OB Test 3 questions

A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom should the nurse prioritize? *A systolic blood pressure increase of 10 mm Hg *Weight gain of 1.2 lb (0.54 kg) during the past 1 week *A dipstick value of 2+ for protein *Pedal edema

A dipstick value of 2+ for protein

A pregnant client at 32 weeks' gestation is treated with magnesium sulfate for seizure management. The nurse assesses which of the following for evidence of magnesium toxicity? *Frequency of micturition *Absence of knee jerk response *Increased blood pressure *Increased rate of respiration

Absence of knee jerk response

A pregnant client is admitted to a health care unit with disseminated intravascular coagulation (DIC). Which prescription is the nurse most likely to receive regarding the therapy for such a client? *Administer a ratio of 1 unit of blood to 4 units of frozen plasma. *Administer cryoprecipitate and platelets. *Aim at keeping the client's hematocrit above 20%. *Give each unit of blood to raise the hematocrit by 3 g/dL.

Administer cryoprecipitate and platelets

A client has opted to receive epidural anesthesia during labor. Which of the following interventions should the nurse implement to reduce the risk of a significant complication associated with this type of pain management? *Administration of 500 mL of IV Ringer's lactate *Administration of 1000 mL of IV glucose solution *Move the woman into a supine position *Administration of aspirin

Administration of 500 mL of IV Ringer's Lactate

The nurse is concerned that a pregnant patient is experiencing abruptio placentae. What did the nurse assess in this patient? *Increased blood pressure and oliguria *Pain in a lower quadrant and increased pulse rate *Painless vaginal bleeding and a fall in blood pressure *Sharp fundal pain and discomfort between contractions

Sharp fundal pain and discomfort between contractions

A pregnant patient is prescribed to have labor induced with oxytocin. How should the nurse prepare to administer this medication? *In a 20-cc bolus of saline *In two divided intramuscular sites *Diluted as a "piggyback" infusion *Diluted in the main intravenous fluid

Diluted as a "piggyback" infusion

When assessing a pregnant woman with vaginal bleeding, the nurse would suspect a threatened abortion based on which finding? *slight vaginal bleeding *cervical dilation *strong abdominal cramping *passage of fetal tissue

Slight vaginal bleeding

A prenatal client who is 6 weeks' gestation calls the clinic to report vaginal bleeding. For what concern will the nurse further assess the client? *Spontaneous abortion *Nuchal cord *Urinary tract infection *Braxton Hicks contractions

Spontaneous abortion

A 16-year-old client has been in the active phase of labor for 14 hours. An ultrasound reveals that the likely cause of delay in dilatation is cephalopelvic disproportion. Which intervention should the nurse most expect in this case? *cesarean birth *administration of oxytocin *administration of morphine sulfate *darkening room lights and decreasing noise and stimulation

cesarean birth

A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which condition in the client is likely to increase the risk for shoulder dystocia? *diabetes *preterm birth *nullipara *pendulous abdomen

diabetes

Which primary symptom does the nurse identify as a potentially fatal complication of epidural or intrathecal anesthesia? *Difficulty breathing *Staggering gait *Decreased level of consciousness *Intense pain

difficulty breathing

The nurse is monitoring a woman who is receiving oxytocin IV to assist with uterine irritability. Which action should the nurse prioritize if the woman's contractions are determined to be 80 seconds in length after 1 hour of administration of the oxytocin? *Slow the infusion to under 10 gtts per minute. *Increase the flow rate of the main line infusion. *Discontinue the oxytocin infusion. *Continue to monitor contraction duration every 2 hours.

discontinue the oxytocin infusion (want the contractions to be longer than 80 seconds, 100-120 is ideal)

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? *hyperglycemia *elevated platelet count *disseminated intravascular coagulopathy (DIC) *elevated liver enzymes

elevated liver enzymes

What terminology would the nurse use to document a newborn who weighs 4,000 grams (8.13 lb) or more at birth? *microsomia *macrosomia *meconia *hydrocephalus

macrosomia

A client asks why she should learn breathing patterns for labor. After instruction is given, the nurse determines teaching has been effective when the client states: *"Breathing patterns must be used with a coach." *"Breathing patterns cannot be taught while in labor." *"Breathing patterns are distraction techniques taught to decrease pain in labor." *"Breathing patterns help a woman concentrate on pain."

