-OB EXAM 2- Flashcards
A postpartum woman reports mood swings, tearfulness, and difficulty sleeping. Which intervention is most appropriate?
A) Prescribe antidepressants.
B) Encourage rest and provide reassurance.
C) Refer to a psychiatrist immediately.
D) Recommend stopping breastfeeding.
Answer: B) Encourage rest and provide reassurance.
Rationale: Postpartum blues are self-limiting and typically resolve within 2 weeks. Rest and support are key interventions.
A postpartum woman diagnosed with postpartum depression is prescribed sertraline. What should the nurse include in the teaching?
A) “You will feel better within 1-2 days.”
B) “This medication is contraindicated during breastfeeding.”
C) “It may take several weeks to see improvement in symptoms.”
D) “Avoid taking the medication with dairy products.”
Answer: C) “It may take several weeks to see improvement in symptoms.”
Rationale: SSRIs like sertraline take 4-6 weeks to show effects.
Which symptom differentiates postpartum psychosis from postpartum depression?
A) Insomnia
B) Feelings of hopelessness
C) Hallucinations
D) Poor appetite
Answer: C) Hallucinations
Rationale: Hallucinations are a hallmark symptom of postpartum psychosis and require immediate intervention.
A postpartum patient presents with a fever of 39°C, tachycardia, and hypotension. What is the nurse’s priority intervention?
A) Start IV fluids and administer broad-spectrum antibiotics.
B) Monitor blood pressure every 4 hours.
C) Administer antipyretics for the fever.
D) Prepare the patient for discharge.
Answer: A) Start IV fluids and administer broad-spectrum antibiotics.
Rationale: Early antibiotic administration and fluid resuscitation are critical in managing sepsis
What is a common risk factor for maternal sepsis?
A) Obesity
B) Cesarean delivery
C) Retained products of conception
D) All of the above
Answer: D) All of the above
Rationale: Obesity, surgical deliveries, and retained placental fragments increase the risk of infection and sepsis
Which characteristic is commonly seen in small-for-gestational-age (SGA) newborns?
A) Proportional growth
B) Wide skull sutures and thin umbilical cord
C) Redundant subcutaneous fat stores
D) Large body with poor motor skills
Answer: B) Wide skull sutures and thin umbilical cord
Rationale: SGA newborns exhibit growth restrictions, decreased fat, and wide sutures
A preterm infant exhibits nasal flaring, grunting, and retractions. What is the nurse’s priority intervention?
A) Monitor glucose levels.
B) Administer surfactant therapy.
C) Begin oral feedings.
D) Encourage kangaroo care.
Answer: B) Administer surfactant therapy.
Rationale: These are signs of respiratory distress syndrome, and surfactant is critical for alveolar function
A large-for-gestational-age (LGA) infant is born to a mother with poorly controlled gestational diabetes. What complication should the nurse monitor for?
A) Hypoglycemia
B) Hyperbilirubinemia
C) Birth trauma
D) All of the above
Answer: D) All of the above
Rationale: LGA infants are at risk for hypoglycemia, jaundice, and birth injuries due to macrosomia.
A newborn has jaundice with a total bilirubin level of 18 mg/dL at 48 hours of life. What type of jaundice is most likely?
A) Physiologic jaundice
B) Breastfeeding jaundice
C) Pathologic jaundice
D) Hemolytic jaundice
Answer: C) Pathologic jaundice
Rationale: Bilirubin levels >17 mg/dL within the first 24-48 hours suggest pathologic jaundice and require immediate treatment
What nursing intervention is essential for maintaining thermal regulation in preterm infants?
A) Encourage breastfeeding frequently.
B) Place the infant under a radiant warmer.
C) Perform frequent heel sticks.
D) Limit stimulation in the NICU.
Answer: B) Place the infant under a radiant warmer.
Rationale: Preterm infants are at risk for hypothermia due to inadequate subcutaneous fat and immature thermoregulation
A laboring patient is in the second stage of labor. Which assessment finding indicates progression toward delivery?
A) Cervical dilation of 5 cm
B) The fetus is at +2 station
C) Regular contractions every 10 minutes
D) The cervix is posterior and firm
Answer: B) The fetus is at +2 station
Rationale: A +2 station indicates the fetus has descended closer to the perineum, a sign of imminent delivery.
A postpartum patient has heavy lochia rubra with large clots. What is the nurse’s first action?
A) Call the healthcare provider
B) Administer oxytocin
C) Perform fundal massage
D) Increase IV fluids
Answer: C) Perform fundal massage
Rationale: Heavy bleeding and clots suggest uterine atony. Fundal massage is the first intervention to promote uterine contraction and reduce bleeding.
During the third stage of labor, what is the nurse’s priority intervention?
A) Assess fundal height and firmness
B) Encourage frequent position changes
C) Monitor for fetal heart rate variability
D) Prepare the patient for an epidural
Answer: A) Assess fundal height and firmness
Rationale: During the third stage of labor (delivery of the placenta), monitoring for hemorrhage is critical by assessing uterine tone.
What is a hallmark sign of uterine subinvolution during postpartum assessment?
A) Firm and midline fundus
B) Persistent lochia rubra and elevated fundal height
C) Decreased lochia and normal fundal position
D) Pain-free uterine cramping
Answer: B) Persistent lochia rubra and elevated fundal height
Rationale: Subinvolution involves delayed uterine involution, presenting as prolonged bleeding and an elevated fundus.
