OB Adaptive Quiz

A community health nurse is planning care for 4 high-risk newborns who were discharged yesterday. Which of the following newborns should the nurse plan to care for first?

A 4-day-old newborn who has an elevated bilirubin level and requires phototherapy

A nurse is teaching a client during the client's first prenatal visit. Which of the following instructions should the nurse include?

A doppler device can detect your baby's heart rate at 12 weeks.

A nurse in a newborn nursery has received reports on 4 newborns. Which of the following newborns should the nurse identify as requiring intervention?

A newborn whose axillary temperature is 36.1C

A nurse is caring for a client who is at 39 weeks gestation and in active labor. Which of the following actions should the nurse include in the plan of care

Check the cervix prior to analgesic administration

A nurse is preparing to provide umbilical cord care for a newborn 12 hours after delivery. Upon inspection, the nurse notes moderate bleeding from a vessel. Which of the following actions should the nurse take?

Check the integrity of the cord clamp

A nurse is planning care for a client who is positive for HIV. Which of the following actions should the nurse take after the baby is born?

Administer the hepatitis B vaccine prior to discharge

A nurse is reviewing recent laboratory values during a prenatal visit for a client who is pregnant. The nurse notes a hemoglobin level of 10g/dL. Which of the following actions should the nurse take?

Advise the client to start iron and vitamin C supplementation

A nurse is discussing epidural anesthesia with a client who is receiving oxytocin to induce labor. Which of the following statements should the nurse make?

An epidural given too early can prolong labor

While caring for a client who is in active labor, a nurse notes late decelerations on the fetal monitor. Which of the following actions should the nurse take?

Apply oxygen at 10L/min via nonrebreather face mask

A nurse is caring for a client who is in the latent phase of labor and is experiencing low back pain. Which of the following actions should the nurse take?

Apply pressure to the clients sacral area during contractions

A nurse is assessing a client who is 14 hr postpartum and has a third-degree perineal laceration. The client's temperature is 37.8C (100F), and her fundus is firm and slightly deviated to the right. The client reports a gush of blood when she ambulates and no bowel movement since delivery. Which of the following actions should the nurse take?

Assist the client to empty her bladder.

A nurse is assessing a client who delivered vaginally 8 hours ago. The nurse notes that the client's fundus is 2 fingerbreadths above the umbilicus and has shifted to the left, and there is a large amount of lochia rubra on the perineal pad. Which of the following actions should the nurse take first?

Assist the client to the toilet

A nurse is caring for an infant who begins displaying manifestations of neonatal abstinence syndrome (NAS). Which of the following actions should the nurse take?

Avoid eye contact during feedings.

A nurse is teaching a parent of a newborn about circumcision care. Which of the following instructions should the nurse include?

Avoid using diaper wipes on the site during diaper changes

A nurse is assessing a newborn who has a congenital diaphragmatic hernia. Which of the following findings should the nurse expect?

Barrel-shaped chest

A nurse at a prenatal clinic is teaching a client how to perform a kick count. Which of the following statements should the nurse include in the teaching?

Before bedtime is a good time to start counting the kicks

A nurse is assessing a pregnant client who is at 38 weeks gestation. The client reports that her breathing has become easier but notes an increased frequency of urination. The nurse should document this occurrence as which of the following?

Lightening

A nurse is caring for a client who is in labor and asks her partner to perform effleurage. The client has on a monitor belt for electronic fetal monitoring. Which of the following instructions should the nurse provide to the client's partner?

Lightly stroke the upper thighs

A nurse is assessing a client who is 3 days postpartum. When examining the client's uterus, which of the following techniques should the nurse use?

Measure the height of the fundus in fingerbreadths in relation to the umbilicus.

A nurse is caring for a client who requests an IUD for contraception. Which of the following findings is a contraindication for this device?

Menorrhagia

A nurse is providing teaching about formula feeding to the guardian of a newborn. Which of the following pieces of information should the nurse include?

Mix 1 scoop of powdered formula with 2 oz of water.

A nurse is preparing to administer an IV infusion of oxytocin for labor induction to a client who is at 41 weeks of gestation. Which of the following actions should the nurse plan to take

Monitor the fetal heart rate every 15 minutes initially

A nurse is assessing a newborn. For which of the following findings should the nurse notify the provider?

Mottling

A nurse is teaching a client who had a vacuum-assisted vaginal delivery. Which of the following statements should the nurse identify as an indication that the client understands the information?

My baby has a higher risk of developing jaundice

A nurse is caring for a client at 36 weeks gestation who has preeclampsia. Which of the following findings should the nurse identify as a priority?

