Final Study set

1. a woman has been diagnosed with pelvic inflammatory disease. Which of the following organisms are (select all that apply)

-Chlamydia trachomatis -Neisseria gonorrhea

61.(Cara 12) while interviewing a 48 year old client during her annual physical exam, the nurse learns that has never had a mammogram....

-Fear of x-ray exposure -Expense of the procedure -Reluctance of hear bad news -Having hear that the test is painful

34. Which of the following assessments on a preterm infant indicates a need for gavage feedings? A. bowel sounds in four quadrants B. caloric need of 20 Cal/ounce C. respiratory rate of 80 D. heart rate of 160

C. Respiratory rate of 80

1. The nurse is doing an initial exam on a 9-pound, 8- ounce girl born vaginally. The nurse should assess for (select all that apply)

Facial nerve damage Fracture Cephalhematoma

1. A postpartum client would be at increased risk for postpartum hemorrhage if she delivered a:

6.5 pound infant after a 2 hour labor

1. Which pregnant adolescent is most at risk for a nutritional deficit during pregnancy?

A 17 year old who has pica

13. An infant at 30 weeks gestation is admitted following a precipitous vaginal delivery. Which of the following assessment data indicates a complication? A. Bulging anterior fontanel B. Poor flexion of extremities C. no voids in the first 18 hours D. positive Babinski sign

A. Bulging anterior fontanel

Which statement by a woman diagnosed with premenstrual syndrome indicates that further health teaching is needed? A. "Salty foods will not affect this condition" B. "I need to limit intake of caffeine" C. "I might try taking some vitamin E" D. "I may have to try some antidepressants"

A. "Salty foods will not affect this condition" Rationale. Eating salty foods contributes to edema and fluid retention and should be avoided as much as possible

29. If the nurse suspects an abruptio placentae with concealed hemorrhage, she should assess for: A. A high uterine tone B. Increase in multiple variables C. decrease in fundal height D. decrease in the contraction frequency

A. A high uterine tone

38. In counseling a patient who has decided to relinquish her baby for adoption, the nurse should do which of the following? A. Affirm her decision while acknowledging her maturity in making it. B. Question her about her feelings regarding adoption C. Tell her she can always change her mind about adoption D. Ask her if anyone coercing her into the decision to relinquish her baby

A. Affirm her decision while acknowledging her maturity in making it Rationale: A supportive, affirming approach by the nurse will strengthen the patient's resolve and help her to appreciate the significance of the event. The teen needs help in coping with her feelings about this decision. It is important for the nurse to support and affirm the decision the patient has made. This will strengthen the patient's resolve to follow through. Later the patient should be given an opportunity to express her feelings. Telling her she can always change her mind should not be an option after the baby is born and placed with the adoptive parents. It is important that the teenager is treated as an adult, with the assumption that she is capable of making an important decision on her own.

53. The labor nurse is a admitting a patient in active labor with a history of genital herps. On assessment, the patient reports a recent outbreak, and the nurse verifies lesions on the perineum. What is the nurse's next action? A. Ask the patient when she last had anything to eat or drink B. Take a culture of lesions to verify the involved organisms C. Ask the patient if she has had unprotected sex since her outbreak D. Use electronic fetal surveillance to determine a baseline fetal heart rate.

A. Ask the patient when she last had anything to eat or drink

11. Fran delivered a 9-lb, 10-ounce baby 1 hour ago. When you arrive to perform her 15-minute assessment, she tells you that she "feels all wet underneath." You discover that both pads are completely saturated and that she is lying in a 6-inch-diameter puddle of blood. What is your first action? A. Assess the fundus for firmness. B. Check the perineum for lacerations C. Call for help D. Take her blood pressure

A. Assess the fundus for firmness.

50. The infant who becomes cold is more likely to develop respiratory distress because A. attempts to raise body temperature increase oxygen demands. B. shivering interferes with the action of respiratory muscles. C. lung secretions increase and pool during cold stress D. increased blood glucose reduces respiratory efforts

A. Attempts to raise body temperature increase oxygen demands

18. Which routine nursing assessment is contraindicated for a client admitted with suspected placenta previa? A. Determining cervical dilation and effacement B. Monitoring FHR and maternal vital signs C. Observing vaginal bleeding or leakage of amniotic fluid D. Determining frequency, duration, and intensity of contractions

A. Determine cervical dilation and effacement Rational: Vaginal examination of the cervix may result in perforation of the placenta and subsequent hemorrhage and is therefore contraindicated. Monitoring FHR and maternal vital signs is a necessary part of the assessment for this woman. Monitoring for bleeding and rupture of membranes is not contraindicated in this woman. Monitoring contractions is not contraindicated in this woman.

