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Evolve OB Exam Version B study guide with complete solution

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Twenty-four hours after admission to the newborn nursery, a full-term male infant develops localized edema on the right side of his head. The nurse knows that in the newborn, an accumulation of blood between the periosteum and skull which does not cross the suture line is a newborn variation known ...

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  • June 3, 2022
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  • 2020/2021
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Evolve OB Exam Version B
Twenty-four hours after admission to the newborn nursery, a full-term male infant
develops localized edema on the right side of his head. The nurse knows that in the
newborn, an accumulation of blood between the periosteum and skull which does not
cross the suture line is a newborn variation known as. - Answer A cephalohematoma,
caused by forceps trauma and may last up to 8 weeks.

The nurse attempts to help an unmarried teenager deal with her feelings following a
spontaneous abortion at 8-weeks gestation. What type of emotional response should
the nurse anticipate? - Answer Grief related to her perceptions about the loss of this
child.

What action should the nurse implement when preparing to measure the fundal height
of a pregnant client? - Answer Have the client empty her bladder.

The nurse identifies crepitus when examining the chest of a newborn who was delivered
vaginally. Which further assessment should the nurse perform? - Answer Observe for
an asymmetrical Moro reflex.

One hour after giving birth to an 8- pound infant a client's lochia rubra has increased
from small to large and her fundus is boggy despite massage. The client's pulse is 84
beats/minute and blood pressure is 156/96. The healthcare provider prescribes
Methergine 0.2 mg IM x 1. What action should the nurse take immediately? - Answer
Call the healthcare provider to question the prescription.
Methergine is contraindicated for clients with elevate blood pressure, so the nurse
should contact the healthcare provider and question the prescription.

The nurse is preparing to give an enema to a laboring client. Which client requires the
most caution when carrying out this procedure?
A. A gravida 6, para 5 who is 38 years of age and in early labor.
B. A 37-week primigravida who presents at 100% effacement, 3 cm cervical dilatation,
and a -1 station.
C. A gravida 2, para 1 who is at 1 cm cervical dilatation and a 0 station admitted for
induction of labor due to post dates.
D. A 40-week primigravida who is at 6 cm cervical dilatation and the presenting part is
not engaged. - Answer D.
When the presenting part is ballottable, it is floating out of the pelvis. In such situation,
the cord can descend before the fetus causing a prolapsed cord, which is a emergency
situation.

In evaluating the respiratory effort of a one-hour-old infant using the Silverman-
anderson Index, the nurse determines the infant has synchronized chest and abdominal
movement, just visible lower chest retractions, just visible xiphoid retractions, minimal
and transient nasal flaring, and an expiratory grunt heard only on auscultation. What
Silverman-Anderson score should the nurse assign to this infant? - Answer 4

, Evolve OB Exam Version B
A client at 32-weeks gestation comes to the prenatal clinic with complaints of pedal
edema, dyspnea, fatigue, and a moist cough. Which question is most important for the
nurse to ask this client? - Answer Do you have a history of rheumatic fever?
Clients with a history of rheumatic fever may develop mitral valve prolapse, which
increases the risk for cardiac decompensation due to the increased blood volume that
occurs during pregnancy, so obtaining information about this client's health history is a
priority.

The nurse is assessing a client who is having a NEST at 41-weeks gestation. The nurse
determines that the client is not having contractions, the FHR baseline is 144 bpm, and
no FHR accelerations are occurring. What action should the nurse take? - Answer Ask
the client if she has felt any fetal movement.

A client in active labor is admitted with preeclampsia. Which assessment finding is most
significant in planning this client's care? - Answer Patellar reflex 4 +
indication of impending seizure

The nurse assesses a client admitted to the labor and delivery unit and obtains the
following data: dark red vaginal bleeding, uterus slightly tense between contractions, BP
110/68, FHR 110 bpm, cervix 1 cm dilated and uneffaced. Based on these assessment
findings, what intervention should the nurse implement? - Answer Monitor bleeding from
IV sites.
The client is presenting with signs of placental abruption. Disseminated intravascular
coagulation is a complication of placental abruption, characterized by abnormal
bleeding. Invasive vaginal procedures can increase the abruption and bleeding.

A client at 32-weeks gestation is diagnosed with preeclampsia. Which assessment
finding is most indicative of an impending convulsion? - Answer 3+ DTR and
hyperclonus

Immediately after birth a newborn is suctioned, dried, and placed under a radiant
warmer. The infant has spontaneous respirations and the nurse assesses an apical
heart rate of 80 bpm and respirations of 20 bpm. What action should the nurse perform
next? - Answer Initiate positive pressure ventilation.
Infant's vital signs are not within the normal range, and oxygen deprivation leads to
cardiac depression in infants.

A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her
childbearing history, the client indicate that she has delivered premature twins, one full-
term baby, and has had no abortions. Which GTPAL should the nurse document in this
client's record? - Answer 3-1-1-0-3

The healthcare provider prescribes terbutaline (Brethine) for a client in preterm labor.
Before initiating this prescription, it is most important for the nurse to assess the client
for which condition? - Answer Gestational diabetes
terbutaline increases blood glucose levels.

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