Maternity Midterm

A nurse should assess a woman in labor who is receiving continuous epidural analgesia for: SATA

- Hypotension - Severe headache - Urinary retention

A client in her 7th month of pregnancy has been complaining of back pain and wants to know what can be done to relieve it. Which of the following responses by the nurse is most effective?

"Avoid lifting heavy loads, and try using the pelvic tilt exercise."

A woman is to have a routine gynecological examination tomorrow. What instructions should the nurse give this client?

"Be sure not to douche today or tomorrow."

The nurse is discussing breast self-examination with a group of women in a clinic. One woman asks, "When should I do this examination?" What is the best response for the nurse?

"Breast self-examination should be done a few days after your period begins every month."

Your patient is a 37-year-old pregnant woman who is 5 weeks pregnant and is considering genetic testing. During your discussion, the woman asks the nurse what the advantages of chorionic villus sampling (CVS) are over amniocentesis. The best response is:

"CVS can be done earlier in your pregnancy, and the results are available more quickly."

As part of a prenatal nutritional teaching program for a 17-year-old who is concerned about weight gain, which of the following statements by the nurse would be most accurate?

"During pregnancy a woman's caloric needs increase by about 300 calories per day. If you like, I can help you with some meal planning."

A young woman comes to the clinic for contraceptive advice. She says she wants to take the pill. Vital signs are within normal limits. She tells the nurse she has been having intercourse for the past year without protection. What question is it most important for the nurse to ask her?

"How many cigarettes do you smoke each day?"

A nurse is caring for a couple whom the woman has had elective abortion due to fetal anomaly. Which of the following statements made by the nurse would be most therapeutic?

"I am sorry that you have lost the baby"

A nurse is providing discharge instructions to a client who underwent vacuum aspiration following incomplete abortion 18 hours ago. Which statement by the client indicates need for further teachings?

"I can resume sexual intercourse once bleeding has stopped."

A 34-year-old at 32 weeks gestation tells the nurse that her baby will be sick because she saw a dead dog on the road yesterday. What is the best response by the nurse?

"I can see that you are concerned. Let's talk about what is bothering you."

The nurse is caring for a woman who delivered a healthy infant via caesarean delivery 30 minutes ago. The mother says to the nurse, "Please don't touch my belly. I had an operation." What is the nurses best response?

"I must touch your abdomen to check you uterus, but I won't touch your incision."

Which one of the following statements made by a pregnant client concerning weight gain during pregnancy will indicate need for further teaching?

"I should gain weight equal to the weight of my baby by maturity time"

A nurse has instructed a pregnant client in measures to prevent varicose veins during pregnancy which statement by the client indicates a need for further instructions?

"I should wear knee-high hose, but I should not leave them on longer than 8 hours."

A woman is being treated for Trichomonas vaginalis with metronidazole (Flagyl). Which statement the woman makes indicates a need for further teaching?

"I will drink only one glass of wine per meal while I am taking Flagyl."

A nurse is reviewing prenatal care with a client. Which of the following statements by the client best expresses adequate understanding of nutritional needs during pregnancy?

"I will need to eat more so that I will gain about 25 pounds, but I want to make sure I don't fill up with junk food."

Which of the following statements if made by a pregnant client who is receiving iron supplements would indicate that she understands the medication instructions?

"I will take the iron with orange juice"

The client is being discharged following a left simple mastectomy. Which statement the client makes indicates an understanding of discharge teaching?

"I won't let anyone take blood pressures on my left arm."

Your pregnant patient is having maternal alpha-fetoprotein (AFP) screening. She does not understand how a test on her blood can indicate a birth defect in the fetus. The best reply by the nurse is:

"If babies have a neural tube defect, alpha-fetoprotein leaks out of the fetus and is absorbed into your blood, causing your level to rise. This serum blood test detects that rise."

When a woman in early pregnancy is leaving the clinic, she blushes and asks the nurse if it is true that sex during pregnancy is bad for the baby. What is the best response for the nurse to make?

"In a normal pregnancy, intercourse will not harm the baby. However, many women experience achange in desire. How are you feeling?"

Which of the following is a medical indication for a cesarean birth? SATA

- Late deceleration of the fetal heart rate with minimal variability - Complete placenta previa - Arrest of fetal descent

A pregnant client with Diabetes Mellitus visits her doctor's office for follow up care on the 36th week gestation. Because she is experiencing a high risk pregnancy, the doctor advised her that she may need to undergo a test for Lecithin/Sphingomyelin (L/S ratio) determination. The client asks the nurse "what is the purpose of this test?" . The nurse's appropriate reply is:

"It is a test to determine the pulmonary maturity of the fetus you are carrying."

A client in the first trimester complains of nausea every morning and asks about medicine to prevent it. What is the nurse's most helpful response?

"Let me tell you about some methods to control nausea without medication."

The nurse has explained physiological changes that occur during pregnancy. Which statement indicates that the woman understands the information?

"My breathing will get deeper and a little faster."

A young woman asks the nurse if oral contraceptives have any side effects. What is the best response for the nurse to make?

"Nausea, fluid retention, and weight gain."

A 39-year-old woman is seen in the gynecology clinic and asks the nurse about menopause. What is the best explanation for the nurse to give her?

"No more ovarian hormones are produced, so you will stop menstruating."

A client diagnosed with Hydatidiform Mole (H-Mole) who has undergone Dilatation and Evacuation via vacuum aspiration to remove uterine contents is being prepared for discharge. Which of the following statements made by the client would indicate a need for further teaching?

