OB Focused
A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. Which of the following would the nurse do next? A) Check the fetal heart rate. B) Perform a vaginal exam. C) Notify the physician immediately. D) Change the linen saver pad.
A) Check the fetal heart rate.
A fetus is assessed at 2 cm above the ischial spines. The nurse would document fetal station as: A) +4 B) +2 C) 0 D) -2
D) -2
A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal? A) 9 B) 7 C) 5 D) 3
A) 9
A pregnant woman with gestational diabetes comes to the clinic for a fasting blood glucose level. When reviewing the results, the nurse determines that which result indicates good glucose control? A) 90 mg/dL B) 100 mg/dL C) 110 mg /dL D) 120 mg/dL
A) 90 mg/dL
A group of students are reviewing the signs of pregnancy. The students demonstrate understanding of the information when they identify which as presumptive signs? (Select all that apply.) A) Amenorrhea B) Nausea C) Abdominal enlargement D) Braxton-Hicks contractions E) Fetal heart sounds
A) Amenorrhea B) Nausea
The nurse strokes the lateral sole of the newborn's foot from the heel to the ball of the foot when evaluating which reflex? A) Babinski B) Tonic neck C) Stepping D) Plantar grasp
A) Babinski
After teaching a group of nursing students about variations in newborn head size and appearance, the instructor determines that the teaching was successful when the students identify which of the following as a normal variation? (Select all that apply.) A) Cephalhematoma B) Molding C) Closed fontanels D) Caput succedaneum E) Posterior fontanel diameter 1.5 cm
A) Cephalhematoma B) Molding D) Caput succedaneum
The fetus of a nulliparous woman is in a shoulder presentation. The nurse would most likely prepare the client for which type of birth? A) Cesarean B) Vaginal C) Forceps-assisted D) Vacuum extraction
A) Cesarean
A nurse is developing a plan of care for a preterm newborn to address the nursing diagnosis of risk for delayed development. Which of the following would the nurse include? (Select all that apply.) A) Clustering care to promote rest B) Positioning newborn in extension C) Using kangaroo care D) Loosely covering the newborn with blankets E) Providing nonnutritive sucking
A) Clustering care to promote rest C) Using kangaroo care E) Providing nonnutritive sucking
After teaching a group of students about the different methods for contraception, the instructor determines that the teaching was successful when the students identify which of the following as a mechanical barrier method? (Select all that apply.) A) Condom B) Cervical cap C) Cervical sponge D) Diaphragm E) Vaginal ring
A) Condom B) Cervical cap C) Cervical sponge D) Diaphragm
A nursing instructor is preparing a class on newborn adaptations. When describing the change from fetal to newborn circulation, which of the following would the instructor most likely include? (Select all that apply.) A) Decrease in right atrial pressure leads to closure of the foramen ovale. B) Increase in oxygen levels leads to a decrease in systemic vascular resistance. C) Onset of respirations leads to a decrease in pulmonary vascular resistance. D) Increase in pressure in the left atrium results from increases in pulmonary blood flow. E) Closure of the ductus venosus eventually forces closure of the ductus arteriosus.
A) Decrease in right atrial pressure leads to closure of the foramen ovale. C) Onset of respirations leads to a decrease in pulmonary vascular resistance. D) Increase in pressure in the left atrium results from increases in pulmonary blood flow. E) Closure of the ductus venosus eventually forces closure of the ductus arteriosus.
Assessment of a postpartum woman experiencing postpartum hemorrhage reveals mild shock. Which of the following would the nurse expect to assess? (Select all that apply.) A) Diaphoresis B) Tachycardia C) Oliguria D) Cool extremities E) Confusion
A) Diaphoresis D) Cool extremities
After determining that a newborn is in need of resuscitation, which of the following would the nurse do first? A) Dry the newborn thoroughly B) Suction the airway C) Administer ventilations D) Give volume expanders
A) Dry the newborn thoroughly
After the birth of a newborn, which of the following would the nurse do first to assist in thermoregulation? A) Dry the newborn thoroughly. B) Put a hat on the newborn's head. C) Check the newborn's temperature. D) Wrap the newborn in a blanket.
