Women's Health HESI
A client in labor begins to experience contractions 2 to 3 minutes apart that last about 45 seconds. Between contractions the nurse identifies a fetal heart rate of 100 beats/min on the internal fetal monitor. What is the next nursing action?
Notify the provider
How do we prepare for a seizure?
Pad the bedside have an airway ready
Which physiological changes would the nurse anticipate after an amniotomy is performed?
Progressive dilation and effacement
Offspring of men of advanced paternal age are at increased risk for which condition?
Schizophrenia
At what gestational age is the fundal height at the umbilicus?
20 weeks
Between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?
24 and 28th
Which preexisting condition necessitates a cesarean birth?
Active genital herpes
A pregnant client is admitted with abdominal pain and heavy vaginal bleeding. Which is the immediate nursing action?
Administering oxygen
Which disease is in the top 5 leading causes of death in American women?
Alzheimer's
Which laboratory test is conducted during the initial prenatal visit? SATA
Cervical culture for N. Gonorrhoeae
What major group of substances in human milk are of special importance to the newborn and cannot be reproduced in a bottle formula?
Gamma globulins
Molar pregnancy is associated with an excess of what hormone?
HCG
What can be done to prevent cystitis?
Increase fluid consumption
A nurse is admitting a client in active labor. When the fetal monitor is applied to the client's abdomen, it records late decelerations. What should the nurse do first?
Reposition her on her left side
Which medication is safe to give during pregnancy?
acetaminophen
Which technique would the nurse employ for an obstetrical client with a foreign body airway obstruction?
chest thrusts
In which position will the fetal heart tones be heard if the fetus's position is left occiput anterior?
d
What concurrent symptom is priority after a fall?
dripping urine (can indicate broken water)
How big should a neonate's head be compared to its chest?
head should be 2cm BIGGER
What is menorrhagia?
heavy menstrual bleeding
What are the two key indicators of preeclampsia?
hypertension and proteinuria
A 16 year old girl has been admitted with eclampsia. She is not presently convulsing, which intervention should be included in her care plan?
keep an airway by the bedside
Why are seizures during pregnancy particularly dangerous?
the fetus gets no oxygen during pregnancy
Cramping and vaginal spotting occurring at 12 weeks gestation with a closed cervix is characteristic of which problem?
threatened abortion
Which is a risk factor associated with IVF?
tubal pregnancy
Which direction regarding sleeping position would the nurse give to a client who is 8 months pregnant?
turn from side to side
Which factor will increase the risk for hypotonic uterine dystocia in a postpartum client?
twin gestation
Which procedure would the nurse anticipate when caring for a client with a tentative diagnosis of placenta previa?
ultrasound
Which test is used to confirm cephalopelvic disproportion?
ultrasound
Which intervention would the nurse recommend for post-cesarean gas pain?
walk around the room
What is a side effect of oxytocin?
water retention
The nurse is preparing a 24 hour discharge. While doing discharge teaching, which intervention is the most important?
Evaluate infant feeding prior to discharge
What deficiency causes spina bifida?
Folic acid
Which assessment would the nurse include in the plan of care for a client with large, painful varicose veins?
Assessing for signs of thrombophlebitis
A nurse is assessing a newborn born after 32 weeks' gestation. What clinical finding does the nurse anticipate?
Barely visible areola and nipple.
Where should the Doppler ultrasound transducer be placed to best auscultate fetal heart tones?
Below the umbilicus on the right side
The nurse is differentiating between cephalhematoma and caput succedaneum. Which finding is unique to caput succedaneum?
Edema that crosses the suture line
Which is the primary focus of teaching for a pregnant adolescent at her first prenatal clinic visit?
Encouraging her to continue regularly scheduled prenatal care
Which would be included in the plan of care for an obstetrical client who has been taking carbamazepine throughout the first trimester of pregnancy?
Evaluation for a neural tube defect
A nurse teaches a new mother about neonatal weight loss in the first 3 days of life. How does the nurse explain the cause of this weight loss?
Excretion of accumulated excess fluids
The nurse teaching a prenatal class is asked why infants of diabetic mothers are larger than those born to women who do not have diabetes.
