OB HESI EAQ - Uncomplicated

The nurse is assigned to care for an adolescent who gave birth 12 hours ago. The client continually talks on the phone to her friends and does not respond when her new baby cries. What is the priority intervention at this time? Calling social service for a consult Calling the psychiatric team for an intervention Calling her mother and having her speak with the client Modeling appropriate behaviors that encourage infant bonding

Modeling appropriate behaviors that encourage infant bonding

The husband of a client who is in the transition phase of the first stage of labor becomes very tense and anxious and asks a nurse, "Would it be best for me to leave, since I don't seem to be doing my wife much good?" What is the appropriate response by the nurse? "This is the time when your wife needs you. Don't run out on her now." "I know that this is hard for you. Let me try to help you coach her during this difficult phase." "I know that this is hard for you. Why don't you go have a cup of coffee to help you relax and then come back in a little while?" "If you feel that way, you'd best go out and sit in the fathers' waiting room for a while. You'll just end up transmitting your anxiety to your wife."

"I know that this is hard for you. Let me try to help you coach her during this difficult phase."

The nurse assists a client to the bathroom to void several times during the first stage of labor. Why is this is an important component of nursing? A full bladder is often injured during labor. A full bladder may inhibit the progress of labor. A full bladder jeopardizes the status of the fetus. A full bladder predisposes the client to urinary infection.

A full bladder may inhibit the progress of labor.

While monitoring the fetal heart rate (FHR) of a client in labor, the nurse identifies an increase of 15 beats more than the baseline rate of 135 beats per minute that lasts 15 seconds. How should the nurse document this event? An acceleration An early increase A sonographic motion A tachycardic heart rate

An acceleration

Which breathing technique should the nurse instruct the client to use as the head of the fetus is crowning? Shallow Blowing Slow chest Modified paced

Blowing

A client at 10 weeks' gestation tells the nurse in the maternity clinic that she is worried because she is voiding frequently. How should the nurse respond? Recommend that she inform her healthcare provider. Explain why this is expected in early pregnancy. Tell the client not to worry because this is expected. Collect the client's urine for a culture and sensitivity test.

Explain why this is expected in early pregnancy.

During the second stage of labor the nurse discourages the client from holding her breath longer than 6 seconds while pushing with each contraction. Which complication does this prevent? Fetal hypoxia Perineal lacerations Carpopedal spasms Maternal hypertension

Fetal hypoxia

During the assessment of a client in labor, the cervix is determined to be dilated 4 cm. What stage of labor does the nurse record? First Second Prodromal Transitional

First

Using the five-digit system, determine the obstetric history in this situation: The client is 38 weeks into her fourth pregnancy. Her third pregnancy, a twin gestation, ended at 32 weeks with a live birth, her second pregnancy ended at 38 weeks with a live birth, and her first pregnancy ended at 18 weeks. G4, T2, P1, A1, L2 G4, T1, P2, A1, L1 G4, T1, P1, A1, L3 G4, T2, P1, A1, L1

G4, T1, P1, A1, L3

A multigravida in the active phase of labor says, "I feel all wet. I think I wet myself." What should the nurse do first? Give her the bedpan. Change the bed linens. Inspect her perineal area. Take an oral temperature.

Inspect her perineal area.

A nurse is assessing a new client in active labor for fetal position. Where will fetal heart tones be heard if the fetus' position is left occiput anterior (LOA)?

LLQ

The nurse is teaching a client to care for her episiotomy after discharge. Which priority instruction should the nurse include in her instructions? Rest with legs elevated at least two times a day. Avoid stair climbing for several days after discharge. Perform perineal care after toileting until healing occurs. Continue sitz baths three times a day if they provide comfort.

Perform perineal care after toileting until healing occurs.

On a routine prenatal visit, what is the sign or symptom that a healthy primigravida at 20 weeks' gestation will most likely report for the first time? Quickening Palpitations Pedal edema Vaginal spotting

Quickening

Physical assessment of a client in active labor reveals that the cervix is dilated 3 to 4 cm and 50% effaced, the fetus is in the right sacrum anterior (RSA) position, and contractions are 5 minutes apart. Where should the nurse place the stethoscope to best locate the fetal heart tones?

