OB Final
Quiz 1
1.) A woman presents to a prenatal clinic appointment at 10 weeks' gestation, in the first trimester of pregnancy. Which of the
... [Show More] following symptoms would be considered a normal finding at this point in pregnancy?
2.) A nurse is providing preconception counseling for a client who is planning a pregnancy. Which of the following supplements should the nurse recommend to help prevent neural tube defects in the fetus?
3.) A nurse provides teaching for a patient scheduled for genetic testing. What should the nurse do to help the patient understand what is being taught? S/A
4.) A woman presents to the prenatal clinic at 30 weeks gestation reporting dysuria, frequency, and urgency with urination. Appropriate nursing actions include:
5.) A client has been prescribed Clomiphene Citrate (Clomid) and calls the clinic complaining of hot flashes, headaches, and breast tenderness ever since taking this medication. What is the best response by the nurse?
6.) The physicians order states to begin Pitocin at 3mu/min. Pharmacy sends you Pitocin 20 units premixed in 1000 ml of Normal Saline. The nurse should set the IV pump to run at:
7.) A patient at 20 weeks gestation is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be palpated?
8.) A nurse is caring for a client who is in her first trimester of pregnancy and asks the nurse if she can continue to exercise during pregnancy. Which of the following responses by the nurse is appropriate?
9.) A nurse is teaching about fetal development to a group of clients in the antenatal clinic. Which of the following statements should the nurse include in the teaching?
10.) Which of the following statements by a pregnant woman indicates she needs additional teaching on ways to reduce risks to her unborn child from the potential effects of exposure to toxoplasmosis?
11.) After receiving information on the signs and symptoms of potential complications during pregnancy, the prenatal client knows to immediately report the following to her health care provider? S/A
12.) A woman at 30 weeks gestation assumes a supine position for a fundal measurement. She begins to complain about feeling dizzy and nauseated. Her skin feels damp and cool. The nurse’s first action would be to:
13.) The nurse notes each of the following findings in a woman at 10 weeks gestation. Which of the findings would enable the nurse to tell the woman that she is probably pregnant (probable sign)?
14.) A client has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. These symptoms best described are:
15.) A client at 10 weeks gestation is being by the nurse. The client reports that she has nausea and vomiting each morning. Which is the nurse’s best response?
16.) A nurse in labor and delivery is caring for a client. Following delivery of the placenta, the nurse examines the umbilical cord. Which of the following vessels should the nurse expect to observe in the umbilical cord?
17.) Which statement by the nurse would be most appropriate when responding to a primigravid client who asks, “Should I be concerned about this new brownish pigmentation across my cheeks and forehead?”
18.) The nurse finds 30 units of Pitocin in 500 ml hanging in the client’s room. The pump is running at 10 ml/hr. How much Pitocin is she receiving?
19.) The nurse is teaching a client how to perform a fetal kick count using the 2-hour method. Which statement by the client indicates teaching was understood?
20.) The nurse is working in a prenatal clinic caring for a patient at 14 weeks gestation, G2 P1. Which of the following findings should the nurse highlight for the nurse midwife?
21.) A woman in her third trimester complains of heartburn. Which of the following recommendations should the nurse make to the patient to help prevent this condition?
22.) A couple who has been attempting to become pregnant for 6 years is seeking assistance from an infertility clinic. The nurse assesses the clients’ emotional responses to their infertility. Which of the following responses would the nurse expect to find? S/A
23.) A nurse is examining a G1 P0 who is 8 weeks gestation. The nurse should demonstrate this find is which positive sign? Bluish discoloration of cervix, vagina, and labia resulting in increased blood flow
24.) A nurse is caring for a client at the first prenatal visit who has a BMI of 26.5. The client asks how much weight she should gain during pregnancy. Which of the following responses should the nurse make?
25.) A client states her last menstrual period was October 10th. Using Naegele’s Rule calculate her estimated due date. Add 7 days, subtract 3 months
26.) The nurse is educating a primigravida patient about prenatal testing/ screening. She inquires why she needs to be tested for HIV. Which of the following is the nurse’s best response?
