Test #1 Maternal Newborn/OB

The nurse is providing care to a 35-year-old female patient who complains of low back pain, pain with defecation, pelvic pressure, and premenstrual spotting. The health care provider has prescribed the hormonal therapy Lupron for this condition. What is the goal of this prescription? 1. To prevent pregnancy at this time to promote healing 2. To suppress menstruation and further growth of the tissue 3. To prevent retrograde menstruation outside the uterine cavity 4. To increase blood flow to decrease the endometrial lining

2. To suppress menstruation and further growth of the tissue

The more prepared a pregnant woman feels for the birth of her baby will lower her anxiety and fear. The behavior is referred to as ____________________.

nesting behavior

The nurse is providing care to the 35-year-old female patient at the family practice clinic who is in the office for her annual physical examination. Which tests should the nurse recommend are the most appropriate for this patient? Select all that apply. 1. Papanicolaou test every 5 years 2. Mammogram every 2 years 3. DEXA screen every 2 years 4. HPV every 5 years 5. HIV testing every 5 years.

1. Papanicolaou test every 5 years 4. HPV every 5 years

A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands? 1. "Due to my weight, there is a possibility that I may develop gestational diabetes." 2. "I am not overweight, but I am still at risk for gestational diabetes." 3. "My mother had preeclampsia during one of her pregnancies." 4. "I will need to do a glucose tolerance test in my second trimester.

1. "Due to my weight, there is a possibility that I may develop gestational diabetes."

A patient in the second trimester of pregnancy seems distressed. With encouragement, the patient states, "I have been totally avoiding physical contact with my husband to avoid prompting any sexual activity." Which statement by the nurse is the best response? 1. "Nonsexual expressions of affection are important for both of you." 2. "Be honest and tell your husband the reason you are avoiding him." 3. "You need to agree to sex in order to prevent infidelity from occurring." 4. "Sex during pregnancy is a healthy and normal display of affection."

1. "Nonsexual expressions of affection are important for both of you."

A patient who is pregnant does not remember the last date of her menstrual period. In which manner does the nurse expect the estimated date of delivery (EDD) to be determined for this patient? 1. Having an ultrasound examination 2. Using the gestational wheel 3. Asking when previous babies were born 4. Obtaining a history of gestational length

1. Having an ultrasound examination

The nurse is providing preoperative education on the laparoscope-assisted vaginal hysterectomy. Which statement by the patient verifies understanding of the procedure? 1. "I will use a mild douche solution to keep the surgical area clean." 2. "I'm relieved that I won't have any visible scars on my abdomen." 3. "I understand that there will be some light vaginal bleeding for several days." 4. "I understand that I must remain on bedrest until cleared by the surgeon."

3. "I understand that there will be some light vaginal bleeding for several days."

The nurse is preparing to teach the community about risk factors for the second most common cancer of the female reproductive system. Which of the following groups of women are at higher risk for this cancer? Select all that apply. 1. Menopausal women with an intact uterus who receive hormonal therapy 2. Women who have undergone treatment for breast cancer 3. Women who have many pregnancies and nursed their infants 4. Women who smoke and have many sexual partners 5. Women with a long-standing history of polycystic ovarian syndrome

1. Menopausal women with an intact uterus who receive hormonal therapy 2. Women who have undergone treatment for breast cancer 5. Women with a long-standing history of polycystic ovarian syndrome

The nurse is assessing a 72-year-old female patient in the women's health clinic. The mildly obese patient's history includes 7 vaginal births, 2 of which necessitated forceps deliveries, type 2 diabetes, and hypertension. The patient states that she has become incontinent of urine, has a history of frequent urinary tract infections (UTIs), and has a sense of fullness "down there." What would be an appropriate nursing intervention to help the patient with her symptoms? 1. Instruct the patient to stop urinating midstream at least twice a day. 2. Instruct the patient to eat a high-fiber diet and increase fluid intake 3. Instruct the patient to add probiotics to their diet while taking antibiotics. 4. Instruct the patient to bear down effectively while having a bowel movement.

1. Instruct the patient to stop urinating midstream at least twice a day.

The nurse is providing care to a 46-year-old female patient. The patient appears hesitant when asked of her sexual history, and the nurse discovers that the patient is a lesbian. What education should the nurse provide to this patient pertaining to her health? 1. Lesbians often are at higher risk for menstrual disorders, abnormal insulin production, and infertility. 2. Lesbians often are at higher risk due to lower socioeconomic disparities than their heterosexual counterparts. 3. Lesbians often refuse choices in health care such as the HPV vaccine as many feel they are not at risk. 4. Lesbians often have fewer health issues than their heterosexual counterparts due to their strong support systems

1. Lesbians often are at higher risk for menstrual disorders, abnormal insulin production, and infertility.

The nurse is assessing a 25-year-old female patient when the patient becomes tearful. The patient states that she has thin milky discharge from her nipples and two small masses on her left breast. She has lost over 40 pounds in the past year due to intensive exercises and finds that she needs to wear a sports bra during her sessions. The patient states that she is afraid that she will become the first member of her family to have breast cancer. Besides a negative mammogram, what other symptoms would correlate with this being a benign finding? Select all that apply. 1. Milky discharge from nipples 2. Extensive weight loss 3. Painful masses 4. Mood swings 5. Multiple masses

1. Milky discharge from nipples 3. Painful masses 5. Multiple masses

The nurse is providing dietary teaching to a patient in the first trimester of pregnancy who is overweight. Which daily dietary suggestions does the nurse make? Select all that apply. 1. One cup of 100% juice and cup of dried fruit. 2. Three cups of raw leafy and 1 cup cooked vegetables 3. One and a half cups of cooked pasta, rice, or cereal 4. Six ounces of lean meat, 2 eggs, and cup of beans 5. One cup of milk, 1 cup of yogurt, and oz of cheese

1. One cup of 100% juice and cup of dried fruit. 5. One cup of milk, 1 cup of yogurt, and oz of cheese

The nurse is assessing a 42-year-old patient who presents to the gynecology office with complaints of pelvic pressure, backaches, menorrhagia, and urinary frequency. The health care provider has diagnosed the patient with leiomyoma of the uterus. What are the treatment options for this condition? Select all that apply. 1. Routine pelvic examinations to assess rate of disease process 2. Oral contraceptives to control the bleeding and pain 3. Myomectomy for women who desire pregnancy 4. Hysterectomy for women who do not desire pregnancy 5. Antibiotic therapy with NSAIDS for symptom managment

1. Routine pelvic examinations to assess rate of disease process 3. Myomectomy for women who desire pregnancy 4. Hysterectomy for women who do not desire pregnancy

The nurse is providing care for the 34-year-old patient diagnosed with polycystic ovarian syndrome. Which interventions would correlate to the common symptoms of this syndrome? Select all that apply. 1. The patient has been unsuccessful with the ability to conceive. 2. The patient has a history of painful and irregular menstrual cycles. 3. The patient has noticed a drastic weight loss and dry skin. 4. The patient has chronic back pain and gastrointestinal issues. 5. The patient has heart palpitations and hypertension

1. The patient has been unsuccessful with the ability to conceive. 2. The patient has a history of painful and irregular menstrual cycles. 5. The patient has heart palpitations and hypertension

The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment? 1. This condition is often associated with use of oral contraceptives and may subside upon discontinuation. 2. This condition is often associated with type 2 diabetes and must be controlled with a different type of birth control. 3. This condition is often associated with hyperplasia of the endometrial tissue, which is exacerbated with oral contraceptives. 4. This condition is often associated with ovarian cysts, which are exacerbated with the use of oral contraceptives.

