Women's Health Exam Two

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.) DIC B.) Amniotic fluid embolism (AFE) C.) Hemorrhage D.) HELLP syndrome

A

In caring for the woman with DIC, which order should the nurse anticipate? A.) Administration of blood B.) Preparation of the client for invasive hemodynamic monitoring C.) Restriction of intravascular fluids D.) Administration of steroids

A

A 3.8-kg infant was vaginally delivered at 39 weeks after a 30-minute second stage. A nuchal cord was found at delivery. After birth, the infant is noted to have petechiae over the face and upper back. Which information regarding petechiae is most accurate and should be provided to the parents? A.) Are benign if they disappear within 48 hours of birth B.) Result from increased blood volume C.) Should always be further investigated D.) Usually occur with a forceps-assisted delivery

A

A 3.8-kg infant was vaginally delivered at 39 weeks of gestation after a 30-minute second stage. A nuchal cord occurred. After the birth, the infant is noted to have petechiae over the face and upper back. Based on the nurses knowledge, which information regarding petechiae should be shared with the parents? A.) Petechiae (pinpoint hemorrhagic areas) are benign if they disappear within 48 hours of childbirth B.) These hemorrhagic areas may result from increased blood volume C.) Petechiae should always be further investigated D.) Petechiae usually occur with a forceps delivery

A

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.) Tocolytic drug B.) Contraction stress test (CST) C.) Local anesthetic D.) Foley catheter

A

A client diagnosed with marginal placenta previa gave birth vaginally 15 minutes ago. At the present time, the client is at the greatest risk for which complication? A.) Hemorrhage B.) Infection C.) Urinary retention D.) Thrombophlebitis

A

A client is warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on high. The nurse instructs the mother that the fan should not be directed toward the newborn and that the newborn should be wrapped in a blanket. The mother asks why. How would the nurse respond? A.) Your baby may lose heat by convection, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped, and should prevent cool air from blowing on him B.) Your baby may lose heat by conduction, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped, and should prevent cool air from blowing on him C.) Your baby may lose heat by evaporation, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped, and should prevent cool air from blowing on him D.) Your baby will easily get cold stressed and needs to be bundled up at all times

A

A client reports painless, bright red vaginal bleeding during the second trimester of pregnancy. On assessment, the nurse notes decreased urine output, increased fundal height, and a nontender uterus with normal tone. Which client condition would the nurse interpret from these findings? A.) Placenta previa B.) Ectopic pregnancy C.) Hydatidiform mole D.) Normal development

A

A client 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 37.1 C - pulse 96 bpm - RR 24 - BP 155/112 mmHg - 3+ deep tendon reflexes - no ankle clonus The nurse calls the primary health care provider and anticipates a prescription for which medication? A.) Hydralazine B.) Magnesium sulfate bolus C.) Diazepam D.) Calcium gluconate

A

A first-time father is changing the diaper of his 1-day-old daughter. He asks the nurse, What is this black, sticky stuff in her diaper? What is the nurse's best response? A.) That's meconium, which is your baby's first stool. Its normal B.) That's transitional stool C.) That means your baby is bleeding internally D.) Oh, don't worry about that. Its okay

A

A lactating client with tuberculosis (TB) has recovered from the infection and completed the TB medication 2 weeks ago. Which recommendation would the nurse provide the client about feeding her 4-month-old baby? A.) "Breastfeed your baby" B.) "Give your baby expressed milk" C.) "Give your baby concentrated formula" D.) "Give your baby fluoride supplements"

A

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.) A large scrotum and swelling indicate a hydrocele, which is a common finding in male newborns B.) I don't know, but I'm sure it is nothing C.) Your baby might have testicular cancer D.) Your babys urine is backing up into his scrotum

A

What is the most important nursing action in preventing neonatal infection? A.) Good handwashing B.) Isolation of infected infants C.) Separate gown technique D.) Standard Precautions

A

A new mother asks the nurse about the white substance covering her infant. How should the nurse explain the purpose of vernix caseosa? A.) Vernix caseosa protects the fetal skin from the amniotic fluid B.) Vernix caseosa promotes the normal development of the peripheral nervous system C.) Vernix caseosa allows the transport of oxygen and nutrients across the amnion D.) Vernix caseosa regulates fetal temperature

A

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.) Infants should be given only human milk for the first 6 months of life B.) Infants fed on formula should be started on solid food sooner than breastfed infants C.) If infants are weaned from breast milk before 12 months, then they should receive cows milk, not formula D.) After 6 months, mothers should shift from breast milk to cows milk

A

A new mother asks whether she should feed her newborn colostrum, because it is not real milk. What is the nurses most appropriate answer? A.) Colostrum is high in antibodies, protein, vitamins, and minerals B.) Colostrum is lower in calories than milk and should be supplemented by formula C.) Giving colostrum is important in helping the mother learn how to breastfeed before she goes home D.) Colostrum is unnecessary for newborns

A

A new mother states that her infant must be cold because the baby's hands and feet are blue. This common and temporary condition is called what? A.) Acrocyanosis B.) Erythema toxicum neonatorum C.) Harlequin sign D.) Vernix caseosa

A

A nurse is discussing the storage of breast milk with a mother whose infant is preterm and in the special care nursery. Which statement indicates that the mother requires additional teaching? A.) I can store my breast milk in the refrigerator for 3 months B.) I can store my breast milk in the freezer for 3 months C.) I can store my breast milk at room temperature for 4 hours D.) I can store my breast milk in the refrigerator for 3 to 5 days

A

A nurse providing couplet care should understand the issue of nipple confusion. In which situation might this condition occur? A.) Breastfeeding babies receive supplementary bottle feedings B.) Baby is too abruptly weaned C.) Pacifiers are used before breastfeeding is established D.) Twins are breastfed together

A

A pregnant client who is in preterm labor has been prescribed dexamethasone. The nurse knows the reason for administering this drug would be to facilitate which action? A.) Maturation of fetal lungs B.) Relaxation of smooth muscles C.) Inhibition of uterine contractions D.) Central nervous system (CNS) depresssion

A

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 infants physical findings, this woman should be questioned about her use of which substance during pregnancy? A.) Alcohol B.) Cocaine C.) Heroin D.) Marijuana

A

A pregnant woman wants to breastfeed her infant; however, her husband is not convinced that there are any scientific reasons to do so. The nurse can give the couple printed information comparing breastfeeding and bottle feeding. Which statement regarding bottle feeding using commercially prepared infant formulas might influence their choice? A.) Bottle feeding using a commercially prepared formula increases the risk that the infant will develop allergies B.) Bottle feeding helps the infant sleep through the night C.) Commercially prepared formula ensures that the infant is getting iron in a form that is easily absorbed D.) Bottle feeding requires that multivitamin supplements be given to the infant

A

A pregnant woman's amniotic membranes have ruptured. A prolapsed umbilical cord is suspected. What intervention would be the nurses highest priority? A.) Placing the woman in the knee-chest position B.) Covering the cord in sterile gauze soaked in saline C.) Preparing the woman for a cesarean birth D.) Starting oxygen by face mask

A

A woman in labor passes some thick meconium as her amniotic fluid ruptures. The client asks the nurse where the baby makes the meconium. What is the correct response by the nurse? A.) Fetal intestines B.) Fetal kidneys C.) Amniotic fluid D.) Placenta

A

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 stimulate fetal surfactant production B.) To reduce maternal and fetal tachycardia associated with ritodrine administration C.) To suppress uterine contractions D.) To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy

A

A woman is 16 weeks pregnant and has elected to terminate her pregnancy. Which is the most common technique used for the termination of a pregnancy in the second trimester? A.) Dilation and evacuation (D&E) B.) Methotrexate administration C.) Prostaglandin administration D.) Vacuum aspiration

A

For which reason would the nurse perform nasal and oral suctioning of a newborn immediately after birth? A.) To stimulate respiration B.) To assist in stimulating cardiac activity C.) To remove fluid from the lungs D.) To increase pulmonary blood flow

A

How are the oligosaccharides that are present in breast milk beneficial to the breastfed infant? A.) They prevent pathogenic bacterial growth B.) They improve blood circulation C.) They increase calcium absorption D.) They promote neurologic development

A

How would the nurse identify an increased volume of breast milk? A.) By observing the infant's urine color B.) By observing the infant's skin color C.) By observing the infant's sleeping pattern D.) By observing the infant's meconium stool color

A

How would the nurse optimally reassure the parents of an infant who develops a cephalhematoma? A.) A cephalhematoma may occur with a spontaneous vaginal birth B.) A cephalhematoma only happens as a result of a forceps- or vacuum-assisted delivery C.) It is present immediately after birth D.) The blood will gradually absorb over the first few months of life

A

I just wanted to have an even number :) So good job at whatever number you're at :) Get a correct answer by putting 'A' as the answer :)

A

What kind of fetal anomalies are most often associated with oligohydramnios? A.) Renal B.) Cardiac C.) Gastrointestinal D.) Neurologic

A

Nursing follow-up care often includes home visits for the new mother and her infant. Which information related to home visits is correct? A.) Ideally, the visit is scheduled within 72 hours after discharge B.) Home visits are available in all areas C.) Visits are completed within a 30-minute time frame D.) Blood draws are not a part of the home visit

A

On reviewing the ultrasound report of a pregnant client, the nurse finds that the placenta is at a distance of 2.5 cm from the internal cervical os. Which complication is likely if the client has a vaginal delivery? A.) Hemorrhage B.) Hyperthyroidism C.) Thrombocytopenia D.) Hypofibrinogenemia

A

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.) Premature infants more easily digest breast milk than formula B.) A glass of wine just before pumping will help reduce stress and anxiety C.) The mother should only pump as much milk as the infant can drink D.) The mother should pump every 2 to 3 hours, including during the night

A

Part of the health assessment of a newborn is observing the infants breathing pattern. What is the pre-dominate pattern of newborns breathing? A.) Abdominal with synchronous chest movements B.) Chest breathing with nasal flaring C.) Diaphragmatic with chest retraction D.) Deep with a regular rhythm

A

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 nurses most appropriate response? A.) The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor B.) I don't know why it is taking so long C.) The length of labor varies for different women D.) Your baby is just being stubborn

A

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? A.) Viral B.) Periodontal C.) Cervical D.) Urinary tract

A

The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone. What approach should the nurse take when performing the test to prevent this complication? A.) Lancet should penetrate at the outer aspect of the heel B.) Lancet should penetrate the walking surface of the heel C.) Lancet should penetrate the ball of the foot D.) Lancet should penetrate the area just below the fifth toe

A

The nurse caring for a newborn checks the record to note clinical findings that occurred before her shift. Which finding related to the renal system would be of increased significance and require further action? A.) The pediatrician should be notified if the newborn has not voided in 24 hours B.) Breastfed infants will likely void more often during the first days after birth C.) Brick dust or blood on a diaper is always cause to notify the physician D.) Weight loss from fluid loss and other normal factors should be made up in 4 to 7 days

A

The nurse is assessing a pregnant client with multifetal gestation. On reviewing the medical history, the nurse finds that the client had a preterm delivery during the first pregnancy. Which intervention would the nurse perform to help prevent preterm delivery in this client? A.) Suggest that the client avoid smoking B.) Suggest that the client increases physical activity to prevent risk C.) Administer progesterone suppositories to the client D.) Administer a 17-alpha hydroxy progesterone injection to the client

