Exam 3 NCLEX Questions: OB

Exam 3 NCLEX Questions: OB

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• The nurse is caring for a laboring client with a known

history of cocaine abuse. What complication is most likely for this client?

• Abruptio placentae.
• Polyhydramnios.
• Placenta previa.
• Prolapsed cord.

a The nurse is assessing a prenatal client at 30 weeks' gestation who was admitted to the hospital with complaints of severe nausea and vomiting, elevated alpha-fetoprotein, and a fundal height of 38 cm. What diagnosis should the nurse anticipate?

• Oligohydramnios

.b. Multiple pregnancy.

• Abruptio placentae.
• Placenta previa.

b The nurse is providing prenatal care to a client pregnant with twins. How much weight should the nurse counsel this client to gain?

• 25-30 pounds.
• 15-20 pounds.
• 30-35 pounds.
• 35-45 pounds.

d

The nurse is caring for a prenatal client at 38 weeks' gestation whose ultrasound reveals approximately 3000 mL of amniotic fluid. She complains of shortness of breath, and has 2+ pitting edema in her lower extremities.

The nurse anticipates preparation for:

• Intravenous antibiotics.
• Delivery by cesarean.
• Amniocentesis.
• Amnioinfusion.

c The nurse is assessing a prenatal client diagnosed with possible placenta previa. What signs and symptoms should the nurse expect this client to demonstrate?

• Severe abdominal pain.
• Bright red vaginal bleeding.
• Absence of fetal heart sounds.
• Dark red vaginal bleeding.

b While monitoring the patient on the central monitor, the nurse notes a sudden drop in fetal heart rate to less than 100 beats per minute, and the contraction pattern appears titanic. Her abdomen is very tender to touch, and there is no increase in vaginal bleeding. One hour ago, the patient was 6 cm dilated, 80?faced, and 0 station. The

nurse understands that these symptoms are indicative of:

• Placental abruption.
• Disseminated intravascular coagulation.
• Impending seizure.
• Placenta previa.

a On examination at 16 weeks' gestation, the physician identifies a shorter-than-average cervix. This patient

might be a candidate for:

• Fern test.
• Cerclage.
• Fetal fibronectin.
• Betamethasone.

b A patient is at risk for abruptio placentae. The patient asks what chance her baby has of survival. A correct response

by the nurse is that perinatal mortality with abruption is:

• 5 percent.
• 25 percent.
• 10 percent.
• 20 percent.

b The drug used in preterm labor that has few side effects

and can be given orally or sublingually is:

• Betamethasone.
• Fetal fibronectin.
• Nifedipine.
• Magnesium sulfate.

c

The nurse is caring for a third-trimester prenatal client admitted with bright red, painless vaginal bleeding.Which nursing intervention is not recommended?

• Vaginal exams.
• Bed rest with bathroom privileges.
• Application of an internal uterine pressure catheter.
• Intravenous fluids with lactated Ringer's.

a

• The nurse is caring for a client whose uterine

contractions are irregular and of low amplitude, and the dilatation of the cervix is less than 1 cm per hour. The

nurse recognizes this pattern as:

• Hypotonic labor.
• Tachysystole labor.
• Arrest of descent.
• Normal labor.

A The nurse is reviewing the complications of breech presentation in preparation for a prepared childbirth class. Which of the fetal/neonatal risks associated with breech presentation should she include? Select all that apply.

• Birth trauma.
• Prolapsed cord.
• Gestational diabetes.
• Macrosomia.

a,b A nurse is admitting a laboring client with a breech presentation to the birthing unit. Where is the most appropriate place for the nurse to auscultate for fetal heart tones?

• Below the umbilicus.
• Lower right maternal quadrant.
• Above the umbilicus.
• Midline of the umbilicus.

c The nurse is performing a pelvic exam on a laboring client, and discovers a loop of cord in the vagina. What is the priority nursing action?

• Place client in a side-lying position to increase

perfusion.

• Call the physician or nurse-midwife for emergency

delivery.

• Push the presenting part upward off the umbilical cord.
• Administer oxygen at 5 L per minute per face mask.

c The nurse knows that hypertonic labor contractions, if

unresolved, can develop into:

• Prolonged latent phase.
• Precipitous delivery.
• Late decelerations.
• Persistent occiput posterior.

a

A client arrives in the labor room and says she started contracting 1 hour ago when her water broke. A vaginal exam reveals the patient to be complete and +2 station.She delivers 15 minutes later. The nurse understands that

this type of labor is classified as:

• Precipitous labor.
• Rapid second stage.
• Dysfunctional birth.
• Imminent birth.

a A client is diagnosed during labor as persistent occiput posterior. Which intervention(s) might help? Select all that apply.

• Knee-chest position.
• Sims position.
• Pelvic rocking.
• Hands-and-knees (on all fours) position.

a, c, d A client of Chinese descent arrives in the labor unit. She indicates she was breech 2 weeks ago and used “moxa” to change her baby’s position. An exam reveals a vertex

presentation. The nurse understands that “moxa” is:

(select all that apply)a. A traditional Chinese medicine.

• A complementary therapy
• An alternative therapy.
• A form of quackery.

a, b The client is experiencing late decelerations. The nurse

understands that this is caused by:

• Fetal cardiac abnormality.
• Uteroplacental insufficiency.
• Umbilical cord compression.
• Fetal head compression.

b A client is admitted to the labor area with a pregnancy at 42 weeks’ gestation. The nurse knows that this client is

especially at risk for: (select all that apply)

• Neonatal respiratory depression.
• Uteroplacental insufficiency.
• Meconium stained amniotic fluid.
• Breech presentation.

b, c A client at 19 weeks gestation complains of vaginal spotting and cramping. Which of the following signs indicates an intrauterine fetal demise? Select all that apply.

• No detected fetal cardiac activity.
• Positive Spalding’s sign.
• Increased estriol levels.
• Decreased estriol levels.

a,b,d