OB Exam 3 prEdictOr vErifiEd 250 quEstiOns and answErs with dEtailEd ratiOnalEs GuarantEEd pass GradEd a+ 2025 latEst

OB Exam 3 prEdictOr vErifiEd 250 quEstiOns and answErs with dEtailEd ratiOnalEs GuarantEEd pass GradEd a+ 2025 latEst A nurse is caring for a client who is to receive oxytocin to augment her labor. Which of the following findings contraindicates the initiation of the oxytocin infusion and should be reported to the provider? Late decelerations Moderate variability of the FHR Cessation of uterine dilation Prolonged active phase of labor - Correct Answer-ANS: Late decelerations - indicative of uteroplacental insufficiency. Therefore, this is a contraindication for the administration of oxytocin and should be reported to the provider. Moderate variability of the FHR - an expected assessment finding associated with normal fetal acid-base balance. It is not a contraindication to the administration of oxytocin. Cessation of uterine dilation - an indication for the initiation of an oxytocin infusion to augment the client's labor progression. Prolonged active phase of labor 2 | P a g e - an indication for the initiation of an oxytocin infusion to augment the client's labor progression. A nurse is caring for a patient that's 32 weeks gestation and has gonorrhea. The nurse should identify that the client is at an increased risk for which of the following complications? Excessive bleeding Oligohydramnios Premature ROM Proteinuria - Correct Answer-ANS: Premature rupture of membranes - The nurse should identify that a client who is pregnant and has gonorrhea is at an increased risk for premature rupture of membranes, chorioamnionitis, preterm birth, neonatal sepsis, and intrauterine growth restriction. Excessive bleeding - A client who is pregnant and has gonorrhea is not at an increased risk for excessive bleeding. Oligohydramnios - A client who is pregnant and has gonorrhea is not at an increased risk for oligohydramnios. Oligohydramnios is a decrease in amniotic fluid and is associated with congenital anomalies such as renal agenesis and intrauterine growth restriction. Proteinuria - A client who is pregnant and has gonorrhea is not at an increased risk for proteinuria. Proteinuria is associated with preeclampsia. Nurse is performing a vag exam on a patient who is in labor and observes the umbilical cord protruding from the vagina. After calling for assistance, which actions should the nurse take? -Insert two gloved fingers into the vagina and apply upward pressure to the presenting part. -Wrap the visible cord tightly with sterile, dry gauze. -Apply oxygen to the client at 2 L/min via nasal cannula. 3 | P a g e -Place the client in the lithotomy position and apply fundal pressure. - Correct Answer-ANS: Insert two gloved fingers into the vagina and apply upward pressure to the presenting part. - The nurse should quickly apply gloves and insert two fingers into the vagina toward the cervix, exerting upward pressure onto the presenting part to relieve umbilical cord compression and increase oxygenation to the fetus. Wrap the visible cord tightly with sterile, dry gauze. - The nurse should wrap the visible cord with a loose sterile towel saturated with warm 0.9% sodium chloride solution, rather than with sterile, dry gauze. Apply oxygen to the client at 2 L/min via nasal cannula. - The nurse should apply oxygen to the client at 8 to 10 L/min via nonbreather mask. Place the client in the lithotomy position and apply fundal pressure. - The nurse should place the client into a modified Sims position, knee-chest position, or extreme Trendelenburg to attempt to relieve the compression of the umbilical cord. Nurse is giving Teaching to patient who gave birth 2 hrs ago about facility policy for newborn safety. Which patient statements indicates an understanding of teaching? "My sister will be able to carry my baby from the nursery to my room when she arrives." "The nurse will match my wrist band to my baby's crib card when they bring him to me." "The person who comes to take my baby's pictures will be wearing a photo identification badge." "My baby doesn't need to wear the electronic security bracelet when he's in my room." - Correct AnswerANS: "The person who comes to take my baby's pictures will be wearing a photo identification badge.": - All personnel working on the unit should be wearing a photo ID badge. The nurse should instruct the parent to never allow anyone who is not wearing an ID badge to come in contact with the newborn. "My sister will be able to carry my baby from the nursery to my room when she arrives.": - A newborn should always be transported in a bassinet when outside the parent's room. 4 | P a g e "The nurse will match my wrist band to my baby's crib card when they bring him to me.": - The nurse will match the newborn's ID number with the parent's ID number when they bring the newborn to the parent's room. "My baby doesn't need to wear the electronic security bracelet when he's in my room.": - The newborn should wear the electronic security bracelet at all times. The bracelet is set to alarm if anyone removes the bracelet or if the newborn is brought near an exit door. While caring for a the postpartum client who is receiving treatment with bed rest and intravenous heparin therapy for a deep vein thromobosis, the nurse should contact the client's health care provider (HCP) immediately if the client exhibited which symptom? a) Dyspnea b) Bradycardia c) Hypertension d) Pain in her calf - Correct Answer-Dyspnea Correct Explanation: A major complication of deep vein thrombosis is pulmonary embolism. Signs and symptoms, which may occur suddenly and require immediate treatment, include dyspnea, severe chest pain, apprehension, cough (possibly accompanied by hemoptysis), tachycardia, fever, hypotension, diaphoresis, pallor, shortness of breath, and friction rub. Pain in the calf is common with a diagnosis of deep vein thrombosis. Hypotension, not hypertension, would suggest a possible pulmonary embolism. It also could suggest possible hemorrhage secondary to intravenous heparin therapy. Bradycardia for the first 7 days in the postpartum period is normal. A 24-year-old primipara decides to breastfeed her baby but says, "I am worried that I will not be able to breastfeed my baby because my breasts are so small." What would the nurse include in the explanation to the client? a) Because her breasts are small, she will have to feed the baby more often. b) The woman's motivation to breast-feed is more important than breast size. c) Breast size poses no influence on a woman's ability to breastfeed a baby. 5 | P a g e d) Breast milk can be enhanced by occasional formula feeding. - Correct Answer-Breast size poses no influence on a woman's ability to breastfeed a baby. Correct Explanation: Breast size is not important as long as there is glandular tissue to secrete the milk, although various factors can influence milk supply, such as suckling, emptying of the breasts, diet, exercise, rest, level of contentment, and stress. The fat in breast tissue plays no role in milk production. Breastfeeding and formula feeding at the same time can result in nipple confusion. The client's belief in her ability to breastfeed is important because women who lack motivation are more likely to discontinue breastfeeding. Women with small breasts do not produce less milk. Also, the size of the breast does not influence the neonate's ability to grasp the nipple. The frequency of feeding is determined by the baby's needs, not the size of the mother's breasts. The nurse evaluates the mothering skills of an adolescent primigravida changing her baby's diaper for the first time. When caring for this client, the nurse should focus on the client's need for which support? a) detailed written instructions b) acceptance by the client's peers c) praise and encouragement d) family availability for assistance - Correct Answer-praise and encouragement Explanation: The adolescent client may have special needs during the postpartum period. Praise and encouragement of her mothering skills are important for building the client's confidence and self-esteem. Although they may be helpful in some instances, detailed written instructions or prolonged verbal instructions are inappropriate. Lengthy explanations, either verbal or in writing, may overwhelm the firsttime mother, adding to her fears and feelings of inadequacy