Family Health Exam II (with sherpath)

A patient in the early postpartum period asks, "How do I know if my baby is getting enough breast milk? I don't feel anything there." What are the desirable outcomes? Select all that apply. "A good way to tell if your baby is taking in enough breast milk is if you continue to see enough wet and soiled diapers." "If your baby is gaining weight with each checkup at the pediatrician, it usually means your baby is getting enough breast milk." "If your baby actively participates in a feeding, you can hear swallowing and your baby seems content in between feeding. These are all signs that your baby is satisfied with the quantity of breast milk your body is producing." "If your baby feeds for at least 10 minutes on each breast with every feed, you know your baby is getting enough breast milk." "When your milk comes in, your breasts will feel full and most women will feel a milk letdown. This is a good sign that your body is producing enough breast milk for your baby."

"A good way to tell if your baby is taking in enough breast milk is if you continue to see enough wet and soiled diapers." "If your baby is gaining weight with each checkup at the pediatrician, it usually means your baby is getting enough breast milk." "If your baby actively participates in a feeding, you can hear swallowing and your baby seems content in between feeding. These are all signs that your baby is satisfied with the quantity of breast milk your body is producing." "When your milk comes in, your breasts will feel full and most women will feel a milk letdown. This is a good sign that your body is producing enough breast milk for your baby."

The nurse recognizes that the patient understands the teaching when she makes which statement? "Premonitory labor signs include rupture of membranes." "I will know I'm in labor when I lose my mucous plug." "Increasing clear vaginal secretions could mean labor will begin soon." "Bright red bleeding is considered bloody show and means labor will begin soon."

"Increasing clear vaginal secretions could mean labor will begin soon."

A woman who is at 38 weeks gestation reports suspected signs of labor to the triage nurse. Which statement by the nurse supports the beginning of true labor? "Your contractions will decrease with activity." "The contractions will be mild and more annoying than painful." "You will feel the contractions in your front pelvic area and not in your back." "Labor contractions will occur in a consistent pattern that increases in frequency, duration, and intensity."

"Labor contractions will occur in a consistent pattern that increases in frequency, duration, and intensity."

Which statement does the nurse use to describe to the patient's partner why opioid analgesics are being administered? "Opioid analgesics prevent nausea." "Opioid analgesics remove the pain of labor." "Opioid analgesics help the laboring woman relax between contractions." "Opioid analgesics reduce respiratory depression for the laboring woman."

"Opioid analgesics help the laboring woman relax between contractions."

Which recommendations would the nurse make to the family whose newborn falls asleep after 2 to 3 minutes of breastfeeding? Select all that apply. "The baby needs to be awakened, so unwrap the newborn and gently stroke his palms or soles." "This is a sign that the newborn is full, so breastfeeding should stop until the baby shows hunger cues." "Change the newborn's diaper to wake your newborn up." "The newborn is having trouble establishing breastfeeding, so switch to bottle feeding." "This is a sign of nipple confusion, so provide pacifiers between feedings."

"The baby needs to be awakened, so unwrap the newborn and gently stroke his palms or soles." "Change the newborn's diaper to wake your newborn up."

A breastfeeding mother who was discharged yesterday calls to ask about a tender, hard area on her right breast. The nurse's first response should be a."This is a normal response in breastfeeding mothers." b."Try massaging the area and apply heat, as this is probably a plugged duct." c."Notify your doctor so he can start you on antibiotics." d."Stop breastfeeding because you probably have an infection."

"Try massaging the area and apply heat, as this is probably a plugged duct."

Which education would the nurse provide a mother who reports latch difficulty with breastfeeding? "The newborn is likely sleepy. You should wait until the baby is fully awake." "Use a breast pump for a few minutes before feedings to increase nipple size." "Wait until the mouth is open wide to insert the nipple into the newborn's mouth." "Apply ointment to the nipple. It has a sweet taste and will prompt the newborn to breastfeed."

"Wait until the mouth is wide open to insert the nipple into the newborns mouth"

Which nursing response is appropriate for a 20-week gestation woman who is concerned about gaining 12 lb (5.4 kg) in her pregnancy? "I will tell the health care provider that you are worried. The health care provider will tell you what to do." "Your weight gain is about average for this point in your pregnancy. What concerns you about it?" "You really have gained a lot! I will consult with the nutritionist for you." "A lot of your weight gain is probably fluid. I suggest you decrease your fluid intake and increase your salt intake."

"Your weight gain is about average for this point in your pregnancy. What concerns you about it?"

Match the appropriate type of anesthesia to the patient description. 1. Patient requires a vaginal laceration repair after deliveryIntravenous anesthesia 2. Patient in labor wants pain relief while being awake for the birth 3. Patient with active skin infection requires an emergency cesarean delivery 4. Patient wants pain relief while being able to move and feel contractions

1- Pudendal block 2- Epidural 3- General Anesthesia 4-Combined spinal-epidural anesthesia

The nurse is assisting a normally active pregnant woman in developing a meal plan. Before she got pregnant, she ate 1800 calories a day. How many calories does she need now? a.2400 b.2000 c.2342 d.2140

2140

Four women are admitted to Labor and Delivery. Which woman met the goal for a healthy weight gain in pregnancy? a.17 years old, 5¢2² tall, initial weight 116 pounds, today's weight 120 pounds b.27 years old, 5¢6² tall, initial weight 112 pounds, today's weight 135 pounds c.24 years old, 5¢3² tall, initial weight 135, today's weight 182 pounds d.22 years old, 5¢2² tall, initial weight 230 pounds, today's weight 245 pounds

22 yrs old, 5'2, initial weight of 230, today's weight 245

A pregnant woman's diet may not meet her need for folate. The nurse teaches the woman to take how much folate as a supplement each day? a.400 to 600 mcg b.400 to 800 mcg c.100 to 200 mcg d.200 to 400 mcg

400-800 mcg

Which nutritional recommendation about fluids is accurate? a.Water with fluoride is especially encouraged because it reduces the child's risk of tooth decay. b.A woman's daily intake should be 8 to 10 cups, and most of it should be water. c.Of the artificial sweeteners, only aspartame has not been associated with any maternity health concerns. d.Coffee should be limited to no more than 2 cups, but tea and cocoa can be consumed without worry.

A woman's daily intake should be 8 to 10 cups, and most should be water

A G2/P1 woman presents for evaluation. She is excited, can talk through regular contractions every 7 to 10 minutes, and states that her pain is "manageable." She does not desire epidural anesthesia in labor. The nurse suspects this patient is in which phase of labor? Transitional labor Early labor The second stage of labor Active labor

Early labor

Recommendations to reduce the risk of Toxoplasmosis during pregnacy includes all of the following except? Have someone else change cat litter daily Throughly cook meat Eat fresh fruits and vegetables Separate raw meat from other foods in the refrigerator

Eat fresh fruit and vegetables

A patient in labor experiences minimal relief after nonpharmacologic interventions, and she is not coping well in labor. Which action would the nurse take next? Suggest an epidural. Educate on the risks and benefits of pharmacologic interventions. Encourage the patient to ambulate in the room. Administer the prescribed dose of intravenous pain medication.

Educate on the risks and benefits of pharmacologic interventions

A patient reports a feeling of lightness in her abdomen, increasing whitish, thin, and odorless vaginal discharge, and occasional contractions that go away after an hour or so. Which action would the nurse take next? Advise the patient to report to the birthing center. Suggest routine sexual transmitted infection counseling. Call the ambulance because she is experiencing an emergency. Educate the patient on the premonitory signs of labor.

