Foundations of Nursing II - Unit 1 Exam

The nurse is recalling the steps in cell division, beginning at conception and ending with fetal development. List the following steps in order of development:

1. Zygote 2. Blastocyst C. Embryo D. Fetus

A woman who is planning to get pregnant started 0.4 mg/day of folic acid. She visited her primary physician and the dose was later increased to 0.8 mg/day because she had an infant with neural tube defect (NTD). The stock volume for folic acid is 0.4 mg. The nurse is expected to instruct the woman to take _____ tablets per day? Fill in the blank. Do not include units.

2

The nurse is documenting the obstetrical history of a client using the GTPAL system. The client is currently pregnant with her third child. Her first pregnancy resulted in the birth of a daughter at 38 weeks and 1-day gestation. Her second pregnancy resulted in the birth of a son at 35 weeks and 5 days gestation. Both are still living. Complete the following GTPAL for client: 3-1-1-0-_. Enter the missing numeral only.

2

How many chromosomes are present in the human cell?

46

A nurse in a health clinic is reviewing contraceptive use with a group of clients. Which of the following client statements demonstrates understanding? A. "A water-soluble lubricant should be used with condoms." B. "A diaphragm should be removed 2 hours after intercourse." C. "Oral contraceptives can worsen a case of acne." D. "A contraceptive patch is replaced once a month."

A. "A water-soluble lubricant should be used with condoms."

A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevations will indicate a high probability that the client is pregnant? A. Chorionic gonadotropin B. Oxytocin C. Prolactin D. Luteinizing hormone

A. Chorionic gonadotropin

A nurse is caring for a client who is at 40 weeks of gestation and experiencing contractions every 3 to 5 min and becoming stronger. A vaginal exam reveals that the client's cervix is 3 cm dilated, 80% effaced, and a -1 station. The client asks for pain medication. Which of the following actions should the nurse take? (Select all that apply) A. Encourage the use of patterned breathing techniques B. Insert an indwelling urinary catheter C. Administer opioid analgesic medication D. Suggest application of cold E. Provide ice chips

A. Encourage the use of patterned breathing techniques C. Administer opioid analgesic medication D. Suggest application of cold

The discussion of comfort measures, breathing techniques, and the patient's birth plan should take place at which stage of labor? A. First stage, latent phase B. Second stage C. First stage, active phase D. Third stage

A. First stage, latent phase

Which assessments of uterine activity are obtained by the nurse when the patient has an intrauterine pressure catheter (IUPC) placed? (Select all that apply) A. Frequency B. Intensity C. Duration D. Fetal heart rate E. Resting tone

A. Frequency B. Intensity C. Duration E. Resting tone

A client in her second trimester presented at the clinic with a history of vaginal bleeding. She has no history of trauma. Which condition in the client's history would assist the nurse to determine the cause for the bleeding? (Select all that apply) A. Friable cervix B. Placenta previa C. Urinary frequency D. Hyperemesis gravidarum E. Absence of fetal movement

A. Friable cervix B. Placenta previa

The nurse auscultates a fetal heart rate of 150 beats per minute (bpm) on a client in early labor. Which of the following actions by the nurse is appropriate? A. Inform the mother that the rate is normal B. Reassess in 5 minutes to verify the results C. Immediately report the rate to the healthcare practitioner D. Place the client on her left side and apply oxygen by face mask

A. Inform the mother that the rate is normal

The Labor and Delivery (L&D) unit educator discusses the prioritization of fetal monitoring goals, creating a plan of care, and setting goals for implementation with a group of nurses. Which goals are correct? (Select all that apply) A. Interpretation of ongoing assessment of fetal oxygenation B. Prevention of significant fetal academia C. Minimize unnecessary interventions D. Promote a satisfying family-centered birth experience E. Use of EFM for all laboring women in the U.S. is required

A. Interpretation of ongoing assessment of fetal oxygenation B. Prevention of significant fetal academia C. Minimize unnecessary interventions D. Promote a satisfying family-centered birth experience

Which finding would the nurse view as normal when evaluating the laboratory reports of a client at 34 weeks' gestation? A. Mild anemia B. Thrombocytopenia C. Polycythemia D. Hyperbilirubinemia

A. Mild anemia

A nurse is caring for a client who is in active labor. The cervix is dilated to 5 cm, and the membranes are intact. Based on the use of external electronic fetal monitoring, the nurse notes a FHR of 115 to 125/min with occasional increases up to 150 to 155/min that lasts for 25 seconds and have moderate variability. There is no slowing of the FHR from the baseline. The client is exhibiting manifestations of which of the following? (Select all that apply) A. Moderate variability B. FHR accelerations C. FHR decelerations D. Normal baseline FHR E. Fetal tachycardia

A. Moderate variability D. Normal baseline FHR

A client was recently admitted to the labor and delivery unit in active labor. The nurse performs Leopold's maneuvers during the assessment. During the third maneuver, the nurse notes a firm and fixed fetal part. Which position correlates with this assessment finding? A. Occiput B. Acromion C. Sacrum D. Transverse

A. Occiput

A client with an obstetrical history of G1 P0000, is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day? (Select all that apply) A. Pap smear B. Mammogram C. Glucose tolerance test D. Biophysical profile E. Complete blood count

A. Pap smear E. Complete blood count

A client at 36 weeks' gestation is lying flat on her back. Which of the following maternal signs/symptoms would the nurse expect to observe? A. Hypertension B. Dizziness C. Rales D. Chloasma

B. Dizziness

A nurse is reviewing findings of a client's biophysical profile (BPP). The nurse should expect which of the following variables to be included in this test? (Select all that apply) A. Fetal weight B. Fetal breathing movement C. Fetal tone D. Fetal position E. Amniotic fluid volume

B. Fetal breathing movement C. Fetal tone E. Amniotic fluid volume

The nurse is reviewing the biophysical profile (BPP) results and would expect which variables to be included in this test? (Select all that apply) A. Fetal position B. Fetal tone C. Amniotic fluid volume D. Fetal breathing movements E. Fetal movement

B. Fetal tone C. Amniotic fluid volume D. Fetal breathing movements E. Fetal movement

When palpating the patient's fundus during a contraction, the nurse notes that it feels like a 'chin.' The nurse documents this finding as which contraction intensity? A. Mild B. Moderate C. Strong D. Firm

B. Moderate

The nurse reviews the client's file upon return from Radiology. The client is 37 weeks gestational age and completed the amniotic fluid index test (AFI). The nurse is concerned with which AFI result? A. The AFI measurement is 22 cm B. The AFI measurement is 4 cm C. The AFI measurement is 12 cm D. The AFI measurement is 9 cm

B. The AFI measurement is 4 cm

When analyzing the need for health teaching of a prenatal client who is a multigravida, the nurse should ask which of the following questions? A. "What are the ages of your children?" B. "What is your marital status?" C. "Do you ever drink alcohol?" D. "Do you have any allergies?"

C. "Do you ever drink alcohol?"

A 20 year old client states that the at home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time? a. "Congratulations, you and your family must be so happy." B. "Have you told the baby's father yet?" C. "How do you feel about that?" D. "Please tell me when your last menstrual period was."

C. "How do you feel about that?"

During a teaching session, the nurse had a discussion on the issue of Y-linked inheritance. Which response by the father indicates that learning has taken place? A. "The baby inherited the disease from my wife." B. "My grand-aunt has the same condition." C. "I passed on the condition to my baby." D. "We both gave the baby our disease."

C. "I passed on the condition to my baby."

A client makes the following statement after finding out that her pregnancy test is positive, "This is not a good time. I am in college and the baby will be due during final exams!" Which of the following responses by the nurse would be most appropriate? A. "I'm absolutely positive that everything will turn out all right." B. "I suggest that you email your professors to set up an alternate plan." C. "It sounds like you're feeling a little overwhelmed right now." D. "You and the baby's father will find a way to get through the pregnancy."

C. "It sounds like you're feeling a little overwhelmed right now."

A pregnant mother in her third trimester is scheduled for an amniotic fluid index (AFI) test. The nurse understands the reason for the test when she verbalizes which statement? A. "The test is a screening tool that assesses fetal accelerations." B. "The test evaluates the uterine and cervical structures of the pregnancy." C. "The test is a screening tool that measures the volume of amniotic fluid with ultrasound." D. "The test uses a needle to puncture the abdomen to obtain amniotic fluid."

C. "The test is a screening tool that measures the volume of amniotic fluid with ultrasound."

Which client would you anticipate to encounter difficulties, such as language barriers and monetary struggles, during their pregnancy? A. A woman diagnosed with preeclampsia B. An adolescent C. A woman who recently immigrated to the United States D. A veteran who recently served in Iraq

C. A woman who recently immigrated to the United States

The following four changes occur during pregnancy. Which of them usually increases the father's interest and involvement in the pregnancy? A. Learning the results of the pregnancy test B. Attending childbirth education classes C. Hearing the fetal heartbeat D. Meeting the obstetrician or midwife

C. Hearing the fetal heartbeat

A nurse is counseling an adolescent client who presented to the clinic for her first prenatal visit. She reports she is currently living alone and the father of the baby is no longer involved. When developing the plan of care for this client, which priority outcome is identified? A. Report increasing acceptance of changes in body image B. Discuss fears related to labor and birth C. Identify appropriate emotional support systems D. Develop a realistic birth plan

C. Identify appropriate emotional support systems

The process of labor is multifactorial. The five primary factors include powers, passage, passenger, psyche, and: A. Pressure B. Patience C. Position D. Pelvis

C. Position

From implantation until 8 weeks gestation, ___________ will have the most profound negative impact on the embryo. A. Organogenesis B. Conception C. Teratogens D. Infertility

C. Teratogens

A nurse is caring for a client who is in active labor, irritable, and reports the urge to have a bowel movement. The client vomits and states, "I've had enough. I can't do this anymore." Which of the following stages of labor is the client experiencing? A. Second stage B. Fourth stage C. Transition stage D. Latent phase

C. Transition stage

Describe the physiological changes that occur during pregnancy DC Ch 4 - LO 1 - 3 questions pgs 58 - 62

CARDIOVASCULAR SYSTEM: -Decrease in blood pressure -Hypervolemia of pregnancy -Heart displaced left and upward, rotated on its axis -Decreased vascular resistance -Decreased arterial pressure -Increased heart rate -Increased cardiac output -Murmurs are common -Physiological anemia of pregnancy -Increased demand in iron for fetal development -Increased fibrinogen -Decreased coagulation inhibiting factors

Discuss important biochemical assessments and maternal assays including the description of the procedure, advantages, risks, and nursing actions of each DC Ch 6 - LO 12 - 1 question pgs 138 - 142

Chorionic villus sampling: -Aspirate small amount of placental tissue (chorionic villi) for testing **ADVANTAGES: -Examine fetal chromosomes and done earlier than amniocentesis **RISKS: -Fetal loss 7% -Bleeding mother vaginally **NURSING ACTIONS: -Breathing techniques -Emotional -Anxiety reducing -Assess mother and fetus afet -Teaching for pt (bleeding, fever, leaking, abdominal pain) -RhoGam to Rh-negative women after

Explain how a nurse can provide culturally responsive care in the pregnant woman DC Ch 5 - LO 9 - 1 question pgs 117 - 121

Culturally sensitive practices: -Decision making -Concept of time -Communication -Religion -Worldview -Modesty -Gender Barriers to culturally sensitive care: -Lack of diversity -Health literacy -Health care disparities Nursing actions: -Cultural assessment -Communication -Accommodate cultural practices when possible -Include family

A woman who states that she "thinks" she is in labor enters the labor suite. Which of the following assessments will provide the nurse with the most valuable information regarding the client's labor status? A. Leopold maneuvers B. Fundal tone C. Fetal heart rate assessment D. Cervical examination

D. Cervical examination

Backache and cramping can both be a sign of ________________. A. Hyperemesis gravidarum B. A large for gestational age fetus C. Preeclampsia D. Preterm labor

D. Preterm labor

A client is scheduled for an amniocentesis. Which is the most important instruction that the nurse would include in the plan of care? A. Tell the client to drink 2 L of fluids B. Instruct the client not to have anything by mouth for eight hours C. Place the client in a lithotomy position D. Provide breathing and relaxation techniques the client can use

D. Provide breathing and relaxation techniques the client can use

The nonstress test (NST) uses electronic fetal monitoring (EFM) to assess fetal well-being. A nursing caring for a 32 weeks' gestational client on EFM will place the client in the following position: A. High-fowler B. Prone C. Lithotomy D. Semi-fowlers or lateral

D. Semi-fowlers or lateral

Eagerness, uncertainty, jealousy, and anger are all possible responses of what family member during pregnancy and delivery? A. Grandparents B. Single moms C. Family pet D. Siblings

D. Siblings

When assisting a family having infertility concerns, it's important to remember which of the following? A. A male partner is not impacted by infertility; resources should be reserved for the female partner in order to ensure she does as well as possible. B. Infertility causes can always be identified and treated, so nurses should be sure to stay positive and give hope to the family. Discussing infertility disappointments will just cause unneeded concern and may impact care. C. Infertility is usually caused by medications or illicit drug use, so be sure to obtain a urine drug screen on the first visit when working with these patients. D. Therapy and outside help can be important for the mental health of the patients, and information for these resources should be offered whenever assessment suggests they are needed.

D. Therapy and outside help can be important for the mental health of the patients, and information for these resources should be offered whenever assessment suggests they are needed.

Differentiate among the four stages of labor including the related nursing and medical care DC Ch 8 - LO 2 - 10 questions pgs 230 - 252

FOURTH STAGE OF LABOR: -Stage usually occurs from the time of delivery of the placenta through the first 1 to 4 hours after birth or stabilization of mother -Uterus should be firmly contracted -Lochia rubra, bright red blood flow with occasional small clots -VS return to pre labor values -Perineal discomfort -Feelings of exhaustion, excitement -Bonding, attachment with infant -Breastfeeding begins NURSING INTERVENTIONS: -Assess the uterus for firmness, height, position -Assess lochia -Assess VS every 5-15 min -Monitor maternal urine output -Promote golden hour (kangaroo care, skin to skin) -Repair laceration or episiotomy -Ice packs -Assess newborn status

Identify the critical components of assessment and nursing care during the first, second, and third trimester visits DC Ch 4 - LO 4 - 5 questions pg 77 - 96

LEOPOLD'S MANEUVERS: First step: determine fetal body part that occupies uterine fundus Second step: determine location of fetal back Third step: confirm presentation, determine engagement Fourth step: determine fetal attitude and extension

Describe the purpose, procedure, advantages, risks, and nursing actions of the following diagnostic tests: fetal ultrasound imaging, 3D and 4D ultrasound, MRI, and Doppler studies DC Ch 6 - LO 11 - 1 question pgs 131 - 139

MRI: **ADVANTAGES: -Provides very detailed images of fetal anatomy; particularly useful for brain abnormalities and complex abnormalities of thorax, GI and GU systems **RISKS: -No known harmful effects **NURSING ACTIONS: -Explain and answer questions Doppler studies: -Assess placental perfusion and fetal status **ADVANTAGES: -Noninvasive -Allows for assessment of placental perfusion **RISKS: -None **NURSING ACTIONS: -Explain and answer questions -Comfort and emotional support -Follow up scheduled as needed

Describe the physiological changes that occur during pregnancy DC Ch 4 - LO 1 - 3 questions pgs 58 - 62

MUSCULOSKELETAL SYSTEM: -Postural changes: lumbar lordosis, waddle gait -Round ligament pain -Diastasis recti -Joint discomfort -Calcium storage -Decreased maternal serum calcium -Lower extremity cramps

Describe the physiological changes that occur during pregnancy DC Ch 4 - LO 1 - 3 questions pgs 58 - 62

NEUROLOGICAL SYSTEM: -Decreased attention span -Poor concentration -Memory lapses -Carpal tunnel syndrome -Syncope -Headaches

Describe the intraoperative nursing care and medical and anesthesia management for cesarean births DC Ch 11 - LO 12 - 1 question

Operative techniques: -Low transverse incision: bikini -Classical incision: umbilicus -Low vertical incision Nursing actions: -Position wedge left hip tilt -FHR monitoring until abdomen prepped -Time out -Position for anesthesia -Grounding device to thigh -Insert foley -Abdominal skin prep sterile -Circulating duties: instrument, needle, sponge counts -Check resuscitation equipment -Asses and communicate with parents/family -Care neonate-time delivery and placenta: ID newborn, parents see/hold newborn, transfer to nursery

Explain how each of the five P's affect the course of labor and delivery, and how the components are interrelated DC Ch 8 - LO 1 - 3 questions pgs 220 - 230

POSITION: -Maternal position during birth and labor -Spinning babies

List common causes of infertility DC Ch 3 - LO 3 - 1 question pgs 52 - 53

Risk factors include: -Autoimmune disorders -Diabetes -Eating disorders -Poor nutrition -Excessive alcohol use -Excessive exercising -History of cancer -Obesity -Older age -STIs -Environmental pollutants -Impotence -Older age -Smoking

Describe client education for the various methods of contraception ATI Ch 1 - LO 8 - 2 questions pgs 3 - 11

STUDY ATI BOOK

Identify advantages and disadvantages of natural family planning, barrier and hormonal contraceptive methods, and permanent sterilization ATI Ch 1 - LO 7 - 1 question pgs 3 - 11

STUDY ATI BOOK

Differentiate among the four stages of labor including the related nursing and medical care DC Ch 8 - LO 2 - 10 questions pgs 230 - 252

THIRD STAGE OF LABOR: -Third stage of labor is the time frame from the birth of the baby to the complete delivery of the placenta -Stage usually lasts 5-10 min, may last up to 30 min -Uterus should be firmly contracted -Some discomfort or cramping as placenta is delivered -Gush of blood as placenta detaches -Mother is focused on well-being of infant, crying is common, expressions of relief NURSING INTERVENTIONS: -Immediate nursing care -Continue to assess/monitor blood loss and VS every 15 min *Pay close attention to BP and HR -Administer oxytocic med (pitocin) after delivery of placenta -Emotional support -Initiate infant bonding -Apgar scoring -Identification of newborn

Describe the physiological changes that occur during pregnancy DC Ch 4 - LO 1 - 3 questions pgs 58 - 62

URINARY/RENAL SYSTEM: -Weight of uterus and increased pressure on bladder -Increased urinary frequency -Incontinence -Increased risk of UTI -Nocturia -Increased urinary output -Glucosuria and proteinuria -Dependent anemia -Hyperemia of bladder and urethra

Discuss frequency of FHR assessment and critical components of three-tier system DC Ch 9 - LO 7 - 1 question pg 281

With high risk factors, monitor every 30 min in latent, every 15 in active, and every 5 seconds stage: -Thick meconium -ROM > 24 hr -Maternal fever -Vaginal bleeding -Intrauterine infection -Previous c/s -Abnormal VS -Fetal conditions like anomalies, anemia, growth problems, multiples, breech, prematurity

Cesarean sections can often be avoided by ___________________. A. Providing continuous support by a labor nurse or doula B. Ensuring the woman is moving through the labor phases as quickly as possible C. Encouraging the patient to get an epidural D. Attempting vaginal deliveries more frequently when breech and previa complications arise

A. Providing continuous support by a labor nurse or doula

A nurse is preparing to assist a new mother with breastfeeding following a cesarean section delivery. Which positions will the nurse recommend to maximize patient comfort while breastfeeding? (Select all that apply) A. Side-lying position B. Cradle hold C. C-cup positioning D. Using a breast pump E. Football hold

A. Side-lying position E. Football hold

A client at 40 weeks' gestation with a Bishop score of 1, is advised by her nurse midwife to take evening primrose daily. The office nurse advises the client to reopen which of the following side effects that has been attributed to the oil? A. Skin rash B. Pedal edema C. Blurred vision D. Tinnitus

A. Skin rash

A nurse is attending to two pregnant clients. The first client was assessed as "early term." The second was assessed as "full term." In order for the nurse to make such assessments, how mature are the clients' pregnancies? A. The first client is between 37 0/7 weeks and 38 6/7 weeks. The second client is between 39 0/7 weeks and 40 6/7 weeks. B. The first client is between 41 0/7 weeks and 41 6/7 weeks. The second client is 42 0/7 weeks and beyond. C. The first client is between 39 0/7 weeks and 40 6/7 weeks. The second client is between 37 0/7 weeks and 38 6/7 weeks. D. The first client is between 42 0/7 weeks and beyond. The second client is between 41 0/7 weeks and 41 6/7 weeks.

