Peds/OB Exam 2 Quiz Questions

The nurse is measuring the fundal height of a woman who is at 28 weeks gestation. Which measurement would the nurse expect? A. 18 cm B. 12 cm C. 32 cm D. 28 cm

28 cm

A nurse discovers a new prescription of RhoGAM for a client who is undergoing a diagnostic procedure. The nurse will administer the medication after which procedure? A. quad marker test B. biophysical exam C. amniocentesis D. nonstress test

Amniocentesis

A newborn is unable to shiver until about 3 months of age when it is cold. At birth, the primary method it uses for heat production is through non-shivering thermogenesis. This process oxidizes which substance in response to cold exposure? A. glycogen stores B. muscle tissue C. white (adipose) tissue D. brown fat tissue

Brown fat tissue

A nurse is caring for a client admitted to the maternity unity at 38 weeks of gestation and experiencing polyhydramnios. The nurse should understand that this diagnosis means which of the following? A. an excessive amount of amniotic fluid B. the client is carrying more than one fetus C. the fetus is likely to have a congenital anomaly, be growth restricted, or demonstrate fetal distress during labor D. there is an elevated level of alpha-fetoprotein (AFP) in the amniotic fluid

An excessive amount of amniotic fluid

On completing a fundal assessment, the nurse notes the fundus is boggy (relaxed) and situated laterally in the client's left abdomen (shifted to the left). Which of the following actions is appropriate? A. increase the pitocin B. ask the client to empty her bladder C. call the healthcare provider (HCP) D. massage the uterus until constricted

Ask the client to empty her bladder

You are the nurse on a Labor and Delivery unit admitting a client in labor. The priority for this client is to place external monitors, a tocomamometer (to monitor uterine contractions), and an ultrasound doppler (to monitor fetal heart rate). After attaching the electrodes, what is the next nursing action? A. identify the types of accelerations B. determine the frequency of contractions C. determine the amount of variability D. assess the baseline fetal heart rate (FHR)

Assess the baseline fetal heart rate (FHR)

When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in client's pulse. What should the nurse do next? A. monitor the fetus for respiratory depression B. assess the client's temperature C. monitor the client for preterm labor D. assess for cord compression

Assess the client's temperature

A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of umbilical cord protruding from the vagina. Which of the following would be the initial nursing action? A. call for assistance and stat page the physician B. gently push the cord back into the vagina C. place the client in side lying position D. administer oxygen via face mask

Call for assistance and stat page the physician

Stages of labor: first stage, latent

Cervical dilation 0-6cm Cervical effacement 0-40%

Stages of labor: first stage, active phase

Cervical dilation 6-10cm Cervical effacement 40-100%

Which of the following are considered Probable signs of pregnancy: A. amenorrhea B. nausea and vomiting C. positive pregnancy test D. fatigue E. Chadwick's sign F. fetal heart sounds

Chadwick's sign Positive pregnancy test

Which woman should receive RHoGAM postpartum? A. Rh-negative mother with an Rh-positive newborn B. Rh-positive mother with an Rh-positive newborn C. Rh-positive mother with an Rh-negative newborn D. Rh-negative mother with an Rh-negative newborn

Rh-negative mother with an Rh-positive newborn

The nurse monitors her postpartum client for which of the following normal physiological changes during the early postpartum period? A. decreased blood volume B. increased temperature C. decreased urinary output D. decreased white blood cell count

Decreased blood volume

A nurse is preparing an in-service education program for a group of nurses about dystocia involving problems with the passenger. Which problem would the nurse likely include as the most common? A. multifetal pregnancy (multiple fetuses) B. macrosomia (large fetus) C. occiput posterior position D. breech presentation

Occiput posterior position

A nurse is advising a pregnant woman about the danger signs of pregnancy. The nurse should teach the mother to notify the physician immediately if she experiences which of the following signs/symptoms? (select all that apply) A. right epigastric pain B. constipation C. seizures D. polyuria E. persistent vomiting

Right epigastric pain Seizures Persistent vomiting

A couple is considered infertile after how many months of trying to conceive? A. 6 months B. 18 months C. 24 months D. 12 months

