EAQ OB 1

Which response would the nurse give to a postpartum client who asks if she can drink a small glass of wine before breast feeding the first time to help her relax? " I think a drinking 1 glass of wine wont be a problem" "you seem a little tense. Tell me how you feel." "You seem to find it relaxing, but you need to find another way to relax" "I think drinking 1 glass of wine is alright, but you had better check with your health care provider first."

"You seem a little tense. Tell me how how you feel about breast feeding."

The nurse is differentiating between cephalhematoma and caput succedaneum. Which finding is unique to caput succedaneum? 1. Edema that crosses the suture line 2. Scalp tenderness over the affected area 3. Edema that increases during the first day 4. Scalp over the area becomes ecchymosed

1. Edema that crosses the suture line

Which statements regarding the involution process our correct? Select all that apply. 1. Begins immediately after expulsion of the placenta 2. Is this self-destruction of excess hypertrophied tissue 3. Progresses rapidly during the next few days after birth 4. Is there return of the uterus to a non-pregnant state after birth 5. May be caused by retained placental fragments in infection

1. Occurs immediately after expulsion of placenta, 3. Progresses rapidly during the next few days after birth. 4. Is the return of the uterus to a non-pregnant stateSub involution is a self-destruction of excess hypertrophied tissue, this process may be caused by retained placental fragments or infection

What characteristic does the nurse anticipate in an infant born at 32 weeks' gestation? 1Barely visible areolae and nipples 2Ear pinnae that spring back when folded 3Definite creases of the infant's palms and soles 4A zero-degree angle on the square window sign

1Barely visible areolae and nipples

Which is the expected color and consistency of amniotic fluid at 36 weeks' gestation? 1Clear, dark amber colored, and containing shreds of mucus 2Straw colored, clear, and containing little white specks 3Milky, greenish yellow, and containing shreds of mucus 4Greenish yellow, cloudy, and containing little white specks

2Straw colored, clear, and containing little white specks

In which location is the presenting part of the fetus when it is at 0 station? 1Entering the vagina 2Floating within the bony pelvis 3At the level of the ischial spines 4Above the level of the ischial spines

3 At the level of the ischial spines

Which method of swaddling could cause risk for injury? 1. Knees flexed 2. Arms flexed 3. Legs extended 4. Arms extended

3. Legs Extended

While caring for a client who gave birth 1 day ago, the nurse determines that the client's uterine fundus is firm at one fingerbreadth below the umbilicus, blood pressure is 110/70 mm Hg, pulse is 72 beats/min, and respirations are 16 breaths/min. The client's perineal pad is saturated with lochia rubra. What is the priority nursing action? 1Recording these expected findings 2Obtaining a prescription for an oxytocic medication 3Asking the client when she last changed the perineal pad 4Notifying the primary health care provider that the client may be hemorrhaging

3Asking the client when she last changed the perineal pad

Although the newborn was just cleaned and examined, the mother notes a red rash consisting of small papules on the face, chest, and back of the newborn. What condition does the nurse recognize? 1 Harlequin sign 2 Vernix caseosa 3 Nevus flammeus 4 Erythema toxicum

4 Erythema toxicum

Which is a gastrointestinal manifestation of infection in the newborn? Select all that apply. One, some, or all responses may be correct. 1 Lethargy 2 Irritability 3 Nasal flaring 4 Poor perfusion 5 Glucose instability

5 Glucose instability

for which reason would the nurse encourage a client to void during the first stage of labor? a. a full bladder is often injured during labor b. a full bladder may inhibit the progress of labor c. a full bladder jeopardizes the status of the fetus d. a full bladder predisposes the client to urinary infection

A full bladder may inhibit the progress of labor. A full bladder encroaches on the uterine space and impedes the descent of the fetal head. The bladder may become atonic, but is not physically damaged during the course of labor. A full bladder may lead to prolonged labor, but generally does not jeopardize fetal status as long as adequate placental perfusion continues. A full bladder during labor does not predispose the client to infection.)

which factor distinguishes true labor from false labor? A) cervical dilation is evident B) contractions stop when the client walks around C) the client's contractions progress only when she is in a side-lying position D) contractions occur immediately after the membranes rupture

A) progressive cervical dilation is the most accurate indication of true labor. with true labor, contractions will increase with activity. contractions of true labor persist in any position. contractions may not begin until 24 to 48 hours after the membranes rupture

Which adverse effect would the nurse monitor for after administering vitamin K to a newborn? Select all that apply. One, some, or all responses may be correct. 1. Pain 2. Edema 3. Jaundice 4. Erythema 5. Hemolysis

ALL

A client tells the nurse that the first day of her last menstrual period was July 22. What is the estimated date of birth (EDB)? a. May 7 b. April 29 c. April 22 d. March 6

