OB CMS Past Paper PDF

OB CMS 1. A nurse is reinforcing teaching with a client who has a pre-pregnancy BMI of 21. How much weight should the nurse recommend the client gain during the course of the pregnancy? A. 16.4 to 20.5 kg (36 to 45 lb) B. 5 to 7.7 kg (11 to 17 lb) C. 11.4 to...

OB CMS 1. A nurse is reinforcing teaching with a client who has a pre-pregnancy BMI of 21. How much weight should the nurse recommend the client gain during the course of the pregnancy? A. 16.4 to 20.5 kg (36 to 45 lb) B. 5 to 7.7 kg (11 to 17 lb) C. 11.4 to 15.9 kg (25 to 35 lb) D. 8.2 to 10.9 kg (18 to 24 lb) 2. A nurse is collecting data from a client who has just had a positive pregnancy test. The first day of her last menstrual period was February 16. Using Naegele's rule, what should the nurse tell the client the estimated date of birth is? (Use the MMDD format.) Nov 23 →To use Naegele's rule, add 7 days to the first day of the last menstrual period and subtract 3 months. 3. A nurse is reinforcing teaching with a client who is postpartum and receiving warfarin for deep- vein thrombosis. Which of the following instructions should the nurse include? A. "Use a disposable razor for shaving while taking this medication." B. "You should not take oral contraceptives while taking this medication." C. "Take 650 milligrams of aspirin for leg discomfort." D. "You will be able to stop taking this medication in 2 weeks." 4. A nurse is collecting data from a client who is at 35 weeks of gestation. The nurse should identify that which of the following findings indicates abruptio placentae? A. Uterine atony B. Polyhydramnios C. Painless vaginal bleeding D. Board-like abdomen 5. 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. Apply elastic stockings before the client gets out of bed. B. Apply warm, moist packs to the client's lower legs. C. Have the client ambulate as often as possible. D. Administer NSAIDs every 4 to 6 hours. 6. 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. Check the newborn's skin for ecchymosis.  B. Assist the mother to breastfeed the newborn after birth. C. Obtain a stool sample of meconium D. Check the newborn's blood glucose level. E. Assist with administering a blood transfusion to the newborn 7.. A nurse is reinforcing teaching with a client about obtaining a clean catch urine specimen. Identify the sequence of steps the nurse should instruct the client to follow. (Move the steps byplacing them in the order of performance. Use all the steps.) D: Separate the labia with the nondominant hand. A: Cleanse the urinary meatus from front to back with antiseptic towelettes. B: Place the specimen container midstream in the flow of urine. C: Secure the cap tightly on the specimen container. 8. A nurse is assisting in the care of a client who is experiencing an unruptured ectopic pregnancy that is at 8 weeks of gestation. Which of the following medications should the nurse expect the provider to prescribe? A. Terbutaline B. Magnesium sulfate C. Methotrexate D. Calcium gluconate 9.A nurse is assisting with a prenatal class discussion about newborn safety. Which of the following statements by a participant indicates an understanding of the teaching? A. "I should elevate my baby's head on a cushion when she is sleeping." B. "I should use baby powder with each diaper change." C. "I should set my hot water heater to 130 degrees Fahrenheit." D. "I should replace the batteries in my smoke detector twice per year." 10. A nurse is collecting data from a client who is receiving epidural anesthesia. Which of the following findings indicates an adverse effect of this method of pain management? A. Tachypnea B. Hypertension C. Tachycardia D. Fever 11.A nurse is receiving change-of-shift report for four newborns. Which of the following newborns should the nurse attend to first? A. A newborn who has blue hands and feet with an axillary temperature of 36.6°C (97.9°F) B. A newborn who has lost 12% of her birth weight  C. A newborn who is 24 hr post-circumcision and has yellow exudate D. A newborn who has a blood glucose level of 63 mg/dL 12.A nurse is caring for a client who inquires about available methods of contraception. Which of the following actions should the nurse take? A. Perform unbiased teaching. B. Select the best method of contraception for the client. C. Assess the client's socioeconomic status. D. Collect a dietary history. 13. A nurse in a prenatal clinic is reinforcing teaching with a client about expected physiological changes during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? A. "I may have an infection if I develop a dark line in the middle of my abdomen." B. "I may develop discoloration on my cheeks from hormonal changes." C. "I should expect my fingers and face to be swollen." D. "I should expect to have burning when I urinate during the third trimester." 