OB Quiz #7
Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman? a. Estrogen b. Progesterone c. Prolactin d. Human placental lactogen
C
Which important component of nutritional counseling should the nurse include in health teaching for a pregnant woman who is experiencing cholecystitis? A. Assess the womans dietary history for adequate calories and proteins. B. Teach the woman that the bulk of calories should come from proteins. C. Instruct the woman to eat a low-fat diet and to avoid fried foods. D. Instruct the woman to eat a low-cholesterol, low-salt diet.
C
Which information related to the newborns developing cardiovascular system should the nurse fully comprehend? a. The heart rate of a crying infant may rise to 120 beats per minute. b. Heart murmurs heard after the first few hours are a cause for concern. c. The point of maximal impulse (PMI) is often visible on the chest wall. d. Persistent bradycardia may indicate respiratory distress syndrome (RDS).
C
Which is the most accurate description of PPD without psychotic features? A. Postpartum baby blues requiring the woman to visit with a counselor or psychologist B. Condition that is more common among older caucasian women because they have higher expectations C. Distinguishable by pervasive sadness along with mood swings D. Condition that disappears without outside help
C
Which neurologic condition would require preconception counseling, if at all possible? A. Eclampsia B. Bell palsy C. Epilepsy D. Multiple sclerosis
C
Which preexisting factor is known to increase the risk of GDM? A. Underweight before pregnancy B. Maternal age younger than 25 years C. Previous birth of large infant D. Previous diagnosis of type 2 diabetes mellitus
C
While examining a newborn, the nurse notes uneven skin folds on the buttocks and a clunk when performing the Ortolani maneuver. These findings are likely indicative of what? a. Polydactyly b. Clubfoot c. Hip dysplasia d. Webbing
C
In terms of the incidence and classification of diabetes, which information should the nurse keep in mind when evaluating clients during their ongoing prenatal appointments? A. Type 1 diabetes is most common. B. Type 2 diabetes often goes undiagnosed. C. GDM means that the woman will receive insulin treatment until 6 weeks after birth. D. Type 1 diabetes may become type 2 during pregnancy.
B
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? A. Lochia rubra B. Lochia sangra C. Lochia alba D. Lochia serosa
D
Which physiologic factors are reliable indicators of impending shock from postpartum hemorrhage? (Select all that apply.) A. Respirations B. Skin condition C. Blood pressure D. Level of consciousness E. Urinary output
A, B, D, E
A new mother states that her infant must be cold because the babys hands and feet are blue. This common and temporary condition is called what? a. Acrocyanosis b. Erythema toxicum neonatorum c. Harlequin sign d. Vernix caseosa
A
A client is warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on high. The nurse instructs the mother that the fan should not be directed toward the newborn and that the newborn should be wrapped in a blanket. The mother asks why. How would the nurse respond? a. Your baby may lose heat by convection, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped, and should prevent cool air from blowing on him. b. Your baby may lose heat by conduction, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped, and should prevent cool air from blowing on him. c. Your baby may lose heat by evaporation, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped, and should prevent cool air from blowing on him. d. Your baby will easily get cold stressed and needs to be bundled up at all times.
A
A first-time father is changing the diaper of his 1-day-old daughter. He asks the nurse, What is this black, sticky stuff in her diaper? What is the nurses best response? a. Thats meconium, which is your babys first stool. Its normal. b. Thats transitional stool. c. That means your baby is bleeding internally. d. Oh, dont worry about that. Its okay.
A
A hospital has a number of different perineal pads available for use. A nurse is observed soaking several of them and writing down what she sees. What goal is the nurse attempting to achieve by performing this practice? A. To improve the accuracy of blood loss estimation, which usually is a subjective assessment B. To determine which pad is best C. To demonstrate that other nurses usually underestimate blood loss D. To reveal to the nurse supervisor that one of them needs some time off
A
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 clients behavior with her infant, what realization does the nurse make? a. 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. b. The woman is inexperienced in caring for a newborn. c. The woman needs a referral to a social worker for further evaluation of her parenting behaviors once she goes home with the newborn. d. Extra time needs to be planned for assisting the woman in bonding with her newborn.
A
A primiparous woman is to be discharged from the hospital the following day with her infant girl. Which behavior indicates a need for further intervention by the nurse before the woman can be discharged? A. The woman is disinterested in learning about infant care. B. The woman continues to hold and cuddle her infant after she has fed her. C. The woman reads a magazine while her infant sleeps. D. The woman changes her infants diaper and then shows the nurse the contents of the diaper
A
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 womans vital signs, which finding would be of greatest concern to the nurse? A. Temperature 37.9 C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg B. Temperature 37.4 C, heart rate 88 bpm, respirations 36 breaths per minute, and blood pressure 126/68 mm Hg C. Temperature 38 C, heart rate 80 bpm, respirations 16 breaths per minute, and blood pressure 110/80 mm Hg D. Temperature 36.8 C, heart rate 60 bpm, respirations 18 breaths per minute, and blood pressure 140/90 mm Hg
A
A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this womans fundus? A. 1 centimeter above the umbilicus B. 2 centimeters below the umbilicus C. Midway between the umbilicus and the symphysis pubis D. Nonpalpable abdominally
A
A young woman arrives at the emergency department and states that she thinks she has been raped. She is sobbing and expresses disbelief that this could happen because the perpetrator was a very close friend. Which statement is most appropriate at this time? A. Rape is not limited to strangers and frequently occurs by someone who is known to the victim. B. I would be very upset if my best friend did that to me; that is very unusual. C. You must feel very betrayed. In what way do you think you might have led him on? D. This does not sound like rape. Didnt you just change your mind about having sex after the fact?
A
According to research, which risk factor for PPD is likely to have the greatest effect on the client postpartum? A. Prenatal depression B. Single-mother status C. Low socioeconomic status D. Unplanned or unwanted pregnancy
A
After delivery, excess hypertrophied tissue in the uterus undergoes a period of self- destruction. What is the correct term for this process? a. Autolysis b. Subinvolution c. Afterpains d. Diastasis
A
Despite warnings, prenatal exposure to alcohol continues to far exceed exposure to illicit drugs. Which condition is rarely associated with fetal alcohol syndrome (FAS)? A. Respiratory conditions B. Intellectual impairment C. Neural development disorder D. Alcohol-related birth defects (ARBDs)
A
During which phase of maternal adjustment will the mother relinquish the baby of her fantasies and accept the real baby? a. Letting go b. Taking hold c. Taking in d. Taking on
A
Historically, what was the justification for the victimization of women? A. Women were regarded as possessions. B. Women were the weaker sex. C. Control of women was necessary to protect them. D. Women were created subordinate to men.
A
How would the nurse optimally reassure the parents of an infant who develops a cephalhematoma? a. A cephalhematoma may occur with a spontaneous vaginal birth. b. A cephalhematoma only happens as a result of a forceps- or vacuum-assisted delivery. c. It is present immediately after birth. d. The blood will gradually absorb over the first few months of life.
