Maternity Final Review

Which nursing response provides correct information for the postpartum patient that states, "I am glad I am breastfeeding and won't have to worry about getting pregnant because I will not have a period?"

"Contraception is important because you will ovulate prior to your first period."*

A nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following responses should the nurse make?

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

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?

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

Which of the following should the nurse advise the pregnant patient to abstain from during pregnancy? Select all that apply:

- Alcohol -Raw/ undercooked meats -tabacco

A nurse is caring for a client who is to undergo a biophysical profile. The client asks the nurse what is being evaluated during this test. Which of the following should the nurse include? (Select all that apply.)

- Fetal breathing - Fetal motion - Amniotic fluid volume

Which prenatal test is used for diagnosing fetal defects in pregnancy? Select all that apply. One, some, or all responses may be correct.

-Cvs -Amniocentesis -PUbs

Which signs are presumptive signs of pregnancy?

-Quickning -amenorrea -chadwicks sign

The nurse is teaching a prenatal client about chorionic villus sampling (CVS). The nurse correctly teaching the client that risks related to CVS include which of the following? Select all that apply:

-Spontaneous abortion -Rupture of membranes -Intrauterine infection

The postpartum nurse is administering vitamin K (phytonadione) to a newborn. The prescribed order is to administer one dose of 0.5 mg of vitamin K via the intramuscular (IM) route within 1 hour after birth. The ampule of vitamin K sent from the pharmacy is 1 mg/0.5 mL. How many milliliters does the nurse draw up to administer the correct dose. Record your answer to two decimal points. __mL

0.25

A nurse in a prenatal clinic is caring for a client who is pregnant and asks the nurse for her estimated date of birth (EDB). The client's last menstrual period began on July 27. What is the client's EDB? (State the date in MMDD, For example, Juiv 27 is 0727)

0504

A nurse is preparing to administer penicillin 2gm/day PO divided into two doses. The amount available is penicillin 500 mg tablets. How many tablets should the nurse administer with each dose? (Round the answer to the nearest whole number)

2

The postpartum nurse is administering ibuprofen (Advil) to a patient with episiotomy discomfort. The prescribed order is 400 mg of Advil by mouth every 6 to 8 hours PRN for discomfort. The Advil sent by the pharmacy is 200 mg/tablet. How many tablets should the nurse administer to the patient? Record your answer as a whole number. ___ Tab(s)

2

A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy, terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes the Client's current status?

4-0-1-2-2

A nurse is preparing to administer amoxicillin 350mg PO. Available is amoxicillin 250mg/5ml. How many ml should the nurse administer? (Round to the nearest whole number.)

7 ml

A nurse observes that a newborn @ 5 min has a pink trunk and head, blueish hands and feet; Has flexed extremities; Has a weak and slow cry; a heart rate of 130/min; and cries in response to suctioning. The nurse should document what Apgar score for this infant?

8

A nurse is caring for a newborn delivered by vaginal birth with a vacuum assist. The newborn's mother asks about the swollen area on her son's head. After palpation to identify that the swelling crosses the suture line, which of the following is an appropriate response by the nurse?

A caput succedaneum is an area of edema on the newborn's occiput, often seen where the cup of the vacuum was applied. It is present at birth and will disappear within 3 to 4 days

A nurse at a prenatal clinic is caring for a client who is in her first trimester of pregnancy. The client tells the nurse that she is upset because, although she and her husband planned this pregnancy, she has been having many doubts and second thoughts about the upcoming changes in her life. Which of the following is an appropriate response by the nurse? A. "Ambivalent feelings are quite common for women early in pregnancy." B. "Perhaps you should see a counselor to discuss these feelings further." C. "Have you spoken to your mother about these feelings?" D. "Don't worry. You will be fine once the baby is born."

A. "Ambivalent feelings are quite common for women early in pregnancy."

A nurse is caring for a client who delivered a healthy term newborn via cesarean birth. The client asks the nurse, "Is there a chance that I could deliver my next baby without having a cesarean section?" Which of the following responses should the nurse provide? A. "The primary consideration is what type of incision was performed this time." B. "There are so many variables that you'll have to ask you obstetrician." C. "It's too soon for you to be worrying about this now." D. "A repeat cesarean birth is always safer for both you and your baby."

A. "The primary consideration is what type of incision was performed this time."

A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy. terminated by elective abortion at 9 weeks: the birth of twins at 36 weeks: and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes the client's current status? A. 4-0-1-2-2 B. 3-0-2-0-2 C. 2-0-0-2-0 D. 4-2-0-2-2

A. 4-0-1-2-2

A nurse is caring for a client who is 2 days postpartum, is breastfeeding, and reports nipple soreness. Which of the following measures should the nurse suggest to reduce discomfort during breastfeeding? (Select all that apply.) A. Apply breast milk to the nipples before each feeding B. Place breast pads inside the nursing bra C. Massage the breasts and nipples prior to feeding D. Start breastfeeding with the nipple that is less sore E. Change the infant's position on the nipples

A. Apply breast milk to the nipples before each feeding D. Start breastfeeding with the nipple that is less sore E. Change the infant's position on the nipples

The nurse is teaching a non- breastfeeding patient measure to suppress lactation. Which information should the nurse include in the teaching session? (Select ail that apply.) A. Avoid massaging the breasts. B. Allow warm shower water to run over the breasts. C. If the breasts become engorged, pumping is recommended. D. Ice packs or cabbage leaves can be applied to the breasts to relieve discomfort. E. Wear a sports bra 24 hours a day until the breasts become soft.

