OB Lippincott Questions - Final

A nurse is educating a pregnant client on what food to eat and what to avoid during the pregnancy. Which precaution will the nurse provide regarding the nutritional requirements? a. Limit the B vitamins. b. Limit caffeine intake. c. Avoid fat intake. d. Avoid starchy food.

B

An 18-year-old pregnant woman asks the nurse why she has to have a routine alpha-fetoprotein serum level drawn. The nurse explains that this: A. is a screening test for placental function. B. tests the ability of her heart to accommodate the pregnancy. C. may reveal chromosomal abnormalities. D. measures the fetal liver function.

C

What terminology would the nurse use to document a newborn who weighs 4,000 grams (8.8 lb) or more at birth? A. meconium B. microsomia C. macrosomia D. hydrocephalus

C

The nurse is teaching a client about mastitis. Which statement should the nurse include in her teaching? a. Symptoms include fever, chills, malaise, and localized breast tenderness. b. The most common pathogen is group A streptococcus (GAS). c. Mastitis usually develops in both breasts of a breastfeeding client. d. A breast abscess is a common complication of mastitis.

A

The nurse is evaluating the fetal heart rate rhythm strip and determines that the amplitude varies with a rate 15 to 20 beats/min. What does this assessment finding indicate to the nurse about variability? A. Variability is absent. B. Variability is minimal. C. Variability is marked. D. Variability is normal.

D

A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client? A. glucagon B. diet C. oral hypoglycemic drugs D. long-acting insulin

B

A G3P2 woman at 39 weeks' gestation presents highly agitated, reporting something "came out" when her membranes just ruptured. Which action should the nurse prioritize after noting the umbilical cord is hanging out of the vagina? A. Place the client in Trendelenburg position and gently attempt to reinsert the cord. B. Put the client in bed immediately, call for help, and lift the presenting part of the fetus off the cord. C. Contact the health care provider and prepare the client for an emergent vaginal birth. D. With the client in lithotomy position, hold her legs and sharply flex them toward her shoulders.

B

A client in her third trimester of pregnancy visits the health care center and asks why she is constipated. The nurse would include which most likely cause when responding to the client? a. Engorgement of veins by the weight of the uterus b. Pressure on intestine by the growing fetus c. Pressure of fetal head on the bladder d. Relaxation of cardioesophageal sphincter

B

The nursing instructor is teaching a class on the nutritional needs of the pregnant client. The instructor determines the session is successful when the students correctly choose which supplement as being known to prevent up to 70% of CNS birth defects? a. Iodine b. Zinc c. Folic acid d. Vitamin A

C

The school nurse is presenting a lecture to adolescents to teach them how conception occurs. Which statement by the nurse would accurately describe this process? a. "Human life begins with the union of two cells: the zygote and the sperm." b. "At the time of conception, the ovum determines the sex of the baby." c. "Conception usually occurs when the ovum is in the outer third of the fallopian tube." d. "The ovum carries the Y chromosome, and the sperm carries an X or Y chromosome."

C

Two weeks after giving birth, a woman is feeling sad, hopeless, and guilty because she cannot take care of the infant and partner. The woman is tired but cannot sleep and has isolated herself from family and friends. The nurse recognizes that this client is exhibiting signs of: a. postpartum psychosis b. postpartum hemorrhage c. postpartum depression d. baby blues

C

What assessment finding would suggest to the care team that the pregnant client has completed the first stage of labor? A. The infant is born. B. The client has contractions once every two minutes. C. The client's cervix is fully dilated. D. The client experiences her first full contraction.

C

When assessing fetal heart rate patterns, which finding would alert the nurse to a possible problem? A. variable decelerations B. accelerations C. prolonged decelerations D. early decelerations

C

Which change in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy? a. Ligament tightening b. Decreased swayback c. Increased lordosis d. Joint contraction

C

The nurse places a warmed blanket on the scale when weighing a newborn to minimize heat loss via which mechanism? A. convection B. conduction C. radiation D. evaporation

B

When completing the morning postpartum data collection, the nurse notices the client's perineal pad is completely saturated. Which action should be the nurse's first response? a. Have the charge nurse review the assessment. b. Ask the client when she last changed her perineal pad. c. Vigorously massage the fundus. d. Immediately call the health care provider.

B

Which description is best when documenting an accurate client contraction? A. The client states the contraction as an 8 on the pain scale. B. The client's contractions are 5 minutes apart and last 45 seconds. C. The client's contractions last 30 seconds with rest between. D. The client cries with each contraction and holds the support partner's hand.

B

Which medication will the nurse anticipate the health care provider will prescribe as treatment for an unruptured ectopic pregnancy? A. promethazine B. methotrexate C. oxytocin D. ondansetron

B

A nurse is assessing a pregnant client. Which of the following would the nurse document as an abnormal finding in a pregnancy? a. Lordosis b. Pedal edema c. Linea nigra d. Visual changes

D

The nurse is planning a class for nurses learning to teach early prenatal classes. Which statement indicates that teaching has been effective? a. Early prenatal care is needed for a healthy newborn. b. The goal of early prenatal care is to optimize the health of the woman and the fetus. c. The first prenatal visit should be as soon as the woman misses her period. d. Early prenatal care is meant to obtain laboratory work and teach the woman regarding danger signs early in the pregnancy.

B

The nurse is teaching a primigravida who does not speak the dominant language. The nurse will teach about the most common type of fetal presentation. Which presentation will the nurse prepare? A. occiput presentation using a PowerPoint presentation B. cephalic presentation using preprinted materials in the client's language C. footling presentation drawing a hand-prepared diagram D. breech presentation using a picture

B

The nurse is visiting a family who has a child with a genetic disorder. The oldest daughter in the family is planning marriage within the next few months. Which intervention should the nurse include that would support the 2030 National Health Goals for genetic disease? a. Counsel the daughter to have no children b. Encourage the daughter to have genetic counseling c. Discuss voluntary sterilization options prior to marriage d. Explain that the chance of genetic anomalies in children is slim

B

The nurse prepares to give the first bath to a newborn and notes a white cheese-like substance on the skin. The nurse should document this as which substance? A. milia B. vernix C. amniotic fluid D. lanugo

B

The nursing instructor is teaching a group of student nurses about the current use of episiotomies during the labor process. The instructor determines the session is successful when the students correctly choose which situation that may require the health care provider to perform an episiotomy? A. VBAC delivery B. shoulder dystocia C. persistent occiput anterior position D. multifetal births

B

The obstetric nurse is caring for a pregnant client who has been diagnosed with a hydatidiform mole. What assessment should the nurse prioritize? A. severe nausea and vomiting B. vaginal bleeding C. pain D. blood pressure

B

When an infant is born by cesarean delivery there is always a risk of complications. What is one of the most common complications to the fetus because of a cesarean delivery? A. bruising on the trunk B. respiratory distress C. broken limb due to being wedged in the pelvis D. a cut on the face from the scalpel

B

When assessing cervical effacement of a client in labor, the nurse assesses which characteristic? A. extent of opening to its widest diameter B. degree of thinning C. fetal presenting part D. passage of the mucous plug

B

Which finding is indicative of hypothermia of the preterm neonate? A. regular respirations B. nasal flaring C. oxygen saturation of 95% D. pink skin

B

Which of the following is true regarding storing breast milk? A. Breast milk can still be used if it sits out overnight. B. Breast milk must be refrigerated immediately after pumping. C. Thawed breast milk must be used within 24 hours. D. Breast milk should never be frozen.

B

Why is the first prenatal visit usually the longest prenatal visit? a. Laboratory tests are performed. b. Baseline data is collected. c. A pelvic exam with Papanicolaou test is performed. d. Extensive client teaching is done.

B

A client suffering a miscarriage at 12 weeks' gestation is very upset that the health care provider has ordered a dilatation and curettage (D&C). How should the nurse respond after the client states she didn't have a D&C the time she lost a previous baby at 5 weeks' gestation? A. "This is the procedure ordered by the doctor." B. "Having the D&C will make it easier to get pregnant next time." C. "This procedure is needed to adequately remove all the fetal tissue." D. "You have the option to refuse the surgery."

C

A client who is 2 months pregnant tells the nurse, "I find that I'm always going to the bathroom to urinate." Which responds by the nurse would be appropriate? a. "Your urine is more concentrated now, so you have to go more often." b. "Your baby is making urine so this is adding to what's in your bladder." c. "Your growing uterus is putting pressure on your bladder causing you to go." d. "Your kidneys now have less cells to filter the fluid that goes through."

