Final

1 (to maintain the hormonal levels in the bloodstream, she should take the pill as soon as she remembers. If two or more are missed she should use alternate form of birth control)

A woman is being issued a new prescription for low dose combination birth control pill. What advice should the nurse give if the woman forgets to take her pill? 1. take as soon as she remembers even if it means taking 2 pills in one day 2. skip that pill and refrain from intercourse for the remainder of the month 3. wear a pad for the next week because she will experience vaginal bleeding 4. take an at home pregnancy test at the end of the month to check for a pregnancy

2

A young woman is seen in the ER. She states I took a preg. test today. Im pregnant. My parents will be furious with me. I have to do something. Which of the following responses by the nurse is most appropriate? 1. you can take medicine to abort the pregnancy so your parents wont know 2. lets talk about your options 3. The best thing you can do is to have the baby and to give it up for adoption 4. I can help you tell your parents

3 (absent variablility would be expected as a result of STadol admin. Variability is a indicator of fetal well being. It shows the competition between the parasympathetic nervous system effect on FHR. When the CNS is depressed from the admin of a narc analgesic, the nurse should expect decreased variability.)

A client with internal fetal monitor just received Stadol (butorphanol) for pain relief. Which of the following monitor tracing changes should the nurse anticipate? 1. early decelerations 2. late decelerations 3. diminished short and long term variablilty 4. accelerations after contractions

4 (Spinnbarkeit is defined as the threat that is created when the vag discharge is slippery and elastic at the time of ovulation. The changes are in response to high estrogen levels. When she is not in her fertile period the mucus is thick and gluey)

A nurse teaches a woman who wishes to become pregnant that is she assesses for spinnbarkeit she will be able to closely predict her time of ovulatoin. Which technique should the client be taught to assess for spinnbarkeit? 1. take her temp each morning before rising 2. carefully feel her breasts for glandular development 3. Monitor her nipples for signs of tingling and sensitivity 4. Assess her vaginal discharge for elasticity and slipperiness

4 (Depo is administered IM q 3 months, it is a progesterone based contraceptive and should not affect breast feeding, amenorrhea and menorrhagia are both possible side effects, many women who use depo for over 2 years have been found to lose bone density, sometimes that is irreversible.)

A postpartum client has decided to use depo provera (medroxyprogesterone acetate) as her contraceptive method. What should the nurse tell the client regarding this medication? 1. take the pill at the same time each day 2. refrain from breast feeding while using this method 3. expect to have no period while taking this med 4. consider switching to another birth control method in a year or so

3 (The level of pain relief between the two is similar. The level of placement of the needle is the same. Both epidural and spinal clients have the potential for N/V. Epidurals DO NOT fully sedate the motor nerves of the client. Epidural clients are capable of moving their lower extremities even when fully pain free)

The nurse is caring for two post op c-sections in post anesthesia. One of the clients had her surgery under spinal anesthesia, while the other had epidural anesthesia. Which of the following is an important difference between the two types of anesthesia that the nurse should be aware of ? 1. the level of pain relief is lower in spinals 2. Placement of the needle is higher in epidurals 3. epidurals do not fully sedate motor nerves 4. spinal clients complain of N/V

4 (shoulder dystocia means difficulty delivering baby shoulders. This is an emergency. In addition the babys life is in danger because the baby is unable to breathe and umbilical cord flow is often dramatically reduced during this phase of the delivery. )

Which of the following situations should the nurse conclude is a vaginal delivery emergency? 1. 3rd stage labor lasting 20 mins 2. FHR dropping during contractions 3. Three-vessel cord 4. Shoulder dystocia

1 (Women on HRT are at high risk for gynecological cancers, especially endometrial and breast cancer.)

