OB Exam 1

A maternal serum alpha-fetoprotein (MSAFP) test is performed at 16 to 18 weeks of gestation. An elevated level has been associated with: A. Down syndrome. B. sickle cell anemia. C. cardiac defects. D. open neural tube defects such as spina bifida.

D; open neural tube defects such as spina bifida.

What would a breastfeeding mother who is concerned that her baby is not getting enough to eat find most helpful and most cost-effective on the day after discharge? A. Visiting a pediatric screening clinic at the hospital B. Placing a call to the hospital nursery "warm line" C. Calling the pediatrician for a lactation consult referral D. Requesting a home visit

B; placing a call to the hospital nursery "warm line"

Which presumptive signs (felt by the woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause? A. Amenorrhea: Stress, endocrine problems B. Quickening: Gas, peristalsis C. Goodell sign: Cervical polyps D. Chadwick sign: Pelvic congestion

C; Goodell sign: Cervical polyps

If exhibited by a pregnant woman, what represents a positive sign of pregnancy? A. Morning sickness B. Quickening C. Positive pregnancy test D. fetal heartbeat auscultated with Doppler/fetoscope

D; fetal heartbeat auscultated with Doppler/fetoscope

Which hematocrit (Hct) and hemoglobin (Hgb) results represent(s) the lowest acceptable values for a woman in the third-trimester of pregnancy? A. 38% Hct; 14 g/dL Hgb B.35% Hct; 13 g/dL Hgb C. 33% Hct; 11 g/dL Hgb D. 32% Hct; 10.5 g/dL Hgb

C; 33% Hct; 11 g/dL Hgb

List the time span in lunar months, calendar months, weeks, and days that indicates the appropriate length for a normal pregnancy.

10 lunar months, 9 calendar months, 40 weeks, 280 days

Which statements about multifetal pregnancy are most appropriate? (Select all that apply.) A. The expectant mother often develops anemia because the fetuses have a greater demand for iron. B. Twin pregnancies come to term with the same frequency as single pregnancies. C. The mother should be counseled to increase her nutritional intake and gain more weight. D. Backache and varicose veins are often more pronounced. E. Spontaneous rupture of membranes before term is uncommon.

A, C, D

Healthy People 2020 goals include: (Select all that apply.) A. promoting quality of life. B. promoting healthy behaviors in middle adulthood. C. attaining high-quality, longer lives. D. eliminating health disparities. E. creating social and physical environments that promote health.

A, C, D, E

A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system?

3-1-0-1-0

Which statement made by the nurse would indicate that she or he is practicing appropriate family-centered care techniques? (Select all that apply.) A. The nurse allows the mother and father to make choices when possible. B. The nurse informs the family about what is going to happen. C. The nurse instructs the patient's sister, who is a nurse, that she cannot be in the room during the birth. D. The nurse commands the mother what to do. E. The nurse provides time for the partner to ask questions.

A, E

The hospital risk management nurse is providing annual in-service training at the obstetrical unit staff meeting. The risk management nurse should discuss which conditions included on the National Quality Forum list that pertain to maternity nursing? (Select all that apply.) A. Injury occurrence to mother during labor admission. B. Decreased incidence of urinary tract infections with catheter use. C. Neonatal death occurring during course of labor and delivery process. D. Foreign objects retained after delivery procedure. E. Problem with artificial insemination procedure leading to the wrong donor egg being used.

A, C, D, E

A pregnant woman is the mother of two children. Her first pregnancy ended in a still birth at 32 weeks of gestation, her second pregnancy with the birth of her daughter at 36 weeks, and her third pregnancy with the birth of her son at 41 weeks. Using the 5-digit system to describe this woman's current obstetric history, the nurse would record _____

4-1-2-0-2

The nurse is developing a dietary teaching plan for a patient on a vegetarian diet. The nurse should provide the patient with which examples of protein containing foods? (Select all that apply.) A. Dried beans B. Seeds C. Peanut butter D. Bagel E. Eggs

A, B, C, E

The women's health nurse knows which statements regarding sexual response are accurate? (Select all that apply.) A. Women and men are more alike than different in their physiologic response to sexual arousal and orgasm. B. Vasocongestion is the congestion of blood vessels. C.The orgasmic phase is the final state of the sexual response cycle. D. Facial grimaces and spasms of hands and feet are often part of arousal. E. Sexual difficulties should be disregarded in the after birth period.

