OB review
A woman at 40 weeks of gestation should be instructed to go to a hospital or birth center for evaluation when she experiences:
a recurrent trickle of fluid from the vagina.
A postpartum mom is breastfeeing and is Dx with mastitis, and ATB is prescribed, what should the mom do
keep breastfeeding the infant, ensure that both breasts are emptied
If a woman's fundus is soft 30 minutes after birth, the nurse's first response should be to:
massage the fundus.
a mother comes into the office and is 17 weeks pregnant, she states that she feels the baby move, what is this called
quickening
FHR is 124 bpm, what action should the nurse take
reassure the mother that the heart rate is normal
A nurse in the delivery room is planning to promote maternal-infant bonding for Sarah who just delivered a full-term female infant with a one- minute Apgar of 8 and five-minute Apgar of 9. Which of the following is the priority action by the nurse?
Position the neonate skin-to-skin on Sarah's chest.
Lactogenesis II requires the release of
Prolactin and Oxytocin
Choose the correct sequence of Rubin's stages of attachment between mother and child.
Taking in, taking hold, letting go
A breastfeeding mother is being discharged with her 2 day old, full-term newborn. A nurse recognizes that the mother understands how to determine if her newborn is getting enough breast milk when the mother says:
"After my milk is established, he will urinate 6-8 times and have 2 or more bowel movements in 24 hrs".
fetal presentation refers to which of the following ?
The fetal body part that enters the maternal pelvis first.
a nurse is assessing the fundal height on a 48 hour pp mother, where would the nurse document the height
2 cm below umbilicus
The nurse is recalling the steps in cell division, beginning at conception and ending with fetal development. List the following steps in order of development: 1 ] Blastocyst 2 ] Embryo 3 ] Fetus 4 ] Zygote
4,1,2,3
The nurse is assessing a newborn at birth. When assessing the umbilical cord, she should expect to see how many vessels?
Two arteries and one vein
At 1 minute after birth, the nurse assesses the newborn to assign an Apgar score. The apical heart rate is 110 beats/minute, and the infant is crying vigorously with the limbs flexed. The infant's trunk is pink, but the hands and feet are blue. The Apgar score for this infant is:
9
The nurse is planning care for a group of clients. Which client would need to receive Rho (D) Immune Globulin (RhoGAM)?
A client whose blood type is O-negative
Which patient with a fetus displaying minimal variability would the nurse assess first?
A patient who is 39 weeks gestation with 8 contractions in 10 minutes.
A nurse is preparing to assess the respiration's of a newborn infant just admitted to the nursery. The nurse performs the procedure and determines that the respiratory rate is normal if which of the following is noted?
A respiratory rate of 50 breaths per minute
Late decelerations
cord compression
If the fundus is palpated on the right side of the abdomen above the expected level, the nurse should suspect that the client has
distended bladder
A client wants to prevent pregnancy using the rhythm method, when is this client most fertile
during day 9-16 (ovulation is day 14 and egg stays alive for 24 hours)
FHR decreases to 120 at the beginning of a contraction and returns to the baseline of 155 at the end of the contraction, what does this show
early decelerations due to head compression
The nurse is requested by the mother to examine her newborn. The mother states that a pink rash suddenly appeared on the infant's back. The nurse explains to the mother this rash is called
erythema toxicum
during the second stage of labor, how often should we monitor FHR
every 5 minutes
During labor, a vaginal examination should be performed only when necessary because of the risk of:
fetal infection
Pregnancy test is positive. Nurse finds the prescence of goodell sign, the nurse knows that this sign indicates
softening of the cervix
A nurse should recommend which preconception supplement as a preventative measure to decrease the incidence of neural tube defects
0.6 mg daily
it has been 6 hours since delivery. the nurse assesses the client for involution and documents a normal assessment. The nurses assessment would state that the fundus is located
At the level of the umbilicus
What are probable signs of pregnancy?
Ballottment - tap cervix and baby rise in amniotic fluid chadwicks - blue v coloring of cervix and vaginal mucosa uterine enlargement braxton hicks hegar - softening of lower part of uterus goodell - softening of the cervix
A client reported that her menstrual period started 14 days ago and she is unsure of when ovulation will be taking place. Based on the client's history, the nurse notes that the client is ovulating. Which activity does the nurse expect to be happening within this client at this time?
Before the surge of luteinizing hormone, estrogen levels decrease and progesterone increase.
