OB Practice Test (Ch. 9-19)
Which patient does the nurse identify as likely to require a Cesarean delivery? A) Postterm B) O-negative blood type C) Active genital herpes D) 35 weeks' gestation
C) Active genital herpes
After a patient has been taught postpartum self-care, which statement by the mother indicates the need for further teaching? A) "I will make an appointment with my provider to have my episiotomy stitches removed next week." B) "I can take acetaminophen and use warm sitz baths to control discomfort at my episiotomy site." C) "I'll keep a squirt bottle filled with warm water in the bathroom to cleanse with each time I urinate." D) "I will wear my nursing bra at all times, even when I go to bed, as long as I continue to nurse the baby."
A) "I will make an appointment with my provider to have my episiotomy stitches removed next week."
Which statement by the nurse is most appropriate when a patient is reluctant to sign the consent for admission? A) "Signing this form gives us permission to take care of you." B) "If you don't sign this form, we cannot take care of you." C) "Everyone admitted to the hospital needs to sign this form." D) "It's your choice whether to sign or not sign this form."
A) "Signing this form gives us permission to take care of you."
A laboring patient becomes severely hypoxic and hypotensive, has altered mental status, and begins to have seizures. Which is the priority nursing intervention? A) Administering oxygen B) Initiating the rapid response team C) Providing emotional support for patient and family D) Administering IV fluids
A) Administering oxygen
A patient is in active labor, 6 cm dilated, 100% effaced with intact amniotic membranes. Which procedure does the nurse anticipate? A) Amniotomy B) Episiotomy C) Amnioinfusion D) Intermittent fetal monitoring
A) Amniotomy
The nurse examines a woman's lochia and notices excessive bleeding. Which is the nurse's priority action? A) Assessing for a full bladder B) Placing the patient in the Trendelenburg position C) Massaging the uterus D) Encouraging the woman to breastfeed
A) Assessing for a full bladder
A woman in active labor has not progressed since reaching 6 cm dilation. Which is the nurse's priority of care? A) Assisting with bladder emptying B) Administering analgesics C) Encouraging and reinforcing relaxation and breathing D) Encouraging position changes
A) Assisting with bladder emptying
When analyzing a fetal heart strip, the nurse notes the absence of accelerations for the past 15 minutes. Which is the nurse's priority action? A) Change the maternal position B) Notify the health-care provider C) Administer oxygen to the mother D) Monitor for an additional 15 minutes
A) Change the maternal position
A woman in labor uses hypnosis to manage pain, which the nurse recognizes as a component of which method? A) Dick-Read method B) Bradley method C) Lamaze method D) Leboyer method
A) Dick-Read method
When analyzing a fetal monitor strip, the nurse recognizes that which decelerations are not an indication for concern and require no nursing interventions? A) Early decelerations B) Late decelerations C) Variable decelerations D) Absent decelerations
A) Early decelerations
During contractions, which is the nurse's priority teaching for a woman in active labor? A) Encouraging proper breathing and relaxation techniques B) Encouraging position changes C) Encouraging urination D) Teaching about the progression of labor contractions
A) Encouraging proper breathing and relaxation techniques
Which method of cervical ripening and induction of labor does the nurse consider safest and least likely to result in complications? A) Insertion of a transcervical Foley catheter B) Application of prostaglandin gel C) Administration of Prepidil Endocervical Gel D) Infusion of oxytocin (Pitocin)
A) Insertion of a transcervical Foley catheter
During the induction process, a patient frequently asks, "What are you doing now?" or "What is that for?" Which nursing diagnosis is most appropriate for this patient? A) Knowledge Deficit related to induction of labor B) Fear/Anxiety C) Risk for Injury D) Altered Mental Status
A) Knowledge Deficit related to induction of labor
A breastfeeding mother says, "One good thing about breastfeeding is that I won't have to worry about getting pregnant till I stop." Which information will the nurse provide to this patient? A) Ovulation and menstruation may be delayed by breastfeeding, but not always. B) Ovulation will resume as early as 27 days after delivery. C) Ovulation will resume within 30 days of stopping breastfeeding. D) By breastfeeding even once a day, she can delay ovulation.
A) Ovulation and menstruation may be delayed by breastfeeding, but not always.
