OB Previous exam questions
The postpartum nurse is preparing to present infant care information to a couple who expresses concern about when to bathe their newborn. Which behaviors will the nurse present as general guidelines? Select all that apply. a) Avoid the use of soap on the face of the newborn. b) Daily bathing with soap is not necessary for the newborn. c) Genital and rectal areas should be cleaned at each diaper change. d) Use a mild preservative-free soap with a neutral pH. e) Bathing is best after a feeding when newborn is relaxed.
a) Avoid the use of soap on the face of the newborn. b) Daily bathing with soap is not necessary for the newborn. c) Genital and rectal areas should be cleaned at each diaper change. d) Use a mild preservative-free soap with a neutral pH.
The nurse is providing care for a patient who is 8 hours postpartum after a vaginal delivery. The patient reports severe perineal pain unaffected by pain medication. The nurse notices a 4 cm area of discoloration on the labia that is tender to the touch. Which action does the nurse take after providing comfort measures? a) Contact the primary care provider for further evaluation. b) Relieve pressure by having the patient sit on her perineum. c) Continue to apply ice to the area for 24 hours. d) Monitor vital signs and report any abnormal readings.
a) Contact the primary care provider for further evaluation.
The nurse educator is in a childbirth education class discussing nonpharmacological ways nurses can assist to enhance labor and spontaneous vaginal delivery. Which of the following facts regarding nonpharmacologic approaches will the nurse use to help illustrate its benefits? a) Effleurage is performed in rhythm with breathing during a contraction. b) Sterile water injections can be very useful for pelvic pain. c) Using orange or lemon aromatherapy oils will help promote relaxation. d) The client can achieve self-hypnosis with a lot of family members present.
a) Effleurage is performed in rhythm with breathing during a contraction.
The nurse is preparing for the discharge of a neonate diagnosed with a congenital breathing disorder. Which health team members does the nurse include in discharge planning? Select all that apply. a) Home health agency nurse b) Respiratory therapist c) Walgreens Pharmacist d) Social worker e) Case manager
a) Home health agency nurse b) Respiratory therapist d) Social worker e) Case manager
The nurse is providing care for a neonate born to a mother with preexisting diabetes mellitus. Which neonatal assessment findings do the nurse expect? Select all that apply. a) Hypocalcemia b) Jaundice c) Macrosomia d) Hyperglycemia e) Dyspnea
a) Hypocalcemia c) Macrosomia e) Dyspnea
The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient? a) Immediate hospitalization in a psychiatric unit b) Prescriptions for antibiotics c) Discharge to home with 24-hour observation in place d) Prescribed neonate visits during in-patient treatment
a) Immediate hospitalization in a psychiatric unit
The nurse is preparing discharge teaching for a postpartum patient who exhibits signs and symptoms of an episiotomy infection and is on oral antibiotic therapy. Which discharge teaching will the nurse provide regarding pain management? a) Information applicable to medication therapy b) Application of hot packs to the perineal area c) Instructions to improve circulation by ambulating d) Medicating for pain above level 2 on a 0 to 10 scale
a) Information applicable to medication therapy
During the fourth stage of labor, which actions by the nurse will promote parent-newborn attachment? Select all that apply. a) Initiate skin-to-skin contact with a warm blanket over the neonate and parent. b) Delay administration of eye ointment until parents have held newborn. c) Explain expected neonatal characteristics such as molding, milia, and lanugo. d) Stay close with the couple and the neonate in case of an emergency. e) Space out necessary assessments to prevent prolonged interruptions.
a) Initiate skin-to-skin contact with a warm blanket over the neonate and parent. b) Delay administration of eye ointment until parents have held newborn. c) Explain expected neonatal characteristics such as molding, milia, and lanugo.
A woman reports that her last normal menstrual period began on August 5, 2013. What is this woman's expected delivery date using Nägele's rule? a) May 12, 2014 b) May 5, 2014 c) April 30, 2014 d) May 26, 2014
a) May 12, 2014
The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient? a) Methylergonovine (Methergine) b) Carboprost-tromethamine (Hemabate) c) Fresh frozen plasma d) Magnesium sulfate
a) Methylergonovine (Methergine)
The nurse is concerned about the number of infants in the community who die from SIDS even with teaching about "back to sleep" being provided. On which additional preventive measures will the nurse focus? Select all that apply. a) Mothers need to be informed that breastfeeding reduces the risk for SIDS. b) During pregnancy, women should not smoke, drink alcohol, or use illegal drugs. c) Infants need to be dressed to prevent infants from overheating during sleep. d) Parents need to avoid products that claim to reduce the risk of SIDS. e) Parents should not smoke or allow smoking around their baby.
a) Mothers need to be informed that breastfeeding reduces the risk for SIDS. b) During pregnancy, women should not smoke, drink alcohol, or use illegal drugs. c) Infants need to be dressed to prevent infants from overheating during sleep. d) Parents need to avoid products that claim to reduce the risk of SIDS. e) Parents should not smoke or allow smoking around their baby.
The nurse is providing care for a patient in the second stage of labor (pushing stage). After more than 4 hours of pushing, the nurse suspects fetal dystocia. Which is the GREATEST risk to the fetus related to the nurse's suspected complication? a) Neonatal asphyxia related to prolonged labor b) Fetal injury confirmed by the presence of bruising c) Increased consideration for a cesarean delivery d) Greater risk for maternal lacerations
a) Neonatal asphyxia related to prolonged labor
What is the most common site for fertilization? a) Outer third of the fallopian tube near the ovary b) Upper portion of the uterus c) Lower segment of the uterus d) Area of the fallopian tube farthest from the ovary
a) Outer third of the fallopian tube near the ovary
The nurse is providing care for a premature neonate born at 28 weeks gestation who is experiencing respiratory distress syndrome (RDS). Which assessment finding indicates to the nurse that the neonate's respiratory status is deteriorating? a) Pao2 is 48 and Paco2 is 55 mm Hg on 90% oxygen. b) Respiratory rate is 58 breaths per minute. c) Breath sounds on auscultation are decreased. d) Heart rate is 162 beats per minute.
a) Pao2 is 48 and Paco2 is 55 mm Hg on 90% oxygen.
