OB exam 1

1. A newborn is experiencing cold stress. Which assessment data by the nurse will require further evaluation? Select all that apply A. Tachypnea B. Shivering C. Hypoglycemia D. Hypertonia E. Lethargy

A. Tachypnea C. Hypoglycemia E. Lethargy

1. The nurse is assessing an 8 hour old infant and notes jitteriness, hypotonia and an axillary temp of 96.5F. What is the most appropriate nursing action? A. Assess the infant's glucose using heel stick B. Place the infant under the radiant warmer C. Place the infant skin to skin with mom and encourage her to express drops of colostrum to infant's mouth D. Bottle feed the infant 20 cc of formula

A. Assess the infant's glucose using heel stick

The nurse assesses a mother's bonding with her new baby. Which action made by the mother does the nurse identify as the "taking in" maternal phase? A. The mother relives and speaks of the birthing experience B. The mother responding and picking up the infant when she cries C. The mother goes back to work D. The mother asking questions about infant care

A. The mother relives and speaks of the birthing experience

A patient is experiencing pregnancy complications. Which factors will affect the client's ability to manage this situation? Select all that apply. a. Current health status b. Perceived threat to self or fetus c. Existence of a support network d. Previously used coping skills e. Implemented nursing interventions

ALL APPLY

1. The nurse is providing teaching to new parents regarding the levels of fatigue that may occur following childbirth. Which statement should the nurse include in the teaching? A. "You are going to feel less fatigued after 3 months of having your infant at home." B. "Since you are younger parents, you will feel less fatigued than an older parent would." C. "Older mothers tend to report higher levels of stress than younger mothers." D. "Mothers tend to be more fatigued than fathers following the birth of a new infant."

D. "Mothers tend to be more fatigued than fathers following the birth of a new infant."

1. The nurse is discussing the stages of "becoming a mother" with a patient. In what order will the nurse review the stages? A. Increasing attachment to infant B. Achieving maternal identity C. Moving toward a new normal D. Commitment and preparation for infant

D. Commitment and preparation for infant A. Increasing attachment to infant C. Moving toward a new normal B. Achieving maternal identity

1. After the birth of a newborn, what is the priority nursing action to prevent cold stress? A. Swaddle in warm blankets B. Place under a radiant warmer C. Place a stocking cap on the neonate's head D. Dry the neonate thoroughly

D. Dry the neonate thoroughly

A client states "I think I might be pregnant. My period is late and I've been feeling really nauseous." Which would be the best response by the nurse? a. "That's great! I am so happy for you." b. "These are presumptive signs of pregnancy. You could be pregnant." c. "These are positive signs of pregnancy. You are absolutely pregnant." d. "You should schedule an appointment to make sure you do not have an ectopic pregnancy."

b. "These are presumptive signs of pregnancy. You could be pregnant."

1. A primiparous patient tells the nurse she wants to bottle-feed her baby. What is the most therapeutic response by the nurse? A. "Have you tried breastfeeding? Let's see if we can get the baby to latch." B. "You'll want to wear a sports bra for 24 hours a day until your breasts are soft." C. "We do not advocate bottle-feeding, so you'll need to bring your own formula." D. "Are you sure? Breastmilk is so much healthier for your baby."

B. "You'll want to wear a sports bra for 24 hours a day until your breasts are soft."

1. Which response by a postpartum patient indicates to the nurse that learning of uterine involution has taken place? Select all that apply A. My uterus will stay this big until I get my period again B. It will take about 6 weeks for my uterus to return to normal size C. Contractions will cause my uterus to shrink D. My uterus will not be as small as it was before I had the baby E. My uterus will return to the size of a grapefruit

B. It will take about 6 weeks for my uterus to return to normal size C. Contractions will cause my uterus to shrink

1. The nurse is preparing to administer the congenital heart screening test to a 24 hours old infant. The nurse correctly applies the pulse oximeter where? A. Right hand, Left hand B. Right hand, Left foot C. Left hand, either foot D. Left hand, right foot

B. Right hand, Left foot

1. The nurse walks into a postpartum room noting a screaming infant in a crib near the bedside. Both parents are asleep. Which statement by the mother shows the need for further assessment for ineffective bonding? A. "We are so tired, she kept us up all night." B. "We are so tired, we must have been sound asleep." C. "Sorry, it won't stop crying, and we are so tired." D. "We are so tired. What if this happens at home?"

