OB UNIT 3

27) The nurse is preparing an education session for women on the prevention of urinary tract infections (UTIs). Which statement should be included? 1. Lower urinary tract infections rarely occur in women. 2. The most common causative organism of cystitis is E. coli. 3. Wiping from back to front after a BM will help prevent a UTI. 4. Back pain often develops with a lower urinary tract infection.

2. The most common causative organism of cystitis is E. coli. E. coli is present in 75% to 90% of women with UTIs.

20) A 16-year-old pregnant client is seen at her 10-weeks-gestation visit. She tells the nurse that she felt the baby move that morning. What response by the nurse is appropriate? 1. That is very exciting. The baby must be very healthy. 2. Would you please describe what you felt for me? 3. That is impossible. The baby is not big enough yet. 4. Would you please let me see whether I can feel the baby?

2. Would you please describe what you felt for me? The nurse should ask the client to describe what she felt, as 10 weeks gestation is too early to feel fetal movement.

23) The adolescent client reports to the clinic nurse that her period is late, but that her home pregnancy test is negative. What should the nurse explain that these findings most likely indicate? 1. This means you are not pregnant. 2. You might be pregnant, but it might be too early for your home test to be accurate. 3. We dont trust home tests. Come to the clinic for a blood test. 4. Most people dont use the tests correctly. Did you read the instructions?

2. You might be pregnant, but it might be too early for your home test to be accurate. This is a true statement. Most home pregnancy tests have low false-positive rates, but the false-negative rate is slightly higher. Repeating the test in a week is recommended.

24) The client is at 6 weeks gestation, and is spotting. The client had an ectopic pregnancy 1 year ago, so the nurse anticipates that the physician will order which intervention? 1. A urine pregnancy test 2. The client to be seen next week for a full examination 3. An antiserumpregnancy test 4. An ultrasound to be done

3. An antiserumpregnancy test A -Subunit radioimmunoassay (RIA) uses an antiserum with specificity for the -subunit of hCG in blood plasma. This test may not only detect pregnancy but also detect an ectopic pregnancy or trophoblastic disease.

5) A client has been diagnosed with bacterial vaginosis. The nurse obtains a sexual history from the client, including contraceptive measures, number of sexual partners, and frequency of intercourse. What is the rationale for the questions? 1. Clients can infect their sexual partners. 2. The nurse is required by law to ask the questions. 3. Clients with bacterial vaginosis can become infected with HIV and other sexually transmitted diseases more easily. 4. The laboratory needs a full client history in order to know for which organisms and antibiotic sensitivities it should test.

3. Clients with bacterial vaginosis can become infected with HIV and other sexually transmitted diseases more easily. The change in normal flora increases the womans susceptibility to other organisms, making the client more vulnerable to sexually transmitted diseases, including HIV.

26) A client comes into the prenatal clinic accompanied by her boyfriend. When asked by the nurse why she is there, the client looks down, and the boyfriend states, She says she is pregnant. She constantly complains of feeling tired, and her vomiting is disgusting. What is a priority for the nurse to do at this point? 1. Ask the client what time of the day her fatigue is more common. 2. Recommend that the woman have a pregnancy test done as soon as possible. 3. Continue the interview of the client in private. 4. Give the woman suggestions on ways to decrease the vomiting.

3. Continue the interview of the client in private. The nurse should suspect that the client is in an abusive relationship. The priority is for the nurse to get the client away from the boyfriend and continue the interview.

6) The client has delivered her first child at 37 weeks. The nurse would describe this to the client as what type of delivery? 1. Preterm 2. Postterm 3. Early term 4. Near term

3. Early term Early term births extend from 37 to 38 weeks gestation.

24) If a woman has the pre-existing condition of diabetes, the nurse knows that she would be prone to what high-risk factor when pregnant? 1. Vasospasm 2. Postpartum hemorrhage 3. Episodes of hypoglycemia and hyperglycemia 4. Cerebrovascular accident (CVA)

3. Episodes of hypoglycemia and hyperglycemia Episodes of hypoglycemia and hyperglycemia would be a high-risk factor for a client with pre-existing diabetes.

31) The nurse in the prenatal clinic is seeing a pregnant 16-year-old for the first time. What comment by the young client is the most critical for the nurse to address first? 1. My favorite lunch is burger and fries. 2. Ive been dating my new boyfriend for 2 weeks. 3. On weekends, we go out and drink a few beers. 4. I dropped out of school about 3 months ago.

3. On weekends, we go out and drink a few beers. The nurse responds to this most critical statement because of the danger of fetal alcohol syndrome.

10) The nurse is examining a pregnant woman in the third trimester. What skin changes should the nurse highlight as an alteration for the womans healthcare provider? 1. Linea nigra 2. Melasma gravidarum 3. Petechiae 4. Vascular spider nevi

3. Petechiae Petechiae are pinpoint red or purple spots on the skin. They are seen in hemorrhagic conditions.

26) Women with pyelonephritis during pregnancy are at significantly increased risk for which condition? 1. Foul-smelling discharge 2. Ectopic pregnancy 3. Preterm labor 4. A colicky large intestine

3. Preterm labor Women with pyelonephritis during pregnancy are at significantly increased risk of preterm labor, preterm birth, development of adult respiratory distress syndrome, and septicemia.

13) The nurse has received a phone call from a multigravida who is 21 weeks pregnant and has not felt fetal movement yet. What is the best action for the nurse to take? 1. Reassure the client that this is a normal finding in multigravidas. 2. Suggest that she should feel for movement with her fingertips. 3. Schedule an appointment for her with her physician for that same day. 4. Tell her gently that her fetus is probably dead.

3. Schedule an appointment for her with her physician for that same day. Quickening, or the mothers perception of fetal movement, occurs about 18 to 20 weeks after the LMP in a primigravida (a woman who is pregnant for the first time) but may occur as early as 16 weeks in a multigravida (a woman who has been pregnant more than once).

8) During her first months of pregnancy, a client tells the nurse, It seems like I have to go to the bathroom every 5 minutes. The nurse explains to the client that this is because of which of the following? 1. The client probably has a urinary tract infection. 2. Bladder capacity increases throughout pregnancy. 3. The growing uterus puts pressure on the bladder. 4. Some women are very sensitive to body function changes.

