OB exam 3
A patient has polyhydramnios. Which of the following questions does the nurse need to ask this patient? A) Are you diabetic? B) Does the baby have kidney issues? C) Do you have a UTI? D) Have you been drinking during this pregnancy ?
ANS: A Feedback: this could be an issue because it makes her at risk for post- partum hemorrhage because the fluid is over stretching the uterus
Why is it important for the nurse to thoroughly assess maternal bladder and bowel status during labor? a) A full bladder or rectum can impede fetal descent. b) If the woman has a full bladder, labor may be uncomfortable for her. c) A full rectum can cause diarrhea. d) If the woman's bladder is distended, it may rupture. .
ANS: A full bladder or rectum can impede fetal descent
A client in labor has requested the administration of narcotics to reduce pain. At 2 cm cervical dilatation, she says that she is managing the pain well at this point but does not want it to get ahead of her. What should the nurse do? A) Explain to the client that narcotics should only be administered an hour or less before birth. B) Advise the client to hold out a bit longer, if possible, before administration of the drug, to prevent slowing labor. C) Refuse to administer narcotics because they can develop dependency in the client and the fetus. D) Agree with the client, and administer the drug immediately to keep the pain manageable.
ANS: A) Advise the client to hold out a bit longer, if possible, before administration of the drug, to prevent slowing labor.
As a woman enters the second stage of labor, which of the following would you expect to assess? A) Feelings of being frightened by the change in contractions B) Complaints of feeling hungry and unsatisfied C) Falling asleep from exhaustion D) Expressions of satisfaction with her labor progress
ANS: A) Feelings of being frightened by the change in contractions
Which type of anesthesia is anticipated when the delivery of the fetus must be done quickly due to an emergency situation? A) General B) Local C) Regional D) Short acting
ANS: A) General
A patient comes into the OB for her 2nd prenatal visit. A nurse notices on the patients chart that she has protein in her urine and her blood pressure is 144/ 94. Which of the following medications does the nurse expect the doctor to put this patient on? A) Nifedipine B) Nubain C) Stadol D) Betamethison
ANS: A) Nifedipine or procardium Feedback: This patient has signs of preeclampsia. and Procardium treats preeclamcia
A nurse looks on a patients chart and sees that the babies position as being ROA. The nurse understands this as meaning which of the following? A) The fetus is laying in a longitudinal lie facing left posterior B) The fetus is laying in a horizontal lie facing the right anterior C) The fetus is laying in a transverse lie facing the left posterior D) The fetus is laying in a longitudinal lie facing the right posterior
ANS: A) The fetus is laying in a longitudinal lie facing left posterior
You're performing a routine assessment on a mother post-delivery. The uterus is soft and displaced to the left of the umbilicus. What is your next nursing action?* A. Perform fundal massage and assist the patient to the bathroom. B. Continue to monitor the mother. This is a normal finding post-delivery. C. Notify the physician. D. Administer PRN dose of Pitocin as ordered by the physician.
ANS: A. Perform fundal massage and assist the patient to the bathroom.
he nurse is reviewing the uterine contraction pattern and identifies the peak intensity, documenting this as which of the following? a) Diastole b) Decrement c) Increment d) Acme
ANS: Acme Explanation: The acme is the peak intensity of a contraction. The increment refers to the building up of the contraction. The decrement refers to the letting down of the contraction. Diastole refers to the relaxation phase of a contraction
A woman is going to have labor induced with oxytocin. Which statement below reflects the induction technique you anticipate her primary-care provider will order? a) Administer oxytocin diluted in the main intravenous fluid. b) Administer Pitocin in two divided intramuscular sites. c) Administer Pitocin in a 20 cc bolus of saline. d) Administer oxytocin diluted as a "piggyback" infusion.
