NUR 230 exam 1 clicker questions
A client reports her obstetric history as follows: #1 Stillbirth at 39 weeks, #2 Viable male at 38 weeks, #3 viable female at 32 weeks, #4 8-week ectopic pregnancy, # 5 Viable female at 38 weeks, and currently pregnant with triplets at 32 weeks. What is her gravidity and parity. Select all that apply. A.G6 P6 B.G6 P3113 C.G6 P4122 D.G6 P4 E.G5 P5 F.G6 P4216
B.G6P3113 D.G6 P4
Based on the following pelvic and/or fetal assessment, which should MOST likely lead to cesarean delivery? A.Anthropoid, ROA B.Gynecoid, RSA C.Platypelloid, LOA D.Android, RMA
B.Gynecoid, RSA
On examination the nurse notes the cervix is 8 cm/90%/+2, What is the interpretation of the client's labor? A.Fetal descent is going well. B.Vaginal delivery will occur in 1 hour C.Fetal head is not engaged D.External rotation is complete
A.Fetal descent is going well.
What causes early decelerations? A.Head compression B.Cord compression C.Utero-placental insufficiency D.Polyhydramnios
A.Head compression
Which of the following prenatal tests is a lab evaluation of an aspect of maternal nutrition? A.Hemoglobin and Hematocrit B.Maternal serum alpha fetoprotein C.Antibody screen D.Urine culture
A.Hemoglobin and Hematocrit
Gestational Wheel: The 1st day of Jan's LMP was 9-8-2019. 1. How many weeks gestation is she TODAY if today's date is 4-15-20? 2. What is her EDC? (ch 14 slide 13)
1. She is 31 1/7 weeks gestation. 2. Her EDC is 6-16-20
***A client is at approximately 20 weeks gestation. Where would you expect the fundal height to be located? A.At the level of the umbilicus B.At the level of the symphysis pubis C.Between 24-34 centimeters with a measuring tape D.Midway between the umbilicus and the symphysis pubis
A. At the level of the umbilicus
Which of the following are NOT SAFE to eat in pregnancy? SATA •1. Home made Caesar salad dressing. •2. Bologna sandwich •3. Cheddar cheese •4. Canned smoked salmon •5. Brie cheese •6. Deli turkey sandwich
1,2,5
Women who are vegans and who do not drink soy milk should supplement their diets with 4mg Vitamin B12, 1200mg calcium, and 10 mg Vit. D. A.True B.False
A.True
In evaluating the intensity of a contraction, the nurse palpates the fundus and describes a mid to moderate contraction as the surface of a: A.Nose B.Chin C.Cheek D.Forehead
B.Chin
Fetal circulation is different from newborn circulation. The most accurate statement related to the function of fetal circulation is A.Premature shunts allow mixing of oxygenated and deoxygenated blood to enter the lungs for oxygenation and then to be circulated to the peripheral tissues. B.There is direct mixing of maternal and fetal blood which allows the fetus to receive adequate oxygenation and perfusion. C.Most blood bypasses the lungs via the ductus vensosus. D.By diffusion, the placenta allows for perfusion and adequate nutrients to be supplied to the developing fetus.
D.By diffusion, the placenta allows for perfusion and adequate nutrients to be supplied to the developing fetus.
A woman who is 39 weeks gestation is in labor. Her vital signs are stable, cervical exam is 6 cm/80%/+1, and the FHR is a category 3 tracing. The client is crying and says she doesn't think that she can continue any further. What is the nurse's priority at this time? A.Explain to the client... It's normal to be anxious about labor, let's talk about what makes you afraid." B.Recommend that the client have an epidural placed. C.Reassure the client that she is doing a great job and help her to focus on her breathing. D.Change the client's position and administer Oxygen at 10 L via facemask.
D.Change the client's position and administer Oxygen at 10 L via facemask.
