L and D Final

When assessing the psychological adjustment of an 8-week gravida, which of the following response would the nurse expect? Ambivalence Depression Anxiety Ecstasy

Ambivalence

A newly delivered client complains of sore nipples while breastfeeding. What is a priority nursing action? A. Administer ibuprofen B. Assess for proper latch and positioning of the baby. C. Request a lactation consult. D. Give the new mother nipple shields to use until the soreness decreases.

B. Assess for proper latch and positioning of the baby.

A nurse is providing discharge teaching to the parents of a newborn. Which of the following should be included when teaching the parents how to care for the baby's umbilical cord? A. Cleanse it with hydrogen peroxide if it starts to smell. B. Remove it with sterile tweezers at one week of age. C. Call the doctor if greenish drainage appears. D. Cover it with sterile dressings until it falls off.

C. Call the doctor if greenish drainage appears.

The RN caring for a multiparous client in the immediate postpartum period assesses a firm fundus and a continuous trickle of blood from the vagina. What should the nurse assess the client for? A. Prolapsed uterus B. Vaginal hematoma C. Cervical or vaginal laceration D. Retained placental fragments

C. Cervical or vaginal laceration

A woman who is 28 weeks pregnant visits the clinic fearing she is experiencing preeclampsia. Which of the following assessments would the nurse make to confirm or negate these thoughts? Select all that apply. A. Dull back ache B. Edema of the feet C. Epigastric pain D. Severe headache E. Uterine contractions F. Visual disturbances

C. Epigastric pain D. Severe headache F. Visual disturbances

Which infant would require the most immediate attention by the nurse? A. The infant with a respiratory rate of 48 and apneic periods that last no more than 15 seconds. B. The infant with bluish color extremities and a heart rate of 120 beats per minute C. The infant with an irregular respiratory rate of 56 breaths/minute and nasal flaring D. The infant with an irregular respiratory rate of 52 breaths/minute and bluish color extremities.

C. The infant with an irregular respiratory rate of 56 breaths/minute and nasal flaring

A labor nurse is caring for a client, 37 weeks' gestation, who has been diagnosed with placenta previa. Which of the following physician orders should the nurse question? A. Type and cross match her blood B. Administer an oral stool softener C. Insert an internal fetal monitor electrode D. Assess her complete blood count

Insert an internal fetal monitor electrode

What are the primary factors in breast milk production for a newly delivered woman? Production of estrogen and progesterone. Production of prolactin and suckling of the infant at the breast. Production of estrogen and oxytocin resulting in the let down reflex. Stored nutrients and development of the lactiferous sinuses.

Production of prolactin and suckling of the infant at the breast.

A client is 35 weeks' gestation. Which of the following findings would the nurse expect to see? Nausea and vomiting Maternal ambivalence Fundal height measurement of 26 cm. Use of three pillows for sleep comfort

Use of three pillows for sleep comfort

The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that she might experience in the coming weeks. Which of the following comments by the client indicates that further teaching is needed? "During the third trimester I may experience frequent urination." "During the third trimester I may experience heartburn." "During the third trimester I may experience back pain." "During the third trimester I may experience persistent headache."

"During the third trimester I may experience persistent headache."

A couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). The nurse's most appropriate reply is: A. "These methods have a few advantages and several health risks." B. "You would be much safer going on the pill and not having to worry." C. "They're not very effective and it's likely you will get pregnant." D. "They can be effective for many couples but they require motivation."

"They can be effective for many couples but they require motivation."

A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. What signs and symptoms should the nurse include in the discussion? Select all that apply. 1. Breast tenderness 2. Warmth in the breast 3. An area of redness on the breast often resembling the shape of a pie wedge 4. A small white blister that may be seen on the tip of the nipple 5. Fever and flulike symptoms.

1. Breast tenderness 2. Warmth in the breast 3. An area of redness on the breast often resembling the shape of a pie wedge 5. Fever and flulike symptoms.

Which woman is at greatest risk for early postpartum hemorrhage? A. A woman with severe preeclampsia on magnesium sulfate whose labor is being induced B. A multiparous woman with an 8 hour labor C. A primagravida in spontaneous labor with pre- term twins. D. A primiparous woman being prepared for an emergency cesarean birth for fetal intolerance to labor

A. A woman with severe preeclampsia on magnesium sulfate whose labor is being induced

Which factor in a client's history places a woman at greatest risk for postpartum endometritis? A. Cesarean delivery after 24 hours of labor and failure to progress. B. Use of external fetal monitoring during labor. C. Ruptured membranes for 4 hours prior to delivery. D. Spontaneous vaginal delivery after 8 hours of labor.

A. Cesarean delivery after 24 hours of labor and failure to progress.

In evaluating the effectiveness of oxytocin induction, the nurse would expect: A. Contractions lasting 60 to 90 seconds, 2 to 3 minutes apart. B. The intensity of contractions to be at least 110 130 mm Hg C. Labor to progress at least 2cm/hr dilation. D. At least 30 milliunits/min of oxytocin will be needed to achieve dilation.

A. Contractions lasting 60 to 90 seconds, 2 to 3 minutes apart.

The client's vaginal exam reveals: 3 centimeters dilated, 80% effaced, vertex at a -1 station. This client is in which stage of labor? A. First stage, latent phase. B. First stage, active phase. C. Second stage, latent phase. D. Third stage, transition phase.