3. The growing uterus puts pressure on the bladder. During the first trimester, the growing uterus puts pressure on the bladder, producing urinary frequency until the second trimester, when the uterus becomes an abdominal organ. Near term, when the presenting part engages in the pelvis, pressure is again exerted on the bladder.

24) Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (PID)? 1. CBC (complete blood count) with differential 2. Venereal Disease Research Laboratory (VDRL) 3. Throat culture for Streptococcus A 4. RPR (Rapid Plasma Reagin)

3. Throat culture for Streptococcus A Streptococcus of the throat is not associated with PID.

1) A client with a normal prepregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy while her underweight friend was told to gain more weight. What should the nurse tell the client the recommended weight gain is during pregnancy? 1. 25-35 pounds, regardless of a clients prepregnant weight 2. More than 25-35 pounds for an overweight woman 3. Up to 40 pounds for an underweight woman 4. The same for a normal weight woman as for an overweight woman

3. Up to 40 pounds for an underweight woman Prepregnant weight determines the recommended weight gain during pregnancy. Underweight women are advised to gain 28-40 pounds.

5) The clinic nurse is compiling data for a yearly report. Which client would be classified as a primigravida? 1. A client at 18 weeks gestation who had a spontaneous loss at 12 weeks 2. A client at 13 weeks gestation who had an ectopic pregnancy at 8 weeks 3. A client at 14 weeks gestation who has a 3-year-old daughter at home 4. A client at 15 weeks gestation who has never been pregnant before

4. A client at 15 weeks gestation who has never been pregnant before Primigravida means a woman who is pregnant for the first time.

35) Which of the following is common in many non-Western cultures and is on the increase in the United States? 1. Ceremonial rituals and rites 2. Cultural assessment 3. Cultural values 4. Cosleeping

4. Cosleeping Some parents advocate cosleeping or bed sharing (one or both parents sleeping with their baby or young child). Cosleeping, which is common in many non-Western cultures, is on the increase in the United States.

30) The nurse is providing guidance for a woman in her second trimester of pregnancy and telling her about some of the signs and symptoms that she might experience. Which statement by the client indicates that further teaching is necessary? 1. During the third trimester, I might have frequent urination. 2. During the third trimester, I might have heartburn. 3. During the third trimester, I might have back pain. 4. During the third trimester, I might have a persistent headache.

4. During the third trimester, I might have a persistent headache. A persistent headache is not normal or expected. This could be related to the complication of preeclampsia.

14) A 12-year-old girl and her mother are at the doctors office for a routine check-up for the daughter. The mother tells the nurse that she would like the daughter to have the Gardasil vaccine that is effective against the human papilloma virus. The nurse does some teaching, and knows it has been successful when the mother makes which statement? 1. The human papilloma virus is spread through casual contact in schools. 2. Gardasil will protect against all types of the human papilloma virus. 3. The human papilloma virus affects a million people in the United States. 4. Gardasil will be given to my daughter in three doses.

4. Gardasil will be given to my daughter in three doses. This is true. The vaccine is given in three doses.

25) A client in the emergency department is diagnosed with pelvic inflammatory disease. Before discharge, the nurse will provide the client with some health teaching about which topic? 1. Endometriosis 2. Menopause 3. Ovarian hyperplasia 4. IUD for contraception

4. IUD for contraception The woman who uses an IUD for contraception and has multiple sexual partners needs to understand clearly the risk she faces.

32) The nurse is providing health teaching to a group of women of childbearing age. One woman states that she is a smoker, and asks about the effect of smoking on her fetus. The nurse tells her that which fetal complication can occur when the mother smokes? 1. Genetic changes in the fetal reproductive system 2. Extensive central nervous system damage 3. Addiction to the nicotine inhaled from the cigarette 4. Low birth rate

4. Low birth rate Smoking can cause low birth rate.

1) A nonpregnant client is diagnosed with bacterial vaginosis (BV). What does the nurse expect to administer? 1. Penicillin G 2 million units IM one time 2. Zithromax 1 mg p.o. b.i.d. for 2 weeks 3. Doxycycline 100 mg p.o. b.i.d. for a week 4. Metronidazole 500 mg p.o. b.i.d. for a weekdays.

4. Metronidazole 500 mg p.o. b.i.d. for a week 4. The nonpregnant woman who is diagnosed with bacterial vaginosis (BV) is treated with metronidazole 500 mg orally twice a day for 7 days.

21) The nurse is assessing a client who is at 35 weeks gestation. What does the nurse expect the client to report at this phase of pregnancy? 1. Nausea and vomiting 2. Maternal ambivalence 3. Emotional shifts from highs to lows 4. Stretch marks on the abdomen

4. Stretch marks on the abdomen Striae are purplish stretch marks that may develop as the pregnancy progresses.

16) The nurse is educating a group of female adolescents regarding sexually transmitted infections. The nurse knows that learning was achieved when an individual states that the most common symptom is which of the following? 1. Menstrual cramps 2. Heavy menstrual periods 3. Flu-like symptoms 4. Usually there are no signs or symptoms

4. Usually there are no signs or symptoms It is common for women to experience no signs or symptoms when they have contracted a sexually transmitted disease.

3) During the initial prenatal visit, the nurse obtains a weight of 42 kg (92.4 lb). The nurse must further assess the client for information about which of the following? Select all that apply. 1. Eating habits 2. Foods regularly eaten 3. Income limitations 4. Blood pressure and pulse rate 5. Weight loss during pregnancy

Answer: 1, 2, 3

37) The clinic nurse is culturally sensitive when, while assessing the pregnant client, he asks about which of the following? Select all that apply. 1. The familys expectations of the healthcare system 2. Which cultural practices should be incorporated into care 3. Any alternative healer who should be consulted 4. Positive consequences of the clients healthcare beliefs 5. The clients giving up her practices and adopting the practices of the dominant culture

Answer: 1, 2, 3

22) The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID). Which statements indicate that teaching was effective? Select all that apply. 1. I might have infertility because of this infection. 2. It is important for me to finish my antibiotics. 3. Tubal pregnancy could occur after PID. 4. My PID was caused by a yeast infection. 5. I am going to have an IUD placed for contraception.

Answer: 1, 2, 3 1. Women sometimes become infertile because of scarring in the fallopian tubes as a result of the inflammation of PID. 2. Antibiotic therapy should always be completed when a client is diagnosed with any infection. 3. The tubal scarring that occurs from tubal inflammation during PID can prevent a fertilized ovum from passing through the tube into the uterus, causing an ectopic or tubal pregnancy.