Extra circulating glucose causes the fetus to acquire fatty deposits
Which cervical changes are observed during pregnancy? Select all that apply.
The cervical tip becomes soft. The volume of cervical muscles increases. The elasticity of cervical collagen-rich connective tissue increases.
Which information would the nurse include in the discharge teaching of a postpartum client?
The prenatal Kegel tightening exercised should be continued
Which is a sensory simulation strategy a laboring client can use as a nonpharmacological strategy for pain management?
Selecting a focal point and beginning breathing techniques
Which statement by a breastfeeding mother indicates that the nurse's teaching regarding stimulating the let-down reflex has been successful?
I will apply warm packs and massage my breasts before feeding
Which direction would the nurse give a client in preparation for ultrasonography at the end of her first trimester?
Increase fluid intake for 1 hour before the procedure
Which conditions are risk factors that may place infants at a higher risk for developing jaundice?
Infection Prematurity Breast-Feeding Maternal diabetes
Which position increases cardiac output in the obstetrical client with cardiac disease?
Lateral positioning
A pregnant client with a history of preterm labor is at home on bed rest. Which instruction would be included in this client's teaching plan?
Lie on side with head raised on a small pillow
What IV medication can prevent seizures in women with preeclampsia?
Mag sulfate
What is most important to monitor in a patient receiving an epidural?
Maternal BP
which type of lochia would the visiting nurse expect to observe on a client's pad on the fourth day after a vaginal delivery?
Moderate rubra
A neonate regurgitates and turns cyanotic. What should be done first?
Stimulate the baby to cry
At what point in the menstrual cycle is pregnancy most likely?
14 days before the next period
Women who become pregnant for the first time at a later reproductive age are at risk for which complications?
Preterm labor Multiple gestation Chromosomal abnormalities
What causes leukorrhea?
increased production of estrogen
What is the teaching for bisphosphates?
take on an empty stomach
Which information would the nurse give a pregnant client about having a chorionic villus sampling (CVS) before the 10th and 12th weeks?
the test can cause fetal anomalies
When does the second stage of labor end?
when the baby is born
Folic acid taken in the first trimester of pregnancy helps reduce the risk for which neonatal disorder?
Neural tube defects
In maternal care, every month is considered to be how long?
4 weeks
The care plan for a client at 30 weeks gestation who is experiencing preterm labor includes?
betamethasone
How many extra kcals should pregnant women consume?
330
How many extra kcals should breastfeeding women consume?
500
How much additional daily protein is recommended for someone who is lactating?
25g
In a patient given oxytocin for hypotonic labor, what action should be taken?
monitor duration, frequency, and intensity
What is the priority nursing action after spontaneous rupture of the membranes?
monitor fetal heart rate
Which is the priority nursing intervention during the admission of a primigravida in labor?
monitoring fetal heart rate
Which condition is detected by an alpha-fetoprotein test?
neural tube defects
What are the vessels of the umbilical cord?
one vein and two arteries
What is dymenorrhea?
painful menstruation
What intervention should be taken for neonate safety when under a warmer?
put a temp probe on the abdomen
Which action would the nurse initiate first to ensure the physical safety of a client with severe preeclampsia?
seizure precautions
What are the requirements for early postpartum discharge?
1 pee and 1 poop form neonate Neonate feeding well No heavy bleeding from mother
The nurse knows that jaundice first becomes visible in a newborn when serum bilirubin reaches what level?
5-7 mg/dL
When do we give rubella vaccination?
72 hours after delivery
Which type of isolation precautions would the postpartum nurse plan to institute for a client who has delivered her infant by C section because of active genital herpes?
Contact
Which food contains at least 100 mcg of folate per serving? Select all that apply.
Black-eyed peas Ready-to-eat breakfast cereal
Which information would tell the nurse if a woman at 40 weeks gestation having contractions is in true labor?
Cervical dilation and effacement
Which action provides support for the fetal head as it is being delivered?
Distributing fingers evenly around the head
When can a primigravida fetal heartbeat be heard for the first time?