A

The nurse is preparing to administer a hepatitis B virus (HBV) vaccine to a newborn. Which intervention by the nurse is correct? A.) Obtaining a syringe with a 25-gauge, 5/8-inch needle for medication administration B.) Confirming that the newborns mother has been infected with the HBV C.) Assessing the dorsogluteal muscle as the preferred site for injection D.) Confirming that the newborn is at least 24 hours old

A

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.) Flexed posture B.) Abundant lanugo C.) Smooth, pink skin with visible veins D.) Faint red marks on the soles of the feet

A

The nurse should be cognizant of which important statement regarding care of the umbilical cord? A.) The stump can become easily infected B.) If bleeding occurs from the vessels of the cord, then the nurse should immediately call for assistance C.) The cord clamp is removed at cord separation D.) The average cord separation time is 5 to 7 days

A

The nurse should be cognizant of which statement regarding the unique qualities of human breast milk? A.) Frequent feedings during predictable growth spurts stimulate increased milk production B.) Milk of preterm mothers is the same as the milk of mothers who gave birth at term C.) Milk at the beginning of the feeding is the same as the milk at the end of the feeding D.) Colostrum is an early, less concentrated, less rich version of mature milk

A

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

A

What is the correct definition of a spontaneous termination of a pregnancy (abortion)? A.) Pregnancy is less than 20 weeks B.) Fetus weighs less than 1000 g C.) Products of conception are passed intact D.) No evidence exists of intrauterine infection

A

What is the correct term for the cheeselike, white substance that fuses with the epidermis and serves as a protective coating? A.) Vernix caseosa B.) Surfactant C.) Caput succedaneum D.) Acrocyanosis

A

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

A

What is the most common medical complication of pregnancy? A.) Hypertension B.) Hyperemesis gravidarum C.) Hemorrhagic complications D.) Infections

A

What nursing diagnosis is the most appropriate for a woman experiencing severe preeclampsia? A.) Risk for injury to mother and fetus, related to central nervous system (CNS) irritability B.) Risk for altered gas exchange C.) Risk for deficient fluid volume, related to increased sodium retention secondary to the administration of magnesium sulfate D.) Risk for increased cardiac output, related to the use of antihypertensive drugs

A

When is a prophylactic cerclage for an incompetent cervix usually placed (in weeks of gestation)? A.) 12 to 14 B.) 6 to 8 C.) 23 to 24 D.) After 24

A

Which assessment finding would the nurse expect when caring for a newborn male infant born at 39 weeks of gestation? A.) Testes descended into the scrotum B.) Extended posture when at rest C.) Abundant lanugo over his entire body D.) Ability to move his elbow past his sternum

A

Which component of the sensory system is the least mature at birth? A.) Vision B.) Hearing C.) Smell D.) Taste

A

Which description most accurately describes the augmentation of labor? A.) Is part of the active management of labor that is instituted when the labor process is unsatisfactory B.) Relies on more invasive methods when oxytocin and amniotomy have failed C.) Is a modern management term to cover up the negative connotations of forceps-assisted birth D.) Uses vacuum cups

A

Which documentation reflects on the neurologic activity of the neonate? A.) The ability to suck B.) Head circumference C.) Abdominal movements D.) Head-to-toe measurements

A

Which education would the nurse provide the parents of a neonate who has petechiae over the face and upper back? A.) The rash is benign if it disappears within 48 hours of birth B.) The rash results from increased blood volume C.) Petechiae should always be further investigated D.) Petechiae usually occur with forceps delivery

A

Which enzyme helps the newborn convert starch into maltose? A.) Amylase in colostrum B.) Mammary lipase in breast milk C.) Amylase in the salivary glands D.) Lactase in the digestive system

A

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

Which guidance would the nurse provide a postpartum client before initiating breastfeeding? A.) "Spread a few drops of milk on the nipple" B.) "Insert only the nipple into the infant's mouth" C.) "First give milk in the feeding bottle to the infant" D.) "Do not give any additional support to your breasts"

A

Which infant behavior would the nurse recognize as indicating respiratory distress? A.) Absent cry after birth B.) Hypoactive bowel sounds C.) Side-to-side head movement D.) Elevated blood pressure (BP)

A

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

A

Which integumentary finding for a newborn is identified as a normal variation? A.) Mongolian spots B.) Nevus flammeus C.) Infantile hemangioma D.) Generalized ecchymosis

A

Which intervention can nurses use to prevent evaporative heat loss in the newborn? A.) Drying the baby after birth, and wrapping the baby in a dry blanket B.) Keeping the baby out of drafts and away from air conditioners C.) Placing the baby away from the outside walls and windows D.) Warming the stethoscope and the nurses hands before touching the baby

A

Which intervention is most important when planning care for a client with severe gestational hypertension? A.) Induction of labor is likely, as near term as possible. B.) If at home, the woman should be confined to her bed, even with mild gestational hypertension C.) Special diet low in protein and salt should be initiated D.) Vaginal birth is still an option, even in severe cases

A

Which intervention would the nurse implement for a 3-day-old newborn whose weight is 7 lb, 12 oz (birth weight 8 lb, 4 oz)? A.) Encourage the client to continue breastfeeding because it is effective in meeting the newborn's nutrient and fluid needs B.) Suggest that the client switch to bottle feeding because breastfeeding is ineffective in meeting newborn needs for fluid and nutrients C.) Notify the provider because the newborn is being poorly nourished D.) Refer the client to a lactation consultant to improve her breastfeeding technique

A

Which is a common outcome of cesarean delivery on the respiratory function of the neonate? A.) Retention of fluid in the lungs B.) Incidence of transient bradypnea C.) Exhaustion from the effort of breathing D.) Episodes of periodic breathing

A

Which is a health outcome related to late cord clamping in the newborn? A.) Improvement in iron status B.) Decreased risk of jaundice C.) Decreased risk of polycythemia D.) Risk of intraventricular bleeding

A

Which is the rationale for placing a full-term infant on the postpartum client's chest after delivery? A.) To help initiate breastfeeding B.) To help the client recognize the infant's hunger cues C.) To promote pulmonary development in the infant D.) To reduce the symptoms of anxiety and restlessness in the mother

A

Which neonatal complications are associated with hypertension in the mother? A.) Intrauterine growth restriction (IUGR) and prematurity B.) Seizures and cerebral hemorrhage C.) Hepatic or renal dysfunction D.) Placental abruption and DIC

A

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.) Babinski B.) Tonic neck C.) Stepping D.) Plantar grasp

A

Which nursing intervention helps promote early passage of meconium in the infant? A.) Encouraging the mother to feed the infant colostrum B.) Administering a vitamin K injection to the infant C.) Providing kangaroo care to the infant immediately after birth D.) Feeding unmodified cow's milk to the infant immediately after birth

A

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

A

Which order should the nurse expect for a client admitted with a threatened abortion? A.) Bed rest B.) Administration of ritodrine IV C.) Nothing by mouth (nil per os [NPO]) D.) Narcotic analgesia every 3 hours, as needed

A

Which parental statement would the nurse recognize as indicating a misunderstanding about newborn nutritional needs? A.) "I will give my baby fruit juice after 4 months" B.) "I will give my baby solid foods after 4 months" C.) "I will give my baby vegetables after 6 months" D.) "I will give my infant cereals before 8 months"

A

Which rationale would the nurse recognize for a client of South Asian origin feeding her neonate honey before breastfeeding? A.) The client believes it helps the infant pass meconium B.) The client believes it helps prevent gastrointestinal illness C.) The client believes it helps prevent nausea and vomiting D.) The client believes it helps prevent hemorrhagic problems

A

Which response would the nurse provide a client who asks why there is corn syrup added to infant formulas? A.) "To provide sufficient carbohydrates to the baby" B.) "To provide sufficient vitamins to the baby" C.) "To provide sufficient protein to the baby" D.) "To provide sufficient minerals to the baby"

A

Which sensory system is least mature at the time of birth? A.) Vision B.) Hearing C.) Smell D.) Taste

A

Which statement is the best rationale for recommending formula over breastfeeding? A.) Mother has a medical condition or is taking drugs that could be passed along to the infant via breast milk B.) Mother lacks confidence in her ability to breastfeed C.) Other family members or care providers also need to feed the baby D.) Mother sees bottle feeding as more convenient

A

Which substance, when abused during pregnancy, is the most significant cause of cognitive impairment and dysfunction in the infant? A.) Alcohol B.) Tobacco C.) Marijuana D.) Heroin

A

With regard to hemorrhagic complications that may occur during pregnancy, what information is most accurate? A.) An incompetent cervix is usually not diagnosed until the woman has lost one or two pregnancies B.) Incidences of ectopic pregnancy are declining as a result of improved diagnostic techniques C.) One ectopic pregnancy does not affect a woman's fertility or her likelihood of having a normal pregnancy the next time D.) Gestational trophoblastic neoplasia (GTN) is one of the persistently incurable gynecologic malignancies

A

A number of common drugs of abuse may cross into the breastmilk of a mother who is currently using these substances, which may result in behavioral effects in the newborn. Which substances are contraindicated if the mother elects to breastfeed her infant (select all that apply): A.) Cocaine B.) Marijuana C.) Nicotine D.) Methadone E.) Morphine

A, B, C

The Baby Friendly Hospital Initiative endorsed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) was founded to encourage institutions to offer optimal levels of care for lactating mothers. Which actions are included in the Ten Steps to Successful Breastfeeding for Hospitals (select all that apply): A.) Give newborns no food or drink other than breast milk B.) Have a written breastfeeding policy that is communicated to all staff members C.) Help mothers initiate breastfeeding within hour of childbirth D.) Give artificial teats or pacifiers as necessary E.) Return infants to the nursery at night

A, B, C

Which actions are examples of appropriate techniques to wake a sleepy infant for breastfeeding (select all that apply): A.) Unwrapping the infant B.) Changing the diaper C.) Talking to the infant D.) Slapping the infant's hands and feet D.) Applying a cold towel to the infant's abdomen

A, B, C

Which anticipatory guidance would the nurse provide the parents of a newborn at discharge (select all that apply): A.) Prevent exposure to people with upper respiratory tract infections B.) Keep the infant away from secondhand smoke C.) Avoid loose bedding, waterbeds and beanbag chairs D.) Do not let the infant sleep on his or her back E) Avoid exposure to people with asthma

A, B, C

Which findings would the nurse expect in a neonate within 20 minutes of birth (select all that apply): A.) Tremors B.) Nasal flaring C.) Audible grunting D.) Pinkish skin color E.) Quick respirations

A, B, C

Which nursing information is appropriate to discuss with a client who has received methotrexate therapy (select all that apply): A.) "Avoid vitamins and foods that contain folic acid" B.) "Make sure to close the lid of the toilet and double-flush" C.) "When you resume intercourse, you must use contraception for 3 months" D.) "You will be scheduled for monthly measurements of hCG at 6 to 12 months" E.) "You can resume intercourse when your hCG levels are normal for 3 consecutive weeks"

A, B, C

Which statements regarding physiologic jaundice are accurate (select all that apply): A.) Neonatal jaundice is common; however, kernicterus is rare B.) Appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic process C.) Because jaundice may not appear before discharge, parents need instruction on how to assess for jaundice and when to call for medical help D.) Jaundice is caused by reduced levels of serum bilirubin E.) Breastfed babies have a lower incidence of jaundice

