Maternity: FINAL chapters 1,2,3,10,11,12,19,20,21,13,14, 5,6,7,8,9,22
___________________ typically occurs around 2 weeks after the last normal menstrual period in a 28-day cycle.
Fertilization
A nurse who is conducting sessions on preventing the spread of sexually transmitted infections (STIs) discovers that there is a very high incidence of hepatitis B in the community. Which measure should the nurse take to ensure the prevention of the disease?
Instruct people to get vaccinated for hepatitis B.
What is the leading cause of death in pregnant women? a) Amniotic fluid embolism b) Undiagnosed cardiac condition c) Pulmonary embolism d) Intimate partner violence
Intimate partner violence
A nurse is required to obtain the fetal heart rate (FHR) for a pregnant client. If the presentation is cephalic, which maternal site should the nurse monitor to hear the FHR clearly?
Lower quadrant of the maternal abdomen
6. A pregnant client has come to the clinic for a pelvis examination. What assessments should a nurse perform when examining external genitalia?
Ans: Assess for any infection due to hematomas, varicosities, and inflammation
6. A nurse is caring for a pregnant client who is in labor. Which of the following maternal physiologic responses should the nurse monitor for in the client as the client progresses through childbirth? Select all that apply
Ans: Increase in HR Ans: Increase in BP Ans: Increase RR
3. A client who has given birth a week ago complains to the nurse of discomfort when defecating and ambulating. The birth involved an episiotomy. Which of the following should the nurse suggest to the client to provide local comfort? Select all that apply
Ans: Use of warm sitz baths Ans: Use of anesthetic sprays Ans: Use of witch hazel pads
22.A woman is scheduled for diagnostic testing to evaluate for endometrial cancer. The nurse would expect to prepare the woman for which of the following? A) CA-125 testing B) Transvaginal ultrasound C) Pap smear D) Mammography
B) Transvaginal ultrasound
15.When describing the various types of reproductive tract cancers to a local women's group, which of the following would the nurse identify as the least common type? A) Vulvar B) Vaginal C) Endometrial D) Ovarian
B) Vaginal
A new mother delivered 1 week ago and is tearful, anxious, sad, and has no appetite. She is diagnosed with postpartum blues. What factors contribute to this problem? Select all that apply.
Fatigue, discomfort, hormonal changes, and disrupted sleep patterns
Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction? A) Posterior position B) Firm C) Closed D) Shortened
Shortened A ripe cervix is shortened, centered (anterior), softened, and partially dilated.
Why does hypertrophy of the heart occur in pregnant women?
To accomodate the increase in cardiac output and blood volume
What test is considered a good indicator of fetal oxygenation and acid-base condition at birth.
Umbilical cord blood analysis *Normal mean pH value range is 7.2 to 7.3
Oxytocin is secreted by
posterior pituitary
Passage of the mucous plug
premonitory sign of labor
During pregnancy, elevated __________________ levels cause smooth-muscle relaxation, which results in delayed gastric emptying an decreased peristalsis.
progesterone
modified sims position
prolapsed cord
The outer surface of the blastocyst, called the trophoblast, will form the __________ and ______________.
chorion and placenta
A young sexually active woman asks the nurse what type of birth control would help prevent sexually transmitted infections as well as pregnancy. Which type would the nurse recommend?
condom
During unprotected sex, a 17-year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk of developing which diagnosis?
condylomata acuminata
An increase in prostiglandins leads to myometrial ______ and to a reduction in cervical resistance
contractions
When the top of the head no longer regresses between contractions, it is said to have ______________
crowned
The fetal head at the vaginal opening is termed _________ and occurs before birth of the head.
crowning
Your pregnant patient has had asthma since she was a teenager. What statement by the patient would alert you to the fact her asthma may not be in control? a) Daytime cough b) Decreased respiratory rate c) Feeling of euphoria d) "I keep waking up at night."
d) "I keep waking up at night." Rationale: Complaint of nocturnal awakening is a classic symptom.
You are doing patient teaching with a 30-year-old gravida 1 who has sickle cell anemia. She is not currently in crisis. Providing education on which topic is the highest nursing priority? a) Control of pain b) Constipation prevention c) Iron-rich foods d) Avoidance of infection
d) Avoidance of infection Rationale: Prevention of crises, if possible, is the focus of treatment for the pregnant woman with sickle cell anemia. Maintaining adequate hydration, avoiding infection, getting adequate rest, and eating a balanced diet are all common-sense strategies that decrease the risk of a crisis.
When providing nutritional counseling to a pregnant woman with diabetes, the nurse would urge the client to obtain most of her calories from which of the following? a) Protein sources b) Unsaturated fats c) Saturated fats d) Complex carbohydrates
d) Complex carbohydrates Rationale: The pregnant woman with diabetes is encouraged to eat three meals a day plus three snacks, with 40% of calories derived from good-quality complex carbohydrates, 35% of calories from protein sources, and 35% of calories from unsaturated fats. The intake of saturated fats should be limited during pregnancy, just as they should be for any person to reduce the risk of heart disease.
A woman develops gestational diabetes. Which of the following assessments should she make daily? a) Test her urine for protein with a chemical reagent strip. b) Measure her uterine height by hand-span distance. c) Measure her abdominal diameter with a tape measure. d) Measure serum for glucose level by a finger prick.
d) Measure serum for glucose level by a finger prick. Rationale: Assessing serum glucose reveals both hyperglycemia and hypoglycemia.
The nurse is assessing a woman with class III heart disease who is in for a prenatal visit. What would be the first recognizable sign that this patient is in heart failure? a) Elevated blood pressure b) Low blood pressure c) Audible wheezes d) Persistent rales in the bases of the lungs
d) Persistent rales in the bases of the lungs Rationale: The earliest warning sign of cardiac decompensation is persistent rales in the bases of the lungs.
A school health nurse is providing education to a group of adolescents regarding the proper procedure for male condom use. The nurse knows the teaching has been effective when which statement is made by a student?
"Withdraw the penis erect, holding the condom firmly against the penis."
A client who gave birth to a baby 36 hours ago informs the nurse that she has been passing unusually large volumes of urine very often. How should the nurse explain this to the client?
"Your body usually retains extra fluids during pregnancy, so this is one way it rids itself of the excess fluid."
What are the top three nonfood items ingested by pregnant women?
- Clay (geophagia) - Ice (pagophagia) - Laundry starch (amylophagia)
what is amniotic fluid? also, how is it made?
- fluid serving as a cushion to fetus + umbilical cord (trauma/compression prevention). good for allowing musculoskeletal development via free-movement, + maintaining fetal temperature. composed 98% water, 2% organic materials (bilirubin, urea, uric acid, creatinine, etc) - the inner-layer amnion (from ectoderm of blastocyst) expands until it touches the outer-layer chorion (from the trophoblast)
what are the three stages of pregnancy, and when do they occur?
- preembryonic stage: fertilization - 2nd week - embryonic stage: end of 2nd week - 8th week - fetal stage - end of 8th week - birth (longest period)
Which position would be most appropriate for the nurse to suggest as a comfort measure to a woman who is in the first stage of labor? (Select all that apply.) A) Walking with partner support B) Straddling with forward leaning over a chair C) Closed knee-chest position D) Rocking back and forth with foot on chair E) Supine with legs raised at a 90-degree angle
-Walking with partner support -Straddling with forward leaning over a chair -Rocking back and forth with foot on chair
Positioning during the first stage of labor includes:
-walking with support from the partner - side-lying with pillows between the knees - leaning forward by straddling a chair, table, or bed or kneeling over a birthing ball -lunging by rocking weight back and forth with a foot up on a chair or birthing ball or an open knee-chest position.
For continuous internal electronic fetal monitoring, four criteria must be met:
1. ruptured membranes 2. cervical dilation of at least 2 cm 3. fetal presenting part low enough to allow placement of the electrode 4. skilled practitioner available to insert the electrode.
A nurse is assessing a postpartum client and notes an elevated temperature. Which temperature protocol should the nurse prioritize?
100.5º F (38.1º C) at 48 hours postbirth and remains the same the third day postpartum
At what age should a woman with no risk factors begin mammography screening for breast cancer?
40
A 29-week-gestation client is admitted with moderate vaginal discharge. The nurse performs a nitrazine test to determine if the membranes have ruptured. The nitrazine tape remains yellow to olive green, with pH between 5 and 6. What should the nurse do NEXT? A. Prepare the client for birth B. Assess the client's cervical status C. notify the health care provider D. perform leopold's maneuver
5 to 6 pH means acidic environment with presence of vaginal fluid and less blood. notify provider
A nurse is reading a journal article about chlamydia. The nurse would expect to find that what percentage of women are asymptomatic when infected with chlamydia?
70%
blastocyst
A thin-walled hollow structure in early embryonic development that contains a cluster of cells called the inner cell mass from which the embryo arises. pg. 336
fetal demise
death of the fetus
When membranes rupture, the priority focus should be on assessing fetal heart rate (FHR) first to identify what?
decelerations *due to cord compression or cord prolapse
____ is downward movement of the fetal head until it is within the pelvic inlet
descent
While making a follow-up home visit to a client in her first week postpartum, the nurse notes that she has lost 5 pounds. Which reason for this loss would be the most likely?
diuresis
Palmar erythema, a well-delineated pinkish area on the palmar surface of the hands, is caused by elevated _______________ levels.
estrogen
Allows the shoulders to rotate internally to fit the maternal pelvis
external rotation
subinvolution
failure of uterus to return to non-pregnant state
structure of umbilical cord:
formed by the amnion, and houses 1 large vein + 2 small arteries wrapped in wharton's jelly to prevent compression. @ term, average length is 22 in long + 1 in thick.
assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? A) Frank B) Full C) Complete D) Footling
frank "I frankly dont care if I show my butt"
_________________ occurs when the uterus never fully relaxes between contractions
hypertonic uterine dysfunction
Turning the woman on her left side would be an appropriate intervention for a _______ deceleration pattern.
late
perpendicular line
lines that form right angles
A 24-year-old female client reports various issues. She admits to having unprotected sexual intercourse. Which findings would indicate a possible PID? Select all that apply.
lower abdominal tenderness adnexal tenderness cervical motion tenderness
The nurse is preparing a new mother to be discharged home after an uncomplicated delivery. Which type of lochia pattern should the nurse point out needs to be reported to her primary care provider immediately during the discharge teaching?
moderate lochia serosa on day 4 postpartum, increasing in volume and changing to rubra on day 5
A sudden increase in energy on the part of the expectant women 24-48 hours before the onset of labor is sometimes referred to as
nesting
this test evaluate fetal well being by monitoring fetal heart tracing
nonstress test
The birth _____ is the route through which the fetus must travel to be birthed vaginally
passageway
A nurse is teaching a postpartum woman about breastfeeding. When explaining the influence of hormones on breast-feeding, the nurse would identify which hormone that is responsible for milk production?
prolactin
A postpartum woman reports hearing voices and says, "The voices are telling me to do bad things to my baby." The clinic nurse interprets these findings as suggesting postpartum
psychosis.
genomics
the branch of molecular biology concerned with the structure, function, evolution, and mapping of genomes.
mutation
the changing of the structure of a gene, resulting in a variant form that may be transmitted to subsequent generations, caused by the alteration of single base units in DNA, or the deletion, insertion, or rearrangement of larger sections of genes or chromosomes.
what is fertilization? also, when does it occur
the meeting of sperm & egg. it occurs around 2 weeks after the last normal menstrual period in a 28-day cycle.
A nurse is working as part of a team to address the prevention of sexually transmitted infections in the community. Based on the nurse's understanding of the groups at highest risk, the team would most likely focus their efforts on which population?
those under age 25
Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection?
trichomoniasis
Ultrasound is used to identify an increase in nuchal translucency, if this is increased it is associated with ______________________-
trisomy 21, 18 and 13 *A fetal nuchal translucency test, as seen on ultrasound, may be suggestive of the presence of trisomy 21 or Down syndrome if increased nuchal thickness is found
Normally implantation occurs in the ____________________, where a rich blood supply is available.
upper uterus (fundus)
The nurse is caring for a client in the postpartum period. The client has difficulty in voiding and is catheterized. The nurse would monitor the client for which condition
urinary tract infection
The nurse reviews the prenatal record to identify risk factors that may contribute to a decrease in __________________ circulation during pregnancy and
uteroplacental
What does the acronym VBAC stand for?
vaginal birth after cesarean
Which finding would alert the nurse to suspect that a client has a yeast infection?
vulvar burning and itching
The fundus reaches it highest level, at the ____________ , at approximately 36 week.
xiphoid process
____ station is designated when the presenting part is at the level of the maternal ischial spines
zero
Which of the following are forms of emotional abuse? Select all that apply. a) Humiliating b) Incest c) Destroying another's property d) Insulting e) Rape
• Insulting • Humiliating • Destroying another's property
A client is experiencing situational low self-esteem about acquiring a sexually transmitted infection. Which nursing intervention may help foster the client's self-esteem?
Affirm the client's good judgment in seeking treatment.
7. A nurse is assessing pregnant clients for the risk of placenta previa. Which of the following clients faces the greatest risk for this condition?
Ans: A client who had undergone a myomectomy to remove fibroids
During a prenatal class for a group of new mothers, the nurse is describing the hormones produced by the placenta. Which of the following would the nurse include? (Select all that apply.) A) Prolactin B) Estriol C) Relaxin D) Progestin E) Human chorionic somatomammotropin
Ans: B, C, D, E Feedback: Estriol, relaxin, progestin, and human chorionic somatomammotropin are secreted by the placenta. Prolactin is secreted after delivery for breast-feeding.
3. During assessment of the mother during the postpartum period, what would alert the nurse that the client is likely experiencing uterine atony?
Ans: Boggy or relaxed uterus.
Amnioinfusion indications
• Oligohydramnios • Umbilical compression - D/T lack of amniotic fluid • To reduce FHR variable deceleration • Dilute meconium stained amniotic fluid
7. The nurse is caring for an Arab American woman. Which approach would be most successful?
Ans: Dealing exclusively with the husband
4. Which of the following information should the nurse give to a client who is breastfeeding her newborn regarding the nutritional requirements of newborns, as per the recommendations of the American Academy of Pediatrics (AAP)?
Ans: Give vitamin D supplements daily for the first 2 months.
7. A pregnant client and her husband have had a session with a genetic specialist. What is the role of the nurse after the client has seen a specialist?
Ans: Review what has been discussed with the specialist
When teaching a group of students about the cycle of violence, which behavior would the nurse describe as eventually disappearing as the violence becomes accelerated over time? a) Denial of the seriousness of the injuries b) Apologies for the pain and abuse c) Loss of control d) Excessive hostility and friction
Apologies for the pain and abuse
Preconception carrier screening for conditions such as Tay-Sachs disease has been in place among high-risk populations such as __________________
Ashkenazi Jews
A woman is bottle-feeding her baby. When the nurse comes into the room the woman says that her breasts are painful and engorged. Which nursing intervention is appropriate?
Assist the woman in placing ice packs on her breasts
____________________ inheritance occurs when a single gene in the heterozygous states is cabable of producing the phenotype.
Autosomal dominant inheritance
____________________ inheritance occurs when two copies of the mutant or abnormal gene in the homozygous state are necessary to produce the phenotype.
Autosomal recessive inheritance
This childbirth method stresses that childbirth is a joyful, natural process and emphasizzes the partner's involvement during pregnancy, labor, birth, and the early newborn period. Training techniques are directed toward the coach.
Bradley (Partner-Coached) Method
A nurse is screening women for risk factors for breast cancer. Which of the following are considered a risk for this disorder? Select all that apply.
• Previous cancer • Using female hormone therapy • Having an extreme fear of cancer • Cystic breast disorders
Before calling the primary care provider to report a slow progression or an arrest of labor, several assessments need to be made. What other maternal assessment does the nurse need to make prior to calling the care provider?
Check for a full bladder. pg. 807
When assessing a woman at follow-up prenatal visits, the nurse would anticipate which of the following to be performed? A) Hemoglobin and hematocrit B) Urine for culture C) Fetal ultrasound D) Fundal height measurement
D) Fundal height measurement
The rationale for using a prostaglandin gel for a client prior to the induction of labor is to: a. Stimulate uterine contractions b. Numb cervical pain receptors c. Prevent cervical lacerations d. Soften and efface the cervix
D. Prostaglandins soften and thin out the cervix in preparation for labor induction. Although they do irritate the uterus, they aren't as effective as oxytocin in stimulating contractions. Prostaglandin gel would stimulate cervical nerve receptors rather than numb them. - Prostaglandins have no power to prevent cervical lacerations.
Side effects experienced by women taking gonadotropin-releasing hormone (GnRH) agonists for the treatment of fibroids closely resemble those of: a. Anorexia nervosa b. Osteoarthritis c. Depression d. Menopause
D. GnRH agonists block the production of estrogen, which produces menopausal symptoms.
A new mother is in the second developmental stage of becoming a mother and is becoming independent in her actions. Which action by the nurse would best foster this stage?
Demonstrating how to do cord care on the newborn
A nurse working in a community health education program is assigned to educate community members about sexually transmitted infections (STIs). Which nursing strategy should be adopted to prevent the spread of STIs in the community?
Discuss limiting the number of sex partners.
A client is being discharged from the gynecological unit after treatment for an acute pelvic inflammatory disease (PID). What priority instruction regarding disease management should the nurse include?
Discuss the necessity of completing the antibiotic therapy.
A nurse is assessing a boy who was recently found to have been molested by a neighbor. Which of the following characteristics is most likely in a pedophile? a) Physically abusive b) Violent c) Emotional fixation at a childhood level d) Homosexual
Emotional fixation at a childhood level
A client is exhibiting signs of engorgement, but her milk is still flowing easily. Which suggestion should the nurse prioritize?
Ensure the baby empties the breasts at each feeding
A nurse is caring for a pregnanct client who is in the active phase of labor. At what interval should the nurse monitor the client's vital signs?
Every 15 minutes
The recommended follow-up visit schedule for 29-36 weeks is _______________
Every 2 weeks
What challenges do abnormal presentations pose at birth
Head is born last and may become stuck in the pelvis Umbilical cord compression Cervix ineffectively dilated due to buttocks birthing first May result in trauma to the head
Research from the __________________has provided a better understanding of the genetic contribution to disease.
Human Genome Project
This hormone modulates fetal and maternal metabolism, participates in the develpment of maternal breasts for lacation, and decreases maternal insulin sensitivity to increase it's availability for fetal nutrition
Human placental lactogen (hPL)
Women in this situation experience a prolonged latent phase, stay at 2 to 3 cm, and do not dilate as they should.
Hypertonic uterine dysfunction
A client in her third trimester of pregnancy arrives at a health care facility complaining of cramping and low back pain; she also notes that she is urinating more frequently and that her breathing has become easier the past few days. Physical examination conducted by the RN indicates that the client has what?
Lightening
Which assessment finding one hour after delivery should be reported to the health care provider?
Lochia rubra is saturating a pad every 45-60 minutes
A woman who has never experienced pregnancy
Nulligravida
The number of times a woman has given birth to a fetus of at least 20 gestational weeks (viable or not), counting multiple births as one birth event
Para
What indicates placenta separation?
Placental separation is indicated by the uterus changing shape to globular and upward rising of the uterus. Additional signs include a sudden trickle of blood from the vaginal opening, and lengthening (not shortening) of the umbilical cord.
A woman's amniotic fluid is noted to be cloudy. The nurse interprets this finding as?
Possible infection
What marker screening test is routinely used for Down syndrome screening in the first trimester?
Pregnancy-associated plasma protein (PAPP-A)
This prenatal test can prevent inheritable genetic disease before implantation by transfering embryos without genetic alterations into the woman's uterus to start a pregnancy.
Preimplantation genetic diagnosis
The nurse is assessing a postpartum client's vital signs 24 hours after the birth of her infant and notes: respirations 18, pulse 110 bpm, temperature 100.1°F (37.8°C), and blood pressure 128/88. Which assessment finding should the nurse prioritize for further attention?
Pulse (tachy)
What is the role oxytocin in pregnancy?
Responsible for uterine contractions and milk ejection
The nurse is conducting the initial postpartum assessment on a client. The nurse will assist the client into which position to properly assess the postpartum uterus?
Supine
Nurses sometimes have difficulty assessing women for violence. Which of the following refers to the screen protocol to use to be the most thorough? a) The RACE model b) The FACE model c) The SBAR model d) The SAVE model
The SAVE model
Pain during the second stage pain is cause by what?
The stretching of the vagina and perineum and compression of the pelvic structures
Homicide from intimate partner violence is the number-one cause of death in pregnant women. a) False b) True
True
Elongate, widen, and curve above pelvic rim by 10th gestational week
Ureters
During pregnancy a woman's cardiovascular system expands to care for the growing fetus. After birth, during the early postpartum period, the woman eliminates the additional fluid volume she has been carrying. What is one way she does this?
Urinary elimination
An HIV-positive client who is on antiretroviral therapy reports anorexia, nausea, and vomiting. Which suggestion should the nurse offer the client to cope with this condition?
Use high-protein supplements.
What do phosphatidyl glycerol level indicate?
Used to assess fetal lung maturity
Which of the following would the nurse expect to find in a newborn of a mother who abuses heroin? a) Sneezing b) Easy consolability c) Vigorous sucking d) Hypotonicity
a) Sneezing Rationale: Newborns of mothers who abuse heroin or other narcotics display irritability, hypertonicity, a high-pitched cry, vomiting, diarrhea, respiratory distress, disturbed sleeping, sneezing, diaphoresis, fever, poor sucking, tremors, and seizures.
As a rule, women can receive chemotherapy in the second and third trimesters without adverse fetal effects. a) True b) False
a) True Rationale: none
Following the birth, the nurse is responsible for assessing the cord pH. The nurse recognizes that which value would be considered a normal pH? a. 7.2 b. 7.0 c. 6.8 d. 6.0
a. 7.2
A pregnant client has opted for hydrotherapy for pain management during labor. Which measure should the nurse consider when assisting the client during the birthing process? a. Initiate the technique only when the client is in active labor. b. Do not allow the client to stay in the bath for long. c. Ensure that the water temperature exceeds body temperature. d. Allow the client into the water only if her membranes have ruptured.
a. Initiate the technique only when the client is in active labor
A nurse is caring for an antenatal mother diagnosed with umbilical cord prolapse. For which should the nurse monitor the fetus? a. Fetal hypoxia b. Preclampsia c. Coagulation defects d. Placental pathology
a. fetal hypoxia
A client presents for her annual Pap test. She wants to know about the risk factors that are associated with cervical cancer. Which should the nurse inform the client is a risk factor for cervical cancer? a) Early age at first intercourse b) Infertility c) Obesity (at least 50 lb [22.7 kg] overweight) d) Hypertension
a: Early onset of sexual activity, within the first year of menarche, increases the risk of acquiring cervical cancer later on. Obesity, infertility, and hypertension are risk factors that are associated with endometrial cancer
fetopelvic disproportion
also called cephalopelvic; the head of the fetus is larger than the pelvic outlet
What marker screening test is used to confirm a fetal abnormality when other screening tests detect a possible problem.
amniocentesis
An ___________________ may be performed to augment or induce labor when the membrane have not ruptured spontaneously.
amniotomy *fetal head should be at -2 station or lower, with the cervix dilated at least 3cm*
___________________ describes the irregular variations or absence of fetal heart rate (FHR) due to erroneous causes on the fetal monitor record.
artifact
Fetal heart tones are best auscultated through the _____________ of the fetus.
back
The ________________ is formed as fluid, which provides nutrients, from the uterine cavity enters the morula.
blastocyst
The nurse is caring for a client who is sent to the obstetric unit for evaluation of fetal well-being. At which location is the nurse correct to place the tocodynamometer? a. On the right side of the abdomen b. At the level of the umbilicus c. On the uterine fundus d. Midline but low on the abdomen
c. On the uterine fundus
A client who recently gave birth to her third child expresses a desire to have her older two children come to the hospital for a visit. What should the nurse say in response to this request?
"As long as they are well, absolutely. Why don't we give you a dose of pain medication beforehand so that you will enjoy the visit?"
A client who gave birth 5 days ago reports profuse sweating during the night. What should the nurse recommend to the client in this regard?
"Be sure to change your pajamas to prevent you from chilling."
The nurse is attempting to reassure her obese female client about the discovery of an ovarian cyst after her pelvic examination. Which of the following statements is true concerning ovarian cysts? They are: A. Frequently seen in polycystic kidney disease B. Always painful and need to be removed surgically C. A precursor to ovarian carcinoma D. Part of a syndrome that includes hypertension and diabetes
"D" because ovarian cysts are frequently seen with polycystic ovarian syndrome (PCOS), which is characterized by hypertension and diabetes as well as amenorrhea, obesity, and hyperlipidemia.
A female client with genital herpes is prescribed acyclovir as treatment. After teaching the client about this treatment, which statement by the client indicates effective teaching?
"This drug will help to suppress any symptoms of the infection."
A client who had a vaginal birth 2 days ago asks the nurse when she will be able to breathe normally again. Which response by the nurse is accurate?
"Within 1 to 3 weeks, your diaphragm should return to normal, and your breathing will feel like it did before your pregnancy."
Which of the following practices would not be included in a physiologic birth? A. Early induction of labor <39 weeks' gestation B. Freedom of movement for the laboring woman C. Continuous presence and support throughout labor D. Encouraging spontaneous pushing when urge felt
A. since inducing labor artificially, rather than waiting for spontaneous labor to start doesn't provide for a physiologic birth. Nature should be allowed to take its course without artificial means to initiate labor.
A potential complication for the mother and fetus is Rh incompatibility; therefore, assessment should include blood typing. If the mother is Rh negative, her antibody titer should be evaluated. If treatment with Rho(D) immune globulin is indicated, the nurse would expect to administer it at which time? A. at 28 weeks B. at 32 weeks C. at 36 weeks D. only at birth
A. at 28 weeks
During labor, the mother experiences various physiologic responses including:
- increase in heart rate by 10 to 20 bpm - a rise in blood pressure by up to 35 mm Hg during a contraction - increase in white blood cell count to 25,000 to 30,000 cells/mm3, perhaps as a result of tissue trauma - an increase in respiratory rate with greater oxygen consumption due to the increase in metabolism.
Active phase of labor:
- moderate to strong contractions every 2 to 5 minutes - cervical dilation of 4 to 7 cm - effacement of 40% to 80% - with the mother becoming intense and inwardly focused.
morula:
- the resulting ball of cells from the mitosis of the zygote. after fertilization, the zygote makes it's way to the uterus (72 hrs), while on its way it goes through mitosis (or cleavage) x4, where it ends up a ball of 16 cells known as a morula.
A pregnant woman admitted to the labor and birth suite undergoes rapid HIV testing and is found to be HIV-positive. Which of the following would the nurse expect to include when developing a plan of care for this women? (Select all that apply.) A) Administration of penicillin G at the onset of labor B) Avoidance of scalp electrodes for fetal monitoring C) Refraining from obtaining fetal scalp blood for pH testing D) Administering zidovudine at the onset of labor. E) Electing for the use of forceps-assisted delivery
-Avoidance of scalp electrodes for fetal monitoring -Refraining from obtaining fetal scalp blood for pH testing -Administering zidovudine at the onset of labor
A nurse is examining a female client and tests the client's vaginal pH. Which finding would the nurse interpret as normal? A) 4.5 B) 7 C) 8.5 D) 10
A) 4.5
While a nurse is obtaining a health history, the client tells the nurse that she practices aromatherapy. The nurse interprets this as which of the following? A) Use of essential oils to stimulate the sense of smell to balance the mind and body B) Application of pressure to specific points to allow self-healing C) Use of deep massage of areas on the foot or hand to rebalance body parts D) Participation in chanting and praying to promote healing.
A) Use of essential oils to stimulate the sense of smell to balance the mind and body
Because a pregnant clients diabetes has been poorly controlled throughout her pregnancy, the nurse would be alert for which of the following in the neonate at birth? A)Macrosomia B)Hyperglycemia C)Low birth weight D)Hypobilirubinemia
A)Macrosomia
A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. Which level would the nurse identify as therapeutic? A) 3.3 mEq/L B) 6.1 mEq/L C) 8.4 mEq/L D) 10.8 mEq/L
Ans: B Although exact levels may vary among agencies, serum magnesium levels ranging from 4 to 7 mEq/L are considered therapeutic, whereas levels more than 8 mEq/dL are generally considered toxic.
Which of the following nursing actions would be least helpful for a client who is a victim of violence? A) Assist the client to project her anger. B) Provide information about a safe home and crisis line. C) Teach her about the cycle of violence. D) Discuss her legal and personal rights.
Ans: A Feedback: The goal of intervention is to enable the victim to gain control by providing sensitive, predictable care in an accepting setting. Assisting the client to project her anger would not be helpful when the woman needs support and education.
A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which of the following would the nurse identify? A) Asian American ethnicity B) Age under 25 years C) Married D) Consistent use of barrier contraception
Ans: B Feedback: High-risk groups for chlamydia and gonorrhea include single women, women younger than 25 years, African American women, women with a history of STIs, those with new or multiple sex partners, those with inconsistent use of barrier contraception, and women living in communities with high infection rates.
Which findings would the nurse expect to find in a client with bacterial vaginosis? A) Vaginal pH of 3 B) Fish-like odor of discharge C) Yellowish-green discharge D) Cervical bleeding on contact
Ans: B Feedback: Manifestations of bacterial vaginosis include a thin, white homogenous vaginal discharge with a characteristic stale fish odor, vaginal pH greater than 4.5, and clue cells on wet-mount examination. A yellowish-green discharge with cervical bleeding on contact would be characteristic of trichomoniasis.
When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)? A) Hive-like rash for the past 2 days B) Five different sexual partners C) Weight gain of 5 lbs in 1 year D) Clear vaginal discharge
Ans: B Feedback: The number of sexual partners is a risk factor for the development of STIs. A rash could be related to numerous underlying conditions. A weight gain of 5 lbs in one year is not a factor increasing one's risk for STIs. A change in the color of vaginal discharge such as yellow, milky, or curd-like, not clear, would suggest an STI.
A nurse is assessing a rape survivor for post-traumatic stress disorder. The nurse asks the woman, "Do you feel as though you are reliving the trauma?" The nurse is assessing for which of the following? A) Physical symptoms B) Intrusive thoughts C) Avoidance D) Hyperarousal
Ans: B Feedback: The question is used to assess the woman for intrusive thoughts that reflect the client reexperiencing the trauma. Physical symptoms would be assessed with questions about sleeping, eating, palpitations and other problems. Avoidance would be reflected in questions involving withdrawal socially, avoiding situations that remind the woman of the rape. Hyperarousal would be noted by irritability and an exaggerated startle response.
A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the: A) Amniotic fluid B) Placenta C) Birth canal D) Breast milk
Ans: B Feedback: The syphilis spirochete can cross the placenta at any time during pregnancy. It is not transmitted via amniotic fluid, passage through the birth canal, or breast milk.
A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate? A) "There is a new vaccine available that prevents the infection from returning." B) "All you need is a dose of penicillin and the infection will be gone." C) "There is no cure, but drug therapy helps to reduce symptoms and recurrences." D) "Once you have the infection, you develop an immunity to it."
Ans: C Feedback: Genital herpes is a lifelong viral infection. No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. A vaccine is available for HPV infection but not genital herpes. Penicillin is used to treat syphilis. No immunity develops after a genital herpes infection.
2. A nurse, assigned to check the pulse, discerns tachycardia in a postpartum client. Which of the following does it suggest?
Ans: Excessive blood loss.
4. Two weeks after a vaginal delivery, a client presents with low-grade fever. The client also complains of a loss of appetite and low energy levels. The physician suspects an infection of the episiotomy. What signs and symptoms is most indicative of an episiotomy infection?
Ans: Foul-smelling vaginal discharge
14. Which of the following hormones is secreted from the hypothalamus in a pulsatile manner throughout the reproductive cycle?
Ans: GnRH
2. When caring for a client with PROM, the nurse observes an increase in the client's pulse. What does this increase in pulse indicate?
Ans: Infection
8. A nurse who is conducting sessions on preventing the spread of STIs in a particular community discovers that there is a very high incidence of hepatitis B in the community. Which of the following measures should she take to ensure the prevention of the disease?
Ans: Instruct people to get vaccinated for hepatitis B
13. A pregnant client is admitted to a maternity clinic for childbirth. Which assessment finding indicates that the client's fetus is in the transverse lie position?
Ans: Long axis of fetus is perpendicular to that of client
5. A nurse is caring for a critically ill female client who has recently been diagnosed with advanced lung cancer. Which of the following reasons could have contributed to the late detection and diagnosis?
Ans: Lung cancer has no early symptoms.
7. A client complains to the nurse of pain in the lower back, hips, and joints 10 days after the birth of her baby. What instruction should the nurse give the client after birth to prevent low back pain and injury to the joints?
Ans: Maintain correct posture and positioning.
12. A postpartum client who was discharged home returns to the primary health care facility after 2 weeks with complaints of fever and pain in the breast. The client is diagnosed with mastitis. What education should the nurse give to the client for managing and preventing mastitis?
Ans: Perform hand-washing before and after breastfeeding
8. Which of the following hormones is called the hormone of pregnancy because it reduces uterine contractions during pregnancy?
Ans: Progesterone
12. A nurse is caring for a newborn with transient tachypnea. What nursing interventions should the nurse perform while providing supportive care to the newborn? Select all that apply
Ans: Provide oxygen supplement Ans: Ensure the newborn's warmth Ans: Observe respiratory status frequently
2. The assessment of a pregnant client, who is toward the end of her third trimester, reveals that she has increased prostiglandin levels. Which of the following factors should the nurse assess for in the client? Select all that apply
Ans: Reduction in cervical resistance Ans: Myometrial contraction Ans: Softening and thinning of the cervix
8. A concerned client tells the nurse that her husband, who was very excited about the baby before birth, is apparently happy but seems to be afraid of caring for the baby. What suggestions should the nurse give to the client's husband to resolve the issue?
Ans: Suggest that her husband begin by holding the baby frequently.
16. While caring for a client following a lengthy labor & delivery, the nurse notes that the client repeatedly reviews her labor & delivery and is very dependent on her family for care. The nurse is correct in identifying the client to be in which phase of maternal role adjustment?
Ans: Taking-in
2. A nurse is teaching a female client about fertility awareness as a method of contraception. Which of the following should the nurse mention as an assumption for this method?
Ans: The "unsafe period" is approximately 6 days
A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2-year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as: A) 3 2 1 0 3 B) 3 1 2 2 3 C) 4 1 1 1 3 D) 4 2 1 3 1
C) 4 1 1 1 3
A group of nurses are reviewing the steps for developing cultural competence. The students demonstrate understanding when they identify which of the following as the final step? A) Cultural knowledge B) Cultural skills C) Cultural encounter D) Cultural awareness
C) Cultural encounter
Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection? A) Provide treatment for clients who test positive for HIV B) Monitor viral load counts periodically C) Educate clients in how to practice safe sex D) Offer testing for clients who practice unsafe sex
C) Educate clients in how to practice safe sex
When preparing a woman for an amniocentesis, the nurse would instruct her to do which of the following? A) Shower with an antiseptic scrub. B) Swallow the preprocedure sedative. C) Empty her bladder. D) Lie on her left side.
C) Empty her bladder.
12.Which of the following would the nurse be least likely to suggest when teaching a group of young women how to reduce their risk for ovarian cancer? A) Pregnancy B) Oral contraceptives C) Feminine hygiene sprays D) Breast-feeding
C) Feminine hygiene sprays
25.A client has an abnormal Pap smear that is classified as ASC-US. Based on the nurses understanding of this classification, the nurse would expect which of the following? A) Immediate colposcopy B) Testing for HPV C) Repeat Pap smear in 4 to 6 months D) Cone biopsy
C) Repeat Pap smear in 4 to 6 months
The United States ranks 50th in the world for maternal mortality and 41st among industrialized nations for infant mortality rate. When developing programs to assist in decreasing these rates, which factor would most likely need to be addressed as having the greatest impact? A) Resolving all language and cultural differences B) Assuring early and adequate prenatal care C) Providing more extensive women's shelters D) Encouraging all women to eat a balanced die
Assuring early and adequate prenatal care
After presenting a class on measures to prevent postpartum hemorrhage, the presenter determines that the teaching was successful when the class states which of the following as an important measure to prevent postpartum hemorrhage due to retained placental fragments? A) Administering broad-spectrum antibiotics B) Inspecting the placenta after delivery for intactness C) Manually removing the placenta at delivery D) Applying pressure to the umbilical cord to remove the placenta
B After birth, a thorough inspection of the placenta is necessary to confirm its intactness because tears or fragments left inside may indicate an accessory lobe or placenta accreta. These can lead to profuse hemorrhage because the uterus is unable to contract fully.
A group of nursing students are reviewing information about mastitis and its causes. The students demonstrate understanding of the information when they identify which of the following as the most common cause? A) E. coli B) S. aureus C) Proteus D) Klebsiella
B The most common infectious organism that causes mastitis is S. aureus, which comes from the breast-feeding infant's mouth or throat.
After teaching a woman with a postpartum infection about care after discharge, which client statement indicates the need for additional teaching? A) "I need to call my doctor if my temperature goes above 100.4°F" B) "When I put on a new pad, I'll start at the back and go forward." C) "If I have chills or my discharge has a strange odor, I'll call my doctor." D) "I'll point the spray of the peribottle so the water flows front to back."
B The pad should be applied using a front-to-back motion.
5. Which finding obtained during a client history would the nurse identify as increasing a clients risk for ovarian cancer? A)Multiple sexual partners B) Consumption of a high-fat diet C) Underweight D)Grand multiparity (more than five children)
B) Consumption of a high-fat diet
The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects with pregnant women? A) Calcium B) Folic acid C) Vitamin C D) Iron
B) Folic acid
13.A woman is diagnosed with adenocarcinoma of the endometrium in situ. The nurse interprets this as indicating which of the following about the cancer? A) Spread to the uterine muscle wall B) Found on the endometrial surface C) Spread to the cervix D) Invaded the bladder
B) Found on the endometrial surface
A group of students are reviewing information about sexually transmitted infections and their effect on pregnancy. The students demonstrate understanding of the information when they identify which infection as being responsible for ophthalmia neonatorum? A) Syphilis B) Gonorrhea C) Chlamydia D) HPV
B) Gonorrhea
20.During a routine health check-up, a young adult woman asks the nurse about ways to prevent endometrial cancer. Which of the following would the nurse most likely include? (Select all that apply.) A) Eating a high-fat diet B) Having regular pelvic exams C) Engaging in daily exercise D) Becoming pregnant E) Using estrogen contraceptives
B) Having regular pelvic exams C) Engaging in daily exercise D) Becoming pregnant
3. A woman comes to the clinic for a routine checkup. A history of exposure to which of the following would alert the nurse that she is at increased risk for cervical cancer? A)Hepatitis B) Human papillomavirus C) Cytomegalovirus D)Epstein-Barr virus
B) Human papillomavirus
A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which of the following would the nurse assess? (Select all that apply.) A) Low whimpering cry B) Hypertonicity C) Lethargy D) Excessive sneezing E) Overly vigorous sucking F) Tremors
B) Hypertonicity C) Lethargy D) Excessive sneezing
When describing ovarian cancer to a local women's group, the nurse states that ovarian cancer often is not diagnosed early because: A. The disease progresses very slowly. B. The early stages produce very vague symptoms. C. The disease usually is diagnosed only at autopsy. D. Clients do not follow up on acute pelvic pain.
B. Typically there are no glaring features of ovarian cancer. Many of the symptoms are nonspecific and can easily be explained away and rationalized as changes related to the aging process.
___________________ are typically felt as a tightening or pulling sensation of the top of the uterus that occur primarily in the abdomen and groin.
Braxton Hicks *Irregular and can be decreased by walking, voiding, eating, increasing fluid intake, or changing position.
In the United States, what type of cancer accounts for one-third of cancer diagnoses and is the most common cancer in women?
Breast cancer
12. A fetus is assessed at 2 cm above the ischial spines. The nurse would document fetal station as: A) +4 B) +2 C) 0 D) -2
D.
A client states, "I think my waters broke! I felt this gush of fluid between my legs." The nurse tests the fluid with Nitrazine paper and confirms membrane rupture if the paper turns: A) Yellow B) Olive green C) Pink D) Blue
D. Amniotic fluid is alkaline and turns Nitrazine paper blue. * Nitrazine paper that remains yellow to olive green suggests that the membranes are most likely intact.
When reviewing the medical record of a client, the nurse notes that the woman has a condition in which the fetus cannot physically pass through the maternal pelvis. The nurse interprets this as: A. Cervical insufficiency B. Contracted pelvis C. Maternal disproportion D. Fetopelvic disproportion
D. Fetopelvic disproportion is defined as a condition in which the fetus is too large to pass through the maternal pelvis.
20. A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction? A) Heart rate increase from 76 bpm to 90 bpm B) Blood pressure rise from 110/60 mm Hg to 120/74 C) White blood cell count of 12,000 cells/mm3 D) Respiratory rate of 10 breaths /minute
D. During labor, there is an increase in respiratory rate with greater oxygen consumption due to the increase in metabolism. *A drop in respiratory rate would be a cause for concern.
Which of the following findings would lead the nurse to suspect that a woman is developing a postpartum complication? A. Moderate lochia rubra for the first 24 hours B. Clear lung sounds upon auscultation C. Temperature of 100 degrees F D. Chest pain experienced when ambulating
D. this may suggest a pulmonary embolism and the health care provider needs to be notified immediately.
Tocolytic
Drug that inhibits uterine contractions.
Which of the following is FALSE regarding emergency contraception (EC)? a) EC will disrupt an established pregnancy if taken within 72 hours. b) EC simply contains the same hormones that are found in birth control pills. c) EC works by preventing fertilization, ovulation, or implantation. d) EC is most effective if it is taken within 12 hours of rape.
EC will disrupt an established pregnancy if taken within 72 hours.
A nursing student studying sexual violence makes the following statement in class, "A man who has sex with his wife even though she did not want it cannot be charged with sexual abuse." Is this statement true or false? a) False b) True
False
The fetus of a woman in labor is determined to be in persistent occiput posterior position. Which of the following would the nurse identify as the priority intervention? A) Position changes B) Pain relief measures C) Immediate cesarean birth D) Oxytocin administration
Pain relief measures Intense back pain is associated with persistent occiput posterior position. Therefore, a priority is to provide pain relief measures. Position changes that can promote fetal head rotation are important after the nurse institutes pain relief measures. Additionally, the woman's ability to cooperate and participate in these position changes is enhanced when she is experiencing less pain. *Oxytocin would add to the woman's already high level of pain.
A young mother brings her 6-month-old in for an examination, appearing listless and inattentive of her child. She sets the child in the floor and reads and sends text messages on her phone. The child appears underweight and lethargic. Which finding would confirm the nurse's suspicion that this child is experiencing failure to thrive? a) The child rests her head on the nurse's shoulder and cuddles with her after the examination b) The child is below the fifth percentile for weight and height c) The child resists when the nurse takes her vital signs d) The child cries when the nurse picks her up
The child is below the fifth percentile for weight and height
When assessing the uterus of a 2-day postpartum client, which finding would the nurse evaluate as normal?
a moderate amount of lochia rubra
A client in her thrid trimester of pregnancy arrives at a health care facility with a report of cramping and low back pain; she also notes that she is urinating more frequently and that her breathing has become easier the past few days. Physical examination conducted by the nurse indicates that the client has edema of the lower extremities along with an increase in vaginal discharge. What should the nurse do next? a. Notify the health care provider b. Continue to monitor the client c. Assess the client's blood pressure d. Prepare the client for birth
b. Continue to monitor the client *The client is experiencing "lightening"
What drug is used to promote fetal lung maturity and is an IM injection give in 2 doses 12 hours apart?
betamethasone (Celestone)
The mucous plug that fills the cervical canal is expelled as a result of cervical softening and increased pressure of the presenting part and when this happens it is known as __________________________
bloody show
During assessment using a nitrazine swab, the membranes are most likely ruptured if the swab turns what color?
blue * amniotic fluid is alkaline
Client experiencing shoulder dystocia during birth. The nurse would place PRIORITY on performing which assessment postbirth? a. extensive lacerations b. monitor of cardiac anomaly c. brachial plexus assessment
brachial plexus to identify nerve damage
A nurse is reviewing the history of a postpartum woman. The nurse determines that the woman is at low risk for uterine subinvolution based on which findings? Select all that apply.
breastfeeding and early ambulation
A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?
burning on urination
A client has presented reporting symptoms that suggest a gonorrheal infection. After laboratory testing confirms this diagnosis, the nurse anticipates that the client will also be treated for which infection?
chlamydia
A nurse is teaching a group of pregnant young women about sexually transmitted infections (STIs) and the possible effects that may occur in the fetus or newborn. Which STIs would the nurse describe as being transmitted to the newborn during birth? Select all that apply.
chlamydia gonorrhea genital herpes HIV
Which finding would lead the nurse to suspect that a postpartum client is developing thrombophlebitis?
redness in lower legs
heterozygous
refers to a particular gene that has different alleles on both homologous chromosomes. pg. 348
A school health nurse is presenting information on sexually transmitted infections (STIs) to a high school class. The nurse feels confident that learning has taken place when the students report:
female adolescents are more susceptible to STIs due to their anatomy.
If the nitrazine test is inconclusive, an additional test, called the ________________ test, can be used to confirm rupture of membranes
fern
What additional test can be used if the nitrazine test is inconclusive to confirm rupture of membranes?
fern test
Methylergonovine is not given if the woman is ___________
hypertensive.
Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis?
latency
At what ages male and female would it benefit them to go to genetic counseling?
male: 55 female: 35
The ___________ provides an indirect measurement of uteroplacental function.
nonstress test (NST)
Allele
one of two or more alternative forms of a gene that arise by mutation and are found at the same place on a chromosome.
imcomplete involution of uterus, or its failure to return to its normal size and condition after birth
subinvolution
What line separates the smallest part of the head from the rest of the skull?
suboccipitobregmatic
At 12 weeks' gestation the fundus can be palpated at the ___________________.
symphysis pubis
Fetal presentation refers to
the body part of the fetus that enters the pevic inlet first (presenting part)
zona pellucida
the thick transparent membrane surrounding a mammalian ovum before implantation. pg. 337
nitrazine paper
to confirm ruptured membrane
colposcopy
visual examination of the lower genital tract
monosomy
when a diploid organism has only one copy of one of its chromosomes instead of two.
Breech positions are associated with what factors?
prematurity, placenta previa, multiparity, abnormalities (fibroids), congenital anomalies such as hydrocephaly
Leopold maneuvers are a method for determing what ?
presentation, position and lie of the fetus
fertilization
process occurs in about an hour. When one spermatozoon penetrates the ovum's thick outer membrane. pg. 336
A community health nurse is conducting an educational session at a local community center on sexually transmitted infections (STIs). The nurse considers the session successful when participants identify which statement as correct?
"Human papillomavirus is the cause of essentially all cases of cervical cancer."
During what week of pregnancy does vernix caseosa, a white greasy film, cover the fetus?
17-20
For the woman who is pregnant for the first time when does lightening occur?
2 weeks before the onset of labor *For women who have had more preganancies it occurs on the onset of labor
Put these events in order from the first that happens to the last during the preembryonic development 1. The inner cell mass is called a blastocyst 2. Fertilization takes place 3. Zygote is formed 4. Implantation occurs 5. Morula is formed (mass of 16 cells) 6. Trophoblast is formed
2, 3, 5, 1, 6, 4 Rationale: Fertilization > Zygote > Morula >Blastocyst > Trophoblast > Implantation
To assist the woman in regaining control of the urinary sphincter for urinary incontinence, the nurse should teach the client to do which of the following? A) Perform Kegel exercises daily. B) Void every hour while awake. C) Limit her intake of fluid. D) Take a laxative every night.
A
6. A nurse is applying ice packs to the perineal area of a client who has had a vaginal delivery. Which of the following interventions should the nurse perform to ensure that the client gets the optimum benefits of the procedure?
Ans: Ensure ice pack is changed frequently.
11. Which of the following organs provides the space and environment for sperm cells to mature?
Ans: Epididymis
A uterine resting tone greater than ____ mm Hg would require intervention.
20
During active labor, the intensity of uterine contractions usually reaches ___ to ___ mmHg
50 to 80 *Resting tone is 12 to 18
trisomy
A genetic disorder in which a person has three copies of a chromosome instead of two. ex. down syndrome
This class of drug has clear health risks for the fetus. Examples include: phenytoin, alcohol, lithium and drugs to treat cancer.
Category D
In a pregnant woman, darker pigmentation of the nipple and areola develops, along with enlargment of ______________ glands in the breast.
Montgomery
____occurs when the greatest transverse diameter of the head in vertex passes through the pelvic inlet
engagement
Vaginal birth is most favorable with ______ type of pelvis because the inlet is round and the outlet is roomy
gynecoid
This hormone preserves the corpus luteum and its progesterone production so that the endometrial lining of the uterus is maintained
hCG
Connective tissue loosens and smooth muscle begins to hypertrophy
Vagina
A nurse is reviewing the various treatment options with a client diagnosed with uterine fibroids. The nurse determines that the teaching was successful based on which statement? "If I use hormone therapy, my fibroids may grow back when I stop the medication." "A myomectomy will not allow me to keep my uterus." "Uterine artery embolization is associated with minimal pain." "Laser surgery won't affect my ability to have children."
"If I use hormone therapy, my fibroids may grow back when I stop the medication." Typically, with hormonal therapy, fibroids regrow when the medication is stopped. A myomectomy preserves the uterus. Uterine artery embolization is frequently painful. Laser surgery can cause scarring and adhesions which could impact future fertility.
By the end of the second stage of labor, the nurse would expect which of the following events? The A. cervix is fully dilated and effaced B. placenta is detached and expelled C. fetus is born and on mother's chest D. woman to request pain medication
"C" because the second stage of labor is defined as beginning with complete dilation of the cervix (10 cm) and ending with the expulsion of the fetus. - Response "A" is incorrect because the cervix is fully dilated at the start of stage 2, not at the end of it. Response "
A new mother is concerned because it is 24 hours after birth and her breasts have still not become engorged with breast milk. How should the nurse respond to this concern?
"It takes about 3 days after birth for milk to begin forming."
A postpartum client has called the unit reporting breast engorgement and asking for suggestions. Which instruction should the nurse prioritize for this client?
"Take a warm shower just before feeding your infant."
Fetal gender can be determined by week _________
12
A fine hair develops on the head of the fetus called lanugo, sucking otions are made with the mouth and fetal movement (quickening) is detected by the mother during what week of pregnancy?
13-16
The nursing student is studying violence and abuse against the older woman. While researching it, she learns that laws require health care professionals to report elder or vulnerable person abuse. How many states currently have these laws? a) 40 b) 52 c) 50 d) 32
50
After teaching a group of students about the changes in health care delivery and funding, which of the following, if identified by the group as a current trend seen in the maternal and child health care settings, would indicate that the teaching was successful? A) Increase in community settings for care B) Decrease in family poverty level C) Increase in hospitalization of children D) Decrease in managed care
A) Increase in community settings for care
After teaching a group of students about the discomforts of pregnancy, the students demonstrate understanding of the information when they identify which as common during the first trimester? (Select all that apply.) A) Urinary frequency B) Breast tenderness C) Cravings D) Backache E) Leg cramps
A) Urinary frequency B) Breast tenderness C) Cravings
A group of nursing students are reviewing information about cesarean birth. The students demonstrate understanding of the information when they identify which of the following as an appropriate indication? (Select all that apply) A) Active genital herpes infection B) Placenta previa C) Previous cesarean birth D) Prolonged labor E) Fetal distress
Active genital herpes infection Placenta previa Previous cesarean birth Fetal distress
A nurse is reviewing the medical record of a woman diagnosed with a uterine fibroid. The nurse would identify which factors as predisposing the client to this condition? Select all that apply. age of 38 African American ethnicity history of hypertension multiparity underweight
African American ethnicity history of hypertension Although the cause of fibroids is not known, several predisposing factors have been identified: age (late reproductive years), with peak incidence occurring around age 45; African American ethnicity; hypertension; nulliparity; and obesity.
When providing care to a victim of abuse, which of the following would the nurse do? a) Provide an overview of the procedures to be done. b) Make the decisions for the woman. c) Take the lead in providing the interventions quickly. d) Allow the woman to participate in her care.
Allow the woman to participate in her care.
After teaching a class on date rape, the instructor determines that the teaching was successful when the class identifies which of the following as the most common date rape drug? A) Gamma hydroxybutyrate B) Liquid ecstasy C) Ketamine D) Rohypnol
Ans: D Feedback: Rohypnol is the most common date rape drug. Others include gamma hydroxybutyrate, or liquid ecstasy, and ketamine.
16. A 49-year old client who is in the perimenopausal phase of life reports to the nurse a loss of lubrication during intercourse, which she feels is hampering her sex life. Which of the following responses is appropriate for the nurse?
Ans: "You can manage the condition by using OTC moisturizers or lubricants"
After reviewing a client's history, which factor would the nurse identify as placing her at risk for gestational hypertension? A) Mother had gestational hypertension during pregnancy. B) Client has a twin sister. C) Sister-in-law had gestational hypertension. D) This is the client's second pregnancy.
Ans: A A family history of gestational hypertension, such as a mother or sister, is considered a risk factor for the client. Having a twin sister or having a sister-in-law with gestational hypertension would not increase the client's risk. If the client had a history of preeclampsia in her first pregnancy, then she would be at risk in her second pregnancy.
After teaching a woman who has had an evacuation for a hydatidiform mole (molar pregnancy) about her condition, which of the following statements indicates that the nurse's teaching was successful? A) "I will be sure to avoid getting pregnant for at least 1 year." B) "My intake of iron will have to be closely monitored for 6 months." C) "My blood pressure will continue to be increased for about 6 more months." D) "I won't use my birth control pills for at least a year or two."
Ans: A After evacuation of a hydatidiform mole, long-term follow-up is necessary to make sure any remaining trophoblastic tissue does not become malignant. Serial hCG levels are monitored closely for 1 year and the client is urged to avoid pregnancy for 1 year because it can interfere with the monitoring of hCG levels. Iron intake and blood pressure are not important aspects of follow-up after evacuation of a hydatidiform mole. Use of a reliable contraceptive is strongly recommended so that pregnancy is avoided.
In a woman who is suspected of having a ruptured ectopic pregnancy, the nurse would expect to assess for which of the following as a priority? A) Hemorrhage B) Jaundice C) Edema D) Infection
Ans: A With a ruptured ectopic pregnancy, the woman is at high risk for hemorrhage. Jaundice, edema, and infection are not associated with a ruptured ectopic pregnancy.
A pregnant woman undergoes maternal serum alpha-fetoprotein (MSAFP) testing at 16 to 18 weeks' gestation. Which of the following would the nurse suspect if the woman's level is decreased? A) Down syndrome B) Sickle-cell anemia C) Cardiac defects D) Open neural tube defect
Ans: A Feedback: Decreased levels might indicate Down syndrome or trisomy 18. Sickle cell anemia may be identified by chorionic villus sampling. MSAFP levels would be increased with cardiac defects, such as tetralogy of Fallot. A triple marker test would be used to determine an open neural tube defect.
A woman just delivered a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify which of the following as normal? (Select all that apply.) A) One vein B) Two veins C) One artery D) Two arteries E) One ligament F) Two ligaments
Ans: A, D Feedback: The normal umbilical cord contains one large vein and two small arteries.
8. Which of the following postoperative interventions should a nurse perform when caring for a client who has undergone a c-section?
Ans: Assess uterine tone to determine fundal firmness
10. A nurse is caring for a postpartum client. What instruction should the nurse provide to the client as precautionary measures to prevent thromboembolic complications?
Ans: Avoid sitting in one position for long periods of time
2. A nurse is caring for a client who has been treated for a deep vein thrombosis. Which teaching point should the nurse tress when discharging the client?
Ans: Avoid use of oral contraceptives
A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which of the following would the nurse include? A) Ankle edema B) Urinary frequency C) Backache D) Hemorrhoids
Ans: B The client is in her first trimester and would most likely experience urinary frequency as the growing uterus presses on the bladder. Ankle edema, backache, and hemorrhoids would be more common during the later stages of pregnancy.
The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes interventions focusing on which of the following because of the woman's increased risk? A) Oligohydramnios B) Preeclampsia C) Post-term labor D) Chorioamnionitis
Ans: B Women with multiple gestations are at high risk for preeclampsia, preterm labor, hydramnios, hyperemesis gravidarum, anemia, and antepartal hemorrhage. There is no association between multiple gestations and the development of chorioamnionitis.
A nurse is assessing a child with Klinefelter's syndrome. Which of the following would the nurse expect to assess? (Select all that apply.) A) Gross mental retardation B) Long arms C) Profuse body hair D) Gynecomastia E) Enlarged testicles
Ans: B, D Feedback: Manifestations of Klinefelter's syndrome include mild mental retardation, small testicles, infertility, long arms and legs, gynecomastia, scant facial and body hair, and decreased libido.
15. A nurse is caring for a pregnant client with eclampic seizures. Which of the following should the nurse know as a characteristic of eclampsia?
Ans: Coma occurs after seizures
The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy body mass index of 26. The nurse determines that the teaching was successful when the woman states that she should gain no more than which amount during pregnancy? A) 35 to 40 pounds B) 25 to 35 pounds C) 28 to 40 pounds D) 15 to 25 pounds
Ans: D A woman with a body mass index of 26 is considered overweight and should gain no more than 15 to 25 pounds during pregnancy. Women with a body mass index of 18.5 to 24.9 (considered healthy weight) should gain 25 to 35 pounds. A woman with a body mass index less than 18.5 should gain 28 to 40 pounds.
The nurse is reviewing the laboratory test results of a pregnant client. Which one of the following findings would alert the nurse to the development of HELLP syndrome? A) Hyperglycemia B) Elevated platelet count C) Leukocytosis D) Elevated liver enzymes
Ans: D HELLP is an acronym for hemolysis, elevated liver enzymes, and low platelets. Hyperglycemia or leukocytosis is not a part of this syndrome.
19. The nurse is required to assess a client for HELLP syndrome. Which of the following are the signs and symptoms of this condition? Select all that apply
Ans: Epigastric pain Ans: Upper right quadrant pain Ans: Hyperbilirubinemia
3. When teaching a client about hormones, which of the following should the nurse identify as responsible in developing the ductal system of the breasts in preparation for lactation during pregnancy?
Ans: Estrogen
3. A client complaining of genital warts has been diagnosed with HPV. The genital warts has been treated, and they have disappeared. Which of the following should the nurse include in the teaching plan when educating the client about the condition?
Ans: Even after warts are removed, HPV still remains
1. A nurse has been assigned to the care of a client who has just given birth. How frequently should the nurse perform the assessments during the first hour after delivery?
Ans: Every 15 minutes.
6. It is important to be able to measure the health status of a group of people or a nation so that the number of people who die prematurely will decrease over time. How does the U.S. measure the health status of its people?
Ans: Examines mortality and morbidity data
5. A nurse has placed an infant with asphyxia on a radiant warmer. Which of the following sign idicate that the resuscitation methods have been successful?
Ans: Good cry
3. The nurse is instructing a client with dysmenorrhea on how to manage her symptoms. Which of the following should the nurse include in teaching plan? Select all that apply.
Ans: Increase water consumption Ans: Use heating pads or take warm baths Ans: Increase exercise and physical activity
8. A nurse is caring for an infant born with hypoglycemia. What care should the nurse administer to a newborn with hypoglycemia?
Ans: Maintain fluid and electrolyte balance
14. A nurse is assigned to educate a pregnant client regarding the changes in the structures of the respiratory system taking place during pregnancy. Which of the following conditions are associated with such changes? Select all that apply.
Ans: Nasal and sinus stuffiness Ans: Nosebleed Ans: Thoracic rather than abdominal breathing
6. A client is experiencing shoulder dystocia during delivery. Which of the following should the nurse identify as risk to the fetus in such a condition?
Ans: Nerve damage
6. Which of the following interventions should a nurse perform to promote thermal regulation in a preterm newborn?
Ans: Observe for clinical signs of cold stress such as weak cry
14. Which of the following instructions should a nurse give an RH-negative nonimmunized client in her early weeks of pregnancy to prevent complications of blood incompatibility?
Ans: Obtain RhoGam at 28 week's gestation
9. A client will full-term pregnancy who is not in active labor has been ordered oxytocin intravenously. Which of the following is an contraindication for oxytocin administration?
Ans: Overdistended uterus
10. A nurse is screening an elderly client for prostate cancer. What are the effects of aging on the prostate gland?
Ans: Prostate gland enlarges with age
8. A first-time mother is nervous about breast-feeding. Which of the following interventions should the nurse perform to reduce maternal anxiety about breast-feeding?
Ans: Reassure the mother that some newborns "latch on and catch on" right away, and some newborns take more time and patience.
3. When caring for a preterm infant, what intervention will most address the sensorimotor needs of the infant?
Ans: Rocking and massaging
9. During cold conditions, how does the body react to maintain scrotal temperature?
Ans: Scrotum is pulled closer to the body
5. A nurse is caring for a client who is scheduled to undergo amnioinfusion. The nurse knows that the client will not be able to have this procedure if which condition is present?
Ans: The client has uterine hypertonicity
A nurse is caring for a client at 38 weeks gestation who is diagnosed with chorioamnionitis. On which intervention should the nurse place priority?
Administer oxytocin pg. 812
client with trichomoniasis is to receive metronidazole (Flagyl). The nurse instructs the client to avoid which of the following while taking this drug? A) Alcohol B) Nicotine C) Chocolate D) Caffeine
Ans: A Feedback: The client should be instructed to avoid consuming alcohol when taking metronidazole because severe nausea and vomiting could occur. There is no need to avoid nicotine, chocolate, or caffeine when taking metronidazole.
When the nurse is alone with a client, the client says, "It was all my fault. The house was so messy when he got home and I know he hates that." Which response would be most appropriate? A) "It is not your fault. No one deserves to be hurt. " B) "What else did you do to make him so angry with you?" C) "You need to start to clean the house early in the day." D) "Remember, he works hard and you need to meet his needs."
Ans: A Feedback: The nurse needs to communicate nonjudgmental support and explain that no one deserves to be abused. Doing so helps to establish trust and rapport. Asking the woman what she did to make the partner so angry, telling her to clean the house earlier in the day, and telling her that she needs to meet his needs all shift the blame to the victim and are thus inappropriate.
When developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging risk group for HIV infection? A) Native Americans B) Heterosexual women C) New health care workers D) Asian immigrants
Ans: B Feedback: According to statistics, more than 90% of all HIV infections have resulted from heterosexual intercourse, making heterosexual women particularly vulnerable due to substantial mucosal exposure to seminal fluids. HIV disproportionately affects African American and Hispanic women, but together they represent less than 25% of all U.S. women. New health care workers and Asian immigrants account for only a very small number of HIV-positive cases.
A nurse at a local community clinic is developing a program to address STI prevention. Which of the following would the nurse least likely include in the program? A) Outlining safer sexual behavior B) Recommending screening for symptomatic individuals C) Promoting the use of barrier contraceptives D) Offering education about STI transmission
Ans: B Feedback: Strategies to prevent STIs include providing basic information about STI transmission, outlining safer sexual behaviors, screening asymptomatic persons with STIs, and promoting the use of barrier contraceptives.
A mother brings her 12-year-old daughter in for well-visit checkup. During the visit, the nurse is discussing the use of prophylactic HPV vaccine for the daughter. The mother agrees and the daughter receives her first dose. The nurse schedules the daughter for the next dose, which would be given at which time? A) In 1 month B) In 2 months C) In 3 months D) In 4 months
Ans: B Feedback: The HPV vaccine is administered intramuscularly in three separate 0.5-mL doses. The first dose may be given to any individual 9 to 26 years old prior to infection with HPV. The second dose is administered 2 months after the first, and the third dose is given 6 months after the initial dose.
A nurse is caring for a woman who was recently raped. The nurse would expect this woman to experience which of the following first? A) Denial B) Disorganization C) Reorganization D) Integration
Ans: B Feedback: The acute phase of rape recovery is disorganization characterized by shock, fear, disbelief, anger, shame, guilt and feelings of uncleanliness. This is followed by denial (outward adjustment), reorganization, and finally integration and recovery.
A battered pregnant woman reports to the nurse that her husband has stopped hitting her and promises never to hurt her again. Which of the following is an appropriate response? A) "That's great. I wish you both the best." B) "The cycle of violence often repeats itself." C) "He probably didn't mean to hurt you." D) "You need to consider leaving him."
Ans: B Feedback: The cycle of violence typically increases in frequency and severity as it is repeated over and over again. The woman needs to understand this.
When describing the cycle of violence to a community group, the nurse explains that the first phase usually is: A) Somehow triggered by the victim's behavior B) Characterized by tension-building and minor battery C) Associated with loss of physical and emotional control D) Like a honeymoon that lulls the victim
Ans: B Feedback: The cyclic behavior begins with a time of tension-building arguments, progresses to violence, and settles into a making-up or calm period.
A group of nurses are researching information about risk factors for intimate partner violence in men. Which of the following would the nurses expect to find related to the individual person? (Select all that apply.) A) Dysfunctional family system B) Low academic achievement C) Victim of childhood violence D) Heavy alcohol consumption E) Economic stress
Ans: B, C, D Feedback: Individual risk factors associated with intimate partner violence include young age, heavy drinking, low academic achievement, and experience of or witnessing of violence as a child. Dysfunctional family system and economic stress are risk factors associated with the relationship.
