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F.A Davis Exam 2 (CH 7,8,9) actual practice test detailed accurate solutions/revised, Exams of Nursing

F.A Davis Exam 2 (CH 7,8,9) actual practice test detailed accurate solutions/revised

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F.A Davis Exam 2 (CH 7,8,9) actual practice test
detailed accurate solutions/revised
1. While assessing the tracing of a term laboring patient on continuous
fetal monitoring, the nurse notes the fetal heart rate is 115 bpm with
moderate vari- ability. There are several early decelerations, along with
a few accelerations that last 30 seconds and increase the heart rate by
20 bpm. What category of fetal heart tracing is this?: Category 1
2. When counting contractions, which of the following is true?: Frequency
is counted as the beginning of one contraction to the beginning of the next
contraction
3. Counterpressure over the sacral area will be most beneficial to which
of the following patients?: Madison, at 6 cm with her baby ROP, kneeling on
her bed rating her pain at a 7 on a 1 to 10 scale during contractions and a
5/10 between them
4. : EFM has reduced the cesarean rate in healthy pregnancies since its
introduction
5. A new nurse on the floor is describing the need for internal fetal
monitoring to the nurse educator during a simulation drill. Which of the
following state- ments made by the new nurse indicates a need for
further education?: "Internal monitors can be placed in my patient at any
time here is a concern for fetal
well-being."
6. A new nurse has placed a laboring patient on the external monitor for
EFM. When the provider comes into the room and notes the location of
the ultrasound transducer and the category I strip, they ask for the
ultrasound machine and to contact the OR to prepare for a nonemergent
cesarean section. What has the provider seen that would prompt this
action?: The transducer is 1 cm above and to the left of the umbilicus
7. Place the maternal structures based on the cardinal movements of
labor in the order in which they are reached.: Entering the maternal inlet
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F.A Davis Exam 2 (CH 7,8,9) actual practice test

detailed accurate solutions/revised

  1. While assessing the tracing of a term laboring patient on continuous fetal monitoring, the nurse notes the fetal heart rate is 115 bpm with moderate vari- ability. There are several early decelerations, along with a few accelerations that last 30 seconds and increase the heart rate by 20 bpm. What category of fetal heart tracing is this?: Category 1
  2. When counting contractions, which of the following is true?: Frequency is counted as the beginning of one contraction to the beginning of the next contraction
  3. Counterpressure over the sacral area will be most beneficial to which of the following patients?: Madison, at 6 cm with her baby ROP, kneeling on her bed rating her pain at a 7 on a 1 to 10 scale during contractions and a 5/10 between them
  4. : EFM has reduced the cesarean rate in healthy pregnancies since its introduction
  5. A new nurse on the floor is describing the need for internal fetal monitoring to the nurse educator during a simulation drill. Which of the following state- ments made by the new nurse indicates a need for further education?: "Internal monitors can be placed in my patient at any time here is a concern for fetal well-being."
  6. A new nurse has placed a laboring patient on the external monitor for EFM. When the provider comes into the room and notes the location of the ultrasound transducer and the category I strip, they ask for the ultrasound machine and to contact the OR to prepare for a nonemergent cesarean section. What has the provider seen that would prompt this action?: The transducer is 1 cm above and to the left of the umbilicus
  7. Place the maternal structures based on the cardinal movements of labor in the order in which they are reached.: Entering the maternal inlet

