OB Tests

A woman, 40 weeks' gestation, calls the labor unit to see whether or not she should go to the hospital to be evaluated. Which of the following statements by the woman indicates that she is probably in labor and should proceed to the hospital? "The contractions are 5-20 minutes apart" "I saw a pink discharge on the toilet tissue when I went to the bathroom" "I have had cramping for the past 3 or 4 hours" "The contractions are about a minute long and I am unable to talk through them."

"The contractions are about a minute long and I am unable to talk through them."

A woman is admitted to the labor and birthing suite. Vaginal examination reveals that the presenting part is approximately 2 cm below the ischial spines. The nurse documents this finding as: 0 Station crowning -2 station +2 station

+2 station

A nurse is reviewing a journal article on the causes of postpartum hemorrhage. Which condition would the nurse most likely find as the most common cause? A. uterine atony B. labor augmentation C. uterine inversion D. cervical or vaginal lacerations

A. uterine atony

A medication order reads: Methergine (ergonovine) 0.2 mg PO q 6 h x 4 doses. Which of the following assessments should be made before administering each dose of this medication? Apical pulse Blood pressure Lochia flow Episiotomy

Blood pressure

Genital herpes is the most common sexually transmitted viral infection in the United States. T/F

False Human Papillomavirus (HPV) is the most common sexually transmitted viral infection in the United States.

A full-term primigravid pregnant client is being assessed for induction of labor. Her Bishop score is less than 6. Which prescription would the nurse anticipate? Prepare the client for a cesarean birth. Rupture membranes. Insert a Cook's catheter into the endocervical canal Administer oxytocin intravenously at 10 mU/minute.

Insert a Cook's catheter into the endocervical canal

The nurse is assessing the fetal station during a vaginal examination. Which of the following structures should the nurse palpate? Sacral promontory Ischial spines Cervix Symphysis pubis

Ischial spines

A nurse is taking care of a pregnant client. She knows the patient is showing common signs of physiologic preparation for labor due to which of the presenting symptoms? SELECT ALL THAT APPLY. energy surges increasing headaches loose stools loss of operculum or mucous plug regular, rhythmic contractions increased vaginal mucous

energy surges loose stools loss of operculum or mucous plug increased vaginal mucous

A woman in labor who received an opioid for pain relief develops respiratory depression. The nurse would expect which agent to be administered? fentanyl butorphanol promethazine naloxone

naloxone

A woman with hyperemesis gravidarum asks the nurse about suggestions to minimize nausea and vomiting. Which suggestion would be most appropriate for the nurse to make? "Drink fluids in between meals rather than with meals." "Make sure that anything around your waist is quite snug." "Lie down for about an hour after you eat." "Try to eat three large meals a day with less snacking."

"Drink fluids in between meals rather than with meals." Suggestions to minimize nausea and vomiting include avoiding tight waistbands to minimize pressure on the abdomen, eating small frequent meals throughout the day, separating fluids from solids by consuming fluids in between meals; and avoiding lying down or reclining for at least 2 hours after eating.

The nurse is caring for a client in labor and delivery with the following history: 28 years old, having her second baby, 39 weeks gestation in transition phase, FH 135 with early decelerations. The clients states, "I'm so scared. Please make sure the baby is OK!". Which of the following responses by the nurse is appropriate? "The fetal heart rate is within normal limits" "Did your first baby die during labor?" "How did your first baby die?" "There is absolutely nothing to worry about".

"The fetal heart rate is within normal limits"

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

A. "I need to take iron with orange juice, and eat foods high in fiber like fruits and vegetables." Iron supplements can lead to constipation, so the woman needs to increase her intake of fluids and high-fiber foods. Milk inhibits absorption and should be discouraged. Vitamin C-containing fluids such as orange juice are encouraged because they promote absorption. Ideally the woman should take the iron on an empty stomach to improve absorption, but many women cannot tolerate the gastrointestinal discomfort it causes. In such cases, the woman should take it with meals. Iron typically causes the stool to become greenish black and tarry; there is no need for the woman to notify her primary care provider.

Upon entering the room of a patient who has had a spontaneous abortion, the nurse observes the patient crying. Which response by the nurse would be most appropriate? A. "I'm very sorry you lost your pregnancy." B. "A baby still wasn't formed in your uterus." C. "What is there to cry about?" D. "Will a pill help your pain?"

A. "I'm very sorry you lost your pregnancy." Telling the client that the nurse is sorry for the loss acknowledges the loss to the woman, validates her feelings, and brings the loss into reality. Asking why the client is crying is ineffective at this time. Offering a pill for the pain ignores the client's feelings. Telling the client that the baby was not formed is inappropriate and discounts any feelings or beliefs that the client has.

A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs). What information would the nurse need to stress to the group? Select all that apply. A. ECs are birth control pills in higher, more frequent doses. B. ECs are not to be used in place of regular birth control. C. ECs induce an abortion-like reaction. D. ECs provide some protection against STIs.

A. ECs are birth control pills in higher, more frequent doses. B. ECs are not to be used in place of regular birth control. Important points to stress concerning ECs are that ECs do not offer any protection against STIs or future pregnancies; they should not be used in place of regular birth control, as they are less effective; they are regular birth control pills given at higher doses and more frequently; and they are contraindicated during pregnancy (Miller, 2011). Contrary to popular belief, ECs do not induce abortion and are not related to mifepristone or RU-486, the so-called abortion pill approved by the FDA in 2000.

A group of nurses are preparing a program about rape and sexual assault for a community health center. Which information would the nurses include as being most accurate? Select all that apply. A. Medication and counseling can help a rape victim cope. B. Few women falsely cry "rape." C. The majority of victims of rape tell someone about it. D. A rape victim feels vulnerable and betrayed afterwards. E. Most women have rape fantasies desiring to be raped.

A. Medication and counseling can help a rape victim cope. B. Few women falsely cry "rape." D. A rape victim feels vulnerable and betrayed afterwards. The majority of women never tell anyone about a rape. Almost two-thirds of victims never report it to the police. The victim feels vulnerable, betrayed, and insecure after a rape. Few women falsely cry "rape." Reality and fantasy are different, and dreams have nothing to do with the brutal violation of rape. Medication can help initially, but counseling is usually needed.

Which method would be most effective in evaluating the parents' understanding about their newborn's care? A. Observe the parents performing the procedures. B. Allow the parents to state the steps of the care. C. Demonstrate all infant care procedures. D. Routinely assess the newborn for cleanliness.

A. Observe the parents performing the procedures.

Which positions would be most appropriate for the nurse to suggest as a comfort measure to a woman who is in the first stage of labor? SELECT ALL THAT APPLY. A. Sitting on an exercise ball at the bedside B. rocking back and forth with foot on chair C. closed knee-chest position D. straddling with forward leaning over a chair E. walking with partner support F. supine with legs raised at a 90-degree angle (lithotomy position)

A. Sitting on an exercise ball at the bedside B. rocking back and forth with foot on chair D. straddling with forward leaning over a chair E. walking with partner support

A nurse is working with a victim of intimate partner violence and helping her develop a safety plan. Which items would the nurse suggest that the woman take with her? Select all that apply. A. Social Security number B. health insurance cards C. her usual cell phone D. driver's license E. cash

A. Social Security number B. health insurance cards D. driver's license E. cash When leaving an abusive relationship, the woman should take her driver's license or photo ID, Social Security number or green card/work permit, birth certificates, any court papers or orders, credit cards, cash, and health insurance cards. The woman should avoid her usual cell phone because it may leave a trail to follow - she should get a new cell phone with a new number.

