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OBSTETRIC NURSING (ABNORMAL)
POST TEST Prepared By: Ms. Lorelie Pomentil
NAME: SECTION: SCORE: /25
1. A nurse is caring for a pregnant client who wants to know B. Rh positive; Rh negative why she needs to be tested for diabetes when she has no C. Rh negative; Rh positive personal family history. What is the best response by the D. Rh negative; Rh negative nurse? A. “Family History has no impact on GDM” 7. The physician prescribed RhIG (RhoGAM) to a woman who B. “Pregnancy increases insulin resistance” have been diagnosed with RH incompatibility. The nurse knows C. “Pregnancy increases glucose production” that this should be administered during D. “If you didn’t have it last pregnancy, you probably A. 28th week of pregnancy won’t this time either” B. Within 72 hrs after delivery C. After invasive procedures 2. A postpartum client is recovering after delivery of a baby 24 D. All of the above hours ago. The provider has ordered a glycosylated haemoglobin (HbA1c) level since the client had gestational 8. The nurse identifies which advice as best for a woman who diabetes during pregnancy. In this situation, which says she is miscarrying? glycosylated hemoglobin level would be considered normal for A. Lie down and remain on bed rest for 24 hours to this client? stop the bleeding. A. Between 10 and 12 percent B. Continue light activity as usual because most B. Between 15 and 20 percent spotting during pregnancy is harmless. C. Between 8 and 10 percent C. Save any clots or material passed for your D. Less than 6 percent healthcare provider to examine. D. Use a tampon to put pressure on your cervix and 3. Which statement by Beverly would the nurse document as stop the bleeding. possible evidence that she might be developing gestational hypertension? 9. The doctor suspects that the client has an ectopic A. "My feet are so swollen at night I can't put on my pregnancy. Which symptom is consistent with a diagnosis of bedroom slippers." ectopic pregnancy? B. "I never guessed I would feel as tired as I do just a. Painless vaginal bleeding from being pregnant." b. Abdominal cramping C."My abdomen feels firm, as if I had a blown-up c. Throbbing pain in the upper quadrant balloon inside me." d. Sudden, stabbing pain in the lower quadrant D. "I can live with my puffy feet, but now it's also my hands and wrists." 10. A woman who's 36 weeks pregnant comes into the labor & delivery unit with mild contracts. Which of the following 4. The nurse knows that preeclampsia tends to occur during complications should the nurse watch out for when the client what time in a pregnancy? informs her that she has placenta prevue? A. before 20 weeks a. pain B. in the third trimester and postpartum b. vaginal bleeding C. after 20 weeks c. emesis D. in the first and second trimester d. fever
5. The patient with preeclampsia is started on Magnesium 11. Which of the following problems mostly occur in pregnant Sulfate. The nurse knows to have what medication to prepare clients in the 2nd trimester of pregnancy? at bedside? A. mastitis A. Acetylcysteine B. Rh incompatibility B. Naloxone C. Pregnancy induced hypertension C. Oxytocin D. Post partum hemorrhage D. Calcium gluconate 12. A 21 y.o. client, 20 weeks pregnant, is diagnosed with 6. RH incompatibility problems can occur if the mother is hydatidiform mole. She experiences excessive vomiting due to _________ and her fetus is __________ A. Abnormally high level of Hcg A. Rh positive; Rh positive
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B. electrolyte imbalance b. Imminent miscarriage C. PIH c. Threatened miscarriage D. Stress d. Incomplete miscarriage
13. Hyperemesis gravidarum can lead to 20. A nurse is teaching a nursing student about risk factors for A. Fetal anomalies postpartum hemorrhage. Teaching has been understood if the B. Dehydration and electrolyte imbalance student identifies the most common cause of postpartum C. miscarriage hemorrhage as which of the following? D. PIH A. Uterine Atony B. Lacerations 14. Which statement is TRUE regarding abruptio placenta? C. Retained placental fragments A. This condition occurs due to an abnormal attachment of the D. Multigravida placenta in the uterus near or over the cervical opening. B. A marginal abruptio placenta occurs when the placenta is 21. A nurse notes trickling of blood with every postpartum located near the edge of the cervical opening. exam since a vaginal delivery, but on assessment, the client’s C. May present as dark red bleeding fundus is firm. Based on these findings, the nurse knows that D. Bleeding is often bright red and painless which of the following is the most likely cause? a. Uterine atony 15. The most common site for ectopic pregnancy is in the b. Disseminated Intravascular Coagulation A. Fallopian tube, isthmus c. Retained placenta B. Fallopian tube, ampulla d. Lacerations C. Fallopian tube, infundibulum D. None of the above 22. A 36-year-old woman who had Abruptio placenta experienced complications post-partum. She is excessively 16. A nurse is providing instructions to a mother who has been bleeding during the post-partum period. She then heard the diagnosed with mastitis. Which of the following statements if physician ordered heparin administration for her. The woman made by the mother indicates a need for further teaching? was confused and asked the nurse why she should receive an A. “I need to take antibiotics, and I should begin to feel anticoagulant. As a knowledgeable nurse you respond better in 24-48 hours.” A. “Heparin promotes uterine contractions thus halt B. “I can use cold compress to assist in alleviating the bleeding” pain.” B. “Heparin corrects the abnormal clotting which C. “I need to wear a supportive bra to relieve the restores coagulation throughout the body thus discomfort.” prevents bleeding” D. “I need to stop breastfeeding until this condition C. “I would need to clarify the doctor’s order” resolves.” D. “You should ask the physician”
17. Mastitis is confirmed and is found to be localized in the left 23. Which best describe Postpartum Depression? breast. What nursing intervention should be implemented for A. Feelings of sadness during the first two patient Ahri? weeks postpartum A. Stop breastfeeding until the pain subsides B. More serious problem requiring follow B. Recommend that patient Ahri continue up and treatment from provider breastfeeding as usual C. Symptoms requiring immediate treatment C. Teach patient Ahri to breastfeed on the unaffected D. None of the above breast and then to the affected breast D. Suggest to patient Ahri to bottle-feed her child 24. The nurse is making an effort to address Bailey Cheshire's psychosocial health in addition to her physiologic well-being. 18. Nurse Mai is putting together a list of instructions for Which of Bailey's statements would be most suggestive of breastfeeding mothers containing preventive measures against possible post-partal psychosis? postpartum mastitis. The list shall include all but one of the A. "I wish my baby had longer hair.“ following. B. "I've felt exhausted ever since birth." A. Gently wipe the breast area with cotton and C. "I'm happy not to have any children." alcohol regularly. D. "Breastfeeding is way harder than I thought." B. Expose the nipples to air for at least part of the day 25. The patient asks about ways to avoid post-partum blues C. Apply vitamin E ointment on the breast area every when she returns home. Nurse Momo would be correct to give day to help soften the nipples. the following advice, except? D. Ensure that the infant is in the correct position A. Recommend that she take some time everyday to during feeding. do something for herself B. Advise the patient to strive for perfection so that 19. Anje, who is 16 weeks pregnant was rushed to the ER after she won’t feel bad about herself having heavy vaginal bleeding, passage of clots, abdominal C. Help the client build a healthy balance in sleep, pain and cramping. Expelled materials were examined and it exercise, and nutrition was determined that part of the conceptus were expelled but D. Encourage the client to verbalize emotions to the placenta was retained. The nurse understands that this is support person what type of miscarriage? a. Missed miscarriage
