OB Exam 3

After teaching a group of students about premenstrual syndrome, the instructor determines that additional teaching is needed when the students identify which finding as a prominent assessment finding?

Weight loss

After teaching a woman with a postpartum infection about care after discharge, which client statement indicates the need for additional teaching?

When I put on a new pad, I'll start at the back and go forward.

A woman is to undergo an amnioinfusion. Which statement would be most appropriate to include when teaching the woman about this procedure?

You'll need to stay in bed while you're having this procedure.

After teaching a woman with pelvic organ prolapse about dietary and lifestyle measure, which statement would indicate the need for additional teaching?

"I should take up jogging to make sure I exercise enough."

The nurse is developing the discharge plan for a woman who has had a left-sided radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which statement by the client indicates the need for additional instructions?

"I should wear clothing with elasticized sleeves."

The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth?

11

A woman gives birth to a newborn at 36 weeks' gestation. She tells the nurse, "I'm so glad my baby isn't premature." Which response by the nurse would be most appropriate?

"We still need to monitor him closely for problems."

The nurse is assessing the respirations of several newborns. The nurse would notify the health care provider for the newborn with which respiratory rate at rest?

68 breaths per minute

The nurse is reviewing the medical records of several clients. Which client would the nurse expect to have an increased risk for developing osteoporosis?

A thin woman with small bones

A nurse is providing car to a LGA newborn. The nurse checks the newborn's blood glucose level and finds it to be 23 mg/dL. Which action would the nurse do first?

Administer intravenous glucose immediately

A woman comes to the clinic because she has been unable to conceive. When reviewing the woman's history, the nurse would least likely identify which factor as a possible risk?

Age of 25 years

While making rounds in the nursery, the nurse sees a 6-hour-old baby girl gagging and turning bluish. What would the nurse do first?

Aspirate the oral and nasal pharynx with a bulb syringe.

The nurse suspects that a client may be developing disseminated intravascular coagulation. The woman has a history of abruptio placenta during delivery. Which finding would help to support the nurse's suspicion?

Appearance of petechiae

A nurse is conducting a presentation for a group of pregnant women who are considered high-risk. After describing the complications that can occur in newborns, the nurse determines that the teaching was successful when the group identifies which newborn as having the lowest risk for problems?

Appropriate-for-gestational age

A group of nurses are reviewing information about mastitis and its causes in an effort to develop a teaching program on prevention for postpartum women. The nurses demonstrate understanding of the information when they focus the teaching on ways to minimize risk of exposure to which organism?

Aureus

A nurse is preparing a class for a group of women at a family planning clinic about contraceptives. When describing the health benefits of oral contraceptives, which benefits would the nurse most likely include? Select all that apply.

Reduced risk for endometrial cancer Protection against pelvic inflammatory disease Improvement in acne

A nurse is assessing a newborn's reflexes. The nurse strokes the lateral side of the newborn's foot from heel to the ball of the foot to elicit which reflex?

Babinski

The nurse is conducting a class for postpartum women about mood disorders. The nurse describes a transient, self-limiting mood disorder that affects mothers after childbirth. The nurse determines that the women understood the description when they identify the condition as postpartum:

Blues

The nurse is assessing a preterm newborn's fluid and hydration status. Which finding would alert the nurse to possible overhydration?

Bulging fontanels

A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse would be alert for which of the following in the newborn?

Caput succedaneum

When assessing a newborn's reflexes, the nurse strokes the newborn's cheek, and then newborn turns toward the side that was stroked and begins sucking. The nurse documents which reflex as being positive?

Rooting reflex

After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against sexually transmitted infections (STIs)?

Condoms

A nurse is conducting a refresher in-service program for a group of neonatal nurses. After teaching the group about hepatic system adaptions after birth, the nurse determines that the teaching was successful when the group identifies which process as reflective of the change in bilirubin from a fat-soluable product to water-soluable product?

Conjugation

A nurse is teaching postpartum client and her partner about caring for their newborn's umbilical cord site. Which statement by the parents indicates a need for additonal teaching?

The cord stump should change from brown to yellow.

A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for:

DEXA scan

The nurses places a newborn with jaundice under the phototherapy lights in the nursery to achieve which goal?

Decrease the serum bilirubin level

On a follow up visit to the clinic, a nurse suspects that a postpartum client is experiencing postpartum psychosis. Which finding would most likely lead the nurse to suspect this condition?

Delusional beliefs

A woman who is 42 weeks pregnant comes to the clinic. Which of the following would be most important?

Determining an accurate gestational age

Assessment of a newborn reveals uneven gluteal (buttocks) skin creases and a "clunk" when Ortolani maneuver is performed. What would the nurse suspect?

Developmental hip dysplasia

Assessment of a postpartum woman experiencing postpartum hemorrhage reveals mild shock. Which finding would the nurse expect to assess? Select all that apply.

Diaphoresis Cool extremities

The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only with a prescription?

Diaphragm

The nurse prepares to assess a newborn who is considered to be large for gestational age (LGA). Which characteristics would the nurse correlate with this gestational age variation?

