Maternity and Women's Health NGN Case Study

The nurse assessing a newborn suspects Down syndrome. Which characteristic supports this conclusion? Select all that apply. One, some, or all responses may be correct. Hypotonia High-pitched cry Strong, rigid flexion Absence of head control Rocker-bottom feet Hypermobility of joints Epicanthal eye folds Single transverse palmar crease

Hypotonia Absence of head control Hypermobility of joints Epicanthal eye folds Single transverse palmar crease

A client notes a yellowish green vaginal discharge 4 days after a vaginal hysterectomy. Which additional clinical manifestation would the nurse expect if pelvic infection is present? Select all that apply. One, some, or all responses may be correct. Abdominal pain Shortness of breath Urinary frequency 950 mL urine output in 24 hours Decreased pulse rate One pad every two hours, perineal bleeding Rising temperature Increased blood pressure

Abdominal pain Rising temperature

Which clinical condition concerns the nurse the most for an obstetrical client with heart disease? Select all that apply. One, some, or all responses may be correct. Obesity Down syndrome Anemia Seasonal allergies Hypertension Degenerative joint disease Hypothyroidism Emotional distress

Obesity Anemia Hypertension Emotional distress

The nurse is obtaining a health history from a client with endometriosis. Which consequence can occur as a result of this disorder? Select all that apply. One, some, or all responses may be correct. Menopause Metrorrhagia Impaired fertility Bowel strictures Multiparity Voiding difficulties Dysmenorrhea Painful intercourse

Metrorrhagia Impaired fertility Bowel strictures Voiding difficulties Dysmenorrhea Painful intercourse

Which medication would the nurse question if prescribed for a pregnant client? Select all that apply. One, some, or all responses may be correct. Warfarin Phenytoin Citalopram Isotretinoin Fluoxetine Clavulanate Methotrexate Sertraline

Warfarin Phenytoin Isotretinoin Clavulanate Methotrexate

Which presumptive sign of pregnancy will the nurse expect to find when assessing a client at 10 weeks' gestation? Select all that apply. One, some, or all responses may be correct. Amenorrhea Hegar sign Breast changes Urinary frequency Chadwick sign Abdominal enlargement Headaches Nausea

Amenorrhea Breast changes Urinary frequency Nausea

Which recommendation for relieving insomnia will the nurse suggest to a client with menopause? Select all that apply. One, some, or all responses may be correct. Drink chamomile tea Avoid caffeine after dinner Limit exercise to the late evening Restrict liquids in the evening Sprinkle lavender oil on a pillow Use the bed for sleeping and sex only Establish a morning waking routine Avoid alcohol throughout the day

Drink chamomile tea Avoid caffeine after dinner Restrict liquids in the evening Sprinkle lavender oil on a pillow Use the bed for sleeping and sex only

Which risk factor associated with intrauterine device (IUD) use would the nurse include in the discussion of an IUD with a client? Select all that apply. One, some, or all responses may be correct. Expulsion of the device Difficulty breathing Risk for infection during insertion Severe leg pain Delay of return to fertility Risk for perforation of the uterus Increased incidents of vaginal yeast infections Ectopic pregnancy

Expulsion of the device Risk for infection during insertion Risk for perforation of the uterus Ectopic pregnancy

Which alternative remedy would the nurse suggest to a client with dysmenorrhea who is interested in treating the condition with herbal therapies? Select all that apply. One, some, or all responses may be correct. Ginger Broom flower Fennel Dong quai Valerian Peony Wild yam Black haw

Ginger Fennel Valerian Wild yam Black haw

A client at 43 weeks' gestation has just given birth to an infant with typical postmaturity characteristics. Which sign of postmaturity would the nurse identify? Select all that apply. One, some, or all responses may be correct. Cracked and peeling skin Long scalp hair and fingernails Red, puffy appearance of face and neck Increased lanugo Decreased subcutaneous fat Umbilical meconium staining Vernix caseosa covering the back and buttocks Creases covering the neonate's full soles and palms

Cracked and peeling skin Long scalp hair and fingernails Decreased subcutaneous fat Umbilical meconium staining Creases covering the neonate's full soles and palms

Which order would the nurse expect to receive for a client with mild preeclampsia and increasing blood pressure? Select all that apply. One, some, or all responses may be correct. Daily weight Side-lying bed rest 2 g/day sodium diet Monitor deep tendon reflexes Glucose tolerance test Normal saline at 150 ml/hr Initiate seizure precautions Maintain non-stimulating environment

Daily weight Side-lying bed rest Monitor deep tendon reflexes Initiate seizure precautions Maintain non-stimulating environment

The nurse is assessing a pregnant 16-year-old client. Which factor associated with adolescent pregnancy would the nurse consider when developing a plan of care for this client? Select all that apply. One, some, or all responses may be correct. Increased risk of gestational diabetes Higher rate of postpartum depression Elevated mortality rate Inappropriate dietary choices Higher rate of anemia More prevalent chromosomal abnormalities Incomplete bone mass Undeveloped secondary sex characteristics

Higher rate of postpartum depression Inappropriate dietary choices Higher rate of anemia Incomplete bone mass

