Women's Health Final Exam

Lakukan tugas rumah & ujian kamu dengan baik sekarang menggunakan Quizwiz!

To prevent gastrointestinal (GI) upset, when should a pregnant client be instructed to take the recommended iron supplements? A.) On a full stomach B.) At bedtime C.) After eating a meal D.) With milk

Which intervention would the nurse perform to provide a relaxed environment for a laboring client? A.) Stand at the bedside B.) Encourage a rapid birth C.) Control sensory stimuli D.) Demonstrate excitement

Which micronutrients can be obtained through dietary sources to meet the nutritional needs of a pregnant client (select all that apply): A.) Iron B.) Folate C.) Calcium D.) Vitamin D E.) Vitamin B12

C, D, E

Which condition is a contraindication when using the spermicide nonoxynol-9 (N-9) as, or with, a client's contraceptive method? A.) Iron-deficiency anemia B.) Risk for human immunodeficiency virus (HIV) C.) Contraceptive diaphragm use D.) Condom use of the partner

Which condition is expected after a laboratory report for a pregnant client shows low levels of serum ferritin? A.) Tetany B.) Anemia C.) Renal failure D.) Hypertension

Which contraceptive method best protects against STIs and the HIV? A.) Periodic abstinence B.) Barrier methods C.) Hormonal methods D.) Same protection with all methods

Which contraceptive method is most often prescribed to clients who are on anticoagulant therapy for thromboembolism? A.) Estrogen-only pills B.) Progestin-only pills C.) Combined oral pills D.) Parenteral progestins

Which describes the nurse's understanding of the fetal risk for intrauterine growth restriction (IUGR)? A.) Asphyxia B.) Stillbirth C.) Traumatic birth injury D.) Asymmetric growth

Which reason is appropriate for a false positive result in the client with a history of epilepsy? A.) The test was taken too early B.) The client is taking tranquilizers C.) The client uses promethazine D.) The client is undergoing diuretic therapy

Nursing follow-up care often includes home visits for the new mother and her infant. Which information related to home visits is correct? A.) Ideally, the visit is scheduled within 72 hours after discharge B.) Home visits are available in all areas C.) Visits are completed within a 30-minute time frame D.) Blood draws are not a part of the home visit

Which condition is appropriate for a 15 year old female client who is experiencing extreme stress caused by schoolwork, which has led to an eating disorder and significant weight loss? A.) Dysmenorrhea B.) Hypothyroidism C.) Hypogonadotropic amenorrhea D.) Premenstrual dysphoric disorder

Which sensory system is least mature at the time of birth? A.) Vision B.) Hearing C.) Smell D.) Taste

Which condition is described in the client who shows signs of depression, is excessively concerned about her body size and shape, and also eats uncontrollably? A.) Anorexia nervosa B.) Bulimia nervosa C.) Binge eating disorder D.) Night eating disorder

Which condition is the reason a client with endometriosis would be unwilling to take danazol in the future? A.) Amenorrhea B.) Abdominal pain C.) Masculinizing trait D.) Temporary infertility

Which position facilitates the pelvic outlet to increase in the second stage of labor? A.) Semirecumbent B.) Sitting C.) Squatting D.) Side-lying

The nurse palpates the fontanels and sutures to determine the fetal presentation. Which is the characteristic of the anterior fontanel? A.) It is diamond-shaped in appearance B.) It measures about 1 cm by 2 cm C.) It closes after 6 to 8 weeks of birth D.) It lies near the occipital bone

What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern? A.) Altered fetal cerebral blood flow B.) Umbilical cord compression C.) Uteroplacental insufficiency D.) Spontaneous rupture of membranes

When assessing a postpartum client, the nurse finds that the client has excessive foul-smelling lochia. Which medication would helpful in treating this condition? A.) A broad-spectrum antibiotic B.) A diuretic to induce urination C.) An intravenous oxytocin agent D.) Intravenous fluids

Which female reproductive organ(s) is(are) responsible for cyclic menstruation? A.) Uterus B.) Ovaries C.) Vaginal vestibule D.) Urethra

Which information is appropriate for the nurse to be aware of with regard to medications, herbs, shots and other substances normally encountered? A.) Prescription and over-the-counter (OTC) drugs that otherwise are harmless can be hazardous because they can cross the placenta and pose a risk to the developing fetus B.) The greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimester C.) Killed-virus vaccines (e.g. tetanus) should not be given during pregnancy, but live-virus vaccines (measles) are permissible D.) No convincing evidences exists that secondhand smoke is potentially dangerous to the fetus

Which information regarding the procedures and criteria for admitting a woman to the hospital labor unit is important for the nurse to understand? A.) Client is considered to be in active labor when she arrives at the facility with contractions B.) Client can have only her male partner or predesignated doula with her at assessment C.) Children are not allowed on the labor unit. D.) NonEnglish speaking client must bring someone to translate

Which initial assessment question is appropriate for a client who is trying to conceive a baby, is 3 days late for her period and has a negative pregnancy test? A.) Are you currently taking any medications B.) Did you take the test before you went to bed C.) Have you been able to conceive before this attempt D.) What type of birth control did you use before trying to conceive

Which is a common outcome of cesarean delivery on the respiratory function of the neonate? A.) Retention of fluid in the lungs B.) Incidence of transient bradypnea C.) Exhaustion from the effort of breathing D.) Episodes of periodic breathing

Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother? A.) Hypoglycemia B.) Hypercalcemia C.) Hypobilirubinemia D.) Hypoinsulinemia

Which presentation is accurately described in terms of both the presenting part and the frequency of occurrence? A.) Cephalic: occiput, at least 96% B.) Breech: sacrum, 10% to 15% C.) Shoulder: scapula, 10% to 15% D.) Cephalic: cranial, 80% to 85%

Which statement indicates that a client requires additional instruction regarding BSE? A.) Yellow discharge from my nipple is normal if Im having my period B.) I should check my breasts at the same time each month, after my period C.) I should also feel in my armpit area while performing my breast examination D.) I should check each breast in a set way, such as in a circular motion

Which term best describes the conscious decision concerning when to conceive or avoid pregnancy as opposed to the intentional prevention of pregnancy during intercourse? A.) Family planning B.) Birth control C.) Contraception D.) Assisted reproductive therapy

A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. Which findings should the nurse include in the discussion (select all that apply): A.) Breast tenderness B.) Warmth in the breast C.) Area of redness on the breast often resembling the shape of a pie wedge D.) Small white blister on the tip of the nipple E.) Fever and flulike symptoms

A, B, C, E

Nurses are in an ideal position to educate clients who experience PMDD. What self-help activities have been documented as helpful in alleviating the symptoms of PMDD (select all that apply): A.) Regular exercise B.) Improved nutrition C.) Daily glass of wine D.) Smoking cessation E.) Oil of evening primrose

A, B, D, E

A group of infections known collaboratively as TORCH infections are capable of crossing the placenta and causing serious prenatal effects on the fetus. Which infections are included in this group of organisms (select all that apply): A.) Toxoplasmosis B.) Other infections C.) Roseola D.) Clostridium E.) Herpes simplex

A, B, E

Which suggestions are appropriate for a client who complains of hot flashes (select all that apply): A.) Avoid caffeine. B.) Drink a glass of wine to relax. C.) Wear layered clothing. D.) Drink ice water. E.) Drink warm beverages for their calming effect

A, C

Which assessment findings would lead the nurse to suspect that a newborn has developed jaundice (select all that apply): A.) Reduced frequency of passing stool B.) Reduced visual acuity C.) Decreased milk intake D.) Increased urine output E.) Weight loss greater than 7%

A, C, E

A nurse is caring for a client in the third stage of labor. Which of the following findings indicate that placental separation has occurred (Select all that apply): A.) Lengthening of the umbilical cord B.) Swift gush of clear amniotic fluid C.) Softening of the lower uterine segment D.) Appearance of dark blood from the vagina E.) Fundus firm upon palpation

A, D, E

A pregnant client is on tocolytic therapy with magnesium sulfate. Under which client circumstance would the nurse suggest discontinuing the therapy? A.) Blood pressure is 120/80 mmHg B.) Respiratory rate is 10 breaths/minutes C.) Urine output is 40 mL/hour D.) Serum magnesium level is 5 mEq/L

An MSAFP screening indicates an elevated level of alpha-fetoprotein. The test is repeated, and again the level is reported as higher than normal. What is the next step in the assessment sequence to determine the well-being of the fetus? A.) PUBS B.) Ultrasound for fetal anomalies C.) BPP for fetal well-being D.) Amniocentesis for genetic anomalies

What is a maternal indication for the use of vacuum-assisted birth? A.) Wide pelvic outlet B.) Maternal exhaustion C.) History of rapid deliveries D.) Failure to progress past station 0

What should the laboring client who receives an opioid antagonist be told to expect? A.) Her pain will decrease B.) Her pain will return C.) She will feel less anxious D.) She will no longer feel the urge to push

Which cardiovascular changes cause the foramen ovale to close at birth? A.) Increased pressure in the right atrium B.) Increased pressure in the left atrium C.) Decreased blood flow to the left ventricle D.) Changes in the hepatic blood flow

Which finding in the urinalysis of a pregnant woman is considered a variation of normal? A.) Proteinuria B.) Glycosuria C.) Bacteria in the urine D.) Ketones in the urine

Which intervention would the nurse perform while using a fiberoptic blanket and phototherapy light for a newborn with jaundice? A.) Provide intermittent feedings of glucose water B.) Cover the newborn's eyes with an opaque mask C.) Place the fully unclothed newborn under the light D.) Wrap the naked newborn with a fiberoptic blanket

Which is a common maternal complication of Chlamydia? A.) Meningitis B.) Preterm labor C.) Chorioamnionitis D.) Postpartum sepsis

Which is the expected total weight gain for the client with a singleton pregnancy during the first trimester? A.) 2 to 3 kg B.) 1 to 2 kg C.) 1.5 to 2 kg D.) 0.5 to 1 kg

Which is the normal range of amniotic fluid index? A.) 1 to 5 cm B.) 10 to 25 cm C.) 25 to 40 cm D.) 40 to 65 cm

Which nursing explanation is appropriate for a client who asks about decreasing the risk for transmission of human immunodeficiency virus (HIV) to her baby during baby? A.) It is recommended that the baby be delivered by cesarean section B.) If the viral load is decreased and you are treated in the intrapartum period, the risk of transmission is reduced C.) If your viral load is low and you recieve zidovudine during labor, there is minimal risk of your baby contracting HIV D.) To decrease the risk of transmitting HIV to the baby; it is essential that you receive adequate treatment during labor

Which nursing instruction is appropriate for a 35 year old client taking combined oral contraceptives (COCs)? A.) "COCs can cause early menopause" B.) "Avoid herbal supplements" C.) "There is a risk for iron-deficiency anemia with COCs" D.) "There is a risk for increased menstrual blood loss"

Foodborne illnesses can cause adverse effects for both mother and fetus. The nurse is in an ideal position to evaluate the client's knowledge regarding steps to prevent a foodborne illness. The nurse asks the client to teach back the fours simple steps of food preparation. What are they (select all that apply): A.) Purchase B.) Clean C.) Separate D.) Cook E.) Chill

B, C, D, E

Which signs and symptoms would the nurse find in assessing the client with abruption placentae (select all that apply): A.) Hypoglycemia B.) Abdominal pain C.) Vaginal bleeding D.) Delayed menses E.) Uterine tenderness

B, C, E

Which foods are appropriate to exclude from the pregnant client's diet plan to ensure good health (select all that apply): A.) Meat B.) Butter C.) Yogurt D.) Beef fat E.) Stick margarine

B, D, E

A woman arrives for evaluation of signs and symptoms that include a missed period, adnexal fullness, tenderness, and dark red vaginal bleeding. On examination, the nurse notices an ecchymotic blueness around the womans umbilicus. What does this finding indicate? A.) Normal integumentary changes associated with pregnancy B.) Turner sign associated with appendicitis C.) Cullen sign associated with a ruptured ectopic pregnancy D.) Chadwick sign associated with early pregnancy

A woman who is 30 weeks of gestation arrives at the hospital with bleeding. Which differential diagnosis would not be applicable for this client? A.) Placenta previa B.) Abruptio placentae C.) Spontaneous abortion D.) Cord insertion

The indirect Coombs test is a screening tool for Rh incompatibility. If the titer is greater than ______, amniocentesis may be a necessary next step. A.) 1:2 B.) 1:4 C.) 1:8 D.) 1:12

The nurse is performing an initial assessment of a client in labor. What is the appropriate terminology for the relationship of the fetal body parts to one another? A.) Lie B.) Presentation C.) Attitude D.) Position

The nurse observes a sudden increase in variability on the ERM tracing. Which class of medications may cause this finding? A.) Narcotics B.) Barbiturates C.) Methamphetamines D.) Tranquilizers

What is the drug of choice for the treatment of gonorrhea? A.) Penicillin G B.) Tetracycline C.) Ceftriaxone D.) Acyclovir

Which information related to the newborns developing cardiovascular system should the nurse fully comprehend? A.) The heart rate of a crying infant may rise to 120 beats per minute B.) Heart murmurs heard after the first few hours are a cause for concern C.) The point of maximal impulse (PMI) is often visible on the chest wall D.) Persistent bradycardia may indicate respiratory distress syndrome (RDS)

Which postpartum infection is most often contracted by mothers who are breastfeeding? A.) Endometritis B.) Wound infections C.) Mastitis D.) Urinary tract infections (UTIs)

Which findings obtained during clinical evaluation of a pregnant client help determine the gestational age of the fetus (select all that apply): A.) Previous cesarean delivery B.) Types of contraception used C.) Current fundal height D.) Current week of gestation

C, D, E

A clients oncologist has just finished explaining the diagnostic workup results to her, and she still has questions. The woman states, The physician says I have a slow-growing cancer. Very few cells are dividing. How does she know this? What is the name of the test that gave the health care provider this information? A.) Tumor ploidy B.) S-phase index C.) Nuclear grade D.) Estrogen-receptor assay

A new mother with a thyroid disorder has come for a lactation follow-up appointment. Which thyroid disorder is a contraindication for breastfeeding? A.) Hyperthyroidism B.) PKU C.) Hypothyroidism D.) Thyroid storm

How would the physiologic process of the sexual response best be characterized? A.) Coitus, masturbation, and fantasy B.) Myotonia and vasocongestion C.) Erection and orgasm D.) Excitement, plateau, and orgasm

In assessing a postpartum client, the nurse is aware that which factor is the primary cause of thromboembolic disease? A.) Viral infection B.) Hypercoagulation C.) Corticosteroid therapy D.) Deficient clotting factors

On reviewing the medical history of a pregnant client, the nurse finds that the client is taking carbamazepine. What consequence of the drug on the fetus should the nurse be aware of? A.) Pylectasis B.) Spina bifida C.) Omphalocele D.) Lupus erythematosus

The nurse is completing a physical examination of the newborn 24 hours after birth. Which component of the evaluation is correct? A.) The parents are excused to reduce their normal anxiety B.) The nurse can gauge the neonates maturity level by assessing his or her general appearance C.) Once often neglected, blood pressure is now routinely checked D.) When the nurse listens to the neonates heart, the S1 and S2 sounds can be heard; the S1 sound is somewhat higher in pitch and sharper than the S2 sound

The nurse working with pregnant clients must seek to gain understanding of the process whereby women accept their pregnancy. Which statement regarding this process is most accurate? A.) Nonacceptance of the pregnancy very often equates to a rejection of the child B.) Mood swings are most likely the result of worries about finances and a changed lifestyle, as well as profound hormonal changes C.) Ambivalent feelings during pregnancy are usually only expressed in emotionally immature or very young mothers D.) Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will naturally resolve themselves after birth

What is the correct term describing the slight overlapping of cranial bones or shaping of the fetal head during labor? A.) Lightening B.) Molding C.) Ferguson reflex D.) Valsalva maneuver

What is the most likely cause for variable FHR decelerations? A.) Altered fetal cerebral blood flow B.) Umbilical cord compression C.) Uteroplacental insufficiency D.) Fetal hypoxemia

Which action would the nurse take after noting that an infant's heart rate is 80 beats/min while sleeping? A.) Immediately wake the infant B.) Reass the heart rate after 30 minutes C.) Advise the mother to stop breastfeeding D.) Inform the parents that the infant has bradycardia

Which information regarding substance abuse is important for the nurse to understand? A.) Although cigarette smoking causes a number of health problems, it has little direct effect on maternity-related health B.) Women, ages 21 to 34 years, have the highest rates of specific alcohol-related problems C.) Coffee is a stimulant that can interrupt body functions and has been related to birth defects D.) Prescription psychotherapeutic drugs taken by the mother do not affect the fetus; otherwise, they would not have been prescribed

Which instruction should the nurse provide to reduce the risk of nipple trauma? A.) Limit the feeding time to less than 5 minutes B.) Position the infant so the nipple is far back in the mouth C.) Assess the nipples before each feeding D.) Wash the nipples daily with mild soap and water

Which statements are accurate regarding the occurrence of obesity in the United States (select all that apply): A.) 25% of women in the United States are presently considered to be obese B.) Women in the age group of 40 to 59 years have the highest prevalence C.) Obesity is associated with hypercholesterolemia D.) Obesity is associated with a decreased incidence of diabetes E.) Women who are obese may be more likely to have irregularities of the menstrual cycle

B, C, E

What are the two primary functions of the ovary (select all that apply): A.) Normal female development B.) Ovulation C.) Sexual response D.) Hormone production E.) Sex hormone release

B, D

A woman with asthma is experiencing a postpartum hemorrhage. Which drug should be avoided when treating postpartum bleeding to avoid exacerbating asthma? A.) Oxytocin (Pitocin) B.) Nonsteroidal antiinflammatory drugs (NSAIDs) C.) Hemabate D.) Fentanyl

In which pregnant client would the nurse identify the need to screen for undiagnosed homozygous maternal phenylketonuria (PKU)? A.) A client who had a macrosomic fetus in a previous pregnancy B.) A client who had obstructed labor in a previous pregnancy C.) A client who gave birth to a microcephalic infant in a previous pregnancy D.) A client who had placental insufficiency in a previous pregnancy

The nurse would assess for which complication before planning care for a client who has undergone a forceps-assisted delivery? A.) Decreased vaginal secretions B.) Decreased urinary frequency C.) Presence of vaginal lacerations D.) Increased pelvic muscles tone

To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet? A.) Eat six small equal meals per day B.) Reduce the carbohydrates in her diet C.) Eat her meals and snacks on a fixed schedule D.) Increase her consumption of protein

What is the primary reason why a woman who is older than 35 years may have difficulty achieving pregnancy? A.) Personal risk behaviors influence fertility B.) Mature women have often used contraceptives for an extended time C.) Her ovaries may be affected by the aging process D.) Prepregnancy medical attention is lacking

What is the primary role of the nonpregnant partner during pregnancy? A.) To provide financial support B.) To protect the pregnant woman from old wives tales C.) To support and nurture the pregnant woman D.) To make sure the pregnant woman keeps prenatal appointments

What is the rationale for the administration of vitamin K to the healthy full-term newborn? A.) Most mothers have a diet deficient in vitamin K, which results in the infant being deficient B.) Vitamin K prevents the synthesis of prothrombin in the liver and must be administered by injection C.) Bacteria that synthesize vitamin K are not present in the newborns intestinal tract D.) The supply of vitamin K in the healthy full-term newborn is inadequate for at least 3 to 4 months and must be supplemented

Which STI does not respond well to antibiotic therapy? A.) Chlamydia B.) Gonorrhea C.) Genital herpes D.) Syphilis

Which action would the nurse take if a client with suspected syphilis has a negative nontreponemal antibody test result? A.) Assess the client's medical history B.) Assess for the presence of genital lesions C.) Administer the test again after 1 to 2 months D.) Assess if the client is receiving alternative therapy

Which instruction would the nurse provide to a pregnant client with mild preeclampsia? A.) "You need to be hospitalized for fetal evaluation" B.) "Nonstress testing can be done once every month" C.) "Fetal movement counts need to be evaluated daily" D.) "Take complete bed rest during the entire pregnancy"

Which intervention helps prevent infection in the newborn? A.) Begin iron supplementation B.) Check the infant's birth weight C.) Encourage the mother to breastfeed the infant D.) Administer a vitamin K injection

Which is an effective relief measure for primary dysmenorrhea? A.) Reduce the physical activity level until menstruation ceases B.) Begin taking prostaglandin synthesis inhibitors on the first day of the menstrual flow C.) Decrease intake of salt and refined sugar about 1 week before menstruation is about to occur D.) Use barrier methods rather than the oral contraceptive pill (OCP) for birth control

Which is appropriate client knowledge when using the basal body temperature method of family planning? A.) She will remain fertile for 5 days after ovulation B.) She should take her temperature each night before going to bed C.) Her temperature will increase about 0.4 to 0.8 F after ovulation D.) Her temperature is normally lower during the second half of her cycle

Which is the best nursing response for a client with a history of breast cancer who had a lumpectomy 2 years ago and is asking about the best time to perform monthly breast self-examination (BSE)? A.) "The best time of the month to perform your breast self-examination is during your menstrual cycle" B.) "The best time of the month to perform your breast self-examination is 2 weeks after your period" C.) "The best time of the month to perform your breast self-examination is 5 to 7 days after menstruation stops" D.) "The best time of the month to perform your breast self-examination is right before you start your period"

Which neurologic condition would require preconception counseling, if at all possible? A.) Eclampsia B.) Bell palsy C.) Epilepsy D.) Multiple sclerosis

Which nursing advice is appropriate for a 5-month pregnant client reporting dizziness after waking up in the morning? A.) "Keep your legs elevated while sleeping" B.) "Try to spend less of your time sleeping" C.) "Try sleeping in the side-lying (lateral) position" D.) "Use two pillows for your head while sleeping"

Which test is used to determine the presence of fetal-to-maternal bleeding in a pregnant client? A.) D-dimer test B.) Nonstress test (NST) C.) Kleihauer-Betke (KB) test D.) Biophysical profile (BPP)

Which testing would be available for a client at 11 weeks of gestation who requests a fetal genetic assessment? A.) Ultrasonography B.) Amniocentesis C.) Chorionic villus sampling D.) Percutaneous umbilical blood sampling (PUBS)

A pregnant client with cystic fibrosis (CF) wants to breastfeed her infant. Which assessments would be performed to make sure that breastfeeding will be safe and effective? A.) Monitor maternal weight B.) Monitor maternal urine for ketones C.) Monitor sodium levels in breast milk D.) Monitor total fat levels in breast milk E.) Monitor the infant growth pattern

C, D, E

During pregnancy, many changes occur as a direct result of the presence of the fetus. Which of these adaptations meet this criterion (select all that apply): A.) Leukorrhea B.) Development of the operculum C.) Quickening D.) Ballottement E.) Lightening

C, D, E

Hypothyroidism occurs in 2 to 3 pregnancies per 1000. Because severe hypothyroidism is associated with infertility and miscarriage, it is not often seen in pregnancy. Regardless of this fact, the nurse should be aware of the characteristic symptoms of hypothyroidism. Which do they include (select all that apply): A.) Hot flashes B.) Weight loss C.) Lethargy D.) Decrease in exercise capacity E.) Cold intolerance

C, D, E

The nurse is caring for a pregnant client with rheumatic heart disease and activity intolerance. Which nursing interventions would the nurse perform to reduce activity intolerance (select all that apply): A.) Monitor fluid intake and output B.) Teach the client to lie on her side C.) Advise the client to maintain an activity log D.) Encourage the client to reduce activity that cause fatigue E.) Help the client develop an individualized program of activity and rest

C, D, E

The nurse is preparing a diet plan for a pregnant client with preeclampsia. Which would the nurse include in the client's diet (select all that apply): A.) Food with a low fiber content B.) Four to five cups of coffee per day C.) Food with a low sodium content D.) Food with a high zinc content E.) Six to eight glasses of water per day

C, D, E

The nurse is teaching a client with gestational diabetes the technique to inject insulin. Which education would the nurse include (select all that apply): A.) Aspirate before injecting B.) Clean the injection site with alcohol C.) Insert the needle at a 90-degree angle D.) Inject the insulin slowly E.) After injection, cover the site with sterile gauze

C, D, E

The nurse is teaching a pregnant client how to recognize signs of preeclampsia and when to report to the primary health care provider. Which statements by the client indicate effective learning (select all that apply): A.) "I should report if I see an increase in urinary output" B.) "I should report if a dipstick test shows proteinuria less than 1+" C.) "I should report if I experience blurred vision or headache" D.) "I should report if I feel a decrease in the baby's movements" E.) "I should sit and use my right arm to accurately measure my blood pressure"

C, D, E

Which conditions describe the assessment findings for a client with secondary syphilis (select all that apply): A.) Papules B.) Chancre C.) Lymphadenopathy D.) Condylomata lata on the vulva, perineum, or anus E.) Maculopapular rash on the hands and soles of the feet

C, D, E

Which dietary modifications are appropriate for the pregnant client who has a folate intake of approximately 580 mcg/day (select all that apply): A.) Include 8 ounces of milk daily B.) Include 6 ounces of yogurt daily C.) Add one extra slice of bread daily D.) Include one boiled egg every day E.) Include one-half cup of corn daily

C, D, E

Which assessment findings support that a 15-year-old high school student may attain her menses late (select all that apply): A.) Morbidly obese B.) Thyroid disorder C.) Anorexia nervosa D.) Type 1 diabetes mellitus E.) Strenuous sports

C, E

A client states that she does not drink milk. Which foods should the nurse encourage this woman to consume in greater amounts to increase her calcium intake? A.) Fresh apricots B.) Canned clams C.) Spaghetti with meat sauce D.) Canned sardines

A nurse is caring for a client who is using patterned breathing during labor. The client reports numbness and tingling of the fingers. Which of the following actions should the nurse take? A.) Administer oxygen via nasal cannula at 2 L/min B.) Apply a warm blanket C. Assist the client to a side-lying position D.) Place an oxygen mask over the client's nose and mouth

A nursing student is helping the nursery nurses with morning vital signs. A baby born 10 hours ago by cesarean section is found to have moist lung sounds. What is the best interpretation of these data? A.) The nurse should immediately notify the pediatrician for this emergency situation B.) The neonate must have aspirated surfactant C.) If this baby was born vaginally, then a pneumothorax could be indicated D.) The lungs of a baby delivered by cesarean section may sound moist during the first 24 hours after childbirth

A pregnant woman's diet may not meet her increased need for folates. Which food is a rich source of this nutrient? A.) Chicken B.) Cheese C.) Potatoes D.) Green leafy vegetables

In which position would the nurse recommend a postpartum client place her 36-week-old newborn during breastfeeding? A.) Cradle position B.) Lying down position C.) Across the lap position D.) Under the arm position

Nurses should be able to teach breastfeeding mothers the signs that the infant has correctly latched on. Which client statement indicates a poor latch? A.) I feel a firm tugging sensation on my nipples but not pinching or pain B.) My baby sucks with cheeks rounded, not dimpled C.) My baby's jaw glides smoothly with sucking D.) I hear a clicking or smacking sound

What is the goal of a long-term treatment plan for an adolescent with an eating disorder? A.) Managing the effects of malnutrition B.) Establishing sufficient caloric intake C.) Improving family dynamics D.) Restructuring client perception of body image

When would an internal version be indicated to manipulate the fetus into a vertex position? A.) Fetus from a breech to a cephalic presentation before labor begins B.) Fetus from a transverse lie to a longitudinal lie before a cesarean birth C.) Second twin from an oblique lie to a transverse lie before labor begins D.) Second twin from a transverse lie to a breech presentation during a vaginal birth

Which FHR finding is the most concerning to the nurse who is providing care to a laboring client? A.) Accelerations with fetal movement B.) Early decelerations C.) Average FHR of 126 beats per minute D.) Late decelerations

Which clinical finding would the nurse report to the provider when examining the external genitalia of a female infant? A.) Slight bloody spotting B.) Presence of hymenal tag C.) Mucoid vaginal discharge D.) Fecal vaginal discharge

Which laboratory findings indicate anemia in the pregnant client reporting dizziness and fatigue? A.) Hematocrit value of 35% B.) Hematocrit value of 40% C.) Hemoglobin value of 11 g/dL D.) Hemoglobin value of 10 g/dL

A 40 year old woman with a body mass index (BMI) over 30 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

A client at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. Which client condition would the nurse suspect? A.) Eclamptic seizure B.) Uterine rupture C.) Placenta previa D.) Placental abruption

A new mother asks the nurse what the experts say about the best way to feed her infant. Which recommendation of the American Academy of Pediatrics (AAP) regarding infant nutrition should be shared with this client? A.) Infants should be given only human milk for the first 6 months of life B.) Infants fed on formula should be started on solid food sooner than breastfed infants C.) If infants are weaned from breast milk before 12 months, then they should receive cows milk, not formula D.) After 6 months, mothers should shift from breast milk to cows milk

A new mother asks whether she should feed her newborn colostrum, because it is not real milk. What is the nurses most appropriate answer? A.) Colostrum is high in antibodies, protein, vitamins, and minerals B.) Colostrum is lower in calories than milk and should be supplemented by formula C.) Giving colostrum is important in helping the mother learn how to breastfeed before she goes home D.) Colostrum is unnecessary for newborns

A nurse in the labor and delivery unit is caring for a client in labor and applies an external fetal monitor and tocotransducer. The FHR is around 140/min. Contractions are occurring every 8 min and 30-40 sec in duration. The nurse performs a vaginal exam and finds the cervix is 2 cm dilated, 50% effaced and the fetus is at -2 station. Which of the following stages and phases of labor is the client experiencing? A.) First stage, latent phase B.) First stage, active phase C.) First stage, transition phase D.) Second stage of labor

A nurse is caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. Which of the following is the first action the nurse should take? A.) Assist the client into the left-lateral position B.) Apply a fetal scalp electrode C.) Insert an IV catheter D.) Perform a vaginal exam

A nurse is caring for a client who is in the second stage of labor. The client's labor has been progressing, and she is expected to deliver vaginally in 20 min. The provider is preparing to administer lidocaine for pain relief and perform an episiotomy. The nurse should know that which of the following types of regional anesthesia blocks should be administered? A.) Pudendal B.) Epidural C.) Spinal D.) Paracervical

A new mother asks the nurse when the soft spot on her sons head will go away. What is the nurse's best response, based upon her understanding of when the anterior frontal closes? A.) 2 months B.) 8 months C.) 12 months D.) 18 months

A nurse is caring for a client with mitral stenosis who is in the active stage of labor. Which action would the nurse take to promote cardiac function? A.) Maintain the client in a side-lying position with the head and shoulders elevated to facilitate hemodynamics B.) Prepare the client for cesarean delivery because this is the recommended method to sustain hemodynamics C.) Encourage the client to avoid the use of narcotics or epidural regional analgesia because this alters cardiac function D.) Promote the use of the valsalva maneuver during pushing in the second stage to improve diastolic ventricular filling

When is a prophylactic cerclage for an incompetent cervix usually placed (in weeks of gestation)? A.) 12 to 14 B.) 6 to 8 C.) 23 to 24 D.) After 24

When is the appropriate time to place elastic compression stockings on the legs of a client who is being treated with intravenous (IV) heparin for deep vein thrombosis (DVT)? A.) Before ambulating B.) During treatment with IV heparin C.) Throughout the client's time on bedrest D.) While the client's leg is elevated

When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. Which instruction best describes these measures? A.) Encouraging the woman to try various upright positions, including squatting and standing B.) Telling the woman to start pushing as soon as her cervix is fully dilated C.) Continuing an epidural anesthetic so pain is reduced and the woman can relax D.) Coaching the woman to use sustained, 10- to 15-second, closed-glottis bearing-down efforts with each contraction

Which behavioral change would the nurse observe in the spouse of a pregnant client during the focusing phase? A.) Engages in building a relationship with the newborn B.) Engages in discussions with others about the philosophy of life C.) Engages in extramarital affairs because of a lack of partner's attention D.) Has difficulty accepting changes in life plans and lifestyles

Which condition places the pregnant client at a higher risk for a cesarean delivery? A.) A client with the fetus in a transverse lie B.) A client with the fetus in a cephalic presentation C.) A client with a fetal biparietal diameter of 9.25 cm at term D.) A client in whom the presenting part is 4 cm below the spines

Which condition would require prophylaxis to prevent subacute bacterial endocarditis (SBE) both antepartum and intrapartum? A.) Valvular heart disease B.) Congestive heart disease C.) Arrhythmias D.) Postmyocardial infarction

Which describes the use for ultrasonography in the third trimester of pregnancy (select all that apply): A.) Detects congenital anomalies B.) Assess the placental location C.) Detects maternal uterine abnormalities D.) Determines the causes of vaginal bleeding E.) Determines the gestational age of the fetus

Which description most accurately describes the augmentation of labor? A.) Is part of the active management of labor that is instituted when the labor process is unsatisfactory B.) Relies on more invasive methods when oxytocin and amniotomy have failed C.) Is a modern management term to cover up the negative connotations of forceps-assisted birth D.) Uses vacuum cups

Which information about dysfunctional uterine bleeding is accurate? A.) It is most commonly caused by anovulation B.) It most often occurs in middle age C.) Diagnosis of dysfunctional uterine bleeding should be the first considered for abnormal menstrual bleeding D.) The most effective medical treatment involves steroids

Which information is an important consideration when comparing the CST with the NST? A.) The NST has no known contraindications B.) The CST has fewer false-positive results when compared with the NST C.) The CST is more sensitive in detecting fetal compromise, as opposed to the NST D.) The CST is slightly more expensive than the NST

Which information is the highest priority for the nurse to comprehend regarding the BPP? A.) BPP is an accurate indicator of impending fetal well-being B.) BPP is a compilation of health risk factors of the mother during the later stages of pregnancy C.) BPP consists of a Doppler blood flow analysis and an amniotic fluid index (AFI) D.) BPP involves an invasive form of an ultrasonic examination

Which information regarding protein in the diet of a pregnant woman is most helpful to the client? A.) Many protein-rich foods are also good sources of calcium, iron, and B vitamins B.) Many women need to increase their protein intake during pregnancy C.) As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet D.) High-protein supplements can be used without risk by women on macrobiotic diets

Which information regarding to injuries to the infants plexus during labor and birth is most accurate? A.) If the nerves are stretched with no avulsion, then they should completely recover in 3 to 6 months B.) Erb palsy is damage to the lower plexus C.) Parents of children with brachial palsy are taught to pick up the child from under the axillae D.) Breastfeeding is not recommended for infants with facial nerve paralysis until the condition resolves

Which initial question is appropriate before explaining the use of cycle beads to a client using the Standard Day Method (SDM) of family planning to avoid pregnancy? A.) How often do you have menstrual cycles? B.) How do you currently track your menstrual cycle? C.) How does your partner feel about abstaining from intercourse during the fertile period? D.) Do you understand that this method has a higher failure rate than other methods of natural planning?

