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NURS 4407 exam 2

Total questions: 38

Worksheet time: 20mins

Name
Class
Date
1.

Which assessment finding after an amniotomy needs to be conducted first?

a)

cervical dilation

b)

bladder distention

c)

fetal heart rate pattern

d)

maternal blood pressure

2.

A nurse is caring for a client with placenta previa. Which finding should the nurse expect?

a)

Severe abdominal pain

b)

bright red bleeding without pain

c)

Sudden ROM

d)

thick, dark vaginal discharge

3.

A client who is 36 weeks gestation is experiencing abrupt onset of intense abdominal pain, vaginal bleeding, and uterine tenderness. What condition does the nurse suspect?

a)

Placenta accreta

b)

placental abruption

c)

preterm labor

d)

ectopic pregnancy

4.

A nurse is preparing to care for a client with a prolapsed umbilical cord. Which intervention should the nurse implement first?

a)

place the client in a left lateral position

b)

apply gentle pressure on the fetal head to relieve pressure on the cord

c)

administer 10L of oxygen via non rebreather

d)

perform an immediate CS

5.

A laboring client is diagnosed with uterine atony after delivery. WHich intervention should the nurse anticipate?

a)

Administer Oxytocin IV as prescribed

b)

Perform a manual removal of the placenta

c)

perform an amniotomy

d)

Position the client in a trendelenburg position

6.

A nurse is assessing a client who has just given birth. The nurse finds that the uterus is soft and boggy, and the client is bleeding heavily> what should the nurse do first?

a)

Massage the uterus

b)

Administer uterotonic medications

c)

Insert an indwelling catheter to empty the bladder

d)

perform a vaginal examination

7.

A nurse is assessing a postpartum client who is experiencing significant bleeding. The nurse notes that the uterus is firm and contracted. Which is the most likely cause of the bleeding?

a)

Lacerations of the genital tract

b)

multiple gestation

c)

retained placental fragments

d)

uterine atony

8.

A baby is deliver and the nurse notes that the baby is small for gestational age. Which of the following could explain why this occurred?

a)

meconium stained amniotic fluid

b)

Battledore cord insertion

c)

Velamentous cord insertion

d)

Placenta previa

9.

A client at 33 weeks gestation is diagnosed with preterm labor. The nurse prepares to administer magnesium sulfate. What is the primary reason for this medication?

a)

To prevent seizures in the mother

b)

to relax the uterine muscles and stop contractions

c)

to promote fetal lung maturity

d)

to reduce fetal heart rate variability

10.

A client with preterm labor is prescribed nifedipine. The nurse understands that this medication is used for which purpose?

a)

To promote fetal lung maturity

b)

to inhibit uterine contractions

c)

to lower the client's blood pressure

d)

to improve cervical dilation

11.

A nurse is caring for a client in the first stage of labor who is experiencing dysfunctional labor. Which of the following factors could contribute to dysfunctional labor? (Select all that apply)

a)

Uterine hyperstimulation

b)

Fetal malpresentation

c)

Maternal pelvic shape

d)

full bladder

e)

High maternal blood pressure

12.

A nurse is educating a pregnant client who has tested positive for Group B Streptococcus (GBS). Which of the following statements made by the client indicates the need for further teaching?

a)

I will need intavenous antibiotics during labor

b)

i need to be testted for GBS again at 36 weeks gestation

c)

If i don't have any symptoms, i won't need antibiotics during labor

d)

This infection is not harmful to me

13.

A nurse is caring for a postpartum client who has been diagnosed with chorioamnionitis. Which of the following is the most likely cause of this infection?

a)

Prolonged ROM

b)

use of epidural anesthesia

c)

fetal malpresentation

d)

maternal obesity

14.

A nurse is caring for a postpartum client whose delivery required an episiotomy and has several hemorrhoids. What is the priority nursing consideration?

a)

client pain level

b)

inadequate urinary output

c)

client perception of body changes

d)

potential for imbalanced body fluid

15.

