OB Selvestri

A pregnant client in the second trimester of pregnancy is admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding would the nurse expect to note if this condition is present?

Abdominal pain

The nurse notes hypotonia, irritability, and a poor sucking reflex in a full-term newborn after admission to the nursery. The nurse suspects fetal alcohol syndrome (FAS) and is aware that which additional sign is consistent with FAS?

Abnormal palmar creases

The nurse is assigned to care for the client after a cesarean section. To prevent thrombophlebitis, the nurse would encourage the woman to take which priority action?

Ambulate frequently.

After delivery the nurse checks the height of the uterine fundus. Which position of the fundus would the nurse expect to note?

At the level of the umbilicus

The nurse is assigned to care for a client who is in early labor. When collecting data from the client, which would the nurse check first?

Baseline fetal heart rate

The nurse is reinforcing measures regarding the care of the newborn with a mother. To bathe the newborn, the mother would be taught which intervention?

Begin with the eyes and face.

The nurse is assisting in caring for a post-term neonate immediately after admission to the nursery. The priority nursing action would be to monitor which clinical parameter?

Blood glucose level

The nurse is assisting with caring for a client who has a placenta previa. The nurse understands that a cervical examination would not be performed on the client primarily because it could have which consequence?

Cause hemorrhage

A client in the third trimester of pregnancy visits the clinic for a scheduled prenatal appointment. The client tells the nurse that she frequently has leg cramps, primarily when she is reclining. On the basis of the client's complaint, which would the nurse do first?

Check for signs of thrombophlebitis.

While assisting with the measurement of fundal height, the client at 36 weeks' gestation states that she is feeling lightheaded. On the basis of the nurse's knowledge of pregnancy, the nurse determines that this is most likely a result of which reason?

Compression of the vena cava

A nursing student is assigned to a client in labor. The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. The instructor determines that the student understands the structure of the ductus venosus if the student states which about the ductus venosus?

Connects the umbilical vein to the inferior vena cava

A primigravida's membranes rupture spontaneously. Which action would the nurse take first?

Determine the fetal heart rate.

The nurse is assigned to assist with caring for a client who is being admitted to the birthing center in early labor. During admission, which action would the nurse take initially?

Determine the maternal and fetal vital signs.

The nurse in the labor room is caring for a client in the first stage of labor. When monitoring the fetal patterns, the nurse notes an early deceleration of the fetal heart rate (FHR) on the monitor strip. Which is the appropriate nursing action?

Document the findings and continue to monitor the fetal patterns.

The pregnant woman complains of being awakened frequently by leg cramps. The nurse reinforces instructions to the client's partner and would tell the client to perform which measure?

Dorsiflex the client's foot while extending the knee.

The nurse is reinforcing instructions to a pregnant client regarding measures to prevent heartburn. The nurse would instruct the client to take which best measure?

Drink decaffeinated coffee and tea.

After birth the nurse prevents hypothermia as a result of evaporation by performing which action?

Drying the baby with a warm blanket

The nurse is assisting in caring for a newborn with respiratory distress syndrome. Which initial action would the nurse plan to best facilitate bonding between the newborn and parents?

Encourage the parents to touch their newborn.

A primipara is being evaluated in the clinic during her second trimester of pregnancy. Which occurrence indicates an abnormal physical finding that necessitates further testing?

Fetal heart rate of 180 beats per minute

The nurse is collecting data from a client who is pregnant with twins. The client has a healthy 5-year-old child who was delivered at 38 weeks, and she tells the nurse that she does not have a history of any type of abortion or fetal demise. The nurse would document which as the GTPAL for this client?

G = 2, T = 1, P = 0, A = 0, L = 1

The nurse caring for a client who is receiving oxytocin for the induction of labor notes a nonreassuring fetal heart rate (FHR) pattern on the fetal monitor. On the basis of this finding, which is the nurse's priority action?

Stop the oxytocin infusion.

The client who is being prepared for a cesarean delivery is brought to the delivery room. To maintain the optimal perfusion of oxygenated blood to the fetus, the nurse would place the client in which position?