A laboratory technician arrives to draw blood for a complete blood count (CBC) for a client who had a left-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her right antecubital space. The nurse enters the room and sees the technician beginning to place a tourniquet on the client's right arm. Which response by the nurse would be most appropriate? A. Stop the technician immediately. B. Have the technician come back later on. C. Tell the technician to obtain the specimen from the client's left arm. D. Notify the surgeon to obtain the specimen via a cut-down procedure.

A. Stop the technician immediately

Which compound would the nurse have readily available for a patient who is receiving magnesium sulfate to treat severe preeclampsia? A. calcium gluconate B. calcium carbonate C. ferrous sulfate D. potassium chloride

A. calcium gluconate The antidote for magnesium sulfate is calcium gluconate, and this should be readily available in case the woman has signs and symptoms of magnesium toxicity.

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

A. cooking all meat to an internal temperature of 140° F Meats should be cooked to an internal temperature of 160° F. Other measures to prevent toxoplasmosis include peeling or thoroughly washing all raw fruits and vegetables before eating them, wearing gardening gloves when in contact with outdoor soil, and avoiding the emptying or cleaning of a cat's litter box.

A nurse is observing the interaction between a new father and his newborn. The nurse determines that engrossment has NOT occurred based on which behavior? A. identifies imperfections in the newborn's appearance B. is able to distinguish his newborn from others in the nursery C. shows feelings of pride with the birth of the newborn D. demonstrates pleasure when touching or holding the newborn

A. identifies imperfections in the newborn's appearance

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

A. low-birthweight infants Substance abuse during pregnancy is associated with low-birthweight infants, preterm labor, abortion, intrauterine growth restriction, abruptio placentae, neurobehavioral abnormalities, and long-term childhood developmental consequences. Excessive weight gain, higher pain tolerance, and longer gestational periods are not associated with substance abuse.

When obtaining the health history from a patient, which factor would lead the nurse to suspect that the patient has an increased risk for sexually transmitted infections (STIs)? A. malodorous vaginal discharge and low abdominal pain B. itchy white vaginal discharge C. weight gain of 5 lbs in one year D. hive-like rash for the past 2 days

A. malodorous vaginal discharge and low abdominal pain A rash could be related to numerous underlying conditions. A weight gain of 5 lbs in one year is not a factor increasing one's risk for STIs. A change in the color of vaginal discharge such as yellow, milky, or curd-like, not clear, along with low abdominal pain would suggest an STI.

A woman with gestational hypertension experiences a seizure (eclampsia). Which intervention would the nurse identify as the first priority? A. oxygenation B. delivery of the fetus C. control of hypertension D. fluid replacement

A. oxygenation As with any seizure, the priority is to clear the airway and maintain adequate oxygenation both to the mother and the fetus. Fluids and control of hypertension are addressed once the airway and oxygenation are maintained. Delivery of fetus is determined once the seizures are controlled and the woman is stable.

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

A. peanut butter B. deep green leafy vegetables E. meats Foods high in iron include meats, green leafy vegetables, legumes, dried fruits, whole grains, peanut butter, bean dip, whole-wheat fortified breads, and cereals.

A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the: A. placenta. B. amniotic fluid. C. breast milk. D. birth canal.

A. placenta. The syphilis spirochete can cross the placenta at any time during pregnancy. It is not transmitted via amniotic fluid, passage through the birth canal, or breast milk.

A client is to receive an implantable contraceptive. The nurse describes this contraceptive as containing: A. synthetic progestin. B. concentrated estrogen. C. concentrated spermicide. D. combined estrogen and progestin.

A. synthetic progestin. Implantable contraceptives deliver synthetic progestin that act by inhibiting ovulation and thickening cervical mucus so sperm cannot penetrate. Implantable contraceptives do not contain combined estrogen and progestin, concentrated spermicide, or concentrated estrogen.

A woman who is living with HIV infection is receiving antiretroviral therapy (ART) and is having difficulty with adherence. To promote adherence, which of the following areas would be least important to assess initially? A. the woman's career B. the woman's beliefs and knowledge about her regimen C. the woman's insurance coverage for medication D. the woman's family and living arrangements

A. the woman's career The most important area to assess initially would be the client's beliefs and knowledge about the disease and its treatment. A common barrier is a lack of understanding about the link between drug resistance and nonadherence. Once this area is assessed, the nurse can assess for other barriers, such as finances and insurance, and family issues, including living arrangements (for example, the woman may be afraid that her HIV status would be revealed if others see her taking medication). The woman's career, while important, would be less relevant than the other factors.

Jane is now at 38 weeks gestation. Her last prenatal visit revealed that her fundal height was measuring larger than expected for her gestation. Which of the following assessments would the nurse prioritize to do first? Hemoglobin A1C for mom Blood pressure and assess for edema, headache, blurred vision Signs of impending labor An ultrasound to check for baby's size and amniotic fluid level

An ultrasound to check for baby's size and amniotic fluid level WIth a fundal height that is large for gestation, there is a need to verify the approximate size of the fetus, and the amount of amniotic fluid. Diabetic mothers often produce larger babies, and are at risk for polyhydramnios. The mother's blood glucose level will give us an idea of her blood sugar at this moment, but it does not apply to the size issue. Blood pressure and a preeclampsia screen (edema, changes in vision and elevated blood pressure) are important to do at every visit, but the priority at this time is to assess for issues related to fetal growth as a result of the GDM.

A nurse is caring for several women in labor. Which of the following women would the nurse prioritize as first to assess her current status? A. A woman having contractions every 5 minutes, cervical dilation 3 cm, coping well, with normal fetal monitoring tracing B. A woman having contractions every 1 minute, cervical dilation 9 cm, feeling very uncomfortable and complaining of pelvic pressure, with normal fetal monitoring tracing C. A woman having contractions every 21/2 minutes, cervical dilation 7 cm, feeling uncomfortable with epidural, with normal fetal monitoring tracing D. A woman having contractions every 3 minutes, cervical dilation 5 cm, coping well with an epidural, with normal fetal monitoring tracing

B. A woman having contractions every 1 minute, cervical dilation 9 cm, feeling very uncomfortable and complaining of pelvic pressure, with normal fetal monitoring tracing

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she's not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor? A. "My contractions are about 5 minutes apart and regular." B. "The contractions slow down after I walk around a while." C. "If I try to talk to my partner during a contraction, I can't." D. "I'm feeling contractions mostly in my back."

B. "The contractions slow down after I walk around a while."

A nurse is reviewing a journal article about vaccines used to prevent STIs. The nurse would expect to find information about vaccines for which STIs? Select all that apply. A. HSV B. HBV C. HPV D. HIV

B. HBV C. HPV Vaccines are under development or are undergoing clinical trials for certain STIs, including HIV and HSV. However, the only vaccines currently available are for prevention of HAV, HBV, and HPV infection.

