OB Exam 1
A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands? 1. ―Due to my weight, there is a possibility that I may develop gestational diabetes. 2. ―I am not overweight, but I am still at risk for gestational diabetes. 3. ―My mother had preeclampsia during one of her pregnancies. 4. ―I will need to do a glucose tolerance test in my second trimester.
1
The nurse is caring for a 15-year-old female who is pregnant with her first child. In her previous prenatal visit, the patient tested negative for chlamydia, syphilis, gonorrhea, and HIV. Based on the information provided, which condition is the patient's baby at higher risk for? 1. Intestinal problems 2. Neonatal conjunctivitis 3. Blindness 4. Pneumonia
1
The nurse is educating the pregnant patient with a body mass index (BMI) of 33. The nurse knows that teaching has been effective when the patient states which of the following? 1. ―My child may be at increased risk for birth injury. 2. ―My child may have a decreased risk of developing childhood diabetes. 3. ―I will probably give birth vaginally. 4. ―I have a lower risk of developing gestational hypertension.
1
A pregnant patient with a BMI of 35 is concerned about health effects she and her baby may face during pregnancy. During routine testing, the patient tested negative for sexually transmitted illnesses (STIs) and indicated that she is in a committed, long-term relationship with the child's father. Which of the following is accurate? 1. The patient's infant is at increased risk of neonatal blindness. 2. The patient's infant has a decreased risk of birth injury. 3. The patient will have increased risk of wound infection. 4. The patient will have a decreased risk of preeclampsia.
3
The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child, who is male. The patient's mother has accompanied her to today's visit. During the nursing assessment, the patient mentions that she is no longer in a relationship with the baby's father but her mother plans to help her. However, the patient's mother asks whether this will have any impact on the child. Which should the nurse indicate the child is at increased risk of during his adolescence? 1. Hypertension 2. Diabetes 3. Alcohol abuse 4. Intraventricular bleeding
3
The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that a pregnant patient may have been using marijuana. With consent, the nurse confirms via urine drug screen. Which statement by the nurse is most appropriate? 1. ―Did you smoke marijuana when pregnant with your other child?‖ 2. ―To avoid negative effects on your baby, you'll need to stop using marijuana during your last trimester.‖ 3. ―Using marijuana while pregnant can have a negative effect on the neurological development of your baby.‖ 4. ―Marijuana use while pregnant greatly increases your risk of miscarriage.‖
3
A patient with a history of hypertension is giving birth. During delivery, the staff was not able to stabilize the patient's blood pressure. As a result, the patient died shortly after delivery. This is an example of what type of death? 1. Early maternal death 2. Late maternal death 3. Direct obstetric death 4. Indirect obstetric death
4
The nurse has made it a goal to increase the rate at which women begin prenatal care in the first trimester. The nurse relates this decision to national goals for better maternal and infant outcomes. What guidelines will the nurse use to guide her maternal health goals? 1. WHO Maternal care guidelines 2. State Practice Acts 3. AWHONN white papers 4. Healthy People 2020
4
For the patient with which of the following medical problems should the nurse question a physiciansorder for beta agonist tocolytics? a. Type 1 diabetes mellitus b. Cerebral palsy c. Myelomeningocele d. Positive group B streptococci culture
A
The perinatal nurse notes a rapid decrease in the fetal heart rate that doesnot recover immediately following an amniotomy. The most likely cause of thisobstetrical emergency is: a. Prolapsed umbilical cord b. Vasa previa c. Oligohydramnios d. Placental abruption
A
Contraindications for induction of labor include: (select all that apply) a. Abnormal fetal position b. Postdated pregnancy c. Pregnancy-induced hypertension d. Placental abnormalities
A, D
A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the attendingphysician immediately of which of the following findings? a. Patellar and biceps reflexes of +4 b. Urinary output of 50 mL/hr c. Respiratory rate of 10 rpm d. Serum magnesium level of 5 mg/dL
C
The color of a person's hair is an example of which of the following? a. Genome b. Sex-link inheritance c. Genotype d. Phenotype
D
The nurse is caring for a 14-year-old patient who is 32 weeks pregnant. After complaining of genital sores and discomfort, the patient tests positive for syphilis. The fetus is at increased risk of which condition? 1. Diabetes 2. Blindness 3. Pneumonia 4. Hypertension
2