C

A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the client's safety, which compound would the nurse have readily available? A. potassium chloride B. ferrous sulfate C. calcium gluconate D. calcium carbonate

C

A couple is discussing starting a family with the nurse. When should the nurse suggest genetic counseling? a. After conception b. Before the second child c. Before they conceive d. In the second trimester

C

A fetus is assessed at 2 cm above the ischial spines. How would the nurse document the fetal station? A. +2 B. +4 C. -2 D. 0

C

A group of nursing students are preparing a presentation that will illustrate various components of the birthing process. When discussing the pelvis, the students should point out that the pelvis is often referred to as which term? A. powers B. psyche C. passageway D. passenger

C

A mother delivers her newborn and has chosen to formula-feed her baby. She asks the nurse how to keep her breasts from making milk. How would the nurse respond to the mother's question? a. When she becomes engorged, it is recommended to not wear a bra to allow the breasts to be more comfortable. b. The doctor can give her a hormone shot to dry up her breasts. c. The mother needs to understand that she will produce some milk, but wearing a constrictive bra will help dry up the milk supply. d. The mother will produce milk after delivery but by manually expressing the milk, she can reduce the discomfort.

C

A nonstress test is an assessment test based on which phenomenon? A. Fetal movement causes an increase in maternal heart rate. B. Braxton-Hicks contractions cause fetal heart-rate alterations. C. Fetal heart sounds increase in connection with fetal movement. D. Fetal heart rate slows in response to a uterine contraction.

C

A nurse assesses a client in labor and suspects dysfunctional labor (hypotonic uterine dysfunction). The woman's membranes have ruptured and fetopelvic disproportion is ruled out. Which intervention would the nurse expect to include in the plan of care for this client? A. preparing the woman for an amniotomy B. providing a comfortable environment with dim lighting C. administering oxytocin D. encouraging the woman to assume a hands-and-knees position

C

A nurse is asked to auscultate the fetal heart sounds in a pregnant client. Which equipment is most appropriate when auscultating fetal heart sounds at the 12th week? A. stethoscope B. fetoscope C. Doppler D. tocodynometer

C

A nurse is preparing a client for rhythm strip testing. She places the woman into a semi-Fowler position. What is the appropriate rationale for this measure? A. to decrease the heart rate of the fetus B. to prevent the woman from falling out of bed C. to prevent supine hypotension syndrome. D. to aid the woman as she pushes during labor

C

A nurse is providing prenatal education about how to avoid microorganisms during pregnancy. Which instruction will the nurse provide? a. "If you are up to date on all your vaccinations, you should be protected from most perinatal infections." b. "You should avoid contact with larger-sized dogs." c. "You should avoid unpasteurized dairy products and undercooked meats." d. "If you have no chronic conditions, you should receive prophylactic antibiotics to prevent infection during the first trimester."

C

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? A. hyperglycemia B. elevated platelet count C. elevated liver enzymes D. disseminated intravascular coagulation (DIC)

C

A nursing instructor identifies which of the following as increasing the chances of infection when coupled with prolonged labor? A. multiple births B. number of previous pregnancies C. ruptured membranes D. age of mother

C

A nursing student is preparing a presentation illustrating the Human Genome Project. Which function will the student point out as being the primary focus? a. Genetic testing in adults b. Detection of genetic mutations in children c. Identification of human genes and functions d. Treatment of gene mutations

C

A postpartum client is recovering from the birth and emergent repair of a cervical laceration. Which sign on assessment should the nurse prioritize and report to the health care provider? a. Elevated blood pressure b. Decreased respiratory rate c. Weak and rapid pulse d. Warm and flushed skin

C

A pregnant client arrives to the clinic for a prenatal visit appearing uncomfortable. During the assessment, the nurse determines the client is experiencing fairly strong contractions at 12:05 p.m., 12:10 p.m., 12:15 p.m., and 12:20 p.m. What can the nurse conclude from these findings? A. The client can be sent home. B. The client is in active labor. C. The frequency of the contractions is every 5 minutes. D. The duration of the contractions is every 5 minutes.

C

A pregnant woman asks the nurse about medications taken during pregnancy and if they cross the placental barrier. What response by the nurse is appropriate? a. "Yes, all medications cross the placental barrier." b. "Medications taken during the first trimester are typically safe." c. "Some medications cross the placental barrier, so be sure to discuss medications with your provider." d. "Medications taken orally typically do not cross the placental barrier because of the gastric absorption."

C

A pregnant woman at term is in the obstetrics unit for induction in the morning. Her membranes rupture, and the external fetal monitor shows deep variable decelerations. The nurse should immediately check the client for: A. placental abruption (abruptio placentae). B. amniotic fluid infection. C. umbilical cord prolapse. D. amniotic fluid embolus.

C

A pregnant woman is asked to observe fetal movements as a fetal-assessment technique. You would instruct her to: A. choose a different time frame each day to count movements. B. count only movements that are strong enough to hurt. C. count fetal movements for 1 hour at the same time each day. D. report if she feels no movement for any half-hour period.

C

A primigravida 28-year-old client is noted to have Rh negative blood and her husband is noted to be Rh positive. The nurse should prepare to administer RhoGAM after which diagnostic procedure? A. Contraction test B. Nonstress test C. Amniocentesis D. Biophysical profile

C

A woman at 15 weeks' gestation is about to undergo amniocentesis. Which nursing intervention should be made first? A. Have the client void. B. Place the client in supine position. C. Obtain a signed consent form. D. Observe the fetal heart rate monitor.

C

A woman comes to the clinic for her first postoperative check after a cesarean birth. When the nurse asks her about what type of birth control she plans to use, she tells the nurse that she is breastfeeding so she does not need to worry. What is the nurse's best response? a. "That gives you more time to think about which type of birth control you want to use." b. "Breastfeeding does give you many advantages." c. "Breastfeeding is not a foolproof method of birth control." d. "That will definitely be easier for you and your spouse."

C

A woman in labor suddenly reports sharp fundal pain accompanied by slight dark red vaginal bleeding. The nurse should prepare to assist with which situation? A. Placenta previa obstructing the cervix B. Possible fetal death or injury C. Premature separation of the placenta D. Preterm labor that was undiagnosed

C

A woman who is Rh negative asks the nurse how many children she will be able to have before Rh incompatibility causes them to die in utero. The nurse's best response would be that: A. no more than three children is recommended. B. she will have to ask her primary care provider. C. as long as she receives Rho(D) immune globulin, there is no limit. D. only her next child will be affected.

C

A woman with a positive history of genital herpes is in active labor. Assessment reveals vesicles in the perineum area, membranes are ruptured, dilated 5 cm, and effaced 70%. The nurse should prepare the client for which type of birth? A. Forceps-assisted B. Spontaneous vaginal C. Cesarean D. Vacuum-assisted

C

After a gavage feeding of a preterm neonate, the nurse aspirates 4 ml of undigested formula. This finding may indicate the development of which complication? A. acute gastroenteritis B. dumping syndrome C. necrotizing enterocolitis D. malabsorption syndrome

C

After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between placental abruption (abruptio placentae) and placenta previa. Which statement will the nurse include in the teaching? A. Placenta previa causes painful, dark red vaginal bleeding during pregnancy. B. Placental abruption results in painless, bright red vaginal bleeding during labor. C. Placenta previa is an abnormally implanted placenta that is too close to the cervix. D. Placental abruption requires "watchful waiting" during labor and birth.

C

An obese woman with diabetes has just given birth to a term, large-for-gestational-age (LGA) newborn. Which condition should the nurse most expect to find in this infant? A. hypotension B. hypertension C. hypoglycemia D. hyperglycemia

C

During a prenatal visit, a pregnant woman says, "I know the amniotic fluid is important, but can you tell me more about it?" When describing amniotic fluid to a pregnant woman, which description would the nurse most likely include? a. "This fluid acts as transport mechanism for oxygen and nutrients." b. "The fluid is mostly protein to provide nourishment to your baby." c. "This fluid acts as a cushion to help to protect your baby from injury." d. "The amount of fluid remains fairly constant throughout the pregnancy."

