Maternity Exam 4 Practice Questions

A client is to have an amniotomy to induce labor. The nurse recognizes that the priority intervention after the amniotomy is to: A. Assess the fetal heart rate and observe for a prolapsed umbilical cord. B. Perform a vaginal exam. C. Apply clean linens under the woman. D. Take the client's vital signs.

A. Assess the fetal heart rate and observe for a prolapsed umbilical cord. Rationale: The FHR is assessed before and immediately after the amniotomy to detect any changes that might indicate cord compression or prolapse.

A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would yield more detailed information about the fetus? A. Biophysical profile B. Ultrasound for structural amomalies of the fetus C. Percutaneous umbilical blood sampling D. Maternal serum alpha-fetoprotein screening

A. Biophysical profile Rationale: Real-time ultrasound permits detailed assessment of the physical and physiologic characteristics of the developing fetus and cataloging of normal and abnormal biophysical responses to stimuli. The BPP is a noninvasive, dynamic assessment of a fetus that is based on acute and chronic markers of fetal disease.

A 30-week gestation client is in the antepartum unit with preterm premature rupture of membranes (PPROM). Which of the following actions by the nurse will enhance rest and sleep for the client? A. Cluster nursing assessments and interventions to minimize interruptions at night. B. Limit visitors during daytime hours to minimize interruptions during the day. C. Remove the client's phone from the room to minimize waking during rest periods. D. Turn off the television to minimize distractions during the day and night

A. Cluster nursing assessments and interventions to minimize interruptions at night. Rationale: Nursing interventions and assessments should be clustered at night to minimize waking.

With regard to preeclampsia and eclampsia, nurses should be aware that: A. Preeclampsia results in decreased function of 40% to 60% in such organs as the placenta, kidneys, liver, and brain. B. The causes of preeclampsia and eclampsia are well documented. C. Severe preeclampsia is defined as preeclampsia plus proteinuria. D. Preeclampsia is a condition of the first trimester; eclampsia is a condition of the second and third trimesters.

A. Preeclampsia results in decreased function of 40% to 60% in such organs as the placenta, kidneys, liver, and brain. Rationale: Vasospasms diminish the diameter of blood vessels, which impedes blood flow to all organs.

A client who has undergone a D&C for early pregnancy loss is likely to be discharged the same day. The nurse must ensure that vital signs are stable, that bleeding has been controlled, and that the woman has adequately recovered from the administration of anesthesia. In order to promote an optimal recovery, discharge teaching should include: A. Referral to a support group if necessary B. Emphasizing the need for rest C. Resumption of intercourse at 6 weeks postprocedure D. Iron supplementation E Expectation of heavy bleeding for at least 2 weeks

A. Referral to a support group if necessary B. Emphasizing the need for rest D. Iron supplementation

The physician has ordered a nonstress test to be done on a 40-week gestation client. During the 30 minute test, the nurse observed three periods of fetal heart rate accelerations that were 15 beats per minute above the baseline and lasted 15 seconds each. No contractions were noted during the test. Based upon these results, what should the nurse do next? A. Send the client home after reporting the results to the health care provider. B. Perform a nipple stimulation test to assess the fetal heart rate in response to contractions. C. Place the client on her side with oxygen via face mask at 8 liters per minute. D. Prepare the client for induction with oxytocin or prostaglandins.

A. Send the client home after reporting the results to the health care provider. Rationale: The client is postdates and the NST is being performed to assess the well-being of the fetus. This is a reactive NST. There is no need to provide emergent care at this moment.

The most effective and least expensive treatment of puerperal infection is prevention. What is important in this strategy? A. Strict aseptic technique, including handwashing, by all health care personnel B. Limited protein and fat intake C. Large doses of vitamin C during pregnancy D. Prophylactic antibiotics

A. Strict aseptic technique, including handwashing, by all health care personnel Rationale: Strict adherence by all health care personnel to aseptic techniques during childbirth and the postpartum period is very important and the least expensive measure to prevent infection.

