Week 3 Practice Questions

Which patient statement would signal a contraindication for a transcervical chorionic villus sampling (CVS) procedure?

"I took fluconazole yesterday for a yeast infection." Vaginal infection is a contraindication for transcervical CVS because of increased risk for uterine infection. The patient would require transabdominal CVS instead.

A nurse has provided discharge instructions to a patient who delivered a healthy infant by cesarean delivery. Which statement made by the patient indicates a need for further instructions?

"I will begin abdominal exercises by week 2." Abdominal exercises should not start immediately after abdominal surgery; the patient should wait until the 6-week follow-up postoperative appointment to allow for healing of the incision and to get approval from the health care provider.

When scheduling a diagnostic procedure, a patient tells the nurse that she plans to terminate the pregnancy if an abnormality is found. Which response from the nurse is appropriate?

"I will give you printed information on how to schedule pregnancy termination so you know what to do if the test finds an abnormality." This response supports the patient's decision and provides follow-up care to assist the patient.

Which statements by the patient indicate a need for additional teaching regarding the need for contraception postdelivery?

"Because I am breastfeeding, I don't need to worry about contraception." For lactating mothers, ovulation and menses will take longer to occur as a result of decreased estrogen levels; however, ovulation may occur before menses postpartum. "I can wait for my period to resume before using contraception." Ovulation may occur as soon as 3 weeks after delivery and may occur before menses postpartum.

Which statement by the nurse is the most supportive of the mother during the taking-hold phase?

"Because I changed the last diaper, let me talk you through changing this diaper." The nurse would instruct mothers how to perform tasks and then reinforce teaching

Which statement made by a patient having an amniocentesis indicates an understanding of the risks associated with the diagnostic test?

"Because the needle is guided by ultrasound, the risk for injury to the baby is small." Risk for injury to the fetus or umbilical cord is low when ultrasound is used to guide needle insertion.

A patient with a family history of spina bifida reports reluctance to attempt conception without knowing the risk for having an infant with spina bifida. Which response from the nurse is appropriate?

"Development of spina bifida depends on more than just genetic factors." Spina bifida is caused by genetic factors as well as environmental influences, such as inadequate maternal intake of folic acid.

Which question would the antepartum nurse ask patients when determining the need for genetic counseling?

"Do you have any relatives who are developmentally delayed?" Family history of developmental disabilities is an indicator for genetic counseling, as it can indicate a patient at increased risk for fetal abnormalities.

The antepartum nurse is caring for a patient who has a 2-year-old child with Down syndrome. The patient declines genetic counseling for her current pregnancy because she states, "There is nothing I can do about it now." Which education is appropriate for this patient regarding the use of genetic counseling?

"Genetic counseling can help us determine the risk for your second child being born with Down syndrome." Genetic counseling is used to determine the risk for anomalies in subsequent pregnancies after the first child is born.

A woman had an emergency cesarean delivery for a prolapsed cord. Both the mother and infant are stable, and the nurse is caring for the mother and infant couplet. Which statement by the mother indicates she is in the taking-in phase?

"I can't wait for my sister to come with food and take pictures of the baby while I rest." The mother's statement that she can't wait for her sister to bring food and give her a chance to rest reflects the taking-in phase, in which the mother reflects on herself and her recovery needs.

The nurse is caring for a patient who has just received genetic counseling and is visibly distressed. The patient tearfully explains to the nurse that the counselor informed her there was a 50% chance of her child having cystic fibrosis and asks, "What should I do about my pregnancy?" Which response from the nurse is appropriate for this patient?

"I know you're faced with a difficult decision, but I'm here to support the choices you make." Genetic counseling is nondirective. The patient's autonomy should be respected, even when the patient does not know what to do. This response is appropriate because it acknowledges the patient's distress but does not make a decision for the patient.

A postpartum patient verbalizes that she is feeling overwhelmed about going back to work full-time after 6 weeks of maternity leave. Which statement by the nurse would be supportive of the mother and her concerns?

"I know you're overwhelmed, and it's common to feel that way. What kind of support do you have from friends and family?" The nurse is acknowledging the patient's feelings. At the same time, the nurse is assisting the woman in considering alternatives, such as support from friends and family.

A patient whose ultrasound resulted in normal findings expresses relief that the fetus is "completely healthy." Which response from the nurse is appropriate?

"I'm very happy that you feel relieved; however, additional tests may still be indicated to detect other possible abnormalities." Ultrasound cannot detect every structural abnormality, and it cannot detect abnormalities that do not affect the structure of the fetus. This response is appropriate because it addresses the patient's misconception regarding ultrasound testing.

