OB EXAM PRACTICE QUESTIONS PART 2

Which of the following is the priority nursing action during the immediate postpartum period? 1. Palpate fundus 2. Check pain level 3. Perform pericare 4. Assess breast

1. Palpate fundus Fundal assessment is the priority nursing action.

A nurse is performing a postpartum assessment on a client who delivered by cesarean section. Which of the following actions will the nurse perform? Select all that apply. 1. Auscultate the abdomen 2. Palpate the fundus 3. Assess the nipple integrity 4. Assess the central venous pressure. 5. Auscultate the lung fields

1,2,3,5 1. Auscultate the abdomen. The nurse should auscultate the abdomen for presence of bowel sounds. 2. Palpate the fundus. The nurse should palpate the firmness of the fundus. 3. Assess the nipple integrity. The nurse should assess the nipple integrity, especially if the client is breastfeeding. 5. Auscultate the lung fields. The nurse should auscultate the lung fields.

During a postpartum assessment, the nurse assesses the calves of client's legs. The nurse is checking for which of the following signs/symptoms? Select all that apply. 1.Pain 2. Warmth 3. Discharge 4. Ecchymosis 5. Redness

1,2,5 1.Pain 2. Warmth 5. Redness

A nurse is performing a postpartum assessment on a client who delivered vaginally. Which of the following actions will the nurse perform? Select all that apply. 1. Palpate the breast 2.Auscultate the carotid 3. Check vaginal discharge 4. Assess the extremities 5. Inspect the perineum

1,3,4,5 1. Palpate the breast The nurse should palpate the breast to assess for fullness and /engorgement 3. Check vaginal discharge The nurse should check the client's vaginal discharge. 4. Assess the extremities The nurse should assess the client's extremities. 5. Inspect the perineum The nurse should inspect the client's perineum.

A nurse is assessing the fundus of a client during the immediate postpartum period. Which of the following actions indicates that the nurse is performing the skill correctly? 1. The nurse measures the fundal height using a paper centimeter tape. 2. The nurse stabilizes the base of the uterus with his or her dependent hand. 3. The nurse palpates the fundus with the tips of his or her fingers. 4. The nurse precedes the assessment with a sterile vaginal exam.

2. The nurse stabilizes the base of the uterus with his or her dependent hand.

The nurse is evaluating the involution of a woman who is 3 days postpartum. Which of the following finding would the nurse evaluate as normal? 1. Fundus 1 cm above the umbilicus, lochia rosa. 2. Fundus 2 cm above the umbilicus, lochia alba. 3. Fundus 2 cm below the umbilicus, lochia rubra. 4. Fundus 3 cm below the umbilicus, lochia serosa.

2. Fundus 2 cm above the umbilicus, lochia alba. The nurse would expect that the client would have lochia alba.

The surgeon has removed the surgical cesarean section dressing from a postop day 1 client. Which of the following actions by the nurse is appropriate? 1. Irrigate the incision twice daily. 2. Monitor the incision for drainage. 3. Apply steristrips to the incision line 4. Palpate the incision and assess for pain.

2. Monitor the incision for drainage. This is appropriate. The nurse should assess for all signs on the REEDA scale.

A breastfeeding woman has been counseled on how to prevent engorgement. Which of the following actions by the mother shows that the teaching was effective? 1. She pumps her breast after each feeding. 2. She feeds her baby every 2 to 3 hours. 3. She feeds her baby 10 minutes on each side. 4. She supplements each feeding with formula.

2. She feeds her baby every 2 to 3 hours. The best way to prevent engorgement is to feed the baby every 2 to 3 hours.

The nurse is assessing the midline episiotomy on a postpartum client. Which of the following findings should the nurse expect to see? 1. Moderate serosanuinous drainage. 2. Well-approximated edges. 3. Ecchymotic are distal to the episiotomy. 4. An area of redness adjacent to the incision.

2. Well-approximated edges. The nurse would expect to see well-approximated edges.

The third stage of labor has just ended for a client who has decided to bottle feed her baby. Which of the following hormones will increase sharply at this time? 1. Estrogen 2.Prolactin 3. Human placental lactogen 4. Human chorionic gonadotropin.

2.Prolactin Prolactin will elevate sharply in the client's bloodstream.

A client has just been transferred to the postpartum unit from labor and delivery. Which of the following tasks should the registered nurse delegate to the nursing care assistant? 1.Assess client's fundal height. 2. Teach client how to massage her fundus 3. Take the client's vital signs. 4. Document quantity of lochia in the chart.

3. Take the client's vital signs. This action can be delegated to a nursing assistant. Once the vital signs are checked, the nursing assistant can report the results to the nurse for his or her interpretation.

The nurse is examining a 2-day -postpartum client whose fundus is 2 cm below the umbilicus and whose bright red lochia saturates about 4 inches of a pad in 1 hour. What should the nurse document in the nursing record? 1. Abnormal involution, lochia rubra heavy. 2. Abnormal involution, lochia serosa scant. 3. Normal involution, lochia rubra moderate. 4.Normal involution, lochia serosa heavy.

3. Normal involution, lochia rubra moderate. This response is correct. The involution is normal and the lochia is rubra.

The nurse is developing a standard care plan for postpartum clients who have had midline episiotomies. Which of the following interventions should be included in the plan? 1. Assist with stitch removal on the third postpartum day. 2. Administer analgesic every four hours per doctor's orders. 3. Teach the client to contract her buttocks before sitting. 4. Irrigate the incision twice daily with antibiotic solution.

3. Teach the client to contract her buttocks before sitting. This statement is correct. When a clients contract their buttocks before sitting, they usually feel less pain then when they sit directly on the suture line.

A client has just been transferred to the postpartum unit from labor and delivery. Which of the following nursing care goals is of highest priority? 1. The client will breastfeed her baby every 2 hours. 2. The client will consume a normal diet. 3. The client will have a moderate lochial flow. 4. The client will ambulate to the bathroom every 2 hours.

3. The client will have a moderate lochial flow. This is the most important goal during the immediate post-delivery period.

A breastfeeding mother states that she has sore nipples. In response to the complaint, the nurse assist with "latch on " and recommends that the mother do which of the following? 1. Use a nipples shield at each breastfeeding. 2.Cleanse the nipple with soap 3 times a day. 3.Rotate the baby's positions at each feed. 4.Bottle feed for 2 days then resume breastfeeding.

3.Rotate the baby's positions at each feed. Rotating positions at feeding is one action that can help to minimize the severity of sore nipples.

The nurse hears the following information on a newly delivered client during shift report: 21 years old, married, G1 P1001, 8 hours post-spontaneous vaginal delivery over an intact perineum: vitals 110/70, 98.6F, 82, 18; fundus firm at umbilicus; moderate lochia rubra; ambulated to bathroom to void 4 times; breastfeeding every 2 hours. Which of the following nursing diagnoses should the nurse include in this client's nursing care plan? 1. Fluid volume deficit r/t excess blood loss. 2. Impaired skin integrity r/t vaginal delivery 3. Impaired urinary elimination r/t excess output. 4. Knowledge deficient r/t lack of parenting experience.

4. Knowledge deficient r/t lack of parenting experience. This client is a primigravida. The nurse would anticipate the she is in need of teaching regarding newborn care as well as self-care.