"Now that my uterus is clear, I am free to conceive anytime I want to"

A young woman has been having lower abdominal pain and amenorrhea. She is diagnosed as having an ovarian cyst. She asks the nurse what the usual treatment is for an ovarian cyst. What is the best response for the nurse to make?

"Ovarian cysts are usually surgically removed."

A primipara client in her 10th month of pregnancy calls the nurse today that she is experiencing slight vagina bleeding. What is the nurse's best response?

"Save any perineal pads, clots, and tissue, and come to the clinic right away"

A young couple asks the nurse which method of contraception is the best and the one that they should use. Which response is most helpful to the couple?

"The best method is the one that you both agree upon and will use consistently."

Methergine 5 mg Q.I.D is ordered for a postpartum client. An hour after taking the drug, the woman complains of uterine cramping. What is the best explanation for the nurse to give her?

"The cramping is uncomfortable, but it is a sign that the drug is keeping your uterus contracted so you won't bleed too much."

Your pregnant patient is in her first trimester and is scheduled for an abdominal ultrasound. When explaining the rationale for early pregnancy ultrasound, the best response is:

"The test will help to determine how many weeks you are pregnant."

A 21-year-old married woman thinks she may be pregnant. She goes to her physician and tells the nurse that the drugstore test was positive for pregnancy. She asks the nurse if the test is reliable. What is the best response for the nurse to make?

"The tests are quite reliable. In order to be sure you are pregnant, I need to get some more information from you."

Which of the following suggestions will a nurse make known to a woman who regularly takes alcohol and is planning to become pregnant?

"There is no "safe" level of alcohol ingestion in pregnancy"

After her examination by the physician, the antepartal client tells the nurse that the doctor said she had positive Chadwick's and Goodell's signs. She asks the nurse what this means. What is the best response for the nurse to make?

"These help to confirm pregnancy. They refer to color changes and changes in the uterus caused by increased hormones of pregnancy."

Which of the following places a couple at higher risk for conceiving a child with a genetic abnormality? SATA

- Maternal age over 35 years - Partner who has a genetic disorder

A mother asks the nurse about the normal time for onset of menstruation. The nurse would be most accurate in telling her that menses occur at about age:

12 to 16 years

A 17-year-old gravida 2, para 1 at 38 weeks' gestation comes to the clinic complaining of headache. She has had leg edema for the past 3 weeks. Her blood pressure is 150/100 mm Hg. The client is admitted for treatment of PIH, and magnesium sulfate I.V. therapy is initiated. The client says she feels "doped and sleepy" and "doesn't like feeling this way." What is the nurse's best response?

"This is one side effect of magnesium sulfate therapy; the feeling will go away when the medication is discontinued."

A client is in the second trimester of her first pregnancy. She confides that she has been smoking about half a pack of cigarettes per day because she had been told that smoking results in smaller babies and she is fearful of delivery. What is the best response by the nurse?

"Unfortunately, the smaller size of the baby of a smoking mother has more to do with its overall development than with the ease of delivery. Let's talk about it."

What will the nurse begin with when asking a patient about drug use during a prenatal history?

"What over-the-counter and prescription drugs have you taken in the past 3 months?

A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients emotional responses to their infertility. Which of the following responses would the nurse expect to find? SATA

- Anger at others who have babies. - Feelings of failure because they cannot make a baby. - Guilt on the part of one partner because he or she is unable to give the other a baby.

A nurse is developing a plan of care for a pregnant client who is complaining of constipations. To help alleviate this problem the nurse instructs the client to: SATA

- Drink at least 8 glasses of water each - Take high-dietary fiber food

A woman seeks care at an infertility clinic. Which of the following tests may this woman undergo to determine what, if any, infertility problem she may have? SATA

- Endometrial biopsy - Hysterosalpingogram - Serum FSH analysis

Which of the following advice given to a pregnant woman concerning exercise in pregnancy would be correct? SATA

- Exercise should be kept to minimum - Certain modifications in position during exercise will be needed - Avoid prolonged exercising

A nurse is instructing a pregnant client on evaluation of kick count and Instructs the client to contact health care provider if the following is noted: SATA

- Fewer than 8 kicks in an hour - Cessation of fetal movement for 12 hours - Fewer than three kicks within an hour

The ovarian cycle includes which of the following phases? SATA

- Follicular phase - Ovulatory phase - Luteal phase

During a community education health fair, the nurse discusses women's issues to a group of interested listeners regarding vaginal health care concerns. Which of the following factor(s) could alter vaginal pH and predispose the woman to develop vaginal infections? SATA

- Frequent douching - Sexual intercourse - Use of tight, synthetic underwear - Treatments involving use of antibiotics

The nurse is obtaining history and physical information on a new patient attending her first prenatal visit. After recording current height, weight, and BMI, it is determined that the patient is obese. What complications related to obesity will the nurse assess this patient for during pregnancy?