A
In many hospitals, new mothers are routinely presented with gift bags containing samples of infant formula. This practice is inconsistent with what? A. Baby Friendly Hospital Initiative B. Promotion of longer periods of breastfeeding C. Perception of being supportive to both bottle feeding and breastfeeding mothers D. Association with earlier cessation of breastfeeding
A
New parents express concern that because of the mothers emergency cesarean birth under general anesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth. Which information should the nurses response convey? a. Attachment, or bonding, is a process that occurs over time and does not require early contact. b. Time immediately after birth is a critical period for humans. c. Early contact is essential for optimal parent-infant relationships. d. These new parents should just be happy that the infant is healthy.
A
Part of the health assessment of a newborn is observing the infants breathing pattern. What is the predominate pattern of newborns breathing? a. Abdominal with synchronous chest movements b. Chest breathing with nasal flaring c. Diaphragmatic with chest retraction d. Deep with a regular rhythm
A
Rho immune globulin will be ordered postpartum if which situation occurs? A. Mother Rh, baby Rh+ B. Mother Rh, baby Rh C. Mother Rh+, baby Rh+ D. Mother Rh+, baby Rh
A
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? A. Macrosomia B. Congenital anomalies of the central nervous system C. Preterm birth D. Low birth weight
A
Several delivery changes in the integumentary system that appear during pregnancy disappear after birth, although not always completely. What change is almost certain to be completely reversed? A. Nail brittleness B. Darker pigmentation of the areolae and linea nigra C. Striae gravidarum on the breasts, abdomen, and thighs D. Spider nevi
A
The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella titer, 1:8 (enzyme immunoassay [EIA] 0.8); hematocrit, 30%. How should the nurse best interpret these data? A. Rubella vaccine should be administered. B. Blood transfusion is necessary. C. Rh immune globulin is necessary within 72 hours of childbirth. D. Kleihauer-Betke test should be performed.
A
The nurse caring for a newborn checks the record to note clinical findings that occurred before her shift. Which finding related to the renal system would be of increased significance and require further action? a. The pediatrician should be notified if the newborn has not voided in 24 hours. b. Breastfed infants will likely void more often during the first days after birth. c. Brick dust or blood on a diaper is always cause to notify the physician. d. Weight loss from fluid loss and other normal factors should be made up in 4 to 7 days.
A
Under which circumstance should the nurse immediately alert the pediatric provider? a. Infant is dusky and turns cyanotic when crying. b. Acrocyanosis is present 1 hour after childbirth. c. The infants blood glucose level is 45 mg/dl. d. The infant goes into a deep sleep 1 hour after childbirth.
A
What is the correct term for the cheeselike, white substance that fuses with the epidermis and serves as a protective coating? a. Vernix caseosa b. Surfactant c. Caput succedaneum d. Acrocyanosis
A
When should discharge instruction, or the teaching plan that tells the woman what she needs to know to care for herself and her newborn, officially begin? A. At the time of admission to the nurses unit B. When the infant is presented to the mother at birth C. During the first visit with the physician in the unit D. When the take-home information packet is given to the couple
A
When the infants behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics, what is the correct term for this behavior? a. Mutuality b. Bonding c. Claiming d. Acquaintance
A
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? A. No one deserves to be hurt. Its not your fault. How can I help you? B. What else do you do that makes him angry enough to hurt you? C. He will never find out what we talk about. Dont worry. Were here to help you. D. You have to remember that he is frustrated and angry so he takes it out on you.
A
Which component of the sensory system is the least mature at birth? a. Vision b. Hearing c. Smell d. Taste
A
Which condition would require prophylaxis to prevent subacute bacterial endocarditis (SBE) both antepartum and intrapartum? A. Valvular heart disease B. Congestive heart disease C. Arrhythmias D. Postmyocardial infarction
A
Which intervention can nurses use to prevent evaporative heat loss in the newborn? a. Drying the baby after birth, and wrapping the baby in a dry blanket b. Keeping the baby out of drafts and away from air conditioners c. Placing the baby away from the outside walls and windows d. Warming the stethoscope and the nurses hands before touching the baby
A
Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother? a. Hypoglycemia b. Hypercalcemia c. Hypobilirubinemia d. Hypoinsulinemia
A
Which newborn reflex is elicited by stroking the lateral sole of the infants foot from the heel to the ball of the foot? a. Babinski b. Tonic neck c. Stepping d. Plantar grasp
A
Which statement by the nurse can assist a new father in his transition to parenthood? a. Pointing out that the infant turned at the sound of his voice b. Encouraging him to go home to get some sleep c. Telling him to tape the infants diaper a different way d. Suggesting that he let the infant sleep in the bassinet
A
Which statement concerning the complication of maternal diabetes is the most accurate? A. Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy. B. Hydramnios occurs approximately twice as often in diabetic pregnancies than in nondiabetic pregnancies. C. Infections occur about as often and are considered about as serious in both diabetic and nondiabetic pregnancies. D. Even mild-to-moderate hypoglycemic episodes can have significant effects on fetal well-being.
A
With one exception, the safest pregnancy is one during which the woman is drug and alcohol free. What is the optimal treatment for women addicted to opioids? a. Methadone maintenance treatment (MMT) b. Detoxification c. Smoking cessationd. 4 Ps Plus
A
The transition to parenting for same-sex couples can present unique challenges. How can the nurse foster adjustment to parenting for these clients? (Select all that apply.) a. Use a supplemental feeding device to simulate breastfeeding. b. Allow the partner to cut the cord c. Gay fathers should meet their new infant soon after the birth mother has recovered. d. Understand that strong social sanctions remain. e. Provide information regarding support groups.
A, B, D, E
Which societal factors have a strong influence on parental response to their infant? (Select all that apply.) a. An adolescent mothers egocentricity and unmet developmental needs interfere with her ability to parent effectively. b. An adolescent mother is likely to use less verbal instruction, be less responsive, and interact less positively than other mothers. c. Adolescent mothers have a higher documented incidence of child abuse. d. Mothers older than 35 years of age often deal with more stress related to work and career issues, as well as decreasing libido. e. Relationships between adolescent mothers and fathers are more stable than older adults.
