OB Cumulative final

The nurse is preparing for the discharge of a neonate diagnosed with a congenital breathing disorder. Which health team members does the nurse include in discharge planning? Select all that apply. a) Home health agency nurse b) Social worker c) Case manager d) Respiratory therapist e) Neighbor who has experience with normal newborns

a) Home health agency nurse b) Social worker c) Case manager d) Respiratory therapist

A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She has a 2-year-old son and had one previous spontaneous abortion. How would the nurse document the patient's obstetric history using the TPALM system? a) Gravida 2, para 20120 b) Gravida 3, para 10110 c) Gravida 2, par 11110 d) Gravida 3, para 1001

b) Gravida 3, para 10110

The nurse is preparing discharge teaching for a postpartum patient who exhibits signs and symptoms of an episiotomy infection and is on oral antibiotic therapy. What specific discharge teaching will the nurse provide regarding pain management? a) Application of hot packs to the perineal area b) Medicating for pain above level 2 on a 0 to 10 scale c) Instructions to improve circulation by ambulating d) Information applicable to medication therapy

d) Information applicable to medication therapy

The nurse is preparing a postpartum patient for discharge. For which reasons does the nurse instruct the patient to call the primary care provider? Select all that apply. a) Not sleeping well b) Hot, red, painful breasts c) Foul-smelling lochia d) Frequent, painful urination e) Mild headache

b) Hot, red, painful breasts c) Foul-smelling lochia d) Frequent, painful urination

A mother who is breastfeeding expresses concern about whether her infant is getting enough milk. Which concrete indicator does the nurse provide to the mother? a) The newborn spontaneously releases the grip on the breast when satiated. b) There are at least six to eight wet diapers and several stools per day. c) The mother is physically and emotionally comfortable during feedings. d) The newborn suckles and the mother can hear and/or see swallowing.

b) There are at least six to eight wet diapers and several stools per day.

What symptom presented by a pregnant women is indicative of abruptio placentae? a) Premature rupture of membranes b) Vaginal bleeding and back pain c) Painless vaginal bleeding d) Uterine irritability with contractions

b) Vaginal bleeding and back pain

Which information is important for the nurse to provide to mothers of infants of 3 months of age regardless of the method of infant feeding? a) Why breastfeeding delays the need for solid foods b) When growth spurts and dietary increases are expected c) When and what order solid foods are introduced d) Why the babies are most likely to prefer food over milk

b) When growth spurts and dietary increases are expected

The nurse is reviewing fetal circulation with a pregnant patient and explains that blood circulates through the placenta to the fetus. What vessel(s) carry blood to the fetus? a) Two umbilical arteries b) Two umbilical veins c) One umbilical artery d) One umbilical vein

d) One umbilical vein

The postpartum nurse is preparing to present infant care information to a couple who expresses concern about when to bathe their newborn. Which behaviors will the nurse present as general guidelines? Select all that apply. a) Avoid the use of soap on the face of the newborn. b) Use a mild preservative-free soap with a neutral pH. c) Bathing is best after a feeding when newborn is relaxed. d) Genital and rectal areas should be cleaned at each diaper change. e) Daily bathing with soap is not necessary for the newborn.

a) Avoid the use of soap on the face of the newborn. b) Use a mild preservative-free soap with a neutral pH. d) Genital and rectal areas should be cleaned at each diaper change. e) Daily bathing with soap is not necessary for the newborn.

A patient who is pregnant expresses a desire to attempt a vaginal delivery after a cesarean birth 2 years before. The primary care provider initiates trial of labor after cesarean (TOLAC) and vaginal birth after cesarean (VBAC) screening. The nurse is aware that which patient information will likely disqualify the patient for VBAC? a) Cesarean due to pelvic abnormalities b) Patient asks multiple questions c) First labor needed to be induced d) A low transverse uterine scar

a) Cesarean due to pelvic abnormalities

A nurse-preceptor is explaining to a new nurse about the fetal heart monitoring. The mother is carrying twins. The new nurse is looking at the EFM paper and sees that, of the two tracked heart rates, the one on the bottom is in the 80s. The nurse is concerned that the fetal heart rate is bradycardic. Which of the following should the nurse do first? a) Check to make sure that the maternal radial pulse is being recorded correctly. b) Immediately call the provider into the room. c) Adjust the monitor on the maternal abdomen. d) Give the mother oxygen to increase the fetal heart rate.

a) Check to make sure that the maternal radial pulse is being recorded correctly.