Which is the most effective way to reduce the adverse consequences of sexually transmitted infections (STIs) for women and for society? A.) Preventing infection (primary prevention) B.) Preventing risky drug-related and sexual behaviors C.) Preventing STIs during pregnancy D.) Getting early treatment for any STIs

Which is the rationale for placing a full-term infant on the postpartum client's chest after delivery? A.) To help initiate breastfeeding B.) To help the client recognize the infant's hunger cues C.) To promote pulmonary development in the infant D.) To reduce the symptoms of anxiety and restlessness in the mother

Which medication would be indicated for a client with human papillomavirus (HPV) infection? A.) Podofilox 0.5% solution B.) Azithromycin 1 g orally C.) Ceftriaxone 125 mg IM D.) Benzathine penicillin G 7.2 million units

Which neonatal complications are associated with hypertension in the mother? A.) Intrauterine growth restriction (IUGR) and prematurity B.) Seizures and cerebral hemorrhage C.) Hepatic or renal dysfunction D.) Placental abruption and DIC

Which nursing advice is appropriate for the client using the ParaGuard Copper T 380A? A.) "Report immediately if rashes occur" B.) "Drink warm water fi you experience cramping" C.) "Irregular spotting is a serious side effect and needs prompt treatment" D.) "Use a condom to increase contraceptive effectiveness"

Which nursing information is appropriate to discuss with a client who is at 32 weeks of gestation? A.) Newborn care B.) Recommended exercise routine C.) Methods for pain management during labor D.) Maternal and fetal requirements

Which nursing intervention should be immediately performed after the forceps-assisted birth of an infant? A.) Assessing the infant for signs of trauma B.) Administering prophylactic antibiotic agents to the infant C.) Applying a cold pack to the infant's scalp D.) Measuring the circumference of the infant's head

Which nursing response is appropriate for a heterosexual couple who asks if they need to use both a male and a female condom during sexual intercourse to reduce the risk for sexually transmitted infections? A.) "There is a possibility of both condoms tearing as a result of friction" B.) "You can use water-based lubricants with condoms" C.) "Using a female condom only may not provide protection" D.) "It will reduce the risk for sexually transmitted infections"

Which nutrients recommended dietary allowance (RDA) is higher during lactation than during pregnancy? A.) Energy (kcal) B.) Iron C.) Vitamin A D.) Folic acid

Which nutritional recommendation regarding fluids is accurate? A.) A woman's daily intake should be six to eight glasses of water, milk, and/or juice B.) Coffee should be limited to no more than 2 cups, but tea and cocoa can be consumed without worry C.) Of the artificial sweeteners, only aspartame has not been associated with any maternity health concerns D.) Water with fluoride is especially encouraged because it reduces the child's risk of tooth decay

Which process in the uterus, a muscular pear-shaped organ, responsible for? A.) Cyclic menstruation B.) Sex hormone production C.) Fertilization D.) Sexual arousal

Which response would the nurse provide a client who asks why there is corn syrup added to infant formulas? A.) "To provide sufficient carbohydrates to the baby" B.) "To provide sufficient vitamins to the baby" C.) "To provide sufficient protein to the baby" D.) "To provide sufficient minerals to the baby"

Which statement is accurate regarding the difference experience can make in labor pain? A.) Pain for nulliparous women often is greater than the multiparous women during early labor B.) Pain for nulliparous woman usually is less than the multiparous women throughout the first stage of labor C.) Women with a history of substance abuse experience more pain during labor D.) Multiparous women have more fatigue from labor and therefore experience more pain

Which substance, when abused during pregnancy, is the most significant cause of cognitive impairment and dysfunction in the infant? A.) Alcohol B.) Tobacco C.) Marijuana D.) Heroin

Which symptom is appropriate to assess for in the client who is taking an oral contraceptive and reports severe leg pain? A.) Thrombus formation B.) Severe muscle spasms C.) High creatinine levels D.) Hyperglycemic events

Which type of medication is used to decrease excessive bleeding and uterine atony in the postpartum client? A.) Oxytocic B.) Anesthetic C.) Antiinflammatory D.) Selective serotonin reuptake inhibitors

A nurse is reviewing the electronic monitor tracing of a client who is in active labor. The nurse should know that a fetus receives more oxygen when which of the following appears on the tracing? A.) Peak of the uterine contraction B.) Moderate variability C.) FHR acceleration D.) Relaxation between uterine contractions

A pregnant client has atypical sharp pain in the left side of the chest that does not respond to nitrates. Which diagnosis would the nurse expect in this client? A.) Tetralogy of Fallot B.) Atrial septal defect C.) Mitral valve stenosis D.) Mitral valve prolapse

The nurse is advising a pregnant client who has been prescribed lispro. Which information would the nurse provide about the insulin (select all that apply): A.) It is rapid-acting insulin preferred for use during pregnancy B.) It is injected just before meals and causes less hyperglycemia C.) It has shorter duration of action as compared to regular insulin D.) It is released slowly in small amounts with no pronounced peak E.) Its action lasts for 12 hours maintaining optimal blood glucose levels

A, B, C

Which are symptoms of a urinary tract infection (UTI) in the pregnant client (select all that apply): A.) Dysuria B.) Dribbling C.) Hematuria D.) Urinary frequency E.) Odor of vaginal discharge

A, B, C, D

Emergency conditions during labor that would require immediate nursing intervention can arise with startling speed. Which situations are examples of such an emergency (select all that apply): A.) Nonreassuring or abnormal FHR pattern B.) Inadequate uterine relaxation C.) Vaginal bleeding D.) Prolonged second stage E.) Prolapse of the cord

A, B, C, E

Pregnancy is a hypercoagulable state in which women are at a fivefold to sixfold increased risk for thromboembolic disease. The tendency for blood to clot is greater, attributable to an increase in various clotting factors. Which of these come into play during pregnancy (select all that apply): A.) Factor VII B.) Factor VIII C.) Factor IX D.) Factor XIII E.) Fibrinogen

A, B, C, E

Which abnormal findings would the nurse immediately report to the health care provider for a client at 37 weeks of gestation who has been in a motor vehicle accident and is being discharged (select all that apply): A.) Leaking fluid B.) Abdominal pain C.) Vaginal bleeding D.) Irregular contractions E.) Decreased fetal movement

A, B, C, E

Which components of a cultural assessment aid in planning effective interventions for a postpartum client (select all that apply): A.) Primary language B.) Dietary preferences C.) Folk medicine practices D.) Client's pharmacologic knowledge E.) Ability to read and write English

A, B, C, E

Which medications are used to manage PPH (select all that apply): A.) Oxytocin B.) Methergine C.) Terbutaline D.) Hemabate E.) Magnesium sulfate

A, B, D

Congenital disorders refer to those conditions that are present at birth. These disorders may be inherited and caused by environmental factors or maternal malnutrition. Toxic exposures have the greatest effect on development between 15 and 60 days of gestation. For the nurse to be able to conduct a complete assessment of the newly pregnant client, he or she should be knowledgeable regarding known human teratogens. Which substances might be considered a teratogen (select all that apply): A.) Cytomegalovirus (CMV) B.) Ionizing radiation C.) Hypothermia D.) Carbamazepine E.) Lead

A, B, D, E

Which presumptive signs (felt by the woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause (select all that apply): A.) Amenorrhea: stress, endocrine problems B.) Quickening: gas, peristalsis C.) Goodell sign: cervical polyps D.) Chadwick sign: pelvic congestion E.) Urinary frequency: infection

A, B, D, E

A pregnant client is being examined by the nurse in an outpatient obstetric clinic. The nurse suspects systemic lupus erythematosus (SLE) after the examination reveals which symptoms (select all that apply): A.) Muscle aches B.) Hyperactivity C.) Weight change D.) Fever E.) Hypotension

A, C, D

A pregnant client is being treated with penicillin G for syphilis. What client condition would the nurse immediately report to the primary care provider (select all that apply): A.) Fever B.) Nausea C.) Myalgias D.) Headache E.) Arthralgias

A, C, D, E

A client who has undergone a D&C for early pregnancy loss is likely to be discharged the same day. The nurse must ensure that her vital signs are stable, that bleeding has been controlled, and that the woman has adequately recovered from the administration of anesthesia. To promote an optimal recovery, what information should discharge teaching include (select all that apply): A.) Iron supplementation B.) Resumption of intercourse at 6 weeks post-procedure C.) Referral to a support group, if necessary D.) Expectation of heavy bleeding for at least 2 weeks E.) Emphasizing the need for rest

A, C, E

Which adverse prenatal outcomes are associated with the HELLP syndrome (select all that apply): A.) Placental abruption B.) Placenta previa C.) Renal failure D.) Cirrhosis E.) Maternal and fetal death

A, C, E

The nurse is aware of which subjective symptoms of cardiac decompensation when assessing a pregnant client (select all that apply): A.) Palpitations B.) Cyanosis of the lips C.) Rapid respiration D.) Difficulty breathing E.) Feeling of smothering

A, D, E

Which areas of the neonate are assessed for jaundice (select all that apply): A.) Skin B.) Sclera C.) Nail beds D.) Buccal mucosa E.) Conjunctival sacs

A, D, E

A woman who is 8 months pregnant asks the nurse, Does my baby have any antibodies to fight infection? What is the most appropriate response by the nurse? A.) Your baby has all the immunoglobulins necessary: immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA) B.) Your baby won't receive any antibodies until he is born and you breastfeed him C.) Your baby does not have any antibodies to fight infection D.) Your baby has IgG and IgM

How does the nurse document a NST during which two or more FHR accelerations of 15 beats per minute or more occur with fetal movement in a 20-minute period? A.) Non-reactive B.) Positive C.) Negative D.) Reactive

In which condition is the pregnant client at risk for having higher-than-normal levels of human chorionic gonadotropin (hCG), excessive vomiting and mild vaginal bleeding? A.) Miscarriage B.) Ectopic pregnancy C.) Intrauterine growth restriction D.) Gestational trophoblastic disease

Nafarelin (Synarel) is used to treat mild to severe endometriosis. What instruction or information should the nurse provide to a client regarding nafarelin administration? A.) Nafarelin stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity B.) It should be administered by intramuscular (IM) injection C.) Nafarelin should be administered by a subcutaneous implant D.) It can cause the client to experience some hot flashes and vaginal dryness

Nurses need to understand the basic definitions and incidence data regarding PPH. Which statement regarding this condition is most accurate? A.) PPH is easy to recognize early; after all, the woman is bleeding B.) Traditionally, it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH C.) If anything, nurses and physicians tend to overestimate the amount of blood loss D.) Traditionally, PPH has been classified as early PPH or late PPH with respect to birth

Nurses should be cognizant of what information with regard to the noncontraceptive medical effects of combination oral contraceptives (COCs)? A.) COCs can cause TSS if the prescription is wrong B.) Hormonal withdrawal bleeding is usually a little more profuse than in normal menstruation and lasts a week for those who use COCs C.) COCs increase the risk of endometrial and ovarian cancers D.) Effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements

The client has been on magnesium sulfate for 20 hours for the treatment of preeclampsia. She just delivered a viable infant girl 30 minutes ago. What uterine findings does the nurse expect to observe or assess in this client? A.) Absence of uterine bleeding in the postpartum period B.) Fundus firm below the level of the umbilicus C.) Scant lochia flow D.) Boggy uterus with heavy lochia flow

The major source of nutrients in the diet of a pregnant woman should be composed of what? A.) Simple sugars B.) Fats C.) Fiber D.) Complex carbohydrates

Which alteration in cyclic bleeding best describes bleeding that occurs at any time other than menses? A.) Oligomenorrhea B.) Menorrhagia C.) Leiomyoma D.) Metrorrhagia

Which condition is indicated when a pregnant client's fundal height has not changed in the past 4 weeks? A.) Polyhydramnios B.) Multifetal gestation C.) Maternal malnourishment D.) Intrauterine growth restriction (IUGR)

Which hormone is responsible for the maturation of mammary gland tissue? A.) Estrogen B.) Testosterone C.) Prolactin D.) Progesterone

Which pregnant woman should strictly follow weight gain recommendations during pregnancy? A.) Pregnant with twins B.) In early adolescence C.) Shorter than 62 inches or 157 cm D.) Was 20 pounds overweight before pregnancy

Which represents a positive sign of pregnancy? A.) Morning sickness B.) Quickening C.) Positive pregnancy test D.) Fetal heartbeat auscultated with Doppler/fetoscope

Which statement by the client indicates the need for further teaching when providing exercise tips to an 18-week pregnant client? A.) I should exercise regularly for 30 minutes at a time B.) I should decrease weight-bearing exercises C.) I should take my pulse for 10 minutes after exercising D.) I should lie on my back for 10 minutes after exercising

Which statement related to the induction of labor is most accurate? A.) Can be achieved by external and internal version techniques B.) Is also known as a trial of labor (TOL) C.) Is almost always performed for medical reasons D.) Is rated for viability by a Bishop score

Which type of cervical mucus would you expect when the woman is in preovulation? A.) Scant B.) Thick, cloudy and sticky C.) Clear, wet, sticky and slippery D.) Cloudy, yellow or white, and sticky

A woman gave birth to a healthy 7-pound, 13-ounce infant girl. The nurse suggests that the client place the infant to her breast within 15 minutes after birth. The nurse is aware that the initiation of breastfeeding is most effective during the first 30 minutes after birth. What is the correct term for this phase of alertness? A.) Transition period B.) First period of reactivity C.) Organizational stage D.) Second period of reactivity

A woman who has a history of sexual abuse may have a number of traumatic memories triggered during labor. She may fight the labor process and react with pain or anger. The nurse can implement a number of care measures to help her client view the childbirth experience in a positive manner. Which intervention is key for the nurse to use while providing care? A.) Tell the client to relax and that it won't hurt much B.) Limit the number of procedures that invade her body C.) Reassure the client that, as the nurse, you know what is best D.) Allow unlimited care providers to be with the client

A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice. What is the nurse's best response? A.) Oral contraceptives are a highly effective method, but they have some side effects B.) Your current medications will reduce the effectiveness of the pill C.) Oral contraceptives will reduce the effectiveness of your seizure medication D.) The pill is a good choice for a woman of your age and with your personal history

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. What is the nurses ideal response? A.) Dont worry about it. You'll do fine B.) It's normal to be anxious about labor. Let's discuss what makes you afraid C.) Labor is scary to think about, but the actual experience isn't D.) You can have an epidural. You wont feel anything

Cardiac output increases from 30% to 50% by the 32nd week of pregnancy. What is the rationale for this change? A.) To compensate for the decreased renal plasma flow B.) To provide adequate perfusion of the placenta C.) To eliminate metabolic wastes of the mother D.) To prevent maternal and fetal dehydration

Which question is appropriate for a client at 36 weeks of gestation who is having problems with her legs swelling and has developed hemorrhoids? A.) Are you taking iron supplements B.) Do you have any pain in your legs C.) Have you been experiencing frequent constipation D.) Have you tried adding foods with fiber in your daily diet

Which statement by the student nurse indicated effective learning about pelvic inflammatory disease (PID)? A.) PID causes miscarriage B.) The menstrual period facilitates the development of PID C.) Neisseria gonorrhoeae is the only organism that causes PID D.) PID occurs as organisms spread from the upper genital tract in the vagina

For an infant experiencing symptoms of drug withdrawal, which intervention should be included in the plan of care? A.) Administering chloral hydrate for sedation B.) Feeding every 4 to 6 hours to allow extra rest between feedings C.) Snugly swaddling the infant and tightly holding the baby D.) Playing soft music during feeding

The nurse would anticipate which client condition in the second stage of labor? A.) The amniotic membranes rupture B.) The cervix cannot be felt during a vaginal examination C.) The client experiences a strong urge to bear down D.) The presenting part is below the ischial spines

Which contraceptive method is contraindicated in woman with a history of toxic shock syndrome? A.) Condom B.) Spermicide C.) Cervical cap D.) Oral contraceptives

Which hematocrit (HCT) and hemoglobin (HGB) results represent the lowest acceptable values for a woman in the third trimester of pregnancy? A.) 38% HCT; 14 g/dl HGB B.) 35% HCT; 13 g/dl HGB C.) 33% HCT; 11 g/dl HGB D.) 32% HCT; 10.5 g/dl HGB

Which minerals and vitamins are usually recommended as a supplement in a pregnant clients diet? A.) Fat-soluble vitamins A and D B.) Water-soluble vitamins C and B6 C.) Iron and folate D.) Calcium and zinc

A client is concerned that her breasts are engorged and uncomfortable. What is the nurse's explanation for this physiologic change? A.) Overproduction of colostrum B.) Accumulation of milk in the lactiferous ducts and glands C.) Hyperplasia of mammary tissue D.) Congestion of veins and lymphatic vessels

A pregnant woman is at 38 weeks of gestation. She wants to know whether there are any signs that labor is getting close to starting. Which finding is an indication that labor may begin soon? A.) Weight gain of 1.5 to 2 kg (3 to 4 lb) B.) Increase in fundal height C.) Urinary retention D.) Surge of energy

The Valsalva maneuver can be described as the process of making a forceful bearing-down attempt while holding one's breath with a closed glottis and a tightening of the abdominal muscles. When is it appropriate to instruct the client to use this maneuver? A.) During the second stage to enhance the movement of the fetus B.) During the third stage to help expel the placenta C.) During the fourth stage to expel blood clots D.) Not at all

The nurse suspects that her postpartum client is experiencing hemorrhagic shock. Which observation indicates or would confirm this diagnosis? A.) Absence of cyanosis in the buccal mucosa B.) Cool, dry skin C.) Calm mental status D.) Urinary output of at least 30 ml/hr

What bacterial infection is definitely decreasing because of effective drug treatment? A.) Escherichia coli infection B.) Tuberculosis C.) Candidiasis D.) Group B streptococci (GBS) infection

A nurse caring for a woman in labor should understand that absent or minimal variability is classified as either abnormal or indeterminate. Which condition related to decreased variability is considered benign? A.) Periodic fetal sleep state B.) Extreme prematurity C.) Fetal hypoxemia D.) Preexisting neurologic injury

Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the client mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. This fetus is at the greatest risk for which condition? A.) Macrosomia B.) Congenital anomalies of the central nervous system C.) Preterm birth D.) Low birth weight

Several delivery changes in the integumentary system that appear during pregnancy disappear after birth, although not always completely. What change is almost certain to be completely reversed? A.) Nail brittleness B.) Darker pigmentation of the areolae and linea nigra C.) Striae gravidarum on the breasts, abdomen, and thighs D.) Spider nevi

The nurse is screening a pregnant client and is aware that which factor is known to increase the risk of gestational diabetes mellitus? A.) Previous birth of large infant B.) Maternal age younger than 25 years C.) Underweight before pregnancy D.) Previous diagnosis of type 2 diabetes mellitus

The nurse is teaching a pregnant client regarding the monitoring of daily fetal movement. Which finding should be reported to the primary health care provider? A.) Fetal movement was not declared for 12 hours B.) An episode of limb straightening was observed C.) One episode of fetal breathing was seen in 30 minutes D.) An amniotic fluid index value of more than 5 cm

The nurse is teaching a student nurse about maternal cardiac risk groups and mortality rates. Which statement is accurate regarding risk groups and mortality rates? A.) Aortic stenosis has a mortality rate of 5% to 15% B.) Pulmonary hypertension is categorized at group I C.) Patent ductus arteriosus is categorized as group II D.) Artificial heart valves has a mortality rate of less than 1%

Which factor is appropriate to identify when providing client instructions about daily monitoring of fetal kick counts? A.) Obesity B.) Alcohol C.) Smoking D.) Antidepressants

Which integumentary finding for a newborn is identified as a normal variation? A.) Mongolian spots B.) Nevus flammeus C.) Infantile hemangioma D.) Generalized ecchymosis

Which is the client's first day of the last menstrual period (LMP) if the estimated date of birth (EDB) is December 2, 2019? A.) February 25, 2019 B.) March 25, 2019 C.) February 2, 2019 D.) March 2, 2019

Which phase of the mother-child relationship is described as the client accepting the biologic fact of pregnancy and views the expectant child as part of herself? A.) Phase 1 B.) Phase 2 C.) Moratorium phase D.) Announcement phase

Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)? A.) All women, regardless of risk factors B.) Women who have had more than one sexual partner C.) Women who have had a sexually transmitted infection (STI) D.) Woman who are monogamous with one partner

Which assessments are included in the fetal BPP (select all that apply): A.) Fetal movement B.) Fetal tone C.) Fetal heart rate D.) AFI E.) Placental grade

A, B, C, D

Which nursing interventions are included in the plan of care for a pregnant client with mitral stenosis (select all that apply): A.) Restrict dietary sodium B.) Reduce activity C.) Assess the echocardiogram D.) Increase the client's activity E.) Assess the client's respiratory status

A, B, C, E

Which related signs are appropriate for the pregnant client whose hormonal reports reveal increased estrogen levels (select all that apply): A.) Mucoid discharge from the cervix B.) Heaviness in the breasts C.) Milk discharge from the nipples D.) Decreased chest expansion E.) Well-defined pink blotches on the palm

A, B, E

Which technique would the nurse use when assessing the respiratory rate of a newborn 12 hours after birth (select all that apply): A.) Count the rise and fall of the abdomen B.) Count for 6 seconds, and multiply by 10 C.) Observe for symmetry of chest movement D.) Assess the infant's respiratory rate E.) Assess respiration after obtaining the temperature

A, C, D

The blood glucose level of a pregnant client is 325 mg/dL. Which test would be performed on the client to assess the risk of maternal or intrauterine fetal death? A.) Ketones in urine B.) Glucose in urine C.) Arterial blood gases D.) Abdominal ultrasonography

The human papillomavirus (HPV), also known as genital warts, affects 79 million Americans, with an estimated number of 14 million new infections each year. The highest rate of infection occurs in young women, ages 20 to 24 years. Prophylactic vaccination to prevent the HPV is now available. Which statement regarding this vaccine is inaccurate? A.) Only one vaccine for the HPV is available B.) The vaccine is given in three doses over a 6-month period C.) The vaccine is recommended for both boys and girls D.) Ideally, the vaccine is administered before the first sexual contact

What is the correct definition of a spontaneous termination of a pregnancy (abortion)? A.) Pregnancy is less than 20 weeks B.) Fetus weighs less than 1000 g C.) Products of conception are passed intact D.) No evidence exists of intrauterine infection

What is the correct name describing a benign breast condition that includes dilation and inflammation of the collecting ducts? A.) Mammary duct ectasia B.) Intraductal papilloma C.) Chronic cystic disease D.) Fibroadenoma

What is the correct placement of the tocotransducer for effective EFM? A.) Over the uterine fundus B.) On the fetal scalp C.) Inside the uterus D.) Over the mothers lower abdomen

When assessing a pregnant client with thalassemia, the nurse knows that which factor is related to this condition? A.) An insufficient amount of hemoglobin is produced to fill the red blood cells (RBCs) B.) The RBCs have a normal life span that are sickled in shape C.) A folate deficiency occurs D.) There are inadequate levels of vitamin B12

When assessing a woman in the first stage of labor, which clinical finding will alert the nurse that uterine contractions are effective? A.) Dilation of the cervix B.) Descent of the fetus to 2 station C.) Rupture of the amniotic membranes D.) Increase in bloody show

Which approximate age is expected for a client to have stated perimenopause if she experienced menopause at 52 years of age? A.) 48 B.) 49 C.) 50 D.) 51

Which diet is recommended for the client who is 6 months pregnant and diagnosed with diverticulosis? A.) Whole grains, bran, vegetables and fruits B.) Citrus fruits and dark green leafy vegetables C.) Shellfish, liver, meats, whole grains and milk D.) Iodized salt, seafood, milk products and rolls

Which documentation reflects on the neurologic activity of the neonate? A.) The ability to suck B.) Head circumference C.) Abdominal movements D.) Head-to-toe measurements

Which education would the nurse provide the parents of a neonate who has petechiae over the face and upper back? A.) The rash is benign if it disappears within 48 hours of birth B.) The rash results from increased blood volume C.) Petechiae should always be further investigated D.) Petechiae usually occur with forceps delivery

Which enzyme helps the newborn convert starch into maltose? A.) Amylase in colostrum B.) Mammary lipase in breast milk C.) Amylase in the salivary glands D.) Lactase in the digestive system

Which food is appropriate to suggest to the postpartum client to increase docosahexaenoic acid (DHA) in breast milk? A.) Fish B.) Eggs C.) Sugar D.) Citrus fruits

Which goal is appropriate for the client diagnosed with hypogonadotropic amenorrhea without a history of sudden weight loss, eating disorder, or involvement in heavy exercise? A.) Identification of the stressor B.) Rule out the possibility of an infection C.) Relief of pain in the client D.) Preparation of a diet regimen

Which guidance might the nurse provide for a client with severe morning sickness? A.) Trying lemonade and potato chips B.) Drinking plenty of fluids early in the day C.) Immediately brushing her teeth after eating D.) Never snacking before bedtime

Which guidance would the nurse provide a postpartum client before initiating breastfeeding? A.) "Spread a few drops of milk on the nipple" B.) "Insert only the nipple into the infant's mouth" C.) "First give milk in the feeding bottle to the infant" D.) "Do not give any additional support to your breasts"

Which interpretation is appropriate when assessing a client who is 7 months pregnant with increased chest movement and decreased abdominal movements while breathing? A.) Normal finding during pregnancy B.) Impaired diaphragm function C.) Decreased abdominal muscle tone D.) Presence of obstructive lung disease

Which intervention is most important when planning care for a client with severe gestational hypertension? A.) Induction of labor is likely, as near term as possible. B.) If at home, the woman should be confined to her bed, even with mild gestational hypertension C.) Special diet low in protein and salt should be initiated D.) Vaginal birth is still an option, even in severe cases

Which intervention would the nurse implement for a 3-day-old newborn whose weight is 7 lb, 12 oz (birth weight 8 lb, 4 oz)? A.) Encourage the client to continue breastfeeding because it is effective in meeting the newborn's nutrient and fluid needs B.) Suggest that the client switch to bottle feeding because breastfeeding is ineffective in meeting newborn needs for fluid and nutrients C.) Notify the provider because the newborn is being poorly nourished D.) Refer the client to a lactation consultant to improve her breastfeeding technique

Which is a health outcome related to late cord clamping in the newborn? A.) Improvement in iron status B.) Decreased risk of jaundice C.) Decreased risk of polycythemia D.) Risk of intraventricular bleeding

Which statement concerning the complication of maternal diabetes is the most accurate? A.) Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy B.) Hydramnios occurs approximately twice as often in diabetic pregnancies than in nondiabetic pregnancies C.) Infections occur about as often and are considered about as serious in both diabetic and nondiabetic pregnancies D.) Even mild-to-moderate hypoglycemic episodes can have significant effects on fetal well-being

Which statement is accurate regarding premenstrual dysphoric disorder (PMDD)? A.) It can present with similar symptoms to panic disorders B.) Symptom presentation is acute, episodic in nature and varies as the disorder progresses, leading to a chronic phase C.) There are no associated physical symptoms in PMDD until the disease is well progressed D.) There is a symptom-free period in the follicular phase of the menstrual cycle

Which statement is the best rationale for recommending formula over breastfeeding? A.) Mother has a medical condition or is taking drugs that could be passed along to the infant via breast milk B.) Mother lacks confidence in her ability to breastfeed C.) Other family members or care providers also need to feed the baby D.) Mother sees bottle feeding as more convenient

Which test is appropriate for the client who reports no menses for the past 6 months? A.) Pregnancy test B.) Blood sugar test C.) Thyroid function test D.) Toxicology blood screening

Which test would the nurse expect to be prescribed for further evaluation after a pathology report indicates that atypical endometrial cells were detected in a postmenopausal client's vaginal pool specimen? A.) Biopsy B.) Chlamydia test C.) Sexually transmitted infection test D.) Human immunodeficiency virus (HIV) test

Which type of laceration is expected in a client who has suffered perineal tears? A.) Vaginal B.) Cervical C.) Urethral D.) Vaginal vault

While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the FHR for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. What is the nurse's first priority? A.) Change the woman's position B.) Notify the health care provider C.) Assist with amnioinfusion D.) Insert a scalp electrode

Which actions are examples of appropriate techniques to wake a sleepy infant for breastfeeding (select all that apply): A.) Unwrapping the infant B.) Changing the diaper C.) Talking to the infant D.) Slapping the infant's hands and feet D.) Applying a cold towel to the infant's abdomen

A, B, C

Which nursing instructions are appropriate for a client who calls the clinic asking the nurse what to do for one missed combination oral contraceptive pill (select all that apply): A.) No backup contraceptive is needed B.) Take the next dose at the usual sign C.) Take one active pill as soon as possible D.) Take two pills and then resume one pill daily E.) Use a backup contraceptive for the next 7 days

A, B, C

Which alternative approaches to relaxation have proven successful when working with the client in labor (select all that apply): A.) Aromatherapy B.) Massage C.) Hypnosis D.) Cesarean birth E.) Biofeedback

A, B, C, E

Which physiologic factors are reliable indicators of impending shock from postpartum hemorrhage (select all that apply): A.) Respirations B.) Skin condition C.) Blood pressure D.) Level of consciousness E.) Urinary output

A, B, D, E

Which are consequences of low estrogen levels in the pregnant client (select all that apply): A.) Peristalsis increases B.) Pepsin secretion decreases C.) Fat deposition is reduced D.) An epulis develops on the gum line E.) End arterioles branch

A, C

Which are known triggers for outbreaks for genital herpes (select all that apply): A.) Stress B.) Safety issues C.) Menstruation D.) Acute illness E.) Family illness

A, C

Which dietary recommendations are appropriate to discuss with a pregnant client with acute viral hepatitis (select all that apply): A.) Low fat B.) Low sodium C.) High protein D.) Low cholesterol E.) High cholesterol

A, C

Which common micronutrient deficiencies are associated with bariatric surgery for the pregnant client (select all that apply): A.) Iron B.) Zinc C.) Folate D.) Calcium E.) Magnesium

A, C, D

A lupus flare-up during pregnancy or early postpartum occurs in 15% to 60% of women with this disorder. Which conditions associated with systemic lupus erythematosus (SLE) are maternal risks (select all that apply): A.) Miscarriage B.) Intrauterine growth restriction (IUGR) C.) Nephritis D.) Preeclampsia E.) Cesarean birth

A, C, D, E

Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. What are possible causes of early miscarriage, (select all that apply): A.) Chromosomal abnormalities B.) Infections C.) Endocrine imbalance D.) Systemic disorders E.) Varicella

A, C, D, E

Chemotherapy with multiple drug agents is used in the treatment of recurrent and advanced breast cancer with positive results. Which side effects would the nurse anticipate for the client once treatment has begun (select all that apply): A.) Hair loss B.) Severe constipation C.) Anemia D.) Leukopenia E.) Thrombocytopenia

A, C, D, E

Which statements concerning the benefits or limitations of breastfeeding are accurate (select all that apply): A.) Breast milk changes over time to meet the changing needs as infants grow B.) Breastfeeding increases the risk of childhood obesity C.) Breast milk and breastfeeding may enhance cognitive development D.) Long-term studies have shown that the benefits of breast milk continue after the infant is weaned E.) Benefits to the infant include a reduced incidence of SIDS