A, B, D
Diabetes refers to a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin action, insulin secretion, or both. Over time, diabetes causes significant changes in the microvascular and macrovascular circulations. What do these complications include? (Select all that apply.) a. Atherosclerosis b. Retinopathy c. Intrauterine fetal death (IUFD) d. Nephropathy e. Neuropathy f. Autonomic neuropathy
A, B, D, E
Screening questions for alcohol and drug abuse should be included in the overall assessment during the first prenatal visit for all women. The 4 Ps Plus is a screening tool specifically designed to identify the need for a more in-depth assessment. Which are the correct components of the 4 Ps Plus? (Select all that apply.) a. Parents b. Partner c. Present d. Past e. Pregnancy
A, B, D, E
The nurse who is evaluating the client for potential abuse should be aware that IPV includes a number of different forms of abuse, including which of the following? (Select all that apply.) a. Physical b. Sexual c. Emotional d. Psychologic emotional Is a form e. Financial
A, B, D, E
Which congenital anomalies can occur as a result of the use of antiepileptic drugs (AEDs) in pregnancy? (Select all that apply.) a. Cleft lip b. Congenital heart disease c. Neural tube defects d. Gastroschisis e. Diaphragmatic hernia
A, B, C
Which statements regarding physiologic jaundice are accurate? (Select all that apply.) a. Neonatal jaundice is common; however, kernicterus is rare. b. Appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic process. c. Because jaundice may not appear before discharge, parents need instruction on how to assess for jaundice and when to call for medical help. d. Jaundice is caused by reduced levels of serum bilirubin. e. Breastfed babies have a lower inc
A, B, C
A thorough abuse assessment screen should be completed on all female clients. This screen should include which components? (Select all that apply.) a. Asking the client if she has ever been slapped, kicked, punched, or physically hurt by her partner b. Asking the client if she is afraid of her partner c. Asking the client if she has been forced to perform sexual acts d. Diagramming the clients current injuries on a body map e. Asking the client what she did wrong to elicit the abuse
A, B, C, D
Which nursing diagnoses would be most appropriate for battered women? (select all that apply) a. Loss of trust b. Ineffective family coping c. Situational low self-esteem d. Risk for self-directed violence e. Enhanced communication
A, B, C, D
During life in utero, oxygenation of the fetus occurs through transplacental gas exchange. When birth occurs, four factors combine to stimulate the respiratory center in the medulla. The initiation of respiration then follows. What are these four essential factors? a. Chemical b. Mechanical c. Thermal d. Psychologic e. Sensory
A, B, C, E
Which statements describe the first stage of the neonatal transition period? (Select all that apply.) a. The neonatal transition period lasts no longer than 30 minutes. b. It is marked by spontaneous tremors, crying, and head movements. c. Passage of the meconium occurs during the neonatal transition period. d. This period may involve the infant suddenly and briefly sleeping. e. Audible grunting and nasal flaring may be present during this time.
A, B, C, E
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.) A. Putting her in antiembolic stockings (thromboembolic deterrent [TED] hose) and/or sequential compression device (SCD) boots B. Having her flex, extend, and rotate her feet, ankles, and legs C. Having her sit in a chair D. Immediately notifying the physician if a positive Homans sign occurs E. Promoting bed rest
A, B, D
Which concerns regarding parenthood are often expressed by visually impaired mothers? (Select all that apply.) a. Infant safety b. Transportation c. Ability to care for the infant d. Visually missing out e. Needing extra time for parenting activities to accommodate the visual limitations
A, B, D, E
A serious but uncommon complication of undiagnosed or partially treated hyperthyroidism is a thyroid storm, which may occur in response to stress such as infection, birth, or surgery. What are the signs and symptoms of this emergency disorder? (Select all that apply.) a. Fever b. Hypothermia c. Restlessness d. Bradycardia e. Hypertension
A, C
In caring for a pregnant woman with sickle cell anemia, the nurse must be aware of the signs =and symptoms of a sickle cell crisis. What do these include? (Select all that apply.) a. Fever b. Endometritis c. Abdominal pain d. Joint pain e. Urinary tract infection (UTI)
A, C, D
Which practices contribute to the prevention of postpartum infection? (Select all that apply.) A. Not allowing the mother to walk barefoot at the hospital B. Educating the client to wipe from back to front after voiding C. Having staff members with conditions such as strep throat, conjunctivitis, and diarrhea stay home D. Instructing the mother to change her perineal pad from front to back each time she voids or defecates E. Not permitting visitors with cough or colds to enter the postpartum unit
A, C, D
A lupus flare-up during pregnancy or early postpartum occurs in 15% to 60% of women with this disorder. Which conditions associated with systemic lupus erythematosus (SLE) are maternal risks? (Select all that apply.) a. Miscarriage b. Intrauterine growth restriction c. Nephritis d. Preeclampsia e. Cesarean birth
A, C, D, E
Many new mothers experience some type of nipple pain during the first weeks of initiating breastfeeding. Should this pain be severe or persistent, it may discourage or inhibit breastfeeding altogether. Which factors might contribute to this pain? (Select all that apply.) A. Improper feeding position B. Large-for-gestational age infant C. Fair skin D. Progesterone deficiency E. Flat or retracted nipples
A, C, E
A parent who has a hearing impairment is presented with a number of challenges in parenting. Which nursing approaches are appropriate for working with hearing-impaired new parents? (Select all that apply.) a. Using devices that transform sound into light b. Assuming that the client knows sign language c. Speaking quickly and loudly d. Ascertaining whether the client can read lips before teaching e. Writing messages that aid in communication
A, D, E
Nurses play a critical role in educating parents regarding measures to prevent infant abduction. Which instructions contribute to infant safety and security? (Select all that apply.) A. The mother should check the photo identification (ID) of any person who comes to her room. B. The baby should be carried in the parents arms from the room to the nursery. C. Because of infant security systems, the baby can be left unattended in the clients room. D. Parents should use caution when posting photographs of their infant on the Internet. E. The mom should request that a second staff member verify the identity of any questionable person.
A, D, E
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? A. PKU is a recognized cause of preterm labor. B. The fetus may develop neurologic problems. C. A pregnant woman is more likely to die without strict dietary control. D. Women with PKU are usually mentally handicapped and should not reproduce.
B
A new mother with a thyroid disorder has come for a lactation follow-up appointment. Which thyroid disorder is a contraindication for breastfeeding? A. Hyperthyroidism B. PKU C. Hypothyroidism D. Thyroid storm
B
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? a. Foster an active role in the babys care. b. Provide time for the mother to reflect on the events of her labor and delivery. c. Recognize the womans limited attention span by giving her written materials to read when she gets home rather than doing a teaching session while she is in the hospital. d. Promote maternal independence by encouraging her to meet her own hygiene and comfort needs.
B
The nurse is circulating during a cesarean birth of a preterm infant. The obstetrician requests that cord clamping be delayed. What is the rationale for this directive? a. To reduce the risk for jaundice b. To reduce the risk of intraventricular hemorrhage c. To decrease total blood volume d. To improve the ability to fight infection
B
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? a. The infant cries only when hungry or wet. b. The infants activity is somewhat predictable. c. The infant clings to the parents. d. The infant seeks attention from any adult in the room.
D
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? A. Deficient fluid volume B. Imbalanced nutrition: less than body requirements C. Imbalanced nutrition: more than body requirements D. Disturbed sleep pattern
B
A client with a history of bipolar disorder is called by the postpartum support nurse for follow- up. Which symptoms would reassure the nurse that the client is not experiencing a manic episode? A. Psychomotor agitation and lack of sleep B. Increased appetite and lack of interest in activities C. Hyperactivity and distractibility D. Pressured speech and grandiosity
B
A primiparous woman is watching her newborn sleep. She wants him to wake up and respond to her. The mother asks the nurse how much he will sleep every day. What is an appropriate response by the nurse? a. He will only wake up to be fed, and you should not bother him between feedings. b. The newborn sleeps approximately 17 hours a day, with periods of wakefulness gradually increasing. c. He will probably follow your same sleep and wake patterns, and you can expect him to be awake soon. d. He is being stubborn by not waking up when you want him to. You should try to keep him awake during the daytime so that he will sleep through the night.
