Care of the Childbearing Exam 2
Which instruction would the nurse include in the teaching plan for a postpartum woman with mastitis?
"Try applying warm compresses to your breasts to encourage the milk to be released."
The experienced labor and birth nurse knows to evaluate progress in active labor by using which simple rule?
1 cm/hr for cervical dilation
At what age should a woman with no risk factors begin mammography screening for breast cancer?
40
What is the most common breast mass in women?
fibroadenoma
A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome?
hemolysis, elevated liver enzymes, low platelet count
Which changes in pregnancy would the nurse identify as a contributing factor for arterial thrombosis, especially for the woman with atrial fibrillation?
hypercoagulable state
A nurse is assisting a client in active labor whose diabetes has been poorly controlled. Which assessment of the neonate should be prioritized after its birth?
macrosomia
A client with hyperemesis gravidarum is admitted to the facility after being cared for at home without success. What would the nurse expect to include in the client's plan of care?
nothing by mouth
A nurse is caring for a young woman who is in her 10th week of gestation. She comes into the clinic reporting vaginal bleeding. Which assessment finding best correlates with a diagnosis of hydatidiform mole?
Dark red, "clumpy" vaginal discharge
The nurse is providing care to a neonate whose mother has heroin use disorder. The nurse suspects that the neonate is experiencing neonatal abstinence syndrome based on which finding?
sneezing
When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage because:
these measurements may not change until after blood loss is large
Which finding would the nurse expect in a client with bacterial vaginosis?
fish-like odor of discharge
When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in the client's pulse. What should the nurse do next?
assess the clients temperature
The nurse reviews the history of a postpartum woman G3P3 and notes it is positive for obesity and smoking. The nurse would be especially alert for the development of signs and symptoms of which complication in this client?
DVT
A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate?
There is no cure, but drug therapy helps to reduce symptoms and recurrences
A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis?
vaginal odor smelling of fish
A pregnant client with diabetes in the hospital reports waking up with shakiness and diaphoresis. Which action should the nurse prioritize after discovering the client's fasting blood sugar is 60 mg/dl (3.33 mmol/L)?
Provide the client some milk to drink
The nurse is preparing the plan of care for a woman hospitalized for hyperemesis gravidarum. Which interventions would the nurse most likely include?
maintaining NPO status for the first day or two; administering antiemetic agents; obtaining baseline blood electrolyte levels; monitoring intake and output
The nurse is administering a postpartum woman an antibiotic for mastitis. Which statement by the mother indicates that she understood the nurse's explanation of care?
I can continue breastfeeding my infant, but it may be somewhat uncomfortable
The nurse notes that a client's uterus, which was firm after the fundal massage, has become boggy again. Which intervention would the nurse do next?
check for bladder distention, while encouraging the client to void
A nurse is reviewing the various treatment options with a client diagnosed with uterine fibroids (uterine myomas). The nurse determines that the teaching was successful based on which statement?
if I use hormone therapy, my fibroids may grow back when I stop the medication
A pregnant client has developed iron-deficiency anemia and has been prescribed 200 mg of elemental iron per day. The nurse should encourage the client to take this medication with which substance?
orange juice
The nurse assesses the client who is 1 hour postpartum and discovers a heavy, steady gush of bright red blood from the vagina in the presence of a firm fundus. Which potential cause should the nurse question and report to the RN or primary care provider?
laceration
Which change in insulin is most likely to occur in a woman during pregnancy?
less effective than normal
A nursing student working with a client in preterm labor correctly identifies which medication as being used to relax the smooth muscles of the uterus and for seizure prophylaxis and treatment in clients with preeclampsia?
magnesium sulfate
A client is considering breast augmentation. What would the nurse recommend to the client to ensure that there are no malignancies?
mammogram
After conducting a refresher class on possible congenital infections with a group of perinatal nurses, the nurse recognizes the class was successful when the group identifies which congenital viral infection as the most common?
CMV
A nurse is educating a client on the basal body temperature method as a form of contraception. Which statement by the client indicates and understanding of when she can expect to see a rise in her temperature?
