Exam 1 Practice Questions- OB
A pregnant woman at 25 weeks of gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate? "That must have been a coincidence; babies can't respond like that." "The fetus is demonstrating the aural reflex." "Babies respond to sound starting at approximately 24 weeks of gestation." "Let me know if it happens again; we need to report that to your midwife."
"Babies respond to sound starting at approximately 24 weeks of gestation." *Quickening begins 16-20 weeks -Babies respond to external sound starting at approximately 24 weeks of gestation. -There is no such thing as an aural reflex.
A woman who is 16 weeks pregnant asks the nurse, "Is it possible to tell by ultrasound if the baby is a boy or girl yet?" What is the best answer? "A baby's sex is determined as soon as conception occurs." "The baby has developed enough to enable us to determine the sex by examining the genitals through an ultrasound scan." "Boys and girls look alike until approximately 20 weeks after conception, and then they begin to look different." "It might be possible to determine your baby's sex, but the external organs look very similar right now."
"The baby has developed enough to enable us to determine the sex by examining the genitals through an ultrasound scan."
Which statement by the client would lead the nurse to believe that labor has been established? "I passed some thick, pink mucus when I urinated this morning." "My bag of waters just broke." "The contractions in my uterus are getting stronger and closer together." "My baby dropped, and I have to urinate more frequently now."
"The contractions in my uterus are getting stronger and closer together." Regular, strong contractions with the presence of cervical change indicate that the woman is experiencing true labor. (would check to see if cervix is dilating to double check!)
A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, "My period is due in a few days, and my temperature has not gone up." What is the nurse's most appropriate response? "This probably means that you're pregnant." "Don't worry; it's probably nothing." "Have you been sick this month?" "You probably didn't ovulate during this cycle."
"You probably didn't ovulate during this cycle."
A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice. What is the nurse's best response? "Oral contraceptives are a highly effective method, but they have some side effects." "Your current medications will reduce the effectiveness of the pill." "Oral contraceptives will reduce the effectiveness of your seizure medication." "The pill is a good choice for a woman of your age and with your personal history."
"Your current medications will reduce the effectiveness of the pill." TB meds, anticonvulsants (seizure meds), and anifungals interact w/ birth control
The obstetric nurse is preparing the client for an emergency cesarean birth, with no time to administer spinal anesthesia, general anesthesia will be used. What is the greatest risk of administering general anesthesia to the client.? Respiratory depression Uterine relaxation Inadequate muscle relaxation Aspiration of stomach contents
*Aspiration of stomach contents
What is the primary rationale for the thorough drying of the infant immediately after birth? Stimulates crying and lung expansion Removes maternal blood from the skin surface Reduces heat loss from evaporation Increases blood supply to the hands and feet
*Reduces heat loss from evaporation (also stimulates crying and lung expansion, but not primary reason)
After an emergency birth, the nurse encourages the woman to breastfeed her newborn. What is the primary purpose of this activity? To facilitate maternal-newborn interaction To stimulate the uterus to contract To prevent neonatal hypoglycemia To initiate the lactation cycle
*To stimulate the uterus to contract helps uterus cramp down and reduces risk of hemorrhage
he uterine contractions of a woman early in the active phase of labor are assessed by an internal uterine pressure catheter (IUPC). The uterine contractions occur every 3 to 4 minutes and last an average of 55 to 60 seconds. They are becoming more regular and are moderate to strong. Based on this information, what would a prudent nurse do next? a. Immediately notify the woman's primary health care provider. b. Prepare to administer an oxytocic to stimulate uterine activity. c. Document the findings because they reflect the expected contraction pattern for the active phase of labor. d. Prepare the woman for the onset of the second stage of labor.
. Document the findings because they reflect the expected contraction pattern for the active phase of labor.
