Prep-U Reproduction

The nurse is instructing a group of women of childbearing age about human immunodeficiency virus (HIV) during pregnancy. What would be a priority recommendation in this setting? A. Screening for HIV B. Screening for sexually transmitted infections (STIs) C. Prophylactic treatment for HIV D. Proper nutrition

A. Screening for HIV No screening mandate has been put forth for HIV, but all pregnant women should be encouraged to undergo this test. Prophylactic treatment would be initiated only once the woman has been screened. Screening for STIs and ensuring proper nutrition are also part of health promotion for women in this age group, but they are of lower priority than identifying HIV-positive individuals. Reference: Chapter 47: Nursing Care of the Child With an Alteration in Immunity/Immunologic Disorder - Page 1756

A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs: A. in the fallopian tubes. B. in the uterus. C. in the ovaries. D. in the vagina.

A. in the fallopian tubes. Fertilization of the ovum can occur in the distal portion of the fallopian tubes. If the egg is fertilized, it will then be moved through the fallopian tube towards the uterus where it implants in the thick endometrium and begins its development. Reference: Chapter 3: Anatomy and Physiology of the Reproductive System - Page 100

A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth? A. the viral load B. prophylactic antiretroviral therapy (ART) to the infant at birth C. the mother's age D. amniocentesis results at 34 weeks' gestation

A. the viral load A woman who has HIV during pregnancy is at risk for transmitting the infection to the fetus during pregnancy or childbirth and to the newborn while breastfeeding. The type of birth, vaginal or cesarean, depends on several factors, including the woman's viral load, use of ART during pregnancy (not waiting until the birth), length of time membranes have been ruptured, and gestational age (not mother's age). With prenatal ART and prophylactic treatment of the newborn, there is a reduced risk of perinatal HIV transmission. The amniocentesis results would not be a factor in preventing the spread of HIV to the infant and may actually lead to the fetus being infected through the puncture site and bleeding into the amniotic sac. Reference: Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations - Page 742

The nurse is assessing a client at her first prenatal visit and notes the fundal height is palpable at the level of the umbilicus. The nurse predicts the client is at which gestational age? A. 18 weeks B. 22 weeks C. 20 weeks D. 24 weeks

C. 20 weeks Some clients will not seek early prenatal care, especially if it is not their first pregnancy. The uterus expands to reach the height of the umbilicus by week 20. Before week 20 it is too low to be palpated, and after week 20 it may be beyond the umbilicus. Reference: Chapter 12: Nursing Management During Pregnancy - Page 396

How long is the neonatal period for a newborn? A. 45 days B. 14 days C. 28 days D. 90 days

C. 28 days The neonatal period is the first 28 days of life. Reference: Chapter 17: Newborn Adaptation - Page 578

A nurse working in a genetic clinic explains to a client that the process through which gene expression is increased is called: A. Repression B. Transcription C. Induction D. Synthesis

C. Induction The nurse explains that the process through which gene expression is increased is induction. Reference: Chapter 4: Genetic Control of Cell Function and Inheritance - Page 62

A woman in her second trimester of pregnancy is beginning to experience more headaches. In addition to suggesting holding an ice pack to the forehead, the health care provider recommends which medication to provide some relief from the pain? A. aspirin products B. ibuprofen C. acetaminophen D. naproxen

C. acetaminophen Resting with an ice pack on the forehead and taking a usual adult dose of acetaminophen usually furnishes adequate relief. Compounds with ibuprofen (class C drugs) are not usually recommended because they cause premature closure of the ductus arteriosus in the fetus. Additionally, they have been found to contribute to fetal renal damage, low amniotic fluid, and fetal intracranial hemorrhage. Aspirin and naproxen are also not recommended to take during pregnancy. Reference: Chapter 12: Nursing Management During Pregnancy - Page 409

The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? A. provides rich blood supply to decidua B. maintains nutrient-rich decidua C. continues progesterone production by corpus luteum D. sustains life of placenta

C. continues progesterone production by corpus luteum The corpus luteum is responsible for producing progesterone until this function is assumed by the placenta. hCG is a fail-safe mechanism to prolong the life of the corpus luteum and ensure progesterone production. Estrogen is responsible for providing a rich blood supply to the decidua. Progesterone helps maintain a nutrient-rich decidua. Reference: Chapter 10: Fetal Development and Genetics - Page 331

The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education? A. "When I ovulate, there is a follicle on my uterus that forms showing that an ova was released." B. "My menstrual cycles are controlled by progesterone production." C. "I will ovulate every month on Day 21 of my cycle." D. "Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)."

D. "Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)." Ovulation is controlled by FSH and LH, with the follicle-stimulating hormone encompassing days 1 to 14 of a 28-day cycle and the luteinizing hormone controlling the luteal phase, which is days 15 to 28. The follicle forms only in the ovary, not the uterus. Ovulation should occur on Day 14 of a normal 28-day cycle. Both estrogen and progesterone are necessary to the menstrual cycle, not just progesterone. Reference: Chapter 3: Anatomy and Physiology of the Reproductive System - Page 103

A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy? A. multiple gestation pregnancy B. high number of pregnancies C. use of oral contraceptives D. history of endometriosis

D. history of endometriosis The nurse needs to complete a full history of the client to determine if she had any other risk factors for an ectopic pregnancy. Adhesions, scarring, and narrowing of the tubal lumen may block the zygote's progress to the uterus. Any condition or surgical procedure that can injure a fallopian tube increases the risk. Examples include salpingitis, infection of the fallopian tube, endometriosis, history of prior ectopic pregnancy, any type of tubal surgery, congenital malformation of the tube, and multiple abortions (elective terminations of pregnancy). Conditions that inhibit peristalsis of the tube can result in tubal pregnancy. A high number of pregnancies, multiple gestation pregnancy, and the use of oral contraceptives are not known risk factors for ectopic pregnancy. Reference: Chapter 19: Nursing Management of Pregnancy at Risk: Pregnancy-Related Complications - Page 665

Which statement will the nurse include when teaching about fetal development? A. Ossification of the fetal skeleton begins in the ninth week. B. Body growth is slowed during weeks 9 through 12. C. Lanugo is the term for the young fetus. D. Weight gain occurs during weeks 9 through 12.

A. Ossification of the fetal skeleton begins in the ninth week. The fetal skeleton is formed and ossification begins in the ninth week. Lanugo is the term for the fine hair covering the fetal skin. Weight gain occurs during weeks 21 through 25. Body growth is accelerated during weeks 9 through 12. Reference: Chapter 49: Disorders of Musculoskeletal Function: Developmental and Metabolic Disorders - Page 1216

A postpartum woman has been unable to urinate since giving birth. When the nurse is assessing the woman, which finding would indicate that this client is experiencing bladder distention? A. Uterus is boggy. B. Percussion reveals tympany. C. Bladder is nonpalpable. D. Lochia is less than usual.