Immediately following ovulation my temperature will increase.
A woman presents at Labor and Delivery very upset. She reports that she has not felt her baby moving for the last 6 hours. The nurse listens for a fetal heart rate and cannot find a heartbeat. An ultrasound confirms fetal death and labor induction is started. What intervention by the nurse would be appropriate for this mother at this time?
Offer to take pictures and footprints of the infant once it is delivered
A woman at 34 weeks' gestation presents to labor and delivery with vaginal bleeding. Which finding from the obstetric examination would lead to a diagnosis of placental abruption (abruptio placentae)?
Onset of vaginal bleeding was sudden and painful
A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next?
Palpate the funds and check fetal heart rate
A woman at 28 weeks' gestation has been hospitalized with moderate bleeding that is now stabilizing. The nurse performs a routine assessment and notes the client sleeping, lying on the back, and electronic fetal heart rate (FHR) monitor showing gradually increasing baseline with late decelerations. Which action will the nurse perform first?
Reposition the client to the left side
A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?
She has a family history of thromboembolism
The nurse is caring for a mother within the first four hours after a cesarean birth. Which nursing intervention would be most appropriate to prevent thrombophlebitis in the mother?
ambulate the client as soon as her vital signs are stable
Six hours after birth, a client's first void is 70 ml. What is the nurse's next action?
assess for residual urine
It is determined that a client's blood Rh is negative and her partner's is Rh positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time?
at 28 weeks' gestation and again within 72 hours after birth
A nurse is preparing a nursing care plan for a client who is admitted at 22 weeks' gestation with advanced cervical dilation (dilatation) to 5 cm, cervical insufficiency, and a visible amniotic sac at the cervical opening. Which primary goal should the nurse prioritize at this point?
bed rest to maintain pregnancy as long as possible
The nurse is monitoring the woman who is 1 hour postpartum and notes on assessment the uterine fundus is boggy, to the right, and approximately 2 cm above the umbilicus. The nurse would conclude this is most likely related to which potential complication?
bladder distention
Which assessment findings, experienced by the client at 36 weeks' gestation, would the nurse document as diagnostic signs of severe preeclampsia?
blood pressure of 164/110 mm Hg, elevated liver enzymes, +1 proteinuria, elevated serum creatinine
In the United States, what type of cancer accounts for one-third of cancer diagnoses and is the most common cancer in women?
breast cancer
A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the client's safety, which compound would the nurse have readily available?
calcium gluconate
A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely?
chancres at the vaginal site
A 24-year-old female client states, "About a week before my period starts, I have recently started craving certain sweets, having terrible mood swings, and feeling fatigued and irritable." Which action will the nurse take next?
educate the client on treatment for premenstrual syndrome
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?
foul-smelling lochia tender uterus strong afterpains
A client is admitted in the health care facility with pelvic inflammatory disease (PID). When reviewing the client's history, what would the nurse identify as a risk factor?
frequent douching
The nurse in the sexual health clinic is obtaining a health history of a client who is addicted to heroin, reporting chronic flu-like symptoms accompanied by pruritis, fatigue, anorexia, and constant upper right quadrant pain. Which sexually transmitted infection would the nurse suspect?
hepatitis A
A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this as:
hydatidiform mole
A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would question the woman about which symptom?
hardening of an area in the affected breast
The nurse observes an ambulating postpartum woman limping and avoiding putting pressure on her right leg. Which assessments should the nurse prioritize in this client?
Assess for warmth, erythema, and pedal edema
A pregnant woman at 36 weeks' gestation comes to the care center for a follow-up visit. The woman is to be screened for group B streptococcus (GBS) infection. When describing this screening to the woman, the nurse would explain that a specimen will be taken from which area(s)?
vagina, rectum
A nurse is caring for a postpartum client who has been treated for deep vein thrombosis (DVT). Which prescription would the nurse question?
take an oral contraceptive pill daily
A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth?
the viral load
What criteria would the ob/gyn base a decision on to begin insulin therapy for a mother with gestational diabetes?
