FINAL EXAM

Five P's of Labor

Passenger, passageway, powers, position, and psychological response

Which maternal factors should the nurse consider contributory to a newborn being large for gestational age? Select all that apply. A) diabetes mellitus B) postdates gestation C) alcohol use D) prepregnancy obesity E) renal infection

A) diabetes mellitus B) postdates gestation D) prepregnancy obesity

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

A) estrogen

Anencephaly

congenital deformity in which some or all of fetal brain is missing

normal blood loss for c-section

1,000 ml

When a pregnant client is victim of intimate partner violence during pregnancy, what complication is likely to occur after birth due to the abuse? A) edema B) postpartum depression C) low birth weight D) schizophrenia

B) postpartum depression

Positive signs of pregnancy

Fetal heartbeat obtained Fetus visualized on ultrasound

second stage of labor

Full dilation- BIRTH!!

Trophoblastic Disease

Gestational trophoblastic disease (GDP), also known as a molar pregnancy, is a nonviable mass of trophoblastic tissue

first assessment done on fertility assessment?

Sperm analysis

How to calculate Nageles rule

Subtract 3 months and add 7 days to the first day of the last menstrual period, then add one year.

A nurse is preparing a teaching plan for a woman who is planning to become pregnant. Which hormone secreted by the corpus luteum would the nurse include in the discussion when describing how the endometrium is prepped for egg implantation? (Ch-14; P-242; DL-34; B-Apply; CO-13) a. Progesterone b. Estrogen c. Testosterone d. Luteinizing hormone

a. Progesterone

Pap smear detects what?

abnormal cells

Bicornate uterus

abnormally shaped uterus

Milia

baby acne on nose and cheeks

fourth degree laceration

continues through anterior rectal wall- rectal mucuosa torn

What is an early symptom of vulvar cancer?

pruritus with genital burning

GnRH (gonadotropin-releasing hormone)

secreted by hypothalamus stimulates release of FSH and LH for ovulation

folic acid is important in moms who have?

seizures

meconium

the greenish material that collects in the intestine of a fetus and forms the first stools of a newborn

tonic neck reflex

turning the head to one side, extending the arm and leg on that side, and flexing the limbs on the opposite side

common sign of shoulder dystocia

turtles sign

_____ works by increasing viscosity of cervical mucus, suppressing ovulation, and thinning the uterine lining

COC

first degree laceration

Involves the superficial vaginal mucosa or perineal skin

T or F women are at a higher risk for abuse during pregnancy?

True!

sunken fontanels are a sign of what?

dehydration

Cephalopelvic disproportion (CPD)

inadequate pelvis size

marcrocephaly

large head

At what age should the first pap smear test be done?

21

Normal blood loss for vaginal birth

500 mL

Tocolytics used to suppress premature delivery:

Indomethacin: Nifedipine: Terbutaline: Magnesium sulfate

fundal height

Measurement of the size of the uterus (should coincide with age of fetus)

In reviewing the postpartum G3, P3 woman's history the nurse notes it is positive for obesity and smoking. The nurse recognizes this client is at risk for which complication? A) deep venous thrombosis B) uterine atony C) postpartum hemorrhage D) metritis

A) deep venous thrombosis

On the third day postpartum, which temperature is internationally defined as a postpartal infection? A) 99.6° F (37.5° C) B) 100.4° F (38° C) C) 102.4° F (39.1° C) D) 104.2° F (40.1° C)

B) 100.4° F (38° C)

______is the most commonly diagnosed bacterial STI in the United States

chlamydia

bacterial vaginosis

a condition in women in which there is an abnormal overgrowth of certain bacteria in the vagina

babinski sign

a reflex - swipe sole of foot to see if big toe flexes up

A nursing student is studying labor and delivery and has learned that the first stage of labor consists of which of the following phases? Select all that apply. 1 latent 2 pre-labor 3 active 4 transition 5 inactive

1. latent 3. active 4. transition

highest apgar score

10

Normal baby HR

110-160

The health care provider has determined that the source of dystocia for a woman is related to the fetus size. The nurse understands that macrosomia would indicate the fetus would weigh: A) 4,000 g or more. B) 3,500 g or more. C) 4,500 g or more. D) 3,000 g or more.

A) 4,000 g or more.

The nurse is assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms? A) trichomoniasis B) herpes simplex II C) human papillomavirus D) syphilis

A) trichomoniasis

The nursing student demonstrates an understanding of dystocia with which statement? A) "Dystocia is diagnosed at the start of labor." B) "Dystocia is not diagnosed until after the birth." C) "Dystocia is diagnosed after labor has progressed for a time." D) "Dystocia cannot be diagnosed until just before birth."

C) "Dystocia is diagnosed after labor has progressed for a time."

SGA

Small for gestational age [below 10th percentile]

Lochia alba

Whitish/yellowish discharge - lasts 10-14 days, may last 3-6 weeks and remain normal.

sign of placental abruption

painful bleeding

___ is responsible for the majority of cervical cancers

HPV

Resp distress in baby

Nasal flaring, chest retractions Grunting on exhalation, labored breathing

Signs of Trich?

Yellow green foamy discharge, pain, dysuria, irritation, itching, urinary frequency

A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which condition in the client is likely to increase the risk for shoulder dystocia? A) diabetes B) preterm birth C) nullipara D) pendulous abdomen

A) diabetes

The parents of a newborn are upset that their newborn needs treatment for ophthalmia neonatorum. The nurse should explain this is related to which maternal infection? Select all that apply. A) Chlamydia B) Gonorrhea C) Trichomonas D) Syphilis E) Candidiasis

A) Chlamydia B) Gonorrhea

Cardinal movements of labor

1. Engagement 2. Descent 3. Flexion 4. Internal Rotation 5. Extension 6. External Rotation 7. Expulsion

Subfertility/infertility is said to exist when a couple has failed to achieve pregnancy after how many months of unprotected sexual intercourse?

12 months

How many vaccines are given for HEP B?

3 doses, with the second dose 1 month after the first and the third dose 6 months after the first

A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history? (Ch14) A) G3, T1, P0, A2, L1 B) G3, T0, P1, A1, L1 C) G2, T1, P2, A1, L2 D) G2, T0, P1, A1, L1

B) G3, T0, P1, A1, L1

A nurse is educating a group of nursing students about the etiology of labor. Which of the following should the nurse explain as the hormone produced by the posterior pituitary? (CH15) A) Progesterone B) Oxytocin C) Estrogen D) Relaxin

B) Oxytocin

A nurse is conducting a presentation on violence and abuse for a community health program. When describing this concept, which information would the nurse include? Select all that apply. A) Violence against men by women is being significantly addressed. B) Violence against women often goes unrecognized and unreported. C) It ranks low on the scale as a cause for morbidity. D) Violence during pregnancy is rare occurrence. E) In some countries, violence against women is considered acceptable behavior.

B) Violence against women often goes unrecognized and unreported. E) In some countries, violence against women is considered acceptable behavior.

The nursing instructor is teaching about Bartholin cysts and informs the students that Bartholin cysts are the most common cystic growth in the vulva. She describes this type of cyst as being: A) a benign proliferation composed of smooth muscle and fibrous connective tissue in the uterus. B) a swollen, fluid-filled, sac-like structure. C) a small growth that is benign. D) an abnormal opening between a genital tract organ and and another organ.

B) a swollen, fluid-filled, sac-like structure.

The nurse suspects that a mother who delivered her infant 2 weeks ago is experiencing postpartum depression. What is the first line of treatment for this client? A) scheduling electroconvulsive therapy B) administrating a selective serotonin reuptake inhibitor C) talking to the client and reassuring her that she will feel better soon D) telling the client that she has no need to be depressed

B) administrating a selective serotonin reuptake inhibitor

When teaching a group of nursing students about the stages of labor, the nurse explains that softening, thinning, and shortening of the cervical canal occur during the first stage of labor. Which term is the nurse referring to in the explanation? A) crowning B) effacement C) dilatation D) molding

B) effacement

third stage of labor

Birth to delivery of placenta

A client is suspected of having endometrial cancer. The nurse would most likely prepare the client for which procedure to confirm the diagnosis? A) transvaginal ultrasound B) colposcopy C) Papanicolau test D) endometrial biopsy

D) endometrial biopsy

Radiation

Energy that is radiated or transmitted in the form of rays or waves or particles.

which cancer does not have a diagnostic test?

Ovarian cancer

Convection

The transfer of heat by the movement of a fluid

postpartum blues

a mild, transient emotional letdown experienced by a majority of women after giving birth should resolve within 2 weeks

There is no recognized safe amount of _______ in pregnancy

alcohol

During which time is the nurse correct to document the end of the third stage of labor? (Ch-16; P-300; DL-19; B-Apply; CO-1) a. Following fetal birth b. At the time of placental delivery c. When pushing begins d. When the mother is moved to the postpartum unit

b. At the time of placental delivery

Cold stress and the newborn

biggest concern resp. distress

The nurse is reviewing client data following a regular monthly appointment at 6 months' gestation. Which fundal height requires no further intervention? (Ch-15; P-280; DL-26; B-Apply; CO-6) a. 32 cm b. 30 cm c. 24 cm d. 18 cm

c. 24 cm

vernix caseosa

cheesy substance covering the skin of the fetus close term babies hardly have any vernix

main cause of placental abruption?

cocaine use

fourth stage of labor

delivery of placenta- 4 hours after

Estrogen

secreted by ovaries helpful in maturation of follicles towards end of proliferation phase. peaks before ovulation

microcephely

small head

Preterm rupture of membranes (PROM) is the rupture of membranes prior to the start of contractions at or after __ weeks?

37 weeks

The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which danger sign might occur at this point in her pregnancy? 1- dyspnea 2- lower abdominal pressure 3- swelling of extremities 4- excessive vomiting

4- excessive vomiting

The nurse instructs a patient on the use of a vaginal estrogen/progestin rings (NuvaRing) for contraception. Which patient statement indicates that additional instruction is needed? A) "I am to take the ring out overnight." B) "I will leave the ring in place for 3 weeks." C) "I leave the ring in place during intercourse." D) "I am to use other birth control if I take the ring out for 4 hours."

A) "I am to take the ring out overnight."

A nurse is conducting a presentation for a local women's group about urinary incontinence. During the presentation, several of the women voice statements about their beliefs related to this condition. Which statements would the nurse identify as misconceptions that need to be corrected? Select all that apply. A) "It is an inevitable part of aging." B) "It is an acceptable part of being a woman." C) "It can be corrected by surgery and other treatments." D) "It is considered a medical condition." E) "It is a condition that cannot be prevented."