A. Uterus is boggy. A distended bladder is dull on percussion and can be palpated as a rounded mass. In addition, the uterus would be boggy and lochia would be more than usual. Reference: Chapter 16: Nursing Management During the Postpartum Period - Page 540

The nurse is caring for a postpartum client with an episiotomy. The nurse assesses the client closely for what complication that the client is at greatest risk of developing? A. infection B. urinary incontinence C. blood loss D. dyspareunia

A. infection An episiotomy involves cutting the perineum to accommodate the fetus, which can result in infection at the incision site. Dyspareunia (painful intercourse) may occur if infection interferes with the healing of the episiotomy site. Minimal blood loss occurs when an episiotomy is performed. Urinary incontinence is not a complication of episiotomy. Remediation: Episiotomy Care

The nursing instructor has just completed a discussion about immunization. Which statement by a student would indicate a need for further instruction? A. "Active immunity develops when a person receives a vaccine." B. "An example of active immunity would be when immunoglobulins are passed from a mother to her infant by colostrum." C. "Immunologic memory develops after a person receives a vaccine." D. "Passive immunity only lasts a few weeks or months."

B. "An example of active immunity would be when immunoglobulins are passed from a mother to her infant by colostrum." Passive, not active, immunity is produced when the immunoglobulins of one person are transferred to another. This can happen via colostrum or the placenta. Active immunity lasts only weeks or months. Active immunity is acquired when a person's own immune system generates the immune response from either a vaccine or the actual disease. This long-term protection is the result of immunologic memory. Reference: Chapter 31: Health Supervision - Page 1095

The nurse is concerned that a client is not obtaining enough folic acid. Which test would the nurse anticipate being used to evaluate the fetus for potential neural tube defects? A. triple-marker screen B. maternal serum alpha-fetoprotein analysis C. Doppler flow study D. amniocentesis

B. maternal serum alpha-fetoprotein analysis Alpha-fetoprotein is a substance produced by the fetus. AFP enters the maternal circulation by crossing the placenta. If there is a developmental defect, more AFP escapes into amniotic fluid from the fetus. The optimal time for AFP screening is 16 to 18 weeks. The triple marker screens for AFP, hCG, and unconjugated estriol. This screens for neural defects and Down syndrome. The Doppler flow study evaluates the blood flow, and amniocentesis evaluates the contents of the amniotic fluid looking for chromosomal defects. Reference: Chapter 12: Nursing Management During Pregnancy - Page 399

Following delivery, the parents have chosen to have their infant's cord blood frozen. A blood test is performed on the cord blood and found to contain IgM antibodies. The nurse interprets this to mean: A. the infant has received active antibodies from the mother. B. the infant has been exposed to an intrauterine infection. C. the child's placenta was defective since it did not filter the IgM out of the blood. D. the child likely already has developed an immunocompromised disease.

B. the infant has been exposed to an intrauterine infection. Protection of a newborn against antigens occurs through transfer of maternal antibodies. Maternal IgG antibodies cross the placenta during fetal development and remain functional in the newborn for the first months of life. IgG is the only class of immunoglobulins to cross the placenta. Cord blood does not normally contain IgM or IgA. If present, these antibodies are of fetal origin and represent exposure to intrauterine infection. Reference: Chapter 11: Innate and Adaptive Immunity - Page 261

It is important that couples who wish to practice natural forms of birth control understand that the mucus-secreting glands of the cervix can store live sperm for up to: A. 12 hours. B. 24 hours. C. 48 hours. D. 36 hours.

C. 48 hours. The mucus-secreting glands of the cervix are capable of storing live sperm for 48 to 72 hours (2 to 3 days), enabling pregnancy to occur after intercourse has occurred 1 or 2 days before ovulation. Reference: Chapter 3: Anatomy and Physiology of the Reproductive System - Page 107

A client has just begun taking an oral contraceptive that contains estrogen and progestin. The nurse should instruct the client to use additional methods of contraception for at least A. 2 weeks. B. 2 months. C. 7 days. D. 1 month.

C. 7 days. Because of the mechanism of action of oral contraceptives, the onset of action is somewhat delayed. Full contraceptive benefits don't occur until an oral contraceptive agent has been taken for at least 7 days. Remediation: Ethinyl Estradiol And Desogestrel

A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priority for this client? A. Set up for a percutaneous endoscopic gastrostomy. B. Administer total parenteral nutrition. C. Administer IV normal saline with vitamins and electrolytes. D. Administer an antiemetic.

C. Administer IV normal saline with vitamins and electrolytes. The first choice for fluid replacement is generally normal saline with vitamins and electrolytes added. If the client does not improve after several days of bed rest, "gut rest," IV fluids, and antiemetics, then total parenteral nutrition or percutaneous endoscopic gastrostomy tube feeding is instituted to prevent malnutrition. Reference: Chapter 19: Nursing Management of Pregnancy at Risk: Pregnancy-Related Complications - Page 680

A young mother gives birth to twin boys who shared the same placenta. What serious complication are they at risk for? A. HELLP syndrome B. ABO incompatibility C. Twin-to-twin transfusion syndrome (TTTS) D. TORCH syndrome

C. Twin-to-twin transfusion syndrome (TTTS) When twins share a placenta, a serious condition called twin-to-twin transfusion syndrome (TTTS) can occur. Reference: Chapter 19: Nursing Management of Pregnancy at Risk: Pregnancy-Related Complications - Page 695

A nurse is counseling a couple who expressed that they are having difficulty conceiving. What could the nurse consider as a cause? A. Changing developmental stage B. "Petting" prior to intercourse C. Masturbating D. Having sex during ovulation

A. Changing developmental stage Changing developmental stages, such as menopause, can interfere with a couple's normal sexual expression. Masturbation, and "petting" or simple stroking as part of foreplay do not affect a couple being able to conceive. Having sex during ovulation would increase the likelihood of the client becoming pregnant. Reference: Chapter 45: Sexuality - Page 1758

The nurse is explaining the process of conception to a group of middle-school students and points out that fertilization occurs: A. in the peritoneal cavity. B. on the outside wall of the ovary. C. on the inside wall of the uterus. D. in the middle to outer portion of the fallopian tube.

D. in the middle to outer portion of the fallopian tube. Fertilization normally occurs in the middle to outer portion of the fallopian tube. Reference: Chapter 45: Disorders of the Female Reproductive System - Page 1118

The nurse determines a client is 7 cm dilated. What is the best response when asked by the client's partner how long will she be in labor? A. "She is in active labor; she is progressing at this point and we will keep you posted." B. "She is in the transition phase of labor, and it will be within 2 to 3 hours, though it might be sooner." C. "She is doing well and is in the second stage; it could be anytime now." D. "She is still in early latent labor and has much too long to go to tell when she will give birth."

