OB Exam 3 Practice Q's!!

A nurse is caring for a client who is at 34 weeks of gestation and has a prescription for terbutaline for preterm labor. Which of the following statements by the client is the priority? "My ankles are swollen at the end of the day." "I can feel the baby kicking my ribs, and it is very uncomfortable." "I'm growing more and more worried every day." "My heart feels as if it is racing."

"My heart feels as if it is racing."

A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa. Which of the following findings support tis diagnosis? 1. Painless red vaginal bleeding 2. Increasing abdominal pain with a non-relaxed uterus 3. Abdominal pain with scant red vaginal bleeding 4. Intermittent abdominal pain following passage of bloody mucus

1. painless red vaginal bleeding

a nurse is caring for a client during a nonstress test (NST). At the end of a 30 minute period of observation, the nurse notes the following findings: the fetal heart rate baseline is 120/min with minimal variability and no accelerations. There are two decelerations of 15/min in the fetal heart rate during a period of fetal movement, each lasting 20 seconds. Which of the following interpretations of these findings should the nurse make? 1. A negative test 2. a nonreactive test 3. A postitive test 4. A reactive test

2. a nonreactive test

A nurse in a provider's office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption? 1. cocaine use 2. hypertension 3. blunt force trauma 4. cigarette smoking

2. hypertelnsion

A nurse is caring for a client who is anemic at 32 weeks of gestation and is in preterm labor. The provider prescribed bethamethasone 12 mg IM. Which of the following outcomes should the nurse expect?

A reduction in respiratory distress in the newborn

A nurse is caring for a client who is to undergo a biophysical profile. The client asks the nurse what is being evaluated during this test. Which of the following should the nurse include? (SATA) A. Fetal breathing B. Fetal motion C. Fetal neck translucency D. Amniotic fluid volume E. Fetal gender

A, B, D

A nurse is admitting a client who is at 37 weeks of gestation and has severe preeclampsia. Which of the following actions should the nurse expect to implement? (Select all that apply.) A. Administer magnesium sulfate IV. B. Provide a dark, quiet environment. C. Assess respiratory status every 6 hr. D. Administer pitocin for induction of labor. E. Ensure that calcium gluconate is readily available.

A, B, D, E. Administer magnesium sulfate IV is correct. Magnesium sulfate IV is given as a tocolytic medication for preterm labor to relax smooth muscle of the uterus and as a treatment for preeclampsia. The underlying pathophysiology of preeclampsia is vasospasm. The nurse should closely monitor the client for signs of magnesium toxicity, such as loss of patellar reflexes, respiratory depression, cardiac arrhythmias, cardiac arrest, urinary retention, and serum magnesium levels higher than 8 mEq/L.

A nurse on the obstetric unit is caring for a client who experienced abruptio placentae. The nurse observes petechiae and bleeding around the IV access site. The nurse should recognize that this client is at risk for which of the following complications? A. Anaphylactoid syndrome of pregnancy B. Disseminated intravascular coagulation C. Preeclampsia D. Puerperal infection

B. DIC

A nurse is caring for several clients. The nurse should recognize that it is safe to administer tocolytic therapy to which of the following clients? A. A client who is experiencing fetal death at 32 weeks of gestation B. A client who is experiencing preterm labor at 26 weeks of gestation C. A client who is experiencing Braxton-Hicks contractions at 36 weeks of gestation D. A client who has a post-term pregnancy at 42 weeks of gestation

B. Tocolytic medications, such as terbutaline, indomethacin, and nifedipine are used to relax the uterus in preterm labor. A client who is in preterm labor at 26 weeks of gestation is a candidate for tocolytic therapy.

A nurse admits a woman who is at 38 weeks of gestation and in early labor with ruptured membranes. The nurse determines that the client's oral temperature is 38.9C/102F. Besides notifying the provider, which of the following is the appropriate nursing action? A. Recheck the client's temperature in 4 hr. B. Administer glucocorticoids intramuscularly. C. Assess the odor of the amniotic fluid. D. Prepare the client for emergency cesarean section.

