OB Test 3 Study Guide
A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome? A) congenital anomalies B) incompetent cervix C) placenta previa D) abruptio placentae
A
A client experienced prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which condition in the mother and the newborn? A) infection B) hemorrhage C) trauma D) hypovolemia
A
A client is suspected of having a ruptured ectopic pregnancy. Which assessment would the nurse identify as the priority? A) hemorrhage B) jaundice C) edema D) infection
A
A nurse is developing a plan of care for a woman who is at risk for thromboembolism. Which measure would the nurse include as the most cost-effective method for prevention? A) prophylactic heparin administration B) compression stockings C) early ambulation D) warm compresses
C
A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which finding would require immediate intervention? A) fetal heart rate of 150 beats/minute B) contractions every 2 minutes, lasting 45 seconds C) uterine resting tone of 14 mm Hg D) urine output of 20 mL/hour
D
A multipara client develops thrombophlebitis after delivery. Which assessment finding would lead the nurse to intervene immediately? 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
The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth? A) 11 B) 8 C) 6 D) 3
A
When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage because: 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
When teaching a class of pregnant women about the effects of substance abuse during pregnancy, the nurse would most likely include which effect? A) low-birthweight infants B) excessive weight gain C) higher pain tolerance D) longer gestational periods
A
Which compound would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia? A) calcium gluconate B) potassium chloride C) ferrous sulfate D) calcium carbonate
A
A nurse is conducting a review class for a group of perinatal nurses working at the local clinic. The clinic sees a high population of women who are HIV positive. After discussing the recommendations for antiretroviral therapy with the group, the nurse determines that the teaching was successful when the group identifies which rationale as the underlying principle for the therapy? A) reduction in viral loads in the blood B) treatment of opportunistic infections C) adjunct therapy to radiation and chemotherapy D) can cure acute HIV/AIDS infections
A
A nurse is making a home visit to a postpartum client. Which finding would most likely lead the nurse to suspect that a woman is experiencing postpartum psychosis? A) delirium B) feelings of guilt C) sadness D) insomnia
A
A nurse is preparing a teaching program for a group of pregnant women about preventing infections during pregnancy. When describing measures for preventing cytomegalovirus infection, which measure would the nurse most likely include? A) frequent handwashing B) immunization C) prenatal screening D) antibody titer screening
A
A nurse is reading a journal article about cesarean births and the indications for them. Which indication for cesarean birth occurs most frequently? A) labor dystocia B) abnormal fetal heart rate tracing C) fetal malpresentation D) multiple gestation
A
A nurse is teaching a woman about measures to prevent preterm labor in future pregnancies because the woman just experienced preterm labor with her most recent pregnancy. The nurse determines that the teaching was successful based on which statement by the woman? A) "I'll make sure to limit the amount of long distance traveling I do." B) "Stress isn't a problem that is related to preterm labor." C) "Separating pregnancies by about a year should be helpful." D) "I'll need extra iron in my diet so I have a extra for the baby."
A
A pregnant client whose diabetes has been poorly controlled throughout her pregnancy is in labor. The nurse would assess the neonate closely at birth for which condition? A) macrosomia B) hyperglycemia C) low birthweight D) hypobilirubinemia
A
A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which effect? A) uterine hyperstimulation B) headache C) blurred vision D) hypotension
A
A pregnant woman tests positive for HBV. What would the nurse expect to administer? A) HBV immune globulin B) HBV vaccine C) acylcovir D) valacyclovir
A
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) 88 mg/dL B) 100 mg/dL C) 110 mg/dL D) 120 mg/dL
A
A woman is to undergo an amnioinfusion. Which statement would be most appropriate to include when teaching the woman about this procedure? A) "You'll need to stay in bed while you're having this procedure." B) "We'll give you an analgesic to help reduce the pain." C) "After the infusion, you'll be scheduled for a cesarean birth." D) "A suction cup is placed on your baby's head to help bring it out."
