OB EAQ's Chapter 10, 11, 12, 13, 14, 15, 16, 17

Fetal monitoring of a pregnant patient revealed a regular smooth, undulating wavelike pattern of the fetal heart rate (FHR). What should the nurse infer about the fetus from these results? 1 Anemia 2 Ischemia 3 Hypertension 4 Hypotension

Anemia

Which pelvic shape is most conducive to vaginal labor and birth? 1 Android 2 Gynecoid 3 Platypelloid 4 Anthropoid

Gynecoid

The nurse assisting a laboring patient recognizes the Ferguson reflex in the patient. What is the Ferguson reflex? 1 Release of endogenous oxytocin 2 Involuntary uterine contractions 3 Maternal urge to bear down 4 Mechanical stretching of the cervix

Maternal urge to bear down

What does the nurse tell a patient with gestational diabetes about the prescribed nonstress test (NST)? 1 "The test is used to evaluate the fetus's well-being." 2 "The test is used to evaluate the weight of your fetus." 3 "The test is used to evaluate fetal cardiac anomalies." 4 "The test is used to evaluate defects in the neural tube."

"The test is used to evaluate the fetus's well-being."

Which statement made by the nursing student about the management of reduced cervical competence (premature dilation of the cervix) in a pregnant patient indicates effective learning? 1 "Progesterone supplementation is the only effective treatment." 2 "An abdominal cerclage is performed at the first week of gestation." 3 "Surgical treatment is ineffective in patients with an extremely short cervix." 4 "A prophylactic cerclage is used to constrict the internal os of the cervix."

"A prophylactic cerclage is used to constrict the internal os of the cervix.

In planning for an expected cesarean birth for a patient who has given birth by cesarean previously and who has a fetus in the transverse presentation, which information should the nurse include? 1 "Because this is a repeat procedure, you are at the lowest risk for complications." 2 "Although this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures." 3 "Because this is your second cesarean birth, you will recover faster." 4 "You will not need preoperative teaching because this is your second cesarean birth."

"Although this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures.

The nurse assesses a pregnant patient and finds that the patient has reduced strength of uterine contractions (UCs). Upon further assessment, the nurse suspects that the patient may have slow progress in labor. Which statement made by the patient indicates the reason for slow progress in labor? 1 "I have a family history of diabetes and hypertension." 2 "I stopped taking folic acid supplements a week ago." 3 "I have been on a diet with high amounts of protein for 15 days." 4

"I am worried a lot this time; I had a lot of problems in my last labor."

After being rehydrated in the emergency department, a 24-year-old primipara in her 18th week of pregnancy is at home and is to rest at home for the next 2 days and take in small but frequent fluids and food as possible. Discharge teaching at the hospital by the nurse has been effective if the patient makes which statement? 1 "I'm going to eat five to six small servings per day, which contain such foods and fluids as tea, crackers, or a few bites of baked potato." 2 "A strip of bacon and a fried egg will really taste good as long as I eat them slowly." 3 "As long as I eat small amounts and allow enough time for digestion, I can eat almost anything, like barbequed chicken or spaghetti." 4 "I'm going to stay only on clear fluids for the next 24 hours and then add dairy products like eggs and milk."

"I'm going to eat five to six small servings per day, which contain such foods and fluids as tea, crackers, or a few bites of baked potato."

A pregnant patient does not allow her partner to touch her and wants to be left alone. What can the nurse suggest to the patient's partner in this situation? 1 "It is due to depression and loneliness." 2 "It is a common behavior during pregnancy." 3 "Massage would help to make your partner relax." 4 "You should leave your partner alone for few days."

"It is a common behavior during pregnancy."

A 24-year-old primipara, 10 weeks pregnant, who has been experiencing vomiting every morning for the past few weeks, asks the nurse at her check-up how long this "morning sickness" will continue. Which statement by the nurse is most accurate? 1 "It will end by the 15th week of pregnancy." 2 "It usually subsides by the 20th week of pregnancy." 3 "It's a very common but not serious problem." 4 "In some women, it can last throughout the pregnancy and become serious."

"It usually subsides by the 20th week of pregnancy."

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. What is the nurse's best response? 1 "Don't worry about it. You'll do fine." 2 "It's normal to be anxious about labor. Let's discuss what makes you afraid." 3 "Labor is scary to think about, but the actual experience isn't." 4 "You may have an epidural. You won't feel anything."

"It's normal to be anxious about labor. Let's discuss what makes you afraid."

The charge nurse instructed a group of student nurses about the monitoring of uterine activity (UA) during labor. Which statement by the student nurse is accurate regarding the calculation of Montevideo units? 1 "They can be calculated using an ultrasound transducer machine." 2 "They can be calculated using a spiral electrode monitoring device." 3 "They can be calculated using a tocotransducer monitoring system." 4 "They can be calculated with an intrauterine pressure catheter (IUPC)."

"They can be calculated with an intrauterine pressure catheter (IUPC)."

The nurse is assessing the fetal heart rate (FHR) by using an ultrasound transducer. The patient asks the nurse, "Why are my baby's heart readings not showing as a continuous pattern?" What would be the nurse's best response? 1 "This is because you may have anxiety." 2 "This is a result of fetal movement." 3 "Perhaps you have a full bladder." 4 "It is because you are lying down now."

"This is a result of fetal movement."

A woman who is at 36 weeks of gestation is having a nonstress test. Which statement by the woman indicates a correct understanding of the test? 1 "I will need to have a full bladder for the test to be done accurately." 2 "I should have my husband drive me home after the test because I may be nauseous." 3 "This test will help to determine if the baby has Down syndrome or a neural tube defect." 4 "This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby."

"This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby."

The nurse is teaching a group of nursing students regarding fetal oxygenation. The nurse questions a student, "What happens when oxytocin levels are elevated in the patient?" What would be the most appropriate answer given by the nursing student related to the patient's condition? 1 "Hemoglobin levels will decrease." 2 "Blood glucose levels will increase." 3 "Placenta lowers the blood supply." 4 "Uterine contractions (UCs) will increase."

"Uterine contractions (UCs) will increase."

A patient who recently had a heart transplant with no evidence of rejection asks the nurse about the safety of conceiving a child. What is the best response by the nurse? 1 "You may conceive 1 year after the transplant." 2 "A heart transplant does not tolerate pregnancy." 3 "The newborn may have congenital heart disease." 4 "You may need to terminate pregnancy at any time."

"You may conceive 1 year after the transplant."

The nurse is caring for a patient in labor who is having an indwelling catheter threaded into the epidural space for the administration of pain medication. What does the nurse tell the patient? 1 "Your body will go numb after 15 seconds." 2 "You may experience a momentary twinge down your hip or back." 3 "Notify someone immediately if you experience any tingling sensations." 4 "There are no medication side effects associated with this route of drug administration."

"You may experience a momentary twinge down your hip or back."

The nurse is documenting the findings of a contraction stress test in a patient. The nurse finds that late decelerations in fetal heart rate occur with 60% of contractions. What does the nurse advise the patient? 1 "Continue with the weekly testing schedule." 2 "Take the test again tomorrow at the same time." 3 "You should take the test again today after resting." 4 "You should be hospitalized and monitored continuously."

"You should be hospitalized and monitored continuously."

What instructions does the nurse give to a patient when preparing to assess the uterine activity using a tocotransducer? 1 "No water can be taken until after the test." 2 "You will sit up at about a 30-degree angle." 3 "Kegel exercises must be done before the test." 4 "Remain still while the test is being performed."

"You will sit up at about a 30-degree angle."

A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The nurse becomes concerned after assessment when the woman exhibits what? 1 A sleepy, sedated affect Correct2 A respiratory rate of 10 breaths/min 3 Deep tendon reflexes of 2+ Incorrect4 Absent ankle clonus

A respiratory rate of 10 breaths/min

During the vaginal examination of a laboring patient, the nurse analyzes that the fetus is in the right occiput anterior (ROA) position at -1 station. What is the position of the lowermost portion of the fetal presenting part? 1 2 cm above the ischial spine 2 1 cm above the ischial spine 3 at the level of the ischial spine 4 1 cm below the ischial spine

1 cm above the ischial spine

The nurse is monitoring the fetal heart rate (FHR) of a patient at 20 weeks of of gestation. What FHR can the nurse expect at this stage? 1 100 beats/min 2 120 beats/min 3 140 beats/min 4 160 beats/min

160 beats/min

What action does the nurse take to relieve choking in a pregnant patient who is in the third trimester? 1 Administering anesthesia 2 Administering chest thrusts 3 Placing a towel under the hips 4 Positioning the patient onto one side

Administering chest thrusts

In caring for the patient with disseminated intravascular coagulation (DIC), what order should the nurse anticipate? 1 Administration of blood 2 Preparation of the patient for invasive hemodynamic monitoring 3 Restriction of intravascular fluids 4 Administration of steroids

Administration of blood

The nurse is caring for a patient in the last trimester of pregnancy. What assessments will the patient display related to the effects of fear and anxiety during labor? 1 An increase in blood flow. 2 An increase in the progression of labor. 3 An increase in contractions. 4 An increase in muscle tension.

An increase in muscle tension.

A labor and delivery nurse is in the process of admitting a patient who is 39 and at 5 weeks of gestation with a diagnosis of preeclampsia. The nurse has evaluated vital signs, weight, and deep tendon reflexes. Although the presence of edema is no longer included in the definition of preeclampsia, it is an important component of the nurse's evaluation. Edema is assessed for distribution, degree and pitting. Although the amount of edema is difficult to quantify, it is important to record the relative degrees of edema formation. From the graphic below, please select the illustration that best displays +3 edema.

3/C

The nurse is caring for a pregnant patient during labor and documents the strength of uterine contractions (UCs) as "mild" after palpating the patient's abdomen. What reading of the intrauterine pressure catheter (IUPC) would be consistent with the strength of the UCs as assessed by the nurse? 1 40 mm Hg 2 60 mm Hg 3 80 mm Hg 4 100 mm Hg

40 mm Hg

A nurse is caring for a woman whose labor is being augmented with oxytocin. The nurse recognizes that the oxytocin should be discontinued immediately if there is evidence of what? 1 Uterine contractions occurring every 8 to 10 minutes 2 A fetal heart rate (FHR) of 180 beats/min with absence of variability 3 The woman needing to void 4 Rupture of the woman's amniotic membranes

A fetal heart rate (FHR) of 180 beats/min with absence of variability

Which patient situation presents the greatest risk for the occurrence of hypotonic dysfunction during labor? 1 A primigravida who is 17 years old 2 A 22-year-old multiparous patient with ruptured membranes 3 A primigravida who has requested no analgesia during her labor 4 A multiparous patient at 39 weeks of gestation who is expecting twins

A multiparous patient at 39 weeks of gestation who is expecting twins

The nurse has performed vibroacoustic stimulation and determines that the fetal heart rate (FHR) has increased by 15 beats/min from the baseline within 15 seconds. Which condition does this acceleration indicate? 1 Mixed acidemia in the fetus Incorrect2 Signs of respiratory acidemia Correct3 A normal pH level in the fetus 4 Elevated Pco2 level in the fetus

A normal pH level in the fetus

Nurses can advise their patients that which of these signs precede labor? Select all that apply. 1 A return of urinary frequency as a result of increased bladder pressure 2 Persistent low backache from relaxed pelvic joints 3 Stronger and more frequent uterine (Braxton Hicks) contractions 4 A decline in energy, as the body stores up for labor 5 Uterus sinks downward and forward in first-time pregnancies.

