OB 2

The health care provider prescribes 50 mg daily by mouth of clomiphene for a client having fertility problems. The client cannot swallow pills. Available is 200 mg/5 mL elixir. How many milliliters of the medication would the nurse administer? Record your answer using two decimal points.

1.25

1. A woman with known cardiac disease is in labor. In what position would the nurse place the client? a. Semi recumbent with a pillow under one hip b. Trendelenburg c. High fowler with a pillow at the back d. Supine

a

1. The maternal health nurse is caring for a pregnant client with a history of asthma who requires maintenance medication for the management of the disease. Which action by the nurse best reinforces information provided to the client regarding maintenance of her health? a. Observe the client taking her inhaler b. Teach the client how to use a spacer with an inhaler c. Review the clients peak flow meter readings d. Ask the client to show the nurse deep breathing techniques

a

A pregnant client is diagnosed with syphilis. Which response would demonstrate respect for the client and therapeutic communication? a. I am sure it is frightening to you to be diagnosed with a disease that can affect your baby b. You should have thought about what diseases you could be exposed to. At least you are HIV negative. c. I noticed that you seem fidgety. Is there something wrong besides your STI? d. Why did you use protection when having intercourse with your partner?

a

A pregnant client with a history of asthma since childhood presents for a prenatal visit. What statement by the client would the nurse prioritize? a. I sometimes get a bit wheezy b. I have trouble getting comfortable in bed c. I sometimes get a feeling of euphoria d. Certain substances make me sneeze

a

A pregnant client with a history of heart disease has been admitted to a health care center reporting breathlessness. The client also reports 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? (334-335) a. Class III b. Class IV c. Class I d. Class II

a

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 (3.33 mmol/L)? a. Provide the client some milk to drink b. Recheck her blood sugar for accuracy c. Withhold her insulin and notify the heath care provider d. Stay with her, and ask another nurse to bring her insulin

a

A pregnant client with iron-deficiency anemia is prescribed an iron supplement. After teaching the woman about using the supplement, the nurse determines that more teaching is needed based on which client statement? a. I will take the iron with milk instead of orange or grapefruit juice b. I will need to avoid coffee and tea when I take this supplement c. Taking the iron supplement with food with help with the side effects d. If I happen to miss a dose I will take it as soon as I remember

a

A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant? (338) a. Prednisone b. Albuterol c. Ipratropium d. Salmeterol

a

In which age range are women most vulnerable for intimate partner violence? (348-350) a. 16 to 24 years b. 35 to 44 years c. 45 years and older d. 25 to 34 years

a

The clinic nurse teaches a pregestational type 1 diabetic client that constant insulin levels are very important during pregnancy. The nurse tells the client that the best way to maintain a constant insulin level is to use: a. An insulin pump b. An insulin drip c. An insulin pen d. Regular insulin twice a day

a

The maternal health nurse cares for a homeless pregnant woman who presented to the emergency room in precipitous labor. The woman has not had prenatal care. Upon delivery, her infant weighs 4.6 kg and notes the infant appears to be jittery. Which nursing action will the nurse perform first? a. Check the infants blood glucose level b. Administer glucose c. Administer intramuscular (IM) vitamin K d. Check the infants axillary temperature

a

The maternal health nurse is caring for a pregnant client with a history of epilepsy. The client's antiepileptic drug (AED) levels have been in the non-therapeutic range the last two times the labs were drawn. Which factor does the nurse associate with this finding? a. Drug metabolism changes during pregnancy b. Most maintenance medications cannot be given in pregnancy c. The action of many medications vary in pregnancy d. Pregnant clients have high rates of noncompliance with maintenance medications

a

The nurse is assessing a pregnant client who has a long history of asthma. She states, "I'm trying not to use my asthma medications because I certainly don't want my baby exposed to them." What is the nurse's best response? a. Actually, having uncontrolled asthma is much riskier for your baby than the medication b. In fact, most modern asthma medications are categorized as safe for use in pregnancy c. I'm glad to hear that you're focused on ensuring your baby's health d. Your health care provider will likely agree with your decision

a

The nurse is caring for a pregnant woman determined to be at high risk for gestational diabetes. The nurse prepares to rescreen this client at which time frame? a. 24 to 28 weeks b. 16 to 20 weeks c. 20 to 24 weeks d. 28 to 32 weeks