41. The exact cause of breast cancer remains undetermined. Researchers have found that there are a number of common risk factors that increase a woman's chance of developing a 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) A. Family history B. Late menarche C. Race D. Nulliparity or first pregnancy after age 30 E. Early menopause

A. Family history C. Race D. Nulliparity or first pregnancy after age 30 Rational: Family history, race, and nulliparity or first pregnancy after age 30 are all risk factors for breast cancer. Early menarche (not late) and late (not early) menopause are also risks factors.

52. Which information should the nurse recognize as contributing to mastitis in the breastfeeding mother? (Select all that apply) A. Insufficient emptying B. Feeding every 2 hours C. Supplementing feedings D. Blisters on both nipples E. Alternating breastfeeding positions

A. Insufficient Emptying C. Supplementing feedings D. Blisters on both nipples Rational: Mastitis may develop because of stasis of milk, inadequate emptying of the breast, skipped feedings, and introduction of bacteria through injured areas of the nipple. Feeding every 2 hours and alternating breastfeeding positions are both interventions that promote emptying of the breasts and support successful breastfeeding.

55. For a shoulder dystocia during delivery, the nurse would use which priority intervention? A. McRoberts maneuver B. knee chest position C. Woods Corkscrew maneuver D. Fundal pressure

A. McRoberts maneuver

30. Approximately 82% of teen pregnancies are unintended. Seventy percent of teens have had sex by their 19th birthday. Factors that contribute to an increased risk for teen pregnancy include which of the following? (Select all that apply). A. Peer pressure B. Lack of role models C. Limited access to contraception D. Planning sexual activity E. High self-esteem

A. Peer pressure B. Lack of role models C. Limited access to contraception

15. The nurse tells the nursing student that late preterm infants are at increased risk for which of the following problems? (Select all that apply.) A. Problems with thermoregulation B. Cardiac distress C. Sepsis D. Hyperglycemia E. Hyperbilirubinemia

A. Problems with thermoregulation C. Sepsis E. Hyperbilirubinemia Rational: Problems with thermoregulation, hyperbilirubinemia, and sepsis are common with late preterm infants. They typically have respiratory distress and hypoglycemia.

70. A nurse is administering magnesium sulfate IV to a client who has severe preeclampsia for seizure prophylaxis. Which of the following indicates magnesium sulfate toxicity? (Select all that apply) A. Respirations less than 12/min B. Urinary output less than 30 mL/hr C. Hyperreflexic deep-tendon reflexes D. Decreased LOC E. Flushing and sweating

A. Respirations less than 12 B. Urinary output less than 30mL/hr D. Decreased LOC

7. What data in the client's history should the nurse recognize as being pertinent to a possible diagnosis of postpartum depression? A. Teenage depression episode B. Unexpected operative birth C. Ambivalence during the first trimester D. Second pregnancy in a 3-year period

A. Teenage depression episode

22. A nurse has instructed a woman on the use of an oral contraceptive. To best evaluate what the woman has learned the nurse should say A. What symptoms do you need to report immediately to the doctor? B. If you have any more questions, please ask your doctor C. Here are the printed instructions Call if you have any questions D. Do you understand what to do if you forget to take a pill?

