MamaBaby Exam 2

A nurse is engaged in primary prevention activities for HPV. The nurse would be most likely involved with which activity?

administering HPV vaccine

Which finding would lead the nurse to suspect that a large-for-gestational-age newborn is developing hyperbilirubinemia?

tea colored urine

After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment?

genital herpes

A nursing instructor is teaching students about fetal presentations during birth. The most common cause for increased incidence of shoulder dystocia is:

increasing birth weight

(see full question) A client is to be examined for the presence and extent of endometriosis. For which test should the nurse prepare the client?

laporoscopy

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

matronidazole antifungal

Hypoglycemia in a mature infant is defined as a blood glucose level below which amount?

40 mg/100 mL whole blood

A nurse in the newborn nursery has noticed that an infant is frothing and appears to have excessive drooling. Further assessment reveals that the baby has episodes of respiratory distress with choking and cyanosis. What disorder should the nurse suspect based on these findings?

esophageal atresia

Question 4: (see full question) A couple in their mid-30s are at their primary care provider's office because they have been unable to conceive for 3 years. They already have one child who is 4 years of age. The care provider explains to them that they are dealing with what kind of infertility?

secondary infertility

Why is fertility testing initiated with sperm analysis of the male partner?

sperm analaysis easy to complete

When developing a plan of care for a pregnant woman who is HIV-positive and in labor, the nurse recognizes that which measure is essential?

using standard precautions

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?

burning on urination

Which assessment finding would best validate a problem in a small-for-gestational age newborn secondary to meconium in the amniotic fluid?

resp rate 60-70

It would be best to place an infant with a myelomeningocele in which position prior to surgery?

On the stomach (prone)

The nurse is assessing a client for amenorrhea. During the assessment, the nurse notes facial hair and acne. The nurse knows this could be related to:

androgen excess due to secondary tumor

Which instruction should the nurse give to a client with genital herpes to help control the infection?

avoid sexual contact until sores heal

A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence?

wt gain of 10lbs

Which findings would lead the nurse to suspect that a postpartum woman has developed metritis? Select all that apply.

• pain on both sides of the abdomen • foul-smelling lochia • leukocytosis

Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection?

trichomoniasis

Dilation and curettage is the method of abortion used when the gestational age of a pregnancy is still less than 13 weeks.

true

A woman with cardiac disease is 32 weeks' gestation and alerts the nurse she has been having spells of light-headedness and dizziness every few days. The nurse provides which intervention as an option to the client?

Decrease activity and rest more often

Which intervention would be most important when caring for the client with breech presentation confirmed by ultrasound?

continuing to monitor maternal and fetal status

A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition?

cytomegalovirus

A nurse is caring for a client who has been diagnosed with precipitous labor. For which potential fetal complication should the nurse monitor?

intracranial hemorrhage

A nurse assisting in a birth notices that the amniotic fluid is stained greenish black as the baby is being born. Which intervention should the nurse implement as a result of this finding?

intubation and suctioning of trachea

In the infant with developmental dysplasia of the hip (DDH), which sign would likely be noted?

limited abduction of affected hip

The nurse is changing the diaper on a newborn and notices that there is a musty smell to the infant's urine. This finding is a characteristic sign of which disorder?

phenylketonuria

A pregnant woman at 31-weeks' gestation calls the clinic and tells the nurse that she is having contractions sporadically. Which instructions would be most appropriate for the nurse to give the woman? Select all that apply.

• "Drink two or three glasses of water." • "Try emptying your bladder." • "Stop what you are doing and rest."

Which statement describes why hypertonic contractions tend to become very painful?

The myometrium becomes sensitive from the lack of relaxation and anoxia of uterine cells.