ANS: Administer oxytocin diluted as a "piggyback"
A client has opted to receive epidural anesthesia during labor. Which of the following interventions should the nurse implement to reduce the risk of a significant complication associated with this type of pain management? a) Administration of aspirin b) Administration of 500 mL of IV Ringer's lactate c) Administration of 1000 mL of IV glucose solution d) Move the woman into a supine position
ANS: Administration of 500 mL of IV Ringer's lactate
Which of the following is true regarding analgesia versus anesthesia? a) Decreased FHR variability is a common side effect when regional anesthesia is used. b) Analgesia only reduces pain, but anesthesia partially or totally blocks all pain in a particular area. c) Hypotension is the most common side effect when systemic analgesia is used. d) Regional anesthesia should be given with caution close to the time of delivery because it crosses the placenta and can cause respiratory depression in the newborn.
ANS: Analgesia only reduces pain, but anesthesia partially or totally blocks all pain in a particular area.
Seven hours ago, a G5 P4014 woman delivered a 4133-g male infant. She has voided once and calls for a nurse to check because she states that she feels "really wet" now. Upon examination, her perineal pad is saturated. The immediate nursing action is to a) Assess and massage the fundus b) Increase the flow of an IV c) Call the physician or the nurse-midwife d) Inspect the perineum for lacerations
ANS: Assess and massage the fundus
The healthcare provider is assessing the glucose level of a patient with a diagnosis of diabetes. Which of these is most helpful in evaluating this patient's long-term glucose management? : A Fasting blood glucose level B Hemoglobin A1c C Urine specific gravity D The patient's food diary
ANS: B
The laboring patient who is at 3 cm dilation and 25% effaced is asking for analgesia. The nurse explains the analgesia usually is not administered prior to the establishment of the active phase. Identify the appropriate rationale for this practice. A) This would cause fetal depression in utero. B) This may prolong labor and increase complications. C) The effects would wear off before delivery. D) This can lead to maternal hypertension.
ANS: B
A patient is delivering a baby and the nurse is told that the baby is ROP. The nurse understands that this mother my experience which of the following during this labor in regards to the baby's current positioning ? A) An increased heart rate B) Increased lower back pain C) Increased chest pain D) A fractured pelvic bone
ANS: B Feedback: The back of this baby's head is lying to the right side but the it is lying towards the posterior part of the pelvic which can result in significant back pain
Which statement by a woman who is 8 weeks pregnant and has a cardiac disease would you most likely follow up closely? A) " I have been really constipated for the last few weeks" B) " I have gained 4 lb during the last week, but I'm not eating more than before" C) " I have not felt any fetal movement as yet" D) " I have had episodes in the morning when I have almost thrown up"
ANS: B) " I have gained 4 lb during the last week, but I'm not eating more than before"
A woman's physician has told her he wants to use an episiotomy for delivery. She asks you what the purpose of this is. Which of the following would be your best answer? A) "It prevents distention of the bladder." B) "It relieves pressure on the fetal head." C) "It aids contraction of the uterus following delivery." D) "It is done primarily for the physician's benefit."
ANS: B) "It relieves pressure on the fetal head."
