Maternity Final Exam review

A baby with O+ blood is born to a Hep B+, O- blood type mom, should receive all of the following medications by 12 hrs of age. Select all that apply A. Hep B Immunoglobulin B. Erythromycin Ophthalmic ointment in both eyes C. Hep B vaccine D. Rhogam E. Vitamin K

A,B,C

The health care provider gives methotrexate to a woman with ectopic pregnancy. Which of the following nursing interventions are needed when giving a patient methotrexate? Select all that apply A. Double check the medication with another nurse B. Dispose of everything touched by the medication in special bin C. Do not expel air from the syringe before you give the medication D. Wear 2 pairs of gloves when administering the drug

A,B,C,D

The following are tocolytics. Select all that apply. A. Magnesium Sulfate B. Terbutaline (Brethine) C. Methergine D. Nifedipine (Procardia)

A,D

Which assessment finding indicates that an infant has cephalohematoma? A. A lump on the head that does not cross the suture lines B. Scalp edema that crosses the suture lines C. Depressed fontanelles D. An elongated head

A. A lump on the head that does not cross the suture lines

A nurse has brought a 2 hr old baby to the mother from the nursery. The nurse is going to assist the mother with breastfeeding experience. Which of the following actions should the nurse perform first? A. Compare the mothers and baby's ID bracelets B. Help the mother into a comfortable position C. Tickle the baby's lips with the mothers nipple D. Teach the mother about proper breast latch

A. Compare the mothers and baby's ID bracelets

If the client has HELLP syndrome, which lab results would the nurse expect to see? A. Decreased hemoglobin and hematocrit, elevated liver enzymes and decreased platelets B. Decreased hemoglobin and hematocrit, elevated liver enzymes and elevated platelets C. Elevated hemoglobin and hematocrit, decreased liver enzymes and increased platelets D. Elevated hemoglobin and hematocrit, elevated liver enzymes and decreased platelets

A. Decreased hemoglobin and hematocrit, elevated liver enzymes and decreased platelets

The nurse is caring for a patient with severe pregnancy induced hypertension who is being managed with IV magnesium sulfate. The patient has an absence of deep tendon reflexes, blood pressure 150/100 mm of Hg, RR is 10 BPM and urine output is 10 mL/hr. Which is the priority nursing intervention in this situation? A. Discontinue the magnesium sulfate B. Decrease the infusion rate of magnesium sulfate C. Continue to monitor the patient D. Administer magnesium sulfate after 1 hr break

A. Discontinue the magnesium sulfate

Jeannie is a 27 yr old woman who presents with irregular bleeding. She had her period at the normal time with a regular flow that stopped and then started again. She now has heavier bleeding with severe right sided pelvic pain and abdominal cramping accompanied by dizziness. Her urine home pregnancy test was positive. The most likely diagnosis is: A. Ectopic pregnancy B. Threatened abortion C. Blighted Ovum D. Chlamydia

A. Ectopic pregnancy

A nurse is caring for a client with a mild active bleeding from placenta previa. Which assessment indicates that an emergency cesarean birth may be necessary? A. Fetal heart rate of 80 bpm B. Increased maternal blood pressure of 150/90 C. Maternal heart rate of 80 bpm D. Decreased amount of vaginal bleeding

A. Fetal heart rate of 80 bpm

If a pregnant woman is not immune to rubella the expected action is to: A. Immunize her early in postpartum B. Inform her that her baby may have defects C. Tell her that there is little risk for the problem D. Limit her contact with other pregnant woman

A. Immunize her early in postpartum

The nurse is assessing an infant for developmental hip dysplasia. What signs would the nurse document that indicates the infant may have developmental hip dysplasia? Select all that apply A. Asymmetrical gluteal folds B. One leg longer than other C. Positive ortalanis click D. Negative ortalanis click

