AQ Pregnancy, Labor, Childbirth

Which tocolytic agent inhibits prostaglandin activity and is given along with sucralfate to help manage preterm labor?

Indomethacin

A woman receiving treatment with topiramate gives birth to a newborn with a cleft lip and cleft palate. Which Food Drug Administration (FDA) Pregnancy Risk category of pregnancy does the drug belong?

D

A mother asks the neonatal nurse why her infant must be monitored so closely for hypoglycemia when her type 1 diabetes was in excellent control during the entire pregnancy. How should the nurse best respond?

"Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mothers during pregnancy, so the glucose level may drop."

A pregnant client tells the nurse that she thinks she has developed an allergy because her nose is often very congested and she has difficulty breathing. How should the nurse reply?

"That is an expected occurrence; the increased hormones are responsible for the congestion."

Prolonged labor is an incident very common in pregnant adolescents. Which age group of adolescents has the highest risk of prolonged labor?

12-13 years

Which gestational period is appropriate for the administration of corticosteroids during preterm labor?

24 to 34 weeks

A client is to undergo amniocentesis at 38 weeks' gestation to determine fetal lung maturity. What lecithin/sphingomyelin ratio (L/S ratio) is adequate for the nurse to conclude that the fetus's lungs are mature enough to sustain extrauterine life?

2:1

A client and her partner are working together to achieve an unmedicated birth. The client's cervix is now dilated to 7 cm, and the presenting part is low in the midpelvis. What should the nurse instruct the client to do that will alleviate discomfort during contractions?

Deep breathe slowly

What is the first line drug used to manage intrauterine fetal death?

Dinoprostone

A client in labor is receiving an oxytocin (Pitocin) infusion. Which intervention is a priority for the nurse when repetitive late decelerations of the fetal heart rate are observed?

Discontinue the oxytocin infusion

The nurse is caring for a pregnant client who is undergoing an ultrasound examination during the first trimester. The nurse explains that an ultrasound during the first trimester is utilized in order to do what?

Estimate fetal age

A primigravida is admitted with a ruptured fallopian tube (resulting from an ectopic pregnancy), and surgery is performed to remove the fallopian tube. Which intervention should be included in the postoperative nursing care plan?

Explaining that the client may still be capable of becoming pregnant

The nurse admits a client in active labor to the birthing center. She is 100% effaced, dilated 3 cm, and at +1 station. What stage of labor has this client reached?

First

What should be included in the nursing care for a client at 41 weeks' gestation who is scheduled for a contraction stress test?

Having the client empty her bladder

A pregnant woman with cervical stenosis has been admitted to the hospital for a labor induction. Which drug should be administered?

Oxytocin

A pregnant woman who reports confusion and jerky arm movements is diagnosed with epilepsy and treated with antiepileptic drugs. Which physiologic change in the drug metabolism would the nurse expect in this client?

There will be an increased hepatic metabolism

Which physiologic alteration does the nurse expect in a client's hematologic system during the second trimester of pregnancy?

An increase in blood volume

A primigravida tells the nurse that she is experiencing morning sickness. What suggestion should the nurse make to help the client relieve the nausea?

Eat small amounts more frequently

A fetal monitor is applied to a client in labor. The nurse should take immediate action in response to which fetal heart rate?

Repeatedly drops abruptly to 90 beats/min unrelated to contractions

The nurse is caring for a client in the first stage of labor, and an external fetal heart monitor is in place. What do the tracings indicate?

Variable decelerations

A pregnant client who has type 2 diabetes and a history of three spontaneous abortions is scheduled for a contraction stress test. Before the test she begins to cry while answering the nurse's questions regarding her previous pregnancies. She states, "I know it's my diabetes. This baby will never live. It's all my fault." What is the best response by the nurse?

"This must be very stressful for you."

A husband sits in the waiting room while his wife is getting her infertility prescription refilled by the clinic pharmacist. As the nurse sits down beside him, he blurts, "It's like there are three of us in bed—my wife, me, and the doctor." Which feeling is reflected by this statement?

Anger

Which instruction is most important for the nurse to include when teaching a client about a contraction stress test (CST)?

Empty the bladder before the test

A client who suspects that she is 6 weeks pregnant appears mildly anxious as she is waiting for her first obstetric appointment. What symptom of mild anxiety does the nurse expect this client to experience?

