OB-FINAL MARC'S

44. The nursery nurse is careful to wear gloves when caring for neonates. Which is the scientific rational for this action by the nurse?

The immune system of the neonate is ummature

98. A post term neonate is admitted to the neonatal intensive care unit. At delivery thick green amniotic fluid was noted. Which action is a ​priority​?

Continue assessment and evaluate for respiratory distress

70. A woman undergoing her first prenatal visit for a current pregnancy is reluctant to discuss her past obstetrical history with the nurse. Which action by the nurse is ​best​?

Explain that past obstetrical experiences frequently recur in later pregnancies.

30. A pregnant woman calls the OB clinic nurse to complain of sharp abdominal pain with coughing or sneezing. What action by the nurse is best?

Explain that the pain is from stretching of the ligaments

79. A nurse is preparing an in-service program for a group of newly hired nurses about trends in care for pregnant women. When describing events of the past decade, the nurse would state that the average length of stay in the hospital for vaginal birth is:

24-48 hours or less

53. A group of nurses are preparing a program about rape and sexual assault for a community health center. Which information would the nurses include as being accurate? SATA

A rape victim feels vulnerable and betrayed afterwards Medication and counseling can help a rape victim cope Few women falsely cry "rape"

13. A nurse is completing a newborn gestational age assessment. What finding would be recorded as part of this assessment on the preterm newborn?

Abundant lanugo

94. A nurse is preparing to dismiss a woman and her infant from the hospital. The woman is Rh(D) negative and the infant is Rh(D) positive. This was her first pregnancy. Which nursing action is most​appropriate?

Administer Rho(D) immune globulin (RhoGAM) and document accurately.

90. A woman received butorphanol (Stadol) IV for labor pain. Thirty minutes later, the patient's respiratory rate is 8 breaths/minute. What action by the nurse is ​best​?

Administer naloxone (narcan) per protocol

2. A pregnant woman is admitted with the diagnosis of premature rupture of membranes. The nurse is continuously assessing the patient for possible infection. Which findings would lead the nurse to suspect the patient is developing an infection? SATA

Elevated maternal pulse Abdominal tenderness Cloudy malodorous fluid

25. A nurse is working with a group of women who are victims of intimate partner violence. The nurse focuses interventions on which area as the ​primary​goal?

Empowering them to regain control of their life

8. Which of the following nursing interventions would be appropriate for the nurse to perform to achieve the patient goal: the patient will not develop postpartum thrombophlebitis?

Encourage early ambulation

72. A woman has returned to the clinic for her second prenatal visit. Her blood pressure is significantly higher than on her previous visit. What action should the nurse do ​first​?

Ensure that the blood pressure cuff is the appropriate size

41. The nurse is caring for a postpartum patient who has a second degree perineal laceration as delivery 2 hours ago. What intervention should the nurse perform at this time?

Apply an ice pack to the perineum

29. A nurse is preparing a class discussion on the clinical manifestations of a heart attack observed in women. Which symptoms would the nurse include as key assessment data? SATA

Arm pain Unusual fatigue Sleep disturbances

36. Which of the following action would the nurse expect to perform immediately before a pregnant woman is to have regional anesthesia? SATA

Assess fetal heart rate Have the woman empty her bladder Infuse 1,000 mL of isolyte solution

22. The perinatal nurse notes that a newborn does not seem to have an opening inside the anal rings, which action by the nurse takes ​priority​?

Assess the abdomen and notify the physician

95. A preterm infant is jittery and has an oxygen saturation of 88%. After stabilizing the newborn, what action by the nurse is ​most​important?

Assess the mother for opioid use during pregnancy

49. A preterm infant is baby grunting. What is the first action that should be done by the nurse?

Assess the respiratory rate

33. A woman in the third trimester of her first pregnancy complains of excessive fatigue. Her hemoglobin is 11.2g/dL. What action by the nurse id ​best​?

