NURSING 306 EXAM OB 60 (GRADED A) QUESTIONS AND ANSWERS: 100% GUARANTEED PASS.

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OB QUESTIONS AND ANSWERS: 1. A nurse is caring for a client who is to receive oxytocin to augment her labor. Which of the following finding contraindicates the initiation of the oxytocin infusion a... nd requires notification of the provider? • Late declaration 2. A nurse is caring for a client who is in premature labor at 32 week of gestation and is receiving magnesium sulfate 2g IV for tocolytic therapy. The nurse should report which of the following finding to the provider? • Absent deep tendon reflexes 3. A nurse is preparing to administer hepatitis B to a new born. The prescription state” Administer 5 mcg IM on my time today” Available is a 5ml via with 10 mcg/mg. what is the correct volume to administered? • 5mcgX 1ml/10mcg= 0.5 ml 4. A nurse is providing care to a client whose labor is being augmented with oxytocin (Pitocin) sees a pattern of a variable declarations on the fetal monitor strip. Which of the following is the priority nursing action? • Chance client’s position 5. A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate 2 g IV. Base on the chart findings, which of the following should the nurse report the provider? • Urine output (90 ml/4hr) 6. Nurse is caring for a client who is in labor and has ruptured membrane and one inch of the umbilical cord protruding into the vagina. After calling for assistance, which of the following is a priority nursing action? • Apply internal upward pressure to the presenting part. 7. A nurse is caring for 8 hr-old newborn who is full-term. Which of the following assessment finding indicate to the nurse that the newborn is developing sepsis? (select all that apply) • Tachypnea • Nasal flaring • Temperature stability • Irritability 8. A nurse is caring for a client diagnosed with hyperemesis gravidarum. The provider has prescribed lactated Ringer’s 1,000 ml IV to infuse over 8 hr. At what rate should the nurse set the IV infusion pump? • 125ml/hr. 9. A nurse is caring for a client who is 3 days post-partum and planning discharge to home. Which of the following non pharmacologic interventions should the nurse include in the plan of care for lactation suppression? • Apply cabbage leaves to the breast 10. A nurse is caring for a newborn who was transferred to the nursery 30 min after delivery. Which of the following actions should a nurse take first? • Verify the newborn ID 11. A Nurse is caring for a client who is at 38 weeks of gestation. Which of the following actions should the nurse take priority to applying external transducer for fetal monitoring? • Leopard’s maneuver 12. A nurse is caring for a client and her newborn, whose culture differs from the nurse’s. Which of the following indicated a need for intervention by the nurse? • Delaying feeding until breast milk comes in. 13. A nurse is caring for a client who has experience post-partum hemorrhage. The nurse should assess loss by measuring which of the following? • Percentage of saturation on perineal pads in a 2-hr-period 14. A nurse is caring for a client who has preterm premature rupture of membrane. Which of the following is the priority nursing action? • Monitor client temperature every 4 hrs. 15. A nurse is assessing fetal tones for a client who is pregnant. The nurse has determined the fetal position as left occipital anterior. To which of the following areas of the client’s abdomen should the nurse apply the ultrasound transducer to assess the point of maximum intensity of the fetal heart. • Left lower quadrant 16. A nurse is caring for a client who is 1 day post-vaginal delivery. The nurse determines the client’s fundus is firm, located 2 fingerbreadths above the umbilicus, and deviated to the left. Which of the following actions should the nurse take first? • Assist the client to empty her bladder. 17. A nurse is caring for an adolescent client who is postpartum. Which of the following assessment finding s should the nurse address first? • Miss interpretation of infant feeding cues 18. A nurse is assessing a fetal heart monitor tracing of a client receiving oxytocin (Pitocin) at 10 milliunits /min. Uterine contractions are noted every 60 to 90 seconds. After turning the client to side-lying position, which of the following actions should the nurse take next? • Discontinue the medication infusion 19. A nurse is caring for a client in labor who is reporting excessive pain. Which of the following interventions requires the nurse to hold an additional certification or licensure? • Acupuncture 20. A nurse is caring for a client who is breastfeeding her infant. The client asks the nurse if she should offer water to her infant. Which of the following responses by nurse is appropriate? • “Water is unnecessary because breast milk provides adequate fluids and nutrition.” 