What are some alternatives to pain medication and an epidural during labor? SATA A.Hypnosis B.Sterile water injections C.Cesarean section D.Peanut Ball E.Guided imagery F.Frequent position changes
A.Hypnosis B.Sterile water injections D.Peanut Ball E.Guided imagery F.Frequent position changes
The nurse notes the infant position as LSA. Where is the best place to place the ultrasound monitor to obtain fetal heart tones? A.Left upper quadrant B.Left mid quadrant C.Left lower quadrant D.Right upper quadrant
A.Left upper quadrant
What causes Variable decelerations? A.Head Compression B.Cord Compression C.Uteroplacental Insufficiency D.Hypotension associated with the epidural
B.Cord Compression
A client in the first trimester of pregnancy tells the nurse, "I urinate frequently and am not able to hold urine for very long." What information is relevant to impart to this client? A.Space out your fluid intake by drinking approximately 100 ml every 4 hours B.Alternate with heat and ice in the area over the bladder C.Educate the client on how to perform Kegel exercises D.Educate the client on how this will resolve as the pregnancy progresses
A.Educate the client on how to perform Kegel exercises
***A nurse counsels a pregnant woman about appropriate weight gain during pregnancy for a singleton pregnancy. The woman's weight is 55 Kg. and she is 1.6 m tall. The nurse feels confident that the woman has a good understanding of this topic when she states: A."I should gain between 25-35 pounds over the course of the pregnancy." B."I should experience consistent and equal weight gain during the pregnancy." C."I should gain between 15-25 pounds over the course of the pregnancy." D."I should consume nutrient dense foods during the pregnancy and aim the total calories to 1,200-1,800 per day in the second and third trimesters."
A."I should gain between 25-35 pounds over the course of the pregnancy."
When examining the difference between true and false labor, which statement is most accurate? A."In true labor, my contractions will progressively increase in intensity." B."In true labor, I will lose my mucous plug." C."In false labor, I will only dilate to 1 cm." D."In false labor, I will feel contractions in my back."
A."In true labor, my contractions will progressively increase in intensity."
Oxytocin/Pitocin administration is NOT acceptable in certain situations? Select all that apply. A.Before delivery with a scheduled Cesarean Section B.Latent phase of Stage 1 C.Significant variable decelerations D.Early decelerations E.Late decelerations F.End of Stage 3
A.Before delivery with a scheduled C.Significant variable decelerations E.Late decelerations
The nurse is aware of possible LATE complications following epidural placement including A.Bladder distension B.Labile blood pressure readings C.One sided pain relief D.Stagnation of labor progress
A.Bladder distension
The nurse is teaching a pregnant client who complains of vomiting about the use of dry carbohydrate in the morning. The client asks the nurse, "My husband has similar problems. Will it be useful for my husband as well?" What can the nurse interpret that the husband has? A.Vena cava syndrome B.Couvade syndrome C.Carpal tunnel syndrome D.Emotional lability
A.Couvade syndrome
During the latent phase, A client diagnosed with spontaneous rupture of membranes (SROM) asks the nurse if she can walk for 30 minutes. Assessment findings include vaginal exam (2 cm, 50%, -2 station); FHR baseline is 160 and reactive; and contractions every 4-6 minutes and strong in intensity. What is the most appropriate nursing action A.Deny the request to ambulate for the time being B.Leave the client on the FHR monitor for another 30 minutes and reassess C.Allow the client to ambulate for 30 minutes D.Assess the maternal temperature
A.Deny the request to ambulate for the time being
The THIRD Leopold Maneuver allows the examiner to A.Determine the presenting part B.Determine if the head or breech is in the fundus C.Determine whether the baby is in a face presentation D.Palpate the baby's back versus arms and legs.