A return of urinary frequency as a result of increased bladder pressure 2 Persistent low backache from relaxed pelvic joints 3 Stronger and more frequent uterine (Braxton Hicks) contractions Uterus sinks downward and forward in first-time pregnancies.

The nurse reviews the ultrasound reports of a pregnant patient and finds that the images of fetal anatomic details are not clear. The nurse then prepares the patient for a magnetic resonance imaging (MRI) scan. What does the nurse administer to the patient before performing the MRI scan? 1 A diuretic 2 A sedative 3 An analgesic 4 An antipyretic

A sedative

Thalassemia is a relatively common anemia in which what occurs? 1 Folate deficiency occurs. 2 There are inadequate levels of vitamin B12. 3 RBCs have a normal life span but are sickled in shape. 4 An insufficient amount of hemoglobin is produced to fill the red blood cells (RBCs).

An insufficient amount of hemoglobin is produced to fill the red blood cells (RBCs).

A pregnant patient with chronic hypertension is at risk for placental abruption. Which symptoms of abruption does the nurse instruct the patient to be alert for? Select all that apply. 1 Weight loss 2 Abdominal pain 3 Vaginal bleeding 4 Shortness of breath 5 Uterine tenderness

Abdominal pain 3 Vaginal bleeding Uterine tenderness

A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset of what? 1 Eclamptic seizure 2 Rupture of the uterus 3 Placenta previa Correct4 Abruptio placentae

Abruptio placentae

The nurse is assessing a pregnant patient in the last week of gestation. The nurse observes that the patient has flushed cheeks, uterine contractions (UCs) of 65 seconds with a frequency of 4 minutes, and pink to bloody mucus. What stage of labor should the nurse infer that the patient is in based on these observations? 1 Latent phase 2 Active phase 3 Transition phase 4 Active pushing phase

Active phase

A blunt abdominal trauma causes fetal hemorrhage in a pregnant patient. The nurse finds that the patient is Rh negative. What action does the nurse take? 1 Initiate magnesium sulfate per protocol. 2 Administer oxytocin (Pitocin). 3 Administer prescribed Rho(D) immunoglobulin. 4 Prepare the patient for magnetic resonance imaging (MRI).

Administer prescribed Rho(D) immunoglobulin.

A pregnant patient is administered misoprostol (Cytotec) to induce labor. After 8 hours of drug administration, the patient develops diarrhea and vomiting. What does the nurse do to alleviate the symptoms? 1 Administer terbutaline (Brethine). 2 Administer oxytocin (Pitocin) infusion. 3 Give a magnesium-containing antacid. 4 Increase the time between doses.

Administer terbutaline (Brethine).

Which is a priority nursing action when a pregnant patient with severe gestational hypertension is admitted to the health care facility? 1 Prepare the patient for cesarean delivery. 2 Administer intravenous (IV) and oral fluids. Incorrect3 Provide diversionary activities during bed rest. Correct4 Administer the prescribed magnesium sulfate.

Administer the prescribed magnesium sulfate.

During the assessment of a 38-week pregnant patient, the nurse finds that the patient is experiencing false labor. After reviewing the medical history, the nurse finds that the patient had rapid labor during the previous pregnancy. What would be the most suitable nursing action? 1 Admit the patient to a latent labor room immediately. 2 Suggest that the patient rest at home until the labor progresses. 3 Inform the patient that cervical dilation of 5 cm indicates true labor. 4 Suggest that the patient take a cold shower to prevent uterine contractions (UCs).

Admit the patient to a latent labor room immediately.

Which finding in the ultrasonography reports of a pregnant woman would indicate a normal fetus? 1 Amniotic fluid index of 6 cm 2 Amniotic fluid index of 2 cm 3 Amniotic fluid index of 30 cm 4 Amniotic fluid index of 13 cm

Amniotic fluid index of 13

While assessing a pregnant patient using a fetoscope, the nurse also palpates the abdomen of the patient. What is the purpose of palpating the abdomen of the patient? 1 Detection of fetal heart rate (FHR) deceleration 2 Evaluation of the severity of the pain caused by active labor 3 Assessment of pain from pressure applied by the fetoscope 4 Assessment of changes in FHR during and after contraction

Assessment of changes in FHR during and after contraction

What care must the nurse take when implementing aromatherapy for a patient in labor? 1 Apply oil to the skin and massage. 2 Ask the patient to choose the scents. 3 Apply a few drops of oil to the hair. 4 Allow inhalation of warm oil vapors.

Ask the patient to choose the scents.

During the assessment, the nurse palpates the abdomen of a pregnant patient to identify the number of fetuses. Which actions should the nurse perform before conducting the assessment? Select all that apply. 1 Help the patient change positions often. 2 Ask the patient to empty the bladder completely. 3 Place a small rolled towel under the patient's hip. 4 Use running water to stimulate voiding of the patient. 5 Suggest that the patient lie in the supine position with a pillow under her head.

Ask the patient to empty the bladder completely. 3 Place a small rolled towel under the patient's hip. Suggest that the patient lie in the supine position with a pillow under her head.

A pregnant patient reports abdominal pain in the right lower quadrant, along with nausea and vomiting. The patient's urinalysis report shows an absence of any urinary tract infection in the patient. A chest x-ray also rules out lower-lobe pneumonia. Which condition does the nurse suspect in the patient? 1 Appendicitis 2 Cholelithiasis 3 Placenta previa 4 Uterine rupture

Appendicitis

The nurse finds that the amniotic membranes in a pregnant patient who is in labor have ruptured and that the amniotic fluid is meconium-stained. The nurse should infer from the findings that the baby has a high risk of presenting with what? 1 Shoulder dystocia 2 Umbilical cord prolapse 3 Aspiration pneumonia 4 Brachial plexus injury

Aspiration pneumonia

Which is an important nursing intervention for a patient with pregestational diabetes mellitus during the first trimester? 1 Encourage oral fluid intake. 2 Increase the insulin dosage. 3 Assess blood glucose levels. 4 Prevent nausea and vomiting

Assess blood glucose levels.

A patient with severe gestational hypertension is prescribed hydralazine (Apresoline). What is a priority nursing intervention in this case? 1 Assess for visual disturbances. 2 Assess airway, breathing, and pulse. 3 Assess blood pressure frequently. 4 Prepare the patient for nonstress testing.

Assess blood pressure frequently.

While caring for a multiparous patient in the second stage of labor, the patient reports the urge to defecate. What is the best nursing intervention? 1 Provide a bedpan to the patient to defecate. 2 Place an enema in the rectum of the patient. 3 Assess cervical dilation and station of the patient. 4 Use running water to stimulate defection for the patient.

Assess cervical dilation and station of the patient.

The emergency department nurse is assessing a pregnant trauma victim who just arrived at the hospital. What are the nurse's most appropriate actions? Select all that apply. 1 Place the patient in a supine position. 2 Assess for point of maximal impulse at fourth intercostal space. 3 Collect urine for urinalysis and culture. 4 Monitor vital signs frequently. 5 Assist with ambulation to decrease risk of thrombosis.

Assess for point of maximal impulse at fourth intercostal space. 3 Collect urine for urinalysis and culture. 4 Monitor vital signs frequently.

What is a priority nursing action after administering magnesium sulfate to a pregnant patient? 1 Assess the patient's weight. Correct2 Assess serum magnesium level. 3 Restrict fluid intake to 250 mL/hr. 4 Evaluate fetal movement counts hourly.

Assess serum magnesium level.

What intervention does the nurse include while providing care for a pregnant patient with primary pulmonary hypertension (PPH)? 1 Assess the heart valve function. 2 Administer parenteral analgesia. 3 Assess the patient's blood pressure. 4 Place the patient in the supine position.

Assess the patient's blood pressure.

At 37 weeks of gestation, the patient is in a severe automobile crash where her abdomen was hit by the steering wheel and her seat belt. What priority action would the emergency room nurse expect to perform upon the patient's arrival at the hospital? 1 Stay with the patient, assure a patent airway is present, and keep the patient as calm as possible. 2 Move the patient's skirt to determine if any vaginal bleeding is present, find out who to call, and monitor the level of consciousness. 3 Assess the patient's vital signs, determine location and severity of pain, and establish continual fetal heart rate monitoring. 4 Obtain arterial blood gases, obtain a hemoglobin and hematocrit, and oxygen saturation rate.

Assess the patient's vital signs, determine location and severity of pain, and establish continual fetal heart rate monitoring.

The nurse is assisting a pregnant patient who is in labor. The nurse finds that the umbilical cord is protruding out from the vagina. With a gloved hand, the nurse attempts to put the umbilical cord into the vagina. The nurse continues to monitor the fetal heart rate, administers oxygen therapy to the patient, and increases the drip rate of the intravenous (IV) fluid. Which nursing action can lead to fetal and maternal complications? 1 Increasing the drip rate of the IV fluid 2 Monitoring fetal heart rate continuously 3 Administering oxygen therapy to the patient 4 Attempting to place the umbilical cord back

Attempting to place the umbilical cord back

The quantitative human chorionic gonadotropin (β-hCG) levels are high in a patient who is on methotrexate therapy for dissolving abdominal pregnancy. Which instruction does the nurse give to this patient? 1 "Avoid sexual activity." 2 "Avoid next pregnancy." 3 "Avoid feeling sad and low." 4 "Take folic acid without fail."

Avoid sexual activity."

The nurse is instructed to count the fetal heart rate (FHR) for 30 to 60 seconds after each uterine contraction in a pregnant patient via intermittent auscultation. This assessment helps to identify a change in what? 1 Placental flow 2 Fetal position 3 Baseline heart rate 4 Uterine activity

Baseline heart rate

From 4% to 8% of pregnant women have asthma, making it one of the most common preexisting conditions of pregnancy. When does severity of symptoms usually peak? 1 In the first trimester 2 Immediately postpartum 3 Between 17 to 24 weeks of gestation 4 During the last 4 weeks of pregnancy

Between 17 to 24 weeks of gestation

The nurse is caring for a pregnant patient who has been prescribed terbutaline (Brethine) to relax the uterus. Following the assessment, the nurse informs the primary health care provider (PHP) that it is not safe to administer terbutaline (Brethine) to the patient. Which patient condition leads the nurse to such a conclusion? 1 Blood pressure of 80/60 mm Hg 2 Short episode of hyperglycemia 3 Irregular episodes of dysrhythmias 4 Heart rate of less than 120 beats/min

Blood pressure of 80/60 mm Hg

A primigravida asks the nurse about signs she can look for that indicate that the onset of labor is getting closer. What should the nurse describe? 1 Weight gain of 1 to 3 lbs 2 Quickening 3 Fatigue and lethargy Correct4 Bloody show

Bloody show

The nurse is caring for a pregnant patient and suspects that the primary health care provider (PHP) would recommend a cesarean section. What could be the most probable reason for this? 1 Increased maternal pulse rate 2 Body mass index (BMI) is 32 kg/m2 3 Elevated blood glucose levels 4 High basal body temperature

Body mass index (BMI) is 32 kg/m2

The nurse is preparing to perform a fetal fibronectin test for a pregnant patient. Which intervention should the nurse perform to collect the sample for the test? 1 Take a blood sample from the forearm. 2 Take a sample of the patient's amniotic fluid. 3 Ask the patient to provide a urine sample. 4 Collect the vaginal secretions using a swab.

