Quiz 2 OB

A man is heterozygous for cystic fibrosis (an autosomal recessive disorder). His partner, however, is homozygous for the healthy gene, meaning she is not a carrier. What are the odds that their child will have the disease cystic fibrosis?

0%

The nurse is providing care to a client in labor. On examination, the nurse determines the fetus is at -1 station. The nurse interprets this as indicating that the fetus is:

1 cm above the ischial spines.

A nurse is caring for a client who has just received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. How does the nurse classify the laceration?

4th degree

The new mother has decided to feed her infant formula. When teaching her about the different types of formula, the nurse should stress the infant should receive how many calories each day?

650

The nurse is caring for a client in active labor who has had a fetal blood sampling to check for fetal hypoxia. The nurse determines that the fetus has acidosis when the pH is:

7.15 or less.

Following the birth, the nurse is responsible for assessing the cord pH. The nurse recognizes that which value would be considered a normal pH?

7.2

A woman at 15 weeks' gestation asks the nurse what the fetus currently looks like at this stage of the pregnancy. Which response by the nurse would be most accurate?

Fingernails are present.

A client in labor with epidural analgesia is fully dilated and preparing to push. The nurse palpates a smooth, firm, oval bulge in the suprapubic area. What action should the nurse take first?

Have the client attempt to void.

A postpartum woman with an episiotomy asks the nurse about perineal care. Which recommendation would the nurse give?

Wash her perineum with her daily shower.

A family is making a decision about amniocentesis during pregnancy. What question(s) will the nurse ask to ensure they have made an informed choice? Select all that apply.

What support and advice do you have to make this choice? Which benefits and risks matter most to you? Are there any other questions that you have in order to make this decision?

The client is experiencing increased labor pain due to a fetal occiput posterior position. What nonpharmacologic intervention will be most helpful for the nurse to offer?

hot pack to the lower back

The nurse is explaining the process of conception and implantation to a group of women attending a preconception planning education program. When describing the hormones involved in these events, the nurse would identify which hormone as being responsible for ensuring implantation of the embryo at the beginning of conception?

human chorionic gonadotropin (hCG)

Which finding(s) indicates that the client has begun the perineal phase of labor? Select all that apply.

increase in bloody show a strong urge to push expresses more control and less agitation cardiac output increased by 50%

A nurse working on the postpartum floor is mentoring a new graduate and instructs the new nurse to make sure that clients empty their bladders. A full bladder can lead to which complication?

increased loch drainage

A nurse sees a pregnant client at the clinic. The client is close to her due date. During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility?

increased risk of infection

A nurse is preparing a presentation for a group of nurses about genetic discoveries and advances. When discussing this topic, the nurse would most likely include which topic area related to the potential for misuse?

individual risk profiling and confidentiality

When genetics and genomics were incorporated into nursing, the decision was made to include them in what part of the nursing process?

interventions that support identification of the genetics-related health needs of people

A woman in labor who is receiving an opioid for pain relief is to receive promethazine. The nurse determines that this drug is effective when the woman demonstrates which finding?

less anxiety

The nurse is performing a routine assessment of the client after birth. Inspection of a woman's perineal pad reveals a 3-in (7.5-cm) lochia stain. This amount should be documented as which type?

light

A nurse is required to obtain the fetal heart rate (FHR) for a pregnant client. If the presentation is cephalic, which maternal site should the nurse monitor to hear the FHR clearly?

lower quadrant of the maternal abdomen

A nurse is caring for a client who is in the first stage of labor. The client is experiencing extreme pain due to the labor. The nurse understands that which factors are causing the extreme pain in the client? Select all that apply.

lower uterine segment distention stretching and tearing of structures dilation (dilatation) of the cervix

Which question would be most important for a nurse to ask a G2P1 client who has a child with sickle cell anemia?

"Did you and your partner get genetic testing?"

