Exam 3 test bank - practice questions PDF

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A nurse providing care for a woman with preterm labor on terbutaline includes which intervention to identify side effects of the drug? a . Assess deep tendon reflexes (DTRs). b .

Assess for dyspnea and crackles.

c .

Assess for bradycardia.

d .

Assess for hypoglycemia.

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, which finding alerts the nurse to possible side effects? a . Urine output of 160 ml in 4 hours b .

Deep tendon reflexes 2+ and no clonus

c .

Respiratory rate (RR) of 16 breaths/min

d .

Serum magnesium level of 10 mg/dl

A woman in preterm labor at 30 weeks of gestation receives two 12mg doses of betamethasone intramuscularly. The purpose of this pharmacologic treatment is to: a . Stimulate fetal surfactant production b .

Reduce maternal and fetal tachycardia associated with ritodrine administration

c .

Suppress uterine contractions

d .

Maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy

A primigravida at 40 weeks of gestation is having uterine contractions every 1 to 2 minutes and says that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this womans labor? a . She is exhibiting hypotonic uterine dysfunction. b .

She is experiencing a normal latent stage.

c .

She is exhibiting hypertonic uterine dysfunction.

d .

She is experiencing pelvic dystocia.

Obese women are at risk for several complications during pregnancy and birth. These include all except: a . Thromboembolism b .

Cesarean birth

c .

Wound infection

d .

Breech presentation

In evaluating the effectiveness of an oxytocin induction, the nurse expects: a . Contractions lasting 40 to 90 seconds, 2 to 3 minutes apart b .

The intensity of contractions to be at least 110 to 130 mm Hg

c .

Labor to progress at least 2 cm/hr dilation

d .

At least 30 milliunits/min of oxytocin are needed to achieve cervical dilation

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation. The nurse recognizes that this medication is administered to: a . Enhance uteroplacental perfusion in an aging placenta b .

Increase amniotic fluid volume

c .

Ripen the cervix in preparation for labor induction

d .

Stimulate the amniotic membranes to rupture

A client is to have an amniotomy to induce labor. The nurse recognizes that the priority intervention after the amniotomy is to: a . Apply clean linens under the woman b .

Take the clients vital signs

c .

Perform a vaginal examination

d .

Assess the fetal heart rate (FHR)

Which statement related to cephalopelvic disproportion (CPD) is the least accurate? a . CPD can be related to either fetal size or fetal position. b .

The fetus cannot be born vaginally.

c .

CPD can be accurately predicted.

d .

The cause may be of maternal or fetal origin.

Complications and risks associated with cesarean births include (choose all that apply):

a .

Pulmonary edema

b .

Wound dehiscence

c .

Hemorrhage

d .

Urinary tract infections

e .

Fetal injuries

The nurse is teaching a client with PPROM about self-care activities. Which activities should the nurse include in her teaching? Choose all that apply. a . Report a temperature higher than 40 C. b .

It is safe to use a tampon to absorb the leaking amniotic fluid.

c .

Do not engage in sexual activity.

d .

It is safe to take frequent tub baths.

e .

It is acceptable to douche to cleanse the vagina of foul-smelling fluids.

A perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is: a . Uterine atony b .

Uterine inversion

c .

Vaginal hematoma

d .

Vaginal laceration

A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to: a . Establish venous access b .

Perform fundal massage

c .

Prepare the woman for surgical intervention

d .

Catheterize the bladder

A perinatal nurse caring for a postpartum woman understands that late postpartum hemorrhage (PPH) is most likely caused by: a . Subinvolution of the uterus b .

Defective vascularity of the decidua

c .

Cervical lacerations

d .

Coagulation disorders

Which client is at greatest risk for early postpartum hemorrhage (PPH)? A primiparous woman (G 2, P 1-0-0-1) being prepared for an emergency a . cesarean birth for fetal distress b .

A woman with severe preeclampsia on magnesium sulfate whose labor being induced

c .

A multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor

d .

A primigravida in spontaneous labor with preterm twins

The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:

a .

Washing the nipples and breasts with mild soap and water once a day

b .

Using proper breastfeeding techniques

c .

Wearing a nipple shield for the first few days of breastfeeding

d .

Wearing a supportive bra 24 hours a day

Lacerations of the cervix, vagina, or perineum are also causes of PPH. Factors that influence the causes and incidence of obstetric lacerations of the lower genital tract include all except: a . Operative or precipitate birth b .

Adherent retained placenta

c .

Abnormal presentation of the fetus

d .

Congenital abnormalities of the maternal soft parts

It is important for the perinatal nurse to be knowledgeable regarding conditions of abnormal adherence of the placenta. This occurs when the zygote implants in an area of defective endometrium and results in little to no zone separation between the placenta and decidua. Which classification of separation is not recognized as an abnormal adherence pattern? a . Placenta accreta b .

Placenta increta

c .

Placenta percreta

d .

Placenta abruptio

Medications used to manage postpartum hemorrhage (PPH) include (choose all that apply): a . Oxytocin b .

Methergine

c .

Terbutaline

d .

Hemabate

e .

Magnesium sulfate

____________________ is the most common postpartum infection. ANS: Endometritis A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization, the infant is weighed, and the birth weight is 4550 g (9 lb, 6 oz). The nurses most appropriate action is to: a . Leave the infant in the room with the mother b .

Take the infant immediately to the nursery

c .

Perform a gestational age assessment to determine whether the infant large for gestational age

d .

Monitor blood glucose levels frequently and observe closely for signs of hypoglycemia

Infants of mothers with diabetes are at higher risk for developing: a . Anemia b .

Hyponatremia

c .

Respiratory distress syndrome

d

Sepsis

. A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. The fetal heart rate before birth is 180 beats/min with limited variability. At birth the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic. Based on the maternal history, the cause of this newborns distress is most likely: a . Hypoglycemia b .

Phrenic nerve injury

c .

Respiratory distress syndrome

d .

Sepsis

The most important nursing action in preventing neonatal infection is: a . Good handwashing b .

Isolation of infected infants

c .

Separate gown technique

d .

Standard Precautions

A pregnant woman presents in labor at term, having had no prenatal care. After birth her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. Based on her infants physical findings, this woman should be questioned about her use of which substance during pregnancy? a . Alcohol

b .

Cocaine

c .

Heroin

d .

Marijuana

A plan of care for an infant experiencing symptoms of drug withdrawal should include: a . Administering chloral hydrate for sedation b .

Feeding every 4 to 6 hours to allow extra rest

c .

Swaddling the infant snugly and holding the baby tightly

d .

Playing soft music during feeding

Human immunodeficiency virus (HIV) may be perinatally transmitted: a . Only in the third trimester from the maternal circulation b .

From the use of unsterile instruments

c .

Only through the ingestion of amniotic fluid

d .

Through the ingestion of breast milk from an infected mother

The abuse of which substance during pregnancy is a significant cause of mental retardation in the United States? a . Alcohol b .

Tobacco

c

Marijuana

. d .

Heroin...