Educate the patient on the premonitory signs of labor.

Which action taken by the patient will reduce discomfort during Leopold maneuvers and make fetal presenting parts easier to feel? Standing Lying prone Emptying the bladder Pushing or bearing down with contractions

Emptying the bladder

Which solution can the nurse consider to encourage a positive birth experience for the patient and her support person following delivery? Offer to take the baby to the nursery to promote rest for the patient and the support person. Encourage the family to talk about the labor and delivery experience. Immediately after birth, remove amniotic fluid and vernix from the baby before placing it skin-to-skin with the mother. Provide all infants with pacifiers to promote infant and family rest.

Encourage the family to talk about the labor and delivery experience

A woman with an epidural is 10 cm dilated and the baby is at 0 station. There is a reassuring fetal heart pattern, although the woman does not feel the urge to push. Which are appropriate actions by the nurse? Encourage the patient to wait to push until she feels the urge. Perform another vaginal examination to check for dilation. Encourage the patient to push so that the baby can be born. Encourage frequent position changes while remaining in the bed. Turn off the epidural so the patient can feel the urge to push.

Encourage the patient to wait to push until she feels the urge. Encourage frequent position changes while remaining in the bed.

A woman is experiencing strong contractions every 1.5 to 2 minutes, feels rectal pressure, and has a large amount of bloody show. At which frequency would the nurse anticipate assessing the fetal heart rate and pattern? Every 30 to 45 minutes Every 5 to 10 minutes Every 15 to 30 minutes Every 45 to 60 minutes NOT SURE

Every 15 to 30 minutes

A woman is visibly anxious, refuses position changes in labor, and verbalizes, "I'm afraid I'm going to die." The nurse knows it is important to help the woman relax through effective coaching because of which responses to stress experienced in labor? Fetal intolerance to labor Bradycardia related to a vagal response Release of catecholamines in the mother's body Inhibited uterine contractions because of decreased blood flow to the placenta Umbilical cord prolapse

Fetal intolerance to labor Release of catecholamines in the mother's body Inhibited uterine contractions because of decreased blood flow to the placenta

Which reason explains why adequate amounts of folic acid are needed during pregnancy? Folic acid prevents birth defects. Folic acid prevents preterm labor. Folic acid increases iron absorption. Folic acid helps maintain the pregnancy.

Folic acid prevents birth defects.

As the nurse assists a new mother with breastfeeding, she asks, "If formula is prepared to meet the nutritional needs of the newborn, what is in breast milk that makes it better?" The nurse's best response is that it contains a.more calcium. b.more calories. c.important immunoglobulins. d.essential amino acids.

Important immunoglobulins

Which advantages are associated with human milk (expressed and/or donor milk) feeding? Select all that apply. Improved infant immunity Lowest infant feeding-related costs Ability to track amount of milk consumed Easy storage and shelf life Others able to feed infant Promotes maternal-infant attachment

Improved infant immunity Ability to track amount consumed Others able to feed infant

Which nursing intervention is necessary before a second trimester transabdominal ultrasound? a.Place the woman NPO for 12 hours. b.Administer a soapsuds enema. c.Perform an abdominal prep. d.Instruct the woman to drink 1 to 2 quarts of water.

Instruct the woman to drink 1 to 2 quarts of water

Which method of anesthesia in labor is considered safest for the fetus? Local infiltration Epidural block Spinal block Combined spinal-epidural (CSE) block

Local infiltration

A new mother recalls that she should feed her newborn when she exhibits feeding readiness cues rather than waiting until her infant is crying frantically. Based on this information, this woman should feed her infant when she a.makes sucking motions. b.waves her arms in the air. c.stretches out her legs straight. d.has hiccups.

Makes sucking motion

Which assessment is most important to monitor after the administration of epidural anesthesia? Maternal blood pressure (BP) Fetal BP Platelet count Respiratory rate

Maternal BP

A woman received 25 mg of meperidine intravenously 1 hour before delivery. Which drug would the nurse have readily available? Ibuprofen Naloxone Nalbuphine Pitocin

Nalaxone

Which nursing instruction is appropriate when recommending food or drink to enhance the absorption of iron during pregnancy? Milk Water Cheese Orange juice

Orange juice

Which action would the nurse take to improve placental blood flow immediately after administration of an epidural? Place the woman flat on her back Place the woman prone Place the woman in the high-Fowler position Place a wedge under the woman's right hip

Place a wedge under the woman's right hip

To initiate the milk ejection reflex, the mother should a.wear a firm-fitting bra. b.apply cool packs to her breast. c.place the infant to the breast d.drink plenty of fluids.

Place infant to her breast

The labor nurse is evaluating the patient's most recent 10-minute segment on the monitor strip and notes a late deceleration. Which explanations most likely explains this occurrence? Select all that apply. Spontaneous fetal movement Compression of the fetal head Placental abruption Nuchal cord around the baby's neck Vena cava syndrome

Placental Abruption Vena Cava syndrome

Which type of formula is not diluted before being administered to an infant? a.Powdered b.Ready-to-use c.Concentrated d.Modified cow's milk

Ready-to-use

After assessment of an actively laboring woman, the nurse finds a fetal heart rate (FHR) of 180 beats/min with contractions occurring less than 2 minutes apart and lasting more than 90 seconds. Which action would the nurse take next? Reposition the patient to her side and alert the health care provider. Nothing, these are normal findings. Prepare for emergent cesarean delivery. Reposition the patient only.

Reposition the patient to her side and alert the health care provider

A woman in labor is given an opioid analgesic for pain. Which vital sign is a priority for the nurse to monitor in the newborn infant? Pulse Temperature Blood pressure Respiratory rate

Respiratory rate

The nurse understands that which hormonal changes are thought to encourage the onset of labor? Rising estrogen counteracts relaxing effect of progesterone on the uterus FSH is secreted in large quantities by Anterior Pit Prostaglandins are secreted by fetal membranes preparing the uterus The fetus secretes cortisol which may act as additional uterine stimulant TSH is enhanced and helps uterus contract Oxytocin is secreted by mother, causing contractions

Rising estrogen counteracts relaxing effect of progesterone on the uterus Prostaglandins are secreted by fetal membranes preparing the uterus The fetus secretes cortisol which may act as additional uterine stimulant Oxytocin is secreted by mother, causing contractions

How is effacement measured? Through digital palpation by a trained professional Using transvaginal ultrasound By estimating the stage of labor Though palpation of cervical dilation Through Leopold maneuvers

Through digital palpation by a trained professional Using transvaginal ultrasound

For which reason would a nurse administer a narcotic to a woman at the beginning of a contraction? To allow the medication to be transferred to both the laboring woman and the fetus To allow for no medication to be transferred to the fetus To allow for less medication to be transferred to the fetus To decrease the likelihood of maternal hypotension

To allow for less medication to be transferred to the fetus

Which phrases describe the goals of perinatal education classes? Select all that apply. To decrease anxiety related to childbirth To teach parents how to perform cardiopulmonary resuscitation (CPR) for their children To provide knowledge related to the labor process and birth To increase knowledge of comfort relief measures during labor To teach the expectant families how to parent and discipline their children

To decrease anxiety related to childbirth To provide knowledge related to the labor process and birth To increase knowledge of comfort relief measures during labor

Which passenger position would interfere with a safe vaginal birth? Transverse fetal lie Flexed fetal head Cephalic presentation Longitudinal fetal lie

Transverse Fetal lie

A primiparous woman wants to begin breastfeeding as soon as possible. The nurse can facilitate the infant's correct latch-on by helping the woman hold the infant a.with his arms folded together over his chest. b.curled up in a fetal position. c.with his head and body in alignment. d.with his head cupped in her hand.

