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77 Cards in this Set
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A nurse is assessing a client who is at 35 weeks of gestation and is receiving magnesium sulfate via continuous IV infusion for severe pre-eclampsia. Which of the following findings should the nurse report to the provider? A) Deep Tendon Reflexes 2+ B) blood pressure 150/96 C) Urinary output 20ml/hr D) respiratory rate 16/min |
C) Urinary output 20ml/hr |
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A nurse is reviewing laboratory results for a client who is at 37 weeks of gestation. The nurse notes that the client is rubella non-immune, positive for group A beta-hemolytic streptococci, and who has a blood type of O negative. Which of the following actions should the nurse take? A) administer a dose of Rh(D) immune globulin B) request a prescription for an antibiotic until delivery C) instruct the client to obtain a rubella immunization after delivery D) inform the client that she will need to deliver via cesarean birth |
C) instruct the client to obtain a rubella immunization after delivery |
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A nurse is assessing a client who is at 34 weeks of gestation and has a mild placental abruption. Which of the following findings should the nurse expect? A) increased platelet count B) fetal distress C) decreased Urinary output D) dark red vaginal bleeding |
D) dark red vaginal bleeding |
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A nurse is teaching a client who is at 8 weeks of gestation and has a uterine fibroid about the potential effects of the fibroid during pregnancy. Which of the following information should the nurse include in the teaching? A) the fibroid will shrink during the pregnancy B) the fibroid can increase the risk for postpartum hemorrhage C) you will receive an injection of medroxyprogesterone acetate to shrink the fibroid D) you will have to undergo a cesarean birth because of the fibroid |
B) the fibroid can increase the risk for postpartum hemorrhage |
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A nurse is caring for a client who has oligohydramnios. Which of the following fetal anomalies should the nurse expect? A) atrial septal defect B) renal agenesis C) spina bifida D) hydrocephalus |
B) Renal agenesis |
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A nurse is teaching a client who has pre-eclampsia and is to receive magnesium sulfate via continuous IV infusion about expected adverse effects. Which of the following adverse effects should the nurse include in the teaching? A) elevated blood pressure B) feeling of warmth C) hyperactivity D) generalized pruritus |
B) feeling of warmth |
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A nurse is assessing a client who is at 35 weeks of gestation and has preeclampsia without severe features. Which of the following findings should the nurse identify as the priority? A) 480 ml urine output in 24hr B) blood pressure 144/92 C) +2 edema of the feet D) 1+ protein in the urine |
A) 480 ml urine output in 24 hr |
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A nurse is reviewing the medical record of a client who is at 39 weeks of gestation and has polyhydramnios. Which of the following findings should the nurse expect? A) fundal height of 34cm B) total pregnancy weight gain of 3.6 kg (8 lb) C) gestational hypertension D. Fetal gastrointestinal anomaly |
D) fetal gastrointestinal anomaly |
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A nurse is assessing a client who is at 37 weeks of gestation and has a suspected pelvic fracture due to blunt abdominal trauma. Which of the following findings should the nurse expect? A) bradycardia B) uterine contractions C) seizures D) bradypnea |
B) uterine contractions |
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A nurse is caring for a client who is at 32 weeks gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer? A) betamethasone B) misoprostol C) methylergonovine D) poractant alfa |
A) betamethasone |
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A nurse is caring for a client who is at 35 weeks of gestation and has severe preeclampsia. Which of the following assessments provides the most accurate information regarding the clients fluid and electrolyte status? A) blood pressure B) intake and output C) daily weight D) severity of edema |
C) daily weight |
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A nurse is reviewing the medical record of a client who is at 33 weeks of gestation and has placenta previa and bleeding. Which of the following prescriptions should the nurse clarify with the provider? A) perform a vaginal examination B) perform continuous external fetal monitoring C) insert a large bore IV catheter D) obtain a blood sample for laboratory testing |
A) perform a vaginal examination |
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A nurse is assessing a client who is at 12 weeks of gestation and has a hydatidiform mole. Which of the following findings should the nurse expect? A) hypothermia B) dark brown vaginal discharge C) decreased Urinary output D) fetal heart tones |
B) dark brown vaginal discharge |
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A nurse is admitting a client who is in labor and experiencing moderate bright red vaginal bleeding. Which of the following actions should the nurse take? A) perform a vaginal examination to determine cervical dilation B) obtain blood samples for baseline laboratory values C. Place a spiral electrode on the fetal presenting part D) prepare the client for a transvaginal ultrasound |
B) obtain blood samples for baseline laboratory values |