A) "It is an inevitable part of aging." B) "It is an acceptable part of being a woman." E) "It is a condition that cannot be prevented."

A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal? A) 9 B) 7 C) 5 D) 3

A) 9

What postpartum client should the nurse monitor most closely for signs of a postpartum infection? A) A client who had a nonelective cesarean birth B) A primaparous client who had a vaginal birth C) A client who had an 8-hour labor D) A client who conceived following fertility treatments

A) A client who had a nonelective cesarean birth

The nurse is concerned that a new mother is developing a postpartum complication. What did the nurse most likely assess in this patient? A) Absence of lochia B) Red-colored lochia for the first 24 hours C) Lochia that is the color of menstrual blood D) Lochia appearing pinkish-brown on the fourth day

A) Absence of lochia

A young woman is having trouble conceiving and has come in to the office for fertility testing. She states that she has irregular and unpredictable menstrual cycles. On blood testing, it is found that her ovaries are producing excess testosterone, which is lowering her follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels. Which of the following is the most likely cause of her subfertility? A) Anovulation B) Endometriosis C) Tubal transport problems D) Stenotic cervical os

A) Anovulation

Assessment of a 26-week-old premature newborn reveals that the newborn is having problems with thermoregulation. The nurse would be alert for the development of which of the following? A) Apnea B) Tachycardia C) Sleepiness D) Crying

A) Apnea

A nurse is caring for an infant. A serum blood sugar of 40 was noted at birth. What care should the nurse provide to this newborn? A) Begin early feedings either by the breast or bottle. B) Give dextrose intravenously before oral feedings. C) Place infant on radiant warmer immediately. D) Focus on decreasing blood viscosity by introducing feedings.

A) Begin early feedings either by the breast or bottle.

A client has been seen and treated in the emergency room several times for injuries that are deemed suspicious. The client is reluctant to participate in a screening process. How best can the nurse provide reassurance to this client? A) Being nonjudgemental B) Giving assurances of help C) Establishing a plan to protect the client D) Having the client be honest about the injuries

A) Being nonjudgemental

The nurse is assessing a newborn who was born vaginally. The newborn was in the vertex position. The nurse notes that the newborn has some localized scalp edema primarily over the presenting part of the head. There is some bruising and edema that crosses the suture line. The nurse documents this finding as which of the following? A) Caput succedaneum B) Cephalhematoma C) Skull fracture D) Subgaleal hemorrhage

A) Caput succedaneum

The nurse has admitted a small for gestational age infant (SGA) to the observation nursery from the birth room. Which action would the nurse prioritize in the newborn's care plan? A) Closely monitor temperature. B) Assess for hyperglycemia. C) Monitor intake and output. D) Observe feeding tolerance.

A) Closely monitor temperature.

The nurse is weighing an infant and is ensuring that the scale is warmed and the procedure is performed as quickly as possible. Doing so allows the nurse to minimize the effects of heat loss by what method? A) Conduction B) Radiation C) Convection D) Evaporation

A) Conduction

The mother of four small children comes to the clinic and has just been diagnosed with an enterocele. What should the nurse teach the client about her diagnosis? A) Her small intestine and peritoneum are jutting downward between the uterus and the rectum. B) Her rectum is protruding into the back wall of the vagina. C) Her uterus has prolapsed and is causing this bulge. D) Her bladder is bulging into the front wall of the vagina.

A) Her small intestine and peritoneum are jutting downward between the uterus and the rectum.

A newborn is diagnosed with a patent ductus arteriosus and despite supportive treatment, the newborn continues to exhibit symptoms. Which of the following would the nurse anticipate as being prescribed? A) Indomethacin B) Aspirin C) Surfactant D) Penicillin

A) Indomethacin

The mother comes to her prenatal appointment. She tells the nurse that it feels like the baby is kicking on her bladder and it is harder to breathe. The nurse suspects the fetus is in breech position. Which procedure would the nurse implement to determine the position of the baby? A) Leopold maneuvers B) McRoberts maneuver C) Rubin maneuver D) Gaskin maneuver

A) Leopold maneuvers

The mother comes to her prenatal appointment. She tells the nurse that it feels like the baby is kicking on her bladder and it is harder to breathe. The nurse suspects the fetus is in breech position. Which procedure would the nurse implement to determine the position of the baby? A) Leopold maneuvers B) McRoberts maneuver C) Rubin maneuver D) Gaskin maneuver

A) Leopold maneuvers

A postpartum client saturates a peripad in 30 minutes. What is the nurse's first action in this situation? A) Massage the fundus B) Take a blood pressure C) Call the provider D) Encourage the client to void

A) Massage the fundus

A nurse is aware that the newborn's neuromuscular maturity is typically completed within 24 hours after birth. Which assessment would the nurse be least likely to complete to determine the newborn's degree of maturity? A) Moro reflex B) square window C) popliteal angle D) scarf sign

A) Moro reflex

What would the nurse suspect in a premature newborn who has difficulty feeding and maintaining a stable temperature and is vomiting bile? A) Necrotizing enterocolitis B) Meconium aspiration syndrome C) Intraventricular hemorrhage D) Respiratory distress syndrome

A) Necrotizing enterocolitis

The nurse is caring for a laboring mother. The mother continues to complain of back pain. The nurse instructs the mother the pain is occurring because the fetus is in which position? A) Occiput posterior B) Occiput transverse C) Left occiput anterior D) Right occiput anterior

A) Occiput posterior

he nurse is caring for a laboring mother who is experiencing a protracted active phase of labor. The nurse prepares for which two interventions to assist the mother through this phase of labor? A) Oxytocin and amniotomy B) Amniotomy and epidural anesthesia C) Oxytocin and epidural anesthesia D) Amniotomy and internal monitoring

A) Oxytocin and amniotomy

A nurse is caring for a newborn client who is diagnosed with myelomeningocele. Which nursing intervention would protect the newborn from injury? A) Place the newborn in a prone or lateral position. B) Delay the parents from holding the newborn. C) Place petroleum jelly gauze on the spinal sac to keep it moist. D) Place a urine collection bag on newborn for the continuous leakage.

A) Place the newborn in a prone or lateral position

A woman in labor suddenly reports sharp fundal pain accompanied by slight dark red vaginal bleeding. The nurse should prepare to assist with which situation? A) Premature separation of the placenta B) labor that was undiagnosed C) Placenta previa obstructing the cervix D) Possible fetal death or injury

A) Premature separation of the placenta

A nurse is preparing a discussion for a group of women at the clinic. When describing vaginal cancer, the nurse would most likely integrate which statement into the discussion? A) Pulmonary metastasis is common with adenocarcinomas of the vagina. B) Adenocarcinomas are the most common cell type. C) Squamous cell cancers develop rapidly and spread late. D) Squamous cell carcinomas are more common in women in their 40s.

A) Pulmonary metastasis is common with adenocarcinomas of the vagina.

A G3P2 woman at 39 weeks' gestation presents highly agitated, reporting something "came out" when her membranes just ruptured. Which action should the nurse prioritize after noting the umbilical cord is hanging out of the vagina? A) Put her in bed immediately, call for help, and hold the presenting part of the cord. B) With the woman in lithotomy position, hold her legs and sharply flex them toward her shoulders. C) Go find the RN or health care provider to care for the client. D) Prep the woman for an emergent vaginal birth.

A) Put her in bed immediately, call for help, and hold the presenting part of the cord.

A woman arrives at the office for her 4-week postpartal visit. Her uterus is still enlarged and soft, and lochial discharge is still present. Which nursing diagnosis is most likely for this client? A) Risk for fatigue related to chronic bleeding due to subinvolution B) Risk for infection related to microorganism invasion of episiotomy C) Risk for impaired breastfeeding related to development of mastitis D) Ineffective peripheral tissue perfusion related to interference with circulation secondary to development of thrombophlebi

A) Risk for fatigue related to chronic bleeding due to subinvolution

The nurse is assisting with a vaginal birth. The patient is fully dilated, 100% effaced and is pushing. The nurse observes the "turtle sign" with each push and there is no progress. What does the nurse suspect may be occurring with this fetus? A) Shoulder dystocia B) Umbilical cord prolapse C) Nuchal cord D) Breech position

A) Shoulder dystocia

]munity health center about congenital malformations. The nurse describes that some common congenital malformations can occur and are recognized to be caused by multiple genetic and environmental factors. Which example would the nurse most likely cite? A) Spina bifida B) cystic fibrosis C) color blindness D) hemophilia

A) Spina bifida

A client who is a victim of intimate partner violence fails to report the violence primarily because of which reason? A) The client feels responsible for causing the incident. B) The client does not want anyone to know. C) The client thinks it will not happen again. D) The client feels lucky to be alive.

A) The client feels responsible for causing the incident.

The nurse is assisting with a G2P1, 24-year-old client who has experienced an uneventful pregnancy and is now progressing well through labor. Which action should be prioritized after noting the fetal head has retracted into the vagina after emerging? A) Use McRoberts maneuver. B) Use Zavanelli maneuver. C) Apply pressure to the fundus. D) Attempt to push in one of the fetus's shoulders.

A) Use McRoberts maneuver.

A nurse is caring for a client who was raped at gunpoint. The client does not want any photos taken of the injuries. The client also does not want the police to be informed about the incident even though state laws require reporting life-threatening injuries. Which intervention should the nurse perform to document and report the findings of the case? A) Use direct quotes and specific language. B) Obtain photos to substantiate the client's case in a court of law. C) Document only descriptions of medical interventions taken. D) Respect the client's opinion and avoid informing the police.

A) Use direct quotes and specific language.