C. Assess the odor of the amniotic fluid. i: Chorioamnionitis is an infection of the amniotic cavity that presents with maternal fever, tachycardia, increased uterine tenderness, and foul-smelling amniotic fluid.

A nurse in a prenatal clinic is caring for a client who is at 38 weeks gestation and undergoing a contraction stress test. The test results are negative. Which of the following interpretations of this finding should the nurse make? A. There is no evidence of cervical incompetence. B. There is no evidence of two or more accelerations in fetal heart rate in 20 min. C. There is no evidence of uteroplacental insufficiency. D. There are less than 3 uterine contractions in a 10 min period.

C. There is no evidence of uteroplacental insufficiency. i: A contraction stress test determines how well the fetus tolerates the stress of uterine contractions. A test is negative when there are at least 3 uterine contractions in a 10-min period with no late or significant variable decelerations during electronic fetal monitoring. Uteroplacental insufficiency produces late decelerations.

A nurse is caring for a client who is in preterm labor with a current L/S ratio of 1:1. Which of the following actions should the nurse take? A. Infuse a bolus of IV fluid. B. Administer hydralazine 25 mg IV. C. Prepare the client for immediate delivery. D. Administer betamethasone 12 mg IM.

D. Administer betamethasone 12 mg IM

A nurse is admitting a client who has severe preeclampsia at 35 weeks of gestation and is reviewing the provider's orders. Which of the following orders requires clarification? A. Assess deep tendon reflexes every hour. B. Obtain a daily weight. C. Continuous fetal monitoring D. Ambulate twice daily.

D. Ambulate twice daily A provider's order to allow the client to ambulate requires clarification. The client who has severe preeclampsia should be placed on bedrest in a quiet, nonstimulating environment to prevent seizures and promote optimal placental blood flow.

A nurse is planning care for a newborn who requires phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan of care? Swaddle the newborn in a receiving blanket during the treatment. Maintain NPO status until the newborn's bilirubin is within the expected reference range. Ensure the newborn's eyes are closed before applying the eye shield. Apply lotion to the newborn's skin twice per day.

Ensure the newborn's eyes are closed before applying the eye shield.

A nurse is caring for a client who is at 24 weeks of gestation and has a suspected placental abruption. Which of the following laboratory tests should the nurse expect the provider to prescribe?

Kleihauer-Betke test

A nurse is caring for a client who is at 36 weeks of gestation and has preeclampsia. Which of the following findings should the nurse identify as the priority? 1+ proteinuria Blood pressure 140/98 mm Hg Nonreactive nonstress test Fundal height 33 cm

Nonreactive nonstress test

A nurse is caring for a client who has disseminated intravascular coagulation (DIC). Which of the following antepartum complications should the nurse understand is a risk factor for this condition?

Preeclampsia

A nurse is assessing a client who is receiving magnesium sulfate as treatment for preeclampsia. Which of the following clinical findings is the nurse's priority? Respirations 16/min Urinary output 40 mL in 2 hr Reflexes +2 Fetal heart rate 158/min

Urinary output 40 mL in 2 hr

A nurse is assessing a client who is at 35 weeks of gestation and has mild gestational HTN. What finding should the nurse identify as the priority? a. 480 mL urine output in 24 hrs b. 1+ protein in the urine c. +2 edema of the feet d. BP 144/92

a. 480 mL urine output in 24 hrs

A nurse is caring for a client who is at 35 wks gestation and has severe pre-eclampsia. What assessment provides the most accurate info regarding the client's fluid and electrolyte status. a. daily wt b. bp c. severity of edema d. I&O

a. daily weight

A nurse is caring for a client who is at 32 wks gestation and is experiencing preterm labor. What meds should the nurse plan to administer? a. misoprostol b. betamethasone c. poractant alfa d. methylergonovine

b. bethamethasone

A nurse is teaching a client who has pre-eclampsia and is to receive magnesium sulfate via continuous IV infusion about expected adverse effects. What adverse effects should the nurse include in the teaching? a. elevated BP b. feeling of warmth c. generalized pruritis d. hyperactivity

b. feeling of warmth

A nurse is reviewing the med record of a client who is at 39 wks gestation and has polyhydramnios. What finding should the nurse expect? a. total pregnancy wt gain of 3.6 kg b. fetal GI anomaly c. gestational HTN d. fundal height of 34 cm

