Labor and Delivery
The nurse is caring for a patient who is 38 weeks gestation who just felt a burst of fluid. The nurse uses nitrazine paper which turns blue. Which of the following is the priority action by the nurse?
A. Perform a vaginal exam
B. Assess fetal heart rate
C. Tell mom to push
D. Assist mom to the bathroom
B. Assess fetal heart rate
Which of following is priority when caring for a pregnant patient in labor who is requiring opioid pain management measures?
A. Assess pain level
B. Leaving the side rails up in bed
C. Sending the partner down to the cafeteria
D. Ambulating the patient
B. Leaving the side rails up in bed
The Nurse is Caring for a client presenting with concerns of Postpartum Depression three weeks post delivery. What manifestations should the nurse expect? Select all that apply
A. Feelings of guilt and inadequacies
B. Anxiety
C. Sleep pattern disturbances
D. Auditory hallucinations
E. Paranoia
F. Thoughts of harming self or newborn
A. Feelings of guilt and inadequacies
B. Anxiety
C. Sleep pattern disturbances
F. Thoughts of harming self or newborn
What interventions would the nurse implement for cord compression?
A. Ambulate
B. Encourage voiding
C. Reposition Mother on Left Side
D. Perform Vaginal Exam
C. Reposition Mother on Left Side
What medication is given to the newborn to prevent sepsis after birth?
A. Doxycycline hyclate
B. Erythromycin ophthalmic ointment
C. Penicillin G
D. Surfactant ET
B. Erythromycin ophthalmic ointment
The nurse is caring for a patient who is 39 weeks gestation. The patient has been having contractions every 2-3 minutes lasting 30-40 seconds. The patient suddenly reports feeling like she urinated. Which is the following is the patient most at risk for?
A. Chorioamnionitis
B. Prolapsed cord
C. Meconium aspiration
D. Shoulder dystocia
B. Prolapsed cord
The nurse is caring for a patient who is 38 weeks gestation who is receiving an epidural infusion. At 1600 the patient's vitals are BP 90/60, SPO2 98, HR 102, Temp 37.0. The patient suddenly reports dizziness. Which of the interventions should the nurse do first.
A. Administer IV fluid bolus
B. Stop the Epidural drip
C. Position the patient on her back
D. Ambulate
A. Administer IV fluid bolus
A new mother comes in the clinical for her postpartum appointment. She offers complaints of feelings of sadness, loss of appetite, and episode of crying without reason. Which condition is the mother most likely experiencing?
A. Postpartum depression
B. Postpartum blues
C. Anxiety
D. Postpartum psychosis
B. Postpartum blues
The nurse notices increased variability on the fetal monitor, what do these findings indicate?
A. Hypoxia
B. Fetal Tachycardia
C. Cord Compression
D. Pre-term Labor
C. Cord Compression
Which laboratory test is used to evaluate for sepsis? Select all that apply
A. Complete blood count
B. CRP
C. Urine culture
D. Basic Metabolic Panel
E. B-type natriuretic protein (BNP)
F. Troponin
G. Lipid panel
H. HGAB1C
A. Complete blood count
B. CRP
C. Urine culture
The nurse is caring for a client who is 40 weeks gestation who is on an Oxytocin drip for labor induction. The nurse is assessing the fetal heart when she suddenly notes an abrupt decrease from the previous recordings. Which of the following is the likely cause for this change.
A. Meconium aspiration
B. Fetal hypoxia
C. Shoulder dystocia
D. Fetal movement
B. Fetal hypoxia
The nurse is caring for a patient who is 39 weeks gestation who is receiving meperidine for pain management during labor. Which of the following would require further intervention by the nurse?
A. Decelerations on fetal heart rate strip
B. Maternal blood pressure 102/60
C. The patient reports feeling more sleepy
D. The patient reports nausea
A. Decelerations on fetal heart rate strip
What is the priority nursing assessment for a client who is experiencing postpartum psychosis?
A. Assess client interactions with their newborn
B. Vital signs
C. Assess for frequency of hallucinations
D. Assess plan for self-harm, or harm to newborn
D. Assess plan for self-harm, or harm to newborn
What would be the nurses action for early decelerations ?