A. Avoid massaging the breasts. D. Ice packs or cabbage leaves can be applied to the breasts to relieve discomfort. E. Wear a sports bra 24 hours a day until the breasts become soft.

A nurse in a provider's office is caring for a client who is at 34 weeks of gestation and at risk fro placental abruption. The nurse should recognize that which of the following are risk factors for abruption? (select all that apply) A. Cocaine use B. Hypertension C. Blunt force abdominal trauma D. Hyperemesis gravidarum

A. Cocaine use B. Hypertension C. Blunt force abdominal trauma

Which type of birth mark is this? A. Dermal melanocytosis (Mongolian spot) B. Nevus simplex (Stork bite) C. Nevus flammeus (Port-wine stain) D. Erythema toxicum

A. Dermal melanocytosis (Mongolian spot)

Which routine nursing assessment is contraindicated for a patient admitted with suspected placenta previa? A. Determining cervical dilation and effacement B. Monitor FHR and maternal vital signs C. Observing vaginal bleeding or leaking of amniotic fluid D. Determining frequency, duration, and intensity of contractions

A. Determining cervical dilation and effacement

Which clinical finding should the nurse suspect if the fundus is palpated on the right side of the abdomen above the expected level? A. Distended bladder B. Normal involution C. Been lying on her right side too long D. Stretched ligaments that are unable to support the uterus

A. Distended bladder

A nurse in a prenatal clinic is caring for a client who asks what her estimated date of delivery will be if her last menstrual period was May 4, 2015. Which of the following is the appropriate response by the nurse? A. February 11, 2016 B. February 27, 2016 C. April 27, 2016 D. April 11, 2016

A. February 11, 2016

A nurse is caring for a client who is to undergo a biophysical profile. The client asks the nurse what is being evaluated during this test. Which of the following should the nurse include? (Select all that apply.) A. Fetal breathing B. Fetal motion C. Fetal neck translucency D. Amniotic fluid volume E. Fetal gender

A. Fetal breathing B. Fetal motion D. Amniotic fluid volume

A nurse is caring for a client who is in labor. The nurse should identify that which of the following infections cabe treated during labor or immediately following birth? (Select all that apply): A. Gonorrhea B. Chlamydia C. HIV D. Group B Streptococcus beta-hemolytic E. TORCH infection

A. Gonorrhea B. Chlamydia C. HIV D. Group B Streptococcus beta-hemolytic

The nurse at the reproductive clinic is educating new nurses. She explains that the corpus luteum remains on the ovary of a pregnancy occurs in response to which factor. A. HCG secretion by the zygote. B. Invasion of the chorionic villi into the endometrium. C. High levels of relaxin hormones. D. The LH surge.

A. HCG secretion by the zygote.

An obstetric patient has presented to the clinic with a heart rate of 140, blood pressure of 90/56, and labored respiratory rate of 20. The patient is pale and reports frequent vomiting and has not been able to keep anything down for over 24 hours. The nurse recognizes that the patient is presenting signs of: A. Hypovolemia B. Poor nutrition C. Pneumonia D. Urinary tract infection

A. Hypovolemia

A nurse is educating a patient about her diagnosis of a Hydatidiform mole. Which response indicates that the patient needs additional teaching? A. I can try to conceive again with my next cycle B. The placenta and fetus will not develop normally C. There is a chance that this pregnancy can become a choriocarcinoma D. I may need to have a D&C

A. I can try to conceive again with my next cycle

A patient is completing their 3-hour glucose challenge test. Their fasting blood sugar result is 105. Which of the following is the correct action? A. Inform the patient that they did not pass. B. Prepare the patient to drink the 100g of glucose drink. C. Inform the patient that she passed and does not need any further testing. D. Prepare the patient to drink 50g of glucose drink.

A. Inform the patient that they did not pass.

A nurse is teaching a client who is postpartum and has a new prescription for an injection of Rho (D) immunoglobulin. Which of the following should be included in the teaching? A. It prevents the formation of Rh antibodies in pregnant patients who are Rh negative B. It destroys Rh antibodies in mothers who are Rh negative C. It destroys Rh antibodies in newborns who are Rh positive D. It prevents the formation of Rh antibodies in newborns who are Rh positive

A. It prevents the formation of Rh antibodies in pregnant patients who are Rh negative

A young female client comes to the health unit at school to discuss her irregular periods. In providing education regarding the female reproductive cycle, the nurse describes the regular and recurrent changes related to the ovaries and the uterine endometrium. Although this is generally referred to as the menstrual cycle, the endometrial cycle includes which phases? A. Menstrual, Proliferative, Secretory B. Menstrual, Ovulatory, Luteal C. Proliferative, Luteal, Follicular D. Menstrual, Proliferative, Luteal