Women who have HRT for an extended period of time have been shown to have a high risk for which of the following complications? 1. endometrial cancer 2. gynecomastia 3. renal dysfunction 4. mammary hypertrophy

2 (The sponge must be moistened with water until it is foamy. The sponge offers protection for up to 24 hrs no matter how many times the couple has sex. It does not protect against STI's and not as effective as other methods. It can be inserted minutes before or any time between 24 hours and a few minutes before. No additional spermicide is needed)

A woman is using the contraceptive sponge as birth control. Which of the following actions is important for her to perform to maximize the sponges effectiveness? 1, insert the sponge at least 1 hr before intercourse 2. thoroughly moisten the sponge with water before inserting 3. Insert spermicidal jelly at the same time the sponge is inserted 4. replace the sponge with a new one if intercourse is repeated

3 (high station is consistent with scenario. Dimensions noted in stem are consistent with a diagnosis of cephalopelvic disproportion because the anterior-posterior diameter of the pelvis (obstetric conjugate ) is smaller than the diameter of the babys head (subocciptitobregmatic). When the fetal head is larger than the maternal pelvis, the baby is unable to descend)

After a multipara has been in active labor 15 hrs an ultrasound is done. The results state that the obstetric conjugate is 10 cm and the suboccipitobregmatic diameter is 10.5 cm. Which of the following labor findings is related to these results? 1. full dilation of the cervix 2. full effacement of the cervix 3. station -3 4 freq every 5 mins.

3 (the most common difference between placenta previa and placental abruption is the absence or presence of pain. With placental abruption blood can be trapped behind the placenta and women usually complain of pain. With placenta previa the condition is usually pain free with blood that flows free from the vagina.)

A 29 week gravid is admitted to the L&D unit with vaginal bleeding. To differentiate between placenta previa and abruptio placentae the nurse should assess which of the following? 1. Leopold maneuvers 2. Quantity of vaginal bleeding 3. prescence of abdominal pain 4. maternal blood pressure

3

A client G3 P2202, 40 weeks gestation, who has vaginal candidiasis has just been admitted into early labor. Which of the following should the nurse advise the woman? 1. she may need a c-section 2. she will be treated with antibiotics during labor 3. the baby may develop thrush after delivery 4. the baby will be isolated for at least one day

1 (secondary means it occurs for a reason other than primary which is never having a period. The most common cause of secondary ammenorrhea is pregnancy, other causes include low body fat, disease. )

A client complaining of secondary amenorrhea is seeking care from her gynecologist. Which of the following may have contributed to her problem? 1. athletic activities 2. vaccination history 3 pet ownership 4. history of asthma

4

A client is to have a hysterosalpingogram. In this procedure the Dr will be able to determine which of the following? 1. whether the ovaries are maturing properly 2. if the endometrium is fully vascularized 3. if the cervix is incompetent 4. whether or not the fallopian tubes are obstructed

4 (the fluid may smell musty but not offensive. Even though labor should start soon, the nurse should ask about fetal movement and then advise the woman to go to the hospital. fetal movement indicates the baby is alive)

A client telephones the L&D unit and states "my water just broke and it smells funny". Which of the following responses would be appropriate for the nurse to make at this time? 1. have you notified your Dr. of the smell? 2. the bag of waters always has an unusual smell 3. your labor should start very soon 4. Have you felt the baby move?

1 (will have c-section.. post op instructions)

A client with a complete placenta previa is on the antepartum clinical unit in preparation for delivery. Which of the following should the nurse include in a teaching session for this client? 1, coughing and deep breathing 2. phases of the 1st stage of labor 3. lamaze labor techniques 4. leboyer hydrobirthing

3 (douching can change the normal flora and PH in the vagina making the environment hostile to sperm. )

A couple is seeking advice regarding actions that they can take to increase their potential of becoming pregnant. Which of the following recommendations should the nurse give to the couple? 1. the couple should use vaginal lubricants during intercourse 2. The couple should delay having intercourse until the day of ovulation 3. The woman should refrain from douching 4. The man should be on top during intercourse