A
A woman who is 42 weeks pregnant comes to the clinic. During the visit, which assessment would be most important for the nurse to perform? A) determining an accurate gestational age B) asking her about the occurrence of contractions C) checking for spontaneous rupture of membranes D) measuring the height of the fundus
A
After reviewing a client's history, which factor would the nurse identify as placing her at risk for gestational hypertension? A) Mother had gestational hypertension during pregnancy. B) Client has a twin sister. C) Sister-in-law had gestational hypertension. D) This is the client's second pregnancy.
A
After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful? A) "I will be sure to avoid getting pregnant for at least 1 year." B) "My intake of iron will have to be closely monitored for 6 months." C) "My blood pressure will continue to be increased for about 6 more months." D) "I won't use my birth control pills for at least a year or two."
A
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 condition? A) hematoma B) laceration C) bladder distention D) uterine atony
A
On a follow up visit to the clinic, a nurse suspects that a postpartum client is experiencing postpartum psychosis. Which finding would most likely lead the nurse to suspect this condition? A) delusional beliefs B) feelings of anxiety C) sadness D) insomnia
A
While assessing a pregnant woman, the nurse suspects that the client may be at risk for hydramnios based on which factor? Select all that apply. A) history of diabetes B) reports shortness of breath C) identifiable fetal parts on abdominal palpation D) difficulty obtaining fetal heart rate E) fundal height below that for expected gestational age
A, B, D
A nurse is teaching a woman with mild preeclampsia about important areas that she needs to monitor. The nurse determines that the teaching was successful based on which statement by the woman? Select all that apply. A) "I should check my blood pressure twice a day." B) "I will weigh myself once a week." C) "I should complete a fetal kick count each day." D) "I will check my urine for protein four times a day." E) "I'll call my health care provider if I have burning when I urinate."
A, C, E
A nurse suspects that a pregnant client may be experiencing abruptio placenta based on assessment of which finding? Select all that apply. A) dark red vaginal bleeding B) insidious onset C) absence of pain D) rigid uterus E) absent fetal heart tones
A, D, E
17. A postpartum woman is diagnosed with metritis. The nurse interprets this as an infection involving which area? Select all that apply. A) endometrium B) decidua C) myometrium D) broad ligament E) ovaries F) fallopian tubes
A,B,C
A nurse is assessing a pregnant woman who has come to the clinic. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings? Select all that apply. A) dull low backache B) malodorous vaginal discharge C) dysuria D) constipation E) four to five contractions in 1 hour
A,B,C
A pregnant client has received dinoprostone. Following administration of this medication, the nurse assesses the client and determines that the client is experiencing an adverse effect of the medication based on which client report? Select all that apply. A) headache B) nausea C) diarrhea D) tachycardia E) hypotension
A,B,C
After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse determines that the teaching was successful when the woman identifies which food as being good sources of iron in her diet? Select all that apply. A) dried fruits B) peanut butter C) meats D) milk E) white bread
A,B,C
A nurse is conducting an in-service program for a group of labor and birth unit nurses about cesarean birth. The group demonstrates understanding of the information when they identify which condition as an appropriate indication? Select all that apply. A) active genital herpes infection B) placenta previa C) previous cesarean birth D) prolonged labor E) fetal distress
A,B,C,E
A nurse is conducting a review course on tocolytic therapy for perinatal nurses. After teaching the group, the nurse determines that the teaching was successful when they identify which drugs as being used for tocolysis? Select all that apply. A) nifedipine B) magnesium sulfate C) dinoprostone D) misoprostol E) indomethacin
A,B,E
A nurse is providing a refresher class for a group of postpartum nurses. The nurse reviews the risk factors associated with postpartum hemorrhage. The group demonstrates understanding of the information when they identify which risk factors associated with uterine tone? Select all that apply. A) rapid labor B) retained blood clots C) hydramnios D) operative birth E) fetal malposition
A,C
A nurse has been invited to speak at a local high school about adolescent pregnancy. When developing the presentation, the nurse would incorporate information related to which aspect? Select all that apply. A) peer pressure to become sexually active B) rise in teen birth rates over the years. C) latinas as having the highest teen birth rate D) loss of self-esteem as a major impact E) majority of teen pregnancies in the 15- to 17-year-old age group
A,C,D