The nurse is caring for a client whose labor is being augmented with Pitocin (oxytocin). The nurse recognizes that the Pitocin should be discontinued immediately if there is evidence of:

A. Uterine contractions occurring every 8 to 10 minutes. B. The client needing to void. C. Rupture of the client's amniotic membranes. D. A FHR of 180 with absence of variability. Rationale: This FHR is nonreassuring. The oxytocin should be immediately discontinued and the physician should be notified

The perinatal nurse is giving discharge instructions to a woman, status postsuction curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. The best response from the nurse would be: A. If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnancy is rare. Therefore, to improve your chance of a successful pregnancy, it is better not to get pregnant at this time." B. "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer more difficult." C. "If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore, if you desire a future pregnancy, it would be better for you to use the most reliable method of contraception available." D. "Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar pregnancy."

B. "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer more difficult." Rationale: This is an accurate statement. Beta-hCG levels will be drawn for 1 year to ensure that the mole is completely gone. There is an increased chance of developing choriocarcinoma after the development of a hydatidiform mole. The goal is to achieve a "zero" hCG level. If the woman were to become pregnant, it may obscure the presence of the potentially carcinogenic cells.

Mary, a 36 year-old G2P1, 30 weeks into her pregnancy was admitted to the hospital with sudden onset of painless bright red vaginal bleeding. Once she is determined to be stable with no active bleeding, she is discharged home. While teaching her about home care, Mary states that she doesn't understand why she must be on pelvic rest since she is not in any pain and didn't even bleed that much. What statement by the nurse accurately explains her instructions? A. Your preeclampsia has worsened and sexual intercourse could increase your blood pressure and cause a seizure." B. "Your placenta has implanted close to the opening of your cervix and sexual intercourse could disrupt the placental attachment and cause more bleeding." C. "Your cervix has dilated prematurely and sexual intercourse could cause premature delivery of your baby." D. "Your placenta has partially detached from your uterine wall and sexual intercourse could further detach it and cause more bleeding."

B. "Your placenta has implanted close to the opening of your cervix and sexual intercourse could disrupt the placental attachment and cause more bleeding." Rationale: Mary is presenting with the classic signs of placenta previa: the sudden onset of painless bright red uterine bleeding in the last half of pregnancy. The placenta is implanted in the lower uterus and can either partially or fully occlude the cervical opening. Bleeding is painless because it does not occur in a closed cavity and does not cause pressure on adjacent tissue. Teaching emphasizes the importance of refraining from sexual intercourse to prevent disruption of the placenta and cause excess bleeding.

Your client has been on magnesium sulfate for 20 hours for treatment of preeclampsia. She just delivered a viable infant girl 30 minutes ago. What uterine findings would you anticipate to observe/assess in this client? A. A fundus firm below the level of the umbilicus B. A boggy uterus with heavy lochia flow C. Absence of uterine bleeding in the postpartum period D. Scant lochia flow

B. A boggy uterus with heavy lochia flow Rationale: Because of the tocolytic effects of magnesium sulfate, this client most likely would have a boggy uterus with increased amounts of bleeding.

A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The nurse becomes concerned after assessment when the woman exhibits: A. Absent ankle clonus B. A respiratory rate of 10 breaths/min C. A sleepy, sedated affect D. Deep tendon reflexes of 2

B. A respiratory rate of 10 breaths/min Rationale: A respiratory rate of 10 breaths/min indicates that the client is experiencing respiratory depression from magnesium toxicity.

Preconception counseling is critical to the outcome of diabetic pregnancies because poor glycemic control before and during early pregnancy is associated with: A. Polyhydramnios B. Congenital anomalies in the fetus C. Frequent episodes of maternal hypoglycemia D. Hyperemesis gravidarum

B. Congenital anomalies in the fetus Rationale: Preconception counseling is particularly important because strict metabolic control before conception and in the early weeks of gestation is instrumental in decreasing the risks of congenital anomalies.

The nurse is caring for a gestational diabetic client that is 8/100/0, and is called away from the bedside to admit a new client who has come in with complaints of painless vaginal bleeding at 29 weeks' gestation. The nurse is concerned the care of her initial patient will be compromised if the nurse has to care for both clients. The nurse asks the charge nurse to assign someone else to the new client until after the recovery is completed for her initial patient. The charge nurse refuses, telling the nurse, "there just isn't anyone else." What should the nurse do next? A. Refuse to care for either client. B. Contact the nursing supervisor. C. Call the clients' healthcare provider. D. Care for both of the clients.

