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    Exam Review

    1. A multiparous client with a history of previous cesarean birth is admitted for labor induction with oxytocin. Which of the following actions is most important before initiating therapy?
      A)
      Administer an IV fluid bolus.
      B)
      Insert a urinary catheter.
      C)
      Perform a glucose monitoring.
      D)
      Verify continuous electronic fetal monitoring is in place.
    2. A nurse administers oxytocin IV after delivery to a client with postpartum hemorrhage. Which assessment best indicates that the oxytocin is effective?
      A)
      The client’s blood pressure increases.
      B)
      The amount of lochia rubra increases.
      C)
      The client reports relief of afterpains.
      D)
      The uterus is firm on palpation.
    3. What is an important nursing consideration when administering oxytocin (Pitocin) in labor?
      A)
      Administer the highest effective dose to establish effective labor.
      B)
      Use of intermittent monitoring with oxytocin infusion.
      C)
      Administer the dose as ordered.
      D)
      Discontinue oxytocin for reassuring fetal heart patterns.
    4. What is the recommended position to improve fetal oxygenation when oxytocin-induced uterine tachysystole occurs?
      A)
      Prone.
      B)
      Left lateral.
      C)
      Trendelenburg.
      D)
      Supine.
    Page 1 of 5

    Exam Review

    1. A nurse is teaching a client and her partner about oxytocin use for labor induction. Which client statement indicates that further teaching is needed?
      A)
      "It's normal for contractions to come one right after another without rest."
      B)
      "The nurse will check my baby's heart rate and my contractions often."
      C)
      "Once labor progresses, the dose can often be decreased or stopped."
      D)
      "The contractions may get stronger and closer together as the dose increases."
    2. A nurse is admitting a client who is at 38 weeks of gestation and is 5/70/-1. Which of the following assessment findings is of concern and should be reported to the provider first?
      A)
      Reassuring fetal heart tracing
      B)
      Continuous contraction lasting 2 minutes
      C)
      Contractions 4 minutes apart
      D)
      Pink mucus plug
    3. A client G3 T2 P0 A0 L2 pregnant at 37 weeks gestation has a chief complaint of contractions which began 3 hours ago. Vaginal exam on admission was 6 cm/70%/-2. Fetal heart baseline is 145 bpm with moderate variability and accelerations. Uterine contractions are 60 minutes apart, lasting 50 seconds. The nurse performs another cervical exam 2 hours later and reports no change. What orders would the nurse anticipate?
      A)
      Continue to monitor the client
      B)
      Obtain an order from the health care provider to start oxytocin
      C)
      Perform a vaginal exam
      D)
      Administer an enema
    4. A nurse is caring for a client in OB triage who is a primigravida, at term, reporting low back pain radiating to the lower abdomen every 5 minutes for 2 hours. The client states, "I am not really sure if I'm in labor or not." Which of the following should the nurse recognize as a sign of true labor?
      A)
      Contractions stop with comfort measures
      B)
      Rupture of membranes
      C)
      Regular contractions with cervical change
      D)
      Station of the presenting part
    Page 2 of 5

    Exam Review

    1. A 39 weeks gestation client presents to the emergency room (ER), contracting every 15 minutes. Each contraction lasts for 30 seconds. The client had spontaneous rupture of membranes (SROM) of clear amniotic fluid for 18 hours. Which of the following nursing interventions is contraindicated?
      A)
      Intermittent fetal heart auscultation
      B)
      Nipple stimulation
      C)
      Administration of IV fluids
      D)
      Vaginal examinations every hour
    2. The nurse has administered Oxytocin 2 hours ago as ordered. The nurse is assessing the fetal heart tracing: baseline 120 with moderate variability and 1 variable deceleration down to 80 bpm followed by a prolonged deceleration. There are 8 contractions in 10 minutes lasting 40-60 seconds. What is the nurse's initial intervention?
      A)
      Perform fetal scalp stimulation
      B)
      Apply oxygen
      C)
      Discontinue Pitocin
      D)
      Administer IV bolus
    3. What change occurs to the uterus 2 days after birth?
      A)
      The uterus descends 2 cm below the umbilicus
      B)
      By 1 week postpartum, the uterus should be nonpalpable
      C)
      The uterus remains an oval shape
      D)
      After delivery of the placenta, the uterus is 3 cm above the umbilicus
    4. A postpartum client with a history of rheumatoid arthritis reports increased joint pain. The nurse recognizes this as:
      A)
      A complication of oxytocin administration
      B)
      A normal immune rebound after pregnancy
      C)
      Hormonal imbalance caused by breastfeeding
      D)
      A sign of infection requiring antibiotics
    Page 3 of 5

    Exam Review

    1. A postpartum client asks when her joints and ligaments will return to normal after delivery. Which response is correct?
      A)
      "Joint relaxation is permanent after childbirth."
      B)
      "They return to normal within 1-2 weeks after birth."
      C)
      "They remain loose until breastfeeding stops."
      D)
      "They return to normal within 6-8 weeks after birth."
    2. The nurse is caring for a woman who had a vaginal delivery 1 hour ago. Her vital signs are T 100.4 P92 R20 BP 120/70. Based on this assessment finding, the nurse should:
      A)
      Draw CBC and blood cultures
      B)
      Continue to monitor the client's temperature
      C)
      Report these findings immediately to the provider
      D)
      Administer Tylenol STAT
    3. A postpartum client with a history of lupus develops a flare-up 2 weeks after birth. The nurse understands this occurs because:
      A)
      Pregnancy causes permanent immune suppression.
      B)
      Breastfeeding suppresses immune function.
      C)
      Estrogen levels rise after birth, triggering autoimmune reactions.
      D)
      The rebound of the immune system postpartum may reactivate autoimmune conditions.
    4. Because a full bladder prevents the uterus from contracting normally, nurses intervene to help the woman spontaneously empty her bladder as soon as possible. If all else fails, what tactic might the nurse use?
      A)
      Asking the healthcare provider to prescribe analgesic agents
      B)
      Pouring water from a squeeze bottle over the woman's perineum
      C)
      Inserting a sterile catheter
      D)
      Placing oil of peppermint in a bedpan under the woman
    Page 4 of 5

    Exam Review

    1. A postpartum client reports no bowel movement for 3 days and fears pain from her episiotomy. Which nursing action is most appropriate?
      A)
      Offer a stool softener and increase fluid and fiber intake.
      B)
      Administer an enema immediately.
      C)
      Withhold oral intake until flatus is passed.
      D)
      Encourage a low-fiber diet and rest.
    2. A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle feed. During the assessment, the nurse notices that both breasts are swollen, warm, and tender on palpation. Which guidance should the nurse provide to the client at this time?
      A)
      Run warm water on her breasts during a shower
      B)
      Express small amounts of milk from the breasts to relieve the pressure
      C)
      Wear a loose-fitting bra to prevent nipple irritation
      D)
      Apply ice to the breasts for comfort
    3. A nurse assesses a postpartum client who is 6 hours post-vaginal delivery. The fundus is noted to be above the umbilicus and deviated to the right. What is the priority nursing action?
      A)
      Encourage the client to void and reassess the fundus.
      B)
      Perform a fundal massage to promote contraction.
      C)
      Notify the health care provider immediately.
      D)
      Assess for retained placental fragments.
    4. When caring for a woman who just gave birth, what would the nurse educate the client in preventing postpartum complications?
      A)
      Change sanitary pad only when completely saturated
      B)
      Change sanitary pad 2 times per day
      C)
      Cleanse from the periurethral to the perineal area
      D)
      Remind her to vigorously wipe to remove excess blood
    Page 5 of 5