A. The first client is between 37 0/7 weeks and 38 6/7 weeks. The second client is between 39 0/7 weeks and 40 6/7 weeks.

The preferred method of delivery includes which of the following? A. The patient in a comfortable position of her choosing while open glottis pushing. B. The patient in lithotomy position with voluntary closed glottis pushing. C. The patient sitting on a birthing ball breathing at her own pace. D. The patient in stirrups being urged to hold her breath and bear down while the health care team counts to 10.

A. The patient in a comfortable position of her choosing while open glottis pushing.

When evaluating the fetal heart rate (FHR) monitor tracing on a client in labor, the nurse notes that there are decelerations present. Which of the following assessments must the nurse make at this time? A. The relationship between the decelerations and the labor contractions B. The maternal blood pressure C. The gestational age of the fetus D. The placement of the fetal heart rate transducer in relation to the fetal position

A. The relationship between the decelerations and the labor contractions

The nurse has taken a health history on four primigravid clients at their first prenatal visits. It is high priority that which of the clients receives nutrition counseling? A. The woman diagnosed with phenylketonuria B. The woman who has Graves' disease C. The woman with Cushing's syndrome D. The woman diagnosed with myasthenia gravis

A. The woman diagnosed with phenylketonuria

A woman states that she frequently awakens with "painful leg cramps" during the night. Which of the following assessments should the nurse make? A. The woman's exercise schedule B. Her Goodell's sign C. Her Hegar's sign D. The woman's dietary intake

A. The woman's exercise schedule

A couple visited the clinic and wanted to know their likelihood of conceiving a child with a genetic disorder. Which risk factor, identified by the nurse, is correct? (Select all that apply) A. Their first child was born with a genetic disorder B. There is a family history of genetic disorders C. Both partners are younger than 35 years old D. The woman is older than 35 years old E. Both parents have a genetic disorder

A. Their first child was born with a genetic disorder B. There is a family history of genetic disorders D. The woman is older than 35 years old E. Both parents have a genetic disorder

A patient has ambulated to labor and delivery reporting bright red spotting for the last hour. On the monitor, the nurse notes a baseline FHR of 165, minimal variability, and recurrent late decelerations. She is a G3P2 at 39 weeks and 3 days. What are the nurse's next steps? A. Turn the patient on her left side, call the provider, place her on O2, and start an IV in order to give a fluid bolus. B. Discharge the patient from OB triage, these are normal findings. C. Take a complete medical history, and then inquire how long she's been taking illegal drugs. D. Inform the patient she is having an abruption and prepare her for surgery.

A. Turn the patient on her left side, call the provider, place her on O2, and start an IV in order to give a fluid bolus.

A client is pregnant with her second child following a cesarean section delivery with the first pregnancy for a breech fetal position. The couple plans to have three children total. What option does the nurse discuss as the best one for this couple? A. Vaginal birth B. Repeat c-section C. External cephalic version D. Only having two children

A. Vaginal birth

A nurse is caring for a client who is pregnant and reviewing manifestations of complications the client should promptly report to the provider. Which of the following complications should the nurse include? A. Vaginal bleeding B. Swelling of the ankles C. Heartburn after eating D. Lightheadedness when lying on the back

A. Vaginal bleeding

Which nursing interventions would support a normal, physiologic birth? (Select all that apply) A. Waiting until 40 weeks gestation to induce labor B. Assisting the mother to change positions frequently C. Collaborating with a doula or other support person to manage discomfort D. Encouraging the mother to lie on her back and place her feet in stirrups for delivery E. Allowing the bag of waters to rupture spontaneously

A. Waiting until 40 weeks gestation to induce labor B. Assisting the mother to change positions frequently C. Collaborating with a doula or other support person to manage discomfort E. Allowing the bag of waters to rupture spontaneously

A client enters the labor and delivery suite stating that she thinks she is in labor. Which of the following information about the woman should the nurse gather from the woman's prenatal record when planning nursing care? (Select all that apply) A. Weight gain B. Ethnicity and religion C. Age D. Type of insurance E. Gravidity and parity

A. Weight gain B. Ethnicity and religion C. Age E. Gravidity and parity

At which time/s during the latent phase of labor should the nurse assess the fetal heart rate pattern of a low-risk woman with an obstetrical history of G1 P0000? (Select all that apply) A. With vaginal examinations B. Before administration of analgesics C. Periodically throughout several contractions D. Every 10 minutes E. Before ambulating

A. With vaginal examinations B. Before administration of analgesics C. Periodically throughout several contractions E. Before ambulating

Differentiate among the four stages of labor including the related nursing and medical care DC Ch 8 - LO 2 - 10 questions pgs 230 - 252

ACTIVE PHASE: -UC establish regular pattern (2-5 min apart), 45-60 sec in duration, moderate strength by palpation -> or = 6 cm -Discomfort increases as UC become stronger and more regular, may have backache -Requires focus to maintain control and manage pain, often requires coaching, more inwardly focused TRANSITION PHASE: -Contractions every 1-3 min, lasting 60-90 sec, strong by palpation -8-10 cm dilated (100% effaced) -Increasing discomfort as UC are strong, little time for relaxation between -Increase in rectal pressure, urge to push as fetal head descends -Often difficult to cope, may emotions: irritable, agitated, hopeless, tired -Most INTENSE phase

A client is learning about the care and use of the diaphragm. Which of the following comments by the woman shows that she understands the teaching that was provided? A. "I should regularly put the diaphragm up to the light and look at it carefully." B. "This is one method that can be used during menstruation." C. "I can leave the diaphragm in place for a day or two." D. "The diaphragm should be well powdered before i put it back in the case."

A. "I should regularly put the diaphragm up to the light and look at it carefully."

Which statement by the client indicates that she understands the teaching provided about the intrauterine device (IUD)? A. "The IUD can remain in place for a year or more." B. "I will not menstruate while the IUD is in." C. "Pain during intercourse is a common side effect." D. "The device will reduce my chances of getting infected."

A. "The IUD can remain in place for a year or more."

The nurse is providing preconception counseling to a client. Which topic is most important to educate the client on at this time? A. Adequate intake of folic acid B. Common discomforts of pregnancy C. Infant safety at home D. Gaining an appropriate amount of weight during pregnancy

A. Adequate intake of folic acid

A client has a history of toxic shock syndrome. Which of the following forms of birth control should she be taught to avoid? A. Diaphragm B. Intrauterine device C. Birth control pills (estrogen-progestin combination) D. Medroxyprogesterone acetate

A. Diaphragm

A nurse is preparing to assist an anesthesia provider who is setting up for insertion of an epidural catheter. Which of the following positions should the nurse anticipate the provider might request the client to assume? (Select all that apply) A. Fetal position B. Lithotomy position C. Trendelenburg position D. Sitting position

A. Fetal position D. Sitting position

A nurse is caring for a client who is pregnant and states that their last menstrual period was April 1st. Which of the following is the client's estimated date of delivery? A. January 8 B. January 15 C. February 8 D. February 15

A. January 8

A nurse is caring for a client who is in the second stage of labor. The client's labor has been progressing, and a vaginal delivery is expected in 20 min. The provider is preparing to administer lidocaine for pain relief and perform an episiotomy. The nurse should know that which of the following regional anesthetic block is to be administered? A. Pudendal B. Epidural C. Spinal D. Paracervical

A. Pudendal

A nurse is caring for a pregnant client in her second trimester who recently received news that her fetus has a potentially fatal condition. During her appointment, the nurse notices the woman appears unattached, and seems to have distanced herself from the fetus. Which is the priority action by the nurse? A. Recognize this as a normal response B. Document the findings in the prenatal record C. Tell the practitioner the woman is having a hard time coping D. Reassure the client that her and her baby will be okay, no matter what happens

A. Recognize this as a normal response

A couple that recently emigrated from another country visited the prenatal clinic for the first time. The nurses decided to conduct a cultural assessment of the couple. Which assessment by the nurse could assist in planning a culture-specific prenatal care for this couple? (Select all that apply) A. The couple's expectation of the health care system B. The couple's need for one-on-one prenatal care C. The couple's beliefs relating to pregnancy D. History of intimate partner violence E. A review of systems

A. The couple's expectation of the health care system C. The couple's beliefs relating to pregnancy

A nursing instructor explains to a group of students that an amnioinfusion is a procedure used most commonly in the first stage of labor to treat which type of decelerations? A. Variable B. Late C. Early D. Prolonged

A. Variable

Discuss the nurse's role in providing sexual and reproductive health care ATI Ch 1 - LO 6 - 2 questions pg 3

Assess clients' need, desire, preference for contraception. A thorough discuss of benefits, risks, and alternatives of each method should be discussed.

A client who is 6 weeks pregnant is having a pelvic examination. Which of the following would the primary healthcare provider expect to find? A. Thin cervical muscle B. An enlarged ovary C. Thick cervical mucus D. pale pink vaginal wall

B. An enlarged ovary

A nurse is caring for a client who is 40 weeks of gestation and reports having large gush of fluid from the vagina while walking from the bathroom. Which of the following actions should the nurse take? A. Examine the amniotic fluid for meconium B. Check the FHR C. Dry the client and make them comfortable D. Apply a tocotransducer

B. Check the FHR

A male client is seen at the provider's office for infertility. Which issue would the nurse question disregard as a possible cause of male infertility? A. Attending daily cycling classes at the local gym B. Having an overweight body mass index C. Smoking two to three cigarettes a day D. Taking a calcium channel blocker for hypertension

B. Having an overweight body mass index

While performing a BPP, the provider is looking for which fetal variables? (Select all that apply) A. Hypoxemia B. Tone C. Breathing D. Amniotic fluid index E. Heart rate

B. Tone C. Breathing D. Amniotic fluid index E. Heart rate

A client at 34 weeks' gestation calls the obstetric office stating, "Since last night I have had three nosebleeds." Which of the following responses by the nurse is appropriate? A. "You should see the doctor to make sure you are not becoming severely anemic." B. "Do you have a temperature?" C. "One of the hormones of pregnancy makes the nasal passages prone to bleeding." D. "Do you use any inhaled drugs?"

C. "One of the hormones of pregnancy makes the nasal passages prone to bleeding."

How is true labor defined? A. Contractions B. Braxton-Hicks contractions C. Cervical change D. Painful uterine activity

C. Cervical change

A 75-gram oral glucose tolerance test (OGTT) is ordered at or after 24 weeks' gestation for a pregnant client to assess her physiological response to which of the following pregnancy hormones? A. Estrogen B. Progesterone C. Human placental lactogen D. Human chorionic gonadotropin

C. Human placental lactogen

A nurse is instructing a client who is taking an oral contraceptive about manifestations to report to the provider. Which of the following manifestations should the nurse include? A. Reduced menstrual flow B. Breast tenderness C. Shortness of breath D. Increased appetite

C. Shortness of breath

The nurse is teaching a pregnant client about positioning to avoid supine hypotensive syndrome. Which positioning would be effective? A. Elevate her feet while she is sitting B. Dangle her feet over the edge of the bed for 30 seconds before getting up C. Sleep in a side-lying position D. Place a pillow under her knees while she is in bed

C. Sleep in a side-lying position

During preconception counseling, the nurse is teaching a client about diagnosing pregnancy. Which signs are considered probable signs of pregnancy? (Select all that apply) A. Fetal heart tones B. Quickening C. Uterine growth D. Frequent urination E. Positive home pregnancy test

C. Uterine growth E. Positive home pregnancy test

While caring for a pregnant client, which can the nurse provide to decrease fear and anxiety throughout labor and delivery? A. Ambulation B. Confidence C. Pain medication D. Labor support

D. Labor support

Describe the purpose, procedure, advantages, risks, and nursing actions of the following diagnostic tests: fetal ultrasound imaging, 3D and 4D ultrasound, MRI, and Doppler studies DC Ch 6 - LO 11 - 1 question pgs 131 - 139

Indications for testing: Factors to assess: -Biophysical -Psychosocial -Socioeconomic -Environmental Nurses role: -Teach -Assess -Provide support -Conduct certain tests -Monitor maternal and fetal response -Screening: Identify those no affected -Diagnostic: Identify a disease or a problem

Describe the emotional changes that occur during pregnancy and nursing actions that facilitate adaptation to pregnancy DC Ch 5 - LO 6 - 1 question pgs 102 - 104

MATERNAL TASKS OF PREGNANCY: -Acceptance of pregnancy, impact on the entire family -Identification with motherhood role -Relationship to her mother -Reordering partner relationships -Preparation for labor -Prenatal fear of losing control in labor -Prenatal fear of losing self-esteem in labor NURSING ROLE/ACTIONS: -Teacher, counselor, clinician, resource person, role model -Focus on health promotion, individualized care, and prevention of individual and family crises

Identify the modes of fetal heart rate assessment: auscultation, palpation, and electronic fetal/uterine monitoring DC Ch 9 - LO 5 - 1 question pgs 272 - 277

-Auscultation -External fetal monitoring (US transducer) -Internal fetal monitoring (FSE) -Palpation: *+1 Mild (Nose) *+2 Moderate (Chin) *+3 Strong (Forehead) -External uterine monitoring (TOCO) -Internal uterine monitoring (IUPC)

Describe the intraoperative nursing care and medical and anesthesia management for cesarean births DC Ch 11 - LO 12 - 1 question

-Awareness of risks: hemorrhage, bladder and bowel trauma, maternal respiratory depression, hypotension r/t anesthesia Methods of anesthesia: -Spinal (preferred for scheduled c/s) -Epidural -General (rarely used) Contraindications for epidural or spinal: -Low platelets (preeclampsia or HELLP) -Infection at proposed sit injection -Hypovolemia unresolved -Refusal by patient -Spine abnormalities -Sepsis Anesthesia management: -Bupivacaine preferred anesthetic spinal/epidural -Morphine or fentanyl given trathecally provider post -Epidural or spinal sitting table or side lying -Monitor VS, O2, level of anesthesia, effectiveness, blood loss, give antibiotics an hour of incision time, administer oxytocin after delivery of placenta

Discuss the preoperative nursing care and medical and anesthesia management for cesarean births DC Ch 11 - LO 11 - 1 question

-Patient teaching -Diagnostic lab tests -Surgical care: catheterization, NPO status -Antibiotics and VTE prophylaxis -Anesthesia management -Care for unscheduled cesarean birth -Anesthesia provider must review hx, physical and answer questions for mother/family Scheduled Nursing actions: -Admission assessment -Labs -FHR assessment -NPO -Education -Cultural assessment -Consent -IV -Foley (in OR preferred) -Pre-operative meds -Prepare support people -Surgery checklist -SCDs

Identify factors that place a woman at risk for cesarean birth DC Ch 11 - LO 10 - 0 questions

-Previous cesarean birth -Arrest of labor -Placental or uterine abnormalities -Cephalopelvic disproportion -Maternal risk factors -Malpresentation of the fetus: breech, transverse, asynclitism, OP, fetal hand presenting Maternal medical risk factors: -Hypertensive disorders -Pregnancy weight gain (>40 lbs) or obesity -Active genital herpes -Positive HIV status -Diabetes -VBAC Fetal factors: -Placental abnormalities (previa) -Dysfunctional labor patterns -Fetal distress, Category 3 FHR patterns -Multiple gestation -Umbilical cord prolapse

The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that are within normal limits during the latter half of the pregnancy. Which of the following comments by the client indicates that teaching was successful? (Select all that apply) A. "During the third trimester I may experience frequent urination." B. "During the third trimester I mya experience heartburn." C. "During the third trimester I may experience nagging backaches." D. "During the third trimester I may experience persistent headache." E. "During the third trimester I may experience blurred vision."

A. "During the third trimester I may experience frequent urination." B. "During the third trimester I mya experience heartburn." C. "During the third trimester I may experience nagging backaches."

