PrepU questions for Maternal Health

When educating parents on the incidence of genetically associated childhood cancers, the nurse will discuss which cancers? Select all that apply.

retinoblastoma Wilms tumor neuroblastoma

A client is diagnosed with pediculosis infection. When teaching the client about measures to treat and minimize the transmission, which measures would the nurse include? Select all that apply.

following the manufacturer's instructions for the medication not sharing any personal items with others removing any nits with a fine toothed comb

A nurse is providing education related to genetic testing. Which benefits of genetic testing would the nurse explain to the client? Select all that apply.

diseases tied to ethnicity and race inborn errors of metabolism

A nurse is caring for a female client in the postpartum phase. The client reports "afterpains." Which intervention should the nurse complete first?

Administer pain medications.

A client in latent labor for the past 12 hours is requesting medication to help her rest. The nurse predicts the health care provider will prescribe which medication?

secobarbital

The nurse who is scheduled to work in a clinic in a Hispanic neighborhood takes time to research Hispanic cultural norms to better provide culturally competent care. This behavior is an example of which cultural component?

Cultural knowledge

The nurse is caring for a client in labor. The nurse realizes it is most common for labor dystocia to occur during which stage of labor?

first stage of labor

Which factors are causes of the high infant mortality rate? Select all that apply.

low birth weight sudden infant death syndrome necrotizing enterocolitis

A nurse is providing education to pregnant clients in birth education classes. Which nursing interventions would the nurse include to promote positive learning? Select all that apply.

Encourage the clients to remain positive about the pregnancy. Provide information about all procedures in the birthing process.

A woman at 9 weeks' gestation is admitted to the obstetrical unit for hyperemesis gravidarum. Which action should the nurse prioritize immediately?

instruct on NPO status

A client is seeking advice for his pregnant wife who is experiencing mild elevations in blood pressure. In which position should a nurse recommend the pregnant client rest?

lateral recumbent position

The mental health clinical nurse specialist is teaching a postpartum nurse how to use the Postpartum Depression Predictor Scale (PDSS) to assess for postpartum depression. The nurse specialist determines the need for additional teaching when the nurse identifies which component as being screened with the scale?

family and social support system

A nurse calls the mother of a 1-month-old infant to conduct preappointment education for genetic screening. What item would the nurse suggest that the client bring to the appointment that will aid in the genetic assessment?

family photos

The nurse is giving a transition-of-care report to the nurse coming on duty. Based on the above report, what would cause the nurse to be prepared for shoulder dystocia during the birth? Select all that apply.

maternal obesity prolonged second stage

A client with full-term pregnancy who is not in active labor has been prescribed oxytocin intravenously. The nurse would notify the health care provider if which finding is noted?

overdistended uterus

The nurse is discharging home a client with gestational hypertension at 30 weeks' gestation with instructions to go on bed rest. Which activities can be managed at home? Select all that apply.

blood pressure monitoring fetal ultrasound monitoring uterine monitoring

Which assessment findings, experienced by the client at 36 weeks' gestation, would the nurse document as diagnostic signs of severe preeclampsia? Select all that apply.

blood pressure of 164/110 mm Hg elevated liver enzymes +1 proteinuria Elevated serum creatinine

The nurse is educating a group of student nurses on symptoms of sexually abused women. What symptoms will the nurse include in the teaching? Select all that apply.

chronic pelvic pain substance use disorder headaches social withdrawal

Which clients should the nurse monitor for fetal demise? Select all that apply.

client who has a prolonged pregnancy client with hypertension

When assessing a 1-day postpartum woman's pulse, what is the first action a nurse should take in response to a rate of 56 beats/min?

Do nothing, this is normal.

A nurse is reading a journal article about sexual violence as a public health problem. Which event would the nurse expect to be discussed within the article? Select all that apply.

human trafficking infanticide female genital mutilation bondage incest forced prostitution

If a delivering mother weighed 140 pounds at the time of delivery, how much weight should she have lost when she goes home 2 days later, based upon the average pattern?

17-29 pounds

The nurse working in the obstetrics clinic is completing an assessment and concerned about possible signs of intimate partner violence during pregnancy. Further abuse screening is completed if the nurse documents which? Select all that apply.

Poor attendance at prenatal visits Unrealistic fears Weight fluctuations Difficulty with physical exams Noncompliance with treatment

A woman in her 16th week of pregnancy comes to the health center for a follow up visit. Which physiologic change would the nurse expect to assess? Select all that apply.

a uterus that is palpable colostrum that can be expelled from the nipples

A pregnant woman is scheduled for chorionic villus sampling. The nurse is describing the procedure and the potential for complications. When providing care to the client after the testing, the nurse would be alert for which complication as the most common? Select all that apply.

cramping vaginal bleeding

On postpartum day 4, a client has a temperature of 101.4°F (38.6°C). Which findings would be consistent with a diagnosis of endometritis? Select all that apply.

foul-smelling lochia tender uterus strong afterpains

When screening a client about intimate partner violence, which question by the nurse would be most appropriate?

"How does your partner treat you?"

A woman arrives to the unit in active labor with her spouse and 7-year-old child. The woman and her spouse do not speak the dominant language, but the child does. Which action(s) by the nurse is appropriate? Select all that apply.

Call the interpreter or use the interpreter phone. Ask another nurse to switch assignments with you because the nurse speaks the woman's language. Use hand gestures to communicate until the interpreter phone is working.

A client has moved into the active phase of labor and is now at 6 cm dilated and +1 station. The nurse is prepared to monitor the contraction pattern how often?

Every 30 minutes

A nurse is reviewing the medical record of a postpartum woman in preparation for assessment. Which factor would the nurse identify as increasing the woman's risk for infection? Select all that apply.

urinary stasis denuded endometrial arteries episiotomy

A client who gave birth 18 hours ago is experiencing a change in lochia flow from scant to moderate. Prioritize the actions the nurse would take to assess the client's fundus. Use all options.

Determine the site of bleeding. Palpate the fundus. Massage the fundus if boggy. Increase IV oxytocin or breastfeed the newborn. Assess blood pressure. Notify the primary care provider.

When assessing the episiotomy site of a postpartum client who delivered 3-hours ago, the nurse would document which findings as expected? Select all that apply.

Edema Slight bruising

The nurse is documenting subjective and objective data changes from a client at 34 weeks' gestation. Which would the nurse report immediately to the health care provider? Select all that apply.

Scant spotting on underwear Sharp abdominal pain

A couple who have been experiencing infertility have been prescribed clomiphene citrate. What information should be included in teaching about the medication therapy? Select all that apply.

This medication therapy will promote ovulation in the woman. The medication is usually used for no more than 3 cycles at a time.

A 17-year-old client comes to the clinic because of irregular menstrual bleeding and facial acne. The client is overweight, despite exercising daily, and has excessive hair growth on the chin and abdomen. The nurse explains to the client that blood will be drawn for which purposes? Select all that apply.

To screen for insulin resistance To obtain fasting cholesterol levels To measure androgen level

A pregnant woman comes to the clinic for a follow-up appointment. The woman had an amniocentesis on her previous visit. The nurse reviews the results from the testing. Which result(s) would the nurse identify as problematic? Select all that apply.

bilirubin positive negative phosphatidylglycerol

If a client is receiving total parenteral nutrition (TPN) for hyperemesis gravidarum, which bedside lab tests need to be performed daily? Select all that apply.

blood glucose testing urine for ketones

A nurse is monitoring a fetal heart rate (FHR) pattern on her client in labor and notes a change from the earlier baseline FHR of 140 bpm to 168 beats/min The nurse is aware that which factors can result in fetal tachycardia? Select all that apply.

fetal movement fetal distress uteroplacental insufficiency maternal fever

A nurse is reviewing the medical record of a postpartum client. The nurse identifies that the woman is at risk for a postpartum infection based on which information? Select all that apply.

history of diabetes hemoglobin level 10 g/dL (100 g/L) placenta requiring manual extraction

A 58-year-old woman comes to the clinic for a routine evaluation. When reviewing the woman's health history, which finding(s) would lead the nurse to suspect that the woman is at risk for heart disease? Select all that apply.

history of gestational hypertension menopause at age 50 years history of polycystic ovary syndrome

After teaching a group of women about breast cancer and potential risk factors, the nurse determines that additional teaching is needed when the group identifies which factors as increasing a woman's risk for breast cancer? Select all that apply.

low body weight multiple pregnancies

A nurse is admitting a female client to the cardiac unit diagnosed with a possible myocardial infarction. During the admission assessment, which symptoms would the nurse expect to find? Select all that apply.

nausea unbalanced pain in the right arm

A nurse is screening a client for intimate partner violence during a health care visit. Which finding would lead the nurse to suspect that the client may be a victim? Select all that apply.

reference to a friend who is being abused evasive answers to questions asked display of anger toward health care providers overprotectiveness of partner

A nurse is assessing a newborn and suspects that newborn may have been exposed to alcohol during gestation. The nurse suspect this based on which newborn findings? Select all that apply.

thin upper lip small head circumference limb abnormality

A nurse is reviewing the labor and birth record of a postpartum woman. The nurse determines the need for frequent monitoring for infection based on which factors in the woman's history? Select all that apply.

use of regional anesthesia for birth use of fetal scalp electrode for internal fetal monitoring forceps-assisted vaginal birth history of gestational diabetes

A pregnant client has been diagnosed with hydramnios and has been referred for further testing. To obtain family history information needed for the testing, which question(s) should the nurse ask the client? Select all that apply.

