OB Final
Sarah is 28 weeks pregnant and her 1 hr gtt is 149. Based on current standards, what is the nurse's next action?
Tell her she needs a 3 hr gtt
A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents?
The correct answer is: "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide."
Which statement by the client will assist the nurse in determining whether she is in true labor as opposed to false labor?
The correct answer is: "The contractions in my uterus are getting stronger and closer together."
What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy?
The correct answer is: Assessing FHR and maternal vital signs
Which description of the four stages of labor is correct for both the definition and the duration?
The correct answer is: First stage: onset of regular uterine contractions to full dilation; great variability in duration
A woman on the day of discharge from the postpartum unit asks a number of questions regarding breastfeeding and shares that she is nervous about taking her baby home and not being able to remember everything she has been taught. These are behaviors associated with:
The correct answer is: Taking hold
The perinatal nurse understands that the purpose of the surgical "time-out" is to:
The correct answer is: Verify that it is the correct patient and planned procedure
Which clinical sign indicates that the client has reached the second stage of labor?
The correct answer is: Woman experiences a strong urge to bear down.
The exact cause of preterm labor is unknown but believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Which type of infection has not been linked to preterm birth?
The correct answer is: Viral
First Stage
labor/Contractions, Includes 3 phases
Which of the following are fetal causes of dysfunctional labor? (select all that apply).
Narrow pelvis, Ineffective contractions ,Malpresentation ,Malposition
Zita is 39 y/o G21002 who is 7 weeks pregnant. For which of the following is she at increased risk
Offspring with chromosomal defect
Which stage of labor varies the most in length?
The correct answer is: First
Which is true regarding breast cyst?
The correct answer is: It can be tender or not
A neonate born at 36 weeks gestation is classified as which of the following?
The correct answer is: Late preterm
A postpartum mother whose baby is 3 days old tells the nurse "I love my baby but I feel like I am in a funk. I cannot get anything done and I cry for no reason." What is the nurse's next best question?
"Tell me more about how you feel like you are in a funk."
Nancy G20101 is 30 weeks pregnant. She calls L&D with complaint of mild contractions every 5-10 minutes for the past 3 hours. What is the nurse's best response?
Come to L&D
What nursing intervention will the L&D nurse not perform on the patient in question 39 (placenta previa)?
Digital exam of the cervix
Which of the following is a risk factor for ovarian cancer?
Early menarche, Infertility treatments
A laboring woman received her epidural 5 minutes ago. Her BP was noted to drop from 128/80 to 90/55. What is the nurse's first action?
Elevate foot of bed
Mary presents to the ED at 29 weeks pregnant, complaining of painless vaginal bleeding. What does the nurse think Mary might have?
Placenta previa
Which of the following variables is NOT assessed on the biophysical profile (BPP)?
Placental position
Which of the following is an early sign of infection in the neonate?
Poor feeding
Which of the following are indications for cesarean birth? (Select all that apply.)
Previous cesarean birth, Desire for elective, non-medically indicated cesarean birth , Failure to progress in labor , Fetal distress
Endometritis is an infection that usually starts at the placental site.
The correct answer is 'True'.
Frieda is 8 weeks pregnant and presents to the ED with complaint of moderate bleeding and cramps. Her cervix is closed on speculum exam. What type of SAB is she experiencing?
Threatened AB
What is One Key Question?
Would you like to become pregnant in the next year?
Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus?
the correct answer is: Assist the client in emptying her bladder
Anna is a 16 y/o G10000 who is 7 weeks pregnant. She is at increased risk for which of the following?
Anemia
The nurse suspects that her postpartum client is experiencing hemorrhagic shock. Which observation indicates or would confirm this diagnosis
Urinary output of less than 30ml/hr
A pregnant woman's one hour GTT results is 129mg/dl. What will the provider tell the patient?
Your result is in normal limits. No further testing is necessary
Which of the following statements indicates that a new mother needs additional teaching?
"I will leave my baby on an elevated flat surface after she is able to turn over on her own."
Which statement regarding the postpartum uterus is correct?
-Answer: After 2 weeks postpartum, it should be abdominally nonpalpable
Heidi is a 19 y/o G10000 who is 26 weeks pregnant. During her prenatal visit, her b/p is 138/90 and proteinuria is TR. What is the nurse's next action?
Assess for other symptoms
What will the nurse do next?
Check urine dipstick for protein
Which of the following is true regarding NST?
Decreased fetal movement is an indication for NST
An ethical dilemma unique to perinatal nursing is the
Embryo/fetal rights
A postpartum patient is bottle-feeding her baby and complains of hard, sore breasts 6 days after delivering her baby. What does the nurse suspect is occurring?
Engorgement
Sierra G21001 is 30 weeks pregnant. She calls L&D with complaint of mild contractions every 5-30 minutes for the past 3 hours. What is the nurse's best response?
Has your water broken?
A 32 y/o G44004 wants an effective method of contraception that she does not have think about. She is uncertain if she wants another baby. Which of the following methods would be best for the nurse to recommend to this client? (Select all that apply)
IUD and Implant
Which of the following make up the classic triad symptoms of ectopic pregnancy? (Select all that apply)
Pelvic pain, Vaginal bleeding, Missed period
During active labor, the nurse notes Emily's contractions have gotten closer together and she is acting more uncomfortable. For which of the following should the nurse assess Emily more closely
Precipitous labor
Which of the following is a sign of magnesium toxicity?
Respirations less than 8
It is noted that the amniotic fluid of a 39-week gestation baby, born 30 seconds ago, is clear and he is not crying vigorously. Which of the following actions by the nurse is critical at this time?
Stimulate the baby to cry
Which neurologic condition would require preconception counseling, if at all possible?
The correct answer is: Epilepsy
What is the most important nursing action in preventing neonatal infection?
The correct answer is: Good handwashing or hand hygiene
Because a full bladder prevents the uterus from contracting normally, nurses intervene to help the woman spontaneously empty her bladder as soon as possible. If all else fails, what tactic might the nurse use?
The correct answer is: Inserting a sterile catheter
in caring for a primiparous woman in labor, one of the factors to evaluate is uterine activity. This is referred to as the ____ of labor.;
The correct answer is: Powers
What is the primary purpose for magnesium sulfate administration for clients with preeclampsia and eclampsia?
The correct answer is: To prevent convulsions
Which client is at greatest risk for early PPH?
The correct answer is: Woman with severe preeclampsia on magnesium sulfate whose labor is being induced
The nurse is explaining to 20 y/o Dana about symptoms that need to be reported to her health care provider. These include which of the following?
The correct answers are: Fever, vaginal bleeding, absence of fetal movements after quickening
Which of the following is true regarding physiologic jaundice? (Select all that apply).
The correct answers are: Jaundice is noted 24 hours after birth, Jaundice is more common in preterm infants
For which of the following does VBAC increase risk?
Uterine rupture
Which nursing intervention should be immediately performed after the forceps-assisted birth of an infant?
Answer: assessing the infant for signs of trauma
Third Stage
Birth of the baby to delivery of the placenta
Which of the following are indications for labor induction?
Fetal death
What is the nurse's priority action when cord prolapse is noted?
Get the presenting fetal part off of the cord
Jenny 31 weeks first pregnancy: jenny, by your information, you are 31 weeks gestation in this pregnancy. Do you have questions for me before your prenatal history and information sharing? Report immediately to her health care provider?
Heartburn with severe headache, vaginal bleeding, and ROM
When a postpartum mother c/o feelings of sadness and anxiety, crying, difficulty sleeping and loss of appetite, what question(s) should the nurse ask to help determine if this mother has postpartum depression or baby blues?
How long have you had these feelings?
Second Stage
Includes 2 phases, Full cervical dilation to birth of the baby
An infant at 26 weeks of gestation arrives intubated from the delivery room. The nurse weighs the infant, places him under the radiant warmer, and attaches him to the ventilator at the prescribed settings. A pulse oximeter and cardiorespiratory monitor are placed. The pulse oximeter is recording oxygen saturations of 80%. The prescribed saturations are 92%. What are the nurse's most appropriate actions at this time? (Select all that apply)
Increase oxygen, Ensure patency of the endotracheal tube, Listen to breath sounds , Call physician
What does HELLP mean? (Select all that apply.) Hemolysis, Elevated Liver Enzymes, & Low Platelets Hemolysis
Low platelets
In gestational diabetes, which complication is commonly associated with poor glycemic control during early pregnancy?
Macrosomia
The nurse assesses a laboring woman to have dark red vaginal blood, BP of 118/70, FHT 110's, her uterus is slightly tense in between contractions, and her cervix is 1 cm dilated, anterior and 0% effaced. What is the nurse's action?
Monitor IV sites for bleeding
In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, which finding alerts the nurse to possible adverse effects?
No DTRs
A multipara, 26 weeks' gestation and accompanied by her husband, has just delivered a fetal demise. Which of the following nursing actions is appropriate at this time
Provide opportunities for grieving parents and family members to spend time with the baby
Which of the following is not an indication for amniocentesis?
Result of NIPS indicates no increase risk for trisomy
What is the difference between PROM and PPROM? (select all that apply).
Rupture of membranes before 37 weeks gestation
Regina is in second stage of labor and after delivery of the fetal head, her physician states "we have shoulder dystocia." What is the nurse's first 2 actions? (Select all that apply).
Stay calm , Call for help, Provide suprapubic support
What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy? (Select all that apply)
The affected arm should not be use for IV therapy, BP should be taken in the unaffected arm
Which of the following is true regarding dizygotic twins?
The correct answer is: Each fetus has their own placenta.
Which health care service represents a primary level of prevention?
The correct answer is: Immunizations
Early decelerations are probably caused by:
The correct answer is: Momentary increase in intracranial pressure due to head compression
Breast pain occurs in many women during their perimenopausal years. Which information is (are) a priority for the nurse to share with the client? (Select all that apply).
The correct answers are: Distinguishing between cyclical and noncyclical pain is important., Assess for prior trauma or possible infection
17 y/o Annie presents to the clinic requesting a pregnancy test. She states her LMP was 7 weeks ago and states she never misses a period. She reports she and her partner have been using condoms 'most of the time' since she ran out of the pill 2 months ago. The nurse performs a pregnancy test and it is positive. Annie asks what the result is. What is the nurse's best response?
The test is positive. What are your thoughts about the results?
Vitamin K shot is given to neonates for which of the following reasons:
To activate coagulation factor II, VII, IX and X
Angela asks the nurse why she needs to keep her bladder empty during labor. Which of the following is the nurse's best answer?
To allow maximum room for the baby to descend
What is the purpose of Daily Fetal Movement Counts?
To monitor the fetus at risk for compromised oxygenation
For which conditions do First and Second Trimester Screening tests 'test' for increase risk?
Trisomy 21 and 18
Claire calls the nurse at her physician's office and complains of dysuria and urinary frequency 3 days after her vaginal delivery. After further assessment, the nurse would follow standing orders for which condition?
Urinary tract infection
Brenda is 35 weeks pregnant and has a biophysical profile score of 6. She asks the nurse what does that mean? The nurse's best response is:
"Your baby may be having some problems and your doctor needs to determine if it is safe for your baby to continue to stay in the uterus. I will call your doctor."
A postmenopausal woman has been diagnosed with two leiomyomas (fibroids). Which clinical finding is most commonly associated with the presence of leiomyomas?
Abnormal uterine bleeding
The PP nurse caring for a 20yr old G1P1 woman who 3 hours ago delivered a healthy full term infant, observes the woman who is lightly touching her baby girl with her fingertips but who seems to be uncomfortable holding her baby close to her body. Which of the following is an accurate interpretation of these observed behaviors?
Infant attachment and take in phase
Common risk factors for breast cancer include: (select all that apply)
Older age, Female, Smoking (Not listed in the book as a risk factor), Paternal family history
Dysfunctional uterine bleeding (DUB) is defined as excessive uterine bleeding without a demonstrable cause. Which statement regarding this condition is most accurate?
The correct answer is DUB is most commonly caused by anovulation
Which of the following prenatal tests is done to screen for gestational diabetes?
The correct answer is: 1 hr GTT test
A woman's obstetric history indicates that she is pregnant for the fourth time, and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?
The correct answer is: 4-1-2-0-4
The time from fertilization to implantation is _____ days.
The correct answer is: 6-10
Which client is most likely to experience strong and uncomfortable afterpains?
The correct answer is: A woman who is a gravida 4-4-0-0-4
A 36 y/o pregnant woman has been diagnosed with polyhydraminos. The nurse knows this is based on which of the following?
The correct answer is: Amniotic fluid index of 30 cm
According to the CDC, which of the following has the highest maternal mortality rate in the United States?
The correct answer is: Black Women
Which statement related to cephalopelvic disproportion (CPD) is the least accurate?
The correct answer is: CPD can be accurately predicted
According to the CDC, all women under the age of 26 years old should be tested for which of the following STDs?
The correct answer is: Chlamydia
The perinatal nurse listens as Chantal describes her labor and emergency cesarean birth. Providing an opportunity to review this experience may assist Chantal in:
The correct answer is: Developing more positive feelings about her labor and birth
Which STD can be prevented by a vaccine and reduce a person's risk for certain types of cancer?
The correct answer is: Human papilloma virus
The perinatal nurse realizes that an FHR that is tachycardic, bradycardic, has late decelerations, or loss of variability is nonreassuring and is associated with which condition?
The correct answer is: Hypoxemia
The nurse is completing the lab order for a pap smear performed on a 22 year old female. Which of the following options will the nurse select?
The correct answer is: Pap smear - cytology only
The nurse assesses that a full-term neonate's temperature is 97.1°F (36.2°C). The first nursing action is to:
The correct answer is: Place the neonate on the mother's chest with a warm blanket over the mother and baby.
Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?
The correct answer is: Prolactin
A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment after childbirth. Recognizing the needs of women during this stage, how should the nurse respond?
The correct answer is: Provide time for the mother to reflect on the events of her labor and delivery.
What is the correct terminology for the nerve block that provides anesthesia to the lower vagina and perineum?
The correct answer is: Pudendal
In caring for the preterm infant, what complication is thought to be a result of high arterial blood oxygen level?
The correct answer is: ROP
Which conditions are infants of diabetic mothers (IDMs) at a higher risk for developing?
The correct answer is: Respiratory distress syndrome
A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. The fetal heart rate (FHR) before birth is 180 beats per minute with limited variability. At birth the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic. Based on the maternal history, what is the most likely cause of this newborn's distress?
The correct answer is: Sepsis
A pregnant woman is at 38 weeks of gestation. She wants to know whether there are any signs that "labor is getting close to starting." Which finding is an indication that labor may begin soon?
The correct answer is: Surge of energy
What is one of the initial signs and symptoms of puerperal infection in the postpartum client?
The correct answer is: Temperature of 38° C (100.4° F) or higher on 2 successive days
What is the primary rationale for nurses wearing gloves when handling the newborn?
The correct answer is: To protect the nurse from contamination by the newborn
A woman has preinvasive cancer of the cervix. Which modality would the nurse discuss as an available option for a client with this condition?
The correct answer is: cryosurgery
Amy is a 20 year old sexually active woman (G0000) who wants an effective birth control method. She denies any medical problems. Which of the following would the nurse not recommend to Amy?
The correct answer is: essure. Key word is NOT recommended - essure is permanent contraception, not reversible
Depo provera, or The Shot, contains which of the following hormones?
The correct answer is: progesterone
Match the prenatal test to the appropriate purpose or correct fact.
The correct answer is:;Noninvasive prenatal screening test → tests for cell-free fetal DNA in maternal blood, 1 hour GTT → screening test for gestational diabetes, Sequential integrated screening → involves 2 blood tests and one ultrasound, GBS testing → test to determine if prophylactic antibiotic is indicated during labor
The obstetric nurse is preparing the client for an emergency cesarean birth, with no time to administer spinal anesthesia. The nurse is aware of and prepared for the greatest risks of administering general anesthesia to the client. What are these risks? (Select all that apply)
The correct answers are: Aspiration of stomach contents, Difficulty or inability to intubate
Which of the following lab tests are routinely performed on pregnant women? (Select all that apply).