A patient who is 10 weeks pregnant feels uncomfortable having a transvaginal ultrasound and asks the nurse if there is any way she could have a transabdominal ultrasound instead. Which responses from the nurse are appropriate?

"If it makes you feel more comfortable, you can insert the probe yourself." Patients may feel more comfortable inserting the probe themselves for a transvaginal ultrasound. "Because you are in your first trimester, the uterus and embryo are difficult to visualize with a transabdominal ultrasound." The uterus, ovaries, and embryo are deep within the pelvis during the first trimester; therefore transvaginal ultrasound is often used.

Which nursing discharge instructions are appropriate to include when teaching a postpartum woman?

"Increase your fluid intake postpartum." Increased oral (PO) fluid intake should be encouraged because it increases peristalsis, decreases constipation, and aids in milk production. "Do light walking as tolerated for the first 6 weeks." Educate women to do only light walking until 6 weeks postpartum to allow for complete healing.

Which is the best response to a mother who voices concern that she feels so clumsy when she tries to swaddle the infant and will never learn how to do it well?

"It does seem difficult, but let me talk you through the process again." The nurse would provide support and encouragement during this phase.

Which statement would a nurse anticipate from a postpartum mother in the letting-go phase?

"It seems strange not to feel the baby kicking in my uterus." As the mother adjusts to the reality of no longer being pregnant, she would verbalize her feelings about not being pregnant anymore, and the nurse would offer reassurance that these feelings are typical postpartum.

A patient with no family history of genetic abnormalities asks the nurse if there may still be a need for prenatal genetic counseling. Which patient statement indicates that genetic counseling may be necessary?

"My family and I practice a religion that does not allow marriage outside of our religion." Patients who are members of groups that are isolated by geography, religion, or culture are at increased risk for autosomal recessive traits.

Which educational statements are appropriate when preparing a postpartum woman for discharge from a birth center?

"Notify your health care provider if you begin saturating a pad every hour and pass large clots." Lochia may last up to 6 weeks; however, it should lighten in flow and color, so a heavy flow and the presence of large clots should be reported to the health care provider. "Perineal self-care should be performed after voiding or defecating." Perineal self-care should be performed after voiding or having a bowel movement by using a bottle of warm water over the perineum and gently patting dry from front to back. "Apply breast milk to nipples to relieve dryness." Breast milk (or lanolin cream or hydrogels) can be used after feedings to relieve nipple dryness.

Which nursing information is appropriate when teaching a postpartum woman about how to increase perineal muscle tone?

"Perform Kegel exercises 30 times per day." Performing Kegel exercises 30 times per day will increase perineal muscle tone.

Which statement would the nurse include when teaching a new mother about postpartum blues?

"Postpartum blues is common and affects 70% to 80% of new mothers." Postpartum blues affects 70% to 80% of new mothers.

Which educational information related to activity would the nurse provide to a postpartum woman who delivered by cesarean birth?

"Stair-climbing should be limited for the first 2 weeks." Stair-climbing should be limited for the first 2 weeks postpartum to allow healing of the abdominal incision. "Leg muscles should be used to lift rather than the abdominal muscles." The leg muscles should be used for lifting the first few weeks postpartum to allow for healing of the abdominal incision.

Which educational information regarding breast care would the nurse provide for a mother who chooses to bottle-feed her infant?

"Take analgesics as needed for engorgement discomfort." Analgesics will decrease inflammation and pain related to breast engorgement. "Apply ice packs to the breasts for several days." Cold compresses will decrease inflammation and pain related to breast engorgement.

A patient has not felt fetal movement in several days so is scheduled for an ultrasound. Which statement by the nurse helps explain the necessity of the ultrasound?

"The ultrasound will let us see your baby's heartbeat." Absence of fetal movement for several days may indicate multiple adverse events, including fetal death. Ultrasound is used to confirm fetal viability, which is the indication that applies to this patient.

A patient with a 2-year-old child with cystic fibrosis declines genetic counseling during her antepartum visit, stating that the birth defect has "already happened," and therefore her future children will not be affected. Which is the appropriate nursing education for this patient?

"This infant has an equal risk for developing cystic fibrosis as your first child." Having one child with a birth defect does not change the risk for subsequent children developing the same defect. This response clarifies the patient's misconception about genetic factors of cystic fibrosis and is appropriate for the patient.

Which nursing questions are appropriate for a patient 9 days postpartum who feels tired and still has vaginal discharge?