A nurse is caring for a nullapara. The nurse recognizes that Which of the following phases in labor would be worse for this patient? A) A active phase lasting 2 hours B) A latent phase at 24 hours C) A Transition phase lasting 3 mins D) A follicular phase lasting 4 hours
ANS: B) A latent phase at 24 hours - this should only last 6 hours
A patient had an incomplete abortion at 20 weeks gestation. Which of following does the nurse need to assess for? A) Mental state B) Bleeding C) Urinary output D) Respiratory rate
ANS: B) Bleeding
Three hours postpartum a patient begins hemorrhaging. Which of the following medications would the nurse give immediately to stop the bleeding? A) Sadol given IV push B) Carbopost given IM C) Magnesium sulfate given PO D) procardium given PO
ANS: B) Carbopost given IM this is also called Hemobate Feedback: Magnesium sulfate is also used in this situation, however, it is given either IM or IV Terbutaline can also be used
A mother is in labor. She has had 5 contractions in the last 10 minutes with each lasting 2 minutes. At this time the nurse knows it is important to get the baby out immediately because which of the following issues could result? A) Hypervolemia B) Hypoxia C) Hyperglycemia D) Hypertension
ANS: B) Hypoxia
Which of the following would be a danger signal of labor for a woman in labor? A) Blood-tinged vaginal discharge at full dilation B) Meconium-stained amniotic fluid C) Maternal pulse of 90 to 95 beats per minute D) Fetus presenting in an LOA position
ANS: B) Meconium-stained amniotic fluid
11. A pregnant woman with preeclampsia is to receive magnesium sulfate IV. Which of the following assessments would be most important prior to administering a new dose? A) Blood pressure B) Patellar reflex C) Pulse rate D) Anxiety level
ANS: B) Patellar reflex
A patient has gestational hypertention and is on a continuous drip of magnesium sulfate. The nurse understands which of the following describe the reason for this? A) This medication is hypotensive medication B) This medication central nervous system depressant C) This medication helps with lung maturity D) This medication relaxes uterine muscles
ANS: B) This medication central nervous system depressant Feedback: this is given to treat hypertension and preeclampsia as well as helps stop labor. It is given 4-6g initially over 30 mins and 1-4g/hr for maintenance
If the monitor pattern of uteroplacental insufficiency were present, which of the following would you do first? A) Help the woman to sit up in a semi-Fowler's position. B) Turn her or ask her to turn to her side. C) Administer oxygen at 3 to 4 L by nasal cannula. D) Ask her to pant with the next contraction.
ANS: B) Turn her or ask her to turn to her side.
What statement is FALSE about the transition phase of stage 1?* A. The mother may experience intense pain, irritation, nausea, and deep concentration. B. The transition phase is the longest phase of stage 1 and contractions are very intense and long in duration. C. The cervix will dilate from 8 to 10 cm. D. The transition phase ends and progresses to stage 2 of labor when the cervix has dilated to 10 cm.
ANS: B. The transition phase is the longest phase of stage 1 and contractions are very intense and long in duration
A client in preterm labor at 31 weeks who is dilated to 4 centimeters has been started on magnesium sulfate and contraction have stopped. If the client's labor can be inhibited for the next 48 hours, what medication does the nurse anticipate will be prescribed? 1. Bethamethasone 2. Nubain 3. Apresoline 4. Procardisem
ANS: Bethamethasone- helps with lung maturity while baby is still in utero - give 12mg IM to mom twice within 24 hours
1. A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which of the following would be the priority for this woman on admission? A) Performing a vaginal examination to assess the extent of bleeding B) Helping the woman remain ambulatory to reduce bleeding C) Assessing fetal heart tones by use of an external monitor D) Assessing uterine contractions by an internal pressure gauge
ANS: C
2. Which of the following would be the physiologic basis for a placenta previa? A) A loose placental implantation B) Low placental implantation C) A placenta with multiple lobes D) A uterus with a midseptum
ANS: C
A patient is at risk for gestational diabetes. The nurse knows which of the following test is the most accurate test of a woman's blood sugar? A) 1 hour glucola B) Fasting glucose C) Hemoglobin A1C D) 24 hour recall
ANS: C
A patient who is in transition reports her pain medication last given 3 hours ago has worn off. She asks if she can have another dose of the Stadol. How should the nurse respond to her request? A) "Since it has been over 3 hours, you should be able to have more of the medication." B) "It is too early as the medication should be given only every 4 hours." C) "Your stage of labor makes giving another dose unsafe." D) "I will get permission from your doctor."
