Maternal-Child Exam 1
The nurse encourages a woman w/ gestational diabetes to maintain an active exercise plan during pregnancy. Prior to exercising, the nurse advises her to take which action?
Eat a high-carb snack
A woman who is 4 months pregnant has Pyrosis (heartburn). Which of the following suggestions would the nurse provide the client?
Eat small meals and do not lie down after eating
A perinatal nurse is caring for a woman who desires an unmedicated birth. Which of the following are options for non-pharmacological methods of pain control in labor? (SATA)
Hydrotherapy Massage Birthball Breathing patterns
A nurse is caring for a client @ 42 weeks who is in active labor. After assessing the client, which of the following findings is the fetus @ risk for developing?
Hyperglycemia
The nurse has notices a change in the type of care to support maternal and child health issues. Which of the following types of changes have occurred in healthcare for maternal & child health? (SATA)
Increased mobility for families More employed mothers More single-parent families
What is the most effective way for a nurse to assess women's usual food intake during pregnancy?
Ask to describe intake over last 24 hrs
A pregnant client is being admitted for severe Preeclampsia. Which room location should the charge nurse assign this client on the obstetrical unit?
Near nurses' station
A nurse is measuring the fundal height of a client who is @ 21 weeks. At which location should the nurse expect to palpate the fundus?
Slightly above umbilicus
A father is preparing a 4 yp son for arrival of newborn baby. Which statement should the nurse suggest the father use to explain this to the child?
" A new baby will make our family bigger but not change our love for you"
A client w/ Type 1 Diabetes in 1st trimester is having difficulty keeping blood glucose levels normal. The client explains she has been "eating for two so the baby is healthy". How should the nurse respond to the client?
"A pregnant woman needs about 300 additional calories a day extra to support a growing fetus"
The nurse is reviewing the results of an abnormal PAP smear w/ a 27 yo female. When explaining to the client the risk for & causes of Cervical Cancer, which of the following statements should be included in the teaching?
"Approx. 70% cervical cancers result from human papillomavirus (HPV)"
The nurse is teaching a client about use of a diaphragm for contraception. Which of the following client statements indicates a need for FURTHER TEACHING?
"I need to have the diaphragm checked if my weight changes by 30lbs"
The nurse is reviewing a prescription for Ferrous Sulfate w/ client who is @ 12 weeks. Which of the following statements by the client indicates an understanding of the teaching?
"I plan to drink more orange juice while taking this pill"
The nurse is teaching a client about best positions for rest during pregnancy. Which of the following responses shows the teaching has been effective?
"I will use side-lying so the weight of the baby doesn't trap blood in my legs and more blood can flow through the placenta"
A pregnant client is concerned her baby is going down in the uterus because of the fluid. How should the nurse respond about fetal respiration?
"Oxygen is provided to the baby through the placenta"
A client in the prenatal clinic reports episodes of dizziness when lying on her back. Which response by the nurse explains this change during pregnancy?
"This is due to the weight of the uterus on the vena cava"
The nurse includes screening for domestic violence in the 1st prenatal visit for all patients. What is an appropriate question by the nurse?
"This is something that we ask everyone. Do you feel safe in your current living environment & relationships?"
The nurse is providing teaching to a client diagnosed w/ Trichomoniasis & prescribed Metronidazole for 7 days. Which of the following statements should be included in this instruction?
"You will need to abstain from alcohol throughout the duration of treatment"
A woman who is 32 weeks is experiencing preterm labor. Which of the following is an INAPPROPRIATE nursing intervention for this client?
Ambulate the client for comfort
A 28 yo G1P0 presents to the OB clinic for prenatal visit. On assessment, the nurse notes a BMI of 32. When discussing expected weight gain during pregnancy, What is the recommended weight gain for this client?
11-20 lbs
Which picture depicts the ideal presentation for a Vaginal Delivery? (picture of developing baby)
2
The nurse is reviewing record of client @ 28 weeks. The history includes... -1 terminated by electrive abortion @ 9 weeks -delivery @ 35 weeks -spontaneous abortion @ 15 weeks According to the GTPAL system, which of following describes current status?
4-0-1-2-1
The nurse is reviewing the health record of a pregnant client. Her Hx includes deliveries of babies at... -39 weeks -40 weeks -35 weeks -Spontaneous abortion @ 17 weeks According to the GTPAL system, which of the following describes best? 4-2-1-1-3 4-1-2-1-3 5-2-1-1-3 5-2-0-2-3
5-2-1-1-3
A nurse is caring for the following clients on the obstetrical unit. The nurse recognizes it is safe to administer Tocolytic Therapy to which of the following clients?
A client experiencing PRETERM LABOR @ 29 weeks gestation
Which of the following trends is currently influencing maternal & child health?