C. "Sorry, it won't stop crying, and we are so tired."

1. The nurse is assessing a newborn and suspects respiratory distress. Which assessment data by the nurse will require further evaluation? A. Irregular breathing pattern B. Rate of 32 breaths per minute C. Retractions of chest wall D. Diaphragmatic and abdominal breathing

C. Retractions of chest wall

1. A postpartum patient expresses concern that she will get a blood clot in her leg because her mother had one after her delivery. What is the most therapeutic response by the nurse? A. "Blood clots do not run in families, so you shouldn't worry." B. "Women are only at risk for developing clots during pregnancy." C. "I will assist you to ambulate around the hallway so that doesn't happen." D. "I understand your concern. Let's take a look at the back of your legs together."

D. "I understand your concern. Let's take a look at the back of your legs together."

A nurse is reviewing the record of a patient in the labor room and notes that the nurse midwife has documented that the fetus is at -1 station. The nurse determines that the fetal presenting part is: a. 1 cm above the ischial spines b. 1 inch below the iliac crest c. 1 inch below the symphysis pubis d. 1 fingerbreadth below umbilicus

a. 1 cm above the ischial spines

A pregnant patient is at the prenatal clinic for a routine visit at 30 weeks gestation. Which finding causes the nurse concern? a. Hgb of 9.5 g/dL and Hct. of 30% b. WBCs of 14,000 mm3 c. Heart rate 103 bmp d. Patient complains of increased vaginal discharge

a. Hgb of 9.5 g/dL and Hct. of 30%

Which of the following statements is correct about fetal attitude? Select all that apply a. Hyperextension of the fetal head may result in a face presentation b. Complete flexion is often the most conducive to normal vaginal delivery c. Cephalic presentation means the baby is in a flexed attitude d. When the mom and baby's spines are aligned, the baby is in a vertical attitude

a. Hyperextension of the fetal head may result in a face presentation b. Complete flexion is often the most conducive to normal vaginal delivery

The nurse is caring for a patient who was just notified that her pregnancy is at increased risk of Down's syndrome, based on the results of her QUAD screening test. She asks the nurse if this means the baby has Down's syndrome. The nurse correctly responds: a. "With a diagnosis of Down's syndrome, we need to schedule an appointment to talk to the neonatologist." b. "Your doctor will talk to you about scheduling an amniocentesis to make a formal diagnosis." c. "Your doctor will talk to you about scheduling a detailed fetal ultrasound to make a formal diagnosis." d. "This was likely a false positive result; we will repeat the test in 1-2 weeks."

b. "Your doctor will talk to you about scheduling an amniocentesis to make a formal diagnosis."

A patient arrives for her 20 week prenatal visit and expresses concern because of a leakage of yellow fluid from her breasts. Which topic does the nurse discus during this visit? a. Signs of infection b. Breast changes c. Signs of clogged ducts and mastitis d. Antenatal testing

b. Breast changes

The nurse is documenting the obstetrical history of a client using the GTPAL system. The client is currently pregnant with her third child. Her first pregnancy resulted in the birth of a daughter at 38 weeks 1 day gestation. Her second pregnancy results in the birth of a son at 34 weeks and 5 days gestation. Both are still living. What would the nurse record this information as? a. G3P1012 b. G3P1102 c. G3P2002 d. G2P2002

b. G3P1102

1. A postpartum nurse is caring for a patient who gave birth 1 hour ago following a 24-hour long induction. The patient had an epidural for pain control during labor. What assessment finding should immediately be reported to the healthcare provider? A. Boggy uterus B. Bilateral lower extremity numbness C. Uncontrollable shaking D. Moderate vaginal bleeding

