Nur 105 mother and baby

During pregnancy, a normal weight woman should gain approximately

25 to 35 pounds

A baby boy was born at 38 weeks of gestation to a mother with type 1 diabetes. Into which category does this infant most likely fall?

Large for gestational age

The nurse has just reviewed the fetal heart rate on an assigned laboring patient. What finding indicates the need to notify the charge nurse?

Late decelerations

A newborn is jaundiced and receiving phototherapy. What is an appropriate nursing intervention when caring for an infant with hyperbilirubinemia who is receiving phototherapy? (Select all that apply.)

Lay the baby down with the back directly on the biliblanket. Place eye shields over the newborn's eyes.

The parents of a 13-year-old boy report their son spends several hours on the Internet and social media sites each day before and after school. What information should be provided by the nurse? (Select all that apply.)

Social media has some benefits including improved communication with others. Social media use may result in mental health concerns. Excessive hours on social media can result in an imbalance between the rest of the social activities of the child. The Internet can provide educational benefits.

Lillian Ward, founder of the Henry Street Settlement in New York City, focused on which of the following? (Select all that apply.)

Social work Educational activities Nursing services

A pregnant woman at 32 weeks of gestation reports feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. What should the nurse's initial action be?

Turn the woman on her side.

A 26-year-old pregnant woman, gravida 2, para 1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what is an expected diagnostic procedure?

Ultrasound scan for placental location

Which of the following foods would help a pregnant woman increase her protein intake?

cheese

The life cycle in which growth occurs in small spurts and appetites taper off during periodic plateaus is

childhood.

A 16-month-old child is admitted to the pediatric floor after surgery to repair a cleft palate. The child's mother asks why her child is restrained. The nurse explains that the elbow SRD is being used to:

help to prevent injury to the operative site.

Amniotic fluid is important because it

protects the fetus from shock or injury

The nutrient essential for tissue building is

protein.

The patient reports experiencing nausea, vomiting, and breast tenderness along with missing her period. These symptoms are considered to be what type of signs of pregnancy?

presumptive

In planning the care of a 30-year-old woman with pregestational diabetes, what is the most important factor that affects pregnancy outcome?

Degree of blood glucose control during pregnancy

The nurse explains to the patient that she should contact her health care provider if she experiences any of the danger signs of pregnancy. Which symptoms are a danger sign during pregnancy? (Select all that apply.)

Diplopia Severe headaches

Proper counseling of the parent of a 1-year-old regarding safety includes which instruction(s)? (Select all that apply.)

Do not tie pacifiers on a string around the infant's neck. Place infant on back to sleep. Fence pools with a self-locking gate. Keep drapery cords out of children's reach.

The nurse helps the breast-feeding woman change her newborn's diaper after the baby's first bowel movement. The mother expresses concern because of a large amount of sticky, dark green—almost black—stool. She asks the nurse if something is wrong. What information should be included in the nurse's response?

Explain that this type of stool is called meconium and is expected for the first few bowel movements of all newborns.

When obtaining a reproductive health history from a female patient, what should the nurse do?

Explain the purpose of questions asked and how they will be used.

A pregnant patient is seen during her second trimester at the health care provider's office. She asks the nurse, "What can I do when my leg goes into a cramp?" The patient demonstrates an understanding of the nurse's instruction regarding relief of leg cramps if she takes which action?

Extends her leg and dorsiflexes her foot during the cramp

The nurse is reviewing the plan of care for a patient being treated for acute deep vein thrombosis. Which can be anticipated to be included in the plan of care at this time? (Select all that apply).

Extremity elevation Activity restriction Intravenous anticoagulant therapies

A patient is scheduled for an ultrasound scan. She is at 22 weeks' gestation. The patient asks how they will be able to tell the gestational age of her fetus. When planning the response, the nurse correctly recognizes that which measurements will be used in this determination? (Select all that apply.)

Femur length Biparietal diameter

A test that may be done in late pregnancy to determine fetal well-being is the nonstress test. This test is based on which phenomenon?

Fetal heart rate increases in connection with fetal movement

An accurate apical heart rate measurement is assessed at the ________________ intercostal space.

Fifth

At one of her prenatal visits, the patient is scheduled for a sonogram. Sonography can be used to assess which of the following? (Select all that apply.)

