FINAL REVIEW PART 2 OB

A woman is to have a Papanicolaou test. When teaching the woman about this test, the nurse would emphasize which instruction to the client?

"Do not douche for 48 hours before the test."

A client is scheduled to have a Papanicolaou test. After the nurse teaches the client about the Pap test, which statement by the client indicates successful teaching?

"I will not engage in sexual intercourse for 48 hours before the test."

A pregnant woman asks the nurse, "I'm a big coffee drinker. Will the caffeine in my coffee hurt my baby?" Which response by the nurse would be most appropriate?

"If you keep your intake to less than 200 mg/day, you should be okay."

The nurse is teaching a prenatal class on the functions of the various structures involved with a pregnancy. The nurse determines the class is successful when the class correctly chooses which function of amniotic fluid?

"It helps cushion the baby."

The nurse is caring for an infant. The infant's mother asks the nurse, "What did the doctor mean when he said she may have regurgitation?" What response by the nurse is appropriate?

"Regurgitation is the backflow of stomach contents up into the esophagus or mouth."

A client who is breastfeeding her newborn tells the nurse, "I notice that when I feed him, I feel fairly strong contraction-like pain. Labor is over. Why am I having contractions now?" Which response by the nurse would be most appropriate?

"The baby's sucking releases a hormone that causes the uterus to contract."

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she is not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor?

"The contractions slow down when I walk around."

During a prenatal visit, a pregnant woman says, "I know the amniotic fluid is important, but can you tell me more about it?" When describing amniotic fluid to a pregnant woman, which description would the nurse most likely include?

"This fluid acts as a cushion to help to protect your baby from injury."

A fetus is assessed at 2 cm above the ischial spines. How would the nurse document the fetal station?

-2

A woman is admitted to the labor and birthing suite. Vaginal examination reveals that the presenting part is approximately 2 cm above the ischial spines. The nurse documents this finding as:

-2 station.

During a neonate resuscitation attempt, the neonatologist has ordered 0.1 ml/kg IV epinephrine (adrenaline) in a 1:10,000 concentration to be given stat. The neonate weighs 3000 grams and is 38 centimeters long. How many milliliters (ml) should the nurse administer? Record your answer using one decimal place.

0.3

The nurse is preparing to assess a client who is 1 day postpartum. The nurse predicts the client's fundus will be at which location on assessment?

1 cm below the umbilicus

A nurse is providing care to a child diagnosed with cerebral palsy who is experiencing painful muscle spasms. The health care provider has prescribed baclofen 40 mg/day PO in three divided doses. How many milligrams should the nurse administer in each dose? Record your answer using one decimal place.

13.3

A client is to receive 3 million units of penicillin G intramuscular to treat gonorrhea. The drug is available in 1,500,000 units/mL. How many milliliters should the nurse administer? Record your answer using a whole number.

2

A health care provider has prescribed hydroxyurea 20 mg/kg to a child as part of a treatment regimen for sickle cell disease. The child weighs 27 lb (12.2 kg). How many milligrams should the nurse administer?

244 The nurse will use the client's weight in kilograms and multiply by the prescribed milligrams per kilogram. 12.2 kg × 20 mg/kg = 244 mg

A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?

gonorrhea

The nurse records a newborn's Apgar score at birth. A normal 1-minute Apgar score is:

7 to 10

A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal?

A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal?

decreased hemoglobin

Both

increased heart rate

Both

A client with preeclampsia is receiving magnesium sulfate to suppress or control seizures. Which nursing intervention should a nurse perform to determine the effectiveness of therapy?

Assess deep tendon reflexes.

A small-for-gestational age infant is admitted to the observational care unit with the nursing diagnosis of ineffective thermoregulation related to lack of fat stores as evidenced by persistent low temperatures. Which are appropriate nursing interventions? Select all that apply.

Assess the axillary temperature every hour. Review maternal history. Assess environment for sources of heat loss. Encourage skin-to-skin contact.

A pregnant client in the first trimester reports drinking 3 to 4 cups of coffee with cream and sugar daily and is hoping to cut down. What will the nurse advise to improve pregnancy health outcomes?

Attempt to reduce coffee consumption or replace with decaffeinated coffee to reduce caffeine intake.

A client in her third month of pregnancy arrives at the health care facility for a regular follow-up visit. The client reports discomfort due to increased urinary frequency. Which instruction should the nurse offer the client to reduce the client's discomfort?

Avoid consumption of caffeinated drinks.

A nurse is caring for a client with vaginitis. What teaching(s) should the nurse provide to the client to prevent recurrent vaginal infections? Select all that apply.

Avoid using deodorant tampons. Wear only cotton panties and ventilated pantyhose. Avoid douching.