"What color is your lochia?" Lochia is associated with uterine involution and changes in the endometrium, is described according to color and amount, and should be serosa by 9 days postpartum. "Is there an odor to your lochia?" Lochia should not have an offensive odor but should smell like normal menstrual flow. "How often are you changing your peripads?" The volume of lochia should be decreasing 9 days postpartum, so it would be helpful to know how often the woman is changing her peripad to approximate discharge amount.

After a primipara's admission to the labor and delivery suite, the nurse assesses her discharge needs. She will be discharged home 4 days after a cesarean delivery. Which questions would the nurse ask the patient?

"Will you have help when you go home?" To determine the discharge needs of the primipara, it is important for the nurse to know if the patient will be returning home with or without help from a partner or family member. Patients who live alone or do not have access to help after a cesarean delivery may need special accommodations, including a home-care visit from a postpartum nurse. "Are there many stairs in your home?" To determine the discharge needs of the primipara after a cesarean delivery, it is important for the nurse to know if the patient will have to maneuver flights of steps. This patient will need additional education about how much activity is appropriate following a cesarean delivery.

Which response is most appropriate when the parents (both heterozygotes) of a child born with cystic fibrosis ask the probability of future pregnancies resulting in a child inheriting the disease?

25% A child that inherits an autosomal recessive disorder must receive the affected gene from both parents. Using a Punnett square, the probability can be seen to be 25%.

A woman of advanced maternal age undergoes genetic testing during her pregnancy. If the fetus has Down syndrome, how many chromosomes would the test identify?

47 The typical child with Down syndrome has 3 copies of the 21st chromosome, which results in a total of 47 chromosomes found in each cell.

What is the probability of having a child with cystic fibrosis if one parent has the disease and the other is a carrier?

50% The probability is 50% because the affected parent will pass on the gene to all children and the other has a 50% chance of passing on the gene.

Which paternal behaviors demonstrate engrossment?

A father stares at the newborn and comments on how beautiful she is. A father staring at the newborn and commenting on how beautiful she is demonstrates engrossment. Engrossment occurs after birth when fathers display an intense interest in how their infants look and respond. A father requests to hold the newborn immediately after the nurse finishes her assessment. A father requesting to hold the newborn immediately after the nurse finishes her assessment demonstrates engrossment. Engrossment occurs after birth when fathers display an intense interest in how their infants look and respond.

Which situation puts a family at risk for poor adaptation after birth?

A mother who delivered at 32 weeks gestation A mother who delivered at 32 weeks gestation would put the family at risk for poor adaptation to birth. A preterm delivery is an unexpected birth event, and the newborn will need to be placed in the neonatal intensive care unit (NICU).

Which patient may be a carrier for an X-linked recessive trait?

A patient whose son is color-blind Color-blindness is an X-linked recessive trait that is commonly displayed in men. Because this patient's son expresses the recessive gene, this patient may be a carrier for an X-linked recessive trait.

Which patient would benefit from prenatal genetic counseling?

A patient with sickle cell disease (SCD) SCD is an autosomal recessive trait that can severely affect a patient's life. This patient would benefit from genetic counseling at any point in the perinatal care period.

Which postpartum women may require nursing care for ineffective bladder elimination?

A woman with third-degree perineal laceration and significant edema A woman with extensive vaginal or perineal lacerations is at risk for ineffective bladder elimination as a result of an altered voiding reflex. A woman who received epidural anesthesia during labor A woman who received epidural anesthesia is at risk for ineffective bladder elimination as a result of decreased sensation to void and altered voiding reflex. A woman who delivered by cesarean birth and had an indwelling catheter removed A woman who delivered by cesarean birth and had an indwelling catheter removed would be at risk for ineffective bladder elimination.

A postpartum mother informs the nurse that she is disappointed in the gender of her baby. Which nursing intervention would be most appropriate to support adaptation after birth?

Acknowledge the patient's feelings and provide emotional support. Acknowledging the patient's feelings and providing emotional support will support adaptation after birth.

A patient with a family history of developmental disability refuses a recommended amniocentesis without explanation. Which types of patient education are appropriate?

Affirm that the patient has the right to refuse any procedure. Affirming the patient's right to refuse treatment provides reassurance to the patient and respects the patient's autonomy. Explain to the patient that amniocentesis can be used to diagnose developmental disabilities. Explaining the purpose of amniocentesis as it relates to the patient's history provides the patient with context necessary to make an informed decision. Inform the patient that prenatal diagnosis can give the family more time to prepare for a child with special needs. Informing the patient of the potential benefits of amniocentesis as it relates to the patient's history provides the missing context that may have influenced the patient's refusal.

Which parental age group is at risk for poor family adaptation to birth?