The nurse is providing care for a patient who is 8 hours postpartum after a vaginal delivery. The patient reports severe perineal pain unaffected by pain medication. The nurse notices a 4 cm area of discoloration on the labia that is tender to the touch. Which action does the nurse take after competing a full assessment and providing comfort measures? a) Contact the primary care provider for further evaluation. b) Continue to apply ice to the area for 24 hours. c) Relieve pressure by having the patient sit on her perineum. d) Monitor vital signs and report any abnormal readings.

a) Contact the primary care provider for further evaluation.

The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient? a) Prescriptions for antibiotics b) Immediate hospitalization in a psychiatric unit c) Prescribed neonate visits during in-patient treatment d) Discharge to home with 24-hour observation in place

b) Immediate hospitalization in a psychiatric unit

The EFM tracing shows the following: FHR baseline 166 bpm, moderate variability, and recurrent late decelerations to 100 bpm. Using the five-tier FHR interpretation system, how should the nurse interpret this tracing? a) Yellow: moderate risk of evolution, increase surveillance b) Orange: acceptable low risk of acidemia, prepare for possible urgent delivery c) Red: unacceptably high risk of acidemia, deliver d) Green: very low risk of evolution, no action

b) Orange: acceptable low risk of acidemia, prepare for possible urgent delivery

The nursing is caring for a 31-year-old female patient who is pregnant at 37 weeks and 5 days gestation. The patient is having contractions every 3 minutes and was found to have a platypelloid pelvis upon examination. The fetus has an estimated fetal weight of 7 lbs and is in the LOA position. This patient is laboring on the birth ball, and her mother-in-law is helping her labor. The nurse is concerned about the five Ps and their effect on the patient's labor. Which P is the nurse most likely concerned about based on the patient's history? a) Passenger b) Passage c) Psyche d) Position

b) Passage

The nurse is reviewing the medical record for a patient who is postpartum. The nurse notices the patient is rubella-nonimmune. Which information does the nurse present to the patient? Select all that apply. a) Maternal immunization carries over to the neonate. b) Pregnancy should be avoided for 4 weeks. c) The patient will need to be immunized before discharge. d) Breastfeeding should be avoided for 24 hours after immunization. e) The risks to the fetuses of any future pregnancies.

b) Pregnancy should be avoided for 4 weeks. c) The patient will need to be immunized before discharge e) The risks to the fetuses of any future pregnancies.

Prior to discharge from the birthing center, the nurse informs the patient that she will receive vaccines for rubella, hepatitis B, pertussis, and influenza. For which reason does the nurse explain the need for the vaccinations? a) Vaccination is more easily accomplished while the mother is under medical care. b) The mother's immune system has been suppressed during pregnancy. c) Vaccinating the mother will protect the neonate and future pregnancies from serious illnesses. d) Discharge with a neonate is discouraged if the mother is not vaccinated.

c) Vaccinating the mother will protect the neonate and future pregnancies from serious illnesses.

A breastfeeding mother is planning to return to work 3 months after her baby is born. The mother is planning to use an electric breast pump and freeze some breast milk for use later. Which information does the nurse need to provide? a) The freezer door shelf decreases the chance of milk contamination. b) Breast milk should not be frozen. c) Frozen breast milk can be defrosted in a microwave. d) Breast milk can be kept in a deep freezer for 6 to 12 months.

d) Breast milk can be kept in a deep freezer for 6 to 12 months.

The nurse is providing care for a premature neonate in the NICU nursery. The neonate is diagnosed with bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA). Which specific intervention does the nurse expect for this neonate? a) Obtain blood glucose levels. b) Administer enteral feedings. c) Monitor of hemoglobin and hematocrit levels. d) Maintain fluid restrictions.

d) Maintain fluid restrictions.

While providing care for a patient who is constantly changing positions, the nurse notices an erratic FHR recording. What action should the nurse take next? a) Check the mother's cervical progress to see if she is in the latent, first stage of labor. b) Remove some of the ultrasound gel from the transducer. c) Help the patient move around to help obtain the signal. d) Place the transducer (ultrasound) in a different position.

d) Place the transducer (ultrasound) in a different position.

The nurse is using the five-tier system fetal heart system. A co-worker is concerned about a patient whose fetus has an acceptably low risk of acidemia but evidence of impending fetal asphyxia (orange color). What is the next best step for the nurse? a) Increase surveillance of patient. b) Perform conservative measures. c) Assist provider in a c-section delivery. d) Prepare for possible urgent delivery.

d) Prepare for possible urgent delivery.