A, B, C

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.) Nonnutritive sucking C.) Skin-to-skin contact with the mother D.) Sucrose E.) Acetaminophen

A, B, C, D

What are the complications and risks associated with cesarean births (select all that apply): A.) Pulmonary edema B.) Wound dehiscence C.) Hemorrhage D.) Urinary tract infections E.) Fetal injuries

A, B, C, D, E

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.) Breast tenderness B.) Warmth in the breast C.) Area of redness on the breast often resembling the shape of a pie wedge D.) Small white blister on the tip of the nipple E.) Fever and flulike symptoms

A, B, C, E

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.) Chemical B.) Mechanical C.) Thermal D.) Psychologic E.) Sensory

A, B, C, E

Which actions would the nurse take when a pregnant client has convulsions (select all that apply): A.) Obtain a prescription for magnesium sulfate B.) Assess the client's airway, breathing and pulse C.) Lower the bed and turn the client onto one side D.) Do not leave the client for more than 10 minutes E.) Raise the side rails of the bed and pads with pillows

A, B, C, E

Which statements describe the first stage of the neonatal transition period (select all that apply): A.) The neonatal transition period lasts no longer than 30 minutes B.) It is marked by spontaneous tremors, crying, and head movements C.) Passage of the meconium occurs during the neonatal transition period D.) This period may involve the infant suddenly and briefly sleeping E.) Audible grunting and nasal flaring may be present during this time

A, B, C, E

Women who are obese are at risk for several complications during pregnancy and birth. Which of these would the nurse anticipate with an obese client (select all that apply): A.) Thromboembolism B.) Cesarean birth C.) Wound infection D.) Breech presentation E.) Hypertension

A, B, C, E

Which hypertensive disorders can occur during pregnancy (select all that apply): A.) Chronic hypertension B.) Preeclampsia-eclampsia C.) Hyperemesis gravidarum D.) Gestational hypertension E.) Gestational trophoblastic disease

A, B, D

Congenital disorders refer to those conditions that are present at birth. These disorders may be inherited and caused by environmental factors or maternal malnutrition. Toxic exposures have the greatest effect on development between 15 and 60 days of gestation. For the nurse to be able to conduct a complete assessment of the newly pregnant client, he or she should be knowledgeable regarding known human teratogens. Which substances might be considered a teratogen (select all that apply): A.) Cytomegalovirus (CMV) B.) Ionizing radiation C.) Hypothermia D.) Carbamazepine E.) Lead

A, B, D, E

The reported incidence of ectopic pregnancy has steadily risen over the past 2 decades. Causes include the increase in sexually transmitted infections (STIs) accompanied by tubal infection and damage. The popularity of contraceptive devices such as the IUD has also increased the risk for ectopic pregnancy. The nurse suspects that a client has early signs of ectopic pregnancy. The nurse should be observing the client for which signs or symptoms (select all that apply): A.) Pelvic pain B.) Abdominal pain C.) Unanticipated heavy bleeding D.) Vaginal spotting or light bleeding E.) Missed period

A, B, D, E

Which statement reflects the benefit of breastfeeding on the family or society at large (select all that apply): A.) Breastfeeding requires fewer supplies and less cumbersome equipment B.) Breastfeeding saves families money C.) Breastfeeding costs employers in terms of time lost from work D.) Breastfeeding benefits the environment E.) Breastfeeding results in reduced annual health care costs

A, B, D, E

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.) An electronic BP device should be used D.) The cuff should cover a minimum of 60% of the upper arm E.) The same arm should be used for every reading

A, B, E

What are the causes of early-onset jaundice (select all that apply): A.) Incompatible fetomaternal blood pump B.) Delay in clamping the umbilical cord C.) Disorders of amino acid metabolism D.) Delay in the elimination of bilirubin E.) Congenital abnormality of red blood cells

A, B, E

Which nursing instruction is appropriate when discussing self-care after a miscarriage (select all that apply): A.) Increase dietary intake of iron B.) Avoid tub baths for 2 weeks C.) Avoid intercourse for 4 weeks D.) Avoid trying to get pregnant until a menstrual cycle has passed E.) Notify the health care provider if vaginal discharge has a foul odor

A, B, E

As recently as 2005, the AAP revised safe sleep practices to assist in the prevention of SIDS. The nurse should model these practices in the hospital and incorporate this information into the teaching plan for new parents. Which practices are ideal for role modeling (select all that apply): A.) Fully supine position for all sleep B.) Side-sleeping position as an acceptable alternative C.) Tummy time for play D.) Infant sleep sacks or buntings E.) Soft mattress

A, C, D

Which technique would the nurse use when assessing the respiratory rate of a newborn 12 hours after birth (select all that apply): A.) Count the rise and fall of the abdomen B.) Count for 6 seconds, and multiply by 10 C.) Observe for symmetry of chest movement D.) Assess the infant's respiratory rate E.) Assess respiration after obtaining the temperature

A, C, D

Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. What are possible causes of early miscarriage, (select all that apply): A.) Chromosomal abnormalities B.) Infections C.) Endocrine imbalance D.) Systemic disorders E.) Varicella

A, C, D, E

Hearing loss is one of the genetic disorders included in the universal screening program. Auditory screening of all newborns within the first month of life is recommended by the AAP. What is the rationale for having this testing performed (select all that apply): A.) Prevents or reduces developmental delays B.) Reassures concerned new parents C.) Provides early identification and treatment D.) Helps the child communicate better E.) Is recommended by the Joint Committee on Infant Hearing

A, C, D, E

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.) Rupture of membranes at or near term B.) Convenience of the woman or her physician C.) Chorioamnionitis (inflammation of the amniotic sac) D.) Postterm pregnancy E.) Fetal death

A, C, D, E

Which statements concerning the benefits or limitations of breastfeeding are accurate (select all that apply): A.) Breast milk changes over time to meet the changing needs as infants grow B.) Breastfeeding increases the risk of childhood obesity C.) Breast milk and breastfeeding may enhance cognitive development D.) Long-term studies have shown that the benefits of breast milk continue after the infant is weaned E.) Benefits to the infant include a reduced incidence of SIDS

A, C, D, E

A client who has undergone a D&C for early pregnancy loss is likely to be discharged the same day. The nurse must ensure that her vital signs are stable, that bleeding has been controlled, and that the woman has adequately recovered from the administration of anesthesia. To promote an optimal recovery, what information should discharge teaching include (select all that apply): A.) Iron supplementation B.) Resumption of intercourse at 6 weeks post-procedure C.) Referral to a support group, if necessary D.) Expectation of heavy bleeding for at least 2 weeks E.) Emphasizing the need for rest

A, C, E

The AAP recommends pasteurized donor milk for preterm infants if the mothers own milk in not available. Which statements regarding donor milk and milk banking are important for the nurse to understand and communicate to her client (select all that apply): A.) All milk bank donors are screened for communicable diseases B.) Internet milk sharing is an acceptable source for donor milk C.) Donor milk may be given to transplant clients D.) Donor milk is used in neonatal intensive care units (NICUs) for severely low-birth-weight infants only E.) Donor milk may be used for children with immunoglobulin A (IgA) deficiencies

A, C, E

Which adverse prenatal outcomes are associated with the HELLP syndrome (select all that apply): A.) Placental abruption B.) Placenta previa C.) Renal failure D.) Cirrhosis E.) Maternal and fetal death

A, C, E

Which assessment findings would lead the nurse to suspect that a newborn has developed jaundice (select all that apply): A.) Reduced frequency of passing stool B.) Reduced visual acuity C.) Decreased milk intake D.) Increased urine output E.) Weight loss greater than 7%

A, C, E

Which measure would the nurse take to protect a newborn from heat loss (select all that apply): A.) Ensure that the infant is dried immediately after birth B.) Place the naked infant on a bare scale for accuracy C.) Place the naked infant on the mother's bare chest and cover him/her with a blanket D.) Ensure that the nursery temperature is 27 C (80.6 F) E.) Wrap the infant and cover the head with a cap

A, C, E

What are the manifestations of HELLP syndrome (select all that apply): A.) Hemolysis B.) Tachycardia C.) Hyperventilation D.) Low platelet count E.) Elevated liver enzymes

A, D, E

Which areas of the neonate are assessed for jaundice (select all that apply): A.) Skin B.) Sclera C.) Nail beds D.) Buccal mucosa E.) Conjunctival sacs

A, D, E

Which recommendations would the nurse make to a mother who reports, "my baby cries incessantly after waking up and does not focus on feeding" (select all that apply): A.) "Allow the baby to suck your finger" B.) "Hold the baby in an upright position" C.) "Gently massage the baby's chest" D.) "Swaddle the baby and talk soothingly" E.) "Place the baby close to the skin"

A, D, E

Which newborn reflex is characterized by abrupt abduction and extension of the arms with the fingers fanned out while the thumb and forefinger form a "C"? A.) Tonic neck reflex B.) Moro reflex C.) Cremasteric reflex D.) Babinski reflex

B

A client with severe gestational hypertension is prescribed hydralazine. Which is the priority nursing intervention in this case? A.) Assess for visual disturbances B.) Assess airway, breathing and pulse C.) Assess blood pressure frequently D.) Prepare the client for nonstress testing

B

A client with severe preeclampsia is receiving a magnesium sulfate infusion. Which assessment finding would be most concerning to the nurse? A.) A sleepy, sedated affect B.) A respiratory rate of 10 breaths/minute C.) Deep tendon reflexes of 2+ D.) Absent ankle clonus

B

Which maternal condition always necessitates delivery by cesarean birth? A.) Marginal placenta previa B.) Complete placenta previa C.) Ectopic pregnancy D.) Eclampsia

B

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.) Amniocentesis for fetal lung maturity B.) Transvaginal ultrasound for placental location C.) Contraction stress test (CST) D.) Internal fetal monitoring

B

A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The fluid consists of bright red blood. Her contractions are consistent with her current stage of labor. No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins to decline rapidly after the ROM. The nurse should suspect the possibility of what condition? A.) Placenta previa B.) Vasa previa C.) Severe abruptio placentae D.) Disseminated intravascular coagulation (DIC)

B

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? A.) Feeding solid foods before your son is 4 to 6 months old may decrease your son's intake of sufficient calories B.) Feeding solid foods between breastfeeding sessions before your son is 4 to 6 months old will lead to an early cessation of breastfeeding C.) Your feeding plan will help your son sleep through the night D.) Feeding solid foods before your son is 4 to 6 months old will limit his growth

B

A new father wants to know what medication was put into his infants 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 and chlamydial infection of the infants eyes, potentially acquired from the birth canal C.) Erythromycin (Ilotycin) prevents potentially harmful exudate from invading the tear ducts of the infant's eyes, leading to dry eyes D.) This ointment prevents the infants eyelids from sticking together and helps the infant see

B

A new mother recalls from prenatal class that she should try to feed her newborn daughter when she exhibits feeding readiness cues rather than waiting until the baby is frantically crying. Which feeding cue would indicate that the baby is ready to eat? A.) Waves her arms in the air B.) Makes sucking motions C.) Has the hiccups D.) Stretches out her legs straight