A) Dry the newborn thoroughly.
A multipara client develops thrombophlebitis after delivery. Which of the following would alert the nurse to the need for immediate intervention? A) Dyspnea, diaphoresis, hypotension, and chest pain B) Dyspnea, bradycardia, hypertension, and confusion C) Weakness, anorexia, change in level of consciousness, and coma D) Pallor, tachycardia, seizures, and jaundice
A) Dyspnea, diaphoresis, hypotension, and chest pain
A postpartum woman is diagnosed with metritis. The nurse interprets this as an infection involving which of the following? (Select all that apply.) A) Endometrium B) Decidua C) Myometrium D) Broad ligament E) Ovaries F) Fallopian tubes
A) Endometrium B) Decidua C) Myometrium
A woman who delivered a healthy newborn several hours ago asks the nurse, "Why am I perspiring so much?" The nurse integrates knowledge that a decrease in which hormone plays a role in this occurrence? A) Estrogen B) hCG C) hPL D) Progesterone
A) Estrogen
Assessment of a postpartum client reveals a firm uterus with bright-red bleeding and a localized bluish bulging area just under the skin at the perineum. The woman also is complaining of significant pelvic pain and is experiencing problems with voiding. The nurse suspects which of the following? A) Hematoma B) Laceration C) Bladder distention D) Uterine atony
A) Hematoma
A nurse is reviewing the medical record of a postpartum client. The nurse identifies that the woman is at risk for a postpartum infection based on which of the following? (Select all that apply.) A) History of diabetes B) Labor of 12 hours C) Rupture of membranes for 16 hours D) Hemoglobin level 10 mg/dL E) Placenta requiring manual extraction
A) History of diabetes D) Hemoglobin level 10 mg/dL E) Placenta requiring manual extraction
A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal tract, which of the following would the nurse expect to find? (Select all that apply.) A) Hyperemic gums B) Increased peristalsis C) Complaints of bloating D) Heartburn E) Nausea
A) Hyperemic gums C) Complaints of bloating D) Heartburn E) Nausea
When assessing a newborn 1 hour after birth, the nurse measures an axillary temperature of 95.8° F, an apical pulse of 114 beats/minute, and a respiratory rate of 60 breaths/minute. Which nursing diagnosis takes highest priority? A) Hypothermia related to heat loss during birthing process B) Impaired parenting related to addition of new family member C) Risk for deficient fluid volume related to insensible fluid loss D) Risk for infection related to transition to extrauterine environment
A) Hypothermia related to heat loss during birthing process
A client experienced prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which of the following in the mother and the newborn? A) Infection B) Hemorrhage C) Trauma D) Hypovolemia
A) Infection
A woman in the 34th week of pregnancy says to the nurse, "I still feel like having intercourse with my husband." The woman's pregnancy has been uneventful. The nurse responds based on the understanding that: A) It is safe to have intercourse at this time. B) Intercourse at this time is likely to cause rupture of membranes. C) There are other ways that the couple can satisfy their needs. D) Intercourse at this time is likely to result in premature labor.
A) It is safe to have intercourse at this time.
