1. A 26 week gestation woman id diagnosed with severe preeclampsia. The nurse assess for which of the following signs/ symptoms associated with HELLP
... [Show More] syndrome?
a. Epigastric pain
b. High serum protein
c. Hyporeflexia
d. Thrombocytopenia
e. Bloody stools
2. Client is being discharged from the hospital after evacuation of a molar pregnancy. The nurse recognizes that additional discharge teaching is required when the client states:
a. “I am so sad for my loss”
b. “I may need to have chemotherapy after this”
c. “I will need to see the doctor in one year for a follow-up”
d. “I will use contraception for the next year”
3. A patient who is having a difficult labor is diagnosed with cephalopelvic disproportion (CPD). The nurse should question which medical order:
a. Maintain NPO status
b. Start IV of Normal Saline
c. Add 10 units of oxytocin to IV fluids – cesarean birth is indicated when there is a cephalopelvic disproportion, no need to induce labor may result in uterine rupture and fetal compromise
d. Record fetal heart tones every 15 minutes
4. A client is admitted to the hospital with an ectopic pregnancy. The symptoms that caused her to seek health care is most likely to have been:
a. Sharp unilateral abdominal pain
b. Uncontrolled vomiting
c. Lack of fetal movement
d. Profuse vaginal bleeding
5. An increased risk for shoulder dystocia is associated with:
a. Preterm labor
b. Maternal diabetes
c. VBAC
d. Previous precipitous birth
6. A primigravida patient who is 29 weeks pregnant comes to the labor and delivery unit. She is O+ and rubella immune. She states she is having regular contractions every 8 minutes. An exam reveals she is 3 cm dilated. Which of the following can the nurse expect to administer?
a. Folic acid
b. Nifedipine
c. Betamethasone
d. Rhogram
e. IV fluids
f. Morphine
7. A 28 year old, G3G2 has just been diagnosed with gestational diabetes at 30 weeks. The client asks what types of complications may occur with this diagnosis. Which complications should the nurse identify as being associated with gestational diabetes?
a. Maternal seizures
b. Large for gestational age infant
c. Hyperglycemia in the newborn
d. Hypoglycemia in the newborn
e. Fetal anemia
8. Which of the following is an indication to discontinue administration of magnesium sulfate in a women with preeclampsia?
a. Blood pressure of 120/70
b. Nausea and vomiting
c. Epigastric pain
d. Respiratory rate of 10
9. When a breech presentation is suspected during the intrapartum period, a priority nursing interventions is to diligently observe the client for signs of:
a. Hip dysplasia
b. Cord prolapse
c. A precipitous delivery
d. Labor progression
10. A 34 year old with chronic hypertension arrives at the emergency department stating that she is in labor and complaining of constant pain between contractions. The nurse palpates a rigid abdomen with no signs of relaxation and concludes that the:
a. fetus birth may be imminent
b. patient may have abruptio placentae
c. patient may have placenta previa
d. fetus may be in the breech presentation
11. A patient is admitted in active labor with her second baby. Her prenatal record indicates she has a history of genital herpes. When performing the admission assessment, the nurse notes herpetic lesions on the genitalia confirmed by the physician, in order to shorten the second stage of labor:
a. Done vaginally, with forceps and an episiotomy, to shorten the second stage of labor
b. Preceded by 2 doses of antibiotics, to decrease transmission to the baby
c. A cesarean birth, to prevent exposure of the baby to herpetic lesions
d. A cesarean birth, to decrease maternal stress from the labor and minimize exacerbation of the herpes.
12. A client who is 3 months pregnant comes to the prenatal clinic because she is having some dark brown vaginal bleeding and experiencing severe nausea and vomiting. Her fundal height is larger
than expected, there are no fetal heart tones auscultated. Which of the following complications should the nurse suspect?
a. Hyperemesis gravidarum
b. Threatened abortion
c. Placenta previa
d. Molar pregnancy
13. A sterile vaginal exam is contraindicated in:
a. A patient with placenta previa
b. A patient who is GBS+ (Group B Strep)
c. A patient with ruptured membranes
d. A patient in transition
14. A primigradida with pregesational type 1 diabeted is at her first prenatal visit. When discussing changes in insulin needs during pregnancy and birth, the nurse explains that based on her blood glucose levels she should expect to decrease her insulin dosage between the:
a. 8th and 11th weeks of gestation
b. 18th and 21st weeks of gestation
c. 24th and 28th weeks of gestation- At the end of the second trimester and the beginning of the third trimester, insulin needs increase because of an increase in maternal resistance to insulin. During the earlier part of pregnancy, fetal demands for maternal glucose may cause a tendency toward hypoglycemia. During the last weeks of pregnancy, maternal resistance to insulin decreases and insulin needs decrease accordingly.
d. 36th week of gestation and the time of birth
15. A baby is entering the pelvis in the vertex presentation with the posterior frontanel palpable near the mothers sacrum. The nurse determines that which of the following malpositions is consistent with this situation?
a. LSP (left sacral posterior)
b. RO [Show Less]