NUR 1310 OB EXAM 3 STUDY GUIDE QUESTION STUDY GUIDE

NUR 1310 OB EXAM 3 STUDY GUIDE QUESTION STUDY GUIDE A home health nurse is teaching a client who is breastfeeding about managing breast engorgement. Which of the following client statements indicates understanding of the teaching? ANSWER: "I’ll feed my baby every 2 hours." A nurse is preparing to administer methylergonovine IM to a client who experienced a vaginal delivery. The nurse should explain to the client that the purpose of this medication is to prevent which of the following conditions? ANSWER: Postpartum hemorrhage A nurse is preparing to measure the fundal height of a client who is at 22 weeks of gestation. At which location should the nurse expect to palpate the fundus? ANSWER: Slightly above the umbilicus A nurse is caring for a client who is at 40 weeks gestation and is in active labor. The client has 6 cm of cervical dilation and 100% cervical effacement. The nurse obtains the client’s blood pressure reading as 82/52 mm Hg. Which of the following nursing interventions should the nurse perform? ANSWER: Assist the client to turn onto her side .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? Answer: The presenting part is 1 cm above the ischial spines. A nurse is admitting a client who is at 36 weeks gestation and has painless, bright red vaginal bleeding. The nurse should recognize this finding as an indication of which of the following conditions? Answer: Placenta previa 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 accelerations. There are two decelerations of 15 /min 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? Answer: A nonreactive test A nurse in a provider’s office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse? Answer: . "It assists in identifying the location of the placenta and fetus." A nurse is caring for a client who is 6 hr postpartum. The client is Rh-negative and her newborn is Rh-positive. The client asks why an indirect Coombs test was ordered by the provider. Which of the following is an appropriate response by the nurse? ANSWER: "It detects Rh-positive antibodies in the mother’s blood." A nurse is caring for a client who is 12 hr postpartum following a vaginal delivery. Which of the following findings should the nurse expect? ANSWER: . Fundus firm, at the level of the umbilicus A nurse is caring for a client who is postpartum and finds the fundus slightly boggy and displaced to the right. Based on these findings, which of the following actions should the nurse take? ANSWER: Assist the client to the bathroom to void A nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz. (4252 g). The nurse should recognize that this client is at risk for which of the following postpartum complications? ANSWER: Uterine atony 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? ANSWER: Massage the client's fundus. A nurse on the obstetric unit is caring for a client who experienced abruptio placentae. The nurse observes petechiae and bleeding around the IV access site. The nurse should recognize that this client is at risk for which of the following complications? ANSWER: Disseminated intravascular coagulation A nurse midwife is examining a client who is a primigravida at 42 weeks of gestation and states that she believes she is in labor. Which of the following findings confirm to the nurse that the client is in labor? ANSWER: Cervical dilation A nurse is caring for a client 2 hr after a spontaneous vaginal birth and the client has saturated two perineal pads with blood in a 30-min period. Which of the following is the priority nursing intervention at this time? ANSWER: Palpate the client’s uterine fundus. A nurse in a prenatal clinic is caring for a client who is at 38 weeks of gestation and undergoing a contraction stress test. The test results are negative. Which of the following interpretations of this finding should the nurse make? ANSWER: . There is no evidence of uteroplacental insufficiency. 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? ANSWER: Client is Rh negative and the newborn is Rh positive. A nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. Uterine contractions occur every 2 min, last 90 sec, and are strong to palpation. The baseline fetal heart rate is 150/min, with uniform decelerations beginning at the peak of the contraction and a return to baseline after the contraction is over. Which of the following actions should the nurse take? ANSWER: Discontinue the infusion of the IV oxytocin. A nurse is admitting a client who experienced a vaginal birth 2 hr ago. The client is receiving an IV of lactated Ringer’s with 25 units of oxytocin infusing and has large rubra lochia. Vital signs include blood pressure 146/94 mm Hg, pulse 80/min, and respiratory rate 18/min. The nurse reviews the prescriptions from the provider. Which of the following prescriptions requires clarification? ANSWER: Methylergonovine 0.2 mg IM now. A nurse is admitting a client who has a diagnosis of preterm labor. The nurse anticipates a prescription by the provider for which of the following medications? (Select all that apply.) ANSWER: Indomethacin, Magnesium sulfate A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which of the following newborn complications as the priority focus of care? ANSWER: Hypoglycemia A nurse is caring for a client who is gravida 3, para 2, and is in active labor. The fetal head is at 3+ station after a vaginal examination. Which of the following actions should the nurse take? ANSWER: Observe for crowning. A nurse in a prenatal clinic is instructing a client about an amniocentesis, which is scheduled at 15 weeks of gestation. Which of the following should be included in the teaching? ANSWER: This test requires the presence of amniotic fluid." 