A 2-hour postprandial glucose level cannot be kept below 120 mg/dl
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?
African heritage history of fibroids cigarette smoking history of urinary tract infections complete blood count results
A new young mother has tested positive for HIV. When discussing the situation with the client, the nurse should advise the mother that she should avoid which activity?
Breastfeeding
The nurse is caring for a pregnant client who indicates that she is fond of meat, works with children, and has a pet cat. Which instructions should the nurse give this client to prevent toxoplasmosis?
Eat meat cooked to 160° F (71° C), Avoid cleaning the cat's litter box, Avoid outdoor activities such as gardening
The nurse is providing education to a client diagnosed with pelvic organ prolapse prescribed Kegel exercises. Place the steps in the correct order the nurse will use to instruct the client.
Empty the bladder; Tighten the pelvic floor muscles; Hold tight and count to 5; Breathe freely; Relax
The nurse assesses that a fetus is in an occiput posterior position. The nurse predicts the client will experience which situation related to this assessment?
Experience of additional back pain
A client is diagnosed with a postpartum infection. The nurse is most correct to provide which instruction?
Finish all antibiotics to decrease a genital tract infection
The nurse is appraising the laboratory results of a pregnant client who is in her second trimester and notes the following: thyroid stimulating hormone (TSH) slightly elevated, glucose in the urine, complete blood count (CBC) low normal, and normal electrolytes. The nurse prioritizes further testing to rule out which condition?
Gestational diabetes
What is the most common viral infection?
Human papillomavirus (HPV)
A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby?
Instill a prophylactic agent in the eyes of the newborn
During a routine health visit for an 11-year-old girl, her mother asks the nurse, "My daughter just got her period about 4 months ago, but they haven't been very regular so far. How long might it take until she gets regular?" Which response by the nurse would be most appropriate?
It can take up to 2 years once she starts for the periods to become regular.
Which recommendation should be given to a client with mastitis who is concerned about breastfeeding her neonate?
She should continue to breastfeed; mastitis will not infect the neonate
A 16-year-old client was at 12 weeks' gestation when she gave birth to a fetus last week. The client has come to the office for follow-up and, while waiting in an examination room, notices that on the schedule is written her name and "follow-up of spontaneous abortion." The client is upset about what is written on the schedule. How can the nurse best explain this terminology?
Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy
The nurse would expect which client to be at a high risk for developing a pelvic support disorder?
a 60 year old mother with four children
A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's first action would be to:
administer oxygen by mask
A nurse assesses a client in labor and suspects dysfunctional labor (hypotonic uterine dysfunction). The woman's membranes have ruptured and fetopelvic disproportion is ruled out. Which intervention would the nurse expect to include in the plan of care for this client?
administering oxytocin
A client is experiencing shoulder dystocia during birth. The nurse would place priority on performing which assessment postbirth?
brachial plexus assessment
A client is diagnosed with chlamydia and gonorrhea and is receiving azithromycin as treatment. In addition to this medication, the nurse anticipates that the client will also be prescribed which drug?
ceftriaxone
The nurse plays a major role in assessing the progress of labor. The nurse integrates understanding of the typical rule for monitoring labor progress. Which finding would the nurse correlate with this rule?
cervix dilates 1 cm per hour
What is the most common early symptom of a sexually transmitted infection?
dysuria
The nurse is assessing a client who is 14 hours postpartum and notes very heavy lochia flow with large clots. Which action should the nurse prioritize?
palpate her fundus
A nurse is educating a 25-year-old client with a family history of cervical cancer. Which test should the nurse inform the client about to detect cervical cancer at an early stage?
papanicolaou test
A client reports lumpy, tender breasts, particularly during the week before menses. She reports pain that often dissipates after the onset of menses. The nurse suspects the client has fibrocystic breast changes. Which should the nurse do next?
perform a breast examination
A 40-year-old woman comes to the clinic reporting having missed her period for two months. A pregnancy test is positive. What is she and her fetus at increased risk for?
