OB- ATI

A nurse is providing teaching to a client who is at 40 weeks of gestation and has a new prescription for misoprostol. Which of the following instructions should the nurse include in the teaching?

"I can administer oxytocin 4 hrs after the insertion of the medication" the nurse can administer oxytocin no sooner than 4 hrs after the last dose of misoprostol. Oxytocin can be administered following misoprostol for clients who have cervical ripening and have not begun labor.

Nurse is teaching newly licensed nurse about collecting a specimen for universal newborn screening. Which statements should the nurse include in teaching?

ANS: "Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen.":- The nurse should ensure that the newborn has been receiving regular feedings for at least 24 hr prior to testing.

Nurse teaching the patient that's 10 weeks gestation about nutrition during pregnancy. Which statements by patient indicates an understanding of teaching?

ANS: "I should take 600 micrograms of folic acid each day.":- A client who is pregnant should increase folic acid intake to 600 mcg daily. Folic acid assists with preventing neural tube birth defects

Nurse is providing teachings to patient about physiological changes that occur during pregnancy. patient is 10 weeks gestation and has BMI WDL. Which statements indicates an understanding of teaching?

ANS: "I will likely need to use alternative positions for sexual intercourse.":- The weight gain of pregnancy will likely require alternative positions for sexual intercourse. This client statement indicates that she understands the nurse's teaching about the physiological changes that occur during pregnancy.\ NOT: "I will not gain more than 15 to 20 pounds during my pregnancy.":- The recommended weight gain during pregnancy for a client who has a BMI within the expected reference range is 25 to 35 lb (11.3 to 15.9 kg). The recommended weight gain during pregnancy for a client who has a BMI above the expected reference range is 15 to 20 lb (6.8 to 9.1 kg).

Nurse is giving Teaching to patient who gave birth 2 hrs ago about facility policy for newborn safety. Which patient statements indicates an understanding of teaching?

ANS: "The person who comes to take my baby's pictures will be wearing a photo identification badge.":- All personnel working on the unit should be wearing a photo ID badge. The nurse should instruct the parent to never allow anyone who is not wearing an ID badge to come in contact with the newborn.

Nurse providing discharge teaching to patient with c-section 3 days ago. Which instructions should the nurse include?

ANS: "You can still become pregnant if you are breastfeeding.":- The nurse should instruct the client that breastfeeding does not prevent ovulation. Therefore, the client can become pregnant. The nurse should discuss contraception that is safe to use while breastfeeding.

A nurse in a prenatal clinic is assessing a group of patients. Which of the following clients should the nurse see first?A client who is at 11 weeks of gestation and reports abdominal crampingA client who is at 15 weeks of gestation and reports tingling and numbness in right handA client who is at 20 weeks of gestation and reports constipation for the past 4 daysA client who is at 8 weeks of gestation and reports having three bloody noses in the past week

ANS: A client who is at 11 weeks of gestation and reports abdominal cramping:- When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is a client who is at 11 weeks of gestation and reports abdominal cramping. Abdominal cramping can indicate an ectopic pregnancy or manifestations of spontaneous abortion. The nurse should request that the provider see this client first.A client who is at 15 weeks of gestation and reports tingling and numbness in right hand:- is nonurgent because it is a common discomfort related to pregnancy for a client who is at 15 weeks of gestation. Therefore, there is another client that the provider should see first.A client who is at 20 weeks of gestation and reports constipation for the past 4 days:- nonurgent because it is a common discomfort related to pregnancy for a client who is at 20 weeks of gestation. Therefore, there is another client that the provider should see first.A client who is at 8 weeks of gestation and reports having three bloody noses in the past week- Epistaxis is nonurgent because it is a common discomfort related to pregnancy for a client who is at 8 weeks of gestation. Therefore, there is another client that the provider should see first.

Nurse is assessing 4 newborns. Which findings should the nurse report to HCP?

ANS: A newborn who is 18 hr old and has an axillary temperature of 37.7° C (99.9° F):- An axillary temp. >37.5° C (99.5° F) is above the expected reference range for a newborn and can be an indication of sepsis. Therefore, the nurse should report this finding to the provider.

Nurse caring for patient who's anemic at 32 weeks gestation and in preterm labor. HCP prescribes betamethasone 12 mg IM. Which outcomes should nurse expect?

