OB practice questions

why is adolescence moms at risk for poor outcomes?

They are more focused on themselves and unable to picture themselves in a role as theyre not developmental ready

what is the purpose of folic acid during pregnancy?

prevents neural tube defects

What is the fourth stage of labor?

From delivery of placenta through 1-2 hours after birth •Monitor position and firmness of the uterus •"boggy" •Report immediately •Initiate fundal massage

During a prenatal education class, the educator discussed the types of environmental substances that can negatively impact pregnancy. Which statement from one of her clients would concern the nurse? 1. "Exposure to substance abuse drugs in not good for the pregnancy." 2. "Exposure to air and environmental pollutants is harmful to the fetus." 3. "Exposure to alcohol use causes harm to the fetus." 4. "It is ok to use marijuana for pain."

"It is ok to use marijuana for pain." Marijuana can cause detrimental effects to the fetus, such as disruption in brain development.

What is the second stage of labor?

Full dilation through birth if an infant

what is Naegele's rule? what is it for?

-3 months +7 days EDD from the first day of LMP

who does a female see when they have a history of infertility?

-OB

What does the nurse check the breast for?

-Shape •Engorgement

who does a male see when they have a history of infertility

-Urologist who checks sperm count, underwear type

Which umbilical blood vessels carry oxygenated blood from the placenta to the fetus? 1. One umbilical vein 2. One umbilical artery 3. Two umbilical arteries 4. Two umbilical veins

1. One umbilical vein There is one umbilical vein in the umbilical cord that carries oxygenated blood from the placenta to the fetus.

The nurse is providing postpartum care to a pt 24 hrs after vaginal delivery. Which action does the nurse perform prior to assessing the pts uterus? A. Place the pt on the left side B. Assess the passage of lochia C. Ask the pt to void D. Administer a dose of oxytocin

C. An overdistended bladder can result in unterine displacement and atony

The nurse is providing care for a new mother durng a follow up 6 week after vaginal delivery. The mother begins to cry and reports difficulity with eating and sleeping. The nurse identifies post partum blues and cites which reason as the most likely cause? A. Fatigue related to "fussy" baby B. Frustration over physical appearance C. Changes in hormonal levels D. Stress r/t new mother role

C. Most likely cause is change in hormone levels

The nurse is palpating the pts uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis? A. To prevent uterine prolapse B. To prevent uterine movement C. To prevent uterine hemmorrhage D. To prevent uterine inversion

D. Pregnancy stretches the ligaments that hold the uterus in place, and fundal pressure could result in uterine inversion

On day 4 following the birth of an average size baby, the nurse would expect the fundus to be at: A. 1cm below umbilicus B. 2cm below umbilicus C. 3 cm below umbilicus D. 4 cm below umbilicus

D. The uterus on average descents 1 cm per day

Why is it important for the nurse to check for a humans sign?

Determine the edema present and if it's positive for early interventions

What is the nurses role for emotional status and bonding with mom and baby?

Education

Positive signs of pregnancy

Fetal heartbeat •Fetal movements palpated by the examiner •Visualization of the fetus

What does the nurse check the bowel movements for?

Last BM •Constipation prevention teachin

Probable signs of pregnancy

Positive pregnancy test •Abdominal enlargement •Piskacek's, Hegar's, Goodell's, and Chadwick's signs •Braxton Hicks Contractions, Ballottement

What does the nurse check the bladder for?

Tender or distended

Why is biodiversity important?

Why is biodiversity important?

a patient is experiencing pregnancy complications which factors will affect the client's ability to manage this situation? (select all that apply) a) current health status b) perceived threat to self or fetus c) previously used coping skills d) assistant of a support network e) implementing nursing interventions

a) current health status b) perceived threat to self or fetus c) previously used coping skills d) assistant of a support network e) implementing nursing interventions

a pregnant patient tells the nurse that her spouse has been diagnosed with covade syndrome, which manifestations does the nurse suspect the spouse is experiencing (select all that apply) a) nausea from unidentified causes b) physical rejection from sexual advances c) significant weight gain d) unexplained abdominal pain e) self imposes social isolation

a) nausea from unidentified causes c) significant weight gain d) unexplained abdominal pain

16. Compared with contraction stress test (CST), nonstress test (NST) for antepartum fetal assessment: a. Has no known contraindications. b. Has fewer false-positive results. c. Is more sensitive in detecting fetal compromise. d. Is slightly more expensive.

a. Has no known contraindications.

embryonic development at week 6

all organs are developed

the nurse is providing care for a 45-year-old patient and has just learned shes in the second trimester of her pregnancy the patient throught she was experiencing manifestations of menopause until she recognized fetal movement. which tests does the nurse expect to be prescribed for this patient a) ultrasound b) amniocentesis c) fetal movement d) chronic villa sampling

b) amniocentesis test which is performed between 15-20 weeks for the detection of genetic testing in mothers over the age of 35 years old.

an adolescent patinet who is 15 weeks pregnant refuses to have the AFP test because "I dint like needles" what does the nurse do to achieve testing? a) insist the testing will be done with or without her cooperation b) explain that it is important in detecting birth defects c) ask a family member to help persuade the patients d) notify the healthcare provider of the refusal

b) explain that it is important in detecting birth defects

a mother has a child who is 4 years old and expecting another child the mother expresses concerns to the nurse about how the older sibling will receive the news. Which intervention shared by the mother should the nurse discourage? a) i plan to let him hear the heartbeat at the next prenatal visit b) i think that i will just bring the new baby home as a surprise c) i have arranged a class at the hospital to get him use to it d) i will let him pick out a gift for the baby

b) i think that i will just bring the new baby home as a surprise

the nurse works in a prenatal clinic and interacts with multiple patients with a variety of socioeconomic backgrounds, which the patient does the nurse asses most carefully for mental health issues? a) women who chooses single parenthood b) military veteran who has been deployed twice c) pregnant partner of a lesbian relationship d) mother is multigenerational with triplets

b) military veteran who has been deployed twice higher risk for having PTSD and problems with relationships afterward

a couple is planning for the birth of their first child and discussing the difference between a physician and a midwife. Which information presented by the couple does the nurse validate as being true? a) midwives are commonly self taught without formal training b) physicians provide care for both low and high-risk patients c) midwives primarily delivery babies in the home setting d) physicians rely on the use of technological procedures for birth

b) physicians provide care for both low and high-risk patients

the nurse is counseling a couple in the third trimester of pregnancy and recommend that the couple attend childbirth education classes for which reason is the nurse least likely yot recommend the class a) the classes will affirm the normalities of birth b) the techniques will allow for a medication-free delivery c) the classes acknowledge the womens ability to give birth d) the classes explore ways to find strength and comfort during labor

b) the techniques will allow for a medication-free delivery

4. A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would yield more detailed information about the fetus? a. Ultrasound for fetal anomalies b. Biophysical profile (BPP) c. Maternal serum alpha-fetoprotein (MSAFP) screening d. Percutaneous umbilical blood sampling (PUBS)

b. Biophysical profile (BPP)

folic acid is best started when?

before pregnancy

17. The nurse providing care for the antepartum woman should understand that contraction stress test (CST): a. Sometimes uses vibroacoustic stimulation. b. Is an invasive test; however, contractions are stimulated. c. Is considered negative if no late decelerations are observed with the contractions. d. Is more effective than nonstress test (NST) if the membranes have already been ruptured.

c. Is considered negative if no late decelerations are observed with the contractions.

what does the amniotic fluid provide to the baby?