The nurse is performing an assessment on a 2-day postpartum client and discovers a boggy fundus at the umbilicus and slightly to the right. The nurse determines that this is most likely related to which situation?

Bladder distention

bright red blood

Both

decreased blood pressure

Both

On the first prenatal visit, an examination of the client's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. How should the nurse document this finding?

Chadwick sign

A nurse is monitoring the fetal heart rate (FHR) of a client in labor using an electronic fetal monitor. The reading shows a late deceleration. Which intervention will the nurse implement?

Change maternal position to side-lying position.

Eliminating drafts in the birth room and in the nursery will help to prevent heat loss in a newborn through which mechanism?

convection

After the birth of a newborn, which action would the nurse do first to assist in thermoregulation?

Dry the newborn thoroughly.

The nurse is preparing a postpartum client for discharge 72 hours after birth. The client reports bilateral breast pain around the entire breast on assessment. The nurse predicts this is related to which cause after noting the skin is intact and normal coloration?

Engorgement

The parents of a newborn are upset that their newborn needs treatment for ophthalmia neonatorum. The nurse should explain this is related to which maternal infection? Select all that apply.

Gonorrhea Chlamydia

A jaundiced neonate must have heel sticks to assess bilirubin levels. Which assessment findings would indicate that the neonate is in pain? Select all that apply.

Heart rate is 180 beats per minutes. Oxygen saturation level is 88%. The infant has facial grimacing and quivering chin.

During a vaginal exam, the nurse notes that the lower uterine segment is softened. How should the nurse document this finding?

Hegar sign

An infant is breastfed. When assessing the stools, which findings would be typical?

Less constipation than bottle-fed infants

A woman presents to the clinic at 1-month postpartum and reports her left breast has a painful, reddened area. On assessment, the nurse discovers a localized red and warm area. The nurse predicts the client has developed which disorder?

Mastitis

A client at 34 weeks' gestation presents to labor and delivery with vaginal bleeding. Which finding from the obstetric examination leads the nurse to anticipate the client is experiencing a placental abruption (abruptio placentae)?

Onset of vaginal bleeding was sudden and painful.

What medication would the nurse administer to a client experiencing uterine atony and bleeding leading to postpartum hemorrhage?

Oxytocin

fundal height greater than expected gestational age

Placenta Previa

pain

Placenta abruption

uterine tenderness

Placental Abruption

The nurse is caring for a neonate. Which is the most important step the nurse can take to prevent and control infection?

Practice meticulous handwashing.

A nurse is coaching a woman during the second stage of labor. Which action should the nurse encourage the client to do at this time?

Push with contractions and rest between them.

After teaching a class of newly pregnant women about the many changes the female body undergoes during pregnancy, the nurse determines that the teaching was successful when the class identifies which hormones as being secreted by the placenta? Select all that apply.

Relaxin estrogen hCG

A nurse is caring for a newborn with jaundice undergoing phototherapy. What intervention is appropriate when caring for the newborn?

Shield the newborn's eyes.

A nurse is presenting an in-service program about complications that can arise during labor. The nurse determines that the teaching was successful when the group correctly chooses which findings as suggesting an amniotic fluid embolism? Select all that apply.

Sudden onset of respiratory distressMaternal hypotensionMaternal tachycardia

The nurse is working in the special care nursery caring for a newborn withdrawing from alcohol. Which nursing intervention promotes client comfort?

Swaddle and decrease stimulation

The nurse is concerned that the child is developing septic shock. Which finding(s) are consistent with this condition? Select all that apply.

The child's blood pressure is reduced. White blood cell count is elevated. The child's respiratory rate is elevated. The child is pale and lethargic.

A newborn is suspected of having gastroschisis at birth. How does the nurse differentiate this condition from other congenital conditions?

The exposed intestines appear reddened and swollen and have no sac around them.

The nurse is explaining the care the newborn will be receiving right after birth to the parents. The nurse should point out the infant will receive an ophthalmic antibiotic ointment by approximately which time?