The correct answers are: Blood type, Syphilis test, Rubella titer
Which guidance might the nurse provide for a client with severe morning sickness? Select all that apply.
The correct answers are: Eat toast or potatoes, Eat small, frequent amounts of food
Which of the following nursing interventions are important in the prenatal care of the woman with prenatal depression? (Select all of the following).
The correct answers are: Educate the woman about depression and plan of care, Maintain a caring relationship
Which of the following hormones basically signal the brain to release the egg during the menstrual cycle? (Select all that apply)
The correct answers are: Follicle-stimulating hormone, Luteinizing hormone
16 y/o Susie presents to the clinic, wanting a pregnancy test. What questions would be appropriate for the professional nurse to ask Susie prior to completing the pregnancy test?
The correct answers are: Have you done a home pregnancy test?, What is the first day of your last menstrual period?, Have you been using birth control?
Which signs and symptoms should a woman immediately report to her health care provider? (Select all that apply.)
The correct answers are: Vaginal bleeding, Rupture of membranes, Heartburn accompanied by severe headache
16 year old Emily lives in Blackfoot, ID. She has a boyfriend but does not want to have a baby for at least 10 years. She wants an effective, easy birth control method and denies medical problems. She has periods every 4-6 weeks. The nurse would recommend which of the following methods to Emily? (Select all that apply).
The correct answers are: hormonal IUD, the implant
The CHOICE Project removed 3 key barriers to contraception for many women. These included which of the following?
The correct answers are: knowledge deficit, cost, lack of access to preferred method
A woman with severe preeclampsia is receiving magnesium sulfate. Which of the following indicate she is receiving a therapeutic dose?
decreased respirations from 24 bpm to 16 bpm
Number of deaths of infants younger than 1 year of age per 1000 births
infant mortality rate
Which of the following indicates a mother is entering the reorganization phase of parental grief
looking forward to return to work
When does the anterior and posterior fontanels close?
mos and 3 mos, respectively
G10000 Ginger enters L&D at 39 weeks gestation with complaint of "bag of waters broke and something is hanging down there." What is the nurse's first action?
Check her vagina/cervix
Fourth Stage
Delivery of the placenta to 1-2 hours after birth/postpartum
If nonsurgical treatment for late PPH is ineffective, which surgical procedure would be appropriate to correct a common cause of this condition?
Dilation and curettage (D&C)
Sandra is 36 weeks pregnant and states she felt the "baby drop" 2 days ago. What term describes this?
Lightening
Which of the following are management strategies for an ectopic pregnancy that is not ruptured?
Methotrexate with expectant observation Long term follow up for hydatidiform mole include which of the following? (Select all that apply);Biweekly hCG tests until level is negative, Birth control for one year
G10000 Ginger enters L&D at 32 weeks gestation with complaint of constant lower abdominal pain (or uterine tenderness) and no bleeding.What is the nurse's first action?
Palpate her abdomen/uterus
Which of the following are functions of the amniotic fluid? (Select all that apply)
Provides constant thermal environment Cushions the fetus
What nursing actions are appropriate during an eclamptic seizure? Select all that apply.
Put side rails up, Turn head to one side, Call for assistance
Evidence-based practice (EBP) is the integration of the best
Research evidence, clinical expertise, and patients' values
Eye movements are an example of newborn/infant style of communication.
The correct answer is 'True'.
Jane's husband Brian has begun to put on weight. What is this a possible sign of?
The correct answer is: Couvade syndrome
Which description of the phases of the second stage of labor is most accurate?
The correct answer is: Descent phase: Significant increase in contractions; Ferguson reflux activated; average duration varies
In caring for an immediate postpartum client, the nurse notes petechiae and oozing from her intravenous (IV) site. The client would be closely monitored for which clotting disorder?
The correct answer is: Disseminated Intravascular Coagulation (DIC)
Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?
The correct answer is: Needle-localization biopsy
While providing care to the maternity client, the nurse should be aware that one of these anxiety disorders is likely to be triggered by the process of labor and birth. Which disorder fits this criterion?
The correct answer is: Posttraumatic stress disorder (PTSD)
The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of ____.
The correct answer is: Sickle cell anemia
A nurse is providing education to a support group of women newly diagnosed with breast cancer. It is important for the nurse to discuss which factor related to breast cancer with the group?
The correct answer is: The exact cause of breast cancer remains unknown.
Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation. What is the primary purpose of prostaglandin administration?
The correct answer is: To ripen the cervix in preparation for labor induction
Which of the following is an example of presymptomatic testing?
The correct answer is: genetic test for huntington's chorea
Which of the following are management options for couples faced with infertility challenges, depending of the cause? (Select all that apply).
The correct answers are: Medication, assisted reproductive technology procedures, adoption, remain child-free
For which of the following reproductive cancers is high risk HPV infection thought to be primarily responsible? (Select all that apply).
correct answers are: Vulvar cancer, Cervical cancer, Vaginal cancer
For which of the following conditions is colposcopy used to further evaluate need for intervention? (Select all that apply).
correct answers are: vaginal cancer, cervical cancer
Rhogam to RH negative woman post-procedure to prevent antibody formation
Amniocentesis, CVS, and PUBS (percutaneous umbilical blood sampling or fetal blood sampling
Maternal risks of c-section include which of the following? (Select all that apply).
Anesthesia complications , Pulmonary embolism , Injuries to the bladder and bowel , Increased risk for placental accreta in future pregnancy
A woman exhibits symptoms that may lead to a possible diagnosis of polycystic ovary syndrome (PCOS). While completing the initial assessment of the client, which clinical finding would the nurse not anticipate?
Anorexia
A G2 P2 woman who experienced a prolonged labor and prolonged rupture of membranes is at risk for metritis. Which of the following nursing actions are directed at decreasing this risk? (Select all that apply.)
Answer: 1) INstruct woman to increase her fluid intake 2)instruct woman to change her peri-pads after each voiding 3)Instruct woman to ambulate in the halls four times a day
As a powerful central nervous system (CNS) stimulant, which of these substances can lead to miscarriage, preterm labor, placental separation (abruption), and stillbirth?
Answer: Cocaine
Paula lives in Preston, ID. She is 24 weeks pregnant and has Class II heart disease. She presents to the ER with tachycardia and shortness of breath. What is the nurse's first action?
Assess maternal V.S.
Robin is 27 weeks pregnant and presents to the ER with c/o abdominal pain for the past 8 hours. What is the nurse's first action?
Assess the pain further
It is noted that the amniotic fluid of a 42-week gestation baby, born 30 seconds ago, is thick and green and he is not crying vigorously. Which of the following actions by the nurse is critical at this time?
Assist the NNP with intubation and suctioning
Susan 36 weeks gestation presents to L&D with complaint of 'something leaking from my vagina." Which of the following assessment tools will the nurse implement first to assess Susan?
Auscultate FHTs
Instructing a woman on how to use natural family planning or fertility awareness method for contraception, the nurse should include which of the following statements? (Select all that apply)
Avoid intercourse for at least 3 days prior to ovulation, Use condoms on fertile days, It is safe to have intercourse during menses
Betty is 35 weeks pregnant with no history of problems. She presents to the L&D with c/o severe headache and spots in front of her eyes. Her b/p is 156/102 and FHT's are 130's. What is the nurse's first impression?
Betty has severe preeclampsia
The symptoms of mild-to-moderate urinary incontinence can be successfully decreased by a number of strategies. Which of these should the nurse instruct the client to use first?
Bladder training and pelvic muscle exercises
What is the first action the nurse performs when jaundice is noted in a neonate who is 12 hours old?
Check maternal Rh factor
Ella is 5 hours postpartum following the vaginal delivery of a 10lb 4oz baby boy. Estimated blood loss at delivery was 900 ml. The RN is aware that Ella experienced an early-postpartum hemorrhage. Select the appropriate nursing action(s) for the care of this patient.
Check uterus more frequently to prevent atony , Insert a foley catheter to make sure bladder stays empty
A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 14 hours. On assessment, the nurse finds the following vital signs: temperature 37.5° C, pulse rate 76 beats per minute, respiratory rate 16 breaths per minute, BP 144/92 mm Hg, +2 deep tendon reflexes (DTRs), and no ankle clonus. What is the nurse's next action?
Continue to monitor patient's condition
A newborn who is a few hours old is noted to have a rash with vesicles on the chest. What is the most appropriate action of the nurse?
Document findings
What pattern of labor is the goal with a labor induction?
Firm contractions every 3 minutes
Which of the following is an example of carrier testing?
Genetic testing for autosomal recessive condition, such as CF
The perinatal nurse explains to the student nurse that a goal of the Healthy People 2020 is to
Increase proportion of infants who are breastfed.
Mary's cervix has been dilated to 5 cm at -1 station for 4 hours. The fetus is vertex with molding noted. Her contractions are every 3 minutes and palpate firm. FHTs are 130's with moderate variability. After reporting to the physician, he tells the nurse to start Pitocin per protocol to augment labor. The nurses best response is?
Initiate Pitocin augmentation
Which of the following is true about preeclampsia
It is a hypoperfusive condition that starts at implantation
Which of the following is true regarding pathologic jaundice? (Select all that apply)
Jaundice is noted within 24 hours after birth
A woman seeks care at an infertility center. Which of the following procedures may she undergo to determine what, if any, infertility problem she may have? (Select all that apply)
LH level, Hystosalphingogram
A married couple lives in a single-family house with their newborn son and the husband's daughter from a previous marriage. Based on this information, what family form best describes this family?
Married-blended family
Lisa, a G4 P3, experienced a precipitous birth 100 minutes ago. Her infant is 4200 grams and a repair of a second-degree laceration was needed following the birth. As part of the nursing assessment, the nurse discovers that Lisa's uterus is boggy. Furthermore, it is noted that Lisa's vaginal bleeding has increased. What is the nurse's most appropriate actions?
Massage the uterine fundus with continual lower segment support
Which of the following factors impact a pregnancy outcome? (Select all that apply)
Maternal nutrition, History of past pregnancies, Maternal age, Family disruption
What is the best action a woman with pregestational diabetes can take to improve outcomes for her baby?
Monitor her blood sugars
Down Syndrome is an example of which kind of inheritance pattern?
Multifactorial
With hormonal contraception, which of the following hormones causes cervical mucus to thicken and helps to prevent pregnancy?
Progesterone
What side effect might a patient experience during a hystosalphingogram?
Shoulder pain
During a newborn assessment, the nurse observes grunting and retractions. What is the nurse's first action?
Suction with bulb syringe
The clinic nurse recognizes that the longer an infant is formula fed, the greater is the immunity and resistance the infant will develop against bacterial and viral infections.
The correct answer is 'False'.
Which of the following health risks can have a negative impact on a pregnancy? (Select all that apply).
The correct answer is maternal diabetes and obesity
Which nursing intervention is paramount when providing care to a client with preterm labor who has received terbutaline?
The correct answer is: Assess for dyspnea and crackles.
The nursery nurse notes the presence of diffuse edema on a baby girl's head. Review of the birth record indicates that her mother experienced a prolonged labor and difficult childbirth. By the second day of life, the edema has disappeared. The nurse documents the following condition in the infant's chart.
The correct answer is: Caput succedaneum
Which presentation is accurately described in terms of both the presenting part and the frequency of occurrence?
The correct answer is: Cephalic: occiput, at least 96%
While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the FHR for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. What is the nurse's first priority?
The correct answer is: Change the woman's position.
A pregnant woman's WBC result is 15,000mm^3. What is the nurse's action based on this result?
The correct answer is: Check differential since result is a normal finding for a pregnant woman.
Which of the following tests should never be performed during the first trimester?
The correct answer is: Contraction Stress test
Postoperative care of the pregnant woman who requires abdominal surgery for appendicitis includes which additional assessment?
The correct answer is: Fetal heart rate (FHR) and uterine activity
Which minerals and vitamins are usually recommended as a supplement in a pregnant client's diet?
The correct answer is: Iron
A woman in labor has just received an epidural block. What is the most important nursing intervention at this time?;
The correct answer is: Monitor the maternal blood pressure for possible hypotension.
A first-time dad is concerned that his 3-day-old daughter's skin looks "yellow." In the nurse's explanation of physiologic jaundice, what fact should be included?
The correct answer is: Physiologic jaundice becomes visible when serum bilirubin levels peak between the second and fourth days of life
Why might it be more difficult to diagnose appendicitis during pregnancy?
The correct answer is: The appendix is displaced upward and laterally, high and to the right
A woman with preeclampsia has a seizure. What is the nurse's highest priority during a seizure?
The correct answer is: To stay with the client and call for help
A nurse notes that an Eskimo woman does not cuddle or interact with her newborn other than to feed him, change his diapers or soiled clothes, and put him to bed. While evaluating this client's behavior with her infant, what realization does the nurse make?
The correct answer is: What appears to be a lack of interest in the newborn is, in fact, the cultural way of demonstrating intense love by attempting to ward off evil spirits.
In assisting the breastfeeding mother to position the baby, which information regarding positioning is important for the nurse to keep in mind?
The correct answer is: Whatever the position used, the infant is "belly to belly" with the mother.
When providing a psychosocial assessment on a pregnant woman at 21 weeks' gestation, the nurse would expect to observe which of the following signs?
The correct answer is: Withdrawn to concentrate on her unborn child. The maternal tasks of pregnancy include ambivalent feelings in the first trimester and phases of acceptance of the pregnancy through the second and third trimesters.
What information should the nurse understand fully regarding rubella and Rh status?
The correct answer is: Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination Which concerns regarding parenthood are often expressed by visually impaired mothers? (Select all that apply.);The correct answers are: Infant safety, Transportation, Needing extra time for parenting activities to accommodate the visual limitations
Which of the following is the most effective contraception?
The correct answer is: the implant
Which woman is at the greatest risk for psychological complications after hysterectomy?
The correct answer is:19-year-old woman who had a ruptured uterus after giving birth to her first child
Which adverse prenatal outcomes are associated with the HELLP syndrome? (Select all that apply.)
The correct answers are: Placental abruption, Renal failure, Maternal and fetal death
Hannah is 39 weeks pregnant and presents to L&D for induction of labor due to preeclampsia. Her B/P is 148/90, +1 proteinuria, and FHTs are 145 with moderate variability. Her Bishop score is 5 (1 cm/50%/-2/soft/posterior). Hannah asks the nurse what does that mean?
The nurse's best answer is: "Your cervix is ready but labor may take several hours"
Regina G10000 is 30 weeks pregnant with twins. Which of the following surveillance activities would be included in Regina's antepartum care?
Weekly NSTs, Serial ultrasounds
When a couple is using natural family planning to get pregnant, which of the following is the best time for them to have intercourse to maximize odds for pregnancy?
When the temperature falls and before it rises
30 y/o Amanda presents to the ER with c/o lower abdominal pain and vaginal bleeding "that won't stop." States her bleeding and pain started approx. 12 hours ago. In order to help the nurse determine what might be happening, what is the nurse's next question?
When was your last normal period?
Which woman has the highest risk for endometrial cancer?
correct answer is: Postmenopausal woman with hypertension
A client is to take Clomiphene Citrate for infertility. Which of the following is the expected action of this medication?
correct answer is: Stimulate release of FSH and LH
Amy is a 20 year old sexually active woman (G0000) who wants an effective birth control method. She denies any medical problems. Which of the following would the nurse not recommend to Amy?
correct answer is: essure
A woman who is 12 weeks postpartum presents with the following behavior: she reports severe mood swings and hearing voices, believes her infant is going to die, she has to be reminded to shower and put on clean clothes, and she feels she is unable to care for her baby. These behaviors are associated with which of the following?
