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NUR |\ 418 |\Exam |\ 2 |\OB |\QUESTIONS |\WITH |\
VERIFIED |\ANSWERS
The |\perinatal |\nurse |\is |\assessing |\a |\woman |\at |\ 36 |\weeks' |\gestation. |
Her |\fundal |\height |\measurement |\was |\last |\recorded |\at |\ 34 |\cm. |\The |
patient's |\abdomen |\appears |\to |\be |\widest |\from |\side |\to |\side. |\Which |
type |\of |\fetal |\presentation |\does |\the |\nurse |\suspect? A. |\Breech B. |\Cephalic C. |\Face D. |\Shoulder |- |\CORRECT |\ANSWERS |\✔✔D A |\nurse |\is |\measuring |\the |\frequency |\of |\a |\laboring |\woman's |
contractions. |\How |\does |\the |\nurse |\accomplish |\this |\correctly? A. |\Counts |\the |\number |\of |\contractions |\measured |\at |\the |\same |
intensity |\in |\ 1 |\full |\minute B. |\Feels |\the |\fundus |\during |\the |\acme |\of |\the |\contraction |\and |\notes |
the |\fundal |\firmness C. |\Measures |\the |\beginning |\of |\one |\contraction |\to |\the |\beginning |\of |
the |\next |\contraction D. |\Measures |\the |\time |\from |\the |\beginning |\of |\one |\contraction |\to |\the |
end |\of |\the |\same |\contraction |- |\CORRECT |\ANSWERS |\✔✔C
A |\patient's |\cervix |\is |\ 8 |\cm |\dilated |\and |\she |\is |\100% |\effaced. |\What |
action |\by |\the |\nurse |\is |\most |\important |\currently? A. |\Allow |\the |\support |\person |\to |\be |\at |\the |\bedside. B. |\Encourage |\the |\woman |\to |\bear |\down. C. |\Have |\the |\woman |\avoid |\pushing. D. |\Instruct |\the |\womanto |\rest |\between |\contractions. |- |\CORRECT |
ANSWERS |\✔✔C At |\9:00 |\a.m., |\the |\OB |\nurse |\assesses |\fetal |\station |\at |\0. |\The |\laboring |
woman |\has |\strong, |\regular |\contractions. |\At |\10:30 |\a.m., |\the |\nurse |
again |\assesses |\fetal |\station |\at |\0. |\What |\action |\by |\the |\nurse |\is |\best? A. |\Document |\the |\findings |\and |\continue |\to |\assess |\frequently. B. |\Encourage |\the |\woman |\to |\bear |\down |\during |\contractions. C. |\Increase |\the |\woman's |\IV |\fluid |\rate |\and |\reassess |\in |\ 30 |\minutes. D. |\Inform |\the |\provider |\and |\prepare |\for |\possible |\cesarean |\delivery. |- |\CORRECT |\ANSWERS |\✔✔D A |\woman |\who |\is |\ 40 |\weeks |\pregnant |\calls |\the |\clinic |\to |\report |\that |
she |\noted |\a |\small |\amount |\of |\blood-tinged |\mucus |\on |\her |\toilet |
tissue |\this |\morning. |\What |\response |\by |\the |\nurse |\is |\most |
appropriate? A. |"Come |\to |\the |\clinic |\today |\for |\an |\examination." B. |"Labor |\will |\probably |\start |\within |\ 48 |\hours." C. |"Lie |\on |\your |\left |\side |\and |\count |\fetal |\kicks."
