OBGYN

the nurse is assigned to care for the client after a cesarean section. To prevent thrombophlebitis, the nurse should encourage the woman to take which priority action?

ambulate frequently

the client is in her second trimester of pregnancy. She complains of frequent low back pain and ankle edema at the end of the day. The nurse should recommend which measure to help relieve both discomforts?

lie on the floor with the legs elevated onto a couch or padded chair with the hips and knees at a right angle.

the nurse is assigned to assist with caring for a neonate born to a mother who is HIV +. The nurse understands that which should be included in the plan of care?

maintaining standard precautions at all times while caring for the neonate

a mother is breastfeeding her newborn baby and experiences breast engorgement. The nurse should encourage the mother to do which to provide relief of the engorgement?

massage the breasts before feeding to stimulate let-down

the nurse working in a prenatal clinic reviews a client's chart and notes the primary HCP documents the client has a gynecoid pelvis. Which findings are characteristic of this type?

round shape, diagonal conjugate measures 12.5 cm to 13cm, blunt, somewhat widely separated ischial spines

the nurse is caring for a client who is in labor. The nurse rechecks the client's blood pressure and notes that it has dropped. To decrease the incidence of supine hypotension, the nurse should encourage the client to remain in which position?

side-lying

which of the following is an accurate statement regarding sidlenafil (viagara)?

sildenafil may cause priapism (prolonged erection)

A couple comes to the family planning clinic & asks about sterilization procedures. Which question by the nurse would determine if this method of family planning would be appropriate?

"do you plan to have any other children?"

a contraction stress test is scheduled for the client. The woman asks the nurse about the test. Which response describes the most accurate description of the test?

"the uterus is stimulated to contract by either small amounts of oxytocin or by nipple stimulation."

the nurse is checking a client's record for probable signs of pregnancy. Which are the probable signs of pregnancy that the nurse should note?

- ballottement - chadwick's sign - uterine enlargement - braxton hicks contraction

a newborn has just been circumcised and is being discharged home in 2 hrs. Which instructions should be provided by the nurse to the parents?

- do not wash penis with soap until the circumcision is healed, which takes 5-6 days -change diaper every 4 hrs or more often to inspect the penis for drainage or infection - monitor the circumcision, penis may appear reddened with small amount of blood drainage shortly after the procedure

the nurse is monitoring a client in preterm labor who is receiving IV mg sulfate. The nurse should monitor for which adverse effects of this medication?

- flushing - depressed respirations - extreme muscle weakness

the nurse is monitoring a client who is receiving oxytocin to induce labor. Which assessment findings should cause the nurse to immediately discontinue oxytocin infusion?

- late decelerations of the fetal heart rate - early decelerations of the fetal heart rate

the nurse is preparing to care for a newborn who is receiving phototherapy. Which measures should be implemented?

- monitor the skin temp. closely - reposition the newborn every 2 hrs - cover the newborn's eyes with shields and patches

the nursing instructor asks a nursing student to list the functions of the amniotic fluid. The student needs further teaching if they say what?

- prevents large particles such as bacteria from passing to the fetus - provides an exchange of nutrients and waste products between the mother and fetus

a pregnant client is receiving mg sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which findings are noted during assessment?

- respirations of 10 breaths/ min - urine output of 20ml/hr

the nurse is preparing a list of self-care instructions for a postpartum client who has been diagnosed with masitis. Which instructions should be included on the list?

- rest during acute phase - wear a supportive non underwire bra - maintain a fluid intake of at least 3000 ml - continue to breastfeed if the breasts are not too sore

the nurse is monitoring a pregnant client with gestational hypertension who is at risk for preeclampsia. The nurse should check the client for which signs of preeclampsia.

-proteinuria -hypertension

the nurse is collecting data from a pregnant client who is currently at 28 weeks. At her prior prenatal visit, her fundal height measured 22 cm. The nurse measures the fundal height at this visit in cm and should expect which finding?

