OB test 6

A nurse is assessing a client who is 34 weeks gestation and has a mild placental abruption. Which of the following findings should the nurse expect?

1. Increased platelet count 2. Fetal distress 3. Decreased urinary output 4. Dark red vaginal bleeding ANS:4

A nurse is providing teaching to a client who is at 8 weeks gestation about manifestations to report to the provider during pregnancy. Which of the following information should the nurse include in the teaching?

1. Nausea upon wakening 2. Leg cramps while sleeping 3. Increase in white vaginal discharge 4. Blurred or double vision ANS:4

A nurse is reviewing the medical record of a client who is 33 weeks gestation and has placenta previa and bleeding. Which of the following prescriptions should the nurse clarify with the provider?

1. Perform a vaginal examination 2.Perform continuous external fetal monitoring 3. Insert a large-bore IV catheter 4. Obtain a blood sample for lab testing ANS:1

A nurse is caring for a client who is at 37 weeks gestation and is undergoing a non-stress test. The fetal heart rate is 130/min without accelerations for the past 10 minutes. Which of the following actions should the nurse take?

1. Use vibroacoustic stimulation on the clients abdomen for 3 seconds. 2. Report the nonreactive test result to the provider immediately 3. Request prescription for an internal fetal scalp electrode 4. Auscultate the FHR with a doppler ANS:1

The nurse is monitoring a client in the immediate postpartum period for signs of hemorrhage. Which sign, if noted, would be an early sign of excessive blood loss?

1.A temperature of 100.4° F (38° C) 2.An increase in the pulse rate from 88 to 102 beats per minute 3.A blood pressure change from 130/88 to 124/80 mm Hg 4.An increase in the respiratory rate from 18 to 22 breaths per minute ANS:2

A maternity unit nurse is creating a plan of care for a client with severe preeclampsia who will be admitted to the nursing unit. The nurse should include which nursing intervention in the plan?

1.Restrict food and fluids. 2.Reduce external stimuli. 3.Monitor blood glucose levels. 4.Maintain the client in a supine position. ANS:2

A nurse is caring for a client who is in the latent phase of labor and is receiving oxytocin via continuous IV infusion. The nurse notes that the client is having contractions every 2 minutes which are lasting 100-110 seconds and that the FHR is reassuring. Which of the following actions should the nurse take?

1. Decrease the infusion rate of the maintenance fluids 2.Administer O2 via non-rebreather 3. Decrease the dose of oxytocin by half 4. Administer terbutaline 0.25 mg subQ ANS:3

A nurse is caring for a client who is at 12 weeks gestation and has a hydatidiform mole. Which of the following findings should the nurse expect?

1. Hypothermia 2. Dark brown vaginal discharge 3. Decreased urinary output 4. Fetal heart tones ANS:2

An ultrasound is performed on a client at term gestation who is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that abruptio placentae is present. On the basis of these findings, the nurse should prepare the client for which anticipated action?

1.Delivery of the fetus 2.Strict monitoring of intake and output 3.Complete bed rest for the remainder of the pregnancy 4.The need for weekly monitoring of coagulation studies until the time of delivery ANS:1

The nurse in a labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. What is the first nursing action with this finding?

1.Gently push the cord into the vagina. 2.Place the client in Trendelenburg's position. 3.Find the closest telephone and page the primary health care provider stat. 4.Call the delivery room to notify the staff that the client will be transported immediately. ANS:2

The nurse is caring for a client with preeclampsia who is receiving an intravenous (IV) infusion of magnesium sulfate. When gathering items to be available for the client, which highest priority item should the nurse obtain?

1.Tongue blade 2.Percussion hammer 3.Potassium chloride injection 4.Calcium gluconate injection ANS:4

A nurse is assessing a client who is at 35 weeks gestation and has preeclampsia without severe features. Which of the following findings should the nurse identify as the priority?

1. 480ml urine output in 24 hrs 2. Blood pressure 144/92 3.+2 edema of the feet 4. 1+ protein in the urine ANS:1

A nurse is admitting a client who is in labor and experiencing moderate bright red vaginal bleeding. Which of the following actions should the nurse take

1. Perform a vaginal exam to determine dilation 2. Obtain blood samples for baseline lab values 3. Place a spiral electrode on the fetal presenting part 4. Prepare the client for a transvaginal ultrasound ANS:2

A nurse is caring for a client who is 39 weeks gestation and is in the active phase of labor. The nurse observes late decelerations in the FHR. Which of the following findings should the nurse identify as the cause of late decelerations?

