Maternity T2

Which of the following findings on a fetal monitor tracing would be of most concern to the nurse? a. Presence of early decelerations b. Minimal or absent baseline variability c. Baseline FHR of 160 d. Occasional accelerations

b. Minimal or absent baseline variability

Based on the results of the Sullivan and Hagan study (2005), the authors believe a moratorium should be placed on mandated reporting until: a. Prison time is mandated for all abusers b. More is known about the consequences for survivors c. Until women experiencing IPV request reporting (Intimate Partner Violence)

b. More is known about the consequences for survivors

The nurse is aware that labor and birth will most likely proceed normally when the fetal position is: a. Occiput posterior b. Occiput anterior c. Mentum posterior d. Occiput transverse

b. Occiput anterior

After several hours of using imagery and music to promote comfort, the laboring client becomes discouraged and frustrated. What action will the nurse take? a. Ask the support person to leave the room temporarily b. Tell the client she needs to relax more c. Choose an alternate method of comfort promotion d. Continue these methods until they work again

c. Choose an alternate method of comfort promotion

Along with gas exchange and nutrient transfer, the placenta produces many hormones necessary for normal pregnancy. These include (select all that apply): a. Testosterone b. Insulin c. Estrogen d. Human chorionic gonadotropin (hCG) e. Progesterone

c. Estrogen d. Human chorionic gonadotropin (hCG) e. Progesterone

The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is: a. Fetal movement left by pregnant woman b. Braxton Hicks contractions. c. Fetal heart rate noted on ultrasound d. A positive pregnancy test

c. Fetal heart rate noted on ultrasound

A 28 year old woman 12 weeks pregnant. She reports her reproductive history as follows: She had an abortion when she was 15 years old; her first child was born at 36 weeks gestation, she experienced a miscarriage at 21 weeks and she has a set of 3 year old twins that were delivered at 37 weeks. What is her GTPAL? a. G5P2 b. G4P3 c. G5P3 d. G4P1

c. G5P3

A woman in labor has just received an epidural block. The most important nursing intervention is for: a. Monitor the maternal pulse for possible bradycardia. b. Monitor the fetus for possible tachycardia. c. Monitor the maternal blood pressure for possible hypotension. d. Limit parenteral fluids.

c. Monitor the maternal blood pressure for possible hypotension.

A physician writes the following order: administer ampicillin 1 g IV every 4 hours until delivery for a newly admitted client with ruptured membranes. The client had positive vaginal and rectal cultures for GBS+ at 36 weeks gestation. Which of the following is a rationale for this order? a. The client is at risk for chorioamnionitis b. The bacteria cause perineal sepsis c. The baby is at high risk for neonatal sepsis d. The bacteria are sexually transmitted

c. The baby is at high risk for neonatal sepsis

When discussing work and travel during pregnancy with a pregnant patient, nurses should instruct them that: a. Women should avoid seat belts and should restraints in the care because they press on the fetus b. Women should sit for as long as possible and cross their legs at the knees from time to time for exercise. c. While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so. d. Metal detectors at airport security checkpoints can harm the fetus if the woman passes through them a number of times.

c. While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so.

The nurse evaluates the fetal monitor tracing of the patient, who is in active labor. Suddenly, the nurse sees the FHR drop from its baseline of 125 down to 80. The nurse repositions the mother, provides oxygen, increases intravenous (IV) fluid, and performs a vaginal exam. The cervix has not changed. Two minutes have passed, and the fetal heart rate remains in the 70's. What additional nursing measures should the nurse first take? a. Insert a Foley catheter b. Repeat the uterine resuscitation measures again c.Notify the care provider immediately, get help and have the operating room ready. d. Start Pitocin

c.Notify the care provider immediately, get help and have the operating room ready.

