Maternal Child

A female carries one positive genetic marker for Huntington's disease. Her partner does not have any markers for the disease. For which reason is it so important for this family to identify persons with the genetic marker?

Symptoms do not manifest until 30 to 50 years of age.

The nurse in labor and delivery is preparing to initiate labor induction with the administration of oxytocin. After research about oxytocin, the nurse is aware of which fact about the drug?

Synthetic oxytocin is identical to endogenous oxytocin.

The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, "I think that my baby is deformed inside and we have to fix him." Which risk factor is most strongly related to possible postpartum psychosis (PPP)?

Separation from the baby's father

The nurse is providing care to a postpartum patient after an emergency cesarean due to eclampsia. The patient received spinal anesthesia prior to delivery. Magnesium sulfate is infusing 2 g/hr in 100 mL of IV fluid. Which assessment finding will cause the nurse to administer calcium gluconate to the patient via IV push?

Serum magnesium level is 10 mg/dL.

The nurse works in a urologist's office. A male patient is scheduled for routine fertility testing. For which test does the nurse refrain from making preparation?

Sexual functioning

The nurse at a prenatal clinic is aware of the important tasks that each expectant mother will need to address. When an expectant mother states, "I will give up everything I have to make sure this baby is safe and well-cared for," which task is the mother addressing?

Stating a willingness to give of oneself

The nurse is providing care for a prenatal patient who is told she will require a cesarean delivery because of cephalopelvic disproportion. Which explanation of the condition will the nurse provide to the patient?

The size and/or shape of either the fetal head or patient pelvis is an issue.

The nurse preceptor is teaching a nursing student about the physiology of the fetal heart rate (FHR) pattern. Which statement by the student indicates successful teaching about this concept?

The sympathetic nervous system is responsible for heart rate variability."

The nurse is counseling a couple in the third trimester of pregnancy and recommends the couple attend childbirth education classes. For which reason is the nurse least likely to recommend the classes?

The techniques will enable a medication-free delivery.

A patient who is pregnant shares details of being in a physically and psychologically abusive relationship with her baby's father. Which statement by the nurse is indicative of AWHONN's standing regarding intimate partner violence (IPV)?

"Let's explore ways to protect you and stop the abuse you have been enduring."

The nurse is educating the pregnant patient with a body mass index (BMI) of 33. The nurse knows that teaching has been effective when the patient states which of the following?

"My child may be at increased risk for birth injury."

When performing a physical assessment on a patient during the initial prenatal visit, the nurse notes spongy gums prone to bleeding during the oral exam. Which comment by the nurse is appropriate?

"Oral bleeding can contribute to anemia."

The nursing is caring for a patient in active labor with significant back pain. The patient has requested nonpharmacologic methods of pain relief. The nurse thinks that sterile water injections may help with her pain management. Which of the following explanations should the nurse explain to the patient?

"We will inject 0.5 mL of sterile water subcutaneously, and it will last for an hour to 90 minutes."

The nurse is conducting a staff education session about preeclampsia and eclampsia complications. Which statements by the nurse are accurate about HELLP syndrome? Select all that apply.

1. This syndrome destroys red blood cells. 2. This syndrome impacts the amount of platelets. 5. This syndrome increases liver enzymes.

A postpartum patient states, "I am really in pain." For which sources of pain will the nurse specifically assess the patient? Select all that apply.

1. Uterine contractions 2. Perineal trauma 3. Breast engorgement 4. Hemorrhoids 5. General soreness

A patient in the third trimester of pregnancy expresses concern to the nurse about changes to her muscles, joints, and bones. Which conditions does the nurse reassure the patient are normal changes of pregnancy? Select all that apply.

1. Waddling gait 2. Low back pain 3. Increased risk of falls

A couple informs the nurse they have decided to make arrangements for a home birth. Which criteria will the nurse share with the couple regarding a safe home birth? Select all that apply.

2. The pregnant woman must be in good health with a normal pregnancy. 4. Adequate medical supplies and resuscitation equipment is available.

The nurse is aware of concern about the increasing numbers of severe maternal morbidity (SMM). It is believed to be related to changes in the overall health of the population of women giving birth. Which reasons does the nurse identify as causes of SMM? Select all that apply.

Preexisting chronic medical conditions

During the fourth stage of labor, which actions by the nurse will promote parent-newborn attachment? Select all that apply.

1. Delay administration of eye ointment until parents have held newborn. 4. Initiate skin-to-skin contact with a warm blanket over the neonate and parent. 5. Explain expected neonatal characteristics such as molding, milia, and lanugo.

Which factors will facilitate the integration of evidence-based practice (EBP) in the maternity-newborn clinical setting? Select all that apply.

1. Frame clinical questions in PICOT format. 2. Collect the best and most relevant evidence. 3. Cultivate a spirit of inquiry in the workplace.

The obstetric nurse is assessing the laboring patient for pain. Which of the following should the nurse identify in a pain assessment? Select all that apply.

1. Intensity of contractions 2. Presence of pain in the neck or back 3. Frequency and duration of contractions 4. Signs of anxiety

The nurse is helping the patient assume a position for placement of an epidural. Which of the following positions are appropriate for placing an epidural? Select all that apply.

1. Lateral position with head flexed toward chest 4. Sitting position with elbows on knees

The nurse is counseling a female patient diagnosed with anovulation as a cause of infertility. Which information does the nurse provide to the patient? Select all that apply.

1. Methods for dietary planning 5. Instructions for clomiphene citrate

The nurse is providing dietary teaching to a patient in the first trimester of pregnancy who is overweight. Which daily dietary suggestions does the nurse make? Select all that apply.

1. One cup of 100% juice and cup of dried fruit. 5. One cup of milk, 1 cup of yogurt, and oz of cheese

The nurse is monitoring a patient when the EFM strip conveys fetal bradycardia. Which action would be the most urgent for the nurse to take?

Check the mother for vaginal bleeding and severe abdominal pain.

A nurse-preceptor is explaining to a new nurse about the tocodynamometer. The new nurse is looking at the EFM paper and sees that, of the two tracked heart rates, the one on the bottom is in the 80s; she is concerned that the fetal heart rate is bradycardic. Which of the following should the nurse do first?

Check to make sure that the maternal radial pulse is being recorded correctly.

In a research study performed by Schneuder, L., Crenshaw, J., and Gilder, R. (2017), which action by the nurse will be implemented following a cesarean delivery?

Encourage skin-to-skin contact between the mother and neonate.

The nurse on a postpartum unit focuses on how to assist the father in identifying his role with the neonate. Which intervention by the nurse is most helpful?

Encourage the couple to identify mutual expectations of the fathering role.

The nurse is providing postpartum care for an adolescent mother and her family. Which factor is most important for the nurse to consider when planning teaching about neonatal care?

Information must be presented on an age-appropriate level.

A patient at 36 weeks gestation reports a constant dull backache, regular frequent contractions that are painless, and lower abdominal pressure. Physical examination reveals intact membranes and cervical dilation of 3 cm. Which order by the health care provider is unexpected by the nurse?

Obtain fetal fibronectin levels

The nurse manager in the labor and delivery unit decides that all unit nurses are to take a course in electronic fetal monitoring (EFM) as recommended by AWHONN. Which is the most important issue related to EFM the nurse manager is expecting to address?

Reduce failure to accurately assess maternal and fetal status.

A patient who is at 39 weeks gestation is scheduled for amniotomy. The nurse is aware that which criteria must be met before the procedure?

The fetal head is currently engaged in the maternal pelvis.

The postpartum nurse is planning a home visit to a mother who delivered her baby 1 week ago. Which finding indicates to the nurse a possible problem with mother-infant bonding?

The mother focuses the visit on her physical recovery and concerns.

The postpartum nurse notices that a new mother has her neonate unwrapped and undressed "to check out the baby." For which reason does the nurse conclude the neonate is at risk for cold stress?

The neonate is moving extremities about.

The nurse works in a postnatal nursery and is required by hospital policy to perform a gestational age assessment on specified neonates. On which neonate is the nurse most likely to perform this assessment?

The neonate with a birth weight of 4,100 g

Which behavior does the nurse identify as a demonstration of unidirectional bonding between a parent and infant?

The parents call the baby by name.

The nurse works in an infertility clinic and is interviewing a male patient whose partner has been unable to conceive. Which finding obtained during a health history will cause the nurse greatest concern?

The patient had a vasectomy reversed.

The nurse-educator is instructing on the physiology of fetal heart rate (FHR) patterns. He is showing the students an EFM strip, and there is a tracing that is classified as baseline 140 bpm, moderate variability, accelerations, and 2 decelerations. A half hour later the baseline is 150 bpm, there is minimal variability, accelerations, and 3 decelerations. Which of these findings would the nurse attribute to the parasympathetic nervous system?

The presence of 2 and then 3 decelerations.

The nurse is using the Parer and Ikeda five-tier system. A co-worker is concerned about a patient whose fetus has an acceptably low risk of acidemia and evidence of impending fetal asphyxia. What is the next best step for the nurse?

Prepare for urgent delivery.

The nurse is collecting health information from a patient who is early in the first trimester of pregnancy. Which topic is most important for the nurse to discuss with the patient after learning that the patient works for a commercial cleaning company?

Risk related to exposure to environmental toxins

The lactation nurse visits the room of a patient who is postpartum and being prepared for discharge. The nurse plans to provide breastfeeding information aimed at assisting the patient to continue breastfeeding her newborn. Which observation by the nurse indicates a possible disruption to the planned teaching?

The patient is excited about taking her baby home.

The nurse is looking at an EFM strip and sees that the patient is having contractions that are measuring 150 MVU every 10 minutes for the past 2 hours and the fetus is in fetal distress. What would this indicate for next steps?

