Final Exam- Maternal Newborn

On a routine home visit, the nurse is asking the new mother about her breastfeeding and personal eating habits. How many additional calories should the nurse encourage the new mother to eat daily? a. 500 additional calories per day b. 1,000 additional calories per day c. 250 additional calories per day d. 750 additional calories per day

A. 500 additional calories

A postpartum client saturates a peripad in 30 minutes. What is the nurse's first action in this situation? a. Massage the fundus b. Take a blood pressure c. Call the provider d. Encourage the client to void

A. Massage the fundus

The nurse is conducting a postparum examination on a client who reports pain and is unable to sit comfortably. The perineal exam reveals an episiotomy appropriately approximated without signs of a hematoma. Which action should the nurse prioritize? a. Notify a primary care provider. b. Apply a warm washcloth. c. Place an ice pack. d. Put on a witch hazel pad.

C. Place an ice pack

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

C. Temperature of 101 F

A postpartum woman is experiencing subinvolution. When reviewing the client's history for factors that might contribute to this condition, which factors would the nurse identify? Select all that apply. a. uterine infection b. prolonged labor c. hydramnios d. breastfeeding e. early ambulation f. empty bladder

a. uterine infection b. prolonged labor c. hydramnios

Which action would be priority for the nurse to complete immediately after the delivery of a 40-week gestation newborn? a. Swaddle the infant and place in the bassinet. b. Complete a full head-to-toe assessment. c. Assess the newborn's glucose level. d. Dry the newborn and place it skin-to-skin on mother.

d. Dry the newborn and place it skin-to-skin on mother.

A multigravid client has been in labor for several hours and is becoming anxious and distressed with the intensity of her frequent contractions. The nurse observes moderate bloody show and performs a vaginal examination to assess the progress of labor. The cervix is 9 cm dilated. The nurse knows that the client is in which phase of labor? a. Latent phase b. Transition phase c. Active phase d. Early phase

B. Transition phase

Which statement best expresses the role of the corpus luteum? a. The corpus luteum promotes the increased production of estrogen before ovulation b. During the luteal phase, the corpus luteum secretes glycogen c. The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation d. Increasing amounts of cervical mucus are produced as a result of the luteinizing hormone produced by the corpus luteum

C. The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation

A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation and enlargement of the birth canal. What is this hormone? a. Estrogen b. Human placental lactogen c. Progesterone d. Relaxin

D. Relaxin

The nurse is teaching a client with gestational diabetes about complications that can occur either following birth or at delivery for her baby. Which statement by the mother indicates that further teaching is needed by the nurse? a. "My baby may be very large and I may need a cesarean section to have him." b. "If my blood sugars are elevated, my baby's lungs will mature faster, which is good." c. "Beginning at 28 weeks' gestation, I will start counting with my baby's movements every day." d. "I may need an amniocentesis during the third trimester to see if my baby's lungs are ready to be born."

b. "If my blood sugars are elevated, my baby's lungs will mature faster, which is good."

During which time is the nurse correct to document the end of the third stage of labor? a. Following fetal birth b. At the time of placental delivery c. When pushing begins d. When the mother is moved to the postpartum unit

b. At the time of placental delivery

A primipara client who is bottle feeding her baby begins to experience breast engorgement on her third postpartum day. Which instruction by the nurse would be most appropriate to aid in relieving her discomfort? a. "Express some milk from your breasts every so often to relieve the distention." b. "Remove your bra to relieve the pressure on your sensitive nipples and breasts." c. "Apply ice packs to your breasts to reduce the amount of milk being produced." d. "Take several warm showers daily to stimulate the milk let-down reflex."

c. "Apply ice packs to your breasts to reduce the amount of milk being produced."

The nurse is preparing to assess a client who is 1 day postpartum. The nurse predicts the client's fundus will be at which location on assessment? a. At level of umbilicus b. 1 cm above the umbilicus c. 1 cm below the umbilicus d. At the symphysis pubis

c. 1 cm below umbilicus

The nurse administers Rho(D) immune globulin to an Rh-negative client after birth of an Rh-positive newborn based on the understanding that this drug will prevent her from: a. becoming Rh positive. b. developing Rh sensitivity. c. developing AB antigens in her blood. d. becoming pregnant with an Rh-positive fetus.

B. Developing Rh sensitivity

When assessing the uterus of a 2-day postpartum client, which finding would the nurse evaluate as normal? a. a scant amount of lochia alba b. a moderate amount of lochia alba c. a moderate amount of lochia rubra d. a scant amount of lochia serosa

C. A moderate amount of lochia rubra

The nurse is performing an assessment on a 2-day postpartum client and discovers a boggy fundus at the umbilicus and slightly to the right. The nurse determines that this is most likely related to which situation? a. Uteruine atony b. Full bowel c. Bladder distention d. Poor bladder tone

C. Bladder distension

A pregnant client in her second trimester is diagnosed with hyperemesis gravidarum. The nurse would monitor the client closely for which of the following? a. Heartburn b. Diarrhea c. Dehydration d. Constipation

