Maternity ATI Review

The nurse is monitoring the amount of lochia drainage in a client who is 2 hours postpartum and notes that the client has saturated a perineal pad in 1 hour. How should the nurse document this finding? 1. Scant 2. Light 3. Heavy 4. Excessive

3. Heavy

A nurse is instructing a client who is taking an oral contraceptive about danger signs to report to her provider. The nurse determines the client understands the teaching when the client states the need to report which of the following? 1. Reduced menstrual flow 2. Breast tenderness 3. Shortness of breath 4. Headaches

3. Shortness of breath

A nurse in a health care clinic is reviewing contraceptive use with a group of adolescent clients. Which of the following statements by an adolescent reflects an understanding of the teaching? 1. "A water-soluble lubricant should be used with condoms." 2. "A diaphragm should be removed 2 hours after intercourse." 3. "Oral contraceptives can worsen a case of acne." 4. "A contraceptive patch is replaced once a month."

1. "A water-soluble lubricant should be used with condoms."

The nurse is providing postpartum instructions to a client who will be breast-feeding her newborn. The nurse determines that the client has understood the instructions if she makes which statement(s)? Select all that apply. 1. "I should wear a bra that provides support." 2. "Drinking alcohol can affect my milk supply." 3. "The use of caffeine can decrease my milk supply." 4. "I will start my estrogen birth control pills again as soon as I get home." 5. "I know if my breasts get engorged I will limit my breast-feeding and supplement the baby." 6. "I plan on having bottled water available in the refrigerator so I can get additional fluids easily."

1. "I should wear a bra that provides support." 2. "Drinking alcohol can affect my milk supply." 3. "The use of caffeine can decrease my milk supply." 6. "I plan on having bottled water available in the refrigerator so I can get additional fluids easily."

The nurse has provided discharge instructions to a client who delivered a healthy newborn by cesarean delivery. Which statement made by the client indicates a need for further instruction? 1. "I will begin abdominal exercises immediately." 2. "I will notify the health care provider if I develop a fever." 3. "I will turn on my side and push up with my arms to get out of bed." 4. "I will lift nothing heavier than my newborn baby for at least 2 weeks."

1. "I will begin abdominal exercises immediately."

The nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates that further teaching is needed? 1. "I will flush the eyes after instilling the ointment." 2. "I will clean the newborn's eyes before instilling ointment." 3. "I need to administer the eye ointment within 1 hour after delivery." 4. "I will instill the eye ointment into each of the newborn's conjunctival sacs."

1. "I will flush the eyes after instilling the ointment."

The nurse is assessing a pregnant client with type 1 diabetes mellitus about her understanding regarding changing insulin needs during pregnancy. The nurse determines that further teaching is needed if the client makes which statement? 1. "I will need to increase my insulin dosage during the first 3 months of pregnancy." 2. "My insulin dose will likely need to be increased during the second and third trimesters." 3. "Episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy." 4. "My insulin needs should return to normal within 7 to 10 days after birth if I am bottlefeeding."

1. "I will need to increase my insulin dosage during the first 3 months of pregnancy."

A nurse is preparing to administer a vitamin K (phytonadione) injection to a newborn. Which of the following response should the nurse make to the newborn's mother regarding why this medication is giving? 1. "It assists with blood clotting." 2. "It promotes maturation of the bowel." 3. "It is a preventative vaccine." 4. "It provides immunity."

1. "It assists with blood clotting."

A nurse in a clinic is caring for a client who is to be seen by the provider for a postoperative appointment following a salpingectomy due to an ectopic pregnancy. Which of the following statements by the client requires clarification? 1. "It is good to know that I won't have a tubal pregnancy in the future." 2. "The doctor said that this surgery can affect my ability to get pregnant again." 3. "I understand that one of my fallopian tubes had to be removed." 4. "Ovulation can still occur because my ovaries were not affected."

1. "It is good to know that I won't have a tubal pregnancy in the future."

A nurse educator in the labor and delivery unit is reviewing the use of chemical agents to promote cervical ripening with a group of newly hired nurses. Which of the following statements by a nurse indicates understanding of the teaching? 1. "They are administered in an oral form." 2. "They act by absorbing fluid from tissues." 3. "They promote dilation of the os." 4. "They include an amniotomy."

1. "They are administered in an oral form."

A nurse is teaching a newly licensed nurse how to bathe a newborn and observes a bluish marking across the newborn's lower back. The nurse should include which of the following information in the teaching? 1. "This is frequently seen in newborns who have dark skin." 2. "This is a finding indicating hyperbilirubinemia." 3. "This is a forceps mark from an operative delivery." 4. "This is related to prolonged birth or trauma during delivery."

1. "This is frequently seen in newborns who have dark skin."

The nurse in a maternity unit is providing emotional support to a client and her husband who are preparing to be discharged from the hospital after the birth of a dead fetus. Which statement made by the client indicates a component of the normal grieving process? 1. "We want to attend a support group." 2. "We never want to try to have a baby again." 3. "We are going to try to adopt a child immediately." 4. "We are okay, and we are going to try to have another baby immediately."

1. "We want to attend a support group."

A stillborn baby was delivered in the birthing suite a few hours ago. After the delivery, the family remained together, holding and touching the baby. Which statement by the nurse would further assist the family in their initial period of grief? 1. "What can I do for you?" 2. "Now you have an angel in heaven." 3. "Don't worry, there is nothing you could have done to prevent this from happening." 4. "We will see to it that you have an early discharge so that you don't have to be reminded of this experience."

1. "What can I do for you?"

The nurse is providing instructions to a pregnant client with human immunodeficiency virus (HIV) infection regarding care to the newborn after delivery. The client asks the nurse about the feeding options that are available. Which response should the nurse make to the client? 1. "You will need to bottle-feed your newborn." 2. "You will need to feed your newborn by nasogastric tube feeding." 3. "You will be able to breast-feed for 6 months and then will need to switch to bottlefeeding." 4. "You will be able to breast-feed for 9 months and then will need to switch to bottlefeeding."

1. "You will need to bottle-feed your newborn."

The postpartum nurse is providing instructions to a client after delivery of a healthy newborn. Which time frame should the nurse relay to the client regarding the return of bowel function? 1. 3 days postpartum 2. 7 days postpartum 3. On the day of delivery 4. Within 2 weeks postpartum

1. 3 days postpartum

The clinic nurse is performing a psychosocial assessment of a client who has been told that she is pregnant. Which assessment finding indicates to the nurse that the client is at risk for contracting human immunodeficiency virus (HIV)? 1. A client who has a history of intravenous drug use 2. A client who has a significant other who is heterosexual 3. A client who has a history of sexually transmitted infections 4. A client who has had one sexual partner for the past 10 years

1. A client who has a history of intravenous drug use

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

1. A normal test result

The nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The health care provider has documented the presence of Goodell's sign. This finding is most closely associated with which characteristic? 1. A softening of the cervix 2. The presence of fetal movement 3. The presence of human chorionic gonadotropin in the urine 4. A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus

1. A softening of the cervix

The nurse in the labor room is caring for a client in the active stage of the first phase of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. What is the most appropriate nursing action? 1. Administer oxygen via face mask. 2. Place the mother in a supine position. 3. Increase the rate of the oxytocin (Pitocin) intravenous infusion. 4. Document the findings and continue to monitor the fetal patterns.

1. Administer oxygen via face mask.

A nurse is caring for a client who has been in labor for 12 hr, and her membranes are intact. The provider has decided to perform an amniotomy in an effort to facilitate the progress of labor. The nurse performs a vaginal examination to ensure which of the following prior to the performance of the amniotomy? 1. Fetal engagement 2. Fetal lie 3. Fetal attitude 4. Fetal position

1. Fetal engagement

The nursing instructor asks a nursing student to list the characteristics of the amniotic fluid. The student responds correctly by listing which as characteristics of amniotic fluid? Select all that apply. 1. Allows for fetal movement 2. Surrounds, cushions, and protects the fetus 3. Maintains the body temperature of the fetus 4. Can be used to measure fetal kidney function 5. Prevents large particles such as bacteria from passing to the fetus 6. Provides an exchange of nutrients and waste products between the mother and the fetus

1. Allows for fetal movement 2. Surrounds, cushions, and protects the fetus 3. Maintains the body temperature of the fetus 4. Can be used to measure fetal kidney function

The nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Which are probable signs of pregnancy? Select all that apply. 1. Ballottement 2. Chadwick's sign 3. Uterine enlargement 4. Braxton Hicks contractions 5. Fetal heart rate detected by a nonelectronic device 6. Outline of fetus via radiography or ultrasonography

1. Ballottement 2. Chadwick's sign 3. Uterine enlargement 4. Braxton Hicks contractions

A nurse is providing care for a client who is at 32 weeks of gestation and who has a placenta previa. The nurse notes that the client is actively bleeding. Which of the following types of medications should the nurse anticipate the provider will prescribe? 1. Betamethasone 2. Indomethacin 3. Nifedipine 4. Methylergonovine

1. Betamethasone

A nurse is teaching a client who is at 6 weeks gestation about common discomforts of pregnancy. Which of the following findings should the nurse include in the teaching? (Select all that apply.) 1. Breast tenderness 2. Urinary frequency 3. Epistaxis 4. Dysuria 5. Epigastric pain

1. Breast tenderness 2. Urinary frequency 3. Epistaxis

The mother of a newborn calls the clinic and reports that when cleaning the umbilical cord, she noticed that the cord was moist and that discharge was present. What is the most appropriate nursing instruction for this mother? 1. Bring the infant to the clinic. 2. This is a normal occurrence. 3. Increase the number of times that the cord is cleaned per day. 4. Monitor the cord for another 24 to 48 hours and call the clinic if the discharge continues.