ANS: A reduction in resp distress in the newborn:- Betamethasone is a glucocorticoid that is given to stimulate fetal lung maturity and prevent resp distress.

Nurse is admitting a patient who's in labor. Patient admits to cocaine use. Which complications should the nurse assess?

ANS: Abruptio placenta:- Cocaine use increases the risk for vasoconstriction and possible abruptio placenta.

Nurse is caring for a client who's 26 weeks gestation and has epilepsy. Nurse enters the room and observes the patient having a seizure. After turning patient's head to one side, which actions should the nurse take immediately after the seizure?

ANS: Administer oxygen via a nonrebreather mask:- When using the airway, breathing, and circulation approach to client care, the nurse should place the priority on administering oxygen to the client via a nonrebreather mask at 10 L/min to ensure adequate oxygenation to the fetus. NOT: Monitor the FHR:- The nurse should monitor the FHR to assess fetal well-being. However, this is not the action the nurse should take next.

Nurse is caring for a patient who has hyperemesis gravidarum and is receiving IV fluid replacement. Which findings should the nurse report to HCP?

ANS: BUN 25 mg/dL:- The nurse should report an elevated BUN to the provider since it can indicate dehydration NOT: UO of 280 mL within 8 hr:- A UO of 280 mL within 8 hr is within the expected reference range. Therefore, the nurse does not need to report this finding to the provider.

Nurse is admitting a patient to L&D unit when patient states, "my water just broke" which interventions is nurse's priority?

ANS: Begin FHR monitoring.- The greatest risk to the client and her fetus following a rupture of membranes is umbilical cord prolapse. The nurse should monitor the fetus closely to ensure well-being. Therefore, this is the priority action the nurse should take.

Nurse is caring for a client who's 36 weeks gestation and positive contraction stress test. Nurse should plan to prepare client for which dx test?

ANS: Biophysical profile:- A positive contraction stress test indicates that further evaluation of the fetus is necessary. A biophysical profile will provide further evaluation with a real-time ultrasound.

Nurse assessing a patient who has severe preeclampsia. Which manifestations should the nurse expect?

ANS: Blurred vision:- The nurse should identify that a client who has severe preeclampsia can have arteriolar vasospasms and decreased blood flow to the retina which can lead to visual disturbances, such as blurred vision, double vision, or dark spots in the visual field.

Nurse giving teaching about nonpharm pain management to patient who's breastfeeding and has engorgement. Nurse should recommend application of which items?

ANS: Cold cabbage leaves:- The application of fresh, raw cabbage leaves that have been chilled is an effective nonpharmacological method to relieve the pain associated with engorgement. The nurse should instruct the client to place the cabbage leaves on the breasts for 15 to 20 min, repeating the application for two to three sessions as needed. More frequent applications could decrease the client's milk supply.

Nurse is performing routine assessment on patient that's 18 weeks gestation. Which findings should the nurse expect?

ANS: FHR 152/min:- The expected range for the FHR is 110/min to 160/min. The FHR is higher earlier in gestation with an average of approximately 160/min at 20 weeks of gestation. Therefore, this is an expected finding by the nurse.

Nurse in an antepartum clinic is providing care for patient who's 26 weeks gestation. Upon review, which findings should the nurse report to HCP?Exhibit: BP 130/78, RR 20, HR 90, Hb 12 g/dL, Hct 34%, 1-hr glucose tolerance test 120 mg/dL, Fundal height 30 cm, Good fetal mvt, Not experiencing headache, dizziness, blurred vision, or vaginal bleeding, FHR 110/min1-hr glucose tolerance testHematocritFundal height measurementFetal heart rate (FHR)

ANS: Fundal height measurement:- A fundal height measurement of 30 cm should be reported to HCP. Fundal height should be measured in centimeters and is the same as the number of gestational weeks plus or minus 2 weeks from 18 to 32 weeks gestation. Therefore, the nurse should report this finding to the provider. NOT: Fetal heart rate (FHR)This FHR is within the expected reference range of 110/min to 160/min for a client at 26 weeks of gestation.

Nurse is caring for patient that's 35 weeks gestation and undergoing a nonstress test that reveals variable deceleration in FHR. Which actions should the nurse take?

ANS: Have the client change position:- an appropriate intervention for a variable deceleration to relieve umbilical cord compression.