A, B, D

The nurse should teach a pregnant woman that which substances are teratogens? (Select all that apply.) A. Cigarette smoke B. Isotretinoin (Retin A) C. Vitamin C D. Salicylic acid E. Rubella

A, B, E

What symptom described by a woman is characteristic of premenstrual syndrome (PMS)? A. "I feel irritable and moody a week before my period is supposed to start." B. "I have lower abdominal pain beginning the third day of my menstrual period." C. "I have nausea and headaches after my period starts, and they last 2 to 3 days." D. "I have abdominal bloating and breast pain after a couple of days of my period."

A; "I feel irritable and moody a week before my period is supposed to start."

During a client's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as: A. Hegar sign. B. McDonald sign. C. Chadwick sign. D. Goodell sign.

A; Hegar sign

A 42-year-old woman asks the nurse about mammograms, now that she is "getting older." Which information provided by the nurse would not be correct given current American Cancer Society recommendations? A. The American Cancer Society recommends mammograms every 1 to 2 years for women ages 40 to 49. B. A mammogram is considered to be an imaging study. C. Even if one has a mammogram, this does not preclude the individual from performing breast self-examination (BSE). D. Mammograms can confirm the diagnosis for breast cancer.

A; The American Cancer Society recommends mammograms every 1 to 2 years for women ages 40 to 49.

A key finding from the Human Genome Project is: A. approximately 20,000 to 25,000 genes make up the genome. B. all human beings are 80.99% identical at the DNA level. C. human genes produce only one protein per gene; other mammals produce three proteins per gene. D. single-gene testing will become a standardized test for all pregnant women in the future.

A; approximately 20,000 to 25,000 genes make up the genome

The term used to describe a situation in which a cultural group loses its identity and becomes part of the dominant culture is called: A. assimilation. B. cultural relativism. C. acculturation. D. ethnocentrism.

A; assimilation

The Center for Disease Control (CDC) recommended medication for the treatment of chlamydia would be: A. doxycycline. B. podofilox. C. acyclovir. D. penicillin.

A; doxycycline

A mother's household consists of her husband, his mother, and another child. She is living in a/an: A. extended family. B. single-parent family. C. married-blended family. D. trinuclear family.

A; extended family

A woman is giving birth to her third child in a setting that allows her husband and other two children to be actively involved in the process. The nurse caring for the woman must also consider the husband and family as patients and work to meet their needs. This type of setting is termed: A. family-centered care. B. emergency care. C. hospice care. D. individual care.

A; family-centered care

The two most frequently reported maternal medical risk factors are: A. hypertension associated with pregnancy and diabetes. B. drug use and alcohol abuse. C. homelessness and lack of insurance. D. behaviors and lifestyles.

A; hypertension associated with pregnancy and diabetes

From the nurse's perspective, what measure should be the focus of the health care system to reduce the rate of infant mortality further? A. Implementing programs to ensure women's early participation in ongoing prenatal care B. Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days C. Expanding the number of neonatal intensive care units (NICUs) D. Mandating that all pregnant women receive care from an obstetrician

A; implementing programs to ensure women's early participation in ongoing prenatal care

What has had the greatest impact on infant mortality rates in the United States? A. Increase in low-birth-weight babies B. Decreased incidence of congenital abnormalities C. Better maternal nutrition D. Improved funding for health care

A; increase in low-birth-weight babies

With regard to dysfunctional uterine bleeding (DUB), the nurse should be aware that: A. it is most commonly caused by anovulation. B. it most often occurs in middle age. C. the diagnosis of DUB should be the first considered for abnormal menstrual bleeding. D. the most effective medical treatment involves steroids.

