OB EAQ 2

The nurse is caring for a client who has had a spontaneous abortion. Which complication should the nurse assess this client for? 1. Hemorrhage 2. Dehydration 3. Hypertension 4. Subinvolution

1. Hemorrhage

A client 36 weeks gestation has a blood pressure of 140/90. Which additional sign of preeclampsia would the nurse assess for? Urine dipstick positive for protein Mild ankle edema Episodes of dizziness on arising Weight gain of 2lb in 2 weeks

Urine dipstick positive for protein

Women, who become pregnant for the first time at later reproductive age (35 years of age or older) are at risk for what complications? Select all answers that apply .A seizures B. Multiple gestations C. Development of seizures D. Chromosomal abnormalities E. Bleeding in the first trimester

.A Preterm labour B. Multiple gestation D. Chromosomal abnormalities E. Bleeding in first trimester

After treatment of a bladder infection, a client asks whether there is anything she can do to prevent cystitis in the future. Which response would the nurse give? Avoid regular use of tampons Decrease your intake of prune juice Increase your daily fluid consumption Cleanse the perineum from back to front

Increase your daily fluid consumption

Which intervention would the nurse recommend to relieve symptoms of a yeast infection? Using a sitz bath Sleeping in tight leggings Sitting in a warm bubble bath using tampons if she is on her period

Using a sitz bath

During an assessment interview the nurse concludes that the client has been experiencing menorrhagia. Which client statement led to this conclusion? "It hurts when I have intercourse." "I have a foul-smelling vaginal discharge." "I have bleeding between my menstrual periods." "I have severe bleeding during my menstrual periods."

"I have severe bleeding during my menstrual periods."

A pregnant client is admitted with abdominal pain and heavy vaginal bleeding. What is the priority nursing action? Administering oxygen Elevating the head of the bed Drawing blood for a hematocrit level Giving an intramuscular analgesic

Administering oxygen

Which Complication is the result of type 1 diabetes in a pregnant client? A)Increased risk of hypertensive states B) Abnormal placental implantation C) Excessive weight gain because of increased appetite D) Decreased amount of amniotic fluid as the pregnancy progresses

A)Increased risk of hypertensive states

During a client's labor, the fetal monitor reveals a fetal heart pattern that signifies uteroplacental insufficiency. What is the nurse's first intervention? Inserting a urinary catheter Administering oxygen by means of nasal cannula Helping the client turn to side-lying position Encouraging the client to pan with her next contraction

Helping the client turn to side-lying position

Which condition is commonly associated with late decelerations of the fetal heart rate? Head Compression Maternal hypothyroidism Uteroplacental insufficiency Umbilical cord compression

Uteroplacental insufficiency

While observing a mother visiting her preterm son in the neonatal intensive care nursery, the nurse notes that she has not yet begun the bonding process. Which statement by the mother supports the nurse's conclusion? "It's such a tiny baby." "Do you think he'll make it?" "Why does he need to be in an incubator? ""My baby looks so much like my husband."

"It's such a tiny baby." By failing to acknowledge the infant as a person, the client indicates that she has not released her fantasy baby and accepted the real baby. Acknowledging the infant by using the word "he" denotes a relationship. Saying that the baby looks like her husband indicates that the mother has incorporated the infant into the family.

The nurse is caring for a group of postpartum clients. Which factor puts a client at increased risk for postpartum hemorrhage? 1 Breastfeeding in the birthing room 2 Receiving a pudendal block for the birth 3 Having a third stage of labor that lasts 10 minutes 4 Giving birth to a baby weighing 9 lb 8 oz

4 Giving birth to a baby weighing 9 lb 8 oz

A nurse is writing a teaching plan about osteoporosis. How should the nurse explain what osteoporosis is? 1It is avascular necrosis. 2It is caused by pathologic fractures. 3It is hyperplasia of osteoblasts.Correct 4It involves a decrease in bone substance.

4It involves a decrease in bone substance.

