During a weekly prenatal visit, a nurse is assessing a client at 38 weeks of gestation. Which of the following findings should the nurse report to the provider?

Correct Answer: C

Rationale: The correct answer is C: Weight gain of 2.2 kg (4.8 lb). This finding should be reported to the provider because sudden excessive weight gain in late pregnancy can be a sign of preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. This could indicate a potential complication that needs immediate medical attention. Explanation: A: Blood pressure 136/88 mm Hg - This blood pressure reading is slightly elevated but not concerning for preeclampsia at this level. B: Report of insomnia - Insomnia is a common issue during pregnancy and not typically a cause for immediate concern. D: Report of Braxton-Hicks contractions - Braxton-Hicks contractions are common in the third trimester and are considered normal as long as they are not regular or increasing in intensity.

Correct Answer: C

Rationale: The correct answer is C: Monitor the client's blood pressure every 5 minutes after the first dose of anesthetic solution. This is crucial as epidural anesthesia can cause hypotension, which can lead to maternal and fetal complications. Monitoring blood pressure every 5 minutes allows for early detection and intervention. A: Positioning the client supine for 30 minutes after the first dose of anesthetic solution can lead to hypotension due to decreased venous return, so this is incorrect. B: Administering dextrose 5% in water is not a standard practice after epidural anesthesia and does not address the risk of hypotension, so this is incorrect. D: Ensuring the client has been NPO for 4 hours before the procedure is important for general anesthesia but not specifically for epidural anesthesia, so this is incorrect.

Correct Answer: D

Rationale: The correct answer is D because it is important to stop suctioning when the newborn's cry sounds clear to avoid causing unnecessary discomfort or injury. Step 1: Gently compress the bulb syringe. Step 2: Insert the tip into the nostril, not the mouth. Step 3: Release the bulb to suction out the secretions. Step 4: Repeat in the other nostril. Incorrect choices: A is incorrect because you should insert the syringe tip before compressing the bulb. B is incorrect as you should suction the mouth before the nose. C is incorrect as you should not insert the syringe tip in the center of the mouth.

Correct Answer: D

Rationale: The correct answer is D: Respiratory distress. Hypoglycemia in a late preterm newborn can lead to respiratory distress due to inadequate energy supply to respiratory muscles. Hypertonia (choice A) may indicate other issues such as hypocalcemia. Increased feeding (choice B) is not a typical clinical manifestation of hypoglycemia, as the newborn may have poor feeding due to low energy levels. Hyperthermia (choice C) is not directly related to hypoglycemia but may occur in response to infection or other causes. Thus, respiratory distress is the most indicative of hypoglycemia in this scenario.

Correct Answer: D

Rationale: The correct answer is D because an axillary temperature of 37.7°C (99.9°F) in a newborn is above the normal range and could indicate a fever, which is a significant concern in newborns due to their immature immune systems. Fever in newborns can be a sign of serious infections that require immediate medical attention. A: Erythema toxicum is a common rash in newborns and typically resolves on its own without medical intervention. B: Failure to pass meconium stool by 48 hours may be a concern but not as urgent as a fever. C: Pink-tinged urine in the first few days of life is likely due to uric acid crystals and is considered normal in newborns.