A; it is most commonly caused by anovulation

A maternity nurse should be aware of which fact about amniotic fluid? A. It serves as a source of oral fluid and as a repository for waste from the fetus. B. The volume remains about the same throughout the term of a healthy pregnancy. C. A volume of less than 300 mL is associated with gastrointestinal malformations. D. A volume of more than 2 L is associated with fetal renal abnormalities

A; it serves as a source of oral fluid and as a repository for waste from the fetus.

The nurse must evaluate a male patient's knowledge regarding the use of a condom. The nurse would recognize the need for further instruction if the patient states that he: A. lubricates the condom with a spermicide containing nonoxynol-9. B. leaves an empty space at the tip of the condom. C. leaves a small amount of air in the tip. D. removes his still-erect penis from the vagina while holding onto the base of the condom.

A; lubricates the condom with a spermicide containing nonoxynol-9.

With regard to protein in the diet of pregnant women, nurses should be aware that: A. many protein-rich foods are also good sources of calcium, iron, and B vitamins. B. many women need to increase their protein intake during pregnancy. C. as with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet. D. high-protein supplements can be used without risk by women on macrobiotic diets.

A; many protein-rich foods are also good sources of calcium, iron, and B vitamins

The nurse is assessing a woman's breast self-examination (BSE) technique. Which action indicates that a woman needs further instruction regarding BSE? A. Performs every month on the first day of her menstrual period B. Uses the pads of her fingers when palpating each breast C. Inspects her breasts while standing before a mirror and changing arm positions D. Places a folded towel under right shoulder and right hand under head when palpating right breast

A; performs every month on the first day of her menstrual period

With regard to medications, herbs, immunizations, and other substances normally encountered, the maternity nurse should be aware that: A. prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus. B. the greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimester. C. killed-virus vaccines (e.g., tetanus) should not be given during pregnancy, but live-virus vaccines (e.g., measles) are permissible. D. no convincing evidence exists that secondhand smoke is potentially dangerous to the fetus.

A; prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus.

A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a: A. primipara. B. primigravida. C. multipara. D. nulligravida.

A; primipara

When planning a diet with a pregnant woman, the nurse's FIRST action would be to: A. review the woman's current dietary intake. B. teach the woman about the food pyramid. C. caution the woman to avoid large doses of vitamins, especially those that are fat-soluble. D. instruct the woman to limit the intake of fatty foods.

A; review the woman's current dietary intake

Most of the genetic tests now offered in clinical practice are tests for: A. single-gene disorders. B. carrier screening. C. predictive values. D. predispositional testing.

A; single-gene disorders

Which statement made by the nurse would indicate that he or she is practicing appropriate family-centered care techniques? A. The nurse encourages the mother and father to make choices whenever possible. B. The nurse updates the family about what is going to happen but instructs the patient's sister that she cannot be present in the room during the birth. C. The nurse believes that he or she is acting in the best interest of the patient and commands her what to do throughout labor. D. The father is discouraged from accompanying his wife during a cesarean birth.

A; the nurse encourages the mother and father to make choices whenever possible.

Which is correct concerning the performance of a Papanicolaou (Pap) smear? A. The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test. B. It should be performed once a year beginning with the onset of puberty. C. A lubricant such as Vaseline should be used to ease speculum insertion. D. The specimen for the Pap smear should be obtained after specimens are collected for cervical infection

A; the woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test.

A nurse counseling a client with endometriosis understands which statements regarding the management of endometriosis is accurate? (Select all that apply.) A. Bone loss from hypoestrogenism is not reversible. B. Side effects from the steroid danazol include masculinizing traits. C. Surgical intervention often is needed for severe or acute symptoms. D. Women without pain and who do not want to become pregnant need no treatment. E. Women with mild pain who may want a future pregnancy may take nonsteroidal antiinflammatory drugs (NSAIDs).