A neonate is born after 37 weeks gestation, and the nurse is concerned about avoiding cold stress after discharge. Which suggestions does the nurse give the mother to keep the baby safe? Select all that apply. a) Place a stocking cap on the neonate's head. b) Change wet clothing immediately. c) Position the baby away from vents and drafts. d) Perform the daily bath in a warm location. e) Keep the baby wrapped in a warm blanket.
a) Place a stocking cap on the neonate's head. b) Change wet clothing immediately. c) Position the baby away from vents and drafts. e) Keep the baby wrapped in a warm blanket.
A woman who is 37 weeks pregnant reports feeling dizzy when lying on her back. What does the nurse explain as the most likely cause of this symptom? a) Supine hypotension syndrome b) Malnutrition c) Gestational diabetes d) Pregnancy-induced hypertension
a) Supine hypotension syndrome
The patient who is 28 weeks pregnant shows a 10-pound weight gain from 2 weeks ago. What is the nurse's initial action? a) Take the blood pressure. b) Assess food intake. c) Weigh the patient again. d) Notify the physician.
a) Take the blood pressure.
The nurse is reviewing the medical record for a patient who is postpartum. The nurse notices the patient is rubella-nonimmune. Which information does the nurse present to the patient? Select all that apply. a) The risks to the fetuses of any future pregnancies. b) The patient will need to be immunized before discharge. c) Breastfeeding should be avoided for 24 hours after immunization. d) Pregnancy should be avoided for 4 weeks. e) Maternal immunization carries over to the neonate.
a) The risks to the fetuses of any future pregnancies. b) The patient will need to be immunized before discharge. d) Pregnancy should be avoided for 4 weeks.
The school nurse is counseling a group of adolescent girls. What does the nurse explain about sperm ejaculated near the cervix? a) They survive up to 5 days and can cause pregnancy. b) They are destroyed by the acidic pH of the vagina. c) They are usually pushed out of the vagina by the muscular action of the vaginal wall. d) They lose their motility in about 12 hours after intercourse.
a) They survive up to 5 days and can cause pregnancy.
A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient's medical record and associates which risk factors related to a possible urinary tract infection (UTI)? Select all that apply. a) Use of a vacuum extractor b) Urinary catheter during labor c) Low-grade fever d) Neonatal macrosomia e) Poor oral fluid intake
a) Use of a vacuum extractor b) Urinary catheter during labor d) Neonatal macrosomia e) Poor oral fluid intake
The nurse is reading the patient's chart, which indicates the patient has a "gynecoid pelvis." What finding is expected in this patient? a) Wider outlet b) Smaller inlet c) Shorter diameter between her coccyx and ischium d) Narrower pubic arch
a) Wider outlet
A multiparous patient reports severe uterine cramps the first day after a vaginal delivery. The nurse is aware the patient is breastfeeding and associates the patient's pain primarily with which occurrence? (Think Physiologically) a)An increase in oxytocin release related to the newborn suckling b) An expected response to the daily administration of oxytocin c) The efforts of the uterus to return to a prepregnancy condition d) The presence of intense afterbirth pains related to multiparity
a)An increase in oxytocin release related to the newborn suckling
A woman's prepregnant weight is determined to be average for her height. What will the nurse advise the woman regarding recommended weight gain during pregnancy? a) 28 to 40 pounds b) 25 to 35 pounds c) 15 to 25 pounds d) 10 to 20 pounds
b) 25 to 35 pounds
The nurse is monitoring the fetal heart rate (FHR) tracing and sees that her patient has a tracing with a baseline of 120bpm, moderate variability, with absence of decelerations and accelerations. According to the National Institute of Child Health and Human Development five tier system, what category tracing does the patient's fall into? a) A Category II tracing b) A Category I tracing c) A Category III tracing d) A Category IV tracing
b) A Category I tracing
A pregnant woman inquires about exercising during pregnancy. What information should the nurse include when planning to educate this woman? a) Exercise increases catecholamines, which can prevent preterm labor. b) A regular schedule of moderate exercise during pregnancy is beneficial. c) Pregnant women should limit water intake during exercise. d) Exercise elevates the mother's temperature and improves fetal circulation.
b) A regular schedule of moderate exercise during pregnancy is beneficial.
The nurse is providing support for the parents of a neonate born with anencephaly. The parents repeatedly state, "I don't believe this is happening to us. We were so careful during pregnancy." The nurse associates the parents' comments with which stage of grief? a) Denial of reality b) Disbelief c) Anger with each other d) Depression
b) Disbelief
An internal fetal monitor (Scalp Electrode) has been ordered for Chrissy, a 24-year-old G2P0010 at 38 weeks and 1 day gestation. Her medical history is significant for a history of pregnancy-induced hypertension. Her laboratory values are as follows: H/H 11/30, O negative, RPR negative, GBS positive. Based on Chrissy's history and presentation, what action should the nurse take next? a) Prepare Chrissy for the placement of an internal monitor. b) Discuss with the health care provider that Chrissy is GBS positive and therefore should not receive an internal monitor. c) Discuss with the health care provider the fact that Chrissy's blood type is O negative and she should therefore receive Rhogam before insertion of an internal monitor. d) Take the required two blood pressure readings every 15 minutes prior to insertion of the internal fetal monitor due to her pregnancy-induced hypertension.
b) Discuss with the health care provider that Chrissy is GBS positive and therefore should not receive an internal monitor.