"Has anyone in your family been born with a problem with the intestines?" "Do you have anyone in the family who has been born with a spine problem?" "Do you have anyone in the family born with Down syndrome?"

A postpartum client has decided to bottle feed her newborn. After teaching the woman about it, the nurse determines that the teaching was successful based on which client statement(s)? Select all that apply.

"I will be sure not to use the microwave to warm the formula." "I will make sure the nipple and neck of the bottle are filled with formula during a feeding." "I will get my newborn to suck by touching the nipple to the lips."

During a routine examination, a 14-year-old client states, "I do have unprotected sex." Which reply by the nurse is most appropriate?

"Let me teach you how to properly apply a condom."

A nurse is teaching a client how to perform Kegel exercises. Which directives would the nurse include? Select all that apply.

"Squeeze your rectal muscles as if you are trying to avoid passing flatus." "Contract and relax your pubococcygeal muscles rapidly 10 times."

A 32-year-old black woman in her second trimester has come to the clinic for an evaluation. While interviewing the client, she reports a history of fibroids and urinary tract infection. The client states, "I know smoking is bad and I have tried to stop, but it is impossible. I have cut down quite a bit though, and I do not drink alcohol." Complete blood count results reveal a low red blood cell count, low hemoglobin, and low hematocrit. When planning this client's care, which factor(s) would the nurse identify as increasing the client's risk for preterm labor? Select all that apply.

African heritage history of fibroids cigarette smoking history of urinary tract infections complete blood count results

A postpartum woman is developing thrombophlebitis in her right leg. Which assessment would the nurse use to assess for thrombophlebitis? Select all that apply.

Assess for redness and warmth in the affected leg. Assess for edema in the affected leg. Assess for a low-grade fever.

The registered nurse has identified that the client's labor progress has slowed. Which nursing intervention, done by the LPN, is completed first?

Assess if the bladder is distended

During a preconception visit, the nurse teaches the client about the risk of inadequate nutrition in early pregnancy. Which statement by the client indicates understanding of the nurse's teaching?

"If I have inadequate nutrients in the first half of pregnancy, an inadequate number of fetal cells are formed."

A pregnant client at 30 weeks' gestation calls the clinic because she thinks that she may be in labor. To determine if the client is experiencing labor, which question(s) would be appropriate for the nurse to ask? Select all that apply.

"Are you feeling any pressure or heaviness in your pelvis?" "Are you having contractions that come and go, off and on?" "Have you noticed any fluid leaking from your vagina?" "Have you been having any nausea or vomiting?"

A nurse is counseling a client preconception and describes pregnancy risk factors for genetic disorders. What risk factors would the nurse include? Select all that apply.

A pregnant client is 35 years old. The partner of a pregnant client is 53 years old. An incestuous relationship has resulted in pregnancy. The pregnant mother has been exposed to teratogens.

Which action(s) will the nurse take when asked to apply suprapubic pressure during a birth with shoulder dystocia? Select all that apply.

Apply downward pressure just above the pubic bone. Apply pressure between contractions. Apply pressure at an angle toward the face of the fetus.

A woman in active labor suddenly sits up, clutches her chest, screams with pain, and then collapses back on the bed. The RN notes she is unconscious and a bluish-gray color. Which interventions are considered the priority for the nurse to implement? Select all that apply.

Apply oxygen mask and start oxygen at 10 L/min. Begin CPR immediately.

The nurse is interviewing a client who has experienced intimate partner violence. Which nursing intervention will likely be most effective in assuring the client that the interview will be kept confidential?

Assure the client agrees before any information can be released

An expectant client asks the childbirth educator about the advantages of going to a birthing center for delivery. Which are the nurse's best responses? Select all that apply.

Birth centers are designed to be more home-like and comfortable with fewer interventions. Birth centers focus on pregnancy as a state of wellness and on women and families as a whole. The rate of cesarean delivery for clients who deliver in a birth center is less than for those who deliver in hospitals. Care is usually provided by midwives for pregnant clients with lower risk of complications. Birth centers have transfer agreements with local hospitals if complications occur.

The nurse is conducting a breast exam on a postpartum mother on the second day following delivery. What findings would the nurse determine to be normal? Select all that apply.

Breasts feel slightly firm. Flattened nipple on the right breast Breasts are non-painful

A breastfeeding client presents with a temperature of 102.4°F (39°C) and a pulse of 110 bpm. She reports general fatigue and achy joints, and her left breast is engorged, red, and tender. Which instructions would the nurse anticipate being given to this client? Select all that apply.

Continue breastfeeding on the left side, if the infant is willing to latch on. Take prescribed antibiotics until all prescribed doses are completed. If infant refuses to feed, pump the breast to maintain flow.

The nurse is asked to provide information for a task force addressing abuse in the community. Which prevention tactics are suggested? Select all that apply.

Develop and teach high school courses on parenting and normal child growth and development. Promote activities that encourage self-esteem in young adults. Role-model for caregivers various behaviors with children that are compassionate, loving, and caring. Educate those who were abused as children, and offer them professional help to break the pattern of violence. Help parents and caregivers find local support in their community.

What findings should the nurse report to the health care provider for a postpartum client who delivered 12 hours ago? Select all that apply.

Fundal height level of one fingerbreadth above the umbilicus Temperature of 101.8°F (38.8°C)

Which protective equipment is most appropriate when assisting the health care provider in the delivery of the fetus? Select all that apply.

Goggles Gloves Gown

An Rh-negative mother delivered an Rh-positive infant. What information would the nurse need to gather prior to administering Rho (D) immune globulin injection? Select all that apply.

Has the mother ever been sensitized to Rh-positive blood? Has the mother had any previous pregnancies? Has the mother experienced any miscarriages or abortions?

A nurse is working at a community prenatal drop-in clinic. Which actions best reflect the principles of family nursing within this clinic? Select all that apply.

Health promotion education activities are planned for the clients and their families. The clients and their families are included in all decision-making collaborations. The nurse would seek other health care provider input to plan care.

The nurse has provided care to a client throughout labor and delivery and is comparing assessment findings with expected norms. When tracking the client's cardiac assessments, the nurse should predict that cardiac output will likely be the highest at which time?

Immediately after birth

Which nursing diagnosis would be most appropriate for a client with a postpartum hematoma?

Impaired urinary elimination

A nurse is preparing for a small group discussion on pelvic organ prolapse. Which suggestions of lifestyle changes could the nurse include in the discussion? Select all that apply.

Increase dietary fiber. Increase fluid intake.

Which symptoms indicate that the client has begun the transition phase of labor? Select all that apply.

Increase in bloody show The client states an urge to push Irritability and restlessness may occur The client may begin to cry Hyperventilation may occur

A gravid client is talking with the nurse about the excessive nausea and vomiting she has been experiencing throughout the day. She asks why this is happening to her and what she can do to reduce the nausea. What information should be included in the nurse's response? Select all that apply.

Ingesting small frequent meals in pregnancy is helpful to manage nausea. Eating a high carbohydrate snack before getting out of bed may be helpful.

The nurse is preparing an educational presentation on interfamilial sexual abuse. What family member will the nurse identify as being the primary sexual assailant?

Male sibling, either biological or step-brother

Which postpartum clients would require the nurse to intervene? Select all that apply.

Primipara with vital signs including temperature 100.2°F (37.9°C), blood pressure 140/86, pulse 124, respiratory rate 12. Multipara with vital signs including temperature 99°F (37.2°C), blood pressure 136/84, pulse 96, respiratory rate 32. Postpartum client with urine output of 30 ml/hour for 2 hours. First day postpartum client with blood pressure 84/48, pulse 128, respiratory rate 16. Primipara with vital signs including temperature 100.2°F (37.9°C), respiratory rate 28, oxygen saturation 94%.

Nurses play important roles in a variety of community settings. Which nursing goal is common to all types of community settings?

Promote the health of a specific group of clients.

A nurse is conducting a class for a group of nurses new to the labor and birth unit about labor and the passage of the fetus through the birth canal. As part of the class, the nurse explains that specific diameters of the fetal skull can affect the birth process. Which diameter would the nurse identify as being most important in affecting the birth process? Select all that apply.

Suboccipitobregmatic Biparietal

Which intervention(s) will the nurse recommend for a breastfeeding mother diagnosed with mastitis? Select all that apply.

Take antibiotics as prescribed Apply warm compresses to the affected breast PRN Rub expressed breast milk on the nipples after each feeding session Take acetaminophen as needed for pain

A nurse is conducting a nutrition class for a group of pregnant women. What information accurately addresses this issue? Select all that apply.

