ob final exam coursepoint

The nurse orienting a student to the nursery determines that teaching has been effective when the student states that the signs of neonate respiratory distress include which findings? Select all that apply.

Nasal flaring Respiratory rate of 64 breaths per minute Chest retractions

The nursing student correctly identifies which procedure as the treatment of choice for endometrial cancer?

hysterectomy and salpingo-oophorectomy

A client is reporting shortness of breath. To ensure there are no developing complications, a tidal volume is obtained. Due to her pregnancy, the health care provider would except to see what type of results on the tidal volume?

increase of 40%

The five "Ps" of labor are:

passageway, passenger, position, powers, psych.

The nurse is caring for a client at 39 weeks' gestation who is noted to be at 0 station. The nurse is correct to document which?

the fetus is in the true pelvis and is engaged

A pregnant client asks the nurse how the fetus breathes if it is floating in the amniotic fluid. The best explanation by the nurse is:

the fetus receives oxygen through the umbilical vein.

Which complication is most likely responsible for a late postpartum hemorrhage?

uterine subinvolution

A nurse is caring for a client with postpartum hemorrhage. What should the nurse identify as the significant cause of postpartum hemorrhage?

uterine atony

A nurse is teaching a woman in her third trimester about Braxton Hicks contractions. When describing these contractions, which information would the nurse likely include? Select all that apply.

"They usually feel like a tightening across the top of your uterus." "They often spread downward before they go away." "They go away when you walk around or change position."

At what age should a woman with no risk factors begin mammography screening for breast cancer?

40

A woman is in labor with her second child. She knows that she will want epidural anesthesia, and she has already signed her consent form. What must the nurse do before the woman receives the epidural?

Administer a fluid bolus through the IV line to reduce the risk of hypotension.

A 30-minute-old newborn starts crying in a high-pitched manner and cannot be consoled by the mother. Which action should the nurse prioritize if jitteriness is also noted and the infant is unable to breastfeed?

Check blood glucose.

A nurse is caring for a client administered general anesthesia for an emergency cesarean birth. The nurse notes the client's uterus is relaxed upon massage. What would the nurse do next? You Selected:

Continue to massage the client's fundus.

A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 66 beats per minute. Which of these actions should the nurse take?

Document the finding, as it is a normal finding at this time

Which physical change would the nurse expect to find in a pregnant client? Select all that apply.

Increased blood volume Supine hypotension

The nursing student is preparing a presentation illustrating the effects of hypoglycemia on an infant. Which signs or symptoms should the student be sure to include in the presentation? Select all that apply.

Jitteriness Lethargy Seizures

A 24-year-old primigravida client at 39 weeks' gestation presents to the OB unit concerned she is in labor. Which assessment findings will lead the nurse to determine the client is in true labor?

The client reports back pain, and the cervix is effacing and dilating.

A nurse is assessing a client who may be pregnant. The nurse reviews the client's history for presumptive signs. Which signs would the nurse most likely note?

amenorrhea nausea

Which factor might result in a decreased supply of breast milk in a postpartum client?

supplemental feedings with formula

A woman comes to the prenatal clinic and undergoes a pelvic exam. The doctor notes a softening of the uterine isthmus

hegar sign

A nurse is explaining to a group of new parents about the changes that occur in the neonate to sustain extrauterine life, describing the cardiac and respiratory systems as undergoing the most changes. Which information would the nurse integrate into the explanation to support this description?

Pulmonary vascular resistance (PVR) is decreased as lungs begin to function.

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding?

elevated liver enzymes

A woman in labor who received an opioid for pain relief develops respiratory depression. The nurse would expect which agent to be administered

nalaxone

A client at 10 weeks' gestation is complaining of ptyalism over the past 2 weeks. What intervention would the nurse recommend to this client? Select all that apply.

chew gum suck on hard candies

A woman comes to the clinic for a routine checkup. After obtaining the client's history, the nurse identifies that the client is at increased risk for cervical cancer based on her history of exposure to which virus?

hpv

The nurse is caring for a woman at 32 weeks' gestation with severe preeclampsia. Which assessment finding should the nurse prioritize after the administration of hydralazine to this client?

tachycardia

The nurse is caring for a multigravid who experienced a placental abruption 4 hours ago. For which potential situation will the nurse prioritize assessment?

uterine atony

Which factor puts a multiparous client on her first postpartum day at risk for developing hemorrhage?

uterine atony

A community health nurse is leading a discussion at a health fair for college students on the topic of the signs of pregnancy. The nurse determines more teaching is necessary when the students choose which sign as a probable sign of pregnancy?

Fetal movement felt by examiner

A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history?

G3, T0, P1, A1, L1

There are advantages and disadvantages to any kind of method used to control pain during labor and birth. What is an advantage of opioid administration?

It can be administered by the nurse.

In assessing the dietary intake over the last 24 hours of a pregnant client, which food would be most concerning to the nurse?

Smoked salmon and bagels

The nursing instructor is teaching the students about pelvic organ prolapse (POP). The nurse understands that teaching has been successful when the students identify which different types of POP? Select all that apply.

cystocele rectocele enterocele uterine prolapse

When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to be:

less than after vaginal birth

thermoreguation in preterm newborn

observe for clinical signs of cold stress such as weak cry

A young couple is having difficulty getting pregnant. The nurse is preparing the couple for the initial tests to determine their fertility. When asked by the couple why they need to start with a sperm analysis, what will be the nurse's best response?

sperm analysis is one of the easiest tests to complete

A nurse is teaching a client how to perform Kegel exercises. Which directives would the nurse include? Select all that apply.

"Squeeze your rectal muscles as if you are trying to avoid passing flatus." "Contract and relax your pubococcygeal muscles rapidly 10 times."

A nurse is preparing a class on newborn adaptations for a group of soon-to-be parents. When describing the change from fetal to newborn circulation, which information would the nurse include? Select all that apply.

Decrease in right atrial pressure leads to closure of the foramen ovale. Onset of respirations leads to a decrease in pulmonary vascular resistance. Increase in pressure in the left atrium results from increases in pulmonary blood flow. Closure of the ductus venosus eventually forces closure of the ductus arteriosus.

The nursery head nurse is conducting a staff in-service on prevention of hypoglycemia. What information would she share with this group? Select all that apply.

Encourage breastfeeding mothers to nurse immediately after delivery. Keep the newborns warm in the nursery and covered with a blanket. Initiate early feedings for all bottle-fed newborns.

After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between placental abruption (abruptio placentae) and placenta previa. Which statement will the nurse include in the teaching?

Placenta previa is an abnormally implanted placenta that is too close to the cervix.

A pregnant woman questions the nurse about changes she is noticing in her breasts and is concerned if they are normal. Which reported changes would the nurse recognize as normal breast changes during pregnancy? Select all that apply.