B,C

The client thinks she may be pregnant. The nurse knows to tell the patient that the following are considered positive signs of pregnancy. SATA A. Braxton hicks contractions B. Visualization of fetus on ultrasound C. Fetal heart beat auscultated on ultrasound D. A positive pregnancy test

B,C,D

An infant is born to a mother with poorly controlled diabetes mellitus. The most important observation the nurse needs to make with the newborn in the first 24 hrs after birth would be: A. Measurement of head circumference B. Assessment for hypoglycemia C. Assessment for hypocalcemia D. Assessment of bowel function

B. Assessment for hypoglycemia

A client who is 24 weeks pregnant has sickle cell anemia. When preparing the care plan, the nurse should identify which factor as a potential trigger for sickle cell crisis during pregnancy? A. Hypertension B. Dehydration C. Sedative use D. Tachycardia

B. Dehydration

A 58 year old woman tells the nurse that she has started experiencing pain during intercourse. The nurse should document that this woman is experiencing? A. Dyspnea B. Dyspareunia C. Dysmenorrhea D. Dyspepsia

B. Dyspareunia

In patients with preterm labor before 32 weeks gestation, Betamethasone is given to: A. Prevent infection B. Enhance fetal lung maturity C. Decrease uterine activity D. Stabilize vascular membrane

B. Enhance fetal lung maturity

A client with eclampsia begins to experience a seizure. Which intervention should the nurse do immediately? A. Place pillow under the left buttocks B. Maintain a patent airway C. Pad the side rails D. Insert padded tongue blade into the mouth

B. Maintain a patent airway

A woman prescribed iron supplements for anemia during pregnancy should be educated to? Select all that apply A. Take with milk to coat the stomach B. Call the Dr if they experience dark tarry stools C. Take with vitamin C containing foods to increase the absorption D. Avoid coffee and tea when taking the supplement

C,D

Which apgar rating in the skin color category would the nurse give to an infant whose entire body is pink? A. 1 B. 0 C. 2 D. 3

C. 2

Order: Ampicillin (Omnipen) 0.5g PO q6h Supply: Capsules labeled 250mg How many capsules will the nurse administer with each doese? A. 250mg B. 500mg C. 2 Capsules D. 2 mg

C. 2 Capsules

A 20 yr old client visiting the clinic requests the use of oral contraceptives. When reviewing the clients history, which finding would alert the nurse to a possible contraindication to using these agents? A. Ulcerative Colitis B. Urinary tract infections C. Thrombophlebitis D. Menorrhagia

C. Thrombophlebitis

A nurse has been assigned to assess a pregnant client for abruptio placenta. For which clinical manifestation of this condition should the nurse assess? A. Painless bright red bleeding B. Generalized vasospasm C. Increased fetal movement D. "Knife-like" abdominal pain with vaginal bleeding

D. "Knife-like" abdominal pain with vaginal bleeding

A patient 28 weeks gestation has pregnancy induced hypertension. Preeclampsia is diagnosed. Which symptom would indicate that her condition is worsening? A. Feeling lethargy B. Dependent edema C. Blood pressure of 138/90 D. Epigastric pain

D. Epigastric pain

Order: Hydroxyzine (Vistaril) 50mg PO qid Supply: Syrup labeled 10mg/5ml How many mLs would the nurse administer with each dose?

25 mL

Prior to discharging a 24-hour-old newborn, the nurse assesses her respiratory status. Which of the following would the nurse expect to assess? A) Respiratory rate 45, irregular B) Costal breathing pattern C) Nasal flaring, rate 65 D) Crackles on auscultation

A) Respiratory rate 45, irregular

Medications used to manage postpartum hemorrhage (PPH) include: SATA A. Pitocin B. Hemabate C. Methergine D. Terbutaline

A,B,C

A nurse is preparing to administer prophylactic eye ointment to a new born to prevent ophthalmia neonatorum. Which of the following medications should the nurse anticipate administering? A. Ofloxacin B. Erythromycin C. Nystatin D. Ceftriaxone