The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, ―I do not need to stop smoking my electronic cigarette because it will not harm my baby.‖ Which is the best response by the nurse? 1. ―You are correct. Electronic cigarettes are not harmful during pregnancy.‖ 2. ―Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity.‖ 3. ―According to the FDA, although electronic cigarettes are safe for you, they can cause harm to the fetus during pregnancy.‖ 4. ―Electronic cigarettes are considered harmful only in the first trimester.‖
2
The nurse is counseling a female patient about alcohol use during pregnancy. Which statement by the patient demonstrates successful patient teaching? 1. ―I will limit my drinking to just one alcoholic beverage per day 2. ―It's best for my baby if I avoid drinking during pregnancy 3. ―An occasional drink on special occasions is okay 4. ―Drinking alcohol is only acceptable in the first trimester
2
The nurse is caring for a patient who is in labor with her first child. The patient's mother is present for support and notes that things have changed in the delivery room since she last gave birth in the early 1980s. Which current trend or intervention may the patient's mother find most different? 1. Fetal monitoring throughout labor 2. Postpartum stay of 10 days 3. Expectant partner and family in operating room for cesarean birth 4. Hospital support for breastfeeding
4
The nurse is providing education to a patient who has given birth to her first child and is being discharged home. The patient expressed concern regarding infant mortality and sudden infant death syndrome (SIDS). The patient had an uncomplicated pregnancy, labor, and vaginal delivery. She has a body mass index of 25 and has no other health conditions. The infant is healthy and was delivered full-term. What will be most helpful thing to explain to the patient? 1. Uses of extracorporeal membrane oxygenation therapy (ECMO) 2. Uses of exogenous pulmonary surfactant 3. The Baby-Friendly Hospital Initiative 4. The Safe to Sleep campaign
4
A laboratory report indicates the L/S ratio (lecithin/sphingomyelin) results from an amniocentesis of a gravid patient with preeclampsia are 2:1. The nurse interprets the result as which of the following? a. The baby's lung fields are mature. b. The mother is high risk for hemorrhage. c. The baby's k idneys are functioning poorly. d. The mother is high risk for eclampsia.
A
A mother of a 10-day-old infant calls the clinic and reports that her baby ishaving loose, green stools. The mother is breastfeeding her infant. Which ofthe following is the best nursing action? a. Instruct the woman to bring her infant to the clinic. b. Instruct the woman to decrease the amount of feeding for 24 hours and tocall if the stools continue to be loose. c. Explain that this is a normal stool pattern. d. Instruct the woman to eat a bland diet for the next 24 hours and call back ifthe stools continue to be loose and green.
A
A neonatal nurse caring for newborns knows that the best time for a mother to first attempt breastfeeding is during which one of the followingstages of activity? a. First period of reactivity b. First period of inactivity and sleep c. Second period of reactivity d. Second period of inactivity and sleep
A
A nurse work ing with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis? a. The couple has established a set schedule for their sexual encounters. b. The couple hasbeen married for more than 8 years. c. The couple lives with one set of parents. d. The couple has close friends who gave birth within the last year.
A
A post-cesarean birth woman has been diagnosed with paralytic ileus. Which of the followingsymptoms would the nurse expect to see? a. Abdominal distension b. Polyuria c. Diastasis recti d. Dependent edema
A
A pregnant woman who has a history of cesarean births is requesting to have a vaginal birth after cesarean (VBAC). In which of the following situationsshould the nurse advise the patient that her request may be declined? a. Transverse fetal lie b. Flexed fetal attitude c. Previous low flap uterine incision d. Positive vaginal candidiasis
A
A woman is considered in active labor when: a. Cervical dilation progresses from 4 to 7 cm with effacement of 40% to 80%, contractions become more intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds. b. Cervical dilation progresses to 3 cm with effacement of 30, contractions become more intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds. c. Cervical dilation progresses to 8 cm with effacement of 80%, contractions become more intense, occurring every 2to 5 minutes with duration of 45 to 60 seconds. d. Cervical dilation progresses to 10 cm with effacement of90%, contractions becomemore intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds.
A
A woman you are caring for in labor requests an epidural for pain relief in labor. Included in your preparation for epidural placement is a baseline set of vital signs. The most common vital sign to changeafter epidural placement: a. Blood pressure, hypotension b. Blood pressure, hypertension c. Pulse, tachycardia d. Pulse, bradycardia
A
After assessing the FHR tracing shown below, which of the following interventions should the nurse perform? a. Turn the woman on her side. b. Administer oxygen by nasal cannula. c. Encourage the patient to push with each contraction. d. Provide the patient with caring labor support.
