OB exam 2 practice questions

A nurse is performing a psychosocial assessment of a client who just found out she is pregnant. Which assessment finding indicates to the nurse the client is at high risk for HIV? 1.A client who has a history of IV drug use. 2.A client who has had one sexual partner for the past 10 years. 3.A client with a history of sexually transmitted diseases. 4.A client who has a significant other who is heterosexual.

1

A woman presented to L&D approximately 28 weeks gestation and is suspected of having a placental abruption. In looking at the prenatal record the nurse notes late entry into prenatal care and missed appointments. The nurse suspects which of the following as the most likely concern? 1.The client probably has a tobacco abuse issue. 2.The client may have been abusing drugs such as cocaine in the pregnancy. 3.This describes manifestations of alcohol abuse. 4.This woman may have underlying anxiety disorder.

2

A client who is 28 weeks just completed her 1 hr GTT and 3 hr GTT which she failed and has been diagnosed with gestational diabetes. Which of the following statements indicates she needs further education? 1." My baby will need closely monitored for low blood pressure after delivery." 2." I should not exercise as it may interfere with my glucose control." 3."My insulin requirements may double or quadruple in my last trimester." 4." I need to eat about 6 times per day and never skip a meal."

2

A postpartum client who admits to heavy alcohol use asks the nurse about breastfeeding her baby. The nurse correctly teaches this client that excessive alcohol consumption while breastfeeding can: 1.Cause seizure disorders in the newborn. 2.Decrease the maternal milk letdown reflex. 3.Cause mental retardation in the newborn 4.Increase the maternal letdown reflex.

2

The nurse is counseling a prenatal client regarding the need to take folic acid supplements during pregnancy. The nurse also encourages the client to eat foods high in folic acid, such as: 1.Eggs and yogurt. 2.Fresh green, leafy vegetables and legumes. 3.Rice and pasta. 4.Fruits and fruit juice.

2

A prenatal client is expected of having iron deficiency anemia. Which finding would the nurse expect to note regarding the patient status? 1.A hematocrit of 36 and hemoglobin level of 11.5. 2.A platelet level of 205,000 and WBC of 12.6. 3.High fluid volume 4.A hematocrit of 34 and hemoglobin level of 10.2.

4

Gestational diabetes in pregnancy carries several maternal and fetal risks. All of the following are considered maternal risks except: 1.Ketoacidosis 2.Sacral agenesis 3.Retinopathy 4.Hydramnios

2 one of the anomalies that can sometimes be seen in the FETUS

Magnesium sulfate is ordered for a preeclamptic patient to prevent seizures. The nurse knows all of the following are true regarding magnesium sulfate except? 1.Common side effects include sedation, flushing, hot, nausea. 2.The client will need extra hydration with IV fluids and monitoring of intake and output. 3.If toxicity is suspected, the magnesium infusion should be discontinued immediately and calcium gluconate may need to be given IV. 4.The nurse will monitor for Magnesium toxicity as indicated by decreased reflexes, respiratory depression, pulmonary edema, change in LOC, decreased urinary output, weakness, and cardiac arrest.

2- Iv and oral fluids should be resticted to no more than 125 mL/hr

A patient who is 11 weeks pregnant presents to the clinic with complaints of severe nausea and vomiting. The nurse should instruct the patient on which of the following? (Select all that apply) 1.Avoid dry, sweet and salty foods. 2.Signs of dehydration are excessive thirst and decreased urine output and would warrant intravenous fluids. 3.Eat frequently while separating foods from liquids. 4.Ginger tea or ginger ale several times per day may be helpful. 5.Eat a high protein snack at bedtime or after sweets.. 6.Avoid dairy products.

2345

The nurse is caring for a laboring client with Type I diabetes. What are the signs and symptoms of hypoglycemia for which the nurse should assess? 1.Dry skin and blurred vision 2.Headache and anorexia 3.Frequent urination and headache 4.Diaphoresis and disorientation

4

preparing a 24 yr old women at 42 weeks at gestation for a nonstress test, the nurse should: a. tell the women to fast for 8 hours before the test b. explain that the test will evaluate how well her baby is moving inside the uterus c. show her how to indicate when her baby moves d. attach a spinal electrode to the presenting part to determine FHR patterns

c

A client who admits to substance abuse during the pregnancy tells the nurse. "I know I am just a really weak person, but I will try to cut down while I am pregnant." Which response by the nurse would be most therapeutic? 1."I don't believe that you are weak at all; you just need to say no to drugs." 2." I have heard this before. You need to get serious now or your baby will suffer." 3."That is a very positive plan. Could you tell me more about feeling like a weak person?" 4."I am concerned about you and your baby. . What can I do to help you?"