A.Determine the presenting part
The nurse notes the fetal heart rate baseline at 115 with moderate variability and decelerations that drop abruptly 30 beats below baseline for 40 seconds during and between contractions. The return to baseline is rapid. What is the priority? A.Discontinue the Oxytocin/Pitocin B.Continue to monitor C.Prepare the client for a cesarean D.Notify the health care provider
A.Discontinue the Oxytocin/Pitocin
What are the necessary nursing interventions for severe, repetitive variable decelerations? SATA A.Oxygen at 10 L via non-rebreather Facemask B.Scalp stimulation C.Change maternal position D.Administer Lactated Ringer's IV bolus E.Decrease Oxytocin/Pitocin F.Amnio-infusion administration
A.Oxygen at 10 L via non-rebreather Facemask C.Change maternal position D.Administer Lactated Ringer's IV bolus F.Amnio-infusion administration
A multigravida presents to the labor and delivery triage area and states that she feels as though she needs to push. What is the priority? A.Perform a sterile cervical exam B.Place the client on the EFM C.Assess the client's vital signs D.Notify the health care provider
A.Perform a sterile cervical exam
A client is in labor with an epidural and Oxytocin/Pitocin infusing. Review the data in the Chart. What will help this situation? (everything looks good except for VE has not changed) A.Recommend a Cesarean Section B.Place a peanut ball between the mother's legs C.Place an indwelling Foley catheter D.Increase the Oxytocin/Pitocin rate
A.Place a peanut ball between the mother's legs (to enhance VE)
Which position or action would the nurse suggest for labor if the pelvic outlet needs to be increased? Select all that apply A.Squatting B.Encourage the use of an episiotomy C.Make sure the client's bladder is empty D.Use a peanut shaped ball between the mother's legs in various positons E.Place the client on her hands and knees F.Use of internal fetal and contraction monitors
A.Squatting C.Make sure the client's bladder is empty D.Use a peanut shaped ball between the mother's legs in various positons E.Place the client on her hands and knees
The nurse is assisting a client who is prepared to use the paced breathing method. What information is accurate? A.Take a deep relaxing breath with the beginning of the contraction. B.Exhale all the air that she is holding as the contraction builds. C.Have her pant at the beginning of the contraction and take cleansing breaths with the acme of the contraction. D.Encourage her to take 3 long breaths with the beginning of the contraction, 2 short breaths in the middle, and one long exhalation with the descent of the contraction.
A.Take a deep relaxing breath with the beginning of the contraction.
On examination the nurse notes the cervix is 6 cm/100%/0. What is the interpretation of the client's labor? A.The client is in active labor and the baby is engaged. B.The client is in transition and the baby is engaged. C.The client is in latent labor and the baby is not engaged. D.The client is in active labor and the baby is not engaged.
A.The client is in active labor and the baby is engaged.
A 19 year old client reports to the nurse that she has become sexually active with several partners over the last three weeks. She began having intercourse at age 16. She would like to go on birth control as she does not desire to become pregnant at this time. She reports that her last period was approximately 2 weeks ago. Before prescribing a birth control method, what important tests are needed? SATA A.Urine and/or serum pregnancy test B.Blood type C.Pap testing D.Hemoglobin E.Hematocrit F.Sexually transmitted infections screening
A.Urine and/or serum pregnancy test C.Pap testing F.Sexually transmitted infections screening
In the first trimester, which practice by the mother is most concerning? A.Smoking ½ pack of cigarettes every 2-3 days B.Vegan diet and lifestyle C.Occasional consumption of beer and wine on the weekends Sedentary lifestyle
C. Occasional consumption of beer and wine on the weekends
A client just delivered a baby at 39 weeks. She delivered her first child at 38 weeks, second child at 39 weeks, and her third pregnancy was twins delivered at 35 weeks. What is her obstetric history? SATA A.G5 P3205 B.G4 P3105 C.G4 P3205 D.G5P5 E.G4P4 F.G4P3
B. G4P3105 E. G4P4
A nurse overhears a client describing the current development of their 8-week fetus to her partner. The nurse recognizes the client has a good understanding fetal development at this gestation when she describes the fetus as A.resembling a human with internal and external sex organs that have developed. B.having a fairly well-formed body; arms, legs, and digits that are well-formed; and eyes, ears, nose, and mouth that are recognizable. C.having skin that is smooth, scant vernix caseosa, moderate to profuse hair; lanugo on shoulders and upper body only. D.having alveolar ducts and sacs are present in the lungs
B. having a fairly well-formed body; arms, legs, and digits that are well-formed; and eyes, ears, nose, and mouth that are recognizable.
Activities that promote healthy mothers and babies are ideally initiated before the period of critical fetal development. This period occurs between A.3-42 days after fertilization B.17-56 days after fertilization C.39-71 days after fertilization D.48-84 days after fertilization
B.17-56 days after fertilization
A nurse is educating clients about the normal discomforts of pregnancy. Which statements need to be further addressed? SATA A.A client at 30 weeks has a darkened butterfly pigmentation noted on her face B.A client at 34 weeks reports clear watery vaginal discharge and is wearing a pad to catch the fluid C.A client at 24 weeks is complaining of some swelling in her legs and ankles at the end of the day D.A client at 22 weeks is complaining of flank pain and burning upon urination E.A client at 30 weeks who reports feeling uterine cramping that is not relieved with rest F.A client at 10 weeks who says that she vomits frequently and hasn't been able to keep anything down for the last 12 hours.