A client at a preconception screening appointment indicates to the nurse that she is a carrier of muscular dystrophy, an X-linked recessive trait. Her partner does not have the trait. Which statement made by the client indicates an understanding of the implications?

"Each time I have a child, there is a 25% chance a female child will be a carrier."

A client is scheduled for a cesarean section under spinal anesthesia. After instruction is given by the anesthesiologist, the nurse determines the client has understood the instructions when the client states:

"I may end up with a severe headache from the spinal anesthesia."

A pregnant client is admitted to the labor and birth unit in the first stage of labor. A nurse reviews a pregnant client's birth plan. Which response from the client would indicate to the nurse that further teaching is indicated?

"I will remain in my bed for my labor and birth like last time."

A nurse is conducting a class for nursing students on genetic inheritance and is focusing specifically on X-linked recessive disorders. Which statement by a nursing student would indicate appropriate learning has occurred?

"If the female is the carrier, the daughter can be too."

A pregnant client is scheduled for a nuchal translucency scan. Which statement by the client demonstrates understanding of the nurse's teaching about this procedure?

"If this scan is positive, we will need further testing to confirm a diagnosis."

The nurse has completed an education program on genetic counseling. Which statement by a participant suggests a need for further education?

"My husband is 45 years old; I guess we need to see a genetic counselor before we try to get pregnant."

A nursing instructor teaching students how to check the client's uterus postpartum realizes that further instruction is needed when one of the students says:

"One to two hours after birth the fundus is typically at the level of the umbilicus."

The nurse takes a health history from the parents under the suspicion that their infant may have a genetic disorder. Which statement(s) by the mother is associated with risk factors of genetic disorders? Select all that apply.

"Our obstetrician told us that I was not making enough amniotic fluid during this pregnancy." "The father is 55 years old." "My sister's baby was born with trisomy 18."

A client who is 15 weeks' gestation is attending prenatal classes and asks the nurse, "What changes in development has my baby made?" Which statement(s) would the nurse include in the response? Select all that apply.

"Soft hair covers your baby's head." "Your baby makes sucking motions now with its mouth." "You will be able to detect quickening."

The nurse is admitting a primigravida client who has just presented to the unit in early labor. Which response should the nurse prioritize to assist the client in remaining calm and cooperative during birth?

"The baby is coming. I'll explain what's happening and guide you."

The nurse is monitoring the client's vital signs and notes: 100.2oF (37.9oC), heart rate 82, respiratory rate 17, and blood pressure 124/78. The client has recently had an epidural. What is the best response when the client's partner asks if she is getting sick?

"The fever may be due to the epidural."

A pregnant client is undergoing an amniocentesis in her third trimester and is worried why she is undergoing this procedure. Which statement by the nurse would best alleviate this client's anxieties?

"We want to be sure your baby's lungs are mature and this measures the development of the baby's lungs.

A nurse is obtaining the genetic history of a pregnant client by eliciting historical information about her family members. Which question is most appropriate for the nurse to ask?

"What was the cause and age of death for deceased family members?"

A woman who has been in labor for a few hours is now complaining of being hungry. Which response by the nurse would be best if the client asks for some food to eat?

"You could have some hard candy to suck on."

When teaching possible differences in labor between the first labor experience and all other labors, which statement is most beneficial to assist a woman's psyche?

"You had a successful labor and vaginal delivery with your first pregnancy."

A client has been discharged from the hospital after a cesarean birth. Which instruction should the nurse include in the discharge teaching?

"You should be seen by your health care provider if you have blurred vision."

The nurse is assisting the health care provider with the pelvic assessment of a pregnant client. The nurse concludes that the obstetric conjugate will be how long if the distance between the symphysis pubis and sacral promontory is 13 cm?

11 cm

A woman is to undergo quad screening testing. The nurse would anticipate that this test would be done at which time?

16 weeks

Review of a woman's labor and birth record reveals a laceration that extends through the anal sphincter muscle. The nurse identifies this laceration as which type?