Secretions from sebaceous glands on the areola Appearance of striae Darkening of the areola Nodular tissue upon palpation

A woman is concerned about the safety of continuing sex with her partner during pregnancy. Which suggestion should the nurse mention to her

Sex is to be avoided after your membranes have ruptured. Sex is generally not harmful to the fetus. Partner oral-female genital contact due to risk of air embolism. A nonmonogamous sexual partner should wear a condom.

A nurse is conducting an in-service program for a group of labor and birth unit nurses about cesarean birth. The group demonstrates understanding of the information when they identify which conditions as appropriate indications? Select all that apply.

active genital herpes infection placenta previa previous cesarean birth fetal distress

A nurse will be speaking at a local high school about women's health. The nurse is planning to talk about sexually transmitted infections (STIs) as well as routine checks, along with guidelines for Papanicolaou testing. What should the nurse include in the Papanicolaou test guidelines about when to have a first test?

at the age of 21 or within 3 years of first sexual intercourse

A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for:

dexa scan

The nurse recognizes that maternal factors can increase the chance of a large-for-gestational-age newborn. When reviewing maternal history, the nurse would interpret which factors as placing a newborn at risk for being LGA? Select all that apply.

diabetes multiparity history of postdates gestation

A postpartum client has a fourth-degree perineal laceration. The nurse would expect which medication to be prescribed?

docusate

Prior to discharge is an appropriate time to evaluate the client's status for preventive measures such as immunizations and Rh status. Which test would the nurse ensure has been conducted to evaluate the Rh-negative mother?

indirect Coombs test

When palpating for fundal height on a postpartum woman, which technique is preferable?

placing one hand at the base of the uterus, one on the fundus

A nurse is developing a teaching plan about sexuality and contraception for a postpartum woman who is breastfeeding. Which information would the nurse most likely include? Select all that apply.

possible experience of fluctuations in sexual interest use of a water-based lubricant to ease vaginal discomfort possibility of increased breast sensitivity during sexual activity

A woman pregnant with twins comes to the clinic for an evaluation. While assessing the client, the nurse would be especially alert for signs and symptoms for which potential problem?

preeclampsia

The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours. Why would the nurse do this?

pulmonary edema

When assessing a postpartum woman, the nurse would find which factor to be most significant in identifying possible postpartum hemorrhage?

pulse rate

A nurse is conducting a presentation for a group of pregnant women about conditions that can occur during pregnancy and that place the woman at high-risk. When discussing blood incompatibilities, which measure would the nurse explain as most effective in preventing isoimmunization during pregnancy?

rhogam to rh negative women

A nurse is assessing a postpartum client. Which finding would the cause the nurse the greatest concern?

sharp, stabbing chest pain with sob

A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. The nurse determines that the drug is at a therapeutic level based on which result?

6.1

The nursing instructor is illustrating the circulatory flow between the mother and fetus. The instructor determines the session is successful when the class correctly chooses which structure with which route?

The one umbilical vein carries oxygen-rich blood to the fetus from the placenta.

The nurse is assessing a client who has given birth within the past hour. The nurse would expect to find the woman's fundus at which location?

at the level of the umbilicus

A client is diagnosed with an enterocele. The nurse interprets this condition as:

bulging of the small intestine through the posterior vaginal wall.

A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the client's safety, which compound would the nurse have readily available?

calcium gluconate

A macrosomic infant in the newborn nursery is being observed for a possible fractured clavicle. For which would the nurse assess? Select all that apply.

facial grimacing with movement bruising over area asymmetrical movement edema present

A nurse is caring for a client in her third stage of labor. The nurse would predict the placenta is separating from the uterus based on which assessment findings? Select all that apply

fresh gushing of blood from the vagina umbilical cord descending lower down a globular shaped uterus

A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply.

hemolysis elevated liver enzymes low platelet count

A client is suspected of having a ruptured ectopic pregnancy. Which assessment would the nurse identify as the priority?

hemorrhage

A pregnant 36-year-old woman has presented to the emergency department with vaginal bleeding. While reviewing the client's history, the nurse suspects placenta previa when which risk factors are found in her record? Select all that apply.

infertility treatment smoking advancing maternal age previous induced surgical abortion

A nurse is caring for a client who has had a vaginal birth. The nurse understands that pelvic relaxation can occur in any woman experiencing a vaginal birth. Which should the nurse recommend to the client to improve pelvic floor tone?

kegel exercises

The obstetrical nurse admits a premature, small-for-gestational age infant to the observational unit for assessment. The maternal record reveals an obese 27-year-old homeless woman with limited prenatal, medical, or dental care. Her blood pressure on admission was 170/90 mm Hg. Which factors in the maternal history would have suggested a high-risk pregnancy? Select all that apply.

lack of prenatal care homelessness periodontal disease maternal hypertension obesity

A nurse finds that a client is bleeding excessively after a vaginal birth. Which assessment finding would indicate retained placental fragments as a cause of bleeding?

large uterus with painless dark red blood mixed with clots

During the birth, the primary care provider performed an episiotomy. The client is now reporting discomfort. To reduce this discomfort and increase hygiene to the perineum, the nurse would encourage the client to use which intervention?

peribottle and warm water

A woman having contractions comes to the emergency department. She tells the nurse that she is at 34 weeks' gestation. The nurse examines her and finds that she is already effaced and dilated 2 cm. What is this woman demonstrating?

preterm labor

A client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal?

prevent maternal seizures

A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the client's fundus and documents which finding as normal?

two fingerbreadths below the umbilicus

A postpartum woman tells the home care nurse, "My hemorrhoids are really uncomfortable. Is there anything I can do?" Which suggestion(s) by the nurse would be appropriate? Select all that apply.

"Applying ice to the area can help." "Witch hazel pads can have a cooling effect." "I will show you how to use a sitz bath."

The nurse takes a health history from the parents under the suspicion that their infant may have a genetic disorder. Which statement(s) by the mother is associated with risk factors of genetic disorders? Select all that apply.

"Our obstetrician told us that I was not making enough amniotic fluid during this pregnancy." "The father is 55 years old." "My sister's baby was born with trisomy 18."

The nurse is conducting a breast exam on a postpartum mother on the second day following delivery. What findings would the nurse determine to be normal? Select all that apply.

Breasts feel slightly firm. Flattened nipple on the right breast Breasts are non-painful

What physical changes take place when a woman becomes pregnant?

Heart rate increases 10 to 15 beats per minute. The areolae become more prominent. Nasal congestion increases due to edema.

The nurse is inspecting a new mother's perineum. What actions would the nurse take for this client? Select all that apply.

Inspect the episiotomy for sutures and to ensure that the edges are approximated. Note any hemorrhoids. Gently palpate for any hematomas.

A pregnant woman is being evaluated for HELLP. The nurse reviews the client's diagnostic test results. An elevation in which result would the nurse interpret as helping to confirm this diagnosis?

LDH

A group of nursing students are preparing a presentation depicting the fetal circulation. The instructor determines the presentation is successful when the students correctly illustrate which route for the ductus arteriosus?