When teaching a class of pregnant women about the effects of substance abuse during pregnancy, which of the following would the nurse most likely include? A) Low-birth-weight infants B) Excessive weight gain C) Higher pain tolerance D) Longer gestational periods
A) Low-birth-weight infants
Because a pregnant client's diabetes has been poorly controlled throughout her pregnancy, the nurse would be alert for which of the following in the neonate at birth? A) Macrosomia B) Hyperglycemia C) Low birth weight D) Hypobilirubinemia
A) Macrosomia
A woman just delivered a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify which of the following as normal? (Select all that apply.) A) One vein B) Two veins C) One artery D) Two arteries E) One ligament F) Two ligaments
A) One vein
A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which of the following would be included as part of this assessment? (Select all that apply.) A) Positive pregnancy test B) Ultrasound visualization of the fetus C) Auscultation of a fetal heart beat D) Ballottement E) Absence of menstruation F) Softening of the cervix
A) Positive pregnancy test D) Ballottement F) Softening of the cervix
When planning the care for an SGA newborn, which action would the nurse determine as a priority? A) Preventing hypoglycemia with early feedings B) Observing for respiratory distress syndrome C) Promoting bonding between the parents and the newborn D) Monitoring vital signs every 2 hours
A) Preventing hypoglycemia with early feedings
A newborn is experiencing cold stress. Which of the following would the nurse expect to assess? (Select all that apply.) A) Respiratory distress B) Decreased oxygen needs C) Hypoglycemia D) Metabolic alkalosis E) Jaundice
A) Respiratory distress C) Hypoglycemia E) Jaundice
While caring for a preterm newborn receiving oxygen therapy, the nurse monitors the oxygen therapy duration closely based on the understanding that the newborn is at risk for which of the following? A) Retinopathy of prematurity B) Metabolic acidosis C) Infection D) Cold stress
A) Retinopathy of prematurity
A pregnant woman is scheduled to undergo percutaneous umbilical blood sampling. When discussing this test with the woman, the nurse reviews what can be evaluated with the specimens collected. Which of the following would the nurse include? (Select all that apply.) A) Rh incompatibility B) Fetal acid-base status C) Sex-linked disorders D) Enzyme deficiencies E) Coagulation studies
A) Rh incompatibility B) Fetal acid-base status E) Coagulation studies
A nurse is describing how the fetus moves through the birth canal. Which of the following would the nurse identify as being most important in allowing the fetal head to move through the pelvis? A) Sutures B) Fontanelles C) Frontal bones D) Biparietal diameter
A) Sutures
When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage based on the knowledge that: A) These measurements may not change until after the blood loss is large B) The body's compensatory mechanisms activate and prevent any changes C) They relate more to change in condition than to the amount of blood lost D) Maternal anxiety adversely affects these vital signs
A) These measurements may not change until after the blood loss is large
A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects trichomoniasis based on which of the following? (Select all that apply.) A) Urinary frequency B) Yellow/green discharge C) Joint pain D) Blister-like lesions E) Muscle aches
A) Urinary frequency B) Yellow/green discharge
Which of the following would indicate to the nurse that the placenta is separating? A) Uterus becomes globular B) Fetal head is at vaginal opening C) Umbilical cord shortens D) Mucous plug is expelled
A) Uterus becomes globular
A nurse is assessing a newborn who has been classified as small for gestational age. Which of the following would the nurse expect to find? (Select all that apply.) A) Wasted extremity appearance B) Increased amount of breast tissue C) Sunken abdomen D) Adequate muscle tone over buttocks E) Narrow skull sutures
A) Wasted extremity appearance C) Sunken abdomen E) Narrow skull sutures
A newborn was diagnosed with a congenital heart defect and will undergo surgery at a later time. The nurse is teaching the parents about signs and symptoms that need to be reported. The nurse determines that the parents have understood the instructions when they state that they will report which of the following? (Select all that apply.) A) Weight loss B) Pale skin C) Fever D) Absence of edema E) Increased respiratory rate
A) Weight loss C) Fever E) Increased respiratory rate
Which statement would alert the nurse to the potential for impaired bonding between mother and newborn? A) "You have your daddy's eyes." B) "He looks like a frog to me." C) "Where did you get all that hair?" D) "He seems to sleep a lot."
B) "He looks like a frog to me."
A postpartum client who is bottle feeding her newborn asks, "When should my period return?" Which response by the nurse would be most appropriate? A) "It's difficult to say, but it will probably return in about 2 to 3 weeks." B) "It varies, but you can estimate it returning in about 7 to 9 weeks." C) "You won't have to worry about it returning for at least 3 months." D) "You don't have to worry about that now. It'll be quite a while."
B) "It varies, but you can estimate it returning in about 7 to 9 weeks."
After reviewing information about postpartum blues, a group of students demonstrate understanding when they state which of the following about this condition? A) "Postpartum blues is a long-term emotional disturbance." B) "Sleep usually helps to resolve the blues." C) "The mother loses contact with reality." D) "Extended psychotherapy is needed for treatment."