ANS: C
You encourage a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, you would advise her to do which of the following? A) Inject a bolus of insulin B) Eat a high-carbohydrate snack C) Eat a sustaining-carbohydrate snack D) Add a bolus of long-acting insulin
ANS: C
Before exercise which of the following should a nurse suggest a gestational diabetic mom have? A) A glass of water B) an injection of 0.5 unites of regular insulin C) A snack with a complex carb and protein D) A snack with good fats and simple carbs
ANS: C) A snack with a complex carb and protein
To deliver her infant, a woman is asked to push with contractions. Which of the following is the most effective and safest pushing technique to teach her? A) Lying supine with legs in lithotomy stirrups B) Squatting while holding her breath C) Head elevated, grasping knees, breathing out D) Lying on side, arms grasped on abdomen
ANS: C) Head elevated, grasping knees, breathing out
A nurse is helping deliver a baby and notices that the babies chin is not fully tucked in as its coming out. The nurse recognizes this as which of the following types of attitude ? A) Vertex- poor attitude B) Face- best attitude C) Sinciput - good attitude D) Brow - bad attitude
ANS: C) Sinciput - good attitude Feed back: the best attitude is vertex - this is full flection and good attitude
A patient is talking to her nurse and ask " my doctor said my baby has good fetal attitude, what does this mean?" Which of the following responses by the nurse would answer this question correctly? A) The baby is engaged and ready for labor B)The baby is in a transverse lie C) The baby is tucked allowing the crown to come out first during labor D) The baby is in a horizontal lie
ANS: C) The baby is tucked allowing the crown to come out first during labor
The fetus of a woman you care for during labor is in a vertex presentation and at a -1 station. You would interpret this to mean that the fetal head is A) at the ischial spines. B) engaged. C) floating. D) crowning.
ANS: C) floating
The healthcare provider is teaching a group of students about the characteristics of type 1 diabetes mellitus. Which of the following describe the underlying cause of the disease? A)Increased hepatic glycogenesis B)Cellular resistance to insulin C) Destruction of pancreatic beta cells D)Atrophy of pancreatic alpha cells
ANS: C)Destruction of pancreatic beta cells
In stage 1 of labor, during the active phase, the cervix dilates?* A. 1-3 cm B. 7-10 cm C. 4-7 cm D. 8-10 cm
ANS: C. 4-7 cm
Your laboring patient has transitioned to stage 2 of labor. What changes in the perineum indicate the birth of the baby is imminent?* A. Increase in meconium-stained fluid and retracting perineum B. Retracting perineum and anus with an increase of bloody show C. Rapid and intense contractions D. Bulging perineum and rectum with an increase in bloody show
ANS: C. Rapid and intense contractions
3. Which of the following supports why a preterm fetus usually is more affected by medication given at birth than a full-term fetus? A) Affinity of the preterm fetus to drugs that are fat-soluble B) Affinity of the preterm fetus to drugs that are strongly bound to protein C) Inability of the preterm fetus to use drugs with a molecular weight over 1000 D) Inability of the immature liver to metabolize or inactivate drugs
ANS: D
A woman develops gestational diabetes. Which of the following assessments should she make daily? A) Test her urine for protein with a chemical reagent strip. B) Measure her abdominal diameter with a tape measure. C) Measure her uterine height by hand-span distance. D) Measure serum for glucose level by a finger prick.
ANS: D
If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which of the following patterns would you anticipate seeing on the monitor? A) A shallow deceleration occurring with the beginning of contractions B) Variable decelerations, too unpredictable to count C) Fetal baseline rate increasing at least 5 mm Hg with contractions D) Fetal heart rate declining late with contractions and remaining depressed
ANS: D
When caring for a pregnant woman with cardiac problems, the nurse must be alert for signs and symptoms of cardiac decompensation (congestive heart failure), which include A) regular heart rate, hypertension. B) increased urinary output, tachycardia, dry cough. C) shortness of breath, bradycardia, hypertension. D) dyspnea, crackles, irregular weak pulse.
ANS: D
Which of the following would be a major disadvantage of any pain-relief method that also affects awareness of the mother? A) The father's coaching role may be disrupted at times. B) The infant may show increased drowsiness. C) The mother may have continued memory loss postpartum. D) The mother may have difficulty working effectively with contractions.
