prepu exam 3 questions

A woman in labor suddenly reports sharp fundal pain accompanied by slight dark red vaginal bleeding. The nurse should prepare to assist with which situation? A. Premature separation of the placenta B. Preterm labor that was undiagnosed C. Placenta previa obstructing the cervix D. Possible fetal death or injury

A. Premature separation of the placenta

A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the client's safety, which compound would the nurse have readily available? A. calcium gluconate B. potassium chloride C. ferrous sulfate D. calcium carbonate

A. calcium gluconate

A client is admitted with a diagnosis of ruptured ectopic pregnancy. For what should the nurse anticipate preparing the client? A. immediate surgery B. internal uterine monitoring C. bed rest for the next 4 weeks D. intravenous administration of a tocolytic

A. immediate surgery

Which medication is administered to reverse the depressant effects of opioids? A. naloxone B. meperidine C. butorphanol D. nalbuphine

A. naloxone

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? A. frequency of micturition B. absence of knee jerk response C. increased blood pressure D. increased rate of respiration

B. absence of knee jerk response

The nurse is giving discharge instructions to a client who experienced a complete spontaneous abortion (miscarriage). Which question should the nurse prioritize at this time? A."Are you going to wait a while before you try to get pregnant again?" B. "Do you have someone to talk to, or may I give you the names and numbers for some possible grief counselors?" C. "Did you know that 75% of women who are trying to get pregnant experience this same thing?" D. "May I give you some resources that you can use to try to prevent this from happening again?"

B. "Do you have someone to talk to, or may I give you the names and numbers for some possible grief counselors?"

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: A."Breathing patterns must be used with a coach." B. "Breathing patterns cannot be taught while in labor." C. "Breathing patterns are distraction techniques taught to decrease pain in labor." D. "Breathing patterns help a woman concentrate on pain."

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

The nurse instructs the client about skin massage and the gate control theory of pain. Which statement would be appropriate for the nurse to include for client understanding of the nonpharmacologic pain relief methods? A. The gating mechanism is located at the pain site. B. Pain perception is decreased if anxiety is present. C. The gating mechanism opens so all the stimuli pass through to the brain. D. These methods are a technique to prevent the painful stimuli from entering the brain.

D. These methods are a technique to prevent the painful stimuli from entering the brain.

The nursing instructor is teaching a group of student nurses about the current use of episiotomies during the labor process. The instructor determines the session is successful when the students correctly choose which situation that may require the health care provider to perform an episiotomy? A. persistent occiput anterior position B. VBAC delivery C. shoulder dystocia D. multifetal births

c. shoulder dystocia

A 35-year-old client is seen for her 2-week postoperative appointment after a suction curettage was performed to evacuate a hydatidiform mole. The nurse explains that the human chorionic gonadotropin (hCG) levels will be reviewed every 2 weeks and teaches about the need for reliable contraception for the next 6 months to a year. The client states, "I'm 35 already. Why do I have to wait that long to get pregnant again?" What is the nurse's best response? A. "After a curettage procedure, it is recommended that you give your body some time to build up its stores." B. "A contraceptive is used so that a positive pregnancy test resulting from a new pregnancy will not be confused with the increased level of hCG that occurs with a developing malignancy." C. "Since you are at the end of your reproductive years, it is suggested that you don't try to have any more pregnancies." D. "You may need chemotherapy, so we don't want to risk pregnancy."

B. "A contraceptive is used so that a positive pregnancy test resulting from a new pregnancy will not be confused with the increased level of hCG that occurs with a developing malignancy."

A woman at 41 weeks' gestation is progressing well in labor; however, the nurse notes the amniotic fluid is greenish in color. When questioned by the client for the reason for this, which explanation should the nurse provide? A. "Amniotic fluid is normally green." B. "This is meconium-stained fluid from the baby." C. "You have an infection and need antibiotics." D. "Green might be a yeast infection and we need to culture the discharge."

