OB Test 1

A patient expresses desire to become pregnant for a second child. The nurse notes that the patient's first child was born with a serious neural tube defect (NTD) and died of complications at 18 months of age. Which recommendation does the nurse make to this client? a. folic acid 0.6 mg/day orally 1 month before conception and throughout pregnancy b. folic acid 0.4 mg/day orally started when pregnant and continued throughout c. folic acid 4 mg/day orally started when pregnant and continued throughout pregnancy d. folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

d. folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

The nurse is assessing a patient who is pregnant to prepare for an MRI scheduled to assess fetal brain development. Which situation causes the nurse to notify the radiology department personnel? a. the patient had breakfast before the test b. the patient reports having an iodine allergy c. the patient expressed concern about pain d. the patient has a permanent body piercing

d. the patient has a permanent body piercing

The nurse is counseling a 15 year old pregnant patient at her first prenatal appointment. Which patient teaching by the nurse is appropriate? a. adolescents usually have very effective coping mechanisms b. teenagers always have larger babies than older patients c. adolescents ego integrity is less easily threatened by stress and pain d. your response to pregnancy, labor, and delivery will differ from that on an adult because your cognitive development is not yet complete

d. your response to pregnancy, labor, and delivery will differ from that on an adult because your cognitive development is not yet complete

The nurse educator is teaching the nursing student the basic principles of using analgesia by using a patient, Christa, as an example. Which of the following demonstrates the basic principles of analgesia during Christa's labor and delivery? Select all that apply. a. Christa has been in labor for 4 hours. She has been having contractions every 3 minutes. Contractions last a minute and are intense. She has had cervical change from 3 to 5 cm over the past 4 hours. b. the medication Christa wants is an epidural. After she receives the epidural, the FHR tracing is within normal limits c. Christa received butophanol within 3 hours of delivery and the infant experienced neonatal depression d. Local anesthesia in the perineal area was used in conjunction with the epidural throughout labor and delivery e. Christa has a history of opiate abuse and therefore it was understood that she might require higher doses of medications to experience relief

a. Christa has been in labor for 4 hours. She has been having contractions every 3 minutes. Contractions last a minute and are intense. She has had cervical change from 3 to 5 cm over the past 4 hours. b. the medication Christa wants is an epidural. After she receives the epidural, the FHR tracing is within normal limits e. Christa has a history of opiate abuse and therefore it was understood that she might require higher doses of medications to experience relief

A pregnant patient is at the prenatal clinic for a routine visit at 30 weeks gestation. The nurse monitors the patient for indications of physiological demands by the fetus on the patient. Which finding causes the nurse concern? a. Hgb of 9.5 g/dL and Hct. of 30% b. PT of 16.5 seconds c. WBCs of 16,000 mm3 d. Heart rate up 20 bpm

a. Hgb of 9.5 g/dL and Hct. of 30%

A patient has experienced an uneventful pregnancy but begins to have vaginal spotting at 38 weeks gestation. The HCP suspects placenta previa initiated by cervical thinning. Which testing does the nurse expect the HCP to schedule? a. doppler flow studies b. nonstress testing c. magnetic resonance imaging d. ultrasonography studies

d. ultrasonography studies

A patient in the second trimester of pregnancy is scheduled for a doppler flow study because the HCP is concerned about an assessment finding during a routine prenatal visit. Which finding of concern does the nurse suspect? a. fetal movement count is less than 8 per hour b. patient shows no weight gain in 2 weeks c. patient exhibits mild lower extremity edema d. fetal growth is below expectation for gestational age

b. patient shows no weight gain in 2 weeks

The obstetric nurse is assessing the laboring patient for pain. Which of the following should the nurse identify in a pain assessment? Select all that apply. a. intensity of contractions b. presence of pain in the neck or back c. frequency and duration of contractions d. signs of anxiety e. presence of FHR with intermittent auscultation

a. intensity of contractions b. presence of pain in the neck or back c. frequency and duration of contractions d. signs of anxiety

