Maternity

Which assessment findings of the fetus during labor are reassuring? 1. variability change between 10-20 bpm. 2. late decelerations 3. FHR baseline 1555 bpm 4. repeated variable deceralations 5. gradual increased in fetal heart baseline

1 & 3

A client has just received combined spinal epidural. Which nursing assessment should be performed first? 1. vital signs 2. labor progress 3. rupture of membranes 4. pain scale

1 vital signs

A nurse is presenting an in-service program about complications that can arise during labor. The nurse determines that the teaching was successful when the group correctly chooses which findings as suggesting an amniotic fluid embolism. 1. maternal respiratory distress 2. maternal hypertension 3. maternal tachycardia 4. fetal heart baseline between 145 and 150 5. maternal cyanosis

1,3 and 5

A client comes to the clinic reporting swelling in the hands and feet, blurred vision, a pounding headache and nausea and vomiting. The client had a positive pregnancy test 15 weeks ago, but has had no prenatal care. This is the client's third pregnancy, and she says that her uterus never grew this big or this fast with the previous pregnancies.Based on the client's reason for seeking care, the nurse would collect additional data to rule out the presence of which conditions? 1. Gestational trophoblastic disease 2. hyperemesis gravidarium 3. twin gestation 4. ectopic pregnancy

1. Gestational trophoblastic disease

A woman is to receive methotrexate and misoprostol to terminate a first-trimester pregnancy.When preparing the teaching plan for this client, the nurse understands that misoprostol works by: 1. causes the uterus to contract to help expel the contents 2. inhibits cell replication and targets rapidly dividing cells 3. helps thicken the cervix 4. blocks the fallopian tubes to prevent the zygote from implanting.

1. causes the uterus to contract to help expel the contents.

The nurse is is giving discharge instructions to a 34 year old G2 P0 who experienced a complete spontaneous abortion at 12 weeks. Which statement should the nurse prioritize at this time? 1. do you have someone to talk to , or would you like information for grief counselors. 2. what birth control methods have you used in the past. 3. about 75% of women who are trying to get pregnant experience this same thing at your age. 4. you may want to begin thinking about infertility counseling.

1. do you have someone to talk to, or would you like information for grief counselors.

You are teaching your patient about effleurage as a comfort measure during labor. After instruction is given, the nurse determines learning has taken place when the client states: 1. it is a light abdominal massage to displace pain 2. it is the use of a focal point to help her concentrate on something outside her body. 3. it is sacral pressure to allevaite back pain 4. it is the use of warm washcloth applied to the back or abdomen

1. it is a light abdominal massage to displace pain

A pregnant client at 33 weeks' gestation calls the clinic and informs the nurse that she is having lower dull back pain for the past 4 hours. She states that some clear fluid has run down her leg.What is the best response by the nurse? 1. it is best for you to visit a hospital so they can check to see if you are in preterm labor. 2. go to the hospital now because you can have a prolapsed cord. 3. theres' nothing to worry about, it sounds like normal discomforts of pregnancy. 4. you may have just passed some urine, I would make sure to mention at your next appointment.

1. it is best for you to visit a hospital so they can check to see if you are in preterm labor.

The nurse is monitoring a laboring patient who is receiving morphine for pain. The nurse is careful to monitor for which of the following adverse effects of this medication? 1. respiratory depression 2. pain control 3. spinal headaches 4. perineal hematoma

1. respiratory depression

A nurse has been assigned to assess a pregnant client for abruptio placenta. For which classic manifestation of this condition should the nurse assess? 1. sharp abdominal pain with vaginal bleeding 2. generalized vasospasms 3. increased fetal movement 4. painless bright red vaginal bleeding

1. sharp abdominal pain vaginal bleeding

A G2 P1001 is admitted for labor and states she had a cesarean birth with her first pregnancy.Which of the following is considered the most critical information the nurse must obtain: 1. the type of uterine incision with the first pregnancy. 2. whether she has been NPO since midnight 3. her LMP 4. the onset of her contractions

1. the type of uterine incision with the first pregnancy

You are caring for a mom at 39 weeks in labor. She had a c-section for her first pregnancy.She suddenly complains of abdominal pain and severe chest pain. She becomes tachycardic, tachypnic, and hypotensive, and you are no longer able to assess fetal heart tones. Which of the following would you consider as a possible cause to these symptoms? 1. uterine rutpure 2. umbilical cord compression 3. uterine prolapse 4. fetal distress