14.A nurse is reinforcing teaching about breastfeeding with a client who is postpartum. Which of the following statements by the client indicates an understanding of the teaching? A. "I will make sure that just the nipple is in my baby's mouth." B. "I will lay my baby on a pillow at the level of my breast." C. "I will nurse my baby for 5 to 10 minutes on each breast." D. "I will apply vitamin E oil to my nipples after each feeding." 15. A nurse is collecting data from a client who is receiving terbutaline to treat preterm labor. Which of the following findings should the nurse report to the provider? Which of the following findings should the nurse report to the provider? A. Nausea B. Tremors C. Dizziness D. Crackles 16. A nurse is caring for a newborn who requires a blood glucose test. Which of the following actions should the nurse take? A. Apply a warm pack to the puncture site prior to the procedure. B. Apply a mummy restraint to the newborn for the procedure. C. Apply antiseptic solution to the puncture site after the procedure. D. Elevate the extremity prior to the procedure. 17.A nurse is caring for a client who reports discomfort due to afterpains following breastfeeding. Which of the following actions should the nurse take? A. Place the client in a side-lying position. B. Apply a cool compress to the client's abdomen. C. Administer ibuprofen to the client. D. Encourage the client to perform Kegel exercises. 18. A nurse is reinforcing teaching with a client who is at 12 weeks of gestation and is scheduled for placement of a cervical cerclage. Which of the following statements by the client indicates understanding of the teaching? A. "I plan to resume my exercise program in 24 hours." B. "I anticipate the cerclage will be removed in 10 weeks." C. "I will call the provider if I experience urinary frequency." D. "I will avoid sexual activity." 19. A nurse is caring for a full-term newborn who is 1 day old. Which of the following laboratory findings should the nurse report to the provider? A. Hgb 9.5 g/dL B. Platelets 225,000/mm C. Glucose 60 mg/dL D. WBC 10,000/mm 20. A nurse is reinforcing teaching about safety precautions to take when driving a car with a client who is in the first trimester of pregnancy. Which of the following instructions should the nurse include in the teaching? A. Place the shoulder harness across the gravid uterus. B. Move the seat as far away as possible from the steering wheel. C. Wear the lap belt high across the abdomen. D. Disable the vehicle's driver-side airbags 21. A nurse is collecting data from a client who is 20 hr postpartum following a vaginal delivery. Which of the following findings should the nurse expect? A. Positive Homans' sign B. Full, firm breasts C. Firm fundus at midline D. Lochia serosa 22. A nurse in a provider's office is collecting data from a client who is requesting a prescription for a transdermal contraceptive patch. The nurse should recognize that which of the following client findings is a contraindication for this method of contraception?  A. History of spontaneous abortion B. Peptic ulcer disease C. BP 120/70 mm Hg D. Weight 98 kg (216 lb) 23. A nurse is discussing a client's maternal serum alpha-fetoprotein screening results with a newly licensed nurse. Which of the following conditions is associated with low levels? A. Multiple gestation B. Down syndrome C. Intrauterine growth restriction D. Neural tube defect 24. A nurse is auscultating fetal heart tones with a Doppler device for a client who is at 12 weeks of gestation. Where should the nurse expect to auscultate the fetal heart tones? A. Suprapubic area B. Umbilical area C. Above the left iliac crest D. Below the liver border on the right abdomen 25. A nurse is collecting data from a client who is 2 days postoperative following a cesarean birth. Which of the following findings should the nurse report to the provider? A. Left calf tenderness B. Moderate lochia rubra C. Urine output of 3,000 mL D. Breast engorgement 26. A nurse in an antepartum unit is assisting with the care of a client who has preeclampsia and is receiving IV magnesium sulfate therapy. For which of the following adverse effects should the nurse monitor and report to the provider? A. Hyporeflexia B. Tachypnea C. Polyuria D. Agitation 27. A nurse is reinforcing teaching with a client about the use of a transcutaneous electrical nerve stimulation (TENS) device for back pain during labor. Which of the following information should the nurse include? A. TENS eliminates pain during a contraction. B. TENS is contraindicated for clients who have gestational diabetes. C. TENS intensity is manually increased during a contraction. D. TENS is most useful during the third stage of labor. 