OB Final

A nurse is conducting a refresher class for a group of nurses working in the prenatal clinic. After reviewing fetal development with the group, the nurse determines that the teaching was successful when the group identifies which barrier to other sperm after fertilization? A. zona pellucida B. zygote C. morula D. cleavage

Zona pellucida The zona pellucida is the clear protein layer that acts as a barrier to other sperm once one sperm enters the ovum for fertilization. The zygote refers to the union of the nuclei of the ovum and sperm resulting in the diploid number of chromosomes. Cleavage is another term for mitosis. The morula is the result of four cleavages leading to 16 cells that appear as a solid ball of cells. The morula reaches the uterine cavity about 72 hours after fertilization.

After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? A. sitting B. knee-chest C. supine D. side-lying

Side-lying

When teaching new parents about the sensory capabilities of their newborn, which sense would the nurse identify as being the least mature? A. taste B. touch C. hearing D. vision

Vision

A nurse is conducting an in-service program for a group of nurses working in the labor and birth suite of the facility. After teaching the group about the factors affecting the labor process, the nurse determines that the teaching was successful when the group identifies which component as part of the true pelvis? Select all that apply. A. pelvic floor muscles B. vagina C. pelvic outlet D. pelvic inlet E. mid pelvis F. cervix

- Pelvic floor muscles - Pelvic outlet - Pelvic inlet The true pelvis is made up of three planes: the pelvic inlet, mid pelvis, and pelvic outlet. The cervix, vagina, and pelvic floor muscles are the soft tissues of the passageway.

A 42-year-old woman is scheduled for a mammogram. Which statement would the nurse include when teaching the woman about the procedure? A. "The room will be darkened throughout the procedure." B. "Make sure to refrain from eating or drinking after midnight." C. "A dye will be injected to highlight the breast tissue and its ducts." D. "Each breast will be firmly compressed between two plates."

"Each breast will be firmly compressed between two plates." A mammogram involves taking x-ray pictures of the breasts while they are compressed between two plastic plates. There is no need to darken the room or to refrain from eating or drinking after midnight. A ductography involves the injection of dye to highlight the breast ducts.

When the nurse is assessing a pregnant woman in her last trimester, which question would be most appropriate to use to gather information about weight gain and fluid retention? A. "What size maternity clothes are you wearing now?" B. "How puffy does your face look by the end of a day?" C. "How swollen do your ankles appear before you go to bed? D. "What's your usual dietary intake for a typical day?"

"How swollen do your ankles appear before you go to bed? Edema, especially in the dependent areas such as the legs and feet, occurs throughout the day due to gravity. It improves after a night's sleep. Therefore, questioning the client about ankle swelling would provide the most valuable information. Asking about her usual dietary intake would be valuable in assessing complaints of heartburn and indigestion. The size of maternity clothing may provide information about weight gain but would have little significance for fluid retention. Swelling in the face may suggest preeclampsia, especially if it is accompanied by dizziness, blurred vision, headaches, upper quadrant pain, or nausea.

A client is diagnosed with fibrocystic breast disease. After teaching the client about this condition, the nurse determines that the teaching was successful based on which client statement? A. "No more cookies and baked goods for me." B. "It's important that I stop smoking or my condition will get worse." C. "I guess I'll have to find a replacement for milk and cheese." D. "I need to cut out drinking coffee like I'm used to doing."

"I need to cut out drinking coffee like I'm used to doing." Caffeine is a stimulant and eliminating it will help reduce symptoms of fibrocystic breast disease. Thus cutting out coffee from the client's intake indicates understanding of the situation. Although smoking cessation is important for anyone, cigarettes, along with dairy products such as milk and cheese, and sweets, such as cookies and baked goods, are not associated with symptoms of fibrocystic breast disease.

A battered pregnant woman reports to the nurse that her husband has stopped hitting her and promises never to hurt her again. Which response by the nurse would be most appropriate? A. "Remember, the cycle of violence often repeats itself." B. "He probably didn't mean to hurt you." C. "You need to consider leaving him." D. "That's great. I wish you both the best."

"Remember, the cycle of violence often repeats itself." The cycle of violence typically increases in frequency and severity as it is repeated over and over again. The woman needs to understand this.

