Weekly quizzes
When doing a health assessment, at which location would the nurse expect to palpate the fundus in a woman on the second postpartum day and how should it feel?
fundus 2 fingerbreadths (2cm) below the umbilics and firm
A nurse is caring for a pregnant patient whose fetus has been diagnosed with macrosomia. When reviewing the patient's history, which information would the nurse expect to find?
gestational diabetes
Which hormone stimulates the release of the follicle-stimulating hormone (FSH) from both make and female glands?
gonadotropin- releasing hormone (GRH)
pregnancy tests (both urine and blood) measure levels of which hormone to validate the existence of pregnancy?
human chorionic gonadotropin (hCG)
The labor and delivery nurse knows that internal monitoring during labor is an invasive technique. She correctly identifies an increase in the risk of which of the following for both mother and fetus if this is done?
infection
The nurse auscultates the fetal heart rate and determines a rate of 120. Which nursing intervention is appropriate?
inform the mother that the rate is normal
Which measure may prevent engorgement in a breastfeeding mother
initiate early and frequent feedings
A patient whose cervix is dilated 2 cm is considered to be in which phase of labor?
latent stage
If the position of a fetus in a cephalic presentation is left occiput anterior, the nurse should assess the fetal heart rates in which quadrant of the maternal abdomen?
left lower
Which fetal position may cause the laboring women more back discomdort?
left occiput posterior
A pregnant patient in her third trimester is diagnosed with supine hypotension. What would the nurse instruct the patient to do?
lie laterally, preferably on her left side
A women in her third trimester shows the nurse a narrow, brown line that has formed on her abdomen, running from her belly button down to her pubic region. She expresses concern about this and asks the nurse whether it is normal. The nurse explains that this is a normal occurrence of pregnancy and that it results from the release of melanocyte-stimulating hormone from the pituitary, causing the appearance of extra-pigmentation on the skin. What is the name of this phenomenon?
linea nigra
The fetal scalp electrode (FSE) is one measure of internal fetal monitoring. Successful use of the FSE includes which of the following?
ruptured membranes
When giving a postpartum patient self-care instructions in preparation for discharge, the nurse instructs her to report heavy or excessive bleeding. How should the nurse describe "heavy bleeding"?
saturating 1 pad in 1 hour
A patient whose is actively "pushing" with contractions is considered to be in which stage of labor?
second stage
which interventions should be included when caring for a patient with a third degree laceration? select all that apply.
- increase fiber in diet - increase fluid intake - administer an oral stool softener
A 30 year old female is attending a health fair for women. The nurse at the fair is reviewing hormonal contraceptives. Which should the nurse include at the fair?
- oral contraceptive - vaginal ring - intrauterine device - subdermal implant
Pathological influences on fetal oxygenation include which of the following? select all that apply
- placental disruption - alterations in umbilical flow - uterine activity
Which of the following patient responses indicates that the nurse's teaching about care following chronic villus sampling (CVS) has been successful?
If the woman starts to bleed or to contract, she should notify her provider
A new parent is distraught and asks the nurse, "Is there something wrong with my newborn?" My newborn has a white discharge coming from the breasts." What will the nurse explain to the parent about the discharge?
It is caused by the mother's hormones
The nurse is planning to teach a class of expectant parents about the cardinal movements (birthing process movements) that occur as the fetus passes through the birth canal. The nurse plans to teach the potential changes of the sequence in which they occur when the fetus is in cephalic presentation. Place the cardinal movements in the correct sequence? 1. expulsion 2. external rotation 3. flexion 4. internal rotation
3, 4, 2, 1
The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of high school students. What would be the BEST response by a high school student about the function of the vagina?
It receives sperm, provides an exit for menstrual flow and serves as the birth canal.
