OB Final Exam ppt practice questions
After the baby is dried off on Karen's abdomen, they remain skin-to-skin, getting to know one another. The nurse immediately assesses the baby while still on Karen's chest. He is acrocyanotic, has a HR of 140, is actively crying, and pulls away in flexion from the nurse's touch. The nurse assigns a one-minute APGAR of _____
9
_____% of newborns require assessment at birth. a. 100 b. 10 c. 1 d. 0.1
a. 100
As a result of magnesium sulfate treatment, your patient is most at risk for: a. Jitteriness b. Increased afterpains c. Uterine atony d. Bladder spasticity
c. Uterine atony
Marcella has been diagnosed as borderline anemic and asks about the supplements she has been prescribed. You know the teaching is successful when she states: a. "I should take my iron half an hour before breakfast." b. "I should take my iron right after a meal." c. "I should take my iron and vitamin whenever I remember them." d. "Iron is best absorbed when taken with milk."
a. "I should take my iron half an hour before breakfast."
Ever the overachiever, at 24 hours Angie, asks you when she can begin exercising to regain her pre-pregnancy shape. Which response is correct? a. "Simple abdominal and pelvic exercises can begin right now." b. "You will need to wait until after your 6-week postpartum checkup." c. "Once your lochia has stopped you can begin exercising." d. "You should not exercise while you are breastfeeding."
a. "Simple abdominal and pelvic exercises can begin right now."
A client has just had a C/S for a prolapsed cord. In reviewing the client's history, which of the following factors places a client at risk for cord prolapse? Select all that apply. a. -2 station at time of rupture b. Prior elective abortion c. Assisted rupture of membranes d. Breech presentation e. Low lying placenta
a. -2 station at time of rupture c. Assisted rupture of membranes d. Breech presentation
New parents should be encouraged to keep follow-up appointments and to call their health care provider if they notice signs of illness in their newborn. Which of the following are warning signs of illness that parents should be aware of? (Select all that apply.) a. Abdominal distention b. Refuse feeding c. Only 8 wet diapers a day d. Temperature of 38.3 C (101 F) or higher e. General fussiness
a. Abdominal distention b. Refuse feeding d. Temperature of 38.3 C (101 F) or higher
Which of the following would alert the nurse to suspect that a newborn is experiencing respiratory distress? a. Asymmetrical chest movement b. Apneic periods lasting 10 seconds c. Acrocyanosis d. Respiratory rate of 50 breaths per minute
a. Asymmetrical chest movement
Before proceeding with an induction related to pre-eclampsia , Dr. Tito performs and ultrasound to determine fetal position of twins. Which presentations will allow for a vaginal delivery? Select all that apply. a. Baby A Vertex/Baby B Breech b. Baby A Vertex/Baby B Vertex c. Baby A Breech/Baby B Vertex d. Baby A Breech/Baby B Breech
a. Baby A Vertex/Baby B Breech b. Baby A Vertex/Baby B Vertex
Karen is 10/100/2. What interventions should the nurse complete to get her ready to push in the second stage of labor? Select all that apply. a. Check her bladder and catheterize if needed b. Set up the instruments for a delivery table c. Get the neonatal bed warmed and ready d. Update the provider with Karen's status
a. Check her bladder and catheterize if needed b. Set up the instruments for a delivery table c. Get the neonatal bed warmed and ready d. Update the provider with Karen's status
Rachel delivers a boy and a girl! Peter (Baby A) and Marissa (Baby B) were both born at 32.1 weeks. Peter weighed 1475 gms (3 lbs 4 oz), APGARs 6/7. Marissa weighed 1702 gms (3 lbs 12 oz), APGARs 7/7. At delivery, which intervention would the nurse perform first? a. Dry/stimulate the newborn b. Suction the airway with a bulb syringe c. Administer ventilations d. Administer chest compressions
a. Dry/stimulate the newborn
Rachel is admitted to labor and delivery for observation, betamethasone therapy, and lab work. Which findings would support a diagnosis of pre-eclampsia? Select all that apply a. Elevated liver enzymes b. Decreased platelets c. Elevated bile salts d. Decreased urine output e. Elevated BUN
a. Elevated liver enzymes b. Decreased platelets d. Decreased urine output e. Elevated BUN
Rachel is quite concerned by the discussion of preeclampsia. Both she and her husband Angelo immediately wants to know what the risk is to their babies. After teaching about fetal risks of preeclampsia, you know that Rachel needs additional instruction after she says preeclampsia can lead to which of the following: a. Hydrocephalic infant b. Abruptio placentae c. Intrauterine growth restriction d. Poor placental perfusion
a. Hydrocephalic infant
