OB final exam book questions

After you complete your nutritional counseling for a pregnant woman, you ask her to repeat your instructions so you can assess her understanding of this instructions given. Which statement indicates that she understands the role of protein in her pregnancy? A. "Protein will help my baby grow." B. "Eating protein will prevent me from becoming anemic." C. "Eating protein will make my baby have strong teeth after he is born." D. "Eating protein will prevent me from being diabetic."

A. "Protein will help my baby grow."

A woman asks the nurse, "What protects my baby's umbilical cord from being squashed while the baby's inside of me?" The nurse's best response is: A. "Your baby's umbilical cord is surrounded by connective tissue called Wharton jelly, which prevents compression of the blood vessels and ensures continued nourishment of your baby." B. "Your baby's umbilical cord floats around in blood anyways." C. "You don't need to worry about things like that." D. "The umbilical cord is a group of blood vessels that are very well protected by the placenta."

A. "Your baby's umbilical cord is surrounded by connective tissue called Wharton jelly, which prevents compression of the blood vessels and ensures continued nourishment of your baby."

A pregnant woman is the mother of two children. Her first pregnancy ended in a stillbirth at 32 weeks of gestation, her second pregnancy with the birth of her daughter at 36 weeks, and her third pregnancy with the birth of her son at 41 weeks. Using the 5-digit system to describe this woman's current obstetric history, the nurse would record: A. 4-1-2-0-2 B. 3-1-2-0-2 C. 4-2-1-0-1 D. 3-1-1-1-3

A. 4-1-2-0-1

The nurse providing care for the laboring woman should understand that accelerations with fetal movement: A. Are reassuring. B. Are caused by umbilical cord compression. C. Warrant close observation. D. Are caused by uteroplacental insufficiency.

A. Are reassuring.

A thorough abuse assessment screen should be done on all patients. This screen includes (choose all that apply): A. Asking the woman whether she has ever been slapped, kicked, punched, or physically hurt by her partner. B. Asking the woman whether she is afraid of her partner. C. Asking the woman whether she has been forced to perform sexual acts. D. Diagramming the woman's current injuries on a body map. E. Asking the woman what she did wrong to elicit the abuse.

A. Asking the woman whether she has ever been slapped, kicked, punched, or physically hurt by her partner. B. Asking the woman whether she is afraid of her partner. C. Asking the woman whether she has been forced to perform sexual acts. D. Diagramming the woman's current injuries on a body map.

With regard to breathing techniques used by a woman during labor, maternity nurses should be aware that: A. Breathing techniques used in the first stage of labor are designed to increase the size of the abdominal cavity to reduce friction. B. By the time labor has begun, it is too late for instruction in breathing and relaxation. C. Controlled breathing techniques are most difficult to adhere to near the end of the second stage of labor. D. The patterned-paced breathing technique can help prevent hyperventilation.

A. Breathing techniques used in the first stage of labor are designed to increase the size of abdominal cavity to reduce friction.

The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by: A. Change in position. B. Oxytocin administration. C. Regional anesthesia. D. Intravenous analgesic.

A. Change in position

When performing vaginal examination on laboring women, the nurse should be guided by what principle? A. Cleanse the vulva and perineum before and after the examination as needed. B. Wear a clean glove lubricated with tap water to reduce discomfort. C. Perform the examination every hour during the active phase of the first stage of labor. D. Perform the examination immediately if active bleeding is present.

A. Cleanse the vulva and perineum before and after the examination as needed.

Which congenital malformations results from multifactorial inheritance? Choose all that apply. A. Cleft lip B. Congenital heart disease C. Cri du chat syndrome D. Anencephaly E. Pyloric stenosis

A. Cleft lip B. Congenital heart disease D. Anecephaly E. Pyloric stenosis

A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure would be to use: A. Counterpressure against the sacrum. B. Pant-blow (breaths and puffs) breathing techniques. C. Effleurage D. Conscious relaxation or guided imagery.

A. Counterpressure against the sacrum.

The uterus is a muscular, pear shaped organ that is responsible for: A. Cyclic menstruation B. Sex hormone production C. Fertilization D. Sexual arousal

A. Cyclic menstruation

On review of a fetal monitor tracing, the nurse notes that for several contractions the fetal heart rate decelerates as a contraction begins and returns to baseline just before it ends. The nurse should: A. Describe the finding in the nurse's notes. B. Reposition the woman onto her side. C. Call the physician for instructions. D. Administer oxygen at 8 to 10 L/min with a tight face mask.

A. Describe the finding in the nurse's notes.

Fibrocystic changes in the breast most often appear in women in their 20's and 30's. The etiology is not known, but it may be an imbalance of estrogen and progesterone. The nurse who cares for this patient should be aware that treatment modalities are conservative. One proven modality that may provide relief is: A. Diuretic administration B. Including caffeine daily in the diet C. Increased vitamin C supplementation D. Application of cold packs to the breast as necessary

A. Diuretic administration

The CDC-recommended medication for the treatment of chlamydia is: A. Doxycycline B. Podofilox C. Acyclovir D. Penicillin

A. Doxycycline

Examples of sexual risk behaviors associated with exposure to a sexually transmitted infection (STI) include (choose all that apply): A. Fellatio B. Unprotected anal intercourse C. Multiple sex partner D. Dry kissing E. Abstinence

A. Fellatio B. Unprotected anal intercourse C. Multiple sex partners

During a woman's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as: A. Hegar's sign B. McDonald's sign C. Chadwick's sign D. Goodell's sign

A. Hegar's sign

Nurses should be aware that infertility: A. Is perceived differently by women and men. B. Has a relatively stable prevalence among the overall population and throughout a women's potential reproductive years. C. Is more likely the result of a physical flaw in the woman than in her male partner. D. Is the same thing as sterility.

A. Is perceived differently by women and men.

A pregnant woman's last menstrual period began on April 8, 2009, and ended on April 13. Using Nagele's rule, her estimated date of birth would be: A. January 15, 2010 B. January 20, 2010 C. December 15, 2009 D. November 5, 2009

A. January 15, 2010

A nurse is caring for a client who is experiencing postpartum hemorrhage. Which of the following should the nurse use to replace fluid volume in this client? (Select all that apply.) A. Lactated Ringer's B. Albumin C. 0.9% sodium chloride D. Packed RBC's E. D5LR

A. Lactated Ringer's B. Albumin C. 0.9% sodium chloride D. Packed RBC's

What position would be least effective when the intent is to use gravity to assist in fetal descent? A. Lithotomy B. Kneeling C. Sitting D. Walking

A. Lithotomy

The nurse must evaluate a male patient's knowledge regarding the use of a condom. The nurse would recognize the need for further instruction if the patient states that he: A. Lubricates the condom with a spermicide containing nonoxynol-9. B. Leaves an empty space at the tip of the condom. C. Leaves a small amount of air in the tip. D. Removes his still-erect penis from the vagina while holding onto the base of the condom.

A. Lubricates the condom with a spermicide containing nonoxynol-9.

A woman in active labor receives an analgesic, an opioid agonist. Which medication relieves severe persistent, or recurrent pain; creates a sense of well-being; overcomes inhibitory factors; and may even relax the cervix but should be used cautiously in women with cardiac disease? A. Meperidine (Demerol) B. Promethazine (Phenergan) C. Butorphanol tartrate (Stadol) D. Nalbuphine (Nubain)

A. Meperidine (Demerol)

A patient has been prescribed adjuvant tamoxifen therapy. What common side effects might she experience? A. Nausea, hot flashes, and vaginal bleeding B. Vomiting, weight loss, and hair loss C. Nausea, vomiting, and diarrhea D. Hot flashes, weight gain, and headaches

A. Nausea, hot flashes, and vaginal bleeding

A nurse is caring for an infant who is preterm and has respiratory distress syndrome (RDS). Which of the following assessment findings will assist the nurse in evaluating the efficacy of synthetic surfactant? A. Oxygen saturation B. Body temperature C. Bilirubin levels D. Heart rate

A. Oxygen saturation

The nurse is assessing a woman's breast self-examination (BSE) technique. Which action indicates that a woman needs further instruction regarding BSE? A. Performs every month on the fist day of her menstrual period. B. Uses the pads of her fingers when palpating each breast. C. Inspects her breasts while standing before a mirror and changing arm positions. D. Places a folded towel under right shoulder and right hand under head when palpating right breast.

A. Performs every month on the first day of her menstrual period.

A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a: A. Primipara B. Primigravida C. Multipara D. Nulligravida

A. Primipara

The nurse should tell a primigravida that the definitive sign indicating that labor has begun would be: A. Progressive uterine contractions B. Lightening C. Rupture of membranes D. Passage of the mucous plug (operculum)

A. Progressive uterine contractions

When planning a diet with a pregnant woman, the nurse's first action would be to: A. Review the woman's current dietary intake. B. Teach the woman about the food pyramid. C. Caution the woman to avoid large doses of vitamins, especially those that are fat-soluble. D. Instruct the woman to limit the intake of fatty foods.

A. Review the woman's current dietary intake.

Nurses should be aware of the differences experience can make in how labor pain is perceived such as: A. Sensory pain for nulliparous women often is greater than for multiparous women during early labor. B. Affective pain for nulliparous women usually is less than for multiparous women throughout the first stage of labor. C. Women with a history of substance abuse experience more pain during labor. D. Multiparous women have more fatigue from labor and therefore experience more pain.

