Exam (elaborations)

OB nclex Exam #2 top questions with accurate answers, 100% Accurate, graded A+

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OB nclex

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OB Nclex

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Uploaded on February 4, 2023
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ob nclex exam 2 top questions with accurate answers
100 accurate
graded a the is assisting a patient who just delivered a healthy baby boy weighing 7 pounds upon cord traction of placenta

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OB nclex Exam #2 top questions with
accurate answers, 100% Accurate,
graded A+

The is assisting a patient who just delivered a healthy baby boy weighing 7 pounds. Upon cord traction
of placenta, she notices a sudden gushing of a large amount of blood and the fundus is no longer
palpable in the abdomen. What are useful nursing interventions if uterine inversion is suspected?

1. Administering oxytocic

2. Assess vital signs

3. Discontinue uterotonic drugs

4. Do not attempt to remove the placenta

5. Establish IV access and fluids - ✔✔2. Assess vital signs

3. Discontinue uterotonic drugs

4. Do not attempt to remove the placenta

5. Establish IV access and fluids

Rationale: Never attempt to remove the placenta if it is still attached, because this will only create a
larger surface area for bleeding. When an inversion occurs a large amount of blood suddenly gushes
from the vagina. The fundus is not palpable in the abdomen. If the loss of blood continues unchecked,
the woman will immediately show signs of blood loss. Uterine inversion may occur after the birth if
traction is applied to the umbilical cord too soon or if the pressure is applied to the uterine fundus when
the uterus is not contracted. Administering an oxytocic drug only compounds the inversion. Uterotonic
drugs should be discontinued to allow uterine relaxation for replacement. IV fluids should be
commenced to support blood pressure.

A nurse is reviewing her assignments. Which patient should she assess first?

1. A 12-hour infant who is small for gestational age.

2. Four hour infant with a cardiac defect.

3. 9 hour old infant who has not voided

4. 3 day old infant waiting for discharge - ✔✔2. Four hour infant with a cardiac defect

, Rationale: The infant with a cardiac defect is at the most risk for complications and should be assessed
first.

At 32 weeks' gestation a 15-year-old primigravid client who is 5'2", has gained 20 lbs, with a 1 lb weight
gain in the last 2 weeks. Urinalysis reveals negative glucose and a trace of protein. The nurse should
advise the client that which of the following factors increases her risk for preeclampsia?

1. Total weight gain

2. Short stature

3. Adolescent age group

4. Proteinuria - ✔✔3. Adolescent age group

Rationale: Client's with increased risk for preeclampsia include primigravid clients younger than 20 years
or older than 40 years, clients with 5 or more pregnancies, women of color, women with multifetal
pregnancies, women with diabetes or heart issues. A total weight gain of 20 lbs in the at 32 weeks
gestation with a 1 lb weight gain in the last 2 weeks is within normal limits. Trace amounts of protein in
the urine is common during pregnancy but amounts of +1 or more may be pregnancy induced
hypertension.

A patient has meconium-stained amniotic fluid. Fetal scalp sampling indicates a blood pH of 7.12 and
fetal bradycardia is present. Based on these findings, the nurse should take which action?

1. Administer amnioinfusion.

2. Prepare for cesarean section.

3. Reposition the patient.

4. Start IV as prescribed. - ✔✔2. Prepare for cesarean section.

Rationale: Infants with meconium-stained amniotic fluid may have respiratory difficulties and
bradycardia at birth. Based on this assessment, fetal metabolic acidosis is present. These findings pose a
great threat to the newborn's well-being. A cesarean section is required. Amnioinfusion is an infusion of
sterile isotonic solution into the uterine cavity during labor to reduce umbilical cord compression. This is
also done to dilute meconium in the amniotic fluid, reducing the risk that the infant will aspirate thick
meconium at birth. The procedure is not sufficient in this scenario neither is the IV.

What is premature rupture of membranes? - ✔✔Premature rupture of the membranes is spontaneous
rupture of the amniotic membrane before the onset of labor. When the rupture of membranes is before
term infection becomes a risk.

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