1. This condition is often associated with use of oral contraceptives and may subside upon discontinuation.

The nurse at a family practice clinic is providing care to a 47-year-old obese patient. The patient states that she realizes that she has put on extra weight but is reluctant to go to any exercise classes. She states that she often has to cross her legs when she sneezes and cannot do any exercises with her legs crossed. The health care provider has prescribed tolterodine (Detrol). What is the rationale for this medication? 1. Tolterodine is used to treat overactive bladders and to decrease urinary frequency, urgency, and urge incontinence. 2. Tolterodine is used to improve the tone and tissue in the urethral and vaginal areas. 3. Tolterodine is used to facilitate weight loss by acting as an appetite suppressant. 4. Tolterodine is used to improve blood flow to the pelvic muscles to decrease urinary tract infections

1. Tolterodine is used to treat overactive bladders and to decrease urinary frequency, urgency, and urge incontinence.

A nurse is caring for a single teen mother who has just given birth to her first child. The patient notes that the child's father "wants no relationship with his son." The patient goes on to express concerns about the short- and long-term impact of her teen pregnancy on herself and on her child. Which statements made by the nurse are accurate? Select all that apply. 1. "You are more likely than others to have additional children before you turn 20." 2. "You may have difficulty completing high school or college." 3. "Your child is less likely to experience behavioral problems." 4. "Your child is at increased risk of abusing alcohol when he is a teenager." 5. "You may not earn enough money to independently support yourself and your child."

1. "You are more likely than others to have additional children before you turn 20." 2. "You may have difficulty completing high school or college." 4. "Your child is at increased risk of abusing alcohol when he is a teenager."

The nurse works in a prenatal clinic that serves a multicultural population. The nurse is culturally aware, and so, which behaviors by a patient are expected due to common restrictive beliefs? Select all that apply. 1. A pregnant woman denies sexual intercourse during her third trimester. 2. A pregnant woman allows a clinic staff member to take a photo of her. 3. A pregnant woman reaches to an overhead shelf to collect her belongings. 4. A pregnant woman avoids sitting in front of a fan or air conditioner. 5. A pregnant woman refuses to watch a televised eclipse of the moon.

1. A pregnant woman denies sexual intercourse during her third trimester. 5. A pregnant woman refuses to watch a televised eclipse of the moon.

The nurse is counseling a couple who just learned their 16-week fetus tested positive for a serious genetic disorder. Which action by the nurse is inappropriate upon learning that the couple plan to continue the pregnancy? 1. Determine whether termination is still a consideration. 2. Explain they will experience grief, which is normal. 3. Provide additional information about the disorder. 4. Refer them to a disorder-specific support group.

1. Determine whether termination is still a consideration.

The nurse explains to a patient who has missed a second menstrual cycle that a combination of presumptive and probable signs is used to make a practical diagnosis of pregnancy. Which signs are expected by the nurse when making a practical diagnosis? Select all that apply. 1. Elevated hCG levels in blood and urine 2. Brownish pigmentation on the face 3. Fetal movement detected by the examiner 4. Bluish-purple coloration of vagina and cervix 5. Occasional mild contractions

1. Elevated hCG levels in blood and urine 2. Brownish pigmentation on the face 4. Bluish-purple coloration of vagina and cervix

Which factors will facilitate the integration of evidence-based practice (EBP) in the maternity- newborn clinical setting? Select all that apply. 1. Frame clinical questions in PICOT format. 2. Collect the best and most relevant evidence. 3. Cultivate a spirit of inquiry in the workplace. 4. Encourage the use of trial and error methods. 5. Base practical decisions on nursing consensus.

1. Frame clinical questions in PICOT format. 2. Collect the best and most relevant evidence. 3. Cultivate a spirit of inquiry in the workplace.

A pregnant patient is at the prenatal clinic for a routine visit at 30 weeks gestation. The nurse monitors the patient for indications of physiological demands by the fetus on the patient. Which finding causes the nurse concern? 1. Hgb of 9.5 g/dL and Hct. of 30% 2. PT of 16.5 seconds 3. WBCs of 16,000 mm3 4. Heart rate up 20 bpm

1. Hgb of 9.5 g/dL and Hct. of 30%

Parents of a neonate are grieving over their child's life-threatening disabilities. The neonate's course of treatment has changed three times in the last 24 hours due to irrational parenteral decisions. Which interventions will the NICU nurse implement in order to fulfill nursing responsibility to both the parents and the neonate? Select all that apply. 1. Inform the parents as to realistic expectations. 2. Use neonate's status with parenteral counseling. 3. Elicit parenteral input regarding medical care. 4. Advocate for medical support of the neonate. 5. Inform parents they are the final decision makers

1. Inform the parents as to realistic expectations. 2. Use neonate's status with parenteral counseling. 4. Advocate for medical support of the neonate.

An infant was recently born weighing 1,498 grams. The nurse understands that the birth weight of this infant is an important indicator of what? Select all that apply. 1. Morbidity rate 2. Prenatal care 3. Mortality rate 4. Infant health outcome 5. Postpartum care

1. Morbidity rate 3. Mortality rate 4. Infant health outcome

The nurse is encouraging cultural sensitivity among the nonmedical personnel in a prenatal clinic. Which type of family does the nurse identify as including children? Select all that apply. 1. Nuclear family 2. Extended family 3. Cohabitating family 4. Dyad family 5. Blended family

1. Nuclear family 2. Extended family 5. Blended family

The nurse is preparing a prenatal plan of care for a patient who is in the first trimester of pregnancy. Which long-range goals does the nurse include in the plan of care? Select all that apply. 1. Perform an ongoing assessment of risk status 2. Determine parental outlook on immunizations 3. Build rapport with the childbearing family 4. Make referral to specific resources as needed 5. Implement a risk-appropriate intervention

1. Perform an ongoing assessment of risk status 3. Build rapport with the childbearing family 4. Make referral to specific resources as needed 5. Implement a risk-appropriate intervention

The nurse works in a prenatal clinic located in a multicultural city. It is important for the nurse to recognize which cultural beliefs as prescriptive? Select all that apply. 1. The mother will aid the baby's circulation by remaining active during pregnancy. 2. The satisfaction of pregnancy cravings will prevent birthmarks on the baby. 3. The mother invites harm to the fetus during the night by sleeping on her back. 4. A safety pin attached to an undergarment will prevent fetal facial deformities. 5. Drinking too much tea will stimulate the fetus and cause a premature birth

1. The mother will aid the baby's circulation by remaining active during pregnancy. 2. The satisfaction of pregnancy cravings will prevent birthmarks on the baby. 4. A safety pin attached to an undergarment will prevent fetal facial deformities.

The nurse notes that a patient in the third trimester of pregnancy feels unable to "mother" her unborn child. Which information about the patient helps the nurse identify the sources of the patient's ambivalence? Select all that apply. 1. The patient is estranged from her mother. 2. The patient asks about classes for baby care. 3. The patient expresses a loss of independence. 4. The patient's partner is excited about a baby. 5. The patient expresses disgust about body changes

1. The patient is estranged from her mother. 3. The patient expresses a loss of independence. 5. The patient expresses disgust about body changes

A patient in the first trimester of pregnancy states, "I don't understand how a term baby can be accommodated by my uterus." Which information by the nurse specifically addresses the patient's comment? 1. The uterus size increases in size 20 times over a nonpregnant uterus. 2. The weight of the uterus increases from 7 g to 1,100 g during pregnancy. 3. About 80% of the increased capacity of the uterus is related to uteroplacental About 75% of the increase in uterus size during pregnancy is related to stretching.

1. The uterus size increases in size 20 times over a nonpregnant uterus.

The labor and delivery nursing staff is conducting research to determine the benefits of childbirth education (CBE). Which finding does evidence-based practice support? 1. Women who participated in CBE and/or had a birth plan had higher odds of a vaginal delivery. 2. Women who are considered to be at high risk had fewer complications if CBE or a birth plan was used. 3. Women of color, younger in age, and who are multipara respond best to CBE and/or a birth plan. 4. Women with a previous cesarean delivery are more likely to have a vaginal delivery after CBE.