Teaching for victims who are recovering from abusive situations must focus on ways to: A) Enhance their personal appearance and hairstyle B) Develop their creativity and work ethic C) Improve their communication skills and assertiveness D) Plan more nutritious meals to improve their own health
Ans: C Feedback: Providing reassurance and support to a victim of abuse is key if the violence is to end. Appropriate actions can help victims express their thoughts and feelings in constructive ways and strengthen their control over their lives. Although interventions related to personal appearance and creativity can enhance the woman's self-esteem, they are not helpful in dealing with the abuse. Planning nutritious meals helps to promote a healthy lifestyle but is ineffective in dealing with the abuse.
The primary goal when working with victims of intimate partner violence is to: A) Convince them to leave the abuser soon B) Help them cope with their life as it is C) Empower them to regain control of their life D) Arrest the abuser so he or she can't abuse again
Ans: C Feedback: The goal of intervention is to enable the victim to gain control over her life. Although the nurse can encourage the woman to leave the abuser, the choice to leave must be made by the woman. The nurse can provide support and assistance with coping, but the ultimate goal is for the woman to become empowered. Arresting the abuser does not necessarily stop the abuse.
Which instructions would the nurse include when teaching a woman with pediculosis pubis? A) "Take the antibiotic until you feel better." B) "Wash your bed linens in bleach and cold water." C) "Your partner doesn't need treatment at this time." D) "Remove the nits with a fine-toothed comb."
Ans: D Feedback: The nurse should instruct the client to remove the nits from the hair using a fine-toothed comb. Permethrin cream and lindane shampoo, not antibiotics, are used as treatment. Bedding and clothing should be washed in hot water to decontaminate it. Sexual partners should be treated also, as well as family members who live in close contact with the infected person.
9. A nurse is caring for a client with hyperemesis gravidarum. Which of the following should be the first choice for fluid replacement for this client?
Ans: 5% dextrose in lactated Ringer soluion with vitamins and electrolytes
12. A client is Rh-negative and has given birth to a newborn who is Rh-positive. Within how many hours should Rh immunoglobulin be injected in the mother?
Ans: 72 hours
While assessing a pregnant woman, the nurse suspects that the client may be at risk for hydramnios based on which of the following? (Select all that apply.) A) History of diabetes B) Complaints of shortness of breath C) Identifiable fetal parts on abdominal palpation D) Difficulty obtaining fetal heart rate E) Fundal height below that for expected gestational age
Ans: A, B, D Factors such as maternal diabetes or multiple gestations place the woman at risk for hydramnios. In addition, there is a discrepancy between fundal height and gestational age, such that a rapid growth of the uterus is noted. Shortness of breath may result from overstretching of the uterus due to the increased amount of amniotic fluid. Often, fetal parts are difficult to palpate and fetal heart rate is difficult to obtain because of the excess fluid present.
A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal tract, which of the following would the nurse expect to find? (Select all that apply. A) Hyperemic gums B) Increased peristalsis C) Complaints of bloating D) Heartburn E) Nausea
Ans: A, C, D, E Gastrointestinal system changes include hyperemic gums due to estrogen and increased proliferation of blood vessels and circulation to the mouth; slowed peristalsis; acid indigestion and heartburn; bloating and nausea and vomiting.
14. A nurse is assessing a client during the postpartum period. Which of the following indicate normal postpartum adjustment? Select all that apply
Ans: Active bowel sounds Ans: Passing gas Ans: Non-distended abdomen.
Assessment of a pregnant woman reveals that she compulsively craves ice. The nurse documents this finding as which of the following? A) Quickening B) Pica C) Ballottement D) Linea nigra
Ans: B Pica refers to the compulsive ingestion of nonfood substances such as ice. Quickening refers to the mother's sensation of fetal movement. Ballottement refers to the feeling of rebound from a floating fetus when an examiner pushes against the woman's cervix during a pelvic examination. Linea nigra refers to the pigmented line that develops in the middle of the woman's abdomen.
11. After teaching a group of students about the maternal bony pelvis, which statement by the group indicates that the teaching was successful? A) The bony pelvis plays a lesser role during labor than soft tissue. B) The pelvic outlet is associated with the true pelvis. C) The false pelvis lies below the imaginary linea terminalis. D) The false pelvis is the passageway through which the fetus travels.
Ans: B Feedback: The maternal bony pelvis consists of the true and false portions. The true pelvis is made up of three planes—the inlet, the mid pelvis, and the outlet. The bony pelvis is the more important part of the passageway because it is relatively unyielding. The false pelvis lies above the imaginary linea terminalis. The true pelvis is the bony passageway through which the fetus must travel.
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which of the following? A) Maternal diabetes B) Placental insufficiency C) Neural tube defects D) Fetal gastrointestinal malformations
Ans: B Feedback: A deficiency of amniotic fluid, oligohydramnios, is associated with uteroplacental insufficiency and fetal renal abnormalities. Excess amniotic fluid is associated with maternal diabetes, neural tube defects, and malformations of the gastrointestinal tract and central nervous system.
A nursing instructor is preparing a teaching plan for a group of nursing students about the potential for misuse of genetic discoveries and advances. Which the following would the instructor most likely include? A) Gene replacement therapy for defective genes B) Individual risk profiling and confidentiality C) Greater emphasis on the causes of diseases D) Slower diagnosis of specific diseases
Ans: B Feedback: Individual risk profiling based on an individual's genetic makeup can raise issues related to privacy and confidentiality. Gene replacement therapy for defective genes and a greater emphasis on looking at the causes of disease are considered benefits associated with genetic advances. Rapid, more specific diagnosis of diseases would be possible.
A nursing student is reviewing an article about preterm premature rupture of membranes. Which of the following would the student expect to find as factor placing a woman at high risk for this condition? (Select all that apply.) A) High body mass index B) Urinary tract infection C) Low socioeconomic status D) Single gestations E) Smoking
Ans: B, C, E High-risk factors associated with preterm PROM include low socioeconomic status, multiple gestation, low body mass index, tobacco use, preterm labor history, placenta previa, abruptio placenta, urinary tract infection, vaginal bleeding at any time in pregnancy, cerclage, and amniocentesis.
A nurse is developing a teaching plan about nutrition for a group of pregnant women. Which of the following would the nurse include in the discussion? (Select all that apply. A) Keep weight gain to 15 lb B) Eat three meals with snacking C) Limit the use of salt in cooking D) Avoid using diuretics E) Participate in physical activity
Ans: B, D, E To promote optimal nutrition, the nurse would recommend gradual and steady weight gain based on the client's prepregnant weight, eating three meals with one or two snacks daily, not restricting the use of salt unless instructed to do so by the health care provider, avoiding the use of diuretics, and participating in reasonable physical activity daily.
A woman hospitalized with severe preeclampsia is being treated with hydralazine to control blood pressure. Which of the following would the lead the nurse to suspect that the client is having an adverse effect associated with this drug? A) Gastrointestinal bleeding B) Blurred vision C) Tachycardia D) Sweating
Ans: C Hydralazine reduces blood pressure but is associated with adverse effects such as palpitation, tachycardia, headache, anorexia, nausea, vomiting, and diarrhea. It does not cause gastrointestinal bleeding, blurred vision, or sweating. Magnesium sulfate may cause sweating.
The nurse is assessing a pregnant woman in the second trimester. Which of the following tasks would indicate to the nurse that the client is incorporating the maternal role into her personality? A) The woman demonstrates concern for herself and her fetus as a unit. B) The client identifies what she must give up to assume her new role. C) The woman acknowledges the fetus as a separate entity within her. D) The client demonstrates unconditional acceptance without rejection.
Ans: C Incorporation of the maternal role into her personality indicates acceptance by the pregnant woman. In doing so, the woman becomes able to identify the fetus as a separate individual. Demonstrating concern for herself and her fetus as a unit is associated with introversion and more commonly occurs during the third trimester. Identification of what the mother must give up to assume the new role occurs during the first trimester. Demonstrating unconditional acceptance without rejection occurs during the third trimester.
Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which of the following responses by the nurse would be most appropriate? A) "Why are you crying?" B) "Will a pill help your pain?" C) "I'm sorry you lost your baby." D) "A baby still wasn't formed in your uterus."
Ans: C Telling the client that the nurse is sorry for the loss acknowledges the loss to the woman, validates her feelings, and brings the loss into reality. Asking why the client is crying is ineffective at this time. Offering a pill for the pain ignores the client's feelings. Telling the client that the baby wasn't formed is inappropriate and discounts any feelings or beliefs that the client has.
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication? A) Urinary output of 20 mL per hour B) Respiratory rate of 10 breaths/minute C) Deep tendons reflexes 2+ D) Difficulty in arousing
Ans: C With magnesium sulfate, deep tendon reflexes of 2+ would be considered normal and therefore a therapeutic level of the drug. Urinary output of less than 30 mL, a respiratory rate of less than 12 breaths/minute, and a diminished level of consciousness would indicate magnesium toxicity.
When describing amniotic fluid to a pregnant woman, the nurse would include which of the following? A) "This fluid acts as transport mechanism for oxygen and nutrients." B) "The fluid is mostly protein to provide nourishment to your baby." C) "This fluid acts as a cushion to help to protect your baby from injury." D) "The amount of fluid remains fairly constant throughout the pregnancy."
Ans: C Feedback: Amniotic fluid protects the floating embryo and cushions the fetus from trauma. The placenta acts as a transport mechanism for oxygen and nutrients. Amniotic fluid is primarily water with some organic matter. Throughout pregnancy, amniotic fluid volume fluctuates.
1. A nurse is caring for a postpartum client who has a history of thrombosis during pregnancy and is at high risk of developing a pulmonary embolism. For which sign or symptom should the nurse monitor the client to prevent the occurrence of pulmonary embolism?
Ans: Calf swelling
6. A nurse is assigned to care for a 38-year old overweight client scheduled to undergo a cesarean section. The client is at an increased risk of thromboembolic complications. During assessment, what factor will help the nurse in the diagnosis of deep vein thrombosis of the leg?
Ans: Calf tenderness
12. A group of women are attending a community presentation discussing the health concerns of women. Which of the following will be included as the leading cause of death for women?
Ans: Cardiovascular disease
7. A full-term pregnant client is being assessed for induction of labor. Her Bishop score is less than 6. Which of the following does it indicate?
Ans: Cervical ripening method should be used
6. A client needs additional info about the cervical mucus ovulation method after having read about it in a magazine. She asks the nurse about cervical changes during ovulation. Which of the following should the nurse inform the client about?
Ans: Cervix is high or deep in the vagina
4. A nurse is caring for obstetric clients. The nurse should be aware of which of the following as an indication for labor induction?
Ans: Chorioamniotitis
8. A pregnant client wishes to know if sexual intercourse would be safe during her pregnancy. Which of the following should the nurse confirm before educating the client regarding sexual behavior during pregnancy?
Ans: Client does not have an incompetent cervix
13. A client reports that she has multiple sex partners and has a lengthy hx of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which of the following should the nurse suggest for this client?
Ans: Condoms
17. A nurse is educating a client about the various psychological feelings experienced by a woman and her partner during pregnancy. Which of the following is the feeling experienced by the expectant partner during the second trimester of pregnancy?
Ans: Confusion when dealing with the partners mood swings
11. A recently licensed nurse is orienting to a pediatric unit in an acute care facility. The nurse is discussing causes of infant mortality with her preceptor. Which of the following should be included as the leading cause of infant mortality?
Ans: Congenital anomalies.
14. The nurse is caring for a client and her partner who are considering a future pregnancy. The client reports her last two pregnancies ended in stillbirth related to an underlying genetic disorder. What response by the nurse is most appropriate?
Ans: Consultation with a genetic counselor before you become pregnant would likely be beneficial
Which of the following findings on a prenatal visit at 10 weeks might lead the nurse to suspect a hydatidiform mole? A) Complaint of frequent mild nausea B) Blood pressure of 120/84 mm Hg C) History of bright red spotting 6 weeks ago D) Fundal height measurement of 18 cm
Ans: D Findings with a hydatidiform mole may include uterine size larger than expected. Mild nausea would be a normal finding at 10 weeks' gestation. Blood pressure of 120/84 would not be associated with hydatidiform mole and depending on the woman's baseline blood pressure may be within acceptable parameters for her. Bright red spotting might suggest a spontaneous abortion.
Which of the following findings would the nurse interpret as suggesting a diagnosis of gestational trophoblastic disease? A) Elevated hCG levels, enlarged abdomen, quickening B) Vaginal bleeding, absence of FHR, decreased hPL levels C) Visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen D) Gestational hypertension, hyperemesis gravidarum, absence of FHR
Ans: D Gestational trophoblastic disease may be manifested by early development of preeclampsia (gestational hypertension), severe morning sickness due to high hCG levels, and absence of fetal heart rate or activity. There is no fetus, so quickening and evidence of a fetal skeleton would not be seen. The abdominal enlargement is greater than expected for pregnancy dates, but hCG, not hPL, levels are increased.
A nurse is assessing a pregnant woman with gestational hypertension. Which of the following would lead the nurse to suspect that the client has developed severe preeclampsia? A) Urine protein 300 mg/24 hours B) Blood pressure 150/96 mm Hg C) Mild facial edema D) Hyperreflexia
Ans: D Severe preeclampsia is characterized by blood pressure over 160/110 mm Hg, urine protein levels greater than 500 mg/24 hours and hyperreflexia. Mild facial edema is associated with mild preeclampsia.
After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests? A) Human placental lactogen (hPL) B) Estrogen (estriol) C) Progesterone (progestin) D) Human chorionic gonadotropin (hCG)
Ans: D Feedback: The placenta produces hCG, which is the basis for pregnancy tests. This hormone preserves the corpus luteum and its progesterone production so that the endometrial lining is maintained. Human placental lactogen modulates fetal and maternal metabolism and participates in the development of the breasts for lactation. Estrogen causes enlargement of the woman's breasts, uterus, and external genitalia and stimulates myometrial contractility. Progesterone maintains the endometrium.
11. A pregnant clients last menstrual period was march 10. Using Naegele's rule, the nurse knows that which of the following dates should be the childs estimated date of birth?
Ans: December 17
11. The mother of a newborn observes a diaper rash on her baby's skin. Which of the following should the nurse instruct the parent to prevent diaper rash?
Ans: Expose the newborn's bottom to air several times a day.
11. A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she's been able to breath easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform a physical examination of the client. Which of the following is the nurse most likely to observe?
Ans: Fundal height has dropped since last recording
13. A nurse is conducting an AIDs awareness program for women. Which of the following instructions should the nurse include in the teaching plan to empower women to develop control over their lives in a practical manner so that thet can prevent becoming infected with HIV? Select the most appropriate responses
Ans: Give opportunities to practice negotiation techniques Ans: Encourage women to develop refusal skills Ans: Encourage women to use female condoms
15. A nurse is caring for a pregnant client during labor. Which of the following methods should the nurse use to provide comfort to the pregnant client? Select all that apply
Ans: Hand holding Ans: Massaging Ans: Acupuncture
12. A client complaining of genital ulcers has been diagnosed with syphilis. Which of the following nursing interventions should the nurse implement when caring for the client? Select all that apply
Ans: Have the client urinate in water if urination is painful Ans: Instruct the client to wash her hands with soap and water after touching lesions Ans: Instruct the client to wear nonconstricting, comfortable clothes
6. A nurse is educating the mother of a new- born about feeding and burping. Which of the following strategies should the nurse offer to the mother regarding burping?
Ans: Hold the baby upright with the baby's head on her mother's shoulder.
13. A nurse is caring for an infant borh with a high bilirubin level. When planning the infants care, what intervention will assist in reducing the bilirubin level? Select all that apply
Ans: Hydration Ans: Easrly feedings Ans: Phototherapy
14. A client in her 7th weeks of the postpartum period is experiencing bouts of sadness and insomnia. The nurse suspects that the client may have developed postpartum depression. What signs or symptoms are indicative of postpartum depression? Select all that apply
Ans: Inability to concentrate Ans: Loss of confidence Ans: Decreased interest in life
11. A nurse is assessing the cause of multiple gestations in client. Which of the following factos should the nurse assess as contributors to increased probability of multiple gestations?
Ans: Infertility treatment
7. Which of the following nursing interventions should the nurse perform when assessing fetal well-being through abdominal ultrasonography in a client?
Ans: Instruct the patient to refrain from emptying her bladder
13. A nurse is caring for a client who has been diagnosed with precipitous labor. For which of the following potential fetal complications should the nurse monitor as a result of precipitous labor?
Ans: Intracranial hemorrhage
13. A client who is in her 6th week of gestation is being seen for a routine prenatal care visit. The client asks the nurse about changes in her eating habits that she should make during pregnancy. The client informs the nurse that she is a vegetarian. The nurse knows that she has to monitor the client for which of the following risks arising from her vegetarian diet? Select all that apply.
Ans: Iron deficiency anemia Ans: Decreased mineral absorption Ans: Low gestational weight gain
15. During a prenatal visit, a client in her second trimester of pregnancy verbalizes positive feelings about the pregnancy and conceptualizes the fetus. Which of the following is the most appropriate nursing intervention when the client expresses such feelings?
Ans: Offer support and validation about the clients feelings
13. A nurse is caring for a client who gave birth a week ago. The client informs the nurse that she experiences painful uterine contractions when breastfeeding the baby. The nurse would be accurate in identifying which hormone as the cause of these after pains?
Ans: Oxytocin
5. A client complains of pain on one side of the abdomen. On further questioning, the nurse discovers that the pain occurs regularly around 2 weeks before menstruation. The client has not missed a period, and she exercises regularly. Which of the following is the most likely cause of the pain?
Ans: Pain during ovulation
17. A client has opted to use an intrauterine device for contraception. Which of the following effects of the device on monthly periods should the nurse inform the client about?
Ans: Periods become lighter
8. A client in her 29th week of gestation complains of dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the clients blood pressure. Which of the following interventions should the nurse implement to help alleviate this client's condition?
Ans: Place the client in the left lateral position
4. A female client who has just given birth arrives in a health care facility wanting to know of ways to prevent sudden infant death syndrome (SIDS). Which of the following instructions should the nurse provide?
Ans: Place the infant on his or her back to sleep.
17. A nurse is caring for a client in her second trimester of pregnancy. During a regular follow-up visit, the client complains of varicosities of the legs. Which of the following instructions should the nurse provide to help the client alleviate varicosities of the legs?
Ans: Refrain from crossing legs when sitting for long periods
14. A pregnant client is admitted to a maternity clinic after experiencing contractions. The nurse knows that which of the following marks the importance of the pauses between contractions during labor?
Ans: Restoration of blood flow to uterus and placenta
10. A client who has given birth is being discharges from the the health care facility. She wants to know how safe it would be for her to have intercourse. Which of the following instructions should the nurse provide to the client regarding intercourse after childbirth?
Ans: Resume intercourse if bright-red bleeding stops.
6. A client asks the nurse how she would know if ovulation has occurred. Which of the following is a sign of ovulation that the nurse should inform the client about?
Ans: Rise in temp by 0.5 to 1 degrees F
10. A pregnant client arrives at the community clinic complaining of fever blisters and cold sores on the lips, eyes, and face. The primary health care provider has diagnosed it as the primary episode of genital herpes simplex, for which antiviral therapy is recommended. Which of the following information should the nurse offer the client when educating her about managing the infection?
Ans: Safety of antiviral therapy during pregnancy has not been established
4. The nurse observes a 2-inch lochia stain on the perineal pad of postpartum client. Which of the following terms should the nurse use to describe the amount of lochia present?
Ans: Scant would describe a 1 - 2-inch lochia stain or approx. 10 mL loss.
15. A client in her third trimester of pregnancy wishes to use the method of feeding formula to her infant. Which of the following instructions should the nurse provide to assist the client in feeding her baby?
Ans: Serve the formula at room temperature
15. When teaching the new mother about breast-feeding, the nurse is correct when providing what instructions? Select all that apply
Ans: Show mothers how to initiate breast-feeding within 30 minutes of birth
15. The nurse is caring for a client in the early stages of labor. What maternal factors will alert the nurse to plan for the possiblity of a small for gestational age newborn? Select all that apply
Ans: Smoking Ans: Asthma Ans: Drug abuse
2. A group of nurses are running a campaign initiated by the Maternal and Child Health Bureau to educate women about better maternal and infant care. Which of the following measures should they advocate for the prevention of neural defects in infants?
Ans: Take folic acid supplements.
14. When caring for a client with reproductive issues, the nurse is required to clear up misconceptions. This enables new learning to take hold and a better client response to whichever methods are explored and ultimately selected. Which of the following are misconceptions that the nurse needs to clear up? select all that apply.
Ans: Taking birth control pills protects against STIs Ans: Douching after sex will prevent pregnancy Ans: Irregular menstruation prevents pregnancy
15. Which of the following statements best expresses the role of the corpus luteum?
Ans: The corpus luteum secretes progesterone to promote preparation of the endometrium for implantation.
15. The physician has ordered a karyotype for a newborn. The mother questions what the type of information that will be provided by the test. What information should be included in the nurses response?
Ans: The karyotype will determine the treatment needed for the infant
4. A nurse is caring for a client who has given birth. The client reports that her breast milk is dark yellow. Which of the following info should the nurse give to the client regarding the situation?
Ans: The yellow fluid is colostrum and is rich in maternal antibodies.
12. A client in her second trimester of pregnancy asks the nurse for infor regarding certain oral medications to induce a miscarriage. What information should this client be given about such medications?
Ans: They can be taken only in the first trimester
10. When caring for a newborn, the nurse observes the neonate has developed white patches on the mucus membranes of the mouth. Which of the following considerations is the newborn most likely to be experiencing?
Ans: Thrush
8. A client in the 3rd stage of labor has experienced placental separation and expulsion. Why is it necessary for a nurse to massage the woman's uterus briefly until it is firm?
Ans: To constrict the uterine blood vessels
3. A pregnant client has come to the health care provider for her first prenatal visit. The nurse need to document useful information about the past health history. What are goals of the nurse in the history taking process? Select all that apply.
Ans: To prepare a plan of care that suits the clients lifestyle Ans: To develop a plan of care for the pregnancy Ans: To assess the clients partners sexual health
2. A client who gave birth about 12 hours ago informs the nurse that she has been voiding small amounts of urine frequently. The nurse examines the client and notes the displacement of the uterus from the mid line to the right. What intervention will help the client most?
Ans: Urinary catheterization
A nurse is completing the assessment of a woman admitted to the labor and birth suite.Which of the following would the nurse expect to include as part of the physical assessment? (Select all that apply.) A) Current pregnancy history B) Fundal height measurement C) Support system D) Estimated date of birth E) Membrane status F) Contraction pattern
Fundal height measurement Membrane status Contraction pattern As part of the admission physical assessment, the nurse would assess: - fundal height - membrane status and contractions * Current pregnancy history, support systems, and estimated date of birth would be obtained when collecting the maternal health history.
A woman delivered her infant 3 hours ago and the postpartum nurse is checking the mother's uterus. She finds that the uterus is still level with the umbilicus and is not firm. What would be the first thing the nurse should check in this client?
Her bladder for distension
When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle? A) Estrogen B) Luteinizing hormone C) Progesterone D) Prolactin
B) Luteinizing hormone
When assessing several women for possible VBAC, which woman would the nurse identify as being the best candidate? A) One who has undergone a previous myomectomy B) One who had a previous cesarean birth via a low transverse incision C) One who has a history of a contracted pelvis D) One who has avertical incision from a previous cesarean birth
B. VBAC is an appropriate choice for women who have had a previous cesarean birth with a lower abdominal transverse incision. It is contraindicated in women who have a prior classic uterine incision (vertical), prior transfundal surgery, such as myomectomy, or a contracted pelvis.
After describing continuous internal electronic fetal monitoring to a laboring woman and her partner, which of the following would indicate the need for additional teaching? A) "This type of monitoring is the most accurate method for our baby." B) "Unfortunately, I'm going to have to stay quite still in bed while it is in place." C) "This type of monitoring can only be used after my membranes rupture." D) "You'll be inserting a special electrode into my baby's scalp."
B. With continuous internal electronic monitoring, maternal position changes and movement do not interfere with the quality of the tracing. *Continuous internal monitoring is considered the most accurate method, but it can be used only if certain criteria are met, such as rupture of membranes.
The _______________ helps to identify women who would be most likely to achieve a successful induction.
Bishop score *8 and up= successful vaginal delivery 6 and below= needed cervical ripening before induction
A pregnant woman is flying across the country to visit her family. After teaching the woman about traveling during pregnancy, which statement indicates that the teaching was successful? A) "I'll sit in a window seat so I can focus on the sky to help relax me." B) "I won't drink too much fluid so I don't have to urinate so often." C) "I'll get up and walk around the airplane about every 2 hours." D) "I'll do some upper arm stretches while sitting in my seat."
C) "I'll get up and walk around the airplane about every 2 hours."
A nurse measures a pregnant woman's fundal height and finds it to be 28 cm. The nurse interprets this to indicate which of the following? A) 14 weeks' gestation B) 20 weeks' gestation C) 28 weeks' gestation D) 36 weeks' gestation
C) 28 weeks' gestation
When comparing community-based nursing with nursing in the acute care setting to a group of nursing students, the nurse describes the challenges associated with community-based nursing. Which of the following would the nurse include? A) Increased time available for education B) Improved access to resources C) Decision making in isolation D) Greater environmental structure
C) Decision making in isolation
What analgesia has a rapid onset of pain relief but allows the mother to maintain her motor power and ambulate. Also known as the "walking epidural"
Combined spinal-epidural analgesia (CSE)
A client's last menstrual period was April 11. Using Nagele's rule, her expected date of birth (EDB) would be: A) January 4 B) January 18 C) January 25 D) February 24
B) January 18
After teaching a group of students about reproductive tract cancers, the nursing instructor determines that the teaching was successful when the students identify which of the following as the deadliest type of female reproductive cancer? A. Vulvar B. Ovarian C. Endometrial D. Cervical
B. Typically ovarian cancer is not diagnosed until it is in advanced stages, when the prognosis and survival rates are poor.
After a vaginal examination, the nurse determines that the client's fetus is in an occiput posterior position. The nurse would anticipate that the client will have:
BACK PAIN
10.The nurse is preparing a presentation for a local women's group about ways to reduce the risk of reproductive tract cancers. Which of the following would the nurse include? A) Blood pressure evaluation every 6 months B) Yearly Pap smears starting at age 40 C) Yearly cholesterol screening starting at age 45 D) Consumption of two to three glasses of red wine per day
C) Yearly cholesterol screening starting at age 45
A client is experiencing shoulder dystocia during birth. The nurse would place priority on performing which assessment postbirth? A) monitor for a cardiac anomaly B) assess for cleft palate C) brachial plexus assessment D) extensive lacerations
C) brachial plexus assessment The nurse should identify nerve damage as a risk to the fetus in cases of shoulder dystocia. Other fetal risks include asphyxia, clavicle fracture, central nervous system injury or dysfunction, and death. Extensive lacerations is a poor maternal outcome due to the occurrence of shoulder dystocia.
A nurse is caring for a female client undergoing radiation therapy after her breast surgery. The client is refusing to eat and states she does not have a desire to eat at this time. Which action should the nurse do first?
Continue to monitor the client A nurse would monitor for signs of anorexia as it is a likely side effect of radiation therapy, along with swelling and heaviness of the breast, local edema, inflammation, and sunburn-like skin changes. The nurse would continue to monitor the client since this is a common, expected side effect of radiation.
After teaching a group of students about pelvic organ prolapse, the instructor determines that the teaching was successful when the group identifies leiomyomas as which of the following? A) Cysts B) Pelvic organ prolapse C) Fistula D) Fibroid
D
10.When assessing a pregnant woman with heart disease throughout the antepartal period, the nurse would be especially alert for signs and symptoms of cardiac decompensation at which time? A) 16 to 20 weeks gestation B) 20 to 24 weeks gestation C) 24 to 28 weeks gestation D) 28 to 32 weeks gestation
D) 28 to 32 weeks gestation
The primary goal of intervention in working with abused women is to: a. Set up an appointment with a mental health counselor for the victim b. Convince them to set up a safety plan to use when they leave c. Help them to develop courage and financial support to leave the abuser d. Empower them and improve their self-esteem to regain control of their lives
Empower them and improve their self-esteem to regain control of their lives
A nurse is describing the risks associated with prolonged pregnancies as part of an inservice presentation. Which of the following would the nurse be least likely to incorporate in the discussion as an underlying reason for problems in the fetus? A) Aging of the placenta B) Increased amniotic fluid volume C) Meconium aspiration D) Cord compression
Increased amniotic fluid volume
The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which of the following?
Lymphedema Lymphedema occurs in some women after breast cancer surgery. It causes disfigurement and increases the lifetime potential for infection and poor healing. Fibrocystic breast disease and fibroadenoma are two benign breast conditions that occur usually in premenopausal woman. Breast abscess is the infectious and inflammatory breast condition that is common among breast-feeding mothers.
A client is considering breast augmentation. Which of the following would the nurse recommend to the client to ensure that there are no malignancies?
Mammogram When caring for a client considering breast augmentation, the nurse should provide her with a general guideline to have a mammogram to verify that there are no malignancies. Mastopexy involves a breast life for drooping breasts. Ultrasound or breast biopsy would not be necessary unless there was evidence of a problem.
This prenatal test is used for diagnosis of inherited blood disorders such as hemophilia A. Performed at 16 weeks.
Percutaneous umbilical blood sampling
The ____ suture is located between the parietal bones and divides the skull into right and left halves
Sagittal
A pregnant client wants to know why the labor of a first-time-pregnant woman usually lasts longer than that of a woman who has already delivered once and is pregnant a second time. What explanation should the nurse offer the client?
The cervix takes around 12-16 hours to dilate during first pregnancy
During what week of pregnancy can the fetal heartbeat be heard?
Week 7
zygote
a diploid cell resulting from the fusion of two haploid gametes; a fertilized ovum. pg.337
A pregnant woman with sickle cell anemia comes to the emergency department in crisis. Which of the following would the nurse expect to find? Select all that apply. a) Fever b) Pallor c) Increased skin turgor d) Joint pain e) Fatigue
a) Fever d) Joint pain Rationale: Signs and symptoms of a sickle cell crisis commonly include severe abdominal pain, muscle spasm, leg pains, joint pain, fever, stiff neck, nausea and vomiting, and seizures. Skin turgor would most likely be poor because the client would probably be dehydrated. Pallor and fatigue are associated with sickle cell anemia and would not help identify a crisis.
The nurse is caring for a client experiencing a prolonged second stage of labor. The nurse would place priority on preparing the client for which intervention? a. A forceps and vacuum assisted birth b. A precipitous birth c. Artificial rupture of membranes d. A cesarean section
a. A forceps-and vacuum-assisted birth
The nursing student correctly identifies which of the following to be a major causative factor in the development of cervical cancer? a) human papillomavirus (HPV) b) National Institutes of Health (NIH) c) American Cancer Society (ACS) d) human immunodeficiency virus (HIV)
a: The development of cervical cancer has been linked to the human papillomavirus (HPV). HIV is the human immunodeficiency virus. ACS stands for the American Cancer Society and NIH stands for the National Institute of Health
Contractions every 3 minutes with cervical dilation of 5 cm and contractions every 21/2 minutes with cervical dilation of 7 cm suggest the __________ phase of labor.
active
The nurse understands when caring for a patient with ovarian cancer that survival depends upon numerous factors, which include which of the following? (Check all that apply.) a) age of patient b) effectiveness of adjunct treatment post-operatively c) grade of differentiation d) amount of residual tumor after surgery e) gross findings at surgery f) stage of tumor
b, c, d, e, f: Early detection of ovarian cancer requires bimanual annual pelvic exams and transvaginal ultrasounds to catch early stages. Pap smears and x-rays are not sufficient to detect early stages of ovarian cancer. It is not recommended to use serum CA-125 as testing because it is nonspecific
A client has presented to the clinic reporting "things not feeling right down there." After discussing the situation with her, the nurse has identified which factors that suggest the woman has a high risk for pelvic organ prolapse? Select all that apply. birth trauma straining with chronic constipation obesity older age for first birth infant birth weight less than 4,500 grams
birth trauma straining with chronic constipation obesity Factors associated with pelvic organ prolapse include birth trauma, young age at first birth, increased abdominal pressure secondary to straining with chronic constipation, obesity, and infant birth weight above 4,500 grams.
in von willebrand disease, there is a ____ in the von Willebrand factor, which is necessary for platelet adhesion and agregation
decrease
high-grade ________ can progress to invasive cervical cancer; the progression takes up to 2 years
dysplasia
A young woman comes to the walk-in clinic seeking treatment for chronic chlamydia trachomatis. Which finding is most likely because it often correlates with this diagnosis?
gonorrhea
The state of being pregnant
gravid
When caring for a client requiring a forceps-assisted birth, the nurse would be alert for:
potential lacerations and bleeding pg. 829
homozygous
refers to a particular gene that has identical alleles on both homologous chromosomes. pg. 348
VBAC
vaginal birth after cesarean section
A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis?
vaginal odor smelling of fish
A public health nurse is teaching a class on sexually transmitted infections (STIs). Which statements would the nurse include in the discussion? Select all that apply.
"65 million people live with incurable STIs." "After a single exposure, women are twice as likely as men to acquire a STI." "STIs contribute to cervical cancer."
A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the client from infecting others in the future. Which statement by the client demonstrates understanding of his health problem?
"Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."
The nurse is monitoring a postpartum client who says she's concerned because she feels mildly depressed. The nurse recognizes that she is most likely experiencing "postpartum blues," and reassures the client that this symptom is experienced by approximately what percentage of women?
85%
A pregnant woman in her second trimester tells the nurse, "I've been passing a lot of gas and feel bloated." Which of the following suggestions would be helpful for the woman? A) "Watch how much beans and onions you eat." B) "Limit the amount of fluid you drink with meals" C) "Try exercising a little more." D) "Some say that eating mints can help." E) "Cut down on your intake of cheeses."
A) "Watch how much beans and onions you eat." C) "Try exercising a little more." D) "Some say that eating mints can help."
A nursing instructor is preparing a class discussion on case management in maternal and newborn health care. Which of the following would the instructor include as a key component? Select all that apply. A) Advocacy B) Coordination C) Communication D) Resource management E) Event managed care
A) Advocacy B) Coordination C) Communication D) Resource management
14.When preparing a woman with suspected vulvar cancer for a biopsy, the nurse expects that the lesion would most likely be located at which area? A) Labia majora B) Labia minora C) Clitoris D) Prepuce
A) Labia majora
A nurse is preparing an inservice education program for a group of nurses about dystocia involving problems with the passenger. Which of the following would the nurse most likely include as the most common problem? A) Macrosomia B) Breech presentation C) Persistent occiput posterior position D) Multifetal pregnancy
A,B,C
A nurse is conducting a class for a group of pregnant women about the risk of substance use during pregnancy. When discussing the effects of nicotine on a pregnancy, which complications would the nurse include? Select all that apply. A. premature rupture of membranes B. ectopic pregnancy C. macrosomia D. placenta previa E. spontaneous abortion
A,D,E R: Smoking increases the risk of spontaneous abortion, tubal ectopic pregnancy, preterm labor and birth, fetal growth restriction, stillbirth, premature rupture of membranes, low fetal iron stores, maternal hypertension, placenta previa, and abruptio placentae.
A woman has just entered the second stage of labor. The nurse would focus care on which of the following? A) Encouraging the woman to push when she has a strong desire to do so B) Alleviating perineal discomfort with the application of ice packs C) Palpating the woman's fundus for position and firmness D) Completing the identification process of the newborn with the mother
A. During the second stage of labor, nursing interventions focus on motivating the woman, encouraging her to put all her efforts toward pushing.
A postpartum woman reports hearing voices and says, "The voices are telling me to do bad things to my baby." The clinic nurse interprets these findings as suggesting postpartum A. psychosis. B.anxiety disorder. C. depression. D. blues.
A. psychosis.
8. A client is suspected of having endometrial cancer. The nurse would most likely prepare the client for which procedure to confirm the diagnosis? A)Transvaginal ultrasound B) Colposcopy C) Pap smear D)Endometrial biopsy
D)Endometrial biopsy
After teaching a class on sexual violence, the instructor determines that the teaching was successful when the class identifies which of the following as a type of sexual violence. (Select all that apply.) A) Female genital cutting B) Bondage C) Infanticide D) Human trafficking E) Rape
Ans: A, B, C, D, E Feedback: Female genital cutting, bondage, infanticide, human trafficking, and rape are all examples of sexual violence.
7. The mother of a formula-fed newborn asks how she will know if her newborn is receiving enough formula during feedings. Which response by the nurse is correct?
Ans: "A sign of good nutrition is when your newborn seems satisfied and is gaining sufficient weight."
9. A client is getting divorced and wants to be sure that her soon to be ex-husband cant have access to her medical information. Which would be the best instruction for the nurse to give the client?
Ans: "You have the right to say who can see your health records and who cant."
A nurse suspects that a pregnant client may be experiencing abruption placenta based on assessment of which of the following? (Select all that apply.) A) Dark red vaginal bleeding B) Insidious onset C) Absence of pain D) Rigid uterus E) Absent fetal heart tones
Ans: A, D, E Feedback: Assessment findings associated with abruption placenta include a sudden onset, with concealed or visible bleeding, dark red bleeding, constant pain or uterine tenderness on palpation, firm to rigid uterine tone, and fetal distress or absent fetal heart tones.
10. A client in the third trimester of pregnancy has to travel a long distance by car. The client is anxious about the effect the travel may have on her pregnancy. Which of the following instructions should the nurse provide to promote easy and safe travel for the client?
Ans: Always wear a three point seat belt
Which of the following changes in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy? A) Ligament tightening B) Decreased swayback C) Increased lordosis D) Joint contraction
Ans: C With pregnancy, the woman's center of gravity shifts forward, requiring a realignment of the spinal curvatures. There is an increase in the normal lumbosacral curve (lordosis). Ligaments of the sacroiliac joints and pubis symphysis soften and stretch. Increased swayback and an upper spine extension to compensate for the enlarging abdomen occur. Joint relaxation and increased mobility occur due to the influence of the hormones relaxin and progesterone.
During a vaginal exam, the nurse notes that the cervix has a bluish color. The nurse documents this finding as: A) Hegar's sign B) Goodell's sign C) Chadwick's sign D) Ortolani's sign
Ans: C Bluish coloration of the cervix is termed Chadwick's sign. Hegar's sign refers to the softening of the lower uterine segment or isthmus. Goodell's sign refers to the softening of the cervix. Ortolani's sign is a maneuver done to identify developmental dysplasia of the hip in infants.
5. A nurse is required to assess a client complaining of unusual vaginal discharge for bacterial vaginosis. Which of the following is a classic manifestation of this condition that the nurse should assess for?
Ans: Characteristic "stale fish" odor
8. A nurse, while examining a newborn, observes salmon patches on the nape and on the eyelids. Which of the following is the most likely cause of the salmon patches?
Ans: Concentration of immature blood vessels
1. A nurse is caring for client in the postpartum period. Which of the following processes should the nurse identify as retrogressive process involved in involution? Select all that apply
Ans: Contraction of muscle fibers Ans: Catabolism, which reduces individual myometrial cells Ans: Regeneration of uterine epithelium.
Which assessment finding would lead the nurse to suspect infection as the cause of a client's PROM? A) Yellow-green fluid B) Blue color on Nitrazine testing C) Ferning D) Foul odor
Ans: D A foul odor of the amniotic fluid indicates infection. Yellow-green fluid would suggest meconium. A blue color on Nitrazine testing and ferning indicate the presence of amniotic fluid.
7. A nurse is caring for a client in labor who is delivering. Which of the following fetal responses should the nurse monitor for in the client's baby?
Ans: Decrease in circulation and perfusion to the fetus
12. A nurse is explaining the menstrual cycle to a 12 yo client who has experience menarche. Which of the following should the nurse tell the client?
Ans: Duration of the flow is about 3 to 7 days.
9. A client in her second trimester arrives at a health care facility for a follow-up visit. During the exam, the client complains of constipation. Which of the following instructions should the nurse offer to help alleviate constipation?
Ans: Ensure adequate hydration and bulk in the diet
11. A pregnant client in labor has to undergo a sonogram to confirm the fetal position of a shoulder presentation. The nurse should assess for which of the following conditions associated with shoulder presentation during a vaginal birth?
Ans: Fetal anomalies
10. A client would like some information about the use of cervical caps. which of the following should the nurse include in the teaching plan of this client? Select all that apply.
Ans: Inspect the cervical cap before insertion Ans: Wait for 30 minutes after insertion before engaging in intercourse Ans: Dont use the cervical cap during menses.
5. A pregnant client is admitted to a maternity clinic for childbirth. The client wishes to adopt the kneeling position during labor. The nurse knows that which of the following is the advantage of adopting a kneeling position during labor?
Ans: It helps to rotate the fetus in a posterior position
8. A client has had a forceps delivery which resulted in laceration and bleeding. How can a nurse identify if the bleeding is due to laceration?
Ans: Look for a contracted uterus with vaginal bleeding
5. A pregnant client in her 12th week of gestation has come to a health care center for a physical examination of her abdomen, Where should the nurse palpate for the fundus in this client?
Ans: Midway between the symphysis and umbilicus
2. A pregnant client complains of increase in thick, whitish vaginal discharge. Which of the following information should a nurse provide this client?
Ans: Such discharge is normal during pregnancy
13. A client in her 39the week of gestation complains of swelling in the legs after standing for long periods of time. The nurse recognizes that these factors increase the clients risk for which of the following conditions?
Ans: Venous thrombosis
1. A nurse is caring for a female client who has a history of recurring vulvovaginal candidiasis. Which of the following instructions should the nurse include in the teaching session with the client?
Ans: Wear white, 100% cotton underpants
When counseling a patient on how to prepare for her first mammogram, what should the nurse include?
"Don't wear any powder, deodorant, or jewelery." Powder, deodorant, and jewelery can distort the images on film and should not be worn. The procedure should be scheduled just after the menses, when the breasts are the least tender. Pain relievers such as acetaminophen and ibuprofen may ease discomfort during the procedure and thereafter. Mammograms are 5- to 10-minute procedures.
After teaching a woman about breast self-examination, the nurse understands that the teaching was successful when the woman makes which statement?
"I'll do the check about a week after my period." Breast self-examination is best performed a week after menses, when swelling has subsided. Breast self-examination is typically performed every month. Both the breast area and the area between the breast and underarm, including the underarm itself, should be part of breast self-examination. The woman should use the pads of her three middle fingers for palpation.
The nursing instructor is teaching a student about urinary incontinence and realizes that the student needs further instruction when she makes which statement? "For many women with urge incontinence simple reassurance and lifestyle interventions might help." "Urinary incontinence is an inevitable problem of aging." "There are many effective treatments for urinary incontinence." "Urinary incontinence is not an inevitable problem of aging."
"Urinary incontinence is an inevitable problem of aging." There is a widespread belief that urinary incontinence is an inevitable problem of getting older and that little or nothing can be done to relieve symptoms or reverse it. This is not true. For many women with urge incontinence simple reassurance and lifestyle changes might help. If they do not, numerous effective treatments are available.
Latent phase of the first stage of labor
- involves cervical dilation of 0 to 3 cm - cervical effacement of 0% to 40%, - contractions every 5 to 10 minutes lasting 30 to 45 seconds.
9. A client is admitted to the labor and birthing suite in early labor. On review of her medical record, the nurse determines that the client's pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal delivery. Which pelvic shape would the nurse have noted? A) Platypelloid B) Gynecoid C) Android D) Anthropoid
B Girl pelvis
A client's maternal serum alpha-fetoprotein (MSAFP) level was unusually elevated at 17 weeks. The nurse suspects which of the following? A) Fetal hypoxia B) Open spinal defects C) Down syndrome D) Maternal hypertension
B) Open spinal defects
Women with polycystic ovarian syndrome (PCOS) are at increased risk for developing which of the following long-term health problems? a. Osteoporosis b. Lupus Type c. 2 diabetes d. Migraine headaches
C. Insulin resistance is characterized by failure of insulin to enter cells appropriately, resulting in hyperinsulinemia, a characteristic of PCOS. Factors that contribute to this include obesity, physical inactivity, and poor dietary habits. This person is at risk for developing type 2 diabetes secondary to insulin resistance.
When you are interviewing a client with uterine fibroids, what subjective data would you expect to find in her history? a. Cyclic migraine headaches b. Urinary tract infections c. Chronic pelvic pain d. Chronic constipation
C. Pressure against adjacent structures and stretching of the uterine muscle with increasing growth of the fibroid creates pain
A nursing diagnosis of Risk for impaired tissue integrity would be most appropriate for which client?
Client having reconstructive breast surgery
A woman comes to the clinic complaining that she has little sexual desire. As part of the client's evaluation, the nurse would anticipate the need to evaluate which hormone level? A) Progesterone B) Estrogen C) Gonadotropin-releasing hormone D) Testosterone
D) Testosterone
Which instruction should be given to a woman newly diagnosed with genital herpes?
Limit stress and emotional upset as much as possible.
A nurse caring for a pregnant client in labor observes that the fetal heart rate is below 110 per minute. Which interventions should the nurse perform?
O2 mask
A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer? A) Sedatives B) Tocolytics C) Oxytocins D) Corticosteroids
Oxytocins - For hypotonic labor, a uterine stimulant such as oxytocin may be ordered once fetopelvic disproportion is ruled out. - Sedatives might be helpful for the woman with hypertonic uterine contractions to promote rest and relaxation. - Tocolytics would be ordered to control preterm labor. - Corticosteroids may be given to enhance fetal lung maturity for women experiencing preterm labor.
A client reports lumpy, tender breasts, particularly during the week before menses. She reports pain that often dissipates after the onset of menses. The nurse suspects the client has fibrocystic breast changes. Which should the nurse do next?
Perform a breast examination To determine if the client is experiencing fibrocystic breast changes, the nurse must first examine the client's breasts. It is not important to know if the client has a mammography at this time. Cryoabation is done to remove a tumor.
Preterm labor Pain in calf Sudden gush or leakage of fluid from vagina Absence of fetal movement for more than 12 hours These are all danger signs that a client should contact her health care provider during which trimester?
Second trimester
The first phase of the abuse cycle is characterized by: a. The woman provoking the abuser to bring about battering b. Tension building and verbal or minor battery c. A honeymoon period that lulls the victim into forgetting d. An acute episode of physical battering
Tension building and verbal or minor battery
What is the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery?
To check for postpartum hemorrhage
Working with pregnant teenagers as a special population requires the nurse to have knowledge of adolescent development. Which of the following is crucial for a positive pregnancy and outcome for the mother and fetus? a) Support network b) Cultural sensitivity c) Acceptance by peers d) Involvement of the father
a) Support network Rationale: One crucial part of management of teenage adolescent pregnancy includes helping the teens to develop an adequate support network. The network may include parents, teachers, friends and the father of the baby in addition to resources needed to provide care for the infant and self. Cultural sensitivity, involvement of the father, and acceptance by peers are important to the teenager who is pregnant, but they are not considered crucial for a positive pregnancy and outcome for the mother and fetus.
An elderly patient who has been seen in the clinic for several months complaining of vulvar itching has been prescribed different creams and ointments but none of them have worked. What should the nurse practitioner suspect based solely on this symptom? a) vulvar cancer b) endometrial cancer c) uterine cancer d) cervical cancer
a: Diagnosis of vulvar cancer is often delayed significantly because there is no single specific clinical symptom that heralds it. The most common presentation is persistent vulvar itching that does not improve with the application of creams or ointments
The nursing instructor is teaching a class on gynecologic (GYN) malignancies and realizes a need for further instruction when a student makes which of the following statements? a) Cervical cancer is the most common GYN malignancy. b) Endometrial cancer is the most common GYN malignancy. c) Endometrial cancer is also known as uterine cancer. d) Endometrial cancer usually has a better prognosis than cervial cancer.
a: Endometrial cancer, also known as uterine cancer, is the most common GYN malignancy. Because it is diagnosed in the early stages, endometrial cancer normally has a better prognosis than cervical or ovarian cancer
A client has come to the office for her first postpartum visit. On evaluating her blood work, the nurse would be concerned if the hematocrit is noted to have:
acutely decreased
teratogen
an agent or factor that causes malformation of an embryo.
A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?
an azole antifungal agent
amniotomy
artificial rupture of membranes
The nurse is teaching a pregnant woman with iron deficiency anemia about foods high in iron. Which food(s) if selected by the woman indicates a successful teaching program? Select all that apply. a) Potatoes b) Peanut butter c) Corn d) Raisins e) Yogurt f) Broccoli
b) Peanut butter d) Raisins f) Broccoli Rationale: Foods high in iron include dried fruits such as raisins, whole grains, green leafy vegetables such as broccoli and spinach, peanut butter, and iron-fortified cereals. Potatoes and corn are high in carbohydrates. Yogurt is a good source of calcium.
As part of a review class for perinatal nurses, the nurse is explaining the laboratory and diagnostic tests that can be conducted to evaluate a woman's risk for preterm labor. The nurse determines that additional teaching is needed when the group identifies which test as being used?
blood chemistry levels pg. 812
A postpartum mother has the following lab data recorded: a negative rubella titer. What is the appropriate nursing intervention? a) Assess the rubella of the baby b) No action needed. c) Administer rubella vaccine before discharge. d) Notify the health care provider.
c) Administer rubella vaccine before discharge. Rationale: Rubella is a virus, which when contracted during pregnancy has significant complications for the fetus. The illness is mild to the adult but can result in the infant being born deaf and blind. There is no cure, the CDC recommends all individuals be vaccinated against rubella. If the titer is negative, the mother does not have protection against rubella and the next pregnancy would be at risk. She should receive the vaccination prior to discharge from the hospital. This makes option A incorrect. Assessing the rubella titer of the baby would not mean anything. The baby has not had rubella and has not received antibodies against rubella from the mother. Notifying the health care provider is not a priority, as most institutions have standing orders to administer the rubella vaccine if the mother's rubella titer is negative.
In a postmenopausal woman with abnormal vaginal bleeding, which diagnostic test would the nurse expect the physician to order to determine whether an endometrial biopsy is needed? a) CA-125 b) Pap smear c) Transvaginal ultrasound d) Mammogram
c: In this situation, a transvaginal ultrasound is used to measure the endometrial thickness to determine if an endometrial biopsy is needed. CA-125 is a nonspecific blood test used as a tumor marker. A Pap smear aids in detecting abnormal cells of the cervix. A mammogram detects calcifications, densities, and nonpalpable cancer lesions of the breast
The nurse should know that what follows and eclamptic seizure?
coma *Respirations do not become rapid during the seizure; they cease and resume after the coma
A young patient with a cardiac problem wants to get pregnant and tells the nurse that she is sad that she will never be able to have a baby. What is the best response by the nurse? a) "Cardiovascular problems are not a concern during pregnancy." b) "Women with your problem should never get pregnant, because the risks and dangers are too high for you and the fetus." c) "If you get pregnant, you are likely to face many complications." d) "Because of improved management, more women with cardiac problems can complete pregnancies successfully."
d) "Because of improved management, more women with cardiac problems can complete pregnancies successfully." Rationale: Because of improved management of cardiac disease, women who might never have risked pregnancy in the past can complete pregnancies successfully today.
A nurse is talking to a newly pregnant woman who had a mitral valve replacement in the past. Which of the following statements by the patient reveals an understanding about the pre-existing condition? a) "I know I will be fine, but I worry about the fetus." b) "I know my baby will be fine, but I am worried about having a personal complication." c) "I don't have to worry about this, because I had the problem fixed before I became pregnant." d) "I understand that my fetus and I both are at risk for complications."
d) "I understand that my fetus and I both are at risk for complications." Rationale: When a woman enters pregnancy with a pre-existing condition, both she and her fetus can be at risk of developing complications.
A client in week 38 of her pregnancy arrives at the emergency room reporting a sharp pain between her umbilicus and the iliac crest in her lower right abdomen that is increasing. She reports having experienced intense nausea and vomiting for the past 3 hours. Given these symptoms, the nurse suspects which of the following conditions? a) Ectopic pregnancy in conjunction with morning sickness b) Pulmonary embolism c) Left-sided heart failure d) Appendicitis
d) Appendicitis Rationale: With appendicitis, the nausea and vomiting is much more intense than with morning sickness and the pain is sharp and localized at McBurney's point (a point halfway between the umbilicus and the iliac crest on the lower right abdomen). With a ruptured ectopic pregnancy, a woman may experience abdominal pain that is either diffuse or sharp, but it is less likely to occur precisely at McBurney's point. The symptoms described do not match those of pulmonary embolism or left-sided heart failure.
A woman with cardiac disease is 32 weeks gestation and alerts the nurse she has been having spells of light-headedness and dizziness every few days. The nurse provides which of the following interventions as an option to the patient? a) Bed rest and bathroom privileges only until delivery. b) Increase fluids and take more vitamins. c) The patient needs to discuss induction of labor with the physician. d) Decrease activity and rest more often.
d) Decrease activity and rest more often. Rationale: If the patient is developing symptoms associated with her heart condition, the first intervention is to monitor activity levels, decrease activity and treat the symptoms. At 32 weeks gestation, the suggestion to induce labor is not appropriate and without knowledge of the type of heart condition one would not recommend increase of fluids or vitamins. Total bed rest may be required if the symptoms do not resolve with decreased activity. Therefore options B, C, and D are incorrect,
A woman is pregnant and has asthma. Her physician has told her to continue taking prednisone during pregnancy, but she is concerned the drug may be teratogenic. What advice would be best to give her regarding this? a) Prednisone is a teratogenic drug, but she may need it to control her asthma symptoms. b) You would recommend she omit the drug during pregnancy. c) She should half her dose during the first 3 months of pregnancy. d) Prednisone is considered safe in the doses prescribed by her physician.
d) Prednisone is considered safe in the doses prescribed by her physician. Rationale: Women should take no medication during pregnancy except that prescribed by their primary-care provider. Prednisone may be prescribed safely because, although it may be teratogenic in animal models, it does not appear to be teratogenic in humans.
The school nurse is teaching middle-school students about cervical cancer and the HPV virus. She is planning on administering the vaccine to protect them from this precursor of cervical cancer. Which vaccine will she administer to the young girls for this purpose? a) MMR b) DTP c) varicella d) gardasil
d: Gardasil is the first vaccine developed to protect girls and women from HPV. Varicella is to protect against chicken pox. The MMR is the vaccine for measles, mumps and rubella. DTP is the vaccine for diptheria, tetanus, and pertussis
3 shunts during fetal life:
ductus venosus: connects umbilical vein to inferior vena cava ductus arteriosus: connects main pulmonary artery to aorta foramen ovale: opening between right and left atria
The estrogen-to-progesterone theory suggest that during the last trimester of pregnancy what happens?
estrogen levels increase and progesterone levels decrease
The head emerges through extension under the symphasis pubis, along with the shoulders
extension
The formation of gametes by the process of meiosis is known as ________________________.
gametogenesis
________________ are proteins that connect cell membranes and facilitate coordination of uterine contactions and myometrial stretching
gap junctions
genotype
genes inherited from parents. Genetic makeup of an individual, usually in the form of DNA, is the internally coded inheritable information. pg.348
A nurse is caring for clients who have a history of genital herpes infection. The client most at risk for an outbreak of genital herpes is the client who reports:
genital pruritus and paresthesia.
Constipation, increased venous pressure, and pressure from the gravid uterus can lead to the formation of _________________ during pregnancy.
hemmorhoids
The community health nurse is teaching sexually transmitted infections to a high school health class. The nurse determines that the teaching was successful when the group identifies what potential cause for cognitive challenges in the newborn?
herpes type II (genital herpes)
What is the most common viral infection?
human papillomavirus (HPV)
A uterine fundus that can be easily indented with fingertip pressure at the peak of each contraction is due to
hypotonic uterine dysfunction
The client who has a uterine prolapse has been given a pessary. When teaching the client about the use of this device, the nurse should teach the client to monitor which common side effects? Select all that apply. increased vaginal discharge decrease in urinary output UTI vaginitis odor
increased vaginal discharge UTI vaginitis odor When educating the client about the use of a pessary the nurse should also include side effects. Because this is a foreign body in the vagina, the most common side effects are increased vaginal discharge, UTIs, vaginitis and odor. Decreased output is not associated with using a pessary.
What drug assist in the closing of the ductus arteriosus?
indomethacin *Not recommended for gestations of 32 weeks or greater
Amniotic fluid should be clear when the membranes rupture, either spontaneously or artificially through an amniotomy. - Cloudy or foul-smelling amniotic fluid indicates __________ .
infection
amnion:
inner membrane containing amniotic fluid. located in the ectoderm. umbilical cord is formed from here.
The ___________________ diameter is the transverse diameter of the pelvic outlet.
ischial tuberosity (10.5> cm)
The imaginary line that separates the false pelvis from the true pelvis
linea terminalis *The false pelvis lies above this line. The TRUE pelvis lies below.
The nurse assesses a postpartum woman's perineum and notices that her lochial discharge is moderate in amount and red. The nurse would record this as what type of lochia?
lochia rubra
A nurse is conducting a health promotion program, encouraging lifestyle changes to help clients prevent various benign and treatable conditions. Which suggestions would the nurse most likely include? Select all that apply. low-fat diet regular exercise high-impact aerobics high vegetable-fruit diet adequate fluid intake
low-fat diet regular exercise high vegetable-fruit diet adequate fluid intake Many of the conditions can be improved and/or prevented by following a low-fat, high vegetable-fruit diet, and getting regular exercise. High-impact aerobics should be avoided because of the excessive downward pressure placed on organs. Educating your clients will help improve their lives and possibly prevent many disorders.
Which medications are appropriate to treat vaginal candidiasis? Select all that apply.
miconazole fluconazole
This type of breathing is used for increased work stress during labor to increase alerness or focus attention or when slow paced breathing is no longer affective
modified-paced breathing
The changed (elongated) shape of the fetal skill birth as a result of overlaping of the cranial bones, is known as ____________________
molding
The elongated shape of the fetal skull at birth as a result of overlapping of the cranial bones is known as ______
molding
Thhis hormone maintains the endometrium, decreases the contractility of the uterus, stimulates maternal metabolism and breast deelpment, provides nourishment for the early conceptus
progesterone (progestin)
This hormone acts synergistically with progesterone to maintain pregnancy, causes relaxation of the pelvic ligaments, softens the cervix in preparation for birth
relaxin
A woman is scheduled to undergo a modified radical mastectomy. Which information would the nurse include when describing this surgery to the client?
removal of breast tissue, axillary nodes, and some chest muscles A modified radical mastectomy involves removal of breast tissue, the axillary nodes, and some chest muscles but not the pectoralis major muscle. The surgery will not produce a concave anterior chest. With a simple mastectomy, all breast tissue, the nipple, and the areola are removed, but the axillary nodes and pectoral muscles are spared. A lumpectomy, or breast-conserving surgery, involves the wide local excision of the tumor along with a 1-cm margin of normal tissue.
The ______________ suture is located between the parietal bones and divides the skull into the right and left halves.
saggital
After birth of the baby, the nurse notices that the uterus rises upward and changes into a globular shape, the umbilical cord lengthens and there is a sudden trickle of blood, what is this indicative of?
separation of the placenta
polyhydramnios:
too much amniotic fluid ( >2000 ml @ term) - associated w/: maternal diabetes, neural tube defects, chromosomal deviations, malformations of CNS &/or GI tract that prevent normal swallowing of amniotic fluid by fetus. - risk for premature rupture of membranes d/t overdistention.
polyhydramnios:
too much amniotic fluid ( >2000 ml @ term) - associated w/: maternal diabetes, neural tube defects, chromosomal deviations, malformations of CNS &/or GI tract that prevent normal swallowing of amniotic fluid by fetus. - risk for premature rupture of membranes d/t overdistention.
The __________ phase is characterized by strong contractions occurring every 1 to 2 minutes and cervical dilation from 8 to 10 cm.
transition
A nurse is caring for a woman who has just been diagnosed with uterine prolapse. Which symptoms may interfere with her daily activities? Select all that apply. urinary frequency low back pain pelvic pressure sinus pressure diarrhea
urinary frequency low back pain pelvic pressure Symptoms of pelvic organ prolapse that can interfere with daily living and activities include urinary, constipation, sexual, and low back pain; pelvic pressure; vaginal heaviness; and abdominal pressure. Sinus pressure and diarrhea are not a symptoms.
The nurse is preparing discharge training for a G2P2 client who will breast-feed her infant. The client mentions she wants more children but wants to wait a couple years and asks about birth control. Which time frame for using a birth control method should the nurse point out will best help the client achieve her goals?
when she resumes sexual activity
As part of a presentation on breast cancer being given to a local woman's group, the nurse describes the need for early detection through screening. Applying the guidelines from the American Cancer Society, the nurse would emphasize which recommendation?
yearly mammograms for women over age 40 The American Cancer Society recommends yearly mammograms for women over age 40. Clinical breast examinations are recommended every year starting at age 40. According to the American Cancer Society Breast Cancer Screening Guidelines, breast self-examination is optional
The nurse is giving a presentation about chlamydia to a group of adult women. The nurse would emphasize the need for annual screening for this infection in all sexually active women younger than which age?
25
A woman's maternal response incudes the white cell count increasing to __________________________cells, perhaps due to tissue trauma.
25,000 to 30,000
A client with polycystic ovary syndrome (PCOS) is receiving oral contraceptives as part of her treatment plan. The nurse understands that the rationale for this therapy is to: A) Restore menstrual regularity B) Induce ovulation C) Improve insulin uptake D) Alleviate hirsutism
A
After teaching a group of students about ovarian cysts, the instructor determines that the teaching was successful when the students identify which type of cyst as being associated with hydatiform mole? A) Theca-lutein cyst B) Corpus luteum cyst C) Follicular cyst D) Polycystic ovary syndrome
A
A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal? A) 9 B) 7 C) 5 D) 3
A) 9
When describing the ovarian cycle to a group of students, which phase would the instructor include? A) Luteal phase B) Proliferative phase C) Menstrual phase D) Secretory phase
A) Luteal phase
The nurse is developing a presentation for a local women's health center about breast cancer. Which of the following would the nurse include as being the most common type of breast cancer?
Invasive ductal carcinoma The most common malignancy is invasive ductal carcinoma (85%), followed by infiltrating ductal carcinoma (75%), tubular carcinoma, colloid carcinoma, medullary, and inflammatory breast cancer, the rarest but most aggressive form of breast cancer.
After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? A) Supine B) Side-lying C) Sitting D) Knee-chest
Knee-chest Pressure on the cord needs to be relieved. Therefore, the nurse would position the woman in a modified Sims, Trendelenburg, or knee-chest position. Supine, side-lying, or sitting would not provide relief of cord compression.
A nurse is caring for a client undergoing treatment for bacterial vaginosis. Which instruction should the nurse give the client to prevent recurrence of bacterial vaginosis?
Practice monogamy.
A nurse needs to provide preoperative care to a woman who is undergoing a scheduled hysterectomy. Her diagnosis is uterine fibroids. Which preoperative instruction should the nurse provide? The client should reduce her activity. The client should turn, cough, and deep-breathe. The client should avoid a high-calorie diet. The client should rest the pelvic area.
The client should turn, cough, and deep-breathe. The client should learn to turn, cough, and deep-breathe to prevent postoperative respiratory issues such as atelectasis and pneumonia. Discharge planning after surgery is completed will include instructions on resting the pelvis and decreasing activity. Regular surgery does not require a reduction in calories.
In securing a health history of a 65-year-old woman, which clinical manifestation described by the client would the nurse suspect is related to pelvic organ prolapse? a. Chronic abdominal pain b. Heavy feeling or dragging in vagina c. Uterine cramping and backache d. Weight gain and edema of ankles
The correct response is "B" because when pelvic organs prolapse into the vaginal area, most women will experience a feeling of dragging, a lump in the vagina, or something coming down. Their symptoms are related to the site and type of prolapse. Responses "A," "C," and "D" are incorrect since none of them are directly related to pelvic organ prolapse.
A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which of the following? A) Uterine hyperstimulation B) Headache C) Blurred vision D) Hypotension
Uterine hyperstimulation A major adverse effect of the obstetric use of Cytotec is hyperstimulation of the uterus, which may progress to uterine tetany with marked impairment of uteroplacental blood flow, uterine rupture (requiring surgical repair, hysterectomy, and/or salpingo-oophorectomy), or amniotic fluid embolism. Headache, blurred vision, and hypotension are associated with magnesium sulfate.
Which of the following is FALSE regarding screening for intimate partner violence in women? a) Screening should be routinely done at every visit. b) Although women who are abused may exhibit certain behavior patterns, all women should be screened for intimate partner violence. c) Women tend to fit a profile of abuse, and victims tend to share similar physical characteristics. d) An elderly female may be a victim of intimate partner violence.
Women tend to fit a profile of abuse, and victims tend to share similar physical characteristics.
For which of the following problems would the nurse be alert in a pregnant woman with gestational diabetes? a) Placenta previa related to diabetes mellitus b) Hypotension related to glucose/insulin imbalance c) Hydramnios related to glucose/insulin imbalance d) Cerebral vascular accident related to diabetes mellitus
c) Hydramnios related to glucose/insulin imbalance Rationale: Hyperglycemia tends to lead to excessive amniotic fluid (hydramnios) because of osmotic pressure fluid shifts.