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The nurse is assessing a new client who is being admitted with gestational hypertension. Which nursing diagnosis should the nurse prioritize for this client? A) decrease reflexes due to medication administration B) imbalanced nutrition related to decreased sodium levels C) risk for injury related to fetal distress D) deficient fluid volume related to vasospasm of arteries |
D) deficient fluid volume related to vasospasm of arteries a client with severe |
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A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the clients safety, which compound would the nurse have readily available? A) calcium carbonate B) potassium chloride C) calcium gluconate D) ferrous sulfate |
C) calcium gluconate |
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Which medication will the nurse anticipate the health care provider will prescribe as treatment for an unruptured Ectopic pregnancy? A) promethazine B) methotrexate C) ondansetron D) oxytocin |
B) methotrexate |
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Current research indicates that supplementation with what before pregnancy may reduce the risk of placental abruption? A) folic acid B) calcium C) iron D) vitamin C |
A) folic acid |
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A nurse administers betamethasone to a client who is at 33 weeks gestation to stimulate fetal lung maturity. When planning care for the newborn, which of the following conditions should the nurse identify as an adverse effect of this medication? A) hyperthermia B) decreased blood glucose C) rapid pulse rate D) irritability |
B) decreased blood glucose |
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A nurse is caring for a client who is 2 hours postpartum. The nurse notes the clients perineal pad has a large amount of lochia rubra with several clots. Which of the following actions should the nurse perform first? A) check for a full bladder B) massage the Fundus C) measure vital signs D) administer carboprost IM |
B) massage the Fundus |
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A nurse is caring for a client who is in labor and is receiving an infusion of oxytocin. The nurse should monitor the client for which of the following potential adverse effects? A) diarrhea B) thromboembolism C) fetal asphyxia D) Oliguria |
C) fetal asphyxia |
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A nurse is teaching a client who is in labor about the use of nitrous oxide analgesia for pain control. Which of the following statements by the client indicates an understanding of the teaching? A) nitrous oxide could make my baby sleepy when he is born B) I should inhale the nitrous oxide between contractions C) I will feel the effects of the nitrous oxide almost immediately D) nitrous oxide can make me feel disoriented |
C) I will feel the effects of the nitrous oxide almost immediately |
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A nurse is assessing a client at 27 weeks of gestation. The client has placenta previa and reports vaginal bleeding. Which of the following additional manifestations should the nurse expect? A) the fundal height measures greater than gestational age B) a rigid abdomen is noted on palpation C) the client reports a pain level of 8 on a 0 to 10 pain scale D) a urine drug screen is positive for cocaine |
A) the fundal height measures greater than gestational age |
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A nurse is caring for a client who has a soft uterus and increased lochial flow. Which of the following medications should the nurse plan to administer to promote uterine contractions? A) terbutaline B) nifedipine C) magnesium sulfate D) methylergonovine |
D) methylergonovine |
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A postpartum nurse is caring for a client who has developed hemorrhagic shock. Which of the following manifestations should the nurse expect? A) Urinary output of 40ml/hr B) deep abdominal breathing C) weak and irregular pulse D) warm, dry hands with prompt capillary refill |
C) weak and irregular pulse |
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A nurse is assessing a postpartum client who has preeclampsia and notes a boggy uterus and excessive uterine bleeding. The nurse should plan to administer which of the following medications? A) terbutaline B) magnesium sulfate C) oxytocin D) methylergonovine |
C) oxytocin |
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A nurse is assessing a client at 34 weeks gestation who has a mild placental abruption. Which of the following findings should the nurse expect? A) Increased platelet count B) fetal distress C) decreased Urinary output D) dark red vaginal bleeding |
D) dark red vaginal bleeding |
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A nurse is caring for a client in the early stage of labor who has preeclampsia with severe features. Which of the following interventions should the nurse perform? A) assess the fetal heart rate and contractions hourly B) encourage oral intake of clear, low sodium fluids C) instruct the client to ambulate during the early phase of labor D. Implement seizure precautions |
D) implement seizure precautions |
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A nurse is reviewing the medical record of a client at 33 weeks gestation who has placenta previa and bleeding. Which of the following prescriptions should the nurse clarify with the provider? A) perform a vaginal examination B) perform continuous external fetal monitoring C. Insert a large bore IV catheter D) obtain a blood sample for laboratory testing |
A) perform a vaginal examination |
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A nurse is assessing a client who has placenta previa. Which of the following findings should the nurse expect? A) painless, bright red bleeding B) board like uterus C) persistent uterine contractions D) abdominal pain |
A) painless, bright red bleeding |