Collect the vaginal secretions using a swab.

The nurse observes that intravenous (IV) administration of magnesium sulfate has resulted in magnesium toxicity in a pregnant patient with preeclampsia. The nurse immediately discontinues the infusion and reports to the primary health care provider (PHP). For which drug does the nurse obtain a prescription from the PHP? 1 Calcium gluconate 2 Nifedipine (Adalat) 3 Hydralazine (Apresoline) 4 Labetalol hydrochloride (Normodyne)

Calcium gluconate

A pregnant patient has been administered magnesium sulfate as prescribed. Following the assessment, the nurse reports to the primary health care provider (PHP) that the patient's respiratory rate is 11 breaths/min. Which medication administration can the nurse expect from the PHP? 1 Dextrose solution intravenously to the patient 2 Calcium gluconate intravenously to the patient 3 Ringer's lactate solution intravenously to the patient 4 Increased doses of magnesium sulfate to the patient

Calcium gluconate intravenously to the patient

The nurse assisting a patient in the second stage of labor asks the patient to avoid the Valsalva maneuver. What is the effect of the Valsalva maneuver? 1 Decreases the cardiac output 2 Decreases blood pressure 3 Causes fetal hypoxia 4 Increases the pulse rate

Causes fetal hypoxia

The nurse acts as an advocate for the patient during an informed consent. What care must the nurse take while obtaining an informed consent? Select all that apply. 1 Check for the patient's signature. 2 Ensure that the consent is in English. 3 Obtain a family member's signature. 4 Check for the date on the consent form. 5 Check the anesthetic care provider's signature.

Check for the date on the consent form. 5 Check the anesthetic care provider's signature. Check for the patient's signature.

A patient has given birth to a baby 1 hour ago. Which intervention should the nurse perform while caring for the patient? 1 Massage the fundus if it is firm to expel any clots. 2 Measure blood pressure every 30 minutes for 2 hours. 3 Check the perineal pads and linen under the patient's buttocks. 4 Access pulse rate and regularity every 30 minutes for 2 hours.

Check the perineal pads and linen under the patient's buttocks.

The nurse is studying the chart of a patient in labor. If the patient's chart indicates "RMA," what is the presenting part? 1 Chin 2 Sacrum 3 Scapula 4 Occiput

Chin " mentum" (middle letter : M: chin/mentum S:sacrum Sc: scapula O: occiput)

While reviewing the ultrasonography reports of a pregnant patient, the nurse finds that there is excessive fluid collection at the nape of the neck of the fetus. Which test will the nurse recommend? 1 Oxytocin challenge test 2 Chorionic villus sampling 3 Fetal acoustic stimulation test 4 Percutaneous umbilical blood test

Chorionic villus sampling

Which technique is used to assess genetic abnormalities in a 12-week-old fetus? 1 Amniocentesis 2 Standard ultrasonography 3 Chorionic villus sampling (CVS) 4 Magnetic resonance imaging (MRI)

Chorionic villus sampling (CVS)

Which hypertensive disorders can occur during pregnancy? Select all that apply. 1 Chronic hypertension 2 Preeclampsia-eclampsia 3 Hyperemesis gravidarum 4 Gestational hypertension 5 Gestational trophoblastic disease

Chronic hypertension 2 Preeclampsia-eclampsia Gestational hypertension

The nurse is caring for a pregnant patient. What interventions should the nurse follow to ensure proper hygiene in the patient? 1 Clean the perineum of the patient frequently. 2 Clean the patient's teeth with a warm wet cloth. 3 Offer a warm washcloth to the patient for a face wash. 4 Allow cool water to flow on the patient's back for 5 minutes.

Clean the perineum of the patient frequently.

A pregnant patient who has chorioamnionitis gave birth to a child through cesarean section. Which medication does the nurse expect the primary health care provider (PHP) to prescribe? 1 Propranolol (Inderal) 2 Clindamycin (Cleocin) 3 Morphine (MS Contin) 4 Terbutaline (Brethine)

Clindamycin (Cleocin)

The nurse is assessing a client who is 6 months pregnant. The nurse determines that the fetus is lying in a longitudinal position with the sacrum as the presenting part and with general flexion. What fetal position should the nurse document? 1 Cephalic presentation 2 Shoulder presentation 3 Complete breech position 4 Single footling breech position

Complete breech position

The biophysical profile (BPP) testing report of a pregnant patient gives the following information: one episode of fetal breathing movement lasting for 30 seconds in a 30-minute observation; three limb movements of the fetus in 30 minutes; an amniotic fluid index greater than 5; a reactive nonstress test; and a BPP score of 1. The test is performed for 120 minutes. What does the nurse expect the primary health care provider to do? 1 Repeat the test twice a week. 2 Consider delivery of the fetus. 3 Repeat the test in 4 to 6 hours. 4 Extend the test time to 120 minutes.

Consider delivery of the fetus.

What will the nurse mention to the patient about the effect of secondary powers during labor? Correct1 Contractions are expulsive in nature. 2 Contractions move downward in waves. 3 Contractions begin at pacemaker points. 4 The intraabdominal pressure is decreased.

Contractions are expulsive in nature.

The primary health care provider prescribes terbutaline (Brethine) for a pregnant patient. As the nurse reviews the patient's medical record, what would be the rationale for this prescription? 1 Blood volume is elevated. 2 Hemoglobin is decreased. 3 Blood pressure is reduced. 4 Contractions are increased.

Contractions are increased.

After a pelvic examination of a pregnant woman, the nurse concludes that the client may require a forceps-assisted delivery. What pelvic finding would support this conclusion? 1 Slightly ovoid-shaped 2 Moderate depth 3 Blunt ischial spines Correct4 Subpubic arch is narrow

Correct4 Subpubic arch is narrow

Which characteristic is associated with false labor contractions? 1 Painful 2 Decrease in intensity with ambulation 3 Regular pattern of frequency established 4 Progressive in terms of intensity and duration

Decrease in intensity with ambulation

The laboratory reports of a pregnant patient revealed that the patient has maternal ketosis. Which intravenous (IV) medication administration does the nurse expect to be ordered for the patient? 1 Saline solution 2 Glucose solution 3 Dextrose solution 4 Ringer's lactate solution

Dextrose solution

Which instructions does the nurse give to a patient who is prescribed methotrexate therapy for dissolving the tubal pregnancy? Correct1 "Discontinue folic acid supplements." 2 "Get adequate exposure to sunlight." 3 "Take stronger analgesics for severe pain." 4 "Vaginal intercourse is safe during the therapy."

Discontinue folic acid supplements."

The nurse is teaching pain relief techniques to a group of expectant patients. What does the nurse teach the patients about the gate-control theory of pain? 1 Distractions block the nerve pathways. 2 Neuromuscular activity can increase pain. 3 All sensations travel together to the brain. 4 Motor activity during labor intensifies pain.

Distractions block the nerve pathways.

During the second phase of labor, the patient initiates pattern-paced breathing. What adverse symptoms must the nurse watch for when the patient initiates this method? 1 Pallor 2 Nausea 3 Dizziness 4 Diaphoresis

Dizziness

What does the nurse advise a pregnant patient who is prescribed phenazopyridine (Pyridium) for cystitis? 1 "Avoid sweet foods in diet." 2 "Limit exposure to sunlight." 3 "Do not wear contact lenses." 4 "Restrict oral fluids to 125 mL per hour."

Do not wear contact lenses."

The nurse is assessing a pregnant patient and finds that her blood pressure is 150/90 mm Hg. What procedure does the nurse recommend for this patient? 1 Doppler blood flow analysis 2 Nuchal translucency (NT) test 3 Chorionic villus sampling (CVS) 4 Percutaneous umbilical blood sampling (PUBS)

Doppler blood flow analysis

The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what tool is useful in confirming the diagnosis? 1 Amniocentesis 2 Doppler blood flow analysis 3 Contraction stress test (CST) 4 Daily fetal movement counts

Doppler blood flow analysis

A pregnant woman presents to the emergency department complaining of persistent nausea and vomiting. She is diagnosed with hyperemesis gravidarum. The nurse should include which information when teaching about diet for hyperemesis? Select all that apply. 1 Eat three larger meals a day. 2 Eat a high-protein snack at bedtime. 3 Ice cream may stay down better than other foods. 4 Avoid ginger tea or sweet drinks. 5 Eat what sounds good to you even if your meals are not well-balanced.

Eat a high-protein snack at bedtime. 3 Ice cream may stay down better than other foods. Eat what sounds good to you even if your meals are not well-balanced

The nurse observes that maternal hypotension has decreased uterine and fetal perfusion in a pregnant patient. What does the nurse need to assess further to understand the maternal status? 1 D-dimer blood test 2 Kleihauer-Betke (KB) test 3 Electronic fetal monitoring 4 Electrocardiogram reading

Electronic fetal monitoring

What intervention must the nurse perform for the patient demonstrating increased anxiety at the onset of labor? 1 Assess the blood pressure every 10 minutes. 2 Instruct the patient to use hypnosis to relieve pain. 3 Reassure the patient that an epidural will ease pain. 4 Encourage a support person to stay with the patient.

Encourage a support person to stay with the patient.

Evidence-based care practices designed to support normal labor and birth recommend which practice during the immediate newborn period? 1 The healthy newborn should be taken to the nursery for a complete assessment. 2 After drying, the infant should be given to the mother wrapped in a receiving blanket. 3 Encourage skin-to-skin contact of mother and baby. 4 The father or support person should be encouraged to hold the infant while awaiting delivery of the placenta.

Encourage skin-to-skin contact of mother and baby.

After performing Leopold maneuvers, the nurse finds that the fetus of a pregnant patient is in occiput posterior position. Which suitable action should the nurse employ while caring for the patient? 1 Help the patient to lie in supine position on the bed. 2 Encourage the patient to sit in hands-and-knees position. 3 Place a pillow under the patient's hip when lying in supine position. 4 Ask the patient to lie in lateral position on the opposite side of the fetal spine.

Encourage the patient to sit in hands-and-knees position.

The nurse is assessing a pregnant patient who was treated with bupivacaine (Marcaine). Which suitable intervention should the nurse perform to prevent the adverse effects of the medication? 1 Ask the patient to reduce the intake of salt. 2 Suggest that the patient change positions frequently. 3 Encourage the patient to void at least every 2 hours. 4 Cleanse the perineal area of the patient to remove any stool.

Encourage the patient to void at least every 2 hours.