C

Hypertonic labor is labor that is characterized by short, irregular contractions without complete relaxation of the uterine wall in between contractions. Hypertonic labor can be caused by an increased sensitivity to oxytocin. What would the nurse do for a client who is in hypertonic labor because of oxytocin augmentation? A. Increase the methotrexate. B. Turn off the methotrexate. C. Turn off the oxytocin. D. Increase the oxytocin.

C

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor? A. fetal baseline rate increasing at least 5 mm Hg with contractions B. variable decelerations, too unpredictable to count C. fetal heart rate declining late with contractions and remaining depressed D. a shallow deceleration occurring with the beginning of contractions

C

Just after birth, a newborn's axillary temperature is 94°F (34.4°C). What action would be most appropriate? A. Observe the newborn every hour. B. Notify the primary care provider if the temperature goes lower. C. Rewarm the newborn gradually. D. Assess the newborn's gestational age.

C

The client's pregnancy screening test shows that the maternal serum alpha-fetoprotein (MS-AFP) level is high. Which information should the nurse provide the client upon this finding? A. "A high level of MS-AFP is associated with an increased risk of preterm labor. We will monitor you closely and start medication if needed." B. "A high level of MS-AFP is associated with a healthy fetus. We will not need to do any additional testing at this time." C. "A high level of MS-AFP is associated with neural tube defects. We will schedule you for another type of test to determine if your baby has a neural tube defect." D. "A high level of MS-AFP is associated with Down syndrome. We will schedule you for another type of test to determine if your baby has Down syndrome."

C

The new mother has decided to formula-feed her infant and is unsure when to introduce soft foods. Which age should the nurse point out will be appropriate to introduce her infant to mashed fruit and vegetables? A. after 12 months B. 4 to 6 months C. 6 to 8 months D. 8 to 10 months

C

The nurse institutes measures to maintain thermoregulation based on the understanding that newborns have limited ability to regulate body temperature because they: A. have a smaller body surface compared to body mass. B. have an abundant amount of subcutaneous fat all over. C. are unable to shiver effectively to increase heat production. D. lose more body heat when they sweat than adults.

C

The nurse is caring for a client who is being prepared for a cesarean birth due to nonprogession of the labor process. The nurse will direct the client to the proper placement on the operating table and abdominal preparation for which type of incision? A. classical incision B. vertical incision C. low transverse incision ("bikini cut") D. low-abdominal incision

C

The nurse is caring for a client with a G=5, T=0, P=3, A=1, L=3 obstetric history. The nurse is most correct to state which interpretation? a. The client has had uncomplicated pregnancies. b. The client has had difficulty becoming pregnant. c. The client has had difficulty reaching full term. d. The client has had multiple abortions (elective terminations of pregnancy).

C

The nurse is conducting prenatal counseling with pregnant women in the community. An 18-year-old G1P0 in her 36th week states, "I don't know if I should breastfeed or not. Isn't formula just as good for the baby?" What is the nurse's best response? A. It is ultimately the woman's choice whether she wants to breastfeed or not. B. The economic status of the woman is an important breastfeeding consideration. C. The immunologic properties in breast milk cannot be duplicated in formula. D. The benefits of breastfeeding are equal to those of formula feeding.

C

The nurse is monitoring the uterine contractions of a woman in labor. The nurse determines the woman is experiencing hypertonic uterine dysfunction based on which contraction finding? A. well coordinated. B. poor in quality. C. erratic. D. brief.

C

The nurse is reviewing the medical records of several infants. Which infant is at highest risk for death according to the infant mortality rate in the United States? a. An infant born to adolescent parents b. An infant born at 38 weeks' gestation c. An infant born at a low birth weight d. An infant born to a 43-year-old mother

C

The nurse is teaching a client in the first trimester of pregnancy about the importance of folic acid in the diet and how folic acid supplements might be beneficial. For which reason is the nurse teaching the client about this vitamin? a. Maintains energy throughout the pregnancy b. Controls the risk of hypertension while pregnant c. Prevents neural tube disorders in the developing fetus d. Sustains a slow and steady weight gain while pregnant

C

The nurse notes uterine atony in the postpartum client. Which assessment is completed next? a. Assessment of bowel function b. Assessment of the lung fields c. Assessment of the perineal pad d. Assessment of laboratory data

C

The nursing instructor is illustrating the circulatory flow between the mother and fetus. The instructor determines the session is successful when the class correctly chooses which structure with which route? a. The one umbilical artery carries oxygen-rich blood to the fetus from the placenta. b. The two umbilical arteries carry waste products from the placenta to the fetus. c. The one umbilical vein carries oxygen-rich blood to the fetus from the placenta. d. The two umbilical veins carry waste products from the fetus to the placenta.

C

The nursing instructor is leading a discussion exploring the various conditions that can result in postpartum hemorrhage. The instructor determines the session is successful when the students correctly choose which condition is most frequently the cause of postpartum hemorrhage? a. Perineal lacerations b. Hematoma c. Uterine atony d. Disseminated intravascular coagulation

C

Which factor puts a multiparous client on her first postpartum day at risk for developing hemorrhage? a. thrombophlebitis b. moderate amount of lochia rubra c. uterine atony d. hemoglobin level of 12 g/dl (120 g/L)

C

You care for a woman in a prenatal clinic who thinks she might be pregnant. Which of the following assessments is a probable sign of pregnancy? a. Fatigue b. Nausea and vomiting c. A positive pregnancy test d. Amenorrhea

C

A nulliparous client at 37 weeks' gestation calls the labor and delivery unit stating she thinks she is in labor. The nurse predicts she is in true labor based on which answer to her assessment questions? A. scant amount of thick, white vaginal discharge, no odor B. contractions, irregular, lasting 15 to 20 seconds C. bloody mucus in the toilet once earlier in the day D. contraction, regular and lasting longer and stronger

D

A nurse is assigned to care for a client experiencing early postpartum hemorrhage. The nurse is required to administer the prescribed methylergonovine maleate intramuscularly to the client. Which condition would the nurse identify as necessitating the cautious administration of this drug? a. respiratory problems b. low blood pressure c. mild fever d. cardiovascular disease

D

A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find? A. small body size of mother B. maternal rickets C. preterm pregnancy D. gestational diabetes

D

A nurse is providing care to four breastfed newborns who are being monitored for hyperbilirubinemia. When assessing each newborn's indirect bilirubin level, the nurse would notify the health care provider about which newborn? A. Newborn B: 2-day-old newborn with bilirubin level of 6 mg/dl (102.62 µmol/l) B. Newborn A: 1-day-old newborn with bilirubin level of 2 mg/dl (34.32 µmol/l) C. Newborn C: 36-hour-old newborn with a bilirubin level of 10 mg/dl (171.04 µmol/l) D. Neworn D: 48-hour-old newborn with bilirubin level of 14 mg/dl (239.46 µmol/l)

D

A pregnant client is concerned that the baby is going to drown in the uterus because of the fluid. What should the nurse teach the client about fetal respiration? a. "You are breathing for the baby." b. "The baby's breathing is very minor until delivery." c. "The baby's lungs can accommodate all of the fluid." d. "Oxygen is provided to the baby through the placenta."

D

A pregnant client is planning travel to a foreign country as part of a work assignment and needs immunizations. What should the nurse instruct the client about immunizations while pregnant? a. Immunizations should be restricted to live viruses only. b. There are no restrictions on immunizations while pregnant. c. The only immunization that should be avoided is for the flu. d. Live virus immunizations are contraindicated while pregnant.

D

A woman develops gestational diabetes. Which assessment should she make daily? A. Measure her abdominal diameter with a tape measure. B. Measure her uterine height by hand-span distance. C. Test her urine for protein with a chemical reagent strip. D. Measure serum for glucose level by a finger prick.

D

A woman has just learned that she is pregnant and would like to know how soon she can find out via ultrasound the sex of her fetus. The nurse should respond with which of the following? A. Fetal gender can only be determined by analysis of maternal serum. B. at about 6 months C. at about 2 months D. at about 4 months

D

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she is not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor? A. "If I try to talk to my partner during a contraction, I can't." B. "I'm feeling contractions mostly in my back." C. "My contractions are about 6 minutes apart and regular." D. "The contractions slow down when I walk around."

