Following a vaginal birth at 1130, the nurse charts 250 mL of blood loss during delivery. The following weights of blood-soaked chux were noted for the postpartum patient: 1330: 225 g, 1600: 175 g, and 1845: 145 g. The dry weight of chux used by the patient is 64 g.
What is the estimated blood loss for the patient during the nurse's shift from 0700-1900?
603 mL
✓
353 mL
481 mL
795 mL
Correct Answer
603 mL
The blood loss from the chux were 161 g (225-65), 111 g (175-65), and 81 g (145-64) respectively. This is 353 g, or 353 mL, total. Combined with the 250 mL lost during delivery is 603 mL.
Question 2
A patient in labor is receiving oxytocin IVPB at 5 mU/min. The current bag hanging reads 10 units oxytocin in 1,000 mL of normal saline. What is the IV pump rate in mL/hr?
30 mL/hr
✓
3 mL/hr
300 mL/hr
0.5 mL/hr
Correct Answer
30 mL/hr
5 mU per minute is 300 mU per hour, or 0.3 units per hour. The bag contains 10 units per 1,000 mL (or 1 unit per 100 mL) so the patient needs to receive 30 mL over the hour.
Question 3
A patient reports to the nurse that they believe their water has broken. What is the nurse's priority action?
Call the provider
Test the pH of the fluid with nitrazine paper
Help the patient back to bed
Assess fetal heart rate
✓
Correct Answer
Assess fetal heart rate
Due to the risk for cord compression or prolapse, the nurse's priority action for a patient who may be experiencing rupture of membranes is to assess the fetal heart rate.
Question 4
A nurse is caring for a patient on postpartum day 3 who reports sudden onset of sharp chest pain and shortness of breath. The patient is tachycardic and tachypneic with an oxygen saturation of 86% on room air. Which action should the nurse take first?
Obtain a 12-lead EKG
Apply oxygen via nonrebreather mask
✓
Notify the provider
Administer prescribed anticoagulant therapy
Correct Answer
Apply oxygen via nonrebreather mask
The patient is exhibiting signs of a pulmonary embolism, a life-threatening emergency. The nurse's priority action is to immediately improve oxygenation with high-flow oxygen. After stabilizing oxygenation, the nurse should notify the provider and anticipate interventions such as a 12-lead EKG and anticoagulant therapy.
Question 5
The nurse is teaching students about risk factors for postpartum hemorrhage (PPH). Which conditions increase the risk of PPH? Select all that apply.
Treatment with magnesium sulfate
Preterm birth
Precipitous delivery
✓
Multiparity
Correct Answer
Precipitous delivery
Risk factors for PPH include uterine atony (from multiparity, prolonged/precipitous labor, magnesium sulfate use), infection, retained placenta, and operative birth. Preterm birth is not a risk factor for postpartum hemorrhage.
Question 6
When assessing a patient who is 30 weeks pregnant, the nurse measures the fundal height to be 38 cm. Which abnormality might the patient be experiencing?
Oligohydramnios
Polyhydramnios
✓
Intrauterine growth restriction
Passage of meconium
Correct Answer
Polyhydramnios
Polyhydramnios (i.e., excessive amniotic fluid volume) may cause the patient to have a larger than expected fundal height.
Question 7
A laboring patient is noted to have a fetus in the occiput posterior position. Which maternal position should the nurse encourage to facilitate rotation to an anterior fetal presentation?
Lithotomy position
Hands and knees
✓
Trendelenburg positioning
Knee-chest
Correct Answer
Hands and knees
Placing a patient on their hands and knees may help rotate a posterior fetus to anterior positioning.
Question 8
The nurse is assessing the fetal position of a patient in active labor. Which fetal position should the nurse identify as being optimal for vaginal delivery?
ROA
LOA
✓
LSA
RSA
Correct Answer
LOA
Left occiput anterior (LOA) is the optimal fetal position for delivery. Right occiput anterior is less preferable. Sacral presentation (e.g., LSA, RSA) is not optimal.
Question 9
For a fetus in the ROA position, the nurse should anticipate placing the external FHR transducer in which quadrant of the maternal abdomen?
LLQ
RLQ
✓
RUQ
LUQ
Correct Answer
RLQ
For a fetus in the ROA position, the transducer should be placed over the fetal back, which would be in the maternal right lower quadrant.
Question 10
On which portion of the infant's foot should the nurse use a lancet to obtain blood?
The lateral aspect of the ball of the foot
The lateral portion of the heel
✓
The lateral aspect of the big toe
The central portion of the heel
Correct Answer
The lateral portion of the heel
The nurse should obtain blood from the lateral or medial portion of the heel, never the central portion or any other location of the foot.
Question 11
Which of the following is the cutoff for expected blood loss with a C-section delivery?
1,500 mL
500 mL
750 mL
1,000 mL
✓
Correct Answer
1,000 mL
Approximately 500 mL blood loss is expected with a vaginal birth. Approximately 1,000 mL blood loss is expected for a C-section.
Question 12
How long does it take for a postpartum patient's blood volume to return to normal following delivery?
4 weeks
✓
15 days
3 months
1 week
Correct Answer
4 weeks
It takes approximately 4 weeks from delivery for a postpartum patient's blood volume to return to normal.
Question 13
What term is used to describe mood changes lasting 1 - 2 weeks following delivery?
Postpartum psychosis
Postpartum cyclothymia
Baby blues
✓
Postpartum depression
Correct Answer
Baby blues
The "baby blues" are a normal finding of mood changes lasting no longer than 2 weeks after delivery.
Question 14
The nurse should educate a postpartum patient that breastfeeding works as a reliable contraceptive for how long following delivery?
Until the infant weans
For 4 weeks
Until menses return
Never
✓
Correct Answer
Never
The nurse should educate this patient that breastfeeding is never a reliable form of contraception, even if menses have not yet returned.
Question 15
What phase of maternal role attainment is characterized by the postpartum patient being eager to talk about their birth experience and relying on others for help?
Dependent-independent phase
Taking hold phase
Dependent phase
✓
Interdependent phase
Correct Answer
Dependent phase
A patient who is eager to talk about their birth experience and needs to rely on others for help is likely in the "dependent' phase or the "taking-in" phase of the maternal role attainment theory.
Question 16
48 hours after giving birth, a patient is eager to learn how to care for the newborn. What phase of the maternal role attainment is the patient likely experiencing?
Dependent phase
Taking in phase
Interdependent phase
Dependent-independent phase
✓
Correct Answer
Dependent-independent phase
A patient who is eager to learn how to care for the newborn 48 hours after birth is likely in the "dependent-independent" or "taking-hold" phase of the maternal role attainment theory.
Question 17
Which type of lochia is expected eight days after delivery?
Lochia rubra
Lochia negra
Lochia serosa
✓
Lochia alba
Correct Answer
Lochia serosa
Lochia serosa, a pinkish brown discharge, is expected 4 - 9 days after delivery.
Question 18
Which part of an infant should be cleaned first during a bath?