The nurse recovers Karen through the fourth stage of labor. She is ready to transfer to a postpartum floor. When transferring to a wheelchair, the nurse assists Karen to a sitting position first, then slowly moves her to a stand before getting in the chair. This is to prevent which possible complication? a. Hypotension b. Hypoglycemia c. Deep vein thrombosis d. Postpartum hemorrhage
a. Hypotension
The nurse frequently assesses the respiratory status of an infant delivered by cesarean based on the understanding that the newborn is at increased risk for Transient Tachypnea of the Newborn (TTN) because of which of the following? a. Inability to clear fluids b. Immature respiratory control c. Deficiency of surfactant d. Smaller respiratory passages e. Meconium causes obstruction of airways
a. Inability to clear fluids
Although Karen has not seen her partner in 2 months (he is abusive), she is afraid he will find out she is in the hospital and will try to come to see the baby. A prudent step for the nurse to take in this situation is to: a. Let hospital security know the situation b. Lock the door to Karen's room to prevent the husband from entering c. Call the nursery to tell them the situation so they can lock the door d. Call the local police and inform them of the situation
a. Let hospital security know the situation
A nurse is assessing a client 2 hours postpartum. Her blood pressure is 98/60, pulse is 90, and she has saturated one pad in the last hour. What should be the immediate nursing action? a. Massage fundus until firm b. Prepare the patient for a manual removal of placental fragments .c Administer Methergine d. Administer platelets
a. Massage fundus until firm
Which of the following S/S might indicate a patient with preterm, premature ROM has developed an infection? Select all that apply. a. Maternal tachycardia b. Fetal tachycardia c. Uterine tenderness d. Leukocytosis e. Foul-smelling amniotic fluid
a. Maternal tachycardia b. Fetal tachycardia c. Uterine tenderness d. Leukocytosis e. Foul-smelling amniotic fluid
A patient with placenta previa at 37.4 weeks gestation presents with active, ongoing bleeding. Her VS are T 98.2 F, HR 88, RR 20, BP 136/80. Which diet is most appropriate for her? a. NPO b. Clear liquid diet c. Low sodium diet d. General diet
a. NPO
You are caring for a GDM A2 G2 P1001 who complains of severe dyspnea. At her 39 week prenatal visit, her AFI was determined to be 30. An induction of labor is scheduled for this patient. Which of the following is an appropriate plan of care? Select all that apply. a. Needle amniotomy with FSE b. Amniocentesis c. Administration of Indocin (Indomethacin) d. Amnioinfusion
a. Needle amniotomy with FSE b. Amniocentesis c. Administration of Indocin (Indomethacin)
At 3 days old, the nurse observes that Martina is slightly jaundiced. What might explain this condition observed in Martina? a. Physiologic jaundice secondary to breast-feeding b. Hemolytic disease of the newborn due to blood incompatibility c. Exposing the newborn to high levels of oxygen d. Overfeeding the newborn with too much glucose water
a. Physiologic jaundice secondary to breast-feeding
The nurse understands that the endometrium is prepped for egg implantation by the corpus luteum, which secretes: a. Progesterone b. Estrogen c. Luteinizing hormone d. Prolactin
a. Progesterone
A primigravid client has completed the lab work from her first prenatal visit. Her bloodwork reveals she is HBsAg positive. What should the nurse anticipate in the plan of care at delivery? Select all that apply. a. Series of 3 hepatitis B vaccines for the newborn started before discharge b. Isolation of the infant during hospitalization c. Universal precautions for mother and infant d. Formula feeding for the infant
a. Series of 3 hepatitis B vaccines for the newborn started before discharge c. Universal precautions for mother and infant
Which assessment finding might be expected with hyperemesis gravid arum? a. Spec grav >1.025 b. Decreased hematocrit c. 3+ edema d. 5 lb Weight gain for first trimester
a. Spec grav >1.025
Karen is admitted to the labor and delivery unit to continue her labor. With the assistance of the nurse, Dr. Wright inserts an intrauterine pressure catheter (IUPC) in Karen. For what reason(s) was this intervention performed. Select all that apply. a. The IUPC will provide more accurate information about the strength of the contractions. b. The IUPC will allow access to instill an amnioinfusion. c. The IUPC is the most dependable way to record the fetal heart rate. d. The IUPC is a standard way to monitor all labors. e. The IUPC will tell us why Karen's labor is not progressing.
a. The IUPC will provide more accurate information about the strength of the contractions. b. The IUPC will allow access to instill an amnioinfusion.
