OB Final Chapters 6 (no breast cancer), 9, 19, 20, 21

21. A nurse is conducting an in-service program for a group of labor and birth unit nurses about cesarean birth. The group demonstrates understanding of the information when they identify which condition as an appropriate indication? Select all that apply. A.fetal distress B.active genital herpes infection C.placenta previa D.previous cesarean birth E.prolonged labor

A.fetal distress B. active genital herpes infection C.placenta previa D.previous cesarean birth

12. 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) Cervical dilation

28. A pregnant client with preeclampsia is being treated with intravenous magnesium sulfate. The nurse assesses the client's deep tendon reflexes and grades them as 4+. The nurse notifies the health care provider about this finding, describing them using which term to ensure accurate communication? A. Absent B. Average C. Brisk D. Clonus

D. Clonus

23. A nurse is teaching a woman about measures to prevent preterm labor in future pregnancies because the woman just experienced preterm labor with her most recent pregnancy. The nurse determines that the teaching was successful based on which statement by the woman? a. "i'll make sure to limit the amount of long distance traveling i do" b. "stress isn't a problem that is related to preterm labor" c. "separating pregnancies by about a year should be helpful" d. "i'll need extra iron in my diet so i have extra for the baby"

a. "i'll make sure to limit the amount of long distance traveling i do"

22. 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. 1 in 3 b. 1 in 5 c. 2 in 15 d. 3 in 20

b. 1 in 5

16. a nurse is assessing a rape survivor for posttraumatic stress disorder. the nurse asks the survivor, "do you feel as though your are reliving the trauma?" the nurse is assessing for which effect of the trauma? a. physical symptoms b. intrusive thoughts c. avoidance d. hyperarousal

b. intrusive thoughts

7. A woman pregnant with twins comes to the clinic for an evaluation. The nurse closely assesses the client for which potential problem? A) oligohydramnios B)preeclampsia C)post-term labor D)chorioamnionitis

B) preeclampsia

11. A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the client's safety, which compound would the nurse have readily available? A. calcium gluconate B. potassium chloride C. ferrous sulfate D. calcium carbonate

A. calcium gluconate

START CHAPTER 19 1. After teaching a woman who has had an evacuation for gestational trophoblastic disease (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."

A) "I will be sure to avoid getting pregnant for at least 1 year."

2. 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

26. A nurse is teaching a woman with mild preeclampsia about important areas that she needs to monitor at home. The nurse determines that the teaching was successful based on which statements by the woman? Select all that apply. A. "I should check my blood pressure twice a day." B. "I will weigh myself once a week." C. "I should complete a fetal kick count each day." D. "I will check my urine for protein four times a day." E. "I'll call my health care provider if I have burning when I urinate."

A. "I should check my blood pressure twice a day." C. "I should complete a fetal kick count each day." E. "I'll call my health care provider if I have burning when I urinate."

8. A client comes to the clinic for an evaluation. The client is at 22 weeks' gestation. After reviewing a client's history, which factor would the nurse identify as placing her at risk for preeclampsia? A. Her mother had preeclampsia during pregnancy. B. Client has a twin sister. C. Her sister-in-law had gestational hypertension. D. This is the client's second pregnancy.

A. Her mother had preeclampsia during pregnancy.

19. A nurse suspects that a pregnant client may be experiencing a placental abruption based on assessment of which finding? Select all that apply. A. dark red vaginal bleeding B. insidious onset C. absence of pain D. rigid uterus E. absent fetal heart tones

A. dark red vaginal bleeding D. rigid uterus E. absent fetal heart tones

14. While assessing a pregnant woman, the nurse suspects that the client may be at risk for hydramnios. Which information would the nurse use to support this suspicion? Select all that apply. A. history of diabetes B. reports 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

A. history of diabetes B. reports of shortness of breath D. difficulty obtaining fetal heart rate

19. A nurse is explaining to a group of nurses new to the labor and birth unit about about methods used for cervical ripening. The group demonstrates understanding of the information when they identify which method as a mechanical one? A. laminaria B. herbal agents C. amniotomy D. membrane stripping

A. laminaria

17. 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 makes which statement? A."I'll drink several glasses of water." B."I'll sit down to rest for 30 minutes." C."I'll try to move my bowels." D."I'll lie down with my legs raised."

A."I'll drink several glasses of water."