Which teaching should the patient scheduled for a Cesarean birth receive during a routine visit with the provider 2 weeks prior to hospital admission? A) Pack for 3 to 5 days in the hospital. B) Obtain preoperative laboratory work. C) Sign a consent for the operative procedure. D) Maintain good hydration.
A) Pack for 3 to 5 days in the hospital.
It is time for a newborn to have blood collected for the newborn screening. How does the nurse turn this into a bonding opportunity for the mother? A) Perform the test in the mother's room and encourage her to comfort the newborn afterward B) Take the baby to the nursery for the test to avoid upsetting the mother C) Explain the bandage on the baby's foot when returning the baby to the mother's room D) Perform the test without mentioning it to the mother to reduce anxiety
A) Perform the test in the mother's room and encourage her to comfort the newborn afterward
Which is the best intervention for the nurse to use to promote eye contact between the mother and newborn? A) Pointing out characteristics of the newborn such as eye color, milia, and other facial features B) Encouraging the mother to change the baby's diaper C) Encouraging the mother to hold the baby D) Taking the baby to the nursery and allowing the mother to rest
A) Pointing out characteristics of the newborn such as eye color, milia, and other facial features
A woman's labor is not progressing, and the fetus is found to be in the breech position. Which of the seven Ps of labor is involved with this woman's failure to progress? A) Presentation B) Passenger C) Passage D) Powers
A) Presentation
Which events after delivery of the placenta cause the uterus to contract and begin shrinking to nonpregnant size? A) Reduced estrogen and progesterone levels B) Reduced estrogen and oxytocin levels C) Reduced progesterone and oxytocin levels D) Estrogen, progesterone, and oxytocin levels decline.
A) Reduced estrogen and progesterone levels
The nurse examines a patient with postpartum hemorrhaging. Which assessment finding indicates placenta accreta rather than retained placenta? A) Severe lower abdominal pain B) Heavy vaginal bleeding C) Elevated heart rate and hypotension D) Pale mucous membranes and nailbeds
A) Severe lower abdominal pain
Which behavior observed by the nurse indicates a new mother is beginning to bond with her newborn? A) Takes the en face position B) Tells the nurse about her labor experience C) Needs reassurance of her ability to be a good mother D) Asks to keep the baby in the nursery overnight so she can sleep
A) Takes the en face position
The nurse identifies which client as being at highest risk for placental abruption? A) The client with hypertension B) The client who reports drinking one beer 2 months ago C) The client who uses marijuana D) The client delivering triplets
A) The client with hypertension
After a successful external cephalic version, the patient says, "Oh good! Now I won't have to worry about having a Cesarean section!" Which teaching should the nurse provide this patient in response to this comment? A) The fetus can drift back into an abnormal presentation. B) There is no reason to worry about having a Cesarean section. C) Potential complications following the procedure D) Need to drink plenty of fluids for the next 24 hours Table for Individual Question Feedback
A) The fetus can drift back into an abnormal presentation.
Which patient does the nurse consider at lowest risk for urinary retention? A) The patient who received an IV narcotic for pain management B) The patient who received a pudendal block prior to delivery C) The patient who received an epidural anesthetic D) The patient who received a spinal anesthetic
A) The patient who received an IV narcotic for pain management
A patient's cervix is 2 cm dilated and 40% effaced, the fetal head is in the 0 station, and the consistency of the cervix is medium and is in the midposition. On the basis of the calculated Bishop score, how does the nurse interpret these findings? A) The patient's cervix is ripe and ready for induction. B) The patient's cervix is ripening, but readiness for induction is questionable. C) Induction could be attempted, but cervical ripening is questionable. D) The patient's cervix is not ripe, and induction should not be initiated at this time.
A) The patient's cervix is ripe and ready for induction.
