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OB ATI FOCUSED REVIEW QUESTIONS AND CORRECT ANSWERS!!
A nurse is admitting client who is in labor and has HIV. Which of the following intervention should the nurse identify as contraindicated for this client? (Select all that apply.)
a. Episiotomy b. Oxytocin infusion c. Forceps d. Cesarean birth e. Internal fetal monitoring f. Vacuum extractor - ANSWER A. Episiotomy C. forceps E. internal fetal monitoring F. Vacuum extractor
An episiotomy should be avoided for a client who is HIV + due to the risk of maternal blood exposure.
The use of forceps during delivery should be avoided due to the risk of fetal bleeding.
Internal fetal monitoring should be avoided due to the risk of fetal bleeding.
The use of vacuum extractor should be avoided due to the risk of exposing the fetus to maternal blood
A nurse in an antepartum clinic is assessing a client who has a TORCH infection. Which of the following findings should the nurse expect? (Select all that apply.)
a. Joint pain b. Malaise c. Rash d. Urinary frequency e. Tender lymph nodes - ANSWER A. Joint pain B. Malaise C. Rash E. Tender lymph nodes
A nurse is caring for a client who has gonorrhea. Which of the following medications should the nurse anticipate the provider will prescribe? a. Ceftriaxone b. Fluconazole c. Metronidazole d. Zidovudine - ANSWER A. Ceftriaxone
Ceftriaxone IM or doxycycline orally for 7 days is prescribed for the treatment of gonorrhea.
A nurse is caring for a client who is in labor. The nurse should identify that which of the following infections can be treated during labor or immediately following birth? (Select all that apply.)
a. Gonorrhea b. Chlamydia c. HIV
A. Scant, nonodorous white vaginal discharge B. Uterine cramping during breastfeeding C. Sore nipple with cracks and fissures D. Decreased response with sexual activity - ANSWER C. Sore nipple with cracks and fissures
A nurse is providing discharge teaching for a non-lactating client. Which of the following instructions should the nurse include in the teaching?
A. "Wear a supportive bra continuously for the first 72 hours." B. "Pump your breast every 4 hours to relieve discomfort." C. "Use breast shells throughout the day to decrease milk supply." D. "Apply warm compresses until milk suppression occurs." - ANSWER A. "Wear a supportive bra continuously for the first 72 hours."
A nurse is providing discharge instructions to a postpartum client following a cesarean birth. The client reports leaking urine every time she sneezes or coughs. Which of the following interventions should the nurse suggest?
A. Sit-ups B. Pelvic tilt exercises C. Kegel exercises D. Abdominal crunches - ANSWER C. Kegel exercises
A nurse is providing care to four clients on the postpartum unit. Which of the following clients is at greatest risk for developing a postpartum infection?
A. A client who has an episiotomy that is erythematous and has extended into a third-degree laceration B. A client who does not wash her hands between perineal care and breastfeeding
C. A client who is not breastfeeding and is using measures to suppress lactation D. A client who has a cesarean incision that is well-approximated with no drainage - ANSWER B. A client who does not wash her hands between perineal care and breastfeeding
A nurse in a clinic is teaching a client about a new prescription for medroxyprogesterone. Which of the following information should the nurse include in the teaching? (SATA)
a. "weight fluctuations can occur" b. "You are protected against STIs" c. "You should increase intake of calcium" d. "You should avoid taking antibiotics" e. "irregular vaginal spotting can occur" - ANSWER a. "weight fluctuations can occur" c. "You should increase intake of calcium" e. "irregular vaginal spotting can occur"
A nurse is teaching a client about potential adverse effects of implantable progestins. Which of the following adverse effects should the nurse include? (SATA)
a. Tinnitus b. Irregular vaginal bleeding c. Weight gain d. Nausea e. Gingival hyperplasia - ANSWER b. irregular vaginal bleeding c. weight gain d. nausea
A nurse in an obstetrical clinic is teaching a client about using IUD for contraception.
C. Oral contraceptives can worsen a case of acne. D. A contraceptive patch is replaced once a month. - ANSWER A. A water-soluble lubricant should be used with condoms
A nurse is reviewing car seat safety with the parents of a newborn. Which of the following instructions should the nurse include in the teaching regarding car seat position?
A. Front seat, rear-facing B. Front seat, forward-facing C. Back seat, rear-facing D. Back seat, forward-facing - ANSWER C. Back seat, rear-facing
Until 2 years of age.
A nurse is caring for a newborn immediately following a circumcision using a Gomco procedure. Which of the following actions should the nurse implement?
A. Apply Gelfoam powder to the site. B. Place the newborn in the prone position. C. Apply petroleum gauze to the site. D. Avoid changing the diaper until the first voiding. - ANSWER c. Apply petroleum gauze to the site.
for 24 hours to prevent the skin edges from sticking to the diaper
A nurse is providing discharge teaching to the parents of a newborn regarding circumcision care. Which of the following statements made by a parent indicates an understanding of the teaching?