19. A pregnant woman comes to the clinical for her first evaluation. The woman is screened for Hepatitis B (HBV) and tests positive. the nurse would anticipate administering which agent? A.HBV immune globulin B.HBV vaccine C. acylcovir D.valacyclovir

A.HBV immune globulin

20. After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse determines that the teaching was successful when the woman identifies which food as being good sources of iron in her diet? Select all that apply. A.dried fruits B.peanut butter C.white bread D.meats E. milk

A.dried fruits B.peanut butter D.meats

27. A nurse is assessing a woman who is at 20 week's gestation. 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? Select all that apply. A.dysuria B.four to five contractions in 1 hour C. viscous vaginal discharge D.dull low backache E.constipation

A.dysuria C. viscous vaginal discharge D. dull low backache

9. The nurse is reviewing the physical examination findings for a client who is to undergo labor induction. Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction? A.shortened B.firm C.posterior position D.closed

A.shortened

20. 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.pulmonary edema C.hypertension D.tachycardia E.bleeding with bruising

A.significant difficulty breathing B.pulmonary edema D.tachycardia E.bleeding with bruising

22. 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 appropriate? A. "My mother lives next door and can drive me here if necessary." B. "I have a toddler and preschooler at home who needs 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."

B. "I have a toddler and preschooler at home who need my attention."

25. A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. The nurse determines that the drug is at a therapeutic level based on which result? A. 3.3 mEq/L B. 6.1 mEq/L C. 8.4 mEq/L D. 10.8 mEq/L

B. 6.1 mEq/L

29. A client who has experienced an incomplete abortion is prescribed mifepristone to assist in removing the retained products of conception. Which medication would the nurse expect to administer if prescribed before administering mifepristone? A. Opioid analgesic for relief of cramping B. Antiemetic to minimize nausea C. Vitamin K to reduce bleeding D. Diuretic to promote fluid loss

B. Antiemetic to minimize nausea

5. A client is suspected of having a ruptured ectopic pregnancy. Which assessment would the nurse identify as the priority? A. Jaundice B. Hemorrhage C. Infection D. edema

B. Hemorrhage

27. A client comes to the emergency department with moderate vaginal bleeding. She says, "I have had to change my pad about every 2 hours and it looks like I may have passed some tissue and clots." The woman reports that she is 9 weeks' pregnant. Further assessment reveals the following: • Cervical dilation • Strong abdominal cramping • Low human chorionic gonadotropin (hCG) levels • Ultrasound positive for products of conception The nurse suspects that the woman is experiencing which type of spontaneous abortion? A. Threatened B. Inevitable C. Incomplete D. Complete

B. Inevitable

30. A client at 33 weeks' gestation comes to the emergency department with vaginal bleeding.Assessment reveals the following: • Onset of slight vaginal bleeding at 29 weeks with spontaneous cessation • Recent onset of bright red vaginal bleeding, more than with previous episode • No uterine contractions at present • Fetal heart rate within normal range • Uterus soft and nontender Based on the assessment findings, which condition would the nurse likely suspect? A. Placental abruption B. Placenta previa C. Ruptured ectopic pregnancy D. Polyhydramnios

B. Placenta previa

16. A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which findings 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

B. abdominal tenderness C. elevated maternal pulse rate E. cloudy malodorous fluid

7. When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which schedule 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

12. A nurse is conducting an assessment of a woman who has experienced PROM. Which amniotic fluid 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

D. foul odor

24. A woman with gestational hypertension develops eclampsia and experiences a seizure. Which intervention would the nurse identify as the priority? A. fluid replacement B. oxygenation C. control of hypertension D. birth of the fetus

B. oxygenation

21. A nurse is reviewing an article about preterm prelabor rupture of membranes. Which factors would the nurse expect to find 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

B. urinary tract infection C. low socioeconomic status E. smoking

9. A pregnant woman is diagnosed with iron-deficiency anemia and is prescribed an iron supplement. After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicates successful teaching? A."I'll call the primary care provider if my stool is black and tarry." B."I need to eat foods high in fiber." C."I should take my iron with milk." D."I should avoid drinking orange juice."

B."I need to eat foods high in fiber."