A. "She is in active labor; she is progressing at this point and we will keep you posted." At 7 cm dilated, she is considered in the active phase of labor. There is no science that can predict the length of labor. She is progressing in labor, and it is best not to give the family a specific time frame. Reference: Chapter 13: Labor and Birth Process - Page 457

The nurse cares for multiple clients planning to have children. Which client will the nurse identify as priority for needing a referral for prenatal genetic testing? A. A male client with family history of sickle cell disease B. A male client who is 45 years of age C. A female client diagnosed with diabetes mellitus D. A female client who is 38 years of age

A. A male client with family history of sickle cell disease The nurse would refer the male client with a family history of a sickle cell disease, a genetic disorder, for prenatal genetic testing. Women older than 35 years of age and men older than 45 years of age should be referred. However, age is not priority over a known family history. Women with diabetes need not necessarily be referred for genetic testing. Reference: Chapter 10: Fetal Development and Genetics - Page 342

After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example? A. Cryptorchidism B. Priapism C. Prostatitis D. Erectile dysfunction

A. Cryptorchidism Structural abnormalities include cryptorchidism, torsion of the spermatic cord, phimosis, paraphimosis, hydrocele, spermatocele, and varicocele. Erectile dysfunction and priapism are erection disorders. Prostatitis is an infectious disorder. Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Risk Factors, p. 1780. Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders - Page 1780

A nurse is reviewing a labor plan with a client who has been admitted to the labor and birth unit. The client states that she has been drinking a significant amount of herbal teas lately to help with uterine contractions. Which is the priority action by the nurse? A. Determine the type of herbal teas recently consumed. B. Ask the client when she last ate or drank anything. C. Prepare the client for a fetal nonstress test. D. Ask about other complementary and alternative therapies.

A. Determine the type of herbal teas recently consumed. Certain herbal teas can be used during pregnancy, and most are made with flower or berries that are safe for both mother and fetus. To determine if the herbal tea is safe or has had any effect on the status of the birth, it is important for the nurse to find out what type of tea the client has been consuming and in what quantities. Reference: Chapter 1: Perspectives on Maternal and Child Health Care - Page 50

A 24-year-old female client states, "About a week before my period starts, I have recently started craving certain sweets, having terrible mood swings, and feeling fatigued and irritable." Which action will the nurse take next? A. Educate the client on treatment for premenstrual syndrome. B. Notify the client's primary health care provider. C. Document the findings in the client's medical record. D. Recommend the client's hormone levels be tested.

A. Educate the client on treatment for premenstrual syndrome. The client is exhibiting symptoms of premenstrual syndrome and the nurse would provide education on treatment options for the client's specific symptoms, such as increased rest and exercise. The nurse would document the findings and education provided in the client's medical record and notify the primary health care provider; however, these are not a priority as the client is stable and in need of treatment options. The client does not have symptoms warranting hormone testing at this time. If the symptoms worsened or became intolerable, then testing may be needed. Reference: Chapter 7: Benign Disorders of the Female Reproductive Tract - Page 248

Which are estrogens produced by the ovaries? (Select all that apply.) A. Estriol B. Testosterone C. Progesterone D. Estrone E. Estradiol

A. Estriol D. Estrone E. Estradiol The estrogens produced by the ovaries include estradiol, estrone, and estriol. Reference: Chapter 39: Introduction to the Reproductive System - Page 662-663

When describing the process of fertilization, the nurse would explain that it normally occurs in which structure? A. Fallopian tube B. Endometrium C. Cervix D. Vagina

A. Fallopian tube Fertilization normally occurs in the fallopian tube. Once fertilized the ovum proceeds down the uterus and attaches itself in the endometrium. The vagina and cervix are not involved in fertilization. Reference: Chapter 39: Introduction to the Reproductive System - Page 662-664

A client is diagnosed with a postpartum infection. The nurse is most correct to provide which instruction? A. Finish all antibiotics to decrease a genital tract infection. B. Change the perineal pad every 3 to 4 hours to decrease the uterine infection. C. Apply ice to the perineum to decrease pain of a perineal infection. D. Drink plenty of fluids to decrease a bladder infection.

A. Finish all antibiotics to decrease a genital tract infection. A postpartum infection is an infection of the genital tract after delivery through the first 6 weeks postpartum. It is most important to include finishing all antibiotics in nursing instructions. Endometritis is an infection of the mucous membrane or endometrium of the uterus. Cystitis is an infection of the bladder. Infection of the perineum or episiotomy is a localized infection and not inclusive of the entire genital tract. Reference: Chapter 22: Nursing Management of the Postpartum Woman at Risk - Page 823

A 32-year-old woman presents to the labor and birth suite in active labor. She is multigravida, relaxed, and talking with her husband. When examined by the nurse, the fetus is found to be in a cephalic presentation. His occiput is facing toward the front and slightly to the right of the mother's pelvis, and he is exhibiting a flexed attitude. How does the nurse document the position of the fetus? A. ROA B. LOP C. LOA D. ROP

A. ROA The nurse should document the fetal position in the clinical record using abbreviations. The first letter describes the side of the maternal pelvis toward which the presenting part is facing ("R" for right and "L" for left). The second letter indicates the reference point ("O" for occiput, "Fr" for frontum, etc.). The last part of the designation specifies whether the presenting part is facing the anterior (A) or the posterior (P) portion of the pelvis, or whether it is in a transverse (T) position. Reference: Chapter 13: Labor and Birth Process - Page 447

A client at 6 weeks' gestation asks the nurse what foods she should eat to help prevent neural tube disorders in her growing baby. The nurse would recommend which foods? A. Spinach, oranges, and beans B. Bananas, avocados, and coconut C. Milk, yogurt, and cheese D. Pork, beans, and poultry

A. Spinach, oranges, and beans Folic acid assists in preventing the incidence of neural tube disorders. These foods include green, leafy vegetables; citrus fruits, beans, and fortified breads; cereals, rice, and pasta. Milk, yogurt, and cheese are high in calcium. Bananas, avocados, and coconut are high in potassium. Pork, beans, and poultry are high in iron. Reference: Chapter 24: Nursing Management of the Newborn at Risk: Acquired and Congenital Newborn Conditions - Page 908

A client experiencing contractions presents at a health care facility. Assessment conducted by the nurse reveals that the client has been experiencing Braxton Hicks contractions. The nurse has to educate the client on the usefulness of Braxton Hicks contractions. Which role do Braxton Hicks contractions play in aiding labor? A. These contractions help in softening and ripening the cervix. B. These contractions increase oxytocin sensitivity. C. These contractions make maternal breathing easier. D. These contractions increase the release of prostaglandins.