21. A prospective father is accompanying his wife for her first prenatal visit at 8 weeks. The father tells the nurse that he is excited, but overwhelmed. The nurse recognizes the father is most likely demonstrating? • Ambivalence 22. A nurse is assessing a client during a routine prenatal examination detect fetal heart tones with an ultrasound stethoscope .Which of the following fetal heart rate (FHR) parameters should the nurse document? (select all that apply) • Rate • Rhythm • location 23. A nurse is caring for a client in labor whose cervix is 9 cm dilated. Oxytocin (Pitocin) is infusing and the nurse observes gradual decelerations beginning and ending with contraction. Which of the following actions should the nurse take? • Continue fetal heart rate monitoring 24. A nurse is providing preconception counseling to a client. Which of the following client statements indicates an understanding of the teaching? • “I should increase my folic acid intake when I am trying to become pregnant.” 25. A nurse is caring for a full-term newborn immediately following delivery. Which of the following actions should the nurse take first? • Dry the newborn 26. A nurse is caring for a client who is at 39 weeks of gestation and had a spontaneous rupture of membranes 24 hr before being admitted to the hospital. Which of the following assessment finding should indicate to the nurse a probable complication? • Maternal tachycardia 27. A nurse is caring for a client whose last menstrual period began April 10. Using Nagele’s rule, what is the estimated date of birth (EDB)? • January 17 28. A nurse is providing discharge teaching for the patients of a 2- day-old newborn who was circumcised 10 hours ago. The nurse should instruct the parents to notify the provider if they observed which of the following? • Swelling of the penis 29. A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain of the procedure for newborn? • Swaddle the newborn before the heel puncture. 30. A nurse is assessing a newborn whose mother has gestational diabetes. The newborn’s blood glucose level is 33 mg/dl. Following finding should the nurse expect? (select all that apply) • Lethargy • Feeding difficulty • Jitteriness • Irregular respiration rate 31. A nurse is caring for a client who is in labor and is to receive epidural analgesia. Which of the following actions is appropriate for the nurse to take after epidural analgesia has been initiated? • Evaluate the client’s blood pressure 32. A nurse is providing discharge teaching for the parents of a newborn regarding car seat safety. The nurse should explain that the car seat should face the rear of the vehicle because it. • Protects the newborn’s neck and head. 33. A nurse is planning care for a postpartum client. Which of the following is an appropriate intervention the nurse should promote maternal postpartum adjustment the taking –hold phase? • Demonstrating to the client how to perform a newborn bath. 34. A nurse is monitoring a newborn who has hyperbillirubinemia and is receiving phototherapy. Which of the following assessment finding indicated a potential complication? • High-pitched cry 35. A nurse is caring for a 2-day-old newborn who was born at 40 weeks gestation. The newborn’s most recent indirect bilirubin level is 16mg/dl, and he is receiving phototherapy. Which of the following actions by the nurse is most appropriate? • Continue the newborn’s current prescribed treatment. 36. A nurse is providing discharge instructions regarding car seat safety to the parents of a newborn. The nurse should instruct the parent that the car seat should be rear facing until the newborn is. • 20lb and 1 year of age. 37. A nurse is caring for a client who is at 36 weeks of gestation and has been prescribe of amniocentesis. For which of the following reasons should the nurse prepare the client for an ultrasound? • To locate a pocket of fluid 38. A nurse is monitoring a client in labor and notes several late decelerations over 10-min period. The nurse should recognize that this is a result of. • Uteroplacental insufficiency 39. A nurse is monitoring a client who is at 35 weeks of gestation and just underwent an amniocentesis. Which of the following finding should the nurse report to the provider? • Leakage of fluid 40. A nurse is caring for a client who is 18 weeks of gestation whose maternal serum alpha- fetoprotein (MSAFP) results are high. Which of the following actions by the nurse is appropriate • Request a prescription for an ultrasound. 41. A nurse is caring for a client in the first stage of labor. The client has had no previous education about relaxation techniques and is experiencing pain during contractions. Which of the following should the nurse use to distract the client? • Effleurage 42. A client at 34 weeks of gestation asks the nurse how she will know when is in labor and should go to the hospital. Which of the following responses by the nurse is appropriate? • “You will notice blood-tingled discharge from vagina.” 