A nurse is preparing a client for a cesarean section. Which of the following steps should be completed before the surgery? (Select all that apply)

a)

Administer Prescribed preoperative antibiotics

b)

insert indwelling catheter

c)

obtain informed consent

d)

perform a vaginal exam

e)

shave the pubic area with a razor

16.

A nurse is caring for a client who is undergoing a vacuum-assisted delivery. What is the nurses responsibility?

a)

apply the vacuum to the babies head

b)

monitor for facial bruising after delivery

c)

count vacuum pop-offs

d)

insert indwelling catheter

17.

A nurse is caring for a client who has an unfavorable cervix and is scheduled for labor induction. Which of the following interventions may be used to help ripen the cervix? (Select all that apply)

a)

Misoprostol

b)

oxytocin

c)

amniotomy

d)

magnesium sulfate

e)

dinoprostone

18.

A nurse is preparing a client for labor induction. Which of the following are contraindications for the use of oxytocin? (Select all that apply)

a)

Placenta previa

b)

active genital herpes

c)

previous CS with vertical incision

d)

HTN

e)

nonreassuring fetal HR patterns

19.

A nurse is caring for a client with a balloon catheter for labor induction. The nurse notes that the catheter has fallen out. Which of the following actions should the nurse take next?

a)

Notify the healthcare provider and prepare for a cesarean section

b)

Reinsert the balloon catheter to continue the induction process

c)

Assess the cervix to determine if any dilation has occurred

d)

Immediately administer oxytocin to augment labor

20.

The nurse is assisting in the delivery of a baby with shoulder dystocia. Which of the following maneuvers should the nurse anticipate the healthcare provider to attempt first?

a)

McRoberts maneuver

b)

fundal pressure

c)

Zavanelli maneuver

d)

episiotomy

21.

A nurse is preparing for the delivery of a newborn with meconium-stained amniotic fluid. Which of the following actions should be performed immediately after birth?

a)

Suction the infants mouth and nose with a bulb suction

b)

administer a dose of surfactant

c)

intubate the neonate for mechanical ventilation

d)

perform a complete physical assessment of the infant

22.

A nurse is teaching a client about breast care during the postpartum period. Which of the following statements by the client indicates an understanding of the teaching?

a)

I will avoid breastfeeding for the first few days to prevent nipple soreness

b)

I should wear a tight-fitting bra to suppress lactation

c)

I will apply warm compresses to my breasts before breastfeeding

d)

I should wash my nipples with soap and water before each feeding

23.

A nurse is educating a postpartum client about normal lochia changes. Which of the following statements by the client indicates an understanding of the teaching?

a)

I should expect lochia rubra for up to 4 weeks after birth

b)

Lochia serosa will be bright red and occur STAT after delivery

c)

Lochia alba will be yellowish and last for the first few days

d)

lochia should gradually become lighter the days following birth

24.

A nurse is monitoring a postpartum client who had a cesarean section. Which of the following interventions is most important to prevent deep vein thrombosis (DVT)?

a)

Encourage early ambulation

b)

apply cold compresses to the legs

c)

elevate the legs above the heart

d)

Limit fluid intake to prevent edema

25.

A postpartum client is at risk for uterine infection. Which of the following is a common sign of endometritis?

a)

chills

b)

severe HA

c)

lower abdominal pain and foul-smelling lochia

d)

decreased BP and pale skin

26.

A postpartum client’s heart rate is 110 beats per minute. What should the nurse consider as the most likely cause?

a)

Dehydration

b)

anemia

c)

pain or anxiety

d)

normal postpartum adaptation

27.

A postpartum client’s white blood cell count is 18,000/mm³. What should the nurse consider when interpreting this result?

a)

The client has an infection

b)

this is a normal postpartum finding

c)

the client is at risk for thrombocytopenia

d)

the result is indicative of anemia

28.