Which instructions would the nurse include when teaching a woman with pediculosis pubis? A. "Remove the nits with a fine-toothed comb." B. "Wash your bed linens in bleach and cold water." C. "Your partner doesn't need treatment at this time." D. "Take the antibiotic until you feel better."

"Remove the nits with a fine-toothed comb." The nurse should instruct the client to remove the nits from the hair using a fine-toothed comb. Permethrin cream and lindane shampoo are used as treatment, not antibiotics. Bedding and clothing should be washed in hot water to decontaminate it. Sexual partners should be treated also, as well as family members who live in close contact with the infected person.

A nurse is teaching postpartum client and her partner about caring for their newborn's umbilical cord site. Which statement by the parents indicates a need for additional teaching? A. "The cord stump should change from brown to yellow." B. "We need to call the primary care provider if we notice a funny odor." C. "We can put him in the tub to bathe him once the cord falls off and is healed." D. "Exposing the stump to the air helps it to dry."

"The cord stump should change from brown to yellow." The cord stump should change color from yellow to brown or black. Therefore, the parents need additional teaching if they state the color changes from brown to yellow. Tub baths are avoided until the cord has fallen off and the area is healed. Exposing the stump to the air helps it to dry. The parents should notify their primary care provider if there is any bleeding, redness, drainage, or foul odor from the cord stump.

A woman is scheduled to undergo fetal nuchal translucency testing. Which statement would the nurse include when describing this test? A. "The doctor will take a sample of fluid from your bag of waters." B. "A needle will be inserted directly into the fetus's umbilical vessel." C. "A small piece of tissue from the fetal part of the placenta is taken." D. "You'll have an intravaginal ultrasound to measure fluid in the fetus."

"You'll have an intravaginal ultrasound to measure fluid in the fetus." Fetal nuchal translucency testing involves an intravaginal ultrasound that measures fluid collection in the subcutaneous space between the skin and cervical spine of the fetus. Insertion of needle into the fetus's umbilical vessel describes percutaneous umbilical blood sampling. Taking a sample of fluid from the amniotic sac (bag of waters) describes an amniocentesis. Obtaining a small tissue specimen from the fetal part of the placenta describes chorionic villus sampling.

A nursing group is examining their hospital's maternal outcomes for the previous 5 years. Which identified factors have contributed to the decline in the maternal mortality rate? Select all that apply. A. Better management of hemorrhage and infection B. Increased use of anesthesia with childbirth C. Closer monitoring for complications associated with hypertension of pregnancy D. Use of ultrasound to detect disorders E. Increased participation of women in prenatal care

- Better management of hemorrhage and infection - Closer monitoring for complications associated with hypertension of pregnancy - Use of ultrasound to detect disorders - Increased participation of women in prenatal care The following factors have contributed to the decline in the maternal mortality rate: increased participation of women in prenatal care, greater detection of disorders such as ectopic pregnancy or placenta previa and prevention of related complications through the use of ultrasound, increased control of complications associated with hypertension of pregnancy, and decreased use of anesthesia with childbirth.

A nurse is completing the assessment of a woman admitted to the labor and birth suite. Which information would the nurse expect to include as part of the physical assessment? Select all that apply. A. support system B. estimated date of birth C. contraction pattern D. fundal height measurement E. current pregnancy history F. membrane status

- Contraction pattern - Fundal height measurement - Membrane status As part of the admission physical assessment, the nurse would assess fundal height, membrane status, and contractions. Current pregnancy history, support systems, and estimated date of birth would be obtained when collecting the maternal health history.

A 24-year-old client who is planning to become pregnant comes to the clinic for an evaluation. When assessing the client, which finding would alert the nurse to implement measures to reduce the client's risk for problems during pregnancy? Select all that apply. A. quit smoking 4 years ago B. has a BMI of 22 C. follows a vegetarian diet D. drinks wine 3 to 4 times/week E. uses ibuprofen daily

- Drinks wine 3 to 4 times/week - Uses Ibuprofen daily The use of alcohol and prescription and over-the-counter drugs can be harmful to a growing fetus. Thus the nurse would need to address these areas with the client. If the client was still smoking, then that too would need to be addressed. Healthy nutrition is important, but being a vegetarian does not necessarily indicate that the client is a nutritional risk. A BMI of 22 is considered normal and would not pose a problem.