When managing the care of a patient in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. What do these measures include? 1 Encouraging the woman to try various upright positions, including squatting and standing 2 Telling the woman to start pushing as soon as her cervix is fully dilated 3 Continuing an epidural anesthetic so that pain is reduced and the woman can relax 4 Coaching the woman to use sustained, 10- to 15-second, closed-glottis bearing-down efforts with each contraction

Encouraging the woman to try various upright positions, including squatting and standing

What does the nurse administer to a patient if there is excessive bleeding after suction curettage? 1 Nifedipine (Procardia) 2 Methyldopa (Aldomet) 3 Hydralazine (Apresoline) 4 Ergonovine (Methergine)

Ergonovine (Methergine)

The nurse is caring for a newly admitted nulliparous patient in the ninth month of pregnancy. What should the nurse do to provide effective care? 1 Ask to photograph the memories of childbirth. 2 Restrict the mobility of the patient in the room. 3 Explain the various labor stages to the patient. 4 Avoid intervening with the patient's psychological issues.

Explain the various labor stages to the patient.

A pregnant patient who is in preterm labor has been prescribed dexamethasone (Decadron). What benefit of the drug would the nurse identify in the patient? 1 Maturation of fetal lungs 2 Relaxation of smooth muscles 3 Inhibition of uterine contractions (UCs) 4 Central nervous system (CNS) depression

Maturation of fetal lungs

The nurse is instructed to administer 12 mg of betamethasone (Celestone) to a pregnant patient at 30 weeks of gestation. Which nursing intervention should be performed for the safe administration of the drug? 1 Give the medication by oral route. 2 Assess platelet levels after drug administration. 3 Administer increased doses of insulin with the drug. 4 Follow a strict time interval of 24 hours between two doses.

Follow a strict time interval of 24 hours between two doses.

The fasting plasma glucose levels are greater than 95 mg/dL in a patient with gestational diabetes mellitus. The patient is unwilling to take the prescribed insulin therapy. Which medication can be used in this case? 1 Isotretinoin (Accutane) 2 Enoxaparin (Lovenox) 3 Terbutaline (Brethine) 4 Glyburide (Micronase)

Glyburide (Micronase)

A nurse caring for a woman in labor understands that increased variability of the fetal heart rate might be caused by what? 1 Narcotics 2 Barbiturates 3 Tranquilizers 4 Methamphetamines

Methamphetamines

During an assessment, the nurse is instructed to determine the position of the fetal head in a pregnant patient. What should the nurse do to determine whether the fetal head is flexed or extended? 1 Palpate the fetal head with the palmar surface of the fingertips of the right hand. 2 Identify the fetal part that occupies the fundus in the uterus of the pregnant patient. 3 Palpate the smooth convex contour of the fetal back using the palmar surface of one hand. 4 Grasp the lower pole of the uterus between the thumb and fingers, pressing in slightly.

Grasp the lower pole of the uterus between the thumb and fingers, pressing in slightly.

The nurse is reviewing the amniocentesis reports of a patient who has completed 20 weeks of pregnancy. The reports reveal the presence of high alpha-fetoprotein (AFP) levels. What can the nurse infer from this information related to the clinical condition of the fetus? 1 Cardiac disorder 2 Neurologic disorder 3 Circulatory disorder 4 Pulmonary disorder

Neurologic disorder

A 4-week pregnant patient is undergoing an ultrasound. The report shows an absence of fetal heart activity. What does the nurse infer about the fetus from the report? 1 Normal finding 2 Impaired growth 3 Cardiac disorder 4 Congenital abnormality

Normal finding

The nurse who is caring for a diabetic pregnant patient finds that the weight gain pattern is poor. Which fetal factor will the nurse check in the ultrasound reports of the patient? 1 Heart activity 2 Growth pattern 3 Anatomic structure 4 Movement frequency

Growth pattern

The nurse is assessing a pregnant client and determines that the client has a round pelvis with moderate depth, straight sidewalls, curved sacrum, and wide subpubic arch. The nurse also finds that the client's ischial spines are blunt. How should the nurse classify the client's pelvis based on these findings? 1 Android 2 Gynecoid 3 Anthropoid 4 Platypelloid

Gynecoid

The patient reports severe lower back pain during labor. Which position does the nurse plan for the patient during childbirth? 1 Lateral position 2 Upright position 3 Semirecumbent position 4 Hands-and-knees position

Hands-and-knees position

Which condition should the nurse suspect in a fetus with oligohydramnios? 1 Potter syndrome 2 Down syndrome 3 Twin-twin syndrome 4 Fetal alcohol syndrome

Potter syndrome

What intervention does the nurse provide to prevent respiratory alkalosis in the patient with hyperventilation? 1 Provide gentle massage during labor. 2 Provide the patient with nourishment. 3 Have the patient breathe into a paper bag. 4 Have the patient breathe at thrice the normal rate.

Have the patient breathe into a paper bag.

What intervention does the nurse perform while caring for a laboring patient who has been administered regional anesthesia? 1 Provide an indwelling urinary catheter. 2 Encourage the patient to void every 4 hours. 3 Ask the patient to void after receiving the block. 4 Position the patient supine in an upright position.

Provide an indwelling urinary catheter.

The nurse is caring for a patient who is using fentanyl citrate (Sublimaze) through patient-controlled analgesia (PCA) while in labor. What effects of fentanyl citrate does the nurse expect? 1 Provides long duration of action 2 Requires only a single dose 3 Provides quick relief to pain 4 Causes sedation and nausea

Provides quick relief to pain

Which is a priority nursing intervention while caring for a pregnant patient with hyperemesis gravidarum? 1 Initiate parenteral nutrition. 2 Observe the patient for seizures. 3 Administer magnesium sulfate. 4 Initiate intravenous (IV) fluid therapy.

Initiate intravenous (IV) fluid therapy.

What does the nurse include in the plan of care of a pregnant patient with mild preeclampsia? Select all that apply. 1 Ensure prolonged bed rest. 2 Provide diversionary activities. 3 Encourage the intake of more fluids. 4 Restrict sodium and zinc in the diet. 5 Refer to Internet-based support group

Provide diversionary activities. 3 Encourage the intake of more fluids. Refer to Internet-based support group

When assessing a fetal heart rate (FHR) tracing, the nurse notes a decrease in the baseline rate from 155 to 110 beats/min. The rate of 110 beats/min persists for more than 10 minutes. The nurse can attribute this decrease in baseline to what? 1 Maternal hyperthyroidism Correct2 Initiation of epidural anesthesia that resulted in maternal hypotension Incorrect3 Maternal infection accompanied by fever 4 Alteration in maternal position from semirecumbent to lateral

Initiation of epidural anesthesia that resulted in maternal hypotension

During the prenatal assessment of a patient, the nurse teaches the patient about nonpharmacologic pain management. What does the nurse tell the patient about this method? 1 It is technical and expensive. 2 It requires intensive training. 3 It provides the patient with a sense of control. 4 It is used only in stage I of labor.

It provides the patient with a sense of control.

Which test is performed to determine if membranes are ruptured? 1 Urine analysis 2 Fern test 3 Leopold maneuvers 4 Artificial rupture of membranes (AROM)

Fern test

A pregnant patient who has undergone a cesarean section in her previous pregnancy needs to be checked for the fetal heart rate pattern. What test will the nurse recommend? 1 Biophysical profile 2 Nipple-stimulated test 3 Oxytocin-stimulated test 4 Fetal acoustic stimulation

Fetal acoustic stimulation

After observing the fetal heart activity in the electronic fetal monitor, the nurse suspects that the patient's umbilical cord is compressed. What did the nurse observe on the monitor? 1 Fetal heart rate (FHR) variable decelerations 2 Increase in the FHR 3 Decrease in the FHR 4 Early decelerations

Fetal heart rate (FHR) variable decelerations

What are the factors that enable the baby to initiate respiration immediately postpartum? 1 Fetal respiratory movements increase during labor. 2 Fetal lung fluid is cleared from the air passage. 3 Arterial carbon dioxide pressure is decreased. 4 Arterial pH and bicarbonate levels are increased.

Fetal lung fluid is cleared from the air passage.

The diagnostic test reports of a pregnant patient reveal a baseline fetal heart rate of 175 beats/min. What does this finding indicate to the nurse? 1 Presence of fetal ischemia 2 Fetal tachycardia 3 Fetal bradycardia 4 Hypotension in the fetus

Fetal tachycardia

After performing an amniocentesis, the primary health care provider asks the nurse to administer Rho(d) immunoglobulin to a pregnant patient with Rh-negative blood. A patient with Rh-negative blood should be administered Rho(d) immunoglobulin to prevent what? 1 Infection in the fetus 2 Pain from amniocentesis 3 Leakage of amniotic fluid 4 Fetomaternal hemorrhage

Fetomaternal hemorrhage

When does the nurse refer the pregnant patient for ultrasonography to detect maternal abnormalities that could affect the fetus? 1 First trimester 2 Third trimester 3 Second trimester 4 Second and third trimesters

First trimester

If a pregnant patient suspects signs and symptoms of preterm labor, which conditions would lead the patient to go to the hospital immediately? Select all that apply. 1 Nausea and vomiting 2 Upper abdominal pain 3 Fluid leakage from vagina 4 Presence of vaginal bleeding 5 Contractions every 10 minutes

Fluid leakage from vagina 4 Presence of vaginal bleeding 5 Contractions every 10 minutes

A woman diagnosed with marginal placenta previa gave birth vaginally 15 minutes ago. At the present time, for what is she at the greatest risk? 1 Hemorrhage 2 Infection 3 Urinary retention 4 Thrombophlebitis

Hemorrhage

The contraction stress test (CST) reports of a pregnant patient are positive. What will the primary health care provider recommend? 1 Repeat testing next week. 2 Repeat testing the next day. 3 Repeat testing within 24 hours. 4 Hospitalize the patient immediately.

Hospitalize the patient immediately.

