Maternal OB Weeks 1 & 2 Quiz

9. A nurse is assessing a patient in the perinatal clinic with diagnosed cervical insufficiency. The patient is in her 18th week of a viable pregnancy. Which action by the nurse is most appropriate? A.Assist with obtaining informed consent for a cerclage. B.Draw blood to assess the maternal Rh status. C.Facilitate a transvaginal and abdominal ultrasound. D.Refer the patient to a perinatal grief specialist.

A.Assist with obtaining informed consent for a cerclage.

A woman at 32 weeks' gestation is admitted to the high-risk OB unit with a diagnosis of preterm labor. On assessment the nurse finds the following: blood pressure, 182/96 mm Hg; pulse, 106 beats/minute; respirations, 16 breaths/minute; regular uterine contractions of 5 in 10 minutes; and fetal heart rate of 145 beats/minute. She is dilated to 8 cm. Which action by the nurse is best? A. Administer the ordered dose of betamethasone (Celestone). B. Call for an immediate electrocardiogram (EKG). C. Document the findings and prepare for emergent delivery. D. Prepare to administer magnesium sulfate (Sulfamag).

A. Administer the ordered dose of betamethasone (Celestone).

A woman reports feeling uterine contractions that are strong, but on subsequent cervical checks, the nurse does not note any changes. What action by the nurse is most appropriate? A.Assess the woman for causes of anxiety. B.Attempt an external version of the fetus. C.Instruct the woman on nipple stimulation. D.Prepare to administer oxytoxin (Pitocin).

A. Assess the woman for causes of anxiety.

Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following? A. Avoid eating greasy foods. B. Drink orange juice before rising. C. Consume 1 teaspoon of nutmeg each morning. D. Eat 3 large meals plus a bedtime snack.

A. Avoid eating greasy foods.

A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative, but "I still think I am pregnant." Which of the following statements would be appropriate for the nurse to make at this time? A) "Your period is probably just irregular." B) "We could do a blood test to check." C) "Home pregnancy test results are very accurate." D) "My recommendation would be to repeat the test in one week."

B) "We could do a blood test to check."

A woman who is 40 weeks pregnant calls the clinic to report that she noted a small amount of blood tined mucus on her toilet tissue this morning. What response by this nurse is most appropriate? A. "Come to the clinic today for an examination." B. "Labor will probably start within 48 hours." C. "Lie on your left side and count fetal kicks." D. "Stay on bedrest until your labor begins."

B. "Labor will probably start within 48 hours."

A woman presents to the perinatal clinic with abdominal pain. She has missed one period and, following a transvaginal ultrasound, pregnancy is confirmed. However, implantation has occurred in the right fallopian tube. The ectopic mass is 3 cm and has not ruptured. The nurse prepares the patient for which therapy? A. Laparoscopic salpingostomy B. Methotrexate C. Partial salpingectomy D. Salpingectomy by laparotomy

B. Methotrexate

A woman in her second trimester of pregnancy presents to the perinatal clinic with complaints of scant vaginal bleeding, abdominal pain, and shoulder pain. What action should the nurse perform first? A. Assess her for a history of preterm labor. B. Obtain a blood sample for a b-hCG test. C. Prepare the woman for a pelvic exam. D. Request an order for methotrexate (Rheumatrex).

B. Obtain a blood sample for a b-hCG test.

The nurse is preparing to admit a diabetic woman who is in labor. The nurse plans care to assess carefully for which of the following conditions in this patient? A.Need for an epidural block. B.Diminishing uterine contractions C. Overly strong, painful contractions D. Onset on intrapartum hypertension

B.Diminishing uterine contractions

A patient who recently had a miscarriage is in the clinic for follow-up.She sees the diagnosis "Spontaneous Abortion" on her charted becomes visibly upset, stating " I did. not have an abortion!"Which response by the nurse is best? A. "Don't be upset; that is just a medical term used commonly." B. "I can come back and talk to you when you are not so upset." C. "I see you are upset. Does it help to know this means miscarriage?" D. "No one is accusing you of having an abortion."

