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Questions and Answers
What is the correct order for a nurse to instruct a client when collecting a midstream urine specimen?
What is the correct order for a nurse to instruct a client when collecting a midstream urine specimen?
A client with an 8-week unruptured ectopic pregnancy is likely to be prescribed which medication?
A client with an 8-week unruptured ectopic pregnancy is likely to be prescribed which medication?
Which statement by a participant in a newborn safety class indicates a correct understanding of safe practices?
Which statement by a participant in a newborn safety class indicates a correct understanding of safe practices?
Which finding indicates an adverse effect of epidural anesthesia?
Which finding indicates an adverse effect of epidural anesthesia?
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Which newborn should the nurse attend to first based on the following change-of-shift reports?
Which newborn should the nurse attend to first based on the following change-of-shift reports?
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When a client inquires about methods of contraception, which action should the nurse take first?
When a client inquires about methods of contraception, which action should the nurse take first?
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Which statement by a client indicates an understanding of expected physiological changes during pregnancy?
Which statement by a client indicates an understanding of expected physiological changes during pregnancy?
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A client reports experiencing afterpains following breastfeeding. Which nursing intervention is most appropriate?
A client reports experiencing afterpains following breastfeeding. Which nursing intervention is most appropriate?
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A client who is 12 weeks pregnant is scheduled for a cervical cerclage. Which statement indicates the client understands the teaching about the procedure?
A client who is 12 weeks pregnant is scheduled for a cervical cerclage. Which statement indicates the client understands the teaching about the procedure?
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A postpartum client is being taught about breastfeeding. Which statement demonstrates an understanding of proper technique?
A postpartum client is being taught about breastfeeding. Which statement demonstrates an understanding of proper technique?
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A client receiving terbutaline for preterm labor reports several symptoms. Which of the following should be reported to the provider?
A client receiving terbutaline for preterm labor reports several symptoms. Which of the following should be reported to the provider?
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A nurse is performing a blood glucose test for a newborn. Which action should the nurse take?
A nurse is performing a blood glucose test for a newborn. Which action should the nurse take?
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A client in their third trimester is asking about body changes. Which finding should the client report immediately?
A client in their third trimester is asking about body changes. Which finding should the client report immediately?
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Which of the following lab results for a 1-day-old newborn should be reported to the provider?
Which of the following lab results for a 1-day-old newborn should be reported to the provider?
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A nurse is caring for a client with afterpains who is breastfeeding. Which action would assist in minimizing the discomfort?
A nurse is caring for a client with afterpains who is breastfeeding. Which action would assist in minimizing the discomfort?
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A pregnant client is scheduled for a nonstress test. Which instruction should the nurse provide?
A pregnant client is scheduled for a nonstress test. Which instruction should the nurse provide?
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A postpartum client is experiencing breast engorgement. Which intervention should the nurse implement to promote comfort?
A postpartum client is experiencing breast engorgement. Which intervention should the nurse implement to promote comfort?
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When collecting a specimen for newborn screening, which action should the nurse take?
When collecting a specimen for newborn screening, which action should the nurse take?
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Which postpartum client should receive Rh (D) immune globulin?
Which postpartum client should receive Rh (D) immune globulin?
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A client at 12 weeks of gestation is being taught about folic acid. Which statement indicates an understanding?
A client at 12 weeks of gestation is being taught about folic acid. Which statement indicates an understanding?
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A client is 4 hours postpartum. For which of these findings should the nurse administer carboprost IM?
A client is 4 hours postpartum. For which of these findings should the nurse administer carboprost IM?
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When teaching a pregnant client about the nonstress test, which of the following is the priority nursing instruction?
When teaching a pregnant client about the nonstress test, which of the following is the priority nursing instruction?
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A breastfeeding client with engorgement asks the nurse about pumping. Which of the following should the nurse include in their teaching?
A breastfeeding client with engorgement asks the nurse about pumping. Which of the following should the nurse include in their teaching?
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A client with a pre-pregnancy BMI of 21 is receiving education about weight gain during pregnancy. Which of the following weight gain ranges is most appropriate for the nurse to recommend?
A client with a pre-pregnancy BMI of 21 is receiving education about weight gain during pregnancy. Which of the following weight gain ranges is most appropriate for the nurse to recommend?
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A client's last menstrual period began on February 16th. Based on Naegele's rule, what is the client's estimated date of birth?
A client's last menstrual period began on February 16th. Based on Naegele's rule, what is the client's estimated date of birth?
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A postpartum client is prescribed warfarin for deep vein thrombosis. Which instruction should the nurse include in the client's discharge teaching?
A postpartum client is prescribed warfarin for deep vein thrombosis. Which instruction should the nurse include in the client's discharge teaching?
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A client at 35 weeks of gestation presents with findings suggestive of abruptio placentae. Which of the following findings is most indicative of this condition?
A client at 35 weeks of gestation presents with findings suggestive of abruptio placentae. Which of the following findings is most indicative of this condition?
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A nurse is reinforcing teaching with a newly licensed nurse concerning a client on a postpartum unit following a cesarean birth. Which of the following measures should the nurse include in the instructions to prevent thrombophlebitis?