A 36-week neonate born weighing 1,800 g has microcephaly and microophthalmia. Based on these findings, which risk factor might be expected in the maternal history? A) Use of alcohol B) Use of marijuana C) Gestational diabetes D) Positive group B streptococci

A) Use of alcohol

A G2P1 woman is in labor attempting a VBAC, when she suddenly complains of light-headedness and dizziness. An increase in pulse and decrease in blood pressure is noted as a change from the vital signs obtained 15 minutes prior. The nurse should investigate further for additional signs or symptoms of which complication? A) Uterine rupture B) Hypertonic uterus C) Placenta previa D) Umbilical cord compression

A) Uterine rupture

A nurse is caring for a neonate of 25 weeks' gestation who is at risk for intraventricular hemorrhage (IVH). Which assessment finding should be reported immediately? A) a sudden drop in hemocrit B) soft, flat anterior fontanels C) pink skin with noted blue extremities D) intake and output for 8 hours

A) a sudden drop in hemocrit

A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity? A) administering HPV vaccine B) teaching about the importance of regular Papanicolau test C) educating about HPV testing in women over age 30 D) encouraging treatment for genital warts

A) administering HPV vaccine

Which intervention would be helpful to a bottle-feeding client who is experiencing hard or engorged breasts? A) applying ice B) restricting fluids C) applying warm compresses D) administering bromocriptine

A) applying ice

During the newborn's assessment, which finding would lead the nurse to suspect that a large-for-gestational-age newborn has experienced birth trauma? A) asymmetrical movement B) temperature instability C) seizures D) feeble sucking

A) asymmetrical movement

Which compound would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia? A) calcium gluconate B) potassium chloride C) ferrous sulfate D) calcium carbonate

A) calcium gluconate

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

A) cannot be palpated

The nurse should carefully screen a client who insists on using only combined oral contraceptives for which contraindication? A) deep vein thrombosis B) gastrointestinal disease C) impaired absorption D) use of alcohol

A) deep vein thrombosis

A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client? A) diminished reflexes B) elevated liver enzymes C) seizures D) serum magnesium level of 6.5 mEq/L

A) diminished reflexes

Vulvar cancer is suspected in a client. When reviewing the client's history which report would the nurse most likely find? Select all that apply. A) dyspareunia B) persistent vulvar itching C) history of herpes simplex D) lesion on the cervix E) abnormal Papanicolau test result

A) dyspareunia B) persistent vulvar itching C) history of herpes simplex

A multipara client develops thrombophlebitis after birth. Which assessment findings would lead the nurse to intervene immediately? A) dyspnea, diaphoresis, hypotension, and chest pain B) dyspnea, bradycardia, hypertension, and confusion C) weakness, anorexia, change in level of consciousness, and coma D) pallor, tachycardia, seizures, and jaundice

A) dyspnea, diaphoresis, hypotension, and chest pain

A client presents for her annual Papanicolau test. She wants to know about the risk factors that are associated with cervical cancer. Which risk factor for cervical cancer should the nurse inform the client about? A) early age at first intercourse B) obesity (at least 50 lb [22.7 kg] overweight) C) hypertension D) infertility

A) early age at first intercourse

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common? A) endometriosis B) multigravida status C) hormonal imbalance D) perimenopause

A) endometriosis

After teaching a health education class on the female reproductive cycle, the nurse determines that the teaching was effective when the group identifies which phase as belonging to the ovarian cycle? (Ch14) A) follicular phase B) proliferative phase C) secretory phase D) ischemic phase

A) follicular phase

The newborn nursery nurse suspects a newborn of having neonatal abstinence syndrome. What assessment findings would most correlate with the diagnosis? A) frequent yawning and sneezing B) vigorous rooting and feeding C) positive Babinski and Moro refelxes D) cyanotic discoloration of the hands and feet

A) frequent yawning and sneezing

When preparing a teaching plan for a female adolescent with a sexually transmitted infection (STI), the nurse plans to address the fact that the adolescent is at increased risk for cervical cancer. Which STI would the adolescent most likely have? A) genital warts B) genital herpes C) syphilis D) chlamydia

A) genital warts

Prevention and early identification of newborns at risk are necessary nursing functions. A nurse anticipates the need for newborn resuscitation secondary to birth asphyxia based on which prenatal risk factors? Select all that apply. A) gestational hypertension B) maternal infection C) congenital heart disease D) nulliparous mother E) labor and birth without anesthesia

A) gestational hypertension B) maternal infection C) congenital heart disease

The AGPAR score is based on which 5 parameters? A) heart rate, muscle tone, reflex irritability, respiratory effort, and color B) heart rate, breaths per minute, irritability, reflexes, and color C) heart rate, respiratory effort, temperature, tone, and color D) heart rate, breaths per minute, irritability, tone, and color

A) heart rate, muscle tone, reflex irritability, respiratory effort, and color

A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this as: A) hydatidiform mole. B) ectopic pregnancy. C) placenta accrete. D) hydramnios.

A) hydatidiform mole.

The nursing instructor is pointing out the various complcations which can occur during pregnancy in women with diabetes mellitus. The instructor determines the session is successful after the students correctly choose which complication that can occur if the diabetes is not kept under control? A) hydramnios B) placenta previa C) cerebral vascular accident D) hypotension

A) hydramnios

An infant that is diagnosed with meconium aspiration displays which symptom? A) intercostal and substernal retractions B) pink skin C) respirations of 45 D) no heart murmur

A) intercostal and substernal retractions

The nurse is providing contraception counseling to a perimenopausal woman who has had negative reactions to oral contraceptives in the past and would like a long-term, nonhormone-based method that has a high rate of success. Neither she nor her husband wants to undergo surgery, however. Which method should the nurse recommend? A) intrauterine device B) transdermal patch C) subdermal progestin implant D) tubal ligation

A) intrauterine device

An Rh positive client vaginally gives birth to a 6 lb, 10 oz (3,005 g) neonate after 17 hours of labor. Which condition puts this client at risk for infection? A) length of labor B) maternal Rh status C) method of birth D) size of the neonate

A) length of labor

A nurse is assessing a client's lochia every 15 minutes for the first hour during the fourth stage of labor. Which finding would the nurse expect to assess? A) moderate lochia rubra with a fleshy odor B) lochia alba saturating at least 3 pads C) lochia rubra with large clots D) lochia rubra saturating two pads

A) moderate lochia rubra with a fleshy odor

The nurse is preparing a new mother to be discharged home after an uncomplicated delivery. Which type of lochia pattern should the nurse point out needs to be reported to her primary care provider immediately during the discharge teaching? A) moderate lochia serosa on day 4 postpartum, increasing in volume and changing to rubra on day 5 B) moderate flow of lochia rubra on day 3 postpartum, changing to serosa on day 5 C) lochia progresses from rubra to serosa to alba within 10 days D) moderate lochia rubra on day 3, mixed serosa and rubra on day 4, light serosa on day 5

A) moderate lochia serosa on day 4 postpartum, increasing in volume and changing to rubra on day 5

A victim of rape is exhibiting symptoms of posttraumatic stress disorder (PTSD) which the nurse interprets as indicative of intrusion. Which symptoms would the client be exhibiting? Select all that apply. A) nightmares B) recurrent thoughts C) flashbacks D) social withdrawal E) emotional numbing

A) nightmares B) recurrent thoughts C) flashbacks

A young woman is newly married and is seeking advice on contraception. She is in a monogamous relationship and would like a temporary contraceptive, as she plans to have children in the future. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea and has a history of recurrent urinary tract infections. Which method should the nurse recommend? A) oral contraceptive B) postcoital douching C) diaphragm D) vasectomy

A) oral contraceptive

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about? A) overstimulation of the ovary resulting in potential multiple births B) extensive bleeding during menstruation C) elevation of her blood glucose level D) hypertension

A) overstimulation of the ovary resulting in potential multiple births

Which findings would lead the nurse to suspect that a postpartum woman has developed metritis? Select all that apply. A) pain on both sides of the abdomen B) foul-smelling lochia C) hematuria D) flank pain E) leukocytosis

A) pain on both sides of the abdomen B) foul-smelling lochia E) leukocytosis

A nurse is working with a victim of intimate partner violence. Which intervention would be most important for this client? A) providing for the client's safety B) reassuring the client he or she is not alone C) documenting the violence D) educating about the cycle of violence

A) providing for the client's safety

A nurse is providing teaching about lifestyle modifications to address a client's pelvic organ prolapse. The nurse understand that the majority of these changes focus on: A) reducing intra-abdominal pressure. B) increasing muscle tone. C) providing mechanical support. D) preventing incontinence.

A) reducing intra-abdominal pressure.

During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn? A) respiratory function B) heart rate C) temperature D) urine output

A) respiratory function

A nurse is caring for a newborn with fetal alcohol spectrum disorder. What characteristic of the fetal alcohol spectrum disorder should the nurse assess for in the newborn? A) small head circumference B) decreased blood glucose level C) poor breathing pattern D) wide eyes

A) small head circumference

A client was in labor for more than 36 hours and now reports urine leaking from her vagina. On examination the nurse would be inspecting for: A) urethrovaginal fistula. B) vesicovaginal fistula. C) urge incontinence fistula. D) rectovaginal fistula.

A) urethrovaginal fistula.

The nurse who counsels clients who suffer from intimate partner violence understands that abuse can come in which different forms? Select all that apply. emotional abuse physical abuse financial abuse sexual abuse spiritual abuse

ALL but spiritual abuse

A gravid woman in her second trimester has shared that she still enjoys a glass of wine about once a week with dinner. What response by the nurse is most appropriate? A) "Now that you have reached the second trimester you are at a reduced risk for causing complications to your fetus." B) "There is no amount of alcohol consumption in pregnancy that is considered safe for the fetus." C) "As long as you do not increase the amount of alcohol you are drinking there is little risk." D) "The best thing for you to do is to reduce the amount of alcohol you are drinking." E) "The best thing for you to do is to reduce the amount of alcohol you are drinking."

B) "There is no amount of alcohol consumption in pregnancy that is considered safe for the fetus."

A client has been given instructions about a scheduled sonohysterosalpingogram. Which statement, if made by the client, should indicate to a nurse that the client has an adequate understanding of the instructions? A) "I will be put under general anesthesia for the procedure." B) "They will place a catheter in my uterus and use an ultrasound to see what the problem is." C) "This is just an ultrasound procedure, like they do for a baby." D) "They will surgically implant the ovum during the procedure."

B) "They will place a catheter in my uterus and use an ultrasound to see what the problem is."

A client gave birth to a child 3 hours ago and noticed a triangular-shaped gap in the bones at the back of the head of her newborn. The attending nurse informs the client that it is the posterior fontanelle. The client is anxious to know when the posterior fontanelle will close. Which time span is the normal duration for the closure of the posterior fontanelle? A) 4 to 6 weeks B) 8 to 12 weeks C) 12 to 14 weeks D) 14 to 8 weeks

B) 8 to 12 weeks

The nurse walks into a client's room and notes a small fan blowing on the mother as she holds her infant. The nurse should explain this can result in the infant losing body heat based on which mechanism? A) Conduction B) Convection C) Radiation D) Evaporation

B) Convection

A woman is 2 weeks postpartum when she calls the clinic and tells the nurse that she has a fever of 101°F (38.3°C). She reports abdominal pain and a "bad smell" to her lochia. The nurse recognizes that these symptoms are associated with which condition? A) Mastitis B) Endometritis C) Subinvolution D) Episiotomy infection

B) Endometritis

The nurse assesses that the fetus of a woman is in an occiput posterior position. The nurse predicts the client will experience which situation related to this assessment? A) Shorter dilatational stage of labor B) Experience of additional back pain C) Need to have the baby manually rotated D) Necessity for vacuum extraction for birth

B) Experience of additional back pain

A nurse is working with a client who is anticipating the possibility of leaving a relationship with intimate partner violence. In helping the client make the decision to leave or to stay in the abusive situation, which action would be most important for the nurse to take? A) Ensure the client understands the behaviors inherent in the cycle of intimate partner violence. B) Explain to the client how to develop a safety plan for leaving the relationship. C) Assist the client in finding a new apartment and a new job. D) Suggest that the client legally change his or her name and move out of state.