B, C, D

A community women's health nurse knows that which groups of people are considered vulnerable populations? (Select all that apply.) A. Caucasian Americans B. Adolescent girls C. Women with underlying health conditions D. Refugee women E. Incarcerated women

B, C, D, E

A married woman has made the decision to use a diaphragm as her primary method of birth control. The clinic nurse should provide which instructions regarding care of, insertion, and removal of the diaphragm? (Select all that apply.) A. Remove the diaphragm by catching the rim from below the dome. B. Avoid using mineral oil body products. C. On insertion, direct the diaphragm down toward the space below cervix. D. Wash diaphragm monthly with mild soap and water. E. A dusting of cornstarch is appropriate after drying the diaphragm.

B, C, D, E

During the preconception phase, the nurse should teach about which infectious diseases as risk factors for maternal complications? (Select all that apply.) A. Diabetes B. Rubella C. Hepatitis B D. Anemia E. HIV/AIDS

B, C, E

The nurse should include which information when teaching a 15-year old about genital tract infection prevention? (Select all that apply.) A. Wear nylon undergarments B. Avoid tight-fitting jeans C. Use floral scented bath salts D. Decrease sugar intake E. Do not douche. F. Limit time spent wearing a wet bathing suit

B, D, E, F

A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate? A. "Many women imagine what their baby is like." B. "A baby in utero does respond to the mother's voice." C. "You'll need to ask the doctor if the baby can hear yet." D. "Thinking that your baby hears will help you bond with the baby."

B; "A baby in utero does respond to the mother's voice."

A male client asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). The nurse's most appropriate response is: A. "The lubricant prevents vaginal irritation." B. "Nonoxynol-9 does not provide protection against sexually transmitted infections, as originally thought; also it has been linked to an increase in the transmission of human immunodeficiency virus (HIV) and can cause genital lesions." C. "The additional lubrication improves sex." D. "Nonoxynol-9 improves penile sensitivity."

B; "Nonoxynol-9 does not provide protection against sexually transmitted infections, as originally thought; also it has been linked to an increase in the transmission of human immunodeficiency virus (HIV) and can cause genital lesions."

An expectant father confides in the nurse that his pregnant wife, 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's BEST response would be: A. "This is normal behavior and should begin to subside by the second trimester." B. "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor that I know." C. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant." D. "You seem impatient with her. Perhaps this is precipitating her behavior."

B; "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor that I know."

A woman inquires about herbal alternative methods for improving fertility. Which statement by the nurse is the most appropriate when instructing the woman in which herbal preparations to avoid while trying to conceive? A. "You should avoid nettle leaf, dong quai, and vitamin E while you are trying to get pregnant." B. "You may want to avoid licorice root, lavender, fennel, sage, and thyme while you are trying to conceive." C. "You should not take anything with vitamin E, calcium, or magnesium. They will make you infertile." D. "Herbs have no bearing on fertility."

B; "You may want to avoid licorice root, lavender, fennel, sage, and thyme while you are trying to conceive."

If exhibited by an expectant father, what would be a warning sign of ineffective adaptation to his partner's first pregnancy? A. Views pregnancy with pride as a confirmation of his virility. B. Consistently changes the subject when the topic of the fetus/newborn is raised. C. Expresses concern that he might faint at the birth of his baby. D. Experiences nausea and fatigue, along with his partner, during the first trimester.

B; Consistently changes the subject when the topic of the fetus/newborn is raised.

What best describes the pattern of genetic transmission known as autosomal recessive inheritance? A. Disorders in which the abnormal gene for the trait is expressed even when the other member of the pair is normal. B. Disorders in which both genes of a pair must be abnormal for the disorder to be expressed. C. Disorders in which a single gene controls the particular trait. D. Disorders in which the abnormal gene is carried on the X chromosome.

B; Disorders in which both genes of a pair must be abnormal for the disorder to be expressed.

The nurse-midwife is teaching a group of women who are pregnant, including instruction on Kegel exercises. Which statement by a participant would indicate a correct understanding of the instruction? A. I will only see results if I perform 100 Kegel exercises each day. B. I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises. C. I should only perform Kegel exercises in the sitting position. D. I will perform daily Kegel exercises during the last trimester of my pregnancy to achieve the best results.

