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OB Exam 6- Kahoot

Terms in this set (54)

A 38wk newborn had thick green amniotic fluid noted. Which is a priority nursing action?
-Give the baby a bath as soon as possible
-Check their eyes for infection
-Assess respiratory closely and watch for distress
-Get a temperature right away
-Assess respiratory closely and watch for distress
24hr post delivery: fundus slightly boggy 2cm above umbilicus. What is your priority?
- Document and check lochia
-Assess mom's vital signs
- Have mom void, then gently massage fundus until firm
- Notify MD and document
- Have mom void, then gently massage fundus until firm
involution of the uterus
the uterus returns to its normal nonpregnant size
What is the highest priority of the RN who is caring for a laboring client?
-Pain relief offered are acceptable to the patient
- Involvement of the patient's partner
- Monitor appropriate fluid intake
- Assess fetal response to the labor
- Assess fetal response to the labor
The RN encourages a client in labor to assume a side lying position... why?
- Prevent prolapse cord
- Relaxes pelvic muscles
- Enhances venous return
- Promotes crowning
- Enhances venous return
Pt's hx includes android pelvis. She is at high risk for what?
- prolonged labor
- post partum hemorrhage
- occiput posterior position
- precipitous delivery
- prolonged labor
As labor progresses the nurse expects contractions are developing which characteristics?
- More intense, less frequent
- More intense, more frequent, longer duration
- Constant intensity, more frequent
- Constant intensity and frequency but shorter duration
- More intense, more frequent, longer duration
*See Table 13.2, p.439-442: latent 0-3cm, active 4-7cm, transition stages 8-10cm
RN is caring for a mom in labor. How are frequency of cx timed?
-End of one to the end of the next
-End of one to the beginning of the next.
- Beginning of one to the beginning of the next
- Beginning of one to the beginning of the next
*See pg. 434, Fig 13.13
The term: attitude, lie, presentation, engagement, station refer to which of the five "P's"?
-Passageway
-Passenger
-Powers
-Psyche
-Passenger
pg.424-433
A new mom c/o "afterpains" with breastfeeding. The first action of the nurse:
- Administer an analgesic
- Encourage her to empty her bladder
-Advise her to stop breastfeeding until the pain stops
-Assess her vital signs
- Administer an analgesic
pg. 503
The PP (post-partum) mom temp is 100.2F 4hrs after her delivery. What is the appropriate action?
-Do nothing, it is expected
- Check the order for antibx to treat infection
- Medicate for pain
- Encourage increasing fluid intake
- Encourage increasing fluid intake
p.524, 16.1, 16.2 boxes
A mom vaginal delivered 90 min ago: she is alert/active in bed. She needs to void. What should you do?
- Walk with her and stay with her in the bathroom
- Get her a bedpan
- Remind her to wipe front to back
- She should wipe stitches gently and increase circulation
- Walk with her and stay with her in the bathroom
p.526
What is included in caring for a 3rd degree episiotomy? ATA
-Increase fiber in diet
- Administer Ducolax suppository
- Increase fluid intake
-Administer an oral stool softener
-Increase fiber in diet
- Increase fluid intake
-Administer an oral stool softener
The mom is having cx every 5 min for seven hrs. What would define true labor?
- The client had two other children
- Contractions are irregular
- The cervix is showing effacement and dilation
- There is spontaneous rupture of membranes
- The cervix is showing effacement and dilation
p.423-434, table 13.1
Which would indicate a sign of impending placental separation and expulsion?
-Steady trickle of blood unchanged cord length
- Lengthening of the cord w/ associated cord tear
- Small gush of blood w/ lengthening of the cord
- Small gush of blood w/ an unchanged cord length
- Small gush of blood w/ lengthening of the cord
p.490
How would the nurse describe a frank breech position?
- Both hips and knees are flexed
- The hips are extended and knees are flexed
- The hips are flexed and knees are extended
- Both the hips and knees are extended
- The hips are flexed and knees are extended
p.429
During exam you note a loop of umbilical cord protruding. What is the action priority?
- Call for help immediately
- A clean moist cloth over the cord to prevent drying
- Immediately turn the client on her side and check FHR
- Continue vaginal exam, upward pressure on part, get ready for C-section
- Call for help immediately

??Clarify with instructor
Fetal HR drops 130 to 70 w cx's followed by rapid recovery unrelated to mom's cx. This is most likely:
- Umbilical cord compression
- fetal head compression
- Severe fetal hypoxia
- Utero-placental insufficiency
- Umbilical cord compression
The nurse assesses: fundus displaced laterally, uterus boggy. The nurse knows which can cause uterine atony?
