OB exam #2 practice
Which of the following is an indication to turn off magnesium sulfate in a woman managed with preeclampsia? A. blood pressure 190/110 B. nausea and vomiting C. epigastric pain D. respiratory rate of 13bpm
D
Specialized ultrasounds are involved in all the following except: A. maternal assays B. BPP C. assessment of amniotic fluid D. measurements of fetal structures
A
Women are more receptive to treatment and lifestyle changes during pregnancy, so pregnancy may be a window of opportunity for chemically dependent women to enter treatment. A. True B. False
A
Type 1 diabetes is associated with: A. decreased pancreatic function B. insulin resistance C. inappropriate response to insulin D. absolute insulin deficiency
D
Umbilical artery doppler flow can replace which antepartal test? A. amniocentesis B. chorionic villus sampling C. multiple marker screen D. delta OD 450
D
Amniocentesis done after 15 weeks is associated with a fetal death rate of: A. less than 1% B. less than 5% C. greater than 1% D. approximately 5%
A
Management of women with pre gestational diabetes should begin: A. before conception B. at the end of the first trimester C. at the end of 20 weeks D. before the onset of labor
A
Smoking during pregnancy increases the risk of: A. LBW and prematurity B. neonatal lung disease C. preeclampsia
A
A common side effect of epidural anesthesia in labor includes: A. maternal hypotension B. maternal hypertension C. variabel decelerations in FHR D. hypertonic labor pattern
A
A nurse applies an external fetal monitor and toco-transducer to monitor the FHR and contractions of a client who is in labor. The FHR is around 140/min. Contractions are every 8 mins and 30-40 seconds in duration. The nurse performs a vaginal exam and finds the cervix is 2 cm dilated 50% effaced and the fetus is at a -2 station. Which of the following stages and phases of labor is the client experiencing? A. The first stage, latent phase B. The first stage, active phase C. The first stage, transition phase D. The second stage of labor
A
A nurse in labor and delivery is caring for a client on an external electronic fetal monitor. The nurse observes the fetal heart rate begins to decelerate after the contraction has started and the lowest point of the deceleration occurs after the peak of the contraction. Which of the following is the priority action by the nurse? A. Place the client in the lateral position. B. Increase the rate of maintenance IV infusion. C. Elevate the client's legs. D. Administer oxygen using a non-re-breather mask.
A
A nurse is caring for a client who has a diagnosis of gonorrhea. Which of the following medications should the nurse anticipate the provider will prescribe? A. Ceftriaxone (Rocephin) B. Fluconazole (Diflucan) C. Metronidazole (Flagyl) D. Zidovudine (Retrovir)
A
A nurse is caring for a client who is in active labor and reports severe back pain. During assessments, the fetus is noted to be in the occiput posterior position. Which of the following maternal positions should the nurse suggest to the client to facilitate normal labor progress? A. Hands and knees B. lithotomy C. trendelenburg D. supine with a rolled towel under one hip
A
A nurse is caring for a client who is in labor and has an external fetal monitor. The nurse notes late decelerations and interprets them as indicating which of the following? A. Potential for fetal distress B. Normal response to contractions C. Labor is failing to progress D. Delivery of the fetus is imminent
A
A nurse is caring for a client who is in labor. When monitoring the uterine contractions the nurse is aware that relaxation between contractions should be greater than A. 30 seconds B. 45 seconds C. 60 seconds. D. 75 seconds.
A
A nurse is conducting a home visit for a client who is 2 weeks postpartum and breastfeeding. The client reports breast engorgement. Which of the following recommendations should the nurse make? A. "Apply cold compresses between feeding." B. "take a warm shower right after feeding." C. "Apply breast milk to the nipples and allow them to air dry." D. "Use the various infant positions for feeding."