The nurse is developing a discharge teaching plan for a postpartum woman who has developed a postpartum infection. Which measures would the nurse most likely include in this teaching plan? Select all that apply. A) taking the prescribed antibiotic until it is finished B) checking temperature once a week C) washing hands before and after perineal care D) handling perineal pads by the edges E) directing peribottle to flow from back to front
A,C,D
The nurse notifies the obstetrical team immediately because the nurse suspects that the pregnant woman may be exhibiting signs and symptoms of amniotic fluid embolism. Which findings would the nurse most likely assess? Select all that apply. A) significant difficulty breathing B) hypertension C) tachycardia D) pulmonary edema E) bleeding with bruising
A,C,D,E
Assessment of a postpartum woman experiencing postpartum hemorrhage reveals mild shock. Which finding would the nurse expect to assess? Select all that apply. A) diaphoresis B) tachycardia C) oliguria D) cool extremities E) confusion
A,D
A home health care nurse is assessing a postpartum woman who was discharged 2 days ago. The woman tells the nurse that she has a low-grade fever and feels "lousy." Which finding would lead the nurse to suspect metritis? Select all that apply. A) lower abdominal tenderness B) urgency C) flank pain D) breast tenderness E) anorexia
A,E
A a nurse is conducting a presentation for a group of pregnant women about measures to prevent toxoplasmosis. The nurse determines that additional teaching is needed when the group identifies which measure as preventative? 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
A group of nurses are reviewing information about mastitis and its causes in an effort to develop a teaching program on prevention for postpartum women. The nurses demonstrate understanding of the information when they focus the teaching on ways to minimize risk of exposure to which organism? A) E. coli B) S. aureus C) Proteus D) Klebsiella
B
A nurse is assessing a client who gave birth vaginally about 4 hours ago. The client tells the nurse that she changed her perineal pad about an hour ago. On inspection, the nurse notes that the pad is now saturated. The uterus is firm and approximately at the level of the umbilicus. Further inspection of the perineum reveals an area, bluish in color and bulging just under the skin surface. Which action would the nurse do next? A) Apply warm soaks to the area. B) Notify the health care provider. C) Massage the uterine fundus. D) Encourage the client to void.
B
A nurse is assessing a postpartum client who is at home. Which statement by the client would lead the nurse to suspect that the client may be developing postpartum depression? A) "I just feel so overwhelmed and tired." B) "I'm feeling so guilty and worthless lately." C) "It's strange, one minute I'm happy, the next I'm sad." D) "I keep hearing voices telling me to take my baby to the river."
B
A nurse is conducting a class for pregnant women with diabetes. Which factor would the nurse emphasize as being most important in helping to reduce the maternal/fetal/neonatal complications associated with pregnancy and diabetes? A) stability of the woman's emotional and psychological status B) degree of glycemic control achieved during the pregnancy C) evaluation of retinopathy by an ophthalmologist D) blood urea nitrogen level (BUN) within normal limits
B
A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world? A) rubella B) hepatitis B C) cytomegalovirus D) parvovirus B19
C
A nurse is conducting a program for pregnant women with gestational diabetes about reducing complications. The nurse determines that the teaching was successful when the group identifies which factor as being most important in helping to reduce complications associated with pregnancy and diabetes? A) stability of the woman's emotional and psychological status B) degree of blood glucose control achieved during the pregnancy C) reduction in retinopathy risk by frequent ophthalmologic evaluations D) control of blood urea nitrogen (BUN) levels for optimal kidney function
B
A nurse is conducting an in-service presentation to a group of perinatal nurses about sexually transmitted infections and their effect on pregnancy. The nurse determines that the teaching was successful when the group identifies which infection as being responsible for ophthalmia neonatorum? A) syphilis B) gonorrhea C) chlamydia D) HPV
B
A nurse is describing the risks associated with prolonged pregnancies as part of an inservice presentation. Which factor 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
A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program? A) administering broad-spectrum antibiotics B) inspecting the placenta after delivery for intactness C) manually removing the placenta at delivery D) applying pressure to the umbilical cord to remove the placenta
B
A nurse is explaining to a group of nurses new to the labor and birth unit about about methods used for cervical ripening. The group demonstrates understanding of the information when they identify which method as a mechanical one? A) herbal agents B) laminaria C) membrane stripping D) amniotomy
B
A nurse is massaging a postpartum client's fundus and places the nondominant hand on the area above the symphysis pubis based on the understanding that this action: A) determines that the procedure is effective. B) helps support the lower uterine segment. C) aids in expressing accumulated clots. D) prevents uterine muscle fatigue.