A patient is admitted in the healthcare facility with pelvic inflammatory disease (PID). When reviewing the patient's history, which of the following would the nurse identify as a risk factor? A. Exposure to phthalates B. Multiple episodes of chlamydia C. Genetic predisposition D. History of preterm delivery

B. Multiple episodes of chlamydia One of the risk factors associated with pelvic inflammatory disease is cervicitis like chlamydia. Women with gestational diabetes are at an increased risk for developing type 2 diabetes later in life. Genetic predisposition and exposure to phthalates are risk factors associated with breast cancer.

You are making a follow-up home visit to a woman who is 2 weeks postpartum. Which finding would you expect when assessing the client's fundus? A. 6 cm below the umbilicus B. cannot be palpated C. 2 cm below the umbilicus D. 8 cm below the umbilicus

B. cannot be palpated

A nurse is examining a postpartum woman who delivered a healthy newborn 2 days ago. Which finding would the nurse expect? A. pinkish brown vaginal discharge B. deep red mucus-like vaginal discharge C. creamy white vaginal discharge D. bright red vaginal discharge

B. deep red mucus-like vaginal discharge

A nurse reviewing laboratory results suspects that a patient is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? A. hyperglycemia B. elevated liver enzymes C. elevated bile acids D. elevated platelet count

B. elevated liver enzymes HELLP is an acronym for hemolysis, elevated liver enzymes, and low platelets. Hyperglycemia is not a part of this syndrome. HELLP may increase the woman's risk for DIC.

A woman in labor is to receive continuous internal electronic fetal monitoring. The nurse prepares the client for this monitoring based on the understanding that which criterion must be present? A. cervix is not dilated B. presenting fetal part is low enough C. a neonatologist to insert the electrode D. intact membranes

B. presenting fetal part is low enough

When the nurse is assessing a postpartum client approximately 6 hours after delivery, which finding would warrant further investigation? A. profuse sweating B. pulse of 120 beats per minute C. voiding of 350 cc D. deep red, fleshy-smelling lochia

B. pulse of 120 beats per minute

The nurse is working with a group of community health members to develop a plan to address the special health needs of women. Which educational program would the group most likely identify as the highest priority? A. importance of having mammograms yearly starting at age 35 B. ways to adopt a heart-healthy lifestyle C. methods for smoking cessation D. risk reduction strategies for diabetes

B. ways to adopt a heart-healthy lifestyle The group needs to address cardiovascular disease, the number one cause of death in women regardless of racial or ethnic group. Thus, education for adopting a heart-healthy lifestyle would be the priority. Smoking is related to heart disease and the development of cancer. However, heart disease and cancer can occur in any woman regardless of her smoking history. Cancer is the second leading cause of death, with women having a one in three lifetime risk of developing cancer. Diabetes is another important health condition that can affect women. However, it is not the major health problem that heart disease is. thus, educational programs focusing on smoking cessation, cancer screening and early detection, and diabetes risk reduction would be lesser priorities.

Patricia is a 17 year-old gravida 1, para 0 at 34 weeks gestation, who is visiting her physician for a routine prenatal visit. When weighing Patricia, the nurse finds that she has gained 6 pounds in the past 2 weeks. The nurse takes Patricia's vital signs. Which of the following sets of vital signs would be concerning and further support the pre-eclampsia diagnosis? Select one. BP 136/84; HR 79; RR 20; T 99.0*F; FHR: 130bpm per doppler; DTR 2+ no clonus BP 108/76, HR 88, RR 18, T 98.0, FHR 120bpm, DTR 2+; no clonus. BP 120/78; HR 110, RR 20; T 98.6* F; FHR 125bpm DTR 2+ no clonus BP 146/90; HR 82 bpm; RR 20 breaths; T 98.6* F; FHR: 145 per doppler; DTR 2+ no clonus

BP 146/90; HR 82 bpm; RR 20 breaths; T 98.6* F; FHR: 145 per doppler; DTR 2+ no clonus

A nurse is observing a new mother interacting with her newborn. Which statement would alert the nurse to the potential for impaired bonding between mother and newborn? A. "You have your daddy's eyes." B. "He seems to sleep a lot." C. "He looks like a frog to me." D. "Where did you get all that hair?"

C. "He looks like a frog to me."

A client is being discharged after having a right-sided modified radical mastectomy. After teaching the client about ways to minimize lymphedema, the nurse determines that the teaching was successful based on which client statement? A. "I should use lotion on my hands after working in my garden." B. "I should have my blood pressure taken in my right arm." C. "I need to avoid wearing tops that have elastic in the sleeves." D. "I need to limit my driving to once a week."

C. "I need to avoid wearing tops that have elastic in the sleeves."

A patient who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. She also admits, "I am worried that the medications you want me to take will harm the baby." Which statement by the nurse would be most appropriate? A. "Antibodies cross the placenta and provide immunity to the newborn." B. "Wait until after the infant is born, and then something can be done." C. "It's important to take antiretroviral medications as prescribed to reduce the risk of transmission." D. "The medications are all proven to put the baby at risk for anomalies."

C. "It's important to take antiretroviral medications as prescribed to reduce the risk of transmission." Drug therapy is the mainstay of treatment for pregnant women infected with HIV. The goal of therapy is to reduce the viral load as much as possible; this reduces the risk of transmission to the fetus. There are very few antiretrovirals that are associated with fetal complications. Decisions about the method of delivery should be based on the woman's viral load, duration of ruptured membranes, progress of labor, and other pertinent clinical factors. The newborn is at risk for HIV because of potential perinatal transmission. Waiting until after the infant is born may be too late.

When developing a teaching plan for a couple who are considering contraception options, the nurse would include which statement? A. "A good contraceptive doesn't require a physician's prescription." B. "The best one is the one that is the least expensive and most convenient." C. "The best contraceptive is one that you will use correctly and consistently." D. "You should select one that is considered to be 100% effective."

C. "The best contraceptive is one that you will use correctly and consistently." For a contraceptive to be most effective, the client must be able to use it correctly and consistently. Even if a method is considered 100% effective, it is not the best choice if the couple does not use it correctly or consistently. Cost is a consideration, but the least expensive method is not necessarily the best choice. The need for a prescription is not relevant to the couple's choice.

A patient with genital human papillomavirus (HPV) infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate? A. "All you need is a dose of penicillin and the infection will be gone." B. "Once you have the infection, you develop an immunity to it." C. "There is no cure, but treatment helps to reduce symptoms." D. "There is a new vaccine available that prevents the infection." s

C. "There is no cure, but treatment helps to reduce symptoms." HPV is a life-long viral infection. No cure exists, but topical treatment helps to reduce symptoms, shedding. A vaccine is available for HPV infection but does not prevent it once a person is exposed to HPV, though they might be protected against new strains. Penicillin is used to treat syphilis. Lifetime immunity does not develop after a genital HPV infection, although the immune system will often suppress the infection.

A woman is to undergo an amnioinfusion. Which statement would be most appropriate to include when teaching the woman about this procedure? A. "A suction cup is placed on your baby's head to help bring it out." B. "After the infusion, you'll be scheduled for a cesarean birth." C. "You'll need to stay in bed while you're having this procedure." D. "We'll give you an analgesic to help reduce the pain."

C. "You'll need to stay in bed while you're having this procedure."

A nurse is providing care to several pregnant women at different weeks of gestation. The nurse would expect to screen for group B streptococcus infection in the client who is at: A. 30 weeks' gestation. B. 16 weeks' gestation. C. 36 weeks' gestation. D. 28 weeks' gestation.