Supine position with a wedge under the right hip

After a precipitous delivery, the nurse notes that the new mother is passive and only touches her newborn briefly with her fingertips. The nurse would do which to help the woman process what has happened?

Support the mother in her reaction to the newborn.

The nurse would monitor for which signs associated with respiratory distress syndrome (RDS) in a preterm newborn?

Tachypnea and retractions

The nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse would tell the client that fetal circulation consists of which components?

Two umbilical arteries and one umbilical vein

The nurse is assigned to assist with caring for a client with abruptio placentae who is experiencing vaginal bleeding. The nurse collects data from the client, knowing that abruptio placentae is accompanied by which additional finding?

Uterine tenderness on palpation

A client who has just been told that she is pregnant asks a clinic nurse when the fetus's heart will be developed and beating. The nurse tells the client that the fetal heart is beating at what gestational week?

Week 5

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which findings are noted during assessment? Select all that apply.

-Respirations of 10 breaths/minute -Urine output of 20 mL in an hour

A postpartum client with mastitis in the right breast complains that the breast is too sore for her to breast-feed her infant. Which would the nurse tell the client?

"Breast-feed from the left breast and gently pump the right breast."

A couple comes to the family planning clinic and asks about sterilization procedures. Which question by the nurse helps determine whether this method of family planning is appropriate?

"Do you plan to have any other children?"

A postpartum client is getting ready for discharge. The nurse suspects that the client needs further teaching related to breast-feeding when she makes which statement?

"I don't need birth control because I will be breast-feeding."

During a prenatal visit, the nurse is explaining dietary management to a client with diabetes mellitus. The nurse determines that the teaching has been effective when the client makes which statement?

"I need to increase the fiber in my diet to control my blood glucose and prevent constipation."

A pregnant human immunodeficiency virus (HIV)-positive woman delivers a baby. The nurse provides guidance to help the client make decisions regarding newborn care. Which statement by the woman indicates that additional guidance is needed?

"I will breastfeed, especially for the first 6 weeks postpartum."

The nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates that further teaching is needed?

"I will flush the eyes after instilling the ointment."

The client at 28 weeks' gestation is Rh negative and Coombs antibody negative. The nurse determines that the client understands what the nurse has taught her about Rh sensitization when the client makes which statement?

"I will tell the nurse at the hospital that I had an Rh shot during pregnancy."

The nursing instructor asks a nursing student to describe the process of quickening. Which statement indicates an understanding of this term?

"It is the fetal movement that is felt by the mother."

A client asks the nurse why her newborn baby needs an injection of vitamin K (phytonadione). The nurse would make which statement to the client?

"Newborns are deficient in vitamin K. This injection prevents your baby from abnormal bleeding."4

The nurse has a teaching session with a malnourished client regarding iron supplementation to prevent anemia during pregnancy. Which statement indicates successful learning?

"The iron is needed for the red blood cells."

A contraction stress test is scheduled for the client. The woman asks the nurse about the test. Which response describes the most accurate description of the test?

"The uterus is stimulated to contract by either small amounts of oxytocin or by nipple stimulation."

A stillborn was delivered in the birthing suite a few hours ago. After the birth, the family has remained together, touching the baby. Which statement by the nurse would further assist the family in their initial period of grief?

"Would you like to hold your baby?"

The nurse is talking to a pregnant client with human immunodeficiency virus (HIV) infection regarding care for the newborn after delivery. The client asks the nurse about the feeding options that are available. Which response would the nurse make to the client?

"You will need to bottle-feed your newborn."

The nurse is checking a client's record for probable signs of pregnancy. Which are the probable signs of pregnancy that the nurse would note? Select all that apply

-Ballottement -Chadwick's sign -Uterine enlargement -Braxton Hicks contractions

The nurse is collecting data from a client who has been diagnosed with placenta previa. Which findings would the nurse expect to note? Select all that apply.

-Bright red vaginal bleeding -Soft, relaxed, nontender uterus

The nurse is monitoring a client in preterm labor who is receiving intravenous magnesium sulfate. The nurse would monitor for which adverse effects of this medication? Select all that apply.

-Flushing -Depressed respirations -Extreme muscle weakness

Which findings indicate to the nurse that placental separation has occurred? Select all that apply.

