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What symptom no matter what stage of pregnancy should be reported immediately?
- A. Backache
- B. Urinary frequency
- C. Vaginal bleeding
- D. Uterine tightening
Correct Answer: C
Rationale: Women should be instructed to contact their health care provider if any bleeding occurs during pregnancy.
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What complication of delivery should the nurse expect with the birth of multiple fetuses?
- A. An ectopic tendency
- B. Difficulty with breast-feeding
- C. A vaginal delivery
- D. Loss of uterine tone
Correct Answer: D
Rationale: Delivery of multiple fetuses is often complicated by loss of uterine tone. Oftentimes multiple fetuses are delivered by cesarean. An ectopic tendency would present before delivery. While it can be difficult to breastfeed multiple infants, this does not relate to the delivery.
A patient with a history of rheumatic heart disease is being admitted to the labor and delivery unit. To prevent further stress on the heart what should the nurse anticipate to be ordered?
- A. Oxygen administration
- B. Administering large amount of IV fluids
- C. Positioning the patient on her back
- D. Encouraging activity between contractions
Correct Answer: A
Rationale: Oxygen is administered to increase blood oxygen saturation and decrease the stress on the heart. IV fluid administration is kept to a minimum to prevent fluid overload. The patient would be positioned in a semi-Fowler's position to improve circulation. The patient should be encouraged to rest between contractions to conserve energy.
What should be specifically monitored in a patient who is hospitalized with gestational hypertension?
- A. Blood sugar
- B. Temperature
- C. Level of consciousness
- D. Deep tendon reflexes
Correct Answer: D
Rationale: If the patient is hospitalized for gestational hypertension, deep tendon reflexes are monitored. The blood sugar, temperature, and LOC will also be monitored, but they are not the priority in the hypertensive patient.
The nurse reports to the charge nurse that the 3-hour postpartum patient is bleeding excessively as she has saturated one peripad in less than ___ minutes.
Correct Answer: 15
Rationale: The saturation of one peripad within 15 minutes is considered to be excessive bleeding.
A neonate is born with weak muscle tone froglike extremities and ears that fold easily. From these observations what gestational age should the nurse give this infant?
- A. Full term
- B. Small for gestational age
- C. Preterm
- D. Postterm
Correct Answer: C
Rationale: Preterm infant posture is froglike, the muscle tone is weak, and the ears are easily folded.