A. What symptoms do you need to report immediately to the doctor

1. Nursing intervention for the pregnant diabetic is based on the knowledge that the need for insulin A. varies depending on the stage of gestation. B. decreases throughout pregnancy and the postpartum period. C. increases throughout pregnancy and the postpartum period. D. should not change because the fetus produces its own insulin. Rational: Insulin needs decrease during the first trimester, when nausea, vomiting

A. varies depending on the stage of gestation.

1. Which of the following findings on the electric fetal monitor may indicate uterine rupture in a patient in the transition---

Absence of measurable intensity by IUPC

28. The nurse is assessing a client's chart for risk factor that may lead to neonatal hyperbilirubinemia. Which of the following risks would be included in the screening? (Select all that apply) A. Neonatal Abstinence Syndrome B. Maternal hypoglycemia C. Rh/ABO incompatibility D. Polycythemia E. Presence of a cephalohematoma

C. Rh/ABO incompatibility D. Polycythemia E. Presence of a cephalohematoma

36. A client with a history of a cystocele should contact the physician if she experiences: A. backache B. constipation. C. urinary frequency and burning D. involuntary loss of urine when she coughs

C. Urinary frequency and burning Rationale: Urinary frequency and burning are symptoms of cystitis, a common problem associated with cystocele

1. To prevent hemorrhage in the woman who has just had a cesarean birth in the recovery room nurse should:

Assess the uterus for firmness every 15 minutes

1. Which nursing measure would be appropriate to prevent thrombophlebitis in the initial recovery period following a cesarean birth?

Assist client in performing leg exercises every 2 hours

39. It is day 17 of a woman's menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states that her cycle is usually 31 days long. Which is an appropriate reply by the nurse? A. "Your hormone levels should be checked" B. "You are probably ovulating" C. "Your breast changes are a worrisome sign" D. "you will probably menstruate early"

B. "You are probably ovulating"

6. Which client situation presents the greatest risk for the occurrence of hypotonic dysfunction during labor? A. A primigravida in latent labor B. A multiparous client at 39 weeks of gestation who is expecting twins C. A 22-year-old multiparous with ruptured membranes D. A primigravida with uncoordinated contraction

B. A multiparous client at 39 weeks of gestation who is expecting twins

32. Which of these interventions should the nurse recognize as the priority for the client diagnosed with an intact tubal pregnancy? A. Assessment of pain level B. Administration of methotrexate C. Administration of Rh immune globulin D. Explanation of the common side effects of the treatment plan

B. Administration of methotrexate Rationale: The goal of medical management of an intact tube is to preserve the tube and improve the chance of future fertility. Methotrexate (a folic acid antagonist) is used to inhibit cell division and stop growth of the embryo.

57. During the course of the birth process, the physician suspects that a shoulder dystocia is occurring and asks the nurse for assistance. They place the patient in McRoberts's position. Which priority should the nurse anticipate next? A. Put pressure on the fundus B. Ask the physician if he or she would like you to apply suprapubic pressure C. Tell the client not to push until you prepare vacuum extraction device for physician D. Reposition the client to facilitate birth

B. Ask the physician if he or she would like you to apply suprapubic pressure

Which are the most common sites of breast cancer metastasis A. Kidneys B. Bones and liver C. Heart and blood vessels D. Central nervous system

B. Bones and liver Rational: Metastasis occurs when the cancer cells spread to the vascular sites, commonly the lungs, liver, and bones.

33. Newborns whose mothers are substance abusers frequently have what behaviors? (Select all that apply.) A. Weak cry B. Difficulty feeding C. Hyperactive Moro (startle) reflex D. Decreased amounts of sleep E. Circumoral cyanosis

B. Difficulty feeding C. Hyperactive Moro (startle) reflex D. Decreased amounts of sleep Rational: Infants exposed to drugs in utero often have poor sleeping patterns, hyperactive reflexes, and uncoordinated sucking and swallowing behaviors. They will have hyperactive muscle tone, a high-pitched cry, and diarrhea, not constipation

42. A benign breast condition that includes dilation and inflammation of the collecting ducts is: A. fibroadenoma B. ductal ectasia C. intraductal papilloma D. chronic cystic disease

B. Ductal Ectasia

20. Which of the following Is a potential disadvantage for a client who wishes to use an intrauterine device (IUD) as a method of birth control? A. Insertion of the device prior to coitus resulting in decreased spontaneity B Ectopic pregnancy C. Protection against STDs D. Decrease in dysmenorrhea

B. Ectopic pregnancy

56. Which finding would indicate an adverse response to terbutaline (Brethine)? A. Fetal heart rate (FHR) of 134 bpm B. Heart rate of 122 bpm C. Two episodes of diarrhea D. Fasting blood glucose level of 100 mg/dl

B. Heart rate of 122 bpm Rational: Terbutaline (Brethine) stimulates beta-adrenergic receptors of the sympathetic system. This action results primarily in bronchodilation, inhibition of uterine muscle activity, increased pulse rate, and widening of pulse pressure. An FHR of 134 bpm and fasting blood glucose level of 100 mg/dL are normal findings, and diarrhea is not a side effect associated with this medication.