B) Explain to the client how to develop a safety plan for leaving the relationship.

A client has been confirmed to be pregnant. She gives a history of two previous full-term normal pregnancies. How will the nurse classify the client's pregnancy history? A) G3, P0 B) G3, P2 C) G2, P1 D) G2, P3

B) G3, P2

The nurse is caring for a client believed to be a victim of human trafficking. What action is mostimportant for the nurse to perform? A) Notify the authorities. B) Gain the client's trust. C) Test for pregnancy. D) Assess for bruising.

B) Gain the client's trust.

A 45-year-old client and her spouse are present in the clinic. Results of fertility testing indicate that the client has damage to her fallopian tubes. Which would be the most appropriate infertility option for this client? A) Gamete intrafallopian transfer B) In vitro fertilization C) Surrogate mother D) Ovulation stimulation

B) In vitro fertilization

A nurse is caring for a preterm newborn born at 29 weeks' gestation. Which nursing diagnosis would have the highest priority? A) Grieving related to the loss of "a healthy full-term newborn" B) Ineffective thermoregulation related to decreased amount of subcutaneous fat C) Risk for injury related to the very thin epidermis layer of skin D) Imbalanced nutrition: Less than body requirements related to the premature digestive system

B) Ineffective thermoregulation related to decreased amount of subcutaneous fat

A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby? A) Administer cephalosporins to mother during pregnancy. B) Instill a prophylactic agent in the eyes of the newborn. C) Perform cesarean birth to prevent infection. D) Administer an antiretroviral syrup to the newborn.

B) Instill a prophylactic agent in the eyes of the newborn.

The nurse cares for preterm infants and assesses them for potential complications to provide adequate countermeasures to prevent futher complications. Which complication should the nurse prioritize and initiate proper measures to protect the newborn? A) Decreased muscle tone B) Loss of body heat C) Excess antibodies acquired from the mother D) Increased caloric intake

B) Loss of body heat

A woman presents at Labor and Delivery very upset. She reports that she has not felt her baby moving for the last 6 hours. The nurse listens for a fetal heart rate and cannot find a heartbeat. An ultrasound confirms fetal death and labor induction is started. What intervention by the nurse would be appropriate for this mother at this time? A) Explain to her that there was probably something wrong with the infant and that is why it died. B) Offer to take pictures and footprints of the infant once it is delivered. C) Call the hospital chaplain to talk to the parents. D) Recommend that she not hold the infant after it is delivered so as to not upset her more.

B) Offer to take pictures and footprints of the infant once it is delivered.

A 24-year-old primigravida client at 39 weeks' gestation presents to the OB unit concerned she is in labor. Which assessment findings will lead the nurse to determine the client is in true labor? A) The contraction pains are 2 minutes apart and 1 minute in duration. B) The client reports back pain, and the cervix is effacing and dilating. C) The contraction pains have been present for 5 hours, and the patterns are regular. D) After walking for an hour, the contractions have not fully subsided.

B) The client reports back pain, and the cervix is effacing and dilating.

Which statement best expresses the role of the corpus luteum? (Ch14) A) The corpus luteum promotes the increased production of estrogen before ovulation. B) The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. C) During the luteal phase, the corpus luteum secretes glycogen. D) Increasing amounts of cervical mucus are produced as a result of the luteinizing hormone produced by the corpus luteum.

B) The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation.

The nurse has administered erythromycin ointment to a newborn. What outcome indicates this nursing intervention has been effective? A) The newborn's active eye infection resolves. B) The newborn does not contract opthalmia neonatorum. C) The newborn's sclerae do not appear yellow. D) The newborn is about to produce sufficient tears.

B) The newborn does not contract opthalmia neonatorum.

A young woman has been referred for a colposcopy by the health care provider. The nurse is educating the woman on the procedure. Which information about the colposcopy should the nurse provide? A) The procedure may be painful. B) The results of the Papanicolau test were abnormal; therefore, this procedure must be done. C) Sexual intercourse should be avoided for 2 weeks. D) There may be some pain while urinating for up to 1 week after the test.

B) The results of the Papanicolau test were abnormal; therefore, this procedure must be done.

A one-day-old neonate born at 32 weeks' gestation is in the neonatal intensive care unit under a radiant overhead warmer. The nurse assesses the morning axilla temperature as 95 degrees F (35 degrees C). What could explain the assessment finding? A) Conduction heat loss is a problem in the baby. B) The supply of brown adipose tissue is not developed. C) Axillary temperatures are not accurate. D) This is a normal temperature.

B) The supply of brown adipose tissue is not developed.

The nurse is caring for clients who have STIs. Which client is most at risk for becoming infertile due to the infection? A) a woman diagnosed with trichomoniasis B) a woman diagnosed with chlamydia C) a woman diagnosed with syphilis D) a woman diagnosed with herpes simplex virus

B) a woman diagnosed with chlamydia

When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which schedule would be most appropriate? A) monthly visits until 32 weeks, then bi-monthly visits B) bi-monthly visits until 28 weeks, then weekly visits C) monthly visits until 20 weeks, then bi-monthly visits D) bi-monthly visits until 36 weeks, then weekly visits

B) bi-monthly visits until 28 weeks, then weekly visits

A client reports that she has multiple sex partners and has a lengthy history of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which method should the nurse suggest for this client? A) intrauterine device (IUD) B) condoms C) oral contraceptives (OCs) D) tubal ligation

B) condoms

Which finding would the nurse expect in a client with bacterial vaginosis? A) vaginal pH of 3 B) fish-like odor of discharge C) yellowish-green discharge D) cervical bleeding on contact

B) fish-like odor of discharge

On an Apgar evaluation, how is reflex irritability tested? (Ch18) A) raising the infant's head and letting it fall back B) flicking the soles of the feet and observing the response C) dorsiflexing a foot against pressure resistance D) tightly flexing the infant's trunk and then releasing it

B) flicking the soles of the feet and observing the response

The nurse would be alert for possible placental abruption during labor when assessment reveals which finding? A) macrosomia B) gestational hypertension C) gestational diabetes D) low parity

B) gestational hypertension

The nurse is making a home visit to a woman who is 5 days postpartum and has no reports. Which finding would concern the nurse and warrant further investigation? A) uterus 5 cm below umbilicus B) lochia rubra C) edematous vagina D) diaphoresis

B) lochia rubra

The nursing instructor is teaching a class on the menstrual cycle. The instrucor determines the class is successful when the class correctly chooses which hormone that is responsible for initating ovulation? A) progesterone B) luteinizing hormone C) estrogen D) follicle-stimulating hormone

B) luteinizing hormone

After teaching an in-service program to a group of nurses working in newborn nursery about a neutral thermal environment, the nurse determines that the teaching was successful when the group identifies which process as the newborn's primary method of heat production? A) convection B) nonshivering thermogenesis C) cold stress D) bilirubin conjugation

B) nonshivering thermogenesis

A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the: A) amniotic fluid. B) placenta. C) birth canal. D) breast milk.

B) placenta.

A patient who experiences premature rupture of membranes can expect to be put on pelvic rest. The nurse should explain to the patient that pelvic rest involves which of the following? A) staying in bed at all times B) placing nothing in the vagina C) staying in bed with bathroom privileges D) staying off of the feet the majority of the day

B) placing nothing in the vagina

The nurse is assessing a client at a postpartum visit and notes the client is emotionally sensitive, complains about being a failure, and appears extremely sad. The nurse concludes the client is presenting with which potential condition? A) postpartum blues B) postpartum depression C) postpartum psychosis D) anxiety disorders

B) postpartum depression

A nurse is assessing a client with polycystic ovary syndrome for metabolic syndrome. Which findings would the nurse assess? Select all that apply. A) waist circumference 32 inches B) triglyceride level 175 mg/dL C) HDL 60 mg/dL D) elevated C-reactive protein E) hypotension

B) triglyceride level 175 mg/dL D) elevated C-reactive protein

Which finding would alert the nurse to suspect that a client has a yeast infection? A) changes in skin color B) vulvar burning and itching C) lymphadenopathy D) acidic vaginal secretions

B) vulvar burning and itching

A nurse is preparing an in-service program about labor and the hormones involved with the initiation of labor. Which information would the nurse include as believing to play a role in the onset of labor? A) suppression of prostaglandin release B) withdrawal of progesterone C) decrease in fetal cortisol levels D) supression of oxytocin

B) withdrawal of progesterone

Chadwick's sign

Bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascular congestion.

Lochia rubra

Bright red, clots, 1-3 days after delivery

A nurse is screening a client for intimate partner violence using indirect questions. Which question would the nurse most likely ask? A) "I know it can be difficult to talk about, but does your partner hit you?" B) "Have you ever been abused?" C) "Clients with your injuries are often abused. Is anything like this happening now?" D) "It's okay to talk about this subject. Are you in an abusive relationship?"

C) "Clients with your injuries are often abused. Is anything like this happening now?"

The experienced labor and birth nurse knows to evaluate progress in active labor by using which simple rule? A) 2 cm/hour for cervical dilation B) 1/2 cm/hour for cervical dilation C) 1 cm/hour for cervical dilation D) 1/4 cm/hour for cervical dilation

C) 1 cm/hour for cervical dilation

A client has had a cesarean birth. Which amount of blood loss would the nurse document as a postpartum hemorrhage in this client? A) 500 mL B) 750 mL C) 1000 mL D) 250 mL

C) 1000 mL

Why is it important for the nurse to thoroughly assess maternal bladder and bowel status during labor? A) If the woman has a full bladder, labor may be uncomfortable for her. B) If the woman's bladder is distended, it may rupture. C) A full bladder or rectum can impede fetal descent. D) A full rectum can cause diarrhea.

C) A full bladder or rectum can impede fetal descent.

Which initial interview technique would be least effective in gathering information from a suspected abuse victim? A) Ask open-ended, non-judgmental questions of the client. B) Avoid questions that appear accusatory such as "Why don't you just leave him?" C) Ask the client to strip down and show you where she has been hurt. D) Convey to the client that the abuse is not her fault, such as "No one deserves to be treated like this."

C) Ask the client to strip down and show you where she has been hurt.