A. Menstrual, Proliferative, Secretory

A nurse is admitting a client who experienced a vaginal birth 2 hr ago. The client is receiving an IV of lactated Ringer's with 25 units of oxytocin infusing and has large rubra lochia. Vital signs include blood pressure 146/94 mm Hg. pulse 80/min. and respiratory rate 18/min. The nurse reviews the prescriptions from the provider. Which of the following prescriptions requires clarification? A. Methylergonovine 0.2 mg IM now B. Insert an indwelling urinary catheter C. Administer oxygen by nonrebreather mask at 5 L/min D. Obtain laboratory study of prothrombin and partial thromboplasin time

A. Methylergonovine 0.2 mg IM now

A newborn has small, whitish, pinpoint spots over the nose, which the nurse knows are caused by retained sebaceous secretions. When charting this observation, the nurse identifies it as: A. Milia B. Erythema toxicum C. Lanugo D. Mongolian spots

A. Milia

In which position should the parents be instructed to place their newborn for sleep? A. On the back B. On the left side C. On the right side D. On the abdomen

A. On the back

A nurse in the reproductive clinic is reviewing conception with a new nurse. She explains that in order for conception to occur ovulation and ejaculation must occur simultaneously. She also includes which of the following correct information during her teaching. A. Ova lives for 24 hours and is fertilizable during that time. B. Conception occurs in the upper portion of the uterus. C. During conception the endometrium is in the proliferative phase. D. The corpus luteum secretes estrogen until the placenta takes over.

A. Ova lives for 24 hours and is fertilizable during that time.

Which of the following are Oxytocics that may be used after deliver to prevent of manage a postpartum hemorrhage? (select all that apply): A. Oxytocin (Pitocin) B. Methylergonovine (Methergine) C. Misoprostol (Cytotec) D. Terbutaline E. Carboprost (Hemabate)

A. Oxytocin (Pitocin) B. Methylergonovine (Methergine) C. Misoprostol (Cytotec) E. Carboprost (Hemabate)

A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa. Which of the following findings support this diagnosis? A. Painless red vaginal bleeding B. Increasing abdominal pain with a non-relaxed uterus C. Abdominal pain with scan red vaginal bleeding D. Intermittent abdominal pain following passage of bloody mucus

A. Painless red vaginal bleeding

The nurse is monitoring a pregnant client that called for decreased fetal movement. She is having a non-stress test. She has been on the monitor for 20 minutes. The findings are interpreted as? A. Reactive NST B. Non reactive NST C. Positive CST D. Negative CST

A. Reactive NST

A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client's blood work, the nurse notices she does not have immunity to rubella. Which of the following times should the nurse understand is recommended for rubella immunization? A. Shortly after giving birth B. In the third trimester C. Immediately D. During her net attempt to get pregnant

A. Shortly after giving birth

A nurse on the labor and delivery unit is caring for a client following a vaginal examination by the provider which is documented as: -1. Which of the following interpretations of this finding should the nurse make? A. The presenting part is 1 cm above the ischial spine. B. The presenting part is 1 cm below the ischial spine. C. The cervix is 1 cm dilated. D. The cervix is effaced 1 cm.

A. The presenting part is 1 cm above the ischial spine.

A yellow crust has formed over the circumcision site. The mother calls the hotline at the local hospital 5 days after her son was circumcised. She is very concerned. Which response by the nurse is most appropriate? A. The yellow crust should not be removed. B. This yellow crust is an early sign of infection. C. Discontinue the use of petroleum jelly to the tip of the penis. D. After the circumcision, the diaper should be changed frequently and fastened snugly.

A. The yellow crust should not be removed.

What are the causes of postpartum hemorrhage? (Select all that apply): A. Tone B. Trauma C. Tissue D. Tachycardia E. Thrombin

A. Tone B. Trauma C. Tissue E. Thrombin

During the postpartum teaching being conducted by the nurse, she includes the importance of hydration of the newborn that appears to have some skin yellowing. This teaching is important because when the bilirubin levels become severe and enter the brain, it is irreversible. This condition is known as kernicterus? True of False A. True B. False

A. True

A nurse is caring for a cilent who is in labor and has an external fetal monitor. The nurse observes late decelerations on the monitor strip and Interprets them as indicating which of the following? A. Uteroplacental insufficiency B. Maternal bradycardia C. Umbilical cord compression D. Fetal head compression

A. Uteroplacental insufficiency

A nurse is caring for a client who is in the first stage of labor, undergoing external fetal monitoring, and recelving IV fluid. The nurse observes variable decelerations in the fetal heart rate on the monitor strip. Which of the following is a correct interpretation of this finding? A. Variable decelerations are due to umbilical cord compression. B.Variable decelerations are caused by uteroplacental insufficiency. C. Variable decelerations are a result of the administration of IV narcotic analgesics. D. Variable decelerations are related to fetal head compressions.

