Dyanmic Quiz OB

A nurse is providing teaching for a client at 7 weeks of gestation who is experiencing nausea and vomiting. Which of the following client statements indicates to the nurse an understanding of the teaching?

• A. 

  "I should eat fatty foods to increase my caloric intake."

• B. 

  "I should brush my teeth right after eating."

• C. 

  "Acupressure bands on my elbows might help me feel better."

• D. 

  "I should have a small snack before bedtime."

D. 

"I should have a small snack before bedtime."

A small snack at bedtime can relieve nausea and vomiting through the night and prevent the client from feeling too hungry on waking.

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Incorrect Answers:

A. The client should reduce her intake of fried or fatty foods, as fatty foods can increase nausea and vomiting.

B. The client should avoid brushing her teeth immediately after eating since this action can trigger nausea and vomiting.

C. Acupressure bands worn on the wrists can reduce nausea and vomiting.

A nurse is planning care for a client in active labor whose fetus is in an occipital brow presentation. Which of the following complications should the nurse anticipate as a result of this fetal presentation?

• A. 

  Precipitous labor

• B. 

  Prolonged labor

• C. 

  Hypertonic uterine dysfunction

• D. 

  Umbilical cord prolapse

B. 

Prolonged labor

An occipital brow presentation increases the diameter of the presenting part, which may prevent the fetal head from descending into the pelvis. This can result in prolonged labor, forceps- or vacuum-assisted birth, or a cesarean delivery.

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Incorrect Answers:

A. Precipitous labor proceeds abnormally fast, progressing from the onset of labor to delivery in less than 3 hours. An occipital brow presentation is not a contributing factor in precipitous labor.

C. Hypertonic uterine dysfunction commonly occurs in the latent, not the active, phase of the first stage of labor. An occipital brow presentation is not a contributing factor to this labor pattern.

D. A cord prolapse occurs when the umbilical cord precedes the fetal presenting part. Risk factors for cord prolapse include an abnormally long cord, breech or shoulder presentation, polyhydramnios, a small fetus, or an unengaged presenting part. An occipital brow presentation is not a contributing factor.

A nurse is caring for a client who recently gave birth and plans to breastfeed. Which of the following actions should the nurse take?

• A. 

  Place the unwrapped newborn on the mother's bare chest.

• B. 

  Feed the infant 5 to 15 mL of 5% glucose water to assess the suck/swallow reflex.

• C. 

  Bathe the newborn under running warm water before feeding.

• D. 

  Administer vitamin K and eye prophylaxis prior to feeding.

A. 

Place the unwrapped newborn on the mother's bare chest.

Skin-to-skin contact will maintain the newborn's temperature and illicit instinctive newborn feeding behaviors.

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B. Breastfed infants should not be fed anything except breast milk unless deemed medically necessary.

C. Newborns should never be bathed under running water. The temperature of the water could change and cause burns or cold stress in the newborn. Additionally, bathing should be delayed until the completion of the first breastfeeding.

D. Routine care such as bathing, weighing, eye prophylaxis, and a vitamin K injection should all be delayed until after the infant has completed the first feeding.

A nurse is admitting a client who is in post-term labor. Which of the following statements should the nurse identify as the priority?

• A. 

  "I had blood-streaked discharge a few hours ago."

• B. 

  "When my water broke, it was not clear."

• C. 

  "I have not felt my baby move as much today."

• D. 

  "I feel like I cannot breathe when I walk up the stairs."

B. 

"When my water broke, it was not clear."

The greatest risk to this client is an injury to the newborn from meconium aspiration; therefore, addressing this statement is the nurse's priority.

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Incorrect Answers:A. The nurse should confirm that there is no active bleeding and reassure the client that this event could have been the bloody show; however, addressing another statement is the nurse's priority.

C. The nurse should confirm the heartbeat of the fetus via Doppler to reassure the client or take action if the heartbeat is not identifiable; however, addressing another statement is the nurse's priority.

D. The nurse should assess the client's respiratory pattern to confirm that the client's shortness of breath is due to elevation of the diaphragm from the enlarging uterus and not a respiratory infection; however, addressing another statement is the nurse's priority.

A nurse is reviewing risk factors for postpartum depression with a newly licensed nurse. Which of the following risk factors should the nurse include?

• A. 

  Gestational diabetes

• B. 

  Planned pregnancy

• C. 

  Being married

• D. 

  Post-term birth

 A. 

Gestational diabetes

Gestational diabetes increases the risk of postpartum depression. Other risk factors include infertility treatment, pregnancy complications, preterm birth, and a history of mood disorder.

A nurse is teaching a client who is at 10 weeks gestation about an abdominal ultrasound in the first trimester. Which of the following pieces of information should the nurse include in the teaching?

• A. 

  "You will have a nonstress test prior to the ultrasound."

• B. 

  "You will need to have a full bladder during the ultrasound."

• C. 

  "The ultrasound will determine the length of your cervix."

• D. 

  "You will experience uterine cramping during the ultrasound."