A nurse is reinforcing teaching with a newly licensed nurse concerning a client on a postpartum unit following a cesarean birth. Which of the following measures should the nurse include in the instructions to prevent thrombophlebitis?
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A nurse is planning care for a newborn who is large for gestational age. Which of the following actions should the nurse include in the plan of care? (Select all that apply)
A nurse is planning care for a newborn who is large for gestational age. Which of the following actions should the nurse include in the plan of care? (Select all that apply)
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A nurse is reinforcing teaching with a client about how to obtain a clean catch urine specimen. Which of the following instructions is most appropriate for the nurse to provide?
A nurse is reinforcing teaching with a client about how to obtain a clean catch urine specimen. Which of the following instructions is most appropriate for the nurse to provide?
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A nurse is caring for a client who is 1 hour postpartum and experiencing excessive bleeding. Which of these options would be the most appropriate first action by the nurse?
A nurse is caring for a client who is 1 hour postpartum and experiencing excessive bleeding. Which of these options would be the most appropriate first action by the nurse?
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Which of the following clinical findings should raise suspicion of a puerperal infection in a postpartum client?
Which of the following clinical findings should raise suspicion of a puerperal infection in a postpartum client?
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A prenatal client presents with several findings. Which requires immediate reporting to the provider?
A prenatal client presents with several findings. Which requires immediate reporting to the provider?
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When administering phytonadione to a newborn, which action is correct?
When administering phytonadione to a newborn, which action is correct?
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A client at 34 weeks gestation received nifedipine 2 hours ago. What therapeutic effect should the nurse monitor?
A client at 34 weeks gestation received nifedipine 2 hours ago. What therapeutic effect should the nurse monitor?
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A newborn undergoing phototherapy shows signs of dehydration. Which finding suggests this?
A newborn undergoing phototherapy shows signs of dehydration. Which finding suggests this?
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When auscultating fetal heart tones at 12 weeks gestation with a Doppler, where should the nurse expect to find them?
When auscultating fetal heart tones at 12 weeks gestation with a Doppler, where should the nurse expect to find them?
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Which contraceptive method is associated with the lowest failure rate?
Which contraceptive method is associated with the lowest failure rate?
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How should a nurse best administer a miconazole vaginal suppository for vaginal candidiasis?
How should a nurse best administer a miconazole vaginal suppository for vaginal candidiasis?
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A nurse is instructing a client in the first trimester of pregnancy about safe driving practices. Which of the following instructions should the nurse include?
A nurse is instructing a client in the first trimester of pregnancy about safe driving practices. Which of the following instructions should the nurse include?
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A nurse is assessing a client 20 hours postpartum after a vaginal delivery. Which of the following findings would the nurse expect?
A nurse is assessing a client 20 hours postpartum after a vaginal delivery. Which of the following findings would the nurse expect?
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A nurse is collecting data from a client requesting a transdermal contraceptive patch. Which finding is a contraindication for this method?
A nurse is collecting data from a client requesting a transdermal contraceptive patch. Which finding is a contraindication for this method?
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A nurse reviews a client's maternal serum alpha-fetoprotein (MSAFP) screening results. Low levels are associated with which condition?
A nurse reviews a client's maternal serum alpha-fetoprotein (MSAFP) screening results. Low levels are associated with which condition?
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A nurse is auscultating fetal heart tones of a client at 12 weeks gestation. Where should the nurse expect to hear them?
A nurse is auscultating fetal heart tones of a client at 12 weeks gestation. Where should the nurse expect to hear them?
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A client is 2 days post-cesarean birth. Which finding should be reported to the provider?
A client is 2 days post-cesarean birth. Which finding should be reported to the provider?
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A client with preeclampsia receives IV magnesium sulfate. Which finding should the nurse report to the provider as an adverse effect?
A client with preeclampsia receives IV magnesium sulfate. Which finding should the nurse report to the provider as an adverse effect?
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A nurse is teaching a client about using a transcutaneous electrical nerve stimulation (TENS) device during labor. Which instruction is appropriate?
A nurse is teaching a client about using a transcutaneous electrical nerve stimulation (TENS) device during labor. Which instruction is appropriate?
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Study Notes
OB CMS Study Notes
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Pre-pregnancy BMI of 21: Recommend weight gain of 11.4 to 15.9 kg (25 to 35 lb) during pregnancy.
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Last Menstrual Period (LMP): February 16th. Calculate estimated date of birth using Naegele's rule (add 7 days to LMP, subtract 3 months).
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Postpartum Warfarin: Instruct client not to use disposable razors or oral contraceptives.
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35 Weeks Gestation: Painless vaginal bleeding could indicate abruptio placentae, a serious complication requiring immediate medical attention.
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Postpartum Thrombophlebitis Prevention: Apply elastic stockings, and encourage ambulation to reduce the risk of blood clots.
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Large for Gestational Age Newborn: Monitor for ecchymosis (bruising). This is one potential, serious complication of large babies.