"Breathing patterns are distraction techniques taught to decrease pain in labor."

A client is scheduled for a cesarean section under spinal anesthesia. After instruction is given by the anesthesiologist, the nurse determines the client has understood the instructions when the client states: *"I can continue sitting up after the spinal is given." *"I may end up with a severe headache from the spinal anesthesia." *"The anesthesia will numb both of my legs to a level above my breasts." *"I will need to lie on my right side to reduce vena cava compression."

"I may end up with a severe headache from the spinal anesthesia."

A woman states that she does not want any medication for pain relief during labor. Her primary care provider has approved this for her. What the nurse's best response to her concerning this choice? *"That's wonderful. Medication during labor is not good for the baby." *"Your health care provider is a man and has never been in labor; he may be underestimating the pain you will have." *"I respect your preference whether it is to have medication or not." *"Let me get you something for relaxation if you don't want anything for pain."

"I respect your preference whether it is to have medication or not."

A woman has been in labor for the past 8 hours, and she has progressed to the second stage of labor. However, after 2 hours with no further descent, the provider diagnoses an "arrested descent." The woman asks, "Why is this happening?" Which response is the best answer to this question? *"Maybe your uterus is just tired and needs a rest." *"It is likely that your body has not secreted enough hormones to soften the ligaments so your pelvic bones can shift to allow birth of the baby." *"Maybe your baby has developed hydrocephaly and the head is too swollen." *"More than likely you have cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal."

"More than likely you have cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal."

Which medication is administered to reverse the depressant effects of opioids? *naloxone *meperidine *butorphanol *nalbuphine

naloxone

When collecting data to devise a labor plan for a multiparous woman, which question best allows the nurse to develop individualized strategies? *"Tell me how you handled labor pain in your past deliveries." *"How do you want the health care team to plan your care?" *"Who do you want to be with you when you are in labor?" *"Picking from these options, what options do you feel is best?"

"Tell me how you handled labor pain in your past deliveries."

A woman's husband expresses concern about risk of paralysis from an epidural block being given to his wife. Which would be the most appropriate response by the nurse? *"An injury is unlikely because of expert professional care given." *"I have never read or heard of this happening." *"The injection is given in the space outside the spinal cord." *"The injection is given at the third or fourth thoracic vertebrae so paralysis is not a problem."

"The injection is given in the space outside the spinal cord."

A client suffering a miscarriage at 12 weeks' gestations is very upset that the health care provider has ordered a D&C. How should the nurse respond after the client states she didn't have a D&C the time she lost a previous baby at 5 weeks' gestation? *"This is the procedure ordered by the doctor." *"You have the option to refuse the surgery." *"This procedure is needed to adequately remove all the fetal tissue." *"Having the D&C will make it easier to get pregnant next time."

"This procedure is needed to adequately remove all the fetal tissue."

A client is 11 weeks pregnant after many years trying to conceive. After arriving home from a normal prenatal visit, she experiences mild cramping and has a gush of bright red vaginal bleeding. She calls the nurse and reports having soaked a pad with fresh blood in fewer than 30 minutes. The uterine cramping is worsening. What is the most appropriate response from the nurse? *"This is nothing to worry about. Many women bleed during pregnancy." *"Lie down and call your health care provider tomorrow if symptoms continue." *"I am sorry. There is nothing you can do because you are likely miscarrying." *"You need to seek immediate attention from the primary care provider."

"You need to seek immediate attention from the primary care provider."

A patient in labor who is dilated 7 cm reports that narcotic pain medication given 3 hours ago has worn off and is asking for another dose. How should the nurse respond to this request? *"I will get permission from your doctor." *"Your stage of labor makes giving another dose unsafe." *"It is too early as the medication should be given only every 4 hours." *"Since it has been over 3 hours, you should be able to have more of the medication."

