Intrapartum NCLEX Questions OB 1-8

Answer the following Intrapartum NCLEX Questions OB . . .

1. The nurse has provided discharge instructions to a client who delivered a healthy newborn by cesarean delivery. Which statement made by the client indicates a need for further instruction?

a) “I will begin abdominal exercises immediately.”
b) “I will notify the health care provider if I develop a fever.”
c) “I will turn on my side and push up with my arms to get out of bed.”
d) “I will lift nothing heavier than my newborn baby for at least 2 weeks.”

2. Intrapartum NCLEX Questions about the OB nurse who is monitoring a client in active labor and notes that the client is having contractions every 3 minutes that last 45 seconds. The nurse notes that the fetal heart rate between contractions is 100 beats/minute. Which nursing action is most appropriate?

a) Notify the health care provider (HCP).
b) Continue monitoring the fetal heart rate.
c) Encourage the client to continue pushing with each contraction.
d) Instruct the client’s coach to continue to encourage breathing techniques.

3. The nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which action is most appropriate?

a) Notify the health care provider of the findings.
b) Reposition the mother and check the monitor for changes in the fetal tracing.
c) Take the mother’s vital signs and tell the mother that bed rest is required to conserve oxygen.
d) Document the findings and tell the mother that the pattern on the monitor indicates fetal well-being.

4. Intrapartum NCLEX Questions about the OB nurse who is admitting a pregnant client to the labor room and attaches an external electronic fetal monitor to the client’s abdomen. After attachment of the electronic fetal monitor, what is the next nursing action?

a) Identify the types of accelerations.
b) Assess the baseline fetal heart rate.
c) Determine the intensity of the contractions.
d) Determine the frequency of the contractions.

5. The nurse is reviewing true and false labor signs with a multiparous client. The nurse determines that the client understands the signs of true labor if she makes which statement?

a) “I won’t be in labor until my baby drops.”
b) “My contractions will be felt in my abdominal area.”
c) “My contractions will not be as painful if I walk around.”
d) “My contractions will increase in duration and intensity.”

6. Which assessment finding following an amniotomy should be conducted first?

a) Cervical dilation
b) Bladder distention
c) Fetal heart rate pattern
d) Maternal blood pressure

7. Intrapartum NCLEX Questions about the OB nurse who has been working with a laboring client and notes that she has been pushing effectively for 1 hour. What is the client’s primary physiological need at this time?

a) Ambulation
b) Rest between contractions
c) Change positions frequently
d) Consume oral food and fluids

8. The nurse is assisting a client undergoing induction of labor at 41 weeks’ gestation. The client’s contractions are moderate and occurring every 2 to 3 minutes, with a duration of 60 seconds. An internal fetal heart rate monitor is in place. The baseline fetal heart rate has been 120 to 122 beats/minute for the past hour. What is the priority nursing action?

a) Notify the health care provider.
b) Discontinue the infusion of oxytocin (Pitocin).
c) Place oxygen on at 8 to 10 L/minute via face mask.
d) Contact the client’s primary support person(s) if not currently present.

Intrapartum NCLEX Questions OB
Answers and Rationale

1) A
- Rationale: A cesarean delivery requires an incision made through the abdominal wall and into the uterus. Abdominal exercises should not start immediately after abdominal surgery; the client should wait at least 3 to 4 weeks postoperatively to allow for healing of the incision. Options 2, 3, and 4 are appropriate instructions for the client after a cesarean delivery.

- Test-Taking Strategy: Note the strategic words need for further instruction . These words indicate a negative event query and ask you to select an option that is an incorrect statement. Keeping in mind that the client had a cesarean delivery and noting the word immediately in the correct option will assist in directing you to this option.

2) A
- Intrapartum NCLEX Questions OB Rationale: A normal fetal heart rate is 110 to 160 beats/minute, and the fetal heart rate should be within this range between contractions. Fetal bradycardia between contractions may indicate the need for immediate medical management, and the HCP or nurse- midwife needs to be notified. Options 2, 3, and 4 are inappropriate nursing actions in this situation and delay necessary intervention.