D

A woman presents to the clinic at 1-month postpartum and reports her left breast has a painful, reddened area. On assessment, the nurse discovers a localized red and warm area. The nurse predicts the client has developed which disorder? a. Breast yeast b. Plugged milk duct c. Engorgement d. Mastitis

D

A young female client is pregnant for the first time and is uncertain who to seek prenatal care from. The nurse should point out which health care provider as the likely choice? a. Perinatologist b. Neonatologist c. Family practitioner d. Obstetrician

D

After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests? a. Human placental lactogen (hPL) b. Estrogen (estriol) c. Progesterone (progestin) d. Human chorionic gonadotropin (hCG)

D

Dilation (dilatation) follows effacement in the primiparous mother. To be fully dilated, the cervix should have a distance of what measurement? A. 12 to 14 cm B. 7 to 8 cm C. 3 to 4 cm D. 8 to 10 cm

D

During an examination, a client at 32 weeks' gestation becomes dizzy, lightheaded, and pale while supine. What should the nurse do first? a. Listen to fetal heart tones. b. Take the client's blood pressure. c. Ask the client to breathe deeply. d. Turn the client on her left side.

D

During which time is the nurse correct to document the end of the third stage of labor? A. Following fetal birth B. When the mother is moved to the postpartum unit C. When pushing begins D. At the time of placental delivery

D

Fetal heart rate monitoring reveals baseline tachycardia in the fetus. Which rate would be most likely? A. 144 beats per minute B. 154 beats per minute C. 134 beats per minute D. 164 beats per minute

D

How does fetal circulation differ from circulation after birth? a. Fetal blood flow bypasses the right atrium and goes directly to the right ventricle. b. In utero, blood through the pulmonary artery is only 50% of the post-delivery blood flow. c. The ductus arteriosus carries the majority of the blood circulating from the left atrium to the left ventricle directly to the aorta. d. The umbilical vein carries oxygenated blood, while deoxygenated blood is carried by the umbilical arteries.

D

If a woman is 3 months pregnant, which of the following findings related to breast changes would you expect to assess? a. Slack, soft breast tissue b. Deeply fissured nipples c. Enlarged lymph nodes d. Darkened breast areolae

D

Immediately after giving birth to a full-term infant, a client develops dyspnea and cyanosis. Her blood pressure decreases to 60/40 mm Hg, and she becomes unresponsive. What does the nurse suspect is happening with this client? A. aspiration B. congestive heart failure C. placental separation D. amniotic fluid embolism

D

The injection of a local anesthetic to block specific nerve pathways is referred to as: A. amnesic medication. B. natural anesthesia. C. gas administration. D. pudendal block.

D

The nurse assists while a pregnant client has an amniotomy. Which action should the nurse take immediately at the conclusion of the procedure? A. Assist the client to wash the perineum. B. Provide clean gown and linens for the client. C. Adjust the intravenous fluid infusion rate. D. Assess the fetal heart rate.

D

The nurse is assessing a new client who presents in early labor. The nurse determines the fetus has an acceptable heart rate if found within which range? A. 90 to 140 bpm B. 100 to 150 bpm C. 120 to 170 bpm D. 110 to 160 bpm

D

The nurse is assessing a newborn by auscultating the heart and lungs. Which natural phenomenon will the nurse explain to the parents is happening in the cardiovascular system? A. Oxygen is exchanged in the lungs. B. The oxygen in the blood decreases. C. Fluid is removed from the alveoli and replaced with air. D. Pressure changes occur and result in closure of the ductus arteriosus.

D

The nurse is assessing a pregnant client at 37 weeks' gestation and notes the fetus is at 0 station. When questioned by the client as to what has happened, the nurse should point out which event has occurred? A. extension B. flexion C. expulsion D. engagement

D

The nurse is assessing a primigravida woman at a routine prenatal visit. Which assessment finding is reinforcing to the client that she is definitely pregnant? a. Continued amenorrhea b. Positive hCG blood result c. Uterine growth d. Ultrasound picture of her fetus

D

The nurse is assessing several pregnant women in a clinic setting. Which assessment finding would alert the nurse to notify the health care provider? a. Increased nasal congestion b. Increased urination and fatigue c. Increased skin pigment d. Blood pressure measured at 170/88 mm Hg

D

The nurse is caring for a client whose fetus is noted to be in the position shown. For which fetal lie would the nurse provide client teaching? A. Obtuse B. Oblique C. Transverse D. Longitudinal

D

A 16-year-old client was at 12 weeks' gestation when she gave birth to a fetus last week. The client has come to the office for follow-up and, while waiting in an examination room, notices that on the schedule is written her name and "follow-up of spontaneous abortion." The client is upset about what is written on the schedule. How can the nurse best explain this terminology? A. "Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy." B. "Spontaneous abortion is the medical name for a miscarriage." C. "Oh, that just means it was a miscarriage." D. "Abortion is a medical term for any interruption of pregnancy before a fetus is viable."

A

A breastfeeding mother calls the clinic asking how much water she should be giving her 2-month-old infant. What would the nurse recommend to this mother? A. The infant does not need any water supplement if nursing well. B. The infant needs 5 oz water. C. The infant needs at least 1 oz of water in between feedings.

A

A breastfeeding mother, 1-month postpartum, calls the clinic and reports left breast soreness, a temperature of 100.4°F (38°C), and feeling tired all the time. The nurse suspects the mother is experiencing which situation after revealing she is still trying to breastfeed on a regular schedule? A. mastitis B. breast yeast infection C. plugged milk duct D. engorgement

A

A client asks why she should learn breathing patterns for labor. After instruction is given, the nurse determines teaching has been effective when the client states: A. "Breathing patterns are distraction techniques taught to decrease pain in labor." B. "Breathing patterns must be used with a coach." C. "Breathing patterns help a woman concentrate on pain." D. "Breathing patterns cannot be taught while in labor."

A

A client is admitted with a diagnosis of ruptured ectopic pregnancy. For what should the nurse anticipate preparing the client? A. immediate surgery B. bed rest for the next 4 weeks C. intravenous administration of a tocolytic D. internal uterine monitoring

A

A mother asks the nurse why her newborn is getting a Vitamin K injection in the birth room. The nurse explains that the injection is necessary because: A. Vitamin K is needed for coagulation, and the newborn does not produce vitamin K in the few days following birth. B. The mother was febrile at the time of birth and prophylactic vitamin K is necessary. C. Vitamin K aids in protein metabolism. Newborns have defective protein metabolism until 24 hours of life. D. Newborns are prone to hypoglycemia, and vitamin K helps maintain a steady blood glucose level.

A

A nurse is analyzing a journal article presenting statistics concerning newborn and infant health. Which condition has been determined to be the most likely cause of infant mortality in the United States? a. Congenital abnormalities b. Increased birth weight c. Breech presentation d. Shoulder dystocia

A

A nurse is giving discharge education to a group of new parents before they are discharged home with their infants. What information will the nurse include in the teaching? A. "Place the newborn on the back to sleep and stomach to play." B. "Newborns can sleep on a couch to allow constant visual monitoring." C. "Change the newborn's diaper every four hours while awake." D. "You need to give your newborn a bath everyday."

A

A nurse is preparing a client for rhythm strip testing. She places the woman into a semi-Fowler position. What is the appropriate rationale for this measure? a. To prevent supine hypotension syndrome. b. To decrease the heart rate of the fetus c. To aid the woman as she pushes during labor d. To prevent the woman from falling out of bed

A

A nurse is preparing to perform a physical examination of a pregnant woman at her first prenatal visit. Which of the following actions should the nurse perform before beginning the physical examination? a. Ask the woman to void for a clean-catch urine specimen b. Have the woman perform a breast self-examination c. Have the woman perform a perineal self-examination. d. Ask the woman to perform Kegel exercises.

