Maternity: Evolve Questions

Which information would tell the nurse if a woman at 40 weeks gestation having contractions is in true labor? A. The cervix dilates and becomes effaced in true labor B. Bloody show is the first sign of true labor C. The membranes ruputre at the beginning of true labor D. Fetal movements lessen and become weaker in true labor.

A. The cervix dilates and becomes effaced in true labor

An increase in which hormone can precipitate nausea and vomiting during the first trimester of pregnancy A. Estrogen B. Progesterone C. Luteinizing hormone D. Chorionic gonadotropin

D. Chorionic gonadotropin

Which nursing action is most appropriate for a pregnant client at 23 weeks gestation with pica? A. Offering referral to a mental health care provider B. Explaining the potential danger of pica to the fetus. C. Obtaining a prescription for an iron supplement D. Determining whether the diet is safe and nutritionally adequate

D. Determining whether the diet is safe and nutritionally adequate

Which is the expected location of the uterine fundus immediately after a vaginal birth and expulsion of the placenta? A. In the pelvic cavity B. Just below the xiphoid process C. In the right quadrant at the umbilicus D. Halfway between the symphysis pubis and the umbilicus.

D. Halfway between the symphysis pubis and the umbilicus.

A client in active labor is admitted to the birthing room. A vaginal examination reveals that her cervix is dilated 6 to 7 cm. In light of this finding, which would the nurse expect A. The client may experience nausea and vomiting. B. The client's bloody show will become more profuse. C. The client will experience uncontrollable shaking of her legs. D. The client's contractions will become longer and more frequent.

D. The client's contractions will become longer and more frequent.

Which assessment finding would the nurse expect in a client at 8 weeks gestation? A. Lightening B. Quickening C. Goodell sign D. Braxton Hicks

C. Goodell sign

Which condition is most commonly associated with late decelerations of this fetal heart rate? A. Head compression B. Maternal hypothyroidism C. Uteroplacental insufficiency D. Umbilical cord compression

C. Uteroplacental insufficiency

Which pregnancy hormone is thought to cause the nausea and vomiting the client is experiencing in the first trimester of pregnancy? A. Estrogen B. Progesterone C. Human placental lactogen D. Human chorionic gonadotropin

D. Human chorionic gonadotropin

While a client is being interviewed on her first prenatal visit she states that she has a 4-year-old son who was born at 41 weeks gestation and a 3-year-old daughter who was born at 35 weeks gestation. The client lost one pregnancy at 9 weeks and another at 18 weeks. Using the GTPAL system, how would you record this information? A. G5 T1 P1 A2 L2 B. G4 T1 P1 A2 L2 C. G4 T2 P0 A0 L2 D. G5 T2 P1 A1 L2

A. G5 T1 P1 A2 L2

The nurse performs Leopold maneuvers on a newly admitted client in labor. Palpation reveals a soft, firm mass in the fundus; a firm, smooth mass on the mother's left side; several knobs and protrusions on the mother's right side; and a hard, round, movable mass in the pubic area with the brow on the right. On the basis of these findings, the nurse determines that the fetus is in which position? A. LOA B. ROA C. LMP D. RMP

A. LOA

Which assessment findings are suggestive of postpartum depression? A. Lethargy B. Ambivalence C. Emotional lability D. Increased appetite E. Long periods of sleep

A. Lethargy B. Ambivalence C. Emotional lability

Which assessments and interventions are necessary once an epidural catheter has been inserted? A. Maintain intravenous fluid administration B. Have oxygen available in case of hypotension C. Check the bladder for distention every 2 hours D. Position the client supine for ease of monitoring E. Monitor fetal heart rate and labor progress per hospital protocol F. Administer an oxytocin infusion to maintain the labor pattern

A. Maintain intravenous fluid administration B. Have oxygen available in case of hypotension C. Check the bladder for distention every 2 hours E. Monitor fetal heart rate and labor progress per hospital protocol

In which week of gestation would the nurse anticipate administering Rho immune globulin to a RH-negative client? A. 12 weeks B. 28 weeks C. 36 weeks D. 40 weeks

B. 28 weeks

For which reason would the nurse encourage a client to void during the first stage of labor? A. A full bladder is often injured during labor B. A full bladder may inhibit the progress of labor C. A full bladder jeopardizes the status of the fetus D. A full bladder predisposes the client to urinary infection

