OB Week 2 EAQ
Which information would the nurse include in the discharge teaching of a postpartum client? A) the prenatal Kegal tightening exercises should be continued B) a bowel movement may not occur for up to a week after the birth C) the episiotomy sutures will be removed at the first postpartum visit D) a postpartum checkup should be scheduled as soon as the menses returns
A) Kegal exercised may be resumed immediately and should be done for the rest of the client's life because they help strengthen muscles needed for urinary continence and may enhance sexual intercourse. episiotomy sutures do not have to be removed. bowel movements should spontaneously return in 2 to 3 days after the client gives birth; a delay in bowel movements promotes constipation, perineal discomfort, and trauma. the usual post part examination is 6 weeks after birth; the menses may return earlier or later than this and should not be a factor when the client is scheduling a postpartum examination
the nurse is teaching participants in a prenatal class regarding breast-feeding versus formula feeding. a client asks, "what's the primary advantage of breast-feeding?" which response is most appropriate? A) "breast-fed infants have fewer infections" B) "breast-feeding inhibits ovulation in the mother" C) "breast-fed infants adhere more easily to a feeding schedule" D) "breast-feeding provides more protein than cow's milk formula does"
A) Maternal antibodies are transferred from the mother in breast milk, providing protection for a longer time than do antibodies transferred to the fetus by way of the placenta. the neonate is protected by the antibodies and this has fewer infections. the fetus' own antibody system is immature at birth. women who breast-feed completely (day and night with no supplementary feedings) may avoid ovulation and resumption of the menstrual cycle. use of formula or solid foods decreases breast-feeding frequency and can lead to ovulation. ovulation generally occurs before menses, making it difficult to know when the menstrual cycle is resuming. therefore, breast-feeding is considered one of the least reliable methods of contraception for the new mother. because of the higher carbohydrate content of breast milk, which is digested rapidly, breast-fed infants wake more frequently than formula-fed infants. their feeding demands take more time to regulate than do the formula-fed infants'. breast milk has 1.1 g protein/100mL; cow's milk has 3.5 g/100 mL. whole cow's milk is unsuitable for infants
which suggestion would the nurse make to a client with morning sickness? A) "eat dry crackers before you get out of bed" B) "increase your fat intake before bedtime" C) "drink high-carbohydrate fluids with meals" D) "eat 2 small meals a day and a snack at noon
A) Nausea and vomiting in the morning occur in almost 50% of all pregnancies. eating dry crackers before getting out of bed in the morning is a simple remedy that may provide relief. increasing fat intake does not relieve the nausea. drinking high-carbohydrate fluids with meals is not helpful; separating fluids from solids at mealtime is more advisable. eating 2 meals a day and a snack at noon does nutmeat the nutritional needs of a pregnant woman, nor will it relieve nausea. some women find that eating 5 to 6 small meals daily instead of 3 large ones is helpful
in the second. hour after the client gives birth, her uterus is firm, above the level of the umbilicus, and to the right of midline. which nursing action is an appropriate response to this situation? A) having the client empty her bladder B) watching for signs of retained secundines C) massaging the uterus vigorously to prevent hemorrhage D) explaining to the client that is a sign of uterine stabilization
A) a full bladder elevates the uterus and displaces it to the right. even though the uterus feels firm, it may relax enough to foster bleeding. the bladder should be emptied to improve uterine tone. watching for signs of retained secundines may be done if emptying the bladder does not rectify the situation. if parts of the placenta, umbilical cord, or fetal membranes are notably expelled during the third stage of labor, their retention limits uterine contraction and involution; a boggy uterus and bleeding may evident. vigorous massage tires the uterus, and even with massage the uterus is unable to contract over a full bladder. explaining to the client that this is a sign of uterine stabilization is not accurate; the uterus will not remain contracted over a full bladder
at which point during a human pregnancy does the embryo become a fetus? A) during the 8th week of the pregnancy B) at the end of the and week of pregnancy C) when the fertilized egg becomes implanted D) when the products of conception as seen on the ultrasound
A) during the 8th week of pregnancy the organ systems and other structures are developed to the extent that they take the human form; at this time the embryo becomes a fetus and remains so until birth. at the end of the 2nd week of pregnancy , the developing cells are called an embryo. at the time of implantation, the group of developing cells are called a blastocyst. the embryo can be visually on ultrasound before it becomes a fetus
