OB NCLEX PREP questions
If a woman is pregnant for her second time, but her first pregnancy did not meet viability, what would be her parity using the four digit scoring system
0-0-1-0 Term: 0 Preterm: 0 Abort: 1 Living: 0 this is correct since the pregnancy did not reach viability
one hour ago, a multipara was examined with following results: 8 cm, 50% effaced, and +1 station. She is now pushing with contractions and the fetal head is seen at the vaginal introitus (opening). The nurse concludes that the client is now:
10 cm, 100%, +3 station the cervix is fully dilated and effaced and the station is low enough to see the fetal head
The following babies are in the nursery. Which baby should be seen first? A. 1-day-old, HR 100bpm, in a deep sleep. B. 2-day-old, T 36.7, slightly jaundiced. C. 3-day-old, breastfeeding q 4hrs, jittery. D. 4-day-old, crying, popular rash on a erythematous base.
3 day old breastfeeding q 4 hours, jittery Babies who breastfeed fewer than 8 hours a day (q 3 hours), are not receiving adequate nutrition. Jitters are indicative of hypoglycemia
The nurse on postpartum is preparing four patient for discharge. It would be MOST important for the nurse to refer which of the following patients for home care?
A 22 year old who delivered by cesarean section and is complaining of burning on urination May indicate a UTI, requires follow up
The nurse notes that a newborn, which is 5 minutes old, exhibits the following characteristics: HR 108 bpm, respiratory effort with a strong, lusty cry, pink body with acrocyanosis and some flexion. What does the nurse determine the APGAR score is?
8 2 for HR, 2 for grimace, 2 for respiratory effort, 1 for color, 1 for flexion
On the second day postpartum the patient experiences engorgement. To relieve her discomfort the nurse should encourage the patient to:
Apply ice packs to the breasts Ice helps relieve the discomfort of engorgement
A nurse is taking care for women from 4 different countries. Which of the women is most likely to request that her head be kept covered throughout her hospitilization?
Arabic woman Muslim women, who are often from Arabic countries, are expected to keep their head covered at all times
Which of the following full-term newborns require immediate attention? A. Baby with seesaw breathing. B. Baby with irregular breathing with 10-second apnea spells. C. Baby with coordinated thoracic and abdominal breathing. D. Baby with respiratory rate of 52.
Baby with seesaw breathing Seesaw breathing is a sign of respiratory distress
A nurse describes a patient's contraction pattern as: frequency every 3 min and duration 60 sec. Which of the following responses corresponds to this description?
Contractions lasting 1 minute followed by a 120 second rest period the frequency and duration of this contraction pattern is every 3 minutes lasting 60 seconds
The nurse in the postpartum unit cares for a patient who delivered her first child the previous day. During her assessment of the patient, the nurse notes multiple varicosities on the patient's lower extremities. Which of the following actions should the nurse perform?
Encourage early and frequent ambulation This facilitates emptying of blood vessels in lower extremities
A 40 week gestation neonate is in the first period of reactivity, which of the following actions should the nurse take at this time?
Encourage the parents to bond with their baby Babies are awake and alert for approximately 30 min- 1 hour immediately after birth. This is the perfect time for the parents to bond with their baby
A postpartum nurse is preparing to care for a woman who has just delivered a healthy newborn infant. In the immediate postpartum period the nurse plans to take the woman's vital signs:
Every 15 minutes for the first hour and then every 30 minutes for the next 2 hours Vital signs are taken this frequently to monitor the transition of the mom from the pregnant state to the postpartum state
A woman has decided to hire a doula to work with her during labor and delivery. Which of the following actions would be appropriate for the doula to perform?
Give the mother a back it is the doula's responsibility to assist the patient in non-pharmacologic pain management
The postpartum nurse is assessing a patient's fundus and finds it firm, 2 fingerbreadths above the umbilicus, and displaced to the right. What is the most appropriate intervention?
Have patient void and reassess a full bladder can deviate a fundus and discourage involution. Having the patient void and reassessing the fundus is the most appropriate intervention
A patient who is 7 cm dilated and 100% effaced, is breathing at a rate of 30 breaths per minute during contractions. Immediately after a contraction, she complains of tingling in her fingers with some lightheadedness. Which of the following actions should the nurse take at this time?
Have the patient breathe into a bag the patient is showing signs of hyperventilation. The symptoms will likely subside if she rebreathes her exhalations
The nurse is assessing a patient who states "I think I'm in labor." Which of the following findings would positively confirm the patient's belief?
Her cervix is dilated from 2 to 4 cm a sign of true labor is when the patient's cervix changes dilation
A nurse is assessing the lochia discharge on a 1 day postpartum woman. The nurse notes that the lochia is red and has a foul smelling odor. The nurse determines that this assessment finding is:
Indicates the presence of infection Lochia is supposed to be red this early in the postpartum period. It can be fleshy smelling but not foul smelling.
Which of the following actions is appropriate for the nurse to perform when caring for a Chinese-speaking woman in active labor?
Inquire regarding the woman's pain level It is important to inquire about the pain level of all women in labor, but especially those from the Asian culture, due to their stoic response to labor.
The nurse is assessing the fetal station during a vaginal examination. Which of the following structures should the nurse palpate?
