Mom Baby Prep U #3

A nurse is reviewing the various treatment options with a client diagnosed with uterine fibroids. The nurse determines that the teaching was successful based on which statement? "If I use hormone therapy, my fibroids may grow back when I stop the medication." "A myomectomy will not allow me to keep my uterus." "Uterine artery embolization is associated with minimal pain." "Laser surgery won't affect my ability to have children."

"If I use hormone therapy, my fibroids may grow back when I stop the medication." Typically, with hormonal therapy, fibroids regrow when the medication is stopped. A myomectomy preserves the uterus. Uterine artery embolization is frequently painful. Laser surgery can cause scarring and adhesions which could impact future fertility.

What should the nurse include when explaining endometriosis as a cause for a female patient's infertility? "You do not ovulate because of endometrial implants on the ovaries." "Your uterine cervix fails to close because it is engorged with tissue." "Menstrual sloughing does not occur, so there is never a new base for embryo growth." "Ovulation does take place misplaced endometrial tissue interferes with transport of the ovum."

"Ovulation does take place misplaced endometrial tissue interferes with transport of the ovum." Endometriosis refers to the implantation of uterine endometrium, or nodules, that have spread from the interior of the uterus to locations outside the uterus. If viable particles of endometrium enter a tube, they can cause tubal obstruction; growths on the ovaries can displace fallopian tubes away from the ovaries, preventing the entrance of ova into the tubes. Peritoneal macrophages, which are drawn to nodules of endometrium, can destroy sperm. Endometriosis does not affect ovulation, cervix competence, or menstruation.

A nursing student, observing care of a 30-week-gestation infant in the neonatal intensive care unit, asks the nurse, "Are premature infants more susceptible to infection as I have to wash my hands so often in this department?" What is the nurse's best response? "Yes, as they lack the antibody called IdD that acts as protection from infections." "Not really, as premature infants are cared for in an isolate, protecting them from infection." "Feeding premature infants breast milk establishes the best protective mechanisms." "That is correct; a 30-week-gestation infant lacks the protective antibody called IgG."

"That is correct; a 30-week-gestation infant lacks the protective antibody called IgG." The preterm newborn's immune system is very immature, increasing his or her susceptibility to infections. A deficiency of IgG may occur because transplacental transfer does not occur until after 34 weeks' gestation. This protection is lacking if the baby was born before this time. Preterm newborns have an impaired ability to manufacture antibodies to fight infection if they were exposed to pathogens during the birth process. The preterm newborn's thin skin and fragile blood vessels provide a limited protective barrier, adding to the increased risk for infection. Anticipating and preventing infections is the goal with frequent hand washing while caring for them the gold standard. Breastfeeding will eventually establish some protective mechanisms.

A 25-year-old woman is at the health care provider's office for her annual checkup. The nurse educated the woman on risks for cervical cancer. Which question would be important to ask as part of a risk screening? "Were you sexually active at an early age?" "Do you have a history of high blood pressure?" "Have you had problems trying to get pregnant?" "How long have you been severely overweight?"

"Were you sexually active at an early age?"

A newborn is exhibiting signs and symptoms of hypoglycemia. The nurse prepares to administer IV glucose based on which blood glucose level? 36 mg/dL 45 mg/dL 50 mg/dL 55 mg/dL

36 mg/dL Any symptomatic newborn with blood glucose less than 40 mg/dL is treated promptly with IV glucose

The results of an amniocentesis conducted just prior to birth showed a fetus's lecithin/sphingomyelin ratio as being 1:1. From this information, for which respiratory problem should the nurse anticipate providing care once the baby is delivered? Alveolar collapse on expiration Bronchial constriction from room air Wheezing from excess fluid accumulation Inspiratory constriction from air contaminants

Alveolar collapse on expiration

A nurse is caring for a client with vaginitis. What teaching(s) should the nurse provide to the client to prevent recurrent vaginal infections? Select all that apply. Avoid using deodorant tampons. Clean the perineal area from back to front. Avoid douching. Wear only cotton panties and ventilated pantyhose. Take a bubble bath once a week.

Avoid using deodorant tampons. Avoid douching. Wear only cotton panties and ventilated pantyhose. The nurse should teach the client ways to help prevent vaginitis. Prevention activities include avoiding douching to prevent altering the vaginal environment; using condoms to avoid spreading the organism; urinating with knees spread wide apart; avoiding tights, nylon underpants, and tight clothes; wiping from front to back after using the toilet; washing only with hypoallergenic bar soap, avoiding liquid soaps or body washes; avoiding powders, bubble baths, and perfumed vaginal sprays; wearing clean cotton underpants; and washing and drying the vulvar area gently after baths or showers.

