OB Quiz #5 (Chapters 20 & 21)

A. in utero transmission

Cytomegalovirus infection can result in different congenital anomalies. It can also be transmitted via different routes. When discussing this infection with a pregnant woman, the nurse integrates understanding that permanent fetal disability can occur with which type of transmission of CMV? A. in utero transmission B. during birth transmission C. after birth transmission D. with any transmission

B. pain relief measures

The fetus of a client in labor is determined to be in a persistent occiput posterior position. Which intervention will the nurse prioritize? A. side-lying position B. pain relief measures C. immediate cesarean birth D. oxytocin administration

A. microcephaly

A pregnant client has tested positive for cytomegalovirus. What can this cause in the newborn? A. microcephaly B. bicuspid valve stenosis C. hypertension D. clubbed fingers and toesmic

A. complications of a post-term pregnancy

A pregnant woman comes to the birthing center, stating she is in labor and does not know far along her pregnancy is because she has not had prenatal care. A primary care provider performs an ultrasound that indicates oligohydramnios. When the client's membranes rupture, meconium is in the amniotic fluid. What does the nurse suspect may be occurring with this client? A. complications of a post-term pregnancy B. complications of preterm labor C. complications of placenta previa D. placental abruption (abruptio placentae)

C. toxoplasmosis

A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection? A. cytomegalovirus B. parvovirus B19 C. toxoplasmosis D. herpes simplex virus

A. Perform a hearing screen test.

The nurse is caring for a 2-day-old newborn whose mother was diagnosed with cytomegalovirus during the first trimester. On which health care provider prescription should the nurse place the priority? A. Perform a hearing screen test. B. Obtain a urine specimen. C. Monitor growth and development. D. Assess pulse rate.

A. Late decelerations

The nurse is caring for a client suspected to have a uterine rupture. The nurse predicts the fetal monitor will exhibit which pattern if this is true? A. Late decelerations B. Early decelerations C. Variable decelerations D. Mild decelerations

C. IV fluids

A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize? A. antihypertensive drugs B. diuretic drugs C. IV fluids D. antibiotics

B. tocolytic therapy

A young woman experiencing contractions arrives at the emergency department. After examining her, the nurse learns that the client is at 33 weeks' gestation. What treatment can the nurse expect this client to be prescribed? A. bronchodilators B. tocolytic therapy C. muscle relaxants D. anti-anxiety therapy

A. magnesium sulfate B. atosiban C. indomethacin D. nifedipine

A nursing student doing a rotation in labor and birth correctly identifies which medications as most commonly used for tocolysis? Select all that apply. A. magnesium sulfate B. atosiban C. indomethacin D. nifedipine E. nitroglycerin

A. variable deceleration pattern

A woman in active labor has just had her membranes ruptured to speed up labor. The nurse is concerned the woman is experiencing a prolapse of the umbilical cord when the nurse notices which pattern on the fetal heart monitor? A. variable deceleration pattern B. fetal heart rate (FHR) increase to 200 beats/min C. early deceleration with each contraction D. late deceleration with late recovery following contraction

A. "Maybe dimming the lights or some soft music will help you relax a bit." C. "I will keep you updated often on how you and your baby are doing." D. "Things are moving along but sometimes it can take a little longer."

A pregnant client's labor has been progressing slower than normal. The client is visibly anxious and tense, telling the nurse, "I am so worried about what is going to happen. And I am so tired and feel so helpless." Other underlying issues that may be contributing to the client's slow labor progress have been ruled out. Which response(s) by the nurse would be appropriate? Select all that apply. A. "Maybe dimming the lights or some soft music will help you relax a bit." B. "Let me leave you alone for a little while so you can get some rest." C. "I will keep you updated often on how you and your baby are doing." D. "Things are moving along but sometimes it can take a little longer." E. "I will have to stop giving you pain medicine because it is slowing your labor."