pelvic floor and cervix Levator ani muscles under the pubic symphysis

  1. Once the infant reaches +4 station, it is at what maternal landmark?: at the pelvic outlet
  2. Which of the following statements are true about intermittent auscultation (IA)?: IA results in fewer cesarean sections IA allows for increased freedom of movements IA should be started right after a uterine contraction has ended IA requires 1:1 care
  3. The nurse is palpating the uterus of a patient who has been in active labor for several hours. The nurse knows the contractions are of moderate intensity when they feel like a .: Chin
  4. A nurse is calling report to the provider of a patient who just came into OB triage actively laboring with delivery imminent. On the phone, the nurse states, "Erika Jones, a 26-year-old G5P3104, is in triage contracting every 2 to 3 minutes with a reactive NST. Her cervix is 9 cm dilated, 100% effaced, and the baby is ROA at +2 station. Her membranes are intact, and vital signs are all within normal limits. She's had a normal healthy pregnancy and is stating she needs to push." What priority information is missing from this report?: the gestational age and EDD
  5. The nurse knows if, while doing a vaginal exam, the fetus' occiput is located to the maternal anterior left, she will chart the position as which of the following?: LOA
  6. Fetal attitude is .: the relationship of fetal body parts to each other
  7. Shelley is a term G3P1102 who has been admitted to labor and delivery in labor. She's breathing deeply with her contractions with eyes closed. She's contracting every 3 to 6 minutes lasting 60 to 80 seconds. What stage and phase of labor is Shelley in?: First stage, active phase
  8. Effects of delayed cord clamping include all of the following except what?- : Increased chance of maternal hemorrhage

labor has been uncomplicated. Why is the provider ordering continuous fetal monitoring and not intermittent auscultation for Marna?: her membranes ruptured 16 hours ago before the onset of labor

  1. The urge to push will usually occur when the presenting part is at what station in the pelvis?: +
  2. When taking a medical history for a newly admitted patient in labor, which of the following statements or questions is phrased appropriately?: Can you tell me about any medications or drugs you took during pregnancy and how much?
  3. When assisting a hypotensive patient receiving an epidural, which of the following situations is the most concerning?: A drop greater than or equal to 20 mm Hg in blood pressure
  4. Which of the following statements about labor and delivery are true? Select all that apply.: Every labor and delivery is different. If the fetus is not in a favorable position, the provider may attempt to turn them externally. True labor can be defined as cervical change
  5. Julia, a G3P1011 at term, was admitted in active labor 6 hours ago. On admittance, she was dilated 5 cm, 70% effaced, and at 0 station. The nurse just checked her cervix and she was 7 cm, 80% effaced, and at 0 station. What is the suspected complication at this time?: Cephalopelvic disproportion
  6. Which of the following statements are true about postpartum administra- tion of oxytocin? Select all that apply.: It can be given IV or IM
  7. Cary has just delivered a healthy baby boy, and the midwife remains at the perineum to assess any damage that may have occurred. The nurse knows the patient has a 2nd-degree laceration when the midwife states which of the following to the patient?: "You'll have several stitches on your perineum, but I won't have to place any near your rectum"
  8. The baseline FHR on a patient on admittance was 130 to 140 with moderate variability. Over the course of the last 5 hours, the FHR has risen to a baseline of 155 to 170. What should be the nurses' priority assessment focus for this?: Maternal infection
  1. Syrah received an epidural an hour ago. Upon re-entering the room, the nurse notes that Syrah is sleeping soundly. Assessing her vitals, the nurse realizes Syrah is not sleeping soundly and may need Naloxone. What in her assessment findings would indicate this to the nurse?: Sarah's oxygen saturation is 88%, respirations are 8
  2. Heather, a term G2P1001, has been actively laboring and progressing through an unmedicated labor for the past 7 hours. She has remained calm and is using breathing techniques with her partner. After a particularly strong contraction, Heather begins to cry and states, "I just wants it done, I can't do much more, how much longer will it take?" What stage and phase of labor is Heather in?: First stage; transition phase
  3. Which of the following are expected findings for a patient who has received an epidural? Select all that apply.: The patient may need help holding her legs and being directed when to push The patient may develop intense pruritus Urinary retention and stress incontinence may occur immediately postpartum
  4. The monitor in a laboring patient's room has shown a category II strip for the past hour. Variability has ranged between minimal and moderate with no accelerations and an occasional variable deceleration. In the past 15 minutes, subtle late decelerations have begun to appear repetitively, and the variability has remained minimal and at times absent. What should be assumed by this assessment?: The fetus is experiencing uteroplacental insufficiency and possibly beginning to suffer hypoxemia
  5. Mariah is in active labor and being continuously monitored. FHR is 120 with moderate variability and contractions every 3 to 5 minutes. The nurse also notes decelerations that begin and end with the contractions. What is the appropriate nursing action to address these decelerations?: Reassure the patient and her support persons that she in the baby are doing well
  6. Stacey is a new nurse on this unit but an experienced labor and delivery nurse. She just received a reprimand for placing internal fetal monitors on her patient, a task she performed routinely at her previous unit in another state but is only done by the provider on this unit. What

something happens"