A. Sensory pain for nulliparous women often is greater than for multiparous women during early labor.

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned that during and after tennis matches this woman consumes: A. Several glasses of fluid. B. Extra protein sources such as peanut butter. C. Salty foods to replace lost sodium. D. Easily digested sources of carbohydrate.

A. Several glasses of fluid.

Which behavior indicates that a woman is "seeking safe passage" for herself and her infant? A. She keeps all prenatal appointments. B. She "eats for two." C. She drives her car slowly. D. She wears only low-heeled shoes.

A. She keeps all prenatal appointments

A nurse is caring for a client who has mastitis. Which of the following is the typical causative agent of mastitis? A. Staphylococcus aureus B. Chlamydia trachomatis C. Klebsiella pneumonia D. Clostridium perfringens

A. Staphylococcus aureus

What factors influence cervical dilation? Choose all that apply. A. Strong uterine contractions B. The force of the presenting fetal part against the cervix C. The size of the female D. The pressure applied by the amniotic sac E. Scarring of the cervix

A. Strong uterine contractions B. The force of the presenting fetal part against the cervix D. The pressure applied by the amniotic sac E. Scarring of the cervix

A woman has just moved to the United States from Mexico. She is 3 months pregnant and has arrived for her first prenatal visit. During her assessment interview, you discover that she has not had any immunizations. Which immunizations should she receive at this point in her pregnancy? Choose all that apply. A. Tetanus B. Diphtheria C. Chickenpox D. Rubella E. Hepatitis B

A. Tetanus B. Diphtheria E. Hepatitis B

A 42-year-old woman asks the nurse about mammograms, now that she is "getting older." The nurse should tell her that: A. The American Cancer Society recommends mammograms every 1 to 2 years for women ages 40 to 49. B. The best time to perform a mammogram is just before a menstrual period. C. Regular mammograms reduce the need to perform breast self-examination (BSE). D. Mammograms can confirm the diagnosis for breast cancer.

A. The American Cancer Society recommends mammograms every 1 to 2 years for women ages 40 to 49.

When using intermittent auscultation (IA) to assess uterine activity, nurses should be aware that: A. The examiner's hand should be placed over the fundus before, during, and after contractions. B. The frequency and duration of contractions is measured in seconds for consistency. C. Contraction intensity is given a judgment number of 1 to 7 by the nurse and patient together. D. The resting tone between contractions is described as either placid or turbulent.

A. The examiner's hand should be placed over the fundus before, during, and after contractions.

On completion of a vaginal examination of a laboring woman, the nurse records the following: 50%, 6 cm, -1. What is a correct interpretation of this data? A. The fetal presenting part is 1 cm above the ischial spines. B. Effacement is 4 cm from completion. C. Dilation is 50% completed. D. The fetus has achieved passage through the ischial spines.

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

Fetal well-being during labor is assessed by: A. The response of the fetal heart rate (FHR) to uterine contractions (UCs). B. Maternal pain control. C. Accelerations in the FHR. D. An FHR above 110 beats/min.

A. The response of the fetal hear rate (FHR) to uterine contractions (UCs).

With regard to umbilical cord care, nurses should be aware that: A. The stump can easily become infected. B. A nurse noting bleeding from the vessels of the cord should immediately call for assistance. C. The cord clamp is removed at cord separation. D. The average cord separation time is 5 to 7 days.

A. The stump can easily become infected.

Which is correct concerning the performance of a Papanicolaou (Pap) smear? A. The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test. B. It should be performed once a year, beginning with the onset of puberty. C. A lubricant such as Vaseline should be used to ease speculum insertion. D. The specimen for the Pap smear should be obtained after specimens are collected for cervical infection.

A. The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test.

Examples of appropriate techniques to wake a sleepy infant for breastfeeding include (choose all that apply): A. Unwrapping the infant. B. Changing the diaper C. Talking to the infant D. Slapping the infant's hands and feet E. Applying a cold towel to the infant's abdomen

A. Unwrapping the infant B. Changing the diaper C. Talking to the infant

A first-time mother at 18 weeks of gestation is in for her regularly scheduled prenatal visit. The woman tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that this is the Braxton Hicks sign and teaches the woman that this type of contraction: A. is painless B. increases with walking C. causes cervical dilation D. impedes oxygen flow to the fetus

A. is painless

The nurse-midwife is teaching a group of women who are pregnant instruction of Kegel exercises is included in the teaching. Which statement by a participant would indicate a correct understanding of the instruction? A. "I will only see results if I perform 100 Kegel exercises each day." B. "I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises." C. "I should only perform Kegel exercises in the sitting positions." D. "I will perform daily Kegel exercises during the last trimester of my pregnancy to achieve the best results."

B. "I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises."

A woman inquires about herbal alternative methods for improving fertility. Which statement by the nurse is the most appropriate when instructing the woman in which herbal preparations to avoid while trying to conceive? A. "You should avoid nettle leaf, dong quai, and vitamin E while you are trying to get pregnant." B. "You may avoid licorice root, lavender, fennel, sage, and thyme while you are trying to conceive." C. "You should not take anything with vitamin E, calcium, or magnesium. They will make you infertile." D. "Herbs have no bearing on fertility."

B. "You may want to avoid licorice root, lavender, fennel, sage, and thyme while you are trying to conceive."

A pregnant woman with a body mass index (BMI) of 22 asks the nurse how much weight she should be gaining during pregnancy. The nurse's best response would be to tell the woman that her pattern of weight gain should be approximately: A. A pound a week throughout pregnancy. B. 2 to 5 pounds during the first trimester, then a pound each week until the end of pregnancy. C. A pound a week during the first two trimesters, then 2 pounds per week during the third trimester. D. A total of 25 to 35 pounds.

B. 2 to 5 pounds during the first trimester, then a pound each week until the end of pregnancy.

With regard to spinal and epidural (block) anesthesia, nurses should know that: A. This type of anesthesia is commonly used for cesarean births but is not suitable for vaginal births. B. A high incidence of after-birth headache is seen with spinal blocks. C. Epidural blocks allow the woman to move freely. D. Spinal and epidural blocks are never used together.

B. A high incidence of after-birth headache is seen with spinal blocks.

With regard to chromosome abnormalities, nurses should be aware that: A. They occur in approximately 10% of newborns. B. Abnormalities of number are the leading cause of pregnancy loss. C. Down syndrome is a result of an abnormal chromosome structure. D. Unbalanced translocation results in a mild abnormality that the child will outgrow.

B. Abnormalities of number are the leading cause of pregnancy loss.

Nurses can help their patients by keeping them informed about the distinctive stages of labor. Which description of the phases of the first stage of labor is accurate? A. Latent: Milk, regular contractions; no dilation; bloody show; duration os 2 to 4 hours. B. Active: Moderate, regular contractions; 4 to 7 cm dilation; duration of 3 to 6 hours. C. Lull: No contractions; dilation stable; duration of 20 to 60 minutes. D. Transition: Very strong but irregular contractions; 8 to 10 cm dilation; duration of 1 to 2 hours.

B. Active: Moderate, regular contractions; 4 to 7 cm dilation; duration of 3 to 6 hours.

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be: A. Constipation B. Alteration in the pattern of fetal movement C. Heart palpitations D. Edema in the ankles and feet at the end of the day

B. Alteration in the pattern of fetal movement

Concerning the third stage of labor, nurses should be aware that: A. The placenta eventually detaches itself from a flaccid uterus. B. An expectant or active approach to managing this stage of labor reduces the risk of complications. C. It is important that the dark, roughened maternal surface of the placenta appear before the shiny fetal surface. D. The major risk for women during the third stage is a rapid heart rate.

B. An expectant or active approach to managing this stage of labor reduces the risk of complications.

With regard to nutritional needs during lactation, a maternity nurse should be aware that: A. The mother's intake of vitamin C, zinc, and protein can be lower than during pregnancy. B. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful. C. Critical iron and folic acid levels, higher than during pregnancy, must be maintained to ensure the health of the infant. D. Lactating women can go back to their prepregnant calorie intake.

B. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful.

If exhibited by an expectant father, what would be a warning sign of ineffective adaptation to his partner's first pregnancy? A. Views pregnancy with pride as a confirmation of his virility. B. Consistently changes the subject when the topic of the fetus/newborn is raised. C. Expresses concern that he might faint at the birth of his baby. D. Experiences nausea and fatigue, along with his partner, during the first trimester.

B. Consistently changes the subject when the topic of the fetus/newborn is raised.

Which characteristic is associated with false labor contractions? A. Painful B. Decrease in intensity with ambulation C. Regular pattern of frequency established D. Progressive in terms of intensity and duration

B. Decrease in intensity with ambulation.

Nurses, certified nurse-midwives, and other advanced practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception. A multidisciplinary approach should ensure that the woman's social, cultural, and interpersonal needs are met. Which action should the nurse take first when meeting with a new patient to discuss contraception? A. Obtain data about the frequency of coitus. B. Determine the woman's level of knowledge about contraception and commitment to any particular method. C. Assess the woman's willingness to touch her genitals and cervical mucus. D. Evaluate the woman's contraceptive life plan.

B. Determine the woman's level of knowledge about contraception and commitment to any particular method.

What best describes the pattern of genetic transmission known as autosomal recessive inheritance? A. Disorders in which the abnormal gene for the trait is expressed even when the other member of the pair is normal. B. Disorders in which both genes of a pair must be abnormal for the disorder to be expressed. C. Disorders in which a single gene controls the particular trait. D. Disorders in which the abnormal gene is carried on the X chromosome.

