review for OB Hesi

A pregnant client calls a clinic and tells a nurse that she is experiencing leg cramps that awaken her at night. To provide relief from the leg cramps, the nurse tells the client the following: 1. "Bend your foot toward your body while flex- ing the knee when the cramps occur." 2. "Bend your foot toward your body while extending the knee when the cramps occur." 3. "Point your foot away from your body while flexing the knee when the cramps occur." 4. "Point your foot away from your body while extending the knee when the cramps occur."

"Bend your foot toward your body while extending the knee when the cramps occur."

A nursing instructor asks a nursing student to list the functions of the amniotic fluid. The student responds correctly by stating that which of the following are functions of amniotic fluid? Select all that apply. 1. Allows for fetal movement 2. Is a measure of kidney function 3. Surrounds, cushions, and protects the fetus 4. Maintains the body temperature of the fetus 5. Prevents large particles such as bacteria from passing to the fetus 6. Provides an exchange of nutrients and waste products between the mother and the fetus

1. Allows for fetal movement 2. Is a measure of kidney function 3. Surrounds, cushions, and protects the fetus 4. Maintains the body temperature of the fetus

A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Which of the following are probable signs of pregnancy? Select all that apply. 1. Ballottement 2. Chadwick's sign 3. Uterine enlargement 4. Braxton Hicks contractions 5. Fetal heart rate detected by a nonelectronic device 6. Outline of fetus via radiography or ultrasonography

1. Ballottement 2. Chadwick's sign 3. Uterine enlargement 4. Braxton Hicks contractions

A nurse is monitoring a postpartum client who received epidural anesthesia for delivery for the presence of a vulvar hematoma. Which of the fol- lowing assessment findings would best indicate the presence of a hematoma? 1. Changes in vital signs 2. Signs of heavy bruising 3. Complaints of intense pain 4. Complaints of a tearing sensation

1. Changes in vital signs

______ labor contractions are short, irregular, and weak and usually occur during the active phase of labor.

Hypotonic

Oligohydramnios is associated with

IUGR and congenital disorders

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year-old child who was delivered at 38 weeks and tells the nurse that she does not have a history of any type of abortion or fetal demise. The nurse would document the GTPAL for this client as 1. G ¼ 3, T ¼ 2, P ¼ 0, A ¼ 0, L ¼ 1 2. G ¼ 2, T ¼ 1, P ¼ 0, A ¼ 0, L ¼ 1 3. G ¼ 1, T ¼ 1, P ¼ 1, A ¼ 0, L ¼ 1 4. G ¼ 2, T ¼ 0, P ¼ 0, A ¼ 0, L ¼ 1

2. G ¼ 2, T ¼ 1, P ¼ 0, A ¼ 0, L ¼ 1

A pregnant client in the first trimester calls a nurse at a health care clinic and reports that she has noticed a thin, colorless vaginal drainage. The nurse should make which statement to the client? 1. "Come to the clinic immediately." 2. "Report to the emergency department at the maternity center immediately." 3. "The vaginal discharge may be bothersome, but is a normal occurrence." 4. "Use tampons if the discharge is bothersome, but to be sure to change the tampons every 2 hours."

3. "The vaginal discharge may be bothersome, but is a normal occurrence." Leukorrhea begins during the first trimester. Many clients notice a thin, colorless or yellow vaginal discharge throughout pregnancy.

A client arrives at a birthing center in active labor. Her membranes are still intact, and the nurse-midwife prepares to perform an amniot- omy. A nurse who is assisting the nurse-midwife explains to the client that after this procedure, she will most likely have: 1. Less pressure on her cervix 2. Decreased number of contractions 3. Increased efficiency of contractions 4. The need for increased maternal blood pres- sure monitoring

3. Increased efficiency of contractions FHR needs to be monitored not maternal blood pressure

A nurse-midwife is assessing a pregnant client for the presence of ballottement. To make this deter- mination, the nurse-midwife does which of the following? 1. Auscultates for fetal heart sounds 2. Assesses the cervix for compressibility 3. Palpates the abdomen for fetal movement 4. Initiates a gentle upward tap on the cervix

4. Initiates a gentle upward tap on the cervix

Violet coloration of the mucous membranes of the cervix, vagina , and vulva that occurs at about week 4

Chadwick's sign

Polyhydramnios is associated with maternal _____ and certain congenital disorders