- Poor involution
-Hemorrhage
-Urinary retention
- Infection
-Urinary retention
Where on the abd. would the uterus be involuted to on PP day #3?
- Fundus 1cm above the umbilicus, lochia rosa
- Fundus 2cm above the umbilicus, lochia alba
- Fundus 2cm below the umbilicus, lochia rubra
- Fundus 3cm below the umbilicus, lochia serosa
- Fundus 3cm below the umbilicus, lochia serosa
PP the fundus in involuting appropriately. Mom is voiding frequently. What would you do?
- Catheterize the client per MD order
- Measure the client's next void
- Inform the client polyuria is normal
- Check specific gravity next void
- Inform the client polyuria is normal
p.506
A pregnant woman has crack cocaine in her pocket, no prenatal care. What complication may occur?
- Prolonged labor
- Prolapsed cord
- Abruptio placenta
- Retained placenta
- Abruptio placenta
Mom 2d PP, the nurse notes her pad is soaked w rubra drainage less than 15min after a change. What should be charted?
-Light lochia rubra
-Moderate lochia rubra
-Scant lochia rubra
- Excessive lochia rubra
- Excessive lochia rubra
p.502
The laboring mom is c/o severe back pain w cx's. The fetus is probably in which position?
- Mentum anterior
- Sacrum posterio
- Scapular anterior
- Occiput posterior
- Occiput posterior
What is effacement?
- the MD is faced with a difficult decision
- the cervix shortens, thins, and is measured in percentages
- Mom may face terminating her pregnancy
- Mom is faced with epidural
- the cervix shortens, thins, and is measured in percentages
p.426
Mom is having cx pattern: frequency every 2 min, duration 60 second. Which corresponds?
- Contraction lasting 60 seconds, rest 2 min
-Contractions lasting 120 seconds, 1 min rest
- Contractions lasting 1 min, with a 1 min rest period
- Contractions lasting 2 min resting 120 seconds
- Contractions lasting 1 min, with a 1 min rest period
p.434
An amniotomy was just done. What assessment should be done immediately by the nurse?
-A sample sent to the lab
- Maternal heart rate
-Maternal blood pressure
- Fetal Heart Rate
- Fetal Heart Rate
Immediately following an epidural anesthesia, the nurse must assess which of the following?
-Mom's blood pressure
- Fetal heart accelerations
- Numbness and tingling in her feet and legs
- Swallowing ability of mother
-Mom's blood pressure
Mom believes she is in labor. The nurse knows which of the following confirm this belief?
-The membranes have ruptured
- Her pain is increasing
- She is contracting every 5 min for 60 seconds
- She is dilated from 2cm to 4cm
- She is dilated from 2cm to 4cm
When would the nurse see the monitor tracing of fetal heart rate changes and contractions matching?
-During second stage of labor
- during latent phase of stage one labor
-during an epidural
- during the delivery of the placenta (3rd stage of labor)
- during latent phase of stage one labor
*review C-sections
*also high-risk handout
What is the scientific reason the nursery nurse wear gloves when handling a neonate?
- meconium is full of bacteria
- Fetal urine is infected
- Amniotic fluid can contain harmful viruses
- The baby must be protected
- Amniotic fluid can contain harmful viruses
p.611
A newborn rec'd Vit K. Which would indicate treatment was effective?
- Blood clots after heel sticks
- Skin color is jaundiced
- BP is high
- Glucose levels are low
- Blood clots after heel sticks
p.487-489
A full term baby is just born. What is the nurses priority?
- Elicit the Moro reflex
- Insert eye prophylaxis
- Assess apgar score
- Remove all wet blankets
- Remove all wet blankets
*Keep baby warm!
p.488-489, 587
To reduce hypoglycemia in a full term newborn weighing 2900gm (~6lbs) )what should the nurse do?
- Feed the baby glucose water until taking breastmilk well
- Assess the blood glucose level every three hours
- Maintain temp above 97.7
- Encourage breast feeding every 3-4 hours
- Encourage breast feeding every 3-4 hours
Newborn Normals:
RR and Temp
RR- 30-60
T (axillary)- 97.7-99.5
HR- 85-190

*Baby V/S while on mom every 15 min for first hour, every 30 min for two hours
A newborn at 2 days old has lost 2.5% of his birth weight. What is the appropriate action of the nurse?