B) "Sleep usually helps to resolve the blues."
After teaching a woman with a postpartum infection about care after discharge, which client statement indicates the need for additional teaching? A) "I need to call my doctor if my temperature goes above 100.4° F." B) "When I put on a new pad, I'll start at the back and go forward." C) "If I have chills or my discharge has a strange odor, I'll call my doctor." D) "I'll point the spray of the peribottle so the water flows front to back."
B) "When I put on a new pad, I'll start at the back and go forward."
A woman is scheduled to undergo fetal nuchal translucency testing. Which of the following would the nurse include when describing this test? A) "A needle will be inserted directly into the fetus's umbilical vessel." B) "You'll have an intravaginal ultrasound to measure fluid in the fetus." C) "The doctor will take a sample of fluid from your bag of waters." D) "A small piece of tissue from the fetal part of the placenta is taken."
B) "You'll have an intravaginal ultrasound to measure fluid in the fetus."
A nurse is assisting in the resuscitation of a newborn. The nurse would expect to stop resuscitation efforts when the newborn has no heartbeat and respiratory effort after which time frame? A) 5 minutes B) 10 minutes C) 15 minutes D) 20 minutes
B) 10 minutes
A newborn has an Apgar score of 6 at 5 minutes. Which of the following is the priority? A) Initiating IV fluid therapy B) Beginning resuscitative measures C) Promoting kangaroo care D) Obtaining a blood culture
B) Beginning resuscitative measures
The nurse places a warmed blanket on the scale when weighing a newborn. The nurse does so to minimize heat loss via which mechanism? A) Evaporation B) Conduction C) Convection D) Radiation
B) Conduction
A group of nursing students are preparing a presentation for their class about measures to prevent toxoplasmosis. Which of the following would the students be least likely to include? Select all that apply. A) Washing raw fruits and vegetables before eating them B) Cooking all meat to an internal temperature of 140° F C) Wearing gardening gloves when working in the soil D) Avoiding contact with a cat's litter box.
B) Cooking all meat to an internal temperature of 140° F
Which of the following would the nurse include in the plan of care for a newborn receiving phototherapy? A) Keeping the newborn in the supine position B) Covering the newborn's eyes while under the bililights C) Ensuring that the newborn is covered or clothed D) Reducing the amount of fluid intake to 8 ounces daily
B) Covering the newborn's eyes while under the bililights
A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which of the following would the nurse assess? (Select all that apply.) A) Low whimpering cry B) Hypertonicity C) Lethargy D) Excessive sneezing E) Overly vigorous sucking F) Tremors
B) Hypertonicity D) Excessive sneezing F) Tremors
When assessing cervical effacement of a client in labor, the nurse assesses which of the following characteristics? A) Extent of opening to its widest diameter B) Degree of thinning C) Passage of the mucous plug D) Fetal presenting part
B) Degree of thinning
The nurse administers RhoGAM to an Rh-negative client after delivery of an Rh-positive newborn based on the understanding that this drug will prevent her from: A) Becoming Rh positive B) Developing Rh sensitivity C) Developing AB antigens in her blood D) Becoming pregnant with an Rh-positive fetus
B) Developing Rh sensitivity
Which of the following, if noted in the maternal history, would the nurse identify as possibly contributing to the birth of an LGA newborn? A) Drug abuse B) Diabetes C) Preeclampsia D) Infection
B) Diabetes
A woman with preterm labor is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately? A) Respiratory rate of 16 breaths per minute B) Diminished deep tendon reflexes C) Urine output of 45 mL/hour D) Alert level of consciousness
B) Diminished deep tendon reflexes
Which finding would the nurse expect to find in a client with endometriosis? A) Hot flashes B) Dysuria C) Fluid retention D) Fever
B) Dysuria
When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which of the following as the primary cause? A) Poor dietary intake B) Estrogen deficiency C) Active lifestyle D) Changes in vaginal pH
B) Estrogen deficiency
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? A) A low-lying placenta B) Fetopelvic disproportion C) Contraction ring D) Uterine bleeding
B) Fetopelvic disproportion
Which findings would the nurse expect to find in a client with bacterial vaginosis? A) Vaginal pH of 3 B) Fish-like odor of discharge C) Yellowish-green discharge D) Cervical bleeding on contact