- Gestational diabetes - Hypertension - Pre-eclampsia

A Gravida 1 Para 0 (G1PO) known alcoholic visits the prenatal clinic for an initial check-up. She asks the nurse "what are the effects of alcohol on my unborn baby?" The nurse discusses the signs of Fetal Alcohol Syndrome with the client. Which of the following are typical of a newborn with FAS? SATA

- Microcephaly - Thin upper lip - Small palpebral fissures

Asking the pregnant woman about her use of recreational drugs is an essential component of the prenatal history. Harmful fetal effects that may occur from recreational drugs include? SATA

- Miscarriage/spontaneous abortion - Low birth weight

Presumptive signs of pregnancy include: SATA

- Nausea - Fatigue - Amenorrhea

The perinatal nurse teaches the student nurse that deep breathing exercises following a cesarean birth are critical to the prevention of: SATA

- Pneumonia - Atelectasis

The clinic nurse advocates for smoking cessation during pregnancy. Potential harmful effects of prenatal tobacco use include? SATA

- Preterm birth - Low birth weight

A pregnant woman in her last trimester is admitted to hospital with diagnosis of severe pre-eclampsia. The nurse monitors for which complications associated with this diagnosis: SATA

- Proteins in urine - Lower limps edema

A woman, gravida 3, Para 2, is attending her fourth prenatal visit and confides in the nurse that she is bartered by her husband. She is assessed to have multiple bruises at various stages of healing. What nursing actions are appropriate for the nurse to implement? SATA

- Provide privacy for the assessment. - Determine if children are being hurt. - Communicate in a non-judgmental way - Determine factors that increase the risk of injury.

The clinic nurse explains to Margaret, a newly diagnosed pregnant woman at 10 weeks gestation, that her rubella titer indicates that she is not immune. Margaret should be advised to: SATA

- Receive the rubella vaccine postpartum - Report signs or symptoms of fever, runny nose, and generalized red rash to the health-care provider

Which of the following statements concerning blood vessels of the umbilical cord are correct? SATA

- The arteries carry blood away from the fetus - There are two arteries and one vein

Vaginal discharge in pregnancy is more noticeable because of increased blood supply to the pelvic area. Which of the following occurrence will the nurse instruct the client to report? SATA

- Yellowish discharge - Discharge accompanied by itchiness - Discharge with a foul odor

A pregnant client inquires from the nurse about when she can find out the sex of her baby. The nurse's response will be based on the knowledge that genitalia is visible on ultrasound by week:

17

80 mg of Solu-Medrol has been prescribed. Available: Solu-Medrol 125 mg in 2 mL. How many mL should you withdraw from the vial?

1.28

During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from:

2 to 8 weeks

The nurse who is assessing a G2 P1 palpates the fundal height at the location noted on the picture below: The nurse concludes that the fetus is equal to which of the following gestational ages?

20 weeks

A post-cesarean section client has been ordered to receive 500 mL of 5% dextrose in water every 4 hours. The drop factor of the macrodrip tubing is 10 gtt/mL. To what drip rate should the nurse regulate the IV? __________ gtt/min

21

An adolescent client asks the nurse about the menstrual cycle. The nurse describes the cycle and tells the client that the normal fluid loss during menses is how much?

30 to 40 ml

The nurse working in a prenatal clinic is providing care to three primigravida patients. Which of the patient findings would the nurse highlight for the physician?

30 weeks, states that her vision is blurry

Early decelerations are probably caused by:

Momentary increase in intracranial pressure due to head compression

Blood volume expansion during pregnancy leads to:

Physiological anemia of pregnancy

The clinic nurse is aware that the pregnant womans blood volume increases by:

40% to 45%

A clinic nurse explains to the pregnant woman that the amount of amniotic fluid present at 24 weeks gestation is approximately:

800 mL

A multigravida in her 34th week of gestation presents in the emergency department complaining of vaginal bleeding. Which of the following should be the nurse's first action?

Assess fetal heart rate (FHR) and maternal blood pressure.

A client on 2 gm/hr of magnesium sulfate has decreased deep tendon reflexes. Identify the priority nursing assessment to ensure client safety:

Assess respiratory rate.

An ultrasound of a fetus heart shows that normal fetal circulation is occurring. Which of the following statements is consistent with the finding?

A right to left shunt is seen between the atria.

The nurse is caring for several immediate postpartum women. Which client should the nurse attend to first?

A woman says her bed suddenly feels wet beneath her bottom.

A client delivered a 2800-gram neonate 4 hours ago by cesarean section with epidural anesthesia. Which of the following interventions should the nurse perform on the mother at this time?

Assess the clients respiratory rate.

A post-cesarean birth woman has been diagnosed with paralytic ileus. Which of the following symptoms would the nurse expect to see?

Abdominal distension

According to agency policy, the perinatal nurse provides the following intrapartal nursing care for the patient with preeclampsia:

Administer magnesium sulfate according to agency policy

A 46-year-old woman visits her gynecologist because she has been spotting. She is to be evaluated for carcinoma of the cervix. If she has cancer of the cervix, she is most likely to report that vaginal spotting occurred at what time?

After intercourse

When planning prenatal education for a client the nurse should initially gather information concerning the following:

All of the above: - Gender of health care provider preferred - Type of infant feeding planned - Previous attendance of child birth class

Intimate partner violence (IPV) against women consists of actual or threatened physical or sexual violence and psychological and emotional abuse. Screening for IPV during pregnancy is recommended for:

All pregnant women

What is the most common expected emotional reaction of a woman to the news that she is pregnant?

Ambivalence

A patient at 37 weeks gestation is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be palpated?

At the xiphoid process

A woman is to have internal radiation as part of her treatment for cancer of the cervix. In teaching her about the preoperative preparation for this procedure, the nurse should include which information?

An indwelling catheter will be inserted.

A client with hypotonic labor dysfunction has been started on oxytocin (Pitocin). Despite adequate contractions, the fetus does not descend lower than 0 station. The physician recommends cesarean delivery. The client and her husband are confused because she had given birth previously to an average-size infant. They ask several questions about cesarean birth. What would be the most accurate nursing diagnosis for this client?