placental abnormalities
When caring for a client requiring a forceps-assisted birth, the nurse would be alert for:
potential lacerations and bleeding
A woman using the cervical mucus ovulation method of fertility awareness reports that her cervical mucus looks like egg whites. The nurse interprets this as which kind of mucus?
spinnbarkeit mucus
A young woman experiencing contractions arrives at the emergency department. After examining her, the nurse learns that the client is at 33 weeks' gestation. What treatment can the nurse expect this client to be prescribed?
tocolytic therapy
A pregnant client at 28 weeks' gestation in preterm labor has received a dose of betamethasone IM today at 1400. The client is scheduled to receive a second dose. At which time would the nurse expect to administer that dose?
tomorrow at 1400
A woman of 16 weeks' gestation telephones the nurse because she has passed some "berry-like" blood clots and now has continued dark brown vaginal bleeding. Which action would the nurse instruct the woman to do?
"Come to the health facility with any vaginal material passed."
A pregnant client is diagnosed with syphilis. Which response would demonstrate respect for the client and therapeutic communication?
"I am sure it is frightening to you to be diagnosed with a disease that can affect your baby."
A mother is talking to the nurse and is concerned about managing her asthma while she is pregnant. Which response to the nurse's teaching indicates that the woman needs further instruction?
"I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring."
A nurse is teaching a woman about measures to prevent preterm labor in future pregnancies because the woman just experienced preterm labor with her most recent pregnancy. The nurse determines that the teaching was successful based on which statement by the woman?
"I'll make sure to limit the amount of long distance traveling I do."
A client who gave birth vaginally 16 hours ago states she does not need to void at this time. The nurse reviews the documentation and finds that the client has not voided for 7 hours. Which response by the nurse is indicated?
"It's not uncommon after birth for you to have a full bladder even though you can't sense the fullness."
A client reporting she recently had a positive pregnancy test has reported to the emergency department stating one-sided lower abdominal pain. The health care provider has prescribed a series of tests. Which test will provide the most definitive confirmation of an ectopic pregnancy?
Abdominal ultrasound
A postpartum mother has the following lab data recorded: a negative rubella titer. What is the appropriate nursing intervention?
Administer rubella vaccine before discharge
A nurse is providing care to a couple who have experienced intrauterine fetal demise. Which action would be least effective in assisting a couple at this time?
Avoid any discussion of the situation with the couple
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)
The nurse encourages a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, the nurse would advise her to take which action? You Selected:
Eat a sustaining-carbohydrate snack
The nurse is caring for a woman who has dysplasia (disordered growth of abnormal cells). The nurse educates her on dysplasia progression that is high-grade. Which information is important for the nurse to include?
High-grade dysplasia progresses to invasive cervical cancer in about 2 years
A laboring client has been pushing without delivering the fetal shoulders. The primary care provider determines the fetus is experiencing shoulder dystocia. What intervention can the nurse assist with to help with the birth?
McRoberts maneuver
A nurse is caring for a female client who is undergoing treatment for genital warts due to human papillomavirus (HPV). Which information should the nurse include when educating the client about the risk for cervical cancer?
Obtaining a Papanicolaou test routinely helps early detection of cervical cancer, Recurrence of genital warts increases risk of cervical cancer, Use of latex condoms is associated with a lower rate of cervical cancer
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?
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.
The nurse cared for a client who gave birth. The duration of labor from the onset of contractions until the birth of the baby was 2 hours. How will the nurse document the client's labor in the health record?
Precipitous labor
The nurse is admitting a client in labor. The nurse determines that the fetus is in a transverse lie by performing Leopold maneuvers. What intervention should the nurse provide for the client?
Prepare the client for a cesarean birth
A multigravida client at 31 weeks' gestation is admitted with confirmed preterm labor. As the nurse continues to monitor the client now receiving magnesium sulfate, which assessment findings will the nurse prioritize and report immediately to the RN or health care provider?
Respiratory depression, hypotension, absent tendon reflexes
A woman receiving an oxytocin infusion for labor induction develops contractions that occur every minute and last 75 seconds. Uterine resting tone remains at 20 mm Hg. Which action would be most appropriate?