B; I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? A. Less audible heart sounds (S1, S2) B. Increased pulse rate C. Increased blood pressure D. Decreased red blood cell (RBC) production

B; Increased pulse rate

With regard to abnormalities of chromosomes, nurses should be aware that: A. they occur in approximately 10% of newborns. B. abnormalities of number are the leading cause of pregnancy loss. C. down syndrome is a result of an abnormal chromosomal structure. D. unbalanced translocation results in a mild abnormality that the child will outgrow.

B; abnormalities of number are the leading cause of pregnancy loss.

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be: A. constipation. B. alteration in the pattern of fetal movement. C. heart palpitations. D. edema in the ankles and feet at the end of the day.

B; alteration in the pattern of fetal movement.

When assessing the fetal heart rate (FHR) of a woman at 30 weeks of gestation, the nurse counts a rate of 82 beats/min. Initially the nurse should: A. recognize that the rate is within normal limits and record it. B. assess the woman's radial pulse. C. notify the physician. D. allow the woman to hear the heartbeat.

B; assess the woman's radial pulse

With regard to nutritional needs during lactation, a maternity nurse should be aware that: A. the mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy. B. caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful. C. critical iron and folic acid levels must be maintained. D. lactating women can go back to their prepregnant calorie intake.

B; caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful.

A pregnant woman experiencing nausea and vomiting should: A. drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning. B. eat small, frequent meals (every 2 to 3 hours). C. increase her intake of high-fat foods to keep the stomach full and coated. D. limit fluid intake throughout the day.

B; eat small, frequent meals (every 2 to 3 hours).

During a health history interview, a woman states that she thinks that she has "bumps" on her labia. She also states that she is not sure how to check herself. The correct response would be to: A. reassure the woman that the examination will not reveal any problems. B. explain the process of vulvar self-examination to the woman and reassure her that she will become familiar with normal and abnormal findings during the examination. C. reassure the woman that "bumps" can be treated. D. reassure her that most women have "bumps" on their labia.

B; explain the process of vulvar self-examination to the woman and reassure her that she will become familiar with normal and abnormal findings during the examination.

A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates an understanding of the nurse's instructions if she states that a positive sign of pregnancy is: A. a positive pregnancy test. B. fetal movement palpated by the nurse-midwife. C. Braxton Hicks contractions. D. quickening.

B; fetal movement palpated by the nurse-midwife

With regard to the diagnosis and management of amenorrhea, nurses should be aware that: A. it probably is the result of a hormone deficiency that can be treated with medication. B. it may be caused by stress or excessive exercise or both. C. it likely will require the client to eat less and exercise more. D. it often goes away on its own.

B; it may be caused by stress or excessive exercise or both.

Semen analysis is a common diagnostic procedure related to infertility. In instructing a male patient regarding this test, the nurse would tell him to: A. ejaculate into a sterile container. B. obtain the specimen after a period of abstinence from ejaculation of 2 to 5 days. C. transport specimen with container packed in ice. D. ensure that the specimen arrives at the laboratory within 30 minutes of ejaculation.

B; obtain the specimen after a period of abstinence from ejaculation of 2 to 5 days.

When providing care to a young single woman just diagnosed with acute pelvic inflammatory disease, the nurse should: A. point out that inappropriate sexual behavior caused the infection. B. position the woman in a semi-Fowler position. C. explain to the woman that infertility is a likely outcome of this type of infection. D. tell her that antibiotics need to be taken until pelvic pain is relieved

B; position the woman in a semi-fowler position

Following a code situation in the clinical setting when the patient expires regardless of intervention, the nursing/medical staff takes a moment to reflect. What is the name for this type of reflection? A. The break B. The pause C. The reflection D. The designated time out

B; the pause

What is descriptive of the family systems theory? A. The family is viewed as the sum of individual members. B. When the family system is disrupted, change can occur at any point in the system. C. Change in one family member cannot create change in other members. D. Individual family members are readily identified as the source of a problem.