3

A multigravida woman 34 weeks gestation presents to the clinic and is worried she might be developing HELLP syndrome. Which of the following is a true statements regarding HELLP? 1.HELLP usually develops during the postpartum period. 2.African American women are more likely to develop HELLP syndrome. 3.HELLP is characterized by hepatic dysfunction and is recognized by low platelet counts and elevating liver enzymes. 4.HELLP is characterized by renal dysfunction and characterized by elevating Blood pressures, proteinuria, and decreased urinary output.

3

A nurse is reviewing lab results for a client diagnosed with preeclampsia. Which laboratory values would the nurse expect to be present? (Select all that apply.) Select all that apply. a. Hemoglobin 8g/dL b. Burr cells c. LDH 100 units/L d. Platelet count of 75,000 e. BUN 25 mg/dL

c d e

Chronic hypertension and signs and symptoms of preeclampsia

Superimposed preeclampsia

A nurse is reviewing clinical diagnoses of preeclampsia and eclampsia. Which statement should the nurse be aware of? a. Preeclampsia results in decreased function in such organs as the placenta, kidneys, liver, and brain. b. Preeclampsia is a condition of the first trimester; eclampsia is a condition of the second and third trimesters. c. The causes of preeclampsia and eclampsia are well documented. d. Severe preeclampsia is defined as preeclampsia plus proteinuria

a

A nurse providing care to a woman in labor should be aware that cesarean birth: a. Is performed primarily for the benefit of the fetus. b. Can be either elected or refused by women as their absolute legal right. c. Is declining in frequency in the United States. d. Is more likely to be performed in the poor in public hospitals who do not receive the nurse counseling that wealthier clients do.

a

A pregnant woman at 28 weeks of gestation has been diagnosed with gestational diabetes. The nurse caring for this client understands that: a. Dietary management involves distributing nutrient requirements over three meals and two or three snacks. b. Dietary modifications and insulin are both required for adequate treatment. c. Glucose levels are monitored by testing urine four times a day and at bedtime. d. Oral hypoglycemic agents can be used if the woman is reluctant to give herself insulin.

a

A nurse is reviewing the clnical diagnosis of early pregnancy loss. Which of the following presentations should the nurse identify as being associated with early pregnancy loss, occurring in less than 12 weeks gestation? (Select all that apply.) Select all that apply. a. Infection b. Cystitis c. Chromosomal abnormalities d. Antiphospholipid syndrome e. Caffeine use f. Hypothyroidism

c d f

Hypertension in a pregnant woman present before or noticed early pregnancy

Chronic hypertension

a 34 yr old women at 36 weeks of gestation has been scheduled for a biophysical profile. She asks the nurse why the test needs to be preformed. The nurses says a. determines how well her baby will breathe after its born b. evaluates the response of her babys heart to uterine contractions c. measures the babys head and length d. observes her babys activites to utero to ensure that her baby is getting oxygen

D

Onset of seizures in a preeclamptic woman

Eclampsia

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. What finding would indicate to the nurse that preterm labor is occurring? a. The cervix is effacing and dilated to 2 cm. b. Fetal fibronectin is present in vaginal secretions. c. Irregular, mild uterine contractions are occurring every 12 to 15 minutes. d. Estriol is not found in maternal saliva.

a

A woman with severe preeclampsia is being treated with an IV infusion of magnesium sulfate. Which finding would the nurse identify as indicating that the treatment is successful? a. Seizures do not occur. b. Diuresis reduces fluid retention. c. Blood pressure is reduced to prepregnant baseline. d. Deep tendon reflexes become hypotonic.