Total iron requirements equal 1,000 mg, with the greatest need being in the second trimester. Calcium supplements may decrease the chance of developing pre-eclampsia in women who had a pre-existing deficiency. Since an iodine deficiency can cause intellectual deficits in infants, mothers are recommended to use iodized salt.

A nurse is taking a history on a woman who is at 20 weeks' gestation. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings? Select all that apply.

dull low backache viscous vaginal discharge dysuria

A woman at the infertility clinic for the first time asks, "What could have caused my infertility?" Learning has taken place when the woman can identify which common causes of infertility? Select all that apply.

endometriosis blocked fallopian tubes ovarian dysfunction

The nursing student correctly identifies which risk factors for developing dystocia? Select all that apply.

epidurals excessive analgesia multiple gestation maternal exhaustion high fetal station at complete cervical dilation shoulder dystocia

A nurse is caring for a client in her third stage of labor. The nurse would predict the placenta is separating from the uterus based on which assessment findings? Select all that apply.

fresh gushing of blood from the vagina umbilical cord descending lower down a globular shaped uterus

A nurse is preparing a class discussion on cardiovascular disease in women. When discussing the priority risk factors for this disease, which would the nurse least likely include? Select all that apply.

gender age

Which occupation may expose a fetus to environmental hazards? Select all that apply.

nurse anesthetist working in a busy oral surgeon's office short-order cook for a busy deli nurse working for a pulmonologist who administers inhalation ribavirin routinely to the client population

The nurse is planning care for a victim of physical abuse. What interventions should the nurse implement when addressing the victim's need to regain a sense of control over one's life? Select all that apply.

providing reinforcement of stress management strategies arranging for a consult with a social services care team member supporting autonomy by encouraging effective decision-making

Which client should the postpartum nurse assess first after receiving shift report?

the 2-day postpartum client who has a blood pressure of 138/90 mm Hg

A father of a newborn tells the nurse, "I may not know everything about being a dad, but I'm going to do the best I can for my son." The nurse interprets this as indicating the father is in which stage of adaptation?

transition to mastery

A nurse has experienced success by utilizing the SAVE model to evaluate clients for possible intimate partner violence. Which action would be least appropriate for the nurse to address?

validating that the client is the cause

The nurse is receiving shift handoff for a client with dystocia. Which nursing interventions are most appropriate in the plan of care? Select all that apply.

Nipple stimulation Administration of an enema Emotional support

A nurse is accepting a new position to provide care in the home. The nurse is prepared to utilize which skills or traits in this new position? Select all that apply.

Acute care nursing skills Great flexibility Ability to teach family members how to give care Ability to encourage frustrated family members

A client arrives at the clinic in labor. The nurse assesses a bulging perineum and prepares for the birth. Place the nurse's actions in sequence. All options must be used.

Call for assistance Put on gloves Support perineum with one hand Deliver the head Palpate for a nuchal cord Use bulb to suction mouth and nose

A pregnant woman in her second trimester comes to the clinic for a follow-up. During the visit, the woman reports discomfort related to hemorrhoids. Which suggestion(s) would be appropriate for the nurse to include when teaching the woman about relief measures. Select all that apply.

"Be sure to drink at least 2 liters of fluid each day." "Try using some cold compresses on the area." "Raise your feet on a stool when having a bowel movement."

The nurse is working with a client who was raped. Which statement, when made by the client, supports that the client is in the outward adjustment phase of the recovery process?

"I'm done talking about this; I've put the experience behind me."

Eight hours after delivery, the client is found to have a perineal hematoma. The health care provider prescribes insertion of a Foley catheter. The client does not understand why she needs a catheter, because she has voided twice since giving birth. Which responses by the nurse explain the need for a Foley catheter? Select all that apply.

"If you are bleeding into the tissue, the hematoma may put pressure on the urethra, making it impossible for you to void." "As the hematoma gets larger or if it extends into the vagina, it will be much harder to place the catheter later."

The nurse is caring for a newborn client and parents whose admission chart notes that they belong to and identify with an Old-Order Amish community. Which action should the nurse take while caring for the client?

Assess which forms of modern medicine are acceptable in the community.

A postpartum mother calls the nurse in and tells her that her right calf hurts whenever she walks around the room or in the hall. What other data needs to be collected in assessing this client for a DVT? Select all that apply.

Feel the right calf for increased warmth. Note any reddened areas on the right calf. Measure the diameter of both calves.

A client at 33 weeks' gestation is calling the office with various reports and is very concerned. The nurse recognizes which report(s) as indicating the client is potentially going into preterm labor? Select all that apply.

GI upset (nausea, vomiting, diarrhea) achiness in the thighs low, dull backache general sense of discomfort

A client at the end of the first trimester asks what her fetus looks like. Which characteristics would the nurse tell the client are present in the fetus at this point in the pregnancy? Select all that apply.

Nail beds are forming on fingers and toes. Tooth buds are present. The baby's sex is distinguishable on outward appearance. The spinal cord is formed and fused at the midpoint.

A nurse is working on developing cultural humility. In what sequence, from first to last, would the nurse apply the steps for developing cultural humility? All options must be used.

Recognize the influence of clients' culture on their health status. Seek resources to increase understanding of different sociocultural groups. Advocate for social justice to eliminate health disparities. Engage in cross-cultural interactions with others from diverse backgrounds.

A home care client who is 30 weeks' gestation with triplets reports to the nurse that she is having increasing difficulty getting out of bed to perform hygiene or elimination. Which is the most appropriate intervention?

Request a hospital bed for the home

The primigravida client is surprised by the continued uterine contractions while holding her new baby. Which explanation by the nurse will best explain these contractions?

Seals off the blood vessels at the site of the placenta

A pregnant woman questions the nurse about changes she is noticing in her breasts and is concerned if they are normal. Which reported changes would the nurse recognize as normal breast changes during pregnancy? Select all that apply.

Secretions from sebaceous glands on the areola Appearance of striae Darkening of the areola Nodular tissue upon palpation

A nurse is describing the events of labor to a group of pregnant women. Put the following events of labor as the nurse would explain them from first to last. All options must be used.

The cervix dilates to 2 cm. Cervix becomes fully effaced. Fetus continues descent. Crowning occurs. Placenta separates. Placenta is expelled.

Which processes that occur after fertilization would lead to a normal pregnancy? Select all that apply.

The morula divides into specialized cells that will form fetal structures. Within the morula is a blastocyst that will form the embryo. The morula enters the uterine cavity about 72 hours after fertilization.

A nurse visits a low-income housing complex to see a 3-month-old infant not yet registered whose follow-up visits have been missed. Upon assessment, the nurse notes the newborn care lacking and the young parents attentive but hesitant to ask questions. Which findings suggest poor health literacy? Select all that apply.

The newborn registration forms have not been filed. Follow-up visits for the infant have been missed. Communication with the parents is limited. The newborn care is inadequate.

At a prenatal class, the nurse educator describes the function of the placenta. What information would the nurse likely include? Select all that apply.

The placenta makes hormones to control the way the fetus is supplied with nutrients and oxygen. The placenta removes the waste products that the fetus produces. The placenta stimulates the mother to bring more food to the placenta. The placenta produces hormones that ready fetal organs for life outside the uterus.

A nurse is counseling a 17-year-old girl on the importance of contraception. The girl states that she is not really concerned about getting pregnant; she says that she will deal with the consequences if and when it happens. Which points should the nurse emphasize with the client regarding the risks of unintended pregnancies? Select all that apply.

The woman is less likely to seek prenatal care. The woman is less likely to breastfeed. The woman is less likely to protect her fetus from harmful substances. The woman is less likely to complete high school or college. The woman is more likely to require public assistance.

A client who is 10 weeks' pregnant reports during a social assessment interview that she has two indoor cats, lives alone, fixes her own meals and enjoys gardening. What precautions would the nurse recommend the woman take to prevent the possibility of contracting toxoplasmosis? Select all that apply.

Use gloves when planting her vegetable garden. Make sure meats are cooked to 152ºF (66.7℃); do not eat raw or rare meats

A woman birth her infant 24 hours ago by cesarean. Which assessment findings should be reported to the assigned nurse? Select all that apply.

Uterus feels boggy. The client reports breakthrough pain level of 7 to 8.

A nurse is providing follow-up teaching to a client regarding the medically induced termination of her pregnancy. Which assessment finding should the nurse tell the client to report to the health care provider? Select all that apply.

Vaginal bleeding of more than two pads per hour Severe depression or sadness Severe abdominal pain

Which assessment findings of the fetus during labor are normal? Select all that apply.