The nurse is helping the patient assume a position for placement of an epidural. Which of the following positions are appropriate for placing an epidural? Select all that apply. a. lateral position with head flexed toward chest b. trendelenburg position c. lithotomy position d. sitting position with elbows on knees e. prone position

a. lateral position with head flexed toward chest b. trendelenburg position

The nurse is providing care for a patient in the third trimester of pregnancy. Which topic of patient education is most likely to be needed during this time? a. update on fetus growth and behavioral patterns b. management for commonly experienced discomforts c. general health maintenance and promotion topics d. counseling and guidance about diet and exercise

b. management for commonly experienced discomforts

The nurse explains to a patient who has missed a second menstrual cycle that a combination of presumptive and probable signs is used to make a practical diagnosis of pregnancy. Which signs are expected by the nurse when making a practical diagnosis? Select all that apply. a. elevated hCG levels in blood and urine b. brownish pigmentation on the face c. fetal movement detected by the examiner d. bluish-purple coloration of vagina and cervix e. occasional mild contractions

a. elevated hCG levels in blood and urine b. brownish pigmentation on the face d. bluish-purple coloration of vagina and cervix

A patient is in her first trimester of her second pregnancy. The patient's first child was born with a trisomy 21 defect. The patient is requesting testing to determine whether the current fetus has the same defect. Which initial testing does the nurse expect the HCP to prescribe? a. fetal ultrasound b. magnetic resonance imaging c. chorionic villa sampling d. amniocentesis

a. fetal ultrasound

A patient who is pregnant does not remember the last date of her menstrual period. In which manner does the nurse expect the estimated date of delivery (EDD) to be determined for this patient? a. having an ultrasound examination b. using the gestational wheel c. asking when previous babies were born d. obtaining a history of gestational length

a. having an ultrasound examination

A patient arrives for her fourth month prenatal visit and expresses concern because of a leakage of yellow fluid from her breasts. Which topic does the nurse discuss during the visit? a. signs of infection b. breast changes c. a change in EDD d. support bras

b. breast changes

The nurse is reading the patient chart, which indicates the patient has a "gynecoid pelvis" What finding is expected in this patient? a. narrower pubic arch b. shorter diameter between her coccyx and ischium c. wider outlet d. smaller inlet

c. wider outlet

The nurse is monitoring the FHR tracing and sees that her patient has a tracing baseline of 120, moderate variability, with absence of decelerations and accelerations. According to the National Institute of Child Health and Human Development tier system, what category tracing does the patient fall into? a. category 1 b. category 2 c. category 3 d. category 4

d. category 4

A patient in the third trimester of pregnancy expresses concern to the nurse about changes to her muscles, joints, and bones. Which conditions does the nurse reassure the patient are normal changes of pregnancy? Select all that apply. a. waddling gait b. low back pain c. increased risk of falls d. fractures e. severe muscle aches

a. waddling gait b. low back pain c. increased risk of falls

An internal fetal monitor has been ordered for Chrissy, a 24-year-old G2P0010 at 38 weeks and 1 day gestation. Her medical history is significant for a history of pregnancy-induced hypertension. Her laboratory values are as follows: H/H 11/30, O negative, RPR negative, GBS positive. Based on Chrissy's history and presentation, what action should the nurse take next? a. Prepare Chrissy for the placement of an internal monitor. b. Take the required two blood pressure readings every 15 minutes prior to insertion of the internal fetal monitor due to her pregnancy-induced hypertension. c. Discuss with the health care provider the fact that Chrissy's blood type is O negative and she should therefore receive Rhogam before insertion of an internal monitor. d. Discuss with the health care provider that Chrissy is GBS positive and therefore should not receive an internal monitor.

d. Discuss with the health care provider that Chrissy is GBS positive and therefore should not receive an internal monitor.

A patient who is pregnant asks the nurse when her baby is due to be born. The patient reports her last menstrual period (LMP) date as April 14. Using Naegele's rule, the nurse will set the estimated date of delivery (EDD) as what date? a. July 21 b. January 7 c. July 14 d. January 21

d. January 21

The obstetric nurse is managing her patients while covering for another nurse who is on a break. Which patient is the lowest priority? a. a patient with a previous cesarean section b. a patient with an epidural in place c. a patient with decreased fetal activity d. a patient with category 1 FHR tracings

d. a patient with category 1 FHR tracings

A patient in the third trimester of pregnancy reports having heartburn nearly every day. Which recommendations does the nurse make to alleviate the problem? Select all that apply. a. consume 3 moderate sized meals daily b. sip clear, carbonated beverages when eating c. assume a low fowler position after meals d. avoid eating 3 hours prior to bedtime e. avoid consuming spicy, fatty or fried food

d. avoid eating 3 hours prior to bedtime e. avoid consuming spicy, fatty or fried food