a

A womens labor is being suppressed using IV mag sulfate, which measure should be implemented during the infusion a. limit IV fluid intake to 125mL/ hour b. Discontinue infusion if maternal respirations are less than 14 breaths per minute c. ensure that indomethacin is available if toxicity occurs d. assist women to maintain a comfortable semirecumbent position

a

following the administration dose of fentanyl, IV for pain associated with uternine contractions, a womens labor pregresses more rapidly than expected. Narcan is ordered to reverse respiratory depression in the newborn after birth. When fullfilling this the nurse should know to a. question the route, bc medication should be oral b. recognize the dose is too low c. asses the women's pain level, bc it will return abruptly d. observe maternal pulse for bradycardia

c

Signs of a threatened abortion (miscarriage) are noted in a woman at 8 weeks of gestation. Which intervention would the nurse identify as being appropriate for this type of abortion? a. Comfort the woman by telling her that if she loses this baby, she may attempt to get pregnant again in 1 month. b. Prepare the woman for an ultrasound and blood work. c. Put the woman on bed rest for at least 1 week and reevaluate. d. Prepare the woman for a dilation and curettage (D&C).

b

which medication is used to reduce anxiety, potentiate the effects of analgesics, and relieve nausea a. Narcan b. metoclopramide (reglan) c. promethazine (phenergan) d. fentanyl (sublimze)

b

When caring for a women with preeclampsia without severe features, it is critical that during assessment the nurse be alert for progresses signs of preeclampsia of these assessments a. serum creatine 0.0 mg/dL b. platelet count of 180,000/mm3 c. positive ankle clonus response DTRs 4+ d. blood pressure of 150/88 and 154/96 6 hours apart

c

Which measure is least effective in helping a women to prevent postpartum depression? a. share feelings with family members and partners b. recognize that emotional problems after having a baby are not usual c. care for the baby herself to increase her level of confidence and and self- esteem d. ask friends and family members to take care of baby while she sleeps or has a date w partner

c

A client who is pregnant already has Type 2 diabetes with a hemoglobin A1c value of 7. The nurse would categorize this client as having: a. Pregestational diabetes mellitus. b. Insulin-dependent diabetes complicated by pregnancy. c. Gestational diabetes. d. Non-insulin-dependent diabetes with complications.

a

A group of nurses are discussing the concept of pain experience during labor. Which statement should the nurses identify as correct? a. Sensory pain for nulliparous women often is greater than for multiparous women during early labor. b. Affective pain for nulliparous women usually is less than for multiparous women throughout the first stage of labor. c. Women with a history of substance abuse experience more pain during labor. Multiparous women have more fatigue from labor and therefore experience more pain.

a

A nurse administers an opioid agonist analgesic to a woman in active labor. Which medication should the nurse identify as being used cautiously due to potential impact on the fetus? a. Meperidine (Demerol) b. Fentanyl (Sublimaze) c. Promethazine (Phenergan) d. Nalbuphine (Nubain)

a

A nurse is caring for a pregnant client in labor using tocolytic therapy. Which statement should the nurse identify as correct? a. Its most important function is to afford the opportunity to administer antenatal glucocorticoids. b. There are no important maternal (as opposed to fetal) contraindications. c. The drugs can be given efficaciously up to the designated beginning of term at 37 weeks. d. If pulmonary edema develops while the client is receiving tocolytics, IV fluids should be given.

a

a women admitted w ruptured ectopic pregnancy in the ER. primary nursing diagnosis at this time a. acute pain related to irritation of peritoneum w blood b. risk for infection related to tissue trama c. deficient fluid volume related to blood loss associated with rupture of uterine tube d. anticipatory grieving realted to unexpected pregnancy outcome

c

A nurse is evaluating several obstetric clients for their risk for cervical insufficiency. Which client would the nurse consider to be at greatest risk? a. Primip who undergoes a cervical cone biopsy for cervical dysplasia prior to the pregnancy b. Grandmultip who has previously had all vaginal deliveries without a problem c. Multip who had her previous delivery via C section due to cephalopelvic disproportion (CPD) d. Primipara

a

Hypertension occurring after 20 weeks gestation in a normotensive woman

Gestational Hypertension

Hypertension and proteinuria in a previous normotensive woman after 20 weeks gestation

