RN maternal newborn assessment B
which of the following findings in the pts hx should the nurse recognize as a contraindication to oral contraceptives? cholecystitis HTN HPV migraine headaches anxiety disorder
HTN cholecystitis migraine headaches
a nurse is reviewing the lab results for a pt who is at 10 wks. which of the following lab findings should the nurse report to the provider? Hemoglobin 10 WBC 15,000 RBC 5.8 million/mm3 Hematocrit 34%
Hemoglobin 10--the expected reference is greater than 11 for a pt who is pregnant
a nurse is assessing FHT for a pt who is pregnant. the nurse has determined the fetal position as left occiptal anterior. which area should the nurse apply the u/s to assess the PMI of the FHR? LUQ RUQ LLQ RLL
LLQ
a nurse is reviewing the MR of a pt who is PP and has preeclampsia. which of the following lab results should the nurse report to the provider? Hct 39% Serum albumin 4.5 ABC 9,000 Plts 50,000
Plts 50,000
a nurse is reviewing the medical record at 1800 for a pt who is 34 wks of gestation. based on the chart findings and documentation, the nursing plan of care should include which of the following actions? administer terbutaline discuss possible genetic anomalies based with pt administer nalbuphine discontinue external fetal monitoring
administer terbulatine
a nurse is performing a vaginal exam on a pt who is in labor and observes the umbilical cord protruding from the vagina. after calling for assistance, which of the following actions should the nurse take next? place a rolled towel beneath one of the pts hips apply internal upward pressure to the presenting part using two gloved fingers administer oxygen to the pt via nonbreather mask at 10 L/min increase the IV infusion
apply internal upward pressure to the presenting part using two gloved fingers
a nurse is caring for a pt who is in labor and whose fetus is in the right occiput posterior position. the pt is dilated to 8 cm and reports back pain. which of the following actions should the nurse take? apply sacral counterpressure perform TENS initiate slow-paced breathing assist with biofeedback
apply sacral counterpressure
a nurse is assessing a newborn following a circumcision. which of the following findings should the nurse identify as an indication that the newborn is experiencing pain? decreased HF chin quivering pinpoint pupils slowed RR
chin quivering
a nurse is caring for a newborn who was transferred to the nursery 30 min after birth bc of mild resp distress. which of the following actions should the nurse take first? confirm the newborns Apgar score verify the newborns identity administer vitamin K determine obstetrical r/f
confirm the newborns identity
a nurse is caring for a newborn who is undergoing phototherapy to treat hyperbilirubinemia. which of the following actions should the nurse take? cover the newborns eyes while under the phototherapy light keep the newborn in a shirt while under the phototherapy light apply a light moisturizing lotion to the newborns skin turn and reposition the newborn every 4 hours
cover the newborns eyes while under the phototherapy light
a nurse is planning care for a pt who is 2 hrs PP. which of the following interventions should the nurse plan to implement during the taking-hold phase of postpartum behavioral adjustment? discuss contraceptive options with the pt and her partner repeat information to ensure pt understanding listen to the pt and her partners as they reflect upon the birth experience demonstrate to the pt how to perform a newborn bath
demonstrate to the pt how to perform a newborn bath
a nurse in the antepartum clinic is assessing a pts adaptation to pregnancy. the pt states that she is happy one min and crying the next. this is an indication as which of the following? emotional lability focusing phase cognitive restructuring couvade syndrome
emotional lability
a nurse is caring for a pt who has preeclampsia and is receiving a continuous infusion of magnesium sulfate IV. which of the following actions should the nurse take? restrict fluid intake 150ml/hr having calcium gluconate readily available assess DTR q6h monitor I&O q4h
having calcium gluconate readily available
a nurse is teaching a pt who is 35 wks about complications to report to the provider. which of the following manifestations should the nurse include? SOB when climbing stairs swelling of ankles at the end of the day headache that is unrelieved by analgesia braxton hicks contractions
headache that is unrelieved by analgesia
a nurse is teaching a pt who has pregestational type 1 diabetes mellitus about management during pregnancy. which of the following statements by the pt indicates an understanding of the teaching? i should have a goal maintaining FBS between 100-120 i should engage in moderate exercise for 30 mins if my BG is 250 or greater i will continue taking my insulin if i experience nausea and vomiting i will ensure that my bedtime snack is high in refined sugar
i will continue taking my insulin if i experience nausea and vomiting
a nurse is teaching a pt who is in preterm labor about terbutaline. which of the follwoing statements by the pt indicates an understanding of the teaching? i will get injections until my labor stops my blood sugar may be low while im on this med i will have blood tests bc my potassium might decrease my BP may increase while on this med
i will have blood tests bc my potassium might decrease
a nurse is teaching a pt who is Rh- about rhogam. which of the following statements by the pt indicates an understanding of teaching? i will receive this med if my baby is Rh- I will receive this med when i am in labor i will need a second dose when my baby is 6wks old i will need this med if i have an amniocentesis
i will need this med if i have an amniocentesis
a nurse is caring for a pt who is 35 wks and has placenta previa. which of the following actions should the nurse take? perform a vaginal exam instruct the pt to ambulate every 4 hours administer bethamethasone initiate continuous external fetal monitoring
initiate continuous external fetal monitoring
a nurse is caring for a pt who is at the end of their first trimester. the nurse should place the us where to assess for FH tones? just above the umbilicis just above the symphysis pubis the right lower quadrant the left lower quadrant
just above the symphysis pubis
