OB PROCTORED

1. A nurse is admitting a client to the birthing unit who reports her contractions started 1 hr ago. The nurse determines the client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions?

Postpartum hemorrhage

1. A nurse is providing discharge teaching to a postpartum client about caring for her 5 day old male newborn at home. Which of the following statements to nurse make to the client?

"Notify your babys pediatrician if he urinates less than six times a day"

1. A nurse is providing teaching to a postpartum client who has a prescription for rubella immunization. Which of the following client statements indicates understanding of the teaching?

"I should avoid becoming pregnant for at least 1 month following the immunization"

1. A nurse is providing teaching to a client who is receiving medroxyprogesterone IM for contraception. Which of the following statements by the client indicates understanding of teaching?

"I should increase my calcium intake while taking this medication"

1. A nurse is providing teaching to a client who is primigravid and is scheduled to have an abdominal ultrasound. Which of the following statements by the client indicates an understanding of the teaching?

"I will drink water before the test until my bladder feels full"

1. A nurse is providing teaching to the parents of a newborn about the Plastibell circumcision technique. Which of the following information should the nurse include?

"Notify the provider if the end of your babys penis appears dark red"

1. A nurse is providing discharge instructions to a client who is 24 hr postpartum and has decided not to breastfeed. Which of the following instructions to the nurse including teaching?

"Apply ice packs to your breasts using a 15 minutes on, 45 minuts off schedule"

1. A nurse is performing an assessment of a newborn's Babinski reflex. Which of the following findings should the nurse expect?

Dorsiflexion of the great toe

1. A nurse is caring for a newborn following delivery. Which of the following actions should the nurse take first?

Apply identification bands to the newborn

1. A nurse is performing a heel stick on the newborn which is the following actions should the nurse take?

Use an automatic puncture device on the heel

1. A nurse is assessing a client who is preterm labor and has a new prescription for terbutaline 0.25 mg subcutaneous. For which of the following findings should the nurse withhold the medication and report to the provider?

BP 88/58 mmHg

1. A nurse is caring for a client who is receiving prenatal care and is at her 24 week appointment. Which of the following laboratory tests should the nurse plant to conduct?

1-hr glucose tolerance test

1. A nurses caring for her newborn. Which of the following assessment findings should indicate to the nurse that suctioning of the nasopharynx is needed?

Newborn is beginning to cough

1. A nurse provided teaching about the expected effects of magnesium sulfate to a client who is at 28 weeks of gestation has preeclampsia. Which of the following response by the nurses appropriate?

"This medication prevents seizures"

1. A nurse in a providers office is caring for a 20-year-old client who is at 12 weeks of gestation and request an amniocentesis to determine the sex of the baby. Which of the following responses should the nurse make?

"This procedure determines if your baby has genetic or congenital disorders"

1. A nurse manager on the labor and delivery unit is teaching a group of newly licensed nurses about maternal cytomegalovirus. Which of the following information should the nurse manager include in the teaching?

"Transmission can occur via the saliva and urine of the newborn"

1. A nurse's conference client followed a vaginal delivery of maternal fetal demise. Which of the following statements of nurse make?

"You can bathe and dress your baby if you'd like to"

1. A client who is at 16 weeks of gestation asks a nurse how to prepare her toddler to have a younger sibling. Which of the following statements should the nurse make?

"You should give your toddler a gift from the baby when she visits you in the facility"

1. A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm contraception. Which of the following instructions should the nurse include?

"You should have your provider refit you for a new diaphragm"

1. A nurse is teaching a client and her partner about the technique of counterpressure during labor. Which of the following statements by the nurse is appropriate?

"Your partner will apply steady pressure with a tennis ball to your lower back"

1. A nurse is providing nutritional guidance to a client who is pregnant and follows a vegan diet. The client asks the nurse which foods she should eat to ensure adequate calcium intake. The nurse should instruct the client that which of the following foods has the highest amount calcium?