A. First stage, latent phase.

What risk should the nurse anticipate for a 30 week preterm infant who weights 1500 grams? A. Increased intercranial pressure B. Hypoplastic left heart disease C. Hyperglycemia D. Hyperthermia

A. Increased intercranial pressure

Identify the purpose of the placenta during pregnancy. Select all that apply. A. Nutrition. B. Maintains thermoregulation of the fetus. C. Produces hormones to maintain the pregnancy. D. Excretion of fetal metabolic wastes. E. Cushions the fetus. F. Respiration: diffusion of oxygen.

A. Nutrition. C. Produces hormones to maintain the pregnancy. D. Excretion of fetal metabolic wastes. F. Respiration: diffusion of oxygen.

The client has been having contractions every 5 minutes for 7 hours. Which finding would the nurse use to determine if this is true labor? A. The cervix is effacing and dilating. B. This is the client's second baby. C. The contractions are more intense. D. The membranes have ruptured.

A. The cervix is effacing and dilating.

A baby's blood type is B negative. The baby is at risk for hemolytic jaundice if the mother has which of the following blood types? A. Type O negative B. Type A negative C. Type B positive D. Type AB positive

A. Type O negative

The nurse has received shift report on the postpartum unit. Which client should the nurse see first? A.Primipara, day of delivery, fundus 2 cm above umbilicus deviated to left. B.Multipara, third day post-cesarean, moderate lochia serosa. C.Multipara, first postpartum day, 3 cm diastasis recti abdominis. D.Primipara, first postpartum day, hypoactive bowel sounds all quadrants.

A.Primipara, day of delivery, fundus 2 cm above umbilicus deviated to left.

Which of the following findings would be concerning to the nurse caring for the newborn? A. Respirations 62 at one minute of age B. Short periods of apnea (< 15 seconds) C. Expiratory grunting D. Shallow and irregular respirations

C. Expiratory grunting

A woman gave birth 48 hours ago to a healthy baby girl. She has decided to bottle feed. During your assessment, you notice that both breasts are swollen, warm, and tender upon palpation. The woman should be advised that this condition can best be treated by: A. Running warm water on her breasts during a shower. B. Applying ice to the breasts for comfort. C. Expressing small amounts of milk from the breasts to relieve pressure. D. Wearing a loose-fitting bra to prevent nipple irritation.

B. Applying ice to the breasts for comfort.

Which structure allows oxygenated blood of the fetus to flow directly into the left atrium of the heart from the right atrium? A. Umbilical vein B. Foramen ovale C. Ductus venosus D. Ductus arteriosus

B. Foramen ovale

Which of the following would the nurse identify as characteristic of an SGA newborn? A. Weight above 10th percentile on standard growth chart. B. Maternal history of malnutrition or premature placental aging. C. Stable temperature control. D. Small anterior fontanel.

B. Maternal history of malnutrition or premature placental aging.

Physiological jaundice is frequently seen in newborns. The nurse understands that this phenomenon is due to: A. Rapid increase in RBC production, along with blocked bile ducts. B. Rapid destruction of the RBC, coupled with immature liver function. C. Contamination of the cord, rapid destruction of WBCs and RBCs. D. Blocked common bile duct and immature function of liver enzymes.

B. Rapid destruction of the RBC, coupled with immature liver function.

A nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which of the following is noted on the external monitor tracing during a contraction? A. Early decelerations B. Variable decelerations C. Late decelerations D. Presence of moderate variability

B. Variable decelerations

A nurse is preparing to perform a fundal assessment on a postpartum client. The initial nursing action in performing this assessment is which of the following? A. Ask the client to turn on her side. B. Ask the client to lie flat on her back with the knees and legs flat and straight. C. Ask the mother to urinate and empty her bladder. D. Massage the fundus gently before determining the level of the fundus.

C. Ask the mother to urinate and empty her bladder.

Which is the best indication that the postpartum client's uterus is involuting normally? A. Lochia alba on the second day postpartum B. Lochia rubra on the fifth day postpartum C. Lochia serosa on the third day postpartum D. Lochia with clots on the fourth day postpartum

C. Lochia serosa on the third day postpartum

A nurse is aware that labor and birth will most likely proceed normally when the fetal position is: A. Occiput posterior. B. Mentum anterior. C. Occiput anterior. D. Mentum posterior.

C. Occiput anterior.

Which of the following nursing observations would indicate a sign of impending placental separation and expulsion? A. Steady trickle of blood with an unchanged cord length. B. No bleeding with lengthening of the cord. C. Small gush of blood with lengthening of the cord. D. Small gush of blood with an unchanged cord length.

C. Small gush of blood with lengthening of the cord.

A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a BMI of 17.5. She admits to having used cocaine "several times" during the past year, and drinks alcohol occasionally. Her blood pressure is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths per minute. Family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect. Which characteristics place the woman in a high risk category? A. Blood pressure, age, BMI. B. Drug & alcohol use, age, family history. C. Family history, blood pressure, BMI. D. Family history, BMI, drug & alcohol use

D. Family history, BMI, drug & alcohol use

A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was September 18, 2015. Her expected date of delivery (EDD) would be: A. July 25, 2016 B. June 18, 2016 C. June 11, 2016 D. June 25, 2016

D. June 25, 2016

While ambulating in the labor triage area, a multipara in latent phase of labor experiences spontaneous rupture of membranes. Which is the first priority nursing action? A. Notify physician or midwife immediately. B. Document the time of rupture of membranes. C. Test the fluid with nitrazine paper to confirm membrane rupture. D. Monitor the fetal heart rate and pattern.

D. Monitor the fetal heart rate and pattern.