OB Quiz #2
The nurse is caring for a client who had a vaginal birth 24 hours ago. The client states, "I think I just passed some more placenta." How would the nurse respond? "I am concerned that could actually have been a large clot. Do you mind if I assess you now?" "That is not physically possible. You are probably experiencing postpartum hemorrhage." "Yes, the health care provider indicated you had some retained placenta that would pass." "Can you tell me more about what passed? Are you experiencing any other symptoms now?"
"I am concerned that could actually have been a large clot. Do you mind if I assess you now?"
The parent of a newborn witnesses the nurse give the baby a vitamin K injection and asks why the baby received it. What is the nurse's most appropriate response? "The medication is given to speed conjugation of bilirubin." "The medication is given to promote absorption of fat-soluble nutrients." "The medication is given to stimulate growth of intestinal flora." "The medication is given to promote synthesis of clotting factors."
"The medication is given to stimulate growth of intestinal flora."
The nurse is caring for a client in labor who has tested positive for gonorrhea. Which will the nurse include in the client's plan of care? Monitor the fetal heart tones every 4 hours. Administer erythromycin eye drops to the infant after birth. Apply an internal fetal scalp electrode. Plan for a cesarean birth.
Administer erythromycin eye drops to the infant after birth.
The healthcare provider has delivered a newborn and hands the child to the nurse. Which action should a nurse perform immediately? Aspirate mucus from the neonate's nose and mouth. Dry the neonate to stabilize the child's temperature. Administer vitamin K. Place antibiotic ointment in the eyes.
Dry the neonate to stabilize the child's temperature.
The nurse is caring for several mother-baby couplets. In planning the care for each of the couplets, the nurse would expect which birth mother to have the most severe afterbirth pains? G4, P1 client who is breastfeeding their infant G3, P3 client who is bottle-feeding their infant G3, P3 client who is breastfeeding their infant G2, P2 cesarean client who had a cesarean birth and who is bottle-feeding their infant
G3, P3 client who is breastfeeding their infant
A client is in the first hour of her recovery after a vaginal birth. During an assessment, the lochia is moderate, bright red, and trickling from the vagina. The nurse locates the fundus at the umbilicus; it is firm and midline with no palpable bladder. The client's vital signs remain at their baseline. Based on this information, the nurse would implement which action? Massage the fundus and expel clots. Recheck the admission hematocrit and hemoglobin levels. Document the findings as normal. Request that the health care provider (HCP) assess the client.
Request that the health care provider (HCP) assess the client.
The parents of a neonate with hypospadias and chordee wish to have them circumcised. Which explanation should the nurse incorporate into the discussion with the parents concerning the recommendation to delay circumcision? The associated chordee is difficult to remove during circumcision. The infant's penis is too small to safely circumcise. The meatus can become stenosed, leading to urinary obstruction. The foreskin is used to repair the deformity surgically.
The foreskin is used to repair the deformity surgically.
A septic preterm neonate's IV was removed due to infiltration. The nurse prioritizes restarting the IV to help which complication? hypoglycemia hyperkalemia fever tachycardia
hypoglycemia
The nurse is assessing an hour-old newborn. Which observations would the nurse note as being abnormal? Select all that apply. temperature of 97.4° F (36.3° C) nasal flaring heart rate of 135 expiratory grunting respiratory rate of 56
temperature of 97.4° F (36.3° C) nasal flaring expiratory grunting
The nurse is caring for a client who is in the transitional stage of labor. The client's partner is concerned and asks, "What else can I do for my partner? She is so irritable." Which of the following interventions would the nurse suggest? Select all that apply. "Continue to praise your partner and give her encouragement." "It is time to have your partner push. I will help you explain what to expect." "Encourage your partner to rest in between contractions." "Stay by your partner's side. It is important that she knows you are there to support her." "Your partner should not be this upset. I will call the doctor immediately."
"Continue to praise your partner and give her encouragement." "Encourage your partner to rest in between contractions." "Stay by your partner's side. It is important that she knows you are there to support her."
Assessment of a primigravid client in active labor reveals a cervix dilated to 5 cm and completely effaced, with the fetus at −1 station. The client has indicated that she wants a "natural birth" with no analgesia or anesthesia. The health care provider (HCP) enters the room and tells the client that it is time for an epidural anesthetic. What would be the nurse's best action at this time? Tell the client that her labor will be more comfortable with an anesthetic. Ask the client if she desires an epidural anesthetic. Ask the client to discuss this with her husband and then make a decision. Tell the HCP that the client desires a "natural birth."
Ask the client if she desires an epidural anesthetic.
The nurse is caring for a client in early labor. The client reports sudden abdominal pain and is noted to have bright red bleeding. What would the nurse include in the client's plan of care? Select all that apply. Call the healthcare provider. Examine the fetal heart monitoring tracing. Administer oxygen to the client. Discontinue the IV fluid. Examine the client's cervix.
Call the healthcare provider. Examine the fetal heart monitoring tracing. Administer oxygen to the client.
The nurse is caring for a client who is in labor and receiving oxytocin. The electronic fetal monitoring strip shows contractions occurring every 30 seconds to 2 minutes, with an intensity of 90 mmHg and increasing resting tone. What is the nurse's priority response to these findings? Discontinue the oxytocin infusion. Check the fetal heart rate (FHR). Call the healthcare provider. Administer oxygen as ordered.
Discontinue the oxytocin infusion.