Nonreactive nonstress test

A nurse is teaching a client who is at 10 weeks gestation about self-care management for common discomforts during pregnancy. Which of the following instructions should the nurse include?

Consume frequent snacks to decrease episodes of nausea.

A nurse receives a report for a client who is in labor and is experiencing contractions that are 4 min apart. Which of the following patterns should the nurse expect on the fetal monitor tracing?

Contractions that las for 60 seconds each with a 3 minute rest between contractions

A nurse is discussing contraceptive choices with a client who has a history of thrombophlebitis. Which of the following methods of contraception should the nurse recommend?

Copper intrauterine device

A nurse is assessing a newborn. Which of the following findings should the nurse report to the provider?

Head circumference 28cm (11 in).

A nurse is reviewing the laboratory report of a newborn who has a blood type of B-negative. The mother's blood type is O-positive. The laboratory results indicate the direct antiglobulin test is positive. Which of the following complications should the nurse anticipate?

Hyperbilirubinemia

A nurse is caring for a client labor who has an epidural for pain relief. Which of the following is a complication of the epidural block>

Hypotension

A nurse is teaching a prenatal class about pain management during labor. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

I can apply a heating pad to my back to relieve back pain

A nurse is providing teaching about the rubella immunization to a client who is 24 hours postpartum. Which of the following client statements indicates an understanding of the teaching?

I should be careful to avoid becoming pregnant within the next month.

A nurse is providing nutritional teaching for a pregnant client who had a prepregnancy body mass index (BMI) of 38. Which of the following statements by the client demonstrate an understanding of the teaching about her recommended weight gain during pregnancy?

I should plan to gain 5 to 9.1 kg during my pregnancy

A nurse is providing discharge teaching about circumcision care to the parent of a newborn who has undergone a Gomco clamp procedure. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

I will apply petroleum jelly to my baby's penis for the first few days

A nurse is preparing to administer naloxone to a newborn. Which of the following conditions can require administration of this medication?

IV narcotics administered to the mother during labor

A nurse is providing education for a pregnant client about symptoms that should be reported immediately to the provider. Which of the following client responses indicates an understanding of the teaching?

If I notice that my eyes are puffy, I should call my provider.

A nurse is monitoring a newborn for indications of septic shock. Which of the following findings should the nurse expect if the newborn develops this complication?

Decreased blood pressure

A nurse is assessing a client who is at 26 weeks of gestation and has mild preeclampsia. Which of the following findings should the nurse report to the provider?

Deep tendon reflexes 4+

A nurse is talking with a client during her initial prenatal visit. The client reports a history of trisomy 13 syndrome in her family and is concerned her fetus might be at risk. Which of the following statements should the nurse provide?

If you sign an informed consent form, we can provide genetic screening to see if your baby has this disorder

A charge nurse is providing teaching for a newly hired nurse about the potential side effects of an epidural anesthetic for a laboring client. Which of the following effects should the charge nurse include in the teaching?

Impaired placental perfusion

A nurse is providing discharge teaching to a client following the removal of a hydatidiform mole. Which of the following statements should the nurse include in the teaching?

Do not become pregnant for at least 1 year.

A nurse is teaching a female client about nutrition during pregnancy. Which of the following instructions should the nurse include in the teaching?

Do not eat swordfish, shark, or king mackerel while you are pregnant

A nurse is assessing a client who is at 36 weeks of gestation. Which of the following manifestations should the nurse recognize as a potential prenatal complication and report to the provider?

Double vision

A nurse is preparing to help with a vacuum-assisted birth. Which of the following actions should the nurse plan to take?

Inform the client that caput succedaneum resolves in a few days

A nurse is assessing a newborn at birth who was delivered at 32 weeks gestation. Which of the following findings should the nurse anticipate?

Extended extremities

A nurse is caring for a client who is in labor and is receiving an infusion of oxytocin. The nurse should monitor the client for which of the following potential adverse effects?

Fetal asphyxia

A nurse is caring for a client who is in labor. Which of the following assessment findings should the nurse report to the provider?

Fetal heart rate baseline of 90 bpm

A nurse in an antepartum clinic is caring for a client who is at 2 weeks gestation. Which of the following findings should the nurse report to the provider?

Frequent headaches

A nurse is caring for a client who is scheduled to receive a continuous IV infusion of oxytocin following a vagina birth. Which of the following assessment findings should the nurse monitor to evaluate the effectiveness of the medication

Fundal consistency

A nurse is caring for a client who is scheduled to receive a continuous IV infusion of oxytocin following a vaginal birth. Which of the following assessment findings should the nurse monitor to evaluate the effectiveness of the medication?

