MCN_Abnormal

a. hypotonic uterine dysfunction due to ineffective contraction

A 26 year old primigravida is admitted in active labor. Four hours later, her contractions are not strong enough to cause the cervix to dilate and uterine tone has decreased. Which would you suspect? a. hypotonic uterine dysfunction due to ineffective contraction b. hypertonic uterine dysfunction related to ineffective contractions c. uterine contraction related to big fetus d. uterine dysfunction related to maternal fatigue

b. enlarged, hardened veins

A PP nurse is assessing a mother who delivered a healthy newborn infant by CS. The nurse is assessing for signs and symptoms of superficial venous thrombosis. Which of the following signs or symptoms would be the nurse note if this is present? a. paleness of the calf area b. enlarged, hardened veins b. coolness of the calf area d. palpable dorsalis pedis pulses

a. betamethasone

A client at 30 weeks gestation enters the labor and delivery unit with ruptured membranes. Which of the following drugs is administered from the 24th and 32nd weeks of pregnancy to promote fetal lung maturity? a. betamethasone b. oxytocin c. Mg SO4 d. Terbutaline

d. excessive fetal activity and fetal tachycardia

A client at 42 weeks gestation is 3 cm dilated 30%effaced, with membranes intact and the fetus at +2 station. FHR is 140-150 beats/min. After 2 hours, the nurse notes on the external fetal monitor that for the past 10 minutes, the FHR ranged from 160-190 beats/minute. The client states that her baby has been extremely active. Uterine contractions are strong, occuring every 3-4 minutes and lasting 40-60 seconds. Which of the following findings would indicate fetal hypoxia? a. abnormally long uterine contractions b. abnormally strong uterine intensity c. excessively frequent contractions with rapid fetal movement d. excessive fetal activity and fetal tachycardia

c. blood pressure of 150/90 mmHg

A client at term arrives in the labor unit experiencing contractions every 4 minutes. After a brief assessment, she is admitted and an electric fetal monitor is applied. Which of the following observations would alert the nurse to an increased potential for fetal distress? a. total weight gain of 30 lbs b. maternal age of 32 years c. blood pressure of 150/90 mmHg d. treatment for syphilis at 15 weeks gestation

a. assess fundal tone and lochia flow

A client has delivered twins. Which of the following intervention would be most important for the nurse to perform? a. assess fundal tone and lochia flow b. administer analgesics as ordered c. apply cold pack to the perineal area d. encourage voiding by offering the bed pan

c. encourage her to empty her bladder and drink plenty of fluids and give IV fluids

A client hospitalized for premature labor tells the nurse she's having occasional contractions. Which of the following nursing interventions would be most important for the nurse to perform? a. teach the client the possible complications of premature birth b. tell the client to walk to see if she can get rid of the contractions c. encourage her to empty her bladder and drink plenty of fluids and give IV fluids d. notify anesthesiologist for immediate epidural placement to relieve the pain associated with contractions

d. all of these

A major reson/s for infertility in women: a. anovulation b. weight c. age d. all of these

b. changes in vital signs

A nurse is caring for a PP woman who has received epidural anesthesia and is monitoring the woman for the presence of vulva hematoma. Which of the following assessment findings would be best indicate the presence of a hematoma? a. complaints of a tearing sensation b. changes in vital signs c. complaints of intense pain d. signs of heavy bruising

a. uterine inversion

A short umbilical cord may predispose to: a. uterine inversion b. nuchal cord c. cord prolapse d. placenta previa

a. clean catch urine specimen

A woman who is 3 days postpartum comes to the emergency clinic because she is having pain and burning sensation when she urinates. She denies that she had any fever. The nurse should expect an initial order for: a. clean catch urine specimen b. intravenous antibiotics c. bladder analgesics d. complete blood count

c. note the color, amount and odor of the fluid

A woman with a term, uncomplicated pregnancy comes into the labor and delivery unit in early labor saying that she thinks her water has broken. Which of the following actions by the nurse would be most appropriate? a. prepare the woman for delivery b. immediately contact the physician c. note the color, amount and odor of the fluid d. collect a sample of the fluid for microbial analysis