Ages 13 to 18 Parents ages 13 to 18 are at risk for poor family adaptation to birth, as adolescents do not have a strong sense of their own identities developmentally.

The antepartum nurse is caring for a couple whose amniocentesis results indicated a positive neural tube defect. The couple is visibly upset and concerned about the future of the pregnancy. Which kinds of nursing care are appropriate for this couple?

Allow the couple time to grieve the loss of the healthy infant they had anticipated. The couple who has received abnormal fetal diagnostic test results should be given time to grieve for the expected healthy infant. Provide the couple with contact information for available counseling services. The couple should be given resources necessary to process the shock of the abnormal test result and to grieve the loss of the expected healthy infant. Explain to the couple that the decision to continue or to terminate the pregnancy is entirely their choice. Perinatal counseling is nondirective. The couple should be informed that the decision to terminate or continue the pregnancy is entirely their choice.

Which description regarding the effects of hormones on the reproductive cycle is accurate?

An abrupt increase in luteinizing hormone (LH) causes ovulation. An abrupt increase in LH is responsible for ovulation during the female reproductive cycle.

Which nursing interventions are appropriate when providing care to a woman who is 8 hours postpartum who reports moderate discomfort related to her perineal laceration?

Apply an ice pack to the perineum. Application of an ice pack will decrease edema and pain in the perineum. Place astringent witch hazel pads directly over the perineum. Placement of astringent witch hazel pads directly over the perineum will decrease inflammation and promote comfort. Administer nonsteroidal antiinflammatory drugs (NSAIDs). Administration of NSAIDs will help decrease inflammation in the perineum and provide comfort.

Which disease is known to have a strong familial association, attributed to several different genes, and requires early and increased screening?

Colon Cancer Several genes have been identified that confer an increased risk for colon cancer, so earlier and increased screening may be considered based on history of a first degree relative.

The antepartum nurse is caring for a patient with a family history of neural tube defects. The patient declines genetic counseling after listening to the health care provider's explanation. Which nursing intervention is appropriate for this patient?

Continue to the next part of the visit. Whether to receive genetic counseling is ultimately the patient's decision. The nurse would acknowledge the patient's choice and continue with the visit.

Match the stage of maternal role attachment with the corresponding statement made by a mother: "The pediatrician assured me my baby was gaining weight OK."

Dependent-Independent: Taking Hold

Match the stage of maternal role attachment with the corresponding statement made by a mother: "Taking a trip to see family will be easy because I am prepared."

Dependent: Taking In

Which noticeable, initial change is expected during the process of sexual maturation in females?

Development of breast buds Development of breast buds is the first noticeable change expected during the process of sexual maturation in girls.

Which effects can a full bladder have on the uterus in the postpartum period?

Displaces the uterus The uterus is displaced to the right of the umbilicus when the bladder is full. Increases uterine toneThe uterine tone is decreased, not increased, with a full bladder, which leads to increased blood loss. Promotes a boggy uterus A boggy uterus is associated with a full bladder, which leads to increased blood loss. Inhibits uterine involution The uterus is unable to contract and involute when the bladder is full.

Which nursing finding requires intervention when assessing a postpartum woman who delivered by cesarean birth?

Distended abdomen with no bowel sounds auscultated Abdominal distention and the absence of bowel sounds would concern the nurse. This may indicate the presence of bowel obstruction.

Which disorders have a known chromosomal inheritance pattern?

Down Syndrome Examples of chromosomal abnormalities include Down, Turner, and Edwards syndromes. Turner Syndrome Examples of chromosomal abnormalities include Down, Turner, and Edwards syndromes. Edwards Syndrome Examples of chromosomal abnormalities include Down, Turner, and Edwards syndromes.

Which findings are concerning when assessing a third-degree laceration of a postpartum woman?

Edema Edema would concern the nurse. This can inhibit a woman's ability to void postpartum and delay perineal healing. Stitches that are not well approximated The wound will not heal appropriately postpartum if sutures are not intact, so the finding of stitches that are not well approximated would concern the nurse.

Which nursing intervention is appropriate to help prevent thrombophlebitis in a postpartum woman who delivered by cesarean birth?

Encourage early and frequent ambulation. Early and frequent ambulation helps prevent thrombophlebitis caused by venous stasis and hypercoagulation in postpartum women who delivered by cesarean birth, who have double the risk.

The nurse is developing a standard care plan for a mother after a cesarean delivery. Which step would the nurse plan to implement?

Encourage early, frequent ambulation after the surgery. It is crucial for patients who have had any surgery, including a cesarean section, to ambulate early and frequently and to use antithrombotic boots during bed rest.