B. "Pregnancy taxes the circulatory system of every woman."

A pregnant woman who has had cardiovascular disease for the last 3 years asks the nurse why this disorder makes her pregnancy an "at-risk" pregnancy. What is the nurse's best response? A. "The fact that you are receiving prenatal care will help." B. "Pregnancy taxes the circulatory system of every woman." C. "Don't worry. You have an excellent primary care provider." D. "Our facility has a lot of experience in dealing with this."

B. high-pitched shrill cry C. almost constant sneezing D. nasal stuffiness E. poor sucking reflex

A woman at 38 weeks' gestation with a history of heroin use disorder has given birth to a newborn several hours ago. Upon assessment, the nurse determines that the newborn is experiencing withdrawal based on which findings? Select all that apply. A. flaccid extremities B. high-pitched shrill cry C. almost constant sneezing D. nasal stuffiness E. poor sucking reflex

C. 6.5%

A pregnant woman with diabetes is having her hemoglobin (glycosylated) level evaluated. The nurse determines that the woman's glucose is under control and continues the woman's plan of care based on which result? A. 8.5% B. 8.0% C. 6.5% D. 7.5%

A. the viral load

A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth? A. the viral load B. amniocentesis results at 34 weeks' gestation C. the mother's age D. prophylactic antiretroviral therapy (ART) to the infant at birth

A. Apply oxygen mask and start oxygen at 10 L/min. B. Begin CPR immediately.

A woman in active labor suddenly sits up, clutches her chest, screams with pain, and then collapses back on the bed. The RN notes she is unconscious and a bluish-gray color. Which interventions are considered the priority for the nurse to implement? Select all that apply. A. Apply oxygen mask and start oxygen at 10 L/min. B. Begin CPR immediately. C. Place stethoscope on the abdomen to verify fetal heart rate. D. Start oxytocin at 4 mu/min and titrate upward every 5 minutes. E. Call lab and request 4 units of whole blood stat.

A. raisins D. broccoli E. peanut butter

The nurse is teaching a pregnant woman with iron deficiency anemia about foods high in iron. Which foods if selected by the woman indicate a successful teaching program? Select all that apply. A. raisins B. potatoes C. corn D. broccoli E. peanut butter F. yogurt

C. client who has a prolonged pregnancy E. client with hypertension

Which clients should the nurse monitor for fetal demise? Select all that apply. A. client with hydramnios B. client with multifetal gestation C. client who has a prolonged pregnancy D. client whose fetus is displaying malpresentation E. client with hypertension

D. contractions most forceful in the middle of uterus rather than the fundus

Which finding would lead the nurse to suspect that the fetus of a woman in labor is in hypertonic uterine dysfunction? A. lack of cervical dilation past 2 cm B. fetal buttocks as the presenting part C. reports of severe back pain D. contractions most forceful in the middle of uterus rather than the fundus

C. preterm birth

Which should the nurse identify as a risk associated with anemia during pregnancy? A. newborn with heart problems B. fetal asphyxia C. preterm birth D. newborn with an enlarged liver

D. formula

The nurse is preparing a postpartum nursing care plan for a single HIV-positive primigravida client. The nurse should prioritize in the plan how to acquire which resource? A. breast pump B. diapers C. car seat D. formula

D. type 1 diabetes

Which factor would contribute to a high-risk pregnancy? A. blood type O positive B. first pregnancy at age 33 C. history of allergy to honey bee pollen D. type 1 diabetes

B. semi-Fowler position D. squatting position

A multipara woman is experiencing a prolonged descent while trying to rest and increase her fluid intake. The nurse suggests that she change position. Which position(s) will be effective for pushing to speed up the descent? Select all that apply. A. supine with knees pulled up to chest B. semi-Fowler position C. lithotomy position D. squatting position E. standing, leaning against a door frame

A. fatigue B. night sweats C. hemoptysis D. anorexia

A woman who immigrated here from a third world country presents to the clinic to find out if she is pregnant. Which signs and/or symptoms would the nurse assess as possible indicators that she might have an active case of tuberculosis as well? Select all that apply. A. fatigue B. night sweats C. hemoptysis D. anorexia E. weight gain