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? ANSWER: Empty her bladder immediately prior to the procedure A nurse is caring for a client who is in active labor and notes late decelerations on the fetal monitor. Which of the following is the priority nursing action? ANSWER: Position the client on her side. A nurse is assessing a client who is pregnant for preeclampsia. Which of the following findings should indicate to the nurse that the client requires further evaluation for this disorder? ANSWER: Elevated blood pressure A nurse is admitting a client who is at 38 weeks of gestation and is in the first stage of labor. Which of the following assessment findings should the nurse report to the provider first? ANSWER: Continuous contraction lasting 2 min A 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? ANSWER: Variable decelerations A nurse in the antepartum unit is caring for 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? ANSWER: Abruptio placentae A nurse is caring for a client who is in labor at 40 weeks of gestation and reports that she has saturated two perineal pads in the past 30 min. The nurse caring for her suspects placenta previa. Which of the following is an appropriate nursing action? ANSWER: Preparation for cesarean birth A nurse is caring for a term macrosomic newborn whose mother has poorly controlled type 2 diabetes. The newborn has respiratory distress syndrome. The nurse should be aware that the most likely cause of the respiratory distress is which of the following? ANSWER: Hyperinsulinemia A nurse is providing teaching to the mother of a newborn born small for gestational age. Which of the following should the nurse include as a possible cause of this condition? ANSWER: Placental insufficiency A nurse is caring for a client who is 2 hr postpartum following a vaginal birth. Which of the following findings indicates the client’s bladder is distended? ANSWER: Fundus palpable to right of midline A nurse is caring for a client who is in the active phase of the first stage of labor. When monitoring the uterine contractions, which of the following findings should the nurse report to the provider? ANSWER: Contractions lasting longer than 90 seconds 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? ANSWER: "This could result in profound bleeding." .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? ANSWER: Report of headache A nurse is caring for a client who is 12 hr postpartum. Which of the following findings should alert the nurse to the possibility of a postpartum complication? ANSWER: Heart rate 110/min A nurse is admitting a client who is at 30 weeks of gestation and is in preterm labor. The client has a new prescription for betamethasone and asks the nurse about the purpose of this medication. The nurse should provide which of the following explanations? ANSWER: "It promotes fetal lung maturity." A nurse is performing Leopold maneuvers on a client who is in labor and determines the fetus is in an RSA position. Which of the following fetal presentations should the nurse document in the client's medical record? ANSWER: Breech A nurse is assessing a client who is 4 hr. postpartum following a vaginal delivery. Which of the following findings should the nurse identify as the priority? ANSWER: Deep tendon reflexes 4+ A nurse is caring for a client who is 2 hr. postpartum. The nurse notes that the client soaked a perineal pad in 10 min, the client's skin color is ashen, and she states she feels weak and light headed. After applying oxygen via nonrebreather face mask at 10 L/min which of the following actions should the nurse take next? ANSWER: Massage the client's fundus to promote contractions. A nurse is caring for a client who had a vaginal delivery 2 hr. ago. Which of the following actions should the nurse anticipate in the care of this client? (Select all that apply.) ANSWER: A)Document fundal height. B)Observe the lochia during palpation of fundus Determine whether the fundus is midline Administer methylergonovine maleate if uterus is boggy. A nurse is caring for a client who is in active labor when the client’s membranes rupture. The fetal monitor tracing shows late decelerations. Which of the following actions should the nurse take first? ANSWER: Turn the client onto her side. A nurse is providing teaching about comfort measures for breast engorgement to a client who is postpartum and is breastfeeding. Which of the following statements by the client indicates a need for further teaching? ANSWER: "I should apply hot packs to my breasts during feeding." A nurse is caring for a client who is at 28 weeks of gestation and received terbutaline. Which of the following findings should the nurse expect? ANSWER: Weakened uterine contractions A nurse is caring for a client who is in preterm labor with a current L/S ratio of 1:1. Which of the following actions should the nurse take? ANSWER: Administer betamethasone 12 mg IM. A nurse is providing teaching to a client who is at 30 weeks of gestation and is to have a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching? ANSWER: "I will have to lie on my back during the test." A nurse is caring for a client who gave birth 2 hr ago. The nurse notes that the client's blood pressure is 60/50 mm Hg. Which of the following actions should the nurse take first? ANSWER: Evaluate the firmness of the uterus. 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? (Select all that apply.) ANSWER: A) Administer magnesium sulfate IV. B)Provide a dark, quiet environment. C)Ensure that calcium gluconate is readily available. A nurse is caring for a client who is in active labor and notes late decelerations in the FHR. Which of the following actions should the nurse take first? ANSWER: Change the client's position. A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first? ANSWER: A client who is at 28 weeks of gestation and reports of painless vaginal bleeding A nurse is performing a physical examination of a client who is 1 day postpartum. Which of the following findings requires immediate intervention? ANSWER: Displaced fundus from the midline A nurse is caring for a client who presents to a labor and delivery unit experiencing rapidly progressing labor. Which of the following is the priority action for the nurse to take? ANSWER: Apply perineal pressure to the emerging fetal head. A nurse is caring for a client who is in the first stage of labor, undergoing external fetal monitoring, and receiving IV fluid. The nurse observes variable decelerations in the fetal heart rate on the monitor strip. Which of the following is a correct interpretation of this finding? ANSWER: Variable decelerations are due to umbilical cord compression. 