48. A client is admitted with vaginal bleeding at approximately 10 weeks of gestation. Her fundal height is 13 cm. Which potential problem should be investigated? A. Placenta previa B. Hydatidiform mole C. Abruptio placenta D. Disseminated intravascular coagulation (DC)

B. Hydatidiform mole Rational: Gestational trophoblastic disease (hydatidiform mole) is usually detected in the first trimester of pregnancy. The frequency of this condition is highest at both ends of a woman's reproductive life. Placenta previa usually occurs in the third trimester. Painless uterine bleeding is the classic symptom. Abruptio placentae usually occurs in the third trimester. Painful uterine bleeding is the classic symptom. DIC is a life-threatening complication of abruptio placentae, in which procoagulation and anticoagulation factors are simultaneously activated

35. A woman at 42 weeks gestation is admitted to L & D in active labor. Which of the following complications are associated with a prolonged pregnancy? A. increased placental perfusion B. meconium stained amniotic fluid C. polyhydramnios D. marked variability of the FHT

B. Meconium stained ammonitic fluid

31. An abortion in which the fetus dies but is retained in the uterus is called ________abortion. A. Inevitable B. Missed C. Incomplete D. Threatened

B. Missed Rational: Missed abortion refers to a dead fetus being retained in the uterus. An inevitable abortion means that the cervix is dilating with the contractions. An incomplete abortion means that not all of the products of conception were expelled. With a threatened abortion the woman has cramping and bleeding but not cervical dilation.

5. Which factor should alert the nurse to an increased risk for prolapsed umbilical cord? A. Meconium-stained amniotic fluid B. Presenting part at a station of -3 C. Small amount of amniotic fluid. D. Pregnancy at 39-weeks of gestation

B. Presenting part at a station of -3

40. Which data collected during your assessment may indicate a vaginal wall hematoma? A. A Firm uterus at U-1 B. Pulse rate of 110 bpm C. Moderate lochia D. Soreness of perineum

B. Pulse rate of 110 bpm Rationale: Trauma to the vaginal area from a forceps birth may result in significant blood loss from hematomas or lacerations. Tachycardia is an early sign of compensation for excessive blood loss. If vital signs suggest hemorrhage but excessive bleeding is not obvious, the cause may be concealed bleeding and the formation of a hematoma; a firm fundus, moderate lochia, and soreness of the perineum are normal findings.

54. A client who tells you that I forgot to take my birth control pill yesterday should be instructed to A. throw away the missed pills and continue to take the rest B. take two pills now and then finish the pack as scheduled C. throw away missed pills and start a new pack D. take an extra pill each day until pack is finished

B. Take two pills now and then finish the pack as scheduled

26. Neonatal hypoglycemia is a great concern because the A. Ability to fight infection is reduced when glucose levels fall B. newborn brain is almost entirely dependent on glucose C. baby is likely to become a diabetic during adolescence or adulthood D. risk of pathological jaundice is severe in the first week of life

B. newborn brain is almost entirely dependent on glucose

43. A woman pregnant with her first child tells the nurse that her husband slapped her across the face several times because his dinner was not ready. She stated that previous to this episode, he had never hit her. The nurse would respond with (select all that apply) A. This is probably an isolated incident B. Did he explain why he slapped you? C. Let's design a safety plan D. I would like to talk with him about this incident E. Abuse often begins during a woman's first pregnancy

C. Let's design a safety plan E. Abuse often begins during a woman's first pregnancy

37. Which client is most at risk for fibroadenoma of the breast? A. Janice, 38 years old B. Helen, 50 years old C. Mary, 16 years old D. Anna, 27 years old

C. Mary, 16 years old Rationale: fibroadenoma is most common in the teenage years.

A woman calls the clinic early on Tuesday morning stating that she needs a prescription for emergency contraception. On questioning by the nurse...

