OB PrepU Exam 2

The nurse wants to maintain a neutral thermal environment for her assigned neonatal clients. Which intervention would best ensure that this goal is met?

Promote early breastfeeding for the infants.

An 18-year-old client has given birth to a very-low-birth-weight preterm infant. Which intervention should the nurse consider to prevent the newborn from losing body temperature?

Provide isolette or radiant warmer care to the newborn.

The nurse is teaching a client with newly diagnosed mastitis about her condition. The nurse would inform the client that she most likely contracted the disorder from which organism?

Staphylococcus aureus

A woman states that she still feels exhausted on her second postpartal day. The nurse's best advice for her would be to do which action?

Walk with the nurse the length of her room.

The nurse is providing teaching to a new mother who is breastfeeding. The mother demonstrates understanding of teaching when she identifies which characteristics as being true of the stool of breastfed newborns? Select all that apply.

stringy to pasty consistency yellowish gold color

Which finding would lead the nurse to suspect that a large-for-gestational-age newborn is developing hyperbilirubinemia?

tea-colored urine

During an assessment, the nurse notes that the client has been unable to urinate properly since she gave birth and is still bleeding more than expected. The nurse suspects which condition?

uterine atony

The nurse is teaching a prenatal class emphasizing factors that pregnant mothers can implement to ensure a healthy newborn. Which nursing recommendations would be important to discuss? Select all that apply.

Keep all prenatal checkups. Have good blood sugar control. Avoid the use of any types drugs and alcohol. Visit the dentist regularly.

A client gives birth to a newborn in a local health care facility. What guidance should the nurse give to the client before discharge regarding thermoregulation of the newborn at home?

Keep the newborn wrapped in a blanket, with a cap on its head.

Upon assessment, a nurse notes the client has a pulse of 90 bpm, moderate lochia, and a boggy uterus. What should the nurse do next?

Massage the client's fundus.

A client is waiting for the results of an endometrial biopsy for suspected endometrial cancer. She wants to know more about endometrial cancer and asks the nurse about the available treatment options. Which treatment information should the nurse give the client?

Surgery involves removal of the uterus, fallopian tubes, and ovaries; adjuvant therapy is used if relevant.

What is the most common viral infection?

human papillomavirus (HPV)

A woman who is breastfeeding her newborn reports that her breasts seem quite full. Assessment reveals that her breasts are engorged. Which factor would the nurse identify as the most likely cause for this development?

inability of infant to empty breasts

A nurse completes the initial assessment of a newborn. According to the due date on the antenatal record, the baby is 12 days' postmature. Which physical finding does not confirm that this newborn is 12 days' postmature?

increased amounts of vernix

When assessing a newborn's gestational age, the nurse evaluates which parameter to indicate physical maturity? Select all that apply.

lanugo genitals

An Rh positive client vaginally gives birth to a 6 lb, 10 oz (3,005 g) neonate after 17 hours of labor. Which condition puts this client at risk for infection?

length of labor

A newborn is designated as extremely low birth weight. The nurse understands that this newborn's weight is:

less than 1,000 g.

The nurse is preparing a teaching plan for new parents about why newborns experience heat loss. Which information about newborns would the nurse include?

limited voluntary muscle activity

While conducting an interview with a 38-year-old client, the nurse recognizes which factor as putting the client at the greatest risk for endometrial cancer?

use of estrogen without progestin for hormone replacement therapy

\ When reviewing the history of a woman diagnosed with endometrial cancer, the nurse would identify which factor as increasing the woman's risk?

use of tamoxifen

A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition?

uterine atony

A nurse is preparing to administer Vitamin K to a newborn. The nurse would adminsiter the drug:

intramuscularly.

While examining a 2-day old newborn, a nurse notices that the skin and sclera of the eyes appear yellow. The nurse recognizes this condition as:

jaundice

After completing an assessment of a newborn, the nurse determines that the newborn is small-for-gestational-age based on which weight assessment?

weight of 2,400 g

A nurse is providing care to a 3-hour-old neonate. The nurse ensures that her hands are warm prior to touching the neonate to prevent heat loss by which mechanism?

conduction

When discussing heat loss in newborns, placing a newborn on a cold scale would be an example of what type of heat loss?

conduction

A newborn is challenged to maintain an adequate body temperature. If a baby is placed too close to a cold air vent, the nurse can assume that the infant will lose heat by which mechanism?

convection

Eliminating drafts in the birth room and in the nursery will help to prevent heat loss in a newborn through which mechanism?

convection

The nurse is providing education to a mother who is going to bottle feed her infant. What information will the nurse provide to this mom regarding breast care?

Wear a tight, supportive bra.

A 36-year-old was diagnosed with uterine fibroids (leiomyomas). The nurse teaches the client to expect which clinical manifestation?

abnormal uterine bleeding

When documenting the newborn's weight on a growth chart, the nurse recognizes the newborn is large-for-gestational-size based on which percentile on growth charts?

above 90th percentile

The mother of a formula-fed newborn asks how she will know if her newborn is receiving enough formula during feedings. Which response by the nurse is correct?

"A sign of good nutrition is when your newborn seems satisfied and is gaining sufficient weight."

A nurse is conducting a class on various issues that might develop after going home with a new infant. After discussing how to care for hemorrhoids, the nurse understands that which statement by the class would indicate the need for more information?

"I only eat a low-fiber diet."

The nurse is working with a group of parents of children who have congenital heart disorders. Which statement made by the parents would be an indication the child is showing signs of congestive heart failure?

"She gets so tired when she is eating."

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?

"That is correct; a 30-week-gestation infant lacks the protective antibody called IgG."

A client at 32 weeks' gestation has recently been diagnosed with acute herpes type 2. The client asks what can happen to the baby as a result of this infection. How should the nurse best respond?

"There is a chance your baby may have a form of cognitive challenge."

A client diagnosed with pelvic organ prolapse is being taught how to perform pelvic floor muscle exercises. During the teaching session, the client asks the nurse, "How do these exercises help?" Which response by the nurse would be most appropriate?

"They help to increase the volume of your muscles which leads to stronger muscle contraction."

A client who gave birth to a baby 36 hours ago informs the nurse that she has been passing unusually large volumes of urine very often. How should the nurse explain this to the client?

"Your body usually retains extra fluids during pregnancy, so this is one way it rids itself of the excess fluid."

In a class teaching new parents basic information on how to care for their new infant, the nurse should suggest that the parents plan to use how many diapers on a daily basis?

10

Mrs. M. and her infant are being discharged home after an unplanned cesarean delivery. You explain to her that she is at a higher risk for postpartum infection than most patients. What is the major risk factor for a post-partum infection?

A nonelective cesarean birth. Explanation: The major risk factor for postpartum infection is a nonelective cesarean birth. Antepartum risk factors include history of infection; history of chronic conditions, such as diabetes, anemia, or poor nutrition; infections of the genital tract; smoking; and obesity

A nurse is preparing a client for intrauterine device (IUD) insertion. What should the nurse inform the client when educating her on IUDs?

A regular check of threads must be done.

A nurse is caring for a preterm infant. Which intervention will prepare the newborn's gastrointestinal tract to better tolerate feedings when initiated?

Administer 0.5 ml/kg/hr of breast milk enterally.

A 29-year-old postpartum client is receiving anticoagulant therapy for deep venous thrombophlebitis. The nurse should include which instructions in her discharge teaching?

Avoid over-the-counter (OTC) salicylates.

The nurse is inspecting the mouth of a newborn and finds small, white cysts on the gums and hard palate. The nurse documents this finding as:

Epstein's pearls.

Which vital sign is not routinely assessed in a term, healthy newborn with an Apgar score of 9?

blood pressure

A postpartum client is having difficulty stopping her urine stream. Which should the nurse do next?

Educate the client on how to perform Kegel exercises.

For several hours after birth a multigravida client who experienced a much more difficult labor this time than any time previously, wants to talk about why the birthing process was so hard for her. She is focusing on this aspect to the point that she seems relatively indifferent to her newborn. How should the nurse handle this situation?

Encourage her to discuss her experience of the birth and answer any questions or concerns she may have.

The nurse collects a urine specimen for culture from a postpartum woman with a suspected urinary tract infection. Which organism would the nurse most likely expect the culture to reveal?

Escherichia coli Explanation: E. coli is the most common causative organism for urinary tract infections. S. aureus is the most common causative organism for mastitis. G. vaginalis is a common cause of metritis. K. pneumoniae is a common cause of metritis, but some species of Klebsiella may cause urinary tract infections.

A woman who is about to be discharged after a vaginal birth notices a flea-like rash on her newborn's chest. The rash has tiny red lesions all across the nipple line. What does this rash indicate?

It is a normal skin finding in a newborn.

A client at 34 weeks' gestation has recently been diagnosed with human immunodeficiency virus (HIV). The client asks how HIV would be transmitted to the newborn. Which statement would be the nurse's best response?

It is recommended to formula-feed your newborn as it is transmitted through your breast milk."

Which instruction should be given to a woman newly diagnosed with genital herpes?

Limit stress and emotional upset as much as possible.

During a routine assessment the nurse notes the client is tachycardic. Which possible cause should be ruled out?

delayed hemorrhage

A 58-year-old woman is diagnosed with uterine prolapse. Which nonsurgical treatments are available for this disorder? Select all that apply.

Pessaries Estrogen replacement therapy Kegel exercises

The infant's temperature is 97.2° F (36.2° C) axillary an hour after birth. Which intervention is appropriate for the nurse?

Place the infant under a radiant warmer or in a heated isolette.

What is a consequence of hypothermia in a newborn?

holds breath 25 seconds

Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis?

latency

A nurse is observing the interaction between a new mother and her neonate. The nurse notes that the neonate moves his head and eyes to focus on the mother's voice and smile. The nurse interprets this as which behavioral response?

orientation

A middle-aged woman is seen in the OB/GYN clinic and reports abdominal bloating, fatigue, abdominal pain, urinary frequency, and constipation. She also says that she had lost 24 pounds in the last month without trying to lose. For which disease should the primary care provider screen this client?

ovarian cancer

When assessing a client for postpartum hemorrhage, the nurse monitors what every hour?

pad count

During the fourth stage of labor, the nurse assesses the client's fundal height and tone. When completing this assessment, the nurse performs which action to prevent prolapse or inversion of the uterus?

places a gloved hand just above the symphysis pubis

A nurse is providing preoperative care to a female newborn client with the congenital abnormality myelomeningocele. Which intervention is the priority?

preventing infection

When assessing a client, a nurse determines that the client has a rectocele based on which finding?

sagging of the rectum, which pushes against or into the posterior vaginal wall

When giving a postpartum client self-care instructions in preparation for discharge, the nurse instructs her to report heavy or excessive bleeding. How should the nurse describe "heavy bleeding?"

saturating 1 pad in 1 hour

Methylergonovine is prescribed for a woman experiencing postpartum hemorrhage. The nurse monitors the woman closely for which adverse effects?

seizures

Four weeks before the birth of a client's already large child, the primary care provider has told the client that if the baby gets bigger and the baby's lungs are ready, the care provider would like to perform a cesarean birth. The woman asks the nurse what the downside is to having a cesarean rather than a vaginal birth. What is an appropriate response by the nurse?

"As the baby passes through the birth canal some of the excess fluid is expelled from the lungs, if that doesn't happen there's a higher risk of respiratory distress."

After teaching a class of pregnant women on ways to decrease the postpartum complication of thrombotic conditions, the nurse recognizes more teaching is needed when one of the participants states:

"At least I don't have to give up smoking for this one."

After teaching a group of college-aged students about condom use, the nurse determines that additional teaching is needed when the students make which statement?

"It's okay to use petroleum jelly with a latex condom."

After a discussion on the HPV vaccine with a mother and her 10-year-old daughter at a well-child visit, the nurse recognizes the discussion was successful when the mother makes which statement?

"My daughter will need three injections over a 6-month period."

Which statement would be most appropriate when explaining endometriosis as a cause of a woman's infertility?

"Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum."

A nurse is providing care to a client with pediculosis pubis. Which information would the nurse include when teaching the client about this condition?

"Remove the nits with a fine-toothed comb."

A 25-year-old woman is at the primary care provider for her annual check up. 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?"

New parents are upset their newborn has lost weight since birth. The nurse explains that newborns typically lose how much of their birth weight by 3 to 4 days of age?

10%

What percentage of neonates require some type of assistance to transition to extrauterine life?

