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NSG550 / NSG 550 EXAM 2 (LATEST 2024 / 2025
UPDATE): DIAGNOSTIC REASONING FOR NURSE
PRACTITIONERS | QUESTIONS AND VERIFIED
ANSWERS | 100% CORRECT | GRADE A - WILKES
A nurse is performing a vaginal exam on a client in labor and finds the fetal presentation 1 cm above the ischial spines. How should the nurse document the fetal station? a) 0 b) - 1 c) + d) - 2 b) - 1 Upon examining a laboring client's cervix, the nurse notes the assessment as 7, 80, - 3. How does the nurse interpret this assessment? a) Cervix dilated 7 cm, 50% effaced, fetus 3 cm below the ischial spines. b) Cervix dilated 7 cm, 80% effaced, presenting 3 cm above the ischial spines. c) Cervix dilated 7 cm, 80% effaced, presenting part at the level of the ischial spines. d) Cervix dilated 5 cm, 80% effaced, presenting 3 cm above the ischial spines. b) Cervix dilated 7 cm, 80% effaced, presenting 3 cm above the ischial spines. The nurse recognizes that uterine activity during labor requires additional assessment and possible intervention when the nurse's assessment reveals which of the following? a) Contractions lasting 60 seconds, 5 minutes apart. b) Contractions lasting longer than 90 seconds with less than 30 seconds of resting. c) Contractions lasting 45 seconds, 5 times within a 10-minute period. d) Contractions lasting 70 seconds, 4 times within a 10-minute period. b) Contractions lasting longer than 90 seconds with less than 30 seconds of resting. A client comes to the prenatal clinic for fetal monitoring, and the nurse notes fetal tachycardia. Which of the following could be a possible cause? a) Maternal hypothermia b) Fetal bradycardia c) Maternal hyperthermia d) Fetal sleep cycle
c) Maternal hyperthermia A 28-year-old woman has now reached the second stage of labor. What is the optimal position for her at this point? a) Lying on her back with legs raised b) Standing c) Squatting d) Sitting in a reclined position c) Squatting The prenatal ultrasound reveals the sacrum of the fetus as the presenting part. How is the fetal position described? a) Vertex b) Transverse c) Breech d) Cephalic c) Breech A client in labor begins complaining of intense pain in her lower back. What non- pharmacological measure would provide the best relief? a) Breathing exercises b) Epidural anesthesia c) Counter-sacral pressure d) Changing positions frequently c) Counter-sacral pressure Which of the following signs indicates that the second stage of labor has begun? a) Contractions are 5 minutes apart. b) The cervix is fully dilated. c) The water breaks. d) Fetal descent into the pelvis. b) The cervix is fully dilated. What type of anesthesia is a spinal epidural classified as? a) Local b) General c) Regional d) Topical c) Regional Methotrexate is recommended as part of the treatment plan for which obstetric complication? a) Gestational diabetes b) Unruptured ectopic pregnancy c) Severe preeclampsia d) Placental abruption
b) Convenience of the woman or her physician c) Chorioamnionitis d) Postterm pregnancy e) Fetal death a) Rupture of membranes at or near term c) Chorioamnionitis, d) Postterm pregnancy e) Fetal death Complications and risks associated with cesarean births include which of the following? (Select all that apply.) a) Placental abruption b) Wound dehiscence c) Hemorrhage d) Urinary tract infections e) Fetal injuries b) Wound dehiscence c) Hemorrhage d) Urinary tract infections e) Fetal injuries How should the umbilical cord be cared for and cleaned? (Select all that apply.) a) Clean cord with plain water around the base of the cord b) Keep diaper folded down to avoid covering the cord c) Apply alcohol to the base of the cord at every diaper change d) Notify healthcare provider (HCP) for odor, discharge, or redness a) Clean cord with plain water around the base of the cord b) Keep diaper folded down to avoid covering the cord d) Notify healthcare provider (HCP) for odor, discharge, or redness After a cesarean section, a mother should be taught to report which of the following symptoms as they could indicate infection or complications? a) Mild abdominal discomfort b) Temperature of 38°C (100.4°F) and abdominal pain c) Slight redness around the incision site d) Itching sensation around the incision area b) Temperature of 38°C (100.4°F) and abdominal pain If a laboring woman is 7 cm dilated, what breathing technique should she be encouraged to use? a) Shallow, rapid breathing b) Hold her breath for longer periods c) Use deep breathing and do not hold her breath d) Pant-like a dog