1. Bring the infant to the clinic.

A nurse is caring for a client who has gonorrhea. Which of the following medications should the nurse anticipate the prescriber will prescribe? 1. Ceftriaxone 2. Fluconazole 3. Metronidazole 4. Zidovudine

1. Ceftriaxone

The nurse is monitoring a postpartum client who received epidural anesthesia for delivery for the presence of a vulvar hematoma. Which assessment finding would best indicate the presence of a hematoma? 1. Changes in vital signs 2. Signs of heavy bruising 3. Complaints of intense pain 4. Complaints of a tearing sensation

1. Changes in vital signs

A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy. The client's health record includes this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? (Select all that apply.) 1. Client has delivered one newborn at term. 2. Client has experienced no preterm labor. 3. Client has been through active labor. 4. Client has two prior pregnancies. 5. Client has one living child.

1. Client has delivered one newborn at term. 4. Client has two prior pregnancies. 5. Client has one living child.

The nurse is planning care for a postpartum client who had a vaginal delivery 2 hours ago. The client had a midline episiotomy and has several hemorrhoids. What is the priority nursing consideration for this client? 1. Client pain level 2. Inadequate urinary output 3. Client perception of body changes 4. Potential for imbalanced body fluid volume

1. Client pain level

A nurse in a prenatal clinic is providing education to a client who is in the 8th week of gestation. The client states that she does not like milk. Which of the following foods should the nurse recommend as a good source of calcium? 1. Dark green leafy vegetables 2. Deep red or orange vegetables 3. White breads and rice 4. Meat, poultry, and fish

1. Dark green leafy vegetables

A nurse is caring for a client who is pregnant and is to undergo a contraction stress test (CST). Which of the following findings are indications for this procedure? (Select all that apply.) 1. Decreased fetal movement 2. Intrauterine growth restriction (IUGR) 3. Postmaturity 4. Placenta previa 5. Amniotic fluid emboli

1. Decreased fetal movement 2. Intrauterine growth restriction (IUGR) 3. Postmaturity

An ultrasound is performed on a client at term gestation who is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that abruptio placentae is present. On the basis of these findings, the nurse should prepare the client for which anticipated prescription? 1. Delivery of the fetus 2. Strict monitoring of intake and output 3. Complete bed rest for the remainder of the pregnancy 4. The need for weekly monitoring of coagulation studies until the time of delivery

1. Delivery of the fetus

A client who is at 7 weeks of gestation is experiencing nausea and vomiting in the morning. Which of the following information should the nurse include in the teaching? 1. Eat crackers or plain toast before getting out of bed. 2. Awaken during the night to eat a snack. 3. Skip breakfast and eat lunch after nausea has subsided. 4. Eat a large evening meal.

1. Eat crackers or plain toast before getting out of bed.

A nurse is caring for a client who is at 40 weeks of gestation and experiencing contractions every 3 to 5 min and becoming stronger. A vaginal exam reveals that the client's cervix is 3 cm dilated, 80% effaced, and -1 station. The client asks for pain medication. Which of the following actions should the nurse take? (Select all that apply.) 1. Encourage use of patterned breathing techniques. 2. Insert an indwelling urinary catheter. 3. Administer opioid analgesic medication. 4. Suggest application of cold. 5. Provide ice chips.

1. Encourage use of patterned breathing techniques. 3. Administer opioid analgesic medication. 4. Suggest application of cold.

A nurse is admitting a client who is in labor and has HIV. Which of the following interventions should the nurse identify as contraindicated for this client? (Select all that apply.) 1. Episiotomy 2. Oxytocin infusion 3. Forceps 4. Cesarean birth 5. Internal fetal monitoring

1. Episiotomy 3. Forceps 5. Internal fetal monitoring

A nurse is caring for an infant who has a high bilirubin level and is receiving phototherapy. Which of the following is a priority finding in the newborn? 1. Conjunctivitis 2. Bronze skin discoloration 3. Sunken fontanels 4. Maculopapular skin rash

3. Sunken fontanels

The nurse is monitoring a client in preterm labor who is receiving intravenous magnesium sulfate. The nurse should monitor for which adverse effects of this medication? Select all that apply. 1. Flushing 2. Hypertension 3. Increased urine output 4. Depressed respirations 5. Extreme muscle weakness 6. Hyperactive deep tendon reflexes

1. Flushing 4. Depressed respirations 5. Extreme muscle weakness

A nurse is caring for a client who is in labor. The nurse should identify which of the following infections can be treated during labor or immediately following birth? (Select all that apply.) 1. Gonorrhea 2. Chlamydia 3. HIV 4. Group B streptoccus beta-hemolytic 5. TORCH infection

1. Gonorrhea 2. Chlamydia 3. HIV 4. Group B streptoccus beta-hemolytic

A nurse is caring for a client who is in active labor and reports severe back pain. During assessment, the fetus is noted to be in the occiput posterior position. Which of the following maternal positions should the nurse suggest to the client to facilitate normal labor progress? 1. Hands and knees 2. Lithotomy 3. Trendelenburg 4. Supine with rolled towel under one hip

1. Hands and knees

The nurse is monitoring a client who is in the active stage of labor. The client has been experiencing contractions that are short, irregular, and weak. The nurse documents that the client is experiencing which type of labor dystocia? 1. Hypotonic 2. Precipitous 3. Hypertonic 4. Preterm labor

1. Hypotonic

The nurse is describing cardiovascular system changes that occur during pregnancy to a client and understands that which finding would be normal for a client in the second trimester? 1. Increase in pulse rate 2. Increase in blood pressure 3. Frequent bowel elimination 4. Decrease in red blood cell production

1. Increase in pulse rate

A nurse is caring for a client who is pregnant and states that her last menstrual period was April 1st. Which of the following is the client's estimated date of delivery? 1. January 8 2. January 15 3. February 8 4. February 15

1. January 8

A nurse in an antepartum clinic is assessing a client who has a TORCH infection. Which of the following findings should the nurse expect? (Select all that apply.) 1. Joint pain 2. Malaise 3. Rash 4. Urinary frequency 5. Tender lymph nodes

1. Joint pain 2. Malaise 3. Rash 5. Tender lymph nodes

A nurse is called to the birthing room to assist with the assessment of a newborn who was born at 32 weeks of gestation. The newborn's birth weight is 1,100 g. Which of the following are expected findings in this newborn? (Select all that apply.) 1. Lanugo 2. Long nails 3. Weak grasp reflex 4. Translucent skin 5. Plump face

1. Lanugo 3. Weak grasp reflex 4. Translucent skin

A nurse is caring for a client in the third stage of labor. Which of the following findings indicate placental separation? (Select all that apply.) 1. Lengthening of the umbilical cord 2. Swift gush of clear amniotic fluid 3. Softening of the lower uterine segment 4. Appearance of dark blood from the vagina 5. Fundus firm upon palpation

1. Lengthening of the umbilical cord 4. Appearance of dark blood from the vagina 5. Fundus firm upon palpation

An opioid analgesic is administered to a client in labor. The nurse assigned to care for the client ensures that which medication is readily available if respiratory depression occurs? 1. Naloxone 2. Morphine sulfate 3. Betamethasone (Celestone) 4. Meperidine hydrochloride (Demerol)

1. Naloxone

The nurse has performed a nonstress test on a pregnant client and is reviewing the fetal monitor strip. The nurse interprets the test as reactive. How should the nurse document this finding? 1. Normal 2. Abnormal 3. The need for further evaluation 4. That findings were difficult to interpret

1. Normal

The nurse is monitoring a client in active labor and notes that the client is having contractions every 3 minutes that last 45 seconds. The nurse notes that the fetal heart rate between contractions is 100 beats/minute. Which nursing action is most appropriate? 1. Notify the health care provider (HCP). 2. Continue monitoring the fetal heart rate. 3. Encourage the client to continue pushing with each contraction. 4. Instruct the client's coach to continue to encourage breathing techniques.

1. Notify the health care provider (HCP).

A nurse is caring for a client who is at 14 weeks gestation and has hyperemesis gravidarum. The nurse should identify that which of the following are risk factors for the client? (Select all that apply.) 1. Obesity 2. Multifetal pregnancy 3. Maternal age greater than 40 4. Migraine headache 5. Oligohydramnios

1. Obesity 2. Multifetal pregnancy 4. Migraine headache

A nurse in an infertility clinic is providing care to a couple who has been unable to conceive for 18 months. Which of the following data should be included in the assessment? (Select all that apply.) 1. Occupation 2. Menstrual history 3. Childhood infectious disease 4. History of falls 5. Recent blood transfusions

1. Occupation 2. Menstrual history 3. Childhood infectious disease

A nurse is caring for a client who is at 42 weeks of gestation and is admitted to the labor and delivery unit. During an ultrasound, it is noted that the fetus is large for gestational age. The nurse reviews the prescription from the provider to begin an amnioinfusion. Which of the following conditions should the nurse plan to prepare an amnioinfusion? (Select all that apply.) 1. Oligohydramnios 2. Hydramnios 3. Fetal cord compression 4. Hydration 5. Fetal immaturity

1. Oligohydramnios 3. Fetal cord compression

A nurse is caring for a newborn who is preterm and has respiratory distress syndrome. Which of the following should the nurse monitor to evaluate the newborn's condition following administration of synthetic surfactant? 1. Oxygen saturation 2. Body temperature 3. Serum bilirubin 4. Heart rate

1. Oxygen saturation

The home care nurse is monitoring a pregnant client with gestational hypertension who is at risk for preeclampsia. At each home care visit, the nurse assesses the client for which classic signs of preeclampsia? Select all that apply. 1. Proteinuria 2. Hypertension 3. Low-grade fever 4. Generalized edema 5. Increased pulse rate 6. Increased respiratory rate

1. Proteinuria 2. Hypertension 4. Generalized edema

A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis. The nurse should evaluate which of the following tests to assess fetal lung maturity? 1. Alpha-fetoprotein (AFP) 2. Lecithin/sphingomyelin (L/S) ratio 3. Kleihauer-Betke test 4. Indirect Coombs' test

2. Lecithin/sphingomyelin (L/S) ratio

The nurse in a labor room is preparing to care for a client with hypertonic uterine contractions. The nurse is told that the client is experiencing uncoordinated contractions that are erratic in their frequency, duration, and intensity. What is the priority nursing action? 1. Provide pain relief measures. 2. Prepare the client for an amniotomy. 3. Promote ambulation every 30 minutes. 4. Monitor the oxytocin (Pitocin) infusion closely.