A nurse is caring for a female client with symptoms of first-degree pelvic organ prolapse. Which instruction related to dietary and lifestyle modifications should the nurse provide to the client to help prevent pelvic relaxation and chronic problems later in life? a. Avoid caffeine products. b. Avoid excess intake of fluids. c. Increase dietary fiber. d. Increase high-impact aerobics.
c. to prevent constipation
A nurse is presenting a program for a local women's group about STIs. When describing the information, the nurse would identify which infection as the most common cause of vaginal discharge?
candidiasis
When providing education to a teenage prenatal class, the nurse states that infants born to teenage mothers are more likely to have which of the following? a) Lower mortality rates b) Genetic problems c) Post-date delivery d) Low-birth weight
d) Low-birth weight Rationale: Infants born to adolescent mothers are more likely to have a low-birth weight and poor outcomes and higher mortality rates when compared to infants of older mothers. Infants born to teenage mothers are not more likely to have genetic problems; they are more likely to be born pre-term rather than post-date.
A 16-year-old girl is seen in an emergency room following a rape. The management of a rape victim should be directed primarily toward a) teaching the child how to prevent further attacks. b) decreasing guilt and increasing self-esteem. c) assessing for sources of infection resulting from the rape. d) relieving physical discomfort and pain.
decreasing guilt and increasing self-esteem.
The _____________________ is the most useful measurement for estimating pelvic size because a misfit with the fetal head occurs if it is under 12.5 cm
diagonal conjugate
The thinning out process of the cervix during labor is termed what?
effacement
When the presenting part is above the ischial spines, the distance is recoreded as __________________
minus stations
What is the drug of choice for ripening the cervix to induce labor?
misoprostol (cytotec)
Some women report a sudden increaed in energy before labor.They may focus this energy toward childbirth preparation, bleaing cooking etc. This is referred to as _________________________
nesting (Usually occurs 24 to 48 hours before the onset of labor) *Safety is key
Refers to the number of pregnancies, not the number of fetuses, carried to the point of viability, regardless of the outcomeq
parity
Pelvic infection is most commonly caused by:
sexual transmission.
phenotype
the physical expression, or characteristics, of a trait.
implantation:
the process of attachment (of the blastocyst?) to the endometrium of the uterus. occurs 7-8 days after fertilization
Uterine contractions have two main unctions:
to dilate the cervix and to push the fetus through the birth canal
oligohydramnios:
too little amniotic fluid (<500 ml @ term). - associates w/: uteroplacental insufficiencies, fetal renal abnormalities, and higher risk for surgical birth (c-section) &/or low-birth weight baby.
A nurse is caring for a 25-year-old woman suspected of having follicular cysts. Which finding is not a clinical manifestation? typically occur after menopause grow less than 5 cm in diameter are detected by vaginal ultrasound usually shrink and do not require treatment
typically occur after menopause Follicular cysts typically appear in women of reproductive age. They can occur at any age but are rare after menopause. All other statements are true.
During assessment using a nitrazine swab, the membranes are most likely intact if the nitrazine swab remains what color?
yellow to olive green (pH is 5 to 6) *vaginal fluid is acidic
If the following data was collected on a group of children, which of the following would most likely be evaluated as possibly related to child abuse? Select all that apply. a) A child who has a spiral fracture in the femur. b) A child who has chronic nausea and diarrhea. c) A child whose blood work shows evidence of anemia. d) A child whose X-ray shows bone fractures in various stages of healing. e) A child whose CT scan shows a cerebral hemorrhage.
• A child who has a spiral fracture in the femur. • A child whose X-ray shows bone fractures in various stages of healing. • A child whose CT scan shows a cerebral hemorrhage.
The nurse is monitoring a pregnant client admitted to a health care center who is in the latent phase of labor. The nurse demonstrates appropriate nursing care by monitoring the fetal heart rate with the Dopplar at least how often?
30 to 60 min
Question: Place the three phases of intimate partner violence in the order in which they occur. 1. Acute violence phase 2.Tension-building phase 3.Honeymoon phase
Tension-building phase, Acute violence phase, Honeymoon phase
When caring for a client during the active phase of labor without continuous electronic fetal monitoring, the nurse would intermittently assess FHR every: A. 15 to 30 minutes B. 5 to 10 minutes C. 45 to 60 minutes D. 60 to 75 minutes
The correct response is A. The current recommendation is that intermittent FHR is assessed every 15 minutes during the active phase of labor.
Structural disorders that cause prolapse of reproductive organs in women can be aided by the practice of Kegel exercises. When the nurse is explaining Kegel exercises to a client, which information is most important to include? These exercises should be done after a meal. These exercises will relieve mild prolapse symptoms. These exercises are not to be performed after surgery. These exercises will increase blood pressure.
These exercises will relieve mild prolapse symptoms. Kegel exercises can alleviate mild prolapse symptoms and may even aid in stopping the progression of prolapse. Symptoms that may be decreased include pelvic pressure and low back pain. These exercises may be done after surgery; they do not increase blood pressure and are not affected by food.
A 13-year-old immigrant from Asia is admitted to the health care facility with vaginal bleeding. A genital examination reveals unhealed circumcision wounds. The client can understand limited English but cannot speak the language fluently. The service of an interpreter is employed. What are the points the nurse should keep in mind when interacting with this client? a) Allow the interpreter to question the client directly to assist with data gathering b) Use pictures and diagrams to supplement the questions and answers of the client's understanding c) Condemn the cultural practice and explain why it is wrong to the client d) She is still a child so convey important information in precise medical terms to ease understanding
Use pictures and diagrams to supplement the questions and answers of the client's understanding
During what week of pregnancy does the brain spinal cord and heart begin development. The neural tube forms later becoming the spinal cord.
Week 3
_________________ a specialized connective tissue, surrounds the three blood vessels in the umbilical cord to prevent compression.
Wharton's jelly
A woman in week 40 of her pregnancy has developed a urinary tract infection (UTI). The nurse recognizes that which of the following treatments would be safe and appropriate to use with this client? (Select all that apply.) a) Cephalosporins b) Heparin c) Amoxicillin d) Sulfonamides e) Tetracyclines f) Ampicillin
a) Cephalosporins c) Amoxicillin f) Ampicillin Rationale: Amoxicillin, ampicillin, and cephalosporins are effective against most organisms causing UTIs and are safe antibiotics during pregnancy. The sulfonamides can be used early in pregnancy but not near term because they can interfere with protein binding of bilirubin, which then leads to hyperbilirubinemia in the newborn. Tetracyclines are contraindicated during pregnancy as they cause retardation of bone growth and staining of the fetal teeth. Heparin is an anticoagulant and is used to prevent clot formation; it would not be prescribed for a UTI.
A woman with a positive history of genital herpes is in active labor. She has small pin-point vesicles in the perineum area. Her membranes are ruptured, she is dilated 5cm, effaced 70%. The nurse should anticipate what type of delivery? a) Cesarean. b) Forceps assisted. c) Spontaneous vaginal. d) Vacuum assisted.
a) Cesarean. Rationale: An active herpes infection can be passed to the fetus during labor or with ruptured amniotic membranes. The nurse should anticipate the infant will be delivered via a cesarean birth. The risk of transmitting herpes to the baby would be increased if the baby were born by spontaneous vaginal delivery, vacuum assisted delivery, or forceps assisted delivery.
A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client? a) Diet b) Glucagon c) Long-acting insulin d) Oral hypoglycemic drugs
a) Diet Rationale: Clients with gestational diabetes are usually managed by diet alone to control their glucose intolerance. Long-acting insulin usually isn't needed for blood glucose control in the client with gestational diabetes. Oral hypoglycemic drugs are contraindicated in pregnancy. Glucagon raises blood glucose and is used to treat hypoglycemic reactions.
You are the clinic nurse caring for a pregnant woman in her third trimester. The woman is HIV positive and voices concerns about passing the infection on to her baby. What is your best response? a) If you are taking antiretroviral medications and you don't breastfeed your baby, you greatly reduce the risk of perinatal transmission of the disease. b) Perinatal transmission of the virus is a real fear. Would you like to talk to a social worker? c) There is nothing you can do. You will just have to wait and see if your baby is born HIV positive. d) Do you have other children? Your baby has a one-in-four chance of having HIV at birth, so if you have three other children who are not HIV positive, then this one will be HIV positive.
a) If you are taking antiretroviral medications and you don't breastfeed your baby, you greatly reduce the risk of perinatal transmission of the disease. Rationale: Receiving appropriate antiretroviral treatment during pregnancy and childbirth and refraining from breastfeeding substantially reduce the risk of perinatal transmission.
A pregnant woman at 4 weeks' gestation who has preexisting diabetes mellitus visits her primary care provider for a check-up. Which fetal complications might occur because of this maternal condition? Select all that apply. a) Macrosomia (oversized fetus) b) Respiratory disorder c) Congenital malformations d) Fetus with juvenile diabetes e) Smaller than gestational age baby
a) Macrosomia (oversized fetus) b) Respiratory disorder c) Congenital malformations Rationale: Potential problems during pregnancy involving maternal diabetes mellitus include fetal death, macrosomia (oversized fetus), a fetus with a respiratory disorder, difficult labor, preeclampsia or eclampsia, polyhydramnios, and congenital malformations.
Which of the following risk factors have been linked to ovarian cancers? Select all that apply. a) Gene mutations BRCA-1 and BRCA-2 b) Early menopause c) Very low body weight d) Nulliparity
a, d: An inherited gene mutation (BRAC-1, BRAC-2 ) is linked to ovarian cancer. Other risk factors include nulliparity, obesity, early menarche, late menopause, and a high fat diet, as well as a history of breast and colon cancers
A 36-year-old was diagnosed with uterine fibroids (leiomyomas). The nurse teaches the client to expect which clinical manifestation? decrease in fibroid size if pregnancy occurs diarrhea acute abdominal pain abnormal uterine bleeding
abnormal uterine bleeding Fibroids are dependent on estrogen and grow rapidly during the childbearing years unless menopause occurs. Abnormal uterine bleeding is a clinical manifestation. Diarrhea is not a factor; constipation and abdominal pain can occur if fibroids are getting larger.
The nursing student is studying gynecological cancers and is excited when she reads that birth control pills can have a positive effect on preventing which of the following diseases? a) vaginal cancer b) ovarian cancer c) endometrial cancer d) uterine cancer
b: Risk-reduction strategies for preventing ovarian cancer include pregnancy, use of oral contraceptives, and breastfeeding. No research states that oral contraceptives help to prevent the other cancers.
Your patient is pregnant and she has tested positive for cytomegalovirus. What can this cause in the newborn? a) Hypertension b) Clubbed fingers and toes c) Microcephaly d) Bicuspid valve stenosis
c) Microcephaly Rationale: Signs that are likely to be present in the 10 percent of newborns who are symptomatic at birth include microcephaly, seizures, IUGR, hepatosplenomegaly, jaundice, and rash.
The nursing instructor is preparing a group of nursing students for their clinical phase and is questioning them on the various assessment skills they will need. The instructor determines the session is successful when the students correctly choose which time interval to assess the fetal heart rate of clients who are in the active phase of labor? a. every 2 to 4 hours b. every 45 to 60 minutes c. every 15 to 30 minutes d. every 10 to 15 minutes
c. every 15 to 30 minutes
In which group is it most important for the client to understand the importance of an annual Papanicolaou test? a) Clients with a long history of oral contraceptive use b) Clients with a history of recurrent candidiasis c) Clients infected with the human papillomavirus (HPV) d) Clients with a pregnancy before age 20
c: HPV causes genital warts, which are associated with an increased incidence of cervical cancer. Recurrent candidiasis, pregnancy before age 20, and use of oral contraceptives don't increase the risk of cervical cancer
A client is being treated for gonorrhea. Which agent would the nurse expect the primary care provider to prescribe?
ceftriaxone
The three main fetal presentations are
cephalic (head first) breech (pelvis first) shoulder (scapula first)
a client is admitted to the health facility. The fetus has a gestational age of 42 weeks and is suspected to have cephalopelvic disproportion. Which should the nurse do next? A. place client in lithonomy position for birth B. administer oxytocin 4 mU/min C. artificial rupture of membranes D. prepare client to have a cesarean birth
cephalopelvic disproportion is associated with postterm pregnancy. Client wouldn't be able to deliver vaginally
The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common STI in the United States would the nurse expect to include?
chlamydia
chorion + chorionic villi:
chorion, made by the trophoblast, consist of the trophoblast cells and a mesodermal lining. it has finger-like projections called chorionic villi which form the fetal portion of the placenta.
A nurse is caring for a pregnant client in labor who is delivering. For which fetal response should the nurse monitor? a. Decrease in arterial carbon dioxide pressure b. Increase in fetal breathing movements c. Increase in fetal oxygen pressure d. Decrease in circulation and perfusion to the fetus
d. Decrease in circulation and perfusion to the fetus *Occurs secondary to uterine contractions
What is the Kleihauer-Betke test?
detects fetal RBCs in the maternal circulation, dtermines the degree of fetal-maternal hemorrhage, and helps calculate the appropriate dosage of RhoGAM to give for Rh-negative clients.
Sex determination is determined at _________________ and depends on whether the ovum is fertilized by a Y-bearing sperm or X-bearing sperm.
fertilization
Which medication is the most effective treatment for trichomoniasis?
metronidazole
A nurse is caring for a client who is nursing her baby boy. The client reports afterpains. Secretion of which substance would the nurse identify as the cause of afterpains?
oxytocin
The nurse is admitting a 42-year-old client to the women's medical floor. During the history, the chief report from the client is "I feel like there is a lump in my vagina, and it feels like it is sometimes dragging." Which disorder does the nurse suspect? urinary incontinence endocervical polyps pelvic organ prolapse uterine fibroids
pelvic organ prolapse In pelvic organ prolapse, the pelvic floor muscles are weak, and this results in a feeling of "dragging," or that some sort of "lump" is present in the vagina. Symptoms of pelvic organ prolapse do not include urinary incontinence. Endocervical polyps manifest with abnormal vaginal bleeding. With uterine fibroids, the uterus is large and has an odd shape.
The nurse is preparing to administer medication therapy to a woman diagnosed with syphilis. The nurse would expect to administer:
penicillin G.
Fetal attitude refers to
posturing (flexion or extension) *most favorable for vaginal birth
During continuous external monitoring the _______________ is placed over the uterine fundus in the area of greatest contractility to monitor uterine contractions.
tocotransducer
A nurse is caring for a client who is scheduled to undergo amnioinfusion. The nurse knows that the client will not be able to have this procedure if which condition is present? a. uterine hypertonicity b. active genital herpes c. BP 130/88 d. decrease urine output
uterine hypertonicity
A postpartum woman is experiencing subinvolution. When reviewing the client's history for factors that might contribute to this condition, which factors would the nurse identify? Select all that apply.
uterine infection; prolonged labor; and hydramnios
A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques on observed on the vaginal wall. The nurse suspects which condition?
vulvovaginal candidiasis
Which factors contribute to the development of breast cancer?
• Aging • Hormonal factors • High breast density • Family history
A nurse is interviewing a client who is a survivor of abuse. The client is telling the nurse about how the violence occurred. Which statement would the nurse interpret as reflecting phase 3 of the cycle of violence? a) "He calls me stupid and incompetent, asking himself why he ever married me." b) "He threw me against the wall and started punching my face." c) "He tells me that he is sorry and that he will never hit me again." d) "He yells at me for not having dinner waiting for him when he came home."
"He tells me that he is sorry and that he will never hit me again."
A nurse on the postpartum floor is conducting a class on danger signs for postpartum women after discharge. The nurse recognizes that further teaching is needed when a new mother makes which statement?
"I am breast-feeding so I can anticipate that there will be reddened, painful areas in my breasts when I am engorged."
The nurse is teaching a client with mastitis about care measures. Which client statement indicates effective teaching?
"I can use warm soaks to my breast to relieve the discomfort." Applying warm soaks to the breast or letting warm water from the shower flow over the breast can help to relieve some of the discomfort. Breast shields should be avoided because they trap breast milk and moisture around the nipple. The client needs to continue antibiotic therapy as prescribed for the entire treatment period, usually 10 days. The client can express milk with a breast pump until the infection resolves sufficiently to resume breast feeding.
While performing a clinical breast examination, the nurse notes a firm and rubbery nodule that is well circumscribed and moves freely. How should the nurse counsel the patient?
"It's most likely a fibroadenoma, but we may need to do a biopsy." This description most closely matches a fibroadenoma, but diagnostic imaging and even biopsy are warranted to confirm and rule out a cancerous tumor. The nurse should never tell the patient that she may have cancer because this will only cause anxiety.
A client is receiving treatment for injuries sustained during a fight with her partner. The nurse observes that the partner visits her daily in the hospital and appears very solicitous and contrite. When questioned, the client tries to convince the nurse that her partner always apologizes and brings gifts after a fight. Which information should the nurse provide this client? a) "Your partner seems to be genuinely contrite." b) "Although your partner seems sorry, often they will repeat this behavior in the future." c) "Sometimes people do things that cause them to be a victim of physical abuse." d) "You should try not to upset your partner in the future."
"Sometimes people do things that cause them to be a victim of physical abuse."
Contractions should occur every
2 to 3 minutes, lasting 40 to 60 seconds.
Screening for gestational diabetes is best done between ______________ weeks' gestation.
24 and 28
During what week of pregnancy does the fetus usually assume the head down position?
25-28
Place the following events in the sequence the pregnant woman would experience them, from first to last. All options must be used. 1 quickening 2 labor 3 ammenorrhea 4 Braxton Hicks contractions 5 uterine enlargement
3, 5, 1, 4, 2 ammenorrhea > uterine enlargement > quickening > Braxton Hicks contractions > labor
A client presents to the office reporting severe lower abdominal pain. Ultrasound reveals an ovarian cyst. The client asks, "Is the cyst benign?" The nurse responds, explaining that ovarian cysts are benign approximately how often? 90% of the time 70% of the time 50% of the time 30% of the time
90% of the time Ovarian cyst are very common growths that are benign 90% of the time. They are also asymptomatic in many women. When the cysts grow large and exert pressure on surrounding structures, women often seek medical treatment.
A pregnant client with diabetes in the hospital reports waking up with shakiness and diaphoresis. Which action should the nurse prioritize after discovering the client's fasting blood sugar is 60 mg/dL? A. Provide the client some milk to drink. B. Withhold her insulin, and notify the health care provider. C. Stay with her, and ask another nurse to bring her insulin. D. Recheck her blood sugar for accuracy.
A R: The client is hypoglycemic when awakening in the morning. The nurse should provide glucose in the form of carbohydrate, such as crackers, and milk, and be prepared to reassess. The nurse should not recheck at this point, since the client is symptomatic. She does not need insulin, and she will have her morning dose adjusted after breakfast.
A multipara client develops thrombophlebitis after delivery. Which of the following would alert the nurse to the need for immediate intervention? A) Dyspnea, diaphoresis, hypotension, and chest pain B) Dyspnea, bradycardia, hypertension, and confusion C) Weakness, anorexia, change in level of consciousness, and coma D) Pallor, tachycardia, seizures, and jaundice
A Sudden unexplained shortness of breath and complaints of chest pain along with diaphoresis and hypotension suggest pulmonary embolism, which requires immediate action. Other signs and symptoms include tachycardia, apprehension, hemoptysis, syncope, and sudden change in the woman's mental status secondary to hypoxemia.
When assessing the postpartum woman, the nurse uses indicators other than pulse rate and blood pressure for postpartum hemorrhage based on the knowledge that: A) These measurements may not change until after the blood loss is large B) The body's compensatory mechanisms activate and prevent any changes C) They relate more to change in condition than to the amount of blood lost D) Maternal anxiety adversely affects these vital signs
A The typical signs of hemorrhage do not appear in the postpartum woman until as much as 1,800 to 2,100 mL of blood has been lost. In addition, accurate determination of actual blood loss is difficult because of blood pooling inside the uterus and on perineal pads, mattresses, and the floor.
The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which of the following situations? a) A 6-year-old with a greenstick fracture of the wrist, which the caregiver reports was caused when the child fell while ice-skating b) A 7-year-old with a spiral fracture of the humerus, which the caregiver reports was caused when the child was hit with a bat swung by a Little League teammate c) A 10-year-old with a simple fracture of the femur, which the caregiver reports was caused when the child fell down a set of stairs d) A 9-year-old with a compound fracture of the tibia, which the caregiver reports was caused when the child attempted a flip on a skateboard
A 7-year-old with a spiral fracture of the humerus, which the caregiver reports was caused when the child was hit with a bat swung by a Little League teammate
A client with a 28-day cycle reports that she ovulated on May 10. The nurse would expect the client's next menses to begin on: A) May 24 B) May 26 C) May 30 D) June 1
A) May 24
A nurse is caring for a client with cardiovascular disease who has just given birth. What nursing interventions should the nurse perform when caring for this client? Select all that apply. A. Assess for shortness of breath. B. Assess for edema and note any pitting. C. Monitor the client's hemoglobin and hematocrit. D. Auscultate heart sounds for abnormalities. E. Assess for a moist cough.
A,B,D,E R: The nurse should assess for possible fluid overload in a client with cardiovascular disease who has just given birth. Signs of fluid overload in the client who has just labored include cough, progressive dyspnea, edema, palpitations, and crackles in the lung bases. Hemoglobin and hematocrit levels are not affected by laboring of the client with cardiovascular disease.
The nurse notifies the obstetrical team immediately because the nurse suspects that the pregnant woman may be exhibiting signs and symptoms of amniotic fluid embolism. Which findings would the nurse most likely assess? (Select all that apply.) A) Significant difficulty breathing B) Hypertension C) Tachycardia D) Pulmonary edema E) Bleeding with bruising
A,C,D,E The clinical appearance is varied, but most women report difficulty breathing. Other symptoms include hypotension, cyanosis, seizures, tachycardia, coagulation failure, disseminated intravascular coagulation, pulmonary edema, uterine atony with subsequent hemorrhage, adult respiratory distress syndrome, and cardiac arrest.
A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which of the following? A) Respiratory depression B) Urinary retention C) Abdominal distention D) Hyperreflexia
A.
Conservative treatment options available for women with pelvic organ prolapse are: a. Pessaries and PFM exercises b. External pelvic fixation devices c. Weight gain and yoga d. Firm panty-and-girdle garments
A. Both pessaries and Kegel exercises help hold up and strengthen the pelvic floor to restore the pelvic organs to their correct anatomic position.
2. Which of the following would indicate to the nurse that the placenta is separating? A) Uterus becomes globular B) Fetal head is at vaginal opening C) Umbilical cord shortens D) Mucous plug is expelled
A. Placental separation is indicated by the uterus changing shape to globular and upward rising of the uterus. Additional signs include a sudden trickle of blood from the vaginal opening, and lengthening (not shortening) of the umbilical cord. - Expulsion of the mucous plug is a premonitory sign of labor.
Which of the following would be most appropriate for the nurse to suggest about pushing to a woman in the second stage of labor? A) "Lying flat with your head elevated on two pillows makes pushing easier." B) "Choose whatever method you feel most comfortable with for pushing." C) " Let me help you decide when it is time to start pushing." D) "Bear down like you're having a bowel movement with every contraction."
Ans. B "Choose whatever method you feel most comfortable with for pushing." * The role of the nurse should be to support the woman in her choice of pushing method and to encourage confidence in her maternal instinct of when and how to push.
A group of students are reviewing information about STIs. The students demonstrate understanding of the information when they identify which of the following as the most common bacterial STI in the United States? A) Gonorrhea B) Chlamydia C) Syphilis D) Candidiasis
Ans: B Feedback: According to the CDC, chlamydia is the most common bacterial STI in the United States. Gonorrhea and syphilis are bacterial infections but not the most common ones. Candidiasis is a fungal infection.
A nurse is teaching a woman with genital ulcers how to care for them. Which statement by the client indicates a need for additional teaching? A) "I need to wash my hands after touching any of the ulcers." B) "I need to abstain from intercourse primarily when the lesions are present." C) "I should avoid applying ice or heat to my genital area." D) "I can try lukewarm sitz baths to help ease the discomfort."
Ans: B Feedback: For genital ulcers, the client needs to abstain from intercourse during the prodromal period and when lesions are present. The client should wash her hands after touching the lesions to avoid inoculation and avoid extremes of temperature such as ice packs or hot pads to the genital area. Comfort measures such as lukewarm sitz baths can be helpful.
A nurse is presenting a discussion on sexual violence at a local community college. When describing the incidence of sexual violence, the nurse would identify that a woman has which chance of experiencing a sexual assault in her lifetime? A) One in three B) One in six C) Two in 15 D) Three in 20
Ans: B Feedback: The National Center for Prevention and Control of Sexual Assault estimates that one out of six women will be sexually assaulted sometime in her life, and two thirds of these assaults will not be reported.
A woman gives birth to a healthy newborn. As part of the newborn's care, the nurse instills erythromycin ophthalmic ointment as a preventive measure related to which STI? A) Genital herpes B) Hepatitis B C) Syphilis D) Gonorrhea
Ans: D Feedback: To prevent gonococcal ophthalmia neonatorum, erythromycin or tetracycline ophthalmic ointment is instilled into the eyes of all newborns. This action is required by law in most states. The ointment is not used to prevent conditions related to genital herpes, hepatitis B, or syphilis.
14. A client who had a vaginal delivery 2 days ago asks the nurse when she will be able to breathe normally again. Which response by the nurse is accurate?
Ans: "Within 1 to 3 weeks, your diaphragm should return to normal and your breathing will feel like it did before your pregnancy."
Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which of the following? A) Linea nigra B) Striae gravidarum C) Melasma D) Vascular spiders
Ans: A Linea nigra refers to the darkened line of pigmentation down the middle of the abdomen in pregnant women. Striae gravidarum refers to stretch marks, irregular reddish streaks on the abdomen, breasts, and buttocks. Melasma refers to the increased pigmentation on the face, also known as the mask of pregnancy. Vascular spiders are small, spiderlike blood vessels that appear usually above the waist and on the neck, thorax, face, and arms.
A woman with gestational hypertension experiences a seizure. Which of the following would be the priority? A) Fluid replacement B) Oxygenation C) Control of hypertension D) Delivery of the fetus
Ans: B As with any seizure, the priority is to clear the airway and maintain adequate oxygenation both to the mother and the fetus. Fluids and control of hypertension are addressed once the airway and oxygenation are maintained. Delivery of fetus is determined once the seizures are controlled and the woman is stable.
A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which of the following? A) Excess folic acid, which could increase the risk for neural tube defects B) Mercury, which could harm the developing fetus if eaten in large amounts C) Lactose, which leads to abdominal discomfort, gas, and diarrhea D) Low-quality protein that does not meet the woman's requirements
Ans: B Nearly all fish and shellfish contain traces of mercury and some contain higher levels of mercury that may harm the developing fetus if ingested by pregnant women in large amounts. Among these fish are shark, swordfish, king mackerel, and tilefish. Folic acid is found in dark green vegetables, baked beans, black-eyed peas, citrus fruits, peanuts, and liver. Folic acid supplements are needed to prevent neural tube defects. Women who are lactose intolerant experience abdominal discomfort, gas, and diarrhea if they ingest foods containing lactose. Fish and shellfish are an important part of a healthy diet because they contain high-quality proteins, are low in saturated fat, and contain omega-3 fatty acids.
A woman is scheduled to undergo fetal nuchal translucency testing. Which of the following would the nurse include when describing this test? A) "A needle will be inserted directly into the fetus's umbilical vessel." B) "You'll have an intravaginal ultrasound to measure fluid in the fetus." C) "The doctor will take a sample of fluid from your bag of waters." D) "A small piece of tissue from the fetal part of the placenta is taken."
Ans: B Feedback: Fetal nuchal translucency testing involves an intravaginal ultrasound that measures fluid collection in the subcutaneous space between the skin and cervical spine of the fetus. Insertion of a needle into the fetus's umbilical vessel describes percutaneous umbilical blood sampling. Taking a sample of fluid from the amniotic sac (bag of waters) describes an amniocentesis. Obtaining a small tissue specimen from the fetal part of the placenta describes chorionic villus sampling.
When describing the structures involved in fetal circulation, the nursing instructor describes which structure as the opening between the right and left atrium? A) Ductus venosus B) Foramen ovale C) Ductus arteriosus D) Umbilical artery
Ans: B Feedback: The foramen ovale is the opening between the right and left atrium. The ductus venosus connects the umbilical vein to the inferior vena cava. The ductus arteriosus connects the main pulmonary artery to the aorta. The umbilical artery carries blood to the placenta.
Which of the following data on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy? A) Use of oral contraceptives for 5 years B) Ovarian cyst 2 years ago C) Recurrent pelvic infections D) Heavy, irregular menses
Ans: C In the general population, most cases of ectopic pregnancy are the result of tubal scarring secondary to pelvic inflammatory disease. Oral contraceptives, ovarian cysts, and heavy, irregular menses are not considered risk factors for ectopic pregnancy.
A woman with hyperemesis gravidarum asks the nurse about suggestions to minimize nausea and vomiting. Which suggestion would be most appropriate for the nurse to make? A) "Make sure that anything around your waist is quite snug." B) "Try to eat three large meals a day with less snacking." C) "Drink fluids in between meals rather than with meals." D) "Lie down for about an hour after you eat"
Ans: C Suggestions to minimize nausea and vomiting include avoiding tight waistbands to minimize pressure on the abdomen, eating small frequent meals throughout the day, separating fluids from solids by consuming fluids in between meals; and avoiding lying down or reclining for at least 2 hours after eating.
Prenatal testing is used to assess for genetic risks and to identify genetic disorders. In explaining to a couple about an elevated alpha-fetoprotein screening test result, the nurse would discuss the need for: A) Special care needed for a Down syndrome infant B) A more specific determination of the acid-base status C) Further, more definitive evaluations to conclude anything D) Immediate termination of the pregnancy based on results
Ans: C Feedback: Increased maternal serum alpha fetoprotein levels may indicate a neural tube defect, Turner syndrome, tetralogy of Fallot, multiple gestation, omphalocele, gastroschisis, or hydrocephaly. Therefore, additional information and more specific determinations need to be done before any conclusion can be made. Down syndrome is associated with decreased maternal serum alpha fetoprotein levels. This type of testing provides no information about the acid-base status of the fetus. Immediate termination is not warranted; more information is needed.
A nurse is teaching a pregnant woman with preterm premature rupture of membranes who is about to be discharged home about caring for herself. Which statement by the woman indicates a need for additional teaching? A) "I need to keep a close eye on how active my baby is each day." B) "I need to call my doctor if my temperature increases." C) "It's okay for my husband and me to have sexual intercourse." D) "I can shower but I shouldn't take a tub bath."
Ans: C Feedback: The woman with preterm premature rupture of membranes should monitor her baby's activity by performing fetal kick counts daily, check her temperature and report any increases to the health care provider, not insert anything into her vagina or vaginal area, such as tampons or vaginal intercourse, and avoid sitting in a tub bath.
1. A pregnant client with hyperemesis gravidarum needs advice on how to minimize nausea and vomiting. Which of the following instructions should a nurse give this client?
Ans: Eat, small, frequent meals throughout the day
11. A breast-feeding client informs the nurse that she is unable to maintain her milk supply. What instructions should the nurse give to the client to improve milk supply?
Ans: Empty the breasts frequently
14. The nurse is reviewing the family hx information in a newly admitted clients chart. The nurse notes that the client lives with is parents and grandparents. Which term best describes the clients family structure?
Ans: Extended family.
1. The Nurse is assessing a client for amenorrhea. Which of the following should the nurse document as evidence of androgen excess secondary to a tumor?
Ans: Facial hair and acne
12. A client in her second trimester of pregnancy is anxious about the blotchy, brown pigmentation appearing on her forehead and cheeks. She also complains of increased pigmentation on her breasts and genitalia. When educating the client, which of the following would the nurse identify as the condition experienced by the client?
Ans: Facial melisma (cholasma)
6. A nurse is questioning the family members of a pregnant client to obtain a genetic history. While asking questions, which of the following should the nurse keep in mind?
Ans: Find out if couples are related to each other or have blood ties.
1. A nurse is caring for an infant born with polycythemia. Which intervention is most appropriate when caring for this infant?
Ans: Focus on decreasing blood viscosity by increasing fluid volume
15. The nurse is caring for a client of Asian descent 1 day after she has given birth. Which foods will the client most likely refuse to eat when her meal tray is delivered? Select all that apply
Ans: Ice cream Ans: Raw carrot and celery Ans: Orange slices
5. The nurse is caring for a client who had been administered an anesthetic block during labor. Which of the following are risks that the nurse should watch for in the client? Select all that apply
Ans: Incomplete emptying of the bladder Ans: Bladder distention Ans: Urinary retention
17. The nurse is assessing a client who is in her 24th week of pregnancy. The nurse knows that which of the client's presenting symptoms should be further assessed as a possible sign of preterm labor? Select all that apply
Ans: Increase in vaginal bleeding Ans: Rupture of membranes Ans: Uterine contractions
17. A pregnant client had been diagnosed with gonorrhea. Which of the following nursing interventions should be performed to prevent gonococcal ophthlmia neonatorum in the baby?
Ans: Instill a prophylactic agent in the eye of the newborn
1. A client is trying to have a baby and wants to know the best time to have intercourse to increase the chances of pregnancy. Which of the following is the ideal time for intercourse, to help her chances in conceiving?
Ans: One or 2 days before ovulation
9. A client in her 20th week of gestation expresses concern about her 5 year old son, who is behaving strangely by not approaching her anymore. He does not seem to be taking the news of a new family member very well. Which of the following strategies can a nurse discuss with the mother to deal with the situation?
Ans: Provide constant reinforcement of love and care to the child
16. A nurse caring for a client in labor has asked her to perform Lamaze breathing techniques to avoid pain. Which of the following should the nurse keep in mind to promote effective Lamaze-method breathing?
Ans: Remain quiet during client's period of imagery
8. A 30 yo client would like to try using basal body temp as a fertility awareness method. Which of the following instructions should the nurse provide the client?
Ans: Take temp before rising and record it on a chart.
14. A mother who is 4 days postpartum, and is breastfeeding, expresses to the nurse that her breast seems to be tender and engorged. What education should the nurse give to the mother to relieve breast engorgement? Select all that apply
Ans: Take warm-to-hot showers to encourage milk release Ans: Express some milk manually before breastfeeding Ans: Apply warm compresses to the breasts prior to nursing
8. A nurse is caring for a client who is pregnant with a female baby. The client and her husband are both Jewish. The client is in her early 30s. They are not directly related by blood. There has been an instance of Tay-Sachs disease occuring in the family. Which of the following information does the nurse need to give the client regarding Tay-Sachs diease?
Ans: Tay-Sachs disease affects both male and female babies
4. A pregnant client wants to know why the labor of a first-time-pregnant woman usually lasts longer than that of a woman who has already delivered once and is pregnant a second time. What explanation should the nurse offer the client?
Ans: The cervix takes around 12-16 hours to dilate during first pregnancy
15. The nurse is caring for a laboring client for the Asian decent. The client appears to closely follow traditional cultural behaviors. Which of the following behaviors is most likely to be noted by the nurse?
Ans: The woman defers to her husband during interactions.
4. A nurse is caring for a 37-year old pregnant client who is expecting twins, both boys. The client used to smoke but has stopped during pregnancy. A relative of the client wants to find out more about the disorder. Which of the following information will the nurse give to the client during genetic counseling?
Ans: There is a greater risk of Klinefelter syndrome due to the client's age
13. A pregnant client asks the nurse about the relationship between her circulation and that of the unborn child. What response by the nurse is most appropriate?
Ans: There is no actual shared blood circulation but the substances in the mothers blood stream may be filtered to the fetus through the placenta
3. A client experiencing contractions presents at a health care facility. Assessment conducted by the nurse reveals that the client has been experiencing Braxton Hick contractions. The nurse hast to educate the client on the usefulness of Braxton Hicks contractions. Which of the following is the role of Braxton Hicks contractions in aiding labor?
Ans: These contractions help in softening and ripening the cervix
14. A nurse is caring for an HIV-positive client who is on triple-combination highly active anretroviral therapy (HAART). Which of the following should the nurse include in the teaching plan when educating the client about the treatment? Select all that apply
Ans: Unpleasant side effects such as nausea and diarrhea are common Ans: Provide written materials describing diet, exercise, and medications Ans: Ensure that the client understands the dosing regimen and schedule
1. A 28-year old client complains of skipping her menses and suspects she is pregnant. When assessinf this client, which of the following would the nurse identify as a presumptive sign of pregnancy?
Ans: Urinary frequency
10. A client is undergoing a routine check-up 2 months after the birth of her child. The nurse understands that the client is not practicing Kegel exercises. Which of the following should the nurse tell the client is caused by poor perineal muscular tone?
Ans: Urinary incontinence
The nurse is providing care to a neonate whose mother abuses heroin. Which finding would the nurse expect to assess? A. easy consolability B. sneezing C. vigorous sucking D. hypotonicity
B
When developing the plan of care for a woman who has had an abdominal hysterectomy, which of the following would be contraindicated? A) Ambulating the client B) Massaging the client's legs C) Applying elasticized stockings D) Encouraging range-of-motion exercises
B
A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages, which statement would indicate that the client understood the information? A) "I like having the privacy,but it might be too expensive for me to set up in my home." B) "I want to have more control, but I am concerned if an emergency would arise." C) "It is safer because I will have a midwife." D) "The midwife is trained to resolve any emergency, and she canbring any pain meds."
B) "I want to have more control, but I am concerned if an emergency would arise."
A woman has been treated for a tumor of the left breast that has not responded to chemotherapy. The woman has just found out that she has the BRCA mutations and discusses her options with her physician. What treatment would be most difficult for this woman?
Bilateral mastectomy Chemotherapy, left mastectomy, and radiation therapy may be difficult for the woman, but the most difficult and controversial treatment is bilateral mastectomy. Right mastectomy is considered a prophylactic mastectomy which is a primary prevention modality. Patients who are considering prophylactic mastectomy are often faced with a very controversial and emotion decision.
A nurse is developing a plan of care for a woman who is at risk for thromboembolism. Which of the following would the nurse include as the most cost-effective method for prevention? A) Prophylactic heparin administration B) Compression stocking C) Early ambulation D) Warm compresses
C Although compression stockings and prophylactic heparin administration may be appropriate, the most cost-effective preventive method is early ambulation. It is also the easiest method. Warm compresses are used to treat superficial venous thrombosis.
On the first prenatal visit, examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse records this finding as: A) Hegar's sign B) Goodell's sign C) Chadwick's sign D) Homans' sign
C) Chadwick's sign
A woman is being evaluated for pelvic organ prolapse. A postvoid residual urine specimen is obtained via a catheter. Which residual volume finding would lead the nurse to suspect the need for further testing? A) 50 mL B) 75 mL C) 100 mL D) 120 mL
D
When implementing the plan of care for a multigravida postpartum woman who gave birth just a few hours ago, the nurse vigilantly monitors the client for which complication? A. Deep venous thrombosis B. Postpartum psychosis C. Uterine infection D. Postpartum hemorrhage
D. Hemorrhage is possible if the uterus cannot contract and clamp down on the vessels to reduce bleeding. When the placenta is expelled, open vessels are then exposed and the risk of hemorrhage is great.
A group of students are reviewing the causes of postpartum hemorrhage. The students demonstrate understanding of the information when they identify which of the following as the most common cause? A) Labor augmentation B) Uterine atony C) Cervical or vaginal lacerations D) Uterine inversion
B The most common cause of postpartum hemorrhage is uterine atony, failure of the uterus to contract and retract after birth. The uterus must remain contracted after birth to control bleeding from the placental site.
A nurse is describing the structure and function of the reproductive system to an adolescent health class. The nurse describes the secretion of the seminal vesicles as which of the following? A) Mucus-like B) Alkaline C) Acidic D) Semen
B) Alkaline
The nurse is assessing a 13-year-old girl who has had her first menses. Which of the following events would the nurse expect to have occurred first? A) Evidence of pubic hair B) Development of breast buds C) Onset of menses D) Growth spurt
B) Development of breast buds
17.A nurse is reviewing the medical record of a woman diagnosed with vulvar cancer. Which of the following would the nurse identify as a risk factor for this cancer? (Select all that apply.) A) Age under 40 years B) HPV 16 exposure C) Monogamous sexual partner D) Hypertension E) Diabetes
B) HPV 16 exposure D) Hypertension E) Diabetes
After teaching a group of students about the different perinatal education methods, the instructor determines that the teaching was successful when the students identify which of the following as the Bradley method? A) Psychoprophylactic method B) Partner-coached method C) Natural childbirth method D) Mind prevention method
B) Partner-coached method
The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion? A) Wide large eyes B) Thin upper lip C) Protruding jaw D) Elongated nose
B) Thin upper lip
A group of nursing students are reviewing information about the male reproductive structures. The students demonstrate understanding of the information when they identify which of the following as accessory organs? (Select all that apply.) A) Testes B) Vas deferens C) Bulbourethral glands D) Prostate gland E) Penis
B) Vas deferens C) Bulbourethral glands D) Prostate gland
The nurse is doing meal planning with a pregnant woman with iron-deficiency anemia. What dietary recommendations would the nurse make to enhance the woman's intake of iron? Select all that apply. A. Since fortified cereals are a poor source of iron, eat eggs or pancakes for breakfast. B. Limit intake of dried fruits, eating only fresh fruit. C. Drink orange juice with the iron supplement. D. Cook food in an iron skillet, if possible. E. Increase intake of dried beans and green leafy vegetables.
C,D,E R:Dried fruits, fortified grains and cereals, and animal protein are all good sources of iron for a pregnant woman. Cooking in an iron skillet also will increase the amount of iron ingested. Vitamin C, like what is found in orange juice, enhances absorption of iron and is recommended to drink when taking iron supplements. Folate also increases the effectiveness of iron supplements; foods high in folate include green leafy vegetables, fortified grains and dried beans.
A nurse is assisting with the delivery of a newborn. The fetal head has just emerged. Which of the following would be done next? A) Suctioning of the mouth and nose B) Clamping of the umbilical cord C) Checking for the cord around the neck D) Drying of the newborn
C. Checking for the cord around the neck once the fetal head has emerged, the primary care provider explores the fetal neck to see if the umbilical cord is wrapped around it. If it is, the cord is slipped over the head to facilitate delivery. * Then the health care provider suctions the newborn's mouth first (because the newborn is an obligate nose breather) and then the nares with a bulb syringe to prevent aspiration of mucus, amniotic fluid, or meconium.
A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect? A) Increased vaginal discharge B) Urinary tract infection C) Vaginitis D) Vaginal ulceration
D
A woman experiencing postpartum hemorrhage is ordered to receive a uterotonic agent. Which of the following would the nurse least expect to administer? A) Oxytocin B) Methylergonovine C) Carboprost D) Terbutaline
D Terbutaline is a tocolytic agent used to halt preterm labor. It would not be used to treat postpartum hemorrhage. Oxytocin, methylergonovine, and carboprost are drugs used to manage postpartum hemorrhage.
A nursing instructor is preparing a class discussion on the trends in health care and health care delivery over the past several centuries. When discussing the changes during the past century, which of the following would the instructor be least likely to include? A) Disease prevention B) Health promotion C) Wellness D) Analysis of morbidity and mortality
D) Analysis of morbidity and mortality
During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. The nurse interprets this as: A) Variable decelerations B) Fetal tachycardia C) A nonreactive pattern D) Reactive pattern
D) Reactive pattern
A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborns risk for the infection. Which of the following statements by the nurse would be most appropriate? A)Youll probably have a cesarean birth to prevent exposing your newborn. B)Antibodies cross the placenta and provide immunity to the newborn. C)Wait until after the infant is born and then something can be done. D)Antiretroviral medications are available to help reduce the risk of transmission.
D. Drug therapy is the mainstay of treatment for pregnant women infected with HIV. The goal of therapy is to reduce the viral load as much as possible; this reduces the risk of transmission to the fetus. Decisions about the method of delivery should be based on the woman's viral load, duration of ruptured membranes, progress of labor, and other pertinent clinical factors. The newborn is at risk for HIV because of potential perinatal transmission. Waiting until after the infant is born may be too late.
A couple asks the nurse what color eyes their baby will have if the mother has brown eyes and the father has blue eyes. What is the best response by the nurse? A. blue B. hazel C. differing D. brown
D. Brown Rationale: If the two alleles differ, the dominant one will usually be ex[ressed in the phenotype of the individual.
What chromosomal abnormality occurs when the abnormalities do not show up in every cell, only some cells and tissues carry it?
Mosaic
cleavage (aka mitosis):
after the sperm meets the egg, in the fallopian tube, the mix (zygote) travels towards the uterus via tubal muscular, movements. during travel, the zygote goes through cleavage x 4, where it becomes a a ball of 16 cells known as a morula.
Which of the following is an early symptom of vulvar cancer? a) Severe abdominal pain b) Pruritus with genital burning c) Fever accompanied by chills d) Dyspareunia
b: Pruritus and genital burning are the most frequent early symptoms of vulvar cancer, followed by a bloody discharge from the vagina. Abdominal pain can be a result of a surgery related to ovary, such as salpingo-oophorectomy, or formation of cysts in the ovary. Dyspareunia and fever accompanied by chills are not the early symptoms of vulvar cancer
A patient with ovarian cancer is admitted to the hospital for surgery. You are completing a health history on the patient. What clinical manifestations would you expect to assess? a) Fever and chills b) Fish-like odor of the vagina c) Increased abdominal girth d) Lower abdominal pelvic pain
c: Clinical manifestations of ovarian cancer include enlargement of the abdomen from an accumulation of fluid. Flatulence and feeling full after a light meal are significant symptoms. In bacterial vaginosis, a fish-like odor, which is noticeable after sexual intercourse or during menstruation, occurs as a result of a rise in the vaginal pH. Fever and chills occur in toxic shock syndrome (TSS). A symptom associated with pelvic inflammatory disease (PID) is lower abdominal pelvic pain
Pain during the first stage of labor is associated with what?
ischemia of the uterus during contractions
What are the fetal tissues called that separate the maternal blood and the fetal blood?
placental barriers *Material is only interchanged through diffusion*
A client experiencing contractions presents at a health care facility. Assessment conducted by the nurse reveals that the client has been experiencing Braxton Hick contractions. The nurse hast to educate the client on the usefulness of Braxton Hicks contractions. Which of the following is the role of Braxton Hicks contractions in aiding labor?
these contractions help in softening and ripening the cervix
A 5-year-old girl is being admitted with a possible diagnosis of child abuse. The child has bruises in various places on her body that the caregiver attributes to the child recently beginning to play soccer. Bruises associated with child abuse would likely be found in which of the following areas of the body? a) elbows b) forehead c) knees d) thighs
thighs
A client in the 3rd stage of labor has experienced placental separation and expulsion. Why is it necessary for a nurse to massage the woman's uterus briefly until it is firm?
to constrict the uterine blood vessels
A nurse is caring for a pregnant client and discovers signs of bruises near her neck. On questioning, the nurse learns that the bruises were caused by her husband. The client tells the nurse that her husband had stopped abusing her some time ago, but this was the first time during the pregnancy that she was assaulted. She blames herself because she admits to not paying enough attention to her husband. Which facts about abuse during pregnancy should the nurse tell the client to convince her that the abuse was not her fault? Select all that apply. a) Most men exhibit violent reactions during pregnancy as a way of coping with the stress. b) Abuse is a result of insecurity and jealousy of the pregnancy and the responsibilities it brings. c) Abuse is a result of the perception of the partner that the baby will be a competitor after he or she is born. d) Abuse is a result of concern for the unborn child when the mother doesn't fulfill her responsibilities toward the newborn. e) Abuse is a result of resentment toward the interference of the growing fetus and change in the woman's shape.
• Abuse is a result of insecurity and jealousy of the pregnancy and the responsibilities it brings. • Abuse is a result of resentment toward the interference of the growing fetus and change in the woman's shape. • Abuse is a result of the perception of the partner that the baby will be a competitor after he or she is born.
A nurse is working in a local community health care facility where she frequently encounters victims of abuse. For which signs should the nurse assess to find out if a client is a victim of abuse? Select all that apply. a) Reported history of the injury is inconsistent with the presenting problem b) Injuries on the face, head, and neck c) Partner of the suspected victim seems relaxed and not overly worried d) Affected by STIs frequently e) Mental health problems such as depression, anxiety, or substance abuse
• Injuries on the face, head, and neck • Mental health problems such as depression, anxiety, or substance abuse • Reported history of the injury is inconsistent with the presenting problem
A nurse is conducting a class for a group of teenage girls about female reproductive anatomy and physiology. Which of the following would the nurse include as an external female reproductive organ? Select all that apply. A) Mons pubis B) Labia C) Vagina D) Clitoris E) Uterus
A) Mons pubis B) Labia D) Clitoris
A nurse is preparing a teaching plan for a woman who is pregnant for the first time. Which of the following would the nurse incorporate into the teaching plan to foster the client's learning? (Select all that apply.) A) Teach "survival skills" first B) Use simple, nonmedical language C) Refrain from using a hands-on approach D) Avoid repeating information E)Use visual materials such as photos and videos
A) Teach "survival skills" first B) Use simple, nonmedical language E)Use visual materials such as photos and videos
19. The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which of the following? A) Increment B) Acme C) Peak D) Decrement
A. The time from the onset to the highest intensity corresponds to the increment.
A nurse is reading a journal article about sexual abuse. Which age range would the nurse expect to find as the peak age for such abuse? A) 7-10 years B) 8-12 years C) 14-18 years D) 18-22 years
Ans: B Feedback: Current estimates indicate that 1 of 5 girls is sexually abused, and the peak ages of such abuse are from 8 to 12 years of age. At every age in the life span, females are more likely to be sexually abused by father, brother, family member, neighbor, boyfriend, husband, partner or ex-partner than by a stranger or anonymous assailant.
A group of nursing students are reviewing information about vaccines used to prevent STIs. The students would expect to find information about which of the following? (Select all that apply). A) HIV B) HSV C) HPV D) HAV E) HBV
Ans: C, D, E Feedback: Vaccines are under development or are undergoing clinical trials for certain STIs, including HIV and HSV. However, the only vaccines currently available are for prevention of HAV, HBV, and HPV infection.
A group of students are reviewing the signs of pregnancy. The students demonstrate understanding of the information when they identify which as presumptive signs? (Select all that apply. A) Amenorrhea B) Nausea C) Abdominal enlargement D) Braxton-Hicks contractions E) Fetal heart sounds
Ans: A, B Presumptive signs include amenorrhea, nausea, breast tenderness, urinary frequency and fatigue. Abdominal enlargement and Braxton-Hicks contractions are probable signs of pregnancy. Fetal heart sounds are a positive sign of pregnancy.
The nurse is developing a presentation for a community group of young adults discussing fetal development and pregnancy. The nurse would identify that the sex of offspring is determined at the time of: A) Meiosis B) Fertilization C) Formation of morula D) Oogenesis
Ans: B Feedback: Sex determination occurs at the time of fertilization. Meiosis refers to cell division resulting in the formation of an ovum or sperm with half the number of chromosomes. The morula develops after a series of four cleavages following the formation of the zygote. Oogenesis refers to the development of a mature ovum, which has half the number of chromosomes.
The health care provider orders PGE2 for a woman to help evacuate the uterus following a spontaneous abortion. Which of the following would be most important for the nurse to do? A) Use clean technique to administer the drug. B) Keep the gel cool until ready to use. C) Maintain the client for 1/2 hour after administration. D) Administer intramuscularly into the deltoid area.
Ans: C When PGE2 is ordered, the gel should come to room temperature before administering it. Sterile technique should be used and the client should remain supine for 30 minutes after administration. RhoGAM is administered intramuscularly into the deltoid area.
Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time in the stirrups. Based on an interpretation of these findings, the nurse would be especially alert for which of the following? A) Retained placental fragments B) Hypertension C) Thrombophlebitis D) Uterine subinvolution
C The woman is at risk for thrombophlebitis due to the prolonged second stage of labor, necessitating an increased amount of time in bed, and venous pooling that occurs when the woman's legs are in stirrups for a long period of time. These findings are unrelated to retained placental fragments, which would lead to uterine subinvolution, or hypertension.
A group of students are reviewing the historical aspects about childbirth. The students demonstrate understanding of the information when they identify the use of twilight sleep as a key event during which time frame? A) 1700s B) 1800s C) 1900s D) 2000s
C) 1900s
A nurse is developing a plan of care for a woman to ensure continuity of care during pregnancy, labor, and childbirth. Which of the following would be most important for the nurse to incorporate into that plan? A) Adhering to strict, specific routines B) Involving a pediatric physician C) Educating the client about the importance of a support person D) Assigning several nurses as a support team
C) Educating the client about the importance of a support person
When palpating the fundus during a contraction, the nurse notes that it feels like a chin. The nurse interprets this finding as indicating which type of contraction? A) Intense B) Strong C) Moderate D) Mild
C. -A contraction that feels like the chin typically represents a moderate contraction. -A contraction described as feeling like the tip of the nose indicates a mild contraction. - A strong contraction feels like the forehead.
A woman is admitted to the labor and birthing suite. Vaginal examination reveals that the presenting part is approximately 2 cm above the ischial spines. The nurse documents this finding as: A) +2 station B) 0 station C) -2 station D) Crowning
C. The ischial spines serve as landmarks and are designated as zero status. If the presenting part is palpated higher than the maternal ischial spines, a negative number is assigned. Therefore, the nurse would document the finding as -2 station.
A nurse is assigned to care for an Asian American client. The nurse develops a plan of care with the understanding that based on this client's cultural background, the client most likely views illness as which of the following? A) Caused by supernatural forces. B) A punishment for sins. C) Due to spirits or demons. D) From an imbalance of yin and yang
D) From an imbalance of yin and yang
When assessing a pregnant woman in her last trimester, which question would be most appropriate to use to gather information about weight gain and fluid retention? A) "What's your usual dietary intake for a typical day?" B) "What size maternity clothes are you wearing now?" C) "How puffy does your face look by the end of a day?" D) "How swollen do your ankles appear before you go to bed?
D) "How swollen do your ankles appear before you go to bed?
A nurse is providing care to several pregnant women at the clinic. The nurse would screen for group B streptococcus infection in a client at: A) 16 weeks gestation B) 28 week gestation C) 32 weeks gestation D) 36 weeks gestation
D) 36 weeks gestation
A nurse is counseling a pregnant woman with rheumatoid arthritis about medications that can be used during pregnancy. Which drug would the nurse emphasize as being contraindicated at this time? A) Hydroxychloroquine B) Nonsteroidal anti-inflammatory drug C) Glucocorticoid D) Methotrexate
D) Methotrexate
The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would be inappropriate for the nurse to include as an accessory gland? A) Seminal vesicles B) Prostate gland C) Cowper's glands D) Vas deferens
D) Vas deferens
Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance? A)Marijuana B)Alcohol C)Heroin D)Cocaine
D)Cocaine
7. Which of the following statements best indicates that a client has taken self-care measures to reduce her risk for cervical cancer? A)Ive really cut down on the amount of caffeine I drink every day. B) Ive thrown out all my bubble baths and just use soap and water now. C) Every time I have sexual intercourse, I douche. D)My partner always uses a condom when we have sexual intercourse.
D)My partner always uses a condom when we have sexual intercourse.
A pregnant woman diagnosed with diabetes should be instructed to do which of the following? a) Notify the physician if unable to eat because of nausea and vomiting. b) Prepare foods with increased carbohydrates to provide needed calories. c) Ingest a smaller amount of food prior to sleep to prevent nocturnal hyperglycemia. d) Discontinue insulin injections until 15 weeks gestation.
a) Notify the physician if unable to eat because of nausea and vomiting. Rationale: During pregnancy, the insulin levels change in response to the production of HPL. The patient needs to alert her provider if she is not able to eat or hold down appropriate amounts of nutrition. The patient is at risk for episodes of hypoglycemia during the first trimester. She should never discontinue insulin therapy without her provider's directions. The increase of carbohydrates needs to be balanced with protein, and smaller meals would result in hypoglycemia rather than hyperglycemia.
A group of second year nursing students are planning a community function to teach about ovarian cancer for their group project. What should they list as risk-reduction strategies on their poster board? (Check all that apply.) a) breastfeeding b) avoidance of talc and hygiene sprays on genitals c) use of oral contraceptives d) eating high fiber foods e) pregnancy
a, b, c, e: Education is a major focus of nursing care. Risk-reduction strategies for ovarian cancer which the nurse should teach include pregnancy, breastfeeding, use of oral contraceptives, and avoiding talc and hygiene sprays on genitals
A 47-year-old woman was just diagnosed with a cancer of her reproductive tract. The public health nurse is aiding in counseling. Which of the following nursing interventions would be supportive in counseling this woman? Select all that apply. a) Give post-operative care and instructions when prescribed b) Validate the client's feelings and provide realistic hope c) Use sincere basic communication techniques d) Give care based on all woman diagnosed with cancer e) Be judgmental of the women's previous lifestyle
a, b, c: Nursing interventions in caring for women with cancers of the female reproductive tract include the following: Validate the client's feelings and provide realistic hope; use basic communication skills in a caring way; give useful, nonjudgmental information to all women; give individual care for each person; and give discharge and postoperative care when ordered
a client who reported changes in her normal voiding pattern and altered bowel habits is diagnosed with polycystic ovarian syndrome. Which instructions is most appropriate for the nurse to provide the client to help alleviate her condition? a. adhere to follow-up-care b. increase intake of fiber c. increase fluid intake d. perform Kegel exercises
a. the nurse should stress follow-up-care so that the client does not overlook this benign disorder.
While obtaining the history, a client reports that her mother was treated with diethylstilbestrol (DES) during her pregnancy. The nurse determines that this client is at risk for which of the following? a) Cervical cancer b) Endometrial cancer c) Vulvar cancer d) Breast cancer
a: Cervical cancer affects the lowest portion of the uterus and is associated with the risk factor of being born to mothers treated with DES during their pregnancy. DES is not a risk factor associated with vulvar or breast cancers. Endometrial cancer occurs in women who take estrogens without the addition of progesterone for 5 or more years during and after menopause
After teaching a client diagnosed with candidiasis about preventative measures, the nurse determines that the teaching was effective when the client states she will take which action?
avoid tight pants
As a class project a group of student nurses are developing a care plan for patients being screened for cervical cancer. When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor? a) Postmenopausal bleeding b) Human papillomavirus (HPV) c) Late childbearing d) Obesity
b: Adenocarcinomas of the cervix begin in the mucus-producing glands and are often due to HPV infection. Risk factors for cervical cancer include multiple sex partners, IV infection, smoking, and early childbearing. Postmenopausal bleeding and obesity are risk factors for uterine cancer.
preembryonic stage
fertilization through the second week. pg. 336
What is the HELLP syndrome?
hemolysis, elevated liver enzymes, low platelets
When planning the care for a client during the first 24 hours postpartum, the nurse expects to monitor the client's pulse and blood pressure frequently based on the understanding that the client is at risk for which condition?
hemorrhage
A nurse is providing care to a client with uterine fibroids who is prescribed a progestin antagonist. Which medication would the nurse most likely expect the client to receive? leuprolide nafarelin goserelin mifepristone
mifepristone Mifepristone is a progestin antagonist used to treat uterine fibroids. Leuprolide, nafarelin, and goserelin are gonadotropin-releasing hormone antagonists.
A young couple have presented to the office with concerns of possible infertility. A physical examination and complete history of the woman reveals type 2 diabetes mellitus, obesity, sleep apnea, and hypertension. The nurse would suspect: polycystic ovary syndrome. irregular menses. leiomyomas. hormonal imbalance.
polycystic ovary syndrome. Polycystic ovary syndrome (PCOS) involves the presence of multiple inactive follicle cysts within the ovary that interfere with ovarian function. It is the most common cause of medically treatable infertility and is responsible for 70% of cases of anovulatory subfertility and up to 20% of couples' infertility cases.
In the fetus ______________ can result in Erb duchenne brachial plexus palsies and clavicular or humeral fractures, also hypoxic encephalopathy.
shoulder dystocia
Signs of _________________ appear while the woman is pushing as the neonate's head slowly extends and emerges over the perineum, but then retracts back into the vagina (turtle sign)
shoulder dystocia
Which factor might result in a decreased supply of breast milk in a postpartum client?
supplemental feedings with formula
disadvantages of myomectomy?
that the fibroids may grow back in the future
The experienced labor and birth nurse knows to evaluate progress in active labor by using which simple rule? A) 1 cm/hour for cervical dilation B) 2 cm/hour for cervical dilation C) 1/4 cm/hour for cervical dilation D) 1/2 cm/hour for cervical dilation
A) 1 cm/hour for cervical dilation In evaluating the progress in active labor, the nurse uses the simple rule of 1 cm/hour for cervical dilation.
A pregnant woman tests positive for HBV. Which of the following would the nurse expect to administer? A) HBV immune globulin B) HBV vaccine C) Acylcovir D) Valacyclovir
A) HBV immune globulin
During pregnancy, one of progesterone's actions is to allow sodium to be "wasted" or lost in the urine. The nurse would expect to see which hormone increased to help counteract this loss? A. aldosterone B. ADH C. glycogen D. cortisol
A. Aldosterone
4. A 28 year old client in her first trimester of pregnancy complains of conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious of its implications. Which of the following maternal emotional responses is the client experiencing?
Ans: Ambivalence
5. A 25-year old client wants to know if her baby boy is ar risk for Down syndrome, as one of her distant relatives was born with it. Which of the following will the nurse tell the client while counseling her about Down syndrome?
Ans: Children with Down syndrome have 47 chromosomes instead of 46
9. A nurse is required to obtain the temperature of a healthy newborn who is placed in an ordinary crib. Which of the following is the most appropriate method for measuring a newborn's temperature?
Ans: Place electronic temperature probe in the midaxillary area.
A 2-day old newborn is crying after being circumcised and the mother is attempting to comfort the infant but he continues to be fussy. Which statement by the nurse would best support the mother's actions?
"Many mothers find that offering a nipple dipped in sugar water helps soothe a baby after a painful procedure."
Leopold's maneuvers steps
- Maneuver 1: What fetal part (head or buttocks) is located in the fundus (top of the uterus)? - Maneuver 2: On which maternal side is the fetal back located? (Fetal heart tones are best auscultated through the back of the fetus.) - Maneuver 3: What is the presenting part? - Maneuver 4: Is the fetal head flexed and engaged in the pelvis?
Flexion and extension are terms used to describe fetal ____________ . Cephalic is a term used to describe fetal _________ .
- attitude - presentation
The active phase of the first stage of labor is characterized by
- cervical dilation of 4 to 7 cm - effacement of 40% to 80% - contractions occurring every 2 to 5 minutes lasting 45 to 60 seconds.
The transition phase of the first stage of labor is characterized by
- cervical dilation of 8 to 10 cm - effacement of 80% to 100% - contractions occurring every 1 to 2 minutes lasting 60 to 90 seconds.
Symptoms of preterm labor
-increase vaginal discharge - pushing down sensation - low dull pain - menstrual- like cramps - uterine contraction without pain
18. A nurse is assigned to care for a pregnant client as she undergoes a nonstress test. Given below are the steps involved in conducting the nonstress test. Arrange the steps in the correct order.
1. Client consumes meal 2. Client placed in left lateral recumbent position 3. External electronic fetal-monitoring device applied 4. Client is handed an event marker 5. Fetal monitor strip marked for fetal movement
8. Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in: A) Latent phase of the first stage B) Active phase of the first stage C) Transition phase of the first stage D) Perineal phase of the second stage
A The latent phase of the first stage of labor involves cervical dilation of 0 to 3 cm, cervical effacement of 0% to 40%, and contractions every 5 to 10 minutes lasting 30 to 45 seconds.
The nurse is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis. His parents are out of town on vacation, and the child is staying with a neighbor. Which action would be the priority? A) Getting telephone consent with two people listening to the verbal consent B) Providing emergency care without parental consent C) Contacting the child's aunt or uncle to obtain their consent D) Advocating for termination of parental rights for this situation
A) Getting telephone consent with two people listening to the verbal consent
A pregnant woman with gestational diabetes comes to the clinic for a fasting blood glucose level. When reviewing the results, the nurse determines that which result indicates good glucose control? A) 90 mg/dL B) 100 mg/dL C) 110 mg /dL D) 120 mg/dL
A) 90 mg/dL
19.The plan of care for a woman diagnosed with a suspected reproductive cancer includes a nursing diagnosis of disturbed body image related to suspected reproductive tract cancer and impact on sexuality as evidenced by the clients statement that she is worried that she won't be the same. Which of the following would be an appropriate outcome for this client? A) Client will verbalize positive statements about self and sexuality. B) Client will demonstrate understanding of the condition and associated treatment. C) Client will exhibit positive coping strategies related to diagnosis. D) Client will identify misconceptions related to her diagnosis.
A) Client will verbalize positive statements about self and sexuality.
A woman in the 34th week of pregnancy says to the nurse, "I still feel like having intercourse with my husband." The woman's pregnancy has been uneventful. The nurse responds based on the understanding that: A) It is safe to have intercourse at this time. B) Intercourse at this time is likely to cause rupture of membranes. C) There are other ways that the couple can satisfy their needs. D) Intercourse at this time is likely to result in premature labor.
A) It is safe to have intercourse at this time.