A |\woman's |\birthing |\plan |\includes |\completing |\the |\latent |\phase |\of |
the |\first |\stage |\of |\labor |\at |\home. |\When |\should |\the |\nurse |\teach |\the |
woman |\to |\come |\into |\the |\birthing |\unit? A. |\After |\ 10 |\hours |\of |\mild |\contractions B. |\When |\contractions |\are |\ 3 |\to |\ 5 |\minutes |\apart C. |\When |\contractions |\are |\experienced |\in |\the |\back D. |\When |\strong |\contractions |\occur |\ 2 |\to |\ 3 |\minutes |\apart |- |\CORRECT |
ANSWERS |\✔✔B A |\nulliparous |\woman |\in |\labor |\is |\ 3 |\cm |\dilated |\at |\10:00 |\a.m. |\Based |
on |\knowledge |\of |\the |\average |\nulliparous |\woman's |\progression, |
when |\would |\the |\nurse |\expect |\her |\to |\be |\fully |\dilated? A. |\12:00 |\p.m. B. |\2:00 |\p.m. |
C. |\5:00p.m. |
D. |\10:00 |\p.m. |- |\CORRECT |\ANSWERS |\✔✔C A |\woman |\is |\in |\the |\early |\latent |\phase |\of |\labor |\and |\is |\frustrated |\by |
the |\length |\of |\time |\this |\stage |\is |\taking. |\What |\action |\by |\the |\nurse |\is |
best? A. |\Administer |\100% |\oxygen |\by |\face |\mask. B. |\Encourage |\frequent |\position |\changes |\or |\walking. C. |\Have |\the |\woman |\rest |\between |\contractions.
D. |\Place |\the |\woman |\in |\a |\left |\side-lying |\position |\with |\side |\rails |\up. |- |
CORRECT |\ANSWERS |\✔✔B A |\woman |\with |\a |\history |\of |\two |\stillbirths |\is |\in |\the |\active |\phase |\of |
the |\first |\stage |\of |\labor |\in |\the |\high-risk |\OB |\unit. |\How |\often |\should |
the |\nurse |\anticipate |\monitoring |\fetal |\heart |\tones |(FHTs)? |
A. |\Continuously B. |\Every |\ 5 |\minutes C. |\Every |\ 15 |\minutes D. |\Every |\ 30 |\minutes |- |\CORRECT |\ANSWERS |\✔✔A A |\new |\nurse |\is |\assessing |\baseline |\fetal |\heart |\tones |(FHTs) |\by |
auscultation |\and |\notes |\that |\the |\heart |\rate |\increased |\during |\a |
contraction |\from |\ 140 |\to |\158. |\What |\action |\by |\the |\nurse |\preceptor |\is |
best? A. |\Gather |\equipment |\for |\internal |\FHT |\monitoring. B. |\Have |\the |\nurse |\document |\FHT |\rate |\as |\140/158 |\on |\the |\chart. C. |\Instruct |\the |\nurse |\to |\assess |\FHT |\between |\contractions. D. |\Tell |\the |\nurse |\to |\count |\only |\for |\ 30 |\seconds. |- |\CORRECT |\ANSWERS |\✔✔C A |\nurse |\assesses |\the |\fetal |\heart |\rate |\at |\ 188 |\beats/minute |\in |\a |
woman |\who |\is |\receiving |\a |\tocolytic |\medication |\to |\halt |\contractions. |
Which |\action |\should |\the |\nurse |\take |\first?
