PrepU Self-Made Quiz for Make-up Work

When developing a labor plan with the client, which outcome is the priority? a. The client will be pain-free during the labor process. b. The client will attend all prenatal classes prior to delivery. c. The client will deliver the fetus vaginally. d. The client will direct her pain management techniques.

d. The client will direct her pain management techniques.

What action shows an example of Erik Erikson's developmental task for the infant? a. The infant smiles as people walk past the crib. b. The infant plays the game peek-a-boo. c. The infant cries when they have a wet diaper. d. The infant cries and the caregiver picks the child up.

d. The infant cries and the caregiver picks the child up.

A nurse caring for a pregnant client in labor observes that the fetal heart rate (FHR) is below 110 beats per minute. Which interventions should the nurse perform? Select all that apply. a. Turn the client on her left side. b. Administer oxygen by mask. c. Assess client for underlying causes. d. Ignore questions from the client. e. Reduce intravenous (IV) fluid rate.

a, b, c

The client pushes and the fetal head emerges. External rotation begins, but the fetal chin is drawn back just inside the vagina. The nurse recognizes that additional health care providers are needed in the delivery room. What emergency protocol does the nurse call? a. nuchal cord b. shoulder dystocia c. fetal macrosomia d. cephalopelvic disproportion

b. shoulder dystocia

The client in labor has patient-controlled epidural anesthesia (PCEA). What will the nurse include in the teaching about this method of pain relief? Select all that apply. a. You should push the button whenever doses are available. b. There is a lockout period between PCEA bolus doses given. c. You must be in bed to receive the PCEA bolus doses. d. Your support person can assist by pushing the button if you appear to be in pain. e. The nurse will notify the anesthesiologist when additional doses are needed.

a,b, c

A woman is lightly stroking her abdomen in rhythm with her breathing during contractions. The nurse identifies this technique as: a. therapeutic touch. b. patterned breathing. c. effleurage. d. acupressure.

c. effleurage.

A nurse is caring for a client who has been administered an epidural block. Which should the nurse assess next? a. temperature b. uterine contractions c. respiratory rate d. pulse

c. respiratory rate

General anesthesia is not used frequently in obstetrics because of the risks involved. There are physiologic changes that occur during pregnancy that make the risks of general anesthesia higher than it is in the general population. What is one of those risks? a. The client is more sensitive to preanesthetic medications. b. Neonatal depression is possible. c. Fetal hypersensitivity to anesthetic is possible. d. The client is less sensitive to inhalation anesthetics.

b. Neonatal depression is possible.

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice? a. Let the child eat only the foods she prefers. b. Serve new foods several times. c. Actively urge the child to eat new foods. d. Provide small portions that must be eaten.

b. Serve new foods several times.

Which procedure is contraindicated in an antepartum client with bright red, painless bleeding? a. Urinalysis b. Vaginal examination c. Nonstress test d. Leopold maneuver

b. Vaginal examination

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice? a. Provide small portions that must be eaten. b. Actively urge the child to eat new foods. c. Let the child eat only the foods she prefers. d. Serve new foods several times.

d. Serve new foods several times.

Assessing a pregnant client in labor reveals that the client has not voided in the past 4 hours. What instruction will the nurse provide? a. "It is important to try to urinate every 2 hours because you might not feel the urge." b. "You need to get up and walk around a bit so that your bladder can get filled more fully," c. "You need to give a urine specimen each time you urinate so we can check for infection." d. "Even though you are sweating, you still need to urinate at least every hour."

a. "It is important to try to urinate every 2 hours because you might not feel the urge."

A mother of a 10-month-old states to the nurse, "I brush my child's teeth every day with flavored kids' toothpaste." Which is the most appropriate response by the nurse? a. "Toothpaste is not necessary; it is the scrubbing that is required." b. "That is great, infants typically hate toothpaste." c. "Drinking water is really all you need to do to rinse your child's mouth." d. "Toothpaste plays an important role in overall oral health."

a. "Toothpaste is not necessary; it is the scrubbing that is required."

