Students

Which of the following are indications for cesarean birth? (Select all that apply.)

Previous cesarean birth Placental abnormalities Previous uterine surgery Failure to progress in labor

A pregnant woman who has a history of cesarean births is requesting to have a vaginal birth after cesarean (VBAC). In which of the following situations should the nurse advise the patient that her request may be declined?

Previous uterine surgery

The single most important risk factor for preterm birth is:

Prior preterm birth

An infant admitted to the newborn nursery has a blood glucose level of 55 mg/dL. Which of the following actions should the nurse perform at this time?

Provide the baby with routine feedings.

In caring for the preterm infant, what complication is thought to be a result of high arterial blood oxygen level?

ROP

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?

"Infants can track their parents' eyes and can distinguish patterns; they prefer complex patterns"

A postpartum woman, who gave birth 12 hours ago, is breastfeeding her baby. She tells her nurse that she is concerned that her baby is not getting enough food since her milk has not come in. The best response for this patient is:

"Milk normally comes in around the third day. Prior to that, he is getting colostrum which is high in protein and immunoglobulins which are important for your baby's health."

A client is diagnosed with having a stillborn infant. At first, she appears stunned by the news, cries a little, and then asks the nurse to call her mother. What is the proper term for the phase of bereavement that this client is experiencing?

Acute distress

A breastfeeding woman develops engorged breasts at 3 days postpartum. What action will help this client achieve her goal of reducing the engorgement?

Breastfeed her infant every 2 hours.

Which of the following tests should never be performed during the first trimester?

Contraction Stress test

You are caring for a woman in active labor who is 6 cm dilated with a normal fetal heart rate (FHR) pattern and regular strong uterine contractions (UCs). The fetal heart rate (FHR) and UCs during active labor should be assessed:

Every 15-30 minutes During the active phase of labor, FHR and UCs should be assessed every 15-30 minutes or by hospital protocol

Define ptyalism

Excessive flow of saliva

Postoperative care of the pregnant woman who requires abdominal surgery for appendicitis includes which additional assessment?

Fetal heart rate (FHR) and uterine activity

Which neonatal complications are associated with hypertension in the mother?

Intrauterine growth restriction (IUGR) and prematurity

Which classification of placental separation is not recognized as an abnormal adherence pattern?

Placenta abruptio

Which of the following perinatal complications have been associated with untreated asymptomatic bacteriuria? (Select all that apply).

Preterm birth Low birth weight

The nurse is advising parents of a full-term neonate being discharged from the hospital regarding car seat safety. Which of the following should be included in the teaching plan?

Put the car seat facing forward only after the baby reaches 20 pounds.

A client is to take Clomiphene Citrate for infertility. Which of the following is the expected action of this medication?

Stimulate release of FSH and LH

What is one of the initial signs and symptoms of puerperal infection in the postpartum client?

Temperature of 38° C (100.4° F) or higher on 2 successive days

All of the following are considered assessment tests of fetal well-being EXCEPT:

Ultrasound (US)

The nurse is preparing to administer methotrexate to the client. This drug is most often used for which obstetric complication?

Unruptured ectopic pregnancy

During the postpartum assessment, the perinatal nurse notes that a patient who has just experienced a forceps-assisted birth now has a large quantity of bright red bleeding. Her uterine fundus is firm and midline. The nurse's most appropriate action is to notify the physician/certified nurse midwife and anticipate the need for:

Vaginal assessment and possible repair of vaginal and/or cervical lacerations

Which client is at greatest risk for early PPH?

Woman with severe preeclampsia on magnesium sulfate whose labor is being induced

Ultrasound can be used in antepartum care for which of the following assessments? (Select all that apply).

adjunct use in chorionic villi sampling (CVS) gestational age placental position and function fetal growth

Maddy, a G3 P1 woman, gave birth 12 hours ago to a 9 lb. 13 oz. daughter. She experiences severe cramps with breastfeeding. The perinatal nurse best describes this condition as:

afterpains

Trina who is 32 weeks pregnant is brought to the ER following an MVC with multiple injuries. What should the ER team do first?

assess Trina's injuries

At 16:09, Mimi delivers Zoe! What are the priority nursing actions? (Select all that apply).

assess Zoe for breathing dry Zoe with warm blankets

At 20 weeks gestation, Florence asks "where is the top of my uterus today?"

at the umbilicus

What is the best time of the menstrual cycle for intercourse to optimize fertilization?

at time of ovulation

A woman has preinvasive cancer of the cervix. Which modality would the nurse discuss as an available option for a client with this condition?

cryosurgery

Define metritis

inflammation of the uterus.

The CHOICE Project removed 3 key barriers to contraception for many women. These included which of the following?

knowledge deficit cost lack of access to preferred method

Define pruritic urticarial papules and plaques of pregnancy

known in United Kingdom as polymorphic eruption of pregnancy (PEP), is a chronic hives-like rash that strikes some women during pregnancy. ... The papules and plaques often first appear within stretch marks.

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.)

lethargy decrease in exercise capacity cold intolerance

During which phase of maternal adjustment will the mother relinquish the baby of her fantasies and accept the real baby?

letting go

Which type of formula is not diluted with water, before being administered to an infant?

ready-to-use

Your pregnant patient is in her first trimester and is scheduled for an ultrasound. When explaining the rationale for early pregnancy ultrasound, the best response is:

"The test will help to determine how many weeks you are pregnant."

The nurse completes an initial newborn examination on a baby boy at 90 minutes of age. The baby was born at 40 weeks' gestation with no birth trauma. The nurse's findings include the following parameters: heart rate 136 beats per minute; respiratory rate 64 breaths per minute; temperature 98.2°F (36.8°C); length 49.5 cm; and weight 3500 g. The nurse documents the presence of a heart murmur, absence of bowel sounds, symmetry of ears and eyes, no grunting or nasal flaring, and full range of movement of all extremities. Which assessment would warrant further investigation and require immediate consultation with the baby's health-care provider?

Absent bowel sounds

Postoperative nursing care and education for a woman who had an abdominal hysterectomy includes (select all that apply):

Administering hormone therapy as per provider orders. Assessing vaginal bleeding Instructing the woman vaginal intercourse until she has followup visit with surgeon. Instructing the woman to resume activities as comfort level permits.

The clinic nurse talks with Suzy, a pregnant woman at 9 weeks' gestation who has just learned of her pregnancy. Suzy's nausea and vomiting are most likely caused by (select all that apply):

An altered carbohydrate metabolism Increased levels of human chorionic gonadotropin Nausea and vomiting during the first trimester most likely are related to rising levels of human chorionic gonadotropin (hCG) and altered carbohydrate metabolism. Changes in taste and smell, due to alterations in the oral and nasal mucosa, can further aggravate the gastrointestinal discomfort.

The clinic nurse describes the respiratory system changes common to pregnancy to the new nurse. These changes include (select all that apply):

An increased tidal volume A decreased airway resistance During pregnancy, a number of changes occur to meet the woman's increased oxygen requirements. The tidal volume (amount of air breathed in each minute) increases 30% to 40%. The enlarging uterus creates an upward pressure that elevates the diaphragm and increases the subcostal angle. The chest circumference may increase by as much as 6 centimeters, and airway resistance decreases. Although the "up and down" capacity of diaphragmatic movement is reduced, lateral movement of the chest and intercostal muscles accommodates for this loss of movement and keeps pulmonary functions stable. There is no increase in airway resistance during pregnancy.

The labor patient you are caring for is ambulating in the hall. Her vaginal exam 1 hour ago indicated she was 4 cm dilated/70% effaced/-1 station. She tells you she has fluid running down her leg. Your priority nursing intervention is to:

Assess the fetal heart rate (FHR). When rupture of membranes (ROM) is suspected, the first nursing action is to assess the fetal heart rate (FHR) as there is an increase risk of umbilical cord prolapse with ROM especially if the fetal head is not well engaged.

What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy?

Assessing FHR and maternal vital signs

Which nursing intervention should be immediately performed after the forceps-assisted birth of an infant?

Assessing the infant for signs of trauma

A nurse is preparing to monitor a patient who is to receive an amnioinfusion. Which of the following actions should the nurse make at this time?

Assist in insertion of an intrauterine pressure catheter (IUPC). Amnioinfusion involves the introduction of room-temperature saline through the cervix into the uterus via intrauterine pressure catheter (IUPC). The main purpose for amnioinfusion is to correct cord compression associated with too little amniotic fluid (oligohydramnios). Prior to amnioinfusion an IUPC must be inserted.

Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus?

Assist the client in emptying her bladder.

The nurse is developing a plan of care for a client who is in the "taking-in" phase after delivering a healthy baby boy. Which of the following should the nurse include in the plan?

Assist the woman in selecting a nutritious meal plan.

According to the CDC, which of the following has the highest maternal mortality rate in the United States?

Black Women

Which of the following is an indication for the administration of methylergonovine (Methergine)?

Boggy uterus that does not respond to massage and oxytocin therapy

Which statement best describes chronic hypertension?

Chronic hypertension can occur independently of or simultaneously with preeclampsia.

A postpartum woman has been diagnosed with postpartum psychosis and will shortly be admitted to the psychiatric unit. Which of the following actions should the nurse perform to ensure safety for both mother and infant?

Closely monitor all mother-infant interactions

Which finding on a prenatal visit at 10 weeks of gestation might suggest a hydatidiform mole? (Select all that apply).

Complaint of severe nausea Fundal height measurement of 18 cm

The clinic nurse schedules Tracy for her first prenatal appointment with the certified nurse-midwife (CNM) in the clinic. Tracy has appropriate questions for her potential health-care provider that include (select all that apply):

Complementary and alternative methods used during labor and birth An opportunity to meet other providers in the practice Beliefs and practices concerning an episiotomy and an epidural anesthetic A woman's journey through the pregnancy experience can have long-term effects on her self-perception and self-concept. Therefore, it is especially important that the patient choose a care provider and group with whom she can openly relate and who shares the same philosophical views on the management of pregnancy. At the first prenatal visit, it is not common to explore whether the nurse-midwife will be continually available for support during labor.

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?

Congenital anomalies in the fetus

Which congenital anomalies can occur as a result of the use of antiepileptic drugs (AEDs) in pregnancy? (Select all that apply.)

Congenital heart disease Neural tube defects Cleft lip

Near the end of the first week of life, an infant who has not been treated for any infection develops a copper-colored maculopapular rash on the palms and around the mouth and anus. The newborn is displaying signs and symptoms of which condition?

Congenital syphilis

A postpartum client is concerned that her breasts are engorged and uncomfortable. What is the nurse's explanation for this physiologic change?

Congestion of veins and lymphatic vessels

Tachysystole, previously referred to as hyperstimulation, is defined as:

Contractions lasting 2 minutes or longer, Five or more contractions in 10 minutes over a 30-minute window, Contractions occurring within 1 minute of each other

In appraising the growth and development potential of a preterm infant, the nurse should be cognizant of the information that is best described in which statement?

Correct for milestones, such as motor competencies and vocalizations, until the child is approximately 2 years of age.

When assisting the mother, father, and other family members to actualize the loss of an infant, which action is most helpful?

Ensuring the baby is clothed or wrapped if the parents choose to visit with the baby

Which of the following findings, seen in pregnant women in the third trimester, would the nurse consider to be within normal limits? Select one:

Epistaxis

Frieda is 11 weeks pregnant and presents to the clinic for her first prenatal visit. She has been taking Accutane, a category X medication, the last 2 years. What is the NPs best course of action?

