1. A nurse is teaching a client about Rho(D) immunoglobulin (RhoGAM). Which of the following statements by the client indicated an understanding of the
... [Show More] teaching?
a. I will receive this medication if my baby is Rh-negative
b. I will receive this medication at time of delivery
c. I will need a second dose of this medication when my baby is 6 weeks old
d. I will need this medication if I have an amniocentesis- Recommended because of the potential of fetal RBCs entering the maternal circulation
2. A nurse is caring for a client who is to receive oxytocin (Pitocin) to augment her labor. Which of the following contraindicates the initiation of the oxytocin infusion and requires notification of the provider?
a. Late decelerations- Oxytocin is contraindicated based on late decelerations noted on fetal assessment findings because they indicate uteroplacental insufficiency.
b. Baseline variability
c. Cessation of uterine dilation
d. Prolonged active phase of labor
3. A nurse on the newborn unit is planning discharge for four clients. Which of the following will require care beyond that of a standard follow-up visit with the provider after delivery?
a. A newborn being sent home after 22 hr after birth- Screening tests must be repeated if they were performed before he newborn was 24 hr. old.
b. A newborn at 38 weeks of gestational age
c. A newborn who is bottle feeding
d. Twin newborns with Apgar scores of 8 and 9
4. A nurse is assessing a newborn who has a weak cry and is grimacing. The nurse notes the newborn has a heart rate of 102/min, blueish extremities, and a flaccid muscle tone. Which of the following reflects the appropriate APGAR score?
a. 4
b. 5
c. 6
d. 7
5. A nurse is caring for a client who has a history of rheumatic disease, but no physical symptoms prior to pregnancy. The client begins to experience dyspnea, orthopnea, and pulmonary edema. Which of the following biological alterations explains this change?
a. Increased maternal weight
b. Increased blood volume- Increase in blood volume during pregnancy increase the workload of the heart, which causes the symptoms
c. Change in hematocrit levels
d. Change in heart size
6. A nurse is providing teaching about nonpharmacological pain management for a postpartum client who is breastfeed and has engorgement. Which of the following methods should the nurse recommend?
a. Cold cabbage leaves- Application of this is an effective nonpharmacological method to relieve pain associated with engorgement
b. Modified lanolin cream
c. A breast binder
d. Breast shells
7. A nurse is providing discharge teaching to a client who is postpartum about resuming sexual activity. Which of the following instructions should the nurse include in the teaching?
a. You should use a water soluble gel for lubrication- This will prevent discomfort
b. You can resume sexual activity in 10 days
c. Your physical reaction to sexual stimulation ill not be altered
d. You will not ovulate for 3 months after delivery
8. A nurse is admitting a client who is in labor. The client admits to recent cocaine use. For which of the following complications should the nurse assess?
a. Abruptio placenta- Cocaines increases the risk for vasoconstriction and possible abruption placenta
b. Placenta previa
c. Preeclampsia
d. Maternal bradycardia
9. A nurse is providing dietary teaching with a client who has hyperemesis gravidarum. Which of the following statements by the client indicates an understanding of the teaching?
a. I should eat to taste instead of trying to balance my meals- Eat to taste to avoid nausea
b. I will avoid having a snack at bedtime
c. I will have 8 oz of hot tea with each meal
d. I should pair my sweets with a starch instead of eating them alone
10. A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain of the procedure for the newborn?
a. Warm the heel prior to the puncture
b. Request a prescription for IM analgesic
c. Use a manual lance blade to pierce the skin
d. Swaddle the newborn after the heel puncture- Effective technique to diminish the pain experience for the newborn.
11. A nurse is conducting an initial prenatal visit for a client who is at 6 weeks gestation. Which of the following laboratory tests should be performed?
a. 24 hour urine for protein
b. Group B streptococcus culture
c. 3-hr glucose tolerance
d. Rubella titer- Obtained at the initial prenatal visit to determine immunity to rubella
12. A nurse is caring for a newborn who was transferred to the nursery 30 min after delivery. Which of the following actions should the nurse take first?
a. Confirm the newborn’s Apgar score
b. Verify the newborn’s identification- Mandatory to continue ongoing identification of the newborn whenever the newborn is removed from the mother’s direct presence and care.
c. Administer vitamin K IM to the newborn
d. Determine the obstetrical risk factors
13. A nurse is assessing a young adult client in a women’s health clinic who asks for a contraceptive. The client reports to the nurse a familial history of osteoporosis. Which of the following contraceptive methods is contraindicated for this client?