B. A full bladder may inhibit the progress of labor

Which points will be part of the nurse preceptor's lecture on caring for the lesbian, gay, bisexual, transgender, queer, or questioning older adult population? A. This group should be forced to answer any questions B. May have sexual organs that conflict with their gender identity C. Are at an elevated risk for disability from chronic disease and mental distress D. Older adults clients are commonly heterosexual E. May hide their gender identities and sexual orientations from their nurse and other health care providers

B. May have sexual organs that conflict with their gender identity C. Are at an elevated risk for disability from chronic disease and mental distress E. May hide their gender identities and sexual orientations from their nurse and other health care providers

A pregnant client is making her first antepartum visit. She has a 2-year-old son born at 40 weeks, a 5-year-old daughter born at 38 weeks, and 7-year-old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. How would the nurse, using the GTPAL format, document the client's obstetic history? A. G4 T3 P2 A1 L4 B. G5 T2 P2 A1 L4 C. G5 T2 P1 A1 L4 D. G4 T3 P1 A1 L4

C. G5 T2 P1 A1 L4

Which area would the fundal height be located for a pregnant client at 16 weeks gestation? A. Above the umbilicus B. At the level of the umbilicus C. Half the distance to the umbilicus D. Slightly above the symphysis pubis

C. Half the distance to the umbilicus

The nurse teaches a pregnant client regarding the necessity for a folic acid supplement. Folic acid taken in the first trimester of pregnancy helps reduce the risk for when neonatal disorder. A. Phenylketonuria B. Down syndrome C. Neural tube defects D. Erythroblastosis fetalis

C. Neural tube defects

The nurse explains preterm labor to a group of nursing students. Which description of preterm labor indicates effective teaching? A. Preterm labor is defined as contractions during the delivery. B. Preterm labor is defined as contractions induced by prostaglandins C. Preterm labor is defined as contractions and cervical dilation between 20 and 36 weeks of gestation D. Preterm labor is defined as contractions occurring before 20 weeks of gestion.

C. Preterm labor is defined as contractions and cervical dilation between 20 and 36 weeks of gestation

Soon after a vaginal examination revealing cervical dilation of 8 cm, bloody show increases and the client becomes nauseated and irritable. Which phase of labor would the nurse conclude the client is entering? A. Latent B. Active C. Transition D. Early active

C. Transition

Which caring for a client during labor, which would the nurse remember about the second stage of labor? A. It ends at the time of birth B. It ends at the placenta is expelled C. It begins with the transition phase of labor D. It begins with the onset of strong contractions

A. It ends at the time of birth

Which action of a nursing student regarding The Joint Commission recommendations for creating a safe and welcoming environment for lesbian, gay, bisexual, transgender, and queer/ questioning clients needs revision? A. Posting a client's bill of rights and nondiscrimination policies visibly. B. Arranging exclusive waiting rooms for LGBTQ+ clients and their families. C. Providing information on special health care concerns for LGBTQ+ clients D. Avoiding assumptions about any client's sexual orientation and gender identity.

B. Arranging exclusive waiting rooms for LGBTQ+ clients and their families.

Which behavior indicates a client has entered the second stage of labor? A. Restless, thrashing about B. Complaint of sudden, intense back pain C. Report of feeling pressure on the rectum D. Request for medication to relieve pain from the strong contractions.

C. Report of feeling pressure on the rectum

When the fetal monitor is applied to a client's abdomen, it record late decelerations. Which action would the nurse take? A. Notify the health care provider B. Elevate the head of the bed C. Reposition the client on her left side D. Administer oxygen by way of facemask.

C. Reposition the client on her left side

Which would the nurse ask the postpartum client to do before assessing her uterine fundus? A. Drink fluids B. Empty her bladder C. Perform the Valsalva maneuver D. Assume the semi-Fowler position

B. Empty her bladder

A client in active labor is 100% effaced, dilated 3 cm, and at +1 station. Which stage of labor has this client reached? A. First B. Latent C. Second. D. Transitional

A. First

Which findings would be considered normal when caring for a primigravida who gave birth by vaginal delivery 24 hours ago? A. Fundus firm at the umbilicus; moderate lochia rubra; voiding quantity sufficent colostrum present B. Fundus firm, 1 fingerbreath above the umbilicus; scant lochia alba; voided twice, 500 ml, 400ml; breasts heavy C. Fundus firm, 2 fingerbreadths above the umbilicus; moderate lochia serosa; voided once, 200 mL; colostrum present D. Fundus firm, 2 fingerbreadths below the umbilicus; moderate serosa alba; voiding quantity sufficient; breasts engorged.