Explain greatest risk of adverse effects to the fetus from the medication has passed.

The nurse is caring for a postpartum woman who gave birth to a healthy, full-term baby girl. She has a 2-year-old son. She voices concern about her older child's adjustment to the new baby. Nursing actions that will facilitate the older son's adjustment to having a new baby in the house would include which of the following?

Explain to the mother that she can have her son visit her in the hospital. Assist her son in holding his new baby sister.

The perinatal nurse explains to the new nurse that ptyalism is a condition more acute than the normal nausea and vomiting of pregnancy and is often associated with dehydration, hypokalemia, and weight loss. Select one: True False

False

Kerry, a 30-year-old G3 TPAL 0110 woman presents to the labor unit triage with complaints of lower abdominal cramping and urinary frequency at 30 weeks' gestation. Appropriate nursing actions include (select all that apply):

Fetal and uterine monitoring for well-being and contractions Obtain urine for analysis and dipstick Assess Kerry's temperature, blood pressure, and pulse

A nurse is performing a newborn assessment on a new admission to the nursery. Which of the following actions should the nurse make when evaluating the baby for congenital dislocation of the hip?

Gently abduct the baby's thighs listening for clicks at the joints.

A 32-year-old woman now at 32 weeks' gestation is complaining of right-sided sharp abdominal pain. The patient is examined by the clinic nurse and given information about abdominal discomfort in pregnancy. She is also instructed to seek immediate attention if she (select all that apply):

Has chills or a fever Feels decreased fetal movements Abdominal pain persists Heartburn is a common discomfort throughout pregnancy. Because the appendix is pushed upward and posterior by the gravid uterus, the typical location of pain is not a reliable indicator for a ruptured appendix during pregnancy. The pain should gradually subside, but if it persists or is accompanied by fever, a change in bowel habits, or decreased fetal movement, the patient should promptly contact her medical provider.

The Apgar score consists of a rapid assessment of five physiological signs that indicate the physiological status of the newborn at 1 and 5 minutes of life. Apgar scores include rapid assessment of:

Heart rate, respiratory effort, muscle tone, reflex irritability, and color The Apgar score consists of 5 physiological signs: heart rate based on auscultation, respiratory rate based on observed movement of the chest, muscle tone based on degree of flexion and movement of extremities, reflex irritability based on response to tactile stimulation, and color based on observation. Each sign is given a score of 0, 1, or 2 with a maximum score of 10.

Which information regarding to injuries to the infant's plexus during labor and birth is most accurate?

If the nerves are stretched with no avulsion, then they should completely recover in 3 to 6 months.

The perinatal nurse examines the thyroid gland as part of the physical examination of Savannah, a pregnant woman who is now at 16 weeks' gestation. The perinatal nurse informs Savannah that during pregnancy (select all that apply):

Increased size of the thyroid gland is normal Increased function of the thyroid gland is normal The thyroid gland will return to its normal size and function during the postpartal period The thyroid gland changes in size and activity during pregnancy. Enlargement is caused by increased circulation from the progesterone-induced effects on the vessel walls, and by estrogen-induced hyperplasia of the glandular tissue. The thyroid gland increases not decreases in size and activity during pregnancy. The thyroid gland returns to normal size and activity postpartum.

While educating the client with cardiac disease, at 28 weeks' gestation, the nurse instructs the client to notify the provider if she experiences which of the following conditions?

Increasing dyspnea even while resting

Faith is ~ 7 weeks pregnant and presents to the ER with complaint of heavy bleeding and severe cramps (9/10). What type of SAB might she be experiencing?

Inevitable AB

Which infant is most likely to express Rh incompatibility?

Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor

A new mother asks the nurse what the "experts say" about the best way to feed her infant. Which recommendation of the American Academy of Pediatrics (AAP) regarding infant nutrition should be shared with this client?

Infants should be given only human milk for the first 6 months of life.

The nurse is working with a 36-year-old, married client, with 6 children who smokes. The woman states, "I don't expect to have any more kids, but I hate the thought of being sterile." Which of the following contraceptive methods would be best for the nurse to recommend to this client?

Intrauterine contraceptive device (IUD)

The nurse who is caring for a woman hospitalized for hyperemesis gravidarum would expect the initial treatment to involve what?

Intravenous (IV) therapy to correct fluid and electrolyte imbalances

Which condition is considered a medical emergency that requires immediate treatment?

Inversion of the uterus

Teera is a 22-year-old woman who is experiencing her third pregnancy. Her obstetrical history includes one first-trimester elective abortion and one first-trimester spontaneous abortion. Teera is a semi-vegetarian who drinks milk and eats yogurt and fish as part of her daily intake. The perinatal nurse discusses Teera's diet with her as she may be deficient in (select all that apply): Select one or more:

Iron Zinc

Which statement most accurately describes complicated grief?

Is an extremely intense grief reaction that persists for a long time

Which is true regarding breast cyst?

It can be tender or not

A woman at 40 weeks' gestation has a diagnosis of oligohydramnios. Which of the following statements related to oligohydramnios is correct?

It indicates that there is a 50% reduction of amniotic fluid.

Early decelerations are probably caused by:

Momentary increase in intracranial pressure due to head compression Early decelerations are visually apparent, usually symmetrical, with a gradual decrease and return of FHR associated with a uterine contraction (UC). Early decels usually mirror the UC and are generally associated with fetal head compression resulting in a transient increase in intracranial pressure. Early decels are considered benign and require no intervention but should be documented in the nurse's charting.

Allison is 32 weeks pregnant presents to L&D and tells the nurse she has not felt her baby move in 48 hours. The nurse begins electronic fetal monitoring and notes the baby's heart rate is in the 130's. The nurse contacts Allison's physician to obtain an order for which of the following tests?

Non stress Test

The clinic nurse reviews the complete blood count results for a 30-year-old woman who is now 33 weeks' gestation. Tamara's hemoglobin value is 11.2 g/dL, and her hematocrit is 38%. The clinic nurse interprets these findings as: Select one:

Normal pregnancy values for the third trimester

Researchers have found a number of common risk factors that increase a woman's chance of developing a breast malignancy. It is essential for the nurse who provides care to women of any age to be aware of which risk factors? (Select all that apply.)

Nulliparity or first pregnancy after age 40 years Family history Age

The nurse assesses that a fullterm neonate's temperature is 97.1°F (36.2°C). The first nursing action is to:

Place the neonate on the mother's chest with a warm blanket over the mother and baby.

The perinatal nurse knows that the term to describe a woman at 26 weeks' gestation with a history of hypertension prior to pregnancy and who now presents with a new onset proteinuria (by dipstick) is:

Preeclampsia superimposed on chronic hypertension Hypertensive women who develop new-onset proteinuria or proteinuria before the 20th week of gestation or sudden increase in proteinuria and BP are classified as preeclampsia superimposed on chronic hypertension.

During the initial antenatal visit, the clinic nurse asks questions about the woman's nutritional intake. Specific questions should include information pertaining to (select all that apply):

Preferred foods The presence of cravings Use of herbal supplements Aversions to certain foods and odors The nurse should obtain a nutritional history on all pregnant patients and patients of childbearing age to gain specific information related to the pregnancy, including foods that are preferred while pregnant (which may provide information about cultural and environmental dietary factors), special diets (which will assist the nurse in planning for education or interventions for risk factors associated with dietary practices), cravings or aversions to specific foods, and use of herbal supplements.

According to research, which risk factor for PPD is likely to have the greatest effect on the client postpartum?

Prenatal depression

The clinic nurse is assessing the complete blood count results for Kim-Ly, a 23-year-old pregnant woman. Kim-Ly's hemoglobin is 9.8 g/dL. This laboratory finding places Kim-Ly's pregnancy at risk for (select all that apply):

Preterm birth Intrauterine growth restriction True anemia, or iron-deficiency anemia, occurs when the hemoglobin level drops below 10 g/dL. The blood's decreased oxygen-carrying capacity causes a reduction in oxygen transport to the developing fetus. Decreased fetal oxygen transport has been associated with intrauterine growth restriction (IUGR) and preterm birth. There is not a risk factor for abruption or thrombocytopenia.

The clinic nurse advocates for smoking cessation during pregnancy. Potential harmful effects of prenatal tobacco use include (select all that apply):

Preterm birth Low birth weight Nurses can help to improve the fetal environment by educating women about the dangers of direct and passive smoking during pregnancy. Effects of tobacco use during pregnancy are well documented and predispose to premature rupture of the membranes, preterm labor, placental abruption, placenta previa, and infants who are low birth weight or small for gestational age (SGA). Gestational hypertension and diabetes are not associated with smoking during pregnancy.

The nurse who elects to work in the specialty of obstetric care must have the ability to distinguish between preterm birth, preterm labor, and low birth weight. Which statement regarding this terminology is correct?

Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation.

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?

Provide time for the mother to reflect on the events of her labor and delivery.

What should the nurse's next action be if the client's white blood cell (WBC) count is 25,000/mm3 on her second postpartum day?

Recognize that this count is an acceptable range at this point postpartum

36 year old Nancy's (G10000) test result is positive for an increased risk of having a baby with Trisomy 21 on noninvasive prenatal screening test. The nurse knows the provider will do which of the following next steps?

Recommend Nancy undergo diagnostic test to confirm these results.

The American Nurses Association Code of Ethics for Nurses directs nurses to provide patient care that is:

Respectful Nurses are autonomous professionals who are required to provide ethically competent care. Some ethical principles related to patient care include: autonomy, respect for others, beneficence, and nonmaleficence.

Despite warnings, prenatal exposure to alcohol continues to far exceed exposure to illicit drugs. Which condition is rarely associated with fetal alcohol syndrome (FAS)?

Respiratory conditions

The nurse should be cognizant of which postpartum physiologic alteration?

Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth

A woman who is admitted to labor and delivery at 30 weeks' gestation, is 1 cm dilated, and is contracting q 5 minutes. She is receiving magnesium sulfate IV piggyback. Which of the following maternal vital signs is most important for the nurse to assess each hour?

Respiratory rate

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).

Restlessness Fever

Jorgina is a 24-year-old pregnant woman at 26 weeks' gestation. This is Jorgina's third pregnancy, and her obstetrical history includes one full-term birth, one preterm birth, and two living children. Today Jorgina arrives at the clinic with complaints of fatigue, insomnia, and backache. She reports that she is a nurse on an oncology unit and is worried about continuing with working her 12-hour shifts. The perinatal nurse identifies concerns in Jorgina's history and work environment including (select all that apply):

Risk of preterm birth Presence of chemotherapeutic agents Women who are currently experiencing pregnancy complications and those who have a history of pregnancy complications (such as history of preterm birth) or other preexisting health disorders may be required to reduce their hours or stop working. The potential for maternal exposure to toxic substances such as chemotherapeutic agents, lead, and ionizing radiation (found in laboratories and health-care facilities); heavy lifting; and use of heavy machinery and other hazardous equipment should prompt reassignment to a different work area. If reassignment is not possible, Jorgina may need to stop working until the pregnancy has been completed. In this scenario there is no history of diabetes.

A primigravida at 40 weeks of gestation is having uterine contractions every 1½ to 2 minutes and states that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman's labor?

She is exhibiting hypertonic uterine dysfunction

For an infant experiencing symptoms of drug withdrawal, which intervention should be included in the plan of care?