The patients' contractions are inadequate; the provider could consider an amnioinfusion through the IUPC, and once the fetus has improved, contractions need to be augmented to be more effective.

A couple announces to their parents that the couple is pregnant. One expectant grandmother says, "Grandchildren will call me by my first name. I am not ready to be a grandmother." Which feelings are being expressed by the grandmother?

The pregnancy presents undeniable evidence the grandmother is growing older.

The nurse is counseling a female patient about alcohol use during pregnancy. Which statement by the patient demonstrates successful patient teaching?

"It's best for my baby if I avoid drinking during pregnancy."

A patient in the second trimester of pregnancy seems distressed. With encouragement, the patient states, "I have been totally avoiding physical contact with my husband to avoid prompting any sexual activity." Which statement by the nurse is the best response?

"Nonsexual expressions of affection are important for both of you."

The nurse works in a prenatal clinic that serves a multicultural population. The nurse is culturally aware, and so, which behaviors by a patient are expected due to common restrictive beliefs? Select all that apply

1. A pregnant woman denies sexual intercourse during her third trimester. 5. A pregnant woman refuses to watch a televised eclipse of the moon.

A patient at 34 weeks gestation is in labor with twins. The primary care provider decides the fetuses need to be delivered by cesarean. Which medical and nursing interventions will be in place for this delivery? Select all that apply.

1. Delivery is attended by two medical personnel. 2. The placement of a large-bore IV access is ensured. 4. A hospital with a Level II or III nursery is selected.

The nurse is concerned about the number of infants in the community who die from SIDS even with teaching about "back to sleep" being provided. On which additional preventive measures will the nurse focus? Select all that apply.

1. During pregnancy, women should not smoke, drink alcohol, or use illegal drugs. 2. Infants need to be dressed to prevent infants from overheating during sleep. 3. Mothers need to be informed that breastfeeding reduces the risk for SIDS. 4. Parents should not smoke or allow smoking around their baby. 5. Parents need to avoid products that claim to reduce the risk of SIDS.

A patient in the third trimester of pregnancy is instructed on how to perform daily fetal movement count. The nurse needs to inform the patient what to do if fetal movement is decreased. Which patient actions are appropriately recommended by the nurse? Select all that apply.

1. Eat something. 3. Arrange for a period of rest. 4. Focus on movement for 1 hour.

The nurse explains to a patient who has missed a second menstrual cycle that a combination of presumptive and probable signs is used to make a practical diagnosis of pregnancy. Which signs are expected by the nurse when making a practical diagnosis? Select all that apply.

1. Elevated hCG levels in blood and urine 2. Brownish pigmentation on the face 4. Bluish-purple coloration of vagina and cervix

An infant was recently born weighing 1,498 grams. The nurse understands that the birth weight of this infant is an important indicator of what? Select all that apply.

1. Morbidity rate 3. Mortality rate 4. Infant health outcome

A pregnant patient tells the nurse that her spouse has been diagnosed with Couvade syndrome. Which manifestations does the nurse suspect the spouse is experiencing? Select all that apply.

1. Nausea from unidentifiable causes 3. Significant recent weight gain 4. Unexplainable abdominal pains

A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient's medical record and associates which risk factors related to a possible urinary tract infection (UTI)? Select all that apply.

1. Neonatal macrosomia 2. Use of a vacuum extractor 3. Poor oral fluid intake 4. Urinary catheter during labor

The nurse is encouraging cultural sensitivity among the nonmedical personnel in a prenatal clinic. Which type of family does the nurse identify as including children? Select all that apply.

1. Nuclear family 2. Extended family 5. Blended family

A patient just learns that her unborn fetus has a life-threatening condition and is not expected to survive long term. Which does the nurse include in a plan of care to meet psychological needs of the patient and her partner? Select all that apply.

1. Provide time for the patient to talk about her feelings. 3. Facilitate referrals related to the fetal condition. 5. Ascertain if the patient and partner have previous crisis skills.

When assisting with a vacuum-assisted vaginal delivery, the nurse is aware that adherence to which guidelines for the vacuum device will minimize the nurse's liability in vacuum-assisted vaginal births? Select all that apply.

1. Pump up the vacuum manually to the pressure indicated on the pump. 2. Recognize that cup detachment (pop off) is a warning sign. 3. Understand that pressure should be released between contractions. 4. The procedure is timed from insertion of the cup into the vagina until the birth.

The nurse uses research from Greenberg and Morris (1974) as a guideline for identifying the presence of engrossment in a new baby by the father. Which behaviors exhibit paternal-infant bonding related to engrossment? Select all that apply.

1. Seeing the baby as attractive 2. Perceiving the baby as being perfect 3. Having a desire to touch the baby 4. Indicating an increasing sense of self-esteem 5. Positively commenting about the baby's features

The nurse is providing care for a patient who is at 42 weeks gestation. The patient's primary care provider is suggesting induction, but the patient is resistant. Which facts can the nurse provide if the patient asks about allowing labor to start spontaneously? Select all that apply.

1. Stillbirth or newborn death increases in pregnancies beyond 42 weeks. 2. There is a greater chance of developing complications because of larger fetal size. 5. Postmature fetuses have decreased subcutaneous fat and lack vernix and lanugo.

The labor and delivery unit nurses are adopting methods to reduce the number of women who develop postpartum depression. Research from Dennis and Dowswell (2013) provides evidence-based suggestions regarding beneficial interventions. Which suggestions do the nurses consider? Select all that apply.

1. Telephone-based peer support 3. Interpersonal psychotherapy 5. Professionally based postpartum home visits

The nurse is obtaining a baseline fetal heart rate (FHR). At 1:00 pm the baseline FHR was 130, at 1:20 pm FHR baseline was 166, and at 1:40 pm the baseline FHR was 204. What should the nurse assess from this trend of fetal baselines? Select all that apply.

1. The 1:00 pm FHR baseline warranted no further action. 5. The 1:40 pm FHR baseline should be corrected immediately.

The nurse is explaining to a mother that her newborn's blood test indicates a high level of unconjugated bilirubin, which causes jaundice. Which information does the nurse present to the mother? Select all that apply

1. The blood test does not indicate a pathological disease. 2. The newborn's liver converts bilirubin to a water-soluble substance. 3. An abundance of RBCs and RBC short life span contributes to the condition. 5. Elevated bilirubin can be excreted in the urine and stool.

The nurse in a postpartum unit evaluates new parents for risk factors that can indicate problems with bonding/attachment. Which situations does the nurse recognize as a cause for bonding/attachment problems? Select all that apply.

1. The mother experienced eclampsia in the third trimester of pregnancy. 2. The neonate is being treated for meconium aspiration syndrome. 3. The mother experienced dystocia in the second phase of labor.

A patient at 35 weeks gestation arrives at the prenatal clinic in physical distress. Assessment reveals hypotension, thready pulse, shallow respirations, pallor, cold and clammy skin, and anxiety. The nurse does not find evidence of vaginal bleeding but suspects placental abruption. For which reason does the nurse call for emergency transport to the hospital? Select all that apply.

1. The patient has all the symptoms of hypovolemia. 3. The absence of blood can indicate a concealed hemorrhage. 4. The patient and fetus are at risk of death from hypovolemic shock. 5. The patient states a sudden onset of severe symptoms.

The nurse notes that a patient in the third trimester of pregnancy feels unable to "mother" her unborn child. Which information about the patient helps the nurse identify the sources of the patient's ambivalence? Select all that apply.

1. The patient is estranged from her mother. 3. The patient expresses a loss of independence. 5. The patient expresses disgust about body changes.

The nurse is assessing patients who are postpartum. Which patients does the nurse identify as being at increased risk for respiratory complications? Select all that apply.

1. The patient who was placed on bedrest for threatened abortion 2. The patient with preeclampsia treated with magnesium sulfate 5. The patient who received large amounts of IV fluid due to blood loss

The nurse is attending to a patient who just delivered a term fetus who was stillborn. Which nursing interventions will the nurse use to provide emotional support to the couple? Select all that apply.

2. Cut a lock of the neonate's hair and get foot and hand prints. 5. Allow parents unlimited time to hold and touch the neonate.

The lactation nurse takes a phone call from a mother who is breastfeeding her 2-month-old infant. The mother reports an area of redness and warmth on the breast and a painful burning sensation when breastfeeding. Which statement by the nurse is correct if mastitis is suspected?

"Continuing to breastfeed will help clear up the condition."

A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands?

"Due to my weight, there is a possibility that I may develop gestational diabetes."

A patient in the second trimester of pregnancy is discussing breastfeeding and other options with the nurse. Which question is most important for the nurses to ask?

"How does your partner feel about you breastfeeding?"

The nurse is collecting information from a parent whose infant has frequent diaper dermatitis. Which comment by the parent indicates a possible cause of the condition? Select all that apply.

"I buy an antibiotic ointment specified for skin rashes."

A mother has a child who is 4 years of age, and she is expecting another child. The mother expresses concern to the nurse about how the older sibling will receive the newborn. Which intervention shared by the mother does the nurse discourage?

"I think that I will just bring the new baby home as a surprise."

A patient in the second trimester of pregnancy becomes upset when the health care provider (HCP) schedules several screening tests. The patient voices concern that something is wrong with her baby. Which statement by the nurse will reduce the patient's anxiety?

"Screening tests are primarily to identify those without disease or abnormality."

The postnatal nurse is making a newborn visit to the parents who are from a different country. The nurse finds the newborn swaddled in a heavy blanket and wearing a knitted cap. The newborn has wet hair and is restless with rapid breathing. Which initial comment from the nurse is appropriate?

"Share with me how babies are cared for in your country."

The nurse is collecting information from a new mother who is bottle-feeding her infant. Which comment, if made by the mother, requires the nurse to provide patient teaching?