  1. A laboring patient is having recurrent, variable decelerations on the EFM. As her nurse, you also know she had a premature rupture of membranes several hours ago. What order would you anticipate?: An amnioinfusion
  2. Katrina, a postterm G3P1102 has arrived at the hospital for her induction and TOLAC. The nurse checks her cervix and finds her to be 2 cm dilated, 30% effaced, and at -2 station. What induction orders would you anticipate?: Lami- naria tent placement
  3. Which of the following actions is not appropriate when assisting a family through an intrauterine fetal demise?: Ensure the infant is taken to the morgue soon after delivery so that the family can begin to heal
  4. Jill is a G2P1001 at 38 weeks 5 days being induced for pre-eclampsia. She has magnesium, LR, and oxytocin running at this time for a total IV input of 125 mL/hr. Her last assessment was as follows: blood pressure 109/63 mm Hg, pulse 60, respirations 10, temperature 36.6°C, oxygen saturation 95%, negative for clonus, reflexes absent, and lungs clear to auscultation bilaterally. The infant has a category II strip, and FHR baseline is 125 with minimal variability. Urine output is 20 mL/hr. As Jill's nurse, what is your next action?: Stop the magnesium sulfate, administer calcium gluconate, and call the provider
  5. Marla is a G4P2012 at 40 weeks 4 days. She was diagnosed with GDM and has a BMI of 34%. She has been laboring for 22 hours and has stated that she is exhausted and can't do this anymore. Her last sterile vaginal exam results were 6 cm dilated, 80% effaced, 0 station, and her strip is a category I. The infant has begun to show signs of distress. Why would the provider choose a cesarean section over the use of forceps in this situation?: Marla has GDM and a high BMI
  6. Which of the following patients would most likely have a uterine rupture?: - Angela, with three previous deliveries, two vaginal, and the last one cesarean section with a classical incision
  7. Sahara is a 35-year-old G4P2103 at 38 weeks 5 days. Her first two preg- nancies were delivered vaginally, and her last pregnancy was

delivered via cesarean section 2 years ago for fetal distress. She has an unremarkable OB history otherwise. She and her partner moved to a small rural town 6 months ago with a secondary level medical center. The practice where she is currently seen has three midwives and one MD who is an OB/GYN. Why may Sahara not be recommended for a TOLAC but encouraged to have a repeat cesarean section?: She may not have the medical staff and care needed for an obstetric emergency at that hospital

  1. As the nurse in OB triage, you've just admitted a G4P3003 patient who states she felt her first contraction 90 minutes ago. As you perform a sterile vaginal exam, you note the patient is 10 cm dilate, 100% effaced, at +2 station. As you call out for the charge nurse and provider, the infant delivers onto the bed. What type of delivery is this called?: Precipitous
  2. Melanie, a G1P0 at 23 weeks 5 days, has called the doctor's office com- plaining of lower back pain, nausea, and pelvic pressure. What should the nurse advise Melanie to do?: Have someone drive her to OB triage at the hospital immediately; the nurse will call the unit and let the unit know Melanie is on her way
  3. Fiona has been diagnosed with pre-eclampsia, and she's currently being induced with oxytocin. Which of the following findings is unexpected in this situation?: DTR's +
  4. can cause sepsis, pneumonia, and fetal demise in up to 4% of cases.: Chorioamnionitis
  5. The nurse midwife is monitoring a term patient in active labor who is hav- ing variable decelerations. The decelerations have become more frequent as the fetus progresses in station. What finding would be expected at delivery?: A knot in the umbilical cord
  6. Marsha is a term 17-year-old G1P0 who has been laboring at home since her water broke 16 hours ago. Her records shows she has good family support, has had physiological anemia, is GBS +, and blood type is A-. Her vital signs on admittance are blood pressure 129/68 mm Hg, pulse 98, respirations 22, and temperature 38.9°C. When placed on the monitor, the infant has a category II strip, FHR is 166, with moderate

nurse she suddenly doesn't feel right and can't catch her breath. Her vital signs are blood pressure 91/56 mm Hg, pulse 123, temperature 36.6°C, respirations 38, and oxygen saturation 82%. What medical emergency is most likely occur- ring?: Anaphylactoid syndrome of pregnancy

