Women/OB 2nd Half

A new father is ready to take his wife and newborn son home. He proudly tells the nurse who is discharging them that within the next week he plans to start feeding the infant cereal between breastfeeding sessions. Which information should the nurse provide regarding this feeding plan?

"Feeding solid foods between breastfeeding sessions before your son is 4 to 6 months old will lead to an early cessation of breastfeeding."

The nurse is preparing to teach an antepartum client with GDM the correct method of administering an intermediate-acting insulin, such as neutral protamine Hagedorn (NPH), with a short-acting insulin (regular). In the correct order from 1 through 6, match the step number with the action needed to teach the client self-administration of this combination of insulin. a. check the insulin bottles for the expiration date b. gently rotate the insulin to mix it, and wipe the stopper c. wash hands d. inject air equal to the dose of regular insulin into the vial, and withdraw the medication e. without adding air, withdraw the correct dose of NPH insulin f. inject air equal to the dose of NPH insulin into the vial, and remove the syringe

1. wash hands 2.Check the insulin bottles for the expiration date. 3.Gently rotate the insulin to mix it, and wipe the stopper. 4. Inject air equal to the dose of NPH insulin into the vial, and remove the syringe 5.Inject air equal to the dose of regular insulin into the vial, and withdraw the medication. 6.Without adding air, withdraw the correct dose of NPH insulin.

At 1 minute after birth a nurse assesses an infant and notes a heart rate of 80 beats per minute, some flexion of extremities, a weak cry, grimacing, and a pink body but blue extremities. Which Apgar score does the nurse calculate based upon these observations and signs?

5

Which intervention can nurses use to prevent evaporative heat loss in the newborn?

Drying the baby after birth, and wrapping the baby in a dry blanket

What bacterial infection is definitely decreasing in neonates because of effective drug treatment?

Group B streptococci (GBS) infection

A diagnostic test commonly used to assess problems of the fallopian tubes is:

Hysterosalpingogram

As part of their teaching function at discharge, nurses should educate parents regarding safe sleep. Based on the most recent evidence, which information is incorrect and should be discussed with parents?

Place the infant on his or her abdomen to sleep.

Abruptio placenta is a risk factor for amniotic fluid embolism. True or False

True

The exact cause of preterm labor is unknown but believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Which type of infection has not been linked to preterm birth?

Viral

Nursing actions focused at reducing a postpartum woman's risk for cystitis include which of the following? (Select all that apply.)

Voiding within a few hours post-birth Oral intake of a minimum of 3000 mL per day Changing peri-pads every 3 to 4 hours or more frequently as indicated Reminding the woman to void every 3 to 4 hours while awake

A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents? a. "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide." b. "Surfactant is used to reduce episodes of periodic apnea." c. "Your baby needs this medication to fight a possible respiratory tract infection." d. "The drug keeps your baby from requiring too much sedation."

a. "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide."

Postoperative nursing care and education for a woman who had an abdominal hysterectomy includes (select all that apply): a. Administering hormone therapy as per provider orders. b. Assessing vaginal bleeding c. Instructing the woman vaginal intercourse until she has followup visit with surgeon. d. Instructing the woman to resume activities as comfort level permits.

a. Administering hormone therapy as per provider orders. b. Assessing vaginal bleeding c. Instructing the woman vaginal intercourse until she has followup visit with surgeon. d. Instructing the woman to resume activities as comfort level permits.

Which adverse prenatal outcomes are associated with the HELLP syndrome? (Select all that apply.) a. Renal failure b. Placenta previa c. Cirrhosis d. Maternal and fetal death e. Placental abruption

a. Renal failure d. Maternal and fetal death e. Placental abruption

A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients' emotional responses to their infertility. Which of the following responses would the nurse expect to find? (Select all that apply.) a. Anger at others who have babies b. Feelings of failure because they cannot make a baby. c. Sexual excitement because they want to conceive a baby. d. Guilt on the part of one partner because he or she is unable to give the other a baby.

a. Anger at others who have babies b. Feelings of failure because they cannot make a baby. d. Guilt on the part of one partner because he or she is unable to give the other a baby.

Which is true regarding breast cyst? a. It can be tender or not b. It is usually fixed and hard c. It requires surgery for diagnosis d. Removal is the best treatment

a. It can be tender or not

Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the client mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. This fetus is at the greatest risk for which condition? a. Macrosomia b. Congenital anomalies of the central nervous system c. Preterm birth d. Low birth weight

a. Macrosomia

23 y/o Amy delivered a baby 2 months ago and presents to the clinic with complaint of stool coming out of her vagina for the past week. The nurse suspects recto-vaginal fistula. What is the next most appropriate question the nurse should ask Amy? a. "How long has this been going on?" b. "Did you deliver your baby vaginally?" c. "How big was your baby?" d. "Are you sure it is stool?"

b. "Did you deliver your baby vaginally?"

Which statement related to cephalopelvic disproportion (CPD) is the least accurate? a. CPD can be related to either fetal size or fetal position. b. CPD can be accurately predicted c. Causes of CPD may have maternal or fetal origins. d. The fetus cannot be born vaginally.

b. CPD can be accurately predicted

Which statement, related to the reconditioning of the urinary system after childbirth, should the nurse understand? a. With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth. b. Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium. CorrectCorrect! c. Kidney function returns to normal a few days after birth. d. Diastasis recti abdominis is a common condition that alters the voiding reflex.

b. Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium.

According to the CDC, which of the following are true? a. Maternal mortality rate in the US has increased but infection is no longer a significant cause. b. Maternal mortality rate in the US has increased from 1987-2013 c. Maternal mortality rate in the US has increased primarily due to anesthesia complications d. Maternal mortality rate in the US has decreased from 1987-2013

b. Maternal mortality rate in the US has increased from 1987-2013

What form of heart disease in women of childbearing years generally has a benign effect on pregnancy? a. Rheumatic heart disease b. Mitral valve prolapse c. Congenital heart disease d. Cardiomyopathy

b. Mitral valve prolapse

Which preexisting factor is known to increase the risk of GDM? a. Underweight before pregnancy b. Previous birth of large infant c. Maternal age younger than 25 years d. Previous diagnosis of type 2 diabetes mellitus

b. Previous birth of large infant

Which conditions are infants of diabetic mothers (IDMs) at a higher risk for developing? a. Sepsis b. Respiratory distress syndrome c. Hyponatremia d. Iron deficiency anemia

b. Respiratory distress syndrome

What is the primary rationale for nurses wearing gloves when handling the newborn? a. As part of the Apgar protocol b. To protect the nurse from contamination by the newborn c. Because the nurse has the primary responsibility for the baby during the first 2 hours d. To protect the baby from infection

b. To protect the nurse from contamination by the newborn

During the assessment of the newborn at 3 hours of age, the perinatal nurse documents the presence on the infant's scalp of a unilateral, well-defined mass which does not cross the suture lines. The mother's chart indicates a prolonged labor with use of a vacuum extractor. The RN identifies this finding as: a. caput succedaneum b. cephalohematoma c. molding d. intraventricular hemorrhage

b. cephalohematoma

For which of the following reproductive cancers is high risk HPV infection thought to be primarily responsible? (Select all that apply). a. endometrial cancer b. cervical cancer c. ovarian cancer d. vulvar cancer e. vaginal cancer

b. cervical cancer d. vulvar cancer e. vaginal cancer

The perinatal nurse demonstrates for the student nurse the correct technique of postpartum uterine palpation. Support for the lower uterine segment is critical, as without it, there is an increased risk of: a. uterine edema b. uterine inversion c. incorrect measurement d. intensifying the patient's level of pain

b. uterine inversion

Pelvic floor exercises, also known as Kegel exercises, will help to strengthen the perineal muscles and encourage healing after childbirth. The nurse requests the client to repeat back instructions for this exercise. Which response by the client indicates successful learning? a. "I stand while practicing this new exercise routine." b. "I perform 10 of these exercises every day." c. "I pretend that I am trying to stop the flow of urine in midstream." d. "I contract my thighs, buttocks, and abdomen

c. "I pretend that I am trying to stop the flow of urine in midstream."

A mother is changing the diaper of her newborn son and notices that his scrotum appears large and swollen. The client is concerned. What is the best response from the nurse? a. "I don't know, but I'm sure it is nothing." b. "Your baby might have testicular cancer." c. "A large scrotum and swelling indicate a hydrocele, which is a common finding in male newborns. d. "Your baby's urine is backing up into his scrotum."

c. "A large scrotum and swelling indicate a hydrocele, which is a common finding in male newborns.

Which condition is considered a medical emergency that requires immediate treatment? a. ITP b. Uterine atony c. Inversion of the uterus d. Hypotonic uterus

c. Inversion of the uterus

According to the CDC, which of the following has the highest maternal mortality rate in the United States? a. White Women b. Asian Women c. Black Women d. Hispanic Women

c. Black Women

Which neurologic condition would require preconception counseling, if at all possible? a. Multiple sclerosis b. Eclampsia c. Epilepsy d. Bell palsy

c. Epilepsy

A new mother notices what appears to be bruising over her newborn's buttocks. She asks the nurse if the baby has been injured in some way. The nurse explains that this is: a. Erythema Toxicum b. Jaundice c. Mongolian spots d. Milia

c. Mongolian spots

Parents have been asked by the neonatologist to provide breast milk for their newborn son, who was born prematurely at 32 weeks of gestation. The nurse who instructs them regarding pumping, storing, and transporting the milk needs to assess their knowledge of lactation. Which statement is valid? a. The mother should only pump as much milk as the infant can drink. b. A glass of wine just before pumping will help reduce stress and anxiety. c. Premature infants more easily digest breast milk than formula. d. The mother should pump every 2 to 3 hours, including during the night.

c. Premature infants more easily digest breast milk than formula.

Which of the following perinatal complications have been associated with untreated asymptomatic bacteriuria? (Select all that apply). a. chorioamniotis b. congenital birth defects c. Preterm birth d. Low birth weight

c. Preterm birth d. Low birth weight

What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy? a. The affected arm should be held down close to the woman's side. b. Venipuncture for blood work should be performed on the affected arm. c. The blood pressure (BP) cuff should not be applied to the affected arm. d. The affected arm should be used for intravenous (IV) therapy.

c. The blood pressure (BP) cuff should not be applied to the affected arm.

The clinic nurse sees Xiao and her infant in the clinic for their 2-week follow-up visit. Xiao appears to be tired, her clothes and hair appear unwashed, and she does not make eye contact with her infant. She is carrying her son in the infant carrier and when asked to put him on the examining table, she holds him away from her body. The clinic nurse's most appropriate question to ask would be: a. "What has happened to you?" b. "Do you have help at home?" c. "Is there anything wrong with your son?" d. "Would you tell me about the first few days at home?"

d. "Would you tell me about the first few days at home?"

When is a prophylactic cerclage for an incompetent cervix usually placed (in weeks of gestation)? a. 23 to 24 b. 6 to 8 c. After 24 d. 12 to 14

d. 12 to 14

The nurse is assessing a full term, quiet, and alert newborn. What is the average expected apical pulse range (in beats per minute)? a. 100 to 120 b. 80 to 100 c. 150 to 180 d. 120 to 160

d. 120 to 160

How many kilocalories per kilogram (kcal/kg) of body weight does a breastfed term infant require each day? a. 75 to 90 b. 50 to 65 c. 150 to 200 d. 95 to 110

d. 95 to 110

A woman exhibits symptoms that may lead to a possible diagnosis of polycystic ovary syndrome (PCOS). While completing the initial assessment of the client, which clinical finding would the nurse not anticipate? a. Infertility b. Hirsutism c. Irregular menses d. Anorexia

d. Anorexia

The perinatal nurse listens as Chantal describes her labor and emergency cesarean birth. Providing an opportunity to review this experience may assist Chantal in: a. Her role development in the "letting go" stage b. Decreasing her ambivalence about her labor and birth c. Understanding her guilt involved in her labor and birth d. Developing more positive feelings about her labor and birth

d. Developing more positive feelings about her labor and birth

Which of the following cancers has no accurate screening test for secondary prevention? a. Uterine cancer b. Breast cancer c. Cervical cancer d. Ovarian cancer

d. Ovarian cancer

The nurse is massaging a boggy uterus. The uterus does not respond to the massage. Which medication would the nurse expect would be given first: a. Methergine b. Epinephrine c. Carboprost (Hemabate) d. Oxytocin or pitocin

d. Oxytocin or pitocin

Having a genetic mutation may create an 85% chance of developing breast cancer in a woman's lifetime. Which condition does not increase a client's risk for breast cancer? a. Cowden syndrome b. Li-Fraumeni syndrome c. BRCA1 or BRCA2 gene mutation d. Paget disease

d. Paget disease

What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony? a. Establishing venous access b. Catheterizing the bladder c. Preparing the woman for surgical intervention d. Performing fundal massage

d. Performing fundal massage

As a powerful central nervous system (CNS) stimulant, which of these substances can lead to miscarriage, preterm labor, placental separation (abruption), and stillbirth? a. alcohol b. phencyclidine c. heroin d. cocaine

d. cocaine

A woman with preeclampsia has a seizure. What is the nurse's highest priority during a seizure? a. To insert an oral airway b. To suction the mouth to prevent aspiration c. To administer oxygen by mask d. To stay with the client and call for help

d. To stay with the client and call for help

The perinatal nurse teaches the postpartum woman about the normal process of diuresis that she can expect to occur approximately 6 to 8 hours after birth. A decrease in which of the following hormones is primarily responsible for the diuresis? a. prolactin b. progesterone c. lactogen d. estrogen

d. estrogen

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman? a. Progesterone b. Estrogen c. Human placental lactogen d. Prolactin

d. prolactin

Infants born between 34 0/7 and 36 6/7 weeks of gestation are called late-preterm infants because they have many needs similar to those of preterm infants. Because they are more stable than early-preterm infants, they may receive care that is similar to that of a full-term baby. These infants are at increased risk for which conditions? (Select all that apply.)

problems with thermoregulation hyperbillirubinemia sepsis

Depo provera, or The Shot, contains which of the following hormones?

progesterone

The nurse is assessing a full term, quiet, and alert newborn. What is the average expected apical pulse range (in beats per minute)? a. 100 to 120 b. 120 to 160 c. 80 to 100 d. 150 to 180

b. 120 to 160

What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy? a. Monitoring uterine contractions b. Assessing FHR and maternal vital signs c. Performing a venipuncture for hemoglobin and hematocrit levels d. Placing clean disposable pads to collect any drainage

b. Assessing FHR and maternal vital signs

A breastfeeding woman develops engorged breasts at 3 days postpartum. What action will help this client achieve her goal of reducing the engorgement? a. Avoid using a breast pump. b. Breastfeed her infant every 2 hours. c. Skip feedings to enable her sore breasts to rest. d. Reduce her fluid intake for 24 hours.

b. Breastfeed her infant every 2 hours.

Which condition might premature infants who exhibit 5 to 10 seconds of respiratory pauses, followed by 10 to 15 seconds of compensatory rapid respiration, be experiencing? a. Suffering from sleep or wakeful apnea b. Breathing in a respiratory pattern common to premature infants c. Experiencing severe swings in blood pressure d. Trying to maintain a neutral thermal environment

b. Breathing in a respiratory pattern common to premature infants

Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. What are possible causes of early miscarriage? (Select all that apply.) a. Nausea and vomiting in early pregnancy b. Chromosomal abnormalities c. Systemic disorders d. Endocrine imbalance e. Varicella

b. Chromosomal abnormalities c. Systemic disorders d. Endocrine imbalance e. Varicella

What information is important for the nurse to include in planning for the care of a woman who has had a vaginal hysterectomy (no oopherectomy) for fibroids? a. Expect surgical menopause. b. Expect no changes in her hormone levels. c. Next pap smear is due in one year. d. Expect to be fully recovered in 4 to 6 weeks.

b. Expect no changes in her hormone levels.

Which diagnostic test is used to confirm a suspected diagnosis of breast cancer? a. Magnetic resonance imaging (MRI) b. Needle-localization biopsy c. Mammogram d. Ultrasound

b. Needle-localization biopsy

A woman at 28 weeks of gestation experiences blunt abdominal trauma as the result of a fall. The nurse must closely observe the client for what? a. Complaints of abdominal pain b. Placental abruption c. Alteration in maternal vital signs, especially blood pressure d. Hemorrhage

b. Placental abruption

In caring for the preterm infant, what complication is thought to be a result of high arterial blood oxygen level?

ROP

Which statement is the most appropriate for the nurse to make when caring for bereaved parents? a. "What can I do for you?" b. "I know how you feel." c. "You have an angel in heaven." d. "This happened for the best."

a. "What can I do for you?"

