NURS 215 - Exam 3 - Chapters 14, 15, 19

Ch. 15 12. A woman has just given birth to a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify what findings as normal? Select all that apply. A) one vein B) two veins C) one artery D) two arteries E) one ligament F) two ligaments

ANS: A, D

Ch. 19 18. The nurse is caring for a pregnant woman with diabetes mellitus. Which potential fetal complications should the nurse monitor the client for as she presents for her scheduled visits? Select all that apply. A) congenital malformations B) macrosomia C) fetus with juvenile diabetes D) smaller than gestational age baby E) respiratory disorder

ANS: A, B, E

Ch. 14 15. A nurse is monitoring a client's hCG levels because she has had a previous ectopic pregnancy and one spontaneous abortion. Which finding would the nurse interpret as indicating that the pregnancy is progressing appropriately? A) doubling of the level every 2 to 3 days B) plateauing of the level at 7 days C) gradually increasing levels every month D) abruptly declining levels after 60 days

ANS: A

Ch. 14 20. An experienced nurse is working with a new graduate on the postpartum unit. Which comment by the new graduate about a client would require the nurse to intervene? A) I have ordered a kosher diet for the Jewish client, since that is usually what they prefer. B) The Pakistani client has requested no male caretakers so I reassigned the male student to another client. C) The Hispanic client has many family members, which I have allowed to visit during the day. D) The Vietnamese client has requested only hot foods, so I contacted dietary to make note of this request. E) I have given the young high school client information about resources in the community such as WIC (Women, Infants and Children).

ANS: A

Ch. 19 4. Which response is most appropriate for a client with diabetes who wants to breast-feed but is concerned about the effects of breastfeeding on her health? A) Diabetic clients who breast-feed have a hard time controlling their insulin needs B) Diabetic clients shouldn't breast feed because of potential complications C) Diabetic clients shouldn't breast-feed; insulin requirements are doubled D) Diabetic clients may breast-feed; insulin requirements may decrease from breast-feeding

ANS: D

Ch. 19 5. A patient who is 36 weeks pregnant has been taking phenytoin for a seizure disorder. Which supplement should the nurse anticipate being prescribed for this patient? A) Vitamin C B) Vitamin D C) Vitamin E D) Vitamin K

ANS: D

Ch. 14 3. During a vaginal exam, the nurse notes that the lower uterine segment is softened. The nurse documents this finding as: A) Hegar sign. B) Goodell sign. C) Chadwick sign. D) Ortolani sign.

ANS:A

Ch. 14 7. A client with a 28-day cycle reports that she ovulated on May 10. When would the nurse expect the client's next menses to begin? A) May 24 B) May 26 C) May 30 D) June 1

ANS: A

Ch. 15 14. A pregnant woman is scheduled to undergo an amniocentesis. When explaining this test to the client, the nurse would also include information about which test being done at the same time? A) ultrasound B) chorionic villus sampling C) biophysical profile D) Doppler flow study

ANS: A

Ch. 15 7. Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which finding? A) linea nigra B) striae gravidarum C) melasma D) vascular spiders

ANS: A

Ch. 14 2. A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2- year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as: A) 3 2 1 0 3. B) 3 1 2 2 3. C) 4 1 1 1 3. D) 4 2 1 3 1.

ANS: C

Ch. 15 13. A woman is at 20 weeks' gestation. The nurse would expect to find the fundus at which area? A) just above the symphysis pubis B) midway between the pubis and umbilicus C) at the level of the umbilicus D) midway between the umbilicus and xiphoid process

ANS: C

Ch. 14 5. When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle? A) menstrual B) proliferative C) secretory D) ischemic

ANS: B

Ch. 19 2. A client is diagnosed with peripartum cardiomyopathy (PPCM). Which therapy would the nurse expect to administer to the client? A) monoamine oxidase inhibitors B) methadone therapy C) restricted sodium intake D) ginger therapy

ANS: C

Ch. 14 8. A young woman is trying to get pregnant. She asks the nurse to recommend a practical way that she can tell the point in her monthly cycle when she will have the best odds of getting pregnant. Which recommendation by the nurse would be best? A) Have sex when the cervical mucus is thin, stretchy, and copious. B) Have sex when the cervical mucus is thick and scant. C) Have sex when fernlike patterns appear on a microscope slide of cervical mucus. D) Have sex immediately after menstruation has ended.