B

A number of methods can be used for inducing labor. Which cervical ripening method falls under the category of mechanical or physical? A.) Prostaglandins are used to soften and thin the cervix B.) Labor can sometimes be induced with balloon catheters or laminaria tents C.) Oxytocin is less expensive and more effective than prostaglandins but creates greater health risks D.) Amniotomy can be used to make the cervix more favorable for labor

B

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.) 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 B.) 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 C.) 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 D.) Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar pregnancy

B

A pregnant client is on tocolytic therapy with magnesium sulfate. Under which client circumstance would the nurse suggest discontinuing the therapy? A.) Blood pressure is 120/80 mmHg B.) Respiratory rate is 10 breaths/minutes C.) Urine output is 40 mL/hour D.) Serum magnesium level is 5 mEq/L

B

A pregnant woman at 29 weeks of gestation has been diagnosed with preterm labor. Her labor is being controlled with tocolytic medications. She asks when she might be able to go home. Which response by the nurse is most accurate? A.) After the baby is born B.) When we can stabilize your preterm labor and arrange home health visits C.) Whenever your physician says that it is okay D.) It depends on what kind of insurance coverage you have

B

A pregnant woman is being discharged from the hospital after the placement of a cervical cerclage because of a history of recurrent pregnancy loss, secondary to an incompetent cervix. Which information regarding postprocedural care should the nurse emphasize in the discharge teaching? A.) Any vaginal discharge should be immediately reported to her health care provider B.) The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure should be reported C.) The client will need to make arrangements for care at home, because her activity level will be restricted D.) The client will be scheduled for a cesarean birth

B

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 will only wake up to be fed, and you should not bother him between feedings B.) The newborn sleeps approximately 17 hours a day, with periods of wakefulness gradually increasing C.) He will probably follow your same sleep and wake patterns, and you can expect him to be awake soon D.) 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

A woman gave birth to a healthy 7-pound, 13-ounce infant girl. The nurse suggests that the client place the infant to her breast within 15 minutes after birth. The nurse is aware that the initiation of breastfeeding is most effective during the first 30 minutes after birth. What is the correct term for this phase of alertness? A.) Transition period B.) First period of reactivity C.) Organizational stage D.) Second period of reactivity

B

A woman with severe preeclampsia is being treated with an intravenous infusion of magnesium sulfate. When is this treatment considered successful? A.) If blood pressure is reduced to pre-pregnant baseline B.) If seizures do not occur C.) If deep tendon reflexes become hypotonic D.) If diuresis reduces fluid retention

B

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? A.) 4 B.) 5 C.) 6 D.) 7

B

In contrast to placenta previa, what is the most prevalent clinical manifestation of abruptio placentae? A.) Bleeding B.) Intense abdominal pain C.) Uterine activity D.) Cramping

B

The breastfeeding mother should be taught a safe method to remove the breast from the baby's mouth. Which suggestion by the nurse is most appropriate? A.) Slowly remove the breast from the baby's mouth when the infant has fallen asleep and the jaws are relaxed B.) Break the suction by inserting your finger into the corner of the infant's mouth C.) A popping sound occurs when the breast is correctly removed from the infants mouth D.) Elicit the Moro reflex to wake the baby and remove the breast when the baby cries

B

The client being cared for has severe preeclampsia and is receiving a magnesium sulfate infusion. Which new finding would give the nurse cause for concern? A.) Sleepy, sedated affect B.) Respiratory rate of 10 breaths per minute C.) DTRs of 2 D.) Absent ankle clonus

B

The condition during which infants are at an increased risk for subgaleal hemorrhage is called what? A.) Infection B.) Jaundice C.) Caput succedaneum D.) Erythema toxicum neonatorum

B

The nurse finds diuresis, weight loss, and muscle atrophy in a pregnant client with mild preeclampsia. Which client condition would the nurse conclude from these findings? A.) The client was mostly on a liquid diet B.) The client was on prolonged bed rest C.) The client has developed HELLP syndrome D.) The client is at risk for placental abruption

B

The nurse is caring for a client whose labor is being augmented with oxytocin. The nurse knows that oxytocin would be discontinued immediately if there is evidence of which conditions? A.) Uterine contractions occurring every 8 to 10 minutes B.) A fetal heart rate of 180 with absence of variability C.) The client needing to void D.) Rupture of the amniotic membranes

B

The nurse is circulating during a cesarean birth of a preterm infant. The obstetrician requests that cord clamping be delayed. What is the rationale for this directive? A.) To reduce the risk for jaundice B.) To reduce the risk of intraventricular hemorrhage C.) To decrease total blood volume D.) To improve the ability to fight infection

B

The nurse is completing a physical examination of the newborn 24 hours after birth. Which component of the evaluation is correct? A.) The parents are excused to reduce their normal anxiety B.) The nurse can gauge the neonates maturity level by assessing his or her general appearance C.) Once often neglected, blood pressure is now routinely checked D.) When the nurse listens to the neonates heart, the S1 and S2 sounds can be heard; the S1 sound is somewhat higher in pitch and sharper than the S2 sound

B

The nurse is explaining the benefits associated with breastfeeding to a new mother. Which statement by the nurse would provide conflicting information to the client? A.) Women who breastfeed have a decreased risk of breast cancer B.) Breastfeeding is an effective method of birth control C.) Breastfeeding increases bone density D.) Breastfeeding may enhance postpartum weight loss

B

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

B

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.) Terms preterm birth and low birth weight can be used interchangeably B.) Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation C.) Low birth weight is a newborn who weighs below 3.7 pounds D.) Preterm birth rate in the United States continues to increase

B

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.) Infants can track their parents eyes and can distinguish patterns; they prefer complex patterns C.) The infant's eyes must be protected. Infants enjoy looking at brightly colored stripes D.) It's important to shield the newborns eyes. Overhead lights help them see better

B

The process during which bilirubin is changed from a fat-soluble product to a water-soluble product is known as what? A.) Enterohepatic circuit B.) Conjugation of bilirubin C.) Unconjugated bilirubin D.) Albumin binding

B

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

B

What is a maternal indication for the use of vacuum-assisted birth? A.) Wide pelvic outlet B.) Maternal exhaustion C.) History of rapid deliveries D.) Failure to progress past station 0

B

What is the basic mechanism for conserving internal heat in infants? A.) Shivering B.) Vasoconstriction C.) Metabolism of brown fat D.) Decrease in muscle activity

B

What is the correct terminology for an abortion in which the fetus dies but is retained within the uterus? A.) Inevitable abortion B.) Missed abortion C.) Incomplete abortion D.) Threatened abortion

B

What is the nurse's initial action while caring for an infant with a slightly decreased temperature? A.) Immediately notify the physician B.) Place a cap on the infant's head, and have the mother perform kangaroo care C.) Tell the mother that the infant must be kept in the nursery and observed for the next 4 hours D.) Change the formula; a decreased body temperature is a sign of formula intolerance

B

What is the rationale for evaluating the plantar crease within a few hours of birth? A.) Newborn has to be footprinted B.) As the skin dries, the creases will become more prominent C.) Heel sticks may be required D.) Creases will be less prominent after 24 hours

B

Which method would the nurse use to assess the temperature of a neonate 12 hours after birth? A.) Rectal route B.) Axillary route C.) Temporal artery D.) Tympanic route

B

When performing a pulse oximetry to assess a newborn for congenital heart defects, which factor would the nurse bear in mind? A.) The screening test is performed after 48 hours of age B.) The test is performed in the newborn's right hand on and on one foot C.) The infant has passed if oxygen saturation is greater than 80% D.) The infant is evaluated in case of a 10% difference in the extremities

B

Which action should the nurse take when measuring the blood pressure of a neonate? A.) Use an oscillometric device to measure blood pressure when the neonate is awake B.) Ensure that the cuff covers 75% of the distance between the axilla and the elbow C.) Report a drop in systolic blood pressure of about 15 mmHg in the first hour of life D.) Report if the systolic pressure is the same in the upper and lower extremities

B

Which action would the nurse take after finding unequal movement and uneven gluteal skinfolds during the Ortolani maneuver? A.) Tell the parents that one leg may be longer than the other, but they will equal out by the time the infant is walking B.) Alert the provider that the infant may have a dislocated hip C.) Inform the parents and provider that molding has not taken place D.) Suggest that if the condition does not change, surgery to correct vision problems might be needed

B

Which action would the nurse take after noting that an infant's heart rate is 80 beats/min while sleeping? A.) Immediately wake the infant B.) Reass the heart rate after 30 minutes C.) Advise the mother to stop breastfeeding D.) Inform the parents that the infant has bradycardia

B

Which action would the nurse take when administering erythromycin ophthalmic ointment to a newborn? A.) Instill within 15 minutes of birth for maximum effectiveness B.) Cleanse eyes from the inner to outer canthus before administration if necessary C.) Apply the ointment directly over the cornea D.) Flush the eyes 10 minutes after instillation to reduce irritation

B

Which action would the nurse take while performing a heelstick for an infant? A.) Puncture the inner aspect of the heel B.) Warm the heel before obtaining the sample C.) Ensure the puncture is no deeper than 1 mm D.) Apply pressure for a minute after the procedure

B

Which cardiovascular changes cause the foramen ovale to close at birth? A.) Increased pressure in the right atrium B.) Increased pressure in the left atrium C.) Decreased blood flow to the left ventricle D.) Changes in the hepatic blood flow

B

Which complication is associated with high bilirubin levels in the newborn? A.) Syndactyly B.) Kernicterus C.) Rectal fistula D.) Down syndrome

B

Which complication may be prevented if clients use skin-to-skin contact with their newborn infant? A.) Jaundice B.) Hypothermia C.) Galactosemia D.) Dehydration

B

Which complication would the nurse anticipate in an infant experiencing cold stress? A.) Hyperglycemia B.) Hyerbilirubinemia C.) Respiratory alkalosis D.) Decreased metabolic rate

B

Which drug is used for treating a client with severe postpartum bleeding? A.) Nifedipine B.) Oxytocin C.) Propranolol D.) Metronidazole

B

Which education would the nurse provide the parents of a neonate about how to use a bulb syringe? A.) Ensure that the bulb syringe is kept near (but not in) the crib B.) Insert the tip of the bulb into the side of the mouth first C.) Insert the tip of the bulb into the mouth and then compress D.) Perform suction first in each nostril and then the mouth

B

Which finding in a urine specimen of a pregnant client indicates that the client has proteinuria? A.) Value greater than or equal to 0.5+ protein in a dipstick testing B.) Value greater than 300 mg/24 hours C.) Concentration greater than or equal to 1 g protein in a 24-hour urine collection D.) Concentration at 10 mg/dL in random urine specimen

B

Which information about variations in the infants blood counts is important for the nurse to explain to the new parents? A.) A somewhat lower-than-expected red blood cell count could be the result of a delay in clamping the umbilical cord B.) An early high white blood cell (WBC) count is normal at birth and should rapidly decrease C.) Platelet counts are higher in the newborn than in adults for the first few months D.) Even a modest vitamin K deficiency means a problem with the blood's ability to properly clot

B

Which information would the nurse include when planning for an expected cesarean delivery for a client who has had a previous cesarean delivery and has a fetus in the transverse presentation? A.) "Because this is a repeat procedure, you are at the lowest risk for complications" B.) "Even though this is your second cesarean delivery, you may wish to review the preoperative and postoperative procedures" C.) "Because this is your second cesarean delivery, you will recover faster" D.) "You will not need preoperative teaching because this is your second cesarean delivery"