The nurse is performing an assessment on a 2-day postpartum client and discovers a boggy fundus at the umbilicus and slightly to the right. The nurse determines that this is most likely related to which situation? A) Uteruine atony B) Full bowel C) Bladder distention D) Poor bladder tone

C) Bladder distention

One of the primary assessments a nurse makes every day is for postpartum hemorrhage. What does the nurse assess the fundus for? A) Content, lochia, place B) Location, shape, and content C) Consistency, shape, and location D) Consistency, location, and place

C) Consistency, shape, and location

A nurse working in a community health education program is assigned to educate community members about sexually transmitted infections (STIs). Which nursing strategy should be adopted to prevent the spread of STIs in the community? A) Promote use of oral contraceptives. B) Emphasize the importance of good body hygiene. C) Discuss limiting the number of sex partners. D) Emphasize not sharing personal items with others.

C) Discuss limiting the number of sex partners.

A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records? A) G2 T2 P1 A0 L2 B) G2 T1 P1 A1 L1 C) G3 T0 P1 A1 L2 D) G3 T2 P2 A0 L1

C) G3 T0 P1 A1 L2

By preventing fetal distress during the intrapartum period, which condition is less likely? A) Hemolytic disease of the newborn B) Transient tachypnea of the newborn C) Meconium aspiration syndrome D) Neonatal abstinence syndrome

C) Meconium aspiration syndrome

The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client? A) Monitor the client's beta-hCG level. B) Monitor the mass with transvaginal ultrasound. C) Monitor the client's vital signs and bleeding. D) Monitor the fetal heart rate (FHR).

C) Monitor the client's vital signs and bleeding.

The nurse should carefully monitor which neonate for hyperbilirubinemia? A) Black neonate B) Neonate of an Rh-positive mother C) Neonate with ABO incompatibility D) Neonate with Apgar scores 9 and 10 at 1 and 5 minutes

C) Neonate with ABO incompatibility

The father of a 2-week-old infant presents to the clinic with his disheveled wife for a postpartum visit. He reports his wife is acting differently, is extremely talkative and energetic, sleeping only 1 or 2 hours at a time (if at all), not eating, and appears to be totally neglecting the infant. The nurse should suspect the client is exhibiting signs and symptoms of which disorder? A) Postpartum blues B) Postpartum depression C) Postpartum psychosis D) Maladjustment

C) Postpartum psychosis

A client at 27 weeks' gestation is admitted to the OB unit afer reporting headaches and edema of her hands. Review of the prenatal notes reveals BP consistently above 136/90 mm Hg. The nurse anticipates the health care provider will order magneisum sulfate to accomplish which primarygoal? A) Decrease blood pressure B) Decrease protein in urine C) Prevent maternal seizures D) Reverse edema

C) Prevent maternal seizures

The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 1, BP 148/110 mm Hg. What other priorityphysical assessments by the nurse should be implemented to assess for potential toxicity? A) Lung sounds B) Oxygen saturation C) Reflexes D) Magnesium sulfate level

C) Reflexes

Labor dystocia is an abnormal progression of labor. It is the most common cause of primary cesarean birth. When is it most common for labor dystocia to occur? A) Fourth stage of labor B) Third stage of labor C) Second stage of labor D) First stage of labor

C) Second stage of labor

Parents tell the nurse that they have been told to keep their newborn away from windows and be sure to cover the baby with a light blanket. They do not understand why this is necessary. What rationale would the nurse provide for this care? A) Newborns weighing below 8 pounds lack enough brown fat to produce heat. B) Windows can be drafty and placing the newborn by one can result in evaporative heat loss. C) Since newborns cannot shiver to produce heat, parents need to be sure to keep them covered up and away from sources of heat loss like a window. D) Newborns have very thin skin, which allows radiant heat loss.

C) Since newborns cannot shiver to produce heat, parents need to be sure to keep them covered up and away from sources of heat loss like a window.

Which sign appears early in a neonate with respiratory distress syndrome? A) Bilateral crackles B) Pale gray skin color C) Tachypnea more than 60 breaths/minute D) Poor capillary filling time (3 to 4 seconds)

C) Tachypnea more than 60 breaths/minute

The nurse is caring for a client at 39 weeks' gestation and whose fetal station is noted as a 0 (zero). The nurse is correct to document which? A) The client is fully effaced. B) The fetus is floating high in the pelvis. C) The fetus is in the true pelvis and engaged. D) The fetus has descended down the birth canal.

C) The fetus is in the true pelvis and engaged.

The nurse is caring for a client who underwent a cesarean birth 24 hours ago. Which assessment finding indicates the need for further action? A) The client is having a moderate amount of rubra lochia. B) The client requires assistance to ambulate in the hallway. C) The fundus is located 2 fingerbreadths above the umbilicus. D) The client is afibrile. E) Bowel sounds are active.

C) The fundus is located 2 fingerbreadths above the umbilicus.

The nurse completes instructing a patient on the use of the contraceptive patch. Which patient response indicates that teaching has been effective? A) The patch is immediately effective after application. B) The patch should be applied to the breasts, hips, or back. C) The patch should be applied to the abdomen, buttocks, or back. D) The patch should be covered when swimming because of chlorine's effect on the adhesive.

C) The patch should be applied to the abdomen, buttocks, or back.

A pregnant woman at term is in the obstetrics unit for induction in the morning. Her membranes rupture, and the external fetal monitor shows deep variable decelerations. For what should the nurse immediately check the patient? A) Amniotic fluid infection B) Amniotic fluid embolus C) Umbilical cord prolapse D) Placental abruption

C) Umbilical cord prolapse

The nurse is performing a cardiac assessment on a newborn and hears a loud, harsh murmur associated with a systolic thrill. What congenital heart defect does the nurse suspect? A) septal defect B) Patent ductus arteriosus C) Ventricular septal defect D) Coarctation of the aorta

C) Ventricular septal defect

Which woman is at greatest risk for developing cervical cancer? A) a client who lacks access to or use of health care B) a client who comes from lower socioeconomic status C) a client whose high-risk HPV infection persists in genital skin cells D) a client who has a high intake of alcohol and nicotine

C) a client whose high-risk HPV infection persists in genital skin cells

A nurse will be speaking at a local high school about women's health. The nurse is planning to talk about sexually transmitted infections (STIs) as well as routine checks, along with guidelines for Papanicolau testing. What should the nurse include in the Papanicolau test guidelines about when to have a first test? A) at the age of 16 B) 2 years after first sexual intercourse C) at the age of 21 or within 3 years of first sexual intercourse D) at the age of 18 or within 2 years of first sexual intercourse

C) at the age of 21 or within 3 years of first sexual intercourse

A nurse is caring for a client who has just given birth. What is the best method for the nurse to assess this client for postpartum hemorrhage? A) by assessing skin turgor B) by assessing blood pressure C) by frequently assessing uterine involution D) by monitoring hCG titers

C) by frequently assessing uterine involution

Assessment of a female client reveals a thick, white vaginal discharge. The client also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has: A) trichomoniasis. B) bacterial vaginosis. C) candidiasis. D) genital herpes simplex.

C) candidiasis.

While performing a physical assessment of a newborn boy, the nurse notes diffuse edema of the soft tissues of his scalp that crosses suture lines. The nurse documents this finding as: A) molding. B) microcephaly. C) caput succedaneum. D) cephalhematoma.

C) caput succedaneum.

A group of nurses are attending an in-service program on STIs. The group demonstrates understanding of the information when they identify which STI as the most commonly reported bacterial STI in the United States? A) gonorrhea B) syphilis C) chlamydia D) candidiasis

C) chlamydia

In which clients is it most important to understand the importance of an annual Papanicolaou test? A) clients with a history of recurrent candidiasis B) clients with a pregnancy before age 20 C) clients infected with the human papillomavirus (HPV) D) clients with a long history of hormonal contraceptive use

C) clients infected with the human papillomavirus (HPV)

A client with a family history of cervical cancer is to undergo a Papanicolau test. During the client education, what group should the nurse include as at risk for cervical cancer? A) clients with irregular menstrual cycles B) clients who have not had babies C) clients who have genital warts D) clients with fibrocystic breast disease

C) clients who have genital warts

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

C) diaphragm

A woman in the 15th week of gestation is planning on terminating the pregnancy. The procedure done for second trimester terminations is which of the following? A) menstrual extraction B) dilatation and curettage C) dilatation and extraction D) hysterotomy

C) dilatation and extraction

A nurse is developing a plan of care for a woman who is at risk for thromboembolism. Which measure would the nurse include as the most cost-effective method for prevention? A) prophylactic heparin administration B) compression stockings C) early ambulation D) warm compresses

C) early ambulation

A nursing instructor is teaching students about fetal presentations during birth. The most common cause for increased incidence of shoulder dystocia is: A) longer lengths of labor. B) increased number of overall pregnancies. C) increasing birth weight. D) poor quality of prenatal care.

C) increasing birth weight.

A nurse is caring for a newborn whose chest X-ray reveals marked hyperaeration mixed with areas of atelectasis. The infant's arterial blood gas analysis indicates metabolic acidosis. For which dangerous condition should the nurse prepare when providing care to this newborn? A) choanal atresia B) diaphragmatic hernia C) meconium aspiration syndrome D) pneumonia

C) meconium aspiration syndrome

A client has an abnormal Papanicolau test result that is classified as ASC-US. Based on the nurse's understanding of this classification, the nurse would expect which procedure? A) Immediate colposcopy B) testing for human papillomavirus (HPV) C) repeat Papanicolau test in 4 to 6 months D) cone biopsy

C) repeat Papanicolau test in 4 to 6 months

A nurse is performing a newborn assessment and notices a small dimple on the sacral area. The infant has a normal neurological assessment and moves all extremities well. What does the nurse suspect that the dimple indicates? A) a normal spinal closure B) spina bifida with menigocele C) spina bifida occulta D) spina bifida with myelomeningocele

C) spina bifida occulta

Review of a woman's labor and birth record reveals a laceration that extends through the anal sphincter muscle. The nurse identifies this laceration as which type? A) first-degree laceration B) second-degree laceration C) third-degree laceration D) fourth-degree laceration

C) third-degree laceration

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

C) two fingerbreadths below the umbilicus

Which factor in a client's history indicates she is at risk for candidiasis? A) nulliparity B) menopause C) use of corticosteroids D) use of spermicidal jelly

C) use of corticosteroids

After teaching a group of young women how to reduce their risk for ovarian cancer, the nurse determines that additional teaching is needed when the group identifies which element as a way to reduce risk? A) pregnancy B) use of oral contraceptives C) use of feminine hygiene sprays D) breastfeeding

C) use of feminine hygiene sprays

A nurse is assessing a client with postpartal hemorrhage; the client is presently on IV oxytocin. Which interventions should the nurse perform to evaluate the efficacy of the drug treatment? Select all that apply. (Ch17) A) Assess the client's uterine tone. B) Monitor the client's vital signs. C) Assess the client's skin turgor. D) Get a pad count. E) Assess deep tendon reflexes.