Following a vaginal exam on a client in labor, the nurse documents the client to be 8cm, 80%, +1. Which do these terms represent?
Cervical dilation, effacement, fetal station
A G4P3003 woman with a history of rapid births arrives at the labor unit demonstrating transitional labor signs. The priority nursing assessments are:
Cervical exam, fetal heart rate, and maternal vital signs.
A nurse receives a call from the laboratory reporting a blood sugar of 46mg/dL for a full term newborn at eight hours old. In response to this information, the nurse should:
Document the information in the newborn's health-care record.
A patient is confirmed to be pregnant. Obstetric history includes two sets of twins born at 30 and 32 weeks gestation, respectively, a singleton birth born at 39 weeks gestation, and two pregnancies lost in the first trimester. In which way will the nurse define the patient's obstetrical history?
G6, T1, P4, A2, L5
A nursing student has been caring for a woman and her newborn all morning. After taking the newborn to the nursery for tests, the student is returning the newborn to the mother. Which procedure is correct for identifying the newborn?
Have the mother read her printed band number and verify that it matches the infant's.
Early decelerations
Head pressed on. This is okay, happens with contractions
A patient tells you her last menstrual period was September 10th, 2016. According to the Naegele's rule when is her expected due date is:
June 17, 2017
LMP was September 10, 2022, calcuate EDD
June 17, 2022
The nurse is discussing genetically linked diseases with a couple planning a pregnancy. The female states, "I am concerned because there is a history of sickle-cell disease in my family." Recognizing that Sickle-Cell Anemia is an autosomal recessive genetic disease, which information from the nurse is correct?
The male partner should consider genetic testing.
The nurse is caring for a patient who is a G4P3 at 38 weeks gestation, contracting every 3 minutes. Which assessment finding by the nurse requires immediate action?
absent variability
A client whose cervical exam is 6 cm/80%/+1 is considered to be in which phase of labor?
active phase
A pregnant mother who was exposed to teratogens is now admitted with a diagnosis of fetal growth restriction. In order for this medical diagnosis to be made, the nurse would determine the mother was mostly likely exposed to teratogens during which period?
after 13 weeks of gestation
A laboring woman is lying in the supine position. The most appropriate nursing action is to:
assist her to turn to one side.
Breastfeeding decreases the infant's incidence and/or severity of (Select all that apply)
asthma, SIDS, otitis media, respiratory tract infections and obesity
If a mother is 20 weeks pregnant where do you expect to locate the fundus
at the umbilicus
Which of the following statements are part of the American Academy of Pediatrics recommendations concerning breastfeeding? (Select all that apply.)
breastfeeding should continue for at least 12 months, exclusively breastfed infants should gradually be introduced to iron-rich solids beginning after 6 months
what is the short term goal for a full term breastfeeding infant
by 1 week of age they will urinate 6 times in 24 hours
Variable decelerations
cord compression
A patient is 10 weeks into her pregnancy. She has a sister with Trisomy 21. The patient is requesting testing to determine whether the current fetus has the same defect. Which testing does the nurse expect the HCP to discuss with the client? (Select all that apply)
harmony/quad screening
what monitor can assess the intensity of contractions
internal
what is reshaping of babies skull
molding
if a mother is 38 weeks gestation, and FHR is 174 what is the nursing action needed
notifiy the physician
Nurse is teaching about placentas oxygen pathway to the newborn. The nurse knows that high levls of oxygenated blood come from what part of fetal circulation?
placenta and umbilical vein
How can a nurse encourage a laboring woman to cope with contraction pain?
position changes
auscultated FHR
positive
palpate fetal movement
positive
N/V
presumptive
amenorrhea
presumptive
breast changes
presumptive
Positive pregnancy test
probable
What is true labor? SATA
progressive cervical dilation and effacement, regular and rhythmic contractions, pain in the lower back that radiates to the abdomen
If the position of a fetus in a cephalic presentation is right occiput anterior, the nurse should assess the fetal heart rates in which quadrant of the maternal abdomen?
right lower
A nurse is reviewing the laboratory tests of a pregnant client after her initial visit. She is now 10 weeks into her pregnancy. Which lab values are considered abnormal for this woman in early pregnancy? Select all that apply.
rubella titer, indirect antibody test, urine culture, hemoglobin
describe the fetal circulation through the umbilical cord
two arteries carry deoxygenated blood and waste products away from the fetus to the placenta
What part of the uterus provides the force for contractions
upper
