OB Final Exam - - - - - - - - - - - -
A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes. Which statement , if made by the client, indicates a need for further education.
"Ineed to avoid exercise bc of the negative effects of insulin production" (this is an INCORRECT statement)
Your patient is having a NST. Which of the following indicated the desired results? a) b) c) d)
"Reactive" the results shows two or more FHR accelerations of at least 15 BPM, lasting 15 seconds from the beginning of the acceleration to the end, in association with fetal movement, during a 20 minuteperiod
A client arrives at the clinic for the first prenatal assessment The client tells a nurse that the first day of her last menstrual period was October 19th. Using the naegele's rule the nurse determines that the estimated date of confinement is? a) July 26th b) May 26th c) July 19th d) April 12th
A
A nurse in a health clinic is instructing a pregnant client how to perform "Kick Counts" Which statement by the client indicates a need for further instruction? a) "I need to lie flat on my back to preform the procedure." b) "I will contact my HCP if I feel less than10 kicks per 2 hrs" c) "I will lie on my left side" d) "I Count the time it takes for my baby to make 10 movements"
A
A nurse in a newborn nursery receives a phone call to prepare for the admission of a 43-week gestation with Apgar scores of 1 & 4. In planning for admission of this newborn. The nurses highest priority should be? a) Connect the resuscitation bag to the oxygen outlet b) Turn on the apnea and cardiorespiratory monitors c) Set up the intravenous line with 5% dextrose in water d) Set the radiant warmer control temperature at 36.5* C (97.6*F)
A
A nurse is developing a teaching plan for a primigravid client who's 2 months pregnant. The nurse should tell the client she can expect to feel the fetus move at which time? a) between 18 & 22 weeks gestation b) at 14 weeks gestation c) at 12 weeks gestation d) now
A
An assisted birth using forceps or a vacuum extractor may be performed for ineffective pushing, for large infants, to shorten the second stage of labor, or for malpresentation. Nurse Sally is caring for the mother following a assisted birth should keep which of the following in mind? a) A vacuum extractor is safer than forceps because it causes less trauma to the baby and the mother's perineum. b) The baby will develop a cephalohematoma as a result of the instrumentation. c) The use of instruments during the birth process is a fairly rare occurrence. d) Additional nursing interventions are needed to ensure an uncomplicated postpartum.
A
During a health teaching session, a pregnant client asks the nurse how soon the fertilized ovum becomes implanted in the endometrium? Which answer should the nurse supply? a) 7 days b) 14 days c) 21 days d) 30 days
A
During a physical examination, a client who is 32 weeks pregnant becomes pale, dizzy, and light headed while supine. Which action should the nurse immediately take? a) Turn the client on her left side b) Ask the client to breathe deeply c) Listen to fetal heart tones d) Measure the client's blood pressure.
A
Following the circumcision of the newborn, the nurse provides instructions to his parents regarding post circumcision care. The nurse should tell the parents to: a) Expect yellowish exudate to cover then glans after the first 24 hours b) wash it with soap c) use clean or sterile cotton balls d) use neosporin to speed up healing
A
Late in the first stage of labor, a client receives spinal anesthesia to relieve discomfort. A short time later, her partner tells the nurse that the client feels dizzy and is complaining of numbness around her lips. What do the client's symptoms suggest? A) Anesthesia overdose B) Transition to the second stage of labor C) Anxiety D) Dehydration
A
When assessing the neonate, the nurse observes a vaguely outline area of scalp edema that is most likely caput succedaneum. What is the most appropriate nursing action based on the finding? a) note the finding on the assessment record b) Notify the health care provider c) Perform a vaginal exam d) take vital signs
A
While performing continuous electronic monitoring of a client in labor, the nurse should document which information about the contractions? A) Duration, frequency, and intensity B) Duration, dilation,, frequency C) Frequency, duration maternal position D) Duration, effacement, position
A
Determine the incorrect function of bishop score:
A score of 5 or less indicated a readiness for labor induction
Which signs are considered a positive sign of pregnancy? (select all that apply) a) Fetal heart beat b) Fetal movement on palpation c) Morning nausea / vomiting d) missed menstrual period
A, B
Early detection of an ectopic pregnancy is paramount in preventing a life threatening rupture. Which symptoms should alert the nurse to the possibility of an ectopic pregnancy? (Select all that apply) a) Abdominal pain b) Vaginal bleeding c) positive pregnancy test d) back pains
A, B, C