cushion, warmth, support, sterile

a patient is in the second trimester of pregnancy and is scheduled for a dopple flow study because the healthcare provider is concerned about assessment findings during a routine prenatal visit what finding does the nurse suspect during the visit? a) fetal movement count less than 8 per hour b) no weight gain in two weeks to patient c) patinet has mild low extremity edmna d) fetal growth is below expectation for gestational age

d) fetal growth is below expectation for gestational age

the pregnant patient and her spouse live in the same home of the spouse's family who is not supportive of the pregnancy. The patient feels the family is running the happiness of the pregnancy. Which is the most important determination for the nurse to make? a) what the potential for improving the potential support network is b) who will provide the patient with the greatest amount of support c) whether the couples finances support a new baby t move to a separate location d) if threats or actual abuse from household members occur towards the patient

d) if threats or actual abuse from household members occur towards the patient

the nurse is providing prenatal care for a patient who is pregnant with a second child. which understanding about the complexity of a second pregnancy does the nurse us to assist the patient with accepting of this pregnancy a)point out that financial obligation is always less with a second child b)make suggest how the first child will be like a helper to the new baby c)recommendn career decision based on additional parental tasks d) offer strategies to work out new relationships with the first child

d) offer strategies to work out new relationships with the first child help with remodeling and feelings associated with the second child

the nurse is assisting a patinet who is pregnant and preparing for an MRI to access fetal brain development which situation causes the nurse to notify the radiology personnel? a) the patinet has breakfast before the test b) the patient has an iodine allergy c) the patient express concerns about the pain d) the patient a permanent body piercing

d) the patient a permanent body piercing

a patinet has experienced an uneventful pregnancy but begins to have vagina spotting at 38 weeks and a healthcare provider suggest placenta Previa initiated by cervical thinning. which testing by the nurse does the suspect the healthcare provider to schedule a) MRI b) Doppler c) nonstress test d) ultrasound

d) ultrasound identifies the placenta location

1. A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to having used cocaine "several times" during the past year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the woman in a high risk category? a. Blood pressure, age, BMI b. Drug/alcohol use, age, family history c. Family history, blood pressure, BMI d. Family history, BMI, drug/alcohol abuse

d. Family history, BMI, drug/alcohol abuse

25. The nurse recognizes that a nonstress test (NST) in which two or more fetal heart rate (FHR) accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period is: a. Nonreactive b. Positive c. Negative d. Reactive

d. Reactive

is it okay for a couple to have sex during pregnancy?

yes as it can be important as long as the female is comfortable and the male is okay with it. Nonsexual expression is important as well

What does the nurse check the lochia for?

•Amount •Odor •Color •Clots

What does BUBBLE HE stand for in the postpartum assessment?

•Breasts •Uterus •Bladder •Bowels •Lochia •Episiotomy •Homan's sign •Emotions

What does the nurse check the uterus for?

•Firm or Boggy •Position

What does GTPAL stand for?

•G- total number of pregnancies •T- full term pregnancies (37-40 weeks) •P- preterm deliveries (20-36 weeks) •A- Abortions- both spontaneous and induced •L- Living- number of living children

A 36 year old female is currently 29 weeks pregnant. She had a miscarriage at 12 weeks gestation five years ago. She has a three year old who was born at 38 weeks? What is her GTPAL

•G-3 •T-1 •P-0 •A-1 •L-1

What are the three parts to first time labor?

•Latent phase (0-3 cm) •Active phase (4-7 cm) •Transition (8-10cm)

why is genetic and genomic medicine important?

-allows for early detection -risk factors identified -early treatment

What's the EDD for 12-28-18?

10-4-19

What's the EDD for 1-1-19?

10-8-19

What are the common teratogens?

Alcohol, cigarettes and illicit drugs, high/low vitamins, some prescription drugs, and viruses

Negele's Rule helps calculate what? A. Date of LMP B. EDD C. GTPAL D. Multiple births

B. EDD Based upon first day of last menstrual period

12. In the first trimester, ultrasonography can be used to gain information on: a. Amniotic fluid volume. b. Location of Gestational sacs c. Placental location and maturity. d. Cervical length.

b. Location of Gestational sacs

how is the baby nourished while in the womb?

placenta that provides nutrition

embryonic development at week 3

heart beat

What is polyhydramnios associated with?

high 1500 ml or more

what happens to maternal blood when pregnant?

-fluid volume increases -cardiac output increases

A male partner was evaluated by a urologist and was asked to do a semen analysis. Which instruction should the nurse give to the couple? Select all that apply. 1. A urine sample can be collected at home to identify the ideal time for intercourse. 2. The specimen should be brought to the site within an hour of collection. 3. Abstain from sex for 2-3 days before providing a masturbated sample of semen. 4. Measure the temperature before getting out of bed in the mornings. 5. Several semen analyses may be required.

. 2. The specimen should be brought to the site within an hour of collection. 3. Abstain from sex for 2-3 days before providing a masturbated sample of semen. 5. Several semen analyses may be required. "The specimen should be brought to the site within an hour of collection" is a key instruction that should be given to the couple. Abstaining from sex for 2 to 3 days before providing a masturbated sample of semen is a key instruction that should be given to the couple. "Several semen analyses may be required" is a key instruction that should be given to the couple.

What suggestions does the nurse give the mother to keep that baby safe regarding cold stress after discharge? ALL THAT APPLY A. Keep the baby wrapped in a warm blanket B. Perform daily bath in a warm location C. Position baby away from the vents and drafts D. Place a stocking cap on the neonates head E change wet clothing immediatly

1,3,4,5, Babies do not need daily baths. undressing and bathing will cause heat loss d/t evaporation

A woman who is being prepped for preimplantation testing worries because she is unsure of what the procedure entails. Which statement by the nurse best describes preimplantation testing? 1. "A cell from the developing fetus will be removed for genetic testing prior to the transferring of the in-vitro embryo into your uterus." 2. "Both you and your partner will be tested to identify who carries one copy of a gene mutation." 3. "Screening will be done to detect genetic disorders that can be treated early in life." 4. "This test allows for the early detection of genetic disorders, such as hemophilia."

1. "A cell from the developing fetus will be removed for genetic testing prior to the transferring of the in-vitro embryo into your uterus." Preimplantation testing detects genetic changes in embryos that were created using assisted reproductive techniques.

When assessing the newborn, the nurse notes two vessels in the umbilical cord. What should the nurse do next? 1. Call the pediatrician. 2. Start an IV on the infant. 3. Check the infant's pulse oximetry. 4. Listen to the infant's heart sounds.

1. Call the pediatrician. Due to the risk of cardiovascular disease, calling the pediatrician is important in order to let the doctor know what is going on.

A newly pregnant client is seen in the clinic for her first prenatal appointment. She states she has a family history of an autosomal recessive disease. Which disease has an autosomal recessive pattern of inheritance? select all that apply 1. Cystic fibrosis 2. Hemophilia 3. Huntington's disease 4. Sickle-cell anemia 5. Tay-Sachs disease

1. Cystic fibrosis 4. Sickle-cell anemia Cystic fibrosis has an autosomal recessive pattern of inheritance. Sickle-cell anemia has an autosomal recessive pattern of inheritance.

In genetic testing, which role would the nurse question performing? 1. Diagnosing a fetus with a genetic disorder 2. Identifying at-risk clients and families 3. Providing emotional support for the client and family 4. Providing a referral to support groups and genetic counseling services

1. Diagnosing a fetus with a genetic disorder Diagnosis of a disorder comes through genetic testing ordered by a provider or genetic counselor.

In preparing a client for endometrial biopsy, the nurse stated that this procedure is usually performed at the end of the menstrual cycle. Which is the indication for doing this procedure during this time? 1. To assess the response of the uterus to hormonal signals that occur during the cycle 2. To detect a rapid increase in the luteinizing hormone 36 hours before ovulation 3. To detect tubal adhesions, fibroids, and uterine fistulas 4. To determine the size of the remaining egg reserve

1. To assess the response of the uterus to hormonal signals that occur during the cycle Endometrial biopsy is done to assess the response of the uterus to hormonal signals that occur during the cycle.

The nurse is teaching the new pregnant mother about the placenta and its many roles in fetal development. Which statements show an understanding of the hormones the placenta produces? Select all that apply. 1. "Progesterone is the hormone that makes you feel bloated." 2. "Testosterone is produced only if you are having a boy." 3. "Human chorionic gonadotropin doubles or triples the longer you are pregnant." 4. "Human placental lactogen helps in the production of breast milk." 5. "Estrogen is the reason for my pregnancy glow."

1. "Progesterone is the hormone that makes you feel bloated." 4. "Human placental lactogen helps in the production of breast milk." This hormone is produced by the placenta.