a

A nurse is obtaining a medication history from a pregnant client with a history of systemic lupus erythematosus (SLE). Which medication(s) would the nurse expect the woman to report to be currently using? Select all that apply. a. Hydroxychloroquine b. Ibuprofen c. Prednisone d. Leflunomide e. Methotrexate

a, b, c

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 (342) a. If you develop any flu-like symptoms, notify your physician immediately to be evaluated for CMV b. Do not share food or drinks with young children, especially if they are in day care c. Wash your hands thoroughly with soap and water after touching saliva or urine d. If you contract CMV, your doctor will give you some oral medicine to treat it e. If you have CMV, it is suggested that you not breastfeed your infant'

a, b, c

The maternal health nurse is caring for a pregnant client with sickle cell disease. Which action(s) will the nurse take to help the client prevent complications related to her disease? Select all that apply. a. Obtain a urine sample at every prenatal visit b. Observe the clients lower extremities for ulcers at every prenatal visit c. Emphasize the importance of maintaining the medication regimen established before pregnancy d. Instruct the client on the need for weekly intravenous fluid therapy e. Instruct the client on the warning signs of stroke

a, c

The nurse is caring for a pregnant client in the first trimester with a preexisting condition of rheumatic heart disease. The client reports mild shortness of breath with strenuous activity. When teaching the client, which statement(s) will the nurse include? Select all that apply. a. Be sure to drink an adequate amount of fluids b. Maintain bed rest to avoid cardiac exertion c. Perform moderate exercises as tolerated d. Avoid cardiac medications in the first trimester e. Be sure to receive an influenza vaccine

a, c, e

A 20-year-old pregnant client is positive for hemoglobin S. The nurse explains to the client that she will need perform which actions during her pregnancy? Select all that apply. a. Avoid conditions of low oxygen tension, such as high altitudes b. Be on bed rest c. Eat high protein meals d. Drink lots of fluids

a, d

1. 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. Parvovirus B19 b. Toxoplasmosis c. Cytomegalovirus d. Herpes simplex virus

b

1. A woman who has sickle cell anemia asks the nurse if her infant will develop sickle cell disease. The nurse would base the answer on which information? a. Sickle cell anemia is not inherited; it occurs following a malaria infection b. Sickle cell anemia is recessively inherited c. Sickle cell anemia is dominantly inherited d. Sickle cell anemia has more than one polygenic inheritance pattern

b

A mother is talking to the nurse and is concerned about managing her asthma while she is pregnant. Which response to the nurse's teaching indicates that the woman needs further instruction? a. It is fine for me to use my albuterol inhaler if I begin to feel tight b. I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring c. I will monitor my peak expiratory flow rate regularly to help me predict when an asthma attack is coming on d. I need to be aware of my triggers and avoid them as much as possible

b

A nurse is talking to a newly pregnant woman who had a mitral valve replacement in the past. Which statement by the client reveals an understanding about the preexisting condition? a. I know I will be fine, but I worry about the fetus b. I understand that my fetus and I both are at risk for complications c. I know my baby will be fine, but I am worried about having a personal complication d. I don't have to worry about this because I had the problem fixed before I became pregnant

b

A nursing instructor is teaching students about preexisting 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 with a chronic condition can put herself at risk b. A pregnant woman does not have to worry about contracting new illnesses during pregnancy c. A pregnant woman needs to be careful of and cautious about accidents and illnesses during her pregnancy d. A pregnant woman with a chronic illness can put the fetus at risk

b

A patient who is 36 weeks pregnant has been taking phenytoin for a seizure disorder. Which supplement should the nurse anticipate being prescribed for this patient? (339) a. Vitamin D b. Vitamin K c. Vitamin C d. Vitamin E

b

A pregnant woman diagnosed with diabetes should be instructed to perform which action? a. Prepare foods with increased carbohydrates to provide needed calories b. Notify the primary care provider if unable to eat because of nausea and vomiting c. Ingest a smaller amount of food prior to sleep to prevent nocturnal hyperglycemia d. Discontinue insulin injections until 15 weeks gestation

