OB practice questions

What vital signs are normal after birth? (SATA) A. temperature up to 100.4 B. decreased heart rate C. decreased blood pressure D. increased heart rate E. increased blood pressure

temperature up to 100.4 decreased blood pressure decreased heart rate

A client with a pendulous abdomen and uterine fibroids (uterine myomas) has just begun labor and arrived at the hospital. After examining the client, the primary care provider informs the nurse that the fetus appears to be malpositioned in the uterus. Which fetal position or presentation should the nurse most expect in this woman? occipitoposterior position anterior fetal position cephalic presentation transverse lie

transverse lie

The nurse would be correct to describe the uterus as weighing ________ after birth. A. 2 oz B. 1,000 g (2.2 lbs) C. 500 g (1 lb) D. 4,000 g (8.8 lbs)

1,000 g (2.2 lbs)

It is discovered that a new mother has developed a postpartum infection. What is the most likely expected outcome that the nurse will identify for this client related to this condition? Client maintains a urinary output greater than 30 ml per hour. Lochia discharge amount is 6 inches or less on a perineal pad in 1 hour. Fundus remains firm and midline with progressive descent. Client's temperature remains below 100.4°F (38.8°C) orally.

Client's temperature remains below 100.4°F (38.8°C) orally.

A postpartum (PP) client is being treated for DVT. The nurse understands that the client's response to treatment will be evaluated by regularly assessing the client for: A. Dysuria, ecchymosis, and vertigo B. Epistaxis, hematuria, and dysuria C. Hematuria, ecchymosis, and epistaxis D. Hematuria, ecchymosis, and vertigo

Hematuria, ecchymosis, and epistaxis

The nurse is monitoring several postpartum women for potential complications related to the birthing process. Which assessment should a nurse prioritize on an hourly basis? Complete blood count Vital signs Pad count Urine volume excreted

Pad count

A G2P1 woman is in labor attempting a VBAC, when she suddenly complains of light-headedness and dizziness. An increase in pulse and decrease in blood pressure is noted as a change from the vital signs obtained 15 minutes prior. The nurse should investigate further for additional signs or symptoms of which complication? Placenta previa Uterine rupture Umbilical cord compression Hypertonic uterus

Uterine rupture

Which of the following complications is most likely responsible for a delayed postpartum hemorrhage? A. Uterine subinvolution B. Clotting deficiency C. Perineal laceration D. Cervical laceration

Uterine subinvolution

Causes of afterpains: (2)

breast feeding oxytocin

A nurse is caring for a client who has just given birth. What is the best method for the nurse to assess this client for postpartum hemorrhage? by assessing blood pressure by monitoring hCG titers by frequently assessing uterine involution by assessing skin turgor

by frequently assessing uterine involution

Lochia results from:

involution

The nurse is preparing to administer Indomethacin to a patient with a gestational age of 29 weeks. The nurse knows to assess the fetal heart rate due to which problem that can occur within 48 hours of administration? A. hydramnios B. placenta previa C. oligohydramnios D. placental abruption

oligohydramnios

A client's membranes have just ruptured. Her fetus is presenting breech. Which action should the nurse do immediately to rule out prolapse of the umbilical cord in this client? Administer oxygen at 10 L/min by face mask. Administer amnioinfusion. Place the woman in Trendelenburg position. Assess fetal heart sounds.

Assess fetal heart sounds.

The nurse is attending a class to catch up on labor and delivery topics before she is moved to work at this unit. She is correct to state that involution is inhibited by which factors: (SATA) A. full bladder B. precipitous labor C. increased age D. anesthesia E. multiparity F. incomplete expulsion of placenta

incomplete expulsion of placenta full bladder anesthesia

A patient comes into the clinic 4 weeks postpartum with whiteish vaginal drainage stating that she is worried the drainage won't stop and that there is something wrong with her. What statement by the nurse is correct? A. "This is a danger sign. You did well coming into the clinic." B. "Although lochia can occur until day 14 postpartum, it can last for 3-6 weeks so there is nothing to worry about." C. "Let's assess your vital signs and see if you have a temperature." D. "Let me call your provider. This is a very rare complication of childbirth."

"Although lochia can occur until day 14 postpartum, it can last for 3-6 weeks so there is nothing to worry about."

What increases lochia flow? (4)

ambulation breast feeding full bladder exercise

Involution is the process by which the uterus shrinks down to its original size. This process involves which three: (SATA) A. anabolism B. regeneration of the uterine epithelium C. nerve involvement in the lower uterus D. catabolism E. contraction of muscle fibers

regeneration of the uterine epithelium catabolism contraction of muscle fibers

A woman who is 30 weeks gestation comes into the clinic with fluid leaking from the vagina and low back pain. After diagnostic tests are ordered and the patient is given medication, the nurse is providing discharge education to the patient if the patient has any more symptoms. What should the nurse include in the teaching? (SATA) A. bed rest B. empty bladder C. lie on back D. call provider E. rest for 1 hour F. fluid restriction

rest for 1 hour empty bladder call provider

A nurse is providing instructions to a mother who has been diagnosed with mastitis. Which of the following statements, if made by the mother, indicates a need for further teaching? A. "I need to take antibiotics, and I should begin to feel better in 24-48 hours." B. "I can use analgesics to assist in alleviating some of the discomfort." C. "I need to wear a supportive bra to relieve the discomfort." D. "I need to stop breastfeeding until this condition resolves."

"I need to stop breastfeeding until this condition resolves."