Anxiety related to lack of knowledge about the need for cesarean birth

A pregnant client is receiving heparin. Which of the following should be a part of nursing assessment on every shift?

Any signs of preterm labor and bleeding from an orifice

A pregnant woman informs the nurse that her last normal menstrual period was on July 6, 2007. Using Naegeles rule, which of the following would the nurse determine to be the patients estimated date of delivery (EDC)?

April 13, 2008

The nurse is caring for a woman who delivered a baby three hours ago. The woman pulls the emergency call light and says she is bleeding all over the bed. The nurse enters the room and sees the blood-soaked bed. What is the best initial action for the nurse to take?

Assess and massage the fundus if soft

The nurse is caring for a woman, G2 P1001, 40 weeks gestation, in labor. A 12 P.M. assessment revealed: cervix 4 cm, 80% effaced, 3 station, and fetal heart 124 with moderate variability. 5 p.m. assessment: cervix 6 cm, 90% effaced, 3 station, and fetal heart 120 with minimal variability. 10 a.m. assessment: cervix 8 cm, 100% effaced, 3 station, and fetal heart 124 with absent variability. Based on the assessments, which of the following should the nurse conclude?

Baby is potentially acidotic.

A woman in her 8th month of pregnancy is having dinner with her husband at their favorite restaurant. The woman suddenly chokes on a piece of chicken and appears to lose consciousness. What would be the best action by a nurse sitting at the next table?

Begin CPR

A client at term arrives at the labor room experiencing contractions every 4 minutes. After a brief assessment, she is admitted and an electronic fetal monitor (EFM) is applied. Which of the following would alert the nurse to an increased potential for fetal distress?

Blood pressure of 146/90 mm Hg

A woman you are caring for in labor requests an epidural for pain relief in labor. Included in your preparation for epidural placement is a baseline set of vital signs. The most common vital sign to change after epidural placement:

Blood pressure, hypotension

During the physical examination for the prenatal visit, it is noted that Chadwick's sign is present:

Bluish or purplish discoloration of the vulva, vagina or cervix

A patient with gestational hypertension is exhibiting all of the signs below. What should the nurse report immediately?

Blurred Vision

The perinatal nurse is assessing a woman in triage who is 34 + 3 weeks gestation in her first pregnancy. She is worried about having her baby too soon, and she is experiencing uterine contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal examination performed by the health- care provider reveals that the cervix is closed, long, and posterior. The most likely diagnosis would be:

Braxton-Hicks contractions

A nurse is providing information to a pregnant client on the changes that occur during pregnancy. While discussing the uterus enlargement that occurs during pregnancy the nurse correctly states that the following ligament is surrounded by muscles that enlarge during pregnancy:

Broad ligament

A client previously diagnosed with Pre-Eclampsia goes into Eclampsia and is being managed with Magnesium Sulfate. The LPN assisting the RN was given instruction to make sure that an antidote used to counteract Magnesium Sulfate toxicity is readily available. What drug should the LPN keep close to the bedside?

Calcium Gluconate (kalcinate)

The nurse is interviewing a gravid woman during the first prenatal visit. The woman confides to the nurse that she lives with a number of pets. The nurse should advise the woman to be especially careful to refrain from coming in contact with the stool of which of the pets?

Cat

A woman is considered in active labor when:

Cervical dilation progresses from 4 to 7 cm with effacement of 40% to 80%, contractions become more intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds.

A first-time mother-to-be is in the labor room, her husband at her bedside. The client states that her contractions began 6 hours ago. Which of the following assessment findings would confirm that the client is in true labor?

Cervix that is 100% effaced and 2 cm dilated

A 23-year-old primigravida client has a normal vaginal delivery. The next day, the nurse assesses the client's lochia for color, amount, and the presence of clots. Which of the following best describes lochia on the first postpartum day?

Dark red (lochia rubra), moderate amount, with a few small clots

When a pregnant client comes to the prenatal clinic, which of the following actions will the nurse perform initially?

Conduct health education

The perinatal nurse explains to the student nurse that __________ is the leading cause of infant death in the United States.

Congenital malformations and chromosomal abnormalities

The nurse is observing a new mother for good maternal-infant attachment. Which observation would be a sign of inappropriate attachment?

Continually saying, "I'm too tired to hold the baby."

A woman who is at 33 weeks gestation has a nonreactive result to nonstress test (NST). The nurse anticipates the following to be done:

Contraction stress test

A client is admitted to the hospital facility and diagnosis of ectopic pregnancy is made. Both nursing and medical measures should give highest priority:

Control of blood loss

The nurse is caring for a pregnant woman receiving an intravenous infusion with magnesium sulfate. What is the most appropriate nursing intervention?

Count respiration and report a rate of less than 12 breaths/min.

A 37-year-old woman who is 17 weeks pregnant has had an amniocentesis. Before discharge, the nurse teaches the woman to call her doctor if she experiences which of the following side effects?

Cramping of the uterus

Information provided by the nurse that addresses the function of the amniotic fluid is that the amniotic fluid helps the fetus to maintain a normal body temperature and also:

Cushions the fetus from mechanical injury

A pregnant client at 38 weeks' gestation is admitted to the emergency room for premature rupture of the membranes (PROM) during the last 24 hours. The nurse should give priority to assessing the woman for:

DONT KNOW ANSWER

While evaluating the needs of a client during the second trimester, the nurse can anticipate which of the following?