Preeclampsia

A nurse is assessing a client at 42 weeks of gestation. Which finding, if noted by the nurse requires more assessment? a. Cervix dilated 2 cm and 50% effaced b. Score of 8 on the biophysical profile c. Fetal heart rate of 116 beats/min d. One fetal movement noted in 1 hour of assessment by the mother

d

A nurse is monitoring a client's reflexes (DTRs) while receiving magnesium sulfate therapy for treatment of preeclampsia. Which assessment finding if observed by the nurse would indicate a cause for concern? a. DTRs response has been noted at 1+ since onset of therapy b. Client reports no pain upon examination of DTRs by nurse c. Bilateral DTRs noted at 2+ d. Positive clonus response elicited unilaterally

d

A nurse is reviewing categories of high risk pregnancy. Which of the options listed here should the nurse not include? a. Psychosocial b. Environmental c. Biophysical d. Geographic

d

A woman is asking about the testing that is done in pregnancy. She is 18 weeks gestation in her current pregnancy. The nurse recognizes that the next routine testing will include which of the following? 1.The client will be asked to complete a one hour 50 g glucose tolerance test at 24-28 weeks. 2.A client will complete a three hour glucose tolerance test at 28 weeks. 3.A client will complete an alpha-fetoprotein test at 24 weeks. 4.The client will be asked to complete a two step glucose testing at 20 weeks gestation.

1

The nurse is teaching a client with diabetes about insulin requirements during pregnancy. Which statement should the nurse include regarding insulin requirements? 1.Insulin needs increase in the second trimester. 2.Insulin needs increase early in the first trimester. 3.Insulin needs decrease early in the third trimester. 4.Insulin needs decrease late in the third trimester.

1

Which of the following classifications of heart disease is the client symptomatic with limitations on physical activity? 1.Class III 2.Class II 3.Class IV 4.Class I

1

A nurse is reviewing clinical indications for a contraction stress test(CST). What should the nurse identify as being an appropriate indicator for this test? a. History of preterm labor and intrauterine growth restriction b. Adolescent pregnancy and poor prenatal care c. Increased fetal movement and small for gestational age d. Maternal diabetes mellitus and postmaturity

d

A nurse is reviewing clinical manifestations between abruptio placentae and placenta previa. Which finding should the nurse identifying as being the most significant difference between the two? a. Cramping. b. Bleeding. c. Uterine activity. d. Intense abdominal pain.

d

A nurse is reviewing spinal and epidural (block) anesthesia use during labor. Which statement should the nurse identify as being accurate? a. Epidural blocks allow the woman to move freely. b. This type of anesthesia is commonly used for cesarean births but is not suitable for vaginal births. c. Spinal and epidural blocks are never used together. d. A high incidence of postbirth headache is seen with spinal blocks.

d

Which of the following is the most accurate description of postpartum depression without psychotic features? a. PPD without psychotic features resolves by 8 weeks postpartum b. Postpartum baby blues and fatigue that resolves with improved sleep c. This condition is more common amongst older women as they have higher expectations for motherhood d. This condition is distinguishable by pervasive sadness with severe mood swings and irritability

d

A nurse is working with a client who is in labor and providing information relative to breathing techniques. Which option should the nurse include in the plan of care? a. Controlled breathing techniques are most difficult near the end of the second stage of labor. b. The patterned-paced breathing technique can help prevent hyperventilation. c. By the time labor has begun, it is too late for instruction in breathing and relaxation. d. Breathing techniques in the first stage of labor are designed to increase the size of the abdominal cavity to reduce friction.

d

A pregnant woman's amniotic membrane has ruptured and a prolapsed cord is suspected. Which intervention is the nurse's highestpriority? a. Cover the cord in a sterile towel saturated with warm normal saline. b. Prepare the woman for a cesarean birth. c. Start oxygen by face mask. d. Place the woman in the knee-chest position.

d

A woman with severe preeclampsia is receiving a magnesium sulfate infusion. Which assessment finding if observed by the nurse would indicate a concern? a. Deep tendon reflexes of 2+. b. A sleepy, sedated affect. c. Absence of ankle clonus. d. A respiratory rate of 10 breaths/min.