1. uterine rupture

Which of the following are consistent with the diagnosis of preeclampsia? 1. deep tendon reflexes at +1 2. +3 proteinuria on dipstick 3. blood pressure of 160/90 4. gestational age of 17 weeks 5. visual disturbances

2, 3 and 5

After teaching a woman who is post-op from a D&C for gestational trophoblastic disease, which statement indicates that the nurse's teaching was successful? 1. I will only need a have my beta hcg level check two more times. 2. I will need to use my birth control pills for at least a year. 3. I can resume intercourse in 6 weeks. 4. I will need to start antihypertensive medications because of my blood pressure.

2. I will need to use my birth control pills for at least a year.

A primigravida of 28 years of age is admitted to the antepartum unit with a diagnosis of hyperemesis gravidarum (HEG). Nursing care should revolve around which of the following? 1. 2200 kcal regular diet 2. intravenous hydration 3. psychotherapy 4. quarantine from family

2. IV hydration

A nurse is monitoring a client in labor. The nurse suspects umbilical cord may be compromised. Which of the following would be noted on the external monitoring tracing if this is the case. 1.Late decelerations 2.Variable decelerations 3.Absent contractions 4.early decelerations

2. Variable decelerations

A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse would want to be alert for which of the following complications in the newborn? 1. Facial palsy 2. Cephalohematoma 3. respiratory rate of 55 bpm 4. a dislocated shoulder

2. cephalohematoma

A primary care provider prescribes medications for a 30 week pregnant woman in preterm labor whose cervix is 4cm. Which of the following orders would the nurse question? 1. ampicillin IV 2. ephedrine IM 3. bethmethasone IM 4.magnesium sulfate IV piggyback

2. ephedrine IM

The nurse is assessing the external fetal monitor on a mom in transition phase and notes the following: FHR of 155 bpm with variable decelerations. Which action should the nurse prioritize at this time? 1. call the provider for further orders as this is not normal 2. have her turn to the left lateral position 3. monitor the patient and document these normal findings 4. immediately administer 2 liters of oxygen by nasal canula

2. have her turn to the left lateral position

Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother? 1. hypobilirubinemia 2. hypoglycemia 3. hyperglycemia 4. hypercalemia

2. hypoglycemia

A nurse is teaching a prenatal client who has class III heart failure .The nurse determines the teaching has been effective when the client states which statement? 1. a should eat foods that are low in iron as they can cause constipation. 2. i will call the clinical when I experience dyspnea at night. 3. I should continue my physical activity, even when I begin to feel fatigued 4. I will take an antibiotic throughout my pregnancy

2. i will call the clinical when I experience dyspnea at night.

The nurse is caring for a pregnant client with fallopian tube rupture from an ectopic pregnancy. Which intervention is the priority for this client? 1. monitor the FHR 2. monitor the clients vital signs & bleeding 3. monitor the clients beta HCG 4. monitor the mass with transvaginal U/S

2. monitor the clients vital signs & bleeding

Which of the following should the nurse be alert for when caring for a mom on the postpartum unit who required a forceps-assisted birth? 1. cleft palate 2. perineal hematoma 3. preeclampsia 4. postpartum mastitis

2. perineal hematoma

Which of the following correctly identifies what an early deceleration looks like on a fetal monitor tracing? 1. the fetal heart rate rises 15 bpm above baseline during each contraction 2. the deceleration mimics the beginning and end of the contraction 3. the deceleration is less than 30 seconds and looks like a V or W. 4. the deceleration ends 30 seconds after the contraction itself ends

2. the deceleration mimics the beginning and the end of the contraction

A client at 32 weeks' gestation is admitted to labor and delivery with vaginal bleeding and contractions. The physician orders a course of two steroid injections. The client asks why she needs steroids. What is the best explanation by the nurse? 1. The steroids will create a layer of fat to help with temperature regulation. 2. the steroids speed up the development of the lungs 3. the steroids will increase the baby's muscle mass. 4. the steroids will help to slow the development of infection.