A
An ultrasound of a fetus' heart shows that normal fetal circulation is occurring. Which of the following statements is consistent with the finding? a. A right to left shunt is seen between the atria. b. Blood is returning to the placenta via the umbilical vein. c. Blood is returning to the right atrium from the pulmonary system. d. A right to left shunt is seen between the umbilical arteries.
A
Augmentation of labor: a. Is part of the active management of labor instituted when the labor processis unsatisfactory and uterine contractions are inadequate b. Relies on more invasive methods when oxytocin and amniotomy have failed c. Is elective induction of labor d. Is an operative vaginal delivery that uses vacuum cups
A
During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from: a. 2 to 8 weeks b. 4 to12 weeks c. 5 to 10 weeks d. 6 to 15 weeks
A
During the postpartum assessment, the perinatal nurse notes that a patient who has just experienced a forceps-assisted birth now has a large quantity of bright red bleeding. Her uterine fundus is firm. The nurse's mostappropriate action is to notify the physician/certified nurse midwife and describe a: a. Need for vaginal assessment and repair b. Requirement for an oxytocin infusion c. Need for further information for the woman/family about forceps d. Requirement for bladder assessment and catheterization
A
Four women are close to delivery on the labor and delivery unit. The nurseknows to be vigilant to the signs of neonatal respiratory distress in which delivery? a. 42-week-gestation pregnancy complicated by intrauterine growth restriction b. 41-week-gestation pregnancy with biophysical profile score of 10 thatmorning c. 40-week-gestation pregnancy with estimated fetal weight of 3200 grams d. 39-week-gestation pregnancy complicated by maternal cholecystitis
A
Painful nipples are a major reason why women stop breastfeeding. A primary intervention to decrease nipple irritation is: a. Teaching proper techniques for latching-on and releasing of suction b. Applying hot compresses to breast prior to feeding c. Instructing woman to express colostrum or milk at the end of the feedingsession and rub it on her nipples d. Air drying nipples for 10 minutes at the end of the feeding session
A
Tanya, a 30-year-old woman, is being prepared for an elective cesarean birth. The perinatal nurseassists the anesthesiologist with the spinal block and then positions Tanya in a supine position. Tanyasblood pressure drops to 90/52, and there is a decrease in the fetal heart rate to 110 bpm. The perinatal nurses best response is to: a. Place a wedge under Tanyas left hip. b. Discontinue Tanyas intravenous administration. c. Have naloxone (Narcan) ready for administration. d. Have epinephrine ready for administration.
A
The best time to give prophylactic antibiotics to the women undergoing cesarean section is: a. One hour before the surgery b. Two hours before the surgery c. Not indicated unless she has an active infection d. At the time the cord is clamped
A
The clinic nurse meets with Rebecca, a 30-year-old woman who is experiencing her first pregnancy. Rebecca's quadruple mark er screen result is positive at 17 week s' gestation. The nurse explains that Rebecca needs a referral to: a. A genetics counselor/specialist b. An obstetrician c. A gynecologist d. A social worker
A
The nurse is advising parents of a full-term neonate being discharged fromthe hospital regarding car seat safety. Which of the following should be included in the teaching plan? a. Put the car seat facing forward only after the baby reaches 20 pounds. b. The infant car seat should be placed facing the rear seat in the front seat ofthe car. c. A fist should fit between the straps of the seat and the baby's body. d. Seat belt adjusters should always be used to support infant car seats.
A
The nurse is assisting a physician in the delivery of a baby via vacuum extraction. Which of the following nursing diagnoses for the gravida is appropriate at this time? a. Risk for injury b. Colonic constipation c. Risk for impaired parenting d. Ineffective individual coping
A
The nurse is interviewing a gravid woman during the first prenatal visit. The woman confides to the nurse that she lives with a number of pets. The nurse should advise the woman to be especially careful to refrain from coming in contact with the stool of which of the pets? a. Cat b. Dog c. Hamster d. Bird
A
The nurse is teaching the parents of a female baby how to change a baby'sdiapers. Which of the following should be included in the teaching? a. Always wipe the perineum from front to back. b. Remove any vernix caseosa from the labia folds. c. Put powder on the buttocks every time the baby stools. d. Weigh every diaper in order to assess for hydration.