D. newborn with respiratory disorder

The nurse is caring for a pregnant client with diabetes mellitus. For which potential fetal complication(s) should the nurse monitor the client as the client presents for their scheduled prenatal visits? Select all that apply. congenital malformations in newborn A. newborn with macrosomia B. newborn with juvenile diabetes C. small-for-gestational-age newborn D. newborn with respiratory disorder

B. Check perineal area frequently for bleeding.

A client arrives in the labor and delivery unit in the beginning early phase with the contractions 5 to 8 minutes apart and dilated 1 cm. Thirty minutes later the nurse finds the client in hard, active labor and 8 cm dilated. The nurse calls for assistance, prepares for a precipitate birth, and monitors the client for which priority assessment caused by a rapid birth? A. Assess bladder for fullness. B. Check perineal area frequently for bleeding. C. Assess the client's breathing and intervene if necessary. D. Assess and administer pain medication as needed.

A. The uterine contractions may or may not be regular, but the quantity or quality or strength is insufficient to dilate the cervix.

A client has been admitted to the birthing suite in labor. She has been in labor for 12 hours and is dilated to 4 cm. The primary care provider notes that the client is in hypotonic labor. What does this mean? A. The uterine contractions may or may not be regular, but the quantity or quality or strength is insufficient to dilate the cervix. B. The uterine contractions are irregular, but the quantity or quality or strength is insufficient to dilate the cervix. C. The uterine contractions are regular, but the quantity or quality or strength is insufficient to dilate the cervix. D. The uterine contractions may or may not be regular, but the quantity or quality or strength is sufficient to dilate the cervix.

A. 2 to 7 days

A client is admitted to the unit in preterm labor. In preparing the client for tocolytic drug therapy, the nurse anticipates that the client's pregnancy may be prolonged for how long when this therapy is used? A. 2 to 7 days B. 1 to 5 days C. 6 to 10 days D. 4 to 8 days

A. Ask the client to decrease her intake of salicylates.

A client with rheumatoid arthritis (RA) is in week 38 of her pregnancy. Which intervention should the nurse make with this client? A. Ask the client to decrease her intake of salicylates. B. Urge the client to be on bed rest. C. Advise the client to continue her normal dosage of methotrexate. D. Perform the Snellen eye test.

A. Assess fetal heart sounds.

A client's membranes have just ruptured. Her fetus is presenting breech. Which action should the nurse do immediately to rule out prolapse of the umbilical cord in this client? A. Assess fetal heart sounds. B. Place the woman in Trendelenburg position. C. Administer oxygen at 10 L/min by face mask. D. Administer amnioinfusion.

A. Decreased fetal oxygenation

A client's membranes rupture. The nurse observes the fetal heart rate drop from 156 to 110. The nurse inspects the client's perineum and sees a loop of umbilical cord. What is the nurse's priority concern in this situation? A. Decreased fetal oxygenation B. Increased risk for infection C. Increased risk for placental abruption D. Decreased strength of uterine contractions

A. history of previous preterm birth B. current multiple gestation pregnancy D. uterine or cervical abnormalities

A primigravida at 28 weeks' gestation comes to the clinic for a checkup. She tells the nurse that her mother gave birth to both of her children prematurely, and she is afraid that the same will happen to her. Which risk factors associated with preterm birth would the nurse discuss with the client? Select all that apply. A. history of previous preterm birth B. current multiple gestation pregnancy C. large-for-gestational-age fetus D. uterine or cervical abnormalities E. previous cesarean birth

A. bleeding tendencies to the point of hemorrhage C. maternal postpartal infection

A woman has been in active labor for over 20 hours, and the nurses are discussing this case with the health care provider. The nurses know to assess this woman for which potential complication from a prolonged labor? Select all that apply. A. bleeding tendencies to the point of hemorrhage B. premature rupture of membranes C. maternal postpartal infection D. exhaustion E. exaggerated pain

