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    Exam Review

    1. The nursing staff in a labor and delivery unit has noticed an increase in the number of patients experiencing placental abruption.The nurses begin to review demographics for the patients involved.Which risk factors will the nurses expect? Select all that apply.(SATA)
      A)Hypertensive disorders.
      B)Uterine fibroids.
      C)Cigarette smoking.
      D)Abdominal trauma.
      E)Methamphetamine use.
    2. A patient with pregestational diabetes mellitus delivers a neonate who is diagnosed with macrosomia.The nurse is aware that the neonate is at risk for additional long-term conditions related to maternal diabetes mellitus.Which long-term effects may occur? Select all that apply.(SATA)
      A)Impaired intellectual development.
      B)Development of metabolic syndrome.
      C)Shoulder injury related to birth size.
      D)Changes in genetic expression.
      E)Increased risk for chronic illnesses.
    3. When assisting with a vacuum-assisted vaginal delivery, the nurse is aware that adherence to which guidelines for the vacuum device will minimize the nurse's liability in vacuum-assisted vaginal births? Select all that apply.(SATA)
      A)Pump up the vacuum manually to the pressure indicated on the pump.
      B)Recognize that cup detachment (pop off) is a warning sign.
      C)The cup should not be on the fetal head for longer than 5 to 10 minutes.
      D)The procedure is timed from insertion of the cup into the vagina until the birth.
      E)Understand that pressure should be released between contractions.
    4. Which of the following physical findings would lead the nurse to suspect that a client who has pre-eclampsia with severe features has developed HELLP syndrome? Select all that apply.(SATA)
      A)Petechiae.
      B)Jaundice.
      C)4+ deep tendon reflexes.
      D)3+ pitting edema.
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    Exam Review

    1. A gravid patient in labor suddenly has dyspnea, hypotension, frothy sputum, and loss of consciousness.The nurse knows these are signs and symptoms of which obstetrical emergency?
      A)Placental abruption.
      B)Uterine rupture.
      C)Uterine inversion.
      D)Anaphylactoid syndrome (previously called amniotic fluid embolism).
    2. While you are taking Monique's vital signs and performing a postpartum assessment 4 hours after delivery, she tells you she is feeling lightheaded.She has a history of chronic hypertension and obesity.Her vital signs are blood pressure 85/57 mm Hg, pulse 132, respirations 28, oxygen saturation 94%. Her uterus is boggy at midline, 1 cm above the umbilicus.What would be your next steps and anticipated orders?(SATA)
      A)Massage her fundus until firm and ensure IV access.
      B)Orders for methylergonovine (Methergine) 0.2 mg IM and an oxytocin bolus.
      C)Orders for carboprost tromethamine (Hemabate) 250 mcg IM. .
    3. A gravid patient in labor suddenly has dyspnea, hypotension, frothy sputum, and loss of consciousness.The nurse knows these are signs and symptoms of which obstetrical emergency?
      A)Placental abruption.
      B)Uterine rupture.
      C)Uterine inversion.
      D)Anaphylactoid syndrome (previously called Amniotic fluid embolism). .
    4. While you are taking Monique's vital signs and performing a postpartum assessment 4 hours after delivery, she tells you she is feeling lightheaded.She has a history of chronic hypertension and obesity.Her vital signs are blood pressure 85/57 mm Hg, pulse 132, respirations 28, oxygen saturation 94%. Her uterus is boggy at midline, 1 cm above the umbilicus.What would be your next steps and anticipated orders?
      A)Massage her fundus until firm and ensure IV access.
      B)Administer pain medication and prepare for possible surgical intervention.
      C)Reassess her vital signs and monitor for further changes.
      D)Immediately contact the attending physician for emergency intervention.
    Page 2 of 5