A woman tells the nurse that she is quite sure she is pregnant. The nurse recognizes which as a positive sign of pregnancy? a) HCG detected in the urine b) Fetal heartbeat c) Uterine enlargement d) Amenorrhea
b) Fetal heartbeat
The nurse is preparing a postpartum patient for discharge. For which reasons does the nurse instruct the patient to call the primary care provider? Select all that apply. a) Not sleeping well b) Hot, red, painful breasts c) Mild headache d) Foul-smelling lochia e) Frequent, painful urination
b) Hot, red, painful breasts d) Foul-smelling lochia e) Frequent, painful urination
A woman is 9 weeks pregnant and experiencing heavy bleeding and cramping. She reports passing some tissue. Cervical dilation is noted on examination. What is the most likely cause of these symptoms? a) Inevitable abortion b) Incomplete abortion c) Missed abortion d) Complete abortion
b) Incomplete abortion
The neonatal nurse understands that some neonates spontaneously take a breath once the head and chest is delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe? a) Oxygen is applied immediately to start respirations. b) Mild hypoxia and decreased pH stimulates the brain. c) Carbon dioxide is administered in small doses. d) Suctioning is used to stimulate breathing efforts.
b) Mild hypoxia and decreased pH stimulates the brain.
The EFM tracing shows the following: FHR baseline 166 bpm, moderate variability, and recurrent late decelerations to 100 bpm. Using the five-tier FHR interpretation system, how should the nurse interpret this tracing? a) Red: unacceptably high risk of acidemia, deliver b) Orange: acceptable low risk of acidemia, prepare for possible urgent delivery c) Yellow: moderate risk of evolution, increase surveillance d) Green: very low risk of evolution, no action
b) Orange: acceptable low risk of acidemia, prepare for possible urgent delivery
What is the most common site for fertilization? a) Lower segment of the uterus b) Outer third of the fallopian tube near the ovary c) Upper portion of the uterus d) Area of the fallopian tube farthest from the ovary
b) Outer third of the fallopian tube near the ovary
An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the entire cervical os. What does the nurse understand best describes this condition? a) Low-lying placenta b) Total placenta previa c) Partial placenta previa d) Marginal placenta previa
b) Total placenta previa
The premature neonate is more susceptible to skin breakdown than a term neonate. Which skin care interventions will the nurse implement for the premature neonate? Select all that apply. a) Perform daily skin assessment to identify problems early. b) Use a neutral pH cleanser and sterile water for bathing. c) Gently apply emollients to avoid unnecessary friction. d) Provide a full bath every other day. e) Use water, air, or gel mattresses.
b) Use a neutral pH cleanser and sterile water for bathing. c) Gently apply emollients to avoid unnecessary friction. e) Use water, air, or gel mattresses.
A patient delivers a term neonate and expresses concern about her neonate getting an injection. Which information from the nurse is accurate? a) Mothers are unable to supply vitamin K to the fetus. b) Vitamin K is needed to activate clotting factors. c) Breastfeeding is an excellent source of vitamin K. d) Neonates will hemorrhage without vitamin K.
b) Vitamin K is needed to activate clotting factors.
Which information is important for the nurse to provide to mothers of infants of 3 months of age regardless of the method of infant feeding? a) Why the babies are most likely to prefer food over milk b) When growth spurts and dietary increases are expected c) When and what order solid foods are introduced d) Why breastfeeding delays the need for solid foods
b) When growth spurts and dietary increases are expected
The nursing is caring for a patient in active labor with significant back pain. The patient has requested nonpharmacologic methods of pain relief. The nurse thinks that sterile water injections may help with her pain management. Which of the following explanations should the nurse explain to the patient? a) "We will inject 1 mL of sterile water intramuscularly, and it will last for about an hour." b) "We will inject 1 mL of sterile water subcutaneously, and it will last for about a half hour." c) "We will inject 0.5 mL of sterile water subcutaneously, and it will last for an hour to 90 minutes." d) "We will inject 0.5 mL of sterile water intramuscularly, and it will last for about 3 hours."
c) "We will inject 0.5 mL of sterile water subcutaneously, and it will last for an hour to 90 minutes."
A postpartum patient calls the OB office 8 days following a vaginal delivery. The patient reports concern regarding vaginal bleeding. Which patient-reported symptom causes the nurse concern? a) Bleeding that is described as scant b) Increased flow noticed with physical activity c) A description of the lochia as being red in color d) Discharge that is noted to have a fleshy odor
c) A description of the lochia as being red in color
The obstetric nurse is managing her laboring patients while covering for another nurse who is on a break. Which patient is the LOWEST priority? a) A patient with decreased fetal activity b) A patient with a previous cesarean section c) A patient with Category I FHR tracings d) A patient with an epidural in place
c) A patient with Category I FHR tracings
A patient who is 12 hours postpartum after a vaginal delivery continues to have difficulty in initiating urination. The nurse is aware that an integrative method used when a woman is unable to void is peppermint oil. In which manner will the peppermint oil be used? a) A small amount of peppermint oil on a cotton ball is left at the bedside. b) A small amount is added to the water of a vaporizer. c) A saturated cotton ball of peppermint oil is placed in a "hat" on the toilet. d) A thin layer is applied to the urinary meatus.
c) A saturated cotton ball of peppermint oil is placed in a "hat" on the toilet.
The nurse is present in the delivery room when a mother is told her neonate was stillborn. The mother begins to wail loudly and pull at her hair. Which action does the nurse take? a) Ask a family member to comfort the mother. b) Attempt to calm the mother and prevent self-harm. c) Allow the mother to express grief in her own way. d) Ask for a sedative to calm the mother's reaction.
c) Allow the mother to express grief in her own way.