A. Maintain a daily blood glucose log

The nurse is preparing information for a client who has just been diagnosed with gestational diabetes. Which instruction should the nurse prioritize in this information? A. Maintain a daily blood glucose log B. Report any signs of possible urinary tract infection C. Plan daily menus with dietitian D. Long-term therapy goals

B. stressing the positive benefits of a healthy lifestyle

What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension? A. stressing the avoidance of dairy products B. stressing the positive benefits of a healthy lifestyle C. stressing the increased use of Vitamin D supplements D. stressing regular walks and exercise

A. Apply downward pressure just above the pubic bone. B. Apply pressure between contractions. C. Apply pressure at an angle toward the face of the fetus.

Which action(s) will the nurse take when asked to apply suprapubic pressure during a birth with shoulder dystocia? Select all that apply. A. Apply downward pressure just above the pubic bone. B. Apply pressure between contractions. C. Apply pressure at an angle toward the face of the fetus. D. Apply pressure with the contractions. E. Apply downward pressure on the fundus of the uterus.

D. less effective than normal

Which change in insulin is most likely to occur in a woman during pregnancy? A. enhanced secretion from normal B. not released because of pressure on the pancreas C. unavailable because it is used by the fetus D. less effective than normal

A. Drink orange juice with the iron supplement. B. Increase intake of dried beans and green leafy vegetables. C. Cook food in an iron skillet, if possible.

The nurse is doing meal planning with a pregnant woman with iron-deficiency anemia. What dietary recommendations would the nurse make to enhance the woman's intake of iron? Select all that apply. A. Drink orange juice with the iron supplement. B. Increase intake of dried beans and green leafy vegetables. C. Cook food in an iron skillet, if possible. D. Limit intake of dried fruits, eating only fresh fruit. E. Since fortified cereals are a poor source of iron, eat eggs or pancakes for breakfast.

A. CBC B. U/A C. amniotic fluid analysis

A nurse preceptor asks a student to list commonly used diagnostic tests for preterm labor risk assessment. Which tests should the student include? Select all that apply. A. CBC B. U/A C. amniotic fluid analysis D. thyroid level E. arterial blood gases

A. low socioeconomic status B. smoking D. high level of stress E. alcohol use

A nursing instructor teaching about risk factors associated with preterm labor should discuss which demographic and lifestyle issues? Select all that apply. A. low socioeconomic status B. smoking C. infection D. high level of stress E. alcohol use F. Hypertension

A. Assist with maneuvers. B. Keep time. C. Document events in the record. D. Lower the head of the bed.

During a shoulder dystocia emergency, what action(s) does the nurse implement to prevent fetal hypoxia? Select all that apply. A. Assist with maneuvers. B. Keep time. C. Document events in the record. D. Lower the head of the bed. E. Administer oxytocin to increase the contractions.

A. presentation B. position D. fetal development

The nursing student doing a rotation in obstetrics is talking to her preceptor about dystocia. She asks what is meant by the term "expulsive forces," better known as the "powers." The preceptor correctly tells her that the "powers" include which factors? Select all that apply. A. presentation B. position C. mother's age D. fetal development E. analgesia

C. Get at least 8 hours sleep each night.

A woman in her 20s has a long history of sickle cell anemia and is 18 weeks' pregnant. What precautions would the nurse recommend the woman take to minimize the chance of experiencing a sickle cell crisis? A. Keep the home temperature around 70°F (21°C) to lessen the heart's workload. B. Notify the health care provider immediately if she develops any jaundice. C. Get at least 8 hours sleep each night. D. If she is feeling well, she needs to come to the office once a month until she is in her third trimester.

