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A nurse is providing discharge instructions to a client who is breast-feeding her newborn. Which
of the following statements should the nurse include?
A. Notify your provider if you notice cracking on your nipples
B. Notify your provider if you have not had a bowel movement within 5 days
C. Notify your provider if your breast leak when you shower
D. Notify your provider if your vaginal discharge is brownish-red color correct answers A
A nurse is providing teaching to a client who is planning to breastfeed her newborn. Which of the
following statements made by the client indicates an understanding of the teaching?
A. I must drink milk everyday in order to assure good quality breast milk
B. Drinking lots of fluids will increase my breast milk production
C. After the first few weeks, my nipples will toughen, and breastfeeding won't hurt anymore
D. My baby may sometimes feed every hour for several hours in a row correct answers D
A nurse is planning care for a client who has a prescription for oxytocin. Which of the following
is a contraindication to the use of this medication?
A. Prolonged rupture of membranes at 38 weeks gestation
B. Intrauterine growth restriction
C. Post-term pregnancy
D. Active genital herpes correct answers D
A nurse is providing teaching to a client who is postpartum and does not plan to breastfeed her
newborn. Which of the following instructions should the nurse include in the teaching?
,A. Stand under a hot shower with your breast exposed
B. Place ice packs on your breast
C. Wear loose fitting, comfortable bra
D. Limit fluid intake to 1L per day correct answers B
A nurse is providing care for a client who is in the second stage of labor. The fetal heart tracing
indicates multiple variable decelerations. Which of the following actions should the nurse take?
A. Prepare an amnioinfusion
B. Place the client in a supine position
C. Administer oxygen 2 L/min via nasal cannula
D. Give a glucocorticoid steroid correct answers A
A nurse is caring for a client who is at 39 weeks gestation and in active labor. Which of the
following actions should the nurse include in the plan of care?
A. Keep all 4 side rails up while the patient is in bed
B. Monitor the fetal heart rate every hour
C. Insert an indwelling urinary catheter
D. Check the cervix prior to analgesic administration correct answers D
A nurse is assessing a client who is at 35 weeks gestation and has preeclampsia without severe
features. Which of the following findings should the nurse identify as the priority?
A. 480 mL urine output in 24 hours
B. Blood pressure 144/92 mmHg
C. +2 edema of the feet
D. 1+ protein in urine correct answers A
, A nurse is caring for a client who is at 16 weeks gestation and has severe iron-deficiency anemia.
The provider prescribes an injection of iron dextran IM. Which of the following methods should
the nurse use to administer the medication?
A. Use a 20-gauge needle and administer the medication using the Z-track method
B. Use a 22-gauge needle and administer the medication deep into the thigh
C. Use a 25-gauge needle and administer the medication into the deltoid muscle
D. Use an 18-gauge needle and administer the medication into the rectus femoris muscle correct
answers A
A nurse is preparing a client who is in labor for the insertion of an intrauterine pressure catheter.
The client asks why this type of monitoring is needed. Which of the following responses should
the nurse make?
A. This type of monitoring is necessary for timing the frequency of your contractions
B. This type of monitoring is noninvasive, so it is the best way to monitor your contractions
C. This type of monitor allows us to evaluate your baby's heart rate while you are in labor
D. This type of monitoring will allow us to measure the intensity of your contractions correct
answers D
A nurse is caring for a client who just had a spontaneous rupture of membranes. The nurse
observes fetal bradycardia on the FHR tracing and a prolapsed umbilical cord. Which of the
following actions should the nurse take first?
A. Place the client in extreme Trendelenburg position
B. Increase the IV fluid infusion rate
C. Manually apply upward pressure intravaginally on the presenting part
D. Administer 8 to 10 L/min of oxygen via a nonrebreather face mask correct answers C
A nurse is providing discharge instructions to a client who is breast-feeding her newborn. Which
of the following statements should the nurse include?
A. Notify your provider if you notice cracking on your nipples
B. Notify your provider if you have not had a bowel movement within 5 days
C. Notify your provider if your breast leak when you shower
D. Notify your provider if your vaginal discharge is brownish-red color correct answers A
A nurse is providing teaching to a client who is planning to breastfeed her newborn. Which of the
following statements made by the client indicates an understanding of the teaching?
A. I must drink milk everyday in order to assure good quality breast milk
B. Drinking lots of fluids will increase my breast milk production
C. After the first few weeks, my nipples will toughen, and breastfeeding won't hurt anymore
D. My baby may sometimes feed every hour for several hours in a row correct answers D
A nurse is planning care for a client who has a prescription for oxytocin. Which of the following
is a contraindication to the use of this medication?
A. Prolonged rupture of membranes at 38 weeks gestation
B. Intrauterine growth restriction
C. Post-term pregnancy
D. Active genital herpes correct answers D
A nurse is providing teaching to a client who is postpartum and does not plan to breastfeed her
newborn. Which of the following instructions should the nurse include in the teaching?
,A. Stand under a hot shower with your breast exposed
B. Place ice packs on your breast
C. Wear loose fitting, comfortable bra
D. Limit fluid intake to 1L per day correct answers B
A nurse is providing care for a client who is in the second stage of labor. The fetal heart tracing
indicates multiple variable decelerations. Which of the following actions should the nurse take?
A. Prepare an amnioinfusion
B. Place the client in a supine position
C. Administer oxygen 2 L/min via nasal cannula
D. Give a glucocorticoid steroid correct answers A
A nurse is caring for a client who is at 39 weeks gestation and in active labor. Which of the
following actions should the nurse include in the plan of care?
A. Keep all 4 side rails up while the patient is in bed
B. Monitor the fetal heart rate every hour
C. Insert an indwelling urinary catheter
D. Check the cervix prior to analgesic administration correct answers D
A nurse is assessing a client who is at 35 weeks gestation and has preeclampsia without severe
features. Which of the following findings should the nurse identify as the priority?
A. 480 mL urine output in 24 hours
B. Blood pressure 144/92 mmHg
C. +2 edema of the feet
D. 1+ protein in urine correct answers A
, A nurse is caring for a client who is at 16 weeks gestation and has severe iron-deficiency anemia.
The provider prescribes an injection of iron dextran IM. Which of the following methods should
the nurse use to administer the medication?
A. Use a 20-gauge needle and administer the medication using the Z-track method
B. Use a 22-gauge needle and administer the medication deep into the thigh
C. Use a 25-gauge needle and administer the medication into the deltoid muscle
D. Use an 18-gauge needle and administer the medication into the rectus femoris muscle correct
answers A
A nurse is preparing a client who is in labor for the insertion of an intrauterine pressure catheter.
The client asks why this type of monitoring is needed. Which of the following responses should
the nurse make?
A. This type of monitoring is necessary for timing the frequency of your contractions
B. This type of monitoring is noninvasive, so it is the best way to monitor your contractions
C. This type of monitor allows us to evaluate your baby's heart rate while you are in labor
D. This type of monitoring will allow us to measure the intensity of your contractions correct
answers D
A nurse is caring for a client who just had a spontaneous rupture of membranes. The nurse
observes fetal bradycardia on the FHR tracing and a prolapsed umbilical cord. Which of the
following actions should the nurse take first?
A. Place the client in extreme Trendelenburg position
B. Increase the IV fluid infusion rate
C. Manually apply upward pressure intravaginally on the presenting part
D. Administer 8 to 10 L/min of oxygen via a nonrebreather face mask correct answers C