4

A couple is seeking family planning advice. They are newly married and wish to delay child bearing for at least 3 years. The woman age 26 G0P0 has no medical problems and does not smoke. She states however that she is very embarrassed when she touches her vagina. Which of the following methods would be most appropriate for the nurse to suggest to this couple? 1. diaphragm 2. cervical cap 3. IUD 4. birth control pills

1

A couple is seeking infertility counseling. The practitioner has identified the factors listed below in the womans health history. Which of these findings may be contributing to the couples infertility? 1. the client is 36 years old 2. the client started menarche at 13 3. The client works as a dental hygienist 3 days a week 4. The client jogs 2 miles every day

4

A nurse is caring for 4 laboring women. Which of the women will the nurse monitor for signs of abruptio placentae? 1. G2 P0010 27 weeks gestation 2. G3 P1101 17 years of age 3. G4 P2101 cancer survivor 4. G5 P1211 cocaine abuser

3,4 (dilation of 3 cm is indicative of preterm labor. Cervical length of 2 cm is indicative of preterm labor. Preterm labor effacement is greater than 80%. Contractions without cervical change is not diagnostic of preterm labor. )

A nurse is caring for a client G1 P0000 35 weeks, which of the following would warrant the nurse notify the HCP that the client is in preterm labor. Select all that apply 1. contraction every 15 mins 2. effacement 10% 3. dilation 3 cm 4. cervical lenght of 2 cm 5. contraction duration 30 sec

2

After a sex ed class, the school nurse overhears a teen woman discussing safe sex practices. Which of the following indicates that teaching about infection control was effective? 1. I dont have to worry about getting infected if I have oral sex 2. Teen women are at the most high risk for STI 3. The best thing to do if I have sex alot is to use a spermicide each and every time 4. Boys get HIV easier than girls do

2 (the placenta cant separate, hemorrhage results. Not uncommon to have hysterectomy to save womans life)

An OB declares at the conclusion of the 3rd stage of labor that a woman is diagnosed with placenta accreta. The nurse would expect to see which of the following s/s? 1. HTN 2. hemorrhage 3. bradycardia 4. hyperthermia

1 (FHR first. The scenario is indicative of placental abruption. Because the only O2 available to the fetus is via the placenta, the appropriate action is to determine the fetus well being. The nurse should also assess the clients HR because an elevated maternal HR would indicate a maternal loss of blood)

At 38 weeks gestation a woman in labor with a painful board like abdomen and progressively larger serial girth measurements. Which of the following assessments is appropriate at this time? 1. FHR 2. cervical dilation 3. WBC 4. Maternal lung sounds

1 (it will be thin, slippery and alkaline)

During counseling on natural family planning techniques, how should the nurse explain the consistency of cervical mucus at the time of ovulation? 1. it becomes thin and elastic 2. it becomes opaque and acidic 3. It contains numerous leukocytes to prevent vaginal infection 4. it decreases in quantity in response to body temp change

1 (TSS S/S: rash, fever, severe vomiting, diarrhea, muscle aches, and chills. Hypertension is not related however hypotension may be.)

Four women who use superabsorbent tampons during their menses are being seen in the medical clinic. The woman with which of the following findings would lead the nurse to suspect the womans complaints are related to her use of tampons rather than an unrelated medical problem? 1. diffuse rash with fever 2. angina 3. HTN 4. thrombocytopenia with pallor

3 (variable decelerations are caused by cord compression and a precipitous drop in the FHR baseline are indirect indications that the cord is being compressed resulting in decreased oxygenation to the fetus)

Immed. prior to an amniotomy the external FHR monitor tracing shows 145 bpm with early decelerations. Immed following the procedure and internal tracing shows a FHR of 90 bpm with variable decels. A moderate amount of clear amniotic fluid is seen on the bed linens. The nurse concludes that which of the following has occurred? 1. placental abruption 2 eclampsia 3. prolapsed cord 4. succenturiate placenta

4

The nurse educating a group of teen women on bacterial sexually transmitted infections. The nurse knows learning was achieved when a group member states thatt the most common S/S of STI's is which of the following? 1. menstrual cramping 2. heavy menstrual periods 3. flu like symptoms 4. lack of S/S

1 (denial)

The nurse is admitting a 38 week client in labor. The nurse is unable to find the FHR with a doppler. Which of the following comments by the nurse would indicate the nurse is in denial? 1. Ill keep trying to I find a heart beat 2. I am sure it is the machine, If I change the battery I am sure it will work 3. I am so sorry I am not able to find your babys heart beat. 4. Sometimes I really hate these machines.