Fundal consistency

A nurse is caring for a client who is pregnant and has a rupture of membranes. The nurse notes the presence of meconium-stained fluid. Which of the following actions should the nurse take?

Gather equipment for neonatal resuscitation

A nurse is reviewing risk factors for postpartum depression with a newly licensed nurse. Which of the following risk factors should the nurse include?

Gestational diabetes

A nurse is caring for a newborn. The nurse should obtain informed consent before taking which of the following actions?

Giving the hepatitis B vaccine

A nurse is reviewing the laboratory findings for 4 clients. Which of the following infections should be reported to the public health department?

Gonorrhea

A nurse is providing education to a female client of child-bearing age. The nurse should state that which of the following structures expels the mature ovum?

Graafian follicle

A nurse is caring for a client who is using patterened-pace breathing during the first stage of labor. The client reports a lightheaded feeling and tingling of the fingers. Which of the following actions should the nurse take?

Have the client breathe into a paper bag

A nurse is caring for a client in active labor whose fetus is in a persistent occiput posterior position. Which of the following actions should the nurse take to promote rotation of the fetal head

Instruct the client to squat during contractions

A nurse is teaching a group of clients who are pregnant about vitamin K for newborns. Vitamin K helps prevent which of the following conditions in a newborn?

Intracranial hemorrhage

A nurse is planning care for a newborn who was born at 30 weeks gestation. The nurse should plan to assess the newborn for which of the following potential complications associated with prematurity?

Intraventricular hemorrhage

A nurse is caring for a client in the latent stage of labor who is reporting a pain level of 4 on a scale of 1 to 10. Which of the following actions should the nurse take?

Lead the client in relaxation breathing techniques

A nurse at a prenatal clinic is assessing an adolescent who is pregnant and is visiting the clinic for the first time. Which of the following factors is the nurse's priority to evaluate?

Nutritional status

A nurse is caring for a client who believes she may be pregnant. Which of the following findings should the nurse identify as a positive sign of pregnancy?

Palpable fetal movement

A nurse is providing care for a client who is in the second stage of labor. The fetal heart tracing indicates multiple variable decelerations. Which of the following actions should the nurse take?

Prepare an amnioinfusion

A nurse is reviewing the laboratory values of a client who is pregnant and has a low progesterone level. Which of the following complications should the nurse expect?

Preterm labor

A nurse is performing an initial physical assessment of a newborn following a vaginal birth. Which of the following findings should the nurse report to the provider?

Small, pinpoint, reddish-purple spots on teh chest

A nurse is preparing to perform Leopold maneuvers on a client who is in labor. Which of the following actions should the nurse plan to take?

Stand at the client's right side if the nurse is right-handed

A nurse is teaching a client about physiological changes that can occur with menopause. Which of the following changes should the nurse include?

Stress incontinence Can occur due to the shrinking of the uterus, vulva, and distal portion of the urethra.

A nurse is teaching a client who is in the third trimester of pregnancy and has herpes genitalis. Which of the following instructions should the nurse include?

Talk with your doctor about a prescription for acyclovir to treat your symptoms

A nurse is planning care for a client in active labor whose fetus is in an occipital brow presentation. Which of the following complications should the nurse anticipate as a result of this fetal presentation?

Prolonged labor

A nurse is providing care to a client who is 2 hours postpartum and is receiving an oxytocin IV. The client asks the nurse, "why is there so little bleeding?" which of the following responses should the nurse make?

The bleeding is minimal until I discontinue your IV medication

A nurse is caring for a client who is postpartum and reports that her episiotomy incision is pulling and stinging. Which of the following actions should the nurse take?

Provide a sitz bath with warm water for the client

A nurse is assessing a client who is at 34 weeks gestation and has a cardiac disorder. The nurse should notify the provider about which of the following assessment findings?

The client reports a cough

A nurse is assessing a client at 27 weeks of gestation. The client has placenta previa and reports vaginal bleeding. Which of the following additional manifestations should the nurse expect?

The fundal height measures greater than gestational age

A nurse is assessing the moro response of a newborn. Which of the following findings should the nurse expect?

The legs move in a similar pattern of response to the arms

A nurse us teaching the guardian of a newborn about caring for the newborns umbilical cord. For which of the following reasons should the nurse instruct the guardian to avoid using antimicrobial agents on the cord?

They can cause delayed cord separation.