B. Erythromycin

Which condition would the nurse document when there is a deep blue color change in a nitrazine paper test on a pregnant woman? A. Active phase of labor B. Rupture of membranes C. Placenta previa D. Urinary incontinence

B. Rupture of membranes

A nurse is providing discharge teaching for a nonlactating client. Which of the following instructions should the nurse include in the teaching? A. Apply warm compresses until milk suppression occurs B. Wear a supportive bra continuously for the first 72 hrs C. Use breast shells throughout the day to decrease milk supply D. Pump your breast every 4 hrs to relieve discomfort

B. Wear a supportive bra continuously for the first 72 hrs

The nurse is providing instructions to a pregnant client with human immunodeficiency virus (HIV) infection regarding care to the newborn after delivery. The client asks the nurse about the feeding options that are available. Which response should the nurse make to the client? A. "You will be able to breast feed for 6 months and then will need to switch to bottle feeding" B. "You will need to feed your newborn by nasogastric tube feeding" C. "You will need to bottle feed your infant" D. "You will be able to breast feed for 9 months and then will need to switch to bottle feeding"

C. "You will need to bottle feed your infant"

The physician prescribes 600mg of a drug. The info on the drug vial says the concentration is 200mg/mL. How much of the drug will the nurse prepare? A. 200mg/3mL B. 3.0mL C. 3mL D. 600mg/mL

C. 3mL

The nurse discharge teaching plan for the woman with PID should include informing her of the following: SATA A. Hot flashes B. Increased risk of ectopic pregnancy C. Chronic pelvic pain D. Increased risk of infertility

D

A multigravid client admitted to the labor area is scheduled for a cesarean birth under spinal anesthesia. Which client statement indicates teaching about spinal anesthesia has been understood? A. "My blood pressure may increase if I lie down too soon after the injection" B. "I can expect immediate anesthesia that can be reversed very easily' C. "The medication will be administered while I am in a prone position" D. "The anesthetic may cause a severe headache which is treatable"

D. "The anesthetic may cause a severe headache which is treatable"

A primiparous client who underwent a c-section birth 30 mins ago is to receive Rho(D) immune globulin (RhoGAM). The nurse should administer the medication within which time frame after birth? A. 96 hours B. 8 hours C. 24 hours D. 72 hours

D. 72 hrs

The nurse is collecting the data of a pregnant patient whose last menstrual period was on February 9 2021. What is the estimated date of delivery. Record answer in MM/DD/YYYY format

11/16/2021

The nurse is preparing to administer cefadroxil 1 g PO. The medication is supplied in 500 mg tablets. How many tablets should the nurse administer ?

2 tablets

Which routine assessment would the nurse perform at a prenatal visit at 18 weeks? Select all that apply A. Urinalysis for protein, glucose and ketones B. Fetal heart rate C. Fundal height D. Glucose tolerance test

A B C

Fifteen mins after an initial postpartum assessment, the RN finds the patient disoriented and lying on her back in a pool of vaginal blood., with the sheets beneath her saturated with blood. What is the priority nursing action? A. Massage the uterus B. Take vitals C. Increase the IV rate D. Check the bladder

A. Massage the uterus

A postpartum client has the following vital signs 12 hrs post delivery. Which of the following vital signs should be reported immediately? A. Pulse 115 B. RR 16 C. BP 114/70 D. Temp of 37.2 C

A. Pulse 115

After teaching the multiparous mother about hemolytic disease for the newborn and Rh sensitization, the nurse determines that the client understands why she was not sensitized during her other pregnancy when she makes the statement: A. "Like most women I have immunity against the Rh factor" B. "Antibodies are not usually formed until after exposure to an antigen" C. " My other baby had a different father" D. "My blood couldn't neutralize antibodies formed from my first pregnancy"