A
The nurse knows that a FHR monitor printout indicates a Category IIIabnormal fetal heart rate pattern when: a. Baseline variability is minimal or absent with decelerations. b. FHR mirrors the uterine contractions. c. Occasional periodic accelerations occur. d. Baseline variability is 6 to 25 bpm with decelerations
A
The nurse uses the external electronic fetal heart monitor to evaluate fetalstatus. The fetal heart tracing shows accelerations. Accelerations in the fetalheart are: a. Associated with fetal well-being and oxygenation b. An indication of potential fetal intolerance to labor c. Never associated with the uterine contraction pattern d. A reason to notify the care providerANS:
A
The perinatal nurse providing care to a laboring woman recognizes a category II, fetal heart rate tracing. The most appropriate initial action is to: a. Assist the laboring woman to a left lateral position b. Decrease the intravenous solution : MUST INCREASE IV INFUSION c. Request that the physician/certified nurse-midwife come to the hospital STAT d. Document the fetal heart rate and variability
A
The physician has ordered intravenous oxytocin for induction for four gravidas. In which of the following situations should the nurse refuse to complywith the order? a. Primigravida with complete placenta previa b. Multigravida with extrinsic asthma c. Primigravida who is 38 years old d. Multigravida who is colonized with group B streptococci
A
The provision of support during labor has demonstrated that women experience a decrease in anxietyand a feeling of being in more control. In clinical situations, this has resulted in: a. Adecrease in interventions b. Increased epidural rates c. Earlier admission to the hospital d. Improved gestational age
A
Which of the following positions for breastfeeding is preferred for a 2-daypost- cesarean-birth woman? a. Lying down on side b. Sitting c. Cradle d. Cross-cradle
A
Which of the following signs or symptoms would the nurse expect to see in a woman with concealedabruptio placentae? a. Increasing abdominal girth measurements b. Profuse vaginal bleeding c. Bradycardia with an aortic thrill d. Hypothermia with chills
A
Which statement correctly describes the nurse's responsibility related toelectronic fetal monitoring? a. Teach the woman and her family about the monitoring equipment anddiscuss any questions they have. b. Report abnormal findings to the care provider before initiating correctiveactions. c. Inform the support person that the nurse will be responsible for all comfortmeasures when the electronic equipment is in place. d. Document the frequency, duration, and intensity of contractions measuredby the external device.
A
A nurse is preparing to monitor a patient who is to receive an amnioinfusion.Which of the following actions should the nurse make at this time? a. Attach the patient to an electronic blood pressure cuff. b. Assist in insertion of an internal uterine pressure catheter. c. Attach the patient to an oxygen saturation monitor. d. Perform an amniotic fluid Nitrazine test.
B
A primigravida woman at 42 weeks' gestation received Prepidil (dinoprostone) for induction 12 hours ago. The Bishop score is now 3. Which ofthe following actions by the nurse is appropriate? a. Perform Nitrazine analysis of the amniotic fluid. b. Report the lack of progress to the obstetrician. c. Place the woman on her left side. d. Ask the doctor for an order for oxytocin.
B
As the nurse explains the purpose of the tocotransducer (Toco), which sheplaces on the abdomen, she states that this monitoring device provides an accurate evaluation of which of the following? a. Uterine hypertonus b. Frequency of contractions c. Intensity of contractions d. Progress of labor
B
During a cesarean section, which action by the nurse is done to prevent compression of thedescending aorta and vena cava? a. Right lateral tilt b. Left lateral tilt c. Elevate head of gurney at 30 degrees d. Administration of IV fluid preload of 500 to 1000 mL
B
Information provided by the nurse that addresses the function of the amniotic fluid is that the amniotic fluid helps the fetus to maintain a normal body temperature and also: a. Facilitates asymmetrical growth of the fetal limbs b. Cushions the fetus from mechanical injury c. Promotes development of muscle tone d. Promotes adherence of fetallung tissue
B
The mechanism of labor known as cardinal movements of labor are the positional changes that the fetusgoes through to best navigate the birth process. These cardinal movements are: a. Engagement, Descent, Flexion, Extension, Internal rotation, External rotation, Expulsion b. Engagement, Descent, Flexion, Internal rotation, Extension, External rotation, Expulsion c. Engagement, Flexion, Internal rotation, Extension, External rotation, Descent, Expulsion d. Engagement, Flexion, Internal rotation, Extension, External rotation, Flexion, Expulsion
B
The nurse is developing a discharge teaching plan for a 21-year-old first- time mom. This was an unplanned pregnancy. She had a prolonged labor andan early postpartum hemorrhage. The woman plans to breastfeed her baby.She plans to return to work when her baby is 3 months old. Based on this information, the three primary learning needs of this woman are: a. Breastfeeding, bathing of the newborn, and infant safety b. Breastfeeding, storage of milk, and nutrition c. Breastfeeding, contraception, infant safety d. Breastfeeding, storage of milk, and rest
B
The perinatal nurse is preparing a woman for a scheduled cesarean birth. The woman will bereceiving spinal anesthesia for the birth. In order to prevent maternal hypotension, the nurse: a. Assists the woman to lie down in a supine position. b. Administers a rapid intravenous infusion of 500 mL of normal saline. c. Assesses blood pressure and pulse every 5 minutes, three times, before the spinal insertion. d. Encourages frequent cleansing breaths after the patient has been placed in the correct position forthe anesthesia administration.