Variability between 18-20 bpm Fetal heart baseline of 130 bpm

A nurse is assessing a client and suspects that the client may be experiencing premenstrual dysphoric disorder (PMDD). Applying the American Psychiatric Association criteria, the nurse would assess which symptoms? Select all that apply.

affective lability sleep difficulties diarrhea

A 22-year-old Latino woman comes to the clinic for an evaluation. Assessment findings are as follows: Age of first intercourse: 15 years Intrauterine contraception inserted 2 months ago Monogamous partner Use of condoms for sexual activity Cigarette smoking since age 16; approximately 1/2 to 1 pack per day Oral temperature 100.4°F (38°C) The woman is diagnosed with pelvic inflammatory disease (PID). Which information from the woman's assessment would the nurse evaluate as increasing the woman's risk for this condition? Select all that apply.

age of first intercourse intrauterine contraceptive device insertion cigarette smoking latino ethnicity

A nursing student is studying postpartum complications. Thromboembolic conditions have which risk factors? Select all that apply.

anemia diabetes cigarette smoking obesity multiparity

A client who is receiving external beam radiation therapy as part of her treatment for breast cancer comes to the clinic for a follow-up visit. The nurse determines that the client is experiencing side effects of the treatment based on which findings? Select all that apply.

anorexia breast swelling

A nurse is caring for a client in her fourth stage of labor. Which assessments would indicate normal physiologic changes occurring during the fourth stage of labor? Select all that apply.

decreased intra-abdominal pressure well-contracted uterus in the midline mild uterine cramping and shivering

A nurse is reviewing the history of a woman diagnosed with pelvic organ prolapse. Which factor in the woman's history would the nurse identify as increasing the woman's risk for this condition? Select all that apply.

delivery of first child at age 18 years hysterectomy 3 years ago history of four term pregnancies

The nurse is providing care to a postpartum woman who has given birth vaginally to a healthy term neonate about 4 hours ago. While assessing the client, the client tells the nurse, "I've really been urinating a lot in the past hour." The nurse interprets this finding as suggestive of a decrease in which hormone?

estrogen

A nurse is reviewing the history of a woman diagnosed with uterine fibroids (uterine myomas). Which factors in the woman's history would the nurse identify as placing the woman at increased risk for this condition? Select all that apply.

history of hypertension obesity

A nursing instructor is teaching a group of nursing students various methods that, are recognized to improve pregnancy outcomes. After the session, the instructor determines the class is successful when the students correctly choose which option as one that helps improve prenatal care?

home care

A nurse is obtaining a medication history from a pregnant client with a history of systemic lupus erythematosus (SLE). Which medication(s) would the nurse expect the woman to report to be currently using? Select all that apply.

ibuprofen hydroxychloroquine prednisone

A nurse is conducting an in-service program for a group of nurses working in the prenatal clinic. When discussing the theories about the onset of labor, the nurse points out which factor as a possible cause? Select all that apply.

release of oxytocin by the pituitary prostaglandin production in the myometrium

A woman comes to the local women's health clinic for an evaluation. The woman is diagnosed with chlamydia. Which action(s) by the nurse would be important? Select all that apply.

report the condition to public health authorities discuss the need for treatment for gonorrhea as well

A pregnant client is concerned about genetic inheritance and asks the nurse which tests she can expect to undergo. What is the appropriate response by the nurse? Select all that apply.

sonogram amniocentesis umbilical blood sampling cfDNA testing

A nurse is conducting a class on the effects of nicotine during pregnancy. Which complications will the nurse include in the teaching? Select all that apply.

spontaneous abortion (miscarriage) placenta previa preterm labor and birth tubal ectopic pregnancy spontaneous rupture of membranes

A pregnant client at 14 weeks' gestation calls the clinic. When talking with the nurse, the client reports continued, frequent nausea and vomiting. She states, "This has been happening since I got pregnant and now I cannot keep anything down." Which intervention would be the priority for this client?

stopping all intake of food and drink

When discussing reproductive options with a couple in which the female is a carrier of a genetic disorder, what are the most appropriate suggestions by the nurse? Select all that apply.

surrogate mother alternative insemination transfer surrogate egg donor natural conception sterilization

A nurse is assessing a client with polycystic ovary syndrome for metabolic syndrome. Which findings would the nurse assess? Select all that apply.

triglyceride level 175 mg/dL (1.98 mmol/L) elevated C-reactive protein

After teaching a pediatric nursing class about childhood diseases in the late 19th and early 20th centuries, the nurse educator concludes that additional teaching is required when the participants indicate which conditions as leading causes of childhood death during that time period? Select all that apply.

tuberculosis roseola

A nurse is caring for a client at 38 weeks' gestation who is diagnosed with chorioamnionitis. On which intervention should the nurse place priority?

Administer oxytocin.

A nurse is conducting a class for a group of pregnant women about ways to minimize the risk of infection during pregnancy. One of the infections that the nurse is discussing is toxoplasmosis. The nurse determines that the class was successful when the group identifies which action(s) as helpful in preventing this infection. Select all that apply.

"Any cutting surface used for raw meats should be washed afterwards with hot, soapy water." "Peeling any raw vegetables is a good idea before eating them." "It is important to wear gardening gloves when digging in the soil."

The pediatric nurse assists the parents of a 26-month-old child newly diagnosed with childhood diabetes. Which statements and questions by the nurse would be appropriate to help the parents grasp the necessary care information? Select all that apply.

"Do you have a support system for you and your family in your community?" "Tell me how your baby's illness has affected your life." "What do you already know about your baby's illness?"

A nurse is providing care to a postpartum woman, her partner, and their neonate and is assessing their preparedness for discharge. Which question(s) would be appropriate for the nurse to ask? Select all that apply.

"How comfortable are you with feeding your neonate?" "Can you tell me who will be at home to help you out." "Tell me how you plan to get rest once you are at home."

The nurse is educating a pregnant client newly diagnosed with chlamydia. Which statement made by the client indicates an understanding of the nurse's teaching?

"I am thankful I am not legally required to tell my partner of my diagnosis."

A postpartum woman who is breastfeeding tells the nurse that she is experiencing nipple pain. After teaching the woman about possible suggestions, the nurse determines that more teaching is needed when the woman makes which statement?

"I apply glycerin-based gel to my nipples."

The parents of a pediatric client tell the home care nurse, "The doctor says there is nothing more they can do for our son's cancer and that he will die. We do not want him to know, so please do not tell him." Which response by the nurse is best?

"I will not say anything to your son, but I will contact the doctor."

A client who has been a victim of intimate partner violence is being counseled on the development of a safety plan. Which statement made by the client suggests the need for additional counseling to ensure the safety of the client and children?

"I have a special telephone card to use if we have to leave in a hurry."

The nurse is monitoring a client at 36 weeks' gestation who is bleeding. The nurse is preparing to insert a Foley catheter. Which explanation(s) should the nurse provide the client regarding the need for a urinary catheter? Select all that apply.

"The amount of urine output is an indication of tissue perfusion." "If urine output is less than 30 ml per hour, it is a sign of hemodynamic instability."

During the assessment of an 86-year-old client, the nurse notes multiple bruises on the torso, arms, and back. The client tells the nurse, "My child is my caretaker. My child is rough with me and very controlling." How will the nurse respond?

"Tell me what you have done in the past to resolve this mistreatment?"

A nurse is teaching a woman in her third trimester about Braxton Hicks contractions. When describing these contractions, which information would the nurse likely include? Select all that apply.

"They usually feel like a tightening across the top of your uterus." "They often spread downward before they go away." "They go away when you walk around or change position."

During a postpartum home visit, a woman tells the nurse that her hip joints are sore, just like they were when she was pregnant. Which information would the nurse likely include when teaching the woman about this condition? Select all that apply.

"This soreness should go away in about 6 to 8 weeks." "Let me show you how to use good body mechanics to lessen the problem."

A nurse is explaining the various methods of pain control used during labor and birth. When explaining why general anesthesia is rarely used, which information would the nurse include? Select all that apply.

A pregnant woman has a risk for vomiting and aspiration. General anesthesia readily crosses the placenta.

The nurse is teaching a birthing class to expectant fathers. A father wants to know how he can directly help his partner. How should the nurse respond? Select all that apply.

"You can be supportive by encouraging your partner during labor." "Providing a back rub helps with pain and provides relaxation." "Be aware that hormonal changes may make your partner have some behavior changes temporarily." "Involving yourself in infant care provides for better family bonding."

The nurse reviews the medical record of a woman who has come to the clinic for an evaluation. The client has a history of mitral valve prolapse and is listed as risk class II. During the visit, the woman states, "We want to have a baby, but I know I am at higher risk. But what is my risk, really?" Which response by the nurse would be appropriate?

"Your risk during pregnancy is small, but you should see your cardiologist first before getting pregnant."

The community nurse is visiting a client who is two weeks postoperative after a cesarean birth. What criteria would the nurse use to determine the effectiveness of the home visits? Select all that apply.

A review of the previous reasons for the home visits would be conducted. The client's health status would be assessed. The client's ability to care for her newborn would be evaluated.

A pregnant woman with gestational diabetes is prescribed 10 units of an intermediate-acting insulin and 5 units of a short-acting insulin each day. The total dose is to be divided into two injections, a morning and an evening dose. To provide the most effective control of the woman's blood glucose levels, the nurse anticipates that the client is likely to be prescribed how many total units for the morning dose?

10

The nurse is reviewing the medical record of a woman for whom induction of labor is being considered. The nurse notes the following: Cervical dilation 4 cm Effacement 60% 0 Station Soft cervix Anterior cervical position Based on this information, which Bishop score would the nurse assign?

10

Which statements illustrate the benefits of birth on a maternity unit that has a family-centered care designation? Select all that apply.