Marcella tells you that she had a spontaneous abortion 12 months ago. She asks if her hormones might have contributed to the loss of the pregnancy. Your response is based upon her knowledge of which of the following facts? a. The client's hCG levels were not high enough to support the corpus luteum. b. Progesterone is produced only by the corpus luteum during pregnancy. c. The client's estrogen levels are too high. d. The spontaneous abortion occurred at 16 weeks.
a. The client's hCG levels were not high enough to support the corpus luteum.
A 33 y/o G2P0 at 8 weeks' gestation has a history of type 1 DM. When explaining about the importance of glucose control in pregnancy, which should the nurse expect to occur regarding the client's insulin needs in the third trimester? a. They will increase. b. They will decrease. c. They will remain constant. d. They will be unpredictable.
a. They will increase.
Rachel receives an epidural and is comfortably resting. When managing her labor, the nurse understands that increased Pitocin may need to be administered because magnesium sulfate is one of the __________ which counteracts the effects of __________. a. Tocolytics; oxytocins b. Corticosteroids; sedatives c. Sedatives; Corticosteroids d. Oxytocins; tocolytics
a. Tocolytics; oxytocins
Which of the following would be a contraindication to receiving IV Hydromorphone Hydrochloride (Dilaudid)? a. Transition stage of labor b. FHR baseline 115 bpm c. Presence of moderate variability d. Use of telemetry FHR monitoring
a. Transition stage of labor
A G2 P0101 at 32 weeks is complaining of UCs q 6-8 minutes for the past hour. She will have several assessments completed, including Fetal Fibronectin, SVE, Transvaginal ultrasound, and a speculum exam. Which test must be performed first? a. fFN b. SVE c. TVUS d. SSE
a. fFN
When conducting an assessment, the nurse observes tiny white pinpoint papules on a newborn's nose. These are documented as: a. Milia b. Vernix Caseosa c. Epstein's pearls d. Lanugo
a. milia
A newborn develops physiologic jaundice, and the mother asks the nurse why this happened. Which response by the nurse would be most accurate? a. "We really don't know why jaundice develops in some babies and not in others. We just know how to treat it." b. "Because his liver is a bit immature, the baby can't break down the bilirubin as fast as needed." c. "There is some type of blood incompatibility between you and your baby that's causing the problem." d. "Your baby must have a blocked duct near his liver that's preventing the bilirubin from being excreted."
b. "Because his liver is a bit immature, the baby can't break down the bilirubin as fast as needed."
Karen says, "I'm going to be breastfeeding. I shouldn't need any other contraception, right?" The nurse educates Karen about Lactational Amenorrhea. Karen understands your teaching when she states: a. "I cannot get pregnant while I am breastfeeding". b. "I may want to use an alternative birth control method in addition". c. "I cannot use any hormones while I am breastfeeding or it will dry up my milk". d. "I cannot use condoms because I will be too dry".
b. "I may want to use an alternative birth control method in addition".
At 24 weeks' gestation Marcella tells the nurse that she has been having a purulent, greenish-yellow discharge, urinary frequency, and painful urination. Which statement, if made by the nurse, is best in this situation? a. "You don't have to worry. It's only a minor infection and cannot harm your baby." b. "Your baby is protected by the presence of the mucous plug in your cervix until your membranes rupture." c. "A vaginal birth is still recommended, and no prophylaxis is recommended for the baby at delivery." d. "Even if your baby becomes exposed to this infection, there are no health risks for the baby."
b. "Your baby is protected by the presence of the mucous plug in your cervix until your membranes rupture."
