Course Point OB Practice questions

A pregnant client is admitted to the labor and birth unit in the first stage of labor. A nurse reviews a pregnant client's birth plan. Which response from the client would indicate to the nurse that further teaching is indicated?

"I will remain in my bed for my labor and birth like last time."

A nurse is teaching a newborn's caregivers how to change a diaper correctly. Which statement by the caregiver best indicates the nurse's teaching was effective?

"We will fold down the front of her diaper under the umbilical cord until it falls off."

In which newborn should the nurse suspect hypoglycemia?

A jittery, irritable newborn with a high-pitched cry

While the placenta is being delivered after labor, a patient experiences an amniotic fluid embolism. What should the nurse do first to help this patient?

Administer oxygen by mask.

A woman who has had a cesarean birth asks you if she will always need to have cesarean births in the future. Which of the following would be your best response?

Although there are some exceptions, surgical techniques allow for vaginal birth after cesarean birth."

As a woman enters the second stage of labor, her membranes spontaneously rupture. When this occurs, what would the nurse do next?

Assess fetal heart rate for fetal safety

The perinatal educator is instructing on various emotions commonly experienced during labor. Which complication of anxiety is most important to stress?

Dystocia (obstructed labor)

A nursing student correctly identifies which of the following as the most important predictor of fetal maturity:

Fetal lung maturity

the nurse is assessing the fundus of a patient on postpartum day 2. What should the nurse expect when palpating the fundus?

Fundus two fingerbreadths below umbilicus and firm

The nurse is assessing reflexes in a newborn infant. What can the nurse do to elicit the rooting reflex?

Gently stroke the newborn's cheek.

The nurse has received the results of a client's postpartum hemoglobin and hematocrit. Review of the client's history reveals a prepartum hemoglobin of 14 g/dl (140 g/L) and hematocrit of 42% (0.42). Which result should the nurse prioritize?

Hemoglobin 9 g/dl (90 g/L) and hematocrit 32% (0.32) in a woman who has given birth by cesarean. Normal hemoglobin women(12-16) hematocrit (33-45%)

The nursing director of a busy postpartum unit has arranged for the lactating consultant to provide some education about ways to create an atmosphere conducive to breastfeeding success. Which topics should be emphasized? Select all that apply.

If feasible, help women initiate breastfeeding within 30 minutes of birth. Assist all mothers who are separated from their infant in the NICU to breastfeed and maintain lactation.

A pregnant patient tells the nurse that she hopes the baby is not in the breech position because she has heard that this causes difficult labor. What should the nurse include when explaining the reasons for this presentation to the patient? Select all that apply.

Multiple fetuses Fetal birth defects Lax abdominal muscles Fetal age less than 40 weeks

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?

Neonatal depression is possible.

The nurse cared for a client who gave birth. The duration of labor from the onset of contractions until the birth of the baby was 2 hours. How will the nurse document the client's labor in the health record?

Precipitous labor

The nurse is providing care to a large-for-gestational age newborn whose mother has diabetes. The mother is breastfeeding the newborn approximately every 2 to 3 hours. The nurse is monitoring the newborn's blood glucose levels. Previous blood glucose levels were as follows: 0900: 44 mg/dL (2.44 mmol/L) 1200: 50 mg/dL (2.77 mmol/L) It is now 1500 and the newborn's blood glucose level is 33 mg/dL (1.83 mmol/L). Which action would the nurse do next?

Prepare to initiate an intravenous infusion of glucose after reporting the result.

A primigravida is 1 cm dilated, in early latent labor, and interested in avoiding epidural anesthesia. After asking about which nonpharmacologic options for pain relief she can use at this time, which option(s) should the nurse point out to the client? Select all that apply.

Simple breathing exercises Effleurage Walking and then using a birthing ball

A 1-day-old newborn is being examined by the nurse practitioner, who makes the following notation: face and sclera appear mildly jaundiced. What causes this finding?

The breakdown of RBCs release bilirubin, which the liver cannot excrete.

Which client outcome during active and transitional labor is best?

The client will practice breathing techniques during contractions

The nurse is observing the perineal care of a 2-year-old in a hip spica cast. For which caregiver actions will the nurse provide additional instruction? Select all that apply.

Uses the tips of the fingers to handle the cast Applies powder to the perineal area after a bowel movement

A nurse is providing care to a postpartum woman who is breastfeeding her 1-day old neonate. While observing the interaction, the woman says to the nurse, "I have noticed some tingling in both of my breasts just before my baby starts to feed and then for a bit during the feeding. What is happening?" Which response by the nurse would be appropriate?

