..

What counts as spontaneous abortion? APregnancy is less than 20 weeks. b. Fetus weighs less than 1000 g. c. Products of conception are passed intact. d. No evidence exists of intrauterine infection.

A

in-vitro fertilization-embryo transfer (IVF-ET). The husband asks the nurse to explain what the procedure entails. Which of the following is the nurse's most appropriate response? a. In vitro fertilization-embryo transfer (IVF-ET) is a type of assisted reproductive therapy that involves collecting eggs from your wife's ovaries, fertilizing them in laboratory with your sperm, and transferring the embryo into her uterus." b. "A donor embryo will be transferred into your wife's uterus." c. "Donor sperm will be used to inseminate your wife d. "Don't worry about the technical stuff, that's what we are here for

A

27. A client at 28 weeks' gestation is admitted to the labor and birth unit. Which test would most likely be used to assess the client's comprehensive fetal status? a. Amniocentesis. b. Biophysical profile (BPP). c. Nonstress test (NST). d. Ultrasound for physical structure.

B

28. While performing the fetal acoustic stimulation test (FAST) in a patient, the nurse observes that there is no fetal response even after 3 minutes of testing. Which test does the nurse suggest? A. Amniocentesis B. Biophysical profile (BPP) C. Cordocentesis D. Coombs' test

B

33. The nurse is teaching a prenatal client about chorionic villus sampling (CVS). The nurse correctly teaches the client that risks related to CVS include which of the following? Select all that apply. a. Spontaneous abortion. b. Intrauterine infection. c. Rupture of membranes. d. Maternal hypertension

Abc

• In planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the: A. Mothers age. B. Number of years since diabetes was diagnosed. C. Amount of insulin required prenatally. D. Degree of glycemic control during pregnancy

ANS: D Women with excellent glucose control and no blood vessel disease should have good pregnancy outcomes.

18. The nurse providing care for the antepartum woman should understand that contraction stress test (CST): a. Sometimes uses vibroacoustic stimulation. b. Is an invasive test; however, contractions are stimulated. c. Is considered negative if no late decelerations are observed with the contractions. d. Is more effective than nonstress test (NST) if the membranes have already been ruptured

C

27. . While working with the pregnant woman in her first trimester, the nurse is aware that chorionic villus sampling (CVS) can be performed during pregnancy at: a. 4 weeks c. 10 weeks b. 8 weeks d. 14 weeks

C

38. During her pregnancy a women with pre gestational diabetes has been monitoring her blood glucose level several times a day. Which level requires further assessment?- a) 85 mg/dl - 15 min prior to breakfast b) 90 mg/dl - prior to lunch c) 140 mg/dl - 2 hours after lunch d) 126 mg/dl - 1 hour after supper

C

4. A woman has a breast mass that is not well delineated and is nonpalpable, immobile, and nontender. This is most likely: a. Fibroadenoma. c. Intraductal papilloma. b. Lipoma. d. Mammary duct ectasia.

C

8. A nurse is instructing a client who is taking an oral contraceptive about manifestations to report to the HCP. Which of the following manifestations should the nurse include? A. Reduced menstrual flow B. Breast tenderness C. Shortness of breath D. Increased appetite

C

A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. The primary health care provider prescribes a contraction stress test, and the results are documented as negative. How should the nurse document this finding? 1. A normal test result 2. An abnormal test result 3. A high risk for fetal demise 4. The need for a cesarean section

1. A normal test result

22. A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would yield more detailed information about the fetus? a. Ultrasound for fetal anomalies b. Biophysical profile (BPP) c. Maternal serum alpha-fetoprotein (MSAFP) screening d. Percutaneous umbilical blood sampling (PUBS)

B

The nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instruction? 1. "I will record the number of movements or kicks," 2. "I need to lie flat on my back to perform the procedure." 3. "If I count fewer than 10 kicks in a 2 hour period, I should count the kicks again over the next two hours." 4. "I should place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks."

2. "I need to lie flat on my back to perform the procedure."