A. Reposition
B. Push fluids
C. Prepare for C-section
D. Continue to monitor
A. Reposition
Which of the following are the root cause of Neonatal Sepsis
A. HIV and AIDS
B. GBS and Gonorrhea
C. Hepatits and Syphilis
D. HPV and Trichomoniasis
B. GBS and Gonorrhea
The nurse is caring for a client who developed sudden onset contractions 20 minutes and is now 7 cm dilated and the fetus is at the 0 station. Which of the following interventions is most appropriate? Select all that apply.
A. Have the client stand up and ambulate
B. Prepare for an emergent delivery
C. Assist the client to the side lying position
D. Apply light pressure to the perineal area and fetal head
B. Prepare for an emergent delivery
C. Assist the client to the side lying position
D. Apply light pressure to the perineal area and fetal head
What are risk factors for postpartum hemorrhage? Select all that apply
A. Prolonged Labor
B. Precipitous delivery
C. Gestational Diabetes
D. Administration of magnesium therapy during labor
A. Prolonged Labor
B. Precipitous delivery
D. Administration of magnesium therapy during labor
A nurse providing discharge education for a patient being treated for postpartum psychosis. What statement from the patient demonstrates an understanding of the teaching?
A. I will stay awake even when exhausted to finish household chores
B. I will make an appointment for outpatient counseling appointments, if my mood worsens
C. I will remember to take time out of the day for myself
D. I will keep my thoughts, to myself as my priority is my child
C. I will remember to take time out of the day for myself
What are the complications of late decelerations? Select all that apply
A. Uteroplacental insufficiency
B. Fetal Hypoxia
C. Maternal Diabetes
D. Uterine tachysystole
A. Uteroplacental insufficiency
B. Fetal Hypoxia
A newborn presents with hyperbilirubinemia 30 hours after delivery. Which of the following are NOT consistent with physiological jaundice?
1) Appears 24 hours after birth
2) Appears within 24 hours of birth
3) Bilirubin levels increase more than 0.5mg/d/hr
4) Rapid decline of bilirubin 5-10 days after birth
5) A positive Coombs test
6) A negative Coombs test
2) Appears within 24 hours of birth
3) Bilirubin levels increase more than 0.5mg/d/hr
5) A positive Coombs test
A nurse is caring for a patient who is 40 weeks gestation on an Oxytocin drip for labor induction. The patient suddenly report difficulty catching their breath and chest discomfort. Which of the following interventions should the nurse take? Select all that apply.
A. Perform an ECG
B. Position the patient to a side lying position
C. Prepare to give PRBCs
D. Prepare for cesarean delivery
B. Position the patient to a side lying position
C. Prepare to give PRBCs
D. Prepare for cesarean delivery
What are the physical assessment findings of postpartum hemorrhage? Select all that apply
A.Uterine atony
B. Perineal pad saturation in 30 minutes or less
C. Oliguira
D. Hypotension
A.Uterine atony
C. Oliguira
D. Hypotension
What action does the nurse take to prevent postpartum hemorrhage?
A. Administer IV fluids
B. Turn mom to left lateral position
C. Massage the fundus
D. Administer tocolytics
C. Massage the fundus
The nurse is caring for a client who is 38 weeks gestation who present to the labor and delivery unit after rupture of the membranes. The nurse is assessing the fetal heart rate and notices accelerations on the monitor. Which of following is most likely the cause? Select all that apply
A. Cord compression
B. Uterine Contractions
C. Fetal hypoxia
D. Fetal hypoglycemia
E. Fetal movement
F. Fundal pressure
B. Uterine Contractions
E. Fetal movement
F. Fundal pressure
The nurse is caring for a newborn that is 5 minutes old with an Apgar of 6. Mom's history includes 40 weeks gestational age. Variable decelerations were noted during labor. Apgar at 1 minute was 6. BG was 70. Mom's amniotic fluid was yellow and thick. Which of following conditions is most likely
A. Neonatal sepsis
B. Meconium stained amniotic fluid
C. Neonatal hypoxia
D. Neonatal cephlahematoma
B. Meconium stained amniotic fluid