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Labour/Delivery & Postpartum - At Risk

Total questions: 12

Worksheet time: 36mins

Name
Class
Date
1.

A client is to undergo amniocentesis at 38 weeks’ gestation to determine fetal lung maturity. What lecithin/sphingomyelin ratio (L/S ratio) is adequate for the nurse to conclude that the fetus’s lungs are mature enough to sustain extrauterine life?

a)

2:1

b)

1:1

c)

1:4

d)

3:4

2.

A 26-year-old G1 P0 client is seen in the clinic for her routine prenatal visit at 29 weeks’ gestation. On examination the nurse notes that she has gained 8 lb (3.6 kg) since her last visit, 2 weeks ago; that her blood pressure is 150/90 mm Hg; and that she has 1+ proteinuria on urine dipstick. What is the most likely diagnosis for this client?

a)

Mild preeclampsia

b)

Severe preeclampsia

c)

Chronic hypertension

d)

Gestational hypertension

3.

The nurse is providing care for parents who have experienced a stillbirth. What is the most appropriate intervention at this time?

a)

Giving a detailed explanation of what may have causes the stillbirth

b)

Providing the parents the opportunity to say goodbye to their newborn

c)

Explaining that autopsy is not recommended in the setting of a stillbirth

d)

Waiting to provide any information about follow-up care until the parents have had an opportunity to adjust to the grief

4.

The nurse is counseling a pregnant client with type 1 diabetes regarding medication changes as pregnancy progresses. Which medication will be needed in increased dosages during the second half of her pregnancy?

a)

Insulin

b)

Antihypertensives

c)

Pancreatic enzymes

d)

Estrogenic hormones

5.

What is the priority nursing intervention during the admission of a primigravida in labor?

a)

Monitoring the fetal heart rate

b)

Asking the client when she last ate

c)

Obtaining the client’s health history

d)

Determining whether the membranes have ruptured

6.

A client is receiving magnesium sulfate therapy for severe preeclampsia. What initial sign of toxicity should prompt the nurse to intervene?

a)

Hyperactive sensorium

b)

Increase in respiratory rate

c)

Lack of knee-jerk reflex

d)

Development of cardiac dysrhythmia

7.

A client who is admitted to the high-risk unit with severe preeclampsia anxiously asks the nurse, "Will my baby be all right?" How should the nurse respond?

a)

“There is no way of telling at this time what the outcome will be”

b)

“Your baby probably will be all right. It’s protected by the amniotic fluid”

c)

"If you follow your primary healthcare provider’s instructions, everything will progress normally”

d)

“We’ll be constantly monitoring your baby’s condition. I’ll let you listen to the baby’s heartbeat.”

8.

A client admitted to the high-risk unit with a threatened abortion anxiously asks the nurse, "Could this have happened because I had the flu?" How should the nurse respond?

a)

“Tell me why you feel this way. Do you think that you did something to cause the bleeding?”

b)

“We know that maternal infection sometimes results in spontaneous abortion. Perhaps the flu did cause it”

c)

“I’m sure that there’s nothing you could have done to cause this. You shouldn’t worry about it”

d)

"The primary healthcare provider will be here soon and will be better prepared to answer your questions. Why don’t you wait until then?”

9.

Several hours after delivery, a new mother expresses ambivalence regarding her infant. How will the nurse promote bonding between this mother and her newborn?

a)

Having the mother feed the infant

b)

Removing the infant from the mother’s arms if it cries

c)

Positioning the infant so its head rests on the mother’s shoulder

d)

Encouraging the mother to sleep for 4 to 6 hours before interacting with the infant

10.

A client in the birthing suite has spontaneous rupture of the membranes, after which a prolapsed cord is identified. The nurse calls for help and with a sterile gloved hand moves the fetal head off the cord. What should the nurse anticipate?

a)

Caesarean birth

b)

Prolonged labour

c)

Rapidly induced labour

d)

Vacuum extraction vaginal birth

11.

During the postpartum period a client tells the nurse that she was very uncomfortable during her pregnancy because of large and painful varicose veins. In light of this information, what should the nurse’s assessment include?

a)

Monitoring daily clotting times

b)

Assessing for peripheral pulses

c)

Monitoring daily hemoglobin values

d)

Assessing for signs of thrombophlebitis

12.

A client in the thirty-eighth week of gestation exhibits a slight increase in blood pressure. The primary healthcare provider advises her to remain in bed at home in a side-lying position. The client asks why this is important. What is the nurse’s response regarding the advantage of this position?

a)

“It increases blood flow to the fetus”

b)

“It decreases intra-abdominal pressure”

c)

“It increases the mean arterial pressure”

d)

“It prevents the development of thrombosis”