DONT KNOW ANSWER

The nurse explain that the softening of the cervix and vagina is a probable sign of pregnancy. What is the appropriate term for this sign?

Goodell's

Folic acid supplementation during pregnancy is to:

Decrease the incidence of neural tube defects in the fetus

A 45 year old woman has been having menorrhagia and metrorrhagia for several months. She is also feeling very tired and run down. Which is the most likely explanation for her fatigue?

Decreased oxygen-carrying capacity of the blood due to chronic loss of iron stores

A woman seeking prenatal care relates a history of macrosomic infants, two stillbirths, and polyhydramnios with each pregnancy. What does the nurse recognize these factors highly suggest?

Diabetes mellitus

You are caring for a patient who was admitted to labor and delivery at 32 weeks gestation and diagnosed with preterm labor. She is currently on magnesium sulfate, 2 gm per hour. Upon your initial assessment you note that she has a respiratory rate of 8 with absent deep tendon reflexes. What will be your first nursing intervention?

Discontinue magnesium sulfate

A 17-year-old primigravida with severe PIH has been receiving magnesium sulfate I.V. for 3 hours. The nurse assesses deep tendon reflexes (UTR), vital signs, and fetal heart tones every 15 minutes and urine output hourly. The latest assessment yields the following data: DIR,+ 1; blood pressure, 150/100 mm Hg; pulse, 92 beats/minute; respiratory rate, 10 breaths/minute; urine output, 20 ml/hour. The client appears flushed and complains of feeling warm. Which nursing action would be most appropriate in light of the current assessment data?

Discontinue the magnesium sulfate infusion.

The fetal circulatory structure that connects the pulmonary artery with the descending aorta is known as which of the following?

Ductus arteriosus

A nurse monitoring the progress of a client in active labor. Which of the following assessment findings, if observed in the fetal monitor, would alert the nurse to suspect the presence of fetal compromise?

Early fetal heart rate deceleration

A pregnant client with a history of multiple sexual partners is at highest risk for which of the following complications:

Ectopic pregnancy

During the early period following a right modified radical mastectomy, which nursing action would be appropriate to include in the client's plan of care?

Elevate the right arm on pillows

The nurse is caring for an adult woman who had a vaginal hysterectomy today. The client is now returned to the nursing care unit following an uneventful stay in the post-anesthesia care unit. What is the priority nursing action for this client?

Encourage coughing and deep breathing

The mechanism of labor known as cardinal movements of labor are the positional changes that the fetus goes through to best navigate the birth process. These cardinal movements are:

Engagement, Descent, Flexion, Internal rotation, Extension, External rotation, Expulsion

A pregnant client states that she has 2-year-old twin boys, and has had one spontaneous abortion at 12 weeks of gestation. What is her GP?

Gravida 3, Para 1 (G3 PI)

The purpose of performing a Biophysical Profile on a woman who is experiencing a high risk pregnancy is to:

Evaluate the wellbeing of the fetus

A client at 42 weeks' gestation is 3 cm dilated, 30% effaced, with membranes intact and the fetus at +2 station. FHR is 140 to 150 beats/minute. The client is started on oxytocin (Pitocin) to induce labor. After 2 hours, the nurse notes on the EFM that the FHR has been ranging from 160 to 190 beats/minute for the past 10 minutes. The client states that her baby has been extremely active. Uterine contractions are strong, occurring every 3 to 4 minutes and lasting 40 to 60 seconds. What part of this assessment data would indicate fetal distress?

FHR ranging from 160 to 190 beats/minute

A nurse is performing assessment of a pregnant client who is at 36 weeks gestation. Which of the following findings would necessitate further evaluation?

Fetal heart rate of 170 beats/minute

In assessing a client for pregnancy, the nurse would look for which sign?

Fetal movement felt by the examiner

The clinic nurse uses Leopold maneuvers to determine the fetal lie, presentation, and position. The nurses hands are placed on the maternal abdomen to gently palpate the fundal region of the uterus. This action is best described as the:

First maneuver

Which of the following nursing diagnoses would be given priority in care of laboring woman who is about to receive epidural analgesia?

Fluid volume deficit

It is determined that the presenting part of the fetus is the buttocks. At delivery the fetus's hips are flexed and the knees are extended. How would the nurse record this presentation?

Frank breech

As the nurse explains the purpose of the tocotransducer (Toco), which she places on the abdomen, she states that this monitoring device provides an accurate evaluation of which of the following?

Frequency of contractions

The clinic nurse is assisting the health care provider perform an initial physical examination on a client on her twelfth week of gestation. Which of the following changes does the nurse expect to see?

Fundal height at or slightly above the symphysis pubis

Which one of the following statements regarding gestational diabetes mellitus is true?

Gestational diabetes is associated with more fetal congenital anomalies than diabetes that occurs before pregnancy.

A client in active labor is having difficulty remaining focused. Her husband, sister and mother are in the room with her. The fetal monitor shows slowing of the FHR that begins after the peak of each contraction. Which of the following nursing measures is best for the client?

Have the client lie on her left side, and ask the family to take turns being with the client one at a time.

A patient's cervix is 8cm dilated and she is 100% effaced. What action by the nurse is the most important at this time?

Have the woman avoid pushing at this time.

The Apgar score consists of a rapid assessment of five physiological signs that indicate the physiological status of the newborn and includes:

Heart rate, respiratory rate, muscle tone, reflex irritability, and color

The nurse is working in a prenatal clinic caring for a patient at 14 weeks gestation, G2 P1001. Which of the following findings should the nurse highlight for the nurse midwife?

