Maternal-Newborn

A nurse is teaching a female client who is unable to conceive how to monitor her basal body temperature. Which instruction would the nurse prioritize for this client? Record body temperature every night Record menses and time of intercourse Chart body temperature for at least a month Record body weight along with the temperature

Chart body temperature for at least a month

A client at 38 weeks' gestation is admitted to labor and delivery with heavy vaginal bleeding after sustaining abdominal trauma during a motor vehicle accident. 1Assess maternal vital signs. 2Assess uterine tone. 3Obtain blood for routine labs. 4Administer pain medication.

Assess maternal vital signs. Assess uterine tone. Obtain blood for routine labs. Administer pain medication.

The nurse's assessment identified signs that the client is depressed. What is the nurse's greatest concern for a client who is depressed? Harm to self Lack of a social network Withdrawal from others Poor nutrition

Harm to self

At 8 weeks' gestation a woman experiences severe cramping and vaginal bleeding with clots. The health care provider confirms that she is having a miscarriage. What is the priority laboratory test for the provider to obtain in the care of this client? Rh factor Blood group Hemoglobin and hematocrit Human chorionic gonadotropin level

Rh factor

The nurse is screening a woman during a home visit following birth. The nurse identifies which risk factors for developing postpartum depression? Select all that apply. Low self-esteem Feeling overwhelmed and out of control Low socioeconomic status Lack of social support Involving family in infant care

Low self-esteem Feeling overwhelmed and out of control Low socioeconomic status Lack of social support

After a postpartum hemorrhage, what signs would alert the nurse to the development of hypovolemic shock? Tachycardia, hypotension, and decreased urine output Bradycardia, hypertension, and low platelets Tachycardia, hypertension, and decreasing hematocrit levels Bradycardia, hypotension, and decreasing SpO2

Tachycardia, hypotension, and decreased urine output

A woman in active labor suddenly experiences a sharp, excruciating low abdominal pain, which the nurse suspects may be a uterine rupture since the shape of the abdomen has changed. The nurse calls a code, and a cesarean birth is performed stat, but the infant does not survive the trauma. A few hours later, after the woman has stabilized, she asks to hold and touch her infant, and the nurse arranges this. Later, the nurse's documentation should include which outcome statement? The parents continue to mourn the loss of their infant. The parents just cannot believe their perfect infant died. The parents are beginning to demonstrate positive grieving behaviors. The parents are exhibiting dysfunctional coping mechanisms related to the death of their newborn.

The parents are beginning to demonstrate positive grieving behaviors

A client at 32 weeks' gestation is admitted to labor and delivery with vaginal bleeding and contractions. The physician orders a course of two steroid injections. The client asks why she needs steriods. What is the best explanation by the nurse? The steroids speed up the development of the lungs. The steroids will help to slow the development of infection. The steroids will increase the baby's muscle mass. The steroids will create a layer of fat to help with temperature regulation.

The steroids speed up the development of the lungs.

An 11-year-old boy was raised in a home where his father beat his mother on a regular basis. Which statement is true regarding children being raised in a home where they have witnessed intimate partner violence? They are at increased risk for being abused. They have higher rates of schizophrenia. It has little impact on child functioning. Female children are more likely to experience depression.

They are at increased risk for being abused.

During her annual visit, a woman states that she is trying to become pregnant. The nurse takes an inventory of all the over-the counter medications, vitamins, and supplements the woman uses. Which item on this list would the nurse instruct the woman to discontinue in case she becomes pregnant? Folate-enriched vitamins Iron supplement Vitamin A capsules Vitamin D Tablets

Vitamin A capsules

A client chooses the mini-pill (progestin-only pill) for contraception. What does the nurse teach the client about the effectiveness of this form of contraception? You must take it in the same three-hour window every day or it will not be effective. You must take one pill each day. If you miss one pill you can take 2 the next day. You must take it within 12 hours of having intercourse to prevent conception. You must take one of the supplemental pills just before having intercourse.

You must take it in the same three-hour window every day or it will not be effective.

A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes? Select all that apply. maternal age less than 18 years genitourinary tract abnormalities obesity hypertension previous large for gestational age (LGA) infant

obesity hypertension previous large for gestational age (LGA) infant

During an ultrasound, the client's placenta is visualized low in the uterus and covers the cervix. The nurse explains to the client that this finding is a characteristic of: placenta previa. placental abruption. placenta accreta. placental insufficiency.

placenta previa.

A woman is using basal body temperature to determine her fertile period. Which statement by the client indicates that she understands this method? "I will take my temperature first thing in the morning, before I lift my head off the pillow." "I will take my temperature before going to bed in the evening, just before my head hits the pillow." "I will take my temperature at the same time each day." "I will take my temperature immediately after getting out of bed in the morning."