A
A nurse is performing a fundal assessment for a client in her second postpartum day and observes the client's perineal pad for lochia. She notes the pad to be saturated approximately 12cm with lochia that is bright red in color and contains small clots. The nurse knows that this finding is A. moderate lochia rubra B. excessive lochia rubra C. light lochia rubra D. scant lochia rubra
A
A nurse is providing care for a client who is at 32 weeks of gestation and who has a placenta previa. The nurse notes that the client is actively bleeding. Which of the following types of medications should the nurse anticipate the provider will prescribe? A. Betamethasone (Celestone) B. Indomethacin (Indocin) C. Nifedipine (Adalat) D. Methylergonovine (Methergine)
A
A nurse is administering magnesium sulfate IV to a client who has severe preeclampsia for seizure prophylaxis. Which of the following indicates magnesium sulfate toxicity? (Select all that apply.) A. Respirations fewer than 12/min B. Urinary output less than 30 mL/hr C. Hyperreflexic deep-tendon reflexes D. Decreased level of consciousness E. Flushing and sweating
A, B, D
A nurse is caring for a client at 14 weeks of gestation who has hyperemesis gravidarum. The nurse is aware that which of the following are risk factors for the client? A. obesity B. Multifetal pregnancy C. maternal age greater than 40 D. migraine headache E. Oligohydramnios
A, B, D
A nurse is caring for a client who is 1 hr following a vaginal birth and experiencing uncontrollable shaking. The nurse should understand that the shaking is due to which of the following? select all that apply A. a change is body fluids B. the metabolic effect of labor C. diaphoresis D. a decrease in body temperature E. a decrease in prolactin levels
A,B
A nurse is caring for a client who is in labor. The nurse is aware that which of the following conditions have medications that can be prescribed as prophylactic treatment during labor or immediately following delivery? (Select all that apply.) A. Gonorrhea B. Chlamydia C. HIV D. Group B Streptococcus ß-hemolytic E. TORCH
A,B,C,D
A nurse is caring for a client who is pregnant and is to undergo a contraction stress test (CST). Which of the following findings are indications for this procedure? (Select all that apply.) A. Decreased fetal movement B. Intrauterine growth restriction (IUGR) C. Postmaturity D. Advanced maternal age E. Amniotic fluid emboli
A,B,C,D
A nurse in an antepartum clinic is providing care for a client. Which of the following clinical findings are suggestive of a TORCH infection? (Select all that apply.) A. Joint pain B. Malaise C. Rash D. Urinary frequency E. Tender lymph nodes
A,B,C,E
A nurse is providing care for a client who is diagnosed with a marginal abruption placenta. The nurse is aware that which of the following findings are risk factors for developing the condition? select all that apply A. maternal hypertension B. blunt abdominal trauma C. cocaine use D. maternal age E. smoking
A,B,C,E
A nurse on the obstetrical unit is admitting a client who is in labor. The client has a positive HIV status. The nurse is aware that which of the following is contraindicated for this client? (Select all that apply.) A. Episiotomy B. Vacuum extraction C. Forceps D. Cesarean birth E. Internal fetal monitoring
A,B,C,E
A nurse is caring for a client who has a prescription for magnesium sulfate. The nurse should recognize that which of the following are contraindications for use of this medication. (Select all that apply.) A. Acute fetal distress B. Preterm labor C. Vaginal bleeding D. Cervical dilation greater than 6 cm E. Severe gestational hypertension
A,C,D
A FHR that increases 15 beats above baseline for 15 seconds twice in 20 minutes is considered: A. category III B. reactive C. nonreactive D. negative
B
A client experiences a large gush of fluid from her vagina while walking in the hallway of the birthing unit. The first nursing action after establishing that the fluid is amniotic fluid should be to: A. Assess the amniotic fluid for meconium. B. Monitor FHR for distress. C. Dry the client and make her comfortable. D.Monitor the client's uterine contractions
B
A nurse if completing postpartum discharge teaching to a client who had no immunity to varicella and was given varicella vaccine. Which of the following statements by the client indicates understanding of the teaching? A. "I will need to use contraception for 3 months before considering pregnancy." B. "I need a second vaccination at my postpartum visit." C. "I was given the vaccine because my baby is O-positive." D. "I will be tested in 3 months to see if I have developed immunity."
