Women and Childbearing Final

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? Select one: a. Hypoglycemia b. Birth injury c. Hypocalcemia d. Seizures

a. Hypoglycemia

Which of the following perinatal complications have been associated with untreated asymptomatic bacteriuria? (Select all that apply). Select one or more: a. Low birth weight b. congenital birth defects c. Preterm birth d. chorioamniotis

a. Low birth weight c. Preterm birth

Which woman has the highest risk for endometrial cancer? Select one: a. Postmenopausal woman with hypertension b. Woman who has an intrauterine device (IUD) c. Woman who has been on birth control pills for 15 years d. Perimenopausal woman who has a cystocele

a. Postmenopausal woman with hypertension

Which finding would indicate to the nurse that the grieving parents have progressed to the reorganization phase of grieving? Select one: a. The parents are discussing sex and a future pregnancy, even if they have not yet sorted out their feelings. b. The parents have abandoned those moments of "bittersweet grief." c. The parents say that they "feel no pain." d. The parents' questions have progressed from "Why?" to "Why us?"

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

Which conditions are infants of diabetic mothers (IDMs) at a higher risk for developing? Select one: a. Hyponatremia b. Respiratory distress syndrome c. Iron deficiency anemia d. Sepsis

b. Respiratory distress syndrome

Zita is 39 y/o G21002 who is 7 weeks pregnant. For which of the following is she at increased risk? Select one: a. anemia b. offspring with chromosomal defect c. postpartum hemorrhage d. cephalo-pelvic disportion (CPD)

b. offspring with chromosomal defect

Which of the following is true regarding dizygotic twins? Select one: a. Each fetus has their own uterus. b. The fetuses share one chorion. c. Each fetus has their own placenta. d. The fetuses share one amnion.

c. Each fetus has their own placenta.

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? Select one: a. Abundant lanugo b. Faint red marks on the soles of the feet c. Flexed posture d. Smooth, pink skin with visible veins

c. Flexed posture

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? Select one: a. Birth injury b. Seizures c. Hypoglycemia d. Hypocalcemia

c. Hypoglycemia

In contrast to placenta previa, what is the most prevalent clinical manifestation of Grade 3 abruptio placentae? Select one: a. Cramping b. Bleeding c. Intense abdominal pain d. Intermittent uterine contractions

c. Intense abdominal pain

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). Select one or more: a. bilateral tubal ligation b. natural family planning c. hormonal IUD d. the implant

c. hormonal IUD d. the implant

A postmenopausal woman has been diagnosed with two leiomyomas (fibroids). Which clinical finding is most commonly associated with the presence of leiomyomas? Select one: a. Diarrhea b. Weight loss c. Acute abdominal pain d. Abnormal uterine bleeding

d. Abnormal uterine bleeding

If nonsurgical treatment for late PPH is ineffective, which surgical procedure would be appropriate to correct the cause of this condition? Select one: a. Hysterectomy b. Laparoscopy c. Laparotomy d. Dilation and curettage (D&C)

d. Dilation and curettage (D&C)

Which of the following can provide contraception and protection against sexually transmitted infections? (Select all that apply). Select one or more: a. birth control pills b. natural family planning c. diaphragm d. abstinence e. condoms f. intrauterine devices

d. abstinence e. condoms

A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse? Select one: a. Dipstick value of 3+ for protein in her urine b. Pitting pedal edema at the end of the day c. Blood pressure (BP) increase to 138/86 mm Hg d. Weight gain of 0.5 kg during the past 2 weeks

a. Dipstick value of 3+ for protein in her urine

To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet? Select one: a. Eat her meals and snacks on a fixed schedule. b. Increase her consumption of protein. c. Eat six small equal meals per day. d. Reduce the carbohydrates in her diet.

a. Eat her meals and snacks on a fixed schedule.

Postoperative care of the pregnant woman who requires abdominal surgery for appendicitis includes which additional assessment? Select one: a. Fetal heart rate (FHR) and uterine activity b. Intake and output (I&O) and intravenous (IV) site c. Vital signs and incision d. Signs and symptoms of infection

a. Fetal heart rate (FHR) and uterine activity

Which neurologic condition would require preconception counseling, if at all possible? Select one: a. Multiple sclerosis b. Epilepsy c. Eclampsia d. Bell palsy

b. Epilepsy

In caring for the preterm infant, what complication is thought to be a result of high arterial blood oxygen level? Select one: a. IVH b. ROP c. BPD d. NEC

b. ROP

How many kilocalories per kilogram (kcal/kg) of body weight does a breastfed term infant require each day? Select one: a. 75 to 90 b. 50 to 65 c. 95 to 110 d. 150 to 200

c. 95 to 110

A client in late middle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems, as well as sensations of bearing down and of something in her vagina. What condition would the nurse suspect based upon this report? Select one: a. Pelvic relaxation b. Genital fistulas c. Cystocele and/or rectocele d. Uterine prolapse

c. Cystocele and/or rectocele

What is the most common cause of birth defects in humans? Select one: a. Single gene mutations b. Drugs c. Unknown causes d. Viral infections

c. Unknown causes

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? Select one: a. "I refrigerate any leftover formula for the next feeding." b. "I warm the bottle in my microwave oven." c. "Since reaching 2 weeks of age, I add rice cereal to my daughter's formula to ensure adequate nutrition." d. "I burp my daughter during and after the feeding as needed."

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

What are the most common causes for subinvolution of the uterus? Select one: a. Uterine tetany and overproduction of oxytocin b. Multiple gestation and postpartum hemorrhage c. Postpartum hemorrhage and infection d. Retained placental fragments and infection

d. Retained placental fragments and infection

When is a prophylactic cerclage for an incompetent cervix usually placed (in weeks of gestation)? Select one: a. 12 to 14 b. 23 to 24 c. 6 to 8 d. After 24

a. 12 to 14

Which statement regarding the postpartum uterus is correct? Select one: a. After 2 weeks postpartum, it should be abdominally nonpalpable. b. At the end of the third stage of labor, the postpartum uterus weighs approximately 500 g. c. Postpartum uterus returns to its original (prepregnancy) size by 6 weeks postpartum. d. After 2 weeks postpartum, it weighs 100 g.

a. After 2 weeks postpartum, it should be abdominally nonpalpable.

Which of the following tests should never be performed during the first trimester? Select one: a. Contraction Stress test b. Maternal screening test for cystic fibrosis c. Noninvasive Prenatal Screening test d. Ultrasound

a. Contraction Stress test

Documentation related to vacuum delivery includes which of the following: Select one or more: a. Fetal heart rate b. Timing and number of applications c. Position and station of fetal head d. Maternal position

a. Fetal heart rate b. Timing and number of applications c. Position and station of fetal head Assessment of fetal heart rate is part of second-stage management, timing and number of applications are part of standard of care related to safe vacuum deliveries, and position and station of fetal head are noted for safe vacuum extraction. Maternal position is not critical to the documentation related to vacuum deliveries.

A woman who is 30 weeks of gestation arrives at the hospital with bleeding. Which differential diagnosis would not be applicable for this client? Select one: a. Spontaneous abortion b. Abruptio placentae c. Cord insertion d. Placenta previa

a. Spontaneous abortion

What is the risk for all pregnancies to have a fetus with minor birth defects? Select one: a. 5-9% b. 10-15% c. Less than 1% d. 3-4%

b. 10-15%

Sandy G21001 is 41 weeks pregnant and presents to L&D for induction. The physician orders Pitocin to be infused at 2mU/min. The IV bag is LR 1000mL with 10 units of Pitocin. The infusion pump delivers ___mL/hour. How will the nurse program the infusion pump to deliver the medication as ordered? Select one: a. 6mL/hour b. 12 mL/hour c. 18mL/hour d. 30mL/hour

b. 12 mL/hour 10 units:1000mL:: X:1mL 1000X=10 X=0.01unit or 10 mU 2mU/min divided by 10mU/mL = 0.2mL/min x 60 min = 12 mL/hour

Which woman is at the greatest risk for psychologic complications after hysterectomy? Select one: a. 46-year-old woman who has had three children and has just been promoted at work b. 19-year-old woman who had a ruptured uterus after giving birth to her first child c. 55-year-old woman who has been having abnormal bleeding and pain for 3 years d. 62-year-old widow who has three friends who have had uncomplicated hysterectomies

b. 19-year-old woman who had a ruptured uterus after giving birth to her first child

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? Select one: a. Intense grief b. Acute distress c. Anticipatory grief d. Reorganization

b. Acute distress

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). Select one or more: a. Breast pain is an early indication of cancer. b. Assess for prior trauma or possible infection c. Pain is almost always an indication of a solid mass. d. Distinguishing between cyclical and noncyclical pain is important.

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

Which nursing intervention should be immediately performed after the forceps-assisted birth of an infant? Select one: a. Administering prophylactic antibiotic agents to the infant b. Assessing the infant for signs of trauma c. Applying a cold pack to the infant's scalp d. Measuring the circumference of the infant's head Feedback

b. Assessing the infant for signs of trauma

Which statement concerning the complication of maternal diabetes is the most accurate? Select one: a. Even mild-to-moderate hypoglycemic episodes can have significant effects on fetal well-being. b. Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy. c. Infections occur about as often and are considered about as serious in both diabetic and nondiabetic pregnancies. d. Hydramnios occurs approximately twice as often in diabetic pregnancies than in nondiabetic pregnancies.

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

A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse? Select one: a. Weight gain of 0.5 kg during the past 2 weeks b. Dipstick value of 3+ for protein in her urine c. Blood pressure (BP) increase to 138/86 mm Hg d. Pitting pedal edema at the end of the day

b. Dipstick value of 3+ for protein in her urine

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). Select one or more: a. Inflammation of the milk ducts and glands behind the nipples b. Does not increase risk for breast cancer c. Lumpiness in both breasts that develops 1 week before menstruation d. Single lump in one breast that can increase in size. e. Thick, sticky discharge from the nipple of the affected breast

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

A woman seeks care at an infertility clinic. Which of the following tests may this woman undergo to determine what, if any, infertility problem she may have? (Select all that apply.) Select one or more: a. Chorionic villus sampling b. Endometrial biopsy c. Hysterosalpingogram d. Serum FSH analysis

b. Endometrial biopsy c. Hysterosalpingogram d. 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.

A 36 y/o pregnant woman has been diagnosed with polyhydraminos. The nurse knows this is based on which of the following? Select one: a. Amniotic fluid index of 20 cm b. Amniotic fluid index of 10 cm c. Amniotic fluid index of 30 cm d. Amniotic fluid index of 7 cm

c. Amniotic fluid index of 30 cm

Preeclampsia begins at what point during the pregnancy? Select one: a. At 12 weeks gestation b. At conception c. At placental implantation d. After 20 weeks gestation

c. At placental implantation

A neonate born at 36 weeks gestation is classified as which of the following? Select one: a. Very preterm b. Moderately preterm c. Late preterm d. Term

c. Late preterm Preterm Births are classified as: Very Premature (<32 weeks gestation); Moderately Premature (32-34 weeks gestation); and Late Premature (34-36 weeks gestation).

Which of the following cancers has no accurate screening test for secondary prevention? Select one: a. Uterine cancer b. Breast cancer c. Ovarian cancer d. Cervical cancer

c. Ovarian cancer

A client is to take Clomiphene Citrate for infertility. Which of the following is the expected action of this medication? Select one: a. Decrease the symptoms of endometriosis b. Increase serum progesterone levels c. Stimulate release of FSH and LH d. Reduce the acidity of vaginal secretions

c. Stimulate release of FSH and LH

Which clinical findings would alert the nurse that the neonate is expressing pain? Select one: a. High-pitched, shrill cry; withdrawal; change in heart rate b. Low-pitched crying; tachycardia; eyelids open wide c. Cry face; flaccid limbs; closed mouth d. Cry face; eyes squeezed; increase in blood pressure

d. Cry face; eyes squeezed; increase in blood pressure

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? Select one: a. Asking the physician to prescribe analgesic agents b. Pouring water from a squeeze bottle over the woman's perineum c. Placing oil of peppermint in a bedpan under the woman d. Inserting a sterile catheter

d. Inserting a sterile catheter

In contrast to placenta previa, what is the most prevalent clinical manifestation of Grade 3 abruptio placentae? Select one: a. Cramping b. Bleeding c. Intermittent uterine contractions d. Intense abdominal pain

d. Intense abdominal pain

Rho immune globulin will be ordered postpartum if which situation occurs? Select one: a. Mother Rh+, baby Rh+ b. Mother Rh+, baby Rh- c. Mother Rh-, baby Rh- d. Mother Rh-, baby Rh+

d. Mother Rh-, baby Rh+

What is one of the initial signs and symptoms of puerperal infection in the postpartum client? Select one: a. Pain with voiding b. Fatigue continuing for longer than 1 week c. Profuse vaginal lochia with ambulation d. Temperature of 38° C (100.4° F) or higher on 2 successive days

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

The postpartum nurse is caring for a couple who experienced an unplanned emergency cesarean birth. The nurse observes the following behaviors: Parents are gently touching their newborn. Mother is softly singing to her baby. Father is gazing into his baby's eyes. Based on this data, the correct nursing diagnosis is altered parent-infant bonding related to emergency cesarean birth. Select one: True False

False Cesarean birth can place the parents at risk for bonding, but based on the observed interaction with their newborn, the parents display positive signs of bonding.