19) The nurse is providing health education to a group of young people. When teaching about the prevention of sexually transmitted infections (STIs), the nurse will teach which concepts? Select all that apply. 1. Decision-making skills in refusing intercourse 2. How to reduce high-risk behaviors 3. That Pap smears might be needed more often 4. The safety of oral sex 5. Use of petroleum-based lubricants with condoms

Answer: 1, 2, 3 Effective prevention and control of STIs is based on planning ahead, review of decision-making skills, and developing strategies to refuse sex.

9) The nurse is assessing a client in the third trimester of pregnancy. What physiologic changes in the client are expected? Select all that apply. 1. The clients chest circumference has increased by 6 cm during the pregnancy. 2. The client has a narrowed subcostal angle. 3. The client is using thoracic breathing. 4. The client may have epistaxis. 5. The client has a productive cough.

Answer: 1, 3, 4

13) The nurse is seeing prenatal clients in the clinic. Which client is exhibiting expected findings? 1. 12 weeks gestation, with fetal heart tones heard by Doppler fetoscope 2. 22 weeks gestation, client reports no fetal movement felt yet 3. 16 weeks gestation, fundus three finger breadths above umbilicus 4. Marked edema

1. 12 weeks gestation, with fetal heart tones heard by Doppler fetoscope This is an expected finding because fetal heart tones should be heard by 12 weeks using a Doppler fetoscope.

4) A woman gave birth last week to a fetus at 18 weeks gestation after her first pregnancy. She is in the clinic for follow-up, and notices that her chart states she has had one abortion. The client is upset over the use of this word. How can the nurse best explain this terminology to the client? 1. Abortion is the obstetric term for all pregnancies that end before 20 weeks. 2. Abortion is the word we use when someone has miscarried. 3. Abortion is how we label babies born in the second trimester. 4. Abortion is what we call all babies who are born dead.

1. Abortion is the obstetric term for all pregnancies that end before 20 weeks. The term abortion means a birth that occurs before 20 weeks gestation or the birth of a fetus-newborn who weighs less than 500 g. An abortion may occur spontaneously or it may be induced by medical or surgical means.

29) The nurse at the prenatal clinic has four calls to return. Which phone call should the nurse return first? 1. Client at 32 weeks, reports headache and blurred vision. 2. Client at 18 weeks, reports no fetal movement in this pregnancy. 3. Client at 16 weeks, reports increased urinary frequency. 4. Client at 40 weeks, reports sudden gush of fluid and contractions.

1. Client at 32 weeks, reports headache and blurred vision. Headache and blurred vision are signs of preeclampsia, which is potentially life-threatening for both mother and fetus. This client has top priority.

15) The nurse has completed a community presentation about the changes of pregnancy, and knows that the lesson was successful when a community member states that which of the following is one probable or objective change of pregnancy? 1. Enlargement of the uterus 2. Hearing the babys heart rate 3. Increased urinary frequency 4. Nausea and vomiting

1. Enlargement of the uterus An examiner can perceive the objective (probable) changes that occur in pregnancy. Enlargement of the uterus is a probable change.

15) The clinic nurse teaches the pregnant client being treated for trichomoniasis about the risks to her pregnancy due to this infection. Which statement would indicate successful teaching? 1. I am at risk of having a preterm birth because of this infection. 2. I might need to have my membranes ruptured because of this infection. 3. I am at risk of having a baby with a high birth weight. 4. I may have intercourse with my husband while bring treated for this infection.

1. I am at risk of having a preterm birth because of this infection. There is a risk of preterm birth and rupture of membranes

19) The nurse is explaining to a new prenatal client that the certified nurse-midwife will perform clinical pelvimetry as a part of the pelvic exam. The nurse knows that teaching has been successful when the client makes which statement about the reason for the exam? 1. It will help us know how big a baby I can deliver vaginally. 2. Doing this exam is a part of prenatal care at this clinic. 3. My sister had both of her babies by cesarean. 4. I am pregnant with my first child.

1. It will help us know how big a baby I can deliver vaginally. By performing a series of assessments and measurements, the examiner assesses the pelvis vaginally to determine whether the size and shape are adequate for a vaginal birth; this procedure is called clinical pelvimetry.

31) The nurse asks a woman how her husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which statement? 1. My husband is ready for the pregnancy to end so that we can have sex again. 2. My husband is much more attentive to me now that I am pregnant. 3. My husband seems more worried about our finances now than he was before the pregnancy. 4. My husband plays his favorite music for my belly so the baby will learn to like it.

1. My husband is ready for the pregnancy to end so that we can have sex again. This is implying that the woman and her husband are not having sex, which indicates the need for counseling. Sex is fine with a normal pregnancy.

30) The nurse is evaluating the outcomes of nursing care for a woman with a urinary tract infection. Which of the following does the nurse include in the evaluation? Select all that apply. 1. The client implements self-care measures for prevention. 2. The client completed the prescribed antibiotics. 3. The client knows self-care measures for worsening symptoms. 4. The client states that UTIs are controlled, not cured. 5. The client knows that cranberry juice can help prevent UTIs.

1. The client implements self-care measures for prevention. 2. The client completed the prescribed antibiotics.

4) A pregnant client at 24 weeks gestation is diagnosed with bacterial vaginosis. Her doctor orders Flagyl to treat the problem. What would be appropriate education for the nurse to provide? 1. The client must be careful to observe for signs of preterm labor. 2. The client should advise her partner to seek therapy as soon as possible. 3. The main side effect of the medication is a large amount of vaginal discharge. 4. A repeat culture should be taken 2 weeks after completing the therapy.

1. The client must be careful to observe for signs of preterm labor. Clients with bacterial vaginosis are at risk for preterm labor.

14) The nurse working in an outpatient obstetric clinic assesses four primigravida clients. Which client findings would the nurse tell the physician about? 1. 17 weeks gestation and client denies feeling fetal movement 2. 24 weeks gestation and fundal height is at the umbilicus 3. 4-6 weeks gestation and softening of the cervix 4. 34 weeks gestation and complains of hemorrhoidal pain

2. 24 weeks gestation and fundal height is at the umbilicus The fundal height at 24 weeks should be 24 cm. The fundal height is usually at the umbilicus at 20-22 weeks.