B. Disorders in which both genes of a pair must be abnormal for the disorder to be expressed.

A pregnant woman at 7 weeks of gestation complains to her nurse midwife about frequent episodes of nausea during the day with occasional vomiting. She asks what she can do to feel better. The nurse midwife could suggest that the woman: A. Drink warm fluids with each of her meals. B. Eat a high-protein snack before going to bed. C. Keep crackers and peanut butter at her bedside to eat in the morning before getting out of bed. D. Schedule three meals and one mid-afternoon snack a day.

B. Eat a high-protein snack before going to bed.

With regard to systemic analgesics administered during labor, nurses should be aware that: A. Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier. B. Effects on the fetus and newborn can include decreased alertness and delayed sucking. C. Intramuscular administration (IM) is preferred over intravenous (IV) administration. D. IV patient-controlled analgesia (PCA) results in increased use of an analgesic.

B. Effects on the fetus and newborn can include decreased alertness and delayed sucking.

A laboring woman becomes anxious during the transition phase of the first stage of labor and develops a rapid and deep respiratory pattern. She complains of feeling dizzy and light-headed. The nurse's immediate response would be to: A. Encourage the woman to breathe more slowly. B. Help the woman breath into a paper bag. C. Turn the woman on her side. D. Administer a sedative.

B. Help the woman breathe into a paper bag.

The viral sexually transmitted infection (STI) that affects most people in the United States today is: A. Herpes simplex virus type 2 (HSV-2) B. Human papillomavirus (HPV) C. Human immunodeficiency virus (HIV) D. Cytomegalovirus (CMV)

B. Human papillomavirus (HPV)

When assessing a fetal heart rate (FHR) tracing, the nurse notes a decrease in the baseline rate from 155 to 110. The rate 110 persists for more than 10 minutes. The nurse could attribute this decrease in baseline to: A. Maternal hyperthyroidism. B. Initiation of epidural anesthesia that resulted in maternal hypotension. C. Maternal infection accompanied by fever. D. Alteration in maternal position from semi recumbent to lateral.

B. Initiation of epidural anesthesia that resulted in maternal hypotension.

Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with: A. Spina bifida. B. Intrauterine growth restriction. C. Diabetes mellitus. D. Down syndrome.

B. Intrauterine growth restriction.

Which correctly matches the type of deceleration with its likely cause? A. Early deceleration- umbilical cord compression. B. Late deceleration- uteroplacental inefficiency. C. Variable deceleration- head compression. D. Prolonged deceleration- cause unknown.

B. Late deceleration- uteroplacental inefficiency.

The slight overlapping of cranial bones, or shaping of the fetal head, that occurs during labor is called: A. Lightening B. Molding C. Ferguson reflex D. Valsalva maneuver

B. Molding

In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that: A. Nonacceptance of the pregnancy very often equates to rejection of the child. B. Mood swings most likely are the result of worries about finances and a changed lifestyle, as well as profound hormonal changes. C. Ambivalent feelings during pregnancy usually are seen only in emotionally immature or very young mothers. D. Conflicts that involve not wanting to be pregnant or be involved in childrearing and career-related decisions that relate to being pregnant need not be addressed during pregnancy, because they will resolve themselves naturally after birth.

B. Mood swings most likely are the result of worries about finances and a changed lifestyle, as well as profound hormonal changes.

Semen analysis is a common diagnostic procedure to infertility. In instructing a male patient regarding this test, the nurse would tell him to: A. Ejaculate into a sterile container. B. Obtain the specimen after a period of abstinence from ejaculation of 2 to 5 days. C. Transport specimen with container packed in ice. D. Ensure that the specimen arrives at the laboratory within 30 minutes of ejaculation.

B. Obtain the specimen after a period of abstinence from ejaculation of 2 to 5 days.

What is an expected characteristic of amniotic fluid? A. Deep yellow color B. Pale, straw color with small white particles C. Acidic result on a Nitrazine test D. Absence of ferning

B. Pale, straw color with small white particles

Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could you use to raise the patient's blood pressure if hypotension occurs? Choose all that apply. A. Place the woman in a supine position. B. Place the woman in a lateral position. C. Increase intravenous (IV) fluids. D. Administer oxygen. E. Perform a vaginal examination.

B. Place the woman in a lateral position. C. Increase intravenous (IV) fluids. D. Administer oxygen.

When providing care to a young single woman just diagnosed with acute pelvic inflammatory disease, the nurse should: A. Point out that inappropriate sexual behavior caused the infection. B. Position the woman in a semi-Fowler position. C. Explain to the woman that infertility is a likely outcome of this type of infection. D. Tell her that antibiotics need to be taken until pelvic pain is relieved.

B. Position the woman in a semi-Fowler position.

A man's wife is pregnant for the third time. One child was born with cystic fibrosis, and the other child is healthy. The man wonders what the chance is that this child will have cystic fibrosis. Testing to determine the chance of cystic fibrosis occurring again is known as: A. Occurrence risk B. Recurrence risk C. Predictive testing D. Predisposition testing

B. Recurrence risk

Late deceleration patterns are noted when assessing the monitor tracing of a woman whose labor is being induced with an infusion of Pitocin. The woman is in a side-lying position, and her vital signs are stable and fall within a normal range. Contractions are intense, last 90 seconds, and occur every 1 1/2 to 2 minutes. The nurse's immediate action would be to: A. Change the woman's position. B. Stop the pitocin. C. Elevate the woman's legs. D. Administer oxygen via a tight mask at 8 to 10 L/min.

B. Stop the pitocin.

A nurse should consider the possibility of neonatal withdrawal syndrome if a newborn: A. has decreased muscle tone. B. has a continuous high-pitched cry. C. sleeps for 2 hr after feeding. D. has milk tremors when disturbed.

B. has a continuous high-pitched cry.

Obstetricians today are seeing more morbidly obese women (those that weigh 400 pounds or greater). A new medical subspecialty referred to as _____ obstetrics has subsequently arisen.

Bariatric

A nurse is caring for a client who is breastfeeding and has mastitis. Which of the following should the nurse teach the client? A. "Limit the amount of time the infant nurses on each breast." B. "Nurse the infant only on the unaffected breast until resolved." C. "Completely empty each breast at each feeding or with a pump." D. "Wear a tight-fitting bra until lactation has ceased."

C. "Completely empty each breast at each feeding or with a pump."

A couple has been counseled regarding genetic anomalies. They ask you, "what is karyotyping?" Your best response would be: A. "Karyotyping will reveal whether the baby's lungs are mature." B. "Karyotyping will reveal whether your baby will develop normally." C. "Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomes." D. "Karyotyping will detect any physical deformities the baby has."

C. "Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomes."

The nurse recognizes that a woman is in true labor when she states: A. "I passed some thick, pink mucus when I urinated this morning." B. "My bag of water just broke." C. "The contractions in my uterus are getting stronger and closer together." D. "My baby dropped, and I have to urinate more frequently now."

C. "The contractions in my uterus are getting stronger and closer together."

An expectant father confides in the nurse that his pregnant wife, 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and then next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's best response would be: A. "This is normal behavior and should begin to subside by the second trimester." B. "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor that I know." C. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant." D. "You seem impatient with her. Perhaps this is precipitating her behavior."

C. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant."

A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her: A. "You don't need to modify your exercising any time during your pregnancy." B. "Stop exercising because it will harm the fetus." C. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month." D. "Jogging is too hard on your joints; switch to walking now."

C. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."

The measurement of lecithin in relation to sphingomyelin (L/S ratio) is used to determine fetal lung maturity. Which ratio reflects maturity of the lungs? A. 1.4:1 B. 1.8:1 C. 2:1 D. 1:1

C. 2:1

Which hematocrit (Hct) and hemoglobin (Hgb) results represents the lowest acceptable values for a woman in the third trimester of pregnancy. A. 38% Hct; 14 g/dL Hgb B. 35% Hct; 13 g/dL Hgb C. 33% Hct; 11 g/dL Hgb D. 32% Hct; 10.5 g/dL Hgb

C. 33% Hct; 11 g/dL Hgb

The student nurse is giving a presentation about milestones in embryonic development. Which information should he or she include? A. At 8 weeks of gestation, primary lung and urethral buds appear. B. At 12 weeks of gestation, the vagina is open or the testes are in position for descent into the scrotum. C. At 20 weeks of age, the vernix caseosa and lanugo appear. D. At 24 weeks of age, the skin is smooth, and subcutaneous fat is beginning to collect.

C. At 20 weeks of age, the vernix caseosa and lanugo appear.

An effective relief measure for primary dysmenorrhea would be to: A. Reduce physical activity level until menstruation ceases. B. Begin taking prostaglandin synthesis inhibitors on the first day of the menstrual flow. C. Decrease intake of salt and refined sugar about 1 week before menstruation is about to occur. D. Use barrier methods rather than the oral contraceptive pill (OCP) for birth control.

C. Decrease intake of salt and refined sugar about 1 week before menstruation is about to occur.

Which action would be correct when palpation is being used to assess the characteristics and pattern of uterine contractions? A. Place the hand on the abdomen below the umbilicus and palpate uterine tone with the fingertips. B. Determine the frequency by timing from the end of one contraction to the end of the next contraction. C. Evaluate the intensity of the contraction by pressing the fingertips into the uterine fundus. D. Assess uterine contractions every 30 minutes throughout the first stage of labor.

C. Evaluate the intensity of the contraction by pressing the fingertips into the uterine fundus.

Self-care instructions for a woman following a modified radical mastectomy would include that she should: A. Wear clothing with snug sleeves to support her affected arm. B. Use depilatory creams instead of shaving the axilla of her affected arm. C. Expect a decrease in sensation or tingling in her affected arm as her body heals. D. Empty surgical drains once a day or every other day.