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Clean Catch Urine Specimen: Instruct client to cleanse urinary meatus from front to back with antiseptic wipes, separate labia, and place the specimen container in the urine stream.
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Unruptured Ectopic Pregnancy (8 weeks): Expect the provider to prescribe methotrexate, a medication to treat ectopic pregnancy.
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Newborn Safety: Elevate baby's head when sleeping, use a cushion, and set hot water heater at 130 Fahrenheit.
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Epidural Anesthesia Adverse Effects: Monitor for symptoms like tachypnea (rapid breathing), hypertension (high blood pressure),and tachycardia (rapid heartbeat).
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Newborn Assessment Priority: Assess a newborn with blue hands and feet and a temperature of 36.6°C (97.9°F) as a priority.
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Contraception Options: Provide unbiased information on various contraceptive methods to the client, including their socioeconomic status and dietary history.
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Expected Physiological Changes in Pregnancy: Dark lines on abdomen, facial discoloration, or finger/face swelling are common and expected physiological changes, not infections.
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Breastfeeding Concerns: Ensure baby's nipple is in mouth for breastfeeding, and nurse should lay baby at level of her breast during feedings.
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Preterm Labor Treatment (Terbutaline): Report tremors, dizziness, and nausea.
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Newborn Blood Glucose Test: Apply antiseptic solution to the puncture site after the procedure.
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Postpartum Discomfort: Place the client in a side-lying position or apply a cool compress to the abdomen.
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Cervical Cerclage Client Education: No exercise for 24 hours, no urinary frequency should be reported to the provider.
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**Postpartum Client Findings:**Report a urine output of 3000 mL, as it's abnormal.
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Newborn Jaundice (Yellow Exudate): Report a newborn who is 24-hr post-circumcision and has a discharge to the provider.
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Gestational Diabetes and TENS: TENS intensity should be manually increased during a contraction, but it's not contraindicated for clients with gestational diabetes.
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Maternal Serum Alpha-fetoprotein (MSAFP): Low levels of MSAFP are associated with conditions like Down syndrome or intrauterine growth restriction.
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Fetal Heart Tones: Fetal heart tones should be heard between the umbilicus and the crest on the left iliac crest and below the liver, not in the suprapubic or umbilical area.
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Postpartum Client (Puerperal Infection): Signs such as upper abdominal pain, hypothermia, or foul-smelling lochia raise concern for puerperal infection.
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Fetal Monitoring: Evaluate recurrent variable decelerations of fetal heart rate, or any uterine contractions occurring every 6 minutes or lasting 30 to 45 seconds, as these may signify a fetal risk.
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Newborn Assessment and Findings: Assess for things like excessive lanugo, hypotonia , and assess the color of the skin, which should be dry and without vernix. Also assess for dry, cracked skin and long, hard nails..
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Newborn Screening: Use a lancet to puncture the inner aspect of the newborn's heel. Apply antiseptic to the puncture site after collecting the specimen. Do not warm the newborn's heel.
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Prenatal Medications: Provide unbiased information on contraception options. Clients should expect this medication to produce a semi-fluid stool within 6 to 12 hours after starting the medication.
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Newborn Medication Administration: Phytonadione should be administered with a 25-gauge needle, and not into the deltoid muscle.
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Postpartum Assessment: Report four saturated perineal pads in 1 hour along with other factors to the provider.
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Vitamin Intake: Recommend foods high in Calcium to the clients with low calcium levels.
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Nonstress Test Instructions: The client should press a button when the baby moves, and the nurse will not give medications during testing.
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Jaundice Concerns: Report elevated bilirubin levels.
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Assessment of Newborn Abstinence Syndrome: Document and report decreased muscle tone, exaggerated Moro reflex, console easily, and weak cry.
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Newborn Abduction Prevention Education: Ensure all clients and families understand appropriate steps to ensuring babies only leave with authorized personnel, ensuring the identification of all personnel and proper identification badge/identification for those individuals and ensuring the baby has some type of identification band on at all times while in the facility.
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Newborn Laboratory Findings: Report Hgb of 9.5 g/dL.
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Prenatal Care for Pregnant Clients: A urine specific gravity of 1.030 and a hematocrit (Hct) of 38% should be reported when a client is at 10 weeks of gestation (early pregnancy). When a non-pregnant client has this Hct, it's considered normal.
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Delivery-related signs: Review positive Homans’ sign, full, firm breasts, and a firm fundus at midline in relation to the postpartum recovery.
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Postpartum Hemorrhage: Monitor and report excessive lochia (lochia serosa, rubra, or alba are different types) and or perineal pads. Also monitor for cramping(afterpains) and uterine atony. (when the uterine muscles do not contract properly after delivery, usually in the postpartum period.)
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Safety Precautions: Discuss proper techniques and methods for a safe driving experience during early pregnancy, including the use of seatbelts and airbags and positioning car seats.
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Description
Test your knowledge on nursing practices related to midstream urine specimen collection, medication for ectopic pregnancy, and newborn safety. This quiz covers essential nursing interventions and patient education for expectant mothers. Assess your understanding of nursing priorities and physiological changes during pregnancy.