10) The nurse seeing a client just diagnosed with Chlamydia trachomatis knows that which client is at greatest risk for the infection? 1. 16-year-old sexually active girl, using no contraceptive 2. 22-year-old mother of two, developed dyspareunia 3. 35-year-old woman on oral contraceptives 4. 48-year-old woman with hot flashes and night sweats

1. 16-year-old sexually active girl, using no contraceptive Teens have the highest incidence of sexually transmitted infections, especially chlamydia. A client not using contraceptives is not using condoms, which decrease the risk of contracting a STI.

33) The nurse is teaching nursing students about the different kind of hepatitis. Which statement is the nurse likely to make? 1. Hepatitis A and B have vaccines to prevent them. 2. Hepatitis A, B, and C have vaccines to prevent them. 3. Hepatitis C, D, and E are all bloodborne. 4. Hepatitis A, C, and E are all fecal-oral contamination.

1. Hepatitis A and B have vaccines to prevent them. Hepatitis A and B are the only two types of hepatitis that have vaccines.

9) The nurse is providing follow-up education to a client just diagnosed with vaginal herpes. What statement by the client verifies correct knowledge about vaginal herpes? 1. I should douche daily to prevent infection. 2. I could have another breakout during my period. 3. I am more likely to develop cancer of the cervix. 4. I should use sodium bicarbonate on the lesions to relieve discomfort.

2. I could have another breakout during my period. Menstruation seems to trigger recurrences of herpes.

27) A prenatal educator is asking a partner about normal psychological adjustment of an expectant mother during the second trimester of pregnancy. Which answer by the partner would indicate a typical expectant mothers response to pregnancy? 1. She is very body-conscious, and hates every little change. 2. She daydreams about what kind of parent she is going to be. 3. I havent noticed anything. I just found out she was pregnant. 4. She has been having dreams at night about misplacing the baby.

2. She daydreams about what kind of parent she is going to be. The second trimester brings increased introspection and consideration of how she will parent. She might begin to get furniture and clothing as concrete preparation, and feels movement and is aware of the fetus and incorporates it into herself.

14) The client in the prenatal clinic tells the nurse that she is sure she is pregnant because she has not had a menstrual cycle for 3 months, and her breasts are getting bigger. What response by the nurse is best? 1. Lack of menses and breast enlargement are presumptive signs of pregnancy. 2. The changes you are describing are definitely indicators that you are pregnant. 3. Lack of menses can be caused by many things. We need to do a pregnancy test. 4. Youre probably not pregnant, but we can check it out if you like.

3. Lack of menses can be caused by many things. We need to do a pregnancy test. This is a true statement, and addresses that these changes could be caused by conditions other than pregnancy.

36) The introduction of a new baby into the family is often the beginning of which of the following? 1. Sibling rivalry 2. Inconsistent childrearing 3. Toilet training 4. Weaning

1. Sibling rivalry Sibling rivalry results from childrens fear of change in the security of their relationships with their parents.

34) Screening for gestational diabetes mellitus (GDM) is typically completed between which of the following weeks of gestation? 1. 36 and 40 weeks 2. Before 20 weeks 3. 24 and 28 weeks 4. 30 and 34 weeks

3. 24 and 28 weeks Screening for gestational diabetes mellitus (GDM) is typically completed between 24 and 28 weeks gestation.

18) The primigravida at 22 weeks gestation has a fundal height palpated slightly below the umbilicus. Which of the following statements would best describe to the client why she needs to be seen by a physician today? 1. Your baby is growing too much and getting too big. 2. Your uterus might have an abnormal shape. 3. The position of your baby cant be felt. 4. Your baby might not be growing enough.

4. Your baby might not be growing enough. The fundal height at 20-22 weeks should be about even with the umbilicus. At 22 weeks gestation, a fundal height below the umbilicus and the size of the uterus that is inconsistent with length of gestation could indicate fetal demise.

12) A client at 32 weeks gestation comes to the clinic with urinary burning and frequency. The nurse explains that urinary tract infections are common in pregnancy due to which of the following? Select all that apply. 1. Ureteral atonia 2. Stasis of urine 3. Increased glomerular filtration rate 4. Increased renal plasma flow 5. Increased clearance of urea

Answer: 1, 2 The presence of amino acids and glucose in the urine in conjunction with the tendency toward ureteral atonia and stasis of urine in the ureters may increase the risk of urinary tract infection.

29) The nurse is teaching a group of young women how to prevent urinary tract infections. What will the nurse include in the teaching? Select all that apply. 1. The importance of good hygiene 2. How to recognize the signs and symptoms 3. How to take prescribed antibiotics 4. Fluids are restricted to 1000 ml 5. To urinate only when the urge is strong

Answer: 1, 2, 3 The nurse should make sure that women are aware of good hygiene practices, and should provide information on other ways to avoid UTI.

33) The partner of a pregnant client comes to the clinic with her. He complains to the nurse that he is experiencing different physical changes. The nurse determines he is experiencing couvade when he describes which symptoms? Select all that apply. 1. Fatigue 2. Increased appetite 3. Headache 4. Backache 5. High anxiety level

Answer: 1, 2, 3, 4

12) The nurse is evaluating the outcomes of nursing care given a female client with a sexually transmitted infection (STI). Which of the following will the nurse verify about the client? Select all that apply. 1. Had an identified infection 2. Could identify the mode of transmission 3. Would never cope with the infection 4. Could recognize the symptoms of an STI 5. Would not disclose the STI to her partner

Answer: 1, 2, 4 The infection must be identified and cured, if possible. If not, supportive therapy is provided. The client and her partner should be able to describe the infection, its method of transmission, its implications, and the therapy.