1. Provide pain relief measures.

A nurse is caring for a client who is in the second stage of labor. The client's labor has been progressing, and she is expected to deliver vaginally in 20 min. The provider is preparing to administer lidocaine for pain relief and perform an episiotomy. The nurse should know that which of the following types of regional anesthetic block is to be administered? 1. Pudendal 2. Epidural 3. Spinal 4. Paracervical

1. Pudendal

A nurse is administering magnesium sulfate IV to a client who has severe preeclampsia for seizure prophylaxis. Which of the following indicates magnesium sulfate toxicity? (Select all that apply.) 1. Respirations less than 12/min 2. Urinary output less than 30 mL/hr 3. Hyperreflexic deep-tendon reflexes 4. Decreased level of consciousness 5. Flushing and sweating

1. Respirations less than 12/min 2. Urinary output less than 30 mL/hr 4. Decreased level of consciousness

A client in labor is transported to the delivery room and prepared for a cesarean delivery. After the client is transferred to the delivery room table, the nurse should place the client in which position? 1. Supine position with a wedge under the right hip 2. Trendelenburg's position with the legs in stirrups 3. Prone position with the legs separated and elevated 4. Semi-Fowler's position with a pillow under the knees

1. Supine position with a wedge under the right hip

A pregnant client asks the nurse about the types of exercises that are allowable during pregnancy. The nurse should tell that client that which exercise is safest? 1. Swimming 2. Scuba diving 3. Low-impact gymnastics 4. Bicycling with the legs in the air

1. Swimming

The nurse in a newborn nursery is monitoring a preterm newborn for respiratory distress syndrome. Which assessment findings would alert the nurse to the possibility of this syndrome? 1. Tachypnea and retractions 2. Acrocyanosis and grunting 3. Hypotension and bradycardia 4. Presence of a barrel chest and acrocyanosis

1. Tachypnea and retractions

A pregnant client tells the clinic nurse that she wants to know the gender of her baby as soon as it can be determined. The nurse understands that the client should be able to find out the gender at 12 weeks' gestation because of which factor? 1. The appearance of the fetal external genitalia 2. The beginning of differentiation in the fetal groin 3. The fetal testes are descended into the scrotal sac 4. The internal differences in males and females become apparent

1. The appearance of the fetal external genitalia

The nurse is teaching a postpartum client about breast-feeding. Which instruction should the nurse include? 1. The diet should include additional fluids. 2. Prenatal vitamins should be discontinued. 3. Soap should be used to cleanse the breasts. 4. Birth control measures are unnecessary while breast-feeding.

1. The diet should include additional fluids.

A nurse is caring for a client who is pregnant and reviewing signs of complications the client should promptly report to the provider. Which of the following complications should the nurse include in the teaching? 1. Vaginal bleeding 2. Swelling of the ankles 3. Heartburn after eating 4. Lightheadedness when lying on back

1. Vaginal bleeding

The nurse is preparing a list of self-care instructions for a postpartum client who was diagnosed with mastitis. Which instructions should be included on the list? Select all that apply. 1. Wear a supportive bra. 2. Rest during the acute phase. 3. Maintain a fluid intake of at least 3000 mL. 4. Continue to breast-feed if the breasts are not too sore. 5. Take the prescribed antibiotics until the soreness subsides. 6. Avoid decompression of the breasts by breast-feeding or breast pump.

1. Wear a supportive bra. 2. Rest during the acute phase. 3. Maintain a fluid intake of at least 3000 mL. 4. Continue to breast-feed if the breasts are not too sore.

The nurse has been working with a laboring client and notes that she has been pushing effectively for 1 hour. What is the client's primary physiological need at this time? 1. Ambulation 2. Rest between contractions 3. Change positions frequently 4. Consume oral food and fluids

2. Rest between contractions

A pregnant client calls a clinic and tells the nurse that she is experiencing leg cramps that awaken her at night. What should the nurse tell the client to provide relief from the leg cramps? 1. "Bend your foot toward your body while flexing the knee when the cramps occur." 2. "Bend your foot toward your body while extending the knee when the cramps occur." 3. "Point your foot away from your body while flexing the knee when the cramps occur." 4. "Point your foot away from your body while extending the knee when the cramps occur."

2. "Bend your foot toward your body while extending the knee when the cramps occur."

A couple comes to the family planning clinic and asks about sterilization procedures. Which question by the nurse would determine whether this method of family planning would be most appropriate? 1. "Has either of you ever had surgery?" 2. "Do you plan to have any other children?" 3. "Do either of you have diabetes mellitus?" 4. "Do either of you have problems with high blood pressure?"

2. "Do you plan to have any other children?"

A nurse is preparing to administer prophylactic eye ointment to a newborn to prevent ophthalmia neonatrum. Which of the following medications should to nurse anticipate administering? 1. Ofloxacin 2. Nystatin 3. Erythromycin 4. Ceftriaxone

3. Erythromycin

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

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

A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement made by the client indicates a need for further instruction? 1. "I will watch for the evidence of the passage of tissue." 2. "I will maintain strict bed rest throughout the remainder of the pregnancy." 3. "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad." 4. "I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding."

2. "I will maintain strict bed rest throughout the remainder of the pregnancy."

A client who is at 8 weeks of gestation tells the nurse that she isn't sure she is happy about being pregnant. Which of the following responses should the nurse make? 1. "I will inform the provider you are having these feelings." 2. "It is normal to have these feelings during the first few months of pregnancy." 3. "You should be happy that you are going to bring new life into the world." 4. "I am going to make an appointment with the counselor for you to discuss these thoughts."

2. "It is normal to have these feelings during the first few months of pregnancy."

A 55-year-old male client confides in the nurse that he is concerned about his sexual function. What is the nurse's best response? 1. "How often do you have sexual relations?" 2. "Please share with me more about your concerns." 3. "You are still young and have nothing to be concerned about." 4. "You should not have a decline in testosterone until you are in your 80s."

2. "Please share with me more about your concerns."

A nurse is teaching a newly licensed nurse about neonatal abstinence syndrome. Which of the following statements by the newly licensed nurse indicate understanding of the teaching? 1. "The newborn will have decreased muscle tone." 2. "The newborn will have a continuous high-pitched cry." 3. "The newborn sleeps for 2 to 3 hours after a feeding." 4. "The newborn will have mild tremors when disturbed."

2. "The newborn will have a continuous high-pitched cry."

A pregnant client in the first trimester calls the nurse at a health care clinic and reports that she has noticed a thin, colorless vaginal drainage. The nurse should make which statement to the client? 1. "Come to the clinic immediately." 2. "The vaginal discharge may be bothersome, but is a normal occurrence." 3. "Report to the emergency department at the maternity center immediately." 4. "Use tampons if the discharge is bothersome, but to be sure to change the tampons every 2 hours."

2. "The vaginal discharge may be bothersome, but is a normal occurrence."

The nurse should include which statement to a pregnant client found to have a gynecoid pelvis? 1. "Your type of pelvis has a narrow pubic arch." 2. "Your type of pelvis is the most favorable for labor and birth." 3. "Your type of pelvis is a wide pelvis, but has a short diameter." 4. "You will need a cesarean section because this type of pelvis is not favorable for a vaginal delivery."

2. "Your type of pelvis is the most favorable for labor and birth."

A nurse in a prenatal clinic is caring for four clients. Which of the following client's weight gain should the nurse report to the provider? 1. 1.8 kg (4 lb) weight gain and is in her first trimester 2. 3.6 kg (8 lb) weight gain is in her first trimester 3. 6.8 kg (15 lb) weight gain and and is in her second trimester 4. 11.3 kg (25 lb) weight gain and is in her third trimester

2. 3.6 kg (8 lb) weight gain is in her first trimester

The nurse is performing an assessment of a pregnant client who is at 28 weeks of gestation. The nurse measures the fundal height in centimeters and expects which finding? 1. 22 cm 2. 30 cm 3. 36 cm 4. 40 cm

2. 30 cm

A nurse in a clinic is caring for a group of female clients who are being evaluated for infertility. Which of the following clients should the nurse anticipate the provider will refer to the genetic counselor? 1. A client whose sister has alopecia 2. A client whose partner has von Willebrand disease 3. A client who has an allergy to sulfa 4. A client who had rubella 3 months ago

2. A client whose partner has von Willebrand disease

The nurse notes hypotonia, irritability, and a poor sucking reflex in a full-term newborn on admission to the nursery. The nurse suspects fetal alcohol syndrome and is aware that which additional sign would be consistent with this syndrome? 1. Length of 19 inches 2. Abnormal palmar creases 3. Birth weight of 6 lb, 14 oz 4. Head circumference appropriate for gestational age

2. Abnormal palmar creases

The nurse is monitoring a client in the immediate postpartum period for signs of hemorrhage. Which sign, if noted, would be an early sign of excessive blood loss? 1. A temperature of 100.4 ° F 2. An increase in the pulse rate from 88 to 102 beats/minute 3. A blood pressure change from 130/88 to 124/80 mm Hg 4. An increase in the respiratory rate from 18 to 22 breaths/minute

2. An increase in the pulse rate from 88 to 102 beats/minute

A nurse is caring for a newborn who was born at 38 weeks of gestation, weighs 3,200 g, and is in the 60th percentile for weight. Based on the weight and gestational age, the nurse should classify this neonate as which of the following? 1. Low birth weight 2. Appropriate for gestational age 3. Small for gestational age 4. Large for gestational age

2. Appropriate for gestational age

The nurse is admitting a pregnant client to the labor room and attaches an external electronic fetal monitor to the client's abdomen. After attachment of the electronic fetal monitor, what is the next nursing action? 1. Identify the types of accelerations. 2. Assess the baseline fetal heart rate. 3. Determine the intensity of the contractions. 4. Determine the frequency of the contractions.