B. Contact the nursing supervisor. Rationale: This is an appropriate use of what is known as the "chain of command." If an RN has a problem, she should first discuss it with the charge nurse. If the nurse is still concerned, the next step is to contact the nursing supervisor. Depending on the supervisor's response, the nurse may or may not need to go "up" the chain of command

Perinatal nurses are legally responsible for: A. Greeting the client on arrival, assessing her, and starting an IV line. B. Correctly interpreting FHR patterns, initiating appropriate nursing interventions, and documenting the outcomes. C. Applying the external fetal monitor and notifying the care provider. D. Making sure the woman is comfortable, her call light is in reach, and a support person is at the bedside.

B. Correctly interpreting FHR patterns, initiating appropriate nursing interventions, and documenting the outcomes. Rationale: Nurses who care for women during childbirth are legally responsible for correctly interpreting FHR patterns, initiating appropriate nursing interventions based on those patterns, and documenting the outcomes of those interventions.

Women with hyperemesis gravidarum: A. Are a majority, because 70% of all pregnant women suffer from it at some time B. Have vomiting severe and persistent enough to cause weight loss, dehydration, and electrolyte imbalance C. Are on IVs for fluid and nutrition for most of their pregnancy D. Often inspire similar, milder symptoms in their male partners and mothers

B. Have vomiting severe and persistent enough to cause weight loss, dehydration, and electrolyte imbalance

The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is: A. Cramping B. Intense abdominal pain C. Bleeding D. Uterine activity

B. Intense abdominal pain Rationale: Pain is absent with placenta previa and may be agonizing with abruptio placentae

Nurses should be aware that HELLP syndrome: A. Is a mild form of preeclampsia B. Is characterized by hemolysis, elevated liver enzymes, and low platelets C. Can be diagnosed by a nurse alert to its symptoms D. Is associated with preterm labor but not perinatal mortality

B. Is characterized by hemolysis, elevated liver enzymes, and low platelets Rationale: The acronym HELLP stands for hemolysis (H), elevated liver enzymes (EL), and low platelets (LP).

With regard to the use of tocolytic therapy to suppress uterine activity, nurses should be aware that: A. There are no important maternal (as opposed to fetal) contraindications. B. Its most important function is to afford the opportunity to administer antenatal glucocorticoids. C. The drugs can be given safely up to 37 weeks gestation. D. If the client develops pulmonary edema while on tocolytics, IV fluids should be given.

B. Its most important function is to afford the opportunity to administer antenatal glucocorticoids. Rationale: Buying time for antenatal glucocorticoids to accelerate fetal lung development might be the best reason to use tocolytics.

The nurse is caring for an eclamptic client. Which of the following is an important action for the nurse to perform? A. Provide visual and auditory stimulation. B. Pad the client's bed rails and head board. C. Check each urine for the presence of ketones. D. Place the bed in the high Fowler's position.

B. Pad the client's bed rails and head board. Rationale: Seizure precautions are essential in an eclamptic client.

Magnesium sulfate is given to women with preeclampsia and eclampsia to: A. Prevent a boggy uterus and lessen lochial flow B. Prevent and treat convulsions C. Shorten the duration of labor D. Improve patellar reflexes and increase respiratory efficiency

B. Prevent and treat convulsions Rationale: Magnesium sulfate is the drug of choice to prevent convulsions, although it can generate other problems.

Cytotec (Misoprostol) has been ordered for a pregnant woman at 41 5/7 weeks of gestation. The nurse recognizes that this medication will be administered to: A. Stimulate the amniotic membranes to rupture B. Ripen the cervix in preparation for labor induction C. Increase amniotic fluid volume D. Enhance uteroplacental perfusion in an aging placenta

B. Ripen the cervix in preparation for labor induction

A woman with preeclampsia has a seizure. The nurse's primary duty during the seizure is to: A. Suction the mouth to prevent aspiration B. Stay with the client to insure safety and call for help C. Administer oxygen by mask D. Insert an oral airway

B. Stay with the client to insure safety and call for help Rationale: If a client becomes eclamptic, the nurse should stay with the client and call for help.

