A patient at 32 weeks gestation in preterm labor is given terbutaline. Her heart rate rises to 135 bpm and she develops mild pulmonary edema. Which action demonstrates the best nursing judgment?, Administer a second dose immediately, Encourage ambulation to reduce fluid retention, Hold the medication, notify the provider, and monitor respiratory status, Increase IV fluids to improve perfusion, During oxytocin induction, a patient exhibits tetanic contractions with minimal fetal variability. The nurse reduces the infusion and administers oxygen. Which rationale explains this intervention?, To prevent maternal hypotension, To reduce the risk of uterine rupture and fetal hypoxia, To accelerate laborTo accelerate labor, To prevent postpartum hemorrhage, A patient at 29 weeks gestation receives betamethasone for fetal lung maturity. She has poorly controlled gestational diabetes. What would be the most critical nursing action to balance maternal-fetal safety?, Hold the betamethasone dose, Administer an additional dose of insulin prophylactically, Monitor maternal blood glucose and adjust insulin as needed, Monitor fetal heart rate only, A postpartum patient with hypertension and uterine atony is considered for methylergonovine or Hemabate. Which is the safer choice, and why?, Methylergonovine, because it is less likely to increase blood pressure, Hemabate, because methylergonovine is contraindicated in hypertension, Both are equally safeBoth are equally safe, Neither; , A Rh-negative mother at 28 weeks is scheduled for Rhogam. Lab results show she has already developed anti-D antibodies. How does this affect the nurse’s plan?, Administer Rhogam as scheduled, Rhogam is ineffective; consult provider for alternative monitoring, Delay Rhogam until delivery, Give double the usual dose, A patient receiving misoprostol for labor induction develops hyperstimulation with fetal tachycardia. The nurse is preparing to stop the medication. What is the most important next step?, Administer oxygen and IV fluids, Encourage ambulation, Apply ice packs, Call the pediatric team, A patient with severe preeclampsia is on magnesium sulfate and develops absent reflexes, RR 8/min, and urine output <30 mL/hr. Which intervention demonstrates the highest level of clinical judgment?, Stop the infusion, administer calcium gluconate, notify provider, and monitor vitals, Increase infusion rate to counteract hyporeflexiaI, Encourage deep breathing and ambulation, Continue infusion and document findings, Postpartum, the patient receives oxytocin for uterine atony, but the uterus remains soft after massage. Which action best demonstrates nursing prioritization?, Administer an alternative uterotonic as ordered, Increase oxytocin infusion indefinitely, Place the patient in Trendelenburg position, Encourage ambulation , A patient with a history of asthma is scheduled for cervical ripening. She asks about misoprostol vs prostaglandin E2. What response demonstrates the best nursing reasoning?, Both are safe without precautions, Misoprostol may trigger bronchospasm; prostaglandin E2 is safer, Avoid induction altogether, Use misoprostol with supplemental oxygen only, Hemabate is ordered for a patient with PPH. She has a history of asthma and cardiovascular disease. Which factor is most critical in planning safe administration?, Monitoring for bronchospasm and hemodynamic changes, Administering a slow IV push only, Ensuring adequate fluid intake, Administering concurrently with oxytocin, A postpartum patient receives tranexamic acid for hemorrhage. Lab values show elevated D-dimer and slightly prolonged PT. Which nursing judgment is most appropriate?, Administer the TXA as ordered but monitor for thrombosis, Hold TXA indefinitely, Administer heparin simultaneously, Monitor fetal heart rate only, Prostaglandin E2 is used for induction in a patient with a previous low-transverse cesarean. Continuous monitoring shows late decelerations. What nursing action demonstrates highest priority?, Continue infusion and document, Stop infusion and prepare for potential emergency delivery, Change maternal position only, Administer analgesia, Magnesium sulfate is given for neuroprotection in a preterm labor patient. How does monitoring differ from its use in preeclampsia?, Reflexes and respiration monitored more closely in preeclampsia, Same monitoring in both situations, Fetal heart rate is not monitored in preeclampsia, Only maternal BP is monitored in preterm laborOnly maternal BP is monitored in preterm labor, A postpartum patient with heavy bleeding receives TXA. Which outcome indicates medication effectiveness?, Stabilization of vital signs and decreased blood loss, Resolution of uterine atony, Fetal heart rate normalization, Pain reduction, Methylergonovine is given postpartum. The patient’s BP rises to 180/110 mmHg. Which demonstrates highest-level nursing judgment?, Continue administration, Hold the medication and notify provider, Massage uterus only, Administer Hemabate concurrently, A Rh-negative mother delivers an Rh-positive baby. How does the nurse determine the correct timing and dose for Rhogam?, Within 72 hours postpartum, standard dose unless high-titer antibodies, Immediately after labor, regardless of maternal antibodies, Only if maternal BP is low, At 28 weeks only, Terbutaline is given for preterm labor. The patient develops chest tightness and arrhythmia. Which nursing action demonstrates critical clinical judgment?, Administer oxygen and notify provider, Increase terbutaline, Encourage deep breathing only, Monitor and wait, Hemabate vs methylergonovine is considered for a patient with PPH. She has a history of hypertension and asthma. Which drug is preferred and why?, Hemabate may cause bronchospasm; methylergonovine may worsen hypertension, Either is safe, Use both concurrently, Only oxytocin is safe, Betamethasone is administered to a preterm patient. What assessment indicates maternal-fetal safety in the presence of gestational diabetes?, Frequent maternal glucose checks and fetal heart rate monitoring, Monitor maternal BP only, Fetal lung maturity , Assess maternal hydration , During prostaglandin E2 induction, late decelerations appear. Which reflects highest-level nursing reasoning?, Stop infusion, reposition patient, notify provider, and prepare for emergency delivery, Continue infusion and monitor, Encourage ambulation only, Administer analgesia.

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