2. Assess the baseline fetal heart rate.

A newborn was not dried completely after birth. Which of the following mechanisms should the nurse understand causes heat loss? 1. Conduction 2. Convection 3. Evaporation 4. Radiation

3. Evaporation

A client in preterm labor (31 weeks) who is dilated to 4 cm has been started on magnesium sulfate and contractions have stopped. If the client's labor can be inhibited for the next 48 hours, the nurse anticipates a prescription for which medication? 1. Nalbuphine (Nubain) 2. Betamethasone (Celestone) 3. Rho(D) immune globulin (RhoGAM) 4. Dinoprostone (Cervidil vaginal insert)

2. Betamethasone (Celestone)

Methylergonovine (Methergine) is prescribed for a woman to treat postpartum hemorrhage. Before administration of methylergonovine, what is the priority nursing assessment? 1. Uterine tone 2. Blood pressure 3. Amount of lochia 4. Deep tendon reflexes

2. Blood pressure

A nurse is providing care for a client who is diagnosed with a marginal abruptio placentae. The nurse is aware that which of the following findings are risk factors for developing the condition? (Select all that apply.) 1. Fetal position 2. Blunt abdominal trauma 3. Cocaine use 4. Maternal age 5. Cigarette smoking

2. Blunt abdominal trauma 3. Cocaine use 5. Cigarette smoking

The nurse in a neonatal intensive care nursery (NICU) receives a telephone call to prepare for the admission of a 43-week gestation newborn with Apgar scores of 1 and 4. In planning for admission of this newborn, what is the nurse's highest priority? 1. Turn on the apnea and cardiorespiratory monitors. 2. Connect the resuscitation bag to the oxygen outlet. 3. Set up the intravenous line with 5% dextrose in water. 4. Set the radiant warmer control temperature at 36.5° C (97.6° F).

2. Connect the resuscitation bag to the oxygen outlet.

The postpartum nurse is providing instructions to the mother of a newborn with hyperbilirubinemia who is being breast-fed. The nurse should provide which most appropriate instruction to the mother? 1. Feed the newborn less frequently. 2. Continue to breast-feed every 2 to 4 hours. 3. Switch to bottle-feeding the infant for 2 weeks. 4. Stop breast-feeding and switch to bottle-feeding permanently.

2. Continue to breast-feed every 2 to 4 hours.

The nurse is assisting a client undergoing induction of labor at 41 weeks' gestation. The client's contractions are moderate and occurring every 2 to 3 minutes, with a duration of 60 seconds. An internal fetal heart rate monitor is in place. The baseline fetal heart rate has been 120 to 122 beats/minute for the past hour. What is the priority nursing action? 1. Notify the health care provider. 2. Discontinue the infusion of oxytocin (Pitocin). 3. Place oxygen on at 8 to 10 L/minute via face mask. 4. Contact the client's primary support person(s) if not currently present

2. Discontinue the infusion of oxytocin (Pitocin).

A nurse is caring for a client who is receiving oxytocin for induction of labor and has an intrauterine pressure catheter (IUPC) placed to monitor uterine contractions. For which of the following contraction patterns should the nurse discontinue the infusion of oxytocin? 1. Frequency of every 2 min 2. Duration of 90 to 120 seconds 3. Intensity of 60 to 90 mm Hg 4. Resting tone of 15 mm Hg

2. Duration of 90 to 120 seconds

A nurse in the emergency department is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states she missed one menstrual cycle and cannot be pregnant because she has an intrauterine device. The nurse should suspect which of the following? 1. Missed aborption 2. Ectopic pregnancy 3. Severe preeclampsia 4. Hydatidiform mole

2. Ectopic pregnancy

A postpartum client is diagnosed with cystitis. The nurse should plan for which priority nursing action in the care of the client? 1. Providing sitz baths 2. Encouraging fluid intake 3. Placing ice on the perineum 4. Monitoring hemoglobin and hematocrit levels

2. Encouraging fluid intake

A nurse is reviewing findings of a client's biophysical profile (BPP). The nurse should expect which of the following variables to be included in the test? (Select all that apply.) 1. Fetal weight 2. Fetal breathing movement 3. Fetal tone 4. Fetal position 5. Amniotic fluid volume

2. Fetal breathing movement 3. Fetal tone 5. Amniotic fluid volume

The nurse is performing an assessment of a client who is scheduled for a cesarean delivery. Which assessment finding would indicate the need to contact the health care provider? 1. Hemoglobin of 11 g/dL 2. Fetal heart rate of 180 beats/minute 3. Maternal pulse rate of 85 beats/minute 4. White blood cell count of 12,000 cells/mm3

2. Fetal heart rate of 180 beats/minute

The nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year-old child who was delivered at 38 weeks and tells the nurse that she does not have a history of any type of abortion or fetal demise. Using GTPAL, what should the nurse document in the client's chart? 1. G = 3, T = 2, P = 0, A = 0, L = 1 2. G = 2, T = 1, P = 0, A = 0, L = 1 3. G = 1, T = 1, P = 1, A = 0, L = 1 4. G = 2, T = 0, P = 0, A = 0, L = 1

2. G = 2, T = 1, P = 0, A = 0, L = 1

A nurse is reviewing the health record of a client who is pregnant. The provider indicated the client exhibits probable signs of pregnancy. Which of the following findings should the nurse expect? (Select all that apply.) 1. Montgomery's glands 2. Goodell's sign 3. Ballottement 4. Chadwick's sign 5. Quickening

2. Goodell's sign 3. Ballottement 4. Chadwick's sign

The nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with a placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which risk associated with placenta previa? 1. Infection 2. Hemorrhage 3. Chronic hypertension 4. Disseminated intravascular coagulation

2. Hemorrhage

The nurse is preparing to administer beractant (Survanta) to a premature infant who has respiratory distress syndrome. The nurse plans to administer the medication by which route? 1. Intradermal 2. Intratracheal 3. Subcutaneous 4. Intramuscular

2. Intratracheal

A nurse is teaching a client about potential adverse effects of implantable progestins. Which of the following adverse effects should the nurse include? (Select all that apply.) 1. Tinnitus 2. Irregular vaginal bleeding 3. Weight gain 4. Breast changes 5. Gingival hyperplasia

2. Irregular vaginal bleeding 3. Weight gain 4. Breast changes

A client arrives at the clinic for the first prenatal assessment. She tells the nurse that the first day of her last menstrual period was October 19, 2014. Using Nägele's rule, which expected date of delivery should the nurse document in the client's chart? 1. July 12, 2014 2. July 26, 2015 3. August 12, 2015 4. August 26, 2015

2. July 26, 2015

The nurse is planning care for a newborn of a mother with diabetes mellitus. What is the priority nursing consideration for this newborn? 1. Developmental delays because of excessive size 2. Maintaining safety because of low blood glucose levels 3. Choking because of impaired suck and swallow reflexes 4. Elevated body temperature because of excess fat and glycogen

2. Maintaining safety because of low blood glucose levels

The nurse develops a plan of care for a woman with human immunodeficiency virus infection and her newborn. The nurse should include which intervention in the plan of care? 1. Monitoring the newborn's vital signs routinely 2. Maintaining standard precautions at all times while caring for the newborn 3. Initiating referral to evaluate for blindness, deafness, learning problems, or behavioral problems 4. Instructing the breast-feeding mother regarding the treatment of the nipples with nystatin ointment

2. Maintaining standard precautions at all times while caring for the newborn

A nurse is preparing to assess the uterine fundus of a client in the immediate postpartum period. After locating the fundus, the nurse notes that the uterus feels soft and boggy. Which nursing intervention would be most appropriate? 1. Elevate the client's legs. 2. Massage the fundus until it is firm. 3. Ask the client to turn on her left side. 4. Push on the uterus to assist in expressing clots.

2. Massage the fundus until it is firm.

The nurse has developed a plan of care for a client experiencing dystocia and includes several nursing actions in the plan of care. What is the priority nursing action? 1. Providing comfort measures 2. Monitoring the fetal heart rate 3. Changing the client's position frequently 4. Keeping the significant other informed of the progress of the labor

2. Monitoring the fetal heart rate

The maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the health care provider's prescriptions and should question which prescription? 1. Prepare the client for an ultrasound. 2. Obtain equipment for a manual pelvic examination. 3. Prepare to draw a hemoglobin and hematocrit blood sample. 4. Obtain equipment for external electronic fetal heart rate monitoring.

2. Obtain equipment for a manual pelvic examination.

The nurse in a labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. What is the first nursing action with this finding? 1. Gently push the cord into the vagina. 2. Place the client in Trendelenburg's position. 3. Find the closest telephone and page the health care provider stat. 4. Call the delivery room to notify the staff that the client will be transported immediately.

2. Place the client in Trendelenburg's position.

A rubella titer result of a 1-day postpartum client is less than 1:8, and a rubella virus vaccine is prescribed to be administered before discharge. The nurse provides which information to the client about the vaccine? Select all that apply. 1. Breast-feeding needs to be stopped for 3 months. 2. Pregnancy needs to be avoided for 1 to 3 months. 3. The vaccine is administered by the subcutaneous route. 4. Exposure to immunosuppressed individuals needs to be avoided. 5. A hypersensitivity reaction can occur if the client has an allergy to eggs. 6. The area of the injection needs to be covered with a sterile gauze for 1 week.

2. Pregnancy needs to be avoided for 1 to 3 months. 3. The vaccine is administered by the subcutaneous route. 4. Exposure to immunosuppressed individuals needs to be avoided. 5. A hypersensitivity reaction can occur if the client has an allergy to eggs.

A nurse is caring for a client who is in the transition phase of labor and reports that she needs to have a bowel movement with the peak of contractions. Which of the following actions should the nurse make? 1. Assist the client to the bathroom. 2. Prepare for an impending delivery. 3. Prepare to remove a fecal impaction. 4. Encourage the client to take deep cleansing breaths.