B
A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle feed. During the assessment, the nurse notices that both breasts are swollen, warm, and tender on palpation. Which guidance should the nurse provide to the client at this time? A. Run warm water on her breasts during a shower. B. Apply ice to the breasts for comfort. C. Express small amounts of milk from the breasts to relieve the pressure. D. Wearing a loose-fitting bra to prevent nipple irritation.
B
A woman gave birth to a healthy 7-pound, 13-ounce infant girl. The nurse suggests that the client place the infant to her breast within 15 minutes after birth. The nurse is aware that the initiation of breastfeeding is most effective during the first 30 minutes after birth. What is the correct term for this phase of alertness? a. Transition period b. First period of reactivity c. Organizational stage d. Second period of reactivity
B
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? A. The woman and her partner are having an argument that is loud and hostile. B. The woman has injuries on various parts of her body that are in different stages of healing. C. Examination reveals a fractured arm and fresh bruises. D. She avoids making eye contact and is hesitant to answer questions.
B
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? A. Risk for injury, to the fetus related to birth trauma B. Deficient knowledge, related to diabetic pregnancy management C. Deficient knowledge, related to insulin administration D. Risk for injury, to the mother related to hypoglycemia or hyperglycemia
B
Bell palsy is an acute idiopathic facial paralysis, the cause for which remains unknown. Which statement regarding this condition is correct? A. Bell palsy is the sudden development of bilateral facial weakness. B. Women with Bell palsy have an increased risk for hypertension. C. Pregnant women are affected twice as often as nonpregnant women. D. Bell palsy occurs most frequently in the first trimester.
B
During an inpatient psychiatric hospitalization, what is the most important nursing intervention? A. Contacting the clients significant other B. Supervising and guiding visits with her infant C. Allowing no contact with anyone who annoys her D. Having the infant with the mother at all times
B
In 1979, Lenore Walker pioneered the cause of women as victims of violence when she published her book The Battered Woman. While Walker conducted her research, she found a similar pattern of abuse among many of the women. This concept is now referred to as the cycle of violence. Which phase does not belong in this three-cycle pattern of violence? A. Tension-building state B. Frustration, followed by violence C. Acute battering incident D. Kindness and contrite, loving behavior
B
In addition to eye contact, other early sensual contacts between the infant and mother involve sound and smell. What other statement regarding the senses is correct? a. High-pitched voices irritate newborns. b. Infants can learn to distinguish their mothers voice from others soon after birth. c. All babies in the hospital smell alike. d. Mothers breast milk has no distinctive odor.
B
In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which is a facilitating behavior? a. Parents have difficulty naming the infant. b. Parents hover around the infant, directing attention to and pointing at the infant. c. Parents make no effort to interpret the actions or needs of the infant. d. Parents do not move from fingertip touch to palmar contact and holding.
B
It is extremely rare for a woman to die in childbirth; however, it can happen. In the United States, the annual occurrence of maternal death is 12 per 100,000 cases of live birth. What are the leading causes of maternal death? A. Embolism and preeclampsia B. Trauma and motor vehicle accidents (MVAs) C. Hemorrhage and infection D. Underlying chronic conditions
B
Many first-time parents do not plan on having their parents help immediately after the newborn arrives. Which statement by the nurse is the most appropriate when counseling new parents regarding the involvement of grandparents? a. You should tell your parents to leave you alone. b. Grandparents can help you with parenting skills. c. Grandparent involvement can be very disruptive to the family. d. They are getting old. You should let them be involved while they can.
B
Nurses must remember that pregnancy is a time of risk for all women. Which condition is likely the biggest risk for the pregnant client? a. Preeclampsia b. IPV c. Diabetes d. Abnormal Pap test
B
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? A. Frequent episodes of maternal hypoglycemia B. Congenital anomalies in the fetus C. Hydramnios D. Hyperemesis gravidarum
B
The client makes an appointment for preconception counseling. The woman has a known heart condition and is unsure if she should become pregnant. Which is the only cardiac condition that would cause concern? A. Marfan syndrome B. Eisenmenger syndrome C. Heart transplant D. Ventricular septal defect (VSD)
B
The condition during which infants are at an increased risk for subgaleal hemorrhage is called what? a. Infection b. Jaundice c. Caput succedaneum d. Erythema toxicum neonatorum
B
The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, would the nurse identify as a possible maladaptive behavior regarding parent-infant attachment? a. The postpartum woman talks and coos to her son. b. She seldom makes eye contact with her son. c. The mother cuddles her son close to her. d. She tells visitors how well her son is feeding.
B
The nurse observes that a first-time mother appears to ignore her newborn. Which strategy should the nurse use to facilitate mother-infant attachment? A. Tell the mother she must pay attention to her infant. B. Show the mother how the infant initiates interaction and attends to her. C. Demonstrate for the mother different positions for holding her infant while feeding. D. Arrange for the mother to watch a video on parent-infant interaction.
B
The nurse should be cognizant of which postpartum physiologic alteration? A. Cardiac output, pulse rate, and stroke volume all return to prepregnancy normal values within a few hours of childbirth. B. Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth. C. Lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections. D. Hypercoagulable state protects the new mother from thromboembolism, especially after a cesarean birth.
B
The nurse who is caring for a woman hospitalized for hyperemesis gravidarum would expect the initial treatment to involve what? A. Corticosteroids to reduce inflammation B. Intravenous (IV) therapy to correct fluid and electrolyte imbalances C. Antiemetic medication, such as pyridoxine, to control nausea and vomiting D. Enteral nutrition to correct nutritional deficits
B
The parents of a newborn ask the nurse how much the newborn can see. The parents specifically want to know what type of visual stimuli they should provide for their newborn. What information provided by the nurse would be most useful to these new parents? a. Infants can see very little until approximately 3 months of age. b. Infants can track their parents eyes and can distinguish patterns; they prefer complex patterns. c. The infants eyes must be protected. Infants enjoy looking at brightly colored stripes. d. Its important to shield the newborns eyes. Overhead lights help them see better.
B
The postpartum nurse should be cognizant of what with regard to the adaptation of other family members (primarily siblings and grandparents) to the newborn? a. Sibling rivalry cannot be dismissed as overblown psychobabble; negative feelings and behaviors can take a long time to blow over. b. Participation in preparation classes helps both siblings and grandparents. c. In the United States, paternal and maternal grandparents consider themselves of equal importance and status. d. Since 1990, the number of grandparents providing permanent care to their grandchildren has been declining.