1. Women who participated in CBE and/or had a birth plan had higher odds of a vaginal delivery.

The nurse is educating a 24-year-old female patient who was newly diagnosed with polycystic ovary syndrome (PCOS). The patient was prescribed an antidiabetic medication. Which medication effects should the nurse educate the patient about? Select all that apply. 1. A period of initial weight gain 2. A change in her integumentary system 3. Low blood sugar until her hormones stabilize 4. Decreased likelihood of pregnancy 5. A decrease in abdominal obesity and weight

2. A change in her integumentary system 3. Low blood sugar until her hormones stabilize 5. A decrease in abdominal obesity and weight

The nurse is assembling data for an education session at the local women's shelter. The majority of the guests at the shelter are 25- to 35-year-old American Indian women with young children. What is the leading cause of death for this population? 1. Situational depression 2. Risk-taking behaviors 3. Poor prenatal care 4. Poor dietary choices

2. Risk-taking behaviors

A mother has a child who is 4 years of age, and she is expecting another child. The mother expresses concern to the nurse about how the older sibling will receive the newborn. Which intervention shared by the mother does the nurse discourage? 1. "I plan to let him hear the baby's heartbeat at the next prenatal visit." 2. "I think that I will just bring the new baby home as a surprise." 3. "I have enrolled him in a sibling preparation class at the hospital." 4. "I let him pick out a gift for the baby, and have one for him from the baby."

2. "I think that I will just bring the new baby home as a surprise."

The nurse is counseling a female patient about alcohol use during pregnancy. Which statement by the patient demonstrates successful patient teaching? 1. "I will limit my drinking to just one alcoholic beverage per day." 2. "It's best for my baby if I avoid drinking during pregnancy." 3. "An occasional drink on special occasions is okay." 4. "Drinking alcohol is only acceptable in the first trimester."

2. "It's best for my baby if I avoid drinking during pregnancy."

The nurse works in a prenatal clinic and interacts with multiple patients from various socioeconomic backgrounds. Which patient does the nurse assess most carefully for a mental health issue? 1. A woman who chooses single parenthood 2. A military veteran who was deployed twice 3. The pregnant partner of a lesbian relationship 4. The mother who is multigestational with triplets

2. A military veteran who was deployed twice

The nurse is assisting a patient in the use of an ethical decision-making model related to quality of life. Which question is inappropriate when using this model? 1. What are the prospects for a normal life? 2. Are arrangements made for prolonging life? 3. Which type of deficits for the patient are likely? 4. Does a present or future condition make life undesirable?

2. Are arrangements made for prolonging life?

A patient at 34 weeks gestation is undergoing an ultrasound. The nurse notes that the amniotic fluid is estimated at between 500 and 600 mL. Which deduction does the nurse make from this finding? 1. Oligohydramnios is present. 2. Fluid is normal for gestation age. 3. Polyhydramnios has formed. 4. Follow-up ultrasound is warranted.

1. Oligohydramnios is present.

A female patient with a history of infertility is scheduled to have a hysterosalpingogram. Which findings can be detected with this procedure? Select all that apply. 1. Tubal occlusions 2. Uterine fibroids 3. Cervical irritation 4. Bicornate uterus 5. Vaginal infection

1. Tubal occlusions 2. Uterine fibroids 4. Bicornate uterus

The nurse is providing education on the prevention of heart disease for adult females ages 35 to 44 years old. Which of the following would be most appropriate for this disease process? Select all that apply. 1. Taking a brisk walking for 50 minutes three times a week 2. Consuming a diet rich in vegetables, fruits, and whole grains 3. Obtaining a varicella vaccine, if no evidence of immunity 4. Recognizing the importance of smoking cessation 5. Taking calcium supplements, if lactose intolerant

1. Taking a brisk walking for 50 minutes three times a week 2. Consuming a diet rich in vegetables, fruits, and whole grains 4. Recognizing the importance of smoking cessation

The nurse is planning an assessment on a patient in the second trimester of pregnancy. For which assessments will the nurse plan? Select all that apply. 1. Urine testing with a dipstick. 2. Presence of dependent edema. 3. Determine EDD by Naegele's rule. 4. Antibody screening for Rh?2- patient. 5. Check for chromosomal abnormalities

1. Urine testing with a dipstick. 2. Presence of dependent edema. 4. Antibody screening for Rh?2- patient.

The telephone triage nurse receives a call from a patient who is 5 days postoperative total abdominal hysterectomy. The patient states that her pain is not relieved with the medications and that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the emergency department. What does the nurse suspect as the surgical complication? 1. Possible complication related to the anesthesia 2. Possible injury to the ureters or bladder 3. Possible hemorrhage from the internal incision 4. Possible peritoneal venous thromboembolism

2. Possible injury to the ureters or bladder

A college-aged female patient states that she understands the risk of sexual assault with overdrinking. She asks the nurse what health risks are associated with excessive alcohol intake for her age. What diseases or conditions should the nurse include in her response? Select all that apply. 1. Infertility 2. Cancer of mouth 3. Hypertension 4. Brain shrinkage 5. Osteoporosis

1. Infertility 2. Cancer of mouth 4. Brain shrinkage

Which nursing interventions would best correlate with the nursing diagnosis of At risk for disturbed sleep patterns related to night sweats? 1. Take a cool shower before bedtime. 2. Avoid medications such as fluoxetine. 3. Eat a consistent carbohydrate prior to bedtime. 4. Avoid liquid intake 2 hours prior to bedtime

1. Take a cool shower before bedtime.

The nurse works in a postpartum maternal-newborn unit and notices a newborn who is exhibiting signs of distress. Through investigation, the nurse learns the newborn's mother has a history of abusing street drugs. Which facility system does the nurse report as being deficient? 1. Risk management 2. Newborn monitoring 3. Patient information 4. Admission process

1. Risk management

The nurse is providing care for a patient in active labor. The patient continuously asks the nurse for medication to "stop the pain." Which ethical principle does the nurse use when replying, "We need to protect the baby from being overmedicated. Let me help you with some breathing and relaxation techniques"? 1. Veracity 2. Beneficence 3. Nonmaleficence 4. Fidelity

2. Beneficence

The nurse is assessing a 59-year-old female patient for her annual examination. The patient had a full hysterectomy, bilateral salpingo-oophorectomy 1 year ago for a noncancerous condition. The patient states that she wants to stop her menopausal hormone therapy at this time, and she will try black cohosh if the symptoms persist. Which response by the nurse is most appropriate? 1. "Hormone therapy is the most effective treatment for menopausal symptoms." 2. "Hormone therapy becomes less effective within 2 years of treatment." 3. "Hormone therapy is most effective with alternative medicines use." 4. "Hormone therapy is most effective when combined with lifestyle changes."

1. "Hormone therapy is the most effective treatment for menopausal symptoms."

The nurse is counseling a patient who shares the intention to become pregnant. Which finding during the collection of health information will the nurse feel the least concern to address? 1. The patient smokes a pack of cigarettes a week. 2. The patient lives in a recently renovated house. 3. The patient travels outside the country for work. 4. The patient has a family history of diabetes mellitus

2. The patient lives in a recently renovated house.

A couple informs the nurse they have decided to make arrangements for a home birth. Which criteria will the nurse share with the couple regarding a safe home birth? Select all that apply. 1. The couple must be trained on how to be in control of the birth. 2. The pregnant woman must be in good health with a normal pregnancy. 3. The birthing home must be within a 1-hour drive of a hospital. 4. Adequate medical supplies and resuscitation equipment is available. 5. The birthing room needs to be sterile prior to labor and delivery.

2. The pregnant woman must be in good health with a normal pregnancy. 4. Adequate medical supplies and resuscitation equipment is available.