Abruptio placenta is a risk factor for amniotic fluid embolism. Select one: True False

True. Risk factors for amniotic fluid embolism include induction of labor, maternal age over 35, operative delivery, placenta previa, abruptio placenta, polyhydramnios, eclampsia, and cervical or uterine lacerations.

Jennifer is a 32 year old lawyer 37 weeks pregnant with her first child. She tells you that she has been on Paroxetine (an SSRI) for anxiety throughout her pregnancy. She asks you if she needs to worry about any side effects for her baby. Your best response would be: Select one: a. SSRIs have been linked to symptoms in the newborn and while they don't usually last too long I will alert your pediatrician and our high-risk nursery so everyone is aware. b. You probably don't need to worry as the use of SSRIs in pregnancy is not a problem. c. Yes, taking SSRIs in late pregnancy can cause symptoms in the baby but these won't show up for several months so I'll share with you what to look for before you are discharged. d. Yes, taking SSRIs in late pregnancy can be dangerous to the baby. You need to stop taking your Paroxetine immediately.

a. SSRIs have been linked to symptoms in the newborn and while they don't usually last too long I will alert your pediatrician and our high-risk nursery so everyone is aware. SSRI are commonly used for the management of depression and anxiety in pregnant women. SSRI use during the last trimester of pregnancy has been associated with symptoms in the baby very similar to clinical signs of Neonatal Abstinence Syndrome (NAS). The onset of clinical signs for infants exposed to SSRIs range from several hours after birth to several days after birth, with symptomatology lasting 1-2 weeks after birth.

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? Select one: a. "Diet and insulin needs change during pregnancy." b. "I will plan my diet based on the results of urine glucose testing." c. "I will need to eat 600 more calories per day because I am pregnant." d. "I can continue with the same diet as before pregnancy as long as it is well balanced."

a. "Diet and insulin needs change during pregnancy."

A primigravida has just delivered a healthy infant girl. The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks, "What is that medicine for?" How should the nurse respond? Select one: a. "Erythromycin is prophylactically given to prevent a gonorrheal infection." b. "It is to protect your baby from contracting herpes from your vaginal tract." c. "It is an eye ointment to help your baby see you better." d. "This medicine will protect your baby's eyes from drying out over the next few days."

a. "Erythromycin is prophylactically given to prevent a gonorrheal infection."

Pelvic floor exercises, also known as Kegel exercises, will help to strengthen the perineal muscles and encourage healing after childbirth. The nurse requests the client to repeat back instructions for this exercise. Which response by the client indicates successful learning? Select one: a. "I pretend that I am trying to stop the flow of urine in midstream." b. "I contract my thighs, buttocks, and abdomen." c. "I perform 10 of these exercises every day." d. "I stand while practicing this new exercise routine."

a. "I pretend that I am trying to stop the flow of urine in midstream."

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? Select one: a. "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." b. "If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnancy is rare. Therefore, to improve your chance of a successful pregnancy, not getting pregnant at this time is best." c. "If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore, if you desire a future pregnancy, it would be better for you to use the most reliable method of contraception available." d. "Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar pregnancy."

a. "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 newborn in the neonatal intensive care unit (NICU) is dying as a result of a massive infection. The parents speak to the neonatologist, who informs them of their son's prognosis. When the father sees his son, he says, "He looks just fine to me. I can't understand what all this is about." What is the most appropriate response or reaction by the nurse at this time? Select one: a. "This must be a difficult time for you. Tell me how you're doing." b. "Didn't the physician tell you about your son's problems?" c. Quietly stand beside the infant's father. d. "You'll have to face up to the fact that he is going to die sooner or later."

a. "This must be a difficult time for you. Tell me how you're doing."

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? Select one: a. 5 b. 4 c. 6 d. 7

a. 5

Which information should nurses provide to expectant mothers when teaching them how to evaluate daily fetal movement counts (DFMCs)? (Select all that apply) Select one or more: a. A count of less than three fetal movements in 1 hour warrants future evaluation. b. Alcohol or cigarette smoke can irritate the fetus into greater activity. c. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours d. Kick counts should be taken every ½ hour and averaged every 6 hours, with every other 6-hour stretch off.

a. A count of less than three fetal movements in 1 hour warrants future evaluation. c. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours

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.) Select one or more: a. Age b. Family history c. Late menarche d. Nulliparity or first pregnancy after age 40 years e. Early menopause

a. Age b. Family history d. Nulliparity or first pregnancy after age 40 years

Which societal factors have a strong influence on parental response to their infant? (Select all that apply.) Select one or more: a. An adolescent motherʼs egocentricity and unmet developmental needs interfere with her ability to parent effectively. b. Relationships between adolescent mothers and fathers are more stable than older adults. c. An adolescent mother is likely to use less verbal instruction, be less responsive, and interact less positively than other mothers. d. Adolescent mothers have a higher documented incidence of child abuse. e. Mothers older than 35 years of age often deal with more stress related to work and career issues, as well as decreasing libido.

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

A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients' emotional responses to their infertility. Which of the following responses would the nurse expect to find? (Select all that apply.) Select one or more: a. Anger at others who have babies. b. Feelings of failure because they cannot make a baby. c. Sexual excitement because they want to conceive a baby. d. Guilt on the part of one partner because he or she is unable to give the other a baby. Infertility can be seen as a crisis in the couple's lives and relationship. The diagnosis and treatment of infertility can cause anger with others who have babies, feelings of failure, and feelings of guile. Sexual dysfunction can occur based on the type of infertility testing required and the method of treatment.

a. Anger at others who have babies. b. Feelings of failure because they cannot make a baby. d. Guilt on the part of one partner because he or she is unable to give the other a baby. Infertility can be seen as a crisis in the couple's lives and relationship. The diagnosis and treatment of infertility can cause anger with others who have babies, feelings of failure, and feelings of guile. Sexual dysfunction can occur based on the type of infertility testing required and the method of treatment.

Which intervention by the nurse would reduce the risk of abduction of the newborn from the hospital? Select one: a. Applying an electronic and identification bracelet to the mother and the infant b. Instructing the mother not to give her infant to anyone except the one nurse assigned to her that day c. Restricting the amount of time infants are out of the nursery d. Carrying the infant when transporting him or her in the halls

a. Applying an electronic and identification bracelet to the mother and the infant

What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy? Select one: a. Assessing FHR and maternal vital signs b. Monitoring uterine contractions c. Placing clean disposable pads to collect any drainage d. Performing a venipuncture for hemoglobin and hematocrit levels

a. Assessing FHR and maternal vital signs

The obstetric provider has informed the nurse that she will be performing an amniotomy on the client to induce labor. What is the nurse's highest priority intervention after the amniotomy is performed? Select one: a. Assessing the fetal heart rate (FHR) b. Performing a vaginal examination c. Applying clean linens under the woman d. Taking the client's vital signs

a. Assessing the fetal heart rate (FHR)

A nurse is completing the initial assessment on a neonate of a mother with type I diabetes. Important assessment areas for this neonate include which of the following? (Select all that apply.) a. Assessment of cardiovascular system b. Assessment of respiratory system c. Assessment of musculoskeletal system d. Assessment of neurological system

a. Assessment of cardiovascular system b. Assessment of respiratory system c. Assessment of musculoskeletal system d. Assessment of neurological system Complications of high maternal levels of glucose during pregnancy include cardiac anomalies, skeletal defects, risk for RDS, neurological damage and seizures. Assessment findings of the macrosomic infant may include fractured clavicle, brachial nerve damage, hypoglycemia, hypocalcemia and hypomagnesemia, poycythemia, hyperbilirubinemia, low muscle tone, and poor feeding abilities.

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? Select one: a. Assist the woman in selecting a nutritious meal plan. b. Teach baby care skills like diapering. c. Discuss the pros and cons of circumcision. d. Counsel her regarding future sexual encounters.

a. Assist the woman in selecting a nutritious meal plan. The "taking-in" phase is a period of dependent behaviors and occurs during the first 24-48 hours. Assisting her in ordering her meals allows her to focus on her comfort while acknowledging her decreased ability to make decisions. Teaching infant skills is probably more appropriate during the "taking-hold"t; phase. "Letting go" phase would include resumption of sexual intimacy. See Table 22-4

An infant boy was delivered minutes ago. The nurse is conducting the initial assessment. Part of the assessment includes the Apgar score. When should the Apgar assessment be performed? Select one: a. At least twice, 1 minute and 5 minutes after birth b. Once by the obstetrician, just after the birth c. Every 15 minutes during the newborn's first hour after birth d. Only if the newborn is in obvious distress

a. At least twice, 1 minute and 5 minutes after birth

General skin care for full-term infants includes which of the following? (Select all that apply.) Select one or more: a. Avoid daily bathing with soap. b. Use a cleanser with a neutral pH. c. Avoid fragrant soaps. d. Apply petrolatum-based ointments sparingly to dry skin, but avoid head and face.

a. Avoid daily bathing with soap. b. Use a cleanser with a neutral pH. c. Avoid fragrant soaps. d. Apply petrolatum-based ointments sparingly to dry skin, but avoid head and face. It is not necessary to bathe an infant daily. Daily bathing with soap can cause dry skin in the infant. The cleanser should be of neutral pH and free of additives such as fragrances that could be irritants.

Which of the following is an indication for the administration of methylergonovine (Methergine)? Select one: a. Boggy uterus that does not respond to massage and oxytocin therapy b. Woman with a large hematoma c. Woman with a deep vein thrombosis d. Woman with severe postpartum depression

a. Boggy uterus that does not respond to massage and oxytocin therapy Methergine is administered IM or IV in the presence of postpartum hemorrhage due to uterine atony or subinvolution when fundal massage and oxytocin therapy are ineffective. Always check BP before administration and notify provider before injection if elevated as Methergine can increase BP.

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? Select one: a. Breathing in a respiratory pattern common to premature infants b. Trying to maintain a neutral thermal environment c. Suffering from sleep or wakeful apnea d. Experiencing severe swings in blood pressure

a. Breathing in a respiratory pattern common to premature infants

The nursery nurse notes the presence of diffuse edema on a baby girl's head. Review of the birth record indicates that her mother experienced a prolonged labor and difficult childbirth. By the second day of life, the edema has disappeared. The nurse documents the following condition in the infant's chart. Select one: a. Caput succedaneum b. Cephalhematoma c. Subperiosteal hemorrhage d. Epstein pearls

a. Caput succedaneum Caput succedaneum is localized soft tissue edema of the scalp; feels spongy; may cross suture lines; results from prolonged pressure of the head against the maternal cervix during labor; resolves within the first week of life.

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? Select one: a. Closely monitor all mother-infant interactions b. Maintain client on strict bed rest. c. Restrict visitation to her partner. d. Carefully monitor toileting.

a. Closely monitor all mother-infant interactions Postpartum psychosis (PPP) is a variant of bipolar disorder and is the most serious form of postpartum mood disorders. Onset of symptoms can be as early as the 3rd postpartum day. Assessment findings include paranoia, delusions associated with the baby, mood swings, extreme agitation, confused thinking, and strange beliefs.

Which finding on a prenatal visit at 10 weeks of gestation might suggest a hydatidiform mole? (Select all that apply). Select one or more: a. Complaint of severe nausea b. Blood pressure of 120/80 mm Hg c. History of bright red spotting for 1 day, weeks ago d. Fundal height measurement of 18 cm

a. Complaint of severe nausea d. Fundal height measurement of 18 cm

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? Select one: a. Congenital anomalies in the fetus b. Hydramnios c. Frequent episodes of maternal hypoglycemia d. Hyperemesis gravidarum

a. Congenital anomalies in the fetus

A postpartum client is concerned that her breasts are engorged and uncomfortable. What is the nurse's explanation for this physiologic change? Select one: a. Congestion of veins and lymphatic vessels b. Hyperplasia of mammary tissue c. Overproduction of colostrum d. Accumulation of milk in the lactiferous ducts and glands

a. Congestion of veins and lymphatic vessels

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.) Select one or more: a. Diarrhea b. Stomatitis c. Constipation d. Increased Appetite e. Nausea and vomiting

a. Diarrhea b. Stomatitis c. Constipation e. Nausea and vomiting

Which of the following actions can decrease the risk for a postpartum infection? (Select all that apply.) Select one or more: a. Diet high in protein and vitamin C b. Increased fluid intake c. Ambulating within a few hours after delivery d. Good hand washing techniques by staff and patients

a. Diet high in protein and vitamin C b. Increased fluid intake c. Ambulating within a few hours after delivery d. Good hand washing techniques by staff and patients Protein and vitamin C assist with tissue healing. Rehydrating a woman after delivery can assist with decreasing risk for infections. Early ambulation decreases risk for infection by promoting uterine drainage. Hand washing by staff and patients has been shown to be the number one measure in the transmission of infection.