B
The perinatal nurse is teaching her new mother about breastfeeding andexplains that the most appropriate time to breastfeed is: a. 3 to 4 hours after the last feeding b. When her infant is in a quiet alert state c. When her infant is in an active alert state d. When her infant exhibits hunger-related crying
B
The perinatal nurse understands that the purpose of combining an opioid with a local anestheticagent in an epidural is primarily to: a. Increase the total anesthetic volume b. Preserve a greater amount of maternal motor function c. Increase the intensity of the motor and sensory block d. Decrease the number of side effects
B
Which of the following statements by a pregnant woman indicates she needs additional teaching on ways to reduce risk to her unborn child from the potential effects of exposure to toxoplasmosis? a. I will avoid rare lamb. b. I will wear a mask when cleaning my cat's litter box. c. I understand that exposure to toxoplasmosis can cause blindness in the baby. d. I will avoid rare beef.
B
You are caring for a primiparous woman admitted to labor and delivery forinduction of labor at 42 weeks' gestation. She asks you to explain the factorsthat contribute to prolonged labor. The best response would be to state thefollowing: a. Primiparous women are not at risk for dystocia because they usually havesmall babies. b. Dystocia is related to uterine contractions, the pelvis, the fetus, the positionof the mother, and psychosocial response. c. Labor is primarily associated with pelvic abnormalities. d. Dystocia is typically diagnosed prior to labor based on pelvimetry.
B
Your patient is a 28-year-old gravida 2 para 1 in active labor. She has been inlabor for 12 hours. Upon further assessment, the nurse determines that she isexperiencing a hypotonic labor pattern. Possible maternal and fetal implications from hypotonic labor patterns are: a. Intrauterine infection and maternal exhaustion with fetal distress usuallyoccurring early in labor. b. Intrauterine infection and maternal exhaustion with fetal distress usuallyoccurring late in labor. c. Intrauterine infection and postpartum hemorrhage with fetal distress early inlabor. d. Intrauterine infection and ruptured uterus and fetal death.
B
Your pregnant patient is having maternal alpha-fetoprotein (AFP) screening. She does not understand how a test on her blood can indicate a birth defect in the fetus. The best reply by the nurse is: a. We have done this test for a long time.‖ b. If babies have a neural tube defect, alpha- fetoprotein leaks out of the fetus and is absorbed into your blood, causing your level to rise. This serum blood test detects that rise.‖ c. Neural tube defects are a genetic anomaly, and we examine the amount of alpha- fetoprotein in your DNA.‖ d. If babies have a neural tube defect, this results in a decrease in your level of alpha- fetoprotein.‖
B
Your pregnant patient is in her first trimester and is scheduled for an abdominal ultrasound. When explaining the rationale for early pregnancy ultrasound, the best response is: a. The test will help to determine the baby's position.‖ b. The test will help to determine how many week s you are pregnant.‖ c. The test will help to determine if your baby is growing appropriately.‖ d. The test will help to determine if you have a boy or girl.‖
B
A clinic nurse explains to the pregnant woman that the amount of amniotic fluid present at 24 weeks gestation is approximately: a. 500 mL b. 750 mL c. 800 mL d. 1000 mL
C
A diagnostic test commonly used to assess problems of the fallopian tubes is: a. Endometrial biopsy b. Ovarian reserve testing c. Hysterosalpingogram d. Screening forsexually transmitted infections
C
A nurse is preparing a woman in early labor for an urgent cesarean birth related to breech presentation. Select the best nursing action for reducing the couples anxiety levels. a. Explainthe reason for the need for a cesarean section. b. Inform parents that their baby is in distress. c.Ask thecouple to share their concerns. d. Reassure the couple that both the woman and baby are in no danger.
C
A nurse is providing discharge teaching to the parents of a 2-day-oldneonate. Which of the following information should be included in the discharge teaching on umbilical cord care? a. Cleanse the cord twice a day with hydrogen peroxide. b. Remove the cord with sterile tweezers if the cord does not fall off by 10 daysof age. c. Call the doctor if greenish discharge appears. d. Cover the cord with sterile dressing until it falls off.