Which client care activity may the nurse safely delegate to an unlicensed health care worker? Assessing a client's mastectomy incision Assisting a client who is recovering to the bathroom Providing information about side effects Evaluating the effectiveness of an antiemetic

Assisting a client who is recovering to the bathroom

Which Maternal complications are associated with precipitous labor and birth? HTN Hypoglycemia Chilling and Shivering Bleeding and Infection

Bleeding and Infection

A client in labor is admitted to the birthing unit. Assessment reveals that the fetus is in a footling breech presentation. What should the nurse consider about breech presentations when caring for this client? Severe back discomfort will occur Length of labor usually is shortened Cesarean birth probably will be necessary Meconium in the amniotic fluid is a sign of fetal hypoxia

Cesarean birth probably will be necessary

A nurse applies fetal and uterine monitors to the abdomen of a client in active labor. When the client has contractions, the nurse notes a 15 beats/min deceleration of the fetal heart rate below the baseline lasting 15 seconds. What is the next nursing action? Calling the primary health care provider Changing the maternal position Obtaining the maternal bp preparing the environment for an immediate birth

Changing the maternal position

A client 36 weeks gestation presents with severe abdominal pain, heavy vaginal bleeding a drop in blood pressure, and an increased pulse rate. Which complication of pregnancy is this? Hydatidiform mole Vena Cava Syndrome Marginal placenta previa Complete abruptio placentae

Complete abruptio placentae

Several hours after delivery, a new mother expresses ambivalence regarding her infant. How will the nurse promote bonding between this mother and her newborn? Having the mother feed the infant Removing the infant from the mother's arms if it cries Positioning the infant so its head rests on the mother's shoulder Encouraging the mother to sleep for 4 to 6 hours before interacting with the infant

Having the mother feed the infant

Which information about nausea and vomiting in the first trimester would the nurse provide to the pregnant client? It is always present during early pregnancy It will disappear when lighting occurs It is a common response to an unwanted pregnancy Increased Human Chorionic gonadotropin level

Increased Human Chorionic gonadotropin level Human chorionic gonadotropin (hCG)hCG, secreted by the chorionic villi during early pregnancy, frequently causes nausea; as the level of hCG decreases, the nausea usually subsides. Estrogen is not associated with nausea; it makes the reproductive tract receptive to the embryo.

A breast-feeding mother experiences redness and pain in the left breast, a temperature of 100.8° F (38.2° C), chills, and malaise. Which condition does the nurse suspect? Mastitis Engorgement Blocked milk duct Inadequate milk production

Mastitis

The nurse teaches a client who is about to undergo an amniocentesis that ultrasonography will be performed just before the procedure to determine what? Gestational age of the fetus Amount of fluid in the amniotic sac Position of the fetus and the placenta Location of umbilical cord and placenta

Position of the fetus and the placenta

Offspring of med of advanced paternal age are at in increased risk of which condition? Schizophrenia Cystic Fibrosis Sickle cell anemia Tay Sachs Disease

Schizophrenia

A pregnant client tells the nurse that she has two toddlers at home and that their father abandoned the family last month and she doesn't know what to do. Which conclusion would the nurse make about the client's emotional state? She is angry that the father left She feels overwhelmed She is expressing ambivalence She is denying the reality

She feels overwhelmed

A client is being initiated on bisphosphonates. Which advice will the nurse provide? Take it on an empty stomach This medication should be taken at night before bed These medications should be taken with food or milk Lie down for a bit after taking this medication

Take it on an empty stomach

A client has just given birth to an infant with down syndrome. The mother is crying and asks the nurse what she is supposed to do now. Which response would the nurse give? Tell me what you know about down syndrome I would just continue to rest and recover from your delivery You really need to pull yourself together Should I call in a chaplain or social worker

Tell me what you know about down syndrome

Cramping and vaginal spotting occurring at 12 weeks gestation is conjunction with a closed cervix is characteristic of which problem? Missed abortion Inevitable abortion Incomplete abortion Threatened abortion

Threatened abortion

After an incomplete abortion, a client asks the nurse to tell her again what is meant by an incomplete abortion. which response by the nurse is appropriate? I don't think you should focus on this anymore Its when the fetus dies but is retained in the uterus for at least 2 months Its when the fetus is expelled but other parts of the pregnancy remain in the uterus I think its best for you to ask your doctor

Its when the fetus is expelled but other parts of the pregnancy remain in the uterus

Which information would the nurse give a pregnant client about having a chorionic villus sampling (CVS) before the 10th and 12th weeks? The test can cause fetal anomalies. The results are not as accurate The Information it provides is inadequate It must be done with the use of laparoscopic surgery

The test can cause fetal anomalies. If performed before 9 weeks gestation, it has the potential of interfering with organogenesis.