10. A woman with preterm labor is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately?A.alert level of consciousness B.+1 deep tendon reflexes C.respiratory rate of 16 breaths per minute D.urine output of 45 mL/hour

B.+1 deep tendon reflexes

13. 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.6 B.11 C.8 D.3

B.11

21. 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.110 mg/dL B.88 mg/dL C.100 mg/dL D.120 mg/dL

B.88 mg/dL

14. A nurse is reviewing the medical record of a pregnant client. The nurse suspects that the client may be at risk for dystocia based on which factors? A.plan for pudendal block anesthetic use B. breech fetal presentation C. multiparity D.short maternal stature E. body mass index 30.2 F. maternal age over 35

B.breech fetal presentation D.short maternal stature F.maternal age over 35

25. A a nurse is conducting a presentation for a group of pregnant women about measures to prevent toxoplasmosis. The nurse determines that additional teaching is needed when the group identifies which measure as preventative? A.avoiding contact with a cat's litter box B.cooking all meat to an internal temperature of 140° F C.wearing gardening gloves when working in the soil D.washing raw fruits and vegetables before eating them

B.cooking all meat to an internal temperature of 140° F

22. A nurse is conducting a program for pregnant women with gestational diabetes about reducing complications. The nurse determines that the teaching was successful when the group identifies which factor as being most important in helping to reduce complications associated with pregnancy and diabetes? A.stability of the woman's emotional and psychological status B.degree of blood glucose control achieved during the pregnancy C.control of blood urea nitrogen (BUN) levels for optimal kidney function D.reduction in retinopathy risk by frequent ophthalmologic evaluations

B.degree of blood glucose control achieved during the pregnancy

12. A nurse is conducting an in-service presentation to a group of perinatal nurses about sexually transmitted infections and their effect on pregnancy. The nurse determines that the teaching was successful when the group identifies which infection as being responsible for ophthalmia neonatorum? A.HPV B.gonorrhea C.chlamydia D.syphilis

B.gonorrhea

16. A nurse is conducting a review course on tocolytic therapy for perinatal nurses. After teaching the group, the nurse determines that the teaching was successful when they identify which drugs as being used for tocolytics? Select all that apply. A.dinoprostone B.magnesium sulfate C.indomethacin D.misoprostol E.nifedipine

B.magnesium sulfate C.indomethacin E.nifedipine

3. A nurse is conducting a review class for a group of perinatal nurses working at the local clinic. The clinic sees a high population of women who are HIV positive. After discussing the recommendations for antiretroviral therapy with the group, the nurse determines that the teaching was successful when the group identifies which rationale as the underlying principle for the therapy? A.can cure acute HIV/AIDS infections B.reduction in viral loads in the blood C.treatment of opportunistic infections D.adjunct therapy to radiation and chemotherapy

B.reduction in viral loads in the blood

15. A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which signs would the nurse assess? Select all that apply. A.low whimpering cry B.tremors C.excessive sneezing D.overly vigorous sucking E.lethargy F.Hypertonicity

B.tremors C.excessive sneezing F.Hypertonicity

3. 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."

C) "I'm sorry you lost your baby."

START CHAPTER 20 1. 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, 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."

13. 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

2. 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

C) Deep tendons reflexes 2+

23. 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."

C. "Drink fluids in between meals rather than with meals."

17. A nurse is teaching a pregnant woman with preterm prelabor rupture of membranes about caring for herself after she is discharged home (which is to occur later this day). 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."

C. "It's okay for my husband and me to have sexual intercourse."

6. It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time? A. At 32 weeks' gestation and immediately before discharge B. 24 hours before delivery and 24 hours after delivery C. At 28 weeks' gestation and again within 72 hours after delivery D. In the first trimester and within 2 hours after delivery

C. At 28 weeks' gestation and again within 72 hours after delivery

20. The health care provider prescribes PGE2 for a woman to help evacuate the uterus following a spontaneous abortion. Which action 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 supine for 30 minutes after administration. D. Administer intramuscularly into the deltoid area.

C. Maintain the client supine for 30 minutes after administration.

15. A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion. The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first trimester abortions? A. maternal disease B. cervical insufficiency C. fetal genetic abnormalities D. uterine fibroids

C. fetal genetic abnormalities

18. A nurse is describing the risks associated with post-term pregnancies as part of an inservice presentation. Which factor would the nurse be least likely to incorporate in the discussion as an underlying reason for problems in the fetus? A.cord compression B.meconium aspiration C.increased amniotic fluid volume D.aging of the placenta

C. increased amniotic fluid volume

17. 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 drugs C. methotrexate D.glucocorticoid

C. methotrexate

9. A client with hyperemesis gravidarum is admitted to the facility after being cared for at home without success. What 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

C. nothing by mouth

6. A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which statement by the nurse would be most appropriate? A."Wait until after the infant is born, and then something can be done." B."You'll probably have a cesarean birth to prevent exposing your newborn." C."Antiretroviral medications are available to help reduce the risk of transmission." D."Antibodies cross the placenta and provide immunity to the newborn."

C."Antiretroviral medications are available to help reduce the risk of transmission."