A patient is scheduled for a contraction stress test (CST) at 36 weeks gestation. The nurse is aware that a successful testing is dependent on which factor? a. whether Braxton-Hicks contractions are occurring b. whether uterine contractions can be stimulated c. if the mother is not overly tired or anxious d. if the fetus is an an awake cycle and active

b. whether uterine contractions can be stimulated

A patient is scheduled for transvaginal ultrasound testing. Which preparation by the nurse is appropriate? a. place the patient supine with a pillow beneath her head b. explain that pain at 4 or less on a 0 to 10 scale is expected c. ascertain whether the patient has a latex or banana allergy d. request that the patient's partner leave the testing room

c. ascertain whether the patient has a latex or banana allergy

The nurse preceptor is explaining to a new nurse about the tocodynamometer. The new nurse is looking at the EFM paper and sees that, of the two tracked heart rates, the one on the bottom is in the 80s; she is concerned that the fetal heart rate is bradycardic. Which of the following should the nurse do first? a. give the mother oxygen to increase the fetal heart rate b. immediately call the provider into the room c. check to make sure that the maternal radial pulse is being recorded correctly d. adjust the monitor on the maternal abdomen

c. check to make sure that the maternal radial pulse is being recorded correctly

The nursing preceptor is teaching the nursing student about fetal bradycardia. Which is true of the maternal reasons for fetal bradycardia? Select all that apply. a. a maternal fever in labor is usually due to dehydration and therefore should be treated with a fluid bolus b. administering terbutaline to the mother for uterine tachysystole; this is self-limiting to when the drug is affecting the mother c. the urine toxicology screen may reveal recent cocaine use; the nurse should also monitor for placental abruption d. check the chart for a history of maternal mental illness, particularly maternal anxiety; speak with the patient regarding her anxiety and take steps to ease her anxieties e. check the maternal blood pressure, as hypertension is linked to fetal tachycardia; identify the on-call provider and correct with lisinopril as necessary

a. a maternal fever in labor is usually due to dehydration and therefore should be treated with a fluid bolus e. check the maternal blood pressure, as hypertension is linked to fetal tachycardia; identify the on-call provider and correct with lisinopril as necessary

The nurse is providing care for a 45 year old patient who has just learned she is in the second trimester of pregnancy. The patient thought she was experiencing manifestations of menopause until she recognized fetal movement. Which diagnostic test does the nurse expect to be prescribed for this patient? a. amniocentesis b. ultrasonography c. daily fetal movement count d. chorionic villi sampling

a. amniocentesis

The EFM tracing shows the following: FHR baseline 166 bpm. moderate variability, and recurrent late decelerations to 100 bpm. Using the 5 tier FHR interpretation system, how should the nurse interpret this finding? a. green: very low risk of evolution, no action b. red: unacceptably high risk of acidemia, deliver c. yellow: moderate risk of evolution, increase surveillance d. orange: acceptable low risk of acidemia, prepare for possible urgent delivery

b. red: unacceptably high risk of acidemia, deliver

The nurse is counseling a patient who shares the intention to become pregnant. Which finding during the collection of health information will the nurse feel the least concern to address? a. the patient smokes a pack of cigarettes a week b. the patient lives in a recently renovated house c. the patient travels outside the country for work d. the patient has a family history of diabetes mellitus

b. the patient lives in a recently renovated house

The nurse is preparing a prenatal plan of care for a patient who is in the first trimester of pregnancy. Which long-range goals does the nurse include in the plan of care? Select all that apply. a. urine testing with dipstick b. presence of dependent edema c. determine EDD by Naegele's rule d. antibody screening for Rh?2- patient e. check for chromosomal abnormalities

a. urine testing with dipstick b. presence of dependent edema d. antibody screening for Rh?2- patient

The nurse is assessing a patient who just received confirmation of pregnancy. While collecting information about the patient's medical history, which information alerts the nurse to biophysical risk factors? Select all that apply. a. the patient is a primip who is 38 years of age b. the patient smokes two packs of cigarettes weekly c. the patient has been a strict vegetarian for 25 years d. the patient works as a nuclear medicine technician e. the patient is medically treated for rheumatoid arthritis

c. the patient has been a strict vegetarian for 25 years e. the patient is medically treated for rheumatoid arthritis

