Exam #2 stdy guide maternal

The use of what during pregnancy is potentially most harmful to the fetus?

alcohol

A woman with preterm labor is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately?

diminished deep tendon reflexes

The nurse is reviewing the laboratory test results of a pregnant client. Which finding would alert the nurse to the development of HELLP syndrome?

elevated liver enzymes

When describing the process of fertilization, the nurse would explain that it normally occurs in which structure?

fallopian tube

A primapara woman, 30 weeks' gestation, has no family support and frequently calls the health care provider's office with questions. Which report by the woman would alert the nurse that she may be having a complication related to the pregnancy and needs to come to the clinic today for further assessment?

feeling of achy, cramping in vaginal area accompanied by bleeding that has saturated 1 pad/hour

A nurse is caring for an antenatal mother diagnosed with umbilical cord prolapse. For which should the nurse monitor the fetus?

fetal hypoxia

The maternal serum alpha fetoprotein blood test is performed on pregnant women to screen for which condition?

fetal neural tube defects

A woman asks the nurse if she can take an over-the-counter vitamin during pregnancy rather than her prescription prenatal vitamin. A chief ingredient in prenatal vitamins that makes them important for pregnancy nutrition is:

folic acid.

Two weeks after a vaginal birth, a client presents with low-grade fever. The client also reports a loss of appetite and low energy levels. The health care provider suspects an infection of the episiotomy. What sign or symptom is most indicative of an episiotomy infection?

foul-smelling vaginal discharge

A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find?

gestational diabetes

A client is admitted to the labor and birthing suite in early labor. On review of her prenatal history, the nurse determines that the client's pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal birth. Which pelvic shape would the nurse have noted?

gynecoid

Which condition is the most common cause of anemia in pregnancy?

iron-deficiency anemia

When teaching a class of pregnant women about the effects of substance use during pregnancy, the nurse would include which effect?

low-birthweight infants

What terminology would the nurse use to document a newborn who weighs 4,000 grams (8.13 lb) or more at birth?

macrosomia

After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first:

menstrual period

A client has asked that an opioid be kept on standby in case she needs it for pain control. As a precaution, the nurse will also have which of medication readily available to reverse the effects of that opioid?

naloxone

What is the term that refers to a woman who has never been pregnant?

nulligravida

A woman in labor for over 12 hours has very little progress. The health care provider thinks that her contractions lack the force needed to propel the infant downward through the birth canal. The provider asks a group of nursing students which hormone may need to be given to increase the force of the contraction. Which hormone would be the best answer?

oxytocin, a posterior pituitary hormone

During a difficult labor of an infant in the face presentation, the nurse notes the infant has a large amount of facial edema with bruising and ecchymosis. Which assessment would be the priority for this infant?

patent airway

On a routine hematocrit screen during a prenatal visit, the nurse notices that the client is mildly anemic. When discussing this with the couple, the husband hints that she might be eating unusual things. The nurse recognizes the need for the woman to be evaluated for which condition?

pica

The nursing student doing a clinical obstetrics rotation correctly picks which term to label a pregnancy that continues past the end of the 42nd week of gestation?

post-term pregnancy

A nurse is caring for a client who gave birth vaginally 2 hours ago. What postpartum complication can the nurse assess within the first few hours following birth?

postpartal hemorrhage

A nursing instructor identifies which factor as increasing the chances of infection when coupled with prolonged labor?

premature rupture of membranes

A woman having contractions comes to the emergency department. She tells the nurse that she is at 34 weeks' gestation. The nurse examines her and finds that she is already effaced and dilated 2 cm. What is this woman demonstrating?

preterm labor

A client comes to the emergency department reporting strong contractions that have lasted for the past 2 hours. Which assessment will indicate to the nurse that the client is in true labor?

progressive cervical dilatation and effacement

The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence?

quickening

A nursing student correctly identifies which action to be the best way to prevent complications of pregnancy?

receiving prenatal care

The injection of a local anesthetic to block specific nerve pathways is referred to as:

regional block.

A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which effect?

respiratory depression

Which neonatal assessment is the highest priority if the mother received meperidine during labor?

respiratory rate

Which assessment finding in a client reporting uterine contractions would be most consistent as an indicator of approaching labor?

rupture of amniotic membranes

A nurse urges a pregnant client at the first prenatal office visit to begin taking iron supplements immediately. What is the rationale for this intervention?

to avoid anemia

During a follow-up prenatal visit, a pregnant woman asks the nurse, "How long do you think I will be in labor?" Which response by the nurse would be most appropriate?