which recommendation would the nurse make to a pregnant client who sits almost continuously during her working hours? A) "try to walk around every few hours during the workday" B) "ask for time in the morning and afternoon to elevate your legs" C) "tell your boss that you won't be able to work beyond the second trimester" D) "ask for time in the morning and afternoon so you can go get something to eat"
A) maintaining the sitting position for prolonged periods may constrict the vessels of the legs, particularly those in the popliteal spaces, and may diminish venous return. walking causes the leg muscles to contract and applies gentle pressure to the veins, thereby promoting venous return. walking around several times each morning and afternoon will improve circulation; the legs may by elevated while the client is sitting other desk. if the client is feeling well, there are no contraindications to working throughout her pregnancy. adequate nourishment can be obtained during mealtimes; the client does not require extra nutrition breaks
which factor distinguishes true labor from false labor? A) cervical dilation is evident B) contractions stop when the client walks around C) the client's contractions progress only when she is in a side-lying position D) contractions occur immediately after the membranes rupture
A) progressive cervical dilation is the most accurate indication of true labor. with true labor, contractions will increase with activity. contractions of true labor persist in any position. contractions may not begin until 24 to 48 hours after the membranes rupture
A non stress test (NST) s scheduled for a client with mild preeclampsia. during a NST, the client asks what it means when the fetal heart rate goes up every time the fetus move. which is an appropriate response? A) "these acceleration are a sign of fetal well-being" B) "these accelerations indicate fetal head compression" C) "umbilical cord compression is causing these accelerations" D) "utter-placental insufficiency is causing these accelerations"
A) the NST is performed before labor begins. Accelerations with movement and a baseline variability of 5 to 15 beats/min indicate fetal well-being. this reactive NST is considered positive. early decelerations are associated with fetal head compression during a contraction stress test (CST) of during labor. variable decelerations are associated with cord compression during a CST ordering labor. Late decelerations during a CST or during labor are associated with utero-placental insufficiency
During a non stress test, the baseline fetal heart rate of 130 to 140 BPM rises to 160 twice and 157 once during a 20 minute period. each of these episodes lasts 20 seconds. which action would the nurse take A) discontinue the test because the pattern is within the normal range B) encourage the client to drink more fluids to decrease fetal heart rate C) notify the primary health care provider and prepare for an emergency birth D) record this non reassuring pattern and continue to test for further evaluation
A) the baseline heart rate is within the expected range. the accelerations meet the criteria for an increase of 15 meats that lasts at least 15 seconds during a 20 minutes period. this is a reassuring pattern that is indicative of fetal well-being. drinking more fluids is unnecessary because the fetal heart rate is within the expected range. preparing for an emergency birth is unnecessary because the test rests indicate fetal well-being. the tests results meet the standards for reassuring pattern; further evaluation is unnecessary
which information would tell the nurse if a woman at 40 weeks' gestation having contractions is in true labor? A) the cervix dilates and becomes effaced in true labor B) bloody show is the first sign of true labor C) the membranes rupture at the beginning of true labor D) fetal movements lessen and become weaker in true labor
A) the major differences between true and false labor is that rue labor can be confirmed by the presence of dilation and effacement of the cervix. bloody show may occur before or after sure labor begins. the membranes may rupture before or after labor begins. fetal movements continue uncharged throughout labor
Morning sickness generally disappears by the end of which month? A) fifth month B) third month C) fourth month D) second month
B) Because of a decrease in chorionic gonadotropin, morning sickness seldom persists beyond the first trimester. morning sickness usually ends at the end of the third month, not the second month when the chorionic gandotropin level falls. it is still present in the second month because of the high level of chorionic gonadotropin but has usually diminished by the fifth month
A client who is at 20 weeks of gestation visits the prenatal clinic for the first time. assessment reveals temperature of 98.8º F, HR of 80 BPM, BP of 128/80, weight of 142 lb (prepregnancy weight was 132 lb), fetal heart rate (FHR) of 140 BPM, urine that is negative for protein, and fasting blood glucose level of 92 mg/dL. Which would the nurse do after making these assessments? A) report the findings because the client needs immediate intervention B) document the results because they are expected at 20 weeks gestation C) record the findings in the medical record because they are not within the norm but are not critical D) prepare the client for an emergency admission because these findings may represent jeopardy to the client and fetus