A woman who is 37 weeks pregnant reports feeling dizzy when lying on her back. What does the nurse explain as the most likely cause of this symptom? a) Malnutrition b) Pregnancy-induced hypertension c) Gestational diabetes d) Supine hypotension syndrome

d) Supine hypotension

A patient who is at 39 weeks gestation is scheduled for amniotomy. The nurse is aware that which criteria must be met before the procedure? a) Prior amniotic fluid leakage must be validated before the procedure. b) The nurse must have certification to perform the procedure. c) Ultrasound indicates the umbilical cord is away from the cervix. d) The fetal head is currently engaged in the maternal pelvis (at the ischial spines).

d) The fetal head is currently engaged in the maternal pelvis (at the ischial spines).

The nurse is preparing a postpartum patient who had a precipitous birth, for discharge. Which patient teaching is most important for the nurse to provide? a) The signs and symptoms of postpartum depression b) The signs and symptoms of uterine infection c) The signs and symptoms of a UTI d) The signs and symptoms of postpartum hemorrhage

d) The signs and symptoms of postpartum hemorrhage

True labor is when...... a) the women feels the urge to push. b) the cervix dilates c) the patient begins to feel abdominal pain. d) the baby is in zero station.

b) the cervix dilates

At what point in prenatal development do the lungs begin to produce surfactant? a) 30 weeks b) 20 weeks c) 25 weeks d) 17 weeks

c) 25 weeks

The nurse educates prenatal patients about the threat of TORCH infections. Which infections are included in this classification? (select all that apply) A) Toxoplasmosis B) Toxemia C) Cytomegalovirus D) Rubella E) Herpes simplex

A) Toxoplasmosis C) Cytomegalovirus D) Rubella E) Herpes simplex

What are the functions of amniotic fluid? (Select all that apply.) A) Impeding excessive fetal movement B) Maintaining an even temperature C) Acting as a reservoir for nutrients D) Acting as a cushion for the fetus E) Lubricating fetal skin

B) Maintaining an even temperature D) Acting as a cushion for the fetus

An extremely low-birth weight infant is one whose weight is 2000 g or less. True False

False

At birth, an Indirect Coombs' test is performed on the newborn's cord blood to determine if the fetus has produced antibodies to his or her mother's blood. True False

False

When meconium is present in the amniotic fluid at birth, the infant should be suctioned below the vocal cords before he or she takes her first breath. True False

False

A newborns normal heart rate is 100-160 bpm and respiratory rate is 30-60 bpm. True False

True

White, pimple-like spots called millia on a newborns face is normal. True False

True

An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the entire cervical opening. What does the nurse understand best describes this condition? a) Total placenta previa b) Marginal placenta previa c) Low-lying placenta d) Partial placenta previa

a) Total placenta previa

A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient's medical record and associates which RISK factors related to a possible urinary tract infection (UTI)? Select all that apply. a) Urinary catheter during labor b) Poor oral fluid intake c) Low-grade fever d) Neonatal macrosomia e) Use of a vacuum extractor

a) Urinary catheter during labor b) Poor oral fluid intake d) Neonatal macrosomia e) Use of a vacuum extractor

The premature neonate is more susceptible to skin breakdown than a term neonate. Which skin care interventions will the nurse implement for the premature neonate? Select all that apply. a) Use a neutral pH cleanser and sterile water for bathing. b) Gently apply emollients to avoid unnecessary friction. c) Perform daily skin assessment to identify problems early. d) Use water, air, or gel mattresses. e) Provide a full bath every other day.

a) Use a neutral pH cleanser and sterile water for bathing. b) Gently apply emollients to avoid unnecessary friction. d) Use water, air, or gel mattresses.

The nurse is reading the patient's chart, which indicates the patient has a "gynecoid pelvis." What finding is expected in this patient? a) Wider outlet b) Shorter diameter between her coccyx and ischium c) Smaller inlet d) Narrower pubic arch

a) Wider outlet

The nurse is collecting information from a new mother who is bottle-feeding her infant. Which comment, made by the mother, requires the nurse to provide patient teaching? a) "I wish that I had tried breastfeeding because formula is expensive." b) "Sometimes I will add a little water to the formula if I am running low." c) "I get frustrated if the last bottle is fed to the baby late at night." d) "At least I get a break every evening when my spouse feeds the baby."

b) "Sometimes I will add a little water to the formula if I am running low."

What should a woman expect after insertion of an intrauterine device (IUD)? a) Menstrual flow will be lighter. b) A string should be felt in the vagina. c) The device should be changed every 2 years. d) Menstrual cramps will be eliminated.

b) A string should be felt in the vagina.

The nurse is present in the delivery room when a mother is told her neonate was stillborn. The mother begins to wail loudly and pull at her hair. Which action does the nurse take? a) Ask a family member to comfort the mother. b) Allow the mother to express grief in her own way. c) Ask for a sedative to calm the mother's reaction. d) Get an order to send this patient to the psychiatric unit.

b) Allow the mother to express grief in her own way.