Stop the infusion immediately
The nurse is teaching a client about mastitis. Which statement should the nurse include in her teaching?
Symptoms include fever, chills, malaise, and localized breast tenderness
Which situation should concern the nurse treating a postpartum client within a few days of birth?
The client feels empty since she gave birth to the neonate
Which of these findings should a nurse investigate first when assessing a female client who has been unable to conceive for 14 months?
The client was diagnosed with thyroid cancer 2 years ago
The nurse is caring for a woman who experienced a vaginal birth 6 hours prior. The health care provider is concerned the woman may have retained placental tissue. What assessment finding would alert the nurse to further assess the client for complications of retained placental tissue?
The client's pulse is 130 beats/min at rest and base line was 98 beat/min
What postpartum client should the nurse monitor most closely for signs of a postpartum infection?
a client who had a nonelective cesarean birth
A nurse is conducting an in-service program for a group of labor and birth unit nurses about cesarean birth. The group demonstrates understanding of the information when they identify which conditions as appropriate indications?
active genital herpes infection placenta previa previous cesarean birth fetal distress
The nurse is caring for a postpartum woman who exhibits a large amount of bleeding. Which areas would the nurse need to assess before the woman ambulates?
blood pressure, pulse, reports of dizziness
The nurse is conducting a class for postpartum women about mood disorders. The nurse describes a transient, self-limiting mood disorder that affects mothers after birth. The nurse determines that the women understood the description when they identify the condition as postpartum:
blues
The nurse provides education to a postterm pregnant client. information will the nurse include to assist in early identification of potential problems?
continue to monitor fetal movements daily
A nurse suspects that a pregnant client may be experiencing a placental abruption (abruptio placentae) based on assessment of which finding?
dark red vaginal bleeding, rigid uterus, absent fetal heart tones
A woman with cardiac disease at 32 weeks' gestation reports she has been having spells of light-headedness and dizziness every few days. Which instruction should the nurse prioritize?
decrease activity and rest more often
A pregnant client has been admitted with reports of brownish vaginal bleeding. On examination, there is an elevated human chorionic gonadotropin (hCG) level, absent fetal heart sounds, and a discrepancy between the uterine size and the gestational age. The nurse interprets these findings to suggest which condition?
gestational trophoblastic disease
A nurse is conducting an in-service presentation to a group of perinatal nurses about sexually transmitted infections and their effect on pregnancy. The nurse determines that the teaching was successful when the group identifies which infection as being responsible for ophthalmia neonatorum?
gonorrhea
The primary care provider has prescribed estrogen replacement therapy (ERT) for a menopausal woman who has been diagnosed with pelvic organ prolapse (POP). The client asks the nurse why she needs to be on hormones. Which would be the nurse's best response?
hormone replacement will increase blood perfusions and the elasticity of the vaginal wall
A nurse in the sexual health clinic assesses a female client and notes wart-like lesions on the genital area and rectum. Which diagnosis best correlates with these findings?
human papillomavirus
A pregnant woman has just found out that she is having twin girls. She asks the nurse the difference between fraternal and identical twins. The nurse explains that with one set of twins there is fertilization of two ova, and with the other set one fertilized ovum splits. What type of twins result from the split ovum?
identical
A postpartum client is prescribed medication therapy as part of the treatment plan for postpartum hemorrhage. Which medication would the nurse expect to administer in this situation?
methylergonovine
During a routine prenatal visit, a client is found to have proteinuria and a blood pressure rise to 140/90 mm Hg. The nurse recognizes that the client has which condition?
mild preeclamsia
A nursing student correctly identifies the most desirable position to promote an easy birth as which position?
occiput anterior
A 26-year-old primigravida has brought her doula to the birthing center for support during her labor and birth. The doula has been helping her through the past 16 hours of labor. The laboring woman is now 6 cm dilated. She continues to report severe pain in her back with each contraction. The client finds it comforting when her doula uses the ball of her hand to put counterpressure on her lower back. What is the likely cause of the woman's back pain?