Marcella is eager to experience every part of pregnancy. She wants to know when would she feel the baby move? a. 8 weeks GA b. 20 weeks GA c. 24 weeks GA d. 37 weeks GA
b. 20 weeks GA
A newborn has a heart rate of 90 beats per minute, a regular respiratory rate of 40 breaths per minute, tight flexion of the extremities, a grimace when stimulated, and acrocyanosis. The nurse assigns an Apgar score of: a. 6 b. 7 c. 8 d. 9
b. 7
Marcella is concerned about a blow to the abdomen if she continues to practice yoga during her pregnancy. The nurse's response is based upon her knowledge of which of the following facts concerning amniotic fluid? a. The total amount of amniotic fluid during pregnancy is 300 mL. b. Amniotic fluid functions as a cushion to protect against mechanical injury. c. The fetus does not contribute to the production of amniotic fluid. d. Amniotic fluid is slightly acidic.
b. Amniotic fluid functions as a cushion to protect against mechanical injury.
Prior to initiation of Indocin therapy for a patient in preterm labor at 28 weeks, which of the following assessments would be appropriate? a. Non-stress test b. Amniotic fluid index c. Contraction stress test d. Amniocentesis
b. Amniotic fluid index
Even though Angie did not have a lengthy second stage of labor, she still has some perineal edema and reports some discomfort from a second degree perineal laceration. Which intervention is most appropriate to implement? a. Application of warm compresses to the laceration b. Application of an ice pack to the perineum c. Administration of Hemabate 250 mcg d. Contacting the physician/CNM for new orders
b. Application of an ice pack to the perineum
It is important that nurses include a discussion about teratogens in their prenatal discussions to help prevent deformities or abnormalities. Teratogens may include which of the following? (Select all that apply.) a. Multivitamin supplement b. Certain medications c. Alcohol d. Infections
b. Certain medications c. Alcohol d. Infections
When performing a heelstick glucose assessment, which of the following are appropriate? a. To decrease pain, apply ice to the site prior to performing the assessment. b. Collect sample from lateral side of heel c. Perform assessment in the nursery to maintain sterility of procedure. d. Use smallest gauge needle to draw sample.
b. Collect sample from lateral side of heel
Upon completing your assessment, which patient are you most concerned will experience a seizure? a. RR 12 and decreased hand grasp b. Complaint of headache and 4+ DTRs c. 3+ edema and rales on auscultation d. Oliguria and elevated BUN e. Elevated ALT/AST and epigastric pain
b. Complaint of headache and 4+ DTRs
Which patient is most at risk for uterine rupture? a. G3P2 with history of 2 prior LTCS b. G2P1 with history of 1 prior classical C/S c. G3 P1102 d. G3 P0030 with history of 3 elective abortions
b. G2P1 with history of 1 prior classical C/S
The best position for the patient post-epidural is: a. High-fowler's b. Left lateral c. Supine d. Knee-chest
b. Left lateral
Marcella has some concerns because her medical history is significant for diabetes, hypertension, migraine headaches, and pelvic inflammatory disease (PID). Which reason might contribute to infertility? a. Hypertension b. PID c. Hyperglycemia d. Migraine headaches
b. PID
A nurse is admitting a full-term pregnant client presenting with active vaginal bleeding and intense abdominal pain. Her VS on admission are T 98.0 F, HR 109, RR 22, BP 150/96. Which problem should the nurse suspect that the client is likely experiencing? a. Placenta previa b. Placenta abruption c. Placenta accreta d. Succenturiate placenta
b. Placenta abruption
Karen experienced a second degree perineal laceration at delivery. What comfort measures would be appropriate? Select all that apply. a. Provide a heating pad b. Provide a sitz bath c. Encourage ice pack for the first 24 hours d. Medicate with analgesia PRN as ordered
b. Provide a sitz bath c. Encourage ice pack for the first 24 hours d. Medicate with analgesia PRN as ordered
The nurse is caring for a multigravid client who speaks little English. As the nurse enters the client's room, the nurse observes the client squatting on the bed and the fetal head crowning. After calling for assistance and helping the client lie down, which of the following actions should the nurse do next? a. Tell the client to push between contractions. b. Provide gentle support to the fetal head. c Apply gentle upward traction on the neonate's anterior shoulder. d. Massage the perineum to stretch the perineal tissues.
b. Provide gentle support to the fetal head.