B
A nurse is reviewing a journal article on the causes of postpartum hemorrhage. Which condition would the nurse most likely find as the most common cause? A) labor augmentation B) uterine atony C) cervical or vaginal lacerations D) uterine inversion
B
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 finding? A) nonpalpable fundus B) moderate lochia serosa C) bruising on arms and legs D) fever
B
A postpartum woman who developed deep vein thrombosis is being discharged on anticoagulant therapy. After teaching the woman about this treatment, the nurse determines that additional teaching is needed when the woman makes which statement? A) "I will use a soft toothbrush to brush my teeth." B) "I can take ibuprofen if I have any pain." C) "I need to avoid drinking any alcohol." D) "I will call my health care provider if my stools are black and tarry."
B
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
A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. Which level would the nurse identify as therapeutic? A) 3.3 mEq/L B) 6.1 mEq/L C) 8.4 mEq/L D) 10.8 mEq/L
B
A woman pregnant with twins comes to the clinic for an evaluation. The nurse closely assesses the client for which potential problem? A) oligohydramnios B) preeclampsia C) post-term labor D) chorioamnionitis
B
A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make? A) "It's probably not a good idea for you to get pregnant since you have lupus." B) "Be sure that your lupus is stable or in remission for 6 months before getting pregnant." C) "Your lupus will not have any effect on your pregnancy whatsoever." D) "If you get pregnant, we'll have to add quite a few medications to your normal treatment plan.
B
A woman with gestational hypertension experiences a seizure. Which intervention would the nurse identify as the priority? A) fluid replacement B) oxygenation C) control of hypertension D) delivery of the fetus
B
A woman with placenta previa is being treated with expectant management. The woman and fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that home care might be inappropriate? A) "My mother lives next door and can drive me here if necessary." B) "I have a toddler and preschooler at home who need my attention." C) "I know to call my health care provider right away if I start to bleed again." D) "I realize the importance of following the instructions for my care."
B
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
After presenting an in-service presentation on measures to prevent postpartum hemorrhage, the nurse determines that the teaching was successful when the group identifies which measure to prevent postpartum hemorrhage due to retained placental fragments? A) administering broad-spectrum antibiotics B) inspecting the placenta after delivery for intactness C) manually removing the placenta at delivery D) applying pressure to the umbilical cord to remove the placenta
B
After teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching? A) "Holding a pillow against my incision will help me when I cough." B) "I'm going to have to wait a few days before I can start breast-feeding." C) "I guess the nurses will be getting me up and out of bed rather quickly." D) "I'll probably have a tube in my bladder for about 24 hours or so."
B
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 (38° C)." 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 peri-bottle so it the water flows front to back."