The nurse assesses a newborn with yellowish discoloration on the palms and soles but no other symptoms. What should the nurse suspect?
A) Pathologic jaundice
B) Carotenemia
C) Physiologic jaundice
D) Hemolytic disease
Answer: B) Carotenemia
Rationale: Yellow discoloration limited to palms and soles without scleral involvement is commonly due to carotenemia.
Which newborn reflex is elicited by stroking the cheek?
A) Moro reflex
B) Babinski reflex
C) Rooting reflex
D) Grasp reflex
Answer: C) Rooting reflex
Rationale: The rooting reflex prompts the newborn to turn their head toward the stimulus, aiding in feeding.
A term newborn is diagnosed with meconium aspiration syndrome (MAS). What is the nurse’s priority intervention?
A) Administer surfactant therapy
B) Perform deep suctioning below the vocal cords
C) Place the newborn in an incubator
D) Monitor glucose levels
B) Perform deep suctioning below the vocal cords
Rationale: Immediate suctioning is critical to clear meconium and prevent respiratory complications in MAS
A newborn of a diabetic mother is jittery with a blood glucose level of 35 mg/dL. What is the nurse’s priority action?
A) Administer IV glucose
B) Initiate breastfeeding
C) Place the newborn under a radiant warmer
D) Monitor glucose every hour
Answer: B) Initiate breastfeeding
Rationale: Feeding is the first-line treatment for mild neonatal hypoglycemia; IV glucose is reserved for severe cases
A breastfeeding newborn has lost 8% of birth weight by day 3. What is the nurse’s best intervention?
A) Reassure the parents that this is normal
B) Advise formula supplementation
C) Encourage more frequent feedings
D) Schedule immediate follow-up testing
Answer: C) Encourage more frequent feedings
Rationale: Weight loss up to 10% is normal in the first week. Frequent breastfeeding helps the infant regain weight.
A postpartum patient is experiencing heavy vaginal bleeding, and the fundus is boggy and midline. What is the nurse’s next step?
A) Insert a Foley catheter
B) Perform a bimanual uterine massage
C) Administer Methergine IM
D) Prepare for surgical intervention
Answer: B) Perform a bimanual uterine massage
Rationale: A boggy uterus indicates uterine atony, the most common cause of PPH. Massage stimulates uterine contractions to reduce bleeding.
The provider prescribes Hemabate (carboprost) for a patient experiencing postpartum hemorrhage. Which condition in the patient’s history would prompt the nurse to question this order?
A) Hypertension
B) Asthma
C) Diabetes mellitus
D) Hypothyroidism
Answer: B) Asthma
Rationale: Hemabate can cause bronchoconstriction and is contraindicated in patients with asthma.
A preterm infant is diagnosed with RDS. The nurse anticipates administering which medication?
A) Surfactant via endotracheal tube
B) Epinephrine IM
C) Intravenous magnesium sulfate
D) Inhaled corticosteroids
Answer: A) Surfactant via endotracheal tube
Rationale: RDS is caused by surfactant deficiency in preterm infants, and surfactant replacement is the primary treatment.
A nurse is monitoring a preterm infant on mechanical ventilation for RDS. Which finding indicates improvement?
A) Decreased oxygen requirements
B) Increased work of breathing
C) Persistent apnea
D) Cyanosis on exertion
Answer: A) Decreased oxygen requirements
Rationale: Improved oxygenation indicates better lung compliance and reduced severity of RDS.
A nurse is caring for a preterm infant who is under a radiant warmer. What is the priority nursing assessment?
A) Monitor skin integrity
B) Assess core body temperature
C) Evaluate feeding tolerance
D) Monitor oxygen saturation
Answer: B) Assess core body temperature
Rationale: Preterm infants are at high risk for hypothermia, and maintaining a neutral thermal environment is critical.
A newborn with NAS exhibits sneezing, irritability, and high-pitched crying. What is the nurse’s priority intervention?
A) Provide frequent skin-to-skin contact
B) Administer morphine as prescribed
C) Offer glucose water between feedings
D) Place the infant under phototherapy
Answer: B) Administer morphine as prescribed
Rationale: Morphine is used to manage severe withdrawal symptoms in NAS, ensuring comfort and stability.
What is the best method to prevent heat loss via conduction in a newborn?
A) Drying the newborn thoroughly after birth
B) Placing a warmed blanket on the scale before weighing the infant
C) Using a radiant warmer during procedures
D) Keeping the infant away from drafts
Answer: B) Placing a warmed blanket on the scale before weighing the infant
Rationale: Warming surfaces that come into contact with the newborn prevents heat loss through conduction.
A newborn with jaundice has a total bilirubin level of 20 mg/dL. The provider orders phototherapy. Which intervention is most critical for the nurse to perform?
A) Keep the newborn dressed to prevent hypothermia
B) Monitor bilirubin levels every 24 hours
C) Ensure the infant’s eyes are covered with protective patches
D) Limit feedings to prevent fluid overload
Answer: C) Ensure the infant’s eyes are covered with protective patches
Rationale: Phototherapy can damage the retina, so eye protection is essential during treatment.