Your patient, who is primigravida, has come to the prenatal clinic for scheduled visit. She is concerned about her facial chloasma which has developed since her last prenatal visit. What is the best response by the nurse?
avoiding sun exposure may help to reduce the pigmentation from getting any darker
During assessment of the mother during the postpartum period, what sign should alert the nurse that the patient is likely experiencing uterine atony?
boggy (soft) or relaxed uterus
Assessment of a patient reveals evidence of a cystocele. The nurse interprets this as?
bulging of the bladder into the vagina
Birth for the nulliparous women with a fetus in a breech presentation is usually a:
caesarean section
which event is the best indicator of true labor?
cervical dilation and effacement
A women with a positive history of genital herpes is in active labor. Assessment reveals vesicles in the perineum area, membranes are ruptured, dilated 5 cm, and effaced 70%. The nurse should prepare the patient for which type of birth?
cesarean
An intrauterine device IUD has been inserted into a patient as a requested birth control method. What is the advantage of IUD's?
continuous protection without client's active participation
Maternal PSYCHE is an important consideration for achievement of a positive birth outcome. All of following are true statements, EXCEPT:
A focus on technology during the birth experience will promote a trusting relationship between the nurse and patient
As the student nurse providing couplet care, a mother is concerned about the bluish discoloration of her baby's hands and feet. What is your best response to this new mother?
educate the new mother this is a normal finding and it should resolve itself as the baby continues to transition to life outside of the womb
A primipara, 30 weeks gestation, has no family support and frequency calls the health care provider's office with questions. Which report by the women would alert the nurse that she may be having a complication related to the pregnancy and needs to come to the clinic for further assessment?
feeling of an achy, cramping in vaginal area accompanied by bleeding that has saturated 1 pad/hour
duration of a contraction is best measured?
from the start of contraction to the end of the contraction
A patient presents at the clinic and is interested in obtaining emergency contraception. The nurse explains that EC must be used within 72 hours of unprotected sex to be effective because?
EC's prevent embryo creation and uterine implantation from occurring
Your patient presents to triage and reports the following: Over the past week, I have noticed increased energy, an increase in irregular, but mild contractions and carrying my baby lower. What is the best response by the nurse?
From what you are describing, it seems as though your baby is preparing for delivery. These are all normal findings and are considered premonitory signs of the birth experience.
Following confirmation of pregnancy's, the patient has come to the clinic for her first prenatal visit. She reports having a 5-year old child who was born at 40 weeks gestation, a set of 3 year old triplets who were born at 34 weeks gestation and a first trimester abortion when she was in college. On her medical record, the nurse would make which entry?
G4 T1 P1 A1 L4
The pregnant patient reports that she has a 3 year old child at home who was born at term, had a miscarriage at 10 weeks gestation and delivered a set of twins at 28 weeks gestation that died within 24 hours of birth. How should the nurse record the patient's status in the prenatal record?
G4, P2
After teaching a group of expectant mothers about how to best protect the fetus while in utero, which statement by a mother would best validate understanding of the teaching session?
I will not take any medications that the doctor has not prescribed without checking first
After a class from expectant parents on the various forms of birth control after the birth of their newborn, the nurse realizes more training is needed when a participant makes which comment?
I'm going to be breastfeeding occasionally, so we won't need to use any other birth control for at least six months
The provider has ordered an oxytocin challenge test. The nurse should interpret which of the following as a negative test?
The FHR remains stable in relation to 3 contractions
A nurse is providing care to a newborn would use which concept underlying adaption of the newborn's immune system when planning nursing care?
The newborn is unable to limit invading organisms at their point of entry
A patient at 36 weeks gestation comes in for her weekly primary care provider visit. She tells the nurse "I am having contractions, but they are irregular and go away when I rest. Do you think I am going into labor? The best response would be?
These are called Braxton-hicks contractions and are preparing your body for labor, but are not "true" labor contractions
A patient is 11 weeks pregnant after many years trying to conceive. After arriving home from a normal prenatal visit, she experiences mild cramping and has a gush of bright red vaginal bleeding. She calls the nurse and reports having soaked a pad with fresh blood in fewer than 30 minutes. The uterine cramping is worsening. What is the most appropriate response from the nurse?
You need to seek immediate attention from the PCP
On performing Leopold's maneuvers on a multiparous patient in early labor, the nurse finds no fetal parts in the fundus or above the symphysis. The fetal head is palpated in the right mid quadrant. The nurse notifies the admitting physician and anticipates which event?
a Cesarean delivery
which maternal factor my inhibit fetal descent?
a full bladder
What is the primary goal of nursing care immediately after birth?
to maintain the safety of the neonate from intrauterine to extrauterine life
During pregnancy a woman's cardiovascular system expands to care for the growing fetus. After birth, during the early postpartum period, the woman eliminates the additional fluid volume she has been carrying. What is one way she does this?
