OB Hesi Final questions and answers

How does the nurse explain physiologic anemia to a pregnant client? 1.Erythropoiesis decreases. 2.Plasma volume increases. 3.Utilization of iron decreases. 4.Detoxification by the liver increases. Correct 2.Plasma volume increases. A client at 30-weeks' gestation is admitted to the hospital with a diagnosis of low-lying placenta previa with slight vaginal bleeding. The client is stabilized and bleeding ceases. What is the nurse's primary focus when providing discharge teaching about care at home for this client? 1.Stay on strict bed rest and use a bedpan. 2. Maintain a calm and quiet environment. 3. Check fetal status with a stethoscope daily. 4. Avoid anything that may stimulate the cervix or uterus. Correct 4. Avoid anything that may stimulate the cervix or uterus. A small-for-gestational-age (SGA) newborn has just been admitted to the nursery. Nursing assessment reveals a high-pitched cry, jitteriness, and irregular respirations. With which condition are these signs associated? 1. Hypervolemia 2. Hypoglycemia 3. Hypercalcemia 4. Hypothyroidism Correct 2. Hypoglycemia During the postpartum period a client with heart disease and type 2 diabetes asks a nurse, "Which contraceptives will I be able to use to prevent pregnancy in the near future?" How should the nurse respond? 1. "You may use oral contraceptives—they're almost completely effective in preventing pregnancy." 2. "You should use foam with a condom to prevent pregnancy—this is the safest method for women with your illnesses." 3. "You'll find that the intrauterine device is best for you, because it prevents a fertilized ovum from implanting in the uterus." 4. "You have little to worry about regarding becoming pregnant in the near future, because women with your illnesses usually become infertile." Correct 2. "You should use foam with a condom to prevent pregnancy—this is the safest method for women with your illnesses." A client arrives at the clinic with swollen, tender breasts and flulike symptoms. A diagnosis of mastitis is made. What does the nurse plan to do? 1. Help her wean the infant gradually. 2. Teach her to empty her breasts frequently. 3. Review breastfeeding techniques with her. 4. Send a sample of her milk to the laboratory for testing. Correct 2. Teach her to empty her breasts frequently. The nurse suspects that a newborn is experiencing opioid withdrawal. Which assessment finding supports this suspicion? 1. Lethargy and constipation 2. Grunting and low-pitched cry 3. Irritability and nasal congestion 4. Watery eyes and rapid respirations Correct 3. Irritability and nasal congestion A nurse is assessing a newborn with caput succedaneum. How does the nurse explain the cause of this fetal condition to the new mother? 1. Overlap of fetal bones as they pass through the maternal birth canal 2. Swelling of the soft tissue of the scalp as a result of pressure during labor 3. Hemorrhage of ruptured blood vessels that does not cross the suture lines 4. Accumulation of fluid resulting from partial blockage of cerebrospinal fluid drainage Correct 2. Swelling of the soft tissue of the scalp as a result of pressure during labor A new mother exclaims to the nurse, "My baby looks like a conehead!" How should the nurse respond? 1. "Are you disappointed in how your baby looks?" 2. "Don't worry—your baby's head will be round in a few days." 3. "Is there anyone in your family whose head shape is similar to your baby's?" 4. "This often happens as the baby's head moves down the birth canal—the bones move for easier passage." Correct 4. "This often happens as the baby's head moves down the birth canal—the bones move for easier passage." What must the nurse assess first when planning to promote mother-infant attachment? 1. Mother-infant interaction 2. Mother-father interaction 3. The infant's physical status 4. The mother's ability to care for her infant Correct 1. Mother-infant interaction The nurse is caring for a postpartum client who has experienced an abruptio placentae. Which assessment indicates that disseminated intravascular coagulation (DIC) is occurring? 1. Boggy uterus 2. Hypovolemic shock 3. Multiple vaginal clots 4.Bleeding at the venipuncture site Correct 4.Bleeding at the venipuncture site The nurse is testing newborns' heel blood for the level of glucose. Which newborn does the nurse anticipate will experience hypoglycemia? Select all that apply. 1.Preterm infant 2. Infant with Down syndrome 3. Small-for-gestational-age infant 4. Large-for-gestational-age infant 5. Appropriate-for-gestational-age infant Correct 1. Preterm infant 3. Small-for-gestational-age infant 4. Large-for-gestational-age infant The nurse evaluates a new mother who is breastfeeding. The client asks how to care for her nipples. What should the nurse recommend? 1. Putting lanolin cream on the nipples after breastfeeding 2. Applying vitamin E gel to the nipples before breastfeeding 3. Using soap and water to clean the breasts and nipples at least once a day 4. Spreading breast milk on the nipples after the feeding and allowing them to air dry Correct 4. Spreading breast milk on the nipples after the feeding and allowing them to air A 36-year-old woman, G1 P0, is admitted to the labor and delivery unit for oxytocin induction. She is at 40 weeks' gestation. Which condition is a contraindication to the use of oxytocin induction? 