OB 2

A nurse in the nursery is caring for a newborn. The grandmother of the newborn asks if she can take the newborn to the mothers room. Which of the following is an appropriate response by the nurse? a. "You may carry your grandchild to the room." b. "Have the mother call and I will take the baby to the room." c. "If you show me your photo identification, you can take the infant." d. "You can push the baby to the room in a wheeled bassinet."

b. "Have the mother call and I will take the baby to the room."

On the third day postpartum, which temperature is internationally defined as a postpartal infection? a. 104.2 F b. 100.4 F c. 99.6 F d. 102.4 F

b. 100.4 F

After delivery of the placenta, a patient's uterus is sluggish to contract. What should the nurse prepare to do to assist the patient at this time? a. Prepare to administer blood products as prescribed b. Administer oxytocin as prescribed c.. Administer intravenous fluids d. Measure blood pressure every 15 minutes.

b. Administer oxytocin as prescribed

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? a. Increase the infusion rate. b. Stop the current infusion. c. Check fetal heart rate. d. Measure blood pressure

b. Stop the current infusion.

A nurse is caring for a newborn and observes signs of diaphoresis, jitteriness, and lethargy. Which of the following actions should the nurse take? a. Initiate phototherapy b. Monitor the newborn's blood pressure. c. Obtain blood glucose by heel stick

c. Obtain blood glucose by heel stick

Dilation follows effacement in the primiparous mother. To be fully dilated, the cervix should have a distance of what measurement? a. 8 to 10 cm b. 12 to 14 cm c. 7 to 8 cm d. 3 to 4 cm

a. 8 to 10 cm

A nurse is caring for a client immediately after delivery. She notes during fundal massage that there are three lemon sized clots expressed with moderate to heavy lochia flowing from the clients vagina. What is the priority nursing assessment? Select all that apply. a. Blood pressure b. Bladder distention c. lower extremity function d. Fundal tone e. Lung sounds

a. Blood pressure b. Bladder distention d. Fundal tone

As a woman enters the second stage of labor, which would the nurse expect to assess? a. Feelings of being frightened by the change in contractions b. Falling asleep from exhaustion c. expressions of satisfaction with her labor progress d. Reports of feeling hungry and unsatisfied

a. Feelings of being frightened by the change in contractions

The nurse assesses that a fetus in a breech presentation. Where would you auscultate for fetal heart sounds? a. High in the abdomen b. Right lateral abdomen c. Low in the abdomen d. Left lateral abdomen

a. High in the abdomen

Risk factors that contribute to preterm labor include which of the following? (select all that apply.) a. History of preterm delivery b. Substance abuse c. Obesity d, Higher socioeconomic class e. Multiple gestation. f. Preeclampsia g. Regular prenatal care

a. History of preterm delivery b. Substance abuse c. Obesity e. Multiple gestation. f. Preeclampsia

The nurse is caring for a patient who desires to become pregnant within a few months. Which outcome regarding folic acid intake would be appropriate for this patient? a. The client will begin taking 400 ug of folic acid every day b. The client will begin taking 400 ug of folic acid immediately after confirmation of pregnancy c. The client will begin taking 400 ug of folic acid with every meal d. The client will ingest foods high in folic acid to avoid needing to take folic acid supplements

a. The client will begin taking 400 ug of folic acid every day

When caring for a newborn several hours after birth, the nurse assesses the newborn's respiratory rate. In a normal newborn this would be: a. 30 to 60 breaths per minute. b. 12 to 16 breaths per minute. c. 20 to 30 breaths per minute. d. 16 to 20 breaths per minute.

a. 30 to 60 breaths per minute.

A nurse is caring for a client who just delivered a newborn. Following the delivery, which nursing action should be done first to care for the newborn? a. Clear the respiratory tract b. Stimulate infant to cry c. Cut umbilical cord d. Dry infant and cover head

a. Clear the respiratory tract

The nurse encourages a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, the nurse would advise her to take which action? a. Eat a sustaining-carbohydrate snack b. Add a bolus of long-acting insulin C. eat a high carbohydrate snack

a. Eat a sustaining-carbohydrate snack

A nurse is caring for a client that has recently been diagnosed with gestational diabetes. The client is upset and stating that she is not unhealthy, exercises regularly, never eats candy or fast food. What is the best response by the nurse? a. Gestational diabetes is caused by the placenta and goes away after delivery. b. Even the occasional unhealthy choice in diet can cause this|

a. Gestational diabetes is caused by the placenta and goes away after delivery.

