OB Quiz #3

When developing a teaching plan for a couple who are considering contraception options, the nurse would include which statement? A. "The best contraceptive is one that you will use correctly and consistently." B. "You should select one that is considered to be 100% effective." C. "A good contraceptive doesn't require a physician's prescription." D. "The best one is the one that is the least expensive and most convenient."

A. "The best contraceptive is one that you will use correctly and consistently."

A woman comes to the clinic because she has been unable to conceive. When reviewing the woman's history, the nurse would least likely identify which factor as a possible risk? A.age of 25 years B.diabetes since age 15 years C.weight below standard for height and age D.history of smoking

A.age of 25 years

When teaching parents about their newborn, the nurse describes the development of a close emotional attraction to a newborn by the parents during the first 30 to 60 minutes after birth. The nurse refers to this process by which term? A.bonding B.attachment C.reciprocity D.engrossment

A.bonding The development of a close emotional attraction to the newborn by parents during the first 30 to 60 minutes after birth describes bonding. Reciprocity is the process by which the infant's capabilities and behavioral characteristics elicit a parental response. Engrossment refers to the intense interest during early contact with a newborn. Attachment refers to the process of developing strong ties of affection between an infant and significant other.

A postpartum client comes to the clinic for her 6-week postpartum check-up. When assessing the client's cervix, the nurse would expect the external cervical os to appear: A.slit-like. B.triangular. C.circular. D.shapeless.

A.slit-like.

A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the client's fundus and documents which finding as normal? A.two fingerbreadths below the umbilicus B.four fingerbreadths below the umbilicus C.two fingerbreadths above the umbilicus D.at the level of the umbilicus

A.two fingerbreadths below the umbilicus

A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which effect? A. urinary retention B. respiratory depression C. abdominal distention D. hyperreflexia

B. respiratory depression

A woman using the cervical mucus ovulation method of fertility awareness reports that her cervical mucus looks like egg whites. The nurse interprets this as which kind of mucus? A. purulent mucus B. spinnbarkeit mucus C. normal pre-ovulation mucus D. postovulatory mucus

B. spinnbarkeit mucus

A client who has come to the clinic is diagnosed with endometriosis. What would the nurse expect the primary care provider to prescribe as a first-line treatment? A. progestins B. gonadotropin-releasing hormone analogues C. NSAIDs D. antiestrogens

C. NSAIDs

After teaching a group of adolescents about female reproductive anatomy, the nurse determines that the teaching was successful when the adolescents identify which structure as the site of fertilization? A. uterus B. vestibule C. fallopian tubes D. vagina

C. fallopian tubes Fertilization occurs in the distal portion of the fallopian tubes. The lining of the uterus is shed with menstruation. The vagina connects the external genitalia to the uterus. The vestibule is an oval area enclosed by the labia minora laterally.

A nurse palpates a woman's fundus to determine contraction intensity. What would be most appropriate for the nurse to use for palpation? A. back of the hand B. finger tips C. finger pads D. palm of the hand

C. finger pads

The nurse is reviewing the laboratory test results of a client with abnormal uterine bleeding (AUB). Which finding would be of concern? A.negative pregnancy test B.serum cholesterol of 140 mg/dL C.hemoglobin level of 10.1 g/dL D.prothrombin time of 60 seconds

C.hemoglobin level of 10.1 g/dL

The nurse is assessing a 13-year-old girl. Which event would the nurse expect to have occurred first? A. onset of menses B. growth spurt C. evidence of pubic hair D. development of breast buds

D. development of breast buds

A woman is diagnosed with a vaginal infection. After teaching the client about measures to reduce her risk, the nurse determines that the client needs additional teaching when she states which factor as increasing her risk? A. douching B. use of feminine hygiene sprays C. antibiotic therapy D. menstruation

D. menstruation

The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first? A. psychological release B. sperm emission C. ejaculation D. penile vasodilation

D. penile vasodilation

After teaching a group of pregnant women about breastfeeding, the nurse determines that the teaching was successful when the group identifies which hormone as important for the production of breast milk after birth? A. placental estrogen B. progesterone C. gonadotropin-releasing hormone D. prolactin

D. prolactin

The nurse is teaching a health education class on male reproductive anatomy and asks the students to identify the site of sperm production. Which structure, if identified by the group, would indicate to the nurse that the teaching was successful? A. prostate gland B. seminal vesicles C. scrotum D. testes

D. testes

When assessing fetal heart rate, the nurse finds a heart rate of 175 bpm, accompanied by a decrease in variability and late decelerations. Which action would the nurse perform next? A. Notify the health care provider. B. Administer oxygen. C. Have the woman change her position. D. Continue to monitor the pattern every 15 minutes.

A. Notify the health care provider.

In the menstrual cycle, every month the female reproductive system generates an ovum. When the ovum is not fertilized, production of which of the following leads to menstruation? A. Progesterone by the corpus luteum beginning to decrease. B. Follicle stimulating hormone by the anterior pituitary. C. Another ovum which begins immediately. D. Estrogen by the corpus luteum begins to decrease.

A. Progesterone by the corpus luteum beginning to decrease.

After explaining the function of the seminal vesicles to a class, the instructor determines the need for additional teaching when the students identify which of the following as a function? A. Reduce sperm motility B. Aid for sperm to reach the ovum C. Nourishment of the sperm D. Prevent sperm destruction by female antibodies

A. Reduce sperm motility

The nurse is reviewing the process of oocyte maturation and ovulation with a client. What occurs during ovulation of the ovarian cycle that the nurse should include in the teaching session with the client? A. Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature B. Preparation of the uterus for implantation of an ovum C. The empty ruptured graafian follicle becomes the corpus luteum and begins to secrete progesterone and estrogen D. About day 14, a surge of hormones cause the ovum to burst through the ovary

A. Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature The follicular phase lasts from about day 4 to about day 14. During this time, under the influence of FSH, several follicles begin to ripen and the ovum within each begins to mature. About day 14, a surge of hormones causes the ovum to burst through the ovary; this act is called ovulation. During the luteal phase, the empty, ruptured graafian follicle becomes the corpus luteum and it begins to secrete progesterone and estrogen. The endometrium of the uterus has a similar cycle. It is called the uterine cycle or endometrial cycle. This process prepares the uterus for implantation of an ovum (egg).