B
The postpartum woman continually repeats the story of her labor, delivery, and recovery experience. What is this new mother attempting to achieve with this behavior? a. Providing others with her knowledge of events b. Making the birth experience real c. Taking hold of the events leading up to her labor and delivery d. Accepting her response to labor and delivery
B
The process during which bilirubin is changed from a fat-soluble product to a water-soluble product is known as what? a. Enterohepatic circuit b. Conjugation of bilirubin c. Unconjugated bilirubin d. Albumin binding
B
The use of methamphetamine (meth) has been described as a significant drug problem in the United States. The nurse who provides care to this client population should be cognizant of what regarding methamphetamine use? A. Methamphetamines are similar to opiates. B. Methamphetamines are stimulants with vasoconstrictive characteristics. C. Methamphetamines should not be discontinued during pregnancy. D. Methamphetamines are associated with a low rate of relapse.
B
What information should the nurse understand fully regarding rubella and Rh status? A. Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus. B. Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination. C. Rh immunoglobulin is safely administered intravenously because it cannot harm a nursing infant. D. Rh immunoglobulin boosts the immune system and thereby enhances the effectiveness of vaccinations.
B
What is the rationale for evaluating the plantar crease within a few hours of birth? a. Newborn has to be footprinted. b. As the skin dries, the creases will become more prominent. c. Heel sticks may be required. d. Creases will be less prominent after 24 hours.
B
When caring for a newly delivered woman, what is the best measure to prevent abdominal distention after a cesarean birth? A. Rectal suppositories B. Early and frequent ambulation C. Tightening and relaxing abdominal muscles D. Carbonated beverages
B
Which cardiovascular changes cause the foramen ovale to close at birth? a. Increased pressure in the right atrium b. Increased pressure in the left atrium c. Decreased blood flow to the left ventricle d. Changes in the hepatic blood flow
B
Which client is most likely to experience strong and uncomfortable afterpains? A. A woman who experienced oligohydramnios B. A woman who is a gravida 4, para 4-0-0-4 C. A woman who is bottle-feeding her infant D. A woman whose infant weighed 5 pounds, 3 ounces
B
Which description of postpartum restoration or healing times is accurate? A. The cervix shortens, becomes firm, and returns to form within a month postpartum. B. Vaginal rugae reappear by 3 weeks postpartum. C. Most episiotomies heal within a week. D. Hemorrhoids usually decrease in size within 2 weeks of childbirth.
B
Which information about variations in the infants blood counts is important for the nurse to explain to the new parents? a. A somewhat lower-than-expected red blood cell count could be the result of a delay in clamping the umbilical cord. b. An early high white blood cell (WBC) count is normal at birth and should rapidly decrease. c. Platelet counts are higher in the newborn than in adults for the first few months. d. Even a modest vitamin K deficiency means a problem with the bloods ability to properly clot.
B
Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand? A. Stress on the heart is greatest in the first trimester and the last 2 weeks before labor. B. Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms. C. Women with class III cardiac disease should get 8 to 10 hours of sleep every day and limit housework, shopping, and exercise. D. Women with class I cardiac disease need bed rest through most of the pregnancy and face the possibility of hospitalization near term.
B
Which information should the nurse take into consideration when planning care for a postpartum client with cardiac disease? A. The plan of care for a postpartum client is the same as the plan for any pregnant woman. B. The plan of care includes rest, stool softeners, and monitoring of the effect of activity. C. The plan of care includes frequent ambulating, alternating with active range-of- motion exercises. D. The plan of care includes limiting visits with the infant to once per day.
B
Which statement best describes the transition period between intrauterine and extrauterine existence for the newborn? a. Consists of four phases, two reactive and two of decreased responses b. Lasts from birth to day 28 of life c. Applies to full-term births only d. Varies by socioeconomic status and the mothers age
B
Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth? A. My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter. B. My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles. C. I will not have a menstrual cycle for 6 months after childbirth. D. My first menstrual cycle will be heavier than normal and then will be light for several months after.
B
Which statement is most accurate regarding the reporting of IPV in the United States? A. Asian women report more IPV than do other minority groups. B. Caucasian women report less IPV than do non-Caucasians. C. Native-American women report IPV at a rate similar to other groups. D. African-American women are less likely to report IPV than Caucasian women.
B
Which statement regarding human trafficking is correct? A. Human trafficking is a multibillion-dollar business that primarily exists in the United States. B. Victims often experience the Stockholm syndrome. C. Vast majority of the victims are young boys and girls. D. Human trafficking primarily refers to commercial sex work.
B
Which statement regarding the postpartum uterus is correct? A. At the end of the third stage of labor, the postpartum uterus weighs approximately 500 g. B. After 2 weeks postpartum, it should be abdominally nonpalpable. C. After 2 weeks postpartum, it weighs 100 g. D. Postpartum uterus returns to its original (prepregnancy) size by 6 weeks postpartum.
B
Which trait is least likely to be displayed by a woman experiencing intimate partner violence (IPV)? A. Socially isolated B. Assertive personality C. Struggling with depression D. Dependent partner in a relationship
B
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? A. I will need to eat 600 more calories per day because I am pregnant. B. I can continue with the same diet as before pregnancy as long as it is well balanced. C. Diet and insulin needs change during pregnancy. D. I will plan my diet based on the results of urine glucose testing.
C
A woman has experienced iron deficiency anemia during her pregnancy. She had been taking iron for 3 months before the birth. The client gave birth by cesarean 2 days earlier and has been having problems with constipation. After assisting her back to bed from the bathroom, the nurse notes that the womans stools are dark (greenish-black). What should the nurses initial action be? A. Perform a guaiac test, and record the results. B. Recognize the finding as abnormal, and report it to the primary health care provider. C. Recognize the finding as a normal result of iron therapy. D. Check the womans next stool to validate the observation.
C
A woman with asthma is experiencing a postpartum hemorrhage. Which drug should be avoided when treating postpartum bleeding to avoid exacerbating asthma? A. Oxytocin (Pitocin) B. Nonsteroidal antiinflammatory drugs (NSAIDs) C. Hemabate D. Fentanyl
C
During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, I dont know whats 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? a. Letting-go b. Postpartum depression (PPD) c. Postpartum blues d. Attachment difficulty
C
In the United States, the en face position is preferred immediately after birth. Which actions by the nurse can facilitate this process? (Select all that apply.) a. Placing the infant in the grandmothers arms b. Placing the infant on the mothers abdomen or breast with their heads on the same plane c. Dimming the lights d. Delaying the instillation of prophylactic antibiotic ointment in the infants eyes e. Washing both the infants face and the mothers face
B, C, D
What are the various modes of heat loss in the newborn? (Select all that apply.) a. Perspiration b. Convection c. Radiation d. Conduction e. Urination
B, C, D
Autoimmune disorders often occur during pregnancy because a large percentage of women with an autoimmune disorder are of childbearing age. Which disorders fall into the category of collagen vascular disease? (Select all that apply.) A. Multiple sclerosis B. SLE C. Antiphospholipid syndrome D. Rheumatoid arthritis E. Myasthenia gravis
B, C, D, E
What are the responsibilities of the nurse who suspects or confirms any type of violence against a woman? (Select all that apply.) a. Report the incident to legal authorities. b. Provide resources for domestic violence shelters. c. Call a client advocate who can assist in the clients decision about what actions to take. d. Accurately and concisely document the incident (or findings) in the clients record. e. Reassure and support the client.
