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Flashcards in FINAL: Test 4 Review Deck (50)
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1

When assessing several women for possible VBAC, which woman would the nurse identify as being the best candidate?

A) One who has undergone a previous myomectomy
B) One who had a previous cesarean birth via a low transverse incision
C) One who has a history of a contracted pelvis
D) One who has a vertical incision from a previous cesarean birth

One who had a previous cesarean birth via a low transverse incision

2

A postpartum client comes to the clinic for her routine 6-week visit. The nurse assesses the client and suspects that she is experiencing subinvolution based on which of the following?

moderate lochia serosa
bruising
a fever

moderate lochia serosa

3

To assist the woman in regaining control of the urinary sphincter for urinary incontinence, the nurse should teach the client to do which of the following?

Fucking kegels.

4

A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, which of the following would the nurse expect to find?

Stress incontinence with feeling of low abdominal pressure

5

A nurse is assessing a postpartum woman. Which finding would cause the nurse to be most concerned?

Sharp stabbing chest pain with shortness of breath

6

When assessing a client with suspected breast cancer, which of the following would the nurse expect to find?

Nipple retraction

7

After teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching?

A) "Holding a pillow against my incision will help me when I cough."
B) "I'm going to have to wait a few days before I can start breast-feeding."
C) "I guess the nurses will be getting me up and out of bed rather quickly."
D) "I'll probably have a tube in my bladder for about 24 hours or so."

“I'm going to have to wait a few days before I can start breast-feeding.”

8

A nurse is teaching a pregnant woman at risk for preterm labor about what to do if she experiences signs and symptoms. The nurse determines that the teaching was successful when the woman states that if she experiences any symptoms, she will do which of the following?

Sit down & drink (dehydration)

I’ll lie down with my legs raised

9

A client with polycystic ovarian syndrome (PCOS) is receiving oral contraceptives as part of her treatment plan. The nurse understands that the rationale for this therapy is to:

a. Restore menstrual regularity
b. Improve insulin uptake
c. Induce ovulation
d. Alleviate hirsutism

Restore menstrual regularity

10

A group of students are reviewing information about benign and malignant breast masses. The students demonstrate understanding when they identify which of the following as indicating a benign breast mass. (Select all the apply.)

Firm consistency
Fixed to the chest wall
Bloody d/c
Absence of dimpling

Firm consistency
Absence of dimpling

11

Assessment of a postpartum client reveals a firm uterus with bright-red bleeding and a localized bluish bulging area just under the skin at the perineum. The woman also is complaining of significant pelvic pain and is experiencing problems with voiding. The nurse suspects which of the following?

laceration
hematoma
bladder distension
uterine atony

Hematoma

The woman most likely has a hematoma based on the findings: firm uterus with bright-red bleeding; localized bluish bulging area just under the skin surface in the perineal area; severe perineal or pelvic pain; and difficulty voiding. A laceration would involve a firm uterus with a steady stream or trickle of unclotted bright-red blood in the perineum. Bladder distention would be palpable along with a soft, boggy uterus that deviates from the midline. Uterine atony would be noted by a uncontracted uterus.

12

A laboratory technician arrives to draw blood for a complete blood count (CBC. for a client who had a right-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her left antecubital space. To obtain the blood specimen, the technician places a tourniquet on the client's right arm. Which action by the nurse would be most appropriate?

Finger prick - distal to the IV

Tell the technician to obtain the blood sample from the client's left arm.

13

A woman who is 2 weeks postpartum calls the clinic and says, “My left breast hurts.” After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would assess for which of the following?

A) An inverted nipple on the affected breast
B) No breast milk in the affected breast
C) An ecchymotic area on the affected breast
D) Hardening of an area in the affected breast

Hardening of an area in the affected breast

14

The nurse is assessing a woman with abruption placentae who has just given birth. The nurse would be alert for which of the following?

Severe uterine pain
Board-like abdomen
uterine inversion
appearance of petechiae

Appearance of petechiae

A complication of abruptio placentae is disseminated intravascular coagulation (DIC), which is manifested by petechiae, ecchymoses, and other signs of impaired clotting. Severe uterine pain, a board-like abdomen, and uterine inversion are not associated with abruptio placentae.