b

A pregnant woman with diabetes is having a glycosylated hemoglobin (HgbA1C) level drawn. Which result would require the nurse to revise the client's plan of care? a. 7% b. 8.5% c. 5.5% d. 6.0%

b

A woman calls the obstetrician's office to inquire how long she needs to wait to get pregnant following a seizure she had last week. The nurse would tell her to wait how long? (339) a. Most doctors recommend that a woman wait 1 year following a seizure to get pregnant b. It is recommended that she wait 6 months after seizures are under control before getting pregnant c. There is no set time to wait before conceiving following a seizure d. She needs to wait 2 months after seizures are controlled before conceiving

b

A woman's obstetrician prescribes vitamin K supplements for a client who is on antiepileptic medications beginning at 36 weeks' gestation. The mother asks the nurse why she is taking this medication. The nurse's best response would be: a. Vitamin K helps in keeping the placenta healthy b. Antiepileptic therapy can lead to vitamin K deficient hemorrhage of the newborn c. Administration of vitamin K aids in lung maturity of the fetus d. The antiepileptic medications can cause the mother's platelets to drop

b

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 g/dl or lower b. Hematocrit of 32% or less c. Blood pressure of 11/68 mmHg d. Heart rate of 84 beats/min

b

The maternal health nurse is caring for a group of high-risk pregnant clients. Which client condition will the nurse identify as being the highest risk for pregnancy? a. Loud systolic murmur b. Pulmonary hypertension c. Secondary hypertension d. Repaired atrial septal defect

b

The nurse encourages a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, the nurse would advise her to take which action? a. Inject a bolus of insulin b. Eat a sustaining-carbohydrate snack c. Each a high carbohydrate snack d. Add a bolus of long acting insulin

b

The nurse instructs a pregnant patient with sickle cell anemia on ways to prevent a crisis. Which patient statement indicates that teaching has been effective? a. I should take an iron supplement every day b. I should drink eight glasses of water every day c. I should make sure I stand for at least 4 hours every day d. I should avoid sitting with my legs elevated during the day

b

The nurse is assessing a pregnant client with a known history of congestive heart failure who is in her third trimester. Which assessment findings should the nurse prioritize? a. Increased urinary output, tachycardia, and dry cough b. Dyspnea, crackles, and irregular weak pulse c. Shortness of breath, bradycardia, and hypertension d. Regular heart rate and hypertension

b

Which factor would contribute to a high-risk pregnancy? a. Blood type O positive b. Type 1 diabetes c. History of allergy to honey bee pollen d. First pregnancy at age 33

b

A nurse is admitting a pregnant woman with sickle cell anemia to the emergency department. Which findings would lead the nurse to suspect the client is in crisis? Select all that apply. a. Increased skin turgor b. Joint pain c. Fatigue d. Fever e. Pallor

b, c, d

The nurse is caring for a pregnant client with asthma that is well managed with long- and short-acting bronchodilators. Which statement(s) does the nurse associate with the client's condition? Select all that apply. a. The woman should increase her maintenance medications during labor b. Adequate analgesia decreases the woman's risk for exacerbation during labor c. The woman should receive her regularly scheduled bronchodilators during labor d. Labor will exacerbate the woman's symptoms e. Adequate hydration decreases the woman's risk for exacerbation during labor

b, c, e

A pregnant woman at 36 weeks' gestation comes to the care center for a follow-up visit. The woman is to be screened for group B streptococcus (GBS) infection. When describing this screening to the woman, the nurse would explain that a specimen will be taken from which area(s)? Select all that apply. a. Nasal cavity b. Vagina c. Conjunctiva d. Throat e. Rectum

b, e

1. A 17-year-old primigravida with type 1 diabetes is at 37 weeks' gestation comes to the clinic for an evaluation. The nurse notes her blood sugar has been poorly controlled and the health care provider is suspecting the fetus has macrosomia. The nurse predicts which step will be completed next? a. Scheduling the woman for induction of labor today b. Allowing her to continue without plans for delivery c. Preparing for amniocentesis and fetal lung maturity assessment d. Scheduling a cesarean delivery at 39 weeks

c

1. 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. Aspirin b. Digoxin c. Heparin d. Warfarin

