NUR 418 Quizzes and PP Questions for Exam 3

The provider wants to insert an intra-uterine pressure catheter (IUPC) into a pregnant patient. Which patient does the nurse recognize as the patient most likely to warrant placement of an IUPC? 1.A patient whose membranes are ruptured, has an exam of 5/90/-2 and a worsening category II tracing 2.A patient progressing 2 cm an hour, but doesn't feel her contractions because of her epidural 3.A patient with a BMI of 40 in latent labor 4. A patient with a category I tracing

1

To decrease the risk of bleeding following a cesarean section, the nurse administers which medication to the client following delivery of the infant? 1.Oxytocin 2.Magnesium Sulfate 3.Famotidine 4.Cefozolin

1

The nurse in a postpartum unit evaluates new parents for risk factors that can indicate problems with bonding/attachment. Which situations does the nurse recognize as a cause for bonding/attachment problems? Select all that apply. 1. The mother experienced eclampsia in the third trimester of pregnancy. 2. The neonate is being treated for meconium aspiration syndrome. 3. The mother experienced dystocia in the second phase of labor. 4. The father of the neonate is in the military and not yet home on leave. 5. The mother's mother lives next door and is available to help with the baby.

1, 2, 3

A patient had spontaneous rupture of membranes and is in active labor with oxytocin augmentation. The FHR is presently 150 with no accelerations. Which is the priority nursing action for this patient? 1.Notify the provider 2.Assess maternal vital signs 3.Discontinue oxytocin 4.Administer an IV fluid bolus

2

A postpartum patient reports dysuria, urinary urgency, and small frequent voids. Which postpartum complication should the nurse suspect? 1.Vaginal hematoma 2.Urinary tract infection 3.Urinary retention 4.Endometritis

2

The nurse is assessing a postpartum patient who had an uncomplicated vaginal delivery one hour ago. Which assessment finding requires immediate intervention? 1.Temperature 99.8 F (37.7 C) 2.Pulse 120 beats/min 3.Respiratory rate 16 breaths/min 4.Blood pressure 152/88 mmHg

2

The nurse is preparing a client in the operating room for a cesarean section. The client asks the nurse why a roll is being placed under the hip. How should the nurse respond? 1."The hip tilt position allows the provider easier access to the uterus for delivery." 2. "The hip tilt position eases pressure on the inferior vena cava and decreases the risk of hypotension." 3."The hip tilt position allows for a quicker delivery of the infant during the c-section." 4."The hip tilt position decreases bladder distention and reduces the risk of bladder injury during surgery."

2

A gravid patient is undergoing induction of labor with oxytocin. The nurse assesses the uterine contractions and notes that there are six contractions in 10 minutes, and the FHR is abnormal. Which is the priority nursing action? 1.Administer oxygen via face mask. 2.Decrease the oxytocin dose. 3.Discontinue oxytocin. 4.Notify the provider.

3

A nurse is preparing to administer the Measles, Mumps, and Rubella (MMR) vaccine to a patient before discharge from the hospital. What question is important for the nurse to ask prior to administering the vaccine? 1."Have you ever had this vaccine before?" 2."Which arm do you prefer I give this in?" 3."Do you plan on becoming pregnant again in the near future?" 4. "Did you recently receive the flu vaccine?"

3

Following an assessment of a mother and infant 4 hours after delivery, the nurse is going to document the stage the mother is in for maternal touch. The nurse observed the mother responding to the infant by using her hand to stroke the infant's head. What stage will the nurse document in the chart? 1.Final stage 2.Third stage 3.Second stage 4.Initial stage

3

The nurse is training a new nurse in the labor and delivery unit. The trainee asks, "How often do we have to assess the fetal heart rate (FHR)?" The nurse instructs the trainee that the frequency of FHR assessment is based on: 1.Hospital census and staffing 2.Type of monitoring (SIA or EFM) 3.Risk status, stage of labor and clinical assessment 4. Patient preference

3

The phone triage nurse at an obstetrical office receives a call from a patient who delivered a healthy infant 1 week ago. The patient states that she is irritable and crying easily. What postpartum concern does the nurse educate the patient on? 1.Postpartum psychosis 2.Postpartum depression 3.Postpartum blues 4.Premenstrual syndrome

3

The student nurse is assisting with discharging an adolescent patient on the postpartum unit. Discharge education on newborn care will need to be provided. What is the student nurse's priority action in preparing the education session ? 1.Insist that the father of the infant be present for the discharge education. 2.Ask the maternal grandmother what has already been taught at home on newborn care. 3.Ask the adolescent what she knows about newborn care. 4.Prepare a video for the adolescent to watch on newborn care.