The nurse recognizes which behavior characteristic(s) of women in their first trimester of pregnancy? (Select all that apply.) a) Fatigue b) Focusing on her infant c) Ambivalence about pregnancy d) Showing off her sonogram photos e) Emotional and labile mood
c) Ambivalence about pregnancy d) Showing off her sonogram photos
What drug will the nurse plan to have available for immediate IV administration whenever magnesium sulfate is administered to a maternity patient? a) Oxytocin b) Ergonovine maleate (Ergotrate) c) Calcium gluconate d) Hydralazine (Apresoline)
c) Calcium gluconate
The nurse is caring for a 24-year-old woman who is G1P0 at 40 weeks, 1 day gestation and in active labor. She has just received an epidural and now complains of "an itchy feeling all over." Her vitals are as follows: HR 120, RR 12, BP 130/74, T 98.8, and O2 sat 98% on room air. Which action should the nurse take first? a) Activate emergency response due to the patient's pruritus and tachycardia postepidural placement. b) Take no further action regarding the patient's complaints, as they are normal after epidural placement. c) Call the health care provider regarding the patient's pruritus to order an antipruritic medication. d) Call the anesthesiologist regarding the patient's oxygen saturation level.
c) Call the health care provider regarding the patient's pruritus to order an antipruritic medication.
A nurse-preceptor is explaining to a new nurse about the fetal heart monitoring. The new nurse is looking at the EFM paper and sees that, of the two tracked heart rates, the one on the bottom is in the 80s. The nurse is concerned that the fetal heart rate is bradycardic. Which of the following should the nurse do first? a) Give the mother oxygen to increase the fetal heart rate. b) Immediately call the provider into the room. c) Check to make sure that the maternal radial pulse is being recorded correctly. d) Adjust the monitor on the maternal abdomen.
c) Check to make sure that the maternal radial pulse is being recorded correctly.
The nurse tells a woman who is trying to conceive to check her cervical mucus for changes. What will she expect the characteristic of cervical mucus to be a few days before ovulation? a) Scant and thick b) Thin and white c) Clear and slippery d) Cloudy and tacky
c) Clear and slippery
The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room? a) Place a basin at the foot of the delivery table to catch any blood. b) Rely on the primary health care provider's estimate of blood loss. c) Collect blood in calibrated, under-buttocks drapes for vaginal birth. d) Ask the patient how many peripads she considered to be "soaked."
c) Collect blood in calibrated, under-buttocks drapes for vaginal birth.
During an ultrasound, two amnions and two placentas are observed. What will be the most likely result of this pregnancy? a) Conjoined twins b) Monozygotic twins c) Dizygotic twins d) High-birth weight twins
c) Dizygotic twins
A new mother expresses severe frustration with an infant that is exhibiting symptoms of colic. Which suggestions from the nurse are aimed at infant safety? Select all that apply. a) Hold the infant and sway from side to side or walk around with the infant. b) Place the infant (abdomen down) over the knees and gently rub or pat the back. c) Do simple household chores, such as vacuuming or washing the dishes. d) Place the infant in a car seat and take him or her for a ride in the car. e) Place the baby in a safe place and allow the baby to cry for 10 to 15 minutes.
c) Do simple household chores, such as vacuuming or washing the dishes. e) Place the baby in a safe place and allow the baby to cry for 10 to 15 minutes.
A woman calls her health care provider to schedule prenatal visits in an uncomplicated pregnancy. How frequently will the nurse assist the patient to schedule these appointments? a) Every 2 to 3 weeks for the entire pregnancy b) Monthly until the 8th month c) Every 4 weeks until the 7th month, after which appointments will become more frequent d) Every 3 weeks until the 6th month, then every 2 weeks until delivery
c) Every 4 weeks until the 7th month, after which appointments will become more frequent
A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She has a 2-year-old son and had one previous spontaneous abortion. How would the nurse document the patient's obstetric history using the TPALM system? a) Gravida 2, para 20120 b) Gravida 3, para 10011 c) Gravida 3, para 10110 d) Gravida 2, para 11110
c) Gravida 3, para 10110
A pregnant woman states, "My husband hopes I will give him a boy because we have three girls." What will the nurse explain to this woman? a) When the sperm and ovum are united, there is a 75% chance the child will be a girl. b) The sex chromosome of the fertilized ovum determines the gender of the child. c) If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced. d) When the pH of the female reproductive tract is acidic, the child will be a girl.
c) If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced.
A pregnant woman is attending her second prenatal visit. Prenatal lab work indicates she is not immune to the rubella virus. What is the most appropriate nursing intervention? a) Hold all immunizations until 1 month postpartum. b) Encourage the patient to decide whether or not to get the rubella vaccine prenatally. c) Inform the woman she should receive the vaccine in the hospital after delivery. d) Provide the rubella vaccine as ordered by the physician immediately.
c) Inform the woman she should receive the vaccine in the hospital after delivery.
The nurse is providing care for a premature neonate in the NICU nursery. The neonate is diagnosed with bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA). Which specific intervention does the nurse expect for this neonate? a) Obtain blood glucose levels. b) Monitor of hemoglobin and hematocrit levels. c) Maintain fluid restrictions. d) Administer enteral feedings.
c) Maintain fluid restrictions.
When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent? a) Mental retardation b) Congenital heart defects c) Neural tube defects d) Premature birth
c) Neural tube defects
The nursing preceptor asks the nursing student how to best determine the intensity of contractions before placing the patient on an electronic fetal monitoring system. How would the nurse assess this? a) Palpate the maternal abdomen right after a contraction has ended. b) Monitor the patients' vocalizations and facial expressions. c) Palpate the maternal abdomen during a contraction. d) Time the amount of time in between the ending of one contraction and the beginning of another.
c) Palpate the maternal abdomen during a contraction.
In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart rate (FHR) has dropped to 120 beats/minute from a rate of 160 beats/minute earlier in the pregnancy. What is the nurse's first action? a) Ask if the patient has taken a sedative. b) Notify the physician. c) Record the rate as a normal finding. d) Turn the patient to her right side.
c) Record the rate as a normal finding.