April 29th Naegeles Rule

A nurse is reviewing the laboratory report of a newborn whose hematocrit level is 45%. Which value denotes a healthy infant? Less than 40% More than 75% Between 45% and 65% Between 65% and 75%

Between 45% and 65%

a prenatal client's vaginal mucosa is noted to have a purplish discoloration. which sign would be documented in the client's clinical record? A) Hegar B) Goodell C) Chadwick D) Braxton-Hicks

C) Chadwick

Which finding is indicative of hypothermia in a newborn? Select all that apply. One, some, or all responses may be correct. 1 Seizure 2 Diaphoresis 3 Flushed skin 4 Poor feeding 5 Hypoglycemia

Correct 5 Hypoglycemia

Which action provides support for the fetal head as it is being delivered? Applying suprapubic Pressure Placing a hand firmly against the perineum Distributing fingers evenly around the head Maintaining pressure against the anterior fontanel

Distributing Fingers evenly around the head

For which reason is an ultrasound done during the first trimester? Estimate fetal age Detect hydrocephalus Rule out congenital defects Approximate fetal linear growth

Estimate fetal age

A nurse teaches a new mother about neonatal weight loss in the first 3 days of life. How does the nurse explain the cause of this weight loss? An allergy to formula A hypoglycemic response Ineffective feeding techniques Excretion of accumulated excess fluids

Excretion of accumulated excess fluids Early weight loss occurs because excess fluid is lost, not body mass. Weight loss is expected; there are no data to support an allergic response. Weight loss is not related to hypoglycemia. Neither breast nor formula feeding will prevent the 10% weight loss that is expected in the first few days of life.

When the cervix of a woman in labor is dilated 9 cm, she states that she has the urge to push. Which action should the nurse implement at this time? Having her pant blow during contractions Placing her legs in stirrups to facilitate pushing Encouraging her to bear down with each contraction Reviewing the pushing techniques taught in childbirth classes

Having her pant blow during contractions

In the second hour after a client gives birth, her uterus is found to be firm, above the level of the umbilicus, and to the right of midline. What is the appropriate nursing intervention at this time? Having the client empty her bladder Watching for signs of retained secundines Massaging the uterus vigorously to prevent hemorrhage Explaining to the client that this is a sign of uterine stabilization

Having the client empty her bladder

Which would evidence of the Babinski reflex indicate during a newborn assessment? Hypoxia during labor Neurological injury during birth Hyperreflexia of the muscular system Immaturity of the CNS

Immaturity of the CNS

What characteristic that may be a potential nutrition problem should the nurse identify in a preterm neonate? Inadequate sucking reflex Diminished metabolic rate Rapid digestion of formula Increased absorption of nutrients

Inadequate sucking reflex

A pregnant client is scheduled for ultrasonography at the end of her first trimester. What should the nurse instruct her to do in preparation for the sonogram? Empty her bladder Avoid eating after 8 hours Take a laxative the night before the test Increase fluid intake 1 hour before the procedure

Increase fluid intake for 1 hour before the procedure.

Which immediate action would the nurse take if a client in active phase of labor says, "I feel all wet. I think I wet myself?" give her the bedpan Change the bed linens Inspect her perineum take an oral temp

Inspect her perineum

After the birth of a neonate, a parents asks, "what is that white substance over the baby's body?" How would the nurse respond? "it is a fungal infection called thrush" "it is unexpected, and it called milia" "it is expected, and called vernix caseosa" "it is a grouped of capillaries called telangiectatic nevi"

It is expected, called vernix caseosa

What should the nurse recommend to a new mother when teaching her about the care of the umbilical cord area? Remove the cord only after the cord stump has separated Smooth ointment or baby lotion around the cord after the sponge bath Leave the area untouched or clean with soap and water; then pat dry Wrap an elastic bandage snugly around the waist area over the cord site

Leave the area untouched or clean with soap and water, then pat it dry.

When calculating the Apgar score for a newborn, what does the nurse assess in addition to the heart rate? Muscle tone Amount of mucus Degree of head lag Depth of respirations

Muscle tone

Which condition would the nurse document when a newborn infant is noted to have small, flat pink spots on the nape of the neck? Nevi Desquamation Mongolian spots Erythema toxicum

Nevi

A nurse in the newborn nursery is monitoring an infant for jaundice related to ABO incompatibility. What blood type does the mother usually have to cause this incompatibility? A B O AB

O

Which sleeping position would the nurse recommend for newborns? On the back, lying flat One either side, head lying flat One the left side, head slightly elevated On the right side, head slightly elevated

On the back, lying flat

Where would the nurse find the area of involvement associated with parietal swelling? Over the eyes Behind the ears At the back of the head On top of the skull