The nurse knows that teaching about the natural family planning method of contraception was effective when the couple responds that an ovum is considered fertile for which period of time? 6 to 8 hours 24 hours 2 to 3 days 1 week
24 hours
Which signs and symptoms should a woman immediately report to her health care provider? (Select all that apply.) a. Vaginal bleeding b. Rupture of membranes c. Heartburn accompanied by severe headache d. Decreased libido e. Urinary frequency
A, B, C *severe headache is also a sign of a potential complication
A woman has requested an epidural block for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. Before the initiation of the epidural, the woman should be informed regarding the disadvantages of an epidural block. Which concerns should the nurse share with this client? (Select all that apply.) a. Ability to move freely is limited. b. Orthostatic hypotension and dizziness may occur. c. Gastric emptying is not delayed. d. Higher body temperature may occur. e. Blood loss is not excessive.
A, B, D
The diagnosis of pregnancy is based on which positive signs of pregnancy? (Select all that apply.) a. Identification of fetal heartbeat b. Palpation of fetal outline c. Visualization of the fetus d. Verification of fetal movement e. Positive hCG test
A, C, D
Which description of the phases of the first stage of labor is most accurate? Latent: mild, regular contractions; no dilation; bloody show Active: moderate, regular contractions; 4 to 7 cm dilation Lull: no contractions; dilation stable Transition: very strong but irregular contractions; 8 to 10 cm dilation
Active: moderate, regular contractions; 4 to 7 cm dilation
What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern? Altered fetal cerebral blood flow Umbilical cord compression Uteroplacental insufficiency Spontaneous rupture of membranes
Altered fetal cerebral blood flow Incorrect: Umbilical cord compression = variable Uteroplacental insufficiency = late Spontaneous rupture of membranes = no influence unless cord prolapse which would be bradycardia
Which presumptive sign or symptom of pregnancy would a client experience who is approximately 10 weeks of gestation? Amenorrhea Positive pregnancy test Chadwick sign Hegar sign
Amenorrhea Incorrect: Positive pregnancy test Chadwick sign Hegar sign are all probable signs!
Which information regarding amniotic fluid is important for the nurse to understand? Amniotic fluid serves as a source of oral fluid and a repository for waste from the fetus. Volume of the amniotic fluid remains approximately the same throughout the term of a healthy pregnancy. The study of fetal cells in amniotic fluid yields little information. A volume of more than 2 L of amniotic fluid is associated with fetal renal abnormalities.
Amniotic fluid serves as a source of oral fluid and a repository for waste from the fetus. -The volume of amniotic fluid constantly changes. -The study of amniotic fluid yields information regarding the sex of the fetus and the number of chromosomes. -Too much amniotic fluid (hydramnios) is associated with gastrointestinal and other abnormalities.
The nurse is palpating the uterus of a client who is 20 weeks pregnant to measure fundal height. Where on the abdomen should the nurse expect to feel the uterine fundus?
At umbilicus
Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could the nurse use to increase the client's blood pressure? (Select all that apply.) a. Place the woman in a supine position. b. Place the woman in a lateral position. c. Increase IV fluids. d. Administer oxygen. e. Perform a vaginal examination.
B, C, D
Which of the following are probable signs of pregnancy? SATA a. Montgomery Tubules b. Goodell's Sign c. Ballottement d. Chadwick's Sign e. quickening
B, C, D A, E = presumptive signs
Which fetal heart rate (FHR) decelerations would require the nurse to change the maternal position? (Select all that apply.) a. Early decelerations b. Late decelerations c. Variable decelerations d. Moderate decelerations e. Prolonged decelerations
B, C, E
The number of routine laboratory tests during follow-up visits is limited; however, those that are performed are essential. Which statements regarding group B Streptococcus (GBS) testing are correct? (Select all that apply.) a. Performed between 32 and 34 weeks of gestation. b. Performed between 35 and 37 weeks of gestation. c. All women should be tested. d. Only women planning a vaginal birth should be tested. e. Women with a history of GBS should be retested.