The nurse assesses a pregnant woman for pregnancy-induced hypertension. What is the first sign of fluid retention suggestive of this complication? a) Abdominal enlargement b) Swelling of the feet and ankles c) Sudden weight gain d) Facial swelling
c) Sudden weight gain
The nurse is preparing a postpartum patient for discharge. Which patient teaching is most important for the nurse to provide? a) The signs and symptoms of a boggy uterus b) The signs and symptoms of postpartum depression c) The signs and symptoms of secondary hemorrhage d) The signs and symptoms of uterine infection
c) The signs and symptoms of secondary hemorrhage
The nurse is palpating a patient's uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis? a) To prevent uterine prolapse. b) To prevent uterine movement c) To prevent uterine inversion d) To prevent uterine hemorrhage
c) To prevent uterine inversion
A woman pregnant for the first time asks the nurse, "When will I begin to feel the baby move?" What is the nurse's best response? a) "You'll feel something by the end of the first trimester." b) "Quickening varies with every woman." c) "The baby will be big enough for you to feel in your 8th month." d) "You may notice the baby moving around the 4th or 5th month."
d) "You may notice the baby moving around the 4th or 5th month."
A woman's prepregnant weight is determined to be average for her height. What will the nurse advise the woman regarding recommended weight gain during pregnancy? a) 10 to 20 pounds b) 15 to 25 pounds c) 28 to 40 pounds d) 25 to 35 pounds
d) 25 to 35 pounds
An ultrasound confirms that a 16-year-old girl is pregnant. How does the need for prenatal care and counseling for adolescents differ from other age populations? a) At this age, a pregnant adolescent will accept the nurse's advice. b) Adolescents who get pregnant are more likely to have other chronic health problems. c) Adolescents are at greater risk for multifetal pregnancies. d) A pregnant adolescent is experiencing two major life transitions at the same time.
d) A pregnant adolescent is experiencing two major life transitions at the same time.
The nurse is providing care for a primip (never been pregnant before this one) patient in active labor. Cervical dilation has progressed 0.5 cm in 2 hours. Intrauterine pressure catheter reading is 20 mm Hg. Which action does the nurse anticipate next? a) Medicating the patient with pain medication to promote uterine rest b) Preparation for a cesarean delivery due to signs of fetal distress c) Rupture of uterine membranes by the nurse d) Augmentation of labor with oxytocin per health care provider's order
d) Augmentation of labor with oxytocin per health care provider's order
Stage two labor is defined as? a) Onset of labor and ends with complete cervical dilation. b) Delivery of placenta and is completed 4 hours later. c) Delivery of baby and ends with delivery of placenta. d) Complete cervical dilation and ends with delivery of baby
d) Complete cervical dilation and ends with delivery of baby
The nurse is teaching a prenatal class. For which reason does the nurse emphasize the importance of managing maternal fear during labor? a) Fear promotes feelings of exhilaration. b) Fear during labor causes postpartum depression. c) Mothers enjoy the birth. d) Dystocia is associated with extreme fear.
d) Dystocia is associated with extreme fear.
When the nurse tells a pregnant woman that she needs 1200 mg of calcium daily during pregnancy, the woman responds, "I don't like milk." What dietary adjustments could the nurse recommend? a) Include molasses and whole-grain breads in the diet. b) Increase intake of organ meats. c) Choose more fresh fruits, particularly citrus fruits. d) Eat more green leafy vegetables.
d) Eat more green leafy vegetables.
A woman calls her health care provider to schedule prenatal visits in an uncomplicated pregnancy. How frequently will the nurse assist the patient to schedule these appointments? a) Every 2 to 3 weeks for the entire pregnancy b) Every 3 weeks until the 6th month, then every 2 weeks until delivery c) Monthly until the 8th month d) Every 4 weeks until the 7th month, after which appointments will become more frequent
d) Every 4 weeks until the 7th month, after which appointments will become more frequent
The nurse in a postpartum unit frequently teaches patients regarding breast care. Which teaching is most helpful to the breastfeeding patient? (Think Primary Engorgement) a) Take analgesics for breast pain management. b) Run warm water over breasts while in the shower. c) Wear a supportive bra for 24 hours a day. d) Express milk by a breast pump or manually.
d) Express milk by a breast pump or manually.
A pregnant woman is experiencing nausea in the early morning. What recommendations would the nurse offer to alleviate this symptom? a) Drink a full glass of fluid at the beginning of each meal. b) Eat three well-balanced meals per day and limit snacks. c) Eat a bland diet and avoid concentrated sweets. d) Have crackers handy at the bedside, and eat a few before getting out of bed.
d) Have crackers handy at the bedside, and eat a few before getting out of bed.
The nurse is reviewing the chart of a 35-year-old G4P2012 woman. The patient is at 38 weeks, 4 days and is in active labor with SROM (spontaneous rupture of membranes) 2 hours ago, with clear fluid. What action should the nurse take? a) Have the patient rate her pain on a scale from 1-10 roughly every hour. b) Monitor the patient's blood pressure, temperature, and respirations every 3 hours. c) Monitor the fetal heart tones every 2 hours. d) Help the patient change her position from side to side every 30 minutes.
d) Help the patient change her position from side to side every 30 minutes.