B. "Antibodies are not usually formed until after exposure to an antigen"

A nurse in a prenatal clinic is providing education to a client who is in the 8th week of gestation. The client states that she does not like milk. Which of the following foods should the nurse recommend as a good source of calcium? A. Deep red or orange vegetables B. Dark green leafy vegetables C. White breads and rice D. Meat, poultry and fish

B. Dark green leafy vegetables

The nursery charge nurse is assessing a 12 hr old female on morning rounds. Which of the following findings should be reported to the neonatologist as soon as possible? A. Newborn extends arms outward then draws in toward body when the crib is shaken B. Grunting during expiration C. Drop of blood in diaper D. Pale pink color over body and slightly bluish color of hands

B. Grunting during expiration

After the patient experienced excessive postpartum bleeding, oxytocin has been infusing at the prescribed rate for 20 mins. Which finding is most indicative that the medication is reaching a therapeutic level? A. HR 94 B. Uterus is firm C. BP 100/80 D. O2 stat 85%

B. Uterus is firm

The nurse is caring for a patient who is being treated with magnesium sulfate therapy to manage pregnancy induced hypertension. The nurse observes respiratory depression and loss of deep tendon reflexes. Which intravenous medication does the nurse expect the primary health care provider to prescribe? A. Promethazine (Remsed) B. Methotrexate (Trexall) C. Calcium gluconate (Kalcinate) D. Nifedipine (Adalat)

C. Calcium gluconate (Kalcinate)

A client is admitted to the facility in preterm labor. To halt her uterine contractions the nurse expects the physician to order: A. Dinoprostone B. Ergonovine C. Terbutaline D. Betamethasone

C. Terbutaline

The nurse is caring for a patient who has undergone an abortion at 28 weeks of gestation. Which dose of Rho (D) immune globulin does the health care provider prescribe for this patient? A. 300mg of RhoGAM if the patient is Rh-positive B. 300mg of RhoGAM if the patient is Rh-negative C. 300mcg of RhoGAM if the patient is Rh-positive D. 300mcg of RhoGAM if the patient is Rh-negative

D. 300mcg of RhoGAM if the patient is Rh-negative

Deficiency of which nutrient in the mother is associated with neural tube defect in the fetus? A. Vitamin A B. Calcium C. Vitamin C D. Folic Acid

D. Folic Acid

The primigravid client is at +1 station and 9cm dilated. Based on this data, the nurse should first: A. Encourage the client to breathe through the urge to push B. Ask the anesthesiologist to increase epidural rate C. Assist the client to push if she feels the need to do so D. Support family members in providing comfort measures

A. Encourage the client to breathe through the urge to push

The nurse is performing a vaginal exam on a client in labor. The nurse finds the fetal presenting part 1cm above the ischial spines. The nurse should chart the station as: A. Engaged B. -1 station C. +1 station D. Floating

A. Engaged

A nurse is caring for a client who is postpartum. The nurse should identify which of the following findings as an early indicator of hypovolemia cause by hemorrhage? A. Increased pulse and decreasing blood pressure B. Cool, clammy skin and pale mucus membranes C. Dizziness and increasing respiratory rate D. Altered mental status and level of consciousness

A. Increased pulse and decreasing blood pressure

When examining the baby's gastrointestinal system, which finding warrants additional assessment by the nurse? A. No bowel movements in the first 36 hours B. Greenish black stool C. Small amount of regurgitation after breast feeding D. Hyperactive bowel sounds

A. No bowel movements in the first 36 hrs

Umbilical cord prolapse occurs with spontaneous rupture of membranes. What should the nurse do immediately? A. Place the client in a Trendelenburg position B. Call for help, relieve pressure off cord C. Administer oxytocin IV D. Ask the client to begin pushing

A. Place the client in a Trendelenburg position

The nurse is developing a plan of care for the postpartum patient during the "taking hold" phase. Which of the following should the nurse include in the plan? A. Provide the patient with nutritious meals B. Assure the client that she is doing a good job with diaper changing C. Encourage the patient to take a nap D. Discuss contraceptive choices with the mother