26 cm

during a prenatal visit, the nurse checks the fetal heart rate of a client in the 3rd trimester of pregnancy. The nurse determines that the FHR is normal if which rate is noted?

150 bpm

a pregnant client asks the nurse in the clinic when she will be able to start feeling the fetus move. The nurse responds by telling the mother that fetal movements will be noted between which weeks of gestation?

16-20 wks

the nursing instructor asks a nursing student to describe the procedure for administering erythromyocin ointment to the eyes of a newborn. Which student statement indicates that further teaching is needed?

" I will flush the eyes after instilling the ointment."

a postpartum client is getting ready for discharge. The nurse suspects that the client needs further teaching related to breastfeeding when she makes which statement?

"I don't need birth control because I will be breastfeeding."

during a prenatal visit, the nurse is explaining dietary management to a client with diabetes. the nurse determines that the teaching has been effective when the client makes which statement?

"I need to increase the fiber in my diet to control my blood glucose & prevent constipation."

a pregnant HIV + woman delivers a baby. The nurse provides guidance to help the client make decisions regarding newborn care. Which statement by the woman indicates that additional guidance is needed?

"I will breastfeed, especially for the first 6 weeks postpartum."

a pt is about to be discharged after TURP. What statement indicates the need for additional instructions?

"I will continue taking one regular daily aspirin for my heart."

the client at 28 weeks is rh negative and Coombs antibody negative. The nurse determines that the client understands what the nurse has taught her about rh sensitization when the client makes which statment?

"I will tell the nurse at the hospital that I had an RH shot during pregnancy."

the nursing instructor asks a nursing student to describe the process of quickening. Which statement indicates an understanding of this term?

"It is the fetal movement that is felt by the mother."

a client asks the nurse why her newborn baby needs an injection of vit K. The nurse should make which statement to the client?

"Newborns are deficient in vit K. This injection prevents your baby from abnormal bleeding."

the nurse is collecting data from a client who is pregnant with triplets. The client also has a 3 yr old who was born at 39 weeks. What's her gravida parity status?

G2, P1

the nurse is collecting data from a client who is pregnant with twins. The client has a healthy 5 yr old who was delivered at 38 weeks, and she tells the nurse that she does not have a history of any abortions or fetal demise. The nurse should document this as.

G=2, T= 1, P=0, A=0, L=1

a male pt tells the nurse that his doctor's office called and told him that he needs to come in for a DRE and PSA now that he is >50 yrs old. He says he was too embarassed to admit that he did not know what that meant and wonders if there is anything he needs to know ahead of time. Which is the most appropriate response by the nurse?

Yes. You should have the PSA (a blood test) drawn before the doctor does the digital rectal exam.

the nurse is assigned to work in the delivery room and is assisting with caring for a client who has just delivered a newborn. The nurse is monitoring for signs of placental separation knowing that which indicates that the placenta has separated?

a change in the uterine contour

Naegele's Rule

add 7 days to LMP, subtract 3 months, add 1 year

rh0 immune globulin is prescribed for a client after delivery and the nurse provides info to the client about the purpose of the medication. The nurse determines that the woman understands the purpose if the woman states that it will protect her baby from which condition?

being affected by rh incompatibility

the nurse is assisting in caring for a post-term neonate immediately after admission to the nursery. The priority nursing action should be to monitor which clinical parameter?

blood glucose level

the client received epidural anesthesia during labor and had a forceps delivery after pushing for 2 hrs. at 6 hrs postpartum, the client's systolic blood pressure dropped 20 points, the diastolic BP dropped 10 points and her pulse is 120 bpm. the client is very anxious and restless. the nurse is told that the client has a vulvar hematoma. Based on this diagnosis, the nurse should plan which action?

prepare the client for surgery

a pt has an abdominal laparascopy this morning. What is the most important subjective assessment by the nurse?

presence of severe pain

the nurse administers erthyromyocin ointment to the newborn's eyes and the mother asks the nurse why this is done. The nurse should give which response to the client?