urinary elimination
A mother asks the nurse why her newborn is getting a Vitamin K injection. The nurse explains that the injection is necessary because?
vitamin K is needed for coagulation and the newborn does not produce vitamin K in the first few days following birth
A patient who is breastfeeding her newborn tells the nurse. "I notice that when I feed him, I have fairly strong contraction-like pain. Labor is over. Why am I having contractions now?" Which response by the nurse would be most appropriate?
your baby's sucking releases a hormone that causes the uterus to contract
Benign and malignant disorders of the female breast are important topics of discussion in optimizing women healthcare. Your patient has been diagnosed with intraductal papilloma and has requested more information regarding her diagnosis. As the nurse assigned to her case, you will be careful to include which of the following in your plan of care?
- recognize and address any noted anxiety on the basis of the diagnosis - educate your patient on the importance of ongoing care, as this diagnosis has been associated with malignant tendencies
A new mother is bottle feeding her newborn. The nurse should teach the patient to take which actions when the baby regurgitates small amounts of formula? select all that apply
- recognize this as a normal occurrence - understand that this may occur as a result of overfeeding
Which of the following are true regarding surfactant?
- surfactant is present in sufficient amounts by weeks 34-36 weeks gestation - surfactant lowers surface tension to prevent alveolar collapse
Some pregnancies result in a negative outcome. On the basics of your knowledge regarding genetic and hereditary influences on childbearing. Which of the following are true regarding genetic counseling? (select all that apply)
- the process may be slow - the process may be inconclusive
APGAR assessments are routinely taken at which timing intervals following birth of a newborn?
1 and 5 minutes
Vascular volume increases by 40% to 50% during pregnancy to:
provide adequate perfusion of the placenta
When assessing a newborns reflexes, the nurse strokes the newborn's cheek and the newborn turns toward the side that was stroked and begins sucking behaviors. The nurse documents which reflex as being present?
rooting reflex
An adolescent patient asks the nurse about how the ovaries work. The nurse would include which information in the reply?
storage of ova and maturation of them is one of the main functions of the ovaries
The mother baby nurse formulates which nursing goal for a newborn in transition from intrauterine to extrauterine life in the first few hours following birth?
to identify actual or potential problems that may require immediate or emergency attention
After teaching a group of adolescents girls about female reproductive development, the nurse determines that teaching was successful when the girl state that menarche is defined as a woman's first?
menstrual period
The nurse completes as assessment of an adolescent patient's menstrual pattern. Which finding should the nurse identify as being within normal limits?
menstrual flow usually lasts 4-6 days
Assessment of a newborn reveals tiny white pinpoint papules on a newborn's nose. The nurse documents this findings as?
milia
A male patient visits a fertility clinic after one year of attempting unsuccessfully to impregnate his wife. What is a risk factor associated with male infertility?
no or few sperm cells produced
During the birth, the primary care provider a mediolateral episiotomy. During the postpartum period the patient reports discomfort. To reduce this comfort and increase hygiene to the perineum, the nurse would encourage the new mother to use which intervention
peri bottle and warm water
To initiate the milk ejection reflex, the mother should?
place the newborn to the breast
A pregnant patient late in the second trimester comes to the emergency department with a report of painless, bright red vaginal bleeding. The patient states "It started all of a sudden and now it seems to have stopped". Which diagnosis is suspected?
placenta previa
Your patient questions the use of a electronic fetal monitor for her childbirth experience. In providing the advantages of the EFM, the nurse will be certain to include?
provides fetal response to each contraction
A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, what would the nurse expect to find?
stress incontinence with feeling low low abdominal pressure
Which assessment finding would indicate dehydration in the newborn?
sunken fontanels
While evaluating the fetal heart monitor tracing on a laboring patient, the nurse notes that there are fetal decelerations present. Which of the following assessments must the nurse make at this time?
the relationship between the decelerations and the labor contractions
A mother is concerned because her 2 day old newborn birth's weight was 8 lb (3584g) and his current weight is 7 lb 8 oz (3360g). What would be the nurse's response to the mother's concern?
the weight loss is a normal finding, since the newborns lose 5-10% of their birth weight in the first few days after birth
Based on a nurse's knowledge level about the postpartum period and the increased coagulability post-delivery, the nurse will closely assess the patients condition?
thromboembolism