Following a cesarean section a few hours ago, the partner of a client comes out to the nurses' station to report severe itchiness the client is experiencing. The partner voices concern that the client is experiencing an allergic reaction to the morphine given during surgery. How does the nurse respond to the client when entering to the room to assess the itching? A. "Itchiness, also known as pruritis, is a common reaction to morphine and is not considered an allergy." B. "Here is some medication to stop the itching." C. "I will note in your medical record that you have an allergy to morphine." D. "Let me call the provider and report the itching."

A. "Itchiness, also known as pruritis, is a common reaction to morphine and is not considered an allergy."

The nurse asks a woman about how the woman's husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which of the following statements? A. "My husband is ready for the pregnancy to end so that we can have sex again." B. "My husband has gained quite a bit of weight during this pregnancy." C. "My husband seems more worried about our finances now than before the pregnancy." D. "My husband plays his favorite music for my belly so the baby will learn to like it."

A. "My husband is ready for the pregnancy to end so that we can have sex again."

The nurse is instructing a woman and her partner on non-pharmacological pain relief interventions such as effleurage and using heat/cold. The client asks how these techniques work to manage pain. Which is the best statement by the nurse? A. "Only a certain number of sensations can travel to the brain at once. We replace pain signals with pleasure signals to reduce discomfort." B. "Massage and heat reduce blood flow to tissues, and temporarily numb the nerve fibers." C. "The placebo effect makes the clients believe their pain is less, even though there is no physiologic benefit of the techniques." D. "The effects are only useful in latent phase labor. As active labor starts, she will likely need opioid pain medication."

A. "Only a certain number of sensations can travel to the brain at once. We replace pain signals with pleasure signals to reduce discomfort."

The nurse is describing baseline fetal heart rate (FHR) to a practicum student. which would the nurse mention when teaching about the definition and assessment criteria related to baseline FHR? (Select all that apply) A. "Periodic changes in baseline of FHR occur in relation to uterine contractions." B. "Recurrent changes in baseline of FHR occur in less than 50% of the contractions in 20 minutes." C. "Intermittent changes in baseline of FHR occur in greater than 50% off the contractions in 20 minutes." D. "Episodic changes in baseline of FHR occur independent of uterine contractions." E. "FHR is rounded to increments of 5 beats per minute during a 10 minute window. This must be at least 2 minutes of identifiable baseline segment."

A. "Periodic changes in baseline of FHR occur in relation to uterine contractions." D. "Episodic changes in baseline of FHR occur independent of uterine contractions." E. "FHR is rounded to increments of 5 beats per minute during a 10 minute window. This must be at least 2 minutes of identifiable baseline segment."

A pregnant client tells the nurse she is concerned about how her older child will react to the birth of the new baby. Which would be the most therapeutic response by the nurse? A. "Sharing the spotlight with a new sibling can be a major crisis for a child. How old is your other child?" B. "All pregnant women feel this way when there is another child involved. It is a normal." C. "Children younger than 2 are usually aware of the pregnancy." D. "Would you like me to refer you to a family counselor so you can discuss your concerns?"

A. "Sharing the spotlight with a new sibling can be a major crisis for a child. How old is your other child?"

While the nurse is preparing a client for an emergency cesarean section, the family voices concern that the client is extremely nervous about the procedure. How does the nurse respond to the client? A. "Tell me about how you are feeling right now." B. "We do many c-sections every day, you will be fine." C. "I am going to insert the foley catheter now." D. "It is important that you try to calm down for the baby."

A. "Tell me about how you are feeling right now."

A 10-week pregnant client verbalizes feelings of ambivalence about her pregnancy. Which would be a therapeutic response by the prenatal nurse? A. "These feelings are common during the first trimester and should decrease as your pregnancy progresses." B. "Most women experience ambivalent feelings their entire pregnancy." C. "You should be excited about the pregnancy as it is a wonderful experience to bring new life into the world." D. "I am going to refer you to a psychologist for prenatal depression."

A. "These feelings are common during the first trimester and should decrease as your pregnancy progresses."

A nurse educator in the labor and delivery unit is reviewing the use of chemical agents to promote cervical ripening with a group of newly licensed nurses. Which of the following statements by a nurse indicates understanding of the teaching? A. "They are tablets absorbed vaginally." B. "They act by absorbing fluid from tissues." C. "They promote dilation of the os." D. "They include an amniotomy."

A. "They are tablets absorbed vaginally."

A pregnant woman asked the nurse why her home is being assessed for the Aedes albopictus mosquitoes. The nurse responded by saying, "I intentionally assessed your home because you are pregnant." Which other reason given by the nurse is correct? (Select all that apply) A. "Your spouse has the Zika virus and can transmit it to you during sexual intercourse." B. "You have been non-compliant with the vaccination to prevent Zika virus infection." C. "You have been reporting fever, rash, headache, and muscle pain for the past week." D. "We do not want the Zika virus to increase the growth of your baby too much." E. "The Zika virus is an infection that is spread by infected Aedes albopictus mosquitoes."

A. "Your spouse has the Zika virus and can transmit it to you during sexual intercourse." C. "You have been reporting fever, rash, headache, and muscle pain for the past week." E. "The Zika virus is an infection that is spread by infected Aedes albopictus mosquitoes."

A clinic nurse is caring for multiple clients. Which client does she identify as high risk for experiencing a teenage birth? A. A client who dropped out of high school B. A client who smokes cigarettes C. A client whose parents are divorced D. A client who uses recreational drugs

A. A client who dropped out of high school

Which of the following statements are true about FHR accelerations? (Select all that apply) A. Acceleration for a fetus over 37 weeks should last for 15 seconds and be an increase of 15 bpm. B. Accelerations are not a requirement to categorize a tracing as a category I. C. Accelerations are indicative of a normal fetus not experiencing any hypoxic concerns. D. Preterm fetuses are expected to have accelerations of 20 seconds with an increase of 20 bpm. E. Accelerations only occur after 32 weeks gestation.

A. Acceleration for a fetus over 37 weeks should last for 15 seconds and be an increase of 15 bpm. B. Accelerations are not a requirement to categorize a tracing as a category I. C. Accelerations are indicative of a normal fetus not experiencing any hypoxic concerns.

The Labor and Delivery (L&D) educator has explained to a group of nurses how the utero-placental unit functions. Which components are necessary for the fetus to receive appropriate oxygenation? (Select all that apply) A. Adequate oxygenation of the mother B. Adequate uteroplacental circulation C. Adequate umbilical circulation D. Adequate fetal blood volume E. Adequate blood flow to the placenta

A. Adequate oxygenation of the mother B. Adequate uteroplacental circulation C. Adequate umbilical circulation E. Adequate blood flow to the placenta

While presenting an educational session on childbirth the nurse was asked to discuss risk factors requiring a cesarean section. What should the nurse include in her response? (Select all that apply) A. Advanced maternal age B. Spontaneous labor onset C. Breech position D. Maternal request E. Multiparity

A. Advanced maternal age C. Breech position

When assessing the psychological adjustment of a client at 8 weeks' gestation, which of the following would the nurse expect to see signs of? A. Ambivalence B. Depression C. Anxiety D. Ecstasy

A. Ambivalence

An antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? (Select all that apply) A. Amenorrhea B. Breast tenderness C. Quickening D. Frequent urination E. Uterine growth

A. Amenorrhea B. Breast tenderness C. Quickening D. Frequent urination

The nurse is reviewing antenatal screening and diagnostic testing with a group of nursing students. The nurse explains that this test inserts a needle into the maternal abdominal area through the uterine cavity to obtain amniotic fluid. One of the student's best response is: (Select all that apply) A. Amniocentesis B. Percutaneous biopsy C. Percutaneous umbilical cord sampling D. Chorionic villus sampling (CVS)

A. Amniocentesis D. Chorionic villus sampling (CVS)

A nurse is teaching a pregnant client with schizophrenia about the care required during pregnancy. Which is the priority nursing action for the nurse? A. Assess the woman's mood, anxiety, and emotional state B. Discuss expectations about pregnancy, childbirth, and parenting C. Educate the client on potential side effects of psychotropic medications D. Determine if the client has adequate support systems in place

A. Assess the woman's mood, anxiety, and emotional state

A nurse is caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. Which of the following is the first action the nurse should take? A. Assist the client into the left-lateral position B. Apply a fetal scalp electrode C. Insert an IV catheter D. Perform a vaginal exam

A. Assist the client into the left-lateral position

Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a client at 6 weeks' gestation by telling her to do which of the following? A. Avoid eating greasy foods B. Drink orange juice before rinsing C. Consume 1 teaspoon of nutmeg each morning D. Eat three large meals plus a bedtime snack

A. Avoid eating greasy foods

Which of the following findings in a client at 8 weeks' gestation with an obstetrical history of G2 P1001, should the nurse highlight for the nurse midwife? (Select all that apply) A. Body mass index of 17 kg/m2 B. Rubella titer of 1:8 C. Blood pressure of 100/60 mm Hg D. Hematocrit of 30% E. Hemoglobin of 13.2 g/dL

A. Body mass index of 17 kg/m2 B. Rubella titer of 1:8 D. Hematocrit of 30%

When assessing the newborn, the nurse notes two vessels in the umbilical cord. What should the nurse do next? A. Call the pediatrician B. Start an IV on the infant C. Check the infant's pulse oximetry D. Listen to the infant's heart sounds

A. Call the pediatrician

Nursing responsibilities during a cesarean section include which of the following? (Select all that apply) A. Calling timeouts B. Placing identification bands on the infant and parents C. Obtaining consent for the procedure D. Placing the infant skin-to-skin E. Placing the grounding pad

A. Calling timeouts B. Placing identification bands on the infant and parents D. Placing the infant skin-to-skin

Tachysystole __________________. (Select all that apply) A. Can be caused by labor inductions and augmentations B. Can be treated by giving the mother plenty of rest and leaving her undisturbed for a few hours C. Can indicate a uterine rupture, especially if accompanied by vaginal bleeding D. Is excessive uterine activity, indicated by six or more contractions in a 10-minute period E. Requires immediate intervention with intrauterine resuscitation

A. Can be caused by labor inductions and augmentations C. Can indicate a uterine rupture, especially if accompanied by vaginal bleeding D. Is excessive uterine activity, indicated by six or more contractions in a 10-minute period E. Requires immediate intervention with intrauterine resuscitation

While assessing a pregnant patient, the nurse notes the fetal heart rate (FHR) is 125 with moderate variability, no accelerations and no decelerations. Using the National Institute of Child Health and Human Development (NICHD) Criteria, which would the nurse record as the appropriate category related to the assessment findings? A. Category I: Strongly predictive of a well- oxygenated, non-acidotic fetus. No action required. B. Category II: Indeterminate. Requires continued surveillance and reevaluation. C. Category III: Abnormal requiring prompt evaluation and intervention. D. Category IV: Fetal Demise.

A. Category I: Strongly predictive of a well- oxygenated, non-acidotic fetus. No action required.

A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy. The client's health record includes this data : G3 T1 A1 L1. how should the nurse interpret this information? (Select all that apply) A. Client has delivered one newborn at term B. Client has experienced no preterm labor C. Client has been through active labor D. Client has had two prior pregnancies E. Client has one living child

A. Client has delivered one newborn at term D. Client has had two prior pregnancies E. Client has one living child

A nurse is caring for a client who is pregnant and is to undergo a contraction stress test (CST). Which of the following findings are indications for this procedure? (Select all that apply) A. Decreased fetal movement B. Intrauterine growth restriction (IUGR) C. Postmaturity D. Placenta previa E. Amniotic fluid emboli

A. Decreased fetal movement B. Intrauterine growth restriction (IUGR) C. Postmaturity

A nurse is caring for an adolescent primiparous client in her first trimester. Which is the highest priority for this client? A. Deficient knowledge related to pregnancy psychosocial and emotional change B. Risk for injury related to the birthing process C. Decreased gastric motility related to normal physiologic pregnancy changes D. Risk for infection related to group beta strep colonization

A. Deficient knowledge related to pregnancy psychosocial and emotional change

A nurse is caring for a 30-year-old G4P2 client. She arrives at the clinic for her first prenatal visit with her husband and stepchildren. When discussing family adaptation, what developmental tasks should be included? (Select all that apply) A. Delegating household chores and tasks after the baby is born B. Purchasing diapers, wipes, bottles, and other baby care items C. Reorienting of relationships with relatives D. Expanding communication to meet emotional needs E. Preparing a birth plan that includes all members of the family

A. Delegating household chores and tasks after the baby is born B. Purchasing diapers, wipes, bottles, and other baby care items C. Reorienting of relationships with relatives D. Expanding communication to meet emotional needs

A pregnant client's primary healthcare provider has ordered a 100-gram glucose solution for a 3-hour oral glucose tolerance test (OGTT) to test the client for gestational diabetes. The nurse providing pre-procedure counseling to the client. Which of the following must the client do? (Select all that apply) A. Fast for 8 to 15 hours prior to the test B. Bring a first void urine specimen to the laboratory for testing C. Consume a solid sugar cube immediately upon awakening D. Dring 16 ounces of water 1 hour prior to the test E. Smoke no cigarettes the day of the test

A. Fast for 8 to 15 hours prior to the test E. Smoke no cigarettes the day of the test

A nurse is caring for a client who has been in labor for 12 hr with intact membranes. The nurse performs a vaginal examination to ensure which of the following prior to the performance of the amniotomy? A. Fetal engagement B. Fetal lie C. Fetal attitude D. Fetal position

A. Fetal engagement

A woman has just arrived at the labor and delivery suite. Before reporting the client's arrival to her primary healthcare practitioner, which of the following assessments should the nurse perform? (Select all that apply) A. Fetal heart rate B. Contraction pattern C. Urinalysis D. Vital signs E. Biophysical profile

A. Fetal heart rate B. Contraction pattern D. Vital signs

The nurse reviews each of the following findings in a client at 10 weeks' gestation. Which of the findings would enable the nurse to tell the client that she is positively pregnant? A. Fetal heart rate via Doppler B. Positive pregnancy test C. Positive Chadwick's test D. Montgomery gland enlargements

A. Fetal heart rate via Doppler

A nurse is caring for a client having contractions every 8 min that are 30 to 40 seconds in duration. The client's cervix is 2 cm dilated, 50% effaced, and the fetus is at a -2 station with a FHR around 140/min. Which of the following stages and phases of labor is this client experiencing? A. First stage, latent phase B. First stage, active phase C. Fist stage, transition phase D. Second stage of labor

A. First stage, latent phase

A pregnant client with four living children, one preterm infant, and one abortion visits the clinic. How is the nurse expected to record the client's data? A. G 6 T 3 P 1 A 1 L 4 B. G 5 T 2 P 1 A 1 L 4 C. G 4 T 4 P 1 A 1 L 4 D. G 3 T 1 P 1 A 1 L 4

A. G 6 T 3 P 1 A 1 L 4

During a counseling session on natural family planning techniques, how should the nurse explain the consistency of cervical mucus at the time of ovulation? A. It becomes thin and elastic B. It becomes opaque and acidic C. It contains numerous leukocytes to prevent vaginal infections D. It decreases in quantity in response to body temperature changes

A. It becomes thin and elastic

The labor and delivery nurse performs Leopold maneuvers. A soft round mass is felt in the fundal region. A flag object is noted on the clients left and small objects are noted on the right of the uterus (the client's right). A hard round mass is noted above the symphysis. Which of the following positions is consistent with these findings? A. Left occipital anterior (LOA) B. Left sacral posterior (LSP) C. Right mentum anterior (RMA) D. Right sacral posterior (RSP)

A. Left occipital anterior (LOA)

A nurse is working in the prenatal clinic. Which of the following findings seen in third-trimester clients would the nurse consider to be within normal limits? (Select all that apply) A. Leg cramps B. Varicose veins C. Hemorrhoids D. Fainting spells E. Lordosis

A. Leg cramps B. Varicose veins C. Hemorrhoids E. Lordosis

A nurse is caring for a client in the third stage of labor. Which of the following findings indicate placental separation? (Select all that apply) A. Lengthening of the umbilical cord B. Swift gush of clear amniotic fluid C. Softening of the lower uterine segment D. Appearance of dark blood from the vagina E. Fundus firm upon palpation

A. Lengthening of the umbilical cord D. Appearance of dark blood from the vagina E. Fundus firm upon palpation

The nurse is preparing a group session for childbirth preparation. The topic will include signs of impending labor. The nurse will include which topics? (Select all that apply) A. Lightening B. Decreased fetal movement C. Nesting D. Bloody show E. Weight gain

A. Lightening C. Nesting D. Bloody show

A nurse is caring for a client who is 42 weeks of gestation and is having an ultrasound. For which of the following conditions should the nurse plan for an amnioinfusion? (Select all that apply) A. Oligohydramnios B. Hydramnios C. Fetal cord compression D. Hydration E. Fetal immaturity

A. Oligohydramnios C. Fetal cord compression

The nurse is preparing a client for a cesarean section. Following the epidural anesthesia, the nurse is ready to show the partner where to stay during the surgery. Where does the nurse show the partner to go? A. On a stool next to the client's head B. On a stool next to the infant warmer C. In a waiting room next to the operating room D. In the recovery room, to await completion of the surgery

A. On a stool next to the client's head

Infertility can be caused by which of the following? (Select all that apply) A. Physical deformities B. Genetics C. Antibiotic use D. Toxoplasmosis E. Environmental factors

A. Physical deformities B. Genetics E. Environmental factors

Postoperative care of the mother and infant includes all of the following except ___________. A. Placing the infant in the nursery to promote rest B. Encouraging early ambulation C. Monitoring voids after the Foley catheter is removed D. Assisting with breastfeeding

A. Placing the infant in the nursery to promote rest

Which of the following vital sign changes should the nurse highlight for a pregnant woman's obstetrician? A. Pre-pregnancy blood pressure (BP0 100/60 and third trimester BP 140/90 B. Pre-pregnancy respiratory rate (RR) 16 rpm and third trimester rate RR 22 rpm C. Pre-pregnancy heart rate (HR) 76 bpm and third trimester HR 88 bpm D. Pre-pregnancy temperature (T) 98.6 F (37 C) and third trimester T 99.2 F (37.3 C)

A. Pre-pregnancy blood pressure (BP0 100/60 and third trimester BP 140/90

Discuss important biochemical assessments and maternal assays including the description of the procedure, advantages, risks, and nursing actions of each DC Ch 6 - LO 12 - 1 question pgs 138 - 142

Amniocentesis: -Genetic testing, fetal lung maturity, assess fetal hemolytic disease, intrauterine infection and therapy polyhydramnios **ADVANTAGES: -99% accuracy results -Find genetic disorders **RISKS: -Trauma to fetus or placenta -Bleeding or leaking amniotic fluid -Preterm labor -Maternal infection -Rh sensitization if fetal blood into circulation **NURSING ACTIONS: -Explain entire procedure -Full bladder -Comfort, suport -Prep abdomen -Assess well being mom/baby after -No heavy lifting 2 days after -Rhogam if needed

In the clinic, the nurse is discussing the recommendations for standard precaution against Zika virus infection. Which advice by the nurse will help clients avoid exposure to the virus? A. "Sleep under mosquito nets since the Aedes albopictus mosquitoes only bite at night." B. "Avoid going to communities that have active mosquito transmission of the virus." C. 'The Zika virus may cause negative pregnancy so remember to take your vaccination by the seventh week of your pregnancy." D. "It is unnecessary to use protection with an infected spouse."