Gestational age of fetus Number of fetuses Congenital anomalies Placement of the placenta

Human papillomavirus (HPV) vaccine is recommended for what population?

Girls from age 13 to 26 years who are not sexually active

What are the approximate daily fluid needs of an infant from birth to 6 months of age?

0.7 L/day

A woman admitted in labor has an obstetric history that indicates that she has had four pregnancies and has 3 living children. One was born at 39 weeks of gestation, another at 34 of weeks of gestation, and another at 35 weeks of gestation. She had a miscarriage at 16 weeks gestation. What are her gravidity and parity with the TPAL system?

1-2-1-3

It is recommended that mothers breastfeed for at least

12 months

A woman pregnant for the first time is dilated 3 cm, with contractions every 5 minutes. She is groaning and perspiring excessively and states that she did not attend childbirth classes. What is the most important nursing action?

Give simple breathing and relaxation instructions.

Fill in the blank with the correct medical term: _______________________ Woman who is pregnant

Gravida

Macrosomia is a complication resulting from

gestational diabetes

When counseling the parents of a 6-month-old about dental health, the nurse includes which statement(s)? (Select all that apply.)

"Avoid toothpaste at this age, especially if it is fluoridated." "Initiate fluoride supplementation at 6 months of age if infant's home water supply is not fluoridated." Begin cleansing the oral cavity by wiping teeth and gums with a damp washcloth."

A woman at 23 weeks of gestation calls to tell the nurse she thinks she is leaking fluid from her vagina. What information should be included in the nurse's response to the patient?

"Come to the office right away."

The nurse is providing postoperative care instructions to the parents of a 5-month-old who is recovering from surgery. Which statement indicates that the teaching was effective? (Select all that apply.)

"I can continue to breast feed as soon as my child is able to eat." "The baby will perhaps be comforted by sucking on a pacifier, being swaddled, or being rocked."

The nurse is discussing dietary intake with the mother of an 18-month-old child. What statement(s) by the mother indicate(s) the need for further instruction? (Select all that apply.)

"I need to begin to decrease the amount of milk my child is allowed to drink." "Until my child is 3 years of age, whole milk is recommended." "Whole milk is not a good option for my child."

A 16-year-old teen reports he uses smokeless tobacco. Which statements by the teen indicate the need for further instruction? (Select all that apply.)

"Smokeless tobacco is safer for me than a cigarette." "I can become sterile from smokeless tobacco use." "As long as I brush my teeth after use I am going to be OK."

A 7-year-old is about to have a finger-stick blood draw. Which statement by the nurse is most effective?

"Some children say that they feel a little pinch."

An expectant father confides in the nurse that his pregnant wife (10 weeks of gestation) is driving him crazy. "One minute she seems happy, and the next minute she seems unhappy, and the next she is crying over nothing at all. Is there something wrong with her?" What is the most appropriate response by the nurse?

"This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will subside as she adjusts to being pregnant."

A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. What information can be provided by the nurse?

"You may find that you need to modify your exercising to walking later in your pregnancy, around the seventh month."

A pregnant woman is attending childbirth classes. She asks the nurse teaching the class when she can have an internal fetal monitor applied. What is the best nursing response?

"Your cervix must be 2 to 3 cm dilated and your membranes ruptured before an internal monitor can be applied."

Approximately how many additional calories are needed during the third trimester of pregnancy?

450

The nursing student is reviewing what he/she knows about the development of pediatrics as a discipline. The nursing student recognizes which of the following individuals as being credited with being the "father of pediatrics"?

Abraham Jacobi

A patient is in labor and suddenly reports sharp fundal pain. She begins to have vaginal bleeding as well. What is the most likely cause of her symptoms?

Abruptio placentae

Responsible sexual behavior among young people most importantly should include what characteristic?

Abstaining from sexual activity or properly using condoms

A 25-year-old woman comes to the clinic and says she thinks she is pregnant. Her last period was July 20. Based on this fact, what is the expected date of delivery (EDD)?

April 27 subtract 3 months add 7 days

The mother of a 6-month-old is worried because the child's grandmother is concerned that the child is "slow" because she is not yet crawling. What action by the nurse is most appropriate?