After teaching a group of students about the different methods for contraception, the instructor determines that the teaching was successful when the students identify which contraceptive methods as mechanical barrier methods? Select all that apply. A. cervical sponge B. condom C. cervical cap D. diaphragm E. vaginal ring

A. cervical sponge B. condom C. cervical cap D. diaphragm

A nurse has been invited to be a guest speaker for a female high school health class about the menstrual cycle and reproduction. When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle? A. luteininzing hormone B. progesterone C. estrogen D. prolactin

A. luteininzing hormone

A nurse is reading a journal article about the various medications used for pain relief during labor. Which drug would the nurse most likely note as producing amnesia but no analgesia? A. midazolam B. fentanyl C. prochlorperazine D. meperidine

A. midazolam

A nurse is conducting a class for a group of teenage girls about female reproductive anatomy and physiology. Which structures would the nurse include as an external female reproductive organ? Select all that apply. A. mons pubis B. clitoris C. labia D. vagina E. uterus

A. mons pubis B. clitoris C. labia

A nurse is assessing a woman after birth and notes a second-degree laceration. The nurse interprets this as indicating that the tear extends through which area? A. muscles of perineal body B. skin C. anterior rectal wall D. anal sphincter

A. muscles of perineal body

A woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which event? A. ovulation B. safe period for intercourse C. onset of menses D. pregnancy

A. ovulation

A nurse is providing care to a woman during the third stage of labor. Which finding would alert the nurse that the placenta is separating? A. sudden gush of dark blood from the vagina B. uterus becoming discoid shaped C. shortening of the umbilical cord D. boggy, soft uterus

A. sudden gush of dark blood from the vagina Signs that the placenta is separating including a firmly contracting uterus, a change in uterine shape from discoid to globular ovoid, a sudden gush of dark blood from the vaginal opening, and lengthening of the umbilical cord protruding from the vagina.

The nurse is reviewing the laboratory test results of a client with dysfunctional uterine bleeding (DUB). Which finding would be of concern? A) Negative pregnancy test B) Hemoglobin level of 10.1 g/dL C) Prothrombin time of 60 seconds D) Serum cholesterol of 140 mg/dL

B) Hemoglobin level of 10.1 g/dL A hemoglobin level of 10.1 g/dL suggests anemia, which might occur secondary to prolonged or heavy menses. A negative pregnancy test, a prothrombin time of 60 seconds, and a serum cholesterol level of 140 mg/dL are within normal parameters.

After the nurse teaches a client about ways to reduce the symptoms of premenstrual syndrome, which client statement indicates a need for additional teaching? A. "I've signed up for an aerobic exercise class three times a week." B. "I will make sure to take my estrogen supplements a week before my period." C. "I quit smoking about a month ago, so that should help." D. "I'll cut down on the amount of coffee and colas I drink."

B. "I will make sure to take my estrogen supplements a week before my period."

A nurse is explaining the use of effleurage as a pain relief measure during labor. Which statement would the nurse most likely use when explaining this measure? A. "This technique redirects energy fields that lead to pain." B. "The technique involves light stroking of the abdomen with breathing." C. "This technique focuses on manipulating body tissues." D. "The technique requires focusing on a specific stimulus."

B. "The technique involves light stroking of the abdomen with breathing."

A nurse is examining a female client and tests the client's vaginal pH. Which finding would the nurse interpret as normal? A. 8.5 B. 4.5 C. 10 D. 7

B. 4.5

A school nurse who is teaching a health course at the local high school is presenting information on human development and sexuality. When talking about the role of hormones in sexual development, which hormone does the nurse teach the class is the most important for developing and maintaining the female reproductive organs? A. Androgens B. Estrogen C. Follicle-stimulating hormone D. Progesterone

B. Estrogen

A nurse is describing the hormones involved in the menstrual cycle to a group of young adult women who are planning to get pregnant. The nurse determines the teaching was successful when the group identifies the follicle-stimulating hormone as being secreted by the: A. ovaries. B. anterior pituitary gland. C. corpus lute. D. hypothalamus.

B. anterior pituitary gland.

A nurse is completing a continuing education program about the male and female reproductive organs. After reviewing the information, the nurse demonstrates understanding of the information by identifying which structures as male accessory organs? Select all that apply. A. teste B. bulbourethral glands C. vas deferens D. penis E. prostate gland

B. bulbourethral glands C. vas deferens E. prostate gland

A woman in labor is to receive continuous internal electronic fetal monitoring. The nurse prepares the client for this monitoring based on the understanding that which criterion must be present? A. a neonatologist to insert the electrode B. cervical dilation of 2 cm or more C. intact membranes D. floating presenting fetal part

B. cervical dilation of 2 cm or more For continuous internal electronic fetal monitoring, four criteria must be met: ruptured membranes, cervical dilation of at least 2 cm, fetal presenting part low enough to allow placement of the electrode, and a skilled practitioner available to insert the electrode.

A nurse is completing the assessment of a woman admitted to the labor and birth suite. Which information would the nurse expect to include as part of the physical assessment? Select all that apply. A. current pregnancy history B. contraction pattern C. support system D. estimated date of birth E. membrane status F. fundal height measurement

B. contraction pattern E. membrane status F. fundal height measurement

The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only with a prescription? A. spermicide B. diaphragm C. basal body temperature D. condom

B. diaphragm

A woman has just entered the second stage of labor. The nurse would focus care on which intervention? A. palpating the woman's fundus for position and firmness B. encouraging the woman to push when she has a strong desire to do so C. completing the identification process of the newborn with the mother D. alleviating perineal discomfort with the application of ice packs

B. encouraging the woman to push when she has a strong desire to do so

When planning the care of a woman in the active phase of labor, the nurse would anticipate assessing the fetal heart rate at which interval? A. every 15 minutes B. every 30 minutes C. every 4 hours D. every 60 minutes

B. every 30 minutes During the active phase of labor, FHR is monitored every 30 minutes. The woman's temperature is typically assessed every 4 hours during the first stage of labor. Contractions and vital signs are monitored every 30 to 60 minutes during the latent phase; contractions are assessed every 15 minutes during the transition phase.

A client comes to the clinic with abdominal pain. Based on her history the nurse suspects endometriosis. The nurse expects to prepare the client for which evaluatory method to confirm this suspicion? A. pelvic examination B. laparoscopy C. transvaginal ultrasound D. hysterosalpingogram

B. laparoscopy

The nurse is conducting a teaching session with a group of adolescent females about the menstrual cycle. When describing the ovarian cycle to the group, which phase would the nurse most likely include? A. proliferative B. luteal C. secretory D. menstrual

B. luteal

When reviewing the medical record of a client diagnosed with endometriosis, the nurse would identify which factor as a risk for this woman? A. short menstrual flow B. menstrual cycles of 24 days C. low fat in the diet D. age of 14 years for menarche

B. menstrual cycles of 24 days

When describing the male sexual response to a group of students, the instructor determines that the teaching was successful when they identify emission as: A. semen forced through the urethra to the outside. B. movement of sperm from the testes and fluid into the urethras. C. body's return to the physiologic nonstimulated state. D. dilation of the penile arteries with increased blood flow to the tissues.