A nurse is developing a teaching plan for a postpartum woman who is breast-feeding about sexuality and contraception. Which information would the nurse most likely include? Select all that apply. A. resumption of sexual intercourse about two weeks after delivery B. use of combined hormonal contraceptives for the first three weeks C. possibility of increased breast sensitivity during sexual activity D. use of a water-based lubricant to ease vaginal discomfort E. possible experience of fluctuations in sexual interest

- Possibility of increased breast sensitivity during sexual activity - Use of a water-based lubricant to ease vaginal discomfort - Possible experience of fluctuations in sexual interest Typically, sexual intercourse can be resumed once bright-red bleeding has stopped and the perineum is healed from an episiotomy or lacerations. This is usually by the third to the sixth week postpartum. Fluctuations in sexual interest are normal. In addition, breast-feeding women may notice a let-down reflex during orgasm and find that breasts are very sensitive when touched by the partner. Precoital vaginal lubrication may be impaired during the postpartum period, especially in women who are breast-feeding. Use of water-based gel lubricants can help. The Centers for Disease Control and Prevention recommend that postpartum women not use combined hormonal contraceptives during the first 21 days after childbirth because of the high risk for venous thromboembolism (VTE) during this period.

A nurse is assessing a newborn who has been classified as small for gestational age. Which characteristics would the nurse expect to find? Select all that apply. A. sunken abdomen B. narrow skull sutures C. increased amount of breast tissue D. wasted extremity appearance E. adequate muscle tone over buttocks

- Sunken abdomen - Narrow skull sutures - Wasted extremity appearance Typical characteristics of SGA newborns include a head that is disproportionately large compared to the rest of the body, wasted appearance of the extremities, reduced subcutaneous fat stores, decreased amount of breast tissue, scaphoid abdomen, wide skull sutures, poor muscle tone over buttocks and cheeks, loose and dry skin appearing oversized, and a thin umbilical cord.

Assessment of a pregnant woman reveals that the presenting part of the fetus is at the level of the maternal ischial spines. The nurse documents this as which station? A. +1 B. -2 C. -1 D. 0

0 Station refers to the relationship of the presenting part to the level of the maternal pelvic ischial spines. Fetal station is measured in centimeters and is referred to as a minus or plus, depending on its location above or below the ischial spines. Zero (0) station is designated when the presenting part is at the level of the maternal ischial spines. When the presenting part is above the ischial spines, the distance is recorded as minus stations. When the presenting part is below the ischial spines, the distance is recorded as plus stations.

A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal? A. 3 B. 5 C. 7 D. 9

9 The biophysical profile is a scored test with five components, each worth 2 points if present. A total score of 10 is possible if the NST is used. Overall, a score of 8 to 10 is considered normal if the amniotic fluid volume is adequate. A score of 6 or below is suspicious, possibly indicating a compromised fetus; further investigation of fetal well-being is needed.

A nurse is developing a plan of care for a preterm infant experiencing respiratory distress. Which measure would the nurse be least likely to include in this plan? A. Keep the newborn in an open bassinet. B. Administer oxygen using a oxygen hood. C. Give intermittent tube feedings. D. Stimulate the infant with frequent handling.

Administer oxygen using a oxygen hood For the preterm infant experiencing respiratory distress, the nurse would expect to handle the newborn as little as possible to reduce oxygen requirements. Other appropriate interventions include keeping the infant warm preferably in a warmed isolette to conserve the baby's energy and prevent cold stress; administer oxygen using an oxygen hood; and provide energy through calories via intravenous dextrose or gavage or continuous tube feedings to prevent hypoglycemia.

A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which factor would the nurse identify? A. Asian American ethnicity B. married C. consistent use of barrier contraception D. age under 25 years

Age under 25 years High-risk groups for chlamydia and gonorrhea include single women, women younger than 25 years, African American women, women with a history of STIs, those with new or multiple sex partners, those with inconsistent use of barrier contraception, and women living in communities with high infection rates.

The parents of a newborn become concerned when they notice that their baby seems to stop breathing for a few seconds. After confirming the parents' findings by observing the newborn, which action would be most appropriate? A. Tell the parents not to worry since his color is fine. B. Notify the health care provider immediately. C. Reassure the parents that this is an expected pattern. D. Assess the newborn for signs of respiratory distress.

Assess the newborn for signs of respiratory distress.

