ch 19 questions

A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does this indicate? a) Fetal distress related to hypoxia b) Central nervous system (CNS) involvement c) Infection d) Cord compression

Fetal distress related to hypoxia

A pregnant woman is diagnosed with abruptio placentae. When reviewing the woman's medical record, which of the following would the nurse expect to find? a) Firm, rigid uterus on palpation b) Fetal heart rate within normal range c) Bright red vaginal bleeding d) Absence of pain

Firm, rigid uterus on palpation

A woman in labor is at risk for abruptio placentae. Which of the following assessments would most likely lead you to suspect that this has happened? a) Painless vaginal bleeding and a fall in blood pressure. b) Sharp fundal pain and discomfort between contractions. c) Pain in a lower quadrant and increased pulse rate. d) An increased blood pressure and oliguria.

Sharp fundal pain and discomfort between contractions.

A nurse is assessing pregnant clients for the risk of placenta previa. Which of the following clients faces the greatest risk for this condition? a) A client who had undergone a myomectomy to remove fibroids b) A client with a history of alcohol ingestion c) A client with a structurally defective cervix d) A 23-year-old client

A client who had undergone a myomectomy to remove fibroids

A 45-year-old pregnant woman with type O blood has had an amniocentesis to rule out Down syndrome. The fetus has type AB blood. What can the nurse warn the patient is a likely outcome if some fetal blood mixed with maternal blood during the procedure?a) The baby will develop hemolytic anemia.b) Placental abruptionc) The baby will have postdelivery jaundice.d) Preterm delivery

The baby will have postdelivery jaundice.

A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm/Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next? a) Obtain a voided urine specimen and determine blood type. b) Measure fundal height. c) Check deep tendon reflexes. d) Palpate the fundus and check fetal heart rate.

Palpate the fundus and check fetal heart rate.

A woman you care for has an Rh-negative blood type. Following the birth of her infant, you administer her Rho(D) (D immune globulin). The purpose of this is to a) Stimulate maternal D immune antigens. b) Prevent maternal D antibody formation. c) Prevent fetal RH blood formation. d) Promote maternal D antibody formation.

Prevent maternal D antibody formation.

A client in her 38th week of gestation is admitted into the labor and birth unit with painless bleeding from the vagina. The client is diagnosed with placenta previa. When reviewing the client's history, which of the following would the nurse identify as a risk factor for placenta previa? a) Maternal age more than 30 years b) Primigravida status c) Previous cesarean birth d) Living in coastal areas

Previous cesarean birth

A woman is suspected of having abruptio placentae. Which of the following would the nurse expect to assess as a classic symptom? A. Painless, bright-red bleeding B. "Knife-like" abdominal pain C. Excessive nausea and vomiting D. Hypertension and headache.

"Knife-like" abdominal pain

A postpartum mother has the following lab data recorded: RH negative and rubella titer is positive. What is the appropriate nursing intervention? a) Administer RhoGam within 72 hours. b) Administer rubella vaccine before discharge. c) Assess the RH of the baby. d) Assess the rubella of the baby

Administer RhoGam within 72 hours.

Rhogam (Rh immune globulin) will be ordered for an RH - mother undergoing which of the following tests? a) Contraction test b) Biophysical profile c) Amniocentesis d) Non-stress test

Amniocentesis

A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which of the following would be the priority for this woman on admission? a) Performing a vaginal examination to assess the extent of bleeding b) Helping the woman remain ambulatory to reduce bleeding c) Assessing uterine contractions by an internal pressure gauge d) Assessing fetal heart tones by use of an external monitor

Assessing fetal heart tones by use of an external monitor

The nurse is required to assess a pregnant client who is complaining of vaginal bleeding. Which of the following assessments should be considered as a priority by the nurse? a) Monitoring uterine contractility b) Assessing signs of shock c) Determining the amount of funneling d) Assessing the amount and color of the bleeding

Assessing the amount and color of the bleeding

When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in the client's pulse. What does this increase in pulse indicate? a) Preterm labor b) Cord compression c) Respiratory distress syndrome d) Infection

Infection

Which of the following would the nurse include in the plan of care for a woman with premature rupture of membranes if her fetus's lungs are mature? a) Reduction in physical activity level b) Administration of corticosteroids c) Labor induction d) Observation for signs of infection

Labor induction

Which of the following would be the physiologic basis for a placenta previa? a) A placenta with multiple lobes b) Low placental implantation c) A uterus with a midseptum d) A loose placental implantation

Low placental implantation

A woman in labor has sharp fundal pain accompanied by slight vaginal bleeding. Which of the following would be the most likely cause of these symptoms? a) Placenta previa obstructing the cervix b) Premature separation of the placenta c) Possible fetal death or injury d) Preterm labor that was undiagnosed

Premature separation of the placenta

A client reports to her obstetrician complaining of a significant amount of bright red, painless vaginal bleeding. A sonogram reveals that her placenta has implanted low in the uterus and is partially covering the cervical os. Which of the following immediate care measures should the nurse initiate? (Select all that apply.) a) Perform a pelvic examination b) Continue to assess blood pressure every 5 to 15 minutes c) Determine from the client the time the bleeding began and about how much blood has been lost d) Place the woman on bed rest in a side-lying position e) Obtain baseline vital signs f) Attach external monitoring equipment to record fetal heart sounds

• Place the woman on bed rest in a side-lying position • Determine from the client the time the bleeding began and about how much blood has been lost • Obtain baseline vital signs • Continue to assess blood pressure every 5 to 15 minutes • Attach external monitoring equipment to record fetal heart sounds

A pregnant client is brought to the health care facility with signs of PROM. Which of the following are the associated conditions and complications of premature rupture of the membranes? Select all that apply. a) Placenta previa b) Prolapsed cord c) Preterm labor d) Abruptio placenta e) Spontaneous abortion

• Prolapsed cord • Abruptio placenta • Preterm labor