a. walking around her room listening to music

Bailey Cheshire develops endometritis. When planning nursing care, which activity would be best to advise for Bailey? a. walking around her room listening to music b. lying supine with cold cloth on her forehead c. reading while resting in a slight trendelenburg position d. alternating between prone and supine positions

a. semi-sitting

Best positions for the woman who has post partum endometritis a.semi-sitting b. supine c. side-lying d. prone

a. endometrial implants obstruct both of the fallopian tubes

Cherry Carlos is diagnosed as having endometriosis as a cause of her sub-fertility. The nurse would want her electronic health record to reflect the fact that this condition interferes with fertility because of which of the following? a. endometrial implants obstruct both of the fallopian tubes b. the ovaries stop producing estrogen and progesterone c. the uterine cervix becomes very inflamed and swollen d. pressure on the pituitary leads to decreased FSH levels

a. she may feel some mild cramping when the contrast medium is inserted

Cherry Carlos is scheduled to have a sonohysterosalphingography. Which of the following instructions would want the nurse and the care team members to know so the patient teaching can be consistent? a. she may feel some mild cramping when the contrast medium is inserted b. the x-ray of the uterus will reveal any fibroid tumors or adhesion present c. she will not be able to conceive for at least 3 months after the procedure d. many women experience mild bleeding for up to 2 hours as an after effect

a. oral temperature of 37.9C 48 hours postpartum

Choose the findings that suggests infectious infections after birth. a. oral temperature of 37.9C 48 hours postpartum b. WBC count of 18,000 at 1 day postpartum c. poorly relieved perineal pain 4 hours postpartum d. persistent and severe cramping 3 days postpartum

a. encourage her to walk several times each day

Choose the most appropriate intervention to prevent deep vein thrombosis (DVT) in a woman who is one day post-cesarian birth. a. encourage her to walk several times each day b. take her temperature to identify an elevation c. provide her with increased fluid that she enjoys d. instruct her to stay in bed most of the day

a. puerperal sepsis

Foul-smelling lochia and fever during the immediate puerperium is a sign of: a. puerperal sepsis b. endometriosis c. retained placental fragments d. sun-involution

d. massage uterus until it is firm

If the nurse finds that a new mother's uterus is soft, the appropriate initial action is to: a. insert an indwelling catheter b. increase the rate of the IV fluid c. Check vital signs d. massage uterus until it is firm

a. massaging the fundus firmly

In performing assessment of a postpartum client 2 hours after delivery, the nurse notices heavy bleeding with large clots. Which of the following responses is most appropriate initially? a. massaging the fundus firmly b. administering ergonovine maleate c. performing bimanual compressions d. notifying the primary health care provider

False

Including the support person in postpartum depression education creates a barrier to recognizing postpartum depression. True or False?

False

Many nurses find it easy to speak with patients regarding postpartum depression. True or False?

a. hypertension

Methygovine (methergine) should be avoid if the woman has: a. hypertension b. hypotension c. uterine atony d. retained placenta

c. android

Mrs. Lim is scheduled for x-ray pelvimetry due to prolonged second stage of labor. Which type of pelvis resembles the male pelvis, is the heart-shaped and often complicates labor? a. gynecoid b. anthropoid c. android d. platypelloid

d. notify the physician of the observation

One hour after vaginal birth, the nurse notes that a woman has a flat purple area, about 2 cm by 3 cm on per perineum. Which is the most appropriate nursing action this time? a. assist her to take a warm sitz bath b. reapply a chemical cold pack on the area c. apply pressure with a tightly applied pad d. notify the physician of the observation

c. depression unrelated to childbirth

Postpartum depression symptoms are similar to ____symptoms a. bipolar disorder b. anorexia nervosa c. depression unrelated to childbirth d. borderline personality

False

Removal of the child from the home is a common response to PPD diagnosis? TRUE or FALSE?