Snugly swaddling the infant and tightly holding the baby

Parents are often asked if they would like to have an autopsy performed on their infant. Nurses who are assisting parents with this decision should be aware of which information?

Some religions prohibit autopsy

The nurse has taken a health history on four multigravida patients at their first prenatal visits. It is high priority that the patient whose first child was diagnosed with which of the following diseases receives nutrition counseling?

Spina bifida

A woman who is 30 weeks of gestation arrives at the hospital with bleeding. Which differential diagnosis would not be applicable for this client?

Spontaneous abortion

A pregnant woman at term is transported to the emergency department (ED) after a severe vehicular accident. The obstetric nurse responds and rushes to the ED with a fetal monitor. Cardiopulmonary arrest occurs as the obstetric nurse arrives. What is the highest priority for the trauma team?

Starting cardiopulmonary resuscitation (CPR)

Betamethasone is a steroid that is given to a pregnant woman with signs of preterm labor. The purpose of giving steroids is to (select all that apply):

Stimulate the production of surfactant in the preterm infant between 24 and 34 weeks gestation Decrease the severity of respiratory distress Accelerate fetal lung maturity Betamethasone is a steroid that is given to pregnant women with signs of preterm labor between 24 and 34 weeks' gestation. It stimulates the production of surfactant in the preterm infant and accelerates fetal lung maturity.

Which statement correctly describes the nurse's responsibility related to electronic fetal monitoring (EFM)?

Teach the woman and her family about the monitoring equipment and discuss any questions they have. Nurses are expected to independently assess, interpret, and intervene related to interpretations of electronic fetal monitoring (EFM). Nurses are expected to provide information and explanations to patients and their families in order to relieve anxiety and answer questions. Nurses are expected to share information with obstetric providers to insure clear communication. EFM is a means to information regarding fetal response to labor but does not take the place of nursing and support person interactions. Remember that external devices cannot measure uterine intensity/pressure during a contraction but can provide information on frequency and duration.

Which of the following statements are true related to teen pregnancies?

Teen mothers are at higher risk for HIV. Teen mothers are at higher risk for hypertensive problems. Infants born to teen mothers are at higher risk for health problems. Health statistics report higher risk for HIV, for hypertensive problems, and for health problems to infants born to teen mothers. Birth rates for teen mothers in all age categories have decreased since 1991 but are higher than in other developed countries. 64% of children born to teen mothers live in poverty.

A major fetal development characteristic at 16 weeks' gestation is:

Teeth begin to form At 16 weeks gestation: lanugo is present on the head, meconium is formed in the intestines, teeth begin to form, sucking motions are made with the mouth, and skin is transparent.

A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When evaluating the woman's vital signs, which finding would be of greatest concern to the nurse?

Temperature 37.9° C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg

A laboratory report indicates the L/S ratio (lecithin/sphingomyelin) results from an amniocentesis of a gravid patient with preeclampsia are 2:1. The nurse interprets the result as which of the following?

The baby's lung fields are mature.

What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

The blood pressure (BP) cuff should not be applied to the affected arm.

A woman at 24 weeks of gestation states that she has a glass of wine with dinner every evening. Why would the nurse counsel the client to eliminate all alcohol?

The fetus is placed at risk for altered brain growth.

A client with maternal phenylketonuria (PKU) has come to the obstetrical clinic to begin prenatal care. Why would this preexisting condition result in the need for closer monitoring during pregnancy?

The fetus may develop neurologic problems.

Another common pregnancy-specific condition is pruritic urticarial papules and plaques of pregnancy (PUPPP). A client asks the nurse why she has developed this condition and what can be done. What is the nurse's best response?

The goal of therapy is to relieve discomfort.

Which statement regarding hemolytic diseases of the newborn is most accurate?

The indirect Coombs' test is performed on the mother before birth; the direct Coombs' test is performed on the cord blood after birth.

In follow-up appointments or visits with parents and their new baby, it is useful if the nurse can identify infant behaviors that can either facilitate or inhibit attachment. What is an inhibiting behavior?

The infant seeks attention from any adult in the room.

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?

The lungs of a baby delivered by cesarean section may sound moist during the first 24 hours after childbirth.

A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM) doses of betamethasone. What is the purpose of this pharmacologic intervention?

To stimulate fetal surfactant production

A client at 39 weeks of gestation has been admitted for an external version. Which intervention would the nurse anticipate the provider to order?

Tocolytic drug

Karen, a 26-year-old woman, has come for preconception counseling and asks about caring for her cat as she has heard that she "should not touch the cat during pregnancy." The clinic nurse's best response is:

Toxoplasmosis is a concern during pregnancy, so it is important to have someone else change the cat's litter pan and also to avoid consuming uncooked meat.

The perinatal nurse explains to the student nurse that in the fetal circulation, the lowest level of oxygen concentration is found in the umbilical arteries. True or False?

True The highest oxygen concentration (PO2 = 30-35 mm Hg) is found in the blood returning from the placenta via the umbilical vein; the lowest oxygen concentration occurs in blood shunted to the placenta where reoxygenation takes place. The blood with the highest oxygen content is delivered to the fetal heart, head, neck, and upper limbs, and the blood with the lowest oxygen content is shunted toward the placenta.

When caring for a primiparous woman being evaluated for admission for labor, a key distinction between true versus false labor is:

True labor contractions bring about changes in cervical effacement and dilation, and with false labor there are irregular contractions with little or no cervical changes.

The nurse should be cognizant of which condition related to skeletal injuries sustained by a neonate during labor or childbirth?

Unless a blood vessel is involved, linear skull fractures heal without special treatment.

The perinatal nurse understands that the purpose of the surgical "time-out" is to:

Verify that it is the correct patient and planned procedure

The exact cause of preterm labor is unknown but believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Which type of infection has not been linked to preterm birth?

Viral

Nursing actions focused at reducing a postpartum woman's risk for cystitis include which of the following? (Select all that apply.)

Voiding within a few hours post-birth Oral intake of a minimum of 3000 mL per day Changing peri-pads every 3 to 4 hours or more frequently as indicated Reminding the woman to void every 3 to 4 hours while awake

A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. Which findings should the nurse include in the discussion? (Select all that apply.)

Warmth in the breast Fever and flulike symptoms Breast tenderness

The nurse is teaching the parents of a healthy newborn about infant safety. Which of the following should be included in the teaching plan?

Water temperature for the infant's bath should be 100.4 degrees F. Do not cook while holding an infant Cover electrical outlets Remove strings from infant sleepwear, bedding, and pacifiers to prevent strangulation.

A nurse notes that an Eskimo woman does not cuddle or interact with her newborn other than to feed him, change his diapers or soiled clothes, and put him to bed. While evaluating this client's behavior with her infant, what realization does the nurse make?

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

16 y/o Susie presents to the clinic, wanting a pregnancy test. What questions would be appropriate for the professional nurse to ask Susie prior to completing the pregnancy test?

What is the first day of your last menstrual period? Have you done a home pregnancy test? Have you been using birth control?

Contraindications for induction of labor include:

abnormal fetal position placental abnormalities

Which substance, when abused during pregnancy, is the most significant cause of cognitive impairment and dysfunction in the infant?

alcohol

Which societal factors have a strong influence on parental response to their infant?

an adolescent mother is likely to use less verbal instruction, be less responsive, and interact less positively than other mother an adolescent mother's egocentricity and unmet developmental needs interfere with her ability to parent effectively mothers older than 35 years of age often deal with more stress related to work and career issues, as well as decreasing libido

Anna is a 16 y/o G10000 who is 7 weeks pregnant. She is at increased risk for which of the following?

anemia

General skin care for full-term infants includes which of the following? (Select all that apply.)

avoid daily bathing with soap use a cleaner with a neutral pH avoid fragrant soaps

According to the article by Constatine (2014), changes in the maternal cardiovascular system during pregnancy can impact the effectiveness which of the following medications taken by pregnant women? (select all that apply)

digoxin antihypertensive drugs

A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates. A nonstress test (NST) in the obstetrician's office revealed a nonreactive tracing. On artificial rupture of membranes, thick meconium-stained fluid was noted. What should the nurse caring for the infant after birth anticipate? (Select all that apply).

dry, cracked skin meconium aspiration hypoglycemia

The letdown reflex occurs in response to the release of oxytocin. Which of the following can stimulate the release of oxytocin?

emotional response to thinking about her baby infant suckling emotional response to hearing an infant crying sexual activity

Amy is a 20 year old sexually active woman (G0000) who wants an effective birth control method. She denies any medical problems. Which of the following would the nurse not recommend to Amy?

essure

Which of the following are indications for ultrasound in the second trimester?

establish or confirm dates determine viability

Documentation related to vacuum delivery includes which of the following:

fetal heart rate timing and number of application position and station of fetal head

Yvonne (G11001) is 2 hours postpartum. She had a 15 hour labor, an epidural with spontaneous vaginal delivery of 7 lb 3oz boy. She has a 2nd degree laceration. Which of the following assessment findings needs intervention?

fundus soft at +1 and to the right

A nurse caring for a family during a loss might notice that a family member is experiencing survivor guilt. Which family member is most likely to exhibit this guilt?

grandparents

Which of the following screens for cervical cancer? (Select all that apply).

high risk HPV test Pap smear test

According to Costantine (2014), which of the following physiologic changes in the gastrointestinal tract during pregnancy can impact effectiveness of drugs?

increased gastric pressure and reduced GI motility alter drug bioavailability

Define mastitis

inflammation of the mammary gland in the breast or udder, typically due to bacterial infection via a damaged nipple or teat.

Sue (G30020) is in active labor. Her cervix is 4/70/0/vertex. She wants an epidural. What actions will the nurse take first to prepare her? (Select all that apply).

infuse IV bolus as ordered have Sue void assess FHR

Metabolic changes during pregnancy ____ glucose tolerance.

lower Metabolic changes during pregnancy lower glucose tolerance.

Which of the following are true of amniotic fluid? (Select all that apply).

maintains constant temperature for the fetus is derived by diffusion from maternal blood and increases weekly to ~800 mL provides freedom of fetal movement and growth

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?

mechanical sensory chemical thermal

Yolanda is 6 weeks pregnant by dates and is considering abortion. What options might be appropriate for her at this point? (Select all that apply).

medical abortion with mifepristone and misopristol surgical abortion with aspiration

Physiologic changes in pregnancy significantly effect which of the following pharmacokinetic properties of medications? (Select all that apply).

metabolism absorption

Which medications are used to manage PPH? (Select all that apply.)

methergine hemabate oxytocin

The perinatal nurse is teaching the new mother who has chosen to formula feed her infant. Appropriate instructions to be given to this mother include

mix the formula according to manufacturer's instructions; do not over-dilute or underdilute periodically check the nipple for slow flow prepare only enough formula to last for 24 hours and discard open containers or prepared formula after 24 hours discard any unused formula that remains in a bottle following use

The clinic nurse teaches expectant mothers about the differences between breast milk and commercially prepared infant formulas. When compared to commercially prepared formulas, breast milk has

more carbohydrates less protein

A nursery nurse observes that a full-term AGA neonate has nasal congestion, hypertonia, and tremors and is extremely irritable. Based on these observations, the nurse suspects which of the following?

neonatal withdrawal

Which of the following are true about the 'new' pregnancy and lactation labeling rule? (select all that apply).

new over-the-counter medicines will not have the same new labeling requirement as new prescription medications there is a new section- females and males of reproductive potential labeling changes are now in effect

An infant at 26 weeks of gestation arrives intubated from the delivery room. The nurse weighs the infant, places him under the radiant warmer, and attaches him to the ventilator at the prescribed settings. A pulse oximeter and cardiorespiratory monitor are placed. The pulse oximeter is recording oxygen saturations of 80%. The prescribed saturations are 92%. What are the nurse's most appropriate actions at this time?

notify physician listen to breath sounds increase oxygen ensure patency of the endotracheal tube

Ellen and Rick want to get pregnant. Which of the following general facts would the nurse include in his/her advice to achieve fertilization? (Select all that apply).

ovulation occurs 14 days prior to menses sexual intercourse should occur within 24-48 hours of ovulation

Define Homans sign

pain in the calf of the leg upon dorsiflexion of the foot with the leg extended that is diagnostic of thrombosis in the deep veins of the area.