Assess the woman's diet for adequate iron and protein

v4. A patient is using a doula to work with her during her labor process. Which of the following actions would be appropriate for the doula to perform? SATA

Assist the patient with her breathing Give the patient a back rub

57. A mother who gave birth 5 minutes ago, states that she would like to breastfeed. The baby's Apgar score is 9/9. Which of the following actions should the nurse perform first?

Assist the woman to breastfeed

50. A nurse is reviewing a newborn's laboratory results. What laboratory results should be the nurse's priority?

Bilirubin 30 mg/dL

64. When integrating the principles of family-centered care into the birthing process, the nurse would base care upon which belief?

Birth results in changes in relationships.

81. A prenatal nurse is preparing a presentation for expectant parents on the use of birthing centers. What information would the nurse likely include? SATA

Birthing centers allow for freedom to eat and move around during labor Birthing centers use a non-interventional approach to obstetric care This setting allows for the ability to give birth in a variety of positions.

17. A nurse is caring for a preterm newborn. What nursing interventions should be included in the plan of care to promote development

Cluster the preterm newborn's care activities

14. Which of the following does the nurse recognize as complications of premature birth? SATA

Cerebral palsy Osteoporosis Intraventricular hemorrhage Retinopathy of prematurity

58. A baby is born with several congenital anomalies. The parents are distraught and begin questioning each other about what they did wrong during the pregnancy. What response by the nurse is ​best​?

Chances are you did everything right; we may never know why this happened

48. A neonate whose mother is a drug addict is listless and sweating. What action by the nurse takes priority​?

Check the baby's blood sugar

60. What actions by the nursing staff would beneficial for parents who have lost a newborn? SATA

Clean the infant and wrap in a blanket Take photographs to give to the parents Explain how the infant will look And the baby's name, and use it

87. The perinatal nurse observes a woman entering the transition phase of labor while she uses a patterned breathing method to cope with the increasing strength of contractions. She complains of light-headedness and tingling in her fingers. The ​most​appropriate intervention by the nurse id to assist the patient in doing which of the following?

Cupping her hands and breathing into them.

6. A 39 week G3P2002, was examined 5 minutes ago. Her cervix was 8cm dilated and 90% effaced. She calls and tells the nurse that she now needs to have a bowel movement. What action should the nurse perform ​first​?

Evaluate the progress of labor

85. A nurse is assessing a pregnant woman who says she drinks 5-7 alcoholic drinks per week. What action by the nurse is ​best​?

Explain that during pregnancy, alcohol in any amount can harm the fetus.

39. GRAPH The nurse is monitoring a fetus during labor using an external fetal monitor. The nurse palpates the contractions as being strong. The patient is currently on 12 milliunits/minute of Pitocin (oxytocin) to augment her labor. Using the strip provided, what would be the ​priority interventions for this labor pattern?

Decrease the amount of oxytocin medication

18. A nurse is caring for a newborn who has hydrocephalus. What should the nurse ​expect​to find when doing the physical assessment?

Dilated scalp veins and separated sutures

42. A grand multiparous, postpartum patient reports severe abdominal cramping whenever she nurses her baby. What is the ​best​response by the nurse?

Discuss the action of breastfeeding hormones

12. A term infant's initial blood glucose level is 52 mg/dL. What action by the nurse is ​most appropriate?

Document the findings in the infant's chart

91. When assessing a newborn baby, which action should the nurse perform ​first​?

Don clean gloves before taking the baby

31. The clinic nurse talks with a patient about her possible pregnancy. The patient has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. She is convinced she is pregnant and is reluctant to pay for a pregnancy test. Which action by the nurse is ​best​?

Explain that these symptoms can be caused by other conditions

88. The perinatal nurse suggests that a laboring woman may wish to use the birth ball. The patient questions the rationale for this suggestion. The ​best​answer by the nurse is that use of the birth ball will facilitate what action?

Fetal descent

5. The MD is performing and amniotomy on a gravid patient in transition. What assessment should the nurse do immediately following the procedure?

