OB exam 3 practice q

A client asks why she should learn breathing patterns for labor. After instruction is given, the nurse determines teaching has been effective when the client states: "Breathing patterns are distraction techniques taught to decrease pain in labor." "Breathing patterns cannot be taught while in labor." "Breathing patterns help a woman concentrate on pain." "Breathing patterns must be used with a coach."

"Breathing patterns are distraction techniques taught to decrease pain in labor."

A client is scheduled for a cesarean section under spinal anesthesia. After instruction is given by the anesthesiologist, the nurse determines the client has understood the instructions when the client states: "I may end up with a severe headache from the spinal anesthesia." "I can continue sitting up after the spinal is given." "I will need to lie on my right side to reduce vena cava compression." "The anesthesia will numb both of my legs to a level above my breasts."

"I may end up with a severe headache from the spinal anesthesia."

A woman states that she does not want any medication for pain relief during labor. Her primary care provider has approved this for her. What the nurse's best response to her concerning this choice? "That's wonderful. Medication during labor is not good for the baby." "Let me get you something for relaxation if you don't want anything for pain." "I respect your preference whether it is to have medication or not." "Your health care provider is a man and has never been in labor; he may be underestimating the pain you will have."

"I respect your preference whether it is to have medication or not."

A woman has been in labor for the past 8 hours, and she has progressed to the second stage of labor. However, after 2 hours with no further descent, the provider diagnoses an "arrested descent." The woman asks, "Why is this happening?" Which response is the best answer to this question? "More than likely you have cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal." "Maybe your uterus is just tired and needs a rest." "It is likely that your body has not secreted enough hormones to soften the ligaments so your pelvic bones can shift to allow birth of the baby." "Maybe your baby has developed hydrocephaly and the head is too swollen."

"More than likely you have cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal."

The nurse is teaching a prenatal class on potential problems during pregnancy to a group of expectant parents. The risk factors for placental abruption are discussed. What comment validates accurate learning by the parents? "If I develop this complication, I will have bright red vaginal bleeding," "I need a cesarean section if I develop this problem." "Since I am over 30, I run a much higher risk of developing this problem." "Placental abruption is quite painful and I will need to let the doctor know if I begin to have abdominal pain."

"Placental abruption is quite painful and I will need to let the doctor know if I begin to have abdominal pain.

A 16-year-old client gave birth to a 12 weeks' gestation fetus last week. The client has come to the office for follow-up and while waiting in an examination room notices that on the schedule is written her name and "follow-up of spontaneous abortion." The client is upset about what is written on the schedule. How can the nurse best explain this terminology? "Abortion is a medical term for any interruption of pregnancy before a fetus is viable." "Spontaneous abortion is the medical name for a miscarriage." "Oh, that just means it was a miscarriage." "Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy."

"Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy."

A woman's husband expresses concern about risk of paralysis from an epidural block being given to his wife. Which would be the most appropriate response by the nurse? "The injection is given at the third or fourth thoracic vertebrae so paralysis is not a problem." "I have never read or heard of this happening." "The injection is given in the space outside the spinal cord." "An injury is unlikely because of expert professional care given."

"The injection is given in the space outside the spinal cord."

A client suffering a miscarriage at 12 weeks' gestations is very upset that the health care provider has ordered a D&C. How should the nurse respond after the client states she didn't have a D&C the time she lost a previous baby at 5 weeks' gestation? "Having the D&C will make it easier to get pregnant next time." "This is the procedure ordered by the doctor." "This procedure is needed to adequately remove all the fetal tissue." "You have the option to refuse the surgery."

"This procedure is needed to adequately remove all the fetal tissue."

A client in her first trimester arrives at the emergency room with reports of severe cramping and vaginal spotting. On examination, the health care provider informs her that no fetal heart sounds are evident and orders a dilatation and curettage. The client looks frightened and confused and states that she does not believe in abortion. Which statement by the nurse is best? "The choice is up to you but the healthcare provider is recommending an abortion." "You have experienced an incomplete miscarriage and must have the placenta and any other tissues cleaned out." "Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications." "I know that it is sad but the pregnancy must be terminated to save your life."

"Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications."

A client is 11 weeks pregnant after many years trying to conceive. After arriving home from a normal prenatal visit, she experiences mild cramping and has a gush of bright red vaginal bleeding. She calls the nurse and reports having soaked a pad with fresh blood in fewer than 30 minutes. The uterine cramping is worsening. What is the most appropriate response from the nurse? "You need to seek immediate attention from the primary care provider." "This is nothing to worry about. Many women bleed during pregnancy." "I am sorry. There is nothing you can do because you are likely miscarrying." "Lie down and call your health care provider tomorrow if symptoms continue."

"You need to seek immediate attention from the primary care provider." (Pregnancy loss during the early weeks of pregnancy may seem like a heavy menstrual period. A primary care provider should assess blood loss of this amount with or without uterine cramping as soon as possible.)

A patient in labor who is dilated 7 cm reports that narcotic pain medication given 3 hours ago has worn off and is asking for another dose. How should the nurse respond to this request? "Your stage of labor makes giving another dose unsafe." "I will get permission from your doctor." "Since it has been over 3 hours, you should be able to have more of the medication." "It is too early as the medication should be given only every 4 hours."

"your stage of labor makes giving another dose unsafe" (The timing of administration of narcotics in labor is especially important. If given close to birth, because the fetal liver takes 2 to 3 hours to activate a drug, the effect will not be registered in the fetus for 2 to 3 hours after maternal administration. For this reason, narcotics are preferably given when the mother is more than 3 hours away from birth. This allows the peak action of the drug in the fetus to have passed by the time of birth. The nurse does not need to get permission from the physician. Pain medication can be provided when needed and not on a set schedule of every 4 hours. The patient is nearing delivery so 3 hours from the last dose will not influence the decision to provide more medication.)

A woman at 10 weeks gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize? report of frequent mild nausea blood pressure of 120/84 mm Hg history of bright red spotting 6 weeks ago fundal height measurement of 18 cm

18 cm fundal height (A fundal height of 18 cm is larger than expected and should be further investigated for gestational trophoblastic disease (hydatidiform mole).

A pregnant client is admitted to a health care unit with disseminated intravascular coagulation (DIC). Which prescription is the nurse most likely to receive regarding the therapy for such a client? Aim at keeping the client's hematocrit above 20%. Give each unit of blood to raise the hematocrit by 3 g/dL. Administer a ratio of 1 unit of blood to 4 units of frozen plasma. Administer cryoprecipitate and platelets.

Administer cryoprecipitate and platelets.

The labor nurse reports to the nurse on the oncoming shift, "The woman in labor room 2 is handling her pain very well. She smiles whenever I go in to talk to her, and she doesn't complain at all!" What assessment by the oncoming labor nurse would best reveal if the off-going labor nurse's observations were correct? Asking the visitors in the room if they think the woman is experiencing pain Asking the woman to describe her pain and rate it on a scale of 0 to 10 Taking the woman's vital signs and consulting with other staff members No additional assessments are indicated until the woman begins to report pain.

Asking the woman to describe her pain and rate it on a scale of 0 to 10

The health care provider is reluctant to provide pain medication to a patient delivering a preterm fetus. What should the nurse explain to the patient as the reason for the preterm fetus being more affected by medication? Affinity of the preterm fetus to fat-soluble drugs Inability of the immature liver to metabolize or inactivate drugs Inability of the preterm fetus to use drugs with a molecular weight over 1,000 Affinity of the preterm fetus to drugs that are strongly bound to protein

Inability of the immature liver to metabolize or inactivate drugs

Why should a woman be cautioned against taking acetylsalicylic acid (aspirin) to relieve pain in labor? Interference with blood coagulation with increased risk of bleeding in mother or infant Interference with the ability to concentrate on contractions Competition with bilirubin-binding sites in fetal circulation increases risk of kernicterus Development of respiratory depression in the newborn

Interference with blood coagulation with increased risk of bleeding in mother or infant

A 24-year-old client presents in labor. The nurse notes there is an order to administer RhoGAM after the birth of her infant. When asked by the client the reason for this injection, which reason should the nurse point out? prevent maternal D antibody formation. promote maternal D antibody formation. prevent fetal Rh blood formation. stimulate maternal D immune antigens.