occiput posterior position
A 40-year-old client arrives at the community health center experiencing a strange, dragging feeling in the vagina. She stated that "at times it feels as if there is a lump" there as well. Which condition do these symptoms indicate?
pelvic organ prolapse
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
A small amount of breast milk is obtained for culture and sensitivity testing from a client with mastitis. The nurse would expect the results to identify which organism as the most likely cause?
staphylococcus aureus
Which complication is most likely responsible for a late postpartum hemorrhage?
uterine subinvolution
A nurse is caring for a postpartum client who has a history of thrombosis during pregnancy and is at high risk of developing a pulmonary embolism. For which sign or symptom should the nurse monitor the client to prevent the occurrence of pulmonary embolism?
calf swelling
Which factor would contribute to a high-risk pregnancy?
type 1 diabetes
A primigravida 28-year-old client is noted to have Rh negative blood and her husband is noted to be Rh positive. The nurse should prepare to administer RhoGAM after which diagnostic procedure?
Amniocentesis
A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?
an azalea anti fungal agent
Which medication will the nurse anticipate the health care provider will prescribe as treatment for an unruptured ectopic pregnancy?
methotrexate
A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition?
multiple sex partners, intrauterine contraceptive device inserted 3 weeks ago, vaginal douching approximately once a week
A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes?
obesity hypertension previous large-for-gestational-age (LGA) infant
A pregnant client is complaining of a large amount of malodorous vaginal discharge that is foamy and yellow-green in color, vaginal itching and painful intercourse. When asked, she also reports that urination is somewhat painful. She is diagnosed with trichomoniasis. What treatment would the nurse anticipate the client receiving?
oral metronidazole
A woman has been in labor for the past 8 hours, and she has progressed to the second stage of labor. However, after 2 hours with no further descent, the provider diagnoses an "arrested descent." The woman asks, "Why is this happening?" Which response is the best answer to this question?
"More than likely you have cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal."
The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth?
11
A client arrives in the emergency department accompanied by her husband and new 10-week-old infant, crying, confused, and with possible hallucinations. The nurse recognizes this could possibly be postpartum psychosis as it can appear within which time frame after birth?
3 months
The nurse is caring for a client after experiencing a placental abruption (abruptio placentae). Which finding is the priority to report to the health care provider?
45 ml urine output in 2 hours
The nurse is assessing a pregnant client who has a long history of asthma. She states, "I'm trying not to use my asthma medications because I certainly don't want my baby exposed to them." What is the nurse's best response?
Actually, having uncontrolled asthma is much riskier for your baby than the medication
The nurse is caring for clients in a community health clinic. Which clients does the nurse recognize need screening for sexually transmitted infections?
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
Which action(s) will the nurse take when asked to apply suprapubic pressure during a birth with shoulder dystocia?
Apply downward pressure just above the pubic bone; Apply pressure between contractions; Apply pressure at an angle toward the face of the fetus.
A nurse is caring for a client with cardiovascular disease who has just given birth. What nursing interventions should the nurse perform when caring for this client?
Assess for shortness of breath, Assess for a moist cough, Assess for edema and note any pitting, Auscultate heart sounds for abnormalities
A postpartum woman is developing thrombophlebitis in her right leg. Which assessment should the nurse no longer use to assess for thrombophlebitis?
Dorsiflex her right foot and ask if she has pain in her calf
The nurse is doing meal planning with a pregnant woman with iron-deficiency anemia. What dietary recommendations would the nurse make to enhance the woman's intake of iron?
Drink orange juice with the iron supplement. Increase intake of dried beans and green leafy vegetables. Cook food in an iron skillet, if possible.
After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful?
I will be sure to avoid getting pregnant for at least 1 year
A pregnant client with preterm premature rupture of the membranes is being discharged home. A nurse is preparing the client's discharge teaching plan. Which instructions would the nurse include?
If you notice your belly starting to tighten, call your health care provider, check your temperature each day reporting any increase immediately
A 45-year-old client and her spouse are present in the clinic. Results of fertility testing indicate that the client has damage to her fallopian tubes. Which would be the most appropriate infertility option for this client?