A, C, D

Risk factors for postpartum depression include: choose all that apply a. history of abuse b. marriage c. history of mental illness d. concurrent life events

a. document/ report frequency and duration of contractions plus facilitate pain relief

Rosanna Abuloyan states that her contractions are irregular in frequency and short duration. She is screaming in pain, however, every time she has a contraction. What action by the nurse would be best? a. document/ report frequency and duration of contractions plus facilitate pain relief b. recognize that this is a usual response to labor and offer her a back rub c. notify the anesthesiologist that Rosanna needs to have an epidural anesthesia d. obtain a prescription from her primary care provider for an analgesic

b. On her hands and knees to help fetal rotation

Rosanna's baby is not only large but also in an occipito-posterior position. The nurse would want the team members to know which position is best for woman whose baby is in occipito-posterior position during labor. a. On her right side to stretch the pelvic inlet b. On her hands and knees to help fetal rotation c. Sitting in a rocking chair to aid presentation d. Walking about 30 mins to encourage fetal descent

c. her fetus is large for gestational age by sonogram

Rosanna's primary care provider is considering whether to augment for labor with oxytocin. What would make the nurse question the care provider's use of oxytocin? a. her blood pressure is slightly elevated above normal b. her membranes ruptured after only one hour of labor c. her fetus is large for gestational age by sonogram d. she had amniocentesis performed during pregnancy

b. if their relationship is not monogamous, they still need to use safer sex practices

The Carlos introduce themselves to the nurse as an infertile couple. As a safety measure, the nurse would want them to understand which of the following? a. couples are not termed infertile until they have been trying to conceive for 2 years b. if their relationship is not monogamous, they still need to use safer sex practices c. infertility can cause depression, so the couple should report any feelings of sadness d. infertility is related to antibiotic-resistant infections, so they need to be tested for these

b. blue

The leaking fluid is tested with nitrazine paper, the nurse confirms that the client's membrane have ruptured when the paper turns into which of the following: a. yellow b. blue c. green d. red

a. hemorrhage

The most common cause of direct maternal death in the Philippine is: a. hemorrhage b. hypertension c. infection d. heart disease

a. discontinue the administration of the oxytocin

The nurse notices Rosanna's contraction are 70 seconds long and occur every 90 seconds when assessing the frequency of her contractions after she receives oxytocin. What would the nurse's first action? a. discontinue the administration of the oxytocin b. increase the rate of rosanna's IV fluid infusion c. ask rosanna to turn onto her left side and breathe deeply d. give an emergency bolus of oxytocin to relax the uterus

b. seldom makes eye contact with her son

The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, does the nurse identify as a possible maladaptive behavior regarding parent-infant attachment? a. talks and coos to her son b. seldom makes eye contact with her son c. cuddles her son close to her d. tells visitors how well her son is feeding

a. uterine rupture

The patient with contracted pelvis may develop what complication because of prolonged labor? a. uterine rupture b. uterine bleeding c. uterine prolapse d. uterine inversion

a. antero-posterior diameter

The pelvic inlet has 4 diameter. The most important of these is the obstetrical conjugate which is the: a. antero-posterior diameter b. bi-tuberosity diameter c. oblique diameter d. transverse diameter

a. vasoconstriction by a well contracted myometrium

The primary mechanism by which bleeding in the placental site is prevented after delivery is: a. vasoconstriction by a well contracted myometrium b. action of oxytocin injected after the 3rd stage c. intravascular blood clotting d. reduction of blood flow to the uterine

b. multiple pregnancy

This can lead to hypotonic uterine maternal fatigue a. pregnancy induce hypertension b. multiple pregnancy c. maternal anemia d. appropriate gestational age

b. early ambulation

To prevent post partum thrombophlebitis, which nursing implementation would be most appropriate? a. breastfeeding of newborn b. early ambulation c. immobilization and elevation of the lower extremities d. administration of anticoagulants

a. feelings of sadness during the first two weeks postpartum

What best describe Baby Blues or post partum blues? a. feelings of sadness during the first two weeks postpartum b. more serious problem requiring follow up and treatment from provider c. symptoms requiring immediate treatment