B

Which instruction should the nurse provide to reduce the risk of nipple trauma? A.) Limit the feeding time to less than 5 minutes B.) Position the infant so the nipple is far back in the mouth C.) Assess the nipples before each feeding D.) Wash the nipples daily with mild soap and water

B

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

B

Which intervention would the nurse perform while using a fiberoptic blanket and phototherapy light for a newborn with jaundice? A.) Provide intermittent feedings of glucose water B.) Cover the newborn's eyes with an opaque mask C.) Place the fully unclothed newborn under the light D.) Wrap the naked newborn with a fiberoptic blanket

B

Which is the priority nursing action after administering magnesium sulfate to a pregnant client? A.) Assess the client's weight B.) Assess the serum magnesium level C.) Restrict fluid intake to 250 mL/hour D.) Evaluate fetal movement counts hourly

B

Which laboratory marker is indicative of DIC? A.) Bleeding time of 10 minutes B.) Presence of fibrin split products C.) Thrombocytopenia D.) Hypofibrinogenemia

B

Which nursing information is appropriate to include in an explanation to the parents regarding their 24-hour-old newborn who did not pass his initial hearing screening? A.) A consult with an audiologist will be obtained B.) The screening will be repeated before discharge C.) The screening will be repeated at 2 months of age D.) The screening will be repeated in the health care provider's office on the first visit

B

Which nursing information is appropriate to include when discussing the storage of breast milk with a client? A.) Store thawed milk for 48 hours B.) Discard unused milk after a feeding within 2 hours C.) Place the containers of stored milk in the door of the freezer D.) Sterilize the containers for milk storage in boiling water

B

Which nursing intervention is paramount when providing care to a client with preterm labor who has received terbutaline? A.) Assess deep tendon reflexes (DTRs) B.) Assess for dyspnea and crackles C.) Assess for bradycardia D.) Assess for hypoglycemia

B

Which statement best describes the transition period between intrauterine and extrauterine existence for the newborn? A.) Consists of four phases, two reactive and two of decreased responses B.) Lasts from birth to day 28 of life C.) Applies to full-term births only D.) Varies by socioeconomic status and the mothers age

B

Which statement is accurate regarding preeclampsia and eclampsia? A.) Preeclampsia is a condition of the first trimester; eclampsia is a condition of the second and third trimesters B.) Preeclampsia results in decreased function in such organs as the placenta, kidneys, liver and brain C.) The causes of preeclampsia and eclampsia are well documented D.) Severe preeclampsia is defined as preeclampsia plus proteinuria

B

Which statement regarding the structure and function of the placenta is correct? A.) Produces nutrients for fetal nutrition B.) Secretes both estrogen and progesterone C.) Forms a protective, impenetrable barrier to microorganisms such as bacteria and viruses D.) Excretes prolactin and insulin

B

While assessing an infant, the nurse notes respiratory distress and a murmur. Which recommendation would the nurse make to the parents about infant care? A.) "Switch to exclusive formula feedings" B.) "Additional cardiac evaluation is necessary" C.) "The infant should be wrapped in a thick blanket" D.) "Maintain skin-to-skin contact with the mother"

B

While assisting the primary health care provider performing an amniotomy, the nurse observes part of the umbilical cord protruding from the client's vagina. The nurse immediately positions the client in the Trendelenburg position and inserts a finger into the client's vagina. Which additional care intervention would the client need to prevent complications? A.) Perform large-bore catheter suction B.) Prepare for an emergency cesarean delivery C.) Administer calcium gluconate intravenously D.) Administer terbutaline subcutaneously

B

What are the various modes of heat loss in the newborn (select all that apply): A.) Perspiration B.) Convection C.) Radiation D.) Conduction E.) Urination

B, C, D

Which recommendations would the nurse provide a postpartum client who intends to breastfeed but is very concerned about returning to her pre-pregnancy weight (select all that apply): A.) "Consider joining Weight Watchers as soon as possible to ensure adequate weight loss" B.) "Even though more calories are needed for lactation, typically women who breastfeed lose weight more rapidly than women who bottle feed in the postpartum period" C.) "Weight-loss diets are not recommended for women who breastfeed" D.) "If breastfeeding, carefully regulate fluid consumption in response to your thirst level" E.) "If you decrease calorie intake by 100 to 200 calories a day, you will lose weight more quickly"

B, C, D

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.) Lengthy interpregnancy interval B.) African-American race C.) Delivery at a rural hospital D.) Estimated fetal weight <4000 g E.) Maternal obesity (BMI >30)

B, C, E

Which early feeding-readiness cues are exhibited for a breastfed newborn (select all that apply): A.) Crying B.) Rooting reflex C.) Suckling motions D.) Withdrawing into sleep E.) Hand-to-mouth movements

B, C, E

Which interventions would the nurse include in the plan of care for a pregnant client with mild preeclampsia (select all that apply): A.) Ensure prolonged bed rest B.) Provide diversionary activities C.) Encourage intake of adequate fluids D.) Restrict sodium and zinc in the diet E.) Refer to the client to an Internet-based support group

B, C, E

Which signs and symptoms would the nurse find in assessing the client with abruption placentae (select all that apply): A.) Hypoglycemia B.) Abdominal pain C.) Vaginal bleeding D.) Delayed menses E.) Uterine tenderness

B, C, E

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions. What clinical cues alert the nurse that the woman is experiencing uterine hyperstimulation (select all that apply): A.) Uterine contractions lasting <90 seconds and occurring >2 minutes in frequency B.) Uterine contractions lasting >90 seconds and occurring <2 minutes in frequency C.) Uterine tone <20 mm Hg D.) Uterine tone >20 mm Hg E.) Increased uterine activity accompanied by a nonreassuring FHR and pattern

B, D, E

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

C

A client reports mild vaginal bleeding, pain and cramping in her lower abdomen at 6 weeks of gestation. On performing a pelvic examination, the nurse finds that the client's cervical os is closed. What is the priority nursing intervention in this case? A.) Administer intravenous fluids to the client B.) Administer carboprost tromethamine to the client C.) Determine the client's human chorionic gonadotropin and progesterone levels D.) Prompt termination of pregnancy in the client by the dilation and curettage method

C

A first-time dad is concerned that his 3-day-old daughter's skin looks yellow. In the nurses explanation of physiologic jaundice, what fact should be included? A.) Physiologic jaundice occurs during the first 24 hours of life B.) 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 D.) Physiologic jaundice is also known as breast milk jaundice

C

A mother expresses fear about changing her infants diaper after he is circumcised. What does the client need to be taught to care for her newborn son? A.) Cleanse the penis with prepackaged diaper wipes every 3 to 4 hours B.) Apply constant, firm pressure by squeezing the penis with the fingers for at least 5 minutes if bleeding occurs C.) Gently cleanse the penis with water and apply petroleum jelly around the glans after each diaper change D.) Wash off the yellow exudate that forms on the glans at least once every day to prevent infection

C

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

C

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 oil-based lotion to the newborns skin to prevent dying and cracking B.) Limiting the newborns intake of milk to prevent nausea, vomiting, and diarrhea C.) Placing eye shields over the newborns closed eyes D.) Changing the newborns position every 4 hours

C

A newborn is placed under a radiant heat warmer. The nurse understands that thermoregulation presents a problem for the newborn. What is the rationale for this difficulty? A.) The renal function of a newborn is not fully developed, and heat is lost in the urine B.) The small body surface area of a newborn favors more rapid heat loss than does an adults body surface area C.) Newborns have a relatively thin layer of subcutaneous fat that provides poor insulation D.) Their normal flexed posture favors heat loss through perspiration

C

A nurse is assessing a newborn girl who is 2 hours old. Which finding warrants a call to the health care provider? A.) Blood glucose of 45 mg/dl using a Dextrostix screening method B.) Heart rate of 160 beats per minute after vigorously crying C.) Laceration of the cheek D.) Passage of a dark black-green substance from the rectum

C

A nurse providing care to a client in labor would be aware of which fact about cesarean delivery? A.) It is declining in frequency in the United States B.) It is more likely to be done for the poor in public hospitals who do not get the nurse counseling that wealthier clients do C.) It is performed primarily for the health of the mother and fetus D.) It can be either elected or refused by clients as their absolute legal right

C

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 nurses immediate action? A.) To call for an immediate magnesium sulfate level B.) To administer oxygen C.) To discontinue the magnesium sulfate infusion D.) To prepare to administer hydralazine

C

A primigravida at 40 weeks of gestation is having uterine contractions every 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 exhibiting hypotonic uterine dysfunction B.) She is experiencing a normal latent stage C.) She is exhibiting hypertonic uterine dysfunction D.) She is experiencing precipitous labor

C

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

C

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.) Dipstick value of 3+ for protein in her urine D.) Pitting pedal edema at the end of the day

C

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.) Incomplete B.) Inevitable C.) Threatened D.) Septic

C

A woman arrives for evaluation of signs and symptoms that include a missed period, adnexal fullness, tenderness, and dark red vaginal bleeding. On examination, the nurse notices an ecchymotic blueness around the womans umbilicus. What does this finding indicate? A.) Normal integumentary changes associated with pregnancy B.) Turner sign associated with appendicitis C.) Cullen sign associated with a ruptured ectopic pregnancy D.) Chadwick sign associated with early pregnancy

C

A woman is having her first child. She has been in labor for 15 hours. A vaginal examination performed 2 hours earlier revealed the cervix to be dilated to 5 cm and 100% effaced, and the presenting part of the fetus was at station 0; however, another vaginal examination performed 5 minutes ago indicated no changes. What abnormal labor pattern is associated with this description? A.) Prolonged latent phase B.) Protracted active phase C.) Secondary arrest D.) Protracted descent

C

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.) Placenta previa B.) Abruptio placentae C.) Spontaneous abortion D.) Cord insertion

C

A woman with worsening preeclampsia is admitted to the hospitals 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 help my wife use the breathing techniques that we learned in our childbirth classes B.) I will give my wife ice chips to eat during labor C.) 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.) I will stay with my wife during her labor, just as we planned

C

According to demographic research, which woman is least likely to breastfeed and therefore most likely to need education regarding the benefits and proper techniques of breastfeeding? A.) Between 30 and 35 years of age, Caucasian, and employed part time outside the home B.) Younger than 25 years of age, Hispanic, and unemployed C.) Younger than 25 years of age, African-American, and employed full time outside the home D.) 35 years of age or older, Caucasian, and employed full time at home

C

An infant boy was delivered minutes ago. The nurse is conducting the initial assessment. Part of the assessment includes the Apgar score. When should the Apgar assessment be performed? A.) Only if the newborn is in obvious distress B.) Once by the obstetrician, just after the birth C.) At least twice, 1 minute and 5 minutes after birth D.) Every 15 minutes during the newborn's first hour after birth

C

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.) Birth injury B.) Hypocalcemia C.) Hypoglycemia D.) Seizures

C

As the nurse assists a new mother with breastfeeding, the client asks, If formula is prepared to meet the nutritional needs of the newborn, what is in breast milk that makes it better? What is the nurse's best response? A.) More calories B.) Essential amino acids C.) Important immunoglobulins D.) More calcium