Which is the most accurate description of PPD without psychotic features? Select one: a. Distinguishable by irritability b. Condition that disappears without outside help c. Postpartum baby blues requiring the woman to visit with a counselor or psychologist d. Condition that is more common among older Caucasian women because they have higher expectations

a. Distinguishable by irritability

Which intervention can nurses use to prevent evaporative heat loss in the newborn? Select one: a. Drying the baby after birth, and wrapping the baby in a dry blanket b. Placing the baby away from the outside walls and windows c. Keeping the baby out of drafts and away from air conditioners d. Warming the stethoscope and the nurse's hands before touching the baby

a. Drying the baby after birth, and wrapping the baby in a dry blanket

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? Select one: a. Dyspnea, crackles, and an irregular, weak pulse b. Shortness of breath, bradycardia, and hypertension c. Increased urinary output, tachycardia, and dry cough d. Regular heart rate and hypertension

a. 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? (Select all that apply.) Select one or more: a. E: evening b. U: unexpected c. P: peak of crying and painful expression d. R: baby is resting at last e. L: extremely loud

a. E: evening b. U: unexpected c. P: peak of crying and painful expression

Which of the following nursing interventions are important in the prenatal care of the woman with prenatal depression? (Select all of the following). Select one or more: a. Educate the woman about depression and plan of care b. Recommend she see a psychiatrist for management c. Maintain a caring relationship d. Counsel her on the importance of medication if the woman refuses it.

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

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? (Select all that apply.) Select one or more: a. Explain to the mother that she can have her son visit her in the hospital. b. Teach her son how to change the baby's diapers. c. Assist her son in holding his new baby sister. d. Recommend that she spend time reading to her older son while he sits in her lap.

a. Explain to the mother that she can have her son visit her in the hospital. c. Assist her son in holding his new baby sister. Younger children experience a sense of loss over no longer being the baby of the family while older children may have a sense of increased responsibility. Siblings should be introduced to the newest family member as soon as possible and spend time with his/her mother and new sibling during the postpartum hospitalization.

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) Select one or more: a. Fetal death b. Postterm pregnancy c. Rupture of membranes at or near term d. Maternal fatigue and frustration at 38 weeks gestation e. Convenience of the woman or her physician

a. Fetal death b. Postterm pregnancy c. Rupture of membranes at or near term

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? Select one: a. Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia. b. Leave the infant in the room with the mother. c. Immediately take the infant to the nursery. d. Perform a gestational age assessment to determine whether the infant is large for gestational age.

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

Which of the following antepartum tests is (are) used to evaluate a Maternal Serum Screening test that is negative for increased risk? Select one: a. Further followup test not necessary b. CVS c. Amniocentesis d. Biophysical profile

a. Further followup test not necessary

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? Select one: a. Grandparents b. Siblings c. Father d. Mother

a. Grandparents

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? Select one or more: a. Have you been using birth control? b. Are you excited that you might be pregnant? c. Does your mother know you are wanting a pregnancy test? d. Have you done a home pregnancy test? e. What is the first day of your last menstrual period?

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

A nurse is providing breast care education to a client after mammography. Which information regarding fibrocystic changes in the breast is important for the nurse to share? Select one: a. Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles. b. Fibrocystic breast disease is a disease of the milk ducts and glands in the breasts c. It is a premalignant disorder characterized by lumps found in the breast tissue. d. Lumpiness is accompanied by tenderness after menses.

a. Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles.

Which medications are used to manage PPH? (Select all that apply.) Select one or more: a. Hemabate b. Terbutaline c. Magnesium sulfate d. Oxytocin e. Methergine

a. Hemabate d. Oxytocin e. Methergine

Primary prevention of preterm labor and birth include which of the following? (Select all that apply). Select one or more: a. Identify risk factors of preterm birth for individual pregnant woman b. Induce pregnant woman at 37 weeks c. Treat pregnant woman with magnesium sulfate d. Manage risk factors for preterm birth in individual pregnant woman

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

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? Select one: a. Imbalanced nutrition: less than body requirements b. Deficient fluid volume c. Imbalanced nutrition: more than body requirements d. Disturbed sleep pattern

a. Imbalanced nutrition: less than body requirements

A woman gave birth to a 3200 g baby girl with an estimated gestational age of 40 weeks. The baby is 1 hour of age. In preparation for administration of Vitamin K to the infant, the nurse will explain to the parents that an injection of this medication: Select one: a. Influences the activation of coagulation factors to prevent delayed clotting and hemorrhagic disease b. Prevents high levels of unconjugated bilirubin in the newborn's blood c. Prevents the excessive loss of RBCs d. Aids the liver in regulation of blood glucose

a. Influences the activation of coagulation factors to prevent delayed clotting and hemorrhagic disease Vitamin K (phytonadione) influences the activation of coagulation factors II, VII, IX, and X. After birth, the neonate experiences a decrease in Vitamin K and is at risk for delayed clotting and for hemorrhage. An injection of Vitamin K is given as a prophylaxis to decreased the risk of bleeding.

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? Select one: a. Instruct the woman to bring her infant to the clinic. b. Instruct the woman to decrease the amount of feeding for 24 hours and to call if the stools continue to be loose. c. Explain that this is a normal stool pattern. d. Instruct the woman to eat a bland diet for the next 24 hours and call back if the stools continue to be loose and green.

a. Instruct the woman to bring her infant to the clinic. Instruct parents to notify the health care provider if stools are runny and green and/or if newborn/infant has less than 6 wet diapers per day. See page 430 of textbook. Watery green stools are a potential sign of illness and baby needs to be seen by healthcare provider. Transitional stool (starts day 3 and lasts for 3-4 days) can be greenish-black, greenish-brown to greenish-yellow (page 381 of textbook); but NOT watery green. A healthy 10 day old neonate should NOT have green stools.

Which important component of nutritional counseling should the nurse include in health teaching for a pregnant woman who is experiencing cholecystitis? Select one: a. Instruct the woman to eat a low-fat diet and to avoid fried foods. b. Instruct the woman to eat a low-cholesterol, low-salt diet. c. Assess the woman's dietary history for adequate calories and proteins. d. Teach the woman that the bulk of calories should come from proteins.

a. 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? (Select all that apply.) Select one or more: a. Instruct woman to increase her fluid intake b. Instruct woman to change her peri-pads after each voiding c. Instruct woman to ambulate in the halls four times a day d. Instruct woman to apply ice packs to the perineum

a. Instruct woman to increase her fluid intake b. Instruct woman to change her peri-pads after each voiding c. Instruct woman to ambulate in the halls four times a day Metritis is an infection of the endometrium, myometrium, and/or parametrial tissue. Risk factors include cesarean birth, prolonged rupture of membranes, prolonged labor, etc. Symptoms include elevated temp, lower abdominal pain, uterine tenderness, tachycardia, subinvolution. Metritis is generally treated with antibiotics based on culture results. Nursing actions include proper hand washing techniques, proper pericare/wipe front to back after urination, change peripad after each urination, early ambulation, rehydration, diet high in protein/vitamin C, and monitoring for symptoms.

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? Select one: a. Intrauterine contraceptive device (IUD) b. Contraceptive patch c. Bilateral tubal ligation d. Birth control pills with estrogen and progestin

a. Intrauterine contraceptive device (IUD) Intrauterine contraception device (IUD) is the recommended method for this patient. IUD has a low failure rate and provides long-term contraception for 3-10 years. Bilateral tubal ligation (BTL) is a surgical procedure which results in sterilization. Due to her history of smoking, neither birth control pills with estrogen nor contraceptive patch is recommended due to the increased risks for blood clots, heart disease, and strokes, also associated with smoking.

Augmentation of labor: Select one: a. Is part of the active management of labor instituted when the labor process is unsatisfactory and uterine contractions are ineffective b. Relies on more invasive methods when oxytocin and amniotomy have failed c. Is elective induction of labor d. Is an operative vaginal delivery that uses vacuum cups

a. Is part of the active management of labor instituted when the labor process is unsatisfactory and uterine contractions are ineffective Labor augmentation is the stimulation of ineffective UCs after the onset of spontaneous labor to manage labor dystocia. Lower doses of oxytocin are required but all of the principles pertaining to the use of oxytocin apply to augmentation.

The nurse has evaluated a client with preeclampsia by assessing DTRs. The result is a grade of 3+. Which DTR response most accurately describes this score? Select one: a. More brisk than expected, slightly hyperactive b. Sluggish or diminished c. Brisk, hyperactive, with intermittent or transient clonus d. Active or expected response

a. More brisk than expected, slightly hyperactive

For which of the following conditions is Daily Fetal Movement Count indicated? (Select all that apply). Select one or more: a. Mother with diabetes during pregnancy b. Mother who complains of headaches during pregnancy that are relieved with Tylenol c. Mother with low amniotic fluid volume or oligohydraminos d. Pregnant woman who is older than 35 years with no complications

a. Mother with diabetes during pregnancy c. Mother with low amniotic fluid volume or oligohydraminos

Cellulitis with or without abscess formation is a fairly common condition. The nurse is providing education for a client whose presentation to the emergency department includes an infection of the breast. Which information should the nurse share with this client? (Select all that apply.) Select one or more: a. Nipple piercing may be the cause of a recent infection b. Obesity, smoking, and diabetes are risk factors. c. Treatment for cellulitis or breast infection will include antibiotics. d. Breast is pale in color and cool to the touch. e. Methicillin- resistant Streptococcus aureus is the most common pathogen.

a. Nipple piercing may be the cause of a recent infection b. Obesity, smoking, and diabetes are risk factors. c. Treatment for cellulitis or breast infection will include antibiotics.

Pain should be regularly assessed in all newborns. If the infant is displaying physiologic or behavioral cues that indicate pain, then measures should be taken to manage the pain. Which interventions are examples of nonpharmacologic pain management techniques? (Select all that apply.) Select one or more: a. Nonnutritive sucking b. Skin-to-skin contact with the mother c. Swaddling d. Acetaminophen e. Sucrose

a. Nonnutritive sucking b. Skin-to-skin contact with the mother c. Swaddling e. Sucrose

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.) Select one or more: a. Obtain written consent from the parents b. Administer acetaminophen PO 1 hour before procedure per provider order. c. Feed the neonate glucose water 30 minutes before the procedure. d. Verify that the neonate has voided

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

A first-time dad is concerned that his 3-day-old daughterʼs skin looks "yellow." In the nurseʼs explanation of physiologic jaundice, what fact should be included? Select one: a. Physiologic jaundice becomes visible when serum bilirubin levels peak between the second and fourth days of life b. Physiologic jaundice is also known as breast milk jaundice. c. Physiologic jaundice is caused by blood incompatibilities between the mother and the infant blood types. d. Physiologic jaundice occurs during the first 24 hours of life.

a. 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: Select one: a. Place Tanya in a left lateral tilt b. Discontinue Tanya's intravenous administration. c. Have naloxone (Narcan) ready for administration. d. Have epinephrine ready for administration.

a. Place Tanya in a left lateral tilt Reposition the woman after epidural or spinal anesthesia in a supine position with a left lateral tilt to decrease the pressure from the uterus on the inferior vena cava and to maintain placental perfusion.

A neonate is born at 33 weeks' gestation. This neonate would be classified as: Select one: a. Premature b. Very premature c. Late premature d. Term

a. Premature Very premature infants are those born at less than 32 weeks' gestation; premature infants are born between 32 and 34 weeks' gestation; late premature are neonates born between 34 and 37 weeks' gestation; term infants are those born between 37-40 weeks' gestation.

Parents have been asked by the neonatologist to provide breast milk for their newborn son, who was born prematurely at 32 weeks of gestation. The nurse who instructs them regarding pumping, storing, and transporting the milk needs to assess their knowledge of lactation. Which statement is valid? Select one: a. Premature infants more easily digest breast milk than formula. b. A glass of wine just before pumping will help reduce stress and anxiety. c. The mother should pump every 2 to 3 hours, including during the night. d. The mother should only pump as much milk as the infant can drink.

a. Premature infants more easily digest breast milk than formula. The question asks- The nurse who instructs them regarding pumping, storing, and transporting the milk needs to assess their knowledge of lactation. Which statement is valid? This answer best reflects knowledge of lactation, as indicated in this statement.