- Notify the neonatologist this is too much loss
- Assess the baby's glucose level
-Advise the mom to bottle feed at the next feeding
- Do nothing this is w/i normal weight loss for a newborn
- Do nothing this is w/i normal weight loss for a newborn
(Normal loss up to 10%)
A 6yo neonate has cyanotic hands and feet. Which of the nurse action is appropriate?
- Administer oxygen
- Place the baby on a pulse oximeter
- Swaddle the baby in a blanket
-Place the baby in an isolette
- Swaddle the baby in a blanket
(normal- acrocyanosis)
A baby was admitted to the nursery. Which should the nurse report to the physician?
- Caput seccedaneum
- Intercostal retractions
- Epstein's pearls
- Harlequin sign
- Intercostal retractions
A baby is admitted to neonatal nursery. Which should you assess first?
- A baby w/ HR 42, sats 95%
-A baby w/ T 98.7
-A baby w/ glucose 60, HR 110
- A baby w/ 440gm (Greater than 8lbs 14oz), apgar 9,9
- A baby w/ HR 42, sats 95%
Which of the following babies require immediate attention?
- A baby w/ irregular breathing w 10 second apnea spells
- A baby w/ coordinated thoracic/abdominal breathing
- A baby w/ seesaw breathing
- A baby w/ respirations of 52
- A baby w/ seesaw breathing
A baby is pink, loud cry, flexed and active, RR:45, HR: 110. Bluish hands and feet. What is the apgar?
-6
-7
-8
-9
-9
The nursery nurse warms her stethoscope. This is preventing what type of heat loss in the newborn?
- Evaporation
- Radiation
- Conduction
- Convection
- Conduction
The newborn with which of the following is at risk for physiological jaundice?
- Mongolian spotting
- Harlequin spotting
-Cephalohematoma
- Caput seccedaneum
-Cephalohematoma
A full term NB: T 96.7, HR 158, RR62, jittery, pink w blue hands and feet. The RN should do which first?
- Assess the glucose lvl of the baby
- Administer oxygen
-Unswaddle the baby and bring to mom to feed
- Give the baby their first bath
- Assess the glucose lvl of the baby
The newborn is grunting. Which is the appropriate action of the nurse?
- Give the baby a pacifier
- Pick up the baby and rock
- Assess the RR
- Have the mother feed the baby
- Assess the RR
A nsg dx that is appropriate for a NB under phototherapy: Risk for fluid deficit. What outcomes would the RN note: SATA
- Breast feed at least 6 times daily
-The newborn has lost 14% his birth weight
- Newborn (day 2) had no wet diapers
-Heart rate is 182
-The newborn has lost 14% his birth weight
- Newborn (day 2) had no wet diapers
-Heart rate is 182
A nurse assesses the newborn apgar at 1min: HR 70, RR weak, tone, flaccid, color pale, grimacing. The score is:
-4
-6
-8
-9
-4
A direct Coombs test was done and it is positive. What should the nurse watch for in the baby?
-Elevated rectal temperature
- Jaundice
- Elevated Blood glucose
-Jitters
- Jaundice
Baby's blood is B-. The baby is at risk for jaundice if the mom's blood type is which?
-Type B
-Type A
-Type AB
-Type O
-Type O
Which of the nursing actions should the RN do when a baby is under phototherapy?
-turn the lights off for 15mins each hour
-Take the baby out of the isolette and rock if he cries
-swaddle the baby
-cover the baby's eyes with eye pads
-cover the baby's eyes with eye pads
A baby was born to a mother with group beta strept vag cx, admitted one hour prior to birth. What should the RN watch for?
-Low Blood Sugar
-Dehydration
-Thrush
-Hypothermia
Hypothermia
A newborn has a weak rooting and sucking reflex. Which is a priority nursing diagnosis?
-Risk for aspiration
-Risk for deficient fluid volume
-Activity intolerance
-Risk for poor bonding
-Risk for deficient fluid volume
A neonate is being assessed for NEC which action by the nurse are appropriate? ATA
- Measure an abdominal girth prior to each feed
- Watch for blood in the stool
- Check for gastric residuals prior to each feed
-Assess bowel sounds prior to each feed
ALL APPLY!
- Measure an abdominal girth prior to each feed
- Watch for blood in the stool
- Check for gastric residuals prior to each feed
-Assess bowel sounds prior to each feed
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