OB Exam
Nausea and vomiting Dizziness Abdominal Pain
A woman is to receive methotrexate IM for an ectopic pregnancy. The nurse should teach the woman about which of the following common side effects of the medication. Select all that apply. Nausea and vomiting Dizziness Breast tenderness Fatigue Abdominal pain
Sexually transmitted infections
A woman seen in the emergency department, is diagnosed with pelvic inflammatory disease (PID), Before discharge, the nurse should provide the woman with health teaching regarding which of the following? Endometriosis Ovarian hyperstimulation Menopause Sexually transmitted infections
A 3-hour fasting glucose tolerance test
At 28 weeks's gestation, a client's 1-hour nonfasting glucose tolerance test is elevated. The nurse explains that, based on this finding, the client will need to take which action? Monthly hemoglobin A1C levels to rule out gestational diabetes Daily insulin injections for gestational diabetes Daily fingersticks for a fasting blood glucose level A 3-hour fasting glucose tolerance test
Painful vaginal bleeding
Which of the following should the nurse expect when assessing a client with placental abruption? Painful vaginal bleeding Severe nausea and vomiting Painless vaginal bleeding Right epigastric pain
Place the client in the left lateral position
A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition? Keep the client's legs elevated Keep the head of the client's bed slightly elevated Place the client in supine position Place the client in the left lateral position
Low platelet count
A client is admitted to the hospital with pre-eclampsia with severe features and HELLP syndrome. The nurse will assess for which of the following signs/symptoms? High serum protein. Low potassium level Low platetet count. Low serum creatinine.
Terbutaline (BRETHINE)
A client is scheduled for an external version. The nurse would expect to prepare which of the following medications to be administered prior to the procedure? Betamethasone (CELESTONE) Ergonovine (METHERGINE) Oxytocin (PITOCIN) Terbutaline (BRETHINE)
The physician should see you. Please go to the emergency department.
A client, who is 2-weeks postpartum, calls the obstetrician's nurse and states that she has had a whitish discharge for 1 week, but today she is "bleeding and saturating a pad about every 1/2 hour". Which of the following is an appropriate response by the nurse? The physician should see you. Please go to the emergency department. You should stay on complete bed rest until the bleeding subsides. Pushing during a bowel movement may have loosened your stitches. That is normal. You are starting to menstruate again.
12 months
A couple is considered infertile after how many months of trying to conceive? 12 months 24 months 18 months 6 months
Occiput posterior
A laboring client complains of lower back pain. The nurse replies that this pain occurs most when the position of the fetus is? Occiput anterior Right occiput posterior Occiput posterior Left occiput transverse
Vitamin K is needed for coagulation, and the newborn does not produce vitamin K in the first few days following birth.
A mother asks the nurse why her newborn receives a vitamin K injection in the birth room. The nurse explains that the injection is necessary because: Newborns are prone to hypoglycemia, and vitamin K helps maintain a steady blood glucose level. Vitamin K aids in protein metabolism. Newborns have defective protein metabolism until 24 hours of life. The mother was febrile at the time of birth, and prophylactic vitamin K is necessary. Vitamin K is needed for coagulation, and the newborn does not produce vitamin K in the first few days following birth.
