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    Exam Review

    1. When the mother's membranes rupture during active labor, the fetal heart rate should be observed for the occurrence of which periodic pattern?
      A)Increase in baseline variability.
      B)Non-periodic accelerations.
      C)Early decelerations.
      D)Variable decelerations.
    2. On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes.What is the nurse's highest priority?
      A)Assessing the woman's vital signs.
      B)Calling the woman's primary health care provider.
      C)Massaging the woman's fundus.
      D)Beginning an intravenous (IV) infusion of Ringer's lactate solution.
    3. The nurse assessing a postpartum client's fundus finds it firm, 2 centimeters above the umbilicus and displaced to the right.What is the most appropriate nursing intervention at this time?
      A)Have the client void and reassess the fundus.
      B)Start a pad count.
      C)Massage the fundus until firm.
      D)Notify the healthcare provider.
    4. A multigravida client at 31 weeks gestation is admitted with confirmed pre-term labor.As the nurse continues to monitor the client now receiving magnesium sulfate, which assessment findings will the nurse prioritize and report immediately to the RN or health care provider?
      A)Pain in the abdomen, shoulder, or back.
      B)Respiratory depression, hypotension, absent tendon reflexes.
      C)Severe lower back pain, leg cramps, sweating.
      D)Low potassium or elevated glucose, tachycardia, chest pain.
    Page 1 of 10

    Exam Review

    1. A nurse is caring for a client who is 1 hour postpartum following a vaginal birth.The client has saturated a perineal pad within 10 minutes.Which of the following actions should the nurse take first?
      A)Prepare to administer a prescribed oxytocic preparation.
      B)Assess the client's blood pressure.
      C)Assess the bladder for distention.
      D)Massage the client's fundus.
    2. The nurse is managing care of a primigravida at full term who is in the active phase of labor.What should be included in developing the plan of care for this client?
      A)Supine positioning on back if it is comfortable.
      B)Anesthesia/pain level assessment every 30 minutes.
      C)Vaginal bleeding and fundus of the uterus after delivery of the placenta.
      D)Oxygen saturation monitoring every half hour.
    3. What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern?
      A)Spontaneous rupture of membranes.
      B)Fetal head compression.
      C)Umbilical cord compression.
      D)Utero-placental insufficiency.
    4. The clinic nurse is caring for a client at 31 weeks gestation who is scheduled for induction of labor at 42 weeks gestation.Which teaching is a priority for this client?
      A)Methods of labor induction.
      B)Benefits of breastfeeding.
      C)Signs of labor.
      D)Monitoring of fetal movement.
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    Exam Review

    1. The obstetric nurse is preparing the client for an emergency cesarean birth, with no time to administer spinal anesthesia; general anesthesia will be used.What is the greatest risk of administering general anesthesia to the client during postpartum?
      A)Risk for newborn infection.
      B)Risk for DVT.
      C)Postpartum bleeding.
      D)Risk for infection.
    2. A nurse on a labor unit is admitting a client who reports painful contractions.The nurse determines that the contractions have a duration of 1 minute and a frequency of 3 minutes.The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min, and maternal blood pressure 82/54 mm Hg. Which of the following is the priority action for the nurse to take?
      A)Ask the client if she needs pain medication.
      B)Position the client with one hip elevated.
      C)Have the client void.
      D)Notify the provider of the findings.
    3. A nurse is caring for a client who is postpartum and received methylergonovine.Which of the following findings indicates that the medication was effective?
      A)Increase in blood pressure.
      B)Report of absent breast pain.
      C)Increase in lochia.
      D)Fundus firm to palpation.
    4. A nurse is preparing to assess the uterine fundus of a client in the immediate postpartum period.When the nurse locates the fundus, she notes that the uterus feels soft and boggy at midline.Which of the following nursing interventions would be most appropriate initially?
      A)Elevate the mother's legs.
      B)Massage the fundus until it is firm.
      C)Encourage the mother to void.
      D)Push on the uterus to assist in expressing clots.
    Page 3 of 10