44. The nurse teaches a 38-year-old man who was recently diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient requires an intervention by the nurse? a. "I will discard any insulin bottle that is cloudy in appearance." b. "The best injection site for insulin administration is in my abdomen." c. "I can wash the site with soap and water before insulin administration." d. "I may keep my insulin at room temperature (75o F) for up to a month."

A

5. . A benign breast condition that includes dilation and inflammation of the collecting ducts is called: a. Ductal ectasia. c. Chronic cystic disease. b. Intraductal papilloma. d. Fibroadenoma.

A

13. A client is to have a hysterosalpingogram. In this procedure, the physician will be able to determine which of the following? 1. Whether or not the ovaries are maturing properly. 2. If the endometrium is fully vascularized. 3. If the cervix is incompetent. 4. Whether or not the fallopian tubes are obstructed

4

37. In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy, the nurse recognizes that further teaching is warranted when the client states: a. "I will need to increase my insulin dosage during the first 3 months of pregnancy." b. "Insulin dosage will likely need to be increased during the second and third trimesters." c. "Episodes of hypoglycemia are more likely to occur during the first 3 months." d. "Insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding

A

7. A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to: a. Endometriosis. c. Primary dysmenorrhea. b. PMS. d. Secondary dysmenorrhea.

A

7. A woman has chosen the calendar method of conception control. During the assessment process, it is most important that the nurse: a. Obtain a history of menstrual cycle lengths for the past 6 to 12 months b. Determine the client's weight gain and loss pattern for the previous year c. Examine skin pigmentation and hair texture for hormonal changes d. Explore the client's previous experiences with conception control

A

The client who is 41 weeks gestation has just had a biophysical profile with a score of two. Which of the following nursing interventions would be most appropriate? A. Contact the provider immediately and prepare the client for imminent delivery

? A. Contact the provider immediately and prepare the client for imminent delivery

16. A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of approximately 120 beats/min without any decelerations. The interpretation of this test is said to be: a. Negative. c. Satisfactory. b. Positive. d. Unsatisfactory.

A

A women at 30 weeks of gestation with a class II cardiac disorder calls her primary health care provider's office and speaks to the nurse practitioner. She tells the nurse that she has been experiencing a frequent moist cough for the past few days. In addition she has been feeling more tired and is having difficulty completing her routine activities as a result of some difficulty with breathing. The nurses' best response is-

A) "have someone bring you to the office so we can assess your cardiastatus

6. The nurse is seeing patients in the antepartum clinic. Be prepared to prioritize patients when given hypothetical information about a group of patients. A. An 18-year old multigravida at 28 weeks gestation with a positive indirect Coombs test. B. A 24-year old multigravida at 32 weeks gestation with moderate facial edema. C. A 30- year old woman at 26 weeks gestation with bilateral yellow breast exudate. D. A 43-year old primigravida at 18 weeks gestation who reports an absence of fetal movement.

A. An 18-year old multigravida at 28 weeks gestation with a positive indirect Coombs test.

18. A prenatal client at 30 weeks' gestation is scheduled for a nonstress test (NST), and asks the nurse, "What is this test for?" The nurse correctly responds that the test is used to determine which of the following? Select all that apply. a. Accelerations of fetal heart rate. b. Fetal lung maturity. c. Adequate fetal oxygenation. d. Fetal well-being.

AC D

8. With regard to endometriosis, nurses should be aware that: a. It is characterized by the presence and growth of endometrial tissue inside the uterus. b. It is found more often in African-American women than in white or Asian women. c. It may worsen with repeated cycles or remain asymptomatic and disappear after menopause. d. It is unlikely to affect sexual intercourse or fertility.

C

• A nurse is reviewing findings of a clients biophyisical profile (BPP) The nurse should expect which of the following variables to be included in this test? (SATA) A. Fetal weight B. Fetal breathing movement C. Fetal tone D. Fetal position E. Amniotic fluid volume

B. Fetal breathing movement C. Fetal tone E. Amniotic fluid volume

• The nurse explains to a client with a family history of breast cancer the difference between benign and malignant neoplasms. Which description is a characteristic of a malignant neoplasm? a. round or oval shape b. irregular shape and hard c. movable d. smooth border

B. Irregular shaped and hard

9. When evaluating a patient for sexually transmitted infections (STIs), the nurse should be aware that the most common bacterial STI is: a. Gonorrhea. c. Chlamydia. b. Syphilis. d. Candidiasis.