A pregnant woman arrives at the birth unit in labor at term, having had no prenatal care. After birth, her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. Based on her infant's physical findings, this woman should be questioned about her use of which substance during pregnancy? a. Alcohol b. Cocaine c. Marijuana d. Heroin

a. Alcohol

A new father wants to know what medication was put into his infant's eyes and why it is needed. How does the nurse explain the purpose of the erythromycin (Ilotycin) ophthalmic ointment? a. Erythromycin (Ilotycin) ophthalmic ointment destroys an infectious exudate caused by Staphylococcus that could make the infant blind. b. This ophthalmic ointment prevents gonorrheal infection of the infant's eyes, potentially acquired from the birth canal. c. This ointment prevents the infant's eyelids from sticking together and helps the infant see. d. Erythromycin (Ilotycin) prevents potentially harmful exudate from invading the tear ducts of the infant's eyes, leading to dry eyes.

b. This ophthalmic ointment prevents gonorrheal infection of the infant's eyes, potentially acquired from the birth canal.

The perinatal nurse understands that the purpose of the surgical "time-out" is to: a. Confirm that the surgeon is ready to begin b. Verify that it is the correct patient and planned procedure . c. Verify that anesthesia is adequate d. Confirm that the neonatal team is in attendance

b. Verify that it is the correct patient and planned procedure

To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet? a. Eat her meals and snacks on a fixed schedule. b. Reduce the carbohydrates in her diet. c. Eat six small equal meals per day. d. Increase her consumption of protein.

a. Eat her meals and snacks on a fixed schedule.

When assisting the mother, father, and other family members to actualize the loss of an infant, which action is most helpful? a. Ensuring the baby is clothed or wrapped if the parents choose to visit with the baby b. Setting a firm time for ending the visit with the baby so that the parents know when to let go c. Using the words lost or gone rather than dead or died d. Making sure the family understands that naming the baby is important

a. Ensuring the baby is clothed or wrapped if the parents choose to visit with the baby

Postoperative care of the pregnant woman who requires abdominal surgery for appendicitis includes which additional assessment? a. Fetal heart rate (FHR) and uterine activity b. Signs and symptoms of infection c. Vital signs and incision d. Intake and output (I&O) and intravenous (IV) site

a. Fetal heart rate (FHR) and uterine activity

Reports have linked third trimester use of selective serotonin uptake inhibitors (SSRIs) with a constellation of neonatal signs. The nurse is about to perform an assessment on the infant of a mother with a history of a mood disorder. Which signs and symptoms in the neonate may be the result of maternal SSRI use? (Select all that apply.) a. Fever b. Hypotonia c. Hyperglycemia d. Irritability e. Shivering

a. Fever d. Irritability e. Shivering

After giving birth to a healthy infant boy, a primiparious client, 1 years of age, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is "Deficient knowledge of infant care." What should the nurse be certain to include in the plan of care as he or she prepares the client for discharge? a. give the client written information on bathing her infant b. provide time for the client to bathe her infant after she views a demonstration of infant bathing c. teach the client how to feed and bathe her infant d. advise the client that all mothers instinctively know how to care for their infants

b. provide time for the client to bathe her infant after she views a demonstration of infant bathing

Which of the following nursing actions are directed at assisting men in their transition to fatherhood? (Select all that apply.) a. encourage the woman to take on the major responsibility for infant care b. talk to the couple about their expectations of the parenting role c. praise the father for his interactions with his infant d. provide information on infant care and behavior to both parents

b. talk to the couple about their expectations of the parenting role c. praise the father for his interactions with his infant d. provide information on infant care and behavior to both parents

A mother of a 10-day-old infant calls the clinic and reports that her baby is having loose, green stools. The mother is breastfeeding her infant. Which of the following is the best nursing action? a. Instruct the woman to bring her infant to the clinic. b. Instruct the woman to decrease the amount of feeding for 24 hours and to call if the stools continue to be loose. c. Explain that this is a normal stool pattern. d. Instruct the woman to eat a bland diet for the next 24 hours and call back if the stools continue to be loose and green.

a. Instruct the woman to bring her infant to the clinic.

An infant admitted to the newborn nursery has a blood glucose level of 55 mg/dL. Which of the following actions should the nurse perform at this time? a. Provide the baby with routine feedings. b. Assess the baby's blood pressure. c. Place the baby under the infant warmer. d. Monitor the baby's urinary output.

a. Provide the baby with routine feedings.

A serious but uncommon complication of undiagnosed or partially treated hyperthyroidism is a thyroid storm, which may occur in response to stress such as infection, birth, or surgery. What are the signs and symptoms of this emergency disorder? (Select all that apply). a. Restlessness b. Fever c. Hypertension d. Hypothermia e. Bradycardia

a. Restlessness b. Fever

Which of the following breath sounds are normal to hear in the neonate during the first few hours postbirth? a. Scattered crackles b. Wheezes c. Stridor d. Grunting

a. Scattered crackles

For an infant experiencing symptoms of drug withdrawal, which intervention should be included in the plan of care? a. Snugly swaddling the infant and tightly holding the baby b. Playing soft music during feeding c. Feeding every 4 to 6 hours to allow extra rest between feedings d. Administering chloral hydrate for sedation

a. Snugly swaddling the infant and tightly holding the baby

What is one of the initial signs and symptoms of puerperal infection in the postpartum client? a. Temperature of 38° C (100.4° F) or higher on 2 successive days b. Fatigue continuing for longer than 1 week c. Pain with voiding d. Profuse vaginal lochia with ambulation

a. Temperature of 38° C (100.4° F) or higher on 2 successive days

A couple who has sought infertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur? a. The testes are overheated. b. The vas deferens is ligated. c. The prostate gland is enlarged. d. alcohol use

a. The testes are overheated.

What is the primary purpose for magnesium sulfate administration for clients with preeclampsia and eclampsia? a. To prevent convulsions b. To improve patellar reflexes and increase respiratory efficiency c. To prevent a boggy uterus and lessen lochial flow d. To shorten the duration of labor

a. To prevent convulsions

Anna wants to know if her baby has Trisomy 18 as early in the pregnancy as possible. She is 8 weeks pregnant. Her physician will suggest which of the following diagnostic test? a. chorionic villi sampling (CVS) b. Noninvasive prenatal screening test c. sequential integrated test d. amniocentesis

a. chorionic villi sampling (CVS)

Which medications are used to manage PPH? (Select all that apply.) a. methergine b. magnesium sulfate c. hemabate d. terbutaline e. oxytocin

a. methergine c. hemabate e. oxytocin

Which of the following is the most effective contraception? a. the implant b. condoms c. natural family planning d. the vaginal ring e. oral contraceptive pills

a. the implant

A first time father is changing the diaper of his 1dayold daughter. He asks the nurse" What is this black, sticky stuff in her diaper?" What is the nurse's best response? a. "That means your baby is bleeding internally." b. "Oh, don't worry about that. It's okay." c. "That's meconium, which is your baby's first stool. It's normal." d. "That's transitional stool."

c. "That's meconium, which is your baby's first stool. It's normal."

A 35-year-old G1 P1 postpartum woman is Rh negative and has given birth to an Rh positive infant. Rh0(D) immune globulin is to be administered. The most appropriate dose that the perinatal nurse would expect to be ordered would be: Select one: a. 120 mcg b. 250 mcg c. 300 mcg d. 350 mcg

c. 300 mcg

Which congenital anomalies can occur as a result of the use of antiepileptic drugs (AEDs) in pregnancy? (Select all that apply.) a. Diaphragmatic hernia b. Gastroschisis c. Congenital heart disease d. Neural tube defects e. Cleft lip

c. Congenital heart disease d. Neural tube defects e. Cleft lip

A premature infant never seems to sleep longer than an hour at a time. Each time a light is turned on, an incubator closes, or people talk near her crib, she wakes up and inconsolably cries until held. What is the correct nursing diagnosis beginning with "ineffective coping, related to"? a. Physiologic distress b. Behavioral responses c. Environmental stress d. Severe immaturity

c. Environmental stress

The nurse is teaching the parents of a 1-day-old baby how to give their baby a bath. Which of the following actions should be included? a. Clean the eye from the outer aspect to the inner aspect. b. Keep the door of the room open to allow for ventilation. c. Gather all supplies before beginning the bath. d. Bathe daily with warm soapy water.

c. Gather all supplies before beginning the bath.

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. The fetal heart rate (FHR) before birth is 180 beats per minute with limited variability. At birth the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic. Based on the maternal history, what is the most likely cause of this newborn's distress? a. Phrenic nerve injury b. Hypoglycemia c. Sepsis d. Respiratory distress syndrome

c. Sepsis

A woman who is 30 weeks of gestation arrives at the hospital with bleeding. Which differential diagnosis would not be applicable for this client? a. Abruptio placentae b. Placenta previa c. Spontaneous abortion d. Cord insertion

c. Spontaneous abortion

A client is to take Clomiphene Citrate for infertility. Which of the following is the expected action of this medication? a. Decrease the symptoms of endometriosis b. Increase serum progesterone levels c. Stimulate release of FSH and LH d. Reduce the acidity of vaginal secretions

c. Stimulate release of FSH and LH

A woman on the day of discharge from the postpartum unit asks a number of questions regarding breastfeeding and shares that she is nervous about taking her baby home and not being able to remember everything she has been taught. These are behaviors associated with: a. Bonding b. Taking in c. Taking hold d. Attachment

c. Taking hold

A nurse is providing education to a support group of women newly diagnosed with breast cancer. It is important for the nurse to discuss which factor related to breast cancer with the group? a. Breast cancer is the leading cause of cancer death in women. b. In the United States, 1 in 10 women will develop breast cancer in her lifetime. c. The exact cause of breast cancer remains unknown. d. Genetic mutations account for 50% of women who will develop breast cancer.

c. The exact cause of breast cancer remains unknown.

The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt? . Limited protein and fat intake b. Prophylactic antibiotics c. Large doses of vitamin C during pregnancy d. Strict aseptic technique, including hand washing, by all health care personnel

d. Strict aseptic technique, including hand washing, by all health care personnel

A nursery nurse observes that a full-term AGA neonate has nasal congestion, hypertonia, and tremors and is extremely irritable. Based on these observations, the nurse suspects which of the following?

neonatal withdrawal

A perinatal nurse assesses a term newborn for respiratory functioning. The nurse knows that which of the following conditions is normal for newborns?

A breathing pattern that is often shallow, diaphragmatic, and irregular

Which client is most likely to experience strong and uncomfortable afterpains?

A woman who is a gravida 4, para 4-0-0-4

A certified nursing assistant (CNA) is working with a registered nurse (RN) in the neonatal nursery. Which of the following actions would be appropriate for the nurse to delegate to the CNA?

Bathe and weigh a 3-hour-old baby

Endometritis is an infection that usually starts at the placental site. True or False

True

If a woman is at risk for thrombus and is not ready to ambulate, which nursing intervention would the nurse use? (Select all that apply.) a. Immediately notifying the physician if a positive Homans sign occurs b. Putting her in antiembolic stockings c. Having her sit in a chair d. Promoting bed rest e. Having her flex, extend, and rotate her feet, ankles, and legs

a positive Homans sign occurs b. Putting her in antiembolic stockings e. Having her flex, extend, and rotate her feet, ankles, and legs

The client is being induced in response to worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active, despite several hours of oxytocin administration. She asks the nurse, "Why is this taking so long?" What is the nurse's most appropriate response? a. "The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor." b. "The length of labor varies for different women." c. "Your baby is just being stubborn." d. "I don't know why it is taking so long."

a. "The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor."

A perinatal nurse is giving discharge instructions to a woman, status postsuction, and curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. What is the best response by the nurse? a. "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, then it would make the diagnosis of this cancer more difficult." b. "If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnancy is rare. Therefore, to improve your chance of a successful pregnancy, not getting pregnant at this time is best." c. "If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore, if you desire a future pregnancy, it would be better for you to use the most reliable method of contraception available." d. "Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar pregnancy."

a. "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, then it would make the diagnosis of this cancer more difficult."

On day 3 of life, a newborn continues to require 100% oxygen by nasal cannula. The parents ask if they may hold their infant during his next gavage feeding. Considering that this newborn is physiologically stable, what response should the nurse provide? a. "You may hold your baby during the feeding." b. "You may only hold your baby's hand during the feeding." c. "Feedings cause more physiologic stress; therefore, the baby must be closely monitored. I don't think you should hold the baby." d. "Parents are not allowed to hold their infants who are dependent on oxygen."

a. "You may hold your baby during the feeding."

Sally is 34 weeks pregnant and has a biophysical profile score of 8. She asks the nurse what does that mean? The nurse's best response is: a. "Your baby has low risk for having a problem having enough oxygen in her body and your doctor will probably want to do the test again soon. I will call your doctor. " b. " Your baby may be having some problems and your doctor may want to check to see if it is safe to deliver her soon. I will call your doctor." c. "Your baby is in danger of dying and you will probably need to deliver ASAP. I will call your doctor." d. "Since you are more than 36 weeks, it is best to deliver your baby as she may have asphyxia. I will call your doctor."

a. "Your baby has low risk for having a problem having enough oxygen in her body and your doctor will probably want to do the test again soon. I will call your doctor. "

A client is diagnosed with having a stillborn infant. At first, she appears stunned by the news, cries a little, and then asks the nurse to call her mother. What is the proper term for the phase of bereavement that this client is experiencing? a. Acute distress b. Reorganization c. Intense grief d. Anticipatory grief

a. Acute distress

The nurse is developing a plan of care for a client who is in the "taking-in" phase after delivering a healthy baby boy. Which of the following should the nurse include in the plan? a. Assist the woman in selecting a nutritious meal plan. b. Teach baby care skills like diapering. c. Discuss the pros and cons of circumcision. d. Counsel her regarding future sexual encounters.

a. Assist the woman in selecting a nutritious meal plan.

The perinatal nurse describes infant feeding cues to a new mother. These feeding cues include (select all that apply): a. Awake and alert b. Mouth movements c. Moving the hand to the mouth d. Yawning

a. Awake and alert b. Mouth movements c. Moving the hand to the mouth

Which of the following lab tests are routinely performed on pregnant women? (Select all that apply). a. Blood type b. 3 hr GTT c. Genetic testing for cystic fibrosis d. Rubella titer e. Syphilis test

a. Blood type d. Rubella titer e. Syphilis test

Which of the following is an indication for the administration of methylergonovine (Methergine)? a. Boggy uterus that does not respond to massage and oxytocin therapy b. Woman with a large hematoma c. Woman with a deep vein thrombosis d. Woman with severe postpartum depression

a. Boggy uterus that does not respond to massage and oxytocin therapy

A postpartum woman has been diagnosed with postpartum psychosis and will shortly be admitted to the psychiatric unit. Which of the following actions should the nurse perform to ensure safety for both mother and infant? a. Closely monitor all mother-infant interactions b. Maintain client on strict bed rest. c. Restrict visitation to her partner. d. Carefully monitor toileting.

a. Closely monitor all mother-infant interactions

In appraising the growth and development potential of a preterm infant, the nurse should be cognizant of the information that is best described in which statement? a. Correct for milestones, such as motor competencies and vocalizations, until the child is approximately 2 years of age. b. Tell the parents that their child will not catch up until approximately age 10 years (for girls) to age 12 years (for boys). c. Know that the length and breadth of the trunk is the first part of the infant to experience catch-up growth. d. Know that the greatest catch-up period is between 9 and 15 months postconceptual age.

a. Correct for milestones, such as motor competencies and vocalizations, until the child is approximately 2 years of age.