C. 36 weeks' gestation. According to the CDC guidelines, all pregnant women should be screened for group B streptococcus infection at 35 to 37 weeks' gestation.

A client who has just given birth to a healthy newborn required an episiotomy. Which action would the nurse implement immediately after birth to decrease the client's pain from the procedure? A. Offer warm blankets. B. Offer a warm sits bath. C. Apply an ice pack to the site. D. Encourage the woman to void.

C. Apply an ice pack to the site.

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

C. achieving good blood glucose control during the pregnancy Therapeutic management for the woman with diabetes focuses on tight glucose control, thereby minimizing the risks to the mother, fetus, and neonate. The woman's emotional and psychological status is highly variable and may or may not affect the pregnancy. Evaluating for long-term diabetic complications such as retinopathy or nephropathy, as evidenced by laboratory testing such as BUN levels, is an important aspect of preconception care to ensure that the mother enters the pregnancy in an optimal state.

A nurse is developing a plan of care for a pregnant patient to address the continuum of care from pregnancy through childbirth. Which aspect would the nurse include as essential to enhancing the woman's birthing experience? A. assigning several nurses to act as the woman's support team B. involving a pediatric physician for care of the child after birth C. educating the patient about the importance of a support person D. ensuring adherence to strict specific routines

C. educating the patient about the importance of a support person Research has demonstrated that educating the client about the importance of a support person during labor and delivery has been shown to improve and enhance the birthing experience. There is no evidence to suggest that adherence to strict specific routines or the involvement of pediatric physician enhances the childbirth experience. Research does indicate that the support, when provided by someone other than a facility staff member and initiated early in labor, proved to be more effective. Thus assigning of several nurses to act as a support team would not be as effective.

When planning the care of a woman in the active phase of labor, the nurse would anticipate assessing the fetal heart rate at which interval? A. every 45 to 60 minutes B. every 2 to 4 hours C. every 15 to 30 minutes D. every 10 to 15 minutes

C. every 15 to 30 minutes

A nurse is describing how the fetus moves through the birth canal. Which component would the nurse identify as being most important in allowing the fetal head to move through the pelvis? A. frontal bones B. parietal bones C. flexion D. occipital bone

C. flexion

A nurse is observing a postpartum woman and her partner interact with the their newborn. The nurse determines that the parents are developing parental attachment with their newborn when they demonstrate which behavior? Select all that apply. A. refrain from checking out the newborn's features B. refer to the newborn as having a monkey-face C. identify common features between themselves and the newborn D. make direct eye contact with the newborn E. frequently ask for the newborn to be taken from the room

C. identify common features between themselves and the newborn D. make direct eye contact with the newborn

A woman in the 34th week of pregnancy says to the nurse, "I still feel like having intercourse with my husband." The woman's pregnancy has been uneventful. The nurse responds based on the understanding that: A. intercourse at this time is likely to cause rupture of membranes. B. intercourse at this time is likely to result in premature labor. C. it is safe to have intercourse at this time. D. there are other ways that the couple can satisfy their needs.

C. it is safe to have intercourse at this time.

A nurse is providing care to a woman in labor. After assessment of the fetus, the nurse documents the fetal lie: the fetal head is toward the mother's pelvis, with the spine aligned with her spine. Which term would the nurse most likely use? A. presentation B. cephalic C. longitudinal D. flexion

C. longitudinal

After teaching a group of adolescents about HIV, the nurse asks them to identify the major means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which means of exposure? A. sharing needles for IV drug use B. perinatal transmission C. sexual intercourse D. blood transfusion

C. sexual intercourse Most HIV-infected adolescents are exposed to the virus through sexual intercourse, with recent data suggesting that the majority of HIV-infected adolescent males are infected through sex with men. Only a few adolescent males appear to be exposed through injection of drugs or heterosexual contact. Adolescent females are mostly exposed through heterosexual contact, with a small percentage exposed through injected drug use. Although perinatal transmission can occur, it is not the major means of transmission for adolescents. Exposure to the virus via blood transfusions had dropped significantly with the testing of blood and blood products.

A nurse is completing a postpartum assessment. Which finding would alert the nurse to a potential problem? A. pain rating of 2 on a scale from 0 to 10 B. lochia rubra with a fleshy odor C. temperature of 101° F (38.3° C) D. respiratory rate of 16 breaths per minute

C. temperature of 101° F (38.3° C)

A nurse is monitoring the FHR of a client in labor using an electronic fetal monitor. The reading shows a late deceleration. Which intervention should the nurse implement first? Change maternal position to an upright or side lying position. Administer exogenous oxytocin. Place the client in the lithotomy position.

Change maternal position to an upright or side lying position. To intervene with late decelerations, the nurse should change maternal position to an upright or side lying posture. Late deceleration in the fetus indicates insufficient uteroplacental perfusion. Changing the maternal position improves the maternal venous return. In upright position, the uterine activity becomes more efficient. Attempts should be made to increase the uteroplacental perfusion and fetal circulation. Administering oxytocin and encouraging Valsalva maneuver (extended breath holding) may augment the uteroplacental insufficiency. In late deceleration, the nurse should administer oxygen through nasal cannula and discontinue administration of oxytocin. Placing the client in the lithotomy position contributes to poor placental circulation.

The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which patient statement indicates that the nurse's teaching was successful? Answers: A. "I'll basically follow the same diet that I was following before I became pregnant." B. "Because I need extra protein, I'll have to increase my intake of milk and meat." C. "I'll adjust my diet and insulin based on the results of my urine tests for glucose." D. "Pregnancy affects insulin sensitivity, so I'll need to make adjustments in my diet."

D. "Pregnancy affects insulin sensitivity, so I'll need to make adjustments in my diet." In pregnancy, placental hormones cause insulin resistance at a level that tends to parallel growth of the fetoplacental unit. Nutritional management focuses on maintaining balanced glucose levels. Thus, the woman will probably need to make adjustments in her diet. Protein needs increase during pregnancy, but this is unrelated to diabetes. Blood glucose monitoring results typically guide therapy.

A nurse is describing the cycle of violence to a community group. When explaining the honeymoon phase, the nurse would most likely include which description? A. associated with loss of physical and emotional control B. somehow triggered by the victim's behavior C. characterized by tension-building and then battery (or violence) D. a calm period that lulls the victim

D. a calm period that lulls the victim The cyclic behavior begins with a time of tension-building arguments, progresses to violence, and settles into a making-up or calm period.

Assessment of a woman in labor reveals cervical dilation of 6 cm, cervical effacement of 90%, and contractions occurring every 2 to 3 minutes, lasting about 60 seconds. The nurse determines that this client is in: A. transition phase of the first stage. B. perineal phase of the second stage. C. latent phase of the first stage. D. active phase of the first stage.

D. active phase of the first stage. The latent phase of the first stage of labor involves cervical dilation of 0 to 3 cm, cervical effacement of 0% to 40%, and contractions every 5 to 10 minutes lasting 30 to 45 seconds. The active phase is characterized by cervical dilation of 4 to 7 cm, effacement of 40% to 80%, and contractions occurring every 2 to 5 minutes lasting 45 to 60 seconds. The transition phase is characterized by cervical dilation of 8 to 10 cm, effacement of 80% to 100%, and contractions occurring every 1 to 2 minutes lasting 60 to 90 seconds. The perineal phase of the second stage occurs with complete cervical dilation and effacement, contractions occurring every 2 to 3 minutes and lasting 60 to 90 seconds, and a tremendous urge to push by the mother.