d

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. Amount of insulin required prenatally. c. Number of years since diabetes was diagnosed. d. Degree of glycemic control during pregnancy.

d

The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what would the nurse identify as being another tool to help confirm the diagnosis? a. Daily fetal movement counts b. Amniocentesis c. Contraction stress test (CST) d. Doppler blood flow analysis

d

A nurse providing care for an antepartum woman receiving a contraction stress test (CST). Which statement should the nurse identify as being accurate? a. Sometimes uses vibroacoustic stimulation. b. Is considered to have a negative result if no late decelerations are observed with the contractions. c. Is more effective than nonstress test (NST) if the membranes have already been ruptured. d. Is an invasive test; however, contractions are stimulated.

b

Which maternal condition always necessitates delivery by cesarean section? a. Ectopic pregnancy b. Eclampsia c. Low-lying placenta d. Complete placenta previa

d

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 to every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. What complication should the nurse suspect? a. Eclamptic seizure. b. Placental abruption. c. Placenta previa. d. Rupture of the uterus.

b

Nurse should recognize that a complication of pregnancy associated with the IV use of cocaine is a. prolonged, difficult labor b. premature separation of the placenta c. increased risk for vaginal and UTI infections d. severe fetal/ neonatal CNS depression

b

Primary expected outcome of mag administration would be a. decrease in both systolic and diastolic BP b. women has no seizures c. women states she feels more relaxed and calm d. women urinates more frequency resulting in decreased pathologic edema

b

A woman presents to the emergency department complaining of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary health care provider finds that the cervix is closed. The nurse bases the anticipated plan of care for this woman as it relates to a probable diagnosis of which type of spontaneous abortion? a. Incomplete b. Threatened c. Septic d. Inevitable

b - presents w spotting, mild cramps, and no cervical dilation

A nurse is monitoring a pregnant woman who has severe nausea and vomiting. What lab result should the nurs identify as being a priorityassessment? a. Bilirubin. b. Fasting blood glucose level. c. Ketonuria. d. White blood cell count.

c- critical assesment in determination of hyperemesis

A nurse is examining a client who has been admitted for possible ectopic pregnancy who is approximately 8 weeks pregnant. Which finding if observed by the nurse would be a priorityconcern? a. Ecchymosis noted around umbilicus b. No FHT heard via Doppler c. Blood pressure 100/80 d. Scant vaginal bleeding noted on peri pad

a

A primigravida at 10 weeks of gestation reports mild uterine cramping and slight vaginal spotting without passage of tissue. when examined, no cervical dilation noted, the nurse should a. anticipate that the women will be sent home w instutions to limit her activity and to avoid stress or orgasm b. prepare the women for dilation and curettage c. notify a greif counselor to assist with a loss of fetus d. tell the women that the doctor will most likely preform a cerclage to help maintain her pregnancy

a

Diabetes in pregnancy puts the fetus at risk in several ways. Which statement should the nurse identify as being correct? a. The most important cause of perinatal loss in diabetic pregnancy is congenital malformations. b. At birth, the neonate of a diabetic mother is no longer in any greater risk. c. Infants of mothers with diabetes have the same risks for respiratory distress syndrome because of the careful monitoring. d. With good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern.

a

The nurse is monitoring a client in labor who is experiencing back labor and complains of intense pain in her lower back. Which relief measure should the nurse implement? a. Apply counterpressure against the sacrum. b. Effleurage. c. Biofeedback. d. Encourage pant-blow (breaths and puffs) breathing techniques.

a

CRNA is preparing a epidural black using local anesthetic and opioid analgesic as pain relief, Nursing measures related to this nerve block include (select all) a. assist the women into a modified sims position or upright with back curved for administration of the block b. alternate her position from side to side every hour c. asses the women for headaches, bc commonly occur in PP period is epidural is used d. assist women to urinate at least every 2 hours during labor to prevent bladder distension e. prepare women for use of forceps or vaccun assisted birth, bc she will not be able to bear down f. asses blood pressure frequently, bc hypotension can occur

a b d f

A client has undergone an amniocentesis for evaluation of fetal well-being. Which intervention would be included in the nurse s plan of care after the procedure? (Select all that apply.) Select all that apply. a. Observe the client for possible uterine contractions. b. Perform a minicatheterization to obtain a urine specimen to assess for bleeding. c. Perform ultrasound to determine fetal positioning. d. Administer RhoGAM to the client if she is Rh negative.