The nurse is providing support to a mother whose newborn is diagnosed with a life-threatening defect. The mother states, "I just want to go home and never come back." Which reaction by the mother does the nurse recognize? a) Disruption of family life b) Normal feelings of attachment c) Ambivalent feelings by the mother d) Maternal emotional distancing
d) Maternal emotional distancing
The nursing is caring for a 31-year-old female patient who is pregnant at 37 weeks and 5 days gestation. The patient is having contractions every 3 minutes and was found to have a platypelloid pelvis upon examination. The fetus has an estimated fetal weight of 7 lbs and is in the LOA position. This patient is laboring on the birth ball, and her mother-in-law is helping her labor. The nurse is concerned about the five Ps and their effect on the patient's labor. Which P is the nurse most likely concerned about based on the patient's history? a) Psyche b) Passenger c) Position d) Passage
d) Passage
While providing care for a patient (the patient is moving around), the nurse notices an erratic FHR recording. What action should the nurse take next? a) Remove some of the ultrasound gel from the transducer. b) Help the patient move around to help obtain the signal. c) Check the mother's cervical progress to see if she is in the latent, first stage of labor. d) Place the transducer (ultrasound) in a different position.
d) Place the transducer (ultrasound) in a different position.
The nurse is providing education about postpartum depression. How does the nurse differentiate baby blues from postpartum depression? a) Baby blues usually requires medication. b) They are essentially the same thing. c) Postpartum depression is less severe than baby blues. d) Postpartum depression usually happens after discharge where a patient has more bad days than good.
d) Postpartum depression usually happens after discharge where a patient has more bad days than good.
What situation would concern the nurse about the presence of Rh incompatibility? a) Rh-positive mother, Rh-negative fetus b) Rh-negative mother, Rh-negative fetus c) Rh-positive mother, Rh-positive fetus d) Rh-negative mother, Rh-positive fetus
d) Rh-negative mother, Rh-positive fetus
The postpartum nurse notices that a new mother has her neonate unwrapped and undressed "to check out the baby." Which neonatal action indicates to the nurse that the neonate is at risk for cold stress? a) The neonate has an increased metabolic rate. b) The neonate's respiratory rate has dropped. c) The neonate's skin is warm and dry. d) The neonate is moving extremities about.
d) The neonate is moving extremities about.
What will the nurse begin with when asking a patient about drug use during a prenatal history? a) "We need to know if you take drugs so we can help your baby." b) "Do you ever use prescription or street drugs?" c) "Do you smoke, drink alcohol, or use drugs?" d)"What over-the-counter and prescription drugs have you taken in the past 3 months?"
d)"What over-the-counter and prescription drugs have you taken in the past 3 months?"
The nurse emphasizes to a patient with a high-risk pregnancy that the impact of such a pregnancy might result in which problems? (Select all that apply.) A) Excessive attachment to infant B) Frustration with activity restriction C) Alteration in child care practices D) Disruption of family roles E) Financial pressures
B) Frustration with activity restriction C) Alteration in child care practices D) Disruption of family roles E) Financial pressures
A newborns normal heart rate is 110-160 bpm and respiratory rate is 30-60 bpm. True False
True
White, pimple-like spots on a newborns face is normal. True False
True
The nurse is preparing a pregnant patient for an abdominal ultrasound at 8 weeks' gestation. What intervention will the nurse implement before this diagnostic test? a) Initiate an IV. b) Instruct the patient to take nothing by mouth after midnight the night before the test. c) Encourage the patient to drink 1 to 2 quarts of water before the test. d) Instruct the patient to remove all jewelry.
c) Encourage the patient to drink 1 to 2 quarts of water before the test.
At what point in prenatal development do the lungs begin to produce surfactant? a) 17 weeks b) 20 weeks c) 30 weeks d) 25 weeks
d) 25 weeks
The nurse is reviewing fetal circulation with a pregnant patient and explains that blood circulates through the placenta to the fetus. What vessel(s) carry blood to the fetus? a) One umbilical artery b) Two umbilical arteries c) Two umbilical veins d) One umbilical vein
d) One umbilical vein
When meconium is present in the amniotic fluid at birth, the infant should be suctioned below the vocal cords before he or she takes her first breath. True False
False
True labor is when...... a) the baby is in zero station. b) the patient begins to feel abdominal pain. c) the women feels the urge to push. d) the cervix dilates
d) the cervix dilates
The nurse educates prenatal patients about the threat of TORCH infections. Which infections are included in this classification? (Select all that apply.) A) Cytomegalovirus B) Herpes simplex C) Toxoplasmosis D) Rubella E) Toxemia
A) Cytomegalovirus B) Herpes simplex C) Toxoplasmosis D) Rubella
What should a woman expect after insertion of an intrauterine device (IUD)? a) A string should be felt in the vagina. b) The device should be changed every 2 years. c) Menstrual cramps will be eliminated. d) Menstrual flow will be lighter.
a) A string should be felt in the vagina.
A mother who is breastfeeding expresses concern about whether her infant is getting enough milk. Which concrete indicator does the nurse provide to the mother? a) The newborn spontaneously releases the grip on the breast when satiated. b) The mother is physically and emotionally comfortable during feedings. c) The newborn suckles and the mother can hear and/or see swallowing. d) There are at least six to eight wet diapers and several stools per day.
d) There are at least six to eight wet diapers and several stools per day.
Prior to discharge from the birthing center, the nurse informs the patient that she will receive vaccines for rubella, hepatitis B, pertussis, and influenza. For which reason does the nurse explain the need for the vaccinations? a) The mother's immune system has been suppressed during pregnancy. b) Discharge with a neonate is discouraged if the mother is not vaccinated. c) Vaccination is more easily accomplished while the mother is under medical care. d) Vaccinating the mother will protect the neonate from serious illnesses.
d) Vaccinating the mother will protect the neonate from serious illnesses.