A G2 P0010 at 16 weeks GA presents with vaginal bleeding. In order to assess her, which intervention(s) is/are appropriate? Select all that apply. a. SVE b. Speculum exam c. Ultrasound d. Laparoscopy e. Non-stress test
b. Speculum exam c. Ultrasound
A neonate was born at 41 weeks GA, weighing 4082 gms (9 lbs). Assessing for signs and symptoms of which of the following findings would be a priority? a. Respiratory rate 44 b. Temperature 96.8 c. Passage of meconium d. Increased rooting reflex
b. Temperature 96.8
The nurse understands that Karen has is ready to deliver the placenta after seeing all of the following signs, except: a. There is a gush of blood b. The umbilical cord retracts c. The uterus (fundus) rises in the abdomen d. The uterus becomes globular in shape
b. The umbilical cord retracts
At 1cm, Karen is not ready to be admitted to the L&D unit. Karen ambulates and after 2 hours of walking, her BOW breaks; the fluid is green-tinged. Karen is now 4-5 cm dilated and is increasingly uncomfortable. Karen wants to know why the fluid is green. The nurse responds: a. This is a sign that you have an infection. b. Your baby had his or her first bowel movement already, called meconium. c. We will give your baby erythromycin eye ointment to protect him or her at delivery. d. Your baby is in distress and will need to deliver by c-section.
b. Your baby had his or her first bowel movement already, called meconium.
Which infant is most likely to have a potentially difficult respiratory transition? a. 38 weeks; vaginal delivery b. 40 weeks; Cesarean delivery c. 34 weeks; Cesarean delivery d. 36 weeks; vaginal delivery
c. 34 weeks; Cesarean delivery
At 6 hours of life, the nurse assessing baby Martina auscultates bowel sounds and documents recent passing of meconium. These findings would indicate: a. Abnormal GI newborn transition and needs to be reported b. An intestinal anomaly that needs immediate surgery c. A patent anus with no bowel obstruction and normal peristalsis d. A malabsorption syndrome resulting in fatty stools
c. A patent anus with no bowel obstruction and normal peristalsis
Karen has no significant medical or surgical history. However, Karen's social history is complicated by the fact that her partner was abusive and there is a protective from abuse order on him. Karen has not seen him for the past 2 months and he cannot visit. Karen's mother is with her today and is very supportive. Karen is in bed when you enter the room and her mother is in the chair. You introduce yourself and can see that Karen is very anxious. She is holding tight to the side rails. You quietly put your hand on her abdomen and wait for the next UC. The best nursing diagnosis for Karen at this point is? a. Impaired mobility related to labor as evidenced by voluntary bed rest. b. Low situational self-esteem related to domestic abuse evidenced by anxiety. c. Anxiety related to impending delivery as evidenced by a tight grip on the handrails. d. Powerlessness related to labor as evidenced by a tight grip on the handrails.
c. Anxiety related to impending delivery as evidenced by a tight grip on the handrails.
A client who is in labor is at risk for shoulder dystocia because she has a history of this event with her first delivery. Which of the following is an important nursing intervention? a. Assess for complaints of intense back pain in the first stage of labor. b. Anticipate possible use of forceps to rotate to anterior position at birth. c. Assist with positioning the woman in squatting position. d. Perform an emergency episiotomy.
c. Assist with positioning the woman in squatting position.
Rachel has a CRIB placed and low-dose Pitocin is started. She also has a magnesium sulfate infusion started. The nurse explains to her and Angelo that the magnesium sulfate acts as which of the following? a. Peripheral vasodilator b. Antihypertensive c. Central nervous system depressant d. Sedative-hypnotic
c. Central nervous system depressant
The nurse performs VS and a BBUBBLE-EE assessment on Karen. Karen's pulse is decreased and the nurse recognizes this is due to: a. Diuresis b. Excessive blood loss c. Changes in cardiac output d. An indication of sepsis
c. Changes in cardiac output
Angie tells you that her milk supply was, "not that great" with Kelsey and Marcus. What instructions should you give her to improve milk supply? a. Increase her folic acid dose b. Apply ice packs to the breasts c. Empty the breasts frequently d. Be sure to increase caloric intake
c. Empty the breasts frequently
Angie Young tells the nurse her last period was May 18. The nurse uses Nagele's rule to compute the client's expected date of birth, and tells the client that the correct date of birth will be: a. February 11 (of the next year) b. February 18 (of the next year) c. February 25 (of the next year) d. February 28 (of the next year)
c. February 25 (of the next year)
When discussing the various risks to the mother and infant, the nurse should include that which of the following is the leading cause of cognitive impairment in the United States? a. Maternal drug addiction b. Pregnancy category X medications c. Fetal alcohol spectrum disorder d. Genetic anomalies
c. Fetal alcohol spectrum disorder
The IUPC is a device that assists with meconium stained amniotic fluid by: a. Instilling cold fluid to coagulate the meconium. b. Extracting the meconium with mild suction. c. Instilling fluid to dilute the meconium. d. Extracting the fluid so the meconium solidifies.
c. Instilling fluid to dilute the meconium.