A nurse describes a patient's contraction pattern as: frequency every 3 minutes and 60 seconds. Which of the following responses corresponds to this description? a. Contractions lasting 120 seconds followed by a 2 minute rest period b. Contractions lasting 2 minutes followed by a 60 second rest period c. Contractions lasting 60 seconds followed by a 3 minute rest period d. Contractions lasting 1 minute followed by a 2 minute rest period

d. Contractions lasting 1 minute followed by a 2 minute rest period

A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 10 to 15 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the woman to be: a. Admitted for extended observation b. Discharged home with a sedative c. Admitted and prepared for a cesarean birth d. Discharged home to await the onset of true labor

d. Discharged home to await the onset of true labor

Jana purchased an over the counter pregnancy test. The results were positive. The hormone responsible for a positive pregnancy test is: a. Testosterone b. Estrogen c. Progesterone d. Human chorionic gonadotropin (HCG)

d. Human chorionic gonadotropin (HCG)

A multipara in latent phase of labor experiences spontaneous rupture of membranes while walking. Which is the first priority nursing action? a. Notify physician or midwife immediately b. Document the time of rupture of membranes] c. Test the fluid with nitrazine paper to confirm membrane rupture d. Monitor the fetal heart rate and pattern

d. Monitor the fetal heart rate and pattern

A woman attends a prenatal visit and is told to start taking a Folic Acid supplement. The nurse practitioner explains that this is to prevent: a. To prevent patient ductus arteriosus b. To reduce risk of pre-eclampsia c. To improve nutrition so she has an easier labor experience d. Neural tube defects such as Spina Bifida

d. Neural tube defects such as Spina Bifida

A pregnant client, at 22 weeks' gestation, has a hematocrit of 35%. Her pre-pregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change? a. Because of your pregnancy, you're making more blood volume b. Because of your pregnancy, you're not making enough red blood cells c. Because of your pregnancy, you're not eating enough iron-rich foods d. Because of your pregnancy, you're developing a serious problem

a. Because of your pregnancy, you're making more blood volume

The maternity nurse understands that as the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products: a. Diminishes as the spiral arteries are compressed. b. Increases as blood pressure decreases c. Is not significantly affected. d. Continues except when placental functions are increased.

a. Diminishes as the spiral arteries are compressed.

Which factor would alert the nurse that a pregnant woman is at risk for the development of toxoplasmosis? a. Having an indoor cat b. Having a horse c. Having a indoor/outdoor dog d. Having a pet turtle

a. Having an indoor cat

50. A nurse is reviewing care for a pregnant women. Which clinical diagnosis would the nurse identify as being the most common medical complication of pregnancy? a. Hypertension b. Infections c. Hemorrhagic complications d. Hyperemesis gravidarum

a. Hypertension

The nurse should realize that the most common and potentially harmful maternal complication of epidural anesthesia is: a. Hypotension b. Severe afterbirth headache c. Limited perception of bladder fullness d. Increased respiratory rate

a. Hypotension

This procedure allows us to identify fetal lie, presentation and engagement: a. Leopold's Maneuvers b. McRobert's Maneuvers c. Robert's Procedure d. X-ray

a. Leopold's Maneuvers

___________ ____________ Can be administered along with Narcotics to decrease pain during labor. a. Nitrous Oxide b. Oxycodone c. Misoprostol d. Methergine

a. Nitrous Oxide

After change of shift report, the nurse assumes care of a multiparous patient in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, and down her thighs. Before implementing a plan of care, the nurse should understand that this type of pain is: a. Referred b. Visceral c. Somatic d. Afterpains

a. Referred

A pregnant woman initiated prenatal care at 12 weeks' gestation. At that time her hemoglobin and hematocrit were (viewed). Review her following prenatal labs at 28 weeks' gestation: Hgb: 10.5 gm/dL Hct: 32% Blood type: B GBS: Positive Rubella: Immune RPR(VDRL): Negative Rh: Positive Based on this data, what is the appropriate nursing action? a. Teach about iron rich foods in her diet. b. Notify the midwife to start PO antibiotics to treat the GBS c. Administer a Rhogam injection d. Teach about avoiding exposure to rubella

a. Teach about iron rich foods in her diet.

