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1. The client and the nurse are discussing birth options. The client delivered her first baby
vaginally and her second baby by cesarean. The client wants to have this baby vaginally.
The nurse reviews the client's surgical history to verify which item of information
before vaginal birth after cesarean (VBAC) can be attempted?
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A) Type of uterine incision
B) Condition of the abdominal scar
C) Fetal weight abirb.com/test
D) Amount of blood loss

2. HELLP Syndrome is an acronym for: abirb.com/test

A) Hemolysis, Elevated Liver enzymes, and Low Platelets

B) Hypertension, Epigastric pain, and Low Level Proteinuria
C) Headache, Elevated Leukocytes, Low Prolactin abirb.com/test
D) HEmolysis, Low Level Platelets

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3. The provider orders labs for the diagnosis of HELLP syndrome. Which obstetric
condition usually precedes the diagnosis of HELLP syndrome?
A) Preeclampsia
B) Gestational Diabetes abirb.com/test
C) Placenta previa
D) Preterm labor
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4. The nurse encourages a new mother to express colostrum for her 30-week preterm
infant. The mother is confused because the baby is too immature to breast-feed. The
nurse explains the baby's mouth will be swabbed with theabirb.com/test
mother's expressed colostrum
every 3 hours. What is the priority purpose of this intervention?
A) To give the neonate the immune system benefits of colostrum
B) To familiarize the neonate with the taste and scent of mother's milk
C) To initiate the bonding process between mother andabirb.com/test
neonate
D) To increase the neonate's caloric intake

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5. A premature neonate is being given oral feedings of 12 mL of breast milk with fortifier
every 3 hours. During the nurse's assessment, which finding is a sign that the neonate is
tolerating the feedings? Select all that apply.
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A) Abdomen soft, nontender
B) Gastric residual of 3 mL
C) Bowel sound present
D) Projectile vomiting abirb.com/test
E) Heme positive stool

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6. Which lab tests would be ordered to make a diagnosis of HELLP syndrome? Select all
that apply.
A) Complete blood count with platelets
B) Total bilirubin level abirb.com/test
C) Serum aspartate aminotransferase
D) Peripheral blood smear
E) Blood urea nitrogen level abirb.com/test

7. A client with HELLP syndrome is being prepared for a cesarean birth. The client wants
epidural anesthesia. The anesthesiologist interviews the client and reviews the client's
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laboratory results. The anesthesiologist recommends the client has general anesthesia.
The client asks the nurse why she cannot have an epidural. What is the best explanation
that the nurse can give this client? abirb.com/test
A) "Your platelet count is low. That means you are at risk for bleeding. This makes
general anesthesia a safer choice."
B) "Your white blood cell count is high. That can indicate an infection, and the
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anesthesiologist does not want to spread the infection to the epidural space."
C) "Your hemoglobin is low. With general anesthesia, the anesthesiologist can
administer a higher concentration of oxygen to perfuse your organs."
D) "Your potassium level is high. That means you are at risk for cardiac dysrhythmia.
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With general anesthesia, the anesthesiologist can better monitor your heart."

8. A 38-year old woman is at the clinic for her first prenatalabirb.com/test

visit following a positive
home pregnancy test last week. She has two children ages 10 and 7. Both of her
previous pregnancies were uncomplicated and she had short labors and vaginal births.
This pregnancy is a happy surprise. In reviewing the planabirb.com/test
of care, the nurse recommends
the client has which test added to the routine testing during this pregnancy?
A) Amniocentesis between 14-16 weeks
B) Glucose tolerance test at 24 weeks
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C) Ultrasound fetal scan at 20 weeks
D) Blood test for fetal anomalies in first trimester

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9. A 38-year old woman, G5P4, is at the clinic for her first prenatal visit following a
positive home pregnancy test last week. In discussing the client's plan of care the nurse
recommends an amniocentesis at 14 to 16 weeks' gestation. The nurse explains that the
following condition of the fetus can be diagnosed duringabirb.com/test
an amniocentesis? Select all
that apply.
A) Neural tube defects
B) Down syndrome abirb.com/test
C) Cerebral palsy
D) Risk for prematurity
E) Necrotizing enterocolitis
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10. The nurse is explaining the complications of prematurity to the parents of a neonate
born at 28 weeks' gestation. The nurse explains that the premature infant is at risk for
which eye-related condition? abirb.com/test
A) Retinopathy of prematurity
B) Amblyopia
C) Congenital corneal opacity abirb.com/test
D) Congenital glaucoma

11. A client at 26 weeks' gestation is in active labor. The woman is afebrile and vital signs
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are stable. The fetal heart rate (FHR) is in the 150s with adequate variability and no
decelerations. The nurse prepares the birthing room to care for a neonate with which
complication? abirb.com/test
A) Respiratory distress
B) Feeding difficulties
C) Congenital heart disease
D) Sepsis abirb.com/test

