OB 14

. She states that she's in labor and says she attended the facility clinic for prenatal care. Which question should the nurse ask her first?

"What is your expected due date?"

After completing a second vaginal examination of a client in labor, the nurse-midwife determines that the fetus is in the right occiput anterior position and at -1 station. Based on these findings, the nurse-midwife knows that the fetal presenting part is:

. 1 cm above the ischial spines.

A client who is 29 weeks pregnant comes to the labor and delivery unit. She states that she's having contractions every 8 minutes. The client is also 3 cm dilated. Which medications can the nurse expect to administer?

1. Betamethasone 2. Terbutaline (Brethine)

The nurse is doing a neurologic assessment on a 1-day-old neonate in the nursery. Which findings would indicate possible asphyxia in utero?

1.The neonate's toes don't curl downward when soles of feet are stroked

The nurse demonstrates infant bathing to a primiparous client. Which statement by the client indicates a lack of understanding?

2. "I have all kinds of pretty, scented soaps and lotions to bathe the baby with.

Which of the following describes a preterm neonate

A neonate born at less than 37 weeks' gestation regardless of weight RATIONALES: A preterm neonate is a neonate born at less than 37 weeks' gestation regardless of what the neonate weighs. Neonates weighing less than 2,500 g are described as low-birth-weight neonates. A neonate who's small for gestational age weighs below the 10th percentile (or two standard deviations below the mean) as a result of intrauterine growth retardation.

A client in labor for the past 10 hours shows no change in cervical dilation and has stayed at 5 to 6 cm for the past 2 hours. Her contractions remain regular at 2-minute intervals, lasting 40 to 45 seconds. Which of the following would be the nurse's initial action

Assess for presence of a full bladder. RATIONALES: A full bladder will slow or stop cervical dilation and produce symptoms that could be misdiagnosed as arrest in labor. Other strategies, such as internal uterine monitoring, relaxation, and oxytocin augmentation, would be appropriate later, but assessing the bladder first is key.

For a client who's fully dilated, which of the following actions would be inappropriate during the second stage of labor?

Assessing for rupture of membranes

Which of the following is the primary reason for putting breast-feeding neonates to the breast immediately after delivery?

Breast-feeding neonates immediately after birth establishes a learned response

When assessing the fetal heart rate tracing, the nurse becomes concerned about the fetal heart rate pattern. In response to the loss of variability, the nurse repositions the client to her left side and administers oxygen. These actions are likely to improve which of the following

Fetal hypoxia

The neonate's respiratory function stabilizes about 24 hours after birth and is maintained by the effects of biochemical and environmental stimulation. What four physiologic conditions must be present in order for the neonate's respiratory functioning to proceed?

Functioning respiratory center, patent airway, intact nerves from RATIONALES:

The nurse is assessing a woman in labor. Her cervix is dilated 8 cm. Her contractions are occurring every 2 minutes. She's irritable and in considerable pain. What type of breathing should the nurse instruct the woman to use during the peak of a contraction?

RATIONALES:

Which of the following describes the term fetal position?

Relationship of the fetus's presenting part to the mother's pelvis RATIONALES: Fetal position refers to the relationship of the fetus's presenting part to the mother's pelvis. Fetal posture refers to "attitude." Presentation refers to the part of the fetus at the cervical os. Lie refers to the relationship of the fetal long axis to that of the mother's long axis.

Which of the following correctly defines puerperium?

The 6 weeks following birth

For a client in active labor, the nurse-midwife plans to use an internal electronic fetal monitoring (EFM) device. What must occur before the internal EFM can be applied?

The membranes must rupture.

A term neonate's mother is O-negative, and cord studies indicate that the neonate is A-positive. Which of the following would be least likely if the neonate developed hemolytic disease?

Weight loss greater than 10%

The nurse is assessing a client on the 2nd postpartum day. Under normal circumstances, the tone and location of the client's fundus is:

firm and two fingerbreadths below the umbilicus RATIONALES: By the 2nd postpartum day, the fundus should be firm and two fingerbreadths below the umbilicus. The fundus should be at the level of the umbilicus on the day of delivery and falls below the umbilicus by approximately one fingerbreadth (1 cm) per day, until it has contracted into the pelvis by the 9th or 10th day. The fundus should be firm, not soft. A soft or boggy fundus indicates that the uterus isn't contracting properly. The fundus should be palpated in the midline of the abdomen; if the woman has a full bladder, however, the fundus may be deviated to the right or left.

A client who used heroin during her pregnancy delivers a neonate. When assessing the neonate, the nurse expects to find

irritability and poor sucking

A primigravid client, age 20, has just completed a difficult, forceps-assisted delivery of twins. Her labor was unusually long and required oxytocin (Pitocin) augmentation. The nurse who's caring for her should stay alert for

uterine atony

A full-term neonate is diagnosed with hydrocephalus. Nursing assessment is most likely to reveal:

wide or bulging fontanels.