- Test-Taking Strategy: Note the strategic words most appropriate. Focus on the data in the question. Knowledge that the normal fetal heart rate is 110 to 160 beats/minute will assist you to recognize that fetal bradycardia is present.

3) D
- Rationale: Accelerations are transient increases in the fetal heart rate that often accompany contractions or are caused by fetal movement. Episodic accelerations are thought to be a sign of fetal well-being and adequate oxygen reserve. Options 1, 2, and 3 are inaccurate nursing actions and are unnecessary.

- Test-Taking Strategy: Note the strategic words most appropriate. Options 1, 2, and 3 are comparable or alike in that they indicate the need for further intervention. Also, knowing that accelerations indicate fetal well-being will direct you to the correct option.

4) B
- Intrapartum NCLEX Questions OB Rationale: Assessing the baseline fetal heart rate is important so that abnormal variations of the baseline rate can be identified if they occur. The intensity of contractions is assessed by an internal fetal monitor, not an external fetal monitor. Options 1 and 4 are important to assess, but not as the first priority. Fetal heart rate is evaluated by assessing baseline and periodic changes. Periodic changes occur in response to the intermittent stress of uterine contractions and the baseline beat-to-beat variability of the fetal heart rate.

- Test-Taking Strategy: Note the strategic word next in the question. Use the ABCs—airway, breathing, and circulation . Fetal heart rate reflects the ABCs.

5) D
- Rationale: True labor is present when contractions increase in duration and intensity. Lightening or dropping is also known as engagement and occurs when the fetus descends into the pelvis about 2 weeks before delivery. Contractions felt in the abdominal area and contractions that ease with walking are signs of false labor.

- Test-Taking Strategy: Focus on the subject , the signs of true labor. Noting the word true in the question and its relationship to the words increase in duration and intensity in the correct option will direct you to this option. Review: Signs of true and false labor Level of Cognitive Ability: Evaluating Client Needs: Health Promotion and Maintenance Integrated Process: Nursing Process—Evaluation

6) C
- Rationale: Fetal heart rate is assessed immediately after amniotomy to detect any changes that may indicate cord compression or prolapse. Bladder distention or maternal blood pressure would not be the first things to check after an amniotomy. When the membranes are ruptured, minimal vaginal examinations would be done because of the risk of infection.

- Intrapartum NCLEX Questions OB Test-Taking Strategy: Note the strategic word first . Because of the risk of a prolapsed cord after an amniotomy, the first action is to check the fetal heart rate for signs of nonreassuring fetal heart rate patterns.

7) B
- Rationale: The birth process expends a great deal of energy, particularly during the transition stage. Encouraging rest between contractions conserves maternal energy, facilitating voluntary pushing efforts with contractions. Uteroplacental perfusion also is enhanced, which promotes fetal tolerance of the stress of labor. Changing positions frequently is not the primary physiological need. Ambulation is encouraged during early labor. Ice chips should be provided. Food and fluids are likely to be withheld at this time.

- Test-Taking Strategy: Note the strategic word primary. Also, noting the words pushing effectively will assist in directing you to the correct option.

8) B
- Intrapartum NCLEX Questions OB Rationale: The priority nursing action is to stop the infusion of oxytocin. Oxytocin can cause forceful uterine contractions and decrease oxygenation to the placenta, resulting in decreased variability. After stopping the oxytocin, the nurse should reposition the laboring mother. Applying oxygen, increasing the rate of the intravenous (IV) fluid (the solution without the oxytocin), and notifying the health care provider are also actions that are indicated in this situation. Contacting the client’s primary support person(s) is not the priority action at this time.

- Test-Taking Strategy: Focus on the strategic word priority. Focus on the data in the question and note the relationship of the words undergoing induction and the correct option. Also recall that physiological needs are prioritized over psychosocial needs.

After you reviewed your answers through its rationale, you can now proceed to the next set of questions:

Intrapartum NCLEX Questions OB 9-15

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