The nurse explains to a client diagnosed with trichomoniasis that the disease is caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse say is a factor that triggers growth of trichomoniasis?

irritation of vaginal walls

An infant with hydrocephalus is scheduled to have a ventriculoperitoneal shunt inserted. Immediately following the procedure, which nursing action would best prevent decompression from excessive CSF flow?

keeping the head of the infant level with the body

A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client?

knowledge of child development

Which instruction should be given to a woman newly diagnosed with genital herpes?

limit stress and emotional upset as much as possible

A full-term pregnant client is being assessed for induction of labor. Her Bishop score is less than 6. Which prescription would the nurse anticipate?

Insert a Foley catheter into the endocervical canal.

On the third day postpartum, which temperature is internationally defined as a postpartal infection?

100.4 C

Assessment of a newborn at 40 weeks' gestation reveals that he is a low-birth-weight newborn. Which weight would the nurse identify as being low birth weight?

2400 g

A pregnant woman with type 2 diabetes is scheduled for a laboratory test of glycosylated hemoglobin (HbA1C). What does the nurse tell the client is a normal level for this test?

6%

A pregnant woman with diabetes is having a glycosylated hemoglobin (HbA1C) level drawn. Which result would require the nurse to revise the client's plan of care?

8.5%

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

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

After teaching a woman who has chosen the vaginal ring as her method of contraception, the nurse determines that the client needs additional teaching when she makes which statement?

I will insert a new ring at the same time and day of every week."

A nurse is assigned to care for a newborn with esophageal atresia. What preoperative nursing care is the priority for this newborn?

Prevent aspiration by elevating the head of the bed, and insert an NG tube to low suction.

A nurse is assessing a pregnant woman who has come to the clinic. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings? Select all that apply.

Symptoms of preterm labor are often subtle and may include change or increase in vaginal discharge with mucus, water, or blood in it; pelvic pressure; low, dull backache; nausea, vomiting or diarrhea, and heaviness or aching in the thighs.

A client is using high-dose estrogen oral contraceptives. The nurse would assess the client for which finding?

Yeast infections

A client has had a cesarean birth. Which amount of blood loss would the nurse document as a postpartum hemorrhage in this client?

a client that lost 1000 mL

A client and her infant are being discharged home after an unplanned cesarean birth. The nurse explains to her that she is at a higher risk for postpartum infection than most clients. What is the major risk factor for a postpartum infection?

a nonelective cesarean birth

A newborn with high serum bilirubin is receiving phototherapy. Which is the most appropriate nursing intervention for this client?

application of eye dressings

A postpartal woman is developing a thrombophlebitis in her right leg. Which assessments would the nurse make to detect this?

assess for pedal edema

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?

azole antifungal

A client in her 42nd week of pregnancy is undergoing a scheduled induction of labor based on consideration of which factors? Select all that apply.

cervical ripeness, fetal size, gestational age

A healthy 28-year-old female client who has a sedentary lifestyle and is a chain smoker is seeking information about contraception. The nurse informs this client of the various options available and the benefits and the risks of each. Which should the nurse recognize as contraindicated in the case of this client?

combo oral contraceptives

A client reports that she has multiple sex partners and has a lengthy history of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which method should the nurse suggest for this client?

condoms

A woman is admitted to the labor suite with contractions every five minutes lasting one minute. She is postterm and has oligohydramnios. What does this increase the risk of during birth?

cord compression

A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which condition in the client is likely to increase the risk for shoulder dystocia?

diabetes

A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Which method would be the best recommendation?

diaphragm, spermicide

A client who has been in prolonged labor reports extreme back pain. She asks why her back hurts so much. What would be the best response by the nurse?

diff fetal positions can cause prolonged labor and pain

A premature infant develops respiratory distress syndrome. With this condition, circulatory impairment is likely to occur because with increased lung tension, the:

ductus arteriosus remains open

When caring for a pregnant woman with cardiac problems, the nurse must be alert for signs and symptoms of cardiac decompensation (congestive heart failure), which include:

dyspnea, crackles, and irregular weak pulse.