B,C,E

When helping a woman cope with postpartum blues, the nurse should offer what appropriate suggestions? a. the father should take over care of the baby, because postpartum blues are exclusively a female problem b. get plenty of rest c. plan to get out of the house occasionally d. asking for help will now foster independence e. use community mental health centers

a. pink vaginal discharge followed by a red drainage

When teaching a woman following vaginal birth 24 hours ago, the nurse should tell her to report: a. pink vaginal discharge followed by a red drainage b. uterine cramping when the infant nurses c. menstrual-like odor of vaginal discharge d. excretion of large quantities of dilute urine

d. brownish

Which amniotic fluid gives most ominous sign of fetal well being? a. greenish b. yellowish c. grayish d. brownish

c. genital tract laceration and uterine atony

Which are the two most common cause of obstetrical hemorrhage? a. precipitate and prolonged labor b. placenta previa and abruption placenta c. genital tract laceration and uterine atony d. difficult traumatic delivery and anemia

b. more serious problem requiring follow up and treatment from provider

Which best describe postpartum depression? a. feelings of sadness during the first two weeks postpartum b. more serious problem requiring follow up and treatment from provider c. symptoms requiring immediate treatment

b. cervical laceration

Which of the following complications may be indicated by continuous seepage of blood from vagina of a postpartum client. When palpation of the uterus reveals a firm uterus 1 cm below the umbilicus? a. retained placental fragments b. cervical laceration c. urinary tract infection d. uterine atony

b. uterine atony

Which of the following factors puts multiparous client on her first postpartum day at risk for developing hemorrhage? a. hemoglobin level of 12 g/dl b. uterine atony c. thrombophlebitis d. moderate amount of lochia rubra

d. pain in left calf dorsiflexion on left foot

Which of the following findings would be a source of concern if noted during the assessment of a woman who is 12 hours postpartum? a. postural hypotension b. bradycardia- pulse rate of 55 bpm c. temperature of 100 F d. pain in left calf dorsiflexion on left foot

b. oxytocin

Which of the following hormones would be administered for the stimulation of uterine contractions? a. estrogen b. oxytocin c. fetal cortisol d. progesterone

b. postpartum depression

Which of the following terms is used to describe maladaptation to the stress and conflicts of the postpartum period characterized by disabling feelings of inadequacy and an inability to cope? a. postpartum blues b. postpartum depression c. postpartum neurosis d. postpartum psychosis

b. the client feels empty since she delivered the baby

Which of the following verbalization's should be cause for concern to the nurse treating a postpartum client within a few days of delivery? a. the client is nervous about taking the baby home b. the client feels empty since she delivered the baby c. the client would like to watch the nurse give the baby her first bath d. the client would like the nurse to take her baby to the nursery so she can sleep

b. She has a forceps-assisted vaginal birth

Which of these postpartum women is at great risk for bleeding from a vaginal wall laceration? a. She delivered a 3632 g (8lb) infant b. She has a forceps-assisted vaginal birth c. She has a history of uterine atony d. Oxytocin (Pitocin) was used to induce labor

c. PPD can easily go undetected

Which statement regarding postpartum depression is essential for the nurse to be aware of when attempting to formulate a plan of care? a. PPD symptoms are consistently severe b. this syndrome affects only new mothers c. PPD can easily go undetected d. only mental health professionals should teach new parents about this condition

a. check the status of the fetal heart rate

While you are assessing the client's vital signs, the client says "I think my bag of water just broke". Which of the following would you do first? a. check the status of the fetal heart rate b. test the leaking fluid with nitrazine paper c. turn the client to the right side d. perform a sterile vaginal examination

A, C

Why is postpartum depression commonly a missed or under diagnosed problem? Select all that apply. a. women do not report symptoms b. providers do not take reports from patients seriously c. symptoms are masked by common experiences of new mothers d. all of the above