Which of the following are indications for cesarean birth? (Select all that apply.) Select one or more: a. Previous cesarean birth b. Placental abnormalities c. Previous uterine surgery d. Failure to progress in labor

a. Previous cesarean birth b. Placental abnormalities c. Previous uterine surgery d. 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? Select one: a. Previous uterine surgery b. Flexed fetal attitude c. Previous low flap uterine incision d. Positive vaginal candidiasis

a. Previous uterine surgery Contraindications for trial of labor after cesarean (TOLAC) leading to VBAC include vertical uterine incision, previous uterine surgery, previous uterine rupture, pelvic abnormalities, complications preventing vaginal delivery, lack of personnel required for operative delivery.

The perinatal nurse notes a rapid decrease in the fetal heart rate that does not recover immediately following an amniotomy. The most likely cause of this obstetrical emergency is: Select one: a. Prolapsed umbilical cord b. Vasa previa c. Oligohydramnios d. Placental abruption

a. Prolapsed umbilical cord Amniotomy is the artificial rupture of membranes (AROM) to induce or augment labor. This is a common procedure seen in obstetrics. Risks associated with amniotomy include umbilical cord prolapse when the presenting part is not engaged. Vasa previa or rupture of fetal vessels unsupported by the placenta is a very rare situation and usually results in rapid fetal exsanguination in the presence of bloody fluid seen following AROM.

Which of the following nursing actions are directed at promoting bonding? (Select all that apply.) Select one or more: a. Providing opportunity for parents to hold their newborn as soon as possible following the birth. b. Providing opportunities for the couple to talk about their birth experience and about becoming parents. c. Promoting rest and comfort by keeping the newborn in the nursery at night. d. Providing positive comments to parents regarding their interactions with their newborn.

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

When caring for clients with neoplasms of the reproductive system, the nurse must begin by assessing the woman's knowledge of the disorder, its management, and prognosis. This assessment should be followed by a nursing diagnosis. Which diagnosis fails to address the psychologic effect of these disorders? Select one: a. Risk for injury, related to lack of skill for self-care b. Disturbed body image, as a result of changes in anatomy c. Anxiety, related to surgical procedures d. Interrupted family processes

a. Risk for injury, related to lack of skill for self-care

The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella non-immune (titer 1<8 or enzyme immunoassay [EIA] 0.8); hematocrit, 30%. How should the nurse best interpret these data? Select one: a. Rubella vaccine should be administered. b. Rh immune globulin is necessary within 72 hours of childbirth. c. Kleihauer-Betke test should be performed. d. Blood transfusion is necessary.

a. Rubella vaccine should be administered. ! Correct! She is non-immune to rubella.

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.) Select one or more: a. Sepsis b. Problems with thermoregulation c. Hyperbilirubinemia d. Cardiac distress e. Hyperglycemia

a. Sepsis b. Problems with thermoregulation c. Hyperbilirubinemia

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, which finding alerts the nurse to possible side effects? Select one: a. Serum magnesium level of 10 mg/dl b. DTRs 2+ and no clonus c. Respiratory rate (RR) of 16 breaths per minute d. Urine output of 160 ml in 4 hours

a. Serum magnesium level of 10 mg/dl

Which client(s) should the nurse report to the health care provider? (Select all that apply). Select one or more: a. Small dimple located in the upper outer quadrant of the right breast b. One 2-3mm sized mobile, nontender mass in lower outer quadrant of left breast c. Left breast slightly smaller than right breast d. Eversion (elevation) of both nipples

a. Small dimple located in the upper outer quadrant of the right breast b. One 2-3mm sized mobile, nontender mass in lower outer quadrant of left breast

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? Select one: a. Starting cardiopulmonary resuscitation (CPR) b. Obtaining IV access, and starting aggressive fluid resuscitation c. Transferring the woman to the surgical unit for an emergency cesarean delivery in case the fetus is still alive d. Quickly applying the fetal monitor to determine whether the fetus viability

a. Starting cardiopulmonary resuscitation (CPR)

Supportive care of the infant with neonatal abstinence syndrome (NAS) include both pharmacologic and nonpharmacologic therapy. Nonpharmacologic therapy would include which of the following (select all that apply): Select one or more: a. Swaddling, clustering care, use of pacifiers to promote "self-soothing" b. Clonidine for infants who do not respond to a single agent c. Use of oral morphine and methadone d. Quiet environment with low lighting and use of soft voices

a. Swaddling, clustering care, use of pacifiers to promote "self-soothing" d. Quiet environment with low lighting and use of soft voices Nonpharmacologic therapy includes quiet environment, low lighting, soft voices, clustering care, swaddling, pacifier use, frequent small feedings, and vertical rocking.

Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. What are possible causes of early miscarriage? (Select all that apply.) Select one or more: a. Systemic disorders b. Nausea and vomiting in early pregnancy c. Varicella d. Chromosomal abnormalities e. Endocrine imbalance

a. Systemic disorders c. Varicella d. Chromosomal abnormalities e. Endocrine imbalance

Painful nipples are a major reason why women stop breastfeeding. A primary intervention to decrease nipple irritation is: Select one: a. Teaching proper techniques for latching-on and releasing of suction b. Applying hot compresses to breast prior to feeding c. Instructing woman to express colostrum or milk at the end of the feeding session and rub it on her nipples d. Air drying nipples for 10 minutes at the end of the feeding session

a. Teaching proper techniques for latching-on and releasing of suction. While all these interventions are correct, the primary intervention is to ensure correct latching-on and suction release as problems with these lead to early cessation of breastfeeding.

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? Select one: a. Temperature 37.9° C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg b. Temperature 36.8° C, heart rate 60 bpm, respirations 18 breaths per minute, and blood pressure 140/90 mm Hg c. Temperature 38° C, heart rate 80 bpm, respirations 16 breaths per minute, and blood pressure 110/80 mm Hg d. Temperature 37.4° C, heart rate 88 bpm, respirations 36 breaths per minute, and blood pressure 126/68 mm Hg

a. Temperature 37.9° C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg All of these vital signs best demonstrate the body's attempt to compensate for significant blood loss

The laboratory reported that the L/S ratio (lecithin/sphingomyelin) results from an amniocentesis of a gravid client with preeclampsia are 2:1. The nurse interprets the result as which of the following? Select one: a. The baby's lung fields are mature. b. The mother is high risk for hemorrhage. c. The baby's kidneys are functioning poorly. d. The mother is high risk for eclampsia.

a. 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? Select one: a. The blood pressure (BP) cuff should not be applied to the affected arm. b. The affected arm should be used for intravenous (IV) therapy. c. The affected arm should be held down close to the woman's side. d. Venipuncture for blood work should be performed on the affected arm.

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

A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis? Select one: a. The couple has established a set schedule for their sexual encounters. b. The couple has been married for more than 8 years. c. The couple lives with one set of parents. d. The couple has close friends who gave birth within the last year.

a. The couple has established a set schedule for their sexual encounters. Pregnancy occurs with ovulation; sexual intercourse outside the time of ovulation will not result in conception.

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? Select one: a. The fetus is placed at risk for altered brain growth. b. She will be at risk for abusing other substances as well. c. Daily consumption of alcohol indicates a risk for alcoholism. d. The fetus is at risk for multiple organ anomalies.

a. The fetus is placed at risk for altered brain growth.

A couple is undergoing an infertility workup. The semen analysis indicates a decreased number of sperm and immature sperm. Which of the following factors can have a potential effect on sperm maturity? (Select all that apply.) Select one or more: a. The man rides a bike to and from work each day. b. The man takes a calcium channel blocker for the treatment of hypertension. c. The man drinks 6 cups of coffee a day. d. The man was treated for prostatitis 12 months ago and has been symptom free since treatment.

a. The man rides a bike to and from work each day. b. The man takes a calcium channel blocker for the treatment of hypertension. The daily riding of a bike can be the cause of prolonged heat exposure to the testicles. Prolonged heat exposure is a gonadotoxin. A number of medications, such as calcium channel blockers, can have an effect on sperm production. Coffee has not been associated with low sperm counts. Prostatitis or other infections within the last 3 months may have an effect on the sperm analysis. This man's episode of prostatitis was 12 months prior.

A couple who has sought infertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur? Select one: a. The testes are overheated. b. The vas deferens is ligated. c. The prostate gland is enlarged. d. alcohol use

a. The testes are overheated.

27 year old Amy G0 presents to the clinic for a preconceptual visit. Her BMI is 41. What would the nurse include in their education for Amy about pregnancy and a high BMI? (Select all that apply). Select one or more: a. There is increased risk for blood clot in her legs and lungs. b. There is decreased risk for cesarean section. c. There is decreased risk for miscarriage. d. There is increased risk for gestational diabetes. e. There is increased risk for preterm birth.

a. There is increased risk for blood clot in her legs and lungs. d. There is increased risk for gestational diabetes. e. There is increased risk for preterm birth.

Which statement regarding the laboratory test for glycosylated hemoglobin Alc is correct? Select one: a. This laboratory test measures the levels of hemoglobin Alc, which should remain at less than 7% b. This laboratory test is a snapshot of glucose control at the moment. c. The laboratory test for glycosylated hemoglobin Alc is performed for all pregnant women, not only those with or likely to have diabetes. d. This laboratory test is performed on the woman's urine, not her blood.

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

A new father wants to know what medication was put into his infant's eyes and why it is needed. How does the nurse explain the purpose of the erythromycin (Ilotycin) ophthalmic ointment? Select one: a. This ophthalmic ointment prevents gonorrheal infection of the infant's eyes, potentially acquired from the birth canal. b. This ointment prevents the infant's eyelids from sticking together and helps the infant see. c. Erythromycin (Ilotycin) prevents potentially harmful exudate from invading the tear ducts of the infant's eyes, leading to dry eyes. d. Erythromycin (Ilotycin) ophthalmic ointment destroys an infectious exudate caused by Staphylococcus that could make the infant blind.

a. This ophthalmic ointment prevents gonorrheal infection of the infant's eyes, potentially acquired from the birth canal.

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? Select one: a. To discontinue the magnesium sulfate infusion b. Call the physician c. To administer oxygen d. To call for an immediate magnesium sulfate level

a. To discontinue the magnesium sulfate infusion

Which client is at greatest risk for early PPH? Select one: a. Woman with severe preeclampsia on magnesium sulfate whose labor is being induced b. Primiparous woman (G 2, P 1-0-0-1) being prepared for an emergency cesarean birth for fetal distress c. Multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor d. Primigravida in spontaneous labor with preterm twins

a. Woman with severe preeclampsia on magnesium sulfate whose labor is being induced The effects of magnesium sulfate puts this patient at greater risk for PPH than the other scenarios.

Which of the following is true regarding infertility? (Select all that apply). Select one or more: a. anovulation can cause primary and/or secondary infertility b. infertility effects approx 5% of reproductive-age couples c. infertility is defined as the inability to achieve pregnancy after a year of unprotected intercourse d. approx 60% of infertility problems are related to the female factors

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

Which of the following are management options for couples faced with infertility challenges, depending of the cause? (Select all that apply). Select one or more: a. assisted reproductive technology procedures b. Medication c. remain child-free d. adoption

a. assisted reproductive technology procedures b. Medication c. remain child-free d. adoption

According to the CDC,which of the following are significant causes of maternal death in the United States? (Select all that apply). Select one or more: a. cardio-vascular disease b. hemorrhage c. ski accidents d. hypertensive disorders e. street drug use f. non-cardiovascular conditions

a. cardio-vascular disease b. hemorrhage d. hypertensive disorders f. non-cardiovascular conditions

A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates. A nonstress test (NST) in the obstetricianʼs 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). Select one or more: a. dry, cracked skin b. meconium aspiration c. excessive vernix caseosa covering the skin d. absence of scalp hair e. increased amount of subcutaneous fat f. hypoglycemia

a. dry, cracked skin b. meconium aspiration f. hypoglycemia

Ultrasound can be used in antepartum care for which of the following assessments? (Select all that apply). Select one or more: a. fetal growth b. placental position and function c. adjunct use in chorionic villi sampling (CVS) d. gestational age

a. fetal growth b. placental position and function c. adjunct use in chorionic villi sampling (CVS) d. gestational age

Ultrasound can be used in antepartum care for which of the following assessments? (Select all that apply). Select one or more: a. gestational age b. placental position and function c. fetal growth d. adjunct use in chorionic villi sampling (CVS)

a. gestational age b. placental position and function c. fetal growth d. adjunct use in chorionic villi sampling (CVS)

Pre-surgical nursing care for the woman who is going to have a hysterectomy for ovarian cancer includes which of the following? (Select all that apply). Select one or more: a. identification band is in place b. Sips of water for hydration c. ensure lab results are available to the surgeon prior to surgery d. teach post-op routine care such as need for early ambulation e. administer enema if ordered

a. identification band is in place c. ensure lab results are available to the surgeon prior to surgery d. teach post-op routine care such as need for early ambulation e. administer enema if ordered

The CHOICE Project removed 3 key barriers to contraception for many women. These included which of the following? Select one or more: a. knowledge deficit b. parental permission c. lack of access to preferred method d. cost e. state laws that restrict methods

a. knowledge deficit c. lack of access to preferred method d. cost

An infant at 26 weeks of gestation arrives intubated from the delivery room. The nurse weighs the infant, places him under the radiant warmer, and attaches him to the ventilator at the prescribed settings. A pulse oximeter and cardiorespiratory monitor are placed. The pulse oximeter is recording oxygen saturations of 80%. The prescribed saturations are 92%. What are the nurse's most appropriate actions at this time? Select one or more: a. notify physician b. increase oxygen c. ensure patency of the endotracheal tube d. notify parents that their infant is not doing well e. complete the admission process and thorough assessment f. listen to breath sounds g. continue to observe until saturations are 75%

a. notify physician b. increase oxygen c. ensure patency of the endotracheal tube f. listen to breath sounds

Combination oral contraceptives, the vaginal ring and the patch contain two hormones. Which of the following is the primary hormone that stops ovulation? Select one: a. progesterone b. estrogen c. testosterone d. hCG

a. progesterone

Depo provera, or The Shot, contains which of the following hormones? Select one: a. progesterone b. estrogen and progesterone c. neither estrogen or progesterone d. estrogen

a. progesterone

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth? Select one: a. "My first menstrual cycle will be heavier than normal and then will be light for several months after." b. "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." c. "My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter." d. "I will not have a menstrual cycle for 6 months after childbirth."