B. movement of sperm from the testes and fluid into the urethras.

The nurse is assessing a 12-year-old girl who has had her first menses. When reviewing the client's history, which event would the nurse expect to have most likely occurred last? A. evidence of pubic hair B. onset of menses C. growth spurt D. breast bud development

B. onset of menses

After teaching a group of pregnant women about breastfeeding, the nurse determines that the teaching was successful when the group identifies which hormone as being inhibited during pregnancy but is important for the production of breast milk after birth? A. progesterone B. prolactin C. placental estrogen D. gonadotropin-releasing hormone

B. prolactin

A client is to receive an implantable contraceptive. The nurse describes this contraceptive as containing: A. concentrated estrogen. B. synthetic progestin. C. combined estrogen and progestin. D. concentrated spermicide.

B. synthetic progestin.

Which female reproductive tract structure would the nurse describe to a group of young women as containing rugae that enable it to dilate during labor and birth? A. cervix B. vagina C. fallopian tube D. vulva

B. vagina The vagina is a tubular, fibromuscular organ lined with mucous membrane that lies in a series of transverse folds called rugae. These rugae allow for extreme dilation of the canal during labor and birth. The cervix, the lower portion of the uterus, is composed of fibrous connective tissue that dilates during labor. The fallopian tube transports the ovum from the ovary to the uterus. The vulva is a collective term used to refer to the external female reproductive organs (mons pubis, labia majora and minora, clitoris, vestibular structures, and perineum).

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? A. "I get sharp pain in my lower abdomen usually starting soon after my period comes." B."I've been having bleeding off and on that's irregular and sometimes heavy." C."My periods have been unusually long and heavy lately." D."I get really irritable and moody about a week before my period."

B."I've been having bleeding off and on that's irregular and sometimes heavy."

The nurse develops a teaching plan for a postpartum client and includes teaching about how to perform pelvic floor muscle training or Kegel exercises. The nurse includes this information for which reason? A.alleviate perineal pain B.improve pelvic floor tone C.reduce lochia D.promote uterine involution

B.improve pelvic floor tone

A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. "I've also been waking up at night feeling really hot and sweating. The nurse interprets these findings as: A.menopause. B.perimenopause. C.menarche. D.climacteric.

B.perimenopause. Perimenopause is the time period occurring 2 to 8 years prior to menopause during which women may experience physical changes associated with decreasing estrogen levels, which may include vasomotor symptoms of hot flashes, irregular menstrual cycles, sleep disruptions, forgetfulness, irritability, mood disturbances, decreased vaginal lubrication, night sweats, fatigue, vaginal atrophy, and depression (Burbos & Morris, 2011). Vasomotor symptoms (hot flushes and night sweats) are the most common complaints for which women seek treatment. Menopause or climacteric is defined as 1 year without a menstrual period. Menarche refers to the onset of the first menses

A woman is admitted to the labor and birthing suite. Vaginal examination reveals that the presenting part is approximately 2 cm above the ischial spines. The nurse documents this finding as: A) +2 station B) 0 station C) -2 station D) Crowning

C) -2 station The ischial spines serve as landmarks and are designated as zero status. If the presenting part is palpated higher than the maternal ischial spines, a negative number is assigned. Therefore, the nurse would document the finding as -2 station. If the presenting part is below the ischial spines, then the station would be +2. Crowning refers to the appearance of the fetal head at the vaginal opening

The nurse is reviewing the medical records of several clients. Which client would the nurse expect to have an increased risk for developing osteoporosis? A) A woman of African American descent B) A woman who plays tennis twice a week C) A thin woman with small bones D) A woman who drinks one cup of coffee a day

C) A thin woman with small bones A woman with a small frame and thin bones is at a higher risk for osteoporosis. Caucasian or Asian women, not African American women, are at higher risk for the condition. A woman who plays tennis twice a week is active and thus would be at low risk for osteoporosis. Women who ingest excessive amounts of caffeine are at increased risk.

A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. What would the nurse do next? A. Notify the primary care provider immediately. B. Perform a vaginal exam. C. Check the fetal heart rate. D. Change the linen saver pad.

C. Check the fetal heart rate When membranes rupture, the priority focus is on assessing fetal heart rate first to identify a deceleration, which might indicate cord compression secondary to cord prolapse. A vaginal exam may be done later to evaluate for continued progression of labor. The physician should be notified, but this is not a priority at this time. Changing the linen saver pad would be appropriate once the fetal status is determined and the physician has been notified.

The nurse is describing the three phases of the uterine cycle with a client. What occurs during the proliferative phase of the uterine cycle that the nurse should include in a teaching session with the client? A. An ovum matures. B. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. C. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. D. If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall.

C. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth during the proliferative phase. If fertilization does not occur, the corpus luteum degenerates and hormonal levels fall during the secretory phase. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. Maturation of an ovum occurs during the ovarian cycle; growth of the lining (endometrium) of the uterus occurs during the uterine cycle. Together, these cycles are known as the menstrual cycle.

A nurse is describing the structure and function of the reproductive system to an adolescent health class. How would the nurse describe the secretion of the seminal vesicles? A. mucus-like B. acidic C. alkaline D. semen

C. alkaline

Which action is a priority when caring for a woman during the fourth stage of labor? A. encouraging the woman to void B. assessing the uterine fundus C. assisting with perineal care D. offering fluids as indicated

C. assisting with perineal care

A pregnant woman admitted to the labor and birth suite undergoes rapid HIV testing and is found to be HIV-positive. Which action would the nurse expect to include when developing a plan of care for this woman? Select all that apply. A. electing for the use of forceps-assisted delivery B. administration of penicillin G at the onset of labor C. avoidance of scalp electrodes for fetal monitoring D. administering zidovudine at the onset of labor. E. refraining from obtaining fetal scalp blood for pH testing

C. avoidance of scalp electrodes for fetal monitoring D. administering zidovudine at the onset of labor. E. refraining from obtaining fetal scalp blood for pH testing

When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which primary cause? A. active lifestyle B. changes in vaginal pH C. estrogen deficiency D. poor dietary intake

C. estrogen deficiency

A nurse is reviewing the fetal heart rate pattern and observes abrupt decreases in FHR below the baseline, appearing as a U-shape. The nurse interprets these changes as reflecting which type of deceleration? A. prolonged decelerations B. late decelerations C. variable decelerations D. early decelerations

C. variable decelerations Variable decelerations present as visually apparent abrupt decreases in FHR below baseline and have an unpredictable shape on the FHR baseline, possibly demonstrating no consistent relationship to uterine contractions. The shape of variable decelerations may be U, V, or W, or they may not resemble other patterns. Early decelerations are visually apparent, usually symmetrical and characterized by a gradual decrease in the FHR in which the nadir (lowest point) occurs at the peak of the contraction. They are thought to be a result of fetal head compression that results in a reflex vagal response with a resultant slowing of the FHR during uterine contractions. Late decelerations are visually apparent, usually symmetrical, transitory decreases in FHR that occur after the peak of the contraction. The FHR does not return to baseline levels until well after the contraction has ended. Delayed timing of the deceleration occurs, with the nadir of the uterine contraction. Late decelerations are associated with uteroplacental insufficiency. Prolonged decelerations are abrupt FHR declines of at least 15 bpm that last longer than 2 minutes but less than 10 minutes.