B, C, D, E
Postpartum fatigue (PPF) is more than just feeling tired. It is a complex phenomenon affected by physiologic, psychologic, and situational variables. Which factors contribute to this phenomenon? (Select all that apply.) A. Precipitous labor B. Hospital routines C. Bottle feeding D. Anemia E. Excitement
B, D, E
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? A. Photographs of injuries B. Clear and legible written documentation C. Summary of information (e.g., The client is a battered woman.) D. Accurate description of the clients demeanor
C
A first-time dad is concerned that his 3-day-old daughters skin looks yellow. In the nurses explanation of physiologic jaundice, what fact should be included? a. Physiologic jaundice occurs during the first 24 hours of life. b. Physiologic jaundice is caused by blood incompatibilities between the mother and the infant blood types. c. Physiologic jaundice becomes visible when serum bilirubin levels peak between the second and fourth days of life. d. Physiologic jaundice is also known as breast milk jaundice.
C
A newborn is placed under a radiant heat warmer. The nurse understands that thermoregulation presents a problem for the newborn. What is the rationale for this difficulty? a. The renal function of a newborn is not fully developed, and heat is lost in the urine. b. The small body surface area of a newborn favors more rapid heat loss than does an adults body surface area. c. Newborns have a relatively thin layer of subcutaneous fat that provides poor insulation. d. Their normal flexed posture favors heat loss through perspiration.
C
A number of metabolic changes occur throughout pregnancy. Which physiologic adaptation of pregnancy will influence the nurses plan of care? A. Insulin crosses the placenta to the fetus only in the first trimester, after which the fetus secretes its own. B. Women with insulin-dependent diabetes are prone to hyperglycemia during the first trimester because they are consuming more sugar. C. During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus. D. Maternal insulin requirements steadily decline during pregnancy.
C
A nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dads. This statement is most descriptive of which process? a. Mutuality b. Synchrony c. Claiming d. Reciprocity
C
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? A. Obtaining IV access, and starting aggressive fluid resuscitation B. Quickly applying the fetal monitor to determine whether the fetus viability C. Starting cardiopulmonary resuscitation (CPR) D. Transferring the woman to the surgical unit for an emergency cesarean delivery in case the fetus is still alive
C
A pregnant woman who abuses cocaine admits to exchanging sex to finance her drug habit. This behavior places the client at the greatest risk for what? A. Depression of the CNS B. Hypotension and vasodilation C. Sexually transmitted infections (STIs) D. Postmature birth
C
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? A. The woman excessively discusses her labor and birth experience. B. The woman feels that her baby is more attractive and clever than any others. C. The woman has not given the baby a name. D. The woman has a partner or family members who react very positively about the baby.
C
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? A. Daily consumption of alcohol indicates a risk for alcoholism. B. She will be at risk for abusing other substances as well. C. The fetus is placed at risk for altered brain growth. D. The fetus is at risk for multiple organ anomalies.
C
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? A. Alteration in maternal vital signs, especially blood pressure B. Complaints of abdominal pain C. Placental absorption D. Hemorrhage
C
How would the nurse differentiate a meconium stool from a transitional stool in the healthy newborn? a. Observed at age 3 days b. Is residue of a milk curd c. Passes in the first 12 hours of life d. Is lighter in color and looser in consistency
C
In the 1970s, the rape-trauma syndrome (RTS) was identified as a cluster of symptoms and related behaviors observed in the weeks and months after an episode of rape. Researchers identified three phases related to this condition. Which phase is not displayed in a client with RTS? A. Acute Phase: Disorganization B. Outward Adjustment Phase C. Shock/Disbelief: Disorientation Phase D. Long-Term Process: Reorganization Phase
C
Intervention for the sexual abuse survivor is often not attempted by maternity and womens 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 womans care? A. Initiating a referral to an expert counselor B. Setting limits on what the client discloses C. Listening and encouraging therapeutic communication skills D. Acknowledging the nurses discomfort to the client as an expression of empathy
C
Nurses who provide care to victims of IPV should be keenly aware of what? A. Relationship violence usually consists of a single episode that the couple can put behind them. B. Violence often declines or ends with pregnancy. C. Financial coercion is considered part of IPV. D, Battered women are generally poorly educated and come from a deprived social background.
C
Postpartum overdistention of the bladder and urinary retention can lead to which complications? A. Postpartum hemorrhage and eclampsia B. Fever and increased blood pressure C. Postpartum hemorrhage and urinary tract infection D. Urinary tract infection and uterine rupture
C
The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, approximately 500,000 women in America experience a more severe syndrome known as PPD. Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis? a. PPD symptoms are consistently severe. b. This syndrome affects only new mothers. c. PPD can easily go undetected. d. Only mental health professionals should teach new parents about this condition.
C
The nurse is assessing a full term, quiet, and alert newborn. What is the average expected apical pulse range (in beats per minute)? a. 80 to 100 b. 100 to 120 c. 120 to 160 d. 150 to 180
C
The nurse is cognizant of which information related to the administration of vitamin K? a. Vitamin K is important in the production of red blood cells. b. Vitamin K is necessary in the production of platelets. c. Vitamin K is not initially synthesized because of a sterile bowel at birth. d. Vitamin K is responsible for the breakdown of bilirubin and the prevention of jaundice.
C
The nurse should be cognizant of which important information regarding the gastrointestinal (GI) system of the newborn? a. The newborns cheeks are full because of normal fluid retention. b. The nipple of the bottle or breast must be placed well inside the babys mouth because teeth have been developing in utero, and one or more may even be through. c. Regurgitation during the first day or two can be reduced by burping the infant and slightly elevating the babys head. d. Bacteria are already present in the infants GI tract at birth because they traveled through the placenta.
C
To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet? A. Eat six small equal meals per day. B. Reduce the carbohydrates in her diet. C. Eat her meals and snacks on a fixed schedule. D. Increase her consumption of protein.
C
Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis. Which physiologic alteration is the cause for the diaphoresis and diuresis that this client is experiencing? A. Elevated temperature caused by postpartum infection B. Increased basal metabolic rate after giving birth C. Loss of increased blood volume associated with pregnancy D. Increased venous pressure in the lower extremities
C
Under the Newborns and Mothers Health Protection Act, all health plans are required to allow new mothers and newborns to remain in the hospital for a minimum of _____ hours after a normal vaginal birth and for _____ hours after a cesarean birth. What is the correct interpretation of this legislation? A. 24; 72 B. 24; 96 C. 48; 96 D. 48; 120
C
What is the primary theme of the feminist perspective regarding violence against women? A. Role of testosterone as the underlying cause of mens violent behavior B. Basic human instinctual drive toward aggression C. Male dominance and coercive control over women D. Cultural norm of violence in Western society
C
What marks on a babys skin may indicate an underlying problem that requires notification of a physician? a. Mongolian spots on the back b. Telangiectatic nevi on the nose or nape of the neck c. Petechiae scattered over the infants body d. Erythema toxicum neonatorum anywhere on the body
C
What should the nurses next action be if the clients white blood cell (WBC) count is 25,000/mm3 on her second postpartum day? A. Immediately inform the physician. B. Have the laboratory draw blood for reanalysis. C. Recognize that this count is an acceptable range at this point postpartum. D. Immediately begin antibiotic therapy.