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

A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents? Select one: a. "The drug keeps your baby from requiring too much sedation." b. "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide." c. "Surfactant is used to reduce episodes of periodic apnea." d. "Your baby needs this medication to fight a possible respiratory tract infection."

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

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: Select one: a. "The test will help to determine the baby's position." b. "The test will help to determine how many weeks you are pregnant." c. "The test will help to determine if your baby is growing appropriately." d. "The test will help to determine if you have a boy or girl."

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

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: Select one: a. "The test will help to determine the baby's position." b. "The test will help to determine how many weeks you are pregnant." c. "The test will help to determine if your baby is growing appropriately." d. "The test will help to determine if you have a boy or girl."

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

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: Select one: a. "Your baby is in danger of dying and you will probably need to deliver ASAP. I will call your doctor." b. "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. " c. "Since you are more than 36 weeks, it is best to deliver your baby as she may have asphyxia. I will call your doctor." d. " Your baby may be having some problems and your doctor may want to check to see if it is safe to deliver her soon. I will call your doctor."

b. "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. "

A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this woman's fundus? Select one: a. Nonpalpable abdominally b. 1 centimeter above the umbilicus c. 2 centimeters below the umbilicus d. Midway between the umbilicus and the symphysis pubis

b. 1 centimeter above the umbilicus

What information is important for the nurse to include in planning for the care of a woman who has had a vaginal hysterectomy (no oopherectomy) for fibroids? Select one: a. Expect to be fully recovered in 4 to 6 weeks. b. Expect no changes in her hormone levels. c. Expect surgical menopause. d. Next pap smear is due in one year.

b. Expect no changes in her hormone levels.

A full-term neonate who is 30 hours old has a bilirubin level of 10 mg/dL. The neonate has a yellowish tint to the skin of the face. The mother is breastfeeding her newborn. The nurse caring for this neonate would anticipate which of the following interventions? Select one: a. Phototherapy b. Feeding neonate every 2 to 3 hours c. Switch from breastfeeding to bottle feeding d. Assess red blood cell count

b. Feeding neonate every 2 to 3 hours Treatment of jaundice is based on bilirubin levels and the age of the neonate in hours. At 30 hours of age and a bilirubin level of 10 mg/dL, the RN would ensure adequate hydration by feeding the neonate every 2-3 hours to promote excretion of bilirubin in the urine and stool. Phototherapy for this infant would be considered if bilirubin level was 12 mg/dL or higher with treatment most likely initiated at a level of 15 mg/dL or higher.

Which statement, related to the reconditioning of the urinary system after childbirth, should the nurse understand? Select one: a. Kidney function returns to normal a few days after birth. b. Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium. c. Diastasis recti abdominis is a common condition that alters the voiding reflex. d. With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth.

b. Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium.

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? Select one: a. Disseminated intravascular coagulation (DIC) syndrome b. Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome c. Idiopathic thrombocytopenia d. Eclampsia

b. 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? Select one: a. Congenital heart defect b. Hemolytic disorders c. Hepatic disease d. Postmaturity

b. Hemolytic disorders

he postpartum mother asks the nurse why is it so important to prevent cold stress in her baby- can't she shiver to stay warm? What should the nurse include in their response? (Select all that apply) Select one or more: a. Yes, your baby can shiver; but it important that we prevent her from needing to so. b. If your baby gets too cold and we don't help her, her body will use alot of oxygen to try and get warm, which can ultimately lead to decrease oxygen to her lungs and body causing respiratory problems. c. Your baby will eventually warm up on her own, but it is best if we keep the hat on her head. d. No, your baby cannot shiver; therefore, it is important to prevent her from losing body heat.

b. If your baby gets too cold and we don't help her, her body will use alot of oxygen to try and get warm, which can ultimately lead to decrease oxygen to her lungs and body causing respiratory problems. d. No, your baby cannot shiver; therefore, it is important to prevent her from losing body heat.

Which of the following are disadvantages of bottle feeding? (Select all that apply.) Select one or more: a. Increases the frequency of feedings as digestion of formula does not take as long as digestion of breastmilk b. Increases cost compared to breastfeeding c. Increases risk of infection due to lack of maternal antibodies d. Increases risk of childhood obesity

b. Increases cost compared to breastfeeding c. Increases risk of infection due to lack of maternal antibodies d. Increases risk of childhood obesity Disadvantages of formula feeding include need for increased time to prepare formula; increased cost compared to breastfeeding; increased risk of infection due to lack of antibodies that are naturally present in human milk; increased risk of childhood obesity and insulin-dependent diabetes. One of the advantages of formula feeding is the decrease in frequency of feedings because digestion of formula is slower than that of human milk.

What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant? Select one: a. Genetic changes and anomalies b. Intrauterine growth restriction c. Fetal addiction to the substance inhaled d. Extensive CNS damage

b. Intrauterine growth restriction

The nurse who is caring for a woman hospitalized for hyperemesis gravidarum would expect the initial treatment to involve what? Select one: a. Enteral nutrition to correct nutritional deficits b. Intravenous (IV) therapy to correct fluid and electrolyte imbalances c. Antiemetic medication, such as pyridoxine, to control nausea and vomiting d. Corticosteroids to reduce inflammation

b. Intravenous (IV) therapy to correct fluid and electrolyte imbalances

Which is true regarding breast cyst? Select one: a. It requires surgery for diagnosis b. It can be tender or not c. Removal is the best treatment d. It is usually fixed and hard

b. It can be tender or not

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.) Select one or more: a. Weight loss b. Lethargy c. Decrease in exercise capacity d. Cold intolerance e. Hot flashes

b. Lethargy c. Decrease in exercise capacity d. Cold intolerance

Karen, a G2 P2, experienced a precipitous birth 90 minutes ago. Her infant is 4200 grams and a repair of a second-degree laceration was needed following the birth. As part of the nursing assessment, the nurse discovers that Karen's uterus is boggy. Furthermore, it is noted that Karen's vaginal bleeding has increased. What is the nurse's most appropriate actions? Select one or more: a. Assess vital signs including blood pressure and pulse. b. Massage the uterine fundus with continual lower segment support. c. Measure and document each perineal pad changed in order to assess blood loss. d. Assess for bladder distention and encourage patient to void.

b. Massage the uterine fundus with continual lower segment support. d. Assess for bladder distention and encourage patient to void. Read pp 487-488 for details- most appropriate actions with boggy uterus and increased lochia are uterinemassage and assess bladder for distention. The other actions are implemented AFTER re-establishing uterine tone, which could include emptying the bladder (by voiding or straight catheterization)

Karen, a G2 P2, experienced a precipitous birth 90 minutes ago. Her infant is 4200 grams and a repair of a second-degree laceration was needed following the birth. As part of the nursing assessment, the nurse discovers that Karen's uterus is boggy. Furthermore, it is noted that Karen's vaginal bleeding has increased. What is the nurse's most appropriate actions? Select one or more: a. Assess vital signs including blood pressure and pulse. b. Massage the uterine fundus with continual lower segment support. c. Measure and document each perineal pad changed in order to assess blood loss. d. Assess for bladder distention and encourage patient to void.

b. Massage the uterine fundus with continual lower segment support. Read pp 487-488 for details- most appropriate actions with boggy uterus and increased lochia are uterine massage and assess bladder for distention. The other actions are implemented AFTER re-establishing uterine tone, which could include emptying the bladder (by voiding or straight catheterization)

For which of the following conditions is Daily Fetal Movement Count indicated? (Select all that apply). Select one or more: a. Mother who complains of headaches during pregnancy that are relieved with Tylenol b. Mother with low amniotic fluid volume or oligohydraminos c. Mother with diabetes during pregnancy d. Pregnant woman who is older than 35 years with no complications

b. Mother with low amniotic fluid volume or oligohydraminos c. Mother with diabetes during pregnancy

Which concerns regarding parenthood are often expressed by visually impaired mothers? (Select all that apply.) Select one or more: a. Ability to care for the infant b. Needing extra time for parenting activities to accommodate the visual limitations c. Infant safety d. Transportation

b. Needing extra time for parenting activities to accommodate the visual limitations c. Infant safety d. Transportation

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? Select one: a. Adequate nutrition and maintenance of fluid and electrolyte balance b. Neonatal abstinence syndrome (NAS) scoring c. Pharmacologic treatment d. Reduction of environmental stimuli

b. Neonatal abstinence syndrome (NAS) scoring

25 year old Susan (G0000) is thinking about getting pregnant this next year, but wants an effective method right now. She currently uses condoms. She denies medical problems. Which of the following birth control methods are most appropriate for the nurse to discuss with Susan? (Select all that apply). Select one or more: a. Copper IUD (Paragard) b. Oral contraceptive pills c. Condoms (continue) d. The birth control patch e. The implant

b. Oral contraceptive pills c. Condoms (continue) d. The birth control patch Long-acting contraception is not the best choice for a woman who desires pregnancy within one year. More appropriate methods include birth control pills and the patch, and the vaginal ring as they are not long acting and are reversible once the woman stops using them. Condoms are short acting with no hormones.

What marks on a babyʼs skin may indicate an underlying problem that requires notification of a physician? Select one: a. Telangiectatic nevi on the nose or nape of the neck b. Petechiae scattered over the infantʼs body c. Erythema toxicum neonatorum anywhere on the body d. Mongolian spots on the back

b. Petechiae scattered over the infantʼs body

Typical signs of abusive head trauma (AHT, also known as Shaken Baby Syndrome) include which of the following? (Select all that apply.) Select one or more: a. Broken clavicle b. Poor feeding c. Vomiting d. Breathing problems

b. Poor feeding c. Vomiting d. Breathing problems Symptoms of abusive head trauma are extreme irritability, poor feeding, breathing problems, convulsions, vomiting, and pale or bluish skin.

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? Select one: a. Low birth weight is a newborn who weighs below 3.7 pounds. b. Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation. c. Preterm birth rate in the United States continues to increase. d. Terms preterm birth and low birth weight can be used interchangeably.

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

Which preexisting factor is known to increase the risk of GDM? Select one: a. Maternal age younger than 25 years b. Previous birth of large infant c. Previous diagnosis of type 2 diabetes mellitus d. Underweight before pregnancy

b. Previous birth of large infant

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman? Select one: a. Human placental lactogen b. Prolactin c. Progesterone d. Estrogen

b. Prolactin

After giving birth to a healthy infant boy, a primiparous client, 16 years of age, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is "Deficient knowledge of infant care." What should the nurse be certain to include in the plan of care as he or she prepares the client for discharge? Select one: a. Teach the client how to feed and bathe her infant. b. Provide time for the client to bathe her infant after she views a demonstration of infant bathing. c. Advise the client that all mothers instinctively know how to care for their infants. d. Give the client written information on bathing her infant.

b. Provide time for the client to bathe her infant after she views a demonstration of infant bathing. Allows nurse to evaluate parental ease with care and adequacy of techniques and provide further instruction if necessary

A family is visiting two surviving triplets. The third triplet died 2 days ago. What action indicates that the family has begun to grieve for the dead infant? Select one: a. Brings in play clothes for all three infants b. Refers to the dead infant in the past tense c. Asks about the dead tripletʼs current status d. Refers to the two live infants as twins

b. Refers to the dead infant in the past tense

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? Select one: a. Perform Nitrazine analysis of the amniotic fluid. b. Report the lack of progress to the obstetrician. c. Place the woman on her left side. d. Ask the provider for an order for oxytocin.

b. Report the lack of progress to the obstetrician. Prepidil is indicated for cervical ripening, the process of physical softening and opening of the cervix. Cervical status is the most important predictor of successful induction of labor. Cervical status is assessed before induction of labor using the Bishop score. A score of 6 or more is considered favorable for successful induction of labor.