Diabetes. Increase in amniotic fluid

Softening of the cervix that occurs at the beginning of the second month

Goodell's sign :

Compressibility and softening of the lower uterine segment that occurs at about week 6

Hegar's sign

a tender uterus and foul smelling locia may indicate

endometritis

Unpleasent odor to amniotic fluid is

an infection

A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. The physician prescribes a contraction stress test, and the results are documented as negative. A nurse interprets the finding of the contraction stress test as indicating: 1. A normal test result 2. An abnormal test result 3. A high risk for fetal demise 4. The need for a cesarean delivery

1. A normal test result Contraction stress test results may be interpreted as negative (normal), positive (abnormal), or equivocal. A nega- tive test result indicates that no late decelerations occurred in the fetal heart rate, although the fetus was stressed by three contractions of at least 40 seconds' duration in a 10-minute period. Options 2, 3, and 4 are incorrect interpretations.

A nurse is describing cardiovascular system changes that occur during pregnancy to a client and understands that which finding would be normal for a client in the second trimester? 1. Increase in pulse rate 2. Increase in blood pressure 3. Frequent bowel elimination 4. Decrease in red blood cell production

1. Increase in pulse rate Between 14 and 20 weeks' gestation, the pulse rate increases about 10 to 15 beats/min, which then persists to term. Options 2, 3, and 4 are incorrect. During pregnancy, the blood pressure usually is the same as the prepregnancy level, but then gradually decreases up to about 20 weeks of gestation. During the second trimester, systolic and diastolic pressures decrease by about 5 to 10 mm Hg.

A nurse is reviewing the physician's prescriptions for a client admitted for premature rupture of the membranes. Gestational age of the fetus is deter- mined to be 37 weeks. Which physician's pre- scription should the nurse question? 1. Perform a vaginal examination every shift. 2. Monitor maternal vital signs frequently. 3. Monitor fetal heart rate continuously. 4. Administer ampicillin 1 g as an intravenous piggyback every 6 hours.

1. Perform a vaginal examination every shift.

A nurse in a labor room is preparing to care for a client with hypertonic uterine contractions. The nurse is told that the client is experiencing unco- ordinated contractions that are erratic in their frequency, duration, and intensity. The priority nursing intervention in caring for the client is to: 1. Provide pain relief measures. 2. Prepare the client for an amniotomy. 3. Promote ambulation every 30 minutes. 4. Monitor the oxytocin (Pitocin) infusion closely.

1. Provide pain relief measures. Hypertonic uterine contractions are painful, occur frequently, and are uncoordinated. Management of hyper- tonic labor depends on the cause. Relief of pain is the primary intervention to promote a normal labor pattern. An am- niotomy and oxytocin infusion are not treatment measures for hypertonic contractions; however, these treatments may be used in clients with hypotonic dysfunction. A client with hypertonic uterine contractions would not be encour- aged to ambulate every 30 minutes, but would be encouragedto rest.

A nurse is preparing a list of self-care instructions for a postpartum client who was diagnosed with mastitis. Which of the following instructions would be included on the list? Select all that apply. 1. Wear a supportive bra. 2. Rest during the acute phase. 3. Maintain a fluid intake of at least 3000 mL. 4. Continue to breast-feed if the breasts are not too sore. 5. Take the prescribed antibiotics until the soreness subsides. 6. Avoid decompression of the breasts by breast- feeding or breast pump.

1. Wear a supportive bra. 2. Rest during the acute phase. 3. Maintain a fluid intake of at least 3000 mL. 4. Continue to breast-feed if the breasts are not too sore.

A nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instructions? 1. "I will record the number of movements or kicks." 2. "I need to lie flat on my back to perform the procedure." 3. "If I count fewer than 10 kicks in a 12-hour period, I need to contact the physician." 4. "I should place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks."

2. "I need to lie flat on my back to perform the procedure."

A nurse is admitting a pregnant client to the labor room and attaches an external electronic fetal monitor to the client's abdomen. After attachment of the electronic fetal monitor, the initial nursing assessment is which of the following? 1. Identify the types of accelerations. 2. Assess the baseline fetal heart rate. 3. Determine the intensity of the contractions. 4. Determine the frequency of the contractions.