With his head and body in alignment

Which pregnant woman should have the least weight gain during pregnancy? a.Woman who was obese before pregnancy b.Woman shorter than 62 inches or 157 cm c.Woman in early adolescence d.Woman pregnant with twins

Woman who was obese before pregnancy

A woman wants to breastfeed, but her nipples are inverted and she is concerned it won't be possible. What does the nurse teach the woman about this condition? a.A woman with inverted nipples rarely is successful at breastfeeding. b.Try changing the infant's position during feedings. c.Massage the breasts prior to feeding to allow milk let-down. d.You can use a breast pump just prior to feeding to evert the nipples.

You can use a breast pump just prior to feeding to evert the nipples

A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. What signs and symptoms should the nurse include in her discussion? ( Select all that apply.) a.An area of redness on the breast often resembling the shape of a pie wedge b.Fever and flulike symptoms c.Breast tenderness d.Warmth in the breast e.A small white blister on the tip of the nipple

a.An area of redness on the breast often resembling the shape of a pie wedge b.Fever and flulike symptoms c.Breast tenderness d.Warmth in the breast

A new mother wants to be sure that she is meeting her daughter's needs while feeding her commercially prepared infant formula. The nurse determines that the mother meets her child's needs when she a.warms the bottles using a microwave oven. b.adds rice cereal to her formula at 2 weeks of age to ensure adequate nutrition. c.refrigerates any leftover formula for the next feeding. d.burps her infant during and after the feeding as needed.

burps her infant during and after the feeding as needed

A postpartum woman telephones about her 4-day-old infant. She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well. Effective breastfeeding is indicated by the newborn who a.has at least one breast milk stool every 24 hours. b.gains 1 to 2 ounces per week. c.has at least six to eight wet diapers per day. d.sleeps for 6 hours at a time between feedings.

has at least six to eight wt diapers per day

An NST in which two or more fetal heart rate (FHR) accelerations of 15 beats per minute (bpm) or more occur with fetal movement in a 20-minute period is termed a.positive. b.negative. c.reactive. d.nonreactive.

reactive

The nurse should explain to new parents that the most serious consequence of propping an infant's bottle is a.aspiration. b.dental caries. c.ear infections. d.colic.

Aspiration

The breastfeeding mother should be taught a safe method to remove the breast from the baby's mouth. Which suggestion by the nurse is most appropriate? a.A popping sound occurs when the breast is correctly removed from the infant's mouth. b.Break the suction by inserting your finger into the corner of the infant's mouth c.Elicit the Moro reflex to wake the baby and remove the breast when the baby cries. d.Slowly remove the breast from the baby's mouth when the infant has fallen asleep and the jaws are relaxed.

Break the suction by inserting your finger into the corner of the infant's mouth

To prevent breast engorgement, the new breastfeeding mother should be instructed to a.breastfeed frequently and for adequate lengths of time. b.apply cold packs to the breast before feeding. c.limit her intake of fluids for the first few days. d.feed her infant no more than every 4 hours.

Breastfeed frequently and for adequate lengths of time

The nurse has taught a vegetarian pregnant woman foods that are high in iron. Which menu selections demonstrate good understanding of the material? (Select all that apply.) a.White bread b.Canned stewed tomatoes c.Peaches d.Raisin bran cereal e.Cooked soybeans

Canned stewed tomatoes Raisin bran cereal Cooked soy beans

Which are examples of appropriate techniques to wake a sleepy infant for breastfeeding? ( Select all that apply.) a.Slap the infant's hands and feet. b.Change the diaper. c.Unwrap the infant. d.Apply a cold towel to the infant's abdomen. e.Talk to the infant.

Change the diaper Unwrap the infant Talk to the infant

While evaluating an external monitor tracing of a woman who just received regional analgesia for pain management, the nurse notes recurrent late decelerations. Which action should the nurse take next? Change the woman's position. Notify the obstetric provider. Assist with amnioinfusion. Rupture the membranes and insert a scalp electrode.

Change the woman's position

A pregnant woman is at a picnic and asks a friend of hers, who is a nurse, what foods she can eat. What response by the nurse is best? a.Hot dog b.Smoked salmon spread c.Cheddar cheese and crackers d.Bologna sandwich

Cheddar cheese and crackers

During fundal assessment 30 minutes after a cesarean delivery, the patient reports discomfort and exhaustion and asks the nurse, "Why do you keep poking at me?" Which response from the nurse is appropriate? "I'll wait until you're on the postpartum floor to assess you again." "I need to do this assessment to make sure your incision is healing correctly." "This assessment must be done every 30 minutes until you transfer out of the recovery room." "A cesarean delivery puts you at risk for excessive bleeding, so it's important to assess you frequently."

"A cesarean delivery puts you at risk for excessive bleeding, so it's important to assess you frequently."

Which statement by a pregnant woman would suggest that she needs further teaching about the purpose of childbirth education classes? "Childbirth preparation programs will increase my sense of control." "Childbirth preparation programs will help prepare my support person to help during labor." "Childbirth preparation programs guarantee a pain-free childbirth." "Childbirth preparation programs teach distraction techniques."

"Childbirth preparation programs guarantee a pain-free childbirth."

Which education would the nurse provide a patient who is worried that the intrauterine catheter will hurt the baby? "The catheter is placed in the uterus next to the baby." "Don't be nervous; everything will be fine!" "The catheter attaches only to the outer layer of skin on the baby's head." "This is the equipment needed for high-risk pregnancies."

"The catheter is placed in the uterus next to the baby."

Which explanation of cesarean delivery incisions would a nurse provide to a patient? "There are a total of three incisions that will be made in your body by the surgeon." "The surgeon may make a vertical incision or a transverse incision on your skin." "You will not be able to the see the incision once it is fully healed if the surgeon makes a Pfannenstiel incision on your skin." "If you have a transverse incision on your uterus, you can never have a vaginal birth."

"The surgeon may make a vertical incision or a transverse incision on your skin."

The nurse knows that patient education has been effective when the patient makes which statement about the difference between a tocodynamometer and an intrauterine pressure catheter (IUPC)? "Only the tocodynamometer shows my uterine activity." "The tocodynamometer is much more accurate than the IUPC." "The tocodynamometer is positioned outside my body, while the IUPC is positioned inside my body." "The tocodynamometer will be connected to my bedside monitor, but the IUPC will not."

"The tocodynamometer is positioned outside my body, while the IUPC is positioned inside my body."

The nurse caring for a patient with a history of a previous cesarean delivery notes a small incision scar on the patient's bikini line (transverse). The patient asks the nurse if a trial of labor will be possible. Which response would the nurse provide? - "Transverse uterine incisions allow for vaginal births, but the skin and uterine incisions do not always match, so we will have to verify." - "You have a transverse skin incision, so that means you also have a transverse uterine incision and a trial of labor is possible." - "Because you have a transverse skin incision, there is a greater chance of having a uterine incision rupture with labor." - "It is never safe to have a vaginal birth after a cesarean delivery."

"Transverse uterine incisions allow for vaginal births, but the skin and uterine incisions do not always match, so we will have to verify."

A patient is concerned about the baseline variability in the heart rate of her fetus. Which responses by the nurse describe the significance of baseline variability to the patient? Select all that apply. "Variability is an artifact." "Variability is a periodic pattern." "Variability demonstrates that there is adequate oxygenation of the fetus." "Variability suggests that the fetus is able to adapt to the labor process." "Variability indicates that the fetus has no congenital abnormalities."