B. "Avoid going to communities that have active mosquito transmission of the virus."

A 16 year old, G1 P0000, is 10 weeks pregnant. She is being seen for a prenatal visit. She tells the nurse that she felt the baby move that morning. Which of the following responses by the nurse is appropriate? A. "That is very exciting. The baby must be very healthy." B. "Can you describe what you felt?" C. "That is impossible. The baby is not big enough yet." D. "Would you please let me see if I can feel the baby?"

B. "Can you describe what you felt?"

A nurse is teaching a client about the benefits of internal fetal heart monitoring. Which of the following statements should the nurse include? (Select all that apply) A. "It is considered a noninvasive procedure." B. "It can detect abnormal fetal heart tones early." C. "It can determine the amount of amniotic fluid you have." D. "It allows for accurate readings with maternal movement." E. "It can measure uterine contraction intensity."

B. "It can detect abnormal fetal heart tones early." D. "It allows for accurate readings with maternal movement." E. "It can measure uterine contraction intensity."

The grandmother of a newly-delivered infant was in the room for the delivery. The newborn is placed skin-to-skin with the mother and covered with a warm blanket while waiting for the placenta to deliver. The grandmother expresses concern that the newborn is too cold with no clothes on. Which is the best response by the nurse? A. "I will check the temperature when I have time." B. "Skin to skin contact helps newborns to regulate temperature." C. "Please just stand out of the way of the provider." D. "The warm blanket will stop all cold air from reaching the baby."

B. "Skin to skin contact helps newborns to regulate temperature."

The nurse is caring for a client who has been dilated to 10 cm for about one hour. When assessing the client, her mother asks why the nurse has not started telling her daughter to push. Which is the appropriate response from the nurse? A. "Times are different now, we do not make women push if they do not want to." B. "The baby does better at birth if the mother waits to push once she feels the urge." C. "It is best to start pushing one hour after reaching full dilation. It will start soon." D. "The provider is not here yet, so pushing must be delayed."

B. "The baby does better at birth if the mother waits to push once she feels the urge."

A client in her third trimester is concerned that she will not know the difference between labor contractions and normal aches and pains of pregnancy. How should the nurse respond? A. "Don't worry. You'll know the difference when the contractions start." B. "The contractions may feel just like a backache, but they will come and go." C. "Contractions are a lot worse than your pregnancy aches and pains." D. "I understand. You don't want to come to the hospital before you are in labor."

B. "The contractions may feel just like a backache, but they will come and go."

A client states, "I think I might be pregnant. My period is late and I've been feeling really nauseous." Which would be the best response by the nurse? A. "That's great! I am so happy for you." B. "These are presumptive signs of pregnancy. You could be pregnant." C. "These are positive signs of pregnancy. You are absolutely pregnant." D. "You should schedule an appointment to make sure you do not have an ectopic pregnancy."

B. "These are presumptive signs of pregnancy. You could be pregnant."

A nurse is interviewing a muslim client at 38 weeks' gestation. Which of the following questions could be inappropriate for the nurse to ask? A. "Do you plan to breastfeed your baby?" B. "What do you plan to name the baby?" C. "Which pediatrician do you plan to use?" D. "How do you feel about having an episiotomy?"

B. "What do you plan to name the baby?"

A client who was seen in the prenatal clinic at 20 weeks' gestation weighed 128 lbs at that time. Approximately how many pounds would the nurse expect the client to weigh at her next visit at 24 weeks' gestation? A. 129 to 130 lb B. 131 to 132 lb C. 133 to 134 lb D. 135 to 136 lb

B. 131 to 132 lb

The nurse working in an outpatient obstetric office assesses four clients who are pregnant for the first time. Which of the client findings should the nurse highlight for the physician? (Select all that apply) A. 17 weeks' gestation; denies feeling fetal movement B. 24 weeks' gestation; fundal height at the umbilicus C. 27 weeks' gestation; salivates excessively D. 34 weeks' gestation; experiences uterine cramping E. 37 weeks' gestation; complains of hemorrhoidal pain

B. 24 weeks' gestation; fundal height at the umbilicus D. 34 weeks' gestation; experiences uterine cramping

A nurse in a prenatal clinic is caring for four clients. Which of the following clients' weight gain should the nurse report to the provider? A. 1.8 kg (4 lb) weight gain and is in the first trimester B. 3.6 kg (8 lb) weight gain and is in the first trimester C. 6.8 (15 lb) weight gain and is in the second trimester D. 11.3 kg (25 lb) weight gain and is in the third trimester

B. 3.6 kg (8 lb) weight gain and is in the first trimester

A nurse in a clinic is caring for a group of female clients who are being evaluated for infertility. Which of the following clients should the nurse anticipate the provider will refer to a genetic counselor? A. A client whose sister has alopecia B. A client whose partner has von Willebrand disease C. A client who has an allergy to sulfa D. A client who had rubella 3 months ago

B. A client whose partner has von Willebrand disease

Fathers may become ___________ when physical signs of pregnancy develop in the second trimester. A. Angry B. Ambivalent C. Regretful D. Fearful

B. Ambivalent

A nurse is caring for a client following a cesarean section four hours ago that occurred due to arrest of labor. Initially, the client was admitted to the hospital two days ago after experiencing spontaneous rupture of membranes. Which medication order does the nurse anticipate for this client? A. Bisacodyl B. Ampicillin C. Methergine D. Dexamethasone

B. Ampicillin

While assessing a post-operative cesarean section client, the nurse notes a temperature of 102.1?. Prior to calling the provider, what other assessment should the nurse complete to include when reporting the concern? A. Identify the time of last pain medication B. Assess the c-section incision C. Assess lung sounds and incentive spirometry D. Assess uterine fundus and lochia

B. Assess the c-section incision

Nursing actions for the expectant family during antenatal testing should include _________. (Select all that apply) A. Education, ensuring privacy, and performing the tests if the provider is unavailable B. Assessing for anxiety, providing emotional support, scheduling follow-up appointments C. Comfortable positioning, maintaining modesty, explaining the procedure D. A tour of the neonatal intensive care unit (NICU), an appointment with the hospital chaplain, and a discussion on maternal "do not resuscitate" (DNR) forms E. Reporting results to the patient, charting the procedure appropriately, and reviewing the patient's chart for any follow-up information that should be provided to the family

B. Assessing for anxiety, providing emotional support, scheduling follow-up appointments C. Comfortable positioning, maintaining modesty, explaining the procedure

The nurse is caring for a patient whose fetus has been diagnosed with Intrauterine Growth Restriction (IUGR). The patient asks the nurse how this could have happened. Which does the nurse recognize as a possible cause? A. The fetus has a lower oxygen tension then an adult B. Available oxygen chronically falls below 50% of normal levels and there is a redistribution of blood to vital organs C. The amount of lactic acids exceeds fetal buffering capacity D. Oxygenated blood from the mother is deliver to the intervillous space in the placenta

B. Available oxygen chronically falls below 50% of normal levels and there is a redistribution of blood to vital organs

A third-trimester client is being seen for routine prenatal care. Which of the following assessments will the nurse perform during the visit? (Select all that apply) A. Blood glucose B. Blood pressure C. Fetal heart rate D. Urine protein E. Pelvic ultrasound

B. Blood pressure C. Fetal heart rate D. Urine protein

The nurse wishes to assess the variability of the fetal heart rate. Which of the following actions must the nurse perform at this time? A. Place the client in the lateral recumbent position B. Carefully analyze the baseline data on the monitor tracing C. Administer oxygen to the mother via face mask D. Ask the mother to indicate when she feels fetal movement

B. Carefully analyze the baseline data on the monitor tracing

The nurse is assessing a laboring client. Which signs and symptoms does the nurse recognize that indicate movement into the transition phase of labor? (Select all that apply) A. Contractions every 3 to 4 minutes B. Contractions lasting 60 to 90 seconds C. Cervix dilated to 8 cm D. Noted trembling of client E. Increase in client anxiety

B. Contractions lasting 60 to 90 seconds C. Cervix dilated to 8 cm D. Noted trembling of client E. Increase in client anxiety

A mother-baby nurse just received report on four mother baby couplets and is preparing to start the first assessments of the shift. All are recovering from cesarean section deliveries. Which couplet will need to be seen first? A. Couplet #1: the infant and mother have been doing well since delivery 3 days ago and would like to be discharged in the next couple hours. B. Couplet #2: the infant has been breastfeeding successfully and the mother has required the uterine fundus to be massaged to firm. C. Couplet #3: the mother has chosen to bottle feed the infant, and the infant has lost 89 grams of the 3200-gram birth weight at 2 days of age D. Couplet #4: the infant has been experiencing difficulties latching on to breastfeed and last nursed successfully an hour and a half ago.

B. Couplet #2: the infant has been breastfeeding successfully and the mother has required the uterine fundus to be massaged to firm.

A nurse is caring for a client who is receiving oxytocin for induction of labor and has an intrauterine pressure catheter (IUPC) placed to monitor uterine contractions. For which of the following contraction patterns should the nurse discontinue the infusion of oxytocin? A. Frequency of every 2 min B. Duration of 90 to 120 seconds C. Intensity of 60 to 90 mm Hg D. Resting tone of 15 mm Hg

B. Duration of 90 to 120 seconds

The nurse is assessing the laboratory report of a client at 40 weeks' gestation. Which of the following values would the nurse expect to find elevated about pre-pregnancy levels? (Select all that apply) A. Glucose B. Fibrinogen C. Hematocrit D. Bilirubin E. White blood cells

B. Fibrinogen E. White blood cells

A client at 36 weeks' gestation is complaining of dyspnea when lying flat. Which of the following is the likely clinical reason for this complaint? A. Maternal hypertension B. Fundal height C. Hydramnios D. Congestive heart failure

B. Fundal height

A nurse is reviewing the health record of a client who is pregnant. The provider indicated the client exhibits probably signs of pregnancy. Which of the following findings should the nurse expect? (Select all that apply) A. Montgomery's glands B. Goodell's sign C. Ballottement D. Chadwick's sign E. Quickening

B. Goodell's sign C. Ballottement D. Chadwick's sign

Maternal adaptations to pregnancy can include a variety of responses. A common response that indicates complete adaptation to the new role of motherhood is _______________. A. Fear of the unknown B. Impatience for delivery to happen C. Anger at the baby and dad D. Ambivalence at the process of pregnancy

B. Impatience for delivery to happen

A nurse is caring for a laboring woman who is in transition. She does not have an epidural for pain control. Which of the following signs/symptoms would indicate that the woman is progressing into the second stage of labor? (Select all that apply) A. Bulging perineum B. Increased bloody show C. Spontaneous rupture of the membranes D. Uncontrollable urge to push E. Inability to breathe through contractions

B. Increased bloody show D. Uncontrollable urge to push E. Inability to breathe through contractions

A nurse is completing an admission assessment for a client who is 39 weeks of gestation and reports fluid leaking from the vagina for 2 days. Which of the following conditions is the client at risk for developing? A. Cord prolapse B. Infection C. Postpartum hemorrhage D. Hydramnios

B. Infection

Sarah has come to the office for her first prenatal visit today. She's a G1P0, 33 years old, and her chart states she's single, a lawyer, and pregnant through IVF. What resources would you offer her? A. A social services consult, and the phone number for a local nonprofit that provides resources for single moms. B. Information for birthing, breastfeeding, and parenting classes in the area, as well as the card for a local doula. C. None, she obviously chose to become a single mom, she should have everything she needs. D. The number for the local Christian center that offers adoption services.

B. Information for birthing, breastfeeding, and parenting classes in the area, as well as the card for a local doula.

The nurse is assessing the fetal station during a vaginal examination. Which of the following structures should the nurse palpate? A. Sacral promontory B. Ischial spines C. Cervix D. Symphysis pubis

B. Ischial spines

During a vaginal examination, the nurse palpates fetal buttocks that are in the left posterior position and are 1 cm above the ischial spines. Which of the following is consistent with this assessment? A. LOA, -1 station B. LSP, -1 station C. Left mentum posterior (LMP), +1 station D. Left sacral anterior (LSA), +1 station

B. LSP, -1 station

A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis. The nurse should evaluate which of the following tests to assess fetal lung maturity? A. Alpha-fetoprotein (AFP) B. Lecithin/sphingomyelin (L/S) ratio C. Kleihauer-Betke test D. Indirect Coombs' test

B. Lecithin/sphingomyelin (L/S) ratio

The nursing student asks the nurse about tests that are commonly performed for a suspected brain abnormality. How would the nurse respond? A. Nonstress test B. Magnetic resonance imaging C. Amniocentesis D. Doppler Velocimetry

B. Magnetic resonance imaging

The nurse plans to provide anticipatory guidance to a client at 10 weeks' gestation who is being seen in the prenatal clinic. Which of the following information would be appropriate for the nurse to provide? A. Pain management during labor B. Methods to relieve backaches C. Breastfeeding positions D. Characteristics of the newborn

B. Methods to relieve backaches

Upon admission, the nurse instructed a 39-week gestation client to lie on her back in bed for assessment and placement of the fetal monitor. After going through the medical history, the nurse assesses the client's blood pressure at 76/42. Which is the appropriate intervention? A. Retake the blood pressure with a manual cuff B. Move the client onto her left side C. Call the provider to obtain an order for IV fluids D. Continue to monitor blood pressure every 30 minutes

B. Move the client onto her left side

A client at 18 weeks' gestation telephones the obstetricians office stating, "I'm really scared. I think I have breast cancer. My breasts are filled with tumors." The nurse should base the response on which of the following? A. Breast cancer is often triggered by pregnancy B. Nodular breast tissue is normal during pregnancy C. The woman is exhibiting signs of a psychotic break D. Anxiety attacks are especially common in the second trimester

B. Nodular breast tissue is normal during pregnancy

The nurse has just completed a fetal monitoring course and is explaining the normal findings of structured intermittent auscultation (SIA) with a handheld Doppler. Which would the nurse identify as a normal finding of SIA? (Select all that apply) A. Moderate variability B. Normal baseline between 110 to 160 bpm C. Regular rhythm D. Presence of FHR increases from baseline E. Absence of FHR decreases from baseline

B. Normal baseline between 110 to 160 bpm C. Regular rhythm D. Presence of FHR increases from baseline E. Absence of FHR decreases from baseline

A nurse is performing Leopold maneuvers on a client who is in labor. Which of the following techniques should the nurse use to identify the fetal lie? A. Apply palms of both hands to sides of uterus B. Palpate the fundus of the uterus C. Grasp lower uterine segment between thumb and fingers D. Stand facing client's feet with fingertips outlining cephalic prominence

B. Palpate the fundus of the uterus

The instructor is teaching the modes of fetal heart rate and contraction assessment to a class of nursing students. What are the modes of uterine monitoring? (Select all that apply) A. Auscultation B. Palpation C. Fetal spiral electrode D. Intrauterine pressure catheter E. Tocodynamometer

B. Palpation D. Intrauterine pressure catheter E. Tocodynamometer

Which of the following exercises should be taught to a pregnant woman who complains of backaches A. Kegel exercises B. Pelvic tilting C. Leg lifting D. Crunching

B. Pelvic tilting

A client is admitted to the labor and delivery unit in active labor. There has been no prenatal care for the current pregnancy, and the on-call provider estimates the pregnancy to be around 35 weeks' gestation. Which medication will the nurse anticipate being ordered for on this client? A. Oxytocin B. Penicillin C. Magnesium sulfate D. Metoclopramide

B. Penicillin

A couple visiting the clinic voiced their concern that their unborn baby might have Trisomy 21 at birth. Which test would the nurse recommend for this couple? A. Carrier testing B. Prenatal testing C. Newborn screening D. Preimplantation testing

B. Prenatal testing

A nurse is caring for a client who is in the transition phase of labor and reports that they need to have a bowel movement with the peak of contractions. Which of the following actions should the nurse make? A. Assist the client to the bathroom B. Prepare for an impending delivery C. Prepare to remove a fecal impaction D. Encourage the client to take deep, cleansing breaths

B. Prepare for an impending delivery

A woman in her third trimester indicates that she wishes to breastfeed her baby, "but I don't think my nipples are right." Upon examination, the nurse notes that the client has inverted nipples. Which of the following actions should the nurse take at this time? A. Advise the client that is unlikely that she will be able to breastfeed B. Refer the client to a lactation consultant for advice C. Call the labor room and notify them that a client with inverted nipples will be admitted D. Teach the woman exercises to evert her nipples

B. Refer the client to a lactation consultant for advice

Conception ______________. (Select all that apply) A. Occurs in the upper posterior of the uterus B. Results in a zygote C. Is also known as ovulation D. Requires spermatogenesis and oogenesis to have occurred E. an only occur on day 14 of the menstrual cycle

