FINAL OB

A woman is admitted to the labor and delivery unit with active tuberculosis. She has not been under a physician's care and is not on medication. Which of the following actions should the nursery nurse perform when the neonate is delivered? 1. Isolate the baby from the other babies in a special care nursery. 2. Keep the baby in the regular care nursery but separated from the mother. 3. Isolate the baby with the mother in the mother's room. 4. Obtain an order from the doctor for antituberculosis medications for the baby.

2

The nurse is caring for a 14-year-old patient who is 32 weeks pregnant. After complaining of genital sores and discomfort, the patient tests positive for syphilis. The fetus is at increased risk of which condition? 1. Diabetes 2. Blindness 3. Pneumonia 4. Hypertension

2

The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, ―I do not need to stop smoking my electronic cigarette because it will not harm my baby.‖ Which is the best response by the nurse? 1. ―You are correct. Electronic cigarettes are not harmful during pregnancy.‖ 2. ―Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity.‖ 3. ―According to the FDA, although electronic cigarettes are safe for you, they can cause harm to the fetus during pregnancy.‖ 4. ―Electronic cigarettes are considered harmful only in the first trimester.‖

2

The nurse is caring for a client in labor and delivery with the following history: G2 P1000, 39 weeks' gestation in transition phase, FH 135 with early decelerations. The client states, "I'm so scared. Please make sure the baby is OK!" Which of the following responses by the nurse is appropriate? 1. "There is absolutely nothing to worry about." 2. "The fetal heart rate is within normal limits." 3. "How did your first baby die?" 4. "Did your first baby die during labor?"

2

The nurse is counseling a female patient about alcohol use during pregnancy. Which statement by the patient demonstrates successful patient teaching? 1. ―I will limit my drinking to just one alcoholic beverage per day 2. ―It's best for my baby if I avoid drinking during pregnancy 3. ―An occasional drink on special occasions is okay 4. ―Drinking alcohol is only acceptable in the first trimester

2

A client has just received synthetic prostaglandins for the induction of labor. The nurse plans to monitor the client for which of the following side effects? 1. Nausea and uterine tetany. 2. Hypertension and vaginal bleeding. 3. Urinary retention and severe headache. 4. Bradycardia and hypothermia.

1

A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands? 1. ―Due to my weight, there is a possibility that I may develop gestational diabetes. 2. ―I am not overweight, but I am still at risk for gestational diabetes. 3. ―My mother had preeclampsia during one of her pregnancies. 4. ―I will need to do a glucose tolerance test in my second trimester.

1

The nurse is caring for a 15-year-old female who is pregnant with her first child. In her previous prenatal visit, the patient tested negative for chlamydia, syphilis, gonorrhea, and HIV. Based on the information provided, which condition is the patient's baby at higher risk for? 1. Intestinal problems 2. Neonatal conjunctivitis 3. Blindness 4. Pneumonia

1

The nurse is educating the pregnant patient with a body mass index (BMI) of 33. The nurse knows that teaching has been effective when the patient states which of the following? 1. ―My child may be at increased risk for birth injury. 2. ―My child may have a decreased risk of developing childhood diabetes. 3. ―I will probably give birth vaginally. 4. ―I have a lower risk of developing gestational hypertension.

1

The triage nurse in an obstetric clinic received the following four messages during the lunch hour. Which of the women should the nurse telephone first? 1. "My section incision from last week is leaking a whitish yellow discharge and I have a fever. What should I do?" 2. "I am 39 weeks pregnant with my first baby. I am having contractions about every twenty minutes." 3. "My boyfriend and I had intercourse this morning and our condom broke. What should we do?" 4. "I started my period yesterday. I need some medicine for these terrible menstrual cramps."

1

A woman is being interviewed by a triage nurse at a medical doctor's office. Which of the following signs/symptoms by the client would warrant the nurse to suggest that a pregnancy test be done? Select all that apply. 1. Amenorrhea. 2. Fever. 3. Fatigue. 4. Nausea. 5. Dysuria.

1, 3, 4

A fetus is in the LOA position in utero. Which of the following findings would the nurse observe when doing Leopold maneuvers? 1. Hard, round object in the fundal region. 2. Flat object above the symphysis pubis. 3. Soft, round object on the left side of the uterus. 4. Small objects on the right side of the uterus.

4

A patient with a history of hypertension is giving birth. During delivery, the staff was not able to stabilize the patient's blood pressure. As a result, the patient died shortly after delivery. This is an example of what type of death? 1. Early maternal death 2. Late maternal death 3. Direct obstetric death 4. Indirect obstetric death

4

A woman is seeking counseling regarding tubal ligation. Which of the following should the nurse include in her discussion? 1. The woman will no longer menstruate. 2. The surgery should be done when the woman is ovulating. 3. The surgery is easily reversible. 4. The woman will be under anesthesia during the procedure.

4

The nurse has made it a goal to increase the rate at which women begin prenatal care in the first trimester. The nurse relates this decision to national goals for better maternal and infant outcomes. What guidelines will the nurse use to guide her maternal health goals? 1. WHO Maternal care guidelines 2. State Practice Acts 3. AWHONN white papers 4. Healthy People 2020

4

The nurse is caring for a client, 37 weeks' gestation, who was just told that she is group B streptococci + (positive). The client states, "How could that happen? I only have sex with my husband. Will my baby be OK?" Based on this information, which of the following should the nurse communicate to the client? 1. The client's partner must have acquired the bacteria during a sexual encounter. 2. The bacteria do not injure babies, but they could cause the client to have a bad sore throat. 3. The client is at high risk for developing pelvic inflammatory disease from the bacteria. 4. Antibiotics will be administered during labor to prevent vertical transmission of the bacteria.

4

The nurse is caring for a patient who is in labor with her first child. The patient's mother is present for support and notes that things have changed in the delivery room since she last gave birth in the early 1980s. Which current trend or intervention may the patient's mother find most different? 1. Fetal monitoring throughout labor 2. Postpartum stay of 10 days 3. Expectant partner and family in operating room for cesarean birth 4. Hospital support for breastfeeding

4

The nurse is providing education to a patient who has given birth to her first child and is being discharged home. The patient expressed concern regarding infant mortality and sudden infant death syndrome (SIDS). The patient had an uncomplicated pregnancy, labor, and vaginal delivery. She has a body mass index of 25 and has no other health conditions. The infant is healthy and was delivered full-term. What will be most helpful thing to explain to the patient? 1. Uses of extracorporeal membrane oxygenation therapy (ECMO) 2. Uses of exogenous pulmonary surfactant 3. The Baby-Friendly Hospital Initiative 4. The Safe to Sleep campaign

4

A laboratory report indicates the L/S ratio (lecithin/sphingomyelin) results from an amniocentesis of a gravid patient with preeclampsia are 2:1. The nurse interprets the result as which of the following? a. The baby's lung fields are mature. b. The mother is high risk for hemorrhage. c. The baby's k idneys are functioning poorly. d. The mother is high risk for eclampsia.

A

A mother of a 10-day-old infant calls the clinic and reports that her baby ishaving loose, green stools. The mother is breastfeeding her infant. Which ofthe following is the best nursing action? a. Instruct the woman to bring her infant to the clinic. b. Instruct the woman to decrease the amount of feeding for 24 hours and tocall if the stools continue to be loose. c. Explain that this is a normal stool pattern. d. Instruct the woman to eat a bland diet for the next 24 hours and call back ifthe stools continue to be loose and green.

A

A neonatal nurse caring for newborns knows that the best time for a mother to first attempt breastfeeding is during which one of the followingstages of activity? a. First period of reactivity b. First period of inactivity and sleep c. Second period of reactivity d. Second period of inactivity and sleep

A

A nurse work ing with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis? a. The couple has established a set schedule for their sexual encounters. b. The couple hasbeen married for more than 8 years. c. The couple lives with one set of parents. d. The couple has close friends who gave birth within the last year.

A

A post-cesarean birth woman has been diagnosed with paralytic ileus. Which of the followingsymptoms would the nurse expect to see? a. Abdominal distension b. Polyuria c. Diastasis recti d. Dependent edema

A

A pregnant woman who has a history of cesarean births is requesting to have a vaginal birth after cesarean (VBAC). In which of the following situationsshould the nurse advise the patient that her request may be declined? a. Transverse fetal lie b. Flexed fetal attitude c. Previous low flap uterine incision d. Positive vaginal candidiasis

A

A woman gave birth to a 3200 g baby girl with an estimated gestational ageof 40 weeks. The baby is 1 hour of age. In preparation of giving the baby an injection of vitamin K, the nurse will: a. Explain to the parents the action of the medication and answer their questions. b. Remove the neonate from the room so the parents will not be distressed byseeing the injection. c. Completely undress the neonate to identify the injection site. d. Replace needle with a 21 gauge 5/8 needle.

A

A woman is considered in active labor when: a. Cervical dilation progresses from 4 to 7 cm with effacement of 40% to 80%, contractions become more intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds. b. Cervical dilation progresses to 3 cm with effacement of 30, contractions become more intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds. c. Cervical dilation progresses to 8 cm with effacement of 80%, contractions become more intense, occurring every 2to 5 minutes with duration of 45 to 60 seconds. d. Cervical dilation progresses to 10 cm with effacement of90%, contractions becomemore intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds.

A

A woman presents to the prenatal clinic at 30 weeks' gestation reporting dysuria, frequency, and urgency with urination. Appropriate nursing actions include: a. Obtain clean-catch urine toassess for a possible urinary tract infection. b. Reassure the woman that the signs are normal urinary changes in the third trimester. c. Teach the woman to decrease fluid intake to manage these symptoms. d. Perform a Leopold's maneuver to assess fetal position and station.