2. Prepare for an impending delivery.

A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxation between hypertonic contractions. The nurse should identify that this contraction pattern increases the risk for which of the following complications? 1. Prolonged labor 2. Reduced fetal oxygen supply 3. Delayed cervical dilation 4. Increased maternal stress

2. Reduced fetal oxygen supply

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which finding is noted on assessment? 1. Proteinuria of 3 + 2. Respirations of 10 breaths/minute 3. Presence of deep tendon reflexes 4. Serum magnesium level of 6 mEq/L

2. Respirations of 10 breaths/minute

A nurse is caring for a client who is in active labor. The client reports lower-back pain. The nurse suspects this pain is related to a persistent occiput posterior fetal position. Which of the following nonpharmacological nursing interventions should the nurse recommend to the client? 1. Abdominal effleurage 2. Sacral counterpressure 3. Showering if not contraindicated 4. Back rub and massage

2. Sacral counterpressure

After a precipitous delivery, the nurse notes that the new mother is passive and only touches her newborn infant briefly with her fingertips. What should the nurse do to help the woman process the delivery? 1. Encourage the mother to breast-feed soon after birth. 2. Support the mother in her reaction to the newborn infant. 3. Tell the mother that it is important to hold the newborn infant. 4. Document a complete account of the mother's reaction on the birth record.

2. Support the mother in her reaction to the newborn infant.

The nurse is performing an initial assessment on a client who has just been told that a pregnancy test is positive. Which assessment finding indicates that the client is at risk for preterm labor? 1. The client is a 35-year-old primigravida 2. The client has a history of cardiac disease 3. The client's hemoglobin level is 13.5 g/dL 4. The client is a 20-year-old primigravida of average weight and height

2. The client has a history of cardiac disease

A nurse is caring for a client who has suspected hyperemesis gravidarum and is reviewing the client's laboratory reports. Which of the following findings is a manifestation of this condition? 1. Hgb 12.2 g/dL 2. Urine ketones present 3. Alanine aminotransferase 20 IU/L 4. Serum glucose 114 mg/dL

2. Urine ketones present

The nurse is assessing a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which assessment finding should the nurse expect to note if this condition is present? 1. Soft abdomen 2. Uterine tenderness 3. Absence of abdominal pain 4. Painless, bright red vaginal bleeding

2. Uterine tenderness

The nurse is providing instructions to a client in the first trimester of pregnancy regarding measures to assist in reducing breast tenderness. Which instruction should the nurse provide? 1. Avoid wearing a bra. 2. Wash the breasts with warm water and keep them dry. 3. Wear tight-fitting blouses or dresses to provide support. 4. Wash the nipples and areolar area daily with soap, and massage the breasts with lotion

2. Wash the breasts with warm water and keep them dry.

The nurse is performing an assessment of a primigravida who is being evaluated in a clinic during her second trimester of pregnancy. Which finding concerns the nurse and indicates the need for follow-up? 1. Quickening 2. Braxton Hicks contractions 3. Fetal heart rate of 180 beats/minute 4. Consistent increase in fundal height

3. Fetal heart rate of 180 beats/minute

A nurse is reviewing a new prescription for ferrous sulfate with a client who is at 12 weeks of gestation. Which of the following statements by the client indicates understanding of the teaching? 1. "I will take this pill with my breakfast." 2. "I will take this medication with a glass of milk." 3. "I plan to drink more orange juice while taking this pill." 4. "I plan to add more calcium-rich foods to my diet while taking this medication."

3. "I plan to drink more orange juice while taking this pill."

The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching? 1. "I should stay on the diabetic diet." 2. "I should perform glucose monitoring at home." 3. "I should avoid exercise because of the negative effects on insulin production." 4. "I should be aware of any infections and report signs of infection immediately to my health care provider."

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

A nurse is caring for a client following administration of an epidural block and is preparing to administer an IV fluid bolus. The client's partner asks about the purpose of the IV fluids. Which of the following is an appropriate response for the nurse to make? 1. "It is needed to promote increased urine output." 2. "It is needed to counteract respiratory depression." 3. "It is needed to counteract hypotension." 4. "It is needed to prevent oligohydramnios."

3. "It is needed to counteract hypotension."

The nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why the fertilized ovum stays in the fallopian tube for 3 days, what is the nurse's best response? 1. "It promotes the fertilized ovum's chances of survival." 2. "It promotes the fertilized ovum's exposure to estrogen and progesterone." 3. "It promotes the fertilized ovum's normal implantation in the top portion of the uterus." 4. "It promotes the fertilized ovum's exposure to luteinizing hormone and follicle-stimulating hormone."

3. "It promotes the fertilized ovum's normal implantation in the top portion of the uterus."

A nurse is caring for a couple who is being evaluated for infertility. Which of the following statements by the nurse indicates understanding of the infertility assessment process? 1. "You will need to see a genetic counselor as a part of the assessment." 2. "It is usually the woman who is having trouble, so the man doesn't have to be involved." 3. "The man is the easiest to assess, and the provider will usually begin there." 4. "Think about adopting first because there are many babies that need good homes."

3. "The man is the easiest to assess, and the provider will usually begin there."

Which assessment finding following an amniotomy should be conducted first? 1. Cervical dilation 2. Bladder distention 3. Fetal heart rate pattern 4. Maternal blood pressure

3. Fetal heart rate pattern

A health care provider has prescribed transvaginal ultrasonography for a client in the first trimester of pregnancy and the client asks the nurse about the procedure. How should the nurse respond to the client? 1. "The procedure takes about 2 hours." 2. "It will be necessary to drink 1 to 2 quarts of water before the examination." 3. "The probe that will be inserted into the vagina will be covered with a disposable cover and coated with a gel." 4. "Gel is spread over the abdomen, and a round disk transducer will be moved over the abdomen to obtain the picture."

3. "The probe that will be inserted into the vagina will be covered with a disposable cover and coated with a gel."

A nurse is caring for a client and her partner during the second stage of labor. The client's partner asks the nurse to explain how he will know when crowning occurs. Which of the following responses should the nurse make? 1. "The placenta will protrude from the vagina." 2. "Your partner will report a decrease in intensity of contractions." 3. "The vaginal area will bulge as the baby's head appears." 4. "Your partner will report less rectal pressure."

3. "The vaginal area will bulge as the baby's head appears."

A nurse in a prenatal clinic is caring for a client who is pregnant experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following responses should the nurse make? 1. "This is due to an increase in blood volume." 2. "This is due to pressure from the uterus on the diaphragm." 3. "This is due to the weight of the uterus on the vena cava." 4. "This is due to increased cardiac output."

3. "This is due to the weight of the uterus on the vena cava."

The nursing student is preparing to teach a prenatal class about fetal circulation. Which statement should be included in the teaching plan? 1. "One artery carries oxygenated blood from the placenta to the fetus." 2. "Two arteries carry oxygenated blood from the placenta to the fetus." 3. "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta." 4. "Two veins carry blood that is high in carbon dioxide and other waste products away from the fetus to the placenta."

3. "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta."

A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements should the nurse include in the teaching? 1. "You will lay on your right side during the procedure." 2. "You should not eat anything for 24 hours prior to the procedure." 3. "You should empty your bladder prior to the procedure." 4. "The test is done to determine gestational age."

3. "You should empty your bladder prior to the procedure."

A nurse in a clinic is teaching a client about her new prescription for medroxyprogesterone. Which of the following information should the nurse include in the teaching? (Select all that apply.) 1. "Weight loss can occur." 2. "You are protected against STIs." 3. "You should increase your intake of calcium." 4. "You should avoid taking antibiotics." 5. "Irregular vaginal spotting can occur."

3. "You should increase your intake of calcium." 5. "Irregular vaginal spotting can occur."

The nurse is reviewing the record of a client in the labor room and notes that the health care provider has documented that the fetal presenting part is at the -1 station. This documented finding indicates that the fetal presenting part is located at which area? 1. 1 inch below the coccyx 2. 1 inch below the iliac crest 3. 1 cm above the ischial spine 4. 1 fingerbreadth below the symphysis pubis

3. 1 cm above the ischial spine

The nurse in a maternity unit is reviewing the clients' records. Which client would the nurse identify as being at the most risk for developing disseminated intravascular coagulation? 1. A primigravida with mild preeclampsia 2. A primigravida who delivered a 10-lb infant 3 hours ago 3. A gravida II who has just been diagnosed with dead fetus syndrome 4. A gravida IV who delivered 8 hours ago and has lost 500 mL of blood

3. A gravida II who has just been diagnosed with dead fetus syndrome

The nurse is providing instructions to a pregnant client who is scheduled for an amniocentesis. What instruction should the nurse provide? 1. Strict bed rest is required after the procedure. 2. Hospitalization is necessary for 24 hours after the procedure. 3. An informed consent needs to be signed before the procedure. 4. A fever is expected after the procedure because of the trauma to the abdomen.

3. An informed consent needs to be signed before the procedure.

A nurse is completing an assessment. Which of the following data indicate the newborn is adapting to extrauterine life? (Select all that apply.) 1. Expiratory grunting 2. Inspiratory nasal flaring 3. Apnea for 10-second periods 4. Obligatory nose breathing 5. Crackles and wheezing

3. Apnea for 10-second periods 4. Obligatory nose breathing

A nursing student is assigned to care for a client in labor. The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. Which statement is correct regarding the ductus venosus? 1. Connects the pulmonary artery to the aorta 2. Is an opening between the right and left atria 3. Connects the umbilical vein to the inferior vena cava 4. Connects the umbilical artery to the inferior vena cava

3. Connects the umbilical vein to the inferior vena cava

The nurse is assessing a newborn who was born to a mother who is addicted to drugs. Which assessment finding would the nurse expect to note during the assessment of this newborn? 1. Lethargy 2. Sleepiness 3. Constant crying 4. Cuddles when being held

3. Constant crying

The nurse is assessing a newborn after circumcision and notes that the circumcised area is red with a small amount of bloody drainage. Which nursing action is most appropriate? 1. Apply gentle pressure. 2. Reinforce the dressing. 3. Document the findings. 4. Contact the health care provider (HCP).