A. Variable decelerations are due to umbilical cord compression.

The nurse is assessing the pain level of the client in labor. The nurse notes that all the following are physical factors influencing pain perception. Select all that apply. A. intensity of labor B. cervical readiness C. fetal position D. childbirth preparation E. culture F. characteristics of the pelvis

A. intensity of labor B. cervical readiness C. fetal position F. characteristics of the pelvis

The provider is assessing the 41 week pregnant client. cervical ripening has been ordered. The nurse notes that which of the following is not a mechanical method of cervical ripening? A. misoprostil B. dilapan C. lamicel D. laminaria tents

A. misoprostil

The nurse cares for a patient who has an irregular reproductive cycle. The patient states, "My gynecologist explained that I have a gland that isn't functioning properly, but I can't remember the name." Which gland is the patient referencing?

Anterior pituitary

A nurse is caring for a client who reports unrelieved episiotomy pain 8 hr following a vaginal birth. Which of the following actions should the nurse take?

Apply an ice pack to the affected area

A nurse is preparing to measure the fundal height of a client who is at 22 weeks of gestation. At which location should the nurse expect to palpate the fundus? A. 3 cm above the umbilicus B. 2 cm above the umbilicus C. Slightly below the umbilicus D. 3 cm below the umbilicus

B. 2 cm above the umbilicus

A nurse is caring for a client during a nonstress test (NST). At the end of a 30-min period of observation. the nurse notes the following findings: The fetal heart rate baseline is at 120/min with minimal variability and no accelerations. There are two decelerations of 15/min in the fetal heart rate during a period of fetal movement, each lasting 20 seconds. Which of the following interpretations of these findings should the nurse make? A. A negative test B. A nonreactive test C. A positive test D. A reactive test

B. A nonreactive test

A nurse in a prenatal clinic is caring for a client who is at 39 weeks of gestation and who asks about the signs that precede the onset of labor. Which of the following should the nurse identify as a sign that precedes labor? A. Decreased vaginal discharge B. A surge of energy C. Urinary retention D. Weight gain of 0.5 to 1.5 kg

B. A surge of energy

A nurse in a clinic is caring for a client who is a 3 weeks postpartum following the birth of a healthy newborn. The client reports feeling "down" and sad, having no energy, and wanting to cry. Which of the following is a priority action by the nurse? A. Assist the family to identify prior use of positive coping skills in family crises. B. Ask the client if she has considered harming her newborn. C. Anticipate a prescription by the provider for an antidepressant. D. Reinforce postpartum and newborn care discharge teaching

B. Ask the client if she has considered harming her newborn.

A nurse in is caring for a client who is to undergo an amniotomy. Which of the following is the priority nursing action following this procedure? A. Observe color and consistency of fluid. B. Assess the fetal heart rate pattern. C. Assess the clients temperature. D. Evaluate client for the presence of chills and increased uterine tenderness using palpation.

B. Assess the fetal heart rate pattern.

A nurse is caring for a client who is in the first stage of labor and is using pattern-paced breathing. The client says she feels lightheaded and her fingers are tingling. Which of the following actions should the nurse take? A. Administer oxygen via nasal cannula. B. Assist the client to breathe into a paper bag. C. Have the client tuck her chin to her chest. D. Instruct the client to increase her respiratory rate to more than 42 breaths per minute.

B. Assist the client to breathe into a paper bag.

Before administering methylergonovine (Methergine), the nurse checks the: A. Color of the lochia B. Blood pressure C. Location of the fundus D. Last administration of analgesics

B. Blood pressure

A nurse is caring for a client who is receiving opioid epidural analgesia during labor. Which of the following findings is the nurse's priority? A. The client reports weakness of the lower extremities. B. Blood pressure 80/56 mm Hg C. Temperature 38.2*C (100.8*F) D. The client reports perfuse itching.

B. Blood pressure 80/56 mm Hg

A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not." which of the following should the nurse recognize as a sign of true labor? A. Rupture of the membranes B. Changes in the cervix C. Station of the presenting part D. Pattern of contractions

B. Changes in the cervix

The nurse is explaining how a newly delivered baby initiates respirations. Which statement explains this process most accurately? A. Drying off the infant B. Chemical, thermal, and mechanical factors C. An increase in the PO2 and a decrease in the PCO2 D. The continued functioning of the foramen ovale

B. Chemical, thermal, and mechanical factors

A nurse is admitting a client who is at 38 weeks of gestation and is in the first stage of labor. Which of the following assessment findings should the nurse report to the provider first? A. Expulsion of a blood-tinged mucous plug B. Continuous contractions lasting 2 minutes C. Pressure on the perineum causing the client to bear down. D. Expulsion of clear fluid from the vagina

B. Continuous contractions lasting 2 minutes

A nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. Uterine contractions occur every 2 min. last 90 sec, and are strong to palpation. The baseline fetal heart rate is 150/min, with uniform decelerations beginning at the peak of the contraction and a return to baseline after the contraction is over. Which of the following actions should the nurse take? A. Decrease the rate of infusion of the maintenance IV solution. B. Discontinue the infusion of the IV oxytocin. C. Increase the rate of infusion of the IV oxytocin. D. Slow the clients rate of breathing.