B
A nurse in the emergency department is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states she missed one menstrual cycle and cannot be pregnant because she has an intrauterine device. The nurse should suspect which of the following? A. Missed abortion B. Ectopic pregnancy C. Severe preeclampsia D. Hydatidiform mole
B
A nurse is assessing a postpartum client for fundal height, location, and consistency. The funds is found to be displace laterally to the right, and there is uterine atony. Which of the following is the cause of the uterine atony? A. poor involution B. urinary retention C. hemorrhage D. infection
B
A nurse is caring for a client who has suspected hyperemesis gravidarum and is reviewing the client's laboratory reports. Which of the following findings is a clinical manifestation of this condition? A. Hgb 12.2 g/dL B. Urine ketones present C. Alanine aminotransferase (ALT) 20 IU/L D. Serum glucose 114 mg/dL
B
A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxations between hypertonic contractions. The nurse recognizes the adverse effect of this contraction pattern is A. prolonged labor B. reduced fetal oxygen supply C. delayed cervical dilation D. increased maternal stress
B
A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis to assess fetal lung maturity. Which of the following is a test for fetal lung maturity? A. Alpha-fetoprotein (ATP) B. Lecithin/sphingomyelin (L/S) ratio c. Kleihauer-betke test D. indirect coombs test
B
A nurse is caring for a client who is receiving nifedipine (Procardia) for prevention of preterm labor. The nurse should monitor the client for which of the following clinical manifestations? A. Blood-tinged sputum B. Dizziness C. Pallor D. Somnolence
B
A nurse is providing care to multiple clients on the postpartum unit. Which of the following clients is at greatest risk for developing a puerperal infection? A. a client who has and episiotomy that is erythematous and has extended into a third-degree laceration B. a client who does not wash her hands between perineal care and breastfeeding C. a client who is not breastfeeding and is using measures to suppress lactation D. a client who has a cesarean incision that is well-approximated with no drainage
B
An appropriate gestational age to do glucose screening is: A. 22 weeks of gestation B. 26 weeks of gestation C. 30 weeks of gestation D. 34 weeks of gestation
B
Assessment for risk factors includes: A. cultural factors B. medical and obstetrical issues C. religion D. sexual preference
B
Hypoglycemia is defined as a blood glucose below: A. 60mg/dL B. 70mg/dL C. 80mg/dL D. 90mg/dL
B
Labor pain in active labor is primarily caused by: A. cervical dilation B. uterine contractions C. fetal descent D. perineal tearing
B
Nurses manage the care of patient receiving regional anesthesia. A. true B. false
B
Screening tests are designed to: A. be offered to all pregnant women B. identify those not affected by a disease C. identify a particular disease D. make a specific diagnosis
B
Supportive activities in labor are: A. interventions ordered by the care provider B. Techniques used to help women in labor C. derived from adhering to the birth plan D. pharmacological interventions
B
The likelihood of dizygotic twinning is affected by: A. advancing maternal age B. use of assisted reproductive technology C. maternal nutritional status
B
What BPP score would indicated the need for immediate delivery of the fetus? A. 6 B. 2 C. 12 D. 4
B
While conducting an admission history for a client who is at 39 weeks of gestation, the client tells the nurse that she has been leaking fluid from the vagina for 2 days. The nurse knows that the client is at risk for A. Cord prolapse B Infection C. Postpartum hemorrhage D. hydramnios
B
A nurse is caring for a client and reviewing the findings of the client's biophysical profile (BPP). Which of the following variables are included in this test? (Select all that apply.) A. Fetal weight B. Fetal breathing movement C. Fetal tone D. Reactive FHR E. Amniotic fluid volume
B,C,D,E
A nurse at an antepartum clinic is caring for a client who is at 4 months of gestation. The client reports continued nausea and vomiting and scant, prune-colored discharge. She has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect? A. Hyperemesis gravidarum B. Threatened abortion C. Hydatidiform mole D. Preterm labor
C
A nurse is caring for a client who is at 42 weeks of gestation and in active labor. The nurse should understand that the fetus is at risk for which of the following? A. intrauterine growth restriction B. hyperglycemia C. meconium aspiration D. polyhydramnios
C
A nurse is caring for a client who is in active labor and becomes nauseous and vomits. The client is also very irritable and feels that she needs to have a bowel movement. She states, "I've had enough. I can't do this anymore. I want to go home right now". The nurse knows that these signs indicate the client is in the A. Second stage of labor B. Fourth stage of labor C. Transition phase of labor D. Latent phase of labor
C
A nurse is providing discharge instructions for a client. At 4 weeks postpartum, the client should contact her provider for which of the following assessment findings? A. scant, non odorous white vaginal discharge B. uterine cramping during breastfeeding C. sore nipple with cracks and fissures D. decreased response with sexual activity
C
A nurse is providing discharge instructions to a postpartum client following a cesarean birth. The client reports leaking urine every time she sneezes or coughs. Which of the following should the nurse suggest? A. performing sit-ups B. performing pelvic tilt exercises C. doing kegel exercises D. doing abdominal cruches
C
A nurse is reviewing a new prescription for ferrous sulfate with a client who is at 12 weeks of gestation. Which of the following statements by the client indicates understanding of the teaching? A. "I will take this pill with my breakfast." B. "I will take this medication with a glass of milk." C. "I plan to drink more orange juice while taking this pill." D. "I plan to add more calcium-rich foods to my diet while taking this medication."