The umbilical cord
The feet
The groin
Their eyes
✓
Correct Answer
Their eyes
The eyes should be cleaned first during a bath to prevent introducing bacteria from other areas of the body.
Question 19
For the first few days following circumcision, what should the caregivers do at each diaper change?
Apply antibiotic ointment to the site
Remove the yellowish crust that may form
Wash the penis with soap and water
Apply petroleum jelly to the site
✓
Correct Answer
Apply petroleum jelly to the site
Petroleum jelly should be applied to the site of circumcision at each diaper change for the first few days following the procedure. Caregivers should be educated not to remove the yellowish crust that may form.
Question 20
How much supplemental vitamin D should be provided to a breastfed baby?
200 IU daily
400 IU daily
✓
1,000 IU daily
2,000 IU daily
Correct Answer
400 IU daily
A breastfed infant should receive 400 IU vitamin D supplementation daily.
Question 21
How frequently should the nurse apply lotion to an infant receiving phototherapy for hyperbilirubinemia?
Never
✓
Before every phototherapy session
Every 15 minutes
Every hour
Correct Answer
Never
Lotion should never be applied to an infant receiving phototherapy, as this may result in burns.
Question 22
What is the cutoff for an infant to be qualified as having macrosomia?
> 4,500 g
> 3,500 g
> 4,000 g
✓
> 3,000 g
Correct Answer
> 4,000 g
An infant > 4,000 g (or 8 lbs 13 oz) is considered to have macrosomia.
Question 23
When assessing the umbilical cord of a newborn, what is considered to be a normal finding?
2 arteries and 1 vein
✓
2 arteries and 2 veins
1 artery and 2 veins
1 artery and 1 vein
Correct Answer
2 arteries and 1 vein
Two arteries and one vein should be present in the newborn's umbilical cord.
Question 24
Small white cysts on the newborn's gums and palate are known as what?
Stork bite/telangiectatic nevi
Erythema toxicum
Epstein's pearls
✓
Milia
Correct Answer
Epstein's pearls
Epstein's pearls are small white cysts on the newborn's gums and palate. These are harmless and will disappear with time.
Question 25
To prevent heat loss via evaporation, what should the nurse do immediately following birth?
Place a hat on the newborn
Dry the newborn thoroughly
✓
Place the infant on the parent's chest
Place the newborn under a radiant warmer
Correct Answer
Dry the newborn thoroughly
To prevent heat loss via evaporation, moisture should be removed from the infant's skin. The other interventions are appropriate ways to prevent other forms of heat loss.
Question 26
Which type of heat loss occurs from direct contact with a cold, metal scale?
Conduction
✓
Evaporation
Radiation
Convection
Correct Answer
Conduction
Conduction is a type of heat loss which occurs from direct contact with a colder object.
Question 27
Which of the following respiratory rates is considered within normal limits for a newborn?
28 bpm
12 bpm
62 bpm
55 bpm
✓
Correct Answer
55 bpm
The expected respiratory rate for newborns is 30 - 60 breaths per minute.
Question 28
The artificial rupture of the amniotic membranes is known as what?
Cervical ripening
Amniotomy
✓
Amniocentesis
Cervical cerclage
Correct Answer
Amniotomy
An amniotomy is the term used to describe the artificial rupture of the amniotic membranes.
Question 29
Which of the following fetal heart rates is considered abnormal?
118 bpm
159 bpm
98 bpm
✓
142 bpm
Correct Answer
98 bpm
Normal fetal heart rate range is between 110 - 160 bpm.
Question 30
What term is used to describe the opening of the cervix during labor?
Dilation
✓
Effacement
Effleurage
Presentation
Correct Answer
Dilation
Cervical opening during labor is known as dilation.
Question 31
What term is used to describe the thinning and stretching of the cervix during labor?
Presentation
Dilation
Effacement
✓
Positioning
Correct Answer
Effacement
Cervical thinning and stretching is known as effacement.
Question 32
The time from when the baby is delivered until the delivery of the placenta is known as which stage of labor?
Fourth stage
Third stage
✓
Latent stage
Second stage
Correct Answer
Third stage
The third stage of labor is the time from when the baby is delivered until the placenta is delivered.
Question 33
What term does the nurse use to describe a burst of energy felt by a patient at 38 weeks pregnant?
Preparation
Nesting
✓
Prodromal labor
Second wind
Correct Answer
Nesting
Nesting is a term used to describe a burst of energy felt by a patient towards the end of their pregnancy.
Question 34
A patient with vulvovaginal candidiasis is likely to have which type of vaginal discharge?
Pink-tinged discharge
Thick, white discharge
✓
Green malodorous discharge
Thin, yellow discharge
Correct Answer
Thick, white discharge
Patients with vulvovaginal candidiasis are likely to have thick, white vaginal discharge with a "cottage cheese" appearance.
Question 35
Which of the following medications can be used to dissolve an ectopic pregnancy?
Misoprostol
Methotrexate
✓
Dinoprostone
Mifepristone
Correct Answer
Methotrexate
Methotrexate is a medication that can be administered IM to dissolve an ectopic pregnancy.
Question 36
The nurse should educate a newly pregnant patient to limit caffeine intake to less than how many mg/day?
< 200 mg/day
✓
< 400 mg/day
< 50 mg/day
No caffeine is allowable
Correct Answer
< 200 mg/day
Caffeine intake is allowable during pregnancy, but should be limited to < 200 mg/day.
Question 37
The nurse should educate a patient with a pre-pregnancy BMI of 22.8 to gain how much total weight during pregnancy?
No more than 15 pounds
Between 15 - 25 pounds
Between 25 - 35 pounds
✓
Between 35 - 45 pounds
Correct Answer
Between 25 - 35 pounds
Patients of average pre-pregnancy weight (e.g., BMI of 22.8) should gain between 25 - 35 total pounds during pregnancy.
Question 38
During which gestational age range does screening for group B streptococcus occur?
24 - 28 weeks
35 - 37 weeks
✓
Immediately prior to delivery
30 - 33 weeks
Correct Answer
35 - 37 weeks
Group B streptococcus screening typically occurs between 35 - 37 weeks gestation.
Question 39
What is the expected fundal height for a patient at 24 weeks gestation?
22 - 26 cm
✓
< 20 cm
24 - 28 cm
20 - 24 cm
Correct Answer
22 - 26 cm
Between 18 - 32 weeks gestation, the fundal height in cm should approximately equal the gestational age +/- 2 weeks.
Question 40
How should the nurse educate a pregnant patient to prevent supine hypotensive syndrome?
Sleep completely flat, without a pillow
Place a pillow under one hip
✓
Lie prone in bed
Sleep in high-Fowler's position
Correct Answer
Place a pillow under one hip
To prevent supine hypotensive syndrome, patients should rest in a side-lying position, or with a pillow under one hip.
Question 41
A patient receiving an IUD asks the nurse how often they need to check the string length. What is the best response by the nurse?
