OB NCLEX Questions - smashpeas123 Save OB NCLEX Style Practice Quest...

OB NCLEX Questions ScienceMedicineNursing smashpeas123 Save OB NCLEX Style Practice Questions...74 terms Gathiri28Preview 25Qw/exp Delegation and Prioritiza...25 terms Preview OB Exam 1 Questions 82 terms corynna_coget Preview NCLEX 110 term kan Which of the following tasks may be delegated to the nursing assistant?

• checking the cervix of the patient who is less likely to deliver soon
• administering oxygen to the mother who has decreasing oxygen saturations
• providing ice chips for a mother who complains of a dry mouth
• Tearing off a strip of paper from the fetal heart rate monitor and putting it in the chart

C- When working in L&D the UAP can help with ADLs. They cannot be delegated tasks that require formulating a care plan, taking off orders, or administering medications Which of the following situations would most likely warrant contact with a physician for further orders for care or treatment?

• A patient has a 3rd degree perineal laceration after delivery
• A patient has lost 100 mL of blood with delivery
• A patient has a boggy uterus that does not firm with massage
• A patient is having rectal pain
• When caring for postpartum patients, the nurse must be familiar with what conditions are common occurrences following delivery and what

situations warrant a call to the physician for further help. Postpartum complications often include infection, blood clots, and hemorrhage. Excess bleeding may occur when the uterus is boggy and it does not firm up with massage.Following removal of the epidural, the patient develops a severe headache when she sits up in bed. The physician has instructed the patient that she will need a blood patch. Which best describes this procedure?

• Removing blood from a vein in the patient and injecting it into the epidural space in the back
• Placement of a large bandage over the site of the epidural insertion.
• Replacement of the epidural catheter into the same space for long-term control
• Placement of a nerve block in the spinal column at the location of the affected epidural space

A- When CSF leaks out of the epidural space a severe headache in the patient can occur. A blood patch can be performed by a physician to close the site. The small amount of blood is withdrawn from the mother's arm and the blood clots in the space.

Which of the patients described should the nurse see first?

• 20 yr old patient who just had her first baby and doesn't know how to breastfeed
• 27 yr old diabetic patient who delivered her second child yesterday and needs her morning dose of insulin
• 24 yr old patient who has had a large amount of lochia and has developed a hematoma on her perineum
• 30 yr old patient who needs to take a shower and eat breakfast before the physician comes to dismiss her
• A patient with a hematoma is at risk of hemorrhage and the nurse should assess her first

On the first following delivery, the physician ordered a hemoglobin level for the patient; the result was 9.9 g/dL. The physician did not list any other orders in the patient's chart since that time. Which response of the nurse is most appropriate>

• call the physician and ask if he wants a blood transfusion for the patient
• ask the physician about the hemoglobin level when he comes in for rounds
• Contact the laboratory and ask them to repeat the test
• continue to monitor the patient and document the result
• A postpartum patient is at risk of hemorrhage following delivery; often the physician will order a hemoglobin level 1-2 days after delivery to

check the mother's risk status. A level of 9.9 g/dL is lower than normal for a female patient, but is not necessarily low enough to warrant a blood transfusion.The patient's medical record states that she tested positive for group B Streptococcus infection. which of the following precautions should be given in this situation?

• the patient should receive antibiotics at this time
• the patient should be given antibiotics during labor
• the fetus should receive antibiotics as a prenatal infusion
• there is no treatment necessary

B- B. Streptococcus can be transferred to the baby during delivery to cause an infection. the test for the bacteria is performed at approximately 35 weeks gestation, but antibiotics are typically not given until the mother is in labor to reduce the chance that she will pass the infection to her child When reviewing information about infant care, the nurse should explain that the postpartum client should call the physician if her infant developed which of the following conditions?

• The infant is only sleeping 4 hours at night
• the baby wants to eat every hour
• The baby's cord has not fallen off within 7 days
• The baby has a dry mouth

D- If a baby has dry mouth or dry mucous membranes, he or she could be dehydrated and not getting enough to eat.Which of the following patients would be at high risk of developing pre-eclampsia? Select all that apply.

• A patient who is pregnant with her 3rd child
• A patient who is married
• A patient who is 40 yrs old
• A patient who is overweight
• A patient who is pregnant with twins

C, D, E-Pre-eclampsia is a state that develops during pregnancy in which a mother has high blood pressure and starts losing protein into the urine.Certain risks that increase such as a first time pregnancy, advanced maternal age, overweight or obesity in the mother, and pregnancy with multiple babies

A high risk pregnant patient has had a complicated delivery and is in the recovery room with active bleeding. The physician has ordered hetastarch in sodium chloride (Hespan) IV infusion. Which best describes the indications for this fluid?