A woman with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the woman and documents the following findings: temperature 37.1° C, pulse rate 96 beats/min, respiratory rate 24 breaths/min, blood pressure 155/112 mm Hg, 3+ deep tendon reflexes, and no ankle clonus. The nurse calls the health care provider, anticipating an order for what? 1 Hydralazine 2 Magnesium sulfate bolus 3 Diazepam 4 Calciumgluconate

Hydralazine

A patient reports excessive vomiting in the first trimester of the pregnancy, which has resulted in nutritional deficiency and weight loss. The urinalysis report of the patient indicates ketonuria. Which disorder does the patient have? 1 Preeclampsia 2 Hyperthyroid disorder 3 Gestational hypertension 4 Hyperemesis gravidarum

Hyperemesis gravidarum

Fetal monitoring of a pregnant patient reveals the fetal baseline heart rate is at 170 beats/min. Which maternal condition might the nurse suspect as the cause for this increased fetal heart rate? 1 Hypothermia 2 Hypoglycemia Correct3 Hyperthermia 4 Hypothyroidism

Hyperthermia

Which condition does the nurse suspect in a pregnant patient if there is weight loss and the patient's pulse rate is greater than 100 beats/min? 1 Macrosomia 2 Phenylketonuria 3 Hyperthyroidism 4 Atrial septal defect

Hyperthyroidism

A patient has been administered zolpidem (Ambien) as prescribed. What is the patient's clinical condition for prescribing this medication to the patient? 1 Prolonged pregnancy 2 Viral infection in the eye 3 Fibrin accumulation in the placenta 4 Hypertonic uterine contractions (UCs)

Hypertonic uterine contractions (UCs)

The nurse observes late decelerations of the fetal heart rate (FHR) in the second phase of labor of a pregnant patient. The nurse assesses the pregnant patient and elevates the lower extremities of the patient. Which assessment finding would be the reason for this nursing intervention? 1 Placental abruption 2 Maternal hypotension 3 Maternal hemorrhage 4 Uterine contractions (UCs)

Maternal hypotension

On reviewing the amniocentesis reports of a pregnant patient, the nurse finds that phosphatidylglycerol (PG) is absent in the amniotic fluid. What can the nurse interpret about development in the fetus from the reports? 1 Impaired brain development 2 Impaired lung development 3 Impaired limb development 4 Impaired cardiac development

Impaired lung development

The nurse is caring for a pregnant patient who is receiving antibiotic therapy to treat a urinary tract infection (UTI). Which dietary changes does the nurse suggest for the pregnant patient who is receiving antibiotic therapy for UTI? 1 "Include yogurt, cheese, and milk in your diet." 2 "Avoid folic acid supplements until the end of therapy." 3 "Include vitamins C and E supplementation in your diet." 4 "Reduce your dietary fat intake by 40 to 50 g per day."

Include yogurt, cheese, and milk in your diet."

The nurse is reviewing lab values to determine Rh incompatibility between mother and fetus. Which specific lab result should the nurse assess? 1 hCG level 2 Hemoglobin level 3 Indirect Coombs test 4 Maternal serum alpha-fetoprotein (MSAFP)

Indirect Coombs test

What are maternal and neonatal risks associated with gestational diabetes mellitus? 1 Maternal preeclampsia and fetal macrosomia 2 Maternal placenta previa and fetal prematurity 3 Maternal hyperemesis and neonatal low birth weight 4 Maternal premature rupture of membranes and neonatal sepsis

Maternal preeclampsia and fetal macrosomia

Which instruction should the nurse include when teaching a pregnant woman with class II heart disease? 1 Advise her to gain at least 30 pounds. 2 Instruct her to avoid strenuous activity. 3 Inform her of the need to limit fluid intake. 4 Explain the importance of a diet high in calcium.

Instruct her to avoid strenuous activity.

What is the most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa)? 1 Bleeding 2 Intense abdominal pain 3 Uterine activity 4 Cramping

Intense abdominal pain

Which device should the nurse use for monitoring the intensity of uterine contractions (UCs) in a pregnant patient? 1 Tocotransducer 2 Spiral electrode 3 Ultrasound transducer 4 Intrauterine pressure catheter (IUPC)

Intrauterine pressure catheter (IUPC)

Upon assessment, the nurse suspects that a pregnant patient has potential complications during the early phase of labor. Which signs in the patient correspond to the nurse's suspicion? Select all that apply. 1 Temperature of 36.5o C 2 Intrauterine pressure of 85 mm Hg 3 Uterine contractions lasting for 92 seconds 4 UCs lasting for 40 seconds 5 Relaxation between UCs lasting for 25 seconds

Intrauterine pressure of 85 mm Hg 3 Uterine contractions lasting for 92 seconds Relaxation between UCs lasting for 25 seconds

The nurse observes that a pregnant patient who is taking terbutaline (Brethine) treatment has a heart rate of 135 beats/min. Which medication administration does the nurse expect the primary health care provider (PHP) to prescribe? 1 Intravenous (IV) propranolol (Inderal) 2 1 g IV calcium gluconate 3 Oral dose of 20 mg of nifedipine (Adalat) 4 500 mg of IV calcium chloride for 30 minutes

Intravenous (IV) propranolol (Inderal)

The nurse is teaching a patient, who is pregnant for the first time, about the signals that indicate the beginning of labor. Which sign will the nurse mention as a signal for the beginning of labor? 1 Involuntary contractions 2 Pain in the pelvic joints 3 100% effacement of the cervix 4 Full dilation of the cervix

Involuntary contractions

The nurse is briefing a patient who is pregnant for the first time about lightening. Which statement should the nurse mention to describe lightening to the patient? 1 It occurs when true labor is in progress. 2 It allows the patient to breathe more easily. 3 It decreases the pressure on the bladder. 4 It leads to decreased urinary frequency.

It allows the patient to breathe more easily.

The nurse palpates the fontanels and sutures to determine the fetal presentation. What is the feature of the anterior fontanel? 1 It is diamond shaped in appearance. 2 It measures about 1 cm by 2 cm. 3 It closes after 6 to 8 weeks of birth. 4 It lies near the occipital bone.

It is diamond shaped in appearance.

When assessing a patient for the possibility of a vaginal birth, what must the nurse keep in mind about the coccyx of the bony pelvis? 1 It is the part above the brim of the bony pelvis. 2 It is movable in the latter part of the pregnancy. 3 It has three planes: the inlet, midpelvis, and outlet. 4 It is ovoid and bound by the pubic arch anteriorly.

It is movable in the latter part of the pregnancy.

A nurse providing care to a woman in labor should be aware of what about cesarean birth? 1 It is declining in frequency in the United States. 2 It is more likely to be done for the poor in public hospitals who do not get the nurse counseling that wealthier patients do. 3 It is performed primarily for the health of the mother and fetus. 4 It can be either elected or refused by women as their absolute legal right.

It is performed primarily for the health of the mother and fetus.

During which phase of labor does passive fetal descent and rotation to an anterior position primarily occur? 1 Latent 2 Active 3 Transition 4 Second stage

Latent

The laboratory reports of a pregnant patient revealed impaired placental perfusion. What position should the nurse suggest to the patient to enhance uteroplacental perfusion? Correct1 Lateral position 2 Upright position 3 Hands-and-knees position 4 Semirecumbent position

Lateral position

What parameter does the nurse check in the amniocentesis report of a pregnant patient to assess fetal lung growth? 1 Antibody titer in the blood 2 Alfa-fetoprotein (AFP) levels 3 Creatinine levels in the blood 4 Lecithin-to-sphingomyelin (L/S) ratio

Lecithin-to-sphingomyelin (L/S) ratio

After reviewing the reports of a pregnant patient, the nurse infers that there might be a high risk for intrauterine growth restriction (IUGR). The reason for this could be that the amniotic fluid index (AFI) is what? 1 Less than 5 cm 2 More than 25 cm 3 Between 5 and 10 cm 4 Equal to or more than 10 cm

Less than 5 cm

The nurse is caring for a pregnant patient who is administered magnesium sulfate to prevent preterm labor. Which parameters should the nurse assess in the patient to determine drug toxicity? Select all that apply. 1 Fluid intake 2 Respiratory status 3 Body temperature 4 Level of consciousness 5 Deep tendon reflexes

Level of consciousness 5 Deep tendon reflexes Respiratory status

Which technique is least effective for the woman with persistent occipitoposterior position? 1 Squat 2 Lie supine and relax 3 Sit or kneel, leaning forward with support 4 Rock the pelvis back and forth while on hands and knees

Lie supine and relax

The nurse is caring for a patient in labor with a history of sexual abuse. What interventions should the nurse perform while caring for the patient? Select all that apply. 1 Explain the need of the procedures. 2 Ask the patient about past memories. 3 Limit the number of invasive examinations. 4 Obtain the patient's permission to touch her. 5 Avoid assessing the uterine contractions (UCs).

Limit the number of invasive examinations. 4 Obtain the patient's permission to touch her. Explain the need of the procedures.

Which condition is a fetus at risk for if the mother has poor glycemic control later in pregnancy? Macrosomia 2 Hydramnios 3 Ketoacidosis 4 Preeclampsia

Macrosomia

The nurse is caring for a woman with mitral stenosis who is in the active stage. What action should the nurse take to promote cardiac function? 1 Maintain the woman in a side-lying position with the head and shoulders elevated to facilitate hemodynamics. 2 Promote the use of the Valsalva maneuver during pushing in the second stage to improve diastolic ventricular filling. 3 Encourage the woman to avoid the use of narcotics or epidural regional analgesia because this alters cardiac function. 4 Prepare the woman for delivery by cesarean section because this is the recommended delivery method to sustain hemodynamics.

Maintain the woman in a side-lying position with the head and shoulders elevated to facilitate hemodynamics.

Which form of heart disease in women of childbearing years usually has a benign effect on pregnancy? 1 Cardiomyopathy 2 Mitral valve prolapse 3 Rheumatic heart disease 4 Congenital heart disease

Mitral valve prolapse

The nurse is evaluating the fetal monitor tracing of a patient who is in active labor. Suddenly, the fetal heart rate (FHR) drops from its baseline of 125 beats/min down to 80 beats/min. The nurse repositions the mother, provides oxygen, increases intravenous (IV) fluid, and performs a vaginal examination. The cervix has not changed. A few minutes have passed, and the FHR remains in the 80s. What additional nursing measures should the nurse take? 1 Notify nursery nurse of imminent birth. 2 Insert a Foley catheter. 3 Start oxytocin (Pitocin). 4 Notify the primary health care provider (HCP) immediately.

Notify the primary health care provider (HCP) immediately.

Which patients are more susceptible to soft-tissue damage with vaginal deliveries? Select all that apply. 1 Multiparous patients 2 Nulliparous patients 3 Patients needing forceps delivery 4 Patients with fetal vertex presentation 5 Patients with fetal breech presentation

Nulliparous patients 3 Patients needing forceps delivery Patients with fetal breech presentation

Which actions does the nurse take when a pregnant patient has convulsions? Select all that apply. 1 Obtains a prescription for magnesium sulfate 2 Assesses the patient's airway, breathing, and pulse 3 Lowers the bed and turns the patient onto one side 4 Does not leave the patient for more than 10 minutes 5 Raises the side rails of the bed and pads with pillows

Obtains a prescription for magnesium sulfate Assesses the patient's airway, breathing, and pulse Lowers the bed and turns the patient onto one side Raises the side rails of the bed and pads with pillows

During the first stage of labor, a pregnant patient complains of having severe back pain. What would the nurse infer about the patient's clinical condition from the observation? 1 Oligohydramnios 2 Chorioamnionitis 3 Frank breech presentation 4 Occipitoposterior position of the fetus

Occipitoposterior position of the fetus

Which pieces of information are important to obtain when assessing a patient admitted with ruptured membranes? Select all that apply. 1 Odor of fluid 2 Amount of fluid 3 Time of rupture 4 Color of amniotic fluid 5 Activity at time of rupture

Odor of fluid 2 Amount of fluid 3 Time of rupture 4 Color of amniotic fluid

For a woman at 42 weeks of gestation, which finding requires more assessment by the nurse? 1 Fetal heart rate of 116 beats/min 2 Cervix dilated 2 cm and 50% effaced 3 Score of 8 on the biophysical profile (BPP) 4 One fetal movement noted in 1 hour of assessment by the mother

One fetal movement noted in 1 hour of assessment by the mother

The student nurse finds that the patient who is in labor has sweat on the upper lip, is shivering in the extremities, and is vomiting. What would the student nurse interpret that the patient has symptoms of from these observations? 1 Postural hypotension 2 Respiratory depression 3 Onset of the first stage of labor 4 Onset of the second stage of labor

Onset of the second stage of labor

During the first phase of labor, a pregnant patient reports having severe pain and expresses the fear of lack of progress in the birth process. Which nursing actions would help the patient have progress in labor? Select all that apply. 1 Provide a warm bath for the patient. 2 Assess the fetal heart rate (FHR) and pattern. 3 Check the characteristics of the amniotic fluid. 4 Administer morphine (MS Contin) as prescribed. 5 Prepare for insertion of an intrauterine pressure catheter (IUPC).