B. Results in a zygote D. Requires spermatogenesis and oogenesis to have occurred

A nurse is caring for a client who is in active labor. The client reports lower-back pain. The nurse suspects that this pain is related to a persistent occiput posterior fetal position. Which of the following non pharmacological nursing interventions should the nurse recommend to the client? A. Abdominal effleurage B. Sacral counterpressure C. Showering if now contraindicated D. Back rub and massage

B. Sacral counterpressure

A laboring client with an obstetrical history of G2 P1001, was admitted 1 hour ago at 4 cm dilated and 50% effaced. She was talkative and excited at that time. During the past 10 minutes she has become serious, closing her eyes and breathing shallowly with each contraction. Which of the following is an accurate nursing assessment of the situation? A. The client is at risk of having a seizure B. The client is exhibiting an expected behavior for labor C. The client is becoming hypoxic and hypercapnic D. The client needs her alpha-fetoprotein levels checked

B. The client is exhibiting an expected behavior for labor

The nurse is caring for a pregnant client with bipolar affective disorder. Which information is important for the nurse to understand regarding mental health disorders in pregnancy? (Select all that apply) A. Mental health issues during pregnancy always create problems for the pregnant women B. The client may show difficulty with taking on the maternal role C. It is the role of the social worker to collaborate with community agencies and psychiatric facilities D. Prenatal depression and anxiety can negatively affect the growing fetus E. Psychiatric medications are not safe for pregnant women to take and should be discontinued right away

B. The client may show difficulty with taking on the maternal role D. Prenatal depression and anxiety can negatively affect the growing fetus

The charge nurse is observing a new nurse on the labor and delivery floor caring for a client in active labor and recognizes the need for additional training. Which care provided by the new nurse demonstrates a need for further orientation? (Select all that apply) A. The new nurse encourages client to use the restroom every hour B. The new nurse recommends client stay in bed and rests until it is time to push C. The new nurse explains all procedures to the client throughout the shift D. The new nurse suggests that all family members leave the room E. The new nurse assists client with breathing techniques to help with relaxation

B. The new nurse recommends client stay in bed and rests until it is time to push D. The new nurse suggests that all family members leave the room

The nurse midwife tells a client that the baby is growing and that ballottement was evident during the vaginal examination. How should the nurse explain what the nurse midwife means by ballottement? A. The nurse midwife saw that the mucous plug was intact B. The nurse midwife felt the baby rebound after being pushed C. The nurse midwife palpated the fetal parts through the uterine wall D. The nurse midwife assessed that the baby is head down

B. The nurse midwife felt the baby rebound after being pushed

Ultrasound use during pregnancy should not be used for which of the following scenarios? A. The provider is concerned about placental placement for a patient at 32 weeks and may need to admit the patient to the unit if there is a placental previa. B. The patient's husband has been able to attend a prenatal appointment for the first time at 22 weeks, and the provider wants to show him the fetus's face profile to assist with paternal adaptation. C. The infant has a nonreactive NST and the provider is going to perform a BPP for further assessment. D. The patient is 9 weeks and 4 days dated by her last menstrual period. The provider is doing an ultrasound to confirm gestational age.

B. The patient's husband has been able to attend a prenatal appointment for the first time at 22 weeks, and the provider wants to show him the fetus's face profile to assist with paternal adaptation.

A nurse is caring for a client in her third trimester. Which actions by the client would necessitate further evaluation by the nurse? A. The woman develops realistic expectations of labor and birth B. The woman does not attend childbirth classes or read books about labor and birth C. The woman deep cleans and organizes her house a few weeks prior to her due date D. The woman does not mentally rehearse or fantasize about labor

B. The woman does not attend childbirth classes or read books about labor and birth

A client is in the 10th week of her pregnancy. Which of the following symptoms would the nurse expect the client to exhibit? (Select all that apply) A. Backache B. Urinary frequency C. Dyspnea on exertion D. Fatigue E. Diarrhea

B. Urinary frequency D. Fatigue

Identify non-pharmacologic methods to promote comfort during labor and delivery DC Ch 8 - LO 3 - 2 questions pgs 255 - 262

BOTH PROMOTE POSITIVE EXPERIENCE, MUST HAVE INFORMED CONSENT Non-pharmacological methods: -Maternal position/movement -Breathing techniques -Music -Other attention-focusing strategies -Hydrotherapy, hypnotherapy, aromatherapy -Application of hot/cold -Biofeedback -Effleurage: counter/sacral pressure -TENS, acupuncture, sterile water injections Pharmacological methods: -Analgesia: pay may be entirely eliminated or lessened -Anesthesia: the partial or complete loss of sensation with or without the loss of consciousness -Analgesic (IM or IV): Morphine, butorphanol (Stadol), nalbuphine (Nubain), Sublimaze (Fentanyl) -Nitrous oxide analgesia: self administered, started and stopped at any point with quick effects, 50% NO+ 50% O2

Discuss the components of FHR and uterine contraction (UC) patterns essential to interpretation of monitor strips DC Ch 9 - LO 8 - 3 questions pgs 283 - 295

Baseline: (110-160 bpm), "average" FHR observed between contractions over a 10 min period Tachycardia: (FHR greater than 160 bpm) for greater than 10 min Bradycardia: (FHR less than 110 bpm) for greater than 10 min Variability: Fluctuations in the baseline FHR observed on the fetal monitor -Marked = > 25 -Moderate = 6- 25 bpm -Minimal = < 5 bpm -Absent: undetectable Accelerations: Increase in the FHR of 15 bpm above the fetal heart baseline; lasting at least 15 seconds to less than 2 min

A clinic nurse is evaluating a pregnant client at her first prenatal appointment. Which statement made by the client most warrants further questioning? A. "I have not been taking my prenatal vitamins because they make me sick." B. "I vomit constantly." C. "I have depression and have a history of suicidal attempts." D. "I am feeling really unsure about this pregnancy. I don't know if I am ready."

C. "I have depression and have a history of suicidal attempts."

Following cesarean delivery, a stable female infant weighing 3,126 grams is placed skin-to-skin with the mother. The client's partner asks why the infant is placed with the mother during the remainder of the surgery. What is the best response from the nurse? A. "Placing the infant with the mother reduces the need to have another nurse in the crowded operating room." B. "We can discuss this later, I need to help the surgeon right now." C. "Infants are less likely to need NICU care when placed skin-to-skin with the mother." D. "It is important to get a picture immediately after delivery of the infant."

C. "Infants are less likely to need NICU care when placed skin-to-skin with the mother."

A nursing student is examining a client's chart on the Antepartum unit and asks why an umbilical artery Doppler flow test is ordered. which would be an appropriate response for the nurse? (Select all that apply) A. "It is used for some mothers to identify the gestational age of the fetus." B. "It is used to detect any abnormal structures of the fetus." C. "It is a noninvasive screening technique that uses advanced ultrasound technology to assess resistance to blood flow in the placenta." D. "Images are obtained of blood flow in the umbilical artery." E. "This test assesses placental perfusion."

C. "It is a noninvasive screening technique that uses advanced ultrasound technology to assess resistance to blood flow in the placenta." D. "Images are obtained of blood flow in the umbilical artery." E. "This test assesses placental perfusion."

A client asks the nurse what was meant when the provider told her she had a positive Chadwick's sign. Which of the following information about the finding would be appropriate for the nurse to convey at this time? A. "It is a purplish stretch mark on your abdomen." B. "It means that you are having heart palpitations." C. "It is bluish coloration of your cervix and vagina." D. "It means the doctor heard abnormal sounds when you breathed in."

C. "It is bluish coloration of your cervix and vagina."

A nurse is caring for a client following the administration of an epidural block and is preparing to administer an IV fluid bolus. The client's partner asks about the purpose of the IF fluids. Which of the following statements should the nurse make? A. "It is needed to promote increased urine output." B. "It is needed to counteract respiratory depression." C. "It is needed to counteract hypotension." D. 'It is needed to prevent oligohydramnios."

C. "It is needed to counteract hypotension."

The nurse instructs the client on second stage positioning and pushing techniques. The nurse recognizes that the client understands the teaching when the client states: A. "Holding my breath helps increase pressure and push the baby out." B. "Having my legs in stirrups reduces the risk that I will tear." C. "Pushing on my side can increase blood flow to the baby." D. "I should begin pushing as soon as I am completely dilated."

C. "Pushing on my side can increase blood flow to the baby."

A provider has determined a client needs a cesarean section for cephalopelvic disproportion. The client asks the nurse to explain what cephalopelvic disproportion means. What is the best response by the nurse? A. "You are needing a c-section due to the baby experiencing stress from labor." B. "Let's focus on preparing for the surgery." C. "The baby is too large for your pelvis." D. "Have you had a recent ultrasound to estimate the baby's weight?"

C. "The baby is too large for your pelvis."

A client is 15 weeks pregnant. She calls her obstetrical provider's office to request medication for a headache. The nurse answers the telephone. Which of the following is the nurse's best response? A. "Because the organ systems in the baby are developing right now, you may take no medication." B. "You can take any of the over the counter medications because they are all safe in pregnancy." C. "The physician will prescribe a medication for you that has been shown not to cause any fetal injuries." D. "The physician will prescribe a rectal suppository because the medicine will not enter your bloodstream."

C. "The physician will prescribe a medication for you that has been shown not to cause any fetal injuries."

A client in her first trimester is undergoing an ultrasound test in the Radiology department. A nursing student is observing and asks the nurse why the physician ordered a three-dimensional (3D) ultrasound. The nurse's best response is: A. "The test will tell us if the mother is in preterm labor." B. "The physician wants to know the age of the fetus." C. "The test is needed for further evaluation of possible fetal anomalies of the face, heart, or skeletal system." D. "The test will identify the sex of the baby."

C. "The test is needed for further evaluation of possible fetal anomalies of the face, heart, or skeletal system."

A nurse is caring for a client and partner during the second stage of labor. The client's partner asks the nurse to explain how to know when crowning occurs. Which of the following responses should the nurse make? A. "The placenta will protrude from the vagina." B. "Your partner will report a decrease in the intensity of contractions." C. "The vaginal area will bulge as the baby's head appears." D. "Your partner will report less rectal pressure."

C. "The vaginal area will bulge as the baby's head appears."

A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements should the nurse include in the teaching? A. "You will lay on your right side during the procedure." B. "You should not eat anything for 24 hours prior to the procedure." C. "You should empty your bladder prior to the procedure." D. "The test is done to determine gestational age."

C. "You should empty your bladder prior to the procedure."

Moderate variability, early decelerations, and a baseline of 115 would indicate __________. A. A category III tracing and the need for immediate intervention B. A normal finding for a fetus having an acid-base imbalance C. A category I tracing and a normal finding D. Tachysystole and the need for internal monitoring

C. A category I tracing and a normal finding

The nurse reviews the client's umbilical artery Doppler test. which would be the nurse's interpretation if the result of the end-diastolic blood flow is absent or reversed? A. Normal B. Equivocal C. Abnormal D. Equal

C. Abnormal

The obstetric nurse is preparing a client for an epidural. What is the priority nursing intervention prior to this procedure? A. Monitor fetal heart tones B. Obtain maternal blood pressure C. Administer IV fluid bolus D. Assess for prior epidural anesthesia

C. Administer IV fluid bolus

The nurse is caring for a pregnant adolescent client during a prenatal visit. Which nursing action is a priority for this client? A. Offer advice on smoking cessation B. Give the client information about adoption C. Assess for bruises in different stages of healing D. Determine what type of birth control the client plans to use after she gives birth

C. Assess for bruises in different stages of healing

In addition to assessing bowel sounds, what other priority gastrointestinal assessment should be completed on a client following a cesarean section delivery? A. Assessing for nausea B. Last bowel movement before surgery C. Assessing for flatulence D. Tolerance of a full liquid diet

C. Assessing for flatulence

When caring for a newly widowed client in her second trimester, which must the perinatal nurse understand the importance? A. Educating the woman about the quad screen B. Assisting the woman to develop a birth plan C. Assessing the woman's level of stress and anxiety D. Assisting the woman to obtain financial assistance

C. Assessing the woman's level of stress and anxiety

A nurse working on the antepartum unit is caring for a 20 weeks gestation mother. As the nurse reviews the client's record, she notices that the lung maturity indicator test L/S ratio is < 2:1. The nurse knows that this result is indicative of: A. Fetal lung maturity B. Effective lung function C. Fetal lung immaturity D. Effective lung growth

C. Fetal lung immaturity

While caring for a client, which interventions would the nurse include in the nursing care plan to provide culturally competent care? (Select all that apply) A. Describe hospital protocols that will be followed during the delivery B. Provide teaching on nonpharmacological pain management options as they are preferred by women of the client's culture C. Identify who the woman prefers to care for her during labor and delivery D. Provide the client's preferred foods as appropriate or encourage the client's family to bring foods from home E. Determine who is the client's support person(s) and how they will participate in her care

C. Identify who the woman prefers to care for her during labor and delivery D. Provide the client's preferred foods as appropriate or encourage the client's family to bring foods from home E. Determine who is the client's support person(s) and how they will participate in her care

When performing Leopold maneuvers, the nurse notes that the fetus is in the left occiput anterior (LOA) position. Which is the best position for the nurse to place a fetoscope to hear the fetal heart rate? A. Left upper quadrant B. Right upper quadrant C. Left lower quadrant D. Right lower quadrant

C. Left lower quadrant

The nurse enters a laboring client's room. The client is complaining of intense back pain with each contraction. The nurse concludes that the fetus is likely in which of the following positions? A. Mentum anterior B. Sacrum posterior C. Occiput posterior D. Scapula anterior

C. Occiput posterior

You are triaging a patient on labor and delivery and have had a patient who is 38 weeks along on the monitors for 40 minutes. The fetal heart rate tracing baseline has been within normal range, but nonreactive for the entire time. What action would you take at this time? A. Contact the provider and request admit orders for an induction. Start an IV, and let your charge nurse know you have an admit. B. Discharge the patient home with instructions on performing fetal kick counts and to come in for her regular appointment next week. A nonreactive NST at 38 weeks is a normal finding. C. Place the vibroacoustic stimulator on the patient's abdomen where you estimate the fetal head to be and proceed to acoustically stimulate the fetus. D. Insist the patient give you a urine sample for a urine drug screen. If the fetus is unreactive, the patient may have done some sort of illicit drug and the medical team needs to know how to proceed.

C. Place the vibroacoustic stimulator on the patient's abdomen where you estimate the fetal head to be and proceed to acoustically stimulate the fetus.

A sudden gush of blood and a lengthening of the umbilical cord indicate _____________. A. Delivery of the infant in the second stage B. Delivery of the infant in the third stage C. Placental delivery in the third stage D. A postpartum hemorrhage

C. Placental delivery in the third stage

An example of a complication that would require an emergent cesarean section is __________. A Breech presentation B. Intrauterine growth retardation (IUGR) diagnosis C. Prolapsed cord D. Category I strip with a maternal febrile episode

C. Prolapsed cord

The nurse is caring for an obese patient and having difficulty maintaining the fetal heart rate (FHR) and contractions on an external fetal monitor (EFM). Which is the best action by the nurse in this situation? A. Notify the provider and document B. Insert intrauterine pressure catheter (IUPC) and fetal spiral/scalp electrode (FSE) C. Reposition patient, adjust tocodynamometer and ultrasound transducer D. Discontinue EFM and notify provider

C. Reposition patient, adjust tocodynamometer and ultrasound transducer

A nurse is caring for a client who had no prenatal care, is Rh-negative, and will undergo an external version at 38 weeks of gestation. Which of the following medications should the nurse plan to administer prior to the version? A. Prostaglandin gel B. Magnesium sulfate C. Rho(d) immune globulin D. Oxytocin

C. Rho(d) immune globulin

A nurse midwife has advised a client at 40 weeks' gestation to take evening primrose oil 2,500 mg daily as a complementary therapy. This suggestion was made because evening primrose has been shown to perform which of the following actions? A. Relieve back strain B. Improve development of colostrum C. Ripen the cervix D. Reduce the incidence of hemorrhoids

C. Ripen the cervix

Mary is a G1P0 who has been in active labor for about 9 hours. She has been focused on breathing through her contractions which have become more intense and are occurring every two minutes. The nurse does a quick assessment to check the progress of the labor and notices the bulging of the vagina and rectum. Where is Mary in the labor process? A. First stage, latent B. First stage, active C. Second stage D. Third stage

C. Second stage

Preconceptual education_______________. A. Is only important for patients who are at increased risk for pregnancy complications B. Should be offered only if the patients seem interested and are asking questions C. Should encompass health promotion, disease prevention, and nutrition for both the male and female D. Should focus on what the patient and family are doing wrong before they conceive in order to prevent infertility

C. Should encompass health promotion, disease prevention, and nutrition for both the male and female

The nurse has decided to implement the Centering Pregnancy model for prenatal care instead of the conventional antenatal care. which is the focus of this model of care? (Select all that apply) A. The nurse spends more time dealing with the complications of pregnancy. B. The nurse will be better able to take responsibility for the client's' health. C. The clients will be spending more time with the nurse in antenatal care. D. More social support will be available for clients. E. The clients will get one-on-one prenatal care.

C. The clients will be spending more time with the nurse in antenatal care. D. More social support will be available for clients.