Quiz 2
1.) A nurse is assessing a client in labor who has had epidural anesthesia for pain relief. Which of the following findings should the nurse identify as a complication from the epidural block?
2.) The nurse is assessing a client who states, “I think I’m in labor.” Which of the following findings would positively confirm the client’s belief?
3.) A nurse is caring for a client who is in labor and has an external fetal monitor. The nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following?
4.) A nurse is teaching a client who is at 23 weeks of gestation and will return to the facility in 2 days for an amniocentesis. Which of the following instructions should the nurse give the client?
5.) The nurse is caring for a pregnant client who was sent to the hospital for a biophysical profile.
She is 37 weeks gestation with her second child, has gestational diabetes, and complains of decreased fetal movement for the last 24 hours. Which action should the nurse take first?
6.) The nurse auscultates a fetal heart rate of 155 on a client in early labor. Which of the following actions by the nurse is appropriate?
7.) The physicians order states to begin Pitocin at 3mu/min. Pharmacy sends you Pitocin 30 units premixed in 500 ml of normal saline. The nurse should set the IV pump to run at:
8.) A nurse is teaching a client who is at 15 weeks gestation and is to undergo an amniocentesis. The nurse should explain that the purpose of this test is to identify which of the following conditions? S/A
9.) A laboratory report indicates the L/S ratio (lechithin/ sphingomyelin) results from an amniocentesis of a gravid patient with preeclampsia are greater than 2:1/ The nurse interprets the result as which of the following?
10.) The nurse reports a nonreactive NST to the physician. The physician orders vibroacoustic stimulation. Which does the nurse understand the appropriate application for the vibroacoustic stimulation to be? S/A
11.) The nurse documents a Category III fetal heart rate pattern when:
12.) According to the fetal monitoring strip the baby’s heart rate is 175. What is the priority action by the nurse?
13.)The nurse identifies recurrent late decelerations on the fetal monitor strip. What is the priority action by the nurse?
14.) A nurse is caring for a client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios. The nurse should understand that this diagnosis means which of the following?
15.)Your patient is 34 weeks pregnant and during a regular prenatal visit tells you she does not understand how to do “kick counts”. The best response by the nurse would be to explain:
16.) A nurse is caring for a client during a nonstress test (NST). At the end of a 30 min period of observation, the nurse notes the following findings. The fetal heart rate baseline is 120/min with minimal variability and no acceleration. There are two decelerations of 15 beats per minute in the fetal heart rate during a period of fetal movement, each lasting 20 seconds. Which of the following interpretations of these findings should the nurse make?
17.) A nurse in a prenatal clinic is caring for a client who is at 38 weeks gestation and is undergoing a contraction stress test. The test results are negative. Which of the following interpretations of this finding should the nurse make?
18.) Complete the clients labor summary: Contractions started at 0800. Water broke at 1130. Client arrived at hospital at 1200 (vaginal exam was at 4cm). Client was 9cm at 1500. Client was completely dilated at 1600 and gave birth to a baby girl at 1715. Placenta delivered at 1721. How long did the client spend in the first stage of labor?
19.) The perinatal nurse providing care to a laboring woman recognizes a category II fetal heart rate tracing. The most appropriate initial action is to:
20.) Two hours post epidural the client in labor complains to the primary nurse she is too numb and wants less medication. Priority action for the nurse is:
21.)A nurse in a clinic is reviewing the medical records of a group of clients who are pregnant. The nurse should anticipate the provider will order a maternal serum alpha fetoprotein (MSAFP) screening for which of the following clients?
22.) The nurse is giving report to the physician on the fetal heart rate tracing. Which scenario indicates a category I tracing?
23.) Nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?
24.)The physician orders the following medication for a laboring client: Stadol 0.5 mg IV for pain. The drug is on hand in the following concentration: Stadol 2mg/mL. How many mL of medication will the nurse administer?
25.)The nurse observes a gradual deceleration of the fetal heart rate from 140 to 90 bpm that begins with a contraction and gradually returns to the normal baseline rate when the contraction ends. Which is this related to?