Difficulty in arousing to a quiet alert state

A woman with preterm labor is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately?

Diminished deep tendon reflexes

After the birth of a newborn, which action would the nurse do first to assist in thermoregulation?

Dry the newborn thoroughly

Which finding would the nurse expect to find in a client with endometriosis?

Dyspareunia

Vulvar cancer is suspected in a client. When reviewing the client's history, which complaint would the nurse most likely find? Select all that apply.

Dyspareunia Persistent vulvar itching History of herpes simplex

A multipara client develops thrombophlebitis after delivery. Which of the following would alert the nurse to the need for immediate intervention?

Dyspnea, diaphoresis, hypotension, and chest pain

A nurse is assessing a pregnant woman who has come to the clinic. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings?

Dysuria

A group of nurses are preparing a presentation about polyps for a local woman's group. Which information would the nurses most likely include in the presentation?

Endocervical polyps are most common in women in their 50s.

Assessment of a woman in labor who is experiencing hypertonic uterine dysfunction would reveal contractions that are:

Erratic

When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which of the following as the primary cause?

Estrogen deficiency

A nurse is conducting an in-service program for a group of labor and birth unit nurses about cesarean birth. The group demonstrates understanding of the information when they identify which condition as an appropriate indication? Select all that apply.

Fetal distress Active genital herpes infection Previous cesarean birth Placenta previa

A primigravida whose labor was initially progressing normally is now experiencing a decrease in frequency and intensity of her contractions. The nurse would assess the woman for which condition?

Fetopelvic disproportion

The nurse would be alert for possible placental abruption during labor when assessment reveals which of the following?

Gestational hyptertension

A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would assess for which of the following?

Hardening of an area in the affected breast

A nurse is massaging a postpartum client's fundus and places the nondominant hand on the area above the symphysis pubis based on the understanding that this action:

Helps support the lower uterine segment

The nurse is reviewing the laboratory test results of a client with abnormal uterine bleeding (AUB). Which finding would be of concern?

Hemoglobin level of 10.1 g/dL

A nurse is reviewing the medical record of a woman diagnosed with vulvar cancer. Which information would the nurse identify as a risk factor for this cancer? Select all that apply.

Hypertension HPV 16 Exposure Diabetes

A nurse is teaching a pregnant woman at risk for preterm labor about what to do if she experiences signs and symptoms. The nurse determines that the teaching was successful when the woman makes which statement?

I'll drink several glasses of water

After teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching?

I'm going to have to wait a few days before I can start breast-feeding.

A nurse is describing the risks associated with prolonged pregnancy as part of an inservice presentation. Which factor would the nurse be least likely to incorporate in the discussion as an underlying reason for problems in the fetus?

Increased amniotic fluid volume

A client experiencing prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which condition in the mother and the newborn?

Infection

A group of nurses are reviewing information about the changes in the newborn's lungs that must occur to maintain respiratory function. The nurses demonstrate understanding of this information when they identify which event as occurring first?

Initiation of respiratory movement

When performing a clinical breast examination, which would the nurse do first?

Inspect the breasts

A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program?

Inspecting the placenta after delivery for intactness

A new mother asks the nurse, "Why has my baby lost weight since he was born?" The nurse integrates knowledge of which cause when responding to the new mother?

Insufficient calorie intake

When discussing contraceptive options, the nurse would recommend which option as being the most reliable?

Intrauterine system

After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position?

Knee-chest

A nurse is reading a journal article about cesarean births and the indications for them. Which indication for cesarean birth occurs most frequently?

Labor dystocia

A group of nursing students are reviewing information about methods used for cervical ripening. The students demonstrate understanding of the information when they identify which of the following as a mechanical method?

Laminaria

A client comes to the clinic with abdominal pain. Based on her history, the nurse suspects endometriosis. The nurse expects to prepare the client for which evaluatory method to confirm the suspicion?

Laparoscopy

The nurse is auscultating a newborn's heart and places the stethoscope at the point of maximal impulse at which location?

Lateral to the midclavicular line at the fourth intercostal space

When developing the plan of care for a woman who has had an abdominal hysterectomy, the nurse would identify which action as contraindicated?

Massaging the client's legs

A postpartum client comes to the clinic for her routine 6-week visit. The nurse assesses the client and suspects that she is experiencing subinvolution based on which finding?

Moderate lochia serosa

A client who has come to the clinic is diagnosed with endometriosis. What would the nurse expect the primary care provider to prescribe as a first-line treatment?

NSAIDs

The nurse completes the initial assessment of a newborn. Which finding would lead the nurse to suspect that the newborn is experiencing difficulty with oxygenation?

Nasal flaring

A postpartum client is prescribed medication therapy as part of the treatment plan for postpartum hemorrhage. Which medication would the nurse least expect to administer in this situation?

Nifedipine

After teaching a group of nursing students about tocolytic therapy, the instructor determines that the teaching was successful when they identify which drug as being used for tocolysis? Select all that apply.