A postpartum client has a blood pressure of 90/60 mmHg. Which of the following assessments should the nurse prioritize?

a)

Assess the client's urine output

b)

monitor for signs of hemorrhage or hypovolemic shock

c)

administer IV fluids to increase BP

d)

document the BP and continue monitoring

29.

A postpartum client’s temperature is 100.8°F (38.2°C) on the second day after delivery. Which of the following should the nurse do?

a)

Administer acetaminophen and monitor the clients temperature

b)

assess the client for signs of infection

c)

notify the healthcare provider immediately

d)

document the finding as normal variation in temperature

30.

A nurse is assessing a postpartum client and finds that the fundus is 3 cm above the umbilicus. What is the nurse’s most appropriate action?

a)

Reassess the fundus after 4 hours

b)

document the finding as normal for day 1 postpartum

c)

perform a fundal massage and assess for bladder distention

d)

notify the healthcare provider immediately

31.

A postpartum client who is breastfeeding asks the nurse, "Can I rely on breastfeeding as my only method of contraception?" What is the nurse's most appropriate response?

a)

Breastfeeding alone is a reliable method of contraception for at least 6 months

b)

breastfeeding can provide some contraception, but it is not foolproof after the first month

c)

breastfeeding is an unreliable method of contraception, and you need to use another method immediately

d)

You can safely use breastfeeding as contraception until your baby starts eating solid food

32.

A mother is concerned that her breastfed infant is not gaining enough weight. Which of the following should the nurse assess first?

a)

the infant's breastfeeding technique and latch

b)

the mothers dietary intake and milk production

c)

the infants feeding frequency and duration

d)

the presence of jaundice in the infant

33.

A nurse is educating a new mother on recognizing infant feeding cues. Which of the following behaviors should the nurse identify as a late feeding cue for an infant?

a)

Suckling on hand

b)

rooting reflex

c)

crying

d)

increasing physical movement

34.

A nurse is providing discharge teaching to a postpartum mother. Which of the following statements by the mother indicates the need for further teaching?

a)

I should call my doctor if i experience any white-yellowish lochia after 10 days

b)

i can continue to take my prenatal vitamins while I'm breastfeeding

c)

It's normal to feel some discomfort when i begin to breastfeed

d)

i can resume exercise after i stop bleeding or at my 6 week check-up

35.

A nurse is teaching a new mother about safe formula preparation. Which of the following instructions should be included in the teaching?

a)

you can use tap water to mic the formula as long as its warm

b)

formula should be made with bottled water only, never tap

c)

always use cool, boiled water to mix the formula, and discard any leftover formula after each feeding

d)

you can prepare the formula in advance and stor it for up to 48 hours in the fridge

36.

A nurse is teaching a postpartum mother about how to recognize signs that her baby is getting enough breast milk. Which of the following is the best indication that the baby is receiving enough milk?

a)

The baby is feeding for 5 minutes per breast every 2 hours

b)

the baby has wet diapers at least 3 times in 24 hours

c)

the baby is having at least 6-8 wet diapers and 3-4 bowel movements per day after the first few days

d)

the baby falls asleep STAT after each feeding and rarely feeds for more than 10 minutes

37.

A postpartum mother is concerned about the discomfort from engorgement while transitioning to bottlefeeding. Which of the following interventions would the nurse suggest to help alleviate the discomfort?

a)

apply cold compresses to your breasts to reduce swelling and pain

b)

increase breastfeeding sessions to help relieve the engorgement

c)

use warm compresses to stimulate milk production and ease the discomfort

d)

tighten your bra strap to provide compression and reduce swelling

38.

A new mother has been diagnosed with HIV. Which of the following is the most appropriate recommendation regarding breastfeeding?

a)

You can breastfeed as long as you use a barrier method to prevent the baby from touching your breasts.

b)

You should exclusively bottlefeed because HIV can be transmitted through breast milk

c)

Breastfeeding is safe as long as you are taking antiretroviral medication

d)

you may breastfeed for the first 6 weeks, then switch to formula feeding.