Nurse is reviewing prenatal lab results for patient at 12 weeks gestation following initial prenatal visit. Which lab findings should nurse report to HCP? Hemoglobin 10 g/dL WBC count 10,000/mm3 Platelets 250,000/mm3 Fasting blood glucose 90 mg/dL

ANS: Hb 10 g/dL:- below the expected reference range of >11 g/dL for a client who is pregnant. The nurse should report this finding to the provider to obtain a prescription for ferrous iron supplementation because of anemia.

Nurse is assessing patient who received carboprost for postpartum hemorrhage. Which findings is an adverse effect of this med?

ANS: Hypertension:- The nurse should recognize that carboprost is a vasoconstrictor that can cause hypertension.

Nurse is assessing a newborn 12 hr after birth. Which manifestations should the nurse report to HCP?

ANS: Jaundice:- Jaundice occurring within the first 24 hr of birth is associated with ABO incompatibility, hemolysis, or Rh-isoimmunization. The nurse should report this manifestation to the provider.

Nurse is caring for patient that's 24 weeks gestation and has suspected placental abruption. Which lab tests should the nurse expect the HCP to prescribe?

ANS: Kleihauer-Betke test:- The nurse should expect the provider to prescribe a Kleihauer-Betke test for a client who has suspected placental abruption to determine if fetal blood is in maternal circulation. This test is useful to determine if Rho-(D) immune globulin therapy should be administered to a client who is Rh-negative.

A nurse is caring for a client who is to receive oxytocin to augment her labor. Which of the following findings contraindicates the initiation of the oxytocin infusion and should be reported to the provider?

ANS: Late decelerations- indicative of uteroplacental insufficiency. Therefore, this is a contraindication for the administration of oxytocin and should be reported to the provider.

Nurse observing a new parent caring for crying newborn who is bottle feeding. Which actions by patent should the nurse recognize as a positive patenting behavior?

ANS: Lays the newborn across her lap and gently sways:- This is a correct technique for quieting a newborn. This tactile stimulation promotes a sense of security for the newborn.

Nurse is caring for a postpartum patient who is receiving heparin via continuous IV infusion for thrombophlebitis in left calf. Which actions should the nurse take?

ANS: Maintain the client on bed rest- The client should remain on bed rest to decrease the risk of dislodging the clot, which could cause a pulmonary embolism. Elevation of the affected leg is recommended.

Nurse caring for patient who has uterine atony and is experiencing postpartum hemorrhage. Which actions is the nurse's priority?

ANS: Massage the client's fundus:- Uterine atony and postpartum hemorrhage indicate that this client is at the greatest risk for hypovolemic shock. This can compromise the perfusion to the client's vital organs, which can lead to death. Therefore, the nurse's priority is to massage the client's fundus to minimize blood loss.

Nurse is assessing a newborn who was born 26 weeks gestation using new ballard score. Which findings should nurse expect?

ANS: Minimal arm recoil:- The nurse should expect a newborn who was born at 26 weeks of gestation to have decreased muscular tone, or minimal arm recoil.

Nurse is developing a POC for a patient who has preeclampsia and is receiving mag sulfate via continuous IV infusion. Which interventions should the nurse include in the plan?

ANS: Monitor the FHR continuously.- Mag sulfate, which is used to prevent seizures in clients who have preeclampsia, is a high-alert medication that requires close monitoring. The FHR and uterine contractions should be monitored continuously while the client is receiving mag sulfate.

Nurse is caring for patient who's 15 weeks gestation, Rh-, and just had amniocentesis. Which interventions is the nurse's priority following the procedure?

ANS: Monitor the FHR:- The greatest risk to this client and her fetus is fetal death. Therefore, the priority nursing intervention is to monitor the FHR following an amniocentesis.

Nurse is providing education about family bonding to patents who recently adopted a newborn. Nurse should make which suggestions to aid family's 7 y/o child in accepting the new family member?

ANS: Obtain a gift from the newborn to present to the sibling:- Presenting a gift from the newborn to the sibling is a strategy to facilitate a school-age sibling's acceptance of a new family member. This ensures that the sibling does not feel left out and that they understand their role in the family.

A nurse is caring for a patient that's 38 weeks gestation. Which actions should the nurse take prior to applying an external transducer for fetal monitoring?