A client in labor has requested the administration of opioids to reduce pain. At 2 cm cervical dilation (dilatation), she says that she is managing the pain well at this point but does not want it to get ahead of her. What should the nurse do? a. Advise the client to hold out a bit longer, if possible, before administration of the drug, to prevent slowing labor. b. Agree with the client, and administer the drug immediately to keep the pain manageable. c. Explain to the client that opioids should only be administered an hour or less before birth. d. Refuse to administer opioids because they can develop dependency in the client and the fetus.

a. Advise the client to hold out a bit longer, if possible, before administration of the drug, to prevent slowing labor.

A primigravida client has just arrived in early labor and is showing signs of extreme anxiety over the birthing process. Why should the nurse prioritize helping the client relax? a. Anxiety can slow down labor and decrease oxygen to the fetus. b. Increased anxiety will increase the risk for needing anesthesia. c. Decreased anxiety will increase trust in the nurse. d. Anxiety will increase blood pressure, increasing risk with an epidural.

a. Anxiety can slow down labor and decrease oxygen to the fetus.

As a woman enters the second stage of labor, her membranes spontaneously rupture. When this occurs, what would the nurse do next? a. Assess fetal heart rate for fetal safety. b. Elevate her hips to prevent cord prolapse. c. Ask her to bear down with the next contraction. d. Test a sample of amniotic fluid for protein.

a. Assess fetal heart rate for fetal safety.

A gravida 1 client is admitted in the active phase of stage 1 labor with the fetus in the LOA position. The nurse anticipates noting which finding when the membranes rupture? a. Clear to straw-colored fluid b. Bloody fluid c. Greenish fluid d. Cloudy white fluid

a. Clear to straw-colored fluid

A nurse is providing care to several clients in labor. The nurse would anticipate preparing for an epidural block with an opioid analgesic for which client? a. Client B: dilated 4 cm and in the late first stage of labor b. Client A: dilated 2 cm and in the first stage of labor c. Client C: dilated 9 cm and in the late transition phase of labor d. Client D: dilated 10 cm and in the second stage of labor

a. Client B: dilated 4 cm and in the late first stage of labor

The nurse is admitting a client who is in early labor. After determining that the birth is not imminent, which assessment should the nurse perform next? a. Fetal status b. Maternal obstetrical history c. Risk factors d. Maternal status

a. Fetal status

A client and her husband have prepared for a natural birth; however, as the client progresses to 8 cm dilation, she can no longer endure the pain and begs the nurse for an epidural. What is the nurse's best response? a. Support the client's decision and call the provider. b. Gently remind the client of her goal of a natural birth and encourage and help her. c. Suggest a less extreme alternative such as a sedative. d. Ask the husband to gently remind her of their goal of natural birth and to encourage and help her.

a. Support the client's decision and call the provider.

What action shows an example of Erik Erikson's developmental task for the infant? a. The infant cries and the caregiver picks the child up. b. The infant cries when they have a wet diaper. c. The infant smiles as people walk past the crib. d. The infant plays the game peek-a-boo.

a. The infant cries and the caregiver picks the child up.

A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child? a. The infant says "da-da" when looking at her father b. The infant squeals with pleasure c. The infant imitates her father's cough d. The infant coos, babbles, and gurgles

a. The infant says "da-da" when looking at her father

The client in labor at 3 cm dilation and 25% effaced is asking the nurse for analgesia. Which explanation should the nurse provide when explaining why it is too early to administer an analgesic? a. This may prolong labor and increase complications. b. This would cause fetal depression in utero. c. The effects would wear off before delivery. d. This can lead to maternal hypertension.

a. This may prolong labor and increase complications.