C
When a woman is diagnosed with postpartum depression (PPD) with psychotic features, what is the nurses primary concern in planning the clients care? A. Displaying outbursts of anger B. Neglecting her hygiene C. Harming her infant D. Losing interest in her husband
C
Which statement is the most comprehensive description of sexual violence? A. Sexual violence is limited to rape. B. Sexual violence is an act of force during which an unwanted and uncomfortable sexual act occurs. C. Sexual violence encompasses a number of sexual acts. D. Sexual violence includes degrading sexual comments and behaviors.
C
Which statement regarding the laboratory test for glycosylated hemoglobin Alc is correct? A. The laboratory test for glycosylated hemoglobin Alc is performed for all pregnant women, not only those with or likely to have diabetes. B. This laboratory test is a snapshot of glucose control at the moment. C. This laboratory test measures the levels of hemoglobin Alc, which should remain at less than 7%. D. This laboratory test is performed on the womans urine, not her blood.
C
Which statement, related to the reconditioning of the urinary system after childbirth, should the nurse understand? A. Kidney function returns to normal a few days after birth. B. Diastasis recti abdominis is a common condition that alters the voiding reflex. C. Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium. D. With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth.
C
Which substance used during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications? a. Alcohol b. Caffeine c. Tobacco d. Chocolate
C
While assessing the integument of a 24-hour-old newborn, the nurse notes a pink papular rash with vesicles superimposed on the thorax, back, and abdomen. What action is the highest priority for the nurse to take at this time? a. Immediately notify the physician. b. Move the newborn to an isolation nursery. c. Document the finding as erythema toxicum neonatorum. d. Take the newborns temperature, and obtain a culture of one of the vesicles.
C
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? a. Phobias b. Panic disorder c. Posttraumatic stress disorder (PTSD) d. Obsessive-compulsive disorder (OCD)
C
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? A. Pouring water from a squeeze bottle over the womans perineum B. Placing oil of peppermint in a bedpan under the woman C. Asking the physician to prescribe analgesic agents D. Inserting a sterile catheter
D
Hypothyroidism occurs in 2 to 3 pregnancies per 1000. Because severe hypothyroidism is associated with infertility and miscarriage, it is not often seen in pregnancy. Regardless of this fact, the nurse should be aware of the characteristic symptoms of hypothyroidism. Which do they include? (Select all that apply.) a. Hot flashes b. Weight loss c. Lethargy D. Decrease in exercise capacity e. Cold intolerance
C, D, E
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.) a. Hypotonia b. Hyperglycemia c. Shivering d. Fevere. Irritability
C, D, E
What are some common characteristics of a potential male batterer? (Select all that apply.) a. High level of self-esteem b. High frustration tolerance c. Substance abuse problems d. Excellent verbal skills e. Personality disorders
C, E
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 nurses next action should be what? a. Assess her for pain. b. Point out how lucky she is to have a healthy baby. c. Explain that she is experiencing postpartum blues. d. Allow her time to express her feelings.
D
A 25-year-old multiparous woman gave birth to an infant boy 1 day ago. Today her husband brings a large container of brown seaweed soup to the hospital. When the nurse enters the room, the husband asks for help with warming the soup so that his wife can eat it. What is the nurses most appropriate response? A. Didnt you like your lunch? B. Does your physician know that you are planning to eat that? C. What is that anyway? D. Ill warm the soup in the microwave for you.
D
A 30-year-old multiparous woman has a boy who is years old and has recently delivered an infant girl. She tells the nurse, I dont know how Ill ever manage both children when I get home. Which suggestion would assist this new mother in alleviating sibling rivalry? A. Tell the older child that he is a big boy now and should love his new sister. B. Let the older child stay with his grandparents for the first 6 weeks to allow him to adjust to the newborn. C. Ask friends and relatives not to bring gifts to the older sibling because you do not want to spoil him. D. Realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time.
D
A client asks the nurse when her ovaries will begin working again. Which explanation by the nurse is most accurate? A. Almost 75% of women who do not breastfeed resume menstruating within 1 month after birth. B. Ovulation occurs slightly earlier for breastfeeding women. C. Because of menstruation and ovulation schedules, contraception considerations can be postponed until after the puerperium. D. The first menstrual flow after childbirth usually is heavier than normal.
D
A client is concerned that her breasts are engorged and uncomfortable. What is the nurses explanation for this physiologic change? A. Overproduction of colostrum B. Accumulation of milk in the lactiferous ducts and glands C. Hyperplasia of mammary tissue D. Congestion of veins and lymphatic vessels
D
A new father states, I know nothing about babies; however, he seems to be interested in learning. How would the nurse best respond to this father? a. Continue to observe his interaction with the newborn. b. Tell him when he does something wrong. c. Show no concern; he will learn on his own. d. Include him in teaching sessions.
D
A nurse is observing a family. The mother is holding the baby she delivered less than 24 hours ago. Her husband is watching his wife and asking questions about newborn care. The 4- year-old brother is punching his mother on the back. How should the nurse react to this situation? a. Report the incident to the social services department. b. Advise the parents that the toddler needs to be reprimanded. c. Report to oncoming staff that the mother is probably not a good disciplinarian. d. Realize that this is a normal family unit adjusting to a major family change.
D
A nursing student is helping the nursery nurses with morning vital signs. A baby born 10 hours ago by cesarean section is found to have moist lung sounds. What is the best interpretation of these data? a. The nurse should immediately notify the pediatrician for this emergency situation. b. The neonate must have aspirated surfactant. c. If this baby was born vaginally, then a pneumothorax could be indicated. d. The lungs of a baby delivered by cesarean section may sound moist during the first 24 hours after childbirth.
D
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 nurses highest priority? A. Monitoring the woman for a ruptured spleen B. Obtaining a physicians order to discharge her home C. Monitoring her for 24 hours D. Using continuous EFM for a minimum of 4 hours
D
A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath three times daily, and a stool softener. Which information regarding the clients condition is most closely correlated with these orders? A. Woman is a gravida 2, para 2. B. Woman had a vacuum-assisted birth. C. Woman received epidural anesthesia. D. Woman has an episiotomy.
D
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? A. 75 mg/dl before lunch. This is low; better eat now. B. 115 mg/dl 1 hour after lunch. This is a little high; maybe eat a little less next time. C. 115 mg/dl 2 hours after lunch. This is too high; it is time for insulin. D. 50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep.
D
After birth, a crying infant may be soothed by being held in a position in which the newborn can hear the mothers heartbeat. This phenomenon is known as what? a. Entrainment b. Reciprocity c. Synchrony d. Biorhythmicity
D
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? A. Teach the client how to feed and bathe her infant. B. Give the client written information on bathing her infant. C. Advise the client that all mothers instinctively know how to care for their infants. D. Provide time for the client to bathe her infant after she views a demonstration of infant bathing.