Hematocrit of 29%

A client in labor has received an epidural of bupivacaine hydrochloride (Sensorcaine) and epinephrine. Which of the following conditions would take highest priority in a nursing assessment?

Hypotension

A diagnostic test commonly used to assess problems of the fallopian tubes is:

Hysterosalpingogram

Which of the following statements by a pregnant woman indicates she needs additional teaching on ways to reduce risks to her unborn child from the potential effects of exposure to toxoplasmosis?

I will wear a mask when cleaning my cats litter box.

The nurse is renewing a nutritional plan of care with a pregnant client. The nurse determines that the client understands the requirements in pregnancy if she states that she will do the following:

Increase intake of milk which is high in folic acid

The perinatal nurse explains to the student nurse that a goal of the Healthy People 2020 report is to:

Increase proportion of infants who are breastfed to 83.9%.

Which of the following is a normal physiological change that occurs during pregnancy?

Increased glomeruli filtration rate

The primary complications of amniocentesis are:

Infection

A nurse midwife is assessing a pregnant client for presence of ballotment. To make this determination, the nurse-midwife does which of the following?

Initiates a gentle upward tap on the cervix

Why does women taking oral hypoglycemic agents to control diabetes mellitus need to switch to insulin during pregnancy?

Insulin does not cross the placental barrier to the fetus.

Augmentation of labor:

Is part of the active management of labor instituted when the labor process is unsatisfactory and uterine contractions are inadequate

A woman at 40 weeks gestation has a diagnosis of oligohydramnios. Which of the following statements related to oligohydramnios is correct?

It indicates that there is a 50% reduction of amniotic fluid.

The following statement on human chronic gonadotrophin (HCG) are true except one:

It suppresses the activity of the corpus luteum

A client on her first trimester of pregnancy reports that her menstrual period has been regular and lasted 5 days. On this current pregnant, she says "my last menstrual flow started on October 5, 2020. When am I expected to have my baby? The clinic nurse correctly responds:

July 12, 2021

An antepartal client asks when her baby is due. Her last menstrual period was August 28. Using Naegele's rule, calculate the estimated date of delivery:

June 4

A 26-year-old primigravida is in labor. Her cervix is 5 cm dilated and 75% effaced; the fetus is at 0 station. The client requests medication to relieve the discomfort of contractions, and the physician prescribes an epidural regional block. What position should the nurse help the client to assume when the epidural is administered?

Lateral

The LPN is attending a class in Childbirth Education that is conducted by the Maternal Child educator of her facility. The educator explains the purpose and value of effleurage for a client in labor. The LPN understands that effleurage is:

Light abdominal stroking during a contraction

The nurse is providing prenatal teaching to a group of diverse pregnant women. One woman, who indicates she smokes two to three cigarettes a day, asks about its impact on her pregnancy. The nurse explains that the most significant risk to the fetus is:

Low neonatal birth weight

A 16-year-old patient is admitted to the hospital with a diagnosis of severe preeclampsia. The nurse must closely monitor the woman for which of the following?

Low platelet count

A pregnant 19-year-old on her 12th week gestation period calls her gynecologist complaining of a milky-white vaginal discharge. She is diagnosed with Bacterial Vaginosis (BV). Which of the following instructions is most important for the nurse to focus on during client teaching?

Maintain cleanliness and avoid contamination after elimination

A client in labor with her second baby is 5 cm dilated. The physician has diagnosed hypotonic labor dysfunction and plans an oxytocin augmentation. What is the nurse's priority intervention?

Maintain placental circulation.

A woman is admitted to the postpartum unit two hours after delivery of a baby. What action is especially important because the membranes were ruptured for 28 hours before delivery?

Monitor her temperature every two hours

The nurse is caring for a client who has had a right modified radical mastectomy this morning. Which exercise should the nurse encourage the client to perform this evening?

Movement of the fingers and wrists of the right arm

The physician prescribes clomiphene(Clomid) for a woman who has been having difficulty getting pregnant. When discussing this drug with the woman, the nurse should know that which of the following is known to be a side effect of clomiphene?

Multiple births

Which narcotic antagonist is used to reverse narcotic-induced respiratory depression during labor?

Naloxone (Narcan)

Which of the following medications would a nurse have available when administering a narcotic to a client intrapartum?

Naloxone hydrochloride

A type 1 diabetic patient has repeatedly experienced elevated serum glucose levels throughout her pregnancy. Which of the following complications of pregnancy would the nurse expect to see?

Neonatal macrosomia

The clinic nurse reviews the complete blood count results for a 30-year-old woman who is now 33 weeks gestation. Tamaras hemoglobin value is 11.2 g/dL, and her hematocrit is 38%. The clinic nurse interprets these findings as:

Normal pregnancy values for the third trimester

In establishing a teaching plan for a client who is in the first trimester of pregnancy, the nurse identifies a long list of topics to discuss. Which is most appropriate for the first visit?

Nutrition and activity during pregnancy

A woman presents to the prenatal clinic at 30 weeks gestation reporting dysuria, frequency, and urgency with urination. Appropriate nursing actions include:

Obtain clean-catch urine to assess for a possible urinary tract infection.

The best time to give prophylactic antibiotics to the women undergoing cesarean section is:

One hour before the surgery

Which of these medications is commonly used to control postpartum bleeding related to uterine atony?

Oxytocin

Which of the following complications of pregnancy are most common among adolescents?