27) A pregnant client calls the clinic nurse to say she is worried about symptoms she is experiencing. The nurse advises the client to come immediately to the clinic because of which reported symptoms? Select all that apply. 1. Vaginal bleeding 2. Abdominal pain 3. Constipation 4. Epigastric pain 5. Blurring of vision

Answer: 1, 2, 4, 5

35) A pregnant client at 30 weeks gestation has had a steady rise in blood pressure. She is now 20 mmHg above her systolic baseline. The nurse advises her to immediately report which symptoms? Select all that apply. 1. Dizziness 2. Even a small amount of dependent edema 3. Spots before her eyes 4. Persistent nausea and vomiting 5. Vaginal spotting

Answer: 1, 3

2) During a clients initial prenatal visit, the nurse must assess and document the clients current medical history, including which information? Select all that apply. 1. Body mass index 2. Infections before the last menstrual period 3. Homeopathic or herbal medication use 4. Blood type and Rh factor 5. History of previous pregnancies

Answer: 1, 3, 4

20) The nurse is explaining clinical pelvimetry to a client. The nurse explains that the anteroposterior diameters consist of which of the following? Select all that apply. 1. Diagonal conjugate 2. Transverse diameter 3. Conjugata vera 4. Obstetric conjugate 5. Oblique diameter

Answer: 1, 3, 4

7) The nurse in the OB-GYN clinic is working with a client who is seeking her initial prenatal visit. The nurse will use the acronym TPAL to document the clients number of which of the following? Select all that apply. 1. Term infants born 2. Children living in the home 3. Pregnancies ending in abortion 4. Preterm infants born 5. Pregnancies that occurred

Answer: 1, 3, 4

17) The nurse is seeing a client who asks about the accuracy of Nageles rule. The nurse explains that accuracy can be compromised under which conditions? Select all that apply. 1. There is a history of regular menses every 28 days. 2. Amenorrhea is present and ovulation occurs with breastfeeding. 3. Oral contraception was discontinued, but no regular menstruation was established. 4. There has been 1 or more months of amenorrhea. 5. There is an accurate date for the last menstrual period.

Answer: 2, 3, 4

22) The nurse recognizes that subjective pregnancy changes such as amenorrhea can be caused by which conditions? Select all that apply. 1. Goodell sign 2. Anemia 3. Pseudocyesis 4. Thyroid dysfunction 5. Fetal heartbeat

Answer: 2, 3, 4

15) What signs would indicate that a pregnant clients urinalysis culture was abnormal? Select all that apply. 1. pH 4.6-8 2. Alkaline urine 3. Cloudy appearance 4. Negative for protein and red blood cells 5. Hemoglobinuria

Answer: 2, 3, 5

33) A pregnant client has a hemoglobin of 10 g/dL and a Hct of 30%. The clinic nurse recognizes the fetus is at risk for which of the following? Select all that apply. 1. Macrosomia 2. Respiratory distress syndrome 3. Low birth weight 4. Prematurity 5. Fetal death

Answer: 3, 4, 5 Anemia places the fetus at risk for a low birth weight, premature birth, and fetal death.

20) The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing intervention would have priority? 1. Encourage oral fluids 2. Administer cefotetan IV 3. Enforce bed rest 4. Remove IUC, if present

2. Administer cefotetan IV Administration of medications to treat the disease is the first

5) What is the increased vascularization causing the softening of the cervix known as? 1. Hegar sign 2. Chadwick sign 3. Goodell sign 4. McDonald sign

3. Goodell sign Increased vascularization causes the softening of the cervix known as Goodell sign.

18) On examination of the prenatal client, the nurse is aware that she will assess for a bluish pigmentation of the vagina. What is this objective (probable) sign of pregnancy also known as? 1. Hegar sign 2. Chadwick sign 3. Nightingale sign 4. Goodell sign

2. Chadwick sign The blue-purple discoloration of the cervix is Chadwick sign.

23) The nurses response to a client with a history of pelvic inflammatory disease who is trying to get pregnant is based on the knowledge that which condition can contribute to an infertility problem? 1. Hepatitis 2. Postinfection tubal damage 3. Pelvic abscess 4. Tubal infection

2. Postinfection tubal damage Postinfection tubal damage is the most likely cause, as the infection causes tubal damage, which can lead to infertility.

12) The nurse begins a prenatal assessment on a 25-year-old primigravida at 20 weeks gestation and immediately contacts the healthcare provider because of which finding? 1. Pulse 88/minute 2. Respirations 30/minute 3. Temperature 37.4 C (99.3 F) 4. Blood pressure 118/82

2. Respirations 30/minute Tachypnea is not a normal finding and requires medical care.

6) The nurse working in a womens clinic recognizes that which clients are most at risk for developing vulvovaginal candidiasis? Select all that apply. 1. Clients using antibiotics 2. Immunocompetent clients 3. Pregnant clients 4. Multiparous clients 5. Diabetic clients

Answer: 1, 3, 5 A predisposing factor to yeast infections includes the use of antibiotics.

11) A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before. The medication the physician is most likely to order would be: 1. Oral acyclovir 2. Ceftriaxone IM 3. Azithromycin p.o. 4. Penicillin G IM

1. Oral acyclovir Malaise, dysuria, and tingling or painful vesicles are indicative of a primary herpes simplex outbreak. Acyclovir treats herpes.

21) The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? 1. Age 30, treated for PID 2. Age 25, monogamous 3. Age 20, pregnant 4. Age 27, uses a diaphragm

1. Age 30, treated for PID Exposure to sexually transmitted infections increases the risk of abnormal cell changes and cervical cancer.

6) It is 1 week before a pregnant clients due date. The nurse notes on the chart that the clients pulse rate was 74-80 before pregnancy. Today, the clients pulse rate at rest is 90. What action should the nurse should take? 1. Chart the findings. 2. Notify the physician of tachycardia. 3. Prepare the client for an electrocardiogram (EKG). 4. Prepare the client for transport to the hospital.

1. Chart the findings. The pulse rate frequently increases during pregnancy, although the amount varies from almost no increase to an increase of 10 to 15 beats per minute. This is a normal response, and does not indicate a need for emergency measures or treatment.

19) The nurse notes the following findings in a client at 12-weeks gestation. Which of the findings would enable the nurse to tell the client that she is diagnostically pregnant? 1. Fetal heart rate by Doppler 2. Positive pregnancy test 3. Positive Chadwicks sign 4. Montgomery gland enlargement

1. Fetal heart rate by Doppler A fetal heart rate by Doppler is a diagnostic (positive) change of pregnancy.

1) While completing the medical and surgical history during the initial prenatal visit, the 16-year-old primigravida interrupts with Why are you asking me all these questions? What difference does it make? Which statement would best answer the clients questions? 1. We ask these questions to detect anything that happened in your past that might affect the pregnancy. 2. We ask these questions to see whether you can have prenatal visits less often than most clients do. 3. We ask these questions to make sure that our paperwork and records are complete and up to date. 4. We ask these questions to look for any health problems in the past that might affect your parenting.