The nurse is assessing a 70-year-old female patient in the family practice clinic. The patient states that she has been experiencing sudden heavy vaginal bleeding the past 3 months. What is the expected diagnostic procedure for this patient? 1. Cervical conization 2. Colposcopy 3. Dilation and curettage 4. Endometrial biopsy

4. Endometrial biopsy

A patient who is pregnant shares details of being in a physically and psychologically abusive relationship with her baby's father. Which statement by the nurse is indicative of AWHONN's standing regarding intimate partner violence (IPV)? 1. "If you are all alone, you need to make arrangements for someone to stay with you." 2. "Your partner needs to come to the office so that we can confront his behavior." 3. "I will call a women's shelter to make arrangement for you to move in immediately." 4. "Let's explore ways to protect you and stop the abuse you have been enduring."

4. "Let's explore ways to protect you and stop the abuse you have been enduring."

A patient in the third trimester of pregnancy reports having heartburn nearly every day. Which recommendations does the nurse make to alleviate the problem? Select all that apply. 1. Consume three moderate-sized meals daily. 2. Sip clear, carbonated beverages when eating. 3. Assume a low Fowler position after meals. 4. Avoid eating 3 hours prior to bedtime. 5. Avoid consuming spicy, fatty, or fried food

4. Avoid eating 3 hours prior to bedtime. 5. Avoid consuming spicy, fatty, or fried food

The nurse is caring for a patient who is in labor with her first child. The patient's mother is present for support and notes that things have changed in the delivery room since she last gave birth in the early 1980s. Which current trend or intervention may the patient's mother find most different? 1. Fetal monitoring throughout labor 2. Postpartum stay of 10 days 3. Expectant partner and family in operating room for cesarean birth 4. Hospital support for breastfeeding

4. Hospital support for breastfeeding

A pregnant patient and her spouse live in the same home as the spouse's family who is not supportive of the pregnancy. The patient feels the family is ruining the happiness about the pregnancy. Which is the most important determination for the nurse to make? 1. What the potential for improving the current support network is 2. Who will provide the patient the greatest amount of support 3. Whether the couple's finances support moving into a separate location 4. If threatened or actual abuse from household members occur toward the patient

4. If threatened or actual abuse from household members occur toward the patient

A patient with a history of hypertension is giving birth. During delivery, the staff was not able to stabilize the patient's blood pressure. As a result, the patient died shortly after delivery. This is an example of what type of death? 1. Early maternal death 2. Late maternal death 3. Direct obstetric death 4. Indirect obstetric death

4. Indirect obstetric death

A patient who is pregnant asks the nurse when her baby is due to be born. The patient reports her last menstrual period (LMP) date as April 14. Using Naegele's rule, the nurse will set the estimated date of delivery (EDD) as what date? 1. July 21 2. January 7 3. July 14 4. January 21

4. January 21

The nurse in an OB's office is evaluating a patient who exhibits vaginal bleeding at 30 weeks gestation. The patient is prescribed bedrest at home and instructed to avoid lifting. The patient states, "I cannot go to bed, I have an 18-month-old at home." On which topic of the Jonsen model for ethical decision making will the nurse focus? 1. Contextual features 2. Quality of life 3. Patient preferences 4. Medical indications

4. Medical indications

A male patient is diagnosed with low sperm count as the cause of infertility. Which interventions will the nurse recommend to improve the patient's sperm count? Select all that apply. 1. Yoga or relaxation techniques 2. Surgical repair of an inguinal hernia 3. Switch to underwear made from cotton 4. Avoidance of showers with hot water temperature 5. Consultation to change hypertension drug

1. Yoga or relaxation techniques 2. Surgical repair of an inguinal hernia 5. Consultation to change hypertension drug

The nurse is counseling a couple in the third trimester of pregnancy and recommends the couple attend childbirth education classes. For which reason is the nurse least likely to recommend the classes? 1. The classes will affirm the normalcy of birth. 2. The techniques will enable a medication-free delivery. 3. The classes acknowledge a woman's ability to inherently give birth. 4. The classes explore ways to find strength and comfort during labor.

2. The techniques will enable a medication-free delivery.

A patient in the third trimester of pregnancy expresses concern to the nurse about changes to her muscles, joints, and bones. Which conditions does the nurse reassure the patient are normal changes of pregnancy? Select all that apply. 1. Waddling gait 2. Low back pain 3. Increased risk of falls 4. Fractures 5. Severe muscle aches

1. Waddling gait 2. Low back pain 3. Increased risk of falls

An infertile couple voices concern to the nurse about assisted reproductive technologies (ART). The nurse agrees that ART has created numerous dilemmas. Which potential questions does the nurse discuss with the couple? Select all that apply. 1. Which partner has ownership of the embryos? 2. Should a child be told about donors or surrogates? 3. Are there parental rights for sperm donors? 4. Does a fertility donor have financial obligations? 5. What happens to any surplus embryos?

1. Which partner has ownership of the embryos? 2. Should a child be told about donors or surrogates? 3. Are there parental rights for sperm donors? 5. What happens to any surplus embryos?

A patient is confirmed to be pregnant. Obstetric history includes two sets of twins born at 30 and 32 weeks gestation, respectively, a singleton birth born at 39 weeks gestation, and two pregnancies lost in the first trimester. In which way will the nurse define the patient's obstetrical history? 1. G4, T3, P2, A2, L3 2. G6, T1, P4, A2, L5 3. G5, T1, P2, A2, L5 4. G6, T4, P0, A4, L3

2. G6, T1, P4, A2, L5

A nursing student is asked to set goals that will decrease the fetal death outcomes during delivery. What guidelines will the nursing student use to assist in setting her goals? 1. WHO Maternal care guidelines 2. Healthy People 2020 3. AWHONN white papers 4. State Practice Act

2. Healthy People 2020

The nurse is providing care for a patient in the third trimester of pregnancy. Which topic of patient education is most likely to be needed during this time? 1. Update on fetus growth and behavioral patterns 2. Management for commonly experienced discomforts 3. General health maintenance and promotion topics 4. Counseling and guidance about diet and exercise

2. Management for commonly experienced discomforts

A 48-year-old female patient presents to the OB/GYN clinic for her annual examination. She states that she has had the following symptoms: mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido. Which of the following does the nurse suspect the patient is experiencing? 1. Menopause 2. Perimenopause 3. Postmenopause 4. Pregnancy

2. Perimenopause

A female patient is concerned about an inability to become pregnant after trying for 1 year. Which information collected during a health history causes the nurse the greatest amount of concern about possible infertility? 1. The patient works as a ballroom dance instructor. 2. The patient is turning 37 years old this year. 3. The patient has hot flashes and mood swings. 4. The patient was treated for a pelvic inflammatory disease while in college

3. The patient has hot flashes and mood swings.

A patient expresses a desire to become pregnant for a second child. The nurse notes that the patient's first child was born with a serious neural tube defect (NTD) and died of complications at 18 months of age. Which recommendation does the nurse make to this client? 1. Folic acid 0.6 mg/day orally 1 month before conception and throughout pregnancy. 2. Folic acid 0.4 mg/day orally started when pregnant and continued throughout pregnancy 3. Folic acid 4 mg/day orally started when pregnant and continued throughout pregnancy 4. Folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

4. Folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

A patient at 13 weeks gestation asks the nurse how her baby is nourished during pregnancy. Which information does the nurse use to explain the process to the mother? 1. Fetal waste products and CO2 pass through the placenta to the mother. 2. The placenta is a special organ developed to create nutrients and oxygen. 3. The mother's blood and fetus's blood mix for an exchange of nutrients. 4. Glucose, amino acids, and oxygen pass through the placenta from mother to baby

4. Glucose, amino acids, and oxygen pass through the placenta from mother to baby

A patient at 33 weeks gestation with a first pregnancy arrives at the labor and delivery unit with contractions. After monitoring the patient, the nurse determines the woman is in active labor and calls the health care provider (HCP), who prescribes a sleeping medication and sends the patient home. Which action does the nurse take? 1. Questions the HCP's prescribed treatment 2. Administers the medication and keeps the patient 3. Calls another HCP for a different prescription 4. Follows the HCP's instructions as prescribed

1. Questions the HCP's prescribed treatment

A couple is planning for the birth of their first child and is discussing the difference between a physician and a midwife. Which information presented by the couple does the nurse validate as being true? 1. Midwives are commonly self-taught without formal training. 2. Physicians provide care for both low- and high-risk patients. 3. Midwives primarily deliver babies in the home setting. 4. Physicians rely on the use of technological procedures for birth

2. Physicians provide care for both low- and high-risk patients.

The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, "I do not need to stop smoking my electronic cigarette because it will not harm my baby." Which is the best response by the nurse? 1. "You are correct. Electronic cigarettes are not harmful during pregnancy." 2. "Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity." 3. "According to the FDA, although electronic cigarettes are safe for you, they can cause harm to the fetus during pregnancy." 4. "Electronic cigarettes are considered harmful only in the first trimester."

