FINAL EXAM OB REVIEW

After describing continuous electronic fetal monitoring to a laboring woman and her partner, which of the following would indicate the need for additional teaching?"

"Unfortunately, I'm going to have to stay quite still in bed while it is in place."

After teaching a woman with postpartum infection about care after discharge, which client statment indicates the need for teaching?

"when i put on a new pad, I'll start at the back and go forward"

When providing care to a woman who is experiencing postpartum hemorrhage, the nurse weighs her perineal pads to estimate blood loss. The pad weighs 20g. The nurse documents this as which amount?

20ml

When assessing a pregnant woman with heart disease throughout the antepartal period, the nurse would be especially alert for signs and symptoms of cardiac decompensation at which time?

28 to 32 weeks gestation.

At which time should the nurse screen a pregnant woman for group B strep infection?

36wks gestation

A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7 year old twins who were born at 24 weeks gestation, a 2 year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as

41113

What should you tell the postpartum patient who does not wish to breast-feed about breast engorgement?

A supportive bra , ice packs, and a mild analgesic relieve discomfort.

A woman in the transitional stage of labor is most likely to exhibit which of the following behaviors?

Agitated and overwhelmed

A client who is HIV positive is in her second trimester and remainsasymptomatic. She voices concern about her newborns risk for the infection. Which of the following statements by the nurse would be most appropriate?

Anti retroviral medications are available to help reduce the risk of transmission

The nurse would be alert for which of the following immediately after a woman with abruptio placentae gives birth?

Appearance of petechiae

A primipara client who is bottle feeding her baby begins to experience breast engorgement on her third postpartum day. Which instruction would be most appropriate to aid in relieving her discomfort?

Apply ice packs to your breasts to reduce the amount of milk being produced

While making rounds in the nursery, the nurse sees a 6hour old baby girl gagging and turning bluish. Which of the following would the nurse do first?

Aspirate the oral and nasal pharynx with a bulb syringe

The parents of a newborn become concerned when they notice that their baby seems to stop breathing for a few seconds. After confirming the parents findings by observing the new born, which of the following actions would be most appropriate?

Assess the newborn for signs of respiratory distress

Which of the following is a priority when caring for a woman during the fourth stage of labor?

Assessing the uterine fundus

The nurse strokes the lateral sole of the newborn's foot from the heel to the ball of the foot when evaluating which reflex?

Babinski

When applying the ultrasound transducers for continuous external electronic fetal monitoring, at which location would the nurse place the transducer to record the FHR?

Between the umbilicus and the symphysis pubis

When preparing a schedule of follow up visits for pregnant woman with chronic HTN, which of the following would be most appropriate?

Bi monthly visit until 28wks, then weekly visits.

A client states, " I think my waters broke! i felt this gush of fluid between my legs." The nurse tests the fluid with Nitrazine paper and confirms membrane rupture if the paper turns :

Blue

After teaching parents about their newborn, the nurse determines that the teaching was successful when they identify the development of a close emotional attraction to a newborn by parents during the first 30 to 60 minutes after birth as which of the following?

Bonding

While performing a physical assessment of a newborn boy, a nurse notes diffuse edema of the soft tissues of his scalp that crosses suture lines. The nurse documents this finding as:

Caput succedaneum

Which of the following conditions is best for a successful passage of the fetus through the birth canal?

Cephalic presentation

A woman in labor is to receive continuous internal electronic fetal monitoring. The nurse reviews the woman's medical record to ensure which of the following as being required?

Cervical dilation of 2cm ormore

A 10-week old pregnant woman with DM has a HbA1c level of 13%. At this time the nurse should be most concerned about which of the following possible fetal outcomes?

Congenital anomalies

The nurse places a newborn with jaundice under the phototherapy lights in the nursery to achieve which goal?

Decrease the serum bilirubin level

Which of the following would most likely lead the nurse to suspect that a woman is experiencing postpartum psychosis?

Delerium

The nurse administers Rhogam to an RH-negative client after delivery of an RH-positive newborn based on the understanding that this drug will prevent her from:

Developing RH sensitivity

The nurse is assessing a 13 year old girl who has had her first menses. which of the following events would the nurse expect to have occured first?

Development of breast buds

Assessment of a newborn reveals uneven gluteal buttocks skin creases and a "clunk" when ORtali's maneuver is performed. Which of the following would the nurse suspect?

Developmental dysplasia

A multipara client develops thrombophlebitis after delivery. Which of the following would alert the nurse to the need for immediate intervention?

Dyspnea, diaphoresis, hypotension, and chest pain

A 42 year old woman is scheduled for a mammogram. Which of the following would the nurse include when teaching the woman about the procedure?

Each breast will be firmly compressed between two plates.

When developing the plan of care for the parents of a newborn, the nurse identifies interventions and attachment are most supported by which measure?

Early parent/infant contact following birth

When preparing a woman for an amniocentesis, the nurse would instruct her to do which of the following?

Empty her bladder

When planning the care of a woman in the active phase of labor, the nurse would anticipate assessing the fetal heart rate at which interval?

Every 30 minutes

After a normal labor and birth, a client is discharged from the hospital 12 hours later. When the community health nurse makes a home visit 2 days later, which finding would alert the nurse to the need for further intervention?

Frequent scant voidings

A pregnant woman needs an update in her immunizations. Which of the following vaccinations would the nurse ensure that the woman receives?

Hepatitis B

When assessing a pregnant woman in her last trimester, which question would be most appropriate to use to gather information about weight gain and fluid retention?

How swollen do your ankles appear before you go to bed?

