OB Week 9 Quiz

A primary care provider prescribes intravenous tocolytic therapy for a woman in preterm labor. Which agent would the nurse expect to administer? magnesium sulfate indomethacin betamethasone nifedipine

magnesium sulfate

The mental health clinical nurse specialist is teaching a postpartum nurse how to use the Postpartum Depression Predictor Scale (PDSS) to assess for postpartum depression. The nurse specialist determines the need for additional teaching when the nurse identifies which component as being screened with the scale? emotional lability cognitive impairment family and social support system guilt

family and social support system

Which findings would lead the nurse to suspect that a postpartum woman has developed endometritis? Select all that apply. hematuria foul-smelling lochia leukocytosis pain on both sides of the abdomen flank pain

foul-smelling lochia leukocytosis pain on both sides of the abdomen

The nurse determines that a woman is experiencing postpartum hemorrhage after a vaginal birth when the blood loss is greater than which amount? 500 mL 1000 mL 300 mL 750 mL

1000 mL

A client presents to her postpartum appointment with vague reports. The nurse suspects postpartum depression based on which assessment finding? feels like eating all the time extreme periods of elation lack of pleasure over interest in her baby

lack of pleasure

A client is entering her 42nd week of gestation and is being prepared for induction of labor. The nurse recognizes that the fetus is at risk for which condition? hemorrhage macrosomia dystocia infection

macrosomia

After the nurse teaches a local woman's group about postpartum affective disorders, which statement by the group indicates that the teaching was successful? "Postpartum psychosis usually appears soon after the woman comes home." "Postpartum blues usually resolves by the 4th or 5th postpartum day." "Postpartum depression develops gradually, appearing within the first 6 weeks." "Postpartum psychosis usually involves psychotropic drugs but not hospitalization."

"Postpartum depression develops gradually, appearing within the first 6 weeks."

A primary care provider prescribes oral tocolytic therapy for a woman with preterm labor. The nurse explains to the client about the drugs that may be used. The nurse determines that the client needs additional teaching when she states which drug might be used for oral therapy? magnesium sulfate betamethasone nifedipine indomethacin

magnesium sulfate

A nurse is providing care to a couple who have experienced intrauterine fetal demise. Which action would be least effective in assisting a couple at this time? Assist the family in making arrangements for their stillborn infant. Allow the couple to spend as much time as they want with their stillborn infant. Give the parents a lock of the infant's hair. Avoid any discussion of the situation with the couple.

Avoid any discussion of the situation with the couple.

A 25-year-old nulliparous client presents in active labor. She has had no prenatal care, and her coagulation status is determined. Which result would the nurse identify as placing the client at risk for postpartum hemorrhage? activated partial thromboplastin time 60 seconds platelet 350,000 international normalized ratio (INF) 1.0 prothrombin time 11 seconds

activated partial thromboplastin time 60 seconds

While assessing a postpartum woman, the nurse palpates a contracted uterus. Perineal inspection reveals a steady stream of bright red blood trickling out of the vagina. The woman reports mild perineal pain. She just voided 200 mL of clear yellow urine. Which condition would the nurse suspect? hematoma uterine inversion laceration uterine atony

laceration

A woman presents to her first postpartum visit reporting she does not feel well. Which findings would lead the nurse to suspect that she has developed endometritis? Select all that apply. leukocytosis odorless lochia hematuria flank pain pain on both sides of the abdomen

leukocytosis pain on both sides of the abdomen

The client is anxious about her prolonged pregnancy. She informs the nurse she has been doing research on the Internet and has read about certain herbs that can help to induce labor. Which response from the nurse would be appropriate? "Personally, I would use them, but I cannot tell you to." "Why would you do something as stupid as that?" "There is no scientific evidence they work. You will just complicate your situation more." "Please talk to your primary care provider first to ensure it is safe."

"Please talk to your primary care provider first to ensure it is safe."

Which instruction would the nurse include in the teaching plan for a postpartum woman with mastitis? "You'll need to take this medication to stop the milk from being produced." "Stop breastfeeding until the pain and swelling subside." "Try applying warm compresses to your breasts to encourage the milk to be released." "Limit the amount of fluid you drink so your breasts don't get much fuller."

"Try applying warm compresses to your breasts to encourage the milk to be released."

What would the nurse use to monitor the effectiveness of intravenous anticoagulant therapy for a postpartum woman with deep vein thrombosis? Platelet level Activated partial thromboplastin time Fibrinogen level Prothrombin time

Activated partial thromboplastin time

The nurse plays a major role in assessing the progress of labor. The nurse integrates understanding of the typical rule for monitoring labor progress. Which finding would the nurse correlate with this rule? Fetus descends 1 cm per hour. Cervix dilates 2 cm per hour. Cervix dilates 1 cm per hour. Fetus descends 2 cm per hour.