12 months

A client enters the labor and delivery suite. It is essential that the nurse note the woman's status in relation to which of the following infectious disease? (select all that apply) A. group B streptococcus B. rubella C. varicella D. HIV/AIDS E. hepatitis B

Group B Streptococcus Rubella HIV/AIDS Hepatitis B

A nurse is caring for a client in labor who is receiving Pitocin by IV infusion to stimulate uterine contractions. Which assessment findings would indicate to the nurse that the infusion needs to be discontinued? A. a fetal heart rate that drops after the peak of the contraction B. three uterine contractions within a 10-minute period C. a fetal heart rate that drops at the beginning of the contraction D. maternal hypertension

A fetal heart rate that drops after the peak of the contraction

A nurse cares for a client during a nonstress test (NST). At the end of the 20 minutes of observation, the nurse notes the following findings. The fetal heart rate (FHR) baseline is 120 bpm with minimal variability and no accelerations. There are two decelerations in the fetal heart rate, each lasting 20 seconds. Which of the following interpretations of these findings should the nurse make? A. a non-reactive test result B. a positive test result C. a negative test result D. a reactive test result

A non-reactive test result

A patient in the 1st trimester of her first pregnancy is having her first prenatal examination. Which of the following assessments should the nurse inform the client that she will have that day? (select all that apply) A. biophysical profile B. complete blood count (CBC) C. mammogram D. pap smear E. glucose tolerance test

Complete blood count (CBC) Pap smear

Stages of labor: second stage

From complete dilation to birth of the newborn

While charting on your patient, you look at the monitors and notice another patient's fetal heart monitoring strip. You notice the fetal heart rate decrease 30 bpm below baseline at the same time as the contraction, noting recovery of the deceleration occurring with the recovery of the contraction. Which intervention would be most appropriate? A. give an IV bolus of lactated ringers B. place the patient on oxygen via face mask C. turn the patient to the left lateral position D. perform a vaginal exam to check for crowning of fetal head

Perform a vaginal exam to check for crowning of fetal head

Which of the following are correct dietary recommendations during pregnancy? (select all that apply) A. consume omega-3-fatty-acid rich foods such as salmon B. avoid sugary drinks, and instead choose sugar-free options C. take a multivitamin that contains folate D. increase protein intake

Take a multivitamin that contains folate Increase protein intake

A client is scheduled for an external version. The nurse would expect to prepare which of the following medications to be administered prior to the procedure? A. oxytocin (pitocin) B. ergonovine (methergine) C. betamethasone (celestone) D. terbutaline (brethine)

Terbutaline (brethine)

A nurse is caring for a client in labor. The nurse determines that the client is beginning the 2nd stage of labor when which of the following assessments is noted? A. the neonate has been birthed B. the client begins to expel clar amniotic fluid C. the cervix is dilated completely D. the contractions are strong and regular

The cervix is dilated completely

A woman has been diagnosed with pre-eclampsia with mild features. Which assessment finding indicates a worsening of the pre-eclampsia and the need to notify the healthcare provider? A. the client has bright painless vaginal bleeding B. the client has a drop in blood pressure C. the client complains of headache and blurred vision D. the client has increased urinary output

The client complains of headache and blurred vision

A client, who is 2-weeks postpartum, calls the obstetrician's nurse and states that she has had a whitish discharge for 1 week, but today she is "bleeding and saturating a pad about every 1/2 hour". Which of the following is an appropriate response by the nurse? A. you should stay on complete bed rest until the bleeding subsides B. that is normal, you are starting to menstruate again C. the physician should see you, please go to the emergency department D. pushing during a bowel movement may have loosened your stitches

The physician should see you, please go to the emergency department

A nurse is caring for a client scheduled for a maternal serum alpha-fetoprotein test at 15 weeks gestation. The nurse provides which of the following explanations about this test? A. this test assesses various parameters of fetal-well being B. this test assesses fetal lung maturity C. this test is a screening test for neural tube defects in the fetus D. this test measures uteroplacental function

The test is a screening test for neural tube defects in the fetus

A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the client's fundus and documents which finding as normal? A. two fingerbreadths (cm) above the umbilicus B. one fingerbreadths (cm) below the umbilicus C. two fingerbreadths (cm) below the umbilicus D. at the level of the umbilicus