The nurse is reviewing antenatal screening and diagnostic testing with a group of nursing students. The nurse explains that this test inserts a needle into the maternal abdominal area through the uterine cavity to obtain amniotic fluid. One of the student's best response is: 1. Amniocentesis 2. Percutaneous biopsy 3. Percutaneous umbilical cord sampling 4. Chorionic villus sampling (CVS)

1. Amniocentesis Amniocentesis is done by inserting a needle intra-abdominally into the uterine cavity using ultrasound to guide the needle placement. The fluid is used to test for chromosomal defects, genetic disorders, including neural tube defects, fetal lung maturity, and hemolytic disease in the fetus or intrauterine infection.

Which response would the prenatal nurse expect for a client who recently learned the fetus has a potentially fatal cardiac defect? (select all that apply) 1. Feelings of powerlessness 2. Sense of loss 3. Distancing herself emotionally from the fetus 4. Increased anxiety and fear 5. Requesting termination of the pregnancy

1. Feelings of powerlessness 2. Sense of loss 3. Distancing herself emotionally from the fetus 4. Increased anxiety and fear Disequilibrium, feelings of powerlessness, increased anxiety and fear, and a sense of loss are all responses to the news of a pregnancy complication. he woman may distance herself emotionally from the fetus as she faces uncertainty about the pregnant.

A neonate was admitted shortly after birth with a history of the mother who consumed at least six alcoholic beverages per day during pregnancy. For which feature of fetal alcohol syndrome should the nurse expect to assess? Select all that apply. 1. Microcephaly 2. Cardiac defects 3. Cerebral infarction 4. Neural tubal defects 5. Unusual facial features

1. Microcephaly 2. Cardiac defects Microcephaly is a characteristic of fetal alcohol syndrome. Cardiac defects are characteristics of fetal alcohol syndrome.

A clinic nurse is caring for a primiparous client. Which nursing actions are recommended to improve social support during pregnancy? Select all that apply. 1. Provide opportunities for the woman to ask for support. 2. Provide information on mommy groups. 3. Suggest church, health clubs, and electronic resources as sites to meet other women. 4. Provide access to the Centering Pregnancy model of care. 5. Invite family members to attend prenatal and postpartum visits.

1. Provide opportunities for the woman to ask for support. 2. Provide information on mommy groups. 3. Suggest church, health clubs, and electronic resources as sites to meet other women. Women should have opportunities to ask for support. The nurse should rehearse appropriate language to use when asking for support. The nurse should provide information regarding community resources, such as mommy groups and online resources. Health clubs, churches, and electronic resources are areas for women to meet other women with similar interests.

The nurse is caring for a 30 weeks gestational client on the antepartum unit. In the client's discharge plan of care, the nurse should include which instructions on daily fetal movement count? Select all that apply. 1. The woman must lie on her side while counting movements. 2. If fetal movement is decreased, inform the client to eat and drink some fluids, rest, and focus on fetal movement for an hour. 3. The client must increase her caffeine intake to initiate fetal movements. 4. Inform the client to report decreased fetal movements below the normal. 5. The client must only begin her fetal count in the morning

1. The woman must lie on her side while counting movements. 2. If fetal movement is decreased, inform the client to eat and drink some fluids, rest, and focus on fetal movement for an hour. 4. Inform the client to report decreased fetal movements below the normal. Side position increase placental perfusion. Four fetal movements or more in an hour is considered reassuring. Fetal kick counts of 10 within two hours is considered normal. Kick counts of four or more within one hour is normal. Anything less is an indication for follow up and further assessment by the health care provider.

A couple visited the clinic and wanted to know their likelihood of conceiving a child with a genetic disorder. Which risk factor, identified by the nurse, is correct? Select all that apply. 1. Their first child was born with a genetic disorder. 2. There is a family history of genetic disorders. 3. Both partners are younger than 35 years old. 4. The woman is older than 35 years old. 5. Both parents have a genetic disorder.

1. Their first child was born with a genetic disorder. 2. There is a family history of genetic disorders. 4. The woman is older than 35 years old. 5. Both parents have a genetic disorder. A previous pregnancy that resulted in a genetic disorder puts the couple at risk of having a baby with a genetic disorder. Family history of genetic disorder passes on the genes to the parents. Women who are older than 35 years old are at a greater risk of having a baby with a genetic disorder. If both parents have a genetic disorder, there is a greater risk of conceiving a child with a genetic disorder.

The nursing student asks the nurse about tests that are commonly performed for a suspected brain abnormality. How would the nurse respond? 1. Nonstress test 2. Magnetic resonance imaging 3. Amniocentesis 4. Doppler Velocimetry

2. Magnetic resonance imaging This is the correct response. A test used to visualize detailed images of the maternal and/or fetal structures, and most commonly used for suspected brain anomalies.

A couple visiting the clinic voiced their concern that their unborn baby might have Trisomy 21 at birth. Which test would the nurse recommend for this couple? 1. Carrier testing 2. Prenatal testing 3. Newborn screening 4. Preimplantation testing

2. Prenatal testing Prenatal testing allows for the early detection of genetic disorders such as Trisomy 21.

The nurse is reviewing the biophysical profile (BPP) results and would expect which variables to be included in this test? Select all that apply. 1. Fetal position 2. Fetal tone 3. Amniotic fluid volume 4. Fetal breathing movements 5. Fetal movement

2. Fetal tone 3. Amniotic fluid volume 5. Fetal movement One or more extremity extension with return to fetal flexion or opening and closing of the hand is expected within 30 minutes. A pocket of amniotic fluid that measures at least 2 cm in two planes perpendicular to each other is expected. Three or more discrete body or limb movements in 30 minutes are expected.

The woman who gave birth to 2nd child informs the nurse that she is bleeding more than her previous birth experience. The initial nursing action is to: A. Explain that this is normal for 2nd time moms B. Assess the location and firmness of the fundus C. Change her pad and return in 1 hr and reassess D. Give her 10 Units of oxytocin as per standing order

B. Assess uterine atony or displaces uterus from full bladder

A pregnant mother in her third trimester is scheduled for an amniotic fluid index (AFI) test. The nurse understands the reason for the test when she verbalizes which statement? 1. "The test is a screening tool that assesses fetal accelerations." 2. "The test evaluates the uterine and cervical structures of the pregnancy." 3. "The test is a screening tool that measures the volume of amniotic fluid with ultrasound." 4. "The test uses a needle to puncture the abdomen to obtain amniotic fluid."

3. "The test is a screening tool that measures the volume of amniotic fluid with ultrasound." This test helps to assess the fetal well-being and placental function by measuring the pockets of amniotic volume in four quadrants of the uterine cavity via ultrasound.

The nurse is caring for a pregnant adolescent client during a prenatal visit. Which nursing action is a priority for this client? 1. Offer advice on smoking cessation. 2. Give the client information about adoption. 3. Assess for bruises in different stages of healing. 4. Determine what type of birth control the client plans to use after she gives birth.

3. Assess for bruises in different stages of healing. Pregnant adolescents are four to six times more likely to experience violence in a dating relationship. Bruises at different stages of healing is a potential sign of physical abuse.

The nurse is caring for an 18 weeks gestation client who recently had an amniocentesis procedure. The client informed the nurse that she feels her underwear is wet. Which would be the nurse's first action? 1. Call the physician 2. Measure the client's vital signs 3. Assess the perineal area 4. Administer IV fluids

3. Assess the perineal area One of the risks for this procedure is rupturing of the amniotic membrane. It is important that the nurse assess the client first to determine if any fluid is present and whether it is amniotic fluid or urine.

A male partner was diagnosed with infertility and a determination is to be made as to which treatment is best. Which nursing assessment is an indication for a surgical intervention to treat his condition? 1. Over production of sperm antibodies 2. Infections of the genitourinary tract 3. Inguinal hernia 4. Poor nutrition

3. Inguinal hernia Surgical intervention is used to correct an inguinal hernia.

The treatment of infertility depends on the cause. For what reason would surgery be an indication for a male who is infertile? 1. Abnormal sperm counts due to lifestyle practices 2. Hormonal imbalance due to endocrine factors 3. Inguinal hernia due to poor lifting techniques 4. Varicocele caused by straining to pass feces 5. Overproduction of sperm antibodies

3. Inguinal hernia due to poor lifting techniques Inguinal hernia repair will help to facilitate sperm transport.

The maternal serum alpha-fetoprotein (MSAFP) is a screening tool for certain developmental defects in the fetus. The client wants to know at what time in her gestational period the test should be performed. which is the nurse's best response? 1. "The test should be scheduled in the first trimester of the pregnancy." 2. "The test should be scheduled in the last trimester of the pregnancy." 3. "The test should be scheduled between 15-20 weeks' gestation." 4. "The test is scheduled between 30-34 weeks' gestation."

