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    Exam Review

    1. A nurse is caring for a client who wants to know if it is possible to have a trial of labor for a vaginal birth after a cesarean birth (TOLAC.. Which of the following statements by the nurse is appropriate?
      A)
      "It is too soon for you to be worrying about that now."
      B)
      "The primary consideration for a safe attempt at a vaginal birth after cesarean (VBAC. is what type of incision you had."
      C)
      "There are so many variables and I don't have time to explain them all to you, so you will have to ask your provider later."
      D)
      "A repeat cesarean section would be safer for both you and your baby."
    2. A nurse is assisting with the care of a client who is experiencing preterm labor and is scheduled to undergo amniocentesis for L/S ratio. The client needs an amniocentesis to determine which of the following findings?
      A)
      Maturity of lungs
      B)
      Gender of the fetus
      C)
      Anatomic abnormalities
      D)
      Weeks of gestation
    3. A nurse is caring for a client who wants to know if it is possible to have a trial of labor for a vaginal birth after a cesarean birth (TOLAC.. Which of the following statements by the nurse is appropriate?
      A)
      "It is too soon for you to be worrying about that now."
      B)
      "The primary consideration for a safe attempt at a vaginal birth after cesarean (VBAC. is what type of incision you had."
      C)
      "There are so many variables and I don't have time to explain them all to you, so you will have to ask your provider later."
      D)
      "A repeat cesarean section would be safer for both you and your baby."
    4. A nurse is caring for a newborn whose mother is positive for the hepatitis B surface antigen. Which of the following treatments should the infant receive?
      A)
      The hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigen
      B)
      The hepatitis B vaccine at 24 hr followed by hepatitis B immune globulin every 12 hr for 3 days
      C)
      Hepatitis B immune globulin and the hepatitis B vaccine within 12 hr of birth
      D)
      Hepatitis B immune globulin at 1 week followed by the hepatitis B vaccine monthly for 6 months
    Page 1 of 12

    Exam Review

    1. Your patient who wants to exclusively breastfeed is afraid her baby isn't latching properly. To assist the mother you would (Select all that apply)
      (SATA)
      A)
      Call the lactation consultant to visit the patient
      B)
      Encourage and support the mother's desire/intention and include the partner in the conversation
      C)
      Give the mother a bottle of formula to supplement
      D)
      Help the mother shove her nipple in the baby's mouth.
      E)
      Check for audible swallowing and a comfortable (non-painful) suck
      F)
      Assist with proper positioning and latch techniques
    2. A nurse is assisting in the care of a client who is in active labor. The nurse notes late decelerations on the fetal monitor tracing. Which of the following actions should the nurse take FIRST?
      A)
      Increase the infusion rate of the IV fluid.
      B)
      Elevate the client's legs.
      C)
      Administer oxygen via face mask.
      D)
      Position the client on her side.
    3. A nurse is caring for a newborn immediately following delivery. Which of the following actions should be the nurse's priority in the resuscitation of this neonate?
      A)
      Administer phytonadione IM and erythromycin in both eyes
      B)
      Document the Apgar score.
      C)
      Apply identification bands.
      D)
      Dry and stimulate the newborn: position and open the airway, clear secretions if necessary
    4. A nurse is caring for a client who is breastfeeding and tells the nurse that she is concerned about her newborn's hydration. Which of the following nursing observations is appropriate to use in evaluating the adequacy of the newborn's hydration?
      A)
      The newborn's skin turgor
      B)
      The number of wet diapers per day
      C)
      The fit of the newborn's clothes
      D)
      How often the newborn cries
    Page 2 of 12

    Exam Review

    1. A nurse is caring for a client who is 4 hr postpartum. The nurse finds a small amount of lochia rubra on the client's perineal pad. The fundus is midline and firm at one fingerbreadth above the umbilicus. Which of the following actions should the nurse take?
      A)
      Increase the rate of the IV fluids.
      B)
      Assist the client to ambulate.
      C)
      Check for blood under the client's buttock.
      D)
      Perform fundal massage.
    2. A nurse is assisting in the care of a client who is in labor. The doctor documents the vaginal examination as: 3 cm, 30%, and -1. The nurse evaluates this documentation to mean which of the following?
      A)
      The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 1 cm below the ischial spines.
      B)
      The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 1 cm below the ischial spines.
      C)
      The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 1 cm above the ischial spines.
      D)
      The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 1 cm above the ischial spines.
    3. A nurse is caring for a newborn. How many blood vessels should the nurse expect to observe in the newborn's umbilical cord?
      A)
      Two arteries and two veins.
      B)
      One artery and one vein.
      C)
      Two arteries and one vein.
      D)
      Two veins and one artery.
    4. A nurse is reviewing the medical record of a client who experienced a vaginal birth 2 hours ago. The nurse should identify that which of the following findings places the client at risk for a postpartum hemorrhage?
      A)
      Precipitous or rapid birth
      B)
      Two-vessel umbilical cord
      C)
      Small for gestational age newborn
      D)
      Gestational hypertension
    Page 3 of 12

