RNSG 2208 OB STUDY QUESTIONS 4 PRACTICE QUESTIONS AND ANSWERS SOLUTION 2021

OB STUDY QUESTIONS 4 PRACTICE QUESTIONS AND ANSWERS SOLUTION 2021 1.        A nurse is caring for a client during a nonstress test (NST). The nurse observes two decelerations of 15 beats/min. in the fetal heart rate during a period of fetal movement. Each deceleration lasts 20 seconds. This indicates which of the following findings?           A positive test           A negative test           A nonreactive test           A reactive test   2.        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?           Infuse a bolus of IV fluid           Administer betamethasone 12 mg IM           Administer hydralazine 25 mg IV           Prepare the client for immediate delivery   3.        A nurse is reviewing contraception options for four clients. The nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives?           A 26-year-old client who has migraine headaches at the start of each menstrual cycle           A 32-year-old client who has benign breast disease           A 38-year-old client who reports smoking one pack of cigarettes every day           A 28-year-old client who has a history of pelvic inflammatory disease   4.        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?           There are less than 3 uterine contractions in a 10-min. period           There is evidence of cervical incompetence           There is no evidence of uteroplacental insufficiency           There is no evidence of two or more accelerations in fetal heart rate in 20 min.   5.        A nurse in a prenatal clinic is caring for a client who is at 12 weeks gestation. The client asks about the cause of her heartburn. Which of the following responses should the nurse make?           Increase estrogen production causes increased secretion of hydrochloric acid           Retained bile in the liver results in delayed digestion           Increased progesterone production causes decreased motility of smooth muscle           Pressure from the growing uterus displaces the stomach   6.        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?           Puerperal infection           Anaphylactoid syndrome of pregnancy           Disseminated intravascular coagulation           Preeclampsia   7.        A nurse in a prenatal clinic is teaching a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?           “I will reduce my exercise schedule to 3 days a week.”           “I will take my glyburide daily with breakfast.”           “I know I am at increased risk to develop type 2 diabetes.”           “I should limit my carbohydrates to 50% of caloric intake.”   8.        A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes the client’s current status?           2-0-0-2-0           4-0-1-2-2           3-0-2-0-2           4-2-0-2-2   9.        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 pregnancy induced hypertension (PIH). Which of the following findings should the nurse identify as inconsistent with the admitting diagnosis?           1+ pitting edema           3+ protein in the urine           Blood pressure 148/98 mm Hg           Deep tendon reflexes of +1   10.     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 is an appropriate nursing intervention?           Immediately report the situation to the client’s provider and prepare the client for induction of labor           Encourage the client to walk around without the monitoring unit for 10 min. then resuming monitoring           Offer the client a snack of orange juice and crackers           Turn the client onto her left side   11.     A nurse is caring for a client who is considering several methods of contraception. Which of the following methods of contraception should the nurse identify as being most reliable?           A male condom           An intrauterine device (IUD)           An oral contraceptive           A diaphragm with spermicide   12.     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?           “The test will be performed if your baby’s heart beat is heard.”           “This test will determine if your baby’s lungs are mature.”           “This test requires the presence of amniotic fluid.”           “After the test, you will be given Rho immune globulin since you are Rh positive.”   13.     A nurse is caring for a client who is receiving IV magnesium sulfate. Which of the following medications should the nurse anticipate administering if magnesium sulfate toxicity is suspected?           Nifedipine           Pyridoxine           Ferrous sulfate           Calcium gluconate   14.     A nurse is caring for a client who is in labor and has an epidural anesthesia block. The clients blood pressure is 80/40 mm Hg and the fetal heart rate is 140/min. Which of the following is the priority nursing action?           Elevate the clients legs           Monitor vital signs every 5 min.           Notify the provider           Place the client in a lateral position   15.     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?           Tachycardia           Absence of clonus           Polyuria           Report of headache   16.     The nurse is admitting a client who is at 10 weeks of gestation and reports abdominal pain and moderate vaginal bleeding. The tentative diagnosis is inevitable abortion. Which of the following actions should the nurse include in the client’s plan of care?           Prepare to administer oxygen           Determine the amount and type of vaginal bleeding           Instruct the client in appropriate birth control methods           Keep the client on bed rest   17.     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?           Limit alcohol consumption           Increase intake of iron-rich foods           Consume foods fortified with folic acid           Avoid foods containing aspartame   18.     A nurse is educating a client who was diagnosed with genital herpes. Which of the following statements indicates the client needs further information?           “Transmission of the disease does not occur when my symptoms are gone.”           “Abstaining from sexual activity prevents transmission of the disease.”           “The use of condoms will reduce the risk of transmission.”           “Antiviral medication reduces the risk of viral transmission.”   19.     