C. Occiput posterior position

A 26-year-old primigravida has brought her doula to the birthing center for support during her labor and birth. The doula has been helping her through the past 16 hours of labor. The laboring woman is now 6 cm dilated. She continues to report severe pain in her back with each contraction. The client finds it comforting when her doula uses the ball of her hand to put counterpressure on her lower back. What is the likely cause of the woman's back pain? A. Breech presentation B. Fetal macrosomia C. Occiput posterior position D. Nongynecoid pelvis

C. placental abnormalities

A 40-year-old woman comes to the clinic reporting having missed her period for two months. A pregnancy test is positive. What is she and her fetus at increased risk for? A. type 2 diabetes mellitus B. type 1 diabetes mellitus C. placental abnormalities D. postterm birth

C. Exercise

A G2P1 woman with type 1 diabetes is determined to be at 8 weeks' gestation by her health care provider. The nurse should point out which factor will help the client maintain glycemic control? A. Vitamin supplements B. Oral hypoglycemic agents C. Exercise D. Plenty of rest

B. 85 mg/dl

A client is 33 weeks' pregnant and has had diabetes since age 21. When checking her fasting blood glucose level, which value would indicate the client's disease is controlled? A. 45 mg/dl B. 85 mg/dl C. 120 mg/dl D. 136 mg/dl

A. Check blood sugar levels daily.

The nurse is assessing a 35-year-old woman at 22 weeks' gestation who has had recent laboratory work. The nurse notes fasting blood glucose 146 mg/dl (8.10 mmol/L), hemoglobin 13 g/dl (130 g/L), and hematocrit 37% (0.37). Based on these results, which instruction should the nurse prioritize? A. Check blood sugar levels daily. B. the signs and symptoms of urinary tract infection C. Include iron-enriched foods in the diet. D. Take daily iron supplements.

B. Increased risk of spontaneous abortion (miscarriage) C. Polyhydramnios D. Hypertension

The nurse is educating a client with type 1 diabetes about the complications associated with diabetes and pregnancy. Which problems would the nurse include in her teaching? Select all that apply. A. Decreased birth weight B. Increased risk of spontaneous abortion (miscarriage) C. Polyhydramnios D. Hypertension E. Cystic fibrosis

A. Precipitous labor

The nurse cared for a client who gave birth. The duration of labor from the onset of contractions until the birth of the baby was 2 hours. How will the nurse document the client's labor in the health record? A. Precipitous labor B. Prolonged labor C. Prodromal labor D. False Labor

D. external cephalic version

The nurse is assisting a primary care provider to attempt to manipulate the position of the fetus in utero from a breech to cephalic position. What does the nurse inform the client the procedure is called? A. internal rotation B. external rotation C. vaginal manipulation D. external cephalic version

A. fetal alcohol spectrum disorder

A nurse is conducting a presentation about prenatal care and preexisting maternal conditions. When discussing the various risks to the mother and infant, the nurse would include information about which condition as the leading cause of intellectual disability in the United States? A. fetal alcohol spectrum disorder B. genetic anomalies C. maternal drug addiction D. pregnancy category X medications

A. Cytomegalovirus

A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition? A. cytomegalovirus B. chlamydia C. gonorrhea D. toxoplasmosis

A. avoidance of infection

A nurse is teaching a 30-year-old gravida 1 who has sickle cell anemia. Providing education on which topic is the highest nursing priority? A. avoidance of infection B. constipation prevention C. administration of immunoglobulins D. consumption of a low-fat diet

A. problems with the uterus C. problems with the fetus

A nursing student correctly identifies the causes of labor dysfunction to include which factors? Select all that apply. A. problems with the uterus B. problems with the mother's diet C. problems with the fetus D. problems with access to health care E. problems with finances

B. "The antibodies may be those transferred across the placenta; the baby may not develop AIDS."

A woman's baby is HIV positive at birth. She asks the nurse if this means the baby will develop AIDS. Which statement would be the nurse's best answer? A. "She already has AIDS. That's what being HIV positive means." B. "The antibodies may be those transferred across the placenta; the baby may not develop AIDS." C. "HIV is transmitted at birth; having a cesarean birth prevented transmission." D. "HIV antibodies do not cross the placenta; this means the baby will develop AIDS."