A client in late middle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems, as well as sensations of bearing down and of something in her vagina. What condition would the nurse suspect based upon this report? a. Cystocele and/or rectocele b. Uterine prolapse c. Pelvic relaxation d. Genital fistulas

a. Cystocele and/or rectocele

Indications for a primary cesarean birth are often nonrecurring. Therefore, a woman who has had a cesarean birth with a low transverse scar may be a candidate for vaginal birth after cesarean (VBAC). Which clients would be less likely to have a successful VBAC? (Select all that apply.) a. Delivery at a rural hospital b. Maternal obesity (BMI >30) c. AfricanAmerican race d. Lengthy interpregnancy interval e. Estimated fetal weight <4000 g

a. Delivery at a rural hospital b. Maternal obesity (BMI >30) c. AfricanAmerican race

The nurse is performing an assessment on a client who thinks she may be experiencing preterm labor. Which information is the most important for the nurse to understand and share with the client? a. Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change. b. Braxton Hicks contractions often signal the onset of preterm labor. c. Because all women must be considered at risk for preterm labor and prediction is so variable, teaching pregnant women the symptoms of preterm labor probably causes more harm through false alarms. d. Because preterm labor is likely to be the start of an extended labor, a woman with symptoms can wait several hours before contacting the primary caregiver.

a. Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

The client is undergoing treatment for ovarian cancer. Which common nutritional problems are related to gynecologic cancers and the treatment thereof? (Select all that apply.) a. Diarrhea b. Constipation c. Increased Appetite d. Stomatitis e. Nausea and vomiting

a. Diarrhea b. Constipation d. Stomatitis e. Nausea and vomiting

If nonsurgical treatment for late PPH is ineffective, which surgical procedure would be appropriate to correct the cause of this condition? a. Dilation and curettage (D&C) b. Laparotomy c. Laparoscopy d. Hysterectomy

a. Dilation and curettage (D&C)

The "Period of Purple Crying" is a program developed to educate new parents about infant crying and the dangers of shaking a baby. Each letter in the acronym "PURPLE" represents a key concept of this program. Which concepts are accurate? (Select all that apply.) a. E: evening b. P: peak of crying and painful expression c. L: extremely loud d. U: unexpected e. R: baby is resting at last

a. E: evening b. P: peak of crying and painful expression d. U: unexpected

The nurse is caring for a postpartum woman who gave birth to a healthy, full-term baby girl. She has a 2-year-old son. She voices concern about her older child's adjustment to the new baby. Nursing actions that will facilitate the older son's adjustment to having a new baby in the house would include which of the following? (Select all that apply.) a. Explain to the mother that she can have her son visit her in the hospital. b. Teach her son how to change the baby's diapers. c. Assist her son in holding his new baby sister. d. Recommend that she spend time reading to her older son while he sits in her lap.

a. Explain to the mother that she can have her son visit her in the hospital. c. Assist her son in holding his new baby sister.

A newborn was admitted to the neonatal intensive care unit (NICU) after being delivered at 29 weeks of gestation to a 28-year-old multiparous, married, Caucasian woman whose pregnancy was uncomplicated until the premature rupture of membranes and preterm birth. The newborn's parents arrive for their first visit after the birth. The parents walk toward the bedside but remain approximately 5 feet away from the bed. What is the nurse's most appropriate action? a. Go to the parents, introduce him or herself, and gently encourage them to meet their infant. Explain the equipment first, and then focus on the newborn b. Leave the parents at the bedside while they are visiting so that they have some privacy. c. Tell the parents only about the newborn's physical condition and caution them to avoid touching their baby. d. Wait quietly at the newborn's bedside until the parents come closer.

a. Go to the parents, introduce him or herself, and gently encourage them to meet their infant. Explain the equipment first, and then focus on the newborn

What is the most important nursing action in preventing neonatal infection? a. Good handwashing or hand hygiene b. Standard Precautions c. Separate gown technique d. Isolation of infected infants

a. Good handwashing or hand hygiene

Which infant is most likely to express Rh incompatibility? a. Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor b. Infant who is Rh positive and a mother who is Rh positive c. Infant who is Rh negative and a mother who is Rh negative d. Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor

a. Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor

A woman gave birth to a 3200 g baby girl with an estimated gestational age of 40 weeks. The baby is 1 hour of age. In preparation for administration of Vitamin K to the infant, the nurse will explain to the parents that an injection of this medication: a. Influences the activation of coagulation factors to prevent delayed clotting and hemorrhagic disease b. Prevents high levels of unconjugated bilirubin in the newborn's blood c. Prevents the excessive loss of RBCs d. Aids the liver in regulation of blood glucose

a. Influences the activation of coagulation factors to prevent delayed clotting and hemorrhagic disease

Which important component of nutritional counseling should the nurse include in health teaching for a pregnant woman who is experiencing cholecystitis? a. Instruct the woman to eat a low-fat diet and to avoid fried foods. b. Assess the woman's dietary history for adequate calories and proteins. c. Teach the woman that the bulk of calories should come from proteins. d. Instruct the woman to eat a low-cholesterol, low-salt diet

a. Instruct the woman to eat a low-fat diet and to avoid fried foods.

A G2 P2 woman who experienced a prolonged labor and prolonged rupture of membranes is at risk for metritis. Which of the following nursing actions are directed at decreasing this risk? (Select all that apply.) a. Instruct woman to increase her fluid intake b. Instruct woman to change her peri-pads after each voiding c. Instruct woman to ambulate in the halls four times a day d. Instruct woman to apply ice packs to the perineum

a. Instruct woman to increase her fluid intake b. Instruct woman to change her peri-pads after each voiding c. Instruct woman to ambulate in the halls four times a day

The nurse is working with a 36-year-old, married client, with 6 children who smokes. The woman states, "I don't expect to have any more kids, but I hate the thought of being sterile." Which of the following contraceptive methods would be best for the nurse to recommend to this client? a. Intrauterine contraceptive device (IUD) b. Contraceptive patch c. Bilateral tubal ligation d. Birth control pills with estrogen and progestin

a. Intrauterine contraceptive device (IUD)

The nurse who is caring for a woman hospitalized for hyperemesis gravidarum would expect the initial treatment to involve what? a. Intravenous (IV) therapy to correct fluid and electrolyte imbalances b. Antiemetic medication, such as pyridoxine, to control nausea and vomiting c. Corticosteroids to reduce inflammation d. Enteral nutrition to correct nutritional deficits

a. Intravenous (IV) therapy to correct fluid and electrolyte imbalances

Which of the following is true regarding physiologic jaundice? (Select all that apply). a. Jaundice is more common in preterm infants b. Jaundice is noted 24 hours after birth c. Jaundice persists longer than 14 days of life in a term infant d. It is recommended the mother stop breastfeeding until jaundice resolves e. Jaundice is noted within 24 hours after birth

a. Jaundice is more common in preterm infants b. Jaundice is noted 24 hours after birth

To accurately measure the neonate's head, the nurse places the measuring tape around the head: a. Just above the ears and eyebrows b. Middle of the ear and over the eyes c. Middle of the ear and over the bridge of the nose d. Just below the ears and over the upper lip

a. Just above the ears and eyebrows

Jennifer is 3 hours postpartum following the vaginal delivery of a 9lb 15oz baby girl. Estimated blood loss at delivery was 800 ml. The RN is aware that Jennifer experienced an early-postpartum hemorrhage. Select the appropriate nursing actions for the care of this patient. (Select all that apply.) a. Maintain IV site in case fluids/medication for PPH are indicated b. Frequent fundal assessment to prevent uterine atony and further blood loss c. Assess for displaced uterus secondary to overdistended bladder. d. Assess lochia for amount and for clots

a. Maintain IV site in case fluids/medication for PPH are indicated b. Frequent fundal assessment to prevent uterine atony and further blood loss c. Assess for displaced uterus secondary to overdistended bladder. d. Assess lochia for amount and for clots

Indications for a primary cesarean birth are often nonrecurring. Therefore, a woman who has had a cesarean birth with a low transverse scar may be a candidate for vaginal birth after cesarean (VBAC). Which clients would be less likely to have a successful VBAC? (Select all that apply.) a. Maternal obesity (BMI >30) b. Lengthy interpregnancy interval c. Estimated fetal weight <4000 g d. Delivery at a rural hospital e. African-American race

a. Maternal obesity (BMI >30) d. Delivery at a rural hospital e. African-American race

For which of the following conditions is Daily Fetal Movement Count indicated? (Select all that apply). a. Mother with low amniotic fluid volume or oligohydraminos b. Pregnant woman who is older than 35 years with no complications c. Mother who complains of headaches during pregnancy that are relieved with Tylenol d. Mother with diabetes during pregnancy

a. Mother with low amniotic fluid volume or oligohydraminos d. Mother with diabetes during pregnancy

Researchers have found a number of common risk factors that increase a woman's chance of developing a breast malignancy. It is essential for the nurse who provides care to women of any age to be aware of which risk factors? (Select all that apply.) a. Nulliparity or first pregnancy after age 40 years b. Late menarche c. Early menopause d. Family history e. Age

a. Nulliparity or first pregnancy after age 40 years d. Family history e. Age

Cellulitis with or without abscess formation is a fairly common condition. The nurse is providing education for a client whose presentation to the emergency department includes an infection of the breast. Which information should the nurse share with this client? (Select all that apply.) a. Obesity, smoking, and diabetes are risk factors. b. Breast is pale in color and cool to the touch. c. Treatment for cellulitis or breast infection will include antibiotics. d. Nipple piercing may be the cause of a recent infection e. Methicillin- resistant Streptococcus aureus is the most common pathogen.

a. Obesity, smoking, and diabetes are risk factors. c. Treatment for cellulitis or breast infection will include antibiotics. d. Nipple piercing may be the cause of a recent infection

a. Obtain written consent from the parents b. Administer acetaminophen PO 1 hour before procedure per provider order. c. Feed the neonate glucose water 30 minutes before the procedure. d. Verify that the neonate has voided

a. Obtain written consent from the parents b. Administer acetaminophen PO 1 hour before procedure per provider order. d. Verify that the neonate has voided

The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, approximately 500,000 women in America experience a more severe syndrome known as PPD. Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis? Select one: a. PPD can easily go undetected. b. Only mental health professionals should teach new parents about this condition. c. PPD symptoms are consistently severe. d. This syndrome affects only new mothers.

a. PPD can easily go undetected.

What marks on a baby's skin may indicate an underlying problem that requires notification of a physician? a. Petechiae scattered over the infant's body b. Erythema toxicum neonatorum anywhere on the body c. Mongolian spots on the back d. Telangiectatic nevi on the nose or nape of the neck

a. Petechiae scattered over the infant's body

Tanya, a 30-year-old woman, is being prepared for a planned cesarean birth. The perinatal nurse assists the anesthesiologist with the spinal block and then positions Tanya in a supine position. Tanya's blood pressure drops to 90/52, and there is a decrease in the fetal heart rate to 110 bpm. The perinatal nurse's best response is to: a. Place Tanya in a left lateral tilt b. Discontinue Tanya's intravenous administration. c. Have naloxone (Narcan) ready for administration. d. Have epinephrine ready for administration.

a. Place Tanya in a left lateral tilt

A woman at 28 weeks of gestation experiences blunt abdominal trauma as the result of a fall. The nurse must closely observe the client for what? a. Placental abruption b. Hemorrhage c. Complaints of abdominal pain d. Alteration in maternal vital signs, especially blood pressure

a. Placental abruption

Which woman has the highest risk for endometrial cancer? a. Postmenopausal woman with hypertension b. Perimenopausal woman who has a cystocele c. Woman who has an intrauterine device (IUD) d. Woman who has been on birth control pills for 15 years

a. Postmenopausal woman with hypertension

Which of the following are indications for cesarean birth? (Select all that apply.) a. Previous cesarean birth b. Placental abnormalities c. Previous uterine surgery d. Failure to progress in labor

a. Previous cesarean birth b. Placental abnormalities c. Previous uterine surgery d. Failure to progress in labor

A pregnant woman who has a history of cesarean births is requesting to have a vaginal birth after cesarean (VBAC). In which of the following situations should the nurse advise the patient that her request may be declined? a. Previous uterine surgery b. Flexed fetal attitude c. Previous low flap uterine incision d. Positive vaginal candidiasis

a. Previous uterine surgery

The perinatal nurse notes a rapid decrease in the fetal heart rate that does not recover immediately following an amniotomy. The most likely cause of this obstetrical emergency is: a. Prolapsed umbilical cord b. Vasa previa c. Oligohydramnios d. Placental abruption

a. Prolapsed umbilical cord

A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment after childbirth. Recognizing the needs of women during this stage, how should the nurse respond? a. Provide time for the mother to reflect on the events of her labor and delivery. b. Recognize the woman's limited attention span by giving her written materials to read when she gets home rather than doing a teaching session while she is in the hospital c. Foster an active role in the baby's care. d. Promote maternal independence by encouraging her to meet her own hygiene and comfort needs

a. Provide time for the mother to reflect on the events of her labor and delivery.

The nurse is advising parents of a full-term neonate being discharged from the hospital regarding car seat safety. Which of the following should be included in the teaching plan? a. Put the car seat facing forward only after the baby reaches 20 pounds. b. The infant car seat should be placed facing the rear seat in the front seat of the car. c. Car seats are recommended only when traveling longer distances from home; holding the infant is safe for short trips d. It is safe to leave an infant in a car seat alone as long as the windows are down at least 1 inch

a. Put the car seat facing forward only after the baby reaches 20 pounds.

Supportive care of the infant with neonatal abstinence syndrome (NAS) include both pharmacologic and nonpharmacologic therapy. Nonpharmacologic therapy would include which of the following (select all that apply): a. Quiet environment with low lighting and use of soft voices b. Clonidine for infants who do not respond to a single agent c. Swaddling, clustering care, use of pacifiers to promote "self-soothing" d. Use of oral morphine and methadone

a. Quiet environment with low lighting and use of soft voices c. Swaddling, clustering care, use of pacifiers to promote "self-soothing"

When caring for clients with neoplasms of the reproductive system, the nurse must begin by assessing the woman's knowledge of the disorder, its management, and prognosis. This assessment should be followed by a nursing diagnosis. Which diagnosis fails to address the psychologic effect of these disorders? a. Risk for injury, related to lack of skill for self-care b. Disturbed body image, as a result of changes in anatomy c. Interrupted family processes d. Anxiety, related to surgical procedures

a. Risk for injury, related to lack of skill for self-care

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, which finding alerts the nurse to possible side effects? a. Serum magnesium level of 10 mg/dl b. Urine output of 160 ml in 4 hours c. DTRs 2+ and no clonus d. Respiratory rate (RR) of 16 breaths per minute

a. Serum magnesium level of 10 mg/dl

Pain should be regularly assessed in all newborns. If the infant is displaying physiologic or behavioral cues that indicate pain, then measures should be taken to manage the pain. Which interventions are examples of nonpharmacologic pain management techniques? (Select all that apply.) a. Swaddling b. Skin-to-skin contact with the mother c. Sucrose d. Nonnutritive sucking e. Acetaminophen

a. Swaddling b. Skin-to-skin contact with the mother c. Sucrose d. Nonnutritive sucking

Painful nipples are a major reason why women stop breastfeeding. A primary intervention to decrease nipple irritation is: a. Teaching proper techniques for latching-on and releasing of suction b. Applying hot compresses to breast prior to feeding c. Instructing woman to express colostrum or milk at the end of the feeding session and rub it on her nipples d. Air drying nipples for 10 minutes at the end of the feeding session

a. Teaching proper techniques for latching-on and releasing of suction

Which explanation will assist the parents in their decision on whether they should circumcise their son? a. The circumcision procedure has pros and cons during the prenatal period. b. American Academy of Pediatrics (AAP) recommends that all male newborns be routinely circumcised. c. Circumcision is rarely painful, and any discomfort can be managed without medication. d. The infant will likely be alert and hungry shortly after the procedure.

a. The circumcision procedure has pros and cons during the prenatal period.

One of the most important components of the physical assessment of the pregnant client is the determination of BP. Consistency in measurement techniques must be maintained to ensure that the nuances in the variations of the BP readings are not the result of provider error. Which techniques are important in obtaining accurate BP readings? (Select all that apply.) a. The client should be seated b. The client's arm should be placed at the level of the heart. c. The same arm should be used for every reading d. An electronic BP device should be used. e. The cuff should cover a minimum of 60% of the upper arm.

a. The client should be seated b. The client's arm should be placed at the level of the heart. c. The same arm should be used for every reading

A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis? a. The couple has established a set schedule for their sexual encounters. b. The couple has been married for more than 8 years. c. The couple lives with one set of parents. d. The couple has close friends who gave birth within the last year.

a. The couple has established a set schedule for their sexual encounters.

A woman at 24 weeks of gestation states that she has a glass of wine with dinner every evening. Why would the nurse counsel the client to eliminate all alcohol? a. The fetus is placed at risk for altered brain growth. b. The fetus is at risk for multiple organ anomalies. c. Daily consumption of alcohol indicates a risk for alcoholism. d. She will be at risk for abusing other substances as well.

a. The fetus is placed at risk for altered brain growth.

What is the primary purpose for the use of tocolytic therapy to suppress uterine activity? a. The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids. b. Drugs can be efficaciously administered up to the designated beginning of term at 37 weeks gestation. c. If the client develops pulmonary edema while receiving tocolytic therapy, then intravenous (IV) fluids should be given. d. Tocolytic therapy has no important maternal (as opposed to fetal) contraindications.

a. The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids.