PREVENT maternal d antibody formation

A client has presented in the early phase of labor, experiencing abdominal pain and signs of growing anxiety about the pain. Which pain management technique should the nurse prioritizeat this stage? Administering an opioid such as meperidine or fentanyl Practicing effleurage on the abdomen Administering a sedative such as secobarbital or pentobarbital Immersing the client in warm water in a pool or hot tub

Practicing effleurage on the abdomen (less meds are better in the beginning)

A client reporting she recently had a positive pregnancy test has reported to the emergency department stating one-sided lower abdominal pain. The health care provider has presribed a series of tests. Which test will provide the most definitive confirmation of an ectopic pregnancy? Quantitative human chorionic gonadotropin (hCG) test. Pelvic examination. Qualitative human chorionic gonadotropin (hCG) test. Abdominal ultrasound.

QUAL human chorionic gonad. test

Which possible outcome would be a major disadvantage of any pain relief method that also affects awareness of the mother? The infant may show increased drowsiness. The mother may have continued memory loss postpartum. The mother may have difficulty working effectively with contractions. The father's coaching role may be disrupted at times.

The mother may have difficulty working effectively with contractions.

Which statement describes why hypertonic contractions tend to become very painful? More than one contraction may begin at the same time, as receptor points in the myometrium act independently of each other. The myometrium becomes sensitive from the lack of relaxation and anoxia of uterine cells. The number of uterine contractions is very low or infrequent. There is an increase in the length of labor because so many contractions are needed to achieve cervical dilation.

The myometrium becomes sensitive from the lack of relaxation and anoxia of uterine cells.

After reporting to the unit, you are assigned to the following patients. Which of the patients should be evaluated first? A. A 7-week pregnant woman who had a cervical cerclage performed 4 hours ago B. A patient diagnosed with pregnancy-induced hypertension experiencing urine output of 75 ml/hr, blood pressure of 135/90 mmHg, and slight proteinuria C. A woman at 5 weeks' gestation with suspected ectopic pregnancy complaining of shoulder and abdominal pain D. A patient in her 20th week of pregnancy suspected of having a trophoblastic pregnancy

a woman at 5 weeks gestation with suspected ectopic pregnancy complaining of shoulder and abdominal pain

The nurse is comforting and listening to a young couple who just suffered a miscarriage. When asked why this happened, which reason should the nurse share as a common cause? The age of the mother Lack of prenatal care Maternal smoking Chromosomal abnormality

chromosomal

Which assessment finding would convince the nurse to "hold" the next dose of magnesium sulfate? a.Absence of deep tendon reflexes b.Urinary output of 100 mL total for the previous 2 hours c.Respiratory rate of 14 breaths per minute d.Decrease in blood pressure from 160/100 to 140/85

absence of deep tendon reflexes (sign of magnesium toxicity)

A pregnant client at 32 weeks' gestation is treated with magnesium sulfate for seizure management. The nurse assesses which of the following for evidence of magnesium toxicity? Absence of knee jerk response Frequency of micturition Increased blood pressure Increased rate of respiration

absence of knee jerk response (Magnesium sulfate toxicity is characterized by absence of deep tendon reflexes like the knee jerk reflex)

A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's firstaction would be to: tell the woman to take short, catchy breaths. administer oxygen by mask. increase her intravenous fluid infusion rate. put firm pressure on the fundus of her uterus.

administer o2 by mask

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? Move the woman into a supine position Administration of aspirin Administration of 1000 mL of IV glucose solution Administration of 500 mL of IV Ringer's lactate

administration of 500 mL of IV ringers lactate (decreases chance of hypotension)

A primigravida client has just arrived in early labor and is showing signs of extreme anxiety over the birthing process. Why should the nurse prioritize helping the client relax? Anxiety can slow down labor and decrease oxygen to the fetus. Decreased anxiety will increase trust in the nurse. Anxiety will increase blood pressure, increasing risk with an epidural. Increased anxiety will increase the risk for needing anesthesia.