On top of the skull

A nurse is planning to use a newborn's foot to obtain blood for the required newborn metabolic testing. What part of the foot is the best site to use for the puncture? Big toe Foot pad Inner sole Outer heel

Outer heel

The practice of separating parents from their newborn immediately after birth and limiting their time with the infant during the first few days after delivery contradicts studies related to what? Early rooming-in Taking-in behaviors Taking-hold behaviors Parent-child attachment

Parent-child attachment

A mother is concerned that her newborn will be exposed to communicable diseases when she goes home. While teaching the mother ways to decrease the risk of Infection; what type of immunity should the nurse explain was transferred to her baby through the placenta? Active natural Active Artificial Passive natural Passive artificial

Passive natural

A client is admitted to the birthing unit in active labor. Which physiologic changes should the nurse anticipate after an amniotomy is performed? Diminished bloody show Increased and more variable fetal heart rate Less discomfort with contractions Progressive dilation and effacement

Progressive dilation and effacement

A primigravida who is at 40 weeks' gestation arrives at the birthing center with abdominal cramping and a bloody show. Her membranes ruptured 30 minutes before arrival. A vaginal examination reveals 1 cm of dilation and the presenting part at -1 station. After obtaining the fetal heart rate and maternal vital signs, what should the nurse's priority intervention be?

Provide the client with comfort measures used for women in labor

Which intervention will be delayed until the newborn is 36 to 48 hours old? Vitamin K injection Test for blood glucose level Screening for phenylketonuria Test for necrotizing enterocolitis

Screening for phenylketonuria

The nurse instructs a pregnant client regarding fetal growth and development. Which statement indicates that the client requires further teaching? The fetus keeps growing throughout pregnancy The fetus gets nutrients from the amniotic fluid The fetus may be underweight if its exposed to smoke the fetus gets oxygen from blood coming through the placenta

The fetus gets nutrients from the amniotic fluid

A 42-year-old client at 39 weeks' gestation has a reactive nonstress test (NST). What should the nurse explain to the client about the positive result? Immediate birth is indicated This is the desired response at this stage of gestation Further testing is unnecessary with this desired outcome The result is inconclusive, indicating the need for further evaluation

This is the desired response at this stage of gestation

Which would the nurse expect to observe in a healthy newborns cord vessels? Two Vessels: one vein one artery Three Vessels: two veins one artery Four Vessels: two veins two arteries Three Vessels: one vein two arteries

Three Vessels: one vein two arteries

A nurse notes that a healthy newborn is lying in the supine position with the head turned to the side with the legs and arms extended on the same side and flexed on the opposite side. Which reflex does the nurse identify? Moro Babinski Tonic neck Palmar grasp

Tonic Neck

A client in active labor starts screaming, "The baby is coming! Do something!" What is the nurse's primary action? Notify the practitioner of the birth tell the client that it is too soon and encourage her to pant check the perineal area for visibility of the presenting part Help the client hold her knees together and explain what to expect

check the perineal area for visibility of the presenting part

The nurse is assessing a newborn with exstrophy of the bladder. Which other defect is often associated with exstrophy of the bladder and may be of concern to the nurse? 1.Absence of one kidney 2. Congenital heart disease 3. Pubic bone malformation 4. Tracheoesophageal fistula

3. Pubic bone malformation

When palpating a client's fundus on the second postpartum day, the nurse determines that it is above the umbilicus and displaced to the right. What does the nurse conclude? 1. There is a slow rate of involution. 2. There are retained placental fragments. 3. The bladder has become overdistended. 4. The uterine ligaments are overstretched

3. The bladder has become overdistended.

A full-term infant who is large for gestational age (LGA) should be monitored for which risk? 1. Hypotension 2. Hypothermia 3. Hypocalcemia 4. Hypoglycemia

4. Hypoglycemia

which suggestion would the nurse make to a client with morning sickness? A) "eat dry crackers before you get out of bed" B) "increase your fat intake before bedtime" C) "drink high-carbohydrate fluids with meals" D) "eat 2 small meals a day and a snack at noon

A) "eat dry crackers before you get out of bed"

which recommendation would the nurse make to a pregnant client who sits almost continuously during her working hours? A) "try to walk around every few hours during the workday" B) "ask for time in the morning and afternoon to elevate your legs" C) "tell your boss that you won't be able to work beyond the second trimester" D) "ask for time in the morning and afternoon so you can go get something to eat"

A) "try to walk around every few hours during the workday"

A client at 35 weeks' gestation asks the nurse why her breathing has become more difficult. How should the nurse respond? your lower rib cage is more restricted Your diaphragm has been displaced upward Your lungs have increased in size since you got pregnant The height of your rib cage has increased since you got pregnant

Your diaphragm has been displaced upward