A pregnant woman is scheduled to undergo percutaneous umbilical blood sampling. When discussing this test with the woman, the nurse reviews what can be evaluated with the specimens collected. Which of the following would the nurse include? (Select all that apply.) A) Rh incompatibility B) Fetal acid-base status C) Sex-linked disorders D) Enzyme deficiencies E) Coagulation studies
A) Rh incompatibility B) Fetal acid-base status E) Coagulation studies
The nurse is caring for a 2-week-old newborn girl with a metabolic disorder. Which of the following activities would deviate from the characteristics of family-centered care? A) Softening unpleasant information or prognoses B) Evaluating and changing the nursing plan of care C) Collaborating with the child and family as equals D) Showing respect for the family's beliefs and wishes
A) Softening unpleasant information or prognoses
The nurse is teaching a health education class on male reproductive anatomy and asks the students to identify the site of sperm production. Which structure, if identified by the group, would indicate to the nurse that the teaching was successful? A) Testes B) Seminal vesicles C) Scrotum D) Prostate gland
A) Testes
A nurse is considering a change in employment from the acute care setting to community-based nursing. The nurse is focusing her job search on ambulatory care settings. Which of the following would the nurse most likely find as a possible setting? Select all that apply. A) Urgent care center B) Hospice care C) Immunization clinic D) Physician's office E) Day surgery center F) Nursing home
A) Urgent care center D) Physician's office E) Day surgery center
A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which condition in the client is likely to increase the risk for shoulder dystocia? A) diabetes B) pendulous abdomen C) nullipara D) preterm birth
A) diabetes Shoulder dystocia is most apt to occur in women with diabetes, in multiparas, and in postdate pregnancies.
6. A client is scheduled for cryosurgery to remove some abnormal tissue on the cervix. The nurse teaches the client about this treatment, explaining that the tissue will be removed by which method? A)Freezing B) Cutting C) Burning D)Irradiating
A)Freezing
When teaching a class of pregnant women about the effects of substance abuse during pregnancy, which of the following would the nurse most likely include? A)Low-birth-weight infants B)Excessive weight gain C)Higher pain tolerance D)Longer gestational periods
A)Low-birth-weight infants
The nurse is developing a discharge teaching plan for a postpartum woman who has developed a postpartum infection. Which of the following would the nurse most likely include in this teaching plan? (Select all that apply.) A) Taking the prescribed antibiotic until it is finished B) Checking temperature once a week C) Washing hands before and after perineal care D) Handling perineal pads by the edges E) Directing peribottle to flow from back to front
A, C, D Teaching should address taking the prescribed antibiotic until finished to ensure complete eradication of the infection; checking temperature daily and notifying the practitioner if it is above 100.4° F; washing hands thoroughly before and after eating, using the bathroom, touching the perineal area, or providing newborn care; handling perineal pads by the edges and avoiding touching the inner aspect of the pad that is against the body; and directing peribottle so that it flows from front to back.
Assessment of a postpartum woman experiencing postpartum hemorrhage reveals mild shock. Which of the following would the nurse expect to assess? (Select all that apply.) A) Diaphoresis B) Tachycardia C) Oliguria D) Cool extremities E) Confusion
A, D Signs and symptoms of mild shock include diaphoresis, increased capillary refill, cool extremities, and maternal anxiety. *Tachycardia and oliguria suggest moderate shock. * Confusion suggests severe shock
A diabetic client who also suffers from urinary incontinence knows the importance of maintaining her blood glucose levels. This is doubly important for this type of client in regards to her incontinence because of which factor? Abnormal glucose levels can cause polyuria. Abnormal glucose levels can cause polyphagia. Abnormal glucose levels can cause polydipsia. all of the above
Abnormal glucose levels can cause polyuria. Managing urinary incontinence is extremely important for a diabetic. Abnormal blood glucose levels (such as seen in hypergylcemia) can cause polyuria, which will add to the incontinence problem. The others might also be present when a client suffers from hyperglycemia, but they do not affect the incontinence the client is suffering from.
A nurse is caring for a rape victim who was just brought to the local emergency care facility. Which interventions should the nurse perform to minimize risk of pregnancy in this client? a) Wait for first signs of pregnancy before taking action b) Administer prescribed double dose of emergency contraceptive pills c) Apply spermicidal cream or gel near the vaginal area upon arrival d) Administer prescribed regular oral contraceptive pills
Administer prescribed double dose of emergency contraceptive pills -first dose within 72 hours - second dose 12 hours after first dose
After teaching a group of students about sexual abuse and violence, the instructor determines that the teaching was successful when the students describe incest as involving which of the following? A) Sexual exploitation by blood or surrogate relatives B) Sexual abuse of individuals over age 18 C) Violent aggressive assault on a person D) Consent between perpetrator and victim.
Ans: A Feedback: Incest is any type of sexual exploitation between blood relatives or surrogate relatives before the victim reaches 18 years of age. Rape is a violent, aggressive assault on the victim's body and integrity. Rape is a legal rather than a medical term. It denotes penile penetration of the vagina, mouth, or rectum of the female or male without consent. It may or may not include the use of a weapon.
A nurse is preparing a presentation for a group of women at the clinic who have been diagnosed with genital herpes. Which of the following would the nurse expect to include as a possible precipitating factor for a recurrent outbreak? (Select all that apply.) A) Exposure to ultraviolet light B) Exercise C) Use of corticosteroids D) Emotional stress E) Sexual intercourse.
Ans: A, C, D, E Feedback: Recurrent genital herpes outbreaks are triggered by precipitating factors such as emotional stress, menses, ultraviolet light exposure, illness, surgery, fatigue, genital trauma, immunosuppression such as from drugs like corticosteroids, and sexual intercourse, but more than half of recurrences occur without a precipitating cause.
The nurse encourages a female client with human papillomavirus (HPV) to receive continued follow-up care because she is at risk for: A) Infertility B) Dyspareunia C) Cervical cancer D) Dysmenorrhea
Ans: C Feedback: Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer. Therefore, the client needs continued follow-up for Pap smears. HPV is not associated with an increased risk for infertility, dyspareunia, or dysmenorrhea.
The nurse reviews the CD4 cell count of a client who is HIV-positive. A result less than which of the following would indicate to the nurse that the client has AIDS? A) 1,000 cells/mm3 B) 700 cells/mm3 C) 450 cells/mm3 D) 200 cells/mm3
Ans: D Feedback: When the CD4 T-cell count reaches 200 or less, the person has reached the stage of AIDS according to the CDC. A CD4 T-cell count between 450 and 1,200 is considered normal.
15. A nurse is assessing a client with postpartal hemorrhage; the client is presently on IV oxytocin. Which of the following interventions should the nurse perform to evaluate the efficacy of the drug treatment? Select all that apply
Ans: Assess client's uterine tone Ans: Monitor client's vital signs Ans: Get a pad count
13. A nurse is providing info regarding ovulation to a couple who want to have a baby. Which of the following should the nurse tell the clients?
Ans: At ovulation, a mature follicle ruptures, releasing an ovum
4. A female client is prescribed metronidazole for the treatment of trichomoniasis. Which of the following instructions should the nurse give the client undergoing treatment?
Ans: Avoid alcohol
2. Which precautions should a nurse take to prevent infection in a newborn? Select all that apply
Ans: Avoid coming to work when ill Ans: Use sterile gloves for an invasive procedure Ans: Monitor laboratory test results for changes
The nurse is developing a plan of care for a client who is receiving highly active antiretroviral therapy (HAART) for treatment of HIV. The goal of this therapy is to: A) Promote the progression of disease B) Intervene in late-stage AIDS C) Improve survival rates D) Conduct additional drug research
Ans: C Feedback: The use of HAART aims to improve the prognosis of HIV/AIDS. Dramatic advances with antiretroviral medication have turned a disease that used to be a death sentence into a chronic, manageable one for individuals who live in countries where antiretroviral therapy is available. Drug therapy does not promote the progression of the disease. It is started at the time of the first infection, not in late-stage AIDS. Treatment advances have been based on research, but drug therapy is not prescribed to conduct additional research.
A woman is at 20 weeks' gestation. The nurse would expect to find the fundus at which of the following? A) Just above the symphysis pubis B) Mid-way between the pubis and umbilicus C) At the level of the umbilicus D) Mid-way between the umbilicus and xiphoid process
Ans: C The uterus, which starts as a pear-shaped organ, becomes ovoid as length increases over width. By 20 weeks' gestation, the fundus, or top of the uterus, is at the level of the umbilicus and measures 20 cm. A monthly measurement of the height of the top of the uterus in centimeters, which corresponds to the number of gestational weeks, is commonly used to date the pregnancy.
While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of: A) Multifactorial inheritance B) X-linked recessive inheritance C) Trisomy numeric abnormality D) Chromosomal deletion
Ans: C Feedback: Down syndrome is an example of a chromosomal abnormality involving the number of chromosomes (trisomy numeric abnormality), in particular chromosome 21, in which the individual has three copies of that chromosome. Multifactorial inheritance gives rise to disorders such as cleft lip, congenital heart disease, neural tube defects, and pyloric stenosis. X-linked recessive inheritance is associated with disorders such as hemophilia. Chromosomal deletion is involved with disorders such as cri du chat syndrome.
11. A healthy 28 yo female client who has a sedentary lifestyle and is a chain smoker is seeking info about contraception. The nurse informs the client of the various options available and the benefits and the risks of each. Which of the following should the nurse recognize as contraindicated in the case of this client?
Ans: Combination Ocs
While talking with a woman in her third trimester, which behavior indicates to the nurse that the woman is learning to give of oneself? A) Showing concern for self and fetus as a unit B) Unconditionally accepting the pregnancy without rejection C) Longing to hold infant D) Questioning ability to become a good mother
Ans: D Learning to give of oneself would be demonstrated when the woman questions her ability to become a good mother to the infant. Showing concern for herself and fetus as a unit reflects the task of ensuring safe passage throughout pregnancy and birth. Unconditionally accepting the pregnancy reflects the task of seeking acceptance of the infant by others. Longing to hold the infant reflects the task of seeking acceptance of self in the maternal role to the infant.
The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time? A) Dysuria B) Dyspnea C) Constipation D) Urinary frequency
Ans: D Lightening refers to the descent of the fetal head into the pelvis and engagement. With this descent, pressure on the diaphragm decreases, easing breathing, but pressure on the bladder increases, leading to urinary frequency. Dysuria might indicate a urinary tract infection. Constipation may occur throughout pregnancy due to decreased peristalsis, but it is unrelated to lightening.
A nursing instructor is teaching a class to a group of students about pregnancy, insulin, and glucose. Which of the following would the instructor least likely include as opposing insulin? A) Prolactin B) Estrogen C) Progesterone D) Cortisol
Ans: D Prolactin, estrogen, and progesterone are all thought to oppose insulin. As a result, glucose is less likely to enter the mother's cells and is more likely to cross over the placenta to the fetus. After the first trimester, hPL from the placenta and steroids (cortisol) from the adrenal cortex act against insulin. hPL acts as an antagonist against maternal insulin, and thus more insulin must be secreted to counteract the increasing levels of hPL and cortisol during the last half of pregnancy.
A couple comes to the clinic for preconception counseling and care. As part of the visit, the nurse teaches the couple about fertilization and initial development, stating that the zygote formed by the union of the ovum and sperm consists of how many chromosomes? A) 22 B) 23 C) 44 D) 46
Ans: D Feedback: With fertilization, the ovum, containing 23 chromosomes, and the sperm, containing 23 chromosomes, join, forming a zygote with a diploid number or 46 chromosomes.
8. The nurse is caring for a client with end stage breast cancer. When she takes chemotherapy medication into the client's room, the client states, "I'm too tired to fight any more. I don't want any more medication that may prolong my life." The client's husband is at the bedside and states, "No! You have to give my wife her medication. I cant let her go." What action by the nurse is most appropriate?
Ans: Explaining to the husband that his wife has the right to refuse medication and care.
7. A client has been following the conventional 28 day regimen for contraception. she is now considering switching to an extended OC regimen. She is seeking info about specific safety precautions. Which of the following is true for the extended OC regimen?
Ans: It carries the same safety profile as the 28 day regimen.
11. The nurse is performing a newborn assessment. What finding will alert the nurse to the development of polycythema in the newborn?
Ans: Jaundice
15. A 52-year old client is seeking tx for menopause. She is not very active and has a history of cardiac problems. Which of the following therapy options should the nurse recognize as contraindicated for this client?
Ans: Long hormone replacement therapy
2. An HIV-positive client who is on antiretroviral therapy complains of anorexia, nausea, and vomiting. Which of the following suggestions should the nurse offer the client to cope with this condition?
Ans: Use high-protein supplements
16. A nurse is caring for a client who has just delivered a baby. Which of the following information should the nurse give the client regarding hepatitis B vaccination for the baby?
Ans: Vaccine consists of a series of three injections given within 6 months
14. A nurse is caring for a pregnant client in her second trimester of pregnancy. The nurse educates the client to look for which of the following danger signs of pregnancy needing immediate attention by the physician.
Ans: Vaginal bleeding
The nurse is conducting a follow-up visit for a 13-year-old girl who has been treated for pelvic inflammatory disease. Which remark indicates a need for further teaching? a."I should be tested for other sexually transmitted diseases." b."Douching is not necessary and can cause bacteria to flourish." c."I cannot have sex again until my partner is treated." d."My partner needs to be treated with antibiotics."
Answer: c The girl's partner should be treated, but she must strongly encourage the girl to require her partner to wear a condom every time they have sex, even after he undergoes antibiotic therapy. The other statements are accurate.
A nurse suspects that a 6-year-old girl is being sexually maltreated by her father, based on some comments made by the girl. Which of the following methods would be most effective in confirming the nurse's suspicion? a) Assess the girl for unexplained fractured bones b) Check for any sexual perpetrators listed in the area under Megan's law c) Ask the girl's mother what she knows of the father's activities d) Ask the girl to draw a picture of what happened
Ask the girl to draw a picture of what happened
A pregnant client and her husband are at their first prenatal visit. While performing the admission history, the nurse notes several new and old bruises on the woman's neck and body. She is silent and withdrawn. The husband answers all the questions. Based on these observations, the nurse suspects intimate partner violence. Which of the following is the most appropriate nursing intervention at this time? a) Ask the woman if she would like her husband to wait outside in the lobby. b) Ask the husband to wait in the lobby while the client is being examined. c) Ask the couple if they would like to see a social worker. d) Ask the husband if he feels the client has been depressed throughout the pregnancy.
Ask the husband to wait in the lobby while the client is being examined.
A woman comes to a local community health care facility with her partner. She has a broken arm and bruises on the face that she reports were caused by a fall. The nature of the injuries, however, causes the nurse to be convinced that this is a case of physical abuse. Which intervention should the nurse perform? a) Tell the partner to leave the room immediately b) Ask the partner directly if he was responsible c) Attempt to interview the woman in private d) Question the client about the injury in front of the partner
Attempt to interview the woman in private
23.A nurse is conducting a class for a local woman's group about recommendations for a Pap smear. One of the participants asks, At what age should a woman have her first Pap smear? The nurse responds by stating that a woman should have her first Pap smear at which age? A) 18 B) 21 C) 25 D) 28
B) 21
When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which of the following would be most appropriate? A) Monthly visits until 32 weeks, then bi-monthly visits B) Bi-monthly visits until 28 weeks, then weekly visits C) Monthly visits until 20 weeks, then bi-monthly visits D) Bi-monthly visits until 36 weeks, then weekly visits
B) Bi-monthly visits until 28 weeks, then weekly visits
A group of nursing students are preparing a presentation for their class about measures to prevent toxoplasmosis. Which of the following would the students be least likely to include? Select all that apply. A) Washing raw fruits and vegetables before eating them B) Cooking all meat to an internal temperature of 140 F C) Wearing gardening gloves when working in the soil D) Avoiding contact with a cats litter box.
B) Cooking all meat to an internal temperature of 140 F
A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects that theclient has an infection. When gathering additional information, which of the following would thenurse be least likely to identify as placing the client at risk for an infection? A) Recent antibiotic therapy for an upper respiratory infection B) Last menstrual period about 5 days ago. C) Weekly douching D) Frequent use of feminine hygiene sprays
B) Last menstrual period about 5 days ago
When discussing fetal mortality with a group of students, a nurse addresses maternal factors. Which of the following would the nurse most likely include? Select all that apply. A) Chromosomal abnormalities B) Malnutrition C) Preterm cervical dilation D) Underlying disease condition E) Poor placental attachment
B) Malnutrition C) Preterm cervical dilation D) Underlying disease condition
When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle? A) Menstrual B) Proliferative C) Secretory D) Ischemic
B) Proliferative
Which of the following statements is accurate regarding women's health care in today's system? A) Women spend 95 cents of every dollar spent on health care. B) Women make almost 90% of all health caredecisions. C) Women are still the minority in the United States. D) Men use more health services than women
B) Women make almost 90% of all health caredecisions.
The nurse would anticipate a cesarean birth for a client who has which active infection present at the onset of labor? A. Hepatitis B. Herpes simplex virus C. Toxoplasmosis D. Human papillomavirus
B. -Herpes exposure during the birth process poses a high risk for mortality to the neonate. If the woman has active herpetic lesions in the genital tract, a surgical birth is planned to avoid this exposure. - Hepatitis is a chronic liver disorder, and the fetus if exposed would at most become a carrier; a surgical birth would not be expected for this woman. -Toxoplasmosis is passed through the placenta to the fetus prior to birth, so a cesarean birth would not prevent exposure. -HPV would be manifested clinically by genital warts on the woman, and a surgical birth would not be anticipated to prevent exposure unless the warts caused an obstruction.
A nurse is massaging a postpartum client's fundus and places the nondominant hand on the area above the symphysis pubis based on the understanding that this action: A) Determines that the procedure is effective B) Helps support the lower uterine segment C) Aids in expressing accumulated clots D) Prevents uterine muscle fatigue
B. The nurse places the nondominant hand on the area above the symphysis pubis to help support the lower uterine segment. The hand, usually the dominant hand that is placed on the fundus, helps to determine uterine firmness (and thus the effectiveness of the massage). Applying gentle downward pressure on the fundus helps to express clots. Overmassaging the uterus leads to muscle fatigue.
A nurse is reviewing the medical record of a client. Which of the following would lead the nurse to suspect that the client is experiencing polycystic ovary syndrome? (Select all that apply.) A) Decreased androgen levels B) Elevated blood insulin levels C) Anovulation D) Waist circumference of 32 inches E) Triglyceride level of 175 mg/dL F) High-density lipoprotein level of 40 mg/dL
BCE
5. A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor? A) Supine B) Lithotomy C) Upright D) Knee-chest
C. The use of any upright position helps to reduce the length of labor. - The knee-chest position would assist in rotating the fetus in a posterior position.
17. The nurse is reviewing the medical record of a woman in labor and notes that the fetal position is documented as LSA. The nurse interprets this information as indicating which of the following is the presenting part? A) Occiput B) Face C) Buttocks D) Shoulder
C. - The second letter denotes the presenting part which in this case is "S" or the sacrum or buttocks. - The letter "O" would denote the occiput or vertex presentation. - The letter "M" would denote the mentum (chin) or face presentation. - The letter "A" would denote the acromion or shoulder presentation.
When applying the ultrasound transducers for continuous external electronic fetal monitoring, at which location would the nurse place the transducer to record the FHR? A) Over the uterine fundus where contractions are most intense B) Above the umbilicus toward the right side of the diaphragm C) Between the umbilicus and the symphysis pubis D) Between the xiphoid process and umbilicus
C. - The ultrasound transducer is positioned on the maternal abdomen in the midline between the umbilicus and the symphysis pubis. - The tocotransducer is placed over the uterine fundus in the area of greatest contractility.
Mammography is recommended for a client diagnosed with intraductal papilloma. Which factor should the nurse ensure when preparing the client for a mammography?
Client has not applied deodorant on the day of testing. When preparing a client for mammography, the nurse should ensure the client has not applied deodorant or powder on the day of testing because these products can appear on the x-ray film as calcium spots. It is not necessary for the client to avoid fluid intake 1 hour prior to testing. Mammography has to be scheduled just after the client's menses to reduce chances of breast tenderness, not when the client is going to start her menses. The client can take aspirin or acetaminophen after the completion of the procedure to ease any discomfort, but these medications are not taken before mammography.
A nurse is caring for a female client with urinary incontinence. Which instructions should the nurse include in the client's teaching plan to reduce the incidence or severity of incontinence? Select all that apply. Continue pelvic floor exercises. Increase fiber in the diet. Increase intake of orange juice. Control blood glucose levels. Wipe from back to front.
Continue pelvic floor exercises. Increase fiber in the diet. Control blood glucose levels. The teaching guidelines include continuing pelvic floor (Kegel) exercises, increasing fiber in the diet to reduce constipation, and controlling blood glucose levels to prevent polyuria. The nurse should instruct the client to reduce the intake of fluids and foods that are bladder irritants, such as orange juice, soda, and caffeine, and the client should wipe from front to back to prevent urinary tract infections.
The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time? A) Dysuria B) Dyspnea C) Constipation D) Urinary frequency
D. Lightening refers to the descent of the fetal head into the pelvis and engagement. With this descent, pressure on the diaphragm decreases, easing breathing, but pressure on the bladder increases, leading to urinary frequency. Dysuria might indicate a urinary tract infection. Constipation may occur throughout pregnancy due to decreased peristalsis, but it is unrelated to lightening.
A postmenopausal woman reports that she has started spotting again. Which of the following would the nurse do? A. Instruct the client to keep a menstrual diary for the next few months. B. Tell her not to worry, since this a common but not serious event. C. Have her start warm-water douches to promote healing. D. Anticipate that the doctor will assess her endometrium thickness.
D. Any postmenopausal bleeding is suspicious for endometrial cancer. This event warrants immediate evaluation, which would include an endometrial biopsy.
A nurse is teaching a preconception class discussing the process of conception. Which information would the nurse likely include? A. Conception occurs when the sperm travels through the vagina to unite with the ovum. B. Conception occurs when a zygote travels through the vagina to meet the sperm. C. Conception occurs when an ovum passes into the uterus to unite with sperm. D. Conception occurs when an ovum passes into a fallopian tube to unite with sperm.
D. Conception occurs when an ovum passes into a fallopian tube to unite with sperm
A fetal nuchal translucency test, as seen on ultrasound, may be suggestive of the presence of trisomy 21 or Down syndrome if what is found?
Increased nuchal thickness
A client diagnosed with fibroadenoma is worried about the chances of developing breast cancer. She also asks the nurse about various breast disorders and their risks. Which benign breast disorder should the nurse include as having the greatest risk for the development of breast cancer?
Intraductal papilloma The nurse should inform the client that intraductal papillomas and fibrocystic breasts, although considered benign, carry a cancer risk with prolific masses and hyperplastic changes within the breasts. Other benign breast disorders such as mastitis, mammary duct ectasia, and fibroadenomas carry little risk. (
A woman is crying because she just recently received the results of her biopsies, and they confirm that she has invasive breast cancer. Which response by the nurse is the most appropriate?
Listen to the woman talk and remain silent for a while When a woman first receives the devastating news of the diagnosis of cancer, most often the best response is to allow the woman to express her feelings and concerns before speaking. Giving her false reassurances is not therapeutic and can break reliability and trust in a provider/patient relationship. Attempting to give her information about groups or next steps before she is in a state to take it in is also nontherapeutic
A nurse is preparing a presentation for a health fair about preventing breast cancer. Which of the following would the nurse include?
Maintaining an ideal weight Maintaining an ideal weight decreases the risk of breast cancer. Having no children or having children after age 30 is associated with an increased risk for breast cancer. Some breast tumors are hormone dependent, such that estrogen (or progesterone) enhances tumor growth. Women are advised to avoid the consumption of alcohol, not caffeine, because alcohol correlates with an increased risk of breast cancer
When assessing a postpartum mother, the nurse asks the client how many peripads she has used over the last 4 hours. The mother responds that she has changed her pad 2 to 3 times per hour when they were saturated. What action should the nurse take
Notify the RN of the finding
During a recent visit to the clinic a woman presents with erythema of the nipple and areola on the right breast. She states this started several weeks ago and she was fearful of what would be found. The nurse suspects
Paget's disease Paget's disease presents with erythema of the nipple and areola. Peau d'orange is associated with breast cancer and is caused by interference with lymphatic drainage. Nipple inversion is considered normal if long-standing; if it is associated with fibrosis and is a recent development, malignancy is suspected. Acute mastitis is associated with lactation but may occur at any age.
45-year-old woman comes into the OB/GYN clinic for her yearly check-up. The woman mentions to the nurse that she has a dimpling of the right breast that has occurred in the last 2 weeks. She has not performed a self-breast examination. What assessment would be appropriate for the nurse to make?
Palpate the area for a breast mass It would be most important for the nurse to palpate the breast to determine the presence of a mass. Edema and pitting of the skin may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance (peau d'orange), a classic sign of advanced breast cancer. Evaluation of milk production is required in lactating women. There is no indication of lactation in the scenario. A mammogram is an appropriate diagnostic test, but unless the nurse is a practitioner this would not be within the nurse's realm of practice. A referral could be made to a physician but the nurse would not proceed to schedule a biopsy
A nurse is caring for a 45-year-old client using a pessary to help decrease leakage of urine and support a prolapsed vagina. Which recommendation is most commonly provided to a client regarding pessary care? Douche the vaginal area with diluted vinegar or hydrogen peroxide. Remove the pessary twice weekly, and clean it with soap and water. Use estrogen cream to make the vaginal mucosa more resistant to erosion. Remove the pessary before sleeping or intercourse.
Remove the pessary twice weekly, and clean it with soap and water. The most common recommendation for pessary care is removing the pessary twice weekly and cleaning it with soap and water. In addition, douching with diluted vinegar or hydrogen peroxide helps to reduce urinary tract infections and odor, which are side effects of using a pessary. Estrogen cream is applied to make the vaginal mucosa more resistant to erosion and strengthen the vaginal walls. Removing the pessary before sleeping or intercourse is not part of the instructions for pessary care.
A nurse is providing discharge teaching to a client who needs Kegel exercises to strengthen the pelvic floor muscles. Which guideline would be appropriate to teach the client? Repeat Kegel exercises once a week. Try to bring up the entire pelvic floor and bear down 3 times. Squeeze the muscles in your rectum as when you are trying to prevent passing flatus. Contract and relax the pubococcygeus muscle rapidly 2 times.
Squeeze the muscles in your rectum as when you are trying to prevent passing flatus. Teaching guidelines for teaching clients about Kegel exercises include the following: Exercises should be repeated 5 times a week; the pelvic floor should be raised followed by bearing down 10 times. Contraction and relaxation of the pubococcygeus muscle should be done 10 times quickly. The only correct guideline listed here is to squeeze the muscles in your rectum as when you are trying to prevent passing flatus.
normal hemoglobin level in pregnancy
There can be a 20% increase in the total number of red blood cells but the amount of plasma increases even more causing dilution of those red cells in the body. A hemoglobin level of pregnancy can naturally lower to 10.5 gm/dL representing a normal anemia of pregnancy.
A nurse is conducting an awareness session on sexual abuse, and she is explaining the psychological profile of an average abuser. Which trait is often displayed by abusers? a) They belong to the low-income group. b) They are usually physically imposing. c) They have parents who are divorced. d) They exhibit antisocial behaviors.
They exhibit antisocial behaviors.
A nurse is caring for a woman who has just been diagnosed with cancer (CIS) of the cervix. The nurse should prepare the women for which of the following treatments? a) Cervical conization with follow-up Pap smears and colposcopy b) Uterine artery embolization (UAE) c) Hysterectomy d) Internal and external radiation therapy
a: CIS is atypical and noninvasive, therefore a conization with Pap smears and follow-up is the treatment of choice. UAE is the treatment for removal of fibroid tumors. The other two choices are radical since this is noninvasive
A pregnant woman with diabetes is having a glycosylated hemoglobin level drawn. Which result would require the nurse to revise the client's plan of care? a) 6.0% b) 8.5% c) 7% d) 5.5%
b) 8.5% Rationale: A glycosylated hemoglobin level of more than 8% indicates poor control and the need for intervention, necessitating a revision in the woman's plan of care.
The nursing instructor is teaching the student about cervical cancer and tells her that it is the one cancer whose incidence and mortality rates have greatly decreased in the past several decades. This can be attributed to which of the following? a) dilation and curettage (D&C;) b) pap tests c) vaginal ultrasounds d) biopsies
b: The incidence and mortality rates of cervical cancer have decreased noticeably in the past several decades, with most of the reduction attributed to the Pap test. The other tests are not used to screen for cervical cancer
A woman with a positive history of genital herpes is in active labor. She has small pin-point vesicles in the perineum area. Her membranes are ruptured, she is dilated 5cm, effaced 70%. The nurse should anticipate what type of delivery? a) Forceps assisted. b) Vacuum assisted. c) Cesarean. d) Spontaneous vaginal.
c) Cesarean. Rationale: An active herpes infection can be passed to the fetus during labor or with ruptured amniotic membranes. The nurse should anticipate the infant will be delivered via a cesarean birth. The risk of transmitting herpes to the baby would be increased if the baby were born by spontaneous vaginal delivery, vacuum assisted delivery, or forceps assisted delivery.
Which of the following changes in pregnancy would the nurse identify as a contributing factor for arterial thrombosis, especially for the woman with atrial fibrillation? a) Increased cardiac output b) Elevation of diaphragm c) Hypercoagulable state d) Increase in blood volume
c) Hypercoagulable state Rationale: The nurse should identify that the increased risk of arterial thrombosis in atrial fibrillation is due to hypercoagulable state of pregnancy. During pregnancy there is a state of hypercoagulation. This increases the risk of arterial thrombosis in clients having atrial fibrillation and artificial valves. Increased cardiac output and blood volume do not cause arterial thrombosis. Elevation of the diaphragm is due to the uterine distension and it causes a shift in the QRS axis and is not a associated with arterial thrombosis.
The nursing student correctly identifies which of the following age group to be when ovarian cancer occurs more frequently? a) 35-55 years of age b) over 70 years of age c) 55-75 years of age d) 25-50 years of age
c: Older women are at risk for ovarian cancer. It occurs most frequently in women between 55 and 75 years of age
When assessing amniotic fluid a ratio of more than 2 of Lecithin-to-sphingomyelin ratio (L/S) generally indicates what?
fetal pulmonary maturity
_____ occurs as the vertex meets resistance from the cervix, walls of the pelvis, or pelvic floor
flexion
A nurse is assessing a client who comes to the clinic reporting urinary incontinence. The nurse suspects that the client may be experiencing urge incontinence based on which findings? Select all that apply. frequency pain on urination nocturia small volume of urine leakage burning when urinating
frequency nocturia Urge incontinence is characterized by urgency, frequency, nocturia, and a large amount of urine loss. There is no pain or burning.
Manual removal of the placenta or excessive traction on the umbilical cord can lead to uterine inversion, which in turn would result in ___________.
hemorrhage
The nurse in a sexual health clinic is reviewing the history of a 30-year-old homosexual client who is an IV drug addict and diagnosed with a sexually transmitted infection. Which therapy would the nurse expect to include in his care?
hepatitis A and hepatitis B recombinant vaccine
During an admission assessment of a client in labor, the nurse observes that there is no vaginal bleeding yet. What nursing intervention is appropriate in the absence of vaginal bleeding? A. Monitor vital signs B. Assess amount of cervical dilation C. Obtain urine speicmen for urinalysis D. Monitor hydration status
if vaginal bleeding is absent during admission assessment, nurse should perform vaginal examination to assess amount of cervical dilation
The postpartum client is reporting her left calf hurts and it is making it difficult for her to walk. The nurse predicts which factor is contributing to this situation after finding an area of warmth and redness?
increased coagulation factors
The nurse is assessing a postpartum woman and is concerned the client may be hemorrhaging. Which assessment finding is the nurse finding most concerning?
increased heart rate
Pelvic phase of the second stage of labor
is characterized by complete cervical dilation and effacement, with strong contractions every 2 to 3 minutes; the mother focuses on pushing.
By 36 weeks of gestation the fundus is located ___________________
just below the xiphoid process
how does blood circulate w/in a fetus?
oxygenated blood is arrives from placenta, half goes through capillaries in liver, while the other half enters inferior vena cava via ductus venosus. from the inferior vena cava, blood [oxygenated] travels to right atrium, then is shunted into the left atrium via foramen ovale, then to the left ventricle. from there, the majority of the blood is pushed to the parts that need it most. the brain & the heart, while a little bit is sent to the lungs to keep them nourished. the blood enters the descending aorta, where it makes its way back to the placenta, via the umbilical arteries.
During the birth, the primary care provider performed an episiotomy. The client is now reporting discomfort. To reduce this discomfort and increase hygiene to the perineum, the nurse would encourage the client to use which intervention?
peribottle and warm water
When the uterus contracts so frequently and with such intensity that a very rapid birth will take place it is called
precipitate labor
genetic counseling
process by which the patients or relatives at risk of an inherited disorder are advised of the consequences and nature of the disorder, the probability of developing or transmitting it, and the options open to them in management and family planning.
A female client comes to the clinic for an evaluation. Assessment reveals flu-like symptoms and a maculopapular rash on her trunk, and the palms of her hands and the soles of her feet. The client also reports hair loss and fatigue. She states, "I had a small ulcer near my vagina about 6 weeks ago that went away." Based on these findings, the nurse suspects that the client has syphilis at which stage?
secondary
The nurse who counsels women who suffer from abuse understands that abuse can come in different forms that include which of the following? (Check all that apply.) a) sexual abuse b) spiritual abuse c) physical abuse d) financial abuse e) emotional abuse
sexual abuse physical abuse financial abuse emotional abuse
After teaching a group of college students about the modes of transmission for herpes simplex virus, the nurse determines that additional teaching is needed when the group identifies which mode of transmission?
sharing contaminated needles
The _________________ approach of the procedure chorionic villus sampling requires the client to have a full bladder to push the uterus into a position accessible to the catheter.
transcervical
The nurse is assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms?
trichomoniasis
The _________________ is the measurement from the anterior surface of the sacral prominence to the posterior surface of th einferior margin of the symphysis pubis.
true conjugate (obstetric conjugate) *Can't truly be measured so determined by subtracting 1 to 2 cm from the diagonal conjugate
The nurse is reviewing with a new client the diagnosis of polycystic ovarian syndrome (PCOS). Which long-term health problems would the nurse review as a risk with this syndrome? migraine celiac disease type 2 diabetes cellulitis
type 2 diabetes With PCOS, the client is at risk for long-term health issues such as reproductive cancers, cardiovascular disease, hypertension, type 2 diabetes, and dyslipidemia. Migraines can be caused by many unknown factors and appear in numerous disorders. Celiac disease is not associated with PCOS. Cellulitis is an acute infection, not a long-term health issue.
A nurse is teaching a pregnant woman at risk for preterm labor about what to do if she experiences signs and symptoms. The nurse determines that the teaching was successful when the woman states that if she experiences any symptoms, she will do which of the following? A) "I'll sit down to rest for 30 minutes." B) "I'll try to move my bowels." C) "I'll lie down with my legs raised." D) "I'll drink several glasses of water."
"I'll drink several glasses of water." If the woman experiences any signs and symptoms of preterm labor, she should stop what she is doing and rest for 1 hour, empty her bladder, lie down on her side, drink two to three glasses of water, feel her abdomen and note the hardness of the contraction, and call her health care provider and describe the contraction.
A woman is scheduled for an anterior and posterior colporrhaphy as treatment for a cystocele. When the nurse is explaining this treatment to the client, which of the following descriptions would be most appropriate to include? A) "This procedure helps to tighten the vaginal wall in the front and back so that your bladder and urethra are in the proper position." B) "Your uterus will be removed through your vagina, helping to relieve the organ that is putting the pressure on your bladder." C) "This is a series of exercises that you will learn to do so that you can strengthen your bladder muscles." D) "These are plastic devices that your physician will insert into your vagina to provide support to the uterus and keep it in the proper position."
A
A woman with polycystic ovary syndrome tells the nurse, "I hate this disease. Just look at me! I have no hair on the front of my head but I've got hair on my chin and upper lip. I don't feel like a woman anymore." Further assessment reveals breast atrophy and increased muscle mass. Which nursing diagnosis would most likely be a priority? A) Situational low self-esteem related to masculinization effects of the disease B) Social isolation related to feelings about appearance C) Risk for suicide related to effects of condition and fluctuating hormone levels D) Ineffective peripheral tissue perfusion related to effects of disease on vasculature
A
After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse determines that the teaching was successful when the woman identifies which of the following as being good sources of iron in her diet? (Select all that apply.) A) Dried fruits B) Peanut butter C) Meats D) Milk E) White bread
A) Dried fruits B) Peanut butter C) Meats
Which of the following is a priority when caring for a woman during the fourth stage of labor? A) Assessing the uterine fundus B) Offering fluids as indicated C) Encouraging the woman to void D) Assisting with perineal care
A. During the fourth stage of labor, a priority is to assess the woman's fundus to prevent postpartum hemorrhage.
11. The nurse is caring for a client at the prenatal care clinic. The client reports to the nurse that she heard her baby referred to as an embryo. The client questions what this means. What statement by the nurse is most appropriate?
Ans: "The products of conception become an embryo around 2 weeks after conception and until it becomes a fetus."
In a client's seventh month of pregnancy, she reports feeling ìdizzy, like I'm going to pass out, when I lie down flat on my back.î The nurse integrates which of the following in to the explanation? A) Pressure of the gravid uterus on the vena cava B) A 50% increase in blood volume C) Physiologic anemia due to hemoglobin decrease D) Pressure of the presenting fetal part on the diaphragm
Ans: A The client is describing symptoms of supine hypotension syndrome, which occurs when the heavy gravid uterus falls back against the superior vena cava in the supine position. The vena cava is compressed, reducing venous return, cardiac output, and blood pressure, with increased orthostasis. The increased blood volume and physiologic anemia are unrelated to the client's symptoms. Pressure on the diaphragm would lead to dyspnea.
After teaching a group of students about fetal development, the instructor determines that the teaching was successful when the students identify which of the following as providing the barrier to other sperm after fertilization? A) Zona pellucida B) Zygote C) Cleavage D) Morula
Ans: A Feedback: The zona pellucida is the clear protein layer that acts as a barrier to other sperm once one sperm enters the ovum for fertilization. The zygote refers to the union of the nuclei of the ovum and sperm resulting in the diploid number of chromosomes. Cleavage is another term for mitosis. The morula is the result of four cleavages leading to 16 cells that appear as a solid ball of cells. The morula reaches the uterine cavity about 72 hours after fertilization.
A woman with placenta previa is being treated with expectant management. The woman and fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that home care might be inappropriate? A) "My mother lives next door and can drive me here if necessary." B) "I have a toddler and preschooler at home who need my attention." C) "I know to call my health care provider right away if I start to bleed again." D) "I realize the importance of following the instructions for my care."
Ans: B Having a toddler and preschooler at home needing attention suggest that the woman would have difficulty maintaining bed rest at home. Therefore, expectant management at home may not be appropriate. Expectant management is appropriate if the mother and fetus are both stable, there is no active bleeding, the client has readily available access to reliable transportation, and can comprehend instructions.
A pregnant woman comes to the clinic and tells the nurse that she has been having a whitish vaginal discharge. The nurse suspects vulvovaginal candidiasis, based on which assessment finding? A) Fever B) Vaginal itching C) Urinary frequency D) Incontinence
Ans: B Vaginal secretions become more acidic, white, and thick during pregnancy. Most women experience an increase in a whitish vaginal discharge, called leukorrhea. This is normal except when it is accompanied by itching and irritation, possibly suggesting Candida albicans, a monilial vaginitis, which is a very common occurrence in this glycogen-rich environment. Fever would suggest a more serious infection. Urinary frequency occurs commonly in the first trimester, disappears during the second trimester, and reappears during the third trimester. Incontinence would not be associated with a vulvovaginal candidiasis. Incontinence would require additional evaluation.
The nurse is discussing the insulin needs of a primiparous client with diabetes who has been using insulin for the past few years. The nurse informs the client that her insulin needs will increase during pregnancy based on the nurse's understanding that the placenta produces: A) hCG, which increases maternal glucose levels B) hPL, which deceases the effectiveness of insulin C) Estriol, which interferes with insulin crossing the placenta D) Relaxin, which decreases the amount of insulin produced
Ans: B hPL acts as an antagonist to insulin, so the mother must produce more insulin to overcome this resistance. If the mother has diabetes, then her insulin need would most likely increase to meet this demand. hCG does not affect insulin and glucose level. Estrogen, not estriol, is believed to oppose insulin. In addition, insulin does not cross the placenta. Relaxin is not associated with insulin resistance.
After teaching a group of students about fetal development, the instructor determines that the teaching was successful when the students identify which of the following as essential for fetal lung development? A) Umbilical cord B) Amniotic fluid C) Placenta D) Trophoblasts
Ans: B Feedback: Amniotic fluid is essential for fetal growth and development, especially fetal lung development. The umbilical cord is the lifeline from the mother to the growing embryo. The placenta serves as the interface between the mother and developing fetus. It secretes hormones and supplies the fetus with nutrients and oxygen needed for growth. The trophoblasts differentiate into all the cells that form that placenta.
After teaching a group of nursing students about the possible causes of spontaneous abortion, the instructor determines that the teaching was successful when the students identify which of the following as the most common cause of first trimester abortions? A) Maternal disease B) Cervical insufficiency C) Fetal genetic abnormalities D) Uterine fibroids
Ans: C The causes of spontaneous abortion are varied and often unknown. The most common cause for first-trimester abortions is fetal genetic abnormalities, usually unrelated to the mother. Chromosomal abnormalities are more likely causes in first trimester and maternal disease is more likely in the second trimester. Those occurring during the second trimester are more likely related to maternal conditions, such as cervical insufficiency, congenital or acquired anomaly of the uterine cavity (uterine septum or fibroids), hypothyroidism, diabetes mellitus, chronic nephritis, use of crack cocaine, inherited and acquired thrombophilias, lupus, polycystic ovary syndrome, severe hypertension and acute infection such as rubella virus, cytomegalovirus, herpes simplex virus, bacterial vaginosis, and toxoplasmosis.
15. A nurse is performing a detailed newborn assessment of a female baby. Which of the following observations indicate a normal finding? Select all that apply
Ans: Mongolian spots Ans: Swollen genitals Ans: Short, creased neck
13. The nurse is required to monitor a pregnant client with fallopian tube rupture. Which of the following interventions should a nurse perform to identify development of hypovolemic shock in this client?
Ans: Monitor the client's vital signs, bleeding
15. A nurse is caring for a female client who is undergoing treatment for genital warts ude to HPV. Which of the following information should the nurse include when educating the client about the risk of cervical cancer? Select all that apply
Ans: Obtaining Pap smears regularly helps early detection of cervical cancer Ans: Recurrence of genital warts increase risk of cervical cancer Ans: Use of latex comdoms is associated with a lower rate of cervical cancer
9. A client who has a breastfeeding newborn complains of sore nipples. Which of the following interventions can the nurse suggest to alleviate the client's condition?
Ans: Offer suggestions based on observation to correct positioning or latching.
1. A nurse is assigned to care for a client who has to undergo a forceps and vacuum-assisted birth. The nurse understands that which of the following factors has contributed to a forceps and vacuum-assisted birth
Ans: Prolonged second stage of labor
A nurse is reviewing the medical record of a pregnant woman and notes that she is gravid II. The nurse interprets this to indicate the number of: A) Deliveries B) Pregnancies C) Spontaneous abortions D) Pre-term births
B) Pregnancies
When teaching a woman how to perform Kegel exercises, the nurse explains that these exercises are designed to strengthen which muscles? A) Gluteus B) Lower abdominal C) Pelvic floor D) Diaphragmatic
C
morula
a solid ball of cells resulting from division of a fertilized ovum, and from which a blastula is formed. pg. 337
A woman with an artificial mitral valve develops heart failure at the 20th week of pregnancy. Which of the following measures would you stress with her during the remainder of the pregnancy? a) Obtaining enough rest b) Beginning a low-impact aerobics program c) Discontinuing her prepregnancy anticoagulant d) Maintaining a high fluid intake
a) Obtaining enough rest Rationale: As the blood volume doubles during pregnancy, heart failure can occur. The pregnant woman needs to obtain adequate rest to prevent overworking the heart. Fluid may need to be restricted.
A nurse informs a pregnant woman with cardiac disease that she will need two rest periods each day and a full night's sleep. The nurse further instructs the patient that the best position for this rest is which of the following? a) left lateral recumbent b) right lateral recumbent c) prone d) on her back
a) left lateral recumbent Rationale: The pregnant woman should rest in the left lateral recumbent position to prevent supine hypotension syndrome and increased heart effort.
A nurse is assessing a 20-year-old female. Which of the data findings below taken during the history would indicate endometrial cancer? a) Vaginal bleeding that is painless and abnormal b) Severe back pain c) Diagnosis of diabetes mellitus d) Diagnosis of liver disease
a: A finding of abnormal bleeding that is painless is a major sign of endometrial cancer. The diagnoses of liver disease and diabetes mellitus are risk factors for women. Back pain can be associated with many things including ovarian cancer
A nurse is speaking to a local women's group about the various types of cancer affecting the female reproductive tract. The nurse explains that ovarian cancer is the leading cause of death from gynecologic malignancies based on the understanding that this type of cancer: a) Typically manifest with vague symptoms resulting in late diagnosis b) Is closely associated with highly resistant sexually transmitted infections c) Arises from extremely rare types of cells that are resistant to treatment d) Spreads more easily than other female reproductive cancers
a: Tumors of the ovary have been lethal largely because they present with nonspecific symptoms and therefore frequently are far advanced and inoperable by the time they are diagnosed. Ease of spread and types of cells involved are not reasons underlying the fatal nature of this type of cancer. Ovarian cancer is not associated with sexually transmitted infections. Cervical cancer is linked to human papilloma virus infection.
When dealing with a pregnant adolescent, the nurse assists the client to integrate the tasks of pregnancy while at the same time fostering development of which of the following? a) Trust b) Self-identity c) Autonomy d) Dependence
b) Self-identity Rationale: The nurse assists the pregnant adolescent to integrate the tasks of pregnancy, bonding, and preparing to care for another with the tasks of developing self-identity and independence. Trust is a developmental task of infancy. Autonomy is a developmental task of toddlerhood. Independence, not dependence, is fostered.
Which risk factors are associated with vaginal cancer? Select all that apply. a) Persistent ovulation over time b) HIV infection c) Hormone replacement therapy for more than 10 years d) Smoking e) Advancing age
b, d, e: Although direct risk factors for the initial development of vaginal cancer have not been identified, associated risk factors include advancing age ( greater than 60 years old), human immunodeficiency virus (HIV) infection, smoking, previous pelvic radiation, exposure to diethylstilbestrol (DES) in utero, vaginal trauma, history of genital warts (human papilloma virus [HPV] infection), cervical cancer, chronic vaginal discharge, and low socioeconomic level. Persistent ovulation over time and hormone replacement therapy for more than 10 years are risk factors associated with ovarian cancer
A pregnant client with sickle cell anemia is at an increased risk for having a sickle cell crisis during pregnancy. Aggressive management for a client experiencing a sickle cell crisis with severe pain includes which measure? a) Acetaminophen (Tylenol) for pain b) Antihypertensive drugs c) Diuretic drugs d) I.V. fluids
d) I.V. fluids Rationale: A sickle cell crisis during pregnancy is usually managed by exchange transfusion, oxygen, and I.V. fluids. Antihypertensive drugs usually aren't necessary. Diuretics wouldn't be used unless fluid overload resulted. The client usually needs a stronger analgesic than acetaminophen to control the pain of a crisis.
The postmenopausal woman who has bleeding and spotting and cannot tolerate a endometrial biopsy in the office would expect to have which of the following tests done to rule out endometrial cancer? a) pelvic exam b) abdominal ultrasound c) pap smear d) transvaginal ultrasound
d: If an endometrial biopsy is inconclusive for cancer, then the patient would have a transvaginal ultrasound to evaluate the endometrial cavity and measure the thickness of the endometrial lining. A pelvic exam and pap smear are not tests used to diagnose this disease
Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection?
dysuria
Contractions every 5 minutes with cervical dilation of 3 cm is typical of the _______ phase.
latent
A male client appears in the walk-in clinic and requests treatment for trichomoniasis as his girlfriend was recently diagnosed with it. What medication would the health care provider most likely prescribe?
metronidazole
A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?
metronidazole
At 16 weeks' gestation the fundus can be palpated ____________________
midway between the symphysis and the umbilicus
Too much amniotic fluid, termed polyhydraminos is more than ________________ mL.
more than 2000 mL *Associated with diabetes and neural tube defects*
A client has presented to the clinic for diagnostic studies to evaluate her for polycystic ovary syndrome. Which test should be included? pregnancy test CBC with PT, PTT lipid panel hormone levels
pregnancy test Diagnostic tests will include a pregnancy test to rule out ectopic pregnancy. A CBC with PT, PTT, lipid panel, and hormone levels may also be ordered based on the client's complaints and evaluation.
A nurse is meeting with a client who developed overdistention of the abdominal muscles during her pregnancy. Which action should the nurse prioritize to best assist this client recover from this situation?
suggest proper exercise
Latent phase of labor:
- is characterized by mild contractions every 5 to 10 minutes, -cervical dilation of 0 to 3 cm - effacement of 0% to 40%, - excitement and frequent talking by the mother.
A pregnant woman in her 39th week of pregnancy presents to the clinic with a vaginal infection. She tests positive for chlamydia. What would this disease make her infant at risk for? A. blindness B. neonatal laryngeal papillomas C.deafness D. chicken pox
A A pregnant woman who contracts chlamydia is at increased risk for spontaneous abortion (miscarriage), preterm rupture of membranes, and preterm labor. The postpartum woman is at higher risk for endometritis (Fletcher & Ball, 2006). The fetus can encounter bacteria in the vagina during the birth process. If this happens, the newborn can develop pneumonia or conjunctivitis that can lead to blindness.
Assessment of a postpartum client reveals a firm uterus with bright-red bleeding and a localized bluish bulging area just under the skin at the perineum. The woman also is complaining of significant pelvic pain and is experiencing problems with voiding. The nurse suspects which of the following? A) Hematoma B) Laceration C) Bladder distention D) Uterine atony
A The woman most likely has a hematoma based on the findings: firm uterus with bright-red bleeding; localized bluish bulging area just under the skin surface in the perineal area; severe perineal or pelvic pain; and difficulty voiding.
11.The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? A) Currently there is no reliable screening test for ovarian cancer. B) A Pap smear is almost always helpful in identifying this type of cancer. C) Theres a blood test for a marker, CA-125, that if elevated indicates cancer. D) A genetic test for two genes, if positive, will identify the ovarian cancer.
A) Currently there is no reliable screening test for ovarian cancer.
The nurse is teaching a pregnant woman about how to prevent contracting cytomegalovirus (CMV) during pregnancy. What tips would the nurse share with this client? Select all that apply. A. Do not share food or drinks with young children, especially if they are in daycare. B. If you develop any flu-like symptoms, notify your physician immediately to be evaluated for CMV. C. Wash your hands thoroughly with soap and water after touching saliva or urine. D. If you have CMV, it is suggested that you not breast-feed your infant. E. If you contract CMV, your doctor will give you some oral medicine to treat it.
A,B,C R: Cytomegalovirus (CMV) is a mild infection and women may not know they have contracted it. The problem arises when a pregnant woman contracts it during the first 20 weeks of gestation. Prevention is the key, so the nurse would reinforce handwashing, not eating or drinking from a container after a small child has done so, and notifying the physician if the client develops mild flu-like symptoms so she can be tested to rule out CMV.
A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects trichomoniasis based on which of the following? (Select all that apply.) A) Urinary frequency B) Yellow/green discharge C) Joint pain D) Blister-like lesions E) Muscle aches
Ans: A, B Feedback: Manifestations of trichomoniasis include a yellow/green or gray frothy or bubbly discharge, dysuria, urinary frequency, and irritation or itching of the genital area. Joint pain suggesting arthritis is associated with gonorrhea. Blister-like lesions and muscle aches would suggest genital herpes.
When describing an episode, the victim reports that she attempted to calm her partner down to keep things from escalating. This behavior reflects which phase of the cycle of violence? A) Battering B) Honeymoon C) Tension-building D) Reconciliation
Ans: C Feedback: During the first phase, tension-building, the woman attempts to keep the situation from exploding based on her belief that the partner's anger is legitimately directed at her. The battering phase involves the explosion of violence. The honeymoon or reconciliation phase is manifested by a period of calm, loving, contrite behavior on the part of the batterer. The batterer may be genuinely sorry for the pain he caused.
Which approach would be most appropriate when counseling a woman who is a suspected victim of violence? A) Offer her a pamphlet about the local battered women's shelter. B) Call her at home to ask her some questions about her marriage. C) Wait until she comes in a few more times to make a better assessment. D) Ask, "Have you ever been physically hurt by your partner?"
Ans: D Feedback: If violence is suspected, the nurse must use direct or indirect questions to screen for abuse. Asking the woman if she has ever been physically hurt by her partner is most appropriate. Offering her a pamphlet, calling her at home, or waiting until she returns are inappropriate and do not validate the suspicion.
Which of the following statements would be most appropriate to empower victims of violence to take action? A) "Give your partner more time to come around." B) "Remember—children do best in two-parent families." C) "Change your behavior so as not to trigger the violence." D) "You are a good person and you deserve better than this."
Ans: D Feedback: To help the woman gain control over her life, the nurse should emphasize that abuse is never okay and that the woman did not deserve the abuse or ask for it. Telling the woman to give her partner more time, saying that children need two parents, and suggesting that she change her behavior do not promote control; rather, they attempt to excuse the partner's behavior.
12. A client has just been told she is pregnant with twins. The ultrasound reveals that the babies are monozygotic. She has several questions about her babies. What information should be shared with the client by the nurse?
Ans: "Your babies likely will share the same placenta" Ans: "Your babies have developed from a single fertilized egg" Ans: "Your babies will be very similar in appearance"
12. The nurse is required to assess a pregnant client who is complaining of vaginal bleeding. Which of the following assessment should be considered as a priority by the nurse?
Ans: Assessing the amount and color of the bleeding
A client with hyperemesis gravidarum is admitted to the facility after being cared for at home without success. Which of the following would the nurse expect to include in the client's plan of care? A) Clear liquid diet B) Total parenteral nutrition C) Nothing by mouth D) Administration of labetalol
Ans: C Typically, on admission, the woman with hyperemesis has oral food and fluids withheld for the first 24 to 36 hours to rest the gut and receives parenteral fluids to rehydrate and reduce the symptoms. Once the condition stabilizes, oral intake is gradually increased. Total parenteral nutrition may be used if the client's condition does not improve with several days of bed rest, gut rest, IV fluids, and antiemetics. Labetalol is an antihypertensive agent that may be used to treat gestational hypertension, not hyperemesis.
The nurse is caring for a woman experiencing hypertonic uterine dystocia. The woman's contractions are erratic in their frequency, duration, and of high intensity. The priority nursing intervention would be to: A. Encourage ambulation every 30 minutes B. Provide pain relief measures C. Monitor the Pitocin infusion rate closely D. Prepare the woman for an amniotomy
B. as women with hypertonic uterine contractions experience a high level of pain related to the high intensity of contractions. - Providing comfort measures along with pharmacologic agents to reduce would be a priority. - Response "A" is incorrect since a woman experiencing a high level of pain secondary to contraction intensity would not feel like ambulating during this challenging time period. - Response "C" is incorrect because with this type of dystocia, augmentation of labor contractions would not be needed. If Pitocin had been infusing prior to the identification of this dystocia pattern, it would be discontinued to reduce the intensity of the contractions.
1. A woman in her 40th week of pregnancy calls the nurse at the clinic and says she's not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor? A) "I'm feeling contractions mostly in my back." B) "My contractions are about 6 minutes apart and regular." C) "The contractions slow down when I walk around." D) "If I try to talk to my partner during a contraction, I can't."
C
A client is diagnosed with an enterocele. The nurse interprets this condition as: A) Protrusion of the posterior bladder wall downward through the anterior vaginal wall B) Sagging of the rectum with pressure exerted against the posterior vaginal wall C) Bulging of the small intestine through the posterior vaginal wall D) Descent of the uterus through the pelvic floor into the vagina
C
After teaching a group of students about female reproductive anatomy, the instructor determines that the teaching was successful when the students identify which of the following as the site of fertilization? A) Vagina B) Uterus C) Fallopian tubes D) Vestibule
C) Fallopian tubes
After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicates successful teaching? A) I should take my iron with milk. B) I should avoid drinking orange juice. C) I need to eat foods high in fiber. D) I'll call the doctor if my stool is black and tarry.
C) I need to eat foods high in fiber.
4. A client is scheduled to have a Pap smear. After the nurse teaches the client about the Pap smear, which of the following client statements indicates successful teaching? A)I need to douche the night before with a mild vinegar solution. B) I will take a bath first thing that morning to make sure I'm clean. C) I will not engage in sexual intercourse for 48 hours before the test. D)I will get a clean urine specimen when I first wake up the morning of the test.
C) I will not engage in sexual intercourse for 48 hours before the test.
A nurse is developing cultural competence. Which of the following indicates that the nurse is in the process of developing cultural knowledge? Select all that apply. A) Examiningpersonal sociocultural heritage B) Reviewing personal biases and prejudices C) Seeking resources to further understanding of other cultures D) Becoming familiar with other culturally diverse lifestyles E) Performing a competent cultural assessment F) Advocating for social justice to eliminate disparities.
C) Seeking resources to further understanding of other cultures D) Becoming familiar with other culturally diverse lifestyles
The nurse would prepare a client for amnioinfusion when which action occurs? A) Maternal pushing is compromised due to anesthesia. B) The fetus shows abnormal fetal heart rate patterns. C) Severe variable decelerations occur and are due to cord compression. D) Fetal presenting part fails to rotate fully and descend into the pelvis.
C) Severe variable decelerations occur and are due to cord compression. Indications for amnioinfusion include severe variable decelerations resulting from cord compression, oligohydramnios (decreased amniotic fluid), postmaturity, preterm labor with rupture of the membranes, and thick meconium fluid. Failure of the fetal presenting part to rotate fully, descend in the pelvis, abnormal fetal heart rate patterns or acute pulmonary edema, and compromised maternal pushing sensations from anesthesia are indications for forceps-assisted birth, and not for amniofusion.
18.A nurse is assisting with the collection of a Pap smear. When collecting the specimen, which of the following is done first? A) Insertion of the speculum B) Swabbing of the endocervix C) Spreading of the labia D) Insertion of the cytobrush
C) Spreading of the labia
During a routine prenatal check up, the nurse interviews a pregnant client to identify possible risk factors for developing gestational diabetes. Which factor would the nurse identify as increasing the woman's risk? Select all that apply. A. younger maternal age at pregnancy B. previous birth of small for gestational age baby C. maternal obesity with body mass index more than 35 D. client of African-American lineage E. previous history of spontaneous abortion
C,E R:The risk factors for gestational diabetes include previous history of spontaneous abortion, maternal obesity with body mass index (BMI) more than 35, and client of a high-risk ethnic group such as Native American, Hispanic, Asian. The other risk factors for gestational diabetes are previous history of stillbirth, birth of large for gestational age infant, and advancing maternal age.
After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicates successful teaching? A) I should take my iron with milk. B) I should avoid drinking orange juice. C) I need to eat foods high in fiber. D) I'll call the doctor if my stool is black and tarry.
C. Iron supplements can lead to constipation, so the woman needs to increase her intake of fluids and high-fiber foods. Milk inhibits absorption and should be discouraged. Vitamin C-containing fluids such as orange juice are encouraged because they promote absorption.
A woman in labor who received an opioid for pain relief develops respiratory depression. The nurse would expect which agent to be administered? A) Butorphanol B) Fentanyl C) Naloxone D) Promethazine
C. Naloxone is an opioid antagonist used to reverse the effects of opioids such as respiratory depression.
A female client with metastatic breast disease is receiving trastuzumab as part of her immunotherapy. The client has nausea, fatigue, diarrhea, appears jaundice, and has a distended abdomen. What would the nurse do next?
Notify the healthcare provider Adverse effects of trastuzumab include cardiac toxicity, vascular thrombosis, hepatic failure, fever, chills, nausea, vomiting, and pain with first infusion. The nurse should monitor for these adverse effects with the first infusion of trastuzumab. The nurse would notify the health care provider since the client is showing signs of hepatic failure.
During a follow-up visit, a female client who underwent a mastectomy asks the nurse if she can work in her backyard or at least do some household work. Which suggestion would be most appropriate?
Wear gloves and protective clothing to avoid any injuries The nurse should recommend that the client wear gloves when doing backyard work or housework to prevent injuries that may heal slowly or become infected. Working whether it be in the backyard or doing some household chores can be helpful in promoting feelings of usefulness, thereby enhancing the client's coping abilities and self-esteem. She could be advised to follow up more frequently however, this would not help prevent any untoward injury (less)
The nursing instructor is teaching about Bartholin cysts and informs the students that Bartholin cysts are the most common cystic growth in the vulva. She describes this type of cyst as being: a benign proliferation composed of smooth muscle and fibrous connective tissue in the uterus. a swollen, fluid-filled, sac-like structure. a small growth that is benign. an abnormal opening between a genital tract organ and and another organ.
a swollen, fluid-filled, sac-like structure. A Bartholin cyst is a swollen, fluid-filled, sac-like structure that results when one of the ducts of the Bartholin's gland becomes blocked. A uterine fibroid is a benign proliferation composed of smooth muscle and fibrous connective tissue in the uterus. A fistual is a abnormal opening between a genital tract organ and another organ. A polyp is a small benign growth
A pregnant woman with type 2 diabetes is scheduled for a laboratory test of glycosylated hemoglobin (HbA). What does the nurse tell the patient is a normal level for this test? a) 6% b) 14% c) 8% d) 12%
a) 6% Rationale: The upper normal level of HbA is 6% of total hemoglobin.
The nurse should encourage a pregnant client who is taking short-acting insulin for her diabetes to avoid eating after self-administering the insulin. a) False b) True
a) False Rationale: Caution women with diabetes to eat almost immediately after injecting short-acting insulin to prevent hypoglycemia before mealtimes.
A nurse is educating a 25-year-old client with a family history of cervical cancer. Which test should the nurse inform the client about to detect cervical cancer at an early stage? a) Papanicolaou test b) CA-125 blood test c) Transvaginal ultrasound d) Blood tests for mutations in the BRCA genes
a: The client should have Papanicolaou tests regularly to detect cervical cancer during the early stages. Blood tests for mutations in the BRCA genes indicate the lifetime risk of the client of developing breast or ovarian cancer. CA-125 is a biologic tumor marker associated with ovarian cancer, but it is not currently sensitive enough to serve as a screening tool. The transvaginal ultrasound can be used to detect endometrial abnormalities
A 25-year-old woman is at the doctor for her annual check-up. The nurse educated the woman on risks for cervical cancer. Which of the following questions would be important to ask as part of a risk screening? a) "Were you sexually active at an early age?" b) "Do you have a history of high blood pressure?" c) "Have you had problems trying to get pregnant?" d) "How long have you been severely overweight?"
a: Women that have a history of sexual activity within the first year of getting their menstrual cycle are at increased risk cervical cancer later in life. Infertility, obesity, and high blood pressure put woman more at risk for endometrial cancer.
A woman with a long history of controlled asthma has just had her first antenatal visit for her fourth child. She is late for a meeting and says she knows what to do. What is the best action the nurse can take? a) Note in the chart that the woman was not counseled about her asthma. b) Acknowledge her need to leave but ask her to demonstrate the use of her inhaler and her peak flow meter before she goes; make any necessary corrections to her technique. Remind her to take her regular medications. c) Remind her to continue taking her asthma medications, to monitor her peak flow daily, and to monitor the baby's kicks in the second and third trimesters. d) Schedule an appointment for her to return to discuss her asthma management.
b) Acknowledge her need to leave but ask her to demonstrate the use of her inhaler and her peak flow meter before she goes; make any necessary corrections to her technique. Remind her to take her regular medications. Rationale: Management of asthma during pregnancy is very important, the nurse must document the patient has the proper ability to manage her asthma for her health and the health of the fetus. Reminding the patient to continue taking her prescribed medication to monitor her peak flow daily is not enough. It is the nurse's responsibility to KNOW that the patient knows how to take her medications. Monitoring the baby's kicks in the second and third trimester is an appropriate action. Scheduling a return appointment to discuss asthma management is not appropriate. She could have an asthma attack between the time you see her and the time you schedule a return appointment. Noting in the chart that the woman was not counseled does not relieve the nurse of her obligation to ensure that the woman knows how to use her inhaler and her peak flow meter.
When educating a pregestational patient on how to control her blood sugar, the nurse knows there are three main facets to glycemic control: diet, exercise and _______. Which of the following is the third facet? a) Glucose tablets b) Insulin c) Folic acid d) Niacin
b) Insulin Rationale: The three main facets to glycemic control for the woman with pregestational diabetes are diet, exercise, and insulin. Folic acid does not impact glycemic control. Glucose tablets are not a facet of glycemic control.
A client in her fifth month of pregnancy is having a routine clinic visit. The nurse should assess the client for which common second trimester condition? a) Metabolic alkalosis b) Physiological anemia c) Mastitis d) Respiratory acidosis
b) Physiological anemia Rationale: Hemoglobin level and hematocrit decrease during pregnancy as the increase in plasma volume exceeds the increase in red blood cell production. Mastitis is an infection in the breast characterized by a swollen tender breast and flulike symptoms. This condition is most commonly seen in breast-feeding clients. Alterations in acid-base balance during pregnancy result in a state of respiratory alkalosis, compensated by mild metabolic acidosis.