3rd degree

The nuse is checking the perineal pad of a client who recently gave birth. Which finding does the nurse describe as "light" or "small" lochia?

4 inch stain on the pad

After completing an assessment, the nurse suspects a woman has confused implantation bleeding with her period. The nurse predicts the woman is at which week in her pregnancy?

4 weeks

A client gave birth to a child 3 hours ago and noticed a triangular-shaped gap in the bones at the back of the head of her newborn. The attending nurse informs the client that it is the posterior fontanel (fontanelle). The client is anxious to know when the posterior fontanel (fontanelle) will close. Which time span is the normal duration for the closure of the posterior fontanel (fontanelle)?

8-12 weeks

A female client is a carrier of the Duchenne muscular dystrophy gene. Her male partner does not have the gene. The couple is planning to conceive and wants to understand the chances of the child acquiring the disease. What information should the nurse give to the couple?

A female child will not be affected by the condition.

Which assessment findings of the fetus during labor are normal? Select all that apply.

Variability between 18-20 bpm Fetal heart baseline of 130 bpm

A nurse is to care for a client during the postpartum period. The client reports pain and discomfort in her breasts. What signs should a nurse look for to find out if the client has engorged breasts? Select all that apply.

Breasts are hard. Breasts are tender.

With which findings would the nurse anticipate a diagnosis of false labor?

Cervical dilation of 1 cm

Which statement is true regarding analgesia versus anesthesia?

Analgesia and anesthesia perform the same function when it comes to blocking pain.

A primigravida has an office appointment at 39 weeks' gestation. Which assessment data is most definitive of the onset of labor?

Cervical ripening is noted on examination.

A client in her third trimester of pregnancy arrives at a health care facility with a report of cramping and low back pain; she also notes that she is urinating more frequently and that her breathing has become easier the past few days. Physical examination conducted by the nurse indicates that the client has edema of the lower extremities, along with an increase in vaginal discharge. What should the nurse do next?

Continue to monitor the client.

The nurse is caring for a client who is a gravida 2 para 1 and had a previous cesarean section. The client has had no complications with the pregnancy and prefers to have this delivery vaginally. Which monitoring system best assesses for the ability to delivery vaginally?

Continuous internal monitoring of uterine contractions

The nursing instructor is presenting a session on the cellular division involved in the reproduction of human life. Which statement indicates the group's need for further education?

At ovulation, the gametes unite to form the cell that becomes the developing fetus.

At which point along the birth canal must the fetal head extend for successful passage?

At the level of the symphysis pubis

The nurse is teaching a class to a group of pregnant women in their second trimester. Which information about the effects of maternal position on labor will the nurse include?

Being upright promotes a sense of control for the mother.

The nursing instructor is conducting a class discussion on the various agents used during labor and delivery to assist the client. The instructor determines the class is successful after the students correctly choose which factor as true about the use of systemic analgesia?

Benzodiazepines enhance pain relief attained with opioids and cause sedation.

A woman, who is 18 weeks' gestation, is at a follow-up appointment regarding the test results of alpha-fetoprotein testing. Which would the nurse suspect with if the woman has low levels of alpha-fetoprotein?

Down syndrome

A postpartum client is having difficulty stopping their urine stream. Which should the nurse do next?

Educate the client on how to perform pelvic floor muscle (Kegel) exercises.

A nurse is providing education to pregnant clients in birth education classes. Which nursing interventions would the nurse include to promote positive learning? Select all that apply.

Encourage the clients to remain positive about the pregnancy. Provide information about all procedures in the birthing process.

When counseling potential parents about genetic disorders, which statement would be appropriate?

Environmental influences may affect multifactorial inheritance.

A pregnant client is diagnosed with hydramnios. The nurse explains that further testing will be done to determine if which conditions are present? Select all that apply.

Esophageal atresia Anencephaly

The nurse is performing Leopold maneuvers as part of the initial assessment. Which action would the nurse do first?