Cervix dilates 1 cm per hour.

The nurse collects a urine specimen for culture from a postpartum woman with a suspected urinary tract infection. Which organism would the nurse expect the culture to reveal? Staphylococcus aureus Gardnerella vaginalis Klebsiella pneumoniae Escherichia coli

Escherichia coli

A client at 33 weeks' gestation is calling the office with various reports and is very concerned. The nurse recognizes which report(s) as indicating the client is potentially going into preterm labor? Select all that apply. GI upset (nausea, vomiting, diarrhea) achiness in the thighs irregular contractions low, dull backache general sense of discomfort

GI upset (nausea, vomiting, diarrhea) achiness in the thighs low, dull backache general sense of discomfort

A woman receiving an oxytocin infusion for labor induction develops contractions that occur every minute and last 75 seconds. Uterine resting tone remains at 20 mm Hg. Which action would be most appropriate? Slow the oxytocin infusion to the initial rate. Notify the birth attendant. Stop the infusion immediately. Continue to monitor contractions and fetal heart rate.

Stop the infusion immediately.

The nurse recognizes that the postpartum period is a time of rapid changes for each client. What is believed to be the cause of postpartum affective disorders? medications used during labor and birth drop in estrogen and progesterone levels after birth preexisting conditions in the client lack of social support from family or friends

drop in estrogen and progesterone levels after birth

The nurse is conducting a review class for a group of perinatal nurses about factors that place a pregnant woman at risk for infection in the postpartum period. The nurse determines that additional teaching is needed when the group identifies which factor? prolonged labor with multiple vaginal examinations to evaluate progress retained placental fragments loss of protection with premature rupture of membranes increased vaginal acidity leading to growth of bacteria

increased vaginal acidity leading to growth of bacteria

A client presents to the emergency department reporting regular uterine contractions. Examination reveals that her cervix is beginning to efface. The client is in her 36th week of gestation. The nurse interprets the findings as suggesting which condition is occurring? normal labor precipitate labor preterm labor dystocia

preterm labor

A woman is experiencing dystocia that appears related to psyche problems. Which intervention would be most appropriate for the nurse initiate? administering oxytocin providing a comfortable environment with dim lighting preparing the woman for an amniotomy encouraging the women to change positions frequently

providing a comfortable environment with dim lighting

After assessing a client's progress of labor, the nurse suspects the fetus is in a persistent occiput posterior position. Which finding would lead the nurse to suspect this condition? lack of cervical dilation past 2 cm reports of severe back pain fetal buttocks as the presenting part contractions most forceful in the middle of uterus rather than the fundus

reports of severe back pain

A nurse is making a follow up visit to a new parent and 3-month-old infant. The nurse is talking with the client about her role as a mother and caring for her infant. Which statement by the client would lead the nurse to immediately call the health care provider? "I am so angry with myself, I just want to give up my life right now." "I get tearful every so often and then suddenly I am all smiles." "I feel really restless and sad, nothing seems to make me happy." "It has been hard getting enough sleep with the infant waking up during the night."

"I am so angry with myself, I just want to give up my life right now."

A pregnant client is experiencing dystocia resulting from persistent occiput posterior position. The client, in the first stage of labor, is reporting significant back pain. The nurse encourages the client to change positions frequently for comfort and to help promote rotation of the fetal head. Which position(s) would be appropriate for the nurse to suggest? Select all that apply. Modified Sims Trendelenburg Hands and knees Side-lying Squatting

Hands and knees Side-lying Squatting

A nurse is teaching a 42-week nulliparous pregnant woman about labor induction which is being recommended by her health care provider. The nurse determines that the woman needs additional teaching when she identifies which assessment as being done before induction? fetal dating Maneuvers for fetal positioning amniotic fluid studies Bishop scoring