RUQ

The nurse is instructing a primigravid client how to identify the onset of labor. Which clinical indicator of labor would necessitate the client to call her healthcare provider? Bloody show and back pressure occurring with no contractions Irregular contractions coming 10 minutes apart Rupture of membranes or contractions 5 minutes apart Contractions 12 minutes apart and lasting about 30 seconds

Rupture of membranes or contractions 5 minutes apart

A nurse caring for a client who gave birth to a healthy neonate evaluates the client's uterine tone 8 hours after delivery. How does the nurse determine that the uterus is demonstrating appropriate involution? The amount of lochia rubra is moderate Numerous clots are being passed vaginally Bleeding from the episiotomy has stopped Uterine cramps are absent during breastfeeding

The amount of lochia rubra is moderate

A woman who is 28 weeks pregnant calls the clinic to report that she is frightened because she has begun leaking breast milk. What is the best response? She needs to come in for a calcium level. She needs to come in for a nonstress test. She needs to get off her feet and rest more. This can be a normal occurrence during pregnancy.

This can be a normal occurrence during pregnancy.

A few hours after being admitted in early labor, a primigravida perspires profusely and becomes restless, flushed, and irritable. The client reports that she feels as though she is going to vomit. Which phase of the first stage of labor does the nurse suspect the client has entered? Latent Transition Late active Early active

Transition

A client had a fourth-degree perineal laceration during the birth of her neonate. What should the nurse recommend to protect the area from additional trauma? "Take sitz baths at least three times each day." "Apply a premoistened anesthetic pad to the area." "Avoid straining at stool with the use of an enema." "Eat a high-fiber diet with increased fluid intake."

"Eat a high-fiber diet with increased fluid intake."

What statement by a breast-feeding mother indicates that the nurse's teaching regarding stimulating the let-down reflex has been successful? "I will take a cool shower before each feeding." "I will drink a couple of quarts of fat-free milk a day." "I will wear a snug-fitting breast binder day and night." "I will apply warm packs and massage my breasts before each feeding."

"I will apply warm packs and massage my breasts before each feeding."

A client in active labor arrives in the birthing unit, and birth is imminent. What is the most important question for the nurse to ask at this time? "Is this your first baby?" "Have your membranes ruptured?" "When did your contractions begin?" "When is your baby's expected date of birth?"

"When is your baby's expected date of birth?"

After performing Leopold maneuvers on a laboring client, the nurse determines that the fetus is in the right occiput posterior (ROP) position. Where should the Doppler ultrasound transducer be placed to best auscultate fetal heart tones? Above the umbilicus in the midline Above the umbilicus on the left side Below the umbilicus on the right side Below the umbilicus near the left groin

Below the umbilicus on the right side

During labor a client begins to experience dizziness and tingling of her hands. What should the nurse instruct the client to do? Breathe into her cupped hands Pant during the next three contractions Hold her breath with the next contraction Use a fast, deep, or shallow breathing pattern

Breathe into her cupped hands

What common problem affects the client in labor when an external fetal monitor has been applied to her abdomen? Intrusion on movement Inability to take sedatives Interference with breathing techniques Increased frequency of vaginal examinations

Intrusion on movement

A 42-year-old client undergoes amniocentesis during the 16th week of gestation because of concern about Down syndrome. Which additional information about the fetus will examination of the amniotic fluid reveal at this time? Lung maturity Type 1 diabetes Cardiac anomaly Neural tube defect

Neural tube defect

A 36-year-old multigravida who is at 14 weeks' gestation is scheduled for an alpha-fetoprotein test. She asks the nurse, "What does this test do?" The nurse responds that this test can reveal what? Kidney defects Cardiac anomalies Neural tube defects Urinary tract anomalies

Neural tube defects

What should a nurse include in nutritional planning for a newly pregnant woman of average height who weighs 145 lb (65.8 kg)? A decrease of 100 calories per day A decrease of 200 calories per day An increase of 300 calories per day An increase of 500 calories per day

An increase of 300 calories per day

Two days after having a cesarean birth, a client tells the nurse that she has pain in her right leg. After an assessment the nurse suspects that the client has a thrombus. What is the nurse's primary response at this time? Maintaining bed rest Applying warm soaks Performing leg exercises Massaging the affected area

Maintaining bed rest

The nurse instructs a pregnant client regarding fetal growth and development. Which statement indicates that the client requires further teaching? "The fetus keeps growing throughout pregnancy." "The fetus may be underweight if it's exposed to smoke." "The fetus gets nutrients from the amniotic fluid." "The fetus gets oxygen from blood in the placenta."

"The fetus gets nutrients from the amniotic fluid."

What is the best advice a nurse can provide to a pregnant woman in her first trimester? Cut down on drugs, alcohol, and cigarettes." "Avoid drugs and don't smoke or drink alcohol." Avoid smoking, limit alcohol consumption, and don't take aspirin." "Take only prescription drugs, especially in the second and third trimesters."

"Avoid drugs and don't smoke or drink alcohol."