C

At a 2-month well-baby examination, it was discovered that an exclusively breastfed infant had only gained 10 ounces in the past 4 weeks. The mother and the nurse develop a feeding plan for the infant to increase his weight gain. Which change in dietary management will assist the client in meeting this goal? A.) Begin solid foods B.) Have a bottle of formula after every feeding C.) Have one extra breastfeeding session every 24 hours D.) Start iron supplements

C

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

C

For which reason is vitamin K administered to newborns? A.) Reduces bilirubin levels B.) Increases the production of red blood cells C.) Enhances the ability of blood to clot D.) Stimulates the formation of surfactant

C

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

C

How would the nurse differentiate a meconium stool from a transitional stool in the healthy newborn? A.) Observed at age 3 days B.) Is residue of a milk curd C.) Passes in the first 12 hours of life D.) Is lighter in color and looser in consistency

C

If the newborn has excess secretions, the mouth and nasal passages can be easily cleared with a bulb syringe. How should the nurse instruct the parents on the use of this instrument? A.) Avoid suctioning the nares B.) Insert the compressed bulb into the center of the mouth C.) Suction the mouth first D.) Remove the bulb syringe from the crib when finished

C

In assisting the breastfeeding mother to position the baby, which information regarding positioning is important for the nurse to keep in mind? A>) The cradle position is usually preferred by mothers who had a cesarean birth B.) Women with perineal pain and swelling prefer the modified cradle position C.) Whatever the position used, the infant is belly to belly with the mother D.) While supporting the head, the mother should push gently on the occiput

C

In most healthy newborns, blood glucose levels stabilize at ______ mg/dL during the first hours after birth: A.) 30 to 40 B.) 40 to 50 C.) 50 to 60 D.) 60 to 70

C

In planning for home care of a woman with preterm labor, which concern should the nurse need to address? A.) Nursing assessments are different from those performed in the hospital setting B.) Restricted activity and medications are necessary to prevent a recurrence of preterm labor C.) Prolonged bed rest may cause negative physiologic effects D.) Home health care providers are necessary

C

In which range would the nurse expect the blood glucose to be in a healthy newborn during the first hours after birth? A.) 80 to 100 mg/dL B.) Less than 40 mg/dL C.) 50 to 60 mg/dL D.) 60 to 70 mg/dL

C

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.) Herpes simplex virus (HSV) infection C.) Congenital syphilis D.) HIV

C

On assessment of a pregnant client, the nurse concludes that the client is less likely to have a preterm delivery. Which client clinical finding led the nurse to conclude this? A.) Previous cesarean delivery B.) Preexisting diabetes mellitus C.) Cervical length more than 30 mm D.) Symptoms of chronic hypertension

C

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation. What is the primary purpose of prostaglandin administration? A.) To enhance uteroplacental perfusion in an aging placenta B.) To increase amniotic fluid volume C.) To ripen the cervix in preparation for labor induction D.)To stimulate the amniotic membranes to rupture

C

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.) Pharmacologic treatment B.) Reduction of environmental stimuli C.) Neonatal abstinence syndrome (NAS) scoring D.) Adequate nutrition and maintenance of fluid and electrolyte balance

C

The American College of Obstetricians and Gynecologists (ACOG) has developed a comprehensive list of risk factors associated with the development of preeclampsia. Which client exhibits the greatest number of these risk factors? A.) 30-year-old obese Caucasian with her third pregnancy B.) 41-year-old Caucasian primigravida C.) 19-year-old African American who is pregnant with twins D.) 25-year-old Asian American whose pregnancy is the result of donor insemination

C

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the womans 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.) Eclampsia B.) Disseminated intravascular coagulation (DIC) syndrome C.) Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome D.) Idiopathic thrombocytopenia

C

The management of the pregnant client who has experienced a pregnancy loss depends on the type of miscarriage and the signs and symptoms. While planning care for a client who desires outpatient management after a first-trimester loss, what would the nurse expect the plan to include? A.) Dilation and curettage (D&C) B.) Dilation and evacuation (D&E) C.) Misoprostol D.) Ergot products

C

The measurement of lecithin in relation to sphingomyelin (lecithin/sphingomyelin [L/S] ratio) is used to determine fetal lung maturity. Which ratio reflects fetal maturity of the lungs? A.) 1.4:1 B.) 1.8:1 C.) 2:1 D.) 1:1

C

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

C

The nurse is cognizant of which information related to the administration of vitamin K? A.) Vitamin K is important in the production of red blood cells B.) Vitamin K is necessary in the production of platelets C.) Vitamin K is not initially synthesized because of a sterile bowel at birth D.) Vitamin K is responsible for the breakdown of bilirubin and the prevention of jaundice

C

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.) Intracranial hemorrhage (ICH) as a result of birth trauma is more likely to occur in the preterm, low-birth-weight infant B.) Subarachnoid hemorrhage (the most common form of ICH) occurs in term infants as a result of hypoxia C.) In many infants, signs of hemorrhage in a full-term infant are absent and diagnosed only through laboratory tests D.) Spinal cord injuries almost always result from vacuum-assisted deliveries

C

The nurse is monitoring a nurse's deep tendon reflexes (DTRs) while receiving magnesium sulfate therapy for treatment of preeclampsia. Which assessment finding would indicate a cause for concern? A.) Bilateral DTRs noted at 2+ B.) DTR response noted at 1+ since onset of therapy C.) Positive clonus response elicited unilaterally D.) Client reports no pain on examination of DTRs by nurse

C

The nurse is performing a gestational age and physical assessment on the newborn. The infant appears to have an excessive amount of saliva. This clinical finding may be indicative of what? A.) Excessive saliva is a normal finding in the newborn B.) Excessive saliva in a neonate indicates that the infant is hungry C.) It may indicate that the infant has a tracheoesophageal fistula or esophageal atresia D.) Excessive saliva may indicate that the infant has a diaphragmatic hernia

C

The nurse is preparing to administer methotrexate to the client. This hazardous drug is most often used for which obstetric complication? A.) Complete hydatidiform mole B.) Missed abortion C.) Unruptured ectopic pregnancy D.) Abruptio placentae

C

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.) Report a temperature higher than 40 C B.) Tampons are safe to use to absorb the leaking amniotic fluid C.) Do not engage in sexual activity D.) Taking frequent tub baths is safe

C

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.) Federal law prohibits newborn genetic testing without parental consent C.) If genetic screening is performed before the infant is 24 hours old, then it should be repeated at age 1 to 2 weeks D.) Hearing screening is now mandated by federal law

C

What condition indicates concealed hemorrhage when the client experiences abruptio placentae? A.) Decrease in abdominal pain B.) Bradycardia C.) Hard, boardlike abdomen D.) Decrease in fundal height

C

What is tandem feeding? A.) Adequate nutritional stores for the mother and infant B.) Using both breasts to nurse the baby C.) Breastfeeding an infant and an older sibling during the same period of time D.) Supplementing breastfeeding with bottle feeding to maintain adequate weight gain

C

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

C

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

C

What is the primary rationale for nurses wearing gloves when handling the newborn? A.) To protect the baby from infection B.) As part of the Apgar protocol C.) To protect the nurse from contamination by the newborn D.) Because the nurse has the primary responsibility for the baby during the first 2 hours

C

What is the rationale for the administration of vitamin K to the healthy full-term newborn? A.) Most mothers have a diet deficient in vitamin K, which results in the infant being deficient B.) Vitamin K prevents the synthesis of prothrombin in the liver and must be administered by injection C.) Bacteria that synthesize vitamin K are not present in the newborns intestinal tract D.) The supply of vitamin K in the healthy full-term newborn is inadequate for at least 3 to 4 months and must be supplemented

C

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

C

Which action by the mother will initiate the milk ejection reflex (MER)? A.) Wearing a firm-fitting bra B.) Drinking plenty of fluids C.) Placing the infant to the breast D.) Applying cool packs to her breast

C

Which anticipatory guidance would the nurse provide the parents of a newborn? A.) Place the newborn on the abdomen (prone) after feeding and for sleep B.) Avoid the use of pacifiers C.) Use a rear-facing car seat D.) Use a crib with side-rail slats that are no more than 3 inches apart

C

Which assessment finding would the nurse recognize as indicating a problem with latching? A.) The infant's cheeks are rounded while sucking B.) The infant's jaw glides smoothly while sucking C.) The mother reports pain in her nipples while breastfeeding D.) The mother reports that the infant swallows audibly

C

Which clinical finding would the nurse attribute to a forceps-assisted birth? A.) Erythematous skin B.) Blotchy or mottled skin C.) Edema and ecchymosis D.) Cyanotic discoloration

C

Which clinical finding would the nurse expect when examining a 36-week-old newborn male infant immediately after birth? A.) Rugae covering the scrotal sack B.) Desquamation of the epidermis C.) Vernix caseosa covering the body D.) Erythema toxicum

C

Which condition is associated with a high risk for disseminated intravascular coagulation (DIC)? A.) Eclampsia B.) Placenta previa C.) Placental abruption D.) Gestational hypertension

C

Which condition is characterized by implantation of fertilized ovum outside the uterine cavity? A.) Placenta previa B.) Molar pregnancy C.) Ectopic pregnancy D.) Cervical insufficiency

C

Which condition would the nurse suspect when observing mouth breathing in a 4-week infant? A.) Hypoxemia B.) Cardiac disorder C.) Nasal obstruction D.) Laryngeal obstruction

C

Which conditions are infants of diabetic mothers (IDMs) at a higher risk for developing? A.) Iron deficiency anemia B.) Hyponatremia C.) Respiratory distress syndrome D.) Sepsis

C

Which dietary practice would the nurse expect a Hmong client to follow to enhance milk production? A.) Avoid eating rice B.) Drink seaweed soup C.) Eat boiled chicken D.) Avoid eating hot food

C

Which finding on a prenatal visit at 10 weeks of gestation might suggest a hydatidiform mole? A.) Complaint of frequent mild nausea B.) Blood pressure of 120/80 mm Hg C.) Fundal height measurement of 18 cm D.) History of bright red spotting for 1 day, weeks ago

C

Which information related to the newborns developing cardiovascular system should the nurse fully comprehend? A.) The heart rate of a crying infant may rise to 120 beats per minute B.) Heart murmurs heard after the first few hours are a cause for concern C.) The point of maximal impulse (PMI) is often visible on the chest wall D.) Persistent bradycardia may indicate respiratory distress syndrome (RDS)

C

Which information should the nurse provide to a breastfeeding mother regarding optimal self-care? A.) She will need an extra 1000 calories a day to maintain energy and produce milk B.) She can return to prepregnancy consumption patterns of any drinks as long as she gets enough calcium C.) She should avoid trying to lose large amounts of weight D.) She must avoid exercising because it is too fatiguing

C

Which instruction would the nurse provide to a pregnant client with mild preeclampsia? A.) "You need to be hospitalized for fetal evaluation" B.) "Nonstress testing can be done once every month" C.) "Fetal movement counts need to be evaluated daily" D.) "Take complete bed rest during the entire pregnancy"

C

Which intervention helps prevent infection in the newborn? A.) Begin iron supplementation B.) Check the infant's birth weight C.) Encourage the mother to breastfeed the infant D.) Administer a vitamin K injection