Which nursing interventions can help prevent abdominal distention and gas discomfort for a postpartum woman who delivered by cesarean birth?

Encourage increased ambulation. Increased ambulation stimulates peristalsis and helps prevent abdominal distention and gas for a woman who delivered by cesarean birth. Encourage increased oral (PO) fluid intake. Increased PO fluid intake stimulates peristalsis and helps prevent abdominal distention and gas for a woman who delivered by cesarean birth. Discourage the use of drinking straws. Women should be instructed to avoid straws to prevent abdominal distention and gas.

Which approaches would the nurse suggest to new parents to promote adaptation?

Encourage the parents to delay visitors. Encouraging the parents to delay visitors will promote rest. Encourage the parents to enlist family and friends to help with household tasks. Encouraging the parents to enlist the help of family and friends for household tasks will promote rest. Emphasize that the priority during the first 4 to 6 weeks should be caring for themselves and the baby. Emphasizing that the priority during the first 4 to 6 weeks should be caring for themselves and the baby will promote rest.

Which nursing intervention can help reduce a family's stress related to adaptation after birth?

Encourage the parents to identify social support to assist them after discharge. Encouraging the parents to identify social support from friends, family, and support groups within the community will help decrease stress related to adaptation after birth.

Which hormones are responsible for the development of female secondary sex characteristics?

Estrogen Estrogen is released from the ovaries and is responsible for development of female secondary sex characteristics. Progesterone Progesterone is released from the ovaries and is responsible for development of female secondary sex characteristics.

Which findings are consistent with subinvolution for a woman 24 hours postpartum?

Excessive blood loss Excessive blood loss is associated with decreased uterine contraction and subinvolution after birth. Foul odor from lochia Endometrial infection is associated with decreased uterine involution, as well as fever, pain, and malodorous lochia. A fundus 2U above the umbilicus A fundus 2 cm above the umbilicus 24 hours after birth is indicative of subinvolution.

Which actions by the nurse are appropriate when speaking with a patient who needs fetal diagnostic testing?

Explain how repeated testing benefits the patient and fetus even though it may seem tedious. Explaining the benefit of repeated testing helps the patient understand how the tests benefit both patient and infant. This helps address potential frustration about repeated testing and is an appropriate action for the nurse to take. Provide the patient with a clear explanation of why the test is indicated and what abnormalities it can detect. Providing the patient with a clear explanation of why the test is indicated and what abnormalities it can detect helps the patient understand the purpose and potential outcomes of the test. Providing the patient with this information is an appropriate action by the nurse. Help the patient understand that there is a baseline risk for fetal abnormalities even when all results are normal. Helping the patient to understand that a baseline risk exists even if all test results are normal helps clarify that normal test results do not guarantee the birth of a perfect infant. This helps the patient set realistic goals and is an appropriate action for the nurse to take.

A patient reports frustration at the health care provider's decision not to perform all the diagnostic tests she wishes to have. Which types of patient education are appropriate?

Explain to the patient that some abnormalities can be detected by more than one test. Explaining the overlap between diagnostic test capabilities helps the patient better understand the purpose and efficacy of fetal diagnostic testing. Explain to the patient that even if all tests were normal, it would not rule out every abnormality. Informing the patient of the baseline risk that exists regardless of normal test results helps the patient better understand the purpose of fetal diagnostic testing. Inform the patient that each procedure carries risks to both patient and infant, and that risk increases when multiple procedures are performed. Explaining the risks of diagnostic procedures helps the patient better understand the risks and advantages of fetal diagnostic testing.

Match the phase of the ovarian cycle with the event that occurs: Cells from follicle persist

Follicular phase

Match the stage of maternal role attachment with the corresponding statement made by a mother: "We are so fortunate to have found a pediatrician close to home."

Formal Stage

Which probabilities are associated with a man with hemophilia A having a child with a woman who does not have the disease and who is not a carrier?

None of his sons will be affected. None of his sons would be affected because they receive only the Y chromosome from him, and all of his daughters will be carriers. All of his daughters will be carriers. All of his daughters will be carriers, and none of his sons would be affected because they receive only the Y chromosome from him.

Which assessment findings suggest excessive blood loss requiring immediate intervention for a postpartum patient who had a cesarean delivery?