Ischial spines Station is assessed by palpating the ischial spines
The nurse determines the fundus of the postpartum patient is boggy. Initially the nurse should:
Massage gently and reassess This would be the initial step prior to further action
To decrease the possibility of a perineal laceration laceration during delivery, the nurse performs which of the following interventions prior to the delivery?
Massage the perineum with lubrication massaging the perineum with lubrication does help to reduce perineal swelling
The nurse is teaching a new mother how to breast-feed her newborn. The nurse knows that teaching has been successful if the patient makes which of the following statements?
My baby should have at least 6-8 wet diapers a day This indicates a newborn is ingesting an adequate amount of nutrition; should have at least 3 bowel movements per day
A patient, G2P1001, 5 cm dilated, 40% effaced, had just received an epidural. Which of the following actions is important for the nurse to do at this time?
Place a wedge under the woman's side
A neonate is admitted to the nursery. The nurse makes the following assessments: 3945 gms, head circumference 35 cm, positive Ortolani sign, and presence of supernumerary nipples. Which of the assessments should be reported to the healthcare practitioner?
Positive Ortolani sign A positive Ortolani sign indicates likely development of hip dysplasia. When performing the Ortolani maneuver, the thighs are gently abducted. If the trochlear displaces from the acetabulum, the result is positive and indicative of developmental dysplasia of the hip
While caring for a patient in the transition phase of labor the nurse notes the fetal monitor tracing shows moderate variability with a baseline of 145 bpm. What should the nurse do?
Provide caring labor support The FHR tracing is normal. No interventions are needed
A patient is complaining of severe back labor. Which of the following nursing interventions should be most effective?
Provide direct sacral pressure When direct sacral pressure is applied, the nurse is providing a counteraction to the pressure being exerted by the fetal head
The nurse is caring for a Rh negative mother who states, "the doctor told me about RhoGAM, but I'm still a little confused." Which of the following responses, if made by the nurse, is MOST appropriate?
RhoGAM is given to you to prevent the formation of antibodies prevents maternal circulation from developing antibodies
During a vaginal exam, the nurse palpates fetal buttocks that are facing the left posterior and are 1 cm above the ischial spines. Which of the following are consistent with this assessment?
The LSP -1 the LSP position is the correct answer. The fetal buttocks (S or sacrum) are facing toward the mother's left posterior (LP) and a presenting part at -1 station is 1 cm above the ischial spines
A patient in labor, G2P1001, was admitted 1 hour ago at 2 cm dilated and 50% effaced. She was talkative and excited at that time. During the past 10 minutes she has become serious, closing her eyes and breathing rapidly with each contraction. Which of the following is an accurate nursing assessment of the situation?
The patient is exhibiting an expected behavior for labor this is expected during the active phase of labor
While evaluating the fetal heart monitor tracing on a patient in labor, the nurse notes that there are fetal heart decelerations present. Which of the following assessments must the nurse make at this time?
The relationship between the decelerations and the labor contractions this will determine the type of deceleration pattern
On the first postpartum day, the nurse teaches the patient about breastfeeding. Two hours later she seems to remember very little of the teaching. The nurse understands this memory lapse to be due to:
The taking in phase The taking in phase the patient is reliving the delivery experience and is very focused on the infant itself. Not the best time for teaching.
A woman had a normal, low-risk, vaginal birth 18 hours ago. Since the birth she has been perspiring profusely and her urine has been 1700 mL. Her pulse is 70 bpm and BP 138/82. How should the nurse interpret these findings
This is a normal postpartum fluid elimination in the first several days in immediate postpartum a patient can diurese up to 3L of fluid
A woman who states that she "thinks" she is in labor enters the labor suite. Which of the following assessments will provide the nurse with the most valuable information regarding the patient's labor status?
Vaginal examination a vaginal examination will provide the nurse with the best information about the status of labor
A patient is in the second stage of labor. She falls asleep immediately after a contraction. Which of the following actions should the nurse perform as a result?
cover the woman's perineum with a sheet the woman's privacy should be maintained while she is resting
Immediately following administration of an epidural anesthesia, the nurse must monitor the mother for which of the following?
drop in blood pressure hypotension is a common side effect of regional anesthesia
A nurse is assisting a nurse anesthetist with an epidural placement. Which of the following positions should the nurse assist the woman into?
fetal position the fetal position allows for the spine to curve enough to facilitate epidural placement
The nurse is providing acupressure to provide pain relief to a woman in labor. Where is the best location for the acupressure to be applied?
on a medial aspect of the lower leg has been shown to reduce the pain of labor contractions
A primigravida is pushing with contractions. The nurse notes that the woman's perineum is beginning to bulge and there is an increase in bloody show. Which of the following actions by the nurse is appropriate at this time?
Provide encouragement during each contraction. Since this is a normal finding, the nurse should continue to provide labor support and encouragement
While performing Leopold's maneuvers on a woman in labor, the nurse palpates a hard round mass in the fundal area, a flat surface on the left side, small objects on the right side, and a soft round mass just above the symphysis. Which of the following is a reasonable conclusion by the nurse?
The fetal lie is vertical with the findings of a hard round mass in the fundal area and soft round mass above the symphysis, the nurse can conclude that the fetal lie is vertical