The nurse works in a postnatal nursery and is required by hospital policy to perform a gestational age assessment on specified neonates. On which neonate is the nurse most likely to perform this assessment? a) The neonate born after an 18-hour labor b) The neonate exposed to oxytocin in utero c) The neonate born at 37 weeks gestation d) The neonate with a birth weight of 4,100 g

d) The neonate with a birth weight of 4,100 g

The nurse is monitoring the fetal heart rate (FHR) tracing and sees that her patient has a tracing with a baseline of 120bpm, moderate variability, with absence of decelerations and accelerations. According to the National Institute of Child Health and Human Development five tier system, what category tracing does the patient's fall into? a) A Category II tracing b) A Category I tracing c) A Category III tracing d) A Category IV tracing

a) A Category II tracing

A pregnant patient asks the nurse when her infant's heart will begin to pump blood. What will the nurse reply? a) Beginning in week 24 b) By the end of week 3 c) Beginning in week 8 d) By the end of week 16

b) By the end of week 3

The nurse is providing care for a premature neonate born at 28 weeks gestation who is experiencing respiratory distress syndrome (RDS). Which assessment finding indicates to the nurse that the neonate's respiratory status is deteriorating? a) Respiratory rate is 58 breaths per minute. b) Breath sounds on auscultation are decreased. c) Pao2 is 48 and Paco2 is 55 mm Hg on 90% oxygen. d) Heart rate is 162 beats per minute.

c) Pao2 is 48 and Paco2 is 55 mm Hg on 90% oxygen.

What situation would concern the nurse about the presence of Rh incompatibility? a) Rh-negative mother, Rh-negative fetus b) Rh-positive mother, Rh-positive fetus c) Rh-negative mother, Rh-positive fetus d) Rh-positive mother, Rh-negative fetus

c) Rh-negative mother, Rh-positive fetus

The nurse notices that a new mother has her neonate unwrapped and undressed "to check out the baby." For which reason does the nurse conclude the neonate is at risk for cold stress? a) The neonate has an increased metabolic rate. b) The neonate's skin is cool and clammy. c) The neonate is moving extremities about. d) The neonate's respiratory rate has dropped.

c) The neonate is moving extremities about.

A neonate is born after 37 weeks gestation, and the nurse is concerned about avoiding cold stress after discharge. Which suggestions does the nurse give the mother to keep the baby safe? (Select all that apply.) a) Keep the baby wrapped in a warm blanket. b) Position the baby away from vents and drafts. c) Perform the daily bath in a warm location. d) Place a stocking cap on the neonate's head. e) Change wet clothing immediately.

a) Keep the baby wrapped in a warm blanket. b) Position the baby away from vents and drafts. d) Place a stocking cap on the neonate's head. e) Change wet clothing immediately.

A multiparous patient reports severe uterine cramps the first day after a vaginal delivery. The nurse is aware the patient is breastfeeding and associates the patient's pain primarily with which occurrence? (Think Physiologically) a) The presence of intense afterbirth pains related to first time pregnancy b) An increase in oxytocin release related to the newborn suckling c) The efforts of the uterus to resist staying tone d) An expected response to the daily administration of oxytocin

b) An increase in oxytocin release related to the newborn suckling

The nurse is assessing a newborn's reflexes. Which response will cause the nurse concern? a) Strong Babinski reflex b) Asymmetrical Moro reflex c) A fencing position when the head is turned d) Absence of rooting or sucking reflexes

b) Asymmetrical Moro reflex

What should the nurse's first action be when postpartum hemorrhage from uterine atony is suspected? a) Ask the patient to void and reassess fundal tone and location. b) Begin massaging the fundus while another person notifies the physician. c) Teach the patient how to massage the abdomen and then get help. d) Start IV fluids to prevent hypovolemia and then notify the registered nurse.

b) Begin massaging the fundus while another person notifies the physician.

A woman is 9 weeks pregnant and experiencing heavy bleeding and cramping. She reports passing some tissue. Cervical dilation is noted on examination. What is the most likely cause of these symptoms? a) Incomplete abortion b) Complete abortion c) Inevitable abortion d) Missed abortion

a) Incomplete abortion

The nurse is explaining telemetry to the patient, who has just begun active labor. The patient would like to have a labor in which she is mobile, able to change positions, and use hydrotherapy. Which response by the nurse is most appropriate? a) "We can start using telemetry now, and if there are no problems with the signal, we can continue it throughout your labor until delivery." b) "Telemetry is used mostly for women who are laboring in bed and changing positions every half hour or so." c) "The nurses will need to come in and check your telemetry reading every half hour." d) "Unfortunately, you will not be able to use the shower while using telemetry."