The nurse is completing a physical examination of the newborn 24 hours after birth. Which component of the evaluation is correct? a. The nurse can gauge the neonate's maturity level by assessing his or her general appearance b. The parents are excused to reduce their normal anxiety. c. When the nurse listens to the neonate's heart, the S and S sounds can be heard; the S sound is somewhat higher in pitch and sharper than the S sound. d. Once often neglected, blood pressure is now routinely checked.

a. The nurse can gauge the neonate's maturity level by assessing his or her general appearance

Which statement regarding the laboratory test for glycosylated hemoglobin Alc is correct? a. This laboratory test measures the levels of hemoglobin Alc, which should remain at less than 7% b. This laboratory test is a snapshot of glucose control at the moment. c. This laboratory test is performed on the woman's urine, not her blood. d. The laboratory test for glycosylated hemoglobin Alc is performed for all pregnant women, not only those with or likely to have diabetes.

a. This laboratory test measures the levels of hemoglobin Alc, which should remain at less than 7%

Which concerns regarding parenthood are often expressed by visually impaired mothers? (Select all that apply.) a. Transportation b. Infant safety c. Needing extra time for parenting activities to accommodate the visual limitations d. Ability to care for the infant

a. Transportation b. Infant safety c. Needing extra time for parenting activities to accommodate the visual limitations

The nurse is preparing to administer methotrexate to the client. This drug is most often used for which obstetric complication? a. Unruptured ectopic pregnancy b. Complete hydatidiform mole c. Abruptio placentae d. Missed abortion

a. Unruptured ectopic pregnancy

During the postpartum assessment, the perinatal nurse notes that a patient who has just experienced a forceps-assisted birth now has a large quantity of bright red bleeding. Her uterine fundus is firm and midline. The nurse's most appropriate action is to notify the physician/certified nurse midwife and anticipate the need for: a. Vaginal assessment and possible repair of vaginal and/or cervical lacerations b. An oxytocin infusion c. Further information for the woman/family about forceps d. Bladder assessment and catheterization

a. Vaginal assessment and possible repair of vaginal and/or cervical lacerations

Nursing actions focused at reducing a postpartum woman's risk for cystitis include which of the following? (Select all that apply.) a. Voiding within a few hours post-birth b. Oral intake of a minimum of 3000 mL per day c. Changing peri-pads every 3 to 4 hours or more frequently as indicated d. Reminding the woman to void every 3 to 4 hours while awake

a. Voiding within a few hours post-birth b. Oral intake of a minimum of 3000 mL per day c. Changing peri-pads every 3 to 4 hours or more frequently as indicated d. Reminding the woman to void every 3 to 4 hours while awake

The nurse is teaching the parents of a healthy newborn about infant safety. Which of the following should be included in the teaching plan? (Select all that apply). a. Water temperature for the infant's bath should be 100.4 degrees F. b. Do not cook while holding an infant c. Cover electrical outlets d. Remove strings from infant sleepwear, bedding, and pacifiers to prevent strangulation.

a. Water temperature for the infant's bath should be 100.4 degrees F. b. Do not cook while holding an infant c. Cover electrical outlets d. Remove strings from infant sleepwear, bedding, and pacifiers to prevent strangulation.

A nurse notes that an Eskimo woman does not cuddle or interact with her newborn other than to feed him, change his diapers or soiled clothes, and put him to bed. While evaluating this client's behavior with her infant, what realization does the nurse make? a. What appears to be a lack of interest in the newborn is, in fact, the cultural way of demonstrating intense love by attempting to ward off evil spirits. b. The woman is inexperienced in caring for a newborn. c. Extra time needs to be planned for assisting the woman in bonding with her newborn. d. The woman needs a referral to a social worker for further evaluation of her parenting behaviors once she goes home with the newborn.

a. What appears to be a lack of interest in the newborn is, in fact, the cultural way of demonstrating intense love by attempting to ward off evil spirits.

The nurse is about to elicit the rooting reflex on a newborn baby. Which of the following responses should the nurse expect to see? a. When the cheek of the baby is touched, the newborn turns toward the side that is touched. b. When the lateral aspect of the sole of the baby's foot is stroked, the toes extend and fan outward. c. When the baby is suddenly lowered or startled, the neonate's arms straighten outward and the knees flex. d. When the newborn is supine and the head is turned to one side, the arm on that same side extends.

a. When the cheek of the baby is touched, the newborn turns toward the side that is touched.

Which client is at greatest risk for early PPH? a. Woman with severe preeclampsia on magnesium sulfate whose labor is being induced b. Multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor c. Primigravida in spontaneous labor with preterm twins d. Primiparous woman (G 2, P 1-0-0-1) being prepared for an emergency cesarean birth for fetal distress

a. Woman with severe preeclampsia on magnesium sulfate whose labor is being induced

What information should the nurse understand fully regarding rubella and Rh status? Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination b. Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus. c. Rh immunoglobulin is safely administered intravenously because it cannot harm a nursing infant. d. Rh immunoglobulin boosts the immune system and thereby enhances the effectiveness of vaccinations.

a. Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination

A parent who has a hearing impairment is presented with a number of challenges in parenting. Which nursing approaches are appropriate for working with hearing-impaired new parents? (Select all that apply.) a. Writing messages that aid in communication b. Assuming that the client knows sign language c. Using devices that transform sound into light d. Ascertaining whether the client can read lips before teaching e. Speaking quickly and loudly

a. Writing messages that aid in communication c. Using devices that transform sound into light d. Ascertaining whether the client can read lips before teaching

Contraindications for induction of labor include: a. abnormal fetal position b. post-term pregnancy c. pre-eclampsia d. placental abnormalities

a. abnormal fetal position d. placental abnormalities

Ultrasound can be used in antepartum care for which of the following assessments? (Select all that apply). a. adjunct use in chorionic villi sampling (CVS) b. gestational age c. placental position and function d. fetal growth

a. adjunct use in chorionic villi sampling (CVS) b. gestational age c. placental position and function d. fetal growth

Maddy, a G3 P1 woman, gave birth 12 hours ago to a 9 lb. 13 oz. daughter. She experiences severe cramps with breastfeeding. The perinatal nurse best describes this condition as: a. afterpains b. uterine hypertonia c. bladder hypertonia d. rectus abdominis diastasis

a. afterpains

Which substance, when abused during pregnancy, is the most significant cause of cognitive impairment and dysfunction in the infant? a. alcohol b. heroin c. marijuana d. tobacco

a. alcohol

Which societal factors have a strong influence on parental response to their infant? (Select all that apply.) a. an adolescent mother is likely to use less verbal instruction, be less responsive, and interact less positively than other mother b. an adolescent mother's egocentricity and unmet developmental needs interfere with her ability to parent effectively c. relationships between adolescent mothers and fathers are more stable than older adults d. mothers older than 35 years of age often deal with more stress related to work and career issues, as well as decreasing libido e. adolescent mothers have higher documented incidence of child abuse.

a. an adolescent mother is likely to use less verbal instruction, be less responsive, and interact less positively than other mother b. an adolescent mother's egocentricity and unmet developmental needs interfere with her ability to parent effectively d. mothers older than 35 years of age often deal with more stress related to work and career issues, as well as decreasing libido

Which of the following is true regarding infertility? (Select all that apply). a. anovulation can cause primary and/or secondary infertiity b. approx 60% of infertility problems are related to the female factors c. infertility is defined as the inability to achieve pregnancy after a year of unprotected intercourse d. infertility effects approx 5% of reproductive-age couples

a. anovulation can cause primary and/or secondary infertiity c. infertility is defined as the inability to achieve pregnancy after a year of unprotected intercourse

General skin care for full-term infants includes which of the following? (Select all that apply.) a. avoid daily bathing with soap b. use a cleaner with a neutral pH c. avoid fragrant soaps d. apply petrolatum-based ointments sparingly to dry skin, but avoid head and face

a. avoid daily bathing with soap b. use a cleaner with a neutral pH c. avoid fragrant soaps

25 year old Susan (G0000) is thinking about getting pregnant this next year, but wants an effective method right now. She currently uses condoms. She denies medical problems. Which of the following birth control methods are most appropriate for the nurse to discuss with Susan? (Select all that apply). a. oral contraceptive pills b. copper IUD (paragard) c. the birth control patch d. condoms (continue) e. the implant

a. birth control pills c. the birth control patch d. condoms

For which of the following conditions is colposcopy used to further evaluate need for intervention? (Select all that apply). a. cervical cancer b. uterine fibroids c. vaginal cancer d. uterine cancer e. bacterial vaginosis

a. cervical cancer c. vaginal cancer

Which of the following can provide contraception and protection against sexually transmitted infections? (Select all that apply). a. condoms b. abstinence c. diaphragm d. intrauterine devices e. natural family planning f. birth control pills

a. condoms b. abstinence

A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates. A nonstress test (NST) in the obstetrician's office revealed a nonreactive tracing. On artificial rupture of membranes, thick meconium-stained fluid was noted. What should the nurse caring for the infant after birth anticipate? (Select all that apply). a. dry, cracked skin b. increased amount of subcutaneous fat c. meconium aspiration d. hypoglycemia e. absence of scalp hair, f. excessive vernix caseosa covering the skin

a. dry, cracked skin c. meconium aspiration d. hypoglycemia

The letdown reflex occurs in response to the release of oxytocin. Which of the following can stimulate the release of oxytocin? (Select all that apply.) a. emotional response to thinking about her baby b. infant suckling c. emotional response to hearing an infant crying d. sexual activity

a. emotional response to thinking about her baby b. infant suckling c. emotional response to hearing an infant crying d. sexual activity

Amy is a 20 year old sexually active woman (G0000) who wants an effective birth control method. She denies any medical problems. Which of the following would the nurse not recommend to Amy? a. essure b. oral contraceptive pills c. the implant d. intrauterine device

a. essure

The induction of labor is considered an acceptable obstetric procedure if it is in the best interest to deliver the fetus. The charge nurse on the labor and delivery unit is often asked to schedule clients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction. What are appropriate indications for induction? (Select all that apply) a. fetal death b. maternal fatigue and frustration at 38 weeks gestation c. postterm pregnancy d. convenience of the woman or her physician e. rupture of membranes at or near term

a. fetal death c. postterm pregnancy e. rupture of membranes at or near term

Ultrasound can be used in antepartum care for which of the following assessments? (Select all that apply). a. fetal growth b. gestational age c. adjunct use in chorionic villi sampling (CVS) d. placental position and function

a. fetal growth b. gestational age c. adjunct use in chorionic villi sampling (CVS) d. placental position and function

Documentation related to vacuum delivery includes which of the following: a. fetal heart rate b. timing and number of application c. position and station of fetal head d. maternal position

a. fetal heart rate b. timing and number of application c. position and station of fetal head

A nurse caring for a family during a loss might notice that a family member is experiencing survivor guilt. Which family member is most likely to exhibit this guilt? a. grandparents b. father c. mother d. siblings

a. grandparents

Which of the following screens for cervical cancer? (Select all that apply). a. high risk HPV test b. chlamydia c. herpes simplex 1 and 2 d. Pap smear test

a. high risk HPV test d. Pap smear test

Hypothyroidism occurs in 2 to 3 pregnancies per 1000. Because severe hypothyroidism is associated with infertility and miscarriage, it is not often seen in pregnancy. Regardless of this fact, the nurse should be aware of the characteristic symptoms of hypothyroidism. Which do they include? (Select all that apply.) a. Lethargy b. Decrease in exercise capacity c. Weight loss d. Hot flashes e. Cold intolerance

a. lethargy b. decrease in exercise capacity e. cold intolerance

During life in utero, oxygenation of the fetus occurs through transplacental gas exchange. When birth occurs, four factors combine to stimulate the respiratory center in the medulla. The initiation of respiration then follows. What are these four essential factors? a. Mechanical b. Sensory c. Chemical d. Psychologic e. Thermal

a. mechanical b. sensory c. chemical e. thermal

Yolanda is 6 weeks pregnant by dates and is considering abortion. What options might be appropriate for her at this point? (Select all that apply). a. medical abortion with mifepristone and misopristol b. surgical abortion with aspiration c. emergency contraception d. it is too late for her to have an abortion

a. medical abortion with mifepristone and misopristol b. surgical abortion with aspiration

The perinatal nurse is teaching the new mother who has chosen to formula feed her infant. Appropriate instructions to be given to this mother include (select all that apply): a. mix the formula according to manufacturer's instructions; do not over-dilute or underdilute b. periodically check the nipple for slow flow c. prepare only enough formula to last for 24 hours and discard open containers or prepared formula after 24 hours d. discard any unused formula that remains in a bottle following use

a. mix the formula according to manufacturer's instructions; do not over-dilute or underdilute b. periodically check the nipple for slow flow c. prepare only enough formula to last for 24 hours and discard open containers or prepared formula after 24 hours d. discard any unused formula that remains in a bottle following use

The clinic nurse teaches expectant mothers about the differences between breast milk and commercially prepared infant formulas. When compared to commercially prepared formulas, breast milk has (select all that apply): a. more carbohydrates b. less protein c. fewer nutrients d. less cholesterol

a. more carbohydrates b. less protein

According to the CDC,which of the following are significant causes of maternal death in the United States? (Select all that apply) a. non-cardiovascular conditions b. hemorrhage c. ski accidents d. hypertensive disorders e. street drug use f. cardio-vascular disease

a. non-cardiovascular conditions b. hemorrhage d. hypertensive disorders f. cardio-vascular disease

An infant at 26 weeks of gestation arrives intubated from the delivery room. The nurse weighs the infant, places him under the radiant warmer, and attaches him to the ventilator at the prescribed settings. A pulse oximeter and cardiorespiratory monitor are placed. The pulse oximeter is recording oxygen saturations of 80%. The prescribed saturations are 92%. What are the nurse's most appropriate actions at this time? a. notify physician b. continue to observe until saturations are 75% c. listen to breath sounds d. complete the admission process and thorough assessment e. increase oxygen f. ensure patency of the endotracheal tube g. notify parents that their infant is not doing well

a. notify physician c. listen to breath sounds e. increase oxygen f. ensure patency of the endotracheal tube

The perinatal nurse observed the pediatrician completing the Ballard Maturational Score (BMS). The maturity components used with this assessment are (select all that apply): a, physical b. behavioral c. reflexive d. neuromuscular

a. physical d. neuromuscular

Which instruction should the nurse provide to reduce the risk of nipple trauma? a. position the infant so the nipple is far back in the mouth b. wash the nipples daily with mild soap and water c. limit the feeding time to less than 5 minutes d. assess the nipples before each feeding

a. position the infant so the nipple is far back in the mouth

Which of the following actions are directed at promoting bonding? (select all that apply) a. providing opportunity for parents to hold their newborn as soon as possible following the birth b. providing opportunities for the couple to talk about their birth experience and about becoming parents c. promoting rest and comfort by keeping the newborn in the nursery at night d. providing positive comments to parents regarding their interactions with their newborn

a. providing opportunity for parents to hold their newborn as soon as possible following the birth b. providing opportunities for the couple to talk about their birth experience and about becoming parents d. providing positive comments to parents regarding their interactions with their newborn

Which of the following are management options for couples faced with infertility challenges, depending of the cause? (Select all that apply). a. remain child-free b. adoption c. Medication d. assisted reproductive technology procedures

a. remain child-free b. adoption c. Medication d. assisted reproductive technology procedures

Reports have linked third trimester use of selective serotonin uptake inhibitors (SSRIs) with a constellation of neonatal signs. The nurse is about to perform an assessment on the infant of a mother with a history of a mood disorder. Which signs and symptoms in the neonate may be the result of maternal SSRI use? (Select all that apply.) a. shivering b. hyperglycemia c. hypotonia d. fever e. irritability

a. shivering d. fever e. irritability

16 year old Emily lives in Blackfoot, ID. She has a boyfriend but does not want to have a baby for at least 10 years. She wants an effective, easy birth control method and denies medical problems. She has periods every 4-6 weeks. The nurse would recommend which of the following methods to Emily? (Select all that apply). a. the implant b. natural family planning c. hormonal IUD d. bilateral tubal ligation

a. the implant c. hormonal IUD

A couple is undergoing an infertility workup. The semen analysis indicates a decreased number of sperm and immature sperm. Which of the following factors can have a potential effect on sperm maturity? (Select all that apply.) a. the man rides a bike to and from work each day b. the man takes calcium channel blocker for the treatment of hypertension c. the man drinks 6 cups of coffee a day d. the man was treated for prostatitis 12 months ago and has been symptom free since treatment

a. the man rides a bike to and from work each day b. the man takes calcium channel blocker for the treatment of hypertension

After the Nurse Practitioner treats a 25 y/o's Bartholin cyst with incision and drainage procedure (I&D), the nurse is providing take-home instructions. The patient asks, "Will this happen again?" The nurse's best response is: a. "I cannot answer that question for you. Let me have the NP come and talk to you." b. "Bartholin cysts can recur. There is another procedure that can be done to reduce risk for recurrence.Would you like to talk to the NP about it?" c. "No, since it is drained it won't come back." d. "If you take your antibiotics and not get an infection, recurrence is rare. Let's talk about how to prevent infection."

b. "Bartholin cysts can recur. There is another procedure that can be done to reduce risk for recurrence.Would you like to talk to the NP about it?"