Which of the following make up the classic triad symptoms of ectopic pregnancy? (Select all that apply).

pelvic pain vaginal bleeding missed period

The perinatal nurse observed the pediatrician completing the Ballard Maturational Score (BMS). The maturity components used with this assessment are (select all that apply):

physical neuromuscular

Mary presents to the ER at 25 weeks pregnant, complaining of painless vaginal bleeding. What does the nurse think Mary might have?

placenta previa

Typical signs of abusive head trauma (AHT, also known as Shaken Baby Syndrome) include which of the following?

poor feeding vomiting breathing problems

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.)

positive Homans sign occurs Putting her in antiembolic stockings Having her flex, extend, and rotate her feet, ankles, and legs

Infants born between 34 0/7 and 36 6/7 weeks of gestation are called late-preterm infants because they have many needs similar to those of preterm infants. Because they are more stable than early-preterm infants, they may receive care that is similar to that of a full-term baby. These infants are at increased risk for which conditions? (Select all that apply.)

problems with thermoregulation hyperbillirubinemia sepsis

Combination oral contraceptives, the vaginal ring and the patch contain two hormones. Which of the following is the primary hormone that stops ovulation?

progesterone

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?

prolactin

After giving birth to a healthy infant boy, a primiparious 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?

provide time for the client to bathe her infant after she views a demonstration of infant bathing

Which of the following are true of the placenta? (Select all that apply).

provides O2 and nutrients to the fetus is functioning within 20 days of conception stores carbohydrates, calcium, proteins and iron

Which of the following actions are directed at promoting bonding?

providing opportunity for parents to hold their newborn as soon as possible following the birth providing opportunities for the couple to talk about their birth experience and about becoming parents providing positive comments to parents regarding their interactions with their newborn

Which of the following are management options for couples faced with infertility challenges, depending of the cause? (Select all that apply).

remain child-free adoption Medication assisted reproductive technology procedures

Which of the following are functions of the placenta? (Select all that apply)

removes CO2 and fetal waste products provides O2 and nutrients to the fetus produces hormones, such as progesterone, that helps to relax the uterus

Define Placental abruption

separation of the placenta from the wall of the uterus, especially when it occurs prematurely during pregnancy.

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.)

shivering fever irritability

Define cryosurgery

surgery using the local application of intense cold to destroy unwanted tissue.

Which of the following nursing actions are directed at assisting men in their transition to fatherhood?

talk to the couple about their expectations of the parenting role praise the father for his interactions with his infant provide information on infant care and behavior to both parents

ACOG recommends all women be offered testing for Cystic Fibrosis (CF) gene mutation. If the woman tests negative for gene mutation, what is the next action to determine risk for the baby?

tell the patient her baby has very little risk to be affected with CF

A couple is undergoing an infertility workup. The semen analysis indicates a decreased number of sperm and immature sperm. Which of the following factors can have

the man rides a bike to and from work each day the man takes calcium channel blocker for the treatment of hypertension

Which substance used during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications?

tobacco

The perinatal nurse demonstrates for the student nurse the correct technique of postpartum uterine palpation. Support for the lower uterine segment is critical, as without it, there is an increased risk of:

uterine inversion

A mother is changing the diaper of her newborn son and notices that his scrotum appears large and swollen. The client is concerned. What is the best response from the nurse?

"A large scrotum and swelling indicate a hydrocele, which is a common finding in male newborns.

A NICU nurse is caring for a full-term neonate being treated for group B streptococcus (GBS). The mother of the neonate is crying and shares that she cannot understand how her baby became infected. The best response by the nurse is:

"Approximately 15% to 40% of women have no symptoms but are carriers of group B streptococcus which is found in the vaginal and lower intestinal areas. What other questions do you have regarding your baby's health?"

Your patient is a 37-year-old pregnant woman who is 5 weeks pregnant and is considering genetic testing. During your discussion, the woman asks the nurse what the advantages of chorionic villus sampling (CVS) are over amniocentesis. The best response is:

"CVS can be done earlier in your pregnancy, and the results are available more quickly."

Which of the following are primary risk factors for subinvolution of the uterus? (Select all that apply.)

Fibroids Retained placental tissue Metritis

If nonsurgical treatment for late PPH is ineffective, which surgical procedure would be appropriate to correct the cause of this condition?

Dilation and curettage (D&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?

Placental abruption

Which preexisting factor is known to increase the risk of GDM?

Previous birth of large infant

Which of the following lab tests are routinely performed on pregnant women? (Select all that apply).

Rubella titer Syphilis test Blood type

A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this woman's fundus?

1 cm above the umbilicus

At 28 weeks gestation, how will the nurse test Mimi for gestational diabetes?

1 hr GTT

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth?

"My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles."

23 y/o Amy delivered a baby 2 months ago and presents to the clinic with complaint of stool coming out of her vagina for the past week. The nurse suspects recto-vaginal fistula. What is the next most appropriate question the nurse should ask Amy?

"Did you deliver your baby vaginally?"

During a prenatal visit, the nurse is explaining dietary management to a woman with pregestational diabetes. Which statement by the client reassures the nurse that teaching has been effective?

"Diet and insulin needs change during pregnancy."

A new father is ready to take his wife and newborn son home. He proudly tells the nurse who is discharging them that within the next week he plans to start feeding the infant cereal between breastfeeding sessions. Which information should the nurse provide regarding this feeding plan?

"Feeding solid foods between breastfeeding sessions before your son is 4 to 6 months old will lead to an early cessation of breastfeeding."

Your patient is 34 weeks pregnant and during a regular prenatal visit tells you she does not understand how to do "kick counts." The best response by the nurse would be to explain:

"Fetal movements are an indicator of fetal well-being. You should count twice a day, and you should feel 10 fetal movements within 2 hours." Maternal assessment of fetal movement by counting fetal movements in a period time can identify potentially hypoxic fetuses. Fetal activity is diminished in the compromised fetus. The pregnant woman is instructed to palpate her abdomen and track fetal movements daily for 1-2 hours. Ten distinct fetal movements within 2 hours is considered normal. Once movement is achieved, counts can be discontinued for the day.

A new mother wants to be sure that she is meeting her daughter's needs while feeding the baby commercially prepared infant formula. The nurse should evaluate the mother's knowledge about appropriate infant feeding techniques. Which statement by the client reassures the nurse that correct learning has taken place?

"I burp my daughter during and after the feeding as needed."

Your pregnant patient is having maternal alpha-fetoprotein (AFP) screening. She does not understand how a test on her blood can indicate a birth defect in the fetus. The best reply by the nurse is:

"If babies have a neural tube defect, alpha-fetoprotein leaks out of the fetus and is absorbed into your blood, causing your level to rise. This serum blood test detects that rise."

Which of the following statements is most appropriate for the nurse to say to a patient with a complete or total placenta previa?

"Please promptly report any vaginal bleeding or if you feel any lower back discomfort."

A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents?

"Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide."

The client is being induced in response to worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active, despite several hours of oxytocin administration. She asks the nurse, "Why is this taking so long?" What is the nurse's most appropriate response?

"The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor."

A perinatal nurse is giving discharge instructions to a woman, status postsuction, and curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. What is the best response by the nurse?

"The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, then it would make the diagnosis of this cancer more difficult."

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?

"The newborn sleeps approximately 17 hours a day, with periods of wakefulness gradually increasing."

A nurse is making a home visit on the twelfth postpartum day to assess a 23-year-old primipara woman and her full-term, healthy baby. Breastfeeding is the method of infant nutrition. The woman tells the nurse that she does not think her milk is good because it looks very watery when she expresses a little before each feeding. The nurse's best response is:

"This is normal and is referred to as foremilk which is higher in water content. Later in the feeding the fat content increases and the milk becomes richer in appearance."

The clinic nurse sees Xiao and her infant in the clinic for their 2-week follow-up visit. Xiao appears to be tired, her clothes and hair appear unwashed, and she does not make eye contact with her infant. She is carrying her son in the infant carrier and when asked to put him on the examining table, she holds him away from her body. The clinic nurse's most appropriate question to ask would be

"Would you tell me about the first few days at home?"

On day 3 of life, a newborn continues to require 100% oxygen by nasal cannula. The parents ask if they may hold their infant during his next gavage feeding. Considering that this newborn is physiologically stable, what response should the nurse provide?

"You may hold your baby during the feeding."

Sally is 34 weeks pregnant and has a biophysical profile score of 8. She asks the nurse what does that mean? The nurse's best response is:

"Your baby has low risk for having a problem having enough oxygen in her body and your doctor will probably want to do the test again soon. I will call your doctor. "

The nurse is preparing to teach an antepartum client with GDM the correct method of administering an intermediate-acting insulin, such as neutral protamine Hagedorn (NPH), with a short-acting insulin (regular). In the correct order from 1 through 6, match the step number with the action needed to teach the client self-administration of this combination of insulin.

1. wash hands 2.Check the insulin bottles for the expiration date. 3.Gently rotate the insulin to mix it, and wipe the stopper. 4. Inject air equal to the dose of NPH insulin into the vial, and remove the syringe 5.Inject air equal to the dose of regular insulin into the vial, and withdraw the medication. 6.Without adding air, withdraw the correct dose of NPH insulin.

A woman who is 36 weeks pregnant presents to the labor and delivery unit with a history of congestive heart disease. Which of the following findings should the nurse report to the primary health-care practitioner?

10-pound weight gain in a month Some of the normal cardiac changes during pregnancy can exacerbate cardiac disease including increase in total blood volume, increase in cardiac output, increased heart rate, and slight enlargement of the heart. Usual signs of deteriorating cardiac function include fluid retention which leads to weight gain above that expected of normal pregnancy. Chloasma, heartburn, and patellar reflexes are not related to cardiac disease.

When is a prophylactic cerclage for an incompetent cervix usually placed (in weeks of gestation)?

12 to 14

The nurse is assessing a full term, quiet, and alert newborn. What is the average expected apical pulse range (in beats per minute)?

120 to 160

At what time during the menstrual cycle do most women ovulate?

14 days prior to the first day of menses.

How many eggs are present in a human female at birth?

2 million

During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from:

2 to 8 weeks The period of organogenesis lasts from approximately the second until the eighth week of gestation during which time the embryo undergoes rapid growth and differentiation. During organogenesis, the embryo is extremely vulnerable to teratogens such as medications, alcohol, tobacco, caffeine, illegal drugs, radiation, heavy metals, and maternal (TORCH) infections. Structural fetal defects are most likely to occur during this period because exposure to teratogens either before or during a critical period of development of an organ can cause a malformation.

