OB Final Flashcards
Anurseiscaringforapostpartumclientwhosaturatesaperinealpadin10minutes.Whichofthefollowingactionsshouldthenursetakefirst?
A.
Administeroxytocin.
B.
Observeforpoolingofbloodunderthebuttocks.
C.
Checktheclient’sbloodpressure.
D.
Massagetheclient’sfundus.
D.
Massagetheclient’sfundus.
Anurseiscompletingdischargeteachingtoaclientinher35thweekofpregnancywhohasmildpreeclampsia.Whichofthefollowinginformationaboutnutritionshouldbeincludedintheteaching?
A.
Drink48to64ouncesofwaterdaily.
B.
Avoidsaltingfoodsduringcooking.
C.
Consume40to50gofproteindaily.
D.
Limitintakeofwholegrains,rawfruits,andvegetables.
A.
Drink48to64ouncesofwaterdaily.
A nurse in a family planning clinic is caring for a 21-year-old female patient who is requesting oral contraceptives. The patient states that she is nervous because she has never had a pelvic examination. Which of the following responses should the nurse make?
A. “What part of the exam makes you most nervous?”
B. “Don’t worry, I will be with you during the exam.”
C. “All you need to do is relax.”
D. “A pelvic exam is required if you want birth control pills.”
A. “What part of the exam makes you most nervous?”
As the nurse, you assess a patient that’s grand multiparity. Upon palpation of the fundus, you find it is shifted to the right. What are you thinking?
They have a full bladder. They need to urinate
Anurseisadmittingaclientwhoisinactivelaborandhashadtwopriorcesareanbirths.Thenurseshouldidentifythattheclientisatanincreasedriskforwhichofthefollowingcomplications?
A.
Failuretoprogress
B.
Abruptioplacentae
C.
Precipitouslabor
D.
Uterinerupture
D.
Uterinerupture
AnurseisreinforcingteachingwithaclientwhoispregnantandhasaprescriptionforRho(D)immuneglobulin.Whichofthefollowinginformationshouldthenurseinclude?
A.
ThismedicationdestroysRhantibodiesinanewbornwhoisRh-positive.
B.
ThismedicationdestroysRhantibodiesinawomanwhoisRh-negative.
C.
ThismedicationpreventstheformationofRhantibodiesbyawomanwhoisRh-negative.
D.
ThismedicationpreventstheformationofRHantibodiesinanewbornwhoisRh-positive.
C.
ThismedicationpreventstheformationofRhantibodiesbyawomanwhoisRh-negative.
A pregnant woman is scheduled to undergo chorionic villus sampling (CVS) based on genetic family history. Which medication does the nurse anticipate will be administered? a. Magnesium sulfate b. Prostaglandin suppository c. RhoGAM if the patient is Rh-negative d. Betamethasone
ANS:C
A nurse is preparing a pregnant client for a Contraction Stress Test (CST). What is the purpose of inducing uterine contractions during the test? A. To assess fetal well-being. B. To monitor the FHR. C. To achieve at least three contractions lasting 40 to 60 seconds. D. To identify fetal hypoxia or distress.
A. To assess fetal well-being
A nurse is counseling a client who has a new diagnosis of chlamydia. Which of the following information should the nurse include in the teaching? (Select all that apply) A. You should avoid sexual contact until therapy is complete. B. Notify anyone with whom you have had sexual contact over the past 2 months. C. You will need to take an antiviral medication for 30 days. D. Once you complete treatment, you will have an acquired immunity against chlamydia. E. You might experience painful urination until the infection has resolved.
A, B , E
Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth Select one: A. Bulging of the vulva B. The membranes rupture during a contraction C. The fetal head is felt at 0 station during vaginal examination D. Bloody mucus discharge increases
A. Bulging of the vulva (bulging of perineum also bloody show, crowning)
A mother of a 3-hour-old infant requests information concerning breastfeeding. The mother has tested positive for human immunodeficiency virus (HIV).A nurse’s response should be based on which fact? A. The breast milk can be sterilized to kill the HIV virus, then bottle-fed to the infant. B. Colostrum should be expressed and analyzed for the presence of the HIV virus prior to breastfeeding. C. Breastfeeding may be initiated if the infant is determined to be HIV positive. D. Breastfeeding may be a mode of transmission of the HIV virus.