  1. Valerie is a 28-year-old G3P1011 at 37 weeks 3 days who was just brought to OB triage by ambulance and is exhibiting signs of hypovolemia. On abdom- inal palpation, bony protrusions are felt. Vital signs are BP 94/55 mm Hg, HR 129, respirations 24 min, oxygen saturation 94%, temperature 36.7°C, and pain is a 4 on a scale of 1 to 10. Valerie states she began having contractions but then had a sharp pain that wasn't a contraction and hasn't had any since. What obstetric emergency is Valerie experiencing?: Uterine rupture
  2. Which of the following would contraindicate an amniotomy?: A patient with bacterial vaginosis who has been laboring for 5 hours, whose cervix is 4 cm dilated, 50% effaced, at zero station
  3. A new nurse on labor and delivery has been assigned to a patient suffering an intrauterine fetal demise or IUFD. Which information in the patient's chart does the nurse know put the patient at risk for an IUFD?: The patient is 42 weeks and 3 days gestation
  4. Which of the following events is not considered to be an obstetric emer- gency?: Marginal placenta previa
  5. McRobert's maneuver is used during which situation?: shoulder dystocia
  6. Melody is a term 16-year-old G1P0 who was admitted several hours ago at 4 cm dilated, 40% effaced, and ballotable. She has been having moderate to strong contractions every 3 to 6 minutes. She hid her pregnancy until she went into labor and has had no prenatal care or prenatal preparation. She has been screaming through every contraction and asking for a cesarean section because "it just hurts too bad". On assessment 10 minutes ago, the provider states Melody is 4 cm dilated, 60% effaced, at -2 station, and not progressing well through the second stage of labor. What is Melody experiencing, and what would be the best actions to take at this time?: Hypertonic labor. Expect an order for hydromorphone, assist Melody into a warm shower, and then encourage her

to rest.

  1. Brandi, a 28-year-old G2P0010, has been laboring for several hours and is exhausted. She has a history of GDM, O+, GBS+, and her vital signs have remained within normal limits throughout labor. Her cervix is 7 cm dilated, 80% effaced, and the fetus is at 0 station. The provider is at the bedside discussing the use of a vacuum to assist Brandi in labor. As her nurse, what in her history makes a vacuum assist contraindicated?: She has a history of GDM
  2. Which of the following statements are true about cesarean section de- liveries? Select all that apply.: Elective cesarean sections may be considered unethical. Active genital herpes is a medical reason to perform a cesarean section. Cephalopelvic disproportion is a medical reason to perform a cesarean section
  3. Which of the following statements is true about the administration of oxytocin?: Oxytocin is considered to be a high-alert medication
  4. Which of the following is an important nursing action for a patient after she's had a successful external version?: Administering RhoGAM if the patient is Rh(D) negative
  5. New symptoms of blurry vision, right upper quadrant abdominal pain, headaches, and restlessness are all signs of impending .: - Eclampsia
  6. Which of the following statements is not true about a cesarean section?: - The incision on the skin will be the same as the incision on the uterus
  7. Ambulation should be encouraged in which of the following situations? Select all that apply.: For Kristi, A G1P0 at 41 weeks 5 days who has been laboring comfortably at home and is trying to augment her labor. For Chelsea, G3P2002 at 40 weeks 3 days who is attempting a TOLAC and whose cervix is 3 cm dilated, 50% effaced, at 0
  8. Which of the following statements are true about dystocia in labor? Select all that apply.: Medical interventions can cause labor dystocia Maternal anxiety can cause labor dystocia Maternal obesity can cause

hard whitish spots they see on their infant's gums. What is this finding?: Epstein pearls