10%

On the third day postpartum, which temperature is internationally defined as a postpartal infection?

100.4° F (38° C)

The nurse is assisting parents who have just experienced the death of their twin infants. What would be the most appropriate action for the nurse?

Allow the parents to be present at medical rounds and the resuscitation.

A nurse is caring for a client who gave birth about 10 hours earlier. The nurse observes perineal edema in the client. What intervention should the nurse perform to decrease the swelling caused due to perineal edema?

Apply ice.

A client reports she has not had a bowel moment since her infant was born 2 days ago. She asks the nurse what she can do to help her have a bowel movement. What intervention is appropriate to encourage having a bowel movement?

Encourage the client to eat more fiber rich foods.

A nurse is applying ice packs to the perineal area of a client who has had a vaginal birth. Which intervention should the nurse perform to ensure that the client gets the optimum benefits of the procedure?

Ensure ice pack is changed frequently.

A postmenopausal woman's pelvic organ prolapse is being treated with a pessary. Which action would be most important for the nurse to do?

Ensure that she has a prescription for an estrogen cream preparation.

A nurse is caring for a client who has just received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. How does the nurse classify the laceration?

Fourth-degree laceration. First-degree = only skin & superficial structures above muscle; second-degree extends through perineal muscles; third-degree extends through the anal sphincter muscle but not through the anterior rectal wall.

The primary care provider has prescribed estrogen replacement therapy (ERT) for a menopausal woman who has been diagnosed with pelvic organ prolapse (POP). The client asks the nurse why she needs to be on hormones. Which would be the nurse's best response?

Hormone replacement will increase blood perfusion and the elasticity of the vaginal wall.

A nurse is performing an assessment on a female client who gave birth 24 hours ago. On assessment, the nurse finds that the fundus is 2 cm above the umbilicus and boggy. Which intervention is a priority?

Have the client void, and then massage the fundus until it is firm.

When teaching the new mother about breastfeeding, the nurse is correct when providing what instructions? Select all that apply.

Help the mother initiate breastfeeding within 30 minutes of birth. Encourage breastfeeding of the newborn infant on demand. Place baby in uninterrupted skin-to-skin contact with the mother.

The nurse is caring for a woman who has dysplasia (disordered growth of abnormal cells). The nurse educates her on dysplasia progression that is high-grade. Which information is important for the nurse to include?

High-grade dysplasia progresses to invasive cervical cancer in about 2 years.

A group of students are reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as the cause of condylomata?

Human papilloma virus Genital warts or condylomata are caused by the human papilloma virus (HPV). Herpes virus causes genital herpes. Treponema pallidum is the cause of syphilis. Haemophilus ducreyi bacillus is the cause of chancroid.

Which nursing diagnosis would be highest in priority for a newborn?

Ineffective airway clearance related to mucous obstruction.

The nurse who is caring for a newborn boy notices that although he has seemed healthy at 18 hours of age, the newborn's abdomen is now distended. By 24 hours he has passed no stool. What should the nurse do?

Inform the primary care provider of the findings.

The nurse is caring for a small-for-gestational-age infant at 1 hour old, after a difficult birth, with a glucose level of 40 mg/dL (2.5 mmol/L). Which nursing action would be the priority?

Initiate early oral feedings.

A client would like some information about the use of a cervical cap. Which information should the nurse include in the teaching plan of this client? Select all that apply.

Inspect the cervical cap before insertion. Do not use the cervical cap during menses. Wait for 30 minutes after insertion before engaging in intercourse

A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby?

Instill a prophylactic agent in the eyes of the newborn.

A 30-year-old client tells the nurse that she would like to use a contraceptive sponge but does not know enough about its use and whether it will protect her against sexually transmitted infections (STIs). Which information should the nurse provide the client about using a contraceptive sponge? Select all that apply.

Leave the sponge in place for at least 6 hours following intercourse. Insert the sponge 24 hours before intercourse. Wet the sponge with water before inserting it.

Shortly after the birth of a newborn, the mother notices a gray patch across the baby's buttocks. She is immediately concerned that the baby has been bruised during the birth and asks the nurse about this. The nurse recognizes patch as a birth mark and explains this to the mother. Which type of birth mark is this most likely to be?

Mongolian spot

A nurse is performing a detailed assessment of a female newborn. Which observations indicate normal findings? Select all that apply.

Mongolian spots swollen genitals short, creased neck

A newborn is being admitted to the intensive care unit with the diagnosis of postterm infant. Which nursing actions would be the priority? Select all that apply.

Monitor for hematocrit levels. Assess for jaundice. Initiate blood glucose monitoring.

A nurse is providing care to a postpartum woman and is completing the assessment. Which finding would indicate to the nurse that a postpartum woman is experiencing bladder distention?

Percussion reveals dullness.

An infant is suspected of having persistent pulmonary hypertension of the newborn (PPHM). What intervention implemented by the nurse would be most beneficial in treating this client?

Provide oxygen by oxygen hood or ventilator.

A nurse is preparing a discussion for a group of women at the clinic. When describing vaginal cancer, the nurse wouldmost likely integrate which statement into the discussion?

Pulmonary metastasis is common with adenocarcinomas of the vagina.

A nurse working in the Family Birthing Center is answering the nurse hot line phone. A client calls in to schedule her annual Pap smear procedure. How could the nurse best educate the client before her procedure to make sure results are not affected?

Refrain from sexual intercourse 48 hours before testing to ensure clear results.

A nurse is caring for a 45-year-old client using a pessary to help decrease leakage of urine and support a prolapsed vagina. Which recommendation is most commonly provided to a client regarding pessary care?

Remove the pessary twice weekly, and clean it with soap and water.

When caring for a newborn who is jittery and irritable 30 minutes after birth, what should the nurse do?

Take blood, using a heel stick, to check for hypoglycemia.

A client with large uterine fibroids is scheduled to undergo a hysterectomy. Which intervention should the nurse perform as a part of the preoperative care for the client?

Teach turning, deep breathing, and coughing.

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 probably had diabetes.

A term neonate has been admitted to the observational newborn nursery with the diagnosis of being small for gestational age. Which factors would predispose the neonate to this diagnosis? Select all that apply.

The mother had chronic placental abruption. At birth the placenta was noted to be decreased in weight. On assessment the placenta had areas of infarction. At birth the placenta was a shiny Schultz presentation.

A neonate born at 40 weeks' gestation, weighing 2300 grams (5 lb, 1 oz) is admitted to the newborn nursery for observation only. What is the nurse's first observation about the infant?

The neonate is small for its gestational age.

The nurse observes a neonate born at 28 weeks' gestation. Which finding would the nurse expect to see?

The pinna of the ear is soft and flat and stays folded.

When caring for a client with postpartum blues, which intervention would be most appropriate?

Validate the client's emotions, allowing her to express them freely.

A nurse is assisting a postpartum client out of bed to the bathroom for the first time. Which interventions would be most appropriate? Select all that apply.

Walk alongside the client to the bathroom. Elevate the head of the bed for several minutes before getting her up. Frequently ask the client how her head feels.

A client is taking oral contraceptives. Which symptom should the nurse report to the primary care provider?

abdominal pain

A nurse finds the uterus of a postpartum woman to be boggy and somewhat relaxed. This a sign of which condition?

atony

A client reports that she has multiple sex partners and has a lengthy history of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which method should the nurse suggest for this client?

condoms

A nurse is monitoring the vital signs of a client 24 hours after birth. She notes that the client's blood pressure is 100/60 mm Hg. Which postpartum complication should the nurse most suspect in this client, based on this finding?

bleeding

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as:

bulging of the bladder into the vagina.

A client has presented reporting symptoms that suggest a gonorrheal infection. After laboratory testing confirms this diagnosis, the nurse anticipates that the client will also be treated for which infection?

chlamydia

The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common STI in the United States would the nurse expect to include?

chlamydia

A nurse is caring for a 30-year-old woman who was just diagnosed with cervical cancer. Which psychosocial need would be the priority for the nurse with her client?

clear information on the disease, management, and treatment

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.

Clients who have had PID are prone to which complication?

ectopic pregnancy

When developing a program for STI prevention, which action would need to be done first?

educating on how to promote sexual health

The nurse needs to conduct a procedure on a preterm newborn. Which measures would be most effective in reducing pain? Select all that apply.

encouraging kangaroo care during procedures offering a pacifier prior to a procedure swaddling the newborn closely

A client who gave birth by cesarean birth 3 days ago is bottle-feeding her neonate. While collecting data the nurse notes that vital signs are stable, the fundus is four fingerbreadths below the umbilicus, lochia are small and red, and the client reports discomfort in her breasts, which are hard and warm to touch. The best nursing intervention based on this data would be:

encouraging the client to wear a supportive bra.

A postmenopausal woman is seen in the clinic and reports vaginal bleeding that has lasted for the past 3 to 4 weeks. A pelvic exam is performed and shows no abnormalites. Which test does the nurse anticipate the primary care provider will prescribe next for this client?

endometrial biopsy

The nursing instructor is teaching about urinary incontinence and informs the students that dysfunction of either the bladder, the urethra, or the levator muscle can cause incontinence. She also lists which contributing factors for incontinence? Select all that apply.

fluids such as alcohol and caffeinated and carbonated drinks constipation habitual "preventive" emptying advancing age pregnancy and birth obesity

Over the course of an eight-hour shift of postoperative care for a child who has had ventriculoatrial shunt placement, the nurse notes that the child's cry has become increasingly shrill and the child has projectile vomiting. The nurse would notify the primary care provider immediately because of the possibility that the child might be experiencing:

increased intracranial pressure.

The nurse is teaching women at a local clinic about vaginal cancer. Which risk factors would be important to include in her presentation? Select all that apply.

increasing age history of HIV smoking

Prior to discharge is an appropriate time to evaluate the client's status for preventative measures such as immunizations and Rh status. Which test would the nurse ensure has been conducted to evaluate the Rh negative mother?

indirect Coombs' test

A client appears to be resting comfortably 12 hours after giving birth to her first child. In contrast, she labored for more than 24 hours, the primary care provider had to use forceps to deliver the baby, and she had multiple vaginal examinations during labor. Based on this information what postpartum complication is the client at risk for developing?

infection

A nurse is assessing vital signs for a postpartum client 48 hours after birth. The vital signs are: T 101.2° F; (38.4° C) HR 82 beats/min.; RR 18 breaths/min.; BP 125/78 mm Hg. How will the nurse interpret the vital signs?

infection

The nurse assesses a postpartum woman's perineum and notices that her lochial discharge is moderate in amount and red. The nurse would record this as what type of lochia?

lochia rubra

A nurse is instructing a woman that it is important to lose pregnancy weight gain within 6 months of birth because studies show that keeping extra weight longer is a predictor of which condition?

long-term obesity

The client is interested in using an injectable contraceptive that works by suppressing pituitary secretions. The nurse provides the client with literature and discusses which contraceptive with her?

medroxyprogesterone acetate

The hereditary defect known as phenylketonuria (PKU) will cause which condition if left untreated?

mental retardation

A nurse is conducting a class for nurses working in the postpartum unit about ways to reduce the risk of postpartum infections. The nurse determines that the teaching was effective when the group identifies which preventive measure as essential?

meticulous handwashing

A nurse needs to monitor the blood glucose levels of a newborn under observation at a health care facility. When should the nurse check the newborn's initial glucose level?

on admission to the nursery

It would be best to place an infant with a myelomeningocele in which position prior to surgery?

on the stomach (prone)

The nurse is observing a client who gave birth yesterday. Where should the nurse expect to find the top of the client's fundus?

one fingerbreadth below the umbilicus

The nurse is educating a female client about lifetime risk for developing cancer. The nurse determines that the teaching was successful when the woman states that regardless of her risk factors, her chances for developing cancer are:

one-in-three.