C

The nurse providing care for a woman with gestational diabetes understands that a laboratory test for glycosylated hemoglobin Alc : a. Is now done for all pregnant women, not just those with or likely to have diabetes. b. Is a snapshot of glucose control at the moment. c. Would be considered evidence of good diabetes control with a result of 5% to 6%. d. Is done on the patients urine, not her blood

C

26. Which information should nurses provide to expectant mothers when teaching them how to evaluate daily fetal movement counts (DFMCs)? (Select all that apply) Select one or more: a. Alcohol or cigarette smoke can irritate the fetus into greater activity. b. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours c. Kick counts should be taken every ½ hour and averaged every 6 hours, with every other 6-hour stretch off. d. A count of less than three fetal movements in 1 hour warrants future evaluation.

Bd

• A couple trying to cope with an infertility problem. They want to know what they can do to help their emotional stress. What is the nurses most appropriate response a. Tell your friends and family so they can help out b. Start adoption proceedings immediately because it is very difficult to obtain an infant c. Get involved with a support group. I will write some names and numbers of groups you can call d. This is an issue that can be handled independently between you as a couple

C

• The public health nurse calls a woman and states, "I am afraid that I have some disturbing news. A man who has been treated for gonorrhea by the health department has told them that he had intercourse with you. It is very important that you seek medical attention." The woman replies, "There is no reason for me to go to the doctor! I feel fine!" Which of the following replies by the nurse is appropriate at this time? A. "I am sure that you are upset by the disturbing news, but there is no reason to be angry with me." B. I am sorry. We must have received the wrong information." C. "That certainly could be the case. Women often report no symptoms." D, "All right, but please tell me your contacts because it is possible for you to pass the disease on even if you have no symptoms."

C

• The nurse is providing discharge instructions after tubal ligation, Which of the following would the nurse include in the instructions? SATA a. being prepared for significant mood swings due to hormonal influences. b. using two forms of birth control to prevent pregnancy. c. There will be no change in sexual functioning d. Use condoms to prevent sexually transmitted infections

C D

• The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching? A. "I should stay on the diabetic diet." B. "I should perform glucose monitoring at home." C. "I should avoid exercise because of the negative effects on insulin production." D. "I should be aware of any infections and report signs of infection immediately to my obstetrician."

C. "I should avoid exercise because of the negative effects on insulin production."

36. A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first? a. A client who is at 38 weeks of gestation and reports a cough and fever b. A client who has missed a period and reports vaginal spotting c. A client who is 14 weeks of gestation and reports nausea and vomiting d. A client who is at 28 weeks of gestation and reports painless vaginal bleeding

D

• A nurse in the local health department is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective? a. "I will apply a water-based lubricant to my lesions." b. "I should rub rather than scratch in response to itching." c. "I can pour hydrogen peroxide and water over my lesions." d. "I will wear loose cotton underwear."

D

• A woman who is 15 weeks pregnant has elected to terminate her pregnancy. The nurse knows that the most common technique used for medical termination of a pregnancy the second trimester is a. instillation of hypertonic saline into the uterine cavity. b. intravenous administration of Pitocin. c. vacuum aspiration. d. dilation and evacuation (D&E).

D

26. For a woman at 42 weeks of gestation, which finding would require further assessment by the nurse? a. Fetal heart rate of 116 beats/min b. Cervix dilated 2 cm and 50% effaced c. Score of 8 on the biophysical profile d. One fetal movement noted in 1 hour of assessment by the mother

D Self-care in a post-term pregnancy should include performing daily fetal kick counts three times per day. The mother should feel four fetal movements per hour. If fewer than four movements have been felt by the mother, she should count for 1 more hour. Fewer than four movements in that hour warrants evaluation. Normal findings in a 42-week gestation include fetal heart rate of 116 beats/min, cervix dilated 20 cm and 50% effaced, and a score of 8 on the biophysical profile

A pregnant woman's biophysical profile score is 8. She asks the nurse to explain the results. The nurse's best response is: a. "The test results are within normal limits." b. "Immediate delivery by cesarean birth is being considered." c. "Further testing will be performed to determine the meaning of this score." d. "An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding delivery."

a. "The test results are within normal limits."