You are assessing a 28 week gestation G3P1011 client. She has a history of preterm labor and is concerned that her baby will be born preterm. Prior to leaving her appointment you provide her teaching about preventing preterm birth. Your client requires more teaching when she states: A. "I will modify my daily schedule to include frequent periods of rest." B. "It is important for me to drink plenty of water and frequently empty my bladder." C. "During pregnancy it is normal to have difficulty emptying my bladder or a burning sensation when I urinate." D. "I will floss regularly and make an appointment with my dentist."

C. "During pregnancy it is normal to have difficulty emptying my bladder or a burning sensation when I urinate." Rationale: These are signs and symptoms of a UTI and it is important that she contact her HCP to get this resolved as it is a risk factor for preterm labor

A pregnant woman's amniotic membranes rupture. Prolapsed cord is suspected. What is the nurse's first action? A. Cover the cord in sterile gauze soaked in saline. B. Prepare the woman for a cesarean birth. C. Elevate the presenting part off of the umbilical cord. D. Start oxygen by face mask.

C. Elevate the presenting part off of the umbilical cord. Rationale: A sterile glove is applied and the fetal presenting part is elevated from the umbilical cord.

During vaginal delivery, the obstetrician declares that a shoulder dystocia has occurred. Which of the following actions by the nurse is appropriate at this time? A. Administer oxytocin intravenously per doctor's orders. B. Apply downward pressure on the woman's fundus. C. Flex the woman's thighs sharply toward her abdomen. D. Apply oxygen using a tight-fitting face mask.

C. Flex the woman's thighs sharply toward her abdomen. Ratonale: Flexing the woman's hips sharply toward her abdomen, called McRoberts' maneuver, is appropriate.

The nurse caring for a woman hospitalized for hyperemesis gravidarum would expect that initial treatment would involve: A. Corticosteroids to reduce inflammation B. An antiemetic, such as pyridoxine, to control nausea and vomiting C. IV therapy to correct fluid and electrolyte imbalances D. Enteral nutrition to correct nutritional deficits

C. IV therapy to correct fluid and electrolyte imbalances Rationale: Initially, the woman who is unable to down clear liquids by mouth requires IV therapy for correction of fluid and electrolyte imbalances.

Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for: A. Low birth weight B. Congenital anomalies of the central nervous system C. Macrosomia D. Preterm birth

C. Macrosomia Rationale: Poor glycemic control later in pregnancy increases the rate of fetal macrosomia.

A pregnant client is admitted to the high-risk unit with abdominal pain and heavy vaginal bleeding. What action among the following should the nurse take first, as soon as the patient is received? A. Drawing blood for laboratory tests B. Administering an opioid C. Starting oxygen therapy D. Elevating the head of the bed

C. Starting oxygen therapy Rationale: The client is hemorrhaging and has decreased cardiac output. Oxygen is needed to prevent further maternal and fetal compromise. Administering an opioid will sedate an already compromised fetus. Elevating the head of the bed will decrease blood flow to vital centers in the brain. Although blood should eventually be drawn for laboratory tests, it is not the priority.

The nurse assists a 12 hour post-cesarean section patient to ambulate in the hallway. Which of the following outcomes indicates that the intervention is effective in preventing complications of immobility? A. The patient ambulates with 2-person assistance. B The patient complains of incisional pain 6/10. C. The patient has no signs or symptoms of deep vein thrombosis and lungs are clear to auscultation. D. The patient states "I'm so glad to finally get out of my room, my roommate has so many visitors."

C. The patient has no signs or symptoms of deep vein thrombosis and lungs are clear to auscultation. RATIONALE: The intervention is done to prevent complications of immobility. The patient having no signs or symptoms of a DVT and clear lung sounds indicate the intervention is effective.

A 26-year-old pregnant woman, gravida 2, para 1-0-0-1 is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. Upon her arrival at the hospital, what would be an expected diagnostic procedure needed to shed more light on the source of bleeding? A. Amniocentesis for fetal lung maturity B. Contraction stress test C. Ultrasound for placental location D. Internal fetal monitoring

C. Ultrasound for placental location Rationale: The presence of painless bleeding should always alert the health care team to the possibility of placenta previa. This can be confirmed through ultrasonography.

Your client is being induced because of her worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active despite several hours of oxytocin administration. She asks the nurse, "Why is it taking so long?" The most appropriate response by the nurse would be: A. "I don't know why it is taking so long." B. "Your baby is just being stubborn." C. "The length of labor varies for different women." D. "The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor."