A nurse is preparing to place a skin temperature probe on a neonate who is lying on his back. To ensure an accurate reading, which location would be most appropriate to use for placement?

over the liver

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about?

overstimulation of the ovary resulting in potential multiple births

A nursing instructor explains to students that, regardless of their gestational age, all newborns experience the same pattern that includes which periods? Select all that apply.

period of decreased responsiveness second period of reactivity first period of reactivity

Two weeks after their baby is born, a father calls to report that his wife is behaving strangely. She is extremely talkative and energetic, and he has not observed her sleeping for more than an hour or two at a time. She is also forgetting to eat and neglecting her appearance, but worse, she seems to barely be aware of the baby's needs and appears surprised when the father asks her about the child, "As if," the father says, "she's forgotten that we even have a baby!" The nurse tells him to bring the mother in right away because the nurse suspects the mother is suffering from what condition?

postpartum psychosis

A nurse is working with a child who has spina bifida. Which nursing goal for this child would have the highest priority?

preventing infection

The nurse is teaching a premenopausal client about dietary and lifestyle modifications that can reduce the risk factors for developing pelvic organ prolapse (POP). The nurse is describing which type of prevention?

primary

The nurse is concerned that the parents are having difficulties relating to their newborn. In an effort to assist with and encourage attachment, which activity should the nurse suggest?

promoting skin-to-skin contact on the chest

A nurse is conducting a presentation for a local women's group about pelvic organ prolapse. When describing the different types, which information would the nurse incorporate into the description of a cystocele?

protrusion of the bladder wall through the anterior vaginal wall

The nurse uses a radiant warmer to transport a newborn to reduce heat loss via which mechanism?

radiation

A nurse is teaching newborn care to students. The nurse correctly identifies which mechanism as the predominant form of heat loss in the newborn?

radiation, convection, and conduction

Which description best explains the hysterosalpingogram procedure?

radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix

When an infant smiles at the mother and the mother in turn smiles and kisses her baby, this would be which phase of attachment?

reciprocity

A 40-year-old woman is being discharged from the walk-in health care clinic after a diagnosis of pelvic inflammatory disease. Which health teaching topic should the nurse address?

sexually transmitted infections

After teaching a group of college students about the modes of transmission for herpes simplex virus, the nurse determines that additional teaching is needed when the group identifies which mode of transmission?

sharing contaminated needles

When using the contraceptive patch, a client should understand that it:

should be applied to the abdomen, buttocks, or back.

A newborn girl who was born at 38 weeks of gestation weighs 2000 g and is below the 10th percentile in weight. The nurse recognizes that this girl will be placed in which classification?

term, small for gestational age, and low-birth-weight infant

Which newborn would the nurse suspect to be most at risk for cognitive challenge due to the mother's actions during pregnancy?

the child of a client who admits to drinking a liter of alcohol daily during the pregnancy

In a postmenopausal woman with abnormal vaginal bleeding, which diagnostic test would the nurse expect the primary care provider to order to determine whether an endometrial biopsy is needed?

transvaginal ultrasound

When assessing the newborn's umbilical cord, what should the nurse expect to find?

two smaller arteries and one larger vein

Which factor in a client's history indicates she is at risk for candidiasis?

use of corticosteroids

A client diagnosed with uterine prolapse is to undergo surgery. The nurse would prepare a preoperative teaching plan for which surgery?

vaginal hysterectomy

A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis?

vaginal odor smelling of fish

Parents often vent their frustration and anger over the loss of their newborn on the nurse. The most appropriate reaction for the nurse is:

validate their feelings and refocus their anger.

A postpartum client who had a cesarean birth reports right calf pain to the nurse. The nurse observes that the client has nonpitting edema from her right knee to her foot. The nurse knows to prepare the client for which test first?

venous duplex ultrasound of the right leg

The nurse is assessing the stools of a 36-hour-old neonate who is being breastfed. The nurse determines that the stools are within normal parameters based on which finding?

yellowy mustard color with seedy appearance

The client has heard of extended oral contraceptive regimens and desires more information. The nurse explains that these regimens consist of active combination pills, followed by placebo pills. How many days of active combination pills and placebo pills are contained in these regimens?

84 active; 7 placebo

A client who gave birth 5 days ago reports profuse sweating during the night. What should the nurse recommend to the client in this regard?

"Be sure to change your pajamas to prevent you from chilling."

A nursing student is aware that fetal gas exchange takes place in which area?

placenta

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?

engaging in daily weight-bearing exercise

Which symptom is an early symptom of vulvar cancer?

pruritus with genital burning

Which intervention would be helpful to a bottle-feeding client who's experiencing hard or engorged breasts?

applying ice

A nurse is caring for a child with complex esophageal atresia who will be undergoing surgery for repair. What comment by the parents indicates further teaching is required?

"After this surgery is done tomorrow, my baby will be able to eat and drink."

A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques on observed on the vaginal wall. The nurse suspects which condition?

vulvovaginal candidiasis

A client has been discharged from the hospital after a cesarean birth. Which instruction should the nurse include in the discharge teaching?

"You should be seen by your healthcare provider if you have blurred vision."

A nurse is caring for a client with pelvic organ prolapse. As part of the client's workup, the nurse obtains a postvoid residual urine specimen via catheterization. Which specimen amount would lead the nurse to suspect that additional testing will be needed?

120 mL

The nurse recognizes that the group of infants born during which time frame are at a higher risk for morbidity and mortality?

34 to 37 weeks

A nurse is assessing a newborn's temperature. Which reading would the nurse document as normal?

37.0° C (98.6° F)

You are caring for a postpartum woman who exhibits a large amount of bleeding. Which areas would you need to assess before the woman ambulates?

Blood pressure, pulse, complaints of dizziness Correct Explanation: Continue to monitor the woman's vital signs for changes. If she reports dizziness or light-headedness when getting up, obtain her blood pressure while lying, sitting, and standing, noting any change of 10 mm Hg or more.

A postpartal woman is developing a thrombophlebitis in her right leg. Which assessment should the nurse no longer use to assess for thrombophlebitis?

Dorsiflex her right foot and ask if she has pain in her calf. Explanation: A Homans' sign (pain in the calf on dorsiflexion of the foot) is a common assessment for thrombophlebitis in conjunction with assessing for edema and calf redness. Having her raise her foot and draw a circle would not be an assessment for thrombophlebitis in her leg, nor would assessing capillary refill in a toe.

A woman arrives at the office for her 4-week postpartal visit. Her uterus is still enlarged and soft, and lochial discharge is still present. Which nursing diagnosis is most likely for this client?

Risk for fatigue related to chronic bleeding due to subinvolution

A nurse is educating a woman diagnosed with small ovarian cysts on follow-up care. Which instruction would be appropriate?

Schedule ultrasound every 3 to 6 months.

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 has a family history of thromboembolism.

Which maternal reaction is the most concerning?

She neglects to engage with or provide care for the baby and shows little interest in it.

Which situation should concern the nurse treating a postpartum client within a few days of birth?

The client feels empty since she gave birth to the neonate.

Which statement is true regarding fetal and newborn senses?

The rooting reflex is an example that the newborn has a sense of touch.

A preterm infant is experiencing cold stress after birth. For which symptom should the nurse assess to best validate the problem?

apnea

The nurse examines a 26-week-old premature infant. The skin temperature is lowered. What could be a consequence of the infant being cold?

apnea

The nurse is caring for a newborn diagnosed with congenital talipes equinovarus. Which treatment would the nurse expect for this newborn?

application of a cast

Seven hours ago, a multigravida woman gave birth to a 4133-g male infant. She has voided once and calls for a nurse to check because she states that she feels "really wet" now. Upon examination, her perineal pad is saturated. The immediate nursing action is to:

assess and massage the fundus.

A young woman comes to the walk-in clinic seeking treatment for chronic chlamydia trachomatis. Which finding is most likely because it often correlates with this diagnosis?

gonorrhea

The nurse is preparing to apply a thermistor probe to a newborn to monitor the newborn's temperature. At which location would the nurse apply the probe?

right upper abdominal quadrant

A female client with genital herpes is prescribed acyclovir as treatment. After teaching the client about this treatment, which statement by the client indicates effective teaching?

"This drug will help to suppress any symptoms of the infection."

For several hours after birth a multigravida client who experienced a much more difficult labor this time than any time previously, wants to talk about why the birthing process was so hard for her. She is focusing on this aspect to the point that she seems relatively indifferent to her newborn. How should the nurse handle this situation?

Encourage her to discuss her experience of the birth and answer any questions or concerns she may have. The client needs to explore her birth experience and clarify her questions. The nurse should allow her to ask questions, be supportive, and encourage her to express her feelings. Redirecting her attention to the baby, asking her to describe how she plans to integrate the new baby into the family, or pointing out positive features of the new baby do not meet the needs of the client at this time.

A nurse determines that a newborn has a 1-minute Apgar score of 5 points. What conclusion would the nurse make from this finding?

The infant is experiencing moderate difficulty in adjusting to extrauterine life.

A client has been referred for a colposcopy by the primary care provider. The client wants to know more about the examination. Which information regarding a colposcopy should the nurse give to the client?

The test is conducted because of abnormal results in Pap smears.

A postmenopausal woman presents to the clinic with painless vaginal bleeding. The health care provider wants to assess for endometrial cancer. The nurse would anticipate the health care provider prescribing which procedure first?

a transvaginal ultrasound

A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence?

a weight gain of 10 lb (4.5 kg)

A client is diagnosed with bacterial vaginosis and is prescribed medication therapy. The nurse would anticipate which drugs as being prescribed? Select all that apply.

clindamycin metronidazole

A 17-year-old nulliparous client presents in active labor. It is discovered that she received no prenatal care. Which information would be important to collect first?

coagulation studies

The public health nurse is teaching a community class of couples on fertility awareness-based methods. The nurse determines that additional teaching is needed when one of the couples states that they will be using which method?

coitus interruptus method

A young woman is seen in the GYN clinic for a follow-up visit and is told that her recent Pap smear has come back abnormal. Which test can the nurse expect the primary care provider to prescribe for this client?

colposcopy

The nurse recognizes that the postpartum period is a time of rapid changes for each client. What is believed to be the cause of postpartum affective disorders?

drop in estrogen and progesterone levels after birth

All the options are signs of respiratory distress in the newborn except:

respiratory rate >50 breaths/minute.

A couple in their mid-30s are at their primary care provider's office because they have been unable to conceive for 3 years. They already have one child who is 4 years of age. The care provider explains to them that they are dealing with what kind of infertility?

secondary infertility

A couple who is in for fertility testing ask the nurse what tests are commonly performed to assess fertility. The nurse replies that there are only three primary tests that are used. What are these tests?

semen analysis, ovulation monitoring, and tubal patency assessment

A nurse is preparing a presentation for a local community women's group about menopause. When describing the body system changes that occur, the nurse would include which changes? Select all that apply.

vaginal dryness increased abdominal fat decreased bone density hot flashes

A client is suspected of having herpes simplex viral infection. The nurse would expect to prepare the client for which diagnostic test to confirm the infection?

viral culture of vesicular fluid

Rubin identified a series of changes that a new mother makes during the postpartum period. The correct sequence of these changes is:

taking-in, taking-hold, letting-go.

Which assessment finding would best validate a problem in a small-for-gestational age newborn secondary to meconium in the amniotic fluid?

respiratory rate of 60 to 70 bpm

A client has undergone an abdominal hysterectomy to remove uterine fibroids. Which interventions should a nurse perform as a part of the postoperative care for the client? Select all that apply.

Administer analgesics promptly and use a patient-controlled analgesia (PCA) pump. Ambulate frequently. Administer antiemetics to control nausea and vomiting.

A nurse is assigned to care for a client with deep vein thrombosis who has to undergo anticoagulation therapy. Which instruction should the nurse offer the client as a caution when the client receives anticoagulation therapy?

Avoid products containing aspirin.

A nurse is caring for a client for whom estrogen replacement therapy has been recommended for pelvic organ prolapse. Which nursing intervention is the most appropriate for the nurse to implement before the start of the therapy?

Evaluate the client to validate her risk for complications.

A nurse is explaining the benefits of breastfeeding to a client who has just given birth. Which statement correctly explains the benefits of breastfeeding to this mother?

Immunoglobulin IgA in breast milk boosts a newborn's immune system.

A client comes to the genitourinary clinic with very mild symptoms of pelvic organ prolapse (POP) that has just started in the last several days. What would be the treatment of choice for this client?

Kegel exercises

A client diagnosed with pelvic organ prolapse is prescribed conservative measures to treat the condition. When developing the client's teaching plan, the nurse would include which measures as first line therapy? Select all that apply.