While performing Leopold maneuvers on a woman in labor, the nurse palpates a hard round mass in the fundal area, a flat surface on the left side, small objects on the right side, and a soft round mass just above the symphysis. Which of the following is a reasonable conclusion by the nurse? A. The fetal position is transverse B. The fetal presentation is vertex C. The fetal lie is vertical D. The fetal attitude is flexed

C. The fetal lie is vertical

A woman is at a 36 weeks' gestation. Which of the following tests will be done during her prenatal visit? A. Oral glucose tolerance test B. Amniotic fluid volume assessment C. Vaginal and rectal cultures D. Karyotype analysis

C. Vaginal and rectal cultures

Being culturally competent and providing sensitive care _______________. A. Will insure a good evaluation from your patient on discharge B. Is only important when dealing with patients who don't speak English C. Will help insure positive birthing outcomes D. Is easily achieved by simply agreeing to whatever the patient preferences are

C. Will help insure positive birthing outcomes

Identify appropriate interventions to relieve common discomforts of pregnancy DC Ch - LO 5 - 1 question pgs 88 - 93

COMMON DISCOMFORTS INCLUDE: -Nausea -Vomiting -Fatigue -Urinary frequency -Nocturia -Breast tenderness -Dyspepsia -Gum hyperplasia/bleeding -Dependent edema -Leg varicosities -SOA -Numbness/tingling fingers -Supine hypotensive syndrome -Fatigue -Flatulence -Leg cramps -Round ligament pain -Painful intercourse -Nasal congestion -Back pain -Leukorrhea -Constipation -Insomnia -Ptyalism -Emotional lability **STUDY TABLE 4-5

Identify key methods for ongoing assessment of fetal wellbeing during pregnancy and nursing actions for each method DC Ch 6 - LO 13 - 1 question pgs 142 - 146

CST: -Assess ability fetus to maintain normal FHR in response to uterine contractions -Negative or normal = no significant decelerations in 10 minutes with three uterine contractions more than 40 seconds -Positive = when late decelerations with 50% of contractions BPP: NST with 30 minutes of ultrasound assessment of fetal status 1. NST reactive 2. Fetal breathing: 1 or more 30 seconds rhythmic breathing or movement 3. Fetal movement: 3 or more body/limb movements 4. Fetal tone: 1 or more extremity extension to flexion or open/close hand 5. Amniotic fluid: pocket measures at least 2 cm in 2 planes

Discuss factors in preparing for birth including choosing a provider and a place of birth, birth plan and importance of childbirth education DC Ch 5 - LO 10 - 1 question pgs 122 - 125

Choosing a provider: -Physician or midwife (mostly european based) Choosing a place of birth: -Hospital -Birth center -Home birth Birth plan Childbirth education: -Primary goal: to promote a positive childbearing experience -Topics: A & P, comfort measures, labor and birth process, relaxation and pain management -Internet resources

A nurse is caring for a client who is in the first stage of labor and is encouraging the client to void every 2 hr. Which of the following statements should the nurse make? A. "A full bladder increases the risk for fetal trauma." B. "A full bladder increases the risk for bladder infections." C. "A distended bladder will be traumatized by frequent pelvic exams." D. "A distended bladder reduces pelvic space needed for birth."

D. "A distended bladder reduces pelvic space needed for birth."

The nurse is teaching a group of students about the different types of tests performed at different stages of pregnancy. Which statement would the nurse include in the teaching? (Select all that apply) A. "Amniocentesis is an ultrasound assessment of the fetal status with an NST. It utilizes ultrasound with EFM to assess five variables." B. "Biophysical Profile (BPP) is a diagnostic procedure where a needle is inserted through the abdominal wall into the uterine cavity to obtain amniotic fluid and commonly performed for genetic testing." C. "Amniocentesis is necessary to elevate the uterus out of the pelvis for better visualization of the fetus body. It is done during the first half of the pregnancy." D. "A nonstress test is a screening tool that uses fetal heart rate patterns and accelerations as an indicator of fetal well-being." E. "Maternal Serum Alpha-Fetoprotein is a screening test that assesses for levels of AFP in the maternal blood to detect certain developmental defects in the fetus, such as neural tube defects."

D. "A nonstress test is a screening tool that uses fetal heart rate patterns and accelerations as an indicator of fetal well-being." E. "Maternal Serum Alpha-Fetoprotein is a screening test that assesses for levels of AFP in the maternal blood to detect certain developmental defects in the fetus, such as neural tube defects."

A client requests to keep the placenta following delivery. How would the nurse respond to this request? A. "We do not allow that in this hospital. It is against all regulations." B. "Can you tell me what you plan to do with the placenta? We only allow this if you plan to bury the placenta." C. "Why would you want to take that home? It will begin to smell and can attract insects." D. "I understand that this is very important to you, and I will see what I can do to honor this request."

D. "I understand that this is very important to you, and I will see what I can do to honor this request."

A nurse is caring for a client who is pregnant and undergoing a nonstress test. The client asks why the nurse is using an acoustic vibration device. Which of the following responses should the nurse make? A. "It is used to stimulate uterine contractions." B. "It will decrease the incidence of uterine contractions." C. "It lulls the fetus to sleep." D. "It awakens a sleeping fetus."

D. "It awakens a sleeping fetus."

During a prenatal education class, the educator discussed the types of environmental substances that can negatively impact pregnancy. Which statement from one of her clients would concern the nurse? A. "Exposure to substance abuse drugs in good for the pregnancy." B. "Exposure to air and environmental pollutants is harmful to the fetus." C. "Exposure to alcohol use causes harm to the fetus." D. "It is ok to use marijuana for pain."

D. "It is ok to use marijuana for pain."

The nurse takes the history of a new client at her first prenatal visit. Her obstetrical history is G2 P1001. Which of the following statements would indicate that the client should be referred to a genetic counselor? A. "My first child has cerebral palsy." B. "My first child has hypertension." C. "My first child has asthma." D. "My first child has cystic fibrosis."

D. "My first child has cystic fibrosis."

The nurse is providing education regarding exercise and pregnancy. Which response by the client indicates an understanding of the teaching? A. "I should start a new exercise routine to keep in shape." B. "I will perform non-weight bearing exercises." C. "Exercise will help me lose weight during the pregnancy." D. "Walking and stretching exercises will help with overall body conditioning."

D. "Walking and stretching exercises will help with overall body conditioning."

The nursing instructor has just completed a lecture on fetal surveillance and the use of structured intermittent auscultation (SIA). The instructor knows that teaching was effective when the students recognize which contradiction to the use of SIA? A. 32 year old G1, P0 patient at 40 weeks who is 6 cm dilated with a Category I tracing B. Presence of nurses and providers experienced in SIA C. Institutional policy addressing technique and frequency of SIA D. 26 year old G4P3 at 39 weeks who is 3 cm dilated with a Category I tracing, being induced for gestational diabetes mellitus (GDM)

D. 26 year old G4P3 at 39 weeks who is 3 cm dilated with a Category I tracing, being induced for gestational diabetes mellitus (GDM)

During her prenatal appointment, a woman's preschool-age daughter asks if she can listen to the fetal heartbeat. The nurse interprets the child's behavior as? A. An unexpected finding, as children this age are not usually interested in the pregnancy B. A cry for attention due to her mom being preoccupied by the pregnancy C. Over-enthusiasm and something that should be discussed with the child before the arrival of the baby D. A normal response of the child, according to their age

D. A normal response of the child, according to their age

The OB nurse is assessing a patient utilizing structured intermittent auscultation (SIA). Which intervention assists the nurse in identifying fetal heart tones (FHT)? A. Perform a 20 minute Non-Stress Test (NST) B. Auscultate fetal heart tones (FHT) for at least 20 minutes C. Auscultate FHT's during and after contractions for 30 seconds D. Auscultate FHT's between contractions for at least 30 to 60 seconds

D. Auscultate FHT's between contractions for at least 30 to 60 seconds

The nurse notes a fetal heart rate (FHR) deceleration that begins after the peak of the contraction and ends once the contraction is over. Which is the priority nursing action for this patient? A. Administer oxygen at 10L/mask via nonrebreather face mask B. Give an IV bolus C. Discontinue oxytocin D. Change the maternal position

D. Change the maternal position

The nurse is caring for a pregnant client and knows that this test is done for chromosomal analysis between 10-12 weeks' gestation to detect fetal anomalies caused by genetic disorders. It does not test for neural tube defects (NTDs). The nurse identified the following test as: A. Amniocentesis B. Triple marker screening C. Percutaneous umbilical cord sampling D. Chorionic villus sampling (CVS)

D. Chorionic villus sampling (CVS)

A nurse describes a client's contraction pattern as: frequency every 3 minutes and duration of 60 seconds. Which of the following responses corresponds to this description? A. Contractions lasting 60 seconds followed by a 1 minute rest period B. Contractions lasting 120 seconds followed by a 2 minute rest period C. Contractions lasting 2 minutes followed by a 60 second rest period D. Contractions lasting 1 minute followed by a 120 second rest period

D. Contractions lasting 1 minute followed by a 120 second rest period

A nurse is planning care for a newly admitted client who reports, "I am in labor and I have been having vaginal bleeding for 2 weeks." Which of the following should the nurse include in the plan of care? A. Inspect the introitus for a prolapsed cord B. Perform a test to identify the ferning pattern C. Monitor station of the presenting part D. Defer vaginal examinations

D. Defer vaginal examinations

The best time to discuss birthing classes, parenting classes, and signs of impending birth is _________. A. At admission to the unit when labor has begun B. At the first trimester visit C. During pre-conceptual screening D. During the third trimester visits

D. During the third trimester visits

Sally is a 38-year-old G3P1011 at 33 weeks 4 days admitted to antepartum for a placenta previa. She's begun having painless, heavy bleeding, and her vital signs are 100/51 mm Hg, pulse 108, respirations 20, oxygen saturation 94%, temperature 99.8°F. What type of cesarean section will she receive? A. Scheduled at 35 weeks B. Urgent, within the next hour C. Nonurgent, sometime during this shift after the other scheduled surgeries D. Emergent, immediately

D. Emergent, immediately

As the nurse, you know AFI results within normal range and a reactive NST together is a sign that the fetus ____________. A. Is in need of immediate delivery B. Is not at risk for a trisomy disorder C. Is term, at least 38 weeks D. Is stable and not suffering from hypoxemia

D. Is stable and not suffering from hypoxemia

A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit? A. Nausea B. Dyspnea C. Urinary frequency D. Leg cramping

D. Leg cramping

A nurse is caring for a client who is using patterned breathing during labor. The client reports numbness and tingling of the fingers. Which of the following actions should the nurse take? A. Administer oxygen via nasal cannula at 2 L/min B. Apply a warm blanket C. Assist the client to a side-lying position D. Place an oxygen mask over the client's nose and mouth

D. Place an oxygen mask over the client's nose and mouth

Following a cesarean section, the nurse caring for the client notes the following assessment data: Temperature 99.1?, Heart rate 136, Respirations 20, Blood pressure 82/48, and skin pale and clammy to the touch. The nurse reports concern of what postpartum complication to the provider? A. Respiratory depression B. Renal failure C. Wound infection D. Postpartum hemorrhage

D. Postpartum hemorrhage

A client states that she noticed a "white liquid" leaking from her breasts during a recent shower. Which of the following nursing responses is appropriate at this time? A. Advise the woman that she may have a galactocele B. Encourage the woman to pump her breasts to stimulate an adequate milk supply C. Assess the liquid because a breast discharge is diagnostic of a mammary infection D. Reassure the mother that this is normal in the third trimester

D. Reassure the mother that this is normal in the third trimester

A nurse is reviewing the electronic monitor tracing of a client who is in active labor. A fetus receives more oxygen when which of the following appears on the tracing? A. Peak of the uterine contraction B. Moderate variability C. FHR acceleration D. Relaxation between uterine contractions

D. Relaxation between uterine contractions

The nurse asks a client at 31 weeks' gestation to lie on the examining table during a prenatal examination. In which of the following positions should the client be placed? A. Orthopneic B. Lateral-recumbent C. Sims D. Semi-fowler

D. Semi-fowler

The nurse is assessing client 12 hours post cesarean section delivery, of a healthy male infant weighing 9 pounds 3 ounces. The client's Foley catheter was removed three hours ago. Which subjective assessment data requires immediate intervention? A. The client reports pain at a level of four and can tolerate a fiver B. The client reports the infant nursed for about 20 minutes one and a half hours ago C. The client has a blood pressure of 92/48 D. The client reports no voiding since the catheter was removed

D. The client reports no voiding since the catheter was removed

After analyzing an internal fetal monitor tracing, the nurse concludes that there is moderate variability. Which of the following interpretations should the nurse make in relation to this finding? A. The fetus is becoming hypoxic B. The fetus is becoming alkalotic C. The fetus is in the middle of a sleep cycle D. The fetus has a healthy nervous system

D. The fetus has a healthy nervous system

The nurse is assessing a pregnant patient who is externally monitored and contracting every 3 to 4 minutes with each contraction lasting 40 to 60 seconds. The peak of the contraction reads 90 on the graph paper with a resting tone of 20. The patient rates her contractions as 10/10 and is crying. Which can the nurse document, based on these findings? A. The contractions are very strong, and the patient will probably deliver soon B. The contractions are not adequate to make cervical changes C. The resting tone is too high D. The frequency and duration of contractions

D. The frequency and duration of contractions

A patient in labor asks the nurse how the monitors work. What is the nurse's best response? A. You should take a nap and not worry about those things, they are too hard to understand. B. The monitors only tell us how close your baby is to delivery. C. The electronic fetal monitors are only showing your contractions and how much fluid you have left. D. The monitors help to let us know if your baby is receiving enough oxygen through the umbilical cord and is doing ok.

D. The monitors help to let us know if your baby is receiving enough oxygen through the umbilical cord and is doing ok.

A client calls a provider's office and reports having contractions for 2 hr that increased with activity and did not decrease with rest and hydration. The client denies leaking of vaginal fluid but did not notice blood when wiping after voiding. Which of the following manifestations is the client experiencing? A. Braxton Hicks contractions B. Rupture of membranes C. Fetal descent D. True contractions

D. True contractions

Discuss pharmacologic interventions used for discomfort and pain during labor including possible complications DC Ch 8 - LO 4 - 5 questions pgs 255 - 262

EPIDURAL: -Local anesthetic - epidural space -Pain relief from UC -Pain relief from birth -Opioid and local anesthetic agent -Most common forms of pain relief in labor REGIONAL ANESTHESIA: -Maternal hypotension **PREVENT with preload IV fluids, monitor VS, constant nursing attendance -Decreased placental perfusion -Ineffective breathing pattern -Urinary retention -Post-dural puncture headache **Autologous epidural blood patch -Possible lengthened duration of labor -Limited mobility GENERAL ANESTHESIA: -May be used for unplanned, rapid (emergent) c-sections -Increased maternal blood loss r/t uterine relaxation -Possible inhalation of vomitus during administration -Fetal depression -Hypoxia

Discuss the components of FHR and uterine contraction (UC) patterns essential to interpretation of monitor strips DC Ch 9 - LO 8 - 3 questions pgs 283 - 295

Early decelerations: Nadir of decel matches peak of contraction Variable decelerations: abrupt onset of nadir <30 sec, with drop of 15 pbm below baseline > 15 sec but < 2 min Late decelerations: onset, nadir, and recovery of decel follow beginning, peak, and end of contraction Prolonged decelerations: decel is > 15 bpm and > 2 min but < 10 min VEAL CHOP: V-Variable decel, CORD COMPRESSION E-Early decel, HEAD COMPRESSION A-Accelerations, OK! L-Late decel, PLACENTAL INSUFFICIENCY, TURN OFF PITOCIN, MOM ON LEFT SIDE, 02 MASK 10 L/MIN, IV FLUIDS, CONTINUE TO MONITOR

Identify factors that influence maternal adaptation to pregnancy DC Ch 5 - LO 7 - 0 questions pgs 104 - 109

FACTORS INFLUENCING: -Multiparity -Age: adolescent, older mother (35 +) -Lesbian mothers -Single parenting -Multigestational pregnancy -Socioeconomic factors -Abused woman -Military deployment Nursing actions: -Assess adaptation: establish trust, validate concerns, refer if needed

Differentiate among the four stages of labor including the related nursing and medical care DC Ch 8 - LO 2 - 10 questions pgs 230 - 252

FIRST STAGE OF LABOR: -Referred to as stage of dilation -Begins with true onset of labor, ends with complete cervical dilation (10 cm, 100%) -Most often the longest stage -Divided into three phases, latent, active, transition Latent: -Contractions every 5-10 min, may be irregular in frequency, duration 30-45 sec, mild -0-4 cm, 0-40% effaced -UC begin as menstrual like cramps or low backache -Pain often well controlled -Pt may be excited, talkative, confident, anxious, withdrawn -May be completed at home-early and slow

Identify key methods for ongoing assessment of fetal wellbeing during pregnancy and nursing actions for each method DC Ch 6 - LO 13 - 1 question pgs 142 - 146

Fetal movement counting: -After 28 weeks is the primary method of fetal surveillance -1 hour method: 4 movements in one hour -2 hour method: 10 movements in 2 hours -Explain method and when to report abnormal findings Non-Stress Test: -Indicates fetal well-being -Widely accepted method of evaluating fetal status -FHR 15 bpm above baseline for 15 seconds X2 in 20 minutes -If <32 weeks, 10 bmp above for 10 seconds X2 in 20 minutes is reactive

Describe the purpose, procedure, advantages, risks, and nursing actions of the following diagnostic tests: fetal ultrasound imaging, 3D and 4D ultrasound, MRI, and Doppler studies DC Ch 6 - LO 11 - 1 question pgs 131 - 139

Fetal ultrasound imaging: -Can be done any trimester, depends on what is needed -Can be transvaginal, or abdominal **ADVANTAGES: -Accurate assessment of GA, fetal growth, detection of abnormalities -Noninvasive -Info on fetal structures and status **RISKS: -None **NURSING ACTIONS: -Explain -Position patient -Comfort and modesty measures -Emotional -Follow up scheduled -Document 3D and 4D Ultrasound: **ADVANTAGES: -More detailed assessment of fetal structures -3D: presentation of placental blood flow -Measurement of fetal organs -4D: allows for evaluation of brain morphology and identification of brain lesions **RISKS: -Same as standard ultrasound **NURSING ACTIONS: -Same as standard ultrasound

Describe the physiological changes that occur during pregnancy DC Ch 4 - LO 1 - 3 questions pgs 58 - 62

GASTROINTESTINAL SYSTEM: -Nausea -Vomiting -Heartburn -Bloating -Flatulence -Pica -Increased risk of gallstone formation -Increased risk of cholestasis, cholecystitis, cholelithiasis -Increase or decrease in appetite -Flatulence -Constipation -Abdominal distention, cramping, pelvic heaviness -Increased levels of estrogen leading to gingivitis, bleeding gums, periodontal disease

Describe key interventions for intrauterine resuscitation DC Ch 9 - LO 9 - 1 question pg 283 table 9-3

Goals: -Improve uterine blood flow -Improve umbilical circulation -Improve maternal/fetal oxygenation -Reduce uterine activity Interventions: -Position change -IV bolus -Oxygen (10 L non-rebreather) -Stop oxytocin