ANS: A

Ch. 15 15. A nurse is auscultating the chest of a client at 16 weeks' gestation. The nurse immediately notifies the health care provider about which finding? A) heart rate 25 bpm above baseline B) soft systolic murmur C) clear breath sounds D) symmetrical chest movement.

ANS: A

Ch. 15 18. The nurse has just informed a client that her pregnancy test is positive and she will need further assessment to determine the complete status of the situation. Which initial emotional response does the nurse expect the client to exhibit? A) ambivalence B) introversion C) acceptance D) emotional lability

ANS: A

Ch. 19 14. The nurse is assessing a pregnant client who has a long history of asthma. She states, "I'm trying not to use my asthma medications because I certainly don't want my baby exposed to them." What is the nurse's best response? A) "Actually, having uncontrolled asthma is much riskier for your baby than the medication." B) "In fact, most modern asthma medications are categorized as safe for use in pregnancy." C) "I'm glad to hear that you're focused on ensuring your baby's health." D) "Your health care provider will likely agree with your decision."

ANS: A

Ch. 19 15. A pregnant client with a history of asthma since childhood presents for a prenatal visit. What statement by the client would the nurse prioritize? A) "I sometimes get a bit wheezy." B) "I have trouble getting comfortable in bed." C) "I sometimes get a feeling of euphoria." D) "Certain substances make me sneeze."

ANS: A

Ch. 19 16. A nurse is teaching a prenatal client with class III heart failure the signs and symptoms which should be reported to the health care provider. The nurse determines the teaching has been effective when the client states which statement? A) "I will call the clinic when I have a cough at night." B) "I will avoid dental work and other invasive procedures." C) "I will call the clinic when I get shortness of breath after exercising." D) "I will take an antibiotic throughout my pregnancy."

ANS: A

Ch. 19 17. A nurse is assisting a client in active labor whose diabetes has been poorly controlled. Which assessment of the neonate should be prioritize after its birth? A) macrosomia B) hyperglycemia C) low birthweight D) hypobilirubinemia

ANS: A

Ch. 19 19. A woman with epilepsy who is taking phenytoin sodium has just learned that she is pregnant. When planning this woman's care, which intervention would the nurse most likely include? A) Teaching about vitamin K during the last 4 weeks of pregnancy B) Discontinuation of phenytoin sodium C) Addition of a second antiseizure medication D) Prepare for a cesarean delivery

ANS: A

Ch. 19 3. The generation-to-generation continuum of violence refers to the fact that: A) violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves. B) violence is an innate behavior, and children become abusers because of external factors in their environment more often than in their family. C) children who grow up in an abusive home are less likely to be abusers themselves because they see first hand the devastation that violence can cause. D) children who grow up in abusive homes almost always become abusers themselves unless they have professional intervention.

ANS: A

Ch. 19 6. A pregnant patient is diagnosed with hyperthyroidism. For which medication should the nurse prepare teaching for this patient? A) Methimazole B) Cephalosporin C) Levothyroxine D) Propylthiouracil

ANS: A

Ch. 19 9. A woman with systemic lupus erythematosus is interested in preconception counseling to discuss her desire to get pregnant. The nurse explains that it would be best if she is symptom-free or in remission for how long before getting pregnant? A) 6 months B) 3 months C) 9 months D) 12 months