A. Provide the patient with nutritious meals

A client whose cervix is 10 cm dilated begins to push. The nurse notes early decelerations of the fetal heart rate. The nurse interprets this finding as being cause by which factor? A. Fetal bradycardia B. Fetal head compressions C. Cord compression D. Inadequate uteroplacental perfusion

B. Fetal head compressions

In a woman who is suspected of having a ruptured ectopic pregnancy, the nurse would expect to assess for which of the following as a priority? A. Jaundice B. Hemorrhage C. Hypertension D. Edema

B. Hemorrhage

A nurse is providing discharge teaching to the parents of a newborn regarding circumcision care using a gomco clamp. Which of the following statements made by a parent indicates an understanding of the teaching? A. I should remove the yellow mucus that will form B. I will clean his penis with each diaper change and apply vasoline C. I will give him a tub bath after the procedure to clean the blood off D. If the ring slides down the shaft call your pediatrician

B. I will clean his penis with each diaper change and apply vasoline

The nurse performs a nonstress test to evaluate fetal wellbeing. The client is getting nervous and anxious about the situation. She asks the nurse why they are doing a nonstress test. What is the nurses best response? A. It measures late decelerations of the HR in response to uterine contractions B. It evaluates the HR of the fetus in response to its own movements C. It measures the oxygen levels of the fetus D. It measures accelerations of the HR in response to uterine contractions

B. It evaluates the HR of the fetus in response to its own movements

A nurse is caring for an antepartum patient who has an initial HCT of 31% and an HGB of 10g/dL. The patient is diagnosed with long standing iron deficiency anemia. When teaching the patient about nutrition, the nurse should emphasize the need for an increased intake of: A. Fresh fruits B. Red and organ meat C. Milk and cheese D. Low fat yogurt

B. Red and organ meat

A nurse is instructing a client who is taking an oral contraceptive about the danger signs to report to her provider. The nurse determines the client understands the teaching when the client states the need to report which of the following? A. Headaches B. Shortness of breath C. Reduce menstrual flow D. Breast tenderness

B. Shortness of breath

An external fetal electronic monitor displays FHR decelerations that begin after the contraction has begun and return to baseline long after the contraction is over. The nurse determines that the fetus is experiencing: A. This is not an abnormal finding B. Late decelerations C. Early decelerations D. Mild variable decelerations

C. Early decelerations

A client in labor is attached to an electronic fetal monitor (EFM). Which finding by the EFM indicates adequate uteroplacental and fetal perfusion? A. Variable decelerations and sinusoidal pattern B. Persistent fetal bradycardia C. Fetal heart rate variability within 5-10 bpm D. Late decelerations

C. Fetal heart rate variability within 5-10 bpm

The patient is attempting a vaginal delivery. The head is born easily over an intact perineum but does not rotate externally and retracts back against the perineum. The HCP recognizes these signs as an indication of shoulder dystocia. What action should be taken by the nurse? A. Notify the OR and prepare for a C-Section B. Administer 0.25mg of terbutaline sulfate subcutaneously C. Help reposition the patient using McRoberts maneuver D. Apply external pressure to the uterine fundus

C. Help reposition the patient using McRoberts maneuver

A nurse is assessing the reflexes of a newborn. In checking for the Moro reflex, the nurse should perform which of the following? A. Hold the newborn vertically under arms and allow one foot to touch the table B. Stimulate the pads of the newborns hands with stroking in message C. Hold the newborns head and shoulders slightly off the crib holding arms, then suddenly release the arms and allow the newborns head and trunk to fall backwards D. Stimulate the soles of the newborns feet on the outer lateral surface of each foot

C. Hold the newborns head and shoulders slightly off the crib holding arms, then suddenly release the arms and allow the newborns head and trunk to fall backwards