    Exam Review

    1. The nurse is caring for the postpartum client.Which assessment finding should prompt the nurse to conclude that the administration of carboprost tromethamine (Hemabate) has been effective?
      A)Reduction of fever.
      B)Stable blood pressure.
      C)Increased comfort.
      D)Decreased lochia rubra.
    2. A nurse massages the uterus of a postpartum woman after making a hypothesis of uterine atony.Which of the following outcomes would indicate that the client's condition had improved?
      A)Decreased pain level.
      B)Stable blood pressure.
      C)Fundus firm at or below the umbilicus.
      D)Reduced lochial flow.
    3. In which of the following situations should a nurse report a possible deep vein thrombosis (DVT)?
      A)The woman complains of numbness in the toes and heel of one foot.
      B)The woman has cramping pain in a calf that is relieved when the foot is dorsiflexed.
      C)The veins in the ankle of one of the woman's legs are spider-like and purple.
      D)The calf of one of the woman's legs is swollen, red, and warm to touch.
    4. A breastfeeding mother calls the obstetrician's office with a complaint of pain in one breast.Upon inspection, a diagnosis of mastitis is made.Which of the following nursing interventions is appropriate?
      A)Advise the woman to apply ice packs to her breasts.
      B)Encourage the woman to breastfeed frequently.
      C)Inform the woman that she should wean immediately.
      D)Direct the woman to notify her pediatrician as soon as possible.
    Page 3 of 5

    Exam Review

    1. A nurse is teaching a newly licensed nurse about neonatal abstinence syndrome.Which of the following statements by the newly licensed nurse indicate understanding of the teaching?
      A)"The newborn will have decreased muscle tone.”.
      B)"The newborn will have a continuous high-pitched cry.”.
      C)"The newborn will sleep for 2 to 3 hours after a feeding.”.
      D)"The newborn will have mild tremors when disturbed.”.
    2. A postpartum client has been diagnosed with postpartum psychosis.Which of the following is essential to be included in the family teaching for this client?
      A)The client should never be left alone with her infant.
      B)Symptoms rarely last more than one week.
      C)Clinical response to medications is usually poor.
      D)The client must have her vitals assessed every two days.
    3. A nurse is teaching a newly licensed nurse about neonatal abstinence syndrome.Which of the following statements by the newly licensed nurse indicate understanding of the teaching?
      A)The newborn will have decreased muscle tone.
      B)The newborn will have a continuous high-pitched cry.
      C)The newborn will sleep for 2 to 3 hours.
      D)The newborn will have mild tremors.
    4. A postpartum client has been diagnosed with postpartum psychosis.Which of the following is essential to be included in the family teaching for this client?
      A)The client should never be left alone with her infant.
      B)Symptoms rarely last more than one week.
      C)Clinical response to medications is usually poor.
      D)The client must have her vitals assessed every two days.
    Page 4 of 5

    Exam Review

    1. While you are taking Monique's vital signs and performing a postpartum assessment 4 hours after delivery, she tells you she is feeling lightheaded. She has a history of chronic hypertension and obesity. Her vital signs are blood pressure 85/57 mm Hg, pulse 132, respirations 28, oxygen saturation 94%. Her uterus is boggy at midline, 1 cm above the umbilicus. What would be your next steps and anticipated orders?
      A)Massage her fundus until firm and ensure IV access. Orders for methylergonovine (Methergine) 0.2 mg IM and an oxytocin bolus.
      B)Massage her fundus until firm and ensure IV access. Orders for carboprost-tromethamine (Hemabate) 250 mcg IM, and an oxytocin bolus.
      C)Gather her peri-pads and chux pads to quantify her blood loss.
      D)Assist her to the restroom to void, then massage her fundus until firm. Inform her that her lightheadedness was from orthostatic hypotension and to be sure to ask for assistance when getting up. There is no change in orders at this time.
      E)Straight catheterize her, then reassess her uterus, massaging it if it's still boggy. Order for oxytocin maintenance at 10 units/1 L of lactated Ringers running at 125 mL/hr.
    2. A nurse makes the following observations when admitting a full-term, breastfeeding baby into the neonatal nursery: 9 lb 2 oz (4,139 grams), 21 inches long, TPR 96.6°F (35.9°C), 158, 62, jittery, pink body with bluish hands and feet, crying.Which of the following nursing actions is of highest importance?
      A)Swaddle the baby to provide warmth.
      B)Assess the glucose level of the baby.
      C)Take the baby to the mother for feeding.
      D)Administer the routine neonatal medications.
    3. Which symptom would the nurse expect to observe in a postpartum client with a vaginal hematoma?
      A)Pain.
      B)Bleeding.
      C)Warmth.
      D)Redness.
    4. Which of the following is the appropriate nursing care outcome for a client who suddenly develops anaphylactoid syndrome of pregnancy (ASP) during labor?
      A)Client will be infection free at discharge.
      B)Client will exhibit normal breathing function at discharge.
      C)Client will exhibit normal gastrointestinal function at discharge.
      D)Client will void without pain at discharge.
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