"It's difficult to predict how your labor will progress, but we'll be there for you the entire time."

A pregnant woman enjoys exercising at a local health spa once a week. Which comment would lead the nurse to believe she needs additional health teaching?

"Nothing feels nicer than a hot sauna after exercise."

The client is anxious about her prolonged pregnancy. She informs the nurse she has been doing research on the Internet and has read about certain herbs that can help to induce labor. Which response from the nurse would be appropriate?

"Please talk to your primary care provider first to ensure it is safe."

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she is not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor?

"The contractions slow down when I walk around."

During a prenatal visit, a pregnant woman says, "I know the amniotic fluid is important, but can you tell me more about it?" When describing amniotic fluid to a pregnant woman, which description would the nurse most likely include?

"This fluid acts as a cushion to help to protect your baby from injury."

A woman at 41 weeks' gestation is progressing well in labor; however, the nurse notes the amniotic fluid is greenish in color. When questioned by the client for the reason for this, which explanation should the nurse provide?

"This is meconium-stained fluid from the baby."

Which instruction would the nurse include in the teaching plan for a postpartum woman with mastitis?

"Try applying warm compresses to your breasts to encourage the milk to be released."

The nurse is preparing discharge instructions for a postpartum woman who has developed DVT after a long and difficult birthing process. The nurse will include instruction on which medication for this client?

Anticoagulants

The blood tests for a primigravida client indicate that the client is Rh-negative and her partner is Rh-positive. What is an appropriate nursing intervention for this client?

Arrange for Rho immune globulin at 28 weeks' gestation.

The nurse notes uterine atony in the postpartum client. Which assessment is completed next?

Assessment of the perineal pad

A nurse is a caring for a postpartum client. What instruction should the nurse provide to the client as a precautionary measure to prevent thromboembolic complications?

Avoid sitting in one position for long periods of time.

On the first prenatal visit, examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse documents this finding as:

Chadwick's sign

A nurse is monitoring the FHR of a client in labor using an electronic fetal monitor. The reading shows a late deceleration. Which intervention should the nurse implement?

Change maternal position to an upright or side lying position.

A pregnant client's last menstrual period was March 10. Using Naegele's rule, the nurse estimates the date of birth to be:

December 17.

A client who has been in prolonged labor reports extreme back pain. She asks why her back hurts so much. What would be the best response by the nurse?

Different fetal positions can cause prolonged labor and back pain.

Which medical pair is the highest concern if reported during a pregnant client's medical history?

Heart disease and diabetes

A pregnant woman who had stress incontinence during a previous pregnancy asks the nurse what could be done to manage this in her current pregnancy. What should the nurse recommend to the client?

Kegel exercises

The nurse is interacting with a young mother and her 2-week-old infant. Which behavior by the mother should the nurse prioritize and report to the RN or health care provider?

Not responding to the infant crying

A pregnant client at 23 weeks' gestation asks the nurse, "What is a doula?" Which statement should the nurse make?

"A doula is a person trained in birth who provides emotional and physical support.

A client asks why she should learn breathing patterns for labor. After instruction is given, the nurse determines teaching has been effective when the client states:

"Breathing patterns are distraction techniques taught to decrease pain in labor."

A nurse is caring for a pregnant client at her 34-week checkup. The client has chosen the Lamaze method for her birthing plan but states that her partner does not agree. The client says she will just change her plan. Which response by the nurse would be appropriate to support the female client?

"Have you and your partner discussed what his/her role will be in the birth?"

A pregnant woman gives birth to a term fetus who has died in utero. She requests time after the birth to hold her baby. What is the best response by the nurse?

"Hold your baby as long as you like. Please let me know what I can do to help you."

A group of nursing students are preparing a presentation which will illustrate various components of the birthing process. When presenting the pelvis, the students should point out that it is often referred to as which term?

Passageway

A client arrives at a health care facility in the latent phase of the first stage of labor. Which intervention should the nurse implement?

Provide emotional and physical support.

A nurse is coaching a woman during the second stage of labor. Which action should the nurse encourage the client to do at this time?

Push with contractions and rest between them.