b. fetal GI anomaly

A nurse in a provider's office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption? A. Cocaine use B. Hypertension C. Blunt force trauma D. Cigarette smoking

b. hypertension

A nurse is reviewing the medical record of a client who is at 33 wks gestation and has placenta previa and bleeding. What scripts should the nurse clarify with the provider? a. insert a large-bore IV catheter b. perform a vaginal exam c. perform continuous external fetal monitoring d. obtain a blood sample for lab testing

b. perform a vaginal exam

A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate IV at 2g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion? A. Deep-tendon reflexes of +1 B. Respiratory rate of 16/min C. Urine output of 50 mL in 4hr D. Heart rate of 56/min

b. respiratory rate of 16/min

A nurse is caring for a client who is at 28 weeks of gestation and received terbutaline. Which of the following findings should the nurse expect? A. Fetal heart rate 100/min B. Weakened uterine contractions C. Enhanced production of fetal lung surfactant D. Maternal blood glucose 63 mg/dL

b. weakened uterine contractions

A nurse is assessing a client who is 34 wks gestation and has mild placental abruption. What finding should the nurse expect? a. decreased urinary output b. fetal distress c. dark red vaginal bleeding d. increased platelet count

c. dark red vaginal bleeding

A nurse is caring for a client who is at 22 weeks of gestation and has been unable to control her gestational diabetes mellitus with diet and exercise. The nurse should anticipate a prescription from the provider for which of the following medications for the client? A. Acarbose B. Repaglinide C. Insulin D. Glipizide

c. insulin

A nurse is caring for a client who is having a nonstress test performed. The fetal heart rate is 130 to 150/min, but there has been no fetal movement for 15min. Which of the following actions should the nurse perform? A. Immediately report the situation to the client's provider and prepare the client for induction of labor. B. Encourage the client to walk around without the monitoring unit for 10min, then resume monitoring. C. Offer the client a snack of orange juice and crackers. D. Turn the client onto her left side.

c. offer the client a snack of orange juice and crackers

A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide? A. "There is an increased risk of introducing infection." B. "This could initiate preterm labor." C. "This could result in profound bleeding." D. "There is an increased risk of rupture of the membranes."

c. this could result in profound bleeding

A nurse is planning care for a newborn who is receiving phototherapy for an elevated bilirubin level. What action should the nurse take? a. apply barrier ointment to the newborn's perianal region b. offer the newborn glucose water between feedings c. use photometer to monitor the lamp's energy d. keep the newborn's eye patches on during feedings

c. use photometer to monitor the lamp's energy

A nurse is caring for a client who is experiencing preeclampsia and has a new prescription for IV magnesium sulfate. Which of the following medications should the nurse anticipate administering if the client develops magnesium toxicity?

calcium gluconate

A nurse is providing teaching about nonpharmological pain management to a client who is breastfeeding and has engorgement. The nurse should recommend the application of which of the following items?

cold cabbage leaves

A nurse is assessing a client who is at 35 wks gestation and is receiving magnesium sulfate via continuous IV infusion for severe pre-eclampsia. What finding should the nurse report to the provider? a. DTR 2+ b. resp 16 c. BP 150/96 d. urinary output 20 mL/hr

d. urinary output 20 mL/hr

A nurse administers betamethasone to a client who is at 33 weeks gestation to stimulate fetal lung maturity. Which planning care for the newborn, which of the following conditions should the nurse identify as an adverse effect of this medication? Hyperthermia Decreased blood glucose Rapid pulse rate Irritability

decreased blood glucose

A nurse is caring for a newborn whose mother received magnesium sulfate to treat preterm labor. Which of the following clinical manifestations in the newborn indicates toxicity due to the magnesium sulfate therapy? Respiratory depression Hypothermia Hypoglycemia Jaundice

respiratory depression

A nurse is teaching a client who is at 12 wks gestation about manifestations of potential complications that she should report to her provider. What info should the nurse include in the teaching? a. intermittent nausea b. white vaginal discharge c. swelling of the face d. urinary frequency

swelling of face