"Variability demonstrates that there is adequate oxygenation of the fetus." "Variability

Which response would the nurse provide the patient who asks why oxygen is being given after the nurse identifies a nonreassuring fetal heart rate? "I will call the health care provider to discuss the new care plan." "We need to increase the perfusion of the baby's placenta." "We need to increase your oxygen, which will increase the baby's oxygen." "Don't worry. This happens all of the time, and everything is fine."

"We need to increase your oxygen, which will increase the baby's oxygen."

What is an appropriate response to a woman's comment that she is worried about having a cesarean birth? a."Patients commonly worry about surgery." b."Don't worry. Everything will be okay." c."What are your feelings about having a cesarean birth?" d."I know you're worried, but this is a routine procedure."

"What are your feelings about having a cesarean birth?"

A patient is experiencing intense back pain and discomfort during active labor. Which position would the nurse encourage the patient to assume? Standing straight Side-lying Semi-sitting Hands and knees

'Hands and knees

The nurse understands that which condition is a contraindication for an amniotomy? a.-2 station b.Right occiput posterior position c.Cephalic presentation d.Dilation less than 3 cm

-2 station

What would the nurse expect when caring for a full-term primigravida who presents for a routine office visit and is not in labor? A fundal height that measures 30 cm A fetus that is engaged in the maternal pelvis A cervix that is already 3 cm dilated Fetal station of −3

A fetus that is engaged in the maternal pelvis

Which patient would most likely require general anesthesia during labor and delivery? A patient with a vaginal infection A patient with severe pain from uterine contractions A patient requiring a vaginal episiotomy A patient refusing regional and local anesthetic methods who needs a cesarean delivery

A patient refusing regional and local anesthetic methods who needs a cesarean delivery

The nurse is caring for a patient in the second stage of labor. Which patient condition is most likely to result in the need for an episiotomy? A patient with a history of perineal laceration A patient receiving oxytocin for induction of labor A patient whose fetus is experiencing shoulder dystocia A patient who had an episiotomy during a previous delivery NOT SURE

A patient whose fetus is experiencing shoulder dystocia

The nurse notes that the fetal heart rate baseline is 120-130 with an increase in FHR to 145 bpm lasting 15 seconds. The nurse would chart this change in baseline as which of the following? Acceleration Early deceleration Variable deceleration Late deceleration

Acceleration

Match the fetal surveillance method to its corresponding advantage. Accurate measurement of fetal heart rate Accurate measurement of uterine contractions, including intensity Noninvasive and suitable for most patients in labor Uterine palpation Intermittent auscultation External electronic fetal monitoring Intrauterine pressure catheter Fetal scalp electrode

Accurate measurement of fetal heart rate- Fetal scalp electrode Accurate measurement of uterine contractions, including intensity- Intrauterine pressure catheter Noninvasive and suitable for most patients in labor- External electronic fetal monitoring

Which order during labor augmentation would cause the nurse to question the health care provider? Administer oxytocin in lactated Ringer solution per protocol. Administer oxytocin in normal saline per protocol. Administer oxytocin in dextrose 10% per protocol. Administer oxytocin intramuscular per protocol.

Administer oxytocin in dextrose 10% per protocol.

When preparing a woman for a cesarean birth, the nurse's care should include a.straight catheterization to empty the bladder. b.administration of an oral antacid. c.full perineal shave preparation. d.injection of narcotic preoperative medications.

Administration of an oral antacid

A postpartum patient who had a spinal block for a scheduled cesarean delivery complains of a headache. Which intervention would the nurse anticipate? Oral (PO) administration of promethazine Administration of blood patch by the anesthesia provider Having patient sit up in chair to help relieve headache Allowing the spinal headache to run its course

Administration of blood patch by the anesthesia provider

A G5/P4 is experiencing painful contractions that start in her back every 10 minutes for the last hour. How would the telephone triage nurse advise this woman? Advise the patient to report to the hospital for labor and delivery. Tell the patient to call an ambulance. Instruct the woman to come to the hospital when the contractions are every 5 minutes. Inform the patient that she is experiencing Braxton Hicks contractions.

Advise the patient to report to the hospital for labor and delivery.

The nurse knows that a urinary catheter is added to the delivery table if a forceps-assisted birth is anticipated. What is the correct rationale for this intervention? Spontaneous release of urine might contaminate the sterile field. An empty bladder provides more room in the pelvis. A Foley catheter prevents the membranes from spontaneously rupturing. A sterile urine specimen is needed preoperatively.

An empty bladder provides more room in the pelvis.

The purpose of initiating contractions in a CST is to a.apply a stressful stimulus to the fetus. b.determine the degree of fetal activity .c.identifying fetal acceleration patterns. d.increase placental blood flow.

Apply a stressful stimulus to the fetus

The nurse is caring for a patient in labor when repetitive late decelerations are noted on the external fetal monitor. The nurse's action after turning the patient to her left side should be: Applying oxygen per nasal cannula Increase the mainline IV Applying oxygen per face mask at 8-10 L/min Turn the patient to her right side after 5 minutes on the left side

Applying oxygen per face mask at 8-10 L/min

After an amniotomy, which action by the nurse takes priority? a. Estimate the amount of amniotic fluid. b. Assess the fetal heart rate c. Change the patient's gown. d. Assess the color of the amniotic fluid.

Assess the fetal heart rate

Immediately after the forceps-assisted birth of an infant, which action by the nurse is next? a.Measure the circumference of the infant's head. b.Assess the infant for signs of trauma. c.Give the infant prophylactic antibiotics. d.Apply a cold pack to the infant's scalp.

Assess the infant for signs of trauma

The nurse caring for a patient in the postanesthesia care unit (PACU) notes that a patient is having bradypnea after general anesthesia. Which immediate interventions are indicated to determine the next actions by the nurse? Select all that apply. Assess the patient's level of consciousness. Ensure the pulse oximeter is on and within normal limits. Call the anesthesiologist for possible intubation. Administer the prescribed dose of naloxone. Continue to monitor the patient, as bradypnea is a normal response to general anesthesia.

Assess the patient's level of consciousness. Ensure the pulse oximeter is on and within normal limits.

The student nurse learns that breastfed babies are less likely to develop certain health conditions as adults. Which conditions does this include? ( Select all that apply.) a.Asthma b.Diabetes c.Obesity d.Kidney failure e.Some cancers

Asthma Diabetes Obesity Some cancers

Which qualities are considered normal when assessing fetal heart rate (FHR)? Select all that apply. FHR variability of <5 beats/min Baseline FHRof 140 beats/min FHR variability of 20 beats/min Baseline FHR of 100 beats/min Baseline FHR of 170 beats/min

Baseline FHRof 140 beats/min FHR variability of 20 beats/min

The nurse is assessing the fetal monitor tracings of a patient in labor. Which of the following heart rate patterns would the nurse interpret as normal during the transitional phase of stage one? Baseline of 140 - 150 with decelerations to 120 noted beginning with the contraction and returning to baseline by the end of the contraction. Baseline of 140-150 with decelerations to 120 noted after the start of the contraction with return to baseline after the end of the contraction. Baseline of 140-145 with V-shaped decelerations to 120 bpm unrelated to contractions. Baseleine of 140-141 with decelerations to 105 noted after the start of the contracton and returning to baseline after the end of the contraction.

Baseline of 140 - 150 with decelerations to 120 noted beginning with the contraction and returning to baseline by the end of the contraction.

