OB OA Review Study Questions With Answers 100% Correctly Tested And Verified Solutions 202, Exams of Nursing

Download OB OA Review Study Questions With Answers 100% Correctly Tested And Verified Solutions 202 and more Exams Nursing in PDF only on Docsity! OB OA Review Study Questions With Answers 100% Correctly Tested And Verified Solutions 2023/2024 Updates Just after delivery, a new mother tells the nurse, “I was unsuccessful breastfeeding my first child, but I would like to try with this baby.” Which intervention is best for the nurse to implement first? A. Ask the client to describe why she was unsuccessful with breastfeeding her last child. B. Provide assistance to the mother to begin breastfeeding as soon as possible after delivery. C. Assess the husband’s feelings about his wife’s decision to breastfeed their baby. D. Encourage the client to develop a positive attitude about breastfeeding to help ensure success. *B When explaining “postpartum blues” to a client who is 1 day postpartum, which symptoms should the nurse include in the teaching plan? Select all that apply. A. Panic attacks B. Tearfulness C. Decreased need for sleep D. Mood swings E. Disinterest in the infant *B and D The nurse is teaching breastfeeding to prospective parents in a childbirth education class. Which instruction should the nurse include as content in the class? A. Feed your baby every 2 to 3 hours or on demand, whichever comes first. B. Begin as soon as your baby is born to establish a four-hour feeding schedule. C. Resting helps with milk production. Ask that your baby be fed at night in the nursery. D. Do not allow your baby to nurse any longer than the prescribed number of minutes. *A A client is admitted with the diagnosis of total placenta previa. Which finding is most important for the nurse to report to the healthcare provider immediately? A. Variable fetal heart rate B. Heart rate of 100 beats/minute C. Onset of uterine contractions D. Burning on urination *C An expectant father tells the nurse he fears that his wife “is losing her mind.” He states she is constantly rubbing her abdomen and talking to the baby, and that she actually reprimands the baby when it moves too much. What recommendations should the nurse make to this expectant father? A. Let him know that these behaviors are part of normal maternal/fetal bonding which occur once the mother feels fetal movement. B. Reassure him that these are normal reactions to pregnancy and suggest that he discuss his concerns with the childbirth education nurse. C. Ask him to observe his wife’s behavior carefully for the next few weeks and report any similar behavior to the nurse at the next prenatal visit. D. Help him understand that his wife is experiencing normal symptoms of ambivalence about the pregnancy and no action is needed. A client at 28-weeks gestation calls the antepartal clinic and states that she is experiencing a small amount of vaginal bleeding which she describes as bright red. She further states that she is not experiencing any uterine contractions or abdominal pain. What instruction should the nurse provide? A. Come to the clinic today for an ultrasound. B. Go immediately to the emergency room. C. Bring a urine specimen to the lab tomorrow to determine if you have a urinary tract infection. D. Lie on your left side for about one hour and see if the bleeding stops. *A A vaginally delivered infant of an HIV positive mother is admitted to the newborn nursery. What intervention should the nurse perform first? A. Bathe the infant with an antimicrobial soap. B. Administer vitamin K (AquaMEPHYTON). C. Measure the head and chest circumference. D. Obtain the infant’s footprints. *A The nurse is assessing the umbilical cord of a newborn. Which finding constitutes a normal finding? A. Two vessels: two arteries and no veins. B. Three vessels: two arteries and one vein. C. Three vessels: two veins and one artery. D. Two vessels: one artery and one vein. *B A client with no prenatal care arrives at the labor unit screaming, “The baby is coming!” The nurse performs a vaginal examination that reveals the cervix is 3 centimeters dilated and 75% effaced. What additional information is most important for the nurse to obtain? A. Gravidity and parity B. Frequency and intensity of contractions. C. Time and amount of last oral intake. D. Date of last normal menstrual period. *D The nurse assessing a client who is having a non-stress test (NST) at 41 weeks gestation. The nurse determines that the client is not having contractions, the fetal heart rate (FHR) baseline is 144 bpm, and no FHR accelerations are occurring. What action should the nurse take? A. Notify the healthcare provider of the nonreactive results. B. Check the client for urinary bladder distention. C. Have the mother stimulate the fetus to move. D. Ask the client if she has felt any fetal movement. *D One hour after giving birth to an 8-pound infant, a client’s lochia rubra has