D. "The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor." Rationale: Because magnesium sulfate is a tocolytic agent, its use may increase the duration of labor. The amount of oxytocin needed to stimulate labor may be more than that needed for the woman who is not receiving magnesium sulfate.

A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should indicate that more investigation needs to be done regarding the patient and her preeclampsia? A. Weight gain of 0.5 kg during the past 2 weeks B. Pitting pedal edema at the end of the day C. Blood pressure increase to 138/86 mm Hg D. A dipstick value of 3+ for protein in her urine

D. A dipstick value of 3+ for protein in her urine Rationale: Proteinuria is defined as a concentration of 1+ or greater via dipstick measurement. A dipstick value of 3+ should alert the nurse that additional testing or assessment should be made.

A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes, dark red vaginal bleeding, and a tense, painful abdomen. The nurse suspects the onset of: A. Rupture of the uterus B. Placenta previa C. Eclamptic seizure D. Abruptio placentae

D. Abruptio placentae Rationale: Uterine tenderness in the presence of increasing tone may be the earliest finding of abruptio placentae. Women with hypertension are at increased risk for an abruption.

The nurse providing care for the laboring woman should understand that accelerations with fetal movement: A. Warrant close observation B. Are caused by umbilical cord compression C. Are caused by uteroplacental insufficiency D. Are signs of fetal well being

D. Are signs of fetal well being Rationale: Accelerations in the FHR occur during fetal movement and are indications of fetal well-being

A woman experienced a miscarriage at 10 weeks of gestation and had a dilation and curettage (D&C). She states that she is just fine and wants to go home as soon as possible. While you are assessing her responses to her loss, she tells you that she had purchased some baby things and had picked out a name. You know you are helping her actualize her loss. Based on your assessment of her responses, what nursing intervention would you do for her first? A. Ready her for discharge. B. Notify pastoral care to offer her a blessing. C. Ask her if she would like to see what was obtained from her D&C. D. Ask her what name she had picked out for her baby

D. Ask her what name she had picked out for her baby Rationale: One way of actualizing the loss is to allow parents to name the infant. The nurse should follow this client's cues and inquire about naming the infant.

In planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the: A. Mother's age B. Number of years since diabetes was diagnosed C. Amount of insulin required prenatally D. Degree of glycemic control during pregnancy

D. Degree of glycemic control during pregnancy Rationale: Women with excellent glucose control and no blood vessel disease should have good pregnancy outcomes.

A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature of 37.3° C, pulse rate of 88 beats/min, respiratory rate of 10 breaths/min, blood pressure of 148/90 mm Hg, absent deep tendon reflexes, and no ankle clonus. The client complains, "I'm so thirsty and warm." The nurse: A. Calls for a stat magnesium sulfate level B. Administers oxygen C. Prepares to administer hydralazine D. Discontinues the magnesium sulfate infusion and notifies the provider.

D. Discontinues the magnesium sulfate infusion and notifies the provider. Rationale: The client is displaying clinical signs and symptoms of magnesium toxicity. Magnesium should be discontinued immediately. Additionally, calcium gluconate, the antidote for magnesium, may be administered.

A client is found to have preeclampsia, and bedrest at home is prescribed. It is doubtful that this client will be able to comply because she has two preschool children. What should be included in the plan of care that may help the client follow the prescribed regimen? A. Suggest a housekeeper for 4 hours a day. B. Contract for 3 hours of naptime each day. C. Warn of the risks of noncompliance. D. Discuss why bedrest is necessary.

D. Discuss why bedrest is necessary. Rationale: Clients who understand the "why" of treatment are more likely to comply. Warning of the risks of noncompliance is a negative approach; the benefits of compliance (https://eaq.elsevier.com/Resources/EAQ_QA/QB-3sk7/Q-k1s9- mkjioumh/nse7Page634_9780323066617.pdf) , not the risks, should be discussed. Suggesting a housekeeper for 4 hours a day may be unrealistic; more data are needed. Contracting for 3 hours of naptime each day does not meet the requirement of bedre

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the Pitocin infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a low platelet count of 90,000, an elevated aspartate transaminase (AST) level (liver enzymes), and a falling hematocrit. The nurse notifies the physician because the lab results are indicative of: A. Eclampsia B. Disseminated intravascular coagulation C. Idiopathic thrombocytopenia D. HELLP syndrome

D. HELLP syndrome Rationale: HELLP syndrome is a laboratory diagnosis for a variant of severe preeclampsia that involves hepatic dysfunction characterized by hemolysis (H), elevated liver enzymes (EL), and low platelets (LP).