Your pregnant patient is in her first trimester and is scheduled for an ultrasound. When explaining the rationale for early pregnancy ultrasound, the best response is: a. "The test will help to determine the baby's position." b. "The test will help to determine how many weeks you are pregnant." c. "The test will help to determine if your baby is growing appropriately." d. "The test will help to determine if you have a boy or girl."

b. "The test will help to determine how many weeks you are pregnant."

A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. The client shows the nurse her readings for the past few days. Which reading signals the nurse that the client may require an adjustment of insulin or carbohydrates? a. 75 mg/dl before lunch. This is low; better eat now. b. 50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep. c. 115 mg/dl 2 hours after lunch. This is too high; it is time for insulin. d. 115 mg/dl 1 hour after lunch. This is a little high; maybe eat a little less next time.

b. 50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep

Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa. The signs of NEC are nonspecific. What are generalized signs and symptoms of this condition? a. Scaphoid abdomen, no residual with feedings, and increased urinary output b. Abdominal distention, temperature instability, and grossly bloody stools c. Hypertension, absence of apnea, and ruddy skin color d. Hypertonia, tachycardia, and metabolic alkalosis

b. Abdominal distention, temperature instability, and grossly bloody stools

A postmenopausal woman has been diagnosed with two leiomyomas (fibroids). Which clinical finding is most commonly associated with the presence of leiomyomas? a. Acute abdominal pain b. Abnormal uterine bleeding c. Weight loss d. Diarrhea

b. Abnormal uterine bleeding

A client is diagnosed with having a stillborn infant. At first, she appears stunned by the news, cries a little, and then asks the nurse to call her mother. What is the proper term for the phase of bereavement that this client is experiencing? Reorganization b. Acute distress c. Anticipatory grief d. Intense grief

b. Acute distress

A 36 y/o pregnant woman has been diagnosed with polyhydraminos. The nurse knows this is based on which of the following? a. Amniotic fluid index of 20 cm b. Amniotic fluid index of 30 cm c. Amniotic fluid index of 7 cm d. Amniotic fluid index of 10 cm

b. Amniotic fluid index of 30 cm

Breast pain occurs in many women during their perimenopausal years. Which information is (are) a priority for the nurse to share with the client? (Select all that apply). a. Pain is almost always an indication of a solid mass. b. Assess for prior trauma or possible infection c. Distinguishing between cyclical and noncyclical pain is important. d. Breast pain is an early indication of cancer.

b. Assess for prior trauma or possible infection c. Distinguishing between cyclical and noncyclical pain is important.

A 25 year-old woman gave birth to her second child 6 hours ago. She informs the nurse that she is bleeding more than with her previous birth experience. The initial nursing action is to: a. Explain that this is normal for second-time moms. b. Assess the location and firmness of the fundus. c. Change her pad and return in 1 hour and reassess. d. Give her 10 units of oxytocin as per standing order.

b. Assess the location and firmness of the fundus.

A postpartum client is concerned that her breasts are engorged and uncomfortable. What is the nurse's explanation for this physiologic change? a. Hyperplasia of mammary tissue b. Congestion of veins and lymphatic vessels c. Overproduction of colostrum d. Accumulation of milk in the lactiferous ducts and glands

b. Congestion of veins and lymphatic vessels

Which clinical findings would alert the nurse that the neonate is expressing pain? a. Low-pitched crying; tachycardia; eyelids open wide b. Cry face; eyes squeezed; increase in blood pressure c. Cry face; flaccid limbs; closed mouth d. High-pitched, shrill cry; withdrawal; change in heart rate

b. Cry face; eyes squeezed; increase in blood pressure

Which statement concerning the complication of maternal diabetes is the most accurate? a. Hydramnios occurs approximately twice as often in diabetic pregnancies than in nondiabetic pregnancies. b. Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy. c. Infections occur about as often and are considered about as serious in both diabetic and nondiabetic pregnancies. d. Even mild-to-moderate hypoglycemic episodes can have significant effects on fetal well-being.

b. Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy.

A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse? a. Pitting pedal edema at the end of the day b. Dipstick value of 3+ for protein in her urine c. Blood pressure (BP) increase to 138/86 mm Hg d. Weight gain of 0.5 kg during the past 2 weeks

b. Dipstick value of 3+ for protein in her urine

A health care provider performs a clinical breast examination on a woman diagnosed with fibroadenoma. How would the nurse explain the defining characteristics of a fibroadenoma? (Select all that apply). a. Thick, sticky discharge from the nipple of the affected breast b. Does not increase risk for breast cancer c. Inflammation of the milk ducts and glands behind the nipples d. Lumpiness in both breasts that develops 1 week before menstruation e. Single lump in one breast that can increase in size

b. Does not increase risk for breast cancer e. Single lump in one breast that can increase in size

Which of the following nursing interventions are important in the prenatal care of the woman with prenatal depression? (Select all of the following). a. Counsel her on the importance of medication if the woman refuses it. b. Educate the woman about depression and plan of care c. Recommend she see a psychiatrist for management d. Maintain a caring relationship

b. Educate the woman about depression and plan of care d. Maintain a caring relationship

A woman seeks care at an infertility clinic. Which of the following tests may this woman undergo to determine what, if any, infertility problem she may have? (Select all that apply.) a. Chorionic villus sampling b. Endometrial biopsy c. Hysterosalpingogram d. Serum FSH analysis

b. Endometrial biopsy c. Hysterosalpingogram d. Serum FSH analysis

The nurse is using the New Ballard Scale to determine the gestational age of a newborn. Which assessment finding is consistent with a gestational age of 40 weeks a. Abundant lanugo b. Flexed posture c. Faint red marks on the soles of the feet d. Smooth, pink skin with visible veins

b. Flexed posture

A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization, the infant is weighed, and the birth weight is 4550 g (9 lb, 6 oz). What is the nurse's first priority? a. Immediately take the infant to the nursery. b. Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia. c. Perform a gestational age assessment to determine whether the infant is large for gestational age. d. Leave the infant in the room with the mother.

b. Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia.

A nurse is performing a newborn assessment on a new admission to the nursery. Which of the following actions should the nurse make when evaluating the baby for congenital dislocation of the hip? a. Grasp the inner aspects of the baby's calves with thumbs and forefingers. b. Gently abduct the baby's thighs listening for clicks at the joints. c. Palpate the baby's patellae to assess for subluxation of the bones. d. Dorsiflex the baby's feet.

b. Gently abduct the baby's thighs listening for clicks at the joints.

A woman with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the client and documents the following findings: temperature of 37.1° C, pulse rate of 96 beats per minute, respiratory rate of 24 breaths per minute, BP of 155/112 mm Hg, 3+ DTRs, and no ankle clonus. The nurse calls the provider with an update. The nurse should anticipate an order for which medication? a. Calcium gluconate b. Hydralazine c. magnesium sulfate bolus d. diazepam

b. Hydralazine

A new mother asks the nurse what the "experts say" about the best way to feed her infant. Which recommendation of the American Academy of Pediatrics (AAP) regarding infant nutrition should be shared with this client? a. If infants are weaned from breast milk before 12 months, then they should receive cow's milk, not formula. b. Infants should be given only human milk for the first 6 months of life. c. After 6 months, mothers should shift from breast milk to cow's milk. d. Infants fed on formula should be started on solid food sooner than breastfed infants.

b. Infants should be given only human milk for the first 6 months of life.

Which condition is considered a medical emergency that requires immediate treatment? a. Hypotonic uterus b. Inversion of the uterus c. Uterine atony d. ITP

b. Inversion of the uterus

Which statement most accurately describes complicated grief? a. Is a state during which the parents are ambivalent, as with an abortion b. Is an extremely intense grief reaction that persists for a long time c. Is felt by the family of adolescent mothers who lose their babies d. Occurs when, in multiple births, one child dies and the other or others live

b. Is an extremely intense grief reaction that persists for a long time

Primary prevention of preterm labor and birth include which of the following? (Select all that apply). a. Treat pregnant woman with magnesium sulfate b. Manage risk factors for preterm birth in individual pregnant woman c. Identify risk factors of preterm birth for individual pregnant woman d. Induce pregnant woman at 37 weeks

b. Manage risk factors for preterm birth in individual pregnant woman c. Identify risk factors of preterm birth for individual pregnant woman

Karen, a G2 P2, experienced a precipitous birth 90 minutes ago. Her infant is 4200 grams and a repair of a second-degree laceration was needed following the birth. As part of the nursing assessment, the nurse discovers that Karen's uterus is boggy. Furthermore, it is noted that Karen's vaginal bleeding has increased. The nurse's most appropriate first action is to: a. Assess vital signs including blood pressure and pulse. b. Massage the uterine fundus with continual lower segment support. c. Measure and document each perineal pad changed in order to assess blood loss. d. Ensure appropriate lighting for a perineal repair if it is needed.

b. Massage the uterine fundus with continual lower segment support.

Rho immune globulin will be ordered postpartum if which situation occurs? a. Mother Rh+, baby Rh- b. Mother Rh-, baby Rh+ c. Mother Rh-, baby Rh- d. Mother Rh+, baby Rh+

b. Mother Rh-, baby Rh+

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem approach. What is the first step in the provision of care for the infant? a. Adequate nutrition and maintenance of fluid and electrolyte balance b. Neonatal abstinence syndrome (NAS) scoring c. Reduction of environmental stimuli d. Pharmacologic treatment

b. Neonatal abstinence syndrome (NAS) scoring

Allison is 32 weeks pregnant presents to L&D and tells the nurse she has not felt her baby move in 48 hours. The nurse begins electronic fetal monitoring and notes the baby's heart rate is in the 130's. The nurse contacts Allison's physician to obtain an order for which of the following tests? a. Maternal Serum Screening Test b. Non stress Test c. Fetal fibronectin d. Leopolds Maneuvers e. Biophysical profile

b. Non stress Test

The nurse assesses that a fullterm neonate's temperature is 97.1°F (36.2°C). The first nursing action is to: a. Turn up the heat in the room. b. Place the neonate on the mother's chest with a warm blanket over the mother and baby. c. Take the neonate to the nursery and place in a radiant warmer. d. Notify the neonate's primary provider.

b. Place the neonate on the mother's chest with a warm blanket over the mother and baby.

A newborn is jaundiced and is receiving phototherapy via ultraviolet bank lights. What is the most appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy? a. Applying an oilbased lotion to the newborn's skin to prevent dying and cracking b. Placing eye shields over the newborn's closed eyes c. Changing the newborn's position every 4 hours d. Limiting the newborn's intake of milk to prevent nausea, vomiting, and diarrhea

b. Placing eye shields over the newborn's closed eyes

What should the nurse's next action be if the client's white blood cell (WBC) count is 25,000/mm3 on her second postpartum day? a. Immediately inform the physician b. Recognize that this count is an acceptable range at this point postpartum c. Have the laboratory draw blood for reanalysis d. Immediately begin antibiotic therapy

b. Recognize that this count is an acceptable range at this point postpartum

A primigravida woman at 42 weeks' gestation received Prepidil (dinoprostone) for induction 12 hours ago. The Bishop score is now 3. Which of the following actions by the nurse is appropriate? a. Perform Nitrazine analysis of the amniotic fluid. b. Report the lack of progress to the obstetrician c. Place the woman on her left side. d. Ask the provider for an order for oxytocin.

b. Report the lack of progress to the obstetrician

Because of the premature infant's decreased immune functioning, what nursing diagnosis should the nurse include in a plan of care for a premature infant? a. Ineffective infant feeding pattern b. Risk for infection c. Delayed growth and development d. Ineffective thermoregulation

b. Risk for infection

A primigravida at 40 weeks of gestation is having uterine contractions every 1½ to 2 minutes and states that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman's labor? a. She is experiencing a normal latent stage. b. She is exhibiting hypertonic uterine dysfunction c. She is experiencing precipitous labor. d. She is exhibiting hypotonic uterine dysfunction.

b. She is exhibiting hypertonic uterine dysfunction

Reports have linked third trimester use of selective serotonin uptake inhibitors (SSRIs) with a constellation of neonatal signs. The nurse is about to perform an assessment on the infant of a mother with a history of a mood disorder. Which signs and symptoms in the neonate may be the result of maternal SSRI use? (Select all that apply.) a. Hypotonia b. Shivering c. Irritability d. Fever e. Hyperglycemia

b. Shivering c. Irritability d. Fever

A pregnant woman at term is transported to the emergency department (ED) after a severe vehicular accident. The obstetric nurse responds and rushes to the ED with a fetal monitor. Cardiopulmonary arrest occurs as the obstetric nurse arrives. What is the highest priority for the trauma team? a. Transferring the woman to the surgical unit for an emergency cesarean delivery in case the fetus is still alive b. Starting cardiopulmonary resuscitation (CPR) c. Obtaining IV access, and starting aggressive fluid resuscitation d. Quickly applying the fetal monitor to determine whether the fetus viability

b. Starting cardiopulmonary resuscitation (CPR)

A client with maternal phenylketonuria (PKU) has come to the obstetrical clinic to begin prenatal care. Why would this preexisting condition result in the need for closer monitoring during pregnancy? a. A pregnant woman is more likely to die without strict dietary control. b. The fetus may develop neurologic problems. c. PKU is a recognized cause of preterm labor. d. Women with PKU are usually mentally handicapped and should not reproduce.

b. The fetus may develop neurologic problems.

Nurses play a critical role in educating parents regarding measures to prevent infant abduction. Which instructions contribute to infant safety and security? (Select all that apply.) a. Because of infant security systems, the baby can be left unattended in the client's room. b. The mom should request that a second staff member verify the identity of any questionable person. c. The baby should be carried in the parent's arms from the room to the nursery. d. The mother should check the photo identification (ID) of any person who comes to her room. e. Parents should use caution when posting photographs of their infant on the Internet.

b. The mom should request that a second staff member verify the identity of any questionable person. d. The mother should check the photo identification (ID) of any person who comes to her room e. Parents should use caution when posting photographs of their infant on the Internet.

A newly delivered mother who intends to breastfeed tells her nurse, "I am so relieved that this pregnancy is over so that I can start smoking again." The nurse encourages the client to refrain from smoking. However, this new mother is insistent that she will resume smoking. How will the nurse adapt her health teaching with this new information? a. No relationship exists between smoking and the time of feedings. b. The mother should not smoke in the same room her baby is in. c. Smoking has little-to-no effect on milk production d. The effects of secondhand smoke on infants are less significant than for adults.

b. The mother should not smoke in the same room her baby is in.

A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed? a. von Willebrand disease (vWD); noting whether bleeding times have been extended b. Thrombophlebitis; using real-time and color Doppler ultrasound c. Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis d. Disseminated intravascular coagulation (DIC); asking for laboratory tests

b. Thrombophlebitis; using real-time and color Doppler ultrasound

A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature 37.3° C, pulse rate 88 beats per minute, respiratory rate 10 breaths per minute, BP 148/90 mm Hg, absent deep tendon reflexes (DTRs), and no ankle clonus. The client complains, "I'm so thirsty and warm." What is the nurse's immediate action? a. To call for an immediate magnesium sulfate level b. To discontinue the magnesium sulfate infusion c. Call the physician d. To administer oxygen

b. To discontinue the magnesium sulfate infusion

A client at 39 weeks of gestation has been admitted for an external version. Which intervention would the nurse anticipate the provider to order? a. Local anesthetic b. Tocolytic drug c. Contraction stress test (CST) d. Foley catheter

b. Tocolytic drug

A client at 39 weeks of gestation has been admitted for an external version. Which intervention would the nurse anticipate the provider to order? a. Local anesthetic b. Tocolytic drug c. Contraction stress test (CST) d. Foley catheter

b. Tocolytic drug

Nurses need to understand the basic definitions and incidence data regarding PPH. Which statement regarding this condition is most accurate? a. Traditionally, it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH. b. Traditionally, PPH has been classified as early PPH or late PPH with respect to birth. c. If anything, nurses and physicians tend to overestimate the amount of blood loss. d. PPH is easy to recognize early; after all, the woman is bleeding.

b. Traditionally, PPH has been classified as early PPH or late PPH with respect to birth.