B. "This is meconium-stained fluid from the baby."

A nurse is preparing a nursing care plan for a client who is admitted at 22 weeks' gestation with advanced cervical dilation (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? A.Give birth vaginally B. Bed rest to maintain pregnancy as long as possible C. Notification of social support for loss of pregnancy D. Education on causes of cervical insufficiency for the future

B. Bed rest to maintain pregnancy as long as possible

A client in labor has been given an epidural anesthetic. Which nursing assessment finding is most important immediately following the administration of epidural anesthesia? A. Maternal respirations decrease from 20 to 14 breaths/minute. B. Maternal blood pressure decreases from 130/70 to 98/50 mm Hg. C. Maternal pulse increases from 78 to 96 beats/minute. D. Maternal temperature increases from 99° F (37.2° C) to 100° F (37.8° C).

B. Maternal blood pressure decreases from 130/70 to 98/50 mm Hg.

After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between placental abruption (abruptio placentae) and placenta previa. Which statement will the nurse include in the teaching? A. Placenta previa causes painful, dark red vaginal bleeding during pregnancy. B. Placenta previa is an abnormally implanted placenta that is too close to the cervix. C. Placental abruption results in painless, bright red vaginal bleeding during labor. D. Placental abruption requires "watchful waiting" during labor and birth.

B. Placenta previa is an abnormally implanted placenta that is too close to the cervix.

A pregnant client nearing her due date expresses anxiety over the labor and delivery process. Which outcome should the nurse select as appropriate for the client during the delivery process? A. The client requests pain medication throughout the labor process. B. The client uses breathing techniques to control anxiety and pain during labor. C. The client tolerates the use of sanitary napkins to absorb vaginal secretions during labor. D. The client refuses complementary and alternative techniques to control pain during labor.

B. The client uses breathing techniques to control anxiety and pain during labor.

The client in labor at 3 cm dilation and 25% effaced is asking the nurse for analgesia. Which explanation should the nurse provide when explaining why it is too early to administer an analgesic? A. This would cause fetal depression in utero. B. This may prolong labor and increase complications. C. The effects would wear off before delivery. D. This can lead to maternal hypertension.

B. This may prolong labor and increase complications.

Hypertonic labor is labor that is characterized by short, irregular contractions without complete relaxation of the uterine wall in between contractions. Hypertonic labor can be caused by an increased sensitivity to oxytocin. What would the nurse do for a client who is in hypertonic labor because of oxytocin augmentation? A. Increase the oxytocin. B. Turn off the oxytocin. C. Increase the methotrexate. D. Turn off the methotrexate.

B. Turn off the oxytocin.

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: A. no more than three children is recommended. B. as long as she receives Rho(D) immune globulin, there is no limit. C. only her next child will be affected. D. she will have to ask her primary care provider.

B. as long as she receives Rho(D) immune globulin, there is no limit.

A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply. A. hyperthermia B. hemolysis C. elevated liver enzymes D. leukocytosis E. low platelet count

B. hemolysis C. elevated liver enzymes E. low platelet count

The nurse is caring for a client who is being prepared for a cesarean birth due to nonprogession of the labor process. The nurse will direct the client to the proper placement on the operating table and abdominal preparation for which type of incision? A. vertical incision B. low transverse incision ("bikini cut") C. low-abdominal incision D> classical incision

B. low transverse incision ("bikini cut")

What terminology would the nurse use to document a newborn who weighs 4,000 grams (8.8 lb) or more at birth? A. microsomia B. macrosomia C. meconium D. hydrocephalus

B. macrosomia

A woman in labor for over 12 hours has made 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 bestanswer? A. antidiuretic hormone, a posterior pituitary hormone B. oxytocin, a posterior pituitary hormone C. luteinizing hormone, an anterior pituitary hormone D. growth hormone, an anterior pituitary hormone