A woman in early labor is using a variety of techniques to cope with her pain. When the nurse enters the room she notes that the woman is making light, circling movements with her fingertips across her abdomen. What technique is she using? a. effleurage b. abdominal imagery c. pain pathway blockage d. massage

a. effleurage

What is a nursing intervention that helps prevent the most frequent side effect from epidural anesthesia in a pregnant client? a. starting an IV and hanging IV fluids b. maintaining the client in a supine position c. administrating IV naloxone d. administrating IV ephedrine

a. starting an IV and hanging IV fluids

The nurse is educating the parents of a newborn prior to discharge home. The parents demonstrate teaching was successful when making which statement(s)? Select all that apply. a. "I plan to add a little rice cereal to my breast milk so my newborn will sleep longer at night." b. "I will not be concerned if my newborn has stools that begin to have a yellowish color to them." c. "We should get some rest in about 1 month when the newborn starts sleeping through the night." d. "I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." e. "My newborn can see up-close things, like our faces, better than things at a distance."

b, d, e

A woman states that she does not want any medication for pain relief during labor. Her primary care provider has approved this for her. What the nurse's best response to her concerning this choice? a. "Let me get you something for relaxation if you don't want anything for pain." b. "I respect your preference, whether it is to have medication or not." c. "Your health care provider is a man and has never been in labor; he may be underestimating the pain you will have." d. "That's wonderful. Medication during labor is not good for the baby."

b. "I respect your preference, whether it is to have medication or not."

The nurse enters a client's room to find the new mother crying softly. The client states, "I had my heart set on breastfeeding but my infant was born with a cleft lip. My dreams of breastfeeding are destroyed." Which response by the nurse is appropriate? a. "I am so sorry your infant has a cleft lip. Bottle feeding will be easiest for you and your infant." b. "You may still breastfeed your infant. I will show you appropriate techniques to use." c. "You can use a supplemental nursing system to get a similar experience." d. "You should speak with a lactation consultant before making a decision on which feeding method to use."

b. "You may still breastfeed your infant. I will show you appropriate techniques to use."

A client has been in labor for 10 hours and is 6 cm dilated. She has already expressed a desire to use nonpharmacologic pain management techniques. For the past hour, she has been lying in bed with her doula rubbing her back. Now, she has begun to moan loudly, grit her teeth, and bear down with each contraction. She rates her pain as 8 out of 10 with each contraction. What should the nurse do first? a. Assist the client in ambulating to the bathroom. b. Assess for labor progression. c. Instruct the client to do slow-paced breathing. d. Prepare the client for an epidural.

b. Assess for labor progression.

During an admission assessment of a client in labor, the nurse observes that there is no vaginal bleeding yet. What nursing intervention is appropriate in the absence of vaginal bleeding when the client is in the early stage of labor? a. Monitor hydration status. b. Assess the amount of cervical dilation (dilatation). c. Monitor vital signs. d. Obtain urine specimen for urinalysis.

b. Assess the amount of cervical dilation (dilatation).

How does a woman who feels in control of the situation during labor influence her pain? a. Decreased feeling of control helps during the third stage. b. Feelings of control are inversely related to the client's report of pain. c. There is no association between the two factors. d. Feeling in control shortens the overall length of labor.

b. Feelings of control are inversely related to the client's report of pain.

The nurse is admitting a client who is in early labor. After determining that the birth is not imminent, which assessment should the nurse perform next? a. Maternal status b. Fetal status c. Risk factors d. Maternal obstetrical history

b. Fetal status

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3750 g) at birth. Weight now is 20 pounds 8 ounces (9300 g). The nurse determines: a. the weight assessment is blatantly inaccurate. b. the child weighs less than expected for age. c. the child weighs more than expected for age. d. the child weighs the expected amount for age.

b. the child weighs less than expected for age.

The nurse reviews the client's chart (above) regarding pain management. What pain management strategy(ies) is appropriate for this client? Select all that apply. a. sterile water subcutaneous injections b. hydrotherapy c. acupuncture d. massage e. acupressure

c, d, e

A labor nurse is caring for a client who is 7 cm dilated, 100% effaced, at a +1 station, and has a face presentation on examination. The nurse knows that teaching was understood when the birth partner makes which statement? a. "Our baby will come out with the buttocks first." b. "Our baby will come out with the back of the head first." c. "Our baby will come out face first." d. "Our baby will come out facing the hip."

c. "Our baby will come out face first."