B.A client at 34 weeks reports clear watery vaginal discharge and is wearing a pad to catch the fluid D.A client at 22 weeks is complaining of flank pain and burning upon urination E.A client at 30 weeks who reports feeling uterine cramping that is not relieved with rest F.A client at 10 weeks who says that she vomits frequently and hasn't been able to keep anything down for the last 12 hours.
An Obstetric clinic nurse would refer which clients to the dietician or educate further on dietary recommendations? A.A 34 5/7 weeks gestation client with a pre-pregnancy BMI of 20 who has gained 20 pounds for the entire pregnancy. B.An insulin dependent diabetic patient at 11 weeks gestation. C.A client at 28 weeks gestation who tells you that she eats about twice a day but cannot quit eating ice chips all day. D.A client in the first trimester who lost one pound in the last four weeks. E.A 20 weeks gestation client with twins who has gained 15 pounds in the last 4 weeks. Pre-pregnancy BMI was 25. F.A client at 8 weeks who reports consuming sushi and deli meat sandwiches 3-4 times a week.
B.An insulin dependent diabetic patient at 11 weeks gestation. C.A client at 28 weeks gestation who tells you that she eats about twice a day but cannot quit eating ice chips all day. E.A 20 weeks gestation client with twins who has gained 15 pounds in the last 4 weeks. Pre-pregnancy BMI was 25. F.A client at 8 weeks who reports consuming sushi and deli meat sandwiches 3-4 times a week.
Which finding indicates normal characteristics of amniotic fluid and the best method to ascertain SROM? A.Clear with a moderate amount of blood, metallic smell; Nitrazine (ph) paper B.Clear with flakes of white, minimal scent; Amnisure test C.Clear with brownish-green substances, anaerobic smell; pooling visualized D.Clear fluid, fishy smell; fern test
B.Clear with flakes of white, minimal scent; Amnisure test
The nurse is caring for a pregnant client who reports fatigue due to anemia. Which intervention helps manage anemia for pregnant clients? A.Advise the client to take frequent rest periods B.Counsel the client on iron rich food sources and nutrient dense food options C.Discuss the use of support systems with the client D.Reassure the client of the transitory nature of fatigue during pregnancy
B.Counsel the client on iron rich food sources and nutrient dense food options
A nurse evaluates the FHR tracing and notes the baseline at 115 with moderate variability, contractions are every 2 minutes with decelerations that drop to the 90's after the acme of the contraction and return to baseline 40 seconds after the end of the contractions. What is the nursing priority? A.Decrease the Oxytocin B.Discontinue the Oxytocin C.Administer Oxygen via nasal cannula D. Perform acoustic stimulation
B.Discontinue the Oxytocin
A nurse is educating clients about foods to AVOID in pregnancy. The client is indicating good understanding of this information when she identifies the following foods...SATA A.Canned chicken B.Home made Caesar salad dressing. C.Cheddar cheese D.Bologna sandwich E.Brie cheese F.Sushi
B.Home made Caesar salad dressing. D.Bologna sandwich E.Brie cheese F.Sushi
The nurse should be aware that the MOST common side-effects/complications of an Epidural are all of the following except: A.Hypotension B.Hypertension C.Increased maternal temperature D.Bladder distension
B.Hypertension
A G2P1 at 40 weeks gestation presents to triage stating "I think I am in labor". In planning care for this client, the nurse should FIRST A.Perform a sterile vaginal exam B.Locate the PMI and place the client on the EFM C.Palpate the strength of the contractions D.Assess maternal vital signs
B.Locate the PMI and place the client on the EFM
The nurse is teaching a group of women about home pregnancy tests. Which instructions are most important to convey to the client for accuracy? Select all that apply. A.Timing of the test is not important. B.Make sure to follow the manufacturer's instructions. C.If the test is positive, then contact your health care provider for follow-up. D.If the test is negative, then contact your health care provider for follow-up. E.If the test is negative and you continue to experience amenorrhea, then repeat the test in one week.
B.Make sure to follow the manufacturer's instructions. C.If the test is positive, then contact your health care provider for follow-up. E.If the test is negative and you continue to experience amenorrhea, then repeat the test in one week.