A nurse is assessing a woman who has a history of genital warts (HPV). The nurse understands that this increases the risk of vulvar cancer. The nurse should teach which of the following prevention methods to decrease the risk of cancer? a) The woman should use oral contraceptives instead of using barrier methods. b) The woman should avoid tight undergarments. c) A genital exam should be done by the woman herself only. d) A genital exam should be completed by the health care provider only. e) The woman should take OTC drugs to self-medicate and treat lesions.
b: The nurse should instruct the woman to wear loose fitting undergarments. The woman should do a genital exam herself and seek an exam from a provider. The woman should not self-medicate and should seek assistance to treat lesions. A barrier method should be used to decrease transmission of STIs
A client presents at a community health care center for a routine check-up. The client wants to know about any tests that can effectively detect ovarian cancer early. About which test that can aid in the detection of ovarian cancer should the nurse inform the client? a) Serum CA-125 b) Yearly bimanual pelvic examinations c) Pap smear d) Regular x-rays of the pelvic area
b: To identify ovarian masses in their early stages, the client needs to have yearly bimanual pelvic examinations. Pap smears are not effective enough to detect ovarian masses. The U.S. Preventive Services Task Force recommends against routine screening for ovarian cancer with serum CA-125 because the potential harm could outweigh the potential benefits. X-rays of the pelvic area do not detect ovarian masses
You are doing patient teaching with a 28 weeks' gestation woman who has tested positive for gestational diabetes mellitus (GDM). What would be important to include in your patient teaching? a) Her baby is at increased risk for neonatal diabetes mellitus. b) She is at increased risk for type I diabetes mellitus after her baby is born. c) She is at increased risk for type II diabetes mellitus after her baby is born. d) Her baby is at increased risk for type I diabetes mellitus.
c) She is at increased risk for type II diabetes mellitus after her baby is born. Rationale: The woman who develops GDM is at increased risk for developing type 2 DM after pregnancy.
A pregnant woman diagnosed with cardiac disease 4 years ago is told that her pregnancy is a high-risk pregnancy. The nurse then explains that the danger occurs primarily because of the increase in circulatory volume. The nurse informs the patient that the most dangerous time for her is when? a) in weeks 12-20 b) in weeks 8-12 c) in weeks 28-32 d) in weeks 20-28
c) in weeks 28-32 Rationale: The danger of pregnancy in a woman with cardiac disease occurs primarily because of the increase in circulatory volume. The most dangerous time for a woman is in weeks 28 to 32, just after the blood volume peaks.
The nurse is helping an indigent HIV-positive pregnant patient set up a postdelivery care plan for her baby. What is an appropriate question/statement during that discussion? a) "You understand that you can't breast-feed, right? Even though formula's expensive, you'll need to figure out a way to get it." b) "You're not planning to breast-feed are you? That would be dangerous for the baby." c) "HIV can be passed to the baby from breast-feeding so it's important that you give the baby formula. You probably can't afford formula can you?" d) "HIV can be passed to the baby from breast-feeding so it's important that you give the baby formula. Formula's pretty expensive so I'll give you some information for places you can contact if you ever need some help getting it."
d) "HIV can be passed to the baby from breast-feeding so it's important that you give the baby formula. Formula's pretty expensive so I'll give you some information for places you can contact if you ever need some help getting it." Rationale: HIV is possible to transmit via breastfeeding and formula is the only option for feeding. The nurse needs to provide positive information and offer to make referral or get assistance for the patient in financial need. Assuming the patient understands the reason she cannot breastfeed is not adequate nursing care. The patient needs the nurse to explain to her the reason for not breastfeeding her infant. Option B is incorrect as it does not fully answer the question being asked. Option C is inappropriate because telling the patient that she probably can't get formula since it is expensive is inappropriate. It is a negative comment about the patient and her status in life.
A pregnant woman in her 39th week of pregnancy presents to the clinic with a vaginal infection. She tests positive for chlamydia. What would this make her infant at risk for? a) Neonatal laryngeal papillomas b) Deafness c) Chicken pox d) Blindness
d) Blindness Rationale: A pregnant woman who contracts chlamydia is at increased risk for spontaneous abortion (miscarriage), pre-term rupture of membranes, and pre-term labor. The postpartum woman is at higher risk for endometritis (Fletcher & Ball, 2006). The fetus can encounter bacteria in the vagina during the birth process. If this happens, the newborn can develop pneumonia or conjunctivitis that can lead to blindness.
A menopausal woman is prescribed estrogen along with progestin. She asks the nurse why she has to take both of them as she only wants to take the estrogen. What should the nurse tell this patient? a) The physician always orders it this way. b) It is given to most patients this way. c) This is what the drug book recommends. d) Estrogen without progestin can lead to cancer of the endometrium.
d: Giving estrogen without progestin for hormone replacement can lead to an increased risk for endometrial cancer. The other explanations are not accurate or informative. They also do not give the rationale for ordering the two medications together.
The nurse is reviewing information with a client who was just diagnosed with endometrial cancer. Which of the following treatment options should the nurse review for this diagnosis? a) Removal of uterus b) Follow-up care after treatment, which should last for at least 6 months c) Radiation and chemotherapy if advanced stages d) Removal of uterus, fallopian tubes, and ovaries
d: In endometrial cancer, the best treatment is have surgery and remove the uterus, fallopian tubes, and ovaries. It is best to remove tubes and ovaries because in this cancer, tumor cells spread early to the ovaries, and any cells that are left dormant are at risk for being stimulated to grow by estrogen. Radiation and chemotherapy are for advanced stages. Follow-up should be provided every 3 to 4 months for 2 years
The ___________ layer of the embryonic cell forms the central nervous system, special senses, skin, and glands
ectoderm
The nurse is making a home visit to a woman who is 5 days postpartum and has no reports. Which finding would concern the nurse and warrant further investigation?
lochia rubra
mosaicism
the property or state of being composed of cells of two genetically different types.
A woman has been given the diagnosis of uterine fibroids. Prescribed treatment consists of gonadotropin-releasing hormone (GnRH). The nurse is teaching her client about the side effects of this medication. Which side effect would be important to include in the explanation? increased vaginal discharge vaginal dryness urinary tract infection vaginitis
vaginal dryness Side effects of GnRH include hot flashes, vaginal dryness, headaches, mood changes, depression, bone loss, and musculoskeletal malaise. Other side effects require use of a pessary, a hard plastic or rubber device placed in the vagina for support
A nurse is educating a group of students in the community clinic about pelvic organ prolapse. What can be a cause of this disorder? facial surgery employment that requires no lifting history of trouble gaining weight weakening of pelvic support related to birth trauma
weakening of pelvic support related to birth trauma Pelvic organ prolapse can be caused by downward gravity from being an erect human, atrophy of muscles with aging and decreasing hormones, obesity, lifting heavy objects, reproductive surgery, and weak pelvic support due to birth trauma. The other choices do not cause pelvic organ prolapse.
A nurse is interviewing a rape victim who was assaulted 6 month ago. Which questions should the nurse ask the client to know the extent of physical symptoms of PTSD? Select all that apply. a) "Are you having trouble sleeping?" b) "Do you have heart palpitations or sweating?" c) "Do you ever feel as you are reliving the event?" d) "Do you feel numb emotionally?" e) "Have you felt irritable or experienced outbursts of anger?"
• "Are you having trouble sleeping?" • "Have you felt irritable or experienced outbursts of anger?" • "Do you have heart palpitations or sweating?" • "Do you ever feel as you are reliving the event?"
At 20 weeks the fundus can be palpated at
the umbilicus
A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure?
"I'm temporarily not contagious once the warts are destroyed."
A client at 32 weeks' gestation has recently been diagnosed with acute herpes type 2. The client asks what can happen to the baby as a result of this infection. How should the nurse best respond?
"There is a chance your baby may have a form of cognitive challenge."
Which of the following statements might empower abuse victims to take action? a. "You deserve better than this." b. "Your children deserve to grow up in a two-parent family." c. "Try to figure out what you do to trigger his abuse and stop it." d. "Give your partner more time to come to his senses about this."
"You deserve better than this."
When does the perineal phase of the second stage occurs
- Period of active pushing - with complete cervical dilation and effacement, contractions occurring every 2 to 3 minutes and lasting 60 to 90 seconds, and a tremendous urge to push by the mother.
A nurse has been invited to speak at a local high school about adolescent pregnancy. When developing the presentation, the nurse would incorporate information related to which of the following? (Select all that apply.) A) Peer pressure to become sexually active B) Rise in teen birth rates over the years. C) Latinas as having the highest teen birth rate D) Loss of self-esteem as a major impact E) Majority of teen pregnancies in the 1517-year-old age group
A) Peer pressure to become sexually active C) Latinas as having the highest teen birth rate D) Loss of self-esteem as a major impact
A group of students are reviewing risk factors associated with postpartum hemorrhage. The students demonstrate understanding of the information when they identify which of the following as associated with uterine tone? (Select all that apply.) A) Rapid labor B) Retained blood clots C) Hydramnios D) Operative birth E) Fetal malposition
A, C Risk factors associated with uterine tone include hydramnios, rapid or prolonged labor, oxytocin use, maternal fever, or prolonged rupture of membranes. Retained blood clots are a risk factor associated with tissue retained in the uterus. Fetal malposition and operative birth are risk factors associated with trauma of the genital tract.
There is a danger of _____________________ if engagement has not occured with the sudden release of fluid and pressure with spontaneous rupture of membranes (PROM)
cord prolapse
A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes? Select all that apply. A. previous large for gestational age (LGA) infant B. hypertension C. maternal age less than 18 years D. obesity E. genitourinary tract abnormalities
A,B,D R: Obesity, hypertension, and a previous infant weighing more than 9 lb (4 kg) are risk factors for developing gestational diabetes. Maternal age less than 18 years and genitourinary tract abnormalities do not increase the risk of developing gestational diabetes.
embryonic stage
end of the second week through the eighth week. pg. 336
A woman who immigrated here from a third world country presents to the clinic to find out if she is pregnant. Which signs and/or symptoms would the nurse assess as possible indicators that she might have an active case of tuberculosis as well? Select all that apply. A. anorexia B. hemoptysis C. weight gain D. night sweats E. fatigue
A,B,D,E R: Women emigrating from developing countries are at high risk for tuberculosis. Clinical manifestations include fatigue, fever or night sweats, nonproductive cough, weakness, slow weight loss, anemia, hemoptysis, and anorexia.
A woman who immigrated here from a third world country presents to the clinic to find out if she is pregnant. Which signs and/or symptoms would the nurse assess as possible indicators that she might have an active case of tuberculosis as well? Select all that apply. A. anorexia B. hemoptysis C. weight gain D. night sweats E. fatigue
A,B,D,E Women emigrating from developing countries are at high risk for tuberculosis. Clinical manifestations include fatigue, fever or night sweats, nonproductive cough, weakness, slow weight loss, anemia, hemoptysis, and anorexia.
A nurse is assessing a newborn and suspects that the mother may have abused alcohol during her pregnancy. The nurse suspect this based on which newborn findings? Select all that apply. A. small head circumference B. thin upper lip C. large inset eyes D. macrocephaly E. limb abnormality
A,B,E R: Characteristics of FASD include craniofacial dysmorphia (thin upper lip, small head circumference, and small eyes), IUGR, microcephaly, and congenital anomalies such as limb abnormalities and cardiac defects.
24. During a follow-up prenatal visit, a pregnant woman asks the nurse, "How long do you think I will be in labor?" Which response by the nurse would be most appropriate? A) "It's difficult to predict how your labor will progress, but we'll be there for you the entire time." B) "Since this is your first pregnancy, you can estimate it will be about 10 hours." C) "It will depend on how big the baby is when you go into labor."
A. It is difficult to predict how a labor will progress and therefore equally difficult to determine how long a woman's labor will last.
7. The fetus of a nulliparous woman is in a shoulder presentation. The nurse would most likely prepare the client for which type of birth? A) Cesarean B) Vaginal C) Forceps-assisted D) Vacuum extraction
A. The fetus is in an oblique lie with the shoulder as the presenting part, necessitating a cesarean birth.
Because a pregnant clients diabetes has been poorly controlled throughout her pregnancy, the nurse would be alert for which of the following in the neonate at birth? A)Macrosomia B)Hyperglycemia C)Low birth weight D)Hypobilirubinemia
A. -Poorly controlled diabetes during pregnancy can result in macrosomia due to hyperinsulinemia stimulated by fetal hyperglycemia. -Typically the neonate is hypoglycemic due to the ongoing hyperinsulinemia that occurs after the placenta is removed. - Infants of diabetic women typically are large and are at risk for hyperbilirubinemia due to excessive red blood cell breakdown.
The nurse is performing Leopold's maneuvers to determine fetal presentation, position, and lie. Which action would the nurse do first? A) Feel for the fetal buttocks or head while palpating the abdomen. B) Feel for the fetal back and limbs as the hands move laterally on the abdomen. C) Palpate for the presenting part in the area just above the symphysis pubis. D) Determine flexion by pressing downward toward the symphysis pubis.
A. - The first maneuver involves feeling for the buttocks and head. - Next the nurse palpates on which side the fetal back is located. - The third maneuver determines presentation and involves palpating the area just above the symphysis pubis. - The final maneuver determines attitude and involves applying downward pressure in the direction of the symphysis pubis.
The nurse is caring for a client experiencing a prolonged second stage of labor. The nurse would place priority on preparing the client for which intervention? A) a forceps and vacuum-assisted birth B) a cesarean birth C) a precipitous birth D) artificial rupture of membranes
A. - a forceps and vacuum-assisted birth A forceps-and-vacuum-assisted birth is required for the client having a prolonged second stage of labor. * The client may require a cesarean birth if the fetus cannot be delivered with assistance.
A client in labor is administered lorazepam to help her relax enough so that she can participate effectively during her labor process rather than fighting against it. For which adverse effect of the drug should the nurse monitor? A. Increased sedation B. Newborn respiratory depression C. Nervous system depression D. Decreased alertness
A. - increase sedation is an adverse effect of lorezapam - diazepam and midazolam cause CNS depression - opiods cause newborn respiration depression
A nurse palpates a woman's fundus to determine contraction intensity. Which of the following would be most appropriate for the nurse to use for palpation? A) Finger pads B) Palm of the hand C) Finger tips D) Back of the hand
A. To palpate the fundus for contraction intensity, the nurse would place the pads of the fingers on the fundus and describe how it feels.
A nurse is describing the different types of regional analgesia and anesthesia for labor to a group of pregnant women. Which statement by the group indicates that the teaching was successful? A) "We can get up and walk around after receiving combined spinal-epidural analgesia." B) "Higher anesthetic doses are needed for patient-controlled epidural analgesia. C) "A pudendal nerve block is highly effective for pain relief in the first stage of labor." D) "Local infiltration using lidocaine is an appropriate method for controlling contraction pain."
A. When compared with traditional epidural or spinal analgesia, which often keeps the woman lying in bed, combined spinal-epidural analgesia allows the woman to ambulate ("walking epidural").
A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. Which of the following would the nurse do next? A) Check the fetal heart rate. B) Perform a vaginal exam. C) Notify the physician immediately. D) Change the linen saver pad.
A. When membranes rupture, the PRIORITY focus is on assessing fetal heart rate first to identify a deceleration, which might indicate cord compression secondary to cord prolapse.
Which of the following dietary and lifestyle modifications might the nurse recommend to help prevent pelvic relaxation as women age? a. Eat a high-fiber diet to avoid constipation and straining. b. Avoid sitting for long periods; get up and walk around frequently. c. Limit the amount of exercise to prevent overdeveloping muscles. d. Space children a year apart to reduce wear and tear on the uterus.
A. Preventing constipation and straining with defecation would lessen the strain on pelvic organs. *B is incorrect: sitting for long periods will not affect pelvic organ movement. Gravity will create a downward pull on all organs regardless of the position, sitting or standing.
The nurse is concerned that a new mother is developing a postpartum complication. What did the nurse most likely assess in this patient?
Absence of lochia
A Chinese mother delivers her newborn and is ready to go home. The grandmother is present and will remain with the mother for 1 month. The grandmother tells the nurse that the mother will not be allowed to leave the house for the first month after delivery. How should the nurse respond to this statement?
Accept the grandmother's statement and do discharge teaching accordingly
What prenatal test takes a sample of the woman's blood to evaluate plasma protein. Increased levels indicate a neural defect and decreased levels indicated Down syndrome.
Alpha-fetoprotein *Performed between 15 and 18 weeks*
2. Which of the following organs is responsible for providing lubrication during intercourse?
Ans: Bartholin glands
7. Which of the following exercises should a nurse suggest to the client during the first day of postpartum?
Ans: Kegel exercises
14. Which of the following indicates meconium aspiration in a newborn?
Ans: Stained unbilical cord
Which instruction should the nurse give to a client with genital herpes to help control the infection?
Avoid sexual contact until sores heal.
Maternal assessment during labor and birth inlcudes what?
Assessment of maternal vital signs Review of the prenatal record If NO vaginal bleeding, vaginal examination Evaluate maternal pain
The nurse is teaching a pregnant woman with iron deficiency anemia about foods high in iron. Which foods if selected by the woman indicate a successful teaching program? Select all that apply. A. potatoes B. broccoli C. peanut butter D. corn E. yogurt F. raisins
B,C,F R:Foods high in iron include dried fruits such as raisins, whole grains, green leafy vegetables such as broccoli and spinach, peanut butter, and iron-fortified cereals. Potatoes and corn are high in carbohydrates. Yogurt is a good source of calcium.
3. When assessing cervical effacement of a client in labor, the nurse assesses which of the following characteristics? A) Extent of opening to its widest diameter B) Degree of thinning C) Passage of the mucous plug D) Fetal presenting part
B. Effacement refers to the degree of thinning of the cervix. Cervical dilation refers to the extent of opening at the widest diameter. occurs with bloody show is a .
A woman in labor is to receive continuous internal electronic fetal monitoring. The nurse reviews the woman's medical record to ensure which of the following as being required? A) Intact membranes B) Cervical dilation of 2 cm or more C) Floating presenting fetal part D) A neonatologist to insert the electrode
B. For continuous internal electronic fetal monitoring, four criteria must be met: 1. ruptured membranes 2. cervical dilation of at least 2 cm 3. fetal presenting part low enough to allow placement of the electrode 4. skilled practitioner available to insert the electrode.
The primary care provider has prescribed estrogen replacement therapy (ERT) for a menopausal woman who has been diagnosed with pelvic organ prolapse (POP). The client asks the nurse why she needs to be on hormones. Which would be the nurse's best response? A. Hormone replacement will decrease blood perfusion and the elasticity of the vaginal wall. B. Hormone replacement will increase blood perfusion and the elasticity of the vaginal wall. C. Hormone replacement will increase the blood perfusion and decrease the elasticity of the vaginal wall. D. Hormone replacement will decrease blood perfusion and increase the elasticity of the vaginal wall.
B. Hormone replacement will increase blood perfusion and the elasticity of the vaginal wall. Hormone replacement therapy may improve the tone and vascularity of the supporting tissue in perimenopausal and menopausal women by increasing blood perfusion and the elasticity of the vaginal wall.
A young woman who is pregnant for the first time goes to the clinic for her first prenatal visit. During the interview, she informs the primary are provider that there is no history of genetic defects in her or her husband's family. What test will most likely be prescribed for this client as a routine screening? A. amniocentesis B. MSAFP C. CVS D. PPD
B. Maternal Serum Alpha-fetoprotein (MSAFP) Test Rationale: Routine test
Which client immunization titer is most important to assess and document in the prenatal record of the pregnant woman? A. Polio B. Rubella C. Rotavirus D. Diphtheria
B. Rubella
When measuring the diagonal conjugate of a woman's pelvis, the distance between which anatomic landmarks would be used? A. When measuring the diagonal conjugate of a woman's pelvis, the distance between which anatomic landmarks would be used? B. anterior surface of the sacral prominence and the anterior surface of the symphysis pubis medial surface of the ischial tuberosities C. interior surface of the sacral prominence and the posterior surface of the symphysis pubis D. posterior surface of sacrum and the axis of the ischial tuberosities
B. anterior surface of the sacral prominence and the posterior surface of the symphysis pubis
A postpartum patient is prescribed docusate sodium (Colace) as treatment for constipation. What should the nurse include when teaching the patient about this medication? Select all that apply.
Be sure to engage in activity to aid in intestinal motility; This medication works the best when a high-fiber diet is consumed; and take each dose of the medication with a full glass of water or juice
The nurse is assisting a new mother who just transferred from the PACU. The nurse determines the client has already been adapting to her role as a mother by performing which actions of the first stage of adaptation?
Beginning attachment and preparation for family
A nurse is preparing a presentation for a local community group about health status and children's health. Which of the following would the nurse include as one of the most significant measures? A) Fetal mortality rate B) Neonatal mortality rate C) Infant mortality rate D) Maternal mortality rate
C) Infant mortality rate
A pregnant woman has a rubella titer drawn on her first prenatal visit. The nurse explains that this test measures which of the following? A) Platelet level B) Rh status C) Immunity to German measles D) Red blood cell count
C) Immunity to German measles
26. Assessment of a pregnant woman reveals that the presenting part of the fetus is at the level of the maternal ischial spines. The nurse documents this as which station? A) -2 B) -1 C) 0 D) +1
C.
A postpartum mother appears very pale and states she is bleeding heavily. The nurse should first: A. Call the client's health care provider immediately. B. Immediately set up an intravenous infusion of magnesium sulfate. C. Assess the fundus and ask her about her voiding status. D. Reassure the mother that this is a normal finding after childbirth.
C. It is important to assess the situation before intervening. In addition, checking the bladder status and emptying a full bladder will correct uterine displacement so that effective contractions to stop bleeding can occur. Assessment of the situation is needed before the nurse can notify the health care provider. At this point, the nurse has no facts to report about the client's condition.
When planning the care of a woman in the active phase of labor, the nurse would anticipate assessing the fetal heart rate at which interval? A) Every 2 to 4 hours B) Every 45 to 60 minutes C) Every 15 to 30 minutes D) Every 10 to 15 minutes
C. During the active phase of labor, FHR is monitored every 15 to 30 minutes.
6. A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating: A) Latent phase of the first stage of labor B) Active phase of the first stage of labor C) Transition phase of the first stage of labor D) Pelvic phase of the second stage of labor
C. The transition phase is characterized by cervical dilation of 8 to 10 cm, effacement of 80% to 100%, contractions that are strong, painful, and frequent (every 1 to 2 minutes) and last 60 to 90 seconds, and irritability, apprehension, and feelings of loss of control.
A nurse is explaining the use of therapeutic touch as a pain relief measure during labor. Which of the following would the nurse include in the explanation? A) "This technique focuses on manipulating body tissues." B) "The technique requires focusing on a specific stimulus." C) "This technique redirects energy fields that lead to pain." D) "The technique involves light stroking of the abdomen with breathing."
C. "This technique redirects energy fields that lead to pain." -Therapeutic touch is an energy therapy and is based on the premise that the body contains energy fields that lead to either good or ill health and that the hands can be used to redirect the energy fields that lead to pain. - Attention focusing and imagery involve focusing on a specific stimulus. - Massage focuses on manipulating body tissues. - Effleurage involves light stroking of the abdomen in rhythm with breathing.
At her 16-week checkup, a client's blood pressure is slightly decreased from her prepregnancy level. The nurse evaluates this change based on which statements concerning blood pressure during pregnancy? A. Normally, blood pressure increases steadily throughout pregnancy. B. Blood pressure remains stable until decreasing the day of the birth. C. A decrease in the second trimester may occur because of placental growth. D. Blood pressure progressively decreases throughout the entire pregnancy.
C. A decrease in the second trimester may occur because of placental growth
The nursing student correctly identifies what information about oogenesis? A. It begins at puberty in the male. B. It is the process by which gametes undergo two sequential cellular divisions of the nucleus. C. It begins in the ovaries before birth but is not fully complete until the childbearing years. D. It is the process by which somatic cells give birth to daughter cells.
C. It begins in the ovaries befire birth but is not fully complete until the childbearing years.
When teaching a group of women about screening and early detection of cervical cancer, the nurse would include which of the following as most effective? A. Fecal occult blood test B. CA-125 blood test C. Pap smear and HPV test D. Sigmoidoscopy
C. Pap smears are done specifically to detect abnormal cells of the cervix that might be cancerous.
A pregnant client wants to know why the labor of a first-time-pregnant woman usually lasts longer than that of a woman who has already delivered once and is pregnant a second time. What explanation should the nurse offer the client? a. Braxton Hicks contractions are not strong enough during first pregnancy b. Contractions are stronger during the first pregnancy than the second c. The cervix takes around 12 to 16 hours to dilate during first pregnancy d. Spontaneous rupture of membranes occurs during first pregnancy
C. The cervix takes around 12 to 16 hours to dilate during first pregnancy
Which of the following is a presumptive sign or symptom of pregnancy? A. Restlessness B. Elevated mood C. Urinary frequency D. Low backache
C. Urinary frequency
A 28-year-old primigravida client with diabetes mellitus, in her first trimester, comes to the health care clinic for a routine visit. The client reports frequent episodes of sweating, giddiness, and confusion. What should the nurse tell the client about these experiences? A. tissue sensitivity to insulin increases as pregnancy advances B. use of insulin needs to be reduced as pregnancy advances C. increased secretion of insulin occurs in the first trimester D. insulin resistance becomes minimal in the latter half of the pregnancy
C. increased secretion of insulin occurs in the first trimester *A woman's insulin secretion works on a supply versus demand mode. As the demand to meet the needs of pregnancy increases, more insulin is secreted.
A nurse is caring for a postpartum client who has a history of thrombosis during pregnancy and is at high risk of developing a pulmonary embolism. For which sign or symptom should the nurse monitor the client to prevent the occurrence of pulmonary embolism? a. sudden change in mental status b. difficulty in breathing c. calf swelling d. sudden chest pain
Calf swelling *swelling in the calf, erythema, and pedal edema are early manifestations of DVT, which may lead to PE
A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse would be alert for which of the following in the newborn? A) Asphyxia B) Clavicular fracture C) Caput succedaneum D) Central nervous system injury
Caput succedaneum Use of forceps or a vacuum extractor poses the risk of tissue trauma, such as ecchymoses, facial and scalp lacerations, facial nerve injury, cephalhematoma, and caput succedaneum.
A nurse is assessing a female client and suspects that the client may have endometrial polyps based on which of the following? A) Bleeding after intercourse B) Vaginal discharge C) Bleeding between menses D) Metrorrhagia
D
A nursing instructor is describing the various childbirth methods. Which of the following would the instructor include as part of the Lamaze method? A) Focus on the pleasurable sensations of childbirth B) Concentration on sensations while turning on to own bodies C) Interruption of the fear-tension-pain cycle D) Use of specific breathing and relaxation techniques
D) Use of specific breathing and relaxation techniques *lamaze is a psychoprophylactic ("mind prevention") method of preparing for labor and birth that promotes the use of specific breathing and relaxation techniques. *The Bradley method emphasizes the pleasurable sensations of childbirth, teaching women to concentrate on these sensations while "turning on" to their own bodies
The health care provider of a newly pregnant client determines the woman also has mitral stenosis and will need appropriate therapy. Which medication should the nurse prepare to teach this client to provide her with the best possible care? A. warfarin B. digoxin C. aspirin D. heparin
D. This client has an increased risk for developing blood clots. If an anticoagulant is required, heparin is the drug of choice as it does not cross the placenta barrier. Warfarin crosses the placenta and may have teratogenic effects. Aspirin is not recommended in this situation. If digoxin is not used to prevent blood clots.
What are the conditions assiciated with early bleeding during pregnancy?
Ectopic pregnancy spontaneous abortion gestational trophoblastic disease
A woman who is 42 weeks pregnant comes to the clinic. Which of the following would be most important? A) Determining an accurate gestational age B) Asking her about the occurrence of contractions C) Checking for spontaneous rupture of membranes D) Measuring the height of the fundus
Determining an accurate gestational age Incorrect dates account for the majority of prolonged or postterm pregnancies; many women have irregular menses and thus cannot identify the date of their last menstrual period accurately. Therefore, accurate gestational dating via ultrasound is essential. - Asking about contractions and checking for ruptured membranes, although important assessments, would be done once the gestational age is confirmed.
After teaching a group of students about pregnancy-related mortality, the instructor determines that additional teaching is needed when the students identify which condition as a leading cause? A) Hemorrhage B) Embolism C) Obstructed labor D) Infection
Embolism
A gravida 4 para 4 mother calls the nurse's station reporting uterine pain following delivery. When the nurse responds to the call, the mother reports that she is having what feels like labor pains again off and on. What would be the nurse's response?
Explain to her that women who have had several babies prior to this delivery often experience afterpains, which is where the uterus is contracting and relaxing at intervals.
While performing leopold maneuvers, if you palpate a hard area on the same side oas the fetal back, what attitude is the fetus in?
Extension *The hard part is the chin
_______________ refers to a procedure in which the fetus is roteated from the breech to the cephalic presentation by manipulation through the mother's abdominal wall at or near term.
External cephalic bersion
A primigravida whose labor was initially progressing normally is now experiencing a decrease in the frequency and intensity of her contractions. The nurse would assess the woman for which condition? A) A low-lying placenta B) Fetopelvic disproportion C) Contraction ring D) Uterine bleeding
Fetopelvic disproportion The woman is experiencing dystocia most likely due to hypotonic uterine dysfunction and fetopelvic disproportion associated with a large fetus. - A low-lying placenta, contraction ring, or uterine bleeding would not be associated with a change in labor pattern.
The mother of four small children comes to the clinic and has just been diagnosed with an enterocele. What should the nurse teach the client about her diagnosis? Her small intestine and peritoneum are jutting downward between the uterus and the rectum. Her rectum is protruding into the back wall of the vagina. Her uterus has prolapsed and is causing this bulge. Her bladder is bulging into the front wall of the vagina.
Her small intestine and peritoneum are jutting downward between the uterus and the rectum. The names of pelvic support disorders correspond to the affected organs. Enterocele occurs when the small intestine and peritoneum jut downward between the uterus and rectum. Cystocele occurs when the bladder bulges into the front wall of the vagina. Rectocele occurs when the rectum protrudes into the back wall of the vagina. Uterine prolapse occurs when the uterus drops down into the vagina.
The nurse is teaching a discharge session to a group of postpartum clients. When asked how long to expect the bleeding, which time frame should the nurse point out?
In approximately 10 days
The nurse explains to a client with a family history of breast cancer the difference between benign and malignant neoplasms. Which of the following is a characteristic of a malignant neoplasm?
Irregular shape and hard Malignant lesions are more likely to be irregularly shaped and hard, and often show secondary signs, such as enlarged lymph nodes in the axillary area, breast asymmetry, nipple retraction, bloody discharge, dimpling, or elevation of one breast. Benign lesions tend to be round or oval with a smooth border and usually show no secondary signs. Furthermore, benign lesions are likely to be movable.
A pregnant client is admitted to a maternity clinic for childbirth. The client wishes to adopt the kneeling position during labor. The nurse knows that which of the following is the advantage of adopting a kneeling position during labor?
It helps to rotate the fetus in a posterior position
When describing sexually transmitted infections and testing, the nurse explains that a client is typically tested for chlamydia, gonorrhea, and syphilis at the same time for which reason?
It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI).
A womant pregnant for at least the third time
Multigravida
A woman who has not produced viable offspring
Nullipara
The __________________ begins with fertilization through the second week also called conception.
Preembryonic stage
A woman pregnant for the first time
Primigravida
A woman who has given birth once after a pregnancy of at least 20 weeks, commonly referred to as a "primip" in clinical practice
Primipara
The nurse is assisting with a physical exam on a child who has been admitted with a diagnosis of possible child abuse. Which of the following findings might alert the nurse to this possibility that the child may have been abused? a) The child has a fractured bone. b) The child has a burn that has not been treated. c) The child has bruises on the knees and elbows. d) The child is hyperactive and angry.
The child has a burn that has not been treated.
How is fetal presenting part determined?
The fetal presenting part is determined by vaginal examination and is commonly the head (cephalic), pelvis (breech), or shoulder.
Obstetric History: GTPAL What does the P stand for?
The number of preterm pregnancies ending >20 weeks or viability but before completion of 37 weeks
A breast tumor is most likely found in what part of the breast?
The upper outer quadrant
A client has been diagnosed with condylomata acuminata and requires treatment for the condition. What would be the treatment of choice?
cryotherapy
A nurse is caring for a female client who has a history of recurring vulvovaginal candidiasis. Which instruction should the nurse include in the teaching session with the client?
Wear white, 100% cotton underpants.
During what week of pregnancy does the fetal heart now beat at a regular rhythm?
Week 5
genes
a unit of heredity that is transferred from a parent to offspring and determines some characteristic of the offspring.
When caring for a client with amniotic fluid embolism, the nurse should monitor for what signs and symptoms?
cyanosis and pulmonary edema *respiratory distress
The women's health clinic nurse is giving a presentation on cancers of the reproductive tract. Which of the following signs and symptoms are abnormal and, if present, should result in notification of a health care provider? Select all that apply. a) Continuous low back pain b) Irregular bowel movements c) Irregular vaginal bleeding d) Increased frequency of urination e) Vulvar lesions of abnormal color that are raised
a, c, e: Abnormal findings that should be reported to the health care provider and could indicate risk of cancer of the reproductive tract are as follows: irregular vaginal bleeding, persistent low backache, and raised or discolored vulvar lesions. Any of these should be reported immediately. Reproductive cancer symptoms do not include urinary frequency and irregular bowel movements
When assessing a woman, which of the following would lead the nurse to suspect cervical cancer? Select all that apply. a) Vaginal bleeding after sexual intercourse b) Pain with vaginal examination c) Postmenopausal bright-red bleeding d) Dysuria e) Malodorous vaginal discharge
a, d, e: Clinically, the first symptom is abnormal vaginal bleeding, usually after sexual intercourse. Other signs and symptoms may include vaginal discomfort, malodorous discharge, and dysuria. Postmenopausal bright-red bleeding and pain during a vaginal examination suggest endometrial cancer
An experienced nurse has just read that women have a one-in-three lifetime risk of developing cancer and becomes concerned that she has provided enough education. What should this nurse do to help prevent deaths from cancer? (Check all that apply.) a) focus on screening b) tell the physcians to do a better job c) there is nothing she can do d) focus on educating all women
a, d: Women do have a one-in-three lifetime risk of developing cancer and one out of every four deaths is from cancer. Therefore, nurses must focus on screening and educating all women regardless of risk factors. The other options are not acceptable
Health clinic nurses are presenting a health fair at a local women's shelter. They are discussing the topic of cervical cancer. Which of the following preventions should be included? Select all that apply. a) Smoking cessation and prohibiting of alcohol consumption b) Maintenance of normal blood pressure and reduction of stress c) Prevention of STIs to decrease risk d) IUD used as a type of contraception e) Encouraging teens to refrain from early sexual activity
a, e: In cervical cancer, high-risk behaviors have been identified as early sexual activity, use of contraception barriers, contracting STIs, and smoking and drinking. Avoidance of these activities is the primary prevention method, along with obtaining the HPV vaccine. Barrier methods, not IUDs, should be used. Avoiding high blood pressure and stress will not prevent cancer
_______________ occurs when the greatest transverse diameter of the head in vertex passess through the pelvic inlet.
engagement
which postoperative intervention should a nurse perform when caring for a client who undergone cesarean birth? A. assess uterine tone and determine fundal firmness B. ensure that the client does not cough or breath deeply
a. * nurse should encoarage client to cough, perform deep-breathing excercises, and use of incentive spirometer every 2 hours
Full-term pregnant client is being assessed for induction of labor. Her bishop score is less than 6. Which order the nurse anticipate? a. insertion of foley catherer into endocervical canal b. prepare client for a cesarian birth c. administer oxytocin IV at 10 mU/minute d. artificial rupture of membrane
a. score less than 6 indicates that cervical ripening method should be used before inducing labor
A nurse caring for a client at 38 weeks' gestation who is diagnosed with chorioamnionitis. On which intervention should the nurse place priority? a. Administer oxytocin b. Monitor WBC count c. Assess temperature d. Assess amniotic fluid
a. Administer oxytocin *Chorioamnionitis is an indication for labor induction due to infection of the fetus placental tissues
A 24-year-old female patient with a family history of cervical cancer is in the office. For which test should the nurse prepare the client to detect early stages of cervical cancer? a) Papanicolaou test b) Transvaginal ultrasound c) Blood test for mutations in BRCA genes d) Serum CA-125 tests
a: A Papanicolaou (Pap) test should be done regularly to detect the early stages of cervical cancer. The BRCA gene is present in breast and ovarian cancers. Serum CA-125 can be a marker in ovarian cancer at 100%. Transvaginal ultrasound cannot detect early stages
After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment?
genital herpes
A nurse caring for a client undergoing treatment for ectopic pregnancy. Which symptom is observed in a client if rupture or hemorrhaging occurs before the ectopic pregnancy is successfully treated? a. Phrenic nerve irritation b. Painless bright red vaginal bleeding c. Fetal distress d. Tetanic contractions
a. Phrenic nerve irritation *also lower abdomen pain (adnexal), feelings of faintness, hypotension etc...
A postmenopausal woman is seen in the clinic and reports vaginal bleeding that has lasted for the past 3-4 weeks. A pelvic exam is performed and shows no abnormalites. Which test does the nurse anticipate the physician will order next for this patient? a) endometrial biopsy b) colposcopy c) endoscopy d) colonoscopy
a: The next test to be ordered would be an endometrial biopsy. It can detect up to 90% of cases of endometrial cancer and can be performed in the office without anesthesia. During this test the HCP can obtain a small sample of tissue for pathology. A colposcopy is done when suspecting cervical cnacer. An endoscopy looks at the upper GI tract while the colonoscopy looks at the lower GI tract and some of the upper
Kegel exercises are recommended for a client with pelvic organ prolapse. Which information about the exercises should the nurse give the client? a. they should be performed after food intake b. they alleviate mild prolapse symptoms c. not recommended after surgery D. increase BP
b. it may limit progression of mild prolapse and alleviate mild prolapse symptoms, including low back pain and pelvic pressure. They do not t cause increase in BP
At which time is it most important to monitor for umbilical cord prolapse? a. At the onset of labor b. After the rupture of membranes c. During transitional labor d. When the fetus is crowning
b. After the rupture of membranes
The nurse is required to assess a client for HELLP syndrome. Which are the signs and symptoms of this condition? Select all that apply. a. Blood pressure higher than 160/110 b. Epigastric pain c. Oliguria d. Upper right quadrant pain e. Hyperbilirubinemia
b. Epigastric pain d. Upper right quadrant pain e. Hyperbilirubinemia *Be alert for complaints of nausea (with or without vomiting), malaise, epigastric or right upper quadrant pain, and demonstrable edema.
A young woman is seen in the GYN clinic for a follow-up visit and is told that her recent Pap smear has come back abnormal. Which of the following tests can the nurse expect the physician to order for this patient? a) cryotherapy b) colposcopy c) hysterectomy d) colonoscopy
b: A colposcopy is a follow-up exam that is commonly used to identify suspicious cells and obtain a biopsy. A colonoscopy is a test to examine the colon and take samples of tissue. Cryotherapy uses liquid nitrogen to freeze cervical tissue and a hysterectomy is a surgical procedure used to remove the uterus
A nursing student is going to speak at a local high school about women's health. She is planning to talk about sexually transmitted diseases (STDs) as well as routine checks, along with guidelines for Pap smears. What should she include in the Pap smear guidelines as far as when to have a "first" Pap smear? a) at the age of 16 b) at the age of 21 or within three years of first sexual intercourse c) at the age of 18 or within two years of first sexual intercourse d) two years after first sexual intercourse
b: Amercian Cancer Society guidelines for Pap smears recommend that the first Pap smear is done at age 21 or within 3 years of first sexual intercourse. Other guidelines state that they should be done yearly until age 30 using the glass slide method and every two years using liquid-based method. At age 30-70 they should be done every 2-3 years if the previous three Pap smears were normal. They may be discontinued after age 70 if the previous three Paps were normal and no Paps in the previous 10 years were abnormal
The patient has just been diagnosed with cervical cancer and after discussing her options with her physician and husband she chooses to have cryotherapy. This procedure does which of the following? a) destroys diseased cervical tissue by using a focused beam to vaporize it b) destroys abnormal cervical tissue by freezing it with liquid nitrogen c) removes a section of cervical tissue d) uses a cold knife (surgical scapel) to remvove tissue
b: Cryotherapy destroys cervical tissue by freezing with liquid nitrogen. Cone biopsy removes a cone-shaped section of cervical tissue. Laser therapy destroys diseased cervical tissue by using a focused beam of high-energy light to vaporize it. A cold knife cone biopsy uses a surgical scalpel instead of heated wire to remove the tissue.
The nurse is teaching the community about ovarian cancer and early detection. Which of the following diagnostic tests would the nurse recommend for early detection? a) X-ray of the pelvic area b) Bimanual annual pelvic exam c) Serum CA-125 d) Pap smear
b: Early detection of ovarian cancer requires bimanual annual pelvic exams and transvaginal ultrasounds to catch early stages. Pap smears and x-rays are not sufficient to detect early stages of ovarian cancer. It is not recommended to use serum CA-125 as testing because it is nonspecific
After teaching a group of nursing students about risk factors associated with dystocia, the instructor determines that the teaching was successful when the students identify which of the following as increasing the risk? (Select all that apply) A) Pudendal block anesthetic use B) Multiparity C) Short maternal stature D) Maternal age over 35 E) Breech fetal presentation
c,d,e According to American College of Obstetrics and Gynecology (ACOG, 2009a), factors associated with an increased risk for dystocia include epidural analgesia, excessive analgesia, multiple gestation, hydramnios, maternal exhaustion, ineffective maternal pushing technique, occiput posterior position, longer first stage of labor, nulliparity, short maternal stature (less than 5 feet tall), fetal birth weight (more than 8.8 lb), shoulder dystocia, abnormal fetal presentation or position (breech), fetal anomalies (hydrocephalus), maternal age older than 35 years, high caffeine intake, overweight, gestational age more than 41 weeks, chorioamnionitis, ineffective uterine contractions, and high fetal station at complete cervical dilation.
Pelvic shape is typically classifed as one of four types: android, anthropoid, gynecoid, and platypelloid. The _________________ type is the typical female pelvis and offers the best shape for a vaginal delivery.
gynecoid
A specialty nurse working in the OB-GYN clinic cares for pregnant women who have been diagnosed with cancer during the pregnancy. The most common cancer in the pregnant population in regards to reproductive malignancies is which of the following? a) endometrial cancer b) ovarian cancer c) cervical cancer d) breast cancer
c: Cervical cancer is more common in the pregnant population than other reproductive malignancies, and can affect the woman's health status and the pregnancy.
lightening
the sensation of the fetus moving from high in the abdomen to low in the birth canal
A 28-year-old woman had a pap smear 4 weeks ago. The results of the test are classified as ASC-US as per the Bethesda System. Which of the following therapeutic management interventions should the nurse expect the health care provider to order? a) Discontinue any further Pap smear screenings. b) Refer for a colposcopy with HPV testing. c) Repeat the Pap smear in 4 to 6 months, or refer for a colposcopy. d) Send for an immediate colposcopy, with follow-up based on results
c: A result of ASC-US for Pap smear testing is classified by the Bethesda System. This system gives a uniform diagnostic term to Pap smear results. This means the health care provider should repeat the test in 4 to 6 months or refer for a colposcopy. Results of AGC or AIS indicate the need for an immediate colposcopy and follow-up based on results. A colposcopy with HPV testing is the treatment when results are ASC-
A nurse assesses and suspects vulvar cancer based on which assessment finding? a) Vulvar bleeding b) Vulvar itching that responds to creams c) Fleshy, ulcerated mass on the labia majora d) Dysuria
c: A vulvar lump or mass is most often noted, and it may be fleshy, ulcerated, leukoplakic, or warty. Vulvar itching that does not respond to creams or ointments is a common complaint associated with vulvar cancer. Vulvar bleeding and dysuria may be seen with vulvar cancer but would be uncommon findings.
While reviewing the history of a client diagnosed with cancer of the vagina, the nurse would expect the client to report which of the following as the major complaint? a) Ascites b) Abdominal discomfort c) Abnormal vaginal bleeding d) Urinary frequency
c: Abnormal vaginal bleeding is the predominant symptom of vaginal cancer. Abdominal discomfort, urinary frequency, and ascites are more commonly associated with ovarian cancer.
The results of a Pap smear test have been classified as atypical squamous cells with possible HSIL (ASC-H) as per the 2001 Bethesda system. Which interpretation of the result is correct? a) Repeat the Pap smear in 4 to 6 months, or refer for a colposcopy. b) No need for any further Pap smear screenings. c) Refer for a colposcopy without human papilloma virus (HPV) testing. d) Immediate colposcopy; follow-up is based on the results of findings.
c: According to the 2001 Bethesda system for classifying Pap smear results, a result of ASC-H means that the client is to be referred for colposcopy without HPV testing. Atypical squamous cells of undetermined significance (ASC-US) means that the test has to be repeated in 4 to 6 months or the client has to be referred for colposcopy. Atypical glandular cells (AGC) or adenocarcinoma in situ (AIS) results indicate immediate colposcopy, with the follow-up based on the results of findings
The ____________________ is the disance between the anterior surface of the sacral prominence and the anterior surface of the inferior margin of the symphysis pubis.
diaganol conjugate
The nurse, assessing the lochia of a client, attempts to separate a clot and identifies the presence of tissue. Which observation would indicate the presence of tissue?
difficult to separate clots
a nurse is caring for a pregnant client in labor in the health care facility. The nurse knows that which of the following marks the termination of the first stage of labor in the client
dilation of the cervix to 10cm
A pregnant client with a history of spinal injury is being prepared for cesarean birth. Which method of anesthesia is to be administered to the client? a. Local infiltration b. Epidural block c. Regional anesthesia d. General anesthesia
d. General anesthesia
A pregnant client is admitted to a maternity clinic for birth. The client wishes to adopt the kneeling poistion during labor. The nurse knows that which to be an advantage of adopting a kneeling position during labor? a. It helps the woman in labor to save energy b. It facilitates vaginal examinations c. It facilitates external belt adjustment d. It helps to rotate fetus in a posterior position
d. It helps to rotate fetus in a posterior position
A nurse is caring for a client in labor who is delivering. Which of the following fetal responses should the nurse monitor for in the client's baby
decrease in circulation and perfusion to the fetus
A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent?
doxycycline
Recently the FDA approved _________ as the first medication to specifically treat morning sickness in pregnancy.
doxylamine succinate 10mg (Diclegis)
The three embryonic layers of cells formed are
ectoderm, mesoderm, endoderm
A nurse is working in a community hospital situated in an area with a history of grievous assaults on women, including rape. The nurse discovers that most rape victims come to the hospital but leaves without seeking medical tx. Which of the following interventions should the nurse perform to ensure that rape victims get legal and medical aid?
ensure that the appropriate law enforcement agencies are apprised of the incident
This hormone causes enlargment of a woman's breasts, uterus, and external genitalia; stimulates myometrial contractility
estrogen (estriol)
A group of students is reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which cause of condylomata?
human papillomavirus
Braxton Hicks contractions
intermittent painless uterine contractions that occur with increasing frequency as the pregnancy progresses
how does newborn circulation work?
it's all a closed system now. unoxygenated blood enters heart through superior/inferior vena cava, enters RA & is pumped in RV. from RV, blood is pumped through pulmonary arteries into lungs, where it's oxygenated. blood travels back via pulmonary veins into LA, then is pumped in LV. from the LV, blood is pumped to all extremities and organs.
identify the 3 layers of the blastocyst & what they form:
outer: ectoderm - CNS, special senses, skin, glands mid: mesoderm - skeleton, urinary, circulatoy systems + reproductive organs inner: endoderm - liver, pancreas, respiratory system, digestive system
Some women complain about excessive salivation, termed ________________ which may be caused by the decrease in unconscious swallowing by the woman when nauseated.
ptyalism
The nurse is caring for a client of Asian descent 1 day after she has given birth. Which foods will the client most likely refuse to eat when her meal tray is delivered? Select all that apply.
raw carrots and celery, ice cream, and orange slices
The nurse is assessing a client at a postpartum visit. Which hemodynamic change will the nurse expect the client to exhibit?
rise in hematocrit
The postural changes of pregnancy coupled with the loosening of the ___________________ joints may result in lower back pain.
sacroiliac
A postpartum patient is experiencing painful hemorrhoids. Which position should the nurse suggest the patient use when resting?
sim's position
This type of breathing is the most relaxed pattern and is recommended throughout labor.
slow-paced
By 20 weeks' gestation, the fundus, or top of the uterus, is at the level of the _______________ and measures 20 cm
umbilicus
A client is suspected of having herpes simplex viral infection. The nurse would expect to prepare the client for which diagnostic test to confirm the infection?
viral culture of vesicular fluid
If it is the initial vaginal examination to check for membrane status __________ is used as a lubricant.
water
A client is using high-dose estrogen oral contraceptives. The nurse would assess the client for which finding?
yeast infections
Which of the following would the nurse identify as indicating emotional abuse? Select all that apply. a) Calling the victim names b) Throwing things at a victim c) Not allowing the victim to seek care for an injury d) Threatening to hit the victim e) Controlling how the family's money is spent f) Forcing the victim to perform a degrading act
• Calling the victim names • Threatening to hit the victim • Forcing the victim to perform a degrading act
Which of the following are modifiable risk factors for breast cancer? Select all that apply.
• Duration of breastfeeding • Obesity • Sedentary lifestyle • Smoking • Alcohol consumption
After a discussion on the HPV vaccine with a mother and her 10-year-old daughter at a well-child visit, the nurse recognizes the discussion was successful when the mother makes which statement?
"My daughter will need three injections over a 6-month period."
The nurse is teaching a female client about early-stage pelvic organ prolapse. Which statement that centers on dietary and lifestyle changes will promote pelvic relaxation and decrease chronic problems later in life? "You will need to increase fiber in your diet." "You will need to avoid products that contain caffeine." "You will want to avoid increasing your fluid intake." "You will want to add high-impact exercise to your routine or increase time spent on it."
"You will need to increase fiber in your diet." A dietary fiber increase and an increase in fluids will help avoid constipation, which puts a strain on the intra-abdominal cavity and pelvic organs. An increase in fiber will help to stimulate peristalsis. The recommended amount of fiber is 25 mg daily. Avoiding caffeine will not change symptoms. The client should avoid high-impact exercise because it increases intra-abdominal pressure.
A woman is to undergo an amnioinfusion. Which statement would be most appropriate to include when teaching the woman about this procedure? A) "You'll need to stay in bed while you're having this procedure." B) "We'll give you an analgesic to help reduce the pain." C) "After the infusion, you'll be scheduled for a cesarean birth." D) "A suction cup is placed on your baby's head to help bring it out."
"You'll need to stay in bed while you're having this procedure." An amnioinfusion involves the instillation of a volume of warmed, sterile normal saline or Ringer's lactate into the uterus via an intrauterine pressure catheter. The client must remain in bed during the procedure. The use of analgesia is unrelated to this procedure. A cesarean birth is necessary only if the FHR does not improve after the amnioinfusion. Application of a suction cup to the head of the fetus refers to a vacuum-assisted birth.
- Signs that the placenta is separating include:
- a firmly contracting uterus - a change in uterine shape from discoid to globular ovoid - a sudden gush of dark blood from the vaginal opening - and lengthening of the umbilical cord protruding from the vagina.
A nurse is caring for a pregnant client during labor. Which of the following methods should the nurse use to provide comfort to the pregnant client? Select all
- hand holding - massaging - acupuncture
Abstinence is usually only recommended for women who are at risk for ______________ or __________________ because of placenta previa.
- preterm labor - antepartum hemorrhage
__________ labor is characterized by contractions that are irregular and weak, often slowing down with walking or a position change. ________ labor contractions begin in the back and radiate around toward the front of the abdomen. They are regular and become stronger over time; the woman may find it extremely difficult if not impossible to have a conversation during a contraction.
-False -True
A nurse is preparing a teaching program for a group of pregnant women about preventing infections during pregnancy. When describing measures for preventing cytomegalovirus infection, which of the following would the nurse most likely include? A) Frequent handwashing B) Immunization C) Prenatal screening D) Antibody titer screening
A) Frequent handwashing
During a follow-up visit to the clinic, a victim of sexual assault reports that she has changed her job and moved to another town. She tells the nurse, "I pretty much stay to myself at work and at home." The nurse interprets these findings to indicate that the client is in which phase of rape recovery? A) Disorganization B) Denial C) Reorganization D) Integration
Ans: C Feedback: During the reorganization phase, the survivor attempts to make life adjustments by moving or changing jobs and uses emotional distancing to cope. The disorganization phase is characterized by shock, fear, disbelief, anger, shame, guilt, and feelings of uncleanliness. During the denial or outward adjustment phase, the survivor appears outwardly composed and returns to work or school and refuses to discuss the assault and denies the need for counseling. During the integration and recovery phase, the survivor begins to feel safe and starts to trust others.
6. A client who delivered a baby 36 hours ago informs the nurse that she has been passing unusually large volumes of urine very often. How should the nurse explain this to the client?
Ans: "Your body usually retains extra fluids during pregnancy, so this is one way it rids itself of the excess fluid."
Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia? A) Calcium gluconate B) Potassium chloride C) Ferrous sulfate D) Calcium carbonate
Ans: A The antidote for magnesium sulfate is calcium gluconate, and this should be readily available in case the woman has signs and symptoms of magnesium toxicity.
13. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? A) Frank B) Full C) Complete D) Footling
Ans: A Feedback: In a frank breech, the buttocks present first, with both legs extended up toward the face. In a full or complete breech, the fetus sits cross-legged above the cervix. In a footling breech, one or both legs are presenting.
A group of students are reviewing information about genetic inheritance. The students demonstrate understanding of the information when they identify which of the following as an example of an autosomal recessive disorder? (Select all that apply.) A) Cystic fibrosis B) Phenylketonuria C) Tay-Sachs disease D) Polycystic kidney disease E) Achondroplasia
Ans: A, B, C Feedback: Examples of autosomal recessive disorders include cystic fibrosis, phenylketonuria, and Tay-Sachs disease. Polycystic kidney disease and achondroplasia are examples of autosomal dominant diseases.
4. A pregnant client has come to a health care facility for a physical examination. Which of the following assessments should a nurse perform when doing a physical examination of the head and neck? Select all that apply.
Ans: Assess for previous injuries and sequelae Ans: Evaluate for limitations in range of motion Ans: Palpate the thyroid gland for enlargement
11. A postpartum client had a difficult labor. Which assessment finding will alert the nurse that the client is most likely hemorrhaging?
Ans: Decreased blood pressure
12. A nurse who has been caring for a pregnant client understands that the client has pica and has been regularly consuming soil. Which of the following conditions should the nurse monitor in the client as a manifestation of consuming soil?
Ans: Iron-deficiency anemia
13. A nurse is caring for a newborn with hypoglycemia. What symptoms of hypoglycemia should the nurse monitor the newborn for? Select all that apply
Ans: Lethargy Ans: Cyanosis Ans: Jitteriness
Which of the following data on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy? A) Use of oral contraceptives for 5 years B) Ovarian cyst 2 years ago C) Recurrent pelvic infections D) Heavy, irregular menses
C In the general population, most cases of ectopic pregnancy are the result of tubal scarring secondary to pelvic inflammatory disease. Oral contraceptives, ovarian cysts, and heavy, irregular menses are not considered risk factors for ectopic pregnancy.
When caring for childbearing families from cultures different from one's own, which of the following must be accomplished first? A) Adapt to the practices of the family's culture B) Determine similarities between both cultures C) Assess personal feelings about that culture D) Learn as much as possible about that culture
C) Assess personal feelings about that culture
When integrating the principles of family-centered care, the nurse would include which of the following? A) Childbirth is viewed as a procedural event B) Families are unable to make informed choices C) Childbirth results in changes in relationships D) Families require little information to make appropriate decisions
C) Childbirth results in changes in relationships
The nurse notes the presence of transient fetal accelerations on the fetal monitoring strip. Which intervention would be most appropriate? A. Reposition the client on the left side. B. Begin 100% oxygen via face mask. C. Document this as indicating a normal pattern. D. Call the health care provider immediately.
C. Fetal accelerations denote an intact central nervous system and appropriate oxygenation levels demonstrated by an increase in heart rate associated with fetal movement. Accelerations are a reassuring pattern, so no intervention is needed.
This classification of drugs have been tested and found safe during pregnancy. Examples include: folic acid, vitamin B6 and thyroid medicine.
Category A
This class of drugs ahve been used frequently during pregnancy and do not appear to cause major birth defects or other fetal problems. Examples include: acetaminophen, famotidinem prenisone, insulin and ibuprofen.
Category B
A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, which of the following would the nurse expect to find? A) Sporadic vaginal bleeding accompanied by chronic pelvic pain B) Heavy leukorrhea with vulvar pruritus C) Menstrual irregularities and hirsutism on the chin D) Stress incontinence with feeling of low abdominal pressure
D
The nurse is explaining the events that lead up to ovulation. Which hormone would the nurse identify as being primarily responsible for ovulation? A) Estrogen B) Progesterone C) Follicle-stimulating hormone D) Luteinizing hormone
D) Luteinizing hormone At ovulation, a mature follicle ruptures in response to a surge of luteinizing hormone. Estrogen is predominant at the end of the follicular phase, directly preceding ovulation. Progesterone peaks 5 to 7 days after ovulation. Follicle-stimulating hormone is highest during the first week of the follicular phase of the cycle.
After teaching a group of pregnant women about breast-feeding, the nurse determines that the teaching was successful when the group identifies which hormone as important for the production of breast milk after childbirth? A) Placental estrogen B) Progesterone C) Gonadotropin-releasing hormone D) Prolactin
D) Prolactin
21.After teaching a group of students about cervical cancer, the instructor determines that the teaching was successful when the students identify which of the following as the area included with a cone biopsy? A) Clitoris B) Uterine fundus C) Ovarian follicle D) Transformation zone
D) Transformation zone
A nursing instructor is describing the various childbirth methods. Which of the following would the instructor include as part of the Lamaze method? A) Focus on the pleasurable sensations of childbirth B) Concentration on sensations while turning on to own bodies C) Interruption of the fear-tension-pain cycle D) Use of specific breathing and relaxation techniques
D) Use of specific breathing and relaxation techniques
22. A nurse is caring for several women in labor. The nurse determines that which woman is in the transition phase of labor? A) Contractions every 5 minutes, cervical dilation 3 cm B) Contractions every 3 minutes, cervical dilation 5 cm C) Contractions every 21/2 minutes, cervical dilation 7 cm D) Contractions every 1 minute, cervical dilation 9 cm
D. The transition phase is characterized by strong contractions occurring every 1 to 2 minutes and cervical dilation from 8 to 10 cm.
A pregnant patient with mitral stenosis needs to begin taking an anticoagulant. The nurse identifies the drug of choice, which is used in early pregnancy and again during the last month of pregnancy, to be which of the following? a) aspirin b) coumadin c) heparin d) levonox
c) heparin Rationale: If an anticoagulant is required, heparin is the drug of choice for the beginning and the end of pregnancy. Heparin does not cross the placenta barrier.
FHR is assessed every 30 to 60 minutes during the _________ phase of labor.
latent
trophoblast:
the outer layer of cells surrounding the blastocyst cavity. it develops into the chorion + helps form the placenta.
A client is to have a vaginal hysterectomy to repair her stage IV uterine prolapse. The nurse realizes she needs more education when she states: "I'm not going home with a Foley catheter in place." "The leg bag will be covered by my clothes, once I am home." "My husband is not crazy about the six weeks of pelvic rest." "I have already picked up the stool softeners."
"I'm not going home with a Foley catheter in place." A Foley catheter will be left in place for up to one week to allow the surgical site time to heal properly. The client may also experience some dysuria once it is removed due to the swelling that can occur. The client will need instructions on how to properly care for a leg bag, the importance of pelvic rest to allow for proper healing, and using stool softeners to avoid straining or stressing the pelvic region.
A woman has just confided in the nurse that her partner slapped and kicked her that morning. What is the best response by the nurse? a) "Oh my goodness, I cannot believe that happened to you. You poor thing, I feel terrible for you." b) "It's very brave of you to tell me all this. Help is available if you choose it." c) "Maybe he didn't mean to do it. Have you talked with him about it?" d) "Is this the first and only time he has done anything?"
"It's very brave of you to tell me all this. Help is available if you choose it."
A nurse is presenting a program to a church group about domestic violence. During the presentation, a member of the audience asks the nurse to explain what "intergenerational transmission of violence" means because he has seen that phrase used in the media. Which of the following responses by the nurse would be most appropriate? a) "Domestic violence seems to skip every other generation when it is traced in families." b) "People who grow up in violent home situations tend to be involved in domestic violence situations as an adult." c) "Recent research has identified a gene that is responsible for transmission of a risk for violent behavior that is passed on from generation to generation." d) "People who are violent are that way because of the various neurochemical imbalances in their brains."
"People who grow up in violent home situations tend to be involved in domestic violence situations as an adult."
A client comes to a local community health care facility for a routine check-up. While talking to the nurse, the client happens to mention that every time she has a serious fight with her husband, he forces her to have intercourse with him. The client seems to be very disturbed when revealing this to the nurse. Which is an appropriate response by the nurse? a) "Your husband is just trying to reconcile using intimacy." b) "It's okay in cases of fights where you're really at fault." c) "This behavior is considered sexual abuse." d) "Such behavior is considered normal in a married couple."
"This behavior is considered sexual abuse."
A client experienced prolonged labor with prolonged premature rupture of membranes. The nurse would be alert for which of the following in the mother and the newborn? A) Infection B) Hemorrhage C) Trauma D) Hypovolemia
A Although hemorrhage, trauma, and hypovolemia may be problems, the prolonged labor with the premature rupture of membranes places the client at high risk for a postpartum infection. The rupture of membranes removes the barrier of amniotic fluid so bacteria can ascend.
After teaching a group of nursing students about the issue of informed consent. Which of the following, if identified by the student, would indicate an understanding of a violation of informed consent? A) Performing a procedure on a 15-year-old without consent B) Serving as a witness to the signature process C) Asking whether the client understands what she is signing D) Getting verbal consent over the phone for emergency procedures
A) Performing a procedure on a 15-year-old without consent
A nurse is working to develop a health education program for a local community to address breast cancer awareness. Which of the following would the nurse expect to include when describing this problem to the group? Select all that apply. A) White women have higher rates of breast cancer than African American women. B) African American women are more likely to die from breast cancer at any age. C) Survival at any stage is worse among white women. D) Women living in South America have the highest rates of breast cancer. E) Breast cancer is the leading cause of cancer mortality in women.
A) White women have higher rates of breast cancer than African American women. B) African American women are more likely to die from breast cancer at any age.
A pregnant woman asks the nurse about giving birth in a birthing center. She says, "I'm thinking about using one but I'm not sure." Which of the following would the nurse need to integrate into the explanation about this birth setting? (Select all that apply.) A) An alternative for women who are uncomfortable with a home birth. B) The longer length of stay needed when compared to hospital births C) Focus on supporting women through labor instead of managing labor D) View of labor and birth as a normal process requiring no intervention E) Care provided primarily by obstetricians withmidwives as backup care
A) An alternative for women who are uncomfortable with a home birth. C) Focus on supporting women through labor instead of managing labor D) View of labor and birth as a normal process requiring no intervention
A pregnant woman tests positive for HBV. Which of the following would the nurse expect to administer? A) HBV immune globulin B) HBV vaccine C) Acylcovir D) Valacyclovir
A) HBV immune globulin The CDC (2015g) recommends that all pregnant women should be tested for hepatitis B surface antigen (HBsAg) regardless of previous HBV vaccine or screening. Infants born to HBsAg-positive mothers should receive single-antigen HBV vaccine and hepatitis B immunoglobulin (HBIG) within 12 hours of birth.
A woman with known cardiac disease from childhood presents at the obstetrician's office 6 weeks' pregnant. What recommendations would the nurse make to the client to address the known cardiac problems for this pregnancy? Select all that apply. A. Plan periods of rest into the workday. B. Receive pneumococcal and influenza vaccines. Continue taking the scheduled warfarin. C. Let the physician know if you become short of breath or have a nighttime cough. D. Increase the amount of sodium in your diet to compensate for the expanding fluid needs of the fetus.
A,B,C R: Women with known heart conditions need to be closely followed by both the obstetrician and a cardiologist. Recommendations would include rest periods, reduction of stress, getting immunizations, and monitoring for heart failure as demonstrated by a nighttime cough and shortness of breath. Consuming more sodium in the diet is not recommended due of the potential of developing hypertension. Warfarin is contraindicated during pregnancy since it crosses the placental barrier and can cause spontaneous abortion, stillbirth or preterm birth.
The nurse is caring for a pregnant client who indicates that she is fond of meat, works with children, and has a pet cat. Which instructions should the nurse give this client to prevent toxoplasmosis? Select all that apply. A. Eat meat cooked to 160° F (71° C). B. Avoid cleaning the cat's litter box. C. Avoid contact with children when they have a cold. D. Avoid outdoor activities such as gardening. E. Keep the cat outdoors at all times.
A,B,D R:To minimize risk of toxoplasmosis, the nurse should instruct the client to eat meat that has been cooked to an internal temperature of 160° F (71° C) throughout and to avoid cleaning the cat's litter box or performing activities such as gardening. Avoiding children with colds is unreasonable when working with children, and contact with children with colds is not a cause of toxoplasmosis. The cat should be kept indoors to prevent it from hunting and eating birds or rodents.
The nurse is educating a client with type 1 diabetes about the complications associated with diabetes and pregnancy. Which problems would the nurse include in her teaching? Select all that apply. A. Decreased birth weight B. Polyhydramnios C. Increased risk of spontaneous abortion D. Hypertension E. Cystic fibrosis
A,B,D R:Women with pregestational diabetes, which is type 1 diabetes, are at a higher risk of having an infant with complications during the pregnancy and at delivery. Spontaneous abortion is higher in women who have pregestational diabetes. Also, they run a higher risk of having a pregnancy with polyhydramnios, and of developing maternal hypertension. The birth weight of an infant born to a mother with diabetes is increased, not decreased. Cystic fibrosis is not associated with maternal diabetes.