prevents opthalmia neonatorum from occurring after delivery to a neonate born to a woman with an untreated gonoccal infection

the client asks the nurse about the purpose of the placenta. The nurse plans to respond to the client knowing which about the placenta?

provides an exchange of nutrients and waste products between the mother and the fetus

the nurse palpates the fundus and checks the character of the lochia of a postpartum client who is in the 4th stage of labor. Which lochia characteristic should the nurse expect to note?

red

after a TURP, a pt confesses to the nurse that although he is able to maintain an erection, he "can't seem to produce anything" on orgasm. The nurse recognizes this as indicative of:

retrograde ejaculation

the client who is being prepared for a cesarean delivery is brought to the delivery room. To maintain the optimal perfusion of oxygenated blood to the fetus, the nurse should place the client in what position?

supine position with a wedge under R hip

After a precipitous delivery, the nurse notes that the new mother is passive and only touches her newborn infant briefly with her fingertips. The nurse would do which of the following to help the woman process what has happened?

support the mother in her reaction to the newborn

a pregnant client is seen in the health care clinic for a regular prenatal visit. The client tells the nurse that she is experiencing irregular contractions. The nurse determines that the client is experiencing Braxton Hick's. Based on this finding, which nursing action is appropriate?

tell the client that these are common and they may occur throughout the pregnancy

a young woman tells the nurse that she has noticed that one of her husband's testicles is much harder than the other. She wonders if this is normal because it is not painful. The nurse responds that:

testicular cancer usually presents as a hard, painless nodule; he should see a physician

the nurse is monitoring a client with mild gestational hypertension. Which data indicate that GH is a concern?

the client complains of a headache and blurred vision

using azithromyocin (zithromax) instead of doxycycline (vibramycin) can improve compliance primarily because zithromax:

is taken in a single dose

a 63 yr old pt with no prior hx of prostate problems has an elevated PSA level. He asks the nurse if this means that he has prostate cancer. The most appropriate response is that:

"Although the PSA increases with prostate cancer, it also increases in BPH. Further tests are necessary."

a 22 yr old pt has primary dysmenorrhea. Which of the following statements indicates that she may need more instruction regarding self-care?

"I will need another form of birth control, since this means I can't continue taking the pills."

an 18 yr old college student has just been diagnosed with a 1st episode infection of herpes simplex type 2. She says, "I can't believe this. I'm so embarrassed. How could he? I trusted him." Your initial response is:

"You can't believe this has happened to you."

which comment by a 20 yr old indicates the pt needs additional teaching about STIs?

"if we only engage in oral sex, we cannot transmit STIs."

a woman experiencing frequent hot flashes and night sweats associated with perimenopause asks the nurse whether she should take hormones. The nurse's response is based on the knowledge that hormone replacement therapy:

- is recommended for all woman during the 5-6 perimenopausal yrs - can reduce the risk of fractures r/t osteoporosis

important nursing responsibilities r/t the STIs of syphillis and gonorrhea are:

- reporting cases of the infection to state agencies - emphasizing the need to identify and treat infected partners

a pt with nonproliferative fibrocystic breast changes complains of monthly breast pain. She is likely to be advised to do all of the following.

- use NSAIDDS for discomfort - try local heat or cold applications - wear a supportive brassiere to reduce discomfort - eliminate caffeine/ chocolate in diet

a pt is one day post-op from a TURP. In what order would the nurse address the pt's complaints?