A, C, D, E

The AAP recommends pasteurized donor milk for preterm infants if the mothers own milk in not available. Which statements regarding donor milk and milk banking are important for the nurse to understand and communicate to her client (select all that apply): A.) All milk bank donors are screened for communicable diseases B.) Internet milk sharing is an acceptable source for donor milk C.) Donor milk may be given to transplant clients D.) Donor milk is used in neonatal intensive care units (NICUs) for severely low-birth-weight infants only E.) Donor milk may be used for children with immunoglobulin A (IgA) deficiencies

A, C, E

Which symptoms are associated with syphilis (select all that apply): A.) Generalized lymphadenopathy B.) Abdominal pain and irregular bleeding C.) Warlike infectious lesions on the vulva D.) A painful papule at the site of inoculation E.) The presence of rash on the palms and soles

A, C, E

A client has requested information regarding alternatives to hormonal therapy for menopausal symptoms. Which current information should the nurse provide to the client (elect all that apply.): A.) Soy B.) Vitamin C C.) Vitamin K D.) Vitamin E E.) Vitamin A

A, D

The nurse is caring for a postpartum breastfeeding client with asthma who has been prescribed theophylline. Which complications would the nurse assess for in the newborn (select all that apply): A.) Jitteriness B.) Hyponatremia C.) Cooley's anemia D.) Cardiac arrhythmias E.) Vitamin A deficiency

A, D

Researchers have found a number of common risk factors that increase a woman's chance of developing a breast malignancy. It is essential for the nurse who provides care to women of any age to be aware of which risk factors (select all that apply): A.) Family history B.) Late menarche C.) Early menopause D.) Race E.) Nulliparity or first pregnancy after age 40 years

A, D, E

Which are prenatal tests used for diagnosing fetal defects in pregnancy (select all that apply): A.) Amniocentesis B.) Polyhydramnios C.) Amniotic fluid index (AFI) D.) Chorionic villus sampling (CVS) E.) Daily fetal movement count (DFMC) F.) Percutaneous umbilical blood sampling (PUBS)

A, D, F

A 31-year-old woman believes that she may be pregnant. She took an over-the-counter (OTC) pregnancy test 1 week ago after missing her period; the test was positive. During her assessment interview, the nurse inquires about the woman's last menstrual period and asks whether she is taking any medications. The client states that she takes medicine for epilepsy. She has been under considerable stress lately at work and has not been sleeping well. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan, which confirms that she is not pregnant. What is the most likely cause of the false-positive pregnancy test result? A.) The pregnancy test was taken too early B.) Anticonvulsant medications may cause the false-positive test result C.) The woman has a fibroid tumor D.) She has been under considerable stress and has a hormone imbalance

A first-time mother is concerned about the type of medications she will receive during labor. The client is in a fair amount of pain and is nauseated. In addition, she appears to be very anxious. The nurse explains that opioid analgesics are often used along with sedatives. How should the nurse phrase the rationale for this medication combination? A.) The two medications, together, reduce complications B.) Sedatives enhance the effect of the pain medication C.) The two medications work better together, enabling you to sleep until you have the baby D.) This is what your physician has ordered for you

Assessment of a woman's nutritional status includes a diet history, medication regimen, physical examination, and relevant laboratory tests. Which finding might require consultation to a higher level of care? A.) Oral contraceptive use may interfere with the absorption of iron B.) Illnesses that have created nutritional deficits, such as PKU, may require nutritional care before conception C.) The womans socioeconomic status and educational level are not relevant to her examination; they are the province of the social worker D.) Testing for diabetes is the only nutrition-related laboratory test most pregnant women need

During labor a fetus displays an average FHR of 135 beats per minute over a 10-minute period. Which statement best describes the status of this fetus? A.) Bradycardia B.) Normal baseline heart rate C.) Tachycardia D.) Hypoxia

The musculoskeletal system adapts to the changes that occur throughout the pregnancy. Which musculoskeletal alteration should the client expect? A.) Her center of gravity will shift backward B.) She will have increased lordosis C.) She will have increased abdominal muscle tone D.) She will notice decreased mobility of her pelvic joints

The nurse should be aware of what important information regarding systemic analgesics administered during labor? A.) Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier B.) Effects on the fetus and newborn can include decreased alertness and delayed sucking C.) Intramuscular (IM) administration is preferred over IV administration D.) IV patient-controlled analgesia (PCA) results in increased use of an analgesic

The nurse should be cognizant of which condition related to skeletal injuries sustained by a neonate during labor or childbirth? A.) Newborns skull is still forming and fractures fairly easily B.) Unless a blood vessel is involved, linear skull fractures heal without special treatment C.) Clavicle fractures often need to be set with an inserted pin for stability D.) Other than the skull, the most common skeletal injuries are to leg bones

The nurse should be cognizant of which postpartum physiologic alteration? A.) Cardiac output, pulse rate, and stroke volume all return to prepregnancy normal values within a few hours of childbirth B.) Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth C.) Lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections D.) Hypercoagulable state protects the new mother from thromboembolism, especially after a cesarean birth

What is the role of the nurse as it applies to informed consent? A.) Inform the client about the procedure, and ask her to sign the consent form B.) Act as a client advocate, and help clarify the procedure and the options C.) Call the physician to see the client D.) Witness the signing of the consent form

What would a steady trickle of bright red blood from the vagina in the presence of a firm fundus suggest to the nurse? A.) Uterine atony B.) Lacerations of the genital tract C.) Perineal hematoma D.) Infection of the uterus

When assessing a pregnant client with heart disease, the nurse knows that which form of heart disease in women of childbearing years usually has a benign effect on pregnancy? A.) Cardiomyopathy B.) Mitral valve prolapse C.) Rheumatic heart disease D.) Congenital heart disease

When caring for a newly delivered woman, what is the best measure to prevent abdominal distention after a cesarean birth? A.) Rectal suppositories B.) Early and frequent ambulation C.) Tightening and relaxing abdominal muscles D.) Carbonated beverages

When performing a health history with a pregnant client, the nurse knows that which hematologic disorder is transferred genetically from parents to offspring? A.) Deep vein thrombosis B.) von Willebrand disease C.) Superficial vein thrombosis D.) Idiopathic thrombocytopenia

When performing a pulse oximetry to assess a newborn for congenital heart defects, which factor would the nurse bear in mind? A.) The screening test is performed after 48 hours of age B.) The test is performed in the newborn's right hand on and on one foot C.) The infant has passed if oxygen saturation is greater than 80% D.) The infant is evaluated in case of a 10% difference in the extremities

Which information would the nurse include when planning for an expected cesarean delivery for a client who has had a previous cesarean delivery and has a fetus in the transverse presentation? A.) "Because this is a repeat procedure, you are at the lowest risk for complications" B.) "Even though this is your second cesarean delivery, you may wish to review the preoperative and postoperative procedures" C.) "Because this is your second cesarean delivery, you will recover faster" D.) "You will not need preoperative teaching because this is your second cesarean delivery"

Which instruction would the nurse include when teaching a pregnant client with class II heart disease? A.) Advise her to gain at least 30 pounds B.) Instruct her to avoid strenuous activity C.) Inform her of the need to limit fluid intake D.) Explain the importance of a diet high in calcium

Which intervention by the nurse would reduce the risk of abduction of the newborn from the hospital? A.) Instructing the mother not to give her infant to anyone except the one nurse assigned to her that day B..) Applying an electronic and identification bracelet to the mother and the infant C.) Carrying the infant when transporting him or her in the halls D.) Restricting the amount of time infants are out of the nursery

Which statement by the client indicates effective learning of the instruction about Kegel exercises? A.) "I will only see results if I perform 100 Kegel exercises each day" B.) "I will hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises" C.) "I will only perform Kegel exercises in the sitting position" D.) "I will perform daily Kegel exercises during the last trimester of my pregnancy to achieve the best results"

Which statement by the client indicates that she understands BSE? A.) I will examine both breasts in two different positions B.) I will examine my breasts 1 week after my menstrual period starts C.) I will examine only the outer upper area of the breast D.) I will use the palm of the hand to perform the examination

Which statement by the client who just gave birth and is not breastfeeding indicates effective learning about menstrual activity after childbirth? A.) "My first menstrual cycle will be lighter than normal and then will get heavier each month thereafter" B.) "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles" C.) "I will not have a menstrual cycle for 6 months after childbirth" D.) "My first menstrual cycle will be heavier than normal and then will be light for several months after"

What are the various modes of heat loss in the newborn (select all that apply): A.) Perspiration B.) Convection C.) Radiation D.) Conduction E.) Urination

B, C, D

Which statements about genital herpes are accurate (select all that apply): A.) Genital herpes is also known as genital warts B.) Stress, menstruation, trauma and illness have been known to trigger recurrences C.) Genital herpes is chronic and recurring, and it has no known cure D.) Plain soap and water are all that are needed to clean hands that have come in contact with herpetic lesions E.) Contact isolation is needed for clients with genital herpes

B, C, D

Women of all ages will receive substantial and immediate benefits from smoking cessation. The process is not easy, and most people have attempted to quit numerous times before achieving success. Which organizations provide self-help and smoking cessation materials (select all that apply): A.) Leukemia and Lymphoma Society B.) March of Dimes C.) American Cancer Society D.) American Lung Association E.) Easter Seals

B, C, D

Autoimmune disorders often occur during pregnancy because a large percentage of women with an autoimmune disorder are of childbearing age. Which disorders fall into the category of collagen vascular disease (select all that apply): A.) Multiple sclerosis B.) SLE C.) Antiphospholipid syndrome D.) Rheumatoid arthritis E.) Myasthenia gravis

B, C, D, E

Which behaviors place women at high risk for human immunodeficiency virus (HIV) (select all that apply): A.) Abstinence B.) IV drug use C.) Having multiple sex partners D.) Engaging in high-risk sexual behaviors E.) Having a history of multiple sexually transmitted infections (STIs)

B, C, D, E

Which nursing interventions are included for the adolescent client who is in competitive gymnastics and experiencing hypogonadotropic amenorrhea (select alt that apply): A.) Suggest increased aerobic exercise B.) Teach deep-breathing exercises C.) Identify the presence of stressors D.) Increase the client's nutritional intake E.) Include biofeedback or massage therapy

B, C, D, E

Which clinical findings are expected during the first 48 to 72 hours postpartum (select all that apply): A.) Diarrhea B.) Glycosuria C.) Diaphoresis D.) Proteinuria E.) Increased urinary output

B, C, E

Which early feeding-readiness cues are exhibited for a breastfed newborn (select all that apply): A.) Crying B.) Rooting reflex C.) Suckling motions D.) Withdrawing into sleep E.) Hand-to-mouth movements

B, C, E

Guidelines for breast cancer screening continue to evolve as new evidence is generated. Which examination or procedure and frequency would be recommended for a 31-year-old asymptomatic client (select all that apply): A.) Annual mammography B.) Clinical breast examination every 3 years C.) Annual MRI D.) Breast self-examination E.) Mammography every 3 years

B, D

A nurse is teaching a client about the benefits of internal fetal heart monitoring. Which of the following should statements the nurse include in the teaching (select all that apply): A.) "It is considered a noninvasive procedure." B.) "It can detect abnormal fetal heart tones early." C.) "It can determine the amount of amniotic fluid you have." D.) "It allows for accurate readings with maternal movement." E.) "It can measure uterine contraction intensity."

B, D, E

Postpartum fatigue (PPF) is more than just feeling tired. It is a complex phenomenon affected by physiologic, psychologic, and situational variables. Which factors contribute to this phenomenon (select all that apply): A.) Precipitous labor B.) Hospital routines C.) Bottle feeding D.) Anemia E.) Excitement

B, D, E

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions. What clinical cues alert the nurse that the woman is experiencing uterine hyperstimulation (select all that apply): A.) Uterine contractions lasting <90 seconds and occurring >2 minutes in frequency B.) Uterine contractions lasting >90 seconds and occurring <2 minutes in frequency C.) Uterine tone <20 mm Hg D.) Uterine tone >20 mm Hg E.) Increased uterine activity accompanied by a nonreassuring FHR and pattern

B, D, E

A 30-year-old gravida 3, para 2-0-0-2 is at 18 weeks of gestation. Which screening test should the nurse recommend be ordered for this client? A.) BPP B.) Chorionic villi sampling C.) MSAFP screening D.) Screening for diabetes mellitus

A client in the third trimester has just undergone an amniocentesis to determine fetal lung maturity. Which statement regarding this testing is important for the nurse in formulating a care plan? A.) Because of new imaging techniques, an amniocentesis should have been performed in the first trimester B.) Despite the use of ultrasonography, complications still occur in the mother or infant in 5% to 10% of cases C.) Administration of Rho(D) immunoglobulin may be necessary D.) The presence of meconium in the amniotic fluid is always a cause for concern

A labor and delivery nurse should be cognizant of which information regarding how the fetus moves through the birth canal? A.) Fetal attitude describes the angle at which the fetus exits the uterus B.) Of the two primary fetal lies, the horizontal lie is that in which the long axis of the fetus is parallel to the long axis of the mother C.) Normal attitude of the fetus is called general flexion D.) Transverse lie is preferred for vaginal birth

A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse? A.) Blood pressure (BP) increase to 138/86 mm Hg B.) Weight gain of 0.5 kg during the past 2 weeks C.) Dipstick value of 3+ for protein in her urine D.) Pitting pedal edema at the end of the day

A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection, and she has been using an over-the-counter cream for the past 2 days to treat it. How should the nurse initially respond? A.) Inform the woman that vaginal creams may interfere with the Papanicolaou (Pap) test for which she is scheduled B.) Reassure the woman that using vaginal cream is not a problem for the examination C.) Ask the woman to describe the symptoms that indicate to her that she has a vaginal infection D.) Ask the woman to reschedule the appointment for the examination

A woman at 28 weeks of gestation experiences blunt abdominal trauma as the result of a fall. The nurse must closely observe the client for what? A.) Alteration in maternal vital signs, especially blood pressure B.) Complaints of abdominal pain C.) Placental absorption D.) Hemorrhage

A woman will be taking oral contraceptives using a 28-day pack. What advice should the nurse provide to protect this client from an unintended pregnancy? A.) Limit sexual contact for one cycle after starting the pill B.) Use condoms and foam instead of the pill for as long as the client takes an antibiotic C.) Take one pill at the same time every day D.) Throw away the pack and use a backup method if two pills are missed during week 1 of her cycle

On assessment of a pregnant client, the nurse concludes that the client is less likely to have a preterm delivery. Which client clinical finding led the nurse to conclude this? A.) Previous cesarean delivery B.) Preexisting diabetes mellitus C.) Cervical length more than 30 mm D.) Symptoms of chronic hypertension

Postpartum overdistention of the bladder and urinary retention can lead to which complications? A.) Postpartum hemorrhage and eclampsia B.) Fever and increased blood pressure C.) Postpartum hemorrhage and urinary tract infection D.) Urinary tract infection and uterine rupture

Preconception and prenatal care have become important components of women's health. What is the guiding principal of preconception care? A.) Ensure that pregnancy complications do not occur B.) Identify the woman who should not become pregnant C.) Encourage healthy lifestyles for families desiring pregnancy D.) Ensure that women know about prenatal care

The nurse is assessing a client for gestational diabetes mellitus (GDM) using the oral glucose tolerance test (OGTT). What intervention by the nurse is appropriate when caring for this client? A.) Teach the client to eat an unrestricted diet the day before the test B.) Instruct the client to avoid caffeine for 6 hours before the test C.) Draw blood for a fasting blood glucose level just before the test D.) Obtain the plasma glucose level 1 hour after a 50-g oral glucose load

The nurse is caring for a pregnant client who is scheduled for cordocentesis. Which could a complication of the test? A.) Destruction of red blood cells B.) Fetal hyperbilirubinemia C.) Fetomaternal hemorrhage D.) Deformity of extremities

The nurse is cognizant of which information related to the administration of vitamin K? A.) Vitamin K is important in the production of red blood cells B.) Vitamin K is necessary in the production of platelets C.) Vitamin K is not initially synthesized because of a sterile bowel at birth D.) Vitamin K is responsible for the breakdown of bilirubin and the prevention of jaundice

The nurse is performing a gestational age and physical assessment on the newborn. The infant appears to have an excessive amount of saliva. This clinical finding may be indicative of what? A.) Excessive saliva is a normal finding in the newborn B.) Excessive saliva in a neonate indicates that the infant is hungry C.) It may indicate that the infant has a tracheoesophageal fistula or esophageal atresia D.) Excessive saliva may indicate that the infant has a diaphragmatic hernia

What is a distinct advantage of external EFM? A.) The ultrasound transducer can accurately measure short-term variability and beat-to-beat changes in the FHR B.) The tocotransducer can measure and record the frequency, regularity, intensity, and approximate duration of uterine contractions C.) The tocotransducer is especially valuable for measuring uterine activity during the first stage of labor D.) Once correctly applied by the nurse, the transducer need not be repositioned even when the woman changes positions

Which condition is the least likely cause of amenorrhea in a 17-year-old client? A.) Anatomic abnormalities B.) Type 1 diabetes mellitus C.) Obesity D.) Pregnancy

Which condition would the nurse assess in a postpartum client who does not breastfeed her newborn infant? A.) Sore nipples B.) Low estrogen levels C.) Breast engorgement D.) Postpartum depression

Which explanation is appropriate when a pregnant client has low hematocrit values but is not considered anemic? A.) Hematocrit does not related to anemia B.) Anemia does not cause risk during pregnancy C.) Plasma volume expands rapidly during pregnancy D.) Erythrocyte production compensates for the low hematocrit

Which finding on a prenatal visit at 10 weeks of gestation might suggest a hydatidiform mole? A.) Complaint of frequent mild nausea B.) Blood pressure of 120/80 mm Hg C.) Fundal height measurement of 18 cm D.) History of bright red spotting for 1 day, weeks ago

Which important component of nutritional counseling should the nurse include in health teaching for a pregnant woman who is experiencing cholecystitis? A.) Assess the woman's dietary history for adequate calories and proteins B.) Teach the woman that the bulk of calories should come from proteins C.) Instruct the woman to eat a low-fat diet and to avoid fried foods D.) Instruct the woman to eat a low-cholesterol, low-salt diet

Which information related to a prolonged deceleration is important for the labor nurse to understand? A.) Prolonged decelerations present a continuing pattern of benign decelerations that do not require intervention B.) Prolonged decelerations constitute a baseline change when they last longer than 5 minutes C.) A disruption to the fetal oxygen supply causes prolonged decelerations D.) Prolonged decelerations require the customary fetal monitoring by the nurse

Which information should nurses provide to expectant mothers when teaching them how to evaluate daily fetal movement counts (DFMCs)? A.) Alcohol or cigarette smoke can irritate the fetus into greater activity B.) Kick counts should be taken every hour and averaged every 6 hours, with every other 6-hour stretch off C.) The fetal alarm signal should go off when fetal movements stop entirely for 12 hours D.) A count of less than four fetal movements in 1 hour warrants future evaluation

Which is the expected delivery date for a pregnant woman whose first day of her last menstrual period was April 20, 2019? A.) December 27, 2019 B.) January 20, 2020 C.) January 27, 2020 D.) February 7, 2020

Which lubricant used by the client reduces contraceptive effect? A.) Nonoxynol-9 lubricant B.) Silicon-based lubricant C.) Suntan oil as lubricant D.) Water-soluble lubricant

Which minerals and vitamins are recommended to supplement the pregnant client's diet? A.) Fat-soluble vitamins A and D B.) Water-soluble vitamins C and B6 C.) Iron and folate D.) Calcium and zinc

Which nursing assessment finding is anticipated for a pregnant client with a history of poor nutritional intake? A.) Poor skin turgor B.) Erosion of dental enamel C.) Hyperactive bowel sounds D.) Yellow discharge from eyes

Which nursing conclusion about a 6-month primigravida is appropriate when blood tests report: - Hemoglobin: 11 g/dL - RBC: 5.5 million/mm3 - Hematocrit: 33% - WBC: 12,000/mm3 A.) Iron deficiency B.) At risk of bleeding C.) Physiologic anemia D.) Myelosuppression

Which physiologic change(s) would the nurse expect to see in the client during labor pain and discomfort? A.) Reduced heart rate B.) Respiratory acidosis C.) Pallor and diaphoresis D.) Reduced blood pressure

Which position is appropriate for a physically disabled client undergoing a pelvic examination who is unable to lie comfortably in the lithotomy position? A.) V-shaped position B.) M-shaped position C.) Comfortable alternative position D.) Side-lying position

Which preexisting factor is known to increase the risk of GDM? A.) Underweight before pregnancy B.) Maternal age younger than 25 years C.) Previous birth of large infant D.) Previous diagnosis of type 2 diabetes mellitus

Which statement related to the condition of endometriosis is most accurate? A.) Endometriosis is characterized by the presence and growth of endometrial tissue inside the uterus B.) It is found more often in African-American women than in Caucasian or Asian women C.) Endometriosis may worsen with repeated cycles or remain asymptomatic and disappear after menopause D.) It is unlikely to affect sexual intercourse or fertility

Which clinical findings are associated with the early phase of labor for a nulliparous client who is 2 cm dilated (select all that apply): A.) Zero station B.) Bloody mucus C.) Client takes direction easily D.) Scant amount of vaginal discharge E.) Presence of mild to moderate contractions

C, D, E

Which infections are collectively known as TORCH infections (select all that apply): A.) Chlamydia B.) Gonorrhea C.) Toxoplasmosis D.) German measles E.) Cytomegalovirus F.) Herpes genitalis

C, D, E, F

The baseline FHR is the average rate during a 10-minute segment. Changes in FHR are categorized as periodic or episodic. These patterns include both accelerations and decelerations. The labor nurse is evaluating the client's most recent 10-minute segment on the monitor strip and notes a late deceleration. Which is likely to have caused this change (select all that apply): A.) Spontaneous fetal movement B.) Compression of the fetal head C.) Placental abruption D.) Cord around the baby's neck E.) Maternal supine hypotension

C, E

A healthy 60-year-old African-American woman regularly receives health care at her neighborhood clinic. She is due for a mammogram. At her first visit, her health care provider is concerned about the 3-week wait at the neighborhood clinic and made an appointment for her to have a mammogram at a teaching hospital across town. She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure. What is the most appropriate statement for the nurse to make to this client? A.) Do you have transportation to the teaching hospital so that you can get your mammogram? B.) I'm concerned that you missed your appointment; let me make another one for you C.) It's very dangerous to skip your mammograms; your breasts need to be checked D.) Would you like me to make an appointment for you to have your mammogram here?

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 occasionally drinks alcohol. Her blood pressure is 108/70 mm Hg. 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 places this client in a high-risk category? A.) Blood pressure, age, BMI B.) Drug and alcohol use, age, family history C.) Family history, blood pressure (BP), BMI D.) Family history, BMI, drug and alcohol abuse

Group B Streptococcus (GBS) is part of the normal vaginal flora in 20% to 30% of healthy pregnant women. GBS has been associated with poor pregnancy outcomes and is an important factor in neonatal morbidity and mortality. Which finding is not a risk factor for neonatal GBS infection? A.) Positive prenatal culture B.) Preterm birth at 37 weeks or less of gestation C.) Maternal temperature of 38 C or higher D.) Premature rupture of membranes (PROM) 24 hours or longer before the birth

How should the nurse interpret an Apgar score of 10 at 1 minute after birth? A.) The infant is having no difficulty adjusting to extrauterine life and needs no further testing B.) The infant is in severe distress and needs resuscitation C.) The nurse predicts a future free of neurologic problems D.) The infant is having no difficulty adjusting to extrauterine life but should be assessed again at 5 minutes after birth

In which situation would the nurse be called on to stimulate the fetal scalp? A.) As part of fetal scalp blood sampling B.) In response to tocolysis C.) In preparation for fetal oxygen saturation monitoring D.) To elicit an acceleration in the FHR

The nurse working in an obstetric clinic is taking health histories and knows that which client is at the highest risk of developing hydatidiform mole? A.) A client with hypothyroidism B.) A client with diabetes mellitus C.) A client with systemic lupus erythematosus D.) A client with prior molar pregnancy

Which assessment finding would the nurse recognize as an indicator for early screening for gestational diabetes mellitus (GDM)? A.) The client is 24 years of age B.) The client's body mass index (BMI) if 22 C.) The client does not have diabetes D.) The client had a previous stillbirth

Which is a possible reason for the absence of congenital anomaly in the offspring of a type 1 diabetic pregnant client? A.) Vitamin supplements taken during pregnancy B.) Calcium supplements taken during pregnancy C.) Stable blood pressure maintained during pregnancy D.) An euglycemic condition maintained during pregnancy

Which low-level finding would indicate that the client has an ectopic pregnancy? A.) Insulin B.) Anemia C.) Thrombocytopenia D.) Human chorionic gonadotropin (hCG)

Which statement is accurate about the difference between health promotion and illness prevention? A.) There is no difference in health promotion and illness prevention B.) Health promotion is preventing illness and illness prevention is promoting health C.) Health promotion is the desire to avoid illness, and illness prevention is the motivation to increase D.) Health promotion is the motivation to increase well-being, and illness prevention is the desire to avoid illness

While assessing the vital signs of a pregnant woman in her third trimester, the client complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate? A.) Have the patient stand up, and then retake her BP B.) Have the patient sit down, and then hold her arm in a dependent position C.) Have the patient lie supine for 5 minutes, and then recheck her BP on both arms D.) Have the patient turn to her left side, and then recheck her BP in 5 minutes

While caring for an infant, which intervention would the nurse implement to prevent heat loss caused by evaporation? A.) Wrap the infant in a cloth B.) Place the infant in a warm crib C.) Place the crim away from windows D.) Dry the infant immediately after the bath

Which nursing intervention would result in an increase in maternal cardiac output? A.) Change in position B.) Oxytocin administration C.) Regional anesthesia D.) IV analgesic

What is important for the nurse to recognize regarding the new father and his acceptance of the pregnancy and preparation for childbirth? A.) The father goes through three phases of acceptance of his own B.) The fathers attachment to the fetus cannot be as strong as that of the mother because it does not start until after the birth C.) In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home D.) Typically, men remain ambivalent about fatherhood right up to the birth of their child

What is the most common reason for late postpartum hemorrhage (PPH)? A.) Subinvolution of the uterus B.) Defective vascularity of the decidua C.) Cervical lacerations D.) Coagulation disorders

What is the nurses understanding of the appropriate role of primary and secondary powers? A.) Primary powers are responsible for the effacement and dilation of the cervix B.) Effacement is generally well ahead of dilation in women giving birth for the first time; they are closer together in subsequent pregnancies C.) Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilation D.) Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs

What is the primary role of the doula during labor? A.) Helps the woman perform Lamaze breathing techniques and to provide support to the woman and her partner B.) Checks the fetal monitor tracing for effects of the labor process on the fetal heart rate C.) Takes the place of the father as a coach and support provider D.) Administers pain medications as needed by the woman

What is the priority nursing action when planning a diet for a pregnant client? A.) Review the client's current dietary intake B.) Teach the client about MyPlate C.) Caution the client to avoid large doses of vitamins, especially those that are fat-soluble D.) Instruct the client to limit the intake of fatty foods

What kind of fetal anomalies are most often associated with oligohydramnios? A.) Renal B.) Cardiac C.) Gastrointestinal D.) Neurologic

Which intervention can nurses use to prevent evaporative heat loss in the newborn? A.) Drying the baby after birth, and wrapping the baby in a dry blanket B.) Keeping the baby out of drafts and away from air conditioners C.) Placing the baby away from the outside walls and windows D.) Warming the stethoscope and the nurses hands before touching the baby

Which laboring client would the nurse expect to be a likely candidate for amnioinfusion? A.) A client with heavily meconium-stained amniotic fluid or a low amniotic fluid index (AFI) B.) A client with an increase in uterine activity (or a high amniotic fluid index) C.) A client with hypertension and diabetes during the third trimester D.) A client with an overdistended uterine cavity during the second stage of labor

Which nursing action is appropriate for the client who reports vaginal bleeding after menopause, along with hot flashes? A.) Notify the primary health care provider B.) Teach the client methods of hygiene and skin care C.) Evaluate the client's previous history D.) Explain to the client that both symptoms are normal and are caused by low estrogen levels

Which nursing action is appropriate to prevent conception for the client who has regular menstrual cycles every 28 days? A.) Abstain from sexual intercourse from days 10 to 17 B.) Abstain from sexual intercourse from days 6 to 19 C.) It is safe to have unprotected sexual intercourse from days 11 to 17 D.) It is safe to have unprotected sexual intercourse from days 12 to 16

Which nursing information is appropriate regarding protein in the diet of pregnant clients? A.) Many protein-rich foods are good sources of calcium, iron and B vitamins B.) Many women need to increase their protein intake during pregnancy C.) As with carbohydrates and fat, no specific recommendations exists for the amount of protein in the diet D.) High-protein supplements can be used without risk on a macrobiotic diet

Which anticipatory guidance would the nurse provide the parents of a newborn at discharge (select all that apply): A.) Prevent exposure to people with upper respiratory tract infections B.) Keep the infant away from secondhand smoke C.) Avoid loose bedding, waterbeds and beanbag chairs D.) Do not let the infant sleep on his or her back E) Avoid exposure to people with asthma

A, B, C

Which congenital anomalies can occur as a result of the use of antiepileptic drugs (AEDs) in pregnancy (select all that apply): A.) Cleft lip B.) Congenital heart disease C.) Neural tube defects D.) Gastroschisis E.) Diaphragmatic hernia

A, B, C

Which nursing information is appropriate to discuss with a client who has received methotrexate therapy (select all that apply): A.) "Avoid vitamins and foods that contain folic acid" B.) "Make sure to close the lid of the toilet and double-flush" C.) "When you resume intercourse, you must use contraception for 3 months" D.) "You will be scheduled for monthly measurements of hCG at 6 to 12 months" E.) "You can resume intercourse when your hCG levels are normal for 3 consecutive weeks"

A, B, C

Which are causes of menorrhagia in a client (select all that apply): A.) Obesity B.) Fibroids C.) Endometritis D.) Chemotherapy E.) Diabetes mellitus

A, B, C, D

At least five factors affect the process of labor and birth. These are easily remembered as the five Ps. Which factors are included in this process (select all that apply): A.) Passenger B.) Passageway C.) Powers D.) Pressure E.) Psychologic response

A, B, C, E

IUGR is associated with which pregnancy-related risk factors (select all that apply): A.) Poor nutrition B.) Maternal collagen disease C.) Gestational hypertension D.) Premature rupture of membranes E.) Smoking

A, B, C, E

Many pregnant teenagers wait until the second or third trimester to seek prenatal care. What should the nurse recognize as reasons for this delay (select all that apply): A.) Lack of realization that they are pregnant B.) Uncertainty as to where to go for care C.) Continuing to deny the pregnancy D.) Desire to gain control over their situation E.) Wanting to hide the pregnancy as long as possible

A, B, C, E

Which adverse effects can be seen in a client who is taking danazol for endometriosis (select all that apply): A.) Hot flashes B.) Depression C.) Deepening of voice D.) Pseudohemaphroditism E.) Decreased lipoprotein levels

A, B, C, E

Which examples of protein-containing foods are appropriate when developing a dietary teaching plan for a client on a vegetarian diet (select all that apply): A.) Dried beans B.) Seeds C.) Peanut butter D.) Bagel E.) Peas

A, B, C, E

Which interventions would the nurse implement when providing care for a pregnant client with cystic fibrosis (select all that apply): A.) Assess the client's weight frequently B.) Assess for pulmonary infection C.) Assess for vitamin ADEK deficiency D.) Encourage exposure to sunlight E.) Monitor the fetal movements

A, B, C, E

While developing an intrapartum care plan for the client in early labor, which psychosocial factors would the nurse recognize upon the client's pain experience (select all that apply): A.) Culture B.) Anxiety and fear C.) Previous experiences with pain D.) Intervention of caregivers E.) Support systems

A, B, C, E

Women who are obese are at risk for several complications during pregnancy and birth. Which of these would the nurse anticipate with an obese client (select all that apply): A.) Thromboembolism B.) Cesarean birth C.) Wound infection D.) Breech presentation E.) Hypertension

A, B, C, E

Which are ways to encourage a client admitted with vaginal bleeding to share her health history (select all that apply): A.) Facilitation B.) Reflection C.) Clarification D.) Interruption E.) Confrontation F.) Empathetic responses

A, B, C, E, F

Diabetes refers to a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin action, insulin secretion, or both. Over time, diabetes causes significant changes in the microvascular and macrovascular circulations. What do these complications include (select all that apply): A.) Atherosclerosis B.) Retinopathy C.) Intrauterine fetal death (IUFD) D.) Nephropathy E.) Neuropathy F.) Autonomic neuropathy

A, B, D, E

In assessing a pregnant client, the nurse is aware of the four high-risk factors when performing a health history. What are the four categories (select all that apply): A.) Biophysical B.) Psychosocial C.) Geographic D.) Enviornmental E.) Sociodemographic