The nurse is instructing a new staff nurse on reassuring FHR patterns. Which of the following information should be included? (SELECT ALL THAT APPLY) Baseline rate of 110-160 bpm Moderate variability Late decelerations are present Early decelerations are present or absent Accelerations are either present or absent

Baseline rate of 110-160 Moderate Variability Early decelerations are present or absent Accelerations are either present or absent

A G3P2 patient at term is admitted to the labor unit for induction of labor. Her Bishop score is 6 and so the nurse would expect which of the following orders? Convert the mainline IV to Pitocin IV Place two misoprostol (Cytotec) tablets behind the cervix every 4 hours for 12 hours Begin oxytocin (Pitocin) per IV piggyback at 0.5 mL and increase per protocol Send the patient home and schedule induction for next week

Begin oxytocin (Pitocin) per IV piggyback at 0.5mL and increase per protocol

A woman at 37 weeks gestation calls and reports, "My water broke and I have bloody show. I am changing my pad every 10 minutes." Which advice would the nurse provide in response? Engage in activity such as walking. Call her health care provider and go to the hospital or birthing center. Advise the woman that overreacting is not good for her or the baby and to call back when she is in "true labor." Remain home, and only come in to the hospital or birthing center if contractions are regular, frequent, and intense.

Call her health care provider and go to the hospital or birthing center.

A G1P0 comes into the hosptal to be induced into labor. Her bishop score is 6. What will be used to begin the induction based on this score? Mainline IV will be changed to Pitocin IV. Pitocin will be started piggybacked to the mainline IV at the lowest dose and increased accoring to contraction frequency. Cervidil will be placed behind the cervix and remain in place for 12 hours overnight. Patient will be sent home and rescheduled for the following week

Cervidil will be placed behind the cervix and remain in place for 12 hours overnight.

Which clinical conditions must be met before placing a fetal scalp monitor? Select all that apply. Patient should not be in labor Absence of fetal scalp hair Cervix should be at least 2 cm dilated The patient's membranes must be ruptured High fetal presentation

Cervix must be at least 2cm dilated Patients membranes must have ruptured

The patient is scheduled for an amniocentesis at 16 weeks gestation. The nurse understands that this is being done for which of the following reasons? To check lung maturity To determine the sex of the fetus To check for genetic abnormalities To determine EDD

Check for genetic abnormalities

The nurse is checking the pad of a patient recovering from a cesarean delivery who has called out, "I just had a large gush of blood!" The nurse does not note an abnormal amount of blood under the patient's legs. Which action would the nurse take next? Request that the health care provider evaluate the patient for possible postpartum hemorrhage. Administer the as-needed (PRN) dose of methylergonovine. Check for pooling of blood under the patient's buttocks and back. Explain that this can be normal and evaluate with the next scheduled fundal check.

Check for pooling of blood under the patient's buttocks and back.

A new mother asks if she should feed her newborn colostrum, because it is not "real milk." The nurse's best answer is that a.colostrum is high in antibodies, protein, vitamins, and minerals. b.colostrum is unnecessary for newborns. c.giving colostrum helps the mother learn how to breastfeed. d.colostrum is lower in calories than milk and should be supplemented by formula.

Colostrum is high in antibodies, protein, vitamins, and minerals

Which type of commercial formula requires dilution with equal parts water? Ready-to-feed Concentrate Powder Hydrolysate formula

Concentrate

A nurse is beginning to care for a patient in labor. The health care provider has prescribed an intravenous (IV) infusion of oxytocin. The nurse makes sure that which implementations occur before initiation of the infusion? Select all that apply. Placing the patient on complete bed rest Continuous electronic fetal monitoring An IV infusion of antibiotics Making sure that a vial of terbutaline is immediately available Preparing an IV infusion pump Placing a code cart at the patient's bedside NOT SURE

Continuous electronic fetal monitoring Making sure that a vial of terbutaline is immediately available Preparing an IV infusion pump

Which assessment findings in the laboring patient would suggest to the nurse that delivery is imminent? Select all that apply. The woman can talk through contractions. Contractions are 1.5 to 2 minutes apart. Regular contractions are mild and 7 minutes apart. Mucous vaginal discharge is bloody. The woman is experiencing vomiting, nausea, and sweating. The patient complains of rectal pressure.

Contractions are 1.5 to 2 minutes apart. Mucous vaginal discharge is bloody. The woman is experiencing vomiting, nausea, and sweating. The patient complains of rectal pressure.

A nurse notes the following fetal heart rate pattern on the external fetal monitor. FHR baseline of 120-130 with V shaped decelerations to 100 noted before and after contractions. The nurse understands that this pattern is related to which of the following? Head compression Fetal movement Placental insufficiency Cord compression

Cord Compression

Which fetal condition can cause a fetal heart rate (FHR) of <60 beats/min for more than 60 seconds that does not quickly return to baseline? Cord compression Fetal head compression Uteroplacental insufficiency No compromise; variable decelerations are normal

Cord compression

A woman has just received pain medication in labor. Which of the following fetal heart responses would the nurse expect to see on the internal monitor tracing? Variable decelerations Late decelerations Decreased variability Accelerations

Decreased variability

A G1/P0 patient arrives for elective induction of labor at 39 weeks and is 1 to 2 cm dilated and 50% effaced. The fetal station is −3 with a posterior and firm cervix. Which order is most appropriate based on this patient's Bishop score? Discharge to home with follow-up in 1 week at the office. Administer oxytocin and titrate per protocol. Assist with amniotomy and initiate oxytocin as prescribed. Initiate electronic fetal monitoring and insert peripheral intravenous device.

Discharge to home with follow-up in 1 week at the office.

Which nursing actions are appropriate when the fetal monitor shows a pattern of late decelerations? Select all that apply: Discontinue oxytocin. Provide water to the patient. Administer oxygen by face mask. Reposition the patient onto her side. Continue monitoring and document findings. NOT SURE

Discontinue oxytocin. Administer oxygen by face mask. Lay patient on her side

While monitoring a patient receiving oxytocin for augmentation of labor, the nurse notes tachysystole with recurrent late decelerations and minimal variability on the electronic fetal monitor. Which actions are appropriate? Select all that apply. Discontinue the oxytocin infusion. Reposition the patient on her side. Administer an intravenous bolus of fluid per protocol. Administer 100% oxygen via tight face mask. Notify the health care provider. Place the patient in semi-Fowler position and continue to monitor.

Discontinue the oxytocin infusion. Reposition the patient on her side. Administer an intravenous bolus of fluid per protocol. Administer 100% oxygen via tight face mask. Notify the health care provider.

Which deceleration is considered a normal finding? Variable Prolonged Early Late

Early

A woman is going to have a vaccum extraction delivery. What nursing intervention is most important to prevent complications? a.Empty the woman's bladder. b.Apply cold packs to the perineum. c.Monitor the woman's temperature. d.Assess vital signs after the procedure.

Empty womans bladder

The nurse explains to the student that increasing the infusion rate of non-additive intravenous fluids can increase fetal oxygenation primarily by a.preventing normal maternal hypoglycemia. b.expanding maternal blood volume. c.maintaining normal maternal temperature. d.increasing the oxygen-carrying capacity of the maternal blood.