3."The test should be scheduled between 15-20 weeks' gestation." This is the appropriate timing of testing. 80 to 85% of all open neural tube defects and abdominal wall defects, and 90% of anencephalies, can be detected at this time in pregnancy.

pregnant client presents to the clinic after a prenatal test detected that her baby boy had a Y-linked inheritance disorder. The client indicates an understanding of Y-linked inheritance disorder when she makes which statement? 1. "Both my partner and I carry this trait and passed it along to our baby." 2. "I am a carrier, so I passed this disease to my baby." 3. "I understand that I also present with this trait and need to be tested." 4. "This disease was passed from my male partner to my baby."

4. "This disease was passed from my male partner to my baby." Y-linked inheritance is a sex-linked inheritance that is located on the Y-chromosome. As a result, the disease can only be passed from father to son.

The nurse is caring for a pregnant client and knows that this test is done for chromosomal analysis between 10-12 weeks' gestation to detect fetal anomalies caused by genetic disorders. It does not test for neural tube defects (NTDs). The nurse identified the following test as: 1. Amniocentesis 2. Triple marker screening 3. Percutaneous umbilical cord sampling 4. Chorionic villus sampling (CVS)

4. Chorionic villus sampling (CVS) This CVS procedure is for chromosomal, metabolic and DNA testing. It does not test for neural tube defects. A small sample of placental tissue is obtained via a catheter transvaginally or abdominally using a needle.

The nonstress test (NST) uses electronic fetal monitoring (EFM) to assess fetal well-being. A nursing caring for a 32 weeks' gestational client on EFM will place the client in the following position: 1. High-fowler 2. Prone 3. Lithotomy 4. Semi-Fowler's or lateral

4. Semi-Fowler's or lateral This is the correct response. The client is placed in either of these positions to avoid the compression of the inferior vena cava, thus improving blood flow.

. A client reported that her menstrual period started 14 days ago and she is unsure of when ovulation will be taking place. Based on the client's history, the nurse notes that the client is ovulating. Which activity does the nurse expect to be happening with this client at this time? Select all that apply. 1. She is unable to get pregnant. 2. The endometrial tissue is about to be sloughed off. 3. The empty Graafian follicles morph to form the corpus luteum. 4. The client's estrogen levels will peak and decrease with the release of the oocyte. 5. Before the surge of luteinizing hormone estrogen levels decrease and progesterone levels increase.

4. The client's estrogen levels will peak and decrease with the release of the oocyte. 5. Before the surge of luteinizing hormone estrogen levels decrease and progesterone levels increase. The client's estrogen levels will peak and decrease with the release of the oocyte during the ovulatory phase. Before the surge of luteinizing hormone, estrogen levels decrease and progesterone levels increase during the ovulatory phase.

A client is asking for a Clomiphene (Clomid) prescription for infertility because she heard "it works." Which would the nurse evaluate before suggesting medication for infertility? 1. Has she and her partner had hormone testing? 2. Does she have a history of uterine fibroids? 3. Has she had surgery to clear her fallopian tubes? 4. How long has the couple been trying to conceive?

4. How long has the couple been trying to conceive? This is a question to ask first before invasive testing and an evaluation of infertility.

The multiparous pt reports severe uterine cramps the first day after a vaginal delivery. The nurse is aware the pt is breastfeeding and assciates the pts pain primarily with which occurrence? A. An increase in oxytocin released to the newborn suckling B. The presence of intense afterbirth pains related to multiparity C. An expected response to the daily administration of oxytocin D. The efforts of the uterus to return to a prepregnancy condition

A. Although pains can be related to multiparity, in this situation the nurse recognizes that the pains are assoc with the release of oxytocin

Prenatal classes provide the couple with: A. Knowledge and confidence B. Mental health counseling C. Nursing-level knowledge D. A birth plan

A. Knowledge and confidence Prenatal classes empower the couple to know, understand, and plan for pregnancy. They gain skills to create their own birth plan and seek resources, if needed.

The multiple marker screenings identify: A. Neural tube defects B. Cerebral palsy C. Hemolytic diseases D. Cleft palate

A. Neural tube defects Multiple marker screenings can identify most open neural tube defects. They also identify Down syndrome.

Does a pregnant test depict ________ sigh of pregnancy A. Probable B. Presumptive C. Positive

A. Probable

Prior to the patient undergoing amniocentesis, the most appropriate nursing intervention is to: A: administer RhoD immunoglobulin. B. send the patient for a computed tomography (CT) scan before the procedure. C. assure the mother that short-term radiation exposure is not harmful to the fetus. D. administer anticoagulant.

A: administer RhoD immunoglobulin. Because of the possibility of fetomaternal hemorrhage, administering RhoD immunoglobulin to the woman who is Rh negative is standard practice after an amniocentesis. Anticoagulants are not administered before amniocentesis as this would increase the risk of bleeding when the needle is inserted transabdominally. A CT is not required before amniocentesis, because the procedure is ultrasound guided. The mother is not exposed to radiation during amniocentesis.

the nurse in encouraging cultural sensitivity among non-medical personnel in a prenatal clinic which type of family does the nurse identify as including children (select all that apply) a) nuclear b) extended c) cohabitating d) diad e) blended

a) nuclear b) extended c) cohabitating e) blended

21. A pregnant woman's biophysical profile score is 8. She asks the nurse to explain the results. The nurse's best response is: a. "The test results are within normal limits." b. "Immediate delivery by cesarean birth is being considered." c. "Further testing will be performed to determine the meaning of this score." d. "An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding delivery."

a. "The test results are within normal limits."

23. While working with the pregnant woman in her first trimester, the nurse is aware that chorionic villus sampling (CVS) can be performed during pregnancy at: a. 4 weeks b. 8 weeks c. 10 weeks d. 14 weeks

c. 10 weeks

11. In comparing the abdominal and transvaginal methods of ultrasound examination, nurses should explain to their clients that: a. Both require the woman to have a full bladder. b. The abdominal examination is more useful in the first trimester. c. Initially the transvaginal examination can be painful. d. The transvaginal examination allows pelvic anatomy to be evaluated in greater detail.

d. The transvaginal examination allows pelvic anatomy to be evaluated in greater detail.

The nurse in a postpartum unit frequently teaches pts regarding breast care. Which teaching is most helpful to the breastfeeding pt. A. Run warm water over breasts while in the shower B. Wear a supportive bra 24 hrs a day C. Express milk by a breast pump or manually D. Take analgesics for brease pain mgmt.

C. This will help relieve breast engorgement

what testing is done with increased materal age associated with pregnancy?

-genetic studies for chromosomal abnormalities

what does the nurse do when somone decides to have an abortion?

-nurse supports decison and educates them will full information needed

what are some reasons to do genetic testing?

-older maternal age -family history -ethnicities at higher risk -previous history loss

A pregnant client tells the nurse she is concerned about how her older child will react to the birth of the new baby. Which would be the most therapeutic response by the nurse? 1. "Sharing the spotlight with a new sibling can be a major crisis for a child. How old is your other child?" 2. "All pregnant women feel this way when there is another child involved. It is a normal." 3. "Children younger than 2 are usually aware of the pregnancy." 4. "Would you like me to refer you to a family counselor so you can discuss your concerns?"

1. "Sharing the spotlight with a new sibling can be a major crisis for a child. How old is your other child?" The reaction of the other child will depend on their age. The nurse must know how old the other child is so she can better assist the woman.

client, 12 weeks' gestational age, is scheduled for a diagnostic ultrasound test to detect ectopic pregnancy and evaluate uterine structures. The nurse anticipates that the client will need: 1. A full bladder for the test 2. Pain medications prior to the test 3. To empty her bladder before the procedure 4. To elevate her legs for the test

1. A full bladder for the test This is the correct response. An abdominal ultrasound is scheduled in the first trimester to detect missed abortion, ectopic pregnancy, evaluate uterine structures, confirm intrauterine pregnancy, and estimate gestational age. This procedure will require a full bladder for better visualization.

