Exam 6: Maternal & Newborn Health

A client at 41 weeks gestation is admitted to the labor and delivery unit for labor induction.  The nurse is assisting the health care provider with an amniotomy.  What actions should the nurse anticipate?  Select all that apply.

A client in labor with a history of a previous cesarean birth has chosen to attempt a vaginal birth.  During labor, which finding would be most concerning to the nurse?

A client at 38 weeks gestation is brought to the emergency department after a motor vehicle crash.  She reports severe, continuous abdominal pain.  The nurse notes frequent uterine contractions and mild, dark vaginal bleeding.  What actions should the nurse take?  Select all that apply.

Following the precipitous birth of a term newborn, what is the best action by the nurse while awaiting expulsion of the placenta and arrival of the health care provider?

The nurse is assessing a client at 36 weeks gestation during a routine prenatal visit.  Which statement by the client should the nurse investigate first?

The labor and delivery nurse is caring for a Japanese client who has declined epidural anesthesia.  The client has been very stoic and quiet throughout labor.  Which nursing action represents the most appropriate care for this client?

The nurse is performing an assessment on a 39-week neonate an hour after a spontaneous vaginal delivery.  What are common expected newborn findings?  Select all that apply.

A client at 39 weeks gestation with preeclampsia has a blood pressure of 170/100 mm Hg, 2+ proteinuria, and moderate peripheral edema.  Immediately after hospital admission, she develops seizures and uterine contractions.  Magnesium sulfate is prescribed.  Which finding indicates that the drug has achieved the desired therapeutic effect?

A pregnant client arrives in the labor and delivery unit with mild contractions and brisk, painless vaginal bleeding.  The client received no prenatal care and reports being "about 7-8 months."  Which actions should the nurse anticipate?  Select all that apply.

A client, gravida 4 para 3, at 38 weeks gestation arrives in the emergency department with strong contractions that began 1 hour ago.  The client is diaphoretic, grunting, and yelling loudly that she wants an epidural because she feels the need to push.  What priority action should the nurse take?

The clinic nurse is collecting data on a pregnant client in the first trimester.  Which finding is most concerning and warrants priority intervention?

The nurse reviews the chart of a client who gave birth 4 hours ago.  Which contributing factor indicates that the client has an increased risk of postpartum hemorrhage?

A pregnant client comes to the labor and delivery unit stating, "My water just broke at home."  On assessment of the client's perineal area, the nurse visualizes a loop of umbilical cord protruding from the vagina.  Which nursing intervention would be appropriate?

A client at 34 weeks gestation reports constipation.  The client has been taking 325 mg ferrous sulfate tid for anemia since the last appointment 4 weeks ago.  Which recommendations should the nurse make for this client?  Select all that apply.

The graduate nurse (GN) and supervising nurse are preparing to follow-up with a client who had a spontaneous abortion at 6 weeks gestation at home.  Which of the following statements by the GN are appropriate?  Select all that apply.

The graduate nurse (GN) receives report on a postpartum client with an Rh-negative blood type.  Which statement by the GN regarding the Rh immune globulin injection requires the preceptor to provide further teaching?

A graduate nurse is reinforcing education to a pregnant client with hepatitis B who expresses concern about transmitting the virus to the newborn after birth.  Which statement about newborn care made by the graduate nurse should cause the precepting nurse to intervene?

The nurse is caring for a 6-hour-old, full-term newborn of a mother with gestational diabetes.  A bedside capillary blood glucose measurement reveals that the newborn's blood glucose level is 45 mg/dL (2.5 mmol/L).  The newborn is asymptomatic.  What is the nurse's first action?