26.) A nurse on the labor and delivery unit is caring for a client following a vaginal examination by the provider which is documented as +1. Which of the following interpretations of this finding should the nurse make?
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27.)The client overheard the OB resident state her baby scored a 4/10 on the biophysical profile (BPP) and asks the nurse what does this mean. The nurse should reply:
28.)A 37-year-old woman is 17 weeks pregnant has had an amniocentesis. Before discharge, the nurse teaches the woman to call her doctor if she experiences which of the following side effects?
29.)A multigravida in active labor is 7cm dilated. The fetal heart rate baseline is 130 bmp with moderate variability. The client begins to have recurrent variable decelerations in the fetal heart rate. What action is the highest priority for the nurse?
30.) The perinatal nurse is assessing a woman in triage who is 34 weeks gestation in her first pregnancy. She is worried about having her baby “too soon” and she is experiencing uterine contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal examination performed by the health care provider reveals that the cervix is closed, long, and posterior. The most likely diagnosis would be:
Quiz 3
1) A nurse is caring for a client who is 4 hr postpartum following a vaginal birth. The client has saturated a perineal pad within 10 min. Which of the following actions should the nurse take first?
2) Which statement best exemplifies adaptation to pregnancy in relation to the adolescent?
3) The nurse is working with a 36-year-old, married client, G6 P6, who smokes. The woman states, “ I don’t expect to have any more kids, but I hate the thought of being sterile.” Which of the following contraceptive methods would be best for the nurse to recommend to this client?
4) After instructing a client on the stages of rubra, which client statement indicates successful teaching?
5) The postpartum patient asks the nurse how to cope with cramping pain. Which of the following should the nurse suggest? (S/A)
6) The nurse is developing a plan of care for a postpartum client during the “taking in” phase. Which of the following should the nurse include in the plan?
• Discuss the labor and birth with the mother
7) A nurse is caring for a client who is postpartum and has a prescription for Rho (D) immunoglobulin. The nurse should verify which of the following prior to administration?
8) A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client’s blood work, the nurse notices she does not have immunity to rubella. Which of the following times should the nurse understand is recommend for rubella immunization?
9) A nurse is caring for a client who is postpartum and received methylergonovine (methergine). Which of the following findings indicates that the medication was effective?
10) Immediately after delivery, a woman is shaking uncontrollably. Which of the following nursing actions is most appropriate?
11) The postpartum nurse caring for a 20-year-old G1 P0 woman who 3 hours ago delivered a healthy full-term infant, observes the woman who is lightly touching her baby girl with her fingertips but who seems to be uncomfortable holding her baby close to her body. Which of the following is an accurate interpretation of these observed behaviors?
12) A nurse is reinforcing teaching about reducing perineal infection with a client following a vaginal delivery. Which of the following should the nurse include in the teaching? (S/A)
13) A nurse is performing a physical examination of a client who is 1 day postpartum. Which of the following findings requires immediate intervention?
14) On the third postpartum day a client tells the nurse that she feels sad and that she cries easily. The nurse should explain about which of the following?
15) The nurse is counseling a morbidly obese client on contraceptive options. Which of the following options should not be recommended for this client?
16) A nurse is teaching a client who has a new prescription for docusate. Which of the following information should the nurse include in the teaching?
17) A nurse is caring for a client who experienced a vaginal delivery 12 hr ago. When palpating the client’s abdomen, at which of the following positions should the nurse expect to find the uterine fundus?
18) The perinatal nurse is teaching the student nurse the correct technique of postpartum uterine palpation. Which of the following statements indicates a need for further teaching?
19) A nurse is performing a postpartum assessment 30 minutes after a vaginal delivery. Which of the following actions indicates that the nurse is performing the assessment correctly?
20) During change of shift report, the nurse hears the following information on a newly delivered client: 27 years old, married G4 P3, 5 hours post spontaneous vaginal delivery with a 3-degree laceration, vitals 110/70, 98.6F, 82, 18, fundus firm at umbilicus, moderate lochia, ambulated to bathroom to void three times for a total of 900 mL. Breastfeeding every 2 hours. Which of the following nursing diagnoses should the nurse include in this client’s nursing care plan?