ANS: Perform Leopold maneuvers:- The nurse should perform Leopold maneuvers to assess the position of the fetus to best determine the optimal placement for the external fetal monitoring transducer.

Nurse is assessing a newborn who has delivered vaginally and experienced a tight nuchal cord. Which findings should the nurse expect?

ANS: Petechiae over the head:- Nuchal cord, or the umbilical cord being wrapped tightly around the neck, can cause bruising and petechiae over the face, head, and neck.

Nurse in a provider's office is reviewing the medical record of a client who is in the 1st trimester of pregnancy. Which findings should the nurse identify as a risk factor for development of preeclampsia?

ANS: Pregestational diabetes mellitus- increases a client's risk for the development of preeclampsia. Other risk factors include preexisting hypertension, renal disease, systemic lupus erythematosus, and rheumatoid arthritis.

A nurse is caring for a patient that's 32 weeks gestation and has gonorrhea. The nurse should identify that the client is at an increased risk for which of the following complications?

ANS: Premature rupture of membranes- The nurse should identify that a client who is pregnant and has gonorrhea is at an increased risk for premature rupture of membranes, chorioamnionitis, preterm birth, neonatal sepsis, and intrauterine growth restriction.

Nurse creating a POC for patient who's postpartum and adheres to traditional Hispanic cultural beliefs. Which cultural practices should the nurse include in POC

ANS: Protect the client's head and feet from cold air:- this is a traditional Hispanic practice during the postpartum period.

Nurse is developing POC for newborn undergoing phototherapy for hyperbilirubinemia. Which actions should the nurse include in plan?

ANS: Remove all clothing from the newborn except the diaper:- The nurse should remove all the newborn's clothing except the diaper while under phototherapy. Maximum skin exposure to the ultraviolet light is needed to break down the excess bilirubin.

Nurse in an antepartum clinic is assessing a patient tha's 32 weeks gestation. Which findings should the nurse report to HCP?

ANS: Report of decreased fetal movement:- The nurse should identify that a client who reports decreased fetal movement could be experiencing a complication related to fetal well-being. A decrease in fetal movement can indicate fetal distress. NOT: Fundal height 34 cm:- A client who is at 32 weeks of gestation should have a fundal height about the same as the number of weeks of gestation, plus or minus 2 cm

Nurse is assessing a patient that's 36 weeks gestation. Which findings should the nurse report to HCP?

ANS: Report of visual disturbances:- Visual disturbances such as blurred vision are a potential prenatal complication associated with HTN. The nurse should report this finding to HCP so that additional fetal and maternal evaluation can be performed.

Nurse caring for a patient who's 30 weeks gestation and has a prescription for mag sulfate IV to treat preterm labor. The nurse should notify the HCP of which adverse effects?

ANS: Respiratory rate 10/min:- The nurse should report a respiratory rate of less than 12/min to the provider, because this is a manifestation of magnesium toxicity. The nurse should ensure that the antidote, calcium gluconate, is readily available.

Nurse is assessing a newborn who is 16 hr old. Which findings should the nurse report to HCP?

ANS: Substernal retractions:- The nurse should identify that substernal retractions, apnea, grunting, nasal flaring, and tachypnea are manifestations of neonatal infection or respiratory distress in the newborn. The nurse should report these findings to the provider for immediate intervention.

Nurse is assessing patient who's 1 day postpartum and has vaginal hematoma. Which manifestations should nurse expect?

ANS: Vaginal pressure:- The nurse should expect a client who has a vaginal hematoma to report pressure in the vagina due to the blood that leaked into the tissues.

Nurse is transporting newborn back to parent's room following procedure. Which actions should the nurse take?

ANS: Verify that the parent's ID band matches the newborn's ID band:- The nurse should verify the newborn's identity every time the newborn is returned to the parents. The nurse should match the info on the parent's ID band to the info on the newborn's ID band.

Nurse performing physical assessment of a newborn upon admission to nursery. Which manifestations should the nurse expect? (SATA)

Acrocyanosis is correct. - an expected finding for at least the first 24 hr following birth. Poor peripheral perfusion leads to bluish discoloration in the newborn's hands and feet.Positive Babinski reflex is correct:- Newborns should exhibit a positive Babinski sign following birth. The nurse should stroke the newborn's foot upward from the heel to the toes. The toes should hyperextend, and dorsal flexion of the big toe should occur. The absence of this finding requires neurological evaluation. The Babinski reflex is no longer present after 1 year of age.Two umbilical arteries visible is correct:- The nurse should observe two arteries and one vein in the umbilical cord. The presence of only one artery can indicate a renal anomaly.