1 (this baby is at high risk for late FHR decelerations; post date decreases uteroplacental perfusion)

The nurse is caring for a laboring gravida who is 43 weeks pregnant. For which of the following should the nurse carefully monitor this client and fetus? 1. late decelerations 2. hyperthermia 3. hypotension 4. early decelerations

2

The nurse is caring for an eclamptic client which of the following is an important action for the nurse to perform? 1. check the urine for ketones 2. pad the bed rails and headboard 3. provide visual and auditory stimulation 4. place the bed in high fowlers position

4 (ruptured membranes, check FHR to assess for prolapsed cord)

The nurse is caring for four clients on the l&d unit. Which of the following actions should the nurse take first? 1. check the blood sugar of the gestational diabetic 2. assess the emotional status of a client with a post spontaneous abortion 3. assess the patellar reflex of a client with mild pre-eclampsia 4. check the FHR of a client who just ruptured membranes

1,3 (LSP = breech. Neuro tube & breech usually c-section. LS shows lung not mature yet. Hep B is not indication of C section low rates of vertical transmission)

The nurse is caring for four in labor. The nurse is aware that he or she will liekly prepare which of the women for c-section? select all that apply 1. fetus in left sacral posterior position 2, placenta attached to posterior portion uterine wall 3. fetus diagnosed with meningomyelocele 4. client Hep B surface antigen positive 5. the LS ration in the amniotic fluid is 1.5:1

1,2,3,4,5

The nurse is developing a plan of care for clients seeking contraception information. Which of the following issues about the woman must the nurse consider before suggesting contraceptive choices? select all that apply 1. age 2. ethical and moral beliefs 3. sexual patterns 4. socioeconomic status 5. childbearing plans

3 (The contractions described in the scenario result form cord compression (variable decels). Diminished variability is a indication of fetal acidosis. Decels related to head compression mirror contractions and occur at the same time as contractions (early decels). Decels related to uteroplacental insufficiency mirror contractions but begin late in the contraction and return to baseline after the contractions end. )

When monitoring a FHR with moderate variability the nurse notes V shaped decelerations to 80 from a baseline of 120. One occured during a contraction, another occurred 10 seconds after a contraction, and a third occurred 40 seconds after yet another contraction. The nurse interprets these findings as resulting from which of the following? 1. metabolic acidosis 2. head compression 3. cord compression 4. insufficient uteroplacental flow

3 (low platelets are consistent. H=hemolysis EL=elevated liver enzymes LP=low platelets Therefore the nurse would expect to see low hgb and hct, high AST and ALT and low platelets)

Which of the following lab values should the nurse report to the HCP as being consistent with the Dx of HELLP syndrome? 1. Hct 48% 2. K 5.5 3. Platelets 75000 4. Na 130

2,3 (petechiae may develop when a client is thrombocytopenic, one sign of HELLP. Hyperbilirubinemia develops when RBC hemolyse, one of the changes that may develop as a result of liver necrosis. Jaundice is a symptom of hyperbilirubinemia. Also elevated liver function test are a manifestation of HELLP syndrome.)