The nurse assesses which patient as having the best chance of a successful vaginal birth after a Cesarean section? A) The woman whose first and third children were born vaginally B) The woman with well-controlled gestational diabetes C) The woman whose last child is 12 months old and was born by Cesarean section D) The woman requiring induction of labor 4 years after a Cesarean section
A) The woman whose first and third children were born vaginally
When planning care, the nurse determines that which patient is appropriate for intermittent fetal monitoring? A) The woman whose pregnancy is at 38 weeks' gestation B) The woman receiving an epidural anesthetic C) The woman with controlled gestational diabetes D) The woman whose 5-year-old was born by Cesarean section
A) The woman whose pregnancy is at 38 weeks' gestation
The physician performs an amniotomy on a laboring woman. Which is the nurse's priority of care after the procedure? A) Pain assessment B) Measuring fetal heart tones C) Assessing cervical dilation D) Encouraging intake of clear liquids
B) Measuring fetal heart tones
What will the nurse instruct the patient to do when the provider begins to apply traction to the vacuum extractor? A) Hold her breath and count to 10 B) Push with the contraction C) Turn to her left side D) Pant to avoid pushing
B) Push with the contraction
A multipara woman presents to the labor unit in active labor, dilated to 9 cm, and requesting something to manage the pain. Which anesthetic is most appropriate for this patient? A) Epidural B) Spinal C) IV narcotic D) Local
B) Spinal
While the nurse is talking to a laboring woman, her amniotic membranes rupture. Which is the nurse's priority of care? A) Vital signs B) Cervical examination C) Assessment of fluid D) Assessment of fetal heart rate
D) Assessment of fetal heart rate
A newborn has a 1-minute Apgar of 3 and a 5-minute Apgar of 5. When will the next Apgar be performed by the nurse? A) At 6 minutes of life B) Every 15 minutes until a score of 10 is achieved C) 4 minutes later D) At 10 minutes of life
D) At 10 minutes of life
The nurse who is teaching a class for peers to explain the physiology of pain explains that somatic pain is caused by what? A) Decrease in blood supply to the uterus during contractions B) Stretching of the perineum during fetal descent C) Afferent and efferent impulses sent from fibers near the cervix D) The early stages of labor from stretching and dilation of the cervix
B) Stretching of the perineum during fetal descent
The nurse recognizes which patient is at risk for delivering an infant with shoulder dystocia? A) The patient in premature labor B) The patient with fetal macrosomia C) The patient whose labor has been induced D) The patient with hypertension
B) The patient with fetal macrosomia
Which patient does the nurse recognize as not an appropriate candidate for amniotomy? A) The woman who is at 41 weeks' gestation B) The woman with a fetus in the breech presentation C) The woman with a history of hypertension D) The woman with a history of precipitous delivery
B) The woman with a fetus in the breech presentation
The nursing instructor observes a student providing care to an adolescent postpartum patient. Which statement made by the student indicates the need for further teaching? A) "Let me show you a way to hold the baby when you're giving him a bath." B) "Do you want your little friend to stay while you breastfeed?" C) "You're going to be a great mother because you really want to learn." D) "Do you have any questions or need help with anything?"
B) "Do you want your little friend to stay while you breastfeed?"
A woman considering options for where to give birth asks the nurse if home birth is safe. Which is the nurse's best response? A) "Home birth is safe if there are no complications for the mother or infant." B) "Home delivery is an option you should talk with the physician about." C) "Delivering at home is safe as long as there's a hospital within a 5-minute drive." D) "I would never consider delivering my baby at home because of the rate of poor outcomes."
B) "Home delivery is an option you should talk with the physician about."
The nurse is assisting with the care of multiple patients in labor and recognizes the need to notify the health-care provider for which patient? A) A primipara whose dilation has progressed from 4 to 5 cm over the past 2 hours B) A primipara who dilated to 6 cm, and then her contractions stopped C) A multipara who is 7 cm dilated with an intact amniotic membrane D) A multipara who is 8 cm dilated and is becoming irritable and restless
B) A primipara who dilated to 6 cm, and then her contractions stopped
The nurse reviews the charts of patients who have expressed an interest in home birth and recommends which patient as a potential candidate? A) A woman whose 1-year-old child was born via Cesarean section B) A primipara with a history of infertility C) A woman desiring an epidural for pain control D) A woman whose last child was stillborn
B) A primipara with a history of infertility
When a patient is prepared for discharge post-Cesarean section, which teaching does the nurse provide? A) Plan to be in the hospital for 3 to 5 days. B) Arrange for help at home. C) Keep hair on the lower abdomen and pubis clipped. D) Avoid unnecessary activity for 2 weeks.
B) Arrange for help at home.