-Lengthening of umbilical cord -Sudden trickle or spurt of blood -Fetal membranes are seen at the introitus

The nurse is preparing to care for a newborn who is receiving phototherapy. Which measures would be implemented? Select all that apply.

-Monitor the skin temperature closely. -Reposition the newborn every 2 hours. -Cover the newborn's eyes with shields or patches.

A newly pregnant client is asking how to prevent neural-tube birth defects. The nurse reinforces which food choices to include in the diet? Select all that apply.

-Oranges -Broccoli -Grapefruit

The nurse is monitoring a pregnant client with gestational hypertension (GH) who is at risk for preeclampsia. The nurse would check the client for which signs of preeclampsia? Select all that apply.

-Proteinuria -Hypertension

The nurse is assigned to work in the delivery room and is assisting with caring for a client who has just delivered a newborn. The nurse is monitoring for signs of placental separation knowing that which indicates that the placenta has separated?

A change in the uterine contour

The perinatal client is admitted to the obstetrical unit during an exacerbation of a heart condition. When planning for the nutritional requirements of the client, the nurse would consult with the dietitian to ensure which dietary measure?

A diet that is high in fluids and fiber to decrease constipation

The client is admitted to the labor suite complaining of painless vaginal bleeding. The nurse assists with the examination of the client, knowing that which routine labor procedure is contraindicated?

A manual pelvic examination

The nurse is reinforcing instructions to a new mother about cord care and how to monitor for the presence of an infection. The nurse would tell the mother that which is a sign of infection?

A moist cord with discharge

The nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The nurse notes that the primary health care provider has documented the presence of Goodell's sign. The nurse determines that this sign is indicative of which change that occurs with pregnancy?

A softening of the cervix

The nurse working in a prenatal clinic reviews a client's chart and notes that the primary health care provider documents that the client has a gynecoid pelvis. The nurse plans care understanding that which findings are characteristic of this type of pelvis? Select all that apply.

-Round shape -Diagonal conjugate measures 12.5 cm to 13 cm -Blunt, somewhat widely separated ischial spines

The nurse is monitoring a client who is receiving oxytocin to induce labor. Which assessment findings would cause the nurse to immediately discontinue the oxytocin infusion? Select all that apply.

-Uterine hyperstimulation -Late decelerations of the fetal heart rate

The nurse-midwife is conducting a session on the process of conception with a group of nursing students. Which statements reflect that the nursing students understand the process of conception? Select all that apply.

1-"Fertilization occurs in the outer third of the fallopian tube." 2-"Only 1 sperm will penetrate the ovum to produce fertilization." 3-"Implantation occurs in the anterior or posterior fundal region of the uterus." 4-"The ovary produces hormones to maintain the pregnancy before placental development."

The nursing student is conducting a clinical conference regarding the hormones that are related to pregnancy, and the instructor asks the student about the function of progesterone. Which response made by the student indicates an understanding of the function of this hormone? Select all that apply.

1-"It maintains the uterine lining for implantation." 2-"It relaxes all smooth muscle, including the uterus."

A newborn has just been circumcised and is being discharged home in 2 hours. Which instructions would be provided by the nurse to the parents? Select all that apply.

1-Do not wash penis with soap until the circumcision is healed, which takes 5 to 6 days. 2-Change diaper every 4 hours or more often to inspect the penis for drainage or infection. 3-Monitor the circumcision; penis may appear reddened with small amount of bloody drainage shortly after the procedure.

The nurse is preparing a list of self-care instructions for a postpartum client who has been diagnosed with mastitis. Which instructions would be included on the list? Select all that apply.

1-Rest during the acute phase. 2-Wear a supportive, nonunderwire bra. 3-Maintain a fluid intake of at least 3000 mL. 4-Continue to breast-feed if the breasts are not too sore.

During a prenatal visit, the nurse checks the fetal heart rate (FHR) of a client in the third trimester of pregnancy. The nurse determines that the FHR is normal if which heart rate is noted?

150 beats per minute

A pregnant client asks the nurse in the clinic when she will be able to start feeling the fetus move. The nurse responds by telling the mother that fetal movements will be noted between which weeks of gestation?

