Exam Review

A client who is 3 weeks postpartum tells the nurse, “I am so tired all the time. I didn’t realize having a baby would be this challenging.”. What should the nurse’s response be?
A)
It can be tough adjusting to a new baby.
B)
You shouldn’t be doing any chores.
C)
It’s common to feel worn out for the first 3 months. Try to rest when the baby is sleeping.
D)
It’s normal to feel fatigued for the first few weeks. Be patient with yourself and try to rest more.
E)
None
F)
None
The nurse is assessing a client who has been admitted in active labor. The cervix is dilated to 3 cm, 50% effaced, and the presenting part is at 0 station. An hour later, the client informs the nurse that she needs to use the restroom. What should be the nurse’s first course of action?
A)
Review the pattern of the fetal heart rate.
B)
Check the client’s bladder.
C)
Determine the dilation of the cervix.
D)
Test the pH of the vaginal fluid.
Which type of anesthesia, when used with a laboring client, results in a loss of sensation confined to the vagina and perineum?
A)
Pudendal block.
B)
Paracervical block.
C)
Epidural block.
D)
Saddle block.
A client at 28 weeks gestation is in preterm labor and it is not expected that the fetus will survive after delivery. What should be the nurse’s initial action?
A)
Contact spiritual support services.
B)
Provide information about an autopsy.
C)
Discuss neonatal resuscitation options.
D)
Get in touch with the organ donation organization.

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Exam Review

A primigravida arrives at the maternity unit’s observation area because she believes she is in labor.The nurse applies the external fetal heart monitor and determines that the fetal heart rate is 140 beats per minute and contractions are occurring irregularly every 10 to 15 minutes.Which assessment finding would confirm to the nurse that the client is not in labor at this time?
A)
Cervical dilation is 1 cm.
B)
Contractions decrease with walking.
C)
There is 2+ pitting edema in the lower extremities.
D)
The membranes are intact.
After breastfeeding for 10 minutes on each breast, a new mother calls the nurse to the postpartum room to assist with changing the newborn’s diaper. As the mother begins the diaper change, the newborn regurgitates the breast milk. What should be the nurse’s first action?
A)
Clean up the spit-up and assist the mother with the diaper change.
B)
Position the newborn on the side and suction the mouth and nares with a bulb syringe.
C)
Position the newborn with the head lower than the feet.
D)
Sit the newborn upright and burp by gently rubbing or patting the upper back.
A newborn, who is 4 hours old, presents with the following symptoms: axillary temperature of 96.8° F (35.8° C), heart rate of 150 beats/minute with a soft murmur, irregular respiratory rate at 64 breaths/minute, jitteriness, hypotonicity, and a weak cry.What should the nurse do based on these findings?
A)
Swaddle the infant in a warm blanket.
B)
Document the findings in the record.
C)
Place a pulse oximeter on the infant’s heel.
D)
Obtain a heel stick blood glucose level.
A pregnant woman is learning how to perform kick (fetal movement) counts. What should the nurse instruct her to do?
A)
Avoid caffeinated drinks for 24 hours before conducting the kick test.
B)
Exercise for 15 minutes before starting the counting to help increase fetal movement.
C)
Count the movements once daily, for one hour, before breakfast.
D)
If 10 kicks are not felt within one hour, drink orange juice and count for another hour.

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Exam Review

The nurse is caring for a client who delivered 6 hours ago.The client’s uterus is boggy and is displaced above and to the right of the umbilicus. What action should the nurse take?
A)
Monitor the client’s vital signs.
B)
Notify the healthcare provider.
C)
Inspect the perineal pad.
D)
Encourage the client to void.
A multiparous client with active herpes lesions has been admitted to the unit due to spontaneous rupture of membranes.What action should the nurse take?
A)
Cover the lesion with a dressing.
B)
Prepare for a cesarean section.
C)
Obtain blood cultures.
D)
Administer penicillin.
An unlicensed assistive personnel (UAP) informs the charge nurse that a client who delivered a 7-pound (3,175 gram) infant 12 hours ago is experiencing a severe headache. The client’s blood pressure is 110/70 mm Hg, respiratory rate is 18 breaths/minute, heart rate is 74 beats/minute, and temperature is 98.6° F (37° C). The client’s fundus is firm and one fingerbreadth above the umbilicus. What should the charge nurse do first?
A)
Notify the healthcare provider of the assessment findings.
B)
Obtain a STAT hemoglobin and hematocrit.
C)
Determine if the client received anesthesia during delivery.
D)
Assign a practical nurse (PN) to reassess the client’s vital signs.
A client at 40-weeks gestation arrives at the obstetrical floor and reports that her amniotic membranes ruptured spontaneously at home.She is in active labor and feels the need to bear down and push. What is the most important information for the nurse to obtain?
A)
Estimated amount of fluid.
B)
Any odor noted when membranes ruptured.
C)
Time the membranes ruptured.
D)
Color and consistency of fluid.