C

Which nursing information is appropriate to include when teaching the parents of a breastfed 3-day-old newborn? A.) "You should wake your baby every 3 hours to feed" B.) "It is important to keep your baby on a feeding schedule" C.) "I recommend that you follow a feeding pattern that is cue-based" D.) "You can expect the infant to feed for about a 20-minute period"

C

Which provider prescription would the nurse expect for a 5-day-old newborn with hypoglycemia and delayed meconium passage? A.) Exclusively breastfeed the newborn B.) Start formula feeding the newborn C.) Give the newborn expressed breast milk D.) Heat the breast milk in a microwave before feeding

C

Which statement accurately describes an appropriate-for-gestational age (AGA) weight assessment? A.) AGA weight assessment falls between the 25th and 75th percentiles for the infants age B.) AGA weight assessment depends on the infants length and the size of the newborn's head C.) AGA weight assessment falls between the 10th and 90th percentiles for the infants age D.) AGA weight assessment is modified to consider intrauterine growth restriction (IUGR)

C

Which statement by the client would indicate effective learning about use of a bulb syringe when caring for her newborn? A.) "It is used to prevent defecation from the anal opening" B.) "It is used to reduce the temperature during hypothermia" C.) "It is used to clear mucous and prevent airway obstruction" D.) "It is used to avoid heat loss caused by evaporation and convection"

C

Which statement most accurately describes the HELLP syndrome? A.) Mild form of preeclampsia B.) Diagnosed by a nurse alert to its symptoms C.) Characterized by hemolysis, elevated liver enzymes, and low platelets D.) Associated with preterm labor but not perinatal mortality

C

Which statement regarding the nutrient needs of breastfed infants is correct? A.) Breastfed infants need extra water in hot climates B.) During the first 3 months, breastfed infants consume more energy than formula-fed infants C.) Breastfeeding infants should receive oral vitamin D drops daily during at least the first 2 months D.) Vitamin K injections at birth are not necessary for breastfed infants

C

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

C

Which technique would the nurse use to assess the plantar reflex of an infant? A.) Touch the corner of the infant's mouth with a finger B.) Tap over the bridge of the infant's nose when awake C.) Place a finger at the base of the infant's toes D.) Place a finger in the palm of the infant's hand

C

Which technique would the nurse use to measure a newborn's physical growth? A.) Place and hold the naked newborn on the scale to obtain weight B.) Allow the caregiver to hold the infant while measuring his or her length C.) Measure the circumference of the head just above the eyebrows D.) Check the plantar reflex by placing a finger in the newborn's palm

C

Which test is used to determine the presence of fetal-to-maternal bleeding in a pregnant client? A.) D-dimer test B.) Nonstress test (NST) C.) Kleihauer-Betke (KB) test D.) Biophysical profile (BPP)

C

Which type of formula is not diluted with water, before being administered to an infant? A.) Powdered B.) Concentrated C.) Ready-to-use D.) Modified cows milk

C

While assessing the integument of a 24-hour-old newborn, the nurse notes a pink papular rash with vesicles superimposed on the thorax, back, and abdomen. What action is the highest priority for the nurse to take at this time? A.) Immediately notify the physician B.) Move the newborn to an isolation nursery C.) Document the finding as erythema toxicum neonatorum D.) Take the newborns temperature, and obtain a culture of one of the vesicles

C

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 saves families money C.) Breastfeeding costs employers in terms of time lost from work D.) Breastfeeding benefits the environment

C

While examining a newborn, the nurse notes uneven skinfolds on the buttocks and a clunk when performing the Ortolani maneuver. These findings are likely indicative of what? A.) Polydactyly B.) Clubfoot C.) Hip dysplasia D.) Webbing

C

Why is vitamin K administered to newborns? A.) It reduces bilirubin levels B.) It increases the production of red blood cells C.) It enhances the ability of blood to clot D.) It stimulates the formation of surfactant

C

Women with mild gestational hypertension and mild preeclampsia can be safely managed at home with frequent maternal and fetal evaluation. Complete or partial bed rest is still frequently ordered by some providers. Which complication is rarely the result of prolonged bed rest? A.) Thrombophlebitis B.) Psychologic stress C.) Fluid retention D.) Cardiovascular deconditioning

C

The nurse is preparing a diet plan for a pregnant client with preeclampsia. Which would the nurse include in the client's diet (select all that apply): A.) Food with a low fiber content B.) Four to five cups of coffee per day C.) Food with a low sodium content D.) Food with a high zinc content E.) Six to eight glasses of water per day

C, D, E

The nurse is teaching a pregnant client how to recognize signs of preeclampsia and when to report to the primary health care provider. Which statements by the client indicate effective learning (select all that apply): A.) "I should report if I see an increase in urinary output" B.) "I should report if a dipstick test shows proteinuria less than 1+" C.) "I should report if I experience blurred vision or headache" D.) "I should report if I feel a decrease in the baby's movements" E.) "I should sit and use my right arm to accurately measure my blood pressure"

C, D, E

The nurse should be cognizant of which important information regarding the gastrointestinal (GI) system of the newborn? A.) The newborns cheeks are full because of normal fluid retention B.) The nipple of the bottle or breast must be placed well inside the baby's mouth because teeth have been developing in utero, and one or more may even be through C.) Regurgitation during the first day or two can be reduced by burping the infant and slightly elevating the baby's head D.) Bacteria are already present in the infants GI tract at birth because they traveled through the placenta

CA

A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Which information assists the nurse in developing the plan of care? A.) Bed rest and analgesics are the recommended treatment B.) She will be unable to conceive in the future. C.) A D&C will be performed to remove the products of conception D.) Hemorrhage is the primary concern

D

A client at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. Which client condition would the nurse suspect? A.) Eclamptic seizure B.) Uterine rupture C.) Placenta previa D.) Placental abruption

D

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.) Leave the infant in the room with the mother B.) Immediately take the infant to the nursery C.) Perform a gestational age assessment to determine whether the infant is large for gestational age D.) Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia

D

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.) Smoking has little-to-no effect on milk production B.) No relationship exists between smoking and the time of feedings C.) The effects of secondhand smoke on infants are less significant than for adults D.) The mother should always smoke in another room

D

A nurse is responsible for teaching new parents regarding the hygienic care of their newborn. Which instruction should the nurse provide regarding bathing? A.) Avoid washing the head for at least 1 week to prevent heat loss B.) Sponge bathe the newborn for the first month of life C.) Cleanse the ears and nose with cotton-tipped swabs, such as Q-tips D.) Create a draft-free environment of at least 24 C (75 F) when bathing the infant

D

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.) The nurse should immediately notify the pediatrician for this emergency situation B.) The neonate must have aspirated surfactant C.) If this baby was born vaginally, then a pneumothorax could be indicated D.) The lungs of a baby delivered by cesarean section may sound moist during the first 24 hours after childbirth

D

A postpartum woman telephones the provider regarding her 5-day-old infant. The client is not scheduled for another weight check until the infant is 14 days old. The new mother is worried about whether breastfeeding is going well. Which statement indicates that breastfeeding is effective for meeting the infants nutritional needs? A.) Sleeps for 6 hours at a time between feedings B.) Has at least one breast milk stool every 24 hours C.) Gains 1 to 2 ounces per week D.) Has at least six to eight wet diapers per day

D

A pregnant client after 20 weeks of gestation reports painless bright red vaginal bleeding. On assessment, the nurse finds that the client vital signs are normal. Which condition would the nurse suspect in the client? A.) Eclampsia B.) Preeclampsia C.) Pyelonephritis D.) Placenta previa

D

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 newborns distress? A.) Hypoglycemia B.) Phrenic nerve injury C.) Respiratory distress syndrome D.) Sepsis

D

A primiparous woman is delighted with her newborn son and wants to begin breastfeeding as soon as possible. How should the client be instructed to position the infant to facilitate correct latch-on? A.) The infant should be positioned with his or her arms folded together over the chest B.) The infant should be curled up in a fetal position C.) The woman should cup the infant's head in her hand D.) The infant's head and body should be in alignment with the mother

D

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding indicates that preterm labor is occurring? A.) Estriol is not found in maternal saliva B.) Irregular, mild uterine contractions are occurring every 12 to 15 minutes C.) Fetal fibronectin is present in vaginal secretions D.) The cervix is effacing and dilated to 2 cm

D

A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes, dark red vaginal bleeding, and a tense, painful abdomen. Which clinical change does the nurse anticipate? A.) Eclamptic seizure B.) Rupture of the uterus C.) Placenta previa D.) Abruptio placentae

D

A woman who is 8 months pregnant asks the nurse, Does my baby have any antibodies to fight infection? What is the most appropriate response by the nurse? A.) Your baby has all the immunoglobulins necessary: immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA) B.) Your baby won't receive any antibodies until he is born and you breastfeed him C.) Your baby does not have any antibodies to fight infection D.) Your baby has IgG and IgM

D

A woman with preeclampsia has a seizure. What is the nurses 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

An African-American woman noticed some bruises on her newborn daughters buttocks. The client asks the nurse what causes these. How would the nurse best explain this integumentary finding to the client? A.) Lanugo B.) Vascular nevus C.) Nevus flammeus D.) Mongolian spot

D

As part of the infant discharge instructions, the nurse is reviewing the use of the infant car safety seat. Which information is the highest priority for the nurse to share? A.) Infant carriers are okay to use until an infant car safety seat can be purchased B.) For traveling on airplanes, buses, and trains, infant carriers are satisfactory C.) Infant car safety seats are used for infants only from birth to 15 pounds D.) Infant car seats should be rear facing and placed in the back seat of the car

D

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? A.) Prevent exposure to people with upper respiratory tract infections B.) Keep the infant away from secondhand smoke C.) Avoid loose bedding, water beds, and beanbag chairs D.) Place the infant on his or her abdomen to sleep

D

Early this morning, an infant boy was circumcised using the PlastiBell method. Based on the nurses evaluation, when will the infant be ready for discharge? A.) When the bleeding completely stops B.) When yellow exudate forms over the glans C.) When the PlastiBell plastic rim (bell) falls off D.) When the infant voids

D

Following a loud noise, the nurse observes the newborn symmetrically abduct and extend his arms, fan his fingers and form a "C" with the thumb and forefinger, and he has a slight tremor. Which reflex would the nurse document? A.) Positive tonic neck reflex B.) Positive glabellar (Myerson) reflex C.) Positive Babinski reflex D.) Positive Moro reflex

D

For a client at 42 weeks of gestation, which finding requires more assessment by the nurse? A.) Fetal heart rate of 120 beats/minute B.) Cervix dilated 2 cm and 50% effaced C.) Score of 8 on the biophysical profile D.) One fetal movement noted in 1 hour of assessment by the mother

D

How should the nurse interpret an Apgar score of 10 at 1 minute after birth? A.) The infant is having no difficulty adjusting to extrauterine life and needs no further testing B.) The infant is in severe distress and needs resuscitation C.) The nurse predicts a future free of neurologic problems D.) The infant is having no difficulty adjusting to extrauterine life but should be assessed again at 5 minutes after birth

D

Human immunodeficiency virus (HIV) may be transmitted perinatally or during the postpartum period. Which statement regarding the method of transmission is most accurate? A.) Only in the third trimester from the maternal circulation B.) From the use of unsterile instruments C.) Only through the ingestion of amniotic fluid D.) Through the ingestion of breast milk from an infected mother