16 and 20 weeks' gestation

A nulliparous woman asks the nurse when she will feel fetal movements. The nurse responds by telling the woman that the first recognition of fetal movement will occur at approximately which week of gestation?

18

The nurse is collecting data from a pregnant client who is currently at 28 weeks' gestation. At her prior prenatal visit, her fundal height measured 22 cm. The nurse measures the fundal height at this visit in centimeters and would expect which finding?

26 cm

The nurse is providing instructions to a pregnant client with genital herpes about the measures that need to be implemented to protect the fetus. Which instruction should the nurse provide to the client?

A cesarean section will be necessary if vaginal lesions are present at the time of labor.

The nurse is collecting data from a client who is pregnant with triplets. The client also has a 3-year-old child who was born at 39 weeks' gestation. The nurse would document which gravida and para status on this client?

Gravida II, para I

The nurse is reinforcing teaching to a pregnant woman about the physiological effects and hormonal changes that occur during pregnancy. The woman asks the nurse about the purpose of estrogen. The nurse bases the response on which purpose of estrogen?

It stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation.

The client arrives at the prenatal clinic for her first prenatal assessment. The client tells the nurse that the first day of her last menstrual period (LMP) was October 20, 2022. Using Nägele's rule, the nurse determines the estimated date of birth is which date?

July 27, 2023

The nurse is assisting with caring for a postpartum client who is experiencing uterine hemorrhage. When planning to meet the psychosocial needs of the client, the nurse would plan which action?

Keep the client and her family members informed of her progress.

The nurse is assigned to assist with caring for a client who has been admitted to the labor unit. The client is 9 cm dilated and is experiencing precipitous labor. Which is the priority nursing action?

Keep the client in a side-lying position.

The client is in her second trimester of pregnancy. She complains of frequent low back pain and ankle edema at the end of the day. The nurse would recommend which measure to help relieve both discomforts?

Lie on the floor with the legs elevated onto a couch or padded chair, with the hips and knees at a right angle.

The nurse is assigned to assist with caring for a neonate born to a mother who is human immunodeficiency virus (HIV)-positive. The nurse understands that which would be included in the plan of care?

Maintaining standard precautions at all times while caring for the neonate

A mother is breast-feeding her newborn baby and experiences breast engorgement. The nurse would encourage the mother to do which to provide relief of the engorgement?

Massage the breasts before feeding to stimulate let-down.

The nurse is reviewing the health record of a pregnant client at 16 weeks' gestation. The nurse would expect to document that the fundus of the uterus is located at which area?

Midway between the symphysis pubis and the umbilicus

The nurse is caring for a postpartum client. At 4 hours postpartum, the client's temperature is 102° F (38.9° C). Which is the appropriate nursing action?

Notify the registered nurse (RN), who will then contact the primary health care provider (PHCP).

The nurse is monitoring a newborn infant who was circumcised. The nurse notes that the infant has a temperature of 100.6° F and that the dressing at the circumcised area is saturated with a foul-smelling drainage. Which is the priority nursing action?

Notify the registered nurse.

The nurse is providing information to a pregnant woman about food items high in folic acid. Which mid-afternoon snack should be recommended to supply folic acid?

Nuts and green, leafy vegetables

A pregnant client asks the nurse about the hormone that stimulates postpartum contractions. The nurse tells the client that which primary hormone stimulates postpartum contractions?

Oxytocin

The nurse caring for a client with abruptio placentae is monitoring the client for signs of disseminated intravascular coagulopathy (DIC). The nurse would suspect DIC if which is observed?

Petechiae, oozing from injection sites, and hematuria

The nurse is reinforcing discharge instructions to the parents of a 2-year-old child who had an orchiopexy procedure done to treat cryptorchidism. The nurse would determine the parents understood the discharge instructions if they state which play activity is best for the child after this procedure?

Playing with clay

A mother is breast-feeding her newborn. The mother complains to the nurse that she is experiencing severe nipple soreness. The nurse would provide which suggestion to the client?

Position the newborn infant with the ear, shoulder, and hip in straight alignment and with the baby's stomach against the mother's.

