Perinatal Exam 3 Practice Questions

It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse anticipates that the client will receive RhoGAM at which times?

At 28 weeks' gestation and again within 72 hours after delivery

Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia?

Calcium gluconate

A woman who is 12 weeks pregnant arrives at her provider's office complaining of vaginal bleeding, strong abdominal cramping, and possible rupture of membranes. A vaginal examination also reveals cervical dilation. Based on these findings the provider suspects:

Inevitable abortion

The nurse is reviewing the laboratory test results of a pregnant client. Which one of the following findings would alert the nurse to the development of HELLP syndrome?

Elevated liver enzymes

A nurse is caring for a client who is at 42 weeks' gestation and in active labor. Which of the following findings would the nurse assess for a post-term pregnancy?

Meconium aspiration

A woman with preeclampsia is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately?

Diminished deep tendon reflexes

When assessing several women for possible VBAC, which woman would the nurse identify as being the best candidate?

One who had a previous cesarean birth via a low transverse incision

Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction?

Anterior position

A woman with severe preeclampsia experiences a seizure. Which of the following would be the first priority?

Oxygenation

Because a pregnant client's diabetes has been poorly controlled throughout her pregnancy, the nurse would be alert for which of the following in the neonate at birth?

Macrosomia

A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which of the following possible outcomes?

Congenital anomalies

A nurse is providing care to several pregnant women at the clinic. The nurse would screen for group B streptococcus infection in a client at:

36 weeks' gestation

The nurse would be alert for possible placental abruption during labor when assessment reveals which of the following?

Gestational hypertension

A woman in labor is experiencing ineffective contractions (hypotonic uterine dysfunction). Assessment reveals no fetal/pelvic disproportion. Which medications would the nurse expect to administer?

Oxytocin

A client in labor experienced prolonged premature rupture of membranes. The nurse would be alert for which of the following in the mother and the newborn?

Infection

A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which statement by the nurse would be most appropriate?

"Antiretroviral medications are available to help reduce the risk of transmission."

A woman who is experiencing preterm labor is prescribed a tocolytic by her provider. Which medication arrests preterm labor by blocking calcium movement into muscle cells?

Nifedipine

A pregnant woman's contractions have slowed and her labor is not progressing. The provider orders oxytocin to enhance her uterine contractions. The intervention to enhance uterine contractions is termed:

Labor augmentation

Which of the following, if noted in the maternal history, would the nurse identify as possibly contributing to the birth of an LGA newborn?

Diabetes

A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse would be alert for which of the following in the newborn?

Cephalohematoma

When a shoulder dystocia emergency is declared, what should the primary interventions focus on?

Manipulating the passenger

A labor and delivery nurse notices that a laboring woman's external fetal monitor shows a variable deceleration. What is the common etiology of this non-reassuring fetal heart pattern?

Cord compression

Which of the following nursing measures has the highest priority when an intrapartum woman has a prolapsed umbilical cord?

Place a sterile gloved hand into the patient's vagina to push the fetus off the umbilical cord.

A nurse is providing care to a newborn who is receiving phototherapy. Which action would the nurse most likely include in the plan of care?

Covering the newborn's eyes while under the bililights.

A nurse is providing care to a newborn. The nurse suspects that the newborn is developing sepsis based on which assessment finding?

Temperature instability

Which information would the nurse include when teaching a new mother about the difference between pathologic and physiologic jaundice?

Pathological jaundice appears within 24 hours of birth.

The nurse frequently assesses the respiratory status of a late preterm newborn based on the understanding that the newborn is at increased risk for respiratory distress syndrome because of which factor?

Deficiency of surfactant

While caring for a newborn delivered at 32 weeks' gestation, the nurse assesses the baby daily for symptoms of necrotizing enterocolitis (NEC). Which of the following would alert the nurse to notify the neonatologist?

Abdominal distension.

A newborn is admitted to the neonatal intensive care unit for observation with a diagnosis of probable meconium aspiration syndrome (MAS). The baby weighs 10 lbs., 4 oz. (4,650 g) and is at 41 weeks' gestation. Which of the following would be the priority problem?

Impaired gas exchange

After teaching a multiparous mother about hemolytic disease of the newborn and Rh sensitization, the nurse determines that the client understands why she is not sensitized when she says which of the following?