The perinatal nurse teaches the postpartum woman about warning signs regarding development of postpartum infection. Signs and symptoms that merit assessment by the health-care provider include the development of a fever and: a. Breast engorgement b. Uterine tenderness c. Diarrhea d. Emotional lability

b. Uterine tenderness

The perinatal nurse teaches the postpartum woman about warning signs regarding development of postpartum infection. Signs and symptoms that merit assessment by the health-care provider include the development of a fever and: a. Breast engorgement b. Uterine tenderness c. Diarrhea d. Emotional lability

b. Uterine tenderness

A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. Which findings should the nurse include in the discussion? (Select all that apply.) a. Small white blister on the tip of the nipple b. Warmth in the breast c. Fever and flulike symptoms d. Breast tenderness

b. Warmth in the breast c. Fever and flulike symptoms d. Breast tenderness

During which phase of maternal adjustment will the mother relinquish the baby of her fantasies and accept the real baby? a. taking in b. letting go c. taking hold d. taking on

b. letting go

Typical signs of abusive head trauma (AHT, also known as Shaken Baby Syndrome) include which of the following? (Select all that apply.) a. Broken clavicle b. Poor feeding c. Vomiting . d. Breathing problems

b. poor feeding c. vomiting d. breathing problems

Combination oral contraceptives, the vaginal ring and the patch contain two hormones. Which of the following is the primary hormone that stops ovulation? a. testosterone b. progesterone c. estrogen d. hCG

b. progesterone

A recently delivered mother and her baby are at the clinic for a 6week postpartum checkup. Which response by the client alerts the nurse that psychosocial outcomes have not been met? a. the woman has a partner or family members who react very positively about the baby b. the woman has not given the baby a name c. the woman feels that her baby is more attractive and cleaver than others d. the woman excessively discusses her labor and birth experience

b. the woman has not given the baby a name

Which of the following statements indicates that a new mother needs additional teaching? a. "I need to supervise my cat when she is in the same room as my baby." b. "I will place my baby on her back when she is sleeping." c. "I will not leave my baby on an elevated flat surface after she is able to turn over on her own." d. "I have asked my husband to install safety latches on the lower cabinets."

c. "I will not leave my baby on an elevated flat surface after she is able to turn over on her own."

A postpartum woman, who gave birth 12 hours ago, is breastfeeding her baby. She tells her nurse that she is concerned that her baby is not getting enough food since her milk has not come in. The best response for this patient is: a. "I understand your concern, but your baby will be okay until your milk comes in." b. "Your baby seems content, so you should not worry about him getting enough to eat." c. "Milk normally comes in around the third day. Prior to that, he is getting colostrum which is high in protein and immunoglobulins which are important for your baby's health." d. "You can bottle feed until your milk comes in."

c. "Milk normally comes in around the third day. Prior to that, he is getting colostrum which is high in protein and immunoglobulins which are important for your baby's health."

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth? a. "My first menstrual cycle will be heavier than normal and then will be light for several months after." b. "My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter." c. "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." d. "I will not have a menstrual cycle for 6 months after childbirth."

c. "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles."

A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents? a. "The drug keeps your baby from requiring too much sedation." b. "Your baby needs this medication to fight a possible respiratory tract infection." c. "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide." d. "Surfactant is used to reduce episodes of periodic apnea."

c. "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide."

Which woman is at the greatest risk for psychologic complications after hysterectomy? a. 55-year-old woman who has been having abnormal bleeding and pain for 3 years b. 62-year-old widow who has three friends who have had uncomplicated hysterectomies c. 19-year-old woman who had a ruptured uterus after giving birth to her first child d. 46-year-old woman who has had three children and has just been promoted at work

c. 19-year-old woman who had a ruptured uterus after giving birth to her first child

An infant at 36 weeks of gestation has increasing respirations (80 to 100 breaths per minute with significant substernal retractions). The infant is given oxygen by continuous nasal positive airway pressure (CPAP). What level of partial pressure of arterial oxygen (PaO2) indicates hypoxia? a. 73 mmHg b. 67 mmHg c. 45 mmHg d. 89 mmHg

c. 45 mmHg

Screening for critical congenital heart disease (CCHD) was added to the uniform screening panel in 2011. The nurse has explained this testing to the new mother. Which action by the nurse related to this test is correct? a. Testing is performed with an electrocardiogram. b. Screening is performed when the infant is 12 hours of age. c. A passing result is an O2 saturation of ≥95%. d. Oxygen (O2) is measured in both hands and in the right foot.

c. A passing result is an O2 saturation of ≥95%

The nurse completes an initial newborn examination on a baby boy at 90 minutes of age. The baby was born at 40 weeks' gestation with no birth trauma. The nurse's findings include the following parameters: heart rate 136 beats per minute; respiratory rate 64 breaths per minute; temperature 98.2°F (36.8°C); length 49.5 cm; and weight 3500 g. The nurse documents the presence of a heart murmur, absence of bowel sounds, symmetry of ears and eyes, no grunting or nasal flaring, and full range of movement of all extremities. Which assessment would warrant further investigation and require immediate consultation with the baby's health-care provider? a. Respiratory rate b. Presence of a heart murmur c. Absent bowel sounds d. Weight

c. Absent bowel sounds

Which statement regarding the postpartum uterus is correct? a. At the end of the third stage of labor, the postpartum uterus weighs approximately 500 g. b. Postpartum uterus returns to its original (prepregnancy) size by 6 weeks postpartum. c. After 2 weeks postpartum, it should be abdominally nonpalpable. d. After 2 weeks postpartum, it weighs 100 g.

c. After 2 weeks postpartum, it should be abdominally nonpalpable.

A woman exhibits symptoms that may lead to a possible diagnosis of polycystic ovary syndrome (PCOS). While completing the initial assessment of the client, which clinical finding would the nurse not anticipate? a. Irregular menses b. Infertility c. Anorexia d. Hirsutism

c. Anorexia

Which intervention by the nurse would reduce the risk of abduction of the newborn from the hospital? a. Restricting the amount of time infants are out of the nursery b. Instructing the mother not to give her infant to anyone except the one nurse assigned to her that day c. Applying an electronic and identification bracelet to the mother and the infant d. Carrying the infant when transporting him or her in the halls

c. Applying an electronic and identification bracelet to the mother and the infant

While discussing the societal impacts of breastfeeding, the nurse should be cognizant of the benefits and educate the client accordingly. Which statement as part of this discussion would be incorrect? a. Breastfeeding requires fewer supplies and less cumbersome equipment. b. Breastfeeding benefits the environment. c. Breastfeeding costs employers in terms of time lost from work. d. Breastfeeding saves families money.

c. Breastfeeding costs employers in terms of time lost from work.

Which statement best describes chronic hypertension? a. Chronic hypertension is general hypertension plus proteinuria. b. Chronic hypertension is considered severe when the systolic BP is higher than 140 mm Hg or the diastolic BP is higher than 90 mm Hg. c. Chronic hypertension can occur independently of or simultaneously with preeclampsia. d. Chronic hypertension is defined as hypertension that begins during pregnancy and lasts for the duration of the pregnancy.

c. Chronic hypertension can occur independently of or simultaneously with preeclampsia.

Which finding on a prenatal visit at 10 weeks of gestation might suggest a hydatidiform mole? (Select all that apply). a. Blood pressure of 120/80 mm Hg b. History of bright red spotting for 1 day, weeks ago c. Complaint of severe nausea d. Fundal height measurement of 18 cm

c. Complaint of severe nausea d. Fundal height measurement of 18 cm

Preconception counseling is critical in the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy? a. Frequent episodes of maternal hypoglycemia b. Hyperemesis gravidarum c. Congenital anomalies in the fetus d. Hydramnios

c. Congenital anomalies in the fetus

Near the end of the first week of life, an infant who has not been treated for any infection develops a copper-colored maculopapular rash on the palms and around the mouth and anus. The newborn is displaying signs and symptoms of which condition? a. Gonorrhea b. HIV c. Congenital syphilis d. Herpes simplex virus (HSV) infection

c. Congenital syphilis

An 18-year-old client who has reached 16 weeks of gestation was recently diagnosed with pregestational diabetes. She attends her centering appointment accompanied by one of her girlfriends. This young woman appears more concerned about how her pregnancy will affect her social life than her recent diagnosis of diabetes. A number of nursing diagnoses are applicable to assist in planning adequate care. What is the most appropriate diagnosis at this time? a. Deficient knowledge, related to insulin administration b. Risk for injury, to the mother related to hypoglycemia or hyperglycemia c. Deficient knowledge, related to diabetic pregnancy management d. Risk for injury, to the fetus related to birth trauma

c. Deficient knowledge, related to diabetic pregnancy management

In caring for an immediate postpartum client, the nurse notes petechiae and oozing from her intravenous (IV) site. The client would be closely monitored for which clotting disorder? a. HELLP syndrome b. Hemorrhage c. Disseminated Intravascular Coagulation (DIC) d. Amniotic fluid embolism (AFE)

c. Disseminated Intravascular Coagulation (DIC)

The nurse is teaching a client with preterm premature rupture of membranes (PPROM) regarding self-care activities. Which activities should the nurse include in her teaching? a. Tampons are safe to use to absorb the leaking amniotic fluid. b. Taking frequent tub baths is safe. c. Do not engage in sexual activity. d. Report a temperature higher than 40° C.

c. Do not engage in sexual activity.

Which intervention can nurses use to prevent evaporative heat loss in the newborn? a. Placing the baby away from the outside walls and windows b. Warming the stethoscope and the nurse's hands before touching the baby c. Drying the baby after birth, and wrapping the baby in a dry blanket d. Keeping the baby out of drafts and away from air conditioners

c. Drying the baby after birth, and wrapping the baby in a dry blanket

A number of metabolic changes occur throughout pregnancy. Which physiologic adaptation of pregnancy will influence the nurse's plan of care? a. Insulin crosses the placenta to the fetus only in the first trimester, after which the fetus secretes its own. b. Women with insulin-dependent diabetes are prone to hyperglycemia during the first trimester because they are consuming more sugar. c. During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus. d. Maternal insulin requirements steadily decline during pregnancy.

c. During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus.

When caring for a pregnant woman with cardiac problems, the nurse must be alert for the signs and symptoms of cardiac decompensation. Which critical findings would the nurse find on assessment of the client experiencing this condition? a. Increased urinary output, tachycardia, and dry cough b. Shortness of breath, bradycardia, and hypertension c. Dyspnea, crackles, and an irregular, weak pulse d. Regular heart rate and hypertension

c. Dyspnea, crackles, and an irregular, weak pulse

When a woman is diagnosed with postpartum depression (PPD) with psychotic features, what is the nurse's primary concern in planning the client's care? a. Losing interest in her husband b. Neglecting her hygiene c. Harming her infant d. Displaying outbursts of anger

c. Harming her infant

A nurse is providing breast care education to a client after mammography. Which information regarding fibrocystic changes in the breast is important for the nurse to share? a. Fibrocystic breast disease is a disease of the milk ducts and glands in the breasts b. It is a premalignant disorder characterized by lumps found in the breast tissue. c. Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles. d. Lumpiness is accompanied by tenderness after menses.

c. Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles.

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a platelet count of 90,000 mm3, an elevated aspartate aminotransaminase (AST) level, and a falling hematocrit. The laboratory results are indicative of which condition? a. Disseminated intravascular coagulation (DIC) syndrome b. Idiopathic thrombocytopenia c. Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome d. Eclampsia

c. Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome

Which information regarding to injuries to the infant's plexus during labor and birth is most accurate? a. Parents of children with brachial palsy are taught to pick up the child from under the axillae. b. Breastfeeding is not recommended for infants with facial nerve paralysis until the condition resolves. c. If the nerves are stretched with no avulsion, then they should completely recover in 3 to 6 months. d. Erb palsy is damage to the lower plexus.

c. If the nerves are stretched with no avulsion, then they should completely recover in 3 to 6 months.

Under which circumstance should the nurse immediately alert the pediatric provider? a. Acrocyanosis is present 1 hour after childbirth. b. The infant's blood glucose level is 45 mg/dl. c. Infant is dusky and turns cyanotic when crying. d. The infant goes into a deep sleep 1 hour after childbirth.

c. Infant is dusky and turns cyanotic when crying.

What is the most critical physiologic change required of the newborn after birth? a. Maintenance of a stable temperature b. Full function of the immune defense system c. Initiation and maintenance of respirations d. Closure of fetal shunts in the circulatory system

c. Initiation and maintenance of respirations

Because a full bladder prevents the uterus from contracting normally nurses intervene to help the woman spontaneously empty her bladder as soon as possible. If all else fails, what tactic might the nurse use? a. Placing oil of peppermint in a bedpan under the woman b. Pouring water from a squeeze bottle over the woman's perineum c. Inserting a sterile catheter d. Asking the physician to prescribe analgesic agents

c. Inserting a sterile catheter

What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant? a. Genetic changes and anomalies b. Fetal addiction to the substance inhaled c. Intrauterine growth restriction d. Extensive CNS damage

c. Intrauterine growth restriction

Which condition is considered a medical emergency that requires immediate treatment? a. ITP b. Uterine atony c. Inversion of the uterus d. Hypotonic uterus

c. Inversion of the uterus

A neonate born at 36 weeks gestation is classified as which of the following? a. Very preterm b. Moderately preterm c. Late preterm d. Term

c. Late preterm

During labor induction with oxytocin, the fetal heart rate baseline is in the 140s with moderate variability. Contraction frequency is assessed to be every 2-3 minutes with duration of 60 seconds, of moderate strength to palpation. Based on this assessment, the nurse should take which action? a. Increase oxytocin infusion rate per provider's protocol. b. Stop oxytocin infusion immediately. c. Maintain present oxytocin infusion rate and continue to assess d. Decrease oxytocin infusion rate by 2 mU/min and report to provider

c. Maintain present oxytocin infusion rate and continue to assess

The nurse has evaluated a client with preeclampsia by assessing DTRs. The result is a grade of 3+. Which DTR response most accurately describes this score? a. Active or expected response b. Sluggish or diminished c. More brisk than expected, slightly hyperactive d. Brisk, hyperactive, with intermittent or transient clonus

c. More brisk than expected, slightly hyperactive

Which congenital anomalies can occur as a result of the use of antiepileptic drugs (AEDs) in pregnancy? (Select all that apply.) a. Gastroschisis b. Diaphragmatic hernia c. Neural tube defects d. Congenital heart disease e. Cleft lip

c. Neural tube defects d. Congenital heart disease e. Cleft lip

Which client(s) should the nurse report to the health care provider? (Select all that apply). a. Left breast slightly smaller than right breast b. Eversion (elevation) of both nipples c. One 2-3mm sized mobile, nontender mass in lower outer quadrant of left breast d. Small dimple located in the upper outer quadrant of the right breast

c. One 2-3mm sized mobile, nontender mass in lower outer quadrant of left breast d. Small dimple located in the upper outer quadrant of the right breast

Which of these medications is commonly used to control postpartum bleeding related to uterine atony? a. Magnesium sulfate b. Phytonadione c. Oxytocin d. Warfarin

c. Oxytocin

In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which is a facilitating behavior? a. Parents make no effort to interpret the actions or needs of the infant. b. Parents do not move from fingertip touch to palmar contact and holding. c. Parents hover around the infant, directing attention to and pointing at the infant. d. Parents have difficulty naming the infant.

c. Parents hover around the infant, directing attention to and pointing at the infant.

