NR 327 Final Exam Practice Questions Maternal- Child Nursing

1) A nurse is caring for a client admitted for induction of labor due to intrauterine fetal demise at 32 weeks. What statement by the nurse would be most therapeutic at this time? a. After you recover you can hopefully conceive again and start your family. b. My sister lost a baby too, I know how you feel and I’m here to help. c. If you want to talk about how you’re feeling, I can call a chaplain. d. Would you like to hold your baby after he is born? 2) A G1P0 is 8 weeks gestation, and the provider does not detect a fetal heartbeat on the ultrasound. What assessment data must be collected in order to ensure the safety of future pregnancies? a. Chromosomal studies of the placental tissue. b. The fetus’ blood type. c. Maternal while blood cell count. d. Maternal Rh status. 3) Following a cerclage at 14 weeks, the nurse counsels the client to report any cramping or contractions. What is the rational for these instructions? a. The client is at risk for bleeding if she contracts with cerclage in place b. Contractions can indicate that cerclage procedure was unsuccessful c. Fetus’ lungs are not yet developed, so preterm birth would be dangerous d. Labor is contraindicated due to the scar on the uterus 4) A client is 10 weeks and arrives at her first prenatal visit. An ultrasound reveals implantation in the right fallopian tube. What important education should the patient receive? a. The client should return in two weeks to see if the pregnancy has migrated into the uterus. b. The client needs to take Methotrexate and stop her prenatal vitamins. c. The client should be rushed to emergency surgery for the removal of her pregnancy. d. The pregnancy could end in miscarriage so the nurse should recommend grief counseling. lOMoAR cPSD| Downloaded by Amos Ndungu () *Methotrexate will stop cell replication so the body will detect not further growth and will then release it and it will be expelled 5) The nurse is caring for a G1P0 who experienced a miscarriage at home. Which statement is true about her future pregnancies? a. She has increased risk of future miscarriages. b. She is a candidate for a Cerclage procedure. c. She should avoid pregnancy for at least one year. d. It is most likely that her next pregnancy will be healthy. *She would only be a greater risk of miscarriages if it was greater than 3 miscarriages. The Cerclage procedure is for an incompetent cervix where it is stitched closed. Avoid pregnancy for a year for a molar pregnancy. 6) A nurse is caring for a client on magnesium sulfate for preeclampsia. Which finding would indicate that the magnesium level is below therapeutic range? a. minimal variability b. deep tendon reflexes +3 c. shallow respirations d. arrhythmias 7) The nurse is assisting with amniotomy. The nurse immediately notes the color of amniotic fluid is port wine. What condition does this finding indicate? a. Incomplete abortion b. Placenta previa c. Uterine rupture d. Placental abruption 8) Which of the following clients would be at risk for developing s placenta previa? a. G2P1 with a history of gestational diabetes b. G1P0 Native American with chronic hypertension c. G3P1 with a placental abruption in her first pregnancy d. G3P2 with a history of 2 C-sections C-sections can leave scarring on fundus, and the implantation will happen in the lower uterus. 9) A 34-week client with a placenta previa arrives for the office visit. What action by the nurse shows understanding of this condition? a. Educate the client about c-section as the vaginal birth is contraindicated b. Educate the client that her previa will likely resolve before the delivery c. Send the patient to the OB triage for the nonstress test NST d. Administer terbutaline to prevent contractions Earlier in the pregnancy (12 weeks) it could resolve. At 34 weeks, it is not getting resolved. Patients with placenta previa usually have spotting. lOMoAR cPSD| Downloaded by Amos Ndungu () 10)Paramedics bring in a G3P2 at 28 weeks, who was hit multiple times by her partner. What is the priority assessment at this time? a. Obtain maternal vital signs and check for injuries b. Ask the client about the events leading up to the attack c. Use an ultrasound to assess the fetus d. Determine if she has a safe place to stay Baby is always first. 11)A 35-week client presents to OB triage with no prenatal care and abdominal pain. The fetal heart tones are within normal limits, and the client has mild spotting. What priority requests or orders should she obtain from the physician? a. Preform a BPP b. Perform an ultrasound to determine location of the placenta c. Perform a cervical exam to evaluate labor status d. Obtain a prenatal lab panel 12) Of the four clients, which one would be a candidate for antenatal steroid? a. A G2P1 at 33 weeks and second stage of labor b. A G3P2 at 28 weeks with severe preeclampsia c. A G2P0 at 20 weeks with placenta previa d. A G1P0 at 32 weeks with chronic hypertension Betamethasone is given to promote surfactant production. 13)A 22 week presents to OB triage with preterm contractions. What assessment would be most helpful in identifying the cause of her contractions? a. Ask her for the list of the current medications b. Review her history of miscarriages c. Obtain urinalysis d. Obtain fetal fibronectin Fetal fibronectin is a protein released by fetus in response to upcoming labor. If there is no fibronectin in the answers, urinalysis is the right answer. 14)Which of the following patients should the nurse assess first on your morning rounds? a. A 33-week client with preterm labor on magnesium sulfate b. A 33-week client with mild preeclampsia on bedrest c. A 29-week client admitted for preterm contractions and antenatal steroids d. A 39-week client with gestational diabetes on Pitocin admitted for induction of labor A patient on Mag should be the first assessment. Continues...