The time in a woman's life when she loses the capability to reproduce is called menopause. Menopause does not occur all at once, but over a period of time that differs from woman to woman. There is, however, an average age when menopause occurs. What is this average age? Between 52 and 60 years Between 55 and 63 years Between 43 and 51 years Between 47 and 55 years

Between 47 and 55 years

A nurse is caring for an infant with an elevated bilirubin level who is under phototherapy. What evaluation data would best indicate that the newborn's jaundice is improving? Reticulocyte count is 6%. Hematocrit is 38. Skin looks less jaundiced. Bilirubin level went from 15 to 11.

Bilirubin level went from 15 to 11. The newborn has physiologic jaundice, which is related to decreased bilirubin conjugation. Newborns have relatively immature livers and cannot conjugate (break down) bilirubin as fast as needed. Bilirubin overproduction is responsible for causing jaundice. A serum bilirubin is the best way to determine whether the jaundice is improving. The other listed methods will not address the needed information.

A pregnant woman comes to the clinic for her first evaluation. The woman is screened for hepatitis B (HBV) and tests positive. The nurse would anticipate administering which agent? HBV immune globulin HBV vaccine acyclovir valacyclovir

HBV immune globulin If a woman tests positive for HBV, expect to administer HBV immune globulin. The newborn will also receive HBV vaccine within 12 hours of birth. Acyclovir or valacyclovir would be used to treat herpes simplex virus infection.

A young couple are disappointed that they are not yet pregnant and are seeking assistance at the health clinic. After assessing their medical history, the nurse discovers the female has a history of several episodes of PID. The nurse predicts this may be a source of the infertility related to which factor? It causes anovulation due to interference with secretion of pituitary hormones. It causes changes in cervical mucus that make it less receptive to penetration by sperm. It causes sperm-agglutinating antibodies to be produced in the vagina. It interferes with the transport of ova due to tubal scarring.

It interferes with the transport of ova due to tubal scarring. Pelvic inflammatory disease results in scarring and adhesions of the tubes, leading to poor transport of ova. PID does not affect hormone metabolism, nor does it affect the production of cervical mucus. Antibodies are present only in a few cases and are unrelated to PID.

Inability to conceive can be very stressful on a couple. What is one psychological aspect of infertility? Emotional stability Growth of intimacy Couple becomes closer Loss of intimacy

Loss of intimacy

The nurse should carefully monitor which neonate for hyperbilirubinemia? Black neonate Neonate of an Rh-positive mother Neonate with ABO incompatibility Neonate with Apgar scores 9 and 10 at 1 and 5 minutes

Neonate with ABO incompatibility The mother's blood type, which is different from the neonate's, has an impact on the neonate's bilirubin level due to the antigen antibody reaction. Black neonates tend to have lower mean levels of bilirubin. Chinese, Japanese, Korean, and Greek neonates tend to have higher incidences of hyperbilirubinemia. Neonates of Rh-negative, not Rh-positive, mothers tend to have hyperbilirubinemia. Low Apgar scores may indicate a risk for hyperbilirubinemia.

A nurse is implementing measures to prevent hypothermia in a premature newborn. The nurse determines that the newborn is experiencing an effect of hypothermia based on which assessment finding? No breathing for 15 seconds Respiratory rate of 45 breaths per minute Heart rate of 130 beats per minute Pink skin color

No breathing for 15 seconds

A nurse is caring for a female client who is undergoing treatment for genital warts due to human papillomavirus (HPV). Which information should the nurse include when educating the client about the risk of cervical cancer? Select all that apply. Use of broad-spectrum antibiotics increases risk of cervical cancer. Obtaining a Papanicolaou test routinely helps early detection of cervical cancer. Abnormal vaginal discharge is a sign of cervical cancer. Recurrence of genital warts increases risk of cervical cancer. Use of latex condoms is associated with a lower rate of cervical cancer.

Obtaining a Papanicolaou test routinely helps early detection of cervical cancer. Recurrence of genital warts increases risk of cervical cancer. Use of latex condoms is associated with a lower rate of cervical cancer. When educating the client about cervical cancer, the nurse should inform the client that recurrence of genital warts increases the risk of cervical cancer and that she should obtain routine Papanicolaou testing to detect cervical cancer. Use of latex condoms reduces the risk of cervical cancer. Abnormal vaginal discharge does not necessarily indicate cervical cancer. There is no significant link between use of broad-spectrum antibiotics and increased risk of cervical cancer.