Which action will the nurse implement to enhance safety for a laboring client and fetus with a prolapsed cord? Select all that apply. One, some, or all responses may be correct. Increasing the client's intravenous fluid drip rate Placing the client in the extreme Trendelenburg position Wrapping the cord tightly in a towel soaked with cold water Administering oxygen to the client via a nonrebreather mask Placing a rolled towel under the client's knees Immediately notifying the client's obstetric health care provider Preparing for immediate caesarean if the client is fully dilated Quickly gloving the examining hand and inserting two fingers into the vagina to the cervix

Increasing the client's intravenous fluid drip rate Placing the client in the extreme Trendelenburg position Administering oxygen to the client via a nonrebreather mask Immediately notifying the client's obstetric health care provider Quickly gloving the examining hand and inserting two fingers into the vagina to the cervix

A client with a large fetus is to have a pudendal block during the second stage of labor. Which education will the nurse plan to provide regarding the effectiveness of the block? Select all that apply. One, some, or all responses may be correct. Contractions will decrease. Perineal pain will not be felt. Bladder sensation may be lost. An episiotomy may not be needed. The bearing-down reflex will be diminished. Fetal heart rate can be reduced. Contraction-related pain continues. Can affect maternal hemodynamics.

Perineal pain will not be felt. The bearing-down reflex will be diminished. Contraction-related pain continues.

The health care provider prescribes a contraction stress test (CST) for a client at 33 weeks' gestation. Which maternal condition will the nurse identify as a contraindication? Select all that apply. One, some, or all responses may be correct. Previous classic cesarean delivery Hypertension Preterm labor Spinal cord injury Placenta previa Cervical insufficiency Reassuring biophysical profile Premature rupture of membranes

Previous classic cesarean delivery Preterm labor Placenta previa Cervical insufficiency Premature rupture of membranes

Which newborn physical assessment finding will the nurse immediately report to the healthcare provider? Select all that apply. One, some, or all responses may be correct. An expiratory grunt Head circumference of 33.5 centimeters Clenched fists A heart rate of 90 beats/minute when sleeping A heart murmur over the base or at the left sternal border in interspace 3 or 4 A persistent heart rate of 180 or more Apneic episodes that last longer than 20 seconds Few large blood vessels indistinctly visible over abdomen

An expiratory grunt A persistent heart rate of 180 or more Apneic episodes that last longer than 20 seconds

Which complication would the nurse monitor for in the infant born at 36 1/7 weeks' gestation? Select all that apply. One, some, or all responses may be correct. Apnea Hypercalcemia Hyperbilirubinemia Feeding difficulties Hyperkalemia Temperature instability Hypoglycemia Hyponatremia

Apnea Hyperbilirubinemia Feeding difficulties Temperature instability Hypoglycemia

A mother and her newborn have just been transferred to the postpartum unit from labor and delivery. Which infant safety education would be provided as soon as mom and baby are settled into their room? Select all that apply. One, some, or all responses may be correct. "Wash your hands before touching the newborn." "Individuals with infectious conditions are not allowed to visit." "Send the newborn to nursery to be monitored during the night." "All client identification bands should remain in place until discharge." "Place the newborn in the bassinet if you become sleepy." "Do not let anyone remove the infant from your sight while you are in the hospital." "Check the identification of staff, and if there is a question of validity, call the nursing station." "It is important for the mother to share the bed with the newborn."

"Wash your hands before touching the newborn." "All client identification bands should remain in place until discharge." "Place the newborn in the bassinet if you become sleepy." "Check the identification of staff, and if there is a question of validity, call the nursing station."

Which recommendation would the nurse make for a pregnant client experiencing nausea and vomiting? Select all that apply. One, some, or all responses may be correct. Avoid an empty or excessively full stomach Drink real ginger ale or tea, or use real ginger in another recipe Try sucking on sour candies or smelling a citrus-scented food or product Eat crackers or vanilla wafers or drink a small amount of liquid before getting out of bed Try eating three good-sized meals throughout the day Eat carbohydrate-rich, low-fat meals throughout the day, such as toast, oatmeal, or noodle soup Locate the pressure points to reduce nausea in the middle of the wrist and press firmly for 3 minutes Maintain a good posture.

Avoid an empty or excessively full stomach Drink real ginger ale or tea, or use real ginger in another recipe Try sucking on sour candies or smelling a citrus-scented food or product Eat crackers or vanilla wafers or drink a small amount of liquid before getting out of bed Eat carbohydrate-rich, low-fat meals throughout the day, such as toast, oatmeal, or noodle soup Locate the pressure points to reduce nausea in the middle of the wrist and press firmly for 3 minutes Maintain a good posture.

The nurse caring for a pregnant client suspects intimate partner violence (IPV). Which assessment supports the concern? Select all that apply. One, some, or all responses may be correct. Low fetal weight is noted on an ultrasound. Injuries are noted to the breasts and abdomen of the client. The partner refuses to come into the examination room. Verbalizations indicating social isolation are noted during visits. The partner answers questions that are asked of the woman. Several visits to the clinic have occurred over the past month. The client has many questions regarding all aspects of her care. Each prenatal visit the client reports generalized somatic symptoms.

Low fetal weight is noted on an ultrasound. Injuries are noted to the breasts and abdomen of the client. Verbalizations indicating social isolation are noted during visits. The partner answers questions that are asked of the woman. Several visits to the clinic have occurred over the past month. Each prenatal visit the client reports generalized somatic symptoms.