Annually
Weekly
Monthly
✓
Daily
Correct Answer
Monthly
IUD string length should be checked monthly. If there is a change in string length, report it to the provider.
Question 42
The nurse is performing a vaginal exam on a patient in active labor and notes the fetus is at station 0. How should the nurse describe the location of the presenting part?
Not yet engaged in the maternal pelvis
Just past the cervical os
At the level of the maternal ischial spines
✓
At the level of the vaginal opening
Correct Answer
At the level of the maternal ischial spines
Station 0 indicates that the presenting part is at the maternal ischial spines, considered "engaged" in the pelvis.
Question 43
A nurse is caring for a pregnant patient who has phenylketonuria (PKU). Which of the following foods should this patient choose to eat?
Low-fat yogurt
Pasta
✓
Steak
Chicken
Correct Answer
Pasta
Pregnant patients with phenylketonuria should follow a low-protein diet. Therefore, pasta is the best choice from the available options, as it is low in protein.
Question 44
When educating a patient on contraception options, which method would the nurse indicate protects against STIs?
Abstinence
✓
Natural Family Planning
Birth control
Withdrawal
Correct Answer
Abstinence
Abstinence is not partaking in sexual intercourse, therefore the patient would not be at risk for STIs. Withdrawal, natural family planning, and birth control do not protect against STIs.
Question 45
Which of the following contraceptives provides protection from STIs?
Internal condom
✓
Combined oral contraceptive pills
Diaphragm
Subdermal progestin-only implants
Correct Answer
Internal condom
Abstinence and condoms (both external and internal) are the only forms of contraception that also protect against STIs.
Question 46
A patient attends a clinic appointment to receive the rubella vaccine. While educating the patient, the nurse should include that the patient should avoid pregnancy for how long?
7 days
3 months
6 months
28 days
✓
Correct Answer
28 days
Pregnancy must be avoided for at least 28 days following rubella immunization.
Question 47
A nurse is caring for a postpartum patient and notes that the patient's perineal pad has been saturated within 15 minutes. How should this amount of lochia be documented?
Heavy
Scant
Moderate
Excessive
✓
Correct Answer
Excessive
Excessive lochia is when a perineal pad is saturated within 15 minutes. This is indicative of postpartum hemorrhage and should be immediately evaluated further.
Question 48
The nurse is caring for a newborn within the first 4 hours of life. Which serum glucose level should the nurse report to the provider?
58 mg/dL
38 mg/dL
✓
40 mg/dL
43 mg/dL
Correct Answer
38 mg/dL
A serum glucose < 40 mg/dL is classified as hypoglycemia within the first 4 hours of life. Between hours 4-24, a serum glucose < 45 mg/dL is considered hypoglycemic.
Question 49
Which prophylactic medication given to the newborn after delivery requires a signed informed consent from the caregiver?
Hepatitis B vaccine
✓
Erythromycin ointment
Sucrose gel
Vitamin K injection
Correct Answer
Hepatitis B vaccine
Vitamin K, hepatitis B vaccination, and erythromycin ointment are all prophylactic medications administered to the newborn after delivery. Only the hepatitis B vaccination requires signed informed consent, however.
Question 50
The nurse strokes the lateral sole of a newborn's foot during a routine exam. Which response indicates a normal Babinski reflex in an infant?
Foot remains motionless
Toes curl inward with plantar flexion of the great toe
Brisk clonus of the ankle noted
Toes fan outward with dorsiflexion of the great toe
✓
Correct Answer
Toes fan outward with dorsiflexion of the great toe
A positive Babinski reflex (toe fanning with dorsiflexion of the great toe) is normal in infants up to about 1 year of age.
Question 51
When the lateral plantar aspect of an infant's foot is stroked, how should the foot react?
Toes should plantar flex then fan outward
Toes should dorsiflex then curl inward
Toes should not react
Toes should dorsiflex and fan outward
✓
Correct Answer
Toes should dorsiflex and fan outward
A positive Babinski reflex should be demonstrated, which is seen when the toes dorsiflex and fan outward.
Question 52
A parent is concerned about a dark purple/blue area on their newborns buttocks. The nurse took note of this marking at birth and explains to the parent it is known as:
Stork bite/telangiectatic nevi
Congenital dermal melanocytosis (formerly known as "Mongolian spots")
✓
Erythema toxicum
Epstein's pearls
Correct Answer
Congenital dermal melanocytosis (formerly known as "Mongolian spots")
Congenital dermal melanocytosis (formerly known by the outdated term, "mongolian spot") is a purple/blue pigment of skin on the back or buttocks. They often resemble bruises so it is important for them to be documented. They are more common in darker-skinned newborns and often fade after a few years.
Question 53
A newborn with acrocyanosis will have a bluish discoloration of which body part(s)?
The extremities
✓
The face
The trunk
The right side
Correct Answer
The extremities
Acrocyanosis is a term used to describe bluish discoloration of the extremities.
Question 54
Which of the following respiratory rates is considered within normal limits for a newborn?
12 bpm
28 bpm
55 bpm
✓
62 bpm
Correct Answer
55 bpm
The expected respiratory rate for newborns is 30 - 60 breaths per minute.
Question 55
A nurse is preparing to assess a newborn and gives the newborn an APGAR score 1 minute after birth. When should the nurse repeat this assessment?
Ten minutes after birth
Thirty minutes after birth
Five minutes after birth
✓
It does not need to be repeated
Correct Answer
Five minutes after birth
The APGAR score is done one minute and five minutes after birth.
Question 56
A patient who experienced a precipitous delivery is at risk for which life-threatening complication?
Eclampsia
Placental abruption
HELLP syndrome
Postpartum hemorrhage
✓
Correct Answer
Postpartum hemorrhage
Patients who experience precipitous delivery are at risk for postpartum hemorrhage, a potentially life threatening complication.
Question 57
During labor, a patient reports a sharp abdominal pain that they describe as "tearing." What complication should the nurse suspect?
Uterine tachysystole
Precipitous labor
Uterine rupture
✓
Umbilical cord prolapse
Correct Answer
Uterine rupture
A sharp abdominal pain described as "tearing" may be associated with uterine rupture.
Question 58
A patient experiencing the labor complication known as shoulder dystocia may benefit from which procedure?
Leopold's maneuver
Trendelenburg positioning
McRoberts maneuver
✓
External cephalic version
Correct Answer
McRoberts maneuver
McRoberts maneuver involves hyperflexing the patient's legs to their abdomen to assist with shoulder dystocia.
Question 59
A nurse collects a vaginal swab from a patient at 30 weeks' gestation to test for fetal fibronectin. A positive result for fetal fibronectin may indicate which of the following?
Risk for prolonged rupture of membranes
Risk for fetal hypoxia
Risk for preterm labor
✓
Presence of group B streptococcus infection
Correct Answer
Risk for preterm labor
Fetal fibronectin, a protein that helps the amniotic sac adhere to the uterine lining, should not be present late in pregnancy. Its presence after 20 weeks may indicate risk for preterm labor.