A

A nurse is speaking with a client who has just learned that she is pregnant with her first child. The nurse reads in the client's chart that she does not drink alcohol on a regular basis. However, the nurse decides to go ahead and warn the client about the dangers of drinking alcohol while pregnant. Which phase of health care would this action be classified as? a. Health promotion b. Health maintenance c. Health restoration d. health rehabilitation

A

A nurse is teaching women the importance of good nutrition and taking prenatal vitamins if they are planning pregnancy. Which measure is the nurse performing? a. Health promotion b. Health maintenance c. Health restoration d. health rehabilitation

A

A nurse urges a pregnant client at the first prenatal office visit to begin taking iron supplements immediately. What is the rationale for this intervention? a. To avoid anemia b. To prevent megalohemoglobinemia c. To maintain proper blood glucose levels d. To reduce the risk for hypertension

A

A nursing instructor is explaining the stages of fetal development to a group of nursing students. The instructor determines the session is successful after the students correctly choose which time period as representing the pre-embryonic stage? a. From fertilization to the end of the second week after fertilization b. Approximately 2 weeks after fertilization to the end of the eighth week c. Approximately 9 weeks after fertilization to birth d. Approximately 6 weeks after fertilization to the end of 8 weeks

A

A patient is at 22 weeks' gestation is preparing to have her fundal height measured. Given the patient's stage of gestation and following McDonald's rule, what result does the nurse expect? a. 22 cm b. 11 cm c. 44 cm d. 2.2 cm

A

A pregnant client at 33 weeks' gestation is in the office for a routine visit. She lies down on her back and while the nurse is listening for fetal heart tones, the client tells the nurse that she feels lightheaded; her blood pressure is 82/58 mm Hg. What is the most likely explanation for this problem? a. She is experiencing supine hypotension syndrome b. She did not drink enough fluids prior to coming to the office. c. Her hematocrit is low and she needs additional iron supplements. d. The baby is kicking her spinal column, causing a pinched nerve.

A

A pregnant client in the first trimester asks the nurse about taking medications while she is pregnant. She tells the nurse that she heard that it can be harmful to the fetus if medications are taken at certain times during pregnancy. What is the best response by the nurse? a. "Exposure to certain substances during the embryonic phase may be harmful to the developing fetus." b. "As long as you are past 4 weeks of pregnancy, you should be able to take most medications." c. "There is no need for you to worry; you are not far enough along in your pregnancy for this to be a problem." d. "You cannot drink alcohol, but you can take some medications, such as cold preparations and over-the-counter medications."

A

A pregnant client refuses treatment for an infection based on cultural beliefs. Which action by the nurse would be appropriate? a. Explain to the client why the treatment is important b. Coerce the cline to have the treatment c. Tell the client she can be arrested for neglect d. Refuse to let the client leave until she consents to treatment

A

A pregnant client scheduled for an amniocentesis asks the nurse how the placenta is not punctured during the procedure. How should the nurse respond to the client? A. "A sonogram to locate it will be done first." B. "It would not be harmful even if it were punctured." C. "A uterus feels soft over the placenta site." D. "Placentas always form on the posterior uterine wall."

A

A primigravida client has just arrived in early labor and is showing signs of extreme anxiety over the birthing process. Why should the nurse prioritize helping the client relax? A. Anxiety can slow down labor and decrease oxygen to the fetus. B. Increased anxiety will increase the risk for needing anesthesia. C. Anxiety will increase blood pressure, increasing risk with an epidural. D. Decreased anxiety will increase trust in the nurse.

A

A student observes during an initial prenatal visit. The student states, "I heard the primary care provider say that the client has a gynecoid pelvis. What does that mean?" The bestresponse by the nurse is: A. "It is rounded in shape and allows ample room for the neonate to fit through the passageway." B. "It is a typical male pelvis. With this type of pelvis, large neonates must be born by cesarean birth although some small neonates are able to be born vaginally." C. "It is flat and narrow, making it extremely difficult for the neonate to pass through." D. "It is elongated, the width is roomy, but the length is narrow."

A

A woman in her third trimester is suffering from heartburn. What should the nurse advise her to do? a. Eat small meals frequently rather than large meals. b. Lie down immediately after eating. c. Sleep on the back with the feet elevated. d. Consume tomato products and citrus juices regularly.

A

A woman in labor for over 12 hours has made very little progress. The health care provider thinks that her contractions lack the force needed to propel the infant downward through the birth canal. The provider asks a group of nursing students which hormone may need to be given to increase the force of the contraction. Which hormone would be the best answer? A. oxytocin, a posterior pituitary hormone B. growth hormone, an anterior pituitary hormone C. antidiuretic hormone, a posterior pituitary hormone D. luteinizing hormone, an anterior pituitary hormone

A

A woman is taking vaginal progesterone suppositories during her first trimester because her body does not produce enough of it naturally. She asks the nurse what function this hormone has in her pregnancy. What should the nurse explain is the primary function of progesterone? a. Maintains the endometrial lining of the uterus during pregnancy b. Ensures the corpus luteum of the ovary continues to produce estrogen c. Contributes to mammary gland development d. Regulates maternal glucose, protein, and fat levels

A

A woman who had a cesarean is getting ready to be discharged from the hospital. Before she leaves, she asks you to assess her breasts because she has pain on both sides. The nurse notices that both breasts are hard, warm, and tender to the touch. Her vital signs are normal. What does the nurse suspect? a. engorgement b. nipple thrush c. a plugged duct d. mastitis

A

A young couple are very excited to learn they are expecting their first child and question the nurse about which test they need to discover its gender. Which procedure will best provide this information to the couple? a. Ultrasound b. Amniocentesis c. Chorionic villus sampling d. HGP

A

After hearing of a lawsuit being filed by a client against another nurse, a nurse becomes concerned about the potential liability in working with premature infants at high risk for morbidity and mortality. Which action is most essential for the nurse to take to limit liability in the event of litigation? a. Carefully documenting every intervention with a client b. Staying up to date on the research in the field c. Having the parents of each infant the nurse works with sign a liability wavier form d. Having an attending HCP confirm each intervention the nurse makes

A

After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful? A. "I will be sure to avoid getting pregnant for at least 1 year." B. "I won't use my birth control pills for at least a year or two." C. "My blood pressure will continue to be increased for about 6 more months." D. "My intake of iron will have to be closely monitored for 6 months."

A

An infant is born to a mother with gestational diabetes. Which long-term maternal complication is associated with this diagnosis? A. Increased risk of development of type 2 diabetes B. Weight gain that is not lost after the pregnancy C. Development of long-term hypertension D. Heart disease

A

Assessment of a pregnant client reveals a pigmented line down the middle of the abdomen. The nurse documents this as which finding? a. Linea nigra b. Striae gravidarum (stretch marks) c. Melasma (chloasma) d. Vascular spiders

A

Assessment of a pregnant client reveals that she is experiencing Braxton Hicks contractions. Which finding would support this assessment? A. irregular pattern B. increasing duration C. cervical dilation (dilatation) occurring D. typically very strong

A

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

A

At 24 weeks' gestation, a client's 1-hour glucose tolerance test is elevated. The nurse explains that, based on this finding, the client will need to take which action? A. A 3-hour glucose tolerance test for follow-up B. Daily insulin injections for gestational diabetes C. Monthly hemoglobin A1C levels to rule out diabetes D. Daily fingersticks for a fasting blood glucose level

A

At 37 weeks' gestation, a woman presents to labor and delivery complaining of intense, knife-like abdominal pain that started suddenly about 1 hour ago and has not subsided. On palpation, the abdomen is rigid and board-like and no vaginal bleeding is evident. What should the nurse do next? A. Assess fetal heart rate B. Insert a Foley catheter C. Administer oxygen by face mask D. Prepare the client for an epidural

A

At birth, the newborn was at the 8th percentile with a weight of 2350 g and born at 36 weeks' gestation. Which documentation is most accurate? A. The infant was a preterm, low-birth-weight and small-for-gestational-age B. The infant was a preterm, very-low-birthweight and small-for-gestational-age C. The infant was born at term but at a very low birth weight and small-for-gestational-age D. The infant was born at term but at a low birth weight and small-for-gestational age

A

Depletion of which nutrient during the first trimester makes the fetus susceptible to neural tube defects? a. Folic acid b. Iron c. Potassium d. Thiamin

A

During a physical exam, the physician notates that the pregnant client has a positive Chadwick sign. What client findings would be noted for this symptom? a. The cervix has a bluish, purple discoloration. b. The cervix is reddened and swollen. c. There is a rebound of the fetus felt when the physician pushes on the abdomen. d. There is hyperpigmentation of the abdomen.

A

During their experience in labor & delivery, a group of nursing students are observing a woman who is having uncoordinated contractions where the monitor shows some contractions close together, followed by a long period without any contractions. The nurse asks the students, "Which medication may help to stimulate a more effective, consistent pattern of contractions?" Which medication would be considered the best answer? A. oxytocin B. terbutaline C. betamethasone D. morphine sulfate

A

On completing fundal palpation, the nurse notes that the fundus is situated in the client's left abdomen. Which action is appropriate? a. Ask the client to empty her bladder. b. Straight-catheterize the client for half of her urine volume. c. Call the client's primary health care provider for direction. d. Straight-catheterize the client immediately.