A family-centered approach is associated with decreased anxiety while in the hospital. A family-centered approach is associated with improved client pain management. A family-centered approach is associated with shorter recovery time. A family-centered approach is associated with increased communication.

The nurse is educating women on characteristics of perpetrators of intimate partner violence. What characteristics of abusers will the nurse include in the teaching? Select all that apply.

A history of oxycodone and diazepam use disorder 10 different employers in the past 18 months Arrested twice in the last year Dominates the control in personal and social situations

A pregnant client arrives at the community health center for a routine check-up. She informs the nurse that a relative on her mother's side has hemophilia, and she wants to know the chances of her child acquiring hemophilia. Which characteristics of hemophilia should the nurse explain to the client to help her understand the odds of acquiring the disease? Select all that apply.

Affected individuals are usually males. Female carriers have a 50% chance of transmitting the disorder to their sons. Females are affected by the condition if it is a dominant X-linked disorder.

The nurse is caring for a client who is having a high-risk pregnancy and requires genetic studies. Which procedures will the nurse anticipate? Select all that apply.

Amniocentesis Chorionic villus sampling Percutaneous umbilical blood sampling

The nurse is caring for clients in a community health clinic. Which clients does the nurse recognize need screening for sexually transmitted infections? Select all that apply.

An incarcerated 28-year-old client. A pregnant woman in the third trimester. Initial examination after a sexual assault. Annual exam for a 24-year-old sexually active woman

A nurse is preparing to assess a family which recently went through a divorce. The family now consists of a 40-year-old female, her 16-year-old son and 5-year-old daughter. The mother will continue as the primary wage earner with her current employment and has full custody of the children. Which action should the nurse prioritize with this family?

Assess the son for emotional trauma.

Place the steps of planning and implementing home care in order from first to last. All options must be used.

Assess the suitability of the family. Obtain a copy of client's referral form. Park in a well-lit area. Wash the hands. Perform a physical examination. Document all findings.

During a shoulder dystocia emergency, what action(s) does the nurse implement to prevent fetal hypoxia? Select all that apply.

Assist with maneuvers. Keep time. Document events in the record. Lower the head of the bed.

While performing a clinical breast examination on a client, the nurse inspects the breasts with the client in various positions. Place the following positions in their proper sequence.

Arms resting at the sides Hands placed on the hips Arms raised over the head Standing with hands on hips, leaning forwar

A nurse is providing care to a client who speaks little of the dominant language. The nurse enlists the aid of an interpreter. Which method(s) will the nurse include when working with the interpreter to educate this this client? Select all that apply.

Ask an interpreter to translate material into the client's primary language. Be certain that rooms in your health care agency, such as bathrooms, are labeled with international symbols. Assess the client's reading level and rewrite information at an easier reading level if necessary. Use hand gestures or draw a figure, if need be, to communicate better.

After teaching nursing students about the trends in women and cancer in the United States, the nurse educator concludes that learning has taken place when the students make which statements? Select all that apply.

Cancer is the second leading cause of death among women. Lung cancer has the lowest survival rate in the United States of any cancer.

A woman is being cared for in the emergency department following a sexual assault. In addition to the physical exam and collection of the rape kit, what sexually transmitted infection (STI) testing should the nurse prepare to collect during the initial examination visit?

Chlamydia, trichomoniasis, gonorrhea and hepatitis B

The nurse is caring for four postpartum client, monitoring them for postpartum infection. Which client is the priority due to current vital signs suggesting a postpartum infection?

Client 30 hours postpartum with a temperature of 100.4°F (38°C)

A nurse is performing discharge teaching for a client who just had an uterine endometrial biopsy. What is the nurse's priority discharge teaching?

Client should call clinic with the date of her next menses

The nurse is caring for a 10-year-old boy with a neuroblastoma. Which activities best describe the role of the nurse as a care coordinator, collaborator, and consultant? Select all that apply.

Collaborating with the family throughout the care path Coordinating care provided by the interdisciplinary team Ensuring that the child's and family's needs are met through activities such as support groups

A nurse is providing preoperative instructions to a client undergoing an emergency cesarean birth. Which actions follow appropriate communication guidelines? Select all that apply.

During the instructions, the nurse uses open-ended questions. The conversation is redirected while maintaining its focus. The client's feelings are addressed. The family's words are used to describe the necessary information.

Which fetal adaptation is anticipated in a vaginal birth? Select all that apply.

Decreasing pH throughout labor Changing heart rate during contractions Excretion of respiratory tract mucus

The nurse will be performing the Leopold maneuver to determine the position of the fetus. List in order the steps that the nurse would take. All options must be used.

Determine presentation. Determine position. Confirm presentation. Determine attitude.

The nurse is educating college students on ways to protect themselves from date and acquaintance rape. What will the nurse include in the teaching? Select all that apply.

Do not attend parties where alcohol will be served. Pour out drinks left unattended for any length of time. Accept drinks in closed containers or from bartenders only.

The nurse is in the process of administering medications to clients on the unit and notices one new mother is in the process of attempting to breastfeed her newborn infant. The nurse makes several suggestions to assist this mother. Which action should the nurse prioritize related to this interaction?

Document the care given

The nurse is caring for a client who is experiencing a noneventful labor process. Which assessment findings may occur as the client progresses through the stages of labor? Select all that apply.

Dry mucous membranes Nausea Increased white blood cell count Increased urine specific gravity Hyperventilation

A client is experiencing postpartum hemorrhage shortly after the birth of the infant. Which nursing intervention(s) would be appropriate for this client? Select all that apply.

Encourage the client to breastfeed the infant, if she is breastfeeding. Begin uterine massage with both hands on the fundus of the uterus. Turn the client on the side and inspect the area under the buttocks for blood. Encourage increased fluid intake. Monitor vital signs every 15 minutes.

The school public health nurse is teaching a high school class on sexually transmitted infections (STIs). The nurse would include what information in the presentation? Select all that apply.

Fifteen- to twenty-four-year-olds represent almost half of all cases of new STIs. Two in five sexually active teen girls have an STI. Teens who are sexually active experience high rates of STIs. Adolescent males make up more than three-quarters of HIV diagnoses among 13- to 19-year-olds.

A nurse is assessing a woman during the first 24 hours after birth. Which assessment finding would the nurse determine as acceptable during this time? Select all that apply.

Fundus one finger-breadth below the umbilicus Moderate saturation of peripad every 3 hours

A nurse is conducting an AIDS awareness program for women. Which instructions should the nurse include in the teaching plan to empower women to develop control over their lives in a practical manner so that they can prevent becoming infected with the HIV? Select all that apply.

Give opportunities to practice negotiation techniques. Encourage women to develop refusal skills. Encourage women to use female condoms.

The nurse is preparing discharge instructions for a client who has developed endometritis after a cesarean birth. As the client is to be discharged on antibiotic therapy, which instruction should the nurse prioritize?

Handwashing

A new mother is diagnosed with a venous thromboembolism in her left calf. Which risk factor is associated with this problem? Select all that apply.

cesarean birth obesity

A new mother delivered 1 week ago and is tearful, anxious, sad, and has no appetite. She is diagnosed with postpartum blues. What factors contribute to this problem? Select all that apply.

Hormonal changes Fatigue Discomfort Disrupted sleep patterns

A nurse is assessing a client whose history reveals that she has undergone female genital mutilation when she was a child. While preparing to assist the health care provider with a pelvic exam, the nurse observes scarring of the area around the vagina which has caused the area to become significantly narrowed. The nurse would interpret this as which type of female genital mutilation?

IV

Which are potential capabilities of umbilical cord blood? Select all that apply.

If a family member develops a disease, umbilical cord blood can be used in treatment. Umbilical cord blood is used for admission laboratory studies in newborns. Transfusion therapies use umbilical cord blood in various treatments. It can be used for bone marrow transplants if needed later in the child's life.

A nurse is providing care for a pediatric client. When performing a cultural assessment, which action(s) is appropriate? Select all that apply.

Interview each member of the family separately. Ascertain who is the primary caregiver. Ask the child what languages the child speaks in the home.

The nurse working with victims of intimate partner violence provides information on interventions to each client. Which intervention is best for the nurse to include?

Methods to strengthen the client's sense of control over one's life.

During the early postpartum period, a new mother is displaying dependent behaviors. What behaviors would the nurse recognize as normal for this period? Select all that apply.

Needing assistance with changing her peripad Telling the nurse about her delivery experience. Asking the nurse to take the newborn away so she can rest

The public health nurse is teaching young adolescents in a sexual health class the proper use of a condom. Which statements made by the students indicate teaching was successful? Select all that apply.

Only use latex condoms. Place the condom on an erect penis. Store the condoms in a cool, dry place.

Which nursing suggestions are options for the client experiencing intense pain in the active phase of labor? Select all that apply.

Patterned breathing Hypnosis Pain medication Massage Acupressure

A postpartum woman is concerned about constipation following delivery. What factor(s) contribute to this problem? Select all that apply.