C
A postpartum woman, who gave birth 12 hours ago, is breastfeeding her baby. She tells her nurse that she is concerned that her baby is not getting enough food since her milk has not come in. The best response for this patientis: a. I understand your concern, but your baby will be okay until your milk comesin. b. Your baby seems content, so you should not worry about him gettingenough to eat. c. Milk normally comes in around the third day. Prior to that, he is gettingcolostrum which is high in protein and immunoglobulins which are importantfor your baby's health. d. You can bottle feed until your milk comes in.
C
A woman who has had no prenatal care was assessed and found to have hydramnios on admission to the labor unit and has since delivered a baby weighing 4500 grams. Which of the following complicationsof pregnancy likely contributed to these findings? a. Pyelonephritis b. Pregnancy-induced hypertension c. Gestational diabetes d. Abruptio placentae
C
During labor induction with oxytocin, the fetal heart rate baseline is in the 140s with moderate variability. Contraction frequency is assessed to be every 2minutes with duration of 60 seconds, of moderate strength to palpation. Based on this assessment, the nurse should take which action? a. Increase oxytocin infusion rate per physician's protocol. b. Stop oxytocin infusion immediately. c. Maintain present oxytocin infusion rate and continue to assess. d. Decrease oxytocin infusion rate by 2 mU/min and report to physician.
C
Early decelerations are probably caused by: ICP a. Decreased maternal-fetal exchange b. Umbilical cord occlusion c. Momentary increase in intracranial pressure due to head compression d. Compression of umbilical cord
C
In caring for a primiparous woman in labor, one of the factors to evaluate is uterine activity. This is referred to as the _________ of labor. a. Passenger b. Passage c. Powers d. Psyche
C
The clinic nurse knows that the part of the endometrial cycle occurring from ovulation to just prior to menses is known as the: a. Menstrual phase b. Proliferative phase c. Secretory phase d. Ischemic phase
C
The fetal circulatory structure that connects the pulmonary artery with the descending aorta is known as which of the following? a. Ductus venosus b. Foramen ovale c. Ductus arteriosus d. Internal iliac artery
C
The labor patient you are caring for is ambulating in the hall. Her vaginal exam 1 hour ago indicatedshe was 4/70/1 station. She tells you she has fluid running down her leg. Your priority nursing intervention is to: a. Assess the color, odor, and amount of fluid. b. Assist yourpatient to the bathroom. c.Assess the fetal heart rate. d. Call the care provider.
C
The nurse is caring for a woman, G2 P1, 40 weeks' gestation, in labor. A 12 P.M. assessment revealed: cervix 4 cm, 80% effaced, -3 station, and fetalheart 124 with moderate variability. 5 p.m. assessment: cervix 6 cm, 90% effaced, -3 station, and fetal heart 120with minimal variability. 10 a.m. assessment: cervix 8 cm, 100% effaced, -3 station, and fetal heart 124with absent variability. Based on the assessments, which of the following should the nurse conclude? a. Descent is progressing well. b. Woman is carrying a small-for-gestational age fetus. c. Baby is potentially acidotic. d. Woman should begin to push with the next contraction.
C
The nurse is teaching the parents of a 1-day-old baby how to give theirbaby a bath. Which of the following actions should be included? a. Clean the eye from the outer canthus to the inner canthus. b. Keep the door of the room open to allow for ventilation. c. Gather all supplies before beginning the bath. d. Check the temperature of the water with your fingertip.
C
The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of: a. Unilateral amblyopia b. Subdural hematoma c. Sickle cell anemia d. Glomerular nephritis
C
The perinatal nurse is providing care to Carol, a 28-year-old multiparouswoman in labor. Upon arrival to the birthing suite, Carol was 7 cm dilated andexperiencing contractions every 1 to 2 minutes which she describes as strong. Carol states she labored for 1 hour at home. As the nurse assists Carol from the assessment area to her labor and birth room, Carol states thatshe is feeling some rectal pressure. Carol is most likely experiencing: a. Hypertonic contractions b. Hypotonic contractions c. Precipitous labor d. Uterine hyperstimulation
C
Which of the following statements indicates that a new mother needsadditional teaching? a. I need to supervise my cat when she is in the same room as my baby. b. I will place my baby on her back when she is sleeping. c. I will not leave my baby on an elevated flat surface after she is able to turnover on her own. d. I have asked my husband to install safety latches on the lower cabinets.