. Because of the effect of cyclic ovarian changes on the breast, the best time for breast self-examination (BSE) is: a. 5 to 7 days after menses ceases. c.Midmenstrual cycle. b. Day 1 of the endometrial cycle. d. Any time during a shower or bath

ANS: A The physiologic alterations in breast size and activity reach their minimal level about 5 to 7 days after menstruation stops. All women should perform BSE during this phase of the menstrual

34. The most common neurologic disorder accompanying pregnancy is: a. Eclampsia. c. Epilepsy. b. Bells palsy. d. Multiple sclerosis.

ANS: C The effects of pregnancy on epilepsy are unpredictable. Eclampsia sometimes may be confused with epilepsy, which is the most common neurologic disorder accompanying pregnancy. Bells palsy is a form of facial paralysis. Multiple sclerosis is a patchy demyelinization of the spinal cord that does not affect the normal course of pregnancy or birth

16. What effect does multiple sclerosis have on contractions?

Contractions will not be strong

The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine whether the fetus has which? a. Hemophilia b. Sickle cell anemia c. A neural tube defect d. A normal lecithin-to-sphingomyelin ratio

c: Neural tube defect

14. A client is to have a hysterosalpingogram. Which of the following information should the nurse provide to the client prior to the procedure? 1. "The test will be performed through a small incision next to your belly button." 2. "You will be on bedrest for a full day following the procedure." 3. "An antibiotic fluid will be instilled through a tube in your cervix." 4. "You will be asked to move from side to side so that x-ray pictures can be taken."

4

22. A pregnant client has a contraction stress test (CST). Which findings would the nurse interpret as indicative of a negative CST result? 1. Persistent late decelarations in fetal heartbeat occurred, with at least three contractions in a 10-minute window. 2. Accelerations of fetal heartbeat occurred, with at least 15 beats/minute, lasting 15 to 30 seconds in a 20-minute window. 3. Accelerations of fetal heartbeat were absent or didn't increase by 15 beats/minute for 15 to 30 seconds in a 20-minute period. 4. There was moderate fetal heart rate variability, and no decelerations from contraction, in a 10-minute period in which there were three contractions

4

23. . Nurses should be aware that the biophysical profile (BPP): a. Is an accurate indicator of impending fetal death. b. Is a compilation of health risk factors of the mother during the later stages of pregnancy. c. Consists of a Doppler blood flow analysis and an amniotic fluid index. d. Involves an invasive form of ultrasound examination.

A

• A nurse is teaching a local women's church group about the risks of cervical cancer. The nurse determines that further teaching is necessary if a group member states that which of the following is a risk factor? a. Promiscuity (Multiple sexual partners) b. History of genital warts c. Monogamy (One sexual partner) d. Early frequent intercourse

A

• The nurse is caring for a woman has chosen the calendar method of contraception. During the assessment process, what is the most important assessment that the nurse would include? a. obtain a history of menstrual cycle lengths for the past 6-12 months. b. determine the client's weight gain and loss pattern for the previous year. c. examine skin pigmentation changes and hair texture for hormonal changes. d. explore the client's previous experience with contraception.