A. "His circumcision will heal within a couple of days." B. "I should remove the yellow mucus that will form," C."I will clean his penis with each diaper change." D."I will give him a tub bath within a couple of days." - ANSWER C."I will clean his penis with each diaper change."
should be cleaned with warm water with each diaper change.
A nurse is reviewing contraindications for circumcision with a newly hired nurse. Which of the following conditions are contraindications? (Select all that apply.)
A. Hypospadias B. Hydrocele C. Family history of hemophilia D. Hyperbilirubinemia E. Epispadias - ANSWER a. hypospadias c. family history of hemophilia e. epispadias
Hypospadias involves a defect in the location of the urethral opening and is a contraindication to circumcision A family history of hemophilia is a contraindication for circumcision Epispadias involves a defect in the location of the urethral opening and is a contraindication to circumcision
A nurse is reviewing care of the umbilical cord with the parent of a newborn. Which of the following instructions should the nurse include in the teaching?
A. Cover the cord with a small gauze square.
a distention of bladder can cause uterine atony and lateral displacement from the midline.
A nurse is completing postpartum discharge teaching to a client who had no immunity to varicella and was given varicella vaccine. Which of the following statements by the client indicates understanding of the teaching?
A. "I will need to use contraception for 3 months before considering pregnancy." B. "I need a second vaccination at my postpartum visit." C. "I was given the vaccine because my baby is O-positive." D. "I will be tested in 3 months to see if I have developed immunity." - ANSWER B. "I need a second vaccination at my postpartum visit."
A second varicella immunization is needed at 4 to 8 weeks following delivery by clients who had no history of immunity.
During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On assessment, a nurse finds the uterus to be firm, midline, andat the level of the umbilicus. Which of the following findings should the nurse interpret this data as being?
A. Evidence of a possible vaginal hematoma B. An indication of a cervical or perineal laceration C. A normal postural discharge of lochia D. Abnormally excessive lochia rubra flow - ANSWER C. A normal postural discharge of lochia
Lochia typically trickles from the vaginal opening but flows more steadily during uterine contractions. Massaging the uterus or ambulation can result in a gush of lochia with the expression of clots and dark blood that has been pooled in the vagina, but it should soon decrease back to a trickle of bright red lochia in the early puerperium.
A nurse is performing a fundal assessment for a client who is 2 days postpartum and observes the perineal pad for lochia. She notes the pad to be saturated approximately 12 cm with lochia that is bright red and contains small clots. Which of the following findings should the nurse document?
A. Moderate lochia rubra B. Excessive blood loss C. Light lochia rubra D. Scant lochia serosa - ANSWER A. Moderate lochia rubra
The client has moderate lochia rubra containing small clots, which is an expected finding for the second day postpartum.
A nurse is teaching a group of clients who are pregnant about measure to relieve backache during pregnancy. Which of the following measures should the nurse include? (Select all that apply)
a. Avoid any lifting b. Perform kegel exercises twice a day c. Perform the pelvic rock exercise every day d. Use proper body mechanics e. Avoid constrictive clothing - ANSWER c. Perform the pelvic rock exercise every day d. Use proper body mechanics
The pelvic rock or tilt exercise stretches the muscles of the lower back and helps relieve lower-back pain Use of proper body mechanics prevents back injury due to the incorrect use of muscles when lifting.
A nurse is caring for a client who is pregnant and reviewing manifestations of complications the client should promptly report to the provider. Which of the following
c. epistaxis.
A client who is at 8 wks of gestation tells the nurse "I am not sure I am happy about being pregnant." Which of the following responses should the nurse make?
a. "I will inform the provider that you are having these feelings." b. "It is normal to have these feelings during the first few months of pregnancy." c. "You should be happy that you are going to bring new life into the world." d. "I am going to make an appointment with the counselor for you to discuss these thoughts." - ANSWER b. "It is normal to have these feelings during the first few months of pregnancy."
A nurse is caring for a client who is 42 weeks gestation and is having an ultrasound. For which of the following conditions should the nurse plan for an amnioinfusion? (Select all that apply)
a. oligohydramnios b. Hydramnios c. Fetal cord compression d. Hydration e. Fetal immaturity - ANSWER a. Oligohydramnios c. Fetal cord compression
Oligohydramnios is an indication for an amnioinfusion because inadequate amniotic fluid can contribute to intrauterine growth restriction of the fetus, restrict fetal movement, and cause fetal distress during labor. Oligohydramnios results in fetal cord compression, which decreases fetal oxygenation. Amnioinfusion prevents cord compression.
A nurse is caring for a client who has been in labor for 12 hours with intact membranes. The nurse performs a vaginal examination to ensure which of the following prior to the
performance of the amniotomy?
a. fetal engagement b. fetal lie c. fatal attitude d. fatal posistion - ANSWER a. Fetal engagement
Prior to the performance of an amniotomy, it is imperative that the fetus is engaged at 0 station and at the level of the maternal ischial spines to prevent prolapse of the umbilical cord.