  1. Crepitus and Erb's palsy are both most likely related to what delivery complication?: Shoulder rotation
  2. Separation of the placenta after delivery results in which of the following physiological responses in the newborn? Select all that apply.: Increased aortic pressure Decreased pulmonary resistance Increased blood flow to the liver
  3. The mother of an 8-hour-old infant has requested the nurse to assess her infant's face. The grandmother of the infant is at the bedside stating, "Those pimples need popped". What skin condition is this?: Milia
  4. Phytonadione should be administered in the newborn .: - vastus lateralis
  5. Infant girl Swinko, who is suspected to have trisomy 21, is 25 hours old when the nurse does her shift assessment. She finds central cyanosis, and the infant's heart rate is varying between tachycardia and bradycardia. What complication is the infant most likely experiencing?: Tetralogy of fallot
  6. Which of the following newborn findings are related to maternal hor- mones? Select all that apply.: Nipple enlargement Pseudomenstruation Nondystocia loose hip joints
  7. The conversion of nonexcretable bilirubin to excretable bilirubin is called .: conjugation
  8. The nurse is educating a new mother on signs and symptoms to report once she and her infant are discharged home. Which statement by the mother indicates a need for further teaching?: "If my baby's soft spot is raised, I know it will go away in a few days."
  9. Which of the following statements are true about hyperbilirubinemia (jaun- dice)? Select all that apply.: It is classified as two separate forms of jaundice depending on when it appears.

Phototherapy can cause dehydration when used for jaundice. Jaundice can occur due to birth trauma and inadequate elimination.

  1. To differentiate caput succedaneum from cephalhematoma, the nurse knows to palpate which structure?: The suture lines
  2. The Greene's infant son was born at term 3 hours ago and taken to the NICU for further assessment due to shoulder dystocia and a true knot in the umbilical cord. APGAR scores were 6 and 8. Blood gas results showed arterial blood gas to be 6.9%. What does this indicate and what complication may result?: Hypoxia, cerebral palsy
  3. Annette delivered her infant 12 hours ago and is concerned about her other two children coming to her room and exposing the infant to chicken pox, which has been going around at their day care. Why does Annette not have to be concerned?: Her varicella titer shows she is immune, which means the infant will be immune through passive immunity
  4. Which of the following findings on a newborn assessment indicate a possible congenital concern? Select all that apply.: A section of white hair in otherwise dark hair A bivalve uvula Webbing of the neck
  5. Missy, a G3P1102 at 31 weeks 2 days, has just been brought to OB triage for a preterm labor assessment. She has had an uneventful pregnancy with routine care. While being placed on the monitor, Missy states she is feeling a lot of pressure and the baby is coming. The nurse pulls back the blanket just in time to guide the infant onto the bed. What is the immediate concern for the infant at this time?: Respiratory distress syndrome
  6. Which one of these term infants would require gloves to be worn during handling by the nurse?: Baby girl hunter, 2 hours old. Erythema toxic, vernix in groin and axilla, born at home and placed skin-to-skin with mom where she has been since delivery.
  7. Which of the following statements about spina bifida is not true?: Surgery is only indicated in the worst cases

Dehydration

  1. Place the following in the order they occur during the establishment of newborn respiration.: Thoracic squeeze Chest recoil Negative intrathoracic pressure Passive inspiration
  2. When assessing newborn respirations, the nurse knows that respirations that are shallow, diaphragmatic, and irregular are all signs of what?: Normal newborn breathing
  3. While assessing the newborn scrotum, which assessments should be performed when there is swelling present? Select all that apply.: Auscultation Transillumination Palpation
  4. Baby girl Mitchell was born 4 hours ago in a vacuum-assisted delivery. On assessment, the nurse notes a large cephalhematoma on her scalp. What complication should the infant be closely monitored for?: Hyperbillirubinemia
  5. Reading the test results for a patient admitted for care, the nurse knows the infant is which gestational age based on a low L/S ratio?: 33 weeks 4 days
  6. While assessing a newborn's head, the nurse notes the anterior fontanelle is depressed. What could this indicate?: Dehydration
  7. Meconium is and can be caused by .: fetal stool; fetal distress
  8. What is a Bandl ring?: A retraction ring of tissue
  9. The provider is delivering a patient with GDM who has had a prolonged labor. When the provider mentions "turtle sign", you know the patient is experiencing which complication?: Shoulder dystocia