21) A woman is in the “taking hold phase” of the postpartum period. Which of the following behaviors would the nurse expect to see?
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22) Which of the following clients is most likely to complain of afterbirth pains during her postpartum period?
23) The nurse is providing discharge counseling to a woman who is breastfeeding her baby. What should the nurse advise the woman to do if she should palpate tender, hard nodules in her breasts? S/A
24) During discharge teaching which assessment finding would the nurse teach the client to report to her physician?
25) The student nurse is teaching postpartum clients preparing for discharge on ways to prevent deep vein thrombosis (DVT). Which of the following responses would indicate teaching was understood?
26) A 25-year-old woman gave birth to her second child 6 hours ago. She informs the nurse that she is bleeding more than with her previous birth experience. The initial nursing action is to:
27) A nurse is caring for a client who is 6 hours postpartum and asks the nurse to feed her newborn. Which of the following responses should the nurse provide?
28) Following delivery of the placenta, the nurse receives a physician order to begin a Pitocin infusion via IV pump at 30 mu/min. The pharmacy provides Pitocin 20 units in 1000 mL of LR. The nurse will set the IV pump to run at what rate per hour.
Quiz 4
1) To prevent a severe post-partum hemorrhage, the physician performs a hysterectomy. After inspecting the uterus and placenta the physician finds the placenta extended fully through the uterine wall. The nurse would document this as a
2) Which of the following nursing diagnoses is the highest priority for a client with an ectopic pregnancy who has developed disseminated intravascular coagulation (DIC)?
3) A 16-year-old patient is admitted to the hospital with a diagnosis of severe preeclampsia. The nurse must closely monitor the woman for which of the following?
4) A nurse in the antepartum unit is caring or a client who is at 36 weeks of gestation and has pregnancy-induced hypertension. Suddenly, the client reports continuous abdominal pain and vaginal bleeding. The nurse should suspect which of the following complications?
5) The physician orders for Magnesium Sulfate 2g/hr IV. Pharmacy sends Magnesium Sulfate 10g/500mL. At what would the nurse set the IV pump?
6) Your client was induced for preeclampsia. After the birth of her baby and placenta the uterus remains boggy despite uterine massage and oxytocin administration. The nurse should anticipate an order for which Uterotonic medication?
7) A nurse in a hospital is caring for client who is at 38 weeks of gestation and has a large amount of painless, bright red vaginal bleeding. The client is placed on a fetal monitor indicating a regular fetal heart rate of 138/min and no uterine contractions. The client’s vital signs are: BP 98/52 mm Hg, HR 118/min, RR 24/min, and temp 36.4 C/97.6 F. Which of the following is the priority nursing action?
8) A client is being induced for pre-eclampsia. Her vital signs are HR 100, BP 210/114, RR 20, T 98.2. The nurse should anticipate an order for which anti-hypertensive medication?
9) A fetal fibronectin test completed on a 28-week gestation patient is positive. Based on these results, which of the following complaints should the nurse advise the patient to report immediately to the healthcare provider?
10) A nurse is completing the admission assessment of a client who is at 38 weeks of gestation and has severe preeclampsia. Which of the following is an expected finding?
11) The nurse is caring for two laboring women. Which of the patients should be monitored most carefully for signs of placental abruption?
12) A 40-year-old G2 P1 patient is admitted to the labor and delivery unit with contractions every 6 minutes. She is 35 weeks pregnant, has a history of placenta previa, and is currently experiencing moderate vaginal bleeding. What should the nurse be prepared to do?
13) The physician order states for the patient to receive Magnesium Sulfate 6g loading dose IV to infuse in 20 minutes. Pharmacy sends Magnesium Sulfate 6g/100mL. What rate would the nurse set the IV pump for the loading dose?
14) The physician is rounding on four clients admitted with pre-term labor. She orders betamethasone for all clients. Which of the following clients would betamethasone administration require further assessments?
15) A nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks of gestation. Which of the following manifestations should the nurse expect to identify as consistent with the diagnosis?