The nurse is caring for a pregnant client whose pre-pregnant body mass index (BMI) is 23.5. Under which BMI category does the nurse categorize the patient? A.Overweight B.Normal C.Underweight D.Morbidly obese
B.Normal
A client has an epidural placed. See the chart findings below. What is the priority in this scenario? (everything looks good except she hasn't voided in three hours) A.Place a peanut ball between the client's legs B.Perform a bladder scan C.Insert a Foley Catheter D.Bolus the client's IV line with 300 ml of Ringer's Lactate
B.Perform a bladder scan
A client with an epidural in place is not making any progress in labor. The nurse palpates the client's bladder and notes the bladder is distended. What is the most appropriate nursing action? A.Anchor an indwelling Foley Catheter B.Place the client on the bedpan and run water so that she is able to hear C.Assist the client to the restroom to empty her bladder D.Reassess her bladder and cervical exam in an hour
B.Place the client on the bedpan and run water so that she is able to hear
A nurse is explaining probable signs of pregnancy to a client. Which signs are under this category? SATA A.Heart tones noted on an ultrasound B.Positive urine pregnancy test C.Quickening noted by the mother D.Amenorrhea E.Positive Chadwick's sign F.Ballottement
B.Positive urine pregnancy test E.Positive Chadwick's sign F.Ballottement
Many tasks are accomplished in the third stage of labor. SATA A.The onset occurs with regular contractions and ends with delivery of the baby. B.The end of the 3rd stage is when the placenta delivers C.Any perineal tears or lacerations are repaired in this stage D.Consists of the latent, active, and transition phases E.Fundal massage is performed at the end of the third stage F.Begins with pushing and ends with delivery of the baby
B.The end of the 3rd stage is when the placenta delivers E.Fundal massage is performed at the end of the third stage
Which is correct in preparing for a Papanicolaou (Pap) test? A.The specimen for the PAP test should be obtained after the specimens for the cervical infection B.The woman should not douche, use vaginal medications, or have intercourse for 24 hours prior to the test C.A lubricant like petroleum jelly may be used on the speculum D.PAP testing should start at age 18 or when the client becomes sexually active
B.The woman should not douche, use vaginal medications, or have intercourse for 24 hours prior to the test
A nurse is educating a client about some of the physiologic changes that occur with pregnancy. The nurse recognizes the client's need for more teaching when she states A."Urinary tract infections are more common in pregnancy, and sometimes they have no symptoms at all." B."It is normal for my blood pressure to be lower in the second trimester." C."If my pubic bone joint starts to hurt, it may be an early sign of labor and I should call my provider." D."Anemia is more common in the second trimester compared to the first trimester."
C. "If my pubic bone joint starts to hurt, it may be an early sign of labor and I should call my provider."
The client (42 year old mother reports being pregnant for the 5th time. She states that her 1st and 2nd babies were born at 39 weeks gestation. Her 3rd pregnancy ended in a miscarriage at 12 weeks. With her 4th pregnancy, she delivered twins at 32 weeks) now delivers at 41 weeks. How does this change her GTPAL? SATA A.G6P5 B.G5P4116 C.G5P4 D.G5P2115 E.G5 P5 F.G5P3115
C. G5P4 F. G5P3115
The nurse is talking with a 28-year-old client after her normal, annual gynecological exam. The nurse recognizes the client understands when she states: A.I will have another annual exam in 1 year and a pap smear at that time. B.I will have another annual exam in 1 year and a pap smear in 5 years. C.I will return for an annual exam in 1 year and a pap smear in 3 years.
C. I will return for an annual exam in 1 year and a pap smear in 3 years.
A woman enters triage who states she "thinks" she is in labor. Which assessment BEST demonstrates TRUE Labor? A.Findings of Leopold's Maneuvers B.Contraction Strength and intensity C.Change/progress in the SVE D.Fetal Heart Rate accelerations
C.Change/progress in the SVE
Pap testing may be delayed or discontinued in which clients? Select all that apply. A.Women who have never engaged in vaginal intercourse until age 25 B.For women over age 40 who have had less than 3 sexual partners over a 10-year time frame C.Clients who have had a total hysterectomy related to benign lesions D.Women who have a partial hysterectomy related to benign lesions E.Low risk women aged 65-70 years of age F.Once the client is age 30 or greater is in a monogamous relationship and has had 3 consecutive normal results, they may go to every 5 years screening
C.Clients who have had a total hysterectomy related to benign lesions E.Low risk women aged 65-70 years of age F.Once the client is age 30 or greater is in a monogamous relationship and has had 3 consecutive normal results, they may go to every 5 years screening
The blood pressure of a pregnant client at 32 weeks becomes low when the client lies on the back. What would be the best nursing intervention to maintain normal blood pressure in the client? A.Have the client sit on the side of the bed for 5 minutes before rising. B.Start and IV bolus of 500 cc of D5LR C.Encourage the client to turn onto her left side. D.Encourage the client to use extra pillows or a wedge pillow to elevate her upper body when sleeping on her back.