A nurse is preparing to administer meperidine hydrochloride to a client who is in labor. Which of the following statements should the nurse make to the client?

This medication can make you sleepy

A nurse is preparing a client who is in labor for the insertion of an intrauterine pressure catheter. The client asks why this type of monitoring is needed. Which of the following responses should the nurse make?

This type of monitoring will allow us to measure the intensity of your contractions

A nurse is assessing a 2-day- old newborn and notes an egg-shaped, edematous, bluish discoloration that does not cross the suture line. Which of the following pieces of information should the nurse provide to the mother when she asks about this finding?

This will resolve in 3 to 6 weeks without treatment

A nurse is performing a physical assessment of a full-term newborn and eliciting the Moro reflex. Which of the following movements are expected responses to this reflex? (select all that apply.)

Thumb and forefinger forming a "c" legs extending before pulling upward Abduct arms and legs form a complete embrace after startling and return to flexion and movement

A nurse is caring for a client in labor whose cervix is dilated to 9 cm. She is experiencing strong contractions every 2 min lasting 75 sec. The nurse should recognize that the client is in which of the following stages of labor?

Transition phase of first stage

A nurse is caring for a client who is at 16 weeks gestation and has severe iron deficiency anemia. The provider prescribes an injection of iron dextran IM. Which of the following methods should the nurse use to administer the medication?

Use a 20-gauge needle and administer the medication using the Z-track method.

A nurse at a family-planning clinic is preparing to teach a class about how to use a diaphragm. Which of the following pieces of information should the nurse plan to include in the teaching?

Use spermicidal jelly whenever you use your diaphragm.

A nurse is caring for a client who is in labor. A vaginal examination reveals the following findings: 2 cm, 50%, +1, right occiput anterior (ROA). Based on this information, which of the following fetal positions should the nurse document in the medical record?

Vertex

A nurse is reinforcing teaching about nutritional requirements during lactation for a client who is planning to breastfeed. Which of the following nutrients should the client increase during lactation?

Vitamin C

A nurse is preparing to perform a heel stick on a newborn. Which of the following actions should the nurse take?

Warm the heel with a warm washcloth prior to the procedure

A nurse is providing teaching about a newborn baths to a client who is 2 days postpartum. Which of the following pieces of information should the nurse include

Wash newborns face with plain warm water

A nurse is monitoring a newborn who is receiving phototherapy. The nurse should identify which of the following findings as requiring intervention?

Weight loss of 12% of birth rate

A nurse is admitting a client who is in post-term labor. Which of the following statements should the nurse identify as the priority?

When my water broke, it was not clear

A nurse is caring for a client who is at 35 weeks of gestation and is scheduled to undergo an amniocentesis. Which of the following statements should the nurse make?

You will feel some mild discomfort during the procedure

A nurse in a clinic is providing teaching to a client who is at 37 weeks of gestation and is scheduled for an external cephalic version. Which of the following statements should the nurse make?

You will receive a medication to relax your uterus prior to the procedure

A nurse is providing teaching for a postpartum client who is breastfeeding. Which of the following pieces of information should the nurse include in the teaching?

Your milk supply will noticeably increase in volume around the third or fourth day after delivery.

A nurse is caring for a client who is in labor. The nurse decides to switch from intermittent auscultation to continuous fetal monitoring. Which of the following data can be only obtained from continuous electric fetal monitoring?

determination of variability

A nurse is assessing a client who is pregnant and reports increased nasal stuffiness. The nurse should inform the client that which of the following hormones is responsible for this discomfort?

estrogen

A nurse is assessing a newborn. Which of the following findings should the nurse identify as an indication of recent maternal heroin use?

incessant crying

A nurse is assessing a 7-month-old infant during a well-child visit and notes the presence of a full Moro reflex. For which of the following conditions should the nurse screen the infant?

neurological disorder

A nurse is assessing a client who is 2 days postpartum. In which of the following locations should the nurse expect to locate the clients fundus?

3 cm below the umbilicus

A nurse is caring for a client who is pregnant with a male child and expresses concern to the nurse about the possibility of the child having hemophilia. The client is a carrier of the gene mutation for this condition. Which of the following percentages represents the chance that the child will have this disorder?

50%

A nurse is caring for a client who is in labor and received meperidine for pain 1 hr prior to entering the second stage of labor. Which of the following actions should the nurse take?

Assess the newborn for respiratory depression

A nurse is caring for a client who reports intestinal gas pain following a cesarean section. Which of the following actions should the nurse take?