D

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

D

In which position would the nurse recommend a postpartum client place her 36-week-old newborn during breastfeeding? A.) Cradle position B.) Lying down position C.) Across the lap position D.) Under the arm position

D

Nurses should be able to teach breastfeeding mothers the signs that the infant has correctly latched on. Which client statement indicates a poor latch? A.) I feel a firm tugging sensation on my nipples but not pinching or pain B.) My baby sucks with cheeks rounded, not dimpled C.) My baby's jaw glides smoothly with sucking D.) I hear a clicking or smacking sound

D

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.) Screening is performed when the infant is 12 hours of age B.) Testing is performed with an electrocardiogram C.) Oxygen (O2) is measured in both hands and in the right foot D.) A passing result is an O2 saturation of 95%

D

The brain is vulnerable to nutritional deficiencies and trauma in early infancy. What is the rationale for this physiologic adaptation in the newborn? A.) Incompletely developed neuromuscular system B.) Primitive reflex system C.) Presence of various sleep-wake states D.) Cerebellum growth spurt

D

The client has been on magnesium sulfate for 20 hours for the treatment of preeclampsia. She just delivered a viable infant girl 30 minutes ago. What uterine findings does the nurse expect to observe or assess in this client? A.) Absence of uterine bleeding in the postpartum period B.) Fundus firm below the level of the umbilicus C.) Scant lochia flow D.) Boggy uterus with heavy lochia flow

D

The nurse appreciates a murmur when assessing a neonate in resting position. Which additional assessments would the nurse make to identify possible cardiac defects? A.) Measure the circumference of the head B.) Assess movements of the lower extremities C.) Monitor blood pressure (BP) in the upper extremities D.) Assess blood pressure (BP) in all four exremities

D

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.) Sluggish or diminished B.) Brisk, hyperactive, with intermittent or transient clonus C.) Active or expected response D.) More brisk than expected, slightly hyperactive

D

The nurse is administering glucocorticoids to a pregnant client in preterm labor. When exploring the purpose of this medicine to the client, which response by the nurse is accurate? A.) To prevent fetal cerebral palsy B.) To prevent early birth of the fetus C.) To prevent gestational hypertension D.) To prevent fetal respiratory distress syndrome

D

The nurse is caring for a client with preeclampsia who is receiving an intravenous (IV) magnesium sulfate infusion. In assessing the client every 20 minutes, which maternal findings would require immediate intervention by the nurse? A.) Deep tendon reflexes of 2+ B.) Urinary output of 30 mL/hour C.) Blood pressure of 130/90 mmHg D.) Respiratory rate of 9 breaths/min

D

The nurse is caring for a lactated client who has undergone bariatric surgery. Which nutritional supplement would be beneficial to prevent deficiency state in the mother and the infant? A.) Folic acid supplement B.) Fluoride supplement C.) Vitamin C supplement D.) Vitamin B12 supplement

D

The nurse is monitoring a pregnant client after amniotomy. Which observation would indicate a likelihood of umbilical cord compression? A.) The fetal heart rate (FHR) confirms tachycardia B.) The client's vaginal drainage has a foul smell C.) The client has frequent maternal chills D.) The fetal heart rate (FHR) has variable decelerations

D

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.) 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.) Braxton Hicks contractions often signal the onset of preterm labor C.) 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 D.) Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change

D

The nurse is using the CRIES pain scale to determine the pain level is a circumcised infant. What does a score of 1 for "Sleeplessness" indicate? A.) The infant has been constantly awake B.) The infant has been asleep for one hour C.) The infant has awakened only when touched D.) The infant has awakened at frequent intervals

D

The nurse who elects to practice in the area of womens health must have a thorough understanding of miscarriage. Which statement regarding this condition is most accurate? A.) A miscarriage is a natural pregnancy loss before labor begins B.) It occurs in fewer than 5% of all clinically recognized pregnancies C.) Careless maternal behavior, such as poor nutrition or excessive exercise, can be a factor in causing a miscarriage D.) If a miscarriage occurs before the 12th week of pregnancy, then it may be observed only as moderate discomfort and blood loss

D

The nurse working in an obstetric clinic is taking health histories and knows that which client is at the highest risk of developing hydatidiform mole? A.) A client with hypothyroidism B.) A client with diabetes mellitus C.) A client with systemic lupus erythematosus D.) A client with prior molar pregnancy

D

The obstetric provider has informed the nurse that she will be performing an amniotomy on the client to induce labor. What is the nurses highest priority intervention after the amniotomy is performed? A.) Applying clean linens under the woman B.) Taking the client's vital signs C.) Performing a vaginal examination D.) Assessing the fetal heart rate (FHR)

D

The ultrasound report of a 12-week old pregnant client shows a snowstorm pattern. On further examination, the nurse finds elevated human chorionic gonadotropin (hCG) levels and dark brown vaginal discharge. Which complication would the nurse expect in the client? A.) Hemorrhage B.) Hypertension C.) Hyperglycemia D.) Molar pregnancy

D

What bacterial infection is definitely decreasing because of effective drug treatment? A.) Escherichia coli infection B.) Tuberculosis C.) Candidiasis D.) Group B streptococci (GBS) infection

D

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

D

When would an internal version be indicated to manipulate the fetus into a vertex position? A.) Fetus from a breech to a cephalic presentation before labor begins B.) Fetus from a transverse lie to a longitudinal lie before a cesarean birth C.) Second twin from an oblique lie to a transverse lie before labor begins D.) Second twin from a transverse lie to a breech presentation during a vaginal birth

D

Which action would the nurse take when placing a newborn under a radiant heat warmer to stabilize temperature after birth? A.) Place a thermistor probe on the left side of the chest B.) Cover the probe with a nonreflective material C.) Recheck the temperature by periodically taking a rectal temperature D.) Perform all examinations and activities under the warmer

D

Which action would the nurse take when weighing a newborn? A.) Leave the diaper on for comfort B.) Place a sterile paper on the scale for infection control C.) Keep hand on the newborn's abdomen for safety D.) Weigh the newborn at the same time each day for accuracy

D

Which anatomic site would the nurse select to administer vitamin K to a term newborn? A.) Bicep muscle B.) Deltoid muscle C.) Dorsogluteal muscle D.) Vastus lateralis muscle

D

Which assessment finding would the nurse recognize as a sign of possible seizure activity? A.) Tremors are easily elicited by a sound or motion B.) Tremors cease with gentle restraint of the extremity C.) Tremors reduce or stop with passive flexion D.) Tremors are accompanied by ocular changes

D

Which assessment is least likely to be associated with a breech presentation? A.) Meconium-stained amniotic fluid B.) Fetal heart tones heard at or above the maternal umbilicus C.) Preterm labor and birth D.) Postterm gestation

D

Which client action might lead to an infant avoiding latching on to the breast? A.) The client breastfeeds the infant at scheduled times only B.) The client gives honey to the infant before breastfeeding C.) The client stopped making skin-to-skin contact with the infant D.) The client has been feeding the infant both formula and breast milk

D

Which clinical finding would the nurse interpret as a possible sign of hydrocephalus? A.) Body weight of 7 pounds B.) Heart rate 120 beats/min C.) Head-to-heel length of 55 cm D.) Head circumference greater than chest circumference

D

Which clinical finding would the nurse report to the provider when examining the external genitalia of a female infant? A.) Slight bloody spotting B.) Presence of hymenal tag C.) Mucoid vaginal discharge D.) Fecal vaginal discharge

D

Which drug prevents the risk of cerebral palsy in the fetus? A.) Nifedipine B.) Propranolol C.) Dexamethasone D.) Magnesium sulfate

D

Which infant response to cool environmental conditions is either not effective or not available to them? A.) Constriction of peripheral blood vessels B.) Metabolism of brown fat C.) Increased respiratory rates D.) Unflexing from the normal position

D

Which interpretation would the nurse have for an Apgar score of 10 at 1 minute after birth? A.) An infant having no difficulty adjusting to extrauterine life and needing no further testing B.) An infant in severe distress who needs ressuscitation C.) A prediction of a future free of neurologic problems D.) An infant having no difficulty adjusting to extrauterine life but who should be assessed again at 5 minutes after birth

D

Which is a priority nursing action when a pregnant client with severe gestational hypertension is admitted to the health care facility? A.) Prepare the client for cesarean delivery B.) Administer intravenous and oral fluids C.) Provide diversionary activities during bed rest D.) Administer the prescribed magnesium sulfate

D

Which recommendation would the nurse make to the parents of a newborn about traveling with the infant in a car? A.) Secure and position the infant upright in the car seat B.) Place the infant in a forward-facing car seat after 6 months of age C.) Place the infant seat in the front in the car with front air bags D.) Secure the infant in a rear-facing car seat in the rear of the car

D

Which sign would the nurse observe in a client with hydatidiform mole? A.) Clear vaginal discharge B.) A small uterus C.) Decreased fetal heart rate D.) Dark brown vaginal discharge

D

Which statement best describes chronic hypertension? A.) Chronic hypertension is defined as hypertension that begins during pregnancy and lasts for the duration of the pregnancy 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 is general hypertension plus proteinuria D.) Chronic hypertension can occur independently of or simultaneously with preeclampsia

D

Which statement by the student nurse student regarding the management of reduced cervical competence (premature dilation of the cervix) indicates effective learning? A.) "Progesterone supplementation is the only effective treatment" B.) "An abdominal cerclage is performed in the first week of gestation" C.) "Surgical treatment is ineffective in women with an extremely short cervix" D.) "A prophylactic cerclage is used to constrict the internal os of the cervix"

D

Which statement is the most complete and accurate description of medical abortions? A.) Medical abortions are performed only for maternal health B.) They can be achieved through surgical procedures or with drugs C.) Medical abortions are mostly performed in the second trimester D.) They can be either elective or therapeutic

D

Which statement related to the induction of labor is most accurate? A.) Can be achieved by external and internal version techniques B.) Is also known as a trial of labor (TOL) C.) Is almost always performed for medical reasons D.) Is rated for viability by a Bishop score

D

Which stool assessment finding would prompt the nurse to evaluate a newborn's breastfeeding effectiveness? A.) Greenish yellow, loose stools on the third day B.) Yellow, soft, and seedy stools on the seventh day C.) Greener, thinner and less sticky stools on the second day D.) Greenish black, thick and sticky meconium stools on the third day

D

Which structure is responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream? A.) Decidua basalis B.) Blastocyst C.) Germ layer D.) Chorionic villi

D

Which technique would the nurse use to distinguish cutaneous jaundice from the normal skin color of a neonate? A.) Evaluate the size of the nipples B.) Measure the circumference of the head C.) Observe the symmetry of lip movement D.) Apply pressure on the forehead with a finger

D

While caring for an infant, which intervention would the nurse implement to prevent heat loss caused by evaporation? A.) Wrap the infant in a cloth B.) Place the infant in a warm crib C.) Place the crim away from windows D.) Dry the infant immediately after the bath

D

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 (Myerson) C.) Babinski D.) Moro

D

Why would the nurse suggest that a client stimulates her baby's lips with her nipple while breastfeeding? A.) To prevent nipple trauma B.) To encourage the baby to swallow the milk C.) To reduce pain while feeding the infant D.) To stimulate the baby to open his or her mouth

D