After the nurse assesses a woman's uterus and finds it soft and boggy with no improvement after massage, which is the priority intervention? A) Notifying the provider B) Assessing the bladder C) Inserting a catheter D) Having the woman breastfeed
B) Assessing the bladder
A patient in the transition phase of labor is 8 cm dilated and reports feeling the need to push. Which is the nurse's priority teaching for this patient? A) Warning her labor coach of potential irritability during this phase B) Assisting with pant-blow breathing C) Instructing her to inform the nurse of feelings of nausea D) Assisting her into a position to push effectively
B) Assisting with pant-blow breathing
The nurse assesses a fetal heart rate as 190 bpm, with minimal baseline variability and recurring variable decelerations with moderate variability. How does the nurse classify these findings? A) Category I B) Category II C) Category III D) Falling between category II and category III
B) Category II
The nurse is caring for a woman who delivered her third child 2 days ago and who says, "I am having pain; it feels like labor pain. I never experienced this with my other children, and it is worse when I breastfeed." Which is the nurse's priority response? A) Further assess the pain's location, intensity, and frequency B) Explain the purpose of afterpains and reassure the patient C) Immediately obtain vital signs and monitor vital signs every 15 minutes D) Administer a narcotic analgesic to control pain
B) Explain the purpose of afterpains and reassure the patient
The nurse is caring for a woman with suspected macrosomia. Which assessment finding best indicates the ability to deliver vaginally? A) Cervical dilation at 10 cm B) Fetus at +3 station C) 100% effacement D) Fetus at +1 station
B) Fetus at +3 station
The nurse is caring for a woman who has been admitted with a diagnosis of polyhydramnios and recognizes which as the most likely cause? A) Fetal kidney failure B) Gastrointestinal blockage C) Rupture of the membranes D) Fetal demise
B) Gastrointestinal blockage
The nurse is caring for a patient in labor with a known history of drug abuse. How does the patient's history impact the nursing plan of care? A) Narcotics should not be administered to someone with a history of drug abuse. B) Higher dosages of medications may be needed to manage this patient's pain. C) Local anesthetics are the anesthetic of choice for this patient. D) The woman should be encouraged to use nonpharmacological pain management.
B) Higher dosages of medications may be needed to manage this patient's pain.
A woman reports she has not urinated since delivering 8 hours ago and says she has no urge to void despite drinking adequate fluids postpartum. The nurse attributes this to what? A) The woman was dehydrated and has not fully hydrated yet to produce urine. B) The woman's bladder tone is reduced, and she does not feel the urge to urinate. C) The bladder has more room to expand and can hold more urine because of a smaller uterus. D) The woman is experiencing a release of epinephrine, causing absence of bladder sensation.
B) The woman's bladder tone is reduced, and she does not feel the urge to urinate.
After Leopold's maneuver is performed, the patient asks the nurse, "Why did you do that?" Which is the nurse's best explanation? A) "This is a check for fetal well-being." B) "This tells me if there will be any complications during delivery." C) "I was checking to see what position the fetus is in." D) "I was checking to see how you are progressing."
C) "I was checking to see what position the fetus is in."
Which assessment finding is most important for the nurse to report immediately after the performance of an amniotomy? A) Temperature of 37.6°C B) Clear, odorless amniotic fluid C) Abnormal fetal heart rate (FHR) pattern D) Leakage of clear fluid from the vagina
C) Abnormal fetal heart rate (FHR) pattern
A laboring patient has received IV fentanyl for labor pain management and requests it again after the cervical check indicates she is 10 cm dilated and ready to start pushing. Which is the nurse's best response to the patient's request? A) "Try to give one or two good pushes, and then I'll get your medication for you." B) "Receiving medication now is a good idea to help you control the pain of delivery." C) "Administering a narcotic now could be dangerous because it will suppress the baby's breathing." D) "If I give you fentanyl now, you might miss the birth of your baby because you'll be asleep."
C) "Administering a narcotic now could be dangerous because it will suppress the baby's breathing."
A patient is approaching 42 weeks' gestation and has been admitted for induction of labor. The patient tells the nurse she does not want an induction and prefers to wait for labor to begin naturally. Which is the nurse's best response? A) "Waiting for labor to begin naturally could result in the death of your baby." B) "The longer you wait, the bigger the baby gets and the harder delivery will be." C) "Complications for you and your baby increase after 42 weeks of gestation." D) "If you had controlled your weight gain during pregnancy, you might have gone into natural labor."