11. After teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching? A."I guess the nurses will be getting me up and out of bed rather quickly." B."I'll probably have a tube in my bladder for about 24 hours or so." C."I'm going to have to wait a few days before I can start breast-feeding." D."Holding a pillow against my incision will help me when I cough."

C."I'm going to have to wait a few days before I can start breast-feeding."

11. After teaching a group of nurses working at the women's health clinic about the impact of pregnancy on the older woman, which statement by the group indicates that the teaching was successful? A."Women over the age of 35 who become pregnant require a specialized type of assessment." B."The majority of women who become pregnant over age 35 experience complications." 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."

4. 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.heroin C.cocaine D.alcohol

C.cocaine

15. A nurse is preparing an inservice education program for a group of nurses about dystocia involving problems with the passenger. Which problem would the nurse most likely include as the most common? A.multifetal pregnancy B. macrosomia C.persistent occiput posterior position D.breech presentation

C.persistent occiput posterior position

10. A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? A. hyperglycemia B. elevated platelet count C. disseminated intravascular coagulation (DIC) D. elevated liver enzymes

D. elevated liver enzymes

13. The nurse is reviewing the laboratory test results of a pregnant client. Which finding would alert the nurse to the development of HELLP syndrome? A. hyperglycemia B. elevated platelet count C. leukocytosis D. elevated liver enzymes

D. elevated liver enzymes

18. A nurse is assessing a pregnant woman with gestational hypertension. Which finding 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

D. hyperreflexia

16. 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 aspect? Select all that apply. A.Asian Americans have the highest teen birth rate B.majority of teen pregnancies in the 15- to 17-year-old age group C. rise in teen birth rates over the years. D. loss of self-esteem as a major impact E.peer pressure to become sexually active

D. loss of self-esteem as a major impact E.peer pressure to become sexually active

5. When teaching a class of pregnant women about the effects of substance abuse during pregnancy, the nurse would most likely include which effect? A.longer gestational periods B.excessive weight gain C.higher pain tolerance D.low-birthweight infants

D. low-birthweight infants

8. 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? A.ipratropium B. albuterol C. salmeterol D. prednisone

D. prednisone

10. 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.elongated nose B.protruding jaw C.wide, large eyes D.thin upper lip

D. thin upper lip

24. A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make? A."It's probably not a good idea for you to get pregnant since you have lupus." B."If you get pregnant, we'll have to add quite a few medications to your normal treatment plan. C."Your lupus will not have any effect on your pregnancy whatsoever." D."Be sure that your lupus is stable or in remission for 6 months before getting pregnant."

D."Be sure that your lupus is stable or in remission for 6 months before getting pregnant."

14. 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."Caffeine is a stimulant and needs to be avoided completely." B."Caffeine has been shown to cause growth restriction in the fetus." C."The caffeine in coffee has been linked to birth defects." D."If you keep your intake to less than 200 mg/day, you should be okay."

D."If you keep your intake to less than 200 mg/day, you should be okay."

18. 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 measure would the nurse most likely include? A.immunization B.antibody titer screening C.prenatal screening D.frequent handwashing

D.frequent handwashing

3. when describing an episode of intimate partner violence, the victim reports attempting to calm the partner down to keep things from escalating. the nurse interprets this behavior as reflecting which phase of the cycle of violence? a. battering b. honeymooning c. tension-building d. reconciliation

c. tension-building

30. a pregnant client at 30 weeks' gestation calls the clinic because she thinks that she may be in labor. to determine if the client is experiencing labor, which questions would be appropriate for the nurse to ask? SATA a. "are you feeling any pressure or heaviness in your pelvis?" b. "are you having contractions that come and go, off and on?" c. "have you noticed any fluid leaking from your vagina?" d. "are you having problems with heartburn?" e. "have you been having any nausea or vomiting?"

a. "are you feeling any pressure or heaviness in your pelvis?" b. "are you having contractions that come and go, off and on?" c. "have you noticed any fluid leaking from your vagina?" e. "have you been having any nausea or vomiting?"