a d

A nurse is caring for a client who had a previous cesarian section and now presents with a transverse presentation in labor. Which information should the nurse provide to the client? a. "Because this is a repeat procedure, you are at the lowest risk for complications." b. "Even though this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures." c. "You will not need preoperative teaching because this is your second cesarean birth." d. "Because this is your second cesarean birth, you will recover faster."

b

A nurse is caring for a client whose labor is being augmented with oxytocin. The nurse recognizes that the oxytocin should be discontinued immediately if there is evidence of: a. Rupture of the client's amniotic membranes. b. A fetal heart rate (FHR) of 180 with absence of variability. c. Uterine contractions occurring every 8 to 10 minutes. d. The client needing to void.

b

A nurse is caring for a laboring client who has a breech presentation. Which statement would the nurse identify as being most associated with this type of presentation? a. A rapid descent b. High rate of neuromuscular disorders c. Least common malpresentation d. Diagnosis by ultrasound only

b

A nurse is providing information to a client in labor with regard to tactile approaches to comfort management. Which option should the nurse include in the plan of care? a. Acupuncture can be performed by a skilled nurse with just a little training. b. Hand and foot massage may be especially relaxing in advanced labor, when a woman's tolerance for touch is limited. c. Therapeutic touch (TT) uses handheld electronic stimulators that produce sympathetic vibrations. d. Either hot or cold applications may provide relief, but they should never be used together in the same treatment.

b

A nurse is reviewing care for pregnant women. Which clinical diagnosis would the nurse identify as being the most common medical complication of pregnancy? a. Hemorrhagic complications. b. Hypertension. c. Infections. d. Hyperemesis gravidarum.

b

A nurse is reviewing the clinical diagnosis of ectopic pregnancy. Which location should the nurse identify as being the most common location for this occurrence? a. Fimbriae. b. Ampulla. c. Uterine fundus. d. Cervical os.

b

A nurse is reviewing the complication of HELLP syndrome. Which finding should the nurse be aware of? a. It can be diagnosed by a nurse alert to its symptoms. b. Is characterized by hemolysis, elevated liver enzymes, and low platelets. c. It is a mild form of preeclampsia. d. Is associated with preterm labor but not perinatal mortality.

b

A nurse is reviewing the use of systemic analgesics administered during labor. Which statement should the nurse indicate as correct? a. Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier. b. Effects on the fetus and newborn can include decreased alertness and delayed sucking. c. IV client-controlled analgesia (PCA) results in increased use of an analgesic. d. IM administration is preferred over IV administration.

b

A nurse is providing instruction for an obstetrical client to perform a daily fetal movement count (DFMC). Which instructions should the nurse include in the plan of care? (Select all that apply.) Select all that apply. a. The fetal alarm signal is reached when there are no fetal movements noted for 5 hours. b. Count all fetal movements in a 12-hour period daily until 10 fetal movements are noted. c. Monitor fetal activity two times a day either after meals or before bed for a period of 2 hours or until 10 fetal movements are noted. d. The client can monitor fetal activity once daily for a 60-minute period and note activity.

b c d

a women diagnosed w preeclampsia without severe features and will be treated at home. In teaching about treatment regimen for preeclampsia, the nurse should tell her too a. low salt diet b. use dipstick to check urine for protien c. maintain a fluid intake 6-8 oz glasses of water each day d. increase roughage in her diet e. perform gentle range of motion exercises of her upper and lower extremities f. ask friends to avoid calling and visiting bc she needs rest

b c d

What factors increase a women for risk of spontaneous preterm labor and birth? a. white race b. OB history of 3-0-2-0-1 c. history of bleeding at 20 weeks d. currently being treated for second bladder infection in 2 months e. multifetal gestation f. a BMI of 22 and a height of 158cm

b c d e

A nurse is reviewing the concept of uterine rupture. Which factors would the nurse identify as leading to an increased likelihood of this occurence? (Select all that apply.) Select all that apply. a. G3P3 with all vaginal deliveries b. Client who had a primary caesarean section with a classic incision c. Short interval between pregnancies d. Client receiving a trial of labor (TOL) following a VBAC delivery e. Preterm singleton pregnancy

bcd

A nurse is providing instructions for a nonstress test (NST) to a woman who is at 36 weeks of gestation. Which statement by the client indicates a correct understanding of the nurse's instructions? a. "This test will help to determine whether the baby has Down syndrome or a neural tube defect." b. "I will need to have a full bladder for the test to be done accurately." c. "This test observes for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby." d. "I should have my husband drive me home after the test because I may be nauseated."

