A nurse is teaching a client about Rho(D) immunoglobulin (RhoGAM). Which of the

following statements by the client indicated an understanding of the teaching?

a. I will receive this medication if my baby is Rh-negative

b. I will receive this medication at time of delivery

c. I will need a second dose of this medication when my baby is 6 weeks old

d. I will need this medication if I have an amniocentesis- Recommended because of the

potential of fetal RBCs entering the maternal circulation

2. A nurse is caring for a client who is to receive oxytocin (Pitocin) to augment her labor. Which

of the following contraindicates the initiation of the oxytocin infusion and requires

notification of the provider?

a. Late decelerations- Oxytocin is contraindicated based on late decelerations noted on

fetal assessment findings because they indicate uteroplacental insufficiency.

b. Baseline variability

c. Cessation of uterine dilation

d. Prolonged active phase of labor

3. A nurse on the newborn unit is planning discharge for four clients. Which of the following

will require care beyond that of a standard follow-up visit with the provider after delivery?

a. A newborn being sent home after 22 hr after birth- Screening tests must be repeated

if they were performed before he newborn was 24 hr. old.

b. A newborn at 38 weeks of gestational age

c. A newborn who is bottle feeding

d. Twin newborns with Apgar scores of 8 and 9

4.

5. 01. A nurse on the postpartum unit is caring for a client following a cesarean birth. Which of

the following assessments is the nurse's priority?

6.

7. Amount of lochia

8. When using the airway, breathing, circulation approach to client care, the nurse should place

the priority in the immediate postpartum period on assessing the amount of postpartum

lochia.

9. The greatest risk to the client is bleeding and postpartum hemorrhage.

10.

11. 02. A nurse is caring for a client who is in labor and whose fetus is in the right occiput

posterior position. The client is dilated to 8 cm and reports back pain. Which of the following

actions should the nurse take?

12.

13. Apply sacral counterpressure

14. The nurse should apply sacral counterpressure to assist in relieving back labor pain related to

fetal posterior position.

15.

16. 03. A nurse is demonstrating to a client how to bathe her newborn. In which order should

the nurse perform the following actions? (Move the steps into the box on the right, placing

them in the selected order of performance. Use all the steps.)

17.

18. Wipe the newborn’s eyes from the inner canthus outward.

19. Wash the newborn’s neck by lifting the newborn’s chin.

20. Cleanse the skin around the newborn’s umbilical cord stump.

21. Wash the newborn’s legs and feet.

22. Clean the newborn’s diaper area.