Two fingerbreadths (cm) below the umbilicus

A woman is 36 weeks gestation. Which of the following tests will be done during her prenatal visit? A. karyotype analysis B. oral glucose tolerance test C. vaginal and rectal cultures D. amniotic fluid volume assessment

Vaginal and rectal cultures

A nurse is reviewing the record of a client in the labor room and notes that the nurse midwife has documented the fetus is at (-1) station. The nurse determines that the fetal presenting part is? A. 1 cm above the ischial spine B. 1 cm below the iliac crest C. 1 finger breadth (fb) below the symphysis pubis D. 1 cm below the ischial spine

1 cm above the ischial spine

At 28 weeks gestation, a client's 1-hour non-fasting glucose tolerance test is elevated. The nurse explains that, based on this finding, the client will need to take which action? A. daily insulin injections for gestational diabetes B. a 3-hour fasting glucose tolerance test C. daily fingersticks for a fasting blood glucose level D. monthly hemoglobin A1C level to rule out gestational diabetes

A 3-hour fasting glucose tolerance test

A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priority for this client? A. set up for a percutaneous endoscopic gastrostomy B. administer parenteral nutrition C. administer an antiemetic D. administer IV normal saline with vitamins and electrolytes

Administer IV normal saline with vitamins and electrolytes

There are four clients in the labor suite. Each client's labor is being augmented with oxytocin (pitocin). Which of the women should the nurse monitor carefully for the potential of uterine rupture? A. age 32, G2P1, fetus has died during labor B. age 15, G1P0, in active labor C. age 25, G4P3, last delivery by cesarean section D. age 22, G3P0, pre-eclampsia with mild features

Age 25, G4P3, last delivery by cesarean section

A primipara woman is in the dependent, taking-in phase of the Maternal Adaptation to Parenthood adjustment following birth. The nurse recognizes the needs of the patient during this stage should include? A. provide tools to help postpartum baby blues B. help the mother play an active role in meeting the baby's needs C. allow time for the mother to reflect on the events of the birth experience D. promote the resumption of the family as a unit

Allow time for the mother to reflect on the events of the birth experience

When you assess the uterine contractions of your laboring client, you explain that the relaxation periods between contractions are important for which of the following reasons? A. avoid uterine rupture B. allows fetal oxygenation C. permits fetal assessment D. prevents uterine ischemia

Allows fetal oxygenation

Which of the following are considered Presumptive signs of pregnancy: A. amenorrhea B. nausea and vomiting C. positive pregnancy test D. fatigue E. Chadwick's sign F. fetal heart sounds

Amenorrhea Nausea and vomiting Fatigue

When examining the fetal monitor strip after the rupture of membranes (ROM) in a laboring client, the nurse notes variable decelerations in the fetal heart rate. The nurse should? A. take the client's blood pressure B. stop the oxytocin (pitocin) perfusion C. change the client's position D. prepare for immediate delivery

Change the client's position

Stages of Lochia: lochia rubra

Lasts from day 1 to day 3

A mother asks the nurse why her newborn receives a vitamin K injection in the birth room. The nurse explains that the injection is necessary because: A. vitamin K is needed for coagulation, and the newborn does not produce vitamin K in the first few days following birth B. the mother was febrile at the time of birth, and prophylactic vitamin K is necessary C. newborns are prone to hypoglycemia, and vitamin K helps maintain a steady blood glucose level D. vitamin K aids in protein metabolism. Newborns have defective protein metabolism until 24 hours of life

Vitamin K is needed for coagulation, and the newborn does not produce vitamin K in the first few days following birth

Upon assessing the newborn's respirations, which finding would cause the nurse to notify the primary care provider? A. a respiratory rate of 50 bpm with acrocyanosis B. a respiratory rate of 15 bpm with nasal flaring C. short periods of apnea that lasts 10 seconds in a pink newborn D. coughing and sneezing in the newborn

A respiratory rate of 15 bpm with nasal flaring

A nurse is caring for an adolescent client who is gravida 1 para 0. The client was admitted to the hospital at 38 weeks gestation with a diagnosis of pre-eclampsia. Which of the following findings should the nurse identify as inconsistent with pre-eclampsia? A. deep tendon reflexes (DTR) of +1 B. 1+ pitting edema C. 3+ protein in the urine (proteinuria)

