Exam Review
- The nurse is assessing a patient who has severe preeclampsia. The assessment finding that should be reported to the physician is:A)2+ Deep Tendon Reflexes.B)Platelets of 20,000C)Urine output of 75 ml per hour.D)1+ proteinuria.
- A primigravida who is 28 weeks pregnant visits the clinic fearing she is experiencing preeclampsia. Which of the following assessments would the nurse make to confirm or negate these thoughts? Select all that apply.(SATA)A)Right Sided Epigastric painB)Uterine contractionsC)Bright red painless vaginal bleedingD)Severe headacheE)Visual disturbancesF)Dull back ache
- A patient has been admitted to the emergency department with a suspected diagnosis of ectopic pregnancy. How should the nurse explain this condition to the patient?A)An ectopic pregnancy does not need major treatment and can be delivered vaginally."B)"An ectopic pregnancy involves a fertilized ovum outside the uterus that cannot be transferred to the uterus."C)"An ectopic pregnancy involves a cancerous fertilized ovum in either fallopian tube."D)"An ectopic pregnancy involves a fertilized ovum in the vagina
- A woman with preeclampsia gave birth vaginally 1 hour ago. She is still receiving a magnesium sulfate infusion at 1 gm/hr. A major concern regarding the administration of magnesium sulfate at this time would be:A)DiuresisB)HypotensionC)Increased risk for seizuresD)Excessive uterine bleeding.
Exam Review
- A 29-week gravid patient is admitted to the labor and delivery unit with vaginal bleeding. To differentiate between placenta previa and abruptio placentae, the nurse should assess which of the following?A)Quantity of vaginal bleedingB)Presence of abdominal painC)Leopold's maneuver results.D)Maternal blood pressure
- Preconception counseling is critical to the outcome of a pregnancy for a patient with diabetes because poor glycemic control before and during early pregnancy is associated with:A)OligohydramniosB)Congenital fetal anomalies.C)Intrauterine fetal seizuresD)Polyhydramnios.
- The nurse is caring for a pregnant woman who is HIV positive. While teaching her about the use of antiretroviral drugs, the nurse explains that these medications willA)Treat opportunistic infectionsB)Supplement radiation and chemotherapyC)Decrease viral loads in the bloodD)Cure acute HIV/AIDS infections
- The nurse is preparing to administer methotrexate to the patient. This drug is most often used for which obstetric complication?A)Preterm laborB)Abruptio placentaeC)Pre-eclampsiaD)Unruptured ectopic pregnancy
Exam Review
- A laboring woman with Type 1 diabetes is on an IV insulin drip, and the nurse is monitoring her glucose levels hourly. The woman's partner asks why the glucose needs to remain between 70-110 mg/dL. The nurse's response is based on which of the following information?A)Maintaining euglycemia in labor reduces the need for insulin postpartum.B)A blood glucose level 110 puts the client at risk for infection in labor.C)More insulin will be available for fetal use via placental transfer.D)An elevated blood glucose in labor increases the risk of neonatal hypoglycemia.