B. oxytocin, a posterior pituitary hormone

A pregnant client presents to the emergency department reporting back-to-back contractions. Within 2 hours, the client is completely effaced and 9 cm dilated, and the fetal head is showing. Within minutes the client gives birth with only the nurse in attendance. This is an example of which occurrence? A. labor dystocia B. precipitate labor C. uterine dysfunction D. protraction disorder

B. precipitate labor

A nursing instructor identifies which of the following as increasing the chances of infection when coupled with prolonged labor? A. multiple births B. ruptured membranes C. age of mother D. number of previous pregnancies

B. ruptured membranes

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? A. "That's wonderful. Medication during labor is not good for the baby." B. "Your health care provider is a man and has never been in labor; he may be underestimating the pain you will have." C. "I respect your preference, whether it is to have medication or not." D. "Let me get you something for relaxation if you don't want anything for pain."

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

A 16-year-old client was at 12 weeks' gestation when she gave birth to a 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? A. "Spontaneous abortion is the medical name for a miscarriage." B. "Abortion is a medical term for any interruption of pregnancy before a fetus is viable." C. "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." D. "Oh, that just means it was a miscarriage."

C. "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 health care provider approves a labor plan which includes analgesia. The client questions how analgesia will help her pain during labor. Which answer is best? A. "The analgesia will limit your ability to be out of bed without assistance." B. "The analgesia will block pain sensation and limit your ability to push." C. "The analgesia will reduce the sensation of pain for a limited period of time." D. "The analgesia will allow for a pain-free birth experience."

C. "The analgesia will reduce the sensation of pain for a limited period of time."

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

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

A client suffering a miscarriage at 12 weeks' gestation is very upset that the health care provider has ordered a dilatation and curettage (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? A. "This is the procedure ordered by the doctor." B. "You have the option to refuse the surgery." C. "This procedure is needed to adequately remove all the fetal tissue." D. "Having the D&C will make it easier to get pregnant next time."

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

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

C. Anxiety can slow down labor and decrease oxygen to the fetus.

A woman with a positive history of genital herpes is in active labor. Assessment reveals vesicles in the perineum area, membranes are ruptured, dilated 5 cm, and effaced 70%. The nurse should prepare the client for which type of birth? A. Spontaneous vaginal B. Vacuum-assisted C. Cesarean D. Forceps-assisted

C. Cesarean

The nurse is monitoring a pregnant client 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? A. Check the fetal heart rate. B. Measure blood pressure. C. Stop the current infusion. D. Increase the infusion rate.

C. Stop the current infusion.

Immediately after giving birth to a full-term infant, a client develops dyspnea and cyanosis. Her blood pressure decreases to 60/40 mm Hg, and she becomes unresponsive. What does the nurse suspect is happening with this client? A. placental separation B. aspiration C. amniotic fluid embolism D. congestive heart failure

C. amniotic fluid embolism

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? A. asphyxia B. clavicular fracture C. cephalohematoma D. central nervous system injury

C. cephalohematoma

A pregnant woman at term is in the obstetrics unit for induction in the morning. Her membranes rupture, and the external fetal monitor shows deep variable decelerations. The nurse should immediately check the client for: A. amniotic fluid infection. B. amniotic fluid embolus. C. umbilical cord prolapse. D. placental abruption (abruptio placentae).

C. umbilical cord prolapse.

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? A. "This is nothing to worry about. Many women bleed during pregnancy." B. "Lie down and call your health care provider tomorrow if symptoms continue." C. "I am sorry. There is nothing you can do because you are likely miscarrying." D. "You need to seek immediate attention from the primary care provider."

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

The nursing instructor is teaching a group of nursing students about the uniqueness of pain involved with the birthing process. The instructor determines the session is successful when the students correctly choose which pain factor to be related to psychosocial influences? A. Stretching of cervix b. Descent of fetus into birth canal C. Pressure in the perineum D. Fear of pain during labor

D. Fear of pain during labor

A woman develops gestational diabetes. Which assessment should she make daily? A. Test her urine for protein with a chemical reagent strip. B. Measure her abdominal diameter with a tape measure. C. Measure her uterine height by hand-span distance. D. Measure serum for glucose level by a finger prick.