The nurse caring for pregnant women must be aware that the most common medical complication of pregnancy is: A. Hyperemesis gravidarum B. Infections C. Hemorrhagic complications D. Hypertensive Disorders of Pregnancy

D. Hypertensive Disorders of Pregnancy Rationale: Preeclampsia and eclampsia are two noted, deadly forms of hypertension.

Bleeding disorders in late pregnancy include all of these except: A. Abruptio placentae B.Cord insertion C. Placenta previa D. Spontaneous abortion (miscarriage)

D. Spontaneous abortion (miscarriage) Rationale: Placenta previa, the premature separation of the placenta (abruptio placentae), and cord insertion are all causes of bleeding disorders in later pregnancy. Spontaneous abortion is another name for miscarriage; it occurs, by definition, early in pregnancy.

A woman in preterm labor at 30 weeks of gestation receives two 12-mg doses of Celestone Soluspan (betamethasone) intramuscularly. The purpose of this pharmacologic treatment is to: A. Reduce maternal and fetal tachycardia associated with ritodrine administration. B. Suppress uterine contractions. C. Maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy. D. Stimulate fetal surfactant production.

D. Stimulate fetal surfactant production. Rationale: Antenatal glucocorticoids given as intramuscular injections to the mother accelerate fetal lung maturity.

When nurses help their expectant mothers assess the daily fetal movement counts (Kick counts) they should be aware that: A. Obese mothers familiar with their bodies can assess fetal movement as well as average-sized women. B. "Kick counts" should be taken every half hour and averaged every 6 hours, with every other 6-hour stretch off. C. Alcohol or cigarette smoke can irritate the fetus into greater activity. D. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours.

D. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours. Rationale: No movement in a 12-hour period is cause for investigation and possibly intervention.

A pregnant woman is being discharged from the hospital after placement of cerclage because of a history of recurrent pregnancy loss secondary to an incompetent cervix. Discharge teaching should emphasize that: A. She will need to make arrangements for care at home, because her activity level will be restricted. B. Any vaginal discharge should be reported immediately to her care provider. C. She will be scheduled for a cesarean birth. D. The presence of any uterine cramping or low backache may indicate preterm labor and should be reported.

D. The presence of any uterine cramping or low backache may indicate preterm labor and should be reported.

The client in labor is showing late decelerations on the fetal monitor. Which intervention should the nurse implement first? A. Notify the health care provider immediately. B. Prepare for an immediate delivery of the fetus. C. Instruct the client to take slow, deep breaths. D. Turn the patient, Place the client in the left lateral position.

D. Turn the patient, Place the client in the left lateral position. Rationales: The late decelerations are the result of insufficient oxygenation of the baby. This position promotes oxygentation and the late decelerations may resolve

Methotrexate is recommended as part of the treatment plan for which obstetric complication? A. Complete hydatidiform mole B. Abruptio placentae C. Missed abortion D. Unruptured ectopic pregnancy

D. Unruptured ectopic pregnancy Methotrexate is an effective, nonsurgical treatment option for a hemodynamically stable woman whose ectopic pregnancy is unruptured and less than 4 cm in diameter.

A client asks her nurse, " My doctor told me that he is concerned with the age of my placenta because I am overdue. What does that mean?" The best response by the nurse is: A. Don't worry about it. Everything is fine." B. "Your placenta isn't working properly, and your baby is in danger." C. "This means that we will need to perform an amniocentesis to detect if you have any placental damage." D. Your placenta ages and changes as your pregnancy progresses, and it is given a score that indicates a number of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby."

D. Your placenta ages and changes as your pregnancy progresses, and it is given a score that indicates a number of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby."

The antidote administered to reverse magnesium toxicity is

calcium gluconate

The condition in which the placenta is implanted in the lower uterine segment near or over the internal cervical os is

placenta previa