a) "We can start using telemetry now, and if there are no

A woman's prepregnant weight is determined to be average for her height. What will the nurse advise the woman regarding recommended weight gain during pregnancy? a) 25 to 35 pounds b) 15 to 25 pounds c) 28 to 40 pounds d) 10 to 20 pounds

a) 25 to 35 pounds

A postpartum patient calls the OB office 8 days following a vaginal delivery. The patient reports concern regarding vaginal bleeding. Which patient-reported symptom causes the nurse concern? a) A description of the lochia as being red in color b) Discharge that is noted to have a fleshy odor c) Increased flow noticed with physical activity d) Bleeding that is described as scant

a) A description of the lochia as being red in color

What drug will the nurse plan to have available for immediate IV administration whenever magnesium sulfate is administered to a maternity patient? a) Calcium gluconate b) Ergonovine maleate (Ergotrate) c) Oxytocin d) Hydralazine (Apresoline)

a) Calcium gluconate

During the fourth stage of labor, which actions by the nurse will promote parent-newborn attachment? Select all that apply. a) Delay administration of eye ointment until parents have held newborn. b) Explain expected neonatal characteristics such as molding, milia, and lanugo. c) Initiate skin-to-skin contact with a warm blanket over the neonate and parent. d) Stay close with the couple and the neonate in case of an emergency. e) Space out necessary assessments to prevent prolonged interruptions.

a) Delay administration of eye ointment until parents have held newborn. b) Explain expected neonatal characteristics such as molding, milia, and lanugo. c) Initiate skin-to-skin contact with a warm blanket over the neonate and parent.

The nurse is providing support for the parents of a neonate born with anencephaly. The parents repeatedly state, "I don't believe this is happening to us. We were so careful during pregnancy." The nurse associates the parents' comments with which stage of grief? a) Denial b) Bargaining c) Anger with each other d) Depression

a) Denial

An internal fetal monitor (Scalp Electrode) has been ordered for Chrissy, a 24-year-old G2P0010 at 38 weeks and 1 day gestation. Her medical history is significant for a history of pregnancy-induced hypertension. Her laboratory values are as follows: H/H 11/30, O negative, RPR negative, GBS positive. Based on Chrissy's history and presentation, what action should the nurse take next? a) Discuss with the health care provider that Chrissy is GBS positive and therefore should not receive an internal monitor. b) Discuss with the health care provider the fact that Chrissy's blood type is O negative and she should therefore receive Rhogam before insertion of an internal monitor. c) Prepare Chrissy for the placement of an internal monitor. d) Take the required two blood pressure readings every 15 minutes prior to insertion of the internal fetal monitor due to her pregnancy-induced hypertension.

a) Discuss with the health care provider that Chrissy is GBS positive and therefore should not receive an internal monitor.

The nurse educator is in a childbirth education class discussing nonpharmacological ways nurses can assist to enhance labor and spontaneous vaginal delivery. Which of the following facts regarding nonpharmacologic approaches will the nurse use to help illustrate its benefits? a) Effleurage is performed in rhythm with breathing during a contraction. b) Walking decreases contractions. c) Using orange or lemon aromatherapy oils will help promote relaxation. d) The client can achieve self-hypnosis with a lot of distractions such as many family members present.

a) Effleurage is performed in rhythm with breathing during a contraction.

A woman tells the nurse that she is quite sure she is pregnant. The nurse recognizes which as a positive sign of pregnancy? a) Fetal heartbeat b) HCG detected in the urine c) Uterine enlargement d) Amenorrhea

a) Fetal heartbeat

The nurse is providing care for a neonate born to a mother with preexisting diabetes mellitus. Which neonatal assessment findings do the nurse expect? Select all that apply. a) Hypocalcemia b) Dyspnea c) Jaundice d) Hyperglycemia e) Macrosomia

a) Hypocalcemia c) Jaundice e) Macrosomia

The nurse is providing support to a mother whose newborn is diagnosed with a life-threatening defect. The mother states, "I just want to go home and never come back." Which reaction by the mother does the nurse recognize? a) Maternal emotional distancing b) Disruption of family life c) Delay of attachment process d) Guilty feelings by the mother

a) Maternal emotional distancing

The labor and delivery nurse understands that some neonates spontaneously take a breath once the head and chest is delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe? a) Mild hypoxia and decreased pH stimulates the brain. b) Oxygen is applied immediately to start respirations. c) Carbon dioxide is administered in small doses. d) Suctioning is used to stimulate breathing efforts.

a) Mild hypoxia and decreased pH stimulates the brain.

