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OB WrapUp

Total questions: 31

Worksheet time: 1hrs 2mins

Name
Class
Date
1.

A gestational diabetic client who delivered yesterday is currently on the postpartum unit. Which of the following statements is appropriate for the nurse to make at this time?

a)

"Monitor your blood glucose five times a day until your 6-week checkup."

b)

"I will teach you how to inject insulin before you are discharged."

c)

"Daily exercise will help to prevent you from becoming diabetic in the future."

d)

"Your baby should be assessed every 6 months for signs of juvenile diabetes."

2.

A client is receiving a blood transfusion after the delivery of a placenta accreta and hysterectomy. Which of the following complaints by the client would warrant immediately discontinuing the infusion?

a)

"My lower back hurts all of a sudden."

b)

"My hands feel so cold."

c)

"I feel like my heart is beating fast."

d)

"I feel like I need to have a bowel movement."

3.

A client has just received Hemabate (carboprost) because of uterine atony not controlled by IV oxytocin. For which of the following side effects of the medication will the nurse monitor this patient? Select all that apply.

a)

Hyperthermia

b)

Diarrhea

c)

Hypotension

d)

Palpitations

e)

Anasarca

4.

A client who is 2 weeks postpartum calls her obstetrician's nurse and states that she has had a whitish discharge for 1 week but that today she is "bleeding and saturating a pad about every 1/2 hour." Which of the following is an appropriate response by the nurse?

a)

"That is normal. You are starting to menstruate again."

b)

"You should stay on complete bedrest until the bleeding subsides."

c)

"Pushing during a bowel movement may have loosened your stitches."

d)

"The physician should see you. Please go to the emergency department."

5.

The nurse is performing a postpartum assessment on a client who delivered 4 hours ago. The nurse notes a firm uterus at the umbilicus with heavy lochial flow. Which of the following nursing actions is appropriate?

a)

Massage the uterus

b)

Notify the obstetrician

c)

Administer an oxytocic as ordered

d)

Assist the client to the bathroom

6.

A client has been receiving magnesium sulfate for severe pre-eclampsia for 12 hours. Her reflexes are 0 and her respiratory rate is 10. Which of the following situations could be a precipitating factor in these findings?

a)

Apical heart rate 104 bpm

b)

Urinary output 240 mL/12 hr

c)

Blood pressure 160/120

d)

Temperature 100oF

7.

A client received general anesthesia during her cesarean section 4 hours ago. Which of the following postpartum nursing interventions is important for the nurse to make?

a)

Place the client flat in bed

b)

Assess for dependent edema

c)

Auscultate lung fields

d)

Check patellar reflexes

8.

The nurse is developing a standard care plan for the post-cesarean client. Which of the following should the nurse plan to implement?

a)

Maintain the client in left lateral recumbent position

b)

Teach sitz bath use on second postoperative day

c)

Perform active range-of-motion exercises until ambulating

d)

Assess central venous pressure during first postoperative day

9.

The nurse has administered Benadryl (diphenhydramine) to a post-cesarean client who is experiencing side effects from the parenteral morphine sulfate that was administered 30 minutes earlier. Which of the following actions should the nurse perform following the administration of the drug?

a)

Monitor the urinary output hourly

b)

Supervise while the woman holds her newborn

c)

Position the woman slightly elevated on her left side

d)

Ask any visitors to leave the room

10.

The nurse should suspect puerperal infection when a client exhibits which of the following?

a)

Temperature of 100.2oF

b)

White blood cell count of 14,500 cells/mm3

c)

Diaphoresis during the night

d)

Malodorous lochial discharge

11.

A rubella non-immune, breastfeeding client has just received the rubella vaccine. Which of the following side effects should the nurse warn the client about?

a)

The baby may develop a rash a week after the shot

b)

The baby may temporarily reject the breast milk

c)

The mother's milk supply may decrease precipitously

d)

The mother's joints may become painful and stiff

12.

The nurse should expect to observe which behavior in a 3-week-multigravid postpartum client with postpartum depression?

a)

Feelings of infanticide

b)

Difficulty with breastfeeding latch

c)

Feelings of failure as a mother

d)

Concerns about sibling jealousy

13.

Which symptom would the nurse expect to observe in a postpartum client with a vaginal hematoma?

a)

Pain

b)

Bleeding

c)

Warmth

d)

Redness

14.

A breastfeeding woman calls the pediatric nurse with the following complaint: "I woke up this morning with a terrible cold. I don't want my baby to get sick. Which kind of formula should I have my husband feed the baby until I get better?" Which of the following replies by the nurse is appropriate at this time?

a)

"Any formula brand is satisfactory, but it is essential that it be mixed with water that has been boiled for at least 5 minutes."

b)

"Don't forget to pump your breast every 3 hours while the baby is being fed the prescribed formula."

c)

"The best way to keep your baby from getting sick is for you to keep breastfeeding him rather than switching him to formula."

d)

"In addition to giving the baby formula, you should wear a surgical face mask when you are around him."

15.

A woman who wishes to breastfeed advises the nurse that she had a breast reduction one year earlier. Which of the following responses by the nurse is appropriate?

a)

Advise the woman that unfortunately she will be unable to breastfeed

b)

Examine the woman's breasts to see where the incision was placed

c)

Monitor the baby's daily weights for excessive weight loss

d)

Inform the woman that reduction surgery rarely affects milk transfer

16.

The nurse is caring for a postoperative cesarean client. The woman is obese and is an insulin-dependent diabetic. For which of the following complications should the nurse carefully monitor this client?

a)

Failed lactogenesis

b)

Dysfunctional parenting

c)

Wound dehiscence

d)

Projectile vomiting

17.