increased from small to large and her fundus is boggy despite massage. The client’s pulse is 84 beats/minute and blood pressure is 156/96. The healthcare provider prescribes Methergine 0.2 mg IM x 1. What action should the nurse take immediately? A. Call the healthcare provider to question the prescription. B. Encourage the client to breastfeed rather than bottle feed. C. Have the client empty her bladder and massage the fundus. D. Give the medication as prescribed and monitor for efficacy. *A A full-term infant is admitted to the newborn nursery. After cervical assessment, the nurse suspects that the infant may have an esophageal atresia. Which symptoms are this newborn likely to exhibit? A. Projectile vomiting and cyanosis. B. Choking, coughing, and cyanosis. C. Apneic spells and grunting. D. Scaphoid abdomen and anorexia. *B The nurse should explain to a 30-year-old primigravida client that alpha fetoprotein testing is recommended for which purpose? A. Detect cardiovascular disorders. B. Assess for maternal pre-eclampsia. C. Screen for neutral tube defects. D. Monitor the placental functioning. *C The nurse is caring for a woman with a previously diagnosed heart disease who is in the second stage of labor. Which assessment findings are of greatest concern? A. Increased urinary output and tachycardia. B. Edema, basilar rates, and an irregular pulse. C. Regular heart rate and hypertension. D. Shortness of breath, bradycardia, and hypertension. *B A 4-week-old premature infant has been receiving epoetin alfa (Epogen) for the last three weeks. Which assessment finding indicates to the nurse that the drug is effective? A. Changes in apical heart rate from the 180s to the 140s. B. Respiratory rate changes from the 40s to the 60s. C. Change in indirect bilirubin from 12 to 8. D. Slowly increasing urinary output over the last week. *A Twenty minutes after a continuous epidural anesthetic is administered, a laboring client’s blood pressure drops from 120/80 to 90/60. What action will the nurse take? A. Continue to assess the blood pressure q5 minutes. B. Place the woman in a lateral position. C. Notify the healthcare provider or anesthesiologist immediately. D. Turn off the continuous epidural. *B A new mother asks the nurse, “How do I know that my daughter is getting enough breast milk?” which response is best for the nurse to provide? A. Weigh the baby daily, and if she is gaining weight, she is eating enough. B. If you’re concerned, you might consider bottle feeding so that you can monitor her intake. C. Your milk is sufficient if the baby is voiding pale straw-colored urine 6 to 10 times a day. D. Offer the baby extra bottle milk after her feeding and see if she is still hungry. *C A client who is in the second trimester of pregnancy tells the nurse that she wants to use herbal therapy. Which response is best for the nurse to provide? A. Herbs are a cornerstone of good health to include in your treatment. B. Your healthcare provider should direct treatment options for herbal therapy. C. Touch is also therapeutic in relieving discomfort and anxiety. D. Is it important that you want to take part in your care. *D The total bilirubin level of a 36-hour, breastfeeding newborn is 14. Based on this finding, which intervention should the nurse implement? A. Provide phototherapy for 30 minutes. B. Assess the newborn’s blood glucose level. C. Encourage the mother to breastfeed frequently. D. Feed the newborn sterile water hourly. *C A mother who is breastfeeding her baby receives instructions from the nurse. Which instruction is most effective to prevent nipple soreness? A. Manually express a small amount of milk before nursing. B. Correctly place the infant on the breast. C. Wear a cotton bra. D. Increase nursing time gradually. *B The nurse is performing a gestational age assessment on a full-time newborn during the first hour of transition using the Ballard (Dubowitz) scale. Based on this assessment, the nurse determines that the neonate has a maturity rating of 40-weeks. What findings should the nurse identify to determine if the neonate is small for gestational age (SGA)? A. Frontal occipital circumference of 12.5 inches (31.25 cm) B. Head to heel length of 17 inches (42.5 cm). C. Full flexion of all extremities in resting supine position. D. Skin smooth with visible veins and abundant vernix. E. Anterior plantar crease and smooth heel surfaces. F. Admission weight of 4 pounds, 15 ounces (2244 grams). *A, B, and F The nurse caring for a laboring client encourages her to void at least q2h and records each time the client empties her bladder. What is the primary reason for implementing tis nursing intervention? A. Emptying the bladder during delivery is difficult because of the position of the presenting fetal part. B. Frequent voiding minimizes the need for catheterization which increases the chance of bladder infection. C. An over-distended bladder could be traumatized during