A nurse is preparing to administer a vitamin K injection to a newborn. Which of the following responses would the nurse make to the newborns mother regarding why this medication is given? A. It promotes maturation of the bowel B. It provides immunity C. It assist with blood clotting D. It is a preventative vaccine

C. It assist with blood clotting

During the second stage of labor the nurse would document: A. The time of the placental delivery B. The infants APGAR score C. The fundal assessment D. The time of the infants birth

C. The fundal assessment

What should be the nurses priority assessment after an epidural anesthetic has been given to a nulligravid client in active labor? A. Contraction pattern B. Level of consciousness C. Cognitive function D. Blood pressure

D. Blood pressure

A nurse is teaching a client who is breastfeeding and has mastitis. Which of the following responses should the nurse make? A. Nurse the infant only on the unaffected side until resolved B. Wear a tight fitting bra until lactation has ceased C. Limit the amount of time the infant nurses each breast D. Completely empty each breast at each feeding or use a pump

D. Completely empty each breast at each feeding or use a pump

Which findings would the nurse expect to find in a client with bacterial vaginosis? A. Vaginal pH of 3 B. Yellowish green discharge C. Cervical bleeding on contact D. Fish like odor or discharge

D. Fish like odor or discharge

The practical nurse at the clinic reviews a patients prenatal history. The patient is in the office for her first prenatal visit after confirming her pregnancy with an ultrasound. She has given birth twice. Once at 35 weeks (twins) and once at 39 weeks (single). All of these children are alive and well. She had one spontaneous abortion at 9 weeks gestation. How should the nurse record the patients obstetrical history using G-T-P-A-L system? A. G-3 T-2 P-0 A-1 L-3 B. G-3 T-1 P-1 A-1 L-2 C. G-4 T-2 P-1 A-0 L-2 D. G-4 T-1 P-1 A-1 L-3

D. G-4 T-1 P-1 A-1 L-3

If a pregnant woman is not immune to rubella, the expected action is to: A. Tell her that there is little risk for the problem B. Inform her that her baby may have defects C. Limit her contact with other pregnant woman D. Immunize her early in the postpartum

D. Immunize her early in the postpartum

A nurse is caring for a newborn who is preterm and has respiratory distress syndrome. Which of the following should the nurse monitor to evaluate the newborns condition following administration of synthetic surfactant? A. Serum bilirubin B. Body temp C. Heart rate D. Oxygen saturation

D. Oxygen saturation

A full term client is admitted for an induction of labor. The HCP has assigned a Bishop score of 10. Which drug would the nurse anticipate administering to this client? A. Methergine 200mg B. Magnesium Sulfate 1G C. Terbutaline 2.5mg D. Oxytocin 20 units in 1000mL D5W

D. Oxytocin 20 units in 1000mL D5W

A nurse in a prenatal clinic is caring for a patient who has been prescribed dinoprostone (Prepidil) gel. The nurse explains to the patient that the purpose of dinoprostone is to do which of the following? A. Stimulate uterine contractions B. Relax uterine contractions C. Cause the patient to abort her pregnancy D. Promote softening of the cervix

D. Promote softening of the cervix

The RN prepares to give the infant a bath. Which data if noted should indicate that the infants bath should be postponed? A. Temp 36.9 axillary B. Pulse ox of 98% C. Apical HR of 138 D. RR of 64

D. RR of 64

The HCP ordered a nonstress test. Which fetal heart rate change indicates a reactive non stress test? A. Persistent late decelerations as associated with 3 uterine contractions lasting 40-60 seconds each in a 10 min period B. An increase in the FHR baseline to 170 bpm lasting 2o mins C. Marked long term FHR variability in response to contractions cause by nipple stimulation D. Two episodes of acceleration >15 BPM, lasting > 15 seconds related to fetal movement in a 20 min period

D. Two episodes of acceleration >15 BPM, lasting > 15 seconds related to fetal movement in a 20 min period