A woman who delivered a healthy newborn several hours ago asks the nurse, "Why am I perspiring so much?" The nurse integrates knowledge that a decrease in which hormone plays a role in this occurrence? A.hCG B.hPL C.estrogen D.progesterone

C.estrogen Although hCG, hPL, and progesterone decline rapidly after birth, decreased estrogen levels are associated with breast engorgement and with the diuresis of excess extracellular fluid accumulated during pregnancy.

A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which statement by the woman would lead the nurse to suspect that the woman needs additional teaching? A) "The warmth and buoyancy of the water has a nice relaxing effect." B) "I can stay in the bath for as long as I feel comfortable." C) "My cervix should be dilated more than 5 cm before I try using this method." D) "The temperature of the water should be at least 105 degrees F."

D) "The temperature of the water should be at least 105 degrees F." Hydrotherapy is an effective pain relief method. The water temperature should not exceed body temperature. Therefore, a temperature of 105 degrees would be too warm. The warmth and buoyancy have a relaxing effect and women are encouraged to stay in the bath as long as they feel comfortable. The woman should be in active labor with cervical dilation greater than 5 cm.

After teaching a group of students about premenstrual syndrome, the instructor determines that additional teaching is needed when the students identify which finding as a prominent assessment finding? A) Bloating B) Tension C) Dysphoria D) Weight loss

D) Weight loss Irritability, fatigue, bloating, tension, and dysphoria are the most prominent and consistently described manifestations of premenstrual syndrome. Weight gain, not weight loss, is associated with this disorder

Which suggestion by the nurse about pushing would be most appropriate to a woman in the second stage of labor? A. "Bear down like you're having a bowel movement with every contraction." B. "Let me help you decide when it is time to start pushing." C. "Lying flat with your head elevated on two pillows makes pushing easier." D. "Choose whatever method you feel most comfortable with for pushing."

D. "Choose whatever method you feel most comfortable with for pushing."

The nurse is performing Leopold's maneuvers to determine fetal presentation, position, and lie. Which action would the nurse do first? A. Palpate for the presenting part in the area just above the symphysis pubis. B. Determine flexion by pressing downward toward the symphysis pubis. C. Feel for the fetal back and limbs as the hands move laterally on the abdomen. D. Feel for the fetal buttocks or head while palpating the abdomen.

D. Feel for the fetal buttocks or head while palpating the abdomen.

The nurse is reviewing the process of oocyte maturation and ovulation with a client. What occurs during the follicular phase of the ovarian cycle that the nurse should include in the teaching session on ovulation with the client? A. About day 14, a surge of hormones cause the ovum to burst through the ovary B. Preparation of the uterus for implantation of an ovum C. The empty ruptured graafian follicle becomes the corpus luteum and it begins to secrete progesterone and estrogen D. Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature

D. Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature The follicular phase lasts from about day 4 to about day 14. During this time, under the influence of FSH, several follicles begin to ripen and the ovum within each begins to mature. About day 14, a surge of hormones causes the ovum to burst through the ovary; this act is called ovulation. During the luteal phase, the empty, ruptured graafian follicle becomes the corpus luteum and it begins to secrete progesterone and estrogen. The endometrium of the uterus has a similar cycle. It is called the uterine cycle or endometrial cycle. This process prepares the uterus for implantation of an ovum (egg)

Which factor in a client's history would alert the nurse to an increased risk for postpartum hemorrhage? A.multiparity, age of mother, operative delivery B.prematurity, infection, length of labor C.size of placenta, small baby, operative delivery D.uterine atony, placenta previa, operative procedures

D.uterine atony, placenta previa, operative procedures

A woman's amniotic fluid is noted to be cloudy. The nurse interprets this finding as: A. possible infection. B. meconium passage. C. normal. D. transient fetal hypoxia

A. possible infection.

The nurse is making a follow-up home visit to a woman who is 12 days postpartum. Which finding would the nurse expect when assessing the client's fundus? A.cannot be palpated B.10 cm below the umbilicus C.2 cm below the umbilicus D.6 cm below the umbilicus

A.cannot be palpated

A nurse is preparing a class for a group of women at a family planning clinic about contraceptives. When describing the health benefits of oral contraceptives, which benefits would the nurse most likely include? Select all that apply. A.protection against pelvic inflammatory disease B.reduced risk for migraine headaches C.decreased risk for depression D.reduced risk for endometrial cancer E.improvement in acne

A.protection against pelvic inflammatory disease D.reduced risk for endometrial cancer E.improvement in acne

When planning the care of a woman in the latent phase of labor, the nurse would anticipate assessing fetal heart rate at which interval? A. every 10 to 15 minutes B. every 30 to 60 minutes C. every 15 to 30 minutes D. every 60 to 90 minutes

B. every 30 to 60 minutes

The nurse is assessing a postpartum client's lochia and finds that there is about a 4-inch stain on the perineal pad. The nurse documents this finding as which description? A.scant B.moderate C.light D.large

C.light

Which finding would the nurse expect to find in a client with endometriosis? A. fluid retention B. hot flashes C. fever D. dyspareunia

D. dyspareunia

A nurse is making a home visit to a postpartum woman who delivered a healthy newborn 4 days ago. The woman's breasts are swollen, hard, and tender to the touch. The nurse documents this finding as: A.engrossment. B.mastitis. C.involution. D.engorgement.

D.engorgement.

A nurse is teaching a postpartum client how to do muscle-clenching exercises for the perineum. The client asks the nurse, "Why do I need to do these exercises?" Which reason would the nurse most likely incorporate into the response? a) promotes uterine involution b) reduces lochia c) alleviates perineal pain d) improves pelvic floor tone

d) improves pelvic floor tone Muscle clenching perineal exercises help to improve pelvic floor tone, strengthen perineal muscles, and promote healing, ultimately helping to prevent urinary incontinence later in life. Kegel exercises have no effect on lochia, involution, or pain.

A nurse is preparing a couple and their newborn for discharge. Which instructions would be most appropriate for the nurse include in discharge teaching

demonstrating comfort measures to quiet a crying infant

After a normal labor and birth, a client is discharged from the hospital 12 hours later. When the community health nurse makes a home visit 2 days later, which finding would alert the nurse to the need for further intervention?

frequent scant voidings Infrequent or insufficient voiding may be a sign of infection and is not a normal finding on the second postpartum day. Lochia serosa, a firm fundus below the umbilicus, and milk filling the breasts are expected findings.