During which day of a typical 28-day menstrual cycle does the follicular phase occur? 1. Cycle days 1 to 13 2. Cycle days 15 to 28 3. Cycle day 14 4. Cycle day 1 to 5

1. Cycle days 1 to 13 The follicular phase is the phase when follicles in the ovary mature. It ends with ovulation. The main hormone controlling this stage is estradiol. The follicular phase begins on the first day of menstruation and ends with ovulation.

What's a normal fetal heart beat rate?

110-160 beats/minute

The nurse on the antepartum unit is caring for a client post chorionic villus sampling procedure. Which would the nurse's priority intervention be? 1. Provide 2L of fluids during the shift. 2. Assess the fetal heart rate (FHR). 3. Administer RhoGAM. 4. Administer oxygen 2L via nasal cannula.

2. Assess the fetal heart rate (FHR). This is a priority. The nurse must assess the fetal heart rate to ensure fetal status. It is auscultated twice in 30 minutes.

A couple was scheduled for an artificial insemination procedure. Which fertility condition does the nurse expect to find documented in the couple's medical record as a reason for needing this procedure? 1. Unexplained infertility 2. Diminished sperm motility 3. Bilaterally blocked fallopian tubes 4. Unsuccessful vasectomy reversal

2. Diminished sperm motility Artificial insemination is done when there is diminished sperm motility.

The nurse is performing an assessment for a client with a high-risk pregnancy. Which screening tool is most important for this client? 1. Fetal Fibronectin Test (fFN) 2. Edinburgh Postnatal Depression Scale 3. DSM-IV 4. Vanderbilt Diagnostic Rating Scale

2. Edinburgh Postnatal Depression Scale Women with high-risk pregnancies have an increased risk for developing postpartum depression and anxiety.

A nurse is caring for a Filipino woman in her third trimester. Which information is most helpful in providing culturally responsive care? 1. Only Western cultures recognize childbirth as a time of great celebration. 2. Every culture has a set of behaviors, beliefs, and practices that influence a woman during childbearing. 3. The woman has most likely incorporated the practices of American culture into her way of life. 4. Childbirth practices are similar among all cultures.

2. Every culture has a set of behaviors, beliefs, and practices that influence a woman during childbearing. Every culture has a set of behaviors, beliefs, and practices that influence women and their families profoundly during childbearing.

During a health assessment, a client was asked to state her last menstrual period. She replied, "This is my second day of having my menstrual flow." Which phase of the ovarian cycle would the nurse determine the client is in currently? 1. Luteal phase 2. Follicular phase 3. Proliferative phase 4. Ovulatory phase

2. Follicular phase The follicular phase begins the first day of menstruation and lasts 12 to 14 days.

The nurse is caring for a 38 weeks gestational client who is scheduled for a contraction stress test (CST). Which would the nurse do to prepare the client? 1. Inform the client to remove all her jewelry. 2. Have the client void before the test. 3. Position the client in the prone position. 4. Perform a fundus measurement.

2. Have the client void before the test. Having the client void will promote comfort for the client and the test can be successfully performed.

. A pregnant client in her second trimester is in the provider's office for an ultrasound. Her provider finds that the fetus has a congenital heart defect. Which condition is the client at risk for during pregnancy? Select all that apply. 1. Oligohydramnios 2. Polyhydramnios 3. One-vessel umbilical cord 4. Two-vessel umbilical cord 5. Three-vessel umbilical cord

2. Polyhydramnios 4. Two-vessel umbilical cord An excess amount of amniotic fluid is associated with chromosomal disorders and gastrointestinal, cardiac, and neural tube defects. An umbilical cord should have three vessels; two arteries and a vein. When a two-vessel cord is found, it is indicative of cardiac defects.

A pregnant client at 34 weeks gestation called the OB/GYN clinic, stating that she does not feel any fetal activity. How would the nurse respond to the client? 1. "Tell me about your intake of meals and fluids." 2. "When was the last time you ate?" 3. "Come to the hospital so that further assessments can be done." 4. "You will need to have a biophysical profile test."

3. "Come to the hospital so that further assessments can be done." This is an appropriate response. The client needs to be seen for further assessment and evaluation.

A nurse is providing emotional support for a woman experiencing infertility. Which statement would require further assessment from the nurse? 1. "Due to my infertility, I have felt isolated and alone. Thus, my provider suggested therapy for depression." 2. "I feel like I am less of a woman because I am unable to become pregnant." 3. "I am afraid of what my partner will do if I am unable to become pregnant in the next few months." 4. "We are hesitant to spend the money on assisted reproductive technology due to the ethical dilemmas that can occur."

3. "I am afraid of what my partner will do if I am unable to become pregnant in the next few months." This comment raises a red flag of intimate partner violence. Although infertility can be stressful on a couple, violence should be further assessed and reported.

A clinic nurse is evaluating a pregnant client at her first prenatal appointment. Which statement made by the client most warrants further questioning? 1. "I have not been taking my prenatal vitamins because they make me sick." 2. "I vomit constantly." 3. "I have depression and have a history of suicidal attempts." 4. "I am feeling really unsure about this pregnancy. I don't know if I am ready."

3. "I have depression and have a history of suicidal attempts." The nurse should inquire about current suicidal ideation and develop a plan based on the client's response.

The nurse is reviewing a client's chart and comes across genetic testing results. When answering questions from the family, which statement would prompt the nurse to provide further education? 1. "The human cell has 46 chromosomes." 2. "The human cell has 22 homologous pairs." 3. "The human cell has two pairs of sex chromosomes." 4. "The human cell has XX or YY chromosomes."

3. "The human cell has two pairs of sex chromosomes." The human cell has one pair of sex chromosomes. It is abnormal to have two pairs. The normal result is one pair of chromosomes, female or male.

A nurse is caring for a pregnant client who is to have a contraction stress test (CST). Which findings are indications for this procedure? Select all that apply. 1. History of bleeding 2. A reactive nonstress test (NST) 3. Decreased fetal movement 4. Preterm labor 5. A non-reactive NST

3. Decreased fetal movement Use IV oxytocin or have the mother simulate her nipples to initiate contractions and assess the ability of the fetus to maintain a normal FHR in response to uterine contractions.

A nursing student is examining a client's chart on the Antepartum unit and asks why an umbilical artery Doppler flow test is ordered. which would be an appropriate response for the nurse? Select all that apply. 1. "It is used for some mothers to identify the gestational age of the fetus." 2. "It is used to detect any abnormal structures of the fetus." 3. "It is non-invasive screening technique that uses advanced ultrasound technology to assess resistance to blood flow in the placenta." 4. "Images are obtained of blood flow in the umbilical artery." 5. "This test assesses placental perfusion."

3. "It is non-invasive screening technique that uses advanced ultrasound technology to assess resistance to blood flow in the placenta." 4. "Images are obtained of blood flow in the umbilical artery." This test is used to assess placental blood flow and is also used with other diagnostic tests to assess fetal status in IUGR fetuses.It is used to assess the blood flow in the umbilical artery and to identify any interruption in flow.

A nurse working on the antepartum unit is caring for a 20 weeks gestation mother. As the nurse reviews the client's record, she notices that the lung maturity indicator test L/S ratio is < 2:1. The nurse knows that this result is indicative of: 1. Fetal lung maturity 2. Effective lung function 3. Fetal lung immaturity 4. Effective lung growth

3. Fetal lung immaturity The ratio is < 2:1. This is indicative of fetal lung immaturity and the fetus at increased risk for RDS.

The nurse reviews a pregnant client's record and notes that the amniotic fluid index (AFI) is 30 cm. The nurse understands that this measurement can indicate: 1. An AFI of 30 cm is average measurement of amniotic fluid in pregnancy and represents good renal perfusion. 2. This result is indicative of oligohydramnios (decreased or no amniotic fluid) and can be associated with increased prenatal death, and close maternal and fetal monitoring is needed. 3. The result is good measurement and shows increased urine production. 4. The result reflects polyhydramnios and may indicate fetal malformation, such as NTDs, obstruction of fetal gastrointestinal tract.