A. Fundus firm at the umbilicus; moderate lochia rubra; voiding quantity sufficent colostrum present

A client is admitted to the birthing unit at 40 weeks gestation, and the nurse determines that the client's contractions are 10 minutes apart and their cervix is dilated 2 cm. Which stage of labor is the client in? A. Second stage B. Latent first stage C. Active first stage D. Transition stage

B. Latent first stage

Which action would the nurse take on finding that the client receiving oxytocin intravenously has a soft, boggy fundus a half-hour after a cesarean birth? A. Elevate the client's legs B. Massage the client's fundus C. Increase the client's oxytocin drip rate D. Examine the client's perineum for bleeding

B. Massage the client's fundus

The nurse used Leopold maneuvers to assess the client at 40 weeks gestation. Which factor would be assessed with this maneuver? A. Station of the fetus B. Position of the fetus C. Duration of the contractions D. Frequency of the contractions

B. Position of the fetus

A primigravida who is at 40 weeks gestation arrives at the birthing center with abdominl cramping and a bloody show. Her membranes ruptured 30 minutes before arrival. A vaginal examination reveals 1 cm of dilation and the presenting part at -1 station. Which action would the nurse take after obtaining the fetal heart rate and maternal vital signs. A. Teach the client how to push with each contraction B. Provide the client with comfort measures for relaxation C. Prepare to have the client's blood typed and cross-matched D. Encourage the client to preform patterned, paced breathing.

B. Provide the client with comfort measures for relaxation

Which term would the nurse use to describe the first fetal movements that a pregnant client feels? A. Lightening B. Quickening C. Engagement D. Ballottement

B. Quickening

Morning sickness generally disappears by the end of which month? A. fifth month B. third month C. fourth month D. second month

B. third month

Which statement by a client who was normal weight before pregnancy indicates the need for further teaching regarding weight gain guidelines? A. "I should gain 25 to 25 pounds total during the pregnancy" B. "I shouldn't try to lose weight or cut calories while pregnant" C. "I should gain 1 to 2 pounds per week through the entire pregnancy" D. "I may need additional testing if I gain more than 6 to 7 pounds in 1 month"

C. "I should gain 1 to 2 pounds per week through the entire pregnancy"

When palpating a client's fundus on the second postpartum day, the nurse determines that it is above the umbilicus and displaced to the right. Which conclusion is supported by this finding? A. There is a slow rate of involution B. There are retained placental fragments C. The bladder has become distended D. The uterine ligaments are overstretched

C. The bladder has become distended

Where would the nurse expect the fundus to be located 3 days after a cesarean birth A. One fingerbreadth below the unbilicus B. Two fingerbreadths below the umbilicus C. Three fingerbreadths below the umbilicus D. Four fingerbreadths below the umbilicus

C. Three fingerbreadths below the umbilicus

All women of childbearing age are advised to include at least 400 ug of folic acid in the daily diet to decrease the risk of neural tube defects in pregnancy. Which foods or supplements would the nurse recommend to meet the recommendation? A. Vitamin A B. Vitamin B6 C. Vitamin B9 D. Vitamin B12 E. Legumes, dark-green leafy vegatables, and citrus fruits F. Eggs, meat, and poultry

C. Vitamin B9 E. Legumes, dark-green leafy vegatables, and citrus fruits

A client with a history of three spontaneous abortions is now at 16 weeks gestation and expresses a concern about remaining at home during this pregnancy. Which questions will elicit responses most helpful to the nurse developing the client's plan of care? A. "Do you have a support system available to help you" B. "Have you been told about the status of your pregnancy C. "Do you know the causes related to spontaneous abortions" D. "Are you aware of how a healthy lifestyle affects a prenancy" E. "What are the characteristics of an impending spontaneous abortion"