The nurse is teaching participants in a prenatal class regarding breastfeeding versus formula feeding. A client asks, "What is the primary advantage of breastfeeding?" Which response is most appropriate? "Breastfed infants have fewer infections." "Breastfeeding inhibits ovulation in the mother." "Breastfed infants adhere more easily to a feeding schedule." "Breastfeeding provides more protein than cow's milk formula does."

"Breastfed infants have fewer infections."

A woman who has just delivered an infant asks to take the placenta home with her upon discharge. What is the most appropriate response by the nurse? "I'll wrap that right up for you." "I'm sorry, but you can't do that." "I'll give it to you for your husband to take home now." "I need to check the hospital protocol for our policy on that practice."

"I need to check the hospital protocol for our policy on that practice."

A client whose weight was average for her height before becoming pregnant is concerned because she has gained 15 lb (6.8 kg) after only 23 weeks of pregnancy. What is the nurse's most appropriate response? "You have not gained enough weight. Can you increase your daily intake of calories?" "Your weight is not a concern. I'll refer you to the dietitian, who will review your diet." "You've gained too much weight for 23 weeks' gestation. Are your rings getting tight?" "Your weight is expected for someone at 23 weeks' gestation. Continue your current diet."

"Your weight is expected for someone at 23 weeks' gestation. Continue your current diet."

A woman in labor hears the primary healthcare provider tell the nurse that the fetal lie is longitudinal. The mother asks the nurse what this means in relation to her labor and birth of the baby. How should the nurse respond? "A vaginal birth is possible." "We're anticipating a cesarean delivery." "It has no relevance to the labor and birth." "Labor probably will be long, and you might have back pain."

A vaginal birth is possible.

A client tells the nurse that the first day of her last menstrual period was July 22. What is the estimated date of birth (EDB)? May 7 April 29 April 22 March 6

April 29

A 22-year-old primigravida is admitted to the hospital in labor. After performing a vaginal examination, the nurse determines that the client's cervix is dilated 2 cm and 80% effaced and that the presenting part is at 0 station. What is the location of the presenting part? Entering the vagina Floating within the bony pelvis At the level of the ischial spines Above the level of the ischial spines

At the level of the ischial spines

How does the nurse determine when true labor and not false labor is present? Cervical dilation is evident. Contractions stop when the client walks around. The client's contractions progress only when she is in a side-lying position. Contractions occur immediately after the membranes rupture.

Cervical dilation is evident.

A client in active labor starts screaming, "The baby is coming! Do something!" What is the nurse's primary action? Notifying the practitioner of the imminent birth Telling the client that it is too soon and encouraging her to pant Checking the perineal area for the presenting part Helping the client hold her knees together and explaining what to expect

Checking the perineal area for the presenting part

A client in active labor is admitted to the birthing room. A vaginal examination reveals that her cervix is dilated 6 to 7 cm. In light of this finding, what does the nurse expect? Client may experience nausea and vomiting. Client's bloody show will become more profuse. Client will experience uncontrollable shaking of her legs. Client's contractions will become longer and more frequent.

Client's contractions will become longer and more frequent.

External fetal uterine monitoring is started for a client in active labor. A nurse identifies fetal heart rate decelerations in a uniform wave shape that reflects the shape of the contraction. What is the nurse's next action? Notifying the healthcare provider of possible head compression Placing the client in a knee-chest position to avoid cord compression Putting the client in a dorsal recumbent position to prevent compression of the vena cava Continuing to monitor the client for the return of the fetal heart rate to baseline when each contraction ends

Continuing to monitor the client for the return of the fetal heart rate to baseline when each contraction ends

The nurse is preparing to counsel a client whose two previous pregnancies were uneventful, ending in term vaginal births of healthy children. What should the nurse consider regarding multiparas with previous uneventful pregnancies before beginning prenatal counseling? Multiparas cope more successfully with pregnancy than do primigravidas. Each pregnancy is a unique experience that is stressful despite multiparity. This pregnancy will provoke a situational crisis because the client has two children at home. Support people play a lesser role because the client has had two prior experiences with pregnancy.

Each pregnancy is a unique experience that is stressful despite multiparity.

A client in her 37th week of gestation calls the nurse at the clinic and reports, "My ankles are so swollen." Which intervention should the nurse recommend? Limiting fluid intake during the day Elevating her legs more frequently during the day Restricting salt intake for the remainder of her pregnancy Taking a mild diuretic that the healthcare provider will prescribe

Elevating her legs more frequently during the day

Which instruction is most important for the nurse to include when teaching a client about a contraction stress test (CST)? Empty the bladder before the test. Eat nothing for 6 hours after the test. Take the prescribed alprazolam before the test. Be prepared to remain in the hospital for 12 hours after the test.

Empty the bladder before the test.

The partner of a woman in labor is having difficulty timing the frequency of contractions and asks the nurse to review the procedure. How should contractions be timed? From the end of one contraction to the end of the next contraction From the end of one contraction to the beginning of the next contraction From the beginning of one contraction to the end of the next contraction From the beginning of one contraction to the beginning of the next contraction

From the beginning of one contraction to the beginning of the next contraction

A client who has been breastfeeding tells the nurse on the third postpartum day that her breasts are painful and that she is afraid that the baby will hurt her while grasping the nipple and suckling. How should the nurse respond at this time? Offering the client an analgesic before breastfeeding Recommending that the client limit fluids for several days Suggesting that the client formula feed the baby for 2 days Helping the client express some milk manually before feeding

Helping the client express some milk manually before feeding

Because of the increased discomfort level during the transition phase of labor, nursing care should be directed toward what? Helping the client maintain control Decreasing the rate of intravenous fluid Administering the prescribed medication Having the client breathe in a uniform pattern

Helping the client maintain control

Nursing assessment of a client in labor reveals that she is entering the transition phase of the first stage of labor. Which clinical manifestations support this conclusion? Facial redness and an urge to push Bulging perineum, crowning, and caput Less intense, less frequent contractions Increased bloody show, irritability, and shaking

Increased bloody show, irritability, and shaking

What is the priority nursing intervention for the postpartum client whose fundus is three fingerbreadths above the umbilicus, boggy, and midline? Massaging the uterine fundus Helping the client to the bathroom Assessing the peripad for the amount of lochia Administering intramuscular methylergonovine (Methergine) 0.2 mg

Massaging the uterine fundus

A client at 42 weeks' gestation has a reactive nonstress test. The nurse determines that the client understands what she was taught about the results when she is overheard telling her husband that the test was what? Normal because of an increase in fetal heart rate (FHR) with fetal movement Abnormal because of a decrease in FHR between contractions Abnormal because of variability in FHR with each contraction Normal because the FHR remained unchanged with maternal movement

Normal because of an increase in fetal heart rate (FHR) with fetal movement

A client in labor begins to experience contractions 2 to 3 minutes apart and lasting about 45 seconds. Between contractions the nurse identifies a fetal heart rate (FHR) of 100 beats/min on the internal fetal monitor. What is the priority nursing action? Notifying the healthcare provider Resuming continuous fetal heart monitoring Continuing to monitor the maternal vital signs Documenting the fetal heart rate as an expected response to contractions

Notifying the healthcare provider

Which information should the nurse include in the discharge teaching of a postpartum client? The prenatal Kegel tightening exercises should be continued. The episiotomy sutures will be removed at the first postpartum visit. She may not have a bowel movement for up to a week after the birth. She should schedule a postpartum checkup as soon as her menses returns.

The prenatal Kegel tightening exercises should be continued.

As the nurse inspects the perineum of a client who is in active labor, the client suddenly turns pale and states that she feels as if she is going to faint even though she is lying flat on her back. What is the nurse's priority intervention? Turn her onto her left side Elevate the head of the bed Place her feet on several pillows Give her oxygen via a face mask

Turn her onto her left side

A client who has had a cesarean birth is being discharged. Which statement indicates to the nurse that further teaching is required? "I may take a Percocet tablet if my incision hurts." "I should take a mild laxative if I don't have a bowel movement." "I can start mild exercises once my incision has stopped hurting." "I don't need perineal care because I didn't give birth through the vagina."

"I don't need perineal care because I didn't give birth through the vagina."

A primigravid client who is at 38 weeks' gestation is undergoing a nonstress test. The nurse determines that the baseline fetal heart rate is 130 to 140 beats per minute. It rises to 160 on two occasions and 157 once during a 20-minute period. Each of the episodes in which the heart rate is increased lasts 20 seconds. Which action should the nurse take? Discontinuing the test because the pattern is within the normal range Encouraging the client to drink more fluids to decrease the fetal heart rate Notifying the primary healthcare provider and preparing for an emergency birth Recording this nonreassuring pattern and continuing the test for further evaluation

Discontinuing the test because the pattern is within the normal range

What type of lochia should the visiting nurse expect to observe on a client's pad on the fourth day after a vaginal delivery? Scant alba Scant rubra Moderate rubra Moderate serosa

Moderate serosa

The nurse observes a laboring client's amniotic fluid and decides that it is the expected color and consistency. Which finding supports this conclusion? Clear, dark amber colored, and containing shreds of mucus Straw-colored, clear, and containing little white specks Milky, greenish yellow, and containing shreds of mucus Greenish yellow, cloudy, and containing little white specks

Straw-colored, clear, and containing little white specks