practice questions
A client at 40 weeks' gestation informs the nurse that she is tired of being pregnant. What is the best response from the nurse?
"That is a very normal feeling, especially at this point in pregnancy."
A client who is breast-feeding her newborn tells the nurse, "I notice that when I feed him, I feel fairly strong contraction-like pain. Labor is over. Why am I having contractions now?" Which response by the nurse would be most appropriate?
"the baby's sucking releases a hormone that causes the uterus to contract."
Normal HCG levels
1,000-2,000=normal 800=minimum
pre-term labor
20-37 weeks
Diphenhydramine (Benadryl) *Nalbuphine (Nubain)
: can be used for patient c/o itching with epidural
The night shift LPN is checking on a woman who had a cesarean delivery with spinal morphine injection anesthesia early that morning. The nurse counts a respiratory rate of 8 per minute. What should the nurse do first?
Administer naloxone per the preprinted orders.
As a woman enters the second stage of labor, her membranes spontaneously rupture. When this occurs, what would the nurse do next?
Assess fetal heart rate for fetal safety.
A primigravida in preterm labor at 34 weeks gestation feels a sudden gush of water and tells the healthcare provider, "I think my water broke." What is the priority action by the healthcare provider?
Assess the fetal heart rate
A woman is bottle-feeding her baby. When the nurse comes into the room the woman says that her breasts are painful and engorged. Which nursing intervention is appropriate?
Assist the woman in placing ice packs on her breasts.
Transcutaneous electrical nerve stimulation (TENS) reduces pain by which of the following mechanisms?
Electrical impulses are created that interfere with nerve transmission.
The healthcare provider is caring for a woman during the birth of her baby. As the fetal head is delivered, the healthcare provider notes that the head retracts against the mother's perineum ("turtle sign"). What actions will the healthcare provider implement?
Empty the woman's bladder call for assistance Flex the woman's thighs against her abdomen
When evaluating the fetal heart rate (FHR) pattern for a woman in active labor, the healthcare provider notes periodic decelerations in the FHR with the following characteristics: Gradual decrease in FHR Onset just prior to the uterine contraction120 beats/minute at the peak of the uterine contractionWaveform inversely mirrors uterine contraction
Document this as a normal finding
tdap
Tdap is a combination vaccine that protects against three potentially life-threatening bacterial diseases: tetanus, diphtheria, and pertussis (whooping cough
A nurse is assessing a pregnant client. The nurse understands that hormonal changes occur during pregnancy. Which hormones would the nurse most likely identify as being inhibited during the pregnancy?
FSH and LH
A client who is trying not to get pregnant calls the nurse on Saturday at 11 a.m. reporting that she had unprotected sex on Thursday at 10 p.m.. She believes she has just ovulated and wants to verify that she has no risk of pregnancy. What can the nurse tell her?
If she ovulated on Saturday around 11 a.m., the egg could be fertilized any time before about 11 a.m. on Sunday.
naloxone
Narcan Opioid antagonist
Meperidine (Demerol)
Opioid
A nurse is educating a group of nursing students about the etiology of labor. Which of the following should the nurse explain as the hormone produced by the posterior pituitary?
Oxytocin
quad screen
Quad Screen. The quad screen is a simple blood test that screens pregnancies for Down syndrome, trisomy 18 and neural tube defects. ... This screen is performed during the second trimester of pregnancy, between 15 and 22 weeks
week 24-28 if needed
RhoGAM, if given to you at the right time, will prevent your immune system from reacting to your baby's blood. ... RhoGAM prevents the Rh-negative mother from making antibodies directed against her baby's Rh-positive red blood cells during her pregnancy.
A woman with a history of pelvic inflammatory disease (PID) presents to the urgent care clinic with a report of dizziness, sharp abdominal pain, and scant dark red vaginal discharge. She has missed two menstrual periods and thinks she might be pregnant. A pregnancy test confirms her pregnancy. These assessment findings indicate the woman is experiencing which of the following problems?
Ruptured ectopic pregnancy
The following fish should be avoided during pregnancy because they are higher in mercury, which can be harmful at very high levels.
Shark Swordfish King mackerel Tilefish Bigeye tuna (found in sushi) Marlin Orange roughy
Hormonal regulation of reproductive functions in both the male and the female are complicated processes. In the male, where are the sex hormones produced?
Testes
A Maternal serum alpha-fetoprotein (MSAFP) test reveals an hCG level of 2.5 MoM. The nurse interprets these results as indicating which of the following?
The fetus is at greater risk for Down's syndrome
side effects of IV oxytocin
Uterine tetany uterine rupture fetal hypoxia Water intoxication
You care for a woman in a prenatal clinic who thinks she might be pregnant. Which of the following assessments is a PROBABLE sign of pregnancy?
a positive pregnancy test
A woman needing home care will be discharged from an antepartum unit in 3 hours. The woman will be monitored for BP and blood glucose, and instruction will be given regarding her self-administration of subcutaneous heparin. The agency is contacted and arrangements are made for which person to make the initial visit?
an RN
when should they take prenatal vitamins to help with N & V
at night time
antepartum
before birth
tdap is offered at the
beginning of the third trimester
taking folic acid
decreases birth defects
ovum
egg
efm
electronic fetal monitoring
corpus luteum
empty ovarian follicle that secretes progesterone after release of the egg cell
nurse is monitoring a fetal heart rate (FHR) pattern on her client in labor and notes a change from the earlier baseline FHR of 140 bpm to 168 bpm. The nurse is aware that which factors can result in fetal tachycardia? Select all that apply.
fetal distress fetal movement maternal fever utero-placental insufficiency
A nurse palpates a woman's fundus to determine contraction intensity. What would be mostappropriate for the nurse to use for palpation?
finger pads
Meconium
first stool of the newborn
After a normal labor and birth, a client is discharged from the hospital 12 hours later. When the community health nurse makes a home visit 2 days later, which finding would alert the nurse to the need for further intervention?
frequent scant voiding `
A nurse is listening to a patient's heart and determines that there is a change since the last normal prenatal visit. The patient has no history of heart disease, so which of the following should the nurse expect has developed?
functional murmor
discoloration of stomach is normal and due to
hormonal changes
episiotomy
incision into the vulva
augmented
increased
macrosomia
large-bodied baby commonly seen in diabetic pregnancies
The nurse is assessing a client in labor for pain and notes she is currently not doing well handling the increased pain. Which opioid can the nurse offer to the client to assist with pain control?
meperidine
clonus
muscle spasm or twitching
A woman is admitted to the obstetric unit at 30 weeks gestation with a sudden onset of vaginal bleeding that is bright red in color. Her uterus is soft and her pain report is 0 on a 0 - 10 pain scale. The fetal heart rate is 140 beats/minute. The healthcare provider correctly identifies these assessment findings are related to which of the following problems?
placenta previa
During the fourth stage of labor, the nurse assesses the client's fundal height and tone. When completing this assessment, the nurse performs which action to prevent prolapse or inversion of the uterus?
places a gloved hand just above the symphysis pubis
checking urine in protein for
pre-eclampsia
optimal spot to check FHR
right lower quadrant
placenta previa
the abnormal implantation of the placenta in the lower portion of the uterus
A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs:
the fallopian tubes
Which vaccine is safe to give in pregnancy?
the flu vaccine after the 1st trimester
effacement
thinning of the cervix
· Ephedrine
used to treat hypotension