28. A nurse is reinforcing teaching about the prevention of newborn abduction with a client who gave birth 8 hr ago. Which of the following statements by the client indicates an understanding of the teaching? A. "My baby doesn't need to wear the security tag when staying in the room with me." B. "I can give the nurse a list of authorized family members who can pick up my baby from the nursery." C. "The staff member who comes to take my baby's picture will be wearing a photo identification badge." D. "I will ensure that my baby has one identification band on during our hospital stay." 29. A nurse is administering a miconazole vaginal suppository to a client who has vaginal candidiasis. Which of the following actions should the nurse take? A. Apply petroleum jelly to the suppository. B. Insert the suppository along the posterior vaginal wall. C. Insert the suppository 5 cm (2 in). D. Assist the client into a prone position. 30. Which of the following symptoms should the nurse recognize as a manifestation of neonatal abstinence syndrome? A. Decreased muscle tone B. Exaggerated Moro reflex C. Consoles easily D. Weak cry 31. A nurse is assisting with the care of a client who is in the latent phase of labor and just had an amniotomy. Which of the following findings indicates that the fetus is at risk? A. Recurrent variable deceleration of the FHR B. Uterine contractions every 6 min C. Uterine contractions lasting 30 to 45 seconds D. Moderate variability of the FHR 32. A nurse in a prenatal clinic is reinforcing teaching with a client who is at 20 weeks of gestation and has a low calcium level. Which of the following foods should the nurse recommend the client increase in her diet? A. Yogurt B. Long-grain rice C. Avocados D. Peanut butter 33. A nurse is reviewing the laboratory data for a client who is at her first prenatal visit. The client is at 10 weeks of gestation. Which of the following manifestations should the nurse report to the provider? A. 2+ ketonuria B. 1.030 urine specific gravity C. Hct 38% D. Fasting blood glucose 70 mg/dL 34. A nurse in a provider's office is reinforcing teaching with a client who is pregnant and is scheduled for a nonstress test. Which of the following statements should the nurse make? A. "You will not be able to eat or drink anything for 8 hours prior to the test." B. "You will press the provided button when you feel the baby moving during the test." C. "You will receive medication through an IV line to stimulate contractions." D. "You will be required to lie flat on your back for the duration of the test." 35. A nurse on a postpartum unit is caring for a client who is breastfeeding and experiencing breast engorgement. Which of the following interventions should the nurse plan to implement to promote comfort for this client? A. Provide the client with ice packs for her breasts. B. Advise the client to avoid using a breast pump. C. Have the client apply purified lanolin to her breasts. D. Encourage the client to wear a loose-fitting bra. 36. A nurse is preparing to collect a specimen for newborn screening. Which of the following actions should the nurse take? A. Apply an antiseptic to the newborn's heel after collecting the specimen. B. Warm the newborn's heel for 5 to 10 min before the puncture. C. Use a lancet to puncture the inner aspect of the newborn's heel. D. Leave the newborn's heel open to the air after the puncture. 37. A nurse on a postpartum unit is assisting with the care of four clients. The nurse should identify that which of the following clients should receive Rh (D. immune globulin? A. An Rh-negative client who has an Rh-negative newborn B. An Rh-negative client who has an Rh-positive newborn C. An Rh-positive client who has an Rh-positive newborn D. An Rh-positive client who has an Rh-negative newborn 38. A nurse is reinforcing teaching at a prenatal visit about the importance of adequate folic acid intake with a client who is at 12 weeks of gestation. Which of the following client statements indicates an understanding of the teaching?  A. "It will reduce my baby's risk of having a spinal cord defect." B. "It will make my baby's bones strong." C. "It will prevent my baby from bleeding." D. "It will strengthen my baby's immune system." 39. A nurse is collecting data from a client who is 4 hr postpartum. For which of the following findings should the nurse administer carboprost IM? A. Increasing systolic blood pressure B. Breast engorgement C. Pooling of blood beneath the buttocks D. Bladder distention 40. A nurse is caring for a client who is at 10 weeks of gestation and reports experiencing frequent nausea. Which of the following instructions should the nurse give the client to help control nausea? A. Reduce odors with an exhaust fan when cooking. B. Eat foods at warm temperatures. C. Increase fluids early in the day when nauseated. D. Brush teeth immediately after meals. E. Brushing teeth after meals is important for oral hygiene but may not have a significant impact on reducing nausea. 41. A nurse is preparing to administer the hepatitis B vaccine to a newborn. Which of the following actions should the nurse take? A. Choose a ⅝-inch needle to administer the vaccine. B. Administer the vaccine into the dorsal gluteal muscle. C. Use a 20-gauge needle to administer the vaccine. D. Administer 0.5 mL of the vaccine. 