a nurse is caring for a pt following an amniocentesis at 19 wks. which of the following findings should the nurse report to the provider as a potential complication? increase fetal movement leakage of fluid from the vagina upper abdominal discomfort urinary frequency
leakage of fluid from the vagina
pt is experiencing hypovolemic shock. after notifying the provider, which of the following actions should the nurse take? massage the fundus insert a foley administer oxygen 10L/min elevate the pts right hip
massage the pts fundus
a nurse is reviewing the medical record of a newly admitted pt who is 32 wks. which of the following conditions is an indication for FH assessment using electronic fetal monitoring? oligohydramnios hyperemesis gravidarum leukorrhea periodic tingling of the fingers
oligohydramnious
steps for leopold maneuvers
palpate the fundus to identify the fetal part determine the location of the back palpate for the fetal presenting inlet identify the attitude of the head
a nurse is providing discharge teaching to the parents of a newborn about car seat safety. which of the following instructions should the nurse include? place the shoulder harness in the slot above the newborns shoulders place the retainer clip at the level of the newborns armpits place the newborn at a 60 degree angle in the car seat place the newborn in a blanket before securing them in the car seat
place the retainer clip at the level of the newborns armpits
a nurse is teaching a PP pt abut the steps the nurses will take to promote the security and safety of the pts newborn. which of the following statements should the nurse make? the nurse will carry your newborn to the nursey for procedures we will document the relationship of visitors in your medical record your baby will stay in the nursey while you are asleep staff members who take care of your baby will be wearing a photo ID badge
staff members who take care of your baby will be wearing a photo ID badge
a nurse is teaching a new mother how to use a bulb syringe to suction her newborns secretions. which of the following instructions should the nurse include? insert the syringe tip before compressing the bulb suction each of the nares before suctioning the mouth insert the tip of the syringe into the center of the newborns mouth stop suctioning when the newborns cry sounds clear
stop suctioning when the newborns cry sounds clear
30 wks for prenatal visit. what should the nurse report to the provider? swelling of the face varicose veins nonpitting edema hyperpigmentation of the cheeks
swelling of the face
a nurse is planning care for a pt who is in labor and is to have an amniotomy. which of the following assessments should the nurse identify as the priority? O2 sat temperature BP urinary output
temperature
a nurse is speaking with a pt who is trying to make the decision about tubal ligation. the pt asks "what effects will this procedure have on my sex life?" which of the following responses should the nurse make? i think that is something you should discuss with your dr this procedure should have no effect on your sexual performance youll be fine. i cant imagine you and your partner will have any problems with sexual function if this concerns you perhaps you should reconsider and use another form of contraception
this procedure should have no effect on your sexual performance or adequacy
a nurse is caring for a pt who is in labor and reports increasing rectal pressure. she is experiencing contractions 2-4m apart, each lasting 80-90 seconds and a vaginal exam reveals her cervix is dilated to 9cm. the nurse should identify that the client is in which of following stage of labor? active transition latent descent
transition--cervical dilation from 8-10 and contractions every 2-3m lasting 45-90 seconds
a nurse is providing discharge teaching to a pt who is PP. for which of the following manifestations should the nurse instruct the pt to monitor and report to the provider? persistent abdominal striae temperature 37.8--100 unilateral breast pain brownish-red discharge on day 5
unilateral breast pain
a nurse is assessing the newborn of a pt who took a SSRI during pregnancy. which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI? LGA hyperglycermia bradypnea vomiting
vomiting
a nurse is teaching a new parent about newborn safety. which of the following instructions should the nurse include in the teaching? you can share your room with your baby for the next few weeks cover your baby with a light blanket while sleeping check the temperature of the bath water with your hand your baby can nap in the car seat during the daytime
you can share your room with your baby for the next few weeks
a nurse is providing teaching about family planning to a pt who has a new order for a diaphragm. which of the following statements should the nurse include in the teaching? you should replace the diaphragm every 2 years you should leave the diaphragm in place 6 hours after intercourse you should use oil-based product as a lubricant when inserting the diaphragm you should insert the diaphragm when your bladder is full
you should leave the diaphragm in place for at least 6 hours after intercourse
teaching about levonorgestrel contraception. what should be included in the teaching? you should take the med within 72 h following unprotected sex you should avoid taking this med if you are on an oral contraceptive if you dont start your period within 5 days of taking this med you will need a pregnancy test one dose of the med will prevent you from becoming pregnant for 14 days after taking it
you should take the med within 72 hours following unprotected sexual intercourse
a nurse is teaching a pt who is 36 wks who has an order for NST. which statement should the nurse include in teaching? you will receive fluids prior to the test the procedure will take approx 10-15min you will be offered OJ to drink during the test you will need to sign an informed consent form each time you have this test
you will be offered OJ to drink during the test
a nurse is caring for a pt who is in active labor and has had no cervical change in the last 4 hours. which of the following statements should the nurse make? let me help you to comfortable position so you can beign bearing down i am going to call the dr to get an order for a med to ripen your cervix i will give you some pain meds to strengthen your contractions your provider will insert an intrauterine pressure catheter to monitor the strength of your contractions
your dr will insert an intrauterine pressure catheter to monitor the strength of your contractions
