OB Exam 3870

A gravida 3 para 2 is in for prenatal care. She states she typically has a glass of wine with her meal at supper. What would be the best teaching provided from the nurse. "Abstain from alcohol intake during the first trimester and then you can have a glass again with supper." "The amount of alcohol you are drinking is an acceptable amount during pregnancy." "A glass of red wine with supper has been shown to be very beneficial for your health." "Do not consume any alcohol during your pregnancy."

"Do not consume any alcohol during your pregnancy."

A primiparous client had a vaginal delivery and is planning to breastfeed her term neonate. She asks, "When will my 'real' milk come in?" The nurse explains to the client that after delivery breasts begin to fill with milk within which of the following time periods? 12 hours 24 hours 2-4 days 7 days

2-4 days

A primagravid client at 34 weeks gestation is experiencing contractions every 3-4 minutes lasting for 35 seconds. Her cervix is 4 cm dilated and 50% effaced. While the nurse is assessing the client's vital signs, the client says, "I think my bag of water just broke." Which of the following would the nurse do first? Test the leaking fluid with nitrazine paper Check the status of the fetal heart rate Perform a sterile vaginal examination Turn the client on her left side

Check the status of the fetal heart rate

As a fetus beings descent into the birth canal and head compression begins, early decelerations of the fetal heart rate can occur. What is the most appropriate intervention from the nurse? Increase fluids Turn the mother on her left side Continue to monitor the fetal heart rate Provide oxygen to the mother via face mask

Continue to monitor the fetal heart rate

A nulligravid client with gestational diabetes tells the nurse that she had a reactive nonstress test 3 days ago and asks, "What does that mean?" The nurse explains that the reactive non-stress test indicates which of the following about the fetus? Fetal well-being at this point in the pregnancy Evidence of late-decelerations occurring during the test No accelerations demonstrated within a 20-minutes period Evidence of some compromise that will require delivery soon

Fetal well-being at this point in the pregnancy

When caring for a women diagnosed with abrupto placent, the nurse would expect to observe which of the following signs and symptoms? Uterine hypotonicity Painless, vaginal bleeding Firm, rigid, painful abdomen Frequency and burning with urination

Firm, rigid, painful abdomen

A 30 year old is in the clinic for a well woman exam and states she and her husband are ready to have children. What vitamin would the nurse instruct the client to take to reduce the incidence of neural tube defects? Folic Acid Calcium Vitamin A Magnesium

Folic Acid

A delivery, a newborn has no complications and appears to be healthy with an APGAR of 8/9. What is the priority nursing intervention for the newborn at this time? Monitor respirations Maintain body temperature Monitor heart rate Ensure proper identification

Maintain body temperature

A newborn has small, pinpoint spots over the nose, which the nurse knows are caused by retained sebaceous secretions. When charting this observation, the nurse identifies it as: Milia Lanugo Vernix Mongolian spots

Milia

A nurse in the labor room is caring for a client in the active phases of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. The most appropriate nursing action is to: Place the mother on her left side Document the findings and continue to monitor the fetal pattern Increase the pitocin Start IV fluids

Place the mother on her left side

A primigravid client at 30 weeks gestation has been admitted to the hospital with premature rupture of membranes without contractions. Her cervix is 2 cm dilated and 50% effaced. Which of the following would be a priority assessment for this client? Degree of comfort Temperature Urinary output Hemoglobin

Temperature

During a prenatal visit the patient asks the nurse if it would be acceptable to use a hot tub during her vacation with her significant other. What is the best response from the nurse? "Hot tubs are relaxing and help to decrease the discomforts of pregnancy." "Hot tubs can be used for only 10 minutes of less to prevent fetal abnormalities.: "Hot tubs are a nice way for you and your significant other to bond and spend time together." "Hot tubs can cause birth defects in the fetus and you should not use them during pregnancy."

"Hot tubs can cause birth defects in the fetus and you should not use the during pregnancy."

A gravida 4 para 4 is recovering in postpartum. The nurse reviews her prenatal care and realized the patient needs a rubella vaccine as she is not immune. After administering the vaccine to the patient, the nurse counsels the patient about the rubella vaccine. How does the nurse know the patient understands the information? "I should not become pregnant again for at least one month." "Rubella vaccine is given to me because I am Rh negative." "Rubella vaccine will help prevent toxoplasmosis in the future." "I will become immune right away and there is no risk in future pregnancies."

"I should not become pregnant again for at least one month."

A nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a neonate. The instructor determines that the student needs to research this procedure further if the student states: "I will cleanse the neonate's eyes before instilling ointment." "I will flush the eyes after instilling the ointment." "I will instill the eye ointment into each of the neonate's conjunctival saves within one hour of birth." "Administration of the eye ointment may be delayed until an hour or so after birth so that eye contact and parent-infant attachment and bonding can occur."

"I will flush the eyes after instilling the ointment."

A primagravida is in the clinic for amenorrhea and thinks she is pregnant. She is afraid she is miscarrying as she has noticed some spotting and vaginal blood and minimal abdominal cramping. During her clinic visit, it is determined she is 6 weeks gestation. What is the best response from the nurse to address the patients concerns? "It is normal to have some spotting during implantation." "You may be miscarrying, we will have you observed for 24 hours in the hospital." "You are probably miscarrying and you can go home and rest and call us when the bleeding increases." "This is a medical emergency as you need an ultrasound to determine if you have an ectopic pregnancy."

"It is normal to have some spotting during implantation."

A nurse prepares to administer a vitamin K injection to a newborn infant. The mother asks the nurse why her newborn needs the injection. The best response by the nurse would be: "Your infant needs vitamin K to develop immunity." "The vitamin K will protect your infant from being jaundiced." "Newborn infants are deficient in vitamin K, and this injection prevents your infant from abnormal bleeding." "Newborn infants have sterile bowels, and vitamin K promotes the growth of bacteria in the bowel."

"Newborn infants have sterile bowels, and vitamin K promotes the growth of bacteria in the bowel."

A 28 year-old Gravida 4 Para 2 is in for prenatal care. During the assessment the nurse learns that the patient is a smoker of 1/4 packs a day and feels she "cannot quit smoking". The nurse provides counseling to the patient. What information is accurate? The baby will most likely be born postterm." "The baby may be hypoglycemic due to your smoking." "The baby will most likely be born small for gestational age." "The baby will not be affected by your smoking but it would be better for your own health to quit."

"The baby will most likely be born small for gestational age."

The nurse is teaching a prenatal class and is presenting information about dilation and effacement. What is accurate information the nurse will convey to the group? "The cervix opens to the size of the baby's head and effacement is when the baby is in the pelvis." "The cervix opens to 10 cm and thins out completely before pushing can occur." "Dilation is the thinning of the cervix and effacement is the position of the baby." "Dilation is the contraction of the uterus and effacement is when you can see the baby's head being born."

"The cervix opens to 10 cm and thins out completely before pushing can occur."

The normal respiratory rate of the newborn is: 20-30 30-60 50-60 60+

30-60

A primpara comes into the clinic noting her last menstrual period being 8/11/15. When is her expected date of delivery? 5/4/16 5/10/16 5/11/16 5/18/16

5/18/16

A primiparous client who underwent a cesarean delivery 30 minutes ago is a candidate for RhoGam as the baby is Rh positive. There is a physician order to administer RhoGam. The nurse needs to administer this medication within which of the following time frames after a delivery? 8 hours 12 hours 24 hours 72 hours

72 hours

Fetal distress is occurring with a laboring patient that is being induced. As the nurse prepares the client for cesarean birth, what other intervention should be done? Place the client in a high Fowler's position Continue the oxytocin drip Slow the intravenous flow rate Administer oxygen at 8-10 L/min via face mask

Administer oxygen at 8-10 L/min via face mask

A nurse is preparing to perform a fundal assessment on a postpartum client. The initial nursing action in performing this assessment is which of the following? Ask the client to turn on her side Ask the client to lie flat on her back with the knees and legs flat and straight Ask the mother to urinate and empty the bladder Massage the fundus gently before determining the level fo the fundus

Ask the mother to urinate and empty her bladder

A multigravid woman is in the office for a stress test. She has had a non-stress test in the past and is wondering what the difference is between the tests. What is the primary difference between a non-stress test and a stress test? Contractions Fetal Heart Rate Internal Monitoring External Monitoring

Contractions

While assessing a 2-hour old neonate, the nurse observes the neonate to have acrocyanosis. Which of the following nursing actions should be performed initially? Activate the code blue or emergency system Do nothing because acrocyanosis is normal in the neonate Immediately take the newborn's temperature according to hospital policy Notify the physician of the need for a cardiac consult

Do nothing because acrocyanosis is normal in the neonate

A nurse is assessing a newborn infant following circumcision and notes that the circumcised area is red with a small amount of bloody drainage. Which of the following nursing actions would be most appropriate? Document the findings Contact the physician Circle the amount of bloody drainage on the dressing and reassess in 30 minutes Reinforce the dressing

Document the findings

A nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which of the following actions is more appropriate. Document the findings and tell the mother that the monitor indicates fetal well-being. Reposition the mother and check the monitor for changes in the fetal tracing Take the mother's vital signs and tell the mother that bed rest is required to conserve oxygen Notify the physician or nurse mid-wife of the findings.