"Sometimes I will add a little water to the formula if I am running low."

The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, "I do not need to stop smoking my electronic cigarette because it will not harm my baby." Which is the best response by the nurse?

"Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity."

The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that a pregnant patient may have been using marijuana. With consent, the nurse confirms via urine drug screen. Which statement by the nurse is most appropriate?

"Using marijuana while pregnant can have a negative effect on the neurological development of your baby."

The nurse is observing a new mother interact with her baby and notices the mother holding the baby close to her body. However, the nurse also notices that the mother does not hold the baby in an enface position. Which question is most appropriate for the nurse to ask?

"What can you tell me about your family's beliefs with new babies?"

The nurse is counseling a 15-year-old pregnant patient at her first prenatal appointment. Which patient teaching by the nurse is appropriate?

"Your response to pregnancy, labor, and delivery will differ from that of an adult because your cognitive development is not yet complete."

The nurse is caring for a 30-year-old woman who is G4P2012 at 38 weeks and 5 days gestation. The nurse is watching her EFM strip and notices that for the past 10 minutes the fetus has shown minimal variability. Which actions should the nurse perform? Select all that apply.

1. Check to see if the patients' membranes have been ruptured, as there could be potential cord compression. 2. Look to see what the patient's position is and is she supine; change her to left side lying. 3. Continue to watch the strip, but know that this could be due to fetal sleep.

The nurse is caring for a pregnant patient who expresses concern about the effects of electronic fetal monitoring (EFM) on her labor and delivery. Which responses by the nurse would be appropriate in this situation? Select all that apply.

1. "There is a reduced rate of seizures if a patient has EFM during labor." 4. "There is a link between the rate of cesarean sections and continuous EFM." 5. "There is an increase in operative vaginal births and the use of continuous EFM."

The nurse is aware that there are multiple classifications for cesarean deliveries. Which situations does the nurse classify as an unscheduled cesarean birth? Select all that apply.

2. There is evidence of a prolapsed cord with membrane rupture. 3. The cervix fails to fully dilate after prolonged labor. 4. Patient has a preexisting cardiac health condition. 5. There is recognition of placenta previa with mild bleeding.

The nurse is teaching the patient about the trends and risks of epidural anesthesia. Which of the following should the nurse relay about the risks of epidural anesthesia? Select all that apply.

2. When using an epidural, women are less likely to sweat with a fever. 4. Labor may be longer with an epidural. 5. There is a higher rate of fever and sepsis.

A new mother states, "I don't want anyone around my baby. I need to protect him from getting sick." Which statement by the nurse will help the mother to understand neonatal immunity? Select all that apply.

3. "The baby has natural passive immunity from you for a few months." 4. "We will give the baby gamma globin for short-term immediate protection."

The nurse is monitoring the fetal heart rate (FHR) tracing and sees that her patient has a tracing with a baseline of 120, moderate variability, with absence of decelerations and accelerations. According to the National Institute of Child Health and Human Development tier system, what category tracing does the patient's fall into?

A Category I tracing

The obstetric nurse is managing her patients while covering for another nurse who is on a break. Which patient is the lowest priority?

A patient with Category I FHR tracings

The nurse is providing care to a patient who is diagnosed with dystocia related to hypertonic uterine dysfunction. Which medical intervention does the nurse implement for this patient?

Administer morphine to decrease contractions and promote uterine rest.

The nurse is teaching a class about embryonic and fetal development to couples in the early stage of pregnancy. For which reason does the nurse emphasize the first 8 weeks of gestation?

All organ systems are developing during this period.

The nurse in the neonate nursery notices a neonate, born 45 minutes ago, is unresponsive to external stimuli, and has a respiratory and heart rate below normal range. Which action does the nurse take?

Allows the neonate to naturally continue deep sleep

The nurse is providing care for a patient who is 42 years of age and in the first trimester of her pregnancy. For which possible complication will the nurse closely monitor the patient and fetus?

Alterations in fetal chromosomal studies

The nurse is assisting a patient in the use of an ethical decision-making model related to quality of life. Which question is inappropriate when using this model?

Are arrangements made for prolonging life?

A patient is scheduled for transvaginal ultrasound testing. Which preparation by the nurse is appropriate?

Ascertain whether the patient has a latex or banana allergy.

The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action does the nurse perform prior to assessing the patient's uterus?

Ask the patient to void.

A patient is threatening spontaneous abortion at 18 weeks gestation. The patient's two previous pregnancies aborted in the same time frame. The patient states, "They want to sew my cervix shut." The nurse shares the terminology for surgical treatment of incompetent cervix, which is _____

CERCLAGE.

The terminology intrauterine inflammation or infection or both or Triple I is now used instead of the term ________. acenta, and the fetal membranes.

CHORIOAMNIONITIS

Premature rupture of membranes is defined as rupture of the ________ membranes before the onset of labor but at term.

CHORIOAMNIOTIC

The nurse is caring for a 24-year-old woman who is G1P0 at 40 weeks, 1 day gestation and in active labor. She has just received an epidural and now complains of "an itchy feeling all over." Her vitals are as follows: HR 120, RR 12, BP 130/74, T 98.8, and O2 sat 98%. Which action should the nurse take first?

Call the health care provider regarding the patient's pruritus to order an antipruritic medication.

A patient arrives at labor and delivery for the induction labor for her first child. The patient tells the nurse, "I can't believe how easy this is just to pick a day, sign a paper, and have a baby." Which action does the nurse take before the induction process?

Call the health care provider to validate patient understanding.

A patient who has just received confirmation that she is pregnant is distressed because she has a seizure disorder that she manages with carbamazepine. Which is the nurse's greatest concern?

Carbamazepine is teratogenic and causes neural and facial defects

The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient?

Carboprost-tromethamine

A patient who is pregnant expresses a desire to attempt a vaginal delivery after a cesarean birth 2 years before. The primary care provider initiates trial of labor after cesarean (TOLAC) and vaginal birth after cesarean (CVAC) screening. The nurse is aware that which patient information will likely disqualify the patient for CVAC?

Cesarean due to pelvic abnormalities

A patient who is expecting her first baby tells the nurse, "I am afraid of the whole birth experience and plan to ask the doctor for a cesarean delivery." Which response by the nurse is most appropriate?

Cesarean will cause you issues with additional pregnancies."

A couple is planning for the birth of their first child and is discussing the difference between a physician and a midwife. Which information presented by the couple does the nurse validate as being true?

Physicians provide care for both low- and high-risk patients.

The nurse in a labor and delivery department carefully assesses postpartum patients for signs of complications related to hemorrhage. Which factor makes it most difficult to identify the risk of hemorrhage through vital sign evaluation?

Changes in blood pressure may not be an immediate sign.

The nurse is providing care for a new mother during a follow-up visit 6 weeks after a vaginal delivery. The mother begins to cry and reports difficulty with eating and sleeping. The nurse identifies postpartum blues and cites which reason as the most likely cause?

Changes in hormonal levels

The nurse in a prenatal unit is providing care for a patient who experienced PPROM at 32 weeks gestation. Which assessment does the nurse consider unnecessary?

Check for cervical dilation

The nurse is caring for a baby who is experiencing fetal tachycardia. Which action should the nurse take next?

Check maternal allergies in the patient chart.

The nurse is discussing contraception with a couple before discharge following the birth of a first child. The couple are uncertain about the method but are certain about avoiding pregnancy for at least 2 years. Which method does the nurse recommend?

Depo-Provera

The nurse is counseling a couple who just learned their 16-week fetus tested positive for a serious genetic disorder. Which action by the nurse is inappropriate upon learning that the couple plan to continue the pregnancy?

Determine whether termination is still a consideration.

The nurse continues to monitor a patient after a vaginal delivery with an estimated blood loss of 1,000 mL. Which assessment finding does the nurse recognize as requiring Stage 3 hemorrhage protocol?

Development of abnormal vital signs.

The nurse is counseling a female patient who has unsuccessfully attempted to become pregnant through a variety of methods and treatments for infertility. Which psychosocial manifestation is the nurse most likely to recognize?

Difficulty accepting pregnancy if it does occur

An internal fetal monitor has been ordered for Chrissy, a 24-year-old G2P0010 at 38 weeks and 1 day gestation. Her medical history is significant for a history of pregnancy-induced hypertension. Her laboratory values are as follows: H/H 11/30, O negative, RPR negative, GBS positive. Based on Chrissy's history and presentation, what action should the nurse take next?

Discuss with the health care provider that Chrissy is GBS positive and therefore should not receive an internal monitor.

The nurse is providing care for a patient at 30 weeks gestation. Which topic related to patient concern or discomfort is most important for the nurse to address?

Dizziness when lying supine

The nurse is providing care for a neonate during the fourth stage of labor. Which action does the nurse take during this stage?

Dry the neonate immediately.

The nurse is teaching a prenatal class. For which reason does the nurse emphasize the importance of managing maternal fear during labor?

Dystocia is associated with extreme fear.

The nurse is taking a history of a mother who admits to cocaine drug use. Which action should the nurse take first?

Educate the patient of the risks associated with cocaine use during pregnancy.

A patient is in her first trimester of her second pregnancy. The patient's first child was born with a trisomy 21 defect. The patient is requesting testing to determine whether the current fetus has the same defect. Which initial testing does the nurse expect the HCP to prescribe?

Fetal ultrasound

The nurse is providing care to a patient who is at 41 weeks gestation. Which factor about the patient does the nurse consider as an indication of late-term or post-term pregnancy?

Fetus is identified as a male

A patient expresses a desire to become pregnant for a second child. The nurse notes that the patient's first child was born with a serious neural tube defect (NTD) and died of complications at 18 months of age. Which recommendation does the nurse make to this client?

Folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

A patient is confirmed to be pregnant. Obstetric history includes two sets of twins born at 30 and 32 weeks gestation, respectively, a singleton birth born at 39 weeks gestation, and two pregnancies lost in the first trimester. In which way will the nurse define the patient's obstetrical history?

G6, T1, P4, A2, L5

A patient at 13 weeks gestation asks the nurse how her baby is nourished during pregnancy. Which information does the nurse use to explain the process to the mother?

Glucose, amino acids, and oxygen pass through the placenta from mother to baby.

The patient is having an unmedicated childbirth and has begun to bear down. She vocalizes, "The baby is coming!" Which action should the nurse take?

Have the patient assume a comfortable and upright position.

A patient who is pregnant does not remember the last date of her menstrual period. In which manner does the nurse expect the estimated date of delivery (EDD) to be determined for this patient?

Having an ultrasound examination

The nurse is assessing a term neonate delivered to a mother with a history of drug and alcohol abuse. Which finding does the nurse relate to the mother's history?

Head circumference is below the 10th percentile of normal for gestational age.

A nursing student is asked to set goals that will decrease the fetal death outcomes during delivery. What guidelines will the nursing student use to assist in setting her goals?

Healthy People 2020

The nurse has made it a goal to increase the rate at which women begin prenatal care in the first trimester. The nurse relates this decision to national goals for better maternal and infant outcomes. What guidelines will the nurse use to guide her maternal health goals?

Healthy People 2020

The nurse is reviewing the chart of a 35-year-old G4P2012 woman. The patient is at 38 weeks, 4 days and is in active labor with SROM clear fluid 2 hours ago. What action should the nurse take?

Help the patient change her position from side to side every 30 minutes.

A pregnant patient is at the prenatal clinic for a routine visit at 30 weeks gestation. The nurse monitors the patient for indications of physiological demands by the fetus on the patient. Which finding causes the nurse concern?

Hgb of 9.5 g/dL and Hct. of 30%

The nurse is caring for a patient who is in labor with her first child. The patient's mother is present for support and notes that things have changed in the delivery room since she last gave birth in the early 1980s. Which current trend or intervention may the patient's mother find most different?

Hospital support for breastfeeding

A patient in the first stage of pregnancy is discussing the options for feeding her infant, and asks the nurse, "Which is the most important reason I should consider breastfeeding my baby?" Which is the most significant reason the nurse presents?

Human milk contains multiple antibodies, enzymes, and immune factors.

The nurse is caring for a 14-year-old patient who is 32 weeks pregnant. After complaining of genital sores and discomfort, the patient tests positive for syphilis. The fetus is at increased risk of which condition?

Hypertension

A pregnant patient and her spouse live in the same home as the spouse's family who is not supportive of the pregnancy. The patient feels the family is ruining the happiness about the pregnancy. Which is the most important determination for the nurse to make?

If threatened or actual abuse from household members occur toward the patient

The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient?

Immediate hospitalization in a psychiatric unit

The patient is a 26-year-old G1P0 at 38 weeks, 2 days of gestation. She is at her provider's office for a visit and complains to the nurse of wrist pain, fatigue, increased discharge, and "feeling heavy." Which complaint could be a sign of impending labor?

Increased discharge

A patient with a history of hypertension is giving birth. During delivery, the staff was not able to stabilize the patient's blood pressure. As a result, the patient died shortly after delivery. This is an example of what type of death?

Indirect obstetric death

The nurse is interested in promoting coparenting because of the high likeability that at some point, both parents will be working outside the home. After reading research by Davis, Schoppe-Sullivan, Mangelsdorf, and Brown (2009), the nurse learns that which factor impacts coparenting the most?

Infant temperament

The nurse is preparing discharge teaching for a postpartum patient who exhibits signs and symptoms of an episiotomy infection and is on oral antibiotic therapy. Which discharge teaching will the nurse provide regarding pain management?

Information applicable to medication therapy

A patient is being prepared for an unplanned cesarean section. Which pre-procedure information is most important for the nurse to report before the administration of regional anesthesia?

Laboratory value indicating a low platelet count

Loutzenhiser, McAuslan, and Sharpe (2015) performed a study regarding maternal and paternal fatigue and factors associated with fatigue across the transition to parenthood. Which evidence-based conclusion is made regarding fatigue and the transitioning parents?

Levels of prenatal and postnatal fatigue are associated.

The nurse is caring for a 34-year-old woman who is G2P1001 at 39 weeks and 1 day. The patient is an observant Muslim and is in active labor. Which outcome would be the most effective form of applying culturally sensitive communication?

Making sure that the patient's hair is covered constantly

The nurse is providing care for a patient in the third trimester of pregnancy. Which topic of patient education is most likely to be needed during this time?

Management for commonly experienced discomforts

The nurse is experiencing an ethical dilemma when confronted with a situation in which either the mother or fetus is predicted to die. The nurse feels bound by the ANA Code of Ethics to protect both patients. Which aspect of care during an ethical dilemma will guide the nurse?

Maternity nurses are bound to advocate first and foremost for the well-being of the mother.

The nurse in an OB's office is evaluating a patient who exhibits vaginal bleeding at 30 weeks gestation. The patient is prescribed bedrest at home and instructed to avoid lifting. The patient states, "I cannot go to bed, I have an 18-month-old at home." On which topic of the Jonsen model for ethical decision making will the nurse focus?

Medical indications

Dayton et al. (2016) performed qualitative research regarding expectant fathers' beliefs and expectations. The nurse identifies which theme as emerging from this research?

Men described fathering as an extremely difficult task.

The nurse on a maternity unit is an Orthodox Jew whose rabbi teaches that pregnancy terminations are permitted only to save the life of the mother. Which situation becomes possible if the nurse puts aside personal values and assists with elective terminations?

Moral distress

The nurse in the post-delivery unit is encouraging skin-to-skin contact for a mother and neonate after cesarean delivery. Which action, if noticed by the nurse, requires immediate intervention by the nurse?

Mother is supine with the neonate prone on her chest.

The more prepared a pregnant woman feels for the birth of her baby will lower her anxiety and fear. The behavior is referred to as __

NESTING BEHAVIOR

The nurse is providing care for a patient in the second phase of labor. After more than 4 hours of pushing, the nurse suspects fetal dystocia. Which is the greatest risk related to the nurse's suspected complication?

Neonatal asphyxia related to prolonged labor

A patient who is at 30 weeks gestation is involved in a car crash. The nurse recognizes that which initial testing will be used to assess fetal well-being?

Nonstress testing

When a patient is diagnosed with preeclampsia, one sign that the fetus is at risk for hypoxia is a change in amniotic fluid called

OLIGOHYDRAMNIOS

The nurse is assisting with the preparation of a patient admitted for a planned cesarean birth. The patient has signed the consent form and discussed the elected regional anesthesia with the nurse anesthetist. Which is the most important action for the nurse related to anesthesia?

Obtain a baseline fetal heart rate monitor strip.

The EFM tracing shows the following: FHR baseline 166 bpm, moderate variability, and recurrent late decelerations to 100 bpm. Using the five-tier FHR interpretation system, how should the nurse interpret this tracing?

Orange: acceptable low risk of acidemia, prepare for possible urgent delivery

A patient who is 8 months postpartum arrives for an OB appointment. The nurse notices that both the patient and the infant appear unkempt. The nurse anticipates a diagnosis of _______

POSTPARTUM DEPRESSION.

The nurse understands that logically _____ cesarean births are an influential factor related to the overall incidence of cesarean births.

PREVIOUS

The nursing preceptor asks the nursing student how to best determine the intensity of contractions before placing the patient on an electronic fetal monitoring strip. How would the nurse assess this?

Palpate the maternal abdomen during a contraction.

The nursing is caring for a 31-year-old female patient who is pregnant at 37 weeks and 5 days gestation. The patient is having contractions every 3 minutes and was found to have a platypelloid pelvis upon examination. The fetus has an estimated fetal weight of 7 lbs and is in the LOA position. This patient is laboring on the birth ball, and her mother-in-law is helping her labor. The nurse is concerned about the five Ps and their effect on the patient's labor. Which P is the nurse most likely concerned about based on the patient's history?

Passage

A patient in the second trimester of pregnancy is scheduled for a Doppler flow study because the health care provider (HCP) is concerned about an assessment finding during a routine prenatal visit. Which finding of concern does the nurse suspect?

Patient shows no weight gain in 2 weeks.

The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately?

Peripad weighs 100 g within 15 minutes.

As a result of the previously mentioned research study, the nurses in a postpartum facility will implement which evidence-based change?

Promote strategies to decrease fatigue during both prenatal and postnatal periods.

The nurse is providing care in PACU for a patient who just delivered a neonate via cesarean section. The patient reports tightness in her chest. Assessment findings include tachypnea, hypotension, and decreasing oxygen saturation levels. Which complication does the nurse report to the health care provider?

Pulmonary embolism

The nurse is counseling a patient regarding pregnancy. The patient lost her first two pregnancies in the second trimester of gestation for undetermined reasons. Which initial advice does the nurse provide for this patient?

Seek genetic studies.

A patient at 33 weeks gestation with a first pregnancy arrives at the labor and delivery unit with contractions. After monitoring the patient, the nurse determines the woman is in active labor and calls the health care provider (HCP), who prescribes a sleeping medication and sends the patient home. Which action does the nurse take?

Questions the HCP's prescribed treatment

The first sign of shoulder dystocia is the ______ of the fetal head against the maternal perineum after delivery of the head.

RETRACTION

When providing care to a multiparous mother, the nurse needs to assess for the presence of ______ between the older children and the new baby.