12. Which characteristic of a preterm neonate places the neonate at risk for hypothermia?
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Select all that apply.
A) Thinner skin
B) Higher body surface-to-weight ratio
C) Inability to flex the body to conserve heat abirb.com/test

D) Inefficient sweat glands

E) Less body fat
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13. A neonate born at 30 weeks' gestation has been in the NICU for 3 weeks. The infant was
started on enteral feedings 5 days ago. The amount of the feeding has been gradually
increased. The last feeding the baby received was 18 mL,abirb.com/test
3 hours ago. Upon
assessment, the gastric residual is 10 mL. Based on this finding, what actions will the
nurse implement? Select all that apply.
A) Hold the feeding. abirb.com/test
B) Check the stool for blood.
C) Assess for abdominal distention and tenderness.
D) Communicate this finding to the neonatologist.
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E) Decrease the amount of the feeding by 10 mL.

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14. The nurse assesses a neonate who is exhibiting signs of feeding intolerance, including
increased gastric residual, a distended abdomen, and bloody stool. The health care
provider prescribes an abdominal x-ray. The nurse receives the results of the x-ray,
which shows free air in the abdomen. The nurse knows this finding means:
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A) rupture of the intestines.
B) diaphragmatic hernia.
C) intestinal obstruction. abirb.com/test
D) pneumatosis intestinalis.

15. A couple is planning a natural birth and discharge to home within 24 hours. Suddenly, at
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32 weeks' gestation, the woman's membranes rupture. She is admitted to the hospital.
After 24 hours her contractions are irregular and her temperature is 101 °F (38.3 °C). A
baby weighing 3 pounds is delivered by cesarean sectionabirb.com/test
and admitted to the NICU. The
nurse recognizes that a priority of caring for this couple is helping them to work through
what process during the postbirth period?
A) Mourning the birth experience they were anticipating
B) Blaming the staff for not inducing labor abirb.com/test

C) Accepting that a cesarean birth is just a different way to give birth

D) Rejoicing that their baby is alive
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16. Which strategy is used by the NICU nurse to help new parents cope with the
environment?
A) Assigning the same nurse to the same baby and family abirb.com/test
each day
B) Limiting the information given to parents about the baby's condition
C) Reassuring parents that their baby will be perfectly normal
D) Limiting the amount of time the parent spends in theabirb.com/test
NICU each day

17. A parent of a 3-day old baby born at 33 weeks' gestation calls the nurse to the baby's
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bedside. The parent has been watching the baby's breathing and is concerned that it is
abnormal. Which explanation by the nurse is the best response to this parent's concern?
A) "Babies normally breathe quickly and at irregular intervals."
B) "Babies will breathe faster when hungry and slowerabirb.com/test
when sleeping."
C) "Babies should be taking slow, deep breaths at regular intervals."
D) "Babies may hold their breath for up to 30 seconds."
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18. A baby born at 30 weeks' gestation has a projected NICU stay of 10-12 weeks. The
parents live about 50 miles away, the father's job involves travel during the week, and
they have four children at home. The parents tell the nurse they will only be able to
come to visit on the weekend. Which action by the nurseabirb.com/test
is important in the care of this
infant?
A) Keep the parents involved by sending emails, photos and making phone calls.
B) Focus on the infant's physical needs. abirb.com/test
C) Contact the social worker to arrange temporary housing close to the hospital.
D) Stress to the parents that the baby needs their presence in the NICU.

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19. A client comes to the clinic reporting swelling in the hands and feet, blurred vision, a
pounding headache and nausea and vomiting. The client had a positive pregnancy test
15 weeks ago, but has had no prenatal care. This is the client's third pregnancy, and she
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says that her uterus never grew this big or this fast with the previous pregnancies. Based
on the client's reason for seeking care, the nurse would collect additional data to rule out
the presence of which conditions? Select all that apply.
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A) Preeclampsia
B) Molar pregnancy
C) Placental abruption abirb.com/test
D) Missed abortion
E) Ectopic pregnancy

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20. The nurse collects a history on a newly pregnant woman. Which data does the nurse
identify in the health history that places this client at risk for having an infant with a
chromosomal anomaly? Select all that apply.
A) Maternal age 37 years abirb.com/test
B) Sister with Down syndrome
C) G8P7
D) Third child born at 28 weeks' gestation abirb.com/test
E) Developed gestational diabetes in last pregnancy

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Answer Key
1. A
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2. A
3. A
4. A
5. A, B, C abirb.com/test
6. A, B, C, D
7. A
8. A
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9. A, B
10. A
11. A
12. A, B, C, E abirb.com/test
13. A, B, C, D
14. A
15. A
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16. A
17. A
18. A
19. A, B abirb.com/test
20. A, B

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