C.Encourage the client to turn onto her left side.
Which of the following actions is CORRECT to assess the characteristics and pattern of uterine contractions? A.Place hand on abdomen below the umbilicus and palpate uterine tone with palm of hand. B.Determine frequency by timing from the beginning of one contraction until the end of the next contraction. C.Evaluate intensity by pressing fingertips into the uterine fundus. D.Place an IUPC when FHR decelerations are present.
C.Evaluate intensity by pressing fingertips into the uterine fundus.
On examination the nurse notes the cervix is 2 cm/50%/-1, What is the interpretation of the client's labor? A.Fetal descent is going well. B.Vaginal delivery will occur in 1 hour C.Fetal head is not engaged D.External rotation is complete
C.Fetal head is not engaged
When assisting a laboring mother into a comfortable position, she requests ambulation/walking. The fetus is vertex and contractions are irregular. Based on this request, the nurse will need to evaluate all of the following EXCEPT: A.Fetal heart rate assessment B.Vaginal exam C.Fetal position D.Amniotic membrane status
C.Fetal position
When assessing fetal station during a vaginal examination the nurse should assess which pelvic structure? A.Cervical OS B.Cervical Effacement C.Ischial Spines D.Ischial Tuberosity
C.Ischial Spines
A nurse is reviewing the fetal heart rate tracing and contraction pattern on a client being triaged for spontaneous labor. The toco monitor is not registering any contractions. The client is tearful and thrashing from side to side. The SVE is 2/50/-2. What is the priority in this scenario? A.Reassure the client that she is doing well with breathing through her contractions. B.Readjust the toco monitor C.Palpate the fundus D.Notify the health care provider
C.Palpate the fundus
A woman is in the second stage of labor and has a spinal block in place for pain management. The nurse obtains the woman's blood pressure and notes that it is 20% lower than the baseline level. Which action should the nurse take? A.Encourage the patient to empty her bladder. B.Stop the IV infusion and notify the Anesthesiologist. C.Turn the client to her left side and increase the IV rate. D.No action is necessary as the drop in blood pressure is an expected finding.
C.Turn the client to her left side and increase the IV rate.
What causes late decelerations? A.Head compression B.Cord compression C.Utero-placental insufficiency D.Eating Veal Chops
C.Utero-placental insufficiency
***Using Nägele's rule, calculate Lori's EDC, based on her LMP of February 13, 2019 A September 6 B September 20 C November 10 D November 20
D November 20
A client gives her LMP as 12/1. Her partner was home from the Army from 12/4-12/14. She had unprotected intercourse, did a lot of binge drinking and smoking marijuana during that time. She has not had any alcohol or smoked marijuana since he left. It is now 1/15 and the client has had a positive pregnancy test. She states "I have always wanted to be a mother but I am scared to death I hurt the baby when I did all that partying in December". The BEST response by the nurse is: A.I will ask your provider to refer you to a geneticist for testing to see if that can ease your mind. B.In about 2.5 months you will have an ultrasound to determine whether the baby has structural abnormalities; I will see if we can move that up a week or two for you. C.You have reason to be concerned. I will ask the doctor to talk with you about the next steps to take. D.If you are sure about your LMP, there is minimal risk that your baby was harmed at that time.
D. If you are sure about your LMP, there is minimal risk that your baby was harmed at that time.
The nurse is teaching the client about dietary sources of folate. Which of the following is the BEST source of dietary folate? A.1 large egg B.½ c. avocado C.½ c. cooked spinach D.1 c. enriched cooked white rice
D.1 c. enriched cooked white rice
The nurse is caring for a female client who recently had an abortion after learning that the fetus had a neural tube defect. The client wants to conceive again and asks the nurse for advice. The nurse consults with the multidisciplinary team. What plan of care is best for this client? A.Advise the client to avoid pregnancy for a year. B.The client will be referred to a genetics counselor. C.The client will be advised to go on a vegetarian diet plan. D.Advise the client to continue to take folic acid supplement every day.