The pulmonary artery to the aorta

The nursery nurse is providing shift handoff on a newborn documented as small for gestational age. Which clinical manifestations would the nurse expect to communicate about this newborn? Select all that apply.

Sunken abdomen Poor muscle tone over buttocks Dry or thin umbilical cord

A client reports prolonged nausea, vomiting every morning for the past week, and no appetite. The pregnancy test comes back positive. What recommendation should the nurse give this client? Select all that apply.

Take small amounts of liquids between meals, not with them. Eat a saltine cracker before getting out of bed in the morning. Delay eating breakfast until the nausea and vomiting has passed.

How does fetal circulation differ from circulation after birth?

The umbilical vein carries oxygenated blood, while deoxygenated blood is carried by the umbilical arteries.

Which reason explains why women should be encouraged to perform Kegel exercises after birth?

They promote blood flow, enabling healing and muscle strengthening.

A nurse is counseling a client preconception and describes pregnancy risk factors for genetic disorders. What risk factors would the nurse include? Select all that apply.

a pregnant client who is 35 years old the partner of a pregnant client is 53 years old an incestuous relationship resulting in pregnancy the pregnant mother has been exposed to teratogens

A potential complication for the mother and fetus is Rh incompatibility; therefore, assessment should include blood typing. If the mother is Rh negative, her antibody titer should be evaluated. If treatment with Rho(D) immune globulin is indicated, the nurse would expect to administer it at which time?

at 28 weeks

The nurse administers Rho(D) immune globulin to an Rh-negative client after birth of an Rh-positive newborn based on the understanding that this drug will prevent her from:

developing Rh sensitivity.

a postpartum woman has a history of von Willebrand disease (vWD). The client is being prepared for discharge, and a referral for health care follow up is made to assess for potential postpartum hemorrhage. The nurse understands that this client is at greatest risk for hemorrhage during which time during the postpartum period?

first week

The nursing instructor is teaching about urinary incontinence and informs the students that dysfunction of either the bladder, the urethra, or the levator muscle can cause incontinence. She also lists which contributing factors for incontinence?

fluids such as alcohol and caffeinated and carbonated drinks constipation habitual "preventive" emptying advancing age pregnancy and birth obesity

The nurse is performing an assessment of a woman who has come to a health care facility for a diagnosis of pregnancy. The women is positive for breast changes, nausea, and amenorrhea. On physical exam, it is noted that the client has softening of the cervix. How should the nurse document this in her notes?

goodell sign

During a vaginal exam, the nurse notes that the lower uterine segment is softened. The nurse documents this finding as:

hegar sign

Which is the most important nursing assessment of the mother during the fourth stage of labor?

hemorrhage

A 52-year-old client is seeking treatment for menopause. She is not very active and has a history of cardiac problems. Which therapy option should the nurse recognize as contraindicated for this client?

long term hormone replacement therapy

A male client visits a fertility clinic after one year of attempting unsuccessfully to impregnate his wife. What is a risk factor associated with male infertility?

no or few sperm cells produced

Which are modifiable risk factors for breast cancer?

obesity smoking alcohol consumption duration of breastfeeding sedentary lifestyle

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 this suspicion?

onset of painless, bright red postmenopausal bleeding

A woman at 34 weeks' gestation presents to labor and delivery with vaginal bleeding. Which finding from the obstetric examination would lead to a diagnosis of placental abruption (abruptio placentae)?

onset of vaginal bleeding was sudden and painful

The nurse has been asked to conduct a class to teach new mothers how to avoid developing stress incontinence. Which action would the nurse include in the discussion as possible strategies for the new mothers to do? Select all that apply.

performing Kegel exercises avoiding smoking losing weight if obese

The purpose of a circulatory shunt, such as the ductus arteriosus, is to:

permit oxygenated blood to supply the most important fetal organs.

A preterm infant receives surfactant by lung lavage. Which interventions should the nurse perform immediately? Select all that apply.

placing the infant in an upright position not suctioning the airway

A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which disorder? Select all that apply.

rectocele cystocele enterocele

A nurse is providing teaching about lifestyle modifications to address a client's pelvic organ prolapse. The nurse understand that the majority of these changes focuses on

reducing intra-abdominal pressure.

The nurse is appraising the medical record of a pregnant client who is resting in a darkened room and receiving betamethasone and magnesium sulfate. The nurse recognizes the client is being treated for which condition?

severe preeclampsia

The nurse is caring for a client in the early stages of labor. What maternal history factors will alert the nurse to plan for the possibility of a small-for-gestational-age (SGA) newborn? Select all that apply.

smoking during pregnancy asthma exacerbations during pregnancy drug use

Which action would the nurse emphasize when teaching postmenopausal women about ways to reduce the risk of osteoporosis?

taking calcium supplements

A nurse is presenting a class about benign female reproductive conditions to a group of women at the local community center. When describing genital fistulas, which condition(s) cause the majority of these fistulas? Select all that apply.

trauma during labor and birth female genital cutting

A nurse is discussing the advantages and disadvantages of intermittent and continuous fetal heart rate monitoring with a colleague. What would the nurse cite as being able to be detected when using continuous monitoring but not intermittent monitoring? Select all that apply.

types of decelerations variability

A client was in labor for more than 36 hours and now reports urine leaking from her vagina. On examination the nurse would be inspecting for:

urethrovaginal fistula.

The nurse discovers that the FHM is now recording late decelerations in a client who is in labor. The nurse predicts this is most likely related to which event?

uteroplacental insufficiency

A woman delivered her infant 24 hours ago by cesarean section. Which assessment findings should be reported to the assigned nurse? Select all that apply.

uterus feels boggy the client reports breakthrough pain level of 7-8

A client is seen in the clinic with symptoms of "dragging" and feeling like something is "coming down." During her assessment, the nurse should look at which risk factors for a prolapse? Select all that apply.

vaginal birth advanced age increased body mass index

A nurse is reviewing a postpartum woman's history and labor and birth record. The nurse determines the need to closely monitor this client for infection based on which factor?

placenta removed via manual extraction

Which suggestion by the nurse about pushing would be most appropriate to a woman in the second stage of labor?

"Choose whatever method you feel most comfortable with for pushing."

The nurse is assessing a male client who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years." What questions would be important for the nurse to ask this client? Select all that apply.

"Do you use drugs or use alcohol excessively? "Are you exposed to X-rays or other radioactive substances?" "Have you ever had any type of trauma or surgery on or near your testicles?"

A client is scheduled to have a Papanicolaou test. After the nurse teaches the client about the Pap test, which statement by the client indicates successful teaching?

"I will not engage in sexual intercourse for 48 hours before the test."

The nurse is teaching a prenatal class on potential problems during pregnancy to a group of expectant parents. The risk factors for placental abruption (abruptio placentae) are discussed. Which comment validates accurate learning by the parents?

"Placental abruption is quite painful and I will need to let the doctor know if I begin to have abdominal pain."