What symptom presented by a pregnant women is indicative of abruptio placentae? a) Premature rupture of membranes b) Uterine irritability with contractions c) Painless vaginal bleeding d) Vaginal bleeding and back pain
d) Vaginal bleeding and back pain
After the examination is completed, the patient asks the nurse why Chadwick's sign occurs during pregnancy. What would the nurse explain as the cause of Chadwick's sign? a) Increasing activity of the fetus b) Progesterone action on the breasts c) Enlargement of the uterus d) Vascular congestion in the pelvic area
d) Vascular congestion in the pelvic area
A pregnant patient asks the nurse when her infant's heart will begin to pump blood. What will the nurse reply? a) Beginning in week 24 b) Beginning in week 8 c) By the end of week 3 d) By the end of week 16
c) By the end of week 3
A patient who is 30 weeks pregnant delivers a stillborn child in the emergency department (ED). What should the ED nurse offer the patient? (Select all that apply.) A) Materials about support groups B) Privacy C) An opportunity to hold the infant D) A memento (footprint or lock of hair) E) A warm beverage
A) Materials about support groups B) Privacy C) An opportunity to hold the infant D) A memento (footprint or lock of hair)
A woman, gravida 3, para 2, is attending her fourth prenatal visit and confides in the nurse that she is battered by her husband. She is assessed to have multiple bruises at various stages of healing. What nursing actions are appropriate for the nurse to implement? (Select all that apply.) A) Provide privacy for the assessment. B) Communicate in a nonjudgmental way. C) Determine if children are being hurt. D) Tell the husband that authorities will be notified immediately. E) Determine factors that increase the risk of injury.
A) Provide privacy for the assessment. B) Communicate in a nonjudgmental way. C) Determine if children are being hurt.
The nurse is obtaining history and physical information on a new patient attending her first prenatal visit. After recording current height, weight, and BMI, it is determined that the patient is obese. What complications related to obesity will the nurse assess this patient for during pregnancy? (Select all that apply.) A) Gestational diabetes B) Infection C) Hypertension D) RH incompatibility E) Pre-eclampsia
A) Gestational diabetes C) Hypertension E) Pre-eclampsia
The nurse is using the five-tier system fetal heart system. A co-worker is concerned about a patient whose fetus has an acceptably low risk of acidemia but evidence of impending fetal asphyxia (orange color). What is the next best step for the nurse? a) Perform conservative measures. b) Assist provider in immediate delivery. c) Increase surveillance of patient. d) Prepare for possible urgent delivery.
d) Prepare for possible urgent delivery.
A woman asks the nurse, "How do oral contraceptives prevent pregnancy?" What will the nurse explain about the combination of estrogen and progesterone in oral contraceptives? a) Acts as a barrier by destroying sperm b) Makes cervical mucus hostile to sperm c) Prohibits implantation of the egg d) Prevents ovulation
d) Prevents ovulation
The labor and delivery nurse is present for the delivery of a premature neonate. Which action by the nurse is most important? a) Stabilize and transfer neonate to NICU. b) Maintain fluid and electrolyte balance. c) Review pregnancy history for risk factors. d) Provide a neutral thermal environment.
d) Provide a neutral thermal environment.
What are the functions of amniotic fluid? (Select all that apply.) A) Acting as a reservoir for nutrients B) Acting as a cushion for the fetus C) Lubricating fetal skin D) Impeding excessive fetal movement E) Maintaining an even temperature
B) Acting as a cushion for the fetus E) Maintaining an even temperature
An extremely low-birth weight infant is one whose weight is 2000 g or less. True False
False
At birth, an indirect Coombs' test is performed on the newborn's cord blood to determine if the fetus has produced antibodies to his or her mother's blood. True False
False
The nurse is collecting information from a new mother who is bottle-feeding her infant. Which comment, made by the mother, requires the nurse to provide patient teaching? a) "Sometimes I will add a little water to the formula if I am running low." b) "At least I get a break every evening when my spouse feeds the baby." c) "I wish that I had tried breastfeeding because formula is expensive." d) "I get frustrated if the last bottle is fed to the baby late at night."
a) "Sometimes I will add a little water to the formula if I am running low."
The nurse is explaining telemetry to the patient, who has just begun active labor. The patient would like to have a labor in which she is mobile, able to change positions, and use hydrotherapy. Which response by the nurse is most appropriate? a) "We can start using telemetry now, and if there are no problems with the signal, we can continue it throughout your labor until delivery." b) "Unfortunately, you will not be able to use the shower while using telemetry." c) "Telemetry is used mostly for women who are laboring in bed and changing positions every half hour or so." d) "The nurses will need to come in and check your telemetry reading every half hour."
a) "We can start using telemetry now, and if there are no problems with the signal, we can continue it throughout your labor until delivery."
Of what is the normal umbilical cord comprised? a) 2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus b) 2 arteries carrying blood to the fetus and 2 veins carrying blood away from the fetus c) 1 artery carrying blood to the fetus and 2 veins carrying blood away from the fetus d) 1 artery carrying blood to the fetus and 1 vein carrying blood away from the fetus
a) 2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus
The nurse in NICU is assessing a neonate delivered at 32 weeks gestation. Which pathophysiological manifestation is the nurse's greatest concern? a) Apnea 20 seconds or longer b) Presence of a heart murmur c) Absent or weak reflexes d) Low hemoglobin lab level
a) Apnea 20 seconds or longer
The nurse is providing care for a neonate during the fourth stage of labor. Which action does the nurse take during this stage? a) Dry the neonate immediately. b) Compete neonate assessment within 1 hour. c) Obtain neonate blood glucose levels. d) Perform Apgar screening until scores are 7.
a) Dry the neonate immediately.
A pregnant woman states, "My husband hopes I will give him a boy because we have three girls." What will the nurse explain to this woman? a) If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced. b) When the pH of the female reproductive tract is acidic, the child will be a girl. c) When the sperm and ovum are united, there is a 75% chance the child will be a girl. d) The sex chromosome of the fertilized ovum determines the gender of the child.
a) If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced.
The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply. a) The father exhibited depression during the pregnancy. b) The birth of this fourth child was unexpected and unplanned. c) The father expresses feeling bored and underappreciated in his job. d) The mother experienced an uneventful labor and delivery. e) The father is recently estranged from his parents and siblings.
a) The father exhibited depression during the pregnancy. b) The birth of this fourth child was unexpected and unplanned. e) The father is recently estranged from his parents and siblings.