C. Dehydration

A nurse is conducting an in-service education program about the female reproductive cycle for a group of nurses working at a women's health clinic. When describing the phases of the endometrial cycle, the nurse would explain that the proliferative phase of the endometrial cycle corresponds to which phase in the ovarian cycle? a. Secretory b. Ischemic c. Menstrual d. Follicular

D. Follicular

A nurse is classifying the pregnancy history of a woman who has had five pregnancies: three full-term, one preterm, and one abortion. How would the nurse document this information on the patient chart? a. G4 P3115 b. G5 P3115 c. G5 P1135 d. G5 P3114

D. G5 P3114

The nurse is assessing the read-out of the external fetal monitor and notes late decelerations. Which action should the nurse prioritize at this time? a. Notify the health care provider b. Palpate for bladder fullness c. Do nothing, this is benign d. Reposition the client on either side

D. Reposition the client to the other side

The nursing instructor is teaching students about normal changes of pregnancy. The instructor talks about diastasis recti. What is the instructor presenting? a. Raising of the uterus into the abdomen b. Relaxation of the kidneys c. Movement of the bladder to the rear of the pelvis behind the uterus d. Separation of the muscles of the abdominal wall

D. Separation of the muscles of the abdominal wall

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client? a. If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall b. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins c. An ovum matures and is released d. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth

D. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth

A postpartum client comes to the clinic for her 6-week postpartum check up. When assessing the client's cervix, the nurse would expect the external cervical os to appear: a. shapeless. b. circular. c. triangular. d. slit-like.

D. slit-like

A nurse is auscultating the fetal heart rate of a woman in labor. To ensure that the nurse is assessing the FHR and not the mother's heart rate, which action would be most appropriate for the nurse to do? a. Palpate the mother's radial pulse at the same time b. Ask the woman to hold her breath while assessing the FHR c. Have the woman lie completely flat on her back while auscultating d. Instruct the woman to bend her knees and flex her hips

a. Palpate the mother's radial pulse at the same time

The five "Ps" of labor are: a. Passageway, passenger, position, powers, psych b. Passenger, posture, position, presentation, psych c. Passenger, position, presentation, pushing, psych d. Passenger, position, powers, presentation, psych

a. Passageway, passenger, position, powers, psych

A nurse is assessing a female client. When obtaining the client's history, the client tells the nurse that her menstrual cycle is usually 30 days and that she expects her next menstruation on March 20. Based on the client's information and the nurse's understanding of the female reproductive cycle, the nurse would identify ovulation as most likely occurring at which time? a. March 1 b. March 6 c. March 13 d. March 27

b. March 6

On an Apgar evaluation, how is reflex irritability tested? a. raising the infant's head and letting it fall back b. flicking the soles of the feet and observing the response c. dorsiflexing a foot against pressure resistance d. tightly flexing the infant's trunk and then releasing it

b. flicking the soles of the feet and observing the response

The nurse is assessing the stools of a 36-hour-old neonate who is being breastfed. The nurse determines that the stools are within normal parameters based on which finding? a. greenish black with a tarry consistency b. yellowy mustard color with seedy appearance c. tan in color with a firm consistency d. brownish black with a mucus-like appearance

b. yellowy mustard color with seedy appearance

The student nurse is learning about normal labor. The teacher reviews the cardinal movements of labor and determines the instruction has been effective when the student correctly states the order of the cardinal movements as follows: a. Internal rotation, flexion, descent, extension, external rotation, expulsion b. Internal rotation, extension, descent, flexion, external rotation, expulsion c. Descent, flexion, internal rotation, extension, external rotation, expulsion d. Descent, flexion, external rotation, extension, internal rotation, expulsion

c. Descent, flexion, internal rotation, extension, external rotation, expulsion

Parents tell the nurse that they have been told to keep their newborn away from windows and be sure to cover the baby with a light blanket. They do not understand why this is necessary. What rationale would the nurse provide for this care? a. Newborns weighing below 8 pounds lack enough brown fat to produce heat. b. Windows can be drafty and placing the newborn by one can result in evaporative heat loss. c. Since newborns cannot shiver to produce heat, parents need to be sure to keep them covered up and away from sources of heat loss like a window. d. Newborns have very thin skin, which allows radiant heat loss.

c. Since newborns cannot shiver to produce heat, parents need to be sure to keep them covered up and away from sources of heat loss like a window.