RIVALRY

The nurse is aware that some ____ tests, such as multiple marker screening and ultrasound, are offered to all pregnant women.

SCREENING

While reviewing the birth plan of an uncomplicated and healthy patient in active labor, the nurse notices that she would like to have a natural labor and potentially experience hydrotherapy. Which option should the nurse suggest for the patient?

Telemetry to allow for the patient to accomplish her birth plan

The nurse in an obstetrician's office is discussing a patient's request for legally terminating an unwanted pregnancy after the fetus tests positive for Down syndrome. The woman and her spouse have five children from ages 11 to 17 years, and the family lives in an isolated rural area. Which action does the nurse take?

Tell the physician of contextual factors identifying an ethical dilemma.

The nurse is assisting the primary care provider with a vacuum-assisted delivery because of a prolonged second stage of labor. The nurse will inform the primary care provider when which guideline of the procedure is met?

The "three-pull rule" has been achieved.

The nurse is providing care in a school clinic established for the care of adolescent mothers. When assessing a patient who is 11 years of age and pregnant, which deduction regarding the patient's psychosocial development will the nurse recognize?

The adolescent is self-centered and oriented toward the present.

The nurse is discussing genetically linked diseases with a couple planning a pregnancy. The female states, "I am concerned because there is a history of sickle-cell disease in my family." Which information from the nurse is correct?

The male partner needs genetic testing.

The nurse is providing care for a patient who is admitted for cervical ripening. The health care provider has prescribed the use of a hygroscopic dilator. Which conclusion is the nurse likely to draw from the prescribed method of cervical ripening?

The method may be indicative of fetal demise.

The nurse works in the maternal-newborn unit dedicated to management of high-risk pregnancy and delivery. A patient has delivered two children who died from a genetic disorder. The current pregnancy tests positive for the same disorder. Which ethical decision-making model will the nurse use with this patient?

The model that focuses on the quality of life

A patient in the first trimester of pregnancy states, "I don't understand how a term baby can be accommodated by my uterus." Which information by the nurse specifically addresses the patient's comment?

The uterus size increases in size 20 times over a nonpregnant uterus.

A mother who is breastfeeding expresses concern about whether her infant is getting enough milk. Which concrete indicator does the nurse provide to the mother?

There are at least eight wet diapers and several stools per day.

In an attempt to improve the effectiveness of postpartum teaching, the nurse uses the AWHONN acronym POST BIRTH. Which teaching points require the patient to call for 911 assistance? Select all that apply.

Thoughts of hurting self or baby

_________stimulation may be effective in eliciting a change in fetal behavior, fetal startle movements, and increased FHR variability.

VIBROACOUSTIC

Which information is important for the nurse to provide to mothers of infants of 3 months of age regardless of the method of infant feeding?

When growth spurts and dietary increases are expected

A patient is scheduled for a contraction stress test (CST) at 36 weeks gestation. The nurse is aware that a successful testing is dependent on which factor?

Whether uterine contractions can be stimulated

The nurse is reading the patient's chart, which indicates the patient has a "gynecoid pelvis." What finding is expected in this patient?

Wider outlet

The labor and delivery nursing staff is conducting research to determine the benefits of childbirth education (CBE). Which finding does evidence-based practice support?

Women who participated in CBE and/or had a birth plan had higher odds of a vaginal delivery.

The nurse is providing information to a postpartum mother about circumcision of her neonate. The neonate's father states, "We have never done that to any baby boy in my family." Which statement is best for the nurse to make?

"I understand that family culture and beliefs form our way of life."

The nurse is preparing a talk with new parents about immunity and their newborns. Which factual information will the nurse present? Select all that apply.

1. A vaccination is an example of acquired immunity. 3. Placental transfer is how newborns get natural passive immunity. 5. Natural passive immunity protects the baby for a few months after birth.

In preparation for a cesarean birth, the nurse expects which medical-based preoperative interventions? Select all that apply.

1. Administration of narrow-spectrum prophylactic antibiotics 4. Assessment for risk of venous thromboembolism (VTE) 5. Prescription for sequential compression devices prior to surgery

The nurse is providing care to a patient who is in labor. The patient's membranes rupture spontaneously, and the nurse notices meconium-stained amniotic fluid. Which actions does the nurse immediately perform? Select all that apply.

1. Alert the neonatal team of a possible meconium aspiration neonate. 5. Notify the primary care provider about the presence of meconium.

The nurses in a postnatal unit are aware of the fears of new parents with regard to infant abduction. Which interventions by the nurse will alleviate the concerns of the parents? Select all that apply.

1. Allow only visitors with identification to enter the unit. 2. Use the hospital abduction alarm systems. 3. Require unit personnel to wear specific name tags. 4. Footprints and a photo of the neonate are taken for identification purposes. 5. Encourage parents to accompany persons transporting the newborn.

Following a cesarean birth, intrathecal morphine is administered to the patient for postoperative pain management. Of which fact about intrathecal morphine therapy is the nurse aware? Select all that apply.

1. An anesthesiologist or CRNA administers it intrathecally. 2. The nurse needs to closely monitor for common side effects. 3. The drug produces generalized CNS depression. 5. The drug alters perception of and response to painful stimuli.

The nurse is taking the history of a gravida 2 para 1 patient. Which findings in the patient's history warrant further action? Select all that apply.

1. Anemia 2. Severe hemorrhage 3. Infections 5. Eclampsia

The nurse is performing a uterus assessment on a patient who is 20 hours postpartum. The nurse finds the fundus of the uterus to be soft and boggy. In addition, the uterus is displaced to the left and moderate bleeding is noted. If the uterus does not respond to uterine massage, which actions does the nurse implement? Select all that apply.

1. Assist the patient to the bathroom to void. 2. Reassess to determine response to treatment. 3. Administer oxytocin as prescribed. 5. Make the patient NPO for surgery.

In an attempt to improve the effectiveness of postpartum teaching, the nurse uses the AWHONN acronym POST BIRTH. Which teaching points require the patient to call for 911 assistance? Select all that apply.

1. Bleeding that soaks a pad per hour 2. A bad headache with vision changes

The nurse educator is teaching the nursing student the basic principles of using analgesia by using a patient, Christa, as an example. Which of the following demonstrates the basic principles of analgesia during Christa's labor and delivery? Select all that apply.

1. Christa has been in labor for 4 hours. She has been having contractions every 3 minutes. Contractions last a minute and are intense. She has had cervical change from 3 to 5 cm over the past 4 hours. 2. The medication Christa wants is an epidural. After she receives the epidural, the FHR tracing is within normal limits. 5. Christa has a history of opiate abuse and therefore it was understood that she might require higher doses of medications to experience relief.

The nurse is counseling a lesbian couple who have decided to have a child. Which considerations does the nurse present with regard to which partner will become pregnant? Select all that apply.

1. Consider the age and health of each partner. 2. Evaluate each partner's career goals. 3. Decide which partner has better insurance. 5. Identify which woman desires to be pregnant.

The nurse is making a plan of care for a patient who is in the first 24-hour period past a cesarean delivery. Which interventions will the nurse include in regard to medications? Select all that apply.

1. Continue a daily stool softener. 2. Manage pain with morphine. 3. Ensure the availability of naloxone. 5. Administer Rhogam if needed.

The nurse is preparing to teach a class on the benefits of breastfeeding for infants. Which benefits will the nurse include in the presentation? Select all that apply.

1. Decreased incidence of SIDS 2. Fewer cases of necrotizing enterocolitis 4. Decreased risk for developing otitis media

Which actions indicate the is assessing uterine activity? Select all that apply.

1. Feeling the maternal abdomen in between contractions 2. Checking the EFM strip to determine if contractions are either 2 or 3 minutes apart 3. Evaluating that the EFM strip shows 200 MVU every 10 minutes. 5. Evaluating that the EFM strip shows that each contraction lasts 1 minute

The nurse-manager on a labor and delivery unit is monitoring the reasons for cesarean births at the facility. Which reasons contribute to the high rates of cesarean births? Select all that apply.

1. Fetuses in breech position unable to deliver vaginally 2. Increased number of elective or maternal request cesareans 3. Incidences of women of older maternal age getting pregnant 5. Presence of nonreassuring fetal tracings during labor

The nurse is preparing a postpartum patient for discharge. For which reasons does the nurse instruct the patient to call the primary care provider? Select all that apply.

1. Foul-smelling lochia 2. Hot, red, painful breasts 5. Frequent, painful urination

Parents of a neonate are grieving over their child's life-threatening disabilities. The neonate's course of treatment has changed three times in the last 24 hours due to irrational parenteral decisions. Which interventions will the NICU nurse implement in order to fulfill nursing responsibility to both the parents and the neonate? Select all that apply.

1. Inform the parents as to realistic expectations. 2. Use neonate's status with parenteral counseling. 4. Advocate for medical support of the neonate.

The nurse-educator is preparing a presentation on fetal heart monitoring. Which of the following should be included? Select all that apply.

1. Intermittent auscultation should be performed every hour in the latent phase. 2. For Category I situations, intermittent electronic fetal monitoring (EFM) should be performed for 10 to 30 minutes every 1 to 2.5 hours. 4. A patient with membranes ruptured over 24 hours should be monitored during the latent phase every 30 minutes, every 15 minutes during the active phase, and every 5 minutes during the second stage. 5. A patient with fever should be monitored during the latent phase every 30 minutes, every 15 minutes during the active phase, and every 5 minutes during the second stage.

A patient in labor receives high-level regional anesthesia, which inhibits her ability to push during the second state of labor. The primary care provider will use forceps to aid in the delivery of the fetus. Which fetal complications is the nurse aware of being related to a forceps birth? Select all that apply.