labor, as well as prolong the progress of labor. D. Urine specimens for glucose and protein must be obtained at certain intervals throughout labor. *C A 40-week gestation primigravida client is being induced with an oxytocin (Pitocin) secondary infusion and complains of pain in her lower back. Which intervention should the nurse implement? A. Place the client in a semi-Fowler’s position. B. Apply firm pressure to sacral area. C. Inform the healthcare provider. D. Discontinue the oxytocin (Pitocin) infusion. *B A client in active labor is admitted with preeclampsia. Which assessment finding is most significant in planning this client’s care? A. Blood pressure 158/80 B. Four-hour urine output 240 mL. C. Respiration 12/minute. D. Patellar reflex 4+ *D A client with gestational hypertension is in active labor and receiving an infusion of magnesium sulfate. Which is the most important drug the nurse should have available for signs of potential toxicity? A. Terbutaline (Brethine) B. Calcium gluconate C. Naloxone (Narcan) D. Oxytocin (Pitocin) *B A woman who gave birth 48 hours ago is bottle-feeding her infant. During assessment, the nurse determines that both breasts are swollen, warm, and tender upon palpation. What action should the nurse take? A. Express small amounts of milk to relieve pressure. B. Wear a loose-fitting bra to prevent nipple irritation. C. Apply cold compresses to both breasts for comfort. D. Instruct the client to run warm water on her breasts. *C A 35-year-old primigravida client with severe preeclampsia is receiving magnesium sulfate via continuous IV infusion. Which assessment data would indicate to the nurse that the client is experiencing magnesium sulfate toxicity? A. Urine output 90 ml/4 hours B. Blood pressure 140/90 C. Deep tendon reflexes 2+ D. Respiratory rate 18/minute. *A When assisting a client to relieve postpartum uterine contractions, which nursing intervention would be most helpful for the nurse to take? A. Massaging the client’s abdomen B. Lying client prone with a pillow on the abdomen C. Giving oxytocic medications D. Asking the client to express milk via breast pump. *B A healthcare provider informs the charge nurse of a labor and delivery unit that a client is coming to the unit with suspected abruptio placentae. What findings should the charge nurse expect the client to demonstrate? Select all that apply. A. Premature rupture of membranes. B. A rigid abdomen. C. Increased uterine irritability. D. Dark, red vaginal bleeding. E. Lower back pain. F. Bilateral pitting edema. *B, C, and D At 14-weeks gestation, a client arrives at the Emergency Center complaining of a dull pain in the right lower quadrant of her abdomen. The nurse obtains a blood sample and initiates an IV. Thirty minutes after admission, the client reports feeling a sharp abdominal pain and a shoulder pain. Assessment findings include diaphoresis, a heart rate of 120 beats/minute, and a blood pressure of 86/48. Which action should the nurse implement next? A. Administer pain medication. B. Check the hematocrit results. C. Increase the rate of IV fluids. D. Monitor client for contractions. *C A 38-week primigravida who works as a secretary and sits at a computer 8 hours each day tells the nurse that her feet have begun to swell. Which instruction would be most effective in preventing pooling of blood in the lower extremities? A. Reduce salt in her diet. B. Avoid constrictive clothing. C. Move about every hour. D. Wear support stockings. *C B. Assess the fetal heart rate and pattern. C. Notify the client’s primary healthcare provider. D. Prepare the client for imminent birth. *B The nurse is assessing a 12-hour-old infant with a maternal history of frequent alcohol consumption during pregnancy. Which finding should the nurse report that is most suggestive of fetal alcohol syndrome (FAS)? A. Flat nasal bridge B. An extra digit on the left hand C. Asymmetrical bulging fontanels D. Corneal clouding *A What assessment finding should the nurse report to the healthcare provider that is consistent with hemorrhage in an abruptio placenta? A. Hard, board-like abdomen. B. Maternal bradycardia C. Decrease in fundal height. D. Decrease in abdominal pain. *A A gravid client develops maternal hypotension following regional anesthesia. What intervention(s) should the nurse implement? Select all that apply. A. Monitor fetal status. B. Place the client in a lateral position. C. Assist client to a sitting position. D. Administer oxygen. E. Perform a vaginal examination. F. Increase IV fluids. *A, B, D, and F A client who is at 24-weeks gestation presents to the emergency department holding her arm and complaining of pain. The client reports she fell down the stairs. Which observation should alert the nurse to a possible battering situation? A. Examination reveals a fracture to the right humerus and multiple bruises. B. The woman avoids eye contact and hesitates while answering questions. C. The