The nursing student doing a clinical rotation in labor and birth has noticed numerous women expressing various emotions during labor. The student's preceptor informs the student that these emotions can lead to psychological stress, which in turn can cause which complication?

dystocia

When developing a program for STI prevention, which action would need to be done first?

educating on how to promote sexual health

The nurse assesses that the fetus of a woman is in an occiput posterior position. Which description identifies the way the nurse would expect the client's labor to differ from others?

experience of additional back pain

Which definition best explains the term "subfertility/infertility"?

failure to achieve pregnancy after 1 year of unprotected intercourse

A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?

gonnarhea

A nurse is caring for a 38-year-old overweight client 24-hours post cesarean birth. The client is reporting calf tenderness. Which should the nurse do first?

have the client rest with the extremity elevated

Your pregnant patient has had asthma since she was a teenager. What statement by the patient would alert you to the fact her asthma may not be in control?

i keep waking up at night

Over the course of an eight-hour shift of postoperative care for a child who has had ventriculoatrial shunt placement, the nurse notes that the child's cry has become increasingly shrill and the child has projectile vomiting. The nurse would notify the primary care provider immediately because of the possibility that the child might be experiencing:

increased intracranial pressure

While the nurse is weighing and measuring a toddler during the child's annual checkup, the toddler's mother mentions that she is thinking of having another child. The toddler is small in stature and seems mildly developmentally delayed. His eyelid folds are short and his nose is flat. What do the toddler's characteristics suggest is the best advice the nurse can give this mother about pregnancy?

it would be a good idea to stop drinking 3 months before pregnancy

A newborn is designated as extremely low birth weight. The nurse understands that this newborn's weight is:

less than 1000 g

Which action would be most important to do for an infant following surgery for myelomeningocele?

measure daily head circumfrence

A 35-year-old client has just given birth to a healthy newborn during her 43rd week of gestation. What should the nurse expect when assessing the condition of the newborn?

meconium aspiration in utero or at birth

A pregnant woman with chronic hypertension comes to the clinic. The nurse reviews the client's medication therapy regimen expecting to find which medication as most commonly prescribed?

methyldopa

A nurse is assessing a client who gave birth vaginally about 4 hours ago. The client tells the nurse that she changed her perineal pad about an hour ago. On inspection, the nurse notes that the pad is now saturated. The uterus is firm and approximately at the level of the umbilicus. Further inspection of the perineum reveals an area, bluish in color and bulging just under the skin surface. Which action would the nurse do next?

notify health care provider

A young woman is newly married and is seeking advice on contraception. She is in a monogamous relationship and would like a temporary contraceptive, as she plans to have children in the future. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea and has a history of recurrent urinary tract infections. Which method should the nurse recommend?

oral contraceptive

When assessing a client for postpartum hemorrhage, the nurse monitors what every hour?

pad count

(see full question) A female client with an anal gonorrheal infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would expect which finding once the microorganism disseminates throughout the body?

painful joints

A client has just given birth at 42 weeks' gestation. What would the nurse expect to find during her assessment of the neonate?

peeling and wrinkling of neonate's epidermis

A woman is seeking information on tubal ligation as a form of birth control. What information should the nurse provide to the client?

permanent and irreversible

A 40-year-old woman comes to the clinic reporting having missed her period for two months. A pregnancy test is positive. What is she and her fetus at increased risk for?

placental abnormalities

A nurse is caring for a newborn with a repaired cleft lip. What intervention can the nurse provide to facilitate drainage of mucus and secretions to prevent aspiration?

position child on side

When caring for a client requiring a forceps-assisted birth, the nurse would be alert for:

potential lacerations and bleeding

A client with postpartum hematoma is admitted to a local healthcare facility. Which of the following would the nurse assess as characteristic of this condition?

rectal pressure

The nurse is giving an educational presentation to the local Le Leche league chapter. One woman asks about mastitis. What would be the nurse's best response?

risk factors include nipple piercing

When caring for a preterm infant, what intervention will best address the sensorimotor needs of the infant?