3. Document the findings.

The nurse assisted with the delivery of a newborn. Which nursing action is most effective in preventing heat loss by evaporation? 1. Warming the crib pad 2. Closing the doors to the room 3. Drying the infant with a warm blanket 4. Turning on the overhead radiant warmer

3. Drying the infant with a warm blanket

The postpartum nurse is assessing a client who delivered a healthy infant by cesarean section for signs and symptoms of superficial venous thrombosis. Which sign would the nurse note if superficial venous thrombosis were present? 1. Paleness of the calf area 2. Coolness of the calf area 3. Enlarged, hardened veins 4. Palpable dorsalis pedis pulses

3. Enlarged, hardened veins

A pregnant client tells the nurse that she has been craving "unusual foods." The nurse gathers additional assessment data and discovers that the client has been ingesting daily amounts of white clay dirt from her backyard. Laboratory studies are performed and the nurse determines that which finding indicates a physiological consequence of the client's practice? 1. Hematocrit 38% 2. Glucose 86 mg/dL 3. Hemoglobin 9.1 g/dL 4. White blood cell count 12,400 cells/mm3

3. Hemoglobin 9.1 g/dL

A nurse at an antepartum clinic is caring for a client who is at 4 months gestation. The client reports continued nausea and vomiting and scant, prune-colored discharge. She has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect? 1. Hyperemesis gravidarum 2. Threatened abortion 3. Hydatidiform mole 4. Preterm labor

3. Hydatidiform mole

A client arrives at a birthing center in active labor. Her membranes are still intact, and the health care provider prepares to perform an amniotomy. What will the nurse relay to the client as the most likely outcome of the amniotomy? 1. Less pressure on her cervix 2. Decreased number of contractions 3. Increased efficiency of contractions 4. The need for increased maternal blood pressure monitoring

3. Increased efficiency of contractions

A pregnant client is seen for a regular prenatal visit and tells the nurse that she is experiencing irregular contractions. The nurse determines that she is experiencing Braxton Hicks contractions. On the basis of this finding, which nursing action is most appropriate? 1. Contact the health care provider. 2. Instruct the client to maintain bed rest for the remainder of the pregnancy. 3. Inform the client that these contractions are common and may occur throughout the pregnancy. 4. Call the maternity unit and inform them that the client will be admitted in a prelabor condition.

3. Inform the client that these contractions are common and may occur throughout the pregnancy.

The nurse is assessing a client who is 6 hours postpartum after delivering a full-term healthy newborn. The client complains to the nurse of feelings of faintness and dizziness. Which nursing action would be most appropriate? 1. Raise the head of the client's bed. 2. Obtain hemoglobin and hematocrit levels. 3. Instruct the client to request help when getting out of bed. 4. Inform the nursery room nurse to avoid bringing the newborn to the client until the mother's symptoms have subsided.

3. Instruct the client to request help when getting out of bed.

Which explanation should the nurse provide to the prenatal client about the purpose of the placenta? 1. It cushions and protects the baby. 2. It maintains the temperature of the baby. 3. It is the way the baby gets food and oxygen. 4. It prevents all antibodies and viruses from passing to the baby.

3. It is the way the baby gets food and oxygen.

On assessment of a postpartum client, the nurse notes that the uterus feels soft and boggy. The nurse should take which initial action? 1. Elevate the client's legs. 2. Document the findings. 3. Massage the fundus until it is firm. 4. Push on the uterus to assist in expressing clots.

3. Massage the fundus until it is firm.

A nurse is taking a newborn to a mother following a circumcision. Which of the following actions should the nurse take for security purposes? 1. Ask the mother to state her full name. 2. Look at the name on the newborn's bassinet. 3. Match the mother's identification band with the newborn's band. 4. Compare name on the bassinet and room number.

3. Match the mother's identification band with the newborn's band.

A nurse is caring for a client who is at 42 weeks of gestation and is in active labor. Which of the following findings is the fetus at risk for developing? 1. Intrauterine growth restriction 2. Hyperglycemia 3. Meconium aspiration 4. Polyhydramnios

3. Meconium aspiration

The nurse is assessing a client in the fourth stage of labor and notes that the fundus is firm, but that bleeding is excessive. Which should be the initial nursing action? 1. Record the findings. 2. Massage the fundus. 3. Notify the health care provider (HCP). 4. Place the client in Trendelenburg's position.

3. Notify the health care provider (HCP).

The nurse is performing an assessment on a client who is at 38 weeks' gestation and notes that the fetal heart rate is 174 beats/minute. On the basis of this finding, what is the priority nursing action? 1. Document the finding. 2. Check the mother's heart rate. 3. Notify the health care provider (HCP). 4. Tell the client that the fetal heart rate is normal

3. Notify the health care provider (HCP).

When performing a postpartum assessment on a client, a nurse notes the presence of clots in the lochia. The nurse examines the clots and notes that they are larger than 1 cm. Which nursing action is most appropriate? 1. Document the findings. 2. Reassess the client in 2 hours. 3. Notify the health care provider. 4. Encourage increased oral intake of fluids.

3. Notify the health care provider.

The nurse is reviewing the health care provider's (HCP's) prescriptions for a client admitted for premature rupture of the membranes. Gestational age of the fetus is determined to be 37 weeks. Which prescription should the nurse question? 1. Monitor fetal heart rate continuously. 2. Monitor maternal vital signs frequently. 3. Perform a vaginal examination every shift. 4. Administer ampicillin 1 g as an intravenous piggyback every 6 hours.

3. Perform a vaginal examination every shift.

A nurse is teaching a group of women who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the nurse include in the teaching? (Select all that apply.) 1. Avoid any lifting. 2. Perform Kegel exercises twice a day. 3. Perform the pelvic rock exercise every day. 4. Use proper body mechanics. 5. Avoid constrictive clothing.

3. Perform the pelvic rock exercise every day. 4. Use proper body mechanics.

The nurse is developing a plan of care for a postpartum client with a small vulvar hematoma. The nurse should include which specific action during the first 12 hours after delivery? 1. Assess vital signs every 4 hours. 2. Measure fundal height every 4 hours. 3. Prepare an ice pack for application to the area. 4. Inform the health care provider of assessment findings.

3. Prepare an ice pack for application to the area.

A nurse is caring for a client who had no prenatal care, is Rh-negative, and will undergo an external version at 37 weeks of gestation. Which of the following medications should the nurse plan to administer prior to the version? 1. Prostaglandin gel 2. Magnesium sulfate 3. Rho(D) immune globulin 4. Oxytocin

3. Rho(D) immune globulin

The nurse is caring for a client in labor. Which assessment finding indicates to the nurse that the client is beginning the second stage of labor? 1. The contractions are regular. 2. The membranes have ruptured. 3. The cervix is dilated completely. 4. The client begins to expel clear vaginal fluid.

3. The cervix is dilated completely.

The nurse is monitoring a client who is receiving oxytocin (Pitocin) to induce labor. Which assessment finding would cause the nurse to immediately discontinue the oxytocin infusion? 1. Fatigue 2. Drowsiness 3. Uterine hyperstimulation 4. Early decelerations of the fetal heart rate

3. Uterine hyperstimulation

A nurse in an obstetrical clinic is teaching a client about using an IUD for contraception. Which of the following statements by the client indicates an understanding of the teaching? 1. "An IUD should be replaced annually during a pelvic exam." 2. "I cannot can an IUD until after I've had a child." 3. "I should expect intermittent abdominal pain while the IUD is in place." 4. "A change in the string length of my IUD is expected."

4. "A change in the string length of my IUD is expected."

A nurse is caring for a client who is in the first stage of labor and is encouraging the client to void every 2 hr. Which of the following statements should the nurse make? 1. "A full bladder increases the risk for fetal trauma." 2. "A full bladder increases the risk for bladder infections." 3. "A distended bladder will be traumatized by frequent pelvic exams." 4. "A distended bladder reduces pelvic space needed for birth."

4. "A distended bladder reduces pelvic space needed for birth."

A nurse manager is reviewing ways to prevent TORCH infection during pregnancy with a group of newly licensed nurses. Which of the following statements by a nurse indicates understanding of the teaching? 1. "Obtain an immunization against rubella early in pregnancy." 2. "Seek prophylactic treatment if cytomegalovirus is detected during pregnancy." 3. "A woman should avoid crowded places during pregnancy." 4. "A woman should avoid consuming undercooked meat while pregnant."

4. "A woman should avoid consuming undercooked meat while pregnant."

The nurse is providing instructions regarding treatment of hemorrhoids to a client who is in the second trimester of pregnancy. Which statement by the client indicates a need for further instruction? 1. "I should avoid straining during bowel movements." 2. "I can gently replace the hemorrhoids into the rectum." 3. "I can apply ice packs to the hemorrhoids to reduce the swelling." 4. "I should apply heat packs to the hemorrhoids to help the hemorrhoids shrink."

4. "I should apply heat packs to the hemorrhoids to help the hemorrhoids shrink."

The clinic nurse is providing instructions to a pregnant client regarding measures that assist in alleviating heartburn. Which statement by the client indicates an understanding of the instructions? 1. "I should avoid between-meal snacks." 2. "I should lie down for an hour after eating." 3. "I should use spices for cooking rather than using salt." 4. "I should avoid eating foods that produce gas and fatty foods."

4. "I should avoid eating foods that produce gas and fatty foods."

The nurse is providing instructions to a maternity client with a history of cardiac disease regarding appropriate dietary measures. Which statement, if made by the client, indicates an understanding of the information provided by the nurse? 1. "I should increase my sodium intake during pregnancy." 2. "I should lower my blood volume by limiting my fluids." 3. "I should maintain a low-calorie diet to prevent any weight gain." 4. "I should drink adequate fluids and increase my intake of high-fiber foods."