A. These contractions help in softening and ripening the cervix. Braxton Hicks contractions assist in labor by ripening and softening the cervix and moving the cervix from a posterior position to an anterior position. Prostaglandin levels increase late in pregnancy secondary to elevated estrogen levels; this is not due to the occurrence of Braxton Hicks contractions. Braxton Hicks contractions do not help in bringing about oxytocin sensitivity. Occurrence of lightening, not Braxton Hicks contractions, makes maternal breathing easier. Reference: Chapter 13: Labor and Birth Process - Page 438-439

Which pregnant woman should consult with her obstetric provider before continuing an exercise program? A. a 33-year-old G5P1 with a history of cervical insufficiency B. a 40-year-old G1P0 who does 30 to 60 minutes of aerobic exercise a day C. a 25-year-old G2P1 with history of heavy periods due to endometriosis D. a 17-year-old G1P0 who used oral contraceptive pills (OCPs) prior to becoming pregnant

A. a 33-year-old G5P1 with a history of cervical insufficiency Women who know they have cervical insufficiency or have had cerclage to correct this should consult with their obstetric provider before beginning or continuing an exercise program. The other pregnant females can continue their exercise programs with the routine precautions outlined.

A mother brings her 10-year-old daughter to the clinic for a routine visit. The mother tells the nurse that she has noticed her daughter beginning to develop and asks the nurse about when her daughter may begin menstruating. The nurse understands that many factors are involved in determining the age at which menstruation begins. Which factor would the nurse include in the response as most important? A. genetics B. cultural practices C. weight D. nutrition

A. genetics Genetics is the most important factor in determining the age at which menarche starts, but geographic location, nutrition, weight, general health, nutrition, cultural and social practices, the girl's educational level, attitude, family environment, and beliefs are also important. Reference: Chapter 3: Anatomy and Physiology of the Reproductive System - Page 104

A woman delivered her infant 3 hours ago and the postpartum nurse is checking the mother's uterus. She finds that the uterus is still level with the umbilicus and is not firm. What would be the first thing the nurse should check in this client? A. her bladder for distention B. her episiotomy C. the size of her infant D. hematocrit level

A. her bladder for distention Bladder distention can cause the uterus to not contract effectively following delivery and displace to the side. This is easily checked and should be the first assessment done for a client whose uterus is not contracting as expected.

A nurse is interviewing the family members of a pregnant client to obtain a genetic history. While asking questions, which information would be most important? A. if couples are related to each other or have blood ties B. socioeconomic status of the family members C. specific physical characteristics of family members D. avoidance of questions on race or ethnic background

A. if couples are related to each other or have blood ties While obtaining the genetic history of the client, the nurse should find out if the members of the couple are related to each other or have blood ties, as this increases the risk of many genetic disorders. The socioeconomic status or the physical characteristics of family members do not have any significant bearing on the risk of genetic disorders. The nurse should ask questions about race or ethnic background because some races are more susceptible to certain disorders than others. Reference: Chapter 10: Fetal Development and Genetics - Page 344

Prior to discharge is an appropriate time to evaluate the client's status for preventive measures such as immunizations and Rh status. Which test would the nurse ensure has been conducted to evaluate the Rh-negative mother? A. indirect Coombs test B. titer screen C. ANA D. CBC with differential

A. indirect Coombs test The indirect Coombs test is an antibody screen that will indicate whether or not the woman has been sensitized to the Rh-positive blood of her infant. A positive result indicates the sensitization has occurred and this can cause complications for future pregnancies. A CBC with differential provides a count of the various blood cells. The ANA and titer screen both analyze the blood for various antibodies that might be present in the blood. They can be used to check for immunization and autoimmune disorders. Reference: Chapter 16: Nursing Management During the Postpartum Period - Page 565

A client who is 29 weeks pregnant comes to the labor and childbirth unit. She states that she is having contractions every 8 minutes. The client is also 3 cm dilated. Which can the nurse expect to administer? Select all that apply. A. intravenous fluids B. Rohm(D) immune globulin (RhoGAM) C. nalbuphine D. betamethasone E. a β-2 agonist F. folic acid

A. intravenous fluids D. betamethasone E. a β-2 agonist The nurse can expect that a β-2 agonist that relaxes smooth muscle will be administered to halt contractions; that betamethasone, a corticosteroid, will be administered to decrease the risk of respiratory distress to the neonate if preterm birth occurs; and that intravenous fluids will be given to expand the intravascular volume and decrease contractions if dehydration is the cause. Folic acid is a mineral recommended throughout pregnancy (especially in the first trimester) to decrease the risk of neural tube defects. RhoGAM is given to Rh-negative clients who have been, or may have been, exposed to Rh-positive fetal blood. Nalbuphine is an opioid analgesic used during labor and birth. Remediation: Labor (Preterm) Betamethasone Dipropionate

After teaching a group of women about reproduction and the structures involved, the nurse determines that the teaching was successful when the group identifies which female reproductive structure as comparable to the male testes? A. ovaries B. fundus C. fallopian tubes D. clitoris

A. ovaries The ovaries are a set of paired glands resembling unshelled almonds that are the organs of gamete production in the female. They are homologous to the male testes. The fallopian tubes are the site of fertilization. The clitoris is a small, cylindrical mass of erectile tissue and nerves that is analogous to the male penis. The fundus is the upper portion of the uterus. Reference: Chapter 3: Anatomy and Physiology of the Reproductive System - Page 100

The nurse is admitting a client at 23 weeks' gestation in preparation for induction and delivery after it was determined the fetus had died secondary to trauma. When asked by the client to explain what went wrong, the nurse can point out which potential cause for this loss? A. placental abruption B. genetic abnormality C. premature rupture of membranes D. preeclampsia

A. placental abruption The most common cause of fetal death after a trauma is placental abruption (abruptio placentae), where the placenta separates from the uterus, and the fetus is not able to survive. Genetic abnormalities typically cause spontaneous abortion (miscarriage) in the first trimester. Trauma does not cause preeclampsia (which is related to various issues in the mother) nor does trauma usually cause PROM. Reference: Chapter 21: Nursing Management of Labor and Birth at Risk - Page 797

The nurse is caring for a client who is in the third stage of labor. Which behaviors by the client does the nurse assess as expected at this stage? Select all that apply. A. reports discomfort from uterine cramping B. feeling embarrassed about an urge to defecate C. exhausted from continued pushing D. excited about the anticipated process E. focused on the neonate's condition F. apprehension about the process

A. reports discomfort from uterine cramping E. focused on the neonate's condition In the third stage of labor, the neonate is delivered, and the placenta has yet to be expelled. A this time, the client is usually focused on the neonate's condition. Before the placenta is expelled, she may also state that she is experiencing discomfort from uterine contractions. Excitement and apprehension are characteristic of the first stage of labor. Exhaustion is common in the second stage of labor, particularly when the client is pushing. The urge to defecate is noted prior to birth at the end of the second stage of labor when the fetus is pushing on the rectum. Remediation: Labor And Birth (Normal)

A pregnant client who is HIV positive asks the nurse if she will be able to breastfeed the newborn. Which response by the nurse is most appropriate? A. "Since your newborn will have HIV it is okay for you to breastfeed." B. "Breastfeeding will increase your newborn's risk of contracting HIV." C. "Breastfeeding passes protective immunity along to your newborn." D. "You should speak to your primary health care provider about breastfeeding."