A 40 year old G5P1031 is attending a childbirth education class. During the class, the woman says, "the worst part of contractions with my last labor was when they were at the peak of intensity" The nurse educator correctly explains that the woman is identifying which part of a contraction? a. when the uterine wall is resistant to indentation b. the longest part of the contraction c. the shortest part of the contraction d. descending of contraction

c. the shortest part of the contraction

The nurse is caring for a 34 year old woman who is G2P1001 at 39 weeks and 1 day. The patient is an observant Muslim and is in active labor. Which outcome would be the most effective form of applying culturally sensitive communication? a. ensuring that the hcp is present every 2 hours to examine labor progress b. making sure that the patient has Kosher meat for her postpartum meal c. making sure that the patient's hair is covered constantly d. assuring the patient that her baby is less than 9 lbs

d. assuring the patient that her baby is less than 9 lbs

The nurse is monitoring a patient when the EFM strip conveys fetal bradycardia. Which action would be the most urgent for the nurse to take? a. check the patients input and output b. take a blood pressure to determine if the mother has hypotension c. change the mothers position from supine to left lateral d. check the mother for vaginal bleeding and severe abdominal pain

d. check the mother for vaginal bleeding and severe abdominal pain

The nurse is caring for a 24 year old woman who is G1P0 at 40 weeks, 1 gestation and in active labor. She has just received an epidural and now complains of an "itchy feeling all over". Her vitals are as follows: HR 120, RR 12, BP 130/74, T 98.8, O2 98%. Which action should the nurse take first? a. call the health care provider regarding the patient's pruritus to order an antipruritic medication b. activate emergency response due to the patients pruritus and tachycardia postepidural placement c. call the anesthesiologist regarding the patients oxygen saturation level d. take no further action regarding the patients complaints, as they are normal after epidural placement

a. call the health care provider regarding the patient's pruritus to order an antipruritic medication

A patient in the third trimester of pregnancy is instructed on how to perform daily fetal movement is decreased. Which patient actions are appropriately recommended by the nurse? Select all that apply. a. eat something b. recount movements the next morning c. arrange for a period of rest d. focus on movement for 1 hour e. exercise or take a walk

a. eat something c. arrange for a period of rest d. focus on movement for 1 hour

The nurse is providing dietary teaching to a patient in the first trimester of pregnancy who is overweight. Which daily dietary suggestions does the nurse make? Select all that apply. a. one cup of 100% juice and 3/4 cup of dried fruit b. three cups of raw leafy and 1 cup cooked vegetables c. one and a half cups of cooked pasta, rice, or cereal d. six ounces of lean meat, 2 eggs, and 1/2 cup of beans e. one cup of milk, 1 cup of yogurt, and 1 1/2 oz of cheese

a. one cup of 100% juice and 3/4 cup of dried fruit e. one cup of milk, 1 cup of yogurt, and 1 1/2 oz of cheese

The nurse is preparing a prenatal plan of care for a patient who is in the first trimester of pregnancy. Which long-range goals does the nurse include in the plan of care? Select all that apply. a. perform an ongoing assessment of risk status b. determine parental outlook on immunizations c. build rapport with the childbearing family d. make referral to specific resources as needed e. implement a risk-appropriate intervention

a. perform an ongoing assessment of risk status c. build rapport with the childbearing family d. make referral to specific resources as needed e. implement a risk-appropriate intervention

The nurse is using the Parer and Ikeda five-tier system. A co-worker is concerned about a patient whose fetus has an acceptably low risk of acidemia and evidence of impending fetal asphyxia. What is the next best step for the nurse? a. perform conservative measures b. prepare for urgent delivery c. assist provider in immediate delivery d. increase surveillance of patient

a. perform conservative measures

A patient who is at 20 weeks gestation is being prepared for an MRI after a nonconclusive ultrasound testing for suspected brain abnormality related to possible zika virus exposure. Which nursing actions are appropriate for this patient? Select all that apply. a. provide information regarding the test b. allow patient to express feelings about her high-risk pregnancy c. promote open communication with her primary hcp d. encourage patient to think about resolutions for negative testing e. provide psychological support to the patient and her partner

a. provide information regarding the test b. allow patient to express feelings about her high-risk pregnancy c. promote open communication with her primary hcp e. provide psychological support to the patient and her partner