A nurse is caring for a client who had no prenatal care, is Rh-negative, and will undergo an external version at 38 weeks of gestation. Which of the following medications should the nurse plan to administer prior to the version?
a. Prostaglandin gel b. Magnesium sulfate c. Rho(D) immune globulin d. Oxytocin - ANSWER Rho(D) immune globulin
Rho(D) is administered to an Rh-negative client at 28 weeks of gestation. Because this client had no prenatal care, it should be given prior to the version to prevent isoimmunization
A nurse is caring for a client who is receiving oxytocin for induction of labor and has an intrauterine pressure catheter placed to monitor uterine contractions. For which of the following contraction patterns should the nurse discontinue the infusion of oxytocin?
a. frequency of every 2 min b. duration of 90 to 120 seconds
A nurse is caring for a client who has stage IV lung cancer and is 3 days postoperative following a wedge resection. The client states, "I told myself that I would go through with the surgery and quit smoking, if I could just live long enough to attend my child's wedding." Based on the Kubler-Ross model, which stage of grief is the client experiencing?
a. Anger. b. Denial c. Bargaining d. Acceptance - ANSWER c. Bargaining
The client is bargaining by attempting to negotiate more time to live to see the child get married.
A nurse is consoling the partner of a client who just died after a long battle with liver cancer. The grieving partner states, "I hate them for leaving me." which of the following statements should the nurse make to facilitate mourning for the partner? (SATA)
a. Would you like me to contact chaplain to come and speak with you? b. You will feel better soon. You have been expecting this for a while now. c. Let's talk about your children and how they are going to react d. You know, it is quite normal to feel anger toward your loved one at this time. e. Tell me more about how you are feeling. - ANSWER a. Would you like me to contact chaplain to come and speak with you?
Asking whether the grieving individual desires spiritual support at this time is an accepted nursing intervention to facilitate mourning.
A nurse is caring for a client who has a terminal illness. Death is expected within 24hr. The client's family is at the bedside and asks the nurse what to expect at this time. Which of following findings should the nurse include?
a. regular breathing pattern b. warm extremities c. increased urine output d. decreased muscle tone - ANSWER d. decreased muscle tone.
Muscle relaxation is an expected finding when a client is approaching death.
A nurse is about to perform postmortem care of a client. The family wishes to view the body. Which of the following actions should the nurse take? (SATA)
a. remove the dentures from the body b. make sure the body is lying completely flat c. apply fresh linens and place a clean gown on the body d. remove all equipment from the bedside e. dim the light in the room. - ANSWER c. apply fresh linens and place a clean gown on the body d. remove all equipment from the bedside e. dim the light in the room
A nurse is caring for a client who is at 40 weeks of gestation and experiencing contractions every 3-5min and becoming stronger. A vaginal exam reveals that the client's cervix is 3cm dilated, 80% effaced, and -1 station. The client asks for pain medication. Which of the following actions should the nurse take?
a. encourage use of patterned breathing techniques b. insert an indwelling urinary catheter c. administer opioid analgesic medication d. suggest application of cold.
administered?
a. pudendal b. epidural c. spinal d. paracervical - ANSWER a. pudendal
A pudendal block is a transvaginal injection of local anesthetic that anesthetizes the perineal area for the episiotomy and repair, and expulsion of the fetus.
A nurse is caring for a client who is using patterned breathing during labor. The client reports numbness and tingling of the fingers. Which of the following actions should the nurse take?
a. administer oxygen via nasal cannula at 2L/min b. apply a warm blanket c. assist the client to a side-lying position d. place an oxygen mask over the client's nose and mouth. - ANSWER d. place an oxygen mask over the client's nose and mouth
The client is experiencing hyperventilation caused by low blood levels of PCO2. Placing an oxygen mask over the client's nose and mouth or having the client breathing into a paper bag will reduce the intake of oxygen, allowing the PCO2 to rise and alleviate the numbness and tingling.
A nurse is caring for a client who reports manifestations of preterm labor. Which of the following findings are risk factors of this condition?
a. urinary tract infection b. multifetal pregnancy
c. hydramnios d. diabetes mellitus e. uterine abnormalities - ANSWER All of the above.
a. urinary tract infection b. multifetal pregnancy c. hydramnios d. diabetes mellitus e. uterine abnormalities
A nurse is providing care for a client who is in preterm labor at 32 weeks of gestation. Which of the following medications should the nurse anticipate the provider will prescribe to hasten fetal lung maturity?
a. Calcium gluconate b. indomethacin c. nifedipine d. betamethasone - ANSWER d. betamethasone
A nurse is caring for a client who is receiving nifedipine for prevention of preterm labor. The nurse should monitor the client for which of the following manifestations?
a. blood tinged sputum b. dizziness c. pallor d. somnolence - ANSWER b. dizziness
dizziness and lightheadedness are associated with orthostatic hypotension which occurs when taking nifedipine