"Your stage of labor makes giving another dose unsafe."

A client reports bright red, painless vaginal bleeding during her 32nd week of pregnancy. A sonogram reveals that the placenta has implanted low in the uterus and is partially covering the cervical os. Which immediate care measures are initiated? Select all that apply. *Place the woman on bedrest maintaining the supine position. *Determine the time the bleeding began and about how much blood has been lost. *Obtain baseline vital signs and compare to those vital signs previously obtained. *Assist the client in stirrups and perform a pelvic examination. *Attach external monitoring equipment to record fetal heart sounds and kick counts.

-Determine the time the bleeding began and about how much blood has been lost. -Obtain baseline vital signs and compare to those vital signs previously obtained -attach external monitoring equipment to record fetal heart sounds and kick counts.

A patient in labor has a spinal cord injury and is unable to effectively push with contractions. Forceps will be used. What should the nurse do to prepare the patient for this type of delivery? Select all that apply. *Provide oxygen 2 L via face mask. *Validate that the cervix is fully dilated. *Determine that the patient's bladder is empty. *Begin an intravenous infusion of replacement fluid *Ensure that the patient's membranes have ruptured.

-validate that the cervix is fully dilated -determine that the patient's bladder is empty -ensure that the patient's membranes have ruptured.

A client reporting she recently had a positive pregnancy test has reported to the emergency department stating one-sided lower abdominal pain. The health care provider has presribed a series of tests. Which test will provide the most definitive confirmation of an ectopic pregnancy? *Quantitative human chorionic gonadotropin (hCG) test. *Qualitative human chorionic gonadotropin (hCG) test. *Pelvic examination. *Abdominal ultrasound.

Qualitative human gonadotropin (hCG) test

A woman who is Rh negative asks the nurse how many children she will be able to have before Rh incompatibility causes them to die in utero. The nurse's best response would be that: *no more than three children is recommended. *as long as she receives RhoGAM, there is no limit. *only her next child will be affected. *she will have to ask her primary care provider.

As long as she receives RhoGAM, there is no limit

The labor nurse reports to the nurse on the oncoming shift, "The woman in labor room 2 is handling her pain very well. She smiles whenever I go in to talk to her, and she doesn't complain at all!" What assessment by the oncoming labor nurse would best reveal if the off-going labor nurse's observations were correct? *Asking the woman to describe her pain and rate it on a scale of 0 to 10. *Asking the visitors in the room if they think the woman is experiencing pain *Taking the woman's vital signs and consulting with other staff members *No additional assessments are indicated until the woman begins to report pain.

Asking the woman to describe her pain and rate it on a scale of 0 to 10

A pregnant patient is diagnosed with placenta previa. Which action should the nurse implement immediately for this patient? *Assess fetal heart sounds with an external monitor. *Help the patient remain ambulatory to reduce bleeding. *Assess uterine contractions by an internal pressure gauge. *Prepare for a vaginal examination to assess the extent of bleeding.A

Assess fetal heart sounds with an external monitor

A nurse in the maternity triage unit is caring for a client with a suspected ectopic pregnancy. Which nursing intervention should the nurse perform first? *Assess the client's vital signs. *Administer oxygen to the client. *Obtain a surgical consent from the client. *Provide emotional support to the client and significant other.

Assess the client's vital signs

It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time? *at 32 weeks' gestation and immediately before discharge *24 hours before birth and 24 hours after birth *in the first trimester and within 2 hours of birth *at 28 weeks' gestation and again within 72 hours after birth

At 28 weeks gestation and again within 72 hours after birth

A nurse is preparing a nursing care plan for a client who is admitted at 22 weeks' gestation with advanced cervical dilatation to 5 cm, cervical insufficiency, and a visible amniotic sac at the cervical opening. Which primary goal should the nurse prioritize at this point? *Give birth vaginally *Bed rest to maintain pregnancy as long as possible *Notification of social support for loss of pregnancy *Education on causes of cervical insufficiency for the future