Heart rate of 120 beats/min An elevated heart rate of 120 beats/min may be related to excessive blood loss/shock and requires immediate intervention. Blood pressure of 80/40 mm Hg A low blood pressure of 80/40 mm Hg may be related to excessive blood loss/shock and requires immediate intervention. Urinary output of 20 mL/hour Urinary output of less than 30 mL/hour may be related to excessive blood loss/shock and requires immediate intervention. Abdominal distension and severe pain Abdominal distension and severe pain may be related to internal bleeding and require immediate intervention.

A newlywed couple has an ultrasound that shows that they are having a boy. Which genetic disorders are more likely in their child?

Hemophilia A Hemophilia A is an X-linked disease. Because the couple is having a boy, this disease is more likely to occur. Fragile X Syndrome Fragile X syndrome is an X-linked disease. Because the couple is having a boy, this disease is more likely to occur. Duchenne Muscular Dystrophy Duchenne muscular dystrophy is an X-linked disease. Because the couple is having a boy, this disease is more likely to occur.

Match the phase of the ovarian cycle with the event that occurs: Follicle ruptures

Ischemic phase

A nurse who is called to a patient's room notes that the patient's cesarean incision has separated. Which action is the highest priority for the nurse to perform?

Notify the health care provider. The nurse should notify the health care provider immediately for orders on how to treat this wound dehiscence.

Forty-eight hours after a patient's cesarean section, she is expressing fear of standing and picking up her newborn. The nurse recognizes these relevant cues and selects a hypothesis that the patient is experiencing which issue?

Knowledge deficit of self-care measures after cesarean section This patient is experiencing fears that are related to her lack of knowledge. It is crucial that the nurse determine whether this patient has had any childbirth or postpartum preparation classes and educate the patient as necessary on self-care following a cesarean section.

Which female anatomic structure protects the labia minora?

Labia majora The labia majora are fleshy folds of tissue that protect the fragile tissues of the external female genitalia, including the labia minora.

A 70-year-old man and his 45-year-old wife have a child who is found to have a genetic disorder. What signs and symptoms are likely to be seen in this child born to parents of advanced maternal and paternal age?

Leukemia Down syndrome is associated with both late maternal and paternal age. It has many manifestations, including leukemia, visual problems (cataracts, strabismus), hearing disorders, and congenital heart defects. Visual Problems Down syndrome is associated with both late maternal and paternal age. It has many manifestations, including leukemia, visual problems (cataracts, strabismus), hearing disorders, and congenital heart defects. Hearing Disorders Down syndrome is associated with both late maternal and paternal age. It has many manifestations, including leukemia, visual problems (cataracts, strabismus), hearing disorders, and congenital heart defects. Congenital Heart Defects Down syndrome is associated with both late maternal and paternal age. It has many manifestations, including leukemia, visual problems (cataracts, strabismus), hearing disorders, and congenital heart defects.

Place the phases of the endometrial cycle in order, starting with day 1 of the female reproductive cycle.

Menstrual phase Proliferative phase Secretory phase Ischemic phase` This is the correct order for the phases of the endometrial cycle, starting with day 1 of the female reproductive cycle, which begins with menstruation.

Which physiologic process in the postpartum period is associated with the hormone prolactin?

Milk production Milk production is associated with increased prolactin hormone levels after birth.

Which nursing findings are concerning when assessing the breasts and nipples of a postpartum woman?

Nipples are pink with a blister line. The nurse would not anticipate that a postpartum mother's nipples would be pink with blisters. Nipple damage is often the result of a poor latch by a breastfeeding infant. Breasts are red and firm. The nurse would not anticipate that a postpartum mother's breasts would be red and firm. This finding may be a symptom of mastitis.

At which time would it be most effective for the nurse to educate a new mother about circumcision care?

On the second postpartum day Education is most effective during the taking-hold phase, which begins 24 hours after birth. During this time, the mother begins to shift her focus from self-care to her infant.

Which types of data are needed to select the appropriate fetal diagnostic procedures?

Parity Grand multiparity (>5 pregnancies) indicates the need for fetal diagnostic procedures; therefore parity is a relevant indicator of whether fetal diagnostic procedures should be performed. Maternal age Maternal age of <16 or >35 years indicates the need for fetal diagnostic procedures; therefore age is a relevant indicator of whether fetal diagnostic procedures should be performed. Fetal movement Decrease in or absence of fetal movement indicates the need for fetal diagnostic procedures; therefore fetal movement is a relevant indicator of whether fetal diagnostic procedures should be performed.

Match the stage of maternal role attachment with the corresponding statement made by a mother: "I can tell by the tone of the baby's cry if he is hungry."

Personal Stage

A newborn child is noted to have malodorous, musty urine and later shows signs of developmental delay and seizures. Which disorder presents with these characteristics?