ANS: A

Ch. 19 20. A nurse is conducting a class on the effects of nicotine during pregnancy. Which complications will the nurse include in the teaching? Select all that apply. A) Spontaneous abortion B) Placenta previa C) Preterm labor and birth D) Tubal ectopic pregnancy E) Spontaneous rupture of membranes

ANS: A, B, C, D, E

Ch. 14 16. A nurse is providing nutritional counseling to a pregnant woman and gives her suggestions about consuming foods that are high in folic acid. As part of the plan of care, the client is to keep a food diary that the client and nurse will review at the next visit. When reviewing the client's diary, which meals would indicate to the nurse that the client is increasing her intake of folic acid? Select all that apply. A) chicken breast with baked potato and broccoli B) cheeseburger with spinach and baked beans C) pork chop with mashed potatoes and green beans D) strawberry walnut salad with romaine lettuce E) fried chicken sandwich with mayonnaise and avocado

ANS: A, B, D

Ch. 14 9. A nurse is conducting a class for a group of teenage girls about female reproductive anatomy and physiology. Which structures would the nurse include as an external female reproductive organ? Select all that apply. A) mons pubis B) labia C) vagina D) clitoris E) uterus

ANS: A, B, D

Ch. 19 10. A nurse is assessing a newborn and suspects that the mother may have abused alcohol during her pregnancy. The nurse suspect this based on which newborn findings? Select all that apply. A) thin upper lip B) small head circumference C) macrocephaly D) limb abnormality E) large inset eyes

ANS: A, B, D

Ch. 14 18. A 24-year-old client who is planning to become pregnant comes to the clinic for an evaluation. When assessing the client, which finding would alert the nurse to implement measures to reduce the client's risk for problems during pregnancy? Select all that apply. A) drinks wine 3 to 4 times/week B) quit smoking 4 years ago C) follows a vegetarian diet D) hasaBMIof22 E) uses ibuprofen daily

ANS: A, E

Ch. 14 10. The nurse is developing a presentation for a community group of young adults discussing fetal development and pregnancy. The nurse would identify that the sex of offspring is determined at the time of: A) meiosis. B) fertilization. C) formation of morula. D) oogenesis.

ANS: B

Ch. 14 11. A nurse is describing the hormones involved in the menstrual cycle to a group of young adult women who are planning to get pregnant. The nurse determines the teaching was successful when the group identifies the follicle-stimulating hormone as being secreted by the: A) hypothalamus. B) anterior pituitary gland. C) ovaries. D) corpus lute.

ANS: B

Ch. 14 12. A nurse has been invited to be a guest speaker for a female high school health class about the menstrual cycle and reproduction. When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle? A) estrogen B) luteinizing hormone C) progesterone D) prolactin

ANS: B

Ch. 14 14. A woman comes to the prenatal clinic for an evaluation because she thinks that she may be pregnant. The nurse is assisting the health care provider with the vaginal examination. The exam reveals a vaginal mucosa and cervix that are bluish-purple in color. Based on this information, the nurse suspects that the client is most likely how many weeks pregnant? A) 5 weeks B) 6 weeks C) 14 weeks D) 16 weeks

ANS: B

Ch. 14 4. A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which possible effect would the nurse include? A) ankle edema B) urinary frequency C) backache D) hemorrhoids

ANS: B

Ch. 15 20. The nurse is assessing the latest laboratory results of a pregnant client who is at 17 weeks gestation. The nurse should prepare to teach the client about which possible defects after noting the maternal serum alpha-fetoprotein level is elevated above normal? A) fetal hypoxia B) open spinal defects C) Down syndrome D) maternal hypertension

ANS: B

Ch. 15 6. A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which component? A) excess folic acid, which could increase the risk for neural tube defects B) mercury, which could harm the developing fetus if eaten in large amounts C) lactose, which leads to abdominal discomfort, gas, and diarrhea D) low-quality protein that does not meet the woman's requirements

ANS: B

Ch. 15 9. When describing the structures involved in fetal circulation to a pregnant woman, the nurse describes which structure as the opening between the right and left atrium? A) ductus venosus B) foramen ovale C) ductus arteriosus D) umbilical artery

ANS: B

Ch. 19 1. You have just admitted a 32-year-old female in active labor to the delivery suite. During the admission assessment she says, "I am so afraid that my asthma will get out of control during labor and my baby will be harmed." Which response by the nurse would be most appropriate? A) "There is a good chance that that will happen." B) "Actually, asthma symptoms tend to diminish during labor." C) "Don't worry, we have a list of your medications and we can treat any problem that arises." D) "As long as you have your inhaler you will be fine."