A

50. Which statement(s) is/are true about seizures and anticonvulsant use in pregnancy? (Select all that apply) A) Seizures may increase up to 25% in epileptic women B) Many anticonvulsants have teratogenic properties C) Anticonvulsant use increases loss of folic acid D) Anticonvulsants increase the effects of vitamin K E) Valproic acid causes malformation in 40% to 80% of fetuses

A B C

• The nurse explains to a client with a family history of breast cancer the difference between benign and malignant neoplasms. Which of the following are characteristics would the nurse include in the description? SATA a. Mass in upper, outer quadrant of breast b. Mass is irregular in shape c. Moves easily d. Hard e. Usually single

A B D

11. 4. You (the nurse) are reviewing the educational packet provided to a client about tubal ligation. What is an important fact you should point out (Select all that apply)? a. It is highly unlikely that you will become pregnant after the procedure. b. This is an effective form of 100% permanent sterilization. You wont be able to get pregnant. Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 79 c. Sterilization offers some form of protection against sexually transmitted infections (STIs). d. Sterilization offers no protection against STIs. e. Your menstrual cycle will greatly increase after your sterilization.

A D

• Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for: A. Macrosomia. B. Congenital anomalies of the central nervous system. C. Preterm birth. D. Low birth weight.

ANS: A Poor glycemic control later in pregnancy increases the rate of fetal macrosomia. Poor glycemic control during the preconception time frame and into the early weeks of the pregnancy is associated with congenital anomalies. Preterm labor or birth is more likely to occur with severe diabetes and is the greatest risk in women with pregestational diabetes. Increased weight, or macrosomia, is the greatest risk factor for this woman.

The nurse is reviewing maternal serum alpha-fetoprotein (MSAFP) results. Which conditions are associated with elevated levels of MSAFP? (Select all that apply.) a. Fetal demise b. Neural tube defects c. Abdominal wall defects d. Chromosomal trisomies e. Gestational trophoblastic disease

ANS: A, B, C Elevated levels of AFP may indicate open neural tube defects (e.g., anencephaly, spina bifida), abdominal wall defects (e.g., omphalocele, gastroschisis), or fetal demise. Low levels of AFP may indicate chromosomal trisomies (e.g., Down syndrome, trisomy 21) or gestational trophoblastic disease.

32. An 18-year-old client who has reached 16 weeks of gestation was recently diagnosed with pregestational diabetes. She attends her centering appointment accompanied by one of her girlfriends. This young woman appears more concerned about how her pregnancy will affect her social life than about her recent diagnosis of diabetes. Several nursing diagnoses are applicable to assist in planning adequate care. The most appropriate diagnosis at this time is: a. Risk for injury to the fetus related to birth trauma. b. Noncompliance related to lack of understanding of diabetes and pregnancy and requirements of the treatment plan. c. Deficient knowledge related to insulin administration. d. Risk for injury to the mother related to hypoglycemia or hyperglycemia

ANS: B Before a treatment plan is developed or goals for the outcome of care are outlined, this client must come to an understanding of diabetes and the potential effects on her pregnancy. She appears to have greater concern for changes to her social life than adoption of a new self-care regimen. Risk for injury to the fetus related to either placental insufficiency or birth trauma may come much later in the pregnancy. At this time the client is having difficulty acknowledging the adjustments that she needs to make to her lifestyle to care for herself during pregnancy. The client may not yet be on insulin. Insulin requirements increase with gestation. The importance of glycemic control must be part of health teaching for this client. However, she has not yet acknowledged that changes to her lifestyle need to be made, and she may not participate in the plan of care until understanding takes place.

10. The nurse is caring for a client with end-stage ovarian cancer who needs clarification on the purpose of palliative surgery. Which outcome should the nurse teach the client is the goal of palliative surgery? A Cure of the cancer B Relief of symptoms or improved quality of life C Allowing other therapies to be more effective D Prolonging the client's survival time

B

11. Which statement made by a client allows the nurse to recognize whether the client receiving brachytherapy for ovarian cancer understands the treatment plan? A "I may lose my hair during this treatment." B "I must be positioned in the same way during each treatment." C "I will have a radioactive device in my body for a short time." D "I will be placed in a semiprivate room for company."