Where would you place an EFM ultrasound to assess fetal heart tones for a baby in LOA position? a. Right lower quadrant b. Right upper quadrant c. Left Lower quadrant d. Left Upper quadrant
c. Left Lower quadrant
Which of the following should the nurse identify as a risk associated with anemia during pregnancy? a. Newborn with heart problems b. Fetal asphyxia c. Low birthweight d. Polyhydramnios
c. Low birthweight
A patient with gestational diabetes is seen for an ultrasound at 39 weeks. The fetus is estimated to be 4500 gms (10 lbs). The patient asks, "What causes the baby to be so large?" The nurse's best response is: a. Family history of large infants b. Fetal anomalies c. Maternal hyperglycemia d. Maternal hypertension
c. Maternal hyperglycemia
A nursing student has read that cleft lip is diagnosed at birth based on appearance and that cleft palate is diagnosed in which of the following ways? a. X-ray b. Alpha-fetoprotein levels c. Palpating the palate with a gloved finger d. Ultrasound
c. Palpating the palate with a gloved finger
Dr. Tito discusses some options for Rachel (pre-eclamptic preterm pregnant with twins) regarding cervical ripening. Which plan of care is appropriate? a. Begin pitocin infusion at 10 mu/min b. Administer cytotec and prepidil gel intracervically via a diaphragm c. Place a CRIB (foley bulb) intracervically and begin low dose pitocin d. Place cervidil insert and remove after 4 hours
c. Place a CRIB (foley bulb) intracervically and begin low dose pitocin
12 hours later, the CRIB is checked and is removed. Rachel's SVE is now 4/1/-2. She is encouraged by this progress, but is exhausted. She would like to get an epidural; however, the CRNA wishes to review her labs first. Which test is most important? a. ALT/AST b. Urinalysis c. Platelet count d. BUN
c. Platelet count
Which of the following clients is most at risk for cephalopelvic disproportion? a. G3 P2002 b. Fetus presenting in ROP c. Poorly controlled Type 2 DM d. Severe pre-eclamptic
c. Poorly controlled Type 2 DM
Angie is not ready to be admitted for labor just yet. You teach her about the differences between true and false labor. Your teaching is effective when she states: a. When I am contracting every 5 minutes, I am in true labor b. The presenting part is engaged and not floating c. Progressive cervical change occurs in true labor d. In true labor, my bag of water will break
c. Progressive cervical change occurs in true labor
A patient with abruptio placenta is entering DIC as a result of significant placental separation. You are reviewing her labs and would expect her PT/PTT to be: a. Unaffected b. Reduced c. Prolonged
c. Prolonged
Rachel has been seen in the office every two weeks during her pregnancy. She is now 32 weeks pregnant with twins and meeting with Dr. Tito. On this visit, Rachel complains of swelling in her hands and feet that does not resolve with rest, and a headache for the past few days. Her BP is 152/94. In addition to Rachel's elevated blood pressure, what further information should the nurse obtain to determine if Rachel is becoming preeclamptic? a. Presence of headaches b. Blood glucose level c. Proteinuria d. Edema in lower extremeties.
c. Proteinuria
Ashley calls you complaining of breast pain. Her breasts are "hot, hard, knotty, and painful to the touch". She is 2 weeks postpartum. The first suggestion you should give her is: a. Don't worry, your breasts will feel better in 24 hours. b. Leave expressed milk on your nipples after feedings. c. Pump your breasts every 2-3 hours if baby can't nurse well d. Refrain from breastfeeding your baby until the pain has resolved.