The nurse is preparing a talk with new parents about immunity and their newborns. Which factual information will the nurse present? Select all that apply. a) Natural passive immunity protects the baby for a few months after birth. b) Antigens are produced as part of natural immunity. c) A vaccination is an example of acquired immunity. d) Gamma globulin is an example of artificial active immunity. e) Placental transfer is how newborns get natural passive immunity.

a) Natural passive immunity protects the baby for a few months after birth. c) A vaccination is an example of acquired immunity. e) Placental transfer is how newborns get natural passive immunity.

The nursing preceptor asks the nursing student how to best determine the intensity of contractions before placing the patient on an electronic fetal monitoring system. How would the nurse assess this? a) Palpate the maternal abdomen during a contraction. b) Time the amount of time in between the ending of one contraction and the beginning of another. c) Palpate the maternal abdomen right after a contraction has ended. d) Monitor the patients' vocalizations and facial expressions.

a) Palpate the maternal abdomen during a contraction.

The labor and delivery nurse is present for the delivery of a premature neonate. Which action by the nurse is MOST important? a) Provide a neutral temperature environment. b) Maintain fluid and electrolyte balance. c) Review pregnancy history for risk factors. d) Stabilize and transfer neonate to NICU.

a) Provide a neutral temperature environment.

The patient who is 28 weeks pregnant shows a 10-pound weight gain from 2 weeks ago. What is the nurse's initial action? a) Take the blood pressure. b) Weigh the patient again. c) Assess food intake. d) Notify the physician.

a) Take the blood pressure.

The nurse is assisting the primary care provider with a vacuum-assisted delivery because of a prolonged second stage of labor. The nurse will inform the primary care provider when which guideline of the procedure is met? a) The "three-pull rule" has been achieved. b) Extension of the episiotomy is performed. c) Signs of fetal compromise have resolved. d) Patient is under full anesthesia status.

a) The "three-pull rule" has been achieved.

The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply. a) The father exhibited depression during the pregnancy. b) The birth of this fourth child was unexpected and unplanned. c) The father spends more time than usual at work. d) The mother experienced an uneventful labor and delivery.

a) The father exhibited depression during the pregnancy. b) The birth of this fourth child was unexpected and unplanned. c) The father spends more time than usual at work.

The nurse is providing care for a patient who is admitted for cervical ripening. The health care provider has prescribed the use of a hygroscopic dilator (Laminaria). Which conclusion is the nurse likely to draw from the prescribed method of cervical ripening? a) The method may be used for a fetal demise. b) This patient is being treated for active herpes. c) This method is quicker than using oxytocin. d) The patient has a history of a horizontal cesarean childbirth.

a) The method may be used for a fetal demise.

Stage two labor is defined as? a) Delivery of placenta and is completed 4 hours later. b) Onset of labor and ends with complete cervical dilation. c) Complete cervical dilation and ends with delivery of baby. d) Delivery of baby and ends with delivery of placenta.

c) Complete cervical dilation and ends with delivery of baby.

The nurse is providing care for a primip (never been pregnant before this one) patient in active labor. Cervical dilation has progressed 0.5 cm in 2 hours. Intrauterine pressure catheter reading is 20 mm Hg. Which action does the nurse anticipate next? a) Preparation for a cesarean delivery due to signs of fetal distress b) Augmentation of labor with oxytocin per health care provider's order c) Medicating the patient with pain medication to promote uterine rest d) Rupture of uterine membranes by the nurse

b) Augmentation of labor with oxytocin per health care provider's order

The nurse is caring for a 24-year-old woman who is G1P0 at 40 weeks, 1 day gestation and in active labor. She has just received an epidural and now complains of "an itchy feeling all over." Her vitals are as follows: HR 120, RR 12, BP 130/74, T 98.8, and O2 sat 98% on room air. Which action should the nurse take first? a) Call the anesthesiologist regarding the patient's oxygen saturation level. b) Call the health care provider regarding the patient's pruritus to order an antipruritic medication. c) Activate emergency response due to the patient's pruritus and tachycardia postepidural placement. d) Take no further action regarding the patient's complaints, as they are normal after epidural placement.

b) Call the health care provider regarding the patient's pruritus to order an antipruritic medication.

During an ultrasound, two amnions and two placentas are observed. What will be the most likely result of this pregnancy? a) Conjoined twins b) Dizygotic twins c) High-birth weight twins d) Monozygotic twins

b) Dizygotic twins

A woman reports that her last normal menstrual period began on August 5, 2013. What is this woman's expected delivery date using Nägele's rule? a) May 26, 2014 b) May 12, 2014 c) April 30, 2014 d) May 5, 2014

b) May 12, 2014

The nurse is concerned about the number of infants in the community who die from SIDS even with teaching about "back to sleep" being provided. On which additional preventive measures will the nurse focus? Select all that apply. a) Parents need to avoid products that claim to reduce the risk of SIDS. b) Mothers need to be informed that breastfeeding reduces the risk for SIDS. c) Parents should not smoke or allow smoking around their baby. d) Infants need to be dressed to prevent infants from overheating during sleep. e) During pregnancy, women should not smoke, drink alcohol, or use illegal drugs.

b) Mothers need to be informed that breastfeeding reduces the risk for SIDS. c) Parents should not smoke or allow smoking around their baby. e) During pregnancy, women should not smoke, drink alcohol, or use illegal drugs.