16) A patient is receiving a magnesium sulfate for severe preeclampsia. The nurse must notify the attending physician immediately of which of the following findings?
17) The nurse is assessing a client who is on Magnesium sulfate. The nurse notes decreased level of consciousness, diminished DTRs, and urinary output of 20 mL. What is the priority action?
18) A nurse is admitting a client who is at 37 weeks of gestation and has severe gestational hypertension. Which of the following actions should the nurse expect to implement? S/A
19) A nurse is caring for a client who is 36 weeks of gestation and who has a suspected placenta previa. Which of the following findings support this diagnosis?
20) A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?
21) A client at 39 weeks is admitted to the labor unit with a blood pressure of 215/118. The physician orders magnesium sulfate. The client states “I feel fine, what is the medication for?”. The best response by the nurse is:
22) A client arrives at the hospital in preterm labor and terbutaline (Brethine) is prescribed. For what therapeutic effect should the nurse monitor the client?
23) A nurse in a prenatal clinic is caring for client who is at 38 weeks of gestation and reports heavy, red vaginal bleeding. The bleeding started spontaneously in the morning and is not accompanied by contractions. The client is not distress and she states that she can “feel the baby moving”. An ultrasound is scheduled stat. The nurse should explain to the client that purpose of the ultrasound is to determine which of the following?
24) A nurse is caring for a client who is in premature labor and is receiving terbutaline. The nurse should monitor the client for which of the following adverse effects that should be reported to the provider?
25) The laboratory department just called and reported a magnesium level of 5.6 for your client. Priority action is to:
26) The perinatal nurse is providing care to Marilym, a 25-year-old G1 P0 woman hospitalized with severe hypertension at 33 weeks gestation. The nurse is preparing to administer the second dose of betamethasone prescribed by the physician. Marilyn, asks “What is this injection for again? The nurse’s best response is:
27) A nurse is caring for several clients. The nurse should recognize that is safe to administer tocolytic therapy to which of the following clients?
28) Which of the following statements is most appropriate for the nurse to say to a patient with a complete previa?
29) A type 1 diabetic patient has repeatedly experienced elevated serum glucose levels throughout her pregnancy. Which of the following complications of pregnancy would the nurse expect to see?
30) A pregnant woman who is in the third trimester arrives in the emergency department with vaginal bleeding. She states that she snorted cocaine approximately two hours ago. Which complication does the nurse suspect is the cause of the bleeding?
Quiz 5
1) To prevent a severe postpartum hemorrhage the physician performs a hysterectomy. After inspecting the uterus and placenta the physician finds the placenta extended fully through the uterine wall. The nurse would document this as a:
2) Which of the following nursing diagnosis is the highest priority for a client with an ectopic pregnancy who has developed disseminated intravascular coagulation (DIC)?
3) A 16-year-old patient is admitted to the hospital with a diagnosis of severe preeclampsia. The nurse must closely monitor the woman for which of the following?
4) A nurse in the antepartum unit is caring for a client who is at 36 weeks of gestation and has pregnancy and has pregnancy- induced hypertension. Suddenly, the client reports continuous abdominal pain and vaginal bleeding. The nurse should suspect which of the following complications?
5) The physician orders for Magnesium Sulfate 2g/hr IV. Pharmacy sends Magnesium Sulfate 10g/500 mL. At what rate would the nurse set the IV pump?
6) Your client was induced for preeclampsia. After the birth of her baby and placenta the uterus remains boggy despite uterine massage and oxytocin administration. The nurse should anticipate an order for which uterotonic medication?
7) A client is being induced for preeclampsia. Her vita signs are HR 100, BP 210/114, RR 20, T 98.2. The nurse anticipates an order for which anti-hypertensive medications?
8) A nurse in a hospital is caring for a client who is at 38 weeks of gestation and has a large amount of painless, bright red vaginal bleeding. The client is placed on a fetal monitor indicating a regular fetal heart rate of 138/min and no uterine contractions. The client’s vital signs are: blood
pressure 98/52 mm Hg, heart rate 118/min, respiratory rate 24/min, and temp 97.6. Which of the following is the priority nursing action?