D. Measure serum for glucose level by a finger prick.

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

D. The mother may have difficulty working effectively with contractions.

The nurse is transcribing messages from the answering service. Which phone message should the nurse return first? A. an 18-year-old, 38-week G2P1 client with intermittent cramping; the client's last blood pressure was 98/50 mm Hg, and proteinuria was 1+ B. a 25-year-old, 31-week G1P0 client with blood pressure of 100/80 mm Hg and left flank pain; the client's last blood pressure was 100/77 mm Hg and she had no proteinuria C. a 20-year-old, 31-week G1P0 client with malaise and rhinitis; the client's last blood pressure was 120/80 mm Hg, and she had no proteinuria D. a 35-year-old, 21-week G3P2 client with blood pressure of 160/110 mm Hg, blurred vision, and whose last blood pressure was 143/99 mm Hg and urine dipstick showed a +2 proteinuria

D. a 35-year-old, 21-week G3P2 client with blood pressure of 160/110 mm Hg, blurred vision, and whose last blood pressure was 143/99 mm Hg and urine dipstick showed a +2 proteinuria

A primigravida 28-year-old client is noted to have Rh negative blood and her husband is noted to be Rh positive. The nurse should prepare to administer RhoGAM after which diagnostic procedure? A. Contraction test B. Nonstress test C. Biophysical profile D. amniocentesis

D. amniocentesis

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

D. elevated liver enzymes

The nurse is monitoring the uterine contractions of a woman in labor. The nurse determines the woman is experiencing hypertonic uterine dysfunction based on which contraction finding? A. well coordinated. B. poor in quality. C. brief. D. erratic.

D. erratic.

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? A. preterm pregnancy B. small body size of mother C. maternal rickets D. gestational diabetes

D. gestational diabetes

Which medication will the nurse anticipate the health care provider will prescribe as treatment for an unruptured ectopic pregnancy? A. oxytocin B. promethazine C. ondansetron D. methotrexate

D. methotrexate

During their experience in labor & delivery, 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? A. morphine sulfate B. betamethasone C. terbutaline D. oxytocin

D. oxytocin

The injection of a local anesthetic to block specific nerve pathways is referred to as: A. amnesic medication. B. gas administration. C. natural anesthesia. D. pudendal block

D. pudendal block

When an infant is born by cesarean delivery there is always a risk of complications. What is one of the most common complications to the fetus because of a cesarean delivery? A. broken limb due to being wedged in the pelvis B. a cut on the face from the scalpel C. bruising on the trunk D. respiratory distress

D. respiratory distress

What is a nursing intervention that helps prevent the most frequent side effect from epidural anesthesia in a pregnant client? A. administrating IV ephedrine B. administrating IV naloxone C. maintaining the client in a supine position D. starting an IV and hanging IV fluids

D. starting an IV and hanging IV fluids

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? A. compression on the inferior vena cava B. an amniotic embolism to the lungs C. an undiagnosed abdominal aorta aneurysm D. uterine rupture

D. uterine rupture

A primigravida is tired of being pregnant. She asks the nurse, "Why can't my doctor just schedule a cesarean delivery? My friend had a cesarean and everything went very well." What is the nurse's best reply? A. "A cesarean birth involves major surgery, which puts you and your baby at higher risk for complications.Your physician will discuss the options with you." B. "I will ask your doctor. Sometimes he will allow a first-time mother to have a cesarean birth if she really wants to do so." C. "Oh no! This would not be good for you or the baby. You would both be at much higher risk of complications. It is always better to have a vaginal delivery." D. "It is always your choice to have a cesarean delivery if that is what you want to do. Would you like me to help you schedule a date for the surgery?"