Perineal pain Hemorrhoidal discomfort Iron supplements

A woman has been progressing through labor uneventfully until following an intense contraction, when she develops signs of umbilical cord compression. The primary care provider can feel a portion of the cord in the vagina. Which emergency intervention should the nurse implement? Select all that apply.

Place a gloved hand in vagina, put upward pressure on presenting part to keep it off the cord. Position the woman in a knee-chest position. Apply oxygen mask at 10 L/min. Administer terbutaline, a tocolytic, as prescribed.

When teaching an unlicensed assistant personnel (UAP) how to provide perineal care on a postpartum woman, the nurse would include which steps? Select all that apply.

Place a protective pad under the client's buttocks. Remove perineal pad in the direction of front to back

A client comes to the clinic reporting swelling in the hands and feet, blurred vision, a pounding headache and nausea and vomiting. The client had a positive pregnancy test 15 weeks ago, but has had no prenatal care. This is the client's third pregnancy, and she says that her uterus never grew this big or this fast with the previous pregnancies. Based on the client's reason for seeking care, the nurse would collect additional data to rule out the presence of which conditions? Select all that apply.

Preeclampsia Molar pregnancy

Which statements about the maternal mortality and morbidity rates for black women in the United States indicate an understanding of the issue? Select all that apply.

Quality obstetrical health care may not be available in the community. Bias among health care providers toward the Black population fosters distrust. Black women often have limited or no health care insurance coverage. Many Black women have low socioeconomic status.

The pregnant mother and her partner ask the nurse why the health care provider chose a chorionic villus sampling (CVS) procedure over an amniocentesis. The nurse is correct to highlight which benefits of CVS over amniocentesis. Select all that apply.

Quicker results Able to be completed earlier in pregnancy

A mother pregnant with her second baby is admitted to L&D for a vaginal birth after cesarean (VBAC). While obtaining an admission assessment, what important information is necessary for the labor and delivery nurse to obtain? Select all that apply.

Reason for the cesarean birth The fetal heart rate The presenting part of the fetus The mother's vital signs The type of uterine incision

A nurse is providing care to a victim of intimate partner violence. Applying the ABCDEs of care, place the actions in the order that reflects this framework from first to last. Use all options.

Reassure the victim that he or she is not alone. Express the belief that violence against women is not acceptable. Ensure confidentiality of information. Document the findings. Provide education about the cycle of violence. Ensure that the victim has resources and a plan of action for when he or she decides to leave.

The nurse is discussing options to provide relief of labor pain when the client states, "Why can't the health care provider provide a sedative during labor?" Which disadvantages are common with providing a sedative as pain management? Select all that apply.

Sedatives are only used in early labor Sedatives will not provide pain relief. The sedation effect can cross to the fetus.

A woman is concerned about the safety of continuing sex with her partner during pregnancy. Which suggestion should the nurse mention to her? Select all that apply.

Sex is to be avoided after your membranes have ruptured. Sex is generally not harmful to the fetus. Partner oral-female genital contact due to risk of air embolism. A nonmonogamous sexual partner should wear a condom.

The nurse is admitting an obstetric client in early labor. As the nurse assists the client into the bed, which assessment should the nurse prioritize?

Signs that birth is imminent

In which situation would the nurse anticipate client admission to the labor and delivery unit? Select all that apply.

The client is experiencing regular contractions every 5 minutes. The nurse notes that the cervix has thinned with 7 cm dilation (dilatation). The client reports a burst of energy and completion of the nursery. Documented pelvic change from last health care provider visit. The client reports a gush of fluid from the perineal region.

The nurse is caring for a client thought to be a perpetrator of intimate partner violence (IPV). Which finding(s) confirms the nurse's suspicion? Select all that apply.

The client was abused as a child by a family member. The client's father abused the client's mother. The client is a veteran with posttraumatic stress disorder (PTSD). The nurse notes the client lie regarding personal health history. The client states, "My partner and I are in therapy for marriage issues."

A nurse is caring for a sexual assault victim in the emergency department and notes that the client is unable to recall what happened. What does the nurse suspect has happened?

The client was given flunitrazepam without knowing.

A client is 2 weeks past her due date, and her health care provider is considering whether to induce labor. Which conditions must be present before induction can take place? Select all that apply.

The fetus is in a longitudinal lie. The cervix is ripe. A presenting part is engaged.

A client's recent prenatal ultrasound assessment reveals a normal placenta. Which outcomes would the nurse expect? Select all that apply.

The hormones made by the placenta support fetal growth. The placenta protects the fetus from an immune attack created by the mother. The placenta produces hormones that ready the fetus for extrauterine life.

A client who has sought treatment after being raped is concerned about possible pregnancy. What information should the nurse provide the client regarding postcoital contraception? Select all that apply.

The pill contains the same medication typically found in oral contraceptives. The medication does not disrupt an established pregnancy. The pill prevents fertilization and implantation of an ovum. The medication is most effective if taken within 12 hours of the rape.

A nurse teaching a prenatal class at the local hospital indicates to the group that the hospital has a "Family-Centered Care Maternity Unit." Which activities best illustrate the philosophy of this type of unit? Select all that apply.

This refers to a partnership among all of the individuals involved to plan for maternity health care. It is an approach in which clients and their families are the main components of the maternity health care decision making. The health and functioning of the family affect the health of the maternity client and other members of the family. It requires sensitivity to the client's and family's beliefs and those supporting their culture.

The nurse is correct to instruct the client in active labor on which type of patterned breathing?

Transitioning breaths from "slow, deep breaths to quicker short breaths" at the contraction peak.

The nurse inspects the client's perineum and finds it is red, swollen, and tender. The nurse explains to the client that she needs to be monitored for blood loss, especially because of bleeding into the tissue of the perineum because of the third degree laceration sustained while giving birth. What parameters will the nurse assess to detect signs of additional blood loss? Select all that apply.

Urine output Blood pressure Pulse rate

The nurse is planning the discharge education session of a postpartum client who recently moved to the United States from Vietnam. What questions would the nurse plan to ask to ensure learning will take place? Select all that apply.

What is the family's religious belief? Does the family have social support system? Who is the authority figure in the family? Who will be the person caring for the newborn at home?

A woman is admitted to the L & D unit for prostaglandin insertion along with IV oxytocin induction to begin 12 hours afterward. The nurse, preparing to insert the prostaglandin, questions this prescription for which of the women on the unit? Select all that apply.

a 24-year-old female with a history of asthma, diagnosed at age 9 a 30-year-old female who developed diabetes at age 5 and is currently in prerenal failure

When establishing a rapport with the client who is a victim of intimate partner violence, it is important that a nurse remain nonjudgmental, be alert for subtle clues of abuse, and avoid classifying the client as:

a chronic complainer.

While obtaining a history from a woman at a regularly scheduled physical, the nurse notices various bruises on the client's upper extremity. The client dismisses the bruising and changes the subject. Which additional information about the woman as a victim would the nurse discuss with the health care provider when relaying the physical assessment data? Select all that apply.

a dysfunctional family system a low academic achievement a victim of childhood violence economic stress

A client who has experienced an incomplete abortion is prescribed mifepristone to assist in removing the retained products of conception. Which medication would the nurse expect to administer if prescribed before administering mifepristone?

antiemetic to minimize nausea

While performing a clinical breast examination on a client, the nurse inspects the breasts with the client in various positions. Place the positions in their proper sequence from first to last. All options must be used.

arms resting at the sides hands placed on the hips arms raised over the head hands on hips while standing

A nurse is conducting a class for a local community clinic that has a large adolescent and young adult pregnant women population. The nurse is focusing on the effects of various substances on the fetus. The nurse determines that the class was successful when the group identifies which condition(s) as associated with cigarette smoking? Select all that apply.

attention-deficit/hyperactivity disorder (ADHD) sudden infant death syndrome (SIDS) cleft lip cerebral palsy

In providing culturally competent care to clients, the home care nurse should assess health care practices. What should be included in the home care nurse's assessment? Select all that apply.

barriers to health care cultural practices health-promotion behaviors education level

Infant mortality continues to be a concern. What factor has done the most to reduce infant mortality?

breastfeeding

In preparing a class for a group of pregnant couples, the nurse includes information about possible newborn complications associated with smoking during pregnancy. Which complications will the nurse include? Select all that apply.

cerebral palsy low birth weight cleft lip and palate sudden infant death syndrome

A nurse is providing care to a woman in labor. The nurse determines that the client is in the active phase based on which assessment findings? Select all that apply.

cervical dilation (dilatation) of 6 cm contractions every 2 to 3 minutes

A nurse is providing care to a woman in labor. The nurse determines that the client has moved into the active phase based on which assessment findings? Select all that apply.

cervical dilation (dilatation) of 6 cm contractions lasting up to 60 seconds

A woman of Chinese descent feels that it is her duty to abort pregnancies after giving birth to one healthy infant, whereas a woman of Catholic faith considers all children a blessing from God and refuses to abort a fetus with a severe birth defect. Which concept would best describe the actions in these different cultures?

controversial taboo

A sexually active client comes to the clinic requesting some form of birth control but is concerned about the bad side effects she has heard are caused by oral contraceptive pills (OCPs). Which information should the nurse point out about the positive aspects of this type of contraceptive? Select all that apply.