The nurse encourages a female patient with high-risk human papillomavirus (HPV) to receive continued follow-up care because she may be at higher risk for: A. dyspareunia. B. dysmenorrhea. C. infertility. D. cervical cancer.

D. cervical cancer. Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer. Therefore, the client needs continued follow-up for Pap smears. HPV is not associated with an increased risk for infertility, dyspareunia, or dysmenorrhea.

A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible adverse fetal outcome?\ A. polyhydramnios B. abruptio placentae C. incompetent cervix D. congenital anomalies

D. congenital anomalies A HbA1c level of 13% indicates poor glucose control. This, in conjunction with the woman being in the first trimester, increases the risk for congenital anomalies in the fetus. Elevated glucose levels are not associated with incompetent cervix, placenta previa, or abruptio placentae.

A nurse is caring for several women in labor. The nurse determines that which woman is in the transition phase of active labor? A. contractions every 21/2 minutes, cervical dilation 5 cm B. contractions every 5 minutes, cervical dilation 2 cm C. contractions every 4 minutes, cervical dilation 3 cm D. contractions every 1-2 minutes, cervical dilation 9 cm

D. contractions every 1-2 minutes, cervical dilation 9 cm The transition phase is characterized by strong contractions occurring every 1 to 2 minutes and cervical dilation from 8 to 10 cm. Contractions every 5 minutes with cervical dilation of 3 cm is typical of the latent phase. Contractions every 3 minutes with cervical dilation of 5 cm and contractions every 21/2 minutes with cervical dilation of 7 cm suggest the active phase of labor.s

A nurse suspects that a pregnant patient may be experiencing abruptio placenta based on assessment of which finding? Select all that apply. A. rigid uterus B. absence of pain C. slow onset D. dark red vaginal bleeding E. decelerations of fetal heart rate

D. dark red vaginal bleeding E. decelerations of fetal heart rate Assessment findings associated with abruptio placenta include a sudden onset, with concealed or visible bleeding, dark red bleeding, constant pain or uterine tenderness on palpation, firm to rigid uterine tone, and fetal distress or absent fetal heart tones.

A pregnant client whose diabetes has been poorly controlled throughout her pregnancy is in labor. The nurse would assess the neonate closely at birth for which condition? A. hypobilirubinemia B. low birthweight C. hyperglycemia D. macrosomia

D. macrosomia Poorly controlled diabetes during pregnancy can result in macrosomia due to hyperinsulinemia stimulated by fetal hyperglycemia. Typically the neonate is hypoglycemic due to the ongoing hyperinsulinemia that occurs after the placenta is removed. Infants of diabetic women typically are large and are at risk for hyperbilirubinemia due to excessive red blood cell breakdown.

A nurse is reading a journal article about the various medications used for pain relief during labor. Which drug would the nurse most likely note as producing amnesia but no analgesia? A. fentanyl B. prochlorperazine C. meperidine D. midazolam

D. midazolam

The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes interventions focusing on which area because of the woman's increased risk? A. cytomegalovirus infection B. chorioamnionitis C. oligohydramnios D. preeclampsia

D. preeclampsia Women with multiple gestations are at high risk for preeclampsia, preterm labor, polyhydramnios, hyperemesis gravidarum, anemia, and antepartal hemorrhage. There is no association between multiple gestations and the development of chorioamnionitis.

Which information on a patient's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy? A. ovarian cyst 2 years ago B. heavy, irregular menses C. use of oral contraceptives for 5 years D. recurrent pelvic infections

D. recurrent pelvic infections In the general population, most cases of ectopic pregnancy are the result of tubal scarring secondary to pelvic inflammatory disease. Oral contraceptives, ovarian cysts, and heavy, irregular menses are not considered risk factors for ectopic pregnancy.

A father of a newborn tells the nurse, "I may not know everything about being a dad, but I'm going to do the best I can for my son." The nurse interprets this as indicating the father is in which stage of adaptation? A. reality B. expectations C. taking-in D. transition to mastery

D. transition to mastery

Which finding would the nurse expect to find in a patient with trichomoniasis? A. thin milky white discharge B. brownish vaginal discharge C. white discharge with a fishy odor D. yellowish-green frothy discharge

D. yellowish-green frothy discharge Manifestations of bacterial vaginosis include a thin, white homogenous vaginal discharge with a characteristic stale fish odor, vaginal pH greater than 4.5, and clue cells on wet-mount examination. A yellowish-green discharge with cervical bleeding on contact would be characteristic of trichomoniasis.

A client, Mary, presents to the prenatal clinic for the first time with complaints of moderate vaginal bleeding and mild abdominal cramping. She reports she has taken a pregnancy test at home that is positive. What are the priority nursing assessments that should be completed? Select all that apply Estimated Gestational Age based off of last menstrual period Amount of vaginal bleeding and assessment of pain location Prenatal Laboratory Results The number of pregnancies she has had in the past

Estimated Gestational Age based off of last menstrual period Amount of vaginal bleeding and assessment of pain location At this point, the nurse needs to know how far along the client is in her pregnancy, as this will dictate the direction of care and treatment. In early pregnancy, this could be a spontaneous abortion; while later in pregnancy, this could be a placenta previa or placental abruption. Pain assessment and amount of bleeding can determine whether this is an urgent situation if it is heavy amount of bleeding vs scant, and pain assessment allows the nurse to differentiate between previa or abruption. Laboratory results and previous pregnancies are not a priority at this point, but can be addressed once the bleeding has resolved.

Patricia is a 17 year-old gravida 1, para 0 at 34 weeks gestation, who is visiting her physician for a routine prenatal visit. When weighing Patricia, the nurse finds that she has gained 6 pounds in the past 2 weeks. Patricia's provider has decided she has mild preeclampsia. Which of the following treatments would you expect at this time? Select all that apply. Magnesium Sulfate Bolus 4gm IVP STAT Transfer to hospital for immediately delivery via cesarean section Expectant management at home Immediate transfer to hospital for antepartum inpatient bedrest More frequent prenatal visits and checks on maternal and fetal status, such as BPP, NST, Urine analysis and BP checks. keeping track of fetal movements

Expectant management at home More frequent prenatal visits and checks on maternal and fetal status, such as BPP, NST, Urine analysis and BP checks. keeping track of fetal movements

The nurse encourages a woman in labor to ambulate based on the understanding that ambulating does what? SELECT ALL THAT APPLY. Helps the fetus line up with the angle of the pelvis. Enlists the aid of gravity to move the fetus Enhances the effectiveness of contractions Increases the urge to push during the second stage. Narrows one side of the pelvis Encourages rotation of the fetus

Helps the fetus line up with the angle of the pelvis. Enlists the aid of gravity to move the fetus Enhances the effectiveness of contractions Increases the urge to push during the second stage. Encourages rotation of the fetus

A client on postpartum day one is assessed. The nurse notes that the client's lochia rubra is moderate and her fundus is boggy, 2 cm above the umbilicus, and deviated to the right. Which of the following actions should the nurse take first? Notify the woman's primary healthcare provider Massage the woman's fundus Escort the woman to the bathroom to urinate Check the quantity of lochia on the peripad.