A

A woman you are caring for in labor requests an epidural for pain relief in labor. Included in your preparation for epidural placement is a baseline set of vital signs. The most common vital sign to changeafter epidural placement: a. Blood pressure, hypotension b. Blood pressure, hypertension c. Pulse, tachycardia d. Pulse, bradycardia

A

After assessing the FHR tracing shown below, which of the following interventions should the nurse perform? a. Turn the woman on her side. b. Administer oxygen by nasal cannula. c. Encourage the patient to push with each contraction. d. Provide the patient with caring labor support.

A

An infant admitted to the newborn nursery has a blood glucose level of 55mg/dL. Which of the following actions should the nurse perform at this time? a. Provide the baby with routine feedings. b. Assess the baby's blood pressure. c. Place the baby under the infant warmer. d. Monitor the baby's urinary output.

A

An ultrasound of a fetus' heart shows that normal fetal circulation is occurring. Which of the following statements is consistent with the finding? a. A right to left shunt is seen between the atria. b. Blood is returning to the placenta via the umbilical vein. c. Blood is returning to the right atrium from the pulmonary system. d. A right to left shunt is seen between the umbilical arteries.

A

Augmentation of labor: a. Is part of the active management of labor instituted when the labor processis unsatisfactory and uterine contractions are inadequate b. Relies on more invasive methods when oxytocin and amniotomy have failed c. Is elective induction of labor d. Is an operative vaginal delivery that uses vacuum cups

A

During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from: a. 2 to 8 weeks b. 4 to12 weeks c. 5 to 10 weeks d. 6 to 15 weeks

A

During the postpartum assessment, the perinatal nurse notes that a patient who has just experienced a forceps-assisted birth now has a large quantity of bright red bleeding. Her uterine fundus is firm. The nurse's mostappropriate action is to notify the physician/certified nurse midwife and describe a: a. Need for vaginal assessment and repair b. Requirement for an oxytocin infusion c. Need for further information for the woman/family about forceps d. Requirement for bladder assessment and catheterization

A

For the patient with which of the following medical problems should the nurse question a physiciansorder for beta agonist tocolytics? a. Type 1 diabetes mellitus b. Cerebral palsy c. Myelomeningocele d. Positive group B streptococci culture

A

Four women are close to delivery on the labor and delivery unit. The nurseknows to be vigilant to the signs of neonatal respiratory distress in which delivery? a. 42-week-gestation pregnancy complicated by intrauterine growth restriction b. 41-week-gestation pregnancy with biophysical profile score of 10 thatmorning c. 40-week-gestation pregnancy with estimated fetal weight of 3200 grams d. 39-week-gestation pregnancy complicated by maternal cholecystitis

A

Painful nipples are a major reason why women stop breastfeeding. A primary intervention to decrease nipple irritation is: a. Teaching proper techniques for latching-on and releasing of suction b. Applying hot compresses to breast prior to feeding c. Instructing woman to express colostrum or milk at the end of the feedingsession and rub it on her nipples d. Air drying nipples for 10 minutes at the end of the feeding session

A

Tanya, a 30-year-old woman, is being prepared for an elective cesarean birth. The perinatal nurseassists the anesthesiologist with the spinal block and then positions Tanya in a supine position. Tanyasblood pressure drops to 90/52, and there is a decrease in the fetal heart rate to 110 bpm. The perinatal nurses best response is to: a. Place a wedge under Tanyas left hip. b. Discontinue Tanyas intravenous administration. c. Have naloxone (Narcan) ready for administration. d. Have epinephrine ready for administration.

A

The best time to give prophylactic antibiotics to the women undergoing cesarean section is: a. One hour before the surgery b. Two hours before the surgery c. Not indicated unless she has an active infection d. At the time the cord is clamped

A

The clinic nurse meets with Rebecca, a 30-year-old woman who is experiencing her first pregnancy. Rebecca's quadruple mark er screen result is positive at 17 week s' gestation. The nurse explains that Rebecca needs a referral to: a. A genetics counselor/specialist b. An obstetrician c. A gynecologist d. A social worker

A

The nurse is about to elicit the rooting reflex on a newborn baby. Which ofthe following responses should the nurse expect to see? a. When the cheek of the baby is touched, the newborn turns toward the sidethat is touched. b. When the lateral aspect of the sole of the baby's foot is stroked, the toesextend and fan outward. c. When the baby is suddenly lowered or startled, the neonate's armsstraighten outward and the knees flex. d. When the newborn is supine and the head is turned to one side, the arm onthat same side extends.

A

The nurse is advising parents of a full-term neonate being discharged fromthe hospital regarding car seat safety. Which of the following should be included in the teaching plan? a. Put the car seat facing forward only after the baby reaches 20 pounds. b. The infant car seat should be placed facing the rear seat in the front seat ofthe car. c. A fist should fit between the straps of the seat and the baby's body. d. Seat belt adjusters should always be used to support infant car seats.

A

The nurse is assisting a physician in the delivery of a baby via vacuum extraction. Which of the following nursing diagnoses for the gravida is appropriate at this time? a. Risk for injury b. Colonic constipation c. Risk for impaired parenting d. Ineffective individual coping

A

The nurse is interviewing a gravid woman during the first prenatal visit. The woman confides to the nurse that she lives with a number of pets. The nurse should advise the woman to be especially careful to refrain from coming in contact with the stool of which of the pets? a. Cat b. Dog c. Hamster d. Bird

A

The nurse is teaching the parents of a female baby how to change a baby'sdiapers. Which of the following should be included in the teaching? a. Always wipe the perineum from front to back. b. Remove any vernix caseosa from the labia folds. c. Put powder on the buttocks every time the baby stools. d. Weigh every diaper in order to assess for hydration.

A

The nurse knows that a FHR monitor printout indicates a Category IIIabnormal fetal heart rate pattern when: a. Baseline variability is minimal or absent with decelerations. b. FHR mirrors the uterine contractions. c. Occasional periodic accelerations occur. d. Baseline variability is 6 to 25 bpm with decelerations

A

The nurse uses the external electronic fetal heart monitor to evaluate fetalstatus. The fetal heart tracing shows accelerations. Accelerations in the fetalheart are: a. Associated with fetal well-being and oxygenation b. An indication of potential fetal intolerance to labor c. Never associated with the uterine contraction pattern d. A reason to notify the care providerANS:

A

The nursery nurse notes the presence of diffuse edema on a baby girl's head. Review of the birth record indicates that her mother experienced a prolonged labor and difficult childbirth. By the second day of life, the edema has disappeared. The nurse documents the following condition in the infant'schart. a. Caput succedaneum b. Cephalhematoma c. Subperiosteal hemorrhage d. Epstein pearls

A

The perinatal nurse notes a rapid decrease in the fetal heart rate that doesnot recover immediately following an amniotomy. The most likely cause of thisobstetrical emergency is: a. Prolapsed umbilical cord b. Vasa previa c. Oligohydramnios d. Placental abruption

A

The perinatal nurse providing care to a laboring woman recognizes a category II, fetal heart rate tracing. The most appropriate initial action is to: a. Assist the laboring woman to a left lateral position b. Decrease the intravenous solution : MUST INCREASE IV INFUSION c. Request that the physician/certified nurse-midwife come to the hospital STAT d. Document the fetal heart rate and variability

A

The physician has ordered intravenous oxytocin for induction for four gravidas. In which of the following situations should the nurse refuse to complywith the order? a. Primigravida with complete placenta previa b. Multigravida with extrinsic asthma c. Primigravida who is 38 years old d. Multigravida who is colonized with group B streptococci

A

The provision of support during labor has demonstrated that women experience a decrease in anxietyand a feeling of being in more control. In clinical situations, this has resulted in: a. Adecrease in interventions b. Increased epidural rates c. Earlier admission to the hospital d. Improved gestational age

A

To accurately measure the neonate's head, the nurse places the measuring tape around the head: a. Just above the ears and eyebrows b. Middle of the ear and over the eyes c. Middle of the ear and over the bridge of the nose d. Just below the ears and over the upper lip

A

Which of the following assessments would indicate instability in the client hospitalized for placenta previa? a. BP <90/60 mm/Hg, Pulse <60 BPM or >120 BPM b. FHR moderate variability without accelerations c. Dark brown vaginal discharge when voiding d. Oral temperature of 99.9°F

A

Which of the following breath sounds are normal to hear in the neonateduring the first few hours postbirth? a. Scattered crackles b. Wheezes c. Stridor d. Grunting

A

Which of the following positions for breastfeeding is preferred for a 2-daypost- cesarean-birth woman? a. Lying down on side b. Sitting c. Cradle d. Cross-cradle

A

Which of the following signs or symptoms would the nurse expect to see in a woman with concealedabruptio placentae? a. Increasing abdominal girth measurements b. Profuse vaginal bleeding c. Bradycardia with an aortic thrill d. Hypothermia with chills

A

Which statement correctly describes the nurse's responsibility related toelectronic fetal monitoring? a. Teach the woman and her family about the monitoring equipment anddiscuss any questions they have. b. Report abnormal findings to the care provider before initiating correctiveactions. c. Inform the support person that the nurse will be responsible for all comfortmeasures when the electronic equipment is in place. d. Document the frequency, duration, and intensity of contractions measuredby the external device.

A

The nurse is teaching an expectant parent class about sleep/awake states of newborn behavior. Which statement is correct regarding these infant states? Select all that apply. A. During light sleep, you may notice the baby breathing irregularly and this is normal. B. During the alert state, the baby will be wide awake with little movement. C. During the drowsy state, breathing is slow and regular and the baby is easily aroused. D. When crying, the baby will be difficult to calm down and feed. E. During eyes open, the baby may move more but not easily startled.