A. Boggy uterus

1. Immediately after birth, the nurse notes the patient's fundus is palpated midway between the umbilicus and the symphysis pubis. What is the priority nursing action? A. Document the findings as within normal limits B. Perform fundal massage C. Instruct the woman to empty her bladder D. Reassess every 5 minutes

A. Document the findings as within normal limits

A pregnant patient and her spouse live in the same home as the spouse's family who is not supportive of the pregnancy. The patient feels the family is ruining the happiness about the pregnancy. Which is the most important determination for the nurse to make? a. What the potential for improving the current support network is b. Who will provide the patient the greatest amount of support c. Whether the couple's finances support moving into a separate location d. If threatened or actual abuse from household members occur toward the patient

d. If threatened or actual abuse from household members occur toward the patient

The nurse is providing care for a patient in the third trimester of pregnancy. Which topic of patient education is more likely to be needed during this time? a. Information on how to manage nausea and vomiting b. General health maintenance and promotion topics c. Counseling and guidance about diet and exercise d. Management of hemorrhoids and varicose veins

d. Management of hemorrhoids and varicose veins

The nurse is providing care for a 43-year-old patient who just learned she is pregnant at 20 weeks gestation. Which testing is most appropriate to offer the patient at this time? a. Integrated screening b. Amniocentesis c. Fetal MRI d. QUAD screen

d. QUAD screen

A patient at 34 weeks gestation is receiving twice weekly non stress tests (NSTs) for high-risk pregnancy. What is the expected outcome of this test? a. Reactive, reassuring b. Reactive, non-reassuring c. Non-reactive, non-reassuring d. Non-reactive, reassuring

a. Reactive, reassuring

A nurse in the labor room is caring for a client in the active phase of labor. The nurse is assessing the fetal patterns and notes 3 late decelerations with the last 8 contractions on the monitor strip. The most appropriate nursing action is to: a. Reposition patient to left lateral side b. Increase the rate of Pitocin IV infusion c. Place the mother in the supine position d. Administer oxygen via face mask

a. Reposition patient to left lateral side

A nurse in monitoring a client in labor. The nurse suspects umbilical cord compression if which of the following is noted on the external monitor tracing during a contraction? a. Variable decelerations b. Accelerations c. Early decelerations d. Late accelerations

a. Variable decelerations

A pregnant patient has just returned from ultrasound where she had a fetal biophysical profile performed. The result is 6/8. The patient asks the nurse to explain the results. The nurse correctly responds: a. "The test results are within normal limits" b. "Immediate delivery by cesarean birth is needed" c. "Further tests are needed to determine the meaning of this score." d. "We will inform you of your options within the next week"

c. "Further tests are needed to determine the meaning of this score."

A nurse is admitting a pregnant client to the labor room and attaches an external electronic fetal monitor to the client's abdomen. After attachment of the monitor, the initial nursing assessment is which of the following? a. Identifying the types of accelerations b. Determining the intensity of the contractions c. Assessing the baseline fetal heart rate d. Determining the frequency of the contractions

c. Assessing the baseline fetal heart rate

The nurse is providing prenatal care for patient who is pregnant with a second child. Which understanding about complexity of second pregnancy does the nurse use the assist the patient with the acceptance of this pregnancy? a. Point out that the financial obligation is always less with a second child. b. Make suggestions of how the first child will be a "helper" with the new baby. c. Recommend career decision needed because of additional parenting tasks. d. Offer strategies for working out a new relationship with the first child.

c. Recommend career decision needed because of additional parenting tasks.

The nurse is teaching a pregnant client about positioning to avoid supine hypotensive syndrome. Which positioning would be effective? a. Elevate her feet while she is sitting b. Dangle her feet over the edge of the bed for 30 seconds before getting up c. Sleep in a side-lying position d. Place a pillow under her knees while she is in bed

c. Sleep in a side-lying position

A nurse is caring for a client in the second stage of labor. The client is experiencing uterine contractions every 2 minutes and cries out in pain with each contraction. The nurse recognizes this behavior as: a. Exhaustion b. Valsalva's maneuver c. Involuntary grunting d. Fear of losing control

d. Fear of losing control