D) Get a pad count. B) Monitor the client's vital signs. A) Assess the client's uterine tone.

Why is a Papanicolau test done at the first prenatal visit? A) It predicts whether cervical cancer will occur. B) It helps to date the pregnancy. C) It detects if uterine cancer is present. D) It identifies abnormal cervical cells.

D) It identifies abnormal cervical cells.

A client with group AB blood whose husband has group O blood has just given birth. Which complication or test result is a major sign of ABO blood incompatibility that the nurse should look for when assessing this neonate? A) Negative Coombs' test B) Bleeding from the nose or ear C) Jaundice after the first 24 hours of life D) Jaundice within the first 24 hours of life

D) Jaundice within the first 24 hours of life

The nurse is admitting a client at 23 weeks' gestation in preparation for induction and delivery after it was determined the fetus had died secondary to trauma. When asked by the client to explain what went wrong, the nurse can point out which potential cause for this loss? A) Genetic abnormality B) Premature rupture of membranes C) Preeclampsia D) Placental abruption

D) Placental abruption

A nurse is preparing a woman for a Papanicolau test. The nurse has already washed her hands and gathered all necessary equipment (maintaining sterility). What is the next step in the procedure? A) Provide support to the client as the provider obtains the sample. B) Drape the client with a sheet, leaving the perineal area exposed. C) Transfer the specimen to a container or a slide. D) Position the client in stirrups or foot pedals so that her knees fall outward.

D) Position the client in stirrups or foot pedals so that her knees fall outward.

A young couple is having difficulty getting pregnant. The nurse is preparing the couple for the initial tests to determiine their fertility. When asked by the couple why they need to start with a sperm analysis, what will be the nurse's best response? A) Asking the male to undergo diagnostic procedures first is the best way to assess interest in treatment of infertility. B) The man is found to be fertile in over 75 percent of couples with infertility problems. C) Male fertility testing is time-consuming and therefore should be initiated early. D) Sperm analysis is one of the easiest tests to complete.

D) Sperm analysis is one of the easiest tests to complete.

The client may spend the latent phase of the first stage of labor at home unless which occurs? A) The client passes the bloody show B) The contractions vary in length and intensity C) The client begins back labor D) The client experiences a rupture of membranes

D) The client experiences a rupture of membranes

A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Which method would be the best recommendation? A) an ovulation suppressant B) a spermicidal suppository C) the rhythm (calendar) method D) a diaphragm and spermicide

D) a diaphragm and spermicide

A client is experiencing shoulder dystocia during birth. The nurse would place priority on performing which assessment postbirth? A) extensive lacerations B) monitor for a cardiac anomaly C) assess for cleft palate D) brachial plexus assessment

D) brachial plexus assessment

A nurse is caring for several women in labor. The nurse determines that which woman is in the transition phase of labor? A) contractions every 5 minutes, cervical dilation 3 cm B) contractions every 3 minutes, cervical dilation 5 cm C) contractions every 2½ minutes, cervical dilation 7 cm D) contractions every 1 minute, cervical dilation 9 cm

D) contractions every 1 minute, cervical dilation 9 cm

The nurse, assessing the lochia of a client, attempts to separate a clot and identifies the presence of tissue. Which observation would indicate the presence of tissue? A) yellowish-white lochia B) foul-smelling lochia C) easy to separate clots D) difficult to separate clots

D) difficult to separate clots

The nurse is assessing a pregnant client with a known history of congestive heart failure who is in her third trimester. Which assessment findings should the nurse prioritize? A) regular heart rate and hypertension B) increased urinary output, tachycardia, and dry cough C) shortness of breath, bradycardia, and hypertension D) dyspnea, crackles, and irregular weak pulse

D) dyspnea, crackles, and irregular weak pulse A patient is admitted with a diagnosis of ectopic pregnancy. For what should the nurse anticipate preparing the patient?A) Immediate surgeryB) Internal uterine monitoringC) Bed rest for the next 4 weeksD) Intravenous administration of a tocolytic

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? A) hyperglycemia B) elevated platelet count C) disseminated intravascular coagulopathy (DIC) D) elevated liver enzyme

D) elevated liver enzyme

The nurse is assessing a newborn suspected of having meconium aspiration syndrome. What sign or symptom would be most suggestive of this condition? A) High-pitched, shrill cry B) bile-stained emesis C) intermittent tachypnea D) expiratory grunting

D) expiratory grunting

A nurse is conducting an assessment of a woman who has experienced PROM. Which finding would lead the nurse to suspect infection as the cause of a client's PROM? A) yellow-green fluid B) blue color on Nitrazine testing C) ferning D) foul odor

D) foul odor

A nurse is caring for a client who has just received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. How does the nurse classify the laceration? A) first degree B) second degree C) third degree D) fourth degree

D) fourth degree

A nurse is caring for clients who have a history of genital herpes infection. The client most at risk for an outbreak of genital herpes is the client who reports: A) headache and fever. B) vaginal and urethral discharge. C) dysuria and lymphadenopathy. D) genital pruritus and paresthesia.

D) genital pruritus and paresthesia.

A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would question the woman about which symptom? A) an inverted nipple on the affected breast B) no breast milk in the affected breast C) an ecchymotic area on the affected breast D) hardening of an area in the affected breast

D) hardening of an area in the affected breast

A nurse completes the initial assessment of a newborn. According to the due date on the antenatal record, the baby is 12 days' postmature. Which physical finding does not confirm that this newborn is 12 days' postmature? A) meconium aspiration B) absence of lanugo C) hypoglycemia D) increased amounts of vernix

D) increased amounts of vernix

Which symptom would most accurately indicate that a newborn has experienced meconium aspiration during the birth process? A) bluish skin discoloration B) listlessness or lethargy C) stained umbilical cord and skin D) meconium stained fluids followed by tachypnea

D) meconium stained fluids followed by tachypnea

A nurse is teaching newborn care to students. The nurse correctly identifies which mechanism as the predominant form of heat loss in the newborn? A) nonshivering thermogenesis B) lack of brown adipose tissue C) sweating and peripheral vasoconstriction D) radiation, convection, and conduction

D) radiation, convection, and conduction

A nurse is assessing a newborn. Which finding would alert the nurse to the possibility of respiratory distress in a newborn? A) symmetrical chest movement B) periodic breathing C) respirations of 40 breaths/minute D) sternal retractions

D) sternal retractions

The estrogen content in the contraceptive pill performs which action? A) decreases the permeability of cervical mucus B) increases the level of luteinizing hormone (LH) C) interferes with endometrial proliferation D) suppresses follicle-stimulating hormone (FSH)

D) suppresses follicle-stimulating hormone (FSH)

A nurse is providing education to a woman who is experiencing postpartum hemorrhage and is to receive a uterotonic agent. The nurse determines that additional teaching is needed when the woman identifies which drug as treating postpartum hemorrhage? A) oxytocin B) methylergonovine C) carboprost D) terbutaline

D) terbutaline

A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which finding would require immediate intervention? A) fetal heart rate of 150 beats/minute B) contractions every 2 minutes, lasting 45 seconds C) uterine resting tone of 14 mm Hg D) urine output of 20 mL/hour

D) urine output of 20 mL/hour

All the options are signs of respiratory distress in the newborn except: A) grunting. B) nasal flaring. C) chest retractions. D) central cyanosis. E) respiratory rate >50 breaths/minute. F) coughing.

E) respiratory rate >50 breaths/minute.

Follow up visits

Every 4 weeks up to 28 weeks Every 2 weeks from 29 to 36 weeks Every week from 37 weeks to birth

A nurse is preparing to conduct a neurological physical assessment of a neonate, including an evaluation of the major congenital reflexes. Which reflexes would the nurse assess? Select all that apply. A) gag B) Babinski C) Moro D) Galant E) rooting F) tonic neck G) stepping

Gag, Moro, babinski, and Galant

Necrotizing enterocolitis

Necrosis of intestinal mucosa and possible perforation. Colon is usually involved, but can involve entire GI tract. In neonates, more common in premies (decreased immunity)

________ is the leading cause of death from gynecologic cancer in the United States because of vague symptoms and late diagnosis

Ovarian cancer

______ is the most common cause of infertility and subfertility in women

PCOS

third degree laceration

Same as second degree, plus involves the anal sphincter

stork bites and salmon patches

Superficial vascular areas found on nape of neck, eyelids, between eyes & upper lip. Normal variant, disappear w/in first year.

Acrocyanosis

Temporary cyanotic condition, usually in newborns resulting in a bluish color around the lips, hands and fingernails, feet and toenails. May last for a few hours and disappear with warming.

Evaporation

The change of a substance from a liquid to a gas

The five "Ps" of labor are: (Ch-16; P-284-291; DL-32; B-Remember; CO-1) a. Passageway, passenger, position, powers, psych b. Passenger, posture, position, presentation, psych c. Passenger, position, presentation, pushing, psych d. Passenger, position, powers, presentation, psych

a. Passageway, passenger, position, powers, psych

The nurse is monitoring a laboring client with continuous fetal monitoring and notes a decrease in FHR with variable deceleration to 75 bpm. Which intervention should the nurse prioritize? (Ch-16; P-304; DL-29; B-Apply; CO-11) a. Administer oxygen b. Change the position of the client c. Increase her IV fluids d. Notify the primary care provider

b. Change the position of the client

The client states that the first day of her last menstrual period is March 23. The nurse is most correct to calculate using Naegele rule that the estimated date of delivery is: (Ch-15; P-254; DL-25; B-Apply; CO-13) a. January 30 b. December 30 c. December 16 d. November 23

b. December 30

A multigravid client has been in labor for several hours and is becoming anxious and distressed with the intensity of her frequent contractions. The nurse observes moderate bloody show and performs a vaginal examination to assess the progress of labor. The cervix is 9 cm dilated. The nurse knows that the client is in which phase of labor? (Ch-16; P-295; DL-36; B-Analyze; CO-1) a. Latent phase b. Transition phase c. Active phase d. Early phase

b. transition phase

Infants of mothers who take antiseizure medications are at increased risk for _____.

bleeding

Encephalocele

brain or meninges protrudes through skull

Contraceptive patches should not be placed on the _______?

breast

Infants produce heat by metabolizing _______stores.