Doppler ultrasound at 10-12 weeks
Which occurs immediately after birth that increases the risk for cardiac decompensation in a client with a compromised cardiac system?
Extravascular fluid is remobilized into the vascular compartment.
During the assessment of a client in labor, the cervix is determined to be dilated 4cm. Which stage of labor would the nurse record?
First
Which hormone is related to nausea in pregnancy?
HCG
What condition would the HCP advise the client to avoid breastfeeding?
HIV
Which STI is caused by a protozoa?
Trichomoniasis
What does a fall or any physical trauma at 39 put the mother at risk for?
abruption
When is an AFP done?
b/t 15-18 wks gestation
Which statements regarding involution the involution process are correct?
begins immediately after expulsion of the placenta progresses rapidly over the next few days return to nonpregnant state
What is the most important assessment for an 15 minute old infant with a Ballard score age of 42 week?
blood glucose
What vital sign is of most concern following birth?
blood pressure
What is the antidote for mag sulfate?
calcium gluconate
Which cardiac disease has the lowest risk for perinatal mortality?
ductus arteriosis
Which instruction would the nurse include when teaching a client about a contraction stress test (CST)?
empty the bladder before the test
Which nursing intervention is necessary to prepare for a repeat sonogram?
ensuring that the client drinks two 8oz glasses of water
For which reason is an ultrasound done during the first trimester?
estimate fetal age
Which would the nurse do to prepare a client in her third trimester who is scheduled for an amniocentesis?
go piss, girl
Which nursing intervention is the most effective in preventing a seizure in a client with severe preeclampsia?
limit stimuli
A neonate weighing 5 lb 6 oz (2438 g) is born in a cesarean birth and admitted to the newborn nursery. What range of resting respiratory rate should the nurse anticipate?
30 to 60 breaths/min
Which information about adolescent growth and development would the nurse need to understand before discussing changes in body size to a 16-year-old adolescent at 24 weeks gestation?
Body image is very important to adolescents; therefore, pregnant teenagers are overly concerned about body size
A 24-year-old client is admitted at 40 weeks' gestation. The cervix is dilated 5 cm and is 100% effaced, and the presenting part is at station 0. The nurse assesses that the fetal heart tones are just above the umbilicus. Which fetal presentation does the nurse document?
Breech
The nurse applies fetal and uterine monitors to the abdomen of a client in active labor. When the client has contractions, the nurse notes a 15 beats/min deceleration of the fetal heart rate below the baseline lasting 15 seconds. What is the next nursing action?
Changing the maternal position
The nurse admits a client with preeclampsia to the high-risk prenatal unit. Which is the next nursing action after the vital signs have been obtained?
Checking the client's reflexes
Which finding would indicate infection in a pregnant client?
Chills Fever Diarrhea Flank pain Burning on urination
Which prenatal test provides the earliest diagnosis of fetal defects?
Chorionic villus sampling
What is most important to assess for when water breaks?
Color and consistency
What is the normal range for fetal heart rate?
120-160 bpm
What is the range for normal fetal heart rate?
110-160 bpm
Which is the best gauge for the pregnant client to use when estimating how heavy the vaginal bleeding is?
Amount of blood lost in relation to usual menstrual flow
Which complication is the result of type 1 diabetes in a pregnant client?
Increased risk of hypertensive states
Which assessment finding from a patient given mag sulfate requires immediate intervention?
absent patellar reflexes
The nurse teaches a client who is about to undergo an amniocentesis that ultrasonography will be performed before the procedure to determine what?
Position of fetus and placenta
A client is admitted in active labor at 39 weeks' gestation. During the initial examination the nurse identifies multiple red blister-like lesions on the edges of the client's vaginal orifice. Once the nurse has spoken to the practitioner and receive prescriptions, the priority nursing action is:
Preparing for c-section birth
How would an apgar score recorded 5 minutes after birth assist the nurse in evaluating the care of the newborn?
adequacy of the transition to extrauterine life?
Why is it important for the nurse to encourage a client with preeclampsia to lie in the left-lateral recumbent position?
Uterine and kidney perfusion are maximized