9) A fetal fibronectin test completed on a 28-week gestation patient is positive. Based on these results, which of the following complaints should the nurse advise the patient to report immediately to the healthcare provider?
10) A nurse is completing the admission assessment of a client who is at 38 weeks of gestation and has severe preeclampsia. Which of the following is an expected finding?
11) The nurse is caring for two laboring women. Which of the patients should be monitored most carefully for signs of placental abruption?
12) A 40-year-old G2 P1 patient is admitted to the labor and delivery unit with contractions every 6 minutes. She is 35 weeks pregnant, has a history of placenta previa, and is currently experiencing moderate vaginal bleeding. What should the nurse be prepared to do?
13) The physician order states for the patient to receive Magnesium Sulfate 6g loading dose IV to infuse in 20 minutes. Pharmacy sends Magnesium Sulfate 6g/100 mL. What rate would the nurse set the IV pump for the loading dose?
14) The physician is rounding on four clients admitted with preterm labor. She orders betamethasone for all clients. Which of the following clients would betamethasone administration require further assessments?
15) A nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks of gestation. Which of the following manifestations should the nurse expect to identify as consistent with the diagnosis?
16) A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the attending physician immediately of which of the following findings?
17) The nurse is assessing a client who is on mag sulfate. The nurse notes decreased level of consciousness, diminished DTRs, and urinary output of 20 mL. What is the priority action?
18) A nurse is admitting a client who is at 37 weeks of gestation and has severe gestational hypertension. Which of the following actions should the nurse expect to implement? (S/A)
19) A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa. Which of the following findings support this diagnosis?
20) A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?
21) A client at 39 weeks is admitted to the labor unit with a blood pressure of 215/118. The physician orders magnesium sulfate. The client states “ I feel fine, what is this medication for”? The best response by the nurse is:
22) A client arrives at the hospital in preterm labor and terbutaline is prescribed. For what therapeutic effect should the nurse monitor the client?
23) A nurse in a prenatal clinic is caring for a client who is at 38 weeks of gestation and reports heavy, red vaginal bleeding. The bleeding started spontaneously in the morning and is not accompanied by contractions. The client is not in distress and she states that she can “feel the
baby moving.” An ultrasound is scheduled stat. The nurse should explain to the client that purpose of the ultrasound is to determine which of the following?
24) A nurse is caring for a client who is in premature labor and is receiving terbutaline. The nurse should monitor the client for which of the following adverse effects that should be reported to the provider?
25) The laboratory department just called and reported a magnesium level of 5.6 for your client. Priority action is to:
26) The perinatal nurse is providing care to Marilyn, a 25-year-old G1 P0 woman hospitalized with severe hypertension at 33 weeks gestation. The nurse is preparing to administer the second dose betamethasone prescribed by the physician. Marilyn, asks “What is this injection for again?” The nurse’s best response is:
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27) A nurse is caring for several clients. The nurse should recognize that is safe to administer tocolytic therapy to which of the following clients?
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28) Which of the following statements is most appropriate for the nurse to say to a patient with a complete previa?
29) A type 1 diabetic patient has repeatedly experienced elevated serum glucose levels throughout her pregnancy. Which of the following complications of pregnancy would the nurse expect to see?
30) A pregnant woman who is in the third trimester arrives in the emergency department with vaginal bleeding. She states that she snorted cocaine approximately two hours ago. Which complication does the nurse suspect is the cause of the bleeding?
Quiz 6
1) The physician has ordered intravenous oxytocin for induction for four clients. In which of the following situations should the nurse refuse to comply with the order?
2) A patient in her 39th week of gestation has just learned that her fetus has died. The nurse explains that the labor will need to be induced within 24 to 48 hours. She explained that her husband is out of the country and asks whether induction can be postponed a few days more until he returns. Which of the following should the nurse mention as a risk of prolonged retention of a dead fetus?