Question 60
A pregnant patient is experiencing preterm labor. If possible, which medication should be given to help fetal lung maturity 24 - 48 hours prior to preterm delivery?
Betamethasone
✓
Oxytocin
Misoprostol
Dinoprostone
Correct Answer
Betamethasone
Betamethasone is a steroid used to promote fetal lung maturity prior to preterm delivery.
Question 61
A nurse is caring for a pregnant patient who reports a possible premature rupture of membranes (PROM). The nurse tests the pH of the vaginal fluid. PROM will be confirmed if the nitrazine paper turns what color?
Green
Blue
✓
Orange
Yellow
Correct Answer
Blue
Nitrazine paper will turn blue with exposure to amniotic fluid.
Question 62
A patient receiving oxytocin for labor augmentation is having contractions lasting 120 seconds with an intensity of 98 mmHg. What is the nurse's priority action?
Decrease the oxytocin rate by half
Discontinue the oxytocin
✓
Prepare for immediate c-section
Increase the oxytocin per order
Correct Answer
Discontinue the oxytocin
This patient is experiencing uterine hyperstimulation and the oxytocin should be immediately discontinued to prevent further complications such as uterine rupture.
Question 63
A patient is inquiring about induction of labor. The nurse explains that prior to scheduling, which scoring system will be used to assess maternal readiness for induction?
Bishop score
✓
Leopold score
Chadwick score
New Ballard score
Correct Answer
Bishop score
The Bishop score assesses cervical favorability for induction by measuring dilation, effacement, position, consistency, and station.
Question 64
A nulliparous patient wishing to undergo labor induction receives a Bishop score. Which of the following scores indicates maternal readiness for labor induction in this nulliparous patient?
8
9
6
11
✓
Correct Answer
11
For a nulliparous patient, a score > 10 indicates maternal readiness for induction. A multiparous patient scoring > 8 is considered ready for induction.
Question 65
For which of the following FHR patterns should the nurse place the patient in knee-chest or Trendelenburg position?
FHR accelerations
Late decelerations
Variable decelerations
✓
Early decelerations
Correct Answer
Variable decelerations
To reduce compression on the cord, patients experiencing variable decelerations should be placed in knee-chest or Trendelenburg position.
Question 66
The nurse notes a gradual decrease in the FHR after a contraction has started. What is the likely cause of this form of this deceleration?
Uteroplacental insufficiency
✓
Head compression
Umbilical cord compression
Uterine atony
Correct Answer
Uteroplacental insufficiency
Late decelerations as described in the question may be caused by uteroplacental insufficiency.
Question 67
A nurse is assessing an external fetal monitoring strip. After the contraction begins the fetal heart rate gradually declines and has a prolonged return to baseline. What fetal heart rate pattern is occuring?
Early deceleration
Acceleration
Late deceleration
✓
Variable deceleration
Correct Answer
Late deceleration
A late deceleration is when the fetal heart rate gradually declines when a contraction begins and has a prolonged return to baseline.
Question 68
What intervention is needed for a FHR showing multiple accelerations?
None
✓
Place patient in knee-chest position
Administer a 1,000 mL IV fluid bolus
Prepare for immediate delivery
Correct Answer
None
No intervention is needed for a FHR showing accelerations, as this is a reassuring finding.
Question 69
Which of the following is the most likely cause of early decelerations in FHR?
Placental insufficiency
Fetal hypoxia
Fetal head compression
✓
Cord compression
Correct Answer
Fetal head compression
Early decelerations are caused by fetal head compression associated with contractions.
Question 70
A healthy fetal nervous system is indicated by which of the following findings in the fetal heart rate?
Minimal variability
Moderate variability
✓
Absent variability
Marked variability
Correct Answer
Moderate variability
Moderate variability (i.e., fluctuations of the FHR by 6 - 25 bpm around the baseline) is indicative of a healthy fetal nervous system.
Question 71
The nurse is performing Leopold maneuvers on a pregnant patient. Which portion of the uterus should be palpated first?
The cervical neck
The body
The right side
The fundus
✓
Correct Answer
The fundus
Leopold maneuvers begin with palpation of the uterine fundus.
Question 72
Patients receiving an epidural should be given an IV fluid bolus to prevent which condition?
Fetal hypoxia
Maternal hypotension
✓
Maternal tachycardia
Fetal bradycardia
Correct Answer
Maternal hypotension
Maternal hypotension is a common side effect of epidural placement. For this reason, an IV fluid bolus may be given.
Question 73
Which type of regional anesthesia may be used to provide pain relief for an episiotomy?
Nitrous oxide
Spinal anesthesia
Pudendal nerve block
✓
Epidural anesthesia
Correct Answer
Pudendal nerve block
A pudendal nerve block may be used to provide pain relief for an episiotomy.
Question 74
Which non-pharmacological intervention would be most appropriate for a patient experiencing low back pain during labor?
Effleurage
Sacral counterpressure
✓
McRoberts maneuver
Biofeedback
Correct Answer
Sacral counterpressure
Sacral counterpressure is most likely to be beneficial for a patient experiencing low back pain during labor.
Question 75
What is the name given to light stroking of the abdomen in rhythm with the patient's breathing during labor contractions?
Effleurage
✓
Hernandez-Reif maneuver
Biofeedback
Counterpressure
Correct Answer
Effleurage
Effleurage is the name given to light abdominal stroking in rhythm with the patient's breathing during labor contractions.
Question 76
A patient is 9 cm dilated, says "I can't do this anymore," and reports the need to have a bowel movement. The nurse knows this is which phase of labor?
Third stage
Latent phase
Active phase
✓
Delivery phase
Correct Answer
Active phase
The transition phase of the first stage of labor occurs between 8 - 10 cm dilation with strong contractions 1.5 - 2 minutes apart. The patient may feel out of control, and may feel the urge to have a bowel movement.
Question 77
A nurse is assessing how far a patient is in the labor process. The patient is 3cm dilated, having contractions every 5 minutes, and is talkative. The nurse determines the patient is in what phase of labor?
Latent phase
✓
Preliminary phase
Second stage
Active phase
Correct Answer
Latent phase
The latent phase of the first stage of labor occurs from 0 - 3 cm dilation with mild-to-moderate contractions that are 5 or more minutes apart. The patient is usually excited and talkative in this phase.
Question 78
After drinking water and lying down, a patient reports to the nurse that their contractions have decreased in intensity. The nurse expects that these are which type of contractions?
Fundal contractions
Prodromal contractions
True contractions
Braxton Hicks
✓
Correct Answer
Braxton Hicks
Braxton Hicks contractions are inconsistent contractions which lessen in intensity when the patient rests, changes position, or drinks water.
Question 79
A pregnant patient has just undergone a contraction stress test. What is the result if the patient had 3 contractions in 10 minutes with no late decelerations of FHR?
Positive
Reactive
Negative
✓
Nonreactive
Correct Answer
Negative
This is a negative or normal result, 3 contractions within 10 minutes with no late decelerations of FHR.