A client at 10 weeks gestation comes to the clinic for a prenatal follow up. The client reports experiencing morning sickness. She states, "It happens at any time of the day. Is there anything I can do?" Which suggestions by the nurse would be most helpful?

"Try eating some dry crackers before you getting out of bed in the morning." "Avoid any strong food odors as much as possible." "Limit your intake of fluids when you eat your meals."

A client has undergone an abdominal hysterectomy to remove uterine fibroids (uterine myomas). Which interventions should a nurse perform as a part of the postoperative care for the client? Select all that apply.

Administer analgesics promptly and use a patient-controlled analgesia (PCA) pump. Ambulate frequently. Administer antiemetics to control nausea and vomiting.

A nurse is conducting a program about the importance of prenatal care for a group of women in a community health clinic. Which information would the nurse include when describing the purpose of prenatal care? Select all that apply.

Establish a baseline of present health. Determine the gestational age of the fetus. Monitor for fetal development and maternal well-being. Identify women at risk for complications.

A nurse is caring for a client for whom estrogen replacement therapy has been recommended for pelvic organ prolapse. Which nursing intervention is the most appropriate for the nurse to implement before the start of the therapy?

Evaluate the client to validate her risk for complications.

What findings should the nurse report to the health care provider for a postpartum client who delivered 12 hours ago? Select all that apply

Fundal height level of one fingerbreadth above the umbilicus Temperature of 101.8°F (38.8°C)

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a 4-year-old child who was delivered at 38 weeks' gestation and tells the nurse that she does have a history of spontaneous abortion (miscarriage) within the first trimester. The nurse is correct to document the history as:

G = 3, T = 1, P = 0, A = 1, L = 1

A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records?

G3 T0 P1 A1 L2

As part of the first prenatal visit, the nurse is assessing a pregnant woman's obstetrical history, which includes an 18-month-old daughter, born 2 days after her estimated date of birth; a 3-year-old son born at 35 weeks' gestation; and two lost pregnancies, one at 12 weeks and one at 21 weeks. How should the nurse document this history?

G5 T1 P2 A1 L2

The nurse is conducting the first prenatal assessment on a newly pregnant client. She shares with the nurse that she has 3 children, 2 born at full-term and one at 34 weeks' gestation. Her last pregnancy ended in a miscarriage. How should the nurse document this client's obstetrical history?

G5 T2 P1 A1 L3

An Rh-negative mother delivered an Rh-positive infant. What information would the nurse need to gather prior to administering Rho (D) immune globulin injection? Select all that apply.

Has the mother ever been sensitized to Rh-positive blood? Has the mother had any previous pregnancies? Has the mother experienced any miscarriages or abortions?

The mother of four small children comes to the clinic and has just been diagnosed with an enterocele. What should the nurse teach the client about her diagnosis?

Her small intestine and peritoneum are jutting downward between the uterus and the rectum.

A new mother delivered 1 week ago and is tearful, anxious, sad, and has no appetite. She is diagnosed with postpartum blues. What factors contribute to this problem? Select all that apply.

Hormonal changes Fatigue Discomfort Disrupted sleep patterns

A nurse is preparing for a small group discussion on pelvic organ prolapse. Which suggestions of lifestyle changes could the nurse include in the discussion?

Increase dietary fiber. Increase fluid intake.

A gravid client is talking with the nurse about the excessive nausea and vomiting she has been experiencing throughout the day. She asks why this is happening to her and what she can do to reduce the nausea. What information should be included in the nurse's response? Select all that apply.

Ingesting small frequent meals in pregnancy is helpful to manage nausea. Eating a high carbohydrate snack before getting out of bed may be helpful.

What measures can a nurse take to reduce the risk of hypoglycemia in a newborn? Select all that apply.

Initiate early and frequent breastfeeding. Dry the newborn off immediately after birth to prevent chilling. Begin skin-to-skin (kangaroo) care for the newborn.

A young woman who is pregnant for the first time goes to the clinic for her first prenatal visit. During the interview, she informs the primary care provider that there is no history of genetic defects in her or her husband's family. What test will most likely be prescribed for this client as a routine screening?

MSAFP

priority interventions for postterm infant admitted to nicu

Monitor for hematocrit levels. Assess for jaundice. Initiate blood glucose monitoring

A nurse is educating a 25-year-old client with a family history of cervical cancer. Which test should the nurse inform the client about to detect cervical cancer at an early stage?

Papanicolaou test

A 58-year-old woman is diagnosed with uterine prolapse. Which nonsurgical treatments are available for this disorder? Select all that apply.

Pessaries Estrogen replacement therapy Kegel exercises

A client at 36 weeks' gestation experiences vaginal bleeding. Which conditions might be the cause of the client's bleeding? Select all that apply.

Placenta previa Placental abruption (abruptio placentae) Bloody show

What are the probable signs of pregnancy

Positive Goodell sign Ballottement

Upon assessing the newborn's respirations, which finding would cause the nurse to notify the primary care provider?

RR of 15 bpms and nasal flaring

A multigravida client at 31 weeks' gestation is admitted with confirmed preterm labor. As the nurse continues to monitor the client now receiving magnesium sulfate, which assessment findings will the nurse prioritize and report immediately to the RN or health care provider?

Respiratory depression, hypotension, absent tendon reflexes

A female client is diagnosed with carcinoma in situ of the endometrium. The nurse interprets this as which definition?

The malignancy is localized.

A young woman has been referred for a colposcopy by the health care provider. The nurse is educating the woman on the procedure. Which information about the colposcopy should the nurse provide?

The results of the Papanicolaou test were abnormal; therefore, this procedure must be done.

If the monitor pattern of uteroplacental insufficiency were present, which action would the nurse do first?

Turn her or ask her to turn to her side.

A nurse is reviewing the obstetric history of a pregnant woman who has come to the clinic for a visit. The history reveals that the woman is "gravida 3, para 2." Which interpretation by the nurse would be appropriate?

Two previous pregnancies, two live births, and currently pregnant

Positive signs of pregnancy are diagnostic, meaning nothing else can elicit that sign except pregnancy. What is the earliest positive sign of pregnancy?

Visualization of the gestational sac or fetus

What treatments would the nurse perform in caring for a newly circumcised newborn? Select all that apply.

Wash the penis with warm water at each diaper change. Fasten the diaper loosely to prevent unnecessary friction as irritation. Explanation:

The above nurse's note was documented in the client's record by the labor room nurse. In which position was the client born?