Increased alertness

A client has a hysterectomy, salpingo-oophorectomy, tumor removal, and multiple abdominal biopsies for ovarian cancer. For which clinical manifestations indicating that the client may be experiencing a pulmonary embolus should the nurse assess the client? Select all that apply.

Increased temperature Decreased O2 saturation Sudden onset shortness of breath

A client is admitted in active labor. The nurse, performing Leopold maneuvers, determines that the fetus is in the left occiput anterior (LOA) position. Where should the nurse place the transducer of the electronic fetal monitor?

Left lower quadrant

A nurse who is caring for a mother and her newborn infant reviews their record. In light of the data the record contains, which nursing intervention is required?

Maternal rubella vaccination

A client who is in the first trimester is being discharged after a week of hospitalization for hyperemesis gravidarum. She is to be maintained at home with rehydration infusion therapy. What is the priority nursing activity for the home health nurse?

Monitoring the client for signs of electrolyte imbalances

At 32 weeks' gestation a client undergoes an ultrasound examination, which reveals a low-lying placenta. What complication should the nurse anticipate as the client's pregnancy approaches term?

Painless vaginal bleeding

While mopping the kitchen floor, a client at 37 weeks' gestation experiences a sudden sharp pain in her abdomen with a period of fetal hyperactivity. When the client arrives at the prenatal clinic, the nurse examines her and detects fundal tenderness and a small amount of dark-red bleeding. What does the nurse conclude is the probable cause of these clinical manifestations?

Partial abruptio placentae

Which of these statements about pregnancy in the adolescent population are true?

Pregnant adolescents often seek out less prenatal care Adolescent mothers need competent day care for their infants Infants of adolescent mothers are at increased risk for prematurity

A client asks the nurse at the prenatal clinic whether she may continue to have sexual relations while pregnant. What is one indication that the client should refrain from intercourse during pregnancy?

Premature rupture of membranes

A primigravida in the first trimester tells a nurse that she has heard that hormones play an important role in pregnancy. Which hormone should the nurse tell the client maintains pregnancy?

Progesterone

A client is admitted to the birthing unit in active labor. Which physiologic changes should the nurse anticipate after an amniotomy is performed?

Progressive dilation and effacement

A nurse is teaching a pregnant client with sickle cell anemia about the importance of taking supplemental folic acid. How does folic acid help this client?

Promotes production of hemoglobin

The cervix of a client in labor is fully dilated and effaced. The head of the fetus is at +2 station. What should the nurse encourage the client to do during contractions?

Push with her glottis open

A nurse, assessing an 18-year-old client, palpates a heavy, hard mass on the lateral aspect of the testis. Which treatment is contraindicated for this condition?

Testicular biopsy

A client with recurrent episodes of nausea, vomiting, and abdominal pain arrives at the hospital. Assessments by the primary healthcare provider reveal that the cremasteric reflex is absent, and emergency surgery is performed. What is the likely diagnosis?

Testicular torsion

A pregnant client is asking the nurse when she will gain the greatest amount of weight during the pregnancy. At which time during prenatal development should the nurse tell the client to expect the greatest fetal and maternal weight gain?

Third trimester

A client at 28 weeks' gestation is scheduled for a sonogram. The results reveal a small-for-gestational age fetus and a low-lying placenta. Which complication should the nurse assess this client for during the last trimester of pregnancy?

Placenta previa

A pregnant client comes to the emergency department because of vaginal bleeding. The nurse asks the client to estimate how heavy the bleeding is. What is the best gauge for the client to use?

Amount of blood lost in relation to usual menstrual flow

The nurse is caring for a postpartum client who has experienced an abruptio placentae. Which assessment indicates that disseminated intravascular coagulation (DIC) is occurring?

Bleeding at the venipuncture site

A client is admitted to the birthing room in active labor. She is gravida 4, para 3. When she is at 8 cm of dilation, her membranes rupture spontaneously. What should the nurse do after assessing fetal well-being?

Perform a vaginal exam

A client at 36 weeks' gestation is admitted to the high-risk unit with the diagnosis of severe preeclampsia, and antiseizure therapy is instituted. A fetal monitor and an electronic blood pressure machine are applied. Which complication of severe preeclampsia requires diligent monitoring of the blood pressure?

Stroke

During a vertex vaginal birth the nurse notes meconium-stained amniotic fluid. What is the priority nursing intervention for the newborn?

Suctioning the airway