Mother Baby Week 4 study questions
After conducting a refresher class on possible congenital infections with a group of perinatal nurses, the nurse recognizes the class was successful when the group identifies which congenital viral infection as the most common? a. CMV b. HIV c. HPV d. RSV
A
The nurse is caring for a client in active labor. Which assessment finding should the nurse prioritize and report to the team? a. Bradypnea b Sudden dyspnea c. Bradycardia d. Unrelieved pain
B
A nurse is conducting a presentation for a group of pregnant women about measures to prevent toxoplasmosis. The nurse determines that additional teaching is needed when the group identifies which measure as preventive? a. Washing raw fruits and vegetables before eating them. b. Cooking meat to an internal temperature of 125F (52C). c. Wearing gloves when working in the soil. d. Avoiding contact with a cat's litter box.
B
A pregnant woman with preeclampsia is to receive magnesium sulfate IV. Which assessment should the nurse prioritize before administering a new dose? a. Blood pressure b. Patellar reflex c. Heart rate d. Anxiety level
B
The nurse is preparing a postpartum nursing care plan for a single HIV-positive primigravida client. The nurse should prioritize in the plan how to acquire which resource? a. Breast pump b. Diapers c. Care seat d. Formula
D
Some women experience a rupture of their membranes before going into true labor. A nurse recognizes that a woman who presents with premature prelabor rupture of membranes (PPROM) has completed how many weeks of gestation? a. Less than 37 weeks b. Less than 38 weeks c. Less than 39 weeks d. Less than 40 weeks
A
The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth? A. 11 B. 7 C. 5 D. 3
A
A nurse is assessing a newborn and suspects that newborn may have been exposed to alcohol during gestation. The nurse suspect this based on which newborn findings? Select all that apply. a. Thin upper lip b. Small head circumference c. Large head circumference d. Limb abnormality e. Large inset eyes
A, B, D
A nursing student doing a rotation in labor and birth correctly identifies which medications as most commonly used for tocolysis? Select all that apply. a. magnesium sulfate b. Folate c. Indomethacin d. Nifedipine e. nitroglycerin
A, C, D
The maternal health nurse is caring for a group of high-risk pregnant clients. Which client condition will the nurse identify as being the highest risk for pregnancy? a. Secondary hypertension b. Repaired atrial septal defect c. Pulmonary hypertension d. Loud systolic murmur
C
A young woman presents at the emergency department reporting lower abdominal cramping and spotting at 12 weeks' gestation. The primary care provider performs a pelvic examination and finds that the cervix is closed. What does the care provider suspect is the cause of the cramps and spotting? a. Ectopic pregnancy. b. Habitual abortion. c. Cervical insufficiency. d. Threatened abortion.
D
The nurse is caring for a client who has been diagnosed with a deep vein thrombosis. Which assessment finding should the nurse prioritize and report immediately? a. Calf pain b. Pyrexia c. Edema d. Shortness of breath
D
The nurse is caring for a mother within the first four hours after a cesarean birth. Which nursing intervention would be most appropriate to prevent thrombophlebitis in the mother? a. Roll a bath blanket or towel and place it firmly behind the knees. b. Limit oral intake of fluids for the first 24 hours to prevent nausea. c. Assist the client in performing leg exercises every 8 hours. d. Ambulate the client as soon as her vital signs are stable.
D
A woman at 38 weeks' gestation with a history of heroin use disorder has given birth to a newborn several hours ago. Upon assessment, the nurse determines that the newborn is experiencing withdrawal based on which findings? Select all that apply. a. Flaccid extremities b. High-pitched shrill cry c. Almost constant sneezing d. Hard to calm or console e. Strong sucking reflex
B, C, D
A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply. a. hyperthermia b. hemolysis c. elevated liver enzymes d. leukocytosis e. low platelet count
B, C, E
A postpartum women who underwent a cesarean section is being treated for hemorrhage and is to receive a blood transfusion. The nurse understands that this treatment is being instituted based on which amount of estimated blood loss? a. 250mL b. 500mL c. 1,000mL d. 1,500mL
D
The nurse is assessing a 37-year-old woman who has presented in active labor and notes the client has an increased risk for placental abruption (abruptio placentae). Which assessment finding should the nurse prioritize? a. Pink-tinged vaginal discharge with pelvic floor pressure. b. Painless vaginal bleeding. c. Sharp, knife-like ABD pain that is worse with contractions. d. Increased blood pressure and oliguria.