"I will take my temperature first thing in the morning, before I lift my head off the pillow."

The client reports that she feels nasal congestion but does not believe she has a cold. Which response by the nurse best explains this symptom? "That is normal. It is because of the hormone changes and increased blood volume during pregnancy, which causes the tiny blood vessels in the nose to swell." "That is not normal. During pregnancy you should have increased resistance to common conditions such as colds. We need to get a culture today." That is not normal. The hormones of pregnancy and the increased immunity associated with pregnancy will decrease your susceptibility to colds. "That is normal. It is because of hormone changes and increased mucus production during pregnancy, which cause the lungs to fill with secretions."

"That is normal. It is because of the hormone changes and increased blood volume during pregnancy, which causes the tiny blood vessels in the nose to swell."

At 24 weeks' gestation a client is asked to drink a sweet orange solution and then wait an hour to have blood drawn. The client asks if this is the test to determine if she has diabetes. What is the best response by the nurse? "This is a screening procedure. If your result is elevated you will be scheduled for a longer test to determine if you have gestational diabetes." "This is a diagnostic test to identify insulin resistance during pregnancy." "Yes. If the results of your blood work are elevated you have gestational diabetes and will be started on insulin." "No, this is part of the routine prenatal lab work. The test for gestational diabetes will be done during your third trimester."

"This is a screening procedure. If your result is elevated you will be scheduled for a longer test to determine if you have gestational diabetes."

As part of the lab work at the client's first prenatal visit, a rubella titer is drawn. The results are negative (4 IU/mL). Based on this result what does the nurse recommend to the client? "You will be vaccinated at the hospital after you give birth." "Get a rubella vaccine immediately." "You can receive the vaccine in the third trimester." "We will give you an attenuated vaccine in the second trimester."

"You will be vaccinated at the hospital after you give birth."

A pregnant woman with gestational diabetes comes to the clinic for a fasting blood glucose level. When reviewing the results, the nurse determines that which result indicates good glucose control? 88 mg/dL 100 mg/dL 110 mg/dL 120 mg/dL

88 mg/dL

During active labor the provider ruptures the client's membranes. The fluid flowing out of the client's vagina is green-colored. The nurse recognizes that this finding is evidence of which condition? Fetal hypoxia Placenta abruption Rupture of the umbilical vessel Fetal bleeding

Fetal hypoxia

A client is being treated for choriocarcinoma following a molar pregnancy. The nurse explains that choriocarcinoma can metastasize to other organs. The nurse schedules the client for testing to assess for signs of metastasis to which organs? Select all that apply. Lung Brain Liver Ovary Uterus

Lung Brain Liver

The nurse is preparing information for a client who has just been diagnosed with gestational diabetes. Which instruction should the nurse prioritize in this information? Maintain a daily blood glucose log Report any signs of possible urinary tract infection Plan daily menus with dietitian Long term therapy goals

Maintain a daily blood glucose log

The nurse is preparing to see a client at 36 weeks' gestation. Which lab specimen would the nurse prepare to collect during this visit? Rectal and vaginal swabs for group B streptococcus (GBS) Blood results from oral glucose tolerance test (GTT) for diabetes Fetal fibrionectin level to predict onset of labor Kleihauer-Betke for a maternal-fetal bleed

Rectal and vaginal swabs for group B streptococcus (GBS)

A 25-year-old woman is a victim of intimate partner violence. For which problem related to self-concept is she most likely to be at risk? Self-esteem disturbance Personal identity disturbance Altered role performance Body image disturbance

Self-esteem disturbance

Following an amniocentesis at 16 weeks' gestation, which instructions would the nurse include in the client's discharge teaching? Select all that apply. "If you experience contractions or severe cramping, call the office." "Avoid strenuous activities for the next 24 hours." "If you have a fever above 100.4°F (38.0°C), call the office." "If you feel the fetus moving, call the office." "Maintain bed rest for the next 24 hours."

"If you experience contractions or severe cramping, call the office." "Avoid strenuous activities for the next 24 hours." "If you have a fever above 100.4°F (38.0°C), call the office."

A 42-year old client at 16 weeks' gestation is scheduled for an amniocentesis. The nurse informs the client that the physician will do an ultrasound first, and then numb an area of her abdomen and withdraw some amniotic fluid. The client looks confused and says, "The doctors said we would skip the screening ultrasound and go straight to the diagnostic amniocentesis, because of my age." What is the best response by the nurse to the client's concern? "This ultrasound is to guide the physician to a pocket of amniotic fluid to collect the specimen." "This is not a screening ultrasound. There will be no pictures of the fetus taken." "The physician needs to locate the position of the placenta, umbilical cord, and the fetus before the procedure." "There is no risk to the ultrasound, so most physicians like to do one with the amniocentesis."