The nurse is collecting health information from a patient who is early in the first trimester of pregnancy. Which topic is most important for the nurse to discuss with the patient after learning that the patient works for a commercial cleaning company? a. risk related to exposure to environmental toxins b. weight limit for lifting during the patient's pregnancy c. importance of resting with feet up during the day d. reasons for the patient to look for a safer job

a. risk related to exposure to environmental toxins

The nurse encourages the patient to bring loved ones to be with her during labor because the nurse knows that their presence does which of the following? Select all that apply. a. shortens the length of labor b. reduces the likelihood that a patient will require an epidural c. reduces the risk of infection after birth d. lowers the chance that the patient will breastfeed e. increases the patients happiness and satisfaction with the outcome of their birth

a. shortens the length of labor b. reduces the likelihood that a patient will require an epidural e. increases the patients happiness and satisfaction with the outcome of their birth

The nurse is obtaining a baseline FHR. At 1:00 pm the baseline FHR was 130, at 1:20 pm FHR baseline was 166, and at 1:40 pm the baseline FHR was 204. What should the nurse assess from this trend of fetal baselines? Select all that apply. a. the 1:00 pm FHR baseline warranted no further action b. the 1:20 pm FHR baseline warranted immediate fetal resuscitation c. the 1:00 pm FHR baseline warranted immediate maternal resuscitation d. the 1:20 pm FHR baseline should be corrected immediately with delivery e. the 1:40 pm FHR baseline should be corrected immediately

a. the 1:00 pm FHR baseline warranted no further action d. the 1:20 pm FHR baseline should be corrected immediately with delivery e. the 1:40 pm FHR baseline should be corrected immediately

The nurse is reviewing the purpose of a modified BPP for a patient at 38 weeks gestation. The nurse recognizes which determinations can be made through a modified BPP regarding fetal well-being? Select all that apply. a. the NST is an indicator of short-term fetal well-being b. the test is normal if NST is considered to be nonreactive c. the test is considered most predictive for perinatal outcomes d. the AFI is an indicator of long-term placental function e. an AFI of 5 cm is indicative of fetal asphyxia

a. the NST is an indicator of short-term fetal well-being c. the test is considered most predictive for perinatal outcomes d. the AFI is an indicator of long-term placental function e. an AFI of 5 cm is indicative of fetal asphyxia

An Eastern European Jewish couple had two children who died from Tay-Sachs disease. The couple is currently pregnant and have asked for genetic confirmation about this fetus with the intention of early termination if the fetus tests positively. For which reason does the nurse expect chorionic villa sampling to be prescribed? a. the test is preformed as early as 10 weeks gestation b. risks to the fetus and mother are less than other tests c. a positive result allows termination during the test d. this is the only testing that is disease specific

a. the test is preformed as early as 10 weeks gestation

A patient in the first trimester of pregnancy states, "I don't understand how a term baby can be accommodated by my uterus." Which information by the nurse specifically addresses the patient's comment? a. the uterus increases in size 20 times over a nonpregnant uterus b. the weight of the uterus increases from 7 g to 1,100 g during pregnancy c. about 80% of the increased capacity of the uterus is related to uteroplacental content d. about 75% of the increase in uterus size during pregnancy is related to stretching

a. the uterus increases in size 20 times over a nonpregnant uterus

While providing care for a patient the nurse notices an erratic FHR recording. What action should the nurse take next? a. help the patient move around to help obtain the signal b. place the transducer in a different position c. check the mothers cervical progress to see if she is in the second stage of labor d. remove some of the ultrasound gel from the transducer

b. place the transducer in a different position

The nurse is caring for a pregnant patient who expressed concern about the effects of EFM on her labor and delivery. Which responses by the nurse would be appropriate in this situation? Select all that apply. a. there is a reduced rate of seizures if a patient had EFM during delivery b. there is a decrease in the incidence of cerebral palsy if a patient has EFM during labor c. there is a link between decreased infant mortality and EFM during delivery d. there is a link between the rate of cesarean sections and continuous EFM e. there is an increase in operative vaginal births and the use of continuous EFM

a. there is a reduced rate of seizures if a patient had EFM during delivery b. there is a decrease in the incidence of cerebral palsy if a patient has EFM during labor d. there is a link between the rate of cesarean sections and continuous EFM e. there is an increase in operative vaginal births and the use of continuous EFM