"You will need to have a full bladder during the ultrasound."

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A. The client can have a nonstress test after 26 weeks gestation to determine fetal wellbeing.

C. The client can have a transvaginal ultrasound to measure cervical length in the second and third trimesters to assess for preterm labor.

D. The client should not experience uterine cramping during an abdominal ultrasound.

A nurse is teaching a client who is pregnant and has pregestational diabetes about dietary changes. Which of the following statements should the nurse include in the teaching?

• A. 

  "Carbohydrates should make up 55% of your diet."

• B. 

  "Protein should make up 70% of your diet."

• C. 

  "Fats should make up 45% of your diet."

• D. 

  "Fiber should make up 10% of your diet."

A. 

"Carbohydrates should make up 55% of your diet."

For clients who have pregestational diabetes, intake of simple carbohydrates should be limited. The ideal diet is composed of 55% carbohydrates, 20% protein, 25% fat, and less than 10% saturated fat.

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B. Protein should only make up 20% of the diet for clients who have pregestational diabetes.

C. The ideal diet for clients who have pregestational diabetes contains 25% fat.

D. There is no limitation on the amount of fiber a client who has pregestational diabetes should consume. Fiber should be recommended to clients to decrease constipation, which can be an effect of pregnancy.

A nurse is planning educational sessions for clients in a childbirth class. Which of the following findings should the nurse plan to instruct the clients to report immediately?

• A. 

  Vaginal leukorrhea

• B. 

  Shortness of breath

• C. 

  Swelling of the face and fingers

• D. 

  Lower back pain

C. 

Swelling of the face and fingers

Swelling of the face, fingers, or area over the sacrum is an indication of hypertensive disorders such as eclampsia. The nurse should ensure these educational sessions include instructing clients about reporting such indications to their provider immediately.

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A. Leukorrhea is a white or grayish vaginal discharge that is an expected finding during pregnancy. There is no need to report this finding.

B. Shortness of breath is a common finding during the third trimester of pregnancy due to the enlarging uterus pushing the diaphragm upward. There is no need to report this finding unless the client has significant difficulty breathing.

D. Lower back pain is a common finding during the second and third trimesters of pregnancy due to the change in the client's center of gravity from the enlarging uterus.

A nurse is assessing a newborn who was circumcised 24 hours ago. Which of the following findings should the nurse report to the provider?

• A. 

  A scant amount of serosanguineous drainage is noted in the newborn's diaper.

• B. 

  The newborn's circumcision site is covered with yellow exudate.

• C. 

  The newborn has urinated once since the circumcision.

• D. 

  The newborn fusses during each diaper change.

C. 

The newborn has urinated once since the circumcision.

A newborn should void 2 to 6 times a day the first 24 to 48 hours after birth and then 6 to 8 times per day starting on the third day. Therefore, the nurse should report 1 void in 24 hours following circumcision to the provider.

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Incorrect Answers:

A. A scant amount of serosanguineous drainage is an expected finding 24 hours following a circumcision. Bright red bleeding should be reported to the provider.

B. A yellow exudate forms on a circumcision site 24 hours after the procedure. This exudate should not be removed and will remain for 2 to 3 days. Edema or odor at the site should be reported to the provider.

D. A newborn may fuss or cry during diaper changes and cleaning of the circumcision site until the site is healed. Inconsolable crying should be reported to the provider.

A nurse is assessing a newborn. Which of the following findings should the nurse report to the provider?

• A. 

  Respiratory rate 52/min

• B. 

  Weight 2500 grams (5.5 lb)

• C. 

  Head circumference 28 cm (11 in)

• D. 

  Blood glucose 48 mg/dL

C. 

Head circumference 28 cm (11 in)

A head circumference of 28 cm (known as microcephaly) is below the expected reference range of 32 to 36.8 cm for a newborn. Microcephaly can indicate fused cranial sutures or prenatal infection with rubella, toxoplasmosis, or cytomegalovirus. The nurse should report this finding to the provider.

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D. A blood glucose level of 48 mg/dL is within the expected reference range of greater than 45 mg/dL for a newborn.

A nurse is providing discharge teaching to the parent of a newborn. Which of the following statements should the nurse include in the teaching?

• A. 

  "Your baby should be rear-facing in a car seat until 2 years of age."

• B. 

  "Cover your baby with a light blanket during naps."

• C. 

  "Set your hot water heater to no more than 140 degrees Fahrenheit."

• D. 

  "Ensure your baby's crib has side rails that can be lowered."

A. 

"Your baby should be rear-facing in a car seat until 2 years of age."

The parent should ensure the baby rides in a rear-facing car seat until at least 2 years of age, or longer if recommended by the car seat manufacturer.

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Incorrect Answers:

B. The parent should place the baby in a lightweight sleeper or sleep sack. Covering the baby with a blanket increases the risk of suffocation.

C. The parent should set the hot water heater to no more than 120°F (48.9°C) to avoid burns and scalding injuries.

D. The parent should ensure the baby's crib rails are stationary to prevent injury.