B. Discontinue the infusion of the IV oxytocin.

A nurse on the obstetric unit is caring for a client who experienced abruptio placentae. The nurse observes petechiae and bleeding around the IV access site. The nurse should recognize that this client is at risk for which of the following complications? A. Anaphylactoid syndrome of pregnancy B. Disseminated intravascular coagulation C. Preeclampsia D. Puerperal Infection

B. Disseminated intravascular coagulation

A nurse in a prenatal clinic is caring for a client who is at 38 weeks of gestation and reports heavy, red vaginal bleeding. The bleeding started spontaneously in the morning and is not accompanied by contractions. The client is not in distress and she states that she can "feel the baby moving." An ultrasound is scheduled stat. The nurse should explain to the client that the purpose of the ultrasound is to determine which of the following? A. Fetal lung maturity B. Location of the placenta C. Viability of the fetus D. The biparietal diameter

B. Location of the placenta

An abortion when the fetus dies but is retained in the uterus is called A. Inevitable B. Missed C. Incomplete D. Threatened

B. Missed

A labor client, gravida 2, para 1, at term has received meperidine (Demerol) for pain control during labor. Her most recent dose was 15 minutes ago and labor is imminent. Maternal vital signs have been stable and the EFM tracing has not shown any baseline changes. Which medication does the nurse have in the delivery room if needed for administration to counteract the effects of meperidine? A. Oxytocin (Pitocin) B. Naloxone (Narcan) C. Bromocriptine (Parlodel) D. Oxygen

B. Naloxone (Narcan)

Which assessment by the nurse would differentiate a placenta previa from an abruptio placentae? A. Saturated perineal pad in 1 hour B. Pain level 0 on a scale of 0 to 10 C. Cervical dilation at 2 cm D. Fetal heart rate at 160 bpm

B. Pain level 0 on a scale of 0 to 10

A nurse on a labor unit is admitting a cliet who reports painful contactions. The nurse determines that the contractions have a duration of 1 minute and a frequency of 3 minutes. The nurse obtains the following vital signs: fetal heart rate 130/ min, maternal heart rate 128/ min and maternal blood pressure 92/54 mm Hg. Which of the following is the priority action for the nurse? A. Notify the provider of the findings. B. Position the client on the left side. C. Ask the client if she needs pain medication. D. Have the client void.

B. Position the client on the left side.

A nurse is assisting a client with breastfeeding. The nurse explains that which of the following reflexes will promote the newborn to latch? A. Babinski B. Rooting C. Moro D. Stepping

B. Rooting

Which maternal condition always necessitates delivery by cesarean birth? A. Partial abruptio placenta B. Total placenta previa C. Ectopic pregnancy D. Eclampsia

B. Total placenta previa

A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The following tracing is interpreted as: A. Early Decelerations B. Variable Decelerations C. Late Decelerations D. Midcycle Decelerations

B. Variable Decelerations

The nurse at the prenatal clinic is educating new perspective parents. She explains to them that the following substance helps protect the babies skin from the amniotic fluid. A. brown fat B. vernis caseosa C. chorion D. linea nigra

B. vernis caseosa

The nurse is reviewing the instructions given to a patient at 24 weeks' gestation for a glucose challenge test (GCT). The nurse determines that the patient understands the teaching when she makes which statement? A. "I have to fast the night before the test." B. "I will drink a sugary solution containing 100 m of glucose. C. "I will have blood drawn at 1 hour after I drink the glucose solution." D. "I should keep track of my baby's movements between now and the test."

C. "I will have blood drawn at 1 hour after I drink the glucose solution."

A nurse is caring for a client who is at 6 weeks of gestation with her first pregnancy and asks the nurse when she can expect to experience quickening. Which of the following responses should the nurse make? A. "This will occur during the last trimester of pregnancy." B. "This will happen by the end of the first trimester of pregnancy." C. "This will occur between the fourth and fifth months of pregnancy." D. "This will happen once the uterus begins to rise out of the pelvis."

C. "This will occur between the fourth and fifth months of pregnancy."

A nurse is assessing a newborn girl who is 2 hours old. What finding warrants a call to the physician? A. Blood glucose of 45 mg/dl B. Heart rate of 160 beats/min after crying vigorously C. A crepitant-ike feeling when assessing the clavicles D. Passage o vaginal discharge with streaks of blood

C. A crepitant-ike feeling when assessing the clavicles

A nurse is caring for a client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios. The nurse should understand that this diagnosis means which of the following? A. The client is carrying more than one fetus. B. There is an elevated level of alpha-fetoprotein (AFP) in the amniotic fluid. C. An excessive amount of amniotic fluid is present. D. The fetus is likely to have a congenital anomaly, be growth restricted, or demonstrate fetal distress during labor.

C. An excessive amount of amniotic fluid is present.

A patient with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is a: A. Diuretic B. Tocolytic C. Anticonvulsant D. Antihypertensive

C. Anticonvulsant

Which finding in the exam of a patient with a diagnosis of threatened abortion would change the diagnosis to inevitable abortion? A. Presence of backache B. Rise in hCG level C. Clear fluid from the vagina D. Pelvic pressure

C. Clear fluid from the vagina

The process in which bilirubin is changed from a fat-soluble product to a water-soluble product is known as: A. Albumin binding B. Enterohepatic circuit C. Conjugation of bilirubin D. Deconjugation of bilirubin

C. Conjugation of bilirubin

A nurse is instructing a woman who is contemplating pregnancy about nutritional needs. To reduce the risk of giving birth to a newborn who has a neural tube defect, which of the following information should the nurse include in the teaching? A. Limit alcohol consumption. B. Increase intake of iron-rich foods. C. Consume foods fortified with folic acid. D. Avoid foods containing aspartame.