The correct answer is: Postpartum psychosis. Postpartum psychosis (PPP) is a variant of bipolar disorder and is the most serious form of postpartum mood disorders. Onset of symptoms can be as early as the 3rd postpartum day. Assessment findings include paranoia, delusions associated with the baby, mood swings, extreme agitation, confused thinking, inability to care for self or infant, and strange beliefs.
The nurse should be cognizant of which physiologic effect of pain?
The correct answer is: Predominant pain of the first stage of labor is visceral pain that is located in the lower portion of the abdomen.
Which of the following is true about twin pregnancy?
The correct answer is: Pregnant women with twins usually require more surveillance during their pregnancy compared to women with singleton pregnancy.
Parents have been asked by the neonatologist to provide breast milk for their newborn son, who was born prematurely at 32 weeks of gestation. The nurse who instructs them regarding pumping, storing, and transporting the milk needs to assess their knowledge of lactation. Which statement is valid?
The correct answer is: Premature infants more easily digest breast milk than formula.
Which resource best describes a health care service representing the tertiary level of prevention?
The correct answer is: Premenstrual syndrome (PMS) support group
According to research, which risk factor for PPD is likely to have the greatest effect on the client postpartum?
The correct answer is: Prenatal depression
Which preexisting factor is known to increase the risk of GDM?
The correct answer is: Previous birth of large infant What form of heart disease in women of childbearing years generally has a benign effect on pregnancy? ; The correct answer is: Mitral valve prolapse
A pregnant woman who has a history of cesarean births is requesting to have a vaginal birth after cesarean (VBAC). In which of the following situations should the nurse advise the patient that her request may be declined?
The correct answer is: Previous uterine surgery
The perinatal nurse notes a rapid decrease in the fetal heart rate that does not recover immediately following an amniotomy. The most likely cause of this obstetrical emergency is:
The correct answer is: Prolapsed umbilical cord. Amniotomy is the artificial rupture of membranes (AROM) to induce or augment labor. This is a common procedure seen in obstetrics. Risks associated with amniotomy include umbilical cord prolapse when the presenting part is not engaged. Vasa previa or rupture of fetal vessels unsupported by the placenta is a very rare situation and usually results in rapid fetal exsanguination in the presence of bloody fluid seen following AROM.
A nurse is teaching a woman about her menstrual cycle. The nurse states that ____ is the most important change that happens during the secretory phase of the menstrual cycle.
The correct answer is: Proliferation of the endometrium
In which clinical situation would the nurse most likely anticipate a fetal bradycardia?
The correct answer is: Prolonged umbilical cord compression
A multipara, 26 weeks' gestation and accompanied by her husband, has just delivered a fetal demise. Which of the following nursing actions is appropriate at this time?
The correct answer is: Provide opportunities for grieving parents and family members to spend time with the baby
After giving birth to a healthy infant boy, a primiparous client, 16 years of age, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is "Deficient knowledge of infant care." What should the nurse be certain to include in the plan of care as he or she prepares the client for discharge?
The correct answer is: Provide time for the client to bathe her infant after she views a demonstration of infant bathing.
Which of the following findings, seen in pregnant women in the third trimester, would the nurse consider to be within normal limits?
The correct answer is: Pyrosis
When assessing the fetus using Leopold's maneuvers (See Box 19-5, page 440), the nurse feels a round, firm/hard, and movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother's right side close to midline. What is the position of the fetus?
The correct answer is: RSA
An 18-year-old pregnant woman, gravida 1, para 0, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. The client states, "My contractions are so strong, I don't know what to do." Before making a plan of care, what should the nurse's first action be?
The correct answer is: Recognize that pain is personalized for each individual
What should the nurse's next action be if the client's white blood cell (WBC) count is 25,000/mm3 on her second postpartum day?
The correct answer is: Recognize that this count is an acceptable range at this point postpartum
A family is visiting two surviving triplets. The third triplet died 2 days ago. What action indicates that the family has begun to grieve for the dead infant?
The correct answer is: Refers to the dead infant in the past tense
An example of a cultural prescriptive belief during pregnancy is:
The correct answer is: Remain active during pregnancy
A primigravida woman at 42 weeks' gestation received Prepidil (dinoprostone) for induction 12 hours ago. The Bishop score is now 3. Which of the following actions by the nurse is appropriate?
The correct answer is: Report the lack of progress to the obstetrician.
What are the most common causes for subinvolution of the uterus?
The correct answer is: Retained placental fragments and infection
Because of the premature infant's decreased immune functioning, what nursing diagnosis should the nurse include in a plan of care for a premature infant?
The correct answer is: Risk for infection
When caring for clients with neoplasms of the reproductive system, the nurse must begin by assessing the woman's knowledge of the disorder, its management, and prognosis. This assessment should be followed by a nursing diagnosis. Which diagnosis fails to address the psychological effect of these disorders?
The correct answer is: Risk for injury, related to lack of skill for self-care
The laboratory results for a postpartum woman are as follows: blood type, A, Rh status, positive, rubella non-immune (titer 1:8 or enzyme immunoassay [EIA] 0.8), hematocrit, 30%. How should the nurse best interpret these data?
The correct answer is: Rubella vaccine should be administered.
Many clients are concerned about the increased levels of mercury in fish and may be reluctant to include this source of nutrients in their diet. What is the best advice for the nurse to provide?
The correct answer is: Shark, swordfish, and mackerel should be avoided.
The nurse observes that a first-time mother appears to ignore her newborn. Which strategy should the nurse use to facilitate mother-infant attachment?
The correct answer is: Show the mother how the infant initiates interaction and attends to her.
What family form tends to be the most socially vulnerable?
The correct answer is: Single-parent family
For an infant experiencing symptoms of drug withdrawal, which intervention should be included in the plan of care?
The correct answer is: Snugly swaddling the infant and tightly holding the baby
Parents are often asked if they would like to have an autopsy performed on their infant. Nurses who are assisting parents with this decision should be aware of which information?
The correct answer is: Some religions prohibit autopsy.
A woman who is 30 weeks of gestation arrives at the hospital with bleeding. Which differential diagnosis would not be applicable for this client?
The correct answer is: Spontaneous abortion
A pregnant woman at term is transported to the emergency department (ED) after a severe vehicular accident. The obstetric nurse responds and rushes to the ED with a fetal monitor. Cardiopulmonary arrest occurs as the obstetric nurse arrives. What is the highest priority for the trauma team?
The correct answer is: Starting cardiopulmonary resuscitation (CPR)
A nurse working in a prenatal clinic is caring for a woman who asks advice on foods that are high in vitamin C because "I hate oranges." The nurse states that 1 cup of which of the following raw foods will meet the patient's daily vitamin C needs?
The correct answer is: Strawberries
The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt
The correct answer is: Strict aseptic technique, including hand washing, by all healthcare personnel
Documentation of abuse can be useful to women later in court, should they elect to press charges. It is of key importance for the nurse to document accurately at the time that the client is seen. Which entry into the medical record would be the least helpful to the court?
The correct answer is: Summary of information (e.g., "The client is a battered woman.")
The perinatal nurse observes the new mother watching her baby daughter closely, touching her face, and asking many questions about infant feeding. This stage of mothering is best described as:
The correct answer is: Taking hold
Which statement correctly describes the nurse's responsibility related to electronic fetal monitoring (EFM)?
The correct answer is: Teach the woman and her family about the monitoring equipment and discuss any questions they have. Nurses are expected to independently assess, interpret, and intervene related to interpretations of electronic fetal monitoring (EFM). Nurses are expected to provide information and explanations to patients and their families in order to relieve anxiety and answer questions. Nurses are expected to share information with obstetric providers to insure clear communication. EFM is a means to information regarding fetal response to labor but does not take the place of nursing and support person interactions. Remember that external devices cannot measure uterine intensity/pressure during a contraction but can provide information on frequency and duration.
During a routine prenatal visit in the third trimester, a woman reports she is dizzy and lightheaded when she is lying on her back. The most appropriate nursing action would be to:
The correct answer is: Teach the woman to avoid lying on her back and to rise slowly because of supine hypotension.
A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When evaluating the woman's vital signs, which finding would be of greatest concern to the nurse?;
The correct answer is: Temperature 37.9° C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg
The laboratory reported that the L/S ratio (lecithin/sphingomyelin) results from an amniocentesis of a gravid client with preeclampsia are 2:1. The nurse interprets the result as which of the following?
The correct answer is: The baby's lung fields are mature.
What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?
The correct answer is: The blood pressure (BP) cuff should not be applied to the affected arm.
A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis?
The correct answer is: The couple has established a set schedule for their sexual encounters.
While performing Leopold's maneuvers on a woman in early labor, the nurse palpates a flat area in the fundal region, a hard round mass on the left side, a soft round mass on the right side, and small parts just above the symphysis. The nurse concludes which of the following?
The correct answer is: The fetal presentation is scapular. This is incorrect!!!! There was no correct answer!!!
A woman at 24 weeks of gestation states that she has a glass of wine with dinner every evening. Why would the nurse counsel the client to eliminate all alcohol?
The correct answer is: The fetus is placed at risk for altered brain growth.
A client with maternal phenylketonuria (PKU) has come to the obstetrical clinic to begin prenatal care. Why would this preexisting condition result in the need for closer monitoring during pregnancy?
The correct answer is: The fetus may develop neurologic problems.
Another common pregnancy-specific condition is pruritic urticarial papules and plaques of pregnancy (PUPPP). A client asks the nurse why she has developed this condition and what can be done. What is the nurse's best response?
The correct answer is: The goal of therapy is to relieve discomfort.
Which statement regarding hemolytic diseases of the newborn is most accurate?
The correct answer is: The indirect Coombs' test is performed on the mother before birth; the direct Coombs' test is performed on the cord blood after birth
In follow-up appointments or visits with parents and their new baby, it is useful if the nurse can identify infant behaviors that can either facilitate or inhibit attachment. What is an inhibiting behavior?
The correct answer is: The infant seeks attention from any adult in the room.
What is the primary purpose for the use of tocolytic therapy to suppress uterine activity?
The correct answer is: The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids.
Yolanda is 28 weeks pregnant. Her blood type is O negative. What will the nurse discuss with her at this prenatal visit?
The correct answer is: The need for a Rhogam injection.
Match the definition with the correct term
The correct answer is: The number of autosomes in humans → 22, Physical feature or psychological trait → phenotype, A pictorial analysis of an individual's chromosomes → karyotype, This/these function(s) to inhibit cell growth and division cycle → tumor suppressor genes
Which finding would indicate to the nurse that the grieving parents have progressed to the reorganization phase of grieving?
The correct answer is: The parents are discussing sex and a future pregnancy, even if they have not yet sorted out their feelings.
Which of the following is correct regarding endometriosis?
The correct answer is: The physical symptoms of endometriosis can affect the woman's mental health.
A couple who has sought infertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur?
The correct answer is: The testes are overheated.
What is a distinct advantage of external EFM?
The correct answer is: The tocotransducer is especially valuable for measuring uterine activity during the first stage of labor.
A woman who is 6 months pregnant has sought medical attention, saying she fell down the stairs. What scenario would cause an emergency department nurse to suspect that the woman has been a victim of IPV?
The correct answer is: The woman has injuries on various parts of her body that are in different stages of healing.
A recently delivered mother and her baby are at the clinic for a 6-week postpartum checkup. Which response by the client alerts the nurse that psychosocial outcomes have not been met?
The correct answer is: The woman has not given the baby a name.
A gravida, G4 P1203, fetal heart rate 150s, is 14 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct?
The correct answer is: The woman is experiencing a normal pregnancy.
Which statement regarding the laboratory test for glycosylated hemoglobin Alc is correct?
The correct answer is: This laboratory test measures the levels of hemoglobin Alc, which should remain at less than 7%
A new father wants to know what medication was put into his infant's eyes and why it is needed. How does the nurse explain the purpose of the erythromycin (Ilotycin) ophthalmic ointment?
The correct answer is: This ophthalmic ointment prevents gonorrheal infection of the infant's eyes, potentially acquired from the birth canal.
A woman arrives at the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion?
The correct answer is: Threatened
A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?
The correct answer is: Thrombophlebitis; using real-time and color Doppler ultrasound
Human immunodeficiency virus (HIV) may be transmitted perinatally or during the postpartum period. Which statement regarding the method of transmission is most accurate?
The correct answer is: Through the ingestion of breast milk from an infected mother
A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature 37.3° C, pulse rate 88 beats per minute, respiratory rate 10 breaths per minute, BP 148/90 mm Hg, absent deep tendon reflexes (DTRs), and no ankle clonus. The client complains, "I'm so thirsty and warm." What is the nurse's immediate action?
The correct answer is: To discontinue the magnesium sulfate infusion
A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM) doses of betamethasone. What is the purpose of this pharmacologic intervention?
The correct answer is: To stimulate fetal surfactant production
Which substance used during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications?
The correct answer is: Tobacco
A client at 39 weeks of gestation has been admitted for an external version. Which intervention would the nurse anticipate the provider to order?
The correct answer is: Tocolytic drug
Karen, a 26-year-old woman and 12 weeks pregnant, has come for her prenatal visit. She asks about avoiding uncooked meat. She also got a new cat and she has heard that she "should not touch the cat during pregnancy." Are these true? The clinic nurse's best response is:
The correct answer is: Toxoplasmosis is a concern during pregnancy, so it is important to have someone else change the cat's litter pan and also to avoid consuming uncooked meat.
Nurses need to understand the basic definitions and incidence data regarding PPH. Which statement regarding this condition is most accurate?
The correct answer is: Traditionally, PPH has been classified as early PPH or late PPH with respect to birth.
A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic procedure will the client most likely have performed?
The correct answer is: Transvaginal ultrasound for placental location. The symptoms, bright red and painless vaginal bleeding, indicate placental previa. An ultrasound can confirm this diagnosis.
The nurse should be cognizant of which condition related to skeletal injuries sustained by a neonate during labor or childbirth?
The correct answer is: Unless a blood vessel is involved, linear skull fractures heal without special treatment.
The nurse is preparing to administer methotrexate to the client. This drug is most often used for which obstetric complication?
The correct answer is: Unruptured ectopic pregnancy
A primigravida patient is 39 weeks pregnant. Which of the following symptoms would the nurse expect the patient to exhibit?
The correct answer is: Urinary frequency
The nurse suspects that her postpartum client is experiencing hemorrhagic shock. Which observation indicates or would confirm this diagnosis?
The correct answer is: Urinary output of at least 30 ml/hr
A pregnant woman at 33 weeks of gestation is brought to the birthing unit after a minor automobile accident. The client is experiencing no pain and no vaginal bleeding, her vital signs are stable, and the FHR is 132 beats per minute with variability. What is the nurse's highest priority?
The correct answer is: Using continuous EFM for a minimum of 4 hours
A 25-year-old gravida 3, para 2 client gave birth to a 9-pound, 7-ounce boy, 2 hours ago after augmentation of labor with oxytocin (Pitocin). She presses her call light, and asks for her nurse right away, stating "I'm bleeding a lot." What is the most likely cause of postpartum hemorrhaging in this client?
The correct answer is: Uterine atony
The nurse who provides care to clients in labor must have a thorough understanding of the physiologic processes of maternal hypotension. Which outcome might occur if the interventions for maternal hypotension are inadequate?
The correct answer is: Uteroplacental insufficiency
A pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirement is the nurse most concerned about?
The correct answer is: Vitamin B12
Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth?
The correct answer is: Vulva bulges and encircles the fetal head
New screening mammogram recommendations by ACOG include which of the following?
The correct answer is: Women should talk to their health care provider to decide the best age to begin screening mammograms
Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand?
The correct answer is: Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms.