In vitro fertilization
The nurse is educating a client with type 1 diabetes about the complications associated with diabetes and pregnancy. Which problems would the nurse include in her teaching?
Increased risk of spontaneous abortion Polyhydramnios Hypertension
A pregnant woman has been admitted to the hospital due to preeclampsia with severe features. Which measure will be important for the nurse to include in the care plan?
Institute and maintain seizure precautions
A high-risk pregnant client is determined to have gestational hypertension. The nurse suspects that the client has developed preeclampsia with severe features based on which finding?
blurred vision
A nurse is conducting a presentation for a local community group on sexually transmitted infections. The nurse determines that the group has understood the information when they identify which infection as the most commonly reported bacterial STI in the United States?
chlamydia
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
A woman who is 42 weeks' pregnant comes to the clinic. During the visit, which assessment should the nurse prioritize?
determining an accurate gestational age
A nurse is assessing a pregnant client for the possibility of preexisting conditions that could lead to complications during pregnancy. The nurse suspects that the woman is at risk for hydramnios based on which preexisting condition?
diabetes
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?
dull low backache viscous vaginal discharge dysuria
The nurse is caring for a client who has been diagnosed with a deep vein thrombosis. Which assessment finding should the nurse prioritize and report immediately?
dyspnea
A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common?
endometriosis
A nurse is conducting a class for high school students on preventing sexually transmitted infections (STIs). Which information would the nurse emphasize as the sole method for not contracting STIs?
engaging in abstinence
A client at 38 weeks' gestation has an ultrasound performed at a routine office visit and learns that her fetus has not moved out of a breech position. Which intervention does the nurse anticipate for this client?
external cephalic version
A woman who immigrated here from a third world country presents to the clinic to find out if she is pregnant. Which signs and/or symptoms would the nurse assess as possible indicators that she might have an active case of tuberculosis as well?
fatigue night sweats hemoptysis anorexia
A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion (miscarriage). The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first-trimester miscarriage?
fetal genetic abnormalities
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
An experienced nurse has just read that women have a one-in-three lifetime risk of developing cancer and becomes concerned that she has provided enough education. What should this nurse do to help prevent deaths from cancer?
focus on screening, provide education to all women, tell women about early symptoms
A nurse is conducting an assessment of a woman who has experienced PROM. Which amniotic fluid finding would lead the nurse to suspect infection as the cause of a client's PROM?
foul odor
A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find?
gestational diabetes
The nurse is assessing a client 48 hours postpartum and notes on assessment: temperature 101.2oF (38.4oC), HR 82, RR 18, BP 125/78 mm Hg. The nurse should suspect the vital signs indicate which potential situation?
infections
A nurse is providing care to a female client just diagnosed with cervical cancer. When developing this client's plan of care, the nurse would focus interventions on which client needs as the priority at this time?
information, emotional support
The nurse is conducting a presentation about urinary incontinence for a local women's group. During the presentation, which statement by a member of the group would the nurse need to clarify?
its normal for a woman to develop incontinence as she ages
A pregnant woman with chronic hypertension comes to the clinic for evaluation. The last several blood pressure readings have been gradually increasing. On today's visit her blood pressure is 166/100 mm Hg. The health care provider prescribes an antihypertensive agent. The nurse anticipates which agent as likely to be prescribed?
labetalol
Which measure would the nurse include in the plan of care for a woman with prelabor rupture of membranes if her fetus's lungs are mature?
labor inductions
A client is to be examined for the presence and extent of endometriosis. For which test should the nurse prepare the client?
laparoscopy
A nurse is reviewing the medical record of a pregnant client. The physical exam reveals that the placenta is implanted near the internal os but does not reach it. The nurse interprets this as which condition?
low-lying placenta
The nurse is preparing information for a client who has just been diagnosed with gestational diabetes. Which instruction should the nurse prioritize in this information?