C. Consume foods fortified with folic acid.

A nurse is teaching a client about positive signs of pregnancy. Which of the following findings should the nurse include? A. Breast tenderness B. Fatigue C. Fetal heart tones detected by ultrasound D. Positive urine pregnancy test

C. Fetal heart tones detected by ultrasound

The office nurse is preparing a chart for one of her new clients. She explains that it is during this phase in which the ovum matures, stimulated by secretion of FSH by the anterior pituitary. A. Proliferative B. Ovulatory C. Follicular D. Luteal

C. Follicular

A nurse is caring for a client who is in active labor, cervical dilation was just assessed and is 7 cm of cervical dilation and 100% effacement. The fetus is at 1+ station, and the client's amniotic membranes are intact. The client states that she needs to push. Which of the following actions should the nurse take? A. Assist the client into a comfortable position. B. Observe the perineum for signs of crowning. C. Have the client pant during the next contraction. D. Help the client to the bathroom to void.

C. Have the client pant during the next contraction.

A nurse is caring for a newborn whose mother is positive for hepatitis B surface antigen. Which of the following should the infant receive? A. Hepatitis B immune globulin at 1 week followed by hepatitis B vaccine monthly for 6 months. B. Hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigen C. Hepatitis B immune globulin and hepatitis B vaccine within 12 hours of birth D. Hepatitis B vaccine at 24 hr followed by hepatitis B immune globulin every 12 hr for 3 days

C. Hepatitis B immune globulin and hepatitis B vaccine within 12 hours of birth

A nurse is caring for a client who is postpartum who asks the nurse when her breast milk will "come in". Which of the following responses should the nurse make? A. Within 2 days B. In 6 to 8 days C. In 3 to 5 days D. In about 10 days

C. In 3 to 5 days

The nurse is assessing the lochia on a 1-day postpartum client. The nurse notes that the lochia is red and has a foul-smelling odor. The nurse determines that this assessment finding: A. Is normal B. Indicates the need for increased fluids C. Indicates the presence of infection D. Indicated the need for increased ambulation

C. Indicates the presence of infection

The nurse is preparing to administer a vitamin K injection to the infant shortly after birth. Which statement is important to understand regarding the properties of vitamin K? A. It is necessary for the production of platelets B. It is important for the production of red blood cells C. It is not initially synthesized because of the sterile bowel at birth D. It is responsible for the breakdown of bilirubin and the prevention of jaundice

C. It is not initially synthesized because of the sterile bowel at birth

The labor nurse is reviewing the client chart with the student nurse. She explains that stage 1 of labor includes these phases in the correct order? A. Transition, laten, active B. Active, laten, transition C. Laten, active, transition D. Active, transition, laten

C. Laten, active, transition

A nurse is caring for a client who is 4 hr postpartum following a vaginal birth. The client has saturated a perineal pad within 10 min. Which of the following actions should the nurse take first? A. Assess clients blood pressure B. Assess the bladder for distention C. Massage the client's fundus D. Prepare to administer a prescribed oxytocin preparation

C. Massage the client's fundus

A nurse is caring for a client who is having a nonstress test performed. The fetal heart rate (FHR) is 130 to 150, but there has been no fetal movement for 15 minutes. Which of the following actions should the nurse perform? A. Immediately report the situation to the client's provider and prepare the client for induction of labor. B. Encourage the client to walk around without the monitoring unit for 10 minutes, then resume monitoring. C. Offer the client a snack of orange juice or water. D. Turn the client onto her left side.

C. Offer the client a snack of orange juice or water.

The office nurse is educating her newly graduated RN. She makes her aware that early in pregnancy the maintenance of early implantation in the decidua relies on continuous support from this process. A. Chorionic villi projections on the fetal side of the placenta B. Secretion of FSH by the anterior pituitary gland C. Progesterone secretion by the corpus luteum D. Progesterone secretion by the placenta

C. Progesterone secretion by the corpus luteum

A 34 Week pregnant client called the prenatal clinic to report that she slipped and fell. She was advised to come into the office for an evaluation. After 40 minutes of fetal monitoring (strip below); the nurse should question which of the following orders? A. Prepare the patient for a Biophysical Profile (BPP) B. Prepare the patient for a possible CST. C. Send the patient home and repeat the test in 1 week. D. Use vibroacoustic stimulation

C. Send the patient home and repeat the test in 1 week.

A nurse in a prenatal clinic is caring for a client who is at 38 weeks of gestation and undergoing a contraction stress test. The test results are negative. Which of the following interpretations of this finding should the nurse make? A. There is evidence of cervical incompetence. B. There is no evidence of two or more accelerations in fetal heart rate in 20 minutes. C. There is no evidence of uteroplacental insufficiency. D. There are less than 3 uterine contractions in a 10 minute period.