An 18-year-old client has given birth at 28 weeks' gestation and her newborn is showing signs of respiratory distress syndrome (RDS). Which statement is true for a newborn with RDS? Glucocorticoid (GC) is given to the newborn following birth. RDS is caused by a lack of alveolar surfactant. Respiratory symptoms of RDS typically improve within a short period of time. RDS is characterized by heart rates below 50 beats per minute.

RDS is caused by a lack of alveolar surfactant. Respiratory distress syndrome (RDS) is a serious breathing disorder caused by a lack of alveolar surfactant. Betamethasone, a glucocorticoid, is often given to the mother 12 to 24 hours before a preterm birth to help reduce the severity of RDS, not to the newborn following birth. Respiratory symptoms in the newborn with RDS typically worsen, not improve, within a short period of time after birth. Diagnosis of RDS is made based on a chest X-ray and the clinical symptoms of increasing respiratory distress, crackles, generalized cyanosis, and heart rates exceeding 150 beats per minute (not below 50 beats per minute).

A newborn baby is documented as large for gestational age. Which features should the nurse associate with this condition? Select all that apply. Round, protruding abdomen Large, broad shoulders Oval and large head Prominent chin pad Angular and pinched face

Round, protruding abdomen Large, broad shoulders Prominent chin pad The features of babies documented as large for gestational age include round, protruding abdomen, large, broad shoulders, and a prominent chin pad. Oval, large head, and an angular, pinched face are features of low birth weight babies.

A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her? She is 30 years old. She has irregular menstrual cycles. She has a history of allergy to foreign protein. She has a family history of thromboembolism.

She has a family history of thromboembolism. The estrogen content of birth control pills may lead to increased blood clotting, leading to an increased incidence of thromboembolism. Women who already are prone to this should not increase their risk further.

At birth, the newborn was at the 8th percentile with a weight of 2350 g and born at 36 weeks' gestation. Which documentation is most accurate? The infant was a preterm, low-birth-weight and small-for-gestational-age The infant was born at term but at a low birth weight and small-for-gestational age The infant was born at term but at a very low birth weight and small-for-gestational-age The infant was a preterm, very-low-birthweight and small-for-gestational-age

The infant was a preterm, low-birth-weight and small-for-gestational-age Born at 36 weeks' gestation is a preterm age (under 37 weeks). The infant was a low birthweight (under 2500 g) and small-for-gestational-age at the 8th percentile (under the 10th percentile). The other documentation is not accurate.

A nurse is assigned to care for a newborn with hyperbilirubinemia. The newborn is relatively large in size and shows signs of listlessness. What most likely occurred? The infant's mother must have had a long labor. The infant's mother probably had diabetes. The infant may have experienced birth trauma. The infant may have been exposed to alcohol during pregnancy.

The infant's mother probably had diabetes. The nurse should know that the infant's mother more than likely had/has diabetes. The large size of the infant born to a mother with diabetes is secondary to exposure to high levels of maternal glucose crossing the placenta into the fetal circulation. Common problems among infants of mothers with diabetes include macrosomia, respiratory distress syndrome, birth trauma, hypoglycemia, hypocalcemia and hypomagnesemia, polycythemia, hyperbilirubinemia, and congenital anomalies. Listlessness is also a common symptom noted in these infants. Infants born to clients who use alcohol during pregnancy, infants who have experienced birth traumas, or infants whose mothers have had long labors are not known to exhibit these particular characteristics, although these conditions do not produce very positive pregnancy outcomes. Infants with fetal alcohol spectrum disorder or alcohol exposure during pregnancy do not usually have hypoglycemia problems.

A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for: a DEXA scan. an ultrasound. an MRI. a pelvic X-ray.

a DEXA scan. Currently, no method exists for directly measuring bone mass. Instead, a bone mass density (BMD) measurement is used. BMD is a two-dimensional measurement of the average content of mineral in a section of bone. The client most likely will be having a DEXA scan, which is a screening test that calculates the mineral content of the bone at the spine and hip. Ultrasound, MRI, and a pelvic X-ray would be of little help in determining bone mass.

