Additional OB questions

The nurse should be concerned about a client's mother-infant bonding if the client is reluctant to do what on the first postpartum day? 1. undress the newborn 2. breast-feed the newborn 3. look at her newborn's face 4. attend classes for newborn care

3. look at her newborn's face

During the postpartum period increased cardiac output with tachycardia is expected in the client with existing heart disease. This knowledge should motivate the nurse who is caring for this client to monitor her for what? 1. irregular pulse 2. respiratory distress 3. hypovolemic shock 4. increased vaginal bleeding

2. respiratory distress With the mobilization of extravascular fluid and the rapid decrease in uterine blood flow, the heart of a client with a cardiac problem may begin to fail. As the heart fails, the respiratory rate and effort increases in an attempt to maintain oxygen to all body cells.

Which intervention should the nurse take immediately when an apnea monitor sounds an alarm 10 seconds after cessation of respirations? 1. assess for changes in skin color 2. use tactile stimuli on the chest or extremities 3. check the monitor for signs of a malfunction 4. resuscitate with a facemask and an Ambu bag

2. use tactile stimuli on the chest or extremities

A client with a suspected placenta previa is to have a repeat sonogram at 16 weeks gestation. Which nursing intervention is necessary to prepare for this procedure? 1. inserting an indwelling urinary catheter 2. cleansing the abdomen with germicidal soap 3. ensuring that the client drinks two 8oz glass of water 4. administering a cleansing enema of 500 mL of normal saline

3. ensuring that the client drinks two 8oz glasses of water

Two days after delivery, a client has a temperature of 101 F (38.3 C), general malaise, anorexia and chills. Which clinical finding does the nurse expect to identify on the client's laboratory report? 1. increased hemoglobin level 2. decreased C-reactive protein 3. increased WBC count 4. right-shift differential WBC count

3. increased WBC count

A preterm newborn will be in the neonatal intensive care until for several weeks. The parents live approximately 100 miles away and say they can only visit every 2 weeks or so. What is the most important thing for the nurse to do when planning care for this newborn and the family? 1. focus on the infant's biophysical needs in view of the current critical condition. 2. maintain contact with the parents by sending e-mails with pictures of the infant 3. refer the infant's parents to the social worker to arrange housing close to the hospital 4. prepare a teaching plan to be given to the parents on the day of their infant's discharge

2. maintain contact with the parents by sending e-mails with pictures of the infant

A client who is in preterm labor at 34 weeks gestation is receiving intravenous tocolytic therapy. The frequency of her contractions increases to every 10 minutes and her cervix dilates to 4 cm. The infusion is discontinued. Toward what outcome should the priority nursing care be directed at this time? 1. reduction of anxiety associated with preterm labor 2. promotion of maternal and fetal well-being during labor 3. supportive communication with the client and her partner 4. helping the family cope with the impending preterm birth

2. promotion of maternal and fetal well-being during labor

While caring for a client during labor, what does the nurse remember about the second stage of labor? 1. it ends at the time of birth 2. it ends as the placenta is expelled 3. it begins with the transition phase of labor 4. it begins with the onset of strong contractions

1. it ends at the time of birth

The nurse concludes that a positive contraction stress test (CST) result may be indicative of potential fetal compromise. A CST result is considered positive when the fetal heart rate shows what during contractions? 1. late decelerations 2. early accelerations 3. variable decelerations 4. prolonged accelerations

1. late decelerations

The nurse is caring for a new mother who has a chlamydial infection. For which complications should the nurse assess the client's neonate? Select all that apply. 1. pneumonia 2. preterm birth 3. microcephaly 4. conjunctivitis 5. congenital cataracts

1. pneumonia 2, preterm birth 4. conjunctivitis

A nurse is planning to teach the parents of a preterm infant regarding the infant's nutritional needs. Some nutrients are required in greater quantities in a preterm infant than a full-term one. Which nutrients should the nurse include in the plan? 1. proteins 2. carbs 3. Vitamins A, D, E, and K 4. calcium and phosphorus

1. proteins Proteins are needed for tissue-building, therefore, the preterm infant's need for protein is greater than the full-term infant

Typical signs of neonatal abstinence syndrome related to opioid withdrawal usually begin within 24 hours after birth. What characteristics should the nurse anticipate in the infant of a suspected or known drug abuser? Select all that apply 1. tremors 2. dehydration 3. hyperactivity 4. muscle hypotonicity 5. prolonged sleep periods

1. tremors 3. hyperactivity

What is the nurse's initial action immediately after assisting with a precipitous birth in the triage area of the emergency department? 1. warming the newborn 2. clamping the umbilical cord 3. assessing maternal bleeding 4. monitoring expulsion of the placenta

1. warming the newborn

After 8 postpartum hours the nurse determines that a client's fundus is 3 cm above the umbilicus and displaced to the right. Which statement is most significant in confirming the reason for the location of the uterus? 1. "I've been so thirsty the past few hours." 2. "I went to the bathroom, but I can't seem to urinate." 3. "I've changed my pad once since I got to my room." 4. "I've had a lot of contractions, especially while I was nursing."

2. "I went to the bathroom, but I can't seem to urinate."