1 dyspnea and chest pain 2 blood clots in urinary catheter 3 pain and bladder spasms 4 leakage around irrigation catheter 5 poor appetite and "Off" taste

the client is admitted to the labor suite complaining of painless vaginal bleeding. The nurse assists with the examination of the client, knowing that which routine procedure is contraindicated?

a manual pelvic examination

the nurse is reinforcing instructions to a new mother about cord care and how to monitor for the presence of an infection. The nurse should tell the mother that which is a sign of infection?

a moist cord with discharge

the nurse is reviewing the record of a client who has just told her that her pregnancy test is +. The nurse notes that the HCP has documented the presence of Goodell's sign. The nurse determines that this sign is indicative of which change that occurs with pregnancy?

a softening of the cervix

the nurse notes that the 4-hr postpartum client has cool, clammy skin and that she is restless and excessively thirsty. The nurse immediately notifies the RN and then performs which action?

checks the vital signs

the nurse is assigned to assist with caring for a client who is at risk for ecclampsia. If the client progresses from preeclampsia to ecclampsia, the nurse should take which action first?

clear and maintain an open airway

while assisting with the measurement of fundal height, the client at 36 weeks gestation states that she is feeling lightheaded. On the basis of the nurse's knowledge of pregnancy, the nurse determines that this is most likely a result of which reason?

compression of vena cava

a male pt diagnosed with genital herpes says that he does not want to use condoms because they are uncomfortable. he asks if there is another way to prevent spreading this infection to his partners. The nurse responds that:

condoms should be used for all sexual relations, especially from the onset of prodromal symptoms until all lesions are healed

the nurse is assigned to assist with caring for a client who has been admitted to the labor unit. The client is 9 cm dilated and is experiencing precipitous labor. which is the priority nursing action?

keep the client in a side-lying position

which findings indicate that placental separation has occurred?

lengthening of umbilical cord, sudden trickle or spurt of blood, fetal membranes are seen at introitus

a pt relates a hx of periods that last up to 2 weeks, with heavy bleeding for the first 5 days. The nurse appropriately charts this as:

menorrhagia

a 19-yr old man presents at the walk-in clinic complaining of severe pain in his scrotum that began suddenly about an hr ago. The nurse should:

notify the physician immediately

a pt with newly diagnosed gonorrhea also undergoes testing for HIV infection. She asks why this is necessary. The nurse's response is based on the knowledge that:

other STIs including HIV often coexist in pts with gonorrhea

a pt has been diagnosed with syphillis. Why allergy would necessitate a change in the usual treatment?

penicillin

the nurse is caring for a client with abruptio placentae is monitoring the client for signs of disseminated intravascular coagulopathy. The nurse should suspect DIC if which is observed?

petechiae, oozing from injection sites, and hematuria

a 23 yr old woman being seen for a pelvic exam and pap smear confesses that she is terrified of cervical cancer because her mom died of the disease at 35. The nurse recommends measures to reduce her risk including:

practicing monogamy and using barrier protection during sexual activity

the nurse is preparing to administer beractant to a premature infant who has respiratory distress syndrome. The nurse plans to administer the medication by which route?

intratracheal

a primigravida's membranes rupture spontaneously. Which action should the nurse take first?

determine the fetal heart rate

the nurse is assigned to assist with caring for a client who is being admitted to the birthing center in early labor. During admission, which action should the nurse take initially?

determine the maternal and fetal vital signs

the pregnant woman complains of being awakened frequently by leg cramps. The nurse reinforces instructions to the client's partner and should tell the client to perform which measures?

dorsiflex the client's foot while extending the knee

the nurse is reinforcing instructions to a pregnant client regarding measures to prevent heartburn. The nurse should instruct the client to take which best measure?

drink decaffeinated coffee and tea

Which of the following instructions should the nurse include when teaching a pt with nonbacterial prostatitis?

have frequent sex

a pt has had a single mastectomy with dissection of the lymph nodes. She has a Jackson-Pratt drain in place. The nurse's discharge instructions should include:

how to empty the drain and clean around the insertion site

a woman has been diagnosed with a chlamydia infection. As the nurse explains her prescription to her, she states, "I don't need any medicine. I feel fine." The nurse's response is based on the knowledge that:

if untreated, chlamydia can progress to PID.