Which of the following would the nurse identify as the priority psychosocial need for a women diagnosed with reproductive cancer? A. Research findings B. Hand-holding C. Cheerfulness D. Offering of hope
A. Women need clear information to make informed choices about treatment and aftercare. This information will help reduce her anxiety and chose the best course of action for her. * D is incorrect: instilling hope is important, but giving clear information would be more of a priority.
After teaching a group of adolescents about HIV, the nurse asks them to identify the major means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which of the following? A) Sexual intercourse B) Sharing needles for IV drug use C) Perinatal transmission D) Blood transfusion
Ans: A Feedback: Nurses can play a key role in preventing and controlling HIV infection by promoting risk-reduction counseling and offering routine HIV testing to adolescents. Most sexually active youth do not feel that they are at risk of contracting HIV and have never been tested. Obtaining a sexual history and creating an atmosphere that promotes nonjudgmental risk counseling is a key component of the adolescent visit. In light of increasing numbers of people with HIV/AIDS and missed opportunities for HIV testing, the CDC recommends universal and routine HIV testing for all clients seen in health care settings who are 13 to 64 years of age. Sharing contaminated needles, perinatal transmission, and blood transfusions are not associated with adolescents and HIV.
After teaching a class on sexually transmitted infections, the instructor determines that the teaching was successful when the class identifies which statement as true? A) STIs can affect anyone if exposed to the infectious organism. B) STIs have been addressed more on a global scale. C) Clients readily view the diagnosis of STI openly. D) Most individuals with STIs are over the age of 30.
Ans: A Feedback: STIs know no gender, class, racial, ethnic, or social barriers—all individuals are vulnerable if exposed to the infectious organism. The problem of STIs has still not been tackled adequately on a global scale, and until this is done, numbers worldwide will continue to increase. Given the high value some cultures place on virginity and fidelity, a diagnosis of an STI can be devastating to the woman and her family. Even to suggest a test for STIs can appear inappropriate or offensive. An estimated two thirds of all STIs occur among persons under the age of 25.
When a nurse suspects that a client may have been abused, the first action should be to: A) Ask the client about the injuries and if they are related to abuse. B) Encourage the client to leave the batterer immediately. C) Set up an appointment with a domestic violence counselor. D) Ask the suspected abuser about the victim's injuries.
Ans: A Feedback: The first step is to screen for abuse and identify the connection between the woman's injuries and abuse. Once abuse is detected, the nurse should immediately isolate the woman to provide privacy and prevent retaliation by the abuser. Encouraging the woman to leave the batterer immediately is not realistic. Setting up an appointment with a counselor would be appropriate once the abuse is detected and the woman is safe. Questioning the suspected abuser might worsen the situation.
A woman who is HIV-positive is receiving HAART and is having difficulty with compliance. To promote adherence, which of the following areas would be most important to assess initially? A) The woman's beliefs and education B) The woman's financial situation and insurance C) The woman's activity level and nutrition D) The woman's family and living arrangements
Ans: A Feedback: The most important area to assess initially would be the client's beliefs and knowledge about the disease and its treatment. A common barrier is a lack of understanding about the link between drug resistance and nonadherence. Once this area is assessed, the nurse can assess for other barriers, such as finances and insurance, nutrition and activity level, and family issues, including living arrangements (for example, the woman may be afraid that her HIV status would be revealed if others see her taking medication).
A nurse is working with a victim of intimate partner violence and helping her develop a safety plan. Which of the following would the nurse suggest that the woman take with her? (Select all that apply.) A) Driver's license B) Social security number C) Cash D) Phone cards E) Health insurance cards
Ans: A, B, C, E Feedback: When leaving an abusive relationship, the woman should take her driver's license or photo ID, social security number or green card/work permit, birth certificates, any court papers or orders, credit cards, cash, and health insurance cards. The woman should avoid phone cards because they leave a trail to follow.
In addition to providing privacy, which of the following would be most appropriate initially in situations involving suspected abuse? A) Allow the client to have a good cry over the situation. B) Tell the client, "Injuries like these don't usually happen by accident." C) Call the police immediately so they can question the victim. D) Ask the abuser to describe his side of the story first.
Ans: B Feedback: Communicating support through a nonjudgmental attitude and telling her that no one deserves to be abused are the first steps in establishing trust and rapport. Allowing the client to cry is appropriate after the client is safe, her privacy is protected, and the nurse has emphasized that there is a problem. Notifying the police is done once the assessment reveals suspicion or actual indications of abuse. Asking the abuser to describe his side of the story is inappropriate.
Which of the following would the nurse describe as a characteristic of the second phase of the cycle of violence? A) The batterer is contrite and attempts to apologize for the behavior. B) The physical battery is abrupt and unpredictable. C) Verbal assaults begin to escalate toward the victim. D) The victim accepts the anger as legitimately directed at her.
Ans: B Feedback: During the second phase of the cycle of violence, the violence explodes and the batterer loses control physically and emotionally. During the honeymoon or third phase, the batterer is contrite and attempts to apologize for the behavior. During the first phase or tension-building phase, verbal or minor battery occurs and the woman often accepts her partner's building anger as legitimately directed toward her.
The nurse is presenting a class at a local community health center on violence during pregnancy. Which of the following would the nurse include as a possible complication? A) Hypertension of pregnancy B) Chorioamnionitis C) Placenta previa D) Postterm labor
Ans: B Feedback: Women assaulted during pregnancy are at risk for chorioamnionitis, placental abruption, preterm labor, stillbirth, miscarriage, uterine rupture, and injuries to the mother and fetus. Hypertension of pregnancy is not associated with violence during pregnancy.
A client is diagnosed with pelvic inflammatory disease (PID). When reviewing the client's medical record, which of the following would the nurse expect to find? (Select all that apply.) A) Oral temperature of 100.4 degrees F B) Dysmenorrhea C) Dysuria D) Lower abdominal tenderness E) Discomfort with cervical motion F) Multiparity
Ans: B, C, D, E Feedback: History and physical examination findings of PID include dysmenorrhea, dysuria, lower abdominal tenderness, and cervical motion tenderness. Typically the client has a fever above 101 degrees F and is nulliparous.
A group of students are preparing a class discussion about rape and sexual assault. Which of the following would the students include as being most accurate? (Select all that apply.) A) Most victims of rape tell someone about it. B) Few women falsely cry "rape." C) Women have rape fantasies desiring to be raped. D) A rape victim feels vulnerable and betrayed afterwards. E) Medication and counseling can help a rape victim cope.
Ans: B, D, E Feedback: The majority of women never tell anyone about a rape. Almost two thirds of victims never report it to the police. The victim feels vulnerable, betrayed, and insecure after a rape. Few women falsely cry "rape." Reality and fantasy are different and dreams have nothing to do with the brutal violation of rape. Medication can help initially, but counseling is usually needed.
Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has: A) Trichomoniasis B) Bacterial vaginosis C) Candidiasis D) Genital herpes simplex
Ans: C Feedback: A thick, white vaginal discharge accompanied by intense itching and dyspareunia suggest vulvovaginal candidiasis. Trichomoniasis is characterized by a heavy yellow, green, or gray frothy or bubbly discharge. Bacterial vaginosis is manifested by a thin, white homogenous vaginal discharge with a characteristic stale fish-like odor. Genital herpes simplex involves genital ulcers.
When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find? A) Ambivalence B) Introversion C) Acceptance D) Emotional lability
Ans: A During the first trimester, the pregnant woman commonly experiences ambivalence, with conflicting feelings at the same time. Introversion heightens during the first and third trimesters when the woman's focus is on behaviors that will ensure a safe and healthy pregnancy outcome. Acceptance usually occurs during the second trimester. Emotional lability (mood swings) is characteristic throughout a woman's pregnancy.
A nurse is describing advances in genetics to a group of students. Which of the following would the nurse least likely include? A) Genetic diagnosis is now available as early as the second trimester. B) Genetic testing can identify presymptomatic conditions in children. C) Gene therapy can be used to repair missing genes with normal ones. D) Genetic agents may be used in the future to replace drugs.
Ans: A Feedback: Genetic diagnosis is now possible very early in pregnancy (see Evidence-Based Practice 10.1). Genetic testing can now identify presymptomatic conditions in children and adults. Gene therapy can be used to replace or repair defective or missing genes with normal ones. Gene therapy has been used for a variety of disorders, including cystic fibrosis, melanoma, diabetes, HIV, and hepatitis (Tamura, Kamuma, Nakazato, et al. 2010). The potential exists for creation of increased intelligence and size through genetic intervention. Recent research using gene therapy shows promise for the generation of insulin-producing cells to cure diabetes (Calne, Gan, & Lee 2010). In the future, genetic agents may replace drugs, general surgery may be replaced by gene surgery, and genetic intervention may replace radiation.
18. A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which of the following would the nurse most likely include? (Select all that apply.) A) Internal rotation B) Abduction C) Descent D) Pronation E) Flexion
Ans: A, C, E Feedback: The positional changes that occur as the fetus moves through the passageway are called the cardinal movements of labor and include engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion. The fetus does not undergo abduction or pronation.
A nurse is discussing fetal development with a pregnant woman. The woman is 12 weeks pregnant and asks, "What's happening with my baby?" Which of the following would the nurse integrate into the response? (Select all that apply.) A) Continued sexual differentiation B) Eyebrows forming C) Startle reflex present D) Digestive system becoming active E) Lanugo present on the head
Ans: A, D Feedback: At 12 weeks, sexual differentiation continues and the digestive system shows activity. Eyebrows form and startle reflex is present between weeks 21 and 24. Lanugo on the head appears about weeks 13-16.
A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which of the following would be included as part of this assessment? (Select all that apply A) Positive pregnancy test B) Ultrasound visualization of the fetus C) Auscultation of a fetal heart beat D) Ballottement E) Absence of menstruation F) Softening of the cervix
Ans: A, D, F Probable signs of pregnancy include a positive pregnancy test, ballottement, and softening of the cervix (Goodell's sign). Ultrasound visualization of the fetus, auscultation of a fetal heart beat, and palpation of fetal movements are considered positive signs of pregnancy. Absence of menstruation is a presumptive sign of pregnancy.
A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which of the following would be included as part of this assessment? (Select all that apply A) Positive pregnancy test B) Ultrasound visualization of the fetus C) Auscultation of a fetal heart beat D) Ballottement E) Absence of menstruation F) Softening of the cervix
Ans: A, D, F Probable signs of pregnancy include: - a positive pregnancy test - ballottement - softening of the cervix (Goodell's sign) * Ultrasound visualization of the fetus, auscultation of a fetal heart beat, and palpation of fetal movements are considered positive signs of pregnancy. Absence of menstruation is a presumptive sign of pregnancy.
9. A pregant client arrives at the community health center for a routine check-up. She informs the nurse that a relative on her mother's side has hemophillia, and she wants to know the chances of her child acquiring hemophillia. Which of the following characteristics of hemophillia should the nurse explain to the client to help her understand the odds of acquiring the disease? Select all that apply
Ans: Affected individuals are usually males Ans: Female carriers have a 50% chance of transmitting the disorder to their sons Ans: Females are affected by the condition if it is a dominant X-linked disorder
10. A client who is in labor presents with shoulder dystocia of the fetus. Which of the following is an important nursing intervention?
Ans: Assist with positioning the woman in squatting position
2. A client in her third month of pregnancy arrives at the health care facility for a regular follow-up visit. The client complains of discomfort due to increased urinary frequency. Which of the following instructions should the nurse offer the client to reduce the clients discomfort?
Ans: Avoid consumption of caffeinated drinks
11. A 19-year old female client has been diagnosed with pelvic inflammatory disease due to untreated gonorrhea. Which of the following instructions should the nurse offer when caring for the client? Select all that apply
Ans: Avoid douching vaginal area Ans: Complete the antibiotic therapy Ans: Limit the number of sex partners
After the nurse describes fetal circulation to a pregnant woman, the woman asks why her fetus has a different circulation pattern than hers. In planning a response, the nurse integrates understanding of which of the following? A) Fetal blood is thicker than that of adults and needs different pathways. B) Fetal circulation carries highly oxygenated blood to vital areas first. C) Fetal blood has a higher oxygen saturation and circulates more slowly. D) Fetal heart rates are rapid and circulation time is double that of adults.
Ans: B Feedback: Fetal circulation functions to carry highly oxygenated blood to vital areas first while shunting it away from less vital ones. Fetal blood is not thicker than that of adults. Large volumes of oxygenated blood are not needed because the placenta essentially takes over the functions of the lung and liver during fetal life. Although fetal heart rates normally range from 120 to 160 beats per minute, circulation time is not doubled.
A nurse is teaching a class on X-linked recessive disorders. Which of the following statements would the nurse most likely include? A) Males are typically carriers of the disorders. B) No male-to-male transmission occurs. C) Daughters are more commonly affected with the disorder. D) Both sons and daughters have a 50% risk of the disorder.
Ans: B Feedback: Most X-linked disorders demonstrate a recessive pattern of inheritance. Males are more affected than females. A male has only one X chromosome and all the genes on his X chromosome will be expressed, whereas a female will usually need both X chromosomes to carry the disease. There is no male-to-male transmission (since no X chromosome from the male is transmitted to male offspring), but any man who is affected will have carrier daughters. If a woman is a carrier, there is a 50% chance that her sons will be affected and a 50% chance that her daughters will be carriers.
A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which of the following would lead the nurse to suspect that the woman is developing an infection? (Select all that apply.) A) Fetal bradycardia B) Abdominal tenderness C) Elevated maternal pulse rate D) Decreased C-reactive protein levels E) Cloudy malodorous fluid
Ans: B, C, E Possible signs of infection associated with premature rupture of membranes include elevation of maternal temperature and pulse rate, abdominal/uterine tenderness, fetal tachycardia over 160 bpm, elevated white blood cell count and C-reactive protein levels, and cloudy, foul-smelling amniotic fluid.
A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, ìI've never urinated as often as I have for the past three weeks.î Which response would be most appropriate for the nurse to make? A) ìHaving to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit it.î B) ìYou shouldn't be urinating this frequently now; it usually stops by the time you're eight weeks pregnant. Is there anything else bothering you?î C) ìBy the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is likely to return toward the end of your pregnancy.î D) ìWomen having their second child generally don't have frequent urination. Are you experiencing any burning sensations?î
Ans: C As the uterus grows, it presses on the urinary bladder, causing the increased frequency of urination during the first trimester. This complaint lessens during the second trimester only to reappear in the third trimester as the fetus begins to descend into the pelvis, causing pressure on the bladder.
A woman in her second trimester comes for a follow-up visit and says to the nurse, ìI feel like I'm on an emotional roller-coaster.î Which response by the nurse would be most appropriate? A) How often has this been happening to you? B) Maybe you need some medication to level things out. C) Mood swings are completely normal during pregnancy. D) Have you been experiencing any thoughts of harming yourself?
Ans: C Emotional lability is characteristic throughout most pregnancies. One moment a woman can feel great joy, and within a short time she can feel shock and disbelief. Frequently, pregnant women will start to cry without any apparent cause. Some women feel as though they are riding an emotional roller-coaster. These extremes in emotion can make it difficult for partners and family members to communicate with the pregnant woman without placing blame on themselves for their mood changes. Clear explanations about how common mood swings are during pregnancy are essential.
A woman suspecting she is pregnant asks the nurse about which signs would confirm her pregnancy. The nurse would explain that which of the following would confirm the pregnancy? A) Absence of menstrual period B) Abdominal enlargement C) Palpable fetal movement D) Morning sickness
Ans: C Only positive signs of pregnancy would confirm a pregnancy. The positive signs of pregnancy confirm that a fetus is growing in the uterus. Visualizing the fetus by ultrasound, palpating for fetal movements, and hearing a fetal heartbeat are all signs that make the pregnancy a certainty. Absence of menstrual period and morning sickness are presumptive signs, which can be due to conditions other than pregnancy. Abdominal enlargement is a probable sign.
Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which of the following responses by the nurse would be most appropriate? A) "Why are you crying?" B) "Will a pill help your pain?" C) "I'm sorry you lost your baby." D) "A baby still wasn't formed in your uterus."
Ans: C Telling the client that the nurse is sorry for the loss acknowledges the loss to the woman, validates her feelings, and brings the loss into reality.
It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse anticipates that the client will receive RhoGAM at which time? A) At 34 weeks' gestation and immediately before discharge B) 24 hours before delivery and 24 hours after delivery C) In the first trimester and within 2 hours of delivery D) At 28 weeks' gestation and again within 72 hours after delivery
Ans: D To prevent isoimmunization, the woman should receive RhoGAM at 28 to 32 weeks gestation and again within 72 hours after delivery.
A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating which of the following? A) Iron-deficiency anemia B) A multiple gestation pregnancy C) Greater-than-expected weight gain D) Hemodilution of pregnancy
Ans: D Feedback: During pregnancy, the red blood cell count increases along with an increase in plasma volume. However, there is a greater increase in the plasma volume as a result of hormonal factors and sodium and water retention. Thus, the plasma increase exceeds the increase in RBCs, resulting in hemodilution of pregnancy, which is also called physiologic anemia of pregnancy. Changes in maternal iron levels would be more indicative of an iron-deficiency anemia. Although anemia may be present with a multiple gestation, an ultrasound would be a more reliable method of identifying it. Weight gain does not correlate with hemoglobin levels.
When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which of the following would the nurse include as the underlying reason for the effect? A) Pancreatic function is affected by pregnancy. B) Glucose is utilized more rapidly during a pregnancy. C) The pregnant woman increases her dietary intake. D) Glucose moves through the placenta to assist the fetus.
Ans: D Feedback: The growing fetus has large needs for glucose, amino acids, and lipids, placing demands on maternal glucose stores. During the first half of pregnancy, much of the maternal glucose is diverted to the growing fetus. The pancreas continues to function during pregnancy. However, the placental hormones can affect maternal insulin levels. The demand for glucose by the fetus during pregnancy is high, but it is not necessarily used more rapidly. Placental hormones, not the woman's dietary intake, play a major role in glucose metabolism during pregnancy.
Which of the following findings on a prenatal visit at 10 weeks might lead the nurse to suspect a hydatidiform mole? A) Complaint of frequent mild nausea B) Blood pressure of 120/84 mm Hg C) History of bright red spotting 6 weeks ago D) Fundal height measurement of 18 cm
Ans: D Findings with a hydatidiform mole may include uterine size larger than expected. Mild nausea would be a normal finding at 10 weeks' gestation. Blood pressure of 120/84 would not be associated with hydatidiform mole and depending on the woman's baseline blood pressure may be within acceptable parameters for her. Bright red spotting might suggest a spontaneous abortion.
5. A pregnant client arrives at the maternity clinic complaining of constipation. Which of the following factors could be the cause of constipation during pregnancy? Select all that apply.
Ans: Decreased activity level Ans: Use of iron supplements Ans: Intestinal displacement
5. A couple is being assessed for infertility. The male partner is required to collect a semen sample for analysis. What instruction should the nurse give him?
Ans: Deliver sample for analysis within 1 to 2 hour after ejaculation.
16. A nurse is assessing a pregnant client with preeclampsia for suspected dependent edema. Which of the following is the most accurate description of dependent edema?
Ans: Dependent edema may be seen in the sacral area if the client is on bed rest
9. A nurse is caring for a pregnant client in labor in the health care facility. The nurse knows that which of the following marks the termination of the first stage of labor in the client?
Ans: Dilation of the cervix to 10 cm
7. A nurse working in a community health education program is assigned to educate community members about STIs. Which of the following nursing strategies should be adopted to prevent the spread of STIs in the community?
Ans: Discuss limiting the number of sex partners
20. A nurse is monitoring a client with spontaneous abortion who has been prescribed misoprostol. The nurse knows that which of the following symptoms are common adverse effects associated with misoprostol?
Ans: Dyspepsia Ans: Hypotension Ans: Tachycardia
10. A nurse is providing genetic counseling to a pregnant client. Which of the following are the nursing responsibilities related to counseling the client? Select all that apply
Ans: Explaining basic concepts of probability and disorder susceptibility Ans: Ensuring complete informed consent to facilitate decisions about genetic testing Ans: Knowing basic genetic terminology and inheritance patterns
2. A client has been informed that the result of the pregnancy test indicates that she is 3 weeks pregnant. Which of the following instructions should the nurse give to the client that is most appropriate given her condition?
Ans: Instruct client to stop using drugs, alcohol, and tobacco.
1. A 28 year old client who has just conceived arrives at a health care facility for her first prenatal visit to undergo a physical examination. Which of the following interventions should the nurse perform to prepare the client for the physical examination?
Ans: Instruct the client to empty her bladder
1. A client in her third trimester of pregnancy arrives at a healthcare facility complaining of cramping and low back pain; she also notes that she is urinating more frequently and that her breathing has become easier the past few days. Physical examination conducted by the nurse indicates that the client has edema of the lower extremities, along with an increase in vaginal discharge. The nurse notes knows that the client is experiencing which of the following conditions?
Ans: Lightening
10. A nurse is caring for a client who is in the first stage of labor. The client is experiencing extreme pain due to the labor. the nurse understands that which of the following is causing extreme pain the client? Select all that apply
Ans: Lower uterine segment distention Ans: Stretching and tearing of structures Ans: Dilation of cervix
3. A nurse is caring for a client who wishes to undergo an abortion. The nurse has concerns because abortion is against her personal convictions, and this is interfering with her professional duty. Which of the following should the nurse do to follow American Nurses Association (ANA) code of ethics for nurses?
Ans: Make arrangements for alternate care providers.
10. A nurse observes that a newborn has a 1-minute Apgar score of 5 points. What should the nurse conclude from the observed Apgar score?
Ans: Moderate difficulty in adjusting to extrauterine life
16. A client in her second trimester of pregnancy complains of discomfort during sexual activity. Which of the following instructions should a nurse provide?
Ans: Modify sexual positions to increase comfort
10. A nurse is caring for a 31 years old pregnant client who is subjected to abuse by her partner. The client has developed a feeling of hopelessness and doesn't feel confident in dealing with the situation at home, which makes her feel suicidal. Which of the following nursing interventions should the nurse offer to help the client deal with her situation?
Ans: Provide emotional support to empower the client to help herself.
12. A nurse is assigned the task of educating a pregnant client about childbirth. Which of the following nursing interventions should the nurse perform as a part of prenatal education for the client to ensure a positive childbirth experience?
Ans: Provide the client clear information on procedures involved Ans: Encourage the client to have a sense of mastery and self-control Ans: Encourage the client to have a positive reaction to pregnancy
6. A client in her 10th week of gestation arrives at the maternity clinic complaining of morning sickness. The nurse needs to inform the client about the body system adaptations during pregnancy. Which of the following factors corresponds to the morning sickness period during pregnancy?
Ans: Reduced stomach acidity Ans: Elevation of human chorionic gonadotropin (hCG) Ans: Increase in estrogen level
The nurse is planning the discharge instructions for the parents of a 1-month-old infant who has had a circumcision completed. Which information should be included in the education provided? a.Use petroleum jelly on the head of the penis for the first 2 weeks after the procedure b.Report any bleeding to the physician c.Reduce the child's fluid intake to reduce voiding during the first 24 hours d.Report redness or swelling on the penile shaft
Answer: d The discharge instructions for the child who has had a circumcision will include a listing of warning signs to report. Redness or swelling of the penile shaft is not a normal finding and must be reported. Petroleum jelly is often used for the first 24 hours after the procedure but not for a period of 2 weeks. Small amounts of bleeding may be noted. This bleeding if scant in amount does not warrant reporting to the physician. Reduction of water to impact voiding is inappropriate.
What criteria would the physician base his decision on to begin insulin therapy for a gestational diabetic mother? A. Urine is 2+ for glucose and serum blood glucose is 120. B. A 2-hour postprandial glucose level cannot be kept below 120 mg/dL. C. Weight gain is over 30 pounds (13.6 kg) and blood sugars are fluctuating between 95 and 130 throughout the day. D. Client cannot keep fasting blood sugar lower than 90 mg/dL.
B R:A physician usually recommends beginning a woman with gestational diabetes on insulin therapy when exercise and diet are ineffective and if she is unable to keep her fasting blood sugar levels below 95 mg/dL or her 2-hour postprandial glucose levels below 120 mg/dL.
A woman with diabetes is in labor. To reduce the likelihood of neonatal hypoglycemia, the nurse monitors the client's blood glucose level closely with the goal to maintain which level? A. below 105 mg/dL B. below 110 mg/dL C. below 120 mg/dL D. below 115 mg/dL
B R: For the laboring woman with diabetes, the blood glucose levels are monitored every 1 to 2 hours with the goal to maintain the levels below 110 mg/dL throughout the labor to reduce the likelihood of neonatal hypoglycemia. If necessary, an infusion of regular insulin may be given to maintain this level.
A postpartum woman who developed deep vein thrombosis is being discharged on anticoagulant therapy. After teaching the woman about this treatment, the nurse determines that additional teaching is needed when the woman states which of the following? A) "I will use a soft toothbrush to brush my teeth." B) "I can take ibuprofen if I have any pain." C) "I need to avoid drinking any alcohol." D) "I will call my health care provider if my stools are black and tarry."
B Individuals receiving anticoagulant therapy need to avoid use of any over-the-counter products containing aspirin or aspirin-like derivatives such as NSAIDs (ibuprofen) to reduce the risk for bleeding.
A postpartum client comes to the clinic for her routine 6-week visit. The nurse assesses the client and suspects that she is experiencing subinvolution based on which of the following? A) Nonpalpable fundus B) Moderate lochia serosa C) Bruising on arms and legs D) Fever
B Subinvolution is usually identified at the woman's postpartum examination 4 to 6 weeks after birth. The clinical picture includes a postpartum fundal height that is higher than expected, with a boggy uterus; the lochia fails to change colors from red to serosa to alba within a few weeks. * Normally, at 4 to 6 weeks, lochia alba or no lochia would be present and the fundus would not be palpable. Thus evidence of lochia serosa suggests subinvolution.
Which of the following would the nurse include when teaching a pregnant woman about chorionic villus sampling? A) "The results should be available in about a week." B) "You'll have an ultrasound first and then the test." C) "Afterwards, you can resume your exercise program." D) "This test is very helpful for identifying spinal defects."
B) "You'll have an ultrasound first and then the test."
9. Which of the following descriptions would the nurse include when teaching a client about her scheduled colposcopy? A)A gel will be applied to your abdomen and a microphone-like device will be moved over the area to identify problem areas. B) A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument. C) Scrapings of tissue will be obtained and placed on slides to be examined under the microscope. D)After you receive anesthesia, a small device will be inserted into your abdomen near your belly button to obtain tissue samples.
B) A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument.
A nursing instructor is describing the hormones involved in the menstrual cycle to a group of nursing students. The instructor determines the teaching was successful when the students identify follicle-stimulating hormone as being secreted by which of the following? A) Hypothalamus B) Anterior pituitary gland C) Ovaries D) Corpus luteum
B) Anterior pituitary gland
A nurse practicing in the community is preparing a presentation for a group of nursing students about this practice setting. Which of the following would the nurse include as characteristic of this role? A) Greater emphasis ondirect physical care B) Broader assessment to include the environment C) Increased dependency on physician D) Limited decision making and support
B) Broader assessment to include the environment
A group of students are reviewing an article describing information related to indicators for women's health and the results of a national study. Which of the following would the students identify as being satisfactory for women? Select all that apply. A) Smoking cessation B) Colorectal cancer screening C) Violence against women D) Health insurance coverage E) Mammograms
B) Colorectal cancer screening E) Mammograms
A group of nursing students are preparing a presentation for their class about measures to prevent toxoplasmosis. Which of the following would the students be least likely to include? A) Washing raw fruits and vegetables before eating them B) Cooking all meat to an internal temperature of 140 F C) Wearing gardening gloves when working in the soil D) Avoiding contact with a cats litter box.
B) Cooking all meat to an internal temperature of 140 F
A group of nursing students are preparing a presentation for their class about measures to prevent toxoplasmosis. Which of the following would the students be LEAST likely to include? Select all that apply. A) Washing raw fruits and vegetables before eating them B) Cooking all meat to an internal temperature of 140 F C) Wearing gardening gloves when working in the soil D) Avoiding contact with a cats litter box.
B) Cooking all meat to an internal temperature of 140 F *Avoid eating raw or undercooked meat, especially lamb or pork. Cook all meat to an internal temperature of 160°F (71°C) throughout. the other ones are truth
During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute) and irregular, with bilateral crackles in the lower lung bases. Which nursing diagnosis would be the priority for this client? A) Ineffective tissue perfusion related to supine hypotensive syndrome B) Impaired gas exchange related to pulmonary congestion C) Activity intolerance related to increased metabolic requirements D) Anxiety related to fear of pregnancy outcome
B) Impaired gas exchange related to pulmonary congestion -Typically, heart rate increases by approximately 10 to 15 beats per minute during pregnancy and the lungs should be clear. Dyspnea may occur during the third trimester as the enlarging uterus presses on the diaphragm. However, the findings described indicate that the woman is experiencing impaired gas exchange. There is no evidence to support problems with tissue perfusion, activity, or anxiety.
When describing the male sexual response to a group of students, the instructor determines that the teaching was successful when they identify emission as which of the following? A) Semen forced through the urethra to the outside B) Movement of sperm from the testes and fluid into the urethras C) Dilation of the penile arteries with increased blood flow to the tissues. D) Body's return to the physiologic nonstimulated state
B) Movement of sperm from the testes and fluid into the urethras
1. The nurse would refer a client, age 54, for follow-up for suspected endometrial carcinoma if she reports which of the following? A)Use of oral contraceptives between ages 18 and 25 B) Onset of painless, red postmenopausal bleeding C) Menopause occurring at age 46 D)Use of intrauterine device for 3 years
B) Onset of painless, red postmenopausal bleeding
A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. "I've also been waking up at night feeling really hot and sweating. The nurse interprets these findings as which of the following? A) Menopause B) Perimenopause C) Climacteric D) Menarche
B) Perimenopause
16.When assessing a female client for the possibility of vulvar cancer, which of the following would the nurse most likely expect the client to report? (Select all that apply.) A) Abnormal vaginal bleeding B) Persistent vulvar itching C) History of herpes simplex D) Lesion on the cervix E) Abnormal Pap smear
B) Persistent vulvar itching C) History of herpes simplex
A nurse is developing a program for pregnant women with diabetes about reducing complications. Which factor would the nurse identify as being most important in helping to reduce the maternal/fetal/neonatal complications associated with pregnancy and diabetes? A)Stability of the woman's emotional and psychological status B)Degree of glycemic control achieved during the pregnancy C)Evaluation of retinopathy by an ophthalmologist D)Blood urea nitrogen level (BUN. within normal limits
B)Degree of glycemic control achieved during the pregnancy
4. A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which of the following? A) Increased energy level with alternating strong and weak contractions B) Moderately strong contractions every 4 minutes, lasting about 1 minute C) Contractions noted in the front of abdomen that stop when she walks D) Pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds
B. - Moderately strong regular contractions 60 seconds in duration indicate that the client is probably in the active phase of the first stage of labor. - Alternating strong and weak contractions, contractions in the front of the abdomen that change with activity - pink-tinged secretions with irregular contractions suggest false labor.
After teaching a group of students about fetal development, the instructor determines that the teaching was successful when the students identify which of the following as essential for fetal lung development? A) Umbilical cord B) Amniotic fluid C) Placenta D) Trophoblasts
B. Amniotic fluid is essential for fetal growth and development, especially fetal lung development. The umbilical cord is the lifeline from the mother to the growing embryo. The placenta serves as the interface between the mother and developing fetus. It secretes hormones and supplies the fetus with nutrients and oxygen needed for growth. The trophoblasts differentiate into all the cells that form that placenta.
A woman with preterm labor is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately? A) Respiratory rate of 16 breaths per minute B) Diminished deep tendon reflexes C) Urine output of 45 mL/hour D) Alert level of consciousness
B. Diminished deep tendon reflexes suggest magnesium toxicity, which requires immediate intervention. Additional signs of magnesium toxicity include a respiratory rate less than 12 breaths/minute, urine output less than 30 mL/hour, and a decreased level of consciousness.
After teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching? A) "Holding a pillow against my incision will help me when I cough." B) "I'm going to have to wait a few days before I can start breast-feeding." C) "I guess the nurses will be getting me up and out of bed rather quickly." D) "I'll probably have a tube in my bladder for about 24 hours or so."
B. Typically, breast-feeding is initiated early as soon as possible after birth to promote bonding. The woman may need to use alternate positioning techniques to reduce incisional discomfort.
During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute) and irregular, with bilateral crackles in the lower lung bases. Which nursing diagnosis would be the priority for this client? A) Ineffective tissue perfusion related to supine hypotensive syndrome B) Impaired gas exchange related to pulmonary congestion C) Activity intolerance related to increased metabolic requirements D) Anxiety related to fear of pregnancy outcome
B. Typically, heart rate increases by approximately 10 to 15 beats per minute during pregnancy and the lungs should be clear. Dyspnea may occur during the third trimester as the enlarging uterus presses on the diaphragm. However, the findings described indicate that the woman is experiencing impaired gas exchange. There is no evidence to support problems with tissue perfusion, activity, or anxiety.
10. A woman telephones her health care provider and reports that her "water just broke." Which suggestion by the nurse would be most appropriate? A) "Call us back when you start having contractions." B) "Come to the clinic or emergency department for an evaluation." C) "Drink 3 to 4 glasses of water and lie down." D) "Come in as soon as you feel the urge to push."
B. When the amniotic sac ruptures, the barrier to infection is gone and there is the danger of cord prolapse if engagement has not occurred. Therefore, the nurse should suggest that the woman come in for an evaluation.
14. A woman in her third trimester comes to the clinic for a prenatal visit. During assessment the woman reports that her breathing has become much easier in the last week but she has noticed increased pelvic pressure, cramping, and lower back pain. The nurse determines that which of the following has most likely occurred? A) Cervical dilation B) Lightening C) Bloody show D) Braxton-Hicks contractions
B. Lightening occurs when the fetal presenting part begins to descend into the maternal pelvis. The uterus lowers and moves into the maternal pelvis. The shape of the abdomen changes as a result of the change in the uterus. The woman usually notes that her breathing is much easier. However, she may complain of increased pelvic pressure, cramping, and lower back pain. * Although cervical dilation also may be occurring, it does not account for the woman's complaints. * Bloody show refers to passage of the mucous plug that fills the cervical canal during pregnancy. It occurs with the onset of labor.
A nurse notes a woman's prelabor vital signs were: temperature 98.8° F (37.1° C); BP 120/70 mm Hg; heart rate 80 bpm. and respirations 20 breaths/min. Which assessment findings during the early postpartum period should the nurse prioritize?
BP 90/50 mm Hg, heart rate 120 bpm, respirations 24 breaths/min
A nurse is conducting an awareness session on sexual abuse, and she is explaining the psychological profile of an average abuser. Which trait is often displayed by abusers? a) They have parents who are divorced. b) They are usually physically imposing. c) They exhibit antisocial behaviors. d) They belong to the low-income group.
C
Many women develop iron-deficient anemia during pregnancy. What diagnostic criteria would the nurse monitor for to determine anemia in the pregnant woman? A. Hemoglobin of 13 or lower B. Heart rate of 84 C. Hematocrit of 32% or less D. Blood pressure of 100/68
C R:Iron-deficiency anemia is diagnosed in a pregnant woman if the hematocrit is less that 33% or the hemoglobin is less than 11 g/dL. Tachycardia, hypotension and tachypnea are all symptoms of iron-deficiency anemia but are not diagnostic criteria.
Which of the following would be most appropriate when massaging a woman's fundus? A) Place the hands on the sides of the abdomen to grasp the uterus. B) Use an up-and-down motion to massage the uterus. C) Wait until the uterus is firm to express clots. D) Continue massaging the uterus for at least 5 minutes.
C - The uterus must be firm before attempts to express clots are made because application of firm pressure on an uncontracted uterus could lead to uterine inversion. - One hand is placed on the fundus and the other hand is placed on the area above the symphysis pubis. - Circular motions are used for massage. There is no specified amount of time for fundal massage. - Uterine tissue responds quickly to touch, so it is important not to overmassage the fundus.
After teaching a class on preventing pelvic inflammatory disease, the instructor determines that the teaching was successful when the class identifies which of the following as an effective method? A) Advising sexually active females to use hormonal contraception B) Encouraging vaginal douching on a weekly basis. C) Emphasizing the need for infected sexual partners to receive treatment D) Promoting routine treatment for asymptomatic females as risk
C Vaccines are under development or are undergoing clinical trials for certain STIs, including HIV and HSV. However, the only vaccines currently available are for prevention of HAV, HBV, and HPV infection.
A postpartum woman is ordered to receive oxytocin to stimulate the uterus to contract. Which of the following would be most important for the nurse to do? A) Administer the drug as an IV bolus injection. B) Give as a vaginal or rectal suppository. C) Piggyback the IV infusion into a primary line. D) Withhold the drug if the woman is hypertensive.
C When giving oxytocin, it should be diluted in a liter of IV solution and the infusion set up to be piggy-backed into a primary line to ensure that the medication can be discontinued readily if hyperstimulation or adverse effects occur. * It should never be given as an IV bolus injection.
Which of the following is considered a risk factor for vulvar cancer? A. Vitamin B12 deficiency B. Epstein-Barr virus C. Human papillomavirus D. Adenovirus
C because HPV isn't just associated with cervical cancer, but also a major risk factor for the development of vulvar cancer. * Choice "B" is incorrect because this virus is associated with mononucleosis, hepatitis, and an increased risk of lymphomas in the transplant client.
A nurse is providing care to a woman who has just delivered a healthy newborn. Which action would least likely demonstrate application of the concept of family-centered care? A) Focusing on the birth as a normal healthy event for the family B) Creating opportunities for the family to make informed decisions C) Encouraging the woman to keep her other children at home D) Fostering a sense of respect for the mother and the family
C) Encouraging the woman to keep her other children at home
A nurse is preparing a presentation for a local women's group about heart disease and women. Which of the following would the nurse expect to address when discussing measures to promote health. A) Women have similar symptoms as men for a heart attack. B) Heart disease is no longer viewed as a "man's disease." C) Women experiencing a heart attack are at greater risk for dying. D) Heart attacks in women are more easily diagnosed.
C) Women experiencing a heart attack are at greater risk for dying.
A nurse is working with a pregnant woman to schedule follow-up visits for her pregnancy. Which statement by the woman indicates that she understands the scheduling? A) "I need to make visits every 2 months until I'm 36 weeks pregnant." B) "Once I get to 28 weeks, I have to come twice a month." C) "From now until I'm 28 weeks, I'll be coming once a month." D) "I'll make sure to get a day off every 2 weeks to make my visits."
C) "From now until I'm 28 weeks, I'll be coming once a month."
During class, a nursing student asks, "I read an article that was talking about integrative medicine. What is that?" Which response by the instructor would be most appropriate? A) "It refers to the use of complementary and alternative medicine in place of traditional therapies for a condition." B) "It means that complementary and alternative medicine is used together with conventional therapies to reduce pain or discomfort." C) "It means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective." D) "It refers to situations when a client and his or her family prefer to use an unproven method of treatment over a proven one."
C) "It means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective."
A nurse is educating a client about a care plan. Which of the following statements would be appropriate to assess the client's learning ability? A) "Did you graduate from high school; how many years of schooling did you have?" B) "Do you have someone in your family who would understand this information?" C) "Many people have trouble remembering information; is this a problem for you?" D) "Wouldyou prefer that the doctor give you more detailed medical information?"
C) "Many people have trouble remembering information; is this a problem for you?"
A pregnant woman in the 36th week of gestation complains that her feet are quite swollen at the end of the day. After careful assessment, the nurse determines that this is an expected finding at this stage of pregnancy. Which intervention would be most appropriate for the nurse to suggest? A) "Limit your intake of fluids." B) "Eliminate salt from your diet." C) "Try elevating your legs when you sit." D) "Wear Spandex-type full-length pants."
C) "Try elevating your legs when you sit."
When assuming the role of discharge planner for a woman requiring ventilator support at home, the nurse would do which of the following? A) Confer with the client's mother B) Teach new self-care skills to the client C) Determine if there is a need for back-up power D) Discuss coverage with the insurance company
C) Determine if there is a need for back-up power
After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first: A) Sexual experience B) Full hormonal cycle C) Menstrual period D) Sign of breast development
C) Menstrual period
A nursing student is reviewing information about documenting client care and education in the medical record and the purposes that it serves. The student demonstrates a need for additional study when the nurse identifies which of the following as a reason? A) Serves as a communication tool for the interdisciplinary team. B) Demonstrates education the family has received if legal matters arise. C) Permits others access to allow refusal of medical insurance coverage. D) Verifies meeting client education standards set by the Joint Commission.
C) Permits others access to allow refusal of medical insurance coverage.
24.An instructor is describing the development of cervical cancer to a group of students. The instructor determines that the teaching was successful when the students identify which area as most commonly involved? A) Internal cervical os B) Junction of the cervix and fundus C) Squamous-columnar junction D) External cervical os
C) Squamous-columnar junction
Which female reproductive tract structure would the nurse describe to a group of young women as containing rugae that enable it to dilate during labor and birth? A) Cervix B) Fallopian tube C) Vagina D) Vulva
C) Vagina
After teaching a group of nursing students about the impact of pregnancy on the older woman, the instructor determines that the teaching was successful when the students state which of the following? A) The majority of women who become pregnant over age 35 experience complications. B) Women over the age of 35 who become pregnant require a specialized type of assessment. C) Women over age 35 and are pregnant have an increased risk for spontaneous abortions. D) Women over age 35 are more likely to have substance abuse problems.
C) Women over age 35 and are pregnant have an increased risk for spontaneous abortions.
Which of the following would the nurse expect to include in the plan of care for a woman with mastitis who is receiving antibiotic therapy? A. Stop breast-feeding and apply lanolin. B. Administer analgesics and bind both breasts. C. Apply warm or cold compresses and administer analgesics. D. Remove the nursing bra and expose the breast to fresh air.
C. Applying compresses and giving analgesics would be helpful in providing comfort to the woman with painful breasts. Treatment for mastitis encourages frequent breast-feeding to empty the breasts. Lanolin applied to the breasts will have little impact on mastitis other than to keep them moist. Binding both breasts will not bring relief; in fact, it could cause additional discomfort. Emptying the breasts frequently through breast-feeding would be helpful. Although wearing a nursing bra will help support the heavy breasts and fresh air is helpful to prevent cracked nipples, these are ineffective once mastitis develops.
16. A nurse is documenting fetal lie of a woman in labor. Which term would the nurse most likely use? A) Flexion B) Extension C) Longitudinal D) Cephalic
C. Fetal lie refers to the relationships of the long axis (spine) of the fetus to the long axis (spine) of the mother. There are two primary lies: longitudinal and transverse.
When assessing fetal heart rate, the nurse finds a heart rate of 175 bpm, accompanied by a decrease in variability and late decelerations. Which of the following would the nurse do next? A) Have the woman change her position. B) Administer oxygen. C) Notify the health care provider. D) Continue to monitor the pattern every 15 minutes.
C. Fetal tachycardia as evidenced by a fetal heart rate greater than 160 bpm accompanied by a decrease in variability and late decelerations is an ominous sign indicating the need for prompt intervention. The health care provider should be notified immediately and then measures should be instituted such as having the woman lie on her side and administering oxygen.
A woman with type 2 diabetes is considering becoming pregnant and asks the nurse whether she will be able to continue taking her current oral hypoglycemics. The nurse's response will point out which factor? A. are usually suggested primarily for women who develop gestational diabetes. B. can be taken until the degeneration of the placenta occurs. C. can be used as long as they control serum glucose levels. D. have been shown to be effective and safe in recent short term studies.
D R: Recent studies have examined the use of oral hypoglycemic medications in pregnancy with much success. Several studies have used glyburide with promising results. Many health care providers are using glyburide and metformin as an alternative to insulin therapy because they do not cross the placenta and therefore do not cause fetal/neonatal hypoglycemia. Some oral hypoglycemic medications are considered safe and may be used if nutrition and exercise are not adequate alone. Maternal and newborn outcomes are similar to those seen in women who are treated with insulin. Oral hypoglycemic agents, however, must be further investigated to determine their safety with confidence and provide better treatment options for diabetes in pregnancy. Currently, there is a growing acceptance of glyburide use as a primary therapy for gestational diabetes. Glyburide and metformin have also been found to be safe, effective, and economical for the treatment of gestational diabetes, although neither drug has been approved by the FDA for use in pregnancy.
A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would assess for which of the following? A) An inverted nipple on the affected breast B) No breast milk in the affected breast C) An ecchymotic area on the affected breast D) Hardening of an area in the affected breast
D Mastitis is characterized by a tender, hot, red, painful area on the affected breast. An inverted nipple is not associated with mastitis. With mastitis, the breast is distended with milk, the area is inflamed (not ecchymotic), and there is breast tenderness.
As part of an inservice program, a nurse is describing a transient, self-limiting mood disorder that affects mothers after childbirth. The nurse correctly identifies this as postpartum: A) Depression B) Psychosis C) Bipolar disorder D) Blues
D Postpartum blues are manifested by mild depressive symptoms of anxiety, irritability,mood swings, tearfulness, increased sensitivity, feelings of being overwhelmed, and fatigue. They are usually self-limiting and require no formal treatment other than reassurance and validation of the woman's experience as well as assistance in caring for herself and her newborn.
A nurse is assessing a postpartum woman. Which finding would cause the nurse to be most concerned? A) Leg pain on ambulation with mild ankle edema B) Calf pain with dorsiflexion of the foot. C) Perineal pain with swelling along the episiotomy D) Sharp stabbing chest pain with shortness of breath
D Sharp stabbing chest pain with shortness of breath suggests pulmonary embolism, an emergency that requires immediate action. * Perineal pain with swelling along the episiotomy might be a normal finding or suggest an infection. Of the conditions, pulmonary embolism is the most urgent.
The health care provider of a newly pregnant client determines the woman also has mitral stenosis and will need appropriate therapy. Which medication should the nurse prepare to teach this client to provide her with the best possible care? A. warfarin B. digoxin C. aspirin D. heparin
D This client has an increased risk for developing blood clots. If an anticoagulant is required, heparin is the drug of choice as it does not cross the placenta barrier. Warfarin crosses the placenta and may have teratogenic effects. Aspirin is not recommended in this situation. If digoxin is not used to prevent blood clots.
The nurse is making a home visit to a client who had a cesarean birth 3 days ago. Assessment reveals that the client is complaining of intermittent pain, rating it as 8 on a scale of 1 to 10. She states, "I'm pretty tired. And with this pain, I haven't been drinking and eating like I should. The medication helps a bit but not much. My mom has been helping with the baby." Her incision is clean, dry, and intact. Which nursing diagnosis would the nurse identify as the priority for this client? A) Impaired skin integrity related to cesarean birth incision B) Fatigue related to effects of surgery and caretaking activities C) Imbalanced nutrition, less than body requirements related to poor fluid and food intake D) Acute pain related to incision and cesarean birth
D) Acute pain related to incision and cesarean birth
A client who is in labor presents with shoulder dystocia of the fetus. Which is an important nursing intervention? A) Assess for prolonged second stage of labor with arrest of descent. B) Assess for reports of intense back pain in first stage of labor. C) Anticipate possible use of forceps to rotate to anterior position at birth. D) Assist with positioning the woman in squatting position.
D) Assist with position the woman in squatting position. The nurse caring for the client in labor with shoulder dystocia of the fetus should assist with positioning the client in squatting position. The client can also be helped into the hands and knees position or lateral recumbent position for birth, to free the shoulders.
2. Which of the following instructions would the nurse include when preparing a woman for a Pap smear? A) Refrain from sexual intercourse for 1 week before the test. B) Wear cotton panties on the day of the test. C) Avoid taking any medications for 24 hours. D) Do not douche for 48 hours before the test.
D) Do not douche for 48 hours before the test.
A nurse is engaged in providing family-centered care for a woman and her family. The nurse is providing instrumental support with which activity? A) Explaining to the woman and family what to expect during the birth process. B) Assisting the woman in breathing techniques to cope with labor contractions. C) Reinforcing the woman's role as a mother after birth D) Helping the family obtain extra financial help for prescribed phototherapy
D) Helping the family obtain extra financial help for prescribed phototherapy
A pregnant woman asks the nurse, I'm a big coffee drinker. Will the caffeine in my coffee hurt my baby? Which response by the nurse would be most appropriate? A) The caffeine in coffee has been linked to birth defects. B) Caffeine has been shown to cause growth restriction in the fetus. C) Caffeine is a stimulant and needs to be avoided completely. D) If you keep your intake to less than 300 mg/day, you should be okay.
D) If you keep your intake to less than 300 mg/day, you should be okay.
A nursing instructor is presenting a class for a group of students about community-based nursing interventions. The instructor determines that additional teaching is needed when the students identify which of the following? A) Conducting childbirth education classes B) Counseling a pregnant teen with anemia C) Consulting with a parent of a child who is vomiting D) Performing epidemiologic investigations
D) Performing epidemiologic investigations Nursing interventions: - Health screening - Health education programs - Medication administration - Telephone consultation - Health system referral - Instructional - Nutritional counseling - Risk identification
A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborns risk for the infection. Which of the following statements by the nurse would be most appropriate? A)Youll probably have a cesarean birth to prevent exposing your newborn. B)Antibodies cross the placenta and provide immunity to the newborn. C)Wait until after the infant is born and then something can be done. D)Antiretroviral medications are available to help reduce the risk of transmission.
D)Antiretroviral medications are available to help reduce the risk of transmission.
A woman with diabetes is considering becoming pregnant. She asks the nurse whether she will be able to take oral hypoglycemics when she is pregnant. The nurses response is based on the understanding that oral hypoglycemics: A)Can be used as long as they control serum glucose levels B)Can be taken until the degeneration of the placenta occurs C)Are usually suggested primarily for women who develop gestational diabetes D)Show promising results but more studies are needed to confirm their effectiveness
D)Show promising results but more studies are needed to confirm their effectiveness
A nurse is caring for a pregnant client who is in labor. Which of the following maternal physiologic responses should the nurse monitor for in the client as the client progresses through childbirth?
Increase in HR Increase in BP Increase RR
The nursing instructor is discussing violence and abuse that is seen in women with a student. She realizes that the student needs further instruction when the student states which of the following? a) Nurses will come in contact with violence no matter what health care setting they work. b) Violence against women is on the rise in the United States. c) Nurses will come in contact with sexual abuse no matter what health care setting they work. d) Nurses only come in contact with violence in the ER.
Nurses only come in contact with violence in the ER.
The nurse is conducting a postpartum examination on a client who reports pain and is unable to sit comfortably. The perineal exam reveals an episiotomy appropriately approximated without signs of a hematoma. Which action should the nurse prioritize?
Place an ice pack
A woman with a history of crack cocaine abuse is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also complains of acute abdominal pain that is continuous. Which of the following would the nurse suspect? A) Amniotic fluid embolism B) Shoulder dystocia C) Uterine rupture D) Umbilical cord prolaps
Uterine rupture Uterine rupture is associated with crack cocaine use, and generally the first and most reliable sign is sudden fetal distress accompanied by acute abdominal pain, vaginal bleeding, hematuria, irregular wall contour, and loss of station in the fetal presenting part.
A nurse is reviewing the fetal heart rate pattern and observes abrupt decreases in FHR below the baseline, appearing as a U-shape. The nurse interprets these changes as reflecting which of the following? A) Early decelerations B) Variable decelerations C) Prolonged decelerations D) Late decelerations
Variable decelerations present as visually apparent abrupt decreases in FHR below baseline and have an unpredictable shape on the FHR baseline, possibly demonstrating no consistent relationship to uterine contractions. The shape of variable decelerations may be U, V, or W, or they may not resemble other patterns.
Fourteen-year-old Ann and her parents have presented at the obstetrician's office in the second trimester, the teen had been hiding the pregnancy. The nurse is helping them develop a plan of care. What is the best thing she can say to the clearly angry parents? a) "I know you must be very upset and angry about Ann's pregnancy but because she's still an adolescent herself, she'll need your guidance in making nutritional and health choices that will be good for the baby and for herself." b) "Anger won't help this situation at all. You'll only push Ann away and she'll be less likely to make good choices." c) "Ann needs to make decisions about this pregnancy for herself." d) "I understand your anger but if you had encouraged Ann to use condoms she would probably not be in this situation."
a) "I know you must be very upset and angry about Ann's pregnancy but because she's still an adolescent herself, she'll need your guidance in making nutritional and health choices that will be good for the baby and for herself." Rationale: The nurse needs to acknowledge the anger of the parents but remember her role is as the patient advocate. The nurse needs to encourage the relationship of support between the parents and the patient. Option A is incorrect as it is attempting to lay down ground rules between the patient and her parents, it also does not acknowledge the parents' feelings in this situation. Option C is incorrect as it might be interpreted as a lecture to the parents, and it does not acknowledge their feelings in this situation. Option D is incorrect; again it sounds like lecturing and it places blame on the parents, which is inappropriate.
A nurse is assessing a client in her seventh month of pregnancy who has an artificial valve prosthesis. The client is taking an oral anticoagulant to prevent the formation of clots at the valve site. Which of the following nursing interventions is most appropriate in this situation? a) Observe the client for signs of petechiae and premature separation of the placenta b) Instruct the client to avoid wearing constrictive knee-high stockings c) Urge the client to discontinue the anticoagulant to prevent pregnancy complications d) Put the client on bed rest
a) Observe the client for signs of petechiae and premature separation of the placenta Rationale: Subclinical bleeding from continuous anticoagulant therapy in the woman has the potential to cause placental dislodgement. Observe a woman who is taking an anticoagulant for signs of petechiae and signs of premature separation of the placenta, therefore, during both pregnancy and labor. The nurse should not urge the client to discontinue the anticoagulant, as this is not within the nurse's scope of practice and, in any case, the client still needs the anticoagulant to prevent clots. Bed rest is prescribed for clients with a thrombus, to prevent it from moving and becoming a pulmonary embolus. Avoiding the use of constrictive knee-high stockings is to prevent thrombus formation.
A young woman with scoliosis has just learned that she is pregnant. Several years ago, she had stainless-steel rods surgically implanted on both sides of her vertebrae to strengthen and straighten her spine. However, her pelvis is unaffected by the condition. Which of the following does the nurse anticipate in this woman's pregnancy? a) Potential for greater than usual back pain b) Cesarean birth c) Increased risk of fetal trauma d) Increased risk of miscarriage
a) Potential for greater than usual back pain Rationale: Surgical correction of scoliosis (lateral curvature of the spine) involves implanting stainless-steel rods on both sides of the vertebrae to strengthen and straighten the spine. Such rod implantations do not interfere with pregnancy; a woman may notice more than usual back pain, however, from increased tension on back muscles. If a woman's pelvis is distorted due to scoliosis, a cesarean birth may be scheduled to ensure a safe birth, but this is not required in this scenario. Vaginal birth, if permitted, requires the same management as for any woman. With the improved management of scoliosis, the high maternal and perinatal risks associated with the disorder reported in earlier literature no longer exist.
A postpartum woman is diagnosed with metritis. The nurse interprets this as an infection involving which of the following? (Select all that apply.) A) Endometrium B) Decidua C) Myometrium D) Broad ligament E) Ovaries F) Fallopian tubes
a, b, c Metritis is an infectious condition that involves the endometrium, decidua, and adjacent myometrium of the uterus. Extension of metritis can result in parametritis, which involves the broad ligament and possibly the ovaries and fallopian tubes, or septic pelvic thrombophlebitis.
After teaching a group of nursing students about tocolytic therapy, the instructor determines that the teaching was successful when they identify which drug as being used for tocolysis? (Select all that apply.) A) Nifedipine B) Terbutaline C) Dinoprostone D) Misoprostol E) Indomethacin
a, b, e Medications most commonly used for tocolysis include: - magnesium sulfate (which reduces the muscle's ability to contract) - terbutaline (Brethine, a beta-adrenergic) - indomethacin (Indocin, a prostaglandin synthetase inhibitor) - nifedipine (Procardia, a calcium channel blocker). * Dinoprostone and misoprostol are used to ripen the cervix.
A nurse caring for a client who is scheduled to undergo an amnioninfusion. The nurse would question this order if which is noted upon client assessment? a. Uterine hypertonicity b. Active genital herpes infection c. Blood pressure of 130/88 d. Decreased urine output
a. Uterine hypertonicity
The assessment of a pregnant client, who is toward the end of her third trimester, reveals that she has increased prostiglandin levels. Which of the following factors should the nurse assess for in the client? Select all that apply
a. reduction in cervical resistance b. Myometrial contraction d. Softening and thinning of the cervix
A nurse prepares a woman with an abnormal Pap smear for further diagnostic evaluation. Which of the following would the nurse expect to be done? a) Colposcopy b) Transvaginal ultrasound c) HSV testing d) Endometrial biopsy
a: An abnormal Pap smear typically requires further evaluation, usually with a colposcopy. HSV testing would not be warranted. A transvaginal ultrasound would be used to identify endometrial thickness to determine the need for an endometrial biopsy for endometrial cancer. An endometrial biopsy would be done to evaluate for endometrial canc
A middle-aged woman is seen in the OB/GYN clinic and reports abdominal bloating, fatigue, abdominal pain, urinary frequency, and constipation. She also says that she had lost 24 pounds in the last month without trying to lose. For which disease should the physician screen this patient? a) Ovarian cancer b) Fibroids c) Breast cancer d) Pelvic organ prolapse (POP)
a: The most common early signs for ovarian cancer include abdominal bloating, early satiety, fatigue, vague abdominal pain, urinary frequency, diarrhea or constipation, and unexplained weight loss or gain. Fibroids do not have these same symptoms, nor does breat cancer or POP
A nurse is caring for a 30-year-old woman who was just diagnosed with cervical cancer. Which of the following psychosocial needs would be the priority for the nurse with her client? a) Clear information on the disease, management, and treatment b) Offering words of hope to the client c) Touching the client's hand for comfort d) Remaining cheerful through all of the interactions
a: Women diagnosed with cancer of the reproduction tract need to understand their disease, prognosis, and what treatment options they have. The nurse's role is to educate with effective and clear communication techniques. The nurse should be sincere and may provide realistic hope, but her role as educator is primary
A woman's baby is HIV positive at birth. She asks the nurse if this means the baby will develop AIDS. Which of the following statements would be the nurse's best answer? a) "She already has AIDS. That's what being HIV positive means." b) "The antibodies may be those transferred across the placenta; the baby may not develop AIDS." c) "HIV is transmitted at birth; having a cesarean birth prevented transmission." d) "HIV antibodies do not cross the placenta; this means the baby will develop AIDS."
b) "The antibodies may be those transferred across the placenta; the baby may not develop AIDS." Rationale: Infants born of HIV-positive women test positive for HIV antibodies at birth because these have crossed the placenta. An accurate disease status cannot be determined until the antibodies fade at about 18 months. Testing positive for HIV antibodies does not mean the infant has AIDS. Having a cesarean birth does decrease the risk of transmitting the virus to the infant at birth; it does not prevent the transmission of the disease. HIV antibodies do cross the placenta, which is why babies born of HIV positive mothers are HIV positive.
A pregnant client with a history of heart disease has been admitted to a healthcare center with complaints of breathlessness. The client also complains of shortness of breath and easy fatigue when doing ordinary activity. The client's condition is markedly compromised. The nurse would document the client's condition using the New York Heart Association (NYHA) classification system as which class? a) Class IV b) Class III c) Class I d) Class II
b) Class III Rationale: The nurse should classify the client's condition as belonging to class III of NYHA. In class III of NYHA classification, the client will be symptomatic with ordinary activity and her condition is markedly compromised. The client is asymptomatic with all kinds of activity and is in uncompromised state in class I. The client is symptomatic with increased activity and is in slight compromised state in class II. The client is symptomatic when resting and is incapacitated in class IV.
The nurse explains to a pregnant patient that she will need to take iron during her pregnancy after being diagnosed with iron-deficiency anemia. The nurse suggests that absorption of the supplemental iron can be increased by taking it with which of the following? a) Milk b) Orange juice c) Meals high in iron d) Legumes
b) Orange juice Rationale: Anemia is a condition in which the blood is deficient in red blood cells, from an underlying cause. The woman needs to take iron to manufacture enough red blood cells. Taking an iron supplement will help improve her iron levels, and taking iron with foods containing ascorbic acid, such as orange juice, improves the absorption of iron.
A client is diagnosed with peripartum cardiomyopathy (PPCM). Which of the following would the nurse expect to administer to the client? a) Methadone therapy b) Restricted sodium intake c) Ginger therapy d) Monoamine oxidase inhibitors
b) Restricted sodium intake Rationale: The client with peripartum cardiomyopathy should be prescribed restricted sodium intake to control the BP. Monoamine oxidase inhibitors are given to treat depression in pregnancy, and not peripartum cardiomyopathy. Methadone is a drug given for the treatment of substance abuse during pregnancy. Complimentary therapies like ginger therapy help in the alleviation of hyperemesis gravidarum, and not peripartum cardiomyopathy.
Which factor would contribute to a high-risk pregnancy? a) First pregnancy at age 33 b) Type 1 diabetes c) History of allergy to honey bee pollen d) Blood type O positive
b) Type 1 diabetes Rationale: A woman with a history of diabetes has an increased risk for perinatal complications, including hypertension, preeclampsia, and neonatal hypoglycemia. The age of 33 without other risk factors doesn't increase risk, nor does type O-positive blood or environmental allergens.
A pregnant single mom living alone tells the nurse she is considering getting a cat for her two year old daughter. Which is the best response by the nurse? a) The exposure to the cat litter may cause you to need a C-section b) You should wait until after you deliver to obtain the cat for your daughter c) This will cut down on the jealousy for your two year old when the baby comes d) If you don't think caring for a cat is too much work, that would be great
b) You should wait until after you deliver to obtain the cat for your daughter Rationale: Toxoplasma gondii is a protozoan that can be transmitted via undercooked meat and through cat litter. Having a cat is not an issue, but cleaning the litter box may expose the mother to the infection and result in fetal anomalies. Option A is incorrect; exposure to the cat litter will not necessitate a cesarean section. Option B is incorrect; having a cat will not cut down on any jealousy the 2-year-old might feel when the new baby is born. Option C is incorrect; the nurse would not encourage the mother to get her child a cat until after the new baby is born.
The nurisng student correctly identifies vaginal cancer as one of the rarest forms of genital cancers. It is mostly asymptomatic, which makes the diagnosis even harder. She further states that it peaks at 60-65 years of age. What does she identify to be symptoms of this disease? (Check all that apply.) a) painful vaginal bleeding b) constipation c) dysuria d) painless vaginal bleeding e) abnormal vaginal discharge f) pelvic pain
b, c, d, e, f: Most women with vaginal cancer are asymptomatic. Those with symptoms have painlesss vaginal bleeding, abnormal vaginal discharge, dysuria, constipation, and pelvic pain.
The nursing student asks the OB/GYN physician why the Pap smear has such a high rate of false-negative results. His best answer would be which of the following? (Check all that apply.) a) performing it too frequently b) human screening c) errors in patient preparation d) errors in preparing the slide e) errors in sampling the cervix
b, c, d, e: Althought the Pap smear is very effective, it does have a high rate of false-negative results which are attributed to human screening, errors in sampling, preparing the slides, and preparing the patient. The frequency of Pap smears do not influence their results
A client presents for a routine check-up at a local health care center. One of the client's distant relatives died of ovarian cancer, and the client wants to know about measures that can reduce the risk of ovarian cancer. The nurse inform the client about which measure to reduce the risk of ovarian cancer? a) Instruct the client to avoid use of oral contraceptives. b) Provide genetic counseling and thorough assessment. c) Instruct the client to avoid breastfeeding. d) Instruct the client to use perineal talc or hygiene sprays
b: Only 5% of ovarian cancers are genetic in origin. However, the nurse needs to tell the client to seek genetic counseling and thorough assessment to reduce her risk of ovarian cancer. Oral contraceptives reduce the risk of ovarian cancer and should be encouraged. Breastfeeding should be encouraged as a risk-reducing strategy. The nurse should instruct the client to avoid using perineal talc or hygiene sprays.