ANS: B

Ch. 19 11. The nurse is assisting a pregnant client who has just underwent a nonstress test that was ruled reactive. Which factor will the nurse point out when questioned by the client about the results? A) There is no evidence of congenital anomalies or deformities B) The fetal heart rate increases with activity and indicates fetal well-being. C) The fetus is developing at a fast rate but doing fine. D) The results indicate a stress test is needed for further evaluation

ANS: B

Ch. 19 13. A woman calls the obstetrician's office to inquire how long she needs to wait to get pregnant following a seizure she had last week. The nurse would tell her to wait how long? A) She needs to wait 2 months after seizures are controlled before conceiving. B) It is recommended that she wait 6 months after seizures are under control before getting pregnant. C) Most doctors recommend that a woman wait 1 year following a seizure to get pregnant. D) There is no set time to wait before conceiving following a seizure.

ANS: B

Ch. 19 8. A nurse is caring for a pregnant client with asthma. Which intervention would the nurse perform first? A) monitoring temperature frequently B) assessing oxygen saturation C) monitoring frequency of headache D) assessing for feeling nauseated

ANS: B

Ch. 15 8. During a prenatal class for a group of new mothers, the nurse is describing the hormones produced by the placenta. Which of the following would the nurse include? Select all that apply. A) Prolactin B) Estriol C) Relaxin D) Progestin E) Human chorionic somatomammotropin

ANS: B, C, D, E

Ch. 19 7. The nurse determines that a fetal nonstress test is nonreactive for over 20 minutes. The nurse interprets this result as suggesting which situation? Select all that apply. A) The patient is sleeping. B) The patient is hypoglycemic. C) The patient is using an illicit drug. D) The patient is exercising too much. E) The patient is smoking while pregnant.

ANS: B, C, E

Ch. 14 19. Which actions by a graduate nurse on the postpartum unit would require the nurse manager to intervene? Select all that apply. A) Graduate nurse speaks to both mother and father about newborn care. B) Graduate nurse questions how a lesbian couple could have a baby together. C) Family members allowed to visit new mother and baby include half-siblings. D) Graduate nurse speaks to the surrogate mother about the care of the newborn. E) Graduate nurse assists single mother in completing birth certificate application. F) Graduate nurse acknowledges unmarried father of baby during postpartum care.

ANS: B, D

Ch. 15 10. A nurse is developing a teaching plan about nutrition for a group of pregnant women. Which recommendations would the nurse include in the discussion? Select all that apply. A) Keep weight gain to 15 lb (6.8 kg). B) Eat three meals with snacking. C) Limit the use of salt in cooking. D) Avoid using diuretics. E) Participate in physical activity.

ANS: B, D, E

Ch. 14 1. On the first prenatal visit, examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse documents this finding as: A) Hagar's sign. B) Goodall's sign. C) Chadwick's sign. D) Homans' sign.

ANS: C

Ch. 14 13. After teaching a group of adolescents about female reproductive anatomy, the nurse determines that the teaching was successful when the adolescents identify which structure as the site of fertilization? A) vagina B) uterus C) fallopian tubes D) vestibule

ANS: C

Ch. 14 6. After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first: A) sexual experience B) full hormonal cycle C) menstrual period D) sign of breast development

ANS: C

Ch. 15 1. Prenatal testing is used to assess for genetic risks and to identify genetic disorders. In explaining to a couple about an elevated alpha-fetoprotein screening test result, the nurse would discuss the need for: A) special care needed for a Down syndrome infant. B) a more specific determination of the acid-base status. C) further, more definitive evaluations to conclude anything. D) immediate termination of the pregnancy based on results.

