OB Final
The following nursing note was documented in the client's record by the labor room nurse. In which postion was the client born?
With the occiput facing the right anterior quadrant of the pelvis
When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage because:
these measurements may not change until after the blood loss is large.
A nurse is caring for a client who is scheduled to undergo an amnioinfusion. The nurse would question this prescription if which finding is noted upon client assessment?
uterine hypertonicity
A 24-year-old woman presents with vague abdominal pains, nausea, and vomiting. An urine hCG is positive after the client mentioned that her last menstrual period was 2 months ago. The nurse should prepare the client for which intervention if the transvaginal ultrasound indicates a gestation sac is found in the right lower quadrant?
Immediate surgery
A full-term pregnant client is being assessed for induction of labor. Her Bishop score is less than 6. Which prescription would the nurse anticipate?
Insert a Foley catheter into the endocervical canal.
When assessing a postpartum mother, the nurse asks the client how many peripads she has used over the last 4 hours. The mother responds that she has changed her pad 2 to 3 times per hour when they were saturated. What action should the nurse take?
Notify the RN of the finding.
A nurse is assessing a postpartal woman. Which behavior would the nurse interpret as an indication that the woman is entering the taking-hold phase of the postpartal period?
She did her perineal care independently.
A female client presents to the emergency department reporting she recently had a positive home pregnancy test but is now suspected of having an ectopic pregnancy. Which assessment should the nures prioritize?
Shoulder pain
A nurse is assessing a postpartum woman's adjustment to her maternal role. Which event would the nurse expect to occur first?
assuming a passive role in meeting her own needs
A client is now in the second stage of labor. While doing the assessment, which data should the nurse prioritize?
contraction pattern every 15 minutes
The nurse has just administered morphine 2 mg IV to a laboring client. Which change in the fetal heart rate pattern would the nurse prioritize?
decreased variability
After an hour of administering oxytocin intravenously, the nurse assesses a woman's contractions to be 80 seconds in length. The nurse's first action would be to:
discontinue the oxytocin infusion.
The nurse is monitoring a pregnant client admitted to a health care center who is in the latent phase of labor. The nurse demonstrates appropriate nursing care by monitoring the fetal heart rate (FHR) with the Doppler at least how often?
every hour
A postpartum woman has been unable to urinate since giving birth. When the nurse is assessing the woman, which finding would indicate that this client is experiencing bladder distention?
Uterus is boggy.
A nurse is providing care to a postpartum woman. The woman gave birth vaginally at 2 a.m. The nurse would anticipate the need to catheterize the client if she does not void by which time?
9:00 a.m.
A primigravida whose labor was initially progressing normally is now experiencing a decrease in the frequency and intensity of her contractions. The nurse would assess the woman for which condition?
fetopelvic disproportion
The nurse would be alert for possible placental abruption during labor when assessment reveals which finding?
gestational hypertension
The nurse is preparing the plan of care for a woman hospitalized for hyperemesis gravidarum. Which interventions interventions should the nurse prioritze? Select all that apply.
maintaining NPO status for the first day administering antiemetic agents obtaining baseline blood electrolyte levels monitoring intake and output
A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would question the woman about which symptom?
hardening of an area in the affected breast
A postpartum client is prescribed medication therapy as part of the treatment plan for postpartum hemorrhage. Which medication would the nurse least expect to administer in this situation?
nifedipine
A multigravida client at 39 weeks' gestation has been in labor for 8 hours without much change. The last vaginal exam revealed cervix 8 cm dilated and zero station. Which is the best response if the client asks the nurse how far the fetus has advanced in the past half hour?
"Once your labor signs change, we can find out.
A 24-year-old primigravida client at 39 weeks' gestation presents to the OB unit concerned she is in labor. Which assessment findings will lead the nurse to determine the client is in true labor?
The client reports back pain, and the cervix is effacing and dilating.
Which psychosocial state is anticipated when the client enters the active phase of labor?
The client will become more quiet and introverted.
A client is 2 weeks past her due date, and her health provider is considering whether to induce labor. Which conditions must be present before induction can take place? Select all that apply.
The fetus is in a longitudinal lie. The cervix is ripe. A presenting part is engaged.
During which phase of labor would the nurse anticipate providing the most emotional support for the mother?