43. A nurse is caring for a client who experiencing postpartum hemorrhage during the fourth stage of labor. Identify the sequence the nurse should following when implementing the appropriate nursing actions. (Move the steps into the box on the right, placing them in the selected order of performance. All steps must be used.) • Massage fundus • Assess the bladder • Give oxytocin (Pitocin) 20unit IV • Administer methylergonovine(Methergine)0.2 mg IM 44. A nurse is caring for a client undergoing an oxytocin-stimulated contraction test. The nurse notes three contractions in 10 min with late decelerations. Which of the following finding should the nurse report to the provider? • Positive 45. A nurse is admitting a client to the labor and delivery unit when the client states, “My water just broke.” Which of the following is the priority intervention for the nurse to take? • Monitor the fetal heart rate. 46. A nurse is caring for a client who has postpartum hemorrhage due to uterine hypotonicity. Which of the following nursing actions is the highest priority? • Massage the fundus 47. A nurse is working in an antepartum clinic is caring for a client who is at 41 weeks of gestation. A biophysical profile (BPP) has been recommended. When educating the client about what the test determines, which of the following should the nurse include? • Fetal breathing movement 48. A client who is in labor has just received an epidural block. The nurse notes that the client’s systolic blood pressure has dropped from 120 mm Hg to 94 mm Hg. After turning the client to her left side, which of the following actions should the nurse take next? • Increased the IV fluid rate 49. A nurse is educating a client who is at 30 weeks of gestation regarding a 3-hr oral glucose tolerance test. Which of the following should the nurse include in her teaching? • Consume 150 g of carbohydrates daily for 3 days prior to the test. 50. A nurse is teaching a group of parents attending a prenatal class about newborn safety. Which of the following statements by a parent demonstrates a need for further teaching? • “I will cover the crib mattress with a plastic to prevent staining.” 51. A nurse is caring for a client in the active stage of labor whose labor has not progressed in the last 4 hrs. Which of the following is an appropriate statement by the nurse? • “ Your contraction pattern will need to be assessed with an intrauterine pressure catheter” 52. A nurse is caring for four clients on the antepartum unit who have mild preeclampsia. Which of the following finding should indicate to the nurse that the client requires further assessment and intervention? • Deep tendon reflexes 4+ 53. A nurse is planning to provide newborn discharge teaching to a client and family. Which of the following is the highest priority to be included in the teaching? • Suctioning with a bulb syringe to maintain an unobstructed airway. 54. A nurse is caring for a client in labor who reports increasing rectal pressure. A vaginal examination reveals her cervix is 8-9 cm dilated, with contractions 2 to 3 apart lasting 80- 90 seconds .The nurse should understand that client is in the • Transition phase of labor. 55. A client is caring for a client who is at 24 weeks of gestation and is undergoing a 1 hr blood glucose screening test. The client’s test result is 160mg/dl. Which of the following actions by the nurse is appropriate? • Schedule the client for a 3-hr oral glucose tolerance test. 56. A nurse in a prenatal clinic is caring for a client who reports that her menstrual period is 2 weeks late. The client appears anxious and asks the nurse id she is pregnant. Which of the following is an appropriate response by the nurse? • “You can skip a period for other reason. Describe your typical cycle.” 57. A nurse is providing care for a client who is in labor. While preparing to perform a sterile vaginal examination, the nurse note a prolapse umbilical cord and abrupt deceleration of the fetal heart rate monitor tracing .Which of the following image illustrate how the nurse should reposition the client? o hand and knees position(pt. facing the pillow) 58. A nurse is preparing a client for an amniocentesis. Which of the following action is appropriate for the nurse to take prior to procedure? o Assess the fetal heart rate 59. A nurse is caring for a client who is early labor. The nurse observes the client tensing at the onset of contractions. Which of the following instructions regarding breathing techniques should the nurse initially provide the client? • Take the cleaning breath. 