The nurse is providing information to 17 y/o Kendra on STD prevention. Which of the following would the nurse NOT include in their counseling to reduce risk for getting an STD?
The correct answer is: oral sex without a barrier
Folic acid 400mcg a day is recommended to all women of reproductive age for which of the following reasons?
The correct answer is: prevents spina bifida and abdominal defects of the baby
Combination oral contraceptives, the vaginal ring and the patch contain two hormones. Which of the following is the primary hormone that stops ovulation?
The correct answer is: progesterone
Ellie is 32 weeks pregnant. She complains of heartburn and constipation. Which of the following hormones relaxes smooth muscle (including that in the intestine and sphincters) that can lead to Ellie's symptoms?
The correct answer is: progesterone
Match the condition or trait with the appropriate mode of inheritance (more than one mode may be used and not all are used)
The correct answer is: sickle cell anemia → autosomal recessive inheritance, Marfans syndrome → autosomal dominant inheritance, cleft lip → multifactorial inheritance, hemophilia → X linked recessive inheritance, ovarian cancer → multifactorial inheritance
The perinatal nurse explains to the student nurse that in the fetal circulation, the lowest level of oxygen concentration is found in ____________.
The correct answer is: the umbilical arteries
Which of the following STDs poses the least danger for the fetus of a mother who has the infection?
The correct answer is: trichomonas vaginalis
Which of the following vaginitis conditions is a sexually transmitted infection?
The correct answer is: trichomonas vaginitis
A nurse who is discussing serving sizes of foods with a new prenatal patient who does not drink milk. The nurse would state that which of the following is equal to 1 (one) serving from the dairy food group? Select all that apply.
The correct answers are: 3 cups of dried beans, 1 cup of collards
Contraindications for induction of labor include:
The correct answers are: Abnormal fetal position, Placental abnormalities
The perinatal nurse screens all pregnant women early in pregnancy for maternal attachment risk factors, which include (select all that apply):
The correct answers are: Adolescence, Low educational level, History of depression
Indications for a primary cesarean birth are often nonrecurring. Therefore, a woman who has had a cesarean birth with a low transverse scar may be a candidate for vaginal birth after cesarean (VBAC). Which clients would be less likely to have a successful VBAC? (Select all that apply.)
The correct answers are: African-American race, Delivery at a rural hospital, Maternal obesity (BMI >30)
A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients' emotional responses to their infertility. Which of the following responses would the nurse expect to find? (Select all that apply.)
The correct answers are: Anger at others who have babies., Feelings of failure because they cannot make a baby., Guilt on the part of one partner because he or she is unable to give the other a baby.
Menorrhagia may result from (select all that apply):
The correct answers are: Anovulatory cycle, Metritis. Menorrhagia is menstrual bleeding excessive in number of days and amount of blood. It may result from an anovulatory cycle,fibroids, inflammatory or infectious disease such as metritis or salpingitis, endometrial issues, or intrauterine device (IUD)
The clinic nurse recognizes that pregnant women who are in particular need of support are those who (select all that apply):
The correct answers are: Are awaiting genetic testing results, Are experiencing a first pregnancy, Are trying to conceal this pregnancy as long as possible. A second pregnancy is not an indication of a woman in need of additional support. A support system may be lacking for women who are trying to conceal a pregnancy or for women who are trying to keep the news of their pregnancy from relatives or friends until results from genetic tests are known. These individuals may need additional support from their nurses and other health-care providers, as they are placed in a powerless situation while awaiting results and face a pregnancy that may be in jeopardy.
General skin care for full-term infants includes which of the following? (Select all that apply.)
The correct answers are: Avoid daily bathing with soap., Use a cleanser with a neutral pH., Avoid fragrant soaps., Apply petrolatum-based ointments sparingly to dry skin, but avoid head and face.
The perinatal nurse describes infant feeding cues to a new mother. These feeding cues include (select all that apply):
The correct answers are: Awake and alert, Mouth movements, Moving the hand to the mouth
Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. What are possible causes of early miscarriage? (Select all that apply.)
The correct answers are: Chromosomal abnormalities, Endocrine imbalance, Systemic disorders, Varicella
Which congenital anomalies can occur as a result of the use of antiepileptic drugs (AEDs) in pregnancy? (Select all that apply.)
The correct answers are: Cleft lip, Congenital heart disease , Neural tube defects
Which of the competencies are most relevant to nurses in maternity and women's health? (Select all that apply)
The correct answers are: Collect a thorough family history to include at least 3 generations., Provide patient with accurate and appropriate genetic and genomic information
Which finding on a prenatal visit at 10 weeks of gestation might suggest a hydatidiform mole? (Select all that apply).
The correct answers are: Complaint of severe nausea, Fundal height measurement of 18 cm
While developing an intrapartum care plan for the client in early labor, which psychosocial factors would the nurse recognize upon the client's pain experience? (Select all that apply.)
The correct answers are: Culture, Anxiety and fear, Previous experiences with pain, Support systems
A client states that she does not eat red meat. Which foods should the nurse encourage this woman to consume in greater amounts to increase her iron intake? (Select all that apply).
The correct answers are: Dark green leafy vegetables, Liver, Dried fruits
Which of the following are true regarding interpreter services? Select all that apply.
The correct answers are: Direct questions to the patient, not the interpreter., Create environment of respect and privacy.
A first-time mother informs her nurse that she is concerned about infant abduction. The nurse should explain to the parents which of the following? (Select all that apply.)
The correct answers are: Do not allow a person without proper unit specific hospital ID to take their baby., Encourage parents to accompany any person who removes their infant from the hospital room, Instruct parents not to leave their newborn unattended at any time, Inform parents that ID bands with matching identification numbers are placed on the parents and infant at birth to ensure identification of the correct infant with the correct parents
Researchers have found a number of common risk factors that increase a woman's chance of developing a breast malignancy. It is essential for the nurse who provides care to women of any age to be aware of which risk factors? (Select all that apply.)
The correct answers are: Family history, Age, Nulliparity or first pregnancy after age 40 years
Researchers have found a number of common risk factors that increase a woman's chance of developing a breast malignancy. It is essential for the nurse who provides care to women of any age to be aware of which risk factors? (select all that apply)
The correct answers are: Family history, Age, Nulliparity or first pregnancy after age 40 years
Documentation related to vacuum delivery includes which of the following:
The correct answers are: Fetal heart rate, Timing and number of applications, Position and station of fetal head. Assessment of fetal heart rate is part of second-stage management, timing and number of applications are part of standard of care related to safe vacuum deliveries, and position and station of fetal head are noted for safe vacuum extraction. Maternal position is not critical to the documentation related to vacuum deliveries.
Which of the following are primary risk factors for subinvolution of the uterus? (Select all that apply.)
The correct answers are: Fibroids, Retained placental tissue, Metritis. Uterine fibroids can interfere with involution. Retained placental tissue does not allow the uterus to remain contracted. Infection in the uterus is a risk factor for subinvolution. UTI does not interfere with involution of the uterus.
Which of the following are among the top 5 causes of death in women in the U.S.? (select all that apply)
The correct answers are: Heart Disease, Lung cancer
Primary prevention of preterm labor and birth include which of the following? (Select all that apply).
The correct answers are: Identify risk factors of preterm birth for individual pregnant woman, Manage risk factors for preterm birth in individual pregnant woman
The postpartum mother asks the nurse why is it so important to prevent cold stress in her baby- can't she shiver to stay warm? What should the nurse include in their response? (Select all that apply)
The correct answers are: If your baby gets too cold and we don't help her, her body will use alot of oxygen to try and get warm, which can ultimately lead to decrease oxygen to her lungs and body causing respiratory problems., No, your baby cannot shiver; therefore, it is important to prevent her from losing body heat.
The nurse expects which maternal cardiovascular finding(s) during labor? (Select all that apply).
The correct answers are: Increased cardiac output, increased white blood cell (WBC) count Nurses can help their clients by keeping them informed about the distinctive stages of labor. Which description of the phases of the first stage of labor is accurate?;The correct answer is: Active: More progress in rate of descent of presenting part
The clinic nurse advocates for smoking cessation. Potential harmful effects of tobacco use include (select all that apply):
The correct answers are: Infertility impairment, low birth weight of the fetus
What is (are) the most critical nursing action(s) in caring for the newborn immediately after the birth? (Select all that apply).
The correct answers are: Keeping the airway clear, Drying and warming the newborn.
The perinatal nurse is caring for Christy following the birth of her first child. Based on Christy's history, the RN recognizes that risk factors for postpartum depression include:
The correct answers are: Loss of friends based on upcoming divorce; family is unable to assist, Separated from spouse pending divorce, Unplanned cesarean delivery secondary to Category III fetal tracing
Karen, a G2 P2, experienced a precipitous birth 90 minutes ago. Her infant is 4200 grams and a repair of a second-degree laceration was needed following the birth. As part of the nursing assessment, the nurse discovers that Karen's uterus is boggy. Furthermore, it is noted that Karen's vaginal bleeding has increased. What is the nurse's most appropriate actions?
The correct answers are: Massage the uterine fundus with continual lower segment support., Assess for bladder distention and encourage patient to void.
A baby was born 4 days ago at 34 weeks' gestation. She is receiving phototherapy as ordered by the physician for physiological jaundice. She has symptoms of temperature instability, dry skin, poor feeding, lethargy, and irritability. The nurse's priority nursing action(s) is (are) to (select all that apply):
The correct answers are: Monitor the baby's temperature to check for hypothermia., Calculate 24-hour intake and output to check for dehydration.
For which of the following conditions is Daily Fetal Movement Count indicated? (Select all that apply).
The correct answers are: Mother with diabetes during pregnancy, Mother with low amniotic fluid volume or oligohydraminos
Cellulitis with or without abscess formation is a fairly common condition. The nurse is providing education for a client whose presentation to the emergency department includes an infection of the breast. Which information should the nurse share with this client? (Select all that apply.)
The correct answers are: Nipple piercing may be the cause of a recent infection, Treatment for cellulitis or breast infection will include antibiotics., Obesity, smoking, and diabetes are risk factors.
Which classification of placental separation is not recognized as an abnormal adherence pattern?
Answer: Placenta abruptio
Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. However, the nurse or midwife may need to refer a client to a registered dietitian for in-depth nutritional counseling. Which conditions would require such a consultation? (select all that apply.)
The correct answers are: Obesity, preexisting or gestational illness such as diabetes
Which of the following screens for cervical cancer? (Select all that apply).
The correct answers are: Pap smear test, high risk HPV test
Which of the following procedures require administration of RhoGAM to RH negative women post-procedure to prevent antibody formation? (Select all that apply)
The correct answers are: Percutaneous umbilical blood sampling or fetal blood sampling (PUBS), Amniocentesis, Chorionic villi sampling (CVS)
Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could the nurse use to increase the client's blood pressure? (Select all that apply.)
The correct answers are: Place the woman in a lateral position., Increase IV fluids. , Administer oxygen
The baseline FHR is the average rate during a 10-minute segment. Changes in FHR are categorized as periodic or episodic. These patterns include both accelerations and decelerations. The labor nurse is evaluating the client's most recent 10-minute segment on the monitor strip and notes a late deceleration. Which is likely to have caused this change? (Select all that apply.)
The correct answers are: Placental abruption, Maternal supine hypotension
Secondary amenorrhea results from (select all that apply):
The correct answers are: Polycystic ovary syndrome, Uncontrolled Diabetes, Emotional distress, Pregnancy. Secondary amenorrhea is no menses in 6 months in a woman who has had normal menstrual cycles. May result from: lack of ovarian production, pregnancy, polycystic ovary syndrome, nutritional and endocrine disturbances, uncontrolled diabetes, heavy athletic activity, or emotional distress.
The clinic nurse encourages paternal attachment during pregnancy by including the father in (select all that apply):
The correct answers are: Prenatal visits, Ultrasound appointments, Prenatal class information
Which of the following perinatal complications have been associated with untreated asymptomatic bacteriuria? (Select all that apply).
The correct answers are: Preterm birth, Low birth weight
If a woman is at risk for thrombus and is not ready to ambulate, which nursing intervention would the nurse use? (Select all that apply.)
The correct answers are: Putting her in antiembolic stockings (thromboembolic deterrent [TED] hose) and/or sequential compression device (SCD) boots, Having her flex, extend, and rotate her feet, ankles, and legs , Immediately notifying the physician if a positive Homans sign occurs
Supportive care of the infant with neonatal abstinence syndrome (NAS) include both pharmacologic and nonpharmacologic therapy. Nonpharmacologic therapy would include which of the following (select all that apply):
The correct answers are: Quiet environment with low lighting and use of soft voices, Swaddling, clustering care, use of pacifiers to promote "self-soothing"
Match the action with the appropriate hormone.
The correct answers are: Remains decreased throughout pregnancy = follicle stimulating hormone, Relaxes the uterine muscle = progesterone, Relaxes pelvic ligaments and joints = estrogen, Stimulates contractions = oxytocin, Prepares the breasts for lactation = prolactin
The induction of labor is considered an acceptable obstetric procedure if it is in the best interest to deliver the fetus. The charge nurse on the labor and delivery unit is often asked to schedule clients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction. What are appropriate indications for induction? (Select all that apply)
The correct answers are: Rupture of membranes at or near term, Postterm pregnancy, Fetal death
Reports have linked third trimester use of selective serotonin uptake inhibitors (SSRIs) with a constellation of neonatal signs. The nurse is about to perform an assessment on the infant of a mother with a history of a mood disorder. Which signs and symptoms in the neonate may be the result of maternal SSRI use? (Select all that apply.)
The correct answers are: Shivering, Fever, Irritability
A healthcare provider performs a clinical breast examination on a women diagnosed with fibroadenoma. How would the nurse explain the defining characteristics of a fibroadenoma? (select all that apply)
The correct answers are: Single lump in one breast that can increase in size, Does not increase risk for breast cancer
A health care provider performs a clinical breast examination on a woman diagnosed with fibroadenoma. How would the nurse explain the defining characteristics of a fibroadenoma? (Select all that apply).
The correct answers are: Single lump in one breast that can increase in size., Does not increase risk for breast cancer
Which client(s) should the nurse report to the health care provider? (Select all that apply).
The correct answers are: Small dimple located in the upper outer quadrant of the right breast, One 2-3mm sized mobile, nontender mass in lower outer quadrant of left breast
Which of the following is true about sperm? (select all that apply).
The correct answers are: Sperm can live up to 72 hours in the female reproductive tract, There are approximately 200-500 million sperm with each ejaculation
The client is undergoing treatment for ovarian cancer. Which common nutritional problems are related to gynecologic cancers and the treatment thereof? (Select all that apply.)
The correct answers are: Stomatitis, Constipation, Diarrhea, Nausea and vomiting
Which factors influence cervical dilation? (Select all that apply.)
The correct answers are: Strong uterine contractions, Force of the presenting fetal part against the cervix, Pressure applied by the amniotic sac , Scarring of the cervix
What are some common characteristics of a potential male batterer? (select all that apply)
The correct answers are: Substance abuse problems, Personality disorders
Pain should be regularly assessed in all newborns. If the infant is displaying physiologic or behavioral cues that indicate pain, then measures should be taken to manage the pain. Which interventions are examples of nonpharmacologic pain management techniques? (Select all that apply.)
The correct answers are: Sucrose, Skin-to-skin contact with the mother , Swaddling, Nonnutritive sucking
Which of the following would the nurse explain to the patient about fertilization? (Select all that apply).
The correct answers are: The best place for fertilization to occur is in the ampulla of the fallopian tube, The sperm must travel up the correct fallopian tube to fertilize the egg, After the sperm enters the egg, the egg becomes impenetrable to other sperm, After fertilization, the chromosomes combine for a total of 46
One of the most important components of the physical assessment of the pregnant client is the determination of BP. Consistency in measurement techniques must be maintained to ensure that the nuances in the variations of the BP readings are not the result of provider error. Which techniques are important in obtaining accurate BP readings? (Select all that apply.)