anxiety can slow down labor and decrease O2 to fetus

A pregnant patient is diagnosed with placenta previa. Which action should the nurse implement immediately for this patient? Help the patient remain ambulatory to reduce bleeding. Prepare for a vaginal examination to assess the extent of bleeding. Assess fetal heart sounds with an external monitor. Assess uterine contractions by an internal pressure gauge.

assess fetal heart sounds w external monitor

The nurse has just applied a sterile pressure dressing to an epidural site after removing the epidural catheter in a client who is now recovering from a standard delivery. Which action should the nurse now prioritize? Assess return of sensory and motor functions to the lower extremities. Make sure the client receives plenty of fluids. Let the client rest and recover while keeping her legs slightly elevated. Help the client get up and walk around immediately.

assess return of sensory/motor fxn to lower extremities

A nurse in the maternity triage unit is caring for a client with a suspected ectopic pregnancy. Which nursing intervention should the nurse perform first? Obtain a surgical consent from the client. Assess the client's vital signs. Provide emotional support to the client and significant other. Administer oxygen to the client.

assess vitals (at risk for hypovolemic shock)

It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time? 24 hours before birth and 24 hours after birth in the first trimester and within 2 hours of birth at 32 weeks' gestation and immediately before discharge at 28 weeks' gestation and again within 72 hours after birth

at 28 weeks gestation and again within 72 hours after birth

The client and her partner have prepared for a natural birth and bring a picture of a sunset over the ocean with them. The nurse predicts they will be using which techniuqe during labor? Water therapy Attention focusing Hypnosis Patterned birthing

attention focusing

A client reports bright red, painless vaginal bleeding during her 32nd week of pregnancy. A sonogram reveals that the placenta has implanted low in the uterus and is partially covering the cervical os. Which immediate care measures are initiated? Select all that apply. Obtain baseline vital signs and compare to those vital signs previously obtained. Place the woman on bedrest maintaining the supine position. Determine the time the bleeding began and about how much blood has been lost. Assist the client in stirrups and perform a pelvic examination. Attach external monitoring equipment to record fetal heart sounds and kick counts.

baseline vitals/compare them determine the time the bleeding began/how much was lost attach external monitoring to record fetal heart sounds/kick counts

After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful? "My blood pressure will continue to be increased for about 6 more months." "I will be sure to avoid getting pregnant for at least 1 year." "I won't use my birth control pills for at least a year or two." "My intake of iron will have to be closely monitored for 6 months."

be sure to avoid getting pregnant for at least 1 year

A nurse is preparing a nursing care plan for a client who is admitted at 22 weeks' gestation with advanced cervical dilatation to 5 cm, cervical insufficiency, and a visible amniotic sac at the cervical opening. Which primary goal should the nurse prioritize at this point? Give birth vaginally Notification of social support for loss of pregnancy Bed rest to maintain pregnancy as long as possible Education on causes of cervical insufficiency for the future

bed rest to maintain pregnancy as long as possible

A 16-year-old client has been in the active phase of labor for 14 hours. An ultrasound reveals that the likely cause of delay in dilatation is cephalopelvic disproportion. Which intervention should the nurse most expect in this case? administration of oxytocin darkening room lights and decreasing noise and stimulation cesarean birth administration of morphine sulfate

cesarean birth

The client is progressing into the second stage of labor and coping well with the natural birth method. Which instructions should the nurse prioritize at this point in the process? Stay low on her back to ease the back pain. Ask for privacy, and have just the partner present. Use the Valsalva maneuver for effective pushing. Use a birthing ball and find a position of comfort.

birthing ball (valsalva manuever may result in hypertension, so must instruct mom to breathe as she pushes)

A client tells that nurse in the doctor's office that her friend developed high blood pressure on her last pregnancy. She is concerned that she will have the same problem. What is the standard of care for preeclampsia? Take low-dose antihypertensive prophylactically. Have her blood pressure checked at every prenatal visit. Take one aspirin every day. Monitor the client for headaches or swelling on the body.