Which of the following physical findings would lead the nurse to suspect that a client with severe preeclampsia has developed HELLP syndrome? select all that apply 1. +3 pitting edema 2. petechiae 3. jaundice 4. +4 DTR 5. elevated specific gravity

1 (IUDs can remain in place for years)

Which statement by the client indicates she understands the teaching provided about the IUD? 1. The IUD can remain in place a year or more 2. I will not menstruate while the IUD is in 3. Pain during intercouse is a common side effect 4. The device will reduce my chances of getting infected

3 (Audible rales should be reported immed. Tachycardia is expected side effect. )

a 30 year old G2 P0010 in preterm labor is receiving nifedipine (procardia) Which of the following maternal assessments noted by the nurse must be reported to the HCP immediately? 1. HR 100 bpm 2. Wakefulness 3. Audible rales 4. Daily output 2000 mL

1,2,5 (When a baby is in the breech presentation there is an increased risk of prolapsed cord. At station -3 the presenting part is floating, increasing the risk of prolapsed cord. When a baby is in transverse lie, there is an increased risk. The situations that include malpresentations, such as breech, and shoulder (same as transverse lie), and additional situations such as hydramnios, premature rupture of membranes and negative fetal station increase risk of prolapsed cord.)

A client with spontaneously ruptured membranes. Which of the following factors makes her especially at high risk for having a prolapsed cord? select all that apply 1. breech presentation 2. station -3 3. oligohydramnios 4. dilation 2 cm 5. transverse lie

4

A female client asks the nurse about treatment for HPV. the nurses response should be based on which of the following? 1. An antiviral injection cures approx. 50% of cases 2. Aggressive treatments are required to cure warts 3. Warts often spread when an attempt is made to remove them surgically 4. Warts often recur a few months after client is treated

2 (The nurse should first notify the HCP of the request. Substance abuse is not a contraindication for pain relief in labor.)

A known drug addict is in labor. She requests pain medication. Which of the following actions by the nurse is appropriate? 1. Encourage the woman to refrain from taking medication to protect the fetus 2. notify the HCP of her request 3. advise the woman she can only receive an epidural because of her history 4. assist the woman to do labor breathing

1

A labor nurse caring for a client 38 weeks gestation, who is diagnosed with symptomatic placenta previa. Which of the following orders by the HCP should the nurse question? 1. begin oxytocin drip at 0.5 milliunit/min 2. assess FHR q 10 min 3. weigh all vaginal pads 4. assess the hct and hgb

3 (vag exams are contraindicated)

A labor nurse is caring for a client 30 weeks gestation who is symptomatic from a complete placenta previa. Which of the following orders should the nurse question? 1. admin betamethasone (celestone) 12 mg IM daily x2 2. Maintain strict bedrest 3. assess cervical dilation 4. regulate RL 150 mL/hr

2 (HPV is not an indication for c-section. Standard precautions are indicated in this situation. A baby born to a woman with HPV receives standard care in the well baby nursery. HPV is not airborne, a mask is not required. Although it is an STD and it can be contracted to the neonate the CDC does not recommend that a c section be performed merely to prevent vertical transmission)

A woman 39 weeks gestation is admitted to the delivery area with vaginal warts from HPV. Which of the following actions by the nurse is appropriate? 1. notify the HCP for a surgical delivery 2. follow standard infectious disease precautions. 3. notify the nursery of the imminent delivery of an infected infant 4. wear a mask whenever the perineum is exposed

2

A woman has been diagnosed with syphilis. Which of the following nursing interventions is appropriate? 1. counsel the woman about how to live with a chronic infection 2. question the woman regarding symptoms of other STI's 3. assist the primary HCP with cryotherapy procedure 4. educate the woman about the safe disposal of sanitary pads

1

A woman is noted to have multiple soft warts on her perineum and rectal areas. The nurse suspects that this client is infected with which of the following sexually transmitted infections? 1. HPV 2. HIV 3. Syphillis 4. Trichomoniasis

1

If a woman has 3 vertical c section would that mandate this delivery also be c section? 1. yes 2. no

4 (looks like HELLP)

A 40 wk client has admitting plt count of 90000 and a hct of 29%. Her lab value 1 week earlier were plt 200000, and hct 37%. Which additional abnormal lab value would the nurse expect? 1. decreased serum creatinine 2. elevated RBC 3. decreased alkaline phosphatese 4. Elevated alanine transaminase (ALT)

3 (The female condom is 95% effective and also protects against infection.)