A, B, D, E

One of the most important components of the physical assessment of the pregnant client is the determination of BP. Consistency in measurement techniques must be maintained to ensure that the nuances in the variations of the BP readings are not the result of provider error. Which techniques are important in obtaining accurate BP readings (select all that apply): A.) The client should be seated B.) The client's arm should be placed at the level of the heart C.) An electronic BP device should be used D.) The cuff should cover a minimum of 60% of the upper arm E.) The same arm should be used for every reading

A, B, E

What are the causes of early-onset jaundice (select all that apply): A.) Incompatible fetomaternal blood pump B.) Delay in clamping the umbilical cord C.) Disorders of amino acid metabolism D.) Delay in the elimination of bilirubin E.) Congenital abnormality of red blood cells

A, B, E

Which are characteristics of Goodell sign (select all that apply): A.) Hypertrophy B.) Hyperplasia C.) Decreased friability D.) Decreased vascularity E.) Softening of the cervical tip

A, B, E

Which nursing action would be included in the initial treatment of a thyroid storm (select all that apply): A.) Oxygen B.) Intravenous fluids C.) Administration of iodide D.) Administration of dexamethasone E.) High doses of propylthiouracil (PTU)

A, B, E

Which nursing actions are included in the primary survey for a client at 19 weeks of gestation who has experienced a stab wound to the upper right abdominal quadrant and is not breathing (select all that apply): A.) Initiating an intravenous line B.) Administering oxygen C.) Performing an ultrasound examination D.) Evaluating the fetal heart rate E.) Using a jaw thrust to establish an airway

A, B, E

Which statements regarding menstruation (periodic uterine bleeding) are accurate (select all that apply): A.) Menstruation occurs every 28 days B.) During menstruation, the entire uterine lining is shed C.) Menstruation begins 7 to 10 days after ovulation D.) Menstruation leads to fertilization E.) Average blood loss during menstruation is 50 ml

A, B, E

As recently as 2005, the AAP revised safe sleep practices to assist in the prevention of SIDS. The nurse should model these practices in the hospital and incorporate this information into the teaching plan for new parents. Which practices are ideal for role modeling (select all that apply): A.) Fully supine position for all sleep B.) Side-sleeping position as an acceptable alternative C.) Tummy time for play D.) Infant sleep sacks or buntings E.) Soft mattress

A, C, D

In caring for a pregnant woman with sickle cell anemia, the nurse must be aware of the signs and symptoms of a sickle cell crisis. What do these include (select all that apply): A.) Fever B.) Endometritis C.) Abdominal pain D.) Joint pain E.) Urinary tract infection (UTI)

A, C, D

Which changes are considered the presumptive signs of pregnancy (select all that apply): A.) Fatigue B.) Hegar sign C.) Quickening D.) Amennorhea E.) Ballottment

A, C, D

Which circumstances would warrant the nurse to perform a vaginal examination (select all that apply): A.) On admission to the hospital at the start of labor B.) When accelerations in fetal heart rate (FHR) are noted C.) On maternal perception of perineal pressure or the urge to bear down D.) When rupture of membranes (ROM) occurs E.) When bright red bleeding is observed

A, C, D

Hearing loss is one of the genetic disorders included in the universal screening program. Auditory screening of all newborns within the first month of life is recommended by the AAP. What is the rationale for having this testing performed (select all that apply): A.) Prevents or reduces developmental delays B.) Reassures concerned new parents C.) Provides early identification and treatment D.) Helps the child communicate better E.) Is recommended by the Joint Committee on Infant Hearing

A, C, D, E

Lacerations of the cervix, vagina, or perineum are also causes of PPH. Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract (select all that apply): A.) Operative and precipitate births B.) Adherent retained placenta C.) Abnormal presentation of the fetus D.) Congenital abnormalities of the maternal soft tissue E.) Previous scarring from infection

A, C, D, E

The induction of labor is considered an acceptable obstetric procedure if it is in the best interest to deliver the fetus. The charge nurse on the labor and delivery unit is often asked to schedule clients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction. What are appropriate indications for induction (select all that apply): A.) Rupture of membranes at or near term B.) Convenience of the woman or her physician C.) Chorioamnionitis (inflammation of the amniotic sac) D.) Postterm pregnancy E.) Fetal death

A, C, D, E

Which are the major goals of prenatal care (select all that apply): A.) Monitor the development of the fetus B.) Provide family planning services to the parents C.) Improve the nutritional status of mother and fetus D.) Provide appropriate education and counseling to the parents E.) Minimize the risk of complications in both the mother and fetus

A, C, D, E

Which medications can be taken by postmenopausal women to treat and/or prevent osteoporosis (select all that apply): A.) Calcium B.) NSAIDs C.) Fosamax D.) Actonel E.) Calcitonin

A, C, D, E

Which nursing measures can be implemented for women to discourage their entry into abusive relationships (select all that apply): A.) Promoting assertiveness B.) Encouraging Pilates classes C.) Encouraging positive self-regard D.) Encouraging support and self-help groups E.) Helping with confidence and empowerment

A, C, D, E

Many new mothers experience some type of nipple pain during the first weeks of initiating breastfeeding. Should this pain be severe or persistent, it may discourage or inhibit breastfeeding altogether. Which factors might contribute to this pain (select all that apply): A.) Improper feeding position B.) Large-for-gestational age infant C.) Fair skin D.) Progesterone deficiency E.) Flat or retracted nipples

A, C, E

Which are factors that accelerate dilation of the cervix (select all that apply): A.) Strong uterine contractions B.) Scarring of the cervix C.) Pressure by amniotic fluid D.) Prior infection of the cervix E.) Force by fetal presenting part

A, C, E

Which measure would the nurse take to protect a newborn from heat loss (select all that apply): A.) Ensure that the infant is dried immediately after birth B.) Place the naked infant on a bare scale for accuracy C.) Place the naked infant on the mother's bare chest and cover him/her with a blanket D.) Ensure that the nursery temperature is 27 C (80.6 F) E.) Wrap the infant and cover the head with a cap

A, C, E

Which nursing instructions are appropriate for the pregnant client about relieving constipation (select all that apply): A.) Consume at least 28 g of fiber per day B.) Eat more eggs daily C.) Eat whole grains and fresh fruits D.) Eat a good quantity of meat daily E.) Drink at least 50 mL/kg/day of fluids

A, C, E

A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The fluid consists of bright red blood. Her contractions are consistent with her current stage of labor. No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins to decline rapidly after the ROM. The nurse should suspect the possibility of what condition? A.) Placenta previa B.) Vasa previa C.) Severe abruptio placentae D.) Disseminated intravascular coagulation (DIC)

Nurses play a critical role in educating parents regarding measures to prevent infant abduction. Which instructions contribute to infant safety and security (select all that apply): A.) The mother should check the photo identification (ID) of any person who comes to her room B.) The baby should be carried in the parents arms from the room to the nursery C.) Because of infant security systems, the baby can be left unattended in the clients room D.) Parents should use caution when posting photographs of their infant on the Internet E.) The mom should request that a second staff member verify the identity of any questionable person

A, D, E

What are the manifestations of HELLP syndrome (select all that apply): A.) Hemolysis B.) Tachycardia C.) Hyperventilation D.) Low platelet count E.) Elevated liver enzymes

A, D, E

Which recommendations would the nurse make to a mother who reports, "my baby cries incessantly after waking up and does not focus on feeding" (select all that apply): A.) "Allow the baby to suck your finger" B.) "Hold the baby in an upright position" C.) "Gently massage the baby's chest" D.) "Swaddle the baby and talk soothingly" E.) "Place the baby close to the skin"

A, D, E

Which symptoms of hyperglycemia are appropriate to include in the teaching for a diabetic client (select all that apply): A.) Thirst B.) Hunger C.) Fatigue D.) Drowsiness E.) Constipation

A, D, E

A client experiences a large gush of fluid from her vagina while walking in the hallway of the birthing unit. Which of the following actions should the nurse take first? A.) Check the amniotic fluid for meconium B.) Monitor FHR for distress C.) Dry the client and make her comfortable D.) Monitor uterine contractions

A client is concerned because she has been experiencing some milky, sticky breast discharge. Which non-malignant condition is exhibited with this finding? A.) Relative inflammatory lesion B.) Galactorrhea C.) Mammary duct ectasia D.) Breast infection

A client is seen at the clinic at 14 weeks of gestation for a follow-up appointment. At which level does the nurse expect to palpate the fundus? A.) Nonpalpable above the symphysis at 14 weeks of gestation B.) Slightly above the symphysis pubis C.) At the level of the umbilicus D.) Slightly above the umbilicus

A client states that she plans to breastfeed her newborn infant. What guidance would be useful for this new mother? A.) The mothers intake of vitamin C, zinc, and protein can now be lower than during pregnancy B.) Caffeine consumed by the mother accumulates in the infant, who may be unusually active and wakeful C.) Critical iron and folic acid levels must be maintained D.) Lactating women can go back to their prepregnant caloric intake

A client who recently had a heart transplant with no evidence of rejection asks the nurse about the safety of conceiving a child. Which is the most accurate response by the nurse? A.) "A heart transplantation does not tolerate pregnancy" B.) "You may conceive one year after the transplant" C.) "The newborn may have congenital heart disease" D.) "You may need to terminate pregnancy at any time"

A client with abnormal uterine bleeding and a hemoglobin level of less than 8 g/dL is given conjugated estrogens, and the nurse is monitoring her for the first 24 hours. Which condition would indicate a need for dilation and curettage in this client? A.) Risk for coma B.) Continuous bleeding C.) Excessive abdominal pain D.) Unstable vital signs

A client with maternal phenylketonuria (PKU) has come to the obstetrical clinic to begin prenatal care. Why would this preexisting condition result in the need for closer monitoring during pregnancy? A.) PKU is a recognized cause of preterm labor B.) The fetus may develop neurologic problems C.) A pregnant woman is more likely to die without strict dietary control D.) Women with PKU are usually mentally handicapped and should not reproduce

A client with severe gestational hypertension is prescribed hydralazine. Which is the priority nursing intervention in this case? A.) Assess for visual disturbances B.) Assess airway, breathing and pulse C.) Assess blood pressure frequently D.) Prepare the client for nonstress testing

A client with severe preeclampsia is receiving a magnesium sulfate infusion. Which assessment finding would be most concerning to the nurse? A.) A sleepy, sedated affect B.) A respiratory rate of 10 breaths/minute C.) Deep tendon reflexes of 2+ D.) Absent ankle clonus

A number of methods can be used for inducing labor. Which cervical ripening method falls under the category of mechanical or physical? A.) Prostaglandins are used to soften and thin the cervix B.) Labor can sometimes be induced with balloon catheters or laminaria tents C.) Oxytocin is less expensive and more effective than prostaglandins but creates greater health risks D.) Amniotomy can be used to make the cervix more favorable for labor

A nurse in labor and delivery unit is completing an admission assessment for a client who is at 39 weeks of gestation. The client reports that she has been leaking fluid from her vagina for 2 days. Which of the following conditions is the client at risk for developing? A.) Cord prolapse B.) Infection C.) Postpartum hemorrhage D.) Hydramnios

A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle feed. During the assessment, the nurse notices that both breasts are swollen, warm, and tender on palpation. Which guidance should the nurse provide to the client at this time? A.) Run warm water on her breasts during a shower B.) Apply ice to the breasts for comfort C.) Express small amounts of milk from the breasts to relieve the pressure D.) Wearing a loose-fitting bra to prevent nipple irritation

A womans obstetric history indicates that she is pregnant for the fourth time, and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system? A.) 3-1-1-1-3 B.) 4-1-2-0-4 C.) 3-0-3-0-3 D.) 4-2-1-0-3

After an emergency birth, the nurse encourages the woman to breastfeed her newborn. What is the primary purpose of this activity? A.) To facilitate maternal-newborn interaction B.) To stimulate the uterus to contract C.) To prevent neonatal hypoglycemia D.) To initiate the lactation cycle

Which client is at greatest risk for early PPH? A.) Primiparous woman (G 2, P 1-0-0-1) being prepared for an emergency cesarean birth for fetal distress B.) Woman with severe preeclampsia on magnesium sulfate whose labor is being induced C.) Multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor D.) Primigravida in spontaneous labor with preterm twins

Which client is most likely to experience strong and uncomfortable afterpains? A.) A woman who experienced oligohydramnios B.) A woman who is a gravida 4, para 4-0-0-4 C.) A woman who is bottle-feeding her infant D.) A woman whose infant weighed 5 pounds, 3 ounces

Which client might be well advised to continue condom use during intercourse throughout her pregnancy? A.) Unmarried pregnant women B.) Women at risk for acquiring or transmitting STIs C.) All pregnant women D.) Women at risk for candidiasis

Which client statement indicates a need for further teaching about sibling adaptation? A.) Show the child how to touch the baby B.) Exclude the child during infant feeding times C.) Don't force interactions between the child and the baby D.) Help the child have realistic expectations about the baby

Which clinical finding is a major use of ultrasonography in the first trimester? A.) Amniotic fluid volume B.) Presence of maternal abnormalities C.) Placental location and maturity D.) Cervical length

Which complication is associated with high bilirubin levels in the newborn? A.) Syndactyly B.) Kernicterus C.) Rectal fistula D.) Down syndrome

Which complication may be prevented if clients use skin-to-skin contact with their newborn infant? A.) Jaundice B.) Hypothermia C.) Galactosemia D.) Dehydration

Which complication would the nurse anticipate in an infant experiencing cold stress? A.) Hyperglycemia B.) Hyerbilirubinemia C.) Respiratory alkalosis D.) Decreased metabolic rate

Which condition is related to inadequate weight gain during pregnancy? A.) Spina bifida B.) Intrauterine growth restriction C.) Diabetes mellitus D.) Down syndrome

Which description of postpartum restoration or healing times is accurate? A.) The cervix shortens, becomes firm, and returns to form within a month postpartum B.) Vaginal rugae reappear by 3 weeks postpartum C.) Most episiotomies heal within a week D.) Hemorrhoids usually decrease in size within 2 weeks of childbirth

Which drug is used for treating a client with severe postpartum bleeding? A.) Nifedipine B.) Oxytocin C.) Propranolol D.) Metronidazole

Which food item is appropriate to include in the vitamin B6-deficient pregnant client's diet to encourage normal fetal development? A.) Yeast B.) Meat C.) Asparagus D.) Strawberries

Which information about variations in the infants blood counts is important for the nurse to explain to the new parents? A.) A somewhat lower-than-expected red blood cell count could be the result of a delay in clamping the umbilical cord B.) An early high white blood cell (WBC) count is normal at birth and should rapidly decrease C.) Platelet counts are higher in the newborn than in adults for the first few months D.) Even a modest vitamin K deficiency means a problem with the blood's ability to properly clot

Which information is accurate regarding the diagnosis and management of amenorrhea? A.) It probably is the result of a hormone deficiency that can be treated with medication B.) It may be caused by stress or excessive exercise, or both C.) It likely will require the client to eat less and exercise more D.) It often goes away on its own

Which is a positive sign of pregnancy when teaching a client about the presumptive, probable and positive signs of pregnancy? A.) A positive pregnancy test B.) Fetal movements palpated by the nurse-midwife C.) Braxton hicks contractions D.) Quickening

Which laboratory marker is indicative of DIC? A.) Bleeding time of 10 minutes B.) Presence of fibrin split products C.) Thrombocytopenia D.) Hypofibrinogenemia

Which laboratory parameter requires monitoring if a pregnant client reports, "My body shook for a while when I was sitting on my couch?" A.) Blood glucose levels B.) Blood pressure C.) Complete blood cell count D.) Electroencephalogram (EEG)

Which laboratory testing is used to detect the human immunodeficiency virus (HIV)? A.) HIV screening B.) HIV antibody testing C.) Cluster of differentiation 4 (CD4) counts D.) Cluster of differentiation 8 (CD8) counts

Which maternal condition always necessitates delivery by cesarean birth? A.) Marginal placenta previa B.) Complete placenta previa C.) Ectopic pregnancy D.) Eclampsia

Which medication is appropriate for the postpartum client with fourth-degree perineal lacerations who has been prescribed opioid analgesics but is now experiencing constipation? A.) Enemas B.) Laxatives C.) Prostaglandins D.) Rectal suppositories

Which menopausal discomfort would the nurse anticipate when evaluating a woman for signs and symptoms of the climacteric? A.) Headaches B.) Hot flashes C.) Mood swings D.) Vaginal dryness with dyspareunia

Which method would the nurse use to assess the temperature of a neonate 12 hours after birth? A.) Rectal route B.) Axillary route C.) Temporal artery D.) Tympanic route

Which newborn reflex is characterized by abrupt abduction and extension of the arms with the fingers fanned out while the thumb and forefinger form a "C"? A.) Tonic neck reflex B.) Moro reflex C.) Cremasteric reflex D.) Babinski reflex

Which nursing action is appropriate for the client at 16 weeks of gestation based on evaluation of the laboratory results - Factor VII: 135 - Factor VIII: 160 - Factor IX: 155 - Factor X: 145 - Factor XI: 130 A.) Make no changes to the plan of acre B.) Take initiatives to reduce venous thromboembolism (VTE) risk C.) Initiate factor replacement therapy D.) Immediately implement bleeding precautions

Which nursing advice is appropriate for the client who thinks she has "bumps" on her labia and is unsure how to check herself? A.) Reassure the client that the examination will not reveal any problems B.) Explain the process of vulvar self-examination, and reassure the client that she will become familiar with normal and abnormal findings during the examination C.) Reassure the client that "bumps" can be treated D.) Reassure the client that most women have "bumps" on their labia

Which nursing assessment is a priority for an adolescent client experiencing amenorrhea? A.) Height B.) Pregnancy status C.) Sensitivity to aspirin D.) Gastrointestinal bleeding

Which nursing information is appropriate to include when preparing to teach a client about calcium intake and pregnancy? A.) Fetal growth increases the need for calcium B.) Dietary intake of calcium is generally inadequate C.) Calcium supplementation is necessary during pregnancy D.) The majority of people are unable to digest foods that are high in calcium

Which nursing information is appropriate to include when preparing to teaching a client about calcium intake and pregnancy? A.) Fetal growth increases the need for calcium B.) Dietary intake of calcium is generally inadequate C.) Calcium supplementation is necessary during pregnancy D.) The majority of people are unable to digest foods that are high in calcium

Which nursing instruction is appropriate for the adolescent client who has been prescribed continuous combined hormone therapy for endometriosis to minimize the drug-related adverse effects? A.) "Have renal and liver function tested regularly" B.) "Have bone mineral density tested regularly" C.) "Stop the use of nonsteroidal antiinflammatory drugs (NSAIDs) for pain relief" D.) "Use an absorbent sanitary pad for heavy bleeding during menses"

Which nursing instruction is appropriate for the pregnant client experiencing nausea and vomiting? A.) Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning B.) Eat small, frequent meals (every 2 to 3 hours) C.) Increase intake of high-fat foods to keep the stomach full and coated D.) Limit fluid intake throughout the day

Which nursing intervention is paramount when providing care to a client with preterm labor who has received terbutaline? A.) Assess deep tendon reflexes (DTRs) B.) Assess for dyspnea and crackles C.) Assess for bradycardia D.) Assess for hypoglycemia

Which sign of a potential complication is the most important for the nurse to share with the client? A.) Constipation B.) Alteration in the pattern of fetal movement C.) Heart palpitations D.) Edema in the ankles and feet at the end of the day

Which statement by the client indicates the need for further teaching about the steps to be followed before undergoing a Papanicolaou (Pap) test? A.) "I should not have sexual intercourse 24 to 48 hours before the test" B.) "I should clean my vagina by douching before the test" C.) "I should trick my menstrual cycle and schedule the test midcycle" D.) "I should empty my bladder before undergoing the test"

Which statement is the best rationale for assessing the maternal vital signs between uterine contractions? A.) During a contraction, assessing the fetal heart rate is the priority B.) Maternal circulating blood volume temporarily increases during contractions C.) Maternal blood flow to the heart is reduced during contractions D.) Vital signs taken during contractions are not accurate

Which statement made by a lactating woman leads the nurse to believe that the client might have lactose intolerance? A.) I always have heartburn after I drink milk B.) If I drink more than a cup of milk, I usually have abdominal cramps and bloating C.) Drinking milk usually makes me break out in hives D.) Sometimes I notice that I have bad breath after I drink a cup of milk

Which statement regarding the postpartum uterus is correct? A.) At the end of the third stage of labor, the postpartum uterus weighs approximately 500 g B.) After 2 weeks postpartum, it should be abdominally nonpalpable C.) After 2 weeks postpartum, it weighs 100 g D.) Postpartum uterus returns to its original (prepregnancy) size by 6 weeks postpartum

Which statement regarding the probable signs of pregnancy is most accurate? A.) Determined by ultrasound B.) Observed by the health care provider C.) Reported by the client D.) Confirmed by diagnostic tests

Which term describes the pregnant client who has a child and is in the 25th week of pregnancy? A.) Primipara B.) Multipara C.) Primigravida D.) Multigravida

Which time-based description of a stage of development in pregnancy is correct? A.) Viability: 22 to 37 weeks of gestation since the last menstrual period (assuming a fetal weight greater than 500 g) B.) Term: pregnancy from the beginning of 38 weeks of gestation to the end of 42 weeks of gestation C.) Preterm: pregnancy from 20 to 28 weeks of gestation D.) Postdate: pregnancy that extends beyond 38 weeks of gestation

Which treatment regime would be most appropriate for a client who has been recently diagnosed with acute pelvic inflammatory disease (PID)? A.) Oral antiviral therapy B.) Bed rest in a semi-Fowler position C.) Antibiotic regimen continued until symptoms subside D.) Frequent pelvic examination to monitor the healing progress

Which type of cervical mucus would you expect if a fertile woman is in postovulation? A.) Scant B.) Thick, cloudy and sticky C.) Clear, wet, sticky and slippery D.) Cloudy, yellow or white, and sticky

Which type of cultural concern is the most likely deterrent to many women seeking prenatal care? A.) Religion B.) Modesty C.) Ignorance D.) Belief that physicians are evil

Which viral sexually transmitted infection (STI) is the most prevalent in the United States? A.) Herpes simplex virus type 2 (HSV-2) B.) Human papillomavirus (HPV) C.) Human immunodeficiency virus (HIV) D.) Cytomegalovirus (CMV)

Within how many days can a client use emergency contraception to prevent pregnancy after unprotected sex? A.) 10 days B.) 3 days C.) 12 days D.) 21 days

Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could the nurse use to increase the client's blood pressure (select all that apply): A.) Place the woman in a supine position B.) Place the woman in a lateral position C.) Increase IV fluids D.) Administer oxygen E.) Perform a vaginal examination

B, C, D

The breast-feeding mother should be taught to expect which changes to the condition of the breasts (select all that apply): A.) Breast tenderness is likely to persist for approximately 1 week after the start of lactation B.) As lactation is established, a mass may form that can be distinguished from cancer by its positional shift from day to day C.) In nonlactating mothers, colostrum is present for the first few days after childbirth D.) If suckling is never begun or is discontinued, then lactation ceases within a few days to a week E.) Little change occurs to the breasts in the first 48 hours

B, C, D

What psychosocial factors are appropriate to assess when understanding a client's behavior during the postpartum period (select all that apply): A.) Current illnesses B.) Family size C.) Cultural beliefs D.) Previous birth experiences E.) Delivery process

B, C, D

Which client's with diabetes may develop complications if they perform exercises (select all that apply): A.) A client who is on insulin B.) A client with diabetic ketoacidosis C.) A client with uncontrolled hypertension D.) A client with severe peripheral neuropathy E.) A client who has lost 5 kg weight after diagnosis

B, C, D

Which factor would the nurse assess to detect the cause of amenorrhea in a client (select all that apply): A.) Obesity B.) Pregnancy C.) Malnutrition D.) Exercise regimen E.) Urinary tract infection

B, C, D

Which fetal abnormalities are prevented by monitoring an obstetric client with phenylketonuria (PKU) with high levels of phenylalanine (select all that apply): A.) Hydrocephaly B.) Cardiac anomalies C.) Intellectual disabilities D.) Intrauterine growth restriction E.) Hypopigmentation of the skin

B, C, D

Which information would the nurse include in the preconception teaching for a client with Marfan syndrome who presents aortic root diameter of more than 6 cm (select all that apply): A.) It should not be repaired before you become pregnant B.) There is an increased chance of maternal mortality C.) The newborn child may develop Marfan syndrome D.) You may not be able to deliver the child vaginally E.) You should not even try to become pregnant at all

B, C, D

Which objective data provides understanding about a client's health status in the immediate postpartum period (select all that apply): A.) HIV test B.) Urinalysis C.) Hematocrit D.) Hemoglobin E.) Rh factor test

B, C, D

A nonstress test (NST) is ordered on a pregnant women at 37 weeks gestation. Which are the most appropriate teaching points to include when explaining the procedure to the client (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, C, E

A pregnant client with pregestational insulin-dependent diabetes is going for a week's vacation in another state. What would the nurse ask the client to carry with her to prevent complications (select all that apply): A.) Antibiotics B.) Insulin vials C.) Glucose tablets D.) Antihypertensives E.) Blood glucose meter

B, C, E

A tiered system of categorizing FHR has been recommended by professional organizations. Nurses, midwives, and physicians who care for women in labor must have a working knowledge of fetal monitoring standards and understand the significance of each category. What is the correct nomenclature for these categories (select all that apply): A.) Reassuring B.) Category I C.) Category II D.) Nonreassuring E.) Category III

B, C, E

Indications for a primary cesarean birth are often nonrecurring. Therefore, a woman who has had a cesarean birth with a low transverse scar may be a candidate for vaginal birth after cesarean (VBAC). Which clients would be less likely to have a successful VBAC (select all that apply): A.) Lengthy interpregnancy interval B.) African-American race C.) Delivery at a rural hospital D.) Estimated fetal weight <4000 g E.) Maternal obesity (BMI >30)

B, C, E

The client and her partner are considering male sterilization as a form of permanent birth control. While educating the client regarding the risks and benefits of the procedure, which information should the nurse include (select all that apply): A.) Sterilization should be performed under general anesthesia B.) Pain, bleeding, and infection are possible complications C.) Pregnancy may still be possible D.) Vasectomy may affect potency E.) Secondary sex characteristics are unaffected

B, C, E

When assessing a pregnant client, the nurse is aware of which complications associated with polyhydramnios (select all that apply): A.) Ketoacidosis B.) Placental abruption C.) Uterine dysfunction D.) Gestational diabetes E.) Postpartum hemorrhage

B, C, E

Which FHR decelerations would require the nurse to change the maternal position (select all that apply): A.) Early decelerations B.) Late decelerations C.) Variable decelerations D.) Moderate decelerations E.) Prolonged decelerations

B, C, E

The number of routine laboratory tests during follow-up visits is limited; however, those that are performed are essential. Which statements regarding group B Streptococcus (GBS) testing are correct (select all that apply): A.) Performed between 32 and 34 weeks of gestation B.) Performed between 35 and 37 weeks of gestation C.) All women should be tested D.) Only women planning a vaginal birth should be tested E.) Women with a history of GBS should be retested

B, D, E

Which foods are appropriate to prevent calcium imbalance when replacing milk for a pregnant client (select all that apply): A.) Rice B.) Cocoa C.) Carrots D.) Yogurt D.) Buttermilk

B, D, E

Which foods are appropriate to suggest to prevent calcium deficiency for the client who maintains a vegan diet (select all that apply): A.) Cheese B.) Collards C.) Carrots D.) Dried figs E.) Cooked dried beans

B, D, E

Which foods would the nurse recommend that the client avoid during pregnancy (select all that apply): A.) Hot dogs B.) Brie cheese C.) Luncheon meals D.) Unpasteurized milk E.) Deli made egg salade

B, D, E

Which is a part of the role of doula care for a laboring client (select all that apply): A.) Administering analgesics B.) Providing comfort measures C.) Interpreting the fetal heart rate pattern D.) Providing support to the client's partner E.) Providing coaching during the second stage of labor

B, D, E

According to the National Institute of Child Health and Human Development (NICHD) Three-Tier System of FHR Classification, category III tracings include all FHR tracings not categorized as category I or II. Which characteristics of the FHR belong in category III (select all that apply): A.) Baseline rate of 110 to 160 beats per minute B.) Tachycardia C.) Absent baseline variability not accompanied by recurrent decelerations D.) Variable decelerations with other characteristics such as shoulders or overshoots E.) Absent baseline variability with recurrent variable decelerations F.) Bradycardia

B, D, E, F

A 25-year-old gravida 3, para 2 client gave birth to a 9-pound, 7-ounce boy, 4 hours ago after augmentation of labor with oxytocin (Pitocin). She presses her call light, and asks for her nurse right away, stating Im bleeding a lot. What is the most likely cause of postpartum hemorrhaging in this client? A.) Retained placental fragments B.) Unrepaired vaginal lacerations C.) Uterine atony D.) Puerperal infection

A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 19. What is this clients total recommended weight gain during pregnancy? A.) 20 kg (44 lb) B.) 16 kg (35 lb) C.) 12.5 kg (27.5 lb) D.) 10 kg (22 lb)

A client who is pregnant already has type 2 diabetes and a hemoglobin A1c of 7. Which client condition would the nurse use to categorize this client as a diabetic? A.) Gestational diabetes B.) Insulin-dependent diabetes complicated by pregnancy C.) Pregestational diabetes mellitus D.) Non-insulin-dependent diabetes with complications

A first-time dad is concerned that his 3-day-old daughter's skin looks yellow. In the nurses explanation of physiologic jaundice, what fact should be included? A.) Physiologic jaundice occurs during the first 24 hours of life B.) Physiologic jaundice is caused by blood incompatibilities between the mother and the infant blood types C.) Physiologic jaundice becomes visible when serum bilirubin levels peak between the second and fourth days of life D.) Physiologic jaundice is also known as breast milk jaundice

A laboring woman has received meperidine (Demerol) intravenously (IV), 90 minutes before giving birth. Which medication should be available to reduce the postnatal effects of meperidine on the neonate? A.) Fentanyl (Sublimaze) B.) Promethazine (Phenergan) C.) Naloxone (Narcan) D.) Nalbuphine (Nubain)

A newborn is jaundiced and is receiving phototherapy via ultraviolet bank lights. What is the most appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy? A.) Applying an oil-based lotion to the newborns skin to prevent dying and cracking B.) Limiting the newborns intake of milk to prevent nausea, vomiting, and diarrhea C.) Placing eye shields over the newborns closed eyes D.) Changing the newborns position every 4 hours

A newborn is placed under a radiant heat warmer. The nurse understands that thermoregulation presents a problem for the newborn. What is the rationale for this difficulty? A.) The renal function of a newborn is not fully developed, and heat is lost in the urine B.) The small body surface area of a newborn favors more rapid heat loss than does an adults body surface area C.) Newborns have a relatively thin layer of subcutaneous fat that provides poor insulation D.) Their normal flexed posture favors heat loss through perspiration

A number of metabolic changes occur throughout pregnancy. Which physiologic adaptation of pregnancy will influence the nurses plan of care? A.) Insulin crosses the placenta to the fetus only in the first trimester, after which the fetus secretes its own B.) Women with insulin-dependent diabetes are prone to hyperglycemia during the first trimester because they are consuming more sugar C.) During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus D.) Maternal insulin requirements steadily decline during pregnancy

A nurse is providing breast care education to a client after mammography. Which information regarding fibrocystic changes in the breast is important for the nurse to share? A.) Fibrocystic breast disease is a disease of the milk ducts and glands in the breasts B.) It is a premalignant disorder characterized by lumps found in the breast tissue C.) Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles D.) Lumpiness is accompanied by tenderness after menses

A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature 37.3 C, pulse rate 88 beats per minute, respiratory rate 10 breaths per minute, BP 148/90 mm Hg, absent deep tendon reflexes (DTRs), and no ankle clonus. The client complains, "I'm so thirsty and warm." What is the nurses immediate action? A.) To call for an immediate magnesium sulfate level B.) To administer oxygen C.) To discontinue the magnesium sulfate infusion D.) To prepare to administer hydralazine

A pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirement is the nurse most concerned about? A.) Calcium B.) Protein C.) Vitamin B12 D.) Folic acid

A primigravida has just delivered a healthy infant girl. The nurse is about to administer erythromycin ointment in the infants eyes when the mother asks, What is that medicine for? How should the nurse respond? A.) It is an eye ointment to help your baby see you better B.) It is to protect your baby from contracting herpes from your vaginal tract C.) Erythromycin is prophylactically given to prevent a gonorrheal infection D.) This medicine will protect your baby's eyes from drying out over the next few days

A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the womans IV fluid for a preprocedural bolus. The nurse reviews her laboratory values and notes that the womans hemoglobin is 12 g/dl, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for this woman? A.) She is too far dilated B.) She is anemic C.) She has thrombocytopenia D.) She is septic

A woman in labor has just received an epidural block. What is the most important nursing intervention at this time? A.) Limit parenteral fluids B.) Monitor the fetus for possible tachycardia C.) Monitor the maternal blood pressure for possible hypotension D.) Monitor the maternal pulse for possible bradycardia.