c

1. The nurse preceptor is working with a novice maternal health nurse. The novice nurse is caring for a pregnant client with an insulin pump due to pregestational type 1 diabetes. Which action by the novice nurse requires the preceptor to intervene? a. Covering the pump insertion site with a piece of gauze b. Cleansing the insertion site daily c. Changing the insertion site every 12 hours d. Choosing the lower abdomen for the insertion site

c

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. Oral hypoglycemic drugs b. Glucagon c. Diet d. Long acting insulin

c

A mother is talking to the nurse and is concerned about managing her asthma while she is pregnant. Which response to the nurse's teaching indicates that the woman needs further instruction? a. I need to be aware of my triggers and avoid them as much as possible b. It is fine for me to use my albuterol inhaler if I begin to feel tight c. I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring d. I will monitor my peak expiratory flow rate regularly to help me predict when an asthma attack is coming on

c

A patient with asthma who is 32 weeks' pregnant is concerned that the health care provider has reduced the doses of asthma maintenance medications. How should the nurse respond to this patient's concern? a. Asthma medication is teratogenic and should not be taken b. Asthma improves during pregnancy so higher doses are not needed c. Asthma medication may reduce labor contractions and should be reduced d. Asthma medication is ineffective during pregnancy and should be stopped

c

A patient with heart disease who is 28 weeks pregnant asks the nurse why office appointments have been scheduled every week for the next 4 weeks. What should the nurse respond to the patient? a. This is the routine schedule for all pregnant patients b. This is when most patients have a risk of going into early labor c. During weeks 28 and 32, blood volume peaks, and heart function can be affected d. Extra care is needed to make sure the fetus is developing normally during this time period

c

A pregnant woman is diagnosed with iron-deficiency anemia and is prescribed an iron supplement. After teaching her about the 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 drink plenty of fluids to prevent constipation d. I will call the health care provider if my stool is black and tarry

c

A pregnant woman is diagnosed with iron-deficiency anemia and is prescribed an iron supplement. After teaching her about the prescribed iron supplement, which statement indicates successful teaching? a. I will call the health care provider if my stool is black and tarry b. I should avoid drinking orange juice c. I need to drink plenty of fluids to prevent constipation d. I should take my iron with milk

c

A woman who has sickle cell anemia asks the nurse if her infant will develop sickle cell disease. The nurse would base the answer on which information? a. Sickle cell anemia has more than one polygenic inheritance pattern b. Sickle cell anemia is not inherited; it occurs following a malaria infection c. Sickle cell anemia is recessively inherited d. Sickle cell anemia is dominantly inherited

c

During a prenatal examination the nurse observes bruises on the client's arms and a black eye. When asked about the bruises, the client states, "It was an accident. My spouse just had a bad day at work, and I was late getting dinner prepared. But my spouse is being so kind now; my spouse brought me flowers yesterday. My spouse is looking for a new job, so it will not happen again." This client is in which phase of the cycle of violence? a. The tension building phase b. The acute explosion or incident phase c. The honeymoon phase d. The resolution and reorganization phase

c

The nurse is caring for a pregnant woman determined to be at high risk for gestational diabetes. The nurse prepares to rescreen this client at which time frame? (329) a. 28 to 32 weeks b. 16 to 20 weeks c. 24 to 28 weeks d. 20 to 24 weeks

c

The nurse is teaching a client with gestational diabetes about complications that can occur either following birth or at delivery for her baby. Which statement by the mother indicates that further teaching is needed by the nurse? a. My baby may be very large and I may need a cesarean section to have him b. Beginning at 28 weeks gestation I will start counting with my baby's movements every day c. If my blood sugars are elevated my baby's lungs will mature faster, which is good d. I may need an amniocentesis during the third trimester to see if my baby's lungs are ready to be born

c

The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse's 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, ill have to increase my intake of milk and meat c. Pregnancy affects insulin production so ill need to make adjustments in my diet d. Ill adjust my diet and insulin based on the results of my urine tests for glucose

c

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

c

1. 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 condition?(335) a. Peripartal cardiomyopathy b. Pulmonary embolism c. Right sided heart failure d. Left sided heart failure

