Labor
How many stages are there for women in labor?
A. 5
B. 4
C. 2
D. 1
B. 4
The nurse assists the primary health care provider with an amniotomy. After the procedure, the FHR dropped, and variable decelerations were noted. Which of the following nursing interventions should be taken next?
A. Cover the cord in sterile, moist gauze.
B. Place a face mask on the client 8-10L O2.
C. Prepare the client for a Cesarean birth.
D. Obtain the client's vital signs.
B. Place a face mask on client 8-10 L O2.
A 38 yo G4P2 is at 29 weeks with itching hands and feet. Schlerae are nonicteric. Urine dip negative for protein. ALT 55. Total Bili is 0.7. What is her diagnosis?
A. cholecystectomy of pregnancy
B. colonoscopy of pregnancy
C. cholestasis of pregnancy
D. cholelithiasis of pregnancy
C. cholestasis of pregnancy
Cholestasis of pregnancy is a liver problem. It slows or stops the normal flow of bile from the gallbladder. This causes itching and yellowing of your skin, eyes, and mucous membranes (jaundice). Cholestasis sometimes starts in early pregnancy. But it is more common in the second and third trimesters.
The client is in the active phase of the first stage of labor, breathing shallow. The client complains of feeling lightheaded, dizzy, and tingling around the mouth. What is the next action for the nurse to take?
A. Administer oxygen via nasal cannula and mask
B. Increase the head of the bed (HOB)
C. Instruct them to slow down their breathing.
D. Notify the Primary Healthcare Provider (PHCP)
C. Instruct them to slow down their breathing.
A client who is diagnosed with oligohydramnios. An amnioinfusion was prescribed. During this infusion, she developed hypotension and an overdistended uterus. After stopping the amnioinfusion. What step should the nurse take next?
A. Document the amount of fluid the client received.
B. Notify the primary healthcare provider.
C. Explain to the client that shortness of breath is caused by additional fluid in the uterus.
D. Retake the client's vital signs and check the FHR.
D. Retake the client's vital signs and check the FHR.
When does the first stage of labor begin?
A. Begins with cervix dilation.
B. Begins with the onset of true labor and ends with full dilation of the cervix at 10 cm.
C. Begins with Braxton Hicks contractions and cervix effacement.
D. Begins after the women's water breaks.
B. Begins with the onset of true labor and ends with full dilation of the cervix at 10 cm.
The nurse is caring for a client who is a primigravida and 41 weeks gestation. Her contractions are timed every 1-2 minutes; the cervix is dilated at 3 cm and has not changed in 2 hours.
A. Hypertonic uterine dysfunction
B. Normal latent stage of labor
C. Hypotonic uterine dysfunction
D. Pelvic dystocia
A. Hypertonic uterine dysfunction
The client is in labor and is receiving an oxytocin drip. The nurse identifies uterine tachysystole and a non-reassuring FHR. The nurse stops the oxytocin drip. Which action should the nurse perform next?
A. Administer oxygen 4 liters via face mask.
B. Turn the client onto their left side.
C. Notify the primary healthcare provider (PCHP).
D. Administer a tocolytic medication.
B. Turn the client onto their left side.
A 26 yo G1P0 at 36 weeks has platelets of 62,000. She has Raynauds and chronic HTN. No personal history of thrombocytopenia, bruising, rash, or joint ache. In the 1st trimester, her platelets were 104,000. The physical exam revealed BP 138/86, trace protein, and trace pedal edema. What is her diagnosis?
A. Immune thrombocytopenic purpura (ITP)
B. DIC (disseminated intravascular coagulation)
C. Anemia
D. HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelets) syndrome
A. Immune thrombocytopenic purpura (ITP)?
Diagnosis of thrombocytopenia in 1st trimester is likely ITP.
Which of the following statements by the nurse indicates a correct understanding of a forceps-assisted birth?
A. "l will explain to the client that postpartum hemorrhage is less common with a forceps delivery."
B. "The client should be placed in Trendelenburg position."
C. "The FHR is assessed before forceps placement and after the procedure."
D. "l will need to place a Foley catheter after the delivery."
C. "The FHR is assessed before forceps placement and after the procedure."
The nurse cares for a client who needs an external version performed by the primary health care provider. What should be prescribed before the procedure?
A. local anesthetic.
B. contraction stress test (CST).
C. urinary catheter.
D. Magnesium Sulfate.
D. Magnesium Sulfate.
A 41-week gestational client is in active labor with a non-reassuring FHR pattern. What fetal assessment should the nurse perform?
A. Complete a Bishop score.
B. Perform a fetal fibronectin (FFN) test
C. Complete an Amniocentesis
D. Perform a fetal scalp blood sampling
D. Vitamin D
D. Perform a fetal scalp blood sampling
What is not a nursing intervention for a prolapsed cord?