1. We ask these questions to detect anything that happened in your past that might affect the pregnancy. The course of a pregnancy depends on a number of factors, including the past pregnancy history (if this is not a first pregnancy), prepregnancy health of the woman, presence of disease/illness states, family history, emotional status, and past health care.

34) The nurse is admitting a client who is 12 weeks pregnant and an IV drug user. She has had a number of sexual partners, complains of malaise, and has yellow in the eyes, nausea, and vomiting. Having obtained this history, the nurse suspects that the client has which condition? 1. Hepatitis E 2. Hepatitis C 3. Gonorrhea 4. Hepatitis A

2. Hepatitis C Hepatitis C is bloodborne, and found in drug users and those who have multiple sexual partners.

8) The nurse is seeing clients in the womens clinic. Which client should be treated with ceftriaxone IM and doxycycline orally? 1. A pregnant client with gonorrhea and a yeast infection 2. A nonpregnant client with gonorrhea and chlamydia 3. A pregnant client with syphilis 4. A nonpregnant client with chlamydia and trichomoniasis

2. A nonpregnant client with gonorrhea and chlamydia The combined treatment of ceftriaxone IM and doxycycline orally provides dual treatment for gonorrhea and chlamydia, which frequently occur together.

16) A client who is experiencing her first pregnancy has just completed the initial prenatal examination with a certified nurse-midwife. Which statement indicates that the client needs additional information? 1. Because we heard the babys heartbeat, I am undoubtedly pregnant. 2. Because I havent felt the baby move yet, we dont know whether Im pregnant. 3. My last period was 2 months ago, which means Im 2 months along. 4. The increased size of my uterus means that I am finally pregnant.

2. Because I havent felt the baby move yet, we dont know whether Im pregnant. Fetal movement is a subjective, or presumptive, change of pregnancy, and is not a reliable indicator in the early months of pregnancy.

7) A client at 16 weeks gestation has a hematocrit of 35%. Her prepregnancy hematocrit was 40%. Which statement by the nurse best explains this change? 1. Because of your pregnancy, you're not making enough red blood cells. 2. Because your blood volume has increased, your hematocrit count is lower. 3. This change could indicate a serious problem that might harm your baby. 4. You're not eating enough iron-rich foods like meat.

2. Because your blood volume has increased, your hematocrit count is lower. Hemoglobin and hematocrit levels drop in early to mid-pregnancy as a result of pregnancy-associated hemodilution. Because the plasma volume increase (50%) is greater than the erythrocyte increase (25%), the hematocrit decreases slightly.

8) The prenatal clinic nurse is designing a new prenatal intake information form for pregnant clients. Which question is best to include on this form? 1. Where was the father of the baby born? 2. Do genetic diseases run in the family of the babys father? 3. What is the name of the babys father? 4. Are you married to the father of the baby?

2. Do genetic diseases run in the family of the babys father? This question has the highest priority because it gets at the physiologic issue of inheritable genetic diseases that might directly impact the baby.

11) The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi present on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings? 1. Document the findings on the prenatal chart. 2. Have the physician see the client today. 3. Instruct the client to avoid direct sunlight. 4. Analyze previous thyroid hormone lab results.

2. Have the physician see the client today. Mottling of the skin is indicative of possible anemia. These abnormalities must be reported to the healthcare provider immediately.

28) The client demonstrates that the nurses teaching regarding ways to prevent a recurrence of her urinary tract infection was effective when she makes which statement? 1. I should wipe from back to front after urination. 2. I should urinate when I feel the urge. 3. I should try to restrict my intake of fruits. 4. I should use a diaphragm.

2. I should urinate when I feel the urge. Retention overdistends the bladder, and can lead to infection.

28) A nurse examining a prenatal client recognizes that a lag in progression of measurements of fundal height from week to week and month to month could signal what condition? 1. Twin pregnancy 2. Intrauterine growth restriction 3. Hydramnios 4. Breech position

2. Intrauterine growth restriction A lag in progression of measurements of fundal height from month to month could signal intrauterine growth restriction (IUGR).

22) The nurse is assessing a primiparous client who indicates that her religion is Judaism. Why is this information is pertinent for the nurse to assess? 1. Religious and cultural background can impact what a client eats during pregnancy. 2. It provides a baseline from which to ask questions about the clients religious and cultural background. 3. Knowing the clients beliefs and behaviors regarding pregnancy is not important. 4. Clients sometimes encounter problems in their pregnancies based on what religion they practice.

2. It provides a baseline from which to ask questions about the clients religious and cultural background. Nurses have an obligation to be aware of other cultures and develop a culturally sensitive plan of care to meet the needs of the childbearing woman and her family.

16) The nurse receives a phone call from a client who claims she is pregnant. The client reports that she has regular menses that occur every 28 days and last 5 days. The first day of her last menses was April 10. What would the clients estimated date of delivery (EDD) be if she is pregnant? 1. Nov. 13 2. Jan. 17 3. Jan. 10 4. Dec. 3

2. Jan. 17 The due date is Jan. 17. Nageles rule is to add 7 days to the last menstrual period and subtract 3 months. The last menstrual period is April 10, therefore Jan. 17 is the EDD.

13) A client comes to the clinic complaining of a thick, white, tenacious discharge and vulvular soreness. Which medication treatment will the nurse teach the client about? Select all that apply. 1. Silver sulfadiazine 2. Metronidazole 3. Clindamycin cream 4. Ceftriaxone sodium 5. Doxycycline

2. Metronidazole 3. Clindamycin cream Metronidazole is the preferred treatment for vulvovaginal candidiasis. Although less effective than metronidazole, clindamycin cream can be used to treat vulvovaginal candidiasis.

34) Nurses who are interacting with expectant families from a different culture or ethnic group can provide more effective, culturally sensitive nursing care by doing what? 1. Recognizing that ultimately it is the familys right to make a womans healthcare choices. 2. Obtaining a medical interpreter of the language the client speaks. 3. Evaluating whether the clients healthcare beliefs have any positive consequences for her health. 4. Accepting personal biases, attitudes, stereotypes, and prejudices.

2. Obtaining a medical interpreter of the language the client speaks. The nurse should provide for the services of an interpreter if language barriers exist.

3) A client who is in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice? 1. Lightening of the nipples and areolas 2. Reddish streaks called striae on her abdomen 3. A decrease in hair thickness 4. Small purplish dots on her face and arms

2. Reddish streaks called striae on her abdomen Striae, or stretch marks, are reddish, wavy, depressed streaks that may occur over the abdomen, breasts, and thighs as pregnancy progresses.