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

A nurse is meeting with a client to develop the nursing care plan for her delivery to include the use of an injectable pain medication. When comparing the various options for the client, which advantage of using an intrathecal anesthesia over an epidural anesthesia should the nurse point out?

Intrathecal anesthesia is a simpler technique providing quicker pain relief than epidural anesthesia.

The nursing student correctly identifies what information about oogenesis?

It begins in the ovaries before birth but is not fully complete until the childbearing years.

There are advantages and disadvantages to any kind of method used to control pain during labor and birth. What is an advantage of opioid administration?

It can be administered by the nurse.

A nurse is describing the development of the fetus to a group of pregnant women. When describing the function of the placenta, which information would the nurse most likely include? Select all that apply.

It supplies oxygen and nutrients to the fetus. It produces hormones that help maintain the pregnancy. It carries waste away for excretion by the mother.

A nurse is providing care to a postpartum woman and is completing the assessment. Which finding would indicate to the nurse that a postpartum woman is experiencing bladder distention?

Percussion reveals dullness.

A nurse is developing a plan of care for a woman who has had a spontaneous vaginal delivery of a healthy newborn. The nurse determines the need for close monitoring for postpartum hemorrhage based on which information? Select all that apply.

Labor of 1 1/2 hours Labor induction with oxytocin Forceps birth

During a prepared childbirth class, the nursing is discussing the differences between true and false labor. Which responses by a client indicate an understanding of false labor? Select all that apply.

Maintaining hydration by drinking water will lessen false labor pains. The intensity of contractions is inconsistent in false labor.

The pregnant client is planning to hire a doula for support during labor. What statement by the client requires follow-up by the nurse?

My doula will help me with contractions so I will not need any pain relief in labor.

Which nursing suggestions are options for the client experiencing intense pain in the activephase of labor? Select all that apply.

Patterned breathing Hypnosis Pain medication Massage Acupressure

A woman gave birth yesterday to a child with a cleft palate. The newborn is in the special care nursery, and the mother has seen the newborn only at birth. Which intervention would be the priority?

Provide time for the mother to grieve for the loss of the imagined baby.

The nurse is discussing options to provide relief of labor pain when the client states, "Why can't the health care provider provide a sedative during labor?" Which disadvantages are common with providing a sedative as pain management? Select all that apply.

Sedatives will not provide pain relief. The sedation effect can cross to the fetus. Sedatives are only used in early labor

Which information would the nurse emphasize in the teaching plan for a postpartum woman who is reluctant to begin taking warm sitz baths?

Sitz baths increase the blood supply to the perineal area.

The nurse is caring for four clients in labor. Which client would the nurse anticipate having continuous internal electronic fetal monitoring?

The client who is very restless and is moving around in the bed

A client is having an induction of labor with oxytocin (above). The nurse is having difficulty monitoring the fetal heart rate and requests that the health care provider apply a fetal scalp electrode. What will be needed for this procedure for this client?

The client will need an amniotomy before a scalp electrode may be applied.

The nurse is preparing to perform a straight catheterization on a client in labor. What assessment data support this nursing action?

The fetal head is not descending as expected.

The nurse is caring for a client at 39 weeks' gestation who is noted to be at 0 station. The nurse is correct to document which?

The fetus is in the true pelvis and engaged.

While conducting a class for a group of pregnant women in their first trimester, one of the woman asks, "How is my baby's sex determined?" Which factors should the nurse include in the response? Select all that apply.

The male gamete is responsible for sex determination. The Y chromosome contains the genes for maleness.

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?

The one umbilical vein carries oxygen-rich blood to the fetus from the placenta.

The nurse is caring for four clients within the labor and delivery unit. Which client does the nurse anticipate will be sent home?

The primigravida who has a thinning cervix and a dilation of 3 cm

A nurse is caring for a 37-year-old pregnant client who is expecting twin boys. The client smoked prior to conception but has stopped during the pregnancy. A relative of the client has Klinefelter syndrome, and the client wants to find out more about the disorder. Which information will the nurse provide to the client during genetic counseling?