B
The fetus of a woman in labor is determined to be in persistent occiput posterior position. Which intervention would the nurse identify as the priority? A) position changes B) pain relief measures C) immediate cesarean birth D) oxytocin administration
B
The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion? A) wide, large eyes B) thin upper lip C) protruding jaw D) elongated nose
B
The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes interventions focusing on which area because of the woman's increased risk? A) oligohydramnios B) preeclampsia C) post-term labor D) chorioamnionitis
B
The nurse would be alert for possible placental abruption during labor when assessment reveals which finding? A) macrosomia B) gestational hypertension C) gestational diabetes D) low parity
B
When assessing several women for possible VBAC, which woman would the nurse identify as being the best candidate? A) one who has undergone a previous myomectomy B) one who had a previous cesarean birth via a low transverse incision C) one who has a history of a contracted pelvis D) one who has a vertical incision from a previous cesarean birth
B
When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which schedule would be most appropriate? A) monthly visits until 32 weeks, then bi-monthly visits B) bi-monthly visits until 28 weeks, then weekly visits C) monthly visits until 20 weeks, then bi-monthly visits D) bi-monthly visits until 36 weeks, then weekly visits
B
A nurse is reviewing an article about preterm premature rupture of membranes. Which factors would the nurse expect to find placing a woman at high risk for this condition? Select all that apply. A) high body mass index B) urinary tract infection C) low socioeconomic status D) single gestations E) smoking
B, C, E
A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which finding would lead the nurse to suspect that the woman is developing an infection? Select all that apply. A) fetal bradycardia B) abdominal tenderness C) elevated maternal pulse rate D) decreased C-reactive protein levels E) cloudy malodorous fluid
B, C, E
A pregnant woman at 31-weeks' gestation calls the clinic and tells the nurse that she is having contractions sporadically. Which instructions would be most appropriate for the nurse to give the woman? Select all that apply. A) "Walk around the house for the next half hour." B) "Drink 2 or 3 glasses of water." C) "Lie down on your back." D) "Try emptying your bladder." E) "Stop what you are doing and rest."
B,D,E
A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which signs 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,D,F
A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion. The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first trimester abortions? A) maternal disease B) cervical insufficiency C) fetal genetic abnormalities D) uterine fibroids
C
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication? A) urinary output of 20 mL per hour B) respiratory rate of 10 breaths/minute C) deep tendons reflexes 2+ D) difficulty in arousing
C
A client is experiencing postpartum hemorrhage, and the nurse begins to massage her fundus. Which action would be most appropriate for the nurse to do when massaging the 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.
C
A client with hyperemesis gravidarum is admitted to the facility after being cared for at home without success. What would the nurse expect to include in the client's plan of care? A) clear liquid diet B) total parenteral nutrition C) nothing by mouth D) administration of labetalol
C
A nurse is preparing an inservice education program for a group of nurses about dystocia involving problems with the passenger. Which problem would the nurse most likely include as the most common? A) macrosomia B) breech presentation C) persistent occiput posterior position D) multifetal pregnancy
C
A nurse is teaching a pregnant woman with preterm premature rupture of membranes who is about to be discharged home about caring for herself. Which statement by the woman indicates a need for additional teaching? A) "I need to keep a close eye on how active my baby is each day." B) "I need to call my doctor if my temperature increases." C) "It's okay for my husband and me to have sexual intercourse." D) "I can shower, but I shouldn't take a tub bath."
C
A nurse suspects that a client may be developing disseminated intravascular coagulation. The woman has a history of abruptio placenta during delivery. Which finding would help to support the nurse's suspicion? A) severe uterine pain B) board-like abdomen C) appearance of petechiae D) inversion of the uterus
C
A postpartum woman is ordered to receive oxytocin to stimulate the uterus to contract. Which action 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
A woman developed abruptio placenta during the birth of her neonate. The nurse would monitor the client closely for changes. Which finding would be a cause for alarm? A) severe uterine pain B) board-like abdomen C) appearance of petechiae D) inversion of the uterus
C
A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse would be alert for which possible effect in the newborn? A) asphyxia B) clavicular fracture C) cephalhematoma D) central nervous system injury
C
A woman hospitalized with severe preeclampsia is being treated with hydralazine to control blood pressure. Which finding would the lead the nurse to suspect that the client is having an adverse effect associated with this drug? A) gastrointestinal bleeding B) blurred vision C) tachycardia D) sweating
C
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
A woman with a history of crack cocaine abuse is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also reports acute abdominal pain that is continuous. Which condition would the nurse suspect? A) amniotic fluid embolism B) shoulder dystocia C) uterine rupture D) umbilical cord prolapse
C
A woman with hyperemesis gravidarum asks the nurse about suggestions to minimize nausea and vomiting. Which suggestion would be most appropriate for the nurse to make? A) "Make sure that anything around your waist is quite snug." B) "Try to eat three large meals a day with less snacking." C) "Drink fluids in between meals rather than with meals." D) "Lie down for about an hour after you eat."