Kegel exercises weight loss regimen avoidance of straining

Which method of contraception is considered a barrier method?

condom

A client who stands all day at her job has been diagnosed with pelvic organ prolapse. The client is asking the nurse in the office about whether she will be a candidate for surgery. The nurse knows that which documented findings will make the client ineligible for surgery? Select all that apply.

documented risk for recurrent prolapse after surgery documented morbid obesity documented chronic obstructive pulmonary disease

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?

exposure to diethylstilbestrol (DES) in utero

Which definition best explains the term "subfertility/infertility"?

failure to achieve pregnancy after 1 year of unprotected intercourse

A female sex trade worker has been diagnosed with secondary syphilis. Which findings would most likely correlate with this diagnosis?

sore throat and flu-like symptoms

A nurse is caring for a preterm newborn who has developed rapid, irregular respirations with periods of apnea. Which additional sign should the nurse consider as an indication of respiratory distress syndrome (RDS) in the newborn?

sternal retraction

A nurse is providing care to a neonate and his mother. On reviewing the maternal history, the nurse notes that the mother's glucose level at birth was 102 mg/dL. The nurse would anticipate that the neonate's blood glucose level would be approximately:

71 to 82 mg/dL.

Which instruction should the nurse offer a client as primary preventive measures to prevent mastitis?

Perform handwashing before breastfeeding.

A school health nurse is presenting information on sexually transmitted infections (STIs) to a high school class. The nurse feels confident that learning has taken place when the students report:

female adolescents are more susceptible to STIs due to their anatomy.

A father is asking questions about the circumcision of his son. He is asking the nurse if there are any disadvantages to the procedure. How should the nurse respond?

pain administration may not be effective during the procedure

A nurse is caring for a newborn with necrotizing enterocolitis (NEC) who is scheduled to undergo surgery for a bowel resection. The infant's parents wish to know the implications of the surgery. What information should the nurse provide to the parents regarding this surgery?

Surgery requires placement of a proximal enterostomy.

Bonding between a mother and her infant can be defined how?

a process of developing an attachment and becoming acquainted with each other

The nurse is admitting a term, large-for-gestational-age neonate weighing 4,610 g (10 lb, 2 oz), born vaginally with a mid-forceps assist, to a 15-year-old primipara. What would the nurse anticipate as a result of the birth?

midclavicular fracture

A client was in labor for more than 36 hours and now reports urine leaking from her vagina. On examination the nurse would be inspecting for:

urethrovaginal fistula.

The nursing student correctly identifies that ovarian cancer occurs more frequently in which age group?

55 to 75 years of age

When teaching a class of new parents about the needs of their newborn, the nurse explains that the newborn's voiding is a good indicator that he or she is getting enough fluids. The nurse determines that the teaching was successful when the parents state which number of voiding per day as a good indicator of adequate fluids?

6 to 8

A public health nurse is teaching a class on sexually transmitted infections (STIs). Which statements would the nurse include in the discussion? Select all that apply.

65 million people live with incurable STIs." "STIs contribute to cervical cancer." "After a single exposure, women are twice as likely as men to acquire a STI."

A nurse is reading a journal article about chlamydia. The nurse would expect to find that what percentage of women are asymptomatic when infected with chlamydia?

70%

The nurse collects a urine specimen for culture from a postpartum woman with a suspected urinary tract infection. Which organism would the nurse expect the culture to reveal?

Escherichia coli

A parent at an educational session on sexually transmitted infections (STIs) asks the nurse if there are vaccines available to prevent STIs. What is the nurse's best response?

"A vaccine has been approved vaccines to prevent the human papillomavirus."

A postmenopausal client is told at her routine gynecological exam that the primary care provider has found a cyst on her right ovary. The nurse notices that this does not cause worry for this client. What should the nurse and/or care provider tell this client?

"After menopause a mass on an ovary is not a cyst and should be considered cancerous until proven otherwise."

The nurse is doing teaching with the caregivers of an infant diagnosed with hypospadias. Which statement made by the caregivers is accurate regarding hypospadias?

"Being able to most likely correct this in one stage rather than several is reassuring."

A woman opts to use a diaphragm for contraception. Which instruction would be most important for the nurse to provide?

"Have your diaphragm refitted if you lose 10 pounds (4.5 kilograms) or more."

A community health nurse is conducting an educational session at a local community center on sexually transmitted infections (STIs). The nurse considers the session successful when participants identify which statement as correct?

"Human papillomavirus is the cause of essentially all cases of cervical cancer."

A postpartum client with a history of deep vein thrombosis is being discharged on anticoagulant therapy. The nurse teaches the client about the therapy and measures to reduce her risk for bleeding. Which statement by the client indicates the need for additional teaching?

"I should brush my teeth vigorously to stimulate the gums."

A nurse is preparing a client for discharge following an abdominal hysterectomy for fibroids. After providing discharge teaching, the nurse determines that the teaching was successful based on which client statement?

"I should shower rather than take a tub bath."

A woman is going to have in vitro fertilization. When preparing her for this, the nurse would make which statement?

"It can be done with frozen donor sperm."

A client who gave birth vaginally 16 hours ago states she does not need to void at this time. The nurse reviews the documentation and finds that the client has not voided for 7 hours. Which response by the nurse is indicated?

"It's not uncommon after birth for you to have a full bladder even though you can't sense the fullness."

A woman seen in the emergency walk-in clinic is diagnosed with chlamydia trachomatis. She asks the nurse how this disease is different from other sexually transmitted infectious diseases. What is the nurse's best response?

"This STI is characterized by an infection of your cervix."

A client asks the nurse if she can recommend a screening test for ovarian cancer. Which response by the nurse would be most appropriate

"Unfortunately, there aren't any routine screening methods currently."

The nursing instructor is teaching a student about urinary incontinence and realizes that the student needs further instruction when she makes which statement?

"Urinary incontinence is an inevitable problem of aging."

A nurse teaches new parents about how to soothe their crying newborn. Which statement by the parents indicates that they understand how to soothe their newborn if he becomes upset?

"We'll turn the mobile on that's hanging above his head in his crib."

A woman comes to the clinic. She gave birth about 2 months ago to a healthy term male newborn. During the visit, the woman tells the nurse, "I've noticed that I'm a bit uncomfortable now when we have sexual intercourse. Is there anything that I can do?" The woman's menstrual period has not yet resumed. Which suggestion by the nurse would be most appropriate?

"You might try using a water-soluble lubricant to ease the discomfort."

A woman who gave birth to a healthy newborn 2 months ago comes to the clinic and reports discomfort during sexual intercourse. Which suggestion by the nurse would be most appropriate?

"You might try using a water-soluble lubricant to ease the discomfort."

A pregnant woman is diagnosed with chlamydia and asks the nurse, "How will this infection affect my baby and pregnancy?" Which responses by the nurse are accurate? Select all that apply.

"Your newborn can be infected during birth." "Your newborn may have eye infections from this infection." "Your membranes may rupture earlier than normal."

During a neonate resuscitation attempt, the neonatologist has ordered 0.1 mL/kg IV epinephrine (adrenaline) in a 1:10,000 concentration to be given stat. The neonate weighs 3000 grams and is 38 centimeters long. How many millimeters (mL) should the nurse administer? Record your answer using one decimal place.

0.3

A nurse is caring for a postpartum client who has a temperature. Which temperature protocols would the nurse use to indicate a possible infection?

100.5º F (38.1º C) at 48 hours postbirth and remains the same the third day postpartum

A client has had a cesarean birth. Which amount of blood loss would the nurse document as a postpartum hemorrhage in this client?

1000 ml Explanation: Postpartum hemorrhage is defined as blood loss of 500 ml or more after a vaginal birth and 1000 ml or more after a cesarean birth.

Subfertility/infertility is said to exist when a couple has failed to achieve pregnancy after how many months of unprotected sexual intercourse?

12

The client is preparing to go home after a cesarean birth. The nurse giving discharge instructions stresses to the family that the client should be seen by her primary care provider within what time interval?

2 weeks

The nurse is teaching a postpartum woman and her spouse about postpartum blues. The nurse would instruct the couple to seek further care if the client's symptoms persist beyond which time frame?

2 weeks

A client is trying to understand how she could have cervical cancer if all her previous Pap smears were negative. When responding to the client, the nurse integrates understanding that false-negative rates of the conventional Pap smear occur at what rate?

20%

A nurse is conducting a teaching session with a group of adolescent females at a local women's health clinic. When describing appropriate screening guidelines for cervical cancer, at which age would the nurse would instruct the group to have their first Pap smear?

21

Neonatal screening is done before the infant leaves the hospital. Blood is drawn through a heel stick and tested for several disorders that can cause lifelong disabilities. When is the ideal time to collect this specimen?

24 hours after the newborn's first protein feeding

How long is the neonatal period for a newborn?

28

The nurse has completed the initial assessment and vital signs for an infant born at 12:00 p.m. The assessment and vital signs were completed at 1:30 p.m. What time will the nurse plan to complete the next set of vital signs?

2:00 p.m.

On a routine home visit, the nurse is asking the new mother about her breastfeeding and personal eating habits. How many additional calories should the nurse encourage the new mother to eat daily?

500 additional calories per day

The nurse works at a cancer treatment center working with clients with a diagnosis of vaginal cancer. The nurse understands that these clients have what percent chance of being diagnosed with another form of cancer?

80%

The nurse is monitoring a postpartum client who says she's concerned because she feels mildly depressed. The nurse recognizes that she is most likely experiencing "postpartum blues," and reassures the client that this symptom is experienced by approximately what percentage of women?

85%

A client presents to the office reporting severe lower abdominal pain. Ultrasound reveals an ovarian cyst. The client asks, "Is the cyst benign?" The nurse responds, explaining that ovarian cysts are benign approximately how often?

90% of the time

The nurse is reviewing a client's electronic medical record and notices that the client has recently experienced dyspareunia. The nurse knows that this is an effect of aging on the female reproductive system. What is the best description of dyspareunia that the nurse can share with the nursing student who is going to see this client with the nurse?

A woman experiences painful intercourse.

A postpartal woman is developing a thrombophlebitis in her right leg. Which assessments would the nurse make to detect this?

Assess for pedal edema.

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. Which action by the nurse should be implemented first?

Assess the woman's fundus.

A G1 P1001 mother is just home after delivering her first child 5 days ago. Her delivery was complicated by an emergency cesarean delivery resulting from incomplete cervical dilation and hemorrhage. The nurse determines that the mother has not slept longer than 3 hours at one time. The appropriate nursing diagnosis for this patient care issue is

At risk for postpartum depression due to inadequate rest Explanation: This scenario refers only to the issue of sleep. Information is insufficient to suggest that the other issues are problematic at this time.

A nurse is assigned to care for a client with deep vein thrombosis who has to undergo anticoagulation therapy. Which of the following instructions should the nurse offer the client as a caution when the client receives anticoagulation therapy?

Avoid products containing aspirin Explanation: The nurse should caution the client to avoid products containing aspirin, which inhibits the synthesis of clotting factors and can further prolong clotting time and precipitate bleeding. The nurse should instruct the client to avoid crossing the legs as a preventive measure. The nurse should not instruct the client to refrain from performing any leg exercises; instead the nurse should instruct the client to perform leg exercises such as flexion and extension of the feet and pushing the back of the knees into the mattress and then flexing slightly to promote venous return. The nurse should instruct the client to avoid prolonged straining during defecation and to avoid heavy lifting and exercises when caring for a client with cystocele and rectocele.

A nurse tests a newborn's nervous functioning by stroking the sole of the baby's foot in an inverted "J" curve from the heel upward. The baby responds by fanning his toes. Which reflex has just been demonstrated?

Babinski reflex

The nurse is caring for a newborn of a mother with human immunodeficiency virus (HIV). What is the priority for the nurse to complete following delivery?

Bathe the newborn thoroughly

During a routine examination, the nurse suspects a teenager is having unprotected sex. To encourage discussion, which action by the nurse would be best?

Be nonjudgmentally direct in the conversation.

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?

Bilirubin level went from 15 to 11.

A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What should be the nurse's priority for this client?

Check the lochia.

The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which of the following would the nurse expect to include as the most common STI in the United States?

Chlamydia Explanation: Chlamydia is the most common and fastest-spreading bacterial STI in the United States, with 2.8 million new cases occurring each year. Gonorrhea is the second most frequently reported communicable disease in the U.S. The incidence of syphilis had been increasing for the past 6 years. One in five people older than age 12 is infected with the virus that causes genital herpes.

It is discovered that a new mother has developed a puerperal infection. What is the most likely expected outcome that the nurse will identify for this client related to this condition?

Client's temperature remains below 100.4° F or 38° C orally.

A newborn male is circumcised. Which instruction would the nurse include in the discharge teaching plan for his parents?

Cover the glans generously with petroleum jelly.

A client is Rh-negative and has given birth to her newborn. What should the nurse do next?

Determine the newborn's blood type and rhesus.