• increasing plasma volume during shock or bleeding
• Causing blood coagulation to promote blood clotting
• Improving circulation by causing vasodilation
• Increasing cardiac contractility to improve circulation

A- Hetastarch in sodium chloride (Hespan) is a type of plasma expanding solution that is used to increase the volume of the intravascular system during times of blood loss. Hespan is typically used for volume replacement to prevent complications of severe hemorrhage, such as hypovolemic shock A patient with high bp during labor has been given magnesium sulfate IV. In addition to regulation of bp, which of the following results would the nurse expect to see after administration of this medication?

• cool, pale skin
• Constipation
• Muscle weakness
• Neck pain

C- Administration of magnesium sulfate is a form of treatment used for some women who have pre-eclampsia during pregnancy and labor.Magnesium sulfate is given to prevent preterm delivery but it can also cause some negative effects in the mother, including muscle weakness, blurred vision, headache, nausea, and vomiting A patient receiving TPN with lipids thru a central line placed in the subclavian vein. Which complication is most closely associated with this type of fluid administration?

• Fractured ribs
• Pneumothorax
• Mental confusion
• Allergic reaction

Pneumothorax A patient who is 28 weeks' gestation undergoes a nonstress test when she noticed that the baby hasn't moved recently. the results are considered reactive. What does this mean?

• the baby has normal heart rate accelerations
• the baby does not have any noted birth defects
• the baby is most likely neurologically impaired
• the baby is going to be born preterm

A- NST may be performed on a pregnant patient after approximately 28 weeks' gestation. the NST is noninvasive and involves monitoring the baby's heart rate and movements for a period of about 30 minutes. A reactive test indicates that the baby has changes in heart rate in response to movement, which is normal

Which of the following increases the risk of postpartum bleeding in a patient? Select all that apply.

• complications during delivery
• retained placental fragments
• involution of the uterus
• administration of oxytocin during delivery
• precipitous delivery

A, B, E- postpartum hemorrhage is a potential complication following delivery that the nurse must remain aware of and continue to assess while caring for a postpartum patient. The patient has excess bleeding following delivery, which include complications during delivery, such as the use of forceps or vacuum extraction; retained placental fragments, subinvolution of the uterus, use of magnesium sulfate during labor, and a precipitous delivery Which of the following demonstrates the effects of chronic stress during pregnancy? Select all that apply.

• increased risk of miscarriage
• low birth weight
• increased risk of preterm birth
• decreased bonding and attachment
• postpartum hemorrhage

A, B, C- chronic stress leads to increased release of the hormone cortisol and chronic inflammation in the blood vessels. A pregnant patient may have an increased risk of miscarriage early in the pregnancy, she may deliver a baby who has a low birth weight, and she has an increased risk of preterm birth a pregnant client is undergoing a laparoscopic cholecystectomy because of severe abdominal pain. Which of the following factors must the nurse consider when providing care to this patient?

• remind the patient that there is an increased risk of bleeding with this procedure during pregnancy
• avoid administering pain medications after surgery to reduce the risk of fetal suppression
• tell the patient that it is riskier to delay treatment of gallstones than to have laparoscopic surgery to correct the situation
• encourage the patient to limit her fluid intake for 48 hrs prior to surgery

C- pregnancy increases the risk of gallstone development and a percentage of women will need to have a cholecystectomy during pregnancy for management and prevention of complications. Studies have shown that the risks of the laparoscopic surgery are less than if the symptomatic patient were left to manage the gallstones without surgery, which could ultimately lead to significant pain and tissue necrosis A woman who is 23 weeks' pregnant is at risk for preterm birth and the physician decides to place a cerclage. which information must the nurse tell this patient as part of routine care with a cerclage?

• the cerclage will stay in place for two weeks
• the patient will need to remain on bed rest for the remainder of pregnancy
• the cerclage may cause a small amount of bleeding after it is placed
• the patient will need to have induced labor at 37 weeks

C- when a pregnant patient is at increased risk of preterm labor because of an incompetent cervix, the physician may place a cerclage which is a small stitch in the opening of the cervix that keeps it closed. this prevents the cervix from opening and prematurely delivering the baby. the cerclage may cause a small amount of bleeding in the time directly after placement, but this should resolve within about a day.