1 cup cooked broccoli

1. The nurse is preparing to perform a fundal massage for a postpartum client who is experiencing uterine atony. In which order should the nurse plan to perform the following actions? (Moving steps into box)

1.Ask the client to lie on her back and whit her knees flexed 2.Position one hand around the top of the clients fundus and one hand just above the clients symphisis pubis 3.Rotate the upper hand to massage the clients uterus while using slight downward pressure to compress the fundus 4.Observe the clients perineum for the passage of clots and the amount of bleeding

1. A nurse is assessing a client during her first prenatal visit. The client reports March 20 as her last menstrual period. Use Nagele's rule to calculate the estimated date of delivery.

12/27?

1. A nurse is assessing a client who is at 32 weeks of gestation and is receiving magnesium sulfate via continuous IV infusion. Which of the following findings should the nurse report to the provider?

Absent deep-tendon reflexes

1. A nurse is planning care for a client who is pregnant and has HIV. Which of The following actions should the nurse include in the plan of care?

Administer a pneumococcal immunization to the newborn within 4 hour following birth

1. A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?

Administer broad-spectrum antibiotics

1. A nurse in a prenatal clinic is reviewing the laboratories results for a client who is at 12 weeks of gestation. Which of the following actions should the nurse take? (click on exhibit button for additional info)

Administer ceftriaxone IM

1. A nurse is providing discharge instructions to the client who is breastfeeding her newborn. Which of the following instructions should the nurse include?

Allow the baby to feed at least every 3 hr

1. A nurse is providing dietary teaching to a client who is at 32 weeks of gestation and has cholelithiasis. Which of the following foods should the nurse recommend for the client to include her diet?

Baked chicken

1. The nurse is providing prenatal teaching to a client who practices a vegan diet and is trying to increase intake of vitamin B12. Which of the following foods should the nurse recommend?

Brown rice

1. A nurse is caring for a client who is in active labor has gonorrhea. Which of the following potential complications of gonorrhea should the nurse monitor?

Chorioamnionitis

1. A nurse is caring for four antepartum clients. Which of the following clients should the nurse assessed first?

Client who is at 32 weeks of gestation and reports seeing floating spots

1. A nurse is caring for a client who is at 6 weeks of gestation and reports nausea and vomiting. Which of the following recommendations should the nurse make?

Consume foods served at cool temperature

1. A nurse is caring for a client who is at 36 weeks of gestation and has methicillin-resistant Staphylococcus aureus. Which of the following types of isolation precautions should the nurse initiate?

Contact

1. A nurse is caring for a client who is postpartum and experiencing hypovolemic shock. Which of the following findings does the nurse expect?

Cool, clammy skin

1. A nurse is caring for a newborn who has exstrophy of the bladder. Which of the following actions should the nurse take prior to beginning of surgical correction?

Cover the newborns bladder with a sterile, non-adherent dressing

1. A nurse is assessing a newborn was exposed to cocaine in utero. Which of the following findings should the nurse expect?

High-pitched cry

1. A nurse is observing an adolescent client who is offering her newborn a bottle while he is lying in the bassinet. When the nurse offers to pick the newborn up and place them in the client's arms, the mother states "No, the baby is too tired to be held". Which of the following action should the nurse take?

Demonstrate how to hold the newborn and allow the client to practice

1. The nurses planning care for a newborn who is scheduled to start phototherapy using a lamp. Which of the following actions should the nurse include in the plan?

Ensure the newborns eyes are closed beneath the shield

1. A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect?

Facial Petechiae

1. A nurse is caring for a client who received epidural analgesia during labor and is 4 hr postpartum. Which of the following client reports should the nurse address first?

Inability to void

1. A nurses caring for a client was preeclampsia and is receiving magnesium sulfate. Which of the following clinical findings should the nurse instruct the client to report?

Increased fetal movement

1. A nurse is caring for a client who has pregestational diabetes mellitus. Which of the following clinical findings should indicate to the nurse the client has hyperglycemia?

Increased urination

1. A nurse is planning care for client following chorionic villus sampling. The nurse should recognize that the client is at risk for developing which of the following complications?

Infection

1. A charge nurse is teaching a newly licensed nurse about fetal monitoring. The newly license nurse should identify that which of the following images indicates prolonged decelerations?

Last image with 2 prolonged deccels

1. A nurse is using Nagele's rule to calculate the expected delivery date of client who reports that the first day of her last menstrual cycle was July 28th. Which of the following dates should the nurse document as the client expected delivery date?