1. Intracranial hemorrhage 2. Cephalohematoma 3. Nerve injuries 4. Skin lacerations 5. Skull fracture

A neonate is born after 37 weeks gestation, and the nurse is concerned about avoiding cold stress after discharge. Which suggestions does the nurse give the mother to keep the baby safe? Select all that apply.

1. Keep the baby wrapped in a warm blanket. 3. Position the baby away from vents and drafts. 4. Place a stocking cap on the neonate's head. 5. Change wet clothing immediately.

The nurse is preparing a prenatal plan of care for a patient who is in the first trimester of pregnancy. Which long-range goals does the nurse include in the plan of care? Select all that apply.

1. Perform an ongoing assessment of risk status 3. Build rapport with the childbearing family 4. Make referral to specific resources as needed 5. Implement a risk-appropriate intervention

The nurse is preparing to perform a visual assessment of the perineum of a postpartum patient. The nurse will use the REEDA acronym. Which specific assessments are covered by REEDA? Select all that apply.

1. Perineal coloration 2. Suture line appearance 3. Amount of swelling 5. Soft tissue trauma

A patient who is at 20 weeks gestation is being prepared for an MRI after a nonconclusive ultrasound testing for suspected brain abnormality related to possible zika virus exposure. Which nursing actions are appropriate for this patient? Select all that apply.

1. Provide information regarding the test. 2. Allow patient to express feelings about her high-risk pregnancy. 3. Promote open communication with her primary health care providers. 5. Provide psychological support to the patient and her partner.

During a vaginal delivery, the primary care provider notices greenish yellow coloration on the fetal head during crowning. Intrapartum suctioning is performed as soon as the fetus's head is delivered. The nurse understands the aspiration of meconium will have which effects on the neonate's respiratory function? Select all that apply.

1. Result in airway obstruction 2. Contribute to pulmonary hypertension 3. Result in chemical pneumonitis 4. Cause surfactant dysfunction

A nurse has recently transferred to a labor and delivery unit. During a scheduled cesarean, the nurse notices a prescription for the administration of 1,000 mL of prewarmed IV fluid. For which reason does the health care provider prescribe the fluid in this manner? Select all that apply.

1. Results in an increased maternal core temperature 2. Results in improved neonatal umbilical arterial pH 3. Results in improved Apgar scores

The nurse encourages the patient to bring loved ones to be with her during labor because the nurse knows that their presence does which of the following? Select all that apply.

1. Shortens the length of labor 2. Reduces the likelihood that a patient will require an epidural 5. Increases patients' happiness and satisfaction with the outcome of their birth

The nurse is providing care for a patient who delivered via cesarean 24 hours ago. Which teaching does the nurse provide for the patient and family? Select all that apply.

1. Signs and symptoms to report to health care provider 2. Comfortable positions for feeding the newborn

The nurse is reviewing the purpose of a modified BPP for a patient at 38 weeks gestation. The nurse recognizes which determinations can be made through a modified BPP regarding fetal well-being? Select all that apply.

1. The NST is an indicator of short-term fetal well-being. 3. The test is considered most predictive for perinatal outcomes. 4. The AFI is an indicator of long-term placental function. 5. An AFI of 5 cm is indicative of fetal asphyxia.

The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply.

1. The father exhibited depression during the pregnancy. 2. The birth of this fourth child was unexpected and unplanned. 4. The father is recently estranged from his parents and siblings.

The nurse is assessing a patient at 26 weeks gestation. The patient has chronic hypertension and exhibited hypertension and proteinuria prior to 20 weeks gestation. Previous blood pressure (BP) readings have been in the range of 130 to 140/88 to 90 mm Hg. Due to superimposed preeclampsia, for which additional manifestations will the nurse immediately contact the health care provider? Select all that apply

2. Current blood pressure reading of 162/102 mm Hg 3. Evident pulmonary edema noted with auscultation. 4. Subjective report of severe headache and photophobia 5. Lack of response to verbal and tactile stimulation

The postpartum nurse is preparing to present infant care information to a couple who expresses concern about when to bathe their newborn. Which behaviors will the nurse present as general guidelines? Select all that apply.

2. Daily bathing with soap is not necessary for the newborn. 3. Use a mild preservative-free soap with a neutral pH. 4. Avoid the use of soap on the face of the newborn. 5. Genital and rectal areas should be cleaned at each diaper change.

The nurse is researching for evidence-based practice related to a mother's response during the postpartum period. Based on research by Rubin and Mercer, which finding will the nurse be able to easily implement to change the culture of the unit?

Alterations in terminology

The nurse is providing care for a 45-year-old patient who has just learned she is in the second trimester of pregnancy. The patient thought she was experiencing manifestations of menopause until she recognized fetal movement. Which diagnostic test does the nurse expect to be prescribed for this patient?

Amniocentesis

A multiparous patient reports severe uterine cramps the first day after a vaginal delivery. The nurse is aware the patient is breastfeeding and associates the patient's pain primarily with which occurrence?

An increase in oxytocin release related to the newborn suckling

The nurse educator is in a childbirth education class discussing nonpharmacological ways nurses can assist to enhance labor and spontaneous vaginal delivery. Which of the following facts regarding nonpharmacologic approaches will the nurse use to help illustrate its benefits?

Effleurage is performed in rhythm with breathing during a contraction

The nurse is providing care for a patient in labor. The unborn fetus was diagnosed with severe microcephaly at 20 weeks' gestation. The patient tells the nurse, "We want everything done to save our baby who has as much right to a good life as anyone else." Which ethical approach does this represent?

Egalitarianism

A patient who is pregnant asks the nurse when her baby is due to be born. The patient reports her last menstrual period (LMP) date as April 14. Using Naegele's rule, the nurse will set the estimated date of delivery (EDD) as what date?

January 21

The nurse is providing prenatal care for a patient who is pregnant with a second child. Which understanding about complexity of a second pregnancy does the nurse use to assist the patient with the acceptance of this pregnancy?

Offer strategies for working out a new relationship with the first child.

A patient at 34 weeks gestation is undergoing an ultrasound. The nurse notes that the amniotic fluid is estimated at between 500 and 600 mL. Which deduction does the nurse make from this finding?

Oligohydramnios is present.

The nurse on a postpartum unit is focused on providing care that will assist the mother and father in making the transition to parenthood. For which reason does the nurse review the prenatal and labor records?

Pregnancy and birth experiences, which can either enhance or impede the process of becoming a mother.

The nurse is monitoring a patient who has been in prolonged labor. Which assessment finding will result in the nurse notifying the health care provider about the development of an emergent situation requiring a cesarean delivery?

Recognition of a Category II fetal heart rate pattern

The parents of a newborn male are concerned about providing care for the baby's new circumcision performed with a Plastibell. Which information will the nurse include in the teaching plan for the parents?

Report if penis is red, warm, and swollen and/or there is surgical site drainage.

The nurse works in a postpartum maternal-newborn unit and notices a newborn who is exhibiting signs of distress. Through investigation, the nurse learns the newborn's mother has a history of abusing street drugs. Which facility system does the nurse report as being deficient?

Risk management

The nurse is providing education to a patient who has given birth to her first child and is being discharged home. The patient expressed concern regarding infant mortality and sudden infant death syndrome (SIDS). The patient had an uncomplicated pregnancy, labor, and vaginal delivery. She has a body mass index of 25 and has no other health conditions. The infant is healthy and was delivered full-term. What will be most helpful thing to explain to the patient?

The Safe to Sleep campaign

An infertile couple learns that the female is unable to produce viable eggs. The male partner suggests the use of a surrogate as a means of having a child. The female states, "I don't want your baby with another woman!" The nurse is aware of which psychosocial issue with this couple?

The female is experiencing self-esteem issues.

The nurse works in a prenatal clinic located in a multicultural city. It is important for the nurse to recognize which cultural beliefs as prescriptive? Select all that apply.

The mother will aid the baby's circulation by remaining active during pregnancy. The satisfaction of pregnancy cravings will prevent birthmarks on the baby. A safety pin attached to an undergarment will prevent fetal facial deformities.

The nurse is assisting a patient who is pregnant to prepare for an MRI scheduled to assess fetal brain development. Which situation causes the nurse to notify the radiology department personnel?

The patient has a permanent body piercing.

The nurse is interviewing a new patient who is in the first trimester of her second pregnancy. The patient shares that her first child was born at 36 weeks gestation. Which information does the patient share that places the patient at risk for a second premature birth?

The premature labor and birth was unexpected and followed a normal pregnancy.

A 40-year-old G5P1031 is attending a childbirth education class. During the class, the woman says, "The worst part of contractions with my last labor was when they were at the peak of intensity." The nurse educator correctly explains that the woman is identifying which part of a contraction?

The shortest part of the contraction

An Eastern European Jewish couple had two children who died from Tay-Sachs disease. The couple is currently pregnant and have asked for genetic confirmation about this fetus with the intention of early termination if the fetus tests positively. For which reason does the nurse expect chorionic villa sampling to be prescribed?

The test is performed as early as 10 weeks gestation.

After counseling with an obstetrician about infertility, a couple is advised to undergo testicular sperm aspiration. The nurse is aware that the procedure may be recommended for which infertility?

Unsuccessful vasectomy reversal

The nurse is explaining telemetry to the patient, who has just begun active labor. The patient would like to have a labor in which she is mobile, able to change positions, and use hydrotherapy. Which response by the nurse is most appropriate?

We can start using telemetry now, and if there are no problems with the signal, we can continue it throughout your labor until delivery."

An experienced OB nurse has accepted a position in labor and delivery of an inner-city hospital providing care for multicultural clients. Which action by the nurse is most helpful in preparation for this position?

Intensely studying qualitative research focused on practice enhancement

The nurse is caring for a 15-year-old female who is pregnant with her first child. In her previous prenatal visit, the patient tested negative for chlamydia, syphilis, gonorrhea, and HIV. Based on the information provided, which condition is the patient's baby at higher risk for?