The nurse who is assessing a G2 P1 palpates the fundal height at the location noted on the picture below. The nurse concludes that the fetus is equal to which of the following gestational ages?

20 weeks

The nurse working in a prenatal clinic is providing care to three primigravida patients. Which of the patient findings would the nurse highlight for the provider?

30 weeks, states that her vision is blurry Visual disturbances may be an indication of preeclampsia. The other responses are normal findings for the various stages of pregnancy.

A 35-year-old G1 P1 postpartum woman is Rh negative and has given birth to an Rh positive infant. Rh0(D) immune globulin is to be administered. The most appropriate dose that the perinatal nurse would expect to be ordered would be:

300 mcg

Which of the following patients should be offered noninvasive prenatal screening test? Select all that apply.

31 year old G31101 Caucasian with history of 'stillbirth' who had Trisomy 18 37 year old G21001 Asian with no risk factors

Baby Sam was born 5 minutes ago. He is crying, moving his arms and legs, and has a heart rate of 160. His color is pink with blue fingers and toes. What Apgar score does the nurse document for Sam?

9

How many kilocalories per kilogram (kcal/kg) of body weight does a breastfed term infant require each day?

95 to 110

What is the recommended minimal amount of Folic acid supplementation prior to pregnancy?

400mcg

An infant at 36 weeks of gestation has increasing respirations (80 to 100 breaths per minute with significant substernal retractions). The infant is given oxygen by continuous nasal positive airway pressure (CPAP). What level of partial pressure of arterial oxygen (PaO2) indicates hypoxia?

45 mmHg

At 1 minute after birth a nurse assesses an infant and notes a heart rate of 80 beats per minute, some flexion of extremities, a weak cry, grimacing, and a pink body but blue extremities. Which Apgar score does the nurse calculate based upon these observations and signs?

5

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?

50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep

Which client is most likely to experience strong and uncomfortable afterpains?

A woman who is a gravida 4, para 4-0-0-4

A perinatal nurse assesses a term newborn for respiratory functioning. The nurse knows that which of the following conditions is normal for newborns?

A breathing pattern that is often shallow, diaphragmatic, and irregular

Ultrasonography is considered: (Select all that apply)

A diagnostic test A screening test

The clinic nurse meets with Rebecca, a 30-year-old woman who is experiencing her first pregnancy. Rebecca's quadruple marker screen result is positive at 17 weeks' gestation. The nurse explains that Rebecca may need a referral to:

A genetics counselor/specialist for further diagnostic testing Quadruple screening includes four chemical markers (AFP, hCG, estriol levels, inhibin-A) along with maternal age to detect trisomies and neural tube defects (NTD). Women with abnormal values should be referred to a genetics counselor/specialist for further testing

Screening for critical congenital heart disease (CCHD) was added to the uniform screening panel in 2011. The nurse has explained this testing to the new mother. Which action by the nurse related to this test is correct?

A passing result is an O2 saturation of ≥95%

Environmental stress

A premature infant never seems to sleep longer than an hour at a time. Each time a light is turned on, an incubator closes, or people talk near her crib, she wakes up and inconsolably cries until held. What is the correct nursing diagnosis beginning with "ineffective coping, related to"?

What is the most common expected emotional reaction of a woman to the news that she is pregnant?

Acceptance

A woman exhibits symptoms that may lead to a possible diagnosis of polycystic ovary syndrome (PCOS). While completing the initial assessment of the client, which clinical finding would the nurse not anticipate?

Anorexia

Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa. The signs of NEC are nonspecific. What are generalized signs and symptoms of this condition?

Abdominal distention, temperature instability, and grossly bloody stools

A postmenopausal woman has been diagnosed with two leiomyomas (fibroids). Which clinical finding is most commonly associated with the presence of leiomyomas?

Abnormal uterine bleeding

The perinatal nurse screens all pregnant women early in pregnancy for maternal attachment risk factors, which include (select all that apply):

Adolescence Low educational level History of depression Maternal attachment to the fetus is an important area to assess and can be useful in identifying families at risk for maladaptive behaviors. The nurse should assess for indicators such as unintended pregnancy, domestic violence, difficulties in the partner relationship, sexually transmitted infections, limited financial resources, substance use, adolescence, poor social support systems, low educational level, the presence of mental conditions, or adolescence that might interfere with the patient's ability to bond with and care for the infant. A strong support system can facilitate the patient's ability to bond with and care for the infant.

Which statement regarding the postpartum uterus is correct?

After 2 weeks postpartum, it should be abdominally nonpalpable.

A pregnant woman arrives at the birth unit in labor at term, having had no prenatal care. After birth, her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. Based on her infant's physical findings, this woman should be questioned about her use of which substance during pregnancy?

Alcohol

Which of the following is not true regarding the use of Amnioinfusion as a resuscitative technique?

Amnioinfusion is the first line of defense against meconium aspiration syndrome (MAS). Amnioinfusion has been used to resolve variable decelerations by relieving umbilical cord compression due to oligohydramnios. Normal saline or lactated Ringer's solution is infused into the uterus by gravity or pump. Amnioinfusion dilutes thick meconium-stained amniotic fluid but does not appear to reduce the risk of moderate or severe meconium aspiration syndrome (MAS).

A 36 y/o pregnant woman has been diagnosed with polyhydraminos. The nurse knows this is based on which of the following?

Amniotic fluid index of 30 cm

When providing a psychosocial assessment on a pregnant woman at 21 weeks' gestation, the nurse would expect to observe which of the following signs?

Anxiety The maternal tasks of pregnancy include acceptance of pregnancy and generally happy feelings during this time. Adaptation to pregnancy in the second trimester, more specifically, includes anxiety regarding body changes, and the presence of fears and phobias. Feelings of anxiety in addition to changes in body image include loss of old life, changing relationships with friends and family, changes in sexual activity and "tuning in" to the fetus in terms of movement, etc.

What is the rationale for evaluating the plantar crease within a few hours of birth?

As the skin dries, the creases will become more prominent

Felicity Chan, a new mother, is accompanied by her mother during her hospital stay on the postpartum unit. Felicity's mother makes specific, various requests of the nurses including bringing warm tea, a cot to sleep on, and that the baby not be bathed at this time. Felicity's mother is also concerned about the amount of work that Felicity may be doing in the provision of infant care. Felicity asks for help with breastfeeding. After Felicity has finished breastfeeding, her mother asks for a bottle so they can warm it and "feed" the baby. How would the perinatal nurse best respond to Felicity's mother in a culturally sensitive way?

Ask Felicity what she knows about breastfeeding, and provide information to both women to support Felicity's decision.

It would be most important for a nurse caring for a mother and the infant in the fourth stage of labor to do which of the following?

Assess and massage the fundus every 15 minutes or more often if needed to maintain tightly contracted uterus Administer oxytocin per protocol or provider order Assess the patient for a distended bladder The fourth stage of labor immediately follows the delivery of the placenta. The nurse should be assessing the fundus every 15 minutes for position, tone, and location. The provider may order oxytocin at this stage, and the nurse should assist the woman to the bathroom if she has a distended bladder which could interfere with the contraction of the uterus.

Breast pain occurs in many women during their perimenopausal years. Which information is (are) a priority for the nurse to share with the client? (Select all that apply).

Assess for prior trauma or possible infection Distinguishing between cyclical and noncyclical pain is important.

A client on 2 gm/hr of magnesium sulfate has decreased deep tendon reflexes. Identify the priority nursing assessment to ensure client safety.

Assess respiratory rate. Magnesium sulfate is a central nervous system depressant and has been proven to help reduce seizure activity without documentation of long-term adverse effects to the woman and fetus. Care of the woman on Magnesium sulfate includes assessment of vital signs every 5-15 minutes during loading dose and then every 30-60 minutes until stabilization. Assess deep tendon reflexes (DTRs) every 2 hours; decreasing DTRs may be a sign of impending respiratory depression. Respiratory depression, <14 breaths/minute, is the primary complication of Magnesium sulfate use.

A 25 year-old woman gave birth to her second child 6 hours ago. She informs the nurse that she is bleeding more than with her previous birth experience. The initial nursing action is to:

Assess the location and firmness of the fundus.

Preeclampsia begins at what point during the pregnancy?

At placental implantation

A patient at 39 weeks' gestation is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be palpated?

At the xiphoid process

The perinatal nurse describes infant feeding cues to a new mother. These feeding cues include

Awake and alert Mouth movements Moving the hand to the mouth

A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse?

Dipstick value of 3+ for protein in her urine

A pregnant client with a history of pelvic inflammatory disease (PID) is at highest risk for which of the following complications:

Ectopic pregnancy

Which of the following nursing interventions are important in the prenatal care of the woman with prenatal depression? (Select all of the following).

Educate the woman about depression and plan of care Maintain a caring relationship

Which of the following women is in most need screening for GDM? (Select all that apply).

BMI of 30 family history of diabetes

The nurse is caring for a woman, G2 P1001, 40 weeks' gestation, in labor. A 12 P.M. assessment revealed: cervix 4 cm, 80% effaced, -3 station, and fetal heart 124 with moderate variability. 5 p.m. assessment: cervix 6 cm, 90% effaced, -3 station, and fetal heart 120 with minimal variability. 10 a.m. assessment: cervix 8 cm, 100% effaced, -3 station, and fetal heart 124 with absent variability. Based on the assessments, which of the following should the nurse conclude?

Baby is potentially acidotic. Moderate variability is the best predictor of normal fetal acid-base balance, adequate fetal oxygenation, and adequate fetal reserve. Minimal or absent variability can occur when the fetus is in a sleep pattern or in the presence of central nervous system depressants such as opiates or magnesium sulfate. Minimal or absent variability can also be significant for the presence of fetal hypoxia or acidosis especially if it persists over 60 minutes despite interventions

A certified nursing assistant (CNA) is working with a registered nurse (RN) in the neonatal nursery. Which of the following actions would be appropriate for the nurse to delegate to the CNA?

Bathe and weigh a 3-hour-old baby

Which of the following medications administered to the pregnant client with GDM and experiencing preterm labor requires close monitoring of the client's blood glucose levels?

Betamethasone Betamethasone will raise blood sugar and may require temporary insulin coverage to maintain euglycemia in diabetic women

While discussing the societal impacts of breastfeeding, the nurse should be cognizant of the benefits and educate the client accordingly. Which statement as part of this discussion would be incorrect?

Breastfeeding costs employers in terms of time lost from work.

Which condition might premature infants who exhibit 5 to 10 seconds of respiratory pauses, followed by 10 to 15 seconds of compensatory rapid respiration, be experiencing?

Breathing in a respiratory pattern common to premature infants

Which of the following is true regarding physiologic jaundice? (Select all that apply).

Jaundice is more common in preterm infants Jaundice is noted 24 hours after birth

Which of the following is true regarding physiologic jaundice? (Select all that apply)

Jaundice is noted 24 hours after birth

To accurately measure the neonate's head, the nurse places the measuring tape around the head:

Just above the ears and eyebrows

A woman is considered in active labor when the following characteristics have occurred:

Cervical dilation progresses from 4 to 7 cm with effacement of 40%-80%, contractions becoming more intense, occurring every 2 to 5 minutes with duration of 45-60 seconds.

The nurse is interviewing a pregnant client who states she plans to drink chamomile tea to ensure an effective labor. The nurse knows that this is an example of:

Cultural prescription

What is the best action a woman with pregestational diabetes can take to improve outcomes for her baby?