A nurse is teaching women at a senior center. Which type of cancer listed below would the nurse explain is the most common type for women between 50 and 65 years of age? a) Ovarian cancer b) Endometrial cancer c) Vaginal cancer d) Cervical cancer
b: Overall, breast cancer is the most common type of cancer in women in the United States. It is also the 2nd leading cancer for deaths related to cancer. However, endometrial cancer or uterine cancer is the most common gynecologic type of cancer and accounts for 6% of all cancers in the United States. It is uncommon to find it in women younger than 40; the risk increases as the woman ages. Cervical cancer typically is found in women younger than 35. Ovarian cancer occurs in women 55 to 76 years old. Ovarian cancer is the 8th most common cause of cancer among women in the United States. It is, however, the cause of the greatest number of deaths in reproductive cancers. Vaginal cancer occurs in women 60 to 65 years of age and accounts for 3% of all genital cancers in the United States
A 65-year-old client presents at a local community health care center for a routine check-up. While obtaining her medical history, the nurse learns that the client had her menarche when she was 13 years old. She experienced menopause at 51. She is between 5 and 10 lb (2.3 and 4.5 kg) underweight but is otherwise in good physical condition. The nurse should inform the client of which factor that increase the client's risk of getting ovarian cancer? a) The client's age at menarche b) The client's present age c) The client's age at menopause d) The client's weight
b: The client's present age increases her risk of developing ovarian cancer, as women who are older than 50 are at a greater risk. The client's age at menarche (older than 12) and menopause (younger than 55) are both normal. The client is underweight and not obese, so her weight is not a risk factor for ovarian cancer
A client has been referred for a colposcopy by the physician. The client wants to know more about the examination. Which information regarding a colposcopy should the nurse give to the client? a) Intercourse should be avoided for at least a week afterward. b) The test is conducted because of abnormal results in Pap smears. c) Client may feel pain in the vaginal area during the examination. d) Client may experience pain during urination for a week following the test.
b: The nurse should explain to the client that the colposcopy is done because the physician has observed abnormalities in Pap smears. The nurse should also explain to the client that the procedure is painless and there are no adverse effects, such as pain during urination. There is no need to avoid intercourse for a week after the colposcopy
Assessment of a client reveals evidence of a cystocele. The nurse interprets this as: herniation of the rectum into the vagina. protrusion of intestinal wall into the vagina. downward displacement of the cervix. bulging of the bladder into the vagina.
bulging of the bladder into the vagina. A cystocele is the bulging of the bladder into the vagina. A rectocele is a herniation of the rectum into the vagina. An enterocele is a protrusion of the intestinal wall into the vagina. A uterovaginal prolapse is the downward displacement of the cervix anywhere from low in the vagina to outside the vagina.
A pregnant client is screened for tuberculosis during her first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli is given. Which sign would indicate a positive test result? a) An indurated wheal under 10 mm in diameter appears in 6 to 12 hours. b) A flat circumscribed area over 10 mm in diameter appears in 48 to 72 hours. c) An indurated wheal over 10 mm in diameter appears in 48 to 72 hours. d) A flat, circumscribed area under 10 mm in diameter appears in 6 to 12 hours.
c) An indurated wheal over 10 mm in diameter appears in 48 to 72 hours. Rationale: A positive PPD result would be an indurated wheal over 10 mm in diameter that appears in 48 to 72 hours. The area must be a raised wheal, not a flat, circumscribed area.
Nursing care for women diagnosed with gestational diabetes includes which of the following? a) Education for the women on life-long diabetic needs b) Counseling the patient on the need for cesarean birth c) Encourage blood glucose control d) Referral for the infant to diabetic care after delivery
c) Encourage blood glucose control Rationale: The patient will need to have control of her blood sugar during her pregnancy to decrease any complications associated with gestational diabetes. The patient with gestational diabetes does not need to be counseled on the need to have a cesarean delivery, receive education on life-long diabetic needs, or have the infant referred for diabetic care after delivery.
Human papillomavirus (HPV) can cause condylomata acuminata that can develop in clusters on the vulva, within the vagina, on the cervix, or around the anus. What is their risk? a) Neonatal auricular papillomas b) Blockage of the birth canal c) Heavy bleeding during vaginal delivery d) Neonatal hemorrhage
c) Heavy bleeding during vaginal delivery Rationale: Genital warts have a tendency to increase in size during pregnancy. This may result in heavy bleeding during vaginal delivery. The pregnant woman can pass HPV to her fetus during the birth process. In rare instances, neonatal HPV infection can result in life-threatening laryngeal papillomas. HPV infection transmitted to the infant may not appear for as long as 10 years after birth.
A client in her eighth month of pregnancy who has cardiac disease is experiencing profound shortness of breath and a cough that produces blood-speckled sputum, in addition to systemic hypotension. The nurse recognizes that this patient most likely is experiencing which of the following conditions? a) Peripartal cardiomyopathy b) Pulmonary embolism c) Left-sided heart failure d) Right-sided heart failure
c) Left-sided heart failure Rationale: In left-sided heart failure, the left ventricle cannot move the large volume of blood forward that it has received by the left atrium from the pulmonary circulation. It is characterized by a decrease in systemic blood pressure and pulmonary edema that produces profound shortness of breath. If pulmonary capillaries rupture under the pressure, small amounts of blood leak into the alveoli and the woman develops a productive cough with blood-speckled sputum. Right-sided heart failure is characterized by extreme liver enlargement, distention of abdominal and lower extremity vessels, ascites, and peripheral edema. A woman with peripartal cardiomyopathy develops signs of myocardial failure such as shortness of breath, chest pain, and nondependent edema. Her heart increases in size (cardiomegaly).The signs of a pulmonary embolism include chest pain, a sudden onset of dyspnea, a cough with hemoptysis, tachycardia or missed beats, or dizziness and fainting.
During a routine prenatal check-up, the nurse interviews a pregnant client to identify possible risk factors for developing gestational diabetes. Which of the following would alert the nurse to an increased risk? Select all that apply. a) Previous history of spontaneous abortion b) Younger maternal age at pregnancy c) Maternal obesity with body mass index more than 35 d) Previous birth of small for gestational age baby e) Client of African-American lineage
c) Maternal obesity with body mass index more than 35 d) Previous birth of small for gestational age baby e) Client of African-American lineage Rationale: The risk factors for gestational diabetes include previous history of spontaneous abortion, maternal obesity with body mass index (BMI) more than 35, and client of African-American lineage. The other risk factors for gestational diabetes are previous history of stillbirth, birth of large for gestational age infant and advancing maternal age. High-risk ethnic groups include African American, Hispanic and Native North American.
A woman with cardiac disease delivered a seven pound baby by C-Section. Which of the following interventions should be implemented during the immediate postpartum period? a) Limit visits with the infant so mom may rest. b) Ambulate to bathroom only. c) Rest, stool softeners, and monitoring tolerance of activity. d) Restrict activity to bedrest.
c) Rest, stool softeners, and monitoring tolerance of activity. Rationale: A woman who has a cardiac condition is at increased risk in the postpartum period. She needs frequent assessment and observation for tolerance. She would also be given education to avoid straining activities such as bowel movements and would be encouraged to have stool softeners and increase fluid and fiber. Restricting the patient's activity to bed rest could be detrimental to the patient, as could be ambulating to the bathroom only. There is no reason to limit the visits with the infant.
When working in a local community health care center, a nurse is frequently asked about cervical cancer and ways to prevent it. Which information should be provided by the nurse? Select all that apply. a) Avoid stress and high blood pressure. b) Encourage the use of an intrauterine device (IUD) for contraception. c) Encourage cessation of smoking and drinking. d) Encourage prevention of sexually-transmitted infections (STIs) to reduce risk factors. e) Counsel teenagers to avoid early sexual activity.
c, d, e:To reduce the risk of cervical cancer, the nurse should encourage clients to avoid smoking and drinking. In addition, because STIs such as HPV increase the risk of cervical cancers, care should be taken to prevent STIs. Teenagers also should be counseled to avoid early sexual activity because it increases the risk of cervical cancer. The use of barrier methods of contraception, not IUDs, should be encouraged. Avoiding stress and high blood pressure will not have a significant impact on the risk of cervical cancer
A nurse is caring for a 32-year-old client for whom pessary usage is recommended for uterine prolapse. Which instruction should the nurse include in the teaching plan for the client concerning the pessary? a. Avoid jogging and jumping. b. Wear a girdle or abdominal support. c. Report any discomfort with urination and defecation. d. Avoid lifting heavy objects.
c. Report any discomfort with urination and defecation. The nurse should instruct the client using a pessary to report any discomfort or difficulty with urination or defecation. Avoiding high-impact aerobics, jogging, jumping, and lifting heavy objects, as well as wearing a girdle or abdominal support, are recommended for a client with prolapse as part of lifestyle modifications and may not be necessary for a client using a pessary.
While reviewing the history of a client diagnosed with cancer of the vagina, the nurse would expect the client to report which of the following as the major complaint? a) Abdominal discomfort b) Urinary frequency c) Abnormal vaginal bleeding d) Ascites
c: Abnormal vaginal bleeding is the predominant symptom of vaginal cancer. Abdominal discomfort, urinary frequency, and ascites are more commonly associated with ovarian cancer
A woman has been referred for laser therapy for her diagnosis of cervical cancer. The client wants to know more about the procedure. Which of the following information regarding laser therapy should the nurse give to the client? a) The client may experience abdominal cramping. b) The client may experience urinary frequency. c) The client may experience a watery brown discharge for a few weeks. d) The client may experience bleeding for 2 weeks.
c: In Laser therapy a high beam light destroys the cancer and vaporizes it. Women may experience a watery brown discharge for few weeks. This is the only after-effect
In a postmenopausal woman with abnormal vaginal bleeding, which diagnostic test would the nurse expect the physician to order to determine whether an endometrial biopsy is needed? a) Pap smear b) CA-125 c) Transvaginal ultrasound d) Mammogram
c: In this situation, a transvaginal ultrasound is used to measure the endometrial thickness to determine if an endometrial biopsy is needed. CA-125 is a nonspecific blood test used as a tumor marker. A Pap smear aids in detecting abnormal cells of the cervix. A mammogram detects calcifications, densities, and nonpalpable cancer lesions of the breast
A 30-year-old client asks the nurse about risk factors for ovarian cancer. Which risk factor should be included in client education? a) Menopause before age 50 b) Breastfeeding c) Infertility d) Less than 40 years of age
c: Pregnancy decreases a woman's risk for ovarian cancer; infertility increases that risk. Risk increases in women older than 50 years, and for women who experienced late menopause (older than 55 years). Breastfeeding may have a protective effect
The nurse reviews the medical record of a woman diagnosed with ovarian cancer, stage II. The nurse interprets this information, understanding that the disease: a) Is limited to the ovary b) Has metastasized to distant sites c) Involves one or both ovaries and extends into the pelvis d) Has spread to the lymph nodes and other organs within the abdomen
c: Stage II ovarian cancer involves one or both ovaries, with pelvic extension. Disease limited to the ovary characterizes stage I ovarian cancer. Stage III ovarian cancer has spread to the lymph nodes and other organs and structures inside the abdominal cavity. Stage IV disease typically involves metastasis to distant sites
An elderly woman is seen in the clinic complaining of a lesion on her labia majora and states that she has experienced some bleeding and itching as well. She states that this has been going on for approximately three months. She tells the nurse that she has not been to a doctor in over 10 years. What diagnosis would the nurse expect the physician to make? a) polyps b) cervical cancer c) vulvar cancer d) vaginal cancer
c: The correct diagnosis for this patient would be vulvar cancer due to the placement of the lesion, the itching, and the bleeding. The other cancers would have different symptoms and not apply to this patient.
An elderly woman who has not seen a doctor in 15 years comes to the gynecology (GYN) clinic with complaints of pelvic and back pain, along with weight loss which she attributes to her lack of appetite. She states that she has been very weak and fatigued for the last 12 months and attributes this to depression. What should the nurse expect this patient to be diagnosed with? a) ovarian cancer b) vaginal cancer c) advanced cervical cancer d) endometrial cancer
c: The health care worker should expect advanced cervical cancer in women with pelvic, back, or leg pain, weight loss, anorexia, weakness and fatigue, and fractures.
A client is waiting for the results of an endometrial biopsy for suspected endometrial cancer. She wants to know more about endometrial cancer and asks the nurse about the available treatment options. Which treatment information should the nurse give the client? a) Follow-up care after the relevant treatment should last for at least 6 months after the treatment. b) Surgery involves removal of the uterus only. c) Surgery involves removal of the uterus, fallopian tubes, and ovaries; adjuvant therapy is used if relevant. d) In advanced cancers, radiation and chemotherapy are used instead of surgery.
c: The nurse should inform the client that surgery most often involves removal of the uterus (hysterectomy) and the fallopian tubes and ovaries (salpingo-oophorectomy). Removal of the tubes and ovaries, not just the uterus, is recommended because tumor cells spread early to the ovaries, and any dormant cancer cells could be stimulated to grow by ovarian estrogen. In advanced cancers, radiation and chemotherapy are used as adjuvant therapies to surgery. Routine surveillance intervals for follow-up care are typically every 3 to 4 months for the first 2 years
A woman with ovarian cancer has been told that she is in stage three of the cancer. The nurse is reviewing the information with her. Which of the following statements would help in the woman's understanding of stage three ovarian cancer? a) The growth involves one or both ovaries. b) The cancer is limited to the ovaries. c) The growth has spread to the lymph nodes and other areas/organs in the abdominal cavity. d) The cancer has spread to distant sites.
c: The staging and diagnosis is performed by a laparoscopy. The staging is 1-4. Stage three means the cancer has spread to the lymph nodes and other areas in the abdominal cavity. A five-year survival rate for this stage is 30%-60%
A 40-year-old woman comes to the clinic complaining of having missed her period for two months. A pregnancy test is positive. What is she and her fetus at increased risk for? a) Post-term delivery b) Type I diabetes Mellituus c) Type II diabetes Mellitus d) Placental abnormalities
d) Placental abnormalities Rationale: A woman older than 35 years is more likely to conceive a child with chromosomal abnormalities, such as Down syndrome. She is also at higher risk for spontaneous abortion (miscarriage), preeclampsia-eclampsia, gestational diabetes, pre-term delivery, bleeding and placental abnormalities, and other intrapartum complications.
The nurse is providing education to women who had diabetes prior to pregnancy. The nurse is discussing pregnancy-related complications from diabetes. Which of the following is a potential complication? a) Post-term delivery b) Small for gestation age infant c) Hypotension of pregnancy d) Polyhydramnios
d) Polyhydramnios Rationale: Polyhydramnios is an increase, or excess, in amniotic fluid and is a pregnancy-related complication associated with diabetes in pregnancy. An infant who is small for gestational age is not associated with a mother who had diabetes prior to pregnancy. Other pregnancy-related complications associated with pregestational DM include hypertensive disorders, preterm delivery, and shoulder dystocia.
Which of the following is recommended to prevent transmission of HIV to a newborn if the mother has AIDS? a) Avoid scalp electrodes for internal fetal monitoring. b) Admit infant to NICU after delivery. c) Perform amniotomy. d) Prepare for cesarean delivery.
d) Prepare for cesarean delivery. Rationale: When a patient is HIV positive, the method of delivery preferred is cesarean. This method has the lowest transmission rate for passage of the HIV infection to the infant. The nurse should educate the woman on the standard of care for delivery in an HIV or AIDS positive mother. Avoiding scalp electrodes for internal fetal monitoring, admitting the infant to NICU, and performing an amniotomy are not recommended methods for preventing transmission of HIV to a newborn.
A woman who has sickle cell anemia asks you if her infant will develop sickle cell disease. The nurse would base the answer on which of the following? a) Sickle cell anemia is not inherited; it occurs following a malaria infection. b) Sickle cell anemia is dominantly inherited. c) Sickle cell anemia has more than one polygenic inheritance pattern. d) Sickle cell anemia is recessively inherited.
d) Sickle cell anemia is recessively inherited. Rationale: Sickle cell anemia is an autosomal recessive disease requiring that the person have two genes for the disease, one from each parent. If one parent has the disease and the other is free of the disease and trait, the chances of the child inheriting the disease is zero. Options B, C, and D are incorrect as they give misinformation to the patient and are inappropriate answers for the nurse to give.
When developing a plan of care for a pregnant woman who is HIV-positive, which of the following is essential? a) Helping her choose a newborn feeding method b) Preparing the woman for cesarean birth c) Educating her about family planning d) Using Standard Precautions
d) Using Standard Precautions Rationale: For the pregnant woman who is HIV-positive, nurses must always use Standard Precautions to reduce the risk of HIV transmission. Educating the woman about family planning methods is not as important as adhering to Standard Precautions. The decision about the mode of delivery is based on the woman's viral load, duration of ruptured membranes, progress of labor, and other clinical factors. Breast-feeding is contraindicated, so helping her choose a feeding method would be inappropriate.
A woman with no previous history of heart disease begins to have symptoms of myocardial failure a few weeks before the delivery of her first child. Findings include shortness of breath, chest pain, and edema, with her heart also showing enlargement. Which disease should the nurse suspect? a) pulmonary valve stenosis b) left sided heart failure c) mitral stenosis d) peripartal cardiomyopathy
d) peripartal cardiomyopathy Rationale: Peripartal cardiomyopathy can occur in pregnancy without any previous history of heart disease. Symptoms include shortness of breath, chest pain, and edema; also, the heart begins to increase. Treatment is with a diuretic, an antidysrhythmic agent, digitalis, low weight heparin, and bed rest.
The nurse is assisting a woman in scheduling an appointment for a Pap smear. The woman's last menstrual period was May 2. Which date would be most appropriate for the appointment? a) May 30 b) May 7 c) May 9 d) May 17
d: A Pap smear should be scheduled about 2 weeks (10 to 18 days) after the first day of the woman's last menstrual period to increase the chance of getting the best sample of cervical cells without menses. In this case, the date would be May 17
A female client is diagnosed with carcinoma in situ of the endometrium. The nurse interprets this as which of the following? a) The malignancy involves the uterine body and cervix b) Cancer is confined to the body of the uterus c) Cancer extends outside the uterus d) The malignancy is localized
d: A localized malignancy is referred to as carcinoma in situ. Stage I endometrial cancer is confined to the body (corpus) of the uterus; Stage II involves the corpus and cervix; Stage III extends outside the uterus but not the true pelvis
When preparing a presentation about screening for cervical cancer, the nurse would include which of the following recommendations? a) Every 2 to 3 years for women over the age of 70 b) Discontinuation of Pap smears between 30 and 70 years if last three were normal c) Initial Pap smear at age 18 d) Pap smears every 3 years until age 30
d: A woman should have an initial Pap smear at age 21 and then every 3 years until age 30. Between the ages of 31 and 65, a woman should have a Pap smear and HPV testing every 5 years. Women whom have had regular cervical testing with normal results should not be tested for cervical cancer. Women with a history of serious cervical pre-cancer lesions should continue testing for at least 20 years after that diagnosis, even if it continues after age 65.
A 30-year-old female is attending a health fair for women. The nurse at the fair is reviewing risk factors for cervical cancer. Which of the following is an important risk factor for the nurse to include at the fair? a) First intercourse after age 25 b) Protected sexual intercourse c) One life partner d) Exposure to diethylstilbestrol (DES) in utero
d: Cervical cancer has several risk factors: early age of first intercourse (in first year of menarche), lower socioeconomic status, unprotected sex, family history of cervical cancer, exposure to DES in utero, HIV, use of oral contraceptives, HPV, and multiple male partners
A nurse is conducting a class at a women's clinic about reproductive cancers. When describing the incidence of reproductive tract cancers in pregnant women, which of the following would the nurse include? a) Many cases of endometrial cancer are detected in pregnant women because of the increase in surveillance. b) Ovarian cancer is detected much later in the pregnant woman because of the hormonal changes that are occurring. c) Reproductive cancers overall are more common in pregnant women. d) Cervical cancer is more common in the pregnant population than other reproductive cancers.
d: Cervical cancer is more common in the pregnant population, affecting the health of the woman and her fetus. Ovarian cancer occurring during pregnancy is found at early stages and is associated with a good prognosis for both the mother and newborn. Few cases of endometrial cancer would be detected during the relatively young pregnancy population, since routine screening is currently not recommended in the general population. Reproductive tract cancers can occur in a pregnant woman, but their incidence is highly variable
A nurse is preparing a woman for a Pap smear procedure. The nurse has already washed her hands and gathered all necessary equipment (maintaining sterility). Which of the following is the next step in the Pap smear procedure? a) Provide support to the client as the provider obtains the sample. b) Transfer the specimen to a container or a slide. c) Drape the client with a sheet, leaving the perineal area exposed. d) Position the client in stirrups or foot pedals so that her knees fall outward.
d: During a Pap smear procedure, the next step would be to position the client in stirrups or foot pedals so that her knees fall outward. This would be followed by draping a sheet over the client and leaving the perineal area exposed. Next would be to support the client while the sample is obtained. Lastly, transfer the specimen to a container or slide
The Obstetric Educator Nurse is reviewing vulvar cancer with nursing staff as part of their continuing education seminar. Which of the following risk factors would the nurse list? a) Gardasil use b) Previous exposure to pelvic irradiation c) Being exposed to DES in utero d) Lichen sclerosus
d: Lichen sclerosus is a skin condition that is a risk factor for or is linked to vulvar cancer. Previous radiation exposure and DES exposure in utero are risk factors for vaginal cancer. Gardasil is used to prevent types of HPV disease
A nurse working in the Family Birthing Center is answering the nurse hot line phone. A client calls in to schedule her annual Pap smear procedure. Which of the following strategies would be best to educate the client on before her procedure to make sure results are not affected? a) It is safe to use tampons 72 hours before testing. b) Make sure your appointment is 5 days after your last menses. c) You make douche at least 48 hours before testing. d) Refrain from sexual intercourse 48 hours before testing to ensure clear results.
d: Nurses should use teaching guidelines with clients to optimize the Pap smear test results. Strategies to educate would include: No douche, no tampons, no jellies, no spermicides, no intercourse. The optimal time for testing is 2 weeks after the first day of your last menses
A student in clinical caring for a woman who has been diagnosed with ovarian cancer consults her nursing instructor. The student demonstrates an understanding of ovarian cancer when she states which of the following? a) It is easy to diagnose. b) It is usually diagnosed in its early stage. c) It is easy to notice its symptoms. d) It is known as the "silent killer."
d: Ovarian cancer has been described as "the overlooked disease" or the "silent killer" because women and/or health care workers often ignore or rationalize the early symptoms. It is typically diagnosed in advanced stages
When reviewing the history of a woman diagnosed with endometrial cancer, the nurse would identify which of the following as increasing the woman's risk? a) Menarche at age 14 years b) Vaginal delivery of 4 children c) Menopause at age 47 years d) Use of tamoxifen
d: Use of tamoxifen is a risk factor for the development of endometrial cancer, as are nulliparity, early menarche (before the age of 12), and late onset of menopause (after age 52 years).
The nurse is caring for a woman who has dysplasia (disordered growth of abnormal cells). The nurse educates her on dysplasia progression that is high-grade. Which of the following information is important for the nurse to include? a) High-grade dysplasia progresses to invasive cervical cancer in about 9 years. b) High- grade dysplasia progresses to invasive cervical cancer in about 7 years. c) High-grade dysplasia progresses to invasive cervical cancer in about 4 years. d) High-grade dysplasia progresses to invasive cervical cancer in about 2 years.
d: With cervical cancer, lesions start as dysplasia and progress over a period of time. Progression of a high-grade dysplasia takes about 2 years to develop into an invasive cancer
A client who stands all day at her job has been diagnosed with pelvic organ prolapse. The client is asking the nurse in the office about whether she will be a candidate for surgery. The nurse knows that which documented findings will make the client ineligible for surgery? Select all that apply. documented low back pain and pelvic pressure documented risk for recurrent prolapse after surgery documented morbid obesity documented severe pelvic organ prolapse documented chronic obstructive pulmonary disease
documented risk for recurrent prolapse after surgery documented morbid obesity documented chronic obstructive pulmonary disease Women who are at too high a risk and therefore are not surgery candidates include those who are morbidly obese, have chronic obstructive pulmonary disease, and are at risk for recurrent prolapse. Most pelvic disorders manifest with symptoms of low back pain and pelvic pressure. A client with severe pelvic prolapse may very well be a surgery prospect.
hCG levels in normal pregnancy usually doubles every 48 to 72 hours until they peak 60 to 70 days after fertilization. Clinicians use this as a marker to differentiate normal or abnormal gestations. What type of pregnancy would low levels indicate?
ectopic pregnancy *higher than normal levels may indicate a molar or multiple gestational pregnancy
The ___________ layer of the embyronic cell forms the respiratory system, liver, pancreas, and digestive system.
endoderm
The nurse has learned that the number one factor that will motivate a woman to escape an abusive relationship is which of the following? a) fear of harm to herself b) fear of death c) fear of harm to other family members d) fear of harm to her unborn child
fear of harm to her unborn child
While performing leopold maneuvers, if you palpate a hard area on the opposite side the fetal back, what attitude is the fetus in?
flexion *The hard part felt is the chin
A 23-year-old sexually active woman tells the nurse practitioner that she is worried because she has been having abnormal vaginal bleeding, dysuria, and weird vaginal discharge. What sexually transmitted infection would the nurse suspect?
gonorrhea
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?
gonorrhea
A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition?
gonorrhea
A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which symptoms would the nurse expect the client to exhibit?
heart disease and inflammation of the aorta, eyes, brain, central nervous system, and skin
The nurse in the sexual health clinic is obtaining a health history of a client who is addicted to heroin, reporting chronic flu-like symptoms accompanied by pruritis, fatigue, anorexia, and constant upper right quadrant pain. Which sexually transmitted infection would the nurse suspect?
hepatitis A
The nurse is reviewing the history and physical exam of a woman who has come to the clinic for a routine physical. Which factor would the nurse identify as increasing the client's risk for breast cancer?mast
history of ovarian cancer A personal history of ovarian cancer is considered a risk factor for breast cancer. Typically, breast cancer is associated with aging (women over 50 years of age). Breast cancer is more common in Caucasian women, but African-American women are more likely to die of it. Early menarche (before 12 years of age) or late onset of menopause (after age 55 years) is associated with an increased risk for breast cancer.
The major risk with this complication is hemorrhage after giving birth because the uterus cannot contract effectively to compres blood vessels.
hypotonic uterine dysfunction
- Green fluid may indicate that the fetus has passed meconium secondary to:
hypoxia, prolonged pregnancy, cord compression, intrauterine growth restriction, maternal hypertension, diabetes, or chorioamnionitis; however, it is considered a normal occurrence if the fetus is in a breech presentation.
_______________ should not be used after 36 weeks of pregnancy to avoid increased blood loss during parturition and to avoid premature closure of the ductus arterious in the fetus.
ibuprofen
Too little amniotic fluid, termed oligohydraminos is less than __________ mL.
less than 500 mL *High risk of low birth weight infants*
Most women experience an increase in a whitish vaginal discharge, called ________________ during pregnancy.
leukorrhea
By 40 weeks, the fetal head begins to descend and engage in the pelvis, which is termed ________________________
lightening
_____ occurs when the fetal presenting part begins to descend into the maternal pelvis
lightening
___________ occurs when the fetal presenting part begins to descend into the maternal pelvis causing the uterus to lower and the mother to breath easier.
lightening
client reports increased respiratory capacity, decreased dyspnea, increased pelvic pressure, cramping, and low back pain, more frequent urination. Also, edema in lower extremities (a result of blood stasis of blood pooling) and increased vaginal discharge. What should the nurse suspect?
lightening when fetal presenting part begins to descend into pelvis ( may occur two weeks before labor)
A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition? Select all that apply.
multiple sex partners intrauterine contraceptive device inserted 3 weeks ago vaginal douching approximately once a week
Respiratory depression Opioids given close to the time of birth can cause central nervous system depression, including respiratory depression, in the newborn, necessitating the administration of ____________
naloxone.
A 40-year-old client arrives at the community health center experiencing a strange, dragging feeling in the vagina. She stated that "at times it feels as if there is a lump" there as well. Which condition do these symptoms indicate? urinary incontinence endocervical polyps pelvic organ prolapse uterine fibroids
pelvic organ prolapse Weakening of the pelvic-floor muscles causes a feeling of dragging and a "lump" in the vagina; these are symptoms of pelvic organ prolapse. These symptoms do not indicate urinary incontinence, endocervical polyps, or uterine fibroids. Urinary incontinence is the involuntary loss of urine. The symptoms of endocervical polyps are abnormal vaginal bleeding or discharge. In cases of uterine fibroids, the uterus is enlarged and irregularly shaped.
When a pregnant patient is abused during her pregnancy what complication is likely to occur after delivery due to the abuse? a) post-partum depression b) schizophrenia c) low birth weight d) edema
post-partum depression
The nurse is assessing a client at a postpartum visit and notes the client is emotionally sensitive, complains about being a failure, and appears extremely sad. The nurse concludes the client is presenting with which potential condition?
postpartum depression
A nurse is caring for a client on the second day postpartum. The client informs the nurse that she is voiding a large volume of urine frequently. Which factor should the nurse identify as a potential cause for urinary frequency?
postpartum diuresis
The nurse is teaching a premenopausal client about dietary and lifestyle modifications that can reduce the risk factors for developing pelvic organ prolapse (POP). The nurse is describing which type of prevention? primary secondary tertiary none of the above
primary Informing the client about factors in her lifestyle that might be modified to reduce her risk of developing POP would be an exmaple of primary prevention.
A nurse is conducting a presentation for a local women's group about pelvic organ prolapse. When describing the different types, which information would the nurse incorporate into the description of a cystocele? sagging of the rectum, pushing against or into the posterior vaginal wall protrusion of the bladder wall through the anterior vaginal wall bulging of the small intestine through the posterior vaginal wall downward movement of the uterus through the pelvic floor and into the vagina
protrusion of the bladder wall through the anterior vaginal wall A cystocele occurs when the posterior bladder wall protrudes downward through the anterior vaginal wall. A rectocele occurs when the rectum sags and pushes into or against the posterior vaginal wall. An enterocele occurs when the small intestine bulges through the posterior vaginal wall. Uterine prolapse occurs when the uterus descends through the pelvic floor and into the vaginal canal.
A nurse is explaining to a client that pessaries have been used through the ages as a nonsurgical means of treating pelvic organ prolapse. The nurse describes the pessaries of today as being primarily constructed of: silicone. rubber. porcelain. metal.
silicone. Today, almost all pessaries are made of medical-grade silicone. They are pliable and have a long shelf life, lack odor and secretion absorption, are biologically inert, and nonallergenic and noncarcinogenic. They can also be boiled or autoclaved for sterilization.
While caring for a client following a lengthy labor and birth, the nurse notes that the client repeatedly reviews her labor and birth and is very dependent on her family for care. The nurse is correct in identifying the client to be in which phase of maternal role adjustment?
taking-in
A nurse is providing care to a postpartum woman during the immediate postpartum period. The nurse recognizes that the mother will need assistance with meeting her basic needs based on the understanding that the mother is most likely in which phase?
taking-in phase
what happens to the ductus venosus & the ductus arteriosus after birth?
the ductus venosus usually closes w/ inhibition of blood flow secondary to cutting of umbilical cord. the ductus arteriosus closes w/ the increased oxygenation of arterial blood levels. its closure prevents mixing of blood from aorta and pulmonary artery.
Lightening
the sensation of the fetus moving from high in the abdomen to low in the birth canal
During the second day postpartum, a nurse notices that a client is initiating breastfeeding with her infant and changing her infant's diapers with some assistance from her partner. Which phase does the nurse recognize that the woman is experiencing?
the taking-hold phase
A client was in labor for more than 36 hours and now reports urine leaking from her vagina. On examination the nurse would be inspecting for: urethrovaginal fistula. vesicovaginal fistula. urge incontinence fistula. rectovaginal fistula.
urethrovaginal fistula. The majority of genital fistulas are the result of obstetric trauma. When labor is obstructed or prolonged, this unrelieved compression causes ischemia, which causes pressure necrosis and subsequent fistula formation. A urethrovaginal fistula is formed between the urethra and vagina. Vesicovaginal fistulas occur between the bladder and genital tract. A rectovaginal fistula would occur between the rectum or sigmoid colon and vagina. Urge incontinence would result with the urine leaking from the urethra, not vagina.
Trendelenburg position
lying on back with body tilted so that the head is lower than the feet
Fetal lie refers to
the relationship of the spine of the fetus to the spine of the mother (oblique and transverse) *logitudinal is most common
genetics
the study of heredity and the variation of inherited characteristics.
4. A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does this indicate?
Ans: Fetal distress related to hypoxia
________________ is the most common (and most favorable) fetal position for birthing today
Left Occiput Anterior (LOA)
__________________ identified maternal tasks that a woman must accomplish to incorporate the maternal role into her personality.
Reva Rubin
Which STI could be transmitted perinatally?
herpes simplex
cervical ripeness
an assessment of the readiness of the cervix to afface and dilate in response to uterine contractions
Phosphatidylglycerol
assess fetal lung activiy
fetal stage
end of the eighth week until birth. pg. 336
The________________ stage is from the end of the 8th week until birth. It is the longest period of prenatl development.
fetal stage
When the presenting part is above the ischial spines, it is noted as a ____________ station.
negative
______________ drugs may prolong pregnancy for 2 to 7 days during; during this time, steroids can be given to improve fetal lung maturity
tocolytic
To reduce perinatal transmission, women who are HIV-positive are given ______________
zidovudine/nevirapine
A parent at an educational session on sexually transmitted infections (STIs) asks the nurse if there are vaccines available to prevent STIs. What is the nurse's best response?
"A vaccine has been approved vaccines to prevent the human papillomavirus."
A woman who gave birth to her infant 1 week ago calls the clinic to report pain with urination and increased frequency. What response should the nurse prioritize?
"After birth it is easier to develop an infection in the urinary system; we need to see you today."
A community health nurse is conducting a class on sexually transmitted infections (STIs). She states that "STIs are discriminatory." What would the nurse most likely use to support this statement?
"After only a single exposure, women are twice as likely as men to acquire STIs." "Women are diagnosed with two thirds of the new cases of STIs annually." "Certain infections can be transmitted to the newborn."
A nurse is preparing a client for discharge following an abdominal hysterectomy for fibroids. After providing discharge teaching, the nurse determines that the teaching was successful based on which client statement? "I can resume using tampons in about 3 weeks." "I don't have any restrictions on what I can lift or carry." "I should shower rather than take a tub bath." "I should limit my intake of foods that are high in fiber for about 2 weeks."
"I should shower rather than take a tub bath." Following an abdominal hysterectomy, the client should not insert anything in her vagina for about 6 weeks (pelvic rest), should avoid heavy lifting or straining for about 6 weeks, shower rather than take tub baths, and increase her intake of high-fiber foods to promote bowel elimination and prevent straining.
The nurse is giving an educational event for a local women's group on self-examination of the breast. The nurse tells the women's group to raise their arms and inspect their breasts in a mirror. A member of the women's group asks the nurse why she needs to do this. What is the nurse's best response?
"It will help to observe for dimpling." The primary reason for raising the arms is to detect any dimpling. To elicit skin dimpling or retraction that may otherwise go undetected, the examiner instructs the patient to raise both arms overhead. This maneuver normally elevates both breasts equally. Pain does not always occur with breast masses. The assessment of the breast should be uniform.
The nurse is conducting a presentation about urinary incontinence for a local women's group. During the presentation, which statement by a member of the group would the nurse need to clarify? "It's normal for a woman to develop incontinence as she ages." "There are ways to prevent urinary incontinence." "Urinary incontinence is a treatable condition." "Incontinence can be cured in some cases."
"It's normal for a woman to develop incontinence as she ages." A common misconception is that incontinence is an age-related change. It is not a normal part of aging. Urinary incontinence is preventable, treatable, and often curable.
A client diagnosed with pelvic organ prolapse is being taught how to perform pelvic floor muscle exercises. During the teaching session, the client asks the nurse, "How do these exercises help?" Which response by the nurse would be most appropriate? "They help to increase the volume of your muscles which leads to stronger muscle contraction." "They help to move the pelvic floor upward so that your symptoms eventually decrease." "The exercises increase the amount of blood that your muscles receive making them less relaxed." "The exercises help you to establish regular bowel elimination patterns so you don't strain so much."
"They help to increase the volume of your muscles which leads to stronger muscle contraction." The purpose of pelvic floor exercises is to increase the muscle volume, which will result in a stronger muscular contraction. The exercises do not move the pelvic floor upward, increase blood supply, or establish regular elimination patterns.
A pregnant woman recently diagnosed with the genital herpes virus asks the nurse for more information on the virus. Which responses by the nurse would be appropriate? Select all that apply.
"Transmission is through contact of infected mucous membranes." "The virus remains quiet until a stressful event occurs to reactivate it." "Infections may be transmitted by individuals unaware that they have it."
The nurse is providing home care for a 6-year-old girl with multiple medical challenges. Which of the following activities would be considered the tertiary level of prevention? A) Arranging for a physical therapy session B) Teaching parents to administer albuterol C) Reminding parent to give a full course of antibiotics D) Giving a DTaP vaccination at the proper interval
-The tertiary level of prevention involves restorative, rehabilitative, or quality-of-life care, such as arranging for a physical therapy session. - Teaching the parents to administer albuterol and reminding them to give the full course of antibiotics as prescribed are part of the secondary level of prevention, which focuses on diagnosis and treatment of illness. - Giving a DTaP vaccination at proper intervals is an example of the primary level of prevention, which centers on health promotion and illness prevention.
The fetus is said to be engaged in the pelvis when the presenting part reaches __________ station.
0
Cervical canal 2cm in length would be descrbied as ___________ effaced
0%
A postpartum mother is recovering from a cesarean delivery and is reporting incisional and abdominal pain at a level of 8. Morphine sulfate is ordered as follows: Morphine Sulfate 8 mg IV q 4 hours prn for pain greater than 6. Morphine Sulfate comes in 10 mg/mL. How many milliliters of morphine would the nurse administer to this client using slow push over 5 minutes? Record your answer using one decimal place.
0.8
The normal fetal heart rate range is
110 to 160
A reactive NST includes at least two FHR accelerations of _________ BPM for 15 seconds within a 20 minute period.
15 *If the test does not meet these criteria after 40 minutes, it is considered nonreactive.
Amniotic fluid surrounds the embryo and increases in volume as the pregnancy progresses, reaching ____________ at term.
1 L
The nurse is preparing to assess a client who is 1 day postpartum. The nurse predicts the client's fundus will be at which location on assessment?
1 cm below the umbilicus
The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth? A) 11 B) 8 C) 6 D) 3
11 The Bishop score helps identify women who would be most likely to achieve a successful induction. The duration of labor is inversely correlated with the Bishop score: a score over 8 indicates a successful vaginal birth. Therefore the woman with a Bishop score of 11 would have the greatest chance for success.
Fetal bradycardia occurs when the FHR is below ____________ bpm and last 10 mins or longer
110 *tachycardia is above 160
The woman's temperature is typically assessed every ____ hours during the first stage of labor and every ____ hours after ruptured membranes.
4 2
15. A nurse is caring for an antenatal mother diagnosed with umbilical cord prolapse. Which of the following should the nurse monitor for in a fetus in cases of umbilical cord prolapse?
Ans: Fetal hypoxia
In which of the follow patients would the nurse first suspect cancer?
A 45-year-old with thickening in one breast with nipple irritation and retraction and a pink discharge The 25-year-old most likely has fibrocystic breast changes. The 30-year-old most likely has a fibroadenoma. The 40-year-old most likely has an intraductal papilloma. Further assessment is needed to confirm each of these, but this is what the nurse would first suspect.
A nurse is teaching a client how to perform Kegel exercises. Which of the following would the nurse include? (Select all that apply.) A) "Squeeze your rectal muscles as if you are trying to avoid passing flatus." B) "Tighten your pubococcygeal muscle for a count of 10." C) "Contract and relax your pubococcygeal muscle rapidly 10 times." D) "Try bearing down for about 10 seconds for no more than 5 times." E) "Do these exercises at least 5 times every hour."
A C
Which of the following would be considered child abuse? Select all that apply. a) A caregiver intentionally is demeaning to a child. b) A caregiver neglects a child's physical needs. c) A caregiver lets a child participate in school activities and the child gets injured. d) A caregiver allows siblings to talk inappropriately to each other.
A caregiver intentionally is demeaning to a child. A caregiver neglects a child's physical needs.
The nurse is talking to a female client who is a survivor of intimate partner violence. The woman relates that her husband has been told that he has the characteristics of an antisocial personality disorder. The woman also informs the nurse that her husband has an extensive criminal record. The nurse interprets this information and suspects that the woman's husband would most likely demonstrate which behavior? a) A risk for moderate to severe violence with people both within and outside his family b) Symptoms of depression along with harboring feelings of inadequacy c) Purposefully remain socially isolated from people other than those in his family d) Intermittent remorse for the violence and abuse that he commits
A risk for moderate to severe violence with people both within and outside his family
The nurse is talking to a female client who is a survivor of intimate partner violence. The woman relates that her husband has been told that he has the characteristics of an antisocial personality disorder. The woman also informs the nurse that her husband has an extensive criminal record. The nurse interprets this information and suspects that the woman's husband would most likely demonstrate which behavior? a) A risk for moderate to severe violence with people both within and outside his family b) Intermittent remorse for the violence and abuse that he commits c) Symptoms of depression along with harboring feelings of inadequacy d) Purposefully remain socially isolated from people other than those in his family
A risk for moderate to severe violence with people both within and outside his family
After teaching nursing students about the basic concepts of family-centered care, the instructor determines that the teaching was successful when the students state which of the following? A) "Childbirth affects the entire family, and relationships will change." B) "Families are not capable of making health care decisions for themselves." C) "Mothers are the family members affected by childbirth." D) "Childbirth is a medical procedure."
A) "Childbirth affects the entire family, and relationships will change."
After teaching a group of students about the concept of maternal mortality, the instructor determines that additional teaching is needed when the students state which of the following? A) "The rate includes accidental causes for deaths." B) "It addresses pregnancy-related causes." C) "The duration of the pregnancy is not a concern." D) "The time frame is typically for a specified year."
A) "The rate includes accidental causes for deaths."
3. Which of the following is the mucosal layer that lines the uterine cavity in nonpregnant women?
Ans: Endometrium
18. A 30-year old client tells the nurse that she would like to use a contraceptive sponge but doesn't know about its use and whether it will protect her against STIs. Which of the following information should the nurse provide the client about using a contraceptive sponge? Select all that apply.
Ans: Wet the sponge with water before inserting it Ans: Insert the sponge 24 hours before intercourse Ans: Leave the sponge in place for at least 6 hr following intercourse
3. A nurse is obtaining the genetic history of a pregnant client by questioning family members. Which of the following questions is most appropriate for the nurse to ask?
Ans: What was the cayse and age of death for deceased family members?
11. A client has been discharges from the hospital after a cesarean birth. Which of the following is the most appropriate time for scheduling a follow-up appointment for the client?
Ans: Within 2 weeks of hospital discharge.
1. The nurse caring for a newborn has to perform assessment at various intervals. When should the nurse complete the second assessment for the newborn?
Ans: Within the first 2 to 4 hours, when the newborn is in the nursery
The nurse is caring for a child with epididymitis. When planning care which intervention may be included? a.Scrotal elevation b.Warm compresses c.Corticosteroid therapy d.Catheterization
Answer: a Epididymitis is caused by a bacterial infection. Treatment may include scrotal elevation, bed rest, and ice packs to the scrotum. Pharmacotherapy may include antibiotics, pain medications, and nonsteroidal anti-inflammatory drugs (NSAIDs). Warm compresses would result in vasodilation and do little to relieve the pain and swelling of the condition. Corticosteroid therapy is not included in the plan of care for the condition. Voiding is not impacted by epididymitis. Catheterization is not indicated.
The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition? a."Our son may need surgery on his testes before we are discharged to go home." b."Our son may have to go through life without two testes." c."Our son's condition may resolve on its own." d."Our son will likely have a high risk of cancer in his teen years as a result of this condition."
Answer: c Normally both testes will descend prior to birth. In the event this does not happen the child will be observed for the first 6 months of life. If the testicle descends without intervention further treatment will not be needed. Surgical intervention is not needed until after 6 months if the testicle has not descended.
When preparing a teaching plan for a woman with mastitis, the nurse would include which instruction?
Apply warm compresses to the affected breast. Warm compresses are soothing and help reduce inflammation. Breastfeeding is encouraged with mastitis to ensure continued emptying of the breast. Fluid intake is encouraged to promote milk production and resolution of infection. Wearing a supportive bra 24 hours a day is necessary to support the breasts.
21. When describing the stages of labor to a pregnant woman, which of the following would the nurse identify as the major change occurring during the first stage? A) Regular contractions B) Cervical dilation C) Fetal movement through the birth canal D) Placental separation
B. The primary change occurring during the first stage of labor is progressive cervical dilation.
A nurse is assessing a woman after birth and notes a second-degree laceration. The nurse interprets this as indicating that the tear extends through which of the following? A) Skin B) Muscles of perineal body C) Anal sphincter D) Anterior rectal wall
B. Muscle of perineal body
A ____________uses a real-time ultrasound and NST to allow assessment of various parameters of fetal well-being.
Biophysical Profile
These class of drugs are more likely to cause problems and safety studies have not been completed. Examples include: fluconazole, ciprofloxacin
Category C
This class of drugs ahve demonstrated poistiove evidence of fetal abnormalities and are contraindicated in women who are or may become pregnant. Examples include: Accutane, Coumadin, Streptomycin.
Category X
What prenatal test requires removal of small tissue specimen from the fetal portion of the placenta to detect fetal karyotype, sickle cell anemia...etc.
Chorionic villus sampling *Done between 10-12 weeks
Prior to discharge from the hospital, a nurse is checking the fundal height for a new mother who delivered 2 days ago. The nurse would anticipate which finding?
Two fingerbreadths below the umbilicus
Which medication would the nurse question if ordered to control a pregnant woman's asthma? A) Budesonide B) Albuterol C) Salmeterol D) Oral prednisone
D) Oral prednisone
A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which statement by the woman would lead the nurse to suspect that the woman needs additional teaching? A) "The warmth and buoyancy of the water has a nice relaxing effect." B) "I can stay in the bath for as long as I feel comfortable." C) "My cervix should be dilated more than 5 cm before I try using this method." D) "The temperature of the water should be at least 105°F."
D. The water temperature should not exceed body temperature. Therefore, a temperature of 105° F would be too warm.
A group of nursing students are reviewing the various medications used for pain relief during labor. The students demonstrate understanding of the information when they identify which agent as the most commonly used opioid? A) Butorphanol B) Nalbuphine C) Fentanyl D) Meperidine
D. Meperidine
A nurse is assigned to care for a hospitalized 14 year old with gastroenteritis. The teen tells the nurse that a brother ran away about 2 months ago and hasn't been heard from since, a sister has a substance abuse problem, and both parents are fighting. What type of situation is this family displaying? a) Child neglect b) Child abuse c) Dysfunctional dynamics d) Impaired parenting
Dysfunctional dynamics
A nurse is assessing a pregnant woman who has come to the clinic. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings? A) Dull low backache B) Malodorous vaginal discharge C) Dysuria D) Constipation
Dysuria Symptoms of preterm labor are often subtle and may include change or increase in vaginal discharge with mucus, water, or blood in it; pelvic pressure; low, dull backache; nausea, vomiting or diarrhea, and intestinal cramping with or without diarrhea.
one of the P's of labor, power has three phases which are:
Each contraction has three phases: - increment or the buildup of the contraction - acme or the peak or highest intensity - the decrement or relaxation of the uterine muscle fibers.
____________ is a light, stroking superficial touch of the abdomen, in rhythm with breathing during contractions.
Effleurage
Assessment of a woman in labor who is experiencing hypertonic uterine dysfunction would reveal contractions that are: A) Well coordinated B) Poor in quality C) Rapidly occurring D) Erratic
Erratic Hypertonic contractions occur when the uterus never fully relaxes between contractions, making the contractions erratic and poorly coordinated because more than one uterine pacemaker is sending signals for contraction.
A nurse is caring for a client for whom estrogen replacement therapy has been recommended for pelvic organ prolapse. Which nursing intervention is the most appropriate for the nurse to implement before the start of the therapy? Discuss the effective dose of estrogen required to treat the client. Evaluate the client to validate her risk for complications. Discuss the dietary modifications following therapy. Discuss the cost of estrogen replacement therapy.
Evaluate the client to validate her risk for complications. Before starting estrogen replacement therapy, each woman must be evaluated on the basis of a thorough medical history to validate her risk for complications such as endometrial cancer, myocardial infarction, stroke, breast cancer, pulmonary emboli, or deep vein thrombosis. The effective dose of estrogen required, the dietary modifications, and the cost of estrogen replacement therapy can be discussed at a later stage when the client understands the risks associated with estrogen replacement therapy and decides to use hormone therapy.
The recommended follow-up visit schedule for 28 weeks (7 months) is ____________________
Every 4 weeks
The recommended follow-up visit schedule from 37 weeks to birth is ___________________
Every week
The nurse is assessing the laboring client to determine fetal oxygenation status. What indirect assessment method will the nurse likely use? A. External electronic fetal monitoring B. Fetal blood pH C. Fetal oxygen saturation D. Fetal position
External electronic fetal monitoring is the first option that we use
____ ____ allows the shoulders to rotate internally to fit the maternal pelvis
External rotation
_________________ is a condition in which irregular uterine contractions are felt, but the cervix is not affected.
False labor
____________________ is the union of ovum and sperm, which is the starting point of pregnancy and takes place in the ampulla of the fallopian tube.
Fertilization
Amniotic fluid is derived from what two sources?
Fluid transported from the maternal blood Fetal urine
A pregnant client with a history of spinal injury is being prepared for a cesarean birth. Which method of anesthesia is to be administered to the client? A. Local infiltration B. Epidural block C. Regional anesthesia D. General anesthesia
General anesthesia is administered in emergency cesarean births
Prader-Willi syndrome, Angelman syndrome and Beckwith-Wiedemann syndrom are examples of what type of nontraditional inheritance disorder?
Genomic printing
The nurse would be alert for possible placental abruption during labor when assessment reveals which of the following? A) Macrosomia B) Gestational hypertension C) Gestational diabetes D) Low parity
Gestational hypertension Risk factors for placental abruption include preeclampsia, gestational hypertension, seizure activity, uterine rupture, trauma, smoking, cocaine use, coagulation defects, previous history of abruption, domestic violence, and placental pathology.
The total nubmer of times a woman has been pregnant, regardless of whether the pregnancy resulted in a termination or if multiple infants were born from a pregnancy
Gravida/Gravidity
Question: While performing a clinical breast examination on a client, the nurse inspects the breasts with the client in various positions. Place the following positions in their proper sequence.
Hands placed on the hips Arms resting at the sides Hands on hips while standing Arms raised over the head During the clinical breast examination, the nurse inspects the breasts first with the client sitting at the edge of the examination table with her arms resting at her sides. Next, the client places her hands on her hips, and then she raises her arms over her head. Lastly, the client stands and places her hands on her hips and leans forward.
While observing care being provided to an infant, the new mother looks at the nurse repeatedly and asks, "Am I doing this the right way?" Which nursing diagnosis should the nurse select to guide the care needs of the mother at this time?
Health-seeking behaviors related to care of newborn
The nurse is working with a group of community health members to develop a plan to address the special health needs of women. Which of the following conditions would the group address as the major problem? A) Smoking B) Heart disease C) Diabetes D) Cancer
Heart disease
The nurse has received the results of a client's postpartum hemoglobin and hematocrit. Review of the client's history reveals a prepartum hemoglobin of 14 gm/dL and hematocrit of 42%. Which result should the nurse prioritize?
Hemoglobin 9 gm/dL and hematocrit 32 percent in a woman who has given birth by cesarean
A pregnant woman tests positive for HBV. Which of the following would the nurse expect to administer? A) HBV immune globulin B) HBV vaccine C) Acylcovir D) Valacyclovir
Hepatitis B A) HBV immune globulin
Amnioinfusion
Infusion of a sterile isotonic solution into the uterine cavity during labor to reduce umbilical cord compression; may also be done to dilute meconium in amniotic fluid and reduce the risk that the infant will aspirate thick meconium at birth.
A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby?
Instill a prophylactic agent in the eyes of the newborn.
A client at 34 weeks' gestation has recently been diagnosed with human immunodeficiency virus (HIV). The client asks how HIV would be transmitted to the newborn. Which statement would be the nurse's best response?
It is recommended to formula-feed your newborn as it is transmitted through your breast milk."
A client comes to the genitourinary clinic with very mild symptoms of pelvic organ prolapse (POP) that has just started in the last several days. What would be the treatment of choice for this client? a. surgery b. Kegel exercises c. nothing d. colpexin sphere
Kegel exercises strengthen the pelvic floor muscles to support the inner organs and prevent further prolapse; they might limit the progression of mild prolapse and alleviate some symptoms. They will not, however, help severe uterine prolapse. Surgery is for more severe cases. Doing nothing is not an option, and the colpexin sphere would be used in a case that had more pronounced symptoms.
______________ is a psychoprophlylactic ("mind prevention") method of preparing for labor and birth that promotes the use of specific breathing and relxation techniques. It believes that women needed to alter the perception of suffering during childbirth.
Lamaze
What are the phases of labor (in proper order)
Latent Phase Active Phase Transition Phase Pelvic Phase Perineal Phase Placental Separation Placental Expulsion
A client seeking advice for his pregnant wife, who is experiencing mild elevations in blood pressure. In which position shoul a nurse recommend the pregnant client rest? a. Supine position b. Lateral recumbent position c. Left lateral lying position d. Head of the bed slightly elevated
Lateral recumbent position *Helps improve uteroplacental bloodflow, reduce blood pressure and promote diuresis.
A pregnant client is admitted to a maternity clinic for childbirth. Which assessment finding indicates that the client's fetus is in the transverse lie position?
Long axis of fetus is perpendicular to that of client
What two elements play the biggest role in becoming a mother after delivery of her newborn?
Love and attachment to the child and engagement with the child
A home health care nurse is assessing a postpartum woman who was discharged 2 days ago. The woman tells the nurse that she has a low-grade fever and feels "lousy." Which of the following findings would lead the nurse to suspect metritis?(Select all that apply.) A) Lower abdominal tenderness B) Urgency C) Flank pain D) Breast tenderness E) Anorexia
Lower abdominal tenderness and Anorexia Manifestations of metritis include lower abdominal tenderness or pain on one or both sides, elevated temperature, foul-smelling lochia, anorexia, nausea, fatigue and lethargy, leukocytosis and elevated sedimentation rate.
A nurse is caring for a client who is in the first stage of labor. The client is experiencing extreme pain due to the labor. the nurse understands that which of the following is causing extreme pain the client? Select all
Lower uterine segment distention Stretching and tearing of structures Dilation of cervix
While assessing a postpartum multiparous woman, the nurse detects a boggy uterus midline 2 cm above the umbilicus. Which intervention would be the priority?
MASSAGE FUNDUS
Advise pregnant women to avoid live virus vaccines such as ________ and ________________ and to avoid becoming pregnant within 1 month of having recieved one of these.
MMR (vaccine against measles, mumps, and rubella) and varicella
A client reports pain in the lower back, hips, and joints 10 days after the birth of her baby. What instruction should the nurse give the client after birth to prevent low back pain and injury to the joints?
Maintain correct posture and positioning
A woman who is 6 months postpartum calls the clinic and reports flu-like symptoms, an elevated temperature, and pain and redness throughout her left breast. What would the nurse first suspect?
Mastitis These symptoms most closely resemble mastitis. Mastitis usually occurs in the postpartum period while the woman is still breastfeeding. Mastitis is usually unilateral and is seen as a red, painful breast with elevated temperature and flu-like symptoms.
What are the two maneuvers to relieve shoulder dystocia
McRoberts and suprapubic pressure
Patterns that occur because a single gene is defective when it comes to genetics is known as ___________law
Mendel's laws of inheritance *The disorders are reffered to as monogenic or Mendelian disorders*
A woman who has had two or more pregnancies of at least 20 weeks' gestation resulting in viable offspring. Commonly referred to as a "multip"
Multipara
What procedure requires the client to eat a meal, lay on their left lateral recumbent position with a button that she pushes every time she perceives fetal movement.
Nonstress test (NST)
When analyzing amniotic fluid the nurse notices that it is clear with white flecks of vernix caseosa in a mature fetus, is this considered normal or abnormal?
Normal *Port wine fluid may indicate abruptio placentae*
While caring for a new mother on her second day postpartum, the nurse notes the new mother handles her newborn tentatively, not kissing her child but appears afraid to interact with her baby. Which situation would the nurse suspect as the probable reason for this?
Normal reaction to accepting a new child.
In caring for a child who has been admitted after being sexually abused, which of the following interventions would be included in the child's plan of care? a) Encourage frequent family visits b) Weigh on the same scale each day c) Observe for signs of anxiety d) Test the urine for glucose upon admission
Observe for signs of anxiety
Which of the following is TRUE regarding intimate partner violence? a) Even though women seldom blame themselves for the abuse, they often cannot leave the relationship. b) One in four women will be a victim of violence. c) Abusers often have outward signs that they are abusers or have a mental illness. d) Women who are in an abusive relationship experience less abuse while they are pregnant.
One in four women will be a victim of violence.
A 24-year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis?
Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease.
A nurse is preparing a class for a group of new parents on the psychological adaptations that occur after the birth. The nurse should include which signs and symptoms that might suggest postpartum depression? Select all that apply.
Restlessness, feelings of worthlessness, and feeling overwhelmed
A pregnant client is admitted to a maternity clinic after experiencing contractions. The nurse knows that what are the importance of the pauses between contractions during labor?
Restoration of blood flow to uterus and placenta
A new mother asks if it is possible to have rooming-in with the newborn. How should the nurse respond to this patient's request?
Rooming-in allows increased maternal-newborn contact
During a routine physical examination, the client is noted to have a Bartholin's cyst abcess. The nurse recognizes the need to obtain testing to rule out: STI. cancer. fungal infection. UTI.
STI. Cultures of the purulent abscess fluid and of the cervix should be obtained for Neisseria gonorrhea and Chlamydia trachomatis to rule out sexually transmitted infection. A careful history should include questions concerning the woman's sexual practices and protective measures used.
A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection?
Safety of antiviral therapy during pregnancy has not been established.
During which primary task of becoming a mother does the mother acknowledge the fetus as a separate entity within her due to quickening?
Second trimester (binding in)
A woman pregnant for the second time
Secundigravida
Women recovering from abusive relationships need to learn ways to improve their: a. Educational level by getting a college degree b. Earning power so they can move to a better neighborhood c. Self-esteem and communication skills to increase assertiveness d. Relationship skills so they will be better prepared to deal with their partners
Self-esteem and communication skills to increase assertiveness
The nurse would prepare a client for amnioinfusion when which action occurs?
Severe variable decelerations occur and are due to cord compression.pg 828
A patient who is abused fails to report the abuse MAINLY because of which of the following reasons? a) She feels lucky to be alive. b) She feels responsible for causing the incident. c) She does not want anyone to know. d) She thinks it will not happen again.
She feels responsible for causing the incident.
While providing care to a postpartum client on her first day at home, the nurse observes which behavior that would indicate the new mother is in the taking-hold phase?
Showing increased confidence when caring for the newborn
After teaching a group of students about fetal heart rate patterns, the instructor determines the need for additional teaching when the students identify which of the following as indicating normal fetal acid-base status? (Select all that apply.) A) Sinusoidal pattern B) Recurrent variable decelerations C) Fetal bradycardia D) Absence of late decelerations E) Moderate baseline variability
Sinusoidal pattern Recurrent variable decelerations Fetal bradycardia
A postpartum patient is reluctant to begin taking warm sitz baths. What should the nurse emphasize when teaching the patient about this treatment approach?
Sitz baths increase the blood supply to the perineal area
You are caring for a 52-year-old woman whose sisters and mother died of breast cancer. The patient states, "My doctor wants me to take tamoxifen to help prevent breast cancer. What do you think?" What would be your best response?
Tamoxifen reduces the incidence. Tamoxifen is referred to as a chemopreventive agent, not a chemotherapeutic agent. It does prevent osteoporosis, but this response does not address breast cancer prevention. Raloxifene (Evista) is another drug that shows promise as a chemopreventive agent. Tamoxifen reduces breast cancer incidence by 49%
A client with large uterine fibroids is scheduled to undergo a hysterectomy. Which intervention should the nurse perform as a part of the preoperative care for the client? Teach turning, deep breathing, and coughing. Instruct the client to reduce activity level. Educate the client on the need for pelvic rest. Instruct the client to avoid a high-fat diet.
Teach turning, deep breathing, and coughing. The nurse should teach the client turning, deep breathing, and coughing prior to the surgery to prevent atelectasis and respiratory complications such as pneumonia. Reducing activity level and the need for pelvic rest are instructions related to discharge planning after the client has undergone a hysterectomy. A high fat diet need not be avoided before undergoing hysterectomy; avoiding a high-fat diet is required for clients with pelvic organ prolapse to reduce constipation.
a nurse is caring for a client who has been diagnosed with genital warts due to human papilloma virus (HPV). The nurse explains to the client that HPV increases the risk for vulvar cancer. Which preventive measures to reduce the risk of vulvar cancer should the nurse explain?
The nurse should teach the client genital self-examination to assess for any unusual growths in the vulvar area. Nurse should instruc client to seek care for any suspicious lesion and to avoid self-medication
Walter is an 11-year-old boy who was raised in a home where his father beat his mother on a regular basis. Which of the following statements is true regarding children being raised in a home where they have witnessed intimate partner violence? a) They have higher rates of schizophrenia b) They are at increase risk for being abused c) It has little impact on child functioning d) Female children are more likely to experience depression
They are at increase risk for being abused
A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which of the following findings would require immediate intervention? a) Fetal heart rate of 150 beats/minute B) Contractions every 2 minutes, lasting 45 seconds C) Uterine resting tone of 14 mm Hg D) Urine output of 20 mL/hour
Urine output of 20 mL/hour Oxytocin can lead to water intoxication. Therefore, a urine output of 20 mL/hour is below acceptable limits of 30 mL/hour and requires intervention. - Contractions should occur every 2 to 3 minutes, lasting 40 to 60 seconds. - A uterine resting tone greater than 20 mm Hg would require intervention.
Its size increases from 70 g to about 1,100 to 1,200 g at term
Uterus
A client has been in labor for 10 hours, with contractions occurring consistently about 5 minutes apart. The resting tone of the uterus remains at about 9 mm Hg, and the strength of the contractions averages 21 mm Hg. The nurse recognizes which condition in this client?
With hypotonic uterine contractions, the number of contractions is unusually infrequent (not more than two or three occurring in a 10-minute period). The resting tone of the uterus remains less than 10 mm Hg, and the strength of contractions does not rise above 25 mm Hg.
A ball of cells that reaches the uterine cavity about 72 hours after fertilization is called a ______________
morula
A nurse is caring for a pregnant client who is in the active phase of labor. At what interval should the nurse monitor the client's vital signs?
every 30 minutes
A nurse is caring for a client who has been prescribed gonadotropin-releasing hormone (GnRH) medication for uterine fibroids. For which side effect of GnRH medications should the nurse monitor the client? increased vaginal discharge vaginal dryness urinary tract infections vaginitis
vaginal dryness Vaginal dryness is one of the side effects of GnRH medications. The other side effects of GnRH medications are hot flashes, headaches, mood changes, musculoskeletal malaise, bone loss, and depression. Increased vaginal discharge, urinary tract infections, and vaginitis are side effects of a pessary, not GnRH medications.
When caring for an abused woman, the nurse uses the ABCDES framework to provide interventions. Which of the following are components of this framework? Select all that apply. a) Plan of action and resources for safety for when the woman decides to leave b) Clear documentation of the nurse's perception of the abuse c) Expression of the belief that there may be a reason for the violence d) Education about the cycle of violence and its escalation e) Maintenance of confidentiality of the information reported f) Reassurance that the woman is not alone in this situation
• Plan of action and resources for safety for when the woman decides to leave • Maintenance of confidentiality of the information reported • Reassurance that the woman is not alone in this situation • Education about the cycle of violence and its escalation
A group of nursing students is preparing a talk on violence against women and how to prevent it. They want to list characteristics of intimate partner violence and should include which of the following? (Check all that apply.) a) use and abuse of substances such as alcohol b) history of childhood abuse c) history of antisocial behavior d) negative affect (hostility and depression) e) current unemployment f) easy-going personality
• history of childhood abuse • use and abuse of substances such as alcohol • history of antisocial behavior • current unemployment • negative affect (hostility and depression)
The nurse working in the obstetrics clinic has been trained to pick up on warning signs of abuse during pregnancy. These include which of the following?(Select all that apply.) a) more weight gain than recommended b) unrealistic fears c) difficulty with physical exams d) weight fluctuations e) noncompliance with treatment f) poor attendance at prenatal visits
• poor attendance at prenatal visits • unrealistic fears • weight fluctuations • difficulty with physical exams • noncompliance with treatment
The nurse who works in a woman's health clinic correctly identifies two key objectives for 2020 National Health Goals that addresses violence against women as which of the following? (Check two.) a) reduce the annual rate of rape or attempted rape b) increase the rate of women's depression c) reduce the rate of physical assault by current or former intimate partners d) increase the rate of women's consumed calories
• reduce the rate of physical assault by current or former intimate partners • reduce the annual rate of rape or attempted rape
A woman with uterine prolapse has undergone a vaginal hysterectomy and is being discharged home with an indwelling urinary catheter in place. The client will be using a leg bag during the day. Which instructions would the nurse most likely include in the client's discharge teaching plan? Select all that apply. "Clean your perineal area each day with a mild soap and water." "Keep the leg bag anchored on your abdomen, above your bladder." "Be sure to empty your leg bag frequently throughout the day." "You shouldn't have any problems urinating after the catheter is removed." "Avoid cleaning around the area where the catheter is inserted."
"Clean your perineal area each day with a mild soap and water." "Be sure to empty your leg bag frequently throughout the day." The client needs to understand that a Foley catheter will be in place for up to 1 week and that she might not be able to urinate due to the swelling after the catheter has been removed. The client should cleanse the perineal area daily with mild soap and water, especially around where the catheter enters the urinary meatus. If the woman is provided with a leg bag to be worn during waking hours, instruct her to empty it frequently and keep it below the level of the bladder to prevent backflow. The same principles are applied to the primary Foley bag when emptying it.
Clients who have had PID are prone to which complication?
ectopic pregnancy
Spotting or bleeding Painful urination Severe vomiting Fever Lower abdominal These are all danger signs that a client should contact her health care provider during which trimester?
First trimester
6. A nurse needs to assesss a female client for primary stage herpes simplex virus (HSV) infection. Which of the following symptoms related to this condition should the nurse assess for?