4. "I should drink adequate fluids and increase my intake of high-fiber foods."

The nurse is providing instructions about measures to prevent postpartum mastitis to a client who is breast-feeding her newborn. Which client statement would indicate a need for further instruction? 1. "I should breast-feed every 2 to 3 hours." 2. "I should change the breast pads frequently." 3. "I should wash my hands well before breast- feeding." 4. "I should wash my nipples daily with soap and water."

4. "I should wash my nipples daily with soap and water."

The nurse has instructed a pregnant client in measures to prevent varicose veins during pregnancy. Which statement by the client indicates a need for further instructions? 1. "I should wear panty hose." 2. "I should wear support hose." 3. "I should wear flat nonslip shoes that have good support." 4. "I should wear knee-high hose, but I should not leave them on longer than 8 hours."

4. "I should wear knee-high hose, but I should not leave them on longer than 8 hours."

Which statement reflects a new mother's understanding of the teaching about the prevention of newborn abduction? 1. "I will place my baby's crib close to the door." 2. "Some health care personnel won't have name badges." 3. "It's OK to allow the unlicensed assistive personnel to carry my newborn to the nursery." 4. "I will ask the nurse to attend to my infant if I am napping and my husband is not here."

4. "I will ask the nurse to attend to my infant if I am napping and my husband is not here."

A nurse is reviewing postpartum nutrition needs with a group of new mothers who are breastfeeding their newborns. Which of the following statements by a member of the group indicates an understanding of the teaching? 1. "I am glad I can have my morning coffee." 2. "I should take folic acid to increase my milk supply." 3. "I will continue adding 330 calories per day to my diet." 4. "I will continue my calcium supplements because I don't like milk."

4. "I will continue my calcium supplements because I don't like milk."

A nurse is caring for a client who is pregnant and undergoing a nonstress test. The client asks why the nurse is using an acoustic vibration device. Which of the following responses should the nurse make? 1. "It is used to stimulate uterine contractions." 2. "It will decrease the incidence of uterine contractions." 3. "It lulls the fetus to sleep." 4. "It awakens a sleeping fetus."

4. "It awakens a sleeping fetus."

The nurse is reviewing true and false labor signs with a multiparous client. The nurse determines that the client understands the signs of true labor if she makes which statement? 1. "I won't be in labor until my baby drops." 2. "My contractions will be felt in my abdominal area." 3. "My contractions will not be as painful if I walk around." 4. "My contractions will increase in duration and intensity."

4. "My contractions will increase in duration and intensity."

The nurse prepares to administer a vitamin K injection to a newborn, and the mother asks the nurse why her infant needs the injection. What best response should the nurse provide? 1. "Your newborn needs vitamin K to develop immunity." 2. "The vitamin K will protect your newborn from being jaundiced." 3. "Newborns have sterile bowels, and vitamin K promotes the growth of bacteria in the bowel." 4. "Newborns are deficient in vitamin K, and this injection prevents your newborn from bleeding."

4. "Newborns are deficient in vitamin K, and this injection prevents your newborn from bleeding."

A nurse in a clinic receives a phone call from a client who believes she is pregnant and would like to be tested in the clinic to confirm her pregnancy. Which of the following information should the nurse provide to the client? 1. "You should wait until 4 weeks after conception to be tested." 2. "You should be off any medications for 24 hours prior to the test." 3. "You should be NPO for at least 8 hours prior to the test." 4. "You should collect urine from the first morning void."

4. "You should collect urine from the first morning void."

A nurse is caring for a client who is at 42 weeks of gestation and in labor. The client asks the nurse what should she expect because her baby is postmature. Which of the following statements should the nurse make? 1. "Your baby will have excess body fat." 2. "Your baby will have flat areola without breast buds." 3. "Your baby's heels will easily move to his ears." 4. "Your baby's skin will have a leathery appearance."

4. "Your baby's skin will have a leathery appearance."

A pregnant client asks the nurse in the clinic when she will be able to begin to feel the fetus move. The nurse responds by telling the mother that fetal movements will be noted between which weeks of gestation? 1. 6 and 8 2. 8 and 10 3. 10 and 12 4. 14 and 18

4. 14 and 18

The nurse is providing instructions to a pregnant client with genital herpes about the measures that are needed to protect the fetus. Which instruction should the nurse provide to the client? 1. Total abstinence from sexual intercourse is necessary during the entire pregnancy. 2. Sitz baths need to be taken every 4 hours while awake if vaginal lesions are present. 3. Daily administration of acyclovir (Zovirax) is necessary during the entire pregnancy. 4. A cesarean section will be necessary if vaginal lesions are present at the time of labor.

4. A cesarean section will be necessary if vaginal lesions are present at the time of labor.

The nurse is preparing to care for four assigned clients. Which client is at highest risk for hemorrhage? 1. A primiparous client who delivered 4 hours ago 2. A multiparous client who delivered 6 hours ago 3. A primiparous client who delivered 6 hours ago and had epidural anesthesia 4. A multiparous client who delivered a large baby after oxytocin (Pitocin) induction

4. A multiparous client who delivered a large baby after oxytocin (Pitocin) induction

A client in a postpartum unit complains of sudden sharp chest pain and dyspnea. The nurse notes that the client is tachycardic and the respiratory rate is elevated. The nurse suspects a pulmonary embolism. Which should be the initial nursing action? 1. Initiate an intravenous line. 2. Assess the client's blood pressure. 3. Prepare to administer morphine sulfate. 4. Administer oxygen, 8 to 10 L/minute, by face mask.

4. Administer oxygen, 8 to 10 L/minute, by face mask.

Fetal distress is occurring with a laboring client. As the nurse prepares the client for a cesarean birth, what is the most important nursing action? 1. Slow the intravenous flow rate. 2. Place the client in a high Fowler's position. 3. Continue the oxytocin (Pitocin) drip if infusing. 4. Administer oxygen, 8 to 10 L/minute, via face mask.

4. Administer oxygen, 8 to 10 L/minute, via face mask.

Rho(D) immune globulin (RhoGAM) is prescribed for a client after delivery and the nurse provides information to the client about the purpose of the medication. The nurse determines that the woman understands the purpose if the woman states that it will protect her next baby from which condition? 1. Having Rh-positive blood 2. Developing a rubella infection 3. Developing physiological jaundice 4. Being affected by Rh incompatibility

4. Being affected by Rh incompatibility

The nurse is performing an assessment on a client diagnosed with placenta previa. Which of these assessment findings would the nurse expect to note? Select all that apply. 1. Uterine rigidity 2. Uterine tenderness 3. Severe abdominal pain 4. Bright red vaginal bleeding 5. Soft, relaxed, nontender uterus 6. Fundal height may be greater than expected for gestational age.

4. Bright red vaginal bleeding 5. Soft, relaxed, nontender uterus 6. Fundal height may be greater than expected for gestational age.

A nurse is caring for a client who is receiving IV magnesium sulfate. Which of the following medications should the nurse anticipate administering if magnesium sulfate toxicity is suspected? 1. Nifedipine 2. Pyridoxine 3. Ferrous sulfate 4. Calcium gluconate

4. Calcium gluconate

A nurse is caring for a client in active labor. When last examined 2 hr ago, the client's cervix was 3 cm dilated, 100% effaced, membranes intact, and the fetus was at a -2 station. The client suddenly states "My water broke." The monitor reveals a FHR of 80 to 85/min, and the nurse performs a vaginal examination, noticing clear fluid and a pulsing loop of umbilical cord in the client's vagina. Which of the following nursing actions should the nurse perform first? 1. Place the client in the Trendelenburg position. 2. Apply pressure to the presenting part with her fingers. 3. Administer oxygen at 10 L/min via a face mask. 4. Call for assistance.

4. Call for assistance.

A nurse is caring for a newborn immediately following birth. Which of the following nursing interventions is the highest priority? 1. Initiating breastfeeding 2. Performing the initial bath 3. Giving a vitamin K injection 4. Covering the newborn's head with a cap

4. Covering the newborn's head with a cap

A nurse in labor and delivery is planning care for a newly admitted client who reports she is in labor and has been having vaginal bleeding for 2 weeks. Which of the following should the nurse include in the plan of care? 1. Inspect the introitus for a prolapsed cord. 2. Perform a test to identify the ferning pattern. 3. Monitor station of the presenting part. 4. Defer vaginal examinations.

4. Defer vaginal examinations.

The nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which action is most appropriate? 1. Notify the health care provider of the findings. 2. Reposition the mother and check the monitor for changes in the fetal tracing. 3. Take the mother's vital signs and tell the mother that bed rest is required to conserve oxygen. 4. Document the findings and tell the mother that the pattern on the monitor indicates fetal wellbeing.

4. Document the findings and tell the mother that the pattern on the monitor indicates fetal wellbeing.

A nurse is completing a newborn assessment and observes small white nodules on the roof of the newborn's mouth. This finding is a characteristic of which of the following conditions? 1. Mongolian spots 2. Milia spots 3. Erythema toxicum 4. Epstein's pearls

4. Epstein's pearls

The nurse is performing an assessment on a pregnant client with a diagnosis of severe preeclampsia. The nurse reviews the assessment findings and determines that which finding is most closely associated with a complication of this diagnosis? 1. Enlargement of the breasts 2. Complaints of feeling hot when the room is cool 3. Periods of fetal movement followed by quiet periods 4. Evidence of bleeding, such as in the gums, petechiae, and purpura

4. Evidence of bleeding, such as in the gums, petechiae, and purpura

A nurse is assessing the reflexes of a newborn. In checking for the Moro reflex, the nurse should perform which of the following? 1. Hold the newborn vertically under the arms and allow one foot to touch the table. 2. Stimulate the pads of the newborn's hands with stroking or massage. 3. Stimulates the souls of the newborn's feet on the outer lateral surface of each foot. 4. Hold the newborn in a semi-sitting position, then allow the newborn's head and trunk to fall backward.