D
An African-American woman noticed some bruises on her newborn daughters buttocks. The client asks the nurse what causes these. How would the nurse best explain this integumentary finding to the client? a. Lanugo b. Vascular nevus c. Nevus flammeus d. Mongolian spot
D
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 nurses best response? A. PUPPP is associated with decreased maternal weight gain. B. The rate of hypertension decreases with PUPPP. C. This common pregnancy-specific condition is associated with a poor fetal outcome. D. The goal of therapy is to relieve discomfort.
D
As a powerful central nervous system (CNS) stimulant, which of these substances can lead to miscarriage, preterm labor, placental separation (abruption), and stillbirth? A. Heroin B. Alcohol C. Phencyclidine (1-phenylcyclohexylpiperidine; PCP) D. Cocaine
D
As part of the discharge teaching, the nurse can prepare the mother for her upcoming adjustment to her new role by instructing her regarding self-care activities to help prevent PPD. Which statement regarding this condition ismost helpful for the client? A. Stay home, and avoid outside activities to ensure adequate rest. B. Be certain that you are the only caregiver for your baby to facilitate infant attachment. C. Keep your feelings of sadness and adjustment to your new role to yourself. D. Realize that PPD is a common occurrence that affects many women.
D
Nurses are often the first health care professional with whom a woman comes into contact after being sexually assaulted. Which statement best describes the initial care of a rape victim? A. All legal evidence is preserved during the physical examination. B. The victim appreciates the legal information; however, decides not to pursue legal proceedings. C. The victim states that she is going to advocate against sexual violence. D. The victim leaves the health care facility without feeling re-victimized.
D
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 nurses highest priority at this time? A. Beginning an intravenous (IV) infusion of Ringers lactate solution B. Assessing the womans vital signs C. Calling the womans primary health care provider D. Massaging the womans fundus
D
Parents who have not already done so need to make time for newborn follow-up of the discharge. According to the American Academy of Pediatrics (AAP), when should a breastfeeding infant first need to be seen for a follow-up examination? A. 2 weeks of age B. 7 to 10 days after childbirth C. 4 to 5 days after hospital discharge D. 48 to 72 hours after hospital discharge
D
Postoperative care of the pregnant woman who requires abdominal surgery for appendicitis includes which additional assessment? A. Intake and output (I&O) and intravenous (IV) site B. Signs and symptoms of infection C. Vital signs and incision D. Fetal heart rate (FHR) and uterine activity
D
Since the gene for cystic fibrosis was identified in 1989, data can be collected for the purposes of genetic counseling for couples regarding carrier status. According to the most recent statistics, how often does cystic fibrosis occur in Caucasian live births? A. 1 in 100 B. 1 in 1000 C. 1 in 2000 D. 1 in 3200
D
The brain is vulnerable to nutritional deficiencies and trauma in early infancy. What is the rationale for this physiologic adaptation in the newborn? a. Incompletely developed neuromuscular system b. Primitive reflex system c. Presence of various sleep-wake states d. Cerebellum growth spurt
D
The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge, called lochia. Which statement is the most appropriate? A. Lochia is similar to a light menstrual period for the first 6 to 12 hours. B. It is usually greater after cesarean births. C. Lochia will usually decrease with ambulation and breastfeeding. D. It should smell like normal menstrual flow unless an infection is present.
D
The trend in the United States is for women to remain hospitalized no longer than 1 or 2 days after giving birth. Which scenario is not a contributor to this model of care? A. Wellness orientation model of care rather than a sick-care model B. Desire to reduce health care costs C. Consumer demand for fewer medical interventions and more family-focused experiences D. Less need for nursing time as a result of more medical and technologic advances and devices available at home that can provide information
D
What are the most common causes for subinvolution of the uterus? A. Postpartum hemorrhage and infection B. Multiple gestation and postpartum hemorrhage C. Uterine tetany and overproduction of oxytocin D. Retained placental fragments and infection
D
What form of heart disease in women of childbearing years generally has a benign effect on pregnancy? a. Cardiomyopathy B. Rheumatic heart disease C. Congenital heart disease D. Mitral valve prolapse
D
What is the most critical physiologic change required of the newborn after birth? a. Closure of fetal shunts in the circulatory system b. Full function of the immune defense system c. Maintenance of a stable temperature d. Initiation and maintenance of respirations
D
What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant? A. Genetic changes and anomalies B. Extensive CNS damage C. Fetal addiction to the substance inhaled D. Intrauterine growth restriction
D
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? A. Regular heart rate and hypertension B. Increased urinary output, tachycardia, and dry cough C. Shortness of breath, bradycardia, and hypertension D. Dyspnea, crackles, and an irregular, weak pulse
D
Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during the puerperium? A. Varicosities of the legs B. Carpal tunnel syndrome C. Periodic numbness and tingling of the fingers D. Headaches
D
Which infant response to cool environmental conditions is either not effective or not available to them? a. Constriction of peripheral blood vessels b. Metabolism of brown fat c. Increased respiratory rates d. Unflexing from the normal position
D
Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus? A. Notify the physician of an impending hemorrhage. B. Assess the blood pressure and pulse. C. Evaluate the lochia. D. Assist the client in emptying her bladder.
D
Which physiologic alteration of pregnancy most significantly affects glucose metabolism? A. Pancreatic function in the islets of langerhans is affected by pregnancy. B. Pregnant women use glucose at a more rapid rate than nonpregnant women. C. Pregnant women significantly increase their dietary intake. D. Placental hormones are antagonistic to insulin, thus resulting in insulin resistance.
D
Which term best describes the interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state? A. Involutionary period because of what happens to the uterus B. Lochia period because of the nature of the vaginal discharge C. Mini-tri period because it lasts only 3 to 6 weeks D. Puerperium, or fourth trimester of pregnancy
D
While evaluating the reflexes of a newborn, the nurse notes that with a loud noise the newborn symmetrically abducts and extends his arms, his fingers fan out and form a C with the thumb and forefinger, and he has a slight tremor. The nurse would document this finding as a positive _____ reflex. a. tonic neck b. glabellar (Myerson) c. Babinski d. Moro
D
While providing routine mother-baby care, which activities should the nurse encourage to facilitate the parent-infant attachment? a. The baby is able to return to the nursery at night so that the new mother can sleep. b. Routine times for care are established to reassure the parents. c. The father should be encouraged to go home at night to prepare for discharge of the mother and baby. d. An environment that fosters as much privacy as possible should be created.
D
Women with severe and persistent mental illness are likely to be more vulnerable to being involved in controlling and/or violent relationships; however, many women develop mental health problems as a result of long-term abuse. Which condition is unlikely to be a psychologic consequence of continued abuse? A. Substance abuse B. Posttraumatic stress disorder (PTSD) C. Eating disorders D. Bipolar disorder
D
elvic 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? A. I contract my thighs, buttocks, and abdomen. B. I perform 10 of these exercises every day. C. I stand while practicing this new exercise routine. D. I pretend that I am trying to stop the flow of urine in midstream.
D