A first-time dad is concerned that his 3-day-old daughter's skin looks "yellow." In the nurse's explanation of physiologic jaundice, what fact should be included? a. Physiologic jaundice occurs during the first 24 hours of life. b. Physiologic jaundice is also known as breast milk jaundice. c. Physiologic jaundice becomes visible when serum bilirubin levels peak between the second and fourth days of life d. Physiologic jaundice is caused by blood incompatibilities between the mother and the infant blood types.

c. Physiologic jaundice becomes visible when serum bilirubin levels peak between the second and fourth days of life

Which classification of placental separation is not recognized as an abnormal adherence pattern? a. Placenta accreta b. Placenta increta c. Placenta abruptio d. Placenta percreta

c. Placenta abruptio

A woman who is 12 weeks postpartum presents with the following behavior: she reports severe mood swings and hearing voices, believes her infant is going to die, she has to be reminded to shower and put on clean clothes, and she feels she is unable to care for her baby. These behaviors are associated with which of the following? a. Postpartum blues b. Postpartum depression c. Postpartum psychosis d. Maladaptive mother-infant attachment

c. Postpartum psychosis

While providing care to the maternity client, the nurse should be aware that one of these anxiety disorders is likely to be triggered by the process of labor and birth. Which disorder fits this criterion? a. Panic disorder b. Phobias c. Posttraumatic stress disorder (PTSD) d. Obsessive-compulsive disorder (OCD)

c. Posttraumatic stress disorder (PTSD)

The perinatal nurse is providing care to Carol, a 28-year-old multiparous woman in labor. Upon arrival to the birthing suite, Carol was 7 cm dilated and experiencing contractions every 1 to 2 minutes which she describes as "strong." Carol states she labored for 1 hour at home. As the nurse assists Carol from the assessment area to her labor and birth room, Carol states that she is feeling some rectal pressure. Carol is most likely experiencing: a. Hypertonic contractions b. Hypotonic contractions c. Precipitous labor d. uterine hyperstimulation

c. Precipitous labor

The nurse who elects to work in the specialty of obstetric care must have the ability to distinguish between preterm birth, preterm labor, and low birth weight. Which statement regarding this terminology is correct? a. Low birth weight is a newborn who weighs below 3.7 pounds. b. Terms preterm birth and low birth weight can be used interchangeably. c. Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation. d. Preterm birth rate in the United States continues to increase.

c. Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation.

The nurse who elects to work in the specialty of obstetric care must have the ability to distinguish between preterm birth, preterm labor, and low birth weight. Which statement regarding this terminology is correct? a. Preterm birth rate in the United States continues to increase. b. Low birth weight is a newborn who weighs below 3.7 pounds. c. Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation. d. Terms preterm birth and low birth weight can be used interchangeably.

c. Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation.

A multipara, 26 weeks' gestation and accompanied by her husband, has just delivered a fetal demise. Which of the following nursing actions is appropriate at this time? a. Encourage the parents to pray for the baby's soul. b. Advise the parents that it is better for the baby to have died than to have had to live with a defect. c. Provide opportunities for grieving parents and family members to spend time with the baby d. Advise the parents to refrain from discussing the baby's death with their other children.

c. Provide opportunities for grieving parents and family members to spend time with the baby

Which of the following lab tests are routinely performed on pregnant women? (Select all that apply). a. Genetic testing for cystic fibrosis b. 3 hr GTT c. Rubella titer d. Syphilis test e. Blood type

c. Rubella titer d. Syphilis test e. Blood type

The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella non-immune (titer 1:8 or enzyme immunoassay [EIA] 0.8); hematocrit, 30%. How should the nurse best interpret these data? a. Blood transfusion is necessary. b. Rh immune globulin is necessary within 72 hours of childbirth. c. Rubella vaccine should be administered. d. Kleihauer-Betke test should be performed.

c. Rubella vaccine should be administered.

One of the following neonates is at highest risk for cold stress: a. LGA neonate at 38 weeks gestation b. AGA neonate at 37 weeks gestation c. SGA neonate at 33 weeks gestation d. SGA neonate at 40 weeks gestation

c. SGA neonate at 33 weeks gestation

A health care provider performs a clinical breast examination on a woman diagnosed with fibroadenoma. How would the nurse explain the defining characteristics of a fibroadenoma? (Select all that apply). a. Inflammation of the milk ducts and glands behind the nipples b. Lumpiness in both breasts that develops 1 week before menstruation c. Single lump in one breast that can increase in size. d. Does not increase risk for breast cancer e. Thick, sticky discharge from the nipple of the affected breast

c. Single lump in one breast that can increase in size. d. Does not increase risk for breast cancer

Another common pregnancy-specific condition is pruritic urticarial papules and plaques of pregnancy (PUPPP). A client asks the nurse why she has developed this condition and what can be done. What is the nurse's best response? a. This common pregnancy-specific condition is associated with a poor fetal outcome. b. The rate of hypertension decreases with PUPPP. c. The goal of therapy is to relieve discomfort. d. PUPPP is associated with decreased maternal weight gain.

c. The goal of therapy is to relieve discomfort.

In follow-up appointments or visits with parents and their new baby, it is useful if the nurse can identify infant behaviors that can either facilitate or inhibit attachment. What is an inhibiting behavior? a. The infant clings to the parents. b. The infant's activity is somewhat predictable. c. The infant seeks attention from any adult in the room. d. The infant cries only when hungry or wet.

c. The infant seeks attention from any adult in the room.

A nursing student is helping the nursery nurses with morning vital signs. A baby born 10 hours ago by cesarean section is found to have moist lung sounds. What is the best interpretation of these data? a. If this baby was born vaginally, then a pneumothorax could be indicated. b. The nurse should immediately notify the pediatrician for this emergency situation. c. The lungs of a baby delivered by cesarean section may sound moist during the first 24 hours after childbirth. d. The neonate must have aspirated surfactant.

c. The lungs of a baby delivered by cesarean section may sound moist during the first 24 hours after childbirth.

The nurse is caring for a recently immigrated Chinese woman in the postpartum unit. Based on cultural beliefs and practices of the woman, the nurse would anticipate which of the following? (Select all that apply.) a. The woman prefers cold water for drinking. b. The woman prefers not to shower. c. The woman prefers to have her female relatives care for her baby. d. The woman prefers a wide variety of foods to eat.

c. The woman prefers to have her female relatives care for her baby

A woman arrives at the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion? a. Septic b. Inevitable c. Threatened d. Incomplete

c. Threatened

The nurse should be cognizant of which condition related to skeletal injuries sustained by a neonate during labor or childbirth? a. Newborn's skull is still forming and fractures fairly easily. b. Clavicle fractures often need to be set with an inserted pin for stability. c. Unless a blood vessel is involved, linear skull fractures heal without special treatment. d. Other than the skull, the most common skeletal injuries are to leg bones.

c. Unless a blood vessel is involved, linear skull fractures heal without special treatment.

16 y/o Susie presents to the clinic, wanting a pregnancy test. What questions would be appropriate for the professional nurse to ask Susie prior to completing the pregnancy test? a. Does your mother know you are wanting a pregnancy test? b. Are you excited that you might be pregnant? c. What is the first day of your last menstrual period? d. Have you done a home pregnancy test? e. Have you been using birth control?

c. What is the first day of your last menstrual period? d. Have you done a home pregnancy test? e. Have you been using birth control?

Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand? a. Women with class III cardiac disease should get 8 to 10 hours of sleep every day and limit housework, shopping, and exercise. b. Women with class I cardiac disease need bed rest through most of the pregnancy and face the possibility of hospitalization near term. c. Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms. d. Stress on the heart is greatest in the first trimester and the last 2 weeks before labor.

c. Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms.

The is assessing the neonate's skin and notes the presence of a rash with red macules and papules on the trunk. The name for this common neonatal skin condition is: a. milia b. neonatal acne c. erythema toxicum d. postular melanosis

c. erythema toxicum

During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, "I don't know what's wrong. I love my son, but I feel so let down. I seem to cry for no reason!" Which condition might this new mother be experiencing? a. postpartum depression b. letting-go c. postpartum blues d. attachment difficulty

c. postpartum blues

Which type of formula is not diluted with water, before being administered to an infant? a. concentrated b. modified cow's milk c. ready-to-use d. powdered

c. ready-to-use

A primigravida has just delivered a healthy infant girl. The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks, "What is that medicine for?" How should the nurse respond? a. "It is to protect your baby from contracting herpes from your vaginal tract." b. "This medicine will protect your baby's eyes from drying out over the next few days." c. "It is an eye ointment to help your baby see you better." d. "Erythromycin is prophylactically given to prevent a gonorrheal infection."

d. "Erythromycin is prophylactically given to prevent a gonorrheal infection."

A new mother wants to be sure that she is meeting her daughter's needs while feeding the baby commercially prepared infant formula. The nurse should evaluate the mother's knowledge about appropriate infant feeding techniques. Which statement by the client reassures the nurse that correct learning has taken place? a. "I refrigerate any leftover formula for the next feeding." b. "I warm the bottle in my microwave oven." c. "Since reaching 2 weeks of age, I add rice cereal to my daughter's formula to ensure adequate nutrition." d. "I burp my daughter during and after the feeding as needed."

d. "I burp my daughter during and after the feeding as needed."

The parents of a newborn ask the nurse how much the newborn can see. The parents specifically want to know what type of visual stimuli they should provide for their newborn. What information provided by the nurse would be most useful to these new parents? a. "Infants can see very little until approximately 3 months of age." b. "It's important to shield the newborn's eyes. Overhead lights help them see better." c. "The infant's eyes must be protected. Infants enjoy looking at brightly colored stripes." d. "Infants can track their parents' eyes and can distinguish patterns; they prefer complex patterns"

d. "Infants can track their parents' eyes and can distinguish patterns; they prefer complex patterns"

A woman with worsening preeclampsia is admitted to the hospital's labor and birth unit. The physician explains the plan of care for severe preeclampsia, including the induction of labor, to the woman and her husband. Which statement by the husband leads the nurse to believe that the couple needs further information? a. "I will stay with my wife during her labor, just as we planned." b. "I will give my wife ice chips to eat during labor." c. "I will help my wife use the breathing techniques that we learned in our childbirth classes." d. "Since we will be here for a while, I will call my mother so she can bring the two boys—2 years and 4 years of age—to visit their mother."

d. "Since we will be here for a while, I will call my mother so she can bring the two boys—2 years and 4 years of age—to visit their mother."

A primiparous woman is watching her newborn sleep. She wants him to wake up and respond to her. The mother asks the nurse how much he will sleep every day. What is an appropriate response by the nurse? a. "He is being stubborn by not waking up when you want him to. You should try to keep him awake during the daytime so that he will sleep through the night." b. "He will probably follow your same sleep and wake patterns, and you can expect him to be awake soon." c. "He will only wake up to be fed, and you should not bother him between feedings." d. "The newborn sleeps approximately 17 hours a day, with periods of wakefulness gradually increasing."

d. "The newborn sleeps approximately 17 hours a day, with periods of wakefulness gradually increasing."

A nurse is making a home visit on the twelfth postpartum day to assess a 23-year-old primipara woman and her full-term, healthy baby. Breastfeeding is the method of infant nutrition. The woman tells the nurse that she does not think her milk is good because it looks very watery when she expresses a little before each feeding. The nurse's best response is: a. "This is normal. You only have to be concerned when your baby does not gain weight." b. "What types of foods are you eating? A lack of protein in the diet can cause watery looking breast milk." c. "How much fluid are you drinking while you are nursing your baby? Too much fluid during the feeding session can dilute the breast milk." d. "This is normal and is referred to as foremilk which is higher in water content. Later in the feeding the fat content increases and the milk becomes richer in appearance."

d. "This is normal and is referred to as foremilk which is higher in water content. Later in the feeding the fat content increases and the milk becomes richer in appearance."

A healthy 60-year-old African-American woman regularly receives health care at her neighborhood clinic. She is due for a mammogram. At her first visit, her health care provider is concerned about the 3-week wait at the neighborhood clinic and made an appointment for her to have a mammogram at a teaching hospital across town. She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure. What is the most appropriate statement for the nurse to make to this client? a. "It's very dangerous to skip your mammograms; your breasts need to be checked." b. "I'm concerned that you missed your appointment; let me make another one for you." c. "Do you have transportation to the teaching hospital so that you can get your mammogram?" d. "Would you like me to make an appointment for you to have your mammogram here?"

d. "Would you like me to make an appointment for you to have your mammogram here?"

Felicity Chan, a new mother, is accompanied by her mother during her hospital stay on the postpartum unit. Felicity's mother makes specific, various requests of the nurses including bringing warm tea, a cot to sleep on, and that the baby not be bathed at this time. Felicity's mother is also concerned about the amount of work that Felicity may be doing in the provision of infant care. Felicity asks for help with breastfeeding. After Felicity has finished breastfeeding, her mother asks for a bottle so they can warm it and "feed" the baby. How would the perinatal nurse best respond to Felicity's mother in a culturally sensitive way? a. Ask Felicity's mother to leave for 30 minutes to allow for some private time with Felicity to explore her learning needs privately. b. Ask both Felicity and her mother about the preferred infant feeding method, and assess what they already know. c. Convey to Felicity and her mother an understanding of the concepts of "hot" and "cold" within their belief system. d. Ask Felicity what she knows about breastfeeding, and provide information to both women to support Felicity's decision.

d. Ask Felicity what she knows about breastfeeding, and provide information to both women to support Felicity's decision.

Which nursing intervention should be immediately performed after the forceps-assisted birth of an infant? a. Administering prophylactic antibiotic agents to the infant b. Applying a cold pack to the infant's scalp c. Measuring the circumference of the infant's head d. Assessing the infant for signs of trauma

d. Assessing the infant for signs of trauma

Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus? a. Assess the blood pressure and pulse. b. Notify the physician of an impending hemorrhage. c. Administer pitocin d. Assist the client in emptying her bladder.

d. Assist the client in emptying her bladder.

Preeclampsia begins at what point during the pregnancy? a. At conception b. At 12 weeks gestation c. After 20 weeks gestation d. At placental implantation

d. At placental implantation

According to the CDC, which of the following has the highest maternal mortality rate in the United States? a. White Women b. Asian Women c. Hispanic Women d. Black Women

d. Black Women

The symptoms of mild to moderate urinary incontinence can be successfully decreased by a number of strategies. Which of these should the nurse instruct the client to use first? a. Pelvic floor support devices b. Surgery c. Medications d. Bladder training and pelvic muscle exercises or Kegels

d. Bladder training and pelvic muscle exercises or Kegels

Which statement related to cephalopelvic disproportion (CPD) is the least accurate? a. Causes of CPD may have maternal or fetal origins. b. CPD can be related to either fetal size or fetal position. c. The fetus cannot be born vaginally. d. CPD can be accurately predicted

d. CPD can be accurately predicted

The nurse is performing an assessment on a client who thinks she may be experiencing preterm labor. Which information is the mostimportant for the nurse to understand and share with the client? a. Because all women must be considered at risk for preterm labor and prediction is so variable, teaching pregnant women the symptoms of preterm labor probably causes more harm through false alarms. b. Because preterm labor is likely to be the start of an extended labor, a woman with symptoms can wait several hours before contacting the primary caregiver. c. Braxton Hicks contractions often signal the onset of preterm labor. d. Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

d. Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse? a. Blood pressure (BP) increase to 138/86 mm Hg b. Weight gain of 0.5 kg during the past 2 weeks c. Pitting pedal edema at the end of the day d. Dipstick value of 3+ for protein in her urine

d. Dipstick value of 3+ for protein in her urine

Which is the most accurate description of PPD without psychotic features? a. Postpartum baby blues requiring the woman to visit with a counselor or psychologist b. Condition that disappears without outside help c. Condition that is more common among older Caucasian women because they have higher expectations d. Distinguishable by irritability

d. Distinguishable by irritability

Which of the following antepartum tests is (are) used to evaluate a Maternal Serum Screening test that is negative for increased risk? a. CVS b. Biophysical profile c. Amniocentesis d. Further followup test not necessary

d. Further followup test not necessary

To explain hemolytic disorders in the newborn to new parents, the nurse who cares for the newborn population must be aware of the physiologic characteristics related to these conditions. What is the most common cause of pathologic hyperbilirubinemia? a. Hepatic disease b. Postmaturity c. Congenital heart defect d. Hemolytic disorders

d. Hemolytic disorders

The nurse is teaching new parents about metabolic screening for the newborn. Which statement is most helpful to these clients? a. All states test for phenylketonuria (PKU), hypothyroidism, cystic fibrosis, and sickle cell diseases. b. Hearing screening is now mandated by federal law. c. Federal law prohibits newborn genetic testing without parental consent. d. If genetic screening is performed before the infant is 24 hours old, then it should be repeated at age 1 to 2 weeks.

d. If genetic screening is performed before the infant is 24 hours old, then it should be repeated at age 1 to 2 weeks.