Which sexually transmitted infection is caused by protozoa? Scabies Chancroid Pediculosis Trichomoniasis

Trichomoniasis

Which is a risk factor associated with IVF-ET? Embryonic Human immunodeficiency virus Tubal Pregnancy Congenital anomalies Hyperemesis gravidarum

Tubal Pregnancy

Between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?a.10th and 12th weeks of gestation b. 18th and 22nd weeks of gestation c. 24th and 28th weeks of gestation d. 36th and 40th weeks of gestation

c. At the end of the second trimester and the beginning of the third trimester, insulin needs increase because of an increase in maternal resistance to insulin. During the earlier part of pregnancy, fetal demands for maternal glucose may cause a tendency toward hypoglycemia. During the last weeks of pregnancy, maternal resistance to insulin decreases, and insulin needs decrease accordingly.

primigravida at 32 weeks' gestation is admitted to the high-risk unit. Her blood pressure is 170/110 mm Hg and she has 4+ proteinuria. She has gained 50 lb (22.7 kg) during the pregnancy, and her face and extremities are edematous. Which complication is this client experiencing? EclampsiaSevere preeclampsia Chronic hypertension Gestational hypertension

preeclampsia

Which time during the menstrual cycle would the nurse stress as the optimal time to achieve pregnancy? Midway between periods Immediately after a period ends 14 days before the next period is expected 14 days after the beginning of last period

14 days before the next period is expected.

A client at the fertility clinic is being treated for hypertension and obesity with a regimen of diet and exercise. During the past month, she has lost 8 lb (3.6 kg) and her blood pressure has decreased to 154/98 mm Hg. The client states that she is using self-control strategies to reduce her blood pressure and weight. What is the nurse's most therapeutic response? 1 Explaining to the client that her current program needs revision to improve results 2 Acknowledging the client's achievement while encouraging continuation of her current program 3 Emphasizing to the client the importance of exercise in addition to reduction of sodium and caloric intake 4 Recommending that the client ask her practitioner about a prescription for an antihypertensive or a diuretic

2 Acknowledging the client's achievement while encouraging continuation of her current program

A nurse in the postpartum unit must complete several interventions before a client's discharge from the hospital. The nurse plans to delegate some of the tasks to an unlicensed health care worker. Which activity must be performed by the nurse? 1 Taking the neonate's picture 2 Placing the infant car seat in the car 3 Comparing the identification bands of mother and infant 4 Preparing the discharge packet and distributing them to parents

3 Comparing the identification bands of mother and infant

When working with a client who has spontaneously aborted a pregnancy, it is important for the nurse to first deal with his or her own feelings about abortion, death, and loss so that he or she may : 1. Maintain control of the situation 2. Share personal grief with the clients 3. Allow the clients to express their grief 4. Teach the clients how to cope effectively

3. Allow the clients to express their grief

What is the priority nursing intervention during the admission of a primigravida in labor? A) Monitoring the fetal heart rate B) Asking the client when she ate last C) Obtaining the client's health history D) Determining whether the membranes have ruptured

A) Monitoring the fetal heart rate

The nurse admits a client with preeclampsia to the high-risk prenatal unit. What is the next nursing action after the vital signs have been obtained? Calling the primary healthcare provider Checking the client's reflexes Determining the client's blood type Administering the prescribed intravenous (IV) normal saline

Checking the client's reflexes

A client who has undergone a cesarean birth because of the presence of active genital herpes is transferred to the postpartum unit. What type of isolation precautions does the nurse plan to institute? Enteric Droplet Contact Airborne