Bed rest to maintain pregnancy as long as possible

A woman has been diagnosed as having gestational hypertension. Which symptom for this condition is the most typical? *increased perspiration *weight loss *susceptibility to infection *blood pressure elevation

Blood pressure elevation

A woman gave birth to a newborn via vaginal birth with the use of a vacuum extractor. The nurse would be alert for which possible effect in the newborn? *asphyxia *clavicular fracture *cephalhematoma *central nervous system injury

Cephalhematoma

The nurse is comforting and listening to a young couple who just suffered a miscarriage. When asked why this happened, which reason should the nurse share as a common cause? *Maternal smoking *Lack of prenatal care *Chromosomal abnormality *The age of the mother

Chromosomal Abnormality

A woman of 16 weeks' gestation telephones the nurse because she has passed some "berry-like" blood clots and now has continued dark brown vaginal bleeding. Which action would the nurse instruct the woman to do? *"Maintain bed rest, and count the number of perineal pads used." *"Come to the health care facility if uterine contractions begin." *"Continue normal activity, but take the pulse every hour." *"Come to the health facility with any vaginal material passed."

Come to the health facility with any vaginal material passed

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication? *urinary output of 20 mL per hour *respiratory rate of 10 breaths/minute *deep tendons reflexes 2+ *difficulty in arousing

Deep tendon reflexes 2+

Which type of anesthesia is anticipated when the delivery of the fetus must be done quickly due to an emergency situation? *General *Regional *Local *Short acting

General

Which nursing action is required before a client in labor receives an epidural? *Giving a fluid bolus of 500 ml *Checking for maternal pupil dilation *Testing maternal reflexes *Observing maternal gait

Giving a fluid bolus of 500 ml

A client tells that nurse in the doctor's office that her friend developed high blood pressure on her last pregnancy. She is concerned that she will have the same problem. What is the standard of care for preeclampsia? *Take low-dose antihypertensive prophylactically. *Have her blood pressure checked at every prenatal visit. *Monitor the client for headaches or swelling on the body. *Take one aspirin every day.

Have her blood pressure checked at every prenatal visit

After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful? *"I will be sure to avoid getting pregnant for at least 1 year." *"My intake of iron will have to be closely monitored for 6 months." *"My blood pressure will continue to be increased for about 6 more months." *"I won't use my birth control pills for at least a year or two."

I will be sure to avoid getting pregnant for at least 1 year

A 24-year-old woman presents with vague abdominal pains, nausea, and vomiting. An urine hCG is positive after the client mentioned that her last menstrual period was 2 months ago. The nurse should prepare the client for which intervention if the transvaginal ultrasound indicates a gestation sac is found in the right lower quadrant? *Bed rest for the next 4 weeks *Intravenous administration of a tocolytic *Immediate surgery *Internal uterine monitoring

Immediate surgery

What would be the physiologic basis for a placenta previa? *a loose placental implantation *low placental implantation *a placenta with multiple lobes *a uterus with a midseptum

Low placental implantation

Which medication would the nurse prepare to administer if prescribed as treatment for an unruptured ectopic pregnancy? *oxytocin *promethazine *ondansetron *methotrexate

Methotrexate

During their experience in L & D, a group of nursing students are observing a woman who is having uncoordinated contractions where the monitor shows some contractions close together, followed by a long period without any contractions. The nurse asks the students, "Which medication may help to stimulate a more effective, consistent pattern of contractions?" Which medication would be considered the best answer? *morphine sulfate *betamethasone *terbutaline *oxytocin

Oxytocin

The nurse is teaching a prenatal class on potential problems during pregnancy to a group of expectant parents. The risk factors for placental abruption are discussed. What comment validates accurate learning by the parents? *"I need a cesarean section if I develop this problem." *"If I develop this complication, I will have bright red vaginal bleeding," *"Placental abruption is quite painful and I will need to let the doctor know if I begin to have abdominal pain." *"Since I am over 30, I run a much higher risk of developing this problem."