C

13. A couple comes in for an infertility workup, having attempted to get pregnant for 2 years. The woman, 37, has always had irregular menstrual cycles but is otherwise healthy. The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 65 the sperm seem to be clumped together. What additional test is needed? a. Testicular biopsy b. Antisperm antibodies c. Follicle-stimulating hormone (FSH) level d. Examination for testicular infection

C

2. Which diagnostic test is used to confirm a suspected diagnosis of breast cancer? a. Mammogram c. Fine-needle aspiration (FNA) b. Ultrasound d. CA 15.3

C

• A patient who is pregnant already has Type 2 diabetes with a hemoglobin A1c value of 7. The nurse would categorize this patient as having: A. Gestational diabetes. B. Insulin-dependent diabetes complicated by pregnancy. C. Pregestational diabetes mellitus. D. Non-insulin-dependent diabetes with complications.

C. Pregestational diabetes mellitus.

14. . In vitro fertilization-embryo transfer (IVF-ET) is a common approach for women with blocked fallopian tubes or unexplained infertility and for men with very low sperm counts. A husband and wife have arrived for their preprocedural interview. The husband asks the nurse to explain what the procedure entails. The nurses most appropriate response is: a. IVF-ET is a type of assisted reproductive therapy that involves collecting eggs from your wifes ovaries, fertilizing them in the laboratory with your sperm, and transferring the embryo to her uterus. b. A donor embryo will be transferred into your wifes uterus. c. Donor sperm will be used to inseminate your wife. d. Dont worry about the technical stuff; thats what we are here for

A

17. . Compared with contraction stress test (CST), nonstress test (NST) for antepartum fetal assessment: a. Has no known contraindications. b. Has fewer false-positive results. c. Is more sensitive in detecting fetal compromise. d. Is slightly more expensive.

A

17. 6. The nurse is reviewing four prenatal charts. Which client would be an appropriate candidate for a contraction stress test (CST)? a. A client with intrauterine growth retardation. b. A client with an incompetent cervix. c. A client with multiple gestation. d. A client with placenta previa

A

10. The viral sexually transmitted infection (STI) that affects most people in the United States today is: a. Herpes simplex virus type 2 (HSV-2). b. Human papillomavirus (HPV). 50 c. Human immunodeficiency virus (HIV). d. Cytomegalovirus (CMV).

B

1. A man smoked 2 packs of cigarettes per day. He wants to now if smoking is contributing to the difficulty, he and his wife are having from getting pregnant. The nurses most appropriate response is A) Your sperm count seems to be okay in the first semen analysis. B) Only marijuana cigarettes affect sperm count. C) Smoking can give you lung cancer, even though it has no effect on sperm. D) Smoking can reduce the quality of your sperm.

D

19. The nurse recognizes that a nonstress test (NST) in which two or more fetal heart rate (FHR) accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period is: a. Nonreactive c. Negative b. Positive d. Reactive

D

28. . In planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the: a. Mothers age. b. Number of years since diabetes was diagnosed. c. Amount of insulin required prenatally. d. Degree of glycemic control during pregnancy

D

• A young couple asks the nurse which method of contraception is the best and the one that they should use. Which response is most helpful to the couple? a. "The pill is the best because it is 100% effective with few side effects." b. "The best method is the one that you both agree upon and will use consistently." c. "The condom is the best method because it will protect you from diseases." d. "No method is completely effective: you should practice abstinence until you are ready to have children."

D

• The nurse is assisting in a community education program, the nurse knows that early cancer of the uterus or cervix causes no symptoms. The nurse would focus interventions on which of the following? a. promoting annual physical examinations for all females. b. distribution of pamphlets describing risk factors for cervical cancer. c. providing sex education programs for high school students. d. Promoting screening and early detection with Papanicolaou (Pap) tests as recommended by HCP.

D

• The nurse is planning care to decrease the risk of the development of lymphedema in the client who has had a mastectomy. The nurse would implement which of these actions? a. Keep the arm flat while lying down. b. Implement passive range of motion to the unaffected arm. c. Encourage coughing, turning, and deep breathing exercises. d. Use the nonsurgical arm for assessing blood pressure and starting IVs.