B, C, E ~36 weeks
The baseline fetal heart rate (FHR) is the average rate during a 10-minute segment. Changes in FHR are categorized as periodic or episodic. These patterns include both accelerations and decelerations. The labor nurse is evaluating the client's most recent 10-minute segment on the monitor strip and notes a late deceleration. Which is likely to have caused this change? (Select all that apply.) a. Spontaneous fetal movement b. Compression of the fetal head c. Placental abruption d. Cord around the baby's neck e. Maternal supine hypotension
C, E VEAL CHOP Late decels = Placental insufficiency Placental insufficiency can be cause by uterine tachysystole, maternal hypotension, epidural or anesthesia, intraamniotic infection, or placental abruption (separation of placenta from uterine wall)
When performing Leopold's maneuver, the nurse detects a hard, round moveable object at the level of the fundus. What position is the fetus in? A. Cephalic presentation B. Transverse position C. Breech position D. Posterior position
C. Breech position
The nurse is providing health education to a pregnant client regarding the cardiovascular system. Which information is correct and important to share? A pregnant woman experiencing disturbed cardiac rhythm requires close medical and obstetric observation no matter how healthy she may appear otherwise. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks of gestation to term. Palpitations are twice as likely to occur in twin gestations. All of the above changes will likely occur.
Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks of gestation to term.
A nurse is caring for a client in labor. The nurse documents that the client is beginning the second stage of labor when which assessment is noted? A.The client begins to expel clear vaginal fluid B.The contractions are regular C. The membranes have ruptured D. The cervix is completely dilated
D. The cervix is completely dilated
During the first trimester, which of the following changes regarding her sexual drive should a client be taught to expect? Increased sexual drive, because of enlarging breasts Decreased sexual drive, because of nausea and fatigue No change in her sexual drive Increased sexual drive, because of increased levels of female hormones
Decreased sexual drive, because of nausea and fatigue (often increases in second and third trimester)
Which consideration is essential for the nurse to understand regarding follow-up prenatal care visits? The interview portions become more intensive as the visits become more frequent over the course of the pregnancy. Monthly visits are scheduled for the first trimester, every 2 weeks for the second trimester, and weekly for the third trimester. During the abdominal examination, the nurse should be alert for supine hypotension. For pregnant women, a systolic BP of 130 mm Hg and a diastolic BP of 80 mm Hg is sufficient to be considered hypertensive.
During the abdominal examination, the nurse should be alert for supine hypotension.
The first hour after birth is sometimes referred to as what? Bonding period Third stage of labor Fourth stage of labor Early postpartum period
Fourth stage of labor The fourth stage of labor begins with the expulsion of the placenta and lasts until the woman is stable in the immediate postpartum period, usually within the first hour after birth.
The nurse is evaluating the electronic feta monitoring (EFM) tracing of the client who is in active labor. Suddenly, the fetal heart rate (FHR) drops from its baseline of 125 down to 80 beats per minute. The mother is repositioned, and the nurse provides oxygen, increased IV fluids, and performs a vaginal examination. The cervix has not changed. Five minutes have passed, and the FHR remains in the 80s. What additional nursing measures should the nurse take next? Call for help. Insert a Foley catheter. Start administering Pitocin. Immediately notify the care provider.
Immediately notify the care provider. *after intrauterine resuscitation, call HCP if FHR still abnormal
The nurse expects which maternal cardiovascular finding during labor? Increased cardiac output Decreased pulse rate Decreased white blood cell (WBC) count Decreased blood pressure
Increased cardiac output
Which characteristic correctly matches the type of deceleration with its likely cause? Early deceleration—umbilical cord compression Late deceleration—uteroplacental insufficiency Variable deceleration—head compression Prolonged deceleration—unknown cause
Late deceleration—uteroplacental insufficiency
Which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur? Maternal fever Umbilical cord prolapse Regional anesthesia Magnesium sulfate administration
Maternal fever *maternal infections, fetal hypoxia most common causes Incorrect: Umbilical cord prolapse Regional anesthesia Magnesium sulfate administration = meds would all likely result in fetal BRADYcardia
A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding? Melasma Linea nigra Striae gravidarum Palmar erythema
Melasma Melasma, (also called chloasma, the mask of pregnancy), usually fades after birth.