Provide a warm bath for the patient. Administer morphine (MS Contin) as prescribed.

After reviewing the umbilical cord acid-base report, the nurse confirms that the fetus has respiratory acidosis. Which reading is consistent with the nurse's conclusion? 1 A base deficit value ≥12 mmol/L 2 Blood glucose levels = 120 mg/dL 3 Arterial pH >7.20 4 Partial pressure carbon dioxide >55 mm Hg

Partial pressure carbon dioxide >55 mm Hg

The charge nurse on the maternity unit is orienting a new nurse to the unit and explains that the 5 Ps of labor and birth are what? Select all that apply. 1 Passenger 2 Placenta 3 Passageway 4 Psychological response 5 Powers 6 Position

Passenger Passageway 4 Psychological response 5 Powers 6 Position

What are the common signs that are observed in the days preceding labor? Select all that apply. Correct1 Persistent low backache 2 Sudden increase in lethargy Correct3 Blood-tinged cervical mucus 4 Increase in weight up to 1.5 kg Correct5 Profuse vaginal mucus

Persistent low backache Blood-tinged cervical mucus Profuse vaginal mucus

What action does the nurse take before performing cardiopulmonary resuscitation (CPR) to revive a pregnant patient undergoing a cardiac arrest? 1 Administer normal saline solution. 2 Assess for fetal-maternal hemorrhage. 3 Call two staff nurses to hold the patient. 4 Place a rolled blanket under the patient's hips.

Place a rolled blanket under the patient's hips.

A pregnant woman's amniotic membranes rupture. Prolapsed cord is suspected. Which intervention is the nurse's top priority? 1 Place the woman in the knee-chest position. 2 Cover the cord in a sterile towel saturated with warm normal saline. 3 Prepare the woman for a cesarean birth. 4 Start oxygen by face mask.

Place the woman in the knee-chest position.

A pregnant patient after 20 weeks of gestation reports painless, bright red vaginal bleeding. Upon assessment, the nurse finds that the patient's vital signs are normal. Which condition does the nurse suspect in the patient? 1 Eclampsia 2 Preeclampsia 3 Pyelonephritis 4 Placenta previa

Placenta previa

During a prenatal evaluation, the nurse notes that the patient has a flat pelvis. What term does the nurse use to refer to this type of pelvis? 1 Gynecoid 2 Android 3 Anthropoid 4 Platypelloid

Platypelloid

Arrange in the correct order the steps the nurse takes while performing transvaginal ultrasonography for a pregnant patient. 1. Cover the transducer probe with a probe cover. 2. Position the pregnant patient in the lithotomy position. 3. Position the probe for proper view of pelvic structures. 4. Lubricate the transducer probe with water-soluble gel. 5. Insert the transducer probe into the patient's vagina.

Position the pregnant patient in the lithotomy position. Cover the transducer probe with a probe cover. .Lubricate the transducer probe with water-soluble gel. Insert the transducer probe into the patient's vagina. Position the probe for proper view of pelvic structures.

The nurse is caring for a pregnant patient who is scheduled for surgery. Which nursing intervention will help provide sufficient fetal oxygenation during the surgery? 1 Positioning the patient with a lateral tilt 2 Providing clear liquids before the surgery 3 Palpating uterine contractions (UCs) manually 4 Giving an antacid before administering anesthesia

Positioning the patient with a lateral tilt

The nurse is reviewing the contraction stress test (CST) reports of a pregnant patient. The nurse expects the fetus to have meconium-stained amniotic fluid. What would be the reason for that conclusion? 1 Positive CST results 2 Negative CST results 3 Suspicious CST results 4 Unsatisfactory CST results

Positive CST results

What change in the cervix is most likely to be observed by the nurse if the patient presents with false labor? 1 Posterior position 2 Softened 3 Presence of effacement 4 Dilation

Posterior position

Which is an important nursing intervention when a patient has an incomplete miscarriage with heavy bleeding? 1 Initiate expectant management at once. 2 Prepare the patient for dilation and curettage. 3 Administer the prescribed oxytocin (Pitocin). 4 Obtain a prescription for ergonovine (Methergine).

Prepare the patient for dilation and curettage.

Which factor should alert the nurse to the potential for a prolapsed umbilical cord? 1 Oligohydramnios 2 Pregnancy at 38 weeks of gestation 3 Presenting part at a station of -3 4 Meconium-stained amniotic fluid

Presenting part at a station of -3

Which factor is known to increase the risk of gestational diabetes mellitus? 1 Previous birth of large infant 2 Maternal age younger than 25 3 Underweight before pregnancy 4 Previous diagnosis of type 2 diabetes mellitus

Previous birth of large infant

A pregnant patient in the first trimester reports spotting of blood with the cervical os closed and mild uterine cramping. What does the nurse need to assess? Select all that apply. 1 Progesterone levels 2 Transvaginal ultrasounds 3 Human chorionic gonadotropin (hCG) measurement 4 Blood pressure 5 Kleihauer-Betke (KB) test reports

Progesterone levels Transvaginal ultrasounds Human chorionic gonadotropin (hCG) measurement

The nurse should tell a primigravida that which is the definitive sign indicating that labor has begun? 1 Lightening 2 Rupture of membranes 3 Passage of the mucous plug (operculum) 4 Progressive uterine contractions with cervical change

Progressive uterine contractions with cervical change

Which finding in a urine specimen of a pregnant patient indicates the client has proteinuria? 1 Value of ≥0.5 protein in a dipstick testing 2 Protein concentration that is ≥300 mg/24 hours 3 Concentration of ≥1 g protein in a 24-hour urine collection 4 Protein concentration at 10 mg/dL in random urine specimen

Protein concentration that is ≥300 mg/24 hours

After reviewing the urinalysis reports of a pregnant patient, the nurse finds that the patient has preeclampsia. What did the nurse find in the patient's urinalysis report? 1 Nitrites 2 Ketones 3 Proteins 4 Leukocytes

Proteins

What does the nurse assess to detect the presence of a hypertensive disorder in a pregnant patient? Select all that apply. 1 Proteinuria 2 Epigastric pain 3 Placenta previa 4 Presence of edema 5 Blood pressure (BP)

Proteinuria Epigastric pain Presence of edema Blood pressure (BP)

A woman at 37 weeks of gestation is admitted with a placental abruption after a motor vehicle accident. Which assessment data are most indicative of her condition worsening? 1 Pulse (P) 112, respiration (R) 32, blood pressure (BP) 108/60; fetal heart rate (FHR) 166--178 2 P 98, R 22, BP 110/74; FHR 150-162 3 P 88, R 20, BP 114/70; FHR 140-158 4 P 80, R 18, BP 120/78; FHR 138-150

Pulse (P) 112, respiration (R) 32, blood pressure (BP) 108/60; fetal heart rate (FHR) 166--178

While reviewing the ultrasonography images of a patient in her seventh month of pregnancy, the nurse observes an enlarged renal pelvis of the fetus. Which screening test does the nurse advise the patient to undergo? 1 Quad screening 2 Coombs' screening 3 Triple marker screening 4 Cell-free DNA screening

Quad screening

Which clinical reports does the nurse evaluate to identify ectopic pregnancy in a patient? Select all that apply. 1 Quantitative human chorionic gonadotropin (β-hCG) levels 2 Transvaginal ultrasound 3 Progesterone level 4 Thyroid test reports 5 Kleihauer-Betke (KB) test

Quantitative human chorionic gonadotropin (β-hCG) levels Transvaginal ultrasound Progesterone level

Preceding labor, a pregnant patient reports a backache and increased vaginal discharge. She is also worried because she has blood-tinged cervical mucus secretions. What should the nurse do in this situation? 1 Send cervical mucus for a culture and sensitivity test. 2 Prepare the patient for induction of labor immediately. 3 Give antibiotics and other medicines to stop hemorrhage. 4 Reassure the patient by informing her that these are normal signs.

Reassure the patient by informing her that these are normal signs.

During the active phase of labor, the nurse prepares for the insertion of an intrauterine pressure catheter (IUPC) to a pregnant patient. What patient clinical presentation would be the reason for this intervention? 1 Amniotic fluid of 300 mL 2 Cervical dilation of 6 cm 3 Complete deprivation of sleep in the patient 4 Reduced uterine contractions (UCs)

Reduced uterine contractions (UCs)

A patient has been admitted to the labor room. What are the measures to be taken by the nurse to support the partner of the patient? Select all that apply. 1 Offer snacks and fluids to the partner as required. 2 Do not discuss the psychological change in the patient. 3 Demonstrate the performance of the comfort measures. 4 Guide the partner to make decisions about his or her involvement. 5 Relieve the person occasionally from the job of supporting the patient.

Relieve the person occasionally from the job of supporting the patient. Demonstrate the performance of the comfort measures. Offer snacks and fluids to the partner as required.

The health care provider has ordered a magnetic resonance imaging (MRI) study to be done on a pregnant woman to evaluate fetal structure and growth. Which instructions should the nurse include when preparing the woman for this test? Select all that apply. 1 Remain still throughout the test. 2 A full bladder is required prior to the test. 3 A lead apron must be worn during the test. 4 Jewellery must be removed before the test. 5 An intravenous line must be inserted before the test.

Remain still throughout the test. Jewellery must be removed before the test.

The amniotic fluid index (AFI) of a pregnant patient is 3 cm. What clinical information related to the fetus does the nurse infer from this? 1 Fetal hydrops 2 Renal defects 3 Low activity level 4 Neural tube defect

Renal defects

Which nursing action should be initiated first when there is evidence of prolapsed cord? 1 Notify the health care provider. 2 Apply a scalp electrode. 3 Prepare the woman for an emergency cesarean birth. 4 Reposition the woman with her hips higher than her head.

Reposition the woman with her hips higher than her head.

A pregnant patient is receiving tocolytic therapy with magnesium sulfate. Under which patient circumstance would the nurse suggest to discontinue the therapy? 1 Blood pressure is 120/80 mm Hg. 2 Respiratory rate is 10 breaths/min. 3 Urine output is 40 mL/hr. 4 Serum magnesium level is 5 mEq/L.Respiratory rate is 10 breaths/min.

Respiratory rate is 10 breaths/min.

Which intervention will help prevent the risk of pulmonary edema in a pregnant patient with severe preeclampsia? 1 Assess fetal heart rate (FHR) abnormalities regularly. 2 Place the patient on bed rest in a darkened environment. 3 Restrict total intravenous (IV) and oral fluids to 125 mL/hr. 4 Ensure that magnesium sulfate is administered as prescribed.