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? ANSWER: At the level of the umbilicus A nurse is preparing to administer methylergonovine IM to a client who experienced a vaginal delivery. The nurse should explain to the client that the purpose of this medication is to prevent which of the following conditions? ANSWER: Postpartum hemorrhage A nurse is planning care for a newborn who is small for gestational age (SGA). Which of the following is the priority intervention the nurse should include in the newborn’s plan of care? ANSWER: Monitor blood glucose levels. A nurse is assessing a newborn immediately following a scheduled cesarean delivery. Which of the following assessments is the nurse’s priority? ANSWER: Respiratory distress A nurse is assessing a client who is in active labor and notes that the presenting part is at 0 station. Which of the following is the correct interpretation of this clinical finding? ANSWER: The lowermost portion of the fetus is at the level of the ischial spines A nurse in a clinic is assessing a client who is at 8 weeks of gestation and has hyperemesis gravidarum. Which of the following findings should the nurse expect? (Select all that apply. ANSWER: A) History of migraines B) Nulliparous C)Twin gestations A nurse in a prenatal clinic is completing a skin assessment of a client who is in the second trimester. Which of the following findings should the nurse expect? (Select all that apply.) ANSWER: Striae gravidarum , Linea nigra ,Chloasma 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? ANSWER: Folic acid A nurse in a community clinic is counseling a client who received a positive test result for chlamydia. Which of the following statements should the nurse provide? ANSWER: "This infection is treated with one dose of azithromycin." A nurse is caring for a client who is beginning to breastfeed her newborn after delivery. The new mother states, "I don't want to take anything for pain because I am breastfeeding." Which of the following statements should the nurse make? ANSWER: "We can time your pain medication so that you have an hour or two before the next feeding." A nurse is caring for a client who has a positive pregnancy test. The nurse is teaching the client about common discomforts in the first trimester of pregnancy as well as warning signs of potential danger. The nurse should instruct the client to call the clinic if she experiences which of the following manifestations? ANSWER: Facial edema A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client? ANSWER: It is a screening test for spinal defects in the fetus. 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? ANSWER: Uteroplacental insufficiency A nurse is caring for a client who has preeclampsia and is being treated with magnesium sulfate IV. The client's respiratory rate is 10/min and deep-tendon reflexes are absent. Which of the following actions should the nurse take? ANSWER: Discontinue the medication infusion. A nurse is teaching a client who is postpartum and has a new prescription for an injection of Rho (D) immunoglobulin. Which of the following should be included in the teaching? ANSWER: . It prevents the formation of Rh antibodies in mothers who are Rh negative. A nurse is caring for a client who is postpartum and received methylergonovine. Which of the following findings indicates that the medication was effective? ANSWER: Fundus firm to palpation A nurse is caring for several clients. The nurse should recognize that it is safe to administer tocolytic therapy to which of the following clients? ANSWER: A client who is experiencing preterm labor at 26 weeks of gestation 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? ANSWER: . Insert a gloved hand into the vagina to relieve pressure on the cord. A nurse is caring for an adolescent client who is gravida 1 and para 0. The client was admitted to the hospital at 38 weeks of gestation with a diagnosis of preeclampsia. Which of the following findings should the nurse identify as inconsistent with preeclampsia? ANSWER: Deep tendon reflexes of +1 A nurse is instructing a woman who is contemplating pregnancy about nutritional needs. To reduce the risk of giving birth to a newborn who has a neural tube defect, which of the following information should the nurse include in the teaching? ANSWER: Consume foods fortified with folic acid. A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not." Which of the following should the nurse recognize as a sign of true labor? ANSWER: Changes in the cervix A nurse is caring for a client who is having a nonstress test performed. The fetal heart rate (FHR) is 130 to 150/min, but there has been no fetal movement for 15 min. Which of the following actions should the nurse perform? ANSWER: Offer the client a snack of orange juice and crackers. 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? ANSWER: Two arteries and one vein 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 recommended for rubella immunization? ANSWER: Shortly after giving birth A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make? ANSWER: "It occurs during the first trimester and near the end of the pregnancy." A nurse is caring for a client who is 1 hr postpartum and observes a large amount of lochia rubra and several small clots on the client's perineal pad. The fundus is midline and firm at the umbilicus. Which of the following actions should the nurse take? ANSWER: Document the findings and continue to monitor the client. 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? ANSWER: Painless red vaginal bleeding