A

On day 3 after a cesarean birth, the client is complaining of soreness in her left leg. On examination the nurse notes the left leg is swollen, and the calf is red, tender and warm to touch. These findings indicate: a. Deep vein thrombosis. b. Venous insufficiency. c. Varicose veins. d. Peripheral artery disease.

A

Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups. Based on an interpretation of these findings, the nurse would be especially alert for which condition? a. thrombophlebitis b. uterine subinvolution c. hypertension d. retained placental fragments

A

The client in labor at 3 cm dilation and 25% effaced is asking the nurse for analgesia. Which explanation should the nurse provide when explaining why it is too early to administer an analgesic? A. This may prolong labor and increase complications. B. This would cause fetal depression in utero. C. This can lead to maternal hypertension. D. The effects would wear off before delivery.

A

The fetal-assessment technique of a rhythm strip refers to: A. a tracing of fetal heart rate and pattern. B. the rhythm of fetal heart rate compared to maternal pulse. C. the response of fetal heart rate to oxytocin-stimulated contractions. D. a fetal EKG, because it is effected by glucose stimulation.

A

The fetus of a nulliparous woman is in a shoulder presentation. The nurse would prepare the client for which type of birth? A. cesarean B. vaginal C. forceps-assisted D. vacuum extraction

A

The fluid-filled, inner membrane sac surrounding the fetus is which structure? a. Amnion b. Chorion c. Endometrium d. Decidua

A

The nurse asks a new mother how she is planning on feeding her newborn. The mother responds that she is planning on formula feeding her baby. Which of the following is the best response for the nurse to give the mother? A. "Have you considered breastfeeding? There are some real benefits that it can offer you and your baby." B. "I wouldn't do that if I were you. It is not healthy for your baby." C. "I understand. I have some formula samples here I can get you started with." D. "That's an excellent choice. Your baby will be well-nourished."

A

The nurse is assessing a woman who is pregnant for the first time. Which of the following terms applies to this client? a. Primigravida b. Primipara c. Nulligravida d. Multipara

A

The nurse is caring for a postpartum woman who exhibits a large amount of bleeding. Which areas would the nurse need to assess before the woman ambulates? a. Blood pressure, pulse, reports of dizziness b. Attachment, lochia color, complete blood cell count c. Height, level of orientation, support systems d. Degree of responsiveness, respiratory rate, fundus location

A

The nurse is caring for the newborn after birth. The nurse has obtained erythromycin ophthalmic ointment and prepares for administration. The parent asks the nurse, "I know all newborns get ointment put in their eyes, but why?" How will the nurse respond? A. It is precautionary to prevent gonorrheal and chlamydial conjunctivitis. B. It helps to moisten the eye after birth to assist in blinking. C. It helps the newborn's vision to be more clear. D. It is to prevent a corneal tear during birth.

A

The nurse notes the following on a newborn's assessment: poor muscle tone, jitteriness, and temperature 97.0oF (36.1oC), HR 120 bpm, RR 26 breathes per minute, and blood pressure 60/40 mm Hg. Which nursing action should the nurse prioritize? A. Assess the infant's blood sugar. B. Check oxygen saturation of the blood. C. Check the infant's temperature again. D. Complete an entire set of vital signs.

A

A client at 32 weeks' gestation tells the nurse that she has been experiencing shortness of breath when walking up the steps at home. She is concerned that something is wrong. What is the nurse's best response? a. "You only have a few more weeks until the birth and then you will breathe fine again." b. "The enlarging uterus pushes against your diaphragm and this makes breathing shallow." c. "Oxygen requirements are increasing in your body because the fetus is growing." d. "Don't worry about this because it is a normal change that occurs with pregnancy."

B

A client has just received combined spinal epidural. Which nursing assessment should be performed first? A. Assess for spontaneous rupture of membranes. B. Assess vital signs. C. Assess for progress in labor. D. Assess pain level using a pain scale. E. Assess for fetal tachycardia.

B

A group of nurses are discussing the reasons for the United States' low rankings for infant and maternal mortality and what impact they could make on these mortality rates in their practice. Which action could nurses implement to reduce these rates? a. Ensuring that all pregnant clients receive their immunizations b. Assuring early and adequate prenatal care c. Providing more extensive women's shelters d. Encouraging all women to eat a balanced diet

B

A newborn girl who was born at 38 weeks' gestation weighs 2000 g and is below the 10th percentile in weight. The nurse recognizes that this girl will be placed in which classification? A. term, small-for-gestational-age, and very-low-birth-weight infant B. term, small-for-gestational-age, and low-birth-weight infant C. late preterm and appropriate for gestational age D. late preterm, large-for-gestational-age, and low-birth-weight infant

B

A nurse assesses a primigravida client and observes darkening of the skin on the client's face. How should the nurse document this pigmentation? a. Linea nigra b. Melasma (chloasma) c. Spider nevi d. Palmar erythema

B

A nurse is assessing a female client in the labor admission unit. The client has been having contractions every 5 minutes for the past 6 hours. Which finding would the nurse use to determine if the client is experiencing true labor? A. The client has a history of giving birth to two infants. B. The client's cervix has changes of effacement and dilation (dilatation). C. Walking helps the reduce the frequency of the client's contractions. D. The client reports the contractions stay in the abdomen.

B

A nurse is classifying the pregnancy history of a woman who has had five pregnancies: three full-term, one preterm, and one abortion, with four children still living. How would the nurse document this information on the client's chart using the GTPAL system? a. G4 T3 P1 A1 L5 b. G5 T3 P1 A1 L4 c. G5 T3 P1 A1 L5 d. G5 T1 P1 A3 L5

B

A nurse is discussing the importance of good nutrition to a young pregnant client. The nurse would point out that the growing fetus is getting nutrition from the mother via which structure? a. Decidua b. Placenta c. Amniotic fluid d. Umbilical arteries

B

A nurse is preparing a nursing care plan for a client who is admitted at 22 weeks' gestation with advanced cervical dilation (dilatation) to 5 cm, cervical insufficiency, and a visible amniotic sac at the cervical opening. Which primary goal should the nurse prioritize at this point? A. Education on causes of cervical insufficiency for the future B. Bed rest to maintain pregnancy as long as possible C. Give birth vaginally D. Notification of social support for loss of pregnancy

B

A pregnant client in her second trimester visits a health care center. She informs the nurse that at times she experiences difficulty breathing. What would the nurse identify as the mostlikely cause of the client's report? a. Displacement of the stomach by the growing fetus b. Pressure on the diaphragm by the growing fetus c. Pressure on the pelvic area by the growing fetus d. Pressure on the rectal vein by the growing fetus

B

A pregnant client presents to the emergency department reporting back-to-back contractions. Within 2 hours, the client is completely effaced and 9 cm dilated, and the fetal head is showing. Within minutes the client gives birth with only the nurse in attendance. This is an example of which occurrence? A. protraction disorder B. precipitate labor C. uterine dysfunction D. labor dystocia

B

A primapara woman, 30 weeks' gestation, has no family support and frequently calls the health care provider's office with questions. Which report by the woman would alert the nurse that she may be having a complication related to the pregnancy and needs to come to the clinic today for further assessment? a. Having a hard time having bowel movements and feeling like anal area is swollen b. Feeling of achy, cramping in vaginal area accompanied by bleeding that has saturated 1 pad/hour c. Experiencing some shortness of breath after walking up five flights of stairs d. Having some discharge from nipples that has never happened before

B

A woman in active labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly, the woman grabs the nurse's hand and states, "Something inside me is tearing." The nurse notes her blood pressure is 80/50 mm Hg, pulse rate is 130 bpm and weak, the skin is cool and clammy, and the fetal monitor shows bradycardia. The nurse activates the code team because the nurse suspects the client may be experiencing which complication? A. an amniotic embolism to the lungs B. uterine rupture C. compression on the inferior vena cava D. an undiagnosed abdominal aorta aneurysm

B

A woman of normal weight asks the nurse what an ideal weight gain is during pregnancy. What would be the nurse's best answer? a. She should not gain over 20 lb. b. Weight gain of 25-35 lb is ideal. c. The amount of weight gain is not important. d. Any gain over 30 lb is ideal.