Assist the client to ambulate in the hallway

A nurse is assessing a client before administering the Hepatitis B vaccine. Which of the following allergies should the nurse identify as a contraindication to receiving this vaccine?

Baker's yeast

A nurse is caring for a client who has a prescription for naloxone. Which of the following is the intended action of the medication in relation to the CNS?

Block the effects of narcotics on the CNS

A nurse is assisting a client who is 4 hr postpartum to get out of bed for the first time. The client becomes frightened by a gush of dark red blood from her vagina. Which of the following statements should the nurse make in response?

Blood pools in the vagina when you are lying in bed.

A nurse is caring for a client who is in preterm labor and is receiving magnesium sulfate. The client begins to show indications of magnesium sulfate toxicity. Which of the following medications should the nurse prepare to administer?

Calcium gluconate

A nurse is caring for a client who is at 39 weeks gestation and shows manifestations of labor. Which of the following findings will alert the nurse that the client is in true labor?

Changes in cervical dilation or effacement

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

Dark red vaginal bleeding

A nurse is reviewing the laboratory findings of a 24-hour-old newborn. Which of the following findings should the nurse report to the provider?

Hemoglobin 12 g/dL

A nurse is caring for a client who is scheduled to receive a spinal anesthetic. Which of the following actions should the nurse plan to perform?

Infuse a 500mL bolus of 0.9% sodium chloride immediately prior to the procedure

A nurse is caring for a client who is 3 days postpartum and has chosen to formula feed her newborn. During an examination of the client's breasts, the nurse notes that they are warm and firm. Which of the following actions should the nurse plan to take?

Instruct the client to apply cold compress

A nurse is caring for a postpartum client 8 hr after delivery. Which of the following factors places the client at risk fro uterine atony? (Select all that apply)

Magnesium sulfate infection Distended bladder Prolonged labor

A nurse is caring for a client who just had spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and a prolapsed umbilical cord. Which of the following actions should the nurse take first?

Manually apply upward pressure intravaginally on the presenting part.

A nurse is discussing the expected changes related to pregnancy with a client who is at 8 weeks gestation. Which of the following findings should the client report to the provider during the first trimester?

Persistent vomiting

A nurse is providing teaching to a client who is postpartum and does not plan to breastfeed her newborn. Which of the following instructions should the nurse include in the teaching?

Place ice packs on your breasts

A nurse is caring for a client who is in labor. The nurse observes late decelerations on the fetal monitor. Which of the following actions should the nurse take?

Place the client in a left lateral position.

A nurse is caring for a newborn immediately following delivery. Which of the following actions should the nurse perform first?

Place the newborn directly on the clients chest

A nurse in a prenatal clinic is reviewing the laboratory results of a client who is at 33 weeks of gestation. For which of the following results should the nurse notify the provider?

Platelet count 135,000 mm3

A nurse is caring for a client who is in the first trimester of pregnancy and asks how to manage heartburn. Which of the following responses should the nurse make?

Reduce the amount of food you eat during meals

A nurse is caring for a client who has oligohydramnios. Which of the following fetal anomalies should the nurse expect?

Renal agenesis

A nurse is discussing risk factors for necrotizing enterocolitis (NEC) in newborns with a newly licensed nurse. Which of the following risk factors should the nurse include?

Respiratory distress syndrome

A nurse is caring for a preterm newborn who is receiving oxygen therapy. Which of the following findings should the nurse identify as a potential complication of the oxygen therapy?

Retinopathy

A nurse is caring for a client who asks, "How will I know if i'm having true or false labor contractions?" Which of the following responses should the nurse make?

True contractions will being irregularly then become regular in timing.

A nurse is performing a routine prenatal examination of a client who is in the second trimester. The client reports backaches with no other symptoms and refuses medication. Which of the following responses should the nurse make?

Try pelvic tilt exercises

A nurse is caring for a newborn who is receiving treatment for jaundice with traditional phototherapy lights. Which of the following interventions should the nurse perform?

Turn the newborn every 2 hours

A nurse is providing education to a client who is at 34 weeks of gestation about a non-stress test (NST). Which of the following pieces of information should the nurse include?

You might have to drink orange juice during the test

A nurse is providing teaching for a client who is pregnant and has type 1 diabetes mellitus. Which of the following statements should the nurse include in the teaching?

You should expect to decrease your insulin dosage immediately after you deliver your baby.

A nurse in a clinic is providing education to a client at 32 weeks of gestation who has pruritus gravidarum. Which of the following pieces of information should the nurse provide?

You should slightly increase your exposure to light