Several nurses were discussing risk factors of transmission when a client has human immunodeficiency virus (HIV). Which of the following individuals are at greatest risk for exposure to HIV?           A counselor who works with the client who has HIV           A personal trainer who works with a client who has HIV           A phlebotomist who collects blood from a client who has HIV           A nurse who works for an insurance company and collects saliva for testing     20.     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 abdominal pain and vaginal bleeding. The nurse should suspect which of the following complications?           Placenta previa           Prolapsed cord           Ruptured ovarian cysts           Abruptio placentae   21.     A nurse is preparing to administer RHO (D) immunoglobulin (RhoGAM). An Rh incompatibility can lead to which of the following?           Hydrops fetalis           Hypobilirubinemia           Congenital hypothermia           Transient clotting difficulties   22.     A nurse is preparing to administer magnesium sulfate IV to a client who is experiencing preterm labor. Which of the following is the priority nursing assessment for this client?           Temperature           Fetal heart rate (FHR)           Bowel sounds           Respiratory rate   23.     A nurse is admitting a client who has severe preeclampsia at 35 weeks of gestation and is reviewing the provider’s orders. Which of the following orders requires clarification?           Assess deep tendon reflexes every hour           Obtain a daily weight           Continuous fetal monitoring           Ambulate twice daily   24.     A nurse is reviewing the health history of a client who has a new prescription for a combined oral contraceptive (COC). The nurse recognizes that which of the following medications can interfere with the effectiveness of the COC?           Antihypertensives           Anticonvulsants           Antioxidants           Antiemetics         25.     A nurse is caring for a client who has preeclampsia and is being treated with magnesium sulfate. It is noted that the client’s respiratory rate is 10 breaths/min. and deep tendon reflexes are 0. Which of the following nursing interventions is appropriate at this time?           Turn off the magnesium sulfate drip           Prepare the client for an emergency cesarean birth           Assess the client’s blood pressure           Place the client in Trendelenburg position   26.     A nurse in a prenatal clinic is assessing a client who is suspected of having a hydatidform mole. Which of the following findings should the nurse expect to observe in this client?           Rapidly dropping human chorionic gonadotropin (hCG) levels           Bright red vaginal bleed           Fetal heart rate irregularities           Excessive uterine enlargement                                                               27.     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?           “This infection is treated with one dose of azithromycin.”           “If your sexual partner has no symptoms, no medication is needed.”           “You have to avoid sexual relations for 3 days.”           “You need to return in 6 months for retesting.”   28.     A nurse is caring for a client who is to undergo a biophysical profile. The client asks the nurse what is being evaluated during the test. Which of the following should the nurse include? (Select all that apply)           Fetal breathing           Fetal motion           Fetal neck translucency           Amniotic fluid volume           Fetal gender   29.     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?           “It’s a minor inconvenience, which you should ignore.”           “In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone.”           “There is no way to predict how long it will last in each individual client.”           “It occurs during the first trimester and near the end of the pregnancy.”     30.     A nurse is caring for a newborn whose mother is positive for the hepatitis B surface antigen. Which of the following should the infant receive?           Hepatitis B immune globulin at 1 week followed by hepatitis B vaccine monthly for 6 months           Hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigen           Hepatitis B immune globulin and hepatitis B vaccine within 12 hrs. of birth           Hepatitis B vaccine at 24 hrs. followed by hepatitis B immune globulin every 12 hrs. for 3 days   31.     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?           It prevents the formation of Rh antibodies in mothers who are Rh negatives           It destroys Rh antibodies in mothers who are Rh negative           It destroys Rh antibodies in newborns who are Rh positive           It prevents the formation of Rh antibodies in newborns who are Rh positive   32.     A nurse is caring for an antepartum client whose laboratory findings indicate a negative rubella titer. Which of the following is the correct interpretation of this data?           The client is not experiencing a rubella infection at this time           The client is immune to the rubella virus           The client requires a rubella vaccination at this time           The client requires a rubella immunization following delivery                                                                                                        33.     A nurse is teaching a group of clients who are in their first trimester about exercise during pregnancy. Which of the following statements should the nurse include in the teaching?           “Refrain from exercises that include stretching.”           “Moderate exercise improves circulation.”           “It is recommended to increase your weight-bearing exercises.”           “It is recommended to rest for 30 minutes before each new exercise.”   34.     A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first?           A client who is at 38 weeks of gestation and reports a cough and fever           A client who has missed a period and reports vaginal spotting           A client who is at 14 weeks of gestation and reports nausea and vomiting           A client who is at 28 weeks of gestation and reports of painless vaginal bleeding                                                         35.     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?           Hypoglycemia           Hypomagnesemia           Hyperbilirubinemia           Hypocalcemia