C
A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements by the client requires clarification? A. "I will report cramping or signs of infection to the physician." B. "I should drink lots of fluids during the 24 hours following the procedure." C. "I need to have a full bladder at the time of the procedure." D. "The test is done to detect genetic abnormalities."
C
A sterile vaginal exam reveals that the women is 5cm/80% effaced/0 station. Based on this exam the woman is: A. in the transition phase B. in the latent phase C. in the active phase
C
An involuntary urge to push is most likely a sign of: A. malposition of the fetus B. transition to active labor C. low fetal station D. imminent delivery
C
During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On assessment, a nurse finds the client's uterus to be firm and midline and at the level of the umbilicus. The nurse interprets this finding as A. evidence of a possible vaignal hematoma B. an indication of a cervical or perineal laceration C. a normal postural discharge of lochia D. abnormally excessive lochia rubra flow
C
Over the past 25 years, the incidence of preterm birth has: A. declined B. remained the same C. increased
C
The goal of magnesium sulfate therapy in treating preeclampsia is to: A. reduce blood pressure B. delay delivery C. prevent seizures D. increase placental perfusion
C
The nurse would suspect preeclampsia if which of the following was found during assessment? A. hypertension and diminished reflexes B. ankle edema and ketonuria C. proteinuria and hypertension D. glucosuria and proteinuria
C
The nurse's role in antepartal testing includes: A. interpreting results B. obtaining consent C. explaining how and why test is performed D. referring the woman's question to a physician
C
The primary reason for administering Nubain to a woman in active labor is to: A. slow uterine contractions B. relieve nausea and vomiting C. relieve pain D. promote dilation
C
What lamellar body count(LBC) value is highly indicative of fetal lung maturity? A. 20000 B. 35000 C. 55000 D. 40000
C
Women who have a support person with them in labor are more likely to: A. have epidural anesthesia B. have a precipitous labor C. experience fewer birth complications D. experience more interventions
C
A client reports that her contractions started about 2 hours ago, did not go away when she had two glasses of water and rested, and became stronger since she started walking. She tells the nurse that the contractions occur every 10 mins and last about half a minute. She hasn't had any fluid leak from her vagina; however she did think she saw some blood when she wiped after voiding. Based on these reports, the nurse should recognize that the client is experiencing A. Braxton Hicks contractions B. Rupture of Membranes C. Fetal descent D. True Contractions
D
A nurse in labor and delivery is providing care for a client who is in preterm labor at 32 weeks of gestation. Which of the following medications should the nurse anticipate the provider will prescribe to hasten fetal lung maturity? A. Calcium gluconate B. Indomethacin (Indocin) C. Nifedipine (Procardia) D. Betamethasone (Celestone)
D
A nurse is caring for a client following an amniotomy who is now in the active phase of the first stage of labor. Which of the following should the nurse implement? A. Maintain the client in the lithotomy position. B. Check the client's temperature every 4 hr. C. Remind the client to bear down with each contraction. D. Encourage the client to empty the bladder every 2 hr.