By Wednesday ----I think the same day so tuesday

Contraindications of HIV mothers include. No use of forceps, no intrauterine monitoring, anything that says something about going in the vagina. This patient should be prepared for what type of delivery? (Vaginal or C section)

C section

46. A nurse on the postpartum unit is assessing several clients. Which clinical finding requires immediate investigation? A. A boggy uterus that firms after prolonged massage B. An estimated blood loss of half a liter during delivery C. A slow trickle of bright red blood from the vagina D. A swollen and inflamed episiotomy

C. A slow trickle of bright red blood from the vagina

45. Which finding in the assessment of a client following an abruption placenta could indicate a major complication? A. Urine output of 30 ml in 1 hour B. Blood pressure of 110/60 mmHg C. Bleeding at IV insertion site D. Respiratory rate of 16 breaths/min

C. Bleeding at IV insertion site Rational: DIC is a life-threatening defect in coagulation that may occur following abruptio placentae. DIC allows excess bleeding from any vulnerable area such as IV sites, incisions, gums, or nose. A urine output of 30 mL in 1 hour, blood pressure of 110/60 mm Hg, and respiratory rate of 16 breaths/min are normal findings in a postpartum client.

10. A client at 28 weeks of gestation is newly diagnosed with gestational diabetes. The nurse caring for this client understands that: (Quizlet) A. Adequate treatment requires insulin administration and diet modification B. Oral hypoglycemic medication can be given if the declines insulin C. Dietary management requires distributing nutrient over 3 meals and 2-3 snacks. D. Urine glucose levels are monitored four times a day and at bedtime

C. Dietary management requires distributing nutrient over 3 meals and 2-3 snacks.

2. If rubella vaccine is indicated for a postpartum client, which instructions to the client should be included? A. Recommendation to stop breastfeeding for 24 hours after the injection B. Drinking plenty of fluids to prevent fever C. Explanation of the risks of becoming pregnant within 28 days following injection D. No specific instructions

C. Explanation of the risks of becoming pregnant within 28 days following injection

When planning care for a woman who has been diagnosed as having uterine fibroids, the nurse should know that A. Fibroids Usually increase in size after menopause B. Pregnancy cannot occur in the fibroid uterus C. Increased menstrual flow is a common symptom D. Fibroids are malignant tumors of the uterus

C. Increased menstrual flow is a common symptom

44. A woman, gravida 5, para 4. at 38 weeks of pregnancy presents to L&D with vaginal bleeding. The nurse's priority action is to assess: A. whether membranes are intact B. cervical dilation and effacement. C. Maternal vital signs and FHR D. uterine contraction pattern

C. Maternal vital signs and FHR

61. Which of the following women is most likely to have osteoporosis A. a 65-year old who walks 2 miles a day B. a 60-year old who takes supplemental calcium. C. a 55-year old with a sedentary lifestyle, D. 50-year old on estrogen therapy

C. a 55 year old with a sedentary lifestyle Rationale: Risk factors for the development of osteoporosis include smoking, alcohol consumption, sedentary lifestyle, family history of the disease, and a high-fat diet. Hormone therapy may prevent bone loss. Weight-bearing exercises have been shown to increase bone density. Supplemental calcium will help prevent bone loss, especially when combined with vitamin D.

4. Preconception counseling is critical of the outcome of diabetic pregnancies because poor glycemic control before and during early pregnancy is associated with: A. frequent episodes of maternal hypoglycemia B. polyhydramnios C. congenital anomalies in the fetus D. hyperemesis gravidarum

C. congenital anomalies in the fetus

25. The nurse should question postpartum order for methylergonovine (Methergine) 0.2mg PO q 4 hours time 4 doses because the woman has a history of A. Asthma and respiratory allergy B. Cesarean birth C. pregnancy induced hypertension D. abruptio placentae

C. pregnancy induced hypertension

In which situation is a dilation and curettage (D&C) recommended? A. Threatened abortion at 6 weeks B. Incomplete abortion at 16 weeks C. Incomplete abortion at 10 weeks D. Complete abortion at 8 weeks

C.. Incomplete abortion at 10 weeks Rational: D&C is used to remove the products of conception from the uterus and can be used safely until week 14 of gestation. After that there is a greater risk of excessive bleeding, and this procedure may not be used.