Intestinal problems

The nursing staff in a labor and delivery unit has noticed an increase in the number of patients experiencing placental abruption. The nurses begin to review demographics for the patients involved. Which risk factors will the nurses expect? Select all that apply.

1. Hypertensive disorders 2. Uterine fibroids 3. Cigarette smoking 4. Methamphetamine use 5. Abdominal trauma

A nurse is caring for a single teen mother who has just given birth to her first child. The patient notes that the child's father "wants no relationship with his son." The patient goes on to express concerns about the short- and long-term impact of her teen pregnancy on herself and on her child. Which statements made by the nurse are accurate? Select all that apply.

1. "You are more likely than others to have additional children before you turn 20." 2. "You may have difficulty completing high school or college." 4. "Your child is at increased risk of abusing alcohol when he is a teenager."

The nurse is reviewing the medical record for a patient who is postpartum. The nurse notices the patient is rubella-nonimmune. Which information does the nurse present to the patient? Select all that apply.

1. The risks to the fetuses of any future pregnancies. 2. The patient will need to be immunized before discharge. 5. Pregnancy should be avoided for 4 weeks.

The nurse is speaking with a pregnant patient who is asking what processes start labor. Which responses by the nurse are appropriate? Select all that apply.

1. There is more pressure on the cervix, which causes the start of contractions by releasing oxytocin. 2. Oxytocin stimulates uterine muscles to contract. 4. The placenta begins to age and deteriorate and this triggers the start of contractions. 5. The fetus releases a stress hormone, cortisol, and this starts contractions.

A female patient with a history of infertility is scheduled to have a hysterosalpingogram. Which findings can be detected with this procedure? Select all that apply.

1. Tubal occlusions 2. Uterine fibroids 4. Bicornate uterus

The nurse is planning an assessment on a patient in the second trimester of pregnancy. For which assessments will the nurse plan? Select all that apply.

1. Urine testing with a dipstick. 2. Presence of dependent edema. 4. Antibody screening for Rh- patient.

The nurse on a postpartum unit is acutely aware that cultural influences impact the patient's process of "becoming a mother." For which cultural influences does the nurse assess? Select all that apply.

1. What amount of time the mother spends in each phase 2. Differences in the mother's expectation related to ability to rest 4. Mother's involvement in decision making for the first few months 5. Whether the mother seems interested in how to care for her baby

An infertile couple voices concern to the nurse about assisted reproductive technologies (ART). The nurse agrees that ART has created numerous dilemmas. Which potential questions does the nurse discuss with the couple? Select all that apply.

1. Which partner has ownership of the embryos? 2. Should a child be told about donors or surrogates? 3. Are there parental rights for sperm donors? 5. What happens to any surplus embryos?

A male patient is diagnosed with low sperm count as the cause of infertility. Which interventions will the nurse recommend to improve the patient's sperm count? Select all that apply.

1. Yoga or relaxation techniques 2. Surgical repair of an inguinal hernia 5. Consultation to change hypertension drugs

The nurse is teaching new parents about the Period of PURPLE Crying Program aimed at the prevention of shaken baby syndrome. At the end of the program, the nurse evaluates the program successful if parents select which fact? Select all that apply.

1. Your baby may not stop crying no matter what you do. 2. Your baby may cry more in the late afternoon and evening. 5. A crying baby may look to be in pain, even when he or she is not.

The nurse is providing pre-amniocentesis teaching for a patient who is at 18 weeks gestation. Which information does the nurse provide? Select all that apply.

2. A full bladder will assist in ultrasound visualization. 3. Discomfort will be minimized with a local anesthetic.

The nursing preceptor is teaching the nursing student about fetal bradycardia. Which is true of the maternal reasons for fetal bradycardia? Select all that apply.

2. Administering terbutaline to the mother for uterine tachysystole; this is self-limiting to when the drug is affecting the mother. 3. A urine toxicology screen may reveal recent cocaine use; the nurse should also monitor for placental abruption. 4. Check the chart for a history of maternal mental illness, particularly maternal anxiety; speak with the patient regarding her anxiety and take steps to ease her anxieties. 5. Check the maternal blood pressure, as hypertension is linked to fetal tachycardia; identify the on-call provider and correct with lisinopril as necessary.

A patient with pregestational diabetes mellitus delivers a neonate who is diagnosed with macrosomia. The nurse is aware that the neonate is at risk for additional long-term conditions related to maternal diabetes mellitus. Which long-term effects may occur? Select all that apply.

2. Development of metabolic syndrome 3. Impaired intellectual development 4. Changes in genetic expression 5. Increased risk for chronic illnesses

The nurse educator is teaching about regional and local anesthesia in a childbirth education class. The nurse should teach that regional anesthesia is used for which of the following? Select all that apply.

2. Epidural with lidocaine for pain in labor 3. Spinal block with lidocaine for a cesarean delivery 5. Lidocaine without epinephrine for forceps use

The postpartum nurse-manager wants the unit to become active as a supporter of the Baby-Friendly Hospital Initiative. Which nursing actions will be initiated? Select all that apply.

2. Help mothers initiate breastfeeding within 1 hour of birth. 3. Teach breastfeeding and promote lactation to mothers separated from infants. 4. Refer mothers to support group resources on discharge.

The labor and delivery nurse is providing care to a patient in active labor. The nurse notes EFM changes that suggest fetal distress and monitors the fetus for an additional 20 minutes before calling the health care provider. The health care provide determines that an emergency cesarean delivery is required. During transport, EFM is interrupted and not resumed due to expectations of an emergent procedure. A stillborn fetus is delivered. For which actions can the nurse be held legally responsible? Select all that

2. Lack of appropriate response to fetal compromise. 4. Delayed communication resulting in a delay of cesarean. 5. Performance of a technical error related to monitoring.

The nursing department of a large facility is interested in improving clinical care with the introduction of EBP. Which barriers to EBP does the nursing department expect within the facility? Select all that apply

2. Outdated facility politics and policies that do not embrace research-based change 4. Limited resources available to clinical care providers from nursing administration

The nurse is caring for a woman who is pregnant. The patient reports that she has also smoked less than five cigarettes per day and that she has continued to smoke during her pregnancy. Routine prenatal examination and diagnostics have indicated she tested negative for sexually transmitted infections and has a BMI of 25. Based on statistics, which is likely true about the patient and the developing fetus? Select all that apply.

2. She is probably aged 20-24. 2. She is probably aged 20-24.

The nurse is assessing a patient who is 36 hours postpartum following a cesarean delivery. Which findings cause the nurse to conclude that a wound infection is developing? Select all that apply.

3. Increased margins of incisional redness 4. Notably warm skin around the incision

A new mother expresses severe frustration with an infant that is exhibiting symptoms of colic. Which suggestions from the nurse are aimed at infant safety? Select all that apply.

3. Place the baby in a safe place and allow the baby to cry for 10 to 15 minutes. 4. Do simple household chores, such as vacuuming or washing the dishes.

The nurse is assessing a patient who just received confirmation of pregnancy. While collecting information about the patient's medical history, which information alerts the nurse to biophysical risk factors? Select all that apply.

3. The patient has been a strict vegetarian for 25 years. 5. The patient is medically treated for rheumatoid arthritis.

A patient is interested in a pain relief option that she can control during labor. The nurse explains to the patient what pain relief options are available that would meet her needs, and they mutually decide on nitrous oxide. Which of the following does the nurse describe to the patient about the use of nitrous oxide in labor? Select all that apply.

4. "The gas takes effect in about 50 seconds after the first breath, and the patient will feel calm." 5. "There is no effect on the labor progress from active labor to delivery, and therefore you do not need to worry about longer labors with the medication."

A patient in the third trimester of pregnancy reports having heartburn nearly every day. Which recommendations does the nurse make to alleviate the problem? Select all that apply.

4. Avoid eating 3 hours prior to bedtime. 5. Avoid consuming spicy, fatty, or fried food.

The nurse is explaining to the new breastfeeding mother the types of neonatal stools the mother can expect. Which examples does the nurse provide? Select all that apply.

4. Golden yellow, a pasty consistency, and sour odor is expected. 5. Neonate's first stool is passed within the first 24 to 48 hours.

The nurse in labor and delivery notices an increase in the number of women requesting cesarean births. Which are the parameters and criteria used when making the decision to perform a cesarean delivery on maternal request (CDMR)? Select all that apply.

4. Patient is aware of possible neonatal complications. 5. Procedure is performed after 39 weeks gestation.

The nurse is performing an NST along with a biophysical profile scoring (BPP) on a patient at 39 weeks gestation. The nurse determines the fetus has a nonreactive NST. The fetus has trunk or limb movement two times; is noted to be opening and closing hands; has a 45-second breathing episode; and has two 2-cm pockets of amniotic fluid. The nurse should assign a BPP score of __/10.

6/10

The nurse is teaching the mother of a neonate the benefits of kangaroo care. Which action is explained to the mother regarding the procedure?

A bare-chested neonate is held against a bare-chested parent.

Postnatal nurses expressed concern about neonatal pain management during painful interventions. Using evidence-based practice from research performed by Thakkar, Arora, Das, Javadekar, and Panigrahi (2016), which method of pain control will be used for heel sticks?

A combination of stimulated sucking and receiving sucrose orally.

A postpartum patient calls the OB office 8 days following a vaginal delivery. The patient reports concern regarding vaginal bleeding. Which patient-reported symptom causes the nurse concern?

A description of the lochia as being red in color

A patient at 30 weeks gestation is exhibiting signs of preterm labor and delivery. The health care provider (HCP) informs the patient that nothing can be done to disrupt this process. The patient is in distress and states, "Why can't something be done to save my baby?" The nurse understands the HCP's decision is likely based on which finding?