The nurse is assisting with planning care for a postpartum woman who has small vulvar hematomas. To assist with reducing the swelling, the nurse would perform which action?

Prepare an ice pack for application to the area.

The client received epidural anesthesia during labor and had a forceps delivery after pushing for 2 hours. At 6 hours postpartum, the client's systolic blood pressure (BP) dropped 20 points, the diastolic BP dropped 10 points, and her pulse is 120 beats per minute. The client is very anxious and restless. The nurse is told that the client has a vulvar hematoma. Based on this diagnosis, the nurse would plan which action?

Prepare the client for surgery.

The nurse administers erythromycin ointment (0.5%) to the newborn's eyes, and the mother asks the nurse why this is done. The nurse would give which response to the client?

Prevents ophthalmia neonatorum from occurring after delivery to a neonate born to a woman with an untreated gonococcal infection

The client asks the nurse about the purpose of the placenta. The nurse plans to respond to the client knowing which about the placenta?

Provides an exchange of nutrients and waste products between the mother and the fetus

The nurse palpates the fundus and checks the character of the lochia of a postpartum client who is in the fourth stage of labor. Which lochia characteristic would the nurse expect to note?

Red

The nurse is caring for a client who is in labor. The nurse rechecks the client's blood pressure and notes that it has dropped. To decrease the incidence of supine hypotension, the nurse would encourage the client to remain in which position?

Side-lying

A pregnant client is seen in the health care clinic for a regular prenatal visit. The client tells the nurse that she is experiencing irregular contractions. The nurse determines that the client is experiencing Braxton Hicks contractions. Based on this finding, which nursing action is appropriate?

Tell the client that these are common and they may occur throughout the pregnancy.

Which would be included in the plan of care for a pregnant teenager to reinforce instructions regarding dental care?

Tell the dental office staff that she is pregnant.

The client is undergoing an amniocentesis at 16 weeks' gestation to detect the presence of biochemical or chromosomal abnormalities. Which instructions would the nurse reinforce to the client?

The bladder must be full during the examination.

After episiotomy and the delivery of a newborn, the nurse performs a perineal check on the mother. The nurse notes a trickle of bright red blood coming from the perineum. The nurse checks the fundus and notes that it is firm. Which determination would the nurse make?

The bright red bleeding is abnormal and should be reported.

The nurse is monitoring a client with mild gestational hypertension (GH). Which data indicate that GH is a concern?

The client complains of a headache and blurred vision.

A client beginning week 30 of gestation comes to the clinic for a routine visit. Which observation by the nurse indicates a need for further teaching?

The client is wearing knee-high hose.

The nurse is preparing a pregnant client for a transvaginal ultrasound exam. The nurse should tell the client that which will occur?

The client will feel some pressure when the vaginal probe is moved.

The nurse is checking lochia discharge on a client in the immediate postpartum period and notes that the lochia is bright red and contains some small clots. Which interpretation would the nurse make about this finding?

The finding is normal.

Leopold's maneuvers will be performed on a pregnant client. The client asks the nurse about the procedure. Which information would the nurse provide to the client about Leopold's maneuvers?

The maneuvers are a systematic method for palpating the fetus through the maternal abdominal wall.

The nurse is planning to reinforce instructions about cord care to a new mother. The nurse should plan to tell the mother which about cord care?

The process of keeping the cord clean and dry will decrease bacterial growth.

The nurse is assigned to care for the client during the postpartum period. The client asks the nurse what the term involution means. Which description would the nurse give to the client?

The progressive descent of the uterus into the pelvic cavity, which occurs at a rate of approximately 1 cm/day

A pregnant client in the third trimester of pregnancy with a diagnosis of mild preeclampsia is being monitored at home for progression of the disease process. The home care nurse reinforces teaching the client about the signs that need to be reported to the primary health care provider (PHCP) and tells the client to call the PHCP if which occurs?

Weight increases by more than 1 pound in a week.

The nurse is collecting data from a pregnant client when the client asks the nurse about the purpose of the fallopian tubes. Which is the accurate response the nurse would make?

Where fertilization occurs