B

A woman's husband expresses concern about risk of paralysis from an epidural block being given to his wife. Which would be the most appropriate response by the nurse? A. "I have never read or heard of this happening." B. "The injection is given in the space outside the spinal cord." C. "An injury is unlikely because of expert professional care given." D. "The injection is given at the third or fourth thoracic vertebrae so paralysis is not a problem."

B

An 18-year-old client has given birth at 28 weeks' gestation and her newborn is showing signs of respiratory distress syndrome (RDS). Which statement is true for a newborn with RDS? A. Glucocorticoid (GC) is given to the newborn following birth. B. RDS is caused by a lack of alveolar surfactant. C. RDS is characterized by heart rates below 50 beats per minute. D. Respiratory symptoms of RDS typically improve within a short period of time.

B

Annie, a new mother, is talking with the nurse about breastfeeding. She asks, "How does lactation work?" The best answer by the nurse is: a. The newborn sucking on the breast stimulates the adrenal gland causing the release of oxytocin. This causes the synthesis and release of breast milk in the breast. b. The newborn sucking on the breast stimulates the pituitary gland causing the release of prolactin and oxytocin. Prolactin causes synthesis and release of breast milk and oxytocin causes contraction of the smooth muscle around the alveoli of the breast. c. The newborn sucking on the breast stimulates the pituitary gland causing the release of prolactin. This causes contractions of the smooth muscle around the alveoli in the breast. d. The newborn sucking on the breast stimulates the pituitary gland causing the release of prolactin. This causes the synthesis and release of breast milk in the breast.

B

During a physical assessment, the nurse palpates a pregnant client's fundus at the level of the umbilicus. What statement should the nurse make to the client about this assessment finding? a. "You are at 12 weeks of your pregnancy." b. "You are at 20 weeks of your pregnancy." c. "You are at 36 weeks of your pregnancy." d. "You can go into labor at any time now."

B

Genetics-related health care is basic to the holistic practice of nursing. What should nursing practice in genetics include? a. Identifying genetic markers b. Gathering relevant family and medical history information c. Providing advice on termination of pregnancy d. Discouraging females to conceive after the age of 40 years

B

Implantation generally occurs at which place on the uterus? a. The lower anterior surface b. The upper posterior surface c. Directly over the cervical os d. Directly over an opening to a fallopian tube

B

The Ballard scoring system evaluates newborns on which two factors? A. body maturity and cranial nerve maturity B. physical maturity and neuromuscular maturity C. tone maturity and extremities maturity D. skin maturity and reflex maturity

B

The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence? a. Lightening b. Quickening c. Placenta previa d. Linea nigra

B

The client in active labor overhears the nurse state the fetus is ROA. The nurse should explain this refers to which component when the client becomes concerned? A. Fetal attitude B. Fetal position C. Fetal size D. Fetal station

B

The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which schedule is recommended for prenatal care? a. Once every 3 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth b. Once every 4 weeks for the first 28 weeks, then every 3 weeks until 36 weeks, and then every 2 weeks until the birth c. Once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth d. Once every 4 weeks for the first 36 weeks, then weekly until the birth

B

The nurse is assessing a client who is 14 hours postpartum and notes very heavy lochia flow with large clots. Which action should the nurse prioritize? a. Assess her blood pressure. b. Palpate her fundus. c. Have her turn to her left side. d. Assess her perineum.

B

The nurse is explaining the process of fertilization to a client who has just learned of being pregnant. On which day during pregnancy should the nurse explain that the embryo implants on the uterine surface? a. By the fourth day after fertilization b. By the tenth day after fertilization c. On the fourteenth day of a "typical" menstrual cycle d. On the tenth day after the start of the menstrual flow

B

The nurse is measuring a contraction from the beginning of the increment to the end of the decrement for the same contraction. The nurse would document this as which finding? A. frequency B. duration C. intensity D. peak

B

A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition? a. uterine prolapse b. uterine atony c. uterine contraction d. uterine subinvolution

B

A newborn with high serum bilirubin is receiving phototherapy. Which is the most appropriate nursing intervention for this client? A. Application of eye dressings to the infant B. Placing light 6 inches above the newborn's bassinet C. Delay of feeding until bilirubin levels are normal D. Gentle shaking of the baby

A

The nurse is caring for several women in the postpartum clinic setting. Which statement(s), when made by one of the clients, would alert the nurse to further assess that client for postpartum psychosis? Select all that apply. a. "When the newborn is sleeping, I can see his thoughts projected on my phone and I do not like the thoughts." b. "I believe my newborn is losing weight because I will not feed him because my milk was poisoned by the health care provider." c. "I am sad because I am not spending as much time with my toddler now that my newborn is here." d. "Sometimes I get tired of being with only the newborn, so I call my mom and sister to come visit." e. "The newborn is not really mine emotionally, since I was never pregnant and do not have children."

A, B, E

A new mother asks the nurse if this thin, watery milk is adequate enough to meet her newborn's nutritional needs. Which information is accurate for the nurse to share with this mother? Select all that apply. A. Colostrum is thin and watery to help the newborn learn to suck, and then mature breast milk will be produced. B. Cow's milk can be substituted for colostrum to meet the infant's nutritional needs. C. Colostrum has maternal antibodies that will help protect the newborn from illness. D. All forms of breast milk have a high enough fat content to help the infant gain weight rapidly. E. Colostrum is easy for the newborn to digest since it is high in protein and low in sugar and fat.

A, C

A nurse is conducting a teaching session on sudden infant death syndrome (SIDS) for expectant parents. Which information should the nurse include? Select all that apply. a. Sharing a room allows for monitoring of the infant. b. Co-bedding or sharing a bed creates parental bonding. c. Place the infant on his or her back to sleep. d. Maintain neutral temperatures and avoid overheating. e. Allow the infant to sleep with a bottle.

A, C, D

A client's menstrual period is two weeks late. She has been feeling tired and has had episodes of nausea in the morning. What classification of pregnancy symptoms is this client experiencing? a. Positive b. Presumptive c. Probable d. No classification

B

A fertilized ovum is known as which structure? a. Fetus b. Zygote c. Embryo d. Chorion

B

Breastfeeding is contraindicated in all of the following conditions in the mother except: a. illicit drug use. b. taking antiviral medications. c. mastitis. d. untreated active tuberculosis.

C

Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting? A. buttocks B. occiput C. shoulders D. brow

B

The nurse notices that there is no vitamin K administration recorded on a newborn's medical record upon arrival to the newborn nursery. What would be the nurse's first action? A. Call the Labor and Delivery nurse who cared for the newborn to inquire about why the medication was not documented. B. Administer an oral dose of vitamin K to the newborn. C. Assume that the parents refused this medication for their infant. D. Give the IM dose of vitamin K to prevent the possibility of hemorrhage in the newborn.

A

The nurse palpates a postpartum woman's fundus 2 hours after birth and finds it located to the right of midline and somewhat soft. What is the correct interpretation of this finding? a. The bladder is distended. b. The uterus is filling up with blood. c. The uterine placement is normal. d. There is an infection inside the uterus.

