Antepartum
A client at 33 weeks' gestation presents with increased vaginal discharge and pelvic pressure. Which complication
does the nurse suspect?
A. PPROM
B. Placenta previa
C. Preterm labor
D. Cervical insufficiency
Preterm Labor
Which condition is an *absolute contraindication* to a Trial of Labor After Cesarean (TOLAC)?
A. One previous low transverse cesarean
B. Macrosomic fetus
C. History of uterine rupture
D. Maternal age over 35
History of uterine rupture
Which nursing intervention is most appropriate for a postpartum client who is experiencing uterine atony?
A. Administer oxytocin as prescribed
B. Apply ice packs to the abdomen
C. Encourage ambulation
D. Restrict oral fluids
Administer oxytocin as prescribed
A postmature newborn is born LGA and exhibits hypoglycemia. What intervention should the nurse implement first?
A. Prepare to administer IV glucose
B. Place the newborn skin-to-skin with the parent
C. Monitor vital signs every hour
D. Perform a CBC to rule out infection
Prepare to administer IV glucose
A 52-year-old woman reports hot flashes, night sweats, and irregular periods. Which treatment would the nurse question based on her history of breast cancer?
A. Acupuncture
B. Black cohosh
C. Hormone replacement therapy (HRT)
D. Lifestyle changes
Hormone replacement therapy
Which of the following medications is administered for fetal neuroprotection in a client in preterm labor?
A. Indomethacin
B. Magnesium sulfate
C. Terbutaline
D. Betamethasone
Magnesium Sulfate
The nurse knows the McRoberts maneuver is primarily used to manage which labor complication?
A. Breech presentation
B. Cord prolapse
C. Uterine rupture
D. Shoulder dystocia
Shoulder dystocia
A postpartum client is having difficulty breastfeeding her newborn. Which physiological adaptation could be contributing to this issue?
A. Decreased breast tissue elasticity
B. Engorgement
C. Increased milk production
D. Lowered prolactin levels
Engorgement
A postmature newborn is at risk for meconium aspiration syndrome. What action should the nurse prioritize during delivery?
A. Monitor for hypoglycemia
B. Prepare for immediate suctioning of the airway
C. Initiate skin-to-skin contact with the parent immediately
D. Administer surfactant therapy
Prepare for immediate suctioning of the airway
The nurse teaches a 60-year-old woman about osteoporosis prevention. Which statement indicates a need for further teaching?
A. “I will take 1,200 mg of calcium daily.”
B. “I should limit alcohol and avoid smoking.”
C. “Swimming every day will help strengthen my bones.”
D. “I need 600–1,000 IU of vitamin D daily.”
“Swimming every day will help strengthen my bones.”
A nurse is caring for a client diagnosed with placenta previa. Which intervention is contraindicated?
A. Continuous fetal monitoring
B. Administering corticosteroids
C. Performing a sterile vaginal exam
D. Continuous toco monitoring
Performing a sterile vaginal exam
A nurse performs Leopold's maneuvers. THe fetus is in vertex position. Where should the nurse place the doppler to assess the FHR?
A. Right upper quadrant
B. Lower abdomen near symphysis pubis
C. Umbilicus
D. Left upper quadrant
Lower abdomen near symphysis pubis
What is the primary reason why a postpartum client should empty her bladder frequently?
A. To prevent urinary tract infections
B. To facilitate uterine involution
C. To measure fluid balance
D. To increase lochia flow
To facilitate uterine involution
A postmature newborn is exhibiting signs of respiratory distress with nasal flaring, grunting, and retractions. What should the nurse prioritize?
A. Initiating early feedings to prevent hypoglycemia
B. Placing the newborn in skin-to-skin contact with the parent
C. Administering supplemental oxygen and monitoring oxygen saturation
D. Performing a CBC to evaluate for infection
Administering supplemental oxygen and monitoring oxygen saturation
A patient with PCOS asks why diabetes screening is necessary. Which nurse response is appropriate?
A. “PCOS lowers your blood sugar.”
B. “PCOS cures insulin resistance.”
C. “PCOS increases your risk for developing diabetes.”
D. “You only need screening if you lose weight.”
“PCOS increases your risk for developing diabetes.”
Which assessment finding is expected in a client with placental abruption?
A. Painless vaginal bleeding
B. Rigid, board-like abdomen
C. Positive Fern test
D. Soft, non-tender uterus
Rigid, board like abdomen
A woman is experiencing a prolapsed cord. What should the nurse do first?
A. Elevate the fetal head off the cord
B. Recheck the cervix
C. Document the time of rupture
D. Administer oxytocin
Elevate fetal head off the cord
A nurse is assessing a postpartum client who underwent a cesarean section. What finding would require immediate intervention?
A. Dried blood on the steri strips
B. Purulent drainage from the incision
C. Mild erythema around the incision
D. Slight swelling at the incision site
Purulent drainage from the incision
A newborn with meconium aspiration syndrome is admitted to the NICU. Which diagnostic test is most appropriate to assess respiratory status?
A. Complete blood count (CBC).
B. Chest x-ray.
C. Serum glucose level.
D. Echocardiogram.
Chest x-ray
A patient with suspected endometriosis reports severe pelvic pain during menstruation. What is the priority nursing action?
A. Encourage no exercise
B. Provide emotional support and acknowledge her pain
C. Advise stopping all hormonal therapy
D. Tell her fertility will not be affected
Provide emotional support and acknowledge her pain
A nurse receives orders to administer methotrexate for a client. Which condition would this be most appropriate
for?
A. Eclampsia
B. PPROM
C. Ectopic pregnancy
D. Hyperemesis gravidarum
Ectopic pregnancy
A nurse is caring for a client in labor with a known android pelvis. What is the client most at risk for?
A. Cord prolapse
B. Postpartum hemorrhage
C. Prolonged second stage of labor
D. Shoulder dystocia
Prolonged second stage of labor
A client who recently had an epidural during labor reports numbness in the lower extremities 7 hours post-delivery. What is the nurse's next action?
A. Encourage ambulation to improve circulation.
B. Assess for bilateral sensation and motor function.
C. Administer pain medication as prescribed.
D. Prepare for emergent imaging studies.
Assess for bilateral sensation and motor function
A nurse is completing discharge instructions for a new mother and her 2-day-old newborn. The mother asks, "How will I know if my baby gets enough breast milk?" Which of the following responses should the nurse make?
A. "Your baby should have a wake cycle of 30 to 60 minutes after each feeding."
B. "Your baby should wet 6 to 8 diapers per day."
C. "Your baby should burp after each feeding."
D. "Your baby should sleep at least 6 hours between feedings."
"Your baby should wet 6 to 8 diapers per day."
A 25-year-old woman with a BRCA1 gene mutation asks about screening. Which recommendation is correct?
A. Mammogram every 5 years
B. No screening needed before age 40
C. Annual MRI and mammogram starting at age 25
D. Pap smear every 6 months
Annual MRI and mammogram starting at age 25