What you are feeling is the normal let-down reflex when milk is released.

When examining a newborn for developmental dysplasia of the hip (DDH), which motion would the newborn's hip be unable to accomplish?

abduction

A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's first action would be to:

administer oxygen by mask.

Immediately after giving birth to a full-term infant, a client develops dyspnea and cyanosis. Her blood pressure decreases to 60/40 mm Hg, and she becomes unresponsive. What does the nurse suspect is happening with this client?

amniotic fluid embolism

During which time is the nurse correct to document the end of the third stage of labor?

at the time of placental delivery

The nurse is assessing a client at a postpartum visit who reports constipation. The nurse should point out this is likely related to which factor?

discomfort due to hemorrhoids

A nurse in the newborn nursery has noticed that an infant is frothing and appears to have excessive drooling. Further assessment reveals that the baby has episodes of respiratory distress with choking and cyanosis. What disorder should the nurse suspect based on these findings?

esophageal atresia

the nurse is caring for an infant diagnosed with a ventricular septal defect. Which assessment findings does the nurse anticipate?

harsh murmer

A nurse is performing an assessment on a female client who gave birth 24 hours ago. On assessment, the nurse finds that the fundus is 2 cm above the umbilicus and boggy. Which intervention is a priority?

have the client void, and then massage the fundus until it is firm

A nurse is preparing to auscultate the fetal heart rate of a pregnant woman at term admitted to the labor and birth suite. Assessment reveals that the fetus is in a cephalic presentation. At which area on the woman's body would the nurse best hear the sounds?

in the woman's lower abdominal quadrant

the postpartum client is reporting her left calf hurts and it is making it difficult for her to walk. The nurse predicts which factor is contributing to this situation after finding an area of warmth and redness?

increased coagulation factors

When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to be:

less than vaginal birth

A full-term neonate delivered an hour after the mother received IV meperidine is showing signs of respiratory depression. The nurse should be prepared to administer which medication?

naloxone

A woman is in the hospital only 15 minutes when she begins to give birth precipitously. The fetal head begins to emerge as the nurse walks into the labor room. The nurse's best action would be to:

place a hand gently on the fetal head to guide birth.

A nurse is assessing a newborn. Which finding would alert the nurse to the possibility of respiratory distress in a newborn?

sternal retractions

Which statement is true regarding fetal and newborn senses?

the rooting reflex is an example that the newborn has a sense of touch.

A young woman experiencing contractions arrives at the emergency department. After examining her, the nurse learns that the client is at 33 weeks' gestation. What treatment can the nurse expect this client to be prescribed?

tocolytic therapy

A student nurse is learning about congenital heart defects in newborns and correctly identifies which of the following to be the most common intracardiac defect?

ventricular septal defect

The lactation nurse is working with a woman who is experiencing some difficulties getting her newborn to "latch on" to her breast. They are trying various positions to see which is best for this infant. The nurse will document which nursing problem related to this teaching session?

Imbalanced nutrition, less than body requirements related to poor latch

A nurse is caring for a preterm newborn born at 29 weeks' gestation. Which nursing diagnosis would have the highest priority?

Ineffective thermoregulation related to decreased amount of subcutaneous fat

The nurse is preparing to administer the vitamin K injection to a newborn. Which action would be correct for this client?

Injecting the medication into the vastus lateralis

The nurse is teaching a couple about the pros and cons of circumcision for their infant son. The nurse knows teaching has been effective when the couple can identify which contraindications to circumcision? Select all that apply.

Preterm infant Bleeding disorder Congenital genitourinary disorder Active infection

A 32-year-old woman presents to the labor and birth suite in active labor. She is multigravida, relaxed, and talking with her husband. When examined by the nurse, the fetus is found to be in a cephalic presentation. His occiput is facing toward the front and slightly to the right of the mother's pelvis, and he is exhibiting a flexed attitude. How does the nurse document the position of the fetus?

ROA

Breastfeeding is generally encouraged except under certain conditions. Which conditions contraindicate breastfeeding? Select all that apply.

When the mother takes certain medications, such as antineoplastics When the mother has active tuberculosis When the mother is diagnosed with breast cancer

The nurse is caring for a woman who has had a baby by cesarean birth. Which of the following would be the most important assessment to make?

Whether her abdomen is soft or not

A 16-year-old client has been in the active phase of labor for 14 hours. An ultrasound reveals that the likely cause of delay in dilation (dilatation) is cephalopelvic disproportion. Which intervention should the nurse most expect in this case?

cesarean birth