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Obstetrics Exam (Regular)
Obstetrics Exam (Regular)
Total Questions : 52
Showing 10 questions Sign up for moreA nurse is preparing a presentation about ways to minimize heat loss in the newborn. Which measure would the nurse include to prevent heat loss through convection?
Explanation
A. Using a radiant warmer to transport a newborn helps prevent radiant heat loss, not convection. Radiant heat loss occurs when heat transfers from the newborn to cooler surfaces not in direct contact, such as walls or windows.
B. Placing a cap on a newborn's head is effective in reducing evaporative and radiant heat loss from the head, but it does not specifically address heat loss through air movement (convection).
C. Placing the newborn skin-to-skin with the mother reduces conductive heat loss by providing a warm surface (the mother's skin), not convection.
D. Closing doors and windows to prevent draft helps reduce convective heat loss, which occurs when air currents pass over the newborn's skin and carry away body heat. Eliminating drafts minimizes this form of heat loss, making this the correct intervention for convection.
A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. The nurse determines that the drug is at a therapeutic level based on which result?
Explanation
A. 8.4 mEq/L is above the therapeutic range and may indicate magnesium toxicity. Levels greater than 7.5–8 mEq/L can lead to loss of deep tendon reflexes, and higher levels can cause respiratory depression and cardiac arrest.
B. 6.1 mEq/L falls within the therapeutic range for magnesium sulfate when used to treat severe preeclampsia, which is generally 4.8–8.4 mEq/L (or 4–7 mEq/L depending on the source and unit of measurement). This level is considered safe and effective for preventing seizures.
C. 10.8 mEq/L is too high and indicates magnesium toxicity, placing the patient at risk for serious complications like respiratory or cardiac arrest.
D. 3.3 mEq/L is below the therapeutic range, suggesting that the dose may be inadequate to prevent eclamptic seizures in a woman with severe preeclampsia.
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. The nurse determines that the medication is at a therapeutic level based on which finding?
Explanation
A. Difficulty in arousing suggests central nervous system depression, which can be a sign of magnesium toxicity. This is not a therapeutic effect and requires immediate assessment and possible discontinuation of the medication.
B. Deep tendon reflexes 2+ indicates normal neuromuscular function, which is consistent with therapeutic levels of magnesium sulfate. Loss of deep tendon reflexes is often the first sign of magnesium toxicity, so their presence at a normal level is reassuring.
C. Urinary output of 20 mL per hour is below the expected minimum (typically 30 mL/hour) and may suggest impaired renal function, which increases the risk of magnesium accumulation and toxicity.
D. Respiratory rate of 10 breaths/minute is lower than normal and may indicate respiratory depression, a serious sign of magnesium toxicity. A rate below 12 breaths/minute is concerning and not consistent with therapeutic dosing.
Twenty minutes after birth, a baby begins to move his head from side to side, making eye contact with the mother, and pushes his tongue out several times. The nurse interprets this as:
Explanation
A. Evidence that the newborn is becoming chilled would typically include signs such as cool skin, mottling, or acrocyanosis ,not active behaviors like head movement and eye contact.
B. A good time to initiate breast-feeding is correct. The described behaviors ,eye contact, head movement, and tongue thrusting, are characteristic of the first period of reactivity, which occurs within the first 30 minutes after birth. During this time, the newborn is alert, responsive, and exhibits strong rooting and sucking reflexes, making it an ideal window to begin breastfeeding.
C. The period of decreased responsiveness preceding sleep typically occurs after the first period of reactivity and is marked by reduced activity and interest in feeding, not alert behaviors.
D. A sign that the infant is being overstimulated would usually involve signs like gaze aversion, hiccupping, or flailing ,not purposeful movements or eye contact.
After the birth of a newborn, which action would the nurse do first to assist in thermoregulation?
Explanation
A. Wrap the newborn in a blanket helps maintain body heat after the initial drying and stimulation but is not the first priority in thermoregulation.
B. Put a hat on the newborn's head also helps prevent heat loss, particularly from the head, which is a major site of heat loss in newborns. However, this should be done after drying to avoid trapping moisture.
C. Check the newborn's temperature is important but should be done after immediate measures to prevent heat loss have been taken.
D. Dry the newborn thoroughly is the first and most critical step in preventing evaporative heat loss, which is the primary cause of newborn heat loss immediately after birth. Removing wet amniotic fluid from the skin helps stabilize temperature effectively.