A

The nurse reviews the newborn's morning laboratory levels and notes a bilirubin level of 5.8 mg/dl (99.20 µmol/l). What will the nurse expect to assess in the newborn? A. yellow-tinted skin on the head and face B. stools that are seedy and yellow C. yellowing of the soles of the feet D. enlarged liver, palpable on examination

A

What term is used to describe the position of the fetal long axis in relation to the long axis of the mother? A. Fetal lie B. Fetal presentation C. Fetal attitude D. Fetal position

A

When caring for a client with lactose intolerance, the nurse would be aware of which potential problem during pregnancy? a. Inadequate calcium for skeletal growth b. Inadequate protein for muscle development c. Inadequate iron for red blood cell production d. Inadequate folate for neural tube closure

A

Which complication occurs as a result of ineffective breathing patterns? A. hyperventilation B. flatus C. nausea D. hiccups

A

Which intervention would be helpful to a client who is bottle feeding her infant and experiencing hard, engorged breasts? a. apply ice b. apply warm compresses c. breastfeed instead d. sitz bath

A

Which medication is administered to reverse the depressant effects of opioids? A. naloxone B. butorphanol C. nalbuphine D. meperidine

A

The client is having her blood drawn for a Triple or Quad screen. For what does this test screen? Select all that apply. A. neural tube defects B. Down syndrome C. gestational diabetes D. rubella E. pre-eclampsia

A, B

The nurse is providing prenatal education in the community. The nurse advises the pregnant women to check with their health care provider before what activity(ies)? Select all that apply. a. Receiving immunizations b. Taking over-the-counter herbs c. Taking "natural" medications d. Eating spicy foods e. Drinking bottled water

A, B, C

A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply. A. hemolysis B. elevated liver enzymes C. hyperthermia D. low platelet count E. leukocytosis

A, B, D

Evidence-based practice research has discovered that which women are most likely to breastfeed exclusively for the first 6 months? Select all that apply. A. women who had in vitro fertilization before becoming pregnant B. women who did not smoke during pregnancy C. older women with a higher income D. young women experiencing financial concerns E. women who gave birth to twins

B, C

A nurse is explaining the Apgar scoring to a new mother and her partner. What should the nurse point out about this scoring method? Select all that apply. A. The Apgar score is used to guide newborn resuscitation. B. The baby is considered vigorous if the 5-minute score is above 7. C. The Apgar score is an immediate assessment of newborn cardiopulmonary adaptation. D. It is done at 1 and 5 minutes after birth. E. Each factor receives a score of 0 or 2.

B, C, D

A nurse is providing care to a pregnant client in labor. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? A. full B. complete C. frank D. footling

C

A 20-year-old client gave birth to a baby boy at 43 weeks' gestation. What might the nurse observe in the newborn during routine assessment? A. The newborn may have short nails and hair. B. The testes in the child may be undescended. C. The newborn may look wrinkled and old at birth. D. The infant may have excess of lanugo and vernix caseosa.

C

A client is diagnosed with a postpartum infection. The nurse is most correct to provide which instruction? a. Change the perineal pad every 3 to 4 hours to decrease the uterine infection. b. Apply ice to the perineum to decrease pain of a perineal infection. c. Finish all antibiotics to decrease a genital tract infection. d. Drink plenty of fluids to decrease a bladder infection.

C

A client is in active labor. Checking the EFM tracing, the nurse notes variables that are abnormal. What would be the nurse's first nursing intervention? A. Obtain assistance to check for a compressed umbilical cord. B. Document the finding. C. Help the woman change positions. D. Prepare the woman for an emergency cesarean birth.

C

A client is to have an amniocentesis with ultrasound. What does the nurse explain to the client that amniocentesis can determine? Select all that apply. A. what the eye color of the baby will be B. what type of facial features the fetus will have C. whether the fetal lungs are mature enough to support respiration outside of the womb D. the amniotic fluid can be used for genetic testing E. how much the fetus will weigh at birth

C, D

A 33-year-old pregnant client asks the nurse about testing for birth defects that are safe for both her and her fetus. Which test would the nurse state as being safe and noninvasive? A. percutaneous umbilical cord sampling B. chorionic villus sampling C. amniocentesis D. ultrasound

D

A 35-year-old client has just given birth to a healthy newborn during her 43rd week of gestation. What should the nurse expect when assessing the condition of the newborn? A. seizures, respiratory distress, cyanosis, and shrill cry B. tremors, irritability, and high-pitched cry C. yellow appearance of the newborn's skin D. meconium aspiration in utero or at birth

D

A 35-year-old client is seen for her 2-week postoperative appointment after a suction curettage was performed to evacuate a hydatidiform mole. The nurse explains that the human chorionic gonadotropin (hCG) levels will be reviewed every 2 weeks and teaches about the need for reliable contraception for the next 6 months to a year. The client states, "I'm 35 already. Why do I have to wait that long to get pregnant again?" What is the nurse's best response? A. "Since you are at the end of your reproductive years, it is suggested that you don't try to have any more pregnancies." B. "After a curettage procedure, it is recommended that you give your body some time to build up its stores." C. "You may need chemotherapy, so we don't want to risk pregnancy." D. "A contraceptive is used so that a positive pregnancy test resulting from a new pregnancy will not be confused with the increased level of hCG that occurs with a developing malignancy."

D

A client in the latent phase of the first stage of labor is noted to be uncomfortable with intact membranes and mild contractions on assessment. The nurse should encourage the client to pursue which action? A. Up in chair TID B. Bathroom privileges C. Complete bed rest D. Ambulation ad lib

D

A couple comes to the clinic for preconception counseling and care. As part of the visit, the nurse teaches the couple about fertilization and initial development, stating that the zygote formed by the union of the ovum and sperm consists of how many chromosomes? a. 22 b. 23 c. 44 d. 46

D

A gravida 1 client is admitted in the active phase of stage 1 labor with the fetus in the LOA position. The nurse anticipates noting which finding when the membranes rupture? A. Cloudy white fluid B. Greenish fluid C. Bloody fluid D. Clear to straw-colored fluid

D

A new mother calls her pediatrician's office concerned about her 2-week-old infant "crying all the time." When the nurse explores further, the mother reports that the infant cries at least 2 hours each day, usually in the afternoons. What recommendation would the nurse not make to this mother? A. Rocking and talking to the infant B. Gently patting or stroking the infant's back C. Swaddling the infant before returning to the crib D. Feeding the infant more formula whenever she begins to fuss

D

A newborn at 1 minute of life is acrocyanotic, HR is 110, is floppy with some flexion, has a weak cry, and grimaces. What Apgar score would the nurse assign this infant? A. 7 B. 9 C. 8 D. 6

D

An infant who is diagnosed with meconium aspiration displays which symptom? A. pink skin B. no heart murmur C. respirations of 45 D. intercostal and substernal retractions

D

The nurse is caring for a multigravid client at 38 weeks' gestation and is reviewing diagnostic studies that estimate 1 liter of amniotic fluid surrounding the fetus. The nonstress test is reactive with a heart rate of 142 beats/min and moderate variability. The client verbalizes lower back discomfort. Which interpretation of the fetal status will the nurse make? A. The mother is experiencing back labor pains, causing a rupture of membranes. B. There is limited amniotic fluid, but the fetal heart is not compromised. C. The fetal heart is stressed, with an elevated heart rate and nonstress test reactivity. D. There is no concerning data. Fetal heart rate is normal and kidney function exists.

D

The nurse is conducting a prenatal class on the pros and cons of breastfeeding versus formula feeding. Which deciding factor should the nurse prioritize when assisting these parents to make their decision? A. It depends on how the newborn responds to the feeding. B. Stress the disadvantages to formula feeding. C. Strongly encourage only breastfeeding to all parents. D. It is based on their personal preference and situation.

D

The nurse is determining a pregnant client's estimated date of delivery/birth (EDD) using Naegele rule. The date of the first day of the client's last normal menstrual period (LNMP) was April 20. What would be this client's EDD? a. December 25 b. December 27 c. January 20 d. January 27

D

The nurse is transcribing messages from the answering service. Which phone message should the nurse return first? A. a 20-year-old, 31-week G1P0 client with malaise and rhinitis; the client's last blood pressure was 120/80 mm Hg, and she had no proteinuria B. a 25-year-old, 31-week G1P0 client with blood pressure of 100/80 mm Hg and left flank pain; the client's last blood pressure was 100/77 mm Hg and she had no proteinuria C. an 18-year-old, 38-week G2P1 client with intermittent cramping; the client's last blood pressure was 98/50 mm Hg, and proteinuria was 1+ D. a 35-year-old, 21-week G3P2 client with blood pressure of 160/110 mm Hg, blurred vision, and whose last blood pressure was 143/99 mm Hg and urine dipstick showed a +2 proteinuria

D

The nursing instructor is conducting a teaching session illustrating the basics of feeding newborns. The instructor determines the class is successful after the students correctly choose which disorder as a contraindication to breastfeeding? a. phenylketonuria (PKU) b. hypothyroidism c. hypertension d. galactosemia

D

When asked by a parent to compare the feeding habits of formula-fed and breastfed infants, what is the correct response from the nurse about breastfed infants? A. digest their milk more slowly B. experience longer periods between feeds C. usually feed every 4 hours D. go approximately 3 hours between feedings

D

Which assessment finding in a client reporting uterine contractions would be most consistent as an indicator of approaching labor? A. decrease in duration of contractions B. decrease in vaginal secretions C. development of a membrane further closing the cervix D. rupture of amniotic membranes

D