2 "Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity."

The nurse is assessing the 19-year-old female patient in the women's health clinic. She reports that for the past several months, she has had lower abdominal pain, elimination issues, and mood swings, and her acne is worse the week before menstruation. The health care provider has prescribed oral contraceptives. The patient asks the nurse for the reason for the prescription. Which response by the nurse is appropriate? 1. "Pregnancy should be avoided because the hormonal shift would place the fetus at risk for birth defects." 2. "The hormones in the oral contraceptives can maintain estrogen-progesterone hormones to alleviate discomfort." 3. "Oral contraceptives may provide an increase in the hormones to help with your possible infertility issues." 4. "Oral contraceptives may balance the chemical changes in your brain to alleviate the depression symptoms."

2. "The hormones in the oral contraceptives can maintain estrogen-progesterone hormones to alleviate discomfort."

A 32-year-old female patient arrives to the emergency department with heavy uterine bleeding. The nurse finds that the patient had a positive pregnancy test 1 month prior to the visit. What is the potential medical management for this patient's issue? 1. Endometrial biopsy 2. Dilation and curettage 3. Colposcopy 4. Laparoscopy

2. Dilation and curettage

The nurse works in an infertility clinic and is interviewing a male patient whose partner has been unable to conceive. Which finding obtained during a health history will cause the nurse greatest concern? 1. The patient is a passionate gardener. 2. The patient had a vasectomy reversed. 3. The patient rides a bicycle daily to work. 4. The patient is concerned about infertility.

2. The patient had a vasectomy reversed.

After counseling with an obstetrician about infertility, a couple is advised to undergo testicular sperm aspiration. The nurse is aware that the procedure may be recommended for which infertility? 1. Blocked fallopian tubes 2. Unsuccessful vasectomy reversal 3. Poor cervical mucus production 4. Diminished sperm motility

2. Unsuccessful vasectomy reversal

The nurse is assessing a 64-year-old female patient. The patient states that she is able to reduce the risk of urinary tract infections (UTIs) by drinking a quart of cranberry juice a day. Which health condition, if present in this patient, contraindicates the use of cranberry juice? 1. Hypertension, managed with lisinopril 2. Diabetes type 1, managed with insulin 3. Atrial fibrillation, managed with warfarin 4. COPD, managed with inhaled steroids

3. Atrial fibrillation, managed with warfarin

The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that a pregnant patient may have been using marijuana. With consent, the nurse confirms via urine drug screen. Which statement by the nurse is most appropriate? 1. "Did you smoke marijuana when pregnant with your other child?" 2. "To avoid negative effects on your baby, you'll need to stop using marijuana during your last trimester." 3. "Using marijuana while pregnant can have a negative effect on the neurological development of your baby." 4. "Marijuana use while pregnant greatly increases your risk of miscarriage.

3. "Using marijuana while pregnant can have a negative effect on the neurological development of your baby."

The nurse in an obstetrician's office is discussing a patient's request for legally terminating an unwanted pregnancy after the fetus tests positive for Down syndrome. The woman and her spouse have five children from ages 11 to 17 years, and the family lives in an isolated rural area. Which action does the nurse take? 1. Inform the patient of programs to meet the needs of special children. 2. Share that children with Down syndrome can be high functioning. 3. Tell the physician of contextual factors identifying an ethical dilemma. 4. Inquire about the presence of an extended family support system

3. Tell the physician of contextual factors identifying an ethical dilemma.

The nurse is developing a plan of care for the 65-year-old obese female patient who states she wishes she could lose the weight but has no stamina for activity. Which nursing intervention would best correlate with the patient's statements? 1. Provide information on local gyms and exercise groups. 2. Provide information on choosemyplate.gov. 3. Provide information on the overall health risks of obesity. 4. Provide guidelines on how to increase daily activity as tolerated

4. Provide guidelines on how to increase daily activity as tolerated

The nurse works in the labor and delivery department. Which action by the nurse indicates a breach in the nursing care principles outlined by AWHONN? 1. Assists with an emergency delivery of a woman in a homeless shelter 2. Informs employer of religious beliefs against pregnancy termination 3. Suggests a nurse care for a patient who speaks the same native language 4. Declines a patient assignment because of a history of illegal drug use

4. Declines a patient assignment because of a history of illegal drug use

The nurse has made it a goal to increase the rate at which women begin prenatal care in the first trimester. The nurse relates this decision to national goals for better maternal and infant outcomes. What guidelines will the nurse use to guide her maternal health goals? 1. WHO Maternal care guidelines 2. State Practice Acts 3. AWHONN white papers 4. Healthy People 2020

4. Healthy People 2020

The nurse is providing prenatal care for a patient who is pregnant with a second child. Which understanding about complexity of a second pregnancy does the nurse use to assist the patient with the acceptance of this pregnancy? 1. Point out that the financial obligation is always less with a second child. 2. Make suggestions of how the first child will be a "helper" with the new baby. 3. Recommend career decisions needed because of additional parenting tasks. 4. Offer strategies for working out a new relationship with the first child

4. Offer strategies for working out a new relationship with the first child

The nurse is providing education to a patient who has given birth to her first child and is being discharged home. The patient expressed concern regarding infant mortality and sudden infant death syndrome (SIDS). The patient had an uncomplicated pregnancy, labor, and vaginal delivery. She has a body mass index of 25 and has no other health conditions. The infant is healthy and was delivered full-term. What will be most helpful thing to explain to the patient? 1. Uses of extracorporeal membrane oxygenation therapy (ECMO) 2. Uses of exogenous pulmonary surfactant 3. The Baby-Friendly Hospital Initiative 4. The Safe to Sleep campaign

4. The Safe to Sleep campaign

An infertile couple learns that the female is unable to produce viable eggs. The male partner suggests the use of a surrogate as a means of having a child. The female states, "I don't want your baby with another woman!" The nurse is aware of which psychosocial issue with this couple? 1. The male blames the female for the infertility. 2. The female is jealous of the surrogate's fertility. 3. The male needs to have a child with his genes. 4. The female is experiencing self-esteem issues

4. The female is experiencing self-esteem issues

The nurse works in the maternal-newborn unit dedicated to management of high-risk pregnancy and delivery. A patient has delivered two children who died from a genetic disorder. The current pregnancy tests positive for the same disorder. Which ethical decision-making model will the nurse use with this patient? 1. The model that focuses on medical treatment 2. The model that focuses on patient preference 3. The model that focuses on religion and culture 4. The model that focuses on the quality of life

4. The model that focuses on the quality of life

The nurse works in a urologist's office. A male patient is scheduled for routine fertility testing. For which test does the nurse refrain from making preparation? 1. STI screening 2. Hormonal levels 3. Sexual functioning 4. Ejaculate analysis

3. Sexual functioning

A nurse is suspended for refusal to participate in the performance of an elective termination of a pregnancy. Which specific group's standards does the nurse use for job reinstatement? 1. American Nurses Association (ANA) 2. Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) 3. State board of nursing 4. Facility ethics committe

2. Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)