ANS: D
A nullapara mom wanted a natural birth. she is in the second stage of labor and is 7 cm dilated. She now is crying out for pain medication. Which of the following actions should the nurse do next? A) Administer an analgesia B) explain that she is too far along for pain medication but you can offer her icy hot to rub on the pained area C) Administer 650 mg of aspirin to her D) Explain to her any medication given right now can effect the baby after birth
ANS: D Feed back : you do not want to give her narcotics when its too close to delivery because that drug will get to baby and once that drug kicks in it will effect babies respirations do not want to ever give aspirin because it effects clotting and no methanol ( icy hot) because it is teratogenic
A nursing instructor ask a nursing student what starts labor, Which of the following statements by the student describe how labor starts? A) " Having intercourse encourages true contractions" B) " The placenta grows too big for the uterus and this starts contractions" C) " The decrease of estrogen causes the cervix to start dilating" D) " Prostogladins are a causative factor in labor."
ANS: D) " Prostogladins are a causative factor in labor." Feed back: A) Sperm may soften the cervix but does not start true contractions. B) The placenta gets old and this may be what starts labor C) The hormone levels increase during the end of the pregnancy
As a woman enters the second stage of labor, her membranes spontaneously rupture. When this occurs, which of the following would you do next? A) Test a sample of amniotic fluid for protein. B) Ask her to bear down with the next contraction. C) Elevate her hips to prevent cord prolapse. D) Assess fetal heart rate for fetal safety.
ANS: D) Assess fetal heart rate for fetal safety.
During the second stage of labor, a woman is generally A) very aware of activities immediately around her. B) anxious to have people around her. C) no longer in need of a support person. D) turning inward to concentrate on body sensations.
ANS: D) turning inward to concentrate on body sensations.
After birth, where do you expect to assess fundal height?* A. At the xiphoid process B. 5 cm below the umbilicus C. 2 cm above the pubic symphysis D. At or near the umbilicus
ANS: D. At or near the umbilicus
Stage 1 of labor includes which phases in the correct order? A. Transition, Latent, Active B. Active, Latent, Transition C. Active, Transition, Latent D. Latent, Active, Transition
ANS: D. Latent, Active, Transition
A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client? a) Long-acting insulin b) Diet c) Oral hypoglycemic drugs d) Glucagon
ANS: Diet Correct Explanation: Clients with gestational diabetes are usually managed by diet alone to control their glucose intolerance. Long-acting insulin usually isn't needed for blood glucose control in the client with gestational diabetes. Oral hypoglycemic drugs are contraindicated in pregnancy. Glucagon raises blood glucose and is used to treat hypoglycemic reactions.
When teaching a group of nursing students about the stages of labor, the nurse explains that softening, thinning, and shortening of the cervical canal occur during the first stage of labor. Which of the following terms is the nurse referring to in the explanation? a) Crowning b) Molding c) Dilatation d) Effacement
ANS: Effacement
You assess that the fetus of a woman is in an occiput posterior position. Which of the following identifies the way you would expect her labor to differ from others? a) Need to have the baby manually rotated. b) Necessity for vacuum extraction for delivery. c) Shorter dilatational stage of labor. d) Experience of additional back pain. .
ANS: Experience of additional back pain
True or False: Stage 2 of labor begins with the delivery of the baby and ends with the delivery of the placenta.* True False
ANS: False
The nurse who works on the labor and delivery floor documents the fetus as ROA. To what does this documentation refer for a fetus? a) Fetal size b) Fetal station c) Fetal position d) Fetal attitude
ANS: Fetal position
A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which of the following would the nurse expect to find? a) Pre-term pregnancy b) Gestational diabetes c) Maternal rickets d) Small body size of mother
ANS: Gestational diabetes Feedback: Macrosomia usually results from uncontrolled gestational diabetes, genetic problems, multiparity, or post-term pregnancy. Pre-term pregnancy, small body size of mother, and maternal rickets are not associated with macrosomia. Small body size and maternal rickets are associated with pelvic contraction at the inlet.