a. Combined estrogen-progestin oral contraceptives
b. An intrauterine device
c. Medroxyprogestrone acetate (Depo-provera)- causes a decrease in bone mineral density and places the client at risk for the development of osteoporosis
d. Norelgestromin/ethinyl estradiol (Ortho Evra)
14. A nurse is admitting a client to the labor and delivery unit when the client states, “my water just broke”, which of the following is the priority intervention for the nurse to take?
a. Perform Nitrazine testing
b. Assess the amniotic fluid
c. Check cervical dilation
d. Monitor the fetal heart rate- Rupture of the membranes places the fetus at risk for umbilical cord prolapse.
15. A nurse in a clinic is caring for a client who is at 32 weeks of gestation. Which of the following clinical findings should alert the nurse to a potential complication?
a. Fundal height is 34 cm
b. Client reports diarrhea for 3 days- Indicates illness or infection
c. Client reports ankle edema
d. Blood pressure is 130/80
16. A nurse is caring for a client who is anemic at 32 weeks of gestation and is in preterm labor. The fetal monitor shows uterine contractions every 6 min, lasting 20-25 seconds, and an FHR of 150/min. The provider prescribed betamethasone (celestone) 12 mg IM. Which of the following outcomes should the nurse expect?
a. Decreased uterine contractions
b. An increase in the client’s hemoglobin levels
c. A reduction in respiratory distress in the newborn- Given to stimulate fetal lung maturity and prevent respiratory distress
d. Increased production of antibodies in the Newborn
17. A nurse is caring for a client newly admitted to the PACU following a cesarean birth. Which of the following is the priority nursing assessment?
a. Parent-child attachment
b. Amount of postpartum lochia- The greatest risk to the client is bleding. The amount of lochia can assist the nurse in determining if excessive bleeding is occurring. Assess the client for postpartum hemorrage.
c. Patency of the IV cathether
d. Quality and quantity of urine output
18. A nurse is caring for a client whose labor is not progressing due to should sytocia of the infant. Which of the following actions should the nurse take?
a. Apply fundal pressure
b. Apply suprapubic pressure- can be used to attempt to push the shoulder to go under the symphysis pubis and thus pass through the birth canals
c. Place the client in the trendelenburg position
d. Place the client in the fowlers position
19. A nurse is preparing to initiate IV oxytocin for a client who is admitted for induction of labor. Oxytocin 30 units is available in 500 ml. At what rate should the nurse set the infusion pump to deliver 2mu/min?
a. 30units/500ml = 0.06units/ml
b. 0.06units=60mU
c. 60mU/1=2mU/xmL
d. x=0.03mL/min 0.03x60=1.8mL/hr
20. A nurse is planning care for a client who is to undergo a nonstress test. Which of the following should the nurse include in the plan of care?
a. Maintain the client NPO throughout the procedure
b. Place the client in a supine position
c. Instruct the client to massage the abdomen to stimulate fetal movement
d. Instruct the client to press the provided button each time fetal movement is detected- Fetal movement may not be evident on the fetal monitor and tracing.
21. A nurse is caring for a client who has been hyperemesis gravidarum and is receiving IV fluid replacement. Which of the following assessment findings by the nurse should be reported to the provider?
a. BUN 25 – Elevated BUN can indicate dehydration and should be reported to the provider
b. Serum creatinine 0.8
c. Urine output 280 mL in 8 hr
d. Weight gain of 0.9kg in 24 hr
22. A nurse is assessing a fetal heart monitor tracing of a client receiving oxytocin at 10 milliunits/min. Uterine contractions are noted every 60 to 90 seconds. After turning the client to a side-lying position, which of the following actions should the nurse take next?
a. Discontinue the medication infusion- Prolonged contractions reduce the blood flow to the placenta and result in FHR decelerations; oxytocin should be discontinued.
b. Prepare to administer terbutaline subcutaneously
c. Administer oxygen at 8 to 10 L/min by face mask
d. Increase the maintenance IV fluid rate.
23. A nurse is teaching a prenatal class about infant safety. Which of the following statements made by a parent indicated a need for further teaching?
a. I will set my hot water heater no higher than 130F- To avoid burns to the infant, the hot water should be set no higher than 49F
b. I will make sure the crib slats are no more than 2 3/8 inches apart
c. I will refrain from using a comforter in the crib
d. I will place the infant carrier on the floor when my baby is inside it [Show Less]