PIH and iron-deficiency anemia

A primipara at 32 week's gestation comes to the hospital complaining of vaginal bleeding. She has soaked one peripad. She has no pain or cramps. In performing an assessment, the nurse would suspect which of the following?

Placenta Previa

A nurse is admitting a woman for a scheduled cesarean section. Which of the following assessment data should be immediately reported to the physician?

Platelet count of 97,000

The nurse notes each of the following findings in a woman at 10 weeks gestation. Which of the findings would enable the nurse to tell the woman that she is probably pregnant?

Positive pregnancy test

In caring for a woman in labor, one of the factors to evaluate is uterine activity. This is referred to as the __________ of labor.

Powers

The clinic nurse talks with Kathy about her possible pregnancy. Kathy has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. These symptoms are best described as:

Presumptive signs of pregnancy

A mother inquires from the nurse why erythromycin ointment is applied to her newborn baby's eyes. The nurse explains that this is done routinely to:

Prevent eye infection

The physician has ordered intravenous oxytocin for induction for four gravidas. In which of the following situations should the nurse refuse to comply with the order?

Primigravida with complete placenta previa

The single most important risk factor for preterm birth includes:

Prior preterm birth

The childbirth educator is conducting a class to a group of expectant parents on the various hormonal changes during pregnancy. Which of the following hormones help preserve pregnancy by reducing uterine contractions and exerting a relaxing effect on the uterine musculature?

Progesterone

A nurse is teaching a woman about her menstrual cycle. The nurse states that __________ is the most important change that happens during the secretory phase of the menstrual cycle.

Proliferation of the endometrium

A 15-year-old pregnant client comes alone to the maternity clinic and states that she and her boyfriend have run away from home. Neither is employed. Which of the following goals is likely to have the greatest long-term effect on the future well-being of this client?

Promotion of physical well-being

A client who is being treated for syphilis says to the nurse, "Why does the doctor want to know who I have had sex with?" What should the nurse include when responding to this question?

Reporting of sexual contacts is mandatory so that the contacts can receive testing and treatment.

A woman at 32 weeks gestation is diagnosed with severe preeclampsia with HELLP syndrome. The nurse will identify which of the following as a positive patient care outcome?

Resolution of thrombocytopenia

A woman who is admitted to labor and delivery at 30 weeks gestation, is 1 cm dilated, and is contracting q 5 minutes. She is receiving magnesium sulfate IV piggyback. Which of the following maternal vital signs is most important for the nurse to assess each hour?

Respiratory rate

Which of the following findings in a pregnant woman's history would be an indication for the woman to receive Rho (D) Immune globulin (RhoGam) at 28 weeks of pregnancy?

Rh negative, Coombs negative

What situation would concern the nurse about the presence of Rh incompatibility?

Rh- negative mother, Rh-positive fetus

A primigravida client with acquired immunodeficiency syndrome (AIDS) is in labor at term. In preparing her nursing care plan, the nurse should include which of the following nursing diagnoses?

Risk for infection related to suppressed immune status

The nurse is assisting a physician in the delivery of a baby via vacuum extraction. Which of the following nursing diagnoses for the gravida is appropriate at this time?

Risk for injury

The clinic nurse knows that the part of the endometrial cycle occurring from ovulation to just prior to menses is known as the:

Secretory phase

A diabetic client delivers a 6-lb baby at 36 weeks' gestation. The infant is placed in the neonatal intensive care unit (NICTJD). The mother is grieving over the early delivery. What action by the nurse would be most helpful to the client?

Seek involvement of external support systems to provide emotional comfort and material resources for the client.

The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of __________.

Sickle cell anemia

The nurse has taken a health history on four multigravida patients at their first prenatal visits. It is high priority that the patient whose first child was diagnosed with which of the following diseases receives nutrition counseling?

Spina bifida

A client is to take Clomiphene Citrate for infertility. Which of the following is the expected action of this medication?

Stimulate release of FSH and LH

A nurse working in a prenatal clinic is caring for a woman who asks advice on foods that are high in vitamin C because I hate oranges. The nurse states that 1 cup of which of the following raw foods will meet the patients daily vitamin C needs?

Strawberries

Identify the hallmark of placenta previa that differentiates it from abruptio placenta:

Sudden onset of painless vaginal bleeding

A 27-year-old primipara in her 5th month of pregnancy has been receiving regular prenatal care since week 8. She complains of feeling dizzy, breathless, and clammy on rising from bed in the morning. In responding to the client, the nurse would assess for which of the following conditions?

Supine hypotension

A woman who is 37 weeks pregnant reports feeling dizzy when lying on her back. What does the nurse explain as the most likely cause of this symptoms?

Supine hypotension syndrome

A woman who had a cesarean section tells the nurse, "I guess I flunked natural childbirth because I had to have a cesarean." This statement is most indicative of which phase of postpartum adjustment?

Taking in

Which statement correctly describes the nurses responsibility related to electronic fetal monitoring?

Teach the woman and her family about the monitoring equipment and discuss any questions they have.

During a routine prenatal visit in the third trimester, a woman reports she is dizzy and lightheaded when she is lying on her back. The most appropriate nursing action would be to:

Teach the woman to avoid lying on her back and to rise slowly because of supine hypotension.

A client in the labor and delivery unit is undergoing Pitocin induction for labor augmentation. The LPN is assisting the RN by observing the client for signs and symptoms of Abruptio Placenta. Which of the following is indicative of this condition?