Your client is in active labor. When you check the EFM tracing, you note variables that are nonreassuring. What would be your first nursing intervention? a) Obtain assistance to check for a compressed umbilical cord b) Prepare the woman for an emergency C-Section. c) Help the woman change positions d) Document the finding
ANS: Help the woman change positions Feed back: First, assist the woman to change positions. Try to find a position that is comfortable for the woman that relieves the compression. If the variables stop after the position change, you will know that the compression has been relieved. However, if the variables continue, try a variety of position changes, including the knee-chest position.
A woman in labor at the hospital has just received an epidural block. Which intervention is priority before and during epidural placement? a) Increase oral fluids every hour to prevent dehydration b) Monitor temperature every four hours and give Tylenol if 100.4 c) Monitor the maternal apical pulse for Bradycardia d) Provide adequate IV fluids to maintain her blood pressure
ANS: Provide adequate IV fluids to maintain her blood
Which factor would contribute to a high-risk pregnancy? a) First pregnancy at age 33 b) History of allergy to honey bee pollen c) Blood type O positive d) Type 1 diabetes
ANS: Type 1 diabetes
A pregnant woman near term is brought to the emergency room because she's been in an automobile accident. She has sustained blunt trauma to her abdomen and has gone into labor. An epidural is started and labor is going as well as can be expected under the circumstances. Suddenly the woman complains of severe pain in her back and shoulder. What do you suspect? a) Placental abruption b) Breech presentation c) Uterine rupture d) Broken bones or torn muscles from the accident
ANS: Uterine rupture Feedback: Uterine rupture occurs when the uterus tears open, leaving the fetus and other uterine contents exposed to the peritoneal cavity. Traumatic rupture can occur in connection with a blunt trauma. Abrupt change in the fetal heart rate pattern is often the most significant sign associated with uterine rupture. Other signs are complaints of pain in the abdomen, shoulder, or back in a laboring woman who had previous good pain relief from epidural anesthesia. The scenario presented does not indicate broken bones or torn muscles from the accident, placental abruption, or a breech presentation of the fetus.
A nurse is caring for a client who has just received an epidural. Which of the following is the MOST common side effect of epidural anesthesia? a) Maternal hypotension, which can lead to fetal tachycardia b) Maternal hypertension, which can lead to fetal bradycardia c) Maternal hypertension, which can lead to fetal tachycardia d) Maternal hypotension, which can lead to fetal bradycardia
ANS: d) Maternal hypotension, which can lead to fetal bradycardia
During labor, a woman at 41 weeks gestation notes her amniotic fluid is leaking and is green in color. She is asking the nurse why the fluid is green. What is an appropriate response by the nurse? a) "This is meconium-stained fluid from the baby." b) "You have an infection and need antibiotics." c) "Green might be a yeast infection and we need to culture the discharge." d) "Amniotic fluid is normally green."
ANS:"This is meconium-stained fluid from the baby."