Within one hour

A nurse is caring for a client in her third stage of labor. The nurse would predict the placenta is separating from the uterus based on which assessment findings? Select all that apply.

a globular shaped uterus fresh gushing of blood from the vagina umbilical cord descending lower down

A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence?

a weight gain of 10 lb (4.5 kg)

cervical dilation 4 to 7 cm

active

complete dilation and effacement

active

contraction duration 45 to 90 seconds

active

contractions 2 to 3 minutes apart, strong to very strong

active

rapid dilation and effacement

active

start of fetal descent

active

A multigravid client has been in labor for several hours and is becoming anxious and distressed with the intensity of the frequent contractions. The nurse observes moderate bloody show and performs a vaginal examination to assess the progress of labor. The cervix is 9 cm dilated. The nurse knows that the client is in which phase of labor?

active phase

The infant has Apgar scores of 7 at 1 minute and 9 at 5 minutes. What is the indication of this assessment finding?

adjusting to extrauterine life

A pregnant woman gives birth to a small-for-gestational-age neonate who is admitted to the neonatal intensive care unit with seizure activity. The neonate appears to have abnormally small eyes and a thin upper lip. The infant is noted to be microcephalic. Based on these findings, which substance would the nurse suspect the women of using during pregnancy?

alcohol

The nurse is assessing a newborn and notes a low nasal bridge with short upturned nose, flattened midface, and a long philtrum with narrow upper lip. What does the nurse suspect to find in the mother's history?

alcohol use

A nurse who has worked in a nursery for 15 years informs the nursing student that feeding an infant early has advantages. The nurse describes which biggest advantage?

allows the baby to pass stools, which helps to reduce bilirubin

A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client's fundus. Which finding would the nurse identify as expected?

at the level of the umbilicus

A newborn has an Apgar score of 6 at 5 minutes. Which action would be the priority?

beginning resuscitative measures

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

caput succedaneum.

A nurse is required to assess a client reporting unusual vaginal discharge for bacterial vaginosis. For which classic manifestation of this condition should the nurse assess?

characteristic "stale fish" odor

A nurse is assisting with the birth of a newborn. The fetal head has just emerged. Which action would be performed next?

checking for the cord around the neck

A nurse is providing care to a 3-hour-old neonate. The nurse ensures that her hands are warm prior to touching the neonate to prevent heat loss by which mechanism?

conduction

A woman is admitted to the labor suite with contractions every 5 minutes lasting 1 minute. She is postterm and has oligohydramnios. What does this increase the risk of during birth?

cord compression

The nurse frequently assesses the respiratory status of a preterm newborn based on the understanding that the newborn is at increased risk for respiratory distress syndrome because of:

deficiency of surfactant.

Assessment of a newborn reveals uneven gluteal (buttocks) skin creases and a "clunk" when the Ortolani maneuver is performed. What would the nurse suspect?

developmental dysplasia of the hip (DDH)

A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client?

diminished reflexes

A postpartum client has a fourth-degree perineal laceration. The nurse would expect which medication to be prescribed?

docusate

A woman comes to the clinic reporting a greenish-colored discharge from her nipple. On examination, the area below the areola is red and slightly swollen, with tortuous tubular swelling. The nurse interprets these findings as suggestive of which disorder?

duct ectasia

A nurse is providing care to a client and actively involves the client's family members in the care planning and implementation, dealing with the client and family as a unit. The nurse is engaging in:

family-centered care.

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy?

fetal movement felt by examiner

Which finding would the nurse expect in a client with bacterial vaginosis?

fish-like odor of discharge

A nurse is massaging a postpartum client's fundus and places the nondominant hand on the area above the symphysis pubis based on the understanding that this action:

helps support the lower uterine segment.

A nursery nurse is explaining to a new parent about how to assess the newborn for pain. Which manifestation indicates that an infant is in pain?

inability to be consoled

The nurse is teaching a prenatal class on the difference between true and false labor contractions. The nurse determines the session is successful when the class correctly chooses which factor as an indication of true labor contraction?

increase even if relaxing and taking a shower

A nurse is describing the risks associated with post-term pregnancies as part of an in-service presentation. The nurse determines that more teaching is needed when the group identifies which factor as an underlying reason for problems concerning the fetus?

increased amniotic fluid volume

An infant who is diagnosed with meconium aspiration displays which symptom?

intercostal and substernal retractions

A woman in the 34th week of pregnancy says to the nurse, "I still feel like having intercourse with my husband." The woman's pregnancy has been uneventful. The nurse responds based on the understanding that:

it is safe to have intercourse at this time.

A client has not received any medication during labor. The client is having frequent contractions about every 1 to 2 minutes, has become irritable with the coach, and no longer will allow the nurse to palpate the fundus during contractions. The cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating:

late active phase of the first stage of labor.

contraction duration 30 to 45 seconds

latent

contractions 5 to 30 minutes apart

latent

contractions irregular, mild to moderate

latent

Assessment of a client in labor reveals cervical dilation (dilatation) of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in

latent phase of the first stage.