C. Expect a decrease in sensation or tingling in her affected arm as her body heals.

A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she: A. Wiggles and points her toes during the cramp. B. Applies cold compresses to the affected leg. C. Extends her leg and dorsiflexes her foot during the cramp. D. Avoids weight bearing on the affected leg during the cramp.

C. Extends her leg and dorsiflexes her foot during the cramp.

Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet? A. Fat-soluble vitamins A and D. B. Water-soluble vitamins C and B6. C. Iron and folate. D. Calcium and zinc.

C. Iron and folate.

Following rupture of membranes, a prolapse of the cord was noted on vaginal examination. A recommended action to alleviate cord compression would be to: A. Place woman in a supine position and elevate legs from the hips. B. Insert a foley catheter to keep the bladder empty. C. Keep the protruding cord moist with warm sterile normal saline compresses. D. Attempt to reinsert the cord.

C. Keep the protruding cord moist with warm sterile normal saline compresses.

To reassure and educate pregnant patients about changes in their breasts, nurses should be aware that: A. The visibility of blood vessels that form an intertwining blue network indicates full function of Montgomery's tubercles and possibly infection of the tubercles. B. The mammary glands do not develop until 2 weeks before labor. C. Lactation is inhibited until the estrogen level declines after birth. D. Colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding.

C. Lactation is inhibited until the estrogen level declines after birth.

During the first trimester the pregnant woman would be most motivated to learn about: A. Fetal development B. Impact of a new baby on family members C. Measures to reduce nausea and fatigue so she can feel better D. Location of childbirth preparation and breastfeeding classes

C. Measures to reduce nausea and fatigue so she can feel better.

The nurse should include questions regarding sexuality when gathering data for a reproductive health history of a female patient. Which principle should guide the nurse when interviewing the patient? A. An in-depth exploration of specific practices should be included for every patient. B. Sexual histories are optional if the patient is not currently sexually active. C. Misconceptions and inaccurate information expressed by the patient should be corrected promptly. D. Questions regarding the patient's sexual relationship are unnecessary if she is monogamous.

C. Misconceptions and inaccurate information expressed by the patient should be correct promptly.

When evaluating a woman whose primary complaint is amenorrhea, the nurse must be aware that lack of menstruation is most often the result of: A. Stress B. Excessive exercise C. Pregnancy D. Eating disorders

C. Pregnancy

A nurse is caring for an infant who has a high bilirubin level and is receiving phototherapy. Which of the following findings in the newborn is the highest priority? A. Conjunctivitis B. Bronze skin discoloration C. Sunken fontanels D. Maculopapular skin rash

C. Sunken fontanels

A woman taking an oral contraceptive pill (OCP) as her birth control method of choice should notify her health care provider immediately if she notes: A. Breast tenderness and swelling. B. Weight gain. C. Swelling and pain in one of her legs. D. Mood swings.

C. Swelling and pain in one of her legs.

With regard to factors that affect how the fetus moves through the birth canal, nurses should be aware that: A. The fetal attitude describes the angle at which the fetus exits the uterus. B. Of the two primary fetal lies, the horizontal lie is that in which the long axis of the fetus is parallel to the long axis of the mother. C. The normal attitude of the fetus is called general flexion. D. The transverse lie is preferred for vaginal birth.

C. The normal attitude of the fetus is called general flexion.

Which statement about female sexual response is NOT accurate? A. Women and men are more alike than different in their physiologic response to sexual arousal and orgasm. B. Vasocongestion is the congestion of blood vessels. C. The orgasmic phase is the final state of the sexual response cycle. D. Facial grimaces and spasms of hands and feet are often part of arousal.

C. The orgasmic phase is the final state of the sexual response cycle.

A 26-year-old woman is considering Depo-Provera as the form of contraception that is best for her because she does not like to worry about taking a pill every day. To assist this woman with decision making concerning this method of contraception, the nurse would tell her that Depo-Provera: A. Is a combination of progesterone and estrogen. B. Is a small adhesive hormonal birth control patch that is applied weekly. C. Thickens and decreases cervical mucus, thereby inhibiting sperm penetration and ovulation. D. Has an effectiveness rate in preventing pregnancy of 99% when used correctly.

C. Thickens and decreases cervical mucus, thereby inhibiting sperm penetration and ovulation.

____ use/abuse during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications. A. Alcohol B. Caffeine C. Tobacco D. Chocolate

C. Tobacco

Newborns are at high risk for injury if appropriate safety precautions are not implemented. Parents should be taught to: A. Place newborn on abdomen (prone) after feeding and for sleep. B. Avoid use of pacifiers. C. Use a rear-facing car seat until the infant weight as least 20 lb. D. Use a crib with side-rail slats that are no more than 3 inches apart.

C. Use a rear-facing car seat until the infant weighs at least 20 lb.

A pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. The nurse would be most concerned about this woman's intake of: A. Calcium B. Protein C. Vitamin B12 D. Folic acid

C. Vitamin B12

The nurse knows that the second stage of labor, the descent phase, has begun when the: A. Amniotic membranes rupture. B. Cervix cannot be felt during a vaginal examination. C. Woman experiences a strong urge to bear down. D. Presenting part is below the ischial spines.

C. Woman experiences a strong urge to bear down.

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wing with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse would tell her: A. "Since you're in your second trimester, there's no problem with having one drink with dinner." B. "One drink every night is too much. One drink three times a week should be fine." C. "Since you're in your second trimester, you can drink as much as you like." D. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

D. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expectant parent's class. Which aspect of their birth would be considered unrealistic and require further discussion with the nurse? A. "My husband and I have agreed that my sister will be my coach since he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure everything is ok." B. "We plan to use the techniques taught in the Lamaze classes to reduce the pain experiences during labor." C. "We want the labor and birth to take place in a birthing room. My husband will come in the minute the baby is born." D. "We do not want the fetal monitor used during labor since it will interfere with movement and doing effleurage."

D. "We do not want the fetal monitor used during labor since it will interfere with movement and doing effleurage."

A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, "My period is due in a few days, and my temperature has not gone up." The nurse's most appropriate response is: A. "This probably means that you're pregnant." B. "Don't worry; it's probably nothing." C. "Have you been sick this month." D. "You probably didn't ovulate during this cycle."

D. "You probably didn't ovulate during this cycle."

In documenting labor experiences, nurses should know that a uterine contraction is described according to all of these characteristics except: A. Frequency (how often contractions occur). B. Intensity (the strength of the contraction at its peak). C. Resting tone (the tension in the uterine muscle). D. Appearance (shape and height).

D. Appearance (shape and height).

A primigravida asks the nurse about what signs she can look for that would indicate that the onset of labor is getting closer. The nurse should describe: A. Weight gain of 1 to 3 pounds. B. Quickening C. Fatigue and lethargy D. Bloody show

D. Bloody show

When counseling a patient about getting enough iron in her diet, the maternity nurse should tell her that: A. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron. B. Iron absorption is inhibited by a diet rich in vitamin C. C. Iron supplements are permissible for children in small doses. D. Constipation is common with iron supplements.

D. Constipation is common with iron supplements.

The nurse who provides preconception care understands that it: A. is designed for women who have never been pregnant. B. includes risk factor assessments for potential medical and psychologic problems but by law cannot consider finances or workplace conditions. C. avoids teaching about safe sex to avoid political controversy. D. could include interventions to reduce substance use and abuse.

D. Could include interventions to reduce substance use and abuse.

When obtaining a reproductive health history from a female patient, the nurse should: A. Limit the time spend on exploration of intimate topics. B. Avoid asking questions that may embarrass the patient. C. Use only accepted medical terminology when referring to body parts and functions. D. Explain the purpose of asking the particular questions and how the information elicited will be used.

D. Explain the purpose of asking the particular questions and how the information elicited will be used.

If exhibited by a pregnant woman, which of the following represents a positive sign of pregnancy? A. Morning sickness B. Quickening C. Positive pregnancy test D. Fetal heartbeat auscultated with doppler/fetoscope.

D. Fetal heartbeat auscultated with doppler/fetoscope.

The most common cause of decreased variability in the fetal heart rate (FHR) that lasts 30 minutes or less is: A. Altered cerebral blood flow. B. Fetal hypoxemia. C. Umbilical cord compression. D. Fetal sleep cycles.

D. Fetal sleep cycles.

Although remarkable developments have occurred in reproductive medicine, assisted reproductive therapies are associated with a number of legal and ethical issues. Nurses can provide accurate information about the risks and benefits of treatment alternatives so couples can make informed decisions about their choice of treatment. Which issue would not need to be addressed by an infertile couple before treatment? A. Risks of multiple gestation. B. Whether or how to disclose the facts of conception to offspring. C. Freezing embryos for later use. D. Financial ability to cover the cost of treatment.

D. Financial ability to cover the cost of treatment.

The most basic information a maternity nurse should know concerning conception is that: A. Ova are considered fertile 48 to 72 hours after ovulation. B. Sperm remain viable in the woman's reproductive system for an average of 12 to 24 hours. C. Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum. D. Implantation in the endometrium occurs 6 to 10 days after conception.

D. Implantation in the endometrium occurs 6 to 10 days after conception.

An expectant couple asks the nurse about intercourse during pregnancy and whether it is safe for the baby. The nurse should tell the couple that: A. Intercourse should be avoided if any spotting from the vagina occurs afterward. B. Intercourse is safe until the third trimester. C. Safer-sex practices should be used once the membranes rupture. D. Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present.