A nurse is caring for a 3-hour-old newborn boy. The nurse makes the initial assessment and finds the following: respiratory rate 30 bpm, BP 60/40 mm/Hg, heart rate 155 bpm, axillary temperature 98.2° F (36.8° C). The nurse assesses that the newborn is in a state of quiet alert. What should the nurse do?

Document the data.

The nurse in the NICU is caring for preterm newborns. Which guidelines are recommended for care of these newborns? Select all that apply.

Dress the newborn in ways to preserve warmth. Supply oxygen for the newborn, if necessary. Take the newborn's temperature often.

A client reports she has not had a bowel moment since her infant was born 2 days ago. She asks the nurse what she can do to help her have a bowel movement. What intervention is appropriate to encourage having a bowel movement?

Encourage the client to eat more fiber rich foods. Encouraging fiber rich foods will help with prevention of constipation. The client needs plenty of water, to ambulate, and take stool softeners if ordered by the provider. Offering a stimulant laxative is not appropriate. Adding dairy products to the diet may be a good thing, but will not generally produce a bowel movement. Holding the feces until there is a strong urge to defecate will only increase the risk of constipation as well as possible resultant complications.

A nurse is caring for a newborn with transient tachypnea. What nursing interventions should the nurse perform while providing supportive care to the newborn? Select all that apply.

Ensure the newborn's warmth. Observe respiratory status frequently. Provide oxygen supplementation.

The mother of a newborn observes a diaper rash on her newborn's skin. Which intervention should the nurse instruct the parent to implement to treat the diaper rash?

Expose the newborn's bottom to air several times a day.

A nurse is caring for an infant born with polycythemia. Which intervention is most appropriate when caring for this infant?

Focus on decreasing blood viscosity by increasing fluid volume.

A fundal massage is sometimes performed on a postpartum woman. Which of the following is a reason for performing a fundal massage?

Fundal massage is performed for uterine atony, which is failure of the uterus to contract and retract after birth. The nurse would place the gloved dominant hand on the fundus and the gloved nondominant hand on the area just above the symphysis pubis. Using a circular motion, the nurse massages the fundus with the dominant hand. Then the nurse checks for firmness and, if firm, applies gentle downward pressure to express clots that may have accumulated. Finally the nurse assists the woman with perineal care and applying a new perineal pad.

A client in her sixth week postpartum complains of general weakness. The client has stopped taking iron supplements that were prescribed to her during pregnancy. The nurse would assess the client for which of the following?

Hypovolemia Explanation: The nurse should assess the client for hypovolemia as the client must have had hemorrhage during birth and puerperium. Additionally, the client also has discontinued iron supplements. Hyperglycemia can be considered if the client has a history of diabetes. Hypertension and hyperthyroidism are not related to discontinuation of iron supplements.

A nurse is reviewing the history, physical exam, and diagnostic test findings for a woman diagnosed with endometrial cancer. The findings reveal that the cancer has spread to the cervix and other parts of the uterus and to nearby lymph nodes. The nurse interprets these findings as suggestive of which stage?

III

What is the best rationale for trying to decrease the incidence of cold stress in the neonate?

If the neonate becomes cold stressed, it will eventually develop respiratory distress.

A client reports pain in the lower back, hips, and joints 10 days after the birth of her baby. What instruction should the nurse give the client after birth to prevent low back pain and injury to the joints?

Maintain correct posture and positioning.

The nurse is educating a woman on interventions to alleviate the signs and symptoms of polycystic ovarian syndrome. Which instruction would be helpful for relief of symptoms?

Maintain follow-up appointments.

The endometrial biopsy of a client reveals cancerous cells, and the primary health care provider has diagnosed it as endometrial cancer. Which responsibilities of the nurse are part of the treatment of the client? Select all that apply.

Make sure the client understands all the available treatment options. Offer the family explanations and emotional support throughout the treatment. Inform the client about the possible advantages of a support group.

The nurse is assessing the breast of a woman who is 1 month postpartum. The woman is complaining of a painful area on one breast with a red area. The nurse notes a local area on one breast, red and warm to touch. Which of the following should the nurse suspect is the potential diagnosis?

Mastitis Correct Explanation: Mastitis usually occurs 2-3 weeks after delivery and is noted to be unilateral. Mastitis needs to be assessed and treated with antibiotic therapy. The scenario described is not indicative of a plugged milk duct or engorgement. Breast yeast is a distracter for this question.

A nurse is assessing a client with postpartal hemorrhage; the client is presently on IV oxytocin. Which interventions should the nurse perform to evaluate the efficacy of the drug treatment? Select all that apply.

Monitor the client's vital signs. Assess the client's uterine tone. Get a pad count

After conducting a class for college students about cervical cancer prevention, the nurse determines that the class understands that steps can be taken to help prevent cervical cancer based on which statement?

More than 90% of squamous cervical cancers contain HPV DNA.

A nurse is aware that the newborn's neuromuscular maturity is typically completed within 24 hours after birth. Which assessment would the nurse be least likely to complete to determine the newborn's degree of maturity?

Moro Reflex

The nurse is developing a presentation for a group of young adult women about premenstrual syndrome. The nurse would include which possible treatment options? Select all that apply.

NSAIDs reduction of caffeine intake vitamin and mineral supplements diuretic therapy

The nurse orienting a student to the nursery determines that teaching has been effective when the student states that the signs of neonate respiratory distress include which findings? Select all that apply.

Nasal flaring Respiratory rate of 64 breaths per minute Chest retractions

A nursing student is preparing a class for new mothers about adaptations they can expect in their newborns. Which information about newborn vision should the student include in the presentation?

Newborns have the ability to focus only on objects in close proximity.

The neonatal intensive care nurse is admitting a large-for-gestational-age infant with respiratory distress who has difficulty with hypothermia, appears lethargic, is jittery, and is not feeding well. What would be the nurse's first action?

Obtain a blood glucose level.

A client who has a breastfeeding newborn reports sore nipples. Which intervention can the nurse suggest to alleviate the client's condition?

Offer suggestions based on observation to correct positioning or latching.

What should a nurse consider when assessing older clients with a sexually transmitted infection (STI)?

Older adults can still be sexually active.

A 24-year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis?

Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease.

A ventilated 33 weeks' gestation newborn in the neonatal intensive care unit (NICU) receives surfactant therapy. Which would the nurse expect to assess as a positive response to this therapy?

Oxygen saturation levels are at 98%.

A nurse is educating a 25-year-old client with a family history of cervical cancer. Which test should the nurse inform the client about to detect cervical cancer at an early stage?

Papanicolaou test

A nurse is providing care to a postpartum woman and is completing the assessment. Which finding would indicate to the nurse that a postpartum woman is experiencing bladder distention?

Percussion reveals dullness Explanation: A distended bladder is dull on percussion and can be palpated as a rounded mass. In addition, the uterus would be boggy and lochia would be more than usual.

Which of the following instructions should the nurse offer a client as primary preventive measures to prevent mastitis?

Perform handwashing before breastfeeding Correct Explanation: As a primary preventive measure to prevent mastitis, the nurse should instruct the client to perform good handwashing before breastfeeding. The nurse should instruct the client to frequently breastfeed to prevent engorgement and milk stasis. If the breast is distended before feeding, the nurse should instruct the client to apply cold, not warm, moist heat to the breast. Gently massaging the affected area of the breast also helps.

A nurse is caring for a newborn client after birth who is diagnosed with myelomeningocele. Which nursing intervention would protect the newborn from injury?

Place the newborn in a prone or lateral position.

A nurse is preparing a woman for a Pap smear procedure. The nurse has already washed her hands and gathered all necessary equipment (maintaining sterility). What is the next step in the Pap smear procedure?

Position the client in stirrups or foot pedals so that her knees fall outward.

A newborn has secretions in his mouth and nose. What are the first steps the nurse should take to clear his airways?

Position the newborn on his side with his head slightly below his body; use a bulb syringe to clear his mouth.

A client presents for a routine check-up at a local health care center. One of the client's distant relatives died of ovarian cancer, and the client wants to know about measures that can reduce the risk of ovarian cancer. The nurse informs the client about which measure to reduce the risk of ovarian cancer?

Provide genetic counseling and thorough assessment.

You are the nurse giving an educational presentation to the local Le Leche league chapter. One woman asks you about mastitis. What would be your best response?

Risk factors include nipple piercing. Correct Explanation: Certain risk factors contribute to the development of mastitis. These include: inadequate or incomplete breast emptying during feeding or lack of frequent feeding leading to milk stasis; engorgement; clogged milk ducts; cracked or bleeding nipples; nipple piercing; use of plastic-backed breast pads.

Which information is important for a woman scheduled to undergo a tubal ligation to understand?

She must think of the procedure as irreversible.

Which recommendation should be given to a client with mastitis who is concerned about breastfeeding her neonate?

She should continue to breastfeed; mastitis will not infect the neonate.

A nurse is providing discharge teaching to a client who needs Kegel exercises to strengthen the pelvic floor muscles. Which guideline would be appropriate to teach the client?

Squeeze the muscles in your rectum as when you are trying to prevent passing flatus.

The nurse in the NICU is caring for preterm newborns. Which guidelines are recommended for care of these newborns? Select all that apply.

Supply oxygen for the newborn, if necessary. Dress the newborn in ways to preserve warmth. Take the newborn's temperature often.

A nurse is instructing a woman on BBT method for fertility awareness. Which information would the nurse provide?

Temperature should be taken prior to any activity every morning.

A preterm newborn is admitted to the neonatal intensive care with the diagnosis of an omphalocele. What nursing actions would the nurse perform? Select all that apply.

The abdominal contents are protected. Fluid loss of the neonate will be minimized. Perfusion to the exposed abdominal contents will be maintained.

She neglects to engage with or provide care for the baby and shows little interest in it.

The bleeding may slowly decrease over the next 1 to 3 weeks, changing color to a white discharge, which may continue for up to 6 weeks.

A nurse needs to provide preoperative care to a woman who is undergoing a scheduled hysterectomy. Her diagnosis is uterine fibroids. Which preoperative instruction should the nurse provide?

The client should turn, cough, and deep-breathe.

A nurse helps a postpartum woman out of bed for the first time postpartally and notices that she has a very heavy lochia flow. Which assessment finding would best help the nurse decide that the flow is within normal limits?

The color of the flow is red.

A nurse helps a postpartum woman out of bed for the first time postpartally and notices that she has a very heavy lochia flow. Which assessment finding would best help the nurse decide that the flow is within normal limits?h

The color of the flow is red. A typical lochia flow on the first day postpartally is red; it contains no large clots; the uterus is firm, indicating that it is well contracted.

The nurse is caring for a newborn with retinopathy of prematurity (ROP). Which statement best explains this disorder?

The infant has a degenerative disease of the retina.

A client gives birth to a baby at a local health care facility. The nurse observes that the infant is fussy and begins to move her hands to her mouth and suck on her hand and fingers. How should the nurse interpret these findings?

The infant is attempting self-consoling maneuvers.

A pregnant woman recently diagnosed with the genital herpes virus asks the nurse for more information on the virus. Which responses by the nurse would be appropriate? Select all that apply.

The virus remains quiet until a stressful event occurs to reactivate it." "Infections may be transmitted by individuals unaware that they have it." "Transmission is through contact of infected mucous membranes."

A nurse is assessing a woman who has a history of genital warts (HPV). The nurse understands that this increases the risk of vulvar cancer. The nurse should teach which prevention method to decrease the risk of cancer?

The woman should avoid tight undergarments.

A client in her second trimester of pregnancy asks the nurse for information regarding certain oral medications to induce a miscarriage. What information should this client be given about such medications?

They can be taken only in the first trimester.

At a health education class for teenagers, the nurse discusses the sexually transmitted infection chlamydia trachomatis. Which information would the nurse most likely include?

This infection is the most common infectious cause of infertility.

Which statement is false regarding bathing the newborn?

To reduce the risk of heat loss, the bath should be performed by the nurse, not the parents, within 2 to 4 hours of birth.

The newborn should have the neurologic status evaluated to determine its maturity and to identify any potential problems. The nurse tests the newborn's Babinski reflex. Which response would the nurse interpret as normal for the newborn?

Toes fan out when sole of foot is stroked.

A nurse educator introduces the class to the Healthy People 2020 initiative, which includes perinatal outcomes as leading health indicators. Which information would the nurse most likely include?

Twelve percent of infants are born prematurely, and eight percent are of low birth weight, increasing morbidity and mortality.