The correct answers are: The client should be seated, The client's arm should be placed at the level of the heart., The same arm should be used for every reading
Which information should nurses provide to expectant mothers when teaching them how to evaluate daily fetal movement counts (DFMCs)? (Select all that apply)
The correct answers are: The fetal alarm signal should go off when fetal movements stop entirely for 12 hours, A count of less than three fetal movements in 1 hour warrants future evaluation.
A couple is undergoing an infertility workup. The semen analysis indicates a decreased number of sperm and immature sperm. Which of the following factors can have a potential effect on sperm maturity? (Select all that apply.)
The correct answers are: The man rides a bike to and from work each day., The man takes a calcium channel blocker for the treatment of hypertension.
27 year old Amy G0 presents to the clinic for a preconceptual visit. Her BMI is 41. What would the nurse include in their education for Amy about pregnancy and a high BMI? (Select all that apply).
The correct answers are: There is increased risk for gestational diabetes., There is increased risk for blood clot in her legs and lungs., There is increased risk for preterm birth.
Pulmonary changes during pregnancy include which of the following? (Select all that apply.)
The correct answers are: Tidal volume increases by 33%, Oxygen consumption increases by 20-40%
A client at 34 weeks of gestation seeks guidance from the nurse regarding personal hygiene. Which information should the nurse provide?
The correct answers are: Tub bathing is permitted even in late pregnancy unless membranes have ruptured., The perineum should be wiped from front to back.
Nursing actions that decrease the risk of skin breakdown include which of the following? (Select all that apply.)
The correct answers are: Using gelled mattresses, Using emollients in dry areas
For which of the following reproductive cancers is high risk HPV infection thought to be primarily responsible? (Select all that apply).
The correct answers are: Vulvar cancer, Cervical cancer, Vaginal cancer
54 y/o Janice has a history of blood clots in her legs when she used birth control pills. Her hot flushes are "driving me crazy". What alternative comfort measures might be appropriate for Janice? (Select all that apply)
The correct answers are: Wear layered clothing, Avoid triggers that bring about hot flushes, Avoid heavy blankets at night
The perinatal nurse is teaching her new mother about breastfeeding and explains that the most appropriate time to breastfeed is:
The correct answers are: When her infant is in a quiet alert state, When her infant is in an active alert state
Which of the following are true regarding chlamydial infection in young women? (Select all that apply).
The correct answers are: Women ages 15-24 have the highest rates of infection, it can increase risk for infertility and ectopic pregnancy, women can have it and have no symptoms
A woman has requested an epidural block for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. Before the initiation of the epidural, the woman should be informed regarding the disadvantages of an epidural block. Which concerns should the nurse share with this client? (Select all that apply)
The correct answers are: ability to move freely is limited, higher body temperature may occur, orthostatic hypotension and dizziness may occur.
Which of the following are milestones in the care of mothers and babies? (Select all that apply)
The correct answers are: abortion is legalized, folic acid is recommended to prevent neural tube defects
According to the CDC,which of the following are significant causes of maternal death in the United States? (Select all that apply).
The correct answers are: cardio-vascular disease, hemorrhage, non-cardiovascular conditions, hypertensive disorders
Which of the following STDs have effective treatment so that a person is no longer infected with the organism? Select all that apply.
The correct answers are: chlamydia, syphilis
Which of the following can provide contraception and protection against sexually transmitted infections? (Select all that apply).
The correct answers are: condoms, abstinence
Ultrasound can be used in antepartum care for which of the following assessments? (Select all that apply).
The correct answers are: fetal growth, placental position and function, adjunct use in chorionic villi sampling (CVS), gestational age
Which of the following is true regarding infertility? (Select all that apply).
The correct answers are: infertility is defined as the inability to achieve pregnancy after a year of unprotected intercourse, anovulation can cause primary and/or secondary infertility
Which of the following are common symptoms for gonorrhea? Select all that apply.
The correct answers are: no symptoms, pelvic pain, rectal discharge
Which of the following are ethical issues regarding genetics/genomics? (Select all that apply)
The correct answers are: privacy and confidentiality of genetic information, discrimination, psychological impact, and stigmatization regarding one's genome, fairness and use of genetic information, informed consent in reproductive issues and genetic testing
Which of the following are functions of the placenta? (Select all that apply)
The correct answers are: provides O2 and nutrients to the fetus, produces hormones, such as progesterone, that helps to relax the uterus, removes CO2 and fetal waste products
Yolanda is 6 weeks pregnant by dates and is considering abortion. What options might be appropriate for her at this point? (Select all that apply).
The correct answers are: surgical abortion with aspiration, medical abortion with mifepristone and misopristol
Pre-surgical nursing care for the woman who is going to have a hysterectomy for ovarian cancer includes which of the following? (Select all that apply).
The correct answers are: teach post-op routine care such as need for early ambulation, administer enema if ordered, ensure lab results are available to the surgeon prior to surgery, identification band is in place
For which of the following conditions is colposcopy used to further evaluate need for intervention? (Select all that apply).
The correct answers are: vaginal cancer, cervical cancer
While performing Leopold's maneuvers on a woman in early labor, the nurse palpates a flat area on the mother's right, a soft mass at the suprapubic bone, a hard round mass on the fundus, and small parts on the mother's left side. The nurse concludes which of the following?
The fetal attitude is breech
While performing Leopold's maneuvers on a woman in early labor, the nurse palpates a soft round mass in the fundal region, a hard round mass just above the symphysis, a small parts on the right side, and a long soft area on the left side. The nurse concludes which of the following?
The fetal presentation is vertex
Susan 39 weeks gestation has been diagnosed with mild preeclampsia and presents to L&D for scheduled induction. Which of the following assessment tools will the nurse use to assess?
Urine dipstick
A nurse is caring for a 2-day-old neonate born at 31 weeks' gestation. The neonate has a diagnosis of respiratory distress syndrome (RDS). Which of the following medical treatments would the nurse anticipate for this neonate? (Select all that apply.)
Answer: 1) umbilical artery and vein catheters 2)Nasal continuous positive airway pressure (NCPAP) 3) Continuous pulse oximetry
A pregnant woman wants to breastfeed her infant however, her husband is not convinced that there are any scientific reasons to do so. The nurse can give the couple printed information comparing breastfeeding and bottle feeding. Which statement regarding bottle feeding using commercially prepared infant formulas might influence their choice?
Answer: Bottle feeding using a commercially prepared formula increases the risk that the infant will develop allergies
The nurse who elects to work in the specialty of obstetric care must have the ability to distinguish between preterm birth, preterm labor, and low birth weight. Which statement regarding this terminology is correct?
Answer: Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation.
The nurse is advising parents of a full-term neonate being discharged from the hospital regarding car seat safety. Which of the following should be included in the teaching plan?
Answer: Put the car seat facing forward only after the baby reaches 20 pounds EXPLANATION: infants are safest when secured in the back seat. Rear-facing car seats are used with infants until they are 1 year of age and weigh 20 pounds. It is never safe to leave an infant unattended in a car seat and car seats should be used whenever traveling in a motor vehicle
Despite warnings, prenatal exposure to alcohol continues to far exceed exposure to illicit drugs. Which condition is rarely associated with fetal alcohol syndrome (FAS)?
Answer: Respiratory conditions
Jennifer is a 32 year old lawyer 37 weeks pregnant with her first child. She tells you that she has been on Paroxetine (an SSRI) for anxiety throughout her pregnancy. She asks you if she needs to worry about any side effects for her baby. Your best response would be:'
Answer: SSRI are commonly used for the management of depression and anxiety in pregnant woman. SSRI use during the last trimester of pregnancy has been associated with symptoms in the baby very similar to clinical signs of Neonatal Abstinence Syndrome (NAS). The onset of clinical signs for infants exposed to SSRIs range from several hours after birth to several days after birth, with symptomatology lasting 1-2 weeks after birth
A primigravida at 40 weeks of gestation is having uterine contractions every 1 ½ to 2 minutes and states that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman's labor?
Answer: She is exhibiting hypertonic uterine dysfunction
Painful nipples are a major reason why women stop breastfeeding. A primary intervention to decrease nipple irritation is:
Answer: Teaching proper techniques for latching-on and releasing suction EXPLANATION: while all these interventions are correct, the primary intervention is to ensure correct latching-on and suction release as problems with these lead to early cessation of breastfeeding
The perinatal nurse teaches the postpartum woman about warning signs regarding development of postpartum infection. Signs and symptoms that merit assessment by the health-care provider include the development of a fever and:
Answer: Uterine tenderness Heat loss through radiation can be reduced by: (Select all that apply);Answer: 1) Providing skin-to-skin contact with the mother and covering both with a warm blanket when the room temperature is cool 2) Placing crib near a warm wall
A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. Which findings should the nurse include in the discussion? (Select all that apply.)
Answers: 1) Breast tenderness 2) Fever and flulike symptoms 3)Warmth in the breast
Typical signs of abusive head trauma (AHT, also known as Shaken Baby Syndrome) include which of the following? (select all that apply.)
Answers: 1) poor feeding 2)Vomiting 3)Breathing problems
Which of the following are indications for cesarean birth? (Select all that apply)
Answers: 1) previous cesarean birth 2)Placental abnormalities 3) previous uterine surgery 4) Failure to progress in labor
Trina who is 32 weeks pregnant is brought to the ER following an MVC with multiple injuries. What should the ER team do first?
Assess Trina's injuries
What is the first action the nurse performs when jaundice is noted in a neonate who is 32 hours old?
Assess for hyperbilirubinemia per provider's order
Sandra is 25 weeks pregnant and tells the nurse she is smoking marijuana. What is the nurse's first action?
Assess her readiness to change her behavior
A laboring patient received an epidural 5 minutes ago. What is the nurse's priority action?
Monitor maternal blood pressure
A woman seeks care at an infertility clinic. Which of the following tests may this woman undergo to determine what, if any, infertility problem she may have? (Select all that apply.)
Select one or more: The correct answers are: Endometrial biopsy, Hysterosalpingogram, Serum FSH analysis
Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth?
The correct answer is: "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles."
A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this woman's fundus?
The correct answer is: 1 centimeter above the umbilicus
The nurse is performing an initial assessment of a client in labor. What is the appropriate terminology for the relationship of the fetal body parts to one another?
The correct answer is: Attitude
A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse?
The correct answer is: Dipstick value of 3+ for protein in her urine
Which action is the first priority for the nurse who is assessing the influence of culture on a client's diet?
The correct answer is: Identify the food preferences and methods of food preparation common to the client's culture
What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant?
The correct answer is: Intrauterine growth restriction
The nurse has evaluated a client with preeclampsia by assessing DTRs. The result is a grade of 3+. Which DTR response most accurately describes this score?
The correct answer is: More brisk than expected, slightly hyperactive
A woman at 28 weeks of gestation experiences blunt abdominal trauma as the result of a fall. The nurse must closely observe the client for what?
The correct answer is: Placental abruption
What is the primary rationale for the thorough drying of the infant immediately after birth?
The correct answer is: Reduces heat loss from evaporation
What is the primary difference between the labor of a nullipara and that of a multipara?
The correct answer is: Total duration of labor
What is the most common cause of birth defects in humans?
The correct answer is: Unknown causes
The nurse providing care for a high-risk laboring woman is alert for late FHR decelerations. Which clinical finding might be the cause for these late decelerations?
The correct answer is: Uteroplacental insufficiency
Strategies for culturally responsive care include (select all that apply)
The correct answers are: Examining one's own biases, Learning another language
Which of the following is effective treatment for dysmenorrhea? (Select all that apply).
The correct answers are: Oral contraceptive pills, NSAIDs
During labor induction with oxytocin, the fetal heart rate baseline is in the 120s with minimal variability. Contraction frequency is assessed to be every 1-2 minutes with duration of 60 seconds, of moderate strength to palpation. Based on this assessment, the nurse should take which action?
Decrease oxytocin infusion rate by 2 mU/min and report to provider
Mary has just been told that the results of her breast biopsy demonstrate that she has breast cancer. Which of the following nursing diagnosis is most appropriate for the nurse to address with Mary during this visit?
Fear and/or anxiety r/t diagnosis of breast cancer
28 y/o G22002 female presents to the clinic with c/o a soft lump in her right breast. She states it changes with her cycle and is more pronounced the week before her period. She has noticed it for 3 months. What is the nurse's first impression?
Fibrocystic changes
Susan and Bill, both 39 years old, have been trying to get pregnant for 6 months with no success. Bill has fathered 2 children from another relationship and his youngest is 13 y/o. Susan has had no pregnancies but has had irregular periods for years. Which of the following will the nurse ask Susan next while taking a health history?
Have you considered infertility workup?
Susan and Bill, both 23 years old, have been trying to get pregnant for 6 months with no success. Bill has fathered 2 children from another relationship and his youngest is 3 y/o. Susan has had no pregnancies but has regular monthly periods. Which of the following will the nurse ask Susan next while taking a health history?
Have you practiced "timed-sex'?
Audra is G101001 and considering getting pregnant again. Her first baby was born at 29 weeks. Which of the following statements demonstrates the most need for further education?
If I do not smoke or drink alcohol, my baby won't be born early
The nurse is teaching parents about metabolic screening for the newborn. Which statement is most helpful to these clients?
If genetic screening is performed before the infant is 24 hours old, then it should be repeated at age 1-2 weeks.
Alena is 30 weeks pregnant and her cervix is dilated to 3/80/-2. Which of the following medications does the nurse expect the physician will order?
Magnesium sulfate
The clinic nurse talks with Kathy about her possible pregnancy. Kathy has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. These symptoms are best described as:
Presumptive signs of pregnancy
25 y/o Nancy G30020 is 38 weeks pregnant and presents to L&D stating that she has not felt the baby move for approx 24 hours. Which of the following should the nurse assess? (select all that apply)
Problems during the pregnancy, Maternal vital signs, Auscultate FHTs, Maternal medical problems, Use of drugs during pregnancy
Infants born between 34 0/7 and 36 6/7 weeks of gestation are called latepreterm infants because they have many needs similar to those of preterm infants. Because they are more stable than early-preterm infants, they may receive care that is similar to that of a full-term baby. These infants are at increased risk for which conditions?
Problems with thermoregulation, Sepsis, Hyperbilirubinemia
Supportive care of the infant with neonatal abstinence syndrome (NAS) include both pharmacologic and nonpharmacologic therapy. These therapies would include which of the following:
Swaddling, clustering care, use of pacifiers to promote "self-soothing", Use of tincture of morphine, Quiet environment
Angie is an ER nurse. Her patient complains of a 'painless sore down there' for the last 5 days. The physician diagnoses syphilis and asks Angie to look up the medication to treat the patient. Angie knows the best resource to find this information is:
The CDC's STDs Treatment Guidelines 2015
Abruptio placenta is a risk factor for amniotic fluid embolism.
The correct answer is 'True'. Risk factors for amniotic fluid embolism include induction of labor, maternal age over 35, operative delivery, placenta previa, abruptio placenta, polyhydramnios, eclampsia, and cervical or uterine lacerations.
The clinic nurse understands the meaning of the following terms related to pregnancy care. Match these terms with the definitions listed below:
The correct answer is Blotchy, brownish hyperpigmentation of the skin of cheeks, nose and forehead. → Melasma Pigmented line extending from the symphysis pubis to the top of the fundus → Linea nigra Stretch marks → Striae gravidarum Mother's experience that her baby has 'dropped' into the pelvis → Lightening Passive movement of the unengaged fetus → Ballottement
Alison tells the nurse she is concerned her health insurance company will raise her premiums if they find out her baby tests positive for a single gene mutation, such as cystic fibrosis. The nurse tells Allison about which of the following laws that protects her from such genetic discrimination?