B) Fish-like odor of discharge
When describing the structures involved in fetal circulation, the nursing instructor describes which structure as the opening between the right and left atrium? A) Ductus venosus B) Foramen ovale C) Ductus arteriosus D) Umbilical artery
B) Foramen ovale
A group of students are reviewing information about sexually transmitted infections and their effect on pregnancy. The students demonstrate understanding of the information when they identify which infection as being responsible for ophthalmia neonatorum? A) Syphilis B) Gonorrhea C) Chlamydia D) HPV
B) Gonorrhea
A nurse is describing the risks associated with prolonged pregnancies as part of an inservice presentation. Which of the following would the nurse be least likely to incorporate in the discussion as an underlying reason for problems in the fetus? A) Aging of the placenta B) Increased amniotic fluid volume C) Meconium aspiration D) Cord compression
B) Increased amniotic fluid volume
A nurse is assessing a newborn who is about 4½ hours old. The nurse would expect this newborn to exhibit which of the following? (Select all that apply.) A) Sleeping B) Interest in environmental stimuli C) Passage of meconium D) Difficulty arousing the newborn E) Spontaneous Moro reflexes
B) Interest in environmental stimuli C) Passage of meconium
A client's last menstrual period was April 11. Using Nagele's rule, her expected date of birth (EDB. would be: A) January 4 B) January 18 C) January 25 D) February 24
B) January 18
When describing newborns with birth-weight variations to a group of nursing students, the instructor identifies which variation if the newborn weighs 5.2 lb at any gestational age? A) Small for gestational age B) Low birth weight C) Very low birth weight D) Extremely low birth weight
B) Low birth weight
A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which of the following? A) Excess folic acid, which could increase the risk for neural tube defects B) Mercury, which could harm the developing fetus if eaten in large amounts C) Lactose, which leads to abdominal discomfort, gas, and diarrhea D) Low-quality protein that does not meet the woman's requirements
B) Mercury, which could harm the developing fetus if eaten in large amounts
A postpartum client comes to the clinic for her routine 6-week visit. The nurse assesses the client and suspects that she is experiencing subinvolution based on which of the following? A) Nonpalpable fundus B) Moderate lochia serosa C) Bruising on arms and legs D) Fever
B) Moderate lochia serosa
A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which of the following? A) Increased energy level with alternating strong and weak contractions B) Moderately strong contractions every 4 minutes, lasting about 1 minute C) Contractions noted in the front of abdomen that stop when she walks D) Pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds
B) Moderately strong contractions every 4 minutes, lasting about 1 minute
During a physical assessment of a newborn, the nurse observes bluish markings across the newborn's lower back. The nurse documents this finding as which of the following? A) Milia B) Mongolian spots C) Stork bites D) Birth trauma
B) Mongolian spots
A nurse is visiting a postpartum woman who delivered a healthy newborn 5 days ago. Which of the following would the nurse expect to find? A) Bright red discharge B) Pinkish brown discharge C) Deep red mucus-like discharge D) Creamy white discharge
B) Pinkish brown discharge
After teaching a group of students about risk factors associated with postpartum hemorrhage, the instructor determines that the teaching was successful when the students identify which of the following as a risk factor? (Select all that apply.) A) Prolonged labor B) Placenta previa C) Null parity D) Hydramnios E) Labor augmentation
B) Placenta previa D) Hydramnios E) Labor augmentation
A newborn is diagnosed with meconium aspiration syndrome. When assessing this newborn, which of the following would the nurse expect to find? (Select all that apply.) A) Pigeon chest B) Prolonged tachypnea C) Intercostal retractions D) High blood pH level E) Coarse crackles on auscultation
B) Prolonged tachypnea C) Intercostal retractions E) Coarse crackles on auscultation
Which of the following would be most appropriate for the nurse to do when assisting parents who have experienced the loss of their preterm newborn? A) Avoid using the terms "death" or "dying." B) Provide opportunities for them to hold the newborn. C) Refrain from initiating conversations with the parents. D) Quickly refocus the parents to a more pleasant topic.