Maneuvers for fetal positioning

A client at 32 weeks' gestation has been admitted to the labor and birth unit with preterm labor. Which medication would the nurse be likely to administer to reduce the risk of complications in the preterm newborn? nifedipine magnesium sulfate indomethacin corticosteroids

corticosteroids

A client has arrived to the birthing center in labor, requesting a VBAC. After reading the client's previous history, the nurse anticipates that the client would be a good candidate based on which finding? has previous lower abdominal incision had prior transfundal uterine surgery had prior classic uterine incision has contracted pelvis

has previous lower abdominal incision

A 19-year-old nulliparous is in early labor with erratic contractions. An assessment notes that she is remaining at 3 cm. There is also a concern that the uterus is not fully relaxing between contractions. The nurse suspects which complication? reduced oxygen to the fetus ruptured uterus precipitate labor cephalopelvic disproportion

reduced oxygen to the fetus

Disseminated intravascular coagulation is a life-threatening condition that the nurse recognizes can occur as a complication secondary to which primary conditions? Select all that apply. isoimmunization ectopic pregnancy septicemia severe preeclampsia abruptio placenta

septicemia severe preeclampsia abruptio placenta

Every postpartum client has the potential of hemorrhage. While assessing a client's status, which finding would be of little benefit in identifying the possibility of hemorrhage? uterine tone estimated amount of blood loss signs of shock vital signs

signs of shock

A nurse is preparing for a class to teach pregnant women and their partners about postpartum complications. Which measure would be most important for the nurse to emphasize as helping to prevent postpartum infection? limiting contact with outsiders for the first week handwashing adequate follow up with their health care provider ensure proper hydration

handwashing

A client arrives in the emergency department accompanied by her husband and new 10-week-old infant, crying, confused, and with possible hallucinations. The nurse recognizes this could possibly be postpartum psychosis as it can appear within which time frame after birth? 2 months 3 months 5 months 4 months

3 months

The health care provider has determined that the source of dystocia for a woman is related to the fetus size. The nurse understands that macrosomia would indicate the fetus would weigh: 3,500 g to 4000 g 3,000 g to 3500 g 4,000 g to 4500 g 2500 to 3000 g

4,000 g to 4500 g

Quickly determining the cause of postpartum hemorrhaging enables effective treatment. A nurse using the 5 Ts tool will recognize which as a potential causes of postpartum hemorrhage? Select all that apply. technique of birth time tissue tone thrombin

tissue tone thrombin

After teaching a class of pregnant women on ways to decrease the postpartum complication of thrombotic conditions, the nurse recognizes more teaching is needed when one of the participants states: "He has to do the deep breathing exercises with me." "I should drink more so I don't get dehydrated." "At least I don't have to give up smoking for this one." "Using passive range-of-motion exercises in bed sounds easy enough."

"At least I don't have to give up smoking for this one."

A postpartum client with a history of deep vein thrombosis is being discharged on anticoagulant therapy. The nurse teaches the client about the therapy and measures to reduce her risk for bleeding. Which statement by the client indicates the need for additional teaching? "I need to avoid using any aspirin-containing products." "If I get a cut, I need to apply direct pressure for about 5 minutes or more." "I should brush my teeth vigorously to stimulate the gums." "If my lochia increases, I need to call my health care provider."

"I should brush my teeth vigorously to stimulate the gums."

A pregnant client's labor has been progressing slower than normal. The client is visibly anxious and tense, telling the nurse, "I am so worried about what is going to happen. And I am so tired and feel so helpless." Other underlying issues that may be contributing to the client's slow labor progress have been ruled out. Which response(s) by the nurse would be appropriate? Select all that apply. "Let me leave you alone for a little while so you can get some rest." "Maybe dimming the lights or some soft music will help you relax a bit." "I will keep you updated often on how you and your baby are doing." "I will have to stop giving you pain medicine because it is slowing your labor." "Things are moving along but sometimes it can take a little longer."

"Maybe dimming the lights or some soft music will help you relax a bit." "I will keep you updated often on how you and your baby are doing." "Things are moving along but sometimes it can take a little longer."

A pregnant client in labor experiences a problem with the passenger related to shoulder dystocia. The health care provider is planning to relieve it with McRoberts maneuver. The client asks the nurse, "What is going to happen when they try this?" Which response by the nurse would be appropriate? "You will get a medicine to increase the strength and frequency of your contractions to move things along." "Your thighs will be flexed and moved away from the center of your body to open things up." "The provider will place firm pressure on the area just above your pubic bone to unstick the shoulder." "A gel will be placed in your vagina to soften the cervix and allow the baby to move."

"Your thighs will be flexed and moved away from the center of your body to open things up."

A postpartum woman is being treated for hemorrhage and is to receive a blood transfusion. The nurse understands that this treatment is being instituted based on which amount of estimated blood loss? 1,250 mL 750 mL 1,500 mL 1000 mL

1,500 mL

The nurse is reviewing the medical record of a woman for whom induction of labor is being considered. The nurse notes the following: Cervical dilation 4 cm Effacement 60% 0 Station Soft cervix Anterior cervical position Based on this information, which Bishop score would the nurse assign? 8 6 10 12

10

A woman is to undergo labor induction. The nurse determines that the woman requires cervical ripening if her Bishop score is: 9 7 5 6

5

A nurse is assessing the perineum of several postpartum clients using the REEDA score. The nurse initiates interventions to minimize the risk for postpartum infection for the client with which score? 7 5 3 9

9

When the nurse is assisting the parents in the grieving process after the death of their neonate, what is the nurse's most important action? Removing the infant quickly. Keeping the communication lines open. Contacting a grief counselor. Leaving the parents alone.