Question 80
The nurse is caring for a pregnant patient undergoing a nonstress test (NST). After 20 minutes, the fetal heart rate does not demonstrate accelerations. What is the nurse's next action?
Ask the patient to ambulate for 30 minutes and then return for further testing.
Notify the provider immediately due to the potential for fetal hypoxia
Perform vibroacoustic stimulation and continue the test for 20 more minutes
✓
Place the patient in Trendelenburg position
Correct Answer
Perform vibroacoustic stimulation and continue the test for 20 more minutes
If a nonstress test is nonreactive (no fetal heart rate accelerations with fetal movement), the next step is to stimulate the fetus, commonly with vibroacoustic stimulation or by extending the testing period, to elicit accelerations. Further testing, such as a biophysical profile, may be ordered if the NST remains nonreactive.
Question 81
The nurse is counseling a patient who had a prior pregnancy with chromosomal abnormalities incompatible with life. The patient is 17 weeks pregnant and wishes to have testing for chromosomal abnormalities performed at this time. Which procedure should the nurse counsel the patient about?
Ultrasound
Amniocentesis
✓
Stress test
Chorionic villus sampling
Correct Answer
Amniocentesis
Amniocentesis is an invasive procedure which can be performed typically between 15 - 18 weeks gestation. It can identify chromosomal abnormalities and neural tube defects.
Question 82
The nurse provides prenatal teaching to a pregnant patient and advises them to consume how many extra calories per day in the first trimester of pregnancy?
100
300
250
None
✓
Correct Answer
None
During the first trimester of pregnancy, no additional calorie intake is required.
Question 83
A prenatal nurse is providing teaching to a patient on proper nutrition during pregnancy. The patient is of average/normal BMI. How much weight should the nurse advise this patient to gain during pregnancy?
25-35 pounds
✓
15-25 pounds
25-40 pounds
15-35 pounds
Correct Answer
25-35 pounds
A person of average weight should gain 25-35 pounds during pregnancy.
Question 84
A nurse is teaching a prenatal class. The nurse explains that an increase in folic acid is needed to prevent neural tube defects in the fetus. How much folic acid should pregnant patients consume?
600 mcg/day
✓
200 mcg/day
400 mcg/day
100 mcg/day
Correct Answer
600 mcg/day
Pregnant patients should consume 600 mcg/day of folic acid.
Question 85
A nurse is reviewing teaching with a pregnant patient about maternal serum alpha-fetoprotein (MSAFP) screening. The nurse should instruct the patient that this test is most accurately performed during which gestational age range?
28 - 32 weeks
15 - 20 weeks
✓
20 - 24 weeks
10 - 13 weeks
Correct Answer
15 - 20 weeks
MSAFP screening is best performed between 15-20 weeks of gestation to evaluate risk for neural tube defects and chromosomal abnormalities.
Question 86
A nurse reviews the laboratory results of a pregnant patient at 16 weeks' gestation. The maternal serum alpha-fetoprotein (MSAFP) level is reported as low. Which condition should the nurse recognize this finding may indicate?
Down syndrome
✓
Hirschsprung's disease
Gestational diabetes
Multiple gestations
Correct Answer
Down syndrome
Low MSAFP may indicate down syndrome.
Question 87
A patient's chart identifies them as being a G4 P2103. How many living children does this patient currently have?
2
1
3
✓
4
Correct Answer
3
This patient is currently pregnant for the fourth time. They have had 1 term birth, 2 preterm births, 0 abortions or miscarriages, and have 3 living children.
Question 88
The nurse is caring for a couple beginning evaluation for infertility. The patient's partner asks, "Why are we starting with a semen analysis instead of testing her first?" Which response by the nurse is most appropriate?
Most infertility problems originate from the male partner, so testing begins with a semen analysis.
The doctor believes a low sperm count is the most likely reason for your infertility, so we're testing you first.
"Male infertility is usually easier to treat than female infertility, so testing begins with the man."
"A semen analysis is a simple, noninvasive, and cost-effective test, which is why it is most commonly performed first."
✓
Correct Answer
"A semen analysis is a simple, noninvasive, and cost-effective test, which is why it is most commonly performed first."
A semen analysis is typically the first diagnostic test performed for infertility, as it is the least invasive and most affordable.
Question 89
Prior to receiving a hysterosalpingogram, the nurse should assess a patient for allergies to which substances?
Bee venom
Penicillin
Adhesive
Iodine
✓
Correct Answer
Iodine
Due to the use of iodinated contrast dye during hysterosalpingography, the nurse should assess for allergy to iodine.
Question 90
A nurse is providing post-operative teaching to a patient following a vasectomy. Which instruction is most important to include?
Take oxycodone around the clock for pain management for 7 days
Remain on strict bedrest for 48 hours to reduce the risk of complications
Use an alternate form of birth control until follow-up semen analysis shows the absence of sperm
✓
Place ice packs on the groin for 30 minutes every hour to reduce swelling and pain
Correct Answer
Use an alternate form of birth control until follow-up semen analysis shows the absence of sperm
A vasectomy cannot be considered successful until a follow-up semen analysis is done demonstrating the absence of sperm in the ejaculate. Until this time, patients should use backup methods of contraceptives.
Question 91
The nurse educates a patient receiving an IUD that they should take what action each month?
Have a confirmatory x-ray
Check the length of their strings
✓
Take a pregnancy test
Have STI testing
Correct Answer
Check the length of their strings
Patients with an IUD should check the length of their strings each month and report any change in string length to their provider.
Question 92
The nurse educates a patient seeking a progestin-only subdermal implant that this device provides contraception for how long?
3 years
✓
5 years
10 years
1 year
Correct Answer
3 years
Subdermal progestin-only implants provide contraception for 3 years.
Question 93
The nurse should schedule a patient's next injection how long after receiving their first injection of medroxyprogesterone (Depo-Provera)?
4 weeks
4 months
12 weeks
✓
6 months
Correct Answer
12 weeks
Patients receiving medroxyprogesterone injections for contraception should receive an injection once every 12 weeks (~3 months).
Question 94
A nurse is teaching a patient who has started medroxyprogesterone acetate injections for contraception. Which dietary instruction is most important?
Increase fiber intake
Increase calcium and vitamin D intake
✓
Increase folic acid intake
Increase vitamin C and vitamin K intake
Correct Answer
Increase calcium and vitamin D intake
Due to the risk for bone demineralization with long-term use, patients taking medroxyprogesterone should increase their intake of calcium and vitamin D.
Question 95
A nurse is caring for a pregnant patient who has phenylketonuria (PKU). Which of the following foods should this patient choose to eat?
Steak
Low-fat yogurt
Celery
✓
Chicken
Correct Answer
Celery
Pregnant patients with phenylketonuria should follow a low-protein diet. Therefore, celery is the best choice from the available options, as it is low in protein.
Question 96
A pregnant patient is Rh-. When should the nurse administer rhogam?