11. when the nurse is alone with a client, the client says, "it was all my fault. the house was so messy when my partner got home, and i know my partner hates that." which response would be the most appropriate a. "it's not your fault. no one deserves to be hurt" b. "what else did you do to make your partner so angry with you?" c. you need to start to clean the house early in the day" d. remember, your partner works hard and you need to meet your partner's needs"

a. "it's not your fault. no one deserves to be hurt"

28. A young adult woman comes to the clinic for a routine check-up. During the visit, the woman who works in a day care facility tells the nurse that she and her partner are considering having a baby. "We are concerned that I might be exposed to common childhood illnesses." The woman undergoes testing and finds out that she is not immune from chickenpox. Based on this information, which information would the nurse give to the client? a. "you will need to be vaccinated now and wait at least 1 month before getting pregnant" b. "it is very likely that you will need to quit your job if you do get pregnant" c. "because chickenpox is so rare nowadays, there is nothing to worry about" d. "you will need to take a leave of absence during winter and spring months"

a. "you will need to be vaccinated now and wait at least 1 month before getting pregnant"

12. when developing a presentation for a local community organization on violence, the nurse is planning to include statistics on intimate partner violence and its effects on children. when addressing these statistics, what is the rate of the cases involving a parent and the children being abused? a. 1 in 8 b. 1 in 3 c. 1 in 5 d. 1 in 10

a. 1 in 8

29. a 32-year old black woman in her second trimester has come to the clinic for an evaluation. while interviewing the client, she reports a history of fibroids and urinary tract infection. the client states, :"i know smoking is bad and i have tried to stop, but it is impossible. i have cut down quite a bit though, and i do not drink alcohol." complete blood count results reveal a low RBC count, low hemoglobin, and low hematocrit. when planning this client's care, which factors would the nurse identify as increasing the client's risk for preterm labor? SATA a. African heritage b. maternal age c. hx of fibroids d. cigarette smoking e. hx of UTI infections f. CBC results

a. African heritage b. maternal age c. hx of fibroids d. cigarette smoking e. hx of UTI infections f. CBC results

26. while obtaining a history from a woman at a regularly scheduled physical, the nurse notices various bruises on the client's upper extremity. the client dismisses the bruising and changes the subject. which additional information about the woman as a victim would the nurse discuss with the healthcare provider when relaying the physical assessment data? SATA a. a dysfunctional family system b. a low academic achievement c. a victim of childhood violence d. limited alcohol consumption e. economic stress

a. a dysfunctional family system b. a low academic achievement c. a victim of childhood violence d. limited alcohol consumption e. economic stress

8. when a nurse suspects that a client may be a victim of intimate partner violence, the first action should be to: a. ask the client about the injuries and if they are related to intimate partner violence b. encourage the client to leave the abuser immediately c. set up an appointment with an intimate partner violence counselor d. ask the suspected abuser about the victim's injuries

a. ask the client about the injuries and if they are related to intimate partner violence

5. a nurse is developing a plan of care for a victim of intimate partner violence. which intervention would be least appropriate for the nurse to include? a. assisting the client to project anger b. providing information about a safe home and crisis line c. teaching the client about the cycle of violence d. discussing the client's legal and personal rights

a. assisting the client to project anger

2. the nurse determines that a woman has implemented prescribed therapy for her fibrocystic breast disease when the client reports that she has eliminated which from her lifestyle? a. caffeine b. cigarettes c. dairy products d. sweets

a. caffeine

21. a nurse is working with a victim of intimate partner violence, helping the client develop a safety plan. which items would the nurse suggest that the client take when leaving? SATA a. driver's license b. social security number c. cash d. phone cards e. health insurance

a. driver's license b. social security number c. cash e. health insurance

30. after teaching a group of young adult about sexual violence, the nurse determines that the teaching was successful when the group identifies which acts as a type of sexual violence? SATA a. female genital mutilation b. bondage c. infanticide d. human trafficking e. prostitution

a. female genital mutilation b. bondage c. infanticide d. human trafficking

20. a woman comes to the clinic and tells the nurse that she has read an article about certain foods that have anticancer properties and help boost the immune system. during the discussion, the nurse would expect the client to identify which foods? select all that apply a. garlic b. soybeans c. milk d. leeks e. flax seed

a. garlic b. soybeans d. leeks e. flax seed

25. A pregnant client has received dinoprostone. Following administration of this medication, the nurse assesses the client and determines that the client is experiencing an adverse effect of the medication based on which client report? Select all that apply. a. headache b. nausea c. diarrhea d. tachycardia e. hypotension

a. headache b. nausea c. diarrhea

8. as part of discharge planning, the nurse refers a woman to Reach for Recovery. the nurse initiates this referral to facilitate which goal? a. help support woman who have undergone mastectomies b. raise funds to support early breast cancer detection programs c. provide all supplies needed after breast surgery for no cost d. collect statistics for research for the American Cancer Society