B) all data presented are expected for a client at 20 week's gestation and should be documented. there is no need for immediate intervention or an emergency admission because all findings are expected
which is the expected color and consistent of amniotic fluid at 36 weeks' gestation A) clear, dark amber colored, and containing shreds of mucus B) straw colored, clear, and containing little white specks C) milky, greenish yellow, and containing shreds of mucus D) greenish yellow, cloudy, and containing little white specks
B) by 36 week's gestation, amniotic fluid could be pale yellow or straw-colored with small particles of vernix caseosa present. dark amber-colored fluid suggests the presences of bilirubin, an ominous sign. greenish-yellow fluid may indicate the presence of meconium and suggests fetal compromise. cloudy fluid suggests the presence of purulent material
a pregnant client asks how smoking will affect her baby. which information about cigarette smoking will influence the nurse's response? A) it relieves maternal tension, and the fetus response accordingly to the reduction in stress B) the resulting vasoconstriction affects both fetal and maternal blood vessels C) substances contained in smoke permeate through the placenta and compromise the fetus's well-being D) effects are limited because fetal circulation and maternal circulation are separated by placental barrier
B) cigarette smoking or continued exposure to secondary smoke causes both maternal and fetal vasoconstriction, resulting in fetal growth retardation and increased fetal and infant mortality. there is no clinical evidence that smoking relieves tension or that the fetus is more relaxed. smoking causes vasoconstriction; permeability of the placenta to smoke is irrelevant. although the fetal and maternal circulations are separate, vasoconstriction coccus in both mother fetus
Which technique would the nurse suggest to a laboring woman's partner that involves gently stroking the woman's abdomen in rhythm with her breathing during a contraction? A) massage B) effleurage C) acupressure D) counterpressure
B) effleurage is the gentle stroking of the abdomen in rhythm with her breathing during a contraction. massage is the application of therapeutic touch and pressure on the body. acupressure is the application of pressure along special acupressure points. counterpressure is the application of pressure to the sacrum during a contraction
the first day of a client's last menstrual period was July 22nd. which is the estimated date of birth (EDB)? A) May 7th B) April 29th C) April 22nd D) March 6th
B) her EDB is April 29th. Naegele's rule is an indirect, noninvasive method for estimating the date of birth: EDB = last menstrual period + 1 year - 3 months + 7 days. May 7 is beyond the EDB, March 22 and March 6 are both before the EDB
When a client at 39 weeks' gestation arrives at the birthing suite she says. "I've been having contractions for 3 hours, and I think my water broke." which action would the take to confirm that the membranes have ruptured? A) take the client's oral temperature B) test the leaking fluid with nitrazine paper C) obtain a clean-catch urine specimen D) inspect the perineum for leaking fluid
B) nitrazine paper will turn dark blue if amniotic fluid is present; it remains the same color in the presence of urine. temperature assessment os not specific to ruptured membranes at this time; vital signs are a part of the initial assessment. although this may be done as a part of the initial assessment, a urine test is unrelated to leakage of amniotic fluid. inspecting the perineum for leaking fluid will not confirm rupture of the membranes
Which response would the nurse give a postpartum client who asks if she can drink a small glass of wine before breast-feeding the first time to help her relax? A) "I think drinking 1 glass of wine won't be a problem. Go ahead" B) "you seem a little tense. Tell me how you feel about breast-feeding" C) "you seem to find it relaxing, but you should try to find another way to relax" D) "I think drinking 1 glass of wine is alright, but you better check with your health care provider first"
B) stating that the client seems tense and initiating a discussion honors the client's feelings and encourages expression of them; there is no reference to alcohol consumption and its relaxing effects. alcohol ingestion should not be encouraged, because it enter the breast milk. Stating that the client needs to find another way to relax reflects the statement but not her underlying feelings. Suggesting that she find another way to relax may make the client defensive and shut off communication. although alcohol ingestion should not be encouraged because it enters breast milk, the primary health care provider need not be involved because health education is within the role of the nurse
a client at 35 weeks' gestation asks the nurse why her breathing has become more difficult. how would the nurse respond? A) "your lower rib cage is more restricted" B) "your diaphragm has been displaced upward" C) "your lungs have increased in size since you got pregnant" D) "the height of your rib cage has increased since you got pregnant