Prepare equipment for possible newborn respiratory resuscitation
A nurse is caring for a client who is in active labor and has meconium staining of the amniotic fluid. The nurse notes a reassuring FHR tracing from the external fetal monitor. Which of the following actions should the nurse take? Prepare equipment for possible newborn respiratory resuscitation Prepare the client for an emergency cesarean birth Prepare the client for an ultrasound examination Change the client's position to left lateral
Administer IV normal saline with vitamins and electrolytes
A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priority for this client? Administer an antiemetic Administer IV normal saline with vitamins and electrolytes Set up for a percutaneous endoscopic gastrostomy Administer parentereal nutrition
Shield the newborn's eyes
A nurse is caring for a newborn with jaundice undergoing phototherapy. What intervention is appropriate when caring for the newborn? Expose the newborn's skin minimally Discourage feeding the newborn Shield the newborn's eyes Discontinue with frequent green, tarry stools
Deep tendon reflexes of +1
A nurse is caring for an adolescent client who is gravida 1 para 0. The client was admitted to the hospital at 38 weeks's gestation with a diagnosis of preeclampsia. Which of the following findings should the nurse identify as inconsistent with preeclampsia. 3+ protein in the urine (proteinuria) Deep tendon reflexes of +1 1+ pitting edema Elevated blood pressure
Occiput posterior position
A nurse is preparing an in-service education program for a group of nurses about dystocia involving problems with the passenger. Which problem would the nurse likely include as the most common? Occiput posterior position Macrosomia (large fetus) Multifetal pregnancy (multiple fetuses) Breech presentation
Respiratory Rate
A nurse is preparing to administer magnesium sulfate IV to a client experiencing preterm labor. Which of the following is the priority nursing assessment for this client? Fetal heart rate (FHR) Temperature Bowel sounds Respiratory rate
1 cm above the ischial spines
A nurse is reviewing the record of a client in the labor room and notes that the nurse midwife has documented the fetus is at (-1) station. The nurse determines that the fetal presenting part is? I finger breadth (fb) below the symphysis pubis 1 cm below the ischial spines 1 cm below the illiac crest 1 cm above the ischial spines
Pap smear Complete blood count (CBC)
A patient in the 1st trimester of her first pregnancy is having her first prenatal examination. Which of the following assessments should the nurse inform the client that she will have that day? Select all that apply Mammogram Glucose tolerance test Pap smear Complete blood count (CBC) Biophysical profile
Two fingerbreadths (cm) below the umbilicus
A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the client's fundus and documents which finding as normal? Two fingerbreadths (cm) above the umbilicus One fingerbreadth (cm) below the umbilicus Two fingerbreadths (cm) below the umbilicus At the level of the umbilicus
Allow time for the mother to reflect on the events of the birth experience
A primipara woman is in the dependent, Taking-in phase of the Maternal Adaptation to Parenthood adjustment following birth. The nurse recognizes the needs of the patient during this stage should include? Allow time for the mother to reflect on the events of the birth experience Help the mother play an active role in meeting the baby's needs Provide tools to help with postpartum baby blues Promote the resumption of the family as a unit
The client complains of headache and blurred vision
A woman has been diagnosed with preeclampsia with mild features. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the health care provider? The client has a drop in blood pressure The client complains of headache and blurred vision The client has increased urinary output The client has bright painless vaginal bleeding
Vaginal and rectal cultures
A woman is 36 weeks' gestation. Which of the following tests will be done during her prenatal visit? Vaginal and rectal cultures Karyotype analysis Oral glucose tolerance test Amniotic fluid volume assessment
Obtain a blood glucose level
The neonatal intensive care nurse is admitting a large-for-gestational age (LGA) infant with respiratory distress who has difficulty with hypothermia, appears lethargic, is jittery, and is not feeding well. What would be the nurse's first action? Order a stool sample for possible illicit drug exposure Obtain a blood glucose level Place infant under a radiant warmer Continure monitoring hourly
28 cm
The nurse is measuring the fundal height of a woman who is at 28 weeks' gestation. Which measurement would the nurse expect? 28 cm 18 cm 32 cm 12 cm