A. "A cesarean birth involves major surgery, which puts you and your baby at higher risk for complications.Your physician will discuss the options with you."

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? A. "I will be sure to avoid getting pregnant for at least 1 year." B. "My intake of iron will have to be closely monitored for 6 months." C. "My blood pressure will continue to be increased for about 6 more months." D. "I won't use my birth control pills for at least a year or two."

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

At 24 weeks' gestation, a client's 1-hour glucose tolerance test is elevated. The nurse explains that, based on this finding, the client will need to take which action? A. A 3-hour glucose tolerance test for follow-up B. Daily insulin injections for gestational diabetes C. Monthly hemoglobin A1C levels to rule out diabetes D. Daily fingersticks for a fasting blood glucose level

A. A 3-hour glucose tolerance test for follow-up

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? A. Asking the woman to describe her pain and rate it on a scale of 0 to 10 B. Asking the visitors in the room if they think the woman is experiencing pain C. Taking the woman's vital signs and consulting with other staff members D. No additional assessments are indicated until the woman begins to report pain.

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

At 37 weeks' gestation, a woman presents to labor and delivery complaining of intense, knife-like abdominal pain that started suddenly about 1 hour ago and has not subsided. On palpation, the abdomen is rigid and board-like and no vaginal bleeding is evident. What should the nurse do next? A. Assess fetal heart rate B. Administer oxygen by face mask C. Insert a Foley catheter D. Prepare the client for an epidural

A. Assess fetal heart rate

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? A. Assess return of sensory and motor functions to the lower extremities. B. Help the client get up and walk around immediately. C. Let the client rest and recover while keeping her legs slightly elevated. D. Make sure the client receives plenty of fluids.

A. Assess return of sensory and motor functions to the lower extremities.

The nurse assists while a pregnant client has an amniotomy. Which action should the nurse take immediately at the conclusion of the procedure? A. Assess the fetal heart rate. B. Adjust the intravenous fluid infusion rate. C. Assist the client to wash the perineum. D. Provide clean gown and linens for the client.

A. Assess the fetal heart rate.

A client has just received combined spinal epidural. Which nursing assessment should be performed first? A. Assess vital signs. B. Assess pain level using a pain scale. C. Assess for progress in labor. D. Assess for spontaneous rupture of membranes. E. Assess for fetal tachycardia.

A. Assess vital signs.

A pregnant client late in the second trimester comes to the emergency department with a report of painless, bright red vaginal bleeding. The client states, "It started all of a sudden and now it seems to have stopped." Placenta previa is suspected. Which action should the nurse implement immediately for this client? A. Determine fetal heart sounds using an external monitor. B. Prepare the client for an immediate cesarean birth. C. Assist with insertion of internal monitoring to assess uterine pressure. D. Prepare the client for a pelvic examination to assess rupture of membranes.

A. Determine fetal heart sounds using an external monitor.

The nurse is preparing an education session on the 2030 National Health Goals to prevent complications of pregnancy. What should the nurse include as the best preventive measure to eliminate complications of pregnancy? A. Encourage all pregnant clients to have prenatal care. B. Suggest all pregnant clients keep weight gain to a minimum. C. Recommend all pregnant clients engage in exercise most days of the week. D. Counsel all pregnant clients to select low-fat dairy products rich in calcium.

A. Encourage all pregnant clients to have prenatal care.

An infant is born to a mother with gestational diabetes. Which long-term maternal complication is associated with this diagnosis? A. Increased risk of development of type 2 diabetes B. Weight gain that is not lost after the pregnancy C. Development of long-term hypertension D. Heart disease

A. Increased risk of development of type 2 diabetes

A woman who is 10 weeks' pregnant calls the physician's office reporting "morning sickness" but, when asked about it, tells the nurse that she is nauseated and vomiting all the time and has lost 5 pounds. What interventions would the nurse anticipate for this client? A. Lab work will be drawn to rule out acid-base imbalances. B. An ultrasound will be done to reassess the correctness of gestational dates. C. Since morning sickness is a common problem for pregnant women, the nurse will suggest the woman drink more fluids and eat crackers. D. The nurse will encourage the woman to lie down and rest whenever she feels ill.