What is the rationale for the use of a blood patch after spinal anesthesia? Preventing related hypotension Minimizing the risk of a spinal headache Eliminating neonatal respiratory depression Limiting the loss of movement
Minimizing the risk of a spinal headache
Which statement regarding the probable signs of pregnancy is most accurate? Determined by ultrasound Observed by the health care provider Reported by the client Confirmed by diagnostic tests
Observed by the health care provider
What is the correct placement of the tocotransducer for effective electronic fetal monitoring (EFM)? Over the uterine fundus On the fetal scalp Inside the uterus Over the mother's lower abdomen
Over the uterine fundus The tocotransducer monitors uterine activity and should be placed over the fundus, where the most intensive uterine contractions occur.
At least five factors affect the process of labor and birth. These are easily remembered as the five Ps. Which factors are included in this process? (Select all that apply.) Passenger Passageway Powers Pressure Psychologic response
Passenger Passageway Powers Psychologic response (psyche) Also: position
What kind of fetal anomalies are most often associated with oligohydramnios? Renal Cardiac Gastrointestinal Neurologic
Renal
Which statement regarding the structure and function of the placenta is correct? Produces nutrients for fetal nutrition Secretes both estrogen and progesterone Forms a protective, impenetrable barrier to microorganisms such as bacteria and viruses Excretes prolactin and insulin
Secretes both estrogen and progesterone
A pregnant woman is at 38 weeks of gestation. She wants to know whether there are any signs that "labor is getting close to starting." Which finding is an indication that labor may begin soon? Weight gain of 1.5 to 2 kg (3 to 4 lb) Increase in fundal height Urinary retention Surge of energy
Surge of energy -Women speak of having a burst of energy before labor. -The woman may lose 0.5 to 1.5 kg, as a result of water loss caused by electrolyte shifts that, in turn, are caused by changes in the estrogen and progesterone levels. -When the fetus descends into the true pelvis (called lightening), the fundal height may decrease. -Urinary frequency may return before labor.
A client at 34 weeks of gestation seeks guidance from the nurse regarding personal hygiene. Which information should the nurse provide? Tub bathing is permitted even in late pregnancy unless membranes have ruptured. The perineum should be wiped from back to front. Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bath. Expectant mothers should use specially treated soap to cleanse the nipples.
Tub bathing is permitted even in late pregnancy unless membranes have ruptured.
Which female reproductive organ is responsible for cyclic menstruation? Uterus Ovary Vaginal vestibule Urethra
Uterus
A new mother asks the nurse about the "white substance" covering her infant. How should the nurse explain the purpose of vernix caseosa? Vernix caseosa protects the fetal skin from the amniotic fluid. Vernix caseosa promotes the normal development of the peripheral nervous system. Vernix caseosa allows the transport of oxygen and nutrients across the amnion. Vernix caseosa regulates fetal temperature.
Vernix caseosa protects the fetal skin from the amniotic fluid. Prolonged exposure to the amniotic fluid during the fetal period could result in the breakdown of the skin without the protection of the vernix caseosa.
A pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirement is the nurse most concerned about? Calcium Protein Vitamin B12 Folic acid
Vitamin B12- found in animal foods
A woman asks the nurse, "What protects my baby's umbilical cord from being squashed while the baby's inside of me?" What is the nurse's best response? a. "Your baby's umbilical cord is surrounded by connective tissue called Wharton's jelly, which prevents compression of the blood vessels." b. "Your baby's umbilical cord floats around in blood and amniotic fluid." c. "You don't need to be worrying about things like that." d. "The umbilical cord is a group of blood vessels that are very well protected by the placenta."
a. "Your baby's umbilical cord is surrounded by connective tissue called Wharton's jelly, which prevents compression of the blood vessels."
