OB peds exam

A postpartum client tells the nurse that she feels like crying for no apparent reason and is unable to sleep well. What should the nurse point out to the client that this may be related to?

decreased progesterone levels.

The nursing instructor is teaching a class on the nutritional needs of the pregnant client. The instructor determines the session is successful when the students correctly choose which supplement as being known to prevent up to 70% of CNS birth defects?

folic acid

The nurse is preparing to assess a toddler during a routine health maintenance visit. Which assessment will the nurse perform to determine the child's growth milestone?

height and weight

A client is in the third stage of labor. Which finding alerts the nurse that the placenta is separating?

uterus becomes globular

A 10-year-old child is receiving end-of-life care at home (above). The home care nurse recommends repositioning the client every 2 hours. The caregiver responds, "My child has been through so much already! Why can't we just let the child stay in a comfortable position?" How will the nurse address the parents' concerns?

"A pressure injury could cause additional pain; we can gently reposition your child to reduce this risk."

A 3-year-old client has been hospitalized for 1 week with her mother rooming-in; however, the mother has gone home to tend to other family responsibilities for a few days. After being inconsolable for the first 24 hours after the mother's departure, the nurse notes the child is now lying quietly in bed sucking her thumb. Which response should the nurse prioritize in this situation?

"Are you feeling sad? Your mom didn't want to leave, but she will be back after two more breakfasts."

What statement by the mother of a preschooler indicates the need for further education by the nurse?

"If food falls on the floor, my child should pick it up quickly and wipe it off before eating it."

The nurse is teaching a prenatal class on the functions of the various structures involved with a pregnancy. The nurse determines the class is successful when the class correctly chooses which function of amniotic fluid?

"It helps cushion the baby."

During a visit to the prenatal clinic, a pregnant woman asks the nurse, "What causes labor to start?" Which response by the nurse would be appropriate?

"Labor starts from a combination of several maternal and fetal hormones working together."

A child who is immobile states, "I am sad because I cannot do what my friends do." Which response by the nurse is appropriate?

"Let's try to figure out how you can do more."

The nurse is spending time with a client who has just learned, unexpectedly, that she is pregnant. Which initial task should the nurse assist the client to focus on?

Accepting the pregnancy

A 5-year-old child is brought to the emergency room with an open chin laceration following a bike accident. The child appears extremely frightened and asks if he will bleed to death. Which nursing action should the nurse prioritize to best assist this child?

Allow him to sit on his parent's lap until time to suture the laceration.

In which manner is the fetal status best assessed during the active and transition stages of labor?

Fetal heart rate at the peak of a contraction

As part of the first prenatal visit, the nurse is assessing a pregnant woman's obstetrical history, which includes an 18-month-old daughter, born 2 days after her estimated date of birth; a 3-year-old son born at 35 weeks' gestation; and two lost pregnancies, one at 12 weeks and one at 21 weeks. How should the nurse document this history?

G5 T1 P2 A1 L2

A woman delivered her infant 2 hours ago and calls to tell the nurse that she needs to go to the bathroom. When the nurse arrives, the mother is getting out of bed alone. What should the nurse do?

Have the client sit dangling her legs off the side of the bed for 5 minutes.

The skull is the most important factor in relation to the labor and birth processes. The fetal skull must be small enough to travel through the bony pelvis. What feature of the fetal skull helps to make this passage possible?

Molding

The nurse is assisting with the circumcision of a male infant. Which nursing intervention is priority immediately after the procedure?

Monitor the site for bleeding.

The nurse is caring for a client in active labor who states, "I need to go to the bathroom to have a bowel movement, now." Which action should the nurse take first?

Position the client for and perform a cervical assessment.

The nurse is planning care for a family whose 3-year-old child is in the final stages of dying. Which outcome demonstrates that the interventions have been successful? Select all that apply.

The parents identify coping measures that are helping. The family prepares a scrapbook with favorite photos. The child remains free of pain during the end stage of life. The parents identify a support group for their family.

A new mother asks the nurse what she is allowed to do when she goes home from the hospital. Which statement by the nurse would be correct?

You should not lift anything heavier than your infant in its carrier.

Which condition is the most common cause of anemia in pregnancy?

iron-deficiency anemia

The nurse assesses a 5-year-old client for a well-child visit prior to the start of school (above). What finding from the assessment requires follow-up?

speech and language

During the second stage of labor, a woman is generally:

turning inward to concentrate on body sensations.

A group of nursing students are analyzing the fetal circulation. After the session, the students correctly point out which fetal structure contains the highest concentration of oxygen?

umbilical vein

A 43-year-old, physically fit, healthy woman who is newly married tells the nurse that she and her husband would like to have a child. What is an appropriate first response?

"Well, I'm sure you know there are some risks involved so it's helpful that you've been taking such good care of yourself."

A school-aged child is in isolation at the hospital and her family members ask what they can do to help the child feel less lonely. What would the nurse suggest to this family? Select all that apply.

1. Have the child's classmates send cards to the child. 2. Have parents bring the child's electronic game system. 3. Draw a smile on the nurse's mask before entering the room.

A postpartum woman is concerned about constipation following delivery. What factor(s) contribute to this problem? Select all that apply.

1. Perineal pain 2. Hemorrhoidal discomfort 3. Iron supplements

In which situation(s) will the nurse anticipate client admission to the labor and delivery unit? Select all that apply.