A |\nurse |\assessing |\a |\woman |\in |\labor |\notes |\late |\decelerations |\on |\the |\fetal |\monitor |\and |\documents |\contractions |\occurring |\every |\ 1 |\to |\ 2 |
minutes. |\Oxytocin |(Pitocin) |\is |\being |\infused |\IV, |\and |\oxygen |\is |\being |
delivered |\at |\ 8 |\L/min |\per |\mask. |\The |\woman |\is |\positioned |\on |\her |\left |\side. |\What |\action |\by |\the |\nurse |\takes |\priority? A. |\Discontinue |\the |\oxygen. B. |\Increase |\the |\oxytocin |\rate. C. |\Assist |\the |\woman |\to |\a |\supine |\position. D. |\Stop |\the |\oxytocin |\infusion. |- |\CORRECT |\ANSWERS |\✔✔D A |\nurse |\is |\caring |\for |\a |\new |\mother |\during |\the |\fourth |\stage |\of |
labor |\and |\assesses |\the |\following: |\patient |\has |\soaked |\two |\peri-pads |
in |\ 45 |\minutes, |\pulse |\is |\ 118 |\beats/minute, |\and |\blood |\pressure |\is |
90/62 |\mm |\Hg. |\Which |\priority |\actions |\should |\the |\nurse |\take? |\Select |
all |\that |\apply. |
A. |"Assess |\the |\firmness |\of |\the |\patient's |\uterus." B. |"Review |\chart |\to |\see |\if |\Pitocin |\was |\administered |\post-delivery |\of |
the |\placenta." C. |"Place |\ice |\on |\the |\perineum." D. |"Encourage |\the |\new |\mother |\to |\attempt |\breastfeeding." |
E. |"Escort |\the |\new |\mother |\to |\the |\bathroom |\to |\void." |- |\CORRECT |
ANSWERS |\✔✔A |\B
A |\woman |\is |\admitted |\in |\labor. |\The |\perinatal |\nurse |\would |
demonstrate |\awareness |\of |\cultural |\values |\by |\assessing |\the |\patient |
for |\which |\of |\the |\following? |\Select |\all |\that |\apply. A! |"Need |\for |\an |\interpreter." B! |"Pain |\management |\and |\coping |\techniques." C! |"Preference |\for |\food |\during |\labor." |
D! |"Preferences |\for |\touch |\during |\labor." |
E! |"Support |\person |\during |\labor." |- |\CORRECT |\ANSWERS |\✔✔A |\B |\D |\E Which |\statements |\are |\accurate |\regarding |\the |\administration |\of |\pain |\medications |\during |\labor? |\Select |\all |\that |\apply. A! |"IVP |\medications |\should |\be |\administered |\during |\contractions." B! |"Hydromorphone |\hydrochloride |(Dilaudid) |\is |\associated |\with |
nausea." C! |"Meperidine |\hydrochloride |(Demerol) |\use |\can |\increase |\FHR |
variability." |
D! |"The |\use |\of |\opioid |\antagonists |\is |\contraindicated |\in |\labor."E! |"The |\use |\of |\opioid |\antagonists |\does |\not |\cause |\amnesia." |- |\CORRECT |
ANSWERS |\✔✔A |\B |\D |\E A |\nurse |\is |\taking |\care |\of |\a |\woman |\who |\has |\just |\been |\admitted |\in |
early |\labor. |\Based |\on |\this |\monitor |\tracing, |\what |\priority |\action |
should |\the |\nurse |\take? A. |\Prepare |\for |\an |\emergent |\delivery.
During |\the |\postpartum |\assessment, |\the |\perinatal |\nurse |\notes |\that |
a |\patient |\who |\has |\just |\experienced |\a |\forceps-assisted |\birth |\now |\has |\a |\large |\amount |\of |\bright |\red |\vaginal |\bleeding. |\Her |\uterine |\fundus |
is |\firm. |\The |\most |\appropriate |\action |\by |\the |\nurse |\is |\to |\collaborate |
with |\the |\health-care |\provider |\in |\which |\activity? A. |\Bladder |\assessment |\and |\catheterization B. |\Preparing |\the |\woman |\for |\a |\hysterectomy C. |\Uterine |\massage |\and |\oxytocin |\infusion D. |\Vaginal |\assessment |\and |\repair |- |\CORRECT |\ANSWERS |\✔✔D The |\perinatal |\nurse |\is |\caring |\for |\a |\patient |\with |\pre-eclampsia. |\What |\intervention |\does |\the |\nurse |\include |\on |\this |\patient's |\care |\plan? A. |\Administer |\magnesium |\sulfate |\per |\agency |\policy. B. |\Assess |\the |\patient's |\blood |\pressure |\every |\ 6 |\hours. C. |\Encourage |\the |\patient |\to |\rest |\on |\her |\back. D. |\Notify |\the |\physician |\of |\urine |\output |\greater |\than |\ 30 |\mL/hr. |- |
CORRECT |\ANSWERS |\✔✔A The |\perinatal |\nurse |\providing |\care |\to |\a |\laboring |\woman |\recognizes |
a |\nonreassuring |\fetal |\heart |\rate |\tracing. |\Which |\of |\the |\following |\is |
the |\most |\appropriate |\initial |\action |\by |\the |\nurse? A. |\Assist |\the |\woman |\to |\a |\left |\lateral |\position. B. |\Decrease |\the |\rate |\of |\the |\intravenous |\solution. C. |\Document |\the |\fetal |\heart |\rate |\and |\variability.