The nurse is speaking with a pregnant patient who is asking what processes start labor. Which responses by the nurse are appropriate? Select all that apply. a. there is more pressure on the cervix, which causes the start of contractions by releasing oxytocin b. oxytocin stimulates uterine muscles to contract c. the uterus begins to contract due to a decrease in estrogen d. the placenta begins to age and deteriorate and this triggers the start of contractions e. the fetus releases a stress hormone, cortisol and this starts contractions

a. there is more pressure on the cervix, which causes the start of contractions by releasing oxytocin b. oxytocin stimulates uterine muscles to contract d. the placenta begins to age and deteriorate and this triggers the start of contractions e. the fetus releases a stress hormone, cortisol and this starts contractions

A patient is confirmed to be pregnant. Obstetric history includes two sets of twins born at 30 and 32 weeks gestation, respectively, a singleton birth born at 39 weeks gestation, and two pregnancies lost in the first trimester. In which way will the nurse define the patient's obstetrical history? a. G4, T3, P2, A2, L3 b. G6, T1, P4, A2, L5 c. G5, T1, P2, A2, L5 d. G6, T4, P0, A4, L3

b. G6, T1, P4, A2, L5

The nurse is providing pre-amniocentesis teaching for a patient who is at 18 weeks gestation. Which information does the nurse provide? Select all that apply. a. positioning on the left side will avoid injury to the fetus b. a full bladder will assist in the ultrasound visualization c. discomfort will be minimized with a local anesthetic d. avoiding lifting heavy objects for a period of 2 weeks e. abdominal cramping and bleeding is normal for 24 hours

b. a full bladder will assist in the ultrasound visualization c. discomfort will be minimized with a local anesthetic

A patient arrives at a maternal health client and tells the nurse she has missed a period and thinks she is pregnant. Which information shared with the nurse is a presumptive sign of pregnancy? a. positive results on a home pregnancy test b. breast enlargement, tenderness, and tingling c. first awareness of fetal movements d. increased appetite

b. breast enlargement, tenderness, and tingling

The nurse is providing care for a patient at 30 weeks gestation. Which topic related to patient concern or discomfort is most important for the nurse to address? a. increased breast enlargement b. dizziness when lying supine c. dependent edema and varicosities d. hyperpigmentation on the face

b. dizziness when lying supine

The nurse educator is teaching about regional and local anesthesia in a childbirth education class. The nurse should teach that regional anesthesia is used for which of the following? Select all that apply. a. lidocaine 1% for episiotomy b. epidural with lidocaine for pain in labor c. spinal block with lidocaine for a cesarean delivery d. lidocaine 1% for episiotomy repair e. lidocaine without epinephrine for forceps use

b. epidural with lidocaine for pain in labor c. spinal block with lidocaine for a cesarean delivery e. lidocaine without epinephrine for forceps use

An adolescent patient who is 15 weeks pregnant refused to have an alpha-fetoprotein test performed because, "I don't like needles". Which initial approach does the nurse take to achieve the testing? a. insist that testing will be done with or without her cooperation b. explain the testing is important in detecting serious birth defects c. ask an accompanying parent to help persuade the patient d. notify the HCP of the patient's refusal

b. explain the testing is important in detecting serious birth defects

The nurse educator is preparing a presentation on fetal heart monitoring. Which of the following should be included? Select all that apply. a. intermittent auscultation should be performed every hour in the latent phase b. for category 1 situations, intermittent EFM should be performed for 10 to 30 min every 1 to 2.5 hours c. a patient with a previous cesarean section should have EFM for 10 to 30 min every 1 to 2.5 hours d. a patient with membranes ruptured over 24 hours should be monitored during the latent phase every 30 min, every 15 min during the active phase, and every 5 min during the second stage e. a patient with fever should be monitored during the latent phase every 30 minutes, every 15 minutes during the active phase, and every 5 min during the second stage

b. for category 1 situations, intermittent EFM should be performed for 10 to 30 min every 1 to 2.5 hours