D

30. After reviewing the biophysical profile (BPP) reports of a pregnant patient close to term, the nurse advises the patient to repeat the test on a weekly basis. What BPP score did the nurse find in the report? A. 1 B. 4 C. 6 D. 9

D (If the BPP score is 8 to 10, then the test should be repeated weekly or twice weekly. If the BPP score is 0 to 2, then chronic asphyxia may be suspected. In this case the testing time should be extended to 120 minutes. If the BPP score is 4 after 36 weeks' gestation, then clinical conditions exist that may lead to an eminent delivery. If the BPP score is 4 before 32 weeks' gestation, the test should be repeated. If the BPP score is 6 at 36 to 37 weeks' gestation with positive fetal pulmonary testing, then delivery can be performed. If the BPP score is 6 before 36 weeks' gestation with negative pulmonary testing, then BPP can be repeated in 4 to 6 hours, and if oligohydramnios is present, then delivery can be done. The BPP provides an insight into fetal maturity and well-being and as such should be used as a diagnostic tool to plan and evaluate management of care. Findings are related to several factors involving both maternal and fetal characteristics.)

A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse would provide which explanation about this test to the client? 1.It is a screening test for spinal defects in the fetus. 2.It looks for different types of diseases in the fetal cells. 3.This test identifies a Rh incompatibility between the mother and fetus. 4.It assesses fetal lung maturity and lecithin/sphingomyelin (L/S) ratio

about 1.It is a screening test for spinal defects

• A client comes to the gynecologists office for a follow up visit related to her abnormal Papanicolaou (PAP) smear, The test revealed that the client has human papillomavirus (HPV). The client askes, " what's that?" can you get rid of it?" Which of the following is best response ? a. "HPV stands for 'human papillomavirus.' It is a sexually transmitted infection (STI) that may lead to cervical cancer. There is no known cure but symptoms are treated." b. "You probably caught this from your current boyfriend. He should get tested for this." c. "It's just a little lump on your cervix. We can freeze it off." d. "HPV is a type of early human immunodeficiency virus (HIV). You will die from this."

A

. The exact cause of breast cancer remains undetermined. Researchers have found that there are many common risk factors that increase a womans chance of developing a malignancy. It is essential for the nurse who provides care to women of any age to be aware of which of the following risk factors (Select all that apply)? a. Family history b. Late menarche c. Early menopause d. Race e. Nulliparity or first pregnancy after age 30

A D E

• In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy, the nurse recognizes that further teaching is warranted when the client states: A. "I will need to increase my insulin dosage during the first 3 months of pregnancy." B. "Insulin dosage will likely need to be increased during the second and third trimesters." C. "Episodes of hypoglycemia are more likely to occur during the first 3 months." D." Insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding."

ANS: A Insulin needs are reduced in the first trimester because of increased insulin production by the pancreas and increased peripheral sensitivity to insulin. "Insulin dosage will likely need to be increased during the second and third trimesters," "Episodes of hypoglycemia are more likely to occur during the first 3 months," and "Insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding" are accurate statements and signify that the woman has understood the teachings regarding control of her diabetes during pregnancy.

31. A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. She shows the nurse her readings for the past few days. Which one should the nurse tell her indicates a need for adjustment (insulin or sugar)? a. 75 mg/dL before lunch. This is low; better eat now. b. 115 mg/dL 1 hour after lunch. This is a little high; maybe eat a little less next time. c. 115 mg/dL 2 hours after lunch; This is too high; it is time for insulin. d. 60 mg/dL just after waking up from a nap. This is too low; maybe eat a snack before going to sleep.

ANS: D 60 mg/dL after waking from a nap is too low. During hours of sleep glucose levels should not be less than 70 mg/dL. Snacks before sleeping can be helpful. The premeal acceptable range is 65 to 95 mg/dL. The readings 1 hour after a meal should be less than 140 mg/dL. Two hours after eating, the readings should be less than 120

20. A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of approximately 120 beats/min without any decelerations. The interpretation of this test is said to be: a. negative. b. positive. c. satisfactory. d. unsatisfactory.