When discussing contraceptive options, the nurse would recommend which option as being the most reliable? A. coitus interruptus B. intrauterine system C. natural family planning D. lactational amenorrheal method (LAM)

B. intrauterine system

A nurse is teaching a new mother about breast-feeding. The nurse determines that the teaching was successful when the woman identifies which hormone as responsible for milk let-down? A) Prolactin B) Estrogen C) Progesterone D) Oxytocin

D) Oxytocin

A nurse is assessing a postpartum woman's adjustment to her maternal role. Which event would the nurse expect to occur first? A. becoming preoccupied with the present B. reestablishing relationships with others C. demonstrating increasing confidence in care of the newborn D. assuming a passive role in meeting her own needs

D. assuming a passive role in meeting her own needs

A woman in labor who received an opioid for pain relief develops respiratory depression. The nurse would expect which agent to be administered? A.promethazine B.butorphanol C.fentanyl D.naloxone

D.naloxone

When developing the plan of care for the parents of a newborn, the nurse identifies interventions to promote bonding and attachment based on the rationale that bonding and attachment are most supported by which measure?

Early parent-infant contact following birth - Optimal bonding requires a period of close contact between the parents and newborn within the first few minutes to a few hours after birth. Expert medical care, nutrition and prenatal care, and grandparent involvement are not associated with the promotion of bonding.

A nurse is conducting a class for a group of nurses who are newly hired for the labor and birth unit. After teaching the group about fetal heart rate patterns, the nurse determines the need for additional teaching when the group identifies which finding as indicating normal fetal acid-base status?

Sinusoidal pattern, Recurrent variable decelerations, Fetal bradycardia

A postpartum client has a fourth-degree perineal laceration. The nurse would expect which medication to be ordered? A) Ferrous sulfate (Feosol) B) Methylergonovine (Methergine) C) Docusate (Colace) D) Bromocriptine (Parlodel)

C) Docusate (Colace)

A client who has just given birth to a healthy newborn required an episiotomy. Which action would the nurse implement immediately after birth to decrease the client's pain from the procedure? A.Apply an ice pack to the site. B.Offer warm blankets. C.Offer a warm sits bath. D.Encourage the woman to void.

.Apply an ice pack to the site.

A couple comes to the clinic for a fertility evaluation. The male partner is to undergo a semen analysis. After teaching the partner about this test, which client statement indicates that the client has understood the instructions? A. "I have to abstain from sexual activity for about 1 to 2 days before the sample." B. "I will withdraw before I ejaculate during sex to collect the specimen." C. "I will place the specimen in a special plastic bag to transport it." D. "I need to bring the specimen to the lab the day after collecting it."

A. "I have to abstain from sexual activity for about 1 to 2 days before the sample."

A postpartum woman who is bottle-feeding her newborn asks the nurse, "About how much should my newborn drink at each feeding?" The nurse responds by saying that to feel satisfied, the newborn needs which amount at each feeding? A. 2 to 4 ounces B. 1 to 2 ounces C. 6 to 8 ounces D. 4 to 6 ounces

A. 2 to 4 ounces Newborns need about 108 cal/kg or approximately 650 cal/day (Dudek, 2010). Therefore, explain to parents that a newborn will need to 2 to 4 ounces to feel satisfied at each feeding.

A client states, "I think my waters broke! I felt this gush of fluid between my legs." The nurse tests the fluid with a Nitrazine swab and confirms membrane rupture if the swab turns: A. blue. B. yellow. C. pink. D. olive green.

A. blue.

A nurse is preparing a couple and their newborn for discharge. Which instructions would be most appropriate for the nurse include in discharge teaching? A. demonstrating comfort measures to quiet a crying infant B. allowing the infant to cry for at least an hour before picking him or her up C. encouraging daily outings to the shopping mall with the newborn D. introducing solid foods immediately to increase sleep cycle

A. demonstrating comfort measures to quiet a crying infant

A nurse is visiting a postpartum woman who delivered a healthy newborn 5 days ago. Which finding would the nurse expect? A. pinkish brown discharge B. creamy white discharge C. deep red mucus-like discharge D. bright red discharge

A. pinkish brown discharge Lochia serosa is pinkish brown and is expelled 3 to 10 days postpartum. Lochia rubra is a deep-red mixture of mucus, tissue debris, and blood that occurs for the first 3 to 4 days after birth. Lochia alba is creamy white or light brown and consists of leukocytes, decidual tissue, and reduced fluid content and occurs from days 10 to 14 but can last 3 to 6 weeks postpartum.

The nurse is assisting a postpartum woman out of bed to the bathroom for a sitz bath. Which action would be a priority? A. placing the call light within her reach B. telling her to use the sitz bath for 30 minutes C. teaching her how the sitz bath works D. cleaning the perineum with the peri-bottle

A. placing the call light within her reach

A nurse is conducting a class for a group of nurses who are newly hired for the labor and birth unit. After teaching the group about fetal heart rate patterns, the nurse determines the need for additional teaching when the group identifies which finding as indicating normal fetal acid-base status? Select all that apply. A. recurrent variable decelerations B. moderate baseline variability C. fetal bradycardia D. absence of late decelerations E. sinusoidal pattern

A. recurrent variable decelerations C. fetal bradycardia E. sinusoidal pattern

After teaching parents about their newborn, the nurse determines that the teaching was successful when they identify which concept as reflecting the enduring nature of their relationship involving placing the infant at the center of their lives and finding their own way to assume the parental identity? A. commitment B. bonding C. attachment D. reciprocity

A. commitment

A nurse is observing the interaction between a new father and his newborn. The nurse determines that engrossment has yet to occur based on which behavior? A. identifies imperfections in the newborn's appearance B.is able to distinguish his newborn from others in the nursery C.shows feelings of pride with the birth of the newborn

A. identifies imperfections in the newborn's appearance Engrossment is characterized by seven behaviors: visual awareness of the newborn, tactile awareness of the newborn, perception of the newborn as perfect, strong attraction to the newborn, awareness of distinct features of the newborn, extreme elation, and increased sense of self-esteem.

Which positions would be most appropriate for the nurse to suggest as a comfort measure to a woman who is in the first stage of labor? Select all that apply. A. straddling with forward leaning over a chair B. rocking back and forth with foot on chair C. walking with partner support D. supine with legs raised at a 90-degree angle E. closed knee-chest position

A. straddling with forward leaning over a chair B. rocking back and forth with foot on chair C. walking with partner support

A nurse is completing a postpartum assessment. Which finding would alert the nurse to a potential problem? A. temperature of 101° F (38.3° C) B.pain rating of 2 on a scale from 0 to 10 C.respiratory rate of 16 breaths per minute D.lochia rubra with a fleshy odor

A. temperature of 101° F (38.3° C)

When developing a teaching plan for a couple considering contraception options, the nurse would include which statement? A."The best contraceptive is one that you will use correctly and consistently." B."The best one is the one that is the least expensive and most convenient." C."You should select one that is considered to be 100% effective." D."A good contraceptive doesn't require a primary care provider's prescription."