c) Use deep breathing and do not hold her breath The acronym HELLP, used in the context of obstetrics, stands for which of the following? a) Healthy Eating, Low Lipids, Pregnancy b) Hemolysis, Elevated Liver enzymes, Low Platelets c) High Estrogen, Low Lactation, Pre-eclampsia d) Hepatitis, Elevated Leukocytes, Pregnancy b) Hemolysis, Elevated Liver enzymes, Low Platelets What drug is likely the cause of early labor due to its effect on the placenta? a) Heroin b) Marijuana c) Cocaine d) Methamphetamines c) Cocaine True or False: A stress test is recommended for diagnosing placenta previa. False During labor, contractions lasting 40-90 seconds are considered: a) Normal b) Too high c) Too low a) Normal The medication terbutaline should be discontinued when the patient exhibits: a) High blood pressure b) Low respiration rate c) Increased heart rate d) Nausea b) Low respiration rate In the management of high blood pressure during pregnancy, what drug is commonly prescribed? a) Metoprolol b) Hydralazine c) Ibuprofen d) Acetaminophen b) Hydralazine Severe preeclampsia can escalate into which serious condition? a) Gestational diabetes b) Hyperemesis gravidarum c) Seizure (Eclampsia) d) HELLP syndrome c) Seizure (Eclampsia)
b) Methylergonovine (Methergine) c) Carboprost tromethamine (Hemabate) d) Misoprostol c) Carboprost tromethamine (Hemabate) After a car accident, what is the priority nursing action for a pregnant woman? a) Assess for maternal injuries b) Administer pain medication c) Assess the fetus d) Check for contractions c) Assess the fetus Which test is used to assess fetal lung maturity? a) Lecithin/sphingomyelin (L/S) ratio b) Amniocentesis c) Alpha-fetoprotein d) Lamellar body count Lecithin/sphingomyelin (L/S) ratio In the first stage of pregnancy, what adjustment should a diabetic make to their insulin regimen? a) Increase insulin b) Decrease insulin c) No change d) Switch to an oral hypoglycemic agent b) Decrease insulin Which vitamin is recommended to prevent neural tube defects? a) Vitamin A b) Vitamin B c) Folic acid d) Vitamin D c) Folic acid Why should a sterile vaginal exam not be performed in the presence of active vaginal bleeding? a) Risk of introducing infection b) May increase bleeding c) Could exacerbate placental abruption d) Could exacerbate placenta previa
d) Could exacerbate placenta previa For a patient with asthma, which medication is considered a contraindication? a) Beta blockers b) Carboprost tromethamine (Hemabate) c) Corticosteroids d) None of the above; asthma medication should be used b) Carboprost tromethamine (Hemabate) Which medication is contraindicated for diabetic patients due to its potential to raise blood glucose levels? a) Insulin b) Metformin c) Betamethasone d) Glyburide c) Betamethasone The sudden gush of dark red blood during pregnancy is most indicative of: a) Placenta previa b) Placental abruption c) Vasa previa d) Uterine rupture b) Placental abruption A baby's heart rate in the 190s could indicate: a) Normal variability b) Fetal distress c) Prolapsed umbilical cord d) Maternal fever b) Fetal distress What indicates magnesium toxicity in a patient? a) Elevated blood pressure b) Respiration rate of 10 c) Urine output of 30 mL/hr d) Swelling of hands and feet b) Respiration rate of 10 In a primigravida being monitored for preeclampsia, which finding should concern the nurse?