There is a greater risk of Klinefelter syndrome due to the client's age.

The client in labor has patient-controlled epidural anesthesia (PCEA). What will the nurse include in the teaching about this method of pain relief? Select all that apply.

There is a lockout period between PCEA bolus doses given. You must be in bed to receive the PCEA bolus doses.

What purpose does amniotic fluid serve in fetal development? Select all that apply.

To allow the fetus to move about in-utero Reservoir for fetal urine and respiratory tract secretions

During a postbirth home visit, the nurse asks the client to complete the Edinburgh Depression Scale. What information will the nurse learn from this scale? Select all that apply.

To identify client at risk for perinatal depressions To identify clients at risk for suicide

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?

To prevent supine hypotension syndrome

A woman is in the second stage of labor and is crowning. Which diameter of the fetal skull—the smallest diameter—should align with the anteroposterior diameter of the mother's pelvis (which is the narrowest diameter at the pelvic inlet)?

Transverse (biparietal)

A mother has come to the clinic with her 13-year-old daughter to find out why she has not started her menses. After a thorough examination and history, genetic testing is prescribed to rule out which abnormality?

Turner syndrome

A postpartum woman has been unable to urinate since giving birth. When the nurse is assessing the woman, which finding would indicate that this client is experiencing bladder distention?

Uterus is boggy.

The nursing instructor has finished leading a general discussion with a group of nursing students exploring the labor and birthing process. The instructor determines the session is successful when the students correctly state which goal should be a priority?

Work with the labor client to plan pain management options.

Which postpartum client will the nurse assess first?

a 35-year-old who had estimated blood loss of 700 ml and has a supine BP of 130/80 mm Hg and BP of 100/65 mm Hg when head of the bed is elevated

A nurse is assessing a client during the postpartum period. Which findings indicate normal postpartum adjustment? Select all that apply.

active bowel sounds passing gas nondistended abdomen

A client who is 12 hours postbirth is reporting perineal pain. After the assessment reveals no signs of an infection, which measure could the nurse offer the client?

an ice pack applied to the perineum

A woman with sickle cell anemia has just found out that she is 6 weeks' pregnant. The woman is being scheduled for chorionic villus testing to determine her child's risk for sickle cell anemia. The nurse would inform the woman that the earliest time she may undergo this test would be at which week of gestation?

at 10 weeks

A couple desires to undergo genetic testing for Huntington disease. The nurse recognizes that this is which type of genetic disorder?

autosomal dominant inherited disorder

After learning that her fetus is in the LST position, the client asks the nurse what this means. Which structure will the nurse point out is presenting first?

buttocks

A client has moved into the active phase of labor and is now at 6 cm dilated and +1 station. The nurse is prepared to monitor the contraction pattern how often?

every 30 minutes

A 28-year-old primigravida client presents to the unit in early labor. The record reveals the client is 5 ft (1.5 m) tall, 95 lb (43 kg), and has gained 25 lb (11.3 kg) over a normal, uneventful pregnancy. The nurse predicts this client will have which type of pelvis upon assessment?

cannot be determined

After a teaching an in-service presentation on genes and genetics, the nurse determines that additional teaching is needed when the group identifies which component as a source of gene mutation?

chemical

Assessment of a pregnant woman in labor reveals that the fetal attitude is normal. The nurse interprets this as indicating which information? Select all that apply.

chin is on the chest legs are flexed at the knees

A 40-year-old client is in her 10th week of pregnancy. So far, her pregnancy appears to be healthy, with no abnormal results from standard diagnostic tests. Because of her age, however, the nurse would anticipate that the client is a candidate for which diagnostic tests? Select all that apply.

chorionic villus sampling amniocentesis cell-free DNA testing

Patterned breathing techniques used in labor provide which benefits? Select all that apply.