A first-time mother informs the nurse that she is unable to breastfeed her newborn through the day as she is usually away at work. She adds that she wants to express her breast milk and store it for her newborn to have later. What instruction would be correct to offer the mother to ensure the safety of the stored expressed breast milk?

Use the sealed and chilled milk within 24 hours.

A woman who has given birth to a postterm newborn asks the nurse why her baby looks so thin with so little muscle. The nurse integrates understanding about which concept when responding to the mother?

With postterm birth, the fetus uses stored nutrients to stay alive, and wasting occurs.

A community health nurse is conducting a class on sexually transmitted infections (STIs). She states that "STIs are discriminatory." What would the nurse most likely use to support this statement?

Women are diagnosed with two thirds of the new cases of STIs annually." "Certain infections can be transmitted to the newborn." "After only a single exposure, women are twice as likely as men to acquire STIs."

The nurse would expect which client to be at a high risk for developing a pelvic support disorder?

a 60-year-old mother with four children

A female client is having a procedure this morning that involves radiologic examination of the fallopian tubes using a radiopaque medium. What procedure should the nurse document as being performed?

a hysterosalpingography

When assessing the uterus of a 2-day postpartum client, which finding would the nurse evaluate as normal?

a moderate amount of lochia rubra

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

In the infant diagnosed with spina bifida with myelomeningocele, the infant will likely have:

a partial to complete paralysis in the lower extremities.

A nurse is caring for a neonate of 25 weeks' gestation who is at risk for intraventricular hemorrhage (IVH). Which assessment finding should be reported immediately?

a sudden drop in hemoglobin

The nursing instructor is teaching about Bartholin cysts and informs the students that Bartholin cysts are the most common cystic growth in the vulva. She describes this type of cyst as being:

a swollen, fluid-filled, sac-like structure.

A client has come to the office for her first postpartum visit. On evaluating her blood work, the nurse would be concerned if the hematocrit is noted to have:

acutely decreased.

A nurse is caring for a client with idiopathic thrombocytopenic purpura (ITP). Which intervention should the nurse perform first?

administration of platelet transfusions as prescribed

A nurse is reviewing the medical record of a female client diagnosed with vaginal cancer. Which factors would the nurse identify as increasing this client's risk? Select all that apply.

age 62 years history of genital warts chronic vaginal discharge

A nurse is reading a journal article about birth defects and finds that some birth defects are preventable. Which risk factor would the nurse expect to find as being cited as the current leading preventable cause of birth defects?

alcohol

Assessment reveals that a young mother has several risk factors for giving birth to an infant with a neural tube defect. Which laboratory test would the nurse expect to be used to monitor the fetus for this birth defect?

alpha-fetoprotein levels

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?

an azole antifungal agent

Which clinical manifestation is seen in the child with hydrocephalus?

an extremely large and rapidly growing head

A new mother tells the nurse at the baby's 3 month check-up, "When she cries, it seems like I am the only one who can calm her down." This is an example of which behavior?

attachment

What is the best way for the nurse to assess the newborn's heartbeat?

auscultating the apical pulse for 60 seconds

When assessing a postpartum client who was diagnosed with a cervical laceration that has been repaired, what sign should the nurse report as a possible development of hypovolemic shock?

b)Weak and rapid pulse Explanation: The sign of weak and rapid pulse is the body in compensatory mechanism attempting to increase the blood circulation. This finding needs to be reported to the health care provider and RN as soon as possible. The other options are incorrect.

A nurse is providing care to a client diagnosed with squamous cell carcinoma of the vagina. The nurse understands that if the cancer metastasizes, which locations would be common sites? Select all that apply.

bladder rectum

On assessment of a 2-day postpartum client the nurse finds that the fundus is boggy, at the umbilicus, and slightly to the right. What is the most likely cause of this assessment finding?

bladder distention

A woman has just given birth to a baby. Her prelabor vital signs were temperature: 98.8° F (37.1° C); blood pressure: 120/70 mm Hg; pulse; 80 beats/min. and respirations: 20 breaths/min. Which combination of findings during the early postpartum period are the most concerning?

blood pressure 90/50 mm Hg, pulse 120 beats/min, respirations 24 breaths/min.

The nurse is caring for a postpartum woman who exhibits a large amount of bleeding. Which areas would the nurse need to assess before the woman ambulates?

blood pressure, pulse, reports of dizziness

A woman states that she still feels exhausted on her second postpartal day. Your best advice for her would be to do which of the following?

c) Walk with you the length of her room. Rationale: Most women report feeling exhausted following childbirth. Ambulation is important, however, so a small amount, such as walking across a room, should be encouraged.

What is the term for a small collection of blood that forms underneath the skull as a result of birth trauma?

cephalhematoma

A nurse is reviewing the physical exam findings of a woman who has come to the clinic with reports of feeling a dragging sensation in her vagina. The exam reveals the posterior bladder wall protruding into the anterior vaginal wall. The nurse interprets this finding as indicative of which condition?

cystocele

In reviewing the postpartum G3, P3 woman's history the nurse notes it is positive for obesity and smoking. The nurse recognizes this client is at risk for which complication?

deep venous thrombosis

Which maternal factors should the nurse consider contributory to a newborn being large for gestational age? Select all that apply.

diabetes mellitus postdates gestation prepregnancy obesity

The nurse, assessing the lochia of a client, attempts to separate a clot and identifies the presence of tissue. Which observation would indicate the presence of tissue?

difficult to separate clots

The nurse assesses an infant. Which finding may indicate heart failure?

diminished peripheral pulses

The nurse is describing fetal circulation to new parents and how the circulation changes after birth. The nurse describes a structure that allows the pulmonary circulation to be bypassed, but that shortly after birth this structure should close. Which structure is the nurse describing?

ductus arteriosus

A common symptom that would alert the nurse that a preterm infant is developing respiratory distress syndrome is:

expiratory grunting.

A nurse is caring for a client who has just received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. How does the nurse classify the laceration?

fourth degree

The nurse is caring for a 14-year-old girl who fears she might have a sexually transmitted infection (STI). What would the nurse expect to assess if the adolescent has trichomoniasis?

green vaginal discharge

What are the functions of kangaroo care? Select all that apply.

helps the parents bond with their neonate keeps the neonate warm is skin-to-skin contact

The nurse in the sexual health clinic is obtaining a health history of a client who is addicted to heroin, reporting chronic flu-like symptoms accompanied by pruritis, fatigue, anorexia, and constant upper right quadrant pain. Which sexually transmitted infection would the nurse suspect?

hepatitis A

The nurse in a sexual health clinic is reviewing the history of a 30-year-old homosexual client who is an IV drug addict and diagnosed with a sexually transmitted infection. Which therapy would the nurse expect to include in his care?

hepatitis A and hepatitis B recombinant vaccine

A young woman comes to the free clinic asking for birth control pills. Which factor best indicates that another type of contraception would be better for this client?

history of noncompliance with medications

A group of students is reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which cause of condylomata?

human papillomavirus

A nurse is assigned to care for a high-risk newborn with a periventricular-intraventricular hemorrhage (PVH-IVH) in the home environment after discharge. For which condition should the nurse monitor the infant?

hydrocephalus

A nursing instructor informs the student that which stimuli initiate respirations in the newborn? Select all that apply.

hypercapnia acidosis hypoxia

An obese woman with diabetes has just given birth to a term, large for gestational age (LGA) newborn. Which condition should the nurse most expect to find in this infant?

hypoglycemia

A client in her sixth week postpartum reports general weakness. The client has stopped taking iron supplements that were prescribed to her during pregnancy. The nurse would assess the client for which condition?

hypovolemia

The nurse is providing care to a client with abnormal uterine bleeding. Treatment with medications has been unsuccessful, and surgical intervention is being considered. The nurse identifies which technique as being the last resort?

hysterectomy

A clinic nurse explains to a client who is undergoing an infertility workup that the patency of her fallopian tubes will be checked. Which test is currently used to do this?

hysterosalpingography

The nurse reviews the medical record of a woman diagnosed with ovarian cancer, stage II. The nurse interprets this information, understanding that the disease:

involves one or both ovaries and extends into the pelvis.

While assessing a postpartum woman, the nurse palpates a contracted uterus. Perineal inspection reveals a steady stream of bright red blood trickling out of the vagina. The woman reports mild perineal pain. She just voided 200 mL of clear yellow urine. Which condition would the nurse suspect?

laceration

A nurse is assessing a preterm newborn. The nurse determines that the newborn is comfortable and without pain based on which finding?

lack of body posturing

A pregnant client is in labor. The nurse reviews a mother's prenatal history and finds that the client has diabetes mellitus. The nurse anticipates that the newborn is at risk for being:

large-for-gestational-age.

A 2-month-old infant is admitted to a local health care facility with an axillary temperature of 96.8° F (36° C). Which observed manifestation would confirm the occurrence of cold stress in this client?

lethargy and hypotonia

In the infant with developmental dysplasia of the hip (DDH), which sign would likely be noted?

limited abduction of the affected hip

When monitoring a postpartum client 2 hours after birth, the nurse notices heavy bleeding with large clots. Which response is most appropriate initially?

massaging the fundus firmly

The nurse is assessing the breast of a woman who is 1 month postpartum. The woman reports a painful area on one breast with a red area. The nurse notes a local area on one breast to be red and warm to touch. What should the nurse consider as the potential diagnosis?

mastitis

The nurse informs the client that a diaphragm is an example of which type of contraception?

mechanical barrier

A 35-year-old client has just given birth to a healthy newborn during her 43rd week of gestation. What should the nurse expect when assessing the condition of the newborn?

meconium aspiration in utero or at birth

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

metronidazole

A nurse is providing care to a client with uterine fibroids who is prescribed a progestin antagonist. Which medication would the nurse most likely expect the client to receive?

mifepristone

A nurse is assessing a newborn and observes the newborn bringing his hand up to his mouth. The nurse interprets this finding as which behavioral response?

motor maturity

A nurse is working in the newborn observational unit and is assigned four newborns. In which newborn will the nurse suspect difficulties with thermal regulation?

newly born preterm infant

A male client visits a fertility clinic after one year of attempting unsuccessfully to impregnate his wife. What is a risk factor associated with male infertility?

no or few sperm cells produced

When working in a free clinic for children, the nurse observes a mother with her 2 week infant. Which behavior should the nurse bring to the attention of the health care provider?

not responding to the infant crying

The nurse working on a postpartum client must check lochia in terms of amount, color, change with activity and time, and:

odor

A nurse is assessing a woman who gave birth vaginally approximately 24 hours ago. Which finding would the nurse report to the primary care provider immediately?

oral temperature 100.8° F (38.2° C)

A client is diagnosed with polycystic ovary syndrome. The nurse would include teaching about which therapies? Select all that apply.

ovulation induction agents antidiabetic agents weight loss

The nurse is changing the diaper on a newborn and notices that there is a musty smell to the infant's urine. This finding is a characteristic sign of which disorder?

phenylketonuria

A nurse is caring for a client on the second day postpartum. The client informs the nurse that she is voiding a large volume of urine frequently. Which factor should the nurse identify as a potential cause for urinary frequency?

postpartum diuresis

A nurse is caring for a client in the postpartum period. When observing the client's condition, the nurse notices that the client tends to speak incoherently. The client's thought process is disoriented, and she frequently indulges in obsessive concerns. The nurse notes that the client has difficulty in relaxing and sleeping. The nurse interprets these findings as suggesting which condition?

postpartum psychosis

A nurse is assessing a newborn with the parents. The nurse explains that which aspect of newborn behavior is an important indication of neurologic development and function?

reflex

A nurse is teaching new parents about keeping follow-up appointments and calling their health care provider if they notice signs of illness in their newborn. The nurse determines that the teaching was successful when the parents identify which signs as needing to be reported? Select all that apply.

refuse feeding temperature of 38.3° C (101° F) or higher abdominal distention

A thin newborn has a respiratory rate of 80 breaths/min, nasal flaring with sternal retractions, a heart rate of 120 beats/min, temperature of 36° C (96.8° F) and persisting oxygen saturation of <87%. The nurse interprets these findings as:

respiratory distress.