Keeping the communication lines open.

A G3, P2 woman arrives at the birthing center stating that she has been in labor for the past 18 hours. The nurse suspects a protracted labor pattern disorder based on which finding? Slower than usual cervical dilation Incomplete relaxation of the uterus between contractions Poor contraction quality and intensity Fetal face presentation

Slower than usual cervical dilation

A pregnant client at 28 weeks' gestation in preterm labor has received a dose of betamethasone IM today at 1400. The client is scheduled to receive a second dose. At which time would the nurse expect to administer that dose? Tomorrow at 1400 Tomorrow at 0800 Today at 2200 Tomorrow at 1800 Tomorrow at 1200

Tomorrow at 1400

A nurse is administering oxytocin to a woman in labor. The nurse monitors the infusion closely and notifies the health care provider if signs and symptoms of which condition occurs? Fetal distress Water intoxication Uterine hypotonicity Hypertension

Water intoxication

A nurse assesses a client in labor and suspects dysfunctional labor (hypotonic uterine dysfunction). The woman's membranes have ruptured and fetopelvic disproportion is ruled out. Which intervention would the nurse expect to include in the plan of care for this client? providing a comfortable environment with dim lighting encouraging the woman to assume a hands-and-knees position administering oxytocin preparing the woman for an amniotomy

administering oxytocin

After teaching a review class to a group of perinatal nurses about various methods for cervical ripening, the nurse determines that the teaching was successful when the group identifies which method as surgical? amniotomy breast stimulation laminaria prostaglandin

amniotomy

As part of a review class for perinatal nurses, the nurse is explaining the laboratory and diagnostic tests that can be conducted to evaluate a woman's risk for preterm labor. The nurse determines that additional teaching is needed when the group identifies which test as being used? blood chemistry levels salivary estriol levels fetal fibronectin testing transvaginal ultrasound

blood chemistry levels

The nurse is assessing a woman who had a forceps-assisted birth for complications. Which condition would the nurse assess in the fetus? cervical lacerations perineal hematoma caput succedaneum infection of episiotomy

caput succedaneum

Various medications are available to help control hemorrhage in the postpartum client. When reviewing the client's history, the nurse notes she has a history of asthma. Which medication if prescribed would the nurse question? carboprost oxytocin methylergonovine misoprostol

carboprost

A 17-year-old nulliparous client presents in active labor. It is discovered that she received no prenatal care. Which information would be important to collect first? coagulation studies urinalysis results HIV status STI status

coagulation studies

The nurse reviews the history of a postpartum woman, G3, P3 and notes it is positive for obesity and smoking. The nurse would be especially alert for the development of signs and symptoms of which complication in this client? uterine atony postpartum hemorrhage deep venous thrombosis metritis

deep venous thrombosis

A nurse is reading a journal article about cervical ripening agents, based on the understanding that certain pharmaceuticals can be used to attain cervical ripening in women who need assistance in this area. They have also often continued into labor without further agents to stimulate uterine contractions. Which agent would the nurse anticipate reading about as an FDA-approved agent for cervical ripening? misoprostol oxytocin dinoprostone magnesium sulfate

dinoprostone

A nurse is conducting a class for nurses working in the postpartum unit about ways to reduce the risk of postpartum infections. The nurse determines that the teaching was effective when the group identifies which preventive measure as essential? meticulous handwashing unlimited visitation from family and friends use of clean gloves for invasive procedures fluid intake limitations

meticulous handwashing

Methylergonovine is prescribed for a woman experiencing postpartum hemorrhage. The nurse monitors the woman closely for which adverse effects? seizures flushing uterine hyperstimulation headache

seizures

Effective nursing management involves many aspects and being aware of subtle changes in the client. Which finding should alert the nurse to a potential infection in the client? temperature of 38.5° C or higher after the first 36 hours after birth temperature of 39° C or higher after the first 48 hours after birth temperature of 37.5° C or higher after the first 12 hours after birth temperature of 38° C or higher after the first 24 hours after birth

temperature of 38° C or higher after the first 24 hours after birth

A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition? uterine prolapse uterine atony uterine subinvolution uterine contraction

uterine atony