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A nurse is assessing a client who is at 26 weeks of gestation and has mild preeclampsia. Which of the following findings should the nurse report to the provider? A) platelet count 96,000/mm3 B) deep tendon reflexes 4+ C) urine protein 1+ D) Bun 22 mg/dl |
B) deep tendon reflexes 4+ |
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A nurse is caring for a client who is in active labor and receiving an oxytocin infusion. The nurse notes tachysystole with a category 1 fetal heart rate tracing. Which of the following actions should the nurse take? A) discontinue oxytocin infusion and apply oxygen B) increase oxytocin infusion rate by 2mg/min C) administer terbutaline 0.25 mg subcutaneously D) reposition the client in a side lying position and continue to monitor |
D) reposition the client in a side lying position and continue to monitor |
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A nurse is caring for a client who has clinical manifestations of an ectopic pregnancy. Which of the following findings is a risk factor for an ectopic pregnancy? A) anemia B) frequent Urinary tract infections C) previous cesarean birth D) pelvic inflammatory disease (PID) |
D) Pelvic inflammatory disease (PID) |
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A nurse is caring for a client who is experiencing preterm labor. Which of the following medications should the nurse anticipate administering to enhance fetal lung maturation? A) betamethasone B) nifedipine C) indomethacin D) verapamil |
A) betamethasone |
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A nurse is assessing a client who is in the first stage of labor and has preeclampsia. Which of the following findings should the nurse expect? A) severe hypotension B) proteinuria C) elevated platelet count D) seizures |
B) proteinuria |
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A nurse is preparing to administer an IV infusion of oxytocin for labor induction to a client who is at 41 weeks of gestation. Which of the following actions should the nurse plan to take? A) administer the oxytocin with manual IV tubing B) monitor the fetal heart rate every 15 minutes initially C) begin the infusion at 10 milliunits/min D) titration the dosage until the client has 1 contraction every minute |
B) monitor the fetal heart rate every 15 minutes initially |
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A nurse is assessing a postpartum client and observes a steady trickle of bright red blood from the clients vagina. The uterus is palpated as firm, midline, and located 1cm below the umbilicus. Which of the following actions should the nurse take? A) massage the Fundus B) instruct the client to empty her bladder C) notify the provider D) teach the client to perform a site bath |
C) notify the provider |
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A nurse is caring for a client at 34 weeks gestation who presents with vaginal bleeding. Which of the following assessments will indicate whether the bleeding is caused by placenta previa or an abruptio placenta? A) uterine tone B) fetal heart rate C) blood pressure D) amount of bleeding |
A) uterine tone |
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A nurse is caring for a newborn whose mother received magnesium sulfate to treat preterm labor. Which of the following clinical manifestations in the newborn indicates toxicity due to the magnesium sulfate therapy? A) respiratory depression B) hypothermia C) hypoglycemia D) jaundice |
A) respiratory depression |
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A nurse is reviewing the laboratory values of a client who is pregnant and has a low progesterone level. Which of the following complications should the nurse expect? A) gestational diabetes B) preterm labor C) inadequate milk supply D) inadequate uterine growth |
B) preterm labor |
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A nurse is providing discharge teaching to a client following the removal of a hydatidiform mole. Which of the following statements should the nurse include in the teaching? A) do not become pregnant for at least one year B) seek genetic counseling for yourself and your partner prior to getting pregnant again C) you should have an hCG level drawn in 6 weeks D) have your blood pressure checked weekly for the next month |
A) do not become pregnant for at least one year |
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A nurse is caring for a client who is at 34 weeks gestation and has a prescription for terbutaline for preterm labor. Which of the following statements by the client is the priority? A) my ankles are swollen at the end of the day B) I can feel the baby kicking my ribs, and it is very uncomfortable C) I’m growing more and more worried everyday D) my heart feels like is racing |
D) my heart feels like it is racing |
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A nurse is teaching a client with preeclampsia who is scheduled to receive magnesium sulfate via continuous IV infusion about expected adverse effects. Which of the following adverse effects should the nurse include in the teaching? A) elevated blood pressure B) feeling of warmth C) hyperactivity D) generalized pruritus |
B) feeling of warmth |
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A nurse is caring for a client who has eclampsia and just had a tonic clonic seizure. After turning the clients head to the side, which of the following actions should the nurse take next? A) administer magnesium sulfate 4 g IV bolus B) insert an indwelling Urinary catheter C) give oxygen at 10 l/min via face mask D. Keep the environment quiet and the lights dimmed |
C) give oxygen at 10 L/min via face mask |
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What is the cause of abruptio placentae? A) failed vaginal delivery B) premature separation of placenta C) history of vaginal birth D) boggy uterus E) dark red/brown vaginal bleeding F) premature rupture of membranes |
