34-year-old female client who is at 34 weeks of gestation in the antepartum unit. Exhibits What is the most appropriate action the nurse should take next?

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Naxlex Comprehensive Predictor Exams

A client with type 1 diabetes mellitus is seeking preconception counseling.She has a high glycosylated hemoglobin (HgbA1c). Before trying to become pregnant, she is strongly encouraged to stabilize her blood glucose to reduce the possibility of her baby developing which of the following?

Correct Answer is A

Explanation

The RN interprets the following external fetal monitoring strip as:

Correct Answer is C

Explanation

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A nurse is caring for a 34-year-old female client who is at 34 weeks of gestation in the antepartum unit.

Exhibits

What is the most appropriate action the nurse should take next?