Tender, hard and woody uterus

What symptom reported by a pregnant patient would lead the nurse to suspect pyelonephritis?

Tenderness in the flank area

A client asks the nurse the difference between an intrauterine device (IUD) and a diaphragm. The nurse's response should be based on which information?

The IUD is placed into the uterine cavity by the doctor, and the diaphragm is placed into the vagina each time by the user.

The nurse is caring for a woman who had a postpartum hemorrhage. Which of the following facts about her delivery most likely contributed t the hemorrhage?

The baby weighed 10 lb 6 oz

A laboratory report indicates the L/S ratio (lecithin/sphingomyelin) results from an amniocentesis of a gravid patient with preeclampsia are 2:1. The nurse interprets the result as which of the following?

The babys lung fields are mature.

The nurse is assessing a woman who thinks she may be pregnant. Which information from the client is most significant in confirming the diagnosis of pregnancy?

The client has a history of regular menstrual periods since age 13, and she has missed her second period.

A client is in labor with her first baby. Which of the following would indicate that the client has moved into the second stage of labor?

The client has an uncontrollable urge to bear down.

The nurse is caring for a woman who had a hysterectomy. Which vascular complication should the nurse be especially alert for because of the location of the surgery?

Thrombophlebitis

The nurse is caring for a woman after insertion of radium rods for treatment of cancer of the cervix. The nurse positions her in a supine position with legs extended for which reason?

To keep the rods in the correct position

A client is 6 weeks pregnant with a first baby. During the initial prenatal visit, the client says to the nurse, "I just can't believe I'm really pregnant. I hope this baby is a good idea." What would the nurse conclude from the client's statement?

The client is experiencing normal ambivalence about being pregnant.

A client is 6 weeks pregnant with her first baby. This is her first prenatal visit. She says to the nurse, "I just can't believe I'm really pregnant. I hope this baby is a good idea." What would be the most likely evaluation the nurse would make from the client's statement?

The client is experiencing normal ambivalence about being pregnant.

The nurse is discussing dietary requirements with a pregnant Hindu client who practices a vegan dietary regimen. The client asks the nurse "how can I increase protein intake in my diet?" The nurse advices her to supplement her intake with:

Tofu and soy meal products

An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the entire cervical os. What does the nurse understand best describes this condition?

Total placenta Previa

A young woman tells the nurse that her boyfriend used a "rubber" once. What is the most important information about condoms for the nurse to provide the client?

The condom must be applied before any penile- vaginal contact.

While performing Leopolds maneuvers on a woman in early labor, the nurse palpates a flat area in the fundal region, a hard round mass on the left side, a soft round mass on the right side, and small parts just above the symphysis. The nurse concludes which of the following?

The fetal presentation is scapular.

Which of the following laboratory values is most concerning in a client with pregnancy-induced hypertension?

Total platelet count of 40,000 mm

A pregnant woman who has a history of cesarean births is requesting to have a vaginal birth after cesarean (VBAC). In which of the following situations should the nurse advise the patient that her request may be declined?

Transverse fetal lie

The positive signs of pregnancy are:

The objective signs of pregnancy that can only be attributed to the fetus

A couple who has sought infertility counseling has been told that the mans sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur?

The testes are overheated.

A gravida, G4 P1203, fetal heart rate 150s, is 14 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct?

The woman is experiencing a normal pregnancy.

The clinic nurse includes screening for domestic violence in the first prenatal visit for all patients. An appropriate question would be:

This is something that we ask everyone. Do you feel safe in your current living environment and relationships?

A 35-year-old client is in the 8th month of her first pregnancy. Her physician orders a biophysical profile to be conducted the next day. What equipment would the nurse assemble to conduct this test?

Ultrasound machine and fetal monitor

The clinical instructor asks a group of LPN students "what is the earliest noninvasive method to positively diagnose pregnancy?" A student correctly responds:

Ultrasound photography

A nurse is reviewing diet with a pregnant woman in her second trimester. Which of the following foods should the nurse advise the patient to avoid consuming during her pregnancy?

Uncooked soft cheese

A woman presents to a prenatal clinic appointment at 10 weeks gestation, in the first trimester of pregnancy. Which of the following symptoms would be considered a normal finding at this point in pregnancy?

Urinary frequency

The nurse is caring for a woman the day after the insertion of radium rods for treatment of cancer of the cervix. The woman calls the nurse and says, "There is something between my legs. It fell out of me." What is the most appropriate initial action for the nurse to take?

Using long forceps, place the radium needle in a lead-lined container

The nurse is caring for a woman after the insertion of radium rods for treatment of cancer of the cervix. Which discomfort should the nurse anticipate that the client may have while the rods are in place?

Uterine cramps

A 45 year old woman was found to have several large fibroid tumors. She is to have an abdominal panhysterectomy. She asks what a panhysterectomy includes. The nurse tells the client that a panhysterectomy consists of the removal of which of the following?

Uterine funds and body, uterine cervix, Fallopian tubes, and ovaries

When educating prenatal clinic clients about embryonic fetal development, the nurse states that the blood begins to pump at:

Week 12

When educating prenatal clinic clients about embryonic fetal development, the nurse and states that the heart begins to pump blood at:

Week 4

A 42-year-old woman sees her physician because of painless spotting between periods that is worse after intercourse. A Pap smear is done. The results come back as stage III. The client asks the nurse what a stage III Pap smear means. The nurse's response is based on the knowledge that a stage III Pap smear indicates that:

cells suggestive but not diagnostic of malignancy are present.