"This ultrasound is to guide the physician to a pocket of amniotic fluid to collect the specimen."

A nurse is caring for a client in labor. The nurse determines that the client is beginning the second stage of labor when which assessment is noted? The cervix is dilated completely. The client begins to leak clear vaginal fluid. The membranes have ruptured. The contractions are regular.

The cervix is dilated completely.

A nurse is listening to a client who is a victim of intimate partner violence. The client is describing how events would unfold with the partner. The nurse interprets the client's statements and identifies which action as characteristic of the second phase of the cycle of violence? The batterer is contrite and attempts to apologize for the behavior. The physical battery is abrupt and unpredictable. Verbal assaults begin to escalate toward the victim. The victim accepts the anger as legitimately directed at him or her.

The physical battery is abrupt and unpredictable.

A 40-year-old woman comes to the clinic reporting having missed her period for two months. A pregnancy test is positive. What is she and her fetus at increased risk for? type 2 diabetes mellitus type 1 diabetes mellitus placental abnormalities postterm birth

placental abnormalities

The nurse is teaching a client about her new diagnosis, polycystic ovary syndrome. Which statement by the client indicates she knows the cause of her symptoms? "I have extra androgen in my system." "I have high levels of estrogen in my system." "My ovaries are secreting high levels of progesterone." "My circulating hCG (human chorionic gonadotropin) levels are low."

"I have extra androgen in my system."

At 36 weeks' gestation, a client's screening for group B streptococcus (GBS) is positive. Which statement by the client indicates she understands the meaning of this finding? "I will need antibiotics during labor." "I will need a cesarean delivery." "My baby will need antibiotics after birth." "My baby will need intensive care after birth."

"I will need antibiotics during labor."

A client receives general anesthesia for an emergency cesarean birth. The nurse should monitor the client for which postpartum complication during the first 2 hours after birth? Uterine atony Endometriosis Pneumonia Urinary retention

Uterine atony

Place the three phases of intimate partner violence in the order in which they occur. Use all options. 1tension-building phase 2acute violence phase 3honeymoon phase

1tension-building phase 2acute violence phase 3honeymoon phase

The nurse is assessing a 35-year-old woman at 22 weeks' gestation who has had recent laboratory work. The nurse notes fasting blood glucose 146 mg/dL (8.10 mmol/L), hemoglobin 13 g/dL (130 g/L), and hematorcrit 37% (0.37). Based on these results which instruction should the nurse prioritize? Check blood sugar levels daily. The signs and symptoms of urinary tract infection. Include iron-enriched foods in the diet. Take daily iron supplements.

Check blood sugar levels daily.

At 37 weeks' gestation, a client comes to labor and delivery with contractions every 4 minutes. A vaginal exam shows the cervix is completely effaced and dilated to 5 cm, with membranes intact. The fetus is at a -2 station. Based on this information, the health care provider will monitor the client for which potential complication? Cord prolapse Premature rupture of membranes Prolonged second stage Intrauterine infection

Cord prolapse

The father of a stillborn infant tells the nurse he wants to hold the child. What is the nurse's best response? Dress the infant in a T-shirt and diaper and let him hold the infant. Give him some photographs of the infant. Tell him that it would be better not to hold the infant. Encourage him to discuss this with the mother first.

Dress the infant in a T-shirt and diaper and let him hold the infant.

A client complaining of right-sided abdominal pain and intermittent vaginal bleeding over the past 2 hours comes to the urgent care center. Based on her last menstrual period and a home pregnancy test she is 8 weeks' pregnant. A blood test confirms the pregnancy but the hCG level is low for 8 weeks' gestation. This client's presentation is consistent with what condition? Ectopic pregnancy Implantation bleeding Threatened abortion Premature placental separation

Ectopic pregnancy

A client who was postive for group B streptococcus is 72 hours postbirth. The nurse's assessment is noted in the above chart. These findings are consistent with which condition? Endometritis Mastitis Breast engorgement Postpartum depression

Endometritis

A G2P1 woman with type 1 diabetes is determined to be at 8 weeks' gestation by her health care provider. The nurse should point out which factor will help the client maintain glycemic control? Vitamin supplements Oral hypoglycemic agents Exercise Plenty of rest

Exercise

Following a dilation and curettage (D & C) for a molar pregnancy the client is scheduled for chemotherapy. The nurse is orienting the client and her family to the treatment process. The nurse explains that the preferred single agent chemotherapy of choice is which agent? Methotrexate Vincristine Actinomycin D Dactinomycin

Methotrexate

The most common neonatal sepsis and meningitis infections seen within 24 hours after birth are caused by: group B beta-hemolytic streptococci. Candida albicans. Escherichia coli. Chlamydia trachomatis.

group B beta-hemolytic streptococci.