Despite warnings, prenatal exposure to alcohol continues to far exceed exposure to illicit drugs. Which condition is rarely associated with fetal alcohol syndrome (FAS)? Select one: a. Neural development disorder b. Respiratory conditions c. Intellectual impairment d. Alcohol-related birth defects (ARBDs)

b. Respiratory conditions

A primigravida at 40 weeks of gestation is having uterine contractions every 11⁄2 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 womanʼs labor? Select one: a. She is experiencing a normal latent stage. b. She is exhibiting hypertonic uterine dysfunction c. She is exhibiting hypotonic uterine dysfunction. d. She is experiencing precipitous labor.

b. She is exhibiting hypertonic uterine dysfunction

For an infant experiencing symptoms of drug withdrawal, which intervention should be included in the plan of care? Select one: a. Playing soft music during feeding b. Snugly swaddling the infant and tightly holding the baby c. Administering chloral hydrate for sedation d. Feeding every 4 to 6 hours to allow extra rest between feedings

b. Snugly swaddling the infant and tightly holding the baby

Which of the following lab tests are routinely performed on pregnant women? (Select all that apply). Select one or more: a. Genetic testing for cystic fibrosis b. Syphilis test c. 3 hr GTT d. Blood type e. Rubella titer

b. Syphilis test d. Blood type e. Rubella titer

Which statement regarding hemolytic diseases of the newborn is most accurate? Select one: a. Rh incompatibility matters only when an Rh-negative child is born to an Rh-positive mother. b. The indirect Coombs' test is performed on the mother before birth; the direct Coombs' test is performed on the cord blood after birth. c. Exchange transfusions are frequently required in the treatment of hemolytic disorders. d. ABO incompatibility is more likely than Rh incompatibility to precipitate significant anemia.

b. 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? Select one: a. The infant cries only when hungry or wet. b. The infant seeks attention from any adult in the room. c. The infant's activity is somewhat predictable. d. The infant clings to the parents.

b. 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? Select one: a. If this baby was born vaginally, then a pneumothorax could be indicated. b. The lungs of a baby delivered by cesarean section may sound moist during the first 24 hours after childbirth. c. The neonate must have aspirated surfactant. d. The nurse should immediately notify the pediatrician for this emergency situation.

b. The lungs of a baby delivered by cesarean section may sound moist during the first 24 hours after childbirth. Baby did not experience the chest pressure during a vaginal delivery, therefore, negative intrathoracic pressure did not help to draw air into the lungs and clear fluid. Read p524

A recently delivered mother and her baby are at the clinic for a 6-week postpartum checkup. Which response by the client alerts the nurse that psychosocial outcomes have not been met? Select one: a. The woman feels that her baby is more attractive and clever than any others. b. The woman has not given the baby a name. c. The woman excessively discusses her labor and birth experience. d. The woman has a partner or family members who react very positively about the baby.

b. The woman has not given the baby a name.

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? Select one: a. To suppress uterine contractions b. To stimulate fetal surfactant production c. To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy d. To reduce maternal and fetal tachycardia associated with ritodrine administration

b. To stimulate fetal surfactant production Correct! Important as baby may deliver preterm.

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? Select one: a. Contraction stress test (CST) b. Transvaginal ultrasound for placental location c. Amniocentesis for fetal lung maturity d. Internal fetal monitoring

b. Transvaginal ultrasound for placental location Correct! The symptoms, bright red and painless vaginal bleeding, indicate placental previa. An ultrasound can confirm this diagnosis.

The nurse is preparing to administer methotrexate to the client. This drug is most often used for which obstetric complication? Select one: a. Complete hydatidiform mole b. Unruptured ectopic pregnancy c. Abruptio placentae d. Missed abortion

b. Unruptured ectopic pregnancy

The nurse suspects that her postpartum client is experiencing hemorrhagic shock. Which observation indicates or would confirm this diagnosis? Select one: a. Absence of cyanosis in the buccal mucosa b. Urinary output of at least 30 ml/hr c. Calm mental status d. Cool, dry skin

b. Urinary output of at least 30 ml/hr Correct!- this answer should read urinary output of less than 30ml/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 nurseʼs highest priority? Select one: a. Monitoring the woman for a ruptured spleen b. Using continuous EFM for a minimum of 4 hours c. Monitoring her for 24 hours d. Obtaining a physicianʼs order to discharge her home

b. Using continuous EFM for a minimum of 4 hours Correct! Need to assess for fetal well-being and try to rule out placental abruption

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: Select one: a. Uterine edema b. Uterine inversion c. Incorrect measurement d. Intensifying the patient's level of pain

b. Uterine inversion Correct! During pregnancy there is stretching of the ligaments that hold the uterus in place. Fundal pressure could result in uterine inversion. Supporting the lower uterine segment may prevent uterine inversion during fundal assessment or massage.

The perinatal nurse understands that the purpose of the surgical "time-out" is to: Select one: a. Confirm that the surgeon is ready to begin b. Verify that it is the correct patient and planned procedure c. Verify that anesthesia is adequate d. Confirm that the neonatal team is in attendance

b. Verify that it is the correct patient and planned procedure Surgical "time-out" is performed by the entire surgical team and the patient prior to the administration of anesthesia. The purpose is to validate correct patient and planned procedure.

The perinatal nurse is teaching her new mother about breastfeeding and explains that the most appropriate time to breastfeed is: Select one or more: a. 3 to 4 hours after the last feeding b. When her infant is in a quiet alert state c. When her infant is in an active alert state d. When her infant exhibits hunger-related crying

b. When her infant is in a quiet alert state The optimal time to breastfeed is when the baby is in a quiet alert state. Crying is usually a late sign of hunger, and achieving satisfactory latch-on at this time is difficult. Latch-on is proper attachment of the infant to the breast for feeding. The neonate is most alert during the first 1 to 2 hours after an unmedicated birth, and this is the ideal time to put the infant to the breast. Read p 613

Women who are obese are at risk for several complications during pregnancy and birth. Which of these would the nurse anticipate with an obese client? (Select all that apply.) Select one or more: a. Breech presentation b. Wound infection c. Hypertension d. Cesarean birth e. Thromboembolism

b. Wound infection c. Hypertension d. Cesarean birth e. Thromboembolism

A woman has preinvasive cancer of the cervix. Which modality would the nurse discuss as an available option for a client with this condition? Select one: a. hysterectomy b. cryosurgery c. colposcopy d. internal radiation

b. cryosurgery

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). Select one or more: a. emergency contraception b. surgical abortion with aspiration c. medical abortion with mifepristone and misopristol d. it is too late for her to have an abortion

b. surgical abortion with aspiration c. medical abortion with mifepristone and misopristol

Which of the following is the most effective contraception? Select one: a. oral contraceptive pills b. the implant c. the vaginal ring d. natural family planning e. condoms

b. the implant

For which of the following conditions is colposcopy used to further evaluate need for intervention? (Select all that apply). Select one or more: a. uterine cancer b. vaginal cancer c. uterine fibroids d. bacterial vaginosis e. cervical cancer

b. vaginal cancer e. cervical cancer

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: Select one: a. "Newborns are more susceptible to infections due to an immature immune system. Would you like additional information on the newborn immune system?" b. "The infection was transmitted to your baby during the birthing process. Do you have a history of sexual transmitted infections?" c. "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 babyʼs health?" d. "I see that this is very upsetting for you. I will come back later and answer your questions."

c. "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 babyʼs health?"

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? Select one: a. "How long has this been going on?" b. "How big was your baby?" c. "Did you deliver your baby vaginally?" d. "Are you sure it is stool?"

c. "Did you deliver your baby vaginally?" Correct- this question starts the nurse's assessment for potential trauma during childbirth that increased Amy's risk for the fistula.

Pelvic floor exercises, also known as Kegel exercises, will help to strengthen the perineal muscles and encourage healing after childbirth. The nurse requests the client to repeat back instructions for this exercise. Which response by the client indicates successful learning? Select one: a. "I contract my thighs, buttocks, and abdomen." b. "I perform 10 of these exercises every day." c. "I pretend that I am trying to stop the flow of urine in midstream." d. "I stand while practicing this new exercise routine."

c. "I pretend that I am trying to stop the flow of urine in midstream."

Which of the following statements indicates that a new mother needs additional teaching? Select one: a. "I need to supervise my cat when she is in the same room as my baby." b. "I will place my baby on her back when she is sleeping." c. "I will not leave my baby on an elevated flat surface after she is able to turn over on her own." d. "I have asked my husband to install safety latches on the lower cabinets."

c. "I will not leave my baby on an elevated flat surface after she is able to turn over on her own." Infants should never be left unattended on an elevated flat surface

Which options for saying "good-bye" would the nurse want to discuss with a woman who is diagnosed with having a stillborn girl? Select one: a. "What funeral home do you want notified after the baby is born?" b. The nurse should not discuss any options at this time; plenty of time will be available after the baby is born. c. "When your baby is born, would you like to see and hold her?" d. "Would you like a picture taken of your baby after birth?"

c. "When your baby is born, would you like to see and hold her?"

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? Select one: a. "You may only hold your babyʼs hand during the feeding." b. "Parents are not allowed to hold their infants who are dependent on oxygen." c. "You may hold your baby during the feeding." d. "Feedings cause more physiologic stress; therefore, the baby must be closely monitored. I donʼt think you should hold the baby."

c. "You may hold your baby during the feeding."

A 35-year-old G1 P1 postpartum woman is Rh negative and has given birth to an Rh positive infant. Rh 0 (D) immune globulin is to be administered. The most appropriate dose that the perinatal nurse would expect to be ordered would be: Select one: a. 120 mcg b. 250 mcg c. 300 mcg d. 350 mcg

c. 300 mcg Nonsensitized women who are Rh negative and have given birth to an Rh positive infant should receive 300 mcg of Rh(D) immune globulin (RhoGAM) within 72 hours after giving birth. RhoGAM should be given whether or not the mother received RhoGAM during the antepartum period. In some situations, depending on the extent of hemorrhage and exchange of maternal-fetal blood, a larger dose of RhoGAM may be indicated.

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? Select one: a. 89 mmHg b. 67 mmHg c. 45 mmHg d. 73 mmHg

c. 45 mmHg

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? Select one: a. Respiratory rate b. Presence of a heart murmur c. Absent bowel sounds d. Weight

c. Absent bowel sounds Bowel sounds are present but may be hypoactive for the first few days.

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? Select one: a. Hirsutism b. Irregular menses c. Anorexia d. Infertility

c. Anorexia

A 3.8-kg infant was vaginally delivered at 39 weeks after a 30-minute second stage. A nuchal cord was found at delivery. After birth, the infant is noted to have petechiae over the face and upper back. Which information regarding petechiae is most accurate and should be provided to the parents? Select one: a. Result from increased blood volume b. Usually occur with a forceps-assisted delivery c. Are benign if they disappear within 48 hours of birth d. Should always be further investigated

c. Are benign if they disappear within 48 hours of birth

The symptoms of mild to moderate urinary incontinence can be successfully decreased by a number of strategies. Which of these should the nurse instruct the client to use first? Select one: a. Surgery b. Medications c. Bladder training and pelvic muscle exercises or Kegels d. Pelvic floor support devices

c. Bladder training and pelvic muscle exercises or Kegels

Which congenital anomalies can occur as a result of the use of antiepileptic drugs (AEDs) in pregnancy? (Select all that apply.) Select one or more: a. Gastroschisis b. Diaphragmatic hernia c. Cleft lip d. Neural tube defects e. Congenital heart disease

c. Cleft lip d. Neural tube defects e. Congenital heart disease

Which of the following tests should never be performed during the first trimester? Select one: a. Noninvasive Prenatal Screening test b. Maternal screening test for cystic fibrosis c. Contraction Stress test d. Ultrasound

c. Contraction Stress test

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 newbornʼs 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 nurseʼs most appropriate action? Select one: a. Wait quietly at the newbornʼs bedside until the parents come closer. b. Tell the parents only about the newbornʼs physical condition and caution them to avoid touching their baby. c. 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. d. Leave the parents at the bedside while they are visiting so that they have some privacy.