C. There is no evidence of uteroplacental insufficiency.

A nurse assists in the delivery of a healthy 7 lb, 4 oz infant. Six days later the parents call the clinic with some concern. They state that their daughter has begun to lose weight - she has lost nearly 10% since birth, despite breastfeeding regularly. How should the nurse counsel this couple? A. This is abnormal and cause for serious concern. B. This is an emergency; the couple should bring their infant to the emergency department. C. This is normals- a breastfed baby will generally lose 5-10% of their birthweight in the first week of life. D. This is not normal but not yet a cause of concern.

C. This is normals- a breastfed baby will generally lose 5-10% of their birthweight in the first week of life.

Which physiologic finding is consistent with normal pregnancy?

Cardiac output increases during pregnancy.

During the postpartum evaluation of a client that delivered 18 hours ago, the nurse discovers a continuous seepage of blood from the vagina. The uterus is firm and midline. Which of the following should the nurse identify as the potential complication?

Cervical or vaginal laceration

The nurse is educating a patient about tracking their reproductive cycle. Which qualities would the nurse tell the patient to look for when tracking the most fertile cervical mucus? Select all that apply:

Clear, elastic, thin

Convection, radiation, conduction, evaporation

Conduction transfers heat from one object to another through physical contact. Convection transfers heat to air or water. Radiation transfers heat via infrared radiation. Evaporation transfers heat as water changes state from a liquid to a gas.

The client has inquired about the purpose of the newborn blood sample that will be obtained from her baby's heal. The nurse explains that the PKU will be performed for the following reason: A. "The test allows the hospital to obtain accurate statistical information." B. "The test is performed to keep the state records updated." C. "The test is done to document the number of births." D. "The test is performed to recognize and treat newborn metabolic disorders early."

D. "The test is performed to recognize and treat newborn metabolic disorders early."

A nurse is caring for a client who is in the first stage of labor and is encouraging the client to void every 2 hours. Which of the following statements should the nurse make? A. A full bladder increases the risks of 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

A patient receiving magnesium sulfate has a respiratory rate of 10 breaths per minute and appears to have mag toxicity. In addition to discontinuing the medication, which action should the nurse take? A. Increase the patients IV fluids B. Instruct the patient to take deep breaths C. Vigorously stimulate the patient D. Administer calcium gluconate

D. Administer calcium gluconate

A nurse is admitting a client who has severe preeclampsia at 35 weeks of gestation and is reviewing the provider's order. Which of the following orders requires clarification? A. Assess deep tendon reflexes every hour B. Sequential compression devices C. Continuous fetal monitoring D. Ambulate twice daily

D. Ambulate twice daily

A nurse is providing teaching to a client who is planning on becoming pregnant about the changes she should expect. Identify the sequence of maternal changes. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.) A. Quickening B. Lightening C. Goodell's signs D. Amenorrhea

D. Amenorrhea C. Goodell's signs A. Quickening B. Lightening

A nurse is caring for a client who has a positive pregnancy test. The nurse is teaching the client about common discomforts in the first trimester of pregnancy as well warning signs of potential danger. The nurse should instruct the client to call the clinic if she experiences which of the following manifestations? A. Leukorrhea B. Urinary frequency C. Nausea and vomiting D. Facial edema

D. Facial edema

A nurse is planning care for a client who is 2 hours postpartum following a cesarean birth. The client has a history of thromboembolic disease. Which of the following nursing interventions should be included in the plan of care? A. Apply warm, moist heat to the client's lower extremities. B. Massage the client's posterior lower legs C. Place pillows under the client's knees when resting in bed. D. Have the client ambulate.

D. Have the client ambulate.

A nurse is assessing a client in labor who has had epidural anesthesia for pain relief. Which of the following findings should the nurse identify as a complication from the epidural block? A. Vomiting B. Tachycardia C. Respiratory depression D. Hypotension

D. Hypotension

A nurse is caring for a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse perform first? A. Cover the cord with a sterile moist saline dressing. B. Prepare the client for an immediate birth. C. Place the client in knee-chest position. D. Insert a gloved hand into the vagina to relieve pressure on the cord.

D. Insert a gloved hand into the vagina to relieve pressure on the cord.

A nurse is caring for a client who is scheduled for a maternal serum alpha- fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client? A. This test assesses fetal lung maturity. B. It assesses various markers of fetal well-being. C. This test identifies an Rh incompatibility between the mother and fetus. D. It is a screening test for spinal defects in the fetus.

D. It is a screening test for spinal defects in the fetus.

A positive sign of thrombophlebitis includes: A. Visible varicose veins B. Positive Homans sign C. Pedal edema in the affected leg D. Local tenderness, heat, and swelling

D. Local tenderness, heat, and swelling

A nurse is caring for a client who is in labor and has an epidural anesthersia block. The client's blood pressure is 80/40 mm Hg and the fetal heart rate is 140/ min. Which of the following is the priority nursing action? A. Elevate the clients legs. B. Monitor vital signs every 5 minutes. C. Notify the provider. D. Place the client in a lateral position.