C) "Complications for you and your baby increase after 42 weeks of gestation."
While performing a BUBBLE LE postpartum assessment, the nurse notes a raised area just above the symphysis pubis. Which is the nurse's priority action? A) Completing the assessment and documenting the findings B) Notifying the provider and obtaining orders C) Assisting the patient to the bathroom D) Massaging the uterus until it becomes firm
C) Assisting the patient to the bathroom
The nurse admits a patient at 32 weeks' gestation with a history of cervical cerclage to rule out preterm labor. Which finding is inconsistent with the patient's history? A) Rupture of membranes B) Signs of infection C) Cervical dilation to 3 cm D) Mild vaginal bleeding
C) Cervical dilation to 3 cm
A laboring patient's amniotic membranes rupture, and a sudden variable deceleration is seen on the fetal heart monitor. Which is the nurse's priority action before notifying the health-care provider? A) Increase IV fluids B) Perform amniotic infusion C) Change the patient's position D) Administer oxygen
C) Change the patient's position
While reviewing laboratory values, the nurse sees a postpartum patient's white blood cell count is 26,699 mg/dL, and her neutrophil count is also elevated. Which is the nurse's priority action? A) Assessing the episiotomy for signs of infection B) Notifying the RN and/or provider C) Continuing to monitor laboratory findings D) Obtaining STAT vital signs
C) Continuing to monitor laboratory findings
Which assessment data will the nurse obtain from a patient who is being prepared for a Cesarean section? A) Cervical dilation and effacement B) Obtain a signed consent form C) Diet history for the past 8 hours D) Insert an indwelling catheter
C) Diet history for the past 8 hours
The nurse is caring for a patient who is receiving oxytocin to promote labor and notes late decelerations on the fetal monitor. Which is the nurse's priority of care? A) Performing Leopold's maneuver to wake the sleeping fetus B) Administering tocolytics C) Discontinuing oxytocin D) Increasing administration of IV fluids
C) Discontinuing oxytocin
The nurse working in a women's clinic admits a patient who is almost 6 weeks postpartum and describes a yellow-white vaginal drainage. The nurse interprets this as indicating what? A) Bacterial infection B) Retained placenta C) Expected lochia progression D) Fungal infection
C) Expected lochia progression
Which medication is contraindicated immediately prior to performance of a Cesarean section? A) Cefazolin 1 g IV B) Famotidine 20 mg IV C) Fentanyl 100 mcg IV D) Citric acid-sodium citrate solution 30 mL PO
C) Fentanyl 100 mcg IV
The nurse performs an assessment of fetal heart rate and determines that the findings indicate a category I on the basis of which assessment finding? A) Marked baseline variability B) Recurring late C) Fetal heart rate of 110 bpm D) Prolonged decelerations of 5 minutes
C) Fetal heart rate of 110 bpm
The nurse admits a woman in labor after a motor vehicle accident that also involved her 14-month-old child. Fetal monitoring shows a nonreassuring fetal heart rate pattern with variable and late decelerations. Maternal examination reveals uterine tenderness and constant abdominal pain. After notifying the provider, which is the nurse's priority of care? A) Encouraging the patient to begin pushing B) Obtaining a precipitous delivery pack C) Initiating an IV with an 18-gauge catheter D) Cleansing the perineum
C) Initiating an IV with an 18-gauge catheter
The nurse is making a home-care visit when the newborn starts to cry. The new mother smiles and says, "That's his hungry cry." The nurse interprets this as indicating the mother is in which phase of maternal role attainment? A) Taking-in phase B) Taking-hold phase C) Letting-go phase D) Transitioning from taking-in to taking-hold phase
C) Letting-go phase
A 28-year-old woman is a primipara who is pregnant with triplets, is at 18 weeks' gestation, and is receiving regular prenatal care. The nurse identifies a risk for preterm labor related to which factor? A) The patient's age B) 18 weeks' gestation C) Multiple gestations D) Previous obstetric history
C) Multiple gestations
The nurse assesses a patient immediately after she receives an epidural anesthetic to control labor pain and notes tachycardia, hypertension, and reports of dizziness and a metallic taste in her mouth. Which is the nurse's priority intervention? A) Administering diphenhydramine if ordered B) Encouraging deep breathing and relaxation techniques C) Notifying the provider immediately D) Administering an IV fluid bolus if ordered
