OB Exam 2 ATI Review Questions with Certified Solutions

OB Exam 2 ATI Review Questions with Certified Solutions Pt indicates preterm labor. which of the following are risk factors? -UTI -multifetal pregnancy -oligohydramnios -diabetes mellitus -uterine abnormalities UTI mulitfetal pregnancy diabetes uterine abnormalities preterm 32 week pt. what medication should be anticipated to hasten fetal lung maturity? betamethasone pt receiving nifedipine, RN should monitor what manifestation dizziness pt with prescription for magnesium sulfate. which are contraindications? -fetal distress -preterm labor -vaginal bleeding -dilation great than 6cm -severe gestational hypertension fetal distress vaginal bleeding dilation greater than 6cm what instructions should the RN give a pt who has premature rupture of membranes? keep a daily record of fetal kick counts Pt's contractions started 2 hr ago contractions got stronger since walking had some blood after voiding what should the RN recognize the pt is experiencing? true contractions 2 cm dilated 50% effaced -2 station contractions every 8 minutes for 30-40 seconds what stage? first stage, latent stage Pt experiences a large gush of fluid from her vagina after walking. what should the RN do? monitor FHR for distress Pt states that her vagina has been leaking fluid for the past two days. What is the pt at risk for? infection Pt is in active labor and states "I've had enough. I can't do this any more. I want to go home." Which stage of labor is she in? transition phase 40 weeks 3-5 cm 3 cm dilated 80% effaced, -1 station pt asks for pain medication, RN should -encourage use of patterned breathing -insert an indwelling cath -admin opioid analgesic -application of cold -provide ice chips encouraged patterned breathing admin opioid application of cold compress Pt with lower back pain. which non-pharmacological nursing intervention should be used? sacral counter pressure pt with epidural block is about to receive IV fluid bolus , what should the RN say? It is needed to counteract hypotension the provider is preparing to admin lidocaine for pain relief and perform an episiotomy. which type of regional anesthetic block is to be administered? pudendal Pt is using patterned breathing and starts to feel numbness and tingling in fingers, what should the RN do? place oxygen mask over the pts nose and mouth dilated 5cm and membranes intact FHR 115/125min w/ increases to 150/155 for 25 seconds beat-to-beat variable 20/min no slowing of FHR baseline pt is exhibiting signs of -moderate variable -FHR accelerations -FHR decelerations -normal baseline FHR -fetal tachycardia moderate variable FHR accelerations normal baseline benefits of internal fetal heart monitoring? -it is considered a noninvasive procedure -it can detect abnormal fetal heart tones -it can determine the amount of amniotic fluid -it allows for accurate readings with maternal mvmt -it can measure uterine contraction intensity -it can detect abnormal fetal heart tones -allows for accurate readings with maternal mvmt -it can measure uterine contraction intensity During active labor the RN knows that the fetus receives more oxygen when what appears on the tracing? relaxation between contractions pt in labor with late decelerations on the electronic fetal monitor, what should RN do first? assist the pt into left lateral position during leopold maneuver the RN should use what technique to determine the fetal lie? palpate the fundus of the uterus How will the pt know she is crowning? the vaginal area will buldge as the baby's head appears What should the RN do when the pt is in the 2nd stage of labor and and reports she needs to have a bowel mvmt? prepare for an impending delivery Pt in 3rd stage, which findings indicate placenta seperation? -lengthening of umbilical cord -swift gush of clear amniotic fluid -softening of lower uterine segment -appearance of dark blood from the vagina -fundus firm upon palpation lengthening of umbilical cord appearance of dark blood from the vagina fundus firm upon palpation pt in labor reports she has been having vaginal bleeding for 2 weeks. what should the RN include in the plan of care? defer vaginal examinations first stage of labor and encouraging the pt to void every 2 hr. what statement should the RN use? a distended bladder reduces pelvis space needed for birth which of the following conditions should the RN plan to prepare an amnioinfusion? -oligohydramnios -hydramnios -fetal cord compression -hydration -fetal immaturity oligohydramnios fetal cord compression Vaginal examination is done to ensure which of the following prior to the performance of an amniotomy? fetal engagement pt is rh- and will undergo an external version at 37 weeks, what medication should the RN expect to give? Rho(D) immune globulin Which of the following contraction pattern should the RN discontinue oxytocin? duration of 90-120 seconds which chemical agent ripens the cervix they are administered in an oral form What contraction pattern increases the risk for which of the following complications? reduced fetal oxygen supply which of the following maternal positions should the RN suggest to the pt to facilitate normal labor progress? hands and kness during leopold maneuver, RN notices the fetus in the breech position, what complication should the RN observe? prolapsed umbilical cord pt in 42 weeks, what is the fetus at risk for? meconium aspiration 3 cm dilated 100% effaced -2 station water broke FHR 80-85/min clear fluid and pulsing loop of umbilical cord what should RN do? call for assistance