Decreased blood volume
The nurse monitors her postpartum client for which of the following normal physiological changes during the early postpartum period? Decreased blood volume Decreased white blood cell count Increased temperature Decreased urinary output
Massage the uterus
The. nurse is preparing to assess the uterine fundus of a client in the immediate postpartum period. After locating the fundus, the nurse notes that the uterus feels soft and boggy. Which nursing intervention is appropriate? Ask the client to turn to her left side Encourage the client to get plenty of rest Massage the uterus Elevate the client's legs
Age 25, G4 P3, last delivery by cesarean section
There are four clients in the labor suite. Each client's labor is being augmented with Oxytocin (Pitocin). Which of the women should the nurse monitor carefully for the potential of uterine rupture? Age 22, G3 P0, preeclampsia with mild features Age 25, G4 P3, last delivery by cesarean section Age 32, G2 P1, fetus has died during labor Age 15, G1 P0, in active labor
a respiratory rate of 15 bpm wih nasal flaring
Upon assessing the newborn's respirations, which finding would cause the nurse to notify the primary care provider? a respiratory rate of 50 bpm with acrocyanosis a respiratory rate of 15 bpm wih nasal flaring coughing and sneezing in the newborn short periods of apnea that last 10 seconds in a pink newborn
Rh-negative mother with an Rh-positive newborn
Which woman should receive RHoGAM postpartum? Rh-positive mother with an Rh-negative newborn Rh-positive mother with an Rh-positive newborn Rh-negative mother with an Rh-negative newborn. Rh-negative mother with an Rh-positive newborn
Dilatation and curettage
A 25-year-old is admitted with the following history: 12 weeks pregnant, vaginal bleeding, no fetal heartbeat seen on ultrasound. The nurse would expect the doctor to write an order to prepare the client for which of the following procedures? Dilatation and curettage Cervical cerclage Continuous fetal heart rate monitoring Fallopian tube repair
Inform the client that ambilvalence is a normal response to pregnancy that many women experience.
A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious about its implications. Which action should the nurse take next? Determine if the client's significant other is experiencing similar feelings about the pregnancy. Schedule the client a consult with a psychiatric health care provider. Provide the client with information about pregnancy support groups. Inform the client that ambilvalence is a normal response to pregnancy that many women experience.
Hepatitis B Group B Streptococcus Rubella HIV/AIDS
A client enters the labor and delivery suite. It is essential that the nurse note the woman's status in relation to which of the following infectious diseases? Select all that apply Hepatitis B Varicella Group B Streptococcus Rubella HIV/AIDS
brown fat tissue
A newborn is unable to shiver until about three months of age when it is cold. At birth, the primary method it uses for heat production is through nonshivering thermogenesis. This process oxidizes which substance in response to cold exposure? brown fat tissue white (adipose) tissue muscle tissue glycogen stores
Placental separation
A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as a sign of? Uterine atony Hematoma Placental separation Placenta previa
A nonreactive test result
A nurse cares for a client during a nonstress test (NST). At the end of the 20 minutes of observation, the nurse notes the following findings. The fetal heart rate (FHR) baseline is 120 bpm with minimal variability and no accelerations. There are two decelerations in the fetal heart rate, each lasting 20 seconds. Which of the following interpretations of these findings should the nurse make? A reactive test result A negative test result A nonreactive test result A positive test result
Diet control with exercise
A pregnant client has just been diagnosed with gestational diabetes. Which of the following therapies will most likely be ordered for this client? Fast acting insulin Diet control with exercise Oral hypogycemic agents Slow acting insulin
Cord Compression
After an hour, you look at the fetal monitoring strip and note the following: (Early and late decels) What is the most likely cause of this type of pattern? Head compression Abruptio placentae (placental abruption) Cord compression Uteroplacental insufficiency
Presumptive Presumptive Probable Presumptive Probable Positive
Classify each sign into the correct category of Signs of pregnancy. (Presumptive, Probable, Positive) Amenorrhea Nausea and vomiting Positive pregnancy test Fatigue Chadwick's Sign Fetal heart sounds
Ask the client to empty her bladder