D. |\Request |\that |\the |\provider |\apply |\a |\fetal |\scalp |\electrode. |- |
CORRECT |\ANSWERS |\✔✔A The |\perinatal |\nurse |\determines |\by |\vaginal |\examination |\that |\a |
patient's |\cervix |\is |\fully |\dilated, |\and |\the |\fetal |\presenting |\part |\is |
descending |\rapidly |\with |\the |\patient's |\pushing |\efforts. |\The |\most |
appropriate |\nursing |\intervention |\at |\this |\time |\would |\be |\to |\do |\which |
of |\the |\following? A. |\Assist |\the |\patient |\with |\breathing |\patterns |\to |\slow |\down |\her |
pushing. B. |\Document |\the |\patient's |\progress |\and |\coping |\abilities |\in |\labor. C. |\Notify |\the |\health-care |\provider |\to |\come |\now |\for |\the |\birth. D. |\Provide |\information |\to |\the |\patient's |\partner |\about |\her |\stage |\of |
labor. |- |\CORRECT |\ANSWERS |\✔✔A The |\perinatal |\nurse |\is |\providing |\care |\to |\a |\32-year-old |\G1 |\TPAL |\ 0000 |\at |\ 34 |\weeks' |\gestation. |\Her |\blood |\pressure |\is |\170/100 |\mm |\Hg, |
reflexes |\are |+3, |\urine |\is |\2+ |\for |\protein, |\and |\the |\patient |\is |
complaining |\of |\a |\headache. |\An |\intravenous |\solution |\of |\magnesium |
sulfate |\is |\begun |\with |\an |\hourly |\dose |\of |\ 2 |\g. |\Which |\laboratory |\value |\would |\be |\assessed |\most |\carefully |\by |\the |\nurse? A. |\Aspartateaminotransferase(AST) B. |\Gamma-glutamyl |\transpeptidase C. |\Hematocrit D. |\Neutrophilcount |- |\CORRECT |\ANSWERS |\✔✔A
assessment |\should |\the |\nurse |\include |\in |\this |\patient's |\plan |\of |\care |
as |\a |\priority? A. |\Hourly |\vital |\signs B. |\Intake |\and |\output |\every |\ 8 |\hours C. |\Blood |\draw |\for |\complete |\blood |\count |(CBC), |\prothrombin |\time |
(PT), |\and |\electrolytes D. |\Checks |\for |\perineal |\bleeding |\every |\ 15 |\minutes |- |\CORRECT |
ANSWERS |\✔✔C A |\woman |\reports |\feeling |\uterine |\contractions |\that |\are |\strong, |\but |
on |\subsequent |\cervical |\checks, |\the |\nurse |\does |\not |\note |\any |
changes. |\What |\action |\by |\the |\nurse |\is |\most |\appropriate? A. |\Assess |\the |\woman |\for |\causes |\of |\anxiety. B. |\Attempt |\an |\external |\version |\of |\the |\fetus. C. |\Instruct |\the |\woman |\on |\nipple |\stimulation. |
D. |\Prepare |\to |\administer |\oxytocin |(Pitocin). |- |\CORRECT |\ANSWERS |
✔✔A The |\nurse |\is |\preparing |\to |\admit |\a |\diabetic |\woman |\who |\is |\in |\labor. |
The |\nurse |\plans |\care |\to |\assess |\carefully |\for |\which |\of |\the |\following |
conditions |\in |\this |\patient? A. |\Diminishing |\uterine |\contractions B. |\Need |\for |\an |\epidural |\block C. |\Onset |\of |\intrapartum |\hypertension
D. |\Overly |\strong, |\painful |\contractions |- |\CORRECT |\ANSWERS |\✔✔A A |\woman |\had |\an |\amniotomy |\ 1 |\hour |\ago. |\Now |\she |\is |\complaining |
of |\uterine |\tenderness. |\What |\action |\by |\the |\nurse |\is |\most |
appropriate? A. |\Increase |\the |\IV |\infusion |\rate. B. |\Notify |\the |\health-care |\provider. C. |\Perform |\a |\vaginal |\examination. D. |\Take |\the |\woman's |\temperature. |- |\CORRECT |\ANSWERS |\✔✔ANS: |\D A |\nulliparous |\woman |\has |\been |\admitted |\to |\the |\labor |\and |\birth |
unit. |\Her |\Bishop |\score |\is |\4. |\What |\medication |\does |\the |\nurse |\plan |