3

A female patient who is four weeks postpartum reports excessive crying and feelings of guilt since she gave birth. Which condition should the nurse be concerned about with this patient? 1.Postpartum blues 2.Postpartum psychosis 3.Attachment disorder 4.Postpartum depression

4

A laboring patient is experiencing labor dystocia. Which statement correctly describes labor dystocia? 1.Uterine contractions >25 mm Hg with intrauterine pressure catheter 2.Fetal head larger than maternal pelvis 3.Fetal shoulder impacted under the maternal symphysis pubis 4.Difficult labor characterized by abnormally slow labor progress

4

A laboring woman was just assessed by the nurse and found to be 8 cm dilated. She calls the nurse back in the room, stating, "I feel pressure, and I think the baby is coming." Which nursing action has the highest priority? 1.Assist her to the bathroom to relieve her bowels. 2.Explain to the patient that she is not yet completely dilated, and it is normal to feel rectal pressure. 3.Call the attending provider. 4.Perform a cervical exam.

4

The nurse is assessing a gravid patient having a trial of labor after cesarean (TOLAC). Which assessment finding would promptly be reported to the provider? 1.Spontaneous rupture of membranes 2. Unable to urinate after epidural placed 3.Fetal heart rate of 140 with early decelerations 4.Ascending station of the fetal presenting part

4

The nurse is assessing a postpartum patient at risk for deep vein thrombosis (DVT). Which assessment finding should the nurse promptly report? 1.Purple spider-like veins on one thigh 2.Patient reports leg cramps relieved with dorsiflexion of feet 3. Bilateral non-pitting edema in ankles 4.One calf has red area and is warm to the touch

4

The nurse is caring for a patient who is a G4P3 at 38 weeks gestation, contracting every 3 minutes. Which assessment finding by the nurse requires immediate action? 1.Variable decelerations with 2 contractions 2.Contraction duration of 60-70 seconds 3. FHR of 120 per minute for the last 15 minutes 4.Minimal variability

4

The nurse is teaching a prenatal class about postpartum depression (PPD). Which of the following should the nurse include in the teaching? 1.Postpartum depression might cause a woman to have delusions or hallucinations. 2.Postpartum depression causes mood swings and will resolve on its own. 3.Postpartum depression is treated with anti-depressants only if the woman is not breastfeeding. 4.Postpartum depression in the mother can affect the newborn and other children in the family through impaired bonding.

4

The postpartum nurse notices the patient holding the infant in the en-face position. What behavior does the nurse note in the chart about this behavior? 1.Parenting 2.Breastfeeding 3.Attachment 4.Bonding

4

A multiparous patient reports severe uterine cramps the first day after a vaginal delivery. The nurse is aware the patient is breastfeeding and associates the patient's pain primarily with which occurrence? A. An increase in oxytocin release related to the newborn suckling B. The presence of intense afterbirth pains related to multiparity C. An expected response to the daily administration of oxytocin D. The efforts of the uterus to return to a pre-pregnancy condition

A

The nurse is preparing a postpartum patient for discharge. For which reasons does the nurse instruct the patient to call the primary care provider? Select all that apply. A. Foul-smelling lochia B. Hot, red, painful breasts C. Mild headache D. Not sleeping well E. Frequent, painful urination

A, B, E

The nurse is preparing to perform a visual assessment of the perineum of a postpartum patient who had a midline episiotomy. The nurse will use the REEDA acronym. Which assessment finding is most concerning? A. Slight bruising B. Gapping suture line C. Free of drainage D. Soft tissue swelling

B

The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, "I think that my baby is deformed inside and we have to fix him." Which risk factor is most strongly related to possible postpartum psychosis (PPP)? A. Separation from the baby's father B. Personal history of bipolar disorder C. Prolonged labor resulting in cesarean D. Loss of first child from a heart defect

B

The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient? A. Methylergonovine B. Fresh frozen plasma C. Carboprost-tromethamine D. Magnesium sulfate

C

The nurse is providing care for a new mother during a follow-up visit 6 weeks after a vaginal delivery. The mother begins to cry and reports difficulty with eating and sleeping. The nurse identifies postpartum blues and cites which reason as the most likely cause? A. Fatigue related to a "fussy" baby B. Frustration over physical appearance C. Changes in hormonal levels D. Stress related to new mother role

C

The nurse is palpating a patient's uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis? A. To prevent uterine prolapse. (falls out the vagina) B. To prevent uterine movement C. To prevent uterine hemorrhage D. To prevent uterine inversion (inside out)

D

When providing care to a multiparous mother, the nurse needs to assess for the presence of ____________________ between the older children and the new baby.

sibling rivalry