C
You are caring for a woman in labor who is 6 cm dilated with a reassuring FHT pattern and regularstrong UCs. The fetal heart rate (FHR) should be: a. Monitored continuously b. Monitored every 15 minutes c. Monitored every 30 minutes d. Monitored every 60 minutes
C
A 37-year-old woman who is 17 week s pregnant has had an amniocentesis. Before discharge, the nurse teaches the woman to call her doctor if she experiences which of the following side effects? a. Pain at the puncture site b. Macular rash on the abdomen c. Decrease in urinary output d.Cramping of the uterus
D
A client delivered a 2800-gram neonate 4 hours ago by cesarean section with epidural anesthesia.Which of the following interventions should the nurse perform on the mother at this time? a. Maintain the client flat in bed. b. Assess the clients patellar reflexes. c. Monitor hourly urinary outputs. d. Assess the clients respiratory rate.
D
A nurse is admitting a woman for a scheduled cesarean section. Which of the following Assessment data should be immediately reported to the physician? a. White cell count of 11,000 b.Hemoglobin of 11 g/dL c. Hematocrit of 33% d. Platelet count of 97,000
D
A nurse is caring for a woman 10 hours post-cesarean birth. She received a dose of intrathecal morphine at the time of the birth. Which of the following assessment data would require immediateintervention? a. Itching of the palms and feet b. Nausea c. Urinary output of300 mL in the past 4 hours d. Respiratory rate of 10 breaths/minute
D
A nurse is making a home visit on the seventh postpartum day to assess a 23-year-old primipara woman and her full-term, healthy baby. Breastfeeding isthe method of infant nutrition. The woman tells the nurse that she does not think her milk is good because it looks very watery when she expresses a littlebefore each feeding. The nurse's best response is: a. This is normal. You only have to be concerned when your baby does notgain weight. b. What types of foods are you eating? A lack of protein in the diet can causewatery looking breast milk.‖ c. How much fluid are you drinking while you are nursing your baby? Toomuch fluid during the feeding session can dilute the breast milk.‖ d. This is normal and is referred to as foremilk which is higher in water content. Later in the feeding the fat content increases and the milk becomes richer in appearance.
D
A patient, G1 P0, is admitted to the labor and delivery unit for induction of labor. The following assessments were made on admission: Bishop score of 4,fetal heart rate 140s with good variability and no decelerations, TPR 98.6oF, 88, 20, BP 120/80, negative obstetrical history. A prostaglandin suppository was inserted at that time. Which of the following findings, 6 hours after insertion, would warrant the removal of the Cervidil (dinoprostone)? a. Bishop score of 5 b. Fetal heart of 152 bpm c. Respiratory rate of 24 rpm d. Contraction frequency of every 2 minutes
D
A woman at 40 weeks gestation has a diagnosis of oligohydramnios. Which of the following statements related to oligohydramnios is correct? a. It indicates that there is a 25% increase in amniotic fluid. b. It indicates that there is a25% reduction of amniotic fluid. c. It indicates that there is a 50% increase in amniotic fluid. d. It indicates that there is a 50% reduction of amniotic fluid.
D
A woman in labor and delivery is being given subcutaneous terbutaline for preterm labor. Which ofthe following common medication effects would the nurse expect to see in the mother? a. Serum potassium level increases b. Diarrhea c. Urticaria d. Complaints of nervousness
D
If the umbilical cord prolapses during labor, the nurse should immediately: a. Type and cross-match blood for an emergency transfusion. b. Await MD order for preparation for an emergency cesarean section. c. Attempt to reposition the cord above the presenting part. d. Apply manual pressure to the presenting part to relieve pressure on thecord.
D
Instructions to a mother of an uncircumcised male infant should includewhich of the following? a. Instruct her to use a cotton swab to clean under the foreskin. b. Instruct her to clean the penis by retracting the foreskin. c. Instruct her to clean the penis with alcohol. d. Instruct her not to retract the foreskin.
D
Karen, a 26-year-old woman, has come for preconception counseling and ask s about caring for her cat as she has heard that she ―should not touch the cat during pregnancy. The clinic nurse's best response is: a. It is best if someone other than you changes the cat's litter pan during pregnancy so that you have no risk of toxoplasmosis during pregnancy. b. It is important to have someone else change the litter pan during pregnancy and also avoid consuming raw vegetables. c. Have you had any ―flu-lik e‖ symptoms since you got your cat? If so, you may have already had toxoplasmosis and there is nothing to worry about. d. Toxoplasmosis is a concern during pregnancy, so it is important to have someone elsechange the cat's litter pan and also to avoid consuming uncooked meat.