C
After teaching a group of nurses working at the women's health clinic about the impact of pregnancy on the older woman, which statement by the group indicates that the teaching was successful? A) "The majority of women who become pregnant over age 35 experience complications." B) "Women over the age of 35 who become pregnant require a specialized type of assessment." C) "Women over age 35 and are pregnant have an increased risk for spontaneous abortions." D) "Women over age 35 are more likely to have substance abuse problems."
C
After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicates successful teaching? A) "I should take my iron with milk." B) "I should avoid drinking orange juice." C) "I need to eat foods high in fiber." D) "I'll call the primary care provider if my stool is black and tarry."
C
Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups. Based on an interpretation of these findings, the nurse would be especially alert for which condition? A) retained placental fragments B) hypertension C) thrombophlebitis D) uterine subinvolution
C
The health care provider orders PGE2 for a woman to help evacuate the uterus following a spontaneous abortion. Which action would be most important for the nurse to do? A) Use clean technique to administer the drug. B) Keep the gel cool until ready to use. C) Maintain the client supine for 1/2 hour after administration. D) Administer intramuscularly into the deltoid area.
C
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
Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which response by the nurse would be most appropriate? A) "Why are you crying?" B) "Will a pill help your pain?" C) "I'm sorry you lost your baby." D) "A baby still wasn't formed in your uterus."
C
Which information on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy? A) use of oral contraceptives for 5 years B) ovarian cyst 2 years ago C) recurrent pelvic infections D) heavy, irregular menses
C
A nurse is reviewing the medical record of a pregnant client. The nurse suspects that the client may be at risk for dystocia based on which factor? A) plan for pudendal block anesthetic use B) multiparity C) short maternal stature D) maternal age over 35 E) breech fetal presentation
C,D,E
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 statement 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
A nurse is assessing a postpartum client. Which finding would the cause the nurse the greatest concern? A) leg pain on ambulation with mild ankle edema B) calf pain with dorsiflexion of the foot C) perineal pain with swelling along the episiotomy D) sharp stabbing chest pain with shortness of breath
D
A nurse is assessing a postpartum woman. Which finding would cause the nurse to be most concerned? A) leg pain on ambulation with mild ankle edema B) calf pain with dorsiflexion of the foot C) perineal pain with swelling along the episiotomy D) sharp, stabbing chest pain with shortness of breath
D
A nurse is assessing a pregnant woman with gestational hypertension. Which finding would lead the nurse to suspect that the client has developed severe preeclampsia? A) urine protein 300 mg/24 hours B) blood pressure 150/96 mm Hg C) mild facial edema D) hyperreflexia
D
A nurse is conducting an assessment of a woman who has experienced PROM. Which finding would lead the nurse to suspect infection as the cause of a client's PROM? A) yellow-green fluid B) blue color on Nitrazine testing C) ferning D) foul odor
D
A nurse is counseling a pregnant woman with rheumatoid arthritis about medications that can be used during pregnancy. Which drug would the nurse emphasize as being contraindicated at this time? A) hydroxychloroquine B) nonsteroidal anti-inflammatory drugs C) glucocorticoid D) methotrexate
D
A nurse is providing care to several pregnant women at different weeks of gestation. The nurse would expect to screen for group B streptococcus infection in the client who is at: A) 16 weeks' gestation. B) 28 weeks' gestation. C) 32 weeks' gestation. D) 36 weeks' gestation.
