1. The nurse has received a report regarding a client in labor. The woman's last vaginal examination was recorded as 3 cm, 30%, and -2. What is the nurse's interpretation of this assessment? a. 3 cm dilated, 30?faced, and 2 cm above ischial spine 2. While evaluating an external monitor tracing of a woman in active labor, the nurse notes an episodes of early decelerations with normal FHR baseline and moderate variability. What is the nurse's first priority at this time? a. Change the womans position 3. A mother at 41 weeks and 2 days is having mild contractions lasting 30-60 seconds in duration and occurring every 8-9 minutes. The fetal heart rate and variability is reassuring. Her last cervical exam 2-3 hours ago was 6/80%/-2 and her current exam has not changed. She was admitted to LD for spontaneous rupture of membranes at home 8 hours ago and began contracting naturally a couple hours after rupture. What is the most likely anticipated doctor's order for this patient at this time? a. Augmentation of labor with Pitocin 4. What is the most critical physiologic change required of the newborn immediately after birth? a. Starting and maintaining respirations 5. A woman's obstetric history indicates that she is pregnant for the fourth time, and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and TPAL (term, preterm, abortions, living) a. GTPAL = 4-1-2-0-4 6. You are assessing a woman in the first two hours following an emergency cesarean delivery of a 9lb 8oz infant. She has severe preeclampsia and experienced a placental abruption during labor and her vital signs are now 100.7-90-18-150/98. You would monitor the mother closely for all of the following conditions except: a. Post natal mitral valve prolapse 7. What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant? a. IUGR 8. Which statement regarding gestation diabetes is correct? a. Is defined as glucose intolerance originating during pregnancy b. In some cases, women with gestational diabetes require insulin injections. 9. An infant is born with diaphragmatic hernia. Which of the following assessment findings would be expected of an infant born with this condition? a. Sunken abdomen, tachypnea 10. You are a new NICU RN caring for a 30 week gestation newborn. All of the following are important nursing care goals when caring for pre-term infants except which of the following? a. Tactile stimulation and auditory stimulation 11. In caring for the woman with DIC, which order should the nurse anticipate? This study source was downloaded by 100000835004878 from CourseHero.com on 10-18-2022 11:00:07 GMT -05:00 https://www.coursehero.com/file/97377845/OB-Final-Updateddocx/ a. Administration of blood b. Preparation of the client for invasive hemodynamic monitoring c. Restriction of intravascular fluids d. Administration of steroids 12. An 18-year-old client who has reached 21 weeks of gestation was recently diagnosed with pregestational diabetes. She attends her appointment accompanied by one of her girlfriends. This young woman appears more concerned about how her pregnancy will affect her social life than her recent diagnosis of diabetes. A number of nursing diagnoses are applicable to assist in planning adequate care. What is the most appropriate diagnosis at this time? a. Knowledge deficit related to maternal gestational diabetes 13. A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents? a. Helps keep the alveoli open to promote exchange of oxygen and carbon dioxide 14. A premature infant never seems to sleep longer than an hour at a time. Each time a light is turned on, an incubator closes, or people talk near her crib, she wakes up and inconsolably cries until held. What is the correct nursing diagnosis beginning with "ineffective coping, related to"? a. Environmental stress 15. A pregnant woman arrives at the birth unit in labor at term, having had no prenatal care. After birth, her infant is noted to be small for gestational age with small eye openings, flat nasal bridge, and a thin upper lip. The infant is also microcephalic. Based on her infant's physical findings, this woman should be questioned about her use of which substance during pregnancy? a. Alcohol 16. A woman who is 6 months pregnant has sought medical attention stating she fell down the stairs. What scenario would cause an emergency department nurse to suspect that the woman has been a victim of intimate partner violence (IPV)? a. The woman has injuries on various parts of her body that are in different stages of healing 17. A newborn has been diagnosed with physiologic jaundice and is receiving phototherapy. A priority nursing intervention when caring for an infant undergoing phototherapy is which of the following? a. Ensuring adequate milk or formula intake 18. A perinatal nurse is caring for a woman in the immediate post birth period. The birth was non problematic with no vaginal/perineal injuries. Assessment reveals that the client is experiencing heavy bleeding saturating a pad in 15-20 minutes. After massaging the fundus to a firm state, what is the next priority intervention? a. Check vitals, continuing monitoring, call for assistance, and check bladder status 19. What is a common reason for late postpartum hemorrhage (PPH)? - subinvolution of the uterus , retained placental fragments, and pelvic infection. (delayed return of the enlarged uterus to nonpregnant size and function) This study source was downloaded by 100000835004878 from CourseHero.com on 10-18-2022 11:00:07 GMT -05:00 https://www.coursehero.com/file/97377845/OB-Final-Updateddocx/ 20. The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt? a. Strict aseptic technique, including hand washing by all health care personnel 21. What would a steady trick of blood from the vagina in the presence of a firm fundus suggest to the nurse? a. Lacerations of the gential tract 22. You are assessing a newly born term infant who is 23 hours old. The vital signs are as follows: T(98.0F), HR (152), and RR (48). The hands and feet of the infant are cyanotic with no other signs of distress. As the nursery nurse you know that which of the following is true? a. Normal finding and requires routine monitoring 23. 32- year old G1P0 mother is admitted to LD with a diagnosis of preeclampsia. She is complaining of headache and blurred vision. Which of the follow is true regarding the pathophysiology of preeclampsia? - poor perfusion, CNS irritability manifests as headaches, Arteriolar vasospasms and decreased blood flow to the retina can lead to visual disturbances/blurred vision.