The correct answer is Genetic Information Nondiscrimination ACT (GINA)
A NICU nurse is caring for a full-term neonate being treated for group B streptococcus (GBS). The mother of the neonate is crying and shares that she cannot understand how her baby became infected. The best response by the nurse is:
The correct answer is: "Approximately 15% to 40% of women have no symptoms but are carriers of group B streptococcus which is found in the vaginal and lower intestinal areas. What other questions do you have regarding your baby's health?"
After the Nurse Practitioner treats a 25 y/o's Bartholin cyst with incision and drainage procedure (I&D), the nurse is providing take-home instructions. The patient asks, "Will this happen again?" The nurse's best response is:
The correct answer is: "Bartholin cysts can recur. There is another procedure that can be done to reduce risk for recurrence.Would you like to talk to the NP about it?"
Susie is 9 weeks pregnant (based on her last menstrual period) on her first prenatal visit. She tells the nurse she smoked marijuana approx 2 months ago but denies any use since then. She asks "will this hurt my baby?" The nurse's best response is:
The correct answer is: "Based on your last menstrual period, the risk of harm to your baby from smoking marijuana at that time is very low."
23 y/o Amy delivered a baby 2 months ago and presents to the clinic with complaint of stool coming out of her vagina for the past week. The nurse suspects recto-vaginal fistula. What is the next most appropriate question the nurse should ask Amy?
The correct answer is: "Did you deliver your baby vaginally?"
During a prenatal visit, the nurse is explaining dietary management to a woman with pregestational diabetes. Which statement by the client reassures the nurse that teaching has been effective?
The correct answer is: "Diet and insulin needs change during pregnancy."
To provide culturally competent care to an Asian-American family, which question should the nurse include during the assessment interview?
The correct answer is: "Do you prefer hot or cold beverages?"
A primigravida has just delivered a healthy infant girl. The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks, "What is that medicine for?" How should the nurse respond
The correct answer is: "Erythromycin is prophylactically given to prevent a gonorrheal infection."
A new father is ready to take his wife and newborn son home. He proudly tells the nurse who is discharging them that within the next week he plans to start feeding the infant cereal between breastfeeding sessions. Which information should the nurse provide regarding this feeding plan?
The correct answer is: "Feeding solid foods between breastfeeding sessions before your son is 4 to 6 months old will lead to an early cessation of breastfeeding."
A new mother wants to be sure that she is meeting her daughter's needs while feeding the baby commercially prepared infant formula. The nurse should evaluate the mother's knowledge about appropriate infant feeding techniques. Which statement by the client reassures the nurse that correct learning has taken place?
The correct answer is: "I burp my daughter during and after the feeding as needed."
Which symptom described by a client is characteristic of premenstrual syndrome (PMS)?
The correct answer is: "I feel irritable and moody a week before my period is supposed to start."
Pelvic floor exercises, also known as Kegel exercises, will help to strengthen the perineal muscles and encourage healing after childbirth. The nurse requests the client to repeat back instructions for this exercise. Which response by the client indicates successful learning?
The correct answer is: "I pretend that I am trying to stop the flow of urine in midstream."
47 y/o Sallie is interested in HRT for her hot flashes and vaginal dryness. She has high blood pressure and her LMP was 3 months ago. She asks the nurse what can she use? What is the nurse's best response?
The correct answer is: "It would be best to talk to the health care provider to determine what type of HRT might be best for you."
A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. What is the nurse's ideal response?
The correct answer is: "It's normal to be anxious about labor. Let's discuss what makes you afraid."
Jenny, a 21-year-old single woman, comes for her first prenatal appointment at 31 weeks' gestation with her first pregnancy. The clinic nurse's most appropriate statement is:
The correct answer is: "Jenny, by your information, you are 31 weeks' gestation in this pregnancy. Do you have questions for me before I begin your prenatal history and information sharing?"
A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in the next few months. Which guidance should she expect to receive?
The correct answer is: "Make sure you include adequate folic acid in your diet."
When the nurse is alone with a battered client, the client seems extremely anxious and says, "It was all my fault. The house was so messy when he got home, and I know he hates that." What is the most suitable response by the nurse?
The correct answer is: "No one deserves to be hurt. It's not your fault. How can I help you?"
A first-time mother is concerned about the type of medications she will receive during labor. The client is in a fair amount of pain and is nauseated. In addition, she appears to be very anxious. The nurse explains that opioid analgesics are often used along with sedatives. How should the nurse phrase the rationale for this medication combination?
The correct answer is: "Sedatives enhance the effect of the pain medication."
A woman with worsening preeclampsia is admitted to the hospital's labor and birth unit. The physician explains the plan of care for severe preeclampsia, including the induction of labor, to the woman and her husband. Which statement by the husband leads the nurse to believe that the couple needs further information?
The correct answer is: "Since we will be here for a while, I will call my mother so she can bring the two boys—2 years and 4 years of age—to visit their mother."
Which statement by the client would lead the nurse to believe that labor has been established?
The correct answer is: "The contractions in my uterus are getting stronger and closer together."
The client is being induced in response to worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active, despite several hours of oxytocin administration. She asks the nurse, "Why is this taking so long?" What is the nurse's most appropriate response?
The correct answer is: "The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor."
A perinatal nurse is giving discharge instructions to a woman, status postsuction, and curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. What is the best response by the nurse?
The correct answer is: "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, then it would make the diagnosis of this cancer more difficult."
Your pregnant patient is in her first trimester and is scheduled for an ultrasound. When explaining the rationale for early pregnancy ultrasound, the best response is:
The correct answer is: "The test will help to determine how many weeks you are pregnant."
A client is in early labor, and her nurse is discussing the pain relief options she is considering. The client states that she wants an epidural "no matter what!" What is the nurse's best response?;
The correct answer is: "The type of analgesia or anesthesia used is determined, in part, by the stage of your labor and the method of birth. It is really too early."
While taking a family history, 37 y/o Bernice tells the nurse her paternal grandmother had breast and colon cancer in her 60's, two paternal aunts had breast cancer in their 40's, one of those aunts also had ovarian cancer in her 40's, one paternal uncle had colon cancer in his 40's, her paternal cousin has breast cancer in her 40's, and her father had colon cancer in his 40's. She denies cancer on her mother's side of the family. Bernice states she has 2 younger sisters. Which of the following responses would be best for the nurse to say to Bernice about her reported family history?
The correct answer is: "The types of cancers reported on your father's side of the family may be due to a gene mutation that can be passed onto to each generation. Have any of your relatives or you considered genetic testing?"
A newborn in the neonatal intensive care unit (NICU) is dying as a result of a massive infection. The parents speak to the neonatologist, who informs them of their son's prognosis. When the father sees his son, he says, "He looks just fine to me. I can't understand what all this is about." What is the most appropriate response or reaction by the nurse at this time?
The correct answer is: "This must be a difficult time for you. Tell me how you're doing."
Which options for saying "good-bye" would the nurse want to discuss with a woman who is diagnosed with having a stillborn girl?
The correct answer is: "When your baby is born, would you like to see and hold her?"
A healthy 60-year-old African-American woman regularly receives health care at her neighborhood clinic. She is due for a mammogram. At her first visit, her health care provider is concerned about the 3-week wait at the neighborhood clinic and made an appointment for her to have a mammogram at a teaching hospital across town. She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure. What is the most appropriate statement for the nurse to make to this client?
The correct answer is: "Would you like me to make an appointment for you to have your mammogram here?"
On day 3 of life, a newborn continues to require 100% oxygen by nasal cannula. The parents ask if they may hold their infant during his next gavage feeding. Considering that this newborn is physiologically stable, what response should the nurse provide?
The correct answer is: "You may hold your baby during the feeding."
Sally is 34 weeks pregnant and has a biophysical profile score of 8. She asks the nurse what does that mean? The nurse's best response is:
The correct answer is: "Your baby has low risk for having a problem having enough oxygen in her body and your doctor will probably want to do the test again soon. I will call your doctor. "
What is the risk for all pregnancies to have a fetus with minor birth defects?
The correct answer is: 10-15%
Sandy G21001 is 41 weeks pregnant and presents to L&D for induction. The physician orders Pitocin to be infused at 2mU/min. The IV bag is LR 1000mL with 10 units of Pitocin. The infusion pump delivers ___mL/hour. How will the nurse program the infusion pump to deliver the medication as ordered?
The correct answer is: 12 mL/hour
The nurse is assessing a full term, quiet, and alert newborn. What is the average expected apical pulse range (in beats per minute)?
The correct answer is: 120 to 160
A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 29. What is this client's total recommended weight gain during pregnancy?
The correct answer is: 15- 25 pound
Which woman is at the greatest risk for psychologic complications after hysterectomy?
The correct answer is: 19-year-old woman who had a ruptured uterus after giving birth to her first child
During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from:
The correct answer is: 2 to 8 weeks. During organogenesis, the embryo is extremely vulnerable to teratogens such as medications, alcohol, tobacco, caffeine, illegal drugs, radiation, heavy metals, and maternal (TORCH) infections. Structural fetal defects are most likely to occur during this period because exposure to teratogens either before or during a critical period of development of an organ can cause a malformation
The nurse who is assessing a G2 P1 palpates the fundal height at the location noted on the picture below.
The correct answer is: 20 weeks
The clinic nurse is aware that the pregnant woman's blood volume increases by:
The correct answer is: 40% to 45%
At 1 minute after birth a nurse assesses an infant and notes a heart rate of 80 beats per minute, some flexion of extremities, a weak cry, grimacing, and a pink body but blue extremities. Which Apgar score does the nurse calculate based upon these observations and signs?
The correct answer is: 5
Mary G10000 is 38 weeks pregnant and has been diagnosed with severe preeclampsia. The physician orders magnesium sulfate infusion for Mary, which includes a maintenance dose of 2 grams/hr. Her IV is a premixed magnesium sulfate solution of 40grams per 1000mL. What will the nurse program the infusion pump to deliver 2 grams/hr?
The correct answer is: 50 mL/hr
A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. The client shows the nurse her readings for the past few days. Which reading signals the nurse that the client may require an adjustment of insulin or carbohydrates?
The correct answer is: 50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep.
A nulliparous woman has just begun the latent phase of the second stage of her labor. The nurse should anticipate which behavior?
The correct answer is: A nulliparous woman will remain quiet with her eyes closed between contractions.
Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa. The signs of NEC are nonspecific. What are generalized signs and symptoms of this condition?
The correct answer is: Abdominal distention, temperature instability, and grossly bloody stools
A postmenopausal woman has been diagnosed with two leiomyomas (fibroids). Which clinical finding is most commonly associated with the presence of leiomyomas?
The correct answer is: Abnormal uterine bleeding
Which term is an accurate description of the process by which people retain some of their own culture while adopting the practices of the dominant society?
The correct answer is: Acculturation
Nurses can help their clients by keeping them informed about the distinctive stages of labor. Which description of the phases of the first stage of labor is accurate?;
The correct answer is: Active: More progress in rate of descent of presenting part
A client is diagnosed with having a stillborn infant. At first, she appears stunned by the news, cries a little, and then asks the nurse to call her mother. What is the proper term for the phase of bereavement that this client is experiencing?
The correct answer is: Acute distress
Maternal nutritional status is an especially significant factor of the many that influence the outcome of pregnancy. Why is this the case?
The correct answer is: Adequate nutrition is an important preventive measure for a variety of problems.
A pregnant woman arrives at the birth unit in labor at term, having had no prenatal care. After birth, her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. Based on her infant's physical findings, this woman should be questioned about her use of which substance during pregnancy?
The correct answer is: Alcohol
Which substance, when abused during pregnancy, is the most significant cause of cognitive impairment and dysfunction in the infant?
The correct answer is: Alcohol
Intimate partner violence (IPV) against women consists of actual or threatened physical or sexual violence and psychological and emotional abuse. Screening for IPV during pregnancy is recommended for
The correct answer is: All pregnant women
A 25-year-old gravida 1 para 1 who had an emergency cesarean birth 3 days ago is scheduled for discharge. As the nurse prepares her for discharge, she begins to cry. The nurse's next action should be what?
The correct answer is: Allow her time to express her feelings.
Tobacco use during pregnancy is associated with adverse effects on the unborn infant such as intrauterine growth restriction, preterm births, and respiratory problems. By race, which has the highest percentages of smokers?
The correct answer is: American Indian and Alaskan Natives.
A pregnant woman informs the nurse that her last normal menstrual period was on July 6, 2017. Using Naegele's rule, which of the following would the nurse determine to be the patient's estimated date of delivery (EDC)?
The correct answer is: April 13, 2018
A 3.8-kg infant was vaginally delivered at 39 weeks after a 30-minute second stage. A nuchal cord was found at delivery. After birth, the infant is noted to have petechiae over the face and upper back. Which information regarding petechiae is most accurate and should be provided to the parents?
The correct answer is: Are benign if they disappear within 48 hours of birth
When a nulliparous woman telephones the hospital to report that she is in labor, what guidance should the nurse provide, or information should the nurse obtain?
The correct answer is: Ask the woman to describe why she believes she is in labor.
A thorough abuse assessment screen should be completed on all female clients. This screen should include which components? (Select all that apply)
The correct answer is: Asking the client if she is afraid of her partner, Asking the client if she has been forced to perform sexual acts, Asking the client if she has ever been slapped/kicked/punched/or physically hurt by her partner
The perinatal nurse providing care to a laboring woman recognizes a Category II fetal heart rate tracing. The most appropriate initial action for uterine resuscitation is to:
The correct answer is: Assist the laboring woman to change her position. Category II tracings are indeterminate and call for increased vigilance. The initial step in intrauterine resuscitation is a change in maternal position. If no improvement is seen in the FHR tracing, other resuscitation measures are indicated such as IV fluid bolus and the use of oxygen. Following resuscitation, document all findings and interventions. Keep obstetric providers aware of nursing actions and results.
The nurse uses the external electronic fetal heart monitor to evaluate fetal status. The fetal heart tracing shows accelerations. Accelerations in the fetal heart are:
The correct answer is: Associated with fetal well-being and adequate oxygenation
An infant boy was delivered minutes ago. The nurse is conducting the initial assessment. Part of the assessment includes the Apgar score. When should the Apgar assessment be performed?
The correct answer is: At least twice, 1 minute and 5 minutes after birth
According to the American Cancer Society, which of the following is true about screening mammogram?
The correct answer is: Average-risk women should begin screening mammogram at 45 y/o
Primary prevention of Pelvic inflammatory disease or PID, includes which of the following?
The correct answer is: Avoid getting STDs, such as chlamydia and gonorrhea
The nurse is developing a plan of care for a African American client who just delivered a newborn. Which cultural variation is most important to include in the care plan?
The correct answer is: Avoid offering tub baths and shampooing after delivery.
Which of the following is considered to be a "reassuring" or Category 1 Fetal Heart Rate (FHR) pattern?
The correct answer is: Baseline rate of 110-160; moderate variability; presence of accelerations; absence of decelerations. A "reassuring" or Category 1 FHR pattern is defined as: baseline rate of 110-160 beats per minute (bpm); moderate variability; presence of accelerations; absence of decelerations.
The nurse knows that a FHR monitor printout indicates a Category III abnormal fetal heart rate pattern when:
The correct answer is: Baseline variability is minimal or absent with decelerations.
Which statement related to fetal positioning during labor is correct and important for the nurse to understand?
The correct answer is: Birth is imminent when the presenting part is at +4 to +5 cm below the ischial spine. The nurse has received a report regarding a client in labor. The woman's last vaginal examination was recorded as 3 cm, 30%, and -2. What is the nurse's interpretation of this assessment?;The correct answer is: Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines.
The symptoms of mild to moderate urinary incontinence can be successfully decreased by a number of strategies. Which of these should the nurse instruct the client to use first?