to |\administer? A. |\Betamethasone |(Celestone) B. |\Hydromorphone |(Dilaudid) C. |\Misoprostol |(Cytotec) D. |\Oxytocin |(Pitocin) |- |\CORRECT |\ANSWERS |\✔✔c A |\woman |\is |\receiving |\oxytocin |(Pitocin) |\via |\infusion. |\The |\nurse |
assesses |\the |\following: |\uterine |\contractions |\lasting |\ 100 |\seconds |
every |\1.5 |\minutes, |\uterine |\resting |\tone |\ 36 |\mm |\Hg, |\baseline |\fetal |
heart |\rate |(FHR) |\ 108 |\beats/minute |\with |\absent |\variability. |\What |
action |\by |\the |\nurse |\takes |\priority? A. |\Document |\the |\findings.
A |\labor |\patient |\who |\has |\delivered |\is |\now |\experiencing |\increased |
vaginal |\bleeding, |\blood |\pressure |\changes |\from |\120/89 |\to |\100/72, |
and |\a |\spontaneous |\nosebleed. |\What |\therapeutic |\treatment |\should |
the |\nurse |\anticipate |\that |\the |\physician |\will |\order? |\Select |\all |\that |
apply. |
A! |"Administration |\of |\Pitocin." B! |"Type |\and |\screen |\for |\ 4 |\units |\blood." |
C! |"Administration |\of |\platelets." D! |"Heparin |\therapy." E! |"Initiation |\of |\oxygen |\therapy." |- |\CORRECT |\ANSWERS |\✔✔C |\D |\E During |\labor, |\the |\patient |\is |\diagnosed |\with |\a |\shoulder |\dystocia |
while |\actively |\pushing. |\Which |\orders |\would |\the |\nurse |\anticipate |
that |\the |\physician |\will |\order? |\Select |\all |\that |\apply. A! |"McRoberts |\maneuver." B! |"Consult |\anesthesia |\for |\epidural |\administration." C! |"Contact |\nursery |\to |\attend |\the |\delivery." |
D! |"Insert |\a |\Foley |\catheter." E! |"Possible |\change |\in |\maternal |\position." |- |\CORRECT |\ANSWERS |
✔✔A |\C |\E A |\nurse |\is |\taking |\care |\of |\a |\woman |\in |\active |\labor. |\Based |\on |\this |
monitor |\tracing, |\what |\priority |\action |\should |\the |\nurse |\take?
A. |\Prepare |\to |\administer |\Pitocin B. |\Continue |\to |\monitor C. |\Encourage |\patterned |\breathing |\responses |\to |\assist |\relaxation |
D. |\Notify |\the |\physician |\that |\delivery |\is |\imminent |- |\CORRECT |
ANSWERS |\✔✔C The |\perinatal |\nurse |\explains |\the |\cardiopulmonary |\adaptations |\that |
occur |\in |\the |\neonate |\to |\a |\student |\nurse. |\Which |\of |\the |\following |
statements |\accurately |\describes |\the |\sequence |\of |\these |\changes? A. |"As |\air |\enters |\the |\lungs, |\the |\PO2 |\rises |\in |\the |\alveoli, |\which |
causes |\pulmonary |\artery |\relaxation |\and |\results |\in |\an |\increase |\in |
pulmonary |\vascular |\resistance." B. |"As |\the |\pulmonary |\vascular |\resistance |\increases, |\pulmonary |
blood |\flow |\increases, |\reaching |\100% |\by |\the |\first |\ 24 |\hours |\of |\life." C. |"Decreased |\pulmonary |\blood |\volume |\contributes |\to |\the |
conversion |\from |\fetal |\to |\newborn |\circulation." D. |"Once |\the |\pulmonary |\circulation |\has |\been |\functionally |
established, |\blood |\is |\distributed |\throughout |\the |\lungs." |- |\CORRECT |
ANSWERS |\✔✔D New |\parents |\are |\concerned |\that |\after |\initially |\breastfeeding |\their |
baby |\ 2 |\hours |\after |\being |\born, |\she |\is |\sleeping |\soundly |\and |\will |\not |\awaken. |\What |\action |\by |\the |\nurse |\is |\most |\appropriate? A. |\Call |\the |\rapid |\response |\team.