A nurse is caring for a client who is 2 hr postpartum. The nurse notes that the client soaked a perineal pad in 10 min, the client's skin color is ashen, and she states she feels weak and light headed. After applying oxygen via nonrebreather face mask at 10L/min which of the following actions should the nurse take next? a. Massage the client's fundus to promote contractions b. Insert an indwelling urinary catheter c. tilt the client onto her right side with her legs elevated to at least 30 degrees d. Administer oxytocin by continuous IV

a. Massage the client's fundus to promote contractions

A woman who is 7 weeks pregnant is admitted with vaginal bleeding. She reports she never should have raised her arms above her head. Based upon your knowledge, what is your best response? a. Recognize her cultural beliefs and explain in a nonjudgmental manner the potential causes of miscarriage b. Advise the client to keep her arms down to reduce the risk of bleeding c. Ignore her comment d. Explain to the client that this is an unfounded myth

a. Recognize her cultural beliefs and explain in a nonjudgmental manner the potential causes of miscarriage

A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns? a. Variable decelerations. b. Early decelerations c. Late decelerations. d. Accelerations

a. Variable decelerations.

A nurse is leading a discussion about contraception with a group of 14-year-old clients. After the presentation, a client asks the nurse which method would be best for her to use. Which of the following responses should the nurse make? a. "Because of your age, i think that a barrier method would be the best choice." b. "Before i can help you, i need to know more about your secual activity." c. "A provider can help you with that after a physical examination." d. "You are so young. Are you ready for the responsibilities of a sexual relationship?"

b. "Before i can help you, i need to know more about your secual activity."

A mother asks you how she can judge that her infant is receiving sufficient breast milk. What would be the most appropriate response? a. "The infant should not become constipated." b. 'The infant should gain weight and have six wet diapers daily." c. "You need to weigh the infant before and after each feeding." d. "The infant should sleep at least 3 hours between feedings."

b. 'The infant should gain weight and have six wet diapers daily."

Which of the following women most likely will not be a candidate to attempt a vaginal birth after having had a previous cesarean section? a. A woman who has a gynecoid shaped pelvis b. A woman who had a cesarean section with a classical uterine incision c. a woman who had a cesarean section because of placenta previa d. A woman who had a cesarean section because of breech presentation

b. A woman who had a cesarean section with a classical uterine incision

A patient with type two diabetes mellitus is planning to become pregnant within the next several months. What should the nurse instruct the patient to support the 2020 national health goals of reducing the complications of pregnancy from diabetes? a. Reduce the current exercise regimen by half b. Avoid episodes of Hyperglycemia c. Limit the intake of carbohydrates and fats in the diet d. Reduce the use of insulin for blood glucose coverage

b. Avoid episodes of Hyperglycemia

A pregnant patient reports feeling pain similar to menstrual cramps. What should the nurse explained about this patient's symptoms? a. They are false labor and do not need to be reported b. If rhythmical they could indicate preterm labor c. Exercise helps reduce the frequency of them d. Lying down for a few hours will help them stop

b. If rhythmical they could indicate preterm labor

A woman develops HELLP syndrome. During labor, which physician order would the nurse question? a. Assess the urine output every hour b. Prepare her for epidural anesthesia c. Assess her blood pressure every 15 minutes d. Urge her to lie on her left side during labor

b. Prepare her for epidural anesthesia

Vaginal birth with vacuum assist. The newborn's mother asks about the swollen area on her son's head. After palpation to identify that the sweling crosses the suture line, which of the following is an appropriate response by the nurse? a. "This is erythema toxicum, which is a transient condition." b. "This is a cephalhematoma, which can occur spontaneously." c. "A caput succedaneum occurs due to compression of blood vessels." d. "Mongolian spots can be found on the skin of many newborns."

c. "A caput succedaneum occurs due to compression of blood vessels."

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 is the nurse's best response to her concerning this choice? a. "Let me get you something for relaxation if you don't want anything for pain." b. "That's wonderful. Medication during labor is not good for the baby." c. "I respect your preference whether it is to have medication or not." d. "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."

Which assessment would lead the nurse to believe a postpartal woman is developing a urinary complication? a. Her perineum is obviously edematous on inspection. b. She says she is extremely thirsty. c. At 8 hours postdelivery she has voided a total of 100 mL in four small voidings. d. She has voided a total of 1000 mL in two voidings, each spaced 1 hour apart

c. At 8 hours postdelivery she has voided a total of 100 mL in four small voidings.