a. help support woman who have undergone mastectomies

29. a client is diagnosed with fibrocystic breast disease. after teaching the client about this condition, the nurse determines that the teaching was successful based on which client statement? a. i need to cut out drinking coffee like i'm used to doing b. it's important that i stop smoking or my condition will get worse c. i guess i'll have to find a replacement for milk and cheese d. no more cookies and baked good for me

a. i need to cut out drinking coffee like i'm used to doing

29. 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. ibuprofen b. hydrocychloroquine c. methotrexate d. leflunomide e. prednisone

a. ibuprofen b. hydrocychloroquine e. prednisone

26. A nurse is reading a journal article about cesarean births and the indications for them. Place the indications for cesarean birth below in the proper sequence from most frequent to least frequent a. labor dystocia b. abnormal fetal heart tracing c. fetal malpresentation d. multiple gestation e. suspected macrosomia

a. labor dystocia b. abnormal fetal heart tracing c. fetal malpresentation d. multiple gestation e. suspected macrosomia

25. a nurse is teaching a group of college students about rape and sexual assault. the nurse determines that additional teaching is necessary based on which statements by the group? SATA a. most victims of rape tell someone about it b. few individuals 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

a. most victims of rape tell someone about it c. women have rape fantasies desiring to be raped

29. a nurse is working with a victim of intimate partner violence. which intervention would be most important for this client? a. providing for the client's safety b. reassuring the client he or she is not alone c. documenting the violence d. educating about the cycle of violence

a. providing for the client's safety

8. a woman receives magnesium sulfate as treatment for preterm labor the nurse assesses and maintains the infusion at the prescribed rate based on which finding? a. respiratory rate 16 breaths per minute b. decreased fetal heart rate variability c. urine output 22mL/hr d. absent deep tendon reflexes

a. respiratory rate 16 breaths per minute

24. a nurse is conducting a in-service program on sexual abuse and violence for a group of nurses working at the community clinic. after teaching the group, the nurse determines that the teaching was successful when the group described incest as involving which action? a. sexual exploitation by blood or surrogate relatives b. sexual abuse of individuals over 18 c. violent aggressive assault on a person d. consent between perpetrator and victim

a. sexual exploitation by blood or surrogate relatives

28. a pregnant client at 24 week's gestation comes to the clinic for an evaluation. the client called the clinic earlier in the day stating that she had not felt the fetus moving since yesterday evening. further assessment reveals absent fetal heart tones. intrauterine fetal demise is suspected. the nurse would expect to prepare the client for which testing to confirm the suspicion? a. ultrasound b. amniocentesis c. human chorionic gonadotropic (hCG) level d. triple marker screening

a. ultrasound

22. A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which effect? a. uterine hyperstimulation b. headache c. blurred vision d. hypotension

a. uterine hyperstimulation

24. A pregnant woman at 31-weeks' gestation calls the clinic and tells the nurse that she is having contractions sporadically. Which instructions would be most appropriate for the nurse to give the woman? Select all that apply. a. "walk around the house for the next half an hour" b. "drink two or three glasses of water" c. "lie down on your back" d. "try emptying your bladder" e. "stop what you are doing and rest"

b. "drink two or three glasses of water" d. "try emptying your bladder" e. "stop what you are doing and rest"

23. 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 to 10 years b. 8 to 12 years c. 14 to 18 years d. 18 to 22 years

b. 8 to 12 years

28. A nurse suspects that a client is experiencing intimate partner violence and uses a screening protocol to gather additional information from the client. when asking the client direct questions, which behavior by the nurse would be appropriate to elicit accurate information? SATA a. look away from the client when asking any questions b. avoid the use of technical language c. minimize what the client says d. use leading questions e. wait patiently for the client to answer

b. avoid the use of technical language e. wait patiently for the client to answer

6. nurse is describing the cycle of violence to a community group. when explaining the first phase, the nurse would include which description? a. somehow triggered by the victim's behavior b. characterized by tension-building and minor battery c. associated with loss of physical and emotion control d. like a honeymoon that lulls the victim

b. characterized by tension-building and minor battery

START CHAPTER 9 1. the nurse is presenting a class at a local community health center on violence during pregnancy. which possible complication would the nurse include? a. gestational HTN b. chorioamnionitis c. placenta previa d. postterm labor

b. chorioamnionitis

19. a nurse is caring for a recent rape victim. the nurse would expect this client to experience which phase first? a. denial b. disorganization c. reorginzation d. integration

b. disorganization

5. a 42 year old woman is scheduled for a mammogram. which statement would the nurse include when teaching the woman about the procedure? a. the room will be darkened throughout the procedure b. each breast will be firmly compressed between two plates c. make sure to refrain from eating or drinking after midnight d. a dye will be injected to highlight the breast tissue and its ducts