An expansion of community-based services
After assessing a client, the nurse determines a combination oral contraceptive would be contraindicated based on the client's history. What finding by the nurse would indicate this method would NOT be contraindicated for the client?
Abnormal uterine shape
The nurse is planning an educational session for community members to address the issue of school-age child mortality. Which of the following topics should the nurse identify as priority for this population?
Accidents
The Perinatal nurse prepares the laboring woman for an epidural anesthesia insertion. The nurse knows that which of the following is done to prevent maternal hypotension?
Administering rapid IV infusion of 500mL of LR soln
The nurse provides care to a client w/ Hypertensive Gravidarum. (severe/constant N/V) Which outcome indicates that nursing interventions have been effective?
Advancing from clear liquids --> soft foods --> regular diet
A pregnant woman is admitted to the hospital w/ Dx of Placenta Previa. Which of the following actions would the nurse expect to perform for this woman on admission?
Assess fetal heart tones by use of external monitor
A client makes an appt. at the prenatal clinic because she thinks she might be pregnant. What assessment is a positive sign of pregnancy?
Audible fetal heart tones w/ doppler
A woman is experiencing preterm labor @ 32 weeks. The nurse administered tocolytics & client placed on bedrest. The client continues to experience regular contractions & cervix is beginning to dilate & efface. What additional medication should be considered to assist dvpt of fetal lung maturity?
Betamethasone
Which of the following routine tests would the nurse anticipate the provider order the 1st trimester?
Blood type & Rh factor CBC HIV
The nurse caring for a laboring woman notes a variable deceleration of the fetal HR on the electronic fetal monitor strip. What is nurses priority intervention for the client?
Chance maternal position
The nurse understands that which of the following are important functions of amniotic fluid for fetal well-being? (SATA)
Cushioning of the baby from minor trauma Temp. control Permits free mvmt of the baby
Because on increased estrogen during pregnancy, what breast changes would the nurse expect to assess in the client?
Darkened breast areolae
A client w/ HTN who is receiving IV Magnesium sulfate therapy has requested an epidural anesthetic. The perinatal nurse should first review the client's CBC results for which of the folloiwng?
Decreased platelet count
The 22 yo G2P0 @ 33 weeks is admitted for preterm labor & magnesium sulfate is initiated via IV. Which of the following will the nurse include in her care for this client? (SATA)
Ensure calcium gluconate is @ bedside Assess respirations every hour Continuous monitoring for contractions & fetal HR Assess deep tendon reflexes (DTR) every hour
The nurse is planning a prenatal educational program for a community health center. Which of the following statement should the nurse include to meet the 2020 National Health Goals for nutrition in pregnancy?
Ensure daily intake of 400µg folic acid
A clinical nurse is caring for a client who asks est. delivery date. Last menstrual period: May 4, 2020. Which is appropriate response?
February 11, 2021
A 22 yo G2P0 presents to L&D unit @ 33 weeks & reports of pressure and cramping in lower back & decreased fetal mvmt. The nurse in L&D triage anticipates orders for which of the following tests? (SATA)
Fetal Fibronectin Non-stress test Complete Metabolic panel
The nurse in the L&D unit is caring for client in labor & applies external fetal monitor. -Fetal HR: 140 bpm -Contractions: every 8 min, 30-40 sec. duration -2cm dilates, 50% effaces -Fetus @ 2 station Which of the following stages/phases of labor Is client experiencing?
First stage / Latent Phase
The nurse is planning to instruct a client who is 12 weeks on IV to stop smoking. What should the nurse include in the instructions? (SATA)
Follow smoking cessation plan Utilize support system while attempting smoking cessation
The nurse is providing info. on contraceptive options to a 25 yo who reports she has a Bicornuate Uterus. (irregular shaped uterus) Which of the following options would be contraindicated for the client?
Intrauterine device
A nurse is completing a health history for a client who is @ 6 weeks gestation. The client informs the nurse that she smokes 1 pack/day. The nurse should advise the client that smoking places the client's newborn at risk for which of the following complications?
Intrauterine growth restriction
A screening @ 24 weeks gestation reveals a pregnant woman has Gestational Diabetes Mellitus (GDM). In planning client care, the nurse and the woman agree that a goal is to prevent fetal injury. What does the nurse identify as the greatest risk for the fetus?
Macrosomia (growth beyond threshold)
Which of the following potential negative outcomes is NOT associated w/ gestational diabetes?
Oligohydramnios (deficiency of amniotic fluid)
A nurse on the L&D floor admits a client who is 38 weeks and reports heavy, red vaginal bleeding. The bleeding started spontaneously in the morning and is not accompanied by contractions. The client is not in distress and she states she can "feel the baby moving". An ultrasound is scheduled stat. The nurse explains to the client that the purpose of the ultrasound is to determine what?