maintain a daily blood glucose log
The nurse is preparing the plan of care for a woman hospitalized for hyperemesis gravidarum. Which interventions would the nurse most likely include?
maintaining NPO status for the first day or two, administering antiemetic agents, obtaining baseline blood electrolyte levels, monitoring intake and output
The nurse is assessing the breast of a woman who is 1 month postpartum. The woman reports a painful area on one breast with a red area. The nurse notes a local area on one breast to be red and warm to touch. What should the nurse consider as the potential diagnosis?
mastitis
A nurse is preparing an in-service education program for a group of nurses about dystocia involving problems with the passenger. Which problem would the nurse likely include as the most common?
persistent occiput posterior position
Disseminated intravascular coagulation is a life-threatening condition that the nurse recognizes can occur as a complication secondary to which primary conditions?
placental abruption, severe preeclampsia, septicemia
Two weeks after giving birth, a woman is feeling sad, hopeless, and guilty because she cannot take care of the infant and partner. The woman is tired but cannot sleep and has isolated herself from family and friends. The nurse recognizes that this client is exhibiting signs of:
postpartum depression
A 55-year-old client presents to the clinic with persistent vulvar pruritus, burning, and a lump. She states she has had the symptoms for 5 months and has been trying to treat them with over-the-counter creams. She has a history of multiple sexual partners and HPV and is a smoker. What should the nurse do next?
prepare the client for a biopsy of the lesion
The nurse is admitting a client in labor. The nurse determines that the fetus is in a transverse lie by performing Leopold maneuvers. What intervention should the nurse provide for the client?
prepare the client for a cesarean birth
A 24-year-old client presents in labor. The nurse notes there is an order to administer Rho(D) immune globulin after the birth of her infant. When asked by the client the reason for this injection, which reason should the nurse point out?
prevent maternal D antibody formation
The nurse is admitting a G3 P2 client at 38 weeks' gestation who arrived reporting painless bleeding from the vagina leading to the diagnosis of placenta previa. When questioned by the client as to what caused this, which most likely factor should the nurse point out in her answer?
previous cesarean birth
A client is questioning the nurse about the various options for contraception. When explaining the implantable form, the nurse should point out it contains which form of contraception?
progestin
The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours. Why would the nurse do this?
pulmonary edema
A nurse is reviewing a client's history and physical examination findings. Which information would the nurse identify as contributing to the client's risk for an ectopic pregnancy?
recurrent pelvic infections
After assessing a client's progress of labor, the nurse suspects the fetus is in a persistent occiput posterior position. Which finding would lead the nurse to suspect this condition?
reports of severe back pain
During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn?
respiratory function
The nurse is assessing a 37-year-old woman who has presented in active labor and notes the client has an increased risk for placental abruption (abruptio placentae). Which assessment finding should the nurse prioritize?
sharp fundal pain and discomfort between contractions
A young woman presents at the emergency department reporting lower abdominal cramping and spotting at 12 weeks' gestation. The primary care provider performs a pelvic examination and finds that the cervix is closed. What does the care provider suspect is the cause of the cramps and spotting?
threatened abortion
Quickly determining the cause of postpartum hemorrhaging enables effective treatment. A nurse using the 5 Ts tool will recognize which of the following as potential causes of postpartum hemorrhage?
tone, tissue, thrombin
A young mother gives birth to twin boys who shared the same placenta. What serious complication are they at risk for?
twin-to-twin transfusion(TTTS)
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
An elderly woman is seen in the clinic reporting a lesion on her labia majora and states that she has experienced some bleeding and itching as well. She states that this has been going on for approximately three months. She tells the nurse that she has not been to a health care provider in over 10 years. What diagnosis would the nurse expect the primary care provider to make?
vulvar cancer
How should the nurse counsel a postpartum client on how to prevent mastitis?
wash your hands thoroughly, and let your breasts dry after each feeding
As part of an in-service program to a group of home health care nurses who care for postpartum women, a nurse is describing postpartum depression. The nurse determines that the teaching was successful when the group identifies that this condition becomes evident at which time after birth of the newborn?
within the first 6 weeks