Deep tendon reflexes (DTR) of +1

On a follow-up visit to the clinic, a nurse suspects that a postpartum client is experiencing postpartum psychosis. Which finding would most likely lead the nurse to suspect this condition? A. feelings of anxiety B. delusional beliefs C. withdrawal from family and friends D. feelings of worthlessness

Delusional beliefs

A pregnant client has just been diagnosed with gestational diabetes. Which of the following therapies will most likely be ordered for this client? A. fast acting insulin B. slow acting insulin C. diet control with exercise D. oral hypoglycemic agents

Diet control with exercise

A 25-year-old is admitted with the following history: 12 weeks pregnant, vaginal bleeding, no fetal heartbeat seen on ultrasound. The nurse would expect the doctor to write an order to prepare the client for which of the following procedures? A. dilation and curettage B. continuous fetal heart rate monitoring C. fallopian tube repair D. cervical cerclage

Dilation and curettage

A woman is to receive methotrexate IM for an ectopic pregnancy. The nurse should teach the woman about which of the following common side effects of the medication. (select all that apply) A. dizziness B. nausea and vomiting C. abdominal pain D. fatigue E. breast tenderness

Dizziness Nausea and vomiting Abdominal pain

With further monitoring, you notice the presence of transient fetal accelerations on the fetal monitoring strip. Which intervention would be most appropriate? A. reposition the client to the left lateral side B. call the health care provider (HCP) C. place the client on oxygen D. document this indicating a normal pattern

Document this indicating a normal pattern

A nurse in a prenatal clinic is caring for a client suspected of having a hytadidiform mole. Which findings should the nurse expect to observe in this client? A. rapid decline in human chorionic gonadotopin (hCG) levels B. irregular fetal heart rate C. profuse, clear vaginal discharge D. excessive uterine enlargement

Excessive uterine enlargement

Which of the following are considered Positive signs of pregnancy: A. amenorrhea B. nausea and vomiting C. positive pregnancy test D. fatigue E. Chadwick's sign F. fetal heart sounds

Fetal heart sounds

A nurse is caring for a client who is 12 hours postpartum. Which of the following findings should alert the nurse to the possibility of a postpartum complication? A. urine output of 3,000 ml in 12 hours B. heart rate 110/minute C. orthostatic hypotension D. Fundus palpable at the umbilicus

Heart rate 110/minute

A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious about its implications. Which action should the nurse take next? A. inform the client that ambivalence is a normal response to pregnancy that many women experience B. determine if the client's significant other is experiencing similar feelings about the pregnancy C. schedule the client a consult with a psychiatric health care provider D. provide the client with information about pregnancy support groups

Inform the client that ambivalence is a normal response to pregnancy that many women experience

A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound. Which of the following is an appropriate response by the nurse? A. this is a screening tool for spina bifida B. it assists in identifying the location of the placenta and fetus C. this will determine if there is more than one fetus D. it is useful for estimating fetal age

It assists in identifying the location of the placenta and fetus

Stages of Lochia: lochia alba

Lasts from day 11 to week 6

Stages of Lochia: lochia serosa

Lasts from day 4 to day 10

A nurse explains the purpose of effleurage to a client in early labor. The nurse tells the client effleurage is? A. the application of pressure to the sacrum to relieve back pain B. light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus C. performed to stimulate uterine activity by contracting a specific muscle group while other parts of the body rest D. a form of biofeedback to enhance bearing down efforts during delivery

Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus

A client is admitted to the hospital with pre-eclampsia with severe features and HELLP syndrome. The nurse will assess for which of the following signs/symptoms? A. low potassium level B. low platelet count C. low serum creatinine D. high serum protein

Low platelet count

The nurse is preparing to assess the uterine fundus of a client in the immediate postpartum period. After locating the fundus, the nurse notes that the uterus feels soft and boggy. Which nursing intervention is appropriate? A. massage the uterus B. encourage the client to get plenty of rest C. elevate the client's legs D. ask the client to turn to her left side