C) Notifying the provider immediately
The nurse caring for a patient during the first hour after delivery needs to notify the provider when which condition is assessed? A) Several small blood clots on the peripad B) Saturation of two peripads over the hour C) Passing a large clot the size of a fist D) Yellow-white drainage from the nipples
C) Passing a large clot the size of a fist
The ICU nurse is caring for a postpartum patient who experienced complications. Which color of lochia does the nurse expect to find on the fifth day postpartum? A) Bright red B) Dark red C) Pink D) Yellow-white
C) Pink
A laboring patient's water breaks, and the umbilical cord protrudes from the vagina. The nurse immediately places the patient in the Trendelenburg position. Which of the seven Ps is most impacted? A) Passage B) Pain C) Powers D) Position
C) Powers
Which is the nurse's priority of care during the immediate post delivery period? A) Inspection of the placenta B) Administration of naloxone C) Assessment of the umbilical cord D) Care of the newborn
D) Care of the newborn
A woman in the latent phase of labor is admitted with a diagnosis of group B Streptococcus. Which order should the nurse question? A) Begin an infusion of lactated Ringer's IV at 125 mL/hr B) Collect her complete blood cell (CBC) count, blood type, Rh, and urinalysis C) Prepare for an amniotomy D) Administer penicillin G 5 million units IV times one dose, then 2.5 million units every 4 hours
C) Prepare for an amniotomy
Which observed behavior arouses the nurse's concern as an indication the mother is not bonding with her baby? A) The mother expresses fear she will hurt the baby because she doesn't know what to do. B) The mother stares at the baby's face and touches it only with her fingertips. C) The mother does not want to hold the infant and asks to keep the baby in the nursery. D) The mother asks many questions about self-care and newborn care.
C) The mother does not want to hold the infant and asks to keep the baby in the nursery.
Which patient does the nurse recognize as a candidate for an amnioinfusion? A) The woman who is postterm B) The woman with multiple gestations C) The woman with oligohydramnios D) The woman carrying a fetus with a neural tube defect
C) The woman with oligohydramnios
Upon admitting a laboring patient, the nurse collects maternal assessment for which purpose? A) To learn about the patient's medication usage B) To learn about any complications during the pregnancy C) To establish a baseline of the patient's condition D) To determine any cultural needs the patient may have
C) To establish a baseline of the patient's condition
A postpartum patient who plans to relinquish her baby for adoption says, "I'm having second thoughts. Maybe I should keep the baby." Which is the nurse's best response? A) "If you aren't sure, you should keep the baby until you make up your mind." B) "You've made a promise to the adopting parents, and it's too late to change your mind." C) "It is such a difficult decision to make. You must feel pulled in two directions." D) "I can hear the indecision in your voice. Would you like to talk about it?"
D) "I can hear the indecision in your voice. Would you like to talk about it?"
Which statement by a postpartum patient indicates teaching regarding menses and contraception has been understood? A) "I don't have to worry about getting pregnant until I get my first menstrual period." B) "Because I am breastfeeding, I don't have to worry about getting pregnant until I quit." C) "I should resume using my diaphragm as soon as I resume sexual activity." D) "I should use a contraceptive when I resume sexual activity to avoid pregnancy."
D) "I should use a contraceptive when I resume sexual activity to avoid pregnancy."
A father who is watching the nurse prepare an injection of vitamin K for his infant asks why the medication is necessary. Which is the nurse's best explanation? A) "It is a routine procedure for all infants immediately after birth." B) "It prevents eye infections and preserves eyesight." C) "Newborns can't produce vitamin K and are at risk for bleeding." D) "It is given to promote blood clotting till the newborn begins eating."
D) "It is given to promote blood clotting till the newborn begins eating."