- A nurse teaching a prenatal class is asked why infants of diabetic mothers are often larger than those born to women who do not have diabetes. On what information about pregnant women with diabetes should the nurse base the response?A)Consuming more calories covers the insulin secreted by the fetus.B)Fetal weight gain increases as a result of the common response of maternal overeating.C)Extra circulating glucose causes the fetus to acquire fatty deposits.D)Taking exogenous insulin stimulates fetal growth
- The nurse caring for a woman hospitalized for hyperemesis gravidarum would expect that the initial treatment would involve:A)Enteral nutrition (TPN) to correct nutritional deficitsB)Small frequent mealsC)Corticosteroids to reduce inflammationD)IV therapy to correct fluid and electrolyte imbalances
- A 26-year old having her first baby is 28 weeks pregnant. She experiences bright red, painless vaginal bleeding, soaking one pad. Upon her arrival at the hospital, after placing her on the FHR Monitor, what would be an expected diagnostic procedure?A)Internal fetal monitoringB)Amniocentesis for fetal lung maturityC)Contraction stress testD)Ultrasound for placenta location
Exam Review
- A pregnant woman is just admitted to the emergency room after a head on auto accident. Her body appears to be uninjured. The nurse carefully monitors the woman for which complication(s) of pregnancy? (Select all that apply)A)Transverse fetal lieB)Preterm laborC)Severe preeclampsiaD)Placenta PreviaE)Placental abruption
- A woman who is 26 weeks pregnant has just found out that she has gestational diabetes. Which of the following therapies will most likely be ordered first for this patient?A)Oral hypoglycemic medicationsB)Diet control and exerciseC)Inhaled insulinD)Regular insulin injections
- A patient is 3 days post c-section delivery for eclampsia. The client is receiving hydralazine (Apresoline). Which of the following would indicate that the medication is effective?A)The patient's blood pressure dropped from 160/120 to 130/90B)The patient states that her headache is goneC)The patient's postoperative weight has dropped from 155 to 144 poundsD)The patient has had no seizures since delivery
- A patient has just spontaneously ruptured her membranes. Which of the following factors makes her especially high risk for having a prolapsed cord? Select all that apply.A)Occiput anterior position.B)Breech presentation.C)Cervical dilation 5 cm.D)Station-4.
Exam Review
- An emergency shoulder dystocia delivery occurred that requires the nurse to apply suprapubic pressure. What is the rationale for this action?A)To prevent uterine atonyB)To facilitate the delivery of the baby's head.C)To facilitate the delivery of the baby's shouldersD)To prepare for the third stage of labor.
- During the admission assessment, a laboring patient shares that her last baby was born by cesarean but she would like to try to deliver vaginally this time. Upon further discussion, the nurse learns the birth was an emergency delivery for fetal intolerance to labor. What information is the most important for the nurse to obtain?A)The type of uterine incision used for the cesarean.B)The client's blood type and Rh status.C)The client's response to anesthesia used for the last delivery.D)Lab values, especially hemoglobin and hematocrit
- During augmentation of labor with intravenous oxytocin (Pitocin), a multiparous client becomes pale and diaphoretic and complains of severe lower abdominal pain with a tearing sensation. An abnormal FHR tracing is noted on the monitor. The nurse should suspect:A)Uterine prolapse.B)Uterine rupture.C)Precipitous labor.D)Amniotic fluid embolus.
- A client at 35 weeks' gestation is admitted with a partial abruptio placenta and a Category III fetal heart rate tracing with minimal variability and a prolonged deceleration. The nurse anticipates a plan of care for this client that includes most importantly:A)Induction of labor with intravenous oxytocin.B)An emergency cesarean sectionC)In-hospital fetal monitoring for 48 hoursD)Discharge home on strict bed rest
Exam Review
- A client has been admitted to the labor and delivery suite for induction of labor for post-term pregnancy. Misoprostol (Cytotec) has been inserted. Which of the following findings would warrant stopping the Cytotec treatment?A)Contraction frequency of 1 minute.B)Cervix is 50% effaced.C)Maternal respiratory rate of 24.D)Fetal heart baseline of 150.
- A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding is most indicative that preterm labor is occurring?A)The cervix is effacing and dilated to 2 cmB)Irregular, mild uterine contractions are occurring every 15-30 minutesC)Estriol is not found in maternal salivaD)Fetal fibronectin is present in vaginal secretions
- For a woman at 42 weeks gestation, which finding would require more assessment by the nurse?A)Fetal heart rate of 118 beats/minB)One fetal movement noted in a two-hour assessment by the motherC)Cervix dilated 2 cm and 50% effacedD)Score of 8 on the biophysical profile
- A client who is 32 weeks pregnant calls the clinic complaining of an increase in vaginal discharge, pelvic pressure, and low back and abdominal pain. Based on this information, what action will the nurse take?A)Tell the client to take a warm shower, rest, and call back tomorrow.B)Schedule an appointment for the client at the clinic tomorrow.C)Instruct the client to drink cranberry juice and call if she experiences a fever.D)Instruct the client to go to labor triage at the hospital for evaluation.