At 28 weeks gestation
Within 72 hours of delivery
After abdominal trauma
All of the above
✓
Correct Answer
All of the above
Rhogam is given to Rh- mothers at 28 weeks gestation, within 72 hours of delivery, and after any pelvic/abdominal trauma or vaginal bleeding.
Question 97
The nurse is assessing a postpartum patient who reports fever, abdominal tenderness, and foul-smelling lochia. Which postpartum complication should the nurse suspect?
Chorioamnionitis
Endometritis
✓
Postpartum hemorrhage
Endometriosis
Correct Answer
Endometritis
Endometritis, an infection of the uterine lining, is often indicated by fever, uterine tenderness, and malodorous lochia.
Question 98
The nurse is caring for a patient with postpartum hemorrhage. Before administering carboprost, which condition should the nurse recognize as a contraindication?
Diabetes
Asthma
✓
Allergy to shellfish
Hypertension
Correct Answer
Asthma
Carboprost, a prostaglandin, can cause bronchospasm and is contraindicated in patients with asthma. Hypertension, shellfish allergy, and diabetes are not contraindications for use.
Question 99
The nurse prepares to administer methylergonovine to a patient with postpartum hemorrhage. Which assessment finding would require the nurse to withhold the medication and notify the provider?
Hemoglobin 9.6 g/dL
Heart rate of 105 bpm
Respiratory rate 22/min
Blood pressure 162/94 mmHg
✓
Correct Answer
Blood pressure 162/94 mmHg
Methylergonovine is contraindicated in patients with hypertension due to its vasoconstrictive properties, which can raise blood pressure further.
Question 100
A postpartum patient asks the nurse when breast milk replaces colostrum. How should the nurse respond?
Within 1 week of delivery
Within 24 hours of delivery
Immediately after delivery
3 - 5 days following delivery
✓
Correct Answer
3 - 5 days following delivery
Colostrum is replaced by breast milk 3 - 5 days following delivery.
Question 101
Which of the following interventions should the nurse suggest to a patient attempting to suppress lactation?
Avoid wearing a bra
Place warm packs in the bra
Place cold, fresh cabbage leaves in their bra
✓
Hand-express milk every 4 - 6 hours
Correct Answer
Place cold, fresh cabbage leaves in their bra
Patients who wish to suppress lactation should wear a supportive bra, place cold/fresh cabbage leaves in the bra, avoid nipple stimulation, avoid heat on the breasts, and hand-express milk as little as is needed for comfort.
Question 102
A nurse is assessing a patient 6 days after a vaginal delivery. Where should the nurse expect to palpate the uterine fundus?
Halfway between the umbilicus and symphysis pubis
✓
1 cm below the umbilicus
It should not be palpable
At the level of the umbilicus
Correct Answer
Halfway between the umbilicus and symphysis pubis
Six days following delivery, the postpartum patient's fundus should be felt halfway between the umbilicus and the symphysis pubis.
Question 103
A nurse is caring for a postpartum patient. The nurse is assessing the fundus and finds that is firm, midline, and at the level of the umbilicus. How soon after delivery should this occur?
One hour
Twenty-four hours
Sixteen hours
Twelve hours
✓
Correct Answer
Twelve hours
Within twelve hours of delivery, the fundus should be firm, midline, and approximately at the level of the umbilicus.
Question 104
The nurse assesses a patient's fundus and finds that it is displaced to the left. What is the priority intervention?
Place the patient in a lateral recumbent position
Have the patient urinate
✓
Assess the patient's blood pressure
Gently massage the fundus until it returns midline
Correct Answer
Have the patient urinate
A laterally displaced fundus may indicate the patient's bladder is full. Having the patient urinate will help return the fundus to the midline, and decrease the risk for hemorrhage.
Question 105
The nurse assesses a patient's fundus and finds it to be boggy. What is the priority intervention?
Assess the patient's blood pressure
Gently massage the fundus until it is firm
✓
Administer high-flow oxygen to the patient
Have the patient urinate
Correct Answer
Gently massage the fundus until it is firm
A boggy fundus places the patient at risk for hemorrhage, and the priority action is to gently massage the fundus until it firms up.
Question 106
The nurse is providing safe sleep teaching to the parents of a newborn. Which position should the nurse emphasize as safest for sleep?
On their left side
On their right side
On their stomach
On their back
✓
Correct Answer
On their back
It is safest for baby to sleep on their back, alone, and in a crib.
Question 107
A new parent states they want to prepare bottles of infant formula for the entire day. The nurse should include which teaching about safe storage of prepared formula?
Refrigerated formula must be discarded if not used within 12 hours.
Prepared formula can be frozen for up to one month.
Prepared formula may be kept in the refrigerator for up to 24 hours.
✓
You can safely store prepared formula at room temperature for 24 hours.
Correct Answer
Prepared formula may be kept in the refrigerator for up to 24 hours.
Prepared formula may be kept in the refrigerator for 24 hours. It should never be stored at room temperature or frozen.
Question 108
The nurse teaches a postpartum patient about breast milk storage. Which statement by the parent demonstrates correct understanding?
I must immediately refrigerate any expressed breast milk for safety.
After thawing breast milk from the freezer, I can re-freeze whatever my baby doesn't eat.
Breast milk can be stored on the counter overnight if it is covered.
I can feed my infant freshly expressed breast milk kept at room temperature for 4 hours.
✓
Correct Answer
I can feed my infant freshly expressed breast milk kept at room temperature for 4 hours.
Due to the presence of white blood cells in breastmilk, freshly expressed milk may be stored at room temperature for up to 4 hours. Breastmilk should never be refrozen after thawing.
Question 109
A patient is concerned that her breastfed newborn is not getting enough milk. The nurse asks how many wet diapers the baby produces each day. Which amount of wet diapers indicates the baby is having adequate feedings?
4 - 6 wet diapers/day
9 - 12 wet diapers/day
6 - 8 wet diapers/day
✓
1 - 3 wet diapers/day
Correct Answer
6 - 8 wet diapers/day
A baby that is receiving enough milk should produce between 6 - 8 wet diapers per day.
Question 110
A mother asks if she should give her 2-week-old infant small amounts of water between breastfeeding to prevent dehydration. Which is the nurse's best response?
Infants younger than 6 months should not be given water.
✓
Yes, half of the baby's oral intake should be water.
Introduce water once your baby starts eating solids.
Supplemental water should only be given to formula-fed infants.
Correct Answer
Infants younger than 6 months should not be given water.
No supplemental water should be administered to an infant until 6 months of age. Giving water to newborns may lead to electrolyte imbalance and decreased caloric intake. Breast milk or formula is sufficient for hydration.
Question 111
The nurse is assessing a newborn with hyperbilirubinemia currently receiving phototherapy. Which of the following is an appropriate finding for phototherapy?
The baby has an eye mask on
✓
The baby is completely naked
Lotion has been applied to the baby as ordered
The baby has a onesie and socks on
Correct Answer
The baby has an eye mask on
During phototherapy the baby should only wear a diaper and eye mask.