Placental abruption is quite painful and I will need to let the doctor know if I begin to have abdominal pain

A client has presented in the early phase of labor, experiencing abdominal pain and signs of growing anxiety about the pain. Which pain management technique should the nurse prioritize at this stage? *Immersing the client in warm water in a pool or hot tub *Practicing effleurage on the abdomen *Administering a sedative such as secobarbital or pentobarbital *Administering an opioid such as meperidine or fentanyl

Practicing effleurage on the abdomen

A 24-year-old client presents in labor. The nurse notes there is an order to administer RhoGAM after the birth of her infant. When asked by the client the reason for this injection, which reason should the nurse point out? *promote maternal D antibody formation. *prevent maternal D antibody formation. *stimulate maternal D immune antigens. *prevent fetal Rh blood formation.

Prevent maternal D antibody formation

A client at 27 weeks' gestation is admitted to the OB unit afer reporting headaches and edema of her hands. Review of the prenatal notes reveals BP consistently above 136/90 mm Hg. The nurse anticipates the health care provider will order magneisum sulfate to accomplish which primary goal? *Decrease blood pressure *Decrease protein in urine *Prevent maternal seizures *Reverse edema

Prevent maternal seizures

A 16-year-old client gave birth to a 12 weeks' gestation fetus last week. The client has come to the office for follow-up and while waiting in an examination room notices that on the schedule is written her name and "follow-up of spontaneous abortion." The client is upset about what is written on the schedule. How can the nurse best explain this terminology? *"Spontaneous abortion is the medical name for a miscarriage." *"Abortion is a medical term for any interruption of pregnancy before a fetus is viable." *"Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy." *"Oh, that just means it was a miscarriage."

Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy.

The nurse is monitoring a pregnant patient who is receiving intravenous magnesium sulfate for eclampsia. During the last assessment, the nurse was unable to elicit a patellar reflex. What should the nurse do? *Check fetal heart rate. *Measure blood pressure. *Stop the current infusion. *Increase the infusion rate.

Stop the current infusion

A client and her husband have prepared for a natural birth; however, as the client progresses to 8 cm dilation, she can no longer endure the pain and begs the nurse for an epidural. What is the nurse's best response? *Suggest a less extreme alternative such as a sedative. *Support the client's decision and call the obstetrician. *Gently remind the client of her goal of a natural birth and encourage and help her. *Ask the husband to gently remind her of their goal of natural birth and to encourage and help her.

Support the client's decision and call the obstetrician

A pregnant patient with a history of premature cervical dilatation undergoes cervical cerclage. Which outcome indicates that this procedure has been successful? *The client delivers a full-term fetus at 39 weeks' gestation. *The client's membranes spontaneously rupture at week 30 of gestation. *The client experiences minimal vaginal bleeding throughout the pregnancy. *The client has reduced shortness of breath and abdominal pain during the pregnancy.

The client delivers a full-term fetus at 39 weeks gestation

A client is 20 weeks pregnant. At a prenatal visit, the nurse begins the prenatal assessment. Which finding would necessitate calling the primary care provider to assess the client? *The client vomited. *The client has a white vaginal discharge. *The client has pink vaginal discharge and pelvic pressure. *The client has rhinitis and epistaxis.

The client has pink vaginal discharge and pelvic pressure

The nurse is monitoring the client's vital signs and notes: 100.2oF (37.9oC), heart rate 82, respiratory rate 17, and blood pressure 124/78. What is the bestresponse when the client's partner asks if she is getting sick? *"She may be developing an infection." *"The fever may be due to the epidural." *"Have you been exposed to any illnesses recently?" *"She's dehydrated and needs something to drink."

The fever may be due to the epidural.

Which possible outcome would be a major disadvantage of any pain relief method that also affects awareness of the mother? *The father's coaching role may be disrupted at times. *The infant may show increased drowsiness. *The mother may have continued memory loss postpartum. The mother may have difficulty working effectively with contractions.

The mother may have difficulty working effectively with contractions

Which statement describes why hypertonic contractions tend to become very painful? *More than one contraction may begin at the same time, as receptor points in the myometrium act independently of each other. *The myometrium becomes sensitive from the lack of relaxation and anoxia of uterine cells. *The number of uterine contractions is very low or infrequent. *There is an increase in the length of labor because so many contractions are needed to achieve cervical dilation.