60. A client present to the clinic for her prenatal visit at 20 weeks of gestation. Which of the following concerns reported by the client should require assessment by the nurse? o Frequency urination of cloudy urine ATI FORM B: 1. A nurse is assessing Apgar score to 41-week gestation newborn. AGPAR findings include: heart rate of 120/min; slow, weak cry; flaccid; grimaces with bulb suctioning; and acrocyanosis. Base on the results, the nurse should assign a score of. o 5 2. A nurse is preparing to administer magnesium sulfate IV to a client who is diagnosed with preterm labor. Available is 20 g magnesium sulfate in 500 ml of dextrose 5% in water. The provider prescribes 2 g/hr to be infused. What rate should the nurse the nurse set the IV? o 50 ml/hr 3. A nurse is providing teaching about nonpharmacological pain management for a postpartum client who is breastfeeding and has engorgement. Which of the following methods should the nurse recommend? o Cold cabbage leaves 4. A nurse is providing education regarding management of diabetes during pregnancy to a client who has type 1 diabetes mellitus and is receiving insulin. Which of the following statements by the client should indicate to the nurse a need for further teaching? o “ I should eat most of my carbohydrates at breakfast” 5. A nurse is assisting a client in the second stage of labor. Which of the following actions by the nurse is appropriate in assisting the client with effleurage? o Have the client stoke the abdomen using circular motions during contractions. 6. A 1-day-old newborn who is hospitalized has bilirubin level of 12.6 mg/dL. While the newborn is receiving phototherapy, the priority nursing intervention is to. o Establish a regular feeding schedule to maintain hydration. 7. A nurse on the unit is planning discharge for four clients. Which of the following newborns will require care beyond that of a standard follow-up visit with the provider after delivery? o A newborn being sent home 22hr after birth. 8. A nursing is caring for a client who is at 26 weeks of gestation. Which of the following finding should the nurse report to the provider? o Pitting edema of the ankles 9. A nurse is discussing birth control with postpartum client prior to discharge. The client prefers not to use hormonal contraceptive methods and would like to use condoms. Which of the following findings should the nurse recognize as placing the client at the highest risk for contraceptive failure? o Reports partner’s reluctance to use contraceptive 10. A nurse is observing a mother caring for her newborn who is crying. Which of the following actions by the mother should the nurse recognize as a positive parenting behavior? o Lay the newborn across her lap and gently sways 11. A client who is at 29 weeks of gestation presents to the clinic for a nonstress test. After obtaining a baseline fetal heart rate (FHR) of 140 to 150/min, the nurse observes the FHR accelerating to 165 to 170/min for 15 seconds three times over 20 min. The nurse reports. o Reactive 12. A nurse is performing a newborn assessment 12 after delivery. Which of the following findings indicate possible neonatal sepsis? (Select all that apply.) o Temperature instability o Tachypnea o Nasal flaring o Irritability 13. A nursing is educating a client who has preeclampsia and has been prescribed a 24-hr urine collection test. The nurse should tell the client that the purpose of this test is to identify which of the following? o Protein 14. A nurse is caring for a client who has just delivered a newborn vaginally. The placenta has just been delivered when the client becomes nonresponsive. Which of the following actions should the nurse take first? o Determine respiratory function 15. A nurse caring for a client 1 hr after delivery finds the perineal pad saturated with bright red blood. Which of the following actions should the nurse anticipate taking first? o Massage the client’s fundus 16. A nurse is caring for a client who has been prescribed Rh immune globulin (RhoGAM). Which of the following statements by the client should indicate to the nurse a correct understanding of the medication? o “ the medication is to prevent blood incompatibilities in my next pregnancy” 17. A charge nurse on the labor and delivery unit is receiving report on four client s in various stage of labor. The charge nurse should plan to first assess the client who is experiencing which of the following types of decelerations? o Prolonged 18. A nurse should question which of the following orders from a primary care provider for admission of a newborn to the nursery? o Check vital sign very 8 hr. 19. A client who is in 9 weeks of gestation presents to the clinic with blurred vision, cool clammy respirations, and a rapid pulse. Which of the following should the nurse anticipate performing first? o Check blood glucose level 20. A nurse is planning care for a client who is to undergo a nonstress test. Which of the following should the nurse include in the plan of care? o Instruct the client to press the provided button each time fetal movement is detected. 