D. Intercourse and orgasm are often contraindicated is a history or signs of preterm labor are present.

Which statement is true about the term contraceptive failure rate? A. It refers to the percentage of users expected to have an accidental pregnancy over a 5-year span. B. It refers to the minimum level that must be achieved to receive a government license. C. It increases over time as couples become more careless. D. It varies from couple to couple, depending on the method and the users.

D. It varies from couple to couple, depending on the method and the users.

You are evaluating the fetal monitor tracing of your patient, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide oxygen, increase intravenous (IV) fluid, and perform a vaginal examination. The cervix has not changed. Five minutes have passed, and the fetal heart rate remains in the 80s. What additional nursing measures should you take? A. Scream for help. B. Insert a foley catheter. C. Start pitocin. D. Notify the care provider immediately.

D. Notify the care provider immediately.

Which description and percentage of occurrence of a basic pelvis type in women is correct? A. Gynecoid: classic female; heart shaped; 75% B. Android: resembling the male; wider oval; 15% C. Anthropoid: resembling the ape; narrower; 10% D. Platypelloid: flattened, wife, shallow; 3%

D. Platypelloid: flattened, wide, shallow; 3%

The hormone responsible for maturation of mammary gland tissue is: A. estrogen B. testosterone C. prolactin D. progesterone

D. Progesterone

The nurse should refer the patient for further testing if she noted which finding on inspection of the breasts of a 55-year-old woman. A. Left breast slightly smaller than right breast. B. Eversion (elevation) of both nipples. C. Bilateral symmetry of venous network, which is faintly visible. D. Small dimple located in the upper outer quadrant of the right breast.

D. Small dimple located in the upper outer quadrant of the right breast.

A number of changes in the integumentary system occurs during pregnancy. What change persists after birth? A. Epulis B. Chloasma C. Telangiectasia D. Striae gravidarum

D. Striae gravidarum

Which finding meets the criteria of a reassuring fetal heart rate (FHR) pattern? A. FHR does not change as a result of fetal activity. B. Average baseline rate ranges between 100 and 140 beats/min. C. Mild late deceleration patterns occur with some contractions. D. Variability averages between 6 to 10 beats/min.

D. Variability averages between 6 to 10 beats/min.

The recommended treatment for the prevention of human immunodeficiency virus (HIV) transmission to the fetus during pregnancy is: A. Acyclovir B. Ofloxacin C. Podophyllin D. Zidovudine

D. Zidovudine

True or False: The Valsalva maneuver can be described as the process of making a forceful bearing-down attempt while holding one's breath with a closed glottis and tightening the abdominal muscles. During the second stage of labor, when the woman is ready to push, this is considered the optimal method to enhance movement of the fetus down the birth canal.

False

____ _____ _______ (LAM) can be a highly effective, temporary method of birth control.

Lactation Amenorrhea Method

_____ occurs when the fetus begins to descend and drop into the pelvis.

Lightening

A _____ degree perineal laceration continues through the anal sphincter muscle.

Third

The ability of the fetus to survive outside the uterus is called _______.

viability.

The nurse is performing a blood glucose test every 4 hours on an infant born to diabetic mother. This is to assess the infant's risk of hypoglycemia. The nurse becomes concerned if the infant's blood glucose concentration falls below _____ mg/dL.

36

What percentage of a newborn's birth weight is expected to be lost during the first 24 hours?

5 to 10%

A postpartum client who is being discharged 2 days after delivery has been diagnosed with a urinary tract infection. The nurse reviews discharge instructions with the client. Which of the following statements by the client indicates a need for further teaching? (Select all that apply.) A. "I will perform peri care and apply a perineal pad in a back-to-front direction." B. "I will drink cranberry and prune juices to make my urine more acidic." C. "I will drink large amounts of fluids to flush the bacteria from my urinary tract." D. "I will not nurse my baby until I have finished taking the antibiotic." E. "I will take Tylenol for any discomfort."

A. "I will perform peri care and apply a perineal pad in a back-to-front direction." D. "I will not nurse my baby until I have finished taking the antibiotic."

Which of the following statements made by the parent of a newborn indicates a good understanding of how to use a bulb syringe to suction excess mucus from the newborn's airway? A. "My baby's mouth should be suctioned before her nose." B. "My baby's nose should be suctioned before her mouth." C. "The bulb syringe should reach to the back of my baby's mouth." D. "The bulb syringe should be compressed after it is placed in my baby's mouth or nose."

A. "My baby's mouth should be suctioned before her nose."

A nurse is preparing to administer a vitamin K (Aquamephyton) injection to a newborn. Which of the following is an appropriate response by the nurse to the newborn's mother regarding why this medication is given? A. "Vitamin K assists with blood clotting." B. "Vitamin K assists the bowel in maturing." C. "Vitamin K is a preventative vaccination." D. "Vitamin K provides immunity."

A. "Vitamin K assists with blood clotting."

A patient feels too warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on "high." The nurse instructs the mother that the fan should not be directed toward the newborn and the newborn should be wrapped in a blanket. The mother asks why. The nurse's best response is: A. "Your baby may lose heat by convection, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him." B. "Your baby may lose heat by conduction, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him." C. "Your baby may lose heat by evaporation, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him." D. "Your baby will get cold stressed easily and needs to be bundled up at all times."

A. "Your baby may lose heat by convection, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him."

Possible alternative and complementary therapies for postpartum depression (PPD) for breastfeeding mothers include (choose all that apply): A. Acupressure B. Aromatherapy C. St. John's wort D. Wine consumption E. Yoga

A. Acupressure B. Aromatherapy E. Yoga

The abuse of which of the following substances during pregnancy is the leading cause of cognitive impairment in the United States? A. Alcohol B. Tobacco C. Marijuana D. Heroin

A. Alcohol

What would be a warning sign of ineffective adaptation to extrauterine life if noted when assessing a 24-hour-old breastfed newborn before discharge? A. Apical heart rate of 90 beats/min, slightly irregular, when awake and active. B. Acrocyanosis C. Harlequin color sign D. Weight loss representing 5% of the newborn's birth weight.

A. Apical heart rate of 90 beats/min, slight irregular, when awake and active.

A nurse is conducting a home visit for a client who is 2 weeks postpartum and breastfeeding. The client reports breast engorgement. Which of the following recommendations should the nurse make? A. Apply cold compresses between feedings. B. Take a warm shower right after feedings. C. Apply breast milk to the nipples and allow them to air dry. D. Use the various infant positions for feedings.

A. Apply cold compresses between feedings.

Which of the following nursing interventions will promote comfort for a client who has a small hematoma of the perineal area? (Select all that apply) A. Apply ice to the perineal area for the first 24 to 48 hr. B. Encourage the use of a donut-shaped pillow for sitting. C. Encourage sitz baths at least twice a day. D. Use a topical antiseptic cream or spray on the perineal area. E. Obtain an order for an indwelling urinary catheter.

A. Apply ice to the perineal area for the first 24 to 48 hr. C. Encourage sitz baths at least twice a day. D. Use a topical antiseptic cream or spray on the perineal area.

A postpartum nurse is caring for a client who has deep vein thrombosis (DVT). Which of the following clinical findings should the nurse anticipate the client will exhibit? (Select all that apply.) A. Calf tenderness B. Calf swelling C. Elevated temperature D. Warm extremity E. Nausea

A. Calf tenderness B. Calf swelling C. Elevated temperature D. Warm extremity

A nurse is caring for a client who is 1-day postpartum. The nurse is assessing for maternal adaptation and mother-infant bonding. Which of the following behaviors by the mother indicates a need for the nurse to intervene? (Select all that apply) A. Demonstrates apathy when the infant cries. B. Touches the infant and maintains close physical proximity. C. Views the infant's behavior as uncooperative during diaper changing. D. Identifies and relates infant's characteristics to those of family members. E. Interprets the infant's behavior as meaningful and a way of expressing needs.

A. Demonstrates apathy when the infant cries. C. Views the infant's behavior as uncooperative during diaper changing.

The birth weight of a breastfed newborn was 8 pounds, 4 ounces. On the third day the newborn's weight was 7 pounds, 12 ounces. On the basis of this finding, the nurse should: A. Encourage the mother to continue breastfeeding because it is effective in meeting the newborn's nutrient and fluid needs. B. Suggest that the mother switch to bottle-feeding because the breastfeeding is ineffective in meeting the newborn's needs for fluid and nutrients. C. Notify the physician because the newborn is being poorly nourished. D. Refer the mother to a lactation consultant to improve her breastfeeding technique.

A. Encourage the mother to continue breastfeeding because it is effective in meeting the newborn's nutrient and fluid needs.

A nurse is caring for a postpartum client who delivered her third infant 2 days ago. The nurse recognizes that which of the following symptoms are suggestive of postpartum depression? (Select all that apply.) A. Fatigue B. Insomnia C. Euphoria D. Flat affect E. Crying

A. Fatigue B. Insomnia D. Flat affect E. Crying

Identify contributing factors to postpartum depression. (Select all that apply.) A. Fatigue from the work of labor and birth. B. Disappointment in the characteristics of the infant. C. Individual or family socioeconomic factors. D. Anxiety about assuming a new role as a mother. E. Rapid decline in estrogen and progesterone. F. Postpartum physical discomfort and/or pain.

A. Fatigue from the work of labor and birth. C. Individual or family socioeconomic factors. D. Anxiety about assuming a new role as a mother. E. Rapid decline in estrogen and progesterone. F. Postpartum physical discomfort and/or pain.