Assure the mother that children develop at their own rate, but most children do not crawl at age 6 months.

fetal heart tones

Ausculation of fetal heart tones at 10-12 weeks with Doppler scanner. Just above symphysis pubis and apply firm pressure.

When teaching parents how to bathe their baby, which point should the nurse stress?

Avoid immersing the baby in water until after the umbilical cord has fallen off.

A nurse is meeting a new 4-year-old patient for the first time. Which intervention is most effective when entering the patient's room for the first time?

Be careful not to use words that may be misinterpreted by the child, such as "take your temperature."

The nurse is planning a program for parents and adolescents in the community related to obesity. What information is most appropriate for inclusion in the information that will be provided?

Being overweight or obese sometimes results in major physical and psychological health problems.

When caring for a pregnant woman with cardiac problems, the nurse should be alert for what signs and symptoms that suggest cardiac decompensation? (Select all that apply.)

Bradycardia Hypertension Shortness of breath

A baby has a Gomco circumcision. What instruction should the nurse give his parents for care of the circumcised penis?

Cover the glans with a petroleum gauze dressing.

HPV infection is associated with what health complication?

Cervical cancer

A patient is diagnosed with an inevitable abortion. Which assessment finding distinguishes an inevitable abortion from a threatened abortion?

Cervical dilation

A primigravida has delivered a baby vaginally after 6 hours of labor. She had an uneventful pregnancy and is in good general health. She is transferred from the recovery room to the postpartum unit. What interventions are included in routine postpartum care? (Select all that apply.)

Checking of breasts for engorgement and cracking of nipples Assessment of intake and output until the patient is voiding in sufficient quantities Assessment of the emotional status of the new mother

The nurse is preparing a patient for a scheduled cesarean section. The nurse will administer medications to reduce gastric acidity. Which medications may be used? (Select all that apply.)

Cimetidine (Tagamet) Sodium citrate (Bicitra) Famotidine (Pepcid) Ranitidine (Zantac)

Constipation is a frequent symptom as a pregnancy progresses. Which measures should be recommended to the gravid woman? (Select all that apply.)

Drink six to eight glasses of water daily. Increase dietary fiber intake.

The nurse is caring for a patient in labor who has had meperidine (Demerol) for pain relief. Which side effects are commonly associated with this drug? (Select all that apply.)

Dry mouth Pruritus Bradycardia Hypotension

The nurse is performing a routine postpartum assessment. Which action is indicated before the fundal height is measured?

Elevate the head of the bed.

An 18-month-old is hospitalized for surgery in the morning. Which intervention is most helpful in relieving the child's stress?

Encouraging parental presence and rooming-in

A baby girl was born at 34 weeks of gestation. At 3 hours old, she is diagnosed with respiratory distress. What is an early symptom of respiratory distress?

Expiratory grunting

Which maternal cardiovascular finding is expected during labor?

Increased pulse rate

What is true regarding the child's nutrition? (Select all that apply.)

Infants can begin solid foods at 4 to 6 months of age. Solid foods should be introduced one at a time and a new one each week

The parents of a 10-month-old are concerned about motor vehicle safety. What education should be provided from the nurse to the parents?

Infants from birth to 20 pounds must be in a rear-facing safety seat.

When planning care for a woman whose membranes have ruptured, the nurse recognizes that the woman's risk for what has increased?

Intrauterine infection

When the woman enters the transition phase to active labor, which behaviors should the nurse expect to see?

Irritability, resistance to touch, withdrawal

When providing education to parents about care of the umbilical cord, what information should be included? (Select all that apply.)

Keeping the diaper folded below the cord Answer Applying triple dye to the cord Cleaning the cord with an alcohol swab

The nurse finds bright red bleeding on a patient's peripad. The stain is about 6 inches long. What is the correct description of the character and amount of lochia?

Lochia rubra, moderate

The first White House Conference on Children focused on issues of child labor, dependent children, and infant care. As a result, what was established in 1987 on behalf of children?

National Commission on Children

A patient has been diagnosed with placenta previa. Which symptom is considered the classic diagnostic criterion for placenta previa?

Painless vaginal bleeding

On examining a woman who gave birth 5 hours previously, the nurse finds that the woman has saturated a perineal pad within 15 minutes. What action is the nurse's first priority?