With the occiput facing the right anterior quadrant of the pelvis

In which client would the nurse suspect cancer?

a 45-year-old with thickening in one breast with nipple irritation and retraction and a pink discharge

The nurse has just informed a client that her pregnancy test is positive and she will need further assessment to determine the complete status of the situation. Which initial emotional response does the nurse expect the client to exhibit?

ambivalence

Place the following events in the sequence the pregnant woman would experience them, from first to last. All options must be used.

amenorrhea uterine enlargement quickening Braxton Hicks contractions labor

A client who has just given birth to a healthy newborn required an episiotomy. Which action would the nurse implement immediately after birth to decrease the client's pain from the procedure?

apply an ice pack to the site

A client with preeclampsia is receiving magnesium sulfate to suppress or control seizures. Which nursing intervention should a nurse perform to determine the effectiveness of therapy?

asses dtr

Which medication will the nurse anticipate the health care provider will prescribe as treatment for an unruptured ectopic pregnancy?

assess fhr

Which action is a priority when caring for a woman during the fourth stage of labor?

assessing the uterine fundus

A nurse is assessing a preterm newborn's status based on the understanding that the newborn is at greatest risk for which complication?

atelectasis

Why is the first prenatal visit usually the longest prenatal visit?

baseline data is collected

The nurse is assisting with a birth, and the client has just delivered the placenta. Suddenly, bright red blood gushes from the vagina. The nurse recognizes that which occurrence is the most likely cause of this postpartum hemorrhage?

cervical lac

A nurse is caring for a 30-year-old woman who was just diagnosed with cervical cancer. Which psychosocial need would be the priority for the nurse with her client?

clear information on the disease, management, and treatment

A nurse prepares a woman with an abnormal Papanicolaou test result for further diagnostic evaluation. Which procedure would the nurse expect to be done?

colposcopy

maternal risk factors for fetal growth restriction

congenital malformations, infections, or placental insufficiency

The nurse notes persistent early decelerations on the fetal monitoring strip. Which action should the nurse take in this situation?

continue to monitor the fhr because this pattern is benign

The nurse cares for a pregnant client in labor and determines the fetus is in the right occiput anterior (ROA) position. Which action by the nurse is best?

continue to monitor the progress of labor

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. The nurse determines that the medication is at a therapeutic level based on which finding?

dtr 2+

what is a positive sign of pregnancy

fetal movement felt by examiner

A woman's breast examination reveals a small mass. Which characteristics would lead the nurse to suspect that the mass is malignant? Select all that apply.

hard on palpation skin dimpling painless

A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal tract, what would the nurse expect to find

hyperemic gums reports of bloating heartburn nausea

The nurse is preparing a client for an epidural block. Which intervention is a priority before the epidural anesthesia is started?

iv fluid bolus

A client is considering breast augmentation. What would the nurse recommend to the client to ensure that there are no malignancies?

mammogram

A nurse is preparing an in-service education program for a group of nurses about dystocia involving problems with the passenger. Which problem would the nurse likely include as the most common?

persistent occiput posterior position

A nurse is caring for a baby girl born at 34 weeks' gestation. Which feature should the nurse identify as those of a preterm newborn?

shiny heels and palms

While waiting for the placenta to deliver during the third stage of labor the nurse must assess the new mother's vital signs every 15 minutes. What sign would indicate impending shock?

tachycardia and a falling blood pressure

A client with advanced breast cancer who has had both chemotherapy and radiation therapy is to start endocrine therapy. Which agent would the nurse expect the client to receive?

tamoxifen

During a physical exam, the physician notates that the pregnant client has a positive Chadwick sign. What client findings would be noted for this symptom?

the vagina has a bluish purple discoloration

A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect?

vaginal ulceration

A nurse is reviewing the fetal heart rate pattern and observes abrupt decreases in FHR below the baseline, appearing as a U-shape. The nurse interprets these changes as reflecting which type of deceleration?

variable decels

A client is about 16 weeks' pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to this client's concern?

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

Following an initial prenatal visit, a woman's rubella titer results were less than 1:8. On her next visit, the woman asks what this test result means. Which is the best answer to this woman's question about her rubella titer results?

"You are susceptible to a rubella viral invasion."

When a client is counseled about the advantages of epidural anesthesia, which statement made by the counselor would indicate the need for further teaching?

"You have no trouble walking around and using the bathroom after you receive the epidural." Explanation:

A breastfeeding client presents with a temperature of 102.4°F (39°C) and a pulse of 110 bpm. She reports general fatigue and achy joints, and her left breast is engorged, red, and tender. Which instructions would the nurse anticipate being given to this client?

Continue breastfeeding on the left side, if the infant is willing to latch on. Take prescribed antibiotics until all prescribed doses are completed. If infant refuses to feed, pump the breast to maintain flow.

A nurse educator is describing the structures of the fetal heart to a pregnant client. What information would the nurse likely include in the description?

The ductus venosus connects the umbilical vein to the inferior vena cava. The ductus arteriosus connects the main pulmonary artery to the aorta. The foramen ovale is an anatomic opening between the right and left atrium.

A nurse is reviewing the maternal history and medical record of an SGA newborn. Which finding would the nurse identify as a placental factor contributing to the newborn's current state?

abnormal cord insertion

A nurse is caring for a female client in the postpartum phase. The client reports "afterpains." Which intervention should the nurse complete first?

administer pain medications

A postterm newborn develops perinatal asphyxia. The nurse understands that this condition is most likely the result of:

aging placenta

A client at 32 weeks' gestation has been admitted to the labor and birth unit with preterm labor. Which medication would the nurse be likely to administer to reduce the risk of complications in the preterm newborn?

corticosteroids

A nurse is assigned to care for a client experiencing early postpartum hemorrhage. The nurse is required to administer the prescribed methylergonovine maleate intramuscularly to the client. Which condition would the nurse identify as necessitating the cautious administration of this drug?

cv disease

A nurse is reviewing the physical exam findings of a woman who has come to the clinic with reports of feeling a dragging sensation in her vagina. The exam reveals the posterior bladder wall protruding into the anterior vaginal wall. The nurse interprets this finding as indicative of which condition?

cystocele

A home health care nurse is visiting a pregnant client with preeclampsia who is being managed at home. The nurse is reviewing the situations for which the client should contact the nurse. The nurse determines that the client demonstrates understanding when identifying which situation(s) as needing to be reported? Select all that apply.

dizziness blurred vision excessive heartburn

A nurse is making a home visit to a postpartum woman who gave birth to a healthy newborn 4 days ago. The woman's breasts are swollen, hard, and tender to the touch. The nurse documents this finding as:

engorgement

A client receives an epidural anesthetic. Which medication would the nurse anticipate the primary care provider will prescribe if the client develops moderate hypotension?

ephedrine

The nurse is required to assess a client for HELLP syndrome. Which are the signs and symptoms of this condition? Select all that apply.

epigastric pain upper right quadrant pain hyperbilirubinemia

A nurse is conducting an in-service program for a group of staff nurses working at the women's health center. After teaching the group about genital fistulas, the nurse determines that the teaching was successful when the group identifies which as a major cause of genital fistula

female genital cutting

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor?

fetal heart rate declining late with contractions and remaining depressed

When preparing a presentation for a group of pregnant women about fetal circulation, the nurse would point out which structure is primarily responsible for ensuring that highly oxygenated blood reaches the fetal brain?

foramen ovale

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.

fundal height measurement membrane status contraction pattern

A pregnant client tells the nurse that she has a 2-year-old child at home who was born at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at 34 weeks. Which documentation would be appropriate for the nurse?