b. each breast will be firmly compressed between two plates

2. 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

b. fetopelvic disproportion

17. a group of nurses are preparing a program about rape and sexual assault for a community health center. which information would the nurses include as being the most accurate? SATA a. most victims of rape tell someone about it b. few people falsely cry rape c. women have rape fantastic desiring to be raped d. a rape victim feels vulnerable and betrayed afterwards e. medication and counseling can help a rape victim cope

b. few people falsely cry rape d. a rape victim feels vulnerable and betrayed afterwards betrayed afterwards e. medication and counseling can help a rape victim cope

3. Which assessment finding will alert the nurse to be on the lookout for possible placental abruption during labor? a. macrosomia b. gestational hypertension c. gestational diabetes d. low parity

b. gestational hypertension

31. a pregnant woman with chronic hypertension is entering her second trimester. the nurse is providing anticipatory guidance to the woman about measures to promote a healthy outcome. the nurse determines that the teaching was successful based on which client state? SATA a. i will need to schedule follow-up appointments every 2 weeks until i reach 32 weeks gestation b. i should try to lie down and rest on my left side for about an hour each day c. i will start doing daily counts of my baby's activity at about 24 weeks gestation d. i will need to have an ultrasound at each visit beginning at 28 weeks gestation e. i should take my blood pressure frequently at home and report any high readings

b. i should try to lie down and rest on my left side for about an hour each day c. i will start doing daily counts of my baby's activity at about 24 weeks gestation e. i should take my blood pressure frequently at home and report any high readings

12. after teaching a woman how to perform breast self-examination, which statement would indicate that the nurse's instructions were successful? a. i should lie down with my arms at my side when looking at my breasts b. i should use the finger pads of my three fingers to apply pressure to my breast c. i don't need to check under my arm on that side if my breast feels fine d. i need to work from left to right down my breast towards my ribs

b. i should use the finger pads of my three fingers to apply pressure to my breast

20. a group of nurses is preparing a violence prevention program. the group is researching information about risk factors for intimate partner violence related to the individual. based on their research, which risk factors would the nurses expect to address? SATA a. dysfunctional family system b. low academic achievement c. victim of childhood violence d. heavy alcohol consumption e. economic stress

b. low academic achievement c. victim of childhood violence d. heavy alcohol consumption

27. A nurse is working with a victim of violence to develop a safety plan. The nurse teaches the client about the necessary items to take when leaving. the nurse determines that additional teaching is needed when the client identifies which items? SATA a. photo id b. phone cards c. most of her clothing d. cash e. health insurance cards

b. phone cards c. most of her clothing

4. a physically abused pregnant woman reports to the nurse that her spouse has stopped hitting her and promises never to hurt her again. which response by the nurse would be most appropriate? a. that's great. i wish you both the best b. remember, the cycle of violence often repeats itself c. he probably didn't mean to hurt you d. you need to consider leaving him

b. remember, the cycle of violence often repeats itself

10. in addition to providing privacy, which action would be the most appropriate initially in situations involving suspected intimate partner violence? 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

b. tell the client, "injuries like these don't usually happen by accident"

9. a nurse is listening to a client who is a victim of intimate partner violence. the client is describing how events would unfold with the partner. the nurse interprets the client's statements and identifies which action as characteristics of the second phase of the cycle of violence? a. the batterer is contrite and attempts to apologize or the behavior b. the physical battery is abrupt and unpredictable c. verbal assaults begin to escalate toward the victim d. the victim accept the anger as legitimately directed at them

b. the physical battery is abrupt and unpredictable

30. the nurse reviews the medical record of a woman who has come to the clinic for an evaluation the client has a history of mitral valve prolapse and is listed as risk class II. during the visit, the woman states, "we want to have a baby, but I know I am at higher risk. but what is my risk, really?" which response by the nurse would be appropriate? a. if you do get pregnant, you will need to be seen by a cardiologist every other month for monitoring b. your risk during pregnancy is small, but you should see your cardiologist first before getting pregnant c. your heart disease would put too much strain on your heart if you were to get pregnant d. your pregnancy would be uneventful, but you would need specialized care for labor and birth

b. your risk during pregnant is small, but you should see your cardiologist first before getting pregnant