Placenta placement
The nurse is examining a client at a routine prenatal visit who is @ 32 weeks gestational age. Assessment findings include: -Fundal height = 28cm -Fetal HR = 115 bpm -Mother states baby's mvmts decreased What might the nurse expect with these findings?
Possible intrauterine growth restriction (IUGR) and the nurse should assess for risk factors & notify physician
A woman develops HELLP syndrome during labor & has thrombocytopenia. Which of the following orders by the HCP would the nurse question?
Prepare her for epidural anesthesia
Frequent urination results from which of the following causes during the 3rd trimester of pregnancy?
Pressure on the bladder from the uterus
A pregnant client's blood type is O-. Following the birth of her baby, the cord blood was tested and is B+. The nurse administer RHo(D) immune globulin. What is the purpose of administering this?
Prevent maternal D antibody formation
Assessing the fetus surfactant level is a primary estimation of fetal maturity. Which statement by the nurse indicates an understanding of the action of surfactant on the fetus?
Prevents alveoli from collapsing on expiration
The nurse is teaching a client the importance of Folic Acid in the diet and how folic acid supplements might be beneficial to her 1st trimester of pregnancy. For which reason is the nurse teaching the client about this vitamin?
Prevents neural tube disorders in the developing fetus
The nurse is providing teaching to a group of student nurses regarding the menstrual cycle. When discussing the thickening of the endometrium, the nurse correctly identifies this occurs during which phase of the cycle?
Proliferative
An 18 yo presents to clinic for eval of vaginal discomfort. On exam, the client is noted to have several vesicles on Erythematous bases on the right inner labial tissue. What testing would the nurse expect to be ordered by HCP for diagnosis of Lesions?
Rapid Plasma Reagin (RPR) for syphilis
An Rh-negative woman who is 6 weeks gestation plans medically induces termination. Which outcome should the nurse identify appropriate for this client?
Receive Rho(D) immune globulin
A 26yo G1 w/ Hx of Oligohydramnios has delivered a small for gestational age (SGA) neonate. The neonatal nurse recognizes the newborn should be evaluated closely for abnormalities of which system?
Renal
A woman w/ Dx of Hyperemesis Gravidarum requires hospitalization. What is the difference btwn this condition and the N/V experienced by 70% of pregnant women?
She has SEVERE vomiting & persistent enough to cause weight loss, dehydration, & electrolyte imbalances
A newly married young woman tells the nurse she hopes to become pregnant soon. What should the nurse recommend to this client to support the 2020 National Health Goals for pregnancy? (SATA)
Smoking cessation Take 400 mg Folic Acid daily No alcohol intake
The nurse in L&D is reviewing frequently used medications in the OB setting. Which of the medications would be used for Tocolysis? (delaying delivery of a fetus in preterm labor)
Terbutaline (relaxes smooth muscle)
A woman has an appt. at clinic for prenatal care @ 18 weeks. The client's labs show glucose in urine. What does this finding indicate to the nurse?
The client should have further testing for gestational diabetes
The nurse is reviewing the dvpt. of early pregnancy w/ group of nursing students. Which statement by one of the students indicates an understanding of progression of embryonic/fetal dvpt.?
The embryonic stage begins @ implantation and continues through 5-8 weeks when fetal stage begins
The nurse determines fetal non-stress test is nonreactive for over 20 minutes. The nurse interprets this result as suggesting which situation?
The pregnant client may be HYPOglycemic
A woman who professes to be a strict vegan voices concern about her ability to meet the nutritional needs of her fetus. Which concerns should be addressed in this session?
The supplementation of vitamin B12 should be addressed
A nurse is caring for a Primiparous woman who is @ 7 weeks and asks the nurse when she can expect to experience quickening. (woman giving birth for 1st time) How should the nurse respond?
This will occur between 16-20 weeks of pregnancy
A health care provider has recommended that a pregnant client have an Amniocentesis. For which genetic condition should the nurse teach the client the diagnostic test will detect?
Trisomy 21 (Down syndrome)
The labor nurses assesses the fetal heart rate pattern below immediately following an epidural procedure. In response to assessment, which of the following actions would be appropriate? (SATA)
Turn client to LEFT side Administer Oxygen Administer IV fluid bolus
A nurse is caring for a client who is in labor and observes the tracing picture below. (picture of EKG)
Umbilical cord compression
The nurse is evaluating fetal heart rhythm strip & determines heart rate amplitude varies w/ rate of 15-20bpm. What does this assessment finding indicate to the nurse variability?
Variability is moderate
A client has gestational HTN. What is the potential problem related to this Dx?
Vasoconstriction of blood vessels