A nurse is assessing a neonate. Health history findings indicate that the mother drank 3 oz(89ml) or more of alcohol per day throughout pregnancy which characteristic should the nurse expect to find? (select all that apply) a) separaed eyes b) upturned nose c) oversized head d) thin upper lip
A, B, D
A client in labor has an episiotomy. The nurse understands that the client is at risk for what complication? (select all that apply) a) infection b) vaginal bleeding c) STD d) Prolong dyspareunia (painful sex)
A, D
A nurse monitoring a client in preterm labor who is receving IV magnesium sulfate. The nurse monitors for which adverse reaction of this medication? Select all that apply: a) Flushing b) Hypertension c) Increase urine output d) Depressed resperations e) Extreame muscle weakness
A, D, E
A client 36 weeks gestation is scheduled for a ultrasound Prior to an amniocentesis. After teaching the client about the purpose of the ultrasound which Client statement would indicate to the nurse that the client needs further instruction?: a. The ultrasound will help to locate the placenta b. The ultrasound identifies blood flow through the umbilical cord c. The test will determine where to insert the needle d. The ultrasound locates a pool of amniotic fluid
B
A nurse has developed a plan of care for a client experiencing dystocia and includes several nursing intervention in the plan of care. The nurse prioritizes the plan of care and selects which intervention as the highest priority? a) Provide comfort measure b) Monitor the fetal heart rate c) Change the client's position frequently d) Keeping the significant other informed of the progress of the labor
B
A pregnant client arrives in the emergency department and states, "My baby is coming" the nurse sees a portion of the umbilical cord protruding from the vagina. Why should the nurse apply manual pressure to the baby's head? a) to hold the baby from an early delivery b) to relieve pressure on the umbilical cord c) to relieve pressure on the mother d) to perform a vaginal examination
B
A teenage girl asks the nurse at the pediatrician's office about tampon use. She does gymnastics and cannot use just sanitary napkins during her menstrual cycle. Which statement, made by the teenage girl, demonstrates that further teaching is needed? a) b) "I should change my tampon every 6-8 hours" c) d)
B
After doing the Leopold's maneuvers, the nurse determines that the fetus is in the ROP (right occipitoposterior) position. To best auscultate the fetal heart tones, the Doppler is placed: a) just below the umbilicus b) below the umbilicus on the right side c) below the umbilicus on the left side d) 1 finger breath above the umbilicus
B
Assessment data of a newborn includes a long, thin, emaciated appearance; loose skin folds; head large in appearance. The nurse recognizes these characteristics are associated with which of the following? a) Symmetric IUGR b) Assymetric IUGR c) Pr AGA d) SGA
B
During the active phase of the first stage of labor , a client undergoes an amniotomy. After this procedure, which nursing diagnosis takes the highest priority? a) Deficient knowledge (testing procedure) related to amniotomy b). Ineffective fetal cerebral tissue perfusion related to cord compression c) Acute pain related to increasing strength of contractions d). Risk for infection related to rupture of membranes
B
A Client in the first stage of labor is being monitored using a external fetal monitor.A nurse notes Variable decelerations on the monitoring strip. Into what position should the nurse assess the client? a) Supine b) Lateral c) Left Lateral d) Sims
C
A client in labor has meconium staining in the amniotic fluid. Which sequence of events will most effectively decrease the risk of meconium aspiration? a) Deliver the thorax, then suction the nose. b) Clamp the umbilical cord, then suction the neonates mouth. c) Deliver the head, then suction the mouth and then the nose d) Deliver the thorax, then suctionthe nose and then the mouth
C
A client is complaining of painful contractions or after pains , on postpartum day 2. Which of the following conditions could increase the severity of afterpains? a) bottle-feeding b) diabetes c) multiple gestation d) primiparity
C
A client states that her "waterbroke" which action requires the nurse to have specialized training? a) Observation for pooling of straw-colored fluid b) Checking vaginal discharge with Nitrazune paper c) Conducting a bedside ultrasound for an amnionic fluid index d) Observe for flakes of verneix in vaginal discharge
C
A client, approximately 11 weeks pregnant, and her husband are seen in the antepartal clinic. The client's husband tells the nurse that he has been experiencing nausea and vomiting and fatigue along with his wife. The nurse interprets these findings as suggestion that the client's husband is experiencing which of the following? a) Ptyalism b) Mittelschmerz c) Couvade syndrome d) Pica
C
A patient , 11 weeks pregnant is admitted to the facility with hyperemesis gravidarum. She tells the nurse she has never known anyone who had such severe morning sickness.The nurse understands that hyperemesis gravidarum results from: a) a neurologic disorder. b) inadequate nutrition. c) an unknown cause. d) hemolysis of fetal red blood cells (RBCs).
