OB Nursing
A client tells the nurse during a postpartum parenting class that she has switched her 6-month infant from formula to cow's milk to save money on the cost of formula. Which one of the following statements made by the nurse would be the best?
"Cow's milk can be safely given to an infant older than one year of age."
A client tells a nurse that she's going to breast-feed her neonate, but she isn't sure what she should eat. Which client statement requires further teaching?
"I'll take all the same medications I was taking before my pregnancy."
A primiparous client who is bottle-feeding her neonate at 12 hours after birth asks the nurse, "When will my menstrual cycle return?" Which response by the nurse would be most appropriate?
"It will probably be 6 to 10 weeks before it starts again."
While the nurse is conducting a teaching session on breast-feeding, a client asks why she should put her newborn to the breast within the first 30 minutes of birth. The nurse's best response will be:
"The neonate will be responsive and eager to suck at this time."
A neonate born at 38 weeks' gestation is admitted to the neonatal nursery for observation. The neonate's mother, who is positive for human immunodeficiency virus (HIV) infection, has received no prenatal care. The mother asks the nurse if her neonate is positive for HIV. The nurse can tell the mother which information?
"We will test your baby now, but testing will need to be repeated for an accurate diagnosis."
Which situations should a supervisor consider in making assignments for nurses in the neonatal unit?
A pregnant nurse shouldn't care for a neonate with cytomegalovirus (CMV).
The nurse is assigned to a client who experiences a syncopal episode on her first ambulation after childbirth. Which nursing actions will the nurse delegate to the licensed practical/vocational nurse (LPN/VN)? Select all that apply.
Assist nurse with ambulating client back to bed Obtain a cool compress for the head
A laboring client on oxyitocin is becoming more vocal and is voicing increased pain with the uterine contractions. The nurse performs a fetal and maternal assessment and finds that the uterus is not relaxing between contractions. Based on the assessment findings, which of the following would be the best action for the nurse?
Discontinue the oxytocin if the uterus does not relax between uterine contractions.
A client who is 5 cm dilated tells the nurse that she has the urge to push. Which of the following is the appropriate response by the nurse?
Have client blow out breath to keep from pushing
The nurse is caring for a client in labor who is receiving epidural anesthesia. The nurse assesses a blood pressure of 80/40 mm Hg. Which of the following interventions will the nurse include in the client's plan of care?
Increase the client's fluid rate
A multiparous client at 33 weeks gestation is admitted to the labor and birth area with painless vaginal bleeding. Ultrasonography shows marginal placenta previa. Which nursing interventions should be included in the plan of care for this client? Select all that apply.
Institute bed rest Establish intravenous (IV) access Apply continuous fetal heart monitoring Administer oxygen as ordered
A client at 27 weeks gestation experiences uterine cramping and also secretes a small amount of bright red bleeding and mucus. The client calls her prenatal clinic nurse. Which of the following recommendations is most appropriate from the nurse?
Instruct the client to go to an emergency room for an urgent assessment.
In a small rural facility, a nurse is caring for a neonate born to a mother with diabetes mellitus. The neonate's respiratory rate is 70 breaths/minute, heart rate 162 beats/minute, and oxygen saturation is 92% on room air. The nurse obtains a blood glucose level, which is [50 mg/dl (2.8 mmol/L)]. Realizing the seriousness of the neonate's condition, the pediatrician arranges transfer to a level III nursery. The social worker asks the nurse what transportation arrangements are needed. What type of transportation is required?
Medical helicopter sent to the rural facility from the level III facility
While preparing to provide neonatal care instructions to a primiparous client who gave birth to a term neonate 24 hours ago, what should the nurse include in the client's teaching plan?
Milia are white papules from plugged sebaceous ducts that disappear by age 2 to 4 weeks.
The nurse is assisting a client during the first stage of labor, who just received an epidural. Which medication will the nurse expect to administer next?
Oxytocin
A nurse is providing care for a postpartum client. Which condition increases this client's risk for a postpartum hemorrhage?
Placenta previa
A gravida 3 para 1 laboring client is 9 cm dilated and is changing position frequently to cope with the intensity of the contractions. The client's husband has gone to the cafeteria to take a break. The client tells the nurse that she is tired but is afraid of being left alone and that her husband will miss the birth. Which of the following is the nurse's most appropriate action?
Use the call bell to ask another nurse if he/she can help locate the client's husband.
A primiparous client, who has just given birth to a healthy term neonate after 12 hours of labor, holds and looks at her neonate and begins to cry. The nurse interprets this behavior as a sign of which response?
a normal response to the birth
A preterm infant born 2 hours ago at 34 weeks' gestation is experiencing rapid respirations, grunting, no breath sounds on one side, and a shift in location of heart sounds. The nurse should prepare to assist with which procedure?
insertion of a chest tube into the neonate
A term primigravida was involved in a car accident 3 hours ago. She is having labor contractions every 4 minutes, and her cervical exam is dilated 3cm, 100% effaced and station -1. She is crying uncontrollably and states her pain is constant and severe, rating it at 10/10. The priority action by the nurse is to:
notify the provider of the pain and request an assessment for potential abruption.
A 25-year-old primiparous client who gave birth 2 hours ago has decided to breastfeed her neonate. Which instruction should the nurse address as the highest priority in the teaching plan about preventing nipple soreness?
placing as much of the areola as possible into the baby's mouth
A primigravid client at about 36 weeks' gestation in active labor has had no prenatal care and admits to cocaine use during the pregnancy. Which person must the nurse notify?
primary care provider who will attend the birth of the infant
A multiparous client visits the urgent care center 5 days after a vaginal birth, experiencing persistent lochia rubra in a moderate to heavy amount. The client asks the nurse, "Why am I continuing to bleed like this?" The nurse should instruct the client that this type of postpartum bleeding is usually caused by which problem?
retained placental fragments
A mother who is breastfeeding and has known food sensitivities is asking the nurse what foods she should avoid in her diet. Which foods should the nurse advise the client to avoid? Select all that apply.
shellfish eggs peanuts
The health care provider (HCP) has performed an amniotomy on a laboring client. Which details must be included in the documentation of this procedure? Select all that apply.
time of rupture color and clarity of fluid fetal heart rate (FHR) and pattern before and after the procedure odor and amount of fluid
A client in labor received an epidural for pain management. Before receiving the epidural, the client's blood pressure was 124/76 mm Hg. Ten minutes after receiving the epidural, the client's blood pressure is 98/56 mm Hg, and the mother is vomiting. Before calling the health care provider (HCP), the nurse should:
turn the client to her side.
The cervix of a 15-year-old primigravid client admitted to the labor area is 2 cm dilated and 50% effaced. Her membranes are intact, and contractions are occurring every 5 to 6 minutes. Which intervention should the nurse recommend at this time?
walking around in the hallway