B

21. The nurse recognizes that a nonstress test (NST) in which two or more fetal heart rate (FHR) accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period is: a. nonreactive. b. positive. c. negative. d. reactive

B

23. The nurse is reviewing the contraction stress test (CST) reports of a pregnant patient. The nurse expects the fetus to have meconium-stained amniotic fluid. What would be the reason for that conclusion? A. Negative CST results B. Positive CST results C. Suspicious CST results D. Unsatisfactory CST results

B

55. An 8-month-pregnant female is sitting quietly with shallow breathing and a respiratory rate of 20. She states that she feels short of breath. What does this finding suggest to the nurse? a. The nurse should check the pulse oximetry reading since this is not a normal finding for an 8-month-pregnant woman. b. This is a normal finding during the third trimester of pregnancy. c. Due to her feeling of shortness of breath, she is using her accessory muscles to breathe. d. This is an abnormal finding and suggests that the fetus may be at risk for decreased oxygenation.

B

• A 45-year-old woman comes into the OB/GYN clinic for her yearly check up. The woman mentions to the nurse that she has a dimpling of the right breast that has occurred in the last 2 weeks. She has not performed a self-breast examination. What assessment would be most appropriate for the nurse to make? a. Evaluate the client's milk production. b. Palpate the area for a breast mass. c. Prescribe an immediate mammogram.

B

• A nurse is reviewing the medical record of a patient who is to undergo hysterosalpingography. Which of the following data alert the nurse that the patient is at risk for a complication related to this procedure? Vital Signs T 97 P 60 History & Physical Employed as a radiology tech Allergic to shrimp Lab Results glucose 103 mg/dI Hgb 13.1 Medications Rosuvastatin Magnesium Oxide A. Vital Signs B. History and Physical C. Laboratory results D. Medications

B

• The nurse is caring for a couple who are trying to get pregnant and have not been able to for over a year. The nurse explains to the couple that diagnostic testing usually begins on the male partner, as these tests are easier. The couple asks what kind of problem a man can have that can cause infertility. What would be the nurses best response? a. Men can have increased prolactin levels that decrease sperm viability b. "Men can have problems that increase the temperature around their testicles, which decreases the quality of their semen." c. Men may not have enough estrogen and FSH in their bodies to maintain testicular function d. Men may ejaculate into the bladder instead of the vagina

B

• the nurse is caring for a patient with endometriosis. the patient asks for an explanation of the disease. which of the following would be the nurses best response? a. It is an infection in the lining of the uterus b. Tissue from the lining of the uterus has implanted in an area outside the uterus c. The lining if the uterus is thicker than usual causing heavy bleeding and cramping d. The lining of the uterus is too thin because endometrial tissue has implanted outside the uterus

B

29. A 34 year old women at 36 weeks gestation has been scheduled for a biophysical profile. She asks the nurse why the tests needs to be performed. The nurse tells her that the test is performed because it a) determines how well her baby will breathe after its born. b) evaluates the response of her baby's heart to uterine contractions. c) measures her babes head and length d) observes her baby's activity in utero to ensure that her baby is getting enough oxygen

D

3. A nurse practitioner performs a clinical breast examination on a woman diagnosed with fibroadenoma. The nurse knows that fibroadenoma is characterized by: a. Inflammation of the milk ducts and glands behind the nipples. b. Thick, sticky discharge from the nipple of the affected breast. c. Lumpiness in both breasts that develops 1 week before menstruation. d. A single lump in one breast that can be expected to shrink as the woman ages.

D

54. Blood volume expansion during pregnancy leads to: a. Iron-deficiency anemia b. Maternal iron stores being insufficient to meet the demands for iron in fetal development c. Plasma fibrin increase of 40% and fibrinogen increase of 50% d. Physiological anemia of pregnancy

D

When nurses help their expectant mothers assess the daily fetal movement counts, they should be aware that: a. Alcohol or cigarette smoke can irritate the fetus into greater activity. b. "Kick counts" should be taken every half hour and averaged every 6 hours, with every other 6-hour stretch off. c. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours. d. Obese mothers familiar with their bodies can assess fetal movement as well as average-size women

c. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours.

The major advantage of chorionic villus sampling (CVS) over amniocentesis is that it a. is not an invasive procedure. b. does not require hospitalization. c. has less risk of spontaneous abortion. d. is performed earlier in pregnancy.

d. is performed earlier in pregnancy.