A woman at 40 weeks' gestation, calls the labor unit to see whether or not she should go to the hospital to be evaluated. Which of the following statements by the woman indicates that she is probably in labor and should proceed to the hospital? a. The contractions are regular, about a minute long and I am unable to talk through them. b. I have had cramping for the past 3 or 4 hours c. I saw a pink discharge on the toilet tissue when I went to the bathroom d. The contractions are 5 to 20 minutes apart

a. The contractions are regular, about a minute long and I am unable to talk through them.

A pregnant patient is asking the nurse when she will gain the most weight. At which time during prenatal development should the nurse tell the patient to expect the greatest fetal and maternal weight gain? a. Third trimester b. Implantation period c. First eight weeks d. End of first trimester

a. Third trimester

When administering Pitocin, you should start at a low dose and work your way up slowly to a dose that provides the best contraction rate. a. True b. False

a. True

With regard to weight gain during pregnancy, the nurse should be aware of which important information? a. Women with inadequate weight gain have an increased risk of delivering a preterm infant with intrauterine growth restriction (IUGR) b. Greater than expected weight gain during pregnancy is almost always attributable to old-fashioned overeating c. Obese women may have their health concerns, but the risk to birth a child with major congenital defects is the same as with women of normal weight d. In pregnancy, the woman's height is not a factor in determining her target weight

a. Women with inadequate weight gain have an increased risk of delivering a preterm infant with intrauterine growth restriction (IUGR)

Pitocin is used for which of the following reasons in the L&D unit: (Select all that apply) a. To increase prolactin receptor sites b. Augmentation of Labor c. To decrease bleeding after delivery d. Induction of labor

b. Augmentation of Labor c. To decrease bleeding after delivery d. Induction of labor

The most common cause of decreased variability in the FHR that lasts 30 minutes or less is: a. Head compression during contractions b. Fetal sleep cycles c. Umbilical cord compression d. Fetal hypoxemia

b. Fetal sleep cycles

Changes in the renal system during pregnancy include which of the following? a. Decrease in glomerular filtration rate b. Increase in renal plasma blood flow c. Increase in plasma creatinine d. Increase in plasma urea

b. Increase in renal plasma blood flow

When planning the care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman''s ________________ has increased.

Infection

The nurse is discussing a patient's vaccination history at her 32-week gestation appointment. The nurse knows that her teaching has been effective when the patient states: a. "I will wait until after I have my baby to get my Rubella shot" b. "I will go now to the clinic and get my rubella shot today" c. "I had my Tdap shot with my last baby 2 years ago, I do not need another now". d. "I will hold off on my flu shot this year"

a. "I will wait until after I have my baby to get my Rubella shot"

The nurse is evaluating the external fetal monitor tracing of a client in labor and observes the pattern shown above. What condition is the nurse concerned about? a. Cord compression b. Cephalopelvic disproportion c. Uteroplacental insufficiency d. Polyhydramnios

a. Cord compression

As relates to the structure and function of the placenta, the nurse should be aware that: a. The placenta is able to keep out most potentially toxic substances such as cigarette smoke to which the mother is exposed to. b. As one of its early functions, the placenta acts as an endocrine gland. c. As the placenta widens, it gradually thins to allow easier passage of air and nutrients. d. Optimal blood circulation is achieved through the placenta when the woman is lying on her back or standing

b. As one of its early functions, the placenta acts as an endocrine gland.