D
The Apgar score consists of a rapid assessment of five physiological signs that indicate the physiological status of the newborn and includes: a. Apical pulse strength, respiratory rate, muscle flexion,reflex irritability, and color b. Heart rate, clarity of lungs, muscle tone, reflexes,and color c. Apical pulse strength, respiratory rate, muscle tone, reflex irritability, and color of extremities d. Heart rate, respiratoryrate, muscle tone, reflex irritability, and color
D
The nurse is caring for a woman at 28 weeks gestation with a history of preterm delivery. Which ofthe following laboratory data should the nurse carefully assess in relation to this diagnosis? a. Human relaxin levels b. Amniotic fluid levels c. Alpha-fetoprotein levels d. Fetal fibronectin levels
D
The nurse is caring for two laboring women. Which of the patients should be monitored mostcarefully for signs of placental abruption? a. The patient with placenta previa b. The patient whose vagina is colonized with group B streptococci c. The patient who is hepatitis B surface antigen positive d. The patient with eclampsia
D
The perinatal nurse is assessing a woman in triage who is 34 + 3 weeks gestation in her first pregnancy. She is worried about having her baby too soon, and she is experiencing uterine contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal examination performed by the health-care provider reveals that the cervix is closed, long, and posterior. The most likelydiagnosiswould be: a. Preterm labor b. Term labor c. Back labor d. Braxton-Hicks contractions
D
The perinatal nurse knows that the term to describe a woman at 26 weeks gestation with a history ofelevated blood pressure who presents with a urine showing 2+ protein (by dipstick) is: a. Preeclampsia b. Chronic hypertension c. Gestational hypertension d. Chronic hypertension with superimposed
D
The perinatal nurse listens as Chantal describes her labor and emergency cesarean birth. Providingan opportunity to review this experience may assist Chantal in: a. Her role development in the letting go stage b. Decreasing her ambivalence about her labor and birth c. Understanding her guilt involved in her labor and birth d. Developing more positive feelings about her labor and birth
D
The primary complications of amniocentesis are: a. Damage to fetal organs b. Puncture of umbilical cord c. Maternal pain d. Infection
D
When caring for a primiparous woman being evaluated for admission for labor, a key distinction between true versus false labor is: a. True labor contractions result in rupture of membranes, and with falselabor, the membranes remain intact. b. True labor contractions resultin increasing anxiety and discomfort,and false labor does not. c. True labor contractions are accompanied by loss of the mucus plug and bloody show, and with false labor there is no vaginal discharge. d. True labor contractions bring about changes incervical effacement and dilation, and with false labor there are irregular contractionswith little or no cervical changes.
D
Which of the following statements is most appropriate for the nurse to say to a patient with a completeplacenta previa? a. During the second stage of labor you will need to bear down. b. You should ambulate in the halls at least twice each day. c. The doctor will likely induce your labor with oxytocin. d. Please promptly report if you experience any bleeding or feel any back discomfort.
D
You are in the process of admitting a multiparous woman to labor and delivery from the triage area. One hour ago her vaginal exam was 4/70/0. While completing your review of her prenatal record and completing the admission questionnaire, she tells you she has an urge to have a bowel movement and feels like pushing. Your priority nursing intervention is to: a. Reassure the patient and rapidly complete theadmission. b. Assist your patient to the bathroom to have a bowelmovement. c. Assess the fetal heart rate and uterine contractions. d. Perform a vaginal exam.
D
Your patient is 34 week s pregnant and during a regular prenatal visit tells you she does not understand how to do kick counts.‖ The best response by the nurse would be to explain: a. ―Here is an information sheet on how to do kick counts.‖ b. ―It is not important to do kick counts because you have a low-risk pregnancy.‖ c. ―Fetal kick counts are not a reliable indicator of fetal well-being in the third trimester.‖ d. ―Fetal movements are an indicator of fetal well-being. You should count twice a day, and you should feel 10 fetal movements in 2 hours.‖
D
Your patient is a 37-year-old pregnant woman who is 5 week s pregnant and is considering genetic testing. During your discussion, the woman ask s the nurse what the advantages of chorionic villus sampling (CVS) are over amniocentesis. The best response is: a. ―You will need anesthesia for amniocentesis, but not for CVS.‖ b. ―CVS is a faster procedure.‖ c. ―CVS provides more detailed information than amniocentesis.‖ d. ―CVS can be done earlier in your pregnancy, and the results are available more quickly
D