Title RECALLS 4 - NP2 - SC ✅

3 | Page perineum and notes the present of umbilical cord. What is the immediate nursing action? A. Monitor the fetal heart rate B. Notify the primary health care provider C. Transfer the client to the delivery room D. Place the client in a Trendelenburg position 35. A laboring client has external electronic fetal monitoring in place. Which of the following assessment data can be determined by examining the fetal heart rate strip produced by the external electronic fetal monitor? A. Gender of the fetus B. Fetal position C. Labor progress D. Oxygenation Situation: Nurse Bianca is assigned to a high-risk OB ward. One of her clients is diagnosed with Pregnancy-Induced Hypertension. The following questions apply. 36. The clinic nurse is caring for a client with a suspected diagnosis of gestational hypertension. The nurse assesses the client, expecting to note which set of findings if gestational hypertension is present? A. Edema, ketonuria, and obesity B. Edema, tachycardia, and ketonuria C. Glycosuria, hypertension, and obesity D. Elevated blood pressure and proteinuria 37. Which of the following lab values should the nurse report to the physician as being consistent with the diagnosis of HELLP syndrome? A. Hematocrit 48%. B. Potassium 5.5 mEq/L. C. Platelets 75,000. D. Sodium 130 mEq/L. 38. The nurse is caring for a pregnant client with preeclampsia who is receiving a prescribed intravenous (IV) infusion of magnesium sulfate. To provide a safe environment, the nurse should ensure that which priority item is available? A. Tongue blade B. Percussion hammer C. Calcium gluconate injection D. Potassium chloride injection 39. Nurse Davis is monitoring a pregnant patient receiving magnesium sulfate for preeclampsia management. During her assessment, Nurse Davis suspects that the patient may be experiencing magnesium sulfate toxicity. Which of the following findings would most likely confirm her concern? A. Serum magnesium level of 7 mEq/L. B. Presence of active deep tendon reflexes. C. Urine output of 25 mL per hour. D. Respiratory rate of 10 breaths per minute 40.  Nurse Harris is caring for a pregnant patient in her third trimester who has been admitted with severe preeclampsia. While monitoring for potential complications, what should Nurse Harris assess for? A. Complaints of feeling warm despite a cool room temperature. B. Alternating periods of fetal movement and quietness. C. Signs of bleeding, such as in the gums, presence of petechiae, and purpura. D. Breast enlargement. Situation: Nurse Jasmine is assigned to the OB ward and is responsible for monitoring and educating several postpartum mothers who recently gave birth. The following questions apply: 41. A new mother was administered methylergonovine maleate intramuscularly after delivery. The nurse understands that this medication was administered for which action? A. Decrease uterine contractions B. Prevent postpartum hemorrhage C. Maintain a normal blood pressure D. Reduce the amount of lochia drainage 42. A postpartum nurse caring for a client who delivered vaginally 2 hours ago palpates the fundus and notes the character of the lochia. Which characteristic of the lochia should indicate to the nurse that the client’s recovery is normal? A. Pink-colored lochia B. White-colored lochia C. Serosanguineous lochia D. Dark red-colored lochia 43. Twelve hours after delivery, the nurse assesses the client for uterine involution. The nurse determines that the uterus is progressing normally towards its prepregnant state when palpation of the clients fundus is at which level? A. At the umbilicus B. One finger breaths below the umbilicus C. Two finger breaths below the umbilicus D. Midway between the umbilicus and the symphysis pubis 44. A 10-day postpartum breast-feeding client telephones the postpartum unit reporting a reddened, painful breast and elevated temperature. Based on assessment of the client’ s complaints, which action should the nurse tell the client to do? A. “Breast-feed only with the unaffected breast.” B. “Stop breast-feeding because you probably have an infection.” C. “Notify your health care provider because you may need medication.” D. “Continue breast-feeding since this is a normal response in breast-feeding mothers.” 45. The postpartum client who delivered her newborn 4 days ago has been observed by the nurse to have started assuming tasks of mothering. She has started doing tasks for herself, not asking assistance. In which postpartum stage of regeneration is the client? A. Taking-in phase B. Taking hold phase C. Letting-go phase D. Holding on phase 46. A pregnant client tests positive for the hepatitis B virus. The client asks the nurse if she will be able to breast-feed the baby as planned after delivery. Which therapeutic response should the nurse communicate to the client? A. “You will not be able to breast-feed the baby until 6 months after delivery .” B. “Breast-feeding is not advised, and you should seriously consider bottle-feeding the baby.” C. “Breast-feeding is not a problem, and you will be able to breast-feed immediately after delivery” D. “Breast-feeding is allowed if the baby receives prophylaxis treatment at birth and scheduled immunizations.” 47. The mother had breastfed her newborn. Which of the following actions of the mother indicates the need for further teaching? A. The mother inserts a clean finger into the baby’s mouth before removing him from the breast. B. The mother burps the baby after feeding from each breast. C. The mother places the baby on the left side after feeding D. The mother exposes her nipples to air for 10-20 minutes after feeding. 48. Which of the following factors might result in a decreased supply of breastmilk in a PP mother? A. Supplemental feedings with formula B. Maternal diet high in vitamin C C. An alcoholic drink D. Frequent feedings 49. A postpartum mother who chose not to breastfeed asks the nurse, "When will my menstrual period return?" The nurse correctly responds that: A. “It usually returns within 3-4 months postpartum.” B. “It will resume after your postpartum check-up at 4 weeks.” C. “It may resume as early as 6 to 8 weeks after delivery.” D. “It won’t return until your baby starts eating solid food.” 50. During a postpartum examination, the nurse notes that a client’s left calf is warm and swollen. Which of the following actions by the nurse is appropriate at this time? A. Notify the client’s physician. B. Teach the client to massage her leg. C. Apply ice packs to the client’s leg.