Nifedipine Terbutaline Indomethacin

A nurse is assessing a client who gave birth vaginally about 4 hours ago. The client tells the nurse that she changed her perineal pad about an hour ago. On inspection, the nurse notes that the pad is now saturated. The uterus is firm and approximately at the level of the umbilicus. Further inspection of the perineum reveals an area, bluish in color, and bulging just under the skin surface. Which action would the nurse do next?

Notify the health care provider.

When assessing several women for possible VBAC, which woman would the nurse identify as being the best candidate?

One who had previous cesarean birth via a low transverse incision

The nurse would refer a client, age 54, for a follow up for suspected endometrial carcinoma if she reports which information?

Onset of painless, red postmenopausal bleeding

A woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which event?

Ovulation

A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer?

Oxytocins

The fetus of a woman in labor is determined to be in persistent occiput posterior position. Which intervention would the nurse identify as the priority?

Pain relief measures

Which measure would the nurse include in the teaching plan for a woman to reduce the risk for osteoporosis after menopause?

Participating in regular daily excercise

A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. After describing the medications that can be used as treatment, the nurse determines that additional teaching is needed when the client identifies which drug as being used?

Penicillin

A nurse is preparing an inservice education program for a group of nurses about dystocia involving problems with the passenger. Which problem would the nurse most likely include as the most common?

Persistent occiput posterior position

The nurse administers vitamin K intramuscularly to the newborn based on which rationale?

Promote blood clotting

Which measure would be most appropriate for the nurse to do when assisting parents who have experienced the loss of their preterm newborn?

Provide opportunities for them to hold the newborn.

A nurse is providing a refresher class for a group of postpartum nurses. The nurse reviews the risk factors associated with postpartum hemorrhage. The group demonstrates understanding of the information when they identify which risk factors associated with uterine tone? Select all that apply.

Rapid labor Hydraminos

A nurse is assessing a postpartum client. Which finding would cause the nurse the greatest concern?

Sharp, stabbing chest pain with shortness of breath.

After teaching a group of nursing students about risk factors associated with dystocia, the instructor determines that the teaching was successful when the students identify which of the following as increasing the risk? Select all that apply.

Short maternal stature Maternal age over 35 Breech fetal presentation

Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction?

Shortened

The nurse notifies the obstetrical team immediately because the nurse suspects that the pregnant woman may be exhibiting signs and symptoms of amniotic fluid embolism. Which findings would the nurse most likely assess? Select all that apply.

Significant difficulty breathing Tachycardia Pulmonary edema Bleeding with bruising

While observing the interaction between a newborn and the mother, the nurse notes the newborn nesting into the arms of the mother. The nurse identifies this as which behavior?

Social behaviors

A woman using the cervical mucus ovulation method of fertility awareness reports that her cervical mucus looks like egg whites. The nurse interprets this as which kind of mucus?

Spinnbarkeit mucus

A nurse is preparing a presentation for a group of perinatal nurses about common problems associated with preterm birth. When describing the preterm newborn's risk for perinatal asphyxia, the nurse includes which factor as contributing to the newborn's risk? Select all that apply.

Surfactant deficiency Immaturity of the respiratory control centers

A client is to receive an implantable contraceptive. The nurse describes this contraceptive as containing:

Synthetic progestin

A nurse is conducting a refresher program for a group of nurses about chemotherapy used for breast cancer. After teaching the group about the different types of chemotherapeutic agents used to treat breast cancer, the nurse determines that the teaching was successful when the group identifies which agent as an example of a selective estrogen receptor modulator (SERM)? Select all that apply.

Tamoxifen Raloxifene

A woman experiencing postpartum hemorrhage is ordered to receive an uterotonic agent. Which of the following would the nurse least expect to administer?

Terbutaline

When developing a teaching plan for a couple considering contraception options, the nurse includes which statement?

The best contraception is the one you will use correctly and consistently.

When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage because:

These measurements may not change until after the blood loss is large

A woman with a history of crack cocaine abuse is admitted to the labor and birth area. While caring for a client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also reports acute abdominal pain that is continuous. Which condition would the nurse suspect?

Uterine rupture

Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups. Based on an interpretation of these findings, the nurse would be especially alert for which of the following?

Thrombophlebitis

A pregnant woman at 31-weeks' gestation calls the clinic and tells teh nurse that she is having contractions sporadically. Which instructions would be most appropriate for the nurse to give the woman? Select all that apply.

Try emptying your bladder Drink 2 to 3 glasses of water Stop what you are doing and rest

A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which finding would require immediate intervention?

Urine output of 20 mL/hour

A nurse is reviewing a journal article on the causes of postpartum hemorrhage. Which condition would the nurse most likely find as the most common cause?

Uterine atony

A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which effect?

Uterine hyperstimulation

When teaching new parents about the sensory capabilities of their newborn, which sense would the nurse identify as being the least mature?

Vision

Which of the following would be most appropriate when massaging a woman's fundus?

Wait until the uterus is firm to express clots.