D. Place the client in a lateral position.

Which action by the nurse can result in hyperthermia in a newborn? A. Placing a cap on the newborn B. Wrapping the newborn in a warm blanket C. Placing the newborn in a skin-to-skin position with the mother D. Placing the newborn in the radiant warmer without attaching the skin probe

D. Placing the newborn in the radiant warmer without attaching the skin probe

A nurse in a prenatal clinic is caring for a client. Using Leopold maneuvers, the nurse palpates a round, firm, movable part in the fundus of the uterus and a long, smooth surface on the client's right side. In which abdominal quadrant should the nurse expect to auscultate fetal heart tones? A. Left lower B. Right lower C. Left upper D. Right upper

D. Right upper

A patient with no prenatal care delivers a healthy male infant via the vaginal route, with minimal blood loss. During the labor period, vital signs were normal. At birth, significant maternal hypertension is noted. When the patient is questioned, she relates that there is history of heart disease in her family, but, that she has never been treated for hypertension. Blood pressure is treated in the hospital setting and the patient is discharged. The patient returns at her scheduled 6 week checkup and is found to be hypertensive. Which type of hypertension is the patient is exhibiting? A. Pregnary-induced hypertension PIH B. Gestational hypertension C. Preeclampsia superimposed on chronic hypertension D. Undiagnosed chronic hypertension

D. Undiagnosed chronic hypertension

A nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz. (4252 g). The nurse should recognize that this client is at risk for which of the following postpartum complications? A. Puerperal infection B. Retained placental fragments C. Thrombophlebitis D. Uterine atony

D. Uterine atony

A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns? A. Early decelerations B. Accelerations C. Late decelerations D. Variable decelerations

D. Variable decelerations

A client that is currently 9 weeks pregnant is being see for her first prenatal visit. The physician orders laboratory testing. The nurse will question which of the following tests that the physician ordered? A. complete blood count (CBC) B. blood type and Rh factor C. rubella titre D. vaginal/rectal swab for GBS screening

D. vaginal/rectal swab for GBS screening

A patient with preeclampsia is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs indicate: A. gastrointestinal upset B. effects of magnesium sulfate C. anxiety caused by hospitalization D. worsening disease and impending convulsions

D. worsening disease and impending convulsions

Physiologic jaundice occurs in the newborn within the first 24 hours

False

A nurse is caring for a client who is postpartum and received methylergonovine. Which of the following findings indicates that the medication was effective?

Fundus firm to palpation

A patient is in the 21st week of their third pregnancy. The patient's first pregnancy ended in fetal death in the 24th week of pregnancy, and the second one was terminated during the third month of gestation. How does the nurse denote the obstetric history of this patient?

G3 p2

A nurse is providing instructions to a client who has been diagnosed with mastitis. Which of the following statements if made by the mother indicates a need for further teaching?

I need to stop breastfeeding until this condition resolves.

When caring for a newborn, which is a sign of cold stress the nurse would anticipate?

Increased respiratory rate

Which medication would the nurse expect to be included in the patient's treatment regimen for a postpartum patient with fourth-degree perineal lacerations who has be prescribed opioid analgesic and now has constipation?

Laxatives

A nurse is planning care for a newborn who is small for gestational age (SGA). Which of the following is the priority intervention the nurse should include in the newborn's plan of care?

Monitor blood glucose levels

Which reflex is occurring when the nurse touches the infant's palm near the base of the fingers and notes that the hand closes into a fist?

Positive palmar grasp reflex

Which hormone prepares the endometrium for possible embryo implantation?

Progesterone

Upon reviewing the reports of a 12-week pregnant patient, the nurse finds that the patient has a low amniotic fluid volume. Which system would the nurse suspect to be affected in the fetus?

Renal insufficiency

Which behavior, if exhibited by this woman, would the nurse identify as a possible maladaptive behavior regarding parent-infant attachment?

Seldom makes eye contact with her son

A newly pregnant client is expressing concern that her baby may not be able to breathe during the pregnancy and may drown. Which is the correct nursing response to this concern?

The placenta provides the oxygen the baby needs

Which statement best describes the reason that fetal circulatory shunts are not needed after birth?

The respiratory function is stimulated.

A nurse is preparing to administer vitamin K by IM injection to a newborn. The nurse should administer the medication into which of the following muscles?

Vastus lateralis

The mother of a 2-day-old newborn asks "How will I know if my baby gets enough breast milk?" Which of the following responses should the nurse make?

Your baby should wet 6-8 diapers per day.

After a woman with blood type Rh-negative undergoes amniocentesis, which is the most appropriate nursing intervention?

administer RhoD immunoglobulin.

A nurse is caring for a newborn immediately following birth. After assuring a patent airway, what is the priority nursing action?

dry skin

Place the following in correct order by which they occur during the ovarian cycle.

follicular phase, ovulation, and the luteal phase.

How many veins and arteries are present between the maternal and the fetal circulatory system by the 5th week of pregnancy?

one vein and two arteries

A nurse is assessing a newborn immediately following a scheduled cesarean delivery. Which of the following assessments is the nurse's priority?

respiratory distress

After teaching a postpartum patient about postpartum blues, which statement indicates effective teaching?

• "I might feel like laughing one minute and crying the next."