After learning about the need for a Cesarean birth, a pregnant patient begins to cry and hyperventilate. Which nursing diagnosis should the nurse use to guide the care that the patient needs at this time? a. Powerlessness related to medical need for cesarean birth. b. Risk for impaired parent/infant attachment related to unplanned method of birth c. Fear related to impending surgery d. Risk for infection related to a surgical incision

c. Fear related to impending surgery

A patient who is 28 weeks pregnant is demonstrating signs of placental insufficiency. The healthcare provider prescribes betamethasone. When teaching the patient about this drug's purpose, which information would the nurse include? a. It stops premature labor b. It improves functioning of the placenta c. It potentiates the formation of surfactant d. It improves immunologic function of the fetus

c. It potentiates the formation of surfactant

The nurse is determining care for a patient entering the active phase of labor. Which outcome would be the most appropriate for the patient at this time? a. Patient will develop an irresistible urge to push b. Patient will combat feelings of nausea to prevent vomiting c. Patient will adjust body to attain the most comfortable position d. Patient will remain in the supine position during contractions

c. Patient will adjust body to attain the most comfortable position

A nurse on the postpartum unit is caring for a group of clients with an assistive personnel (AP). Which of the following tasks should the nurse plan to delegate to the AP? a. Observe an area of redness on the breast of a client who is 1 day postpartum. b . Change the perineal pad of a client who just transferred from labor and delivery. c. Provide a sitz bath to a client who has a fourth degree laceration and is 2 days postpartum. d. Monitor vital signs during admission of a client who has a gestational hypertension

c. Provide a sitz bath to a client who has a fourth degree laceration and is 2 days postpartum.

A pregnant patient is diagnosed with preterm labor. Based on current evidence, what should the nurse teach the patient to help prevent the recurrence of preterm labor? Select all that apply a. Lie flat on the back should uterine contractions occur. b. Engage in mild activities of daily living with frequent rest periods. c. Report any signs of ruptured membranes d. Remain on bed rest except to use the bathroom e. Drink 8 to 10 glasses of fluid each day

c. Report any signs of ruptured membranes e. Drink 8 to 10 glasses of fluid each day

At midpoint during pregnancy, you review beginning signs of labor with a patient. One of the beginning signs of labor you would review is a. An increased pulse rate and upper abdominal pain b. Sharp, right sided abdominal pain c. a sudden gush of clear fluid from the vagina d. Excessive fatigue and headache

c. a sudden gush of clear fluid from the vagina

A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission? a. Assessing uterine contractions by an internal pressure gauge b. Helping the woman remain ambulatory to reduce bleeding c. assessing fetal heart tones by use of an external monitor d. Performing a vaginal examination to assess the extent of bleeding

c. assessing fetal heart tones by use of an external monitor

If the monitor pattern of uteroplacental insufficiency were present, which action would the nurse do first? a. Administer oxygen at 3 to 4 L by nasal cannula b. Ask her to pant with the next contraction c. turn her or ask her to turn to her side d. Help the woman to sit up in a semi-fowler's position

c. turn her or ask her to turn to her side

During a physical assessment, the nurse palpates a pregnant patient's fundus at the level of the umbilicus. What statement should the nurse make to the patient about this assessment finding? a. "You are at approximately 12 weeks of your pregnancy." b. "You can go into labor at any time now." c. "You are at approximately 36 weeks of your pregnancy." d. "You are at approximately 20 weeks of your pregnancy."

d. "You are at approximately 20 weeks of your pregnancy."

A nurse caring for a client who is in preterm labor at 32 weeks of gestation. The client asks the nurse, "Will my baby be okay?" Which of the following responses should the nurse offer? a. "Everyone worries about her baby when she's in labor." b. "We have a neonatal unit here that's equipped to handle emergencies." c. "Your pregnancy is advanced so your baby should be fine." d. "You must be feeling scared and powerless."

d. "You must be feeling scared and powerless."

A woman is in labor with her second child. She knows that she will want epidural anesthesia, and she has already signed her consent form. What must the nurse do before the woman receives the epidural? a. Please the woman in the fetal position on the table, and keep her steady so that she won't move during the procedure. b. Review the woman's medical history and laboratory results, and interview her to confirm all information is accurate and up-to-date c. Prepare a sterile field with the supplies and medications that will be needed d. Administer a fluid bolus through the IV line to reduce the risk of hypotension

d. Administer a fluid bolus through the IV line to reduce the risk of hypotension