When integrating the principles of family-centered care into the birthing process, the nurse would base his or her care upon which belief? A. Families are unable to make informed choices due to stress. B. Birth results in changes in relationships. C. Birth is viewed as a medical event. D. Families require little information to make appropriate decisions for care.

Birth results in changes in relationships. Family-centered care is based on the following principles: Birth affects the entire family, and relationships will change; birth is viewed as a normal, healthy event in the life of the family; and families are capable of making decisions about their own care if given adequate information and professional support.

A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. When preparing the client's preoperative plan of care, which area would the nurse most likely address as the priority? A. urinary elimination B. fluid balance C. activity D. body image

Body image

A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome? A. incompetent cervix B. congenital anomalies C. abruptio placentae D. placenta previa

Congenital anomalies A HbA1c level of 13% indicates poor glucose control. This, in conjunction with the woman being in the first trimester, increases the risk for congenital anomalies in the fetus. Elevated glucose levels are not associated with incompetent cervix, placenta previa, or abruptio placentae.

A 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 preventative? A. wearing gardening gloves when working in the soil B. avoiding contact with a cat's litter box C. washing raw fruits and vegetables before eating them D. cooking all meat to an internal temperature of 140° F

Cooking all meat to an internal temperature of 140° F Meats should be cooked to an internal temperature of 160° F. Other measures to prevent toxoplasmosis include peeling or thoroughly washing all raw fruits and vegetables before eating them, wearing gardening gloves when in contact with outdoor soil, and avoiding the emptying or cleaning of a cat's litter box.

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication? A. urinary output of 20 mL per hour B. respiratory rate of 10 breaths/minute C. deep tendons reflexes 2+ D. difficulty in arousing

Deep tendon reflexes 2+ With magnesium sulfate, deep tendon reflexes of 2+ would be considered normal and therefore a therapeutic level of the drug. Urinary output of less than 30 mL, a respiratory rate of less than 12 breaths/minute, and a diminished level of consciousness would indicate magnesium toxicity.

The nurse is assessing a 13-year-old girl. Which event would the nurse expect to have occurred first? A. growth spurt B. onset of menses C. development of breast buds D. evidence of pubic hair

Development of breast buds Pubertal events preceding the first menses have an orderly progression beginning with the development of breast buds, followed by the appearance of pubic hair, then axillary hair, then a growth spurt. Menses typically occurs about 2 years after the start of breast development.

A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. Which nursing diagnosis would the nurse most likely include in the client's preoperative plan of care as the priority? A. risk for deficient fluid volume B. disturbed body image C. impaired urinary elimination D. activity intolerance

Disturbed body image

After determining that a newborn is in need of resuscitation, the nurse would perform which action first? A. Give volume expanders. B. Administer ventilations. C. Suction the airway. D. Dry the newborn thoroughly.

Dry the newborn throughly If resuscitation is needed, the nurse must first stabilize the newborn by drying the newborn thoroughly with a warm towel and provide warmth by placing him or her under a radiant heater to prevent rapid heat loss. Next the newborn's head is placed in a neutral position to open the airway, and the airway is cleared with a bulb syringe or suction catheter. Breathing is stimulated. Often handling and rubbing the newborn with a dry towel may be all that is needed to stimulate respirations. Next ventilations and then chest compressions are done. Administration of epinephrine and/or volume expanders is the last step.

A nurse is making a home visit to a postpartum woman who delivered a healthy newborn 4 days ago. The woman's breasts are swollen, hard, and tender to the touch. The nurse documents this finding as: A. involution. B. mastitis. C. engrossment. D. engorgement.

Engorgement Engorgement is the process of swelling of the breast tissue as a result of an increase in blood and lymph supply as a precursor to lactation (Figure 15.4). Breast engorgement usually peaks in 3 to 5 days postpartum and usually subsides within the next 24 to 36 hours (Chapman, 2011). Engorgement can occur from infrequent feeding or ineffective emptying of the breasts and typically lasts about 24 hours. Breasts increase in vascularity and swell in response to prolactin 2 to 4 days after birth. If engorged, the breasts will be hard and tender to touch. Involution refers to the process of the uterus returning to its prepregnant state. Mastitis refers to an infection of the breasts. Engrossment refers to the bond that develops between the father and the newborn.