A patient with pregnancy-induced hypertension asks the nurse to please remove the continuous fetal monitor to allow for easier movement. Which is the nurse's best response? A) "I cannot remove the fetal monitor without a direct order from your provider, and there is an order to keep it on." B) "The fetal monitor allows me to make sure the baby is okay during contractions, so we need to leave it on." C) "Fetal monitoring restricts movement, but you don't want something to happen to the baby, do you?" D) "Let me try to adjust the monitor to give you more freedom to move about in bed so you can be more comfortable."
D) "Let me try to adjust the monitor to give you more freedom to move about in bed so you can be more comfortable."
A laboring woman's membranes rupture, and the umbilical cord prolapses. The nurse notifies the provider and prepares the patient for an immediate Cesarean section. The patient asks, "Why is a Cesarean section necessary?" Which is the nurse's best response? A) "It is our policy to always perform a Cesarean section when there is a prolapsed cord." B) "The baby could die if we don't rush to deliver it, and a Cesarean section is the fastest method." C) "A Cesarean section is needed to save your life and prevent the risk of hemorrhaging." D) "The baby cannot be born vaginally without crimping off blood supply through the cord."
D) "The baby cannot be born vaginally without crimping off blood supply through the cord."
The fetus of a laboring patient is found to be in a breech position, and the nurse prepares the patient for a Cesarean section. The patient asks, "Can't I try to deliver vaginally?" Which is the nurse's best response? A) "If the fetus has CPD, it could result in serious complications for you and the baby." B) "A fetus in the breech position causes labor to progress more slowly." C) "We'll have to talk to the delivering provider to see if that is even possible." D) "When the fetus is breech, a Cesarean section is the safest choice for you and the baby."
D) "When the fetus is breech, a Cesarean section is the safest choice for you and the baby."
When does the nurse expect to be unable to palpate the uterus in a postpartum patient? A) Immediately after delivery B) 5 days post delivery C) 1 week post delivery D) 2 weeks post delivery
D) 2 weeks post delivery
After delivery of an infant and prior to delivery of the placenta, which is the priority assessment of the mother? A) Suturing of any tears B) Administering oxytocin infusion C) Examination of the umbilical cord D) Condition of the cervix, vagina, and perineum
D) Condition of the cervix, vagina, and perineum
The experienced nurse recognizes that a graduate nurse needs guidance in caring for a woman at 38 weeks' gestation with premature rupture of membranes when the graduate nurse is seen preparing to do what? A) Fetal monitoring B) Vital signs C) Provide support and education D) Conduct a cervical examination
D) Conduct a cervical examination
The nurse reviews a plan of care and sees the nursing diagnosis of Fear Related to Uncertainty of Pregnancy Outcome. Which priority nursing intervention should the nurse include when caring for this patient? A) Reinforcing teaching provided to the patient by the provider and registered nurse B) Providing information both verbally and in writing for the patient to refer to C) Monitoring the patient and fetus for any nonreassuring signs and symptoms D) Encouraging the participation of the support person in providing care
D) Encouraging the participation of the support person in providing care
A patient is 39 weeks pregnant and is admitted for induction of labor. Her Bishop score is 2. Which teaching does the nurse prepare for this patient? A) Explain the process of inducing labor B) Describe the fetal monitoring equipment C) Explain the importance of monitoring fetal activity D) Explain the need for chemical or mechanical cervical ripening
D) Explain the need for chemical or mechanical cervical ripening
The nurse is caring for an obese pregnant woman in preterm labor with intact amniotic membranes who is receiving medications to stop labor. Which type of monitoring is best for this patient? A) Internal fetal and contraction monitoring B) Internal fetal and external contraction monitoring C) External fetal and internal contraction monitoring D) External fetal and contraction monitoring
D) External fetal and contraction monitoring
Which patient does the nurse assess as most likely to be able to delivery vaginally rather than requiring a Cesarean delivery? A) Active genital herpes B) Fetal macrosomia C) Multiple gestations D) History of previous Cesarean section
D) History of previous Cesarean section