5. A woman gave birth to a newborn via vaginal birth with the use of a vacuum extractor. The nurse would be alert for which possible effect in the newborn? a. asphyxia b. clavicular fracture c. cephalhematoma d. central nervous system injury

c. cephalhematoma

10. a woman comes to the clinic reporting a greenish-colored nipple discharge. on examination, the area below the areola is red and slightly swollen, with tortuous tubular swelling. the nurse interprets these findings as suggestive of which disorder? a. fibrocystic breast disorder b. intraductal papilloma c. duct ectasia d. fibroadenoma

c. duct ectasia

13. a nurse is working with a group of clients who are victims of intimate partner violence. the nurse focuses intervention on which area as the primary goal? a. convincing them to leave the abuser soon b. helping them cope with their life as it is c. empowering them to regain control of their life d. arresting the abuser so her or she cannot abuse again

c. empowering them to regain control of their life

START CHAPTER 6 1. The nurse is developing the discharge plan for a woman who has had a left-sided radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which statement by the client indicates the need for additional instruction? a. I need to wear gloves when doing any gardening b. any blood pressures need to be taken on the right arm c. i should wear clothing with elasticized sleeves d. i need to avoid driving to and from work every day

c. i should wear clothing with elasticized sleeves

26. 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. taking the iron supplement with food will help with the side effects b. i will need to avoid coffee and tea when I take this supplement c. i will take the iron with milk instead of orange or grapefruit juice d. if i happen to miss a dose, i will take it as soon as i remember

c. i will take the iron with milk instead of orange or grapefruit juice

14. a nurse is preparing a teaching plan for victims who are recovering from intimate partner violence. the nurse would focus the teaching 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

c. improve their communication skills and assertiveness

4. A nurse is reviewing a client's history and physical examination findings. which information would the nurse identify as contributing to the client's risk for an ectopic pregnancy? a. use of oral contraceptive for 5 years b. ovarian cyst 2 years ago c. recurrent pelvic infections d. heavy, irregular menses

c. recurrent pelvic infections

15. during a follow-up visit to the clinic, a victim of sexual assault reports changing jobs and moving to another town. the client 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

c. reorganization

7. A woman with a history of crack cocaine use disorder 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 prolapse

c. uterine rupture

4. 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. uterine stimulants d. corticosteroids

c. uterine stimulants

23. A nurse is providing care to several pregnant women at different weeks of gestation. The nurse would expect to screen for group B streptococcus infection in the client who is at: a. 16 weeks b. 28 weeks c. 32 weeks d. 36 weeks

d. 36 weeks

2. which approach would be most appropriate when counseling a client who is a suspected victim or intimate partner violence? a. offer the client a pamphlet about the local shelter for victims of intimate partner violence b. call the client at home to ask some question about the marriage c. wait until the client comes in a few more times to make a better assessment d. ask "have you ever been physically hurt by your partner?"

d. ask "have you ever been physically hurt by your partner?"

11. when performing a clinical breast examination, which would the nurse do first? a. palpate the axillary area b. compress the nipple for a discharge c. palpate the breasts d. inspect the breasts

d. inspect the breasts

START CHAPTER 21 1. 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

d. knee-chest

25. a nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. after describing the medications that can be used as treatment, the nurse determines that additional teaching is needed when the client identifies which drugs as being used? a. tamoxifen b. bromocriptine c. danazol d. penicillin

d. penicillin

18. after teaching a class at a local college campus on date rape, the nurse determines that the teaching was successful when the class identifies which substance as the most common date rape drug? a. gamma hydroxybutyrate b. liquid ecstasy c. ketamine d. rohypnol

d. rohypnol

27. A client in her first trimester comes to the clinic for an evaluation. Assessment reveals reports of fatigue, anorexia, and frequent upper respiratory infections. The client's skin is pale and the client is slightly tachycardic. The client also reports drinking about 6 cups of coffee on average each day. A diagnosis of iron-deficiency anemia is suspected. The client is scheduled for laboratory testing and the results are as follows: Hemoglobin 11.5 g/dL (115 g/L) Hematocrit 35% (0.35) Serum iron 32 µg/dL (5.73 µmol/L) Serum ferritin 90 ng/dL (90 µg/L) Which laboratory finding would the nurse correlate with the suspected diagnosis? a. hemoglobin b. hematocrit c. serum iron level d. serum ferritin level

d. serum ferritin level

6. 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 150b/min b. contractions every 2 minutes, lasting 45 seconds c. uterine resting tone of 14 mmHg d. urine output of 20mL/hour

d. urine output of 20mL/hour

7. a nurse is working with a victim of violence. which statement would be the most appropriate to empower the victim 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, you deserve better than this

d. you are a good person, you deserve better than this