Massage the woman's fundus

The public health nurse is preparing a presentation for an adolescent group with the focus being on primary prevention topics. Which topics would the nurse include? Nutrition Guidelines Smoking Cessation Skin Cancer Screening Sexually Transmitted Infection Treatments

Nutrition Guidelines

It has been determined that Mary is 32 weeks along and has complete placenta previa. This incidence of bleeding is the third episode in past couple weeks. This is her first pregnancy. Scheduled cesarean delivery Admittance to antepartum unit for bedrest and monitoring Daily vaginal exams to assess cervical dilation Magnesium sulfate continuous through IV line Induced labor at 37 weeks

Scheduled cesarean delivery Admittance to antepartum unit for bedrest and monitoring With placenta previa, a patient with active recurrent bleeding would be admitted to hospital for close monitoring, as well as a scheduled cesarean delivery. She would be unable to deliver vaginally. Additionally, cervical exams are contraindicated, and magnesium sulfate is ordered for elevated blood pressure and for preterm labor.

During the fourth stage of labor, the nurse assesses the woman at frequent intervals after giving childbirth. What assessment data would cause the nurse the most concern? Moderate amount of dark red lochia drainage on peripad Uterine fundus palpated to the right of the umbilicus An oral temperature reading of 100.3* F Perineal area bruised and edematous beneath her ice pack

Uterine fundus palpated to the right of the umbilicus

A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which findings would lead the nurse to suspect that the woman is developing an infection? Select all that apply. fetal bradycardia abdominal tenderness elevated maternal pulse rate cloudy malodorous fluid decreased C-reactive protein levels

abdominal tenderness elevated maternal pulse rate cloudy malodorous fluid Possible signs of infection associated with premature rupture of membranes include elevation of maternal temperature and pulse rate, abdominal/uterine tenderness, fetal tachycardia over 160 bpm, elevated white blood cell count and C-reactive protein levels, and cloudy, foul-smelling amniotic fluid.

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

at 28 weeks' gestation and again within 72 hours after birth if the baby's blood is Rh positive To prevent isoimmunization, the woman should receive Rho(D) immune globulin at 28 weeks and again within 72 hours after birth if the baby's blood is (+).

A nurse is completing the assessment of a woman admitted to the labor and birth suite. Which information would the nurse expect to include as part of the physical assessment? blood pressure family history Birthing plan Family relationships

blood pressure

Nurses in the United States working in maternity services need to have knowledge of a variety of cultures and show cultural humility in caring for women and their families because: care can be improved by demonstrating sensitivity for different cultural preferences physiological differences exist among different cultures all members of a specific culture are homogenous nondominant cultural groups are made up of new immigrants

care can be improved by demonstrating sensitivity for different cultural preferences

Which factor would most likely be responsible for a pregnant women's failure to receive adequate prenatal care in the United States? lack of health insurance to cover costs hiding the pregnancy in order to cope inability to trust hospitals belief that it is not necessary because pregnancy is normal

lack of health insurance to cover costs

The nurse is monitoring a client and notes: contractions every 3 to 5 minutes, duration 45 to 50 seconds, mild intensity, cervix 1 cm, 50% effaced, fetal head at -2 station. The nurse determines the client is currently in which stage or phase of labor? latent phase of first stage transition phase of first stage second stage third stage

latent phase of first stage

A nurse is reading a journal article about family-centered care. Which concept would the nurse expect to find as the fundamental core of this type of care? open communication strengthening of neighborhood resources partnership with the client and family providing adequate health care information

partnership with the client and family

After conducting a review class on the labor and birth process for a group of nurses working in the community clinic, the nurse determines that the teaching was successful when the group identifies which factors as affecting the labor process? SELECT ALL THAT APPLY. powers place psychological passenger participation

powers psychological passenger

A community based nurse is involved in secondary prevention activities. Which activities might be included? SELECT ALL THAT APPLY. smoking cessation program hearing screening hygiene program cholesterol testing fecal occult blood testing

smoking cessation program hearing screening cholesterol testing fecal occult blood testing

A 1-day postpartum patient states, "I think I have a urinary tract infection. I have to go the bathroom all the time." Which of the following actions should the nurse take? Assure the woman that frequent urination is normal after delivery, and assess her for dysuria Obtain an order for a urine culture Assess the urine for cloudiness Ask the woman if she is prone to urinary tract infections

Assure the woman that frequent urination is normal after delivery, and assess her for dysuria

Which statement best indicates that a client has taken self-care measures to reduce her risk for cervical cancer? A. "I've really cut down on the amount of caffeine I drink every day." B. "I've thrown out all my bubble baths and just use soap and water now." C. "Every time I have sexual intercourse, I douche." D. "My partner always uses a condom when we have sexual intercourse to reduce my exposure to human papillomavirus."

D. "My partner always uses a condom when we have sexual intercourse to reduce my exposure to human papillomavirus."

A woman developed abruptio placenta during the birth of her baby. The nurse would monitor the client closely for changes. Which finding would be a cause for alarm? A. severe uterine pain B. inversion of the uterus C. board-like abdomen D. sudden appearance of petechiae on the skin

D. sudden appearance of petechiae on the skin

True or false: A labor epidural is the only safe pain management option for a woman in labor.

False

The nurse is conducting a class for postpartum women about mood disorders. The nurse describes a major depressive mood disorder that affects mothers after childbirth for 6 weeks or longer. The nurse determines that the women understood the description when they identify the condition as postpartum: A. bipolar disorder. B. depression. C. psychosis. D. blues.

B. depression.

A nurse is describing the risks associated with prolonged pregnancies (pregnancies with gestational age over 42 weeks) as part of an inservice presentation. Which factor would the nurse be least likely to incorporate in the discussion as an underlying reason for problems in the fetus? A. meconium aspiration B. increased amniotic fluid volume C. aging of the placenta D. low Apgar scores

B. increased amniotic fluid volume

A woman with placenta previa is being treated with expectant management. The woman and fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that the woman needs more education about expectant management at home? A. "I realize the importance of following the instructions for my care." B. "I know to call my health care provider right away if I start to bleed again." C. "I can have sexual intercourse with my partner again." D. "My mother lives next door and can drive me here if necessary."

C. "I can have sexual intercourse with my partner again." Expectant management at home may not be appropriate. Expectant management is appropriate if the mother and fetus are both stable, there is no active bleeding, the client has readily available access to reliable transportation, and can comprehend instructions like avoiding intercourse.

A client is scheduled to have a Pap smear (cervical cancer screening). After the nurse teaches the client about the Pap smear, which of the following client statements indicates successful teaching? A. "I will take a bath first thing that morning to make sure I'm clean." B. "I need to douche the night before with a mild vinegar solution." C. "I will not engage in sexual intercourse for 48 hours before the test." D. "I will get a clean urine specimen when I first wake up the morning of the test."

C. "I will not engage in sexual intercourse for 48 hours before the test."

A nurse is teaching a pregnant woman at risk for preterm labor about what to do if she experiences signs and symptoms. The nurse determines that the teaching was successful when the woman makes which statement? A. "I'll lie down with my legs raised." B. "I'll walk around for 30 minutes." C. "I'll drink several glasses of water." D. "I'll try to move my bowels."