gravida 4, para 2

When planning the care for a client during the first 24 hours postpartum, the nurse expects to monitor the client's pulse and blood pressure frequently based on the understanding that the client is at risk for which condition?

hemorrhage

A nurse is reviewing the medical record of a postpartum client. The nurse identifies that the woman is at risk for a postpartum infection based on which information? Select all that apply.

history of diabetes hemoglobin level 10 g/dL (100 g/L) placenta requiring manual extraction

The nurse develops a teaching plan for a postpartum client and includes teaching about how to perform pelvic floor muscle training or Kegel exercises. The nurse includes this information for which reason?

improve pelvic floor tone

A nurse is teaching a postpartum client how to do muscle-clenching exercises for the perineum. The client asks the nurse, "Why do I need to do these exercises?" Which reason would the nurse most likely incorporate into the response?

improves pelvic floor tone

A nurse working on the postpartum floor is mentoring a new graduate and instructs the new nurse to make sure that clients empty their bladders. A full bladder can lead to which complication?

increased lochia drainage

A nurse sees a pregnant client at the clinic. The client is close to her due date. During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility?

increased risk of infection

A nurse is preparing a presentation about cervical cancer for a local woman's group. Which risk factor for the development of cervical cancer would the nurse include?

infection with hpv

A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program?

inspecting the placenta

The nurse is developing a teaching plan for a client who has decided to bottle-feed her newborn. Which information would the nurse include in the teaching plan to facilitate suppression of lactation?

instructing her to apply ice packs to both breasts every other hour

A nurse is caring for a newborn with hypoglycemia. For which symptoms of hypoglycemia should the nurse monitor the newborn? Select all that apply.

lethargy cyanosis jitteriness

The nurse is preparing the plan of care for a woman hospitalized for hyperemesis gravidarum. Which interventions would the nurse most likely include? Select all that apply.

maintaining NPO status for the first day or two administering antiemetic agents obtaining baseline blood electrolyte levels monitoring intake and output

When assessing a woman, the nurse would suspect cervical cancer because of which findings? Select all that apply.

malodorous vaginal discharge dysuria vaginal bleeding after sexual intercourse

A neonate is being admitted to the observational nursery with the diagnosis of postmaturity. What would the nurse expect to find with this gestational age variation?

meconium-stained skin and fingernails thin umbilical cord peeling, wrinkled skin

A perinatal nurse is providing care for a large for gestational age neonate admitted to the observational unit after a complicated vaginal birth resulting in shoulder dystocia. Which assessment would be a priority for the nurse to perform?

moro assessmnet

A nurse is conducting a review course on tocolytic therapy for perinatal nurses. After teaching the group, the nurse determines that the teaching was successful when they identify which drugs as being used for tocolysis? Select all that apply.

nifedipine magnesium sulfate indomethacin

A woman has just given birth to a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify what findings as normal? Select all that apply.

one vein two arteries

The nurse is meeting with a 36-year-old client who wishes to begin using contraceptives. The client reports being in a long-term, monogamous relationship, runs 2 miles per day, and smokes a pack of cigarettes each day. Which method will the nurse be least likely to suggest to the client?

oral contraceptive pills

when attempting to resuscitate a preterm newborn, the nurse would

place the newborn's head in a neutral position

nurse is providing care to a multiparous client. The client has a history of cesarean births. The nurse anticipates the need to closely monitor the client for which condition?

placenta accreda

The nurse is assessing a client who believes she is pregnant. The nurse points out a more definitive assessment is necessary due to which sign being considered a probable sign of pregnancy?

positive pregnancy test

A nurse is preparing a client for rhythm strip testing. She places the woman into a semi-Fowler position. What is the appropriate rationale for this measure?

prevent supine hypotension syndrome

A nurse is reviewing the medical record of a pregnant client. The nurse suspects that the client may be at risk for dystocia based on which factors? Select all that apply.

short maternal stature Body mass index 30.2 breech fetal presentation

A nurse is conducting a class for a group of nurses who are newly hired for the labor and birth unit. After teaching the group about fetal heart rate patterns, the nurse determines the need for additional teaching when the group identifies which finding as indicating normal fetal acid-base status? Select all that apply.

sinusoidal pattern recurrent variable decelerations fetal bradycardia

A nurse is working as part of a group of health care providers implementing a community health initiative for primary prevention of cervical cancer. The nurse would focus educational efforts on which areas? Select all that apply.

steps to prevent sexually transmitted infections (STIs) consistent use of barrier contraceptives immunization with the human papillomavirus (HPV) vaccine

A woman receiving an oxytocin infusion for labor induction develops contractions that occur every minute and last 75 seconds. Uterine resting tone remains at 20 mm Hg. Which action would be most appropriate?

stop the infusion immediately

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 expect the client to receive?

tamoxifen

When reviewing the history of a woman diagnosed with endometrial cancer, the nurse would identify which factor as increasing the woman's risk?

tamoxifen

The nurse-midwife is performing a pelvic examination on a client who came to her following a positive home pregnancy test. The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell sign.

the cervix softens

The nurse is assessing a post-term newborn. Which finding would the nurse be least likely to assess?

thick umbilical cord

A client has just given birth to a healthy baby boy, but the placenta has not yet delivered. What stage of labor does this scenario represent?

third

A group of nursing students are analyzing the fetal circulation. After the session, the students correctly point out which fetal structure contains the highest concentration of oxygen?

umbilical vein

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?

uterine atony

A nurse is caring for a client who has had a cesarean birth with general anesthesia. The nurse would assess the woman closely for which possible complication?

uterine atony

A nurse is reviewing a journal article on the causes of postpartum hemorrhage. Which condition would the nurse most likely find as the most common cause?

uterine atony

Which factor in a client's history would alert the nurse to an increased risk for postpartum hemorrhage?

uterine atony, placenta previa, operative procedures

A nurse is preparing to teach a class to pregnant women about the signs of preterm labor and what to do if these occur. Which signs of preterm labor should the nurse include in the presentation? Select all that apply.

uterine contractions, cramping, low back pain feeling of pelvic pressure or fullness increase in vaginal discharge nausea, vomiting, and diarrhea leaking of fluid from the vagina

A postpartum woman is experiencing subinvolution. When reviewing the client's history for factors that might contribute to this condition, which factors would the nurse identify? Select all that apply.

uterine infection prolonged labor hydramnios

The nursing student exhibits an understanding of pelvic organ prolapse (POP) when she correctly identifies which factors as contributing to its development?

vaginal birth obesity lifting chronic cough estrogen deficiency

As part of an in-service program to a group of home health care nurses who care for postpartum women, a nurse is describing postpartum depression. The nurse determines that the teaching was successful when the group identifies that this condition becomes evident at which time after birth of the newborn?

within the first 6 weeks

As part of a presentation on breast cancer being given to a local woman's group, the nurse describes the need for early detection through screening. Applying the guidelines from the American Cancer Society, the nurse would emphasize which recommendation?

yearly mammograms for women starting at age 40

A nurse is making an initial call on a new mother who gave birth to her third baby 5 days ago. The woman says, "I just feel so down this time. Not at all like when I had my other babies. And this one just doesn't sleep. I feel so inadequate." What is the best response to this new mother?