Massage the uterus

Shoulder dystocia is a medical emergency that can cause fetal demise because the baby cannot be born. When stuck in the birth canal, the infant cannot take its first breath. Which maneuver is first attempted to deliver an infant with shoulder dystocia? A. McRobert's maneuver B. McGeorge's maneuver C. McDonald's maneuver D. McRonald's maneuver

McRobert's maneuver

The neonatal intensive care nurse is admitting a large-for-gestational age (LGA) infant with respiratory distress who has difficulty with hypothermia, appears lethargic, is jittery, and is not feeding well. What would be the nurse's first action? A. obtain a blood glucose level B. continue monitoring hourly C. place infant under a radiant warmer D. order a stool sample for possible illicit drug exposure

Obtain a blood glucose level

A laboring client complains of lower back pain. The nurse replies that this pain occurs most when the position of the fetus is? A. occiput posterior B. left occiput transverse C. occiput anterior D. right occiput posterior

Occiput Posterior

Which of the following should the nurse expect when assessing a client with placental abruption? A. right epigastric pain B. severe nausea and vomiting C. painful vaginal bleeding D. painless vaginal bleeding

Painful vaginal bleeding

Which of the following should the nurse expect when assessing a client with placenta previa? A. painless vaginal bleeding B. severe headache C. rigid "boardlike" uterine tone D. painful vaginal bleeding

Painless vaginal bleeding

Stages of labor: fourth stage

Physiological adjustment and stabilization

A client in her 29th week of gestation reports dizziness and claminess when assuming a supine position. During the assessment, the nurse observes there is marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition? A. place the client in the left lateral position B. keep the client's legs elevated C. keep the head of the client's bed slightly elevated D. place the client in supine position

Place the client in the left lateral position

A nurse in the antepartum unit is caring for a client who is at 36 weeks gestation and has pre-eclampsia. Suddenly, the client reports continuous abdominal pain and vaginal bleeding. The nurse should suspect which of the following complications? A. incompetent cervix B. prolapsed cord C. placenta previa D. placental abruption

Placental abruption

A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as a sign of? A. hematoma B. uterine atony C. placental separation D. placenta previa

Placental separation

A nurse is caring for a client who is in active labor and has meconium staining of the amniotic fluid. The nurse notes a reassuring FHR tracing from the external fetal monitoring. Which of the following actions should the nurse take? A. prepare equipment for possible newborn respiratory resuscitation B. change the client's position to left lateral C. prepare the client for an ultrasound examination D. prepare the client for an emergency cesarean birth

Prepare equipment for possible newborn respiratory resuscitation

When administering magnesium sulfate to a client with pre-eclampsia with severe features, the nurse explains that the primary reason the drug is given is to? A. lower blood pressure B. slow uterine contractions C. decrease blood glucose levels D. prevent seizures

Prevent seizures

When explaining how a newborn adapts to extrauterine life, the nurse would describe which body systems as undergoing the most rapid changes? A. gastrointestinal and hepatic B. respiratory and cardiovascular C. urinary and hematologic D. neurological and integumentary

Respiratory and cardiovascular

A nurse is preparing to administer magnesium sulfate IV to a client experiencing preterm labor. Which of the following is the priority nursing assessment for this client? A. temperature B. fetal heart rate (FHR) C. bowel sounds D. respiratory rate

Respiratory rate

Stages of labor: third stage

Separation and delivery of the placenta

A woman seen in the Emergency Department is diagnosed with pelvic inflammatory disease (PID). Before discharge, the nurse should provide the woman with health teaching regarding which of the following? A. sexually transmitted infections B. ovarian hyperstimulation C. menopause D. endometriosis

Sexually transmitted infections

A nurse is caring for a newborn with jaundice undergoing phototherapy. What intervention is appropriate when caring for the newborn? A. discontinue with frequent green, tarry stools B. shield the newborn's eyes C. discourage feeding the newborn D. expose the newborn's skin minimally

Shield newborn's eyes

A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client's blood work the nurse notices she does not have immunity to rubella. Which of the following times should the nurse understand is recommended for rubella immunization? A. during her next attempt to get pregnant B. in the third trimester C. immediately D. shortly after giving birth

Shortly after giving birth