B. |\Assess |\daily |\hemoglobin |\and |\hematocrit |\levels. C. |\Coordinate |\laboratory |\sticks |\to |\minimize |\blood |\loss. D. |\Handle |\the |\infant |\gently |\to |\prevent |\injury. |- |\CORRECT |\ANSWERS |
✔✔A A |\nurse |\is |\assessing |\a |\newborn |\who |\is |\jittery, |\diaphoretic, |\and |
hypothermic, |\and |\has |\poor |\feeding. |\What |\laboratory |\value |\would |
the |\nurse |\correlate |\with |\this |\condition? A. |\Bilirubin: |\ 5 |\mg/dL B. |\Blood |\glucose: |\ 32 |\mg/dL C. |\Hematocrit:50% D. |\White |\blood |\cell |\count: |\25,000/mm3 |- |\CORRECT |\ANSWERS |\✔✔B A |\term |\infant |\is |\ 22 |\hours |\old, |\has |\a |\total |\serum |\bilirubin |\level |\of |
13 |\mg/dL, |\and |\has |\visible |\jaundice. |\What |\action |\by |\the |\nurse |\is |
most |\appropriate? A. |\Assure |\the |\parents |\that |\this |\is |\temporary. B. |\Document |\the |\findings |\in |\the |\infant's |\chart. C. |\Have |\the |\mother |\switch |\to |\bottle |\feeding. D. |\Review |\the |\chart |\for |\history |\of |\a |\traumatic |\birth. |- |\CORRECT |
ANSWERS |\✔✔D
A |\mother |\brings |\her |\1-week-old |\baby |\to |\the |\clinic |\with |\complaints |
that |\the |\baby |\is |\not |\eating |\well. |\The |\mother |\is |\attempting |\to |\bottle |\feed |\about |\ 120 |\mL |\every |\ 2 |\hours. |\What |\action |\by |\the |\nurse |\is |
best? A. |\Explain |\that |\this |\is |\too |\much |\volume |\at |\one |\time. B. |\Have |\the |\mother |\demonstrate |\her |\feeding |\and |\burping |
technique. C. |\Reassure |\the |\mother |\that |\the |\baby |\is |\eating |\fine. D. |\Weigh |\the |\baby |\and |\plot |\her |\weight |\on |\a |\graph. |- |\CORRECT |
ANSWERS |\✔✔A A |\mother-baby |\nurse |\assesses |\newborns |\for |\their |\risk |\of |\developing |\hypoglycemia. |\Which |\infant |\would |\the |\nurse |\assess |\as |\being |\at |
highest |\risk? A. |\Asian |\ethnic |\background B. |\Delayed |\feedings |\after |\birth C. |\Infant |\with |\heat |\stress D. |\Maternal |\use |\of |\terbutaline |(Brethine) |- |\CORRECT |\ANSWERS |\✔✔D What |\assessment |\finding |\indicates |\to |\the |\nurse |\that |\goals |\for |\the |
diagnosis |\of |\ineffective |\thermoregulation |\related |\to |\newborn's |
immature |\temperature |\regulatory |\system |\have |\been |\met? A. |\Axillary |\temperature |\is |\98.1°F |(36.7°C). B. |\Fluctuations |\in |\infant's |\temperature |\cease. |\