A, B, D

Contraindications for induction of labor include: (select all that apply) a. Abnormal fetal position b. Postdated pregnancy c. Pregnancy-induced hypertension d. Placental abnormalities

A, D

A 28 year old female, who is 33 weeks pregnant with her second child, has uncontrolled hypertension. What risk factor below found in the patient's health history places her at risk for abruptio placentae? A. childhood polio B. preeclampisa C. c-section D. her age

B

A certified nursing assistant (CNA) is working with a registered nurse (RN) in the neonatal nursery. Which of the following actions would be appropriate forthe nurse to delegate to the CNA? a. Admit a newly delivered baby to the nursery. b. Bathe and weigh a 3-hour-old baby. c. Provide discharge teaching to the mother of a 4-day-old baby. d. Interpret a bilirubin level reported by the laboratory.

B

A nurse is doing a newborn assessment on a new admission to the nursery.Which of the following actions should the nurse make when evaluating the baby for developmental dysplasia of the hip? a. Grasp the inner aspects of the baby's calves with thumbs and forefingers. b. Gently abduct the baby's thighs. c. Palpate the baby's patellae to assess for subluxation of the bones. d. Dorsiflex the baby's feet.

B

A nurse is preparing to monitor a patient who is to receive an amnioinfusion.Which of the following actions should the nurse make at this time? a. Attach the patient to an electronic blood pressure cuff. b. Assist in insertion of an internal uterine pressure catheter. c. Attach the patient to an oxygen saturation monitor. d. Perform an amniotic fluid Nitrazine test.

B

A primigravida woman at 42 weeks' gestation received Prepidil (dinoprostone) for induction 12 hours ago. The Bishop score is now 3. Which ofthe following actions by the nurse is appropriate? a. Perform Nitrazine analysis of the amniotic fluid. b. Report the lack of progress to the obstetrician. c. Place the woman on her left side. d. Ask the doctor for an order for oxytocin.

B

As the nurse explains the purpose of the tocotransducer (Toco), which sheplaces on the abdomen, she states that this monitoring device provides an accurate evaluation of which of the following? a. Uterine hypertonus b. Frequency of contractions c. Intensity of contractions d. Progress of labor

B

During a cesarean section, which action by the nurse is done to prevent compression of thedescending aorta and vena cava? a. Right lateral tilt b. Left lateral tilt c. Elevate head of gurney at 30 degrees d. Administration of IV fluid preload of 500 to 1000 mL

B

Information provided by the nurse that addresses the function of the amniotic fluid is that the amniotic fluid helps the fetus to maintain a normal body temperature and also: a. Facilitates asymmetrical growth of the fetal limbs b. Cushions the fetus from mechanical injury c. Promotes development of muscle tone d. Promotes adherence of fetallung tissue

B

The clinic nurse talks with Kathy about her possible pregnancy. Kathy has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. These symptoms are best described as: a. Positive signs of pregnancy b. Presumptive signs of pregnancy c. Probable signs of pregnancy d. Possible signs of pregnancy

B

The mechanism of labor known as cardinal movements of labor are the positional changes that the fetusgoes through to best navigate the birth process. These cardinal movements are: a. Engagement, Descent, Flexion, Extension, Internal rotation, External rotation, Expulsion b. Engagement, Descent, Flexion, Internal rotation, Extension, External rotation, Expulsion c. Engagement, Flexion, Internal rotation, Extension, External rotation, Descent, Expulsion d. Engagement, Flexion, Internal rotation, Extension, External rotation, Flexion, Expulsion

B

The nurse assesses that a full-term neonate's temperature is 36.2°C. Thefirst nursing action is to: a. Turn up the heat in the room. b. Place the neonate on the mother's chest with a warm blanket over themother and baby. c. Take the neonate to the nursery and place in a radiant warmer. d. Notify the neonate's primary provider.

B

The nurse encourages the mother to hold her newborn skin-to-skin shortly after birth. What is the most appropriate reason for this action? A. To encourage breastfeeding B. To promote parent-infant attachment C. For infant security until identification bands are applied D. To provide the newborn protective antibodies

B

The nurse is assessing a neonate 1 hour after birth. Which assessment data by the nurse will require further evaluation? A. Apical pulse of105 beats per minute B. Axillary temperature at 97 oF C. Respiratory rate of 32 breaths per minutes D. Hands and feet cyanotic

B

The nurse is developing a discharge teaching plan for a 21-year-old first- time mom. This was an unplanned pregnancy. She had a prolonged labor andan early postpartum hemorrhage. The woman plans to breastfeed her baby.She plans to return to work when her baby is 3 months old. Based on this information, the three primary learning needs of this woman are: a. Breastfeeding, bathing of the newborn, and infant safety b. Breastfeeding, storage of milk, and nutrition c. Breastfeeding, contraception, infant safety d. Breastfeeding, storage of milk, and rest

B

The nurse notes each of the following findings in a woman at 10 weeks' gestation. Which of the findings would enable the nurse to tell the woman that she is probably pregnant? a. Fetal heart rate via Doppler b. Positive pregnancy test c. Positive ultrasound assessment d. Absence of menstrual period

B

The nurse performs a newborn assessment and finds a heart rate of 180 beats per minute. What data by the nurse is necessary to determine if the heart rate is a sign of distress? A. Skin color B. Time of birth C. Maternal temperature D.Apgar score

B

The perinatal nurse is preparing a woman for a scheduled cesarean birth. The woman will bereceiving spinal anesthesia for the birth. In order to prevent maternal hypotension, the nurse: a. Assists the woman to lie down in a supine position. b. Administers a rapid intravenous infusion of 500 mL of normal saline. c. Assesses blood pressure and pulse every 5 minutes, three times, before the spinal insertion. d. Encourages frequent cleansing breaths after the patient has been placed in the correct position forthe anesthesia administration.

B

The perinatal nurse is teaching her new mother about breastfeeding andexplains that the most appropriate time to breastfeed is: a. 3 to 4 hours after the last feeding b. When her infant is in a quiet alert state c. When her infant is in an active alert state d. When her infant exhibits hunger-related crying

B

The perinatal nurse understands that the purpose of combining an opioid with a local anestheticagent in an epidural is primarily to: a. Increase the total anesthetic volume b. Preserve a greater amount of maternal motor function c. Increase the intensity of the motor and sensory block d. Decrease the number of side effects

B

What is the nurses first intervention with a preterm labor admission? A. History B. Assess baby FHR C. Vaginal exam D. Maternal vitals

B

What is the term of someone who ingests non food productions such as dirt or clay? A. Bulimia B. Pica c. Binge eating D. Anorexia

B

What statement made by a primiparous patient 4 hours post-delivery requires further assessment by the nurse? A. "Is it normal for it to burn when I go pee?" B."My uterus is cramping really bad. C. "I think I want to try breastfeeding." D. Will you take the baby to the nursery so I can nap?"

B

Which of the following findings, seen in pregnant women in the third trimester, would the nurse consider to be within normal limits? a. Diplopia b. Epistaxis c. Bradycardia d. Oliguria

B

Which of the following laboratory values is most concerning in a client with pregnancy-induced hypertension? a. Total urine protein of 200 mg/dL b. Total platelet count of 40,000 mm c. Uric acid levelof 8 mg/dL d. Blood urea nitrogen 24 mg/dL

B

Which of the following statements by a pregnant woman indicates she needs additional teaching on ways to reduce risk to her unborn child from the potential effects of exposure to toxoplasmosis? a. I will avoid rare lamb. b. I will wear a mask when cleaning my cat's litter box. c. I understand that exposure to toxoplasmosis can cause blindness in the baby. d. I will avoid rare beef.

B

While educating the client with class II cardiac disease, at 28 weeks' gestation, the nurse instructs the client to notify the physician if she experiences which of the following conditions? a. Emotional stress at work b. Increased dyspnea while resting c. Mild pedal and ank leedema d.Weight gain of 1 pound in 1 week

B

You are caring for a primiparous woman admitted to labor and delivery forinduction of labor at 42 weeks' gestation. She asks you to explain the factorsthat contribute to prolonged labor. The best response would be to state thefollowing: a. Primiparous women are not at risk for dystocia because they usually havesmall babies. b. Dystocia is related to uterine contractions, the pelvis, the fetus, the positionof the mother, and psychosocial response. c. Labor is primarily associated with pelvic abnormalities. d. Dystocia is typically diagnosed prior to labor based on pelvimetry.

B

Your patient is a 28-year-old gravida 2 para 1 in active labor. She has been inlabor for 12 hours. Upon further assessment, the nurse determines that she isexperiencing a hypotonic labor pattern. Possible maternal and fetal implications from hypotonic labor patterns are: a. Intrauterine infection and maternal exhaustion with fetal distress usuallyoccurring early in labor. b. Intrauterine infection and maternal exhaustion with fetal distress usuallyoccurring late in labor. c. Intrauterine infection and postpartum hemorrhage with fetal distress early inlabor. d. Intrauterine infection and ruptured uterus and fetal death.

B

Your pregnant patient is having maternal alpha-fetoprotein (AFP) screening. She does not understand how a test on her blood can indicate a birth defect in the fetus. The best reply by the nurse is: a. We have done this test for a long time.‖ b. If babies have a neural tube defect, alpha- fetoprotein leaks out of the fetus and is absorbed into your blood, causing your level to rise. This serum blood test detects that rise.‖ c. Neural tube defects are a genetic anomaly, and we examine the amount of alpha- fetoprotein in your DNA.‖ d. If babies have a neural tube defect, this results in a decrease in your level of alpha- fetoprotein.‖

B

Your pregnant patient is in her first trimester and is scheduled for an abdominal ultrasound. When explaining the rationale for early pregnancy ultrasound, the best response is: a. The test will help to determine the baby's position.‖ b. The test will help to determine how many week s you are pregnant.‖ c. The test will help to determine if your baby is growing appropriately.‖ d. The test will help to determine if you have a boy or girl.‖

B

You're providing an educational class for pregnant women about gestational diabetes. You discuss the role of insulin in the body. Select all the CORRECT statements about the role and function of insulin: A. "Insulin is a type of cell that provides glucose to the body from the blood." B. "Insulin is a hormone secreted by the beta cells of the pancreas." C. "Insulin influences cells by causing them to uptake glucose from the blood." D. "Insulin is a protein that helps carry glucose into the cell for energy."