A new adolescent mother asks the nurse how to bathe her baby. Which is the nurse's best approach to teach her this procedure? A) Have the new mother bathe the baby while the nurse talks her through the process B) Explain the procedure using pictures and diagrams C) Give the new mother a brochure and tell her to ask if she has any questions D) Let the new mother watch the nurse bathe the baby and then give a return demonstration tomorrow
D) Let the new mother watch the nurse bathe the baby and then give a return demonstration tomorrow
Which outcome is most appropriate for a nursing diagnosis of Risk for Injury in a patient whose labor is induced? A) Demonstrates and verbalizes reduced anxiety B) Verbalizes understanding of the process of labor induction C) Verbalizes readiness to become a mother D) Maintains a good labor pattern with a reassuring FHR pattern
D) Maintains a good labor pattern with a reassuring FHR pattern
The nurse accepts a newborn from the provider immediately after delivery and assesses the 1-minute Apgar as 6. How does the nurse maintain thermoregulation for this newborn? A) Wrap the infant in warm blankets B) Apply a hat C) Place the infant skin-to-skin with the mother D) Place the infant on a radiant warmer
D) Place the infant on a radiant warmer
The postpartum nurse finds a patient who delivered 15 hours ago in shock with hypotension and tachycardia. Perineal assessment reveals hemorrhage and a mass protruding from the vagina. Upon reviewing the woman's medical record, the nurse recognizes which risk factor for this event? A) Precipitous delivery B) Premature delivery C) Multiple pregnancy D) Placenta accreta
D) Placenta accreta
The nurse performs a focal postpartum assessment using the BUBBLE LE mnemonic. Which assessment finding is incorrect to document as part of this examination? A) Breasts firm and tender; patient reports sore nipples B) Fundus 2 cm below umbilicus, firm C) Lochia pink, small amount of drainage D) Pulse strong and regular at rate of 84 beats per minute
D) Pulse strong and regular at rate of 84 beats per minute
The nurse, while assessing a fetal monitor strip for a woman in term labor, determines there is significant fetal distress when she notes which finding? A) Fetal heart rate of 160 bpm B) Moderate variability C) Accelerations of 25 bpm with contractions D) Recurrent late decelerations with minimal variability
D) Recurrent late decelerations with minimal variability
The nurse examines a postpartum woman who is 1 day post delivery. Which finding does the nurse consider abnormal? A) Fundus 1 cm below the umbilicus B) Bright red lochia C) Dilated cervix D) Reduced fibrinogen levels
D) Reduced fibrinogen levels
The nurse admits a patient who reports a desire to push. A quick assessment shows crowning of the fetal head. Which is the nurse's priority action? A) Running to the nursing station and calling the provider B) Hurrying to the supply room for a precipitous delivery pack C) Washing the hands, applying gloves, and cleansing the perineum D) Remaining calm and staying with the patient while calling for help
D) Remaining calm and staying with the patient while calling for help
What is the nurse's role when caring for a mother who is relinquishing her infant for adoption? A) Discouraging her from holding or seeing her infant B) Encouraging her to see the infant and take pictures C) Avoiding discussion about the baby or her labor unless she brings it up D) Respecting the mother's choices regarding the baby
D) Respecting the mother's choices regarding the baby
The nurse is caring for a patient who received an epidural analgesic minutes ago. Which assessment finding should the nurse report to the provider immediately? A) A slowdown in labor contractions B) A reduction in blood pressure C) Complaints of numbness in the legs D) Shortness of breath, itching, and hives
D) Shortness of breath, itching, and hives
The nurse enters a postpartum patient's room and finds the father staring at the newborn in the bassinet with a contemplative look on his face. How should the nurse interpret this behavior? A) The father may be a danger to the baby. B) The father feels resentful toward the baby. C) The father is uncertain about being a father. D) The father is bonding with the baby.
D) The father is bonding with the baby.
Which patient does the nurse anticipate is most likely to experience afterpains? A) The woman who had a precipitous delivery B) The woman who delivered a preterm infant C) The primipara who had a difficult pregnancy D) The multipara who delivered her fifth child
D) The multipara who delivered her fifth child
The nurse questions an order to administer a tocolytic drug for which patient? A) The patient under age 18 B) The patient with a history of multiple gestations C) The patient who is 2 cm dilated D) The patient with acute vaginal bleeding
D) The patient with acute vaginal bleeding
When caring for a woman undergoing a trial of labor after Cesarean (TOLAC), the nurse most carefully observes for signs of what? A) Macrosomia B) Failure to progress C) Anxiety D) Uterine rupture
D) Uterine rupture