3) A nurse is preparing to administer Cefazolin 1 gram by IV bolus over 30 min. Available is Cefazolin 1 gram in 100 mL dextrose 5% (D5W). The nurse should set the IV pump to deliver how many mL/hr? (Round to nearest whole number)
4) A woman with her first pregnancy has been in the second stage of labor for 3 hours with lack of continuing progress. The primary care provider has made three attempts so gar to deliver the infant using vacuum extraction. Which of the following interventions should the nurse expect next?
5) A nurse is caring for a client who is to undergo an amniotomy. Which of the following is the priority nursing action following this procedure?
6) A nurse is caring for a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse perform first?
7) The nurse is preparing a client for a scheduled cesarean section. Which of the following assessment findings is contraindicated for this client to receive epidural or spinal anesthesia?
8) A client calls the labor unit and states her water broke and the umbilical cord is hanging out of her vagina. The nurse should instruct her to:
9) The nurse is providing care for a prenatal client who is told she will require a cesarean delivery because of cephalopelvic disproportion. Which explanation of the condition will the nurse provide to the client?
10) A patient is undergoing a scheduled cesarean birth. It is the fourth cesarean section she has had. Which of the following should the nurse identify as the most significant long-term complication of repeat surgical birth?
11) A patient admitted to the labor and delivery unit is reported to have a fetus that is in the breech position. Which of the following is a nursing priority?
12) A nurse is caring for a woman 10 hours post-cesarean birth. She received a dose of intrathecal morphine at the time of the birth. Which of the following assessment data would require immediate intervention?
13) While assisting the physician during an amniotomy, the nurse observes a prolonged deceleration on the fetal heart monitor. The nurse should interpret this as a sign of which of the following obstetrical emergencies?
14) An emergency cesarean is being implemented. The patient describes ringing in her ears and a metallic taste with the administration of regional anesthesia. The nurse is aware that which incidence has occurred?
15) While the nurse is caring for a multiparous client in active labor at 36 weeks gestation, the client tells the nurse, “I think my water just broke.” What is the nurse’s priority action?
16) Your client is 6 hours post cesarean delivery and asks for something to eat. What is the best response by the nurse?
17) A nurse in a prenatal clinic is teaching a client who has a new prescription for dinoprostone gel. Which of the following statements should the nurse include in the teaching?
18) Which of the following assessment findings would the nurse report to the physician immediately following a cesarean birth?
19) Your client has just delivered a 4300 gram infant after a 3 minute shoulder dystocia that was relieved by performing McRoberts and the Woods corkscrew maneuvers. Upon assessment the nurse notices the infant not moving his left arm. The nurse should expect
20) A woman is rushed to the hospital in labor. She says labor began about 1 hour ago and has progressed rapidly. She is already dilated to 9cm, and her contractions occur every 2 minutes and last about 80 seconds. The nurse interprets this dysfunction of labor a which of the following?
21) The nurse is caring for a patient during induction of labor. The oxytocin is currently infusing at 7 mu/min. The fetal heart rate tracing displays a 130 baseline, moderate variability, and no accelerations or decelerations. Uterine contractions have been every 1 minute for the last 30
minutes. The nurse has repositioned the patient to left lateral and given an IV fluid bolus. What is the nurse’s priority action?
22) While assisting in the delivery of a baby, the nurse observes the fetal head retract back into the maternal perineum after it had been delivered. The nurse should identify this as a sign of which of the following obstetrical emergencies?
23) The nurse finds 20 units of Pitocin in 1,000 ml hanging in the client’s room. The pump is running at 21 ml/hr. How much Pitocin is she receiving?
24) Which of the following is a medical indication for a cesarean birth? S/A
25) Which client cervical exam most indicates the use of dinoprostone?
26) A G3 P2 patient had her two other children by cesarean section. Which of the following situations would mandate that this delivery also be by cesarean section?
27) The nurse is working with four clients on the obstetrical unit. Which client will be the highest priority for a cesarean section?
28) Which client is the best candidate for a vaginal birth after cesarean (VBAC)?
29) Which client is the best candidate for a trial of labor after cesarean (TOLAC)?
30) A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first? [Show Less]