C
A client at 25 weeks' gestation presents with a blood pressure of 152/99 mm Hg, pulse 78 beats/min, no edema, and urine negative for protein. What would the nurse do next? a. Notify the health care provider b. Provide health education c. Assess the client for ketonuria d. Document the client's blood pressure
A
A client in the first stage of labor is diagnosed with dystocia involving the powers of labor. What would the nurse identify as the problem? a. Uterine contractions are too weak or uncoordinated. b. Contractions are regular and cause fetal descent. c. Fetus is in a different position or presentation d. Pelvis is either android type or platypelloid type.
A
A client who gave birth several hours ago is experiencing postpartum hemorrhage. She had a cesarean birth and received deep, general anesthesia. She has a history of postpartum hemorrhage with her previous births. The blood is a dark red. Which cause of the hemorrhage is most likely in this client? a. Uterine atony b. Cervical laceration c. Retained placental fragments d. Disseminated intravascular coagulation
A
A nurse is caring for a client who is scheduled to undergo an amnioinfusion. The nurse would question this prescription if which finding is noted upon client assessment? a. A firm abdomen with difficulty palpating fetal parts and obtaining a fetal heart rate with a Doppler. b. Active genital herpes infection. c. Blood pressure of 130/88 mmHg. d. Decreased urinary output.
A
A nurse working with a woman in preterm labor receives a telephone report for the fetal fibronectin test done 10 hours ago. The report indicates an absence of the protein, which the nurse knows indicates: a. Birth is unlikely within the next 2 weeks. b. Birth is likely within the next 2 weeks. c. No infection is present. d. Infection is present.
A
A pregnant client at 24 weeks' gestation arrives in the office and reports that her feet and legs swelling. During a client evaluation, the nurse notes that she can elicit a 4-mm skin depression that disappears in 10 to 15 seconds. The client is considered at risk for preeclampsia. What additional assessment would be most beneficial for the nurse to complete? a. Urine analysis to assess for proteinuria b. Urine culture c. Weight d. Complete blood count
A
A pregnant client in her third trimmest presents to the birthing center triage area with the cief complaint of painless bright-red vaginal bleeding. The bleeding stopped on the way to the hospital and has now started again. The nurse would expect that the patient is experiencing which of the following: a. Placenta previa b. Cervical insufficiency c. Abruptio placenta d. Uterine rupture
A
A 24-year-old woman presents with severe abdominal pains, nausea, and vomiting. A serum hCG is lower than it is supposed to be at 2 months gestation. The nurse should prepare the client for which intervention if the transvaginal ultrasound indicates a 6cm gestation sac is found in the right lower quadrant? a. Administration of methotrexate. b. Bed rest for the next 4 weeks. c. Immediate surgery. d. Internal uterine monitoring.
C
A nurse is caring for a client who just experienced a spontaneous abortion (miscarriage) in her first trimester. When asked by the client why this happened, which is the best response from the nurse? a. Rejection of the embryo through an immune response. b. Implantation abnormality. c. Abnormal fetal development due to chromosomal issues. d. Lack of sufficient progesterone produced by the corpus luteum.
C
The nurse is monitoring a client in labor who has had a previous cesarean section and is trying a vaginal birth with an epidural. The nurse observes a sudden drop in blood pressure, increased heart rate, and deep variable deceleration on the fetal monitor. The client reports severe pain in her abdomen and shoulder. What should the nurse prepare to do? a. Bolus the client with another dose of medication through the epidural. b. Place the client in a knee-chest position. c. Place the client on her right side. d. Prepare the client for a cesarean birth.