B, C

A patient is currently 34 weeks pregnant with her first baby. Which findings below could indicate the development of preeclampsia in this patient that would need to be reported to the physician? Select all that apply: A. 1600: blood pressure 144/100, 1700: blood pressure 120/80 B. 3+ dipstick urine protein C. 1 hour glucose tolerance test 90 mg/dL D. 0800: blood pressure 142/92, 1230: blood pressure: 144/98 E. <300 mg/dL 24-hour urine protein

B, D

A G6P5 patient who is 24-hours post vaginal delivery reports severe cramp-like uterine pain. What is the priority nursing intervention for this patient? A. Document the pain score in the electronic medical record. B. Assess the perineum for a vaginal hematoma. C. Encourage warm packs to the abdomen. D. Notify the healthcare provider STAT.

C

A clinic nurse explains to the pregnant woman that the amount of amniotic fluid present at 24 weeks gestation is approximately: a. 500 mL b. 750 mL c. 800 mL d. 1000 mL

C

A diagnostic test commonly used to assess problems of the fallopian tubes is: a. Endometrial biopsy b. Ovarian reserve testing c. Hysterosalpingogram d. Screening forsexually transmitted infections

C

A nurse is assessing for the tonic neck reflex. This is elicited by: a. Making a load sound near the neonate. b. Placing the neonate in a sitting position. c. Turning the neonate's head to the side so that the chin is over the shoulderwhile the neonate is in a supine position. d. Holding the neonate in a semi-sitting position and letting the head slightlydrop back.

C

A nurse is preparing a woman in early labor for an urgent cesarean birth related to breech presentation. Select the best nursing action for reducing the couples anxiety levels. a. Explainthe reason for the need for a cesarean section. b. Inform parents that their baby is in distress. c.Ask thecouple to share their concerns. d. Reassure the couple that both the woman and baby are in no danger.

C

A nurse is providing discharge teaching to the parents of a 2-day-oldneonate. Which of the following information should be included in the discharge teaching on umbilical cord care? a. Cleanse the cord twice a day with hydrogen peroxide. b. Remove the cord with sterile tweezers if the cord does not fall off by 10 daysof age. c. Call the doctor if greenish discharge appears. d. Cover the cord with sterile dressing until it falls off.

C

A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the attending physician immediately of which of the following findings? a. Patellar and biceps reflexes of +4 b. Urinary output of 50 mL/hr c. Respiratory rate of 10rpm d. Serum magnesium level of 5 mg/dL

C

A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the attendingphysician immediately of which of the following findings? a. Patellar and biceps reflexes of +4 b. Urinary output of 50 mL/hr c. Respiratory rate of 10 rpm d. Serum magnesium level of 5 mg/dL

C

A postpartum woman, who gave birth 12 hours ago, is breastfeeding her baby. She tells her nurse that she is concerned that her baby is not getting enough food since her milk has not come in. The best response for this patientis: a. I understand your concern, but your baby will be okay until your milk comesin. b. Your baby seems content, so you should not worry about him gettingenough to eat. c. Milk normally comes in around the third day. Prior to that, he is gettingcolostrum which is high in protein and immunoglobulins which are importantfor your baby's health. d. You can bottle feed until your milk comes in.

C

A pregnant client with a history of multiple sexual partners is at highest risk for which of the following complications: a. Premature rupture of membranes b. Gestational diabetes c. Ectopic pregnancy d. Pregnancy-induced hypertension

C

A woman who has had no prenatal care was assessed and found to have hydramnios on admission to the labor unit and has since delivered a baby weighing 4500 grams. Which of the following complicationsof pregnancy likely contributed to these findings? a. Pyelonephritis b. Pregnancy-induced hypertension c. Gestational diabetes d. Abruptio placentae

C

During labor induction with oxytocin, the fetal heart rate baseline is in the 140s with moderate variability. Contraction frequency is assessed to be every 2minutes with duration of 60 seconds, of moderate strength to palpation. Based on this assessment, the nurse should take which action? a. Increase oxytocin infusion rate per physician's protocol. b. Stop oxytocin infusion immediately. c. Maintain present oxytocin infusion rate and continue to assess. d. Decrease oxytocin infusion rate by 2 mU/min and report to physician.

C

Early decelerations are probably caused by: ICP a. Decreased maternal-fetal exchange b. Umbilical cord occlusion c. Momentary increase in intracranial pressure due to head compression d. Compression of umbilical cord

C

Four babies have just been admitted into the neonatal nursery. Which of thebabies should the nurse assess first? a. The baby with respirations 52, oxygen saturation 98% b. The baby with Apgar 9/9, weight 2960 grams c. The baby with temperature 96.3°F, length 17 inches d. The baby with glucose 60 mg/dL, heart rate 132

C

In caring for a primiparous woman in labor, one of the factors to evaluate is uterine activity. This is referred to as the _________ of labor. a. Passenger b. Passage c. Powers d. Psyche

C

The clinic nurse is aware that the pregnant woman's blood volume increases by: a. 20% to 25% b. 30% to 35% c. 40% to 45% D. 50% to 55%

C

The clinic nurse knows that the part of the endometrial cycle occurring from ovulation to just prior to menses is known as the: a. Menstrual phase b. Proliferative phase c. Secretory phase d. Ischemic phase

C

The fetal circulatory structure that connects the pulmonary artery with the descending aorta is known as which of the following? a. Ductus venosus b. Foramen ovale c. Ductus arteriosus d. Internal iliac artery

C

The labor patient you are caring for is ambulating in the hall. Her vaginal exam 1 hour ago indicatedshe was 4/70/1 station. She tells you she has fluid running down her leg. Your priority nursing intervention is to: a. Assess the color, odor, and amount of fluid. b. Assist yourpatient to the bathroom. c.Assess the fetal heart rate. d. Call the care provider.

C

The nurse is about to elicit the Moro reflex. Which of the followingresponses should the nurse expect to see? a. When the cheek of the baby is touched, the newborn turns toward the sidethat is touched. b. When the lateral aspect of the sole of the baby's foot is stroked, the toesextend and fan outward. c. When the baby is suddenly lowered or startled, the neonate's armsstraighten outward and the knees flex. d. When the newborn is supine and the head is turned to one side, the arm onthat same side extends.

C

The nurse is assessing the neonate's skin and notes the presence of small,irregular, red patches on the cheeks that will develop into single, yellow pimples on the chest or abdomen. The name for this common neonatal skin condition is: a. Milia b. Neonatal acne c. Erythema toxicum d. Pustular melanosis

C

The nurse is caring for a 12-hour-old neonate and incorporating measures to prevent heat loss through conduction. What is the priority nursing action? A. Drying the infant after the first bath B. Placing the infant away from the window C. Warming the stethoscope prior to assessment D. Moving the crib away from the air conditioner vent

C

The nurse is caring for a woman, G2 P1, 40 weeks' gestation, in labor. A 12 P.M. assessment revealed: cervix 4 cm, 80% effaced, -3 station, and fetalheart 124 with moderate variability. 5 p.m. assessment: cervix 6 cm, 90% effaced, -3 station, and fetal heart 120with minimal variability. 10 a.m. assessment: cervix 8 cm, 100% effaced, -3 station, and fetal heart 124with absent variability. Based on the assessments, which of the following should the nurse conclude? a. Descent is progressing well. b. Woman is carrying a small-for-gestational age fetus. c. Baby is potentially acidotic. d. Woman should begin to push with the next contraction.

C

The nurse is teaching the parents of a 1-day-old baby how to give theirbaby a bath. Which of the following actions should be included? a. Clean the eye from the outer canthus to the inner canthus. b. Keep the door of the room open to allow for ventilation. c. Gather all supplies before beginning the bath. d. Check the temperature of the water with your fingertip.

C

The nurse is working in a prenatal clinic caring for a patient at 14 weeks' gestation, G2 P1001. Which of the following findings should the nurse highlight for the nurse midwife? a. Body mass index of 23 b. Blood pressure of 100/60 c. Hematocrit of 29% d. Pulse rate of 76 bpm

C

The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of: a. Unilateral amblyopia b. Subdural hematoma c. Sickle cell anemia d. Glomerular nephritis

C

The perinatal nurse is providing care to Carol, a 28-year-old multiparouswoman in labor. Upon arrival to the birthing suite, Carol was 7 cm dilated andexperiencing contractions every 1 to 2 minutes which she describes as strong. Carol states she labored for 1 hour at home. As the nurse assists Carol from the assessment area to her labor and birth room, Carol states thatshe is feeling some rectal pressure. Carol is most likely experiencing: a. Hypertonic contractions b. Hypotonic contractions c. Precipitous labor d. Uterine hyperstimulation

C

When assessing the apical pulse of the neonate, the stethoscope should beplaced at the: a. First or second intercostal space b. Second or third intercostal space c. Third or fourth intercostal space d. Fourth or fifth intercostal space

C

Which of the following neonates is at highest risk for cold stress? a. A 36 gestational week LGA neonate b. A 32 gestational week AGA neonate c. A 33 gestational week SGA neonate d. A 38 gestational week AGA neonate

C

Which of the following statements indicates that a new mother needsadditional teaching? a. I need to supervise my cat when she is in the same room as my baby. b. I will place my baby on her back when she is sleeping. c. I will not leave my baby on an elevated flat surface after she is able to turnover on her own. d. I have asked my husband to install safety latches on the lower cabinets.