Restrict total intravenous (IV) and oral fluids to 125 mL/hr.

A woman with severe preeclampsia is being treated with an intravenous infusion of magnesium sulfate. This treatment is considered successful if what occurs? 1 Blood pressure is reduced to prepregnant baseline Correct2 Seizures do not occur 3 Deep tendon reflexes become hypotonic 4 Diuresis reduces fluid retention

Seizures do not occur

Which intervention does the nurse implement for a patient immediately after a severe abdominal trauma? 1 Prepare the patient for cesarean birth. 2 Send the patient for pelvic computed tomography (CT) scanning. 3 Provide fluids to the patient as part of the protocol for ultrasound examination. 4 Prepare to administer Rho(D) immunoglobulin.

Send the patient for pelvic computed tomography (CT) scanning.

Nurses should be aware of the difference experience can make in labor pain, such as what? 1 Sensory pain for nulliparous women often is greater than for multiparous women during early labor. 2 Affective pain for nulliparous women usually is less than for multiparous women throughout the first stage of labor. 3 Women with a history of substance abuse experience more pain during labor. 4 Multiparous women have more fatigue from labor and therefore experience more pain.

Sensory pain for nulliparous women often is greater than for multiparous women during early labor.

What is the most important instruction to include in a teaching plan for a woman in early pregnancy who has class I heart disease? 1 She must report any nausea or vomiting. 2 She may experience mild fatigue in early pregnancy. 3 She must report any chest discomfort or productive cough. 4 She should plan to increase her daily exercise gradually throughout pregnancy.

She must report any chest discomfort or productive cough.

During the vaginal examination of a patient in labor, the nurse identifies the presenting part as the scapula. Which fetal presentation does the nurse recognize? 1 Cephalic 2 Frank breech 3 Complete breech 4 Shoulder

Shoulder

A full-term pregnant patient reports labor pain. What would be the nature of contractions if the patient has false labor? Select all that apply. 1 Do not stop with change in position 2 Stop with use of comfort measures 3 Stop when the patient starts walking 4 Felt in back and abdomen above navel 5 Become stronger and last longer over time

Stop with use of comfort measures 3 Stop when the patient starts walking 4 Felt in back and abdomen above navel

What are the factors that speed up the dilation of the cervix? Select all that apply. 1 Strong uterine contractions 2 Scarring of the cervix 3 Pressure by amniotic fluid 4 Prior infection of the cervix 5 Force by fetal presenting part

Strong uterine contractions Pressure by amniotic fluid Force by fetal presenting part

The nurse is examining a newly admitted patient who is 39 weeks pregnant and notes that the patient is in the active phase of labor. Which symptoms does the nurse note to reach this conclusion? 1 No evidence of uterine contractions (UCs) 2 Mild uterine contractions (UCs) 3 Strong uterine contractions (UCs) 4 Moderate uterine contractions (UCs)

Strong uterine contractions (UCs)

Which statement made by the nursing student about the management of molar pregnancy indicates effective learning? 1 "Methotrexate therapy is prescribed to abort molar pregnancy." 2 "Expectant management is initiated as per the amount of bleeding." 3 "Suction curettage is the safest way of terminating molar pregnancy." 4 "Induction of labor with oxytocic agents is one of the treatment options."

Suction curettage is the safest way of terminating molar pregnancy."

The nurse is assessing a pregnant patient with multifetal gestation. Upon reviewing the medical history, the nurse finds that the patient had preterm delivery during the first pregnancy. What will the nurse do to prevent preterm delivery in the patient during the second pregnancy? 1 Suggest that the patient avoids smoking and consuming alcohol. 2 Suggest that the patient increases physical activity to prevent risk. 3 Administer progesterone (Prometrium) suppositories to the patient. 4 Administer a 17-alpha hydroxyprogesterone injection to the patient.

Suggest that the patient avoids smoking and consuming alcohol.

While caring for a patient who is treated with terbutaline (Brethine), the nurse tries to reduce pressure on the patient's cervix to prevent preterm labor. Which nursing action would be most relevant? 1 Suggesting that the patient lie on her side 2 Infusing Ringer's lactate solution intravenously 3 Increasing the terbutaline (Brethine) concentration 4 Encouraging drinking a full glass of water periodically

Suggesting that the patient lie on her side

The nurse is assisting a patient who is prepared to use the paced breathing method. What does the nurse remind the patient to do at the beginning of the breathing pattern? 1 Exhale a deep breath. 2 Take a deep relaxing breath. 3 Take 32 breaths per minute. 4 Take three breaths per minute.

Take a deep relaxing breath.

During a prenatal visit, the nurse finds that the patient has symptoms of preterm labor. Which nursing intervention is to be followed to prevent thrombophlebitis? 1 Teach gentle lower extremity exercises to the patient. 2 Suggest that the patient lie in the supine position in bed. 3 Provide a calm and soothing atmosphere to the patient. 4 Give tocolytic medications as per the health care provider's prescription.

Teach gentle lower extremity exercises to the patie

A pregnant patient was given a tocolytic drug to prevent preterm delivery. After observing that the patient has a history of migraine headaches, the primary health care provider (PHP) instructs the nurse to stop administering the drug. Which tocolytic drug was the patient most likely taking? 1 Nitrous oxide 2 Magnesium sulfate 3 Terbutaline (Brethine) 4 Prednisolone (Deltasone)

Terbutaline (Brethine)

A patient in labor at 34 weeks of gestation is hospitalized and treated with intravenous magnesium sulfate for 18 to 20 hours. When the magnesium sulfate is discontinued, which oral drug will be prescribed for continuation of the tocolytic effect? 1 Buccal oxytocin (Pitocin) 2 Terbutaline sulfate (Brethine) 3 Calcium gluconate (Calgonate) 4 Magnesium sulfate (Magnesium sulfate)

Terbutaline sulfate (Brethine)

The nurse is assessing a pregnant patient and uses spiral electrode monitoring to record the fetal heart rate. Under what circumstances can the nurse consider implementing this method? 1 The cervix has partially dilated. 2 Uterine contractions have increased. 3 The patient's placenta cannot be ruptured. 4 The umbilical cord is compressed.

The cervix has partially dilated.

In planning for the care of a 30-year-old woman with pregestational diabetes, what does the nurse recognize as the most important factor affecting pregnancy outcome? 1 The mother's age 2 The amount of insulin required prenatally 3 The degree of glycemic control during pregnancy 4 The number of years since diabetes was diagnosed

The degree of glycemic control during pregnancy

Concerning the third stage of labor, of what should the nurses be aware? 1 The placenta eventually detaches itself from a flaccid uterus. 2 The duration of the third stage may be as short as 3 to 5 minutes. 3 It is important that the dark, roughened maternal surface of the placenta appear before the shiny fetal surface. 4 The major risk for women during the third stage is a rapid heart rate.

The duration of the third stage may be as short as 3 to 5 minutes.

To assess the health of the mother accurately during labor, of what should the nurse be aware? 1 The woman's blood pressure increases during contractions and falls back to prelabor normal between contractions. 2 Use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxia. 3 Having the woman point her toes reduces leg cramps. 4 The endogenous endorphins released during labor raise the woman's pain threshold and produce sedation.

The endogenous endorphins released during labor raise the woman's pain threshold and produce sedation.

Biochemical examination of the amniotic fluid of a pregnant patient yields the following results: lecithin-to-sphingomyelin (L/S) ratio, 2:1; surfactant-to-albumin (S/A) ratio, 60 mg/g; and phosphatidylglycerol (PG) present. What conclusions will the nurse draw from this report? 1 The gestational age is 36 weeks. 2 The fetal lungs are well developed. 3 The fetus has a neural tube defect. 4 The fetus has an open neural tube defect.

The fetal lungs are well developed.

On completion of a vaginal examination on a laboring woman, the nurse records: 50%, 6 cm, -1. What is a correct interpretation of the data? 1 The fetal presenting part is 1 cm above the ischial spines. 2 Effacement is 4 cm from completion. 3 Dilation is 50% completed. 4 The fetus has achieved passage through the ischial spines.

The fetal presenting part is 1 cm above the ischial spines.

The nurse palpates the abdomen of a pregnant patient and reports that the fetus lies in longitudinal position with cephalic presentation. Which observation enabled the nurse to report about the fetal position? 1 The presenting part has deeply descended in the pelvis. 2 The cephalic prominence is on the same side as the back. 3 The head is presenting to the true pelvis and is not engaged. 4 The head feels round, firm, freely movable, and palpable by ballottement.

The head feels round, firm, freely movable, and palpable by ballottement.

The nurse assesses that a fetus is in a cephalic presentation. What does the nurse mean by the term fetal presentation? 1 The relation of the presenting part to the mother's pelvis 2 The relation of the fetus's and mother's spine Correct3 The part of the fetus that enters the pelvic inlet first 4 The relation of the fetal body parts to one another

The part of the fetus that enters the pelvic inlet first

Upon reviewing the laboratory reports, the nurse finds that the patient has meconium in the amniotic fluid. What would the nurse infer from this finding? 1 The patient has a stillbirth. 2 The patient has placental abruption. 3 The patient has prolonged pregnancy. 4 The patient has elevated uterine contractions (UCs).

The patient has prolonged pregnancy.

The nurse is performing a nonstress test in a pregnant patient. Arrange the steps for performing the test in the correct order. 1. The Doppler transducer is applied to the patient's abdomen. 2. The fetal movement is noted in the tracing. 3. The patient is placed in a semi-Fowler position. 4. The patient is asked to depress the button of the event marker.

The patient is placed in a semi-Fowler position. The Doppler transducer is applied to the patient's abdomen. he patient is asked to depress the button of the event marker. The fetal movement is noted in the tracing.

The nurse is caring for a Native-American patient during labor. What does the nurse keep in mind about the patient's cultural approach to pain? 1 The patient may not exhibit reactions to pain. 2 The patient may be vocal in response to pain. 3 The patient may use remedies from indigenous plants. 4 The patient may express pain vocally late in labor.

The patient may use remedies from indigenous plants.

The nurse finds diuresis, weight loss, and muscle atrophy in a pregnant patient with mild preeclampsia. What does the nurse conclude from these findings? 1 The patient was mostly on a liquid diet. 2 The patient was on prolonged bed rest. 3 The patient has developed HELLP syndrome. 4 The patient is at risk for placental abruption.

The patient was on prolonged bed rest.

Fetal well-being during labor is assessed by what? 1 The response of the fetal heart rate (FHR) to uterine contractions (UCs) 2 Maternal pain control 3 Accelerations in the FHR 4 An FHR greater than 110 beats/min

The response of the fetal heart rate (FHR) to uterine contractions (UCs)

The nurse is reviewing the ultrasound report of a 20-week pregnant patient to find out whether the patient has placental vascular disease. What assessment parameter does the nurse check in the reports? 1 The fetal heart rate through stethoscope 2 The fluid volume in the nape of the fetal neck 3 The biophysical profile through ultrasonography 4 The systolic-to-diastolic (S/D) ratio of umbilical and uterine arteries

The systolic-to-diastolic (S/D) ratio of umbilical and uterine arteries

The nurse is preparing a patient for transvaginal ultrasonography. What information does the nurse give the patient before the test? 1 There is no pain felt during transvaginal ultrasonography. 2 There is no pressure felt during transvaginal ultrasonography. 3 The patient needs to be in the semi-Fowler position for the test. 4 The patient needs to drink lots of fluids to keep the bladder full before the test.