1. Chorioamnionitis 2. Postterm pregnancy 3. Active genital herpes infection 4. Hypertension associated with pregnancy Correct 3. Active genital herpes infection The nurse is caring for a postpartum client with preeclampsia being managed with a magnesium sulfate infusion. What is the priority nursing assessment? 1. Counting respiratory rate 2. Obtaining blood pressure 3. Eliciting deep tendon reflexes 4. Monitoring urine output Correct 1. Counting respiratory rate Which client is at the greatest risk for a postpartum infection? 1. A primipara who gives birth to an infant weighing more than 8.5 lb 2. A woman who required catheterization after voiding less than 75 mL 3. A multipara with a hemoglobin level of 11 g at the time of admission 4. A woman who loses at least 350 mL of blood during the birthing process Correct 2. A woman who required catheterization after voiding less than 75 mL The nurse is caring for a pregnant client who is undergoing an ultrasound examination during the first trimester. The nurse explains that an ultrasound during the first trimester is utilized in order to do what? 1. Estimate fetal age 2. Detect hydrocephalus 3. Rule out congenital defects 4. Approximate fetal linear growth Correct 1. Estimate fetal age Which statements regarding the involution process are correct? Select all that apply. 1. Involution begins immediately after expulsion of the placenta. 2. Involution is the self-destruction of excess hypertrophied tissue. 3. Involution progresses rapidly during the next few days after birth. 4. Involution is the return of the uterus to a nonpregnant state after birth. 5. Involution may be caused by retained placental fragments and infections. Correct. 1. Involution begins immediately after expulsion of the placenta. 3. Involution progresses rapidly during the next few days after birth. 4. Involution is the return of the uterus to a nonpregnant state after birth. A client at her first visit to the prenatal clinic states that she has missed three menstrual periods and thinks that she is carrying twins because her abdomen is so large. She now has a brownish vaginal discharge. Her blood pressure is increased, indicating that she may have gestational hypertension. What condition does the nurse suspect the client may have? 1. Renal failure 2. Placenta previa 3.Hydatidiform mole 4. Abruptio placentae Correct 3. Hydatidiform mole A client in active labor has requested epidural anesthesia for pain management. The anesthetist has completed an evaluation, and the nurse has initiated an intravenous fluid bolus. The client's partner asks why this is necessary. What is the best explanation? 1. It is the policy of the institution to provide 2 bags of lactated Ringer solution. 2. There is a risk of hypotension, and the large amount of IV fluid reduces this risk. 3. Giving the large amount of IV fluid is a means of hydrating the client when she is unable to drink. 4. The client must be given 500 mL of fluid to ascertain that the line is patent. Correct 2. There is a risk of hypotension, and the large amount of IV fluid reduces this risk. A client who is in labor is admitted 30 hours after her membranes ruptured. Which condition is this client at increased risk for? 1. Cord prolapse 2. Placenta previa 3. Chorioamnionitis 4. Abruptio placentae Correct 3. Chorioamnionitis A mother is concerned that her newborn will be exposed to communicable diseases after she is discharged. While teaching the mother ways to decrease the risk of infection, what type of immunity should the nurse explain was transferred to her baby through the placenta? 1. Active natural 2. Passive natural 3. Active artificial 4. Passive artificial Correct 2. Passive natural Which of the following variables are scored on a biophysical profile? Select all that apply. 1.Fetal tone 2. Fetal position 3. Fetal movement 4. Amniotic fluid index 5. Fetal breathing movements 6. Contraction stress test results Correct 1.Fetal tone 3. Fetal movement 4. Amniotic fluid index 5. Fetal breathing movements Which information in a postpartum client's health history should alert the nurse to monitor the client for signs of infection? 1. Three spontaneous abortions 2. B-negative maternal blood type 3. Blood loss of 850 mL after a vaginal birth 4. Temperature of 99.9° F (37.7° C) during the first postpartum day Correct 3. Blood loss of 850 mL after a vaginal birth A client in the high-risk postpartum unit has had a precipitous labor and birth. Which maternal complication should the nurse anticipate? 1. Hypertension 2. Hypoglycemia 3. Chilling and shivering 4. Bleeding and infection Correct 4. Bleeding and infection The nurse is caring for a pregnant woman with class II cardiac disease. The client has anemia with a hemoglobin level of 8 g/dL (80 mmol/L). What is the nurse's primary concern for this client? 1. Impending heart failure 2. Development of heart block 3. Appearance of atrial fibrillation 4. Imminent ventricular fibrillation Correct 1. Impending heart failure What is the focus of nursing care for a newborn with respiratory distress syndrome (RDS)? 