A nurse is monitoring a client in preterm labor who is receiving I.V. magnesium sulfate. The nurse monitors for which adverse reactions of this medication? SATA 1. Flushing 2. Hypertension 3. Increased urine output 4. Depressed respirations 5. Extreme muscle weakness 6. Hyperactive deep tendon reflexes
ANS:1. Flushing, 4. Depressed respirationS 5. Extreme muscle weakness
Methylergonovine is prescribed for a client with postpartum hemorrhage. Before administering the medication, the nurse contacts the health care provider who prescribed the medication if which condition is documented in the client's medical history? 1. hypotension 2. hypothyroidism 3. diabetes mellitus 4. peripheral vascular disease
ANS:4. peripheral vascular disease
3. A woman in labor is at risk for abruptio placentae. Which of the following assessments would most likely lead you to suspect that this has happened? A) Sharp fundal pain and discomfort between contractions B) Painless vaginal bleeding and a fall in blood pressure C) Pain in a lower quadrant and increased pulse rate D) An increased blood pressure and oliguria
ANS:A
A nurse recognizes which of the following as the force that propels the fetus through that vagina? A) The middle portion of the uterus B) Fundal pressure and abdominal muscles C) Abdominal muscles and contractions near the cervix D) The erector spinae and fundal pressure
ANS:B) Fundal pressure and abdominal muscles
A woman is in labor with her second child. She knows that she will want epidural anesthesia, and she has already signed her consent form. What must the nurse do before the woman receives the epidural? A) Review the woman's medical history and laboratory results and interview her to confirm all information is accurate and up to date. B) Place the woman in the fetal position on the table and keep her steady so that she won't move during the procedure. C) Administer a fluid bolus through the IV line to reduce the risk of hypotension. D) Prepare a sterile field with the supplies and medications that will be needed.
ANS:C
During stage 3 of labor, you note a gush of blood and that the uterus changes shape from an oval shape to globular shape. This indicates?* A. Postpartum hemorrhage B. Imminent delivery of the baby C. Signs of placental separation D. Answers B and C
ANS:C. Signs of placental separation
You are doing patient teaching with a 28 weeks' gestation woman who has tested positive for gestational diabetes mellitus (GDM). What would be important to include in your patient teaching? a) She is at increased risk for type I diabetes mellitus after her baby is born. b) She is at increased risk for type II diabetes mellitus after her baby is born. c) Her baby is at increased risk for type I diabetes mellitus. d) Her baby is at increased risk for neonatal diabetes mellitus. =
ANS:She is at increased risk for type II diabetes mellitus after her baby is born.
Question: During labor, progressive fetal descent occurs. Place the stations listed in their proper sequence. A) -4 station B) +2 station C)+4 station D) 0 station E) -2 station
ANS: -4 station -2 station 0 station +2 station +4 station
Working with pregnant teenagers as a special population requires the nurse to have knowledge of adolescent development. Which of the following is crucial for a positive pregnancy and outcome for the mother and fetus? a) Involvement of the father b) Acceptance by peers c) Support network d) Cultural sensitivity
ANS: Support network
Opioids are often used in labor for pharmacologic pain management. A patient in the transition phase of labor is requesting fentanyl (Sublimaze) for pain. How should the nurse respond to her request? a) "I will page the provider and ask for your pain medication." b) "You are so close to delivery; don't you want to have natural child birth?" c) "Rather than use fentanyl, we can ask the provider to order another analgesic at this point." d) "Pain medication given now might cause the baby to have slow respirations and is not recommended, let's try to focus and breathe."
ANS: "Pain medication given now might cause the baby to have slow respirations and is not recommended, let's try to focus and breathe." Correct Explanation: Once the woman has entered into the transition phase of labor, she is considered to be imminent for delivery. Any opioid medication might pass to the fetus and is not recommended due to the effects of respiratory compromise. The nurse will need to encourage nonpharmacologic methods at this point and should not consult the provider. The nurse should also remain supportive of the mother.
A fetus is assessed at 2 cm above the ischial spines. The nurse would document fetal station as: a) +2 b) -2 c) 0 d) +4
ANS: -2
The nurse is monitoring a client in preterm labor who is receiving IV magnesium sulfate. The nurse should monitor for which adverse effects of this medication? (select all that apply) 1. flushing 2. hypertension 3. increased urine output 4. depressed respirations 5. extreme muscle weakness 6. hyperactive deep tendon reflexes
ANS: 1, 4, 5 flushing, depressed respirations, extreme muscle weakness
An opioid analgesic is administered to a client in labor. The nurse assigned to care for the client ensures that which medication is readily available if respiratory depression occurs? 1. Naloxone 2. Morphine sulfate 3. betamethasone (Celestone) 4. Meperidine hydrochloride (Demerol)
ANS: 1. Naloxone
A nurse is prepared to perform a fundal assessment on a postpartum client. The initial nursing action in performing this assessment is which of the following? 1. Ask the client to turn on her side. 2. Ask the client to urinate and empty her bladder. 3. Massage the fundus gently before determining the level of the fundus. 4. Ask the client to lie flat on her back with the knees and legs flat and straight.