bp checked every visit

A woman has been diagnosed as having gestational hypertension. Which symptom for this condition is the most typical? susceptibility to infection increased perspiration weight loss blood pressure elevation

bp elevation

A pregnant woman who is carrying triplets is concerned when her obstetrician suggested that she give birth by cesarean delivery. What is the most accurate statement that the nurse can make to the woman regarding this? A. Traditional labor room suites cannot accommodate the personnel needed during the birth of three infants like the operating room can. B. It is safer to know exactly when the delivery will occur so that the healthcare team will be available. C. A cesarean delivery helps to prevent complications due to cord prolapse or premature placental separation. D. Labor contractions are so powerful in a multiple gestation that a cesarean delivery is safer for the infants and mother.

c section helps to prevent complications due to cord prolapse or premature placental separation

A woman gave birth to a newborn via vaginal birth with the use of a vacuum extractor. The nurse would be alert for which possible effect in the newborn? central nervous system injury asphyxia clavicular fracture cephalhematoma

cephalhematoma

A woman of 16 weeks' gestation telephones the nurse because she has passed some "berry-like" blood clots and now has continued dark brown vaginal bleeding. Which action would the nurse instruct the woman to do? "Continue normal activity, but take the pulse every hour." "Come to the health facility with any vaginal material passed." "Come to the health care facility if uterine contractions begin." "Maintain bed rest, and count the number of perineal pads used."

come to the health facility with any vaginal material passed

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication? deep tendons reflexes 2+ urinary output of 20 mL per hour respiratory rate of 10 breaths/minute difficulty in arousing

deep tendon reflexes 2+

A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which condition in the client is likely to increase the risk for shoulder dystocia? diabetes nullipara preterm birth pendulous abdomen

diabates

Which primary symptom does the nurse identify as a potentially fatal complication of epidural or intrathecal anesthesia? Intense pain Staggering gait Difficulty breathing Decreased level of consciousness

difficulty breathing

A pregnant patient is prescribed to have labor induced with oxytocin. How should the nurse prepare to administer this medication? Diluted in the main intravenous fluid In two divided intramuscular sites Diluted as a "piggyback" infusion In a 20-cc bolus of saline

diluted as a piggyback infusion

A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom should the nurse prioritize? A dipstick value of 2+ for protein Pedal edema Weight gain of 1.2 lb (0.54 kg) during the past 1 week A systolic blood pressure increase of 10 mm Hg

dipstick value of 2+ for protein

The nurse is monitoring a woman who is receiving oxytocin IV to assist with uterine irritability. Which action should the nurse prioritize if the woman's contractions are determined to be 80 seconds in length after 1 hour of administration of the oxytocin? Slow the infusion to under 10 gtts per minute. Continue to monitor contraction duration every 2 hours. Discontinue the oxytocin infusion. Increase the flow rate of the main line infusion.

discontinue the oxytocin infusion (If uterine contractions lengthen beyond 70 seconds, there is apt to be an interference with fetal circulation. Discontinuing the infusion allows contractions to shorten in length and allow fetal nourishment. The nurse would not increase the flow rate of the main line infusion or slow the infusion without the primary care provider's prescription. Uterine contractions are monitored continuously.)

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? elevated liver enzymes elevated platelet count hyperglycemia disseminated intravascular coagulopathy (DIC)

elevated liver enzymes

A patient in labor has a spinal cord injury and is unable to effectively push with contractions. Forceps will be used. What should the nurse do to prepare the patient for this type of delivery? Select all that apply. Begin an intravenous infusion of replacement fluid Ensure that the patient's membranes have ruptured. Validate that the cervix is fully dilated. Provide oxygen 2 L via face mask. Determine that the patient's bladder is empty.

ensure the patients membranes have ruptured validate that the cervix is fully dilated determine the patient's bladder is empty

A client in week 38 of her pregnancy has an ultrasound performed at a routine office visit and learns that her fetus has not moved out of a breech position. Which intervention does the nurse anticipate for this client? forceps birth vacuum extraction external cephalic version trial labor

external cephalic version

Which type of anesthesia is anticipated when the delivery of the fetus must be done quickly due to an emergency situation? Short acting Local Regional General

general (reserved for emergencies in which the fetus must be delivered immediately to save the life of the fetus, mother or both)