"It sounds like you have the 'baby blues.' They are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the birth. They will most likely go away in a day or two."

The nurse is caring for a 52-year-old woman whose sisters and mother died of breast cancer. The client states, "My doctor wants me to take tamoxifen to help prevent breast cancer. What do you think?" What would be the nurse's best response?

"Tamoxifen reduces the incidence."

A nursing instructor is teaching about changes the newborn must make to survive outside of the uterus. The instructor realizes that further teaching is needed when a student makes which statement?

"The baby takes the first breath when ready to leave the uterus."

A client is seen in the clinic requesting an emergency postcoital contraception pill levonorgestrel (Plan B). The client states that she had unprotected sex 3 ½ days ago. What is the most appropriate response by the nurse?

"Unfortunately you are past the time frame to take that prescription."

Assessment of a woman in labor reveals that the fetus is in a cephalic presentation and engagement has occurred. The nurse interprets this finding to indicate that the presenting part is at which station?

0

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

1000 ml

A nurse is conducting a class for a local woman's group about recommendations for a Papanicolaou test. One of the participants asks, "At what age should a woman have her first test?" The nurse responds by stating that a woman should have her first Pap smear

21

A nurse is preparing a presentation for a health fair at a local college. The nurse is creating a poster to emphasize the need for cervical cancer screening. The nurse would list which age to begin screening?

21 years

The nurse is caring for a client who has given birth to twins. During which time period would the nurse instruct on the possibility of a late postpartum hemorrhage?

25 hrs to 12 weeks

The nurse is assessing the respirations of several newborns. The nurse would notify the health care provider for the newborn with which respiratory rate at rest?

68 breaths/min

Which assessment findings indicate a distressed fetus? Select all that apply.

Absent accelerations Late deceleration patterns Persistent bradycardia

Rho(D) immune globulin is administered to which clients?

An Rh-negative woman who had a spontaneous abortion (miscarriage) yesterday An Rh-negative woman following an ectopic pregnancy A Rh negative woman who gives birth at 32 weeks gestation to a baby with A+ blood

A small-for-gestational age infant is admitted to the observational care unit with the nursing diagnosis of ineffective thermoregulation related to lack of fat stores as evidenced by persistent low temperatures. Which are appropriate nursing interventions? Select all that apply. You Selected:

Assess the axillary temperature every hour. Review maternal history. Assess environment for sources of heat loss. Encourage skin-to-skin contact.

When preparing for a class on breast cancer, the nurse should explain which nonmodifiable risk factors? Select all that apply.

BRCA1 gene menarche at age 11 being a 52-year-old female

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?

Bring the client's knees back toward the shoulders, causing hyperflexion of the hips and rotation of the pubic symphysis

A 22-year-old woman experiencing homelessness arrives at a walk-in clinic seeking pregnancy confirmation. The nurse notes on assessment her uterus suggests 12 weeks' gestation, a blood pressure of 110/70 mm Hg, and a BMI of 17.5. The client admits to using cocaine a few times. The client has been pregnant before and indicates she "loses them early." What characteristic(s) place the client in the high-risk pregnancy category? Select all that apply.

BMI 17.5 prenatal history homelessness prenatal care

cancer and ways to prevent it. Which information should the nurse provide?

Encourage cessation of smoking and drinking. Encourage prevention of sexually transmitted infections (STIs) to reduce risk factors. Counsel teenagers to avoid early sexual activity.

The parents of a neonate born at 32 weeks' gestation ask about the purpose of the surfactant being given to the baby. What is the best response by the nurse?

Helps the lungs remain expanded after the initiation of breathing

A nurse is performing an assessment on a female client who gave birth 24 hours ago. On assessment, the nurse finds that the fundus is 2 cm above the umbilicus and boggy. Which intervention is a priority?

Have the client void, and then massage the fundus until it is firm

A nurse is reviewing the history of a woman diagnosed with pelvic organ prolapse. Which factor in the woman's history would the nurse identify as increasing the woman's risk for this condition? Select all that apply.

Delivery of first child at age 18 years Hysterectomy 3 years ago History of four term pregnancies

a client reports bright red, painless vaginal bleeding during her 32nd week of pregnancy. A sonogram reveals that the placenta has implanted low in the uterus and is partially covering the cervical os. Which immediate care measures are initiated? Select all that apply.

Determine the time the bleeding began and about how much blood has been lost. Obtain baseline vital signs and compare to those vital signs previously obtained. Attach external monitoring equipment to record fetal heart sounds and kick counts

A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs).

ECs are birth control pills in higher, more frequent doses. ECs are not to be used in place of regular birth control. ECs provide little protection for future pregnancies.

A client presents at the clinic and is interested in obtaining emergency contraception (EC). The nurse explains that EC must be used within 72 hours of unprotected sex to be effective. This is because:

ECs simply prevent embryo creation and uterine implantation from occurring in the first place

A nurse is developing the plan of care for a small-for-gestational-age newborn. Which action would the nurse determine as a priority?

Preventing hypoglycemia with early feedings

A client is waiting for the results of an endometrial biopsy for suspected endometrial cancer. She wants to know more about endometrial cancer and asks the nurse about the available treatment options. Which treatment information should the nurse give the client?

Surgery involves removal of the uterus, fallopian tubes, and ovaries; adjuvant therapy is used if relevant.

A nurse is caring for the client who gave birth a week ago. The client informs the nurse that she experiences painful uterine contractions when breastfeeding the baby. Which should the nurse do next?

Tell the client to take an NSAID orally.

The nurse has completed assessing the vital signs of several clients who are from 36 to 48 hours postpartum. For which set of vital signs should the nurse prioritize for interaction?

Temp: 98.6° F (37° C), HR 74, RR 16, BP 150/85

Which client should the postpartum nurse assess first after receiving shift report?

The 2-day postpartum client who has a blood pressure of 138/90 mm Hg.