A client is diagnose with a leiomyoma. The client asks the nurse what this is. The nurse describes this as a: A. fistula. B. cyst. C. fibroid. D. pelvic organ prolapse.

Fibroid Leiomyomas are also called uterine fibroids. Cysts are fluid-filled sac-like structures. A fistula is an abnormal opening. Pelvic organ prolapse is an abnormal descent or herniation of the pelvic organs from their original attachment sites or their normal position in the pelvis.

A client is admitted in the healthcare facility with pelvic inflammatory disease (PID). When reviewing the client's history, which of the following would the nurse identify as a risk factor? A. Genetic predisposition B. Environmental exposure C. Gestational diabetes D. Frequent douching

Frequent douching

The nurse would be alert for possible placental abruption during labor when assessment reveals which finding? A. gestational hypertension B. gestational diabetes C. low parity D. macrosomia

Gestational hypertension Risk factors for placental abruption include preeclampsia, gestational hypertension, seizure activity, uterine rupture, trauma, smoking, cocaine use, coagulation defects, previous history of abruption, domestic violence, and placental pathology. Macrosomia, gestational diabetes, and low parity are not considered risk factors.

A client is admitted to the labor and birthing suite in early labor. On review of her prenatal history, the nurse determines that the client's pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal delivery. Which pelvic shape would the nurse have noted? A. gynecoid B. anthropoid C. platypelloid D. android

Gynecoid The most favorable pelvic shape for vaginal delivery is the gynecoid shape. The anthropoid pelvis is favorable for vaginal birth, but it is not the most favorable shape. The android pelvis is not considered favorable for a vaginal birth because descent of the fetal head is slow and failure of the fetus to rotate is common. Women with a platypelloid pelvis usually require cesarean birth.

When developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging risk group for HIV infection? A. New health care workers B. Native Americans C. Heterosexual women D. Asian immigrants

Heterosexual women The number of women with HIV infection and AIDS has been increasing steadily worldwide. Today, women account for one in four (25%) new HIV infections in the United States. HIV disproportionately affects African-American and Hispanic women, but together they represent less than 25% of all women in the US, yet they account for more than 82% of AIDS cases among women. New health care workers and Asian immigrants account for only a very small number of HIV-positive cases.

After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests? A. estrogen (estriol) B. human chorionic gonadotropin (hCG) C. progesterone (progestin) D. human placental lactogen (hPL)

Human chorionic gonadotropin (hCG) The placenta produces hCG, which is the basis for pregnancy tests. This hormone preserves the corpus luteum and its progesterone production so that the endometrial lining is maintained. Human placental lactogenmodulates fetal and maternal metabolism and participates in the development of the breasts for lactation. Estrogen causes enlargement of the woman's breasts, uterus, and external genitalia and stimulates myometrial contractility. Progesterone maintains the endometrium.

A nurse is preparing a presentation for a group of nurses about genetic discoveries and advances. When discussing this topic, the nurse would most likely include which topic area related to the potential for misuse? A. greater emphasis on the causes of diseases B. individual risk profiling and confidentiality C. slower diagnosis of specific diseases D. gene replacement therapy for defective genes

Individual risk profiling and confidentiality Individual risk profiling based on an individual's genetic makeup can raise issues related to privacy and confidentiality. Gene replacement therapy for defective genes and a greater emphasis on looking at the causes of disease are considered benefits associated with genetic advances. Rapid, more specific diagnosis of diseases would be possible.

A client experienced prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which condition in the mother and the newborn? A. trauma B. hypovolemia C. hemorrhage D. infection

Infection Although hemorrhage, trauma, and hypovolemia may be problems, the prolonged labor with the prolonged premature rupture of membranes places the client at high risk for a postpartum infection. The rupture of membranes removes the barrier of amniotic fluid, so bacteria can ascend.

During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman's left breast. The nurse notifies the primary care provider. What would the nurse anticipate the care provider to order next? A. genetic testing for BRCA B. mammogram C. hormone receptor status D. fine-needle aspiration

Mammogram The characteristics of the palpated mass suggest that it is a benign mass, most likely a fibroadenoma. However, since other breast lesions have similar characteristics, the lump needs to be evaluated via mammography. Hormone receptor status is used to determine if a malignant mass is stimulated to grow by estrogen or progesterone. A fine-needle aspiration may be done later on if there is reason to suspect a malignancy. Genetic testing for the BRCA genes would be done to determine a woman's risk for breast cancer, but this would not be done next.