A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find? preterm pregnancy gestational diabetes maternal rickets small body size of mother

gestational diabetes

Which nursing action is required before a client in labor receives an epidural? Observing maternal gait Checking for maternal pupil dilation Giving a fluid bolus of 500 ml Testing maternal reflexes

giving a fluid bolus of 500 ml (prevents hypotension)

When collecting data to devise a labor plan for a multiparous woman, which question bestallows the nurse to develop individualized strategies? "How do you want the health care team to plan your care?" "Who do you want to be with you when you are in labor?" "Tell me how you handled labor pain in your past deliveries." "Picking from these options, what options do you feel is best?"

how did you handle labor pain in the past

A patient is admitted with a diagnosis of ectopic pregnancy. For what should the nurse anticipate preparing the patient? Bed rest for the next 4 weeks Immediate surgery Intravenous administration of a tocolytic Internal uterine monitoring

immediate surgery (An ectopic pregnancy is one in which implantation occurred outside the uterine cavity, usually within the fallopian tube. As the embryo grows, the fallopian tube can rupture. The therapy for ruptured ectopic pregnancy is laparoscopy to ligate the bleeding vessels and to remove or repair the damaged fallopian tube.)

A 24-year-old woman presents with vague abdominal pains, nausea, and vomiting. An urine hCG is positive after the client mentioned that her last menstrual period was 2 months ago. The nurse should prepare the client for which intervention if the transvaginal ultrasound indicates a gestation sac is found in the right lower quadrant? Bed rest for the next 4 weeks Intravenous administration of a tocolytic Immediate surgery Internal uterine monitoring

immediate surgery (s/s of ectopic pregnancy)

The nurse is assisting a client through labor, monitoring her closely now that she has received an epidural. Which finding should the nurse prioritize to the anesthesiologist? Dry, cracked lips Urinary retention Inability to push Rapid progress of labor

inability to push (epidural dose may need to be adjusted)

After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? supine side-lying sitting knee-chest

knee to chest

The nurse is caring for a client suspected to have a uterine rupture. The nurse predicts the fetal monitor will exhibit which pattern if this is true? Early decelerations Mild decelerations Variable decelerations Late decelerations

late decels

What would be the physiologic basis for a placenta previa? a placenta with multiple lobes low placental implantation a uterus with a midseptum a loose placental implantation

low placental implantation

What terminology would the nurse use to document a newborn who weighs 4,000 grams (8.13 lb) or more at birth? meconia macrosomia microsomia hydrocephalus

macrosomia

The most important nursing intervention after the injection of epidural anesthesia is monitoring: a.Urinary output. b.Contractions. c.Maternal blood pressure. d.Intravenous infusion rate.

maternal BP

You assess that the fetus of a woman is in an occiput posterior position. You know that her labor most likely will be different from a woman whose fetus is in an anterior position in that the woman A.Will have a shorter second stage of labor B.May experience more pronounced back pain C.May need to have an external cephalic version performed D.Probably will need to have the delivery assisted by forceps or vacuum extraction

may experience more pronounced back pain

Which medication would the nurse prepare to administer if prescribed as treatment for an unruptured ectopic pregnancy? ondansetron oxytocin methotrexate promethazine

methotrexate (Methotrexate, a folic acid antagonist that inhibits cell division in the developing embryo, is most commonly used to treat ectopic pregnancy.)

Which medication is administered to reverse the depressant effects of opioids? naloxone butorphanol nalbuphine meperidine

naloxone

A woman who is Rh negative asks the nurse how many children she will be able to have before Rh incompatibility causes them to die in utero. The nurse's best response would be that: she will have to ask her primary care provider. as long as she receives RhoGAM, there is no limit. no more than three children is recommended. only her next child will be affected.

no limit as long as she receives RhoGAM

A nurse assesses a client in labor and suspects hypotonic uterine dysfunction. Which intervention would the nurse expect to include in the plan of care for this client? administering oxytocin encouraging the woman to assume a hands-and-knees position providing a comfortable environment with dim lighting preparing the woman for an amniotomy

oxytocin

During their experience in L & D, a group of nursing students are observing a woman who is having uncoordinated contractions where the monitor shows some contractions close together, followed by a long period without any contractions. The nurse asks the students, "Which medication may help to stimulate a more effective, consistent pattern of contractions?" Which medication would be considered the best answer? terbutaline morphine sulfate betamethasone oxytocin

oxytocin (Oxytocin administration may be helpful in uncoordinated labor to stimulate a more effective and consistent pattern of contractions with a better, lower resting tone.)