Teaching the patient with genital warts (HPV) should include:

importance of regular Pap testing

a pt has a hx of PID. She is at increased risk for:

infertility and ectopic pregnancy

the nurse is assisting with planning care for a postpartum woman who has small vulvar hematomas. To assist with reducing the swelling, the nurse should perform which action?

prepare an ice pack for application to the area

a pt with prostate cancer asks why the physician is planning to remove his testicles when the cancer is in his prostate gland, not his scrotum. The nurse responds based on the knowledge that:

removing the testes reduces testosterone needed to support tumor growth

all of the following are good advice, but which is especially important for the F taking tamoxifen?

stop smoking

the nurse should monitor for which signs associated with respiratory distress syndrome in a preterm newborn?

tachycardic and retraction

the nurse is assigned to care for the client during the postpartum period. The client asks the nurse what the term involution means. Which description should the nurse give to the client?

the progressive descent of the uterus into the pelvic cavity, which occurs at a rate of approximately 1 cm/ day

Your 65 yr old neighbor asks the nurse about some vaginal bleeding she is having. She is postmenopausal and not on HRT. The nurse's best advice is:

to see her doctor immediately

a pt with syphilis is reluctant to take the prescribed antibiotic. The nurse stresses which of the following as the most important reason for treating this disease?

treatment prevents transmission of the disease to others

the nurse is assisting with caring for a client abruptio placentae. While caring for the client the nurse notes that the client begins to develop signs of shock. The nurse should take which action first?

turn the client onto her side

the nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse should tell the client that fetal circulation consists of which components?

two umbilical arteries and one umbilical vein

a 45 yr old woman sees her gyne because she has stopped menstruating and is concerned that it may be r/t her exercise or signal a problem of the reproductive organs. Her labs were serum estradiol 12pg/ml, FSH 60 mu/ml, LH 33 mu/ml. The nurse correctly interprets these results as:

typical of a woman after menopause

a 52 yr old woman tells the clinic nurse that her husband felt a lump in the area between her breast and axilla. She wonders if this is anything to worry about given that it really is not in her breast. The nurse's response is based on the knowledge that the most frequent location for breast cancer is:

upper outer quadrant

the nurse is assigned to assist with caring for a client with abruptio placentae who is experiencing vaginal bleeding. The nurse collects data from the client, knowing that abruptio placentae is accompanied by which additional finding?

uterine tenderness on palpation

the nurse is caring for a postpartum client with a diagnosis of thrombophlebitis. The client suddenly complains of chest pain and dyspnea. The nurse should initially check which item?

vital signs

the nurse is collecting data from a pregnant client when the client asks the nurse about the purpose of the fallopian tubes. What is the accurate response the nurse should make?

where fertilization occurs

the nurse notes hypotonia, irritability, and a poor sucking reflex in a full-term newborn after admission to the nursery. The nurse suspects fetal alcohol syndrome and is aware that which sign is consistent with FAS?

abnormal palmar creases

the nurse suspects that the client has a pulmonary embolism. Which is the most important nursing action?

adminsiter O2 by face mask, as prescribed

the nurse has a teaching session with a malnourished client regarding iron supplementation to prevent anemia during pregnancy. Which statement indicates successful learning?

"The iron is needed for the rbcs."

the nursing student is asked to describe the size of the uterus in a nonpregnant client. Which response indicates an understanding of the anatomy of this structure?

"The uterus weighs about 2 oz."

a pregnant woman has a positive history of genital herpes, but she has not had lesions during her pregnancy. The nurse plans to provide which information to the client?

"You will be evaluated at the time of delivery for herpetic genital tract lesions. If they are present, a c-section will be needed."

the nurse is planning to reinforce instructions about cord care to a new mom. The nurse should plan to tell the mom about which cord care?

the process of keeping the cord clean and dry will decrease bacterial growth

methylergonovine is prescribed for a client with postpartum hemorrhage. Before administering the med, the nurse contacts the HCP who prescribed the med if which condition is documented?