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? a painless genital ulcer that appeared about 3 weeks after unprotected sex copper-colored macules on the palms and soles that appeared after a brief fever patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas one or more flat, wartlike papules in the genital area that are sensitive to touch

a painless genital ulcer that appeared about 3 weeks after unprotected sex A painless genital ulcer is a symptom of primary syphilis. Macules on the palms and soles after fever are indicative of secondary syphilis, as is patchy hair loss. Wartlike papules are indicative of genital warts.

A 36-year-old was diagnosed with uterine fibroids (uterine myomas). The nurse teaches the client to expect which clinical manifestation? decrease in fibroid size if pregnancy occurs diarrhea acute abdominal pain abnormal uterine bleeding

abnormal uterine bleeding Uterine fibroids are dependent on estrogen and grow rapidly during the childbearing years unless menopause occurs. Abnormal uterine bleeding is a clinical manifestation. Diarrhea is not a factor; constipation and abdominal pain can occur if fibroids are getting larger.

A nurse will be speaking at a local high school about women's health. The nurse is planning to talk about sexually transmitted infections (STIs) as well as routine checks, along with guidelines for Papanicolaou testing. What should the nurse include in the Papanicolaou test guidelines about when to have a first test? at the age of 16 2 years after first sexual intercourse at the age of 21 or within 3 years of first sexual intercourse at the age of 18 or within 2 years of first sexual intercourse

at the age of 21 or within 3 years of first sexual intercourse

The nurse suspects a preterm newborn receiving enteral feedings of having necrotizing enterocolitis (NEC). What assessment finding best correlates with this diagnosis? bloody stools poor suck reflex high-pitched cry meconium stools

bloody stools NEC assessment includes assessing the newborn's health history and physical examination as well as laboratory and diagnostic testing. The onset of NEC is demonstrated by the development of feeding intolerance, abdominal distention, and bloody stools in a preterm infant receiving enteral feedings. As the disease worsens, the infant develops signs and symptoms of septic shock with RDS, temperature instability, lethargy, hypotension, and oliguria.

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? burning on urination dry, hacking cough diffuse skin rash painless chancre

burning on urination Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry, hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may indicate secondary stage syphilis. A painless chancre is the hallmark of primary syphilis. It appears wherever the organisms enter the body, such as on the genitalia, anus, or lips.

A nurse is presenting a program for a local women's group about STIs. When describing the information, the nurse would identify which infection as the most common cause of vaginal discharge? candidiasis syphilis gonorrhea chlamydia

candidiasis Although vaginal discharge can occur with any STI, genital/vulvovaginal candidiasis is one of the most common causes of vaginal discharge. It is also referred to as yeast, monilial, and a fungal infection. It is not considered an STI because candida is a normal constituent in the vagina and becomes pathogenic only when the vaginal environment becomes altered.

A nurse is conducting a presentation for a local community group on sexually transmitted infections. The nurse determines that the group has understood the information when they identify which infection as the most commonly reported bacterial STI in the United States? chlamydia syphilis gonorrhea candidiasis

chlamydia Chlamydia is the most commonly reported bacterial STI in the United States. The CDC estimates that over 3 million new cases occur each year.

The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only by prescription? condom spermicide diaphragm basal body temperature

diaphragm The diaphragm is available only by prescription and must be professionally fitted by a health care provider. Condoms and spermicides are available over the counter. Basal body temperature requires the use of a special thermometer that is available over the counter.

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common? endometriosis multigravida status hormonal imbalance perimenopause

endometriosis Secondary dysmenorrhea is painful menstruation due to pelvic or uterine pathology. Endometriosis is the most common cause of secondary dysmenorrhea. Other recognized causes include adenomyosis, fibroids, pelvic infection, an intrauterine device, cervical stenosis, or congenital uterine or vaginal abnormalities.

The nurse is planning to speak at a local community center to a group of middle-aged women about osteoporosis. Which measure would the nurse be sure to include as effective in reducing the risk for osteoporosis? decreasing vitamin D intake drinking at least 1 glass of wine per day engaging in daily weight-bearing exercise limiting intake of cholesterol and saturated fats

engaging in daily weight-bearing exercise

A nurse in the newborn nursery has noticed that an infant is frothing and appears to have excessive drooling. Further assessment reveals that the baby has episodes of respiratory distress with choking and cyanosis. What disorder should the nurse suspect based on these findings? cleft palate esophageal atresia cleft lip coarctation of the aorta

esophageal atresia Any swallowed mucus or fluid enters the blind pouch of the esophagus when a newborn suffers from esophageal atresia. The newborn with this disorder will have frothing, excessive drooling, and periods of respiratory distress with choking and cyanosis. If this happens, no feedings should be given until the newborn has been examined.