21. A nurse is caring for a client who is being seen 2 weeks after a cesarean birth. Which of the following findings should the nurse recognize as a possible sign of postpartum infection? o Unilateral breast pain 22. A nurse is providing education about family bonding to parents who recently adopted a newborn. The nurse should make which of the following suggestions to enable the family’s 7-year-ld son to accept the new family member? o Encourage the sibling to sing to help soothe the newborn 23. A nurse is caring for a client who has been diagnosed with placenta previa. The nurse should expect which of the following findings? o Painless vaginal bleeding 24. A nurse is performing an initial newborn assessment following a low forceps vaginal delivery. Which of the following image illustrated a finding the nurse should report to the provider? o Baby with lots of red marks on the back 25. A nurse who is pregnant arrives at the labor and delivery unit reporting leakage of fluid from the vagina. The nurse determines that the client has probable rupture of membranes when assessment reveals that o The ferning test is positive 26. A nurse is caring for a client who is at 32 weeks of gestation and has gonorrhea. This infection places the client at risk for which of the following during pregnancy? o Premature rupture of membranes 27. A nurse is caring for a client who has just delivered a newborn. The nurse is preparing to administer oxytocin (Pitocin). Which of the following findings is an indication for the use of oxytocin? (Select all that apply.) o Flaccid uterus o Excess vaginal bleeding 28. A nurse is proving education about car seat safety to the parents of a newborn. Which of the following should the nurse include in the teaching? o Position the newborn in the car seat at a 45 degree angle. 29. A client in the transitional phase of labor is using breathing techniques to manage her pain. Which of the following actions by the client should indicate to the nurse that the client’s plan of care should be altered? o The client reports tingling sensation in her fingers. 30. A nurse is caring for a client newly admitted to the PACU following a cesarean birth. Which of the following is the priority nursing assessment? o Amount of postpartum lochia 31. A nurse is caring for a client who is hospitalized at 8 weeks of gestation for hyperemesis gravidarum. Which of the following actions should the nurse anticipate taking first? o Start IV fluid 32. A nurse is assessing a client on her first postpartum day and notes that the fundus is firm, three fingerbreadths above the umbilicus, and located on the right side of the abdomen. Which of the following actions should the nurse anticipate taking first? o Assist the client to void 33. A client in labor receives an epidural anesthetic. While resting in a supine position, the client has a hypotensive episode. Which of the following interventions should the nurse perform first? o Turn the client to a lateral position. 34. A nurse is assessing young adult in a women’s health clinic who asks for a contraceptive. The client report to the nurse a familial history of osteoporosis. Which of the following contraceptive methods is contraindicated for this client? o Medroxyprogesterone acetate (Depo-Provera) 35. A nurse is caring for antipartal clinic is providing care for a client who is 26 week gestation. Upon reviewing the client’s medical record, which of the following findings should the nurse report to the provider? (Click on the “Exhibit” button below for additional client information. There are three tabs that contain separate categories of data.) o Fundal height measurement 36. A nurse is caring for a client who is using jet hydrotherapy during labor. The nurse is aware that which of the following methods of monitoring the fetal heart rate is contraindicated for this client? o An internal electrode 37. A nurse is teaching a prenatal class on infant safety. Which of the following statements made by a parent indicates a need for further teaching? o “I will set my hot water heater no higher than 130 F.” 38. A nurse is caring for a client whose last menstrual period was January 20. Using Nagele’s rule, what is the client’s estimated date of birth? o October 27 39. A nurse is admitting a client who is at 38 weeks of gestation and states her uterine contraction are every 4 min the nurse notes variable decelerations on the fetal heart rate tracing. Which of the following interventions is the highest priority? o Reposition the client on her side. 40. A nurse is caring for a laboring client. Following a sterile vaginal exam, the nurse notes the umbilical cord from the vagina and views a prolonged fetal heart rate deceleration. o Perform vaginal exam exerting upward pressure against the………. o Place in knee-chest position o Wrap cord loosely in sterile towel saturated with saline. o Apply 8-10 L/min of oxygen via facemask o Provide support to the client. 41. A nurse is caring for four postpartum clients who delivered vaginally, which of the following clients should the nurse assessing first for pain management? o A client who delivered her second child and breastfeeding. 