10) A 25-year-old primigravida is at 20 weeks gestation. The nurse takes her vital signs and notifies the healthcare provider immediately because of which finding? 1. Pulse 88/minute 2. Rhonchi in both bases 3. Temperature 37.4 C (99.3 F) 4. Blood pressure 122/78

2. Rhonchi in both bases Any abnormal breath sounds should be reported to the healthcare provider.

17) After a sex education class at a high school, the nurse overhears a student discussing safe sex practices. Which statement indicates that teaching was successful? 1. I dont have to worry about getting infected if I have oral sex. 2. Teen women are the group at highest risk for sexually transmitted infections. 3. The best thing to do if I have sex a lot is to use spermicide each and every time. 4. Boys get the HIV virus more easily than girls do.

2. Teen women are the group at highest risk for sexually transmitted infections. Teens with multiple sex partners are more susceptible to sexually transmitted diseases.

3) The nurse is caring for a client in the clinic whom she suspects has vaginosis. Which test best determines whether this sexually active woman has the disorder? 1. The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation 2. The addition of a 10% potassium hydroxide solution to the vaginal secretions 3. A vaginal pH of less than 4.5 4. A Gram stain positive for the fungus

2. The addition of a 10% potassium hydroxide solution to the vaginal secretions Adding a 10% potassium hydroxide solution to the vaginal secretion of a client with bacterial vaginosis, called a whiff test, produces a fishy smell.

30) The pregnant client at 14 weeks gestation is in the clinic for a regular prenatal visit. Her mother also is present. The grandmother-to-be states that she is quite uncertain about how she can be a good grandmother to this baby because she works full-time. Her own grandmother was retired, and was always available when needed by a grandchild. What is the nurses best response to this concern? 1. Dont worry. Youll be a wonderful grandmother. It will all work out fine. 2. What are your thoughts on what your role as grandmother will include? 3. As long as there is another grandmother available, you dont have to worry. 4. Grandmothers are supposed to be available. You should retire from your job.

2. What are your thoughts on what your role as grandmother will include? Although relationships with parents can be very complex, the expectant grandparents often become increasingly supportive of the expectant couple, even if conflicts previously existed. But it can be difficult for even sensitive grandparents to know how deeply to become involved in the childrearing process. In some areas, classes for grandparents provide information about changes in birthing and parenting practices.

23) What would the nurse include as part of a routine physical assessment for a second-trimester primiparous patient whose prenatal care began in the first trimester and is ongoing? 1. Pap smear 2. Hepatitis B screening (HBsAg) 3. Fundal height measurement 4. Complete blood count

3. Fundal height measurement At each prenatal visit, the blood pressure, pulse, and weight are assessed, and the size of the fundus is measured. Fundal height should be increasing with each prenatal visit.

7) The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement? 1. She could become pregnant. 2. She could have severe vaginal itching. 3. He could get an infection in the tube that carries the urine out. 4. It could cause us to develop a rash.

3. He could get an infection in the tube that carries the urine out. Chlamydia is a major cause of nongonococcal urethritis (NGU) in men.

4) The nurse is listening to the fetal heart tones of a client at 37 weeks gestation while the client is in a supine position. The client states, Im getting lightheaded and dizzy. What is the nurses best action? 1. Assist the client to sit up. 2. Remind the client that she needs to lie still to hear the baby. 3. Help the client turn onto her left side. 4. Check the clients blood pressure.

3. Help the client turn onto her left side. During pregnancy the enlarging uterus may put pressure on the vena cava when the woman is supine, resulting in supine hypotensive syndrome. This pressure interferes with returning blood flow and produces a marked decrease in blood pressure with accompanying dizziness, pallor, and clamminess, which can be corrected by having the woman lie on her left side.

2) The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (VVC), and knows the client understands when she makes which of the following statements? 1. I need to apply the miconazole for 10 days. 2. I need to douche daily. 3. I need to add yogurt to my diet. 4. I need to wear nylon panties.

3. I need to add yogurt to my diet. Yogurt helps reestablish normal vaginal flora.

17) The nurse is assessing a new client in the clinic. The nurse knows that the subjective (presumptive) signs and symptoms of pregnancy include which of the following? 1. Positive urine pregnancy test, enlarged abdomen, and Braxton Hicks contractions 2. Positive urine pregnancy test, amenorrhea, changes in pigmentation of the skin, and softening of the cervix 3. Increase in urination, amenorrhea, fatigue, breast tenderness, and quickening 4. Enlarged abdomen and fetal heartbeat

3. Increase in urination, amenorrhea, fatigue, breast tenderness, and quickening An increase in urination, amenorrhea, fatigue, breast tenderness, and quickening are all subjective (presumptive) changes of pregnancy.

9) During the initial prenatal visit, the nurse assesses the history of the father of the child for which of the following? Select all that apply. 1. Stability of living conditions 2. Blood type and Rh type 3. Significant health problems 4. Nutritional history 5. Current use of tobacco

Answer: 2, 3, 5

11) The nurse in the prenatal clinic will tell the client at 38-weeks gestation to lie on her left side when the client complains of which of the following? Select all that apply. 1. Nausea 2. Pallor 3. Clamminess 4. Constipation 5. Dizziness

Answer: 2, 3, 5 Vena caval syndrome can cause pallor, clamminess, and dizziness which is relieved when the client turns to lie on her left side.

25) Which third-trimester client would the nurse suspect might be having difficulty with psychological adjustments to her pregnancy? 1. A woman who says, Either a boy or a girl will be fine with me 2. A woman who puts her feet up and listens to some music for 15 minutes when she is feeling too stressed 3. A woman who was a smoker but who has quit at least for the duration of her pregnancy 4. A woman who has not investigated the kind of clothing or feeding methods the baby will need

4. A woman who has not investigated the kind of clothing or feeding methods the baby will need By the third trimester, the client should be planning and preparing for the baby (for example, living arrangements, clothing, feeding methods).

21) The nurse is assessing a newly pregnant client. Which finding does the nurse note as a normal psychosocial adjustment in this clients first trimester? 1. An unlisted telephone number 2. Reluctance to tell the partner of the pregnancy 3. Parental disapproval of the womans partner 4. Ambivalence about the pregnancy

4. Ambivalence about the pregnancy Ambivalence toward a pregnancy is a common psychosocial adjustment in early pregnancy.