1. Tapping the toes to stimulate respirations 2. Turning the infant frequently to prevent apnea 3. Maintaining oxygen concentration at 40% to support respiration 4. Keeping the infant warm to maintain body temperature at 98° F (37° C) Correct 4. Keeping the infant warm to maintain body temperature at 98° F (37° C) Laboratory studies reveal that a pregnant client's blood type is O, and she is Rh positive. The client asks whether her newborn will have a problem with blood incompatibility. Before responding, the nurse must remember that fetal problems may develop in what circumstance? 1. The fetus has type A or B blood. 2. The fetus is born preterm. 3. The fetus has type O, Rh positive blood. 4. The mother has diabetes. Correct 1. The fetus has type A or B blood. The nurse notes that a client is voiding frequently in small amounts 8 hours after giving birth. What should the nurse conclude about this minimal output of urine during the early postpartum period? 1. It may indicate retention of urine with overflow. 2. It may be indicative of beginning pyelonephritis. 3. This is common because less fluid is excreted after birth. 4. This is common because fluid intake diminishes after birth. Correct 1. It may indicate retention of urine with overflow During labor a client begins to experience dizziness and tingling of her hands. What should the nurse instruct the client to do? 1. Breathe into her cupped hands 2. Pant during the next three contractions 3. Hold her breath with the next contraction 4. Use a fast, deep, or shallow breathing pattern Correct 1. Breathe into her cupped hands The nurse is assigned to care for an adolescent who gave birth 12 hours ago. The client continually talks on the phone to her friends and does not respond when her new baby cries. What is the priority intervention at this time? 1. Calling social service for a consult 2. Calling the psychiatric team for an intervention 3. Calling her mother and having her speak with the client 4. Modeling appropriate behaviors that encourage infant bonding Correct 4. Modeling appropriate behaviors that encourage infant bonding A female client asks a nurse about using an intrauterine device (IUD) for contraception. When explaining this method, what common problem should the nurse include in the discussion? 1. The device can be expelled. 2. The uterus may be perforated. 3. Discomfort during intercourse may occur. 4. Vaginal infections are frequent consequences. Correct 1. The device can be expelled. A new mother who has begun breastfeeding asks for assistance removing the baby from her breast. Which instruction is most appropriate for the nurse to provide? 1. "Pinch the baby's nostrils gently to help release the nipple." 2. "Let the baby nurse as long as desired without interruption." 3. "Pull your nipple out of the baby's mouth when the baby falls asleep." 4. "Insert your finger in the corner of the baby's mouth to break the suction." Correct 4. "Insert your finger in the corner of the baby's mouth to break the suction." A new mother who is learning about infant feedings asks the nurse how anyone who is breast-feeding gets anything done with a baby feeding on demand. What is the best response by the nurse? 1. "Most mothers find that feeding whenever the baby cries works out fine." 2. "Perhaps a schedule would be better because the baby is already accustomed to the hospital routine." 3. "Babies on demand feedings eventually set a schedule, so there should be time for you to do other things." 4. "Most breast-feeding mothers find that their babies do better on demand because the amount of milk ingested varies from feeding to feeding." Correct 3. "Babies on demand feedings eventually set a schedule, so there should be time for you to do other things." The most appropriate method for a nurse to evaluate the effects of the maternal blood glucose level in the infant of a diabetic mother is by performing a heel stick blood test on the newborn. What specifically does this test determine? 1. Blood acidity 2. Glucose tolerance 3. Serum glucose level 4. Glycosylated hemoglobin level Correct 3. Serum glucose level A new mother asks the nurse administering erythromycin ophthalmic ointment to her newborn why her baby must be subjected to this procedure. What is the best response by the nurse? 1. "It will keep your baby from going blind." 2. "This ointment will protect your baby from bright lights." 3. "There is a law that newborns must be given this medicine." 4. "This antibiotic helps keep babies from contracting eye infections." Correct 4. "This antibiotic helps keep babies from contracting eye infections." Which nursing intervention holds the highest priority for a client with class I heart disease during the postpartum period? 1. Promoting early ambulation 2. Watching for signs of cardiac decompensation 3. Assessing the mother's emotional reaction to the birth 4. Instructing the mother about activity levels during the postpartum period Correct 2. Watching for signs of cardiac decompensation On her first visit to the prenatal clinic, a client with rheumatic heart disease asks the nurse whether she has any special nutritional needs. What supplements in addition to the regular pregnancy diet and prenatal vitamin and minerals will she need? Select all that apply. 1. Iron 2. Calcium 3. Folic acid 4. Vitamin C 5. Vitamin B12 Correct 1. Iron 3. Folic acid