B) Provide opportunities for them to hold the newborn.
A nursing instructor is teaching a class to a group of students about pregnancy, insulin, and glucose. Which of the following would the instructor least likely include as opposing insulin? A) Prolactin B) Estrogen C) Progesterone D) Cortisol
D) Cortisol
Which of the following would be most appropriate when massaging a woman's fundus? A) Place the hands on the sides of the abdomen to grasp the uterus. B) Use an up-and-down motion to massage the uterus. C) Wait until the uterus is firm to express clots. D) Continue massaging the uterus for at least 5 minutes.
B) Use an up-and-down motion to massage the uterus.
A group of students are reviewing the causes of postpartum hemorrhage. The students demonstrate understanding of the information when they identify which of the following as the most common cause? A) Labor augmentation B) Uterine atony C) Cervical or vaginal lacerations D) Uterine inversion
B) Uterine atony
A pregnant woman comes to the clinic and tells the nurse that she has been having a whitish vaginal discharge. The nurse suspects vulvovaginal candidiasis based on which assessment finding? A) Fever B) Vaginal itching C) Urinary frequency D) Incontinence
B) Vaginal itching
When planning the care of a newborn addicted to cocaine who is experiencing withdrawal, which of the following would be least appropriate to include? A) Wrapping the newborn snugly in a blanket B) Waking the newborn every hour C) Checking the newborn's fontanels D) Offering a pacifier
B) Waking the newborn every hour
A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, "I've never urinated as often as I have for the past three weeks." Which response would be most appropriate for the nurse to make? A) "Having to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit it." B) "You shouldn't be urinating this frequently now; it usually stops by the time you're eight weeks pregnant. Is there anything else bothering you?" C) "By the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is likely to return toward the end of your pregnancy." D) "Women having their second child generally don't have frequent urination. Are you experiencing any burning sensations?"
C) "By the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is likely to return toward the end of your pregnancy."
A new mother who is breast-feeding her newborn asks the nurse, "How will I know if my baby is drinking enough?" Which response by the nurse would be most appropriate? A) "If he seems content after feeding, that should be a sign." B) "Make sure he drinks at least 5 minutes on each breast." C) "He should wet between 6 to 12 diapers each day." D) "If his lips are moist, then he's okay."
C) "He should wet between 6 to 12 diapers each day."
Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has: A) Trichomoniasis B) Bacterial vaginosis C) Candidiasis D) Genital herpes simplex
C) Candidiasis
The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse's teaching was successful? A) "I'll basically follow the same diet that I was following before I became pregnant." B) "Because I need extra protein, I'll have to increase my intake of milk and meat." C) "Pregnancy affects insulin production, so I'll need to make adjustments in my diet." D) "I'll adjust my diet and insulin based on the results of my urine tests for glucose."
C) "Pregnancy affects insulin production, so I'll need to make adjustments in my diet."
A nurse measures a pregnant woman's fundal height and finds it to be 28 cm. The nurse interprets this to indicate which of the following? A) 14 weeks' gestation B) 20 weeks' gestation C) 28 weeks' gestation D) 36 weeks' gestation
C) 28 weeks' gestation
A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2-year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as: A) 3 2 1 0 3 B) 3 1 2 2 3 C) 4 1 1 1 3 D) 4 2 1 3 1
C) 4 1 1 1 3
A group of pregnant women are discussing high-risk newborn conditions as part of a prenatal class. When describing the complications that can occur in these newborns to the group, which would the nurse include as being at lowest risk? A) Small-for-gestational-age (SGA. newborns B) Large-for-gestational-age (LGA. newborns C) Appropriate-for-gestational-age (AGA. newborns D) Low-birth-weight newborns
C) Appropriate-for-gestational-age (AGA. newborns
The nurse is reviewing the medical record of a woman in labor and notes that the fetal position is documented as LSA. The nurse interprets this information as indicating which of the following is the presenting part? A) Occiput B) Face C) Buttocks D) Shoulder
C) Buttocks
A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs). Which of the following would the nurse need to stress to the group. Select all that apply. A) ECs induce an abortion like reaction. B) ECs provide some protection against STIs C) ECs are birth control pills in higher, more frequent doses D) ECs are not to be used in place of regular birth control E) ECs provide little protection for future pregnancies.