4. The result reflects polyhydramnios and may indicate fetal malformation, such as NTDs, obstruction of fetal gastrointestinal tract. An AFI above 24 cm is polyhydramnios and indicates the presence of too much amniotic fluid.

How many chromosomes are present in the human cell?

46

What's the EDD for 9-17-18?

6-24-19

27. Transvaginal ultrasonography is often performed during the first trimester. While preparing your 6-week gestation patient for this procedure, she expresses concerns over the necessity for this test. The nurse should explain that this diagnostic test may be indicated for a number of situations (Select all that apply). a. Multifetal gestation b. Obesity c. Fetal abnormalities d. Amniotic fluid volume e. Ectopic pregnancy

A, B, C, E

Which of the following nursing actions are directed at promoting bonding? (select all that apply) A. Providing opportunity for parents to hold their newborn as soon as possible following birth B. Providing opportunities for the couple to talk about their birth experience and about beoming parents C. Promoting rest and comfort by keeping the newborn in the nursery at night D. Providing positive comments to parents regarding their interactions with their newborn

A, B,D

The nuse is providing teaching to a pt who is breastfeeding a newborn. The pt expresses interest in maintaining a healthy nutritional status for her and the baby. Which information does the nurse present to meet the pts needs? ALL THAT APPLY A. Increase caloric intake by 500 to 1000 per day B. Drink 2-3L of fluid each day C. Abstain from the intake of alcohol D. Eat fresh fruits and veg E. avoid the intake of processed food

A,B, . No evidence an occasional alcoholic drink is harmful, Some fruits and veg may cause the baby to have gas or loose stools, the mother should be conscious of consuming a healthy balanced diet.

The nurse is performing a uterus assessment on a pt who is 20 hrs postpartum. The nurse finds the fundus of the uterus to be soft and boggy. In addition the uterus is disiplaces to the left and moderate bleeding is noted If the uterus does not respond to uterine massage, which actions does the nurse implement? ALL THAT APPLY A. Assist the pt to the bathroom to void B. Reassess to determine response to treatment C. Administer oxytocin as prescribed D. Place an emergency call to HCP E. Make the pt NPO for sx

A,B,C,E

During the 4th stage of labor which actions by the nurse will promote parent-newborn bonding? ALL THAT APPLY A. Delay administration of eye ointment until parents have held newborn B. Stay close to the couple and teh neonate in case of emergency C. Space out necessary assessments to prevent prolonged interruptions D. Initiate skin to skin contact with a warm blanket over neonate and parent E. Explain expected neonatal charactericts such as molding, milia and lanugo

A,D,E

The nurse is providing care for a neonate during the 4th stage of labor. Which action does the nurse take in this stage. A. Dry neonate immmediatly B. Complete neonate assessment within 1 hr C. Obtain neonate blood glucose levels D. Perform Apgar screening until scores are 7

A. 4th stage is birth to 4 hours postpartum. Nurse will dry immediately to aid with thermoregulation

Presumptive signs of pregnancy

Amenorrhea •Nausea/vomiting •Urinary frequency •Breast tenderness •Fatigue

A pt delivers a term neonate and expresses concerns about the reason for giving the neonate an injection. Which information from the nurse is accurate. A. neonates will hemorrhage without vitamin K B. Vitamin K is needed to activate clotting factors C. Mothers are unable to supply vitamin K to the fetus D. Breastfeeding is an excellent sourse of vitamin K

B

During a psotpartum assessment the nurse notes that the uterus is midline and boggy. The immediate action is: A. notify pts provider B. Massage fundus until firm and reevaluate in 30 min C. Give oxytocin as ordered D. Assist the pt to the bathroom and ask her to void

B

A woman is 2 days postpartum from a normal vaginal delivery over an intact perineum of a 300-gram baby. Where would the nurse expect to palpate the clients fundus? a. At the umbilicus b. 2 cm below umbilicus c. 2cm above the symphysis d. At the symphysis

B After 24 hours, fundus is 1cm below umbilicus per day

The nurse assesses that a full-term neonates temperature is 36.2C. The first nursing action is to: a. Turn up the heat in the room. b. Place the neonate on the mothers chest with a warm blanket over the mother and baby. c. Take the neonate to the nursery and place in a radiant warmer. d. Notify the neonates primary provider.

B Skin to skin contact along with use of warm blanket is the best intervention with mild temperature decrease in neonate

The nurse is perfroming a postpartum assessment 30 min after a vaginal delivery. Which of the following actions indicated that the nurse is perfoming the assessement correctly? A. Nurse measures the fundal height in relation to the symphysis pubis B. Nurse monitors the clients central venous pressure C. Nurse assesses the clients perineum for edema and ecchymoses D. Nurse performs a sterile vaginal speculum exam

C.

The nurse is observing a new mother interact with her baby and notices the mother holding the baby close to her body. However, the nurse also notices that the mother does not hold the baby in the enface positon. Which question is the most appropriate for then nurse to ask? A. Can I help you with a nice position in which to hold our baby? B. Can you tell me about your familes beliefs with a new baby? C. Is there some reason I have not seen you look into your baby's eyes? D. Your baby is so expressive, have you looked into his eyes yet?

B. Cultural information may be influencing the mothers interaction with the baby

Which test best provides an answer to the question of whether or not the infant has a congenital defect? A. Screening B. Diagnostic test C. Biophysical profile D. Multiple marker screening

B. Diagnostic test Diagnostic tests, which are often invasive and can pose risks to the fetus, can obtain a definitive answer on suspected congenital defects.

The postpartum nurse is planning a home visit to a mother who delivered the baby 1 week ago. Which finding indicates to the nurse a possible problem with mother-infant bonding A. Mother is pleased to have the nurse visit her home and baby B. The baby's grandmother is present and involved with mother/baby care C. The mother focuses the visit on her physical recovery and concerns D. The baby's father is on "Paternity leave" and involved with the baby

C. After first 48 the mother moves into the "taking hold" phase when the mothers focus moves form self to infant.

What structure provides cushioning and warmth for the fetus? A. The placenta B. Embryonic membrane C. Amniotic fluid D. Umbilical cord

C. Amniotic fluid

What is an indicator for performing a contraction stress test? A. Increased fetal movement and small for gestational age B. Maternal diabetes mellitus and postmaturity C. Adolescent pregnancy and poor prenatal care D. History of preterm labor and intrauterine growth restriction

B. Maternal diabetes mellitus and postmaturity Decreased fetal movement is an indicator for performing a contraction stress test; the size (small for gestational age) is not an indicator. Maternal diabetes mellitus and postmaturity are two indications for performing a contraction stress test. Although adolescent pregnancy and poor prenatal care are risk factors of poor fetal outcomes, they are not indicators for performing a contraction stress test. Intrauterine growth restriction is an indicator; but history of a previous stillbirth, not preterm labor, is the other indicator.

The nurse is collecting the urine of a postpartum pt who is passing large clots. For which reason does the nurse examine the large collected clots? A. To validate the presence of clotting B. To determine the presence of tissue C. To obtain an accurate description D. To document the number of clots

B. Presence of tissue could indicate retained placenta tissue which can lead to excessive bleeding

The nurse is preparing a postpartum pt for discharge. Which pt teaching is most important for the nurse to provide? A. s/s of uterine infection B. s/s of secondary hemorrhage C. s/s of postpartum depression D. s/s of boggy uterus

B. Secondary hemorrhage often occurs after discharge and pt needs to report abnormal amts of bleeding

Which pt reported sysmptms cause the nurse to most concern 8 days following a vaginal delivery? A. Increased flow noticed with physical activity B. A description of the lochia as being red in color C. Discharge that is noted to have a fleshy odor D. Bleeding that is described as scant

B. The lochia during the period of 4-10 days should be serosa (pink or brown) Red is indicative of bleeding

The nurse notices a neonate born 45 min ago is unresponsive to external stimuli, and has a respiratory rate and heart rate beow normal range. Which action does the nurse take? A. Picks up the neonate and tries to get a response B. Allows the neonate to naturally continue deep sleep C. Asks another nurse to assist with reassessment D. Notifies the caregiver of the neonate's condition

B. This Deep sleep could last for about 2 hours

Which behavior does the nurse edentify as a demonstration of unidirectional bonding between a parent and infant? A. The parents respond to baby's cry B. The parents call the baby by name C. The baby responds to comforting measures D. The parents stiulate and entertain the baby

B. Using the baby's name is unidirectional bonding

A nonstress test (NST) is ordered on a pregnant women at 37 weeks gestation. What are the most appropriate teaching points to include when explaining the procedure to the patient? (Select all that apply) A. After 20 minutes, a nonreactive reading indicates the test is complete. B. Vibroacoustic stimulation may be used during the test. C. Drinking orange juice before the test is appropriate. D. A needle biopsy may be needed to stimulate contractions. E. Two sensors are placed on the abdomen to measure contractions and fetal heart tones.