    Exam Review

    1. The nurse is assessing the lochia on a 1-day postpartum patient.The nurse notes that the lochia is red and has a foul-smelling odor.The nurse determines that this assessment finding:
      A)Indicates the need for increasing ambulation.
      B)Indicates the need for increasing oral fluids.
      C)Indicates the presence of infection.
      D)Is normal.
    2. A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not.”. Which of the following should the nurse recognize as a sign of true labor?
      A)Changes in the cervix.
      B)Station of the presenting part.
      C)Rupture of the membranes.
      D)Pattern of contractions.
    3. A nurse is caring for a client who is 5 hours postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz (4252 g). The nurse should recognize that this client is at risk for which of the following postpartum complications?
      A)Puerperal infection.
      B)Retained placental fragments.
      C)Thrombophlebitis.
      D)Uterine atony.
    4. A nurse is performing a nonstress test (NST) on a client who is at 36 weeks of gestation and asks "what are you looking for during this test?" Which of the following responses should the nurse make?
      A)"We are looking for increases in fetal heart rate of 15 beats per minute for at least 15 seconds.
      B)"We will draw blood to evaluate the baby's risk of genetic problems.”.
      C)"If the baby moves 5 times in 15 minutes, then the baby is healthy.”.
      D)"I am looking at the ultrasound to see if the baby has any congenital anomalies.”.
    Page 4 of 10

    Exam Review

    1. In which clinical situation would the nurse most likely anticipate a fetal bradycardia?
      A)Drug consumed by the mother like cocaine.
      B)Prolonged umbilical cord compression.
      C)Fetal anemia.
      D)Tocolytic treatment using terbutaline.
    2. A nurse is caring for a 37-year-old G3P2 client who is at 14 weeks of gestation. The client asks, "why are you taking my blood pressure? It's always been normal.”. Which of the following responses should the nurse make?
      A)"Because blood pressure often increases early in the second trimester of pregnancy.”.
      B)"You are at an increased risk for high blood pressure since you've had several pregnancies.”.
      C)"Your age is a risk factor for developing high blood pressure during pregnancy.”.
      D)"No need to worry about that, let's talk about how you're feeling.”.
    3. Which of the following are common methods used for the induction of labor in obstetric practice? (Select All that Apply)(SATA)
      A)Epidural anesthesia.
      B)Prostaglandin administration.
      C)Bed rest.
      D)Vitamin supplementation.
      E)Fetal ultrasound.
      F)Amniotomy.
      G)Oxytocin administration.
    4. The labor and delivery nurse caring for a client at 39 weeks gestation notes that the fetal heart tone is heard most loudly and clearly when auscultated in the upper right abdominal quadrant above the umbilicus.What is the nurse's best interpretation of this finding?
      A)The fetus may be in a breech presentation.
      B)The fetus is likely in the left occiput anterior position.
      C)The fetus may have polyhydramnios.
      D)The fetus is likely in the right occiput posterior position.
    Page 5 of 10

    Exam Review

    1. A primigravida at 40 weeks of gestation is having erratic uterine contractions every 5 to 10 minutes and states 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 woman's 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 precipitous labor.
    2. A patient who is 36 weeks pregnant tells you she has been counting her baby's kicks and is concerned because within a 4-hour period the baby has only kicked 32 times.What nursing intervention is correct?
      A)Assess the patient's urine for protein and glucose.
      B)Prep the patient for an abdominal ultrasound.
      C)Reassure the patient this kick count is normal.
      D)Notify the MD of this finding.
    3. What is the priority nursing intervention for a patient experiencing umbilical cord prolapse during labor?
      A)Performing a cervical exam to assess dilation.
      B)Increasing the rate of intravenous fluids.
      C)Administering oxygen to the mother.
      D)Repositioning the mother to a knee-chest position.
    4. During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, "I don't know what's wrong.I love my son, but I feel so let down.I seem to cry for no reason!" Which condition might this new mother be experiencing?
      A)Postpartum blues.
      B)Postpartum depression (PPD).
      C)Postpartum delirium.
      D)Attachment difficulty.
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