rocking and massaging

When dealing with a pregnant adolescent, the nurse assists the client to integrate the tasks of pregnancy while at the same time fostering development of which trait?

self-identity

The nurse is working with a group of parents of children who have congenital heart disorders. Which statement made by the parents would be an indication the child is showing signs of congestive heart failure?

she gets so tired when she is eating

What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension?

stressing the benefits of a healthy lifestyle

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?

syphilis

A nurse is caring for a postpartum client who has been treated for deep vein thrombosis (DVT). Which prescription would the nurse question?

take oral contraceptive daily

(see full question) A woman with active tuberculosis in her sixth month of pregnancy is taking ethambutol hydrochloride. Which of the following interventions should the nurse make to assess the client for a common side effect of this drug?

test for color recognition using Snellen eye chart

A client with a pendulous abdomen and uterine fibroid tumors had just begun labor and arrived at the hospital. After examining the client, the primary care provider informs the nurse that the fetus appears to be malpositioned in the uterus. Which fetal position or presentation should the nurse most expect in this woman?

transverse lie

Couples who engage in coitus daily, hoping to cause early impregnation, may actually have more difficulty conceiving than those who space coitus to every other day.

true

Which factor in a client's history indicates she is at risk for candidiasis?

use of corticosteroids

A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition?

uterine atony

Following birth, the newborn's independent circulatory system is established. If there is an abnormal opening between the chambers in the heart, which cardiac defect may occur?

ventricular septal defect

A procedure used in the treatment of the child with hydrocephalus is to surgically insert a shunt that drains cerebrospinal fluid into a chamber in the heart. This type of shunt procedure is referred to as which of the following?

ventriculoatrial

When assessing a postpartum client who was diagnosed with a cervical laceration which has been repaired, what sign should the nurse report as a possible development of hypovolemic shock?

weak and rapid pulse

In which woman would an IUD be contraindicated?

women w/ multiple sex partners

A nurse is caring for a client with vaginitis. What instructions should the nurse provide to the client to prevent recurrent vaginal infections? Select all that apply

• Avoid using deodorant tampons. • Avoid the use of colored toilet tissue. • Wear only cotton panties and ventilated pantyhose.

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

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

A pregnant woman at 4 weeks' gestation who has preexisting diabetes mellitus visits her primary care provider for a check up. Which fetal complications might occur because of this maternal condition? Select all that apply.

• macrosomia (oversized fetus) • congenital malformations • respiratory disorder Correct

Which findings would the nurse expect in a newborn who is considered small for gestational age? Select all that apply.

• sunken abdomen • poor muscle tone over buttocks • dry or thin umbilical cord

A client is 32 weeks pregnant and sent home on modified bedrest for preterm labor. She is on tocolytics and wants to know when she can have intercourse again with her husband. What is the most appropriate response by the nurse?

"That is a question to ask your health care provider; at this point you are on pelvic rest to try and stop any further labor.

A nurse is caring for a 45-year-old pregnant client with a cardiac disorder who has been instructed by her primary care provider to follow class I functional activity recommendations. The nurse correctly instructs the client to follow which limitations?

"You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath."

Which intervention should a nurse implement to promote thermal regulation in a preterm newborn?

Observe for clinical signs of cold stress such as weak cry.

A client is experiencing situational low self-esteem about acquiring a sexually transmitted infection. Which nursing intervention may help foster the client's self-esteem?

Affirm the client's good judgment in seeking treatment.

A woman is going to have labor induced with oxytocin. Which statement reflects the induction technique the nurse anticipates the primary care provider will prescribe?

administer oxytocin as a piggyback infusion

A nurse is assessing a client in her seventh month of pregnancy who has an artificial valve prosthesis. The client is taking an oral anticoagulant to prevent the formation of clots at the valve site. Which of the following nursing interventions is most appropriate in this situation?

Observe the client for signs of petechiae and premature separation of the placenta