When providing care for a postpartum client at a 6-week check up, which behavior would alert the nurse the client may have postpartum psychosis?

restless and agitated, concerned with self

The nurse is documenting assessment of infant reflexes. She strokes the side of the infant's face, and the baby turns toward the stroke. What reflex has the nurse elicited?

rooting

When evaluating neurologic maturity to determine gestational age, the nurse understands that which activity is not part of the assessment?

rooting

A nurse is explaining to a client that pessaries have been used through the ages as a nonsurgical means of treating pelvic organ prolapse. The nurse describes the pessaries of today as being primarily constructed of:

silicone

Which findings would the nurse expect in a newborn who is considered small for gestational age? Select all that apply.

sunken abdomen poor muscle tone over buttocks dry or thin umbilical cord

Which factor might result in a decreased supply of breast milk in a postpartum client?

supplemental feedings with formula

A newborn infant born by a cesarean birth is experiencing a common problem seen in these type of births. What finding would the nurse anticipate in an infant following a cesarean birth?

tachypnea

A new mother gave birth to her baby 24 hours ago and today has been content to rest in her hospital bed, hold her baby, allow the nurse to care for her, and to discuss her labor and birth experience with visitors. Which phase of the puerperium is this client in?

taking-in phase

All of the following are ways the nurse can encourage bonding between the parents and the newborn except:

telling the mother that the best way to bond with her baby is to breastfeed.

Which is the best place to perform a heel stick on a newborn?

the fat pads on the lateral aspects of the foot

The American Academy of Pediatrics and the American Dietetic Association recommend breastfeeding exclusively for how long?

the first 6 months

During the second day postpartum, a nurse notices that a client is initiating breastfeeding with her infant and changing her infant's diapers with some assistance from her partner. Which phase does the nurse recognize that the woman is experiencing?

the taking-hold phase

Which description characterizes cervical mucus during ovulation?

thin and watery

A nurse is working as part of a team to address the prevention of sexually transmitted infections in the community. Based on the nurse's understanding of the groups at highest risk, the team would most likely focus their efforts on which population?

those under age 25

The client, who has just been walking around her room, sits down and reports leg tightness and achiness. After resting, she states she is feeling much better. The nurse recognizes that this discomfort could be due to which cause?

thromboembolic disorder of the lower extremities

A nurse provides care to pregnant women and their families from a wide range of cultural backgrounds and considers their culture and traditions when providing care. As the nurse communicates with the families, the nurse integrates understanding of communication as being more than just speaking and listening. Which aspect must the nurse also consider?

touching

A client desires protection from unwanted pregnancies. However, the client does not enjoy sex when her partner wears a male condom. Also, the client experiences breast tenderness, headache, and nausea after taking oral contraceptives. Which method would be the most likely choice for the couple to help them enhance their sexual experience as well as prevent any side effects?

transdermal contraceptive

Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection?

trichomoniasis

The nurse is assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms?

trichomoniasis

A couple comes to the clinic and states to the nurse, "I don't think we are ever going to be able to have children. We have been trying but have had no luck." What assessments does the nurse anticipate will be performed for this couple? Select all that apply.

tubal patency ovulation monitoring semen analysis

The nurse is reviewing with a new client the diagnosis of polycystic ovarian syndrome (PCOS). Which long-term health problems would the nurse review as a risk with this syndrome?

type 2 diabetes

A nurse is speaking to a local women's group about the various types of cancer affecting the female reproductive tract. The nurse explains that ovarian cancer is the leading cause of death from gynecologic malignancies based on the understanding that this type of cancer:

typically manifests with vague symptoms resulting in late diagnosis.

A client asks the nurse at a prenatal class about acquired disorders. The nurse correctly responds that an acquired disorder:

typically occurs at or soon after birth.

The nurse is admitting a newborn male for observation with the diagnosis of preterm. What assessment finding corresponds with this gestational age diagnosis?

undescended testes

The nurse is caring for a client in the postpartum period. The client has difficulty in voiding and is catheterized. The nurse then would monitor the client for which condition?

urinary tract infection The nurse would need to monitor the client for signs and symptoms of a urinary tract infection, a risk associated with catheterization. Stress incontinence is caused due to loss of pelvic muscle tone after birth. Increased urinary output is observed in diuresis. Catheterization does not cause loss of pelvic muscle tone, increased urine output, or stress incontinence.

A nurse is providing care to a preterm neonate. Which interventions would be most effective in minimizing the newborn's pain? Select all that apply.

using a colorful mobile for distraction removing tape gently from the skin encouraging kangaroo care during procedures

A nurse is caring for a client with postpartum hemorrhage. What should the nurse identify as the significant cause of postpartum hemorrhage?

uterine atony

Which complication is most likely responsible for a late postpartum hemorrhage?

uterine subinvolution

A nurse is assessing a 20-year-old female. Which data finding taken during the history would indicate endometrial cancer?

vaginal bleeding that is painless and abnormal

A nurse explains to a client that although HPV infection is more commonly associated with cervical cancer, which cancer would the nurse identify as also a risk?

vulvar cancer

The nurse determines a newborn is small-for-gestational age based on which characteristics?

wasted appearance of extremities, thin umbilical cord, and reduced subcutaneous fat stores

A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus?

when it is thin, watery, and copious

The nurse caring for a newborn has to perform assessment at various intervals. When should the nurse complete the second assessment for the newborn?

within the first 2 to 4 hours, when the newborn reaches the nursery

A postpartal woman calls you into her room because she is having a very heavy lochia flow containing large clots. Your first action would be to

Palpate her fundus. Correct Explanation: Palpating the fundus will cause it to contract and reduce bleeding. This makes options A, C, and D incorrect.

The LVN/LPN will be assessing a postpartum client for danger signs after a vaginal birth. What assessment finding would the nurse assess as a danger sign for this client?

fever more than 100.4° F (38° C)

A nurse is conducting a class for expectant parents about newborns and the changes that they experience after birth. The nurse discusses the neonatal period, describing it as which time frame?

first 28 days of life

The nurse is assessing a neonate as he transitions to extrauterine life. The nurse integrates understanding that which structure closes as a result of tne neonate's first breath?

foramen ovale

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

A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?

gonorrhea

A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition?

gonorrhea

While assessing a newborn, the nurse notes that half the body appears red while the other half appears pale. The nurse interprets this finding as:

harlequin sign.

The AGPAR score is based on which 5 parameters?

heart rate, muscle tone, reflex irritability, respiratory effort, and color

The nurse is reviewing the laboratory test results of a newborn. Which results would the nurse identify as normal? Select all that apply.

hemoglobin 17 g/dL platelets 200,00 u/L red blood cells 5.3 (1,000,000/uL) white blood cells 8,000 /mm3

A nursing instructor is teaching about newborn congenital disorders and realizes that the student needs further instruction after making which statement?

"All congenital disorders can be diagnosed at birth."

The nurse is assessing a male client who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years." What questions would be important for the nurse to ask this client? Select all that apply.

"Are you exposed to X-rays or other radioactive substances?" "Have you ever had any type of trauma or surgery on or near your testicles?" "Do you use drugs or use alcohol excessively?

A woman with uterine prolapse has undergone a vaginal hysterectomy and is being discharged home with an indwelling urinary catheter in place. The client will be using a leg bag during the day. Which instructions would the nurse most likely include in the client's discharge teaching plan? Select all that apply.

"Clean your perineal area each day with a mild soap and water." "Be sure to empty your leg bag frequently throughout the day."

A nurse is conducting a health promotion program, encouraging lifestyle changes to help clients prevent various benign and treatable conditions. Which suggestions would the nurse most likely include? Select all that apply.

low-fat diet regular exercise high vegetable-fruit diet adequate fluid intake

A nurse is explaining to new parents about the numerous changes that occur shortly after birth to the newborn. When describing how the ductus arteriosus closes, the nurse explains that which factor is most important to assist in its closure?

oxygen

A nurse is conducting a in-service education program for a group of nurses working in the postpartum unit about postpartal infection. The nurse determines that the teaching was successful when the group identifies which factor as contributing to the risk for infection postpartally?

placenta removed via manual extraction

A client is diagnosed with endometriosis. As part of the teaching plan, the nurse is explaining the condition, including the ways that the diagnosis would be confirmed. The nurse determines that the teaching was successful when the client states that which test would confirm the diagnosis?

pelvic laparoscopy

The nurse working in the genitourinary clinic understands that the most common cause for women suffering from urinary incontinence is:

pelvic organ prolapse (POP).

Which factor places newborns at risk for ongoing health problems?

perinatal asphyxia

The Ballard scoring system evaluates newborns on which two factors?

physical maturity and neuromuscular maturity

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 nurse is conducting a presentation for a local women's group about urinary incontinence. During the presentation, several of the women voice statements about their beliefs related to this condition. Which statements would the nurse identify as misconceptions that need to be corrected? Select all that apply.

"It is a condition that cannot be prevented." "It is an acceptable part of being a woman." "It is an inevitable part of aging."

A nurse is providing care to a postpartum woman who gave birth about 2 days ago. The client asks the nurse, "I haven't moved my bowels yet. Is this a problem?" Which response by the nurse would be most appropriate?

"It might take up to a week for your bowels return to their normal pattern."

A nurse is making an initial call on a new mother who gave birth to her third baby five days ago. The woman says,"I just feel so down this time. Not at all like when I had my other babies. And this one just doesn't sleep. I feel so inadequate." What is the best response to this new mother?

"It sounds like you have the 'baby blues.' They are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the birth. They will most likely go away in a day or two."

A woman is scheduled to undergo a loop electrosurgical excision procedure (LEEP) as treatment for an abnormal Pap smear. Which instruction would the nurse include in the teaching plan for this client?

"It takes about 10 minutes to do in your healthcare provider's office."

A new mother is concerned because it is 24 hours after birth and her breasts have still not become engorged with breast milk. How should the nurse respond to this concern?

"It takes about 3 days after birth for milk to begin forming."

The nurse is conducting a presentation about urinary incontinence for a local women's group. During the presentation, which statement by a member of the group would the nurse need to clarify?

"It's normal for a woman to develop incontinence as she ages."

The primapara tells the nurse, "My baby jumps every time I pick her up. Is she afraid that I will drop her?" Which response by the nurse would be best?

"No, it is the Moro reflex. This reflex simulates the action of warding off an attacker."

A couple is seeking guidance for their inability to conceive a child after trying for 15 months. They are morbidly obese but state they have friends with the same weight problem who have had no difficulty conceiving. What education can the nurse provide this couple to increase their chances of success?

"Obesity may interfere with effective penetration and deposition of sperm. We will look at several factors to discover what issues you may be encountering."

A newborn boy is diagnosed with esophageal atresia and tracheoesophageal fistula. After the nurse provides preoperative teaching, which statement indicates that the parents need additional teaching?

"We can probably start feeding him with the bottle about a day after the surgery."

A school health nurse is providing education to a group of adolescents regarding the proper procedure for male condom use. The nurse knows the teaching has been effective when which statement is made by a student?

"Withdraw the penis erect, holding the condom firmly against the penis."

A client who had an emergency cesarean birth for fetal distress 3 days ago is preparing for discharge. When reviewing the home care instructions with the nurse, the client reveals she is saddened about her cesarean and feels let down that she was not able to have a vaginal birth. When questioned further, the client states she feels "weepy about everything" and cannot stop crying. What nursing action is indicated first?

Ask the client to elaborate on her feelings.

Place the items regarding changes in fetal circulation at birth in which they occur. All options must be used.

Birth occurs. Pulmonary vascular resistance decreases. Pulmonary blood flow increases, and pulmonary venous return to the left side of the heart increases. The foramen ovale closes. An increase in systemic blood pressure occurs with continued increase in blood flow to the lungs. The ductus arteriosus closes.

A nurse is caring for a postpartum woman who is Muslim. When developing the woman's plan of care, the nurse would make which action a priority?

Assign a female nurse to care for her.

Which assessment would lead the nurse to believe a postpartal woman is developing a urinary complication?

At 8 hours postdelivery she has voided a total of 100 mL in four small voidings.

Which of the following assessments would lead you to believe a postpartal woman is developing a urinary complication?

At 8 hours postdelivery she has voided a total of 100 mL in four small voidings. Explanation: Postpartal women who void in small amounts may be experiencing bladder overflow from retention

A G1 P1001 mother is just home after giving birth to her first child 5 days ago. Her birth was complicated by an emergency cesarean birth resulting from incomplete cervical dilation and hemorrhage. The nurse determines that the mother has not slept longer than 3 hours at one time. The appropriate nursing diagnosis for this client care issue is:

At risk for postpartum depression due to inadequate rest.

The nurse is assessing an infant's reflexes. While eliciting a rooting reflex, the infant strongly sucks on the nurse's finger. How does the nurse interpret this finding?