A woman is having her first child. She has been in labor for 15 hours. A vaginal examination performed 2 hours earlier revealed the cervix to be dilated to 5 cm and 100% effaced, and the presenting part of the fetus was at station 0; however, another vaginal examination performed 5 minutes ago indicated no changes. What abnormal labor pattern is associated with this description? A.) Prolonged latent phase B.) Protracted active phase C.) Secondary arrest D.) Protracted descent

A woman who has just undergone a first-trimester abortion will be using oral contraceptives. To protect against pregnancy, the client should be advised to do what? A.) Avoid sexual contact for at least 10 days after starting the pill B.) Use condoms and foam for the first few weeks as a backup C.) Use another method of contraception for 1 week after starting the pill D.) Begin sexual relations once vaginal bleeding has ended

A woman with worsening preeclampsia is admitted to the hospitals labor and birth unit. The physician explains the plan of care for severe preeclampsia, including the induction of labor, to the woman and her husband. Which statement by the husband leads the nurse to believe that the couple needs further information? A.) I will help my wife use the breathing techniques that we learned in our childbirth classes B.) I will give my wife ice chips to eat during labor C.) Since we will be here for a while, I will call my mother so she can bring the two boys, 2 years and 4 years of age, to visit their mother D.) I will stay with my wife during her labor, just as we planned

A woman's position is an important component of the labor progress. Which guidance is important for the nurse to provide to the laboring client? A.) The supine position, which is commonly used in the United States, increases blood flow B.) The laboring client positioned on her hands and knees (all fours position) is hard on the womans back C.) Frequent changes in position help relieve fatigue and increase the comfort of the laboring client D.) In a sitting or squatting position, abdominal muscles of the laboring client will have to work harder

According to demographic research, which woman is least likely to breastfeed and therefore most likely to need education regarding the benefits and proper techniques of breastfeeding? A.) Between 30 and 35 years of age, Caucasian, and employed part time outside the home B.) Younger than 25 years of age, Hispanic, and unemployed C.) Younger than 25 years of age, African-American, and employed full time outside the home D.) 35 years of age or older, Caucasian, and employed full time at home

After a mastectomy, which activity should the client be instructed to avoid? A.) Emptying surgical drains twice a day and as needed B.) Lifting more than 4.5 kg (10 lb) or reaching above her head until given permission by her surgeon C.) Wearing clothing with snug sleeves to support the tissue of the arm on the operative side D.) Immediately reporting inflammation that develops at the incision site or in the affected arm

An infant boy was delivered minutes ago. The nurse is conducting the initial assessment. Part of the assessment includes the Apgar score. When should the Apgar assessment be performed? A.) Only if the newborn is in obvious distress B.) Once by the obstetrician, just after the birth C.) At least twice, 1 minute and 5 minutes after birth D.) Every 15 minutes during the newborn's first hour after birth

As the nurse assists a new mother with breastfeeding, the client asks, If formula is prepared to meet the nutritional needs of the newborn, what is in breast milk that makes it better? What is the nurse's best response? A.) More calories B.) Essential amino acids C.) Important immunoglobulins D.) More calcium

At 35 weeks of pregnancy, a woman experiences preterm labor. Although tocolytic medications are administered and she is placed on bed rest, she continues to experience regular uterine contractions and her cervix is beginning to dilate and efface. What is an important test for fetal well-being at this time? A.) PUBS B.) Ultrasound for fetal size C.) Amniocentesis for fetal lung maturity D.) NST

Breast pain occurs in many women during their perimenopausal years. Which information is a priority for the nurse to share with the client? A.) Breast pain is an early indication of cancer B.) Pain is almost always an indication of a solid mass C.) Distinguishing between cyclical and noncyclical pain is important D.) Breast pain is most often treated with narcotics

During a prenatal visit, the nurse is explaining dietary management to a woman with pregestational diabetes. Which statement by the client reassures the nurse that teaching has been effective? A.) I will need to eat 600 more calories per day because I am pregnant B.) I can continue with the same diet as before pregnancy as long as it is well balanced C.) Diet and insulin needs change during pregnancy D.) I will plan my diet based on the results of urine glucose testing

During the second phase of labor, the client initiates pattern-paced breathing. Which adverse symptom would the nurse watch for when the client initiates this breathing method? A.) Pallor B.) Nausea C.) Dizziness D.) Diaphoresis

If the newborn has excess secretions, the mouth and nasal passages can be easily cleared with a bulb syringe. How should the nurse instruct the parents on the use of this instrument? A.) Avoid suctioning the nares B.) Insert the compressed bulb into the center of the mouth C.) Suction the mouth first D.) Remove the bulb syringe from the crib when finished

In assisting the breastfeeding mother to position the baby, which information regarding positioning is important for the nurse to keep in mind? A>) The cradle position is usually preferred by mothers who had a cesarean birth B.) Women with perineal pain and swelling prefer the modified cradle position C.) Whatever the position used, the infant is belly to belly with the mother D.) While supporting the head, the mother should push gently on the occiput

In most healthy newborns, blood glucose levels stabilize at ______ mg/dL during the first hours after birth: A.) 30 to 40 B.) 40 to 50 C.) 50 to 60 D.) 60 to 70

In which clinical situation would the nurse most likely anticipate a fetal bradycardia? A.) Intraamniotic infection B.) Fetal anemia C.) Prolonged umbilical cord compression D.) Tocolytic treatment using terbutaline

In which range would the nurse expect the blood glucose to be in a healthy newborn during the first hours after birth? A.) 80 to 100 mg/dL B.) Less than 40 mg/dL C.) 50 to 60 mg/dL D.) 60 to 70 mg/dL

In which stage of labor would the nurse expect the placenta to be expelled? A.) First B.) Second C.) Third D.) Fourth

Pregnant adolescents are at greater risk for decreased BMI and fad dieting with which condition? A.) Obesity B.) Gestational diabetes C.) Low-birth-weight babies D.) High-birth-weight babies

The first 1 to 2 hours after birth is sometimes referred to as what? A.) Bonding period B.) Third stage of labor C.) Fourth stage of labor D.) Early postpartum period

The nurse is assessing a full term, quiet, and alert newborn. What is the average expected apical pulse range (in beats per minute)? A.) 80 to 100 B.) 100 to 120 C.) 120 to 160 D.) 150 to 180

The nurse is evaluating a neonate who was delivered 3 hours ago by vacuum-assisted delivery. The infant has developed a cephalhematoma. Which statement is most applicable to the care of this neonate? A.) Intracranial hemorrhage (ICH) as a result of birth trauma is more likely to occur in the preterm, low-birth-weight infant B.) Subarachnoid hemorrhage (the most common form of ICH) occurs in term infants as a result of hypoxia C.) In many infants, signs of hemorrhage in a full-term infant are absent and diagnosed only through laboratory tests D.) Spinal cord injuries almost always result from vacuum-assisted deliveries

The nurse is monitoring a nurse's deep tendon reflexes (DTRs) while receiving magnesium sulfate therapy for treatment of preeclampsia. Which assessment finding would indicate a cause for concern? A.) Bilateral DTRs noted at 2+ B.) DTR response noted at 1+ since onset of therapy C.) Positive clonus response elicited unilaterally D.) Client reports no pain on examination of DTRs by nurse

The uterine contractions of a woman early in the active phase of labor are assessed by an internal uterine pressure catheter (IUPC). The uterine contractions occur every 3 to 4 minutes and last an average of 55 to 60 seconds. They are becoming more regular and are moderate to strong. Based on this information, what would a prudent nurse do next? A.) Immediately notify the woman's primary health care provider B.) Prepare to administer an oxytocic to stimulate uterine activity C.) Document the findings because they reflect the expected contraction pattern for the active phase of labor D.) Prepare the woman for the onset of the second stage of labor

When assessing the fetal heart rate (FHR) of a client in labor, which would the nurse identify as normal variability of the FHR? A.) Absent variability B.) Minimal variability C.) Moderate variability D.) Marked variability

When assessing the fetus using Leopold maneuvers, the nurse feels a round, firm, and movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother's right side close to midline. What is the position of the fetus? A.) ROA B.) LSP C.) RSA D.) LOA

When monitoring the client in labor, the nurse knows that the likely cause of variable fetal heart rate (FHR) decelerations in which factor? A.) Uterine tachysystole B.) Maternal hypertension C.) Umbilical cord compression D.) Epidural or spinal anesthesia

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman? A.) Estrogen B.) Progesterone C.) Prolactin D.) Human placental lactogen

Which is the initial treatment for the client with vWD who experiences a PPH? A.) Cryoprecipitate B.) Factor VIII and von Willebrand factor (vWf) C.) Desmopressin D.) Hemabate

Which is the likely effect of low prostaglandin levels on the client's menstrual cycle? A.) The endometrium in the uterus fails to form B.) Peak levels of progesterone are not attained in the luteal phase C.) The ovum remains entrapped in the graafian follicle D.) Ovum growth is inhibited in the proliferative phase

Which is the role of the nurse in initial family planning? A.) Refer the couple to a reliable health care provider B.) Decide on the best method for the couple C.) Educate couples on the various methods of contraception D.) Advise couples on which contraceptive to use

Which mineral intake is restricted in a pregnant client with renal failure? A.) Zinc B.) Iron C.) Sodium D.) Manganese

Which nursing information is appropriate for the postpartum client who is taking analgesics for pain relief and is anxious that the medication may pass into her breast milk and adversely affect the infant? A.) "Medications do not pass into the breast milk" B.) "Take the medication just before bedtime" C.) "Take the medication immediately after breastfeeding" D.) "You need to avoid breastfeeding and use infant formula"

Which nursing information is appropriate to include in the postpartum client's teaching to help her adjust to her role as a mother? A.) Knowledge of pediatric terminology B.) The importance of Western medicine C.) Probable family issues and coping strategies D.) Use of the Internet to learn about parenting

Which nursing information is appropriate to include when teaching the parents of a breastfed 3-day-old newborn? A.) "You should wake your baby every 3 hours to feed" B.) "It is important to keep your baby on a feeding schedule" C.) "I recommend that you follow a feeding pattern that is cue-based" D.) "You can expect the infant to feed for about a 20-minute period"

Which nursing instruction is appropriate for the pregnant client taking oral iron supplements and experiencing constipation? A.) Drink mineral oil before going to bed B.) Take a stool softened before going to bed C.) Drink six to eight glasses of water every day D.) Discontinue taking iron supplements

Which nursing intervention is appropriate to suggest for the pregnant client who has a history of miscarriage? A.) Avoid exercise B.) Avoid vaccinations C.) Eat a healthy diet including folic acid D.) Limit alcohol while trying to conceive

Which nursing response is appropriate for an adolescent client who experiences primary dysmenorrhea and complains of pain and lower abdominal cramps? A.) "You need to increase sugar and fats in your diet" B.) "Call the clinic only if you have dark-colored stools" C.) "A hot bath or heating pad may help the problem" D.) "The problem will diminish in 2 to 3 months"

Which nursing response is appropriate for the expectant father who confides in the nurse that his 10-week-pregnant wife is driving him crazy seeming happy one minute and crying over nothing the next minute? A.) This is normal behavior and should begin to subside by the second trimester B.) She may have difficulty adjusting to pregnancy C.) This is called emotional lability and is related to hormonal changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant D.) You seem impatient with her. Perhaps this is precipitating her behavior

Which organism is the causative agent for ophthalmia neonatorum? A.) Neisseria gonorrhoeae B.) Human papillomavirus C.) Chlamydia trachomatis D.) Gardnerella and Mobiluncus

Which phase of the endometrial cycle best describes a heavy, velvety soft, fully matured endometrium? A.) Menstrual B.) Proliferative C.) Secretory D.) Ischemic

Which phase of the menstrual cycle describes the implantation of the fertilized ovum? A.) Menstrual B.) Proliferative C.) Secretatory D.) Progesterone

Which sexually transmitted infection (STI) is the most commonly reported in American women? A.) Gonorrhea B.) Syphilis C.) Chlamydia D.) Candidiasis

Which sexually transmitted infection would the nurse suspect for a client who reports purulent anal discharge, rectal pain and blood in her stool? A.) Syphilis B.) Chlamydia C.) Gonorrhea D.) Human papillomavirus (HPV)

Which side effect would be monitored for a client who has been prescribed danazol therapy for treatment of endometriosis? A.) Increased breast size and fullness B.) Increase in heart-protective cholesterol C.) Migraine headaches D.) Weight loss

Which statement accurately describes the centering model of care? A.) Group sessions begin with the first prenatal visit B.) Blood pressure (BP), weight, and urine dipsticks are obtained by the nurse at each visit C.) Approximately 8 to 12 women are placed in each gestational-age cohort group D.) Outcomes are similar to traditional prenatal care

Which statement by the client indicates a risk of genital tract infection? A.) I eat yogurt almost every day B.) I use hosiery with a cotton crotch C.) I take a bubble bath once a day D.) I void before and after intercourse

Which statement by the client would indicate effective learning about use of a bulb syringe when caring for her newborn? A.) "It is used to prevent defecation from the anal opening" B.) "It is used to reduce the temperature during hypothermia" C.) "It is used to clear mucous and prevent airway obstruction" D.) "It is used to avoid heat loss caused by evaporation and convection"

Which statement indicates effective learning regarding the manifestations of true labor? A.) "The fetus is usually not engaged in the pelvis" B.) "The cervix is often soft and is felt in the posterior position" C.) "Contractions become more intense with walking" D.) "Contractions are felt above the navel"

Which statement made by the client correlates with a probable pregnancy? A.) My period is three weeks late B.) I can feel the baby moving around C.) I can feel my uterine contract, but it does not hurt D.) I have been experiencing nausea and vomiting almost daily

Which symptom occurs for the postpartum client who has splanchnic engorgement? A.) Inability to perform Kegel exercises B.) Late ambulation C.) Orthostatic hypotension D.) Venous thromboembolism

Which symptoms in the pregnant client would prompt the nurse to immediately inform the primary health care provider? A.) Dyspnea B.) Persistent anemia C.) Fluid leaking from the vagina D.) Imbalanced nutrition

Which type of formula is not diluted with water, before being administered to an infant? A.) Powdered B.) Concentrated C.) Ready-to-use D.) Modified cows milk

Which statement(s) might the nurse appropriately include when teaching a client about calcium intake for osteoporosis (select all that apply): A.) You should try to increase your protein intake when you are taking calcium B.) It is best to take calcium in one large dose C.) Tums are the most soluble form of calcium D.) You should take calcium with vitamin D because the vitamin D helps your body better absorb calcium E.) It's okay to take calcium if you have had a history of kidney stones

C, D

A 25-year-old multiparous woman gave birth to an infant boy 1 day ago. Today her husband brings a large container of brown seaweed soup to the hospital. When the nurse enters the room, the husband asks for help with warming the soup so that his wife can eat it. What is the nurses most appropriate response? A.) Didn't you like your lunch? B.) Does your physician know that you are planning to eat that? C.) What is that anyway? D.) I'll warm the soup in the microwave for you

A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Which information assists the nurse in developing the plan of care? A.) Bed rest and analgesics are the recommended treatment B.) She will be unable to conceive in the future. C.) A D&C will be performed to remove the products of conception D.) Hemorrhage is the primary concern

A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath three times daily, and a stool softener. Which information regarding the client's condition is most closely correlated with these orders? A.) Woman is a gravida 2, para 2 B.) Woman had a vacuum-assisted birth C.) Woman received epidural anesthesia D.) Woman has an episiotomy

A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, My period is due in a few days, and my temperature has not gone up. What is the nurses most appropriate response? A.) This probably means that you're pregnant B.) Don't worry; it's probably nothing C.) Have you been sick this month? D.) You probably didn't ovulate during this cycle

A woman who is pregnant for the first time is dilated 3 cm and having contractions every 5 minutes. She is groaning and perspiring excessively; she states that she did not attend childbirth classes. What is the optimal intervention for the nurse to provide at this time? A.) Notify the woman's health care provider B.) Administer the prescribed narcotic analgesic C.) Assure her that her labor will be over soon D.) Assist her with simple breathing and relaxation instructions

A woman with preeclampsia has a seizure. What is the nurses highest priority during a seizure? A.) To insert an oral airway B.) To suction the mouth to prevent aspiration C.) To administer oxygen by mask D.) To stay with the client and call for help

An 18-year-old pregnant woman, gravida 1, para 0, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. The client states, My contractions are so strong, I don't know what to do. Before making a plan of care, what should the nurses first action be? A.) Assess for fetal well-being B.) Encourage the woman to lie on her side C.) Disturb the woman as little as possible D.) Recognize that pain is personalized for each individual

An African-American woman noticed some bruises on her newborn daughters buttocks. The client asks the nurse what causes these. How would the nurse best explain this integumentary finding to the client? A.) Lanugo B.) Vascular nevus C.) Nevus flammeus D.) Mongolian spot

An adolescent complains of postcoital bleeding and purulent cervical discharge. On assessment, the nurse finds that the adolescent has multiple sex partners. What is the priority nursing action in this case? A.) Encourage the client to use a condom B.) Obtain a thorough history of allergies C.) Recommend that the client undergo yearly screening for sexually transmitted infections (STIs) D.) Prepare the client for STI testing

As part of their teaching function at discharge, nurses should educate parents regarding safe sleep. Based on the most recent evidence, which information is incorrect and should be discussed with parents? A.) Prevent exposure to people with upper respiratory tract infections B.) Keep the infant away from secondhand smoke C.) Avoid loose bedding, water beds, and beanbag chairs D.) Place the infant on his or her abdomen to sleep

Because a full bladder prevents the uterus from contracting normally, nurses intervene to help the woman spontaneously empty her bladder as soon as possible. If all else fails, what tactic might the nurse use? A.) Pouring water from a squeeze bottle over the woman's perineum B.) Placing oil of peppermint in a bedpan under the woman C.) Asking the physician to prescribe analgesic agents D.) Inserting a sterile catheter

Following a loud noise, the nurse observes the newborn symmetrically abduct and extend his arms, fan his fingers and form a "C" with the thumb and forefinger, and he has a slight tremor. Which reflex would the nurse document? A.) Positive tonic neck reflex B.) Positive glabellar (Myerson) reflex C.) Positive Babinski reflex D.) Positive Moro reflex

For a client at 42 weeks of gestation, which finding requires more assessment by the nurse? A.) Fetal heart rate of 120 beats/minute B.) Cervix dilated 2 cm and 50% effaced C.) Score of 8 on the biophysical profile D.) One fetal movement noted in 1 hour of assessment by the mother

Human immunodeficiency virus (HIV) may be transmitted perinatally or during the postpartum period. Which statement regarding the method of transmission is most accurate? A.) Only in the third trimester from the maternal circulation B.) From the use of unsterile instruments C.) Only through the ingestion of amniotic fluid D.) Through the ingestion of breast milk from an infected mother

If nonsurgical treatment for late PPH is ineffective, which surgical procedure would be appropriate to correct the cause of this condition? A.) Hysterectomy B.) Laparoscopy C.) Laparotomy D.) Dilation and curettage (D&C)

In comparing the abdominal and transvaginal methods of ultrasound examination, which information should the nurse provide to the client? 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

Parents who have not already done so need to make time for newborn follow-up of the discharge. According to the American Academy of Pediatrics (AAP), when should a breastfeeding infant first need to be seen for a follow-up examination? A.) 2 weeks of age B.) 7 to 10 days after childbirth C.) 4 to 5 days after hospital discharge D.) 48 to 72 hours after hospital discharge

Pelvic floor exercises, also known as Kegel exercises, will help to strengthen the perineal muscles and encourage healing after childbirth. The nurse requests the client to repeat back instructions for this exercise. Which response by the client indicates successful learning? A.) I contract my thighs, buttocks, and abdomen B.) I perform 10 of these exercises every day C.) I stand while practicing this new exercise routine D.) I pretend that I am trying to stop the flow of urine in midstream

Postoperative care of the pregnant woman who requires abdominal surgery for appendicitis includes which additional assessment? A.) Intake and output (I&O) and intravenous (IV) site B.) Signs and symptoms of infection C.) Vital signs and incision D.) Fetal heart rate (FHR) and uterine activity

Pregnancy hormones prepare the vagina for stretching during labor and birth. Which change related to the pelvic viscera should the nurse share with the client? A.) Because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests are easier to evaluate B.) Quickening is a technique of palpating the fetus to engage it in passive movement C.) The deepening color of the vaginal mucosa and cervix (Chadwick sign) usually appears in the second trimester or later as the vagina prepares to stretch during labor D.) Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester

The nurse is caring for a pregnant client at 19 weeks of gestation. On reviewing the ultrasound reports, the nurse notes that the fetus has a ventricular septal defect (VSD). The nurse knows which type of ultrasound helps detect VSD? A.) Limited examination B.) Nonmedical examination C.) Standard or basic examination D.) Specialized or targeted examination

The nurse is caring for a pregnant client who is prescribed levothyroxine for hypothyroidism. The client is also prescribed an iron supplement. Which education would the nurse provide the client about taking these medications? A.) Take both medications together in the morning B.) Take levothyroxine 1 hour after taking the iron supplement C.) Take the iron supplement 2 hours after taking levothyroxine D.) Take the two medications at different times of the day

The nurse is evaluating the EFM tracing of the client who is in active labor. Suddenly, the FHR drops from its baseline of 125 down to 80 beats per minute. The mother is repositioned, and the nurse provides oxygen, increased IV fluids, and performs a vaginal examination. The cervix has not changed. Five minutes have passed, and the FHR remains in the 80s. What additional nursing measures should the nurse take next? A.) Call for help B.) Insert a Foley catheter C.) Start administering Pitocin D.) Immediately notify the care provider

The nurse is monitoring a pregnant client after amniotomy. Which observation would indicate a likelihood of umbilical cord compression? A.) The fetal heart rate (FHR) confirms tachycardia B.) The client's vaginal drainage has a foul smell C.) The client has frequent maternal chills D.) The fetal heart rate (FHR) has variable decelerations

The nurse is performing an assessment on a client who thinks she may be experiencing preterm labor. Which information is the most important for the nurse to understand and share with the client? A.) Because all women must be considered at risk for preterm labor and prediction is so variable, teaching pregnant women the symptoms of preterm labor probably causes more harm through false alarms B.) Braxton Hicks contractions often signal the onset of preterm labor C.) Because preterm labor is likely to be the start of an extended labor, a woman with symptoms can wait several hours before contacting the primary caregiver D.) Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change

The nurse providing care in a women's health care setting must be knowledgeable about STIs. Which STIs can be successfully treated? A.) HSV B.) AIDS C.) Venereal warts D.) Chlamydia

The nurse who elects to practice in the area of womens health must have a thorough understanding of miscarriage. Which statement regarding this condition is most accurate? A.) A miscarriage is a natural pregnancy loss before labor begins B.) It occurs in fewer than 5% of all clinically recognized pregnancies C.) Careless maternal behavior, such as poor nutrition or excessive exercise, can be a factor in causing a miscarriage D.) If a miscarriage occurs before the 12th week of pregnancy, then it may be observed only as moderate discomfort and blood loss

What are the most common causes for subinvolution of the uterus? A.) Postpartum hemorrhage and infection B.) Multiple gestation and postpartum hemorrhage C.) Uterine tetany and overproduction of oxytocin D.) Retained placental fragments and infection

What is the importance of obtaining informed consent for a number of contraceptive methods? A.) Contraception is an invasive procedure that requires hospitalization B.) The method may require a surgical procedure to insert a device C.) The contraception method chosen may be unreliable D.) The method chosen has potentially dangerous side effects

What is the most critical physiologic change required of the newborn after birth? A.) Closure of fetal shunts in the circulatory system B.) Full function of the immune defense system C.) Maintenance of a stable temperature D.) Initiation and maintenance of respirations

What represents a typical progression through the phases of a woman's establishing a relationship with the fetus? A.) Accepts the fetus as distinct from herself; accepts the biologic fact of pregnancy; has feelings of caring and responsibility B.) Fantasizes about the child's gender and personality; views the child as part of herself; becomes introspective C.) Views the child as part of herself; has feelings of well-being; accepts the biologic fact of the pregnancy D.) I am pregnant; I am going to have a baby; I am going to be a mother

What type of cultural concern is the most likely deterrent to many women seeking prenatal care? A.) Religion B.) Modesty C.) Ignorance D.) Belief that physicians are evil

When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended? A.) Increasing the intake of red meat to replace blood loss B.) Reducing the intake of diuretic foods, such as peaches and asparagus C.) Temporarily substituting physical activity for a sedentary lifestyle D.) Using a heating pad on the abdomen to relieve cramping

When caring for a client in labor, which instruction would the nurse provide in the second stage of labor? A.) "Point your toes to prevent pain" B.) "Avoid fluids until the infant is delivered" C.) "Lie still and avoid movement to prevent fatigue" D.) "Avoid holding your breath or tightening the abdominal muscles"

Which action would the nurse take when placing a newborn under a radiant heat warmer to stabilize temperature after birth? A.) Place a thermistor probe on the left side of the chest B.) Cover the probe with a nonreflective material C.) Recheck the temperature by periodically taking a rectal temperature D.) Perform all examinations and activities under the warmer

Which action would the nurse take when weighing a newborn? A.) Leave the diaper on for comfort B.) Place a sterile paper on the scale for infection control C.) Keep hand on the newborn's abdomen for safety D.) Weigh the newborn at the same time each day for accuracy

Which basic type of pelvis includes the correct description and percentage of occurrence in women? A.) Gynecoid: classic female pelvis; heart shaped; 75% B.) Android: resembling the male pelvis; wide oval; 15% C.) Anthropoid: resembling the pelvis of the ape; narrow; 10% D.) Platypelloid: flattened, wide, and shallow pelvis; 3%

Which characteristic of a uterine contraction is not routinely documented? A.) Frequency: how often contractions occur B.) Intensity: strength of the contraction at its peak C.) Resting tone: tension in the uterine muscle D.) Appearance: shape and height

Which classification of placental separation is not recognized as an abnormal adherence pattern? A.) Placenta accreta B.) Placenta increta C.) Placenta percreta D.) Placenta abruptio

Which client is a safe candidate for the use of oral contraceptives? A.) 39 year old client with a history of thrombophlebitis B.) 16 year old client with a benign liver tumor C.) 20 year old client who suspects she may be pregnant D.) 43 year old client who does not smoke cigarettes

Which client is most likely at the perimenopause stage? A.) A 52 year old client with no bleeding or spotting for 1 year B.) A 58 year old client whose ovaries have ceased to produce estrogen C.) A 32 year old client with vaginitis and postcoital bleeding D.) A 46 year old client with irregular, heavier periods and clotting

Which clinical finding would the nurse interpret as a possible sign of hydrocephalus? A.) Body weight of 7 pounds B.) Heart rate 120 beats/min C.) Head-to-heel length of 55 cm D.) Head circumference greater than chest circumference

Which hormone is essential for maintaining pregnancy? A.) Estrogen B.) hCG C.) Oxytocin D.) Progesterone

Which is the best response by the nurse to a client who complains of the urge to have a bowel movement during each contraction? A.) "There is a possibility of an infection" B.) "I will have to evaluate your urine reports" C.) "There is a complication with the delivery" D.) "This is a normal occurrence at the onset of labor"

Which laboratory finding indicates that the female client is pregnant? A.) Decreased level of insulin B.) Increased levels of tyroxine C.) Increased levels of follicle stimulating hormone (FSH) D.) Increased levels of human chorionic gonadotropin (hCG)

Which nursing response is appropriate for a female client who conceived in the first month after discontinuing combined oral contraceptives (COCs) and is worried about the effect of possible COC use on this pregnancy? A.) "The child may have a birth defect" B.) "Conception is safe only after 6 months of discontinuing the pill" C.) "The child may have iron-deficiency anemia" D.) "There is no evidence that COCs cause maternal or fetal harm"

Which pain control mechanism of ginger is indicated for the client with dysmenorrhea who suffers from cramps during menses? A.) Hormones B.) Prolactin levels C.) Muscle spasms D.) The inflammatory reaction

Which statement by the pregnant client indicates the need for further teaching about body mechanics to decrease discomfort related to the lumbar curve of pregnancy? A.) "I should avoid platform shoes and high heels" B.) "I should use a pillow in the car to support my lower back area" C.) "I should change positions often if I have to stand for a long time" D.) "I should adjust my car seat such that my knees are lower than my hips"

Which structure is responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream? A.) Decidua basalis B.) Blastocyst C.) Germ layer D.) Chorionic villi

Which surgical side effect would a client with uterine leiomyomata undergoing uterine artery embolization experience? A.) Obesity B.) Menopause C.) Osteoporosis D.) Loss of fertility

An 18-year-old client who has reached 16 weeks of gestation was recently diagnosed with pregestational diabetes. She attends her centering appointment accompanied by one of her girlfriends. This young woman appears more concerned about how her pregnancy will affect her social life than her recent diagnosis of diabetes. A number of nursing diagnoses are applicable to assist in planning adequate care. What is the most appropriate diagnosis at this time? A.) Risk for injury, to the fetus related to birth trauma B.) Deficient knowledge, related to diabetic pregnancy management C.) Deficient knowledge, related to insulin administration D.) Risk for injury, to the mother related to hypoglycemia or hyperglycemia

During the physical examination of a client beginning prenatal care, which initial action is most important for the nurse to perform? A.) Only women who show physical signs or meet the sociologic profile should be assessed for physical abuse B.) The client should empty her bladder before the pelvic examination C.) The distribution, amount, and quality of body hair are of no particular importance D.) The size of the uterus is discounted in the initial examination because it will be increasing in size during the second trimester

Ideally, when should prenatal care begin? A.) Before the first missed menstrual period B.) After the first missed menstrual period C.) After the second missed menstrual period D.) After the third missed menstrual period

Macromastia, or breast hyperplasia, is a condition in which women have very large and pendulous breasts. Breast hyperplasia can be corrected with a reduction mammoplasty. Which statement regarding this procedure is the most accurate? A.) Breast reduction surgery is covered by insurance B.) Breastfeeding might be difficult C.) No sequelae after the procedure is known D.) Pain in the back and shoulders may not be relieved

Many clients are concerned about the increased levels of mercury in fish and may be reluctant to include this source of nutrients in their diet. What is the best advice for the nurse to provide? A.) Canned white tuna is a preferred choice B.) Shark, swordfish, and mackerel should be avoided C.) Fish caught in local waterways is the safest D.) Salmon and shrimp contain high levels of mercury

The Centers for Disease Control and Prevention (CDC) recommends which therapy for the treatment of the HPV? A.) Miconazole ointment B.) Topical podofilox 0.5% solution or gel C.) Two doses of penicillin administered intramuscularly (IM) D.) Metronidazole by mouth

The breastfeeding mother should be taught a safe method to remove the breast from the baby's mouth. Which suggestion by the nurse is most appropriate? A.) Slowly remove the breast from the baby's mouth when the infant has fallen asleep and the jaws are relaxed B.) Break the suction by inserting your finger into the corner of the infant's mouth C.) A popping sound occurs when the breast is correctly removed from the infants mouth D.) Elicit the Moro reflex to wake the baby and remove the breast when the baby cries

While evaluating the reflexes of a newborn, the nurse notes that with a loud noise the newborn symmetrically abducts and extends his arms, his fingers fan out and form a C with the thumb and forefinger, and he has a slight tremor. The nurse would document this finding as a positive _____ reflex. A.) Tonic neck B.) Glabellar (Myerson) C.) Babinski D.) Moro

While performing a contraction stress test in a pregnant client, the nurse finds that the client has three uterine contractions in a 10-minute period with no significant variable decelerations. The nurse communicates the test findings to the primary health care provider, and which instruction would the nurse expect to receive? A.) "Repeat the test in the client the next day" B.) "Administer intravenous fluids to the client" C.) "Immediately admit the client to the hospital" D.) "Resume a routine weekly testing schedule for the client"

Who is most likely to experience the phenomenon of someone other than the mother-to-be having pregnancy-like symptoms such as nausea and weight gain? A.) Mother of the pregnant woman B.) Couples teenage daughter C.) Sister of the pregnant woman D.) Expectant father

Which nursing instruction is appropriate to give the postpartum client before administering the varicella vaccine of the day of discharge from the hospital (select all that apply): A.) "Stop breastfeeding after receiving the vaccine" B.) "You need not return to the hospital because one dose is enough for you" C.) "Stop taking all medications before returning home" D.) "You must return for a second dose in 4 to 8 weeks" E.) "Use contraception for 1 month to avoid pregnancy"

D, E

Which nursing interventions are performed to assist a client during a pelvic examination (select all that apply): A.) Collection of specimens B.) Using a water-soluble lubricant C.) Changing into a hospital gown D.) Performing relaxation techniques E.) Moving the client into a sitting position after completion

D, E

The nurse instructor is teaching a group of students about the structure of the fetal head during labor and birth. Which statement by the student indicates effective learning? A.) "The fetal skull bones are firmly united during labor" B.) "The fetal skull bones are united by membranous sutures" C.) "The two important fontanels are the parietal and temporal" D.) "The sutures and fontanels restrict brain growth after delivery"