B. "Breastfeeding will increase your newborn's risk of contracting HIV." HIV can be transmitted by breastfeeding. A newborn who received the recommended plan of drug treatment has a reduced risk for contracting the infection. Contracting HIV is not an absolute for this newborn. The client should be discouraged from breastfeeding to limit exposure to the newborn. Breastfeeding does provide immunity when the mother is free of infection but not in this scenario. Telling the mother to speak to the health care provider is not the best response as the nurse is able to provide this education to the client. Reference: Chapter 47: Nursing Care of the Child With an Alteration in Immunity/Immunologic Disorder - Page 1756

A pregnant client asks the nurse what is causing her lower leg edema, nausea, and constipation that she is experiencing. What is the nurse's best response? A. "These could be early warning signs of miscarriage." B. "The increase in progesterone during pregnancy is most likely the cause of these discomforts." C. "The decrease in estrogen levels is usually the cause of these discomforts." D. "We need to monitor you carefully since you should not be experiencing these."

B. "The increase in progesterone during pregnancy is most likely the cause of these discomforts." Smooth muscle relaxation under the influence of progesterone plays an important role in maintaining pregnancy by decreasing uterine contractions and is responsible for many of the common discomforts of pregnancy (e.g., edema, nausea, constipation, flatulence, and headaches). Reference: Chapter 45: Disorders of the Female Reproductive System - Page 1121

Which intervention would be the best treatment option to prevent perinatal transmission of HIV antibodies to a fetus from the HIV-positive mother? A. Administration of zidovudine to the newborn immediately after delivery B. Administration of zidovudine to the mother during pregnancy, labor, and delivery C. Administration of efavirenz starting within the first trimester of pregnancy D. Administration of a fusion inhibitor immediately on diagnosis of pregnancy

B. Administration of zidovudine to the mother during pregnancy, labor, and delivery The administration of zidovudine has proven to be effective in lowering the perinatal transmission by two-thirds as compared to those who do not take the medications. Administration of zidovudine to the infant would not be therapeutic. Efavirenz, a fusion inhibitor, is contraindicated related to its teratogenic effects in the first trimester. Reference: Chapter 12: Disorders of the Immune Response - Page 298

A nurse who is caring for a new mother realizes that the woman is not prepared to go home with her newborn after a hospital stay of only 24 hours. However, hospital policy dictates that the mother be discharged. This nurse may be faced with which moral problem? A. Ethical dissatisfaction B. Ethical distress C. Ethical dilemma D. Ethical uncertainty

B. Ethical distress Ethical distress occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action. Ethical dilemmas arise when attempted adherence to basic ethical principles results in two conflicting courses of action. The nurse is not uncertain about what is ethical in this case, nor is the nurse merely dissatisfied with an ethical situation. Reference: Chapter 6: Values, Ethics, and Advocacy - Page 110-116

Fetal circulation differs from the circulatory path of the newborn infant. In utero the fetus has a hole connecting the right and left atria of the heart. This allows oxygenated blood to quickly pass to the major organs of the body. What is this hole called? A. Foramen venosus B. Foramen ovale C. Foramen arteriosus D. Foramen magnum

B. Foramen ovale The foramen ovale is a hole that connects the right and left atria so the majority of oxygenated blood can quickly pass into the left side of the fetal heart, go to the brain, and move to the rest of the fetal body. Reference: Chapter 10: Fetal Development and Genetics - Page 332

A client who is 7 weeks' pregnant comes to the clinic for her first prenatal visit. She reports smoking 20 to 25 cigarettes per day. The nurse should include what priority implementation in this client's plan of care? A. Have the client switch to vaping. B. Reduce the number of cigarettes smoked. C. Implement a smoking cessation program. D. Measure the fundal height.

B. Reduce the number of cigarettes smoked. With the number of cigarettes this client smokes, she is considered a heavy smoker. Intrauterine growth retardation (IUGR) increases with the number of cigarettes a woman smokes per day. Babies born to smokers are smaller than in mothers who do not smoke. The infants are at risk for many problems, including congenital heart defects. Smoking increases the risk of placental abruption. Smoking cessation is the ultimate goal for this mother, but realistically it will be difficult for her to abruptly stop. The most immediate goal is to reduce the number of cigarettes smoked per day after explaining all the risks associated with smoking. Vaping carries the same risk as cigarettes because nicotine is still present, but it also increases other risks from other ingredients in the product. Because IUGR can be significant, the fundal height should be measured regularly to assess for fetal growth. Remediation: Low Birth Weight Abruptio Placentae

The nurse is most correct to assess for transient tachypnea of the newborn (TTN) in which neonate? A. The neonate born at 41 weeks' gestation B. The neonate delivered by cesarean section C. The large-for-gestational-age neonate D. The neonate whose mother received limited prenatal care

B. The neonate delivered by cesarean section While every neonate has the respiratory system assessed, some are at higher risk of complications than others. The neonate born via cesarean section is at highest risk for TTN since this infant did not have the opportunity of having fluid expressed from the lungs as he/she descended down the birth canal. The other options are not in the high-risk category. Reference: Chapter 24: Nursing Management of the Newborn at Risk: Acquired and Congenital Newborn Conditions - Page 876

A 24-year-old male client with a complete transection of the spinal cord asks, "Will I be able to father children in the future?" The nurse responds: A. Probably not since your spinal cord has been completely severed. B. With proper stimulation of your genitals, you may be able to produce an erection and ejaculation. C. A urologist may be able to insert a needle into your testes and withdraw some sperm. D. It takes sympathetic innervation to produce an erection and ejaculation, which is lost with your type of injury.

B. With proper stimulation of your genitals, you may be able to produce an erection and ejaculation Genital stimulation can produce erection and ejaculation in some men with complete transection of the spinal cord. This negates telling the man that his severed spinal cord will keep him from reproducing, and negates telling the name that it takes sympathetic innervation to produce an erection and ejaculation. Reference: Chapter 43: Disorders of the Male Reproductive System - Page 1095

Which measurement best describes postpartum hemorrhage? A. blood loss of 600 ml, occurring at least 24 hours after birth B. blood loss of 1,000 ml, occurring at least 24 hours after birth C. blood loss of 800 ml, occurring at least 24 hours after birth D. blood loss of 400 ml, occurring at least 24 hours after birth

B. blood loss of 1,000 ml, occurring at least 24 hours after birth Postpartum hemorrhage involves blood loss in excess of 1,000 mL within the first 24 hours of delivery. Reference: Chapter 22: Nursing Management of the Postpartum Woman at Risk - Page 809

The nurse is teaching a primigravida who does not speak the dominant language. The nurse will teach about the most common type of fetal presentation. Which presentation will the nurse prepare? A. breech presentation using a picture B. cephalic presentation using preprinted materials in the client's language C. occiput presentation using a PowerPoint presentation D. footling presentation drawing a hand-prepared diagram

B. cephalic presentation using preprinted materials in the client's language The most common presentation type is the cephalic presentation, and it is most appropriate to highlight the information using preprinted materials in the client's language. Both portions of this answer are best. With pictures, the nurse can communicate on a common level and then the client has the opportunity to review as needed. The breech and occiput presentations are not the most common types of fetal presentation. The footling is not a type of fetal presentation.