C

You are caring for a woman in labor who is 6 cm dilated with a reassuring FHT pattern and regularstrong UCs. The fetal heart rate (FHR) should be: a. Monitored continuously b. Monitored every 15 minutes c. Monitored every 30 minutes d. Monitored every 60 minutes

C

A 16-year-old patient is admitted to the hospital with a diagnosis of severe preeclampsia. The nurse must closely monitor the woman for which of the following? a. High leuk ocyte count b. Explosive diarrhea c. Fractured pelvis d. Low platelet count

D

A 32-year-old female is diagnosed with gestational diabetes. As the nurse you know that what test below is used to diagnose a patient with this condition? A. 1 hour glucose tolerance test B. 24 hour urine collection C. Hemoglobin A1C D. 3 hour glucose tolerance test

D

A 37-year-old woman who is 17 week s pregnant has had an amniocentesis. Before discharge, the nurse teaches the woman to call her doctor if she experiences which of the following side effects? a. Pain at the puncture site b. Macular rash on the abdomen c. Decrease in urinary output d.Cramping of the uterus

D

A client delivered a 2800-gram neonate 4 hours ago by cesarean section with epidural anesthesia.Which of the following interventions should the nurse perform on the mother at this time? a. Maintain the client flat in bed. b. Assess the clients patellar reflexes. c. Monitor hourly urinary outputs. d. Assess the clients respiratory rate.

D

A client on 2 gm/hr of magnesium sulfate has decreased deep tendon reflexes. Identify the priority nursing assessment to ensure client safety. A. Assess uterine contractions continuously B. Assess fetal heart rate continuously. C. Assess urinary output. D. Assess respiratory rate.

D

A mother refused to allow her son to receive the vitamin K injection at birth. Which of the following signs or symptoms might the nurse observe in the baby as a result? a. Skin color is dusky. b. Vital signs are labile. c. Glucose levels are subnormal. d. Circumcision site oozes blood.

D

A neonate is admitted to the nursery. The nurse makes the following assessments: weight 2845 grams, overriding sagittal suture, closed posterior fontanel, and point of maximum intensity at the xiphoid process. Which of theassessments should be reported to the health-care practitioner? a. Birth weight b. Sagittal suture line c. Closed posterior fontanel d. Point of maximum intensity

D

A nurse is admitting a woman for a scheduled cesarean section. Which of the following Assessment data should be immediately reported to the physician? a. White cell count of 11,000 b.Hemoglobin of 11 g/dL c. Hematocrit of 33% d. Platelet count of 97,000

D

A nurse is caring for a woman 10 hours post-cesarean birth. She received a dose of intrathecal morphine at the time of the birth. Which of the following assessment data would require immediateintervention? a. Itching of the palms and feet b. Nausea c. Urinary output of300 mL in the past 4 hours d. Respiratory rate of 10 breaths/minute

D

A nurse is making a home visit on the seventh postpartum day to assess a 23-year-old primipara woman and her full-term, healthy baby. Breastfeeding isthe method of infant nutrition. The woman tells the nurse that she does not think her milk is good because it looks very watery when she expresses a littlebefore each feeding. The nurse's best response is: a. This is normal. You only have to be concerned when your baby does notgain weight. b. What types of foods are you eating? A lack of protein in the diet can causewatery looking breast milk.‖ c. How much fluid are you drinking while you are nursing your baby? Toomuch fluid during the feeding session can dilute the breast milk.‖ d. This is normal and is referred to as foremilk which is higher in water content. Later in the feeding the fat content increases and the milk becomes richer in appearance.

D

A patient who is 24 hours post vaginal delivery is complaining of polyuria. What is the best response by the nurse? A. We will notify the doctor. B. We will restrict fluids to help decrease urination C. We will administer medication to decrease urination. D. This is normal within the first 24 hours.

D

A patient, G1 P0, is admitted to the labor and delivery unit for induction of labor. The following assessments were made on admission: Bishop score of 4,fetal heart rate 140s with good variability and no decelerations, TPR 98.6oF, 88, 20, BP 120/80, negative obstetrical history. A prostaglandin suppository was inserted at that time. Which of the following findings, 6 hours after insertion, would warrant the removal of the Cervidil (dinoprostone)? a. Bishop score of 5 b. Fetal heart of 152 bpm c. Respiratory rate of 24 rpm d. Contraction frequency of every 2 minutes

D

A perinatal nurse assesses the skin condition of a newborn, which is characterized by a yellow coloration of the skin, sclera, and oral mucous membranes. What condition is most likely the cause of this symptom? a. Hypoglycemia b. Physiologic anemia of infancy c. Low glomerular filtration rate d. Jaundice

D

A pregnant patient at 35 weeks' gestation gives birth to a healthy baby boy. What factors regarding the development of the normal respiratory systemshould the nurse consider when performing an assessment of the neonate? a. As the fetus approaches term, there is an increase in the secretion of intrapulmonary fluid. b. Lung expansion after birth suppresses the release of surfactant. c. Surfactant causes an increased surface tension within the alveoli, whichallows for alveolar reexpansion following each exhalation. d. Under normal circumstances, by the 34th to 36th weeks of gestation,surfactant is produced in sufficient amounts to maintain alveolar stability.

D

A woman at 40 weeks gestation has a diagnosis of oligohydramnios. Which of the following statements related to oligohydramnios is correct? a. It indicates that there is a 25% increase in amniotic fluid. b. It indicates that there is a25% reduction of amniotic fluid. c. It indicates that there is a 50% increase in amniotic fluid. d. It indicates that there is a 50% reduction of amniotic fluid.

D

A woman in labor and delivery is being given subcutaneous terbutaline for preterm labor. Which of the following common medication effects would the nurse expect to see in the mother? a. Serum potassium level increases b. Diarrhea c. Urticaria d. Complaints of nervousness

D

A woman in labor and delivery is being given subcutaneous terbutaline for preterm labor. Which ofthe following common medication effects would the nurse expect to see in the mother? a. Serum potassium level increases b. Diarrhea c. Urticaria d. Complaints of nervousness

D

Blood volume expansion during pregnancy leads to: a. Iron-deficiency anemia b. Maternal ironstores being insufficient to meet the demands for iron in fetal development c. Plasma fibrin increase of 40% and fibrinogen increase of 50% d. Physiological anemia of pregnancy

D

Heat loss through radiation can be reduced by: a. Closing door to room b. Warming equipment used on the neonate c. Drying the neonate d. Placing crib near a warm wall

D

If the umbilical cord prolapses during labor, the nurse should immediately: a. Type and cross-match blood for an emergency transfusion. b. Await MD order for preparation for an emergency cesarean section. c. Attempt to reposition the cord above the presenting part. d. Apply manual pressure to the presenting part to relieve pressure on thecord.

D

Instructions to a mother of an uncircumcised male infant should includewhich of the following? a. Instruct her to use a cotton swab to clean under the foreskin. b. Instruct her to clean the penis by retracting the foreskin. c. Instruct her to clean the penis with alcohol. d. Instruct her not to retract the foreskin.

D

Karen, a 26-year-old woman, has come for preconception counseling and ask s about caring for her cat as she has heard that she ―should not touch the cat during pregnancy. The clinic nurse's best response is: a. It is best if someone other than you changes the cat's litter pan during pregnancy so that you have no risk of toxoplasmosis during pregnancy. b. It is important to have someone else change the litter pan during pregnancy and also avoid consuming raw vegetables. c. Have you had any ―flu-lik e‖ symptoms since you got your cat? If so, you may have already had toxoplasmosis and there is nothing to worry about. d. Toxoplasmosis is a concern during pregnancy, so it is important to have someone elsechange the cat's litter pan and also to avoid consuming uncooked meat.

D

The Apgar score consists of a rapid assessment of five physiological signs that indicate the physiological status of the newborn and includes: a. Apical pulse strength, respiratory rate, muscle flexion,reflex irritability, and color b. Heart rate, clarity of lungs, muscle tone, reflexes,and color c. Apical pulse strength, respiratory rate, muscle tone, reflex irritability, and color of extremities d. Heart rate, respiratoryrate, muscle tone, reflex irritability, and color

D

The color of a person's hair is an example of which of the following? a. Genome b. Sex-link inheritance c. Genotype d. Phenotype

D

The nurse is caring for a woman at 28 weeks gestation with a history of preterm delivery. Which ofthe following laboratory data should the nurse carefully assess in relation to this diagnosis? a. Human relaxin levels b. Amniotic fluid levels c. Alpha-fetoprotein levels d. Fetal fibronectin levels

D

The nurse is caring for two laboring women. Which of the patients should be monitored mostcarefully for signs of placental abruption? a. The patient with placenta previa b. The patient whose vagina is colonized with group B streptococci c. The patient who is hepatitis B surface antigen positive d. The patient with eclampsia

D

The nurse working in a prenatal clinic is providing care to three primigravida patients. Which of the patient findings would the nurse highlight for the physician? a. 15 week s, denies feeling fetal movement b. 20 week s, fundal height at the umbilicus c. 25 week s, complains of excess salivation d. 30 week s, states that her vision is blurry

D

The perinatal nurse explains to a student nurse the cardiopulmonary adaptations that occur in the neonate. Which one of the following statementsaccurately describes the sequence of these changes? a. As air enters the lungs, the PO2 rises in the alveoli, which causes pulmonaryartery relaxation and results in an increase in pulmonary vascular resistance. b. As the pulmonary vascular resistance increases, pulmonary blood flow increases, reaching 100% by the first 24 hours of life. c. Decreased pulmonary blood volume contributes to the conversion from fetalto newborn circulation. d. Once the pulmonary circulation has been functionally established, blood is distributed throughout the lungs.