Phenylketonuria Phenylketonuria leads to buildup of toxic phenylalanine. This can be neurotoxic, causing brain damage, developmental delay, and seizures. There is also a characteristic musty odor to the urine.

A child is born with a genetic disorder and is found to have 46 chromosomes. Which type of disorder could have caused the genetic disorder?

Polygenic Disorder Polygenic disorders are characterized by changes in multiple genes, but the number of chromosomes remains the normal 46. Single Gene Disorder Single disorders are characterized by changes in one gene, but the number of chromosomes remains the normal 46. Autosomal Recessive Disorder Autosomal recessive disorders are characterized by changes in single genes, but the number of chromosomes remains the normal 46. Autosomal Dominant Disorder Autosomal dominant disorders are characterized by changes in single genes, but the number of chromosomes remains the normal 46.

Which nursing care actions promote bonding between a postpartum patient and her newborn?

Position the infant in the en face position. Positioning the infant in the en face position so the mother's face is 8 inches from the newborn's face will promote bonding between a postpartum patient and her newborn. Point out the reciprocal bonding activities of the infant. Pointing out the reciprocal bonding activities of the infant will promote bonding between a postpartum patient and her newborn. For example, "Notice how the infant squeezes your finger when you place it in his hand." Point out the infant's characteristics in a positive manner. Pointing out the infant's characteristics in a positive manner will promote bonding between a postpartum patient and her newborn.

Which interventions would the nurse use to assist the postpartum woman who has difficulty voiding?

Pour warm water over the vulva. Pouring warm water over the vulva will relax the perineal muscles and stimulate the sensation to void. Encourage the woman to urinate in the shower. Encourage the woman to urinate by running warm water over the vulva in the shower. It will relax the perineal muscles and stimulate the sensation to void.

Which nursing interventions can help increase a new father's confidence in caring for his newborn?

Praise paternal effort with newborn care. Praising paternal effort with newborn care will increase a new father's confidence in caring for his newborn. Include the father in education related to newborn care. Including the father in education related to newborn care will increase his confidence in caring for his newborn. Offer opportunities for the father to perform newborn care. Offering opportunities for the father to perform newborn care will increase his confidence in caring for his newborn. Include the father in the care of the baby after delivery. Including the father in care of the baby after delivery will increase his confidence in caring for his newborn.

Which statements explain how plasma volume returns to baseline after delivery?

Profuse sweating aids in decreasing plasma volume levels. Diaphoresis, or profuse sweating, especially at night, aids in the depletion of excess plasma volume after birth. Increased urinary output promotes the excretion of excess plasma volume. Increased urinary output (diuresis) promotes the excretion of excess plasma volume after birth. Diuresis is caused by decreased aldosterone, decreased oxytocin, and decreased sodium retention after delivery. Decreased aldosterone hormone levels promote diuresis of excess plasma volume. Decreased aldosterone hormone levels promote diuresis and depletion of excess plasma volume after birth.

Which factors put a patient at risk for postpartum complications?

Prolonged rupture of membranes A patient with prolonged rupture of membranes is at an increased risk for postpartum infection. 30-hour long labor Prolonged labor increases a woman's risk for excessive bleeding postpartum caused by uterine atony. Third-degree perineal laceration and moderate edema Women with lacerations and edema are at risk for impaired urinary elimination and excessive bleeding postpartum.

Which signs and symptoms would the postpartum nurse expect to see in a patient with a wound infection?

Purulent drainage Purulent drainage is a sign of infection, and it should be treated immediately to avoid further complications associated with a wound infection. Maternal fever greater than 100.4°F (38.0°C) A maternal fever is a sign of infection, and it should be treated immediately to avoid further complications associated with a wound infection. In addition to a fever, the patient may also complain of extreme pain that is not relieved with prescribed medications. Redness around incision Redness around the incision site is a sign of infection, and it should be treated immediately to avoid further complications associated with a wound infection.

Which teaching elements are appropriate to include in the plan of care for the postpartum patient with a third-degree laceration?

Recommend a high-fiber diet. A diet that is high in fiber will facilitate having a bowel movement without straining and potentially disrupt healing of the laceration. Apply cold to the area for the first 12 hours as needed. The application of cold for the first 12 hours as needed will prevent swelling that could potentially disrupt the healing of the laceration. Recommend stool softeners. The use of stool softeners can be implemented to facilitate the patient's comfort during the healing process.

Development of female breast tissue is related to which process of sexual maturation?

Release of estrogen from the ovaries Estrogen is released from the ovaries and is responsible for breast development related to female sexual maturation.