Transition phase of labor
A pregnant woman comes to the birthing center, stating she is in labor and does not know far along her pregnancy is because she has not had prenatal care. A primary care provider performs an ultrasound that indicates oligohydramnios. When the client's membranes rupture, meconium is in the amniotic fluid. What does the nurse suspect may be occurring with this client?
complications of a postterm pregnancy
Which is identified as the primary outcome for initiating comfort measures during the labor process?
Maintain the labor process
The perinatal educator is instructing on various emotions commonly experienced during labor. Which complication of anxiety is most important to stress?
Dystocia
Which findings would lead the nurse to suspect that a postpartum woman has developed metritis? Select all that apply.
pain on both sides of the abdomen foul-smelling lochia leukocytosis
The nurse determines a client is 7 cm dilated. What is the best response when asked by the client's partner how long will she be in labor?
"She is in active labor; she is progressing at this point and we will keep you posted."
A multigravida client is still focusing on her difficult labor and discusses it with the nurse at each opportunity, several hours after the birth. Which action should the nurse prioritize after noting the client's partner is spending more time with the infant than the client?
Encourage her to discuss her experience of the birth and answer any questions or concerns she may have.
At which time does the nurse anticipate that the woman will need the most pain relief measures?
In the active phase of the first stage of labor
A woman gave birth vaginally approximately 12 hours ago, and her temperature is now 100.8° F (38.2° C). Which action would be most appropriate for the nurse to take?
Notify the health care provider about this elevation; this finding reflects infection.
A nurse is evaluating the external fetal monitor tracing shown. Which nursing intervention would follow?
Offer comfort measures.
The nurse is admitting an obstetric client in early labor. As the nurse assists the client into the bed, which assessment should the nurse prioritize?
Signs that birth is imminent
A client whose membranes have prematurely ruptured is admitted to the hospital. Which nursing intervention is a priority?
Vital signs every shift
A nurse working with a woman in preterm labor receives a telephone report for the fetal fibronectin test done 10 hours ago. The report indicates an absence of the protein, which the nurse knows indicates:
birth is unlikely within the 2 next weeks.
Review of a woman's labor and birth record reveals a laceration that extends through the anal sphincter muscle. The nurse identifies this laceration as which type?
third-degree laceration
The nurse is monitoring a client in labor who has had a previous cesarean section and is trying a vaginal birth with an epidural. The nurse observes a sudden drop in blood pressure, increased heart rate, and deep variable deceleration on the fetal monitor. The client reports severe pain in her abdomen and shoulder. What should the nurse prepare to do?
Prepare the client for a cesarean birth.
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
A client is exhibiting signs of engorgement, but her milk is still flowing easily. Which suggestion should the nurse prioritize?
Ensure the baby empties the breasts at each feeding
A client in labor has been diagnosed with shoulder dystocia. Which risk factors would the nurse expect in the prenatal history? Select all that apply.
History of maternal diabetes Dates indicating a post-term pregnancy Measurements indicating fetal macrosomia
A woman with severe preeclampsia is receiving magnesium sulfate. The woman's serum magnesium level is 9.0 mEq/L. Which finding would the nurse most likely note?
diminished reflexes
While assessing a postpartum woman, the nurse palpates a contracted uterus. Perineal inspection reveals a steady stream of bright red blood trickling out of the vagina. The woman reports mild perineal pain. She just voided 200 mL of clear yellow urine. Which condition would the nurse suspect?
laceration
The nurse is admitting a G3 P2 client at 38 weeks' gestation who arrived reporting painless bleeding from the vagina leading to the diagnosis of placenta previa. When questioned by the client as to what caused this, which most likely factor should the nurse point out in her answer?
previous cesarean birth
When assessing a postpartum woman, the nurse would find which factor to be most significant in identifying possible postpartum hemorrhage?
pulse rate
Which information on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy?
recurrent pelvic infections
The nurse is performing a routine assessment of the client after birth. Inspection of a woman's perineal pad reveals a 2-inch lochia stain. This amount should be documented as which type?
scant
A woman in labor is at risk for abruptio placentae. Which assessment would most likely lead the nurse to suspect that this has happened?
sharp fundal pain and discomfort between contractions
A multigravid client has been in labor for several hours and is becoming anxious and distressed with the intensity of her frequent contractions. The nurse observes moderate bloody show and performs a vaginal examination to assess the progress of labor. The cervix is 9 cm dilated. The nurse knows that the client is in which phase of labor?
transition phase