The nurse is caring for a client in the first trimester of pregnancy who is prescribed propylthiouracil (PTU) for hyperthyroidism. What are the fetal side effects of this medication? A.) Facial anomalies B.) Hepatic toxicity C.) Esophageal atresia D.) Developmental delay

The nurse is caring for a client whose labor is being augmented with oxytocin. The nurse knows that oxytocin would be discontinued immediately if there is evidence of which conditions? A.) Uterine contractions occurring every 8 to 10 minutes B.) A fetal heart rate of 180 with absence of variability C.) The client needing to void D.) Rupture of the amniotic membranes

The nurse is planning the care for a laboring client with diabetes mellitus. This client is at greater risk for which clinical finding? A.) Oligohydramnios B.) Polyhydramnios C.) Postterm pregnancy D.) Chromosomal abnormalities

Under which circumstance would it be unnecessary for the nurse to perform a vaginal examination? A.) Admission to the hospital at the start of labor B.) When accelerations of the FHR are noted C.) On maternal perception of perineal pressure or the urge to bear down D.) When membranes rupture

What fatty acids (classified as hormones) are found in many body tissues with complex roles in many reproductive functions? A.) GnRH B.) Prostaglandins (PGs) C.) FSH D.) Luteinizing hormone (LH)

What is the basic mechanism for conserving internal heat in infants? A.) Shivering B.) Vasoconstriction C.) Metabolism of brown fat D.) Decrease in muscle activity

What is the correct terminology for an abortion in which the fetus dies but is retained within the uterus? A.) Inevitable abortion B.) Missed abortion C.) Incomplete abortion D.) Threatened abortion

What is the correct terminology for the nerve block that provides anesthesia to the lower vagina and perineum? A.) Epidural B.) Pudendal C.) Local D.) Spinal block

What is the nurse's initial action while caring for an infant with a slightly decreased temperature? A.) Immediately notify the physician B.) Place a cap on the infant's head, and have the mother perform kangaroo care C.) Tell the mother that the infant must be kept in the nursery and observed for the next 4 hours D.) Change the formula; a decreased body temperature is a sign of formula intolerance

What is the primary difference between the labor of a nullipara and that of a multipara? A.) Amount of cervical dilation B.) Total duration of labor C.) Level of pain experienced D.) Sequence of labor mechanisms

What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony? A.) Establishing venous access B.) Performing fundal massage C.) Preparing the woman for surgical intervention D.) Catheterizing the bladder

What is the rationale for evaluating the plantar crease within a few hours of birth? A.) Newborn has to be footprinted B.) As the skin dries, the creases will become more prominent C.) Heel sticks may be required D.) Creases will be less prominent after 24 hours

The nurse is monitoring the fetal heart rate (FHR) of a full-term client in labor. Which measure would the nurse take to obtain the most accurate baseline FHR? A.) Record or monitor a 10-minute segment of tracing B.) Include periods of marked variability in the segment C.) Include episodic changes in the segment of tracing D.) Obtain at least 5 minutes of interpretable data in the segment

The nurse is preparing to administer a hepatitis B virus (HBV) vaccine to a newborn. Which intervention by the nurse is correct? A.) Obtaining a syringe with a 25-gauge, 5/8-inch needle for medication administration B.) Confirming that the newborns mother has been infected with the HBV C.) Assessing the dorsogluteal muscle as the preferred site for injection D.) Confirming that the newborn is at least 24 hours old

The nurse is reviewing lab values to determine Rh incompatibility between mother and fetus. Which specific lab result should the nurse assess? A.) Indirect Coombs test B.) Hemoglobin level C.) Human chorionic gonadotropin (hCG) lecel D.) Maternal serum alpha-fetoprotein (MSAFP)

The nurse is using the New Ballard Scale to determine the gestational age of a newborn. Which assessment finding is consistent with a gestational age of 40 weeks? A.) Flexed posture B.) Abundant lanugo C.) Smooth, pink skin with visible veins D.) Faint red marks on the soles of the feet

The client has delivered by urgent caesarean birth for fetal compromise. Umbilical cord gases were obtained for acid-base determination. The pH is 6.9, partial pressure of carbon dioxide (PCO2) is elevated, and the base deficit is 11 mmol/L. What type of acidemia is displayed by the infant? A.) Respiratory B.) Metabolic C.) Mixed D.) Turbulent

A pregnant woman's BPP score is 8. She asks the nurse to explain the results. How should the nurse respond at this time? 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 pregnant woman's amniotic membranes have ruptured. A prolapsed umbilical cord is suspected. What intervention would be the nurses highest priority? A.) Placing the woman in the knee-chest position B.) Covering the cord in sterile gauze soaked in saline C.) Preparing the woman for a cesarean birth D.) Starting oxygen by face mask

The nurse should be cognizant of which statement regarding the unique qualities of human breast milk? A.) Frequent feedings during predictable growth spurts stimulate increased milk production B.) Milk of preterm mothers is the same as the milk of mothers who gave birth at term C.) Milk at the beginning of the feeding is the same as the milk at the end of the feeding D.) Colostrum is an early, less concentrated, less rich version of mature milk

Under which circumstance should the nurse assist the laboring woman into a hands-and-knees position? A.) Occiput of the fetus is in a posterior position B.) Fetus is at or above the ischial spines C.) Fetus is in a vertex presentation D.) Membranes have ruptured

Under which circumstance should the nurse immediately alert the pediatric provider? A.) Infant is dusky and turns cyanotic when crying B.) Acrocyanosis is present 1 hour after childbirth C.) The infant's blood glucose level is 45 mg/dl D.) The infant goes into a deep sleep 1 hour after childbirth

What are the 4 Cs of cultural competence? A.) Call, cause, cope and concerns B.) Call, culture, coping and competence C.) Culture, coping, competence and concerns D.) Culture, competence, concerns and coping

What are the legal responsibilities of the perinatal nurses? A.) Correctly interpreting FHR patterns, initiating appropriate nursing interventions, and documenting the outcomes B.) Greeting the client on arrival, assessing her status, and starting an IV line C.) Applying the external fetal monitor and notifying the health care provider D.) Ensuring that the woman is comfortable

What diagnostic test would be used by the health care team to detect anencephaly in the fetus? A.) Amniocentesis B.) Doppler blood flow analysis C.) Nonstress test D.) Contraction stress test

What fundal height is appropriate on the second postpartum day for a client whose fundal height one day postpartum was U+1, midline and firm? A.) U/U B.) U+2 C.) U-2 D.) U-3

What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy? A.) The blood pressure (BP) cuff should not be applied to the affected arm B.) Venipuncture for blood work should be performed on the affected arm C.) The affected arm should be used for intravenous (IV) therapy D.) The affected arm should be held down close to the woman's side

A primiparous woman is to be discharged from the hospital the following day with her infant girl. Which behavior indicates a need for further intervention by the nurse before the woman can be discharged? A.) The woman is disinterested in learning about infant care B.) The woman continues to hold and cuddle her infant after she has fed her C.) The woman reads a magazine while her infant sleeps D.) The woman changes her infants diaper and then shows the nurse the contents of the diaper.

The client is being induced in response to worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active, despite several hours of oxytocin administration. She asks the nurse, "Why is this taking so long?" What is the nurses most appropriate response? A.) The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor B.) I don't know why it is taking so long C.) The length of labor varies for different women D.) Your baby is just being stubborn

The exact cause of preterm labor is unknown but believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Which type of infection has not been linked to preterm birth? A.) Viral B.) Periodontal C.) Cervical D.) Urinary tract

The female athlete triad includes which common menstrual disorder? A.) Amenorrhea B.) Dysmenorrhea C.) Menorrhagia D.) Metrorrhagia

The health history and physical examination cannot reliably identify all persons infected with HIV or other blood-borne pathogens. Which infection control practice should the nurse use when providing eye prophylaxis to a term newborn? A.) Wear gloves B.) Wear mouth, nose, and eye protection C.) Wear a mask D.) Wash the hands after medication administration

The nurse should be cognizant of which important information regarding nerve block analgesia and anesthesia? A.) Most local agents are chemically related to cocaine and end in the suffix caine B.) Local perineal infiltration anesthesia is effective when epinephrine is added, but it can be injected only once C.) Pudendal nerve block is designed to relieve the pain from uterine contractions D.) Pudendal nerve block, if performed correctly, does not significantly lessen the bearing-down reflex

The nurse should be cognizant of which important statement regarding care of the umbilical cord? A.) The stump can become easily infected B.) If bleeding occurs from the vessels of the cord, then the nurse should immediately call for assistance C.) The cord clamp is removed at cord separation D.) The average cord separation time is 5 to 7 days

The nurse should be cognizant of which physiologic effect of pain? A.) Predominant pain of the first stage of labor is visceral pain that is located in the lower portion of the abdomen B.) Referred pain is the extreme discomfort experienced between contractions C.) Somatic pain of the second stage of labor is more generalized and related to fatigue D.) Pain during the third stage is a somewhat milder version of the pain experienced during the second stage

The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella titer, 1:8 (enzyme immunoassay [EIA] 0.8); hematocrit, 30%. How should the nurse best interpret these data? A.) Rubella vaccine should be administered B.) Blood transfusion is necessary C.) Rh immune globulin is necessary within 72 hours of childbirth D.) Kleihauer-Betke test should be performed

The most conservative approach for early breast cancer treatment involves lumpectomy followed by which procedure? A.) Radiation B.) Adjuvant systemic therapy C.) Hormonal therapy D.) Chemotherapy

The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone. What approach should the nurse take when performing the test to prevent this complication? A.) Lancet should penetrate at the outer aspect of the heel B.) Lancet should penetrate the walking surface of the heel C.) Lancet should penetrate the ball of the foot D.) Lancet should penetrate the area just below the fifth toe

The nurse assesses fetal wellbeing during labor by monitoring which factor? A.) Response of the fetal heart rate (FHR) to uterine contractions B.) Maternal pain control to uterine contractions C.) Accelerations in FHR D.) FHR greater than 110 bpm

The nurse caring for a laboring client is aware that maternal cardiac output can be increased by which factor? A.) Change in position B.) Oxytocin administration C.) Regional anesthesia D.) Intravenous analgesic

A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When evaluating the woman's vital signs, which finding would be of greatest concern to the nurse? A.) Temperature 37.9 C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg B.) Temperature 37.4 C, heart rate 88 bpm, respirations 36 breaths per minute, and blood pressure 126/68 mm Hg C.) Temperature 38 C, heart rate 80 bpm, respirations 16 breaths per minute, and blood pressure 110/80 mm Hg D.) Temperature 36.8 C, heart rate 60 bpm, respirations 18 breaths per minute, and blood pressure 140/90 mm Hg

A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this woman's fundus? A.) 1 centimeter above the umbilicus B.) 2 centimeters below the umbilicus C.) Midway between the umbilicus and the symphysis pubis D.) Nonpalpable abdominally

A woman has chosen the calendar method of conception control. Which is the most important action the nurse should perform during the assessment process? A.) Obtain a history of the woman's menstrual cycle lengths for the past 6 to 12 months B.) Determine the client's weight gain and loss pattern for the previous year C.) Examine skin pigmentation and hair texture for hormonal changes D.) Explore the client' s previous experiences with conception control

A woman in labor passes some thick meconium as her amniotic fluid ruptures. The client asks the nurse where the baby makes the meconium. What is the correct response by the nurse? A.) Fetal intestines B.) Fetal kidneys C.) Amniotic fluid D.) Placenta

A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM) doses of betamethasone. What is the purpose of this pharmacologic intervention? A.) To stimulate fetal surfactant production B.) To reduce maternal and fetal tachycardia associated with ritodrine administration C.) To suppress uterine contractions D.) To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy

A woman is 16 weeks pregnant and has elected to terminate her pregnancy. Which is the most common technique used for the termination of a pregnancy in the second trimester? A.) Dilation and evacuation (D&E) B.) Methotrexate administration C.) Prostaglandin administration D.) Vacuum aspiration

A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. Which statement best describes why this may be happening to this client? A.) This respiratory change is normal in pregnancy and caused by an elevated level of estrogen B.) This cardiovascular change is abnormal, and the nosebleeds are an ominous sign C.) The woman is a victim of domestic violence and is being hit in the face by her partner D.) The woman has been intranasally using cocaine

A woman is undergoing a nipple-stimulated CST. She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline heart rate of approximately 120 beats per minute without any decelerations. What is the correct interpretation of this test? A.) Negative B.) Positive C.) Satisfactory D.) Unsatisfactory

After a woman with blood type Rh negative undergoes amniocentesis, the most appropriate nursing intervention is to: A.) Administer RhoD immunoglobulin B.) Administer anticoagulant C.) Send the patient for a computed tomography (CT) scan before the procedure D.) Assure the mother that short-term radiation exposure is not harmful to the fetus

After delivery, excess hypertrophied tissue in the uterus undergoes a period of self-destruction. What is the correct term for this process? A.) Autolysis B.) Subinvolution C.) Afterpains D.) Diastasis

After reviewing a client's blood glucose levels, the nurse finds that the client is hypoglycemic and administers three glucose tablets. After 15 minutes, the client is still hypoglycemic, so the nurse administers three more glucose tablets. What would the nurse do next if the client's blood glucose is 60 mg/dL after 15 minutes? A.) Notify the primary health care provider B.) Administer a 50% dextrose intravenous push C.) Obtain blood samples for blood gas analysis D.) Give three more glucose tablets for the client

After reviewing the medical history and dietary habits of a pregnant client, the nurse suspects that the client's newborn may have risk of hyperactivity and learning disabilities due to which factors? A.) The client consumed alcohol during the pregnancy B.) The client has three pregnancies in two years C.) The client drinks 6 ounces of coffee daily D.) The client is on valproic acid therapy

After the nurse completes nutritional counseling for a pregnant woman, she asks the client to repeat the instructions to assess the clients understanding. Which statement indicates that the client understands the role of protein in her pregnancy? A.) Protein will help my baby grow B.) Eating protein will prevent me from becoming anemic C.) Eating protein will make my baby have strong teeth after he is born D.) Eating protein will prevent me from being diabetic

The nurse caring for a newborn checks the record to note clinical findings that occurred before her shift. Which finding related to the renal system would be of increased significance and require further action? A.) The pediatrician should be notified if the newborn has not voided in 24 hours B.) Breastfed infants will likely void more often during the first days after birth C.) Brick dust or blood on a diaper is always cause to notify the physician D.) Weight loss from fluid loss and other normal factors should be made up in 4 to 7 days

The nurse expects which maternal cardiovascular finding during labor? A.) Increased cardiac output B.) Decreased pulse rate C.) Decreased white blood cell (WBC) count D.) Decreased blood pressure

The nurse has formulated a diagnosis of Imbalanced nutrition: Less than body requirements for the client. Which goal is most appropriate for this client to obtain? A.) Gain a total of 30 pounds B.) Consistently take daily supplements C.) Decrease her intake of snack foods D.) Increase her intake of complex carbohydrates

The nurse is assessing a pregnant client with multifetal gestation. On reviewing the medical history, the nurse finds that the client had a preterm delivery during the first pregnancy. Which intervention would the nurse perform to help prevent preterm delivery in this client? A.) Suggest that the client avoid smoking B.) Suggest that the client increases physical activity to prevent risk C.) Administer progesterone suppositories to the client D.) Administer a 17-alpha hydroxy progesterone injection to the client

The nurse is caring for a client in early labor. Membranes ruptured approximately 2 hours earlier. This client is at increased risk for which complication? A.) Intrauterine infection B.) Hemorrhage C.) Precipitous labor D.) Supine hypotension

Although reported in small numbers, toxic shock syndrome (TSS) can occur with the use of a diaphragm. If a client is interested in this form of conception control, then the nurse must instruct the woman on how best to reduce her risk of TSS. Which comment by the nurse would be most helpful in achieving this goal? A.) You should always remove your diaphragm 6 to 8 hours after intercourse. Don't use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4 C, hypotension, and a rash B.) You should remove your diaphragm right after intercourse to prevent TSS C.) It's okay to use your diaphragm during your menstrual cycle. Just be sure to wash it thoroughly first to prevent TSS D.) Make sure you don't leave your diaphragm in for longer than 24 hours, or you may get TSS

An essential component of counseling women regarding safe sex practices includes a discussion regarding avoiding the exchange of body fluids. The most effective physical barrier promoted for the prevention of STIs and HIV is the condom. To educate the client about the use of condoms, which information related to condom use is the most important? A.) Strategies to enhance condom use B.) Choice of colors and special features C.) Leaving the decision up to the male partner D.) Places to carry condoms safely

As the United States and Canada continue to become more culturally diverse, recognizing a wide range of varying cultural beliefs and practices is increasingly important for the nursing staff. A client is from which country if she requests to have the baby's father in attendance? A.) Mexico B.) China C.) Iran D.) India

Breathing patterns are taught to laboring women. Which breathing pattern should the nurse support for the woman and her coach during the latent phase of the first stage of labor if the couple has attended childbirth preparation classes? A.) Slow-paced breathing B.) Deep abdominal breathing C.) Modified-paced breathing D.)Patterned-paced breathing

Clients treated for syphilis with penicillin may experience a Jarisch-Herxheimer reaction. Which clinical presentation would be unlikely if a client is experiencing this reaction? A.) Vomiting and diarrhea B.) Headache, myalgias, and arthralgia C.) Preterm labor D.) Jarisch-Herxheimer in the first 24 hours after treatment

Conscious relaxation is associated with which method of childbirth preparation? A.) Grantly Dick-Read childbirth method B.) Lamaze method C.) Bradley method D.) Psychoprophylactic method

Due to the effects of cyclic ovarian changes in the breast, when is the best time for breast self-examination (BSE)? A.) Between 5 and 7 days after menses ceases B.) Day 1 of the endometrial cycle C.) Midmenstrual cycle D.) Any time during a shower or bath

During which period would the health care provider perform an episiotomy for a client who is expected to deliver a newborn who is large for gestational age (LGA)? A.) During crowning B.) Before pushing C.) During dearing of the perineum D.) During delivery of the shoulders

Dysfunctional uterine bleeding (DUB) is defined as excessive uterine bleeding without a demonstrable cause. Which statement regarding this condition is most accurate? A.) DUB is most commonly caused by anovulation B.) DUB most often occurs in middle age C.) The diagnosis of DUB should be the first consideration for abnormal menstrual bleeding D.) Steroids are the most effective medical treatment for DUB

For which reason would the nurse perform nasal and oral suctioning of a newborn immediately after birth? A.) To stimulate respiration B.) To assist in stimulating cardiac activity C.) To remove fluid from the lungs D.) To increase pulmonary blood flow

How are the oligosaccharides that are present in breast milk beneficial to the breastfed infant? A.) They prevent pathogenic bacterial growth B.) They improve blood circulation C.) They increase calcium absorption D.) They promote neurologic development

How would the nurse identify an increased volume of breast milk? A.) By observing the infant's urine color B.) By observing the infant's skin color C.) By observing the infant's sleeping pattern D.) By observing the infant's meconium stool color

How would the nurse optimally reassure the parents of an infant who develops a cephalhematoma? A.) A cephalhematoma may occur with a spontaneous vaginal birth B.) A cephalhematoma only happens as a result of a forceps- or vacuum-assisted delivery C.) It is present immediately after birth D.) The blood will gradually absorb over the first few months of life

I just wanted to have an even number :) So good job at whatever number you're at :) Get a correct answer by putting 'A' as the answer :)

In caring for an immediate postpartum client, the nurse notes petechiae and oozing from her intravenous (IV) site. The client would be closely monitored for which clotting disorder? A.) DIC B.) Amniotic fluid embolism (AFE) C.) Hemorrhage D.) HELLP syndrome

In caring for the woman with DIC, which order should the nurse anticipate? A.) Administration of blood B.) Preparation of the client for invasive hemodynamic monitoring C.) Restriction of intravascular fluids D.) Administration of steroids

In many hospitals, new mothers are routinely presented with gift bags containing samples of infant formula. This practice is inconsistent with what? A.) Baby Friendly Hospital Initiative B.) Promotion of longer periods of breastfeeding C.) Perception of being supportive to both bottle feeding and breastfeeding mothers D.) Association with earlier cessation of breastfeeding

In recovery, if a woman is asked to either raise her legs (knees extended) off the bed or flex her knees, and then place her feet flat on the bed and raise her buttocks well off the bed, the purpose of this exercise is to assess what? A.) Recovery from epidural or spinal anesthesia B.) Hidden bleeding underneath her C.) Flexibility D.) Whether the woman is a candidate to go home after 6 hours

Individual irregularities in the ovarian (menstrual) cycle are most often caused by what? A.) Variations in the follicular (preovulatory) phase B.) Intact hypothalamic-pituitary feedback mechanism C.) Functioning corpus luteum D.) Prolonged ischemic phase

Just sticking this there to make the number even. Select 'A' to get a correct answer :) Have fun!!

Nursing care measures are commonly offered to women in labor. Which nursing measure reflects the application of the gate-control theory? A.) Massage the woman's back B.) Change the woman's position C.) Give the prescribed medication D.) Encourage the woman to rest between contractions

Of these psychosocial factors, which has the least negative effect on the health of the mother and/or fetus? A.) Moderate coffee consumption B.) Moderate alcohol consumption C.) Cigarette smoke D.) Emotional distress

On reviewing the ultrasound report of a pregnant client, the nurse finds that the placenta is at a distance of 2.5 cm from the internal cervical os. Which complication is likely if the client has a vaginal delivery? A.) Hemorrhage B.) Hyperthyroidism C.) Thrombocytopenia D.) Hypofibrinogenemia

On vaginal examination of a 30-year-old woman, the nurse documents the following findings: profuse, thin, grayish-white vaginal discharge with a fishy odor and complaints of pruritus. Based upon these findings, which condition would the nurse suspect? A.) Bacterial vaginosis B.) Candidiasis C.) Trichomoniasis D.) Gonorrhea

Ovarian function and hormone production decline during which transitional phase? A.) Climacteric B.) Menarche C.) Menopause D.) Puberty

The nurse is caring for a pregnant client who is on antibiotic therapy to treat a urinary tract infection (UTI). Which dietary changes would the nurse suggest for this client? A.) "Include yogurt, cheese and milk in your diet" B.) "Avoid folic acid supplements until the end of therapy" C.) "Include vitamins C and E supplementation in your diet" D.) "Reduce your dietary intake by 40 and 50 grams per day"

Parents have been asked by the neonatologist to provide breast milk for their newborn son, who was born prematurely at 32 weeks of gestation. The nurse who instructs them regarding pumping, storing, and transporting the milk needs to assess their knowledge of lactation. Which statement is valid? A.) Premature infants more easily digest breast milk than formula B.) A glass of wine just before pumping will help reduce stress and anxiety C.) The mother should only pump as much milk as the infant can drink D.) The mother should pump every 2 to 3 hours, including during the night

Part of the health assessment of a newborn is observing the infants breathing pattern. What is the pre-dominate pattern of newborns breathing? A.) Abdominal with synchronous chest movements B.) Chest breathing with nasal flaring C.) Diaphragmatic with chest retraction D.) Deep with a regular rhythm

Part of the nurses role is assisting with pushing and positioning. Which guidance should the nurse provide to her client in active labor? A.) Encourage the woman's cooperation in avoiding the supine position B.) Advise the woman to avoid the semi-Fowler position C.) Encourage the woman to hold her breath and tighten her abdominal muscles to produce a vaginal response D.) Instruct the woman to open her mouth and close her glottis, letting air escape after the push

A client is warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on high. The nurse instructs the mother that the fan should not be directed toward the newborn and that the newborn should be wrapped in a blanket. The mother asks why. How would the nurse respond? A.) Your baby may lose heat by convection, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped, and should prevent cool air from blowing on him B.) Your baby may lose heat by conduction, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped, and should prevent cool air from blowing on him C.) Your baby may lose heat by evaporation, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped, and should prevent cool air from blowing on him D.) Your baby will easily get cold stressed and needs to be bundled up at all times

Rho immune globulin will be ordered postpartum if which situation occurs? A.) Mother Rh, baby Rh+ B.) Mother Rh, baby Rh C.) Mother Rh+, baby Rh+ D.) Mother Rh+, baby Rh

A client reports painless, bright red vaginal bleeding during the second trimester of pregnancy. On assessment, the nurse notes decreased urine output, increased fundal height, and a nontender uterus with normal tone. Which client condition would the nurse interpret from these findings? A.) Placenta previa B.) Ectopic pregnancy C.) Hydatidiform mole D.) Normal development

A client who gave birth 4 days ago reports that her vaginal discharge has an offensive odor. Which client condition would the nurse infer from this report? A.) Infection B.) High oxytocin levels C.) Postpartum hemorrhage D.) Normal lochial discharge

A client who is at 32 weeks of gestation asks the nurse when she will start menstruating after delivery. Which question would the nurse ask before responding to the client's question? A.) "Will you be breastfeeding your child after delivery" B.) "Do you plan to opt for elective cesarean delivery" C.) "Do you plan to conceive again immediately after delivery" D.) "What form of contraception do you plan to use after delivery"

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?" What is the nurse's best response? A.) Your placenta changes as your pregnancy progresses, and it is given a score that indicates how well it is functioning B.) Your placenta isn't working properly, and your baby is in danger C.) We need to perform an amniocentesis to detect if you have any placental damage D.) Dont worry about it. Everything is fine

A client at 34 weeks of gestation seeks guidance from the nurse regarding personal hygiene. Which information should the nurse provide? A.) Tub bathing is permitted even in late pregnancy unless membranes have ruptured B.) The perineum should be wiped from back to front C.) Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bath D.) Expectant mothers should use specially treated soap to cleanse the nipples

A client at 39 weeks of gestation has been admitted for an external version. Which intervention would the nurse anticipate the provider to order? A.) Tocolytic drug B.) Contraction stress test (CST) C.) Local anesthetic D.) Foley catheter

A client complains of severe abdominal and pelvic pain around the time of menstruation. This pain has become progressively worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to become pregnant for the past 18 months. To which condition are these symptoms most likely related? A.) Endometriosis B.) PMS C.) Primary dysmenorrhea D.) Secondary dysmenorrhea

A client diagnosed with marginal placenta previa gave birth vaginally 15 minutes ago. At the present time, the client is at the greatest risk for which complication? A.) Hemorrhage B.) Infection C.) Urinary retention D.) Thrombophlebitis

A client exhibits a thick, white, lumpy, cottage cheeselike discharge, along with white patches on her labia and in her vagina. She complains of intense pruritus. Which medication should the nurse practitioner order to treat this condition? A.) Fluconazole B.) Tetracycline C.) Clindamycin D.) Acyclovir

A client has arrived for her first prenatal appointment. She asked the nurse to explain exactly how long the pregnancy will be. What is the nurse's best response? A.) Normal pregnancy is 10 lunar months B.) Pregnancy is made up of four trimesters C.) Pregnancy is considered term at 36 weeks D.) Estimated date of delivery (EDD) is 40 completed weeks

A client has been prescribed adjuvant tamoxifen therapy. What common side effect might she experience? A.) Weight gain, hot flashes, and blood clots B.) Vomiting, weight loss, and hair loss C.) Nausea, vomiting, and diarrhea D.) Hot flashes, weight gain, and headaches

A client is experiencing back labor and complains of intense pain in her lower back. Which measure would best support this woman in labor? A.) Counterpressure against the sacrum B.) Pant-blow (breaths and puffs) breathing techniques C.) Effleurage D.) Conscious relaxation or guided imagery

The nurse is caring for a pregnant client who is scheduled for surgery. Which nursing intervention would help provide sufficient fetal oxygenation during the surgery? A.) Positioning the client with a lateral tilt B.) Providing clear liquids C.) Palpating uterine contractions manually D.) Giving an antacid before administering anesthesia

A client is scheduled for surgery after a recent breast cancer diagnosis. The nurse is discussing the procedure with the client. To allay her fears, which explanation best describes a skin-sparing mastectomy? A.) Removal of the breast, nipple, and areola, leaving only the skin B.) Removal of the breast, nipple, areola, and axillary node dissection C.) Incision on the outside of the breast, leaving the nipple intact D.) Removal of both breasts in their entirety

A client is undergoing percutaneous umbilical blood sampling (PUBS). What is the best intervention for the nurse to perform after conducting the test? A.) Monitor the fetal heart rate (FHR) B.) Give fluids to the client frequently C.) Elevate the client's bed to a 60 degree angle D.) Check the patient's blood glucose levels

A client with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the client and documents the following findings: - temperature 37.1 C - pulse 96 bpm - RR 24 - BP 155/112 mmHg - 3+ deep tendon reflexes - no ankle clonus The nurse calls the primary health care provider and anticipates a prescription for which medication? A.) Hydralazine B.) Magnesium sulfate bolus C.) Diazepam D.) Calcium gluconate

A first-time father is changing the diaper of his 1-day-old daughter. He asks the nurse, What is this black, sticky stuff in her diaper? What is the nurse's best response? A.) That's meconium, which is your baby's first stool. Its normal B.) That's transitional stool C.) That means your baby is bleeding internally D.) Oh, don't worry about that. Its okay

The nurse is caring for a pregnant client with gestational diabetes. What would the nurse teach the client about diet during pregnancy? A.) Eat three meals a day with two or three snacks B.) Avoid meals or snacks just before bedtime C.) Use artificial sweeteners instead of sugar D.) Avoid foods that are high in dietary fiber

A first-time mother at 18 weeks of gestation is in for her regularly scheduled prenatal visit. The client tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that these are Braxton Hicks contractions. What other information is important for the nurse to share? A.) Braxton Hicks contractions should be painless B.) They may increase in frequency with walking C.) These contractions might cause cervical dilation D.) Braxton Hicks contractions will impede oxygen flow to the fetus

A hospital has a number of different perineal pads available for use. A nurse is observed soaking several of them and writing down what she sees. What goal is the nurse attempting to achieve by performing this practice? A.) To improve the accuracy of blood loss estimation, which usually is a subjective assessment B.) To determine which pad is best C.) To demonstrate that other nurses usually underestimate blood loss D.) To reveal to the nurse supervisor that one of them needs some time off

A 21-year-old client exhibits a greenish, copious, and malodorous discharge with vulvar irritation. A speculum examination and wet smear are performed. Which condition is this client most likely experiencing? A.) Bacterial vaginosis B.) Candidiasis C.) Yeast infection D.) Trichomoniasis

What is the most common medical complication of pregnancy? A.) Hypertension B.) Hyperemesis gravidarum C.) Hemorrhagic complications D.) Infections

What is the most critical nursing action in caring for the newborn immediately after the birth? A.) Keeping the airway clear B.) Fostering parent-newborn attachment C.) Drying the newborn and wrapping the infant in a blanket D.) Administering eye drops and vitamin K

What is the most important nursing action in preventing neonatal infection? A.) Good handwashing B.) Isolation of infected infants C.) Separate gown technique D.) Standard Precautions

What nursing diagnosis is the most appropriate for a woman experiencing severe preeclampsia? A.) Risk for injury to mother and fetus, related to central nervous system (CNS) irritability B.) Risk for altered gas exchange C.) Risk for deficient fluid volume, related to increased sodium retention secondary to the administration of magnesium sulfate D.) Risk for increased cardiac output, related to the use of antihypertensive drugs

When assessing a multiparous woman who has just given birth to an 8-pound boy, the nurse notes that the woman's fundus is firm and has become globular in shape. A gush of dark red blood comes from her vagina. What is the nurse's assessment of the situation? A.) The placenta has separated B.) A cervical tear occurred during the birth C.) The woman is beginning to hemorrhage D.) Clots have formed in the upper uterine segment

When should discharge instruction, or the teaching plan that tells the woman what she needs to know to care for herself and her newborn, officially begin? A.) At the time of admission to the nurses unit B.) When the infant is presented to the mother at birth C.) During the first visit with the physician in the unit D.) When the take-home information packet is given to the couple

Which component of the sensory system is the least mature at birth? A.) Vision B.) Hearing C.) Smell D.) Taste

Which type of cervical mucus would you expect in a non-fertile woman in postovulation? A.) Scant B.) Thick, cloudy and sticky C.) Clear, wet, sticky and slippery D.) Cloudy, yellow or white, and sticky

Which are bacterial sexually transmitted infections (STIs) (select all that apply): A.) Syphilis B.) Gonorrhea C.) Chlamydia tracheomatis D.) Vulvovaginal candidiasis E.) Pelvic inflammatory disease (PID)

A, B, C, E

Which laboratory testing is anticipated on the initial prenatal visit for a client who is at 8 weeks of gestation (select all that apply): A.) Pap test B.) Urine culture C.) Rubella titer D.) 1-hour glucose tolerance test E.) Vaginal and anal culture for group B Streptococcus (GBS) F.) Gonorrhea and chlamydia cervical cultures

A, B, C, E

Because of its size and rigidity, the fetal head has a major effect on the birth process. Which bones comprise the structure of the fetal skull (select all that apply): A.) Parietal B.) Temporal C.) Fontanel D.) Occipital E.) Femoral