brown fat

A pregnant client in her second trimester is diagnosed with hyperemesis gravidarum. The nurse would monitor the client closely for which of the following? (Ch-15; P-270; DL-4; B-Apply; CO-6) a. Heartburn b. Diarrhea c. Dehydration d. Constipation

c. Dehydration

The student nurse is learning about normal labor. The teacher reviews the cardinal movements of labor and determines the instruction has been effective when the student correctly states the order of the cardinal movements as follows: (Ch-16; P-297; DL-29; B-Apply; CO-1) a. Internal rotation, flexion, descent, extension, external rotation, expulsion b. Internal rotation, extension, descent, flexion, external rotation, expulsion c. Descent, flexion, internal rotation, extension, external rotation, expulsion d. Descent, flexion, external rotation, extension, internal rotation, expulsion

c. Descent, flexion, internal rotation, extension, external rotation, expulsion

The nurse is assisting a client in labor and delivery and notes the placenta is now delivered. Which documentation should the nurse prioritize? (Ch-16; P-300; DL-28; B-Apply; CO-1) a. The client's vital signs b. The end of recovery c. The completion of the third stage of labor d. The transition phase

c. The completion of the third stage of labor

A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every: (Ch-15; P-272; DL-28; B-Apply; CO-6) a. 1 week b. 2 weeks c. 3 weeks d. 4 weeks

d. 4 weeks

The nurse has been monitoring a multipara client for several hours. She cries out that her contractions are getting harder and that she cannot do this. The nurse notes the client is very irritable, nauseated, annoyed, and doesn't want to be left alone. Based on the assessment the nurse predicts the cervix to be dilated how many centimeters? (Ch-16; P-294-295; DL-24; B-Analyze; CO-1) a. 0 to 2 b. 5 to 7 c. 3 to 4 d. 8 to 10

d. 8 to 10

The nurse is analyzing the readout on the EFM and determines the FHR pattern is reassuring based on which recording? (Ch-16; P-306; DL-28; B-Analyze; CO-1) a. Increase in variability by 27 bpm b. Deceleration followed by acceleration of 15 bpm c. Decrease in variability for 15 seconds d. Acceleration of at least 15 bpm for 15 seconds

d. Acceleration of at least 15 bpm for 15 seconds

A woman reports that her last menstrual period (LMP) occurred February 1, 2017. Using the Naegele rule, what would be her estimated date of delivery (EDD)? (Ch-15; P-277; DL-36; B-Apply; CO-13) a. October 1, 2018 b. November 8, 2018 c. October 1, 2017 d. November 8, 2017

d. November 8, 2017

The nurse midwife is performing a pelvic examination on a client who came to her following a positive home pregnancy test. The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell's sign. Which description illustrates this alteration? (Ch-15; P-265; DL-31; B-Apply; CO-1) a. The cervix looks blue or purple when examined b. The lower uterine segment softens c. The fundus enlarges d. The cervix softens

d. The cervix softens

The nursing instructor is teaching a group of nursing students about the menstrual cycle. The instructor determines the session is successful when the students correctly choose which action as responsible for the increased thickness of the endometrium? (Ch-14; P-242; DL-33; B-Apply; CO-13) a. The level of the FSH b. The decreasing level of the progesterone c. The dropping level of LH d. The increasing level of estrogen

d. The increasing level of estrogen

caput succedaneum

diffuse edema of the fetal scalp that crosses the suture lines. reabsorbes within 1 to 3 days

vuvlar cancer

lesion or plaque on labia majora

cephelahematoma

looks like a horn does not cross suture line

Trichomoniasis may be treated with a single dose of _______

metronidazole

pathological jaundice

occurs before 24 hours and may indicate early hemolysis

sign of placental previa

painless vaginal bleeding

placental abruption

premature separation of the placenta

mag sulfate is given for patients with preeclampsia for?

prevention of seizures

Progesterone

primary mediator for inflammatory response pregnancy cannot be maintained without it.

cystocele

protrusion of the bladder pressure on anterior vaginal wall

meconium aspiration occurs because of?

stress

second degree laceration

superficial skin to vaginal mucousa- may go through muscle

coloposcopy

visual examination of the vagina and cervix using a colposcope

postpartum psychosis

2-3 days after delivery in patient hospital treatment

How often should women diagnosed with human papillomavirus (HPV) have Papanicolau testing? A) Yearly B) Every 6 months C) Every 2 years D) Every 3 years

A) Yearly

A nurse is conducting a review course on tocolytic therapy for perinatal nurses. After teaching the group, the nurse determines that the teaching was successful when they identify which drugs as being used for tocolysis? Select all that apply. A) nifedipine B) magnesium sulfate C) dinoprostone D) misoprostol E) indomethacin

A) nifedipineB) magnesium sulfateE) indomethacin

What is the medication of choice for early syphilis? A) penicillin G benzathine B) doxycycline C) tetracycline D) ceftriaxone

A) penicillin G benzathine

A woman comes to the clinic reporting vaginal discharge. The nurse suspects trichomoniasis based on which symptoms? Select all that apply. A) urinary frequency B) yellow/green discharge C) joint pain D) blister-like lesions E) muscle aches

A) urinary frequency B) yellow/green discharge

A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus? A) when it is thin, watery, and copious B) when it is thick C) Cervical mucus is not a reliable indicator. D) when it does not stretch

A) when it is thin, watery, and copious

A pregnant client has tested positive for hepatitis B virus. When discussing the situation with the client, the nurse explains that her infant should be vaccinated with an initial HBV vaccine dose at which time? A) within 12 hours of birth B) within 24 hours of birth C) within 36 hours of birth D) within 48 hours of birth

A) within 12 hours of birth

FSH

Anterior pituitary maturation of ovarian follicle

The nurse is conducting an assessment on a newborn and witnesses a startled response with the extension of the arms and legs. The nurse should document this as which response? A) Fencing B) Moro C) Tonic neck D) Rooting

B) Moro

A common symptom that would alert the nurse that a preterm infant is developing respiratory distress syndrome is: A) inspiratory stridor. B) expiratory grunting. C) expiratory wheezing. D) inspiratory "crowing."

B) expiratory grunting.

Probable signs of pregnancy

Braxton Hicks contractions Positive pregnancy test Softening of the cervix (Goodell's sign) Bluish discoloration of the female genitalia (Chadwick's sign) Softening of the isthmus (lower portion) of the uterus, may be felt between 6 and 12 weeks (Hegar's sign)

A nurse is assessing a newborn and notifies the primary health care provider because the nurse suspects increased intracranial pressure. When reporting the findings, which of the following would the nurse most likely include? A) Soft, nonbulging fontanels B) Overriding C) Seizure activity D) Vital signs within acceptable ranges

C) Seizure activity

When assessing the uterus of a 2-day postpartum client, which finding would the nurse evaluate as normal? (Ch17) A) a scant amount of lochia alba B) a moderate amount of lochia alba C) a moderate amount of lochia rubra D) a scant amount of lochia serosa

C) a moderate amount of lochia rubra

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

C) uterine atony, placenta previa, operative procedures

The nurse assesses a 20-week gestational client at a routine prenatal visit. What will the nurse predict the fundal height to be on this client experiencing an uneventful pregnancy? (Ch-15; P-280; DL-15; B-Apply; CO-6) a. 12 cm b. 16 cm c. 20 cm d. 24 cm

C. 20 cm

A nurse is educating a client on the basal body temperature method as a form of contraception. Which statement by the client indicates and understanding of when she can expect to see a rise in her temperature? A) "My temperature will increase with the start of my menses." B) "If I am pregnant, I will have a temperature spike." C) "There will be an increase in my temperature right before I ovulate." D) "Immediately following ovulation my temperature will increase."

D) "Immediately following ovulation my temperature will increase."

Which action would be priority for the nurse to complete immediately after the delivery of a 40-week gestation newborn? A) Swaddle the infant and place in the bassinet. B) Complete a full head-to-toe assessment. C) Assess the newborn's glucose level. D) Dry the newborn and place it skin-to-skin on mother

D) Dry the newborn and place it skin-to-skin on mother

A client is admitted to the health care facility. The fetus has a gestational age of 42 weeks and is suspected to have cephalopelvic disproportion. Which should the nurse do next? A) Place the client in lithotomy position for birth. B) Administer oxytocin intravenously at 4 mU/minute. C) Perform artificial rupture of membranes. D) Prepare the client for a cesarean birth.

D) Prepare the client for a cesarean birth.

The nurse is working at a clinic that conducts abortions. Which laboratory values would the nurse expect to review for each client? A) Electrolyte levels B) Red blood cell count C) Urine specific gravity D) Rh status

D) Rh status

The nurse is assessing a woman who had a forceps-assisted birth for complications. Which condition would the nurse assess in the fetus? A) cervical lacerations B) perineal hematoma C) infection of episiotomy D) caput succedaneum

D) caput succedaneum

GTPAL

Gravida, Term, Preterm, Abortions, Living

first stage of labor

Latent, Active and Transition 0-10 cm

Lochia serosa

Pink, serous, and blood-tinged vaginal discharge that follows lochia rubra and lasts until the 7th to 10th day after birth.

rooting reflex

a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple

spina bifida

a congenital defect that occurs during early pregnancy when the spinal canal fails to close completely around the spinal cord to protect it Dimple on sacrum, bulge, or tuft of hair.

Presumptive signs of pregnancy

amenorrhea, nausea, breast tenderness

Cardiac decompensation S/S

edema, SOB, moist cough, cyanosis, tachypnea, rapid weak irregular pulse, tachy greater than 100 bpm. May report: palpitations, increased fatigue, having a hard time catching breath

endometriosis

endometrial tissue located outside the uterus

postpartum depression

first 4 weeks major depressive episode, treated with antidepressants

BV major sign?

fishy odor, white/gray vaginal discharge

uAdequate levels of __________ prior to conception may help prevent neural tube defects.

folic acid

prostlaglandins

frees egg from follicle

What does HELLP stand for?

hemolysis, elevated liver enzymes, low platelets

rectocele

hernia of the rectum into the vagina

ectopic pregnancy

implantation of the fertilized egg in any site other than the normal uterine location

IUDs are the ______ ________

most effective

hyperemesis gravidarum

severe nausea and vomiting in pregnancy that can cause severe dehydration in the mother and fetus

involution of the uterus

uterus returns to normal

After a discussion on the HPV vaccine with a mother and her 10-year-old daughter at a well-child visit, the nurse recognizes the discussion was successful when the mother makes which statement? A) "My daughter will need three injections over a 6-month period." B) "She will need one injection every 5 years." C) "One injection will give her a lifetime of protection." D) "She will need to get a total of two injections in the next 3 months."

A) "My daughter will need three injections over a 6-month period."