D
A nurse is providing education to a woman who is experiencing postpartum hemorrhage and is to receive a uterotonic agent. The nurse determines that additional teaching is needed when the woman identifies which drug as treating postpartum hemorrhage? A) oxytocin B) methylergonovine C) carboprost D) terbutaline
D
A nurse is teaching a pregnant woman at risk for preterm labor about what to do if she experiences signs and symptoms. The nurse determines that the teaching was successful when the woman makes which statement? A) "I'll sit down to rest for 30 minutes." B) "I'll try to move my bowels." C) "I'll lie down with my legs raised." D) "I'll drink several glasses of water."
D
A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? A) hyperglycemia B) elevated platelet count C) disseminated intravascular coagulopathy (DIC) D) elevated liver enzymes
D
A postpartum client is prescribed medication therapy as part of the treatment plan for postpartum hemorrhage. Which medication would the nurse least expect to administer in this situation? A) oxytocin B) methylergonovine C) carboprost D) nifedipine
D
A pregnant woman asks the nurse, "I'm a big coffee drinker. Will the caffeine in my coffee hurt my baby?" Which response by the nurse would be most appropriate? A) "The caffeine in coffee has been linked to birth defects." B) "Caffeine has been shown to cause growth restriction in the fetus." C) "Caffeine is a stimulant and needs to be avoided completely." D) "If you keep your intake to less than 300 mg/day, you should be okay."
D
A woman at 10 weeks gestation comes to the clinic for an evaluation. Which finding might lead the nurse to suspect gestational trophoblastic disease? A) report of frequent mild nausea B) blood pressure of 120/84 mm Hg C) history of bright red spotting 6 weeks ago D) fundal height measurement of 18 cm
D
A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would question the woman about which symptom? A) an inverted nipple on the affected breast B) no breast milk in the affected breast C) an ecchymotic area on the affected breast D) hardening of an area in the affected breast
D
A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant? A) budesonide B) albuterol C) salmeterol D) oral prednisone
D
A woman with diabetes is considering becoming pregnant. She asks the nurse whether she will be able to take oral hypoglycemics when she is pregnant. The nurse's response is based on the understanding that oral hypoglycemics: A) can be used as long as they control serum glucose levels. B) can be taken until the degeneration of the placenta occurs. C) are usually suggested primarily for women who develop gestational diabetes. D) show promising results, but more studies are needed to confirm their degree of safety.
D
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
As part of an inservice program to a group of home health care nurses who care for postpartum women, a nurse is describing postpartum depression. The nurse determines that the teaching was successful when the group identifies that this condition becomes evident at which time after birth of the newborn? A) in the first week B) within the first 2 weeks C) in approximately 1 month D) within the first 6 weeks
D
Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance? A) marijuana B) alcohol C) heroin D) cocaine
D
Assessment of a woman in labor who is experiencing hypertonic uterine dysfunction would reveal contractions that are: A) well coordinated. B) poor in quality. C) brief. D) erratic.
D
It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time? A) at 32 weeks' gestation and immediately before discharge B) 24 hours before delivery and 24 hours after delivery C) in the first trimester and within 2 hours of delivery D) at 28 weeks' gestation and again within 72 hours after delivery
D
The nurse is conducting a class for postpartum women about mood disorders. The nurse describes a transient, self-limiting mood disorder that affects mothers after childbirth. The nurse determines that the women understood the description when they identify the condition as postpartum: A) depression. B) psychosis. C) bipolar disorder. D) blues.
D
The nurse is reviewing the laboratory test results of a pregnant client. Which finding would alert the nurse to the development of HELLP syndrome? A) hyperglycemia B) elevated platelet count C) leukocytosis D) elevated liver enzymes
D
The nurse is reviewing the physical examination findings for a client who is to undergo labor induction. Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction? A) posterior position B) firm C) closed D) shortened
D
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
Which finding would the nurse interpret as suggesting a diagnosis of gestational trophoblastic disease? A) elevated hCG levels, enlarged abdomen, quickening B) vaginal bleeding, absence of FHR, decreased hPL levels C) visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen D) gestational hypertension, hyperemesis gravidarum, absence of FHR
D