conscious relaxation distraction pain relief without special tools

A parent who just gave birth has difficulty sleeping despite exhaustion from labor. What is a potential cause(s) of this inability to rest? Select all that apply.

crying newborn inadequate pain relief frequent trips to the bathroom due to diuresis excess fatigue and overstimulation by visitors

The student nurse is learning about normal labor. The teacher reviews the cardinal movements of labor and determines the instruction has been effective when the student correctly states the order of the cardinal movements as follows:

descent, flexion, internal rotation, extension, external rotation, expulsion

Some chromosomal abnormalities of number often result because of the failure of the chromosome pair to correctly separate during cell division. One type is referred to as polyploidy. The nurse recognizes that this type usually results in:

early spontaneous abortion (miscarriage).

The nurse completes an initial assessment for a newborn (above). The parents declined prenatal genetic screening. What does the nurse anticipate in the health care provider's prescription for this newborn? Select all that apply.

echocardiogram chromosomal analysis

When teaching a group of nursing students about the stages of labor, the nurse explains that softening, thinning, and shortening of the cervical canal occur during the first stage of labor. Which term is the nurse referring to in the explanation?

effacement

A client is ready to push. The nurse instructs her to push vigorously and grunt and breathe out during a pushing effort. What would be important to monitor on the client while she is pushing vigorously?

fatigue

A nurse performs an initial assessment of a laboring woman and reports the following findings to the primary care provider: fetal heart rate is 152 bpm, cervix is 100% effaced and 5 cm dilated, membranes are intact, and presenting part is well applied to the cervix and at -1 station. The nurse recognizes that the client is in which stage of labor?

first, active

Which cardinal movement allows the fetus to travel through the birth canal most efficiently?

flexion

A pregnant client with a history of spinal injury is being prepared for a cesarean birth. Which method of anesthesia is to be administered to the client?

general anesthesia

The skull is the most important factor in relation to the labor and birth processes. The fetal skull must be small enough to travel through the bony pelvis. What feature of the fetal skull helps to make this passage possible?

molding

A 47-year-old woman with osteoarthritis and hypertension is diagnosed with breast cancer. She tells the nurse that her mother also suffered from osteoarthritis and hypertension and she developed breast cancer at the age of 51 years. The nurse explains that this could be a result of:

multifactorial inheritance.

A nurse is conducting a presentation for a group of pregnant women about labor and the importance of being well prepared and having good labor support. The nurse determines that additional discussion is needed when the group identifies which possible outcome as the result of being prepared?

need for someone to control the situation

A client has just given birth to a healthy term newborn. Upon assessing the umbilical cord, the nurse identifies what finding(s) as normal? Select all that apply.

one vein two arteries (AVA)

A female client has the Huntington's disease gene. She and her husband want to have a child but are apprehensive about possibly transmitting the disease to their newborn child. They have strong views against abortion (elective termination of pregnancy). They would also like to have their "own" child and would consider adopting only as a last resort. Which action would bemost appropriate in this situation?

opting for a preimplantation genetic diagnosis

The term that describes the percentage of individuals known to carry the gene for a trait and who actually manifest the condition is:

penetrance

The nurse has been asked to conduct a class to client who have recently given birth on ways to avoid developing stress incontinence. Which action(s) will the nurse include in the discussion as possible strategies for these clients? Select all that apply.

performing pelvic floor muscle (Kegel) exercises avoiding smoking losing weight if your BMI >30

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?

placenta

A nurse is conducting a class for a group of women who are planning on becoming pregnant. As part of the class, the nurse describes how teratogens can affect a pregnancy. The nurse determines that the teaching was successful when the class identifies which effects that may result with the use of cocaine? Select all that apply.

placental abruption (abruptio placentae) premature birth microcephaly

When educating a group of nursing students about the different types of pelves, the nurse describes one type as being flat, having a wider transverse diameter than anterior-posterior diameter, with ischial spines that are wide apart, and a short sacrum. The students are correct when they identify this description with which type?