A. "Do you have a support system available to help you" B. "Have you been told about the status of your pregnancy

Immediately after the third stage of labor the nurse administers the prescribed oxytocin infusion. Which explanation would the nurse give the client for the purpose of this medication? A. "It is used to help the uterus contract" B. "It is given to decrese uterine discomfort" C. "It assists in the separation of the placenta" D. "It helps stimulate the production of your breast milk"

A. "It is used to help the uterus contract"

Immediately after the third stage of labor the nurse administers the prescribed oxytocin infusion. Which explanation would the nursr give the client for the purpose of this medication? A. "It is used to help the uterus contract" B. "It is given to decrese uterine discomfort" C. "It assists in the separation of the placenta" D. "It helps stimulate the production of your breast milk"

A. "It is used to help the uterus contract"

Which assessing a client during the fourth stage of labor, the nurse notes that the perineal pad is soaked with approximately 75 ml of lochia rubra. Which nursing action is the priority? A. Assess the uterine fundus B. Document the amount and type of lochia C. Accompany the client to the bathroom to empty her bladder. D. Draw blood to test for hemoglobin and hematocrit levels.

A. Assess the uterine fundus

A primigravida, unsure of the date of their last menstrual period, is told by the nurse that they appear to be at 22 weeks gestation. Which data supports the nurse's conclusion? A. Fundus just above the umbilicus B. Fundus just above the symphysis C. Fundal height of 13 inches D. Fundal height of 14 inches

A. Fundus just above the umbilicus

A pregnant client has two children at home, the first born at 38 weeks gestation and the second born at 34 weeks gestation. The client has also had one miscarriage, at 18 weeks, and an elective abortion. Which summary is correct about the obstetric history using the GTPAL system? A. G5 T1 P1 A2 L2 B. G4 T2 P2 A1 L4 C. G2 T3 P3 A2 L1 D. G3 T2 P1 A3 L3

A. G5 T1 P1 A2 L2

Which is the priority intervention for the nurse to preform on a client who is noted to have a relaxed and boggy uterus 1 hour after delivery? A. Massage the uterus until firm B. Check the client's blood pressure C. Obtain a prescription for oxytocin D. Notify the primary health care provider immediately

A. Massage the uterus until firm

On a routine prenatal visit, which is the sign or symptoms that a healthy primigravida at 20 weeks gestation will most likely report for the first time? A. Quickening B. Palpitations C. Pedal edema D. Vaginal spotting

A. Quickening

A woman who gave birth to a second child 3 weeks ago is depressed, crying, and having extreme difficulty caring for her children. Which approach would the nurse take when the husband calls the women's health clinic and asks what he should do? A. Telling him that hsi wife may be suffering from depression and needs emergency care B. Letting him know that fatigue is expeced and that his wife needs to take rest periods during the day. C. Reassuring him that his wife is experencing postartum blues that will lessen in several days D. Advising him to make a appointment for his wife to see her primary health care provider if the problem continues

A. Telling him that hsi wife may be suffering from depression and needs emergency care

Which is the appropriate nursing action for a client in active labor whose cervix is dilated 4 cm and 100% effaced with the fetal head at 0 station? A. Document the fetal heart rate every 5 minutes B. Call the anesthesia department to alert the staff there of an imminent birth C. Assist the client's coach in helping her with the use of breathing techniques D. Suggest that the client accept the as-needed (PRN) medication for pain that has been prescribed.

C. Assist the client's coach in helping her with the use of breathing techniques

Which is the desired outcome for the intrapartum client during the third stage of labor? A. Absence of discomfort B. Firmly contracted uterine fundus C. Efficient fetal heart beat-to-beat variability D. Maternal respiratory rate within the expected range.

B. Firmly contracted uterine fundus

According to Naegele rule, which is the expected date of delivery of a client whose last menstrual period began on April 15? A. January 8 B. January 22 C. February 8 D. February 22

B. January 22

A vaginal examination reveals that a client's cervix is 90% effaced and dilated to 6 cm. The fetus's head is at station 0, and the fetus is in a right occiput anterior position. THe contractions are occuring every 3 to 4 minutes, are lasting 60 seconds, and are of moderate intensity. Which description is appriopriate to use when reporting on the client's condition? A. Early first stage of labor B. Transition stage of labor C. Beginning second stage or labor D. Midway through first stage of labor

D. Midway through first stage of labor