15

Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups. Based on an interpretation of these findings, the nurse would be especially alert for which of the following?

Thrombophlebitis
Retained placental fragments
Hypertension

Thrombophlebitis

16

As part of an inservice program, a nurse is describing a transient, self-limiting mood disorder that affects mothers after childbirth. The nurse correctly identifies this as postpartum:

Blues
Depression
Psychosis
Bipolar disorder

Blues

17

A nurse is preparing an inservice education program for a group of nurses about dystocia involving problems with the passenger. Which of the following would the nurse most likely include as the most common problem?

Persistent OP position
Macrosomia
Breech
Multifetal pregnancy

Persistent occiput posterior position

18

A nurse suspects that a postpartum client is experiencing postpartum psychosis. Which of the following would most likely lead the nurse to suspect this condition?

anxiety
sadness
delirium
insomnia

Delirium

19

A woman with a history of crack cocaine abuse is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an *irregular wall contour*. The client also complains of acute abdominal pain that is continuous. Which of the following would the nurse suspect?

Shoulder dystocia
Umbilical cord prolapse
Amniotic fluid embolism
Uterine rupture

Uterine rupture

20

A 42-year-old woman is scheduled for a mammogram. Which of the following would the nurse include when teaching the woman about the procedure?

“Each breast will be firmly compressed between two plates.”

21

A nurse is conducting a class on breast cancer prevention. Which statement would the nurse most likely include in the discussion?

Feeling a lump means it’s been there a while

Answer is not “Most often a lump is felt before it is seen.”

22

A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse would be alert for which of the following in the newborn?

A) Asphyxia
B) Clavicular fracture
C) Caput succedaneum
D) Central nervous system injury

Caput succedaneum

23

The nurse would be least likely to find which of the following in a client with uterine fibroids?

Abdominal pain

Answer is not “Regularly shaped, shrunken uterus”

24

A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which of the following findings would require immediate intervention?

A) Fetal heart rate of 150 beats/minute
B) Contractions every 2 minutes, lasting 45 seconds
C) Uterine resting tone of 14 mm Hg
D) Urine output of 20 mL/hour

Urine output of 20 mL/hour. Normal = 30 ml/hr

25

A group of students are reviewing the causes of postpartum hemorrhage. The students demonstrate understanding of the information when they identify which of the following as the most common cause?

Lacerations of the birth canal
Uterine Atony
Uterine inversion
Labor augmentation

Uterine Atony

26

A woman with breast cancer is undergoing chemotherapy. Which of the following side effects would the nurse interpret as being most serious?

a. Myelosuppression
b. Hair loss
c. Fatigue
d. Vomiting

Myelosuppression

27

A home health care nurse is assessing a postpartum woman who was discharged 2 days ago. The woman tells the nurse that she has a low-grade fever and feels “lousy.” Which of the following findings would lead the nurse to suspect metritis? (Select all that apply.)

Urgency & flank pain
Lower abdominal tenderness
Anorexia
Breast tenderness
Foul-smelling lochia
Enlarged uterus

Lower abdominal tenderness
Anorexia
Foul-smelling lochia
Enlarged uterus

Metritis is characterized by an enlarged uterus and a watery red-brown fluid to viscous off-white purulent uterine discharge, which often has a bad smell

Manifestations of metritis include lower abdominal tenderness or pain on one or both sides, elevated temperature, foul-smelling lochia, anorexia, nausea, fatigue and lethargy, leukocytosis and elevated sedimentation rate. Urgency and flank pain would suggest a urinary tract infection. Breast tenderness may be related to engorgement or suggest mastitis.

28

The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate?

There is no standard/routine testing for ovarian cancer.

29

The nurse is developing the discharge plan for a woman who has had a left-sided modified radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which suggestion would most likely increase the woman's symptoms?

Wear gardening gloves
Wear clothing w/ elasticized sleeves
Do all heavy lifting w/ affected arm
Avoid raising the arm above the breast

“Wear clothing with elasticized sleeves.”

30

When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage based on the knowledge that:

These measurements may not change until after the blood loss is large