1. Which of the following assessment findings may indicate anaphylactoid syndrome?

Chest pain

1. The client who has had an intrauterine device (IUD) inserted should be instructed to

Check the placement of the string once a week for 4 weeks

1. The best way to detect early signs of preeclampsia is to:

Check urine and blood pressure at each prenatal visit

17. Which of these substances can lead to miscarriage, preterm labor, placental separation (abruption), and stillbirth? A. Heroin B. Alcohol C. PCP D. Cocaine

Cocaine Rational: Cocaine is a powerful CNS stimulant. Effects on pregnancy associated with cocaine use include abruptio placentae, preterm labor, precipitous birth, and stillbirth. Heroin is an opiate. Its use in pregnancy is associated with preeclampsia, intrauterine growth restriction, miscarriage, premature rupture of membranes, infections, breech presentation, and preterm labor. The most serious effect of alcohol use in pregnancy is FAS. The major concerns regarding PCP use in pregnant women are its association with polydrug abuse and the neurobehavioral effects on the neonate.

49. Which nursing action is especially important for an SGA newborn? A. Promote bonding B. Observe for and prevent dehydration C. Observe for respiratory distress syndrome, D. Prevent hypoglycemia with early and frequent feedings

D Prevent hypoglycemia with early and frequent feedings Rationale: The SGA infant has poor glycogen stores and is subject to hypoglycemia. Respiratory distress syndrome is seen in preterm infants. Dehydration is a concern for all infants and is not specific for SGA infants. Promoting bonding is a concern for all infants and is not specific for SGA infants.

59. A newly married woman states "my friend told me I would never have a baby because I had pelvic inflammatory disease when I was younger. I don't understand how that can affect where or not pregnant." The nurse's best response is: A. "Your friend may be right. the disease may affect your ability to conceive" B. "Pelvic inflammatory disease may damage the ovaries and prevent ovulation" C. "Your friend has been misinformed. Fallopian tube damage occurs only following gonorrhea" D. "infection may cause scarring and obstruction of the fallopian tubes, which can prevent the fertilized egg from reaching the uterus"

D. "infection may cause scarring and obstruction of the fallopian tubes, which can prevent the fertilized egg from reaching the uterus"

14. The physician orders IV fluids to total 125ml/hr. on a preeclamptic patient. Her main line IV is lactated ringers and her Magnesium Sulfate is 2 grams/hour IVPB (1 gram = 25 ml/hr.). She is being induced with Pitocin solution of 30 units in 500 ml (1 mu/min = 1ml/hr.). Her Pitocin is now at 10 mu/min. What is the main IV (LR) rate per hour? A. 125 ml/hr. B. 75 ml/hr. C. 180 ml/hr. D. 65 ml/hr.

D. 65 ml/hr. Rational: Magnesium Sulfate is 50ml/hr. + Pitocin 10ml/hr. = 60 125-60 = 65

8. Moments after delivery of a meconium stained 8-pound baby, the woman suddenly complains that she can't get her breath. The nurse should suspect A. Increased level of epidural anesthesia B. Decreased in blood pressure C. Placenta accreta D. Amniotic fluid embolus

D. Amniotic fluid embolus

9. A primipara is 5 hours postpartum after a low forceps birth of an 8-pound baby. She was medicated with an oral analgesic 1 hour ago, but now requests stronger pain medications. At this point the nurse should A. Have her empty her bladder to reduce pressure within the vagina B. Tell her that she can have strong analgesic, but not until the next dose is due C. Check the orders for a strong medication and give it to her D. Ask her to turn on her side and assess her vaginal and perineal area

D. Ask her to turn on her side and assess her vaginal and perineal area

51. Camille is 27 years old and delivered here first baby yesterday. She and her husband do not want to have another baby for at least 3-4 years. Which of the following is the best method of birth control to meet their needs? A. Vasectomy without reversal in 3years B. Withdrawal C. Fertility awareness method. D. combination of .condom and foam

D. Combination of condom and foam Rational: Of the methods listed, condoms and foam would be the best for this couple. Withdrawal is the least effective form of birth control. Fertility awareness is not that effective, and an unwanted pregnancy could result. They want another child so a vasectomy with a reversal would not be an appropriate option.