Expanding the maternal blood volume

Which fetal heart rate finding may result from maternal fever? No expected changes Prolonged decelerations Fetal heart rate of 90 beats/min for 15 minutes Fetal heart rate of 180 beats/min for 12 minutes

Fetal HR of 180 beats/min for 12 minutes

A nurse is caring for a patient in labor who is receiving oxytocin via intravenous infusion to stimulate uterine contractions. Which assessment finding would indicate to the nurse that the infusion needs to be discontinued? Three contractions occurring within a 10-minute period A fetal heart rate of 90 beats/min A resting uterine tone of 15 mm Hg via the intrauterine pressure catheter Early decelerations

Fetal HR of 90 beats/min

Which event indicates a complication of an external version? a.Fetal bradycardia persisting 10 minutes after the version b.Increased maternal anxiety after the version c.Maternal pulse rate of 100 bpm d.Fetus returning to the original position

Fetal bradycardia persisting 10 minutes after the version

Which maternal or fetal condition might require an amnioinfusion? The mother has polyhydramnios (excess amniotic fluid). The fetal heart rate (FHR) is 140 beats/min. The patient's blood pressure has dropped. The fetus has experienced umbilical cord compression.

Fetus has experienced umbilical cord compression

Which uterine contraction strength classification is used when labor is measured at >500 Montevideo units (MVUs)? Normal Moderate Hypotonic Hypertonic

Hypertonic

A pregnant woman in the perinatal clinic is a recovering anorexic. She is distressed at the emphasis on weight gain. The nurse explains that the most important reason for evaluating the pattern of weight gain in pregnancy is to a.assess if this woman has relapsed. b.determine cultural influences on the woman's diet. c.identify potential nutritional problems or complications of pregnancy. d.prevent excessive adipose tissue deposits.

Identify potential nutritional problems or complications of pregnancy

The nurse notes a prolonged deceleration of the FHR to 80 bpm and begins intrauterine resuscitation. Which of the following steps are included in this intervention? (SELECT ALL THAT APPLY). Provide oxygen per nasal cannula at 2L/min Place mom on her back with a wedge under her right hip Increase mainline IV Turn off oxytocin (Pitocin) Turn mother to her left side

Increase mainline IV Turn off oxytocin Turn mother to her left side

The nurse notes fetal tachycardia and suspects that the patient may be dehydrated. Which nursing action is appropriate to address this nonreassuring finding? Consult with the dietician. Administer parenteral feeding. Increase the rate of intravenous (IV) saline administration. Provide the patient an oral (PO) electrolyte replacement.

Increase the rate of intravenous (IV) saline administration.

A patient arrives at a birthing center in active labor. Her membranes are still intact, and the health care provider prepares to perform an artificial rupture of membranes (AROM). What will the nurse relay to the patient as the most likely outcome of the procedure? Less pressure on the cervix Decreased number of contractions Increased pressure on the cervix The need for more cervical exams

Increased pressure on the cervix

A pregnant woman wants to breastfeed her infant; however, her husband is not convinced that there are any scientific reasons to do so. Which statement by the nurse is true? Bottle-feeding using commercially prepared infant formulas a.requires that multivitamin supplements be given to the infant. b.helps the infant sleep through the night. c.increases the risk that the infant will develop allergies. d.ensures that the infant is getting iron in a form that is easily absorbed.

Increases risk that the infant will develop allergies

According to the recommendations of the American Academy of Pediatrics (AAP) on infant nutrition a.Infants should be given only human milk for the first 6 months of life. b.After 6 months, mothers should shift from breast milk to cow's milk. c.If infants are weaned from breast milk before 12 months, they should receive cow's milk, not formula. d.Infants fed on formula should be started on solid food sooner than breastfed infants.

Infants should be given only human milk for the first 6 months of life

A student nurse in the perinatal clinic sees the term "pica" on a woman's chart and asks the registered nurse what this means. What definition is most accurate? a.Intolerance of milk products b.Ingestion of nonfood substances c.Iron deficiency anemia d.Episodes of anorexia and vomiting

Ingestion of nonfood substances

How can the nurse help the mother who is breastfeeding and has engorged breasts? a.Apply heat to her breasts between feeding and cold to the breasts just before feedings. b.Instruct and assist the mother to massage her breasts. c.Assist her in removing her bra, making her more comfortable. d.Suggest that she switch to bottled formula just for today.

Instruct and assist the mother to massage her breasts

Which uterine activity indicators does the intrauterine pressure catheter (IUPC) measure in mm HG? Select all that apply. Frequency Duration Intensity Resting tone Variability

Intensity Resting tone

What information about iron supplementation should the nurse teach a new mother? a.Start iron supplementation shortly after birth if the infant is breastfeeding exclusively. b.Iron-fortified formula will meet the infant's iron requirements. c.Iron supplements must be given when the infant begins teething. d.Infants need a multivitamin with iron every day.

Iron-fortified formula will meet the infant's iron requirements

Which duties are appropriate for a support person during labor? Select all that apply. Keeping patient calm Keeping track of contractions Interpreting fetal monitoring Administering pain medication Ensuring physical and emotional comfort

Keeping patient calm Keeping track of contractions Ensuring physical and emotional comfort

A woman in labor has been having regular contractions but has remained 5 cm dilated for 5 hours, with a reassuring fetal heart rate. Which intervention may be necessary for this patient? Labor augmentation Cesarean delivery Vacuum-assisted delivery Intrauterine resuscitation

Labor augmentation

A woman in active labor has just received an epidural. The nurse understands that that if the woman has hypotension the fetal monitor tracing would indicate which of the following? Early decelerations Late decelerations Accelerations Variable decelerations

Late Decelerations

A pregnant patient would like to know a good food source of calcium other than dairy products. Which answer by the nurse is best? a. Yellow vegetables b. Legumes c. Whole grains d. Lean meat

Legumes

Which advantages of a low transverse skin incision would a nurse explain to a patient? Select all that apply. Less visibility when healed Less chance of wound dehiscence Pubic hair will grow back Works well with obese patients Allows the surgeon to extend the incision upward

Less visibility when healed Less chance of wound dehiscence Pubic hair will grow back

The nurse notes that the fetal heart rate is 140-170 bpm and charts that the variability is which of the following? Marked Minimal Absent Moderate

Marked

Which of the following are conditions for use of forceps in a delivery? (SELECT ALL THAT APPLY) Cervix has to be dilated to 8cm Presenting part is located at -2 Membranes are ruptured Bladder is empty Fetus is in a transverse position

Membranes are ruptured Bladder is empty

The FHR baseline is 120-130 bpm. The nurse will chart the variability as which of the following? Absent Moderate Minimal Marked

Moderate

The nurse is assessing a newborn's head following a vacuum-assisted birth and notices that there is a cephalohematoma present. A nursing intervention related to this assessment should include which of the following: Instruct the parents that this is normal and will disappear in a few days. Monitor the newborn for the development of jaundice Implement hourly vital signs for three days Place the child under light therapy immediately

Monitor the newborn for the development of jaundice

The patient in labor is having multiple deep variable decelerations down to 60-70 bpm. The health care provider has ordered an amnioinfusion. The nurse understands that the primary intervention is to: Monitor the uterine resting tone Monitor for accelerations Cool the intravenous fluid prior to infusion Administer the infusion per gravity

Monitor the uterine resting tone

The priority nursing care associated with an oxytocin (Pitocin) infusion is a.measuring urinary output b.monitoring uterine response. c.evaluating cervical dilation. d.increasing infusion rate every 30 minutes.

Monitoring uterine response

For which condition would the nurse teach the family that breastfeeding is contraindicated but feeding expressed breast milk is safe? Infant galactosemia Mother with human immunodeficiency virus (HIV) Mother with active tuberculosis Mother with active herpes simplex virus (HSV) lesions on the breast

Mother with active TB

The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine if the fetus has a.hemophilia. b.a normal lecithin/sphingomyelin (L/S) ratio. c. a neural tube defect. d.sickle cell anemia.

