NR571 Women's Health & Childbearing — Original Latest Version Study Set

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Sample questions from NR571 Women's Health & Childbearing — Original Latest Version Study Set

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 32-year-old client at 34 weeks' gestation is admitted to labor and delivery with painless bright-red vaginal bleeding. Blood pressure is 118/72 mm Hg, pulse 92/min, and fetal heart rate 145/min. Which action should the nurse take first?

   • A.Perform a digital vaginal examination to assess cervical dilation
   • B.Prepare the client for immediate oxytocin induction
   • C.Apply external fetal monitoring and assess maternal status
   • D.Encourage the client to ambulate to determine whether bleeding increases

   Rationale: External fetal monitoring and maternal assessment identify compromise while avoiding a potentially dangerous examination. A digital examination is contraindicated until placenta previa is excluded. Ambulation and oxytocin are not appropriate before the cause of bleeding is evaluated.

2. 2.A 35-year-old client at 37 weeks' gestation is admitted with severe preeclampsia. Blood pressure is 168/112 mm Hg, deep tendon reflexes are brisk, and magnesium sulfate is infusing. Which nursing actions are appropriate? Select all that apply.

   • A.Maintain seizure precautions
   • B.Assess respiratory rate and level of consciousness regularly
   • C.Monitor urine output and report a marked decrease
   • D.Keep calcium gluconate available per protocol
   • E.Encourage ambulation to reduce venous stasis

   Rationale: Calcium gluconate is the antidote for magnesium toxicity, and respiratory and neurologic checks help detect toxicity early. Seizure precautions are indicated, and decreased urine output can impair magnesium clearance. Ambulation is unsafe for a client at risk for seizure and with severe preeclampsia.

3. 3.A 30-year-old client at 39 weeks' gestation is in active labor. The cervix is 7 cm dilated, contractions occur every 2 minutes, and the fetal heart rate is 140/min with moderate variability. The client says, 'I can't do this anymore.' Which nursing response is most appropriate?

   • A.Leave the room to allow the client to focus without interruption
   • B.Tell the client that an epidural is the only way to manage labor
   • C.Explain that the client should stop vocalizing to conserve energy
   • D.Stay with the client, reinforce progress, and coach breathing through contractions

   Rationale: Continuous support, encouragement, and coping coaching are appropriate for a client experiencing labor distress with reassuring fetal status. An epidural may be discussed if desired but should not be presented as the only option. Leaving or criticizing the client's coping can increase distress and reduce support.

4. 4.A 28-year-old client at 38 weeks' gestation is receiving oxytocin for induction. Contractions occur every 1 minute and last 90 seconds; the fetal heart rate shows recurrent late decelerations. What should the nurse do first?

   • A.Ask the client to push with each contraction
   • B.Stop the oxytocin infusion
   • C.Increase the oxytocin rate to shorten labor
   • D.Document the tracing and reassess in 30 minutes

   Answer and rationale are in the full material.

5. 5.A 23-year-old client at 36 weeks' gestation has a positive group B streptococcus screening result. The client is admitted in labor with intact membranes, temperature 37.0 C (98.6 F), and fetal heart rate 138/min. Which intervention should the nurse anticipate?

   • A.Administer intrapartum antibiotic prophylaxis as prescribed
   • B.Plan a cesarean birth solely because of the positive screening result
   • C.Withhold antibiotics unless the newborn develops symptoms
   • D.Give antibiotics now and discontinue them when labor begins

   Answer and rationale are in the full material.