1. Uteroplacental insufficiency 2. Fetal head compression 3. Fetal ventricular septal defect 4. Umbilical cord compression ANS:1

A pregnant client being admitted to the labor room tells the nurse that she felt a large gush of fluid before arriving at the hospital. The nurse performs an assessment on the client and notes that the fetal heart rate is 90 beats/minute and that the umbilical cord is protruding from the vagina. What is the appropriate nursing action?

1.Place the woman in a high-Fowler's position. 2.Palpate and evaluate contractions while administering a tocolytic. 3.Wrap the cord loosely in a sterile towel saturated with warm, sterile normal saline. 4.Start an intravenous (IV) line with fluids to be administered at a keep-vein-open (KVO) rate only. ANS:3

The nurse is preparing to assess the uterine fundus of a client in the immediate postpartum period. After locating the fundus, the nurse notes that the uterus feels soft and boggy. Which nursing intervention is appropriate?

1.Elevate the client's legs. 2.Massage the fundus until it is firm. 3.Ask the client to turn on her left side. 4.Push on the uterus to assist in expressing clots. ANS:2

A nurse is reviewing lab results for a client who is 37 weeks gestation. The nurse notes that the client is rubella non-immune, positive for group B strep, and has a blood type of O negative. Which of the following actions should the nurse take?

1. Administer a dose of Rh0(D) immune globulin 2. Request a prescription for an antibiotic until delivery 3. Instruct the client to obtain a rubella immunization after delivery 4. Inform the client that she will need to deliver via c-section ANS:3

The nurse is assessing a client in the fourth stage of labor and notes that the fundus is firm, but that bleeding is excessive. Which should be the initial nursing action?

1.Record the findings. 2.Massage the fundus. 3.Notify the obstetrician (OB). 4.Place the client in Trendelenburg's position. ANS: 3

The nurse is performing a prenatal assessment on a pregnant client. The nurse should plan to implement teaching related to risk for abruptio placentae if which information is obtained on assessment?

1.The client is 28 years of age. 2.This is the second pregnancy. 3.The client has a history of hypertension. 4.The client performs moderate exercise on a regular daily schedule. ANS:3

The nurse is performing an assessment on a client diagnosed with placenta previa. Which assessment findings should the nurse expect to note? Select all that apply.

1.Uterine rigidity 2.Uterine tenderness 3.Severe abdominal pain 4.Bright red vaginal bleeding 5.Soft, relaxed, nontender uterus 6.Fundal height may be greater than expected for gestational age ANS: 4, 5, 6

A nurse is caring for a client who is 38 weeks gestation and reports no fetal movement for 24 hours. Which action should the nurse take?

1. Auscultate for a fetal heart rate 2. Have the client drink orange juice 3. Reassure the client that a term fetus is less active 4.Palpate the uterus for fetal movements ANS:1

The nurse is monitoring a client in preterm labor who is receiving intravenous magnesium sulfate. The nurse should monitor for which adverse effects of this medication? Select all that apply

1.Flushing 2.Hypertension 3.Increased urine output 4.Depressed respirations 5.Extreme muscle weakness 6.Hyperactive deep tendon reflexes ANS: 1, 4, 5

The nurse is reviewing the primary health care provider's (PHCP's) prescriptions for a client admitted for premature rupture of the membranes. Gestational age of the fetus is determined to be 37 weeks. Which order should the nurse question?

1.Monitor fetal heart rate continuously. 2.Monitor maternal vital signs frequently. 3.Perform a vaginal examination every shift. 4.Administer an antibiotic per prescription and per agency protocol. ANS:3

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which findings are noted on assessment? Select all that apply.

1.Proteinuria of 3 + 2.Respirations of 10 breaths per minute 3.Presence of deep tendon reflexes 4.Urine output of 20 mL in an hour 5.Serum magnesium level of 4 mEq/L (2 mmol/L) ANS: 2,4