Which client would not be a suitable candidate for internal electronic fetal monitoring (EFM)? a. Client who still has intact membranes b. Woman whose fetus is well engaged in the pelvis c. Pregnant woman who has a comorbidity of obesity d. Client whose cervix is dilated to 4 to 5 cm
a. Client who still has intact membranes For internal EFM, membranes must be ruptured and Mom dilated 2-3 cm.
A client is experiencing back labor and reports intense pain in her lower back. Which measure provided by the woman's labor coach would best support this woman in labor? a. Counterpressure against the sacrum b. Pant-blow (breaths and puffs) breathing techniques c. Effleurage d. Conscious relaxation or guided imagery
a. Counterpressure against the sacrum
When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. Which instruction best describes these measures? a. Encouraging the woman to try various upright positions, including squatting and standing b. Telling the woman to start pushing as soon as her cervix is fully dilated c. Continuing an epidural anesthetic so pain is reduced and the woman can relax d. Coaching the woman to use sustained, 10- to 15-second, closed-glottis bearing-down efforts with each contraction
a. Encouraging the woman to try various upright positions, including squatting and standing *if possible, gravity helps progress of fetal descent
Which description of the four stages of labor is correct for both the definition and the duration? a. First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours b. Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours c. Third stage: active pushing to birth; 20 minutes (multiparous woman), 50 minutes (nulliparous woman) d. Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour
a. First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours The fourth stage begins after the expulsion of the placenta and lasts until homeostasis is reestablished (approximately 2 hours).
The nurse should be aware of which physiologic effect of labor pain? a. Predominant pain of the first stage of labor is visceral pain that is in the lower portion of the abdomen. b. Referred pain is the extreme discomfort experienced between contractions. c. Somatic pain of the second stage of labor is more generalized and related to fatigue. d. Pain during the third stage is a somewhat milder version of the pain experienced during the second stage.
a. Predominant pain of the first stage of labor is visceral pain that is in the lower
A nurse is caring for a client at 40 weeks gestation and experiencing contractions every 3-5 min and becoming stronger. A vaginal exam reveals that the client's cervix is 3 cm dilated, 80% effaced, and -1 station. The client asks for pain medication. Which of the following actions should the nurse take? SATA a. encourage the use of patterned breathing techniques b. insert an indwelling catheter c. administer opioid analgesic medications d. suggest application of cold e. provide ice chips
a. encourage the use of patterned breathing techniques c. administer opioid analgesic medications d. suggest application of cold *is able to get pain medications at this point in labor as long as baby looks good
Which of the following data would the nurse assess at an infertility clinic? SATA a. occupation b. menstrual history c. childhood infections diseases d. history of falls e. recent blood transfusions
a. occupation b. menstrual history c. childhood infections diseases- eg mumps!
A first-time mother is concerned about the type of medications she will receive during labor. The client is in a fair amount of pain and is nauseated. In addition, she appears to be very anxious. The nurse explains that opioid analgesics are often used along with sedatives. How should the nurse phrase the rationale for this medication combination? a. "The two medications, together, reduce complications." b. "Sedatives enhance the effect of the pain medication." c. "The two medications work better together, enabling you to sleep until you have the baby." d. "This is what your physician has ordered for you."
b. "Sedatives enhance the effect of the pain medication."
Which statement related to fetal positioning during labor is correct and important for the nurse to understand? a. Position is a measure of the degree of descent of the presenting part of the fetus through the birth canal. b. Birth is imminent when the presenting part is at +4 to +5 cm below the spine. c. The largest transverse diameter of the presenting part is the suboccipitobregmatic diameter. d. Engagement is the term used to describe the beginning of labor.
b. Birth is imminent when the presenting part is at +4 to +5 cm below the spine.