A. low Apgar score C. perinatal death D. postnatal TB E. underweight

The infant born to a woman with untreated tuberculosis (TB) is more likely to have which conditions? Select all that apply. A. low Apgar score B. overweight C. perinatal death D. postnatal TB E. underweight

A. reduced oxygen to the fetus

A 19-year-old nulliparous woman is in early labor with erratic contractions. An assessment notes that she is remaining at 3 cm. There is also a concern that the uterus is not fully relaxing between contractions. The nurse suspects which complication? A. reduced oxygen to the fetus B. ruptured uterus C. cephalopelvic disproportion D. precipitate labor

A. diet

A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client? A. diet B. long-acting insulin C. oral hypoglycemic drugs D. glucagon

A. Uterine rupture

A G2P1 woman is in labor attempting a VBAC, when she suddenly complains of light-headedness and dizziness. An increase in pulse and decrease in blood pressure is noted as a change from the vital signs obtained 15 minutes prior. The nurse should investigate further for additional signs or symptoms of which complication? A. Uterine rupture B. Hypertonic uterus C. Placenta previa D. Umbilical cord compression

C. "I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring."

A mother is talking to the nurse and is concerned about managing her asthma while she is pregnant. Which response to the nurse's teaching indicates that the woman needs further instruction? A. "I need to be aware of my triggers and avoid them as much as possible." B. "It is fine for me to use my albuterol inhaler if I begin to feel tight." C. "I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring." D. "I will monitor my peak expiratory flow rate regularly to help me predict when an asthma attack is coming on."

B. Use a fist to apply counterpressure to the lower back.

A nurse is assessing a full-term client in labor and determines the fetus is occiput posterior. The client states that all her discomfort is in her lower back. What intervention can the nurse provide that will help alleviate this discomfort? A. Place the client supine with the head of bed elevated 30 degrees. B. Use a fist to apply counterpressure to the lower back. C. Apply a warm washcloth to the lower back. D. Have the health care provider administer a pudendal block.

D. "You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath."

A nurse is caring for a 45-year-old pregnant client with a cardiac disorder who has been instructed by her primary care provider to follow class I functional activity recommendations. The nurse correctly instructs the client to follow which limitations? A. "You will need to be on bedrest for the remainder of your pregnancy." B. "It is important for you to rest after any physical activity in order to prevent any cardiac complications." C. "It will be beneficial if you plan rest periods throughout your day." D. "You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath."

A. uterine hypertonicity

A nurse is caring for a client who is scheduled to undergo an amnioinfusion. The nurse would question this prescription if which finding is noted upon client assessment? A. uterine hypertonicity B. active genital herpes infection C. blood pressure of 130/88 mm Hg D. decreased urine output

D. assessing for cardiac decompensation

A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum? A. limiting sodium intake B. inspecting the extremities for edema C. ensuring that the client consumes a high fiber diet D. assessing for cardiac decompensation

A. Sudden onset of respiratory distress C. Maternal hypotension D. Maternal tachycardia

A nurse is presenting an in-service program about complications that can arise during labor. The nurse determines that the teaching was successful when the group correctly chooses which findings as suggesting an amniotic fluid embolism? Select all that apply. A. Sudden onset of respiratory distress B. Slow onset of fetal distress C. Maternal hypotension D. Maternal tachycardia E. Acute, continuous abdominal pain

A. "I need to avoid any fat with my meals."

A nurse is teaching a woman diagnosed with gestational diabetes about meal planning and nutrition. The nurse determines that additional teaching is needed based on which client statement? A. "I need to avoid any fat with my meals." B. "I should get most of my calories from good complex carbs." C. "Having a bedtime snack is good for me." D. "It's okay to eat small meals or snacks throughout the day."