The rooting reflex was tested incorrectly.

A nurse teaches new parents that the bestway to help prevent infections in the newborn is which method?

Breastfeed

A nurse is to care for a client during the postpartum period. The client reports pain and discomfort in her breasts. What signs should a nurse look for to find out if the client has engorged breasts? Select all that apply.

Breasts are hard. Breasts are tender.

The nurse is conducting discharge teaching with a postpartum woman. What would be an important instruction for this client?

Call her caregiver if lochia moves from serosa to rubra.

What is the most important thing the nurse can teach the family of a newborn to prevent abduction while the baby is in the hospital?

Check the identification badge of any health care worker before he or she takes the baby from the room.

A woman gave birth vaginally approximately 12 hours ago, and her temperature is now 100° F (37.8° C). Which action would be most appropriate?

Continue to monitor the woman's temperature every 4 hours; this finding is normal.

A woman gave birth vaginally approximately 12 hours ago and her temperature is now 100 degrees F. Which action would be most appropriate?

Continue to monitor the woman's temperature every 4 hours; this finding is normal. Rationale: A temperature of 100.4 degrees F or less during the first 24 hours postpartum is normal and may be the result of dehydration due to fluid loss during labor. There is no need to notify the physician, obtain a urine culture, or inspect the perineum (other than the routine assessment of the perineum), because this finding is normal.

Eliminating drafts in the delivery room and in the nursery will help to prevent heat loss in a newborn through which mechanism?

Convection Explanation: Convection refers to loss of heat from the newborn's body to the cooler surrounding air.

A nurse is making a home visit to an African American woman who gave birth to a healthy newborn 4 days ago. When developing the plan of care for this woman, which considerations would the nurse need to integrate into the plan of care? Select all that apply.

Extended family members may be involved with caring for the infant. Bathing the newborn may be postponed for the first week. Oils may be used on the newborn's skin and hair.

A nurse is caring for a breastfeeding client who reports engorgement. The nurse identifies that the client's condition is due to not fully emptying her breasts at each feeding. Which suggestion should the nurse make to help her prevent engorgement?

Feed the baby at least every two or three hours.

The nurse is caring for a pregnant woman with gestational diabetes mellitus, which the woman is having great difficulty keeping under control. What effect is the woman's condition most likely to have on the fetus?

The fetus might grow to an unusually large size.

A woman with ovarian cancer has been told that she is in stage III of the cancer. The nurse is reviewing the information with her. Which statement would help in the woman's understanding of stage III ovarian cancer?

The growth has spread to the lymph nodes and other areas/organs in the abdominal cavity.

The nurse is performing a newborn assessment and the infant's lab work reveals a heelstick hematocrit of 66. What is the best response to this finding?

The hematocrit needs to be repeated as a venous stick to see what the central hematocrit level is.

You are conducting discharge teaching with a postpartum woman. What would be an important instruction for this patient?

a)Call her caregiver if lochia moves from serosa to rubra. Explanation: Most cases of late postpartum hemorrhage occur after the woman leaves the health care or birthing facility. Therefore, patient education before discharge about expected changes and danger signs and symptoms is crucial. Instruct the woman to call her primary-care provider if she experiences any signs of infection, such as fever greater than 100.4°F (38°C), chills, or foul-smelling lochia. She should also report lochia that increases (versus decreasing) in amount, or reversal of the pattern of lochia (i.e., moves from serosa back to rubra).

When examining a newborn for developmental hip dysplasia, which motion would the newborn's hip be unable to accomplish?

abduction

A nurse is participating at a health fair and is presenting information on ways to reduce one's risk for cancer. Which information would the nurse include? Select all that apply.

annual cholesterol level checks starting at age 45 alcohol intake of no more than 1 drink per day blood pressure evaluations at least every 2 years

A 24-hour-old, full-term, small-for-gestational-age neonate is being assessed. Which maternal factors would the nurse correlate with this gestational age variation? Select all that apply.

blood pressure baseline of 140/90 mm Hg positive for TORCH infections hemoglobin 7g/dL BMI under 17

The nurse is admitting a 10-pound (4.5-kg) newborn to the nursery. What is important for the nurse to monitor during the transition period?

blood sugar

A nurse is preparing a presentation for a group of women who are of age to have children about the risk for cancer during pregnancy. When describing the risk, which cancer would the nurse most likely include as being the most common cancer occurring during pregnancy?

breast

A nurse is preparing a presentation about vaginal cancer for a group of women at the local community clinic. The nurse plans to include information about metastatic forms of vaginal cancer. Which cancers would the nurse most likely include as commonly metastasizing to the vagina? Select all that apply.

breast cervical skin colon

As a part of the newborn assessment, the nurse examines the infant's skin. Which nursing observation would warrant further investigation?

bright red, raised bumpy area noted above the right eye

A new mother has been reluctant to hold her newborn. A nurse can promote this mother's attachment to her newborn by:

bringing the newborn into the room.

A client with pelvic organ prolapse is using lifestyle modifications and working to lose weight. The client asks the nurse, "Which type of exercise would be best?" The nurse would most likely suggest which exercise?

brisk walking

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

A nurse is assessing a term neonate and notes transient tachypnea. When reviewing the mother's history, which conditions would the nurse most likely find as contributing to this finding? Select all that apply.

cesarean birth use of heavy sedation during labor

A client is being prepared for artificial insemination. Which finding is the most suggestive to determine if the client is ovulating?

change in the cervical mucus

In which group is it most important for the client to understand the importance of an annual Papanicolaou test?

clients infected with the human papillomavirus (HPV)

A client with a family history of cervical cancer is to undergo a Pap test. During the client education, what group should the nurse include as at risk for cervical cancer?

clients who have genital warts

A healthy 28-year-old female client who has a sedentary lifestyle and is a chain smoker is seeking information about contraception. The nurse informs this client of the various options available and the benefits and the risks of each. Which should the nurse recognize as contraindicated in the case of this client?

combination oral contraceptives

A nursing student has read that cleft lip is diagnosed at birth based on inspection of physical appearance and that cleft palate is diagnosed in which way?

feeling the palate with a gloved finger or using a tongue blade

The nurse notices while holding him upright that a day-old newborn has a significantly indented anterior fontanelle. She immediately brings it to the attention of the primary care provider. What does this finding indicate?

dehydration

When teaching the woman about dietary and lifestyle changes to assist with pelvic organ prolapse, the nurse would include which measure?

drinking at least 64 ounces of fluid per day

The nurse is assessing a couple who has come to the health care facility because they have been unable to conceive a child. When assessing the woman, the nurse would identify which factor as increasing the woman's risk for infertility?

endometriosis

A new mother asks the nurse why her baby's back and groin have a red and raised rash. The nurses uses which term to correctly identify this condition?

erythema toxicum

A woman is inquiring about the effectiveness of birth control methods. She is considering diaphragm, condoms, oral contraceptives, and etonogestrel implant. Which method should the nurse advise her is the most reliable?

etonogestrel implant

The newborn has been placed in skin-to-skin contact with his mother. A blanket covers all of his body except his head. His hair is still wet with amniotic fluid, etc. What is the most likely type of heat loss this baby may experience?

evaporative

A nurse is preparing a presentation about cervical cancer for a local woman's group. Which risk factor for the development of cervical cancer would the nurse include?

infection with human papilloma virus (HPV)

An infant that is diagnosed with meconium aspiration displays which symptom?

intercostal and substernal retractions

A nurse is preparing to administer vitamin K to a newborn. The nurse would administer the drug by which route?

intramuscularly in the thigh

A nurse assisting in a birth notices that the amniotic fluid is stained greenish black as the baby is being born. Which intervention should the nurse implement as a result of this finding?

intubation and suctioning of the trachea

When conducting an assessment, the nurse observes fine, downy hair covering the newborn's shoulders and back. The nurse interprets this finding as:

lanugo

Which symptom would most accurately indicate that a newborn has experienced meconium aspiration during the birth process?

meconium stained fluids followed by tachypnea

The nurse assesses a newborn considered to be large-for-gestational age. What finding corresponds with this gestational age diagnosis?

meconium-stained skin and fingernails

A client is diagnosed with trichomoniasis infection. The nurse prepares to teach the client about which medication?

metronidazole

Which finding is indicative of hypothermia of the preterm infant?

nasal flaring

A diabetic woman presented to the emergency department in active labor. Assessment confirms placenta previa. She was given oxytocin to stimulate the labor. The nurse should anticipate that the newborn will requiring monitoring for which condition?

neonatal asphyxia

A nurse is auscultating the lungs of a postpartum client and notices crackles and some dyspnea. The client's respiratory rate is 12 breaths/minute; she appears in some distress. What complication should the nurse suspect based on these data?

pulmonary edema

A nursing student learns that a certain condition occurring in up to 3 in every 1,000 births is a major cause of death. What is this condition?

pulmonary embolism

During examination of clients, the nurse will question women concerning their LMP. This indicates:

the first day of their last menstrual period.

It has been 2 hours since a woman gave birth vaginally to a healthy newborn. When assessing the woman's uterine fundus, the nurse would expect to find it at:

the level of the umbilicus.

A nurse working in the newborn observational unit is assigned four newborns closely being monitored. Which newborn is at greatest risk of developing respiratory distress syndrome?

the male preterm infant born by cesarean birth with cold stress

A nurse is caring for a client who has been prescribed gonadotropin-releasing hormone (GnRH) medication for uterine fibroids. For which side effect of GnRH medications should the nurse monitor the client?

vaginal dryness

A client has been diagnosed with cervical cancer during her second trimester of pregnancy. She decides to delay treatment until after the baby is born. The nurse prepare her for birth by explaining the birth will most likely be:

via cesarean section.

Which finding would alert the nurse to suspect that a client has a yeast infection?

vulvar burning and itching

Which measurements were most likely obtained from a normal newborn born at 38 weeks to a healthy mother with no maternal complications?

weight = 3500 g, length = 20 inches (51 cm), head circumference = 34 cm, and chest circumference = 32 cm

A nurse is conducting a physical examination of a newborn. The nurse documents which finding as within normal parameters? Select all that apply.

weight of 3,300 grams length of 54 cm temperature of 98.6° F (37° C)

In a class for expectant parents, the nurse may discuss the various benefits of breastfeeding. However, the nurse also describes that there are situations involving certain women who should not breastfeed. Which examples would the nurse cite? Select all that apply.

women on antithyroid medications women on antineoplastic medications women using street drugs

A client who is hypertensive and who received corticosteroids during pregnancy gave birth by cesarean and subsequently developed endometritis. Her incision is red, warm, and very sensitive to touch, and she remains febrile despite antibiotic therapy. What is the most important aspect of post hospital care the nurse should teach her?

wound care and hand washing

A client who had a vaginal birth 2 days ago asks the nurse when she will be able to breathe normally again. Which response by the nurse is accurate?

"Within 1 to 3 weeks, your diaphragm should return to normal, and your breathing will feel like it did before your pregnancy."

A community health nurse is conducting a class on sexually transmitted infections (STIs). She states that "STIs are discriminatory." What would the nurse most likely use to support this statement?

"Women are diagnosed with two thirds of the new cases of STIs annually." "After only a single exposure, women are twice as likely as men to acquire STIs." "Certain infections can be transmitted to the newborn."

Which safety precautions should a nurse take to prevent infection in a newborn? Select all that apply.

Initiate universal precautions when caring for the infant. Avoid coming to work when ill. Use sterile gloves for an invasive procedure.

Given that the first 24 hours after birth is a time for return to homeostasis, which postpartum findings are considered acceptable during this time? Select all that apply.

Moderate saturation of peripad every 3 hours Fundus one fingerbreadth below the umbilicus

A 55-year-old client presents to the clinic with persistent vulvar pruritus, burning, and a lump. She states she has had the symptoms for 5 months and has been trying to treat them with over-the-counter creams. She has a history of multiple sexual partners and HPV and is a smoker. What should the nurse do next?

Prepare the client for a biopsy of the lesion.

At birth there are multiple changes in the cardiac and respiratory systems. What is one of the changes to occur at birth in the cardiovascular system?

Pressure changes occur and result in closure of the ductus arteriosus.

Why is fertility testing initiated with sperm analysis of the male partner?

Sperm analysis is one of the easiest tests to complete.

What should the nurse expect for a full-term newborn's weight during the first few days of life?

There is a loss of 5% to 10% of birth weight in formula-fed and breastfed newborns.