Question 112
A newborn has been diagnosed with pathologic jaundice. The nurse can identify pathologic jaundice vs. physiologic jaundice because pathologic jaundice occurs how soon after birth?
Within 24 hours
✓
36-48 hours
4-5 days
48 hours
Correct Answer
Within 24 hours
Pathologic jaundice occurs within the first 24 hours after birth. Physiologic jaundice begins on day 2-3, peaks on day 4-5, and resolves in 2 weeks.
Question 113
A nurse is caring for a newborn with neonatal abstinence syndrome. How often should Finnegan scoring be performed to assess the infant's withdrawal symptoms?
Once per shift
Only when symptoms worsen
Every 8 hours
Every 3 hours
✓
Correct Answer
Every 3 hours
Finnegan screening for infants experiencing neonatal abstinence syndrome should be performed every 3 hours.
Question 114
The nurse is assessing a 2-day-old newborn with suspected neonatal abstinence syndrome. The infant is irritable and difficult to console. Which cry pattern should the nurse expect to observe?
Quiet and hoarse
Absent entirely
Low-pitched and weak
High-pitched and shrill
✓
Correct Answer
High-pitched and shrill
An infant experiencing neonatal abstinence syndrome is likely to have a high-pitched, shrill, persistent cry.
Question 115
A nurse is explaining a vaccine to the parents of a newborn. The nurse says this is the first vaccine the child will receive which is given at birth. Which vaccination is this nurse going to administer?
Hepatitis B
✓
Hepatitis A
Varicella
Hepatitis C
Correct Answer
Hepatitis B
Hepatitis B vaccine is given at birth. Signed informed consent is required prior to giving this vaccine.
Question 116
A nurse assesses a newborn by stroking the infant's cheek. The newborn turns toward the stimulus and opens the mouth. Which reflex does this response represent?
Rooting
✓
Sucking
Moro
Tonic neck
Correct Answer
Rooting
The rooting reflex is demonstrated by the infant turning their head and opening their mouth when their cheek or mouth is stroked.
Question 117
A nurse is assessing reflexes on a newborn. Which reflex is demonstrating if the baby extends its arms and then pulls them back in toward the body with a brief cry?
Moro/startle
✓
Rooting
Sucking
Walking
Correct Answer
Moro/startle
The moro/startle reflex occurs in response to a loud noise or sudden movement. The baby extends its arms then bends and pulls them in toward the body with a brief cry.
Question 118
When assessing the infant, the nurse notes an area of swelling that does not cross the suture line. What is the name for this condition?
Caput succedaneum
Cephalohematoma
✓
Molding
Erythema toxicum
Correct Answer
Cephalohematoma
Cephalohematoma is the term used to describe an area of swelling that does not cross the suture line.
Question 119
A parent is concerned about their newborn's appearance.The newborn has fine hair on the shoulders and upper back.The nurse explains that this is an expected finding on a newborn and is known as what?
Meconium
Lanugo
✓
Jaundice
Vernix
Correct Answer
Lanugo
Fine, downy hair on a newborn is known as lanugo. This is expected and can be found in small amounts on the shoulders, upper back, or sides of the face.
Question 120
Which of the following New Ballard findings is consistent with a mature infant?
Plentiful lanugo
0 degree square window
✓
Flat, smooth scrotum
Sticky, friable skin
Correct Answer
0 degree square window
A 0 degree square window is the only finding consistent with a mature infant. The other findings are consistent with a premature infant.
Question 121
What APGAR score should the nurse give an infant who is well flexed, crying, has a pulse of 120 bpm and a pink body with bluish hands/feet?
9
✓
10
7
8
Correct Answer
9
This infant should receive a score of 9 (off 1 point due to acrocyanosis).
Question 122
A patient who tested positive for group B streptococcus asks what medication they will be given during labor. Which medication will the patient likely receive?
Levofloxacin
Meropenem
Cefepime
Ampicillin
✓
Correct Answer
Ampicillin
Ampicillin or penicillin G are the most common medications given to treat group B streptococcus infection during labor.
Question 123
The nurse is reviewing medications for a patient with chronic hypertension who is 22 weeks pregnant. Which medication is considered safe and indicated in pregnancy?
Losartan
Enalapril
Labetalol
✓
Lisinopril
Correct Answer
Labetalol
ACE inhibitors (e.g., lisinopril, enalapril) and angiotensin receptor blockers (e.g., losartan) are contraindicated in pregnancy. Labetalol, a beta blocker, may be indicated for treatment of hypertension in a patient who is pregnant.
Question 124
A patient receiving magnesium sulfate for preeclampsia has absent DTRs and is breathing 8 times per minute. What is the nurse's priority action?
Prepare the OR for an emergent c-section
Begin CPR
Administer calcium gluconate
✓
Place the patient in high-Fowler's position
Correct Answer
Administer calcium gluconate
This patient appears to be experiencing magnesium toxicity, so the nurse should administer calcium gluconate, which is the antidote for magnesium.
Question 125
How much protein should the nurse expect to find in the urine of a patient with gestational hypertension?
None
✓
2+
Trace
1+
Correct Answer
None
Proteinuria is seen in preeclampsia, not gestational hypertension.
Question 126
How should the nurse explain the difference between preeclampsia and eclampsia?
Preeclampsia does not have vision changes
Preeclampsia has no proteinuria
Eclampsia begins with decreased DTRs
Eclampsia is marked by the onset of seizures
✓
Correct Answer
Eclampsia is marked by the onset of seizures
Eclampsia is marked by the onset of seizures.
Question 127
A 30 week pregnant patient presents with sudden onset severe abdominal pain, a rigid board-like abdomen, and dark red vaginal bleeding. Based on these findings the nurse suspects the patient has which complication of pregnancy?
Placenta previa
HELLP syndrome
Ectopic pregnancy
Abruptio placentae
✓
Correct Answer
Abruptio placentae
Premature separation of the placenta from the uterus after 20 weeks gestation is known as abruptio placenta. It causes sudden pain, dark red vaginal bleeding, a rigid abdomen, and fetal distress.
Question 128
A pregnant patient presents with bright red vaginal bleeding at 32 weeks gestation. The patient states that there is no pain associated with the bleeding. Which complication of pregnancy does the nurse suspect?
Placenta previa
✓
Eclampsia
Group B strep
Abruptio placentae
Correct Answer
Placenta previa
Bright red, painless vaginal bleeding during the second half of pregnancy is likely to be associated with placenta previa.
Question 129
A patient has been diagnosed with cervical insufficiency. Which of the following is an appropriate intervention for this condition?
Cervical cerclage
✓
Dinoprostone
Hourly cervical exams
Misoprostol
Correct Answer
Cervical cerclage
Cervical cerclage is indicated in the treatment of cervical insufficiency.
Question 130
Which finding of the urine is consistent with a patient who has hyperemesis gravidarum?
Glycosuria
Proteinuria
Ketonuria
✓
Hematuria
Correct Answer
Ketonuria
Ketones may be present in the urine of a patient with hyperemesis gravidarum.