C
A woman in her 34th week of pregnancy presents with sudden onset of bright red vaginal bleeding. Her Uterus is soft and she is experiencing no pain. FHR is 120 BPM. Based on this history, the nurse should suspect: a) Rupture of membrane b) Placenta abruption c) Placenta previa d) Vaginal Bleeding
C
What is the function of Operculum? a) To stimulate the uterus to contract after child birth b) To provide nutrients to the fetus. c) To act as a barrier against bacterial invasion during pregnancy d) To cushion the infants head during childbirth.
C
When Caring for a woman who has a positive contraction stress test (CST), What complications does the nurse suspect? a) eeclampsia b) baby is ready to be delivered c) uteroplacental insufficiency d) UTI
C
A breastfeeding client is diagnosed with mastitis.Which nursing intervention is appropriate? a) Instructing her to breast-feed the neonate at least every 4 hours b) Teaching her to apply a cold compress to the affected breast after each feeding c) Recommending that she wear a special brassiere when breast-feeding d) Advising her to massage the affected area gently while breast-feeding
D
A client in the 13th week of pregnancy develops hyperemesis gravidarum. Which laboratory finding indicates the need for intervention? a. Urine specific gravity 1.010 b. Serum potassium 4 mEq/L c. Serum sodium 140 mEq/L d. Ketones in the urine
D
A nurse is caring for a client after evacuation of a hydatidiform mole. The nurse should tell the woman to: a) Wait one month before trying to become pregnant again. b) Make an appointment for follow-up human chorionic gonadotropin(hCG) level monitoring at the end of 1 year. c) Discuss options for sterilization with the physician d) Use birth control for at least 1 year.
D
A nurse is monitoring a woman in labor. The mother is having dysfunctional labor. Which of the following assessment findings would alert the nurse to fetal or maternal compromise? a) Maternal fatigue b) Coordinated uterine contractions c) Progressive change in cervix d) Persistent nonreassuring FHR
D
A nursing midwife is performing an assessment of a client and is assessing the client for the presence of ballottement. Which of the following would the nurse implement to test for the presence of ballottement? a) Ausculatating for fetal heart sounds b) Palpating the abdomen for fetal movement c) Assessing the cervix for thinning d) Initiating a gental upward tap on the cervix
D
Client is a multigravida in her 39th week of gestation, is diagnosed with PIH and HELLP syndrome. The nurse's top priority is to assess the client's: a) White blood cell count(WBC) b) Blood glucose levels c) Plasma levels d) Platelet count
D
Which condition poses the greates risk to 32 year old client who is 15 weeks pregnant and has a history of hypertension? a) Anemia b) Spontaneious abortion c) Preterm labor d) Abruptio placentae
D
A client who is having a difficult labor is diagnosed with cephalopelvic disproportion. Which medical orders should the nurse question? a) Maintain NPO status b) Start peripheral IV of ¼ NS c) Record fetal heart tones every 15minutes d) Piggyback another 10-unit bag of oxytocin (Pitocin)
D Rational: when there is cephalopelvic disproportion, a cesarean birth is indicated. Infusing oxytocin (Pitocin) at this time may result in fetal compromise and uterine rupture.
A client who is 41 weeks pregnant is about to undergo a biophysical profile (BBP) to evaluate her fetus well being. The nurse knows that which components are included in a BBP? Select all that apply: (3)
Fetal tone Fetal breathing movements Amniotic fluid volume
The nurse is researching the topic of uteroplacenta blood flow. Which of the following statements accurately describe funic souffle?
Funic souffl'e is a soft blowing sound of blood that is at the same rate as the FH
A client is in her 38th week of her first pregnancy. She calls the prenatal facility to report occasional tightening sensations in the lower abdomen and pressure on the bladder from the fetus. Which she says is lower than usual. The nurse should take which action?
Review the premonitory signs of labor
When assessing the fetal heart rate tracing, nurse assesses the fetal heart rate at 170 BPM. This rate is considered fetal tachycardia if:
The FHR remains at greater than 160 BPM for 10 minutes
During the 4th stage of labor , the client should be assessed carefully for:
Uterine atony
A client with cervical incompetence undergoes cerclage. What complications should the nurse monitor for following the procedure? (Select all that apply) a) ROM b) Intrauterine infection c) Painful, regular contractions d) Active bleeding
a, b, c, d
A client isn't progressing with dilation. Her physician recommends a C-section birth to minimize the potential for fetal distress. After surgery, What should the nurse assess for in this client? (Select all that apply) a) daily weight b) Infection c) Hemorrhage d) Hematuria
b, c, d