Keep her HgbA1-c at 7.0% or below

Which statement related to cephalopelvic disproportion (CPD) is the least accurate?

CPD can be accurately predicted

Infants whose mothers were obese during pregnancy are at higher risk for which of the following? (Select all that apply.)

Childhood diabetes. Heart defects. Hypospadias. Fetuses and/or infants of obese women are at higher risk for fetal abnormalities such as spina bifida, heart defects, anorectal atresia, and hypospadias. Additionally, intrauterine fetal death (IUFD), birth injuries secondary to macrosomia (weight over 4000 gm), and childhood obesity and diabetes may be related to obesity.

A 26-year-old woman at 29 weeks' gestation experienced epigastric pain following the consumption of a large meal of fried fish and onion rings. The pain resolved a few hours later. The most likely diagnosis for this symptom is:

Cholelithiasis

Which of the following procedures require administration of RhoGAM to RH negative women post-procedure to prevent antibody formation? (Select all that apply)

Chorionic villi sampling (CVS) Percutaneous umbilical blood sampling or fetal blood sampling (PUBS) Amniocentesis

Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. What are possible causes of early miscarriage? (Select all that apply.)

Chromosomal abnormalities Systemic disorders Endocrine imbalance Varicella

A 37-year-old woman who is 17 weeks pregnant has had an amniocentesis. Before discharge, the nurse teaches the woman to call her doctor if she experiences which of the following side effects?

Cramping of the uterus

Which clinical findings would alert the nurse that the neonate is expressing pain?

Cry face; eyes squeezed; increase in blood pressure

The nurse is caring for a woman at 28 weeks' gestation with a history of preterm delivery. Which of the following laboratory data should the nurse carefully assess in relation to this diagnosis?

Fetal fibronectin levels Fetal fibronectin (fFN) is a biochemical marker used in the assessment of preterm labor. A negative fFN (<50 ng/mL) has a high negative predictive value that the woman will not deliver in 7-14 days.

The nurse is performing an assessment on a client who thinks she may be experiencing preterm labor. Which information is the most important for the nurse to understand and share with the client?

Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

The client is undergoing treatment for ovarian cancer. Which common nutritional problems are related to gynecologic cancers and the treatment thereof? (Select all that apply.)

Diarrhea Constipation Stomatitis Nausea and vomiting

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?

Deficient knowledge, related to diabetic pregnancy management

Indications for a primary cesarean birth are often nonrecurring. Therefore, a woman who has had a cesarean birth with a low transverse scar may be a candidate for vaginal birth after cesarean (VBAC). Which clients would be less likely to have a successful VBAC? (Select all that apply.)

Delivery at a rural hospital Maternal obesity (BMI >30) AfricanAmerican race

The perinatal nurse listens as Chantal describes her labor and emergency cesarean birth. Providing an opportunity to review this experience may assist Chantal in:

Developing more positive feelings about her labor and birth

The perinatal nurse describes risk factors for placenta previa to the student nurse. Placenta previa risk factors include (select all that apply):

Diabetes or hypertension Cigarette smoking Previous caesarean birth Multiple gestation

Which statement concerning the complication of maternal diabetes is the most accurate?

Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy.

You are caring for a patient who was admitted to labor and delivery at 32 weeks' gestation and diagnosed with preterm labor. She is currently on magnesium sulfate, 2 gm per hour. Upon your initial assessment you note that she has a respiratory rate of 8 with absent deep tendon reflexes. What will be your first nursing intervention?

Discontinue magnesium sulfate and notify the provider Initial nursing intervention needs to be discontinuing magnesium sulfate because the patient is exhibiting signs of magnesium toxicity with absent deep tendon reflexes and decreased respiratory rate.

In caring for an immediate postpartum client, the nurse notes petechiae and oozing from her intravenous (IV) site. The client would be closely monitored for which clotting disorder?

Disseminated Intravascular Coagulation (DIC)

Which is the most accurate description of PPD without psychotic features?

Distinguishable by irritability

The nurse is teaching a client with preterm premature rupture of membranes (PPROM) regarding self-care activities. Which activities should the nurse include in her teaching?

Do not engage in sexual activity.

A health care provider performs a clinical breast examination on a woman diagnosed with fibroadenoma. How would the nurse explain the defining characteristics of a fibroadenoma? (Select all that apply).

Does not increase risk for breast cancer Single lump in one breast that can increase in size

The fetal circulatory structure that connects the pulmonary artery with the descending aorta is known as which of the following?

Ductus arteriosus

A number of metabolic changes occur throughout pregnancy. Which physiologic adaptation of pregnancy will influence the nurse's plan of care?

During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus.

When caring for a pregnant woman with cardiac problems, the nurse must be alert for the signs and symptoms of cardiac decompensation. Which critical findings would the nurse find on assessment of the client experiencing this condition?

Dyspnea, crackles, and an irregular, weak pulse

The "Period of Purple Crying" is a program developed to educate new parents about infant crying and the dangers of shaking a baby. Each letter in the acronym "PURPLE" represents a key concept of this program. Which concepts are accurate?

E: evening P: peak of crying and painful expression U: unexpected

To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet?

Eat her meals and snacks on a fixed schedule.

The clinic nurse describes possible interventions for the pregnant woman who is experiencing pain and numbness in her wrists. The nurse suggests (select all that apply):

Elevating the arms and wrists at night Reassessment during the postpartum period The use of "cock splints" to prevent wrist flexion Edema from vascular permeability can lead to a collection of fluid in the wrist that puts pressure on the median nerve lying beneath the carpal ligament, leading to carpal tunnel syndrome. Elevation of the hands at night may help to reduce the edema. Occasionally, a woman may need to wear a "cock splint" to prevent the wrist from flexing. Reassessment in the postpartum period is indicated because although carpal tunnel syndrome usually subsides after the pregnancy has ended, some women may require surgical treatment if symptoms persist. Massaging the hands and wrists with alcohol does not improve pain and numbness.

The perinatal nurse provides a hospital tour for couples and families preparing for labor and birth in the future. Teaching is an important component of the tour. Information provided about preterm labor and birth prevention includes (select all that apply):

Encouraging regular, ongoing prenatal care Reporting symptoms of urinary frequency, abdominal cramping, and low back pain to the health-care provider Coming to the labor triage unit if back pain or cramping persist or become regular contractions

A woman seeks care at an infertility clinic. Which of the following tests may this woman undergo to determine what, if any, infertility problem she may have? (Select all that apply.)

Endometrial biopsy Hysterosalpingogram Serum FSH analysis Common diagnostic tests to determine infertility include: screening for STIs, assessment of hormonal levels (TSH, FSH, LH), assessment for ovulatory dysfunction, detection of LH surge, endometrial biopsy, hysterosalpingogram, and laparoscopy to visualize pelvic structures.. Chorionic Villus Sampling is aspiration of a small amount of placental tissue for genetic testing.

Which neurologic condition would require preconception counseling, if at all possible?

Epilepsy

The clinic nurse uses Leopold maneuvers to determine the fetal lie, presentation, and position. The nurse's hands are placed on the maternal abdomen to gently palpate the fundal region of the uterus. This action is best described as the:

First maneuver

The nurse is using the New Ballard Scale to determine the gestational age of a newborn. Which assessment finding is consistent with a gestational age of 40 weeks

Flexed posture

Which statement, related to the reconditioning of the urinary system after childbirth, should the nurse understand?

Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium (the period of about six weeks after childbirth during which the mother's reproductive organs return to their original nonpregnant condition.).

The ovarian cycle includes which of the following phases? (Select all that apply.)

Follicular phase Ovulatory phase Luteal phase

As the tocodynamometer (Toco) is placed on the laboring patient's abdomen, the nurse explains that this monitoring device provides information on which of the following?

Frequency of contractions Uterine contractions are measured via a tocodynamometer (Toco) which is an external uterine monitor. The Toco measures the frequency and duration of uterine contractions but cannot measure uterine pressure/intensity. Uterine pressure/intensity can be estimated by palpation during contractions or through the use of an internal monitor such as an intrauterine pressure catheter (IUPC).

A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization, the infant is weighed, and the birth weight is 4550 g (9 lb, 6 oz). What is the nurse's first priority?

Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia.

A nurse is performing an assessment on a pregnant woman during a prenatal visit. Which of the following findings would lead the nurse to report to the obstetrician that the patient may be experiencing intrauterine growth restriction (IUGR)?

Fundal height measurement: 22 cm at 26 weeks' gestation

Which of the following antepartum tests is (are) used to evaluate a Maternal Serum Screening test that is negative for increased risk?

Further followup test not necessary

The nurse is teaching the parents of a 1-day-old baby how to give their baby a bath. Which of the following actions should be included?

Gather all supplies before beginning the bath.

A woman who has had no prenatal care was assessed and found to have polyhydramnios on admission to the labor unit and has since delivered a baby weighing 4500 grams (macrosomia). The nurse knows that polyhydramnios can be related to fetal anomalies and fetal hyperglycemia. Which of the following complications of pregnancy likely contributed to these findings?

Gestational diabetes Gestational diabetes puts pregnant women at risk for hypo- or hyper-glycemia and polyhydramnios. The risks for the fetus/newborn based on the mother's gestational diabetes include macrosomia which is birth weight over 4000 grams. Macrosomia or large infant size is related to birth injuries.

A newborn was admitted to the neonatal intensive care unit (NICU) after being delivered at 29 weeks of gestation to a 28-year-old multiparous, married, Caucasian woman whose pregnancy was uncomplicated until the premature rupture of membranes and preterm birth. The newborn's parents arrive for their first visit after the birth. The parents walk toward the bedside but remain approximately 5 feet away from the bed. What is the nurse's most appropriate action?

Go to the parents, introduce him or herself, and gently encourage them to meet their infant. Explain the equipment first, and then focus on the newborn

What bacterial infection is definitely decreasing in neonates because of effective drug treatment?

Group B streptococci (GBS) infection

When a woman is diagnosed with postpartum depression (PPD) with psychotic features, what is the nurse's primary concern in planning the client's care?

Harming her infant

Taboos are cultural restrictions that: Select one:

Have serious supernatural consequences Taboos are believed to have serious supernatural consequences. Taboos are not known to have clinical or superstitious consequences and are not functional or neutral practices.

What changes occur in a mother's heart and blood flow during pregnancy?

Heart rate increases 10-15 bpm Blood volume increases by 40-50% Cardiac output increases by 30-50% by 30 weeks

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a platelet count of 90,000 mm3, an elevated aspartate aminotransaminase (AST) level, and a falling hematocrit. The laboratory results are indicative of which condition?

Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome

To explain hemolytic disorders in the newborn to new parents, the nurse who cares for the newborn population must be aware of the physiologic characteristics related to these conditions. What is the most common cause of pathologic hyperbilirubinemia?

Hemolytic disorders

A woman with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the client and documents the following findings: temperature of 37.1° C, pulse rate of 96 beats per minute, respiratory rate of 24 breaths per minute, BP of 155/112 mm Hg, 3+ DTRs, and no ankle clonus. The nurse calls the provider with an update. The nurse should anticipate an order for which medication?

Hydralazine

An infant was born 2 hours ago at 37 weeks of gestation and weighs 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of what condition?