Nurse is performing a physical assessment of newborn. Which clinical findings should the nurse expect? (SATA)

HR 154/min is correct. - The expected reference range for a newborn's HR is from 110/min to 160/min while awake. RR 58/min is correct. - The expected reference range for a newborn's respiratory rate is from 30/min to 60/min. Weight 2.6 kg (5 lb 12 oz) is correct. The expected reference range for a newborn's weight is from 2,500 to 4,000 g (5.5 lb to 8.8 lb). Axillary temp 36° C (96.8° F) is incorrect.- A healthy newborn's temp averages 37° C (98.6° F), with a range of 36.5° to 37.5° C (97.7° to 99.5° F). Length 43 cm (16.9 in) is incorrect. The expected reference range for a newborn's length is from 45 to 55 cm (17.7 to 21.7 in).

A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain of the procedure for the newborn?

Place the newborn skin to skin on the mothers chestR: to decrease the newborn's pain level and anxiety, this should be implemented before, during, and aftre the procedure.

Nurse is assessing a late preterm newborn. Which manifestations is an indication of hypoglycemia?

Respiratory distress:- Late preterm newborns are at an increased risk for hypoglycemia due to decreased glycogen stores and immature insulin secretion. Respiratory distress is a manifestation of hypoglycemia. Other manifestations of hypoglycemia include an abnormal cry, jitteriness, lethargy, poor feeding, apnea, and seizures.

a nurse is caring for a prenatal client who has parvovirus B19 (fifth disease). Which of the following actons should the nurse take?

Schedule an ultrasound examination.(The nurse should schedule serial ultrasound examinations to monitor the fetus during the pregnancy to detect the possible development of fetal hydrops)

Nurse is demonstrating how to bathe their newborn. Which order should the nurse perform actions?

The nurse should demonstrate how to bathe a newborn by using a head to toe, clean to dirty, approach. Therefore, the nurse should first wipe the newborn's eyes from the inner canthus outward using plain water. The nurse should then wash the newborn's neck by lifting the newborn's chin. Next, the nurse should cleanse the skin around the umbilical cord stump followed by washing the newborn's legs and feet. The last step of the bath should be to clean the newborn's diaper area.

A nurse is caring for a client who is at 36 weeks gestation and has a prescription for amniocentesis. FOr which of the following reasong should the nurse prepare the client for an ultrasound.

To locate a pocket of fluid an ultrasound is done to locate a pocket of amniotic fluid and the placenta prior to an amniocentesis. This decreases the risk of injury to the fetus.

A nurse is providing teaching for a client who has a new prescription from combined OC. which of the following findings should the nurse include as an adverse effect of this medication

depression the nurse should instruct the client that depression is a common adverse effect of combined oral contraceptives. Other adverse effects of the medication include amenorrhea, weight gain, headache, nausea, breakthrough bleeding, and brest tenderness

a nurse is performing a vaginal examination on a client who is in labor and observes the umbilical cord protruding from the vagina. Afer calling for assistance, which of the following actions should the nurse take

insert two gloved fingers into the vagina toward the cervix, excerting upward pressure onto the presenting part to relieve umbilical cord compression and increase oxygenation to the fetus.

a nurse is assessing a client who is receiving morphine via IV bolus for pain following a cesarean birth. The nurse notes a repiration rate of 8/min. which of the following medications shoud the nurse administer?

nolaxone morphine is a common opidof analgestic used for postoperative pain management that can cause central nervous system depression and can cause respiratory depression. The nurse should administer naloxone, an opiod antagonist, to reverse the opiod-induced respiratory depression in the client.

a nurse is assessing a client who is at 38 weeks of gestation during a weekly prenatal visit. WHich of the following findings should the nurse report to the provider? A- bP 136/88 B- report of insomia C- weight gain os 2.2 kg (4.8lb) D- report of braxton hick contractions

weight gain of 2.2 k a weight gain of 2.2 k is a week is above the expected reference range and could indicate complications. Therefore, this finding should be reported to the provider. NOT: braxton hicks, they are expected for a client who is at 38 wks of gestation.