D. Breastfeeding may be a mode of transmission of the HIV virus.
Which factor is most likely to result in fetal hypoxia during a dysfunctional labor? a. Incomplete uterine relaxation b. Maternal fatigue and exhaustion c. Maternal sedation with narcotics d. Administration of tocolytic drugs
ANS: A. Incomplete uterine relaxation (prolonged contractions on top can cause fetal hypoxia)
NGN bow tie:The nurse is called into a room and sees a pad is saturated with a lot of lochia. What are you thinking is happening and what should you do?
Dx: Postpartum Hemorrhage Actions: palpate fundus, check bladder for distention (empty bladder), give medications (methergin, carbaprost, misoprostol, TSA) monitor; check bp and vitals, monitor for bleeding lochia amount
Baby is jittery. What should you do?
- Check blood glucose - Check respirations Pregnant Patient’s fasting blood glucose should be 140 for glucose testing
You are monitoring a baby and their temperature is 97 degrees Fahrenheit, what are we thinking?
- Cold stress (causes hypoglycemia, hypothermia, Respiratory distress) - Monitor blood sugars and for respiratory distress seen by nasal flaring or substernal retractions
How often do we expect an infant to breastfeed in the first 24hours?
- Every 2-4hrs for at least 15-20mins - if a baby hasn’t fed in 6hrs there’s a big problem.
NGN: A client comes into the clinic, what are some signs that they have Diabetes Mellitus?
monitor blood glucose - Assess hemoA1c, - perform NST, - Monitor FHR
A nurse is caring for a client who is 2 hours postpartum. The client has an IV infusion of lactated Ringer’s with 25 units of oxytocin and large lochia rubra. Vital signs include blood pressure 146/81, pulse 80/min, and respirations 18/min. Which of the following actions should the nurse clarify with the provider? A. Administer oxygen by non-rebreather mask at 5 L/min. B. Administer methylergonovine 0.2 mg IM now. C. Insert a urinary catheter. D. Increase the infusion rate of the IV fluid
B. Administer methylergonovine 0.2 mg IM now.
A nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. Uterine contractions occur every 2 minutes, last 90 seconds, and are strong to palpation. The baseline fetal heart rate is 150/minute, with uniform decelerations beginning at the peak of the contraction and a return to baseline after the contraction is over. Which of the following actions should the nurse take? A. Increase the rate of infusion of the IV oxytocin, B. Discontinue the infusion of the IV oxytocin. C. Decrease the rate of infusion of the maintenance IV solution. D. Slow the client’s rate of breathing.
B. Discontinue the infusion of the IV oxytocin.
A nurse is assessing a client who is in labor and has received epidural analgesia. Which of the following findings should the nurse recognize and document as an adverse effect of epidural analgesia? A. Hypotension. B. Polyuria. C. Fetal heart rate 152/min. D. Maternal temperature of 37.4° C (99.4° F).
A. Hypotension. (Extra: make sure they are hydrated)
A woman who is gravida 3, para 2 enters the intrapartum unit. The most important nursing assessments include
contraction pattern, amount of discomfort, and pregnancy history.
fetal heart rate, maternal vital signs, and the woman’s nearness to birth.
last food intake, when labor began, and cultural practices the couple desires.
identification of ruptured membranes, the woman’s gravida and para, and access to
a support person.
fetal heart rate, maternal vital signs, and the woman’s nearness to birth.
When is the optimal time for AFP screen?
16-18 weeks gestation
What do we give for immature fetal lungs?
Surfactant
A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. The nurse locates the fetal heart tones above the client’s umbilicus at midline. The nurse should suspect that the fetus is in which of the following positions? A. Frank breech B. Cephalic C. Posterior D. Transverse
A. Frank breech
maternal serum alpha-fetoprotein tests for what?
spinal defects neural tube defects
What are some cervical ripening drugs?