    Exam Review

    1. A nurse is caring for a client who is at 38 weeks of gestation and has a score of 10 on her biophysical profile. Which of the following actions should the nurse take?
      A)
      Assure the client that the score is within the expected range.
      B)
      Offer the client orange juice and repeat the assessment in 1 hour.
      C)
      Administer oxygen and notify the provider.
      D)
      Assist the client into a side-lying position.
    2. A nurse is caring for a client in the immediate postoperative period following removal of an ectopic pregnancy via salpingostomy. For which of the following indications should the nurse administer Rho(D. immune globulin?
      A)
      The client is Rh negative.
      B)
      The client has had significant blood loss during the procedure.
      C)
      The client has previously given birth to an Rh-negative infant.
      D)
      The client has expressed a desire to conceive again.
    3. Delayed cord clamping provides many benefits to the neonate and is considered a standard of care. The benefits include improvement in transitional circulation and..
      A)
      Decreased iron stores during the first few months of life
      B)
      Decreased in RBC volume and hemoglobin levels
      C)
      Lowered incidence of necrotizing enterocolitis and intraventricular hemorrhage in preterm babies
      D)
      Increased need for blood transfusions
    4. A nurse is caring for a client in the prenatal clinic who has a possible ectopic pregnancy at 8 weeks of gestation. Which of the following findings should the nurse expect?
      A)
      Severe nausea and vomiting
      B)
      Pelvic pain
      C)
      Uterine enlargement greater than expected for gestational age
      D)
      Copious vaginal bleeding
    Page 4 of 12

    Exam Review

    1. Your patient is diagnosed with perinatal mood and anxiety disorder. You know your patient understands your teaching about this when she states:
      A)
      I am a terrible mother and should give my child up for adoption.
      B)
      This is just normal baby blues and I will be fine in a few days.
      C)
      I will have to be on medications the rest of my lifE.
      D)
      I am not alone, I am not to blame, I will get better with help.
    2. Signs and symptoms of preeclampsia with severe features include (Select all that apply):
      A)
      Elevated liver function tests
      B)
      Unremitting headache
      C)
      Rising protein in sequential 24-hour urine
      D)
      Increased urine output
      E)
      Pain in the left upper quadrant
      F)
      BP > 160/110
    3. A nurse is assisting a nurse midwife in examining a client who is a primigravida at 40 weeks of gestation and states that she thinks she is in labor.Which of the following findings confirm that the client is in labor? (Select all that apply):
      A)
      Amniotic fluid in the vaginal vault
      B)
      Pain just above the navel
      C)
      Cervical dilation
      D)
      Contractions every 3 to 4 minutes
    4. A nurse is assisting in the care of a client who had a vaginal birth 2 hours ago. Which of the following actions should the nurse take? (Select all that apply):
      A)
      Massage a firm fundus.
      B)
      Determine whether the fundus is midlinE.
      C)
      Observe the lochia during palpation of fundus.
      D)
      Document fundal height.
      E)
      Administer terbutaline if the fundus is boggy.
    Page 5 of 12

    Exam Review

    1. A nurse is assisting with the care of a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagin
      A)
      Explain to the client what is happening over the next few minutes in detail and ask for teach back from the spousE.
      B)
      Place the client in a knee-chest or Trendelenburg position and raise the presenting part off the cord with your hanD.
      C)
      Cover the cord with a sterile, moist saline dressinG.
      D)
      Prepare the client for an emergency cesarean birtH.
    2. A nurse is assisting in the care of a client who had a vaginal birth 2 hours ago. Which of the following actions should the nurse take? (Select all that apply):
      A)
      Massage a firm fundus.
      B)
      Determine whether the fundus is midlinE.
      C)
      Observe the lochia during palpation of fundus.
      D)
      Document fundal height.
      E)
      Administer terbutaline if the fundus is boggy.
    3. Your patient presents to labor and delivery with opioid use disorder and is taking methadonE. The best treatment for her baby that will develop neonatal abstinence syndrome is:
      A)
      Do not use even soft lullaby music or cuddler therapy for this neonate as it will increase stimulI.
      B)
      Use only pharmacological agents for withdrawal.
      C)
      Keep the baby and mother together, promoting bonding and providing support and resources for dischargE.
      D)
      Separate the baby from the mother and tell the social worker to contact child protection services.
    4. Benefits of immediate skin to skin contact include (Select all that apply):
      A)
      Delayed bonding with maternal newborn dyad
      B)
      Decreased breastfeeding exclusivity
      C)
      Regulation of blood sugar
      D)
      Stabilization of temperature
      E)
      Transfer of good bacteria from amniotic fluid and vernix
      F)
      Improvement of lung and heart function
    Page 6 of 12