The nurse is caring for a 30 year old woman who is G4P2012 at 38 weeks and 5 days gestation. The nurse is watching her EFM strip and notices that for the past 10 minutes the fetus has shown minimal variability. Which actions should the nurse perform? Select all that apply. a. check to see if the patients membranes have been ruptured, as there could be potential cord compression b. look to see what the patients position is and is she supine; change her to left side lying c. continue to watch the strip, but know that this could be due to fetal sleep d. recognize that the fetus is 38 weeks and therefore this could be due to fetal maturity e. check the FHR and connect the minimal variability to fetal bradyasystole

b. look to see what the patients position is and is she supine; change her to left side lying c. continue to watch the strip, but know that this could be due to fetal sleep d. recognize that the fetus is 38 weeks and therefore this could be due to fetal maturity e. check the FHR and connect the minimal variability to fetal bradyasystole

A patient who is at 30 weeks gestation is involved in a car crash. The nurse recognizes that which initial testing will be used to assess fetal well-being? a. ultrasonography b. nonstress testing c. contraction stress test d. fetal movement counting

b. nonstress testing

The nurse is looking at an EFM strip and sees that the patient is having contractions that are measuring 150 MVU every 10 minutes for the past 2 hours and the fetus is in fetal distress. What would this indicate for next steps? a. the patients contractions are adequate, so the main focus should be on resuscitating the fetus with maternal oxygen and maternal position change b. the patients contractions are inadequate; the provider could consider an amnioinfusion through the IUPC, and once the fetus has improved, contractions need to be augmented to be more effective c. the patients contractions are adequate, so the main focus should be on determining her progress through cervical change d. the patients contractions are inadequate; the provider could consider augmenting with pitocin to be more effective

b. the patients contractions are inadequate; the provider could consider an amnioinfusion through the IUPC, and once the fetus has improved, contractions need to be augmented to be more effective

The nurse preceptor is teaching a nursing student about the physiology of the FHR pattern. Which statement by the student indicates successful teaching about this concept? a. the vagus nerve stimulation increased FHR and helps maintain variability b. the sympathetic nervous system is responsible for heart rate variability c. action of the FHR occurs through the absence of norepinephrine d. baroreceptors are responsible for increasing FHR and fetal blood pressure

b. the sympathetic nervous system is responsible for heart rate variability

The nurse is caring for a patient in active labor with significant back pain. The patient has requested nonpharmacologic methods of pain relief. The nurse thinks that sterile water injections may help with her pain management. Which of the following explanations should the nurse explain to the patient? a. we will inject 1 mL of sterile water intramuscularly, and it will last for about an hour b. we will inject 0.5 mL of sterile water subcutaneously, and it will last for an hour to 90 minutes c. we will inject 1 mL of sterile water subcutaneously, and it will last for about a half hour d. we will inject 0.5 mL of sterile water intramuscularly, and it will last for about 3 hours

b. we will inject 0.5 mL of sterile water subcutaneously, and it will last for an hour to 90 minutes

The nurse is teaching the patient about the trends and risks of epidural anesthesia. Which of the following should the nurse relay about the risks of epidural anesthesia. Which of the following should the nurse relay about the risks of epidural anesthesia? Select all that apply. a. there is a higher rate of instrumental vaginal delivery b. when using an epidural, women are less likely to sweat with a fever c. there is a higher rate of spontaneous vaginal delivery d. labor may be longer with an epidural e. there is a higher rate of fever and sepsis

b. when using an epidural, women are less likely to sweat with a fever d. labor may be longer with an epidural e. there is a higher rate of fever and sepsis

The patient is having an unmedicated childbirth and has begun to bear down. She vocalizes, "The baby is coming!" Which action should the nurse take? a. help the patient in a lithotomy position b. help the patient onto all fours c. have the patient assume a comfortable and upright position d. help the patient into a knee-chest position

c. have the patient assume a comfortable and upright position

The nurse is reviewing the chart of a 35 year old G4P2012 woman. The patient is at 38 weeks, 4 days and is in active labor with SROM clear fluid 2 hours ago. What action should the nurse take? a. monitor the patients blood pressure, temperature, and respirations every 2 hours b. have the patient rate her pain on a scale from 1-10 roughly every hour c. help the patient change her position from side to side every 30 minutes d. monitor the fetal heart tones every hour