Hypoglycemia

A diagnostic test commonly used to assess problems of the fallopian tubes is:

Hysterosalpingogram

Intrauterine resuscitation techniques are generally initiated by nurses in an effort to improve maternal blood flow to the placenta and oxygen delivery to the fetus. These techniques include:

IV fluid bolus to correct hypovolemia and/or hypotension Reposition mother off her back and onto the right or left side to correct/prevent aortocaval syndrome. Intrauterine resuscitation techniques are generally initiated by nurses in an effort to improve maternal blood flow to the placenta and oxygen delivery to the fetus. These techniques include lateral repositioning of the mother to prevent aortocaval syndrome; reduction of uterine activity to prevent interruption of blood flow to the placenta; intravenous fluid administration to correct hypovolemia and hypotension; oxygen administration by non-rebreather facemask to increase oxygen saturation; correction of maternal hypotension through position change, IV bolus, or IV medication as ordered; Amnioinfusion to correct umbili

The nurse is teaching new parents about metabolic screening for the newborn. Which statement is most helpful to these clients?

If genetic screening is performed before the infant is 24 hours old, then it should be repeated at age 1 to 2 weeks.

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?

Imbalanced nutrition: less than body requirements

A woman at 10 weeks' gestation is diagnosed with gestational trophoblastic disease (hydatiform mole). The nurse is aware that this condition puts the woman at an increased risk for choriocarcinoma. Medical management the nurse would expect to see include:

Immediate evacuation of hydatiform mole by aspiration/suction D&C A hydatiform mole is a benign proliferating growth with formation of vascular transparent vesicles in grape-like clusters without a viable fetus. Due to the use of Ultrasound, this condition is diagnosed early in pregnancy. The mole must be immediately evacuated and hCG levels are drawn at the time of diagnosis and as follow-up for at least 6 months to detect trophoblastic neoplasia.

The nurse is evaluating a neonate who was delivered 3 hours ago by vacuum-assisted delivery. The infant has developed a cephalhematoma. Which statement is most applicable to the care of this neonate?

In many infants, signs of hemorrhage in a full-term infant are absent and diagnosed only through laboratory tests

The perinatal nurse explains to the student nurse that a goal of the Healthy People 2020 report is to:

Increase proportion of infants who are breastfed to 81.9%.

Under which circumstance should the nurse immediately alert the pediatric provider?

Infant is dusky and turns cyanotic when crying.

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?

Inserting a sterile catheter

PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of the client's circulatory status can be performed with noninvasive monitoring. Match the type of noninvasive assessment that the nurse would perform with the appropriate clinical manifestation or body system.

Inspection: skin color, temperature, and turgor Auscultation: heart pulses Observation: presence or absence of anxiety Palpation: arterial pulses Measurement: pulse oximetry

A mother of a 10-day-old infant calls the clinic and reports that her baby is having loose, green stools. The mother is breastfeeding her infant. Which of the following is the best nursing action?

Instruct the woman to bring her infant to the clinic.

Which important component of nutritional counseling should the nurse include in health teaching for a pregnant woman who is experiencing cholecystitis?

Instruct the woman to eat a low-fat diet and to avoid fried foods.

A G2 P2 woman who experienced a prolonged labor and prolonged rupture of membranes is at risk for metritis. Which of the following nursing actions are directed at decreasing this risk?

Instruct woman to increase her fluid intake Instruct woman to change her peri-pads after each voiding Instruct woman to ambulate in the halls four times a day

In contrast to placenta previa, what is the most prevalent clinical manifestation of Grade 3 abruptio placentae?

Intense abdominal pain

What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant?

Intrauterine growth restriction

A neonate born at 36 weeks gestation is classified as which of the following?

Late preterm Preterm Births are classified as: Very Premature (<32 weeks gestation); Moderately Premature (32-33 weeks gestation); and Late Premature (34-37 weeks gestation).

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?

Lochia serosa

Mrs. H is telling you she feels the urge to push. This is most likely caused by what reflex?

Low fetal station triggering the Ferguson reflex Once the cervix is fully dilated, the vertex (head) is low in the pelvis, and the woman feels the urge to push, she will involuntarily bear down. This is activated by the presenting part as it descends and stretches the pelvic floor muscles and triggers the Ferguson reflex.

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?

Macrosomia

Jennifer is 3 hours postpartum following the vaginal delivery of a 9lb 15oz baby girl. Estimated blood loss at delivery was 800 ml. The RN is aware that Jennifer experienced an early-postpartum hemorrhage. Select the appropriate nursing actions for the care of this patient. (Select all that apply.)

Maintain IV site in case fluids/medication for PPH are indicated Frequent fundal assessment to prevent uterine atony and further blood loss Assess for displaced uterus secondary to overdistended bladder. Assess lochia for amount and for clots

During labor induction with oxytocin, the fetal heart rate baseline is in the 140s with moderate variability. Contraction frequency is assessed to be every 2-3 minutes with duration of 60 seconds, of moderate strength to palpation. Based on this assessment, the nurse should take which action?

Maintain present oxytocin infusion rate and continue to assess

Primary prevention of preterm labor and birth include which of the following? (Select all that apply).

Manage risk factors for preterm birth in individual pregnant woman Identify risk factors of preterm birth for individual pregnant woman

Karen, a G2 P2, experienced a precipitous birth 90 minutes ago. Her infant is 4200 grams and a repair of a second-degree laceration was needed following the birth. As part of the nursing assessment, the nurse discovers that Karen's uterus is boggy. Furthermore, it is noted that Karen's vaginal bleeding has increased. The nurse's most appropriate first action is to:

Massage the uterine fundus with continual lower segment support.

According to the CDC, which of the following are true?

Maternal mortality rate in the US has increased from 1987-2013

A 27-year-old woman, GTPAL 4-0-0-3-0, at 37 weeks gestation presented for a biophysical profile. The certified nurse midwife and obstetrician are discussing her results, and the woman's score is a "2". The nurse knows this score:

Means delivery is recommended.

Asking the pregnant woman about her use of recreational drugs is an essential component of the prenatal history. Harmful fetal effects that may occur from recreational drugs include (select all that apply):

Miscarriage/spontaneous abortion Low birth weight Illegal or recreational drug use can have a number of detrimental effects on maternal and fetal health, including spontaneous abortion, low birth weight, placental abruption, and preterm labor.

What form of heart disease in women of childbearing years generally has a benign effect on pregnancy?

Mitral valve prolapse

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.

Moro

Rho immune globulin will be ordered postpartum if which situation occurs?

Mother Rh-, baby Rh+

For which of the following conditions is Daily Fetal Movement Count indicated? (Select all that apply).

Mother with low amniotic fluid volume or oligohydraminos Mother with diabetes during pregnancy

By understanding the four mechanisms of heat transfer (convection, conduction, radiation, and evaporation), the nurse can create an environment for the infant that prevents temperature instability. Which significant symptoms will the infant display when experiencing cold stress?

Mottled skin with acrocyanosis

Presumptive signs of pregnancy include (select all that apply):

Nausea Fatigue Amenorrhea Nausea and vomiting, fatigue, and amenorrhea are all common during pregnancy and are the presumptive signs of pregnancy. Ballottement is a probably sign, noted during a vaginal exam.

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem approach. What is the first step in the provision of care for the infant?

Neonatal abstinence syndrome (NAS) scoring

A type 1 diabetic patient has repeatedly experienced elevated serum glucose levels throughout her pregnancy. Which of the following complications of pregnancy would the nurse expect to see?

Neonatal macrosomia

What information regarding a fractured clavicle is most important for the nurse to take into consideration when planning the infant's care?

No special treatment is necessary.

A healthy, full-term baby boy is scheduled for a circumcision. Nursing actions prior to the procedure include which of the following? (Select all that apply.)

Obtain written consent from the parents Administer acetaminophen PO 1 hour before procedure per provider order. Verify that the neonate has voided

During Anne's intrapartum experience, the nurse notes her GBS result to be positive. What is the appropriate nursing action for Anne's GBS results?

Order PCN G to administer IV piggy back

Marked hemodynamic changes in pregnancy can impact the pregnant woman with cardiac disease. Signs and symptoms of deteriorating cardiac status include (select all that apply):

Orthopnea Nocturnal dyspnea Palpitations

Which of these medications is commonly used to control postpartum bleeding related to uterine atony?

Oxytocin

The nurse is massaging a boggy uterus. The uterus does not respond to the massage. Which medication would the nurse expect would be given first:

Oxytocin or pitocin

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?

Parents hover around the infant, directing attention to and pointing at the infant.

What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony?

Performing fundal massage

What marks on a baby's skin may indicate an underlying problem that requires notification of a physician?

Petechiae scattered over the infant's body

A first-time dad is concerned that his 3-day-old daughter's skin looks "yellow." In the nurse's explanation of physiologic jaundice, what fact should be included?

Physiologic jaundice becomes visible when serum bilirubin levels peak between the second and fourth days of life

Tanya, a 30-year-old woman, is being prepared for a planned cesarean birth. The perinatal nurse assists the anesthesiologist with the spinal block and then positions Tanya in a supine position. Tanya's blood pressure drops to 90/52, and there is a decrease in the fetal heart rate to 110 bpm. The perinatal nurse's best response is to:

Place Tanya in a left lateral tilt

A newborn is jaundiced and is receiving phototherapy via ultraviolet bank lights. What is the most appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy?

Placing eye shields over the newborn's closed eyes

Which woman has the highest risk for endometrial cancer?

Postmenopausal woman with hypertension

A woman who is 12 weeks postpartum presents with the following behavior: she reports severe mood swings and hearing voices, believes her infant is going to die, she has to be reminded to shower and put on clean clothes, and she feels she is unable to care for her baby. These behaviors are associated with which of the following?

Postpartum psychosis

The perinatal nurse is providing care to Carol, a 28-year-old multiparous woman in labor. Upon arrival to the birthing suite, Carol was 7 cm dilated and experiencing contractions every 1 to 2 minutes which she describes as "strong." Carol states she labored for 1 hour at home. As the nurse assists Carol from the assessment area to her labor and birth room, Carol states that she is feeling some rectal pressure. Carol is most likely experiencing:

Precipitous labor

An overweight or obese pre-pregnancy weight increases the risk for which poor maternal outcomes? (Select all that apply.)

Preeclampsia Hemorrhage Being overweight or obese can substantially increase perinatal risk; however, no data support an increase in vaginal infections for the obese pregnant population.

An example of a cultural prescriptive belief during pregnancy is:

Remain active during pregnancy

Which adverse prenatal outcomes are associated with the HELLP syndrome? (Select all that apply.)

Renal failure Maternal and fetal death Placental abruption

A primigravida woman at 42 weeks' gestation received Prepidil (dinoprostone) for induction 12 hours ago. The Bishop score is now 3. Which of the following actions by the nurse is appropriate?

Report the lack of progress to the obstetrician

Evidence-based practice (EBP) is the integration of the best:

Research evidence, clinical expertise, and patients' values To practice EBP, a nurse is expected to combine the best research evidence with clinical expertise while taking into account the patients' preferences and their situation in the context of the available resources.

A woman at 32 weeks' gestation is diagnosed with severe preeclampsia with HELLP (Hemolysis, elevated Liver enzymes, Low Platelets) syndrome. The nurse will identify which of the following as a positive patient care outcome?

Resolution of thrombocytopenia

Which conditions are infants of diabetic mothers (IDMs) at a higher risk for developing?

Respiratory distress syndrome

The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella non-immune (titer 1:8 or enzyme immunoassay [EIA] 0.8); hematocrit, 30%. How should the nurse best interpret these data?

Rubella vaccine should be administered.