The myomentrium becomes sensitive from the lack of relaxation and anoxia of uterine cells.

A young woman presents at the emergency department reporting lower abdominal cramping and spotting at 12 weeks' gestation. The primary care provider performs a pelvic examination and finds that the cervix is closed. What does the care provider suspect is the cause of the cramps and spotting? *Ectopic pregnancy *Habitual abortion *Cervical insufficiency *Threatened abortion

Threatened abortion

Immediately following an epidural block, a pregnant patient's blood pressure suddenly falls to 90/50 mmHg. What action should the nurse take first? *Place the patient supine. *Raise the head of the bed. *Ask the patient to take deep breaths. *Turn onto the left side or raise the legs.

Turn onto the left side or raise the legs

A client in her first trimester arrives at the emergency room with reports of severe cramping and vaginal spotting. On examination, the health care provider informs her that no fetal heart sounds are evident and orders a dilatation and curettage. The client looks frightened and confused and states that she does not believe in abortion. Which statement by the nurse is best? *"Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications." *"I know that it is sad but the pregnancy must be terminated to save your life." *"The choice is up to you but the healthcare provider is recommending an abortion." *"You have experienced an incomplete miscarriage and must have the placenta and any other tissues cleaned out."

Unfortunately the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications.

A woman with a history of crack cocaine use disorder is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also reports acute abdominal pain that is continuous. Which condition would the nurse suspect? *amniotic fluid embolism *shoulder dystocia *uterine rupture *umbilical cord prolapse

Uterine rupture

The obstetric nurse is caring for a pregnant client who has been diagnosed with hydatidiform mole. What assessment should the nurse prioritize? *Vaginal bleeding *Blood pressure *Pain *Severe nausea and vomiting

Vaginal Bleeding

A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's first action would be to: *administer oxygen by mask. *increase her intravenous fluid infusion rate. *put firm pressure on the fundus of her uterus. *tell the woman to take short, catchy breaths.

administer oxygen by mask

A nurse assesses a client in labor and suspects hypotonic uterine dysfunction. Which intervention would the nurse expect to include in the plan of care for this client? *administering oxytocin *preparing the woman for an amniotomy *encouraging the woman to assume a hands-and-knees position *providing a comfortable environment with dim lighting

administering oxytocin

A primigravida client has just arrived in early labor and is showing signs of extreme anxiety over the birthing process. Why should the nurse prioritizehelping the client relax? *Anxiety will increase blood pressure, increasing risk with an epidural. *Decreased anxiety will increase trust in the nurse. *Anxiety can slow down labor and decrease oxygen to the fetus. *Increased anxiety will increase the risk for needing anesthesia.

anxiety can slow down labor oxygen to the fetus

The nurse has just applied a sterile pressure dressing to an epidural site after removing the epidural catheter in a client who is now recovering from a standard delivery. Which action should the nurse now prioritize? *Assess return of sensory and motor functions to the lower extremities. *Help the client get up and walk around immediately. *Let the client rest and recover while keeping her legs slightly elevated. *Make sure the client receives plenty of fluids.

assess return of sensory and motor functions to the lower extremities

The client and her partner have prepared for a natural birth and bring a picture of a sunset over the ocean with them. The nurse predicts they will be using which technique during labor? *Patterned birthing *Water therapy *Attention focusing *Hypnosis

attention focusing

A client in week 38 of her pregnancy has an ultrasound performed at a routine office visit and learns that her fetus has not moved out of a breech position. Which intervention does the nurse anticipate for this client? *external cephalic version *trial labor *forceps birth *vacuum extraction

external cephalic version

A woman at 10 weeks gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize? *report of frequent mild nausea *blood pressure of 120/84 mm Hg *history of bright red spotting 6 weeks ago *fundal height measurement of 18 cm

fundal height measurement of 18 cm

A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find? *preterm pregnancy *small body size of mother *maternal rickets *gestational diabetes