A."The best contraceptive is one that you will use correctly and consistently."

The nurse is assessing a postpartum client's lochia and finds that there is about a 4-inch stain on the perineal pad. The nurse interprets this finding as indicating which amount of blood loss? A.10 to 25 mL B.10 mL C.over 50 mL D.25 to 50 mL

A.10 to 25 mL Scant: a 1- to 2-inch lochia stain on the pad or a 10 ml loss; Light or small: 4-inch stain or a 10 to 25 ml loss; Moderate: 4- to 6-inch stain with an estimated loss of 25 to 50 ml; Large or heavy: a pad is saturated within 1 hour after changing it.

Which method would be most effective in evaluating the parents' understanding about their newborn's care? A.Observe the parents performing the procedures. B.Demonstrate all infant care procedures. C.Routinely assess the newborn for cleanliness. D.Allow the parents to state the steps of the care.

A.Observe the parents performing the procedures.

A nurse is reviewing information about maternal and paternal adaptations to the birth of a newborn. The nurse observes the parents interacting with their newborn physically and emotionally. The nurse documents this as: A) Puerperium B) Lactation C) Attachment D) Engrossment

C) Attachment

A woman who gave birth 24 hours ago tells the nurse, "I've been urinating so much over the past several hours." Which response by the nurse would be most appropriate? A) "You must have an infection, so let me get a urine specimen." B) "Your body is undergoing many changes that cause your bladder to fill quickly." C) "Your uterus is not contracting as quickly as it should." D) "The anesthesia that you received is wearing off and your bladder is working again."

B) "Your body is undergoing many changes that cause your bladder to fill quickly." Postpartum diuresis occurs as a result of several mechanisms: the large amounts of IV fluids given during labor, a decreasing antidiuretic effect of oxytocin as its level declines, the buildup and retention of extra fluids during pregnancy, and a decreasing production of aldosterone—the hormone that decreases sodium retention and increases urine production. All these factors contribute to rapid filling of the bladder within 12 hours of birth. Diuresis begins within 12 hours after childbirth and continues throughout the first week postpartum. Rapid bladder filling, possible infection, or effects of anesthesia are not involved.

A postpartum woman who has experienced diastasis recti asks the nurse about what to expect related to this condition. Which response by the nurse would be most appropriate? A) "You'll notice that this will fade to silvery lines." B) "Exercise will help to improve the muscles." C) "Expect the color to lighten somewhat." D) "You'll notice that your shoe size will increase."

B) "Exercise will help to improve the muscles." Separation of the rectus abdominis muscles, called diastasis recti, is more common in women who have poor abdominal muscle tone before pregnancy. After birth, muscle tone is diminished and the abdominal muscles are soft and flabby. Specific exercises are necessary to help the woman regain muscle tone. Fortunately, diastasis responds well to exercise, and abdominal muscle tone can be improved. Stretch marks (striae gravidarum) fade to silvery lines. The darkened pigmentation of the abdomen (linea nigra), face (melasma), and nipples gradually fades. Parous women will note a permanent increase in shoe size.

After describing continuous internal electronic fetal monitoring to a laboring woman and her partner, which statement by the woman would indicate the need for additional teaching? A) "This type of monitoring is the most accurate method for our baby." B) "Unfortunately, I'm going to have to stay quite still in bed while it is in place." C) "This type of monitoring can only be used after my membranes rupture." D) "You'll be inserting a special electrode into my baby's scalp."

B) "Unfortunately, I'm going to have to stay quite still in bed while it is in place." With continuous internal electronic monitoring, maternal position changes and movement do not interfere with the quality of the tracing. Continuous internal monitoring is considered the most accurate method, but it can be used only if certain criteria are met, such as rupture of membranes. A spiral electrode is inserted into the fetal presenting part, usually the head.

A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for: A. pelvic X-ray. B. DEXA scan. C. ultrasound. D. MRI.

B. DEXA scan.

A nurse is preparing a presentation about changes in the various body systems during the postpartum period and their effects for a group of new mothers. The nurse explains which event as influencing a postpartum woman's ability to void? Select all that apply. A) Use of an opioid anesthetic during labor B) Generalized swelling of the perineum C) Decreased bladder tone from regional anesthesia D) Use of oxytocin to augment labor E. need for an episiotomy

B) Generalized swelling of the perineum C) Decreased bladder tone from regional anesthesia D) Use of oxytocin to augment labor

A nurse is observing a postpartum woman and her partner interact with the their newborn. The nurse determines that the parents are developing parental attachment with their newborn when they demonstrate which behavior? Select all that apply. A) Frequently ask for the newborn to be taken from the room B) Identify common features between themselves and the newborn C) Refer to the newborn as having a monkey-face D) Make direct eye contact with the newborn E) Refrain from checking out the newborn's features

B) Identify common features between themselves and the newborn D) Make direct eye contact with the newborn

A nurse is observing a postpartum client interacting with her newborn and notes that the mother is engaging with the newborn in the en face position. Which behavior would the nurse be observing? A) Mother placing the newborn next to bare breast. B) Mother making eye-to-eye contact with the newborn C) Mother gently stroking the newborn's face D) Mother holding the newborn upright at the shoulder

B) Mother making eye-to-eye contact with the newborn

A nurse is developing a teaching plan for a postpartum woman who is breast-feeding about sexuality and contraception. Which information would the nurse most likely include? Select all that apply. A) Resumption of sexual intercourse about two weeks after delivery B) Possible experience of fluctuations in sexual interest C) Use of a water-based lubricant to ease vaginal discomfort D) Use of combined hormonal contraceptives for the first three weeks E) Possibility of increased breast sensitivity during sexual activity

B) Possible experience of fluctuations in sexual interest C) Use of a water-based lubricant to ease vaginal discomfort E) Possibility of increased breast sensitivity during sexual activity

A postpartum client is experiencing subinvolution. When reviewing the woman's labor and birth history, which contributor would the nurse identify as being a significant to this condition? A) Early ambulation B) Prolonged labor C) Large fetus D) Use of anesthetics A. short duration of labor B. use of anesthetics C. breast-feeding D. early ambulation

B) Prolonged labor B. use of anesthetics Factors that inhibit involution include prolonged labor and difficult birth, incomplete expulsion of amniotic membranes and placenta, uterine infection, overdistention of uterine muscles (such as by multiple gestation, hydramnios, or large singleton fetus), full bladder (which displaces the uterus and interferes with contractions), anesthesia (which relaxes uterine muscles), and close childbirth spacing. Factors that facilitate uterine involution include complete expulsion of amniotic membranes and placenta at birth, complication-free labor and birth process, breast-feeding, and early ambulation.