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

A nurse is explaining the use of effleurage as a pain relief measure during labor. Which statement would the nurse most likely use when explaining this measure? A. "The technique requires focusing on a specific stimulus." B. "This technique focuses on manipulating body tissues." C. "The technique involves light stroking of the abdomen with breathing." D. "This technique redirects energy fields that lead to pain."

C. "The technique involves light stroking of the abdomen with breathing."

A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which statement by the woman would lead the nurse to suspect that the woman needs additional teaching? A. "The warmth and buoyancy of the water has a nice relaxing effect." B. "My cervix should be dilated more than 5 cm before I try using this method." C. "The temperature of the water should feel hot, and be at least 105 degrees F." D. "I can stay in the bath for as long as I feel comfortable."

C. "The temperature of the water should feel hot, and be at least 105 degrees F."

A postpartum client comes to the clinic for her routine 6-week visit. The nurse assesses the client and suspects that she is experiencing subinvolution and endometritis based on which finding? A. nonpalpable fundus B. shortness of breath C. moderate lochia serosa with odor D. bruising on arms and legs

C. moderate lochia serosa with odor

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

C. persistent occiput posterior position

A nurse is conducting an in-service program for a group of nurses about cervical cancer. The nurse determines that the teaching was successful when the group identifies which area as most commonly involved? A. junction of the cervix and fundus B. internal cervical os C. squamous-columnar junction on the cervix D. posterior vaginal fornix

C. squamous-columnar junction on the cervix

A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which finding would require immediate intervention? A. fetal heart rate of 150 beats/minute B. uterine resting tone of 14 mm Hg C. urine output of 20 mL/hour D. contractions every 2 minutes, lasting 45 seconds

C. urine output of 20 mL/hour

A woman with a history of crack cocaine abuse is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also reports acute abdominal pain that is continuous. Which condition would the nurse suspect? A. umbilical cord prolapse B. shoulder dystocia C. uterine rupture D. amniotic fluid embolism

C. uterine rupture

Which description would the nurse include when teaching a client about her scheduled colposcopy? A. "A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument." B. "Scrapings of tissue will be obtained and placed on slides to be examined under the microscope." C. "A gel will be applied to your abdomen and a microphone-like device will be moved over the area to identify problem areas." D. "After you receive anesthesia, a small device will be inserted into your abdomen near your belly button to obtain tissue samples."

A. "A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument."

The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? A. "Currently there is no reliable screening test for ovarian cancer." B. "A Pap smear is almost always helpful in identifying this type of cancer." C. "There's a blood test for a marker, CA-125, that if elevated indicates cancer." D. "A genetic test for two genes, if positive, will identify the ovarian cancer."

A. "Currently there is no reliable screening test for ovarian cancer."

A pregnant woman at 31-weeks' gestation calls the clinic and tells the nurse that she is having contractions sporadically. Which instructions would be most appropriate for the nurse to give the woman? Select all that apply. A. "Drink 2 or 3 glasses of water." B. "Lie down on your back." C. "Try emptying your bladder." D. "Stop what you are doing and rest." E. "Walk around the house for the next half hour."

A. "Drink 2 or 3 glasses of water." C. "Try emptying your bladder." D. "Stop what you are doing and rest."

A nurse is teaching a pregnant woman with preterm premature rupture of membranes who is about to be discharged home about caring for herself. Which statement by the woman indicates a need for additional teaching (because it is incorrect)? A. "It's okay for my husband and me to have sexual intercourse." B. "I can shower, but I shouldn't take a tub bath." C. "I need to keep a close eye on how active my baby is each day." D. "I need to call my doctor if my temperature increases."

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

A nurse is assessing a postpartum client. Which finding would the cause the nurse the greatest concern? A. Severe headache with blurred vision, and hypertension B. perineal pain with swelling along the episiotomy C. calf pain with dorsiflexion of the foot D. fever of greater than 38 degrees celsius on one occasion

A. Severe headache with blurred vision, and hypertension

A nurse is making a home visit to a postpartum client. Which finding would most likely lead the nurse to suspect that a woman is experiencing postpartum psychosis? A. delirium B. feelings of guilt C. insomnia D. sadness

A. delirium

A nurse is assessing a pregnant woman who has come to the clinic. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings? Select all that apply. A. dull low backache B. increase in vaginal discharge C. nausea D. constipation E. four contractions in 1 hour

A. dull low backache B. increase in vaginal discharge C. nausea

A primigravida whose labor was initially progressing normally is now experiencing a decrease in the frequency and intensity of her contractions. The nurse would assess the woman for which possible condition? A. fetopelvic disproportion B. contraction ring C. a low-lying placenta D. uterine bleeding

A. fetopelvic disproportion

A woman who is 2 weeks postpartum calls the clinic and says, "My left breast hurts." After further assessment on the phone, the nurse suspects the woman has mastitis. In addition to pain, the nurse would question the woman about which symptom? A. hardening of an area in the affected breast B. no breast milk in the affected breast C. an inverted nipple on the affected breast D. an ecchymotic area on the affected breast

A. hardening of an area in the affected breast

Assessment of a postpartum client reveals a firm uterus with bright-red bleeding and a localized bluish bulging area just under the skin at the perineum. The woman also is complaining of significant pelvic pain and is experiencing problems with voiding. The nurse suspects which condition? A. hematoma B. laceration C. uterine atony D. bladder distention

A. hematoma

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

A. placenta previa B. active genital herpes infection D. two previous cesarean births E. fetal distress

A nurse at a local community clinic is developing a program to address sexually transmitted infection (STI) prevention. What would the nurse least likelyinclude in the program? A. promoting use of oral contraceptive pills B. offering education about STI transmission C. outlining safer sexual behavior D. promoting the use of barrier contraceptives

A. promoting use of oral contraceptive pills Strategies to prevent STIs include providing basic information about STI transmission, outlining safer sexual behaviors, screening asymptomatic persons with STIs, and promoting the use of barrier contraceptives.

A laboring woman and two men enter the labor suite. One of the men states, "We and our surrogate are here for our baby's delivery. Where should we go?" Which of the following responses would be appropriate? Congratulate the surrogate on the gift she is giving the gay couple. Remind the men that labor and delivery experience is very stressful. Remind the men that the woman is the baby's mother. Ask the laboring woman whom she would like to be with her during labor.

Ask the laboring woman whom she would like to be with her during labor.

A 42-year-old woman is scheduled for a mammogram. Which statement would the nurse include when teaching the woman about the procedure? A. "It's fine to use deodorants or antiperspirants on that day." B. "Each breast will be gently compressed between two panels for a low-dose type of x-ray." C. "You will have to avoid wearing metals of any kind during the examination." D. "Make sure to refrain from eating or drinking after midnight."

B. "Each breast will be gently compressed between two panels for a low-dose type of x-ray."

A postpartum woman who developed deep vein thrombosis is being discharged on anticoagulant therapy. After teaching the woman about this treatment, the nurse determines that additional teaching is needed when the woman makes which statement? A. "I will use a soft toothbrush to brush my teeth." B. "I can take ibuprofen if I have any pain." C. "I need to avoid drinking any alcohol." D. "I will call my health care provider if my stools are black and tarry."