The nurse is providing care for a patient in the second stage of labor (pushing stage). After more than 4 hours of pushing, the nurse suspects fetal dystocia. Which is the GREATEST risk to the fetus related to the nurse's suspected complication? a) Increased consideration for a cesarean delivery b) Neonatal asphyxia related to prolonged labor c) Greater risk for maternal lacerations d) Fetal injury confirmed by the presence of bruising

b) Neonatal asphyxia related to prolonged labor

The nurse is looking at an EFM (external monitoring) strip and sees that the patient in active labor is having contractions that are every 10 minutes with mild intensity for the past 2 hours and the fetus is in fetal distress. What would this indicate for next steps? a) The patients' contractions are adequate, so the main focus should be on resuscitating the fetus with maternal oxygen and maternal position change. b) The patients' contractions are inadequate; the provider could consider an amnioinfusion through the IUPC, and once the fetus has improved, contractions need to be augmented to be more effective. c) The patients' contractions are inadequate; the provider could consider augmenting with Pitocin to be more effective. d) The patients' contractions are adequate, so the main focus should be on determining her progress through cervical change.

b) The patients' contractions are inadequate; the provider could consider an amnioinfusion through the IUPC, and once the fetus has improved, contractions need to be augmented to be more effective.

When assessing the patient's cervical dilatation, which factors are included in the exam? (select all that apply) a) Crowning-how far the head is presented outside of the birthing canal b) AROM- detection of amniotic fluid c) Cervix dilation from 0-10 d) Station- level the head is at in relation to the ischial spines e) Effacement- thickness of the cervix from 0-100%

c) Cervix dilation from 0-10 d) Station- level the head is at in relation to the ischial spines e) Effacement- thickness of the cervix from 0-100%

A new mother expresses severe frustration with an infant that is exhibiting symptoms of colic. Which suggestions from the nurse are aimed at infant safety? Select all that apply. a) Hold the infant and sway from side to side or walk around with the infant. b) Place the infant (abdomen down) over the knees and gently rub or pat the back. c) Do simple household chores, such as vacuuming or washing the dishes. d) Place the baby in a safe place and allow the baby to cry for 10 to 15 minutes. e) Place the infant in a car seat and take him or her for a ride in the car.

c) Do simple household chores, such as vacuuming or washing the dishes. d) Place the baby in a safe place and allow the baby to cry for 10 to 15 minutes.

The nurse is teaching a prenatal class. For which reason does the nurse emphasize the importance of managing maternal fear during labor? a) Mothers enjoy the birth. b) Fear during labor causes postpartum depression. c) Dystocia is associated with extreme fear. d) Fear promotes feelings of exhilaration.

c) Dystocia is associated with extreme fear.

The nurse in a postpartum unit frequently teaches patients regarding breast care. Which teaching is most helpful to the breastfeeding patient who is experiencing primary engorgement? a) Wear a supportive bra for 24 hours a day. b) Take analgesics for breast pain management. c) Express milk by a breast pump or manually. d) Run warm water over breasts while in the shower.

c) Express milk by a breast pump or manually.

After a prolonged labor, a woman vaginally delivered a 10-pound, 3-ounce infant boy. What complication should the nurse be alert for in the immediate postpartum period? a) Metritis b) Breast infection c) Hematoma d) UTI

c) Hematoma

A pregnant patient tells the nurse that she has been nauseated and vomiting. How will the nurse explain that hyperemesis gravidarum is distinguished from morning sickness? a) The woman with hyperemesis gravidarum will have persistent vomiting without weight loss. b) Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum. c) Hyperemesis gravidarum causes dehydration and electrolyte imbalances. d) Hyperemesis gravidarum usually lasts for the duration of the pregnancy.

c) Hyperemesis gravidarum causes dehydration and electrolyte imbalances.

A pregnant woman states, "My husband hopes I will give him a boy because we have three girls." What will the nurse explain to this woman? a) When the pH of the female reproductive tract is acidic, the child will be a girl. b) When the sperm and ovum are united, there is a 75% chance the child will be a girl. c) If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced. d) The sex chromosome of the fertilized ovum determines the gender of the child.

c) If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced.