Palpate the woman's fundus.

fundal height

Patient should be lying flat, bladder should be emptied. A paper tape measure or pelvi meter May be used. Measure from Pubic bone to fundus.

After admitting a new patient to the maternity unit, the nurse writes a care plan. This process of determining outcomes and interventions is which stage of the nursing process?

Planning

The nurse can help a father in his transition to parenthood with what action?

Pointing out that the infant turned to his voice

A patient is admitted to the hospital with a diagnosis of suspected ectopic pregnancy. Which findings in the patient's history and assessment would be supportive of this diagnosis? (Select all that apply.)

Positive serum HCG test results Abdominal pain History of pelvic inflammatory disease Uterine enlargement

What is true of intramuscular injections in children younger than 2 years old? (Select all that apply.)

Possible to give in the vastus lateralis muscle. Help should be obtained to restrain the child. Possible to give in the ventrogluteal muscle.

The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. Which are positive signs of pregnancy? (Select all that apply.)

Presence of fetal heart tones Fetal movement palpated by the primary caregiver

Fill in the blank with the correct medical term: _______________________ Woman who is pregnant for the first time

Primigravida

A 4-year-old child is to be hospitalized for the first time, and the parents voice anxiety about his condition and hospitalization. Which action by the nurse best addresses the concerns of the child's parents?

Provide anticipatory guidance and explain all procedures.

After giving birth to a healthy baby boy, a primiparous woman, age 16 years, is admitted to the postpartum unit. An appropriate patient problem statement for her at this time is the Potential for Compromised Parenting Skills, related to deficient knowledge of newborn care. In planning for the woman's discharge, the nurse should include what in the care plan?

Provide time for the woman to bathe her baby after she views a baby bath demonstration.

What is the appropriate method to examine a 6-month-old's ear with an otoscope?

Pull the ear down and back.

The nurse is discussing planned well-child appointments with the mother of a toddler who frequently misses them. What actions should be taken by the nurse? (Select all that apply.)

Review the family's ability to pay for health care. Seek family input on the dates and times for scheduling the appointments. Determine if the family has transportation for the appointments. Assess the parent's beliefs on the importance of the health promotion activities.

When planning a diet with a pregnant woman, what should the nurse's initial action be?

Review the woman's dietary intake.

The most common asymmetry with lateral curvature of the spine in the adolescent is known as ________________.

Scoliosis

Which method is the most effective when preparing a child for a pediatric procedure?

Sensation-based approach

The patient delivers an 8-lb, 1-oz boy. Ten minutes later, there is a sudden gush of blood from her vagina. At the same time, the woman's uterus becomes globular in shape and the umbilical cord lengthens. What do these findings most likely indicate?

Separation of the placenta

When preparing snacks for an 18-month-old child, which would be appropriate? (Select all that apply.)

Sliced apples Crackers Orange segments

A baby boy is 1 hour old when admitted to the newborn nursery. He weighs 7 lb, 3 oz; is 21 inches long; has irregular respirations of 42 breaths/min with adequate chest movement, a heart rate of 145 beats/min, and a temperature of 35.6°C, axillary; and is acrocyanotic. What is an appropriate goal for this baby within the next 2 hours, based on these findings?

Temperature will stabilize at 36.5° to 37°C.

Alcohol use and cigarette smoking, which can cause injury to the fetus, are known as

Teratogens

A woman asks the nurse how she will know her baby is getting enough milk. The nurse's response is based on understanding that which is the best determinant?

The baby has 6 to 10 wet diapers per day.

In evaluating maternal adjustment, which behavior leads the nurse to believe that the patient is still in the taking-in phase? (Select all that apply.)

The majority of the mother's time is spent talking about her delivery experience. Answer The mother reports she feels as if she needs to get more rest. Answer The mother states she is "starving" and can't wait to eat.

A first-time mother is to be discharged from the hospital tomorrow with her baby girl. Which maternal behavior indicates a need for further intervention by the nurse before she can be discharged?

The mother leaves the baby on her bed while she takes a shower.

The nurse observes several interactions between a postpartum woman and her new son. Which behavior, if exhibited by this woman, does the nurse identify as maladaptive regarding parent-infant attachment?

The mother seldom makes eye contact with her son.

