A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. The fetal heart rate (FHR) before birth is 180 beats per minute with limited variability. At birth, the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic. Based on the maternal history, what is the most likely cause of this newborn's distress?

Hypoglycemia

Phrenic nerve injury

Sepsis

Meconium aspiration syndrome

Answer and Explanation

The Correct Answer is C

Choice A reason: Hypoglycemia is a low blood sugar level that can affect newborns, especially those who are premature, small for gestational age, or have diabetic mothers. However, hypoglycemia does not explain the high FHR, the low Apgar scores, or the pale and tachypneic appearance of the newborn.

Choice B reason: Phrenic nerve injury is a rare complication of cesarean section that can cause diaphragmatic paralysis and respiratory distress in the newborn. However, phrenic nerve injury usually affects only one side of the chest, and does not cause high FHR, low Apgar scores, or pallor.

Choice C reason: Sepsis is a serious infection that can affect newborns, especially those who are exposed to prolonged rupture of membranes, as in this case. Sepsis can cause high FHR, low Apgar scores, pale and tachypneic appearance, and other signs of shock and organ failure.

Choice D reason: Meconium aspiration syndrome is a condition where the newborn inhales meconium-stained amniotic fluid into the lungs, causing respiratory distress. However, meconium aspiration syndrome usually occurs in term or post-term infants, and is associated with low FHR, not high FHR. Meconium aspiration syndrome also causes cyanosis, not pallor.

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Correct Answer is D

Explanation

Choice A reason: "I'll basically follow the same diet that I was following before I became pregnant." is an incorrect statement, because it indicates that the client does not understand the need for dietary changes during pregnancy. The client should follow a diet that is individualized, balanced, and consistent in carbohydrate intake, and that meets the nutritional needs of pregnancy.

Choice B reason: "Because I need extra protein, I'll have to increase my intake of milk and meat." is an incorrect statement, because it indicates that the client does not understand the role of protein in diabetes management. The client should consume adequate but not excessive amounts of protein, and choose lean sources of protein, such as poultry, fish, eggs, and legumes.

Choice C reason: "I'll adjust my diet and insulin based on the results of my urine tests for glucose." is an incorrect statement, because it indicates that the client does not understand the limitations of urine tests for glucose. The client should monitor her blood glucose levels regularly, and adjust her diet and insulin accordingly, under the guidance of the provider. Urine tests for glucose are not accurate or reliable indicators of blood glucose levels.

Choice D reason: "Pregnancy affects insulin production, so I'll need to make adjustments in my diet." is a correct statement, because it indicates that the client understands the impact of pregnancy on diabetes. The client should be aware that pregnancy can cause insulin resistance, especially in the second and third trimesters, and that her diet may need to be modified to achieve optimal glycemic control.

Correct Answer is ["0.5"]

Explanation

To calculate the number of tablets, the nurse should use the following formula:

Number of tablets = (Desired dose / Available dose) x (Available form / Desired form)

In this case, the desired dose is 50 mg, the available dose is 100 mg, the available form is 1 tablet, and the desired form is 1 tablet. Therefore, the formula becomes:

Number of tablets = (50 mg / 100 mg) x (1 tablet / 1 tablet)

Number of tablets = 0.5 x 1

Number of tablets = 0.5

The nurse should round the answer to the nearest tenth, which is 0.5. The nurse should use a leading zero if the answer is less than 1, which is 0.5. The nurse should not use a trailing zero, which means 0.5 and not 0.50.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching a pregnant woman with type 2 diabetes about her diet during pregnancy. Which client statement indicates that the nurse's teaching was successful?

Correct Answer is D

Explanation

A nurse is preparing to administer atenolol 50 mg PO daily to a client. The amount available is atenolol 100 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero)

Correct Answer is ["0.5"]

Explanation

A nurse on the obstetric unit is caring for a client who experienced abruptio placentae. The nurse observes petechiae and bleeding around the IV access site. The nurse should recognize that this client is at risk for which of the following complications?

A nurse is caring for a client who is in premature labor and is receiving terbutaline. The nurse should monitor the client for which of the following adverse effects that should be reported to the provider?

A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse?

What is the first line medication for postpartum hemorrhage?

A nurse is planning care for a client who is at 10 weeks of gestation and reports abdominal pain and moderate vaginal bleeding. The tentative diagnosis is inevitable abortion. Which of the following nursing interventions should be included in the plan of care?

A nurse in a provider's office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption?

A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first?

A nurse is admitting a client who is at 30 weeks of gestation and is in preterm labor. The client has a new order for betamethasone and asks the nurse about the purpose of this medication. The nurse should provide which of the following explanations?