B. Vibroacoustic stimulation may be used during the test. C. Drinking orange juice before the test is appropriate. E.Two sensors are placed on the abdomen to measure contractions and fetal heart tones. A nonreactive test requires further evaluation. The testing period is often extended, usually for an additional 20 minutes, with the expectation that the fetal sleep state will change and the test will become reactive. During this time vibroacoustic stimulation (see later discussion) may be used to stimulate fetal activity. Vibroacoustic stimulation is often used to stimulate fetal activity if the initial NST result is nonreactive and thus hopefully shortens the time required to complete the test (Greenberg, Druzin, and Gabbe, 2012). Care providers sometimes suggest that the woman drink orange juice or be given glucose to increase her blood sugar level and thereby stimulate fetal movements. Although this practice is common, there is no evidence that it increases fetal activity (Greenberg, Druzin, and Gabbe, 2012). A needle biopsy is not part of a NST. The FHR is recorded with a Doppler transducer, and a tocodynamometer is applied to detect uterine contractions or fetal movements. The tracing is observed for signs of fetal activity and a concurrent acceleration of FHR.

What is the third stage of labor?

Birth of baby to complete delivery of placenta

When assessing apical rate of neonate, the stethescople whould be placed at the: A. 1st or 2nd intercostal space B. 2nd or 3rd intercostal space C. 3rd or 4th intercostal space D. 4th or 5th intercostal space

C

Which of the following clients is most likely to complain if afterbirth pains during her postpartum period? a. G1 P0, diagnosed with preclampsia b. G2 P0, group B streptococci in vagina c. G3 P2, gave birth to a 4100-gram baby d. G4 P1, diagnosed wit preterm labor

C a. this client is a primipara b. this client is a primipara c. This client is multipara and she delivered a macrosomic baby. She is likely to complain of sever afterbirth pain since she is multi paraous d. Altho patient is gravida 4, she is para 1 while client c is para 2. Nurse would not expect her to complain excessively of after birth pain compared to client c

A fertilized egg that implants outside the uterus is called? A. A molar pregnancy B. Eclampsia C. An ectopic pregnancy D. An elective termination

C. An ectopic pregnancy A pregnancy that implants in the fallopian tubes and must be removed is called an ectopic pregnancy.

A woman on the day of discharge from the postpartum unit requests clean towels so she can take a shower, asks a number of questions regarding breastfeeding, and shares that she is nervous about taking her baby home and not being able to remember everything she has been taught. These are behmore independentaviors associates with: A. Bonding B. Taking in C. Taking hold D. Attachment

C. more independant and able to initiate self care. Interested about learning about the care of their baby.

A mother refused to allow her son to receive the vitamin K injection at birth. Which of the following signs or symptoms might the nurse observe in the baby as a result? a. Skin color is dusky. b. Vital signs are labile. c. Glucose levels are subnormal. d. Circumcision site oozes blood.

D May ooze blood due to lack of vitamin K, which is required for hepatic synthesis of blood coagulation factors

The nuse is providing post partum care for an adolescent mother and her family. Which factor is most important for the nurse to consider when planning teaching about neonatal care? A. the grandparents decided they want to be involved B. The parents need to discuss their expectations of each other C. The mother is determined the father should be involved D. Information shoud be presented on age-appropriate level

D.

A woman who is at 36 weeks of gestation is having a nonstress test. Which statement by the woman would indicate a correct understanding of the test? A. "I will need to have a full bladder for the test to be done accurately." B. "I should have my husband drive me home after the test because I may be nauseous." C. "This test will help to determine if the baby has Down syndrome or a neural tube defect." D."This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby."

D. "This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby." An ultrasound is the test that requires a full bladder. An amniocentesis would be the test that a pregnant woman should be driven home afterward. A maternal alpha-fetoprotein test is used in conjunction with unconjugated estriol levels, and human chorionic gonadotropin helps to determine Down syndrome. The nonstress test is one of the most widely used techniques to determine fetal well-being and is accomplished by monitoring fetal heart rate in conjunction with fetal activity and movements.

What cardiovascular changes occur during pregnancy? A. Increased cardiac output B. Dependent edema C. Increased plasma volume D. All of the above

D. All of the above

Which of the following are maternal tasks of pregnancy? A. Accepting the pregnancy B. Identifying with the role of motherhood C. Solving mother/daughter conflicts D. All of the above

D. All of the above

Who's at risk for gestational diabetes? A. Obese pregnant women B. History of fetal macrosomia C. Family history of diabetes D. All of the above

D. All of the above Obesity, history of fetal macrosomia, and family history of diabetes increases the risk of gestational diabetes.

Risk factors for infertility include? A. Maternal obesity B. Parental smoking C. Heavy alcohol use D. All of the above

D. All of the above Life style changes can assist couples with conception

The health care provider has ordered a magnetic resonance imaging (MRI) study to be done on a pregnant patient to evaluate fetal structure and growth. The nurse should include which instructions when preparing the patient for this test? (Select all that apply.) A. A lead apron must be worn during the test. B. A full bladder is required prior to the test. C. An intravenous line must be inserted before the test. D. Jewelry must be removed before the test. E. Remain still throughout the test.

D. Jewelry must be removed before the test. E. Remain still throughout the test. Magnetic resonance imaging (MRI) is a noninvasive radiologic technique used for obstetric and gynecologic diagnosis. Similar to computed tomography (CT), MRI provides excellent pictures of soft tissue. Unlike CT, ionizing radiation is not used. Therefore vascular structures within the body can be visualized and evaluated without injecting an iodinated contrast medium, thus eliminating any known biologic risk. Similar to sonography, MRI is noninvasive and can provide images in multiple planes, but no interference occurs from skeletal, fatty, or gas-filled structures, and imaging of deep pelvic structures does not require a full bladder. The woman is placed on a table in the supine position and moved into the bore of the main magnet, which is similar in appearance to a CT scanner. Depending on the reason for the study, the procedure may take from 20 to 60 minutes, during which time the woman must be perfectly still except for short respites.

How is a normal fetal heart beat determined by?

Fetoscope •Doppler ultrasound stethoscope •Electronic fetal monitoring •Non-stress test

What are the four steps to Leopold's Maneuver's rule?

First- determine the fetal body part that occupies the uterine fundus •Second- determine location of the fetal back •Third- confirm presentation; determine engagement •Fourth- determine fetal attitude

A 38 year old female is currently pregnant with twins. She has 10 year old triplets born at 32 weeks gestation, and a 17 year old who was born at 41 weeks gestation. Twelve years ago she had a miscarriage at 8 weeks gestation. What is her GTPAL?