What is the correct terminology for the nerve block that provides anesthesia to the lower vagina and perineum? a. Epidural b. Pudendal c. Local d. Spinal block
b. Pudendal
A nurse is completing an admission assessment for a patient who is 39 weeks and reports fluid leaking from the vagina for 2 days. Which of the following conditions is the patient at risk for developing? a. cord prolapse b. infection c. postpartum hemorrhage d. hydraminos
b. infection *rupture of membranes longer than 24 hr before delivery increases risk of infection
Which of the following are adverse effects of implantable progestins? SATA a. tinnitus b. irregular vaginal bleeding c. weight gain d. nausea e. gingival hyperplasia
b. irregular vaginal bleeding c. weight gain d. nausea
A client arrives for her initial prenatal examination. This is her first child. She asks the nurse, "How does my baby get air inside my uterus?" What is the correct response by the nurse? a. "The baby's lungs work in utero to exchange oxygen and carbon dioxide." b. "The baby absorbs oxygen from your blood system." c. "The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream." d. "The placenta delivers oxygen-rich blood through the umbilical artery to the baby's abdomen."
c. "The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream." *through the umbilical VEIN, not artery (d)
Which information related to a prolonged deceleration is important for the labor nurse to understand? a. Prolonged decelerations present a continuing pattern of benign decelerations that do not require intervention. b. Prolonged decelerations constitute a baseline change when they last longer than 5 minutes. c. A disruption to the fetal oxygen supply causes prolonged decelerations. d. Prolonged decelerations require the customary fetal monitoring by the nurse.
c. A disruption to the fetal oxygen supply causes prolonged decelerations.
Where is the point of maximal intensity (PMI) of the fetal heart tone (FHR) located? a. Usually directly over the fetal abdomen b. In a vertex position, heard above the mother's umbilicus c. Directly over the fetal back d. In a breech position, heard below the mother's umbilicus
c. Directly over the fetal back
Which action is correct when palpation is used to assess the characteristics and pattern of uterine contractions? a. Placing the hand on the abdomen below the umbilicus and palpating uterine tone with the fingertips b. Determining the frequency by timing from the end of one contraction to the end of the next contraction c. Evaluating the intensity by pressing the fingertips into the uterine fundus d. Assessing uterine contractions every 30 minutes throughout the first stage of labor
c. Evaluating the intensity by pressing the fingertips into the uterine fundus
Nurses with an understanding of cultural differences regarding likely reactions to pain may be better able to help their clients. Which clients may initially appear very stoic but then become quite vocal as labor progresses until late in labor, when they become more vocal and request pain relief? a. Chinese b. Arab or Middle Eastern c. Hispanic d. African-American
c. Hispanic Hispanic women may be stoic early in labor but more vocal and readier for medications later. Chinese women may not show reactions to pain. Medical interventions must be offered more than once. Arab or Middle Eastern women may be vocal in response to labor pain from the start; they may prefer pain medications. African-American women may openly express pain; the use of medications for pain is more likely to vary with the individual.
Which statement regarding the development of the respiratory system is a high priority for the nurse to understand? a. The respiratory system does not begin developing until after the embryonic stage. b. The infant's lungs are considered mature when the L/S ratio is 1:1, at approximately 32 weeks of gestation. c. Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity. d. Fetal respiratory movements are not visible on ultrasound scans until at least 16 weeks of gestation.
c. Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity. *A reduction in placental blood flow stresses the fetus, increases blood levels of corticosteroids, and thus accelerates lung maturity. -The development of the respiratory system begins during the embryonic phase and continues into childhood. The infant's lungs are considered mature when the L/S ratio is 2:1, at approximately 35 weeks of gestation. Lung movements have been visualized on ultrasound scans at 11 weeks of gestation.
A woman in labor has just received an epidural block. What is the most important nursing intervention at this time? a. Limit parenteral fluids. b. Monitor the fetus for possible tachycardia. c. Monitor the maternal blood pressure for possible hypotension. d. Monitor the maternal pulse for possible bradycardia.
c. Monitor the maternal blood pressure for possible hypotension.