The nurse caring for the laboring woman should understand that early decelerations are caused by: a. Placental-utero insufficiency b. Spontaneous rupture of membranes c. Umbilical cord compression d. Head compression of the fetus during contractions

d. Head compression of the fetus during contractions

After the nurse completes nutritional counseling for a pregnant woman, she asks the client to repeat the instructions to assess the client's understanding. Which statement indicates that the client understands the role of protein in her pregnancy? a. "Protein help my baby grow" b. "Eating protein will prevent me from becoming anemic" c. Eating protein will make my baby have strong teeth after he is born" d. Eating protein will prevent me from being diabetic"

a. "Protein help my baby grow"

Upon entering our patient room we notice that the patient's partner is physically abusing them. We would do which of the following? a. Contact the social worker to file a report per the mandated reporting laws b. Attempt to physically stop the abuser from attacking their partner c. Leave the room and call security d. Ignore it because we don't want to start trouble

a. Contact the social worker to file a report per the mandated reporting laws c. Leave the room and call security

The nurse caring for a client in labor observes the external fetal monitor tracing shown above. Which of the following actions is most appropriate? a. Document the findings and tell the mother that the monitor indicates fetal well-being. b. Take the mother's vital signs and tell her that bed rest is required to conserve oxygen. c. Notify MD or CNM of the findings d. Do another assessment on the uterus

a. Document the findings and tell the mother that the monitor indicates fetal well-being.

49. A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2019. What is the client's expected date of birth (EDB)? a. November 21, 2019 b. December 17, 2019 c. November 7, 2019 d. September 17, 2019

a. November 21, 2019

A patient is admitted to Labor & Delivery unit at 39 weeks. She is 5/60/-2. After several hours she is at 5/70/-2. What can be given to help augment her labor? a. Pitocin b. Betamethasone c. Terbutaline d. Magnesium Sulfate

a. Pitocin

A new father wants to know what medication was put into his infant's eyes, and why it is needed. How does the nurse explain the purpose of the erythromycin ophthalmic ointment? a. This ophthalmic ointment prevents gonorrheal infection of the infant's eyes, potentially acquired from the birth canal b. Erythromycin ophthalmic ointment destroys an infectious exudate caused by staphylococcus that could make the infant blind. c. Erythromycin prevents potentially harmful exudate from invading the tear ducts of the infant's eyes, leading to dry eyes d. This ointment prevents the infant's eyelids from sticking together and helps the infant see.

a. This ophthalmic ointment prevents gonorrheal infection of the infant's eyes, potentially acquired from the birth canal

When providing care for the laboring woman should understand that accelerations with fetal movement: a. Warrant close observation b. Are caused by umbilical cord compression c. Are a positive sign of oxygenation d. Are caused by placental-utero insufficiency

c. Are a positive sign of oxygenation

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained in her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse would tell you: a. Since you're in your second trimester, you can drink as much as you like. b. One drink every night is too much. One drink three times a week should be fine. c. Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy. d. Order some wine online with permission of the spouse.

c. Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy.

37. The nurse places a Toco (tocodynamometer) on a client admitted in early labor. The nurse explains to the client that this device provides an accurate assessment of which of the following? a. Frequency and intensity of contractions b. Duration of contractions only c. Frequency and duration of contractions d. Last option not viewable

c. Frequency and duration of contractions

The nurse is caring for a laboring woman, G3 P2002, who was examined 15 minutes ago. Her cervix was 8cm dilated and 90% effaced. Patient now states she is feeling strong pressure in her rectum and wants to move her bowels. Which of the following action should the nurse perform first? a. Offer the patient the bedpan b. Notify the MD c. Perform a vaginal exam d. Encourage the patient to push

c. Perform a vaginal exam

The client has been having contractions every 5 minutes for 7 hours. Which factor would the nurse use to determine if this is true labor? a. The membranes have ruptured b. The contractions are more intense c. The cervix is effacing and dilating d. This is the client's second baby

c. The cervix is effacing and dilating

The fetal monitor tracing shown is associated with: a. Cord compression b. Head compression c. Abruption d. Placental insufficiency

d. Placental insufficiency

The nurse has received a report regarding her patient in labor. The woman's last vaginal examination was recorded as 3 cm, 30%, and -2. The nurse's interpretation of this assessment is that: a. The cervix is effaced 3cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines. b. The cervix is dilated 3cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines. c. The cervix is effaced 3cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines. d. The cervix is 3cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.

d. The cervix is 3cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.