Fetal heart rate

11. A nursing student asks the faculty member t define "lanugo". Which description is ​best​?

Fine, downy hair on the fetus

67. A patient provides the nurse with the following obstetrical history: delivered a son now 7 years old, at 28 weeks gestation, delivered a daughter now 5 years old, at 39 weeks gestation; had a spontaneous miscarriage 3 years ago; and had a first-trimester abortion 2 years ago. She is now currently pregnant with twins. Which portrays an accurate picture of her gravidity and parity?

G5P1122

38. A patient who is dilated to 7 cm and is 100% effaced is breathing at a rate of 50 bpm during her contractions. Immediately after her contraction, she complains of tingling in her fingers and some light=headedness. What action by the nurse would take ​priority​at this time?

Have the woman breath into a bag

61. A nurse is assessing the bonding of the father with his newborn baby. Which of the following actions by the father would be of concern to the nurse?

He tells the mother to pick up the crying baby

69. The prenatal nurse believes in advocating for the patient. What action by the nurse best reflects this role?

Helping the woman formulate and vocalize questions.

73. The nurse is caring for a woman who is undergoing an induction with oxytocin (Pitocin). The nurse explains to a nursing student that contraindications to labor induction include which of the following? SATA

History of a myomectomy Active genital herpes infection Vasa previa or complete placenta previa

28. A nurse in the sexual health clinic assesses a female client and notes wart-like lesions on the genital area and rectum. Which diagnosis ​best​correlates with these findings?

Human papillomavirus

82. The community health nurse is preparing a presentation for an adolescent group with the focus being on primary prevention topics. Which topics would the nurse include? SATA

Hygiene practices Sun protection routine Smoking cessation programs Nutrition guidelines

100. A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which complications as the ​priority​focus of care?

Hypoglycemia

63. A woman comes for her fitst prenatal appointment at 31 weeks gestation with her first pregnancy. Which of the following are appropriate statements by the nurse? SATA

I am interested in hearing about your life and what prompted you to begin your prenatal care today? It is nice to meet you and I will try to help you get caught up in your prenatal care Do you have questions before I begin your prenatal history and information sharing?

75. A nurse is caring for a woman who will be induced, but her cervix is not yet favorable for this intervention. The provider leaves an order for dinoprostone vaginal insert (Cervidil), which the nurse administers at 9:00 a.m. At which time does the nurse anticipate induction with oxytocin (Pitocin)?

In 60-90 minutes after the dinoprostone insert is removed

62. A pregnant patient in the prenatal clinic had a negative rubella titer. Which action by the nurse is ​most​appropriate?

Instruct the woman to avoid anyone who may have the disease

97. A nurse wishes to improve his or her cultural sensitivity while working with patients. Which action by the nurse would ​best​indicate progress toward this goal?

Interact respectfully with patients who have differing health beliefs

3. A patient has severe preeclampsia. What tests would the perinatal nurse expect the MD to order to assess the fetus?

Intrauterine growth restriction

54. A nurse is assessing a rape survivor for post-traumatic stress disorder. The nurse asks the woman, "Do you feel as though you are reliving the trauma?" The nurse is assessing foe which effect of the trauma?

Intrusive thoughts.

74. A woman has been diagnosed with hypertonic labor. She has an order for Fentanyl. The student is preparing the medication and asks the labor nurse the rationale for using it. What response by the nurse is ​best​?

It is to induce prescribes rest and relax the uterus.

45. A full term baby's bilirubin level is 18mg/dL on day 3. Which of the following behaviors would the nurse expect to see?

Lethargy

26. A group of nurses are researching information about risk factors for intimate partner violence in men, they are preparing a community presentation for the local health center. When describing the information, which factors would the nurse discuss as being associated with the relationship? SATA

Low academic achievement Victim of childhood violence Economic stress Heavy alcohol consumption

71. During the first prenatal visit, a nurse teaches a pregnant woman about emergencies for which she needs to be seen immediately. Which situations does the nurse include in this education?

Low, dull backache or pelvic pressure Reduction in fetal movement Maternal fever over 100.5 (38.1C)

19. A nurse is preparing to administer oxygen via hood therapy to a newborn who was born at 30weeks of gestation. What is an appropriate nursing action when providing care to this infant?