A laboring woman has received meperidine intravenously (IV), 90 minutes before giving birth. Which medication should be available to reduce the postnatal effects of meperidine on the neonate? a. Fentanyl b. Promethazine c. Naloxone d. Nalbuphine
c. Naloxone opioid antagonist!
Which clinical finding in a primiparous client at 32 weeks of gestation might be an indication of anemia? a. Ptyalism b. Pyrosis c. Pica d. Decreased peristalsis
c. Pica
In which clinical situation would the nurse most likely anticipate a fetal bradycardia? a. Intraamniotic infection b. Fetal anemia c. Prolonged umbilical cord compression d. Tocolytic treatment using terbutaline
c. Prolonged umbilical cord compression Other answers - fetal tachycardia
When assessing the fetus using Leopold's maneuvers, the nurse feels a round, firm, and movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother's right side close to midline. What is the position of the fetus? a. ROA b. LSP c. RSA d. LOA
c. RSA R = facing Mom's right side S = sacral (butt) facing down A = anterior, close to midline is facing the front
Which phase of the endometrial cycle best describes a heavy, velvety soft, fully matured endometrium? a. Menstrual b. Proliferative c. Secretory d. Ischemic
c. Secretory
A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. The nurse reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dl, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for this woman? a. She is too far dilated. b. She is anemic. c. She has thrombocytopenia. d. She is septic.
c. She has thrombocytopenia *platelets too low- should not be below 140,000/150,000 for epidural
What is a distinct advantage of external electronic fetal monitoring (EFM)? a. The ultrasound transducer can accurately measure short-term variability and beat-to-beat changes in the fetal heart rate (FHR). b. The toco transducer can measure and record the frequency, regularity, intensity, and approximate duration of uterine contractions. c. The toco transducer is especially valuable for measuring uterine activity during the first stage of labor. d. Once correctly applied by the nurse, the transducer need not be repositioned even when the woman changes positions.
c. The toco transducer is especially valuable for measuring uterine activity during the first stage of labor. -The toco transducer is valuable for measuring uterine activity during the first stage of labor and is especially true when the membranes are intact. -Short-term variability and beat-to-beat changes cannot be measured with this technology. The toco transducer cannot measure and record the intensity of uterine contractions.
Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth? a. Fetal head is felt at 0 station during vaginal examination. b. Bloody mucous discharge increases. c. Vulva bulges and encircles the fetal head. d. Membranes rupture during a contraction.
c. Vulva bulges and encircles the fetal head
A nurse is caring for a client who is in active labor, irritable, and reports the urge to have a bowel movement. The client vomits and states, "I can't take this anymore". Which stage of labor is the client experiencing? a. second stage b. fourth stage c. transitional phase d. latent phase
c. transitional phase
Which definition of an acceleration in the fetal heart rate (FHR) is accurate? a. FHR accelerations are indications of fetal well-being when they are periodic. b. FHR accelerations are greater and longer in preterm gestations. c. FHR accelerations are usually observed with breech presentations when they are episodic. d. An acceleration in the FHR presents a visually apparent and abrupt peak.
d. An acceleration in the FHR presents a visually apparent and abrupt peak. *I think this question is too specific for what we need to know- but D is still right
A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. What is the nurse's highest priority in this situation? a. Prepare the woman for imminent birth. b. Notify the woman's primary health care provider. c. Document the characteristics of the fluid. d. Assess the fetal heart rate (FHR) and pattern.
d. Assess the fetal heart rate (FHR) and pattern. *risk of cord prolapse when membranes rupture
The nurse performs a vaginal examination to assess a client's labor progress. Which action should the nurse take next? a. Perform an examination at least once every hour during the active phase of labor. b. Perform the examination with the woman in the supine position. c. Wear two clean gloves for each examination. d. Discuss the findings with the woman and her partner.
d. Discuss the findings with the woman and her partner. *only do exam when necessary, use sterile glove = increased risk of infection *PREVENT supine position (supine hypotension)
A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is approximately twice the normal adult breathing rate. She starts to report feeling lightheaded and dizzy and states that her fingers are tingling. Which intervention should the nurse immediately initiate? a. Contact the woman's health care provider. b. Tell the woman to slow her pace of her breathing. c. Administer oxygen via a mask or nasal cannula. d. Help her breathe into a paper bag.
d. Help her breathe into a paper bag.