A 55-year-old postmenopausal female patient presents to the family practice clinic for her annual examination. The nurse notes that the patient has lost inch in height. Upon further investigation, the nurse discovers that the patient has a slow-healing fracture of the left radius. What screening will most likely be initiated at this time for the patient? 1. Assessment for domestic violence 2. Dual-energy x-ray absorptiometry scan 3. Follicle-stimulating hormone 4. Serum levels of calcium and vitamin D

2. Dual-energy x-ray absorptiometry scan

The nurse is providing care to the adult female patient who presents to the emergency department with a suspected myocardial infarction (MI). Which symptom indicates a possible MI for the female patient? 1. Chest pain that radiates to the right arm and jaw 2. Episodic nausea/indigestion and palpitations 3. Sudden onset of trouble walking, and loss of balance 4. Swelling of the feet and shortness of breath

2. Episodic nausea/indigestion and palpitations

The nurse is providing education to the patient that is receiving a bisphosphate medication for osteoporosis. Which instructions should the nurse include in the teaching plan to reduce side effects and enhance absorption while taking bisphosphates? Select all that apply. 1. Take the medication with a small meal at the same time. 2. Take the medication with at least 8 oz. of water. 3. Remain upright for at least 30 minutes after taking a dose. 4. Take the medication on an empty stomach. 5. Take the medication with a calcium supplement

2. Take the medication with at least 8 oz. of water. 3. Remain upright for at least 30 minutes after taking a dose. 4. Take the medication on an empty stomach.

The nurse is assessing a 22-year-old female patient who arrives at the family clinic. The patient has finished her prescription for a urinary tract infection and now reports a milky discharge from her vagina and has a fishy odor. After microscopic examination of the vaginal discharge, the health care provider prescribed metronidazole gel to be inserted vaginally. What is the suspected medical diagnosis for this patient? 1. The patient has gonorrhea due to lowered immunity after antibiotic therapy. 2. The patient has bacterial vaginosis due to recent disruption of normal vaginal flora. 3. The patient has genital condylomas due to the recent UTI treatment. 4. The patient has candida vaginitis due to recent disruption of normal vaginal flora.

2. The patient has bacterial vaginosis due to recent disruption of normal vaginal flora.

The nurse is providing care to a 72-year-old female patient. While providing care, the nurse instructs the patient to slowly rise from a sitting or prone position. What is the pathophysiological reason for this instruction? 1. The patient is at higher risk for fractures due to postmenopausal osteoporosis. 2. The patient is at higher risk for hypotension due to decreased baroreceptor sensitivity. 3. The patient is at higher risk for falls due to decreased muscle strength and balance. 4. The patient is at higher risk for adverse drug reactions due to decreased hepatic function.

2. The patient is at higher risk for hypotension due to decreased baroreceptor sensitivity.

The nurse is caring for a 14-year-old patient who is 32 weeks pregnant. After complaining of genital sores and discomfort, the patient tests positive for syphilis. The fetus is at increased risk of which condition? 1. Diabetes 2. Blindness 3. Pneumonia 4. Hypertension

2. Blindness

A patient arrives at a maternal health client and tells the nurse she has missed a period and thinks she is pregnant. Which information shared with the nurse is a presumptive sign of pregnancy? 1. Positive results on a home pregnancy test 2. Breast enlargement, tenderness, and tingling 3. First awareness of fetal movements 4. Increased appetite

2. Breast enlargement, tenderness, and tingling

The nurse is providing care for a patient at 30 weeks gestation. Which topic related to patient concern or discomfort is most important for the nurse to address? 1. Increased breast enlargement 2. Dizziness when lying supine 3. Dependent edema and varicosities 4. Hyperpigmentation on the face

2. Dizziness when lying supine

The labor and delivery nurse is providing care to a patient in active labor. The nurse notes EFM changes that suggest fetal distress and monitors the fetus for an additional 20 minutes before calling the health care provider. The health care provide determines that an emergency cesarean delivery is required. During transport, EFM is interrupted and not resumed due to expectations of an emergent procedure. A stillborn fetus is delivered. For which actions can the nurse be held legally responsible? Select all that apply. 1. Inappropriate use of oxytocin, causing fetal distress. 2. Lack of appropriate response to fetal compromise. 3. Inability to initiate resuscitation to a compromised fetus. 4. Delayed communication resulting in a delay of cesarean. 5. Performance of a technical error related to monitoring

2. Lack of appropriate response to fetal compromise. 4. Delayed communication resulting in a delay of cesarean. 5. Performance of a technical error related to monitoring

The nursing department of a large facility is interested in improving clinical care with the introduction of EBP. Which barriers to EBP does the nursing department expect within the facility? Select all that apply. 1. Changes in nursing academia to include how to integrate research into practice 2. Outdated facility politics and policies that do not embrace research-based change 3. A general lack of information addressing nursing-focused research and change 4. Limited resources available to clinical care providers from nursing administration 5. Resistance by other health care professionals to providing nursing with autonomy

2. Outdated facility politics and policies that do not embrace research-based change 4. Limited resources available to clinical care providers from nursing administration

The nurse is counseling a patient regarding pregnancy. The patient lost her first two pregnancies in the second trimester of gestation for undetermined reasons. Which initial advice does the nurse provide for this patient? 1. Consider adoption. 2. Seek genetic studies. 3. Plan for fertility tests. 4. Attend grief counseling

2. Seek genetic studies.

What is the common risk factor for hypertension, abnormal menstrual cycles, osteoarthritis, and high-risk pregnancies? 1. Polycystic ovarian syndrome 2. Diabetes mellitus 3. Body mass index over 32 4. Sedentary lifestyle

3. Body mass index over 32

The nurse is assessing a 16-year-old sexually active patient in the family practice clinic. The patient's symptoms include breakthrough vaginal bleeding, abdominal pain, nausea, and fever. The health care provider obtains cultures of the cervical epithelial cells during a Pap smear and orders doxycycline 100 mg orally twice a day for 7 days for her and her partner. The nurse understands that this prescription is consistent with the treatment of which medical diagnosis? 1. Herpes 2. Condylomas 3. Chlamydia 4. Gonorrhea

3. Chlamydia

The nurse is providing care to a 75-year-old female patient diagnosed with osteoporosis. Which of the following would be the priority nursing diagnosis? 1. At risk for falls related to impaired balance 2. Knowledge deficit related to new medication regimen 3. Impaired physical mobility related to pain and skeletal changes 4. Ineffective health maintenance related to continued immobility

3. Impaired physical mobility related to pain and skeletal changes

The nurse is providing education for disease prevention to the adult female patient. Which factor puts the patient at a higher risk for multisystem disease processes such as cardiac issues, gynecological issues, and cancers? 1. Consuming two glasses of wine a week 2. Smoking two packs of cigarettes a day 3. Having a body mass index of over 32 4. Having poor intake of calcium and vegetables

3. Having a body mass index of over 32

An experienced OB nurse has accepted a position in labor and delivery of an inner-city hospital providing care for multicultural clients. Which action by the nurse is most helpful in preparation for this position? 1. Reviewing quantitative research focused on current birth procedures 2. Comparing facility policies with recent research recommendations 3. Intensely studying qualitative research focused on practice enhancement 4. Obtaining access to the department's recent research of evidence-based practice

3. Intensely studying qualitative research focused on practice enhancement

The nurse manager in the labor and delivery unit decides that all unit nurses are to take a course in electronic fetal monitoring (EFM) as recommended by AWHONN. Which is the most important issue related to EFM the nurse manager is expecting to address? 1. Eliminate the amount of litigation related to fetal injury. 2. Strengthen the staff's level of confidence with monitoring. 3. Reduce failure to accurately assess maternal and fetal status. 4. Improve the lack of communication with health care providers.