c. Pump your breasts every 2-3 hours if baby can't nurse well
The nurse checks initial VS on Peter and auscultate HR 146 with murmur noted, RR 52 with coarse lung sounds, Temp 97.0°F via skin probe. Which is most concerning? a. HR b. RR c. Temp d. Murmur
c. Temp
A nurse assesses four clients at 32 weeks GA in the prenatal clinic. Which client will present with the most accurate fundal height related to gestational age? a. The client who develops polyhydramnios (lost of fluid) b. The client with obesity c. The client who develops hypertension d. The client with a 70-pound weight gain
c. The client who develops hypertension
A nurse is caring for four postpartum clients who each have an order for Methergine (methylergonovine maleate). Based on the data collected during the nurse's initial shift assessment, which client would not receive the medication? a. The client with a temperature of 101ºF b. The client with a respiratory rate of 20 c. The client with a blood pressure of 156/94 d. The client with a white blood cell count of 22,000
c. The client with a blood pressure of 156/94
A patient on antepartum for preterm premature ROM may exhibit which FHR tracing? a. early decelerations b. late decelerations c. variable decelerations
c. variable decelerations
You are teaching a couple about the process of fertilization. Which statement by the couple would indicate understanding of fertilization? a. "Fertilization takes place in the fimbria, or outer third, of the fallopian tube." b. "Fertilization takes place in the uterine cavity." c. "Fertilization takes place in the isthmus, or inner third, of the fallopian tube." d. "Fertilization takes place in the ampulla, or outer third, of the fallopian tube."
d. "Fertilization takes place in the ampulla, or outer third, of the fallopian tube."
As you admit Angie, she reveals that she and Steve have written a birth plan. Which statement would help assure you that she has a workable plan? a. "I've written down everything I have to have to make labor a success." b. "I didn't include anything Steve wanted; I'm the one having the baby." c. "My mother strongly suggested I ask for morphine like she did, so I'm going to add that." d. "I've tried to keep it flexible because I know circumstances can change."
d. "I've tried to keep it flexible because I know circumstances can change."
Which of the following, if reported by Angie, might be a sign of labor onset? a. Sudden loss of energy from epinephrine release b. "Nagging" but constant pain in the lower back c. Urinary urgency from increased bladder pressure d. "Show" or release of the cervical mucus plug
d. "Show" or release of the cervical mucus plug
At18 weeks' gestation, Marcella expresses her concern to you in the prenatal clinic about her 15-pound weight gain. What is the best response by the nurse? a. "You have gained an appropriate amount of weight." b. "You have not gained enough weight at this time in your pregnancy." c. "You should not gain any more weight until the third trimester." d. "You should continue to gain weight, but at a slower rate."
d. "You should continue to gain weight, but at a slower rate."
Which patient is most at risk for respiratory distress syndrome (RDS)? a. 39.4 week male born via C/S b. 38 week female of a diabetic mother c. 40.1 week male with transient tachypnea of the newborn d. 28 week female born via NSVD
d. 28 week female born via NSVD
Karen is very concerned her first bowel movement will "tear the stitches". What is an appropriate nursing intervention? a. Call the provider for an order for an enema b. Keep Karen NPO until she is more comfortable c. Encourage a high-protein diet d. Administer Colace as ordered PRN
d. Administer Colace as ordered PRN
At delivery, Peter required oxygen as part of resuscitation. While administering oxygen, the nurse would place Peter in which position? a. Left side, with the neck slightly flexed b. Back, with the head turned to the left side c. Abdomen, with the head down d. Back, with the neck slightly extended
d. Back, with the neck slightly extended
Martina is a healthy baby girl. Which of the following could be described as breathing normally in a newborn? a. Breathing deeply, with regular rhythm at a rate of 20 bpm b. Breathing diaphragmatically with sternal retractions, at a rate of 70 bpm c. Breathing shallowly, with 40 second periods of apnea and cyanosis d. Breathing shallowly, at a rate of 36 bpm, with short periods of apnea
d. Breathing shallowly, at a rate of 36 bpm, with short periods of apnea
If Karen were to decide to get an epidural, what lab work would you anticipate sending? a. Urinalysis b. Glucose c. H&H d. CBC
d. CBC
Karen's contractions are mild, lasting 30-40 seconds, every 5-7 minutes for the past 5 hours. She has no c/o fluid leaking, no c/o vaginal bleeding. She last felt fetal movement in the car on the way to the hospital. As assessment of Karen continues, what should the nurse do first? a. Perform a speculum exam to rule out rupture of membranes. b. Perform a sterile vaginal exam c. Place the patient in a lithotomy position d. Check fetal heart tones
d. Check fetal heart tones
Periventricular hemorrhage is suspected in a newborn of 30 weeks GA. The nurse would anticipate preparing the newborn for which of the following to confirm the diagnosis? a. Arterial blood gases b. Blood glucose level c. Chest x-ray d. Cranial ultrasound
d. Cranial ultrasound
You complete your BBUBBLE-EE assessment on Angie who is now 12-hours postpartum. Findings include lochia rubra, with a firm fundus at the level of the umbilicus. What nursing action is indicated? a. Massage the fundus to prevent early postpartum hemorrhage. b. Administer uterotonic medications to stop the bleeding. c. Call the physician/CNM and prepare for a pelvic exam. d. Document findings and continue to monitor.
d. Document findings and continue to monitor.