At birth, the infant has dry, cracked skin, absence of vernix, lack of subcutaneous fat, fingernail extending beyond the fingertips, and poor skin turgor. Based on these findings, how would the nurse would classify this neonate? A) postterm B) preterm C) SGA D) LGA

A) postterm

Which body system is most vulnerable to infection during the postpartum period? A) Gastrointestinal B) Urinary C) Breasts D) Respiratory

B) Urinary

The nurse is preparing to assess a client who is 1 day postpartum. The nurse predicts the client's fundus will be at which location on assessment? (CH17) A) At level of umbilicus B) 1 cm above the umbilicus C) 1 cm below the umbilicus D) At the symphysis pubis

C) 1 cm below the umbilicus

A woman is in the fourth stage of labor. During the first hour of this stage, the nurse would assess the woman's fundus at which frequency? A) every 5 minutes B) every 10 minutes C) every 15 minutes D) every 20 minutes

C) every 15 minutes

A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition? A) genital warts B) genital herpes C) gonorrhea D) syphilis

C) gonorrhea

A postpartum woman is experiencing subinvolution. When reviewing the client's history for factors that might contribute to this condition, which factors would the nurse identify? Select all that apply. A) uterine infection B) prolonged labor C) hydramnios D) breastfeeding E) early ambulation F) empty bladder

C) hydramnios A) uterine infection B) prolonged labor

A nurse working in the neonatal nursery anticipates the primary care provider to prescribe which medication for a premature newborn having difficulty breathing? A) epinephrine B) albuteral C) surfactant D) norepinephrine

C) surfactant

The nurse notes that a patient has a history of "fibroids" and is aware that this term refers to a benign tumor of the uterus. What is a more appropriate term for a fibroid? A) Bartholin's cyst B) Dermoid cyst C) Hydatidiform mole D) Leiomyoma

D) Leiomyoma

During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. The nurse interprets this as: (Ch15) A) variable decelerations. B) fetal tachycardia. C) a nonreactive pattern. D) reactive pattern

D) reactive pattern

A postpartum client comes to the clinic for her 6-week postpartum check up. When assessing the client's cervix, the nurse would expect the external cervical os to appear: (CH17) A) shapeless. B) circular. C) triangular. D) slit-like.

D) slit-like.

grasp reflex

an infantile reflex in which an infant closes her hand into a fist when her palm is touched

Trichomoniasis

an infection caused by the protozoan parasite Trichomonas vaginalis; also known as trich

LH

anterior pituitary helpful in final maturation of the follicles

Mongolian spots

areas of deep bluish-gray pigmentation most commonly on the sacral aspect of a newborn normal for darker babies

treatment for chlamydia

azithromycin or doxycycline

BUBBLE-EE

beats uterus bladder bowels episiotomy epidural extremities

A patient makes an appointment at the prenatal clinic because she thinks she might be pregnant. Which assessment is a probable sign of pregnancy? (Ch14) a. Amenorrhea b. Enlargement and darkening of areola c. Nausea and vomiting d. A positive pregnancy test

d. A positive pregnancy test

Major sign of vulvar cancer?

itching

Fetal malposition

most common posterior position (OPP) - lots of back pain

uNeonates typically do not ______ to produce heat.

shiver

A young couple have presented to the office with concerns of possible infertility. A physical examination and complete history of the woman reveals type 2 diabetes mellitus, obesity, sleep apnea, and hypertension. The nurse would suspect: A) polycystic ovary syndrome. B) irregular menses. C) leiomyomas. D) hormonal imbalance.

A) polycystic ovary syndrome.

Which symptom is an early symptom of vulvar cancer? A) pruritus with genital burning B) fever accompanied by chills C) severe abdominal pain D) dyspareunia

A) pruritus with genital burning

A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable abortion? A) strong abdominal cramping B) slight vaginal bleeding C) closed cervical os D) no passage of fetal tissue

A) strong abdominal cramping

A nurse is conducting an in-service program for a group of staff nurses. After teaching the group about ovarian cysts, the nurse determines that the teaching was successful when the group identifies which type of cyst as being associated with hydatidiform mole? A) theca-lutein cyst B) corpus luteum cyst C) follicular cyst D) polycystic ovarian syndrome

A) theca-lutein cyst

Which description would the nurse include when teaching a client about a scheduled colposcopy? A) "A gel will be applied to your abdomen and a microphone-like device will be moved over the area to identify problem areas." B) "A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument." C) "Scrapings of tissue will be obtained and placed on slides to be examined under the microscope." D) "After you receive anesthesia, a small device will be inserted into your abdomen near your belly button to obtain tissue samples."

B) "A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument."

A nurse is assessing a client who gave birth vaginally about 4 hours ago. The client tells the nurse that she changed her perineal pad about an hour ago. On inspection, the nurse notes that the pad is now saturated. The uterus is firm and approximately at the level of the umbilicus. Further inspection of the perineum reveals an area, bluish in color and bulging just under the skin surface. Which action would the nurse do next? A) Apply warm soaks to the area. B) Notify the health care provider. C) Massage the uterine fundus. D) Encourage the client to void.

B) Notify the health care provider.

pasageway

cervix pelvic floor vagina

placenta previa

implantation of the placenta over the cervical opening or in the lower region of the uterus

The nurse is caring for a client suspected to have a uterine rupture. The nurse predicts the fetal monitor will exhibit which pattern if this is true? A) Late decelerations B) Early decelerations C) Variable decelerations D) Mild decelerations

A) Late decelerations

After teaching a class about intimate partner violence to a group of young adults, the nurse determines that additional teaching is needed based on which statement by the group? A) "People who are battered typically come from lower socioeconomic groups." B) "Violence is a learned behavior that can be changed." C) "Violence against women and children is a crime in every state." D) "Intimate partner violence reflects a pattern of behavior that is repeated over time."

A) "People who are battered typically come from lower socioeconomic groups."

The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? A) "Currently there is no reliable screening test for ovarian cancer." B) "A Papanicolau test is almost always helpful in identifying this type of cancer." C) "There's a blood test for a marker, CA-125, that if elevated indicates cancer." D) "A genetic test for two genes, if positive, will identify the ovarian cancer."

A) "Currently there is no reliable screening test for ovarian cancer."

A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which effect? A) uterine hyperstimulation B) headache C) blurred vision D) hypotension

A) uterine hyperstimulation

A nurse is teaching a client how to use a pessary. The nurse determines that the teaching was successful based on which statement? A) "I will remove the pessary every night before I go to bed." B) "I need to clean the pessary with soap and water." C) "I will use petroleum jelly to help make the insertion easier." D) "I will have follow up examinations every month for the first year."

B) "I need to clean the pessary with soap and water."

The nurse is assessing a client at her first prenatal visit and notes the fundal height is palpable at the level of the umbilicus. The nurse predicts the client is at which gestational age? (CH15) A) 18 weeks B) 20 weeks C) 24 weeks D) 22 weeks

B) 20 weeks

What should the nurse include when explaining endometriosis as a cause for a female patient's infertility? A) "You do not ovulate because of endometrial implants on the ovaries." B) "Your uterine cervix fails to close because it is engorged with tissue." C) "Menstrual sloughing does not occur, so there is never a new base for embryo growth." D) "Ovulation does take place misplaced endometrial tissue interferes with transport of the ovum."

D) "Ovulation does take place misplaced endometrial tissue interferes with transport of the ovum."

Which approach would be most appropriate when counseling a client who is a suspected victim of intimate partner violence? A) Offer the client a pamphlet about the local shelter for victims of intimate partner violence. B) Call the client at home to ask some questions about the marriage. C) Wait until the client comes in a few more times to make a better assessment. D) Ask, "Have you ever been physically hurt by your partner?"

D) Ask, "Have you ever been physically hurt by your partner?"

A postpartal woman is developing a thrombophlebitis in her right leg. Which assessments would the nurse make to detect this? A) Bend her knee, and palpate her calf for pain. B) Ask her to raise her foot and draw a circle. C) Blanch a toe, and count the seconds it takes to color again. D) Assess for pedal edema.

D) Assess for pedal edema.

Types of IPV

Physical abuse, sexual abuse, emotional abuse, financial abuse

PPROM

Preterm premature rupture of membranes (before 37 weeks)

Conduction

The direct transfer of heat from one substance to another substance that it is touching.

Subinvolution of the uterus

Uterus remains enlarged with continued lochial discharge which may result in postpartum hemorrhage

stepping reflex

a neonatal reflex in which an infant lifts first one leg and then the other in a coordinated pattern like walking

A nurse is working with a pregnant woman to schedule follow-up visits for her pregnancy. Which statement by the woman indicates that she understands the scheduling? (Ch-15; P-272; DL-25; B-Analyze; CO-6) a. "From now until I'm 28 weeks, I'll be coming once a month." b. "I need to make visits every 2 months until I'm 36 weeks pregnant." c. "Once I get to 28 weeks, I have to come twice a month." d. "I'll make sure to get a day off every 2 weeks to make my visits."

a. "From now until I'm 28 weeks, I'll be coming once a month."

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client? (Ch-14; P-243; DL-34; B-Apply; CO-13) a. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth b. If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall c. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins d. An ovum matures and is released

a. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth

A nurse is classifying the pregnancy history of a woman who has had five pregnancies: three full-term, one preterm, and one abortion. How would the nurse document this information on the patient chart? (Ch-14; P-233; DL-31; B-Analyze; CO-1) a. G4 P3115 b. G5 P3115 c. G5 P1135 d. G5 P3114

d. G5 P3114

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a 4-year-old child who was delivered at 38 weeks' gestation and tells the nurse that she does have a history of a miscarriage within the first trimester. The nurse is correct to document the history as: (CH14) a. G = 4, T = 2, P = 0, A = 0, L = 1 b. G = 3, T = 1, P = 0, A = 1, L = 1 c. G = 1, T = 1, P = 1, A = 0, L = 1 d. G = 2, T = 0, P = 0, A = 0, L = 1

b. G = 3, T = 1, P = 0, A = 1, L = 1

The nurse midwife is performing a pelvic examination on a client who came to her following a positive home pregnancy test. The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell's sign. Which description illustrates this alteration? (Ch-15; P-265; DL-31; B-Apply; CO-1) a. The cervix looks blue or purple when examined b. The cervix softens c. The lower uterine segment softens d. The fundus enlarges

b. The cervix softens

McRoberts maneuver

sharp flexion of the maternal hips that decreases the inclination of the pelvis increasing the AP diameter of the free anterior shoulder

entrocele

small intestine between uterus and rectum putting pressure on perineum

Goodell's sign

softening of the cervix

Hegar's sign

softening of the lower uterine segment