c

A nurse is reviewing assessments used to determine gestational age. When timeframe should the nurse identify as being the best to establish gestational age based on ultrasound? a. At term b. 36 weeks c. Between 14 and 22 weeks d. 8 weeks

c

A physician has ordered cervidil be administered to ripen a pregnant women's cervix in preparation for labor, when doing this the nurse should a. insert the cervidil in the cervical canal just below the internal os b. tell the women to remain in bed for at least 15 minutes c. observe signs for uterine tachysystole d. remove the cervidil as soon as women experiences uterine contractions

c

A pregnant woman at 14 weeks of gestation is admitted to the hospital with a diagnosis of hyperemesis gravidarum. What does the nurse identify as the primary goal of her treatment? a. Restore the woman's ability to take and retain oral fluid and foods. b. Reduce emotional distress by encouraging the woman to discuss her feelings. c. Reverse fluid, electrolyte, and acid-base imbalances. d. Rest the gastrointestinal (GI) tract by restricting all oral intake for 48 hours.

c

A pregnant woman at 21 weeks of gestation has an elevated blood pressure of 140/98. Past medical history reveals that the woman has been treated for hypertension. On the basis of this information, the nurse would classify this client as having: a. Gestational hypertension. b. Chronic hypertension. c. Superimposed preeclampsia. d. Preeclampsia.

c

A woman diagnosed with marginal placenta previa gave birth vaginally 15 minutes ago. Which complication should the nurse anticipate as the being the greatest risk for thie client? a. Thrombophlebitis. b. Infection. c. Hemorrhage. d. Urinary retention.

c

A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. What action should the nurse implement? a. Tell the woman to slow the pace of her breathing. b. Administer oxygen via a mask or nasal cannula. c. Help her breathe into a paper bag. d. Notify the woman's physician.

c

A woman with severe preeclampsia has been receiving magnesium sulfate by IV infusion for 8 hours. The nurse assesses the woman and documents the following findings: temperature 37.1° C, pulse rate 96 beats/min, respiratory rate 24 breaths/min, blood pressure 155/112 mm Hg, 3+ deep tendon reflexes, and no ankle clonus. Which physician order should the nurse anticipate? a. Diazepam. b. Calcium gluconate. c. Hydralazine. d. Magnesium sulfate bolus.

c

After change of shift report, the nurse assumes care of a multiparous client in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, and buttocks, and down her thighs. Before implementing a plan of care, the nurse should understand that this type of pain is: a. Somatic b. Afterpain c. Referred d. Visceral

c

In caring for the woman with disseminated intravascular coagulation (DIC), what order should the nurse anticipate? a. Administration of steroids b. Preparation of the woman for invasive hemodynamic monitoring c. Administration of blood d. Restriction of intravascular fluids

c

In her birth plan, a women requests that she should be allowed to use the new whirlpool bah during labor, when implementing the nurse should a. assist the women to maintain a reclining position when in the tub b. tell the women she will need to leave the tub as soon as her membranes rupture c. begin hydrotherapy when the women is in active labor d. limit her to no longer than an hour in the tub

c

Provider has ordered a mag sulfate infusion to be started, based on this order the nurse should (select all that apply) a. prepare 20g of mag in 100mL of 5% of glucose in water b. monitor maternal vitals signs, FHR patterns, and uterine contractions every hour c. expect maintenance dose approx 1-3g an hour d. administer a loading dose of 4-6g over 15-30 min e. prepare to administer hydralazine if signs of mag toxicity occurs f. report respiratory rate of under 12 breaths/ min to primary health provider

c d f