ANS: 2. Ask the client to urinate and empty her bladder.
The nurse is preforming an assessment of a client who is scheduled for a cesarean delivery. Which assessment finding would indicate the need to contact the health care provider? 1. Hemoglobin of 11g/dL 2. Fetal heart rate of 180 beats/minute 3. Maternal pulse rate of 85 beats/minute 4. White blood cell count of 12,000 cells/mm3
ANS: 2. Fetal heart rate of 180 beats/minute
client in preterm labor (31 weeks) who is dilated to 4 cm has been started on magnesium sulfate and contractions have stopped. If the client's labor can be inhibited for the next 48 hrs, the nurse anticipates a prescription for which medication? 1. nalbuphine 2. betamethasone (Celestone) 3. Rh (D) immune globulin (RhoGAM) 4. Dinoprostone (Cercidil vaginal insert)
ANS: 2. betamethasone (Celestone)
Methylergonovine is prescribed for a woman to treat postpartum hemorrhage. Before administration of methylergonovine, what is the priority nursing assessment? 1. uterine tone 2. blood pressure 3. amount of lochia 4. deep tendon reflexes
ANS: 2. blood pressure Methylergonovine causes continuous uterine contractions and may cause elevated blood pressure
The nurse is preparing to administer beractant (Survanta) to a premature infant who has respiratory distress syndrome. The nurse plans to administer the medication by which route? 1. intradermal 2. intratracheal 3. subcutaneous 4. intramuscular
ANS: 2. intratracheal
A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which finding is noted on assessment? 1. proteinuria 3+ 2. respirations of 10/min 3.presence of deep tendon reflexes 4. serum magnesium level of 6 mEq/L
ANS: 2. respirations of 10/min
The maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the health care provider's prescriptions and should question which prescription? 1.Prepare the client for an ultrasound. 2.Obtain equipment for a manual pelvic examination. 3.Prepare to draw a hemoglobin and hematocrit blood sample 4. Obtain equipment for external electronic fetal heart rate monitoring
ANS: 2.Obtain equipment for a manual pelvic examination
The nurse is reviewing the record of a client in the labor room and notes that the health care provider had documented the fetal presenting part is at the -1 station. This documented finding indicates that the fetal presenting part is located at which area? 1. 1 inch below the coccyx 2. 1 inch below the iliac crest 3. 1 cm above the ischial spine 4. 1 fingerbreadth below the symphysis pubis
ANS: 3. 1 cm above the ischial spine
The nurse is caring for a client in labor. Which assessment finding indicates to the nurse that the client is beginning the second stage of labor? 1. The contractions are regular. 2. The membranes have ruptured 3. The cervix is completely dilated 4. The client starts to expel clear vaginal fluid
ANS: 3. The cervix is completely dilated
When performing Leopold's maneuvers, the nurse notes that the fetus is in the left occiput anterior position. Where should the nurse place a fetoscope best to hear the fetal heart beat? 1. Left upper quadrant. 2. Right upper quadrant. 3. Left lower quadrant. 4. Right lower quadrant.
ANS: 3. The fetoscope should be placed in the left lower quadrant for a fetus positioned in the LOA position as described in the question
A nurse is assisting in a labor and the doctor says "cephalic presentation" the nurse translates this as which of the following? A) the babies head is down B) the babies shoulder is coming out first C) the babies buttocks is coming out first D) the baby is horizontal
ANS: A