When developing the plan of care for a woman who has had an abdominal hysterectomy, the nurse would identify which action as contraindicated? A. ambulating the client B. applying elasticized stockings C. massaging the client's legs D. encouraging range-of-motion exercises

Massaging the client's legs After an abdominal hysterectomy, massaging the client's legs would be contraindicated because the woman is at risk for venous stasis, thrombophlebitis, and thromboembolism. Ambulation, elasticized stockings, and range-of-motion exercises would be appropriate to reduce the woman's risk for thrombophlebitis.

When describing the male sexual response to a group of students, the instructor determines that the teaching was successful when they identify emission as: A. dilation of the penile arteries with increased blood flow to the tissues. B. semen forced through the urethra to the outside. C. body's return to the physiologic nonstimulated state. D. movement of sperm from the testes and fluid into the urethras.

Movement of sperm from the testes and fluid into the urethras Emission refers to the movement of sperm from the testes and fluids from the accessory glands into the urethra, where it is mixed to form semen. As the urethra fills with semen, the base of the erect penis contracts, thus increases pressure. This pressure forces the semen through the urethra to the outside (ejaculation). Dilation of the penile arteries with increased blood flow describes erection. The body's return to the physiologic nonstimulated state describes resolution.

A woman just delivered a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify what findings as normal? Select all that apply. A. two ligaments B. one artery C. one ligament D. one vein E. two veins F. two arteries

One vein Two arteries The normal umbilical cord contains one large vein and two small arteries.

A 58-year-old client comes to the clinic for evaluation. After obtaining the client's history, the nurse suspects endometrial cancer. Which information would lead the nurse to suspicion? A. use of oral contraceptives between ages 18 and 25 B. use of intrauterine device for 3 years C. menopause occurring at age 46 D. onset of painless, red postmenopausal bleeding

Onset of painless, red postmenopausal bleeding

A 58-year-old client comes to the clinic for evaluation. After obtaining the client's history, the nurse suspects endometrial cancer. Which information would lead the nurse to suspicion? A. menopause occurring at age 46 B. use of intrauterine device for 3 years C. onset of painless, red postmenopausal bleeding D. use of oral contraceptives between ages 18 and 25

Onset of painless, red postmenopausal bleeding Any episode of bright red painless bleeding occurring after menopause needs to be investigated. Abnormal uterine bleeding in postmenopausal women should be regarded with suspicion. Oral contraceptive use is associated with cervical cancer. Late menopause (after age 52) is associated with endometrial cancer. Use of an intrauterine device is not associated with endometrial cancer.

After teaching a group of prospective new parents about the different perinatal education methods, the nurse determines that the teaching was successful when the parents identify which method as the Bradley method? A. partner-coached method B. psychoprophylactic method C. mind prevention method D. natural childbirth method

Partner-coached method The Bradley method is also a partner-coached method that uses various exercises and slow, controlled abdominal breathing to accomplish relaxation and active participation of the partner as labor coach. The Lamaze method is a psychoprophylactic or mind prevention method. The Dick-Read method is referred to as natural childbirth. Dick-Read believed that prenatal instruction was essential for pain relief and that emotional factors during labor interfered with the normal labor progression. The woman achieves relaxation and reduces pain by arming herself with the knowledge of normal childbirth and using abdominal breathing during contractions.

The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first? A. penile vasodilation B. psychological release C. ejaculation D. sperm emission

Penile vasodilation With sexual stimulation, the arteries leading to the penis dilate and increase blood flow into erectile tissue. Blood accumulates, causing the penis to swell and elongate. Sperm emission (movement of sperm from the testes and fluid from the accessory glands) occurs with orgasm. Orgasm results in a pleasurable feeling of physiologic and psychological release. Ejaculation results in the discharge of semen from the urethra.

The nurse is counseling a couple who suspect that they could bear a child with a genetic abnormality. What would be most important for the nurse to do when working with this family? A. Maintain the confidentiality of the information. B. Inform the family of the need for information. C. Gather information for three generations. D. Present the information in a nondirective manner.