3. Reduce failure to accurately assess maternal and fetal status.

The nurse at a prenatal clinic is aware of the important tasks that each expectant mother will need to address. When an expectant mother states, "I will give up everything I have to make sure this baby is safe and well-cared for," which task is the mother addressing? 1. Expressing an attachment to the child 2. Ensuring safe birth for mother and child 3. Stating a willingness to give of oneself 4. Ensuring social acceptance of the child

3. Stating a willingness to give of oneself

A female carries one positive genetic marker for Huntington's disease. Her partner does not have any markers for the disease. For which reason is it so important for this family to identify persons with the genetic marker? 1. The Huntington gene is recessive. 2. All of the couple's offspring will have the disease. 3. Symptoms do not manifest until 30 to 50 years of age. 4. The expression of the disease is varied by individual

3. Symptoms do not manifest until 30 to 50 years of age.

A patient who has just received confirmation that she is pregnant is distressed because she has a seizure disorder that she manages with carbamazepine. Which is the nurse's greatest concern? 1. The carbamazepine may be discontinued. 2. The pregnancy is likely to end with fetal demise. 3. The fetus will experience loss of vision and hearing. 4. Carbamazepine is teratogenic and causes neural and facial defects.

4. Carbamazepine is teratogenic and causes neural and facial defects.

The nurse is taking the history of a gravida 2 para 1 patient. Which findings in the patient's history warrant further action? Select all that apply. 1. Anemia 2. Severe hemorrhage 3. Infections 4. Malnutrition 5. Eclampsia

1. Anemia 2. Severe hemorrhage 3. Infections 5. Eclampsia

The nurse is caring for a 15-year-old female who is pregnant with her first child. In her previous prenatal visit, the patient tested negative for chlamydia, syphilis, gonorrhea, and HIV. Based on the information provided, which condition is the patient's baby at higher risk for? 1. Intestinal problems 2. Neonatal conjunctivitis 3. Blindness 4. Pneumonia

1. Intestinal problems

The nurse is counseling a female patient diagnosed with anovulation as a cause of infertility. Which information does the nurse provide to the patient? Select all that apply. 1. Methods for dietary planning 2. Consultation for myomectomy 3. Refrain from unprotected sex 4. Surgical correction of fallopian tubes 5. Instructions for clomiphene citrate

1. Methods for dietary planning 5. Instructions for clomiphene citrate

The nurse is providing care in a school clinic established for the care of adolescent mothers. When assessing a patient who is 11 years of age and pregnant, which deduction regarding the patient's psychosocial development will the nurse recognize? 1. The adolescent is self-centered and oriented toward the present. 2. At this age, pregnancy is likely a result of attachment to a first love. 3. Moving into the mothering role will be nearly impossible at this age. 4. The role of the grandmother will be as the baby's primary caretaker

1. The adolescent is self-centered and oriented toward the present.

The nurse is employed in a NICU. With each new admission, the neonate is classified in a specific category regarding care. The nurse is in the process of admitting a neonate at 22 weeks gestation with multiple life-threatening conditions involving both cardiac and respiratory systems. In which category of care does the nurse expect the neonate to be placed? 1. The category where aggressive care is probably futile. 2. The category where aggressive care is mostly uncertain. 3. The category where aggressive care is likely to be beneficial. 4. The category of "wait and see" to determine possible survival.

1. The category where aggressive care is probably futile.

The nurse is educating the pregnant patient with a body mass index (BMI) of 33. The nurse knows that teaching has been effective when the patient states which of the following? 1. "My child may be at increased risk for birth injury." 2. "My child may have a decreased risk of developing childhood diabetes." 3. "I will probably give birth vaginally." 4. "I have a lower risk of developing gestational hypertension."

1. "My child may be at increased risk for birth injury."

A woman has recently given birth to an infant born at 35 weeks and 5 days gestation. What long- term effects should the nurse be concerned about with the infant being born at this gestation? Select all that apply. 1. Cerebral palsy 2. Respiratory disorders 3. Developmental delays 4. Visual impairments 5. Hearing impairments

1. Cerebral palsy 2. Respiratory disorders 3. Developmental delays 4. Visual impairments 5. Hearing impairments

The nurse is experiencing an ethical dilemma when confronted with a situation in which either the mother or fetus is predicted to die. The nurse feels bound by the ANA Code of Ethics to protect both patients. Which aspect of care during an ethical dilemma will guide the nurse? 1. Maternity nurses are bound to advocate first and foremost for the well-being of the mother. 2. The nurse is ethically bound to provide the best care for both the mother and fetus. 3. If the fetus is viable and healthy, its survival is the priority of the maternity nurse. 4. Survival of the mother is solely based on both patient and family decision making

1. Maternity nurses are bound to advocate first and foremost for the well-being of the mother.

The nurse on a maternity unit is an Orthodox Jew whose rabbi teaches that pregnancy terminations are permitted only to save the life of the mother. Which situation becomes possible if the nurse puts aside personal values and assists with elective terminations? 1. Moral distress 2. Legal actions 3. Loss of spirituality 4. Professional dilemma

1. Moral distress

A pregnant patient tells the nurse that her spouse has been diagnosed with Couvade syndrome. Which manifestations does the nurse suspect the spouse is experiencing? Select all that apply. 1. Nausea from unidentifiable causes 2. Physical rejection of sexual advances 3. Significant recent weight gain 4. Unexplainable abdominal pains 5. Self-imposed social isolation

1. Nausea from unidentifiable causes 3. Significant recent weight gain 4. Unexplainable abdominal pains

A couple announces to their parents that the couple is pregnant. One expectant grandmother says, "Grandchildren will call me by my first name. I am not ready to be a grandmother." Which feelings are being expressed by the grandmother? 1. The pregnancy presents undeniable evidence the grandmother is growing older. 2. The grandmother has specific wishes about how she is to be addressed as a person. 3. The grandmother is most likely teasing and actually feels overwhelming delight. 4. The grandmother has never thought of herself in this role and will adapt with time.

1. The pregnancy presents undeniable evidence the grandmother is growing older.

A patient arrives for her fourth month prenatal visit and expresses concern because of a leakage of yellow fluid from her breasts. Which topic does the nurse discuss during this visit? 1. Signs of infection 2. Breast changes 3. A change in EDD 4. Support bras

2. Breast changes

The nurse is caring for a woman who is pregnant. The patient reports that she has also smoked less than five cigarettes per day and that she has continued to smoke during her pregnancy. Routine prenatal examination and diagnostics have indicated she tested negative for sexually transmitted infections and has a BMI of 25. Based on statistics, which is likely true about the patient and the developing fetus? Select all that apply. 1. She will breastfeed her infant. 2. She is probably aged 20-24. 3. She likely has earned a college degree. 4. Her child may have impaired brain development. 5. Her child is more likely to be born prematurely.

2. She is probably aged 20-24. 4. Her child may have impaired brain development. 5. Her child is more likely to be born prematurely.

The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child, who is male. The patient's mother has accompanied her to today's visit. During the nursing assessment, the patient mentions that she is no longer in a relationship with the baby's father but her mother plans to help her. However, the patient's mother asks whether this will have any impact on the child. Which should the nurse indicate the child is at increased risk of during his adolescence? 1. Hypertension 2. Diabetes 3. Alcohol abuse 4. Intraventricular bleeding

3. Alcohol abuse

The nurse is arranging education for the menopausal support group regarding the approaches to treat the symptoms. Which of the following would be components of current treatments? Select all that apply. 1. Moderately intense exercises 2. Balanced diet, rich in calcium 3. Alternative medicine such as black cohosh 4. Over-the-counter sleep aid 5. Hormone therapy

1. Moderately intense exercises 2. Balanced diet, rich in calcium 5. Hormone therapy

A patient is experiencing pregnancy complications. Which factors will affect the client's ability to manage this situation? Select all that apply. 1. Current health status 2. Perceived threat to self or fetus 3. Previously used coping skills 4. Existence of a support network 5. Implemented nursing interventions

1. Current health status 2. Perceived threat to self or fetus 3. Previously used coping skills 4. Existence of a support network 5. Implemented nursing interventions

A patient at 37 weeks gestation arrives at the labor and delivery unit and reports a rupture of her membranes. Which factor causes the nurse to anticipate the HCP will prescribe a medical method of labor induction? 1. The fetus is viable and the barrier for a sterile uterine environment is breached. 2. The fetus is at risk for "drying out" and causing the mother to have a dry birth. 3. The mother must be maintained on complete bedrest until contractions begin. 4. The mother is at risk for developing an infection and passing it to the fetus.