With regard to the special qualities of human breast milk, nurses should be aware that: A. Frequent feedings during predictable growth spurts stimulate increased milk production. B. The milk of preterm mother is the same as the milk of mothers who gave birth at term. C. The milk at the beginning of the feeding is the same as the milk at the end of the feeding. D. Colostrum is an early, less concentrated, less rich version of mature milk.

A. Frequent feedings during predictable growth spurts stimulate increased milk production.

A nurse is preparing to bathe a newborn and notices a bluish marking across the newborn's lower back. The nurse should understand that this mark is: A. Frequently seen in newborns who have dark skin. B. Abnormal and may indicate hyperbilirubinemia. C. May be a forceps mark from an operative delivery. D. A sign of prolonged birth or trauma during delivery.

A. Frequently seen in newborns who have dark skin.

A nurse is aware that which of the following is a contraindication for circumcising a male newborn? A. Hypospadias B. Hydrocele C. Familiar history of hemophilia D. Hyperbilirubinemia E. Epispadias

A. Hypospadias C. Familiar history of hemophilia E. Epispadias

With regard to injuries to the infant's plexus during labor and birth, nurses should be aware that: A. If the nerves are stretched with no avulsion, they should recover completely in 3 to 6 months. B. Erb palsy is damage to the lower plexus. C. Parents of children with brachial palsy are taught to pick up the child from under the axillae. D. Breastfeeding is not recommended for infants with facial nerve paralysis until the condition resolves.

A. If the nerves are stretched with no avulsion, they should recover completely in 3 to 6 months

A nurse is caring for a postpartum client. The nurse understands that which of the following findings are the earliest indication of hypovolemia caused by hemorrhage? A. Increasing pulse and decreasing blood pressure. B. Dizziness and increasing respiratory rate. C. Cool, clammy skin, and pale mucous membranes. D. Altered mental status and level of consciousness.

A. Increasing pulse and decreasing blood pressure.

Which infant would be more likely to have Rh incompatibility? A. Infant of an Rh-negative mother and father who is rH positive and homozygous for the Rh factor. B. Infant who is Rh negative and whose mother is Rh negative. C. Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor. D. Infant who is Rh positive and whose mother is Rh positive.

A. Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor.

What PPH conditions are considered medical emergencies that require immediate treatment? A. Inversion of the uterus and hypovolemia shock. B. Hypotonic uterus and coagulopathies. C. Subinvolution of the uterus and idiopathic thrombocytopenic purport (ITP). D. Uterine atony and disseminated intravascular coagulation (DIC).

A. Inversion of the uterus and hypovolemic shock.

A nurse is called to the birthing room to assist with the assessment of a newborn who was born at 32 weeks of gestation. The newborn's birth weight is 1,100 g. His Apgar scores are 3 at 1 min and 7 at 5 min. He is experiencing nasal flaring, grunting, and intercostal retractions. Which of the following are characteristics that the nurse may see at this birth? (Select all that apply.) A. Large head in comparison to body B. Lanugo C. Long hair D. Long nails E. Weak grasp reflex F. Translucent skin G. Plump face

A. Large head in comparison to body B. Lanugo E. Weak grasp reflex F. Translucent skin

A nurse is performing a fundal assessment for a client in her second postpartum day and observes the client's perineal pad for lochia. She notes the pad to be saturated approximately 12 cm with lochia that is bright red in color and contains small clots. The nurse knows that this finding is: A. Moderate lochia rubra B. Excessive lochia rubra C. Light lochia rubra D. Scant lochia serosa

A. Moderate lochia rubra

Which of the following are risk factors for postpartum hemorrhage? (Select all that apply.) A. Precipitous delivery B. Lacerations C. Inversion of the uterus D. Oligohydramnios E. Retained placental fragments

A. Precipitous delivery B. Lacerations C. Inversion of the uterus E. Retained placental fragments

A nurse is caring for a client who has disseminated intravascular coagulation (DIC). Which of the following antepartum complications should the nurse understand is a risk factor for this client? A. Preeclampsia B. Thrombophlebitis C. Placenta previa D. Hyperemesis gravidarum

A. Preeclampsia

The nurse taught new parents the guidelines to follow regarding the bottle feeding of their newborn. They will be using formula from a can of concentrate. The parents would demonstrate an understanding of the nurse's instructions if they: A. Wash the top of the can and the can opener with soap and water before opening the can. B. Adjust the amount of water added according to weight gain pattern of the newborn. C. Add some honey to sweeten the formula and make it more appealing to a fussy newborn. D. Warm formula in a microwave oven for a couple of minutes prior to feeding.

A. Wash the top of the can and the can opener with soap and water before opening the can.

A nurse is caring for a newborn following a spontaneous vaginal delivery. Five minutes after birth, the newborn's heart rate is 90/min. Which of the following Apgar heart rates should the newborn receive? A. 0 B. 1 C. 2 D. 3

B. 1

A nurse is providing care to multiple clients on the postpartum unit. Which of the following clients is at greatest risk for developing a puerperal infection? A. A client who has an episiotomy that is erythematous and has extended into a third-degree laceration. B. A client who does not wash her hands between perineal care and breastfeeding. C. A client who is not breastfeeding and is using measures to suppress lactation. D. A client who has a cesarean incision that is well-approximated with no drainage.

B. A client who does not wash her hands between perineal care and breastfeeding.

Which woman is at greatest risk for early postpartum hemorrhage (PPH)? A. A primiparous woman (G 2 P1 0 0 1) being prepared for an emergency cesarean birth for fetal distress. B. A woman with severe preeclampsia on magnesium sulfate whose labor is being induced. C. A multiparous woman (G 3 P2 0 0 2) with an 8-hour labor. D. A primigravida in spontaneous labor with preterm twins.

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

A nurse is caring for a newborn who was born at 38 weeks of gestation, weighs 3,200 g, and is in the 60th percentile for weight. Based on the weight and gestational age of this newborn, the nurse should classify this neonate as: A. low birth weight B. appropriate for gestational age C. small for gestational age D. large for gestational age

B. Appropriate for gestational age

The nurse must administer erythromycin ophthalmic ointment to a newborn after birth. The nurse should: A. Instill within 15 minutes of birth for maximum effectiveness. B. Cleanse eyes from inner to outer can thus before administration. C. Apply directly over the cornea. D. Flush eyes 10 minutes after instillation to reduce irritation.

B. Cleanse eyes from inner to outer can thus before administration.

In appraising the growth and development potential of a preterm infant, nurses should: A. Tell parents their child won't catch up until about age 10 (girls) to 12 (boys). B. Correct for milestones such as motor competencies and vocalizations until the child is approximately 3 years of age. C. Know that the greatest catch-up period is between 9 and 15 months post conceptual age. D. Know that the length and breadth of the trunk is the first part of the infant to experience catch-up growth.

B. Correct for milestones such as motor competencies and vocalizations until the child is approximately 3 years of age.

A mother in late middle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems and sensations of bearing down and of something in her vagina. The nurse would realize that the woman most likely is suffering from: A. Pelvic relaxation B. Cystoceles and/or rectoceles C. Uterine displacement D. Genital fistulas

B. Cystoceles and/or rectoceles

Following circumcision of a newborn, the nurse provides instructions to his parents regarding postcircumcision care. The nurse should tell the parents to: A. Apply topical anesthetics with each diaper change. B. Expect a yellowish exudate to cover the glans after the first 24 hours. C. Change the diaper every 2 hours and cleanse the site with soap and water or bay wipes. D. Apply constant pressure to the site if bleeding occurs and call the physician.

B. Expect a yellowish exudate to cover the glans after the first 24 hours.

The nurse helps a breastfeeding mother change the diaper of her 16-hour-old newborn after the first bowel movement. The mother expresses concern because the large amount of thick, sticky stool is very dark green, almost black in color. She asks the nurse if something is wrong. The nurse should response to this mother's concern by: A. Telling the mother not to worry because all breastfed babies have this type of stool. B. Explaining to the mother that the stool is called meconium and is expected of all newborns for the first few bowel movements. C. Asking the mother what she ate at her last meal. D. Suggesting that the mother ask her pediatrician to explain newborn stool patterns to her.

B. Explaining to the mother that the stool is called meconium and is expected of all newborns for the first few bowel movements.

A client in the early postpartum period is very excited and talkative. She is repeatedly telling the nurse every detail of her labor and birth. Because the woman will not stop talking, the nurse is having difficulty completely her postpartum assessments. The appropriate response of the nurse is to: A. Come back later when the client is more cooperative. B. Give the client time to express her feelings. C. Tell the client that she needs to be quiet so the assessment can be completed. D. Redirect the client's focus so that she will become quiet.

B. Give the client time to express her feelings.

A newborn was admitted to the neonatal intensive care unit after being delivered at 29 weeks of gestation to a 28-year-old multiparous, married, Caucasian female whose pregnancy was uncomplicated until premature rupture of membranes and preterm birth. The newborn's parents arrive for their first visit after the birth. The parents walk toward the bedside but remain approximately 5 feet away from the bed. The nurse's appropriate action would be to: A. Wait quietly at the newborn's bedside until the parents come closer. B. Go to the parents, introduce himself or herself, and gently encourage them to come meet their infant; explain the equipment first, and then focus on the newborn. C. Leave the parents at the bedside while they are visiting so they can have some privacy. D. Tell the parents only about the newborn's physical condition and caution them to avoid touching their baby.

B. Go to the parents, introduce himself or herself, and gently encourage them to come meet their infant; explain the equipment first, and then focus on the newborn.