Discuss important biochemical assessments and maternal assays including the description of the procedure, advantages, risks, and nursing actions of each DC Ch 6 - LO 12 - 1 question pgs 138 - 142

Maternal Assays: AFP (Alpha-fetoprotein) -High and low levels -Abnormal findings, false positives, false negatives -Abnormal findings, false positives, false negatives **ADVANTAGES: -Can detect abdominal wall defects and anencephalies **RISKS: -False positive rate -False negative rate **NURSING ACTIONS: -Educate -Emotional support -Assist with scheduling Multiple marker screening -Used as an alternative to amniocentesis **ADVANTAGES: -Can detect 60-80% of downs -Can detect 85-90% of NTDs **RISKS: -None **NURSING ACTIONS: -Educate -Emotional support -Assist in scheduling

Identify nursing assessments and interventions that promote positive adaptation for the pregnant woman's family DC Ch 5 - LO 8 - 2 questions pgs 110 - 116

NURSING ACTIONS: -Asses knowledge related to pregnancy and childbirth -Assess cultural traditions -Assess response to pregnancy -Include entire family if appropriate -Children: allow questions, keep them involved, prepare with education -Involve social services, other referral agencies as needed

Differentiate between the presumptive, probable and positive signs of pregnancy and how to determine an estimated date of delivery DC Ch 4 - LO 3 - 2 questions pgs 74 - 76

Naegele's rule LMP-3 months+7 days+1 year= EDD, EDC (April to December) LMP+7 days+9 months= EDD, EDC (January to March) *Date of last normal menstrual period *Date of positive home pregnancy test

Differentiate among the four stages of labor including the related nursing and medical care DC Ch 8 - LO 2 - 10 questions pgs 230 - 252

Nursing interventions for FIRST STAGE: -Continually assess pt and fetus, ensuring safe birth -Labor support: presence, spirituality, promotion of comfort, anticipatory guidance, caring for birth partner, ensuring culture-centered care -Fetal assessment

Differentiate among the four stages of labor including the related nursing and medical care DC Ch 8 - LO 2 - 10 questions pgs 230 - 252

Onset of labor: -Maternal factors: pressure on the cervix, hormones, uterine contractions -Fetal factors: placenta, prostaglandins, fetal cortisol Signs of impending labor: -Contractions are at regular intervals -Contractions increase in frequency, duration, intensity -Pains usually begin in lower back, radiating to abdomen -Dilation and effacement of the cervix are progressive -Activity such as walking usually increases labor pains -Lightening -Braxton hicks -Cervical changes -Bloody show -ROM (either spontaneous or amniotomy) -Energy spurt -Weight loss -GI disturbances ROM: -Majority of time membranes rupture once labor is established -Amniotomy: artificial rupture -Amniotic fluid should be clear and odorless -Yellow-green tinged may indicate infection or fetal passage of meconium

Explain how each of the five P's affect the course of labor and delivery, and how the components are interrelated DC Ch 8 - LO 1 - 3 questions pgs 220 - 230

PASSAGE: *Passageway consists of the maternal pelvis and the soft tissues -Bony pelvis is divided into three sections: 1. Inlet 2. Midpelvis (pelvic cavity) 3. Outlet 4 types of pelvis: -Gynecoid -Android -Platypelloid -Anthropoid Station: *Refers to the level of the presenting part in relation to the maternal ischial spines -The maternal ischial spines represent the narrowest diameter through which the fetus must pass -Engagement occurs when the present part is at zero

Explain how each of the five P's affect the course of labor and delivery, and how the components are interrelated DC Ch 8 - LO 1 - 3 questions pgs 220 - 230

PASSENGER *Fetus and placenta -96% of pregnancies present with the fetus in a head-first position -Fetal skull is usually the largest part of the body structure; also the least flexible part of the fetus -The sutures and fontanelles provide some amount of flexibility in the fetal skull *These structures allow the cranial bones to move and overlap in response to the powers of labor; known as molding Fetal attitude: Refers to the relationship of the fetal parts to one another Fetal lie: Refers to the relationship of the long axis of the woman and the long axis of the fetus Fetal presentation: Refers to the fetal part that enters the pelvic inlet first and leads through the birth canal during labor Fetal position: Relationship between the passageway and the passenger -Assess engagement, station, fetal position -Presenting part can be right anterior, left anterior, right posterior, left posterior -Occiput (vertex), chin (face), sacrum (breech), acromion (shoulder) -ROA, LOA most common

Identify nursing assessments and interventions that promote positive adaptation for the pregnant woman's family DC Ch 5 - LO 8 - 2 questions pgs 110 - 116

PATERNAL ADAPTATION: -Fathers participation: styles of involvement: observer, expressive, manager, and instrumental -Effects of pregnancy on fathers: Couvade syndrome (pregnancy symptoms), changes in roles and relationships -3 Phases of adaptation: 1. Announcement phase 2. Moratorium phase 3. Focusing phase FAMILY ADAPTATION -Family adaptation: changing familial structures, developmental tasks -Sibling adaptation: greatly influenced by child's age and developmental level -Grandparent adaptation

Explain how each of the five P's affect the course of labor and delivery, and how the components are interrelated DC Ch 8 - LO 1 - 3 questions pgs 220 - 230

POWERS: *Physiological forces of labor and birth that include the uterine contractions and the maternal pushing efforts -Primary force of labor are the uterine contractions -Causes cervical effacement and dilation -Pushes the fetus down toward the birth canal -Once complete cervical dilation, maternal pushing effort serve as an additional force (secondary force of labor) What are contractions: -Rhythmic tightening of the uterus, occurring intermittently -Each contraction consists of three specific parts: 1. Increment (building of the contraction 2. Acme (peak of the contraction) 3. Decrement (decrease in the contraction) **DESCRIBED BY: -Frequency -Duration -Intensity Maternal pushing efforts: -Cervix must be fully dilated (10 cm) -Woman experiences bearing down sensation -Abdominal muscles assist -Women who experience strong urge to push are more effect than women that force themselves to push

Explain how each of the five P's affect the course of labor and delivery, and how the components are interrelated DC Ch 8 - LO 1 - 3 questions pgs 220 - 230

PSYCHE -Culture -Expectations: readiness for labor and birth, previous labor and delivery experiences -Support system -Labor support -Who is the designated birth support person? -To what extent will this person's role be? -What is the patient's level of comfort with touch? -Are there any special rituals or practices that will be used during the childbirth experience?

Describe the function of the placenta and amniotic fluid DC Ch 3 - LO 2 - 1 question pgs 48 - 51

Placenta: -Nutrients -Hormone production -Filters waste -Metabolic and gas exchange Amniotic fluid: -Cushioning -Protection -Prevents adhesion to the amniotic membranes -Freedom of fetal movement -Warmth, temperature stabilization -2nd/3rd trimester babies kidneys help produce

Differentiate among the four stages of labor including the related nursing and medical care DC Ch 8 - LO 2 - 10 questions pgs 230 - 252

SECOND STAGE OF LABOR: -Begins with full dilation of the cervix, ends with delivery of fetus -UC continue at a similar rate, every 2-3 min, last 60 sec, strong by palpation Urge to push increases as fetal head descends, many prefer to push with UC -Intense pain, burning sensation "ring of fire" -Second stage can produce second wind as pt is making progress in labor -Intense UC with pushing efforts NURSING INTERVENTIONS: -Promoting effective pushing -Achieving a position of comfort -Preparation for birth -Continued assessment of pt and fetus, monitor moves with baby

Articulate the physiology of fetal heart rate (FHR) patterns DC Ch 9 - LO 6 - 0 questions

Study charts, powerpoints, diagrams in book

Discuss the preoperative nursing care and medical and anesthesia management for cesarean births DC Ch 11 - LO 11 - 1 question

Unscheduled Nursing Actions: -Notify anesthesia, neonatal team -Continuous FHR monitor -Labs done? -Consent -Hair clip if needed -Surgery checklist -IV preload -Foley now -Pre-operative meds -Prepare support people, emotional support, communication essential -Communication team

Discuss pharmacologic interventions used for discomfort and pain during labor including possible complications DC Ch 8 - LO 4 - 5 questions pgs 255 - 262

Vaginal birth: -Local infiltration anesthesia -Pudendal block -Epidural block analgesia/anesthesia -Spinal block anesthesia -Combined spinal-epidural analgesia/anesthesia Cesarean birth: -Spinal block anesthesia -Epidural block anesthesia -General anesthesia (emergency use)

Identify the major components of preconception health care DC Ch 4 - LO 2 - 1 question pgs 68 - 74

**ACCESS TO CARE: -Always look at the baseline -Physical exam and risk assessment -Routine physical examination and screening **PRECONCEPTION ANTICIPATORY GUIDANCE AND EDUCATION: -Health maintenance -Self-care -Lifestyle choices to contraception and safety behaviors **PRECONCEPTION EDUCATION -Nutrition: BMI - obesity and risk facts, can be more difficult to conceive -Daily food checklist -Calories, increase RDA around 300 kcal/day -Protein -Water 8 -10 (8 oz) glasses/day -Prenatal vitamins: folic acid, iron supplementation, calcium, magnesium, vitamin D **EDUCATION: -Exercise - what should they avoid? -Self-care -Contraception cessation -Timing conception - natural family planning

Differentiate between the presumptive, probable and positive signs of pregnancy and how to determine an estimated date of delivery DC Ch 4 - LO 3 - 2 questions pgs 74 - 76

**PRESUMPTIVE: -Amenorrhea -Nausea -Vomiting -Breast changes -Fatigue -Urinary frequency -Quickening **PROBABLE: -Chadwick's sign -Goodell's sign -Hegar's sign -Uterine and abdominal growth -Skin hyperpigmentation: Melasma, linea nigra -Ballottement -Positive pregnancy test **POSITIVE: -Auscultation of FHR -Observation and palpation of fetal movement -Sonographic visualization of the fetus

Describe the most common methods used in assisted fertility and the nurse's role DC Ch 3 - LO 5 - 0 questions pg 53

-Hormonal therapy for endocrine factors -Lifestyle changes to correct abnormal sperm count -Corticosteroids -Antibiotics -Repair of varicocele -Repair of inguinal hernia -Transurethral resection of ejaculatory ducts -Lifestyle changes to correct fertility in females -Surgery to open fallopian tubes -Removal of uterine fibroids; myomectomy -Antibiotics to treat cervical infection

Describe the diagnostic tests/procedures used to identify causes of infertility DC Ch 3 - LO 4 - 1 question pg 53

-Lab tests: hormonal -Semen analysis -Ovulatory dysfunction analysis -Endometrial biopsy -Hysterosalpingogram -Laparoscopy

A nurse in a clinic is caring for a client who is postoperative following a salpingectomy due to an ectopic pregnancy. Which of the following statements by the client requires clarification? A. "It is good to know that I won't have a tubal pregnancy in the future." B. "The doctor said that this surgery can affect my ability to get pregnant again." C. "I understand that one of my fallopian tubes had to be removed." D. "Ovulation can still occur because my ovaries were not affected."

A. "It is good to know that I won't have a tubal pregnancy in the future."

The nurse is teaching the new pregnant mother about the placenta and its many roles in fetal development. Which statements show an understanding of the hormones the placenta produces? (Select all that apply) A. "Progesterone is the hormone that makes you feel bloated." B. "Testosterone is produced only if you are having a boy." C. "Human chorionic gonadotropin doubles or triples the longer you are pregnant." D. "Human placental lactogen helps in the production of breastmilk." E. "Estrogen is the reason for my pregnancy glow.

A. "Progesterone is the hormone that makes you feel bloated." D. "Human placental lactogen helps in the production of breastmilk." E. "Estrogen is the reason for my pregnancy glow.

Which statements indicate a phenotype? (Select all that apply) A. "The child has brown hair." B. "Wow, he sounds exactly like his father." C. "She has the most beautiful blue eyes." D. "I carry the mutation in my genes for diabetes." E. "He is short like his mother."

A. "The child has brown hair." B. "Wow, he sounds exactly like his father." C. "She has the most beautiful blue eyes." E. "He is short like his mother."

A nurse in a clinic is teaching a client about a new prescription for medroxyprogesterone. Which of the following information should the nurse include in the teaching? (Select all that apply) A. "Weight fluctuations can occur." B. "You are protected against STIs." C. "You should increase your intake of calcium." D. "You should avoid taking antibiotics." E. "Irregular vaginal spotting can occur."

A. "Weight fluctuations can occur." C. "You should increase your intake of calcium." E. "Irregular vaginal spotting can occur."

A nurse is teaching a client who is at 6 weeks of gestation about common discomforts of pregnancy. Which of the following findings should the nurse include? (Select all that apply) A. Breast tenderness B. Urinary frequency C. Epistaxis D. Dysuria E. Epigastric pain

A. Breast tenderness B. Urinary frequency C. Epistaxis

A nurse in a prenatal clinic is providing education to a client who is at 8 weeks of gestation. The client states, 'I don't like milk." Which of the following foods should the nurse recommend as a good source of calcium? A. Dark green leafy vegetables B. Deep red or orange vegetables C. White breads and rice D. Meat, poultry and fish

A. Dark green leafy vegetables

In genetic testing, which role would the nurse question performing? A. Diagnosing a fetus with a genetic disorder B. Identifying at-risk clients and families C. Providing emotional support for the client and family D. Providing a referral to support groups and genetic counseling services

A. Diagnosing a fetus with a genetic disorder

A client who is at 7 weeks of gestation is experiencing nausea and vomiting in the morning. Which of the following information should the nurse include? A. Eat crackers or plain toast before getting out of bed B. Awaken during the night to eat a snack C. Skip breakfast and eat lunch after nausea has subsided D. Eat a large evening meal

A. Eat crackers or plain toast before getting out of bed

Which statement below is true when discussing fetal kick counts? A. Kick counts, or daily fetal movement counts, should be done for about an hour every day, and include any movement, not just kicking, such as swishes, rolling, or fluttering. B. At 36 weeks gestation, patients should be taught to feel for kicking motions hourly. If the fetus isn't forcefully kicking, the patient should immediately come to the hospital. C. Daily kick counts are only important if dealing with high-risk pregnancies, otherwise they will unnecessarily worry the patient. D. Kick counts should be monitored on the external monitors at the provider's office or at the hospital. About

A. Kick counts, or daily fetal movement counts, should be done for about an hour every day, and include any movement, not just kicking, such as swishes, rolling, or fluttering.

A nurse in an infertility clinic is providing care to clients who have been unable to conceive for 18 months. Which of the following data should the nurse assess? (Select all that apply) A. Occupation B. Menstrual history C. Childhood infectious diseases D. History of falls E. Recent blood transfusions

A. Occupation B. Menstrual history C. Childhood infectious diseases

Which is an appropriate assistance the nurse can provide to the couple who found out during pregnancy that their child has a genetic disorder? (Select all that apply) A. Provide credible websites containing information specifically about the genetic disorder. B. Leave them be. They have time to learn about it later on in the pregnancy or when the child is born. C. Encourage them to communicate with one another. D. Find a support group for the couple. E. Ask the couple closed-ended questions

A. Provide credible websites containing information specifically about the genetic disorder. C. Encourage them to communicate with one another. D. Find a support group for the couple.

Ethical issues arise when clients use assisted reproductive therapies. Which are ethical issues? (Select all that apply) A. Who owns the embryos? B. Do sperm donor have rights? C. The surrogate mother funds her own treatment D. Who decides what happens with the surplus embryos? E. Should the surrogate mother do skin-to-skin with the infant after birth?

A. Who owns the embryos? B. Do sperm donor have rights? D. Who decides what happens with the surplus embryos? E. Should the surrogate mother do skin-to-skin with the infant after birth?

A nurse is education a client who has been diagnosed with infertility on how to complete a basal body temperature chart to determine her ovulation pattern. The client states, "I really don't want to take my temperature every day. Is there any other way to find out if and when I ovulate?" A. "There are a number of other ways to determine ovulation, but they all require you to be examined by an obstetrician every month." B. "A test you can do at home requires you to spit on a microscopic slide and then look at the slide under a microscope." C. "You can test your vaginal discharge each day to determine when you should have intercourse because the hormone progesterone is elevated." D. "Although there are some tests that you can perform at home, they all cost well over a hundred dollars to purchase."

B. "A test you can do at home requires you to spit on a microscopic slide and then look at the slide under a microscope."

A client who is at 8 weeks of gestation tells the nurse, "I am not sure I am happy about being pregnant." Which of the following responses should the nurse make? A. "I will inform the provider that you are having these feelings." B. "It is normal to have these feelings during the first few months of pregnancy." C. "You should be happy that you are going to bring new life into the world." D. "I am going to make an appointment with the counselor for you to discuss these thoughts."

B. "It is normal to have these feelings during the first few months of pregnancy."

After a sex education class, the school nurse overhears an adolescent discussing safe sex practices. Which of the following comments by the young person indicates that teaching about infection control was effective? A. "I don't have to worry about getting infected if I have oral sex." B. "Teen women are at highest risk for sexually transmitted infections (STIs)." C. "The best thing to do if I have sex a lot is to use spermicide each and every time." D. "Boys get human immunodeficiency virus (HIV) easier than girls do."