The partner of a woman who has given birth to a healthy newborn says to the nurse, "I want to be involved, but I'm not sure that I'm able to care for such a little baby." The nurse interprets this as indicating which stage? A) Expectations B) Reality C) Transition to mastery D) Taking-hold

B) Reality The partner's statement reflects stage 2 (reality), which occurs when fathers or partners realize that their expectations in stage 1 are not realistic. Their feelings change from elation to sadness, ambivalence, jealousy, and frustration. Many wish to be more involved in the newborn's care and yet do not feel prepared to do so. New fathers or partners pass through stage 1 (expectations) with preconceptions about what home life will be like with a newborn. Many men may be unaware of the dramatic changes that can occur when this newborn comes home to live with them. In stage 3 (transition to mastery), the father or partner makes a conscious decision to take control and be at the center of his newborn's life regardless of his preparedness. Taking-hold is a stage of maternal adaptation.

After teaching a postpartum woman about breast-feeding, the nurse determines that the teaching was successful when the woman makes which statement? A. "I should notice a decrease in abdominal cramping during breast-feeding." B. "I should wash my hands before starting to breast-feed." C. "The baby can be awake or sleepy when I start to feed him." D. "The baby's mouth will open up once I put him to my breast."

B. "I should wash my hands before starting to breast-feed." To promote successful breast-feeding, the mother should wash her hands before breast feeding, and make sure that the baby is awake and alert and showing hunger signs. In addition, the mother should lightly tickle the infant's upper lip with her nipple to stimulate the infant to open the mouth wide and then bring the infant rapidly to the breast with a wide-open mouth. The mother also needs to know that her afterpains will increase during breast-feeding.

The nurse is providing an in-service education program to a group of home health care nurses who provide care to postpartum women. After teaching the group about the process of involution, the nurse determines that additional teaching is needed when the group identifies which process as being involved? A. muscle fiber contraction B. vasodilation C. catabolism D. epithelial regeneration

B. vasodilation

A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 66 beats per minute. Which of these actions should the nurse take? A. Obtain an order for a CBC, as it suggests postpartum anemia. B. Document the finding, as it is a normal finding at this time. C. Contact the primary care provider, as it indicates early DIC. D. Contact the primary care provider, as it is a first sign of postpartum eclampsia.

B. Document the finding, as it is a normal finding at this time.

After teaching a group of nurses during in-service program about risk factors associated with postpartum hemorrhage, the nurse determines that the teaching was successful when the group identifies which risk factors? Select all that apply. A. prolonged labor B. labor augmentation C. hydramnios D. null parity E. placenta previa

B. labor augmentation C. hydramnios E. placenta previa

A primipara client who is bottle feeding her baby begins to experience breast engorgement on her third postpartum day. Which instruction would be most appropriate to aid in relieving her discomfort? A."Express some milk from your breasts every so often to relieve the distention." B."Apply ice packs to your breasts to reduce the amount of milk being produced." C."Take several warm showers daily to stimulate the milk let-down reflex." D."Remove your bra to relieve the pressure on your sensitive nipples and breasts."

B."Apply ice packs to your breasts to reduce the amount of milk being produced."

A client with a 28-day cycle reports that she ovulated on May 10. When would the nurse expect the client's next menses to begin? A.May 30 B.May 24 C.May 26 D.June 1

B.May 24

A nurse is reviewing the medical record of a postpartum client. The nurse identifies that the woman is at risk for a postpartum infection based on which information? Select all that apply. A. rupture of membranes for 16 hours B.history of diabetes C.labor of 12 hours D.placenta requiring manual extraction E.hemoglobin level 10 mg/dL

B.history of diabetes D.placenta requiring manual extraction E.hemoglobin level 10 mg/dL

When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to be: - A.greater than after a vaginal delivery. B.less than after a vaginal delivery. C.saturated with clots and mucus. D.about the same as after a vaginal delivery.

B.less than after a vaginal delivery.

When palpating the fundus during a contraction, the nurse notes that it feels like a chin. The nurse interprets this finding as indicating which type of contraction? A) Intense B) Strong C) Moderate D) Mild

C) Moderate A contraction that feels like the chin typically represents a moderate contraction. A contraction described as feeling like the tip of the nose indicates a mild contraction. A strong contraction feels like the forehead.

A client with a 28-day cycle reports that she ovulated on May 10. When would the nurse expect the client's next menses to begin? A. June 1 B. May 30 C. May 24 D. May 26

C. May 24

A nurse teaches a postpartum woman about her risk for thromboembolism. The nurse determines that additional teaching is required when the woman identifies which as a factor that increases her risk? A. immobility B. vessel damage C. increase in red blood cell production D. increase in clotting factors

C. increase in red blood cell production

After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first: A. sign of breast development. B. full hormonal cycle. C. menstrual period. D. sexual experience.

C. menstrual period.

The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first? A. ejaculation B. sperm emission C. penile vasodilation D. psychological release

C. penile vasodilation

A nurse is assessing a postpartum woman. Which finding would lead the nurse to suspect that a postpartum woman is having a problem? A. elevated white blood cell count B. slightly increased hematocrit C. increased levels of clotting factors D. pulse rate of 110 beats/minute

D. pulse rate of 110 beats/minute

When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle? A. ischemic B. menstrual C. proliferative D. secretory

C. proliferative Estrogen levels are the highest during the proliferative phase of the endometrial cycle, when the endometrial glands enlarge in response to increasing amounts of estrogen. Progesterone is the predominant hormone of the secretory phase. Levels of estrogen and progesterone drop sharply during the ischemic phase and fall during the menstrual phase.

A father of a newborn tells the nurse, "I may not know everything about being a dad, but I'm going to do the best I can for my son." The nurse interprets this as indicating the father is in which stage of adaptation? A. taking-in B. expectations C. transition to mastery D. reality

C. transition to mastery

A nurse is assisting with the delivery of a newborn. The fetal head has just emerged. Which action would be performed next? A. clamping of the umbilical cord B. drying of the newborn C. checking for the cord around the neck D. suctioning of the mouth and nose

C. checking for the cord around the neck

A nurse is developing a teaching plan for a postpartum woman who is breast-feeding about sexuality and contraception. Which information would the nurse most likely include? Select all that apply A. use of combined hormonal contraceptives for the first three weeks B. resumption of sexual intercourse about two weeks after delivery C. possibility of increased breast sensitivity during sexual activity D. use of a water-based lubricant to ease vaginal discomfort E. possible experience of fluctuations in sexual interest

C. possibility of increased breast sensitivity during sexual activity D. use of a water-based lubricant to ease vaginal discomfort E. possible experience of fluctuations in sexual interest

A postpartum woman who is breast-feeding tells the nurse that she is experiencing nipple pain. After teaching the woman about possible suggestions, the nurse determines that more teaching is needed when the woman makes which statement? A. "I apply expressed breast milk to my nipples." B."I apply glycerin-based gel to my nipples." C."I use of a mild analgesic about 1 hour before breast-feeding." D."My baby latches on."

