NursGuru

    Exam Review

    1. A nurse is reinforcing teaching with a client who is in labor about why epidural anesthesia is not initiated until a good labor pattern has been established. Which of the following explanations should the nurse include?
      A)
      "Given too soon, epidural anesthesia will delay rupture of fetal membranes.".
      B)
      "Given too soon, epidural anesthesia can prolong labor.".
      C)
      "Given too soon, epidural anesthesia can cause fetal depression.".
      D)
      "Given too soon, epidural anesthesia can cause maternal hypertension.".
    2. A nurse is caring for a client who is experiencing shaking chills during the immediate postpartum period. Which of the following actions should the nurse take?
      A)
      Determine the client's temperature.
      B)
      Place the client on seizure precautions.
      C)
      Notify the charge nurse.
      D)
      Cover the client with warm blankets.
    3. A nurse is assisting with the care of a client who is at 32 weeks of gestation and in labor. The client asks the nurse, "Will my baby be okay?”. Which of the following responses should the nurse make?
      A)
      "We have a neonatal unit here equipped to handle emergencies.".
      B)
      "You must be feeling very scared.".
      C)
      "Everyone worries about their baby while they are in labor.".
      D)
      "You are far enough along that your baby will be just fine.".
    4. A nurse is assisting with the monitoring of a client who is in the first stage of labor, with an external fetal monitor in place and IV fluids infusing. Which of the following factors will cause variable decelerations in the fetal heart rate?
      A)
      Fetal head compression.
      B)
      Umbilical cord compression.
      C)
      Maternal opioid administration.
      D)
      Uteroplacental insufficiency.

    Exam Review

    1. A nurse is assisting with the monitoring of a client who is in the first stage of labor, with an external fetal monitor in place and IV fluids infusing. Which of the following factors will cause variable decelerations in the fetal heart rate?
      A)
      Fetal head compression.
      B)
      Umbilical cord compression.
      C)
      Maternal opioid administration.
      D)
      Uteroplacental insufficiency.
    2. A nurse is caring for a client who might have a hydatidiform mole. The nurse should monitor the client for which of the following findings?
      A)
      Excessive uterine enlargement.
      B)
      Rapidly dropping human chorionic gonadotropin (hCG) levels.
      C)
      Fetal heart rate irregularities.
      D)
      Whitish vaginal discharge.
    3. A nurse is reinforcing teaching with a client who is pregnant and has a prescription for Rho(D) immune globulin. Which of the following information should the nurse include?
      A)
      This medication destroys Rh antibodies in a newborn who is Rh-positive.
      B)
      This medication destroys Rh antibodies in a woman who is Rh-negative.
      C)
      This medication prevents the formation of Rh antibodies by a woman who is Rh-negative.
      D)
      This medication prevents the formation of RH antibodies in a newborn who is Rh-positive.
    4. 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 vagina. Which of the following actions should the nurse take first?
      A)
      Prepare the client for an emergency cesarean birth.
      B)
      Explain to the client what is happening.
      C)
      Cover the cord with a sterile, moist saline dressing.
      D)
      Place the client in a knee-chest or Trendelenburg position.

    Exam Review

    1. A nurse is assisting with the admission of a client who is in preterm labor at 30 weeks of gestation and has a new prescription for betamethasone. Which of the following statements should the nurse make?
      A)
      "The purpose of this medication is to increase the fetal heart rate.".
      B)
      "The purpose of this medication is to halt cervical dilation.".
      C)
      "The purpose of this medication is to stop preterm labour contractions.".
      D)
      "The purpose of this medication is to boost fetal lung maturity.".
    2. A nurse is assisting in the care of a client who is in active labour. The nurse notes variable decelerations of the FHR. The nurse should identify which of the following is a cause of variable decelerations.
      A)
      Fetal head compression.
      B)
      Umbilical cord compression.
      C)
      Maternal fever.
      D)
      Polyhydramnios.
    3. A nurse is preparing to administer vitamin K 1 mg IM to a newborn. Available is vitamin K injection 1 mg/0.5 mL. How many mL should the nurse administer per dose?
      A)
      Choice A: 0.25 mL
      B)
      Choice B: 0.5 mL
      C)
      Choice C: 0.75 mL
      D)
      Choice D: 1 mL
    4. A nurse is preparing to administer vitamin K IM to a newborn. Into which of the following muscles should the nurse inject the medication?
      A)
      Deltoid.
      B)
      Dorsogluteal.
      C)
      Ventrogluteal.
      D)
      Vastus lateralis.

