A nurse on the labor and delivery unit is caring for a patient following a vaginal examination by the provider which is documented as: -1. Which of the following interpretations of this finding should the nurse make?

A nurse is caring for a client who is in the second stage of labor. The nurse observes retraction of the fetal head against the maternal perineum as the head is birthed.
Which condition is the client most likely experiencing?

A nurse has received an order to administer Morphine 5mg IV once immediately.
The available concentration is 2.5 mg/mL. How many mL of morphine should the nurse prepare for administration?

A nurse is assessing a client who is pregnant for preeclampsia.
Which of the following findings should indicate to the nurse that the client requires further evaluation for this disorder?

A patient is in preterm labor at 30 weeks gestation.

Her OB orders antenatal steroids.

The order is for the nurse to administer betamethasone IM and to repeat the dose after 2 hours.

Betamethasone is available as 4mg/mL in 10 mL vials.

How many mL will the nurse draw up in the syringe for each dose?

A nurse is caring for a client who is 39 weeks pregnant and in active labor.

The nurse detects the fetal heart tones above the client’s umbilicus at the midline.

Which of the following positions should the nurse suspect the fetus is in?

A woman’s obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living.

One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation.

What is her gravidity and parity using the GTPAL System?

A nurse is caring for a client in the first stage of labor who is undergoing external fetal monitoring and receiving IV fluids. The nurse observes variable decelerations in the fetal heart rate on the monitor strip.
Which of the following is the correct interpretation of this finding

A nurse is leading a discussion about contraception with a group of 14-year-old clients. After the presentation, a client asks the nurse which method would be best for her to use.
Which of the following responses should the nurse make?

A nurse is caring for a client in the second stage of labor.

The nurse observes retraction of the fetal head against the maternal perineum after the fetal head is birthed.

What potential condition could the client be experiencing, what parameters should the nurse monitor to assess the client’s progress, and what actions should the nurse take?

A nurse is caring for a client who is receiving opioid epidural analgesia during labor.
Which of the following findings is the nurse’s priority?