ANS: C

Ch. 15 11. While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of a: A) multifactorial inheritance. B) X-linked recessive inheritance. C) trisomy numeric abnormality. D) chromosomal deletion.

ANS: C

Ch. 15 4. A pregnant woman in the 36th week of gestation reports that her feet are quite swollen at the end of the day. After careful assessment, the nurse determines that this is an expected finding at this stage of pregnancy. Which intervention is appropriate for the nurse to suggest? A) "Limit your intake of fluids." B) "Eliminate salt from your diet." C) "Try elevating your legs when you sit." D) "Wear spandex-type full-length pants."

ANS: C

Ch. 14 17. A pregnant woman asks the nurse, "I've heard that I should avoid eating certain types of fish. So what fish can I eat?" Which type of fish would the nurse recommend? Select all that apply. A) shark B) tilefish C) shrimp D) salmon E) catfish

ANS: C, D, E

Ch. 15 16. A nurse is reviewing the results of four clients who have undergone amniocentesis. Which client would the nurse recommend that the health care provider see first? A) client at 16 weeks' gestation with placenta previa and high alpha-fetoprotein level B) client at 34 weeks' gestation with gestational diabetes and L/S ratio of 2:1 C) client at 36 weeks' gestation with preeclampsia and amniotic fluid negative for bilirubin D) client at 38 weeks' gestation with fetal heart rate of 110 and green amniotic fluid sample

ANS: D

Ch. 15 17. A nurse assessing the laboratory results of a pregnant client in her second trimester notes that she has a hemoglobin level of 11 gm/dL. What will the nurse interpret this finding to most likely indicate? A) iron-deficiency anemia B) a multiple gestation pregnancy C) greater-than-expected weight gain D) hemodilution of pregnancy

ANS: D

Ch. 15 19. The nurse is teaching a pregnant woman with a prepregnancy body mass index (BMI) of 26 about recommended weight gain. The nurse determines that the teaching was successful when the woman states that she should gain approximately how much during her pregnancy? A) 35 to 40 pounds (16 to 18 kilograms) B) 25 to 35 pounds (11 toa16 kilograms)÷ C) 28 to 40 pounds (13 to 18 kilograms) D) 15 to 25 pounds (7 to 11 kilograms)

ANS: D

Ch. 15 2. When assessing a woman at follow-up prenatal visits, the nurse would anticipate which procedure to be performed? A) hemoglobin and hematocrit B) urine for culture C) fetal ultrasound D) fundal height measurement

ANS: D

Ch. 15 3. A nurse is assessing a pregnant woman in her last trimester. Which question would be most appropriate to use to gather information about weight gain and fluid retention? A) "What's your usual dietary intake for a typical week?" B) "What size maternity clothes are you wearing now?" C) "How puffy does your face look by the end of a day?" D) "How swollen do your ankles appear before you go to bed?

ANS: D

Ch. 15 5. When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which underlying reason for the effect would the nurse include? A) Pancreatic function is affected by pregnancy. B) Glucose is utilized more rapidly during a pregnancy. C) The pregnant woman increases herdietary intake. D) Glucose moves through the placenta to assist the fetus.

ANS: D

Ch. 19 12. A 17-year-old primigravida at 37 weeks' gestation has been unable to maintain adequate control of her blood glucose throughout her pregnancy. The nurse should prioritize which action after the health care provider suspects the infant has macrosomia based on the recent ultrasound? A) Schedule induction of labor today. B) Allow her to continue without plans for delivery. C) Schedule cesarean delivery at 39 weeks. D) Prepare for assessment of fetal lung maturity.

ANS: D