A woman in labor for over 12 hours has very little progress. The health care provider thinks that her contractions lack the force needed to propel the infant downward through the birth canal. The provider asks a group of nursing students which hormone may need to be given to increase the force of the contraction. Which hormone would be the best answer? oxytocin, a posterior pituitary hormone antidiuretic hormone, a posterior pituitary hormone luteinizing hormone, an anterior pituitary hormone growth hormone, an anterior pituitary hormone

oxytocin, a posterior pituitary hormone

The nurse is preparing an educational event for pregnant women on the topic of labor pain and birth. The nurse understands the need to include the origin of labor pain for each stage of labor. What information will the nurse present for the first stage of labor? It is reported as the worst pain a woman will ever feel. Pain originates from the cervix and lower uterine segment. Diffuse abdominal pain signals a complication with progression of labor. Pain is focal in nature.

pain originates from the cervix/lower uterine segment

A client is 20 weeks pregnant. At a prenatal visit, the nurse begins the prenatal assessment. Which finding would necessitate calling the primary care provider to assess the client? The client has pink vaginal discharge and pelvic pressure. The client vomited. The client has a white vaginal discharge. The client has rhinitis and epistaxis.

pink vaginal discharge and pelvic pressure

Glucose metabolism is profoundly affected during pregnancy because a.pancreatic function in the islets of Langerhans is affected by pregnancy. b.a pregnant woman uses glucose at a more rapid rate than a nonpregnant woman. c.a pregnant woman increases her dietary intake significantly. d.placental hormones are antagonistic to insulin, resulting in insulin resistance.

placental hormones are antagonistic to insulin, resulting in insulin resistance.

You are preparing for an induction of labor. Which of these would the nurse expect to do in preparation? A.Prepare oxytocin as prescribed using a piggyback intravenous setup. B.Teach the pregnant woman to lie on her back as much as possible during labor. C.Make sure that a fetoscope is available in the room for monitoring. D.Assure the pregnant woman that the induction process will assure a shorter than usual labor.

prepare oxytocin as prescribed using a piggyback IV set up (As a safety measure, oxytocin should always be administered through a secondary line. A side-lying position (especially the left side) is preferable because it is the optimum position for fetal oxygenation and avoids vena cava syndrome.)

A client at 27 weeks' gestation is admitted to the OB unit afer reporting headaches and edema of her hands. Review of the prenatal notes reveals BP consistently above 136/90 mm Hg. The nurse anticipates the health care provider will order magneisum sulfate to accomplish which primary goal? Prevent maternal seizures Decrease blood pressure Decrease protein in urine Reverse edema

prevent seizures

Which neonatal assessment is the highest priority if the mother received meperidine during labor? Respiratory rate Temperature regulation Time of first meconium Lung sounds

resp. rate

A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which effect? hyperreflexia abdominal distention urinary retention respiratory depression

respiratory depression

What action should be initiated to limit hypovolemic shock when uterine inversion occurs? a.Administer oxygen at 3 L/minute by nasal cannula. b.Administer an oxytocic drug by intravenous push. c.Monitor the fetal heart rate every 5 minutes. d.Restore circulating blood volume by increasing the intravenous infusion rate

restore circulating blood volume by increasing the IV rate (Intravenous fluids are necessary to replace the lost blood volume that occurs in uterine inversion)

The nurse is concerned that a pregnant patient is experiencing abruptio placentae. What did the nurse assess in this patient? Sharp fundal pain and discomfort between contractions Pain in a lower quadrant and increased pulse rate Painless vaginal bleeding and a fall in blood pressure Increased blood pressure and oliguria

sharp fundal pain and discomfort between contractions

When assessing a pregnant woman with vaginal bleeding, the nurse would suspect a threatened abortion based on which finding? cervical dilation slight vaginal bleeding passage of fetal tissue strong abdominal cramping

slight vaginal bleeding (Slight vaginal bleeding early in pregnancy, no cervical dilation, and a closed cervical os are associated with a threatened abortion)