4. Hold the newborn in a semi-sitting position, then allow the newborn's head and trunk to fall backward.

The postpartum nurse is taking the vital signs of a client who delivered a healthy newborn 4 hours ago. The nurse notes that the client's temperature is 100.2° F. What is the priority nursing action? 1. Document the findings. 2. Retake the temperature in 15 minutes. 3. Notify the health care provider (HCP). 4. Increase hydration by encouraging oral fluids.

4. Increase hydration by encouraging oral fluids.

The health care provider (HCP) is assessing the client for the presence of ballottement. To make this determination, the HCP should take which action? 1. Auscultate for fetal heart sounds. 2. Assess the cervix for compressibility. 3. Palpate the abdomen for fetal movement. 4. Initiate a gentle upward tap on the cervix.

4. Initiate a gentle upward tap on the cervix.

A pregnant client reports to a health care clinic, complaining of loss of appetite, weight loss, and fatigue. After assessment of the client, tuberculosis is suspected. A sputum culture is obtained and identifies Mycobacterium tuberculosis. Which instruction should the nurse include in the client's teaching plan? 1. Therapeutic abortion is required. 2. She will have to stay at home until treatment is completed. 3. Medication will not be started until after delivery of the fetus. 4. Isoniazid plus rifampin (Rifadin) will be required for 9 months.

4. Isoniazid plus rifampin (Rifadin) will be required for 9 months.

The nurse is preparing to care for a newborn receiving phototherapy. Which interventions should be included in the plan of care? Select all that apply. 1. Avoid stimulation. 2. Decrease fluid intake. 3. Expose all of the newborn's skin. 4. Monitor skin temperature closely. 5. Reposition the newborn every 2 hours. 6. Cover the newborn's eyes with eye shields or patches.

4. Monitor skin temperature closely. 5. Reposition the newborn every 2 hours. 6. Cover the newborn's eyes with eye shields or patches.

The nurse is preparing a plan of care for a newborn with fetal alcohol syndrome. The nurse should include which priority intervention in the plan of care? 1. Allow the newborn to establish own sleep-rest pattern. 2. Maintain the newborn in a brightly lighted area of the nursery. 3. Encourage frequent handling of the newborn by staff and parents. 4. Monitor the newborn's response to feedings and weight gain pattern.

4. Monitor the newborn's response to feedings and weight gain pattern.

A nurse in a clinic is teaching a client of a childbearing age about recommended folic acid supplements. Which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency? 1. Iron deficiency anemia 2. Poor bone formation 3. Macrosomic fetus 4. Neural tube defects

4. Neural tube defects

A nurse is reviewing a new prescription for a client with iron supplements with a client who is in the 8th week of gestation and has iron deficiency anemia. Which of the following beverages should the nurse instruct the client to take the iron supplement with? 1. Ice water 2. Low-fat whole milk 3. Tea or coffee 4. Orange juice

4. Orange juice

Methylergonovine (Methergine) is prescribed for a client with postpartum hemorrhage. Before administering the medication, the nurse contacts the health care provider who prescribed the medication if which condition is documented in the client's medical history? 1. Hypotension 2. Hypothyroidism 3. Diabetes mellitus 4. Peripheral vascular disease

4. Peripheral vascular disease

The nurse in a labor room is monitoring a client with dysfunctional labor for signs of fetal or maternal compromise. Which assessment finding would alert the nurse to a compromise? 1. Maternal fatigue 2. Coordinated uterine contractions 3. Progressive changes in the cervix 4. Persistent nonreassuring fetal heart rate

4. Persistent nonreassuring fetal heart rate

A nurse is caring for a client who is using patterned breathing during labor. The client reports numbness and tingling of the fingers. Which of the following actions should the nurse take? 1. Administer oxygen via nasal cannula 2 L/min. 2. Apply a warm blanket. 3. Assist the client to a side-lying position. 4. Place an oxygen mask over the client's nose and mouth.

4. Place an oxygen mask over the client's nose and mouth.

The nurse administers erythromycin ointment (0.5%) to the eyes of a newborn and the mother asks the nurse why this is performed. Which explanation is best for the nurse to provide about neonatal eye prophylaxis? 1. Protects the newborn's eyes from possible infections acquired while hospitalized. 2. Prevents cataracts in the newborn born to a woman who is susceptible to rubella. 3. Minimizes the spread of microorganisms to the newborn from invasive procedures during labor. 4. Prevents an infection called ophthalmia neonatorum from occurring after delivery in a newborn born to a woman with an untreated gonococcal infection.

4. Prevents an infection called ophthalmia neonatorum from occurring after delivery in a newborn born to a woman with an untreated gonococcal infection.

A nurse is caring for a client who is admitted to the labor and delivery unit. With the use of Leopold maneuvers, it is noted that the fetus is in breech presentation. For which of the following possible complications should the nurse observe? 1. Precipitous delivery 2. Premature rupture of membranes 3. Postmaturity syndrome 4. Prolapsed umbilical cord

4. Prolapsed umbilical cord

A nurse is caring for a client who has a diagnosis of ruptured ectopic pregnancy. Which of the following findings is seen with this condition? 1. No alteration in menses 2. Transvaginal ultrasound indicating a fetus in the uterus 3. Serum progesterone greater than the expected reference range 4. Report of severe shoulder pain

4. Report of severe shoulder pain

The home care nurse visits a pregnant client who has a diagnosis of mild preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the health care provider? 1. Urinary output has increased. 2. Dependent edema has resolved. 3. Blood pressure reading is at the prenatal baseline. 4. The client complains of a headache and blurred vision.

4. The client complains of a headache and blurred vision.

The nurse is caring for four 1-day postpartum clients. Which client would require further nursing action? 1. The client with mild afterpains 2. The client with a pulse rate of 60 beats/minute 3. The client with colostrum discharge from both breasts 4. The client with lochia that is red and has a foul-smelling odor.

4. The client with lochia that is red and has a foul-smelling odor.

The nurse evaluates the ability of a hepatitis B-positive mother to provide safe bottle-feeding to her newborn during postpartum hospitalization. Which maternal action best exemplifies the mother's knowledge of potential disease transmission to the newborn? 1. The mother requests that the window be closed before feeding. 2. The mother holds the newborn properly during feeding and burping. 3. The mother tests the temperature of the formula before initiating feeding. 4. The mother washes and dries her hands before and after self-care of the perineum and asks for a pair of gloves before feeding.

4. The mother washes and dries her hands before and after self-care of the perineum and asks for a pair of gloves before feeding.

The nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which is noted on the external monitor tracing during a contraction? 1. Variability 2. Accelerations 3. Early decelerations 4. Variable decelerations

4. Variable decelerations

infant

A human born alive; also, a human from 28 days of age until the first birthday.

newborn; neonate

A human from the time of birth to the twenty-eighth day of life.

gravida

A pregnant woman; called gravida I (primigravida) during the first pregnancy, gravida II during the second pregnancy, and so on

delivery

Actual event of birth; the expulsion or extraction of the neonate.

Hegar's sign

Compressibility and softening of the lower uterine segment that occurs at about week 6 of gestation. This is considered a probable sign of pregnancy.

labor

Coordinated sequence of rhythmic involuntary uterine contractions resulting in effacement and dilation of the cervix, followed by expulsion of the products of conception.

Nägele's rule

Determines the estimated date of birth based on the premise that the woman has a 28-day menstrual cycle. Subtract 3 months and add 7 days to the first day of the last menstrual period; then add 1 year. Alternatively, add 7 days to the last menstrual period and count forward 9 months.

lochia

Discharge from the uterus that consists of blood from the vessels of the placental site and debris from the decidua; lasts for 2 to 6 weeks after delivery.

implantation

Embedding of the fertilized ovum in the uterine mucosa 6 to 10 days after conception.

quickening

Maternal perception of fetal movement for the first time, occurring usually in the sixteenth to twentieth week of pregnancy.

parity

Number of pregnancies that have reached viability regardless of whether the fetus was born alive or stillborn.

uterus

Organ located behind the symphysis pubis, between the bladder and the rectum. It has four parts—fundus (upper part), corpus (body), isthmus (lower segment), and cervix.

placenta

Organ that provides for the exchange of nutrients and waste products between the fetus and the mother and produces hormones to maintain pregnancy. The placenta develops by the third month of gestation. Is also called afterbirth.

amniotic fluid

Pale, straw-colored fluid in which the fetus floats. It serves as a cushion against injury from sudden blows or movements and helps maintain a constant body temperature for the fetus. The fetus modifies the amniotic fluid through the processes of swallowing, urinating, and movement through the respiratory tract.

surfactant

Phospholipid that is necessary to keep the fetal lung alveoli from collapsing; amount is usually sufficient after 32 weeks' gestation.

lecithin-to-sphingomyelin (L/S) ratio

Ratio of two components of amniotic fluid, used for predicting fetal lung maturity; normal L/S ratio in amniotic fluid is 2:1 or greater when the fetal lungs are mature.

ballottement

Rebounding of the fetus against the examiner's finger on palpation. When the examiner taps the cervix, the fetus floats upward in the amniotic fluid. The examiner feels a rebound when the fetus falls back.

Goodell's sign

Softening of the cervix that occurs at the beginning of the second month of gestation. This is considered a probable sign of pregnancy.

embryo

Stage of fetal development that lasts from day 15 until approximately 8 weeks after conception or until the embryo measures 3 cm from crown to rump.

vagina

Tubular structure located behind the bladder and in front of the rectum; it extends from the cervix to the vaginal opening in the perineum. It functions as the outflow tract for menstrual fluid and for vaginal and cervical secretions, as the birth canal, and as the organ for coitus.

fertilization

Uniting of the sperm and ovum, which occurs within 12 hours of ovulation and within 2 to 3 days of insemination, the average duration of viability for the ovum and sperm.

Chadwick's sign

Violet coloration of the mucous membranes of the cervix, vagina, and vulva that occurs at about 4 weeks of pregnancy; caused by increased vascularity. This is considered a probable sign of pregnancy.