D

The perinatal nurse is assessing a woman in triage who is 34 + 3 week s' gestation in her first pregnancy. She is worried about having her baby ―too soon,‖ and she is experiencing uterine contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal examination performed by the health-care provider reveals that the cervix is closed, long, and posterior. The most lik ely diagnosis would be: a. Preterm labor b. Term labor c. Back labor d. Braxton-Hicks contractions

D

The perinatal nurse is assessing a woman in triage who is 34 + 3 weeks gestation in her first pregnancy. She is worried about having her baby too soon, and she is experiencing uterine contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal examination performed by the health-care provider reveals that the cervix is closed, long, and posterior. The most likelydiagnosiswould be: a. Preterm labor b. Term labor c. Back labor d. Braxton-Hicks contractions

D

The perinatal nurse knows that the term to describe a woman at 26 weeks gestation with a history ofelevated blood pressure who presents with a urine showing 2+ protein (by dipstick) is: a. Preeclampsia b. Chronic hypertension c. Gestational hypertension d. Chronic hypertension with superimposed

D

The perinatal nurse listens as Chantal describes her labor and emergency cesarean birth. Providingan opportunity to review this experience may assist Chantal in: a. Her role development in the letting go stage b. Decreasing her ambivalence about her labor and birth c. Understanding her guilt involved in her labor and birth d. Developing more positive feelings about her labor and birth

D

The primary complications of amniocentesis are: a. Damage to fetal organs b. Puncture of umbilical cord c. Maternal pain d. Infection

D

When caring for a primiparous woman being evaluated for admission for labor, a key distinction between true versus false labor is: a. True labor contractions result in rupture of membranes, and with falselabor, the membranes remain intact. b. True labor contractions resultin increasing anxiety and discomfort,and false labor does not. c. True labor contractions are accompanied by loss of the mucus plug and bloody show, and with false labor there is no vaginal discharge. d. True labor contractions bring about changes incervical effacement and dilation, and with false labor there are irregular contractionswith little or no cervical changes.

D

When do most patients tend to develop gestational diabetes during pregnancy? A. usually during the 1-3 month of pregnancy B. usually during the 2-3 month of pregnancy C. usually during the 1-2 trimester of pregnancy D. usually during the 2-3 trimester of pregnancy

D

Which of the following statements is most appropriate for the nurse to say to a patient with a completeplacenta previa? a. During the second stage of labor you will need to bear down. b. You should ambulate in the halls at least twice each day. c. The doctor will likely induce your labor with oxytocin. d. Please promptly report if you experience any bleeding or feel any back discomfort.

D

You are in the process of admitting a multiparous woman to labor and delivery from the triage area. One hour ago her vaginal exam was 4/70/0. While completing your review of her prenatal record and completing the admission questionnaire, she tells you she has an urge to have a bowel movement and feels like pushing. Your priority nursing intervention is to: a. Reassure the patient and rapidly complete theadmission. b. Assist your patient to the bathroom to have a bowelmovement. c. Assess the fetal heart rate and uterine contractions. d. Perform a vaginal exam.

D

Your patient is 34 week s pregnant and during a regular prenatal visit tells you she does not understand how to do kick counts.‖ The best response by the nurse would be to explain: a. ―Here is an information sheet on how to do kick counts.‖ b. ―It is not important to do kick counts because you have a low-risk pregnancy.‖ c. ―Fetal kick counts are not a reliable indicator of fetal well-being in the third trimester.‖ d. ―Fetal movements are an indicator of fetal well-being. You should count twice a day, and you should feel 10 fetal movements in 2 hours.‖

D

Your patient is a 37-year-old pregnant woman who is 5 week s pregnant and is considering genetic testing. During your discussion, the woman ask s the nurse what the advantages of chorionic villus sampling (CVS) are over amniocentesis. The best response is: a. ―You will need anesthesia for amniocentesis, but not for CVS.‖ b. ―CVS is a faster procedure.‖ c. ―CVS provides more detailed information than amniocentesis.‖ d. ―CVS can be done earlier in your pregnancy, and the results are available more quickly

D

A certified nursing assistant (CNA) is working with a registered nurse in the neonatal nursery. It would be appropriate for the nurse to delegate which of the following actions to the assistant? 1. Admission assessment on a newly delivered baby. 2. Patient teaching of a neonatal sponge bath. 3. Placement of a bag on a baby for urine collection. 4. Hourly neonatal blood glucose assessments.

3

A patient is placed on bedrest at home for mild pre-eclampsia at 38 weeks' gestation. Which of the following must the nurse teach the patient regarding her condition? 1. Eat a sodium-restricted diet. 2. Check her temperature 4 times daily. 3. Report swollen hands and face. 4. Limit fluids to 1 liter per day.

3

A pregnant patient with a BMI of 35 is concerned about health effects she and her baby may face during pregnancy. During routine testing, the patient tested negative for sexually transmitted illnesses (STIs) and indicated that she is in a committed, long-term relationship with the child's father. Which of the following is accurate? 1. The patient's infant is at increased risk of neonatal blindness. 2. The patient's infant has a decreased risk of birth injury. 3. The patient will have increased risk of wound infection. 4. The patient will have a decreased risk of preeclampsia.

3

The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child, who is male. The patient's mother has accompanied her to today's visit. During the nursing assessment, the patient mentions that she is no longer in a relationship with the baby's father but her mother plans to help her. However, the patient's mother asks whether this will have any impact on the child. Which should the nurse indicate the child is at increased risk of during his adolescence? 1. Hypertension 2. Diabetes 3. Alcohol abuse 4. Intraventricular bleeding

3

The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that a pregnant patient may have been using marijuana. With consent, the nurse confirms via urine drug screen. Which statement by the nurse is most appropriate? 1. ―Did you smoke marijuana when pregnant with your other child?‖ 2. ―To avoid negative effects on your baby, you'll need to stop using marijuana during your last trimester.‖ 3. ―Using marijuana while pregnant can have a negative effect on the neurological development of your baby.‖ 4. ―Marijuana use while pregnant greatly increases your risk of miscarriage.‖

3

A gravida, G4 P1203, fetal heart rate 150s, is 14 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct? a. The woman is experiencing a normal pregnancy. b. The woman may be having difficulty accepting this pregnancy. c. The woman must see a nutritionist as soon as possible. d. The woman will likely miscarry the conceptus.

A

You're performing a head-to-toe assessment on a patient admitted with abruptio placentae. Which of the following assessment findings would you immediately report to the physician? A. Oozing around the IV site B. Tender uterus C. Hard abdomen D. Vaginal bleeding

A

A multiparous patient asks the nurse why she is feeling contractions 8 hours after giving birth. What information should the nurse include in her teaching? Select all that apply. A. The intensity of the afterpains should decrease in a few days." B. "The pains are from your abdominal muscles stretching during pregnancy." C. "You probably don't remember feeling afterpains after your first baby." D. "The afterpains are more intense because you are not breastfeeding." E. "Because you had Pitocin during labor, you will feel more contractions after delivery."

A, C

A 35-year-old female is in labor. The baby is engaged in the pelvis. As the nurse you know that this means that the fetal station is approximately? A. +1 B. 0 C. +2 D. -1

B

The instructor is teaching the role of the hepatic system in blood coagulation of neonates. Which statement by the nursing student requires further teaching? A. The neonate is not born with intestinal flora to synthesize Vitamin K." B. "The Vitamin K injection is not necessary if the mother is breastfeeding." C. "Coagulation factors II, VII, IX, and X are synthesized in the liver." D. "The neonate is given a Vitamin K injection to decrease the risk of bleeding."

B

A nurse is caring for a patient who gave birth 30 minutes ago. Upon fundal assessment, the nurse notes moderate vaginal bleeding and a boggy uterus that does not respond to fundal massage. What is the priority nursing action? A. Continue fundal massage. B. Document the findings and reassess in 5 to 10 minutes. C. Increase IV Oxytocin rate. D. Administer misoprostol 600mg rectally.

C

You are caring for a patient who was admitted to labor and delivery at 32 weeks' gestation and diagnosed with preterm labor. She is currently on magnesium sulfate, 2 gm per hour. Upon your initial assessment you note that she has a respiratory rate of 8 with absent deep tendon reflexes. What will be your first nursing intervention? a. Elevate head of the bed b. Notify the MD c. Discontinue magnesium sulfate d. Draw aserum magnesium level

C

Which of the following statements is most appropriate for the nurse to say to a patient with a complete placenta previa? a. During the second stage of labor you will need to bear down. b. You should ambulate in the halls at least twice each day. c. The doctor will lik ely induce your labor with oxytocin. d. Please promptly report if you experience any bleeding or feel any back discomfort.

D

A 26-year-old woman at 29 weeks' gestation experienced epigastric pain following the consumption of a large meal of fried fish and onion rings. The pain resolved a few hours later. The most likely diagnosis for this symptom is: a. Cholelithiasis b. Influenza c. Urinary tract infection d. Indigestion

A

A nurse is reviewing diet with a pregnant woman in her second trimester. Which of the following foods should the nurse advise the patient to avoid consuming during her pregnancy? a. Brie cheese b. Bartlett pears c. Sweet potatoes d. Grilled lamb

A

A nurse working in a prenatal clinic is caring for a woman who asks advice on foods that are high in vitamin C because ―I hate oranges.‖ The nurse states that 1 cup of which of the following raw foods will meet the patient's daily vitamin C needs? a. Strawberries b. Asparagus c. Iceberg lettuce d. Cucumber

A

A patient at 37 weeks' gestation is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be palpated? a. At the xiphoid process b. At a point between the umbilicus and the xiphoid c. At the umbilicus d. At a level directly above the symphysis pubis

A

A patient is 35 weeks pregnant. She has gestational diabetes and uncontrolled hyperglycemia. Her current blood glucose is 290 mg/dL. You administer insulin per physician's order and recheck the blood glucose level per protocol. It is now 135 mg/dL. Which statement by the patient requires you to notify the physician? A. "It burns when I urinate." B. "My back is hurting." C. "I feel tired." D. "I feel the baby kick about 10 times an hour."