decreased incidence of dysmenorrhea decreased acne improved cycle regularity decreased acute pelvic inflammatory disease

A home health care nurse is visiting a pregnant client with preeclampsia who is being managed at home. The nurse is reviewing the situations for which the client should contact the nurse. The nurse determines that the client demonstrates understanding when identifying which situation(s) as needing to be reported? Select all that apply.

dizziness blurred vision excessive heartburn

The nurse is required to assess a client for HELLP syndrome. Which are the signs and symptoms of this condition? Select all that apply.

epigastric pain upper right quadrant pain hyperbilirubinemia

A grandmother feels that it is important to teach the young woman in her family about reciting a lullaby to "call the child outside" of the woman's body during birth. Her goal is to pass this ritual down to the younger generation. What term best describes this process?

ethnocentrism

After teaching a group of young adults about sexual violence, the nurse determines that the teaching was successful when the group identifies which act(s) as a type of sexual violence? Select all that apply.

female genital mutilation bondage infanticide human trafficking forced prostitution

A nurse practitioner is conducting an in-service education program for a group of nurses working in the labor and birth unit. The program is focusing on interpreting FHR patterns. The nurse practitioner determines that the teaching was successful when the group identifies which patterns as indicating abnormal fetal acid-base status? Select all that apply.

fetal bradycardia sinusoidal pattern recurrent late decelerations

A nurse is admitting a pregnant woman with sickle cell anemia to the emergency department. Which findings would lead the nurse to suspect the client is in crisis? Select all that apply.

fever joint pain fatigue

A woman at 38 weeks' gestation with a history of heroin use disorder has given birth to a newborn several hours ago. Upon assessment, the nurse determines that the newborn is experiencing withdrawal based on which findings? Select all that apply.

high-pitched shrill cry almost constant sneezing nasal stuffiness poor sucking reflex

A nurse is teaching a client with urinary incontinence about fluid intake and the need to reduce fluids that may act as bladder irritants. The nurse determines that the teaching was effective when the client states she should avoid which fluids? Select all that apply.

iced tea hot chocolate orange juice soft drinks

A client asks the nurse about her potential risk factors for breast cancer. Which risks would be important for the nurse to include in the response? Select all that apply.

oral contraceptive use irregularities in menstruation obesity

A client comes to the emergency department with moderate vaginal bleeding. She says, "I have had to change my pad about every 2 hours and it looks like I may have passed some tissue and clots." The woman reports that she is 9 weeks' pregnant. Further assessment reveals the following: Cervical dilation Strong abdominal cramping Low human chorionic gonadotropin (hCG) levels Ultrasound positive for products of conception The nurse suspects that the woman is experiencing which type of spontaneous abortion?

inevitable

A nurse is assessing a client who was a victim of rape and suspects that the client may be experiencing hyperarousal symptoms of posttraumatic stress disorder (PTSD). Which finding would lead the nurse to suspect this?

irritability

A nurse is reading a journal article about cesarean births and the indications for them. Place the indications for cesarean birth below in the proper sequence from most frequent to least frequent. All options must be used.

labor dystocia abnormal fetal heart rate tracing fetal malpresentation multiple gestation suspected macrosomia

A group of nurses is preparing a violence prevention program. The group is researching information about risk factors for intimate partner violence related to the individual. Based on their research, which risk factors would the nurses expect to address? Select all that apply.

low academic achievement victim of childhood violence heavy alcohol consumption

A nurse is conducting an in-service program for the staff of a local emergency department. The nurse is explaining intimate partner violence and discussing the possible risk factors. Which information would the nurse most likely include when describing individual factors for becoming an abuser? Select all that apply.

low income desire for control experience of violence as a child

A nursing instructor teaching about risk factors associated with preterm labor should discuss which demographic and lifestyle issues? Select all that apply.

low socioeconomic status smoking high level of stress alcohol use

A nurse is caring for a client who is in the first stage of labor. The client is experiencing extreme pain due to the labor. The nurse understands that which factors are causing the extreme pain in the client? Select all that apply.

lower uterine segment distention stretching and tearing of structures dilation (dilatation) of the cervix

A nursing student doing a rotation in labor and birth correctly identifies which medications as most commonly used for tocolysis? Select all that apply.

magnesium sulfate atosiban indomethacin nifedipine

A woman has been in active labor for over 20 hours, and the nurses are discussing this case with the health care provider. The nurses know to assess this woman for which potential complication from a prolonged labor? Select all that apply.

maternal postpartal infection bleeding tendencies to the point of hemorrhage

Childhood morbidity produces a large amount of disability in children. What factor has the highest impact on childhood disability?

missed days of school

A pregnant client has been prescribed a quinolone medication to treat gonorrhea. What is most important for the nurse to do before administering the medication?

notify the health care provider

A client who is diagnosed with septic pelvic thrombophlebitis is prescribed heparin therapy by the health care provider. Which nursing assessment(s) should the nurse prioritize to begin each nursing shift? Select all that apply.

pain platelet count clotting profiles evidence of bleeding

A woman presents to her first postpartum visit reporting she does not feel well. Which findings would lead the nurse to suspect that she has developed endometritis? Select all that apply.

pain on both sides of the abdomen leukocytosis

A nurse is reading a journal article about family-centered care. Which concept would the nurse expect to find as the fundamental core of this type of care?

partnership with the clients

A female client comes to the emergency room with pain in her jaw and neck, being dizzy and feeling so tired she just wants to sit or lie down. What priority nursing intervention(s) should the nurse include in this client's plan of care? Select all that apply.

perform an electrocardiogram insert a peripheral IV obtain cardiac enzymes assess the blood pressure

A nurse is conducting a teaching program for pregnant woman who are older than age 35. The nurse explains that although most women in their age group have healthy pregnancies and healthy newborns, they are at increased risk for possible complications. Which complications would the nurse include? Select all that apply.

postpartum hemorrhage preterm labor preeclampsia

After conducting a review class on the labor and birth process for a group of nurses working in the community clinic, the nurse determines that the teaching was successful when the group identifies which factors as affecting the labor process? Select all that apply.

powers passenger patience

A nurse is making a postpartum home visit to a woman who gave birth vaginally about 12 days ago. The woman's partner is present during the visit. When assessing the woman and the family, which finding related to the partner would lead the nurse to suspect that the partner may be experiencing postpartum depression? Select all that apply.

reports of feeling highly stressed reports of frequent headaches statements that the woman is getting all the attention

A nurse who works with victims of sexual assault is conducting an in-service education program for a group of nurses working at a community mental health center. The nurse is describing the phases of recovery that a victim commonly goes through after a sexual assault. Place the behaviors listed below in the order that the victim experiences them. Use all options.

reports problems with anger and insomnia refuses to discuss the assault changes job or moves reports being able to trust others

A multipara woman is experiencing a prolonged descent while trying to rest and increase her fluid intake. The nurse suggests that she change position. Which position(s) will be effective for pushing to speed up the descent? Select all that apply.

semi-Fowler position squatting position

A client in her first trimester comes to the clinic for an evaluation. Assessment reveals reports of fatigue, anorexia, and frequent upper respiratory infections. The client's skin is pale and the client is slightly tachycardic. The client also reports drinking about 6 cups of coffee on average each day. A diagnosis of iron-deficiency anemia is suspected. The client is scheduled for laboratory testing and the results are as follows: Hemoglobin 11.5 g/dL (115 g/L) Hematocrit 35% (0.35) Serum iron 32 µg/dL (5.73 µmol/L) Serum ferritin 90 ng/dL (90 µg/L) Which laboratory finding would the nurse correlate with the suspected diagnosis?

serum ferritin level

A nurse has been assisting a client who has been in labor. The nurse determines the client is moving into the transition phase based on which assessment findings? Select all that apply.

strong desire to push irritability with restlessness

A nurse is discussing the advantages and disadvantages of intermittent and continuous fetal heart rate monitoring with a colleague. What would the nurse cite as being able to be detected when using continuous monitoring but not intermittent monitoring? Select all that apply.

types of decelerations variability

A nurse is preparing to teach a class to pregnant women about the signs of preterm labor and what to do if these occur. Which signs of preterm labor should the nurse include in the presentation? Select all that apply.

uterine contractions, cramping, low back pain feeling of pelvic pressure or fullness increase in vaginal discharge nausea, vomiting, and diarrhea leaking of fluid from the vagina

A woman in labor with a history of drug and alcohol addiction and no prenatal care has arrived in the emergency department in active labor with cervix 5 cm dilated. An ultrasound shows the fetus in a breech presentation. As a nurse prepares to care for this woman, which assessments indicate the fetus is in distress and needs immediate help to survive? Select all that apply.

variable deceleration FHR pattern noted on monitor fetal heart rate decreasing into the 80s

A nurse is reviewing the history and physical examination of a client diagnosed with polycystic ovary syndrome (PCOS). Which factors would the nurse most likely find? Select all that apply.

virilization obstructive sleep apnea obesity

A 30-year-old woman reports that she has not had a menstrual period for the last 4 or 5 months. Pregnancy is ruled out and she is experiencing no endocrine symptoms. What factors could be contributing to her amenorrhea? Select all that apply.

working out at the gym 3 hours per day hypothyroidism endometrial adhesions

A nurse visiting a postpartum client at home is reviewing the need for the woman to meet her own nutritional needs. The woman is breastfeeding her newborn. The nurse determines that the client understands her nutritional needs based on which statements? Select all that apply.