You will know that the magnesium sulfate treatment for preeclampsia is successful if your patient: a. Decreases her blood pressure b. Remains afebrile c. Maintains a respiratory rate of 18 bpm d. Does not experience a seizure
d. Does not experience a seizure
Karen, a 26 y/o patient at 38.3 weeks GA arrives to the obstetrical evaluation unit. This is Karen's fourth pregnancy. One pregnancy ended in spontaneous abortion at 12 weeks, another in an induced abortion at 7 weeks, and the third was a delivery of preterm twins at 22 weeks that did not survive. What is Karen's G TPAL obstetrical history? a. G3 T0 P2 A2 L0 b. G3 T0 P1 A2 L0 c. G4 T0 P2 A2 L0 d. G4 T0 P1 A2 L0
d. G4 T0 P1 A2 L0
Karen is planning on breastfeeding, but she is worried that she will become engorged. The nurse understands that a therapeutic intervention for breast engorgement is: a. Instruct the patient to wait to being breastfeeding until the baby is strong enough to suck effectively. b. Instruct the patient to go without a bra. c. Instruct the patient to use ice packs. d. Instruct the patient to feed frequently.
d. Instruct the patient to feed frequently.
The nurse is preparing a teaching plan for new parents about why newborns experience heat loss. Which of the following would the nurse include? a. Thick skin with deep-lying blood vessels b. Enhanced shivering ability c. Expanded stores of glucose and glycogen d. Limited voluntary muscle activity
d. Limited voluntary muscle activity
The magnesium sulfate bolus has completed (4 gm/30 min) and Rachel's dose is turned to the maintenance rate (2 gm/hr). Which of the following assessment findings should the nurse report immediately? a. Urinary output 60 ml/hr b. Patellar reflex of 2+ c. Blood pressure 160/88 d. Respiratory rate of 10 bpm e. Frontal headache
d. Respiratory rate of 10 bpm
Karen's labor continues for 6 hours. She has been comfortable with the epidural until she calls out with complains of feeling rectal pressure. Her EFM tracing shows early decelerations. What other information/intervention may be appropriate at this time? a. Restart amnioinfusion b. Oxygen 10 L by mask c. IV bolus d. SVE e. Epidural re-dose
d. SVE
The third stage of labor is from: a. The time the infant is crowning to the time of the birth of the placenta. b. From the delivery of the placenta until the immediate recovery period is over. c. The time the infant's cord is cut to the time of the birth of the placenta. d. The time the infant is fully delivered to the time of the birth of the placenta.
d. The time the infant is fully delivered to the time of the birth of the placenta.
A 21 year old woman presents to the ED with complaint of acute L lower abdominal pain and no c/o vaginal discharge. Her last normal menstrual period was approximately 8 weeks ago. Which of the following is the most appropriate diagnostic test? a. Abdominal-pelvic CT scan b. Abdominal radiograph c. CBC d. hCG level e. Progesterone level
d. hCG level
The triage RN re-checks Angie's SVE and she is now 6/90/0. What stage/phase of labor is she in now?
stage 1 active phase
Karen's contractions are mild, lasting 30-40 seconds, every 5-7 minutes for the past 5 hours. Karen's cervix is checked and she is 1/2/-2. What stage/phase of labor is she in? What would be an appropriate nursing intervention at this stage of labor? a. Teach patterned breathing b. Offer her pain medication c. Encourage her to get out of bed and walk d. Apply sacral pressure
stage 1 laten phase 1 c. Encourage her to get out of bed and walk
Angie arrives on your unit, talkative and excited about being in labor. She describes her contractions and discomfort as mild. You examine her report VSS, FHR 135 with moderate variability, UCs q 6-7 min, SVE 3/50/-2, membranes intact. What stage and phase of labor is Angie in?
stage 1 latent phase