c) Accelerations d) Bradycardia c) Accelerations The mechanism of labor is influenced by: a) The mother's emotional state b) The administration of epidural anesthesia c) The forces determining descent, modified by the shape of the woman's pelvis and the size of the fetal head d) The time of day c) The forces determining descent, modified by the shape of the woman's pelvis and the size of the fetal head Effleurage performed by a nurse for a primigravida in labor is: a) Deep tissue massage b) Application of cold compresses c) Light stroking of the skin surface d) Application of pressure to specific points c) Light stroking of the skin surface After administering an epidural to a client in labor, the most important nursing intervention is to: a) Encourage the client to walk around b) Monitor blood pressure for hypotension c) Immediately start a tocolytic medication d) Increase the rate of intravenous fluids b) Monitor blood pressure for hypotension When administering pain medication to a laboring client via IV, it is important for the nurse to know that: a) The medication should be given as a rapid bolus b) Pain medication is contraindicated during labor c) The medication is given slowly in small increments between contractions d) Oral administration is preferred over IV c) The medication is given slowly in small increments between contractions Which cardinal movement allows the fetal head to be born by having the baby's neck extend as the head passes under the pubic symphysis? a) Flexion b) Descent
c) Internal rotation d) Extension d) Extension What is the leading cause of maternal mortality among the conditions listed? a) Gestational diabetes b) Gestational hypertension c) Postpartum hemorrhage d) Infection b) Gestational hypertension For which condition is amnioinfusion most appropriately administered? a) Polyhydramnios b) Oligohydramnios & fetal cord compression c) Gestational diabetes d) Fetal bradycardia b) Oligohydramnios & fetal cord compression Fetal monitor tracings showing accelerations are interpreted as: a) Non-reassuring b) Reassuring c) Indicative of fetal distress d) Inconclusive b) Reassuring Which description correctly categorizes the fetal heart rate patterns according to the standard categories? a) Category 1: Everything is good b) Category 2: Not everything is good, but not terrible c) Category 3: Terrible d) All of the above d) All of the above Which statement about the stages of labor is correct? a) The first stage begins with regular uterine contractions and ends with full dilation. b) The second stage starts with full dilation and ends with the birth of the baby. c) The third stage is from the birth of the baby to the delivery of the placenta. d) All of the above d) All of the above
Increasing the infusion rate of non-additive IV fluids can primarily increase fetal oxygenation by: a) Decreasing maternal blood pressure b) Expanding maternal blood volume c) Reducing fetal heart rate d) Increasing maternal oxygen intake b) Expanding maternal blood volume What does a contraction stress test with no decelerations indicate? a) Positive b) Negative c) Inconclusive d) Abnormal b) Negative A pregnant woman has been receiving magnesium sulfate for severe preeclampsia. Her respiratory rate has dropped to 10 breaths/min, and she has absent tendon reflexes. What should be the nurse's priority intervention? a) Continue monitoring the patient closely b) Increase the magnesium sulfate infusion rate c) Discontinue the magnesium sulfate infusion d) Administer a bolus of IV fluids c) Discontinue the magnesium sulfate infusion The nurse understands that the administration of opioids during labor can have which effect on the mother and fetus? a) Increased maternal blood pressure b) No significant effects c) Late or variable decelerations of the fetal heart rate d) Accelerated fetal heart rate c) Late or variable decelerations of the fetal heart rate Screening for gestational diabetes mellitus (GDM) is recommended during which weeks of pregnancy? a) 16-20 weeks b) 20-24 weeks c) 24-28 weeks d) 28-32 weeks c) 24-28 weeks
Med math 0. Med math 0. Med math 2 Med math 12 Med math 0. Med math 0. Med math 2 Med math 12 SATA 4: ALL EXCEPT METABOLIC PANEL At how many weeks can lightening or dropping occur in prima gravidas? a) 36 b) 38 c) 37 d) 35 c) 37 By what week should cerclage be placed, and until what week does it stay in? a) 16; 36 b) 14; 28 c) 15, 30 d) 18; 32 a) 16; 36 What is the resting tone range? a) 10 mmHg b) 15 mmHg c) 8 mmhHg d) 12 mmHg a) 10 mmHg A woman with preeclampsia has a seizure. The nurse's primary duty during the seizure is to a) insert an oral airway. b) suction the mouth to prevent aspiration. c) administer oxygen by mask. d) stay with the patient and call for help. d) stay with the patient and call for help. In planning care for women with preeclampsia, nurses should be aware that a) induction of labor is likely, as near term as possible. b) if at home, the woman should be confined to her bed, even with mild preeclampsia.
B) Umbilical cord compression C) Uteroplacental insufficiency D) Fetal hypoxia A) Head compression