A, B, D

Which factors influence cervical dilation (select all that apply): A.) Strong uterine contractions B.) Force of the presenting fetal part against the cervix C.) Size of the woman D.) Pressure applied by the amniotic sac E.) Scarring of the cervix

A, B, D, E

What are signs and symptoms of supine hypotension (select all that apply): A.) Pallor B.) Acid reflux C.) Dizziness D.) Tachycardia E.) Breathlessness F.) Dry, warm skin

A, C, D, E

The nurse is teaching the client insulin self-administration techniques. Which education would the nurse include in the lessons (select all that apply): A.) Allow the alcohol to dry before injecting the insulin B.) Puncture the skin at a 45-degree angle C.) Ensure that the insulin is injected rapidly D.) Apply gentle pressure after the injection E.) Record the dose and time of the injection

A, D, E

At 1 minute after birth a nurse assesses an infant and notes a heart rate of 80 beats per minute, some flexion of extremities, a weak cry, grimacing, and a pink body but blue extremities. Which Apgar score does the nurse calculate based upon these observations and signs? A.) 4 B.) 5 C.) 6 D.) 7

The nurse is circulating during a cesarean birth of a preterm infant. The obstetrician requests that cord clamping be delayed. What is the rationale for this directive? A.) To reduce the risk for jaundice B.) To reduce the risk of intraventricular hemorrhage C.) To decrease total blood volume D.) To improve the ability to fight infection

What is a subjective symptom of pregnancy? A.) Vaginal changes B.) Urinary frequency C.) Breast enlargement D.) Abdominal enlargement

Which education would the nurse provide the parents of a neonate about how to use a bulb syringe? A.) Ensure that the bulb syringe is kept near (but not in) the crib B.) Insert the tip of the bulb into the side of the mouth first C.) Insert the tip of the bulb into the mouth and then compress D.) Perform suction first in each nostril and then the mouth

Which nursing intervention is necessary before a first-trimester transabdominal ultrasound? A.) Place the woman on nothing by mouth (nil per os [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

Which factors place a client at risk for postpartum infection (select all that apply): A.) Asthma B.) Obesity C.) Preeclampsia D.) Hypothyroidism E.) History of blood transfusion

B, C

Which factors change significantly during pregnancy (select all that apply): A.) Bilirubin levels B.) Albumin levels C.) Platelet count D.) Hematocrit value E.) Gastric secretions

B, D, E

A woman has a breast mass that is not well delineated and is nonpalpable, immobile, and nontender. Which condition is this client experiencing? A.) Fibroadenoma B.) Lipoma C.) Intraductal papilloma D.) Mammary duct ectasia

In which stage of labor would the nurse expect the placental to be expelled? A.) First B.) Second C.) Third D.) Fourth

The measurement of lecithin in relation to sphingomyelin (lecithin/sphingomyelin [L/S] ratio) is used to determine fetal lung maturity. Which ratio reflects fetal maturity of the lungs? A.) 1.4:1 B.) 1.8:1 C.) 2:1 D.) 1:1

The microscopic examination of scrapings from the cervix, endocervix, or other mucous membranes to detect premalignant or malignant cells is called what? A.) Bimanual palpation B.) Rectovaginal palpation C.) Papanicolaou (Pap) test D.) Four As procedure

While discussing the societal impacts of breastfeeding, the nurse should be cognizant of the benefits and educate the client accordingly. Which statement as part of this discussion would be incorrect? A.) Breastfeeding requires fewer supplies and less cumbersome equipment B.) Breastfeeding saves families money C.) Breastfeeding costs employers in terms of time lost from work D.) Breastfeeding benefits the environment

While examining a newborn, the nurse notes uneven skinfolds on the buttocks and a clunk when performing the Ortolani maneuver. These findings are likely indicative of what? A.) Polydactyly B.) Clubfoot C.) Hip dysplasia D.) Webbing

While obtaining a diet history, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. Which nutritional problem does this behavior indicate? A.) Preeclampsia B.) Pyrosis C.) Pica D.) Purging

While working with the pregnant client in her first trimester, what information does the nurse provide regarding when CVS can be performed (in weeks of gestation)? A.) 4 B.) 8 C.) 10 D.) 14

A client asks the nurse when her ovaries will begin working again. Which explanation by the nurse is most accurate? A.) Almost 75% of women who do not breastfeed resume menstruating within 1 month after birth B.) Ovulation occurs slightly earlier for breastfeeding women C.) Because of menstruation and ovulation schedules, contraception considerations can be postponed until after the puerperium D.) The first menstrual flow after childbirth usually is heavier than normal

A client currently uses a diaphragm and spermicide for contraception. She asks the nurse to explain the major differences between the cervical cap and the diaphragm. What is the most appropriate response by the nurse? A.) No spermicide is used with the cervical cap, so its less messy B.) The diaphragm can be left in place longer after intercourse C.) Repeated intercourse with the diaphragm is more convenient D.) The cervical cap can be safely used for repeated acts of intercourse without adding more spermicide later

A health care provider performs a clinical breast examination on a woman diagnosed with fibroadenoma. How would the nurse explain the defining characteristics of a fibroadenoma? A.) Inflammation of the milk ducts and glands behind the nipples B.) Thick, sticky discharge from the nipple of the affected breast C.) Lumpiness in both breasts that develops 1 week before menstruation D.) Single lump in one breast that can be expected to shrink as the woman ages

A nurse is responsible for teaching new parents regarding the hygienic care of their newborn. Which instruction should the nurse provide regarding bathing? A.) Avoid washing the head for at least 1 week to prevent heat loss B.) Sponge bathe the newborn for the first month of life C.) Cleanse the ears and nose with cotton-tipped swabs, such as Q-tips D.) Create a draft-free environment of at least 24 C (75 F) when bathing the infant

A nurse is teaching a pregnant client with a history of psoriasis. Which information would the nurse provide to the client? A.) Pregnancy has no effect on psoriasis B.) Staying out of direct sunlight will stop progression of disease C.) Psoriasis typically worsens during pregnant in approximately 50% of clients D.) Clients who have psoriasis during pregnancy experience a varied response

A postpartum woman telephones the provider regarding her 5-day-old infant. The client is not scheduled for another weight check until the infant is 14 days old. The new mother is worried about whether breastfeeding is going well. Which statement indicates that breastfeeding is effective for meeting the infants nutritional needs? A.) Sleeps for 6 hours at a time between feedings B.) Has at least one breast milk stool every 24 hours C.) Gains 1 to 2 ounces per week D.) Has at least six to eight wet diapers per day

A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. The client shows the nurse her readings for the past few days. Which reading signals the nurse that the client may require an adjustment of insulin or carbohydrates? A.) 75 mg/dl before lunch. This is low; better eat now B.) 115 mg/dl 1 hour after lunch. This is a little high; maybe eat a little less next time C.) 115 mg/dl 2 hours after lunch. This is too high; it is time for insulin D.) 50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep

Another common pregnancy-specific condition is pruritic urticarial papules and plaques of pregnancy (PUPPP). A client asks the nurse why she has developed this condition and what can be done. What is the nurse's best response? A.) PUPPP is associated with decreased maternal weight gain B.) The rate of hypertension decreases with PUPPP C.) This common pregnancy-specific condition is associated with a poor fetal outcome D.) The goal of therapy is to relieve discomfort

As part of the infant discharge instructions, the nurse is reviewing the use of the infant car safety seat. Which information is the highest priority for the nurse to share? A.) Infant carriers are okay to use until an infant car safety seat can be purchased B.) For traveling on airplanes, buses, and trains, infant carriers are satisfactory C.) Infant car safety seats are used for infants only from birth to 15 pounds D.) Infant car seats should be rear facing and placed in the back seat of the car

As part of their participation in the gynecologic portion of the physical examination, which approach should the nurse take? A.) Take a firm approach that encourages the client to facilitate the examination by following the physicians instructions exactly B.) Explain the procedure as it unfolds, and continue to question the client to get information in a timely manner C.) Take the opportunity to explain that the trendy vulvar self-examination is only for women at risk for developing cancer D.) Help the woman relax through the proper placement of her hands and proper breathing during the examination

The nurse is caring for a lactated client who has undergone bariatric surgery. Which nutritional supplement would be beneficial to prevent deficiency state in the mother and the infant? A.) Folic acid supplement B.) Fluoride supplement C.) Vitamin C supplement D.) Vitamin B12 supplement

The nurse is caring for a pregnant client diagnosed with mitral valve stenosis. Which position would the nurse suggest to the client to ensure a safe labor? A.) Supine B.) Standing C.) Lithotomy D.) Side-lying

The nurse is evaluating the fetal monitor tracing of a client who is in active labor and notes a sudden drop in fetal heart rate (FHR) from its baseline of 125 down to 80. The nurse repositions the client, provides oxygen, increases intravenous (IV) fluid, and performs a vaginal examination. The cervix has not changed. Five minutes have passed, and the FHR remains in the 80s. Which additional measure would the nurse take? A.) Care for help B.) Insert a Foley catheter C.) Start oxytocin D.) Immediately notify the primary health care provider

The nurse is performing a fetal acoustic stimulation test (FAST) in conjunction with a nonstress test. The nurse observes a nonreactive baseline fetal heart rate (FHR) after 5 minutes. What is the best nursing intervention in this situation? A.) Performing the test after an interval of 2 hours B.) Performing a contraction stress test immediately C.) Administering 0.5 milliunits/min oxytocin for 20 minutes D.) Activating a stimulator for 3 seconds on the patient's abdomen

The nurse is teaching a client in the second trimester about fetal kick count. Which statement by the client needs correction? A.) "I should count the fetal kicks once a day for 60 minutes" B.) "I may not feel any movements when the fetus is sleeping" C.) "I should count the fetal kicks either after meals or before bedtime" D.) "I should consult an obstetrician if the fetal movements are less than 10 in one hour"

The obstetric provider has informed the nurse that she will be performing an amniotomy on the client to induce labor. What is the nurses highest priority intervention after the amniotomy is performed? A.) Applying clean linens under the woman B.) Taking the client's vital signs C.) Performing a vaginal examination D.) Assessing the fetal heart rate (FHR)

The perinatal nurse realizes that an FHR that is tachycardic, bradycardic, has late decelerations, or loss of variability is nonreassuring and is associated with which condition? A.) Hypotension B.) Cord compression C.) Maternal drug use D.) Hypoxemia

The trend in the United States is for women to remain hospitalized no longer than 1 or 2 days after giving birth. Which scenario is not a contributor to this model of care? A.) Wellness orientation model of care rather than a sick-care model B.) Desire to reduce health care costs C.) Consumer demand for fewer medical interventions and more family-focused experiences D.) Less need for nursing time as a result of more medical and technologic advances and devices available at home that can provide information

The ultrasound report of a 12-week old pregnant client shows a snowstorm pattern. On further examination, the nurse finds elevated human chorionic gonadotropin (hCG) levels and dark brown vaginal discharge. Which complication would the nurse expect in the client? A.) Hemorrhage B.) Hypertension C.) Hyperglycemia D.) Molar pregnancy

To reassure and educate their pregnant clients regarding changes in their blood pressure, nurses should be cognizant of what? A.) A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high B.) Shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit C.) Systolic blood pressure slightly increases as the pregnancy advances; diastolic pressure remains constant D.) Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of a term pregnancy

What form of heart disease in women of childbearing years generally has a benign effect on pregnancy? A.) Cardiomyopathy B.) Rheumatic heart disease C.) Congenital heart disease D.) Mitral valve prolapse

What is one of the initial signs and symptoms of puerperal infection in the postpartum client? A.) Fatigue continuing for longer than 1 week B.) Pain with voiding C.) Profuse vaginal lochia with ambulation D.) Temperature of 38 C (100.4 F) or higher on 2 successive days

What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant? A.) Genetic changes and anomalies B.) Extensive central nervous system damage C.) Fetal addiction to the substance inhaled D.) Intrauterine growth restriction

What physiologic change occurs as the result of increasing the infusion rate of nonadditive IV fluids? A.) Maintaining normal maternal temperature B.) Preventing normal maternal hypoglycemia C.) Increasing the oxygen-carrying capacity of the maternal blood D.) Expanding maternal blood volume

When a nulliparous woman telephones the hospital to report that she is in labor, what guidance should the nurse provide or information should the nurse obtain? A.) Tell the woman to stay home until her membranes rupture B.) Emphasize that food and fluid intake should stop C.) Arrange for the woman to come to the hospital for labor evaluation. D.) Ask the woman to describe why she believes she is in labor

When caring for a pregnant woman with cardiac problems, the nurse must be alert for the signs and symptoms of cardiac decompensation. Which critical findings would the nurse find on assessment of the client experiencing this condition? A.) Regular heart rate and hypertension B.) Increased urinary output, tachycardia, and dry cough C.) Shortness of breath, bradycardia, and hypertension D.) Dyspnea, crackles, and an irregular, weak pulse

Which action would the nurse take before administering meperidine hydrochloride to a client to relieve labor pain? A.) Administer 1000 mL of normal saline solution B.) Ask the client to use relaxation techniques C.) Ask the client to assume an upright position D.) Monitor maternal vital signs and fetal heart rate

Which anatomic site would the nurse select to administer vitamin K to a term newborn? A.) Bicep muscle B.) Deltoid muscle C.) Dorsogluteal muscle D.) Vastus lateralis muscle

Which infant response to cool environmental conditions is either not effective or not available to them? A.) Constriction of peripheral blood vessels B.) Metabolism of brown fat C.) Increased respiratory rates D.) Unflexing from the normal position

Which nursing information is recognized as part of the protocol of a perimortem cesarean delivery? A.) The goal is to deliver the neonate in less than 5 minutes B.) Maternal resuscitation cease after delivery of the neonate C.) The neonate must be delivered after 5 minutes of maternal resuscitation D.) After 4 minutes of maternal pulselessness, the neonate must be delivered

Which nursing instruction is appropriate when counseling a woman about getting enough iron in her diet? A.) Milk, coffee and tea aid iron absorption if consumed at the same time as iron B.) Iron absorption is inhibited by a diet rich in vitamin C C.) Iron supplementation are permissible for children in small doses D.) Constipation is common with iron supplements

Which nursing intervention reduces urinary frequency in the pregnant client? A.) Advise the client to limit fluid intake B.) Encourage the client to wear a perineal pad C.) Advise the client to empty her bladder regularly D.) Encourage the client to perform Kegel exercises

Which nursing intervention would suppress lactation in the client who had a stillbirth? A.) Run warm water over the client's breasts B.) Administer strong analgesics C.) Administer oral and intravenous fluids D.) Advise the client to wear a breast binder for the first 72 hours after giving birth

Which nursing statement is appropriate for a married couple discussing male and female sterilization? A.) "Male and female sterilization are 100% effective" B.) "A vasectomy may have a slight effect on sexual performance" C.) "Tubal ligation can be easily reserved if you change your mind in the future" D.) "Major complications after sterilization are rare"

Which risk is associated with iron supplementation for the pregnant client? A.) Tetany B.) Anemia C.) Diabetes D.) Constipation

Which statement is accurate regarding educating the client about preconception care? A.) It is designed for women who has never been pregnant B.) It includes risk factor assessments for potential medical and psychological problems but by law cannot consider finances or workplace conditions C.) It does not teach about safe sex to avoid political controversy D.) It could include interventions to reduce substance use and abuse

Which system responses would the nurse recognize as being unrelated to prostaglandin (PGF2) release? A.) Systemic responses B.) Gastrointestinal system C.) Central nervous system D.) Genitourinary system

hCG is an important biochemical marker for pregnancy and therefore the basis for many tests. Which statement regarding hCG is true? A.) hCG can be detected as early as weeks after conception B.) hCG levels gradually and uniformly increase throughout pregnancy C.) Significantly lower-than-normal increases in the levels of hCG may indicate a postdate pregnancy D.) Higher-than-normal levels of hCG may indicate an ectopic pregnancy or Down syndrome

Which medication is contraindicated in a client who is on anticoagulant therapy? A.) Aspirin B.) Clindamycin C.) Midoprostol D.) Ergovine

Which preconception counseling interventions can decrease the incidence of spina bifida in the fetus? A.) Include a daily intake of 600 mcg of folic acid during pregnancy B.) Eat a well-balanced diet during pregnancy C.) Include aerobic exercise regularly during pregnancy D.) Focus on methods to maintain a euglycemic condition during pregnancy

Which type of contraception is associated with toxic shock syndrome? A.) Diaphragm B.) Female condom C.) Intrauterine device D.) Contraceptive sponge

Which type of vaginal discharge is more common during the transition phase of the first stage of labor? A.) Bloody mucus B.) Pale pink mucus C.) Brownish discharge D.) Pink-to-bloody mucus

Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes? A.) Herpes simplex virus 2 (HSV-2) B.) HPV C.) HIV D.) CMV

Which common complications are seen during the third trimester of pregnancy (select all that apply): A.) Constipation B.) Urinary frequency C.) Disturbance in sleep D.) Difficulty breathing E.) Nausea and vomiting

A, B, C, D

Transvaginal ultrasonography is often performed during the first trimester. While preparing a 6-week gestational client for this procedure, she expresses concerns over the necessity for this test. The nurse should explain that this diagnostic test may be indicated for which situations (select all that apply): A.) Multifetal gestation B.) Obesity C.) Fetal abnormalities D.) Amniotic fluid volume E.) Ectopic pregnancy

A, B, C, E

If a woman is at risk for thrombus and is not ready to ambulate, which nursing intervention would the nurse use (select all that apply): A.) Putting her in antiembolic stockings (thromboembolic deterrent [TED] hose) and/or sequential compression device (SCD) boots B.) Having her flex, extend, and rotate her feet, ankles, and legs C.) Having her sit in a chair D.) Immediately notifying the physician if a positive Homans sign occurs E.) Promoting bed rest

A, B, D

A woman has just moved to the United States from Mexico. She is 3 months pregnant and has arrived for her first prenatal visit. During her assessment interview, the nurse learns that the client has not had any immunizations. Which immunizations should she receive at this point in her pregnancy (select all that apply): A.) Tetanus B.) Diphtheria C.) Chickenpox D.) Rubella E.) Hepatitis B

A, B, E

Which sexually transmitted infections are caused by bacteria (select all that apply): A.) Chlamydia B.) Gonorrhea C.) Trichomoniasis D.) Hepatitis A and B E.) Lymphogranuloma venereum

A, B, E

The diagnosis of pregnancy is based on which positive signs of pregnancy (select all that apply): A.) Identification of fetal heartbeat B.) Palpation of fetal outline C.) Visualization of the fetus D.) Verification of fetal movement E.) Positive hCG test

A, C, D

Bell palsy is an acute idiopathic facial paralysis, the cause for which remains unknown. Which statement regarding this condition is correct? A.) Bell palsy is the sudden development of bilateral facial weakness B.) Women with Bell palsy have an increased risk for hypertension C.) Pregnant women are affected twice as often as nonpregnant women D.) Bell palsy occurs most frequently in the first trimester

The process during which bilirubin is changed from a fat-soluble product to a water-soluble product is known as what? A.) Enterohepatic circuit B.) Conjugation of bilirubin C.) Unconjugated bilirubin D.) Albumin binding

Which finding is associated with endometriosis? A.) Positive Chandelier sign B.) Chocolate cyst C.) Chadwick sign D.) Blood in the cul-de-sac

Which statement best describes the rationale for the physiologic anemia that occurs during pregnancy? A.) Physiologic anemia involves an inadequate intake of iron B.) Dilution of hemoglobin concentration occurs in pregnancy with physiologic anemia C.) Fetus establishes the iron stores D.) Decreased production of erythrocytes occur

Which medications are likely to be prescribed for a client with endometriosis (select all that apply): A.) Sertraline B.) Nafarelin C.) Leuprolide D.) Fluoxetine E.) Goserelin

B, C, E

A nurse is caring for a client who is in active labor and becomes nauseous and vomits. The client is very irritable and feels the urge to have a bowel movement. She states, "I've had enough. I can't do this anymore. I want to go home right now." Which of the following stages of labor is the client experiencing? A.) Second stage B.) Fourth stage C.) Transition stage D.) Latent phase

The nurse observes that maternal hypotension has decreased uterine and fetal perfusion in a pregnant client. To further assess this situation, which factor would the nurse select to understand the maternal status? A.) D-dimer blood test B.) Kleihauer-Betke (KB) test C.) Electronic fetal monitoring D.) Electrocardiogram reading

Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth? A.) Fetal head is felt at 0 station during vaginal examination B.) Bloody mucous discharge increases C.) Vulva bulges and encircles the fetal head D.) Membranes rupture during a contraction.

Which stressor can result in "empty nest syndrome"? A.) Financial crisis caused by loss of job B.) Loss of job caused by personal inefficiency C.) Children leaving home to seek higher education D.) Chronic illness, such as diabetes and hypertension

A woman gave birth to a healthy infant boy 5 days ago. What type of lochia does the nurse expect to find when evaluating this client? A.) Lochia rubra B.) Lochia sangra C.) Lochia alba D.) Lochia serosa

During a physical assessment of an at-risk client, the nurse notes generalized edema, crackles at the base of the luns and some pulse irregularity. These are most likely signs of which problems? A.) Euglycemia B.) Rheumatic fever C.) Pneumonia D.) Cardiac decompensation

Which client should the nurse refer for further testing? A.) Left breast slightly smaller than right breast B.) Eversion (elevation) of both nipples C.) Faintly visible bilateral symmetry of venous network D.) Small dimple located in the upper outer quadrant of the right breast

Which statement by the student nurse regarding the advantages of fertility awareness-based methods (FABs) of contraception indicates effective learning? A.) FABs protect against sexually transmitted infections (STIs) B.) There is no difficulty with adherence to this contraceptive method C.) There is increased effectiveness in women with irregular cycles D.) FABs promote increased involvement and intimacy with the partner

A 21-year-old client complains of severe pain immediately after the commencement of her menses. Which gynecologic condition is the most likely cause of this clients presenting complaint? A.) Primary dysmenorrhea B.) Secondary dysmenorrhea C.) Dyspareunia D.) Endometriosis

A 3.8-kg infant was vaginally delivered at 39 weeks after a 30-minute second stage. A nuchal cord was found at delivery. After birth, the infant is noted to have petechiae over the face and upper back. Which information regarding petechiae is most accurate and should be provided to the parents? A.) Are benign if they disappear within 48 hours of birth B.) Result from increased blood volume C.) Should always be further investigated D.) Usually occur with a forceps-assisted delivery

A 3.8-kg infant was vaginally delivered at 39 weeks of gestation after a 30-minute second stage. A nuchal cord occurred. After the birth, the infant is noted to have petechiae over the face and upper back. Based on the nurses knowledge, which information regarding petechiae should be shared with the parents? A.) Petechiae (pinpoint hemorrhagic areas) are benign if they disappear within 48 hours of childbirth B.) These hemorrhagic areas may result from increased blood volume C.) Petechiae should always be further investigated D.) Petechiae usually occur with a forceps delivery

A 39-year-old primigravida woman believes that she is approximately 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; however, she tells the nurse that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique would be useful at this time? A.) Ultrasound examination B.) Maternal serum alpha-fetoprotein (MSAFP) screening C.) Amniocentesis D.) Nonstress test (NST)

A mother is changing the diaper of her newborn son and notices that his scrotum appears large and swollen. The client is concerned. What is the best response from the nurse? A.) A large scrotum and swelling indicate a hydrocele, which is a common finding in male newborns B.) I don't know, but I'm sure it is nothing C.) Your baby might have testicular cancer D.) Your babys urine is backing up into his scrotum

A new mother asks the nurse about the white substance covering her infant. How should the nurse explain the purpose of vernix caseosa? A.) Vernix caseosa protects the fetal skin from the amniotic fluid B.) Vernix caseosa promotes the normal development of the peripheral nervous system C.) Vernix caseosa allows the transport of oxygen and nutrients across the amnion D.) Vernix caseosa regulates fetal temperature

The nurse is supervising a student nurse while performing a nonstress test. Which action of the student nurse indicates the need for further teaching? A.) Placing the client in the left side-lying position B.) Instructing the client to press the handheld marker C.) Offering glucose water prior to the test D.) Applying a tocodynamometer with Doppler transducer

The nurse sees a primigravida at 30 weeks gestation for the first time. The nurse notes the client has smoked throughout the pregnancy, and fundal height measurements are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, the nurse knows which tool is useful in confirming this condition? A.) Doppler blood flow analysis B.) Contraction stress test (CST) C.) Amniocentesis D.) Daily fetal movement counts

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

The nurse should be aware of which information related to a woman's intake and output during labor? A.) Traditionally, restricting the laboring woman to clear liquids and ice chips is being challenged because regional anesthesia is used more often than general anesthesia B.) Intravenous (IV) fluids are usually necessary to ensure that the laboring woman stays hydrated C.) Routine use of an enema empties the rectum and is very helpful for producing a clean, clear delivery D.) When a nulliparous woman experiences the urge to defecate, it often means birth will quickly follow

Which additional caloric intake information is appropriate to include in the teaching for a client who is 6 weeks postpartum and breastfeeding? A.) 330 B.) 340 C.) 400 D.) 452

Which alteration in the FHR pattern would indicate the potential need for an amnioinfusion? A.) Variable decelerations B.) Late decelerations C.) Fetal bradycardia D.) Fetal tachycardia

Which alterations in the perception of pain by a laboring client should the nurse understand? A.) Sensory pain for nulliparous women is often greater than for multiparous women during early labor B.) Affective pain for nulliparous women is usually less than for multiparous women throughout the first stage of labor C.) Women with a history of substance abuse experience more pain during labor D.) Multiparous women have more fatigue from labor and therefore experience more pain

Which analysis of maternal serum may predict chromosomal abnormalities in the fetus? A.) Multiple-marker screening B.) L/S ratio C.) BPP D.) Blood type and crossmatch of maternal and fetal serum

Which are the five As implemented by smoking cessation? A.) Ask, assess, advise, assist and arrange follow-up B.) Ask, answer, admit, be accountable and accept for help C.) Ask, answer, assess, administer meds and arrange support group D.) Ask, advise, assist, administer therapy and arrange support group

Which assessment finding would the nurse expect when caring for a newborn male infant born at 39 weeks of gestation? A.) Testes descended into the scrotum B.) Extended posture when at rest C.) Abundant lanugo over his entire body D.) Ability to move his elbow past his sternum

Which behavior indicates that a woman is seeking safe passage for herself and her infant? A.) She keeps all prenatal appointments B.) She eats for two C.) She slowly drives her car D.) She wears only low-heeled shoes

Which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur? A.) Maternal fever B.) Umbilical cord prolapse C.) Regional anesthesia D.) Magnesium sulfate administration

Which component of the physical examination are Leopold maneuvers unable to determine? A.) Gender of the fetus B.) Number of fetuses C.) Fetal lie and attitude D.) Degree of the presenting parts descent into the pelvis

Which condition in a client who is suing a copper-bearing intrauterine device indicates a need for removal of this device? A.) Rashes B.) Nausea C.) Occasional bleeding D.) Minor cramping

Which condition is considered a medical emergency that requires immediate treatment? A.) Inversion of the uterus B.) Hypotonic uterus C.) ITP D.) Uterine atony

Which condition is likely to be identified by the quadruple marker screen? A.) Down syndrome B.) Diaphragmatic hernia C.) Congenital cardiac abnormality D.) Anencephaly

Which description of the four stages of labor is correct for both the definition and the duration? A.) First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours B.) Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours C.) Third stage: active pushing to birth; 20 minutes (multiparous woman), 50 minutes (nulliparous woman) D.) Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour

Which dietary intake is appropriate for the pregnant client who is still playing tennis at 32 weeks of gestation? A.) Several glasses of fluid B.) Extra protein sources, such as peanut butter C.) Salty foods to replace lost sodium D.) Easily digested sources of carbohydrate

Which explanation will assist the parents in their decision on whether they should circumcise their son? A.) The circumcision procedure has pros and cons during the prenatal period B.) American Academy of Pediatrics (AAP) recommends that all male newborns be routinely circumcised C.) Circumcision is rarely painful, and any discomfort can be managed without medication D.) The infant will likely be alert and hungry shortly after the procedure

Which infant behavior would the nurse recognize as indicating respiratory distress? A.) Absent cry after birth B.) Hypoactive bowel sounds C.) Side-to-side head movement D.) Elevated blood pressure (BP)

Which initial treatment would the nurse anticipate when teaching an obstetric client who is newly diagnosed with idiopathic thrombocytopenic purpura (ITP)? A.) Prednisone B.) Splenectomy C.) Platelet transfusion D.) Coagulation studies

Which instruction is appropriate for a client who takes combined oral contraceptives (COCs)? A.) "Take only 1 pill at the same time each day" B.) "You may have increased menstrual blood flow" C.) "Iron-deficiency anemia is a side effect of the pill" D.) "The pill increases the risk for endometrial cancer"

Which instruction is appropriate in preparing a client for a Papanicolaou (Pap) test? A.) The client should not douche, use vaginal medications or have intercourse for at least 24 hours before the test B.) It should be performed once a year beginning with the onset of puberty C.) A lubricant such as petroleum jelly should be used to ease speculum insertion D.) The specimen for the Pap test should be obtained after specimens are collected for cervical infection

Which is an effective nursing intervention for a laboring client who is experiencing back labor and complains of intense pain in her lower back? A.) Counterpressure against the sacrum B.) Pant-blow (breaths and puffs) breathing techniques C.) Effleurage D.) Biofeedback

Which medication is recommended by the Centers for Disease Control and Prevention (CDC) for the treatment of chlamydia? A.) Doxycycline B.) Podofilox C.) Acyclovir D.) Penicillin

Which newborn reflex is elicited by stroking the lateral sole of the infant's foot from the heel to the ball of the foot? A.) Babinski B.) Tonic neck C.) Stepping D.) Plantar grasp

Which nonpharmacologic contraceptive method has a failure rate of less than 25%? A.) Standard days variation B.) Periodic abstinence C.) Postovulation D.) Coitus interruptus

Which nursing information is appropriate regarding a father's acceptance of the pregnancy and preparation for childbirth? A.) The father goes through three phases of acceptance of his own B.) The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after birth C.) In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home D.) Typically men remain ambivalent about fatherhood right up to the birth of their child

Which nursing instruction is appropriate for a client with endometriosis who is planning to start danazol therapy and is found to be 3 weeks pregnant on assessment? A.) Discontinue the drug prescription B.) Initiate surgical treatment immediately C.) Lower the medication dose by half D.) Recommend terminating the pregnancy

Which nursing instruction is appropriate to assist a client in regaining control of the urinary sphincter? A.) Perform Kegel exercises B.) Void every hour while awake C.) Drink 8 to 10 glasses of water each day D.) Allow the bladder to become distended before voiding

Which nursing instruction is appropriate to give a postpartum client to prevent infection? A.) "Wipe from front to back after using the toilet" B.) "Use cold water to cleanse the perineal area" C.) "Change the perineal pad from back to front" D.) "Avoid the use of slippers while in the hospital"

Which nursing intervention helps promote early passage of meconium in the infant? A.) Encouraging the mother to feed the infant colostrum B.) Administering a vitamin K injection to the infant C.) Providing kangaroo care to the infant immediately after birth D.) Feeding unmodified cow's milk to the infant immediately after birth

Which nursing intervention reduces postpartum fatigue (PPF) in the breastfeeding client? A.) Encourages relatives and friends to bring meals and help with housework B.) Ask the client to postpone hospital discharge for a few days C.) Encourage the client to avoid ambulation and increase rest D.) Ask the client to assume the side-lying position for breastfeeding

Which order should the nurse expect for a client admitted with a threatened abortion? A.) Bed rest B.) Administration of ritodrine IV C.) Nothing by mouth (nil per os [NPO]) D.) Narcotic analgesia every 3 hours, as needed

Which parameter is closely monitored in a client during the latent phase of the first stage of labor? A.) Fetal heart rate B.) Cervical dilation C.) Maternal temperature D.) External cephalic version

Which parental statement would the nurse recognize as indicating a misunderstanding about newborn nutritional needs? A.) "I will give my baby fruit juice after 4 months" B.) "I will give my baby solid foods after 4 months" C.) "I will give my baby vegetables after 6 months" D.) "I will give my infant cereals before 8 months"

Which phase of female sexual response is characterized by the retraction of the clitoris under the clitoral hood and engorgement of the lower one-third of the vagina? A.) Plateau phase B.) Orgasmic phase C.) Resolution phase D.) Excitement phase

Which physiologic change is appropriate to discuss with a client who is concerned about the resolution of her carpal tunnel syndrome? A.) Diuresis B.) Joint relaxation C.) Hormonal changes D.) Hypermobility of the joints

Which postpartum conditions are considered medical emergencies that require immediate treatment? A. Inversion of the uterus and hypovolemic shock B. Hypotonic uterus and coagulopathies C. Subinvolution of the uterus and idiopathic thrombocytopenic purpura (ITP) D. Uterine atony and disseminated intravascular coagulation (DIC)

Which presumptive sign or symptom of pregnancy would a client experience who is approximately 10 weeks of gestation? A.) Amenorrhea B.) Positive pregnancy test C.) Chadwick sign D.) Hegar sign