When caring for a newborn, the nurse must be alert for signs of cold stress, including: A. Decreased activity level. B. Increased respiratory rate. C. Hyperglycemia D. Shivering

B. Increased respiratory rate.

Benefits to the mother associated with breastfeeding include all except it: A. Decreases risk of breast cancer. B. Is an effective method of birth control. C. Increases bone density. D. May enhance postpartum weight loss.

B. Is an effective method of birth control.

Which action of a breastfeeding mother indicates the need for further instruction? A. Holds breast with four fingers along bottom and thumb at top. B. Leans forward to bring breast toward the baby. C. Stimulates the rooting reflex and then inserts nipple and areola into newborn's open mouth. D. Puts her finger into the newborn's mouth before removing breast.

B. Leans forward to bring breast toward the baby.

The nurse notes that, when the newborn is placed on the scale, he immediately abducts and extends his arms and his fingers fan out with the thumb and forefinger forming a "C." This response is known as a: A. Tonic neck reflex B. Moro reflex C. Cremasteric reflex D. Babinski reflex

B. Moro reflex

With regard to the classification of neonatal bacterial infection, nurses should be aware that: A. Congenital infection progresses slower than nosocomial infection. B. Nosocomial infection can be prevented by effective hand washing; early-onset infections cannot. C. Infections occur with about the same frequency in boy and girl infants, although female mortality is higher. D. The clinical sign of a rapid, high fever makes infection easier to diagnose.

B. Nosocomial infection can be prevented by effective hand washing; early-onset infections cannot.

Which of the following signs pertaining to respirations indicate that a newborn is having no difficulty adapting to extrauterine life? (Select all that apply.) A. Expiratory grunting B. Respirations of 46/min C. Inspiratory nasal flaring D. Apnea for 10-second periods E. Obligatory nose breathing F. Respirations of 26/min G. Crackles and wheezing

B. Respirations of 46/min D. Apnea for 10-second periods E. Obligatory nose breathing

The nurse is caring for an infant born at 28 weeks of gestation. Which complication could the nurse expect to observe during the course of the neonate's hospitalization? Select all that apply. A. Polycythemia B. Respiratory distress syndrome C. Meconium aspiration syndrome D. Periventricular hemorrhage E. Persistent pulmonary hypertension F. Patent ductus arteriosus

B. Respiratory distress syndrome D. Periventricular hemorrhage F. Patent ductus arteriosus

A nurse is caring for a multiparous client who just gave birth to her newborn at 40 weeks of gestation. After prolonged pushing in the second stage, a forceps-assisted birth was necessary. The newborn weighs 9 lb, 8 oz (4,318 g). The newborn has marked kaput succedaneum and marked bruising about the face, head, and shoulders. How should the nurse characterize this infant? (Select all that apply.) A. Preterm B. Term C. Postterm D. LGA E. SGA F. AGA

B. Term D. LGA

A newborn male, estimated to be 39 weeks of gestation, would exhibit: A. Extended posture when at rest. B. Testes descended into scrotum. C. Abundant lanugo over his entire body. D. Ability to move his elbow past his sternum.

B. Testes descended into scrotum.

During the complete physical examination 24 hours after birth: A. The parents are excused from the room to reduce their normal anxiety. B. The nurse can gauge the neonate's maturity level by assessing its general appearance. C. Once often neglected, blood pressure is now routinely checked. D. When the nurse listens to the heart, the S1 and S2 sounds can be heard; the first sound is somewhat higher in pitch and sharper than the second.

B. The nurse can gauge the neonate's maturity level by assessing its general appearance.

A home-health nurse is conducting a visit to the home of a client who has a 2-month-old infant and a 4-year-old on. The mother expresses frustration about the behavior of the 4-year-old who was previously toilet trained and is now frequently wetting himself. The nurse provides client education and explains to the mother that: A. Her son was probably not ready for toilet training and should wear training pants. B. This is an adverse sibling response to the infant. C. This is abnormal and counseling should be sought for the child. D. This can be resolves by sending the child to preschool.

B. This is an adverse sibling response to the infant.

A nurse is assessing a postpartum client for fundal height, location, and consistency. The fundus is found to be displaced laterally to the right and there is uterine atony. Which of the following is the cause of the uterine atony? A. Poor involution B. Urinary retention C. Hemorrhage D. Infection

B. Urinary retention

A client who is at the greatest risk for postpartum infection is the client who: A. experienced a precipitous labor less than 3 hr in duration. B. has premature rupture of membranes and prolonged labor. C. delivered a large for gestational age infant. D. has a boggy uterus that is not well-contracted.

B. has premature rupture of membranes and prolonged labor.

At 1 minute following birth, a newborn exhibited the following: heart rate of 155; loud, vigorous crying with active movement of all extremities; sneezing when nose was stimulated with a catheter; hands and feet bluish and cool to the touch. The Apgar score of this newborn should be recorded as: A. 5 B. 7 C. 9 D. 10

C. 9

During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On assessment, a nurse finds the client's uterus to be firm and midline and at the level of the umbilicus. The nurse interprets this finding as: A. A sign of a possible vaginal hematoma. B. An indication of a cervical or perineal laceration. C. A normal postural discharge of lochia. D. Abnormally excessive lochia rubra flow.

C. A normal postural discharge of lochia.

A newborn has just been circumcised using a Gomco procedure. Which of the following nursing interventions is part of the initial care for this newborn? A. Apply alcohol to the site. B. Keep the newborn in the prone position. C. Apply petroleum gauze to the site for 24 hr. D. Avoid changing the newborn's diaper unless absolutely needed.

C. Apply petroleum gauze to the site for 24 hr.

When providing teaching about car seat safety to the parents of a newborn, the nurse should instruct the parents to restrain the newborn in a car seat in the: A. front seat in a semi-reclined, rear-facing position. B. front seat in a semi-reclined, forward-facing position. C. back seat in a semi-reclined, rear-facing position. D. back seat in a semi-reclined, forward-facing position.

C. Back seat in a semi-reclined, rear-facing position.

Vitamin K is given to the newborn to: A. Reduce bilirubin levels. B. Increase the production of red blood cells. C. Enhance ability of blood to clot. D. Stimulate the formation of surfactant.

C. Enhance ability of blood to clot.

A nurse is preparing to administer prophylactic eye ointment into the eyes of a newborn to treat ophthalmia neonatorum. Which of the following medications should the nurse anticipate administering? A. Ofloxacin (Floxin) B. Nystatin (Mycostatin) C. Erythromycin (Romycin) D. Ceftriaxone (Rocephin)

C. Erythromycin (Romycin)

A newborn was not dried completely after delivery. The nurse understands that which of the following mechanisms causes the newborn to lose heat? A. Conduction B. Convection C. Evaporation D. Radiation

C. Evaporation

While examining a newborn, the nurse notes uneven skin folds on the buttocks and a click sound when performing the Ortolani maneuver. The nurse recognizes these findings as a sight that the newborn probably has: A. Polydactyly B. Clubfoot C. Hip dysplasia D. Webbing

C. Hip dysplasia

An infant was born 2 hours ago at 37 weeks of gestation, weighing 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of: A. Birth injury B. Hypocalcemia C. Hypoglycemia D. Seizures

C. Hypoglycemia

With regard to laboratory tests and diagnostic tests performed in the hospital after birth, nurses should be aware that: A. All states test for phenylketonuria (PKU), hypothyroidism, cystic fibrosis, and sickle cell diseases. B. Federal law prohibits newborn genetic testing without parental consent. C. If genetic screening is done before the infant is 24 hours old, it should be repeated at age 1 to 2 weeks. D. Hearing screening is now mandated by federal law.

C. If genetic screening is done before the infant is 24 hours old, it should be repeated at age 1 to 2 weeks.

After delivery, the uterus contracts and gradually returns to its prepregnant state. This is referred to as uterine: A. Inversion B. Subinvolution C. Involution D. Exfoliation

C. Involution

A nurse is teaching a group of new parents about proper techniques for bottle feeding. Which of the following instructions should the nurse provide? A. Burp the newborn at the end of the feeding. B. Hold the newborn close in a supine position. C. Keep the nipple full of formula throughout the feeding. D. Refrigerate any unused formula.

C. Keep the nipple full of formula throughout the feeding.

A nurse is providing discharge instructions to a postpartum client following a cesarean birth. The client reports leaking urine every time she sneezes or coughs. The nurse suggests the client perform which of the following to help alleviate this problem? A. Sit-ups B. Pelvic tilt C. Kegel exercises D. Crunches

C. Kegel exercises

During the initial acute distress phase of grieving, parents still must make unexpected and unwanted decisions about funeral arrangements and even naming the baby. The nurse's role should be to: A. Take over as much as possible to relieve the pressure. B. Encourage grandparents to take over. C. Make sure the parents themselves approve the final decisions. D. Let them alone to work things out.

C. Make sure the parents themselves approve the final decisions.

What infection is contracted mostly by first-time mothers who are breastfeeding? A. Endometritis B. Wound infections C. Mastitis D. Urinary tract infections

C. Mastitis

Which of the following actions should a nurse take when bringing a newborn to a mother for breastfeeding for security purposes? A. Ask the mother to state her full name. B. Look at the name on the newborn's bassinet. C. Match the mother's identification band with the newborn's. D. Compare names on the bassinet and room number.