Document the findings and tell the mother that the monitor indicates fetal well-being.

The APGAR scores is a method of rapid evaluation of the infant after birth. You are preparing to score the one minute APGAR on a newborn infant and understand that the assessments are ranked in order form the most important to the least important. The first assessment you will make when obtaining the APGAR is" Heart rate Muscle tone Respiratory Effort Reflex response

Heart rate

The nurse is preparing to administer terbutaline (Brethine) to a multigravid client in preterm labor. Before administering this drug intervenously, the nurse should conduct a priority assessment of which of the following? Heart rate Respirations Hematocrit Urinary output

Heart rate

The labor nurse understands that the most common and potentially harmful maternal complication of epidural anesthesia would be: Severe postpartum headache Limited perception of bladder fullness Increase in respiratory rate Hypotension

Hypotension

The nurse is assessing the lochia on a 1 day PP patient. The nurse notes that the lochia is red and has a foul-smelling odor. The nurse determines that this assessment finding is: Normal Indicates the presence of infection Indicates the need for increasing oral fluids Indicates the need for increasing ambulation

Indicates the presence of infection

A multipara patient is having her third 15 minute postpartum exam. The nurse assessment reveals a boggy uterus and heavy lochia rubra. What is the priority nursing intervention? Massage the uterus Call the MD for medications to control hemorrhage Have the patient use the bedpan to urinate Obtain vital signs

Massage the uterus

A multigravid client is receiving oxytocin (Pitocin) augmentation. When the client's cervix is dilated to 6 cm, her membranes rupture spontaneously with meconium-stained amniotic fluid. Which of the following actions should the nurse do next? Increase the rate of the oxytocin infusion Access the cervical dilation and effacement Monitor the fetal heart rate continuously Assist the lient to knee-to-chest position

Monitor the fetal heart rate continuously

The nurse is assigned to care for a patient with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note which of the following prescribed treatments for the condition? Oxytocin (Pitocin) infusion IV Terbutaline (Brethine) IV Betamethasone (Celestone) IM Administer magmesium sulfate IV

Oxytocin (Pitocin) infusion IV

A gravida 2 para 1 patient has been diagnosed with HELLP syndrome and is given magnesium sulfate to help control her blood pressure. What are the important areas to assess before administering magnesium sulfate? Deep tendon reflexes and urine protein Respirations and Blood Pressure Pulse and Temperature CBC and urinalysis

Respirations and blood pressure

A nurse is performing an assessment on a client diagnosed with placenta previa. Which of these assessment finding would the nurse expect to note with vaginal bleeding? Uterine rigidity Uterine tenderness Severe abdominal pain Soft, relaxed, non-tender uterus

Soft, relaxed, non-tender uterus

You are caring for a client in labor. You determine that she is beginning in the 2nd stage of labor when which of the following assessments is notes? The client begins to expel clear vaginal fluid The cervix is completely dilated The membranes have ruptured The contractions are regular

The cervix is completely dilated

The physician orders betamethasone (Celestone) for a 34 year old multigravid client at 32 weeks gestation that is experiencing preterm labor. The nurse explains that this drug is given for which of the following reasons? To enhance fetal lung maturity To counter the effects of tocolytic therapy To slow down or stop the progression of labor To decrease neonatal production of surfactant

To enhance fetal lung maturity

A 28 year-old anxious multigravid client at 37 weeks gestation arrives at the emergency department via ambulance with a blood pressure of 160/104 mm Hg and a +3 reflexes without clorus, and 3+ pitting edema. this client is diagnosed with severe preeclampsia. She asks the nurse, "What is the cure for my high blood pressure?" Which of the following would the nurse identify as the primary cure? Sedation with phenytoin (Dilantin) Administration of magnesium sulfate Vaginal or cesarean delivery of the fetus Reduction of fluid retatntion with thiazide diuretics

Vaginal or cesarean delivery of the fetus

Which of the following findings meets the criteria of a reassuring FHR pattern? Variability averages between 6-10 BPM FHR does not change as a result of fetal activity Average baseline rate ranges between 100-140 BPM Mild late decelerations patterns occur with some contractions

Variability averages between 6-10 BPM