D
The nurse is preparing to teach a pregnant client with iron deficiency anemia about the various iron-rich foods to include in her diet. Which food should the nurse point out will help increase the absorption of her iron supplement? a. Dried apples b. Fortified grains c. Dried beans d. Orange juice
D
A woman in week 16 of her pregnancy calls her primary care provider's office to report that she has experienced abdominal cramping, cervical dilation (dilatation), vaginal spotting, and the passing of grape-like tissue. The nurse instructs the client to bring the passed tissue to the hospital with her. What is the correct rationale for this instruction? a. To determine whether gestational trophoblastic disease is present. b. To determine whether infection is present. c. To determine whether the fetus is viable. d. To determine the stage of development of the fetus.
A
A pregnant client has tested positive for hepatitis B virus. When discussing the situation with the client, the nurse explains that her newborn will be vaccinated with an initial HBV vaccine dose at which time? a. Within 48 hours of birth b. Within 36 hours of birth c. Within 24 hours of birth d. Within 12 hours of birth
D
The nurse is caring for a pregnant woman determined to be at high risk for gestational diabetes. The nurse prepares to rescreen this client at which time frame? a. 16 - 20 weeks b. 20 - 24 weeks c. 24 - 28 weeks d. 28 - 32 weeks
C
The nurse is educating an asthmatic mother about taking her asthma medication while pregnant. The nurse identifies that the patient demonstrates understanding when she verbalizes which of the following: a. "The only medication that I will need to take during pregnancy is a steroid like prednisone to prevent asthma attacks.' b. "My asthma medications are harmful to the baby; therefore, I won't be taking them while I am pregnant." c. "My ability to breathe and provide oxygen to the baby is very important: therefore, I will use my inhalers as prescribed by my primary care provider." d. "My obstetrician will place me on a terbutaline drip during labor to prevent bronchoconstriction."
C
A nurse is assisting a client in active labor whose diabetes has been poorly controlled. Which sign and/or symptom should the nurse expect to find after birth? a. Hyperglycemia b. Low birthweight c. Macrosomia d. Hypobilirubinemia
C
A woman has been progressing through labor uneventfully until following an intense contraction, when she develops signs of umbilical cord compression. The primary care provider can feel a portion of the cord in the vagina. Which emergency intervention should the nurse implement? Select all that apply. a. Place a gloved hand in vagina, put upward pressure on presenting part to keep it off the cord. b. Position the woman in a knee-chest position. c. Locate and insert a vacuum suction catheter into the vagina and push infant back into the uterus. d. apply high flow oxygen via mask. e. Position the women in a supine position.
A, B, D
A woman at 39 weeks' gestation is brought to the emergency department in labor following blunt trauma from an vehicle accident. The labor has been progressing well after the epidural when suddenly the woman reports severe pain in her back and shoulders. Which potential situation should the nurse suspect? a. Fractured ribs b. Placenta previa c. Uterine rupture d. Dystocia
C
A woman with a positive history of genital herpes is in active labor. Assessment reveals vesicles in the perineum area, membranes are ruptured, dilated 5 cm, and effaced 70%. The nurse should prepare the client for which type of birth? a. Spontaneous vaginal b. Vacuum-assisted c. Cesarean d. Forceps-assisted
C
A pregnant client in her second trimester presents to the birthing center triage area with the chief complaint of painless pink-tinged vaginal discharge. The nurse would expect that the patient is experiencing which of the following: a. Placenta previa b. Cervical insufficiency c. Abruptio placenta d. Uterine rupture
B
A client has arrived to the birthing center in labor, requesting a VBAC. After reading the client's previous history, the nurse anticipates that the client would be a good candidate based on which finding? a. Had prior classic uterine incision b. Had prior transfundal uterine surgery. c. Has previous lower abdominal incision. d. Has contracted pelvis.