A

A primiparous woman has been admitted at 35 week s' gestation and diagnosed with HELLP syndrome. Which of the following laboratory changes is consistent with this diagnosis? a. Hematocrit dropped to 28%. b. Platelets increased to 300,000 cells/mm3. c. Red bloodcells increased to 5.1 million cells/mm3. d. Sodium dropped to 132 mEq/dL.

A

An early indication of magnesium sulfate toxicity is ? a. Absent deep tendon reflexes B. Increase in respirations C. Hypertension D. Increased heart rate

A

For the patient with which of the following medical problems should the nurse question a physician's order for beta agonist tocolytics? a. Type 1 diabetes mellitus b. Cerebral palsy c. Myelomeningocele d. Positive group Bstreptococci culture

A

Identify the hallmark of placenta previa that differentiates it from abruptio placenta. a. Sudden onset of painless vaginal bleeding b. Board-lik e abdomen with severe pain c. Sudden onset of bright red vaginal bleeding d. Severe vaginal pain with bright red bleeding

A

The clinic nurse uses Leopold maneuvers to determine the fetal lie, presentation, and position. The nurse's hands are placed on the maternal abdomen to gently palpate the fundal region of the uterus. This action is best described as the: a. First maneuver b. Second maneuver c. Third maneuver d. Fourth maneuver

A

The nurse has just completed discharge teaching for a primiparous patient. Which statement by the patient indicates to the nurse understanding of discharge instructions following vaginal delivery of a term infant? A. "I will call my doctor if my uterus is squishy when I massage it." B. "I will experience heavy bleeding for the first week" C. "I should change my peripad twice a day." D. "I might notice a foul smell to my discharge."

A

The nurse places the newborn on the mother skin-to-skin immediately after birth. What is the most appropriate teaching for the mother at this time? A. Encourage the mother to initiate breastfeeding and provide support. B. Provide education for the Hepatitis B vaccine before administration. C. Teach the importance of bonding and rooming-in. D. Discuss the methods of heat loss and provide examples.

A

Which of the following nursing diagnoses is of highest priority for a client with an ectopic pregnancy who has developed disseminated intravascular coagulation (DIC)? a. Risk for deficient fluid volume b.Risk forfamilyprocessinterrupted c. Risk for disturbed identity d. High risk for injury

A

Which of the following signs or symptoms would the nurse expect to see in a woman with concealed abruptio placentae? a. Increasing abdominal girth measurements b. Profuse vaginal bleeding c. Bradycardiawith an aortic thrill d. Hypothermia with chills

A

A patient on the postpartum unit reports passing an egg-sized clot. What are the priority nursing interventions for this patient? Select all that apply. A. Weigh the clot. B. Report the findings to the physician or midwife. C. Assist the patient to the bathroom. D. Administer Oxytocin 10U IM. E. Call for rapid response

A, B

The nurse is assessing a 4-hour-old neonate. What behaviors would the nurse expect the newborn to exhibit? Select all that apply. A. Passage of meconium B. Responsive to external stimuli C. Sleepy and uninterested in breastfeeding D. Grunting and irregular respirations E. Spontaneous Moro reflexes

A, B

The Mother Baby educator is orienting a group of new nurses and discussing the hepatic system. The educator determines the group understands bilirubin production when choosing which statements as correct? Select all that apply. A. The neonate produces more bilirubin after birth due to an increase in RBC production." B. "Direct (conjugated) bilirubin is a water-soluble substance." C. "Hyperbilirubinemia may occur from immature liver function." D. "All neonates develop physiological jaundice from the increased production of RBCs." E. "Indirect (unconjugated) bilirubin can be excreted in the urine and stool."

A, B, C

A 34-week s' gestation multigravida, G3 P1 is admitted to the labor suite. She is contracting every 7 minutes and 40 seconds. The woman has several medical problems. Which of the following of her comorbidities is most consistent with the clinical picture? a. Kyphosis b. Urinary tract infection c. Congestive heart failure d. Cerebral palsy

B

A G4P4 patient who is 6 hours post-delivery is complaining of severe cramp-like uterine pains. What is a therapeutic nursing response? A. The cramping should go away when you start breastfeeding." B. "The pains are caused by your uterus contracting and should get better in a few days." C. "Afterpains are usually the worse with your first baby." D. "The contractions will subside over the next 6 weeks as your uterus goes back to its normal size."

B

A client is concerned because her 2-hour-old newborn is sleeping skin-to-skin and will not breastfeed. Which response by the nurse is correct to explain this behavior? A. The medication you received in labor is affecting the baby's ability to stay awake." B. "This is a normal response after birth and may last an hour or two." C. "The baby could be sleepy because of a low glucose level. Try to wake the baby up and breastfeed." D. "We can give the baby a bath to wake the baby up."

B

A labor nurse is caring for a patient, 39 week s' gestation, who has been diagnosed with placenta previa. Which of the following physician orders should the nurse question? a. Type and cross-match her blood. b. Insert an internal fetal monitor electrode. c.Administer an oral stool softener. d. Assess her complete blood count.

B

A patient comes to labor and delivery with a ruptured membrane of 12 hours. What assessment should be made first? A. Blood pressure B. Temperature C. Pulse D. O2 saturation

B

A patient who is 25 weeks pregnant has partial placenta previa. As the nurse you're educating the patient about the condition and self-care. Which statement by the patient requires you to re-educate the patient? A. "I will avoid sexual intercourse and douching throughout the rest of the pregnancy." B. "I may start to experience dark red bleeding with pain." C. "I will have another ultrasound at 32 weeks to re-assess the placenta's location." D. "My uterus should be soft and non-tender."

B

A postpartum nurse caring for a patient 3 days post-delivery notes brown vaginal discharge. How should the nurse document this finding in the electronic health record? A. Lochia rubra B. Lochia serosa C. Lochia alba D. Brown vaginal discharge

B

A postpartum nurse is caring for a G1P1 patient 24 hours post-vaginal delivery. What is the priority action for the nurse when preparing to assess for uterine involution? A. Assist the woman to a supine. B. Instruct the woman to void. C. Reassure the woman that she will not feel pain during the procedure. D. Notify the woman that you will be visualizing her perineum.

B

A postpartum nurse is caring for multiple patients on the mother-baby unit. Which patient should the nurse evaluate first? A. A G1P1 who gave birth 30 minutes ago and reports uncontrollable shaking B. A G6P5 who gave birth 6 hours ago and reports passing a basketball-sized blood clot C. A G3P1 who is 3 days post-op cesarean section and reports cracked and bloody nipples D. A G2P1 who is 2 days post-op cesarean section and reports 7/10 abdominal pain

B

A woman at 10 week s' gestation is diagnosed with gestational trophoblastic disease (hydatiform mole). Which of the following findings would the nurse expect to see? a. Platelet count of 550,000/ mm3 b. Dark brown vaginal bleeding c. White blood cell count 17,000/ mm3 d. Macular papular rash

B

A woman presents to a prenatal clinic appointment at 10 weeks' gestation, in the first trimester of pregnancy. Which of the following symptoms would be considered a normal finding at this point in pregnancy? a. Occipital headache b. Urinary frequency c. Diarrhea d. Leg cramps

B

At the end of her 32-week prenatal visit, a woman reports discomfort with intercourse and tells you shyly that she wants to maintain a sexual relationship with her partner. The best response is to: a. Reassure woman/couple of normalcy of response b. Suggest alternative positions for sexualintercourse and alternative sexual activity to sexual intercourse c. Recommend cessation of intercourse until after delivery due to advanced gestation d. Suggest woman discuss this with her care provider at her next appointment

B

During pregnancy, poorly controlled asthma can place the fetus at risk for: a. Hyperglycemia b. IUGR c. Hypoglycemia d. Macrosomia

B

Folic acid supplementation during pregnancy is to: a. Improve the bone density of pregnant women b. Decrease the incidence of neural tube defects in the fetus c. Decrease the incidence of Down syndrome in the fetus d. Improve calcium uptake in pregnant women

B

Four newborns have been admitted to the nursery. Which of the newborns should the nurse assess first? A. Newborn with respiratory rate 36, oxygen saturation 98% B. Newborn with Apgar 8/9, weight 4590 grams C. Newborn with Apgar 6/8, temperature 97.9 degrees F D. Newborn with heart rate 156, intrauterine growth restriction (IUGR)

B

The clinic nurse reviews the complete blood count results for a 30-year-old woman who is now 33 weeks' gestation. Tamara's hemoglobin value is 11.2 g/dL, and her hematocrit is 38%. The clinic nurse interprets these findings as: a. Normal adult values b. Normal pregnancy values for the third trimester c. Increased adult values d. Increased values for 33 weeks' gestation

B

The nurse has received a report about a woman in labor. The woman's last vaginal exam was recorded as 3 cm, 30%, and -2. the nurse's interpretation of this assessment is that? A. the cervix is effaced 3 cm, it is dilated 30% and the presenting part is 2 cm above the ischial spines B. the cervix is 3 cm dilated, it is effaced 30% and the presenting part is 2 cm above the ischial spines C. the cervix is effaced 3 cm it is dilated 30% and the presenting part is 2 cm below the ischial spines D. the cervix is dilated 3 cm it is effaced 30% and the presenting part is 2 cm below the ischial spine

B

Which of the following medications administered to the pregnant client with GDM and experiencing preterm labor requires close monitoring of the client's blood glucose levels? a. Nifedipine b. Betamethasone c. Magnesium sulfate d. Indomethacin

B

You're providing an in-service to a group of new labor and delivery nurse graduates about the pathophysiology of preeclampsia. Which statement by one of the group participants demonstrates they understood how this condition develops? A. "The basal arteries of the myometrium fail to widen to support blood flow to the placenta." B. "The placenta experiences ischemia because the spiral arteries of the uterus fail to reshape and increase in diameter." C. "The cardiovascular system of the mother fails to compensate for the increased blood flow from the fetus and placental ischemia occurs." D. "If the mother experience uncontrolled hypertension and proteinuria, it compromises blood flow to the placenta and leads to preeclampsia."