A. Assisting the client into the modified Sims position.
B. Notifying the anesthesiologist.
C. Applying petroleum jelly to the exposed umbilical cord.
D. Providing upward pressure on the presenting part of the fetus.
C. Applying petroleum jelly to the exposed umbilical cord.
The nurse is caring for a client who is in labor and complains of increased pain with contractions. The fetus is not descending as normally expected. What action should the nurse take first?
A. Encourage the client to go to the bathroom to empty their bladder.
B. Notify the Primary Healthcare Provider (PHCP).
C. Have the client get up and walk.
D. Encourage breathing through the contractions.
A. Encourage the client to go to the bathroom to empty their bladder.
Which nursing interventions should the nurse expect the PHCP to implement along with the McRoberts maneuver?
A. Prescribe oxytocin for contractions.
B. Suprapubic pressure.
C. Encourage the client to push.
D. Leopold's maneuvers.
B. Suprapubic pressure.
The nurse is caring for a client diagnosed with preeclampsia; they are receiving Magnesium Sulfate IV. The patient has a decreased LOC. What other symptom should the nurse assess the client for possible magnesium toxicity?
A. Change in level of consciousness (LOC)
B. Hypertension
C. Increased respirations
D. Increased deep tendon reflexes
E. Oliguria
E. Oliguria
A 40 yo G1P0 is taking metformin, amlodipine and simvastatin. Which of these medications should be stopped?
A. Metformin
B. Amlodipine
C. Simvastatin
D. Glucophage
C. Simvastatin
It is category X. With an increased risk of CNS, facial and limb anomalies to the fetus.
What are the risks to the fetus with Cholestasis? Select all that apply.
A. pre-term labor
B. Fetal distress/meconium-stained fluid
C. intrauterine fetal demise (IUFD)
D. post-term labor
E. rupture of membranes (ROM)
A. pre-term labor
B. Fetal distress/meconium-stained fluid
C. IUFD
A client has a scheduled cesarean section. The nurse witnesses the informed consent. What action should the nurse perform next?
A. Initiate a small-bore intravenous (IV) catheter.
B. Place a fetal monitor on top of the client's abdomen.
C. Insert an indwelling urethral catheter.
D. Notify anesthesia that the client has arrived.
B. Place a fetal monitor on top of the client's abdomen.
The client has a placental abruption and is suspected of going into disseminated intravascular coagulation (DIC). After notifying the primary health care provider, which nursing interventions should the nurse perform first?
A. Perform a pelvic examination to determine if the client is ready for delivery.
B. Provide emotional support to the family.
C. Start an IV Heparin drip.
D. Monitor urine output and ensure it is greater than 30 mL an hour.
C. Start an IV Heparin drip.
The nurse is caring for a nulliparous client who is 34 weeks gestation. The client has a blood pressure (BP) of 170/1 00 mm Hg, 2+ protein in the urine, and reports a headache. Which of the following prescriptions should the nurse administer to the client?
A. Calcium gluconate.
B. Naloxone.
C. Magnesium Sulfate.
D. Furosemide.
C. Magnesium Sulfate
A 36 yo G2P2 comes in at 24 weeks with no history of diabetes. What is the recommended test for Gestational diabetes?
A. Glucophage challenge test
B. Glucose challenge test
C. 24-hour urine test
D. Blood test
B. Glucose challenge test.
50 g Glucose challenge test? 140 mg/dL is 80% sensitive 130 mg/dL is 90% sensitive. OB #35
The nurse is assessing a client who gave birth to a term infant 1 hour ago. The chart notes that the baby was born after demonstrating a positive turtle sign. Which of the following assessment findings by the nurse indicates immediate action?
A. Lochia rubra is noted an hour after delivery.
B. Maternal blood pressure (BP) has changed from 125/75 to 95/55 mm.
C. Maternal pulse (P) has changed from 95 to 99.
D. Client saturates one perineal pad in 2 hours.
B. Maternal blood pressure (BP) has changed from 125/75 to 95/55 mm
A client in the arrest of labor needs a vacuum-assisted birth, What is an indication for this procedure?
A. cephalic presentation.
B. post-term fetus.
C. 6 hours or more of inadequate contractions with no cervical change.
D. -1 station.
C. 6 hours or more of inadequate contractions with no cervical change.
For a client whose labor is being augmented with oxytocin. When should oxytocin be discontinued?
A. The client's membranes have ruptured.
B. There is evidence of severe maternal hypertension.
C. The client expresses a need to have a bowel movement.
D. The client had a previous myomectomy.
D. The client had a previous myomectomy.