What is the most common site for fertilization? a) Area of the fallopian tube farthest from the ovary b) Upper portion of the uterus c) Outer third of the fallopian tube near the ovary d) Lower segment of the uterus

c) Outer third of the fallopian tube near the ovary

The nurse is caring for a pregnant woman diagnosed with preeclampsia. What will the nurse explain is the objective of magnesium sulfate therapy for this patient? a) To act as a saline cathartic b) To increase reflex irritability c) To prevent convulsions d) To promote diaphoresis

c) To prevent convulsions

The nurse is palpating a patient's uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis? a) To prevent uterine movement b) To prevent uterine hemorrhage c) To prevent uterine inversion d) To prevent uterine prolapse.

c) To prevent uterine inversion

A patient delivers a term neonate and expresses concern about the reason for giving the neonate an injection. Which information from the nurse is accurate? a) Breastfeeding is an excellent source of vitamin K. b) Mothers are unable to supply vitamin K to the fetus. c) Vitamin K is needed to activate clotting factors. d) Neonates will hemorrhage without vitamin K.

c) Vitamin K is needed to activate clotting factors.

The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. The patient is suffering from postpartum hemorrhage in which she has already received two doses of oxytocin. Which medical prescription does the nurse anticipate for this patient? a) Magnesium sulfate b) Methylergonovine (Methergine) c) Fresh frozen plasma d) Carboprost-tromethamine (Hemabate)

d) Carboprost-tromethamine (Hemabate)

The obstetric nurse is managing her laboring patients while covering for another nurse who is on a break. Which patient is the LOWEST priority? a) A patient with an epidural in place b) A patient with a previous cesarean section c) A patient with decreased fetal activity d) A patient with Category I FHR tracings

d) A patient with Category I FHR tracings

The nurse in NICU is assessing a neonate delivered at 32 weeks gestation. Which pathophysiological manifestation is the nurse's greatest concern? a) Low hemoglobin lab level b) Absent or weak reflexes c) Presence of a heart murmur d) Apnea 20 seconds or longer

d) Apnea 20 seconds or longer

The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action does the nurse perform prior to assessing the patient's uterus? a) Assess the passage of lochia. b) Place the patient on the left side. c) Administer a dose of oxytocin. d) Ask the patient to void.

d) Ask the patient to void.

When the nurse tells a pregnant woman that she needs 1200 mg of calcium daily during pregnancy, the woman responds, "I don't like milk." What dietary adjustments could the nurse recommend? a) Include molasses and whole-grain breads in the diet. b) Choose more fresh fruits, particularly citrus fruits. c) Increase intake of organ meats. d) Eat more green leafy vegetables.

d) Eat more green leafy vegetables.

The nurse is reviewing the chart of a 35-year-old G4P2012 woman. The patient is at 38 weeks, 4 days and is in active labor with SROM (spontaneous rupture of membranes) 2 hours ago, with clear fluid. What action should the nurse take? a) Have the patient rate her pain on a scale from 1-10 roughly every hour. b) Monitor the patient's blood pressure, temperature, and respirations every 3 hours. c) Monitor the fetal heart tones every 2 hours. d) Help the patient change her position from side to side every 30 minutes.

d) Help the patient change her position from side to side every 30 minutes.

The nurse is providing education about postpartum depression. How does the nurse differentiate baby blues from postpartum depression? a) Postpartum depression is less severe than baby blues. b) Postpartum depression usually happens after discharge where a patient has more bad days than good. c) Baby blues usually requires medication. d) They are essentially the same thing.

b) Postpartum depression usually happens after discharge where a patient has more bad days than good.

A patient who is at 41 weeks gestation is concerned when the primary care provider decides to induce labor. Which reason does the nurse explain as the most important need for this procedure? a) Ability to deliver vaginally b) Risk for placental dysfunction c) Likelihood of meconium aspiration d) Increasing size of the neonate

b) Risk for placental dysfunction

The nurse is providing care for a neonate during the fourth stage of labor. Which action does the nurse take during this stage? a) Obtain neonate blood glucose levels. b) Dry the neonate immediately. c) Compete neonate assessment within 1 hour. d) Perform Apgar screening until scores are 7.

b) Dry the neonate immediately.

When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent? a) Mental retardation b) Premature birth c) Neural tube defects d) Congenital heart defects

c) Neural tube defects

A woman asks the nurse, "How do oral contraceptives prevent pregnancy?" What will the nurse explain about the combination of estrogen and progesterone in oral contraceptives? a) Prohibits implantation of the egg b) Makes cervical mucus hostile to sperm c) Acts as a barrier by destroying sperm d) Prevents ovulation

d) Prevents ovulation