Which intervention is appropriate for a patient with Rh-negative blood who is unsensitized and just received percutaneous umbilical blood?

Rho(D) immune globulin administration A patient who is Rh-negative and unsensitized should be given Rho(D) immune globulin after percutaneous umbilical blood sampling (PUBS) to prevent Rh sensitization.

Which description represents the normal anatomic structure of the external os of the cervix in a nulliparous woman?

Round and smooth The normal anatomic structure of the external os of the cervix in a nulliparous woman is round and smooth.

A patient with a family history of spina bifida is 16 weeks pregnant. Which action by the nurse is the priority?

Schedule the patient for maternal serum alpha fetoprotein (MSAFP). MSAFP should be scheduled between 15 and 20 weeks to test AFP level, which is used in screening for neural tube defects such as spina bifida. Scheduling this test should be a priority action for the nurse to take.

Match the phase of the ovarian cycle with the event that occurs: Ovum matures

Secretory phase

Maternal role attainment is a process that spans from pregnancy through which time period?

Several months after delivery Maternal role attainment spans from pregnancy through several months postpartum.

An 18-year-old presents with a history of hip pain and is found to have avascular necrosis. Which genetic disorder may be present?

Sickle Cell Disease Sickle cell disease is characterized by avascular necrosis, frequent painful crises, and acute chest syndrome.

Which genetic disorders can be understood using Punnett squares?

Single Gene Disorder Single gene disorders are characterized by changes in one gene and can be understood using Punnett squares. Autosomal Recessive Disorder Autosomal recessive disorders are characterized by changes in single genes and can be understood using Punnett squares. Autosomal Dominant Disorder Autosomal dominant disorders are characterized by changes in single genes and can be understood using Punnett squares.

During which phase related to newborn care is a mother most receptive to teaching by the nurse?

Taking hold Mothers are most receptive to teaching related to newborn care during the taking-hold phase, during which they shift their attention from themselves to their newborns.

Which vaccine information is appropriate for a woman with the following prenatal laboratory test results: B-positive blood type, hepatitis B negative, human immunodeficiency virus (HIV) negative, and rubella nonimmune?

Tetanus, diphtheria & acellular pertussis vaccine (Tdap) Tdap vaccine information should be included in teaching and offered to all postpartum women. Rubella Rubella vaccine information should be included in postpartum teaching, as the woman is rubella nonimmune and will need to be offered the vaccine.

A 38-year-old patient declines prenatal diagnostic testing as result of a lack of family history of genetic or chromosomal abnormalities. Which nursing education is appropriate for this patient?

The patient's age increases the risk for having a child with an abnormality. Advanced maternal age increases the risk for chromosomal trisomy, such as trisomy 21 (Down syndrome).

Which statement best describes the function of the fallopian tube?

Transports ovum to the uterus The function of the fallopian tube is best described as transporting an ovum to the uterus.

Which chromosomal abnormalities result in a form of Down syndrome?

Trisomy 21 Down syndrome is most often characterized by three chromosomes, rather than the normal two, in the 21 position. This is also known as trisomy 21. Translocation Some forms of Down syndrome may have part of a chromosome 21 attached to another chromosome, which is an example of translocation.

Which interventions are appropriate to promote comfort and healing for a woman during the first 24 hours after a cesarean delivery?

Use intravenous or intramuscular medication for comfort. The patient may not tolerate oral (PO) medications immediately postpartum. Use an incentive spirometer and deep breathing. Women are at risk for respiratory complications after a surgical intervention such as a cesarean delivery, as a result of respiratory depression. An incentive spirometer and deep breathing enhance the expansion of the lungs with air postoperatively. Provide extra assistance with newborn care and lactation. Especially during the first 24 hours after a cesarean delivery, the woman may need additional help with lactation and newborn care.

On assessment, the nurse learns that a male toddler born with a congenital heart defect lives with his parents and two young siblings in the Midwest. The mother is pregnant with a fourth child. Which additional information would the nurse need to know to evaluate the risk for the fourth child being born with a heart defect?

Variations of symptoms because of time or season Seasonal variations of symptoms are a factor that may influence the risk for developing a heart defect. The nurse would need this information to evaluate the fourth child's risk for developing a heart defect. Sex of family members born with a heart defect Sex of affected family members is a factor that may influence the risk for developing a heart defect, as it can help determine whether the trait is X-linked. The nurse would need this information to evaluate the fourth child's risk for developing a heart defect. Number of close relatives born with a heart defect Number of affected relatives is a factor that may influence the risk for developing a heart defect. The nurse would need this information to evaluate the fourth child's risk for developing a heart defect.