c. help the patient change her position from side to side every 30 minutes

The patient is a 26 year old G1P0 at 38 weeks, 2 days of gestation. She is at her provider's office for a visit and complains to the nurse of wrist pain, fatigue, increased discharge, and "feeling heavy". Which complaint could be a sign of impending labor? a. wrist pain b. fatigue c. increased discharge d. heavy feeling

c. increased discharge

The nursing preceptor asks the nursing nursing how to best determine the intensity of contractions before placing the patient on an electronic fetal monitoring strip. How would the nurse assess this? a. time the amount of time in between the ending of one contraction and the beginning of another b. palpate the maternal abdomen right after a contraction ceases c. palpate the maternal abdomen during a contraction d. monitor the patients vocalizations and facial expressions

c. palpate the maternal abdomen during a contraction

The nurse is caring for a 31 year old female patient who is pregnant at 37 weeks and 5 days gestation. The patient is having contractions every 3 minutes and was found to have a platypelloid pelvis upon examination. The fetus has an estimated fetal weight of 7lbs and is in the LOA position. This patient is laboring on the birth ball, and her mother in law is helping her labor. The nurse is concerned about the 5 Ps and their effect on the patient's labor. Which P is the nurse most likely concerned about based on the patients history? a. passenger b. position c. passage d. pysche

c. passage

A patient in the second trimester of pregnancy becomes upset when the health care provider schedules several screening tests. The patient voices concern that something is wrong with her baby. Which statement by the nurse will reduce the patient's anxiety? a. multiple screening tests are ordered for every pregnancy b. it is better to identify problems before birth than afterward c. screening tests are primarily to identify those without disease or abnormality d. diagnostic testing is a reason for worry because they indicate fetal problems

c. screening tests are primarily to identify those without disease or abnormality

While reviewing the birth plan of an uncomplicated and healthy patient in active labor, the nurse notices that she would like to have a natural labor and potentially experience hydrotherapy. Which option should the nurse suggest for the patient? a. IUPC to make sure that her contraction are adequate to keep labor progressing b. FSE to make sure that her fetus is tolerating the hydrotherapy c. telemetry to allow for the patient to accomplish her birth plan d. external EFM to make sure that there is continuous monitoring

c. telemetry to allow for the patient to accomplish her birth plan

A patient who is pregnant shares details of being in a physically and psychologically abusive relationship with her baby's father. Which statement by the nurse is indicative of AWHONN's standing regarding intimate partner violence? a. if you are all alone, you need to make arrangements for someone to stay with you b. your partner needs to come to the office so that we can confront his behavior c. I will call a women's shelter to make arrangement for you to move in immediately d. lets explore ways to protect you and stop the abuse you have been enduring

d. lets explore ways to protect you and stop the abuse you have been enduring

The nurse is caring for a baby who is experiencing fetal tachycardia. Which action should the nurse take next? a. perform fetal scalp stimulation for 5 seconds b. check maternal allergies in the patient chart c. apply heat packs to the maternal chest and head d. stimulate the fetus with a vibroacoustic device

d. stimulate the fetus with a vibroacoustic device

A patient is interested in a pain relief option that she can control during labor. The nurse explains to the patient what pain relief options are available that would meet her needs, and they mutually decide on nitrous oxide. Which of the following does the nurse describe to the patient about the use of nitrous oxide in labor? Select all that apply. a. if started, it should be used throughout the entire labor b. it has no trade name and is only available in generic forms c. the nurses will administer it to you during every contraction so we will need to be with you during the entire labor d. the gas takes effect in about 50 seconds after the first breath, and the patient will feel calm e. there is no effect on the labor progress from active labor to delivery, and therefore you do not need to worry about longer labors with the medication

d. the gas takes effect in about 50 seconds after the first breath, and the patient will feel calm e. there is no effect on the labor progress from active labor to delivery, and therefore you do not need to worry about longer labors with the medication

The nurse is explaining telemetry to the patient who has just begun active labor. The patient would like to have a labor in which she is mobile, able to change positions, and use hydrotherapy. Which response by the nurse is most appropriate? a. telemetry is used mostly for women who are laboring in bed and changing positions every half hour or so b. unfortunately, you will not be able to use the shower while using telemetry c. the nurses will need to come in and check your telemetry reading every half hour d. we can start using telemetry now, and if there are no problems with the signal, we can continue it throughout your labor until delivery

d. we can start using telemetry now, and if there are no problems with the signal, we can continue it throughout your labor until delivery