B; when the family system is disrupted, change can occur at any point in the system

The student nurse is giving a presentation about milestones in embryonic development. Which information should be included? A. At 8 weeks of gestation, primary lung and urethral buds appear. B. At 12 weeks of gestation, the vagina is open or the testes are in position for descent into the scrotum. C. At 20 weeks of age, the vernix caseosa and lanugo appear. D. At 24 weeks of age, the skin is smooth, and subcutaneous fat is beginning to collect.

C; At 20 weeks of age, the vernix caseosa and lanugo appear

In which culture is the father more likely to be expected to participate in the labor and delivery? A. Asian-American B. African-American C. European-American D. Hispanic

C; European-American

A couple has been counseled for genetic anomalies. They ask you, "What is karyotyping?" Your best response is: A. "Karyotyping will reveal if the baby's lungs are mature." B. "Karyotyping will reveal if your baby will develop normally." C. "Karyotyping will provide information about the gender of the baby, and the number and structure of the chromosomes." D. "Karyotyping will detect any physical deformities the baby has."

C; "Karyotyping will provide information about the gender of the baby, and the number and structure of the chromosomes

A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? A. "We don't really know when such defects occur." B. "It depends on what caused the defect." C. "They occur between the third and fifth weeks of development." D. "They usually occur in the first 2 weeks of development."

C; "They occur between the third and fifth weeks of development."

A pregnant woman at 10 weeks of gestation jogs 3 or 4 times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her: A. "You do not need to modify your exercising any time during your pregnancy." B. "Stop exercising, because it will harm the fetus." C. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month." D. "Jogging is too hard on your joints; switch to walking now."

C; "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."

The nurse should include questions regarding sexuality when gathering data for a reproductive health history of a female patient. Which principle should guide the nurse when interviewing the patient? A. An in-depth exploration of specific sexual practices should be included for every patient. B. Sexual histories are optional if the patient is not currently sexually active. C. Misconceptions and inaccurate information expressed by the patient should be corrected promptly. D. Questions regarding the patient's sexual relationship are unnecessary if she is monogamous.

C; Misconceptions and inaccurate information expressed by the patient should be corrected promptly.

The nurse is taking care of a family that includes parents, maternal grandparents and children residing in one home. Which family unit this represent? A. Nuclear family B.Extended family C. Multigenerational family D. Married blended family

C; Multigenerational family

A nurse is reviewing information related to home pregnancy tests so as to prepare for a patient teaching session. Which statement by the patient indicates that additional instruction is needed following the teaching session? A. The patient states that she will follow directions as listed on the testing package. B. The patient indicates that a positive result will be seen if there is a color change on the applicator. C. The patient states there is no need for concern as home pregnancy test results are 100% correct. D. The patient can perform the test without any assistance in the home setting.

C; The patient states there is no need for concern as home pregnancy test results are 100% correct.

Which health risk is not associated with menopause? A. Osteoporosis B. Coronary heart disease C. Breast cancer D. Obesity.

C; breast cancer

A 65-year-old woman, G6 P6006, is complaining of increasing stress incontinence and pelvic pressure and fullness. Pelvic examination reveals a bulging in the anterior vaginal wall. This woman is most likely experiencing: A. uterine prolapse. B. rectocele. C. cystocele. D. vesicovaginal fistula.

C; cystocele

An effective relief measure for primary dysmenorrhea would be to: A. reduce physical activity level until menstruation ceases. B. begin taking prostaglandin synthesis inhibitors on the first day of the menstrual flow. C. decrease intake of salt and refined sugar about 1 week before menstruation is about to occur. D. use barrier methods rather than the oral contraceptive pill (OCP) for birth control.

C; decrease intake of salt and refined sugar about 1 week before menstruation is about to occur

A nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. The nurse should: A. tell the couple they need to have an abortion within 2 to 3 weeks. B. explain that the fetus has a 50% chance of having the disorder. C. discuss options with the couple, including amniocentesis to determine whether the fetus is affected. D. refer the couple to a psychologist for emotional support.

C; discuss options with the couple, including amniocentesis to determine whether the fetus is affected.