On completing a fundal assessment, the nurse notes the fundus is boggy (relaxed) and situated laterally in the client's left abdomen (shifted to the left). Which of the following actions is appropriate? Ask the client to empty her bladder Massage the uterus until constricted Increase the Pitocin Call the healthcare provider (HCP)
McRobert's maneuver
Shoulder dystocia is a medical emergency that can cause fetal demise because the baby cannot be born. When stuck in the birth canal, the infant cannot take its first breath. Which maneuver is first attempted to deliver an infant with shoulder dystocia? McDonald's maneuver McRonald's maneuver McGeorge's maneuver McRobert's maneuver
Amniocentesis
The nurse discovers a new prescription for RhoGHAM for a client who is undergoing a diagnostic procedure. The nurse will administer the medication after which procedure? Biophysical profile Quad marker test Amniocentesis Nonstress test
Prevent Seizures
When administering magnesium sulfate to a client with preeclampsia with severe features, the nurse explains that the primary reason the drug is given is to? Prevent seizures Slow uterine contractions Decrease blood glucose levels Lower blood pressure
Monitor the fetus for respiratory depression
When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in the client's pulse. What should the nurse do next? Assess the client's temperature Monitor the client for preterm labor Assess for cord compression Monitor the fetus for respiratory depression
Change the client's position
When examining the fetal monitor strip after the rupture of membranes (ROM) in a laboring client, the nurse notes variable decelerations in the fetal heart rate. The nurse should? Stop the oxytocin (pitocin) perfusion Take the client's blood pressure Prepare for immediate delivery Change the client's position
respiratory and cardiovascular
When explaining how a newborn adapts to extrauterine life, the nurse would describe which body systems as undergoing the most rapid changes? urinary and hematologic respiratory and cardiovascular neurological and integumentary gastrointestinal and hepatic
Allows fetal oxygenation
When you assess the uterine contractions of your laboring client, you explain that the relaxation periods between contractions are important for which of the following reasons? Prevents uterine ischemia Allows fetal oxygenation Avoids uterine rupture Permits fetal assessment
Delusional beliefs
On a follow-up visit to the clinic, a nurse suspects that a postpartum client is experiencing postpartum psychosis. Which finding would most likely lead the nurse to suspect this condition? Feelings of anxiety Delusional beliefs Withdrawal from family and friends Feelings of worthlessness
Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus
A nurse explains the purpose of effleurage to a client in early labor. The nurse tells the client effleurage is? A form or biofeedback to enhance bearing down efforts during delivery Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus The application of pressure to the sacrum to relieve back pain Performed to stimulate uterine activity by contracting a specific muscle group while other parts of the body rest
Excessive uterine enlargement
A nurse in a prenatal clinic is caring for a client suspected of having a hytadidiform mole. Which findings should the nurse expect to observe in this client? Excessive uterine enlargement Irregular fetal heart rate Rapid decine in human chorionic gonadotopin (hCG) levels Profuse, clear vaginal discharge
It assists in identifying the location of the placenta and fetus
A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound. Which of the following is an appropriate response by the nurse? This is a screening tool for spina bifida This will determine if there is more than one fetus It assists in identifying the location of the placenta and fetus It is useful for estimating fetal age
Placental abruption
A nurse in the antepartum unit is caring for a client who is at 36 weeks' gestation and has preeclampsia. Suddenly, the client reports continuous abdominal pain and vaginal bleeding. The nurse should suspect which of the following complications? Placental abruption Incompetent cervix Placenta previa Prolapsed cord
Call for assistance and stat page the physician
A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following would be the initial nursing action? Administer oxygen via face mask Gently push the cord back into the vagina Call for assistance and stat page the physician Place the client in side lying position
Seizures Right epigastric pain Persistent vomiting
A nurse is advising a pregnant woman about the danger signs of pregnancy. The nurse should teach the mother to notify the physician immediately if she experiences which of the following signs/symptoms? Select all that apply Constipation Polyuria Seizures Right epigastric pain Persistent vomiting