The correct answer is: Bladder training and pelvic muscle exercises or Kegels
An ultrasound of a fetus' heart shows that "normal fetal circulation is occurring." Which of the following statements is consistent with the finding?
The correct answer is: Blood is seen moving from the right to left atria. High levels of oxygenated blood enter the fetal circulatory system from the placenta vial the umbilical vein. The foramen ovale, an opening between the right and left atria, allow for oxygenated blood to be shunted right to left, or move from the right to left atria. Deoxygenated blood returns to the placenta via the umbilical arteries.
Susie is 19 y/o and presents to the clinic for her well-woman exam. She denies any problems or family history of cancer. Which of the following are recommended for Susie? (select all that apply).
The correct answer is: Blood pressure
A patient at 28 weeks' gestation was last seen in the prenatal clinic at 24 weeks' gestation. Which of the following changes should the nurse bring to the attention of the Certified Nurse Midwife?
The correct answer is: Blood pressure change from 110/70 to 140/90
Which of the following is an indication for the administration of methylergonovine (Methergine)?
The correct answer is: Boggy uterus that does not respond to massage and oxytocin therapy
In providing counseling to pregnant women, the nurse can include information on the components of weight gain during pregnancy and the amount of weight that will be lost after the birth. Match the tissues contributing to maternal weight gain at 40 weeks of gestation with the approximate amount of weight gain in kilograms.
The correct answer is: Breast tissue → 0.5 to 1.8 Amniotic fluid → 0.9 Fetus → 3.2 to 3.9 Placenta → 0.9 to 1.1 Blood volume → 1.8 to 2.3
A nurse is reviewing diet with a pregnant woman in her second trimester. Which of the following foods should the nurse advise the patient to avoid consuming during her pregnancy?
The correct answer is: Brie cheese
A nurse is providing discharge teaching to the parents of a 2-day-old neonate. Which of the following information should be included in the discharge teaching on umbilical cord care?
The correct answer is: Call the provider if greenish discharge appears.
The nurse is caring for a client in early labor. Membranes ruptured approximately 4 hours earlier. What should the nurse implement to detect potential complication?
The correct answer is: Check temperature for intrauterine infection
Which statement is not an expected outcome for the client who attends a reputable childbirth preparation program?
The correct answer is: Childbirth preparation programs guarantee a pain-free childbirth.
A mother refused to allow her son to receive the vitamin K injection at birth. Which of the following signs or symptoms might the nurse observe in the baby as a result?
The correct answer is: Circumcision site oozes blood.
Preconception counseling is critical in the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy?
The correct answer is: Congenital anomalies in the fetus
The perinatal nurse explains to the student nurse that _______ is the leading cause of neonatal death in the United States
The correct answer is: Congenital malformations --The leading causes of neonatal deaths (in order) are: 1) congenital malformations; 2) disorders related to short gestation and low birth weight; and 3) sudden infant death syndrome
A postpartum client is concerned that her breasts are engorged and uncomfortable. What is the nurse's explanation for this physiologic change?
The correct answer is: Congestion of veins and lymphatic vessels
Health promotion includes contraception for which of the following reasons?
The correct answer is: Contraception can positively affect future health.
In appraising the growth and development potential of a preterm infant, the nurse should be cognizant of the information that is best described in which statement?
The correct answer is: Correct for milestones, such as motor competencies and vocalizations, until the child is approximately 2 years of age.
The clinic nurse visits with Wayne, a 32-year-old man whose partner is pregnant for the first time and is at 12 weeks. Wayne describes nausea and vomiting, fatigue, and weight gain. His symptoms are best described as:
The correct answer is: Couvade syndrome
Which clinical findings would alert the nurse that the neonate is expressing pain?
The correct answer is: Cry face; eyes squeezed; increase in blood pressure
Information provided by the nurse that addresses the function of the amniotic fluid is that the amniotic fluid helps the fetus to maintain a normal body temperature and also:
The correct answer is: Cushions the fetus from mechanical injury. Amniotic fluid is contained within the amniotic sac. Amniotic fluid acts as a cushion for the fetus, allows freedom of fetal movement and symmetrical growth, provides for oral fluid and excretion of water, acts as a barrier to infection, allows for lung development, and provides a consistent thermal environment.
A client in late middle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems, as well as sensations of bearing down and of something in her vagina. What condition would the nurse suspect based upon this report?
The correct answer is: Cystocele and/or rectocele
An 18-year-old client who has reached 16 weeks of gestation was recently diagnosed with pregestational diabetes. She attends her centering appointment accompanied by one of her girlfriends. This young woman appears more concerned about how her pregnancy will affect her social life than her recent diagnosis of diabetes. A number of nursing diagnoses are applicable to assist in planning adequate care. What is the most appropriate diagnosis at this time?
The correct answer is: Deficient knowledge, related to diabetic pregnancy management
Which statement concerning the complication of maternal diabetes is the most accurate?
The correct answer is: Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy.
If nonsurgical treatment for late PPH is ineffective, which surgical procedure would be appropriate to correct the cause of this condition?
The correct answer is: Dilation and curettage (D&C)
When assessing a woman in the first stage of labor, which clinical finding will alert the nurse that uterine contractions are effective?
The correct answer is: Dilation of the cervix
Which statement best describes the rationale for the physiologic anemia that occurs during pregnancy?
The correct answer is: Dilution of hemoglobin concentration occurs in pregnancy with physiologic anemia.
A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The FHR has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. What disposition would the nurse anticipate?
The correct answer is: Discharged home to await the onset of true labor
The nurse is teaching a client with preterm premature rupture of membranes (PPROM) regarding self-care activities. Which activities should the nurse include in her teaching?
The correct answer is: Do not engage in sexual activity.
The uterine contractions of a woman early in the active phase of labor are assessed by an internal uterine pressure catheter (IUPC). The uterine contractions occur every 3 to 4 minutes and last an average of 55 to 60 seconds. They are becoming more regular and are moderate to strong. Based on this information, what would a prudent nurse do next?
The correct answer is: Document the findings because they reflect the expected contraction pattern for the active phase of labor.
A number of metabolic changes occur throughout pregnancy. Which physiologic adaptation of pregnancy will influence the nurse's plan of care?
The correct answer is: During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus.
When caring for a pregnant woman with cardiac problems, the nurse must be alert for the signs and symptoms of cardiac decompensation. Which critical findings would the nurse find on assessment of the client experiencing this condition?
The correct answer is: Dyspnea, crackles, and an irregular, weak pulse
To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet?
The correct answer is: Eat her meals and snacks on a fixed schedule.
A woman in the 34th week of pregnancy reports that she is very uncomfortable because of heartburn. Which recommendation would be appropriate for this client?
The correct answer is: Eat several small meals a day
The nurse should be aware of what important information regarding systemic analgesics administered during labor?
The correct answer is: Effects on the fetus and newborn can include decreased alertness and delayed sucking.
When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. Which instruction best describes these measures?
The correct answer is: Encouraging the woman to try various upright positions, including squatting and standing
When assisting the mother, father, and other family members to actualize the loss of an infant, which action is most helpful?
The correct answer is: Ensuring the baby is clothed or wrapped if the parents choose to visit with the baby
A premature infant never seems to sleep longer than an hour at a time. Each time a light is turned on, an incubator closes, or people talk near her crib, she wakes up and inconsolably cries until held. What is the correct nursing diagnosis beginning with "ineffective coping, related to"?
The correct answer is: Environmental stress
All pregnant women should be instructed to recognize and report potential complications for each trimester of pregnancy. Match the sign or symptom with a possible cause.
The correct answer is: Epigastric pain in late pregnancy → Hypertension, preeclampsia, Decreased fetal movement → Fetal jeopardy or intrauterine fetal death, Severe backache and flank pain → Kidney infection or stones, Severe vomiting in early pregnancy → Hyperemesis gravidarum, Glycosuria → Gestational diabetes
The perinatal nurse teaches the postpartum woman about the normal process of diuresis that she can expect to occur approximately 6 to 8 hours after birth. A decrease in which of the following hormones is primarily responsible for the diuresis?
The correct answer is: Estrogen
What information is important for the nurse to include in planning for the care of a woman who has had a vaginal hysterectomy (no oopherectomy) for fibroids?
The correct answer is: Expect no changes in her hormone levels.
A woman who is gravida 3 para 2 arrives on the intrapartum unit. What is the most important nursing assessment at this time?
The correct answer is: FHR, maternal vital signs, and the woman's nearness to birth
A woman presents to a prenatal clinic appointment at 10 weeks' gestation, in the first trimester of pregnancy. Which of the following symptoms would be considered a normal finding at this point in pregnancy?
The correct answer is: Fatigue
A full-term neonate who is 30 hours old has a bilirubin level of 10 mg/dL. The neonate has a yellowish tint to the skin of the face. The mother is breastfeeding her newborn. The nurse caring for this neonate would anticipate which of the following interventions?
The correct answer is: Feeding neonate every 2 to 3 hours
Certain changes stimulate chemoreceptors in the aorta and carotid bodies to prepare the fetus for initiating respirations immediately after birth. Which change in fetal physiologic activity is not part of this process?
The correct answer is: Fetal respiratory movements increase during labor.
The clinic nurse uses Leopold maneuvers to determine the fetal lie, presentation, and position. The nurse's hands are placed on the maternal abdomen to gently palpate the fundal region of the uterus. This action is best described as the:
The correct answer is: First maneuver
Through a vaginal examination, the nurse determines that a woman is 4 cm dilated. The external fetal monitor shows uterine contractions every 3½ to 4 minutes. The nurse reports this as what stage of labor?
The correct answer is: First stage, active phase
Which collection of risk factors will most likely result in damaging lacerations, including episiotomies?
The correct answer is: First-time mother with reddish hair whose rapid labor was overseen by an obstetrician
The nurse is using the New Ballard Scale to determine the gestational age of a newborn. Which assessment finding is consistent with a gestational age of 40 weeks?
The correct answer is: Flexed posture
Which statement, related to the reconditioning of the urinary system after childbirth, should the nurse understand?
The correct answer is: Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium.
When assessing the apical pulse (point of maximal impulse: PMI) of the neonate, the stethoscope should be placed at the:
The correct answer is: Fourth intercostal space
As the tocodynamometer (Toco) is placed on the laboring patient's abdomen, the nurse explains that this monitoring device provides information on which of the following?
The correct answer is: Frequency of contractions
A woman's position is an important component of the labor progress. Which guidance is important for the nurse to provide to the laboring client?
The correct answer is: Frequent changes in position help relieve fatigue and increase the comfort of the laboring client.
A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization, the infant is weighed, and the birth weight is 4550 g (9 lb, 6 oz). What is the nurse's first priority?
The correct answer is: Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia.
A nurse is performing an assessment on a pregnant woman during a prenatal visit. Which of the following findings would lead the nurse to report to the obstetrician that the patient may be experiencing intrauterine growth restriction (IUGR)?
The correct answer is: Fundal height measurement: 22 cm at 26 weeks' gestation
A woman presents to the clinic complaining of nausea and LMP was 2 months ago. Her pregnancy test is positive. The nurse takes the following information from the patient about her history of pregnancy. She miscarried at 8 weeks, delivered her second baby at 39 weeks and she is alive, delivered her second baby at 32 weeks and he is doing well, and had a stillbirth at 17 weeks.
The correct answer is: G5 T1 P1 A2 L2
The nurse is teaching the parents of a 1-day-old baby how to give their baby a bath. Which of the following actions should be included?
The correct answer is: Gather all supplies before beginning the bath.
A nurse caring for a family during a loss might notice that a family member is experiencing survivor guilt. Which family member is most likely to exhibit this guilt?
The correct answer is: Grandparents
A pregnant woman's diet may not meet her increased need for folates. Which food is a rich source of this nutrient?
The correct answer is: Green leafy vegetables
A baby boy was just born to a mother who had positive vaginal cultures for group B streptococci. The mother was admitted to the labor room 30 minutes before the birth. For which of the following should the nursery nurse closely observe this baby?
The correct answer is: Grunting
When a woman is diagnosed with postpartum depression (PPD) with psychotic features, what is the nurse's primary concern in planning the client's care?
The correct answer is: Harming her infant
A nurse is providing breast care education to a client after mammography. Which information regarding fibrocystic changes in the breast is important for the nurse to share?
The correct answer is: Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles.
A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is approximately twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. Which intervention should the nurse immediately initiate?
The correct answer is: Help her breathe into a paper bag.
The nurse is working in a prenatal clinic caring for a patient at 13 weeks' gestation, G21001. Which of the following findings should the nurse highlight for the nurse midwife?
The correct answer is: Hematocrit of 29%
The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a platelet count of 90,000 mm3, an elevated aspartate aminotransaminase (AST) level, and a falling hematocrit. The laboratory results are indicative of which condition?
The correct answer is: Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome
To explain hemolytic disorders in the newborn to new parents, the nurse who cares for the newborn population must be aware of the physiologic characteristics related to these conditions. What is the most common cause of pathologic hyperbilirubinemia?
The correct answer is: Hemolytic disorders
Nurses with an understanding of cultural differences regarding likely reactions to pain may be better able to help their clients. Which clients may initially appear very stoic but then become quite vocal as labor progresses until late in labor, when they become more vocal and request pain relief?
The correct answer is: Hispanic
A woman with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the client and documents the following findings: temperature of 37.1° C, pulse rate of 96 beats per minute, respiratory rate of 24 breaths per minute, BP of 155/112 mm Hg, 3+ DTRs, and no ankle clonus. The nurse calls the provider with an update. The nurse should anticipate an order for which medication?
The correct answer is: Hydralazinec (calicum gluconate)
An infant was born 2 hours ago at 37 weeks of gestation and weighs 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of what condition?
The correct answer is: Hypoglycemia
The nurse is teaching new parents about metabolic screening for the newborn. Which statement is most helpful to these clients?
The correct answer is: If genetic screening is performed before the infant is 24 hours old, then it should be repeated at age 1 to 2 weeks.
Mary G10000 is 12 weeks pregnant in October. She is not sure if she wants the flu shot. What is the best message the nurse should include in their education for Mary?
The correct answer is: If pregnant women get the flu, they can get seriously ill, require hospitalization and possibly die. We recommend you get the flu shot because it is a safe protective action to avoid these bad outcomes.
Which information regarding to injuries to the infant's plexus during labor and birth is most accurate?
The correct answer is: If the nerves are stretched with no avulsion, then they should completely recover in 3 to 6 months.
A 26-year-old primigravida has come to the clinic for her regular prenatal visit at 12 weeks. She appears thin and somewhat nervous. She reports that she eats a well-balanced diet, although her weight is 5 pounds less than it was at her last visit. The results of laboratory studies confirm that she has a hyperthyroid condition. Based on the available data, the nurse formulates a plan of care. Which nursing diagnosis is most appropriate for the client at this time?
The correct answer is: Imbalanced nutrition: less than body requirements
The nurse is evaluating a neonate who was delivered 3 hours ago by vacuum-assisted delivery. The infant has developed a cephalhematoma. Which statement is most applicable to the care of this neonate?
The correct answer is: In many infants, signs of hemorrhage in a full-term infant are absent and diagnosed only through laboratory tests.
Which renal system adaptation is an anticipated anatomic change of pregnancy?
The correct answer is: Increased bladder sensitivity and then compression of the bladder by the enlarging uterus result in the urge to urinate even when the bladder is almost empty.
Which of the following neonatal signs or symptoms would the nurse expect to see in a breastfed neonate with an elevated bilirubin level in the first 24 hours of life?
The correct answer is: Ineffective breastfeeding
Which infant is most likely to express Rh incompatibility?
The correct answer is: Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor
A woman gave birth to a 3200 g baby girl with an estimated gestational age of 40 weeks. The baby is 1 hour of age. In preparation for administration of Vitamin K to the infant, the nurse will explain to the parents that an injection of this medication:
The correct answer is: Influences the activation of coagulation factors to prevent delayed clotting and hemorrhagic disease
What is the most critical physiologic change required of the newborn after birth?