G- 4 •T- 1 •P- 1 •A- 1 •L- 4

a patient is in the second trimester of pregnancy and seems distressed with encouragement the patient states "i have been totally avoiding physical with my husband to avoid prompting any sexual activity" which statement by the nurse is the best response? a) nonsexual expressions are important to both of you b) be honest and tell your husband why you are avoiding him c) you need to agree to sex in order to prevent inferdelity from occurring d) sex during pregnancy is healthy and normal display of affection

a) nonsexual expressions are important to both of you

an eastern European Jewish couple has 2 children who died from tay sacs the couple is currently pregnant and has asked for genetic confirmation about the fetus with the intention of early termination of the fetus tests positively. for what reason for the nurse suspect chronic villa sampling to occur? a) risk to the fetus b) positive result c) can be done that day d) chronic villa sampling

a) risk to the fetus can be performed as early as 10 weeks

the nurse works in a prenatal clinical located in a multicultural city. its is important for the nurse to recognize which cultural beliefs as rescripted (select all that apply) a) the mother will aid the baby circulation will remain active during pregnancy ' b) the satisfaction of pregnancy cravings will prevent birthmarks on the baby c) the mother invites harm to the fetus which sleeping on her back at night d) a safety pin attached to an undergarment will prevent fetal facial deformities e) drinking too much tea will cause a premature birth

a) the mother will aid the baby circulation will remain active during pregnancy b) the satisfaction of pregnancy cravings will prevent birthmarks on the baby d) a safety pin attached to an undergarment will prevent fetal facial deformities

the nurse notes that a patient in a third trimmest feels unable mother her unborn child. Which information about the patient helps the nurse identify the sources of the patients ambivalence. (select all that apply) a) the patient is estranged from her mother b) the patient asks about classes for baby care c) the patient expresses loss of independence d) the patient's partner is excited about the baby e) the patient expresses disgust about body changes

a) the patient is estranged from her mother c) the patient expresses loss of independence e) the patient expresses disgust about body changes

a couple announces that they are pregnant one expected grandmother says "as grandchildren will call me by my first name, not ready to be a grandma" which feelings are expressed by the grandmother? a) the pregnancy presents undesirable evidence that the grandmother is growing older b) the grandmother has specific wishes on how she wants to be addressed c) the grandmother is most likely teasing and most likely feels overwhelmed delight d) the grandmother has never throught of herself in this role and will adapt with time

a) the pregnancy presents undesirable evidence that the grandmother is growing older

a patinet is in her first trimester (first 12 weeks) of pregnancy with her second child. the first child was born with trisomy 21 defect the patinet is requesting testing to determine whether this current fetus has the same defect. Which testing doe the nurse expect the healthcare provider to prosceribe? a) ultrasound b)MRI c) chronic villi sampling d) amniocentesis

a) ultrasound

the nurse is providing care in a school clinic established for the care of adolescents mothers when assessing a patient whos 11 years old and pregnant which deduction regarding the patient's psychosocial development will the nurse recognize? a)adolescents are self-centered and oriented towards the present b)this age pregnancy is likely an attachment to a first love c)moving into the mothering role will be nearly impossible at this age d)the role of the grandmother will be the primary caretaker for the baby

a)adolescents are self-centered and oriented towards the present pregnancy in easrly adolescents is difficult as the adolescent is self-centered and oriented towards the present which make maternal adaptation towards the baby difficult

8. A client asks her nurse, "My doctor told me that he is concerned with the grade of my placenta because I am overdue. What does that mean?" The best response by the nurse is: a. "Your placenta changes as your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby." b. "Your placenta isn't working properly, and your baby is in danger." c. "This means that we will need to perform an amniocentesis to detect if you have any placental damage." d. "Don't worry about it. Everything is fine."

a. "Your placenta changes as your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby."

3. The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what other tool would be useful in confirming the diagnosis? a. Doppler blood flow analysis b. Contraction stress test (CST) c. Amniocentesis d. Daily fetal movement counts

a. Doppler blood flow analysis Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the fetus and the placenta. It is a helpful tool in the management of high-risk pregnancies because of intrauterine growth restriction (IUGR), diabetes mellitus, multiple fetuses, or preterm labor. Because of the potential risk of inducing labor and causing fetal distress, a CST is not performed on a woman whose fetus is preterm. Indications for an amniocentesis include diagnosis of genetic disorders or congenital anomalies, assessment of pulmonary maturity, and the diagnosis of fetal hemolytic disease, not IUGR. Fetal kick count monitoring is performed to monitor the fetus in pregnancies complicated by conditions that may affect fetal oxygenation. Although this may be a useful tool at some point later in this woman's pregnancy, it is not used to diagnose IUGR.

13. Nurses should be aware that the biophysical profile (BPP): a. Is an accurate indicator of impending fetal death. b. Is a compilation of health risk factors of the mother during the later stages of pregnancy. c. Consists of a Doppler blood flow analysis and an amniotic fluid index. d. Involves an invasive form of ultrasound examination.

a. Is an accurate indicator of impending fetal death.

22. Which analysis of maternal serum may predict chromosomal abnormalities in the fetus? a. Multiple-marker screening b. Lecithin/sphingomyelin (L/S) ratio c. Biophysical profile d. Type and crossmatch of maternal and fetal serum

a. Multiple-marker screening

2. A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique could be used with this pregnant woman at this time? a. Ultrasound examination b. Maternal serum alpha-fetoprotein (MSAFP) screening c. Amniocentesis d. Nonstress test (NST)

a. Ultrasound examination

20. Risk factors tend to be interrelated and cumulative in their effect. While planning the care for a laboring client with diabetes mellitus, the nurse is aware that she is at a greater risk for: a. Oligohydramnios. b. Polyhydramnios. c. Postterm pregnancy. d. Chromosomal abnormalities.

b. Polyhydramnios.

what is a teratogen?

an agent or factor that causes malformation of an embryo

what are pregnant women at risk for during pregnancy?

anemia which is helped with iron which is absorbed by vitamin C

18. A woman has been diagnosed with a high risk pregnancy. She and her husband come into the office in a very anxious state. She seems to be coping by withdrawing from the discussion, showing declining interest. The nurse can best help the couple by: a. Telling her that the physician will isolate the problem with more tests. b. Encouraging her and urging her to continue with childbirth classes. c. Becoming assertive and laying out the decisions the couple needs to make. d. Downplaying her risks by citing success rate studies.

b. Encouraging her and urging her to continue with childbirth classes.

24. Which nursing intervention is necessary before a second-trimester transabdominal ultrasound? a. Place the woman NPO for 12 hours. b. Instruct the woman to drink 1 to 2 quarts of water. c. Administer an enema. d. Perform an abdominal preparation.

b. Instruct the woman to drink 1 to 2 quarts of water.

a patinet is scheduled for transvaginal ultrasound testing which preparation intervention by the nurse should the make that is appropriate? a) placing the patient supine with a pillow under her head b) explain that pain at 4 or less on a 1-10 scale is expected c) determine if the patient has a banana or latex allergy d) request the patient's partner leave the testing room

c) determine if the patient has a banana or latex allergy

when the nurse a prenatal clinic is aware of the important tasks that are each exected mother will need to address when the expected mother states "I will give up everything I have to make sure this baby is safe and well cared for" which task is the mother expressing? a)attachment b) ensuring safety for mother and child c)stating a willingness to give up on herself d)ensuring social acceptance

c) address her efforts to make personal sacrifices to care for this child

a patient is in the second trimester when the patient becomes upset when the healthcare provider schedules several screening tests the patient sees this as something being wrong with her baby which statement by the nurse will help with reducing the patient's anxiety? a)multiple screening tests are ordered for every pregnancy b) it's better to identify problems before birth than afterward c) screening tests are primarily to identify those without disease or abnormality d) diagnosis test is a reason for worry as they indicate fetal problems

c) screening tests are primarily to identify those without disease or abnormality

the nurse is providing care for a patient who is 42 and in the first trimester of her pregnancy for which complication will the nurse monitor for the mom and the fetus? a) elevated BP And proteinuria b) indication to maladaptations to pregnancy c)alteration in fetal chromosomal studies d) study indicators of menopause occurring

c)alteration in fetal chromosomal studies moms over the age of 35 are at a higher risk for chromosomal defects

5. At 35 weeks of pregnancy a woman experiences preterm labor. Tocolytics are administered and she is placed on bed rest, but she continues to experience regular uterine contractions, and her cervix is beginning to dilate and efface. What would be an important test for fetal well-being at this time? a. Percutaneous umbilical blood sampling (PUBS) b. Ultrasound for fetal size c. Amniocentesis for fetal lung maturity d. Nonstress test (NST)

c. Amniocentesis for fetal lung maturity

6. A 40-year-old woman with a high body mass index (BMI) is 10 weeks pregnant. Which diagnostic tool is appropriate to suggest to her at this time? A. Biophysical profile B. Amniocentesis C. Maternal serum alpha-fetoprotein (MSAFP) D. Transvaginal ultrasound

d. Transvaginal ultrasound

What is oligohydramnios associated with?

low less than 500 ml

how might a patient feel who becomes pregnant with a long history of infertility beforehand?

males may feel indifference at first which is normal and females may be in denial