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

A diagnostic test commonly used to assess problems of the fallopian tubes is: Select one: a. Endometrial biopsy b. Ovarian reserve testing c. Hysterosalpingogram d. Screening for sexually transmitted infections

c. Hysterosalpingogram

The nurse is teaching new parents about metabolic screening for the newborn. Which statement is most helpful to these clients? Select one: a. Hearing screening is now mandated by federal law. b. Federal law prohibits newborn genetic testing without parental consent. c. If genetic screening is performed before the infant is 24 hours old, then it should be repeated at age 1 to 2 weeks. d. All states test for phenylketonuria (PKU), hypothyroidism, cystic fibrosis, and sickle cell diseases.

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

Mary G10000 is 12 weeks pregnant in October. She is not sure if she wants the flu shot. What is the best message the nurse should include in their education for Mary? Select one: a. If pregnant women get the flu, they usually don't get seriously ill. The flu shot is a good idea for women to get. b. If pregnant women get the flu, they get a little ill. It is OK if you choose not to get flu shot even if it is safe. c. If pregnant women get the flu, they can get seriously ill, require hospitalization and possibly die. We recommend you get the flu shot because it is a safe protective action to avoid these bad outcomes. d. If pregnant women get the flu, they can get sick, require hospitalization and possibly die. It is really up to you to get the flu shot.

c. If pregnant women get the flu, they can get seriously ill, require hospitalization and possibly die. We recommend you get the flu shot because it is a safe protective action to avoid these bad outcomes.

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.) Select one or more: a. Promoting bed rest b. Having her sit in a chair c. Immediately notifying the physician if a positive Homans sign occurs d. Having her flex, extend, and rotate her feet, ankles, and legs e. Putting her in antiembolic stockings (thromboembolic deterrent [TED] hose) and/or sequential compression device (SCD) boots

c. Immediately notifying the physician if a positive Homans sign occurs d. Having her flex, extend, and rotate her feet, ankles, and legs e. Putting her in antiembolic stockings (thromboembolic deterrent [TED] hose) and/or sequential compression device (SCD) boots

18 year old Ellen has a positive pregnancy test and cries when she sees the result. Per her LMP, the nurse determines she is approx 7 weeks pregnant. She asks the nurse what should she do. Which of the following is the nurse's best initial response? Select one: a. Here is a list of clinics that provide abortions. My sister liked this one best. b. You need to decide what obstetrician you want to see for prenatal care. c. Let's discuss your three options. d. I think adoption would be your best choice at this time.

c. Let's discuss your three options.

Which diagnostic test is used to confirm a suspected diagnosis of breast cancer? Select one: a. Magnetic resonance imaging (MRI) b. Mammogram c. Needle-localization biopsy d. Ultrasound

c. Needle-localization biopsy

What information regarding a fractured clavicle is most important for the nurse to take into consideration when planning the infantʼs care? Select one: a. Parents should be taught range-of-motion exercises. b. Prone positioning facilitates bone alignment. c. No special treatment is necessary. d. The shoulder should be immobilized with a splint.

c. No special treatment is necessary.

Which of these medications is commonly used to control postpartum bleeding related to uterine atony? Select one: a. Magnesium sulfate b. Phytonadione c. Oxytocin d. Warfarin

c. Oxytocin Oxytocin promotes contraction of the uterus by stimulating the smooth muscle of the uterus.

What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony? Select one: a. Establishing venous access b. Preparing the woman for surgical intervention c. Performing fundal massage d. Catheterizing the bladder

c. Performing fundal massage

During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, "I don't know what's wrong. I love my son, but I feel so let down. I seem to cry for no reason!" Which condition might this new mother be experiencing? Select one: a. Attachment difficulty b. Letting-go c. Postpartum blues d. Postpartum depression (PPD)

c. Postpartum blues

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: Select one: a. Hypertonic contractions b. Hypotonic contractions c. Precipitous labor d. Uterine hyperstimulation

c. Precipitous labor Precipitous labor that lasts fewer than 3 hours from onset to birth. Precipitous labor is more likely to be seen in woman who have previously given birth or have a previous history of rapid labors. As the fetal head descends, the woman may feel rectal pressure indicating delivery is imminent.

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? Select one: a. Recognize the woman's limited attention span by giving her written materials to read when she gets home rather than doing a teaching session while she is in the hospital. b. Foster an active role in the baby's care. c. Provide time for the mother to reflect on the events of her labor and delivery. d. Promote maternal independence by encouraging her to meet her own hygiene and comfort needs.

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

Which adverse prenatal outcomes are associated with the HELLP syndrome? (Select all that apply.) Select one or more: a. Placenta previa b. Cirrhosis c. Renal failure d. Placental abruption e. Maternal and fetal death

c. Renal failure d. Placental abruption e. Maternal and fetal death

The nurse should be cognizant of which postpartum physiologic alteration? Select one: a. Lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections. b. Hypercoagulable state protects the new mother from thromboembolism, especially after a cesarean birth. c. Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth d. Cardiac output, pulse rate, and stroke volume all return to prepregnancy normal values within a few hours of childbirth.

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

The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt? Select one: a. Limited protein and fat intake b. Large doses of vitamin C during pregnancy c. Strict aseptic technique, including hand washing, by all health care personnel d. Prophylactic antibiotics

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

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.) Select one or more: a. An electronic BP device should be used. b. The cuff should cover a minimum of 60% of the upper arm. c. The client's arm should be placed at the level of the heart. d. The same arm should be used for every reading e. The client should be seated

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

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? (Select all that apply.) Select one or more: a. The woman prefers cold water for drinking. b. The woman prefers not to shower. c. The woman prefers to have her female relatives care for her baby. d. The woman prefers a wide variety of foods to eat.

c. The woman prefers to have her female relatives care for her baby. In traditional Chinese beliefs and practices, the woman is to rest and female family members take care of the infant. During the first month, the woman is to avoid yin energy by eating specific foods and avoiding drinking or touching cold water.

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? Select one: a. Inevitable b. Septic c. Threatened d. Incomplete

c. Threatened

During the initial acute distress phase of grieving, parents still must make unexpected and unwanted decisions about funeral arrangements and even naming the baby. What is the nurse's role at this time? Select one: a. To encourage the grandparents to take over b. To take over as much as possible to relieve the pressure c. To ensure that the parents, themselves, approve the final decisions d. To leave them alone to work things out

c. To ensure that the parents, themselves, approve the final decisions

What is the primary purpose for magnesium sulfate administration for clients with preeclampsia and eclampsia? Select one: a. To prevent a boggy uterus and lessen lochial flow b. To improve patellar reflexes and increase respiratory efficiency c. To prevent convulsions d. To shorten the duration of labor

c. To prevent convulsions

In assisting the breastfeeding mother to position the baby, which information regarding positioning is important for the nurse to keep in mind? Select one: a. Women with perineal pain and swelling prefer the modified cradle position. b. The cradle position is usually preferred by mothers who had a cesarean birth. c. Whatever the position used, the infant is "belly to belly" with the mother. d. While supporting the head, the mother should push gently on the occiput.

c. Whatever the position used, the infant is "belly to belly" with the mother.

The nurse is about to elicit the Moro or Startle reflex. Which of the following responses should the nurse expect to see? Select one: a. When the cheek of the baby is touched, the newborn turns toward the side that is touched. b. When the lateral aspect of the sole of the baby's foot is stroked, the toes extend and fan outward. c. When the baby is suddenly lowered or startled, the neonate's arms straighten outward and the knees flex. d. When the newborn is supine and the head is turned to one side, the arm on that same side extends.

c. When the baby is suddenly lowered or startled, the neonate's arms straighten outward and the knees flex. The Moro or Startle Reflex is elicited when the neonate is suddenly lowered or exposed to a loud noise: symmetrical abduction and extension of the arms and legs with legs flexed up against the trunk. Choice 1 indicates the Rooting Reflex; Choice 2 indicates the Babinski Reflex; Choice 4 indicates the Tonic Neck Reflex

New screening mammogram recommendations by ACOG include which of the following? Select one: a. All women begin screening mammogram at 40 years old b. All women after 55 y/o should have annual screening mammograms c. Women should talk to their health care provider to decide the best age to begin screening mammograms d. Only women with increased risk for breast begin screening mammogram at age 40

c. Women should talk to their health care provider to decide the best age to begin screening mammograms

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? Select one: a. the implant b. intrauterine device c. essure d. oral contraceptive pills

c. essure Key word is NOT recommend- essure is permanent contraception, not reversible

After the Nurse Practitioner treats a 25 y/o's Bartholin cyst with incision and drainage procedure (I&D), the nurse is providing take-home instructions. The patient asks, "Will this happen again?" The nurse's best response is: Select one: a. "I cannot answer that question for you. Let me have the NP come and talk to you." b. "If you take your antibiotics and not get an infection, recurrence is rare. Let's talk about how to prevent infection." c. "No, since it is drained it won't come back." d. "Bartholin cysts can recur. There is another procedure that can be done to reduce risk for recurrence. Would you like to talk to the NP about it?"

d. "Bartholin cysts can recur. There is another procedure that can be done to reduce risk for recurrence. Would you like to talk to the NP about it?"

A woman with worsening preeclampsia is admitted to the hospital's labor and birth unit. The physician explains the plan of care for severe preeclampsia, including the induction of labor, to the woman and her husband. Which statement by the husband leads the nurse to believe that the couple needs further information? Select one: a. "I will stay with my wife during her labor, just as we planned." b. "I will give my wife ice chips to eat during labor." c. "I will help my wife use the breathing techniques that we learned in our childbirth classes." d. "Since we will be here for a while, I will call my mother so she can bring the two boys—2 years and 4 years of age—to visit their mother."

d. "Since we will be here for a while, I will call my mother so she can bring the two boys—2 years and 4 years of age—to visit their mother."

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: Select one: a. "This is normal. You only have to be concerned when your baby does not gain weight." b. "What types of foods are you eating? A lack of protein in the diet can cause watery looking breast milk." c. "How much fluid are you drinking while you are nursing your baby? Too much fluid during the feeding session can dilute the breast milk." d. "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."

d. "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." There are 3 stages of human milk production: Stage 1 is colostrum, a yellowish fluid present for 2-3 days after birth and rich is protein; Stage 2 is transitional milk and consists of colostrum and milk and is present from day 3-10; Stage 3 is mature milk and consists of foremilk which is produced and stored between feedings and is higher in water content and hind milk which is produced during the feeding session and is higher in fat content. The correct answer 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."

A healthy 60-year-old African-American woman regularly receives health care at her neighborhood clinic. She is due for a mammogram. At her first visit, her health care provider is concerned about the 3-week wait at the neighborhood clinic and made an appointment for her to have a mammogram at a teaching hospital across town. She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure. What is the most appropriate statement for the nurse to make to this client? Select one: a. "I'm concerned that you missed your appointment; let me make another one for you." b. "Do you have transportation to the teaching hospital so that you can get your mammogram?" c. "It's very dangerous to skip your mammograms; your breasts need to be checked." d. "Would you like me to make an appointment for you to have your mammogram here?"

d. "Would you like me to make an appointment for you to have your mammogram here?" The BEST answer to meet this pt's needs. It is evident the pt can make it to the neighborhood clinic, not the hospital across town.

Mary G10000 is 38 weeks pregnant and has been diagnosed with severe preeclampsia. The physician orders magnesium sulfate infusion for Mary, which includes a maintenance dose of 2 grams/hr. Her IV is a premixed magnesium sulfate solution of 40grams per 1000mL. What will the nurse program the infusion pump to deliver 2 grams/hr? Select one: a. 20mL/hr b. 40mL/hr c. 80mL/hr d. 50 mL/hr

d. 50 mL/hr 40 gm = 40,000mg 40,000mg:1000mL:: X: 1mL 1000X = 40000 X= 40mg 2 grams = 2000 mg 2000mg: X:: 40mg: 1 mL X=50mL/hr

A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. The client shows the nurse her readings for the past few days. Which reading signals the nurse that the client may require an adjustment of insulin or carbohydrates? Select one: a. 115 mg/dl 1 hour after lunch. This is a little high; maybe eat a little less next time. b. 115 mg/dl 2 hours after lunch. This is too high; it is time for insulin. c. 75 mg/dl before lunch. This is low; better eat now. d. 50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep.

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

A 25-year-old gravida 1 para 1 who had an emergency cesarean birth 3 days ago is scheduled for discharge. As the nurse prepares her for discharge, she begins to cry. The nurse's next action should be what? Select one: a. Point out how lucky she is to have a healthy baby. b. Explain that she is experiencing postpartum blues. c. Assess her for pain. d. Allow her time to express her feelings.

d. Allow her time to express her feelings. The nurse needs to hear from the patient why she is crying before offering a response.