C."I use of a mild analgesic about 1 hour before breast-feeding."

A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs). What information would the nurse need to stress to the group? Select all that apply. a.ECs induce an abortion-like reaction. B. ECs provide some protection against STIs. C.ECs are birth control pills in higher, more frequent doses. D.ECs provide little protection for future pregnancies. E.ECs are not to be used in place of regular birth control.

C.ECs are birth control pills in higher, more frequent doses. D.ECs provide little protection for future pregnancies. E.ECs are not to be used in place of regular birth control.

A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client's fundus. Which finding would the nurse identify as expected? A.four fingerbreadths below the umbilicus B.two fingerbreadths above the umbilicus C.at the level of the umbilicus D.two fingerbreadths below the umbilicus

C.at the level of the umbilicus

When the nurse is assessing a postpartum client approximately 6 hours after delivery, which finding would warrant further investigation? A.profuse sweating B.voiding of 350 cc C.blood pressure 90/50 mm Hg D.deep red, fleshy-smelling lochia

C.blood pressure 90/50 mm Hg

The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only by prescription? A.basal body temperature B.condom C.diaphragm D.spermicide

C.diaphragm

A nurse is reviewing the policies of a facility related to bonding and attachment with newborns. Which practice would the nurse identify as needing to be changed? A.allowing unlimited visiting hours on maternity units B.promoting rooming-in C.offering round-the-clock nursery care for all infants D.encouraging infant contact immediately after birth

C.offering round-the-clock nursery care for all infants

A nurse is working as part of a committee to establish policies to promote bonding and attachment. Which practice would be least effective in achieving this goal? A.allowing unlimited visiting hours on maternity units B.promoting rooming-in C.offering round-the-clock nursery care for all infants D.encouraging infant contact immediately after birth

C.offering round-the-clock nursery care for all infants

Which action would the nurse emphasize when teaching postmenopausal women about ways to reduce the risk of osteoporosis? A.taking vitamin A B.swimming daily C.taking calcium supplements D.using hormone replacements

C.taking calcium supplements

A nurse is conducting a class for pregnant women who are in their third trimester. The nurse is reviewing information about the emotional changes that occur in the postpartum period, including postpartum blues and postpartum depression. After reviewing information about postpartum blues, the group demonstrates understanding when they make which statement about this condition? A. "Postpartum blues is a long-term emotional disturbance." B. "The mother loses contact with reality." C. "Extended psychotherapy is needed for treatment." D. "Getting some outside help for housework can lessen feelings of being overwhelmed."

D. "Getting some outside help for housework can lessen feelings of being overwhelmed."

A postpartum client who is bottle feeding her newborn asks, "When should my period return?" Which response by the nurse would be most appropriate? A. "You won't have to worry about it returning for at least 3 months." B. "It's difficult to say, but it will probably return in about 2 to 3 weeks." C. "You don't have to worry about that now. It'll be quite a while." D. "It varies, but you can estimate it returning in about 7 to 9 weeks."

D. "It varies, but you can estimate it returning in about 7 to 9 weeks."

A nurse is providing care to a postpartum woman. The nurse determines that the client is in the taking-in phase based on which finding? A. Client confidently cares for the newborn. B. Client performs self-care independently. C. Client shows interest in caring for the newborn. D. Client states, "He has my eyes and nose."

D. Client states, "He has my eyes and nose."

The nurse notes persistent early decelerations on the fetal monitoring strip. Which action would the nurse do next? A. Stay with the client while reporting the finding to the primary care provider. B. Perform a vaginal exam to assess cervical dilation and effacement. C. Administer oxygen after turning the client on her left side. D. Continue to monitor the FHR because this pattern is benign

D. Continue to monitor the FHR because this pattern is benign

When applying the ultrasound transducers for continuous external electronic fetal monitoring, at which location would the nurse place the transducer to record the FHR? A. between the xiphoid process and umbilicus B. above the umbilicus toward the right side of the diaphragm C. over the uterine fundus where contractions are most intense D. between the umbilicus and the symphysis pubis

D. between the umbilicus and the symphysis pubis

A nurse is describing the different types of regional analgesia and anesthesia for labor to a group of pregnant women. Which statement by the group indicates that the teaching was successful? A."Local infiltration using lidocaine is an appropriate method for controlling contraction pain." B."Higher anesthetic doses are needed for patient-controlled epidural analgesia." C."A pudendal nerve block is highly effective for pain relief in the first stage of labor." D."We can get up and walk around after receiving combined spinal-epidural analgesia."

D."We can get up and walk around after receiving combined spinal-epidural analgesia."

The nurse administers Rho(D) immune globulin to an Rh-negative client after delivery of an Rh-positive newborn based on the understanding that this drug will prevent her from: A. developing AB antigens in her blood. B.becoming pregnant with an Rh-positive fetus. C.becoming Rh positive. D.developing Rh sensitivity.

D.developing Rh sensitivity.

The nurse is developing a teaching plan for a client who has decided to bottle feed her newborn. Which information would the nurse include in the teaching plan to facilitate suppression of lactation? A.encouraging the woman to manually express milk B.telling her to limit the amount of fluids that she drinks C.suggesting that she take frequent warm showers to soothe her breasts D.instructing her to apply ice packs to both breasts every other hour

D.instructing her to apply ice packs to both breasts every other hour If the woman is not breast-feeding, relief measures for engorgement include wearing a tight supportive bra 24 hours daily, applying ice to her breasts for approximately 15 to 20 minutes every other hour, and not stimulating her breasts by squeezing or manually expressing milk. Warm showers enhance the let-down reflex and would be appropriate if the woman was breast-feeding. Limiting fluid intake is inappropriate. Fluid intake is important for all postpartum women, regardless of the feeding method chosen.

A postpartum woman is having difficulty voiding for the first time after giving birth. Which action would be least effective in helping to stimulate voiding? A. having her hear the sound of water running nearby B.standing her in the shower with the warm water on C.pouring warm water over her perineal area D.placing her hand in a basin of cool water

D.placing her hand in a basin of cool water

When reviewing the medical record of a postpartum client, the nurse notes that the client has experienced a third-degree laceration. The nurse understands that the laceration extends to which area? A.through the anterior rectal wall B.superficial structures above the muscle C.through the perineal muscles D.through the anal sphincter muscle

D.through the anal sphincter muscle

As part of an education program for a group of pregnant women, the nurse teaches them about the changes that occur in the respiratory system during the postpartum period. The women demonstrate understanding of the information when they identify which occurrence as a postpartum adaptation?

Relief of rib aching