C) ECs are birth control pills in higher, more frequent doses D) ECs are not to be used in place of regular birth control E) ECs provide little protection for future pregnancies.
A newborn is suspected of having fetal alcohol syndrome. Which of the following would the nurse expect to assess? A) Bradypnea B) Hydrocephaly C) Flattened maxilla D) Hypoactivity
C) Flattened maxilla
A nurse is developing a plan of care for a woman who is at risk for thromboembolism. Which of the following would the nurse include as the most cost-effective method for prevention? A) Prophylactic heparin administration B) Compression stocking C) Early ambulation D) Warm compresses
C) Early ambulation
The parents of a preterm newborn being cared for in the neonatal intensive care unit (NICU. are coming to visit for the first time. The newborn is receiving mechanical ventilation and intravenous fluids and medications and is being monitored electronically by various devices. Which action by the nurse would be most appropriate? A) Suggest that the parents stay for just a few minutes to reduce their anxiety. B) Reassure them that their newborn is progressing well. C) Encourage the parents to touch their preterm newborn. D) Discuss the care they will be giving the newborn upon discharge.
C) Encourage the parents to touch their preterm newborn.
The nurse is assessing the skin of a newborn and notes a rash on the newborn's face, and chest. The rash consists of small papules and is scattered with no pattern. The nurse interprets this finding as which of the following? A) Harlequin sign B) Nevus flammeus C) Erythema toxicum D) Port wine stain
C) Erythema toxicum
A nurse is teaching the mother of a newborn diagnosed with galactosemia about dietary restrictions. The nurse determines that the mother has understood the teaching when she identifies which of the following as needing to be restricted? A) Phenylalanine B) Protein C) Lactose D) Iodine
C) Lactose
When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to be: A) Greater than after a vaginal delivery B) About the same as after a vaginal delivery C) Less than after a vaginal delivery D) Saturated with clots and mucus
C) Less than after a vaginal delivery
A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer? A) Sedatives B) Tocolytics C) Oxytocins D) Corticosteroids
C) Oxytocins
A postpartum woman is ordered to receive oxytocin to stimulate the uterus to contract. Which of the following would be most important for the nurse to do? A) Administer the drug as an IV bolus injection. B) Give as a vaginal or rectal suppository. C) Piggyback the IV infusion into a primary line. D) Withhold the drug if the woman is hypertensive.
C) Piggyback the IV infusion into a primary line.
When assessing a postterm newborn, which of the following would the nurse correlate with this gestational age variation? A) Moist, supple, plum skin appearance B) Abundant lanugo and vernix C) Thin umbilical cord D) Absence of sole creases
C) Thin umbilical cord
A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the client's fundus, expecting it to be at which location? A) Two fingerbreadths above the umbilicus B) At the level of the umbilicus C) Two fingerbreadths below the umbilicus D) Four fingerbreadths below the umbilicus
C) Two fingerbreadths below the umbilicus
A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor? A) Supine B) Lithotomy C) Upright D) Knee-chest
C) Upright
Which of the following factors in a client's history would alert the nurse to an increased risk for postpartum hemorrhage? A) Multiparity, age of mother, operative delivery B) Size of placenta, small baby, operative delivery C) Uterine atony, placenta previa, operative procedures D) Prematurity, infection, length of labor
C) Uterine atony, placenta previa, operative procedures
The nurse places a newborn with jaundice under the phototherapy lights in the nursery to achieve which goal? A) Prevent cold stress B) Increase surfactant levels in the lungs C) Promote respiratory stability D) Decrease the serum bilirubin level
D) Decrease the serum bilirubin level
A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which of the following statements by the nurse would be most appropriate? A) "You'll probably have a cesarean birth to prevent exposing your newborn." B) "Antibodies cross the placenta and provide immunity to the newborn." C) "Wait until after the infant is born and then something can be done." D) "Antiretroviral medications are available to help reduce the risk of transmission."