Neural tube defect

Which classes are appropriate for a 34-week pregnant patient and her partner who report being nervous about the upcoming delivery and baby care? Select all that apply. Newborn care Prenatal exercise Early prenatal care Preconception care Childbirth preparation

Newborn care Childbirth preparation

Which patient condition is a common breastfeeding cue in the first 24 hours following delivery? Mastitis Nipple soreness Plugged milk ducts Everted nipples

Nipple soreness

The nurse is reviewing a non-stress test (NST) and notes the following: FHR baseline of 120-130 bpm with increase in FHR noted to 150 for 15 seconds and an increase of FHR noted to 135 for 10 seconds over a 20 minute time frame. The nurse understands that this NST will be read as: Reactive Negative Nonreactive Positive

Nonreactive

The nurse teaches a pregnant woman that which diagnostic test evaluates the effect of fetal movement on fetal heart activity? a.Biophysical profile b.Sonography c.Contraction stress test (CST) d.Nonstress test (NST)

Nonstress Test (NST)

A nurse is teaching a woman how to do "kick counts." What information about this assessment is most appropriate? a. Count the number of fetal movements over 2 hours once a day b. Have your partner verify your count at the same time you perform it. c. Call the OB triage area if there are fewer than 10 movements/hour. d. Notify your provider if the baby's movement slows down

Notify your provider if the baby's movement slows down

The nurse is providing care for a patient in labor, and the health care provider has just stated the patient's need for a forceps-assisted delivery. Which actions would the nurse's preparation include? Select all that apply. Obtaining a urinary catheter Establishing intravenous (IV) access Performing a head-to-toe assessment Educating the patient about the risk for lacerations Preparing the forceps using aseptic technique Monitoring the fetal heart rate for signs of distress

Obtaining urinary catheter Establishing IV access Preparing the forceps using aseptic technique Monitoring the fetal heart rate for signs of distress

To increase the absorption of iron in a pregnant woman, the nurse teaches her that iron preparations should be given with a.milk. b.coffee. c.orange juice. d.tea.

Orange juice

Place the steps in the order in which they would be applied to perform Leopold maneuvers: Palpate for the fetal back. Determine if head is flexed (vertex) or extended (face). Palpate the suprapubic area to confirm presentation. Palpate the uterine fundus.

Palpate the uterine fundus. Palpate for the fetal back. Palpate the suprapubic area to confirm presentation. Determine if head is flexed (vertex) or extended (face).

Occiput posterior refers to which component of the birth process? Powers Passenger Passage Psyche

Passenger

A nursing faculty member explains to students that which patient status is an acceptable indication for serial oxytocin induction of labor? Polyhydramnios History of pre-eclampsia Multiple fetuses Past 42 weeks' gestation

Past 42 weeks' gestation

e recognizes them in a primipara during labor as the patient progresses from the first stage of labor to the second stage of labor. Patient has bloody show and reports rectal pressure. Contractions become closer and coordinated. Patient wakes up and feels mild contractions at home. Cervix is thick and 50% effaced on assessment at the hospital. Cervix is 6 cm dilated.

Patient wakes up and feels mild contractions at home Cervix is thick and 50% effaced on assessment at the hospital Contractions become closer and coordinated Cervix is 6cm dilated Patient has blood show and reports rectal pressure

Following an amniotomy the nurse notes that the FHR is 90 and decreasing on the monitor. The priority action of the nurse should be to: Perform a vaginal examination Document the color of the fluid Call the health care provider immediately Increase the mainline IV

Perform a vaginal examination

In order to prevent nipple trauma, the nurse should teach the new mother to a.assess the nipples before each feeding. b.position the infant so the nipple is far back in the mouth. c.wash the nipples daily with mild soap and water. d.limit the feeding time to less than 5 minutes.

Position the infant so the nipple is far back in the mouth

A student nurse is placing a tocotransducer on a woman for electronic fetal monitoring. What action by the student indicates to the registered nurse that the student understands the procedure? a.Positions the tocotransducer on the woman's upper arm b.Places the tocotransducer over the uterine fundus c.Attaches the tocotransducer to the woman's lower abdomen d.Prepares sterile field for fetal scalp electrode placement

Positions the tocodransducer over the uterine fundus

The nurse is administering a contraction stress test and notes the presence of late decelerations corresponding to three contractions in a ten-minute period of time. The nurse understands that the test will be read as which of the following? Negative Equivocal Unsatisfactory Positive

Positive

Which patient data would the nurse validate as part of routine preparation for cesarean delivery to determine adequate fetal maturity? Select all that apply. Rh-positive antibody test performed 4 weeks before surgery Negative rubella titer performed 6 weeks before surgery Positive serum pregnancy test performed at least 36 weeks before surgery High serum alpha-fetoprotein (AFP) level performed 26 weeks before surgery Ultrasound examination between 6 and 11 weeks of pregnancy

Positive serum pregnancy test performed at least 36 weeks before surgery

A new graduate nurse is preparing to hang oxytocin for a woman to augment her labor. What action by the new nurse warrants intervention from the preceptor? a.Assesses FHR and uterine activity prior to starting the infusion b.Adds oxytocin to the IV as a piggyback c.Attaches the infusion line to the proximal port d.Programs the IV pump for a primary infusion

Programs the IV pump for a primary infusion

The nurse receives reports on two women in early labor, a nulliparous woman and a multiparous woman. Both are 3 cm dilated. Which statement is true regarding who will enter active labor first? The multiparous woman will enter active labor first. The nulliparous woman will enter active labor first. They will both progress at similar rates. The patient whose contractions palpate stronger will enter active labor first.

Progress at similar rates

The student nurse learns that the hormone necessary for milk production is a.lactogen. b.progesterone. c.estrogen. d.prolactin.

Prolactin

Which nonreassuring fetal heart rate (FHR) pattern includes a reduction in FHR of ≥15 beats/min for more than 2 minutes? Accelerations Tachycardia Early decelerations Prolonged decelerations

Prolonged decelerations

A patient experiences nausea and vomiting during labor. Which medication might the nurse anticipate administering? Fentanyl Naloxone Nalbuphine Promethazine

Promethazine

The nurse is caring for a patient who had a forceps delivery that caused a perineal hematoma. Which nursing intervention is most appropriate? Administer topical analgesic ointment as prescribed. Provide the patient with an ice pack and educate her about its use. Encourage the patient to lie on her side as much as possible until the injury heals. Educate the patient about the fact that the hematoma was caused by the introduction of forceps.

Provide patient with an ice pack and educate on how to use it

The fetal heart rate baseline increases 15 beats per minute after vibroacoustic stimulation. What action by the nurse is most appropriate? a.Administer oxygen at 4 L via nasal cannula. b.Reassure the family the finding is normal. c.Prepare to assist with obtaining cord blood gases. d.Position the woman on her left side.

Reassure the family the finding is normal

For which reasons would patient education focus on smoking cessation during pregnancy? Select all that apply. Risk for low blood sugar Risk for premature birth Risk for congenital anomalies Risk for increased fetal circulation Risk for low birth weight

Risk for premature birth Risk for low birth weight

Which infant actions are common cues indicating a readiness to feed? Select all that apply. Sucking Rooting Mouthing Crying Hand-to-mouth movements Vocalizations

Rooting Mouthing Sucking Hand-to-mouth movements

Which food or beverage is the most important for a pregnant woman at 32 weeks of gestation to consume before, during, and after her tennis matches? Extra protein sources, such as peanut butter crackers Salty foods to replace lost sodium Caffeinated energy water Several glasses of water

Several glasses of water

Which nursing instruction is appropriate to give a pregnant woman who will be travelling in a car for 8 hours? Decrease fluid intake. Drive with minimal stops. Avoid travel by automobile. Stop frequently to walk.