Which nursing intervention is paramount when providing care to a client with preterm labor who has received terbutaline? Select one: a. Assess deep tendon reflexes (DTRs). b. Assess for hypoglycemia. c. Assess for bradycardia. d. Assess for dyspnea and crackles.

d. Assess for dyspnea and crackles.

According to the American Cancer Society, which of the following is true about screening mammogram? Select one: a. Average-risk women should begin screening mammogram at 40 y/o " b. Only high risk women should get screening mammograms. c. Screening mammograms every year for average-risk women after age 65y/o. d. Average-risk women should begin screening mammogram at 45 y/o

d. Average-risk women should begin screening mammogram at 45 y/o

Which statement best describes chronic hypertension? Select one: a. Chronic hypertension is considered severe when the systolic BP is higher than 140 mm Hg or the diastolic BP is higher than 90 mm Hg. b. Chronic hypertension is defined as hypertension that begins during pregnancy and lasts for the duration of the pregnancy. c. Chronic hypertension is general hypertension plus proteinuria. d. Chronic hypertension can occur independently of or simultaneously with preeclampsia.

d. Chronic hypertension can occur independently of or simultaneously with preeclampsia.

As a powerful central nervous system (CNS) stimulant, which of these substances can lead to miscarriage, preterm labor, placental separation (abruption), and stillbirth? Select one: a. Alcohol b. Heroin c. Phencyclidine (1-phenylcyclohexylpiperidine; PCP) d. Cocaine

d. Cocaine

A new mother asks whether she should feed her newborn colostrum, because it is not "real milk." What is the nurse's most appropriate answer? Select one: a. Colostrum is unnecessary for newborns. b. Colostrum is lower in calories than milk and should be supplemented by formula. c. Giving colostrum is important in helping the mother learn how to breastfeed before she goes home. d. Colostrum is high in antibodies, protein, vitamins, and minerals.

d. Colostrum is high in antibodies, protein, vitamins, and minerals.

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? Select one: a. HIV b. Gonorrhea c. Herpes simplex virus (HSV) infection d. Congenital syphilis

d. Congenital syphilis

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? Select one: a. Know that the greatest catch-up period is between 9 and 15 months postconceptual age. b. Tell the parents that their child will not catch up until approximately age 10 years (for girls) to age 12 years (for boys). c. Know that the length and breadth of the trunk is the first part of the infant to experience catch-up growth. d. Correct for milestones, such as motor competencies and vocalizations, until the child is approximately 2 years of age.

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

The perinatal nurse listens as Chantal describes her labor and emergency cesarean birth. Providing an opportunity to review this experience may assist Chantal in: Select one: a. Her role development in the "letting go" stage b. Decreasing her ambivalence about her labor and birth c. Understanding her guilt involved in her labor and birth d. Developing more positive feelings about her labor and birth

d. Developing more positive feelings about her labor and birth After a cesarean birth, especially when unplanned, nurses must be aware of the myriad of potential psychological issues that may arise. Research suggests that women may perceive cesarean birth to be a less positive experience than a vaginal birth. Unplanned or emergent cesarean deliveries and the experience of cesarean birth may be associated with more negative perceptions of the birthing experience. Allowing Chantal to talk about the experience can help her develop a more positive attitude about her own experience.

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? Select one: a. Hemorrhage b. Amniotic fluid embolism (AFE) c. HELLP syndrome d. Disseminated Intravascular Coagulation (DIC)

d. Disseminated Intravascular Coagulation (DIC)

When assisting the mother, father, and other family members to actualize the loss of an infant, which action is most helpful? Select one: a. Setting a firm time for ending the visit with the baby so that the parents know when to let go b. Making sure the family understands that naming the baby is important c. Using the words lost or gone rather than dead or died d. Ensuring the baby is clothed or wrapped if the parents choose to visit with the baby

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

A premature infant never seems to sleep longer than an hour at a time. Each time a light is turned on, an incubator closes, or people talk near her crib, she wakes up and inconsolably cries until held. What is the correct nursing diagnosis beginning with "ineffective coping, related to"? Select one: a. Severe immaturity b. Physiologic distress c. Behavioral responses d. Environmental stress

d. Environmental stress

What is the most important nursing action in preventing neonatal infection? Select one: a. Standard Precautions b. Isolation of infected infants c. Separate gown technique d. Good handwashing or hand hygiene

d. Good handwashing or hand hygiene

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? Select one: a. Neglecting her hygiene b. Displaying outbursts of anger c. Losing interest in her husband d. Harming her infant

d. Harming her infant

What is the most critical physiologic change required of the newborn after birth? Select one: a. Full function of the immune defense system b. Maintenance of a stable temperature c. Closure of fetal shunts in the circulatory system d. Initiation and maintenance of respirations

d. Initiation and maintenance of respirations

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? Select one: a. Lochia alba b. Lochia sangra c. Lochia rubra d. Lochia serosa

d. Lochia serosa

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? Select one: a. Congenital anomalies of the central nervous system b. Low birth weight c. Preterm birth d. Macrosomia

d. Macrosomia

According to the CDC, which of the following are true? Select one: a. Maternal mortality rate in the US has decreased from 1987-2013 b. Maternal mortality rate in the US has increased primarily due to anesthesia complications c. Maternal mortality rate in the US has increased but infection is no longer a significant cause. d. Maternal mortality rate in the US has increased from 1987-2013

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

A patient, G1 P0, is admitted to the labor and delivery unit for induction of labor. The following assessments were made on admission: Bishop score of 4, fetal heart rate 140s with moderate variability and no decelerations, TPR 98.6°F, 88, 20, BP 120/80, negative obstetrical history. A prostaglandin suppository was inserted at that time. Which of the following findings, 6 hours after insertion, would warrant the removal of the Cervidil (dinoprostone)? Select one: a. Bishop score of 5 b. Fetal heart of 152 bpm c. Respiratory rate of 24 rpm d. More than 5 contractions in 10 minutes

d. More than 5 contractions in 10 minutes

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? Select one: a. Increased physical activity b. Decreased respiratory rate c. Bradycardia, followed by an increased heart rate d. Mottled skin with acrocyanosis

d. Mottled skin with acrocyanosis

A nurse assesses that a 3-day-old neonate who was born at 34 weeks' gestation has abdominal distention and vomiting. These assessment findings are most likely related to: Select one: a. Respiratory Distress Syndrome (RDS) b. Bronchopulmonary Dysplasia (BPD) c. Periventricular Hemorrhage (PVH) d. Necrotizing Enterocolitis (NEC)

d. Necrotizing Enterocolitis (NEC) Necrotizing enterocolitis (NEC) findings include abdominal distention, bloody stools, abdominal tenderness, vomiting, increased gastric residuals, discoloration of abdomen, and visible bowel loops.

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? Select one: a. Hypoglycemia b. Hypercalcemia c. Cold stress d. Neonatal withdrawal

d. Neonatal withdrawal

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? Select one: a. Biophysical profile b. Leopolds Maneuvers c. Fetal fibronectin d. Non stress Test e. Maternal Serum Screening Test

d. Non stress Test

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: Select one: a. Methergine b. Epinephrine c. Carboprost (Hemabate) d. Oxytocin or pitocin

d. Oxytocin or pitocin If the cause of the hemorrhage is uterine atony, continual fundal massage with lower uterine segment support is mandatory. While one member of the team massages the fundus, another nurse establishes intravenous access with a large bore needle and administers oxytocic drugs in the following order: oxytocin (Pitocin), followed by methylergonovine (Methergine), and carboprost (Hemabate).

The nurse is completing the lab order for a pap smear performed on a 22 year old female. Which of the following options will the nurse select? Select one: a. Pap smear- cytology with high risk HPV test b. Pap smear - no cytology, high risk HPV testing only c. Pap smear- cytology with reflux to high risk HPV test for ASCUS result d. Pap smear - cytology only

d. Pap smear - cytology only

If the umbilical cord prolapses during labor, the nurse should immediately: Select one: a. Type and cross-match blood for an emergency transfusion. b. Await provider order for preparation for an emergency cesarean section. c. Attempt to reposition the cord above the presenting part. d. Perform vaginal exam and lifting the presenting part off of the cord to relieve pressure on the cord

d. Perform vaginal exam and lifting the presenting part off of the cord to relieve pressure on the cord. Prolapse of the umbilical cord is when the cord lies below the presenting part of the fetus. The cord becomes trapped against the presenting part and circulation is occluded; FHR will usually show bradycardia or prolonged decel. An emergency cesarean birth is typically performed. Occlusion of the cord may be partially relieved by lifting the presenting part off the cord with a vaginal exam. The examiner's hand remains in the vagina, lifting the presenting part off the cord until delivery by cesarean. There is no attempt to push the cord above the presenting part. Type and screen of blood is generally done on admission for all laboring women; type and cross-match can readily be accomplished using the blood sample already in the lab.

According to research, which risk factor for PPD is likely to have the greatest effect on the client postpartum? Select one: a. Low socioeconomic status b. Single-mother status c. Unplanned or unwanted pregnancy d. Prenatal depression

d. Prenatal depression

Because of the premature infant's decreased immune functioning, what nursing diagnosis should the nurse include in a plan of care for a premature infant? Select one: a. Delayed growth and development b. Ineffective infant feeding pattern c. Ineffective thermoregulation d. Risk for infection

d. Risk for infection

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 newbornʼs distress? Select one: a. Respiratory distress syndrome b. Hypoglycemia c. Phrenic nerve injury d. Sepsis

d. Sepsis

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? Select one: a. Breast cancer is the leading cause of cancer death in women. b. In the United States, 1 in 10 women will develop breast cancer in her lifetime. c. Genetic mutations account for 50% of women who will develop breast cancer. d. The exact cause of breast cancer remains unknown

d. The exact cause of breast cancer remains unknown

What is the primary purpose for the use of tocolytic therapy to suppress uterine activity? Select one: a. If the client develops pulmonary edema while receiving tocolytic therapy, then intravenous (IV) fluids should be given. b. Drugs can be efficaciously administered up to the designated beginning of term at 37 weeks gestation. c. Tocolytic therapy has no important maternal (as opposed to fetal) contraindications. d. The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids.

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

Which substance used during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications? Select one: a. Alcohol b. Chocolate c. Caffeine d. Tobacco

d. Tobacco

Nurses need to understand the basic definitions and incidence data regarding PPH. Which statement regarding this condition is most accurate? Select one: a. If anything, nurses and physicians tend to overestimate the amount of blood loss. b. PPH is easy to recognize early; after all, the woman is bleeding. c. Traditionally, it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH. d. Traditionally, PPH has been classified as early PPH or late PPH with respect to birth.

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

The nurse should be cognizant of which condition related to skeletal injuries sustained by a neonate during labor or childbirth? Select one: a. Other than the skull, the most common skeletal injuries are to leg bones. b. Newborn's skull is still forming and fractures fairly easily. c. Clavicle fractures often need to be set with an inserted pin for stability. d. Unless a blood vessel is involved, linear skull fractures heal without special treatment.

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

Which condition would require prophylaxis to prevent subacute bacterial endocarditis (SBE) both antepartum and intrapartum? Select one: a. Postmyocardial infarction b. Congestive heart disease c. Arrhythmias d. Valvular heart disease

d. Valvular heart disease

Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand? Select one: a. Women with class III cardiac disease should get 8 to 10 hours of sleep every day and limit housework, shopping, and exercise. b. Women with class I cardiac disease need bed rest through most of the pregnancy and face the possibility of hospitalization near term. c. Stress on the heart is greatest in the first trimester and the last 2 weeks before labor. d. Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms

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

While taking a family history, 37 y/o Bernice tells the nurse her paternal grandmother had breast and colon cancer in her 60's, two paternal aunts had breast cancer in their 40's, one of those aunts also had ovarian cancer in her 40's, one paternal uncle had colon cancer in his 40's, her paternal cousin has breast cancer in her 40's, and her father had colon cancer in his 40's. She denies cancer on her mother's side of the family. Bernice states she has 2 younger sisters. Which of the following responses would be best for the nurse to say to Bernice about her reported family history? Select one: a. "Have you had a screening mammogram?" b. "Since all of these cancers are on your father's side of the family, you have no increased risk for cancer." c. "Do you have cancer on your mother's side of the family?" d. "Have you had your pap smear recently?" e. "The types of cancers reported on your father's side of the family may be due to a gene mutation that can be passed onto to each generation. Have any of your relatives or you considered genetic testing?"

e. "The types of cancers reported on your father's side of the family may be due to a gene mutation that can be passed onto to each generation. Have any of your relatives or you considered genetic testing?"