1. The fetus is viable and the barrier for a sterile uterine environment is breached.

During the nurse's assessment of a 44-year-old female patient in the family medicine clinic, the patient becomes tearful and states she may be pregnant, as she has some unintentional weight gain, mood swings, and irregular menstrual cycles. The urine hCG reveals that the patient is not pregnant. What is the possible reason for her symptoms at this time? 1. The patient has a false pregnancy. 2. The patient is menopausal. 3. The patient is perimenopausal. 4. The patient may be pregnant.

3. The patient is perimenopausal.

The nurse is providing care for a patient in labor. The unborn fetus was diagnosed with severe microcephaly at 20 weeks' gestation. The patient tells the nurse, "We want everything done to save our baby who has as much right to a good life as anyone else." Which ethical approach does this represent? 1. Autonomy 2. Libertarianism 3. Egalitarianism 4. Utilitarianism

3. Egalitarianism

The nurse is discussing genetically linked diseases with a couple planning a pregnancy. The female states, "I am concerned because there is a history of sickle-cell disease in my family." Which information from the nurse is correct? 1. Any offspring will have the disease. 2. Only male children will have the disease. 3. The male partner needs genetic testing. 4. The couple should not become pregnant.

3. The male partner needs genetic testing.

A pregnant patient with a BMI of 35 is concerned about health effects she and her baby may face during pregnancy. During routine testing, the patient tested negative for sexually transmitted illnesses (STIs) and indicated that she is in a committed, long-term relationship with the child's father. Which of the following is accurate? 1. The patient's infant is at increased risk of neonatal blindness. 2. The patient's infant has a decreased risk of birth injury. 3. The patient will have increased risk of wound infection. 4. The patient will have a decreased risk of preeclampsia

3. The patient will have increased risk of wound infection.

The nurse is preparing a teaching plan for a polycystic ovary syndrome (PCOS) support group. One of the teaching points will include diet and weight loss to decrease hirsutism and acne. What is the reasoning for this rationale? 1. Diet and exercise will promote weight loss, which will decrease hyperandrogenemia. 2. Diet and exercise will decrease the risk of type 2 diabetes and gestational diabetes. 3. Diet and exercise will decrease serum lipid levels and lower the risk for cardiovascular disease. 4. Diet and exercise will increase the frequency of ovulation and menstruation and increase fertility.

1. Diet and exercise will promote weight loss, which will decrease hyperandrogenemia.

A patient arrives to the family practice clinic for her annual examination. The nurse's assessment data includes thin, 35-year-old female, history of weight loss surgery and total hysterectomy, BMI is 19, patient has been taking corticosteroids for severe asthma. Which of the following is an expected diagnostic screening for a potential health problem? 1. Dual-energy x-ray absorptiometry scan 2. Serum electrolyte levels and vitamin D 3. Serum cholesterol and diabetic screening. 4. Papanicolaou (Pap) Smear

1. Dual-energy x-ray absorptiometry scan

The nurse is caring for a 33-year-old female patient who has just undergone laparoscopic removal of endometrial lesions. Which statement by the patient illustrates her understanding of the disease process and prognosis? 1. "I realize that this is not a cure for the issue, but I want to have more children within the next year." 2. "I'm happy to know that the surgeon has been able to cure me of this disease without a hysterectomy." 3. "I realize that my type 2 diabetes will be cured now that I have those lesions removed." 4. "I understand that I will not have to have a colostomy now that the growths were removed from my bowels."

1. "I realize that this is not a cure for the issue, but I want to have more children within the next year."

The nurse is providing care to the 24-year-old patient in the OB/GYN clinic. The patient states that she thinks she may be pregnant because she has missed three menstrual cycles. The patient says, "This couldn't be happening at a worse time. I have been training heavily for a triathlon in 4 months." Which response by the nurse is most appropriate? 1. "Secondary amenorrhea, or no menses for 3 months, is not always a sign of pregnancy; it may be due to your heavy athletic activity." 2. "Pregnancy during times of stress such as heavy athletic activity can occur when precautions are not followed." 3. "If the pregnancy test is negative, the physician will need to perform a diagnostic laparoscopy to rule out a neoplasm. 4. "Amenorrhea may occur at times of nutritional disturbances. Are you eating a well-balanced diet?"

1. "Secondary amenorrhea, or no menses for 3 months, is not always a sign of pregnancy; it may be due to your heavy athletic activity."

The nurse is providing postoperative care to a patient who underwent a total abdominal hysterectomy 12 hours ago. Which of the following are appropriate nursing interventions? Select all that apply. 1. Assist the patient with ambulation. 2. Maintain the Foley catheter for 48 to 72 hours postoperatively. 3. Monitor intake and output and characteristics of urine. 4. Maintain bedrest while taking narcotic pain medications. 5. Initiate antiembolism therapy as ordered.

1. Assist the patient with ambulation. 3. Monitor intake and output and characteristics of urine. 5. Initiate antiembolism therapy as ordered.

The nurse is collecting health information from a patient who is early in the first trimester of pregnancy. Which topic is most important for the nurse to discuss with the patient after learning that the patient works for a commercial cleaning company? 1. Risk related to exposure to environmental toxins 2. Weight limit for lifting during the patient's pregnancy 3. Importance of resting with feet up during the day 4. Reasons for the patient to look for a safer job

1. Risk related to exposure to environmental toxins

Genomic medicine is an emerging medical discipline that involves using genomic information about an individual as part of the individual's clinical care. Which example does the nurse associate with genomic medicine? 1. Screening of neonates for inherited, treatable genetic diseases 2. Creating drugs specifically for the treatment of cancer 3. Conducting trial studies to determine how drugs effect individuals 4. Tracing and gaining knowledge about how genetic mutations occu

1. Screening of neonates for inherited, treatable genetic diseases

The nurse is teaching a class about embryonic and fetal development to couples in the early stage of pregnancy. For which reason does the nurse emphasize the first 8 weeks of gestation? 1. Pregnancies often abort before or at this time of development. 2. Lack of size and movement prevents confirmation of pregnancy. 3. All organ systems are developing during this period. 4. Factors that can interrupt the pregnancy are no longer a concern.

3. All organ systems are developing during this period.

The nurse is providing care for a patient who is 42 years of age and in the first trimester of her pregnancy. For which possible complication will the nurse closely monitor the patient and fetus? 1. Elevated blood pressure and proteinuria 2. Indications of maladaptation to pregnancy 3. Alterations in fetal chromosomal studies 4. Subtle indicators of menopause occurring

3. Alterations in fetal chromosomal studies

The nurse is counseling a female patient who has unsuccessfully attempted to become pregnant through a variety of methods and treatments for infertility. Which psychosocial manifestation is the nurse most likely to recognize? 1. Close connections with extended family 2. Strong intimate relationship with her partner 3. Difficulty accepting pregnancy if it does occur 4. Greater focus on career and job opportunities

3. Difficulty accepting pregnancy if it does occur

The nurse is taking a history of a mother who admits to cocaine drug use. Which action should the nurse take first? 1. Refer the patient to a drug abuse program. 2. Screen the infant for side effects associated with cocaine use. 3. Educate the patient of the risks associated with cocaine use during pregnancy. 4. Advise the patient that her baby will be okay even with the history of cocaine use.

3. Educate the patient of the risks associated with cocaine use during pregnancy.