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    Exam Review

    1. A nurse is caring for a client in labor who has an epidural in place and is on continuous internal monitoring with a fetal scalp electrode and intrauterine pressure catheter. The nurse notes a strong contraction on the monitor and the client reports nausea accompanied by an urgent need to have a bowel movement. Which of the following assessments is the nurse's highest priority?
      A)Obtain the client's temperature, heart rate, and blood pressure.
      B)Examine the vaginal discharge for the presence of meconium.
      C)Perform a sterile vaginal examination to assess labor progress.
      D)Determine the fetal heart rate in relationship to the contraction.
    2. A nurse is assessing the lifestyle practices of a pregnant client. Which of the following lifestyle factors indicates an increased risk for high-risk pregnancy?
      A)Consuming 3 L (101 oz) of water daily.
      B)Consuming 300 mg of caffeine daily.
      C)Consuming 400 mcg of folate daily.
      D)Consuming 27 mg of iron daily.
    3. A nurse is caring for a postpartum client who recently had an indwelling urinary catheter removed. Which of the following findings indicates that the client is able to void effectively?
      A)The bladder is distended upon palpation.
      B)The client does not feel the urge to urinate.
      C)The client urinates 30 mL/hr.
      D)The uterine fundus is 2 cm above the umbilicus.
    4. A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect? (Select all that apply.)(SATA)
      A)Tachypnea.
      B)Shrill pitched cry.
      C)Acrocyanosis.
      D)Hypotonia.
      E)Exaggerated Moro reflex.
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    Exam Review

    1. A nurse is caring for a newborn who has herpes simplex virus as a result of in utero transmission. Which of the following actions should the nurse take?
      A)Immediately bathe the newborn.
      B)Initiate contact precautions.
      C)Withhold breastfeeding.
      D)Administer ampicillin IV. . .
    2. A nurse is caring for a client who is 9 hours postpartum following a cesarean birth with a quantitative blood loss of 1200 mL. Which of the following findings indicates the client is experiencing a fluid volume deficit?
      A)Reports of excessive sweating.
      B)900 mL of urine output since the birth.
      C)Temperature 37.6°C (99.6°F).
      D)Blood pressure 80/55 mm Hg.
    3. A nurse is caring for a client who is at 35 weeks of gestation and has preterm premature rupture of the membranes. Which of the following complications should the nurse monitor the newborn for following delivery?
      A)Sepsis.
      B)Fractured clavicle.
      C)Polycythemia.
      D)Meconium aspiration.
    4. A nurse is planning care for a postpartum client who expresses a desire to follow the traditional beliefs regarding the balance of yin and yang for postpartum care. Which of the following actions should the nurse plan to take?
      A)Maintain a cool environment in the client's room.
      B)Assist the client with showering twice daily.
      C)Provide the client with a warm beverage.
      D)Apply a new ice pack to the client's perineal area every 4 hr.
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    Exam Review

    1. A nurse is teaching the parents of a newborn about the critical congenital heart disease screening. Which of the following statements should the nurse include in the teaching?
      A)The test will be performed when your newborn is between 6 and 12 hours of age.
      B)To perform the test, I will collect a blood sample from your newborn's heel.
      C)It will take 1 to 2 weeks to obtain the results of your newborn's test.
      D)The test compares the oxygen saturation in your newborn's upper and lower extremities.
    2. A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hours ago. Which of the following findings place the client at risk for postpartum hemorrhage?(SATA)
      A)Newborn weight 2.948 kg (6 lb 8 oz).
      B)History of human papillomavirus.
      C)History of uterine atony.
      D)Vacuum-assisted delivery.
    3. A nurse is reviewing signs of effective breastfeeding with a client who is 5 days postpartum. Which of the following information should the nurse include in the teaching?
      A)You should expect your baby to have two to three wet diapers in a 24-hour period.
      B)Your breasts should stay firm after the baby breastfeeds.
      C)You should feel a tugging sensation when the baby is sucking.
      D)Your baby's urine should appear dark and concentrated.
    4. A nurse is performing a nonstress test for a client who is at 38 weeks of gestation. The fetal monitor tracing reveals a series of late decelerations. Which of the following interventions should the nurse implement first?
      A)Prepare the client for a cesarean birth.
      B)Administer lactated Ringer's via IV bolus.
      C)Place the client in a lateral position.
      D)Elevate the client's legs.
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    Exam Review

    1. A nurse is caring for a client who is in labor and is receiving epidural analgesia. Which of the following changes in the fetal heart rate should the nurse report to the provider?
      A)Fetal heart rate increase to 150/min.
      B)Fetal heart rate accelerations of 15/min for 15 seconds.
      C)Early decelerations of the fetal heart rate.
      D)Prolonged period of absent fetal heart rate variability.
    2. A nurse is providing vehicle safety education to the parents of a premature newborn. Which of the following statements should the nurse include in the teaching?
      A)Place your newborn in a front-facing car seat in the back seat of the vehicle.
      B)Position the retainer clip at the level of your newborn's abdomen.
      C)You should secure your newborn's car seat at a 60-degree angle.
      D)Your newborn will need to have a car seat test prior to discharge.
    3. A nurse is caring for a client who is receiving epidural anesthesia. The client is hypotensive with decreased placental perfusion. Which of the following actions should the nurse take?
      A)Administer lactated Ringer's 500 mL bolus.
      B)Place the client in a knee-chest position.
      C)Administer oxygen via nasal cannula at 2 L/min.
      D)Monitor the client's blood pressure every 30 minutes.
    4. A nurse is caring for a client who is receiving 1 milliunit/min of oxytocin for the induction of labor. The provider prescription reads to increase the rate by 1 milliunit/min every 30 minutes until the client demonstrates an expected labor pattern. Which of the following findings indicates the nurse should titrate the infusion rate to 2 milliunits/min after the first 30 minutes?
      A)The client experiences spontaneous rupture of membranes.
      B)The cervical Bishop score is 2.
      C)The client's contractions palpate as mild.
      D)The client reports severe back pain.
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    Exam Review

    1. A nurse is assessing a client who is 1 hour postpartum. Which of the following findings should the nurse report to the provider?
      A)Lochia rubra with small clots.
      B)Minimal perineal edema.
      C)Boggy fundus.
      D)Temperature 37.7° C (99.9° F).
    2. A nurse is reviewing laboratory findings for a client who is at 20 weeks of gestation. Which of the following findings should the nurse report to the provider?
      A)Fasting blood glucose 180 mg/dL (74 to 106 mg/dL).
      B)Creatinine 0.9 mg/dL (0.5 to 1 mg/dL).
      C)Hematocrit 37% (37% to 47%).
      D)WBC count 11,000/mm³ (5,000 to 10,000/mm³). . .
    3. A nurse is performing a nutritional assessment for a client during their first prenatal visit at 12 weeks of gestation. Which of the following findings indicates that the client should be referred to a registered dietician?
      A)The client reports that they eat prunes to help manage their constipation.
      B)The client reports a 4.5 kg (10 lb) weight gain since their positive pregnancy test.
      C)The client reports that they take a multivitamin daily.
      D)The client reports that they consume less than 1,000 calories per day.
    4. A nurse is caring for a client who is receiving an epidural for continuous labor analgesia. Which of the following findings should indicate to the nurse that the treatment is effective?
      A)The client is unable to move their legs or feet.
      B)The client has bladder distention.
      C)The client's systolic blood pressure decreases by 20 mm Hg.
      D)The client reports slight pressure with contractions.
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