The nurse is caring for a newborn following a circumcision. Which will the nurse include in the newborn's plan of care? Select all that apply. Call the healthcare provider with any bleeding noted. Monitor for the first void. Assess for increased swelling. Apply petroleum ointment and gauze to the circumcision. Clean the circumcision with hydrogen peroxide.
Monitor for the first void. Assess for increased swelling. Apply petroleum ointment and gauze to the circumcision.
After birth of a male neonate at 38 weeks' gestation, the nurse dries the neonate and places him skin to skin on his mother's chest to prevent which condition? increased shivering to keep warm metabolism of brown adipose tissue decreased utilization of calorie stores hyperglycemia
metabolism of brown adipose tissue
The nurse performs an assessment on a laboring client. The contractions are 3 minutes apart, 60 seconds duration, and of mild intensity for the past 4 hours. The client's cervix remains dilated at 5 cm and 100% effaced. Based on these findings, what plan of care does the nurse anticipate? oxytocin augmentation amnioinfusion oxytocin induction biophysical profile
oxytocin augmentation
The lab results show that a mother has a blood type of O positive and her infant has the blood type of A negative. As part of the plan of care, the nurse should assess the infant for which condition? Rh incompatibility physiologic hyperbilirubinemia breast milk jaundice pathologic hyperbilirubinemia
pathologic hyperbilirubinemia
The nurse has completed breastfeeding discharge instructions and determines the mother understands the instructions when she makes which statement(s)? Select all that apply. "My calorie intake will need to increase by 1,000 calories per day." "I have the phone number for the lactation consultant if I have questions." "Any drugs I take may pass through to my baby through my breast milk." "Babies should have six to eight wet diapers a day after the first 3 days of life." "Babies should be content 5 to 6 hours after daytime feedings."
"I have the phone number for the lactation consultant if I have questions." "Any drugs I take may pass through to my baby through my breast milk." "Babies should have six to eight wet diapers a day after the first 3 days of life."
A client's estranged partner arrives to visit the client's newborn because he believes he is the child's father. How does the nurse respond to the visitor? "Please wait at the nurse's station while I discuss your desire to visit with the client." "You can observe the infant through the nursery window, but I can't permit physical contact." "Due to privacy concerns, I can't disclose whether the person you're asking about is present on this unit." "I'll need to see your identification prior to allowing you to have any contact with the baby."
"Please wait at the nurse's station while I discuss your desire to visit with the client."
The nurse is providing postpartum teaching to a couple. Which of the following statements indicates to the nurse that the couple understands the teaching about physiologic jaundice? Select all that apply. "The symptoms disappear between the 7th and 10th day postpartum." "The symptoms start after the first 48 hours of life." "It occurs more often in formula-fed babies." "The jaundice is caused by normal lessening of red blood cells in the baby's body." "Often the treatment requires a blood transfusion for the baby."
"The symptoms disappear between the 7th and 10th day postpartum." "The symptoms start after the first 48 hours of life." "The jaundice is caused by normal lessening of red blood cells in the baby's body."
A client is a gravida 1, para 0. During the first 24 hours after birth, she doesn't show consistent interest in her neonate. What should the nurse do next? Document these expected behaviors of the taking-in period. Request a social service consultation. Call the physician for an order for an antidepressant. Question the client about how she feels about being a mother.
Document these expected behaviors of the taking-in period.
During a home visit to a breastfeeding primiparous client 1 week after birth, the client tells the nurse that their nipples have become sore and cracked from the feedings. Which instruction should the nurse give the client? Wipe off any lanolin creams from the nipple before each feeding. Feed the baby less often for the next several days. Position the baby with as much of the areola as possible in the baby's mouth. Use a mild soap while in the shower to prevent an infection.
Position the baby with as much of the areola as possible in the baby's mouth.
The nurse is providing breastfeeding teaching to a client 36 hours postpartum prior to discharge. The nurse recognizes an audible suck-swallow cycle during breastfeeding. Which intervention should the nurse perform next? Reinforce the technique with the mother. Remove the infant from the breast. Assess for dimpling in the baby's cheeks. Confirm that the entire nipple is in the baby's mouth.
Reinforce the technique with the mother.
The nurse cares for a 2-day-old newborn born at 37 weeks' gestation on the birth parent and baby unit. Nurses' Notes Day 2 0800 The neonate is rooming in with the parent. Breastfeeding occurs every 3.5 hours, with an audible swallow. The neonate has had two wet diapers and one meconium stool since birth. The infant is quiet and alert, and the fontanelle is flat. Acrocyanosis and slight jaundice are noted at the clavicles. Cephalhematoma has been present since 2 hours after birth. Vital signs are temperature 97.8°F (36.5°C); heart rate 120 bpm; and respiration rate 52 breaths/min, which is irregular with pauses of 10 seconds. Today's weight of 3410 g (3.41 kg) is down 100 g (0.1 kg) from birth.
Actions: obtain a bilirubin level, provide lactation support Possible Condition: Neonatal jaundice Parameters to Monitor: intake and output, color
The nurse is caring for a newborn of a primiparous woman with insulin-dependent diabetes. When the parent visits the neonate at 1 hour after birth, the nurse explains to the parent that the neonate is being closely monitored for symptoms of hypoglycemia because of which reason? increased pancreatic enzyme production caused by decreased glucose stores a normal response that occurs during the transition from intrauterine to extrauterine life interrupted supply of maternal glucose and continued high neonatal insulin production increased use of glucose stores during a difficult labor and birth process
interrupted supply of maternal glucose and continued high neonatal insulin production