2. the steroids speed up the development of the lungs

A young woman presents at the emergency department reporting lower abdominal cramping and spotting at 12 weeks' gestation. There is positive fetal heart tones on the ultrasound. The primary care provider performs a pelvic examination and finds that the cervix is closed. What does the care provider suspect is the cause of the cramps and spotting? 1. non viable fetus 2. threatened abortion 3. incomplete abortion 4. missed abortion

2. threatened abortion

The nurse is caring for a client who was in a motor vehicle accident and suffered trauma to her abdomen. The nurse suspects a placenta abruption after seeing which pattern on the fetal monitor? 1. Variable decelerations 2. moderate variability 3. late decelerations 4. early decelerations

3. Late decelerations

A multigravida client at 31 weeks' gestation is admitted with confirmed preterm labor. As the nurse continues to monitor the client now receiving magnesium sulfate, which assessment findings will the nurse prioritize and report immediately to the RN or health care provider? 1. uterine cramping 2. low potassium 3. respiratory depression 4. hypertension

3. Respiratory Depression

Which of the following patients would the nurse question the provider's orders on beginning a Pitocin induction? 1. an 18 year old primipare client at 41 weeks with support from a doula 2. a 33 year old female who at 34 weeks gestation with twins 3. a 27 year old primipara who has been in early labor for the last 4 hours 4. a 30 year old at 39 weeks not in labor who has been ruptured for over 18 hours.

3. a 27 year old primipara who has been in early labor for the last 4 hours.

A nurse is caring for a pregnant mom just diagnosed with gestational diabetes. Which meal should the nurse recommend for her as part of her plan of care? 1. pizza, corn, and orang slices 2. steak, baked potato with butter and ice cream 3. baked turkey, brown rice and strawberries 4. baked chicken, green beans, and chocolate cake

3. baked turkey, brown rice, and strawberries

A G2 P1001 gestational diabetic mom woman at 39 weeks with a Bishops score of 10 is being induced.Which statement should the nurse anticipate prescribed by the midwife? 1. foley urinary catheter 2. cytotec 25 mcg po 3. oxytocin infusion at 2mu/hr 4. bethamethasone IM injection

3. oxytocin infusion 2mu/hr

A pregnant woman with preeclampsia is to receive magnesium sulfate IV. Which assessment should the nurse prioritize before administering a new dose? 1. anxiety level 2. pulse rate 3. patellar reflexes 4. blood glucose level

3. patellar reflexes

A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor who just ruptured her membranes. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following would be the initial nursing action? 1. turn on the warmer on to prepare for a vaginal delivery 2. reassure her that this is a normal finding after a rupture 3. place her in the knee to chest 4. collect her vital signs and call the physician for a status update

3. place her in the knee to chest

You are caring for a laboring patient and notice that she is having late decelerations on the monitor strip. Which of the following can be associated with this fetal heart pattern? 1. cord wrapped around the fetal neck 2. fetal head compression 3. preeclampsia 4. transition phase of labor

3. preeclampsia

Which of the following should the nurse avoid conducting on a patient who presents cramping and painless red vaginal bleeding? 1. NST 2. urinalysis 3. sterile cervical examination 4. abdominal ultrasound

3. sterile cervical exam

A G1 P0 at 42 weeks is being assessed for induction of labor.She currently has no contractions.Her Bishop score is 5. Which of the following should the nurse anticipate for this patient? 1. administration of oxytocin intravenously at 10 mu/minute 2. preparation for a cesarean birth 3. preparation for an immediate amniotomy 4. administration of a prostaglandin agent

4. administration of a prostatglandin agent

A nurse is admitting a patient who has severe preeclampsia at 35 weeks and is reviewing the provider's orders.Which of the following orders should the nurse question? 1. obtain a daily weight 2. assess deep tendon reflexes every hour 3. continuous fetal monitoring 4. ambulate twice daily

4. ambulate twice daily

A laboring patient in second stage has pushed the fetal head out. The physician determines the fetus is experiencing shoulder dystocia. Which of the following interventions can the nurse use to help with delivering the shoulders? 1. encouraging lamaze breathing techniques 2. applying pressure on the fundus 3. positioning the woman in the upright position 4. assisting with suprapubic pressure.