B) the pressure of the enlarging fetus causes upward displacement of the diaphragm, which results in thoracic breathing; this limits the descent of the diaphragm on inspiration. the lower ribcage expands; it does not become restricted. there is no charge in the size of the lungs during pregnancy. the thoracic cage enlarges; it does not rise
a prenatal client's vaginal mucosa is noted to have a purplish discoloration. which sign would be documented in the client's clinical record? A) Hegar B) Goodell C) Chadwick D) Braxton-Hicks
C) a purplish discoloration, called Chadwick sign, results from the increased vascularity and blood vessel engorgement of the vagina. the Hegar sign is the softening of the lower uterine segment. the Goodell sign is the softening of the cervix. after the fourth month of pregnancy, irregular, painless uterine contractions, called Braxton-Hicks contractions can be felt through the abdominal wall
When the fetal monitor is applied to a client's abdomen, it records late decelerations. which action would the nurse take A) notify the health care provider B) elevate the head of the bed C) reposition the client on her left side D) administer oxygen by way of facemask
C) late decelerations may indicate impaired placental perfusion. turning the client on her left side relieves pressure on the vena cava and aorta, improving circulation to the placenta. calling the health care provider is premature. the nurse should notify the practitioner if late decelerations continue after nursing interventions are implemented. elevating the head of the bed will increase pressure on the vena cava and aorta, further reducing placental perfusion. oxygen may be administered if placing the client on her left side does not resolve the late decelerations
when assessing a client who gave birth 1 day ago, the nurse finds the fungus firm at 1 finger breadth below the umbilicus and the perineal pad is saturated with lochia rubra. which is the nurses's next action? A) recording these expected findings B)obtains a prescription for an oxytocin medication C) asking the client when she last changed the perineal pad D) notifying the primary health care provider of excessive bleeding
C) the amount lochia would be excessive if the pad were saturated in 15 minutes' saturating the pad in 2 hours is considered heavy bleeding. if the pad has not been changed for a longer period, this could account for the large quantity of lochia, so asking the client when she last changed the perineal pad is appropriate. these findings cannot be supported or recorded without additional information. excessive bleeding cannot be established without more information from the client. oxytocin's are administered for uterine any; the need for this is not supported by the assessment of a firm funds
Which statement by a breast-feeding mother indicates that the nurse's teaching regarding stimulating the let-down reflex has been successful? A) "I will take a cool shower before each feeding" B) "I will drink a couple of quarts of fat-free milk a day" C) "I will wear a snug-fitting breast binder day and night" D) "I will apply warm packs and massage my breasts before each feeding"
D) applying warm packs and massaging the breasts before each feeding helps dilate milk ducts, promote emptying of the breasts, and stimulate further lactation. taking a cool shower before each feeding contracts the milk ducts and interferes with the let-dow reflex. Heavy consumption of milk products is not required to stimulate the production of milk. breast binders may inhibit lactation by fooling the body into thinking that milk secretion is no longer needed
one hour after a birth the nurse palpates a client's fungus to determine whether involution is taking place. the fundus is firm, in the inline, and 2 finger breadths below the umbilicus. which would the nurse do next? A) encourage the client to void B) notify the health care provider immediately C) massage the uterus and attempt to express clots D) continue periodic assessments and record the findings
D) immediately after birth the uterus is 2 cm below the umbilicus; during the first several postpartum hours, the uterus will rise slowly to just above the level of the umbilicus. these findings are expected, and they should be recorded. encouraging the client to void is unnecessary; if the bladder is full, the uterus will be high and pushed to one side. notifying the health care provider is unnecessary; involution is occurring as expected. massage is used when the uterus is soft and "boggy"
Which descriptor would the nurse use when explaining to a client how to time the frequency of contractions? A) From the end of 1 contraction to the end of the next contraction B) from the end of 1 contraction to the beginning of the next contraction C) from the beginning of 1 contraction to the end of the next contraction D) from the beginning of 1 contraction to the beginning of the next contraction
D) the frequency of contractions is timed from the beginning of 1 contraction to the beginning of the next; this is the definition of 1 contraction cycle. the beginning, not the end, of a contraction is the starting point for timing the frequency of contractions. the time between the end of 1 contraction and the beginning of the next contraction is the interval between contractions. timing from the beginning of 1 contraction to the end of the next contraction is too long a time Frame and will produce inaccurate information