When collecting data to devise a labor plan for a multiparous woman, which question best allows the nurse to develop individualized strategies? a. "How do you want the health care team to plan your care?" b. "Picking from these options, what options do you feel are best?" c. "Tell me how you handled labor pain in your past deliveries." d. "Who do you want to be with you when you are in labor?"

c. "Tell me how you handled labor pain in your past deliveries."

The health care provider approves a labor plan which includes analgesia. The client questions how analgesia will help her pain during labor. Which answer is best? a. "The analgesia will allow for a pain-free birth experience." b. "The analgesia will limit your ability to be out of bed without assistance." c. "The analgesia will reduce the sensation of pain for a limited period of time." d. "The analgesia will block pain sensation and limit your ability to push."

c. "The analgesia will reduce the sensation of pain for a limited period of time."

The nurse is caring for a parent following the birth of the newborn. The new parent asks the nurse, "When is the best time for me to start bonding with my baby?" Which response by the nurse is appropriate? a. "Newborns prefer to have verbal interaction as they enter a drowsy state." b. "Interaction has the best effect on bonding when the newborn is in a quiet sleep state." c. "You should interact with your newborn when the eyes are open wide and bright." d. "When newborns begin to cry, they are in need of parental interaction."

c. "You should interact with your newborn when the eyes are open wide and bright."

The infant measures 21.5 in (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for the infant at the age of 6 months? a. 29 in (74 cm) b. 30.5 in (77.5 cm) c. 27.5 in (70 cm) d. 32 in (81 cm)

c. 27.5 in (70 cm)

The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child? a. A push-pull toy b. Pots and pans from the kitchen cupboard c. A yellow rubber duck for the bath d. Brightly colored stacking toy

c. A yellow rubber duck for the bath

The nurse is analyzing the readout on the EFM and determines the FHR pattern is normal based on which recording? a. Increase in variability by 27 bpm b. Decrease in variability for 15 seconds c. Acceleration of at least 15 bpm for 15 seconds d. Deceleration followed by acceleration of 15 bpm

c. Acceleration of at least 15 bpm for 15 seconds

A nurse is caring for a client administered general anesthesia for an emergency cesarean birth. The nurse notes the client's uterus is relaxed upon massage. What would the nurse do next? a. Continue to monitor the client. b. Assess the client's vaginal bleeding. c. Continue to massage the client's fundus. d. Administer oxygen to the client.

c. Continue to massage the client's fundus.

While assessing the progress of the labor, the nurse explains that the fetal heart rate variability is moderate. Which explanation is best to use with the parents? a. FHR fluctuates less than 5 beats per minute. b. FHR fluctuation range is undetectable. c. FHR fluctuates from 6 to 25 beats per minute. d. FHR fluctuates over 25 beats per minute.

c. FHR fluctuates from 6 to 25 beats per minute.

The nurse notes that the client has a moderate amount of bleeding after birth. Which instruction is anticipated to control bleeding? a. Provide intravenous clotting factors. b. Have the client bear down to expel any clots. c. Put the newborn to the breast to suck. d. Do nothing as this is normal after delivery.

c. Put the newborn to the breast to suck.

The client may spend the latent phase of the first stage of labor at home unless which occurs? a. The client begins back labor b. The contractions vary in length and intensity c. The client experiences a rupture of membranes d. The client passes the bloody show

c. The client experiences a rupture of membranes

At what time is the laboring client encouraged to push? a. When the nurse wants the client to push b. When the health care provider has arrived c. When the cervix is fully dilated d. When the fetal head can be seen

c. When the cervix is fully dilated

A labor nurse is caring for a client who is 7 cm dilated, 100% effaced, at a +1 station, and has a face presentation on examination. The nurse knows that teaching was understood when the birth partner makes which statement? a. "Our baby will come out with the buttocks first." b. "Our baby will come out with the back of the head first." c. "Our baby will come out facing the hip." d. "Our baby will come out face first."

d. "Our baby will come out face first."

The nurse is teaching the parents of a 9-month-old infant about proper dental care. Which statement by the parents most concerns the nurse? a. "We use a fluoridated toothpaste to brush our infant's teeth." b. "We only brush our infant's teeth twice a day." c. "We prefer to use a cloth instead of a brush for cleaning the teeth and gums." d. "Our infant goes to sleep at night with a bottle of milk or juice."

d. "Our infant goes to sleep at night with a bottle of milk or juice."