Question 131
A nurse provides teaching to a pregnant patient about avoiding infections during pregnancy. Which statement by the patient indicates correct understanding?
"I should avoid deli meats and unpasteurized cheese to prevent hepatitis B."
"I should avoid cleaning cat litter and wear gloves while gardening to prevent toxoplasmosis."
✓
"Since I've never had chickenpox, I should receive the varicella vaccine in the first trimester."
"I should drink extra milk to prevent cytomegalovirus."
Correct Answer
"I should avoid cleaning cat litter and wear gloves while gardening to prevent toxoplasmosis."
Toxoplasmosis is a teratogenic parasitic infection transmitted through cat feces and contaminated soil. Pregnant patients should avoid handling cat litter and soil directly.
Question 132
A patient at 10 weeks' gestation presents to the emergency department with vaginal spotting and sharp right-sided pelvic pain. Which complication should the nurse suspect?
Hydatidiform mole
Placenta previa
Ectopic pregnancy
✓
Hyperemesis gravidarum
Correct Answer
Ectopic pregnancy
Ectopic pregnancy occurs when a fertilized ovum implants outside the uterus. Ectopic pregnancy may cause unilateral stabbing pelvic pain, vaginal bleeding/spotting, and signs of hemorrhage.
Question 133
A nurse is caring for a pregnant patient with vaginal bleeding that resembles prune juice. Lab results indicate the patient's hCG level is elevated. What pregnancy complication does the nurse suspect?
Hyperemesis gravidarum
Ectopic pregnancy
Molar pregnancy
✓
Spontaneous abortion
Correct Answer
Molar pregnancy
Molar pregnancy (hydatidiform mole) is characterized by abnormal growth of trophoblastic villi , which prevents normal embryo maturity. This causes dark brown vaginal bleeding, high hCG, cramps, and passage of tissue that look like clusters of grapes.
Question 134
A patient undergoes a contraction stress test. The nurse notes late decelerations of the fetal heart rate in 65% of contractions. How should the nurse document this result?
Negative
Nonreactive
Reactive
Positive
✓
Correct Answer
Positive
A positive CST indicates late decelerations are present with ≥ 50% of contractions, suggesting uteroplacental insufficiency and increased risk for fetal compromise.
Question 135
A patient at 34 weeks' gestation is undergoing a biophysical profile (BPP). The patient asks what a normal result is. Which response by the nurse is most appropriate?
A score of 12 is the highest possible
A score of 0 means the baby is healthy
Any score above 2 is considered normal
A score of 8 - 10 is normal
✓
Correct Answer
A score of 8 - 10 is normal
The BPP assesses fetal well-being with a maximum score of 10. An overall score of 8 -10 on a BPP is normal. <8 may indicate fetal hypoxia.
Question 136
A patient receives a score of 4 during a biophysical profile. What does this indicate?
Polyhydramnios
Fetal macrosomia
Fetal hypoxia
✓
Intrauterine growth restriction
Correct Answer
Fetal hypoxia
A BPP score less than 8 is indicative of fetal hypoxia.
Question 137
A patient has just undergone a nonstress test. The results indicate the patient had a normal FHR, moderate variability, and accelerations 20 bpm 18 seconds three times in 20 minutes. How should the nurse document the results of this NST?
Negative
Non Reactive
Positive
Reactive
✓
Correct Answer
Reactive
This is a normal result, reactive. Reactive means the FHR was normal, moderate variability with accelerations >=15 bpm for >=15 seconds >=2 times in 20 minutes.
Question 138
A nurse is preparing a pregnant patient for an amniocentesis. Which action should the nurse instruct the patient to take prior to the procedure?
Drink 1 L of water
Take ibuprofen for pain relief
Remain NPO for 12 hours
Empty their bladder
✓
Correct Answer
Empty their bladder
To decrease the risk of accidental bladder injury, the nurse should have the patient empty their bladder prior to an amniocentesis. There is no need for the other interventions.
Question 139
A nurse is teaching a patient about an upcoming transabdominal ultrasound in the second trimester. Which statement by the patient indicates understanding?
I cannot eat for 6 hours before this test.
I should make sure to empty my bladder completely beforehand.
This test will measure the length of my cervix.
I will need to have a full bladder for this test.
✓
Correct Answer
I will need to have a full bladder for this test.
Transabdominal ultrasounds require a full bladder, however the patient does not need to be NPO. Transvaginal ultrasounds are used to measure cervical length.
Question 140
During the second and third trimesters, how much weight should a pregnant patient expect to gain each week?
2 pounds
1 kilogram
0.5 pounds
1 pound
✓
Correct Answer
1 pound
During the second and third trimesters, patients should expect to gain 1 pound per week.
Question 141
A patient at 28 weeks' gestation undergoes a 3-hour oral glucose tolerance test after an abnormal 1-hour screen. The nurse should recognize that a diagnosis of gestational diabetes mellitus is made when how many values are abnormal?
Any one value
Two or more
✓
All four
Three or more
Correct Answer
Two or more
Two or more values from a patient's 3-hour glucose tolerance test must be elevated for a patient to be diagnosed with gestational diabetes mellitus.
Question 142
A nurse is reviewing maternal serum alpha-fetoprotein (MSAFP) results with a patient at 17 weeks' gestation. The level is abnormally elevated. Which conditions might this result indicate?
Down syndrome in the developing fetus
Neural tube defects in the developing fetus
✓
Fetal macrosomia
Gestational diabetes for the pregnant patient
Correct Answer
Neural tube defects in the developing fetus
A high MSAFP level may indicate neural tube defects in the developing fetus.
Question 143
A nurse is explaining the oral glucose tolerance test (OGTT) to a pregnant patient. Which result should the nurse state requires a 3-hour OGTT?
glucose >100mg/dL
glucose >120 mg/dL
glucose >150 mg/dL
glucose >140 mg/dL
✓
Correct Answer
glucose >140 mg/dL
If glucose is >140 mg/dL the patient must follow up with a 3-hour OGTT.
Question 144
A nurse is determining a patient's estimated delivery date. The first day of the patient's last period was January 7, 2022. When is this patient expected to deliver?
October 14, 2022
✓
October 7, 2022
September 7, 2022
October, 7 2023
Correct Answer
October 14, 2022
To determine the expected delivery date by Naegele's rule, subtract 3 months, then add one week and 1 year to the first day of the patient's last period.
Question 145
The nurse is educating a pregnant patient on fetal movement monitoring. At which gestational age should the nurse instruct the patient to begin daily kick counts?
20 weeks
26 weeks
34 weeks
30 weeks
✓
Correct Answer
30 weeks
Daily kick counts should begin at 30 weeks gestation.
Question 146
During an education session, the patient understands the correct use of a diaphragm when they state they should leave it in for how many hours after sexual intercourse?
6 hours
✓
48 hours
3 hours
2 hours
Correct Answer
6 hours
A diaphragm should be left in for 6 or more hours after sexual intercourse, but no longer than 24 hours.