d

A 15-year-old adolescent arrives at the office with a report of flu symptoms, including nausea and vomiting and recent weight loss. A pregnancy test is done and is positive. The client begins crying and tells the nurse her mother will be furious with her. What can the nurse do to assist this adolescent at this point? a. Tell the adolescent that this is too big of a problem for her to make decisions about and she needs to listen to her mother b. Recommend some adoption agencies for her to talk to in the near future c. Contact the mother of the adolescent to be sure the child gets prenatal care d. Support her by respecting her right to privacy and confidentiality

d

A nurse is teaching a 30-year-old gravida 1 who has sickle cell anemia. Providing education on which topic is the highest nursing priority? a. Constipation prevention b. Administration of immunoglobulins c. Consumption of a low fat diet d. Avoidance of infection

d

A patient with diabetes is in the first trimester of pregnancy and is currently having difficulty keeping blood glucose levels within normal limits. The patient explains that she has been "eating for two" so the baby is healthy. How should the nurse respond to the patient? a. Elevated blood glucose levels hasten the development of the fetus in utero b. Elevated blood glucose levels ensure the baby has mature lungs at birth c. Elevated blood glucose levels cause low birth weights in infants d. Elevated blood glucose levels in the first trimester have been linked to congenital abnormalities

d

A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize? a. Antibiotics b. Diuretic drugs c. Antihypertensive drugs d. IV fluids

d

A pregnant client with type 1 diabetes is in labor. The client's blood glucose levels are being monitored every hour and she has a prescription for an infusion of regular insulin as needed based on the client's blood glucose levels. Her levels are as follows: 1300: 105 mg/dL (5.83 mmol/L) 1400: 100 mg/dL (5.55 mmol/L) 1500: 120 mg/dL (6.66 mmol/L) 1600: 106 mg/dl (5.88 mmol/L) Based on the recorded blood glucose levels, at which time would the nurse likely administer the regular insulin infusion? a. 1400 b. 1300 c. 1600 d. 1500

d

A pregnant woman with diabetes at 10 weeks' gestation has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome? a. Placental abruption (abruptio placentae) b. Incompetent cervix c. Placenta previa d. Congenital anomalies

d

A woman in her 20s has a long history of sickle cell anemia and is 18 weeks' pregnant. What precautions would the nurse recommend the woman take to minimize the chance of experiencing a sickle cell crisis? a. Keep the home temperature around 70 to lessen he hearts workload b. If she is feeling well, she needs to come to the office once a month until shes in her third trimester c. Notify the health care provider immediately if she develops any jaundice d. Get at least 8 hours of sleep each night

d

The maternal health nurse is caring for a pregnant client with a history of asthma who requires maintenance medication for the management of the disease. Which action by the nurse best reinforces information provided to the client regarding maintenance of her health? a. Ask the client to show the nurse deep breathing techniques b. Teach the client how to use a spacer with an inhaler c. Review the clients peak flow meter readings d. Observe the client taking her inhaler

d

The maternal health nurse is caring for a pregnant client with a history of epilepsy. The client's antiepileptic drug (AED) levels have been in the non-therapeutic range the last two times the labs were drawn. Which factor does the nurse associate with this finding? a. Pregnant clients have high rates of noncompliance with maintenance medications b. Most maintenance medications cannot be given in pregnancy c. The action of many medications vary in pregnancy d. Drug metabolism changes during pregnancy

d

The nurse is assessing a pregnant client who has a history of heart disease. The nurse will prioritize assessments focusing on the heart during which time frame? a. 16 to 20 week's gestation b. 20 to 24 week's gestation c. 24 to 28 week's gestation d. 28 to 32 week's gestation

d

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 client is in heart failure? (335) a. Elevated blood pressure b. Low blood pressure c. Audible wheezes d. Persistent rales in the bases of the lungs

d

The nurse is caring for a pregnant client with pregestational diabetes. Which goal does the nurse identify as priority during the client's pregnancy? a. Ensure compliance of glucose monitoring b. Monitor for associated complications c. Encourage minimal weight gain d. Maintain glycemic control

d

Which change in insulin is most likely to occur in a woman during pregnancy? a. Unavailable because it is used by the fetus b. Enhanced secretion from normal c. Not released because of pressure on the pancreas d. Less effective than normal

d