gestational diabetes

A patient is admitted with a diagnosis of ectopic pregnancy. For what should the nurse anticipate preparing the patient? *Immediate surgery *Internal uterine monitoring *Bed rest for the next 4 weeks *Intravenous administration of a tocolytic

immediate surgery

The health care provider is reluctant to provide pain medication to a patient delivering a preterm fetus. What should the nurse explain to the patient as the reason for the preterm fetus being more affected by medication? *Affinity of the preterm fetus to fat-soluble drugs *Inability of the immature liver to metabolize or inactivate drugs *Affinity of the preterm fetus to drugs that are strongly bound to protein *Inability of the preterm fetus to use drugs with a molecular weight over 1,000

inability of the immature liver to metabolize or inactivate drugs

The nurse is assisting a client through labor, monitoring her closely now that she has received an epidural. Which finding should the nurse prioritize to the anesthesiologist? *Dry, cracked lips *Urinary retention *Rapid progress of labor *Inability to push

inability to push

Why should a woman be cautioned against taking acetylsalicylic acid (aspirin) to relieve pain in labor? *Competition with bilirubin-binding sites in fetal circulation increases risk of kernicterus *Development of respiratory depression in the newborn *Interference with blood coagulation with increased risk of bleeding in mother or infant *Interference with the ability to concentrate on contractions

interference with blood coagulation with increased risk of bleeding in mother or infant

After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? *supine *side-lying *sitting *knee-chest

knee-chest

The nurse is caring for a client suspected to have a uterine rupture. The nurse predicts the fetal monitor will exhibit which pattern if this is true? *Late decelerations *Early decelerations *Variable decelerations *Mild decelerations

late decelerations

A woman in labor for over 12 hours has very little progress. The health care provider thinks that her contractions lack the force needed to propel the infant downward through the birth canal. The provider asks a group of nursing students which hormone may need to be given to increase the force of the contraction. Which hormone would be the best answer? *antidiuretic hormone, a posterior pituitary hormone *oxytocin, a posterior pituitary hormone *luteinizing hormone, an anterior pituitary hormone *growth hormone, an anterior pituitary hormone

oxytocin, a posterior pituitary hormone

The nurse is preparing an educational event for pregnant women on the topic of labor pain and birth. The nurse understands the need to include the origin of labor pain for each stage of labor. What information will the nurse present for the first stage of labor? *Pain originates from the cervix and lower uterine segment. *It is reported as the worst pain a woman will ever feel. *Pain is focal in nature. *Diffuse abdominal pain signals a complication with progression of labor.

pain originates from the cervix and lower uterine segment

A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which effect? *respiratory depression *urinary retention *abdominal distention *hyperreflexia

respiratory depression

Which neonatal assessment is the highest priority if the mother received meperidine during labor? *Respiratory rate *Time of first meconium *Temperature regulation *Lung sounds

respiratory rate

The client is progressing into the second stage of labor and coping well with the natural birth method. Which instructions should the nurse prioritize at this point in the process? *Use a birthing ball and find a position of comfort. *Stay low on her back to ease the back pain. *Use the Valsalva maneuver for effective pushing. *Ask for privacy, and have just the partner present.

use a birthing ball and find a position of comfort

A woman at 39 weeks' gestation is brought to the emergency department in labor following blunt trauma from an vehicle accident. The labor has been progressing well after the epidural when suddenly the woman reports severe pain in her back and shoulders. Which potential situation should the nurse suspect? *Fractured ribs *Placental abruption *Uterine rupture *Dystocia

uterine rupture

A woman in active labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly, the woman grabs the nurse's hand and states, "Something inside me is tearing." The nurse notes her blood pressure is 80/50 mm Hg, pulse rate is 130 bpm and weak, the skin is cool and clammy, and the fetal monitor shows bradycardia. The nurse activates the code team because the nurse suspects the client may be experiencing which complication? *compression on the inferior vena cava *an amniotic embolism to the lungs *an undiagnosed abdominal aorta aneurysm *uterine rupture

uterine rupture

A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer? *sedatives *tocolytics *uterine stimulants *corticosteroids

uterine stimulants