Which rationale would the nurse recognize for a client of South Asian origin feeding her neonate honey before breastfeeding? A.) The client believes it helps the infant pass meconium B.) The client believes it helps prevent gastrointestinal illness C.) The client believes it helps prevent nausea and vomiting D.) The client believes it helps prevent hemorrhagic problems

Which sign of pregnancy may manifest as an increase of urinary frequency in the client? A.) Hegar sign B.) Goodell sign C.) Ballottement D.) Chadwick sign

Which stage of labor varies the most in length? A.) First B.) Second C.) Third D.) Fourth

Which statement best describes Kegel exercises? A.) Kegel exercises were developed to control or reduce incontinent urine loss B.) Kegel exercises are the best exercises for a pregnant woman because they are so pleasurable C.) Kegel exercises help manage stress D.) Kegel exercises are ineffective without sufficient calcium in the diet

Which statement best describes a normal uterine activity pattern in labor? A.) Contractions every 2 to 5 minutes B.) Contractions lasting approximately 2 minutes C.) Contractions approximately 1 minute apart D.) Contraction intensity of approximately 500 mm Hg with relaxation at 50 mm Hg

Which statement by the client indicates an understanding of the education regarding the concern of fetal exposure to high levels of mercury through maternal consumption of fish and seafood? A.) I will limit my intake of canned light tuna to 12 ounces per week B.) I will limit my intake of shark to no more than 6 ounces per week C.) I should only eat fish that has been caught by a commercial fisherman D.) I should avoid eating fish caught by my family if I am not sure the water is safe

Which statement by the client indicates the need for further teaching about the use of condoms? A.) "Condoms can prevent me from getting STIs" B.) "I can use lubricant-based jelly if I need to" C.) "I will check the condom for tears after intercourse" D.) "Condoms may reduce sensation during intercourse"

Which statement regarding emergency contraception is correct? A.) Emergency contraception requires that the first dose be taken within 72 hours of unprotected intercourse B.) Emergency contraception may be taken right after ovulation C.) Emergency contraception has an effectiveness rate in preventing pregnancy of approximately 50% D.) Emergency contraception is commonly associated with the side effect of menorrhagia

Which symptom control measures are appropriate for a client with premenstrual syndrome (PMS)? A.) Decrease consumption of caffeine B.) Drink a small glass of wine with the evening meal C.) Decrease fluid intake to prevent fluid retention D.) Eat three large meals a day to maintain glucose levels

Which symptom described by a client is characteristic of premenstrual syndrome (PMS)? A.) "I feel irritable and moody a week before my period is supposed to start" B.) "I have lower abdominal pain beginning the third day of my menstrual period" C.) "I have nausea and headaches after my period starts and they last 2 to 3 days" D.) "I have abdominal bloating and breast pain after a couple days on my period"

Which symptom described by a client is characteristic of premenstrual syndrome (PMS)? A.) I feel irritable and moody a week before my period is supposed to start B.) I have lower abdominal pain beginning on the third day of my menstrual period C.) I have nausea and headaches after my period starts, and they last 2 to 3 days D.) I have abdominal bloating and breast pain after a couple days of my period

Which technique is an adequate means of controlling the birth of the fetal head during delivery in a vertex presentation? A.) Ritgen maneuver B.) Fundal pressure C.) Lithotomy position D.) De Lee apparatus

Which testing for ruptured membranes is appropriate for a client at 39 weeks gestation who presents to labor and delivery concerned that she has ruptured amniotic membranes? A.) Ferning B.) Nitrazine pH C.) Nitrazine pH and farning D.) Ultrasound measurement of the amniotic fluid index

Which type of ultrasound is the standard medical scan used in pregnancy? A.) Two-dimensional (2D) B.) Three-dimensional (3D) C.) Four-dimensional (4D) D.) Five-dimensional (5D)

With regard to hemorrhagic complications that may occur during pregnancy, what information is most accurate? A.) An incompetent cervix is usually not diagnosed until the woman has lost one or two pregnancies B.) Incidences of ectopic pregnancy are declining as a result of improved diagnostic techniques C.) One ectopic pregnancy does not affect a woman's fertility or her likelihood of having a normal pregnancy the next time D.) Gestational trophoblastic neoplasia (GTN) is one of the persistently incurable gynecologic malignancies

With regard to medications, herbs, boosters, and other substances normally encountered by pregnant women, what is important for the nurse to be aware of? A.) Both prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus B.) The greatest danger of drug-caused developmental deficits in the fetus is observed in the final trimester C.) Killed-virus vaccines (e.g., tetanus) should not be administered during pregnancy, but live-virus vaccines (e.g., measles) are permissible D.) No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus

Which findings would the nurse expect in a neonate within 20 minutes of birth (select all that apply): A.) Tremors B.) Nasal flaring C.) Audible grunting D.) Pinkish skin color E.) Quick respirations

A, B, C

Which hepatic changes are considered normal during pregnant (select all that apply): A.) Increased serum albumin B.) Increased serum alkaline phosphate C.) Increased serum cholesterol D.) Increased blood urea nitrogen E.) Increased nonprotein nitrogen

A, B, C

Which nursing instructions is included when educating female clients on how to use a contraceptive diaphragm (select all that apply): A.) "The diaphragm should completely cover your cervix" B.) "Empty your bladder before inserting the diaphragm' C.) "Remove the diaphragm 6 to 8 hours after intercourse" D.) "Insert the diaphragm up to 9 hours before sexual intercourse" E.) "Avoid the use of spermicide with the diaphragm"

A, B, C

Which sexual behaviors are associated with exposure to an STI (select all that apply): A.) Fellatio B.) Unprotected anal intercourse C.) Multiple sex partners D.) Dry kissing E.) Abstinence

A, B, C

Which signs and symptoms should a woman immediately report to her health care provider (select all that apply): A.) Vaginal bleeding B.) Rupture of membranes C.) Heartburn accompanied by severe headache D.) Decreased libido E.) Urinary frequency

A, B, C

Which statements are accurate regarding the most common bacterial sexually transmitted infections (select all that apply): A.) Chlamydial infections and gonorrhea are more likely to occur in women younger than 20 years of age B.) Gonorrhea can be transmitted to the newborn by direct contact with gonococcal organisms in the cervix C.) Syphilis can be transmitted through kissing, biting or oral-genital sex D.) Medications for pelvic inflammatory disease can be discontinued once symptoms disappear E.) Herpes is a common bacterial STI

A, B, C

Which statements regarding physiologic jaundice are accurate (select all that apply): A.) Neonatal jaundice is common; however, kernicterus is rare B.) Appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic process C.) Because jaundice may not appear before discharge, parents need instruction on how to assess for jaundice and when to call for medical help D.) Jaundice is caused by reduced levels of serum bilirubin E.) Breastfed babies have a lower incidence of jaundice

A, B, C

In assessing the immediate condition of the newborn after birth, a sample of cord blood may be a useful adjunct to the Apgar score. Cord blood is then tested for pH, carbon dioxide, oxygen, and base deficit or excess. Which clinical situation warrants this additional testing (select all that apply): A.) Low 5-minute Apgar score B.) Intrauterine growth restriction (IUGR) C.) Maternal thyroid disease D.) Intrapartum fever E.) Vacuum extraction

A, B, C, D

Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. However, the nurse or midwife may need to refer a client to a registered dietitian for in-depth nutritional counseling. Which conditions would require such a consultation (select all that apply): A.) Preexisting or gestational illness such as diabetes B.) Ethnic or cultural food patterns C.) Obesity D.) Vegetarian diets E.) Multifetal pregnancy

A, B, C, D

Pain should be regularly assessed in all newborns. If the infant is displaying physiologic or behavioral cues that indicate pain, then measures should be taken to manage the pain. Which interventions are examples of nonpharmacologic pain management techniques (select all that apply): A.) Swaddling B.) Nonnutritive sucking C.) Skin-to-skin contact with the mother D.) Sucrose E.) Acetaminophen

A, B, C, D

Which nursing interventions are appropriate for a client who is learning to use a vaginal ring for the first time (select all that apply): A.) Encouraging the client to ask questions B.) Providing written instructions about the vaginal ring C.) Asking the client to perform a return demonstration D.) Providing information about emergency contraception E.) Asking the client to apply spermicidal foam to the ring before insertion

A, B, C, D

Women who have participated in childbirth education classes often bring a birth plan with them to the hospital. Which items might this plan include (select all that apply): A.) Presence of companions B.) Clothing to be worn C.) Care and handling of the newborn D.) Medical interventions E.) Date of delivery

A, B, C, D

What are the complications and risks associated with cesarean births (select all that apply): A.) Pulmonary edema B.) Wound dehiscence C.) Hemorrhage D.) Urinary tract infections E.) Fetal injuries

A, B, C, D, E

Which risk factors are associated with an increased risk for postpartum infection (select all that apply): A.) Hematoma B.) Prolonged labor C.) Cesarean delivery D.) Postpartum hemorrhage E.) Prolonged rupture of membranes

A, B, C, D, E

During life in utero, oxygenation of the fetus occurs through transplacental gas exchange. When birth occurs, four factors combine to stimulate the respiratory center in the medulla. The initiation of respiration then follows. What are these four essential factors? A.) Chemical B.) Mechanical C.) Thermal D.) Psychologic E.) Sensory

A, B, C, E

The nurse is informing the pregnant client with a cardiac disorder about the dietary changes that are needed. Which instructions would the nurse include in the teaching (select all that apply): A.) "Take iron and folic acid supplements daily" B.) "Increase your daily intake of dietary fiber" C.) "Take a stool softener daily as prescribed" D.) "Cut intake of dark green leafy vegetables" E.) "Include potassium-rich foods in the diet"

A, B, C, E

Which actions would the nurse take when a pregnant client has convulsions (select all that apply): A.) Obtain a prescription for magnesium sulfate B.) Assess the client's airway, breathing and pulse C.) Lower the bed and turn the client onto one side D.) Do not leave the client for more than 10 minutes E.) Raise the side rails of the bed and pads with pillows

A, B, C, E

Which statements describe the first stage of the neonatal transition period (select all that apply): A.) The neonatal transition period lasts no longer than 30 minutes B.) It is marked by spontaneous tremors, crying, and head movements C.) Passage of the meconium occurs during the neonatal transition period D.) This period may involve the infant suddenly and briefly sleeping E.) Audible grunting and nasal flaring may be present during this time

A, B, C, E

A 23-year-old primiparous client with inconsistent prenatal care is admitted to the hospitals maternity unit in labor. The client states that she has tested positive for the HIV. She has not undergone any treatment during her pregnancy. The nurse understands that the risk of perinatal transmission can be significantly decreased by a number of prophylactic interventions. Which interventions should be included in the plan of care (select all that apply): A.) Intrapartum treatment with antiviral medications B.) Cesarean birth C.) Postpartum treatment with antiviral medications D.) Avoidance of breastfeeding E.) Pneumococcal, HBV, and Haemophilus influenzae vaccine

A, B, D

A nurse is providing care for a client who is in active labor. Her cervix is dilated to 5 cm, and her membranes are intact. Based on the use of external electronic fetal monitoring, the nurse notes a FHR of 115 to 125/min with occasional increases up to 150 to 155/min that last for 25 seconds, and have beat-to-beat variability of 20/min. There is no slowing of FHR from the baseline. The nurse should recognize that this client is exhibiting signs of which of the following (select all that apply): A.) Moderate variability B.) FHR accelerations C.) FHR decelerations D.) Normal baseline FHR E.) Fetal tachycardia

A, B, D

A woman has requested an epidural block for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. Before the initiation of the epidural, the woman should be informed regarding the disadvantages of an epidural block. Which concerns should the nurse share with this client (select all that apply): A.) Ability to move freely is limited B.) Orthostatic hypotension and dizziness may occur C.) Gastric emptying is not delayed D.) Higher body temperature may occur E.) Blood loss is not excessive

A, B, D

Cellulitis with or without abscess formation is a fairly common condition. The nurse is providing education for a client whose presentation to the emergency department includes an infection of the breast. Which information should the nurse share with this client (select all that apply): A.) Nipple piercing may be the cause of a recent infection B.) Treatment for cellulitis will include antibiotics C.) Streptococcus aureus is the most common pathogen D.) Obesity, smoking, and diabetes are risk factors E.) Breast is pale in color and cool to the touch

A, B, D

The nurse is responsible for providing health teaching regarding the side effects of COCs. These side effects are attributed to estrogen, progesterone, or both. Which side effects are related to the use of COCs (select all that apply): A.) Gallbladder disease B.) Myocardial infarction and stroke C.) Hypotension D.) Breast tenderness and fluid retention E.) Dry skin and scalp

A, B, D

Which hypertensive disorders can occur during pregnancy (select all that apply): A.) Chronic hypertension B.) Preeclampsia-eclampsia C.) Hyperemesis gravidarum D.) Gestational hypertension E.) Gestational trophoblastic disease

A, B, D

The reported incidence of ectopic pregnancy has steadily risen over the past 2 decades. Causes include the increase in sexually transmitted infections (STIs) accompanied by tubal infection and damage. The popularity of contraceptive devices such as the IUD has also increased the risk for ectopic pregnancy. The nurse suspects that a client has early signs of ectopic pregnancy. The nurse should be observing the client for which signs or symptoms (select all that apply): A.) Pelvic pain B.) Abdominal pain C.) Unanticipated heavy bleeding D.) Vaginal spotting or light bleeding E.) Missed period

A, B, D, E

Which actions are low-risk sexual practices (select all that apply): A.) Abstinence B.) Dry kissing C.) Wet kissing D.) Mutual masturbation E.) Hugging, massaging, touching (assuming no break in skin) F.) Monogamous (both partners and no high-risk activities) but not tested for human immunodeficiency virus (HIV) or other sexually transmitted in sexually transmitted infections

A, B, D, E

Which factors contribute to the increased nutritional need during pregnancy (select all that apply): A.) Maternal mammary development B.) Increased maternal blood volume C.) Increased need for maternal fat stores D.) Increased metabolic rate E.) Development and growth of the uterine-placental-fetal unit

A, B, D, E

Which statement reflects the benefit of breastfeeding on the family or society at large (select all that apply): A.) Breastfeeding requires fewer supplies and less cumbersome equipment B.) Breastfeeding saves families money C.) Breastfeeding costs employers in terms of time lost from work D.) Breastfeeding benefits the environment E.) Breastfeeding results in reduced annual health care costs

A, B, D, E

A woman is in for a routine prenatal checkup. The nurse is assessing her urine for glycosuria and proteinuria. Which findings are considered normal (select all that apply): A.) Dipstick assessment of trace to +1 B.) <300 mg/24 hours C.) Dipstick assessment of +2 glucose D.) >300 mg/24 hours E.) Albumin < 30 mg/24 hours

A, B, E

Which nursing instruction is appropriate when discussing self-care after a miscarriage (select all that apply): A.) Increase dietary intake of iron B.) Avoid tub baths for 2 weeks C.) Avoid intercourse for 4 weeks D.) Avoid trying to get pregnant until a menstrual cycle has passed E.) Notify the health care provider if vaginal discharge has a foul odor

A, B, E

Which nursing instructions are appropriate for the gymnast client who reports she has had her menstrual period for the past 2 months and is stressed out by excessive training (select all that apply): A.) "Reduce your physical workout" B.) "Increase your nutritional intake" C.) "Lower your caloric intake" D.) "Engage in regular physical activity" E.) "Meditate or do power yoga"

A, B, E

Which nursing interventions are performed when conducting a client's health screening (select all that apply): A.) Ask the client direct questions to elicit specific details B.) Assure the client of strict confidentiality of her case history C.) Remain objective and avoid empathetic responses D.) Concentrate on asking about specific concerns rather than general concerns E.) Repeat words or phrases the client has used and ask her for clarification

A, B, E

Which risks would the nurse expect to find in a pregnant client with a large ventricular septal defect (select all that apply): A.) Arrhythmias B.) Heart failure C.) Aortic dissection D.) Ineffective endocarditis E.) Pulmonary hypertension

A, B, E

A serious but uncommon complication of undiagnosed or partially treated hyperthyroidism is a thyroid storm, which may occur in response to stress such as infection, birth, or surgery. What are the signs and symptoms of this emergency disorder (select all that apply): A.) Fever B.) Hypothermia C.) Restlessness D.) Bradycardia E.) Hypertension

A, C

A nurse is caring for a client who is at 40 weeks of gestation and experiencing contractions every 3 to 5 min and becoming stronger. A vaginal exam reveals that the client's cervix is 3 cm dilated, 90% effaced and -1 station. The client asks for pain medication. Which of the following actions should the nurse take (select all that apply): A.) Encourage use of patterned breathing techniques B.) Insert in indwelling urinary catheter C.) Administer opioid analgesic medication D.) Suggest application of cold E.) Provide ice chips

A, C, D

The nurse is aware of which symptoms of carpal tunnel syndrome when performing a prenatal assessment (select all that apply): A.) Tingling of fingers B.) Increased urination C.) Increased sweating D.) Numbness of fingers E.) Yellow-colored sputum

A, C, D

When assessing a client, the nurse is aware of which manifestations associated with hypoglycemia (select all that apply): A.) Dizziness B.) Fruity breath C.) Blurred vision D.) Excessive hunger E.) Presence of acetone in urine

A, C, D

Which changes take place in the woman's reproductive system, days or even weeks before the commencement of labor (select all that apply): A.) Lightening B.) Exhaustion C.) Bloody show D.) Rupture of membranes E.) Decreased fetal movement

A, C, D

Which practices contribute to the prevention of postpartum infection (select all that apply): A.) Not allowing the mother to walk barefoot at the hospital B.) Educating the client to wipe from back to front after voiding C.) Having staff members with conditions such as strep throat, conjunctivitis, and diarrhea stay home D.) Instructing the mother to change her perineal pad from front to back each time she voids or defecates E.) Not permitting visitors with cough or colds to enter the postpartum unit

A, C, D

Which statement about multifetal pregnancy is accurate (select all that apply): A.) The expectant mother often develops anemia because the fetuses have a greater demand for iron B.) Twin pregnancies come to term with the same frequency as single pregnancies C.) The mother should be counseled to increase her nutritional intake and gain more weight D.) Backache and varicose veins are more pronounced E.) There is always a history of fertility drugs

A, C, D

Which symptoms are seen in a client who experiences secondary dysmenorrhea (select all that apply): A.) Feelings of bloating B.) Poor concentration C.) Heavy menstrual flow D.) Lower abdominal aching E.) Gastrointestinal bleeding

A, C, D

The nurse should be familiar with the use of the five Ps as a tool for evaluating risk behaviors for STIs and the HIV. Which components would the nurse include in her use of the five Ps as an assessment tool (select all that apply): A.) Number of partners B.) Level of physical activity C.) Prevention of pregnancy D.) Protection from STIs E.) Past history

A, C, D, E

The nurse is reviewing the educational packet provided to a client about tubal ligation. Which information regarding this procedure is important for the nurse to share (select all that apply): A.) It is highly unlikely that you will become pregnant after the procedure B.) Tubal ligation is an effective form of 100% permanent sterilization. You won't be able to get pregnant C.) Sterilization offers some form of protection against STIs D.) Sterilization offers no protection against STIs E.) Your menstrual cycle will greatly increase after your sterilization

A, D

Which clients are appropriate to include in a teaching session about the risk of developing dysmenorrhea (select all that apply): A.) Smoker B.) Low body mass index (BMI) C.) More than 2 children D.) High stress caused by work E.) Involved in strenuous exercise

A, D

Which vaccinations reduce the risk for contracting sexually transmitted infections (STIs) (select all that apply): A.) Hepatitis B B.) Pneumococcal conjugate C.) Meningococcal conjugate D.) Human papillomavirus (HPV) E.) Pneumococcal polysaccharide

A, D

Which is the role of a registered nurse in women's health promotion and illness prevention (select all that apply): A.) Integrating various modalities of care B.) Providing comprehensive primary care C.) Coordinating care in communities D.) Working to influence health policy E.) Collaborating with other health care practitioners

A, D, E

Which are some safety measures to take while pregnant (select all that apply): A.) Use correct body mechanics B.) Avoid travel to high-altitude regions about 1000 feet C.) Perform activities requiring coordination, balance and concentration D.) Take rest periods; reschedule daily activities to meet rest and relaxation needs E.) Avoid environmental teratogens, such as cleaning agents, paints, sprays, herbicides and pesticides F.) Use safety features on tools and vehicles (e.g. safety seat belts, shoulder harnesses, headrests, goggles, helmets) are specified

A, D, E, F

Place in order the developmental tasks required to achieve maternal adaptation: A.) Preparing for the birth experience B.) Establishing a relationship with the unborn child C.) Reordering the relationship between herself and her partner D.) Identifying with the role of mother E.) Accepting the pregnancy F.) Reordering a the relationship between herself and her mother

A, D, F, C, B, A

A 41-week pregnant multigravida arrives at the labor and delivery unit after a NST indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool yields more detailed information about the condition of the fetus? A.) Ultrasound for fetal anomalies B.) Biophysical profile (BPP) C.) MSAFP screening D.) Percutaneous umbilical blood sampling (PUBS)

A 62-year-old woman has not been to the clinic for an annual examination for 5 years. The recent death of her husband reminded her that she should come for a visit. Her family physician has retired, and she is going to see the women's health nurse practitioner for her visit. What should the nurse do to facilitate a positive health care experience for this client? A.) Remind the woman that she is long overdue for her examination and that she should come in annually B.) Carefully listen, and allow extra time for this woman's health history interview C.) Reassure the woman that a nurse practitioner is just as good as her old physician D.) Encourage the woman to talk about the death of her husband and her fears about her own death

A client becomes anxious during the transition phase of the first stage of labor, develops a rapid and deep respiratory pattern and complains of feeling dizzy and lightheaded. Which action would the nurse's immediate response? A.) Encourage the woman to breathe more slowly B.) Help the woman breathe into a paper bag C.) Turn the woman on her side D.) Administer a sedative

A male client asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). Which response by the nurse is the most accurate? A.) The lubricant prevents vaginal irritation B.) Nonoxynol-9 does not provide protection against STIs as originally thought; it has also been linked to an increase in the transmission of the HIV and can cause genital lesions C.) The additional lubrication improves sex D.) Nonoxynol-9 improves penile sensitivity

A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). Which response by the nurse is most appropriate? A.) They're not very effective, and it is very likely that you'll get pregnant B.) FAMs can be effective for many couples; however, they require motivation C.) These methods have a few advantages and several health risks D.) You would be much safer going on the pill and not having to worry

A new client and her partner arrive on the labor, delivery, recovery, and postpartum (LDRP) unit for the birth of their first child. The nurse applies the electronic fetal monitor (EFM) to the woman. Her partner asks you to explain what is printing on the graph, referring to the EFM strip. He wants to know what the baby's heart rate should be. What is the nurse's best response? A.) Don't worry about that machine; that's my job B.) The baby's heart rate will fluctuate in response to what is happening during labor C.) The top line graphs the baby's heart rate, and the bottom line lets me know how strong the contractions are D.) Your physician will explain all of that later

A new father is ready to take his wife and newborn son home. He proudly tells the nurse who is discharging them that within the next week he plans to start feeding the infant cereal between breastfeeding sessions. Which information should the nurse provide regarding this feeding plan? A.) Feeding solid foods before your son is 4 to 6 months old may decrease your son's intake of sufficient calories B.) Feeding solid foods between breastfeeding sessions before your son is 4 to 6 months old will lead to an early cessation of breastfeeding C.) Your feeding plan will help your son sleep through the night D.) Feeding solid foods before your son is 4 to 6 months old will limit his growth

A new father wants to know what medication was put into his infants eyes and why it is needed. How does the nurse explain the purpose of the erythromycin (Ilotycin) ophthalmic ointment? A.) Erythromycin (Ilotycin) ophthalmic ointment destroys an infectious exudate caused by Staphylococcus that could make the infant blind B.) This ophthalmic ointment prevents gonorrheal and chlamydial infection of the infants eyes, potentially acquired from the birth canal C.) Erythromycin (Ilotycin) prevents potentially harmful exudate from invading the tear ducts of the infant's eyes, leading to dry eyes D.) This ointment prevents the infants eyelids from sticking together and helps the infant see

A new mother recalls from prenatal class that she should try to feed her newborn daughter when she exhibits feeding readiness cues rather than waiting until the baby is frantically crying. Which feeding cue would indicate that the baby is ready to eat? A.) Waves her arms in the air B.) Makes sucking motions C.) Has the hiccups D.) Stretches out her legs straight

A nurse is caring for a client who is in active labor. The client reports lower-back pain. The nurse suspects that this pain is related to a persistent occiput posterior fetal position. Which of the following nonpharmacological nursing interventions should the nurse recommend to the client? A.) Abdominal effleurage B.) Sacral counterpressure C.) Showering if not contraindicated D.) Back rub and massage

A nurse is caring for a client who is in the transition phase of labor and reports that she needs to have a bowel movement with the peak of contractions. Which of the following actions should the nurse make? A.) Assist the client to the bathroom B.) Prepare for an impending delivery C.) Prepare to remove a fecal impaction D.) Encourage the client to take deep, cleansing breaths

A nurse is making rounds on a client who had a vaginal delivery, and suspects that the client is having excessive postpartum bleeding. Which would be the priority intervention at this time? A.) Call the primary health care provider B.) Massage the uterine fundus C.) Increase the rate of intravenous fluids D.) Monitor pad count, and perform catheterization

A nurse is performing Leopold maneuvers on a client who is in labor. Which of the following techniques should the nurse use to identify fetal lie? A.) Apply palms of both hands to sides of uterus B.) Palpate the fundus of the uterus C.) Grasp lower uterine segment between thumb and fingers D.) Stand facing client's feet with fingertips outlining cephalic prominence

A patient in her first trimester complains of nausea and vomiting. She asks, Why does this happen? What is the nurse's best response? A.) Nausea and vomiting are due to an increase in gastric motility B.) Nausea and vomiting may be due to changes in hormones C.) Nausea and vomiting are related to an increase in glucose levels D.) Nausea and vomiting are caused by a decrease in gastric secretions

A perinatal nurse is giving discharge instructions to a woman, status postsuction, and curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. What is the best response by the nurse? A.) If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore, if you desire a future pregnancy, it would be better for you to use the most reliable method of contraception available B.) The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, then it would make the diagnosis of this cancer more difficult C.) If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnancy is rare. Therefore, to improve your chance of a successful pregnancy, not getting pregnant at this time is best D.) Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar pregnancy

A postpartum client reports severe headaches. When reviewing the client's medical record, the nurse finds that the client's blood pressure was 150/100 mmHg and 160/90 mmHg on the second and third postpartum days, respectively. Which condition may be responsible for these alterations in blood pressure? A.) Bradycardia B.) Preeclampsia C.) Hypovolemia D.) Hyponatremia

A pregnant client is infected with human immunodeficiency virus (HIV), with a viral load of 800 copies/mL at 36 weeks. The client has ruptured membranes and labor is progressing rapidly. Which order is the primary health care provider likely to make? A.) Scalp pH sampling B.) Immediate vaginal birth C.) Immediate cesarean birth D.) Use of fetal scalp electrode

A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild-to-moderate intensity. Which intervention should the nurse recommend? A.) Kegel exercises B.) Pelvic rock exercises C.) Softer mattress D.) Bed rest for 24 hours

A pregnant woman at 29 weeks of gestation has been diagnosed with preterm labor. Her labor is being controlled with tocolytic medications. She asks when she might be able to go home. Which response by the nurse is most accurate? A.) After the baby is born B.) When we can stabilize your preterm labor and arrange home health visits C.) Whenever your physician says that it is okay D.) It depends on what kind of insurance coverage you have

A pregnant woman is being discharged from the hospital after the placement of a cervical cerclage because of a history of recurrent pregnancy loss, secondary to an incompetent cervix. Which information regarding postprocedural care should the nurse emphasize in the discharge teaching? A.) Any vaginal discharge should be immediately reported to her health care provider B.) The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure should be reported C.) The client will need to make arrangements for care at home, because her activity level will be restricted D.) The client will be scheduled for a cesarean birth

A primiparous woman is watching her newborn sleep. She wants him to wake up and respond to her. The mother asks the nurse how much he will sleep every day. What is an appropriate response by the nurse? A.) He will only wake up to be fed, and you should not bother him between feedings B.) The newborn sleeps approximately 17 hours a day, with periods of wakefulness gradually increasing C.) He will probably follow your same sleep and wake patterns, and you can expect him to be awake soon D.) He is being stubborn by not waking up when you want him to. You should try to keep him awake during the daytime so that he will sleep through the night

A woman who is gravida 3 para 2 arrives on the intrapartum unit. What is the most important nursing assessment at this time? A.) Contraction pattern, amount of discomfort, and pregnancy history B.) FHR, maternal vital signs, and the woman's nearness to birth C.) Identification of ruptured membranes, woman's gravida and para, and her support person D.) Last food intake, when labor began, and cultural practices the couple desires

According to professional standards (the Association of Women's Health, Obstetric and Neonatal Nurses [AWHONN], 2007), which action cannot be performed by the nonanesthetist registered nurse who is caring for a woman with epidural anesthesia? A.) Monitoring the status of the woman and fetus B.) Initiating epidural anesthesia C.) Replacing empty infusion bags with the same medication and concentrate D.) Stopping the infusion, and initiating emergency measures

After massaging the boggy fundus of a client who delivered a large baby after a prolonged labor with a forceps-assisted birth, the nurse is unable to obtain a firm fundus. Which nursing action is indicated at this time? A.) Increase the rate of the intravenous infusion B.) Massage the fundus while another nurse notifies the primary health care provider C.) Change the peripad, replacing it with a double pad D.) Administer a half-dose of a uterine-contracting medication

An unmarried young woman describes her sex life as active and involving many partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). Which information is most important for the nurse to share? A.) The IUD does not interfere with sex B.) The risk of pelvic inflammatory disease will be higher with the IUD C.) The IUD will protect you from sexually transmitted infections D.) Pregnancy rates are high with the IUD

Anxiety is commonly associated with pain during labor. Which statement regarding anxiety is correct? A.) Even mild anxiety must be treated B.) Severe anxiety increases tension, increases pain, and then, in turn, increases fear and anxiety, and so on C.) Anxiety may increase the perception of pain, but it does not affect the mechanism of labor D.) Women who have had a painful labor will have learned from the experience and have less anxiety the second time because of increased familiarity

Developing a realistic birth plan with the pregnant woman regarding her care is important for the nurse. How would the nurse explain the major advantage of nonpharmacologic pain management? A.) Greater and more complete pain relief is possible B.) No side effects or risks to the fetus are involved C.) The woman will remain fully alert at all times D.) Labor will likely be more rapid

Diabetes in pregnancy puts the fetus at risk in several ways. Nurses should be aware of which factor? A.) With good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern B.) The most important of perinatal loss in diabetic pregnancy is congenital malformations C.) Infants of mothers with diabetes have the same risk for respiratory distress syndrome because of the careful monitoring D.) At birth, the neonate of a diabetic mother is no longer at any greater risk

During a health history interview, a woman states that she thinks that she has bumps on her labia. She also states that she is not sure how to check herself. The correct response by the nurse would be what? A.) Reassure the woman that the examination will reveal any problems B.) Explain the process of vulvar self-examination, and reassure the woman that she should become familiar with normal and abnormal findings during the examination C.) Reassure the woman that bumps can be treated D.) Reassure her that most women have bumps on their labia

During the first trimester, which of the following changes regarding her sexual drive should a client be taught to expect? A.) Increased sexual drive, because of enlarging breasts B.) Decreased sexual drive, because of nausea and fatigue C.) No change in her sexual drive D.) Increased sexual drive, because of increased levels of female hormones

Five different viruses (A, B, C, D, and E) account for almost all cases of hepatitis infections. Which statement regarding the various forms of hepatitis is most accurate? A.) Vaccine exists for hepatitis C virus (HCV) but not for HBV B.) HAV is acquired by eating contaminated food or drinking polluted water C.) HBV is less contagious than HIV D.) Incidence of HCV is decreasing

Importantly, the nurse must be aware of which information related to the use of IUDs? A.) Return to fertility can take several weeks after the device is removed B.) IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse C.) IUDs offer the same protection against STIs as the diaphragm D.) Consent forms are not needed for IUD insertion

In contrast to placenta previa, what is the most prevalent clinical manifestation of abruptio placentae? A.) Bleeding B.) Intense abdominal pain C.) Uterine activity D.) Cramping

In providing care for a laboring client, the nurse is aware that the client's prior experience with labor may have which effect? A.) Nulliparous women often have greater coping skills than multiparous women during early labor B.) Pain perception for a multiparous women can be increased if the previous birth experience was difficult C.) Women with a history of substance abuse experience more pain during labor D.) Multiparous women have more fatigue from labor and therefore experience more pain

In terms of the incidence and classification of diabetes, which information should the nurse keep in mind when evaluating clients during their ongoing prenatal appointments? A.) Type 1 diabetes is most common B.) Type 2 diabetes often goes undiagnosed C.) GDM means that the woman will receive insulin treatment until 6 weeks after birth D.) