OB Midterm

A nurse is teaching a client who is pregnant and has gestational diabetes about dietary changes. Which of the following statements should the nurse include in the teaching? A. "Carbohydrates should make up 55% of your diet." B. "Protein should make up 70% of your diet." C. " Fats should make up 40% of your diet." D. "Fiber should make up 10% of your diet."

A. "Carbohydrates should make up 55% of your diet."

A nurse is caring for a client who is scheduled to undergo an amniocentesis to assess fetal lung maturity. The client is G2P1 and at 36 weeks of gestation, and she has an O+ blood type. Which of the following interventions should the nurse perform? A. Apply an external fetal monitor to the client B. Instruct the client to drink fluids and not void before the procedure C. Administer Rho(D) Immunoglobulin after the procedure D. Instruct the client to take a deep breath and hold it during the entry of the needle

A. Apply an external fetal monitor to the client

A nurse is caring for a client in the third trimester of pregnancy who is scheduled to undergo a nonstress test. Which of the following actions should the nurse take prior to the test? A. Ask the client to drink a glass of orange juice B. Prepare the client for a vaginal exam C. Request a serum hemoglobin level D. Obtain a clean catch urine specimen

A. Ask the client to drink a glass of orange juice

A nurse is providing care to a client who is in labor. A fetal heart tracing shows early decelerations. Which of the following actions should the nurse take? A. Continue to monitor the fetal heart tracings B. Elevate the client's legs C. Increase the rate of the maintenance IV fluids D. Administer oxygen via facemask

A. Continue to monitor the fetal heart tracings

A nurse is in the labor and delivery unit caring for a client who is in the second stage of labor. Which of the following actions should the nurse take? A. Encourage the client to change positions frequently B. Instruct the client to take breaths and hold them for 10 seconds while pushing C. Assess maternal vital signs every 1 hour D. Assist the client to the restroom

A. Encourage the client to change positions frequently

A nurse is monitoring a client who is receiving spinal anesthesia. The nurse should identify which of the following findings as a complication of the infusion? A. Maternal hypotension B. Fetal tachycardia C. Increased fetal heart rate variability D. maternal hypothermia

A. Maternal hypotension

A nurse is assessing a client who reports that she might be pregnant. Which of the following findings should the nurse identify as a presumptive sign of pregnancy? A. Nausea in the morning B. Positive home pregnancy test C. Increased sensitivity of the cervix noted upon examination D. Gestational sac observed by transvaginal ultrasound

A. Nausea in the morning

A nurse is assessing a client who has a placenta previa. Which of the following findings should the nurse expect? A. Painless, bright red bleeding B. Board-like uterus C. Persistent uterine contractions D. Abdominal pain

A. Painless, bright red bleeding

A nurse is planning care for a client in labor who is positive for HIV. Which of the following actions should the nurse take after the baby is born? A. Encourage the mother to breast feed B. Administer the hep B vaccine prior to discharge C. Implement contact and droplet precautions when providing care for the infant. D. Collect a cord blood specimen to test for the presence of HIV

B. Administer the hep B vaccine prior to discharge

A nurse receives a report for a client who is in labor and is experiencing contractions 4 minutes apart. Which of the following patterns should the nurse expect on the fetal monitor tracing? A. Contractions that last for 60 sec each with a 4 min rest between each contraction. B. Contractions that last for 60 sec each with a 3 min rest between each contraction. C. A contraction that lasts 4 minutes followed by a period of relaxation D. Contractions that last 45 sec each with a 3 min rest between each contraction

B. Contractions that last for 60 sec each with a 3 min rest between each contraction.

A nurse is admitting a client who is in labor and experiencing moderate bright red vaginal bleeding. Which of the following actions should the nurse take? A. Perform a vaginal examination to determine cervical dilation B. Obtain blood samples for baseline laboratory values C. Place a spiral electrode on the fetal presenting part D. Prepare the client for a transvaginal ultrasound

B. Obtain blood samples for baseline laboratory values

A nurse is reviewing the medical record of a client at 33 weeks gestation who has placenta previa and bleeding. Which of the following prescriptions should the nurse clarify with the provider? A. Perform a vaginal examination B. Perform continuous external fetal monitoring C. Insert a large-bore IV catheter D. Obtain a blood sample for lab testing

A. perform a vaginal examination

A nurse is discussing the expected changes related to pregnancy with a client who is at 8 weeks gestation. Which of the following findings should the client to report to the provider during the first trimester? A. Breast tenderness B. urinary frequency C. persistent vomiting D. No fetal movement

C. persistent vomiting

A nurse is caring for a client who is in labor. Which of the following methods will determine the frequency of the client's contractions? A. Palpating the firmness of the uterus during a contraction. B. Calculating the time from the end of each contraction to the beginning of the next. C. Measuring the time from the beginning of a contraction to the end of the same contraction D. Evaluating the time from the beginning of a contraction to the end of the next.

D. Evaluating the time from the beginning of a contraction to the end of the next.

A nurse is using Naegele's rule to determine the estimated date of birth (EDB) for a client whose first day of her last menstrual period was February 2, 2018. The nurse should identify which of the following dates as the client's EDB. A. November 16, 2018 B. October 19, 2018 C. October 26, 2018 D. November 9, 2018

D. November 9, 2018

A nurse is reviewing the lab report for a client with suspected HELLP syndrome. Which of the following findings should the nurse report to the provider as an indication of this disorder? A. Elevated hemoglobin B. Elevated creatinine clearance C. Elevated liver enzymes D. Elevated platelet count

C. Elevated liver enzymes (HELLP= hemolysis, elevated liver enzymes, low platelet count)

A nurse is caring for a client who is in labor and receiving an infusion of Oxytocin. The nurse should monitor the client for which of the following adverse effects? A. Diarrhea B. Thromboembolism C. Fetal asphyxia D. Oliguria

C. Fetal asphyxia

A nurse is providing care to a client who is in labor and experienced a spontaneous rupture of membranes (SROM). Which of the following findings requires intervention by the nurse? A. Intense contractions lasting less than 30 sec B. Rest periods between contractions lasting longer than 90 seconds C. Fetal heart rate decreased by 15/min D. Maternal temperature of 37.8C (100F) after ruptured membranes

C. Fetal heart rate decreased by 15/min (indicates cord compression)

A nurse is caring for a client who states, "I think I am pregnant.". Which of the following findings should the nurse identify as a positive sign of pregnancy. A. Positive serum pregnancy test B. Amenorrhea C. Fetal heart tones auscultated by doppler D. Chadwick sign

C. Fetal heart tones auscultated by doppler

A nurse is assessing a pregnant client who is at 38 weeks gestation . The client reports that her breathing has become easier but notes an increased frequency of urination. The nurse should document this occurrence as which of the following? A. Effacement B. Dilation C. Lightening D. Quickening

C. Lightening

A nurse at a family planning clinic is preparing to teach a class about how to use a diaphragm. Which of the following pieces of information should the nurse plan to include in the teaching? A. "Use a spermicidal jelly whenever you use your diaphragm." B. "Insert the diaphragm about 8 hours before sexual activity." C. "You should remove the diaphragm 30 minutes after intercourse." D. "A diaphragm comes in a single size and does not require fitting."

A. "Use a spermicidal jelly whenever you use your diaphragm."

A nurse is providing nutritional counseling for a client who is pregnant. Which of the following nutrients should the nurse instruct the client to increase in her diet daily? A. Iron B. Calcium C. Vitamin E D. Vitamin K

A. Iron

A nurse is assessing a client who is at 12 weeks gestation and has a hydatidiform mole. Which of the following findings should the nurse expect? A. hypothermia B. Dark brown vaginal discharge C. decreased urinary output D. Fetal heart tones

B. Dark brown vaginal discharge

A nurse is assessing a client who is in the first stage of labor and has preeclampsia. Which of the following findings should the nurse expect? A. Severe hypotension B. Proteinuria C. Elevated platelet count D. Seizures

B. Proteinuria

A nurse is teaching a client about a nonstress test. Which of the following statements by the client indicate an understanding of the teaching? A. "I know not to eat anything after midnight." B. "I will have medication given to me to cause contractions." C. "I should press the button on the handheld marker when my baby moves." D. "I will have to stimulate my breast to cause contractions."

C. "I should press the button on the handheld marker when my baby moves."

A nurse is discussing diaphragm use with a client. Which of the following statements made by the client indicate an understanding of the teaching? A."I should clean my diaphragm with alcohol each time I use it? B. "I should leave my diaphragm in place for 4 hours after intercourse." C. "I should replace my diaphragm every 2 years." D. "I should use a vaginal lubricant to insert my diaphragm."

C. "I should replace my diaphragm every 2 years."

A nurse is caring for a client who is receiving magnesium sulfate IV. Which of the following medications should the nurse have available as an antidote to magnesium sulfate? A. Betamethasone B. Terbutaline C. Calcium Gluconate D. Indomethacin

C. Calcium Gluconate

A nurse is caring for a client in labor. A vaginal examination reveals the following findings: 2cm, 50%, +1, Right occiput anterior (ROA). Based on this information, which of the following fetal positions should the nurse document in the medical record? A. Transverse B. Breech C. Vertex D. Mentum

C. Vertex

A nurse is planning care for a client who has a prescription for oxytocin. Which of the following is a contraindication to the use of this medication. A. Prolonged rupture of membranes at 38 weeks gestation B. Intrauterine growth restriction (IUGR) C. Post-term pregnancy D. Active genital herpes

D. Active genital herpes

A nurse is planning care for a client who is pregnant and is RH-. In which of the following situations should the nurse administer Rh(D) immune globulin? A. While the client is in labor B. Following an episode of influenza during pregnancy C. Prior to a blood transfusion D. At 28 weeks gestation

D. At 28 weeks gestation

A nurse is assessing a client who missed 2 menstrual cycles and reports she might be pregnant. Which of the following findings is a positive sign of pregnancy? A. Quickening B. Breast tenderness C. Uterine enlargement D. Auscultation of a fetal heart rate

D. Auscultation of a fetal heart rate

A nurse is reviewing the laboratory findings for 4 clients. Which of the following infections should be reported to the public health department . A. Bacterial Vaginosis B. Trichomoniasis C. Candidiasis D. Gonorrhea

D. Gonorrhea

A nurse is caring for a client in active labor whose membranes have ruptured. The fetal monitoring tracing reveals late decelerations. Which of the following actions should the nurse take first? A. Turn the client onto her left side B. Palpate the client's uterus C. Administer oxygen to the client D. Increase the client's IV fluids

A. Turn the client onto her left side

A nurse is teaching a client who is pregnant about toxoplasmosis. Which of the following instructions should the nurse include? A. "To prevent toxoplasmosis, you will need to receive the mumps, measles, an rubella vaccination during your pregnancy." B. "You should avoid gardening during your pregnancy to decrease your risk of contracting toxoplasmosis." C. "You will get a body rash if you are infected with toxoplasmosis." D. "Toxoplasmosis is transmitted through a bite from an infected mosquito."

B. "You should avoid gardening during your pregnancy to decrease your risk of contracting toxoplasmosis."

A nurse is caring for a client who is scheduled to receive intravenous Oxytocin for the induction of labor. The client has a bishop score of 10. Which of the following findings should the nurse expect? A. The client will receive Dinoprostone for ripening of the cervix. B. The client will experience lower back pain during labor C. The client will experience a successful induction of labor D. The client will require a vacuum or forceps assisted delivery

C. The client will experience a successful induction of labor

A nurse is caring for a client is in labor. The client asks the nurse, "Why are you pressing on my abdomen?" Which of the following responses should the nurse make? A. " I can determine your baby's heart rate." B. "I can confirm that you have sufficient fluid around your baby." C. "I can confirm that your baby moves with stimulation." D. "I can determine the position of your baby."

D. "I can determine the position of your baby."

A nurse is preparing to administer Meperidine Hydrochloride to a client who is in labor. Which of the following statements should the nurse make to the client? A. "This medication can cause your blood pressure to rise." B. "This medication can cause dry mouth." C. "This medication can cause you to urinate excessively." D. "This medication can make you sleepy."

D. "This medication can make you sleepy."

A nurse is caring for a client whose last menstrual period (LMP) began on July 8. Using Naegele's rule, what is the client's estimated date of birth (EDB)? A. October 1st B. April 1st C. October 15th D. April 15th

D. April 15th

A nurse is caring for a pregnant client who reports nausea and vomiting. Which of the following instructions should the nurse share with the client? A. "You should eat some crackers before rising from bed in the morning." B. "You should eat foods served at warm temperatures." C. "You should sip whole milk with breakfast." D. "You should brush your teeth immediately after each meal."

A. "You should eat some crackers before rising from bed in the morning."

A nurse is caring for a client who is at 38 weeks of gestation and reports dark red vaginal bleeding and contractions that do not stop. Which of the following actions should the nurse take first? A. Check the fetal heart tones B. Assess the uterine contraction pattern C. Measure maternal vital signs D. Obtain a biophysical profile

A. Check fetal heart tones

A nurse is teaching a client during the client's first prenatal visit. Which of the following instructions should the nurse include? A. "A fetal stethoscope can first detect your baby's heartrate at 22 weeks." B. "After week 16, we can see if your baby is a boy or a girl." C. "A doppler device can first detect your baby's heart rate at 12 weeks." D. "You will first feel the baby move at about 8 weeks."

C. "A doppler device can first detect your baby's heart rate at 12 weeks."

A nurse is caring for a client who is in the first stage of labor. Which of the following findings should the nurse identify as a cause for concern? A. Pink, mucoid vaginal discharge B. Brownish vaginal discharge C. Contractions lasting 100 seconds D. Contractions occurring every 4-5 minutes

C. Contractions lasting 100 seconds

A nurse is caring for a client who is receiving IV oxytocin for the induction of labor and notes repetitive early decelerations on the electronic fetal heart rate (FHR) tracing. Which of the following actions should the nurse take? A. Increase the rate of IV fluid infusion B. Discontinue the infusion of oxytocin C. Re-evaluate the FHR tracing in 15 minutes D. Request a prescription for an amnioinfusion.

C. Re-evaluate the FHR tracing in 15 minutes

A nurse is preparing a client who is in labor for the insertion of an intrauterine pressure catheter. The client asks why this type of monitoring is needed. Which of the following responses should the nurse make? A. "This type of monitoring is necessary for timing the frequency of your contractions." B. "This type of monitoring is noninvasive, so it is the best way to monitor your labor contractions." C. "This type of monitor allows us to evaluate your baby's heart rate while you are in labor." D. "This type of monitoring will allow us to measure the intensity of your contractions."

D. "This type of monitoring will allow us to measure the intensity of your contractions."

A nurse is providing teaching to a client who is at 8 weeks gestation about manifestations to report to the provider during pregnancy. Which of the following pieces of information should the nurse include in the teaching? A. Nausea upon awakening B. Leg cramps while sleeping C. Increased white vaginal discharge D. Blurred or double vision

D. Blurred or double vision (can be a sign of gestational diabetes)

A nurse is caring for a client who is 24 years old and at 13 weeks gestation. The client's history includes a BMI of 31 prior to pregnancy, a prior post-term delivery, and a newborn birthweight of 4,167.38 g (9 lbs 3 oz). Which of the following lab values should the nurse expect to collect? A. maternal serum alpha-fetoprotein B. pregnancy-associated plasma protein A C. Chorionic villus sampling D. HbA1C

D. HbA1C

A nurse is caring for a client who is experiencing prolonged labor. Which of the following fetal monitoring results indicate fetal compromise. A. Baseline fetal heart rate of 110-130 per minute B. Moderate baseline variability C. Accelerations in response to fetal stimulation D. Late decelerations with fetal bradycardia

D. Late decelerations with fetal bradycardia

A nurse is assessing a client who is at 30 weeks gestation and has gestational hypertension. Which of the following should the nurse identify as an indication that the client needs a biophysical profile. A. Fundal height of 30 cm B. Fetal movement count 12 kicks in 12 hours C. Fetal heart rate 136/min D. Nonreactive Nonstress test

D. Nonreactive nonstress test

A nurse is assessing a client with hyperemesis gravidarum. Which of the following findings should the nurse expect? A. Elevated serum potassium level B. Rapid weight gain C. Peripheral edema D. Presence of ketones in the urine

D. Presence of ketones in the urine

A nurse is caring for a client at 12 weeks gestation who has a BMI of 45. Which of the following pieces of information should the nurse provide for the client regarding the recommended weight gain during her pregnancy? A. "You should plan to gain no more than 20 pounds during your pregnancy." B. "You should plan to gain between 25 and 35 pounds during your pregnancy." C. "You should not plan to gain any weight during your pregnancy because you are already well-nourished." D. "Since you have higher energy needs than an average sized pregnant client, you should plan to gain 45-50 pounds."

A. "You should plan to gain no more than 20 pounds during your pregnancy."

A nurse is caring for a client at 37 weeks of gestation who is undergoing a nonstress test. The fetal heart rate (FHR) is 130/min without accelerations for the past 10 minutes. Which of the following actions should the nurse take? A. A vibroacoustic stimulation on the client's abdomen for 3 sec B. Report the nonreactive test to the provider immediately C. Request a prescription for an internal fetal scalp electrode. D. Auscultate the FHR with a doppler transducer.

A. A vibroacoustic stimulation on the client's abdomen for 3 sec

A nurse is discussing contraceptive choices with a client who has a history of thrombophlebitis. Which of the following methods of contraception should the nurse recommend? A. Copper intrauterine device B. combination pill C. vaginal ring D. medroxyprogesterone injection

A. Copper intrauterine device

A nurse is caring for a client who is in labor. Which of the following assessment findings should the nurse report to the provider? A. Fetal heart rate baseline of 90 bpm B. Maternal temperature of 37.8C (100F) C. Uterine relaxation for 1 minute between contractions D. Uterine contractions increasing in intensity

A. Fetal heart rate baseline of 90 bpm

A nurse in an antepartum clinic is caring for a client who is at 24 week gestation. Which of the following findings should the nurse report to the provider. A. Frequent headaches B. Leukorrhea C. epistaxis D. Periodic numbness of fingers

A. Frequent headaches ( associated with preeclampsia)

A nurse is caring for a client who is scheduled to receive a spinal anesthetic. Which of the following actions should the nurse plan to perform? A. Infuse a 500 mL bolus of 0.9% sodium chloride immediately prior to the procedure B. Assess the fetal heart rate pattern for 10 minutes prior to the procedure. C. Position the client upright and erect on the edge of the bed prior to the procedure. D. Monitor vital signs every 15 minutes after the anesthetic is placed

A. Infuse a 500 mL bolus of 0.9% sodium chloride immediately prior to the procedure (to prevent hypotension)

As a nurse in a prenatal care clinic answers a phone call from a client who is at 37 weeks gestation and reports, " I became very dizzy while lying in bed this morning, but the feeling went away when I turn on my side." Which of the following actions should the nurse take? A. Instruct the client about vena cava syndrome and measures to prevent it. B. Arrange for the client to come to the clinic for an assessment C. Check the client's chart for gestational diabetes mellitus D. Schedule a nonstress test for the client

A. Instruct the client about vena cava syndrome and measures to prevent it.

A nurse is caring for a client is at 38 weeks gestation and is receiving an oxytocin IV for labor augmentation. The nurse notes variable decelerations on the FHR tracing. Which of the following actions should the nurse take first? A. Place the client in a side-lying position B. Discontinue the oxytocin infusion C. Apply oxygen to the client via a face mask D. Check for umbilical cord prolapse

A. Place the client in a side-lying position

A nurse is caring for a newborn whose mother received magnesium sulfate to treat preterm labor. Which of the following clinical manifestations in the newborn indicates toxicity due to the magnesium sulfate therapy? A. Respiratory depression B. hypothermia C. hypoglycemia D. Jaundice

A. Respiratory depression

A nurse in a clinic is caring for a client who is pregnant and reports a last menstrual period (LMP) that began on December 7. Which of the following dates would be the client's estimated date of birth (EDB)? A. September 14 B. September 7 C. March 14 D. March 7

A. September 14

A nurse is caring for a client who is in labor and is receiving IV oxytocin. The nurse notes contractions lasting 3 mins each. What action should the nurse take? A. Stop the Oxytocin infusion B. Apply oxygen at 2 L/min via nasal cannula C. Administer Methylergonovine intramuscularly D. Prepare for an emergent cesarean section

A. Stop the Oxytocin infusion

A nurse is teaching a client about using the lamaze method to manage pain during labor. Which of the following pieces of information should the nurse include? A. "Learning about childbirth will reduce any fear you may have, which will help you focus more on abdominal breathing during contractions." B. "You will learn how to prevent pain during labor by forcing your mind to control your breathing." C. "During labor, you will be encouraged to disassociate by using an internal focal point." D. "During labor, You will use conscious relaxation and levels of progressive breathing."

B. "You will learn how to prevent pain during labor by forcing your mind to control your breathing."

A nurse is teaching a client who is at 10 weeks gestation about an abdominal ultrasound in the first trimester. Which of the following pieces of information should the nurse include in the teaching? A. "You will have a nonstress test prior to the ultrasound." B. "You will need to have a full bladder during the ultrasound." C. "The ultrasound will determine the length of your cervix." D. "You will experience uterine cramping during the ultrasound."

B. "You will need to have a full bladder during the ultrasound."

A nurse is preparing to perform the leopold maneuvers on a client who is in labor. Which of the following actions should the nurse plan to take? A. Ensure the client has a full bladder B. Stand at the clients right side, if the nurse is right handed. C. assist the client onto her back with her knees extended. D. Palpate the outline of the fetus's head with the palms of the hands

B. Stand at the clients right side, if the nurse is right handed.

A nurse in the prenatal clinic is reviewing the laboratory results of a client who is at 33 weeks of gestation. For which of the following results should the nurse notify the provider? A. hgb 11.3 g/dL B. platelet count 135,000/mm^3 C. WBC count 10,500/mm^3 D. HCT 38%

B. platelet count 135,000/mm^3 a low platelet count can be a sign of preeclampsia or HELLP syndrome.

A nurse is teaching a client at 13 weeks gestation about the treatment of an incompetent cervix with cervical cerclage. Which of the following statements made by the client indicate an understanding of the teaching? A. "I am sad that I won't be able to get pregnant again." B. "I can resume having sex as soon as I feel up to it." C. "I should go to the hospital if I think I may be in labor." D. "I should expect bright red bleeding while the cerclage is in place."

C. "I should go to the hospital if I think I may be in labor."

A nurse is providing counseling for a couple experiencing infertility issues. Which of the following statements by the nurse is appropriate? A. "Even though you can't have children biologically, you can still adopt." B. "You need to take a break from these attempts to conceive." C. "You might want to join our support group for couples who are experiencing similar problems." D. "why didn't you get your immunizations when you were younger?"

C. "You might want to join our support group for couples who are experiencing similar problems."

A nurse in an outpatient setting is providing education to a client who is pregnant. Which of the following statements should the nurse include in the teaching? A. "During the last trimester, you should sleep mainly on your back." B. "During the second trimester, you will notice increased urinary frequency and urgency." C. "You will probably first notice your baby moving when you are around 20 weeks gestation." D. "You should plan to gain 40-45 pounds during your pregnancy"

C. "You will probably first notice your baby moving when you are around 20 weeks gestation." ( also called quickening)

A nurse is providing teaching to a client that has come to the family-planning clinic requesting an intrauterine device (IUD). Which of the following pieces of information should the nurse provide the client? A. "If you lose weight, you will need to have your IUD refitted." B. "An IUD provides protection from certain sexually transmitted infections." C. "Your risk for ectopic pregnancy increases with an IUD." D. "You shouldn't use an IUD if you want kids later."

C. "Your risk for ectopic pregnancy increases with an IUD."

A nurse is caring for a client in the latent phase of labor who is receiving oxytocin via continuous IV infusion. The client is having contractions every 2 minutes that last 100-110 sec, and the fetal heart rate (FHR) is reassuring. Which of the following actions should the nurse take? A. Decrease the infusion rate of the maintenance IV fluid B. Administer oxygen via nonrebreather mask C. Decrease the dose of oxytocin by half D. Administer terbutaline 0.25 mg subcutaneously

C. Decrease the dose of oxytocin by half

A nurse is assessing a client who delivered vaginally 8 hours ago. The nurse notes that the client's fundus is 2 fingerbreadths above the umbilicus and has shifted to the left, and there is a large amount of lochia rubra on the perineal pad. Which of the following actions should the nurse take first? A. Administer analgesia B. Administer Carboprost IM C. Assist the client to the toilet D. Obtain a blood specimen to test HCG and HCT levels

C. assist the client to the toilet

A nurse is providing teaching about exercise to a client who is pregnant. Which of the following pieces of information should the nurse include? A. " You can continue participating in whatever sports or activities you did prior to becoming pregnant." B. "Intermittent exercise is a great way to stay healthy during pregnancy." C. "You should limit your exercise to walking if you did not exercise prior to becoming pregnant." D. "Vigorous exercises should be limited and should not be performed in hot, humid weather."

D. "Vigorous exercises should be limited and should not be performed in hot, humid weather."

A nurse is teaching a client who is at 12 weeks gestation and has human immunodeficiency virus (HIV). Which of the following statements should the nurse include in the teaching? A. "Breastfeed Your newborn to provide passive immunity." B. "abstain from sexual intercourse throughout the pregnancy." C. "You will be in isolation after delivery." D. "You should continue to take Zidovudine throughout the pregnancy.

D. "You should continue to take Zidovudine throughout the pregnancy.

A nurse is educating a client who is at 10 weeks gestation and reports nausea and vomiting. Which of the following statements should the nurse include in the teaching? A. "You should eat foods that are served at warm temperatures." B. "You should brush your teeth right after you eat." C. "You should try to eat sweet foods when you feel nauseated." D. "You should eat dry foods high in carbohydrates when you wake up."

D. "You should eat dry foods high in carbohydrates when you wake up."

A nurse is caring for a client who is 35 weeks gestation and is scheduled to undergo an amniocentesis. Which of the following statements should the nurse make? A. "You will need to drink 3-5 8-ounce glasses of water to fill your bladder." B. "This procedure will not rupture your membranes or cause premature labor." C. "You might feel a little pressure during the collection of a blood sample from the baby." D. "You will feel some minor discomfort during the procedure."

D. "You will feel some minor discomfort during the procedure."

A nurse is caring for a client who is at 39 weeks gestation and in active labor. Which of the following actions should the nurse include in the plan of care. A. Keep all 4 siderails up when the client is in bed. B. Monitor the fetal heart rate every hour C. Insert an indwelling urinary catheter D. Check the cervix prior to analgesic administration

D. Check the cervix prior to analgesic administration

A nurse is reviewing the provider's admission orders for a client who is at 37 weeks of gestation and is HIV positive. Which of the following orders should the nurse clarify with the provider? A. Intermittent auscultation B. Biophysical profile C. Non-stress test (NST) D. Fetal scalp electrode

D. Fetal scalp electrode

A nurse is caring for a client who is using pattern-paced breathing during the first stage of labor. The client reports a light-headed feeling and a tingling of the fingers. Which of the following actions should the nurse take? A. Instruct the client to hold her breath and bear down. B. Ensure that the client's breathing rate is more than twice her normal rate. C. Apply counter pressure to the client's lower back D. Have the client breathe into a paper bag.

D. Have the client breathe into a paper bag.

A nurse is caring for a client in the early stage of labor who has preeclampsia with severe features. Which of the following interventions should the nurse perform? A. Assess the fetal heart rate and contractions hourly B. Encourage oral intake of clear, low sodium fluids C. Instruct the client to ambulate during the early phase of labor D. Implement seizure precautions

D. Implement seizure precautions

A nurse is assisting with monitoring the fetal heart rate tracings of a client who is in labor. Which of the following findings should the nurse report to the provider? A. Baseline fetal heart rate of 110-130/min B. Moderate baseline variability C. Accelerations in response to fetal stimulation D. Late decelerations with fetal bradycardia

D. Late decelerations with fetal bradycardia

A nurse at a prenatal clinic is assessing an adolescent who is pregnant and visiting the clinic for the first time. Which of the following is the nurse's priority to evaluate? A. Psychological readiness B. Partner support C. Socioeconomic status D. Nutritional status

D. Nutritional status

A nurse is caring for a client who has clinical manifestations of an ectopic pregnancy. Which of the following findings is a risk factor for ectopic pregnancy? A. Anemia B. Frequent urinary tract infections C. Previous cesarean birth D. Pelvic inflammatory disease (PID)

D. Pelvic inflammatory disease (PID)

A nurse is caring for a pregnant client who is 37 weeks gestation and who had a biophysical profile with a total score of 4. Which of the following actions should the nurse anticipate taking? A. Discharge the client to home B. Administer betamethasone C. Perform an amnioinfusion D. Prepare for delivery of the infant

D. Prepare for delivery of the infant

A nurse is assessing a client who is suspected of having Hyperemesis Gravidarium. Which of the following lab tests should the nurse check first? A. CBC B. Liver enzymes C. Bilirubin level D. Urine keytones

D. Urine keytones

A nurse is caring for a client in the third trimester of pregnancy who reports difficulty sleeping. Which of the following instructions should the nurse provide? A. Eat a high fat snack before bed B. Exercise in the evening before bed C. Sleep in the supine position D. Use additional pillows to support abdomen and extremities

D. Use additional pillows to support abdomen and extremities

A nurse is creating a plan of care for a client who is in the active stages of labor and expresses a desire to use nonpharmacological methods of pain relief. Which of the following interventions should the nurse include? A. Encourage the client to listen to music B. Instruct the client how to use informational biofeedback C. Ask the client to reconsider using a regional anesthetic D. Assist the client into a warm shower

D. assist the client into a warm shower

A nurse is assessing a client who is receiving magnesium sulfate as a treatment for preeclampsia. Which of the following clinical findings is the nurse's priority. A. Respirations 16/min B. Urinary output of 40 mL in 2 hours C. Reflexes 2+ D. Fetal heart rate 158/min

B. Urinary output of 40 mL in 2 hours

A nurse is assessing a client who is in the fourth stage of labor. Which of the following findings should the nurse expect. A. Breast engorgement B. hypothermia C. urinary retention D. rupture of membranes

C. urinary retention

A nurse in a clinic is providing education to a client at 32 weeks gestation who has pruritus gravidarum. Which of the following pieces of information should the nurse provide? A. "You should slightly increase your exposure to sunlight." B. "You will need extensive dermatologic treatment for this condition after you deliver your baby." C. "Your provider will require weekly lab tests to monitor your liver function D. Your provider will prescribe Isotretinoin cream."

A. "You should slightly increase your exposure to sunlight."

A nurse is teaching a client who has active genital herpes simplex virus, type 2. Which of the following statements should the nurse include in her teaching? A. "You will have a cesarean birth prior to the onset of labor." B. "Your baby will receive erythromycin eye ointment after birth to treat the infection." C. "You should take oral metronidazole for 7 weeks prior to 37 weeks gestation" D. "You should schedule a Cesarean birth after your water breaks."

A. "You will have a cesarean birth prior to the onset of labor."

A nurse is assessing a client who is at 35 weeks gestation and had preeclampsia without severe features. Which of the following findings should the nurse identify as the priority. A. 480 mL urine output in 24 hours B. Blood pressure 144/92 mmHg C. +2 edema of the feet D. 1+ protein in urine

A. 480 mL urine output in 24 hours

A nurse is assisting with fetal heart monitoring during labor for a client who is at 40 weeks gestation. The nurse should identify that which of the following findings on the fetal monitoring tracing requires intervention? A. A fetal heart rate of 180/min for 15 min B. A deceleration that returns to baseline at the end of the contraction C. An acceleration of 20/min for 18 seconds during a contraction D. An occasional variable deceleration in fetal heart rate

A. A fetal heart rate of 180/min for 15 min

A nurse is assisting with an amniotomy for a client who is in active labor. Which of the following actions should the nurse take? A. Assess the fetal heart rate before and after the procedure B. Monitor the client's temperature every 4 hours after the procedure C. Medicate the client's pain 30 min prior to the procedure D. Perform cervical assessments every 2 hours after the procedure.

A. Assess the fetal heart rate before and after the procedure

A nurse is caring for a client who is at 38 weeks gestation and reports no fetal movement for the past 24 hours. Which of the following actions should the nurse take? A. Auscultate for a fetal heart rate B. Have the client drink orange juice C. Reassure the client that a term fetus who is less active D. Palpate the uterus for fetal movement

A. Auscultate for a fetal heart rate

A nurse is caring for a client at 32 weeks gestation who is experiencing preterm labor. Which of the following medications should the nurse plan to administer? A. Betamethasone B. Misoprostol C. Methylergonovine D. Poractant alfa

A. Betamethasone

A nurse is caring for a client who is in the second stage of labor. The fetal heart tracing indicates multiple variable decelerations. Which of the following actions should the nurse take? A. Prepare an amnioinfusion B. Place the client in a supine position C. Administer 2 L/min of oxygen via nasal cannula D. Give a glucocorticoid

A. Prepare an amnioinfusion (this decreases cord compression)

A nurse is reviewing the medical record of a client who is at 20 weeks of gestation. Which of the following findings should the nurse identify as a presumptive indication of pregnancy. A. Report of fetal movement by the client B. Auscultation of the fetal heart rate with a doppler ultrasound C. Presence of Chadwick's sign on pelvic examination D. Report of Braxton-Hick's contractions by the client

A. Report of fetal movement by the client

A nurse is assessing a client who is at 34 weeks gestation and has a cardiac disorder. The nurse should notify the provider about which of the following assessment findings? A. The client reports a frequent cough B. The client reports that none of her shoes fit anymore C. The client reports a weight gain of 2 lbs in a 2 week period D. The client reports leg cramps in the evening

A. The client reports a frequent cough

A nurse is assessing a client at 27 weeks of gestation. The client has placenta previa and reports vaginal bleeding. Which of the following additional manifestations should the nurse expect? A. The fundal height measures greater than gestational age B. A rigid abdomen is noted on palpation C. The client reports a pain level of 8 on a 0-10 pain scale D. A urine drug screen is positive for cocaine

A. The fundal height measures greater than gestational age (Client's with placenta previa often measure slightly larger than expected because the fetus remains higher in the uterus)

A nurse is caring for a client at 39 weeks gestation who is in the active phase of labor. The nurse observes late decelerations in the fetal heart rate (FHR). Which of the following findings should the nurse identify as the cause of late decelerations? A. Uteroplacental insufficiency B. Fetal head compression C. Fetal ventricular septal defect D. Umbilical cord compression

A. Uteroplacental insufficiency

A nurse is providing a nonstress test to a client at 41 weeks gestation. The client asks what the purpose of the test is. Which of the following responses should the nurse provide? A. "This test will determine if you are likely to deliver in the next week." B. "This test will determine if your baby is healthy." C. "This test can see how your baby responds when you have contractions." D. "This test will determine if your baby's lungs are mature."

B. "This test will determine if your baby is healthy."

A nurse is providing education to a client who is at 35 weeks gestation about a nonstress test. Which of the following pieces of information should the nurse include? A. "It will take about 10 minutes to complete the test." B. "You might have to drink orange juice during the test." C. "During the test you will be asked to massage your nipples." D. "During the test, you will receive a medication to relax your uterus."

B. "You might have to drink orange juice during the test."

A nurse is assessing a client who is at 36 weeks of gestation. Which of the following manifestations should the nurse recognize as a potential prenatal complication and report to the provider. A. Varicose veins B. Double vision C. Leukorrhea D. Flatulence

B. Double vision

A nurse is caring for a client who requests an IUD for contraception. Which of the following would be contraindicated for this device? A. hypertension B. Menorrhagia C. History of multiple gestations D. history of thromboembolic disease

B. Menorrhagia

A nurse is caring for a client who is pregnant and whose last menstrual period began on April 8. Using Naegele's rule, which of the following dates would be the client's estimated date of birth? A. July 15 B. July 11 C. January 11 D. January 15

D. January 15

A nurse is caring for a client at 35 weeks gestation who has severe pre-eclampsia . Which of the following assessments provides the most accurate information regarding the client's fluid and electrolyte status? A. Blood pressure B. Intake and output C. Daily weight D. Severity of edema

C. Daily weight

A nurse is assisting with an amniocentesis for a client who is Rh-negative. Which of the following actions should the nurse take following the procedure. A. Send a sample of amniotic fluid to the lab to screen the client for chlamydia. B. Send a sample of amniotic fluid to the lab to test for an elevated Rh-negative titer C. Administer immune globulin to the client to prevent fetal isoimmunizations D. Administer IV antibiotics to prevent an infection

C. Administer immune globulin to the client to prevent fetal isoimmunizations

A nurse is caring for a client who is in preterm labor and is receiving magnesium sulfate. The client begins to show signs of magnesium sulfate toxicity. Which of the following medications should the nurse prepare to administer? A. Protamine sulfate B. Naloxone C. Calcium gluconate D. Flumazenil

C. Calcium gluconate

A nurse is planning care for a client who is 35 weeks gestation. Which of the following lab tests should the nurse obtain? A. Rubella titer B. Blood type C. Group B streptococcus B-hemolytic D. 1 hour glucose tolerance test

C. Group B streptococcus B-hemolytic

A nurse is caring for a client labor has an epidural for pain relief. Which of the following is a complication of the epidural block? A. Nausea and vomiting B. tachycardia C. Hypotension D. Respiratory depression

C. Hypotension

A charge nurse is providing teaching for a newly hired nurse about the potential side effects of an epidural anesthetic for a laboring client. Which of the following effects should the charge nurse include in the teaching? A. Newborn respiratory depression at birth B. Impaired ability of the neonate to maintain body temperature C. Impaired placental perfusion D. Decreased fetal heart rate (FHR) variability

C. Impaired placental perfusion

A nurse is caring for a client in active labor who is experiencing hypotension following epidural placement. Which of the following actions should the nurse take? A. Decrease IV fluid B. Give oxygen at 2L/min via nasal cannula C. Place the client in a lateral position D. Administer Indomethacin

C. Place the client in a lateral position

A nurse is planning educational sessions for clients in childbirth class. Which of the following findings should the nurse plan to instruct the clients to report immediately? A. Vaginal Leukorrhea B. Shortness of breath C. Swelling of the face and fingers D. Lower back pain

C. Swelling of the face and fingers (can indicate hypertension/ eclampsia)

While caring for a client in active labor, a nurse notes late decelerations on the fetal monitor. Which of the following actions should the nurse take? A. Administer methyl-prostaglandin IM B. Encourage the client to use the shower C. Place the client in a supine position D. Apply oxygen at 8-10 L/min via a nonrebreather face mask

D. Apply oxygen at 8-10 L/min via a nonrebreather face mask

A nurse is caring for a client in the latent phase of labor and is experiencing low back pain. Which of the following actions should the nurse take? A. Instruct the client to pant during contractions B. Position the client supine with legs elevated C. Encourage the client to soak in a warm bath D. Apply pressure to the client's sacral area during contractions

D. Apply pressure to the client's sacral area during contractions

A nurse is performing an admission assessment of a client who just arrived at the labor and delivery unit. Which of the following findings should the nurse identify as the priority? A. The client reports a pain level of an 8 on a scale from 0-10 during contractions. B. The client's blood pressure is 148/92 mmHg C. the client's temperature is 38.3 C (101F) D. The fetal heart rate is 90/min

D. The fetal heart rate is 90/min

A nurse at a clinic is preparing to teach the process of involution to a group of antenatal clients. Which of the following information should the nurse provide? A. The fundus is approximately 2 cm (0.79 in) above the level of the umbilicus at the end of the 3rd stage of labor. B. The fundus is approximately 3 cm (1.18 in) above the umbilicus within 12 hours after delivery. C. The fundus is located halfway between the umbilicus and mons pubis on the 6th day post partum D. The fundus is not palpable abdominally at 2 weeks post partum.

D. The fundus is not palpable abdominally at 2 weeks post partum.

A nurse is caring for a client who is in labor and has fetal heart tracings of variable decelerations. Which of the following actions should the nurse take? A. Request a prescription of oxytocin B. Administer oxygen at 2L/min via nasal cannula C. Prepare for the insertion of an intrauterine balloon D. Reposition the client from side to side

D. Reposition the client from side to side

A nurse is teaching a prenatal class about pain management during labor. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I can apply a heating pad to my back to relieve back pain." B. "I can have a low spinal block to help with labor pain." C. "I can have butorphanol every 2 hours during labor." D. "My time limit for staying in the hydrotherapy tub is 30 minutes."

A. "I can apply a heating pad to my back to relieve back pain."

A nurse is caring for a client who is in labor and asks her partner to perform effleurage. The client has on a monitor belt for electronic fetal monitoring. Which of the following instructions should the nurse provide to the client's partner? A. "Lightly stroke the upper thighs." B. "Steadily apply pressure to the sacrum." C. "Gently massage the mid-abdominal area." D. "Firmly squeeze both hips."

A. "Lightly stroke the upper thighs."

A nurse on the antepartum unit is caring for a client who is at 28 weeks gestation and reports dizziness when lying on her back. Into which of the following positions should the nurse assist the client? A. lateral B. lithotomy C. trendelenburg D. prone

A. lateral

A nurse is caring for a client who is at 38 weeks gestation and in the active phase of the first stage of labor. The nurse notes 2 late decelerations of fetal heart rate during the last 5 contractions. Which of the following actions should the nurse take? A. Slow the IV infusion rate B. Assist the client to a lateral position C. Assess the bladder for urinary retention D. Initiate an oxytocin infusion

B. Assist the client to a lateral position

A nurse is teaching a client who is at 10 weeks gestation about self-care management for common discomforts during pregnancy. Which of the following instructions should the nurse include? A. Douche every other day to minimize leukorrhea. B. Consume frequent snacks to decrease episodes of nausea C. Refrain from scheduling dental procedures until the 3rd trimester D. Decrease fluid intake to reduce urinary frequency

B. Consume frequent snacks to decrease episodes of nausea

A nurse is caring for a client who is in active labor and whose birth plan requests only non-pharmacological pain relief strategies. Which of the following strategies should the nurse offer as a form of cutaneous stimulation? A. Breathing techniques B. Counter-pressure C. biofeedback D. Use of a focal point

B. Counter pressure other cutaneous stimulation include walking, effleurage, water therapy and hot/cold therapy. Breathing techniques are sensory stimulation, biofeedback is cognitive stimulation, and use of a focal point is sensory stimulation.

A nurse is caring for a client who is in labor. The nurse decides to switch from intermittent auscultation to a continuous fetal monitoring. Which of the following data can be obtained from continuous electronic fetal monitoring? A. Determination of a baseline B. Determination of variability C. Presence of accelerations D. Presence of decelerations

B. Determination of variability

A nurse is caring for a client in labor and observes a pattern of early decelerations on the fetal monitor. Which of the following actions should the nurse take? A. Notify the provider B. Document the findings and continue to monitor C. Administer oxygen via face mask D. Assist with a sterile speculum examination

B. Document the findings and continue to monitor

A nurse is teaching a client with preeclampsia who is scheduled to receive magnesium sulfate via continuous IV infusion about the expected adverse effects. Which of the following adverse effects should the nurse include in the teaching? A. Elevated blood pressure B. Feeling of warmth C. Hyperactivity D. Generalized pruritus

B. Feeling of warmth

A nurse is teaching a client who is pregnant about nonstress testing. Which of the following pieces of information should the nurse include? A. "This test is an invasive procedure that presents minimal risk to the fetus." B. "If the test is reactive, that means your baby's heart rate is healthy." C. "When your baby moves, the test should record the baby's heart rate decreasing by about 15 beats per minute." D. "The results of the test will be recorded as positive if no fetal movement occurs during the 20-minute testing period."

B. "If the test is reactive, that means your baby's heart rate is healthy."

A nurse is admitting a client who is in post-term labor. Which of the following statements should the nurse identify as priority? A. "I had blood-streaked discharge a few hours ago." B. "When my water broke, it was not clear." C. "I have not felt my baby move as much today." D. "I feel like I cannot breathe when I walk up the stairs."

B. "When my water broke, it was not clear."

A nurse is caring for a client who is in labor and has received Meperidine for pain 1 hour prior to entering the second stage of labor. Which of the following actions should the nurse take? A. Assess the client's reflexes B. Assess the newborn for respiratory depression C. Assess the client for bradycardia D. Assess the newborn for signs of opiate withdrawl

B. Assess the newborn for respiratory depression

A nurse is caring for a client who is in labor and has received epidural analgesia. The client's blood pressure is 88/50mmHg, and the fetal heart tracing shows late decelerations. Which of the following actions should the nurse take? A. Assist the client to the bathroom to empty her bladder. B. Increase the rate of of the primary IV infusion C. Position the client in a semi-fowlers position D provide glucose via oral hydration or IV

B. Increase the rate of of the primary IV infusion

A nurse in a clinic is assessing a client who is at 13 weeks gestation and has hyperemesis gravidarium. Which of the following findings should the nurse identify as the priority? A. Blood pressure 90/52mmHg B. Keytones 2+ C. Specific gravity of 1.035 D. sodium of 130 mEq/L

B. Keytones 2+ (this means that they are breaking down protein and fat for energy and not passing any to baby)

A nurse is preparing to administer an IV infusion of oxytocin for labor induction to a client who is at 41 weeks gestation. Which of the following actions should the nurse plan to take? A. Administer the oxytocin with manual IV tubing B. Monitor the fetal heart rate every 15 minutes initially C. Begin the infusion at 10 milliunits/min D. Titrate the dosage until the client has 1 contraction every minute

B. Monitor the fetal heart rate every 15 minutes initially

A nurse is caring for a client in labor. The nurse observes late decelerations on the fetal monitor. Which of the following actions should the nurse take? A. Decrease the rate of the client's maintenance IV fluids B. Place the client in a left lateral position C. Apply oxygen at 2L/min via nasal cannula D. Prepare the client for an amniocentesis

B. Place the client in a left lateral position

A nurse is planning care for a client who is in active labor whose fetus is in an occipital brow presentation. Which of the following complications should the nurse anticipate as a result of this fetal presentation? A. Precipitous labor B. Prolonged labor C. Hypertonic uterine dysfunction D. Umbilical cord prolapse

B. Prolonged labor

A nurse is caring for a client who just had a spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and a prolapsed umbilical cord. Which of the following actions should the nurse take first? A. Place the client in an extreme trendelenburg position B. Influence the IV fluid infusion rate C. Manually apply upward pressure intravaginally on the presenting part D. Administer 8-10 L/min of oxygen via a nonrebreather face mask

C. Manually apply upward pressure intravaginally on the presenting part

A nurse is caring for a client who is 36 weeks gestation who has preeclampsia. Which of the following findings should the nurse identify as the priority? A. 1+proteinuria B. Blood pressure 140/90 mm/Hg C. Nonreactive nonstress test D. Fundal height 33 cm

C. Nonreactive nonstress test

A nurse is caring for a client who had a precipitous delivery. Which of the following assessments is the priority during the fourth stage of labor? A. Obtaining the client's temperature. B. Inspecting the client's perineum C. Palpating the client's fundus D. Checking the client for hemorrhoids

C. Palpating the client's fundus

A nurse is caring for a client in active labor who has meconium staining of the amniotic fluid. The nurse notes a reassuring fetal heart rate (FHR) from the external fetal monitor. Which of the following actions should the nurse perform? A. Prepare the client for an ultrasound examination B. Prepare the client for an emergency cesarean birth C. Prepare equipment needed for newborn resuscitation D. Perform endotracheal suctioning as soon as the fetal head is delivered

C. Prepare equipment needed for newborn resuscitation

The nurse is providing nutritional teaching to a pregnant client who had a pre-pregnancy BMI of 38. Which of the following statements by the client demonstrate an understanding of the teaching about her recommended gain weight during pregnancy? A. "I should plan to gain 12.7-18.1 kg during my pregnancy." B. " I should plan to gain 11.3-15.9 kg during my pregnancy." C. "I should plan to gain 6.8-11.3 kg during my pregnancy." D. " I should plan to gain 5-9.1 kg during my pregnancy."

D. " I should plan to gain 5-9.1 kg during my pregnancy."

A nurse is caring for a client who is in active labor and receiving an oxytocin infusion. The nurse notes tachysystole with a category 1 fetal heart rate tracing. Which of the following actions should the nurse take? A. Discontinue oxytocin infusion and apply oxygen B. Increase oxytocin infusion rate by 2 mu/min C. Administer Terbutaline 0.25 mg subcutaneously D. Reposition the client in a side-lying position and continue to monitor.

D. Reposition the client in a side-lying position and continue to monitor.

While assessing a client who is in the fourth stage of labor, the nurse suspects bladder distention. Which of the following findings should the nurse anticipate with bladder distention? A. The fundus is at midline. B. The fundus is below the umbilicus. C. The bladder is resonant with percussion. D. The bladder fluctuates with palpation.

D. The bladder fluctuates with palpation.

A nurse is caring for a client in labor who is dilated to 9 cm. She is experiencing strong contractions every 2 minutes lasting 75 sec. The nurse should recognize that the client is in which of the following phases or stages of labor? A. Latent phase of first stage B. Active phase of first stage C. Second stage D. Transition stage of first stage

D. Transition stage of first stage