A teen woman confides to the school nurse she is sexually active. The young woman wants a very reliable method for birth control, but refuses to be seen by a gynecologist. Which of the following methods would be best for the nurse to recommend? 1. contraceptive patch 2. withdrawal method 3. female condom 4. contraceptive sponge

1 (endometriosis is characterized by the presence of endometrial tissue outside the uterine cavity. The tissue may be on for example, the tubes, ovaries or colon. Adhesions develop from the monthly bleeding at the site of the misplaced endometrial tissue, often resulting in infertility)

An infertile woman has been diagnosed with endometriosis. She asks why that diagnosis has made her infertile. which of the following explanations is appropriate for the nurse to make? 1. Scarring surrounds the ends of your tubes preventing your eggs from being fertilized by you partners sperm 2. you are producing insufficient quantities of follicle stimulating hormone that is needed to mature an egg every month 3. inside your uterus is a benign tumor that makes it impossible for the fertilized egg to implant 4. you have a chronic infection of the vaginal tract that makes the secretions hostile to your partners sperm

3 (repositioning is the first action that should be taken. Increasing the IV rate is appropriate, but NOT first. Applying O2 is appropriate, but NOT first. Reporting to OB is appropriate, but NOT first. Variable deceleartions that look like a V or extended U and that occur irrespective of the timing of contractions occur as a result of cord compression. It is possible that if the mother is repositioned the pressure will shift and decelerations will resolve. If the first position change doesnt work, reposition again. Do all you can before calling the HCP to do otherwise is patient abandonment)

Given the fetal heart rate pattern shown, which of the following interventions should the nurse perform first? 1. increase the IV rate 2. apply O2 by face mask 3. turn the woman on her side 4. report tracing to OB

1 (The first action is to place the woman in the knee chest position, the nurse should assess FHR but this is not the first action. O2 should be administered, but this is not the first action. The OB should be notified, but this is not the first action. The weight of the fetus on the prolapsed cord can rapidly result in fetal death. Therefore the nurse must act quickly to relieve the pressure on the cord. Additional actions that can take pressure off the cord are placing the client in trendelenburg position and pushing the head off the cord with a gloved hand. This situation is an OB emergency)

Immed. after a woman spontaneously ruptures her membranes, the nurse notes a loop of the umbilical cord protruding from the womans vagina. Which of the following actions should the nurse perform first? 1. put the client in the knee chest position 2. assess the FHR 3. admin O2 by a tight face mask 4. telephone the OB with the findings

3 (the nurse needs to learn whether the client is having intercourse with more than one partner.)

In analyzing the need for teaching regarding sexual health in a client who is sexually active, which of the following questions is the most important for the nurse to ask? 1. How old are your children 2. Did you have intercourse last evening? 3. With whom do you have intercourse? 4. Do you use a vaginal lubricant?

1 (TSS is associated with diaphragm use and super absorbent tampon use)

A woman has a history TSS. Which of the following forms of birth control should she be taught to avoid? 1. diaphragm 2. IUD 3. Birth control bills (estrogen-progestin combination) 4. Depo-Provera (medroxyprogesterone acetate)

4 (early onset menopause is a risk factor, but not multiparity. Obesity may be a protective factor)

A nurse is educating a group of women in her parish about osteoporosis. The nurse should include in her discussion that which of the following is a risk factor for the disease process? 1. multiparity 2. increased body weight 3. late onset of menopause 4. Heavy alcohol use

4 (At this point the appropriate action is to provide support if accepted, emergency interventions such as providing O2 by face mask and repositioning the client. The provider may take action by getting a court order, but the nurses role at this point is to provide care in a non-threatening compassionate manner and acknowledge the clients right to refuse.)