Self-care instructions for a woman following a modified radical mastectomy would include that she: A. wears clothing with snug sleeves to support her affected arm. B. use depilatory creams instead of shaving the axilla of her affected arm. C. expect a decrease in sensation or tingling in her affected arm as her body heals. D. empty surgical drains once a day or every other day.

C; expect a decrease in sensation or tingling in her affected arm as her body heals.

A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she: A. wiggles and points her toes during the cramp. B. applies cold compresses to the affected leg. C. extends her leg and dorsiflexes her foot during the cramp. D. avoids weight bearing on the affected leg during the cramp.

C; extends her leg and dorsiflexes her foot during the cramp.

An infertile woman is about to begin pharmacologic treatment. As part of the regimen, she will take purified follicle-stimulating hormone (FSH) (urofollitropin [Metrodin]). The nurse instructs her that this medication is administered in the form of a/an: A. intranasal spray. B. vaginal suppository. C. intramuscular injection. D. tablet.

C; intramuscular injection

A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates: A. the fetus is at risk for Down syndrome. B. the woman is at high risk for developing preterm labor. C. lung maturity. D. meconium is present in the amniotic fluid.

C; lung maturity

During the first trimester the pregnant woman would be most motivated to learn about: A. fetal development. B. impact of a new baby on family members. C. measures to reduce nausea and fatigue so she can feel better. D. location of childbirth preparation and breastfeeding classes.

C; measures to reduce nausea and fatigue so she can feel better.

Which personal safety precaution should guide the nurse working in home care? A. Do not carry personal items, such as extra car keys or a cellular phone. B. Avoid making a visit with another nurse. C. Schedule visits during daylight hours. D. Never wear a name tag.

C; schedule visits during daylight hours

A 26-year-old woman is considering Depo-Provera as the form of contraception that is best for her since she does not like to worry about taking a pill every day. To assist this woman with decision making concerning this method of contraception, the nurse would tell her that Depo-Provera: A. is a combination of progesterone and estrogen. B. is a small adhesive hormonal birth control patch that is applied weekly. C. thickens and decreases cervical mucus, thereby inhibiting sperm penetration and ovulation. D. has an effectiveness rate in preventing pregnancy of 99% when used correctly.

C; thickens and decreases cervical mucus, thereby inhibiting sperm penetration and ovulation

An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the baby. The nurse should tell the couple that: A. intercourse should be avoided if any spotting from the vagina occurs afterward. B. intercourse is safe until the third trimester. C. safer-sex practices should be used once the membranes rupture. D. intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present.

D; intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present.

Discharge instructions after tubal ligation should include: (Select all that apply.) A. being prepared for significant mood swings due to hormonal influences. B. expecting heavier menstrual periods. C. using two forms of birth control to prevent pregnancy. D. not expecting change in sexual functioning; may enjoy more. E. using condoms to prevent sexually transmitted infections.

D, E

A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, "My period is due in a few days, and my temperature has not gone up." The nurse's most appropriate response is: A. "This probably means you're pregnant." B. "Don't worry; it's probably nothing." C. "Have you been sick this month?" D. "You probably did not ovulate during this cycle."

D; "You probably did not ovulate during this cycle"

The nurse is planning care for a patient with a different cultural background. What would be an appropriate goal? A. Strive to keep the patient's cultural background from influencing health needs. B. Encourage the continuation of cultural practices in the hospital setting. C. In a nonjudgmental way attempt to change the patient's cultural beliefs. D. As necessary adapt the patient's cultural practices to her health needs.

D; As necessary adapt the patient's cultural practices to her health needs.

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse tells her: A. Because you are in your second trimester, there is no problem with having one drink with dinner. B. One drink every night is too much. One drink 3 times a week should be fine. C. Because you are in your second trimester, you can drink as much as you like. D. Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy.

D; Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy.

A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is MOST important for the nurse to implement? A. Perform a nutrition assessment. B. Refer the woman to a social worker. C. Advise the woman to see an obstetrician, not a midwife. D. Explain to the woman the importance of keeping her prenatal care appointments.