A client at 24 weeks gestation is admitted in early labor. What should the nurse take into consideration regarding the client's early gestation? 1. if contractions are regular, labor cannot be stopped effectively. 2. Birth at this gestational age usually results in a severely compromised neonate 3. Attempts will be made to sustain the pregnancy for 2-3 more weeks to ensure neonatal survival 4. Infants born at 30-34 weeks' gestation have a low morbidity rate because of advances in neonatal health care.

2. Birth at this gestational age usually results in a severely compromised neonate

A nurse is caring for a client during an ultrasonogram. Which parameters does the nurse expect to be used in the determination o pregnancy dates? 1. occipital frontal diameter at term 2. crown-to-rump measurement until 11 weeks 3. biparietal diameter of 12 cm or more at term 4. diagonal conjugate between 26 and 37 weeks

2. crown-to-rump measurement until 11 weeks.

What action should the nurse take to assist parents with bonding immediately after birth? 1. assess for typical parenting techniques 2. demonstrate desired behaviors to the parents 3. delay applying the antibiotic to the newborn's eyes 4. postpone footprinting the newborn until later in the day

2. delay applying the antibiotic to the newborn's eyes. The parents need an opportunity for close eye-to-eye contact during the first hour after birth. Prophylactic eye medications may irritate the newborn's eyes, preventing them from opening.

A 28 year old woman is recovering from her third consecutive spontaneous abortion in 2 years. What is the most therapeutic nursing intervention for this client at her follow-up appointment? 1. focusing on the client's physical needs 2. encouraging the client to verbalize her feelings about the loss 3. reminding the client that she will be able to become pregnant again 4. encouraging the client to think of herself, her husband and their future

2. encouraging the client to verbalize her feelings about the loss

The nurse is caring for the newborn of a mother with diabetes. For which signs of hypoglycemia should the nurse assess the newborn? Select all that apply. 1. Pallor 2. Irritability 3. hypotonia 4. ineffective sucking 5. excessive birth weight

2. irritability 3. hypotonia 4. ineffective sucking

In her 36th week of gestation, a client with type 1 diabetes delivers a 9 lb, 10 oz infant via c-section birth. For which condition should the nurse monitor this infant of a diabetic mother? 1. meconium ileus 2. physiologic jaundice 3. respiratory distress syndrome 4. increased intracranial pressure

3. respiratory distress syndrome A large for gestational age infant born at 36 weeks gestation to a mother with diabetes may have immature lung tissue, which predisposes the newborn to respiratory distress.

A client who has type O Rh-positive blood gives birth. The neonate has type B Rh-negative blood. When the nurse assesses the neonate 11 hours after birth, the infant's skin appears yellow. What is the most likely cause? 1. neonatal sepsis 2. Rh incompatibility 3. physiologic jaundice 4. ABO incompatibility

4 ABO incompatibility

The mother of a newborn son tells the nurse that she is concerned about circumcision because of the pain involved. What is the nurse's best response? 1. "It's such a short procedure that the pain won't last long." 2. "Your baby should have no memory of it, even if there is pain." 3. "A newborn's nerves are not mature enough for him to feel pain." 4. "The health care provider will tell you how your baby's pain will be controlled."

4. "The health care provider will tell you how your baby's pain will be controlled."

Placenta previa is diagnosed when a client at 24 weeks gestation presents with painless vaginal bleeding. The client is concerned that she has done something to cause the bleeding. How should the nurse respond? 1. "it's not your fault. These things happen." 2. "Don't worry. It's just a sign that labor is beginning." 3. "Your uterus may be weak - that's what causes the vaginal bleeding." 4. "You have a low-lying placenta that separates when the cervix dilates."

4. "You have a low-lying placenta that separates when the cervix dilates."

The primary heatlhcare provider plans to perform a vaginal examination of a client with a partial placenta previa. What should the nurse have available when this examination is performed? 1. unit of freeze-dried plasma 2. vitamin K and a syringe for injecction 3. heparin sodium for intravenous infusion 4. 2 units of typed and crossmatched blood

4. 2 units of typed and crossmatched blood Vaginal examination in a patient with placenta previa may result in sudden, severe hemorrhage because of the location of the placenta near the cervical os, whole blood should be ready for administration to prevent shock. Because of this possible complication, a sonogram is preferred to a vaginal examination.

The parents of a newborn male decide not to have their son circumcised. What should the nurse's discharge teaching for the care of an uncircumcised neonate include? 1. check the penis for bleeding 2. apply petrolatum to the end of the penis 3. pull the foreskin back toward the shaft of the penis 4. clean the penis with warm water without moving the foreskin.

4. clean the penis with warm water without moving the foreskin. Washing removes urine and feces, a light prepuce (foreskin) is common in newborns and may not be retractable for 3-4 years

A client's membranes rupture during labor, and the amniotic fluid is meconium stained. Which heart rate pattern indicates that the fetus's status is nonreassuring? 1. early decelerations with average variability 2. changes in baseline variability from 5 to 10 beats/min. 3. increases in fetal heart rate from 135 to 150 beats/min with fetal activity 4. variable decelerations that last 60 seconds then return to baseline tachycardia

4. variable decelerations that last 60 seconds then return to baseline tachycardia