woman and her partner are having a loud and hostile argument. D. Other parts of her body have injuries that are in different stages of healing. *D A client at 35-weeks gestation visits the clinic for a prenatal check-up. Which complaint by the client warrants further assessment by the nurse? A. Periodic abdominal pain. B. Backache with prolonged standing. C. Shortness of breath when climbing stairs. D. Ankle edema in the afternoon. *A Which procedure evaluates the effect of fetal movement on fetal heart activity? A. Contraction test B. Sonography C. Non-stress test (NST) D. Biophysical profile *C A client at 28-weeks gestation at the labor and delivery unit with a complaint of bright red, painless vaginal bleeding. For which diagnostic procedure should the nurse prepare the client? A. Abdominal ultrasound B. Lecithin-sphingomyelin ratio C. Internal fetal monitoring D. Contraction stress test *A The nurse observes a new mother avoiding eye contact with her newborn. Which action should the nurse take? A. Recognize this as a common reaction in new mothers. B. Ask the mother why she won’t look at the infant. C. Observe the mother for other attachment behaviors. D. Examine the newborn’s eyes for the ability to focus. *C The nurse is preparing a client with a term pregnancy who is in active labor for an amniotomy. What equipment should the nurse have available at the client’s bedside? Select all that apply. A. A sterile glove B. Litmus paper C. Lubricant D. Sterile vaginal speculum E. Fetal scalp electrode F. An amnihook *A, C, and F Which action is most important for the nurse to implement for a client at 36- weeks gestation who is admitted with vaginal bleeding? A. Apply disposable pads under the client. B. Obtain blood samples for hemoglobin hematocrit levels. C. Monitor uterine contractions. D. Determine fetal heart rate and maternal vital signs. *D Which client finding should the nurse document as a positive sign of pregnancy? A. A urine sample with a positive pregnancy test. B. Presence of Braxton Hicks contractions. C. Fetal heart tones (FHT) heard with a doppler. D. Last menstrual cycle occurred 2 months ago. *C A client in labor receives an epidural block. What intervention should the nurse implement first? A. Monitor blood pressure. B. Obtain a radial pulse. C. Encourage oral fluids. D. Assess contractions. *A While assessing a newborn the nurse observes diffuse edema of the soft tissues of the scalp that cross the suture lines. How should the nurse document this finding? A. Molding A primigravida at 12-weeks gestation who just moved to the United States indicates she has not received any immunization. Which immunization(s) should the nurse administer at this time? Select all that apply. A. Rubella B. Chickenpox C. Hepatitis B D. Diphtheria E. Tetanus *C, D, and E A multiparous client is experiencing bleeding 2 hours after a vaginal delivery. What action should the nurse implement next? A. Assess the vital signs for indicators of shock. B. Give oxytocin (Pitocin) intravenously. C. Determine the firmness of the fundus. D. Inform the healthcare provider of the bleeding. *C A client at 39-weeks gestation is admitted to the labor and delivery unit. Her obstetrical history includes 3 live births at 39-weeks, 34-weeks, and 35-weeks gestation. Using the GTPAL system, which designation is the most accurate summary of this client’s obstetrical history? A. 4-3-1-0-2 B. 3-1-1-1-3 C. 3-0-3-0-3 D. 4-1-2-0-3 *D A client who is stable has family members present when the nurse enters the birthing suite to assess the mother and newborn. What action should the nurse implement at this time? A. Reschedule the visit so that the mother and infant can be assessed privately. B. Do a brief assessment for only the infant while family members are present. C. Observe interactions of family members with the newborn and each other. D. Ask to meet with the client and infant without family members present. *C A multiparous client delivered a 7 lb 10 oz infant 5 hours ago. Upon fundal assessment, the nurse determines the uterus is boggy and is displaced above and to the right of the umbilicus. Which action should the nurse implement next? A. Document the color of the lochia. B. Observe maternal vital signs. C. Assist the client to the bathroom. D. Notify the healthcare provider. *C What action should the nurse implement when caring for a newborn receiving phototherapy? A. Limit the intake of formula. B. Reposition every 6 hours. C. Apply an oil-based lotion to the skin. D. Place an eye shield over the eyes. *D Which prescription should the nurse administer to a newborn to reduce complications related to birth-trauma? A. Silver nitrate B. Ceftriaxone (Rocephin). C. Erythromycin (llotycin ointment) D. Vitamin k *D Which finding in the medical history of a post-partum client should the nurse withhold the administration of a routine standing order for methylergonovine maleate (Methergine)? A. Postpartum