42. A client at 18 weeks of gestation has had an abnormal maternal serum alpha- fetoprotein and elects to have an amniocentesis for diagnostic confirmation. Which of the following statements by the client should the nurse recognize as indicating a complication? o “My stomach seems tight since the doctor left” 43. A nurse id caring for a client who is at 25 weeks of gestation and in preterm labor. The nurse should recognize which of the following purposes for administering betamethasone (Celestone) to the client? o Increase fetal lung maturity. 44. A nurse who is working in the newborn nursery is assessing a newborn who was born 12 hr ago. Which of the following findings requires an intervention by the nurse? o Substernal retraction 45. A charge nurse is observing a newly licensed nurse who is administering pain medication to a client who had a vaginal delivery. The charge nurse should intervene when the newly licensed nurse uses which of the following to identify the client? o The clients room number 46. A nurse is caring for a client who has history of rheumatic heart disease, but no physical symptoms prior to pregnancy. The client begins to experience dyspnea, and pulmonary edema. Which of the following physiological alteration explain this change? o Increase blood volume 47. A nurse is caring for a client who has received epidural anesthesia during her labor. Which of the following findings should the nurse report to the provider? o The client reports ringing in her ears. 48. A nurse is caring for a Group B streptococcus infection (GBS) and has been prescribe penicillin G. 2.4 million units. The medication arrives from the pharmacy in 250ml bag of 0.9% sodium chloride to be given over 30 min. the administration set delivers 15 gtt/ml. Which of the following is the correct drop per minutes rate?(Round to the nearest number) o 125gtt/min 49. A nurse is caring for a client who is at 27 weeks of gestation and has an elevated 1-hr, 50-g glucose screening results. The nurse should plan to initiate which of the following for managing this client’s care? o Request a prescription for 3-hr-glucose tolerance test (GTT). 50. A nurse is completing for a New Ballard gestational age assessment of an infant who was born at 26 weeks of gestation. Which of the following finding s should the nurse anticipate? o Minimal arm recoil 51. A nurse on an antepartum unit is receiving the assessment findings of four clients who are in the third trimester of pregnancy. Which of the following assessment finding is the highest priority? o A client who is reporting epigastric pain 52. A client is caring for a client who is at 40 weeks of gestation and has a positive contraction stress test. The nurse should plan to prepare the client for which of the following diagnostic tests? o Biophysical profile 53. A nurse is caring for a postpartum client who is receiving treatment for thrombophlebitis in her left calf. Which of the following actions should he nurse take? o Compare the circumference measurement of each calf. 54. A nurse in the birthing unit is caring for a newborn who is rooming in with her mother. Which of the following actions is consistent with the facility’s safety plan for newborn? o The nurse compares the identification band on the newborn to that of the parents. 55. A nurse is providing teaching to a client of normal weight is at 10 weeks of gestation. Which of the following client statements should indicate to the nurse that the client is accepting expected body image changes related to pregnancy? o “ I will use new position during intercourse” 56. A nurse is caring for a client who has preeclampsia and is receiving 2 g magnesium sulfate IV bolus. Which of the following findings indicates the need to notify the provider? o Absents of deep tendon reflexes 57. A nurse is caring for a client who is postpartum and has a history of preeclampsia. Upon assessment, the nurse observes petechiae and serosanguineous fluid oozing from the IV insertion site. Which of the following findings should be reported to the provider? o Platelet count of 50,000/mm3 58. A nurse is providing anticipatory guidance to a client about the first day at home with her newborn. Which of the following statements by the client indicates a need for further teaching? o “I will complete household works when my baby is sleeping.” 59. A nurse is providing discharge instructions to a postpartum client who is breastfeeding. Which of the following statements by the client indicates that the teaching has been effective? o “I will notify my doctor if my baby’s skin begins to turn yellow.” 60. A nurse is performing an admission assessment on a newborn who is large for gestational age (LGA). Which of the following findings indicates a need for further assessment? o Jitteriness [Show More]

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