D. tomorrow at 1400

A pregnant client at 28 weeks' gestation in preterm labor has received a dose of betamethasone IM today at 1400. The client is scheduled to receive a second dose. At which time would the nurse expect to administer that dose? A. today at 2200 B. tomorrow at 0800 C. tomorrow at 1200 D. tomorrow at 1400 E. tomorrow at 1800

B. cervical ripeness C. fetal size D. gestational age

A pregnant client at 42 weeks' gestation is undergoing a scheduled induction of labor based on consideration of which factors? Select all that apply. A. abnormal fetal presentation B. cervical ripeness C. fetal size D. gestational age E. complete placenta previa

A. misoprostol

A pregnant client has a history of asthma. After reviewing the possible medications that may be prescribed during her pregnancy to control her asthma, the nurse determines additional teaching is needed when the client identifies which drug as being used? A. misoprostol B. ipratropium C. albuterol D. salmeterol

C. obesity D. hypertension E. previous large-for-gestational-age (LGA) infant

A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes? Select all that apply. A. maternal age less than 18 years B. genitourinary tract abnormalities C. obesity D. hypertension E. previous large-for-gestational-age (LGA) infant

A. "You will need to have another test to confirm the diagnosis."

A pregnant client has tested positive for HIV using an enzyme-linked immunoassay (ELISA) test. When talking with the client about the results, she asks, "So what happens next?" Which response by the nurse would be appropriate as the next step? A. "You will need to have another test to confirm the diagnosis." B. "First you will get treated with antibiotics and then antiviral medicines." C. "You will need testing for other infections like gonorrhea or syphilis." D. "You will need to have an amniocentesis to check on the baby."

B. check her blood sugars frequently and adjust insulin accordingly.

A pregnant client with type I diabetes asks the nurse about how to best control her blood sugar while she is pregnant. The best reply would be for the woman to: A. limit weight gain to 15 pounds during the pregnancy. B. check her blood sugars frequently and adjust insulin accordingly. C. exercise for 1 to 2 hours each day to keep the blood glucose down. D. begin oral hyperglycemic medications along with the insulin she is currently taking.

D. "You should wait until after you give birth to obtain the cat for your daughter."

A pregnant single mom living alone tells the nurse she is considering getting a cat for her 2-year-old daughter. Which is the best response by the nurse? A. "The exposure to the cat litter may cause you to need a C-section." B. "This will cut down on the jealousy for your two-year-old when the baby comes." C. "If you don't think caring for a cat is too much work, that would be great." D. "You should wait until after you give birth to obtain the cat for your daughter."

B. variable deceleration FHR pattern noted on monitor D. fetal heart rate decreasing into the 80s

A woman in labor with a history of drug and alcohol addiction and no prenatal care has arrived in the emergency department in active labor with cervix 5 cm dilated. An ultrasound shows the fetus in a breech presentation. As a nurse prepares to care for this woman, which assessments indicate the fetus is in distress and needs immediate help to survive? Select all that apply. A. meconium staining noted on fluid seeping from vagina B. variable deceleration FHR pattern noted on monitor C. premature rupture of membranes with yellow-green color fluid that smells foul D. fetal heart rate decreasing into the 80s E. minimal movement as the fetus descends into the pelvic opening

A. obtaining enough rest

A woman with an artificial mitral valve develops heart failure at the 20th week of pregnancy. Which measure would the nurse stress with her during the remainder of the pregnancy? A. obtaining enough rest B. maintaining a high fluid intake C. beginning a low-impact aerobics program D. discontinuing her prepregnancy anticoagulant

A. Decrease activity and rest more often.

A woman with cardiac disease at 32 weeks' gestation reports she has been having spells of light-headedness and dizziness every few days. Which instruction should the nurse prioritize? A. Decrease activity and rest more often. B. Increase fluids and take more vitamins. C. Bed rest and bathroom privileges only until birth. D. Discuss induction of labor with the health care provider.

C. Lie in a semi-recumbent position.

A woman with class II heart disease is experiencing an uneventful pregnancy and is now prescribed bed rest at 36 weeks' gestation by her health care provider. The nurse should point out that this is best accomplished with which position? A. Lie flat on her back. B. Stay in high Fowler position. C. Lie in a semi-recumbent position. D. Use pillows and wedges to stay in a fully recumbent position.