B. "I can take ibuprofen if I have any pain."

A nurse is assessing a postpartum client who is at home. Which statement by the client would lead the nurse to suspect that the client may be developing postpartum depression? A. "I just feel so overwhelmed and tired." B. "I'm feeling so guilty and worthless lately." C. "It's strange, one minute I'm happy, the next I'm sad." D. "I keep hearing voices telling me to take my baby to the river."

B. "I'm feeling so guilty and worthless lately."

The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse describes the Bishop Score to the women. What is the most likely description s/he will give? A. This is a calculation allowing providers to know when a woman is past her due date. B. This is a score to assess ripeness of the cervix, or likelihood of successful induction. C. This is a score allowing providers to predict likelihood of fetal tolerance of labor. D. This is a score to indicate how well the fetus is oxygenated in utero.

B. This is a score to assess ripeness of the cervix, or likelihood of successful induction.

A client is diagnose with a leiomyoma, also known as a fibroid. The client asks the nurse what this is. The nurse describes this as a: A. fistula between the vagina and rectum. B. benign uterine tumor. C. cyst-like structure in the ovary D. cancerous growth on the cervix.

B. benign uterine tumor.

After presenting an in-service presentation on measures to prevent postpartum hemorrhage, the nurse determines that the teaching was successful when the group identifies which measure to prevent postpartum hemorrhage due to retained placental fragments? A. manually removing the placenta at delivery B. inspecting the placenta after delivery for intactness C. applying pressure to the umbilical cord to remove the placenta D. administering broad-spectrum antibiotics

B. inspecting the placenta after delivery for intactness

A nurse is providing a refresher class for a group of postpartum nurses. The nurse reviews the risk factors associated with postpartum hemorrhage. The group demonstrates understanding of the information when they identify which risk factors associated with uterine atony? Select all that apply. A. small for gestational age fetus B. maternal fever and presumed chorioamnionitis C. rapid labor D. hydramnios E. operative birth

B. maternal fever and presumed chorioamnionitis C. rapid labor D. hydramnios

A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer? A. corticosteroids B. oxytocins C. tocolytics D. sedatives

B. oxytocins

Review of a primiparous woman's labor and birth record reveals a prolonged second stage of labor and extended time immobilized in the stirrups. Based on an interpretation of these findings, the nurse would be especially alert for which condition? A. uterine subinvolution B. thrombophlebitis C. retained placental fragments D. hypertension

B. thrombophlebitis

A postpartum woman is ordered to receive oxytocin to stimulate the uterus to contract. Which action would be most important for the nurse to do? A. Administer the drug as an IV bolus injection. B. Withhold the drug if the woman is hypertensive. C. Piggyback the IV infusion into a primary line. D. Give as a vaginal or rectal suppository.

C. Piggyback the IV infusion into a primary line.

When the nurse is alone with a woman who experienced physical violence from her spouse, the client says, "It was all my fault. The house was so messy when he got home, and I know he hates that." Which response would be most appropriate? A. "You need to start to clean the house early in the day." B. "What else did you do to make him so angry with you?" C. "Remember, he works hard and you need to meet his needs." D. "It is not your fault. No one deserves to be hurt."

D. "It is not your fault. No one deserves to be hurt." The nurse needs to communicate nonjudgmental support and explain that no one deserves to be abused. Doing so helps to establish trust and rapport. Asking the woman what she did to make the partner so angry, telling her to clean the house earlier in the day, and telling her that she needs to meet his needs all shift the blame to the victim and are thus inappropriate.

A women who is breast-feeding her third baby tells the nurse, "I notice that when I feed him, I feel strong contraction-like pain. Labor is over. Why am I having contractions now?" Which response by the nurse would be most appropriate? A. "Your uterus is still shrinking in size, that's why you're feeling this pain." B. "Your body is responding to the events of labor, just like after a tough workout." C. "Let me check your vaginal bleeding just to make sure everything is fine." D. "The baby's suckling releases a hormone that causes the uterus to contract, and causes pain."

D. "The baby's suckling releases a hormone that causes the uterus to contract, and causes pain."

A nurse is teaching a pregnant woman, her support person, and the couple for whom she is a gestational surrogate about childbirth education. The nurse determines that the teaching was successful when the couple makes which statement? A. "We'll have the knowledge to ensure a pain-free childbirth." B. "We will be in total control of the birth process." C. "We won't be anxious, so the birth will be uncomplicated." D. "We'll know what to do to actively take part in our child's birth and support the mom in labor."

D. "We'll know what to do to actively take part in our child's birth and support the mom in labor."

A client is experiencing postpartum hemorrhage due to uterine atony. Which action is priority for the nurse to perform? A. Use an up-and-down motion to massage the uterus. B. Place the hands on the sides of the abdomen to grasp the uterus. C. Notify the provider. D. Continue massaging the uterus until it is firm.

D. Continue massaging the uterus until it is firm.

When teaching parents about their newborn, the nurse describes the development of a close emotional attraction to a newborn by the parents during the first 30 to 60 minutes after birth. The nurse refers to this process by which term? A. attachment B. engrossment C. reciprocity D. bonding

D. bonding

The nurse would be alert for possible placental abruption during labor when the patient history reveals which finding? A. low parity B. small for gestational age fetus C. gestational diabetes D. cigarette smoking

D. cigarette smoking

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

D. diminished deep tendon reflexes

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

D. elevated liver enzymes

After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? A. supine B. sitting C. side-lying D. knee-chest

D. knee-chest

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

D. nifedipine E. magnesium sulfate

When assessing several women for possible vaginal birth after cesarean (VBAC), which woman would the nurse identify as being the best candidate? A. one who has a vertical incision from a previous cesarean birth B. one who had a previous cesarean birth and has undergone a previous myomectomy C. one who had a previous cesarean birth and has a history of a contracted pelvis D. one who had a previous cesarean birth via a low transverse incision and a prior normal birth

D. one who had a previous cesarean birth via a low transverse incision and a prior normal birth

A nurse is providing education to a woman who is experiencing postpartum hemorrhage and is to receive a uterotonic agent. The nurse determines that additional teaching is needed when the woman identifies which drug as treating postpartum hemorrhage? A. carboprost B. oxytocin C. methylergonovine D. terbutaline

D. terbutaline

A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions, and complains of increased lower abdominal pressure. Her cervix is 8 cm dilated and 90% effaced, and has increased bloody show. The nurse interprets these findings as indicating: A. active phase of the first stage of labor. B. second stage of labor. C. latent phase of the first stage of labor. D. transition phase of the first stage of labor.

D. transition phase of the first stage of labor.

A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor? A. lithotomy B. knee-chest C. supine D. upright

D. upright

Jane is a 28 year old Gravida 2 Para 1 pregnant woman at 28 weeks pregnant. She has just completed a 3 hour Oral Glucose Tolerance Test, and her results show that she has gestational diabetes. The nurse has given this information to Jane, which some basic teaching regarding this condition. The nurse knows that further education is needed when Jane states the following: This condition means I will have to be more closely monitored. I have to schedule a cesarean section at 38 weeks as I will be unable to deliver vaginally I may not need insulin if I can manage my blood sugar by diet or oral medications. It is likely that my blood sugars will return to normal after I deliver the baby.

I have to schedule a cesarean section at 38 weeks as I will be unable to deliver vaginally