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1. Postpartum patient's lab data 12 hours after delivery includes maternal blood type and Rh factor is
A+, rubella status 1:8, hematocrit 30% and WBC 12,000. What is the nurse's expected response to
this information?
a. Anticipate administration of antibiotics for treatment of an infection
b. Contact physician for new orders to address effects of postpartum hemorrhage
c. Administer Rhogam as ordered at time of discharge
d. Administer Rubella vaccination prior to discharge from hospital - CORRECT ANSWERS D
2. A 32-year-old primigravida who is 8 weeks pregnant presents to the emergency room with a chief
complaint of "unilateral stabbing pain in her lower abdomen with dark red bleeding." Based on these
assessment findings the nurse would suspect which pregnancy-related complications?
a. Placenta Previa
b. Ectopic pregnancy
c. Preterm labor
d. Cervical Insufficiency - CORRECT ANSWERS B
3. A patient is being admitted to the maternity unit because she is in early labor. The nurse would
initially
a. Assess maternal vital signs and fetal heartrate
b. Measure fundal height to determine fetal size
c. Perform a sterile vaginal exam to determine cervical dilation and effacement - CORRECT ANSWERS
A
5. While obtaining the obstetric history the pregnant patient reports she is 36 weeks with her fourth
child. She states she had one elective abortion at 5 weeks, a daughter who was born at 40 weeks
gestation, and a son who was born at 37 weeks gestation. What is this patients GTPAL total?
a. 4-1-1-1-2
b. 3-1-1-1-2
c. 2-1-0-1-1
,d. 4-2-1-0-2 - CORRECT ANSWERS A
9. The post-partum patient delivered five hours ago and has cool, clammy skin, and she is restless.
The patient is excessively thirsty. The nurse's first action is to
a. Obtain maternal vital signs
b. Notify the healthcare provider
c. Massage the fundus of uterus
d. Calculate total urinary output since delivery - CORRECT ANSWERS C
10. The patient arrives to the emergency department bleeding heavily. She reports being 32-weeks
pregnant, heavy smoker, her vital signs are stable, fetal heart baseline is within the normal range,
and she denies pain. Other assessment findings include the abdomen is soft and non-tender, fundal
height appropriate for gestational age and there are no contractions. Upon inspection of the peri-pad
you note it is moderately saturated with bright-red bleeding. This patient is experiencing
a. Placental abruption
b. Placenta previa
c. Threatened abortion
d. Inevitable abortion - CORRECT ANSWERS B
11. The laboring patient is having strong contractions every one to two minutes that are lasting 60-70
seconds. She notifies the nurse she is having intense sensations of pressure on the perineal area. The
nurse's priority action is to
a. Perform sterile vaginal exam for cervical dilation, effacement, and station
b. Notify the healthcare provider that the patient will be delivering soon
c. Offer the patient a bed pan
d. Reposition the patient - CORRECT ANSWERS A
6. The maternal serum alfa-fetal protein (MSAFP) sample collected from the patient at 16 weeks
gestation indicated that this pregnancy is at high-risk for having Down Syndrome. The patient is
informed that she will require further diagnostic testing. For these findings, the MSAFP level was
a. Decreased
b. Increased - CORRECT ANSWERS A
, 8. The pregnant patient's lab values obtained on the first prenatal visit has indicated that the rubella
titer is negative. The nurse should
a. Offer the patient the rubella vaccine at the next prenatal visit
b. Inform the patient of the dangers of not receiving the rubella vaccine prior to delivery
c. Prepare the patient to receive the vaccine within 72 hours from the birth of her child
d. Explain to the patient that a negative titer indicated that she is immune to rubella at this time -
CORRECT ANSWERS C
12. A 34-week gestation patient phones the health care providers office with concerns about feeling
light headed. She states she is dizzy while lying down and states that she "feels like I could pass out."
She also reports she has awakened in the middle of the night feeling this way. The nurse should
a. Instruct the patient to see the HCP right away to have her blood pressure checked
b. Discuss supine hypertension with the patient and encourage her to avoid lying flat on her back
c. Reassure the patient that this is a normal finding for the pregnant patient
d. Inform the patient to increase her fluid intake to two liters a day - CORRECT ANSWERS B
14. A client with hyperemesis gravidarum has been admitted to the facility. The nurse would expect
that the initial treatment for this client would involve:
a. Corticosteroids to advance fetal ling maturity
b. Total parenteral nutrition to correct nutritional deficits
c. IV therapy to correct fluid and electrolyte imbalances
d. Administration of labetalol - CORRECT ANSWERS C
15. A client with mild preeclampsia is admitted to the unit. She is complaining of a pounding
headache, visual changes and epigastric pain. These findings most appropriately indicate:
a. Anxiety due to the unknown
b. Worsening condition and impending seizure
c. Therapeutic effects of magnesium sulfate therapy
d. Gallbladder disease - CORRECT ANSWERS B