D; Explain to the woman the importance of keeping her prenatal care appointments

What laboratory results would be a cause for concern if exhibited by a woman at her first prenatal visit during the second month of her pregnancy? A. Hematocrit 38%, hemoglobin 13 g/dL B. White blood cell count 6000/mm3 C. Platelets 300,000/mm3 D. Rubella titer 1:6

D; Rubella titer 1:6

A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How would the nurse interpret this? A. This weight gain indicates possible gestational hypertension. B. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR). C. This weight gain cannot be evaluated until the woman has been observed for several more weeks. D. The woman's weight gain is appropriate for this stage of pregnancy.

D; The woman's weight gain is appropriate for this stage of pregnancy.

A Native American woman gave birth to a baby girl 12 hours ago. The nurse notes that the woman keeps her baby in the bassinet except for feeding and states that she will wait until she gets home to begin breastfeeding. The nurse recognizes that this behavior is most likely a reflection of: A. delayed attachment. B. embarrassment. C. disappointment that the baby is a girl. D. a belief that babies should not be fed colostrum.

D; a belief that babies should not be fed colostrum

In order to reassure and educate pregnant clients about changes in their blood pressure, maternity nurses should be aware that: A. a blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high. B. shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit. C. the systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant. D. compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the latter stage of term pregnancy.

D; compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the latter stage of term pregnancy.

When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that: A. milk, coffee, and tea aid iron absorption if consumed at the same time as iron. B. iron absorption is inhibited by a diet rich in vitamin C. C. iron supplements are permissible for children in small doses. D. constipation is common with iron supplements.

D; constipation is common with iron supplements.

When a nurse is unsure about how to perform a patient care procedure, the BEST action would be to: A. ask another nurse. B. discuss the procedure with the patient's physician. C. look up the procedure in a nursing textbook. D. consult the agency procedure manual and follow the guidelines for the procedure.

D; consult the agency procedure manual and follow the guidelines for the procedure

When obtaining a reproductive health history from a female patient, the nurse should: A. limit the time spent on exploration of intimate topics. B. avoid asking questions that may embarrass the patient. C. use only accepted medical terminology when referring to body parts and functions. D. explain the purpose for the questions asked and how the information will be used.

D; explain the purpose for the questions asked and how the information will be used

Evidence-based practice is best described as: A. gathering evidence of mortality and morbidity in children. B. meeting physical and psychosocial needs of the family in all areas of practice. C. using a professional code of ethics as a means for professional self-regulation. D. providing care based on evidence gained through research and clinical trials.

D; providing care based on evidence gained through research and clinical trials.

The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that: A. she will have to give birth at home. B. she must see an obstetrician as well as the midwife during pregnancy. C. she will not be able to have epidural analgesia for labor pain. D. she must be having a low risk pregnancy.

D; she must be having a low risk pregnancy.

The nurse should refer the patient for further testing if she noted this on inspection of the breasts of a 55-year-old woman: A. left breast slightly smaller than right breast. B. eversion (elevation) of both nipples. C. bilateral symmetry of venous network, which is faintly visible. D. small dimple located in the upper outer quadrant of the right breast.

D; small dimple located in the upper outer quadrant of the right breast

With regard to the estimation and interpretation of the recurrence of risks for genetic disorders, nurses should be aware that: A. with a dominant disorder, the likelihood of the second child also having the condition is 100%. B. an autosomal recessive disease carries a one in eight risk of the second child also having the disorder. C. disorders involving maternal ingestion of drugs carry a one in four chance of being repeated in the second child. D. the risk factor remains the same no matter how many affected children are already in the family.

D; the risk factor remains the same no matter how many affected children are already in the family.

A pregnant woman at 32 weeks of gestation complains of feeling dizzy and light-headed while her fundal height is being measured. Her skin is pale and moist. The nurse's initial response would be to: A. assess the woman's blood pressure and pulse. B. have the woman breathe into a paper bag. C. raise the woman's legs. D. turn the woman on her side.

D; turn the woman on her side.

A pregnant woman's last menstrual period began on April 8, 2009, and ended on April 13. Using Nägele's rule, her estimated date of birth would be _.

January 15, 2010