The nurse is caring for a client at 36 weeks' gestation with a temperature of 101.2°F (38.4°C). Examination indicates that the client is leaking amniotic fluid. What is the nurse's priority concern based on these findings? A. stress response to labor B. intrauterine infection C. urinary tract infection D. group B Streptococcus colonization

B. intrauterine infection Premature membrane rupture creates an open port for intrauterine infection, indicated by an elevated temperature. The client doesn't exhibit common symptoms that would indicate a urinary tract infection. Fever and premature rupture of membranes aren't normal findings in labor. Group B strep colonization has no outward symptoms. Remediation: Prelabor Rupture Of Membranes (PROM) Patient Care

The first stage of labor is often a time of introspection. In light of this, which information would guide the nurse's plan of care? A. A woman should be left entirely alone during this period. B. A woman will rarely speak or laugh during this period. C. A woman may spend time thinking about what is happening to her. D. No nursing care is needed to be done during this time.

C. A woman may spend time thinking about what is happening to her. Women need a support person with them during all stages of labor. Reference: Chapter 13: Labor and Birth Process - Page 454-455

Long, stretchy cervical mucus that exhibits ferning on a microscope slide is characteristic of: A. High progesterone levels B. Low estrogen levels C. Crystallization of inorganic salts D. Low human chorionic gonadotropin levels

C. Crystallization of inorganic salts Cervical mucus that exhibits ferning and so-called spinnbarkeit occurs right around the time of ovulation (midcycle) due to increased water content and alteration in the concentration of inorganic salts. This is influenced by high serum levels of estrogen, which lead to the LH spike that promotes ovulation (bursting of the oocyte from the mature follicle). Progesterone levels increase only after ovulation during the luteal phase, at which point the cervical mucus "dries up" (becomes more scant). Reference: Chapter 45: Disorders of the Female Reproductive System - Page 1122

The nurse is monitoring a client who is in the second stage of labor, at +2 station, and anticipating birth within the hour. The client is now reporting the epidural has stopped working and is begging for something for pain. Which action should the nurse prioritize? A. Give the meperidine because she needs pain relief now. B. Call the anesthetist from the nurse's station to retry the epidural. C. Encourage her through the contractions, explaining why she cannot receive any pain medication. D. Call the primary care provider, and obtain a reduced dose of meperidine.

C. Encourage her through the contractions, explaining why she cannot receive any pain medication. At this point, any medication would be contraindicated as it would pass to the fetus and may cause respiratory depression. The nurse will have to work with the mother through the contractions and pushing. The client has progressed too far to retry the epidural medication. No meperidine should be given due to the risk to the fetus. Reference: Chapter 14: Nursing Management During Labor and Birth - Page 482

A woman who is 4 months pregnant notices frequent heart palpitations and leg cramps. She is anxious to learn how to alleviate these. Which nursing diagnosis would best apply to her? A. Pain related to severe complications of pregnancy B. Risk for ineffective breathing pattern related to pressure of the growing uterus C. Health-seeking behaviors related to ways to relieve discomforts of pregnancy D. Impaired urinary elimination related to inability to excrete creatine from her muscles

C. Health-seeking behaviors related to ways to relieve discomforts of pregnancy Health-seeking behaviors is a diagnosis used to describe clients who are actively interested in learning ways to improve their health. Reference: Chapter 12: Nursing Management During Pregnancy - Page 405-410

A baby is born with what the primary care provider believes is a diagnosis of trisomy 21. This means that the infant has three number 21 chromosomes. What factor describes this genetic change? A. The client will have a single X chromosome and infertility. B. During meiosis, a reduction of chromosomes resulted in 23. C. The client has a nondisjunction occurring during meiosis. D. The mother also has genetic mutation of chromosome 21.

C. The client has a nondisjunction occurring during meiosis. During meiosis, a pair of chromosomes may fail to separate completely, creating a sperm or oocyte that contains either two copies or no copy of a particular chromosome. This sporadic event, called nondisjunction, can lead to trisomy. Down syndrome is an example of trisomy. The mother does not have a mutation of chromosome 21, which is indicated in the question. Also, trisomy does not produce a single X chromosome and infertility. Genes are packaged and arranged in a linear order within chromosomes, which are located in the cell nucleus. In humans, 46 chromosomes occur in pairs in all body cells except oocytes and sperm, which contain only 23 chromosomes. Reference: Chapter 10: Fetal Development and Genetics - Page 341

When describing the role of a doula to a group of pregnant women, the nurse would include which information? A. The doula is a professionally trained nurse hired to provide physical and emotional support. B. The doula can perform any necessary clinical procedures. C. The doula primarily focuses on providing continuous labor support. D. The doula is capable of handling high-risk births and emergencies.

C. The doula primarily focuses on providing continuous labor support. Doulas provide the woman with continuous support throughout labor. The doula is a laywoman trained to provide women and families with encouragement, emotional and physical support, and information through late pregnancy, labor, and birth. A doula does not perform any clinical procedures and is not trained to handle high-risk births and emergencies. Reference: Chapter 12: Nursing Management During Pregnancy - Page 424

A child possesses a trait that is the result of the interaction of two different genes, neither of which could have produced the trait independently. Which explanation best captures the genetic explanation for this? A. The phenomenon is an example of polygenic inheritance. B. The trait is an expression of multiple alleles. C. The outcome is the result of the interaction between collaborative genes. D. Epistasis has dictated the phenotypic outcome.

C. The outcome is the result of the interaction between collaborative genes. The expression of two genes influencing the same phenotype, neither of which could have produced it alone, is an example of collaborative genes. Multiple alleles involve more than one gene at a particular locus affecting the same trait, and in epistasis a gene masks the phenotypic effects of another nonallelic gene. Polygenic inheritance involves multiple genes each affecting a small influence on a genetic outcome. Reference: Chapter 4: Genetic Control of Cell Function and Inheritance - Page 68

The nurse discovers a soft systolic murmur when auscultating the heart of a client at 32 weeks' gestation. Which action would be most appropriate? A. Ask another nurse to assess the heart. B. Inquire if the client has chest pain. C.Document this and continue to monitor the murmur at future visits. D. Refer her for cardiac catheterization.

C.Document this and continue to monitor the murmur at future visits. Due to the increased blood volume that occurs with pregnancy, soft systolic murmurs may be heard and are considered normal. Reference: Chapter 12: Nursing Management During Pregnancy - Page 392

When providing preconception care to a client, which instruction will the nurse to provide about medications during pregnancy? A. "It is safe for you to take over-the-counter medications." B. "You should switch to herbal remedies because they are safer to use than other types medicines." C. "You need to avoid all prescription, over-the-counter, and herbal medications when you are pregnant." D. "You need to talk with your health care provider about using all prescription, over-the-counter, and herbal medications."