    Exam Review

    1. A nurse is speaking on the phone to a client who is pregnant and taking iron supplements for iron-deficiency anaemia. The client reports that her stools are black but she has no abdominal pain or cramping. Which of the following responses by the nurse is appropriate?
      A)
      "Go to the emergency room and your provider will meet you there.".
      B)
      "What else have you been eating?.".
      C)
      "This is expected because of the way iron is broken down during digestion.".
      D)
      "Come to the office, and we will check things out.".
    2. A nurse is caring for a client who has unrelieved episiotomy pain 8 hr following delivery. Which of the following actions should the nurse take?
      A)
      Place a soft pillow under the client’s buttocks.
      B)
      Position a heating lamp toward the episiotomy.
      C)
      Prepare a warm sitz bath.
      D)
      Apply an ice pack to the perineum.
    3. A nurse is reinforcing teaching with a client who is at 34 weeks of gestation and at risk for placental abruption. Does the nurse recognize that which of the following is the most common risk factor for a placental abruption?
      A)
      Maternal hypertension.
      B)
      Maternal cocaine use.
      C)
      Maternal cigarette smoking.
      D)
      Maternal battering.
    4. A nurse is assisting with the care of a client who presents to a labor and delivery unit with rapidly progressing labor. Which of the following actions is the priority for the nurse to take?
      A)
      Promoting delivery of the placenta
      B)
      Preventing the perineum from tearing
      C)
      cutting the umbilical cord
      D)
      Supporting the infant during the birth

    Exam Review

    1. A nurse is assisting with the care of a client who is multigravid and in active labor with 7 cm of cervical dilation and 100% effacement. The fetus is at 1+ station, and the client's amniotic membranes are intact. The client suddenly states that she needs to push. Which of the following is the appropriate nursing response?
      A)
      Help the client to the bathroom to empty her bladder.
      B)
      Assist the client into a comfortable position.
      C)
      Have the client pant during the next few contractions.
      D)
      Assess the perineum for signs of crowning.
    2. A nurse is caring for a client who is pregnant in a provider's office. Vital Signs. Medical History. 0830:. Medical History: Gravida 3 Para 2. 32 weeks of gestation. Allergies: Penicillin. Height 54, 163 cm. Weight 80.7 kg (178 lb). BMI 30.6. 6 lb weight gain over the last 2 weeks. The client reports, "I have had a headache for 5 days, blurred vision, and dizziness. Tylenol does not relieve it.". The client reports swelling of their feet and fingers. 2+ pitting edema of the lower extremities noted bilaterally. Swelling of the fingers and hands noted. Deep tendon reflexes 3+, absent clonus. Fetal heart tones (FHT) 148. Which of the following findings should the nurse report to the provider?
      A)
      Visual disturbances.
      B)
      Blood pressure.
      C)
      Respirations.
      D)
      Deep tendon reflexes.
      E)
      Weight.
    3. A nurse is reinforcing teaching with a client who is at 30 weeks of gestation and scheduled for a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching?
      A)
      "I will have to lie on my back during the test."
      B)
      "The baby's heart rate will be monitored during the test."
      C)
      "I need to schedule the test when the baby is usually active."
      D)
      "I will be able to go to the bathroom during the test as necessary."
    4. A nurse is assisting with the care of a client who is using pattern-paced breathing during the first stage of labor. The client says she feels lightheaded, and her fingers are tingling. Which of the following actions should the nurse take?
      A)
      Instruct the client to maintain a breathing rate no less than twice the normal rate.
      B)
      Administer oxygen via nasal cannula.
      C)
      Assist the client to breathe into a paper bag.
      D)
      Have the client tuck her chin to her chest.

    Exam Review

    1. A nurse is assisting with the care of a client who is in labor. Immediately after the delivery of a newborn, which of the following actions should the nurse take first?
      A)
      Confirm identification and apply a bracelet.
      B)
      Examine the newborn for birth defects.
      C)
      Dry the newborn.
      D)
      Conduct a gestational age assessment.
    2. A nurse in a prenatal clinic is caring for a client who is at 38 weeks of gestation and has heavy, red vaginal bleeding without contractions, that started spontaneously. She is in no distress and states that she can "feel the baby moving.”. The client should undergo an ultrasound to determine which of the following findings?
      A)
      Rh incompatibility.
      B)
      Frequency and duration of contractions.
      C)
      Fetal lung maturity.
      D)
      Location of the placenta.
    3. A nurse is reviewing laboratory results from a client who is at 28 weeks of gestation and has gestational diabetes. The nurse notes that blood glucose levels taken 1 hr following a meal range from 145 mg/dL to 162 mg/dL over the past week. Which of the following actions should the nurse take?
      A)
      Schedule a 3-hr oral glucose tolerance test.
      B)
      Tell the client to increase carbohydrates to 65% of daily nutritional intake.
      C)
      Obtain an HbA1c.
      D)
      Reinforce instruction about insulin administration.
    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