D.Advise the client to continue to take folic acid supplement every day.
Based on the following pelvic and fetal assessment, which should BEST indicate probable success for a vaginal delivery? A.Anthropoid, ROP B.Gynecoid, LSA C.Platypelloid, LOA D.Android, ROA
D.Android, ROA
When caring for a laboring client the nurse notes FHR at 170's up from 150's with moderate variability over the last 15 minutes. Based on this finding the nurse would FIRST: A.Notify the health care practitioner B.Send urine for urinalysis C.Send blood cultures D.Assess the maternal temperature
D.Assess the maternal temperature
***A client is at 28 weeks gestation. Approximately what level would the nurse expect the fundal height to be located? A.At the level of the umbilicus B.At the level of the symphysis pubis C.Between 24-34 centimeters with a measuring tape D.Between 26-30 centimeters with a measuring tape
D.Between 26-30 centimeters with a measuring tape explanation: (After 20 weeks' gestation, fundal height = weeks in gestation +/- 2 cms)
***A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is what? A.Positive urine pregnancy test B.Positive serum pregnancy test C.Maternal report of fetal movement D.Fetal movement noted by the health care provider
D.Fetal movement noted by the health care provider
A nurse palpates a round object in the fundal region of the uterus. The smooth contour of the back is noted on the mother's left side. What is the most likely presentation? A.RSA B.ROA C.LScT D.LSA
D.LSA
A nurse palpates a round object in the fundal region of the uterus. The smooth contour of the back is noted on the mother's left side. What will the FHTs most likely be located? A.RLQ B.LLQ C.RUQ D.LUQ
D.LUQ
The nurse notes on the EFM decelerations that drop 40 beats below baseline after the peak of the contraction and return to baseline 20 seconds after the completion of the contraction. What is the type of deceleration and are there any necessary interventions? A.Late Deceleration, SVE B.Early Deceleration, continue to monitor C.Variable Deceleration, UNCOIL D.Late Deceleration, discontinue Oxytocin
D.Late Deceleration, discontinue Oxytocin
***A client is at approximately 16 weeks gestation. Where would you expect the fundal height to be located? A.At the level of the umbilicus B.At the level of the symphysis pubis C.Between 24-34 centimeters with a measuring tape D.Midway between the umbilicus and the symphysis pubis
D.Midway between the umbilicus and the symphysis pubis
What is the most appropriate nursing intervention for Early decelerations? A.Administer oxygen at 10 L via facemask B.Discontinue Oxytocin/Pitocin C.Increase intravenous fluids D.Perform a sterile vaginal /cervical exam
D.Perform a sterile vaginal /cervical exam
A patient at 33 weeks gestation has been on the external fetal monitor for 40 minutes and the strip is determined to be non-reactive. The nurse suspects that the infant is in a sleep cycle. The priority in this scenario is? A.Notify the HCP immediately B.Instruct the client to ambulate for 30 minutes C.Encourage the significant other to sing to the gravid abdomen D.Perform acoustic stimulation
D.Perform acoustic stimulation
***A client is at approximately 12 weeks gestation. Where would you expect the fundal height to be located? A.Slightly above the umbilicus B.At the level of the umbilicus C.At 12 cm on the fundal measurement D.Slightly above the pubis symphysis
D.Slightly above the pubis symphysis
When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include which actions? A.Coaching the woman to utilize 10-15 second closed glottis bearing down efforts with each contraction. B.The client should begin pushing as soon as the cervix is completely dilated. C.The nurse will consult with the anesthesiologist to make sure the epidural is properly dosed to manage the client's pain. D.The client should push with her urge using a combination of 6-8 second open and closed glottis efforts.
D.The client should push with her urge using a combination of 6-8 second open and closed glottis efforts.
Of the following, what is the most appropriate nursing action when late decelerations are noted on the external fetal monitor? A.Prepare the client for a cesarean section B.Perform acoustic stimulation C.Perform a sterile vaginal/cervical exam D.Turn the client to her left side
D.Turn the client to her left side
A client has experienced a spontaneous vaginal delivery but the placenta has not yet delivered. What stage of labor is the client in? A.Active B.Latent C.Transition D.First E.Second F.Third G.Fourth
F.Third
***A client reports that her last menstrual period was June 18, 2019. What is her estimated date of birth (EDB) when using the Naegle rule?
March 25, 2020