A fetal heartbeat could not be obtained.

The nurse works in a prenatal clinic and interacts with multiple patients from various socioeconomic backgrounds. Which patient does the nurse assess most carefully for a mental health issue?

A military veteran who was deployed twice

A patient who is 12 hours postpartum after a vaginal delivery continues to have difficulty in initiating urination. The nurse is aware that an integrative method used when a woman is unable to void is peppermint oil. In which manner will the peppermint oil be used?

A saturated cotton ball is placed in a "hat" on the toilet.

The nurse is assisting a newborn's primary care provider with the performance of a circumcision. Which intervention is used to manage the neonate's pain?

A sucrose-dipped pacifier is offered during the nerve block.

The _______ in conjunction with NST is a strong indicator of fetal status, as it is accurate in detecting fetal hypoxia.

AMNIOTIC FLUID INDEX

The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child, who is male. The patient's mother has accompanied her to today's visit. During the nursing assessment, the patient mentions that she is no longer in a relationship with the baby's father but her mother plans to help her. However, the patient's mother asks whether this will have any impact on the child. Which should the nurse indicate the child is at increased risk of during his adolescence?

Alcohol abuse

A nurse is suspended for refusal to participate in the performance of an elective termination of a pregnancy. Which specific group's standards does the nurse use for job reinstatement?

Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)

The nurse is assessing a newborn's reflexes. Which response will cause the nurse concern?

Asymmetrical Moro reflex

The nurse is providing care for a primip patient in active labor. Cervical dilation has progressed 0.5 cm in 2 hours. Intrauterine pressure catheter reading is 20 mm Hg. Which action does the nurse anticipate next?

Augmentation of labor with oxytocin per health care provider's order

During an initial assessment of the neonate's skin the nurse notices the presence of red marks called _______ on the neonate's eyelid and upper lip.

BITES

The nurse is providing care for a patient in active labor. The patient continuously asks the nurse for medication to "stop the pain." Which ethical principle does the nurse use when replying, "We need to protect the baby from being overmedicated. Let me help you with some breathing and relaxation techniques"?

Beneficence

A patient arrives for her fourth month prenatal visit and expresses concern because of a leakage of yellow fluid from her breasts. Which topic does the nurse discuss during this visit?

Breast changes

A patient arrives at a maternal health client and tells the nurse she has missed a period and thinks she is pregnant. Which information shared with the nurse is a presumptive sign of pregnancy?

Breast enlargement, tenderness, and tingling

A breastfeeding mother is planning to return to work 3 months after her baby is born. The mother is planning to use an electric breast pump and freeze some breast milk for use later. Which information does the nurse need to provide?

Breast milk can be kept in a deep freezer for 6 to 12 months.

The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room?

Collect blood in calibrated, under-buttocks drapes for vaginal birth.

The nurse is providing care for a patient who is 8 hours postpartum after a vaginal delivery. The patient reports severe perineal pain unaffected by pain medication. The nurse notices a 4 cm area of discoloration on the labia that is tender to the touch. Which action does the nurse take?

Contact the primary care provider for further evaluation.

The nurse is aware the greatest source of bleeding during childbirth occurs following detachment of the placenta. Which physiological change takes place immediately after the expulsion of the placenta to decrease the amount of blood loss?

Contractions of the uterine myometrium

An adolescent patient who is 15 weeks pregnant refuses to have an alpha-fetoprotein test performed because, "I don't like needles." Which initial approach does the nurse take to achieve the testing?

Explain the testing is important in detecting serious birth defects

The nurse in a postpartum unit frequently teaches patients regarding breast care. Which teaching is most helpful to the breastfeeding patient?

Express milk by a breast pump or manually.

While providing care for a patient, the nurse notices an erratic FHR recording. What action should the nurse take next?

Place the transducer in a different position.

A patient who is in the third trimester of pregnancy is informed that she will need a cesarean hysterectomy and bladder reconstruction due to a placenta defect. Which medical condition does the nurse explain to the patient?

Placenta percreta

The nurses in a labor and delivery unit are concerned about the high incidence of cesarean deliveries at their facility and initiate an internal study. Which is the most likely condition the nurses will recognize as a contributor to the rate of cesarean births?

Policies and parameters for cesarean need to be reviewed and refined.

A new mother expresses frustration about how to know what her baby wants. The mother states, "I don't know what I expect, but then, the baby doesn't know either." Which situation does the nurse use as an example of neonate communication?

The baby roots for the breast when the cheek is stroked.

The nurse is employed in a NICU. With each new admission, the neonate is classified in a specific category regarding care. The nurse is in the process of admitting a neonate at 22 weeks gestation with multiple life-threatening conditions involving both cardiac and respiratory systems. In which category of care does the nurse expect the neonate to be placed?

The category where aggressive care is probably futile.

The nurse is aware that some parenting skills are acquired through the process of intentional learning. Which activity does the nurse associate with intentional learning?

The couple attends hospital classes addressing newborn and infant care.

A female patient is concerned about an inability to become pregnant after trying for 1 year. Which information collected during a health history causes the nurse the greatest amount of concern about possible infertility?

The patient has hot flashes and mood swings.

A patient undergoes chorionic villa sampling to rule out the presence of a genetic disorder. Following the procedure, the patient experiences iatrogenic PPROM. Which explanation does the nurse provide to promote patient understanding?

The premature rupture of the membranes is a known risk to the test.

The nurse is preparing a postpartum patient for discharge. Which patient teaching is most important for the nurse to provide?

The signs and symptoms of secondary hemorrhage

The nurse is collecting the urine of a postpartum patient who is passing large clots. For which reason does the nurse examine the large collected clots?

To determine the presence of tissue

The nurse is palpating a patient's uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis?

To prevent uterine inversion

A patient has experienced an uneventful pregnancy but begins to have vaginal spotting at 38 weeks gestation. The health care provider (HCP) suspects placenta previa initiated by cervical thinning. Which testing does the nurse expect the HCP to schedule

Ultrasonography studies

Prior to discharge from the birthing center, the nurse informs the patient that she will receive vaccines for rubella, hepatitis B, pertussis, and influenza. For which reason does the nurse explain the need for the vaccinations?

Vaccinating the mother will protect the neonate from serious illnesses.

A patient delivers a term neonate and expresses concern about the reason for giving the neonate an injection. Which information from the nurse is accurate?

Vitamin K is needed to activate clotting factors.

The nurse is providing care to a patient who is postpartum. Using anatomy and physiology knowledge, which expectation does the nurse relate to the cardiovascular system?

WBC laboratory level of 30,000/mm a few hours after delivery

After pregnancy and birth, a mother may notice a condition called diastasis recti abdominis, which is a(n) _______ of the rectus muscle.

SEPARATION

The nurse is providing postpartum care for a patient after a vaginal delivery. Which assessment finding causes the nurse to suspect endometritis from beta-hemolytic streptococcus?

Scant amount of odorless lochia

Genomic medicine is an emerging medical discipline that involves using genomic information about an individual as part of the individual's clinical care. Which example does the nurse associate with genomic medicine?

Screening of neonates for inherited, treatable genetic diseases

The labor and delivery nurse understands that some neonates spontaneously take a breath once the head and chest is delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe?

Mild hypoxia and decreased pH stimulates the brain.

A mother who is 2 weeks postpartum asks the nurse lactation specialist how she knows if her baby is hungry. Which hunger indicator does the nurse discuss?

Opening the mouth in response to tactile stimulation

The nurse educator is preparing a presentation on preterm labor (PTL) and birth (PTB). Which information does the nurse recognize as being inaccurate?

PTL is defined as regular uterine contractions resulting in cervical changes before 40 weeks gestation.

The nurse is presenting information to new parents regarding screening of their newborn. Which information does the nurse identify as being most important to the parents?

Screenings are for infections, genetic diseases, and inherited disorders.

The nurse in a prenatal clinic is assessing a patient who is at 37 weeks gestation for twins. The patient reports increased discomfort and increased lower pelvic pressure. Which action does the nurse take with this patient?

Sends the patient to the hospital to be checked for possible signs of labor

The nurse is counseling a patient who shares the intention to become pregnant. Which finding during the collection of health information will the nurse feel the least concern to address?

The patient lives in a recently renovated house.

The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits. Which patient does the nurse identify as having the highest-risk pregnancy?

The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension

A pregnant patient with a BMI of 35 is concerned about health effects she and her baby may face during pregnancy. During routine testing, the patient tested negative for sexually transmitted illnesses (STIs) and indicated that she is in a committed, long-term relationship with the child's father. Which of the following is accurate?

The patient will have increased risk of wound infection.

The nurse is teaching newborn care to an adolescent mother. When the nurse attempts to teach how to swaddle the newborn, the mother states, "What's the big deal about how to wrap up a baby?" The nurse needs to convey which reason as being most important for proper swaddling?

Improper swaddling can cause hip dysplasia.

An emergency cesarean is being implemented. The patient describes tingling in her ears and a metallic taste with the administration of regional anesthesia. The nurse is aware that which incidence has occurred?

Inadvertent injection of the anesthetic agent into the maternal bloodstream

A woman has recently given birth to an infant born at 35 weeks and 5 days gestation. What long-term effects should the nurse be concerned about with the infant being born at this gestation? Select all that apply.

1. Cerebral palsy 2. Respiratory disorders 3. Developmental delays 4. Visual impairments 5. Hearing impairments

A patient is experiencing pregnancy complications. Which factors will affect the client's ability to manage this situation? Select all that apply.

1. Current health status 2. Perceived threat to self or fetus 3. Previously used coping skills 4. Existence of a support network 5. Implemented nursing interventions