4. assisting with suprapubic pressure

While assessing the progress of the labor, the nurse explains that the fetal heart rate variability is marked. Which explanation is best to use with the parents? 1. Fetal heart rate flucuates less than 5 beats per minute 2. fetal heart rate flucates range is undetectable 3. fetal heart rate flucuates from 6 to 25 beats per minute 4. fetal heart rate flucuates more than 25 beats per minute

4. fetal heart rate flucuates more than 25 beats per minute

You are caring for a healthy G4P3003 at 6cm/80%/-1. She is getting uncomfortable and is now requesting an epidural for pain. The midwife wrote an order to give the epidural as requested. What would your next intervention be? 1. Teach her other coping methods since this is her fourth baby 2. Discuss how this will increase her risk of having getting pitocin and vacuum delivery. 3. Advise the patient she will have to wait until she is in more active labor for an epidural. 4. notify the anesthesiologist and begin to bolus her about 1 liter of normal saline

4. notify the anesthesiologist and begin to bolus her about 1 liter of normal saline

When admitting a pregnant woman with fetal demise to a laboring room, which of the following should be important to keep in mind? 1. discussing with the mom the various types of birth control available 2. starting the pitocin induction before discussing an epidural option 3. keeping her npo as her risk for a c-section is increased 4. placing the mom in a private room away from the nursery`

4. placing the mom in a private room away from the nursery`

A client who gave birth several hours ago is experiencing postpartum hemorrhage on your shift. She had a cesarean birth and received deep, general anesthesia. She has a history of postpartum hemorrhage with her previous births. The blood is a dark red. Which is most likely the cause of the hemorrhage in this client? 1. general anesthesia 2. retained placental fragments 3. cervical laceration 4. prolonged second stage

4. prolonged second stage

Your G2 P0010 patient at 28 week is scheduled to obtain a repeat indirect Coombs' test.Which of the following is the most appropriate response for this patient? 1. since she is rH positive, this will determine if she rH negative antibodies from her previous pregancies 2. this will help to determine the amount of rhogam her infant needs after birth. 3. this will help to determine the amount of rhogam she needs to get after birth. 4. since she is rH negative, this will determine if she has rH positive antibodies from her previous pregnancy.

4. since she is rH negative, this will determine if she has rH positive antibodies from her previous pregnancy.

Which of the following should the nurse notify the obstetrician about on a patient admitted with severe preeclampsia and placed on magnesium sulfate? 1. decreased liver enzymes 2. elevated white blood cells 3. deep tendon reflexes at +2 bilateral 4. thrombocytopenia

4. thrombocytopenia

Oxytocin (Pitocin) 5 milli-units/min is prescribed for a client with an ineffective contraction pattern. To administer the prescribed dosage, the nurse adds 20 units of oxytocin to 500 ml of Ringer's Lactate.The infusion pump should be set to deliver how many ml/hour?______ ml/hr

7.5 mL/hr

Anna is admitted to labor for preeclampsia and has MgSo4 ordered at 30grams in 1000 ml of D5W.After Anna's infusion of Magnesium Sulfate initial bolus is completed, you have an order for a maintenance rate of 0.5 grams/hour.What should the pump be set at for this maintenance dose? _______ml/hour

?

Anna was admitted to labor unit for preeclampsia.A magnesium sulfate infusion was ordered at 30 grams in 1000 ml of D5W.She has a 4 gram bolus ordered over 30 minutes. What is the bolus rate? _________ ml/hour

?

Which of the following factors are risk factors for an umbilical cord prolapse after spontaneous ruptured membranes? 1. vertex is at -2 station 2. fetus is macrosomic 3. she is having a threatened abortion 4. fetus is in breech presentation 5. she has polyhdramnios

?

You are conducting patient teaching with a 28 weeks' gestation female positive for gestational diabetes mellitus (GDM). Which of the following would be important to include? 1. she is not at risk fro developing gestational diabetes with her next pregnancy 2. her baby will develop type 2 diabetes 3. she will be scheduled for C/section at 39 weeks. 4. she is at risk for developing type 2 diabetes later in life.

?

A G2P1 V-BAC patient is receiving an oxytocin infusion for labor induction develops contractions that occur every 3 to 4 minutes but are lasting about 80 seconds in duration. When palpating the uterus, you note that the resting tone remains hard to palpation. Which action would be most appropriate at this time? 1. continue to monitor contractions and fetal heart rate as this is normal 2. assist the patient to the shower for pain management 3. slow the oxytocin infusion to every 60 mins. 4. stop the oxytocin infusion

stop the oxytocin (tachysystole)