The AGPAR score is based on which 5 parameters? a. heart rate, muscle tone, reflex irritability, respiratory effort, and color b. heart rate, breaths per minute, irritability, reflexes, and color c. heart rate, respiratory effort, temperature, tone, and color d. heart rate, breaths per minute, irritability, tone, and color

a. heart rate, muscle tone, reflex irritability, respiratory effort, and color

After teaching a class on the stages of fetal development, the nurse determines that the teaching was successful when the group identifies which stages? Select all that apply a. Pre-embryonic b. Embryonic c. Placental d. Umbilical e. Fetal

A. Pre-embryonic B. Embryonic E. Fetal

A nurse is coaching a woman during the second stage of labor. Which action should the nurse encourage the client to do at this time? a. Push with contractions and rest between them b. Hold the breath while pushing during contractions c. Begin pushing as soon as the cervix has dilated to 8 cm d. Pant while pushing

A. Push with contractions and rest between them

The nursing instructor is teaching a group of nursing students about the menstrual cycle. The instructor determines the session is successful when the students correctly choose which action as responsible for the increased thickness of the endometrium? a. The increasing level of estrogen b. The level of the FSH c. The decreasing level of the progesterone d. The dropping level of LH

A. The increasing level of estrogen

The nurse who is working with parents and their newborn encourages which action to assist the bonding and attachment between them? a. touching b. talking c. looking d. feeding

A. touching

The nurse assesses a 20-week gestational client at a routine prenatal visit. What will the nurse predict the fundal height to be on this client experiencing an uneventful pregnancy? a. 12 cm b. 16 cm c. 20 cm d. 24 cm

C. 20 weeks

A nurse is teaching a postpartum client how to do muscle-clenching exercises for the perineum. The client asks the nurse, "Why do I need to do these exercises?" Which reason would the nurse most likely incorporate into the response? a. reduces lochia b. promotes uterine involution c. improves pelvic floor tone d. alleviates perineal pain

C. Improves pelvic floor tone

A client presents to the birthing center in labor. The client's membranes have just ruptured. Which assessment is the nurse's priority? a. signs of infection b. fetal position c. FHR d. maternal comfort level

C> FHR

All the options are signs of respiratory distress in the newborn except: a. grunting. b. nasal flaring. c. chest retractions. d. central cyanosis. e. respiratory rate >50 breaths/minute. f. coughing.

E. Respiratory rate > 50 breaths/minute

While performing a physical assessment of a newborn boy, the nurse notes diffuse edema of the soft tissues of his scalp that crosses suture lines. The nurse documents this finding as: a. molding. b. microcephaly. c. caput succedaneum. d. cephalhematoma.

c. caput succedaneum.

Rubin identified a series of changes that a new mother makes during the postpartum period. The correct sequence of these changes is: a. taking, holding-on, letting-go. b. taking-in, holding-on, letting-go. c. taking-in, taking-hold, letting-go. d. taking-in, taking-on, letting-go.

c. taking-in, taking-hold, letting-go.

The nurse is analyzing the readout on the EFM and determines the FHR pattern is reassuring based on which recording? a. Increase in variability by 27 bpm b. Deceleration followed by acceleration of 15 bpm c. Decrease in variability for 15 seconds d. Acceleration of at least 15 bpm for 15 seconds

d. Acceleration of at least 15 bpm for 15 seconds

A client asks the nurse about cervical mucus changes that occur during the menstrual cycle. Which statement should the nurse expect to include in the client's teaching plan? a. As ovulation approaches, cervical mucus is abundant and stretchable b. Cervical mucus disappears immediately after ovulation, resuming with menses c. About midway through the menstrual cycle, cervical mucus is clear and sticky d. During ovulation, the cervix remains dry with scant mucus secretion

A. As ovulation approaches, cervical mucus is abundant and stretchable

A nurse is assessing a client with postpartal hemorrhage; the client is presently on IV oxytocin. Which interventions should the nurse perform to evaluate the efficacy of the drug treatment? Select all that apply. a. Assess the client's uterine tone. b. Monitor the client's vital signs. c. Assess the client's skin turgor. d. Get a pad count. e. Assess deep tendon reflexes.

A. Assess the client's uterine tone B. Monitor the client's vital signs D. Get pad count

The nurse is weighing an infant and is ensuring that the scale is warmed and the procedure is performed as quickly as possible. Doing so allows the nurse to minimize the effects of heat loss by what method? a. Conduction b. Radiation c. Convection d. Evaporation

A. Conduction

A nurse working in the newborn nursery hears an innocent murmur on auscultation of a 24-hour-old infant's chest. The nurse recognizes this as most likely the result of which condition? a. delayed fetal shunt closure b. dysfunctional foramen ovale c. congenital defect d. attached umbilical cord stump

A. Delayed fetal shunt closure

A nurse is working with a pregnant woman to schedule follow-up visits for her pregnancy. Which statement by the woman indicates that she understands the scheduling? a. "From now until I'm 28 weeks, I'll be coming once a month." b. "I need to make visits every 2 months until I'm 36 weeks pregnant." c. "Once I get to 28 weeks, I have to come twice a month." d. "I'll make sure to get a day off every 2 weeks to make my visits."

A. From now until I'm 28 weeks, I'll be coming once a month

The nurse midwife is performing a pelvic examination on a client who came to her following a positive home pregnancy test. The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell's sign. Which description illustrates this alteration? a. The cervix looks blue or purple when examined b. The cervix softens c. The lower uterine segment softens d. The fundus enlarges

B The cervix softens

A woman reports that her last menstrual period (LMP) occurred February 1, 2017. Using the Naegele rule, what would be her estimated date of delivery (EDD)? a. October 1, 2018 b. November 8, 2018 c. October 1, 2017 d. November 8, 2017

D. November 8, 2017