One of the following neonates is at highest risk for cold stress:

SGA neonate at 33 weeks gestation

Which of the following breath sounds are normal to hear in the neonate during the first few hours postbirth?

Scattered crackles

The clinic nurse knows that the part of the endometrial cycle occurring from ovulation to just prior to menses is known as the:

Secretory phase

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. The fetal heart rate (FHR) before birth is 180 beats per minute with limited variability. At birth the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic. Based on the maternal history, what is the most likely cause of this newborn's distress?

Sepsis

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, which finding alerts the nurse to possible side effects?

Serum magnesium level of 10 mg/d

The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt?

Strict aseptic technique, including hand washing, by all health care personnel

Since 1995 there has been a significant decrease in the rate of infant death related to which of the following:

Sudden infant death

Identify the hallmark of placenta previa that differentiates it from abruptio placenta.

Sudden onset of painless vaginal bleeding

The perinatal nurse knows that tocolytic agents are most often used to (select all that apply):

Suppress uterine contractions Prolong pregnancy to facilitate administration of antenatal corticosteroids Allow for transport of the woman to a tertiary care facility prior to delivery Tocolytic drugs are used to suppress uterine contractions in preterm labor and prolong pregnancy for 2-7 days to allow for administration of steroids to improve fetal lung maturity and plan for possible transport to a tertiary care facility prior to delivery.

A woman in labor and delivery is being given subcutaneous terbutaline for preterm labor. Which of the following common medication effects would the nurse expect to see in the mother?

Tachycardia

A woman on the day of discharge from the postpartum unit asks a number of questions regarding breastfeeding and shares that she is nervous about taking her baby home and not being able to remember everything she has been taught. These are behaviors associated with:

Taking hold

The mechanisms of labor include engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion. These mechanisms are also referred to as:

The cardinal movements of labor The cardinal movements of labor allow passage of the fetus through the birth canal. These include engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion.

Which explanation will assist the parents in their decision on whether they should circumcise their son?

The circumcision procedure has pros and cons during the prenatal period.

One of the most important components of the physical assessment of the pregnant client is the determination of BP. Consistency in measurement techniques must be maintained to ensure that the nuances in the variations of the BP readings are not the result of provider error. Which techniques are important in obtaining accurate BP readings? (Select all that apply.)

The client should be seated The client's arm should be placed at the level of the heart. The same arm should be used for every reading

A nurse is providing education to a support group of women newly diagnosed with breast cancer. It is important for the nurse to discuss which factor related to breast cancer with the group?

The exact cause of breast cancer remains unknown.

While performing Leopold's maneuvers on a woman in early labor, the nurse palpates a flat area in the fundal region, a hard round mass on the left side, a soft round mass on the right side, and small parts just above the symphysis. The nurse concludes which of the following?

The fetal presentation is scapular.

Nurses play a critical role in educating parents regarding measures to prevent infant abduction. Which instructions contribute to infant safety and security?

The mom should request that a second staff member verify the identity of any questionable person. The mother should check the photo identification (ID) of any person who comes to her room Parents should use caution when posting photographs of their infant on the Internet.

What is the primary purpose for the use of tocolytic therapy to suppress uterine activity?

The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids.

A newly delivered mother who intends to breastfeed tells her nurse, "I am so relieved that this pregnancy is over so that I can start smoking again." The nurse encourages the client to refrain from smoking. However, this new mother is insistent that she will resume smoking. How will the nurse adapt her health teaching with this new information?

The mother should not smoke in the same room her baby is in.

The nurse is completing a physical examination of the newborn 24 hours after birth. Which component of the evaluation is correct?

The nurse can gauge the neonate's maturity level by assessing his or her general appearance

Which finding would indicate to the nurse that the grieving parents have progressed to the reorganization phase of grieving?

The parents are discussing sex and a future pregnancy, even if they have not yet sorted out their feelings

The nurse is caring for two laboring women. Which of the patients should be monitored most carefully for signs of placental abruption?

The patient with eclampsia Hypertensive disorders of pregnancy is the only risk factor of placental abruption in these responses.

Which statement best exemplifies adaptation to pregnancy in relation to the adolescent? Select one:

The pregnant adolescent faces the challenge of multiple developmental tasks.

Nurses need to understand the basic definitions and incidence data regarding PPH. Which statement regarding this condition is most accurate?

Traditionally, PPH has been classified as early PPH or late PPH with respect to birth.

Which concerns regarding parenthood are often expressed by visually impaired mothers?

Transportation Infant safety Needing extra time for parenting activities to accommodate the visual limitations

The nurse is caring for a recently immigrated Chinese woman in the postpartum unit. Based on cultural beliefs and practices of the woman, the nurse would anticipate which of the following?

The woman prefers to have her female relatives care for her baby

Which statement regarding the laboratory test for glycosylated hemoglobin Alc is correct?

This laboratory test measures the levels of hemoglobin Alc, which should remain at less than 7%

A woman arrives at the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion?

Threatened

A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?

Thrombophlebitis; using real-time and color Doppler ultrasound

A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature 37.3° C, pulse rate 88 beats per minute, respiratory rate 10 breaths per minute, BP 148/90 mm Hg, absent deep tendon reflexes (DTRs), and no ankle clonus. The client complains, "I'm so thirsty and warm." What is the nurse's immediate action?

To discontinue the magnesium sulfate infusion

What is the primary purpose for magnesium sulfate administration for clients with preeclampsia and eclampsia?

To prevent convulsions

What is the primary rationale for nurses wearing gloves when handling the newborn?

To protect the nurse from contamination by the newborn

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation. What is the primary purpose of prostaglandin administration?

To ripen the cervix in preparation for labor induction

A woman with preeclampsia has a seizure. What is the nurse's highest priority during a seizure?

To stay with the client and call for help

A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic procedure will the client most likely have performed?

Transvaginal ultrasound for placental location

This screening test increases the detection of trisomy 21.

Triple or Quad marker screen

Abruptio placenta is a risk factor for amniotic fluid embolism. True or False

True

Endometritis is an infection that usually starts at the placental site. True or False

True

The nurse assessing a newborn for heat loss is aware that nonshivering thermogenesis utilizes the newborn's stores of brown adipose tissue (BAT) to provide heat in the cold-stressed newborn. True or False

True

The perinatal nurse knows that the laboring diabetic patient's blood glucose level should be maintained at 70-110 mg/dL. True or False?

True

For the patient with which of the following medical problems should the nurse question a physician's order for beta agonist tocolytics?

Type 1 diabetes mellitus

A woman presents to a prenatal clinic appointment at 10 weeks' gestation, in the first trimester of pregnancy. Which of the following symptoms would be considered a normal finding at this point in pregnancy?

Urinary frequency

The nurse suspects that her postpartum client is experiencing hemorrhagic shock. Which observation indicates or would confirm this diagnosis?

Urinary output of at least 30 ml/hr

A pregnant woman at 33 weeks of gestation is brought to the birthing unit after a minor automobile accident. The client is experiencing no pain and no vaginal bleeding, her vital signs are stable, and the FHR is 132 beats per minute with variability. What is the nurse'shighest priority?

Using continuous EFM for a minimum of 4 hours

The perinatal nurse teaches the postpartum woman about warning signs regarding development of postpartum infection. Signs and symptoms that merit assessment by the health-care provider include the development of a fever and:

Uterine tenderness

Which condition would require prophylaxis to prevent subacute bacterial endocarditis (SBE) both antepartum and intrapartum?

Valvular heart disease

What information should the nurse understand fully regarding rubella and Rh status?

Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination

Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand?

Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms.

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?

Writing messages that aid in communication Using devices that transform sound into light Ascertaining whether the client can read lips before teaching

Define hydatidiform mole

a cluster of fluid-filled sacs formed in the uterus by the degeneration of chorionic tissue around an aborting embryo.

Define placenta previa

a condition in which the placenta partially or wholly blocks the neck of the uterus, thus interfering with normal delivery of a baby.

Define GBS

a disorder in which the body's immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs.

Define polyhydramnios

a medical condition describing an excess of amniotic fluid in the amniotic sac.

Define Neonatal macrosomia

a newborn who's significantly larger than average

Define prophylactic cerclage

a procedure in which stitches are used to close the cervix during pregnancy to help prevent pregnancy loss or premature birth.

Which of the following is true regarding infertility? (Select all that apply).

anovulation can cause primary and/or secondary infertiity infertility is defined as the inability to achieve pregnancy after a year of unprotected intercourse

Define puerperal infection

any bacterial infection of the female reproductive tract following childbirth or miscarriage.

Define GDM

any degree of glucose intolerance with onset or first recognition during pregnancy

Which newborn reflex is elicited by stroking the lateral sole of the infant's foot from the heel to the ball of the foot?

babinski

Define acrocyanosis

bluish or purple coloring of the hands and feet caused by slow circulation.

During the assessment of the newborn at 3 hours of age, the perinatal nurse documents the presence on the infant's scalp of a unilateral, well-defined mass which does not cross the suture lines. The mother's chart indicates a prolonged labor with use of a vacuum extractor. The RN identifies this finding as:

cephalohematoma

For which of the following conditions is colposcopy used to further evaluate need for intervention? (Select all that apply).

cervical cancer vaginal cancer

Anna wants to know if her baby has Trisomy 18 as early in the pregnancy as possible. She is 8 weeks pregnant. Her physician will suggest which of the following diagnostic test?

chorionic villi sampling (CVS)

As a powerful central nervous system (CNS) stimulant, which of these substances can lead to miscarriage, preterm labor, placental separation (abruption), and stillbirth?

cocaine

Nancy G20101 is 30 weeks pregnant. She calls L&D with c/o mild contractions every 5-10 minutes for the past 3 hours. What is the nurse's best response?

come to L&D

The perinatal nurse teaches the postpartum woman about the normal process of diuresis that she can expect to occur approximately 6 to 8 hours after birth. A decrease in which of the following hormones is primarily responsible for the diuresis?

estrogen

According to the CDC,which of the following are significant causes of maternal death in the United States? (Select all that apply)

non-cardiovascular conditions hemorrhage hypertensive disorders cardio-vascular disease

Define hydrocele

the accumulation of serous fluid in a body sac.

Define avulsion

the action of pulling or tearing away.

Which of the following is the most effective contraception?

the implant

The is assessing the neonate's skin and notes the presence of a rash with red macules and papules on the trunk. The name for this common neonatal skin condition is:

erythema toxicum

The induction of labor is considered an acceptable obstetric procedure if it is in the best interest to deliver the fetus. The charge nurse on the labor and delivery unit is often asked to schedule clients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction. What are appropriate indications for induction? (Select all that apply)

fetal death postterm pregnancy rupture of membranes at or near term

Define cephalopelvic disproportion

occurs when a baby's head or body is too large to fit through the mother's pelvis

Depo provera, or The Shot, contains which of the following hormones?

progesterone

16 year old Emily lives in Blackfoot, ID. She has a boyfriend but does not want to have a baby for at least 10 years. She wants an effective, easy birth control method and denies medical problems. She has periods every 4-6 weeks. The nurse would recommend which of the following methods to Emily? (Select all that apply).

the implant hormonal IUD

Which of the following is true about preeclampsia?

the main problem is reduced organ perfusion that is secondary to vasospasm and endothelial activation

A recently delivered mother and her baby are at the clinic for a 6week postpartum checkup. Which response by the client alerts the nurse that psychosocial outcomes have not been met?

the woman has not given the baby a name