Which statement correctly describes the effects of various pain factors? a. Higher prostaglandin levels arising from dysmenorrhea can blunt the pain of childbirth. b. Upright positions in labor increase the pain factor because they cause greater fatigue. c. Women who move around trying different positions experience more pain. d. Levels of pain-mitigating beta-endorphins are higher during a spontaneous, natural childbirth.
d. Levels of pain-mitigating beta-endorphins are higher during a spontaneous, natural childbirth.
Which hormone is essential for maintaining pregnancy? a. Estrogen b. hCG c. Oxytocin d. Progesterone
d. Progesterone *party planner
Which hormone is responsible for the maturation of mammary gland tissue? a. Estrogen b. Testosterone c. Prolactin d. Progesterone
d. Progesterone -Progesterone causes maturation of the mammary gland tissue, specifically acinar structures of the lobules. -Estrogen increases the vascularity of the breast tissue.
In which situation would the nurse. be called on to stimulate the fetal scalp? a. As part of fetal scalp blood sampling b. In response to tocolysis c. In preparation for fetal oxygen saturation monitoring d. To elicit an acceleration in the fetal heart rate (FHR)
d. To elicit an acceleration in the fetal heart rate (FHR)
A nurse is caring for a client who is using patterned breathing during labor. The client reports numbness and tingling of the fingers. Which of the following actions should the nurse take? a. administer O2 via nasal cannula at 2 L/min b. apply a warm blanket c. assist the client to a side-lying position d. place an O2 mask over the client's nose and mouth
d. place an O2 mask over the client's nose and mouth *for hyperventilation = not to GIVE O2, but to help patient breathe in CO2 which is what they really need! Paper bag would also do the trick
Which of the following represents the average amount of weight gained during pregnancy? ■12-22lbs ■15-25 lbs ■20-30 lbs ■25-35 lbs
■25-35 lbs
On which of the following areas would the nurse expect to observe chloasma? ■Breasts, areola, and nipples ■Chest, neck, arms, and legs ■Abdomen, breast, and thighs ■Cheeks, forehead, and nose
■Cheeks, forehead, and nose *mask of pregnancy
Which of the following urinary symptoms does the pregnant woman most frequently experience during the first trimester? ■Dysuria ■Frequency ■Incontinence ■Burning
■Frequency
Which of the following would the nurse identify as a presumptive sign of pregnancy? ■Chadwick's sign ■Nausea and vomiting ■Braxton Hicks contractions ■Positive serum pregnancy test
■Nausea and vomiting
When talking with a pregnant woman who has aching, swollen leg veins, the nurse would explain that this is most probably the result of which of the following ■Thrombophlebitis ■PIH ■Pressure on blood vessels from the enlarging uterus ■The force of gravity pulling down on the uterus
■Pressure on blood vessels from the enlarging uterus
Cervical softening and a positive hCG are classified as which of the following? ■Diagnostic signs ■Presumptive signs ■Probable signs ■Positive signs
■Probable signs
Which of the following would be the nurse's best response to a woman who at 5 months gestation, reports that she has felt intermittent, painless, irregular contractions of her uterus? ■It is important to time these contractions because it may be the beginning of labor ■If these contractions occur again, call your physician immediately ■The contractions help stimulate the movement of blood through the placenta ■They are called braxton hicks contractions. They may occur throughout the pregnancy
■They are called braxton hicks contractions. They may occur throughout the pregnancy *Give her knowledge- know what to look for w/ TRUE contractions + signs of labor