D. have been shown to be effective and safe in recent short term studies.

A woman with type 2 diabetes is considering becoming pregnant and asks the nurse whether she will be able to continue taking her current oral hypoglycemics. The nurse's response will point out which factor? A. can be used as long as they control serum glucose levels. B. can be taken until the degeneration of the placenta occurs. C. are usually suggested primarily for women who develop gestational diabetes. D. have been shown to be effective and safe in recent short term studies.

A. respiratory function

During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn? A. respiratory function B. heart rate C. temperature D. urine output

C. 24 to 28 weeks

The nurse is caring for a pregnant woman determined to be at high risk for gestational diabetes. The nurse prepares to rescreen this client at which time frame? A. 16 to 20 weeks B. 20 to 24 weeks C. 24 to 28 weeks D. 28 to 32 weeks

B. "If my blood sugars are elevated, my baby's lungs will mature faster, which is good."

The nurse is teaching a client with gestational diabetes about complications that can occur either following birth or during the birth for the infant. Which statement by the mother indicates that further teaching is needed by the nurse? A. "My baby may be very large and I may need a cesarean birth to have him." B. "If my blood sugars are elevated, my baby's lungs will mature faster, which is good." C. "Beginning at 28 weeks' gestation, I will start counting with my baby's movements every day." D. "I may need an amniocentesis during the third trimester to see if my baby's lungs are ready to be born."

B. a 44-year-old primipara diagnosed with gestational diabetes in active labor for the past 6 hours C. a 33-year-old female who is 32 weeks' gestation in labor with twins E. a 30-year-old multipara woman who has experienced premature rupture of membranes 5 days ago but is just now reporting it to the health care provider

The nurse manager is reviewing all the L & D clients on the unit in order to prepare assignments for the nursing staff. For which clients would augmentation of labor with oxytocin be contraindicated, or used cautiously? Select all that apply. A. a 27-year-old primipara in active labor for the past 4 hours B. a 44-year-old primipara diagnosed with gestational diabetes in active labor for the past 6 hours C. a 33-year-old female who is 32 weeks' gestation in labor with twins D. an 18-year-old primipara client who is experiencing acute pain and refusing an epidural catheter E. a 30-year-old multipara woman who has experienced premature rupture of membranes 5 days ago but is just now reporting it to the health care provider

C. Use fingers to press upward on the presenting part.

The nurse notes the fetal heart rate has slowed in a woman in labor at 8 cm dilation (dilatation). Assessment reveals a prolapsed umbilical cord. Which action should the nurse prioritize? A. Turn client to her left side. B. Place client in a knee-chest position. C. Use fingers to press upward on the presenting part. D. Prep for immediate cesarean delivery.

C. "Continue to monitor fetal movements daily."

The nurse provides education to a postterm pregnant client. What information will the nurse include to assist in early identification of potential problems? A. "Increase your fluid intake to prevent dehydration." B. "Be sure to measure 24-hour urine output daily." C. "Continue to monitor fetal movements daily." D. "Monitor your bowel movements for constipation."

A. macrosomia B. shoulder dystocia D. brachial plexus injuries E. cephalopelvic disproportion

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. A. macrosomia B. shoulder dystocia C. failure to thrive D. brachial plexus injuries E. cephalopelvic disproportion

C. a G4P3 client who is having twins and wants to experience a "natural birth"

There are several women in active labor on the unit. Which woman is at highest risk for developing hypotonic contractions and therefore will need frequent nursing assessments? A. a 21-year-old primipara woman who does not have a support person with her and is very anxious B. a 17-year-old primipara requesting more pain medication every 15 to 30 minutes (and not receiving it) even though there is an epidural catheter in place that is working effectively C. a G4P3 client who is having twins and wants to experience a "natural birth" D. a 37-year-old G2P1 woman being induced whose last ultrasound at 36 weeks' gestation showed oligohydramnios