2. Assess the baseline fetal heart rate.

A maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the physician's prescriptions and would question which prescription? 1. Prepare the client for an ultrasound. 2. Obtain equipment for a manual pelvic examination. 3. Prepare to draw a hemoglobin and hemato- crit blood sample. 4. Obtain equipment for external electronic fetal heart rate monitoring.

2. Obtain equipment for a manual pelvic examination.

A nurse is monitoring a client in labor who is receiving oxytocin (Pitocin) and notes that the client is experiencing hypertonic uterine contrac- tions. List in order of priority the actions that the nurse takes. (Number 1 is the first action, and number 6 is the last action.) ____ Reposition the client. ____ Stop the oxytocin infusion. ____ Perform a vaginal examination. ____ Check the client's blood pressure. ____ Administer oxygen by face mask at 8 to 10 L/min. ____ Administer medication as prescribed to reduce uterine activity

2. Stop the oxytocin infusion. 1. Reposition the client. 4. check the client's blood pressure. 5. Administer oxygen by face mask at 8 to 10 L/min. 3. Perform a vaginal examination. 6. Administer medication as prescribed to reduce uterine activity

A nurse in a labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the follow- ing is an initial nursing action?should do which of the following to help the woman process what has happened? 1. Encourage the mother to breast-feed soon after birth. 2. Support the mother in her reaction to the newborn infant. 3. Tell the mother that it is important to hold the newborn infant. 4. Document a complete account of the mother's reaction on the birth record.

2. Support the mother in her reaction to the newborn infant.

A nurse is performing an initial assessment on a client who has just been told that a pregnancy test is positive. Which assessment finding would indicate that the client is at risk for preterm labor? 1. The client is a 35-year-old primigravida. 2. The client has a history of cardiac disease. 3. The client's hemoglobin level is 13.5 g/dL. 4. The client is a 20-year-old primigravida of average weight and height.

2. The client has a history of cardiac disease.

A nurse is performing an assessment of a primi- gravida who is being evaluated in a clinic during her second trimester of pregnancy. Which of the following indicates an abnormal physical finding that necessitates further testing? 1. Quickening 2. Braxton Hicks contractions 3. Fetal heart rate of 180 beats/min 4. Consistent increase in fundal height

3. Fetal heart rate of 180 beats/min

A clinic nurse is providing instructions to a preg- nant client regarding measures that assist in alle- viating heartburn. Which statement by the client indicates an understanding of the instructions? 1. "I should avoid between-meal snacks." 2. "I should lie down for an hour after eating." 3. "I should use spices for cooking rather than using salt." 4. "I should avoid eating foods that produce gas, such as beans and some vegetables, and fatty foods such as deep-fried chicken."

4. "I should avoid eating foods that produce gas, such as beans and some vegetables, and fatty foods such as deep-fried chicken."

A pregnant client asks a nurse in the clinic when she will be able to begin to feel the fetus move. The nurse responds by telling the mother that fetal movements will be noted between which of the following weeks of gestation? 1. 6 and 8 2. 8 and 10 3. 10 and 12 4. 16 and 20

4. 16 and 20

A nurse is performing an assessment on a client diagnosed with placenta previa. Which of these assessment findings would the nurse expect to note? Select all that apply. 1. Uterine rigidity 2. Uterine tenderness 3. Severe abdominal pain 4. Bright red vaginal bleeding 5. Soft, relaxed, nontender uterus 6. Fundal height may be greater than expected for gestational age

4. Bright red vaginal bleeding 5. Soft, relaxed, nontender uterus 6. Fundal height may be greater than expected for gestational age

Risk Factors for Preterm Labor includes

Anemics, Multigravida,<18yo and >40yo. Cardiac patient

Ductus Arteriosis joins the _____ and the pulmonary artery

Aorta

____ is a technique of palpating a float- ing structure by bouncing it gently and feeling it rebound. Rebounding of the fetus against the examiner's fingers on palpation

Ballottement

Productice cough or chills may indicate ______ and should encourage patient to use incentive spiromenter

Pneumonia

What are the 4 p's

Powers, Passageway, Passenger, Psyche

The first perception of fetal move- ment by the mother may occur the sixteenth to twentieth week of gestation is ______

Quickening

Foraman Ovale is a temporary opening betwee the ____ and _____

the right and left atra

Ductus Venosus connectrs the _______ to the inferior vena cava

umbilical vein