"I need to drink about 2 to 3 quarts of fluid each day." "I should have about 4 servings of fruits each day." "I will have at least 4 to 5 servings of milk each day."

During a home visit with new parents, the nurse also assesses the new father's adaptation to his new role. Which statement would indicate that he is in the expectation stage?

"It'll be fun to have a baby in the house, but things shouldn't change too much."

A pregnant woman in her second trimester tells the nurse, "I've been passing a lot of gas and feel bloated." Which suggestion would be helpful for the woman? Select all that apply.

"Watch how much beans and onions you eat." "Try exercising a little more." "Some say that eating mints can help." "Cut down on your intake of cheeses."

A woman gave birth to a healthy term neonate today at 1330. It is now 1430 and the nurse has completed the client's assessment. At which time would the nurse next assess the client?

1500

A nurse is making a home visit to a new mother who gave birth vaginally 5 days ago. The woman tells the nurse that she has lost some weight but still feels as if she has a long way to go to return to her prepregnancy weight. The woman asks the nurse about the average weight loss for 5 days postpartum. Which information would the nurse incorporate into the response?

19 lb

Which finding would the nurse describe as "light" or "small" lochia?

4-inch stain or a 10 to 25 ml loss

The nurse is caring for several clients at the prenatal clinic. Which client would the nurse prepare for a routine fetal ultrasound?

A woman at 20 weeks' gestation reporting increased nasal stuffiness

Which occurs as a result of contraction decrement? Select all that apply.

Blood flow to the fetus improves. Fetal heart rate should return to baseline.

A woman in her first trimester shares with the nurse that she has been experiencing terrible nausea when she gets up in the morning. Which action should the nurse suggest? Select all that apply.

Eat some saltine crackers before rising in the morning. Suck on sour candies. Delay breakfast until 10 or 11 AM. Try eating a snack before bedtime

A client arrives in labor and delivery following a motor vehicle accident. She was sitting in the passenger seat and wearing a seat belt. On admission the nurse notes vaginal bleeding. The client says she is 30 weeks' pregnant, but only had an initial prenatal visit during which the pregnancy was confirmed. The external monitor shows irregular uterine contractions and a fetal heart rate of 152. The provider orders an ultrasound examination prior to establishing a plan of care. What is the priority purpose for an ultrasound examination in this situation?

Determine placental location

What physiological changes would be noted in a pregnant woman? Select all that apply.

Enlarged pituitary gland Lordosis Delayed gastric emptying and decreased peristalsis

A woman was diagnosed as having experienced a missed abortion at 10 weeks' gestation. When reviewing the client's medical records, which finding would most likely be noted?

Feeling diminished signs of pregnancy such as breast tenderness and nausea.

A woman who delivered her infant by cesarean section 1 week ago called her physician's office to report chills, fever of 101.6℉ (38.7℃) and a poor appetite. She also tells the nurse that she is having strong afterbirth pains and her lochia has increased in volume and has an odor. Lab work shows an elevated WBC count. Which of these reported findings is the most significant finding related to the suspected diagnosis of endometritis?

Fever

At 28 weeks' gestation, the client has gained 7.5 lb (3.4 kg) since the last visit. What assessments would the nurse complete next? Select all that apply.

Inspect hands for edema. Measure blood glucose level. Examine for excessive amniotic fluid.

The nurse is preparing to talk to a group of pregnant women about elective induction and why it is not highly recommended. Which statements should she include in her presentation? Select all that apply.

It significantly increases the risk of cesarean birth. It significantly increases instrumented birth. It significantly increases the use of epidural analgesia. It significantly increases the admissions to the neonatal ICU.

After teaching a class about conception, the nursing instructor asks the attendees to explain the process of fertilization. Which statements indicate the students need additional teaching? Select all that apply.

Sperm are viable for only about 48 hours after ejaculation. Sperm are able to fertilize the ovum up to 12 hours after ejaculation, and the ovum remains fertile for at least 24 hours after ovulation.

Which interventions would the nurse take to reduce the incidence of infection in a postpartum woman? Select all that apply.

Teach proper positioning of the infant for breastfeeding. Encourage intake of fluids following delivery and after discharge. Wash her hands before and after caring for the client.

A nurse is caring for a pregnant client with sickle cell anemia. What should the nursing care for the client include? Select all that apply.

Teach the client meticulous handwashing. Assess hydration status of the client at each visit. Urge the client to drink 8 to 10 glasses of fluid daily.

The nurse has completed assessing the vital signs of several clients who are from 36 to 48 hours postpartum. For which set of vital signs should the nurse prioritize for interaction?

Temp: 98.6° F (37° C), HR 74, RR 16, BP 150/85

A client is experiencing postpartum hemorrhage and the nurse begins to massage her fundus. Which action would be most appropriate for the nurse to do when massaging the woman's fundus?

Wait until the uterus is firm to express clots.

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:

between the umbilicus and symphysis pubis.

A nurse is making a home visit to the parents of a newborn. This is their first baby. During the visit, the nurse observes the parents interacting with their newborn and notes that they demonstrate responsible behaviors to promote the infant's growth and development. The nurse interprets this behavior as reflecting:

centrality.

In preparing for a birth education class for a group of pregnant women and their partners, the nurse will be describing the uterine involution changes that occur after the pregnancy. Which information will be included in the class? Select all that apply.

contraction of muscular fibers catabolism of the individual myometrial cells regeneration of the uterine epithelium

A pregnant client tells the nurse her gums and tongue are tender and she keeps getting small cracks in the skin around the mouth. Which foods would the nurse suggest this client add to the diet? Select all that apply.

dark green vegetables liver eggs

The nurse realizes that accommodating for the various cultural differences in her clients is an important aspect in providing their care. When caring for a postpartum woman of Japanese descent, which action would be a priority?

ensuring that the newborn receives a daily bath

When describing the hormonal changes that occur after birth of a newborn, the nurse would identify a decrease in which hormone as being associated with breast engorgement?

estrogen

A nurse is providing care to a pregnant woman with preterm prelabor rupture of membranes (PPROM). On admission, the client's baseline information was as follows: temperature, 97.6°F (36.5°C); pulse, 76 beats/minute; fetal heart rate, 136 beats/minute; white blood cell count, 7 x 103cells/mm3 (7.0 x 109/L). Now, 8 hours later, assessment reveals the following: temperature, 99.6°F (37.7°C); pulse, 82 beats/minute; fetal heart rate, 180 beats/minute; white blood cell count, 8.5 x 103 cells/mm3 (8.5 X 109/L). The nurse suspects a possible infection based on the change in which parameter?

fetal heart rate

A nurse is preparing a presentation about changes in the various body systems during the postpartum period and their effects for a group of new mothers. The nurse explains which event as influencing a postpartum woman's ability to void? Select all that apply.

generalized swelling of the perineum decreased bladder tone from regional anesthesia use of oxytocin to augment labor

The nurse is caring for a client who had been administered an anesthetic block during labor. For which risks should the nurse watch in the client? Select all that apply.

incomplete emptying of bladder bladder distention urinary retention

A urinalysis is done on a postpartum mother 24 hours after delivery. Which findings would be considered normal for this client? Select all that apply.

moderate glycosuria mild ketonuria trace WBCs Occasional RBCs

The nursing instructor is illustrating the fetal circulation to a group of nursing students. The instructor determines the session is successful after the students correctly choose which main structure is most responsible for providing nutrition and removing waste from the fetus?

mother's blood

After teaching a group of nurses during an in-service program about risk factors associated with postpartum hemorrhage, the nurse determines that the teaching was successful when the group identifies which risk factors? Select all that apply.

placenta previa hydramnios labor augmentation

A nurse is conducting a class for a group of women who are planning on becoming pregnant. As part of the class, the nurse describes how teratogens can affect a pregnancy. The nurse determines that the teaching was successful when the class identifies which effects that may result with the use of cocaine? Select all that apply.

placental abruption (abruptio placentae) premature birth microcephaly

When assessing a postpartum woman, the nurse would find which factor to be most significant in identifying possible postpartum hemorrhage?

pulse rate

The nurse notifies the obstetrical team immediately because the nurse suspects that the pregnant woman may be exhibiting signs and symptoms of amniotic fluid embolism. When reporting this suspicion, which finding(s) would the nurse include in the report? Select all that apply.

significant difficulty breathing tachycardia pulmonary edema bleeding with bruising

A G3P2 woman arrives at the birthing center stating that she has been in labor for the past 18 hours. The nurse suspects a protracted labor pattern disorder based on which finding?

slower than usual cervical dilation (dilatation)

The nurse is reviewing all of the documentation on determining estimated date of delivery. Which objective data is included? Select all that apply.

sonogram calculating Naegele rule fundal height