A patient who is at 39 weeks gestation is scheduled for amniotomy. The nurse is aware that which criteria must be met before the procedure? a) The fetal head is currently engaged in the maternal pelvis (at the ischial spines). b) Ultrasound indicates the umbilical cord is away from the cervix. c) The nurse must have certification to perform the procedure. d) Prior amniotic fluid leakage must be validated before the procedure.
a) The fetal head is currently engaged in the maternal pelvis (at the ischial spines).
The nurse works in a postnatal nursery and is required by hospital policy to perform a gestational age assessment on specified neonates. On which neonate is the nurse most likely to perform this assessment? a) The neonate with a birth weight of 4,100 g b) The neonate exposed to oxytocin in utero c) The neonate born after an 18-hour labor d) The neonate born at 37 weeks gestation
a) The neonate with a birth weight of 4,100 g
The nurse is caring for a pregnant woman diagnosed with preeclampsia. What will the nurse explain is the objective of magnesium sulfate therapy for this patient? a) To prevent convulsions b) To act as a saline cathartic c)To promote diaphoresis d) To increase reflex irritability
a) To prevent convulsions
The nurse is preparing a talk with new parents about immunity and their newborns. Which factual information will the nurse present? Select all that apply. a) Antigens are produced as part of natural immunity. b) A vaccination is an example of acquired immunity. c) Natural passive immunity protects the baby for a few months after birth. d) Gamma globulin is an example of artificial active immunity. e) Placental transfer is how newborns get natural passive immunity.
b) A vaccination is an example of acquired immunity. c) Natural passive immunity protects the baby for a few months after birth. e) Placental transfer is how newborns get natural passive immunity.
The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action does the nurse perform prior to assessing the patient's uterus? a) Assess the passage of lochia. b) Ask the patient to void. c) Administer a dose of oxytocin. d) Place the patient on the left side.
b) Ask the patient to void.
The nurse is assessing a newborn's reflexes. Which response will cause the nurse concern? a) A fencing position when the head is turned b) Asymmetrical Moro reflex c) Strong Babinski reflex d) Absence of rooting or sucking reflexes
b) Asymmetrical Moro reflex
A pregnant patient asks the nurse when her infant's heart will begin to pump blood. What will the nurse reply? a) By the end of week 16 b) By the end of week 3 c) Beginning in week 8 d) Beginning in week 24
b) By the end of week 3
A patient who is at 41 weeks gestation is concerned when the primary care provider decides to induce labor. Which reason does the nurse explain as the most important need for this procedure? a) Likelihood of meconium aspiration b) Risk for placental dysfunction c) Increasing size of the neonate d) Ability to deliver vaginally
b) Risk for placental dysfunction
The nurse is assisting the primary care provider with a vacuum-assisted delivery because of a prolonged second stage of labor. The nurse will inform the primary care provider when which guideline of the procedure is met? a) Signs of fetal compromise have resolved. b) The "three-pull rule" has been achieved. c) Patient is under full anesthesia status. d) Extension of the episiotomy is performed.
b) The "three-pull rule" has been achieved.
The nurse is providing care for a patient who is admitted for cervical ripening. The health care provider has prescribed the use of a hygroscopic dilator (Laminaria). Which conclusion is the nurse likely to draw from the prescribed method of cervical ripening? a) This patient is being treated for active herpes. b) The method may be used for a fetal demise. c) The patient has a history of a horizontal cesarean childbirth. d) This method is quicker than using oxytocin.
b) The method may be used for a fetal demise.
The nurse is looking at an EFM (external monitoring) strip and sees that the patient in active labor is having contractions that are every 10 minutes with mild intensity for the past 2 hours and the fetus is in fetal distress. What would this indicate for next steps? a) The patients' contractions are inadequate; the provider could consider augmenting with Pitocin to be more effective. b) The patients' contractions are inadequate; the provider could consider an amnioinfusion through the IUPC, and once the fetus has improved, contractions need to be augmented to be more effective. c) The patients' contractions are adequate, so the main focus should be on resuscitating the fetus with maternal oxygen and maternal position change. d) The patients' contractions are adequate, so the main focus should be on determining her progress through cervical change.
b) The patients' contractions are inadequate; the provider could consider an amnioinfusion through the IUPC, and once the fetus has improved, contractions need to be augmented to be more effective.
A pregnant patient tells the nurse that she has been nauseated and vomiting. How will the nurse explain that hyperemesis gravidarum is distinguished from morning sickness? a) Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum. b) The woman with hyperemesis gravidarum will have persistent vomiting without weight loss. c) Hyperemesis gravidarum causes dehydration and electrolyte imbalances. d) Hyperemesis gravidarum usually lasts for the duration of the pregnancy.
c) Hyperemesis gravidarum causes dehydration and electrolyte imbalances.
A breastfeeding mother is planning to return to work 3 months after her baby is born. The mother is planning to use an electric breast pump and freeze some breast milk for use later. Which information does the nurse need to provide? a) Breast milk should not be frozen in the special plastic freezer bags. b) The freezer door shelf decreases the chance of milk contamination. c) Frozen breast milk can be defrosted in a microwave. d) Breast milk can be kept in a deep freezer for 6 to 12 months.
d) Breast milk can be kept in a deep freezer for 6 to 12 months.
A patient who is pregnant expresses a desire to attempt a vaginal delivery after a cesarean birth 2 years before. The primary care provider initiates trial of labor after cesarean (TOLAC) and vaginal birth after cesarean (VBAC) screening. The nurse is aware that which patient information will likely disqualify the patient for VBAC? a) First labor needed to be induced b) A low transverse uterine scar c) Patient asks multiple questions d) Cesarean due to pelvic abnormalities
d) Cesarean due to pelvic abnormalities