D
A nurse is caring for a client in active labor. When last examined 2 hr ago, the client's cervix was 3cm dilated, 100% effaced, membranes intact, and the fetus was at a -2 station. The client suddenly states "my water broke." The monitor reveals a FHR of 80 to 85/min, and the nurse performs a vaginal examination, noticing clear fluid and pulsing loop of umbilical cord in the client's vagina. Which of the following actions should the nurse perform first? A. place the client in the trendelenburg position B. apply pressure to the presenting part with her fingers C. administer oxygen at 10mL/min via a face mask D. call for assistance
D
A nurse is caring for a client who had an epidural anesthesia block during the early stages of labor. The client's blood pressure is 80/40 and the fetal heart recording is 140/min. Which of the following actions by the nurse is a priority? A. Elevate the legs. B. Monitor vital signs every 5 min. C. Call the physician immediately. D. Turn the client in a lateral position.
D
A nurse is caring for a client who has a diagnosis of ruptured ectopic pregnancy. Which of the following is an expected finding? A. No alteration in menses B. Transvaginal ultrasound indicating a fetus in the uterus C. Serum progesterone greater than the expected reference range D. Report of severe shoulder pain
D
A nurse is caring for a client who is admitted to the labor and delivery unit. With the use of leopards maneuvers, it is noted that the fetus is in a breech presentation. For which of the following possible complications should the nurse observe? A. precipitous labor B. premature rupture of membranes C. postmaturity syndrome D. prolapsed umbilical cord
D
A nurse is caring for a client who is pregnant and undergoing a nonstress test. The client asks why the nurse is using an acoustic vibration device. Which of the following is an appropriate response by the nurse? A. "It is used to stimulate uterine contractions." B. "It will decrease the incidence of uterine contractions." C. "It lulls the fetus to sleep." D. "It awakens a sleeping fetus."
D
A nurse is conducting a home visit with a client who is 3 months postpartum and breastfeeding. Menses has not yet resumed. The client is discussing contraception with the nurse, stating that she does not want to have another child for a couple of years. The nurse understands that this client needs further instruction if the client makes which of the following statements? A. "I have already started using the mini pill for protection." B. "because of our beliefs, we are going to use the rhythm method." C. "I am being refitted for a diaphragm by my doctor next week." D. "I will begin using birth control when I stop breastfeeding."
D
A nurse is reviewing discharge teaching with a client who has premature rupture of membranes at 26 weeks of gestation. Which of the following should be included in the teaching? A. Use a condom with sexual intercourse. B. Avoid bubble bath solution when taking a tub bath. C. Wipe from the back to front when performing perineal hygiene. D. Keep a daily record of fetal kick counts
D
A nurse manager in a prenatal clinic is reviewing ways to prevent a TORCH infection during pregnancy with a group of newly licensed nurses during an education program. Which of the following statements by a nurse indicates understanding of the teaching? A. "Obtain a vaccination against rubella early in pregnancy." B. "Seek prophylactic treatment if cytomegalovirus is detected." C. "A woman should avoid handling dog feces." D. "A woman should avoid consuming undercooked meat."
D
A nursing is caring for a client who is receiving IV magnesium sulfate. Which of the following medications should the nurse anticipate administering if magnesium sulfate toxicity is suspected? A. Nifedipine (Adalat) B. Pyridoxine (vitamin B6) C. Ferrous sulfate D. Calcium gluconate
D
An oxygen saturation below_______ is an abnormal finding for pregnant women. A. 90% B. 92% C. 95% D. 97%
D
Daily fetal movement counts are done: A. only in high-risk pregnancies B. by care providers during prenatal visits C. as soon as the pregnancy is confirmed D. to identify potentially hypoxic fetuses
D
False labor is characterized by: A. irregular uterine contractions and cervical change B. back pain that radiates to the lower abdomen C. the presence of bloody show D. irregular contractions with no cervical change
D
Passenger, as one of the 4 Ps of labor, refers to: A. the position of the mother B. the passage of the vagina C. the fetal descent in the pelvis D. the fetus
D