C. "I see you are upset. Does it help to know this means miscarriage?"

A patient's cervix is 8 cm dilated and she is 100% effaced. What action by the nurse is most important at this time? A. instruct the woman to rest between contractions B. encourage the woman to bear down C. Have the woman avoid pushing D. Allow the support person to be at the bedside

C. Have the woman avoid pushing

A pregnant patient in the second trimester is in the emergency department after a motor vehicle crash. She has a severe laceration of her arm resulting in a large blood loss. Which assessment should the nurse perform first? A. Blood pressure B. Fetal heart tones C. Pulse D. Respiratory rate

C. Pulse

The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits. Which patient does the nurse identify as having the highest-risk pregnancy? A. The patient who is 16 years of age just diagnosed with gestational diabetes B. The patient who is 28 years of age who delivered a premature neonate 3 years prior. C. The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension D.The patient with preexisting hypertension who is currently pregnancy with twins

C. The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension

A 22-year-old woman presents to the emergency department with abdominal pain andvaginal bleeding. Her blood pressure is 90/58 mm Hg, her pulse is 120 beats/minute, and she complains of dizziness. Which action by the nurse takes priority? A. Assess the woman for sexually transmitted infections. B. Collect a urine sample for pregnancy testing. C. Obtain informed consent for a salpingectomy. D. Start two large-bore IVs for fluid replacement.

D. Start two large-bore IVs for fluid replacement.

A woman had an amniotomy 1 hour ago. Now she is complaining of uterine tenderness. What action by the nurse is most appropriate? A. Increase the IV infusion rate. B. Notify the health-care provider. C. Perform a vaginal examination. D. Take the woman's temperature

D. Take the woman's temperature

Which of the following clients is at highest risk for developing a hypertensive illness of pregnancy? a) G1 P0000, age 44 w/ history of DM b) G2 P0101, age 27 w/ history of rheumatic fever c) G3 P1102, age 25 w/ history of scoliosis d) G1 P1011, age 20 w/ history of celiac disease

a) G1 P0000, age 44 w/ history of DM

A 32-gestation client was last seen in the prenatal clinic at 28 weeks' gestation. Which of the following changes should the nurse bring to the attention of the certified nurse midwife? a) Weight change from 128 pounds to 138 pounds b) Pulse rate change from 88 to 92 bpm c) BP change from 120/80 to 118/78 d) RR change from 16 to 20 rpm

a) Weight change from 128 pounds to 138 pounds

A 25 year old woman at 35 weeks pregnant is brought to the labor and delivery unit by her husband. She is lethargic and complains of abdominal pain. Her husband states she started vomiting the previous day and hasn't eaten anything since then.This is her first pregnancy . Her medical history includes type 1 diabetes mellitus for 2 years. Until the pain started, her insulin regimen was to administer and intermediate-acting insulin twice a day, and a short acting insulin at each meal. Her husband states she has not been checking her blood sugar regularly because of the vomiting, and he's not sure she's been taking insulin since she has not been eating. He checked her blood sugar 30 minutes ago before bringing her in and it was 320 mg/dL. The clients vital signs are T: 98.6 F, P:110, R:24, BP: 106/70. Her electronic medical record indicates a weight of 180 lbs at her last office visit 7 days ago. Select all that apply.

a. fetal heart rate b. fundal height c. height and weight d. capillary blood glucose e. urinalysis

A 24-week gravid client is being seen in the prenatal clinic. She states, "I have had a terrible headache for the past 2 days." Which of the following is the most appropriate action for the nurse to perform next? a) Inquire whether or not the client has allergies b) Take the woman's BP c) Assess the woman's fundal height d) Ask the woman about stressors at work

b) Take the woman's BP

The perinatal nurse is working with a patient who is diagnosed with hyperemesis gravidarum. The. nurse should anticipate orders for which of the following treatments? Select all that apply. a. three small meals and avoid snacking. b. ginger chews may be taken as a supplement. c. avoid foods that may act as sensory triggers. d.minimize protein intake to decrease nausea. e. crackers upon arising may alleviate nausea.

c. avoid foods that may act as sensory triggers (?) d.minimize protein intake to decrease nausea. e. crackers upon arising may alleviate nausea.