C. Match the mother's identification band on the newborn's.

As a result of large body surface in relation to weight, the preterm infant is at high risk for heat loss and cold stress. By understanding the four mechanisms of heat transfer (convection, conduction, radiation, and evaporation), the nurse can create an environment for the infant that prevents temperature instability. While evaluating the plan that has been implemented, the nurse knows that the infant is experiencing cold stress when he or she exhibits: A. Decreased respiratory rate. B. Bradycardia followed by an increased heart rate. C. Mottled skin with acrocyanosis D. Increased physical activity.

C. Mottled skin with acrocyanosis

The first and most important nursing intervention when a nurse observes profuse postpartum bleeding is to: A. Call the woman's primary health care provider. B. Administer the standing order for an oxytocic. C. Palpate the uterus and massage it if it is boggy. D. Assess maternal blood pressure and pulse for signs of hypovolemic shock.

C. Palpate the uterus and massage it if it is boggy.

For clinical purposes, preterm and postterm infants are defined as: A. Preterm before 34 weeks if appropriate for gestational age (AGA); before 37 weeks if small for gestational age (SGA). B. Postterm after 40 weeks if large for gestational age (LGA); beyond 42 weeks if AGA. C. Preterm before 37 weeks, post term beyond 42 weeks, no matter the size for gestational age at birth. D. Preterm, SGA before 38 to 40 weeks; post term, LGA beyond 40 to 42 weeks.

C. Preterm before 37 weeks, post term beyond 42 weeks, no matter the size for gestational age at birth.

With regard to basic care of the breastfeeding mother, nurses should be able to advise her that she: A. will need an extra 1000 calories a day to maintain energy and produce milk. B. Can go back to pre pregnancy consumption patterns of any drinks as long as she gets enough calcium. C. Should avoid trying to lose large amounts of weight. D. Must avoid exercising because it is too fatiguing.

C. Should avoid trying to lose large amounts of weight.

A nurse is providing discharge instructions for a client. At 4 weeks postpartum, the client should contact her primary care provider for which of the following client findings? A. Scant, non odorous white vaginal discharge. B. Uterine cramping during breastfeeding. C. Sore nipple with cracks and fissures. D. Decreased response with sexual activity.

C. Sore nipple with cracks and fissures.

A plan of care for an infant experiencing symptoms of drug withdrawal should include: A. Administering chloral hydrate for sedation. B. Feeding every 4 to 6 hours to allow extra rest. C. Swaddling the infant snugly and holding the baby tightly. D. Playing soft music during feeding.

C. Swaddling the infant and holding the baby tightly.

A parent has been given instructions about care of a newborn following circumcision. Which of the following statements made by the parent indicates a need for further clarification? A. "His circumcision will heal completely within a couple of weeks." B. "I do not need to remove the yellow exudate that will form." C. "I will clean his penis with each diaper change." D. "I will give him a tub bath within a couple of days."

D. "I will give him a tub bath within a couple of days."

A nurse is conducting a home visit with a client who is 3 months postpartum and breastfeeding. Menses has not yet resumed. The client is discussing contraception with the nurse stating that she does not want to have another child for a couple of years. The nurse understands that this client needs further instruction if the client makes which of the following statements? A. "I have already started using the mini pill for protection." B. "Because of our beliefs, we are going to use the rhythm method." C. "I am being refitted for a diaphragm with my doctor next week." D. "I will not need birth control until I stop breastfeeding."

D. "I will not need birth control until I stop breastfeeding."

When performing nursing care for a newborn after birth, which of the following nursing interventions is the highest priority? A. Initiating breastfeeding B. Performing the initial bath C. Giving a vitamin K injection D. Covering the newborn's head with a cap

D. Covering the newborn's head with a cap.

During newborn assessment, a nurse observes small white nodules on the roof of the newborn's mouth. This finding is a characteristic of which of the following conditions? A. Mongolian spots B. Milia spots C. Erythema toxicum D. Epstein's pearls

D. Epstein's pearls

Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse would suspect: A. Bladder distention B. Uterine atony C. Constipation D. Hematoma formation

D. Hematoma formation

A nurse is assessing the reflexes of a newborn. In checking for the Moro reflex, the nurse should perform which of the following? A. Make a loud noise such as clapping hands together over the newborn's crib. B. Stimulate the pads of the newborn's hands with stroking or massage. C. Stimulate the soles of the newborn's feet on the outer lateral surface of each foot. D. Hold the newborn in a semi-sitting position, then allow the newborn's head and trunk to fall backward.

D. Hold the newborn in a semi-sitting position, then allow the newborn's head and trunk to fall backward.

All of these statements describe the first phase of the transition period except: A. It lasts no longer than 30 minutes. B. It is marked by spontaneous tremors, crying, and head movements. C. It includes the passage of meconium. D. It may involve in the infant suddenly sleeping briefly.

D. It may involve the infant suddenly sleeping briefly.

When teaching parent's about how to care for their newborn's umbilical cord, a nurse should include which of the following nursing interventions? A. Cover the cord with petroleum jelly after bathing. B. Wash the cord with soap and water each day during a tub bath. C. Apply hydrogen peroxide to the cord with each diaper change. D. Keep the cord dry and clean with the diaper folded below it.

D. Keep the cord dry and clean with the diaper folded below it.

A nurse is examining an infant who was just delivered at 41 weeks of gestation. Which of the following characteristics indicates that this infant is post term? A. Abundant lanugo B. Flat areola without breast buds C. Heels moveable fully to the ears D. Leathery skin

D. Leathery skin

To provide adequate postpartum care, the nurse should be aware that postpartum depression (PPD) with psychotic features: A. Is more likely to occur in women with more than two children. B. Is rarely delusional and then usually about someone trying to harm her (the mother). C. Although serious, is not likely to need psychiatric hospitalization. D. May include bipolar disorder (formerly called "manic depression").

D. May include bipolar disorder (formerly called "manic depression").

A client with a deep vein thrombus is being cared for by a postpartum nurse. Which of the following nursing interventions should the nurse include in the client's plan of care? A. Apply cold compresses to the affected extremity. B. Massage the affected extremity. C. Allow the client to ambulate. D. Measure leg circumference.

D. Measure leg circumference.

Postpartum women experience an increased risk for urinary tract infection. A prevention measure the nurse could teach the postpartum woman would be to: A. Acidify the urine by drinking 3 glasses of orange juice each day. B. Maintain a fluid intake of 1 to 2 L/day. C. Empty bladder every 4 hours throughout the day. D. Perform perineal care on a regular basis.

D. Perform perineal care on a regular basis.

A nurse is assessing a postpartum client who is exhibiting signs of tearfulness, insomnia, lack of appetite, and a feeling of letdown. The nurse knows these signs and symptoms are characteristics of: A. postpartum fatigue B. postpartum psychosis C. the letting-go phase D. postpartum depression

D. Postpartum depression

A mother asks why it is important to keep the nipple full of formula when bottle feeding. The nurse explains that the nipple is always full of formula to: A. prevent damaging the newborn's gums. B. keep the newborn from getting too tired. C. keep the newborn from regurgitating the formula. D. prevent the newborn from swallowing air when sucking.

D. Prevent the newborn from swallowing air when sucking.

When placing a newborn under a radiant heat warmer to stabilize temperature after birth, the nurse should: A. Place the thermistor probe on left side of the chest. B. Cover probe with a non reflective material. C. Recheck temperature by periodically taking a rectal temperature. D. Prewarm the radiant heat warmer and place the undressed newborn under it.

D. Prewarm the radiant heat warmer and place the undressed newborn under it.

A nurse concludes that the father of an infant is not showing positive signs of parent-infant bonding and appears to be very anxious and nervous when the mother asks him to bring her the infant. Which of the following is an appropriate nursing intervention to promote father-infant bonding? A. Hand the father the infant and insist that he change the diaper. B. Ask the father why he is so anxious and nervous. C. Tell the father that he will get used to the infant in time. D. Provide education about infant care when the father is present.

D. Provide education about infant care when the father is present.

Nurses should be able to tell breastfeeding mothers that all of the following are signs that the infant has latched on correctly to her breast except: A. She feels a firm tugging sensation on her nipples but no pinching or pain. B. The baby sucks with cheeks rounded, not dimpled. C. The baby's jaw glides smoothly with sucking. D. She hears a clicking or smacking sound when the infant feeds.

D. She hears a clicking or smacking sound when the infant feeds.

A nurse is giving instructions to a mother about how to breastfeed her newborn. Which of the following actions by the mother indicates the need for additional teaching? A. The mother expresses a few drops of colostrum and places it on her nipple. B. The mother inserts a finger in the side of the newborn's mouth before removing the nipple from the newborn's mouth. C. The mother gently strokes the newborn's lips with her nipple when she is ready to breastfeed. D. The mother places a breast shield over her nipple before placing the nipple in the newborn's mouth.

D. The mother places a breast shield over her nipple before placing the nipple in the newborn's mouth.

Four hours after admission to the nursery a newborn is taken to his mother for his first feeding. The mother wants to bottle feed. The nurse reviews basic principles of bottle feeding with the mother. Which of the following observations by the nurse indicates that the mother needs additional teaching? A. The mother burps the newborn after each 1/2 oz of formula he consumes. B. The mother discards unused formula after feeding. C. The mother places the nipple on the tongue of the newborn. D. The mother places the newborn in a supine position during feeding.

D. The mother places the newborn in a supine position during feeding.

When weighing a newborn, the nurse should: A. Leave its diaper on for comfort. B. Place a sterile scale paper on the scale for infection control. C. Keep a hand on the newborn's abdomen for safety. D. Weigh the newborn at the same time each day for accuracy.

D. Weight the newborn at the same time each day for accuracy.