Maintain oxygen saturations between 93%-95%

56. The perinatal nurse describes infant feeding cues to a new mother. These feeding cues include which of the following behaviors? SATA

Mouth movements Moving the hand to the mouth Vocalization

23. A nurse is caring for a preterm newborn who has a nasogastric tube and who recently began intermittent gavage feeding of formula. The nurse notes increased abdominal distention, lethargy, bloody stools, and increasing gastric residuals before feeding. What should the nurse suspect from the assessment data?

Necrotizing enterocolitis

89. A nurse is caring for a pregnant woman scheduled to have an epidural block. The nurse reviews the woman's admission laboratory results and finds the following: white blood count (WBC) 6,500/mm3, hemoglobin 14mg/dL, hematocrit 38%, and platelet count 28,000. What action by the nurse is best?

Notify the health care provider immediately

43. A G2P2002, who is postpartum for 6 hours from a spontaneous vaginal delivery, is assessed. The nurse notes that the fundus is firm at the umbilicus, there is heavy amount of lochia rubra, and perineal is intact. What would be the ​best​actions should the nurse so at this time?

Notify the patient's practitioner of the findings

84. The public health nurse is teaching your adolescents in a sexual health class the proper use of a condom. Which statement made by the students indicate teaching was successful? SATA

Only use latex condoms Store the condoms in a cool, dry place Place the condom on an erect penis

51. After teaching the parents of a newborn with periventricular hemorrhage about the disorder and treatment, which statement by the parents indicates that the teaching was successful?

Our newborn could develop a learning disability later on.

9. During a postpartum assessment, the nurse assess the calves of a patient's legs. The nurse is checking for which of the following signs and symptoms? SATA

Pain Warmth Redness

1. Which finding would the nurse to expect when assessing a patient with placenta previa?

Painless vaginal bleeding

32. The nurse reads "positive hegar's sign" in a patient's chart. What can the nurse conclude about the patient?

Patient may be pregnant

47. The newborn is in the NICU and is exhibiting signs of neonatal abstinence syndrome. Which of the following ​signs/symptoms/intervention​should the nurse ​observe or do​for this newborn?

Persistent shrill cry Hyperphagia Tightly swaddle the baby

37. A patient G2P1001, is 5 cm dilated and 70% effaced, has just received an epidural. What is the action takes priority at this time?

Place a wedge under the patient's side

16. A nurse is planning care for a newborn who has spinal bifida. What action should be included in the plan of care?

Place the newborn in the prone position

77. A mother is attempting to latch her newborn baby to the breast. Which of the following actions are important for the mother to perform to achieve effective breastfeeding? SATA

Point the baby's nose to the mother's nipple Hold the baby at the level of the mother's breast Wait until the baby opens his or her mouth wide

96. Immediately after an uncomplicated delivery without meconium, a full term newborn is warmed, dried, suctioned, and positioned appropriately but has a heart rate of 80 bpm. What would be the next step in managing this infant?

Positive pressure ventilation

15. A mother-baby nurse assesses newborns for their risk of developing hypoglycemia. What infant would the nurse assess as being at ​highest​risk?

Post term large for gestational age infant

21. A nurse is caring for a premature baby. What assessment findings would indicate the clinical manifestation of pyloric stenosis?

Projectile vomiting after feedings

10. A patient who is 24 hours postpartum is complaining of profuse diaphoresis. She has no other complaints. What is the most appropriate action by the nurse?

Reassure the patient that this is normal

55. During the follow up visit to the clinic a victim of sexual assault reports that she has changed her job and moved to another town. She tells the nurse, "I pretty much stay to myself at work and at home." The nurse interprets these findings to indicate that the client is in which phase of rape recovery?

Reorganization

99. A nurse assessing an infant notes that the baby is jittery, has muscle twitches, has jittery movement of the arms and legs, and is inconsolable. What action by the nurse is ​most appropriate?