D) "Antiretroviral medications are available to help reduce the risk of transmission."
When assessing a pregnant woman with heart disease throughout the antepartal period, the nurse would be especially alert for signs and symptoms of cardiac decompensation at which time? A) 16 to 20 weeks' gestation B) 20 to 24 weeks' gestation C) 24 to 28 weeks' gestation D) 28 to 32 weeks' gestation
D) 28 to 32 weeks' gestation
A nurse is providing care to several pregnant women at the clinic. The nurse would screen for group B streptococcus infection in a client at: A) 16 weeks' gestation B) 28 week' gestation C) 32 weeks' gestation D) 36 weeks' gestation
D) 36 weeks' gestation
The nurse institutes measure to maintain thermoregulation based on the understanding that newborns have limited ability to regulate body temperature because they: A) Have a smaller body surface compared to body mass B) Lose more body heat when they sweat than adults C) Have an abundant amount of subcutaneous fat all over D) Are unable to shiver effectively to increase heat production
D) Are unable to shiver effectively to increase heat production
As part of an inservice program, a nurse is describing a transient, self-limiting mood disorder that affects mothers after childbirth. The nurse correctly identifies this as postpartum: A) Depression B) Psychosis C) Bipolar disorder D) Blues
D) Blues
When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which of the following would the nurse include as the underlying reason for the effect? A) Pancreatic function is affected by pregnancy. B) Glucose is utilized more rapidly during a pregnancy. C) The pregnant woman increases her dietary intake. D) Glucose moves through the placenta to assist the fetus.
D) Glucose moves through the placenta to assist the fetus
A woman gives birth to a healthy newborn. As part of the newborn's care, the nurse instills erythromycin ophthalmic ointment as a preventive measure related to which STI? A) Genital herpes B) Hepatitis B C) Syphilis D) Gonorrhea
D) Gonorrhea
The nurse is developing a teaching plan for a client who has decided to bottle feed her newborn. Which of the following would the nurse include in the teaching plan to facilitate suppression of lactation? A) Encouraging the woman to manually express milk B) Suggesting that she take frequent warm showers to soothe her breasts C) Telling her to limit the amount of fluids that she drinks D) Instructing her to apply ice packs to both breasts every other hour
D) Instructing her to apply ice packs to both breasts every other hour
After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? A) Supine B) Side-lying C) Sitting D) Knee-chest
D) Knee-chest
A nurse is assessing a newborn and observes the newborn moving his head and eyes toward a loud sound. The nurse interprets this as which of the following? A) Habituation B) Motor maturity C) Social behavior D) Orientation
D) Orientation
A group of students are reviewing the process of breast milk production. The students demonstrate understanding when they identify which hormone as responsible for milk let-down? A) Prolactin B) Estrogen C) Progesterone D) Oxytocin
D) Oxytocin
Which of the following measures would the nurse include in the teaching plan for a woman to reduce the risk of osteoporosis after menopause? A) Taking vitamin supplements B) Eating high-fiber, high-calorie foods C) Restricting fluid to 1,000 mL daily D) Participating in regular daily exercise
D) Participating in regular daily exercise
When assessing a newborn's reflexes, the nurse strokes the newborn's cheek and the newborn turns toward the side that was stroked and begins sucking. The nurse documents which reflex as being positive? A) Palmar grasp reflex B) Tonic neck reflex C) Moro reflex D) Rooting reflex
D) Rooting reflex
A woman experiencing postpartum hemorrhage is ordered to receive a uterotonic agent. Which of the following would the nurse least expect to administer? A) Oxytocin B) Methylergonovine C) Carboprost D) Terbutaline
D) Terbutaline