There is no pain felt during transvaginal ultrasonography.

The nurse has a prescription to obtain a blood sample from a patient to determine fetal lactate levels. What information should the nurse provide to the patient before the procedure? 1 "There is an increased risk for after birth hemorrhage." 2 "There may be a need to reconduct the diagnostic test." 3 "There is an increased risk for requiring a cesarean birth." 4 "There will be a small incision on the scalp of the newborn."

There will be a small incision on the scalp of the newborn."

What is the rationale for the nurse asking a pregnant patient with heart disease to document the daily weight? 1 To monitor for heart failure 2 To monitor nutritional intake 3 To assess for fluid retention 4 To assess for any weight loss

To assess for fluid retention

After reviewing the standard ultrasound scan reports of a pregnant patient, the nurse advises the patient to undergo a specialized ultrasound scan. What is the nurse's rationale for this suggestion? 1 To estimate the amniotic fluid volume 2 To identify the detailed fetal anatomy 3 To assess for physiologic abnormalities 4 To assess for fetal genetic abnormalities

To assess for physiologic abnormalities

The primary health care provider (PHP) advised the nurse to assess the maternal temperature and vaginal discharge of a pregnant patient every 2 hours. What is the reason behind this advice? 1 To evaluate fetal status 2 To know the onset of labor 3 To assess for potential risk for infection 4 To prevent fetal hypertensionTo assess for potential risk for infection

To assess for potential risk for infection

A laboring patient's amniotic membranes have just ruptured. What is the immediate action of the nurse? 1 To assess the fetal heart rate (FHR) pattern 2 To perform a vaginal examination 3 To inspect the characteristics of the fluid 4 To assess maternal temperature

To assess the fetal heart rate (FHR) pattern

During a prenatal checkup, the patient who is 7 months pregnant reports that she is able to feel about two kicks in an hour. The nurse refers the patient for an ultrasound. What is the primary reason for this referral? 1 To check fetal position 2 To check gestational age 3 To check for fetal anomalies 4 To check for fetal well-being

To check for fetal well-being

While reviewing the reports of a pregnant patient in the third trimester, the nurse finds that the patient has been referred for transvaginal and transabdominal ultrasound scanning. What is the most likely reason for referring the patient for both tests? 1 To determine genetic abnormalities 2 To determine the risk of preterm labor 3 To assess development of the embryo 4 To determine the risk of ectopic pregnancy

To determine the risk of preterm labor

The nurse instructs a pregnant patient to breathe through the mouth and keep it open while pushing during labor. What is the rationale for this nursing intervention? 1 To avoid nasal congestion in the patient 2 To decrease the efforts required for pushing 3 To facilitate increased oxygen to the fetus 4 To avoid deceleration in the fetal heart rate

To facilitate increased oxygen to the fetus

The nurse is caring for a pregnant client who is in the second stage of labor. The nurse instructs the client not to hold her breath or tighten the abdominal muscles while having intense labor pain. What is the rationale for this instruction? 1 To prevent the onset of fetal hypoxia 2 To prevent maternal hypotension 3 To prevent increased fetal heart rate 4 To prevent hemorrhoids in the client

To prevent the onset of fetal hypoxia

Late deceleration patterns are noted when assessing the monitor tracing of a woman whose labor is being induced with an infusion of Pitocin. The woman is in a side-lying position, and her vital signs are stable and fall within a normal range. Contractions are intense, last 90 seconds, and occur every 1½ to 2 minutes. What is the nurse's immediate action? 1 To change the woman's position 2 To stop the Pitocin 3 To elevate the woman's legs 4 To administer oxygen via a tight mask at 8 to 10 L/min

To stop the Pitocin

A patient has been laboring for several hours and after checking the patient's cervix, the nurse finds the patient's cervix is dilated 9 cm and the patient is having strong uterine contractions (UCs) each lasting for 45 to 90 seconds. Based on these observations, the nurse determines that the patient is in which stage of labor? 1 Latent phase of the first stage of labor 2 Active phase of the first stage of labor Incorrect3 Active phase of the second stage of labor Correct4 Transition phase of the first stage of labor

Transition phase of the first stage of labor

The nurse is caring for an obese pregnant patient. Which test does the nurse recommend for the patient to assess the risk for intrauterine growth restriction? 1 Daily fetal movement count 2 Abdominal ultrasonography 3 Computed tomography (CT) 4 Transvaginal ultrasonography

Transvaginal ultrasonography

The nurse finds that the umbilical cord in a pregnant patient who is in labor has prolapsed, following the rupture of membranes. Which positions are suitable for the patient to promote fetal perfusion? Select all that apply. 1 Lithotomy 2 Recumbent Correct3 Trendelenburg Correct4 Modified Sims' Correct5 Knee-chest position

Trendelenburg Correct4 Modified Sims' Correct5 Knee-chest position

A patient in the sixth month of pregnancy expresses her wish to see the fetus. What investigation does the nurse suggest for the patient to help her see the fetus? 1 Ultrasonography 2 Nuchal translucency (NT) 3 Computed tomography (CT) 4 Magnetic resonance imaging (MRI)

Ultrasonography

After observing the reports of the umbilical cord acid-base determination test, the nurse informs the patient that the newborn's condition is normal. Which value indicates the normal condition of the newborn? 1 Umbilical artery: pH, 7.1; Pco2, 50 mm Hg; Po2, 20 mm Hg 2 Umbilical artery: pH, 7.3; Pco2, 40 mm Hg; Po2, 10 mm Hg 3 Umbilical artery: pH, 7.4; Pco2, 52 mm Hg; Po2, 27 mm Hg 4 Umbilical artery: pH, 7.3; Pco2, 45 mm Hg; Po2, 25 mm Hg

Umbilical artery: pH, 7.3; Pco2, 45 mm Hg; Po2, 25 mm Hg

The labor and delivery nurse is admitting a woman complaining of being in labor. The nurse completes the admission database and notes that which factors may prohibit the woman from having a vaginal birth? Select all that apply. 1 Unstable coronary artery disease 2 Previous cesarean birth 3 Placenta previa 4 Initial blood pressure of 132/87 mm Hg 5 History of three spontaneous abortions

Unstable coronary artery disease 2 Previous cesarean birth 3 Placenta previa

Which finding meets the criteria of a reassuring fetal heart rate (FHR) pattern? 1 FHR does not change as a result of fetal activity. 2 Average baseline rate ranges between 100 and 140 beats/min. 3 Mild late deceleration patterns occur with some contractions. 4 Variability averages between 6 to 10 beats/min.

Variability averages between 6 to 10 beats/min.

What is the primary cause of maternal weight loss preceding labor? 1 Diarrhea 2 Water loss 3 Loss of appetite 4 Nausea and vomiting

Water loss

A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expectant parent's class. Which aspect of their birth plan is considered unrealistic and requires further discussion with the nurse? 1 "My husband and I have agreed that my sister will be my coach because he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure everything is OK." 2 "We plan to use the techniques taught in the Lamaze classes to reduce the pain experienced during labor." 3 "We want the labor and birth to take place in a birthing room. My husband will come in the minute the baby is born." 4 "We do not want the fetal monitor used during labor because it will interfere with movement and doing effleurage."

We do not want the fetal monitor used during labor because it will interfere with movement and doing effleurage."

The nurse is caring for a Hispanic patient who has given birth to a baby. When does the nurse expect the patient to start breastfeeding? Incorrect1 First hour after birth Correct2 When the milk comes 3 When the infant cries 4 After the patient has rested

When the milk comes

At 38 weeks of gestation, a 24-year-old primipara delivers a 6-lb 2-oz infant whose five-minute Apgar was 8. How should the neonatal nurse evaluate the outcome of this pregnancy because his mother had been experiencing hyperemesis gravidarum since the eighth week of pregnancy? 1 High-risk and needs extensive monitoring. 2 Within healthy parameters for gestation, weight, and Apgar. 3 Very small for gestational age and needs frequent feedings. 4 At high risk for hypoglycemia and tremors.

Within healthy parameters for gestation, weight, and Apgar.

A patient with gestational hypertension is prescribed labetalol hydrochloride (Normodyne) therapy, which is continued after giving birth. What does the nurse instruct the patient about breastfeeding? 1 "You may breastfeed the infant if you desire." 2 "Breastfeeding may cause convulsions in the infant." 3 "Breastfeed only once a day and use infant formulas." 4 "There may be high levels of the drug in the breast milk."

You may breastfeed the infant if you desire."

The nurse is assessing a pregnant patient who is paralyzed due to a spinal injury at the level of the twelfth thoracic vertebra. Presently, she is in full-term gestation and under nursing care. What should the nurse inform the patient? 1 "You may have a prolonged labor." 2 "You may have painless uterine contractions." 3 "Your uterus may not contract due to paralysis." 4 "Your baby may develop neurologic problems."

You may have painless uterine contractions."

The nurse is assessing a pregnant patient and finds that the patient has inflammation around the teeth and bleeding of the gums. What should the nurse tell the patient after the assessment? 1 "You might be at risk for preterm labor." 2 "Your baby might have spina bifida." 3 "You may be at risk of having a miscarriage." 4 "Your baby might have delayed tooth eruption."

You might be at risk for preterm labor."

While assessing a newborn immediately after vaginal birth, the mother is concerned that the newborn's head has assumed an abnormal shape. What should the nurse inform the mother of the baby? Select all that apply. 1 "Your baby's head should assume a normal shape within 3 days." 2 "Our physical therapist will be able to fix the shape of your baby's head." 3 "Our experienced pediatric surgeon will need to perform surgery on your baby's head." 4 "Applying baby oil daily for 2 weeks should help normalize the shape of your baby's head." 5 "This molding of the head allowed your child to adapt to the shape of your pelvis during labor."

Your baby's head should assume a normal shape within 3 days." "This molding of the head allowed your child to adapt to the shape of your pelvis during labor."

After performing the nitrazine test for pH in a pregnant patient, the nurse finds that the amniotic membranes are ruptured. Which finding led the nurse to confirm the result of the test? 1 pH of 5.0 and yellow in color 2 pH of 6.5 and blue-green in color 3 pH of 6.0 and olive-green in color 4 pH of 5.5 and olive-yellow in color

pH of 6.5 and blue-green in color

The primary health care provider (PHP) reports that the baby of a patient may have an injury resulting from shoulder dystocia during labor. What patient clinical condition should the nurse infer from the report? 1 Preterm labor 2 postterm pregnancy 3 Secondary uterine inertia 4 Hypertonic uterine dysfunction

postterm pregnancy

Which test does the nurse recommend for the patient to help assess fetal genetic abnormalities? 1 Fetal heart activity 2 Fetal body movements 3 Nuchal translucency (NT) 4 Amniotic fluid volume (AFV)

uchal translucency (NT)