During the fourth stage of labor, which mother typically experiences the strongest afterpains?

a multipara who is breastfeedings

A woman's amniotic fluid is noted to be cloudy. The nurse interprets this finding as:

a possible infection

A nurse practitioner is performing a clinical breast exam and notes a mass. Which findings would lead the nurse practitioner to suspect that the mass is benign?

absence of nipple retraction firmness on palpation clearly delineated margins

A 36-year-old was diagnosed with uterine fibroids (uterine myomas). The nurse teaches the client to expect which clinical manifestation?

abnormal uterine bleeding

Disseminated intravascular coagulation is a life-threatening condition that the nurse recognizes can occur as a complication secondary to which primary conditions? Select all that apply.

abruptio placentae severe preeclampsia septicemia

Which assessment findings, experienced by the client at 36 weeks' gestation, would the nurse document as diagnostic signs of severe preeclampsia? Select all that apply.

bp 164/11 elevated liver enzymes +1 proteinuria elevated serum creat

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy

breast changes morning sickness amenorrhea

A pregnant woman notices that sometimes her heartbeat is irregular when she is lying down resting on her back. The provider suspects she is experiencing low blood pressure. Which intervention would the health care provider suggest to the woman to prevent this from occurring? Select all that apply.

change positions slowly and try sleeping and resting on your side with a small pillow in between your legs

A nurse receives the shift report on four infants. Baby A is 16 hours old, HR 117, RR 32, axillary temperature 98oF (36.6oC), BP 72/43 mm Hg, bilirubin 3.5 mg/dL rooming in with mother Baby B is 8 hours old, HR 152, RR 48, axillary temperature 97.7oF (36.5oC), BP 60/40 mm Hg, bilirubin 3 mg/dL, returning to nursery for night Baby C is 19 hours old, HR 140, RR 45, axillary temperature 98.6oF (37oC), BP 68/45 mm Hg, bilirubin 4 mg/dL, rooming in with mother Baby D is 4 hours old, HR 160, RR 60, axillary temperature 98.6oF (37oC), BP 80/45 mm Hg, bilirubin 2 mg/dL, returning to nursery for night. Which baby would the nurse assess first?

baby c

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:

birth is unlikely within the 2 next weeks.

A client has presented to the clinic reporting "things not feeling right down there." After discussing the situation with her, the nurse has identified which factors that suggest the woman has a high risk for pelvic organ prolapse? Select all that apply.

birth trauma straining with chronic constipation obesity

Prior to infusing medication into an epidural catheter inserted into a laboring mother, which vital sign is a priority?

blood pressure

The nurse is assessing a 52-year-old perimenopausal female who is concerned about the changes occurring in her body. When questioned about the most serious changes, which effect should the nurse point out?

bone mineral density decreases

A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. What would the nurse do next?

check fhr

A woman is experiencing dystocia that appears related to psyche problems. Which intervention would be most appropriate for the nurse initiate?

comfortable environment with dim lighting

After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against sexually transmitted infections (STIs)?

condoms

A nurse is caring for a woman who has just been diagnosed with cervical carcinoma in situ. The nurse should prepare the women for which treatment?

cervical conization with follow-up Papanicolaou test and colposcopy

A nurse is assessing a term neonate and notes transient tachypnea. When reviewing the mother's history, which conditions would the nurse most likely find as contributing to this finding? Select all that apply.

cesarean birth use of heavy sedation during labor

A nurse suspects that a pregnant client may be experiencing a placental abruption (abruptio placentae) based on assessment of which finding? Select all that apply.

dark red vaginal bleeding rigid uterus absent fetal heart tones

The nurse has just administered morphine 2 mg IV to a laboring client. Which change in the fetal heart rate pattern would the nurse prioritize?

decreased variability

A client with breast cancer is receiving tamoxifen. After teaching the client about this drug, the nurse determines that the teaching was successful when the client identifies that she is at increased risk for which conditions? Select all that apply.

deep vein thrombosis hot flashes cataract

A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client?

diminished reflexes

The nurse is planning to speak at a local community center to a group of middle-aged women about osteoporosis. Which measure would the nurse be sure to include as effective in reducing the risk for osteoporosis?

engaging in daily weight-bearing exercise

A nurse is assigned to educate a group of women on cancer awareness. Which risk factors for breast cancer are modifiable? Select all that apply.

failing to breastfeed for up to a year after pregnancy postmenopausal use of estrogen and progestins not having children until after age 30

a nurse is preparing a presentation about changes in the various body systems during the postpartum period and their effects for a group of new mothers. The nurse explains which event as influencing a postpartum woman's ability to void? Select all that apply.

generalized swelling of the perineum decreased bladder tone from regional anesthesia use of oxytocin to augment labor

A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements?

gestational htn

A nurse is documenting the obstetric history for a pregnant woman who has previously given birth to two infants at term and had one abortion at 12 weeks' gestation. How would the nurse document this information?

gravida 4, para 2

A nurse is meeting with a group of pregnant clients who are in their last trimester to teach them the signs that may indicate they are going into labor. The nurse determines the session is successful after the clients correctly choose which signs as an indication of starting labor? Select all that apply.

lightening bloody show backache

A client is entering her 42nd week of gestation and is being prepared for induction of labor. The nurse recognizes that the fetus is at risk for which condition?

macrosomia

The nurse who works at the local health department is preparing to give a talk on post-term pregnancies. She wants to include the fetal risks. Which risks should she include? Select all that apply

macrosomia shoulder dystocia brachial plexus injuries cephalopelvic disproportion

A primary care provider prescribes intravenous tocolytic therapy for a woman in preterm labor. Which agent would the nurse expect to administer?

mag sulfate

When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage because:

measurements may not change until after blood loss is large

Which medication will the nurse anticipate the health care provider will prescribe as treatment for an unruptured ectopic pregnancy?

methotrexate

A woman who is pregnant for the first time has arrived to the labor department thinking she was in labor only to be diagnosed with Braxton Hicks contractions and sent home. Prior to leaving the unit, the woman asks, "How will I know when it is 'true' labor?" Which signs/symptoms should the woman associate with true labor? Select all that apply.

pain in back that wraps across the abdomen and increases in frequency and intensity pink-tinged blood and mucus mixture on underwear sudden gush of clear fluid coming from the vagina

A nurse is caring for a client who gave birth vaginally 2 hours ago. What postpartum complication can the nurse assess within the first few hours following birth?

pp hemorrhage

A nurse is conducting a presentation for a local women's group about pelvic organ prolapse. When describing the different types, which information would the nurse incorporate into the description of a cystocele?

protrusion of the bladder wall through the anterior vaginal wall

The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 12 breaths/min, BP 148/110 mm Hg. What other priority physical assessments by the nurse should be implemented to assess for potential toxicity?

reflexes

A client has an abnormal Papanicolaou test result that is classified as ASC-US. Based on the nurse's understanding of this classification, the nurse would expect which procedure?

repeat Papanicolaou test in 4 to 6 months

A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which effect?

respiratory depression

A client at 37 weeks' gestation presents to the emergency department with a BP 150/108 mm Hg, 1+ pedal edema, 1+ proteinuria, and normal deep tendon reflexes. Which assessment should the nurse prioritize as the client is administered magnesium sulfate IV?

respiratory rate

Prior to discharging a 24-hour-old newborn, the nurse assesses the newborn's respiratory status. What would the nurse expect to assess?

respiratory rate 45 breaths/minute, irregular

A pregnant client is admitted to a maternity clinic after experiencing contractions. The assigned nurse observes that the client experiences pauses between contractions. The nurse knows that which event marks the importance of the pauses between contractions during labor?

restoration of blood flow to uterus and placenta