C
The nursing instructor is pointing out the various complications that can occur during pregnancy in women with diabetes mellitus. The instructor determines the session is successful after the students correctly choose which complication that can occur if the diabetes is not kept under control? a. Placenta previa b. Cerebral vascular accident c. Hydramnios d. Hypotension
C
When planning care for a postpartum client, the nurse is aware that which site is the most common for postpartum infection? a. In the milk ducts b. In the lungs c. In the genitourinary system d. Within the blood stream
C
A pregnant woman comes to the birthing center, stating she is in labor and does not know far along her pregnancy is because she has not had prenatal care. A primary care provider performs an ultrasound that indicates oligohydramnios. When the client's membranes rupture, meconium is in the amniotic fluid. What does the nurse suspect may be occurring with this client? a. Complications of preterm labor. b. Complications of postterm pregnancy. c. Complications of placenta previa. d. Placental abruption.
B
The nurse is working with several clients who have recently delivered healthy newborns. Which statement by a mother would alert the nurse to further assess the mother for postpartum depression? a. "The first few days I was home, I was overwhelmed." b. "I seem to cry more each and every day that goes by." c. "I am hearing voices and sometimes want to harm myself and my newborn." d. "Life sure has changed since I had the newborn....I am so tired but it is worth it."
B
When a woman in labor has reached 8 cm dilation, the nurse notices the fetal heat rate suddenly slows. On perineal inspection, the nurse observes the fetal cord has prolapsed. The nurse's first action would be to: a. Turn her to her left side b. Pace her in a knee-chest position. c. Replace the cord with gentle pressure. d. Cover the exposed cord with a dry, sterile wrap.
B
A shoulder dystocia situation is called in room 4. The nurse enters the room to help and the health care provider says to the nurse, "McRoberts maneuver." What does the nurse do next? a. Bring the client's knees back toward the shoulders, causing hyperflexion of the hips and rotation of the pubic symphysis b. Move the client into a hands-and-knees position, to straighten the sacral curve and release the posterior shoulder c. Apply downward pressure above the pubic bone of the client, in an attempt to rotate the anterior shoulder d. Push the fetal head back into the uterus and prepare the client for cesarean birth
A
A woman who is 10 weeks' pregnant calls the physician's office reporting "morning sickness" but, when asked about it, tells the nurse that she is nauseated and vomiting all the time and has lost 5 pounds. What interventions would the nurse anticipate for this client? a. Lab work will be drawn to rule out electrolyte disturbances b. An ultrasound will be done to reassess the correctness of gestational dates c. Since morning sickness is a common problem for pregnant women, the nurse will suggest the woman drink more fluids and eat crackers. d. The nurse will encourage the woman to lie down and rest whenever she feels ill.
A
The nurse is caring for a pregnant client who is in her 30th week of gestation and has congenital heart disease. Which finding should the nurse recognize as a symptom of cardiac decompensation with this client? a. Dry cough b. Nausea and vomiting c. Slow respirations d. Jugular venous distention (JVD)
D
A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would question the woman about which symptom? a. An inverted nipple on the affected breast. b. No breast mild in the affected breast. c. An ecchymotic area on the affected breast. d. An erythemic and edematous hardening of an area in the affected breast.
D
A nurse is assessing a pregnant woman with gestational hypertension. Which finding would lead the nurse to suspect that the client has developed severe preeclampsia? a. Urine protein 300mg/24 hours b. Blood pressure 150/96 mmHg c. Mild facial edema d. Hyperreflexia
D
A nurse is providing care to several pregnant women at different weeks of gestation. The nurse would expect to screen for group B streptococcus infection in the client who is at: a. 16 weeks' gestation. b. 28 weeks' gestation. c. 32 weeks' gestation. d. 36 weeks' gestation.
D
A woman comes to the clinic for her first prenatal visition. As part of the assessment, the woman is screened for rubella antibodies. The nurse determines that a client has immunity against rubella based on which rubella titer? a. 1:0 b. 1:4 c. 1:6 d. 1:8
D