Contact

What preexisting condition is the most likely reason for the cesarean birth? A. Gonorrhea B. Chlamydia C. Chronic hepatitis D. Active genital herpes

D. Active genital herpes

Which assessment would the nurse include in the plan of care for a postpartum client with large, painful varicose veins? A. Monitoring daily clotting times B. Assessing for peripheral pulses C. Monitoring daily hemoglobin values D. Assessing for signs of thrombophlebitis

D. Assessing for signs of thrombophlebitis

The nurse is caring for a client who is admitted to the birthing unit with a diagnosis of abruptio placentae. Which complication associated with a placental abruption should the nurse carefully monitor this client for? A. Cerebral hemorrhage B. Pulmonary edema C. Impending seizures D. Hypovolemic shock

D. Hypovolemic shock

The nurse is caring for four postpartum clients, each with a different medical condition. Which condition will result in the primary health care provider advising the new mother not to breastfeed? Mastitis Inverted Nipples Herpes HIV

HIV

The nurse in the birthing unit is caring for several postpartum clients. Which factor will increase the risk for hypotonic uterine dystocia? Twin gestation Gestational anemia Hypertonic contractions Gestational hypertension

Twin gestation multiple gestation thins the uterine wall by overstretching it; therefore the efficiency of contractions is reduced. Gestational anemia is physiologic anemia that is benign; although anemia may cause fatigue during labor, it does not affect uterine contractility. Hypertonic contractions will cause increased discomfort, fatigue, dehydration, and increased emotional distress, not hypotonic uterine dystocia. Therapeutic interventions include rest and sedation. Gestational hypertension may trigger preterm labor; it does not cause hypotonic uterine dysfunction.

A 16-year-old high school student is referred to a community health center by a local hotline because of the fear of having contracted herpes. The teenager is upset and shares this information with the community health center nurse. What should the nurse's initial response be? a. "Let me get a brief health history now." b. "Try not to worry until you know whether you have herpes." c. "You sound worried. Let me make arrangements to have you examined." d. "Herpes has received too much attention in the media; let's be realistic."

c. "You sound worried. Let me make arrangements to have you examined." Telling the client that she sounds worried and offering to arrange an examination immediately identifies the client's fear as real and offers a service to meet the need for information about the client's physical status. Obtaining the health history ignores the client's concern and focuses on the nurse's need to complete the task of obtaining a history. Telling the client not to worry minimizes the client's concern about having a sexually transmitted infection. Saying that herpes has received too much attention in the media minimizes the client's concern and implies that the client is being unrealistic.

A client is visiting the prenatal clinic for the first time. While giving the nursing history the client states that her last menstrual period started on June 10. What is her expected date of birth (EDB), according to Nägele's rule? a. March 3 b. March 10 c. March 17 d. March 24

c. March 17 The date is March 17 of the following year. Using Nägele's rule, subtract 3 months from the first day of the last menstrual period and add 7 days. March 3 and March 10 are too early. March 24 is too late.

a client at 37 weeks' gestation experiences a sudden sharp pain in her abdomen with a period of fetal hyperactivity. When the client arrives at the prenatal clinic, the nurse examines her and detects fundal tenderness and a small amount of dark-red bleeding. What does the nurse conclude is the probable cause of these clinical manifestations? a. true labor b. Placenta previa c. Partial abruptio placentae d. Abdominal muscular injury

c. Partial abruptio placentae

A 24-year-old client is admitted at 40 weeks' gestation. The cervix is dilated 5 cm and is 100% effaced, and the presenting part is at station 0. The nurse assesses that the fetal heart tones are just above the umbilicus. Which fetal presentation does the nurse document? A. Face B. Brow C. Breech D. Shoulder

C. Breech In the breech presentation, the fetal head is in the fundal portion of the uterus; the chest or back is at or above the umbilicus, where fetal heart tones can be heard. In the vertex presentation the head is the presenting part; the chest and back are in lower quadrants, where the fetal heart is heard. The brow presentation is a type of cephalic presentation in which the fetal head is partially extended; the fetal heart is heard in the lower abdomen, not above the umbilicus. In the shoulder presentation the fetal heart usually is heard in the midabdominal region.