platypelloid

When assessing a newborn identified genetically as 47XY21+, what can the nurse expect to note on the assessment findings? Select all that apply.

poor muscle tone palmar crease protruding tongue

While discussing labor with a client and her partner, the nurse is asked what the best position is for giving birth to the baby. The nurse provides them with information that indicates research has shown which position as the best?

position of comfort for the mother

The nurse is conducting a health history for an infant with a presumed genetic disorder. On which family members will the nurse gather information? Select all that apply.

siblings parents grandparents

The nurse is reviewing the medical record of a postpartum client. The nurse determines that the client is at risk for thromboembolism based on which factors from her history? Select all that apply.

previous oral contraceptive use preeclampsia severe vericose veins

A nursing student learns that a certain condition occurring in up to 3 in every 1,000 births is a major cause of death. What is this condition?

pulmonary embolism

When an infant smiles at the mother and the mother in turn smiles and kisses her baby, this would be which phase of attachment?

reciprocity

The assessment of a pregnant client who is toward the end of her third trimester reveals that she has increased prostaglandin levels. For which factors should the nurse assess the client? Select all that apply.

reduction in cervical resistance myometrial contractions softening and thinning of the cervix

Fentanyl has been administered to a client in labor. What assessment should the nurse prioritize?

respiratory status

When teaching a group of nursing students about the different types of pelvis, the nurse describes which features of a gynecoid pelvis? Select all that apply.

round-shaped inlet dull ischial spines wide pubic arch

The nurse is working triage in the emergency department. The nurse realizes the client is in true labor when she states that the she is experiencing:

ruptured membranes

The nurse is monitoring a pregnant client and notes: contractions causing urge to push, strong intensity, cervix 10 cm, 100% effaced, fetal head crowns when client pushes. The nurse determines the client is currently in which stage or phase of labor?

second

A pregnant client requires administration of an epidural block for management of pain during labor. For which conditions should the nurse check the client before administering the epidural block? Select all that apply.

spinal abnormality hypovolemia coagulation defects

During the admission assessment, the nurse notes many café-au-lait spots on the client's trunk, back, neck, and legs and suspects that she has neurofibromatosis. The client's chart confirms that she has neurofibromatosis type 1. Based on the nurse's knowledge of neurofibromatosis, the nurse understands that a single family member has a:

spontaneous mutation.

An episiotomy or a cesarean incision requires assessment. Which assessment criterion for skin integrity is not initially noted?

temperature

On examination, the nurse determines the client is at 50% effacement. This means:

the cervical canal is 1 cm long.

A pregnant client asks the nurse how the fetus breathes if it is floating in the amniotic fluid. The best explanation by the nurse is:

the fetus receives oxygen through the umbilical vein.

Genetic testing has revealed that a couple's unborn child shows the possibility of mosaicism. When counseling this couple, the nurse explains this means that:

the genetic abnormality occurred after fertilization and during the mitotic cell division.

A woman's perception of pain can differ according to all of the following except:

the presentation, lie, and attitude of the fetus.

A client in the third stage of labor has experienced placental separation and expulsion. Why is it necessary for a nurse to massage the woman's uterus briefly until it is firm?

to constrict the uterine blood vessels

A nurse is discussing the advantages and disadvantages of intermittent and continuous fetal heart rate monitoring with a colleague. What would the nurse cite as being able to be detected when using continuous monitoring but not intermittent monitoring? Select all that apply.

types of decelerations variability

A nurse is reviewing the medical record of a postpartum woman in preparation for assessment. Which factor would the nurse identify as increasing the woman's risk for infection? Select all that apply.

urinary stasis denuded endometrial arteries episiotomy

Which actions would protect a fetus from exposure to environmental teratogens?

use gloves when handling chemicals

The nurse is assessing a young couple who desire to start a family and are questioning the nurse concerning various cautions to keep in mind. Which time period should the nurse point out that teratogenics pose the greatest risk and should be avoided?

weeks 3 to 8