A nurse is required to obtain the fetal heart rate (FHR) for a pregnant client. If the presentation is cephalic, which maternal site should the nurse monitor to hear the FHR clearly?

lower quadrant of the maternal abdomen

A nursing student working with a client in preterm labor correctly identifies which medication as being used to relax the smooth muscles of the uterus and for seizure prophylaxis and treatment in clients with preeclampsia?

magnesium sulfate

The nurse informs the client that a diaphragm is an example of which type of contraception?

mechanical barrier

A newborn has been diagnosed with a group B streptococcus infection shortly after birth. The nurse understands that the newborn most likely acquired this infection from which cause?

mother's birth canal

The obstetrical nurse admits a premature, small-for-gestational age infant to the observational unit for assessment. The maternal record reveals an obese 27-year-old homeless woman with limited prenatal, medical, or dental care. Her blood pressure on admission was 170/90 mm Hg. Which factors in the maternal history would have suggested a high-risk pregnancy? Select all that apply.

obesity homelessness maternal hypertension lack of prenatal care periodontal disease

A nurse is caring for a client who is nursing her baby boy. The client reports afterpains. Secretion of which substance would the nurse identify as the cause of afterpains?

oxytocin

A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the:

placenta.

Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which condition?

placental insufficiency

A woman who is using an intrauterine system for contraception comes to the clinic. When assessing the woman, which finding(s) would alert the nurse to a possible complication? Select all that apply.

reports of abdominal pain oral temperature of 101°F (38.3°C) string length shorter than on initial visit

A thin newborn has a respiratory rate of 80 breaths/min, nasal flaring with sternal retractions, a heart rate of 120 beats/min, temperature of 36° C (96.8° F) and persisting oxygen saturation of <87%. The nurse interprets these findings as:

respiratory distress.

A newborn is experiencing cold stress. Which findings would the nurse expect to assess? Select all that apply.

respiratory distresshypoglycemiajaundice

A 40-year-old woman is being discharged from the walk-in health care clinic after a diagnosis of pelvic inflammatory disease (PID). Which health teaching topic should the nurse address?

sexually transmitted infections (STIs)

While providing care to a postpartum client on her first day at home, the nurse observes which behavior that would indicate the new mother is in the taking-hold phase?

showing increased confidence when caring for the newborn

The nurse notifies the obstetrical team immediately because the nurse suspects that the pregnant woman may be exhibiting signs and symptoms of amniotic fluid embolism. When reporting this suspicion, which finding(s) would the nurse include in the report? Select all that apply.

significant difficulty breathing hypertension tachycardia pulmonary edema bleeding with bruising

A nurse is assessing a newborn. Which finding would alert the nurse to the possibility of respiratory distress in a newborn?

sternal retractions

While caring for a client following a lengthy labor and birth, the nurse notes that the client repeatedly reviews her labor and birth and is very dependent on her family for care. The nurse is correct in identifying the client to be in which phase of maternal role adjustment?

taking-in

A nurse is providing care to a postpartum woman during the immediate postpartum period. The nurse recognizes that the mother will need assistance with meeting her basic needs based on the understanding that the mother is most likely in which phase?

taking-in phase

A nurse is providing care to a newborn. The nurse suspects that the newborn is developing sepsis based on which assessment finding?

temperature instability

It has been 8 hours since a woman gave birth vaginally to a healthy newborn. When assessing the woman's fundus, the nurse would expect to find it at:

the level of the umbilicus.

A nurse is assessing a postterm newborn. Which finding would the nurse correlate with this gestational age variation?

thin umbilical cord

Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups. Based on an interpretation of these findings, the nurse would be especially alert for which condition?

thrombophlebitis

A client who gave birth several hours ago is experiencing postpartum hemorrhage. She had a cesarean birth and received deep, general anesthesia. She has a history of postpartum hemorrhage with her previous births. The blood is a dark red. Which cause of the hemorrhage is most likely in this client?

uterine atony

A client is in the third stage of labor. Which finding alerts the nurse that the placenta is separating?

uterus becomes globular

A nurse is reviewing the fetal heart rate pattern and observes abrupt decreases in FHR below the baseline, appearing as a U-shape. The nurse interprets these changes as reflecting which type of deceleration?

variable decelerations

As part of a presentation on breast cancer being given to a local woman's group, the nurse describes the need for early detection through screening. Applying the guidelines from the American Cancer Society, the nurse would emphasize which recommendation?

yearly mammograms for women starting at age 40

The nurse describes the changes in stool that a new mother would see when feeding her newborn formula. Which description best indicates what the mother would observe after several days?

yellow-green, pasty, unpleasant-smelling stool

The nurse observes the stool of a newborn who is being bottle-fed. The newborn is 2 days old. What would the nurse expect to find?

yellowish-green, pasty stool

The nurse is assessing the stools of a 36-hour-old neonate who is being breastfed. The nurse determines that the stools are within normal parameters based on which finding?

yellowy mustard color with seedy appearance