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Exam Review

While conducting a daily assessment of a one-day-old newborn, the nurse notices a yellow tint on the baby’s forehead, sternum, and abdomen.What should be the nurse’s next course of action?
A)
Initiate phototherapy for the newborn.
B)
Review the mother’s medical records for blood type and Rh factor.
C)
Measure bilirubin levels using transcutaneous bilirubinometry.
D)
Evaluate the results of the cord blood Coomb’s test.
A client with gestational diabetes is scheduled for an amniocentesis due to the fetus weighing an estimated 8 pounds (3629 grams) at 36-weeks gestation.What information is being sought through this amniocentesis?
A)
The maturity of the fetal lungs.
B)
The presence of a neural tube defect.
C)
Any chromosomal abnormalities.
D)
The gender of the fetus.
A postpartum client who is formula-feeding her new baby inquires about when she should expect her menstruation to resume.What should the nurse inform the client?
A)
When the placental site has healed.
B)
When ovulation resumes.
C)
Six to eight weeks after birth.
D)
Four weeks after birth.
A 25-year-old client experienced a severe postpartum hemorrhage following the vaginal birth of twins and is now transferred to the postpartum unit.What complication should the nurse prioritize during the client’s assessment?
A)
Hard, painful uterine afterpains.
B)
Disseminated intravascular coagulation.
C)
Postpartum psychosis.
D)
Placenta accreta.

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Exam Review

An 18-week pregnant client was informed this morning that she has an elevated alpha-fetoprotein (AFP) level. After the healthcare provider leaves the room, the client asks about the next steps.What should the nurse advise?
A)
Reassure the client that the AFP results could be a false reading.
B)
Discuss options for intrauterine surgical correction of congenital defects.
C)
Inform her that a repeat AFP test should be conducted.
D)
Explain that a sonogram should be scheduled for definitive results.
A client at 35 weeks gestation complains of pain whenever the baby moves.The nurse notes the client’s temperature to be 101.20 F (38.4° C), with severe abdominal or uterine tenderness on palpation.What condition do these findings suggest?
A)
Abruptio placenta.
B)
Chorioamnionitis.
C)
Round ligament strain.
D)
Viral infection.
A client who is anovulatory and has hyperprolactinemia is undergoing infertility treatment with metformin, menotropins, and human chorionic gonadotropin.What side effect should the nurse instruct the client to report immediately?
A)
Episodes of headache and irritability.
B)
Persistent daytime fatigue.
C)
Nausea and vomiting.
D)
Rapid increase in abdominal girth.
A nurse is evaluating a newborn who was delivered quickly at 38 weeks gestation. The newborn is shaky, has a fast heart rate, and high blood pressure.Which assessment action should the nurse prioritize?
A)
Conduct a gestational age assessment.
B)
Weigh and measure the newborn.
C)
Evaluate the neonatal reflexes’ reactivity.
D)
Perform a drug screen for cocaine.

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Exam Review

What is the most crucial assessment for the nurse to perform after administering epidural anesthesia to a patient who is at 40 weeks gestation?
A)
Monitor the variability of the fetal heart rate.
B)
Assess the level of pain sensation.
C)
Check the maternal blood pressure.
D)
Determine the station of the presenting part.
A client at 32 weeks gestation visits the women’s health clinic and reports feeling nauseous and vomiting. Upon examination, the nurse notes that the client’s blood pressure is elevated.What should the nurse do next?
A)
Inspect the client’s face for edema.
B)
Inquire about a history of cluster headaches.
C)
Determine the frequency of headaches.
D)
Monitor and time the client’s contractions.
The nurse is caring for a postpartum client who is experiencing severe pain and a sensation of pressure in her perineum.Her uterus is firm, and she has a moderate flow of lochia.Upon inspection, the nurse discovers that a perineal hematoma is starting to form. What should the nurse assess first?
A)
Heart rate and blood pressure.
B)
Urinary output and IV fluid intake.
C)
Hemoglobin and hematocrit levels.
D)
Abdominal contour and bowel sounds.
A mother inquires about what to use when changing her newborn’s diaper. What should the nurse recommend to this mother?
A)
Corn starch powder.
B)
Clear water.
C)
Talcum powder.
D)
Baby lotion.

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