B

Your patient is 36 weeks pregnant and has gestational diabetes. Which lab result below is euglycemic? A. Blood glucose 55 mg/dL B. Blood glucose 82 mg/dL C. Blood glucose 148 mg/dL D. Blood glucose 325 mg/dL

B

A baby is born at 37 weeks gestation to a mother with gestational diabetes. As the nurse you know at birth that the newborn is at risk for? Select all that apply: A. Hyperglycemia B. Hypoglycemia C. Respiratory distress D. Jaundice E. Hyperthermia

B, C

A nurse is checking several newborn reflexes on a 2-day-old neonate. Which reflex would require further investigation? A. The neonate turning the head toward the nurse's finger after stroking the cheek B. The neonate grasping the nurse's fingers tightly when one finger is placed in the palm of the hand C. Asymmetrical abduction of the arms when the nurse jars the crib D. The toes fanning out when the nurse strokes the lateral surface of the sole in an upward motion

C

A nurse is performing an assessment on a pregnant woman during a prenatal visit. Which of the following findings would lead the nurse to report to the obstetrician that the patient may be experiencing intrauterine growth restriction (IUGR)? a. Leopold's maneuvers: Hard round object in the fundus, flat object on left of uterus, small parts on right of uterus, soft round object above the symphysis b. Weight gain: 6-pound increase over 4-week period c. Fundal height measurement: 22 cm at 26 weeks' gestation d. Alpha-fetoprotein assessment: level is one-half normal, accompanied by complaints of severe nausea and vomiting

C

A postpartum nurse is caring for multiple patients on the mother-baby unit. Which task can the nurse delegate to the Licensed Practical Nurse (LPN)? A. Re-admit a patient 2 weeks post-op cesarean section with an infection B. A G1P1 needing discharge teaching C. A G2P1 who gave birth yesterday and has moderate lochia rubra D. A G6P6 2 days post-op cesarean section at 34 weeks gestation

C

A primigravida patient is 39 weeks pregnant. Which of the following symptoms would the nurse expect the patient to exhibit? a. Nausea b. Dysuria c. Urinary frequency d. Intermittent diarrhea

C

A woman at 32 week s' gestation is diagnosed with severe preeclampsia with HELLP syndrome. The nurse will identify which of the following as a positive patient care outcome? a. Rise in serum creatinine b. Drop in serum protein c. Resolution of thrombocytopenia d.Resolution of polycythemia

C

A woman who has had no prenatal care was assessed and found to have hydramnios on admission to the labor unit and has since delivered a baby weighing 4500 grams. Which of the following complications of pregnancy likely contributed to these findings? a. Pyelonephritis b. Pregnancy-induced hypertension c. Gestational diabetes d. Abruptioplacentae

C

A woman who is admitted to labor and delivery at 30 week s' gestation, is 1 cm dilated, and is contracting q 5 minutes. She is receiving magnesium sulfate IV piggyback. Which of the following maternal vital signs is most important for the nurse to assess each hour? a. Temperature b. Pulse c. Respiratory rate d. Blood pressure

C

A woman, who is 22 weeks pregnant, has a routine ultrasound performed. The ultrasound shows that the placenta is located at the edge of the cervical opening. As the nurse you know that which statement is FALSE about this finding: A. This is known as marginal placenta previa. B. The placenta may move upward as the pregnancy progresses and needs to be re-evaluated with another ultrasound at about 32 weeks gestation. C. The patient will need to have a c-section and cannot deliver vaginally. D. The woman should report any bleeding immediately to the doctor.

C

During a routine prenatal visit in the third trimester, a woman reports she is dizzy and lightheaded when she is lying on her back. The most appropriate nursing action would be to: a.Order an EKG. b. Report this abnormal finding immediately to her care provider. c. Teach the woman to avoid lying on her back and to rise slowly because of supine hypotension. d. Order a nonstress test to assess fetal well-being.

C

The nurse has taken a health history on four multigravida patients at their first prenatal visits. It is high priority that the patient whose first child was diagnosed with which of the following diseases receives nutrition counseling? a. Development dysplasia of the hip b. Achondroplastic dwarfism c. Spina bifida d. Muscular dystrophy

C

The nurse is providing prenatal teaching to a group of diverse pregnant women. One woman, who indicates she smokes two to three cigarettes a day, asks about its impact on her pregnancy. The nurse explains that the most significant risk to the fetus is: a. Respiratorydistress at birth b. Severe neonatal anemia c. Low neonatal birth weight d. Neonatal hyperbilirubinemia

C

The nurse knows that preeclampsia tends to occur during what time in a pregnancy?* A. before 20 weeks B. in the third trimester and postpartum C. after 20 weeks D. in the first and second trimester

C

What is an intervention that is the least invasive in early labor? A. Medication B. Ambulation C. Breathing D. Epidural

C

Which statement is TRUE regarding abruptio placenta? A. This condition occurs due to an abnormal attachment of the placenta in the uterus near or over the cervical opening. B. A marginal abruptio placenta occurs when the placenta is located near the edge of the cervical opening. C. Nursing interventions for this condition includes measuring the fundal height. D. Fetal distress is not common in this condition as it is in placenta previa.

C

While performing Leopold's maneuvers on a woman in early labor, the nurse palpates a flat area in the fundal region, a hard round mass on the left side, a soft round mass on the right side, and small parts just above the symphysis. The nurse concludes which of the following? a. The fetal position is right occiput posterior. b. The fetal attitude is flexed. c. The fetal presentation is scapular. d. The fetal lie is vertical.

C

During routine assessment, a nurse caring for a postpartum patient notes the uterus is shifted to the side. What is the priority nursing action? A. Notify the physician or midwife. B. Document the findings in the electronic medical record. C. Perform gentle fundal massage. D. Assist the woman to the bathroom.

D

During the assessment of a laboring woman, it is noted the fetal station is +2. You interpret this to mean? A. The baby's presenting part is 2 cm above the iliac spine. B. The baby's presenting part is 2 cm below the iliac spine. C. The baby's presenting part is 2 cm above the ischial spine. D. The baby's presenting part is 2 cm below the ischial spine.

D

The clinic nurse talks to a 30-year-old woman at 34 weeks' gestation who complains of having difficulty sleeping. Jayne has noticed that getting back to sleep after she has been up at night is difficult. The nurse's best response is: a. This is abnormal; it is important that you describe this problem to the doctor. b. This is normal, and many women have this same problem during pregnancy; try napping for several hours each morning and afternoon. c. This is abnormal; tell the doctor about this problem because diagnostic testing may be necessary. d. This is normal in pregnancy, particularly during the third trimester when you also feel fetal movement at night; try napping once a day.

D

The nurse is assigned four newborns in the nursery. Which newborn should the nurse report to the physician? A. 23-hour-old neonate who has not passed meconium B. Six-hour-old neonate who is large for gestational age with a glucose of 41 C. 2-day-old neonate who has a blood-tinged vaginal discharge D. 2-day-old neonate with irregular respirations at 70 per minute

D

The nurse is caring for a woman at 28 week s' gestation with a history of preterm delivery. Which of the following laboratory data should the nurse carefully assess in relation to this diagnosis? a. Human relaxin levels b. Amniotic fluid levels c. Alpha-fetoprotein levels d. Fetalfibronectin levels

D

The nurse is caring for two laboring women. Which of the patients should be monitored most carefully for signs of placental abruption? a. The patient with placenta previa b. The patient whose vagina is colonized with group Bstreptococci c. The patient who is hepatitis B surface antigen positive d. The patient with eclampsia

D

The perinatal nurse k nows that the term to describe a woman at 26 week s' gestation with a history of elevated blood pressure who presents with a urine showing 2+ protein (by dipstick ) is: a. Preeclampsia b. Chronic hypertension c. Gestational hypertension d. Chronichypertension with superimposed preeclampsia

D

The positive signs of pregnancy are: a. All physiological and anatomical changes of pregnancy b. All subjective signs of pregnancy c. All those physiological changes perceived by thewoman herself d. The objective signs of pregnancy that can only be attributed to the fetus

D

Your patient with preeclampsia is started on Magnesium Sulfate. The nurse knows to have what medication on standby? A. Acetylcysteine B. Calcium carbonate C. Oxytocin D. Calcium gluconate

D

A 39 week pregnant patient is in labor. The patient has preeclampsia. The patient is receiving IV Magnesium Sulfate. Which finding below indicates Magnesium Sulfate toxicity and requires you to notify the physician? A. Deep tendon reflex 4+ B. Respiratory rate of 13 breaths per minute C. Urinary output of 600 mL over 12 hours D. Clonus presenting in the lower extremities E. Patient reports flushing or feeling hot

E