B. "Teen women are at highest risk for sexually transmitted infections (STIs)."

A woman asks the obstetrician's nurse about cord blood banking. Which of the following responses by the nurse would be best? A. "I think it would be best to ask the doctor to tell you about that." B. "The cord blood is frozen in case your baby develops a serious illness in the future." C. "The doctors could transfuse anyone who gets into a bad accident with the blood." D. "Cord blood banking is very expensive and the blood is rarely ever used"

B. "The cord blood is frozen in case your baby develops a serious illness in the future."

A client's amniocentesis results were reported as 46, XY. Her obstetrician informed her at the time that everything "looks good." Shortly after birth the baby is diagnosed with cerebral palsy. Which of the following responses will explain this result? A. It is likely that the client received the wrong amniocentesis results B. Cerebral palsy is not a genetic disease C. The genes that cause cerebral palsy have not yet been discovered D. The genes were never tested for cerebral palsy

B. Cerebral palsy is not a genetic disease

A couple was scheduled for an artificial insemination procedure. Which fertility condition does the nurse expect to find documented in the couple's medical record as a reason for needing this procedure? A. Unexplained infertility B. Diminished sperm motility C. Bilaterally blocked fallopian tubes D. Unsuccessful vasectomy reversal

B. Diminished sperm motility

The nurse is working with a client who states that she has multiple sex partners. Which of the following contraceptive methods would be best for the nurse to recommend to this client? A. Intrauterine device B. Female condom C. Bilateral tubal ligation D. Birth control pills

B. Female condom

From 9 weeks gestation until delivery, the growing human is referred to as a(n) ______________. A. Embryo B. Fetus C. Baby D. Zygote

B. Fetus

During a health assessment, a client was asked to state her last menstrual period. She replied, "This is my second day of having my menstrual flow." Which phase of the ovarian cycle would the nurse determine the client is in currently? A. Luteal phase B. Follicular phase C. Proliferative phase D. Ovulatory phase

B. Follicular phase

A nurse is teaching a client about potential adverse effects of implantable progestins. Which of the following adverse effects should the nurse include? (Select all that apply) A. Tinnitus B. Irregular vaginal bleeding C. Weight gain D. Nausea E. Gingival hyperplasia

B. Irregular vaginal bleeding C. Weight gain D. Nausea

Which of the following is true about isoimmunization? (Select all that apply) A. It only occurs in patients who have a positive Rh factor. B. It can be avoided with a RhoGAM injection at 28 weeks and again within 72 hours of delivery. C. The injection schedule is the same for every pregnancy to prevent it. D. It may cause hypoglycemia in the newborn after delivery. E. Abdominal trauma, such as a fall or motor vehicle accident, can also cause it.

B. It can be avoided with a RhoGAM injection at 28 weeks and again within 72 hours of delivery. C. The injection schedule is the same for every pregnancy to prevent it. E. Abdominal trauma, such as a fall or motor vehicle accident, can also cause it.

The nurse is teaching an uncircumcised male to use a condom. Which of the following information should be included in the teaching plan? A. Apply mineral oil to the tip and shaft of the condom-covered penis B. Pull back the foreskin before applying the condom C. Create a reservoir at the tip of the condom after putting it on D. Wait five minutes after ejaculating before removing the condom

B. Pull back the foreskin before applying the condom

A 3-month-old baby has been diagnosed with cystic fibrosis (CF). The mother says, "How could this happen? I had an amniocentesis during my pregnancy and everything was supposed to be normal!" What must the nurse understand about this situation? A. Cystic fibrosis cannot be diagnosed by amniocentesis B. The baby may have an uncommon genetic variant of the disease C. It is possible that the laboratory technician made an error D. Instead of obtaining fetal cells, the doctor probably harvested maternal cells

B. The baby may have an uncommon genetic variant of the disease

The nurse is administering medroxyprogesterone acetate to a postpartum client. Which of the following data must the nurse consider before administering the medication? A. The patch must be replaced at the same time each week B. The client must be taught to use sunscreen whenever in the sunlight C. The medicine is contraindicated if the woman has lung or esophageal cancer D. The client must use an alternate form of birth control for the first two months

B. The client must be taught to use sunscreen whenever in the sunlight

A woman who has had multiple miscarriages is advised to go through genetic testing. The client asks the nurse the rationale for this recommendation. The nurse should base their response on which of the following? A. The woman's pedigree may exhibit a mitochondrial inheritance pattern B. The majority of miscarriages are caused by genetic defects C. A woman's chromosomal pattern determines her fertility D. There is a genetic marker that detects the presence of an incompetent cervix

B. The majority of miscarriages are caused by genetic defects

Nurses employed in a midwifery office are attending a conference to learn about factors that increase a woman's risk of becoming infertile. To evaluate the nurses' learning, the conference coordinator tests the nurses' knowledge at the conclusion of the seminar. The nurses should know that which of the following problems increase/s a client's risk of developing fertility problems? (Select all that apply) A. Women who have menstrual cycles that are up to 30 days long B. Women who experience pain during intercourse C. Women who have had pelvic inflammatory disease D. Women who have excess facial hair E. Women who have menstrual periods that are over 5 days long

B. Women who experience pain during intercourse C. Women who have had pelvic inflammatory disease D. Women who have excess facial hair

A client asks the nurse about the importance of preconception counseling. In responding, the nurse states that preconception counseling helps women lessen risky behaviors and eliminate exposure to harmful substances. Which statement made by the nurse about contraception cessation would be included in the preconception counseling? A. "Women taking contraception up to a month before pregnancy will be better able to conceive and date the pregnancy." B. "Women using hormonal contraception need to discontinue its use at least one menstrual period before conception." C. "It may take several months or up to a year to conceive after discontinuing Depo-Provera." D. "Women using an intrauterine device (IUD) will have it removed during labor."

C. "It may take several months or up to a year to conceive after discontinuing Depo-Provera."

A couple seeking contraception and infection-prevention counseling state, "We know that the best way for us to prevent both pregnancy and infection is to use condoms plus spermicide every time we have sex." Which of the following is the best response by the nurse? A. "That is correct. It is best to use a condom with spermicide during every sexual contact." B. "That is true, except if you have intercourse twice in one evening. Then you do not have to apply more spermicide." C. "That is not true. It has been shown that condoms alone are very effective and that spermicide can increase the transmission of some viruses." D. "The is not necessarily true. Spermicide has been shown to cause cancer in men and women who use it too frequently."

C. "That is not true. It has been shown that condoms alone are very effective and that spermicide can increase the transmission of some viruses."

A nurse is caring for a couple who is being evaluated for infertility. Which of the following statements by the nurse indicates understanding of the infertility assessment process? A. "You will need to see a genetic counselor as part of the assessment." B. "It is usually the female who is having trouble, so the male doesn't have to be involved." C. "The male is the easiest to assess, and the provider will usually being there." D. "Think about adopting first because there are many babies that need good homes."

C. "The male is the easiest to assess, and the provider will usually being there."

A nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episode of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following responses should the nurse make? A. "This is due to an increase in blood calcium." B. "This is due to pressure from the uterus on the diaphragm." C. "This is due to the weight of the uterus on the vena cava." D. "This is due to increased cardiac output."

C. "This is due to the weight of the uterus on the vena cava."

A woman has been advised that the reason she has had a number of spontaneous abortions is because she has an inheritable mutation. Which of the following situations is consistent with this statement? A. A client developed skin cancer after being exposed to the sun B. A client developed colon cancer from an inherited dominant gene C. A client's genetic analysis report revealed a reciprocal translocation D. A client's left arm failed to develop when she was a fetus

C. A client's genetic analysis report revealed a reciprocal translocation

A 19-year-old client with multiple sex partners is being counseled about the hepatitis B vaccination. During the counseling sessions, which of the following should the nurse advise the client to receive? A. Hepatitis B immune globulin before receiving the vaccine B. Vaccine booster every 10 years C. Complete series of three intramuscular injections D. Vaccine as soon as she becomes 21

C. Complete series of three intramuscular injections

The nurse teaches a couple that the diaphragm is an excellent method of contraception providing that the woman does which of the following? A. Does not use any cream or jelly with it B. Douches promptly after its removal C. Leaves it in place for 6 hours following intercourse D. Inserts it at least 5 hours prior to having intercourse

C. Leaves it in place for 6 hours following intercourse

A nurse is teaching a group of clients who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the nurse include. (Select all that apply) A. Avoid any lifting B. Perform Kegel exercises twice a day C. Perform the pelvic rock exercise every day D. Use proper body mechanics E. Avoid constrictive clothing

C. Perform the pelvic rock exercise every day D. Use proper body mechanics

A man has inherited the gene for familial adenomatous polyposis (FAP), an autosomal dominant disease. He and his wife wish to have a baby. Which of the following would provide the couple with the highest probability of conceiving a healthy child? A. Amniocentesis B. Chorionic villus sampling (CVS) C. Preimplantation genetic diagnosis (PGD) D. Gamete intrafallopian transfer (GIFT)

C. Preimplantation genetic diagnosis (PGD)

A couple is seeking infertility counseling. During the history, it is noted that the man is a cancer survivor, drinks one beer every night with dinner, and takes a sauna every day after work. The response provided by the nurse should be based on which of the following? A. It is unlikely that any of these factors is affecting his fertility B. Daily alcohol consumption could be altering his sperm count C. Sperm may be malformed when exposed to the heat of the sauna D. Cancer survivors have the same fertility rates as healthy males

C. Sperm may be malformed when exposed to the heat of the sauna

A nurse is teaching an infertile couple about how the sperm travel through the man's body during ejaculation. Please put the following five major structures in order, beginning with the place where spermatogenesis occurs and continuing through the path that the sperm and semen travel until ejaculation. A. Epididymis B. Prostate C. Testes D. Urethra E. Vas deferens

C. Testes A. Epididymis E. Vas deferens B. Prostate D. Urethra

During a written exam, a nursing student was asked to list the structures derived from the primary germ layers. The student states that the mucosa of the oral and nasal cavities is derived from the ectoderm. Which other statement about the primary germ made by the student is correct? A. The mucosa of the esophagus, stomach, and intestines are developed from the mesoderm B. The bone marrow, blood, and lymphatic tissues are developed from the ectoderm C. The epidermis, hair, and nail follicles are developed from the ectoderm D. The lens, cornea, and internal ear are developed from the mesoderm

C. The epidermis, hair, and nail follicles are developed from the ectoderm

Identify the critical components of assessment and nursing care during the first, second, and third trimester visits DC Ch 4 - LO 4 - 5 questions pg 77 - 96

COMPONENTS OF INITIAL PRENATAL ASSESSMENT: -History current pregnancy -Obstetrical history (what to ask? - presumptive signs -Medical, social and family history -Physical including pelvic assessments, pap smear -Uterine growth -FHR -Nutritional assessment -Lab diagnostics: CVC, UA, HIV, RH Factor, STIs, Hep, TB, Rubella STUDY TABLE ON SLIDE 32 CH 4 POWERPOINT

Identify critical components of conception, embryonic development, and fetal development DC Ch 3 - LO 1 - 2 questions pgs 46 - 48

Conception: "Also known as fertilization, occurs when a nucleus enters the nucleus of the oocyte. Fertilization normally occurs in the outer third of the fallopian tube, The fertilized oocyte is called a zygote and contains the diploid number of chromosomes." -Occurs during fertile time of menstrual cycle -Blastocyst implants in uterus day 5-6 Implantation: "The embedding of the blastocyst into the endometrium of the uterus. Progesterone stimulates the endometrium to become thicker and more vascular. Implantation normally occurs in the upper part of the posterior wall of the uterus." Embryonic and fetal development: -Embryonic organs: --Ectoderm: Outer germ layer --Mesoderm: Middle germ layer --Endoderm: Inner germ layer Female circulatory structures: -Ductus venosus: connects the umbilical vein to the IVC -Foramen ovale: opening between the right and left atria -Ductus arteriosus: connects the pulmonary artery with the descending aorta

A woman asks the nurse, "My nuchal fold scan results were abnormal. What does that mean?" Which of the following comments is appropriate for the nurse to make at this time? A. "I am sorry to tell you that your baby will be born with a serious deformity." B. "The results show that your child will have cri du chat syndrome." C. "The test is done to see if you are at high risk for preterm labor." D. "An abnormal test indicates that your baby may have a chromosomal disorder."

D. "An abnormal test indicates that your baby may have a chromosomal disorder."

A nurse in an obstetrical clinic is teaching a client about using an IUD for contraception. Which of the following statements by the client indicates an understanding of the teaching? A. "An IUD should be replaced annually during a pelvic exam." B. "I cannot get an IUD until after I've had a child." C. "I should plan on regaining fertility 5 months after the IUD is removed." D. "I will check to be sure the strings of the IUD are still present after my periods."

D. "I will check to be sure the strings of the IUD are still present after my periods."

A nurse is reviewing postpartum nutrition needs with a group of clients who have begun breastfeeding their newborns. Which of the following statements by a member of the group indicates an understanding of the teaching? A. "I am glad I can have my morning coffee." B. "I should take folic acid to increase my milk supply." C. "I will continue adding 330 calories per day to my diet." D. "I will continue my calcium supplements because I don't like milk."

D. "I will continue my calcium supplements because I don't like milk."

A nurse in a clinic receives a phone call from a client who would like to be tested in the clinic to confirm a pregnancy. Which of the following information should the nurse provide to the client? A. "You should wait until 4 weeks after conception to be tested." B. "You should be off any medications for 24 hours prior to the test." C. "You should be NPO for at least 8 hours prior to the test." D. "You should collect urine from the first morning void."

D. "You should collect urine from the first morning void."

A postpartum client has decided to use medroxyprogesterone acetate as her contraceptive method. What should the nurse advise the client regarding this medication? A. Take the pill the same time each day B. Refrain from breastfeeding while using the method C. Expect to have no periods as long as she takes the medicine D. Consider switching to another birth control method in a year or so

D. Consider switching to another birth control method in a year or so

A nurse in a clinic is teaching a client of childbearing age about recommended folic acid supplements. Which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency? A. Iron deficiency anemia B. Poor bone formation C. Macrosomic fetus D. Neural tube defects

D. Neural tube defects

A nurse is reviewing a new prescription for iron supplements with a client who is at 8 weeks of gestation and has iron deficiency anemia. Which of the following beverages should the nurse instruct the client to take the iron supplements with? A. Ice water B. Low-fat or whole milk C. Tea or coffee D. Orange juice

D. Orange juice

The nurse is teaching a young woman how to use the female condom. Which of the following should be included in the teaching plan? A. Reuse female condoms no more than five times B. Refrain from using lubricant because the condom may slip out of the vagina C. Wear both female and male condoms together to maximize effectiveness D. Removed the condom by twisting the outer ring and pulling gently

D. Removed the condom by twisting the outer ring and pulling gently

Describe the physiological changes that occur during pregnancy DC Ch 4 - LO 1 - 3 questions pgs 58 - 62

ENDOCRINE SYSTEM: -Corpus luteum: increased hCG until placenta fully functional (in ovaries, only during pregnancy) -Estrogen: growth -Progesterone: maintenance -Increased prolactin: facilitates lactation -Increase oxytocin: contractions -Vasopressin (ADH) -Hyperplasia and increase vascularity of thyroid -Increased BMR -Increased need for glucose -Increase in circulating cortisol

Identify critical components of conception, embryonic development, and fetal development DC Ch 3 - LO 1 - 2 questions pgs 46 - 48

Ectoderm: -Epidermis, hair and nail follicles, sweat glands, nervous system, pituitary gland, adrenal medulla, lens and cornea, internal ear, mucosa of oral and nasal cavities, salivary glands Mesoderm: -Dermis, bone and cartilage, skeletal muscles, cardiac muscles, most smooth muscles, kidneys, adrenal cortex, bone marrow and blood, lymphatic tissue, lining of blood vessels Endoderm: -Mucosa of esophagus, stomach, intestines, epithelium of respiratory tract, lungs, liver and mucosa of gallbladder, thyroid gland, pancreas

Describe the physiological changes that occur during pregnancy DC Ch 4 - LO 1 - 3 questions pgs 58 - 62

INTEGUMENTARY SYSTEM: -Hyperpigmentation: chloasma, linea nigra -Cutaneous vascular changes -Striae gravidarum -Varicosities, spider nevi -Palmar erythema -Hot flashes -Facial flushing -Alternating sensation of hot/cold -Increased perspiration

List common causes of infertility DC Ch 3 - LO 3 - 1 question pgs 52 - 53

Male: -Endocrine disorders/diseases -Impaired spermatogenesis -Drugs -Infections/viruses -Systemic illness -Prolonged heat exposure -Pesticide exposure -Radiation -Vasectomy reversal -Erectile dysfunction Female: -Hormonal imbalances -Hyperthyroidism -Hypothyroidism -High prolactin levels -Premature ovarian failure -Polycystic ovarian syndrome

Identify the critical components of assessment and nursing care during the first, second, and third trimester visits DC Ch 4 - LO 4 - 5 questions pg 77 - 96

Pregnancy classification system: -Trimesters: *First: 0-13 weeks *Second: 14-27 weeks *Third: 28-40 weeks Gravid/gravida/gravidity: -Nulligravida: never had a baby -Primigravida: first pregnancy -Multigravida: several pregnancies -Parity: reach 20 wks 0 days GTPAL (Gravida, Term, Pre-term, Abortions, Living) -Abortion: <20 weeks -Preterm: Before 20-37 weeks gestation -Term: 37 weeks exactly -Post term: >42 weeks Viability: 24 weeks

Describe the physiological changes that occur during pregnancy DC Ch 4 - LO 1 - 3 questions pgs 58 - 62

REPRODUCTIVE SYSTEM: BREASTS: -Tenderness, feeling of fullness, tingling sensation -Increase in weight of breast by 400 g -Enlargement of breasts, nipples, areola, montgomery follicles -Striae -Prominent veins -Increase in lactiferous ducts -Production of colostrum UTERUS, CERVIX: -Hypertrophy of uterine wall -Softening of vaginal muscle and connective tissue -Uterus contractility increases -Hypertrophy of cervical glands, mucus plug -Increased vascularity -Cessation of menstrual cycle -Weight increases from 70 to 1100 g at term -Braxton-hicks contractions -Chadwick's sign -Goodell sign VAGINA AND VULVA: -Thickening of vaginal mucosa -Rugae -Become edematous -More susceptible to yeast infections -pH: decreases from 6.0 to 3.5 - more acidic -Increase in vaginal discharge (leukorrhea) -Discuss vulvar hygiene

Describe the physiological changes that occur during pregnancy DC Ch 4 - LO 1 - 3 questions pgs 58 - 62

RESPIRATORY SYSTEM: -Tidal volume increases 35-50% -Increased hormones = dyspnea, nasal/sinus congestion (nosebleeds) -Diaphragm displaced upward, shift abdominal to thoracic breathing as pregnancy progresses -Slight increase in RR -Increase in respiratory capacity -Decrease in expiratory volume -Slight hyperventilation -Slight respiratory alkalosis