An infant has been brought to the clinic for a well-child check. The infant is 12 months of age. The child's birth weight was 6 pounds, 7 ounces. What is the anticipated weight for the child at this visit? a. 20 pounds b. 21 pounds, 9 ounces c. 18 pounds d. 19 pounds, 5 ounces

d. 19 pounds, 5 ounces

The nurse is reviewing the medication administration record (MAR) of a client at 39 weeks' gestation and notes that she is ordered an opioid for pain relief. Which is an assessment priority after administering? a. Assess maternal blood pressure. b. Assess for constipation. c. Assess for dry mouth. d. Assess fetal heart rate.

d. Assess fetal heart rate.

The nurse is assessing a 6-month-old infant in the clinic. Which characteristic represents normal language development for this age? a. Producing noises when spoken to b. Laughing out loud c. Cooing d. Babbling

d. Babbling

The nurse is assessing a client in active labor and notes a small, rounded mass above the symphysis pubis that is distended but nontender. Which action should the nurse prioritize? a. Assume this is part of the uterus. b. Ask the client if the mass has always been present. c. Notify the health care provider about the mass. d. Check the chart for the last void.

d. Check the chart for the last void.

The nursing instructor is preparing a class discussing the role of the nurse during the labor and birthing process. Which intervention should the instructor point out has the greatest effect on relieving anxiety for the client? a. Prenatal classes b. Pharmacologic pain management c. Massage therapy d. Continuous labor support

d. Continuous labor support

The nurse is monitoring the electronic fetal heart rate monitor and notes the following: variable V-shaped decelerations in the fetal heart rate (FHR) lasting about 30 seconds, accelerations of about 5 beats/min before and after each deceleration, no overshoot, and baseline FHR within normal limits. Which response should the nurse prioritize? a. Encourage pushing with contractions during second stage of labor. b. Start an oxytocic infusion and decrease the rate of IV fluids. c. Discontinue supplemental oxygen. d. Help the woman change positions.

d. Help the woman change positions.

In providing culturally competent care to a laboring woman, which is a priority? a. Identify the decision maker within the family. b. Identify who is the support person during the labor. c. Identify any cultural foods used prior to labor. d. Identify how the client expresses labor pain.

d. Identify how the client expresses labor pain.

A nurse is auscultating the fetal heart rate of a woman in labor. To ensure that the nurse is assessing the FHR and not the mother's heart rate, which action would be most appropriate for the nurse to do? a. Have the woman lie completely flat on her back while auscultating. b. Ask the woman to hold her breath while assessing the FHR. c. Instruct the woman to bend her knees and flex her hips. d. Palpate the mother's radial pulse at the same time.

d. Palpate the mother's radial pulse at the same time.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? a. They sing to her before she goes to sleep. b. If she is safe, they lie her down and leave. c. The child has a regular, scheduled bedtime. d. They put her to bed when she falls asleep.

d. They put her to bed when she falls asleep.

The nurse is assessing a woman at 37 weeks' gestation who has presented with possible signs of labor. The nurse determines the membranes have ruptured based on which color of the nitrazine paper? a. white b. yellow c. pink d. blue

d. blue

A nurse is performing Leopold maneuvers on a pregnant woman. The nurse determines which information with the first maneuver? a. fetal position b. fetal flexion c. fetal attitude d. fetal presentation

d. fetal presentation

The student nurse is preparing to assess the fetal heart rate (FHR) and has determined that the fetal back is located toward the client's left side, the small parts toward the right side, and there is a vertex (occiput) presentation. The nurse should initially begin auscultation of the fetal heart rate in the mother's: a. right lower quadrant. b. right upper quadrant. c. left upper quadrant. d. left lower quadrant.

d. left lower quadrant.

A client in active labor is given spinal anesthesia. Which information would the nurse include when discussing with the client and family about the disadvantages of spinal anesthesia?

headache following anesthesia