Request laboratory work to detect substance abuse

93. A patient has had a screening test for gestational diabetes and the 1-hour result is 250 mg/dL. What does the nurse conclude about this patient?

Results are high; the patient has gestational diabetes

78. A breastfeeding woman has been counseled on how to prevent engorgement. Which of the following actions by the mother shows that the teaching was effective?

She feeds her baby every two to three hours

20. Which action would be most appropriate for the nurse to take when a newborn has an unexpected anomaly at birth?

Show the newborn to the parents as soon as possible while explaining the defects

92. The perinatal nurse teaches new patents the best sleeping position for infants. The parents verbalize their understanding by stating which position is ​best​for the baby?

Supine

86. A 34 week gravid patient is being seen in the prenatal clinic. She tells the nurse that she has had a terrible headache for the last 2 days. Which is the ​most​appropriate action for the nurse to perform next?

Take the patient's blood pressure

83. A nurse working in the community is involved in providing primary prevention. Which intervention would be appropriate to implement?

Teaching parents of toddlers about ways to prevent poisoning

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

Temperature instability

46. A mother and her 2-day old baby are preparing for discharge. Which of the following situations would require the baby's discharge to be cancelled?

The baby's bilirubin is 19mg/dL

34. The perinatal nurse is assessing a patient who states, "I think that I am in labor." What assessment findings would ​positively​confirm the patients' statement?

The cervix has dilated from 2 cm to 4 cm

66. A teenager from a rural area has been airlifted to the nearest urban center hospital for investigation of abdominal pains. Which actions by the nurse best exemplify the principles of family-centered care? SATA

The family is assisted with travel plans to be able to stay with the patient The patient and family can communicate with caregivers their potential fears The health care team gives the patient and family regular updates

80. The nurse working in a maternity clinic suspects that a client and her children are in an abusive relationship. While waiting for test results, the nurse decides to teach the client about partner abuse. What would be the ​best​rationale for the nurse's decision?

The nurse knows that children exposed to family violence are likely to be abused

35. A patient G1P0000, at 40 weeks' gestation, presents to the labor and delivery unit stating that she is in labor. Upon examination, it is noted that she is dilated 2cm, 30% effaced, and -3 station with contractions every 12minutes lasting 30 seconds. Fetal heart rate is 140 with moderate variability and spontaneous accelerations of 15*15. What should the nurse conclude when reporting these findings to the practitioner?

The patient is in early labor and could be sent home

76. GRAPGH A G5P3 pregnant woman, at 41.6 weeks gestation, came in for complaints of decreased fetal movement. The nurse places her on the external fetal monitor and observes the below strip. What would be the ​priority​interventions for this patient and the fetus?

Turn the patient to the side, call the doctor, start ocytocic

7. GRAPH The nurse is monitoring a fetus during labor using an external fetal monitor. Using the strip provided, what would be the ​priority​interventions for the fetus?

Turn the patient, give oxygen via nonrebreather mask, and infuse a bolus of IV fluid

65. When teaching a parenting class on childhood discipline, the nurse is asked by a parent, "How long do I place my child in time-out?" How should the nurse respond?

Use 1 minute per year of age, but do not exceed 5 minutes

68. For which diseases does the prenatal nurse recommend a newly pregnant woman be screened?

Varicella Chlamydia Rubella

40. The nurse is assessing the midline episiotomy on a postpartum patient. What should the nurse expect to see?

Well approximated edges

59. A new nurse is struggling to care for a woman whose baby was stillborn. What advice should the nurse preceptor give the novice?

You can simply say "I am sorry for your loss"

27. A pregnant woman is diagnosed with gonorrhea and asks the nurse, "How will this infection affect my baby and pregnancy?" which responses by the nurse are accurate? SATA

Your membranes may rupture earlier than normal Your newborn can be infected during birth Your newborn may have eye infections from this infection

24. A pregnant woman is diagnosed with chlamydia and asks the nurse, "How will this infection affect my baby and pregnancy?" which responses by the nurse are accurate?

Your newborn can be infected during birth Your membranes may rupture earlier than normal Your newborn may have eye infections from this infection