D. "You need to talk with your health care provider about using all prescription, over-the-counter, and herbal medications." Medication use is common during pregnancy, with prevalence estimates generally exceeding 65% and increasing over the years. Pregnant women use a wide variety of both prescription and over-the-counter medications for both pregnancy-related conditions and conditions unrelated to pregnancy conditions. Little is known about the effects of taking most medications during pregnancy. It is best for pregnant women to not take any medications during their pregnancy. At the very least, they should be encouraged to discuss with the health care provider their current medications and any herbal remedies they take so that they can learn about any potential risks should they continue to take them during pregnancy. A common concern of many pregnant women involves the use of over-the-counter medications and herbal agents. Many women consider these products benign simply because they are available without a prescription. Although herbal medications are commonly thought of as "natural" alternatives to other medicines, they can be just as potent as some prescription medications. The nurse should encourage pregnant women to check with their health care providers before taking anything. Reference: Chapter 12: Nursing Management During Pregnancy - Page 419

The diagonal conjugate of a pregnant woman's pelvis is measured. Which measurement would the nurse interpret as presenting a potential problem? A. 13.5 cm B. 12.5 cm C. 13.0 cm D. 12.0 cm

D. 12.0 cm The diagonal conjugate, usually 12.5 cm or greater, indicates the anteroposterior diameter of the pelvic inlet. The diagonal conjugate is the most useful measurement for estimating pelvic size because a misfit with the fetal head occurs if it is too small. Reference: Chapter 12: Nursing Management During Pregnancy - Page 393

The nurse is explaining ovulation to a female client. The nurse explains that follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are important hormones needed to ovulate and are secreted by which gland? A. Thyroid B. Adrenal C. Posterior pituitary D. Anterior pituitary

D. Anterior pituitary After puberty, the anterior pituitary secretes follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Reference: Chapter 45: Disorders of the Female Reproductive System - Page 1120

Mary is heterozygous for blue eyes, a recessive trait. John is homozygous for brown eyes, a dominant trait. What color eyes will their four children have? A. Some will have blue, and some will have brown B. Impossible to tell C. Blue D. Brown

D. Brown A heterozygote with a dominant and a recessive allele will have the dominant phenotype. In Mary's case, this will manifest itself in her brown eyes. A homozygote with two dominant alleles will have the dominant phenotype, so John also has brown eyes. To have blue eyes, the children would have to inherit two alleles for blue eyes. Because they will inherit, at most, one recessive allele for blue eyes, the children's eyes will be brown. Reference: Chapter 4: Genetic Control of Cell Function and Inheritance - Page 69

A client who is 32 weeks' pregnant comes to the emergency department with bright red bleeding and no abdominal pain. What should the nurse assess first for this client? A. Assess the client's blood pressure. B. Perform a pelvic examination. C. Assess the fetal heart rate. D. Determine the amount of bleeding.

D. Determine the amount of bleeding. This client is demonstrating signs of placenta previa. The nurse should first assess the amount of bleeding the woman is having. The nurse should assess the perineum for blood that may be pooled underneath the client. If the woman is actively bleeding, an IV should be inserted and fluids started to prevent shock. Labs should be obtained for hemoglobin and hematocrit and blood typing and cross-matching. Avoid doing a vaginal examination because there is a potential to disrupt the placenta and cause hemorrhage. The fetal heart rate and contractions should be monitored continuously to determine any abnormalities. The woman's vital signs should be assessed regularly to determine the client's cardiopulmonary status. Remediation: Placenta Previa

A 24-year-old female client states, "About a week before my period starts, I have recently started craving certain sweets, having terrible mood swings, and feeling fatigued and irritable." Which action will the nurse take next? A. Document the findings in the client's medical record. B. Recommend the client's hormone levels be tested. C. Notify the client's primary health care provider. D. Educate the client on treatment for premenstrual syndrome.

D. Educate the client on treatment for premenstrual syndrome. The client is exhibiting symptoms of premenstrual syndrome and the nurse would provide education on treatment options for the client's specific symptoms, such as increased rest and exercise. The nurse would document the findings and education provided in the client's medical record and notify the primary health care provider; however, these are not a priority as the client is stable and in need of treatment options. The client does not have symptoms warranting hormone testing at this time. If the symptoms worsened or became intolerable, then testing may be needed. Reference: Chapter 7: Benign Disorders of the Female Reproductive Tract - Page 248

A nurse is counseling pregnant women about the detrimental effects of smoking and drinking on a fetus. During what stage of development is the fetus most susceptible to these teratogens? A. Fetal stage B. Pre-embryonic stage C. Neonatal stage D. Embryonic stage

D. Embryonic stage The fetus is most susceptible to teratogens during the embryonic stage. Reference: Chapter 22: Conception through Young Adult - Page 527

A nurse is applying ice packs to the perineal area of a client who has had a vaginal birth. Which intervention should the nurse perform to ensure that the client gets the optimum benefits of the procedure? A. Apply ice packs directly to the perineal area. B. Apply ice packs for 40 minutes continuously. C. Use ice packs for a week after birth. D. Ensure ice pack is changed frequently.

D. Ensure ice pack is changed frequently The nurse should ensure that the ice pack is changed frequently to promote good hygiene and to allow for periodic assessments. Ice packs are wrapped in a disposable covering or clean washcloth and then applied to the perineal area, not directly. The nurse should apply the ice pack for 20 minutes, not 40 minutes. Ice packs should be used for the first 24 hours, not for a week after birth. Reference: Chapter 16: Nursing Management During the Postpartum Period - Page 549

The partner of a pregnant client in her first trimester asks the nurse about the client's behavior recently, stating that she is very moody, seems happy one moment and is crying the next and all she wants to talk about is herself. What response would correctly address these concerns? A. What you are describing may be normal but we need to talk to her more in depth. B. Moodiness and irritability are not usual responses to pregnancy. C. Her body is changing and she may be angry about it. D. Pregnant women often experience mood swings and self-centeredness but this is normal.

D. Pregnant women often experience mood swings and self-centeredness but this is normal. During the first trimester of pregnancy, the woman often has mood swings, bouts of irritability and is hypersensitive. The partner needs to know that these are all normal behaviors for a pregnant woman. Reference: Chapter 11: Maternal Adaptation During Pregnancy - Page 373

A client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal? A. Reverse edema B. Decrease protein in urine C. Decrease blood pressure D. Prevent maternal seizures

D. Prevent maternal seizures The primary therapy goal for any client with preeclampsia is to prevent maternal seizures. Use of magnesium sulfate is the drug therapy of choice for severe preeclampsia and is only used to manage and attempt to prevent progression to eclampsia. Magnesium sulfate therapy does not have as a primary goal of decreasing blood pressure, decreasing protein in the urine, or reversing edema. Reference: Chapter 19: Nursing Management of Pregnancy at Risk: Pregnancy-Related Complications - Page 683

A homeless client diagnosed with human papillomavirus (HPV) is seen in the maternity clinic requesting a pregnancy test. Which nursing action would be the best example of the secondary level of prevention? A. Send a referral to social work for adequate housing assessment. B. Arrange for her to have the HPV vaccination. C. Discuss with her the need for folic acid supplementation. D. Suggest she have a Papanicolaou test.