B) premature separation of placenta |
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During your assessment of a patient with abruptio placenta, which of the following is a typical sign or symptom? A) dilated and tortuous veins B) contractions C) no fetal heartbeat, no cervical dilation, no bleeding D) no cervical dilation and minimal bleeding E) bleeding and cervical dilation with loss of some products of conception |
B) contractions |
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Which of the following is most likely indicated in patients with abruptio placenta? A) cryotherapy B) epidurals C) c-section delivery D) prepare for vaginal delivery E) blood transfusions F) exchange transfusion |
D) prepare for vaginal delivery |
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What must you consider when encountering a patient with abruptio placenta? A) monitor for hypothermia B) septic shock C) increased risks for neonate D) monitor for increased ICP E) monitor for fluid intake F) monitor for arrhythmias |
C) increased risks for neonate |
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During your assessment of a patient with abruptio placenta which of the following is a typical sign or symptom? A) bimanual compression of uterus B) failed vaginal delivery C) no vaginal bleeding D) uterine polyps inside uterus E) a decrease of endometrial tissue inside the uterus F) tearing pain |
F) tearing pain |
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What must you consider when encountering a patient with abruptio placenta? A) septic shock B) toxic shock syndrome C) increased risk for shock D) invasive hemodynamic monitoring E) blood glucose monitor F) EEG monitor |
C) increased risk for shock |
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What must you consider when encountering a patient with abruptio placenta? A) monitor for over hydration B) monitor for infection C) monitor liver enzymes D) monitor fetal heart rate |
D) monitor fetal heart rate |
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During your assessment of a patient with abruptio placenta which of the following is a typical sign or symptom? A) bleeding (often concealed) B) no vaginal bleeding C) painless vaginal bleeding D) abnormal growth of endometrial tissue inside uterus |
A) bleeding (often concealed) |
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A nurse is caring for a client who is at 24 weeks gestation and has a suspected placental abruption. Which of the following laboratory tests should the nurse expect the provider to prescribe? A) kleihauer-Berkeley test B) progesterone serum level C) lecithin/sphingomyelin (L/S) ratio D) maternal alpha-fetoprotein (AFP) |
A) Kleihauer-Betke test |
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A nurse is providing teaching to a client who is at 40 weeks gestation and has a new prescription for misoprostol. Which of the following instructions should the nurse include in the teaching? A) I can administer oxytocin 4 hours after the insertion of the medication B) you will need a full bladder prior to the insertion of the medication C) remain in a side lying position for 15 minutes after the medication is inserted D) an antacid will be given 20 minutes prior to the insertion of the medication |
A) I can administer oxytocin 4 hours after the insertion of the medication |
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A nurse is developing a plan of care for a client who has preeclampsia and is receiving magnesium sulfate via a continuous IV infusion. Which of the following interventions should the nurse include in the plan? A) monitor the clients blood pressure every hour B) restrict the total hourly intake to 200 ml C) monitor the FHR continuously D) administer protamine sulfate for manifestations of toxicity |
C) monitor the FHR continuously |
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A nurse is assessing a client who is one day postpartum and has a vaginal hematoma. Which of the following manifestations should the nurse expect? A) lochia serosa vaginal drainage B) vaginal pressure C) intermittent vaginal pain D) yellow exudate vaginal drainage |
B) vaginal pressure |
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A nurse is caring for a client who is at 30 weeks of gestation and has a prescription for magnesium sulfate IV to treat preterm labor. The nurse should notify the provider of which of the following adverse effects? A) client reports nausea B) Urinary output of 40 ml/hr C) respiratory rate 10/min D) client reports feeling flushed |
C) respiratory rate 10/min |
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A nurse is assessing a client who is at 36 weeks of gestation. Which of the following findings should the nurse report to the provider? A) report of visual disturbances B) report of tingling of the fingers C) report of urinary frequency D) report of leg cramps |
A) report of visual disturbances |
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A nurse is performing a vaginal examination on a client who is in labor and observes the umbilical cord protruding from the vagina. After calling for assistance, which of the following actions should the nurse take? A) insert 2 gloved fingers into the vagina and apply upward pressure to the presenting part B) wrap the visible cord tightly with sterile, dry gauze C) apply oxygen to the client at 2 L/min via nasal cannula D) place the client in the lithotomy position and apply fundal pressure |
A) insert 2 gloved fingers into the vagina and apply upward pressure to the presenting part |
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A nurse is caring for a client who is anemic at 32 weeks of gestation and is in preterm labor. The provider prescribed betamethasone 12mg IM. Which of the following outcomes should the nurse expect? A) decrease uterine contractions B) an increase in the clients hemoglobin levels C) a reduction in respiratory distress in the newborn D) increased production of antibodies in the newborn |