Stop frequently to walk

A woman is receiving oxytocin to augment labor. The nurse notes that the contractions occur every one to two minutes and the fetus is showing late decelerations. What action by the nurse takes priority? Document the findings in the chart. Increase the rate of oxytocin slowly. Notify the charge nurse of the situation. Stop the oxytocin infusion.

Stop the oxytocin infusion.

Which are the advantages of external electronic fetal monitoring (EFM)? Select all that apply. Suitable for most patients in labor Visualization of heart rate pattern Allows measurement of contraction intensity Uninterrupted by fetal or patient movement Allows mobility if connected to mobile unit

Suitable for most patients in labor Visualization of heart rate pattern Allows mobility if connected to mobile unit

Which factors are likely to support breastfeeding as the family's feeding method choice? Select all that apply: Support from family Formula access Cultural practices Return to work Health care provider knowledge

Support from family Cultural practices Health Care Provider knowledge

Which action would the nurse take for a breastfeeding mother who is afebrile but reports erythema and tenderness over her right breast? Apply cold compress. Administer local anesthetic. Teach breast massage technique. Administer intramuscular antibiotic.

Teach breast massage technique

A pregnant woman arrives at the emergency department, and after completing a vaginal examination the nurse midwife states that the patient is 5 cm dilated and 75% effaced and the fetus is at −3 station. Which statement is accurate regarding this assessment? The patient may initiate pushing efforts. The cervix is fully dilated. The cervix is fully effaced. The fetus is not engaged within the maternal pelvis.

The fetus is not engaged within the maternal pelvis.

The best reason for recommending formula over breastfeeding is that a.the mother has a medical condition or is taking drugs that could be passed along to the infant via breast milk. b.the mother lacks confidence in her ability to breastfeed. c.the mother sees bottle-feeding as more convenient. d.other family members or care providers also need to feed the baby.

The mother has a medical condition or is taking drugs that could be passed along to the infant via breast milk

When responding to the question "Will I produce enough milk for my baby as she grows and needs more milk at each feeding?" the nurse should explain that a.early addition of baby food will meet the infant's needs. b.the breast milk will gradually become richer to supply additional calories. c.the mother's milk supply will increase as the infant demands more at each feeding. d.as the infant requires more milk, feedings can be supplemented with cow's milk.

The mother's milk supply will increase as the infant demands more at each feeding

Before the physician performs an external version, the nurse should expect an order for a a.indwelling catheter. b.contraction stress test (CST). c.local anesthetic. d.tocolytic drug.

Tocolytic drug

The client is admitted at 37 weeks gestation for external version. The nurse understands that the priority assessment following the procedure will be which of the following: Unusual pain or bleeding Cervical dilation Fetal accelerations Vertex presentation of fetus

Unusual pain or bleeding

When witnessing informed consent for cesarean delivery, which risks to the patient is the nurse acknowledging the patient understands? Select all that apply. Urinary tract infection or trauma to the bladder Cervical laceration or trauma Increased risk for blood clots, which can be in the legs or can travel to the heart or lungs Injury to the newborn including lacerations, bruising, or fractures The need for cesarean birth with every delivery after this procedure regardless of the incision type The risk that the baby's lungs might be compromised or need extra support at birth

Urinary tract infection or trauma to the bladder Increased risk for blood clots, which can be in the legs or can travel to the heart or lungs Injury to the newborn including lacerations, bruising, or fractures The risk that the baby's lungs might be compromised or need extra support at birth

The nurse caring for the woman in labor recognizes that maternal hypotension puts the laboring woman at risk for which result? Early decelerations Fetal dysrhythmias Uteroplacental insufficiency Spontaneous rupture of membranes

Uteroplacental insufficiency

The nurse explains to the expectant mother that which vitamin or mineral can lead to congenital malformations of the fetus if taken in excess by the mother? a.Zinc b.Folic acid c.Vitamin A d.Vitamin D

Vitamin A

When teaching about infant feeding cues in the first days of life, which solution can the nurse consider to encourage the best time to initiate breastfeeding? Whenever the newborn begins to cry Every 2 hours, around the clock When the infant is in the quiet alert state When the newborn naturally wakes itself up, regardless of the time interval

When the infant is in the quiet alert state

Induction of labor is contraindicated in which of the following women? (SELECT ALL THAT APPLY) Woman who is post term - 43 weeks pregnant. Woman who had a classic cesarean section two years ago. Woman who has a breech presentation. Patient with cephalopelvic Disproportion (CPD) Presence of repetitive late decelerations

Woman who had a classic cesarean section two years ago. Woman who has a breech presentation. Patient with cephalopelvic Disproportion (CPD)

Which of the following women are candidates for cesarean section deliveries? (SELECT ALL THAT APPLY) Woman with a positive HIV status Woman with a history of Genital Herpes, no active outbreak at this time. Woman with a breech presentation Woman with early decelerations who is pushing Fetal distress that persists despite intrauterine resuscitation

Woman with a positive HIV status Woman with a breech presentation Fetal distress that persists despite intrauterine resuscitation

What is the Bishop score?

assesses and rates cervical favorability and readiness for induction of labor. a score above 8 is good Used to determine maternal readiness for labor by evaluating whether the cervix is favorable by rating the following: dilation, effacement, cervical consistency, cervical position and station of presenting part

The nurse caring for a woman in labor understands that the primary risk associated with an amniotomy is a.separation of the placenta. b.prolapse of the umbilical cord. c.maternal infection. d.maternal hemorrhage.

b.prolapse of the umbilical cord.

To monitor for potential hemorrhage in the woman who has just had a cesarean birth, what action by the recovery room nurse is most appropriate? a.Assess the abdominal dressings for drainage. b.Maintain an intravenous infusion at 100 mL/hr. c.Monitor her urinary output. d.Assess the uterus for firmness every 15 minutes.

d.Assess the uterus for firmness every 15 minutes.

Surgical, medical, or mechanical methods may be used for labor induction. Which technique is considered a mechanical method of induction? a.Vaginal insertion of prostaglandins b.Amniotomy c.Intravenous Pitocin d.Transcervical catheter

d.Transcervical catheter

A maternal indication for the use of vacuum extraction is maternal exhaustion. a history of rapid deliveries. a wide pelvic outlet. failure to progress past -1 station.

maternal exhaustion.

The greatest risk to the newborn after an elective cesarean birth is a.prematurity due to miscalculation of gestation. b.trauma due to manipulation during delivery. c.tachycardia due to maternal narcotics. d.tachypnea due to maternal anesthesia.

prematurity due to miscalculation of gestation.

A pregnant woman's biophysical profile score is 8. She asks the nurse to explain the results. The nurse's best response is a."The test results are within normal limits." b."Immediate delivery by cesarean birth is needed." c."We will inform you of your options within the next week." d."Further tests are needed to determine the meaning of this score."

the test results are within normal limits

The nurse is assessing a fetal monitor tracing and notes that the FHR baseline is 140-150 bpm with decreases to 120 bpm noted beginning after the contraction begins with return to baseline after the contraction ends. The nurse's first action should be which of the following? Document the findings Turn the patient to her left side Call the health care provider Turn the mainline intravenous fluid rate up

turn the patient onto her left side