A nurse is teaching a postpartum client how to do muscle-clenching (Kegel) exercises for the perineum. The client asks the nurse, "Why do I need to do these exercises?" Which reason would the nurse most likely incorporate into the response?
Explanation
A. Lochia is the normal postpartum vaginal discharge of blood and tissue, and its duration or volume is not affected by Kegel exercises.
B. Uterine involution ,the shrinking of the uterus to its pre-pregnancy size ,is a natural physiological process and is not influenced by Kegel exercises.
C. Kegel exercises specifically target the pelvic floor muscles, which may be weakened during pregnancy and childbirth. These exercises help strengthen the muscles, support pelvic organs, and prevent issues such as urinary incontinence.
D. While improved muscle tone may eventually support healing, these exercises are not a direct method for pain relief.
The nurse is caring for a client in labor who has refused epidural anesthesia. An order was placed for Stadol 3mg IV Q4h PRN pain. The drug is supplied 2 mg per ml. How much of the medication should the nurse give?
Explanation
A. 0.75 mL would provide only 1.5 mg, which is half the prescribed dose
B. 15 mL would provide 30 mg, which is ten times the prescribed dose and could be dangerously toxic
C. 1.5 mL is correct and delivers exactly 3 mg of Stadol, matching the provider's order. To calculate the correct volume to administer, use the formula: Dose to give= ordered dose/concentration= 3/2= 1.5ml
D. 0.9 mL would give 1.8 mg, which is below the ordered dose.
A postpartum client has a fourth-degree perineal laceration. The nurse would expect which medication to be prescribed?
Explanation
A. Ferrous sulfate is typically prescribed to prevent or treat iron deficiency anemia, which may be needed postpartum if there was significant blood loss during delivery, but it is not related to the care of a perineal laceration.
B. Methylergonovine is a medication used to prevent or treat postpartum hemorrhage by promoting uterine contraction. While it is important for hemorrhage management, it is not used for perineal laceration care.
C. Bromocriptine is used to suppress lactation in clients who are not breastfeeding, but it is not relevant to a fourth-degree laceration.
D. Docusate is a stool softener, which is often prescribed after a fourth-degree perineal laceration. The client needs to avoid straining during bowel movements, as it could put strain on the perineal area and hinder healing. Docusate helps prevent constipation and reduces the risk of further injury to the perineum.
A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 66 beats per minute. Which of these actions should the nurse take?
Explanation
A. A pulse rate of 66 beats per minute is within the normal range for a postpartum woman, particularly 12 hours after birth. It's common for the pulse rate to decrease after delivery, as the body stabilizes and returns to its pre-pregnancy state. This is not a cause for concern and can be considered a normal physiological response to the postpartum period.
B. Contact the primary care provider, as it indicates early DIC (disseminated intravascular coagulation). This is unlikely, as DIC typically presents with more severe symptoms, such as bleeding, bruising, and a drop in blood pressure, not a lower pulse rate. A normal or slightly decreased pulse is not indicative of DIC.
C. While it's important to monitor for signs of anemia in the postpartum period (such as fatigue, dizziness, or weakness), a pulse of 66 beats per minute is not a typical sign of anemia. Anemia would more likely be accompanied by other symptoms, such as pallor or weakness.
D. Postpartum eclampsia typically presents with high blood pressure, severe headache, visual disturbances, or seizures, not a low pulse rate. A pulse rate of 66 beats per minute is not a sign of eclampsia.
A nurse is providing care to a postpartum woman. Which of the following behavior by the client would indicate the client is in the Taking in phase?
Explanation
A. The client talks frequently about her labor and delivery is a characteristic behavior of the Taking In phase, which occurs during the first few days postpartum. During this phase, the mother is primarily focused on her own needs and recovering from childbirth. She may want to discuss her labor and delivery experience and may be more focused on rest and reflection rather than engaging with the baby.
B. The client hesitates to initiate contact with the baby is more characteristic of the Taking Hold phase, which comes after the Taking In phase. In the Taking Hold phase, the mother begins to take more responsibility for her baby’s care, though she may still seek guidance.
C. The client questions the nurse about the amount of formula for the baby indicates a more active engagement in learning about infant care, which is typical of the Taking Hold phase, where the mother starts to focus on baby care and becomes more involved.
D. The client requests between meals snacks is a sign of physical recovery and possibly an increased need for nourishment, but it does not specifically indicate being in the Taking In phase. This behavior may occur in any phase but is not a defining characteristic.
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