C) a reduction in respiratory distress in the newborn |
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A nurse is assessing a client who has severe preeclampsia. Which of the following manifestations should the nurse expect? A) 2+ deep tendon reflexes B) proteinuria of 200mg in a 24hr specimen C) polyuria D) blurred vision |
D) blurred vision |
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A nurse is caring for a prenatal client who has parvovirus B19 (fifth disease). Which of the following actions should the nurse take? A) administer antiviral medication B) schedule an ultrasound examination C) administer haemophilus influenzae type b vaccine D) schedule an indirect Coombs test |
B) schedule an ultrasound examination |
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A nurse in a providers office is reviewing the medical record of a client who is in the first trimester of pregnancy. Which of the following findings should the nurse identify as a risk factor for the development of preeclampsia? A) singleton pregnancy B) BMI of 20 C) maternal age 32 years D) pregestational diabetes mellitus |
D) pregestational diabetes mellitus |
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A nurse is assessing a client who received carboprost for postpartum hemorrhage. Which of the following findings is an adverse effect of this medication? A) hypertension B) hypothermia C) constipation D) muscle weakness |
A) hypertension |
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A nurse is caring for a client who is at 34 weeks gestation and has a prescription for terbutaline for preterm labor. Which of the following statements by the client is the priority? A) my ankles are swollen at the end of the day B) I can feel the baby kicking my ribs, and it is very uncomfortable C) I’m growing more and more worried everyday D) my heart feels as if it is racing |
D) my heart feels as if it is racing |
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What complication will the nurse be alert for in the client who uses cocaine during the pregnancy? A) placental abruption B) hyperemesis gravidarum C) placenta previa D) gestational diabetes |
A) placental abruption |
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A nurse educator in the labor and delivery unit is reviewing the use of chemical agents to promote cervical ripening with a group of newly licensed nurses. Which of the following statements by a nurse indicates understanding of the teaching? A) they are tablets administered vaginally B) they act by absorbing fluid from tissues C) they promote dilation of the os D) they include an amniotomy |
A) they are tablets administered vaginally |
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A nurse is caring for a client who is receiving oxytocin for induction of labor and has an intrauterine pressure catheter (IUPC) placed to monitor uterine contractions. For which of the following contraction patterns should the nurse discontinue the infusion of oxytocin? A) frequency of every 2 minutes B) duration of 90 to 120 seconds C) intensity of 60 to 90 mm hg D) resting tone of 15 mm Hg |
B) duration of 90 to 120 seconds |
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A nurse is caring for a client who is receiving oxytocin for induction of labor and has an intrauterine pressure catheter (IUPC) placed to monitor uterine contractions. For which of the following contraction patterns should the nurse discontinue the infusion of oxytocin? A) frequency of every 2 minutes B) duration of 90 to 120 seconds C) intensity of 60 to 90 mm hg D) resting tone of 15 mm Hg |
B) duration of 90 to 120 seconds |
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A nurse is caring for a client who had no prenatal care, is Rh-negative and will undergo an external version at 38 weeks of gestation. Which of the following medications should the nurse plan to administer prior to the version? A) prostaglandin gel B) magnesium sulfate C) Rho(D) immune globulin D) oxytocin |
C) Rho(D) immune globulin |
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A nurse is caring for a client who has been in labor for 12 hours with intact membranes. The nurse performs a vaginal examination to ensure which of the following prior to the performance of the amniotomy? A) fetal engagement B) fetal lie C) fetal attitude D) fetal position |
A) fetal engagement |
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To assess for clonus, the nurse briskly dorsiflexes the patients foot and then releases it. What would a positive response look like? |
Jerky, rapid contraction of the ankle and foot |
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What is the therapeutic blood level for a patient receiving an IV infusion of magnesium sulfate? |
Between 4 and 7 mEq/L |
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Patients with severe preeclampsia are at risk for developing acute pulmonary edema. What can the nurse do to prevent the development of this condition? |
Monitor intake and output hourly |
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Signs of magnesium toxicity in a patient |
Central nervous system depression, absent deep tendon reflexes, respiratory rate of of 10 breaths/minute |
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Priorities of care for a patient experiencing an eclamptic seizure? |
Assess breathing, administer oxygen, protect patient from injury |
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Interventions that should be implemented when a patient with preeclampsia with severe features is admitted to the hospital? |
Reduce environmental stimulation, lateral lying positions, low ambient lighting, seizure precautions |