60. In the woman who has Diabetes Mellitus poor glycemic control before and during early pregnancy is associated with: A. frequent episodes of maternal hyperglycemia B. hyperemesis gravidarum C. polyhydramnios D. congenital anomalies in the fetus

D. Congenital anomalies in the fetus Rational: Preconception counseling is particularly important because strict metabolic control before conception and in the early weeks of gestation is instrumental in decreasing the risks of congenital anomalies. Frequent episodes of maternal hypoglycemia may occur during the first trimester (not before conception) as a result of hormone changes and the effects on insulin production and usage. Hydramnios occurs about 10 times more often in diabetic pregnancies than in nondiabetic pregnancies. Typically, it is seen in the third trimester of pregnancy. Hyperemesis gravidarum may exacerbate hypoglycemic events as the decreased food intake by the mother and glucose transfer to the fetus contribute to hypoglycemia

12 Which assessment finding indicates uterine rupture? A. Fetal tachycardia occurs. B. The client becomes dyspneic. C. Labor progresses unusually quickly. D. Contractions abruptly stop during labor.

D. Contractions abruptly stop during labor.

47. The laboring woman is having uterine contractions every 1 ½ to 2 minutes and says they are extremely painful. Her cervix is dilated to 2 cm. 50% effaced and it has not changed in 4 hours. She is crying and wants an epidural. She is most likely experiencing: A. fetal lie disproportions B. prolonged active phase C. Cephalopelvic dystocia D. Hypertonic uterine dysfunction

D. Hypertonic uterine dysfunction

20. While providing care for the patient in preterm labor who is receiving terbutaline and to identify a side effect of this drug the nurse would assess A. level of consciousness B. for hypoglycemia C. deep tendon reflexes D. maternal heart rate

D. Maternal Heart Rate

16. As the nurse performs her morning assessment, she notes the infant appears pale and lethargic She should immediately assess the infant for other signs of A. jaundice B. hypervolemia C. drug exposure. D. Sepsis

D. Sepsis

21. Which assessment finding 24 hours after vaginal birth would indicate a need for further intervention? A. Pain level 5 on scale of O to 10 B. Saturated pad over a 2-hour period C. Urinary output of 500 mL in one voiding D. Uterine fundus 2 cm above the umbilicus

D. Uterine Fundus 2 cm above the umbilicus

19. Transient tachypnea of the newborn (TTN) is thought to occur as a result of A. lack of surfactant B. a slow vaginal delivery associated with meconium-stained fluid C. hypo-inflation of the lungs D. delayed absorption of fetal lung fluid

D. delayed absorption of fetal lung fluid Rational: Delayed absorption of fetal lung fluid is thought to be the reason for TTN. Lack of surfactant and hypoinflation of the lungs are not related to TTN. A slow vaginal delivery will help prevent TTN.

What is a contraindication to HELLP Syndrome

Do not palpate the abdomen

What is methotrexate used for?

Ectopic pregnancy

1. A woman has an incomplete abortion followed by a vacuum aspiration. She is in the recovery area,--- husband. The most appropriate nursing action at this time is to:

Express regret at their loss and remain near in case they want to talk

1. A 32 year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nurse caring is based on the

Hemorrhage is the major concern

1. The method of contraception that is considered the safest for the female is the:

Male Condom

1. In which of these situations is there the greatest risk for a blood group incompatibility?

Mother O positive, Infant B negative

1. A 38 weeks pregnant woman is seen in the ER after being kicked in the abdomen by her boyfriend---- and constant pain in her abdomen. The nurse recognizes that these symptoms may indicate:

Separation of the placenta

1. Sharon, a postmenopausal female, confides to you that she has started experiencing pain with intercourse—

Topical or oral estrogen is usually effective for this problem

71. The best time for a woman of childbearing age to perform a self breast exam would be: A. The week prior to her next period B. Three weeks from the onset of her last period C. At the beginning of her next period D. The week after her period

The week after her period

1. An infant has been under phototherapy for 24 hour sand begins to have stools that are watery and green.

This is an expected side effect if phototherapy

A baby receiving phototherapy should be turned every ______ hours

Turned every 2 hours