The correct answer is: Initiation and maintenance of respirations
The nurse is preparing to teach an antepartum client with GDM the correct method of administering an intermediate-acting insulin, such as neutral protamine Hagedorn (NPH), with a short-acting insulin (regular). In the correct order from 1 through 6, match the step number with the action needed to teach the client self-administration of this combination of insulin.
The correct answer is: Inject air equal to the dose of NPH insulin into the vial, and remove the syringe → step 4, Inject air equal to the dose of regular insulin into the vial, and withdraw the medication. → step 5, Wash hands. → step 1, Check the insulin bottles for the expiration date. → step 2, Gently rotate the insulin to mix it, and wipe the stopper. → step 3, Without adding air, withdraw the correct dose of NPH insulin. → step 6
Instructions to a mother of an uncircumcised male infant should include which of the following?
The correct answer is: Instruct her not to retract the foreskin.
Which important component of nutritional counseling should the nurse include in health teaching for a pregnant woman who is experiencing cholecystitis?
The correct answer is: Instruct the woman to eat a low-fat diet and to avoid fried foods.
In contrast to placenta previa, what is the most prevalent clinical manifestation of Grade 3 abruptio placentae?
The correct answer is: Intense abdominal pain
The nurse is working with a 36-year-old, married client, with 6 children who smokes. The woman states, "I don't expect to have any more kids, but I hate the thought of being sterile." Which of the following contraceptive methods would be best for the nurse to recommend to this client?
The correct answer is: Intrauterine contraceptive device (IUD)
Which neonatal complications are associated with hypertension in the mother?
The correct answer is: Intrauterine growth restriction (IUGR) and prematurity
The nurse is caring for a client in early labor. Membranes ruptured approximately 2 hours earlier. This client is at increased risk for which complication?
The correct answer is: Intrauterine infection
Which statement most accurately describes complicated grief?
The correct answer is: Is an extremely intense grief reaction that persists for a long time
Augmentation of labor:
The correct answer is: Is part of the active management of labor instituted when the labor process is unsatisfactory and uterine contractions are ineffective. Labor augmentation is the stimulation of ineffective UCs after the onset of spontaneous labor to manage labor dystocia. Lower doses of oxytocin are required but all of the principles pertaining to the use of oxytocin apply to augmentation.
Elisa asks the nurse why a bimanual examination is done?
The correct answer is: It allows for the provider to palpate your uterus and ovaries.
Mary asks the nurse why does she have to have a speculum exam during her first prenatal visit? The nurse's best answer is:
The correct answer is: It enables the provider to inspect your cervix and vaginal walls
18 year old Ellen has a positive pregnancy test and cries when she sees the result. Per her LMP, the nurse determines she is approx 7 weeks pregnant. She asks the nurse what should she do. Which of the following is the nurse's best initial response?
The correct answer is: Let's discuss your three options.
Which of the following findings, seen in pregnant women in the first trimester, would the nurse consider to be within normal limits?
The correct answer is: Leukorrhea
Intervention for the sexual abuse survivor is often not attempted by maternity and women's health nurses because of the concern about increasing the distress of the woman and the lack of expertise in counseling. What initial intervention is appropriate and most important in facilitating the woman's care?
The correct answer is: Listening and encouraging therapeutic communication skills
A woman gave birth to a healthy infant boy 5 days ago. What type of lochia does the nurse expect to find when evaluating this client?
The correct answer is: Lochia serosa
The nurse is providing prenatal teaching to a group of diverse pregnant women. One woman, who indicates she smokes two to three cigarettes a day, asks about its impact on her pregnancy. The nurse explains that the most significant risk to the fetus is:
The correct answer is: Low neonatal birth weight
Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the client mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. This fetus is at the greatest risk for which condition?
The correct answer is: Macrosomia
During labor induction with oxytocin, the fetal heart rate baseline is in the 140s with moderate variability. Contraction frequency is assessed to be every 2-3 minutes with duration of 60 seconds, of moderate strength to palpation. Based on this assessment, the nurse should take which action?
The correct answer is: Maintain present oxytocin infusion rate and continue to assess.
Nursing care measures are commonly offered to women in labor. Which nursing measure reflects the application of the gate-control theory?
The correct answer is: Massage the woman's back. A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. The nurse reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dl, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for this woman?;The correct answer is: She has thrombocytopenia.
On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. What is the nurse's highest priority at this time?
The correct answer is: Massaging the woman's fundus
Which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur?
The correct answer is: Maternal fever
Providing maternal oxygen has been shown to improve fetal oxygen status and resolve non-Category 1 Fetal Heart Rate (FHR) patterns. Which of the following is not true regarding current research on the appropriate use of maternal oxygen?
The correct answer is: Maternal oxygen therapy can be appropriately administered via nasal cannula. Maternal oxygen is best provided at 10L via nonrebreather facemask. Maternal oxygen can improve FHR variability, decrease fetal tachycardia, and reduce/eliminate late decelerations. The benefits of maternal oxygenation on the fetus have been shown to continue for as much as 30 minutes after discontinuation. Evidence is inconsistent as to how long maternal oxygen therapy should last. This article recommends maternal oxygen therapy be used for 15-30 minutes but there is a need for more research.
A 42-weeks' gestation neonate is admitted to the NICU (neonatal intensive care unit). This neonate is at risk for which complication?
The correct answer is: Meconium aspiration
A patient, G1 P0, is admitted to the labor and delivery unit for induction of labor. The following assessments were made on admission: Bishop score of 4, fetal heart rate 140s with moderate variability and no decelerations, TPR 98.6°F, 88, 20, BP 120/80, negative obstetrical history. A prostaglandin suppository was inserted at that time. Which of the following findings, 6 hours after insertion, would warrant the removal of the Cervidil (dinoprostone)?
The correct answer is: More than 5 contractions in 10 minutes
Rho immune globulin will be ordered postpartum if which situation occurs?
The correct answer is: Mother Rh-, baby Rh+
Which statement is the best rationale for recommending formula over breastfeeding?
The correct answer is: Mother has a medical condition or is taking drugs that could be passed along to the infant via breast milk.
By understanding the four mechanisms of heat transfer (convection, conduction, radiation, and evaporation), the nurse can create an environment for the infant that prevents temperature instability. Which significant symptoms will the infant display when experiencing cold stress?
The correct answer is: Mottled skin with acrocyanosis
A laboring woman has received meperidine (Demerol) intravenously (IV), 90 minutes before giving birth. Which medication should be available to reduce the postnatal effects of meperidine on the neonate?
The correct answer is: Naloxone (Narcan)
A patient at 36 weeks' gestation is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be palpated?
The correct answer is: Near the xiphoid process (approx 36 cm above the symphysis pubis)
Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem approach. What is the first step in the provision of care for the infant?
The correct answer is: Neonatal abstinence syndrome (NAS) scoring
Developing a realistic birth plan with the pregnant woman regarding her care is important for the nurse. How would the nurse explain the major advantage of nonpharmacologic pain management?
The correct answer is: No side effects or risks to the fetus are involved.
What information regarding a fractured clavicle is most important for the nurse to take into consideration when planning the infant's care?
The correct answer is: No special treatment is necessary.
Allison is 32 weeks pregnant presents to L&D and tells the nurse she has not felt her baby move in 48 hours. The nurse begins electronic fetal monitoring and notes the baby's heart rate is in the 130's. The nurse contacts Allison's physician to obtain an order for which of the following tests?
The correct answer is: Non stress Test
During labor a fetus displays an average FHR of 135 beats per minute over a 10-minute period. Which statement best describes the status of this fetus?
The correct answer is: Normal baseline heart rate
The clinic nurse reviews the complete blood count results for a 30-year-old woman who is now 33 weeks' gestation. Tamara's hemoglobin value is 11.2 g/dL, and her hematocrit is 38%. The clinic nurse interprets these findings as:
The correct answer is: Normal pregnancy values for the third trimester
The Valsalva maneuver can be described as the process of making a forceful bearing-down attempt while holding one's breath with a closed glottis and a tightening of the abdominal muscles. When is it appropriate to instruct the client to use this maneuver?
The correct answer is: Not at all. Spontaneous, open glottis pushing has been shown to facilitate positive maternal and neonatal outcomes
Trina is 16 y/o and presents to the clinic with complaint of symptoms consistent with endometriosis. She does not want to get pregnant for several years. Which of the following treatments will the physician probably implement?
The correct answer is: OCPs
What is the correct placement of the tocotransducer for effective EFM?
The correct answer is: Over the uterine fundus
Which of these medications is commonly used to control postpartum bleeding related to uterine atony?
The correct answer is: Oxytocin
Having a genetic mutation may create an 85% chance of developing breast cancer in a woman's lifetime. Which condition does not increase a client's risk for breast cancer?
The correct answer is: Paget disease
If the umbilical cord prolapses during labor, the nurse should immediately:
The correct answer is: Perform vaginal exam and lifting the presenting part off of the cord to relieve pressure on the cord. Prolapse of the umbilical cord is when the cord lies below the presenting part of the fetus. The cord becomes trapped against the presenting part and circulation is occluded; FHR will usually show bradycardia or prolonged decel. An emergency cesarean birth is typically performed. Occlusion of the cord may be partially relieved by lifting the presenting part off the cord with a vaginal exam. The examiner's hand remains in the vagina, lifting the presenting part off the cord until delivery by cesarean. There is no attempt to push the cord above the presenting part. Type and screen of blood is generally done on admission for all laboring women; type and cross-match can readily be accomplished using the blood sample already in the lab.
What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony?
The correct answer is: Performing fundal massage
Tanya, a 30-year-old woman, is being prepared for a planned cesarean birth. The perinatal nurse assists the anesthesiologist with the spinal block and then positions Tanya in a supine position. Tanya's blood pressure drops to 90/52, and there is a decrease in the fetal heart rate to 110 bpm. The perinatal nurse's best response is to:
The correct answer is: Place Tanya in a left lateral tilt
A newborn is jaundiced and is receiving phototherapy via ultraviolet bank lights. What is the most appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy?
The correct answer is: Placing eye shields over the newborn's closed eyes
During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, "I don't know what's wrong. I love my son, but I feel so let down. I seem to cry for no reason!" Which condition might this new mother be experiencing?
The correct answer is: Postpartum blues
The nursery nurse notes the presence of edema on one side of a baby girl's head, that does not cross the suture line. Review of the birth record indicates that her mother experienced a prolonged labor and difficult childbirth. The nurse documents the following condition in the infant's chart.
cephalohematoma
A newborn was admitted to the neonatal intensive care unit (NICU) after being delivered at 29 weeks of gestation to a 28-year-old multiparous, married, Caucasian woman whose pregnancy was uncomplicated until the premature rupture of membranes and preterm birth. The newborn's parents arrive for their first visit after the birth. The parents walk toward the bedside but remain approximately 5 feet away from the bed. What is the nurse's most appropriate action?
correct answer is: Go to the parents, introduce him or herself, and gently encourage them to meet their infant. Explain the equipment first, and then focus on the newborn.
A diagnostic test commonly used to assess problems of the fallopian tubes is:
correct answer is: Hysterosalpingogram
According to the CDC, which of the following are true?
correct answer is: Maternal mortality rate in the US has increased from 1987-2013
Which of the following cancers has no accurate screening test for secondary prevention?
correct answer is: Ovarian cancer
The nurse is completing the lab order for a pap smear performed on a 22 year old female. Which of the following options will the nurse select?
correct answer is: Pap smear - cytology only
Which of the following is the most effective contraception?
correct answer is: the implant
Postoperative nursing care and education for a woman who had an abdominal hysterectomy includes (select all that apply):
correct answers are: Administering hormone therapy as per provider orders., Assessing vaginal bleeding, Instructing the woman vaginal intercourse until she has followup visit with surgeon., Instructing the woman to resume activities as comfort level permits.
25 year old Susan (G0000) is thinking about getting pregnant this next year, but wants an effective method right now. She currently uses condoms. She denies medical problems. Which of the following birth control methods are most appropriate for the nurse to discuss with Susan? (Select all that apply).
correct answers are: Oral contraceptive pills, Condoms (continue), The birth control patch.
Which of the following screens for cervical cancer? (Select all that apply).
correct answers are: Pap smear test, high risk HPV test
Infants born between 34 0/7 and 36 6/7 weeks of gestation are called late-preterm infants because they have many needs similar to those of preterm infants. Because they are more stable than early-preterm infants, they may receive care that is similar to that of a full-term baby. These infants are at increased risk for which conditions? (Select all that apply.)
correct answers are: Problems with thermoregulation, Hyperbilirubinemia, Sepsis
Number of live births in 1 year per 1000 population
Birth rate
A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. What is the nurse's highest priority in this situation?
The correct answer is: Assess the fetal heart rate (FHR) and pattern.
A 25 year-old woman gave birth to her second child 6 hours ago. She informs the nurse that she is bleeding more than with her previous birth experience. The initial nursing action is to
The correct answer is: Assess the location and firmness of the fundus.
The obstetric provider has informed the nurse that she will be performing an amniotomy on the client to induce labor. What is the nurse's highest priority intervention after the amniotomy is performed?
The correct answer is: Assessing the fetal heart rate (FHR)
It is noted that the amniotic fluid of a 42-week gestation baby, born 30 seconds ago, is thick and green and he is not crying vigorously. Which of the following actions by the nurse is critical at this time?
The correct answer is: Assist a physician with intubation and suctioning.
Sally is in her third trimester and has begun to sing and talk to the fetus. Sally is probably exhibiting signs of:
The correct answer is: Attachment
What are the legal responsibilities of the perinatal nurses?
The correct answer is: Correctly interpreting FHR patterns, initiating appropriate nursing interventions, and documenting the outcomes
A client is experiencing back labor and complains of intense pain in her lower back. Which measure would best support this woman in labor?
The correct answer is: Counterpressure against the sacrum
Which of the following would be a priority for the nurse when caring for a pregnant woman who has recently emigrated from another country?
The correct answer is: Encourage her to include her family for support.
The nurse would expect a preterm delivery at 26 weeks gestation that the neonate would be born with ____________ .
Deficient surfactant
Number of maternal deaths from births and complications of pregnancy, childbirth and puerperium per 100.000 live births
Maternal Mortality rate
Which statement is the most appropriate for the nurse to make when caring for bereaved parents?
The correct answer is: "What can I do for you?"
Which is the most accurate description of PPD without psychotic features?
The correct answer is: Distinguishable by irritability
Which of the following antepartum tests is (are) used to evaluate a Maternal Serum Screening test that is negative for increased risk?
The correct answer is: Further followup test not necessary
Which of the following cancers has no accurate screening test for secondary prevention?
The correct answer is: Ovarian cancer
What is the nurse's understanding of the appropriate role of primary and secondary powers?
The correct answer is: Primary powers are responsible for the effacement and dilation of the cervix.
Anna wants to know if her baby has Trisomy 18 as early in the pregnancy as possible. She is 8 weeks pregnant. Her physician will suggest which of the following diagnostic test?
The correct answer is: chorionic villi sampling (CVS)
Which of the following is true about CV changes in pregnancy?
Blood volume increase by 40-50% above prepregnancy levels
The nurse is working in a prenatal clinic caring for a patient at 28 weeks' gestation, G21001. Which of the following findings should the nurse highlight for the nurse midwife?
1 hr gtt of 143
Which of the following statements is true about menopause?
The correct answer is no menses or spotting for 1 year
A woman's obstetric history indicates that she is pregnant for the fifth time. One was born at 39 weeks of gestation and he is alive
one was born at 34 weeks of gestation and that one died shortly after birth; she "lost one" at 9 weeks; and she had twins born at 36 weeks of gestation and they are alive. What is her gravidity and parity using the GTPAL system? ; 5-1-2-1-3