"Antibodies are not usually formed until after exposure to an antigen."

While assessing a newborn who was born to a primiparous client who admits to opiate use during pregnancy, which of the following would alert the nurse to possible opiate withdrawal?

High-pitched cry

Which of the following characteristics should the nurse teach the mother about her newborn diagnosed with fetal alcohol syndrome (FAS)?

Hyperactivity and speech disorders are common.

While assessing a male newborn whose mother desires him to be circumcised, the nurse observes that the urinary meatus appears to be located on the underside surface of the penis. The primary health care provider is notified because the nurse suspects which of the following?

Hypospadias

Which of the following statements by the mother of a newborn diagnosed with bronchopulmonary dysplasia (BPD) indicates effective teaching?

"My baby may require long- term respiratory support."

A nurse is reviewing a newborn's maternal prenatal record and notes that the mother used narcotics during her pregnancy. A primary nursing intervention when caring for a drug-exposed newborn is to:

Minimize environmental stimuli.

A nurse is developing a plan of care for a large for gestational age (LGA) newborn. Which action would the nurse determine as a priority?

Preventing hypoglycemia with early and frequent feedings.

A full term male infant was delivered by cesarean section 24 hours ago. Upon assessment the nurse notes that the newborn has mild expiratory grunting, a respiratory rate of 76, nasal flaring, mild cyanosis, and decreased breath sounds. Based on these findings, the nurse suspects which of the following:

Transient tachypnea of the newborn

Which congenital heart disease is associated with cyanotic heart lesions that contribute to decreased pulmonary blood flow?

Tetralogy of Fallot

An infant is born with a neural tube defect where the meninges and spinal fluid have protruded through a herniation in the spine. This type of neural tube defect is termed:

Meningocele

A newborn has been diagnosed with retinopathy of prematurity. The nurse is teaching the parents about this condition. Which statement would the nurse most likely include in the teaching?

"You'll need to schedule follow-up eye examination with the pediatric ophthalmologist."

After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful?

"I will be sure to avoid getting pregnant for at least 1 year."

Which information on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy?

recurrent pelvic infections

The nurse prepares to administer a gavage feeding for a newborn with transient tachypnea based on the understanding that this type of feeding is necessary because:

Oxygen demands need to be reduced

After teaching the parents of a newborn with periventricular hemorrhage about the disorder and treatment, which statement by the parents indicates that the teaching was successful?

"Our newborn could have learning deficits later on."

A nurse is conducting a class for expectant parents about newborns. As part of the class the nurse describes newborns with birth-weight variations. The nurse identifies which variation if the newborn weighs 5.2 lb (2,358 g) at any gestational age?

low birth weight

While assessing a pregnant woman, the nurse suspects that the client may be at risk for hydramnios based on which of the following? (Select all that apply.)

• History of diabetes

• Complaints of shortness of breath

• Difficulty obtaining fetal heart rate

A nurse is educating a 38 week pregnant client on the signs and symptoms of preeclampsia. The nurse instructs her to contact the provider if which of the following occur? (Select all that apply).

• Right upper quadrant pain

• Infrequent urination

• Decreased fetal movement

• Visual changes

A nurse is caring for a patient in labor who reports severe back pain. During assessment, the fetus is noted to be in the occiput posterior position. Which of the following maternal positions should the nurse suggest to the client to facilitate normal labor progress?

Hands and knees

A nurse is instructing a pregnant client on ways to prevent TORCH infections. Which of the following statements by the client indicates understanding of the teaching?

"I should avoid eating under-cooked meat while pregnant."

A nurse is caring for a client who is in preterm labor at 32 weeks of gestation. Which of the following medications will the provider order to hasten fetal lung maturity?

Betamethasone

The nurse is caring for a newborn who coughs, chokes, and becomes cyanotic after breastfeeding. The nurse suspects that the newborn may have which of the following conditions?

Tracheoesophageal fistula

A client who is 20 weeks of gestation comes to OB triage complaining of painless bright red bleeding. The nurse suspects placenta previa. The assessment of the client includes all of the following except :

performing a vaginal exam.

A nurse is assessing a newborn who has microcephaly, jaundice, petechiae, and he did not pass his hearing screen. What type of infection was this baby exposed to in-utero?

Cytomegalovirus