A woman G3 P2002 is 6 cm dilated. The fetal monitor tracing shows recurring deep late decelerations. The womans Dr, informs her that the baby must be delivered by C-section. The woman refuses to sign the consent. Which of the following actions by the nurse is appropriate? 1. strongly encourage the woman to sign the informed consent 2. prepare the woman for c-section 3. inform the woman the baby will likely die without the surgery 4, provide the woman with ongoing labor support

1,4,5 (IMMED important. also assess for HSV lesions)

A client enters the L&D suite. It is essential the nurse note the womans status in relation to which of the following infectious diseases? select all that apply 1. hep B 2. rubeola 3. varicella 4. Group B strep 5. HIV/AIDS

1

A client has just had an amniocentesis to determine whether the baby has an inheritable genetic disease. Which of the following interventions is the highest priority? 1. assess the FHR 2. check the clients temp 3. acknowledge the clients anxiety about potential findings 4. answer questions regarding the genetic abnormality

3 (Vaccine can be given as young as 9 and up to age 26 whether sexually active or not. Both Gardisil and Cervarix effectively protect recipients against HPV types 16 and 18; those are the 2 types that cause most HPV related cancers. Only Gardisil also protects against two additional strains ; types 6 and 11 that cause most cases of genital warts.)

A client who is sexually active is asking the nurse about the vaccines administered to prevent HPV. Which of the following should be included in the counseling session? 1. The vaccines are not recommended for women who are already sexually active 2. the vaccines protect recipients from all strains of the virus 3. The most common side effect from the vaccines is pain at the injection site 4. Anyone who is allergic to eggs is advised against receiving the vaccines

1,2,4,5 (they experience all stages of grief, including denial, anger, bargaining and depression. Acceptance may take many years)

A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients emotional responses to their infertility. Which of the following responses would the nurse expect to find? select all that apply 1. anger at others who have baby's 2. feelings of failure because they cant make a baby 3. sexual excitement because they want so desperately to conceive a baby 4. sadness because of the perceived loss of being a parent 5. Guilt on the part of one partner because he or she is not able to give the other a baby

3 (abruptio placentae is assoc. with maternal illicit drug use. Crack cocaine is a vasoconstrictive agent. )

A delirious patient is admitted to hospital in labor. She has had no prenatal care and vials of crack cocaine are found in her pockets. The nurse monitors this client carefully for which of the following intrapartal complications? 1. prolonged labor 2. prolapsed cord 3. abruptio placentae 4. retained placenta

1,2,3,4

The nurse is providing counseling to a group of sexually active women. Most of the women have expressed a desire to have children in the future, but not within the next few years. Which of the following actions should the nurse suggest the women take to protect their fertility for the future? select all that apply 1. use condoms during intercourse 2. refrain from smoking cigarrettes 3. maintain appropriate weight for height 4. exercise in moderation 5. refrain from drinking carbonated beverages

4 (increasing the IV rate helps improve perfusion to the placenta. O2 should be administered during labor delivered via a tight fitting mask at 8-10 L/min. The client should be placed on her side or trendelenberg. The best way to monitor the fetus is with the internal electrode)

The nurse is to intervene when caring for a laboring client whose baby is exhibiting signs of fetal distress. Which of the following actions shoudl the nurse take? 1. admin O2 via nasal cannula 2. place the client in high fowlers position 3. remove the internal fetal monitor electrode 4. increase the IV infusion rate

3 (diaphragm should be left in place at least 6 hours after intercourse and inserted no more than 4 hours before. Spermicide should be used with it. Douching may increase risk of pregnancy)

The nurse teaches a couple that the diaphragm is an excellent method of contraception providing the woman does which of the following? 1. does not use any cream or jelly with it 2. douches promptly after removal 3. leaves in place for 6 hrs following intercourse 4. inserts it at least 5 hrs prior to intercourse