Ans: Genital vesicular lesions
During which task of becoming a mother does the woman focus on herself, not on the fetus?
First trimester (Ensuring safe passage throughout the pregnancy and birth )
Which of the following are biologic indicators of posttraumatic stress disorder (PTSD)? a) Auditory hallucinations b) A feeling of unreality about oneself c) Memory difficulties d) Flashbacks
Flashbacks
For a biophysical profile is a score of 10 considered normal or abnormal?
normal *Body movements, Fetal tone, Fetal breathing, Amniotic fluid volume and NST are all scored a 2 or 0*
statutory rape
the act of unlawful sexual intercourse by an adult with someone under the age of consent, even if the minor is a willing and voluntary participant in the sexual act
2. A nurse is assigned to care for a client who has been diagnosed with placental abruption. The nurse knows that which of the following could have led to placental abruption in the client?
Ans: Gestational hypertention
5. The nurse is caring for a pregnant client with severe preeclampsia. Which of the following nursing interventions should a nurse perform to institute and maintain seizure precautions in this client?
Ans: Keep the suction equipment readily available
4. A nurse is caring for a client who has had a vaginal birth. The nurse understands that pelvic relaxation can occur in any woman experiencing a vaginal birth. Which of the following should the nurse recommend to the client to improve pelvic floor tone?
Ans: Kegel exercises
4. A client is to be examined for the presence and extent of endometriosis. Which of the following tests should the nurse prepare the client for?
Ans: Laparoscopy
7. A nurse finds that a client is bleeding excessively after a vaginal delivery.Which assessment finding would indicate retained placental fragments as a cause of bleeding?
Ans: Large uterus with painless dark-red blood mixed with clots
A client is scheduled to have a screening mammogram. When teaching the woman about this test, the nurse should include which instruction?
"Don't use deodorant that day because it may interfere with the X-ray image." Deodorants and powder can appear on the x-ray film as calcium spots. The procedure should be scheduled just after menses, when breast tenderness is reduced. All jewelry must be removed from around the woman's neck because metal can cause distortions on the film image. Acetaminophen or aspirin can relieve any discomfort after the procedure.
When counseling a woman with monthly breast pain, what dietary recommendations should the nurse provide?
"Eat plenty of fruits, vegetables, and whole grains, and follow a low-fat diet." Maintaining a healthy weight will reduce pain from fibrocystic breasts. Caffeine and too much salt can contribute to fibrocystic breast changes. Calcium does not have a conclusive effect on breast pain.
The postpartum client and her husband are excited about their new baby. However, they are also concerned about getting pregnant again too soon and ask about using birth control. Which instruction should the nurse include in their discharge teaching to address this issue?
"Ovulation may return as soon as 3 weeks after birth."
A nurse is providing care to a client with pediculosis pubis. Which information would the nurse include when teaching the client about this condition?
"Remove the nits with a fine-toothed comb."
A woman who delivered her infant 2 days ago asks the nurse why she wakes up at night drenched in sweat. She is concerned that this is a problem. The nurse's best reply would be:
"Sweating is very normal for the first few days after childbirth because your body needs to get rid of all the excess water from pregnancy."
A 20-year-old female comes to the sexual health clinic for follow up related to a positive test for the human papillomavirus (HPV). The client asks the nurse, "Is there anything I can do to get rid of this?" What is the nurse's best response?
"There is currently no medical treatment to cure HPV."
A woman comes to the clinic. She gave birth about 2 months ago to a healthy term male newborn. During the visit, the woman tells the nurse, "I've noticed that I'm a bit uncomfortable now when we have sexual intercourse. Is there anything that I can do?" The woman's menstrual period has not yet resumed. Which suggestion by the nurse would be most appropriate?
"You might try using a water-soluble lubricant to ease the discomfort."
A pregnant woman is diagnosed with chlamydia and asks the nurse, "How will this infection affect my baby and pregnancy?" Which responses by the nurse are accurate? Select all that apply.
"Your newborn can be infected during birth." "Your newborn may have eye infections from this infection." "Your membranes may rupture earlier than normal."
8. A client is seeking advice for his pregnant wife, who is experiencing mild elevations in blood pressure. In which of the following positions should a nurse recommend the pregnant client rest?
Ans: Lateral recumbent position
A nurse is assigned the task of educating a pregnant client about childbirth. Which of the following nursing interventions should the nurse perform as a part of prenatal education for the client to ensure a positive childbirth experience?
- Provide the client clear information on procedures involved - Encourage the client to have a sense of mastery and self-control - Encourage the client to have a positive reaction to pregancy
5. A nurse is caring for a client who has just received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. Which of the following classifications will the nurse use to describe the laceration?
Ans: Fourth-degree laceration
13. The nursing instructor is discussing culture with a group of nursing students. Which of the following should be included in the discussion of this topic? Select all that apply.
Ans: Personal space Ans: Primary language spoken Ans: Religious beliefs
Which of the following would the nurse include when teaching women about preventing pelvic support disorders? A) Performing Kegel isometric exercises B) Consuming low-fiber diets C) Using hormone replacement D) Voiding every 2 hours
A
When preparing the discharge teaching plan for the woman who had surgery to correct pelvic organ prolapse, which of the following would the nurse include? A) Care of the indwelling catheter at home B) Emphasis on coughing to prevent complications C) Return to usual activity level in a few days D) Daily douching with dilute vinegar solution
A
A pregnant woman in her 39th week of pregnancy presents to the clinic with a vaginal infection. She tests positive for chlamydia. What would this disease make her infant at risk for? A. blindness B. neonatal laryngeal papillomas C.deafness D. chicken pox
A R:A pregnant woman who contracts chlamydia is at increased risk for spontaneous abortion (miscarriage), preterm rupture of membranes, and preterm labor. The postpartum woman is at higher risk for endometritis (Fletcher & Ball, 2006). The fetus can encounter bacteria in the vagina during the birth process. If this happens, the newborn can develop pneumonia or conjunctivitis that can lead to blindness.
A nurse is conducting a class on gestational diabetes for a group of pregnant women who are at risk for the condition. The nurse determines that additional teaching is needed when the class identifies which complication as affecting the neonate? A. hyperglycemia B. birth trauma C. hypoglycemia D. macrosomia
A R:Gestational diabetes is associated with either neonatal complications such as macrosomia, hypoglycemia, and birth trauma or maternal complications such as preeclampsia and cesarean birth.
A woman with diabetes is in labor. To reduce the likelihood of neonatal hypoglycemia, the nurse monitors the client's blood glucose level closely with the goal to maintain which level? A. below 110 mg/dL B. below 115 mg/dL C. below 105 mg/dL D. below 120 mg/dL
A R: For the laboring woman with diabetes, the blood glucose levels are monitored every 1 to 2 hours with the goal to maintain the levels below 110 mg/dL throughout the labor to reduce the likelihood of neonatal hypoglycemia. If necessary, an infusion of regular insulin may be given to maintain this level.
25. A nurse is describing how the fetus moves through the birth canal. Which of the following would the nurse identify as being most important in allowing the fetal head to move through the pelvis? A) Sutures B) Fontanelles C) Frontal bones D) Biparietal diameter
A Sutures are important because they allow the cranial bones to overlap in order for the head to adjust in shape (elongate) when pressure is exerted on it by uterine contractions or the maternal bony pelvis. * Fontanelles are the intersections formed by the sutures.
11. A nurse is caring for a client undergoing treatment for ectopic pregnancy. Which of the following symptoms is observed in a client if rupture or hemorrhage occurs before the ectopic pregnancy is successfully treated?
Ans: Phrenic nerve irritation
3. As a part of the newborn assessment, the nurse determines the skin turgor. Which of the following nursing interventions is relevant when observing the turgor of the newborn's skin?
Ans: Pinch skin and note return to original position
A nursing instructor is describing trends in maternal and newborn health care. The instructor addresses the length of stay for vaginal births during the past decade, citing that which of the following denotes the average stay? A) 24-48 hours or less B) 72-96 hours or less C) 48-72 hours or less D) 96-120 hours or less
A) 24-48 hours or less
After teaching a group of students about the different levels of prevention, the instructor determines a need for additional teaching when the students identify which of the following as a secondary prevention level activity in community-based health care? A) Teaching women to take folic acid supplements to prevent neural tube defects B) Working with women who are victims of domestic violence C) Working with clients at an HIV clinic to provide nutritional and CAM therapies D) Teaching hypertensive clients to monitor blood pressure
A) Teaching women to take folic acid supplements to prevent neural tube defects
A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1C. level of 13%. At this time the nurse should be most concerned about which of the following possible fetal outcomes? A)Congenital anomalies B)Incompetent cervix C)Placenta previa D)Abruptio placentae
A)Congenital anomalies
A client in her 10th week of gestation arrives at the maternity clinic reporting morning sickness. The nurse needs to inform the client about the body system adaptations during pregnancy. Which factors correspond to the morning sickness period during pregnancy? A. Reduced stomach acidity B. Elevated human chorionic gonadotropin (hCG) C. Increased red blood cell (RBC) production D. Increased estrogen level E. Elevated human placental lactogen (hPL)
A, B, D Reduced stomach acidity, Elevated hCG, Increased estrogen level
15. After teaching a group of students about the factors affecting the labor process, the instructor determines that the teaching was successful when the group identifies which of the following as a component of the true pelvis? (Select all that apply.) A) Pelvic inlet B) Cervix C) Mid pelvis D) Pelvic outlet E) Vagina F) Pelvic floor muscles
A, C, D The true pelvis is made up of three planes: the pelvic inlet, mid pelvis, and pelvic outlet. The cervix, vagina, and pelvic floor muscles are the soft tissues of the passageway.
23. A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which of the following would the nurse most likely include when discussing measures to promote coping for a positive labor experience? (Select all that apply.) A) Presence of a support partner B) View of birth as a stressor C) Low anxiety level D) Fear of loss of control E) Participation in a pregnancy exercise program
A, C, E
A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which of the following? (Select all that apply.) A) Rectocele B) Fecal incontinence C) Cystocele D) Urinary incontinence E) Enterocele
A, C, E
A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1C. level of 13%. At this time the nurse should be most concerned about which of the following possible fetal outcomes? A)Congenital anomalies B)Incompetent cervix C)Placenta previa D)Abruptio placentae
A. HbA1c level of 13% indicates poor glucose control. This, in conjunction with the woman being in the first trimester, increases the risk for congenital anomalies in the fetus. Elevated glucose levels are not associated with incompetent cervix, placenta previa, or abruptio placentae.
When describing genetic disorders to a group of childbearing couples, the nurse would identify which as an example of an autosomal dominant inheritance disorder? A) Huntington's disease B) Sickle cell disease C) Phenylketonuria D) Cystic fibrosis
Ans: A Feedback: Huntington's disease is an example of an autosomal dominant inheritance disorder. Sickle cell disease, phenylketonuria, and cystic fibrosis are examples of autosomal recessive inheritance disorders.
4. Which of the following is a risk to newborn because of meconium in the amniotic fluid?
Ans: Acute respiratory complications
7. A nurse is caring for a preterm infant. Which intervention will prepare the preterm newborm's gut to overcome feeding difficulties?
Ans: Administer 0.5ml of breast milk enterally
18. A pregnant client is diagnosed with AIDS. Which of the following interventions should the nurse undertake to minimize the risk of transmission of AIDS to the infant?
Ans: Administer antiretroviral syrup to the infant within 12 hours after birth
12. A nurse is assessing a term newborn and finds the blood glucose level is 23 mg per dL and the newborn has a weak cry, is irritable, and bradycardic. Which intervention is most appropriate?
Ans: Administer dextrose intravenously
3. A nurse is caring for a client with idiopathic thrombocytopenic purpura. The nurse is correct when performing which interventions?
Ans: Administration of platelet transfusion as ordered
After teaching a class on the stages of fetal development, the instructor determines that the teaching was successful when the students identify which of the following as a stage? (Select all that apply.) A) Placental B) Preembryonic C) Umbilical D) Embryonic E) Fetal
Ans: B, D, E Feedback: The three stages of fetal development are the preembryonic, embryonic, and fetal stage. Placental and umbilical are not stages of fetal development.
2. A nurse is caring for a 5-hour-old newborn. The physician has asked the nurse to maintain the newborn's temperature between 97.7° and 99.5° F (between 36.5° and 37.5° C). What nursing intervention should the nurse perform to maintain the temperature within the recommended range?
Ans: Place the newborn skin-to-skin with the mother
13. A nurse is caring for a client who has had an intrauterine fetal death with prolonged retention of the fetus. Which of the following signs and symptoms should the nurse watch for in a client to assess for an increased risk of disseminated intravascular coagulation? Select all that apply
Ans: Bleeding gums Ans: Tachycardia Ans: Acute renal failure
7. A pregnant client in her first trimester of pregnancy complains of spontaneous, irregular, painless contractions. What does this indicate?
Ans: Braxton Hicks contractions
13. A nurse is to care for a client during the postpartum period. The client complains of pain and discomfort in her breasts. What signs should a nurse look for to find out if the client has engorged breasts? Select all that apply
Ans: Breast are hard Ans: Breast are tender
1. A female client who has just given birth has been reading health reports and is alarmed at the high rate of infant mortality. She seems anxious about the health of her child and wants to know ways to keep her baby from getting an infection. Which of the following instructions should the nurse offer?
Ans: Breastfeed the infant.
3. A nurse is caring for a client who has just undergone delivery. What is the best method for the nuse to assess this client for postpartum hemorrhage?
Ans: By frequently assessing uterine involution
9. A nurse is caring for a client who delivered vaginally 2 hours ago. What postpartum complication can the nurse assess within the first few hours following delivery?
Ans: Postpartal hemorrhage
3. A nurse is caring for a client who is experiencing acute onset of dyspnea and hypotension. The physician suspects the client has amniotic fluid embolism. What other sign or symptoms would alert the nurse to the presence of this condition?
Ans: Cyanosis Ans: Pulmonary edema
9. The nurse is caring for a client at the ambulatory care clinic who questions the nurse for info about contraception. The client reports that she isn't comfortable about using barrier methods and would like the option of regaining fertility after a couple of years. Which of the following methods should the nurse suggest to this client?
Ans: Cycle beads or depo-provera
9. A nurse is caring for a client undergoing treatment for bacterial vaginosis. Which of the following instructions should the nurse give the client to prevent recurrence of bacterial vaginosis? Select all that apply.
Ans: Practice monogamy
18. A pregnant client is brought to the healthcare facility with signs of PROM. Which of the following are the associated conditions and complication of premature rupture of membranes? Select all that apply
Ans: Prolapsed cord Ans: Abruptio placenta Ans: Preterm labor
5. A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What assessment findings will the nurse expect to find in the client?
Ans: Prolonged bleeding time
9. A client who gave birth 5 days ago complains to the nurse of profuse sweating during the night. What should the nurse recommend to the client in this regard?
Ans: "Be sure to change your pajamas to prevent you from chilling."
1. The nurse is counseling a couple who are concerned that the woman has achondroplasia in her family. The woman is not affecred. Which of the following statements by the couple indicates the need for more teaching?
Ans: "If the father doesn't have the gene, then his son won't have achondroplasia"
10. A nurse has been assigned to assess a pregnant client for abruptio placenta. Which of the following is a classic nanifestation of this condition that the nurse should assess for?
Ans: "Knife-like" abdominal pain with vaginal bleeding
12. A nurse is examining a client who underwent a vaginal birth 24 hours ago. The client asks the nurse why her discharge is such a deep red color. What explanation is most accurate for the nurse to give to the client?
Ans: "The discharge consists of mucus, tissue debris, and blood; this gives it the deep red color."
14. The nurse is newly posted to the obstetric unit of the health care facility. Which of the following are the causes of intrauterine fetal demise in late pregnancy that the nurse should be aware of? Select all that apply
Ans: Prolonged pregnancy Ans: Hypertension
The nursing instructor overhears students discussing their recent lecture topic of abuse and realizes that they need clarification when she hears a student say which of the following? a) Violence against lesbian relationships may go unreported for fear of harassment. b) Abuse occurs only in heterosexual relationships. c) Violence against gay relationships may go unreported for fear of harassment. d) Abuse occurs in both heterosexual and homosexual relationships.
Abuse occurs only in heterosexual relationships.
Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which of the following components is critical to the success of the plan? a) A quality of life assessment tool b) An intimate partner violence (IPV) counselor c) Educational materials d) Avenues for referral
Avenues for referral
A female client is prescribed metronidazole for the treatment of trichomoniasis. Which instruction should the nurse give the client undergoing treatment?
Avoid alcohol.
A nurse is caring for a client with vaginitis. What instructions should the nurse provide to the client to prevent recurrent vaginal infections? Select all that apply
Avoid the use of colored toilet tissue. Wear only cotton panties and ventilated pantyhose. Avoid using deodorant tampons
After teaching a woman with pelvic organ prolapse about dietary and lifestyle measures, which of the following statements would indicate the need for additional teaching? A) "If I wear a girdle, it will help support the muscles in the area." B) "I should take up jogging to make sure I exercise enough." C) "I will try to drink at least 64 oz of fluid each day." D) "I need to increase the amount of fiber I eat every day.
B
Which of the following factors in a postpartum woman's history would lead the nurse to monitor the woman closely for an infection? A. Hemoglobin of 12 mg/dL B. Manually extracted placenta C. Labor of 10 hours length D. Multiparity of 5 pregnancies
B since manual removal of a placenta increases the risk for infection since the uterus was entered and traumatized during the procedure. This extraction places her at high risk for a subsequent infection.
What criteria would the physician base his decision on to begin insulin therapy for a gestational diabetic mother? A. Urine is 2+ for glucose and serum blood glucose is 120. B. A 2-hour postprandial glucose level cannot be kept below 120 mg/dL. C. Weight gain is over 30 pounds (13.6 kg) and blood sugars are fluctuating between 95 and 130 throughout the day. D. Client cannot keep fasting blood sugar lower than 90 mg/dL.
B A physician usually recommends beginning a woman with gestational diabetes on insulin therapy when exercise and diet are ineffective and if she is unable to keep her fasting blood sugar levels below 95 mg/dL or her 2-hour postprandial glucose levels below 120 mg/dL.
After undergoing diagnostic testing, a woman is diagnosed with a corpus luteum cyst. The nurse anticipates that the woman will require: A) Biopsy B) No treatment C) Oral contraceptives D) Glucophage
B Corpus luteum cysts form when the corpus luteum becomes cystic or hemorrhagic and fails to degenerate after 14 days. Typically, these cysts appear after ovulation and resolve without intervention. Biopsy would be indicated if a malignancy was suspected. Oral contraceptives and metformin would be used to treat polycystic ovarian syndrome.
A nurse is assessing a postpartum client who is at home. Which statement by the client would lead the nurse to suspect that the client may be developing postpartum depression? A) "I just feel so overwhelmed and tired." B) "I'm feeling so guilty and worthless lately." C) "It's strange, one minute I'm happy, the next I'm sad." D) "I keep hearing voices telling me to take my baby to the river."
B Indicators for postpartum depression include feelings related to restlessness, worthlessness, guilt, hopeless, and sadness along with loss of enjoyment, low energy level, and loss of libido. Thus, the statement by the mother about feeling guilty and worthless suggest postpartum depression.
The nursing student demonstrates an understanding of dystocia with which statement? A) "Dystocia is not diagnosed until after birth." B) "Dystocia is diagnosed after labor has progressed for a time." C) "Dystocia is diagnosed at the start of labor." D) "Dystocia cannot be diagnosed until just before birth."
B) "Dystocia is diagnosed after labor has progressed for a time." Nursing management of the woman with dystocia, regardless of etiology, requires patience. The nurse needs to provide physical and emotional support to the client and family. Dystocia is diagnosed not at the start of labor, but rather after it has progressed for a time.
The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first? A) Sperm emission B) Penile vasodilation C) Psychological release D) Ejaculation
B) Penile vasodilation -With sexual stimulation, the arteries leading to the penis dilate and increase blood flow into erectile tissue. Blood accumulates, causing the penis to swell and elongate. -Sperm emission (movement of sperm from the testes and fluid from the accessory glands) occurs with orgasm.
When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes that the primary goal of these classes is to: A) Equip a couple with the knowledge to experience a pain-free childbirth B) Provide knowledge and skills to actively participate in birth and parenting C) Eliminate anxiety so that they can have an uncomplicated birth D) Empower the couple to totally control the birth process
B) Provide knowledge and skills to actively participate in birth and parenting
The nurse is counseling a couple who are concerned that the woman has achondroplasia in her family. The woman is not affected. Which statement by the couple indicates the need for more teaching? A. "If the mother has the gene, then there is a 50% chance of passing it on." B. "If the father doesn't have the gene, then his son won't have achondroplasia." C. "If the father has the gene, then there is a 50% chance of passing it on." D. "Since neither one of us has the disorder, we won't pass it on."
B. "If the father doesn't have the gene, then his son won't have achondroplasia." Rationale: This is an autosomal dominant disorder. It does not discriminate between male or female.
The primary objectives of the __________________ are to reduce stillbirth and to detect hypoxia early enough to allow delivery in time to avoid permanent fetal damage resulting from fetal asphyxia.
Biophysical Profile
A nurse is providing care to a female client receiving treatment for a Bartholin's cyst. The client has had a small loop of plastic tubing secured in place to allow for drainage. The nurse instructs the client that she will have a follow-up appointment for removal of the plastic tubing at which time? A) 1 week B) 2 weeks C) 3 weeks D) 4 weeks
C
After teaching a group of students about genital fistulas, the instructor determines that the teaching was successful when the students identify which of the following as a major cause? A) Radiation therapy B) Congenital anomaly C) Female genital cutting D) Bartholin's gland abscess
C
A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world? A) Rubella B) Hepatitis B C) Cytomegalovirus D) Parvovirus B19
C) Cytomegalovirus
The nurse is assessing a woman with abruption placentae who has just given birth. The nurse would be alert for which of the following? A) Severe uterine pain B) Board-like abdomen C) Appearance of petechiae D) Inversion of the uterus
C A complication of abruptio placentae is disseminated intravascular coagulation (DIC), which is manifested by petechiae, ecchymoses, and other signs of impaired clotting. *Severe uterine pain, a board-like abdomen, and uterine inversion are not associated with abruptio placentae.
A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world? A) Rubella B) Hepatitis B C) Cytomegalovirus D) Parvovirus B19
C) Cytomegalovirus CMV is the leading cause of congenital infection, with morbidity and mortality at birth and sequelae
The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurses teaching was successful? A)I'll basically follow the same diet that I was following before I became pregnant. B)Because I need extra protein, I'll have to increase my intake of milk and meat. C)Pregnancy affects insulin production, so I'll need to make adjustments in my diet. D)I'll adjust my diet and insulin based on the results of my urine tests for glucose.
C)Pregnancy affects insulin production, so I'll need to make adjustments in my diet.
Between weeks 6 and 8 of gestation, softens due to vasocongestion
Cervix
A female client with a malignant tumor of the breast has to undergo chemotherapy for a period of 6 months. For which side effect should the nurse monitor when caring for this client?
Constipation The side effects of chemotherapy are constipation, hair loss, weight loss, vomiting, diarrhea, immunosuppression, and, in extreme cases, bone marrow suppression. The nurse should monitor for these side effects when caring for the client undergoing chemotherapy. Vaginal discharge, headache, and chills are not side effects of chemotherapy. Vaginal discharge is one of the side effects of SERMs as a part of hormonal therapy, which is used to prevent cancer from spreading further into the body. Headache is a side effect of aromatase inhibitors under hormonal therapy to counter cancer. Chills are a side effect of immunotherapy.
When preparing a teaching plan for a group of first-time pregnant women, the nurse expects to review how maternity care has changed over the years. Which of the following would the nurse include when discussing events of the 20th century? A) Epidemics of puerperal fever B) Performance of the first cesarean birth C) Development of the x-ray to assess pelvic size D) Creation of free-standing birth center
Creation of free-standing birth centers
A group of students are preparing a class presentation about polyps. Which of the following would the students most likely include in the presentation? A) Polyps are rarely the result of an infection. B) Endocervical polyps commonly appear after menarche. C) Cervical polyps are more common than endocervical polyps. D) Endocervical polyps are most common in women in their 50s.
D
After teaching a local woman's group about incontinence, the nurse determines that the teaching was successful when the group identifies which of the following as characteristic of stress incontinence? A) Feeling a strong need to void B) Passing a large amount of urine C) Most common in women after childbirth D) Sneezing may be an initiating stimulus
D
Many women develop iron-deficient anemia during pregnancy. What diagnostic criteria would the nurse monitor for to determine anemia in the pregnant woman? A. Blood pressure of 100/68 B. Heart rate of 84 C.Hemoglobin of 13 or lower D. Hematocrit of 32% or less
D R: Iron-deficiency anemia is diagnosed in a pregnant woman if the hematocrit is less that 33% or the hemoglobin is less than 11 g/dL. Tachycardia, hypotension and tachypnea are all symptoms of iron-deficiency anemia but are not diagnostic criteria.
Methergine has been ordered for a postpartum woman because of excessive bleeding. The nurse should question this order if which of the following is present? A. Mild abdominal cramping B. Tender inflamed breasts C. Pulse rate of 68 beats per minute D. Blood pressure of 158/96 mmHg
D. Methergine can cause hypertension. Therefore, if the woman's blood pressure was already elevated, the nurse would need to question the order for the drug. Typically if methergine is ordered, her lochia flow would be increased, not minimal.
A 52-year-old female client with an estrogen receptors positive (ER+) breast cancer is undergoing hormonal therapy. While taking a selective estrogen receptor modulator (SERM), the client begins to experience hot flashes. What should the nurse do next?
Document the hot flash in the client's chart When caring for a client who is being administered selective estrogen receptor modulator, the nurse should monitor for side effects such as hot flashes, vaginal discharge, bleeding, and cataract formation. Hot flashes are an expected side effect of SERM; therefore the nurse should document the finding in the chart.
When implementing an intervention for a woman in an abusive situation, what is the primary goal? a) For the woman to be able to stand up to her abuser b) For the woman to be removed from her abusive relationship c) For the woman to regain a sense of control in her life d) For the woman to be able to care for herself
For the woman to regain a sense of control in her life
an infectious condition that involves the endometrium, decidua and adjacen myometrium of the uterus
Metritis
Kearns-Syre syndrome and Leber's hereditary optic neruopathy are examples of what type of nontraditional inheritance disorder?
Mitochondrial *Exclusively comes from the mother*
What are the "five P's" that affect the process of labor and birth
Passageway (birth canal) Passenger (fetus and placenta) Powers (contractions) Position (maternal) Psychological response
Active in hormone production to support the pregnancy until about weeks 6 to 7
Ovaries
A nurse is conducting a class for a group of pregnant women about the risk of substance use during pregnancy. When discussing the effects of nicotine on a pregnancy, which complications would the nurse include? Select all that apply. A. premature rupture of membranes B. ectopic pregnancy C. macrosomia D. placenta previa E. spontaneous abortion
Smoking increases the risk of: - spontaneous abortion - tubal ectopic pregnancy - preterm labor and birth - fetal growth restriction - stillbirth - premature rupture of membranes - low fetal iron stores - maternal hypertension - placenta previa - abruptio placentae
A female client has been admitted to the inpatient psychiatric facility with a diagnosis of posttraumatic stress disorder after a history of violence by her boyfriend. During the initial assessment interview, which assessment would be the priority? a) Hydration status b) Suicide risk c) Sleep patterns d) Nutritional status
Suicide risk
Research validates that nonmoving back-lying positions such as supine and lithotomy positions during labor are not healthy.
TRUE
A new mother tells the postpartum nurse that she thinks her baby does not like her since it cries often when she holds it. How should the nurse respond to this statement?
Tell the mother that it is natural to have feelings of uncertainty when adjusting to a new baby.
a nurse is caring for a client who is experiencing acute onset of dyspnea and hypotension. Physician suspect client has amniotic fluid embolism. What other signs would alert the nurse?
nurse should watch for cyanosis, pulmonary edema, hypotension, seizures, tachycardia, coagulation failure, hemorrhage
The nurse is developing a teaching plan for a client diagnosed with genital herpes simplex (HSV). Which would the nurse include? Select all that apply.
The management of genital herpes includes antiviral therapy. The need to use good hand washing technique to prevent spread. Educate the client to abstain from sexual activity until HSV lesions resolve. The goal is for recurrences to be less frequent over time.
At a health education class for teenagers, the nurse discusses the sexually transmitted infection chlamydia trachomatis. Which information would the nurse most likely include?
This infection is the most common infectious cause of infertility.
These drugs promote uterine relaxation by interfering with uterine contraction
Tocolytic
__________ contractions are more commonly felt in the lower back, and bring about progressive cervical dilation and effacement.
True labor
The nurse is preparing discharge for a client who plans to bottle-feed her infant. Which instruction should the nurse prioritize for this client in the discharge teaching?
Wear a tight, supportive bra
During what week of pregnancy does the lungs begin formation?
Week 6
The nurse would expect which client to be at a high risk for developing a pelvic support disorder? an 18-year-old college freshman a 29-year-old mother of one son a 60-year-old mother with four children a 30-year-old who just gave birth to twin girls
a 60-year-old mother with four children Women may experience pelvic support disorders related to pelvic relaxation or urinary continence. These disorders usually develop after years of wear and tear on the muscles and tissues that support the pelvic floor, such as what occurs with childbearing, chronic coughing, straining, surgery, or simply aging.
placenta
a flattened circular organ in the uterus of pregnant eutherian mammals, nourishing and maintaining the fetus through the umbilical cord. pg.336
umbilical cord
a flexible cordlike structure containing blood vessels and attaching a human or other mammalian fetus to the placenta during gestation.
trophoblast
a layer of tissue on the outside of a mammalian blastula, supplying the embryo with nourishment and later forming the major part of the placenta. pg. 336
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?
a painless genital ulcer that appeared about 3 weeks after unprotected sex
Rohypnol
a potent sedative drug of the benzodiazepine class. "forget pill" (date rape drug)
A 40-year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. What most likely contributed to her present condition?
a sharp reduction in the number of lactobacilli in the client's vaginal flora
A client with juvenile rheumatoid arthritis (JRA) is in week 38 of her pregnancy. Which of the following interventions should the nurse make with this client? a) Ask the client to decrease her intake of salicylates b) Perform the Snellen eye test c) Urge the client to be on bed rest d) Advise the client to continue her normal dosage of methotrexate
a) Ask the client to decrease her intake of salicylates Rationale: Although women with JRA should continue to take their medications during pregnancy to prevent joint damage, large amounts of salicylates have the potential to lead to increased bleeding at birth or prolonged pregnancy. The infant may be born with a bleeding defect and may also experience premature closure of the ductus arteriosus because of the drug's effects. For this reason, a woman is asked to decrease her intake of salicylates approximately 2 weeks before term. - A number of women also take low-dose methotrexate, a carcinogen. - As a rule, they should stop taking this prepregnancy because of the danger of head and neck defects in the fetus. - (Salicylates are a group of chemicals derived from salicylic acid. They are found naturally in certain foods and also synthetically produced for use in products like aspirin, toothpaste and food preservatives.)
Fetal _______________ as evidenced by a fetal heart rate greater than 160 bpm accompanied by a decrease in variability and late decelerations is an ominous sign indicating the need for prompt intervention.
tachycardia
A 16-year-old girl comes to the public health office and tells you she is pregnant. She is afraid to tell her parents. As a nurse, what is important for you to know that can help this 16 year old? a) Know about community resources for the pregnant teen b) Know who the father of the baby is c) Know who the mother's parents are d) Know what school district she resides in
a) Know about community resources for the pregnant teen Rationale: Be knowledgeable regarding community resources for the pregnant teen. If you or the primary-care practitioner refers the teen to another entity, follow up to make certain the adolescent receives the services for which she was referred. If she does not, try to determine the barriers that prevent her from following through with treatment. Assist her to work through the barriers to obtain needed services.
A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection? a) Toxoplasmosis b) Parvovirus B19 c) Cytomegalovirus d) Herpes simplex virus
a) Toxoplasmosis Rationale: Toxoplasmosis is transferred by hand to mouth after touching cat feces while changing the litter box or through gardening in contaminated soil. Cytomegalovirus is transmitted via sexual contract, blood transfusions, kissing, and contact with children in daycare centers. Parvovirus B19 is a common self-limiting benign childhood virus that causes fifth disease. A pregnant woman may transmit the virus transplacentally to her fetus if she is exposed to an infected child. Herpesvirus infection occurs by direct contact of the skin or mucous membranes with an active lesion through kissing, sexual contact, or routine skin-to-skin contact.
When caring for a pregnant woman with cardiac problems, the nurse must be alert for signs and symptoms of cardiac decompensation (congestive heart failure), which include a) dyspnea, crackles, irregular weak pulse. b) regular heart rate, hypertension. c) shortness of breath, bradycardia, hypertension. d) increased urinary output, tachycardia, dry cough.
a) dyspnea, crackles, irregular weak pulse. Rationale: Signs of cardiac decompensation to congestive heart failure include crackles in the lungs from fluid, difficulty breathing, and weak pulse from heart exhaustion. The heart rate would not be regular, and a cough would not be dry. The heart rate would increase rather than decrease.
The nurse is teaching women at a local clinic about vaginal cancer. Which of the following risk factors would be important to include in her presentation? Select all that apply. a) Smoking b) History of HIV c) Persistent ovulation over time d) Having taken any type of hormone replacement therapy for longer than 10 years e) Increasing age
a, b, e: Direct risk factors for vaginal cancer have not been proved. However, risk factors associated with vaginal cancer are as follows: smoking, age greater than 60 years, HIV, vaginal trauma, HPV, cervical cancer, exposure to DES in utero, and pelvic radiation. Use of hormone replacement therapy for longer than 10 years and persistent ovulation are risk factors associated with ovarian cancer
A 47-year-old woman was just diagnosed with a cancer of her reproductive tract. The public health nurse is aiding in counseling. Which of the following nursing interventions would be supportive in counseling this woman? Select all that apply. a) Give post-operative care and instructions when prescribed b) Validate the client's feelings and provide realistic hope c) Be judgmental of the women's previous lifestyle d) Give care based on all woman diagnosed with cancer e) Use sincere basic communication techniques
a, b, e: Nursing interventions in caring for women with cancers of the female reproductive tract include the following: Validate the client's feelings and provide realistic hope; use basic communication skills in a caring way; give useful, nonjudgmental information to all women; give individual care for each person; and give discharge and postoperative care when ordered
A nurse is reviewing the symptoms of ovarian cancer with a recently diagnosed 60-year-old woman. Which of the following are common symptoms of ovarian cancer? Select all that apply. a) Abdominal fullness b) Decrease in urination c) Back pain d) Abdominal pressure
a, c, d: Ovarian cancer, the "silent killer", develops slowly. The symptoms usually do not show up until the advanced stages. The most common symptoms are gastrointestinal; therefore women sometimes think stress is the cause and further investigation is not done. Symptoms include urine frequency, constipation, unusual bloating, abdominal fullness, back pain, and abdominal pressure
A young woman has been referred for a colposcopy by the health care provider. The nurse is educating the woman on the procedure. Which of the following information about the colposcopy should the nurse provide? a) The results of the Pap smear were abnormal; therefore this procedure must be done. b) Sexual intercourse should be avoided for 2 weeks. c) The procedure may be painful. d) There may be some pain while urinating for up to a week after the test.
a: A colposcopy is performed when results of a Pap smear are abnormal. This is a painless procedure with no after effects, so urinating afterwards is not a problem, and sexual intercourse need not be avoided
A 30-year-old woman had a Pap smear 4 weeks ago. The results of the test are classified as ASC-H, as per the Bethesda System. Which of the following therapeutic management interventions should the nurse expect the health care provider to order? a) Refer for a colposcopy with HPV testing. b) Repeat the Pap smear in 4 to 6 months, or refer for a colposcopy c) Discontinue any further Pap smear screenings d) Send for an immediate colposcopy, and follow up based on results
a: A result of ASC-H for Pap smear testing is classified by the Bethesda System. This system gives a uniform diagnostic term to Pap smear results. This classification means that the health care provider should refer the patient for a colposcopy with HPV testing. A result of ASC-US means that the health care provider should refer to repeat the test in 4 to 6 months, or should refer to colposcopy. Results of AGC or AIS indicate the need for an immediate colposcopy with follow-up based on results.
In a breech presentation the FHR is best heard where?
at or above the level of the maternal umbilicus
Working at the local health clinic, the nurse recognizes that STIs can often result in PID. When a client with a history of repeat STIs presents to the clinic reporting severe abdominal cramping and bleeding, the immediate concern is to ensure the client does not have:
ectopic pregnancy.
Which of the following changes in insulin is most likely to occur in a woman during pregnancy? a) Unavailable because it is used by the fetus b) Not released because of pressure on the pancreas c) Less effective than normal d) Enhanced secretion from normal
c) Less effective than normal Rationale: Somatotropin released by the placenta makes insulin less effective. This is a safeguard against hypoglycemia.
You encourage a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, you would advise her to do which of the following? a) Eat a high-carbohydrate snack b) Eat a sustaining-carbohydrate snack c) Inject a bolus of insulin d) Add a bolus of long-acting insulin
b) Eat a sustaining-carbohydrate snack Rationale: Because exercise uses up glucose, women with diabetes should take a sustaining-carbohydrate snack before hard exercise to prevent hypoglycemia.
You are doing a nursing assessment on a new patient in the obstetric clinic. The woman estimates that she is approximately 16 weeks pregnant. While assessing her you ask about what appear to be scratch marks on her hands, and she tells you that she has three cats at home. What screening would be ordered for this woman? a) Cytomegalovirus b) Toxoplasmosis c) Herpes Simplex Virus d) Hepatitis C
b) Toxoplasmosis Rationale: Toxoplasmosis is an infection caused by the protozoan Toxoplasma gondii, also referred to as T. gondii. Transmission is via undercooked meat and through cat feces. Toxoplasmosis is a common infection in humans and usually produces no symptoms. However, when the infection passes from the woman through the placenta to the fetus, a condition called congenital toxoplasmosis can occur. Approximately 400 to 4,000 cases of congenital toxoplasmosis occur per year in the United States (Williams, 2007). The classic triad of symptoms for congenital toxoplasmosis is chorioretinitis, intracranial calcification, and hydrocephalus in the newborn.
A nurse is conducting a session on education about cancers of the reproductive tract and is explaining the importance of visiting a health care professional if certain unusual symptoms appear. Which should the nurse include in her list of symptoms that merit a visit to a health care professional for further evaluation? Select all that apply. a) Irregular bowel movements b) Irregular vaginal bleeding c) Increase in urinary frequency d) Elevated or discolored vulvar lesions e) Persistent low backache not related to standing
b, d, e: Irregular vaginal bleeding, persistent low backache not related to standing, and elevated or discolored vulvar lesions are some of the symptoms that should be immediately brought to the notice of the primary health care provider. Increase in urinary frequency and irregular bowel movements are not symptoms related to cancers of the reproductive tract
a 40- year-old client reports low back pain after standing for a long time. The primary care provider has diagnosed the client with pelvic organ prolapse. The nurse correctly recognizes which client are likely not candidates for corrective surgery for pelvic organ prolapse? select all that apply a. client with low back pain and pelvic pressure b. client at high risk of recurrent prolapse after surgery c. client who is morbidly obese before surgery d. client who has severe organ prolapse e. client has chronic obstructive pulmonary disease
b,c,e
A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely?
chancres at the vaginal site
The nursing student correctly identifies which of the following to be the treatment of choice for endometrial cancer? a) hysterectomy b) hysterectomy and salpingo-oophorectomy c) dilation and curettage (D&C;) d) salpingo-oophorectomy
b: Surgery is the usual and best treatment for endometrial cancer. It usually involves remmoval of the uterus (hysterectomy) and the fallopian tubes and ovaries (salpingo-oophorectomy). In a D&C;the surgeon dilates the cervix and removes part of the lining of the uterus and/or contents of the uterus.
what happens to the lungs + the foramen ovale, after baby's first breath?
baby breathes = inflation of lungs. this causes increased blood flow to lungs via RV, which then cause pressure to increase in LA. the increased pressure in the LA causes septum primum, a flap that closes to the ductus arteriosus, to snap shut (now the atria are seperated by a wall). the foramen ovale functionally closes w/in 1-2 hrs. physiologically closed by 1 mo d/t deposits of fibrin. permanently closed by 6th month of life.
When developing a program for STI prevention, which action would need to be done first?
educating on how to promote sexual health
A pregnant woman who has had cardiovascular disease for the last 3 years asks the nurse why this disorder makes her pregnancy an "at-risk" pregnancy. What is the nurse's best response? a) "The fact that you are receiving prenatal care will help." b) "Our facility has a lot of experience in dealing with this." c) "Pregnancy taxes the circulatory system of every woman." d) "Don't worry. You have an excellent doctor."
c) "Pregnancy taxes the circulatory system of every woman." Rationale: Pregnancy taxes the circulatory system of every woman because both the blood volume and cardiac output increase by approximately 30% to 50%. Half of these increases occur by 8 weeks; they are maximized by mid-pregnancy.
A client is 33 weeks pregnant and has had diabetes since age 21. When checking her fasting blood glucose level, which value would indicate the client's disease is controlled? a) 45 mg/dl b) 120 mg/dl c) 85 mg/dl d) 136 mg/dl
c) 85 mg/dl Rationale: Recommended fasting blood glucose levels in pregnant clients with diabetes are 60 to 95 mg/dl. A fasting blood glucose level of 45 g/dl is low and may result in symptoms of hypoglycemia. A blood glucose level below 120 mg/dl is recommended for 2-hour postprandial values. A blood glucose level above 136 mg/dl in a pregnant client indicates hyperglycemia.
A woman with Class II heart disease is in the third trimester of her pregnancy. She's been taking good care of herself and has had little difficulty, but to be on the safe side the obstetrician has ordered bed rest for her for the final month. For her own and the baby's safety, in what position should the nurse advise the patient to sleep? a) Lie flat on her back. b) Stay in high Fowler's position. c) Lie in a semirecumbent position. d) Use pillows and wedges to stay in a fully recumbent position.
c) Lie in a semirecumbent position. Rationale: Semirecumbent position is the best position for circulation of the mother and fetus. Laying flat on the back can induce supine hypotensive syndrome and fully recumbent impedes other circulation. Therefore options A, B, and D are incorrect answers for this question.
Which medication is prescribed most commonly for a pregnant woman with chronic hypertension? a) Nifedipine b) Atenolol c) Methyldopa d) Labetolol
c) Methyldopa Rationale: Although labetolol, atenolol, and nifedipine may be ordered, methyldopa the most commonly prescribed agent because of its safety record during pregnancy. It is a slow-acting antihypertensive agent that also helps to improve uterine perfusion.
The inner surface of the blastocyst will form the __________ and ____________.
embryo and amnion
A nursing instructor is teaching students about anemia during pregnancy. Which type of anemia does the instructor teach students is most prevalent during pregnancy? a) sickle-cell anemia b) pernicious anemia c) iron-deficiency anemia d) folic acid anemia
c) iron-deficiency anemia Rationale: Iron-deficiency anemia is the most common type in pregnancy. Many woman enter pregnancy with a low iron count because of poor diet, heavy menstrual periods, unwise weight-loss programs, or a combination of these.
The endometrial biopsy of a client reveals cancerous cells, and the primary health care provider has diagnosed it as endometrial cancer. Which responsibilities of the nurse are part of the treatment of the client? Select all that apply. a) Inform the client that follow-up care is not required unless something unusual occurs. b) Inform the client that changes in sexuality are normal and need not be reported. c) Offer the family explanations and emotional support throughout the treatment. d) Make sure the client understands all the available treatment options. e) Inform the client about the possible advantages of a support group.
c, d, e: The responsibilities of a nurse while caring for a client with endometrial cancer include ensuring that the client understands all the treatment options available, suggesting the advantages of a support group and providing referrals, and offering the family explanations and emotional support throughout the treatment. The nurse should also discuss changes in sexuality with the client as well as stress the importance of regular follow-up care after the treatment and not just in cases where something unusual occurs
A postmenopausal patient is told at her routine gynecological exam that the physician has found a cyst on her right ovary. The nurse notices that this does not cause worry for this patient. What should the nurse and/or physician tell this patient? a) She is correct not to be concerned; after all, it is only a cyst. b) You may get a second opinion if you would like. c) After menopause a mass on an ovary is not a cyst and should be considered cancerous until proven otherwise. d) We will keep a eye on it and re-check it at your next yearly appointment
c: After menopause, a mass on an ovary is not a cyst; physiologic cysts can arise only from a follicle that has not ruptured or from the cystic degeneration of the corpus luteum. Brushing it off is not responsible and waiting a full year would put the patient at serious risk from dying from the cancer. Suggesting a second opinion instead of explaining the seriousness of it to the patient would not be responsible or ethical
After teaching a local woman's community group about cervical cancer, which of the following if stated by the group as a risk factor indicates a successful teaching program? a) Vulvar dermatosis b) Chronic vulvitis c) Genital herpes d) Obesity and menopause
c: Genital herpes increases the risk for cervical cancer. Chronic vulvitis and vulvar dermatosis are risk factors for vulvar cancer. Obesity and menopause are risk factors for pelvic relaxation alteration
A nurse is assisting with the pelvic exam of a woman who has come to the clinic with reports of abnormal vaginal bleeding. The client is diagnosed with an endocervical polyp. The nurse understands that the pelvic exam most likely revealed a polyp appearing as: cherry red. grayish-white. purplish-blue. pinkish-gray.
cherry red. Most endocervical polyps are cherry red; most cervical polyps are grayish-white.
In which clients is it most important to understand the importance of an annual Papanicolaou test?
clients infected with the human papillomavirus (HPV)
A client with a family history of cervical cancer is to undergo a Pap test. During the client education, what group should the nurse include as at risk for cervical cancer?
clients who have genital warts
_____________ is the presence of rhythmic involuntary contractions, most often at the foot or ankle.
clonus *Clonus is the presence of rhythmic involuntary contractions, most often at the foot or ankle. Sustained clonus confirms CNS involvement.
During the stress of pregnancy, _______________ is secreted by the adrenal glands to help keep up the level of glucose in the plasma by breaking down noncarbohydrate sources.
cortisol
A nursing instructor is teaching students about pre-existing illnesses and how they can complicate a pregnancy. The instructor recognizes a need for further education when one of the students makes which statement? a) "A pregnant woman needs to be careful of and cautious about accidents and illnesses during her pregnancy." b) "A pregnant woman with a chronic illness can put the fetus at risk." c) "A pregnant woman with a chronic condition can put herself at risk." d) "A pregnant woman does not have to worry about contracting new illnesses during pregnancy."
d) "A pregnant woman does not have to worry about contracting new illnesses during pregnancy." Rationale: When a woman enters a pregnancy with a chronic illness, it can put both her and the fetus at risk. She needs to be cautious about developing a new illness during her pregnancy as well as having an accident during the pregnancy.
A pregnant woman is determined to be at high risk for gestational diabetes. At which time would the nurse expect the client to undergo rescreening? a) 28 to 32 weeks b) 16 to 20 weeks c) 20 to 24 weeks d) 24 to 28 weeks
d) 24 to 28 weeks Rationale: A woman identified as high risk would undergo rescreening between 24 and 28 weeks.
An alert, diabetic, pregnant woman in the hospital experiences some shakiness and diaphoresis with a fasting blood sugar of 60 mg/dl when she awakens in the morning. Which action should the nurse take first? a) Recheck her blood sugar for accuracy. b) Stay with her and ask another nurse to bring her insulin. c) Withhold her insulin and notify the health care provider. d) Administer the patient's glucose tablets.
d) Administer the patient's glucose tablets. Rationale: The patient is hypoglycemic when awakening in the morning. The nurse should provide glucose and be prepared to reassess. The nurse should not recheck at this point, since the patient is symptomatic. She does not need insulin, and she will have her morning dose adjusted after breakfast.
While the nurse is weighing a pregnant woman at a regularly scheduled OB visit, the patient complains of vaginal itching, a great deal of foamy yellow-green discharge, and pain during intercourse. She says this is her first pregnancy and she didn't know this was what happened. What can the nurse tell her? a) This is not normal for pregnancy but the doctor might test her for a simple yeast infection. If it is a yeast infection, it can be treated with a single-dose suppository that will not harm the fetus. Remind the patient that she should call immediately if she has any symptoms that don't seem normal to her. b) This is not normal for pregnancy; the doctor might test her for chlamydia. If it is chlamydia, she and her partner can be treated with a 7-day course of antibiotics. Remind the patient that she should call immediately if she has any symptoms that don't seem normal to her. c) This is not normal for pregnancy; the doctor might test her for gonorrhea. If it is gonorrhea, she and her partner will be treated with antibiotics; they might be treated with different medications because some antibiotics normally used to treat gonorrhea are damaging to the fetus. Remind the patient that she should call immediately if she has any symptoms that don't seem normal to her. d) This is not normal for pregnancy; the doctor might test her for trichomoniasis. If it is trichomoniasis, she can be treated with an oral dose of metronidazole. Remind the patient that she should call immediately if she has any symptoms that don't seem normal to her.
d) This is not normal for pregnancy; the doctor might test her for trichomoniasis. If it is trichomoniasis, she can be treated with an oral dose of metronidazole. Remind the patient that she should call immediately if she has any symptoms that don't seem normal to her. Rationale: Trichomoniasis is caused by a one-celled protozoa. The symptoms include large amounts of foamy, yellow-green vaginal discharge. Treatment is with metronidazole, her partner needs to be treated as well. A yeast infection presents with a cottage-cheese like discharge, so option A is incorrect. Chlamydia often has no symptoms. If the woman does experience symptoms, these may include vaginal discharge, abnormal vaginal bleeding, and abdominal or pelvic pain. Gonorrhea may have symptoms so mild that they go unnoticed in the woman. The woman who contracts gonorrhea may have vaginal bleeding during sexual intercourse, pain, and burning while urinating, and a yellow or bloody vaginal discharge.
Oxytocin aids in stimulating prostaglandin synthesis through receptors in the ___________________
decidua
Oxytocin aids in stimulating prostiglandin synthesis through receptors in the _____
decidua
5 hormones of the placenta:
estrogen progesterone relaxin HPL HCG
_____________ acts as an antagonist against maternal insulin and thus more insulin must be secreted to counteract the increasing levels.
human placental lactogen (hPL)
If the woman is a diabetic, it is critical to alert the newborn nursery of potential __________________ in the newborn.
hypoglycemia
Of all of the synthetic opioids ___________ is the most commonly used opioid for the management of pain during labor.
meperidine
The __________ layer of the embryonic cell forms the skeletal, urinary, circulatory, and reproductive organs.
mesoderm
A client is diagnosed with trichomoniasis infection. The nurse prepares to teach the client about which medication?
metronidazole
what is the blastocyst? also, how is it formed?
once the morula enters the uterus, uterine fluid enters it, turning it into a fluid-filled ball of cells. these cells will continue to divide in specialized cells that will turn into fetal structures. the fluid filled ball of cells is the blastocyst, which will form the embryo & the amnion.
The cervix, vagina, and pelvic floor muscles are the soft tissues of one of the 5 P's
passageway
genome
the complete set of genes or genetic material present in a cell or organism.
karyotype
the number and visual appearance of the chromosomes in the cell nuclei of an organism.
During an assessment, the nurse notes that the client has been unable to urinate properly since she gave birth and is still bleeding more than expected. The nurse suspects which condition?
uterine atony
failure of uterus to contract and retract immediately after birth
uterine atony
Lumpectomy is a treatment option for clients diagnosed with breast cancer with tumors smaller than 5 cm. For which clients is lumpectomy contraindicated? Select all that apply.
• Client who has had previous radiation to the affected breast • Client whose connective tissue is reported to be sensitive to radiation • Client whose surgery will not result in a clean margin of tissue
A nurse is assigned to educate a group of women on cancer awareness. Which risk factors for breast cancer are modifiable? Select all that apply.
• Failing to breastfeed for up to a year after pregnancy • Postmenopausal use of estrogen and progestins • Not having children until after age 30
What are three positive signs of pregnancy?
- Ultrasound - Fetal movement felt by the provider - Auscultation of fetal heart tones via Doppler
The extent of the laceration is defined by depth:
- a first-degree laceration extends through the skin - a second-degree laceration extends through the muscles of the perineal body - a third-degree laceration continues through the anal sphincter muscle - a fourth-degree laceration also involves the anterior rectal wall.
6. A client with preeclampsia is receiving magnesium sulfate to suppress or control seizures. Which of the following nursing interventions should a nurse perform to determine the effectiveness of therapy?
Ans: Assess deep tendon reflexes
9. What assessment by the nurse will best monitor the nutrition and fluid balance in the postterm newborn?
Ans: Assess for decrease in urinary output
12. A client is admitted to the health care facility with gestation age of 42 weeks. The client is to undergo a C-section. Which of the following would be the feal risk associated with postterm pregnancy?
Ans: Cephalopelvic disproportion
10. Which maternal factors should the nurse consider that could lead to a newborn's being "large for gestational age?" Select all that apply
Ans: Diabetes mellitys Ans: Postdates gestation Ans: Glucose intolerance
The nurse notes persistent early decelerations on the fetal monitoring strip. Which of the following would the nurse do next? A) Continue to monitor the FHR because this pattern is benign. B) Perform a vaginal exam to assess cervical dilation and effacement. C) Stay with the client while reporting the finding to the physician. D) Administer oxygen after turning the client on her left side.
A Early decelerations are not indicative of fetal distress and do not require intervention. Therefore, the nurse would continue to monitor the fetal heart rate pattern. They are most often seen during the active stage of any normal labor, during pushing, crowning, or vacuum extraction. They are thought to be a result of fetal head compression that results in a reflex vagal response with a resultant slowing of the FHR during uterine contractions.
A nurse suspects that a postpartum client is experiencing postpartum psychosis. Which of the following would most likely lead the nurse to suspect this condition? A) Delirium B) Feelings of anxiety C) Sadness D) Insomnia
A Postpartum psychosis is at the severe end of the continuum of postpartum emotional disorders. It is manifested by depression that escalates to delirium, hallucinations, anger toward self and infant, bizarre behavior, mania, and thoughts of hurting herself and the infant. Feelings of anxiety, sadness, and insomnia are associated with postpartum depression.
A nurse is conducting a class on gestational diabetes for a group of pregnant women who are at risk for the condition. The nurse determines that additional teaching is needed when the class identifies which complication as affecting the neonate? A. hyperglycemia B. birth trauma C. hypoglycemia D. macrosomia
A R:Gestational diabetes is associated with either neonatal complications such as macrosomia, hypoglycemia, and birth trauma or maternal complications such as preeclampsia and cesarean birth.
A group of nursing students are reviewing information about factors affecting maternal, newborn, and women's health. The students demonstrate understanding of the information when they identify which of the following deficiencies as being associated with poverty? Select all that apply. A) Literacy B) Employment opportunities C) Mobility D) Political representation E) Skills
A) Literacy B) Employment opportunities C) Mobility D) Political representation E) Skills
After teaching a group of students about the use of antiretroviral agents in pregnant women who are HIV- positive, the instructor determines that the teaching was successful when the group identifies which of the following as the underlying rationale? A)Reduction in viral loads in the blood B)Treatment of opportunistic infections C)Adjunct therapy to radiation and chemotherapy D)Can cure acute HIV/AIDS infections
A)Reduction in viral loads in the blood
Which vaccines are contraindicated during pregnancy since they may transmit a viral infection to the fetus? Select all that apply. A. measles B. mumps C. influenza D. rubella E. Tdap vaccine (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis)
A, B, D Measles, Mumps, Rubella
When developing a presentation for a local community organization on violence, the nurse is planning to include statistics on intimate partner abuse and its effects on children. In what percentage of the cases in which a parent is abused are the children battered also? A) 50% to 75% B) 25% to 50% C) 10% to 25% D) Less than 5%
Ans: A Feedback: In 50% to 75% of cases when a parent is abused, the children are abused as well.
A woman is going to have labor induced with oxytocin. Which statement reflects the induction technique the nurse anticipates the primary care provider will prescribe?
Administer oxytocin diluted as a "piggyback" infusion. Pg.820
What prenatal test takes a sample of amniotic fluid to perform chromosome analysis. Results take 2-4 weeks.
Amniocentesis *Contraindicated in HIV patients. Done between 15-20 weeks*
5. A first-time mother informs the nurse that she is unable to breastfeed her baby through the day as she is usually away at work. She adds that she wants to express her breast milk and store it for her baby. What instruction should the nurse offer the woman to ensure the safety of stored expressed breast milk?
Ans: Use sealed and chilled milk within 24 hours
7. A nurse is assessing a 45 yo client. The client asks for info regarding the changes that are most likely to occur with menopause. Which of the following should the nurse tell the client?
Ans: Uterus shrinks and gradually atrophies
The nurse would be least likely to find which of the following in a client with uterine fibroids? A) Regularly shaped, shrunken uterus B) Acute pelvic pain C) Menorrhagia D) Complaints of bloating
B
_________________ contractions increase in strength and frequency and aid in moving the cervix from a posterior position to an anterior position. They also help in ripening and softening the cervix.
Braxton-Hicks
After teaching a group of students about the signs and symptoms of breast cancer, the instructor determines that additional teaching is needed when the group identifies which of the following?
Breast symmetry The primary sign of breast cancer is a painless mass in the breast. Other signs of breast cancer include a bloody discharge from the nipple, a dimpling of the skin over the lesion, retraction of the nipple, peau d'orange (orange peel) appearance of the skin, and a difference in size between the breasts.
The nurse is conducting a breast exam on a postpartum mother on the second day following delivery. What findings would the nurse determine to be normal? Select all that apply.
Breasts feel slightly firm; Flattened nipple on the right breast; and breasts are non-painful
A nurse is providing care to a woman during the third stage of labor. Which of the following would alert the nurse that the placenta is separating? A) Boggy, soft uterus B) Uterus becoming discoid shaped C) Sudden gush of dark blood from the vagina D) Shortening of the umbilical cord
C. Sudden gush of dark blood from the vagina
A nurse is preparing a presentation for a group of women which will cover various dietary and lifestyle changes to help avoid future pelvic structure changes. Which key point should the nurse point out in this presentation to the women? Limit fiber intake to less than 25 grams daily. Eat more refined, processed foods. Drink plenty of fluids each day. Engage in vigorous exercise.
Drink plenty of fluids each day. All women should drink at least eight 8-ounce glasses of fluid a day. Fiber intake needs to be increased; the recommended daily intake of fiber for women is 25 grams. Refined, processed, low-fiber foods need to be replaced with high-fiber foods. The women should be encouraged to perform Kegel exercises to help increase the strength of the pelvic floor muscles. Other exercising should also be encouraged but the Kegel exercises are specific to the affected area which will lead to pelvic floor prolapse. Depending on the type of vigorous exercise, some will actually result in pelvic floor prolapse, if it puts lots of strain on the pelvic floor.
A client has undergone a mastectomy for breast cancer. Which instruction should the nurse include in the postsurgery client-teaching plan?
Elevate the affected arm on a pillow When providing care to the client, the nurse should instruct the client to elevate the affected arm on a pillow. As part of the respiratory care, the nurse should instruct the client to turn, cough, and breathe deeply every 2 hours; rapid breathing is not encouraged. Active range-of-motion and arm exercises are necessary. To counter any pain experienced by the client, analgesics are administered as needed; intake of medication is not restricted.
The ____________ stage of development begins at day 15 through week 8. Basic structures of all major body organs and the main external features are completed during this time period.
Embryonic stage
The nurse manager of a postpartum care area is planning educational sessions for the nursing staff to support the 2020 National Health Goals for postpartum care. Which information should be included in this staff training? Select all that apply.
Encourage postpartum patients to participate in breast-feeding; Explain the importance of close observation to detect postpartum maternal hemorrhage; Provide information on reproductive life planning if requested
A pregnant client in labor has to undergo a sonogram to confirm the fetal position of a shoulder presentation. The nurse should assess for which of the following conditions associated with shoulder presentation during a vaginal birth?
Fetal anomalies
What is the most common breast mass in women?
Fibroadenoma A fibroadenoma is a benign mass in the breast. It is the most common breast mass among women.
When assessing a family for possible barriers to health care, the nurse would consider which factor to be most important? A) Language B) Health care workers' attitudes C) Transportation D) Finances
Finances
A client who gave birth about 12 hours ago informs the nurse that she has been voiding small amounts of urine frequently. The nurse examines the client and notes the displacement of the uterus from the midline to the right. What intervention would the nurse perform next?
Perform urinary catheterization
A group of nursing students are reviewing information about methods used for cervical ripening. The students demonstrate understanding of the information when they identify which of the following as a mechanical method? A) Herbal agents B) Laminaria C) Membrane stripping D) Amniotomy
Laminaria is a hygroscopic dilator that is used as a mechanical method for cervical ripening. Herbal agents are a nonpharmacologic method. Membrane stripping and amniotomy are considered surgical methods.
____________, or cleavage occurs as the zygote is slowly transported into the uterine cavity by tubal muscular movements.
Mitosis
A nurse observes telltale signs of injuries from physical abuse on the face and neck of a female client. When questioned, the client tells the nurse that the injuries are the result of a physical attack by her partner and that she has developed palpitations thereafter. Which action should the nurse take to gain the trust of the client and enhance the nurse-client relationship? a) Tell the client to forget about the incident to avoid the trauma b) Inform the client that there is no connection between the violence and palpitations c) Offer referrals so the client can get help that will allow her to heal d) Confirm with the partner whether the client's story is true
Offer referrals so the client can get help that will allow her to heal
A patient who has been seen in the clinic multiple times for counseling recently admitted to being abused by her husband over a period of five years. Today she states, "He has been so sweet to me the last six days that I think this time he has really changed. He even brought me flowers yesterday and said he loves me." How should the nurse respond to this? a) Over a period of time the honeymoon phase ends and abuse becomes accelerated and thus more dangerous. b) That was a very sweet gesture. c) It seems as if he really loves you. d) I certainly would not be sucked into that.
Over a period of time the honeymoon phase ends and abuse becomes accelerated and thus more dangerous.
A nurse is performing a routine physical for a 7-year-old girl who is thin, unwashed, and dressed in rags. Although it is winter time, she has no coat with her. Her teenaged brother in the waiting room, however, is dressed in trendy clothes and looks healthy and well-fed. Which of the following should the nurse most strongly suspect regarding this girl? a) Physical neglect b) Sexual maltreatment c) Psychological maltreatment d) Physical maltreatment
Physical neglect
A client with abnormal uterine bleeding is diagnosed with small ovarian cysts. The nurse has to educate the client on the importance of routine check-ups. Which assessment is most appropriate for this client's condition? Monitor gonadotropin level every month. Monitor blood sugar level every 15 days. Schedule periodic Pap smears. Schedule an ultrasound every 3 to 6 months.
Schedule an ultrasound every 3 to 6 months. The nurse should monitor the client with ultrasound scans every 3 to 6 months. Monitoring gonadotropin level and blood sugar level and scheduling periodic Pap smears are not important assessments for the client with small ovarian cysts.
A small amount of breast milk is obtained for culture and sensitivity testing from a client with mastitis. The nurse would expect the results to identify which organism as the most likely cause?
Staphylococcus aureus The most common causative microorganism associated with mastitis is Staphylococcus aureus. Chlamydia is a sexually transmitted infection. Streptococcus is commonly associated with strep throat. E. coli is a common cause of urinary tract infections.
Sudden weight gain Facial edema Severe upper abdominal pain or headace with visual changes Decrease of fetal movement more than 24 hours These are all danger signs that a client should contact her health care provider during which trimester?
Third trimester
A nurse is caring for a client who was raped at gunpoint. The client does not want any photos taken of her injuries. The client also does not want the police to be informed about the incident even though state laws require reporting life-threatening injuries. Which intervention should the nurse perform to document and report the findings of the case? a) Document only descriptions of medical interventions taken b) Use direct quotes and specific language c) Respect the client's opinion and avoid informing the police d) Obtain photos to substantiate the client's case in a court of law
Use direct quotes and specific language dont take pictures without informed consent. Document refusal of client to be photographed
___________________ is a catastrophic tearing of the uterus at the site of a preious scar into the abdominal cavity. The onset is marked by sudden fetal bradycardia and cessation of contractions.
Uterine rupture *immediate surgical attention is needed
The generation-to-generation continuum of violence refers to the fact that a) Children who grow up in abusive homes almost always become abusers themselves unless they have professional intervention b) Children who grow up in an abusive home are less likely to be abusers themselves because they see first hand the devastation that violence can cause c) Violence is an innate behavior, and children become abusers because of external factors in their environment more often than in their family d) Violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves
Violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves
How should the nurse counsel a postpartum patient on how to prevent mastitis?
Wash your hands thoroughly, and let your breasts dry after each feeding. Handwashing is one of the best ways to prevent infection. If the woman feels that her breast is warm, hard, or red, she should increase the amount of breastfeeding from that side. It is not necessary to sterilize bottles and pumping equipment after each use. Normal dish washing is sufficient. Keeping the breasts exposed to the air to dry will aid in preventing infection.
A new mother asks the nurse what she is allowed to do when she goes home from the hospital. Which statement by the nurse would be correct?
You should not lift anything heavier than your infant in its carrier
Bishop score less than 6
indicates that cervical ripening method should be used before inducing labor
The ________________ is a clear protein layer that blocks all but one sperm from entering the ovum to fertilize it. It disappears in 5 days.
zona pellucida
When the nucleus of the ovum and sperm combine to restore the 46 chromosomes the result is a _______________ which begins the process of a new life.
zygote