Present the information in a nondirective manner. It is essential to respect client autonomy and present information in a factual, nondirective manner. In these situations, the nurse needs to understand that the choice is the couple's to make. Gathering information for three generations obtains a broad overview of what has been seen in both sides of the family. Maintaining confidentiality of the information is as important as with any other client information gathered. Informing the family of the need for information is necessary because of its personal nature.

A client with advanced breast cancer, who has had both chemotherapy and radiation therapy, is to start hormonal therapy using a selective estrogen receptor modulator (SERM). Which agent would the nurse most likely expect the client to receive? A. cortisone B. exemastine C. raloxifene D. letrozole

Raloxifene Raloxifene is an example of a SERM used as adjunctive treatment for breast cancer. Letrozole and exemastine are aromatase inhibitors used to treat advanced breast cancer. Cortisone is a steroid and would not be used.

Which information on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy? A. recurrent pelvic infections B. ovarian cyst 2 years ago C. use of oral contraceptives for 5 years D. heavy, irregular menses

Recurrent pelvic infections

A nurse is assigned to care for a pregnant woman of Native American descent who is experiencing an illness. The nurse develops a plan of care for this client integrating the client's cultural background and implementing interventions based on the understanding that this client most likely views illness as the result of: A. imbalance between external and internal energy. B. supernatural forces. C. possession by spirits or demons. D. inadequate diet.

Supernatural forces Native Americans typically believe that illness is caused by supernatural forces. Asian Americans believe that illness is caused by an imbalance of yin (internal energy) and yang (external energy). African Americans may believe that illness is caused by spirits or demons. Arab Americans may believe that illness is a result of an inadequate diet.

A woman hospitalized with severe preeclampsia is being treated with hydralazine to control blood pressure. Which finding would the lead the nurse to suspect that the client is having an adverse effect associated with this drug? A. tachycardia B. sweating C. gastrointestinal bleeding D. blurred vision

Tachycardia Hydralazine reduces blood pressure but is associated with adverse effects such as palpitation, tachycardia, headache, anorexia, nausea, vomiting, and diarrhea. It does not cause gastrointestinal bleeding, blurred vision, or sweating. Magnesium sulfate may cause sweating.

A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which effect? A. blurred vision B. uterine hyperstimulation C. headache D. hypotension

Uterine hyperstimulation A major adverse effect of the obstetric use of misoprostol is hyperstimulation of the uterus, which may progress to uterine tetany with marked impairment of uteroplacental blood flow, uterine rupture (requiring surgical repair, hysterectomy, and/or salpingo-oophorectomy), or amniotic fluid embolism. Headache, blurred vision, and hypotension are associated with magnesium sulfate.

A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating: A. latent phase of the first stage of labor. B. pelvic phase of the second stage of labor. C. transition phase of the first stage of labor. D. active phase of the first stage of labor.

Transition phase of the first stage of labor Response Feedback: The transition phase is characterized by cervical dilation of 8 to 10 cm, effacement of 80% to 100%, contractions that are strong, painful, and frequent (every 1 to 2 minutes) and last 60 to 90 seconds, and irritability, apprehension, and feelings of loss of control. The latent phase is characterized by mild contractions every 5 to 10 minutes, cervical dilation of 0 to 3 cm and effacement of 0% to 40%, and excitement and frequent talking by the mother. The active phase is characterized by moderate to strong contractions every 2 to 5 minutes, cervical dilation of 4 to 7 cm and effacement of 40% to 80%, with the mother becoming intense and inwardly focused. The pelvic phase of the second stage of labor is characterized by complete cervical dilation and effacement, with strong contractions every 2 to 3 minutes; the mother focuses on pushing.

A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which possible effect would the nurse include? A. hemorrhoids B. backache C. urinary frequency D. ankle edema

Urinary freqency

Which factor in a client's history would alert the nurse to an increased risk for postpartum hemorrhage? A. size of placenta, small baby, operative delivery B. prematurity, infection, length of labor C. multiparity, age of mother, operative delivery D. uterine atony, placenta previa, operative procedures

Uterine atony, placenta previa, operative procedures Risk factors for postpartum hemorrhage include a precipitous labor less than three hours, uterine atony, placenta previa or abruption, labor induction or augmentation, operative procedures such as vacuum extraction, forceps, or cesarean birth, retained placental fragments, prolonged third stage of labor greater than 30 minutes, multiparity, and uterine overdistention such as from a large infant, twins, or hydramnios.