hemorrhage B. Pregnancy induced hypertension C. Placenta previa D. Gestational diabetes *B At 10-weeks gestation, a high-risk multiparous client with a family history of Down Syndrome is admitted for observation following a chorionic villi sampling (CVS) procedure. What assessment finding requires immediate intervention? A. Systolic blood pressure < 100 mmHg B. Intermittent nausea C. Abdominal tenderness D. Uterine cramping *D The nurse is giving discharge instructions for a client following a suction curettage for hydatidiform mole. The client asks why oral contraceptives are being recommended for the next 12 months. What information should the nurse provide? A. Molar reoccurrences are higher if conception occurs within 1 year after an initial mutation. B. Diagnostic testing for human chorionic gonadotropin (hCG) levels are elevated by pregnancy. C. Pregnancy within 1 year decreases the chances of a future successful pregnancy. D. Oral contraceptives prevent a reoccurrence of a molar pregnancy. *B A client at 28-weeks gestation is concerned about her weight gain of 17 pounds. What information should the nurse provide this client? A. Increase the calories in your diet to gain more weight per week. B. It is not necessary to keep such a close watch on weight gain. C. The weight gain is acceptable for the number of weeks pregnant. D. Try to exercise more because too much weight has been gained. *C A newborn infant is jaundiced due to Rh incompatibility. Which finding is most important for the nurse to report to the healthcare provider? A. Hemoglobin B. Bilirubin C. Oral intake D. Bruising *B A 36-week gestation client with pregnancy-induced hypertension (PIH) is receiving an IV infusion of magnesium sulfate. Which assessment finding should the nurse report to the healthcare provider? A. Fetal heart rate of 120-125 beats/minute. B. Contractions occurring every 30 minutes. C. Respiratory rate of 11 breaths/minute. D. Blood pressure of 100/60 mmHg. *C A client is experiencing “back” labor and complains of intense pain in the lower lumbar- sacral area. What action should the nurse implement? A. Assist the client in guided imagery. B. Apply counter pressure against the sacrum. C. Encourage pant-blow breathing techniques. D. Perform effleurage on the abdomen. *B The nurse is planning for the care of a 30-year-old primigravida with pre-gestational diabetes. What is the most important factor affecting this client’s pregnancy outcome? A. Degree of glycemic control during pregnancy. B. Amount of insulin required prenatally. C. Number of years since diabetes was diagnosed. D. Mother’s age. *A The nurse notes a pattern of the fetal heart rate decreasing after each contraction. What action should the nurse implement? A. Obtain an oral maternal temperature. B. Continue to monitor the fetal heart rate pattern. C. Give 10 liters of oxygen via face mask. D. Prepare for an emergency cesarean section. *C What information should the nurse include about perineal self-care for a client who is 24- hours post-delivery? A. Perineal care should be done at least twice per day. B. Reapply ice packs to perinium after each voiding. C. Use cool water to decrease swelling of the perineum. D. Spray warm water from front to back using a squeeze bottle. *D What action should the nurse implement to prevent conductive heat loss in a newborn? A. Place the infant under a radiant warming system. B. Dry the newborn with a warmed blanket. C. Position the crib away from the windows. D. Put a blanket on the scale when weighing the infant. *D A primigravida at 37-weeks gestation tells the nurse that her “bag-of-water” has broken. While inspecting the client’s perineum, the nurse notes the umbilical cord protruding from the vagina. What action should the nurse implement first? A. Give the healthcare provider a status report. B. Administer 10 L of oxygen via face mask. C. Wrap the cord with gauze soaked in saline. D. Place the client in the knee-chest position. *D A client is receiving an oxytocin infusion for induction of labor. When the client begins active labor, the fetal heart rate (FHR) slows at the onset of several contractions with subsequent return to baseline before each contraction ends. What action should the nurse implement? A. Change the woman’s position. B. Insert an internal monitor device. C. Document the finding in the client record. D. Discontinue the oxytocin infusion. *C A client delivers twins, one is stillborn, and the other is recovering in the intensive care nursery. As the nurse provides assistance to the bathroom, the client softly crying, states, “I wish my baby could have lived.” Which response is best for the nurse to provide? A. Do not be sad. You will need to be strong to care for your healthy baby. B. Do you want to go to the nursery and see your baby? C. It is always sad to lose a baby. Would you like me to call your minister? D. I am sorry for your loss. Do you want to talk about it? *D