May 5th

1. A nurse is reviewing the electronic medical record of the postpartum client. The nurse should identify that which of the following factors places the client at risk for infection?

Midline episiotomy

1. A nurse is caring for client who is in labor and just received epidural anesthesia. The client's blood pressure is 90/50 mmHg. Which of the following actions should the nurse take?

Monitor the clients blood pressure every 15 min

1. A nurse in a newborn nursery is receiving change of shift report for four newborns. Which of the following newborns should the nurse assessed first?

Newborn who has a short frenulum and is having difficulty breathing

1. A nurse is assessing the results of a nonstress test for an antepartal client at 35 weeks of gestation. Which of the following findings should indicate the nurse the need for further diagnostic testing?

No late decelerations in the fetal heart rate noted with three uterine contractions of 60 seconds in duration within a 10-min testing period

1. The nurse is providing teaching about increasing dietary fiber to an antepartum client who reports constipation. Which of the following food selections has the highest fiber content per cup?

Oatmeal

1. A nurse is caring for a client who has placenta previa. Which of the following findings to the nurse expect?

Painless, vaginal bleeding

1. A nurse is caring for a client who report spontaneous rupture of membranes. The nurse observes a fetal bradycardia on the FHR tracing and notices that the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following action should the nurse take next?

Perform a vaginal examination by applying upward pressure on the presenting part

1. A nurse is assessing a client who is at 27 weeks of gestation and has preeclampsia. Which of the following findings should the nurse report to the provider?

Platelet count 60,000 mm3

1. A nurse is reviewing the laboratory results of a newborn. Which of the following findings should the the nurse reports the provider?

Platelets 100,000/mm3

1. A nurse is caring for a newborn who is 6 hr old and has a bedside glucometer reading of 65 mg/dL. The newborns mother has typed type 2 diabetes mellitus. Which the following actions should the nurse take?

Reassess the blood glucose level prior to the next feeding

1. The nurses discussing risk factors of postpartum hemorrhage with the newly licensed nurse. Which of the following conditions is a risk factor for postpartum hemorrhage that the nurse should include in teaching?

Retained placental fragments

1. A nurse is caring for a client who is in preterm labor and receiving magnesium sulfate by continuous IV infusion. Which of the following laboratory values should the nurse review during tocolytic therapy?

Serum medication level

1. A nurse is assessing a full term newborn upon admission to the nursery. Which of the following clinical findings to the nurse reports the provider?

Single palmar creases

1. A nurse is caring for a client was receiving oxytocin to induce labor. The nurse should discontinued the oxytocin if which of the following occurs?

Six contractions in 10 min

1. A nurse is caring for a client who is at 32 weeks of gestation and has gestational diabetes mellitus. Which of the following findings should the nurse report to the provider?

The client has a fundal height of 38 cm

1. A nurse is reviewing the chart of a client who is 2 days postpartum following a vaginal delivery and reports constipation. Which of the following findings should the nurse identify as a contraindication to the use of a suppository?

Third-degree perineal laceration

1. A nurse is caring for a client who has hyperemesis and gravidarum. Which of the following laboratory tests should the nurse anticipate?

Urine ketones

1. A nurse is caring for a client who is at 30 weeks of gestation and receiving magnesium sulfate for preeclampsia. The nurse should recognize which of the following manifestations as an adverse reaction to medication?

Urine output 20 mL/hr

1. A nurse is assisting the provider to administer a dinoprostone insert to induce labor for client. Which of the following actions should the nurse take?

Verify that informed consent is obtained prior to administration

1. A nurse is conducting a class for a group of clients about birth control. Which of the following information should the nurse include in the teaching?

You should have an annual examination to assess your diaphragm

1. A nurse is caring for a client was at 30 weeks of gestation. The nurse should plan to immunize the client with which of the following vaccines? (SATA)

a. Diphtheria-acellular pertussis b. Inactivated influenza

1. A nurse is caring for a client who is in the latent phase of the first stage of labor and is in pain. Which of the following nursing interventions are appropriate to reduce pain? Select all that apply

a. Have the client sit in a tub of warm water b. Ambulate the client in the hallway