1. The client reports experiencing regular contractions every 5 minutes. 2. The nurse notes that the cervix has thinned with 7 cm dilation (dilatation). 3. The health care provider has documented pelvic change from the client's last visit. 4. The client reports a gush of fluid from the perineal region.

A woman arrives at the prenatal clinic and is accompanied by her partner. Which behaviors would be suggestive of intimate partner violence (IPV)? Select all that apply.

1. The partner answers questions for the pregnant client. 2. The partner is overly protective of the pregnant client. 3. Poor weight gain during the pregnancy and low-birth-weight infant

A 6-year-old has been administered a hypnotic before going to surgery. The child remains kicking and screaming. The nurse is considering whether restraints should be used in this situation. Which guidelines should the nurse follow in this instance? Select all that apply.

1. Use the least amount of restraint necessary. 2. Obtain a primary care provider's prescription for restraint. 3. Explain to the parents the need to restrain their child.

The mother of a 4-year-old is concerned her child is not eating well. In addressing the concerns of this mother, which foods should the nurse point out are high in protein? Select all that apply.

1. cheese and crackers 2.whole grain granola with yogurt 3. turkey sandwich

The nurse discharging a newly delivered mother and her newborn infant needs to assess the mother's knowledge about how to take care of herself and her baby. This is her second child. Which approach would be best to verify the client's understanding of these topics?

Ask her questions and observe her caring for the baby.

A client at 27 weeks' gestation still walks daily but reports "terrible" heartburn at night. Which action should the nurse point out will best address this situation?

Elevate the head of the bed.

A 30-minute-old newborn starts crying in a high-pitched manner and cannot be consoled by the mother. Which action should the nurse prioritize if jitteriness is also noted and the infant is unable to breastfeed?

Check blood glucose.

The nurse is teaching a prenatal class illustrating the steps that are used to keep families safe. The nurse determines the session is successful when the parents correctly choose which precaution to follow after the birth of their infant?

Check the identification badge of any health care worker before releasing baby from room.

The nurse is working with a 12-year-old who is hospitalized with a chronic illness. Which action by the nurse might help the chronically ill preteen thrive while hospitalized?

Encourage the client to wear his or her own clothes, talk to friends on the phone, and interact with other clients who have similar illnesses.

The parents are bonding with their newborn when the nurse notes the infant's axillary temperature is 97.2oF (36.2oC) an hour after birth. Which intervention should the nurse prioritize for this family?

Help the mother provide skin-to-skin (kangaroo) care.

The nurse is caring for a newborn after the parents have spent time bonding. As the nurse performs the assessment and evidence-based care, which eye care will the nurse prioritize?

Instill 0.5% ophthalmic erythromycin.

The nurse removed a client's indwelling urinary catheter 24 hours after the cesarean birth. Four hours later, the client has not yet voided. The client reports 6/10 incisional pain and no urge to void. The nurse can palpate a full bladder. What action(s) will the nurse take? Select all that apply.

Provide analgesic for incisional pain. Run water while the client attempts to void.

A mother tells the nurse that her toddler does not want to go to bed at night and keeps getting back up when she is put to bed. What recommendations would the nurse make to this mother to foster sleep in the toddler?

Read the child a book in bed and take time to calm the child down before turning out the lights.

The nurse is assessing a client at her first prenatal visit and reports her LMP started December 1. Which date will the nurse predict for the EDD?

September 8

The school nurse is aware that providing proper care involves cooperation from the adolescent. Which technique will the nurse prioritize to develop open communication with the adolescents?

Show interest in the adolescent and develop a rapport before asking questions.

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 pregnant client is planning a vacation to a different state and questions the nurse concerning precautions. Which suggestion should the nurse prioritize for this client who will be traveling by automobile?

Stop and walk every 2 hours.

The nurse has completed assessing the vital signs of several clients who are from 36 to 48 hours postpartum. For which set of vital signs should the nurse prioritize for interaction?

Temp: 98.6° F (37° C), HR 74, RR 16, BP 150/85

A group of nursing students are preparing a presentation depicting the fetal circulation. The instructor determines the presentation is successful when the students correctly illustrate which route for the ductus arteriosus?

The pulmonary artery to the aorta

The parent of a toddler observes the child play next to another child but not with the child. What should the nurse explain to the parent about this type of play behavior?

This is parallel play and is expected.

The nurse is caring for a client who has remained in stable condition at 37 weeks' gestation. The client's condition suddenly changes. Which assessment change should the nurse prioritize?

Vaginal bleeding and no pain

The maternal health nurse is caring for a pregnant client with pre-existing heart disease. Which concept will the nurse identify as a priority?

balancing weight gain

The nurse reviews the notes (above) of a pregnant client. What would concern the nurse the most?

caring for indoor cats

A new mother asks the nurse when she should begin caring for her baby's teeth. Which response is the most appropriate for the nurse to make at this time?

now

A pregnant client reports difficulty sleeping well. Which suggestion for sleeping should the nurse prioritize to assist this client?

on her side with the weight of the uterus on the bed

The pediatric nurse is aware that chronic illness can affect which of the following for a child?

physical development psychosocial development cognitive development.

Assessment for surfactant level via lecithin/sphingomyelin (L/S) ratio in the amniotic fluid is a primary estimation of fetal maturity. The purpose of surfactant is to:

prevent alveoli from collapsing on expiration.

A client in labor received an opioid close to the time of birth. At the time of the birth, the nurse will assess for which effect?

respiratory depression in the newborn.