A prenatal client who is 6 weeks' gestation calls the clinic to report vaginal bleeding. For what concern will the nurse further assess the client? Nuchal cord Urinary tract infection Braxton Hicks contractions Spontaneous abortion

spontaneous abortion

The nurse is monitoring a pregnant patient who is receiving intravenous magnesium sulfate for eclampsia. During the last assessment, the nurse was unable to elicit a patellar reflex. What should the nurse do? Stop the current infusion. Check fetal heart rate. Increase the infusion rate. Measure blood pressure.

stop the current infusion (When infusing magnesium sulfate, the nurse should stop the infusion if deep tendon reflexes are absent)

A client and her husband have prepared for a natural birth; however, as the client progresses to 8 cm dilation, she can no longer endure the pain and begs the nurse for an epidural. What is the nurse's best response? Suggest a less extreme alternative such as a sedative. Support the client's decision and call the obstetrician. Gently remind the client of her goal of a natural birth and encourage and help her. Ask the husband to gently remind her of their goal of natural birth and to encourage and help her.

support the clients decision and call the OB

A pregnant patient with a history of premature cervical dilatation undergoes cervical cerclage. Which outcome indicates that this procedure has been successful? The client delivers a full-term fetus at 39 weeks' gestation. The client's membranes spontaneously rupture at week 30 of gestation. The client has reduced shortness of breath and abdominal pain during the pregnancy. The client experiences minimal vaginal bleeding throughout the pregnancy.

the client delivers a full term fetus at 39 weeks

The nurse is monitoring the client's vital signs and notes: 100.2oF (37.9oC), heart rate 82, respiratory rate 17, and blood pressure 124/78. What is the best response when the client's partner asks if she is getting sick? "Have you been exposed to any illnesses recently?" "She may be developing an infection." "She's dehydrated and needs something to drink." "The fever may be due to the epidural."

the fever may be due to the epidural

A young woman presents at the emergency department reporting lower abdominal cramping and spotting at 12 weeks' gestation. The primary care provider performs a pelvic examination and finds that the cervix is closed. What does the care provider suspect is the cause of the cramps and spotting? Habitual abortion Threatened abortion Cervical insufficiency Ectopic pregnancy

threatened abortion

Immediately following an epidural block, a pregnant patient's blood pressure suddenly falls to 90/50 mmHg. What action should the nurse take first? Ask the patient to take deep breaths. Turn onto the left side or raise the legs. Raise the head of the bed. Place the patient supine.

turn onto left side or raise the legs

A woman at 39 weeks' gestation is brought to the emergency department in labor following blunt trauma from an vehicle accident. The labor has been progressing well after the epidural when suddenly the woman reports severe pain in her back and shoulders. Which potential situation should the nurse suspect? Dystocia Uterine rupture Fractured ribs Placental abruption

uterine rupture

A woman in active labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly, the woman grabs the nurse's hand and states, "Something inside me is tearing." The nurse notes her blood pressure is 80/50 mm Hg, pulse rate is 130 bpm and weak, the skin is cool and clammy, and the fetal monitor shows bradycardia. The nurse activates the code team because the nurse suspects the client may be experiencing which complication? an undiagnosed abdominal aorta aneurysm uterine rupture an amniotic embolism to the lungs compression on the inferior vena cava

uterine rupture

A woman with a history of crack cocaine use disorder is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also reports acute abdominal pain that is continuous. Which condition would the nurse suspect? uterine rupture umbilical cord prolapse amniotic fluid embolism shoulder dystocia

uterine rupture

A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer? corticosteroids sedatives uterine stimulants tocolytics

uterine stimulants

The obstetric nurse is caring for a pregnant client who has been diagnosed with hydatidiform mole. What assessment should the nurse prioritize? Vaginal bleeding Blood pressure Severe nausea and vomiting Pain

vaginal bleeding