D. Suggest she have a Papanicolaou test. Secondary prevention is the early detection and treatment of adverse health conditions and is aimed at halting the disease. Health screenings are the mainstay of secondary prevention. Papanicolaou tests are at this level of prevention. Primary prevention encompasses immunizations, and as she is already infected with HPV, the vaccine would not be effective. The referral for social work and the use of folic acid supplements while pregnant are examples of primary prevention. Reference: Chapter 2: Family-Centered Community-Based Care - Page 72

The health care provider has prescribed a karyotype for a newborn. The mother questions the type of information that will be provided by the test. What information should be included in the nurse's response? A. A karyotype is useful in determining the potential complications the baby may face as a result of its condition. B. The karyotype will provide information about the severity of your baby's condition. C. The karyotype will determine the treatment needed for the infant. D. The karyotype will assess the baby's chromosomal makeup.

D. The karyotype will assess the baby's chromosomal makeup. The pictorial analysis of the number, form, and size of an individual's chromosomes is referred to as a karyotype. This analysis commonly uses white blood cells and fetal cells in amniotic fluid. The chromosomes are numbered from the largest to the smallest, 1 to 22, and the sex chromosomes are designated by the letter X or the letter Y. The severity and related complications of a disorder are not determined by the karyotype. Condition management is not determined by the karyotype. Reference: Chapter 10: Fetal Development and Genetics - Page 337

Which sexually transmitted infection has the following characteristics: thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina? A. Nonspecific vaginitis B. Herpes simplex 1 C. Herpes simplex 2 D. Trichomoniasis

D. Trichomoniasis Trichomoniasis is characterized by thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina; it is often asymptomatic in males. Nonspecific vaginitis is characterized by foul-smelling, thin, grayish-white vaginal discharge. Herpes simplex virus type 1 and 2 are characterized by lesions. Reference: Chapter 45: Sexuality - Page 1760-1788

While teaching a sex education class to a group of preadolescents, the school nurse explains that human growth and development begins at which of the following events? A. When ovulation occurs in the female B. When intercourse takes place C. When ovum implants in the uterus D. When ovum is fertilized by sperm

D. When ovum is fertilized by sperm When ovum and sperm unite, genetic material is combined to begin growth and development. Intercourse is needed for the ovum and sperm to unite. Human growth and development has already occurred before implantation in the uterus. Ovulation is release of the ovum from the ovary. Reference: Chapter 22: Conception through Young Adult - Page 527

The nurse is explaining congenital defects to a newly pregnant client. She explains that one of the most common birth defects is: A. spina bifida. B. pyloric stenosis. C. congenital heart disease. D. cleft lip with or without cleft palate.

D. cleft lip with or without cleft palate. Cleft lip with or without cleft palate is one of the most common birth defects. Other congenital defects that are thought to arise through multifactorial inheritance are clubfoot, congenital dislocation of the hip, congenital heart disease, pyloric stenosis, and urinary tract malformation. Reference: Chapter 5: Genetic and Congenital Disorders - Page 81

The nurse is creating an educational pamphlet for pregnant mothers. Which is the best description of fetal development for the nurse to emphasize? A. length, weight, sex B. sex and systems developed C. age in weeks and systems developed D. gestational age, length, weight, and systems developed

D. gestational age, length, weight, and systems developed Client education is a major component of maternal-child nursing. During pregnancy, nurses provide anticipatory guidance to prepare the woman and her significant other for the changes each month brings. Clients most often want to know gestational age in weeks, length, weight, and systems developed; the client is then able to visualize what the fetus looks like. Reference: Chapter 10: Fetal Development and Genetics - Page 328-329

A woman is taking vaginal progesterone suppositories during her first trimester because her body does not produce enough of it naturally. She asks the nurse what function this hormone has in her pregnancy. What should the nurse explain is the primary function of progesterone? A. contributes to mammary gland development B. regulates maternal glucose, protein, and fat levels C. ensures the corpus luteum of the ovary continues to produce estrogen D. maintains the endometrial lining of the uterus during pregnancy

D. maintains the endometrial lining of the uterus during pregnancy Progesterone is necessary to maintain the endometrial lining of the uterus during pregnancy. It is human chorionic gonadotropin (hCG) that acts to ensure the corpus luteum of the ovary continues to produce estrogen and progesterone. Estrogen contributes to mammary gland development, and human placental lactogen regulates maternal glucose, protein, and fat levels. Reference: Chapter 10: Fetal Development and Genetics - Page 331

A client in labor has administered an epidural anesthesia. Which assessment findings should the nurse prioritize? A. maternal hypertension and fetal tachycardia B. maternal hypertension and fetal bradycardia C. maternal hypotension and fetal tachycardia D. maternal hypotension and fetal bradycardia

D. maternal hypotension and fetal bradycardia Epidural anesthesia conveys the risk of hypotension, especially if the client has not received an adequate amount of fluid before the procedure is performed. A sudden drop in maternal blood pressure can cause uterine hypoperfusion, which may result in fetal bradycardia. The other choices are not an adverse effect of epidural anesthesia. Reference: Chapter 14: Nursing Management During Labor and Birth - Page 476

The nurse is caring for a woman who gave birth vaginally to a healthy 6 pound (2.72 kg) newborn after a 2-hour labor at 37 weeks gestation. For which complication will the nurse assess as a priority due to the increased risk in this client? A. postpartum infection B. delay in lactation C. delayed infant bonding D. postpartum hemorrhage

D. postpartum hemorrhage The client's labor was under 3 hours in length, which meets the definition for precipitous labor. This increases the risk for postpartum hemorrhage but decreases the risk for infection. The client is at early term (37 weeks) and gave birth vaginally without any noted complications, so there should be no delay in either lactation or infant bonding. Remediation: Postpartum Hemorrhage Management

Early in pregnancy, frequent urination results mainly from which of the following? A. increased concentration of urine B. addition of fetal urine to maternal urine C. decreased glomerular selectivity D. pressure on the bladder from the uterus

D. pressure on the bladder from the uterus Early in pregnancy, the expanding uterus presses on the bladder. Later, it rises above the bladder so the pressure is relieved.

During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn? A. urine output B. heart rate C. temperature D. respiratory function

D. respiratory function The nurse should identify respiratory distress syndrome as a major risk that can be faced by the offspring of a client with cardiovascular disease. While the other assessments are important, they are not priority. Reference: Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations - Page 717

At what point in pregnancy does the average woman switch from accepting she is pregnant to accepting she is having a child? A. around the third month B. after lightening happens C. after the seventh month D. when quickening occurs

D. when quickening occurs Quickening, or feeling the baby move inside the body, is such a dramatic event that it can cause a woman's perceptions about the pregnancy to change.