When assessing a newborn 1 hour afterbirth, the nurse measures an axillary temperature of 95.8 F, apical pulse of 114bpm, and a respiratory rate of 60 breaths/minute. Which nursing diagnosis takes highest priority?

Hypothermia related to heat loss during birthing process

After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicated successful teaching?

I need to eat foods high in fiber

A woman is flying across the country to visit her family. After teaching the woman about traveling during pregnancy, which statement indicates that the teaching was successful?

I'll get up and walk around the airplane about every 2 hours.

During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 bpm (increased from baseline readings of 70 to 74 bpm , and irregular, with bilateral crackles in the lower lung bases.Which nursing diagnosis would be the priority for this client?

IMpaired gas exchange related to pulmonary congestions.

Which of the following would be essential to implement to prevent lat postpartum hemorrhage?

INspecting the placenta after delivery for intactness

When discussing contraceptive options, which method would the nurse recommend as being the most reliable?

INtrauterine system

A client experienced prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which of the following in the mother and the newborn?

Infection

A clients last menstrual period was April 11. Using Nageles rulse her EDB would be

January 18th

A client comes to the unit with abdominal pain. Based on her history, the nurse suspects endometriosis. the nurse expects to prepare the client for which of the following to confirm this suspicion?

Laparoscopy

When teaching a class of pregnant women about the effects of substance abuse during pregnancy, which of the following would the nurse most likely include?

Low birth weight infants

During a clinical breast examination, the nurse palpates a well-defined firm, mobile lump in a 60year old womans left breast. The nurse notifies the physician. Which of the following would the nurse anticipate the physician to order next?

Mammogram

When palpating the fundus during a contraction, the nurse notes that it feels like a chin. The nurse interprets this finding as indicating which type of contraction?

Moderate

During a physical assessment of a newborn, the nurse observes bluish markings across the newborns lower back. The nurse documents this finding as which of the following?

Mongolian spots

The nurse completes the initial assessment of the newborn. Which finding would lead the nurse to suspect that the newborn is experiencing difficulty with oxygenation?

Nasal flaring

When assessing fetal heart rate, the nurse finds a heart rate of 175 bpm, accompanied by a decrease in variability and late decelerations. Which of the following would the nurse do next?

Notify the health care provider

Which method would be most effective in evaluating the parents' understanding about their newborn's care?

Observe the parents performing the procedures

A nurse is working as part of a committee to establish policies to promote bonding and attachment. Which practice would be least effective in achieving this goal?

Offering round the clock nursery care for all infants

A client's maternal serum alpha-fetoprotein (MSAFP) level was unusually elevated at 17 weeks. The nurse suspects which of the following?

Open spinal defects

Which medication would the nurse question if ordered to control a pregnant womans asthma?

Oral prednisone

A postpartum woman is having difficulty voiding for the first time after giving birth.Which of the following would be least effective in helping to stimulate voiding?

PLacing her hand in a basin of cool water.

The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first?

Penile vasodilation

The nurse is assisting a postpartum woman out of bed to the bathroom for a sits bath. Which of the following would be a priority?

Place the call light within her reach

The nurse administers vitamin K IM to the newborn base on which of the following rationales?

Promote blood clotting

During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. The nurse interprets this as:

Reactive pattern

After teaching a group of students about the use of antiretroviral agents in pregnant women who are HIV-positive, the instructor determines that the teaching was successful when the group identifies which of the following as the underlying rationale?

Reduction in viral loads in the blood

A woman in labor received an opiod close to the time of birth. the nurse would assess the newborn for which of the following?

Respiratory depression

Just after delivery, a newborn's axillary temperature is 94 degrees F. What action would be most appropriate?

Rewarm the newborn gradually.

Which of the following would the nurse least expect to administer to a woman experiencing postpartum hemorrhage?

Terbulatine

The nurse is teaching a health education class on male reproductive energy and asks the students to identify the site of sperm production. Which structure, if identified by the group, would indicate to the nurse that the teaching was successful?

Testes

A woman comes to the clinic complaining that she has little sexual desire. As part of the clients evaluation, the nurse would anticipate the need to evaluate which hormone level?

Testosterone

A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which statement by the woman would lead the nurse to suspect that the woman needs additional teaching?

The temperature of the water should be at least 105degreesF

When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage because:

These measurements may not change until after the blood loss is large

The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion?

Thin upper lip

A pregnant woman in the 36th week of gestation complains that her feet are quite swollen at the end of the day. After careful assessment, the nurse determines that this is an expected finding at this stage of pregnancy. Which intervention would be most appropriate for the nurse to suggest?

Try elevating your legs when you sit.

Which of the following factors in a clients history would alert the nurse to an increased risk for post partum hemorrhage?

Uterine atony, placenta previa, operative procedures

The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would be inappropriate for the nurse to include as an accessory gland?

Vas deference

Which of the following would be most appropriate when massaging a womans fundus?

Wait until the uterus is firm to express clots

Which of the following would the nurse include when teaching a pregnant woman about chorionic villus sampling?

You'll have an ultrasound first and then the test.

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about the use of which substance?

cocaine

After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against STI's?

condoms

Which instructions would the nurse include in discharge teaching for parents of a newborn?

demonstrating comfort measures to quiet a crying infant

During the 4th stage of labor the nurse should assess the patients vital signs, height of the fundus and amount of vaginal discharge

every 15 minutes for the first hour

A client is to receive an implantable contraceptive. The nurse describes this contraceptive as containing

synthetic progestin

Which of the following statements regarding the stages of labor is true?

the first stage begins with the first true labor contraction and ends with 10cm dilatation