31) A nurse is teaching a middle school health class on the different types of viral hepatitis. Which statement made by a student indicates the need for further teaching? 1. Both hepatitis A and E are not chronic infections. 2. Hepatitis A is characterized by symptoms of jaundice, anorexia, nausea, vomiting, malaise, and fever. 3. Hepatitis B, C, and D have symptoms similar to those of hepatitis A, and can also include arthralgias, arthritis and skin eruptions or rash. 4. Both hepatitis B and C have an incubation period of 45-160 days.

4. Both hepatitis B and C have an incubation period of 45-1 Hepatitis B has an incubation period of 45-160 days, but hepatitis C has an incubation period of 14-180 days.

32) The client has been diagnosed with hepatitis B. Which statement indicates to the nurse that the client needs more education? Select all that apply. 1. This infection could be sexually transmitted. 2. I might get jaundiced from this illness. 3. An immunization exists to prevent getting hepatitis B. 4. I might have gotten this infection from food. 5. The incubation period is 15-50 days. Answer: 4, 5 Explanation: 4. Hepatitis B is found in blood and body fluids, and therefore can be sexually transmitted. Hepatitis A and E are foodborne, and transmitted by fecal-oral contamination. 5. The incubation period for hepatitis B is 45-160 days.

4. I might have gotten this infection from food. 5. The incubation period is 15-50 days. Hepatitis B is found in blood and body fluids, and therefore can be sexually transmitted. Hepatitis A and E are foodborne, and transmitted by fecal-oral contamination. The incubation period for hepatitis B is 45-160 days.

28) The partner of a client at 16 weeks gestation accompanies her to the clinic. The partner tells the nurse that the baby just doesnt seem real to him, and he is having a hard time relating to his partners fatigue and food aversions. Which statement would be best for the nurse to make? 1. If you would concentrate harder, youd be aware of the reality of this pregnancy. 2. My husband had no problem with this. What was your childhood like? 3. You might need professional psychological counseling. Ask your physician. 4. Many men feel this way. Feeling the baby move in a few weeks will help make it real to you.

4. Many men feel this way. Feeling the baby move in a few weeks will help make it real to you. Initially, expectant fathers may have ambivalent feelings.The extent of ambivalence depends on many factors, including the fathers relationship with his partner, his previous experience with pregnancy, his age, his economic stability, and whether the pregnancy was planned. The expectant father must first deal with the reality of the pregnancy and then struggle to gain recognition as a parent from his partner, family, friends, coworkers, societyand from his baby as well.

18) A client asks the nurse about treatment for human papilloma viral warts. The nurses response should be based on what knowledge? 1. An antiviral injection cures approximately 50% of all cases. 2. Aggressive treatment is required to cure warts. 3. Warts often spread when an attempt is made to remove them surgically. 4. No single treatment is best for all types of warts or for all clients.

4. No single treatment is best for all types of warts or for all clients. All atypical, pigmented, and persistent warts should be biopsied and treatment instituted promptly.

25) A woman calls the clinic and tells a nurse that she thinks she might be pregnant. She wants to use a home pregnancy test before going to the clinic, and asks the nurse how to use it correctly. What information should the nurse give? 1. The false-positive rate of these tests is quite high. 2. If the results are negative, the woman should repeat the test in 2 weeks if she has not started her menstrual period. 3. A negative result merely indicates growing trophoblastic tissue and not necessarily a uterine pregnancy. 4. The client should follow up with a healthcare provider after taking the home pregnancy test.

4. The client should follow up with a healthcare provider after taking the home pregnancy test. It is important that clients remember that the tests are not always accurate and they should follow up with a healthcare provider.

29) The client at 30 weeks gestation with her first child is upset. She tells the prenatal clinic nurse that she is excited to become a mother, and has been thinking about what kind of parent she will be. But her mother has told her that she doesnt want to be a grandmother because she doesnt feel old enough, while her husband has said that the pregnancy doesnt feel real to him yet, and he will become excited when the baby is actually here. What is the most likely explanation for what is happening within this family? 1. Her husband will not attach with this child and will not be a good father. 2. Her mother is rejecting the role of grandparent, and will not help out. 3. The client is not progressing through the developmental tasks of pregnancy. 4. The family members are adjusting to the role change at their own paces.

4. The family members are adjusting to the role change at their own paces. This is a true statement. With each pregnancy, routines and family dynamics are altered, requiring readjustment and realignment.

2) The nurse understands that a clients pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks gestation? Select all that apply. 1. The joints of the pelvis have relaxed, causing a waddling gait. 2. The cervix is firm and blue-purple in color. 3. The uterus vasculature contains one sixth of the total maternal blood volume. 4. Gastric emptying time is delayed, and the client complains of constipation and bloating. 5. Supine hypotension occurs when the client lies on her back.

Answer: 1, 3, 4, 5

32) The clinic nurse is assessing how the prenatal client is meeting developmental tasks using Rubins tasks, including which of the following? Select all that apply. 1. Ensuring safe passage through pregnancy, labor, and birth. 2. Turning in on oneself to focus on the child. 3. Seeking commitment and acceptance of self as mother to the infant. 4. Completing the tasks of nesting at the appropriate time. 5. Seeking acceptance of the child by others.

Answer: 1, 3, 5 The tasks Rubin identified form the basis for a mutually gratifying relationship with the baby, and include ensuring safe passage through pregnancy, labor, and birth.

26) To answer a clients question about home pregnancy tests and their accuracy, the nurse must know that accuracy is affected by which of the following? Select all that apply. 1. Unclear directions 2. Unable to comprehend the directions 3. Blood in the specimen giving a false reading 4. Completing the test too late 5. Tagged antibodies becoming outdated

Answer: 1, 4 1. Women may not comprehend the HPT instructions, which can affect the accuracy results. 4. False-negative results typically occur when the test is completed too early or too late.

35) In providing community education about hepatitis, the nurse includes information on the chronic forms of hepatitis. A form of hepatitis that becomes chronic is which of the following? Select all that apply. 1. Hepatitis A 2. Hepatitis B 3. Hepatitis C 4. Hepatitis D 5. Hepatitis E

Answer: 2, 3, 4 Unlike hepatitis A infection, hepatitis B infection is chronic.