A. Lab work will be drawn to rule out acid-base imbalances.

A G3P2 woman at 39 weeks' gestation presents highly agitated, reporting something "came out" when her membranes just ruptured. Which action should the nurse prioritize after noting the umbilical cord is hanging out of the vagina? A. Put the client in bed immediately, call for help, and lift the presenting part of the fetus off the cord. B. With the client in lithotomy position, hold her legs and sharply flex them toward her shoulders. C. Place the client in Trendelenburg position and gently attempt to reinsert the cord. D. Contact the health care provider and prepare the client for an emergent vaginal birth.

A. Put the client in bed immediately, call for help, and lift the presenting part of the fetus off the cord.

A woman who had preterm labor and preterm PROM successfully halted has reached week 36 of pregnancy and is doing well on home care. Which of the following nursing diagnoses should the nurse prioritize for this client? A. Risk for fetal infection related to early rupture of membranes B. Hopelessness related to potential loss of pregnancy C. Anticipatory grieving related to high probability for fetal death from placental dysfunction D. Powerlessness related to inability to sustain pregnancy

A. Risk for fetal infection related to early rupture of membranes

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

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

A nurse assesses a client in labor and suspects dysfunctional labor (hypotonic uterine dysfunction). The woman's membranes have ruptured and fetopelvic disproportion is ruled out. Which intervention would the nurse expect to include in the plan of care for this client? A. administering oxytocin B. preparing the woman for an amniotomy C. encouraging the woman to assume a hands-and-knees position D.providing a comfortable environment with dim lighting

A. administering oxytocin

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 dilation (dilatation) is cephalopelvic disproportion. Which intervention should the nurse most expect in this case? A. cesarean birth B. administration of oxytocin C. administration of morphine sulfate D. darkening room lights and E. decreasing noise and stimulation

A. cesarean birth

A pregnant woman with diabetes at 10 weeks' gestation has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome? A. congenital anomalies B. incompetent cervix C. placenta previa D. placental abruption (abruptio placentae)

A. congenital anomalies

A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be mostappropriate for this client? A. diet B. long-acting insulin C. oral hypoglycemic drugs D. glucagon

A. diet

Which nursing action is required before a client in labor receives an epidural? A. giving a fluid bolus of 500 ml B. checking for maternal pupil dilation C. testing maternal reflexes D. observing maternal gait

A. giving a fluid bolus of 500 ml

Early in labor, a pregnant client asks why contractions hurt so much. Which answer should the nurse provide? A. lack of oxygen to the muscle fibers of the uterus due to compression of blood vessels B. release of endorphins in response to the uterine contractions C. distraction of the brain cortex by other stimuli occuring in the body D. blocking of nerve transmission via mechanical irritation of nerve fibers

A. lack of oxygen to the muscle fibers of the uterus due to compression of blood vessels

The obstetric nurse is caring for a pregnant client who has been diagnosed with a hydatidiform mole. What assessment should the nurse prioritize? A. vaginal bleeding B. blood pressure C. pain D. severe nausea and vomiting

A. vaginal bleeding

The nurse in an obstetric clinic is conducting client education with a group of expectant mothers. One young woman asks the nurse to tell the group what labor pain is like. What would be the nurse's best response? A."The pain of labor is unique and multidimensional. It originates from different places depending on what stage of labor you are in." B. "It has been described as the worst pain you will ever feel." C. "It comes in waves." D. "It is best evaluated by talking with visitors in the labor room because they know you best."

A."The pain of labor is unique and multidimensional. It originates from different places depending on what stage of labor you are in."