PVD

after TURP surgery, the nurse irrigates the bladder:

as needed to clear blood clots and reduce spasms

after delivery, the nurse checks the height of the uterine fundus. Which position of the fundus should the nurse expect to note?

at the level of the umbilicus

the nurse is assigned to care for a client who is in early labor. When collecting data from the client which should the nurse check first?

baseline fetal heart rate

the nurse is reinforcing measures regarding the care of the newborn with a mother. To bathe the newborn, the mother should be taught which intervention?

begin with eyes and face

A client in preterm labor (31 weeks) who is dilated to 4 cm has been started on magnesium sulfate & contractions have stopped. If the client's labor can be inhibited for the next 48 hours, what medication does the nurse anticipate will be prescribed?

betamethasone

methylergonovine is prescribed for a woman to treat postpartum hemorrhage. Before administration of methylergonovine, what is the priority nursing assessment?

blood pressure

the nurse is collecting data from a client who has been diagnosed with placenta previa. Which findings should the nurse expect to note?

bright red vaginal bleeding -soft, relaxed, nontender uterus

After birth, the nurse prevents hypothermia as a result of evaporation in the newborn by:

drying the baby with a warm blanket

the nurse is talking to a pregnant client with HIV infection regarding care for the newborn after delivery. The client asks the nurse about the feeding options that are available. Which response should the nurse make to the client?

"You will need to bottle-feed your newborn."

a pt asks the nurse how it is possible for the egg to make it all the way from the ovary to the uterus when it does not have a tail to propel it like the sperm. The nurse's response is based on the knowledge that movement of the egg to the uterus occurs:

by smooth muscle contraction and ciliary movement

the nurse in the newborn nursery receives a call to prepare for the admission of a neonate born at 43 weeks gestation with Apgar scores of 1 and 4. When planning for the admission of this infant, which is the nurse's highest priority?

connecting the resuscitation bag to the O2 outlet

a nursing student is assigned to a client in labor. The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. The instructor determines that the student understands the structure of the ductus venosus if the student states which about the ductus venosus?

connects the umbilical vein to the inf. vena cavae

a primipara is being evaluated in the clinic during her 2nd trimester. Which occurence indicates an abnormal physical finding that necessitates further testing?

fetal HR of 180 bpm

the nurse is reinforcing teaching to a pregnant woman about the physiological effects and hormonal changes that occur during pregnancy. The woman asks the nurse about the purpose of estrogen. The nurse bases the response on which purpose of estrogen?

it stimulates uterine development to provide an env. for the fetus and stimulates the breasts to prepare for lactation

the nurse is assisting with caring for a postpartum client who is experiencing uterine hemorrhage. When planning to meet the psychological needs of the client, the nurse should plan which action?

keep the client and her family members informed of her progress

a woman in active labor has contractions every 2-3 min. that last for 45 sec. The fetal heart rate between contractions is 100 bpm. On the basis of these findings which is the priority nursing action?

notify the RN immediately

the nurse is caring for a postpartum client. At 4 hrs postpartum, the client's temperature is 102. Which is the appropriate nursing action?

notify the RN who will then contact the HCP

the client is undergoing an amniocentesis at 16 weeks gestation to detect the presence of biochemical or chromosomal abnormalities. which instructions should the nurse reinforce to the client?

the bladder must be full during the exam.

after episiotomy and the delivery of a newborn, the nurse performs a perineal check on the mother. The nurse notes a trickle of bright red blood coming from the perineum. The nurse checks the fundus and notes that it is firm. Which determination should the nurse make?

the bright red bleeding is abnormal and should be reported

leopald's maneuver will be performed on a pregnant client. The client asks the nurse about the procedure. Which information should the nurse provide to the client about leopald's maneuvers?

the maneuvers are a systematic method for palpating the fetus through the maternal abdominal wall

The perinatal client is admitted to the obstetrical unit during an exacerbation of a heart condition. When planning for the nutritional requirements of the client, the nurse should consult with the dietician to ensure which dietary measure?

a diet that is high in fluids and fiber to decrease constipation

An opioid analgesic is administered to a client in labor. The nurse assigned to care for the client ensures that which medication is readily available if respiratory depression occurs?

naloxene