A woman has heard that hypotension can be a problem during pregnancy, but she is not sure what it is or what causes it. The nurse explains that it is simply a temporary bout of low blood pressure due to impaired blood return to the heart. It is commonly caused by sleeping in a position that causes compression of the vena cava blood vessel. To avoid this condition, which suggestion should the nurse make?

Sleep on your side.

A prenatal client who is 6 weeks' gestation calls the clinic to report vaginal bleeding. For what concern will the nurse further assess the client?

Spontaneous abortion

A woman gave birth to a healthy baby girl 2 days ago. Which observation by the nurse indicates the need for additional assessment and follow up?

The woman tells a friend, referring to her baby, "It just cries all the time.

A nurse is caring for a client who has given birth. The client reports that her breast milk is dark yellow. Which information should the nurse give to the client regarding the situation?

The yellow fluid is colostrum and is rich in maternal antibodies.

When caring for a client with postpartum blues, which intervention would be most appropriate?

Validate the client's emotions, allowing her to express them freely.

A nurse is performing a nursing assessment on a new client. The woman estimates that she is approximately 16 weeks pregnant. While assessing her the nurse asks her about what appear to be scratch marks on her hands, and she tells the nurse that she has three cats at home. What screening would be prescribed for this woman?

toxoplasmosis

A nurse is reviewing a journal article on the causes of postpartum hemorrhage. Which condition would the nurse most likely find as the most common cause?

uterine atony

A pregnant woman is flying across the country to visit her family. After teaching the woman about traveling during pregnancy, which statement indicates that the teaching was successful?

"I'll get up and walk around the airplane about every 2 hours."

A pregnant client at 32 weeks' gestation calls the clinic and informs the nurse that she thinks her membranes are leaking. She states that some clear fluid has run down her leg. What is the best response by the nurse

"It is best for you to visit a hospital immediately. They can use a nitrazine strip to determine if it is amniotic fluid."

A woman's primary care provider has told her he wants to use an episiotomy for birth. She asks the nurse what the purpose of this is. Which answer would be best?

"It relieves pressure on the fetal head."

Assessment of a pregnant woman reveals that the presenting part of the fetus is at the level of the maternal ischial spines. The nurse documents this as which station?

0

Fetal heart rate monitoring reveals baseline tachycardia in the fetus. Which rate would be most likely?

164 beats per minute

A patient is in her 22nd week of pregnancy and is preparing to have her fundal height measured. Given the patient's stage of gestation and following McDonald's rule, what result does the nurse expect?

22 cm

The nurse determines that a woman is experiencing postpartum hemorrhage after a vaginal birth when the blood loss is greater than which amount?

500 mL

Dilation follows effacement in the primiparous mother. To be fully dilated, the cervix should have a distance of what measurement?

8 to 10 cm

A client in the latent phase of the first stage of labor is noted to be uncomfortable with intact membranes and mild contractions on assessment. The nurse should encourage the client to pursue which action?

Ambulation ad lib

A pregnant client in her second trimester reports feeling tired all the time. The nurse notes pale skin and low normal hemoglobin on assessment. Which recommendation should the nurse prioritize for this client?

An iron supplement

The nurse is conducting discharge teaching with a postpartum woman. What would be an important instruction for this client?

Call her caregiver if lochia moves from serosa to rubra.

A nurse is assisting a client who is in the first stage of labor. Which principle should the nurse keep in mind to help make this client's labor and birth as natural as possible?

Women should be able to move about freely throughout labor.

A couple is discussing starting a family with the nurse. When should the nurse suggest genetic counseling?

before they conceive

Which feature would alert the nurse that the client is in the transition phase of labor?

beginning urge to bear down

A nurse is assigned to care for a client with lacerations. The nurse knows that which factor would be the most likely cause of lacerations of the genital tract?

birth of a large newborn

A nursing student correctly identifies the problem of fetal buttocks instead of the head presenting first as which type of presentation?

breech presentation

A woman gave birth to a newborn via vaginal birth with the use of a vacuum extractor. The nurse would be alert for which possible effect in the newborn?

cephalhematoma

A nurse is caring for woman in labor. The woman's membranes just ruptured. The nurse assesses the characteristics of the fluid. Which finding would the nurse identify as normal?

clear

When assessing cervical effacement of a client in labor, the nurse assesses which characteristic?

degree of thinning

A pregnant client in her first trimester visits the health care facility for regular checkups. The nurse instructs the client to increase her dietary intake of folic acid based on the understanding that folic acid is important for which action?

decreasing incidence of birth defects