A nurse who is called to a client's room notes that the client's cesarean incision has separated. Which of the following actions is the highest priority for the nurse to perform?

a)

Cover the wound with sterile wet dressings

b)

Notify the surgeon

c)

Elevate the head of the client's bed slightly

d)

Flex the client's knees

18.

The nurse notes the following vital signs of a postoperative cesarean client during the immediate postpartum period:

T 100.0oF, P 68, R 10, BP 130/80. Which of the following is a correct interpretation of the findings?

a)

Temperature is elevated, a sign of infection

b)

Pulse is too low, a sign of vagal pathology

c)

Respirations are too low, a sign of medication toxicity

d)

Blood presure is elevated, a sign of pre-eclampsia

19.

The nurse is discharging five Rh-negative clients from the maternity unit. The nurse knows that the teaching was successful when the clients who had which of the following deliveries stated that they understand why they must receive a RhoGAM injection? Select all that apply.

a)

Abortion at 10 weeks' gestation

b)

Amniocentesis at 16 weeks' gestation

c)

Fetal demise at 24 weeks' gestation

d)

Birth of Rh-negative twins at 35 weeks' gestation

e)

Delivery of a 40-week-gestation, Rh-positive baby

20.

In which of the following situations should a nurse report a possible deep vein thrombosis (DVT)?

a)

The woman complains of numbness in the toes and heel of one foot

b)

The woman has cramping pain in a calf that is relieved when the foot is dorsiflexed

c)

The calf of one of the woman's legs is swollen, red, and warm to the touch

d)

The veins in the ankle of one of the woman's legs are spider-like and purple

21.

The nurse in a pediatric clinic is caring for a 9-year-old girl who has been diagnosed with gonorrhea. Which of the following actions is appropriate for the nurse to take?

a)

Notify the physician so the child can be admitted to the hospital

b)

Discuss with the girl the need to stop future sexual encounters

c)

Question the mother about her daughter's menstrual history

d)

Report the girl's medical findings to child protective services

22.

A 19-year-old client with multiple sex partners is being counseled about the hepatitis B vaccination. During the counseling sessions, which of the following should the nurse advise the client to receive?

a)

Hepatitis B immune globulin before receiving the vaccine

b)

Vaccine booster ever 10 years

c)

Complete series of three intramuscular injections

d)

Vaccine as soon as she becomes 21

23.

A postpartum client has decided to use Depo-Provera (medroxyprogesterone acetate) as her contraceptive method. What should the nurse advise the client regarding this medication?

a)

Take the pill at the same time each day

b)

Refrain from breastfeeding while using the method

c)

Expect to have occasional periods as long as she takes the medicine

d)

Consider switching to another birth control method in a year or so

24.

The nurse is administering Depo-Provera (medroxyprogesterone acetate) to a postpartum client. Which of the following data must the nurse consider before administering the medication?

a)

The patch must be replaced at the same time each week

b)

The client must be taught to use sunscreen whenever in the sunlight

c)

The medicine is contraindicated if the woman has lung or esophageal cancer

d)

The client must use an alternate form of birth control for the first two months

25.

Which statement by the client indicates that she understands the teaching provided about the intrauterine device (IUD)?

a)

"The IUD can remain in place for a year or more."

b)

"I will not menstruate while the IUD is in."

c)

"Pain during intercourse is a common side effect."

d)

"The device will reduce my changes of getting infected."

26.

A client has been diagnosed with pubic lice. Which of the following signs/symptoms would the nurse expect to see?

a)

Macular rash on the labia

b)

Pruritus

c)

Hyperthermia

d)

Foul-smelling discharge

27.

The nurse is teaching a client regarding the treatment for pubic lice. Which of the following should be included in the teaching session?

a)

The antibiotics should be taken for a full 10 days

b)

All clothing should be pre-treated with bleach before wearing

c)

Shampoo should be applied for at least 2 hours before rinsing

d)

The pubic hair should be combed after shampoo is removed

28.

The parent of a newborn angrily asks the nurse, "Why would the doctor want to give my baby the vaccination for hepatitis B? It's a sexually transmitted disease, you know!" Which of the following is the best response by the nurse?

a)

"The hepatitis B vaccine is given to all babies. It is given because many babies get infected from their mothers during pregnancy."

b)

"It is important for your baby to get the vaccine in the hospital because the shot may not be available when your child gets older."

c)

"Hepatitis B can be a life-threatening infection that is contracted by contact with contaminated blood and blood products as well as sexually."

d)

"Most parents want to protect their children from as many serious disease as possible. Hepatitis B is one of those diseases."

29.

A gravid, married client, 24 weeks' gestation, is found to have bacterial vaginosis. Her healthcare practitioner has ordered metronidazole (Flagyl) to treat the problem. Which of the following educational information is most important for the nurse to provide the woman at this time?

a)

The woman must be careful to observe for signs of preterm labor

b)

The woman must advise her partner to seek therapy as soon as possible

c)

A common side effect of the medicine is a copious vaginal discharge

d)

A repeat culture should be taken two weeks after completing the therapy

30.

A woman is noted to have multiple soft warts on her perineum and rectal areas. The nurse suspects that this client is infected with which of the following sexually transmitted infections?

a)

Human papillomavirus (HPV)

b)

Human immunodeficiency virus (HIV)

c)

Syphilis

d)

Trichomoniasis

31.

A woman is to receive 2.4 million units of penicillin G benzathine IM to treat syphilis. The medication is available as 1,200,000 units/mL. How many mL should the nurse administer?

a)

1

b)

2

c)

3

d)

4