42. A nurse is reinforcing teaching with a client who is at 20 weeks of gestation and has a new prescription for docusate sodium to treat constipation. Which of the following statements should the nurse make? A. "Expect this medication to produce a semi-fluid stool within 6 to 12 hours." B. "Decrease your intake of high-fiber foods while taking this medication." C. "Take this medication with a full 8-ounce glass of water." D. "Avoid eating citrus fruits while taking this medication." 43. A nurse is collecting data from a client who is postpartum and has received methylergonovine. Which of the following findings should indicate to the nurse that the medication was effective?  A. Increased uterine tone B. Blood pressure 120/74 mm Hg C. Decreased perineal edema D. Urinary output 100 mL/hr 44. A nurse is reinforcing teaching about crib safety with a group of prenatal clients. Which of the following information should the nurse include in the teaching? A. "Use a plastic cover to protect the crib mattress.” B. "Place bumper pads securely between the mattress and the rails of the crib." C. "Place your newborn on a foam-wedge cushion during naps." D. "Ensure that the mattress fits securely against the sides of the crib." 45. A nurse is collecting data from a newborn who is 1 hr old and was born at 43 weeks of gestation. Which of the following findings should the nurse expect? (Select all that apply.) A. Excessive lanugo B. Hypotonia C. Absent vernix D. Dry, cracked skin E. Long, hard nails 46. A nurse is collecting data from a client who is 2 days postpartum. Which of the following findings should alert the nurse to the possibility of a puerperal infection? A. Upper abdominal pain B. Bradycardia C. Hypothermia D. Foul-smelling lochia 47. A nurse in a prenatal clinic is collecting data from four clients. Which of the following findings is the nurse's priority to report to the provider? A. Gingivitis B. Varicose veins C. Dysuria D. Leukorrhea 48. A nurse is preparing to administer phytonadione to a newborn. Which of the following actions should the nurse take? A. Administer the medication into the deltoid muscle. B. Check the mother's Rh factor prior to administration. C. Administer the medication 12 hr after birth. D. Administer the medication with a 25 gauge needle. 49. A nurse is assisting with the care of a client who is at 34 weeks of gestation and received a dose of nifedipine 2 hr ago. For which of the following therapeutic effects should the nurse monitor? A. An increase in platelet count B. A decrease in blood pressure C. A decrease in FHR D. An increase in urinary output 50. A nurse is collecting data from a newborn who is receiving phototherapy. Which of the following findings is an indication of dehydration? A. Bulging anterior fontanel B. Decreased urine specific gravity C. Bounding pulses D. Decreased skin turgor 51. A nurse is auscultating fetal heart tones with a Doppler device for a client who is at 12 weeks of gestation. Where should the nurse expect to auscultate the fetal heart tones? A. Suprapubic area B. Umbilical area C. Above the left iliac crest D. Below the liver border on the right abdomen 52. A nurse in a clinic is discussing contraceptive methods with a client. Which of the following methods should the nurse recommend as having the lowest failure rate? A. Intrauterine device B. Oral contraceptives C. Contraceptive sponge D. Diaphragm 53. A nurse is administering a miconazole vaginal suppository to a client who has vaginal candidiasis. Which of the following actions should the nurse take? A. Apply petroleum jelly to the suppository. B. Insert the suppository along the posterior vaginal wall. C. Insert the suppository 5 cm (2 in). D. Assist the client into a prone position. 54. A nurse is caring for a client who is 4 hr postpartum. The nurse notes four saturated perineal pads in the past hour. Which of the following actions should the nurse take first?  A. Administer misoprostol. B. Increase maintenance IV fluid. C. Perform perineal hygiene. D. Perform fundal assessment and massage 55. A nurse is collecting data from a newborn who is 3 hr old. Which of the following findings should the nurse report to the provider? A. Positive Moro reflex B. Erythema toxicum C. Acrocyanosis D. Elevated bilirubin level 56. A nurse is assisting with the care of a newborn who has neonatal abstinence syndrome. Which of the following actions should the nurse take first? A. Weigh the newborn's wet diaper. B. Auscultate the newborn's bowel sounds. C. Determine the newborn's respiratory rate. D. Swaddle the newborn in blankets. 57. A nurse is reinforcing teaching with a client who tested positive for group B streptococcus B- hemolytic (GBS) during a prior pregnancy and is at 30 weeks of gestation. Which of the following statements should the nurse make? A. “This infection can cause your baby to experience hearing loss at birth." B. “If you test positive for GBS, the provider will need to perform a cesarean birth." C. "You will be tested again for GBS at about 36 weeks of gestation." D. "You will take an antibiotic during the last 2 weeks of pregnancy to avoid transferring GBS to your baby."