Which of the following statements is true about breastfeeding? a. Uterine involution is slowed by breastfeeding b. Breastfeeding mothers have a decreased risk of developing thrombophlebitis c. Breastfeeding increased the risk of breast cancer d. Breastfeeding offers a good chance for bonding with the infant

d. Breastfeeding offers a good chance for bonding with the infant

A nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. Uterine contractions occur every 2 min, last 90 sec, and are strong to palpation. The baseline fetal heart rate is 150/min, with uniform decelerations beginning at the peak of the contraction and a return to baseline after the contraction is over. Which of the following actions should the nurse take? a. Slow the client's rate of breathing b. Increase the rate of infusion of the IV oxytocin c. Decrease the rate of infusion of the maintenance IV solution d. Discontinue the infusion of the IV oxytocin

d. Discontinue the infusion of the IV oxytocin

The nurse is preparing an education session on the 2020 national health goals to prevent complications of pregnancy. What should the nurse include as the best preventive measure to eliminate complications of pregnancy? a. Recommend all pregnant patients engage in exercise most days of the week. b. Suggest all pregnant patients keep weight gain to a minimum c. Counsel all pregnant patients to select low-fat dairy products rich in calcium. d. Encourage all pregnant patients to have prenatal care.

d. Encourage all pregnant patients to have prenatal care.

The nurse administers methylergonovine 0.2 mg to a postpartal woman with uterine subinvolution. Which assessment should the nurse make prior to administering the medication? a. She can walk without experiencing dizziness b. Her urine output is over 50 mL/h c. Her hematocrit level is over 45% d. Her blood pressure is below 140/90 mm Hg

d. Her blood pressure is below 140/90 mm Hg

A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which of the following newborn complications as the priority focus of care? a. Hypocalcemia b. Hyperbilirubinemia c. Hypomagnesemia d. Hypoglycemia

d. Hypoglycemia

A new mother asks you how soon she can breastfeed after delivery. Which of the following would be your best answer (barring unforeseen complications)? a. In 24 hours after her infant is given water b. After the infant is allowed to rest c. once the infant has a first feeding of formula d. Immediately after birth

d. Immediately after birth

To administer oxygen by bag and mask to a newborn, you would position the baby a. On the back with the neck slightly flexed b. Position is unimportant as long as the tongue is pulled forward c. in Trendelenburg's position d. On the back with the head slightly extended in a sniffing position

d. On the back with the head slightly extended in a sniffing position

When a woman in labor has reached 8 cm dilation, the nurse notices the fetal heart rate suddenly slows. On perineal inspection, the nurse observes the fetal cod has prolapsed. The nurse's first action after calling for help would be to: a. Turn her to her left side b. Replace the cord with gentle pressure. c. cover the exposed cord with a dry, sterile wrap. d. Place her in a knee-chest position

d. Place her in a knee-chest position

A nurse is assessing a client who received magnesium sulfate to treat preterm labor. Which of the following clinical findings should the nurse identify as an indication of toxicity of magnesium sulfate therapy and report to the provider? a. Drowsiness b. Facial flushing c. Nausea d. Respiratory depression

d. Respiratory depression

A woman in labor is at risk for abruptio placentae. Which assessment would most likely lead the nurse to suspect that this has happened? a. Painless caginal bleeding and a fall in blood pressure b. An increased blood pressure and oliguria c. pain in a lower quadrant and increased pulse rate d. Sharp fundal pain and discomfort between contractions

d. Sharp fundal pain and discomfort between contractions

A client in labor has been diagnosed with oligohydramnios. What type of fetal heart rate decelerations would the nurse anticipate to see on the electronic fetal heart rate tracing? a. Early deceleration b. Prolonged deceleration c. Late deceleration d. Variable deceleration

d. Variable deceleration

A postpartal woman with an episiotomy asks the nurse about perineal care. Which recommendation would the nurse give? a. Refrain from washing lochia from the suture line b. Avoid using soap for any perineal care c. use an alcohol wipe to wash her episiotomy line d. Wash her perineum gently when she showers, and as needed throughout the day

d. Wash her perineum gently when she showers, and as needed throughout the day

To assess the frequency of a woman's labor contractions, the nurse would time: A. the beginning of one contraction to the beginning of the next. B. How many contractions occur in 5 minutes C. the interval between the acme of two consecutive contractions D. The end of one contraction to the beginning of the next.

A. the beginning of one contraction to the beginning of the next.

A new mother does not want the baby to return to the nursery because of the fear of someone taking the baby without her permission. What should the nurse explain to the mother to allay her fears? A. Only people who are known to the staff are permitted in the nursery B. Keeping the baby in the mother's room at all times is the best approach C. Both mother and infant have identification bands that need to match. D. Security questions everyone before permitting them access to the hospital

C. Both mother and infant have identification bands that need to match.

The nurse assesses a newborn's Apgar score at birth and documents that it is normal. Which score did the nurse most likely record? A.8 B.4 C.1 D.13

A.8

The nurse is completing a physical assessment with a patient who has just learned of being pregnant. The patients last menstrual period was August 15. When should the nurse instruct the patient that the baby will be due? a. April 15 B. May 22 c . June 22

B. May 22