A 30-year-old female is attending a health fair for women. The nurse at the fair is reviewing risk factors for cervical cancer. Which important risk factor should the nurse include at the fair? one life partner first intercourse after age 25 exposure to diethylstilbestrol (DES) in utero protected sexual intercourse

exposure to diethylstilbestrol (DES) in utero

A 12-hour-old infant is receiving IV fluids for polycythemia. For which complication should a nurse monitor this client? tachycardia hypotension decreased level of consciousness fluid overload

fluid overload The possibility of fluid overload is increased and must be considered by a nurse when administering IV therapy to a newborn. IV therapy does not significantly increase heart rate or change blood pressure, as well as the level of consciousness, unless fluid overload occurs.

After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment? genital herpes syphilis gonorrhea chlamydia

genital herpes Besides AIDS, the five most common STIs are chlamydia, gonorrhea, syphilis, genital herpes, and genital warts. Of these, chlamydia, gonorrhea, and syphilis are easily cured with early and adequate treatment. Genital herpes recurs.

A nurse is asked to teach a woman to take her basal body temperature daily to assess the time of ovulation. She can detect her day of ovulation, following ovulation, because her temperature will: increase a degree. decrease a degree. fluctuate a degree daily. no longer reflect basal body temperature.

increase a degree. The effect of progesterone, released with ovulation, is to increase body temperature.

A 30-year-old client asks the nurse about risk factors for ovarian cancer. Which risk factor should be included in client education? infertility less than 40 years of age menopause before age 50 breastfeeding

infertility Pregnancy decreases a woman's risk for ovarian cancer; infertility increases that risk. Risk increases in women older than 50 years and for women who experienced late menopause (older than 55 years). Breastfeeding may have a protective effect.

What would the nurse expect to prioritize in the assessment of a newborn who has a positive Coombs test? tremor activity hyperglycemia jaundice development phenylketonuria

jaundice development A direct Coombs test is done to identify hemolytic disease of the newborn; positive results indicate that the newborn's red blood cells have been coated with antibodies and thus are sensitized. The Coombs test is frequently used in the evaluation of a jaundiced infant. Phenylketonuria (PKU) is a genetic disorder in which the body cannot process part of a protein called phenylalanine.

A client with polycystic ovary syndrome (PCOS) is receiving oral contraceptives as part of her treatment plan. When discussing this treatment with the client, the nurse would discuss which rationale for this therapy? restore menstrual regularity induce ovulation improve insulin uptake alleviate hirsutism

restore menstrual regularity Oral contraceptives are used as treatment for PCOS to restore menstrual irregularities and treat acne. Ovulation induction agents such as clomiphene are used to induce ovulation. Metformin is used to improve insulin uptake. Mechanical hair removal methods are used to treat hirsutism.

A nurse is conducting a presentation at a community health center about congenital malformations. The nurse describes that some common congenital malformations can occur and are recognized to be caused by multiple genetic and environmental factors. Which example would the nurse most likely cite? spina bifida cystic fibrosis color blindness hemophilia

spina bifida Spina bifida is a multifactorial inherited disorder thought to be due to multiple genetic and environmental factors. Cystic fibrosis is considered an autosomal recessive inherited disorder, while color blindness and hemophilia are considered X-linked inheritance disorders.

A premature infant develops respiratory distress syndrome. With this condition, circulatory impairment is likely to occur because, with increased lung tension,: the ductus arteriosus remains open. the foramen ovale closes prematurely. there are aortic valve strictures. the pulmonary artery closes.

the ductus arteriosus remains open. Excess pressure in the alveoli stimulates the ductus arteriosus to remain open, compromising efficient cardiovascular function.

The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion? wide, large eyes thin upper lip protruding jaw elongated nose

thin upper lip

Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection? candidiasis Gardnerella vaginalis vaginitis gonorrhea trichomoniasis

trichomoniasis The discharge associated with infection caused by Trichomonas organisms is homogenous, greenish gray, watery, and frothy or purulent. The discharge associated with candidiasis is thick, white, and resembles cottage cheese in appearance. The discharge associated with infection due to G. vaginalis is thin and grayish white, with a marked fishy odor. With gonorrhea, vaginal discharge is purulent when present but, in many women, gonorrhea produces no symptoms.