WorksheetsRisk Conditions Related to Pregnancy AM
Total questions: 15
Worksheet time: 30mins
A client gives birth within an hour of arriving at the labor and delivery unit and delivers the placenta 5 minutes later. During assessment, the nurse notes that the uterus is midline and boggy. Which action should the nurse take first?
1. Check for pooled blood under buttocks
2. Increase IV oxytocin infusion rate
3. Monitor blood pressure and pulse
4. Perform firm fundal massage
The nurse reviews the chart of a client who gave birth 4 hours ago. Which contributing factor indicates that the client has an increased risk of postpartum hemorrhage?
1. Infant birth weight of 9 lb 2 oz (4139 g)
2. Labor and birth without pain medication
3. Labor that lasted 8 hours
4. Third stage of labor lasting 20 minutes
A client at 41 weeks gestation is admitted to the labor and delivery unit for labor induction. The nurse is assisting the health care provider with an amniotomy. What actions should the nurse anticipate? Select all that apply.
1. Assessing the fetal heart rate before and after the procedure
2. Checking the client's temperature every 2 hours
3. Informing the client she will feel a sharp pain during the procedure
4. Keeping the client in a supine position after the procedure
5. Noting the characteristics of the amniotic fluid
The labor and delivery (L&D) nurse is floated to a medical-surgical floor for a shift. Which client is most appropriate for the charge nurse to assign to the L&D nurse?
1. Client with an occluded arteriovenous fistula receiving IV heparin infusion
2. Client with cirrhosis and ascites who requires bedside paracentesis
3. Client with diabetes who is one day postoperative below-the-knee amputation
4. Client with pyelonephritis who is febrile and receiving IV antibiotics
A nulliparous client asks about being in "real" labor. The nurse should teach that which signs are most indicative of true labor? Select all that apply.
1. Contractions that increase in frequency
2. Contractions that lessen after resting
3. Increased blood-tinged, mucoid vaginal discharge
4. Pain in lower back that moves to lower abdomen
5. Progressive cervical effacement and dilation
A nurse is caring for a pregnant client at 27 weeks gestation after a motor vehicle collision with side airbag deployment. The client's blood type is O negative. Which laboratory test should the nurse anticipate?
1. Group B streptococcal culture
2. Indirect Coombs test
3. Rubella immunity titer
4. Serum alpha-fetoprotein
The nurse is performing a postpartum assessment 12 hours after the prolonged vaginal delivery of a term infant. Which assessment findings should be reported to the health care provider?
1. Complaints of discomfort during fundal palpation
2. Foul-smelling lochia
3. Oral temperature 100.1 F (37.8 C)
4. White blood cell (WBC) count 24,000/mm3 (24.0 x 109/L)
The nurse assesses a client at term gestation who reports having contractions for the last 2 hours. The client states, "I'm not sure, but I think my water broke." The nurse performs a nitrazine pH test, which turns blue. When documenting the results of the test, which client statement is most concerning to the nurse?
1. "I did have sexual intercourse with my partner 1 hour before coming in today."
2. "I have noticed constant wetness in my panties since I thought my water broke."
3. "It is difficult for me to tell if my water broke or if I just peed on myself a little bit."
4. "With my last three pregnancies, my water never broke on its own."
The nurse is documenting assessments of pregnant clients in the antepartum unit. Which client's assessment findings are most important to report to the health care provider?
1. Client at 28 weeks gestation with an asymptomatic systolic murmur
2. Client at 34 weeks gestation with 1+ edema of bilateral lower extremities
3. Client at 35 weeks gestation with painful genital lesions
4. Client at 39 weeks gestation with brownish, mucoid vaginal discharge
The nurse is assisting with a vaginal birth at term gestation. Which newborn assessment finding is most important for the nurse to follow-up?
1. Edema of the scalp crossing the suture lines
2. Flat, bluish, discolored area on the buttocks
3. Small tuft of hair at the base of the spine
4. White, waxy substance in the axillae and labial folds
Following the precipitous birth of a term newborn, what is the best action by the nurse while awaiting expulsion of the placenta and arrival of the health care provider?
1. Clean the perineal area
2. Gently pull on the cord
3. Keep the infant warm
4. Massage the fundus
The nurse receives report on several postpartum clients who gave birth at term gestation. Which client should the nurse assess first?
1. Client, G1, P1, who is 24 hours postcesarean birth with cramping and foul-smelling lochia
2. Client, G1, P1, who is 72 hours postvaginal birth, on bed rest, and taking enoxaparin for a deep venous thrombosis
3. Client, G4, P3, who is 72 hours postcesarean birth with a temperature of 100.8 F (38.2 C) and a red, swollen breast
4. Client, G5, P5, who is 12 hours postvaginal birth and saturating perineal pads every hour for 2 hours with lochia rubra
A float nurse from labor and delivery is assigned to the cardiac care unit. Which client is most appropriate for the charge nurse to assign to the float nurse?
1. Client 3 days following a myocardial infarction who is on 6 L of oxygen and reports nausea
2. Client admitted for hypertensive crisis with blood pressure of 154/92 mm Hg on amlodipine PO
3. Client with a demand pacemaker set at 70/min who has a ventricular rate of 65/min
4. Client with angina at rest who has normal troponin levels and normal sinus rhythm on ECG
The nurse is planning education for clients in group prenatal care who are entering the second trimester of pregnancy. Which of the following are appropriate for the nurse to include in second-trimester teaching? Select all that apply.
1. Anticipate light fetal movements around 16-20 weeks gestation
2. Expect to have an abdominal ultrasound for fetal anatomy evaluation
3. Gain about 1 lb (0.5 kg) per week if pre-pregnancy BMI was normal
4. Increase consumption of iron-rich foods like meat and dried fruit
5. Plan for gestational diabetes screening near the end of the second trimester
The labor and delivery charge nurse receives report on several clients. Which task is appropriate for the nurse to delegate to the unlicensed assistive personnel?
1. Assist a client to the restroom 1 hour after a vaginal birth with regional anesthesia
2. Check the perineal pad of a client who is in triage with possible rupture of membranes
3. Obtain vital signs on a newborn who is skin-to-skin with the mother 1 hour after birth
4. Reposition an unmedicated client who is in active labor onto a birthing ball