A woman who is in her first trimester is talking with the nurse. The patient has inquired about the feelings she will have when she first feels her baby move. What information can be provided by the nurse?

The movement is flutter-like and is called quickening.

The fetal position is ROA. Where is the fetal presenting part in relation to the maternal pelvis?

The occiput is facing the right side and the front of the maternal pelvis.

Which statement by the new pediatric nurse indicates an understanding of medication administration to children? (Select all that apply.)

The six rights of medication must be followed when administering medication. "BSA is a reliable method of calculating children's medication dosage."

To assess the frequency of regular labor contractions, what should the nurse record?

The start of one contraction to the start of the next

A 15-year-old male patient states that he does not smoke. Further assessment reveals he uses chewing tobacco. What information should the nurse provide to the patient about smokeless tobacco? (Select all that apply.)

The use of smokeless tobacco carries a similar risk for the development of lung cancer. Individuals using smokeless tobacco have an increased risk for the development of lip, gum, and throat cancer.

A breastfeeding mother reports to the nurse that her breasts are very firm and tender. What information should be included in the response by the nurse? (Select all that apply.)

This is known as engorgement." Correct! "More frequent breast-feeding will be helpful in managing this condition."

A patient is Rh-negative and delivers an infant with Rh-positive blood. RhoGAM is prescribed. What is the rationale for the use of this medication?

To prevent production of maternal blood antibodies

What is the most common cause of postpartum hemorrhage?

Uterine atony

Fortified milk and sunlight help to meet the pregnant mother's need for

Vitamin D

The nurse is teaching breast care for the lactating woman. What information should be included? (Select all that apply.)

Wear a supportive bra 24 hours a day for the first few weeks. Expose the nipples to air for 20 to 30 minutes daily.

A woman gave birth 48 hours ago to a healthy baby girl. She has decided to bottle feed. During the assessment, the nurse notices that both breasts are swollen, warm, and tender on palpation. The patient should be advised that this is best treated with which action? (Select all that apply)

Wearing a snug bra Applying ice to the breasts for comfort Running warm water over her breasts during a shower

What is the most accurate method to measure urine output in an infant?

Weigh the diaper before and after the infant voids.

What component in the blood prevents edema in pregnancy?

albumin

The nurse notes accelerations with fetal movement. The nurse correctly recognizes that heart accelerations most commonly:

are reassuring.

As the woman's labor progresses, which assessment finding indicates that the second stage of labor has begun?

bearing-down reflex

What value on the growth chart can be used continuously from age 2 to 20?

body mass index

The nutrient that provides the main source of energy for the body is

carbohydrates.

A 23-year-old primigravida arrives at the labor unit in early labor. Which assessment finding indicates that labor has begun?

cervical dilation

Which of the following micronutrients, when eaten in adequate amounts, aids in the prevention of spina bifida?

folate

Children are most commonly exposed to lead through

house paint

Which age group requires more water per unit of body weight?

infants

A patient is suspected of having gestational hypertension. Which assessments are likely to be included in the nursing assessment? (Select all that apply.)

intake and output daily weight Deep tendon reflexes

A woman has progressed through her labor without difficulty. However, the fetal heart rate has been decreasing with each contraction for the past 15 minutes. The rate decreases from 150 to 125 bpm after the peak of the contraction and returns to 150 bpm 15 seconds after the contraction is finished. What phenomena do the clinical manifestations most support?

late decelerations

An infant classified as having a very low birth weight weighs

less than 1500 g (3 lb 5 oz).

Fill in the blank with the correct medical term: _______________________ Woman who has had two or more pregnancies

multigravida

While giving a health history to the nurse, the patient reports that she usually has a glass of wine with dinner. What is the safe level of alcohol intake for her during her pregnancy?

no alcohol

To determine fetal lie, presentation, and position, the caregiver uses which assessment technique?

palpation of contractions

A woman tells the nurse she thinks her membranes have ruptured. What action by the nurse best validates rupture of membranes?

performing a nitrazine test

Which age group has the highest kcal/kg/day need?

premature infants

Which symptom is considered a first-trimester warning sign and should be reported immediately to the health care provider?

vaginal bleeding

Fill in the blank with the correct medical term: _______________________ Capacity to live outside the uterus

viability

The two vitamins that are needed in supplemental form for breastfed infants are

vitamins K and D.