An excessive amount of amniotic fluid
A nurse is caring for a client admitted to the maternity unit at 38 weeks of gestation and experiencing polyhydramnios. The nurse should understand that this diagnosis means which of the following? The fetus is likely to have a congenital anomaly, be growth restricted, or demonstrate fetal distress during labor The client is carrying more than one fetus There is an elevated level of alpha-fetoprotein (AFP) in the amniotic fluid An excessive amount of amniotic fluid
Shortly after giving birth
A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client's blood work the nurse notices she does not have immunity to rubella. Which of the following times should the nurse understand is recommended for rubella immunization? Shortly after giving birth During her next attempt to get pregnant Immediately In the third trimester
A fetal heart rate that drops after the peak of the contraction
A nurse is caring for a client in labor who is receiving Pitocin by IV infusion to stimulate uterine contractions. Which assessment finding would indicate to the nurse that the infusion needs to be discontinued? Maternal hypertension Three uterine contractions within a 10-minute period A fetal heart rate that drops after the peak of the contraction A fetal heart rate that drops at the beginning of the contraction
The cervix is dilated completely
A nurse is caring for a client in labor. The nurse determines that the client is beginning the 2nd stage of labor when which of the following assessments is noted? The neonate has been birthed The contractions are strong and regular The cervix is dilated completely The client begins to expel clear amniotic fluid
The test is a screening test for neural tube defects in the fetus
A nurse is caring for a client scheduled for a maternal serum alpha-fetoprotein test at 15 weeks gestation. The nurse provides which of the following explanations about this test? This test measures uteroplacental function This test assesses fetal lung maturity The test is a screening test for neural tube defects in the fetus This test assesses various parameters of fetal-well being
Heart rate 110/minute
A nurse is caring for a client who is 12 hr postpartum. Which of the following findings should alert the nurse to the possibility of a postpartum complication? Urine output of 3,000 mL in 12 hrs. Orthostatic hypotension Fundus palpable at the umbilicus Heart rate 110/minute
Cervical dilation 0-6 cm. Cervical effacement 0%-40% Cervical dilation 6-10 cm. Cervical effacement 40%-100% From complete dilation to birth of the newborn Separation and delivery of the placent Physiological adjustment and stabilization
Please match the Stages of Labor with the correct definition: First Stage, Latent phase First Stage, Active phase Second Stage Third Stage Fourth Stage
Lasts from day 4 to day 10 Lasts from day 1 to day 3 Last from day 11 to week 6
Please match the following Stages of Lochia with the correct timeline: Lochia Serosa Lochia Rubra Locha Alba
Painless vaginal bleeding
Which of the following should the nurse expect when assessing a client with placenta previa? Painful vaginal bleeding Rigid "boardlike" uterine tone Painless vaginal bleeding Severe headache
Perform a vaginal exam to check for crowning of fetal head
While charting on your patient, you look at the monitors and notice another patient's fetal heart monitoring strip. You notice the fetal heart rate decrease 30 bpm below baseline at the same time as the contraction, noting recovery of the deceleration occurring with the recovery of the contraction. Which intervention would be most appropriate? Perform a vaginal exam to check for crowning of fetal head Give an IV bolus of lactated ringers Turn the patient to the left lateral position Place the patient on oxygen via face mask
Document this indicating a normal pattern.
With further monitoring, you notice the presence of transient fetal accelerations on the fetal monitoring strip. Which intervention would be most appropriate? Place the client on oxygen. Document this indicating a normal pattern. Call the health care provider (HCP) Reposition the client to the left lateral side.
Assess the baseline fetal heart rate (FHR)
You are the nurse on a Labor and Delivery unit admitting a client in labor. The priority for this client is to place external monitors, a tocomamometer (to monitor uterine contractions), and an ultrasound doppler (to monitor fetal heart rate). After attaching the electrodes, what is the next nursing action? Determine the frequency of contractions. Identify the types of accelerations. Determine the amount of variability. Assess the baseline fetal heart rate (FHR)