A 26-year-old primigravida has come to the clinic for her regular prenatal visit at 12 weeks. She appears thin and somewhat nervous. She reports that she eats a well-balanced diet, although her weight is 5 pounds less than it was at her last visit. The results of laboratory studies confirm that she has a hyperthyroid condition. Based on the available data, the nurse formulates a plan of care. Which nursing diagnosis is most appropriate for the client at this time? a. Imbalanced nutrition: more than body requirements b. Disturbed sleep pattern c. Deficient fluid volume d. Imbalanced nutrition: less than body requirements

d. Imbalanced nutrition: less than body requirements

The nurse is evaluating a neonate who was delivered 3 hours ago by vacuum-assisted delivery. The infant has developed a cephalhematoma. Which statement is most applicable to the care of this neonate? a. Subarachnoid hemorrhage (the most common form of ICH) occurs in term infants as a result of hypoxia. b. Intracranial hemorrhage (ICH) as a result of birth trauma is more likely to occur in the preterm, low-birth-weight infant. c. Spinal cord injuries almost always result from vacuum-assisted deliveries. d. In many infants, signs of hemorrhage in a full-term infant are absent and diagnosed only through laboratory tests

d. In many infants, signs of hemorrhage in a full-term infant are absent and diagnosed only through laboratory tests

Which infant is most likely to express Rh incompatibility? a. Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor b. Infant who is Rh positive and a mother who is Rh positive c. Infant who is Rh negative and a mother who is Rh negative d. Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor

d. Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor

In contrast to placenta previa, what is the most prevalent clinical manifestation of Grade 3 abruptio placentae? a. Bleeding b. Intermittent uterine contractions c. Cramping d. Intense abdominal pain

d. Intense abdominal pain

Which neonatal complications are associated with hypertension in the mother? a. Seizures and cerebral hemorrhage b. Hepatic or renal dysfunction c. Placental abruption and DIC d. Intrauterine growth restriction (IUGR) and prematurity

d. Intrauterine growth restriction (IUGR) and prematurity

The nurse who is caring for a woman hospitalized for hyperemesis gravidarum would expect the initial treatment to involve what? a. Corticosteroids to reduce inflammation b. Antiemetic medication, such as pyridoxine, to control nausea and vomiting c. Enteral nutrition to correct nutritional deficits d. Intravenous (IV) therapy to correct fluid and electrolyte imbalances

d. Intravenous (IV) therapy to correct fluid and electrolyte imbalances

Which of the following is true regarding physiologic jaundice? (Select all that apply). a. It is recommended the mother stop breastfeeding until jaundice resolves b. Jaundice persists longer than 14 days of life in a term infant c. Jaundice is more common in preterm infants d. Jaundice is noted 24 hours after birth

d. Jaundice is noted 24 hours after birth

18 year old Ellen has a positive pregnancy test and cries when she sees the result. Per her LMP, the nurse determines she is approx 7 weeks pregnant. She asks the nurse what should she do. Which of the following is the nurse's best initial response? a. I think adoption would be your best choice at this time. b. You need to decide what obstetrician you want to see for prenatal care. c. Here is a list of clinics that provide abortions. My sister liked this one best. d. Let's discuss your three options.

d. Let's discuss your three options.

A woman gave birth to a healthy infant boy 5 days ago. What type of lochia does the nurse expect to find when evaluating this client? a. Lochia rubra b. Lochia sangra c. Lochia alba d. Lochia serosa

d. Lochia serosa

According to the CDC, which of the following are true? a. Maternal mortality rate in the US has increased primarily due to anesthesia complications b. Maternal mortality rate in the US has decreased from 1987-2013 c. Maternal mortality rate in the US has increased but infection is no longer a significant cause. d. Maternal mortality rate in the US has increased from 1987-2013

d. Maternal mortality rate in the US has increased from 1987-2013

While evaluating the reflexes of a newborn, the nurse notes that with a loud noise the newborn symmetrically abducts and extends his arms, his fingers fan out and form a C with the thumb and forefinger, and he has a slight tremor. The nurse would document this finding as a positive _____ reflex. a. tonic neck b. glabellar c. Babinski d. Moro

d. Moro

By understanding the four mechanisms of heat transfer (convection, conduction, radiation, and evaporation), the nurse can create an environment for the infant that prevents temperature instability. Which significant symptoms will the infant display when experiencing cold stress? a. Increased physical activity b. Decreased respiratory rate c. Bradycardia, followed by an increased heart rate d. Mottled skin with acrocyanosis

d. Mottled skin with acrocyanosis

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem approach. What is the first step in the provision of care for the infant? a. Reduction of environmental stimuli b. Pharmacologic treatment c. Adequate nutrition and maintenance of fluid and electrolyte balance d. Neonatal abstinence syndrome (NAS) scoring

d. Neonatal abstinence syndrome (NAS) scoring

What information regarding a fractured clavicle is most important for the nurse to take into consideration when planning the infant's care? a. Parents should be taught range-of-motion exercises. b. The shoulder should be immobilized with a splint. c. Prone positioning facilitates bone alignment. d. No special treatment is necessary.

d. No special treatment is necessary.

If the umbilical cord prolapses during labor, the nurse should immediately: a. Type and cross-match blood for an emergency transfusion. b. Await provider order for preparation for an emergency cesarean section. c. Attempt to reposition the cord above the presenting part. d. Perform vaginal exam and lifting the presenting part off of the cord to relieve pressure on the cord.

d. Perform vaginal exam and lifting the presenting part off of the cord to relieve pressure on the cord

Despite warnings, prenatal exposure to alcohol continues to far exceed exposure to illicit drugs. Which condition is rarely associated with fetal alcohol syndrome (FAS)? a. Alcohol-related birth defects (ARBDs) b. Intellectual impairment c. Neural development disorder d. Respiratory conditions

d. Respiratory conditions

Parents are often asked if they would like to have an autopsy performed on their infant. Nurses who are assisting parents with this decision should be aware of which information? a. Autopsies are usually covered by insurance. b. Autopsies must be performed within a few hours after the infant's death. c. In the current litigious society, more autopsies are performed than in the past. d. Some religions prohibit autopsy

d. Some religions prohibit autopsy

Which statement regarding hemolytic diseases of the newborn is most accurate? a. ABO incompatibility is more likely than Rh incompatibility to precipitate significant anemia. b. Rh incompatibility matters only when an Rh-negative child is born to an Rh-positive mother. c. Exchange transfusions are frequently required in the treatment of hemolytic disorders. d. The indirect Coombs' test is performed on the mother before birth; the direct Coombs' test is performed on the cord blood after birth.

d. The indirect Coombs' test is performed on the mother before birth; the direct Coombs' test is performed on the cord blood after birth.

A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed? a. von Willebrand disease (vWD); noting whether bleeding times have been extended b. Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis c. Disseminated intravascular coagulation (DIC); asking for laboratory tests d. Thrombophlebitis; using real-time and color Doppler ultrasound

d. Thrombophlebitis; using real-time and color Doppler ultrasound

A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM) doses of betamethasone. What is the purpose of this pharmacologic intervention? a. To reduce maternal and fetal tachycardia associated with ritodrine administration b. To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy c. To suppress uterine contractions d. To stimulate fetal surfactant production

d. To stimulate fetal surfactant production

A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM) doses of betamethasone. What is the purpose of this pharmacologic intervention? a. To suppress uterine contractions b. To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy c. To reduce maternal and fetal tachycardia associated with ritodrine administration d. To stimulate fetal surfactant production

d. To stimulate fetal surfactant production

A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic procedure will the client most likely have performed? a. Internal fetal monitoring b. Amniocentesis for fetal lung maturity c. Contraction stress test (CST) d. Transvaginal ultrasound for placental location

d. Transvaginal ultrasound for placental location

A pregnant woman at 33 weeks of gestation is brought to the birthing unit after a minor automobile accident. The client is experiencing no pain and no vaginal bleeding, her vital signs are stable, and the FHR is 132 beats per minute with variability. What is the nurse'shighest priority? a. Monitoring the woman for a ruptured spleen b. Obtaining a physician's order to discharge her home c. Monitoring her for 24 hours d. Using continuous EFM for a minimum of 4 hours

d. Using continuous EFM for a minimum of 4 hours

Which condition would require prophylaxis to prevent subacute bacterial endocarditis (SBE) both antepartum and intrapartum? a. Postmyocardial infarction b. Arrhythmias c. Congestive heart disease d. Valvular heart disease

d. Valvular heart disease

Which newborn reflex is elicited by stroking the lateral sole of the infant's foot from the heel to the ball of the foot? a. plantar grasp b. stepping c. tonic neck d. babinski

d. babinski

Which substance used during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications? a. Chocolate b. Alcohol c. Caffeine d. Tobacco

d. tobacco

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation. What is the primary purpose of prostaglandin administration?

To ripen the cervix in preparation for labor induction

The nurse is teaching the parents of a female baby how to change a baby's diapers. Which of the following should be included in the teaching?

Always wipe the perineum from front to back

What is the rationale for evaluating the plantar crease within a few hours of birth?

As the skin dries, the creases will become more prominent

Tachysystole, previously referred to as hyperstimulation, is defined as:

Contractions lasting 2 minutes or longer, Five or more contractions in 10 minutes over a 30-minute window, Contractions occurring within 1 minute of each other

The postpartum nurse is caring for a couple who experienced an unplanned emergency cesarean birth. The nurse observes the following behaviors: Parents are gently touching their newborn. Mother is softly singing to her baby. Father is gazing into his baby's eyes. Based on this data, the correct nursing diagnosis is altered parent-infant bonding related to emergency cesarean birth. True or False

False

Which of the following are primary risk factors for subinvolution of the uterus? (Select all that apply.)

Fibroids Retained placental tissue Metritis

10. A 25-year-old multiparous woman gave birth to an infant boy 1 day ago. Today her husband brings a large container of brown seaweed soup to the hospital. When the nurse enters the room, the husband asks for help with warming the soup so that his wife can eat it. What is the nurse's most appropriate response?

I'll warm the soup in the microwave for you."

PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of the client's circulatory status can be performed with noninvasive monitoring. Match the type of noninvasive assessment that the nurse would perform with the appropriate clinical manifestation or body system.

Inspection: skin color, temperature, and turgor Auscultation: heart pulses Observation: presence or absence of anxiety Palpation: arterial pulses Measurement: pulse oximetry

The nurse should be cognizant of which postpartum physiologic alteration?

Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth

A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When evaluating the woman's vital signs, which finding would be of greatest concern to the nurse? a. Temperature 37.9° C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg b. Temperature 37.4° C, heart rate 88 bpm, respirations 36 breaths per minute, and blood pressure 126/68 mm Hg c. Temperature 36.8° C, heart rate 60 bpm, respirations 18 breaths per minute, and blood pressure 140/90 mm Hg d. Temperature 38° C, heart rate 80 bpm, respirations 16 breaths per minute, and blood pressure 110/80 mm Hg

Temperature 37.9° C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg

An infant was born 2 hours ago at 37 weeks of gestation and weighs 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of what condition? a. Hypocalcemia b. Seizures c. Birth injury d. Hypoglycemia

d. Hypoglycemia

Which finding would indicate to the nurse that the grieving parents have progressed to the reorganization phase of grieving?

The parents are discussing sex and a future pregnancy, even if they have not yet sorted out their feelings

The nurse assessing a newborn for heat loss is aware that nonshivering thermogenesis utilizes the newborn's stores of brown adipose tissue (BAT) to provide heat in the cold-stressed newborn. True or False

True

A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this woman's fundus? a. 1 cm above the umbilicus b. 2 cm below the umbilicus c. midway between the umbilicus and the symphysis pubis d. nonpalpable abdominally

a. 1 cm above the umbilicus

The nurse suspects that her postpartum client is experiencing hemorrhagic shock. Which observation indicates or would confirm this diagnosis?

Urinary output of at least 30 ml/hr

Which of the following is an indication for the administration of methylergonovine (Methergine)? a. Boggy uterus that does not respond to massage and oxytocin therapy b. Woman with a large hematoma c. Woman with a deep vein thrombosis d. Woman with severe postpartum depression

a. Boggy uterus that does not respond to massage and oxytocin therapy

Which of the following is an indication for the administration of methylergonovine (Methergine)? a. Boggy uterus that does not respond to massage and oxytocin therapy b. Woman with a large hematoma c. Woman with a deep vein thrombosis d. Woman with severe postpartum depression

a. Boggy uterus that does not respond to massage and oxytocin therapy

During a prenatal visit, the nurse is explaining dietary management to a woman with pregestational diabetes. Which statement by the client reassures the nurse that teaching has been effective? a. "I can continue with the same diet as before pregnancy as long as it is well balanced." b. "Diet and insulin needs change during pregnancy." c. "I will need to eat 600 more calories per day because I am pregnant." d. "I will plan my diet based on the results of urine glucose testing."

b. "Diet and insulin needs change during pregnancy."

Hypothyroidism occurs in 2 to 3 pregnancies per 1000. Because severe hypothyroidism is associated with infertility and miscarriage, it is not often seen in pregnancy. Regardless of this fact, the nurse should be aware of the characteristic symptoms of hypothyroidism. Which do they include? (Select all that apply.) a. Hot flashes b. Cold intolerance c. Decrease in exercise capacity d. Weight loss e. Lethargy

b. cold intolerance c. decrease in exercise capacity e. lethargy

A woman has preinvasive cancer of the cervix. Which modality would the nurse discuss as an available option for a client with this condition? a. internal radiation b. cryosurgery c. hysterectomy d. colposcopy

b. cryosurgery

Pre-surgical nursing care for the woman who is going to have a hysterectomy for ovarian cancer includes which of the following? (Select all that apply). a. Sips of water for hydration b. ensure lab results are available to the surgeon prior to surgery c. identification band is in place d. administer enema if ordered e. teach post-op routine care such as need for early ambulation

b. ensure lab results are available to the surgeon prior to surgery c. identification band is in place d. administer enema if ordered e. teach post-op routine care such as need for early ambulation

The CHOICE Project removed 3 key barriers to contraception for many women. These included which of the following? a. state laws that restrict methods b. knowledge deficit c. cost d. parental permission e. lack of access to preferred method

b. knowledge deficit c. cost e. lack of access to preferred method

A NICU nurse is caring for a full-term neonate being treated for group B streptococcus (GBS). The mother of the neonate is crying and shares that she cannot understand how her baby became infected. The best response by the nurse is: a. "Newborns are more susceptible to infections due to an immature immune system. Would you like additional information on the newborn immune system?" b. "The infection was transmitted to your baby during the birthing process. Do you have a history of sexual transmitted infections?" c. "Approximately 15% to 40% of women have no symptoms but are carriers of group B streptococcus which is found in the vaginal and lower intestinal areas. What other questions do you have regarding your baby's health?" d. "I see that this is very upsetting for you. I will come back later and answer your questions."

c. "Approximately 15% to 40% of women have no symptoms but are carriers of group B streptococcus which is found in the vaginal and lower intestinal areas. What other questions do you have regarding your baby's health?"

Which of the following tests should never be performed during the first trimester? a. Ultrasound b.Maternal screening test for cystic fibrosis c. Contraction Stress test d. Noninvasive Prenatal Screening test

c. Contraction Stress test

What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony? a. Preparing the woman for surgical intervention b. Catheterizing the bladder c. Performing fundal massage d. Establishing venous access

c. Performing fundal massage

Combination oral contraceptives, the vaginal ring and the patch contain two hormones. Which of the following is the primary hormone that stops ovulation? a. estrogen b. testosterone c. progesterone d. hCG

c. progesterone

A newborn in the neonatal intensive care unit (NICU) is dying as a result of a massive infection. The parents speak to the neonatologist, who informs them of their son's prognosis. When the father sees his son, he says, "He looks just fine to me. I can't understand what all this is about." What is the most appropriate response or reaction by the nurse at this time? a. "Didn't the physician tell you about your son's problems?" b. Quietly stand beside the infant's father. c. "You'll have to face up to the fact that he is going to die sooner or later." d. "This must be a difficult time for you. Tell me how you're doing."

d. "This must be a difficult time for you. Tell me how you're doing."

According to research, which risk factor for PPD is likely to have the greatest effect on the client postpartum? a. Low socioeconomic status b. Unplanned or unwanted pregnancy c. Single-mother status d. Prenatal depression

d. Prenatal depression

While taking a family history, 37 y/o Bernice tells the nurse her paternal grandmother had breast and colon cancer in her 60's, two paternal aunts had breast cancer in their 40's, one of those aunts also had ovarian cancer in her 40's, one paternal uncle had colon cancer in his 40's, her paternal cousin has breast cancer in her 40's, and her father had colon cancer in his 40's. She denies cancer on her mother's side of the family. Bernice states she has 2 younger sisters. Which of the following responses would be best for the nurse to say to Bernice about her reported family history? a. "Do you have cancer on your mother's side of the family?" b. "Have you had a screening mammogram?" c. "Have you had your pap smear recently?" d. "Since all of these cancers are on your father's side of the family, you have no increased risk for cancer." e. "The types of cancers reported on your father's side of the family may be due to a gene mutation that can be passed onto to each generation. Have any of your relatives or you considered genetic testing?"

e. "The types of cancers reported on your father's side of the family may be due to a gene mutation that can be passed onto to each generation. Have any of your relatives or you considered genetic testing?"