The nurse is assigned to care for a postpartum client with a deep vein thrombosis (DVT) who is prescribed anticoagulation therapy. Which statement will the nurse include when providing education to this client? "You need to avoid medications which contain acetylsalicylic acid." "It is expected for you to have minimal blood in your urine during therapy." "It is appropriate for you to sit with your legs crossed over each other." "You can breastfeed your newborn while taking any anticoagulation medication."

"You need to avoid medications which contain acetylsalicylic acid."

A woman who is 36 weeks had a preterm labor scare, but it was able to be prolonged with tocolytic drugs. The woman asks the nurse how to prevent this in the future because she wants to have more kids. The nurse is correct to respond: A. "Unfortunately, this will happen every time you try to have children." B. "This is such a rare occurrence that I wouldn't worry about it if I were you." C. "You should wait at least 18 months in between having children." D. "We do not know enough about preterm labor to know how to prevent it."

"You should wait at least 18 months in between having children."

A PP nurse is providing instructions to a woman after delivery of a healthy newborn infant. The nurse instructs the mother that she should expect normal bowel elimination to return: A. One the day of the delivery B. 3 days PP C. 7 days PP D. within 2 weeks PP

3 days PP

A new mother asks about the fourth trimester, stating that she has never heard about it. When explaining the postpartum period to the patient, the nurse correctly states that the fourth trimester lasts A. 6 months B. 6 weeks C. 12 months D. 3 weeks

6 weeks

A new mother comes in with severe pain in her perineum and difficulty voiding. The nurse looks into the patient's history and finds that she had a second-degree laceration while giving birth a week ago. What should the nurse's priority concern be? A. Uterus atony B. Uterus distention C. Hemorrhage D. Infection

Hemorrhage

A nurse is caring for a postpartum (PP) client with a diagnosis of DVT who is receiving a continuous intravenous infusion of heparin sodium. Which of the following laboratory results will the nurse specifically review to determine if an effective and appropriate dose of the heparin is being delivered? A. Prothrombin time B. International normalized ratio C. Activated partial thromboplastin time D. Platelet count

Activated partial thromboplastin time

A nurse is monitoring a new mother in the PP period for signs of hemorrhage. Which of the following signs, if noted in the mother, would be an early sign of excessive blood loss? A. A temperature of 100.4°F. B. An increase in the pulse from 88 to 102 BPM. C. An increase in the respiratory rate from 18 to 22 breaths per minute. D. Blood pressure changes from 130/88 to 124/80 mm Hg.

An increase in the pulse from 88 to 102 BPM.

Methergine or Pitocin is prescribed for a woman to treat PP hemorrhage. Before administration of these medications, the priority nursing assessment is to check the: A. Amount of lochia B. Blood pressure C. Deep tendon reflexes D. Uterine tone

Blood pressure

A postpartum nurse is taking the vital signs of a woman who delivered a healthy newborn infant 4 hours ago. The nurse notes that the mother's temperature is 100.2°F. Which of the following actions would be most appropriate? A. Retake the temperature in 15 minutes. B. Notify the physician. C. Document the findings. D. Increase hydration by encouraging oral fluids

Increase hydration by encouraging oral fluids

A new mother comes in with severe pain in her perineum and difficulty voiding. The nurse looks into the patient's history and finds that she had a second-degree laceration while giving birth a week ago. After the nurse identifies the primary concern, what education should she provide to the patient about caring for a laceration site? (SATA) A. Use a peribottle back to front B. Hot packs C. Sitz baths with warm water D. Cold packs E. Use warm water in the peribottle

Sitz baths with warm water Cold packs Use warm water in the peribottle

Which of the following factors might result in a decreased supply of breastmilk in a postpartum (PP) mother? A. Supplemental feedings with formula B. Maternal diet high in vitamin C C. An alcoholic drink D. Frequent feedings

Supplemental feedings with formula

Which intervention would be helpful to a client who is bottle feeding her infant and experiencing hard, engorged breasts? restricting fluids applying warm compresses applying ice administering bromocriptine

applying ice

The nurse is assessing a woman who had a forceps-assisted birth for complications. Which condition would the nurse assess in the fetus? infection of episiotomy perineal hematoma caput succedaneum cervical lacerations

caput succedaneum

Various medications are available to help control hemorrhage in the postpartum client. When reviewing the client's history, the nurse notes the client's history of asthma. Which medication if prescribed would the nurse question? methylergonovine oxytocin dinoprostone carboprost

carboprost

A patient of 38 weeks is admitted regarding labor dystocia. The nurse is preparing to administer oxytocin. She knows that oxytocin must be administered with what kind of solution? A. hypotonic (0.45% NaCl) B. isotonic (lactated ringers) C. hypertonic (3% NaCl)

isotonic (lactated ringers)

A primary care provider prescribes intravenous tocolytic therapy for a woman in preterm labor. Which agent would the nurse expect to administer? indomethacin magnesium sulfate nifedipine betamethasone

magnesium sulfate

The nurse is assessing the patient who has just given birth every 15 minutes when she discovers that she cannot feel the fundus. What is the priority intervention? A. manual massage B. oxytocin C. call for help D. assess vital signs

manual massage

A woman who is 30 weeks gestation comes into the clinic with fluid leaking from the vagina and low back pain. What diagnostic tests would the nurse expect to be ordered? A. urinalysis, ultrasound, amniotic fluid analysis B. urinalysis, CBC, amniotic fluid analysis C. CT, ultrasound, CBC D. MRI, CBC, ultrasound

urinalysis, CBC, amniotic fluid analysis