Misoprostol, Dinoprostone
What is a contraction stress test for? What do we want to see?
To see how the baby is tolerating contractions, which can show us any uteroplacental insufficiency - We want to see a negative result
When there is a bruise that crosses the suture line, it is called:
caput succedaneum
The nurse is performing a newborn assessment and evaluates a collection of blood beneath the newborn’s scalp that does not cross the suture lines. The nurse documents this finding as A. Sinciput B. Occiput posterior C. Caput succedaneum D. Cephalohematoma
D. Cephalohematoma
A nurse is caring for a client who is to undergo an amniotomy. Which of the following is the priority nursing action immediately following this procedure? A. Assess the client’s temperature. B. Assess the fetal heart rate and pattern. C. Record color and consistency of fluid in the chart. D. Evaluate the client for the presence of chills and increased uterine tenderness using palpation.
B. Assess the fetal heart rate and pattern.
What does a early deceleration indicate?
head compression; it mirrors contractions. Good sign.
What does a late deceleration indicate?
uteroplacental insufficiency; decelerates after contractions
What does a variable deceleration indicate?
Cord compression
There are late decelerations on the FHR. What should be priority intervention?
Answer: Reposition first. Second is oxygen
A nurse is reinforcing teaching with a client who is at 34 weeks of gestation and at risk for placental abruption. Does the nurse recognize that which of the following is the most common risk factor for a placental abruption? A. Maternal hypertension. B. Maternal cocaine use. C. Maternal cigarette smoking. D. Maternal battering.
A. Maternal hypertension.
A nurse in a prenatal clinic is teaching a client who has a new prescription for dinoprostone gel. Which of the following statements should the nurse include in the teaching? A. This medication promotes softening of the cervix. B. It causes relaxation of the uterine muscles. C. This medication is used to treat preeclampsia D. his used to treat genital herpes simplex virus
A. This medication promotes softening of the cervix.
A nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks of gestation. Which of the following manifestations should the nurse expect to identify as consistent with the diagnosis? A. Uterine enlargement greater than expected for gestational age B. Unilateral, cramp-like abdominal pain C. Severe nausea and vomiting D. Large amount of vaginal bleeding
B. Unilateral, cramp-like abdominal pain
A woman is 14 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is:. A. “You should have felt the baby move by now.”. B. “Within the next month or so, you should start to feel fluttering sensations.”. C. “The baby is moving; however, you can’t feel it yet.”. D. “Some babies are quiet, and you don’t feel them move.”.
B. “Within the next month or so, you should start to feel fluttering sensations.”
A nurse is caring for a client who is at 6 weeks of gestation with her first pregnancy and asks the nurse when she can expect to experience quickening. Which of the following responses should the nurse make? A. “This always happens by the end of the first trimester of pregnancy.” B. “This will occur during the last trimester of pregnancy.” C. “This usually happens between the fourth and fifth months of pregnancy” D. “This will happen once the uterus begins to rise out of the pelvis.”
C. “This usually happens between the fourth and fifth months of pregnancy”
A nurse is caring for a client who is postpartum and received methylergonovine (methergine). Which of the following findings indicates that the medication was effective? A. Report of absent breast pain B. Increase in lochia C. Increase in blood pressure D. Fundus firm to palpation
D. Fundus firm to palpation
Your patient is receiving magnesium sulfate for neuroprotection and preterm labor at 1 gram/hour. The most concerning vital sign below is: A. Heart rate of 99 B. Respiratory rate of 9 C. BP of 99/69 D. Temperature of 99.9
B. Respiratory rate of 9
A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is “not really sure if she is in labor or not.”. Which of the following should the nurse recognize as a sign of true labor? A. Rupture of the membranes. B. Pattern of contractions. C. Changes in the cervix. D. Station of the presenting part.
C. Changes in the cervix.
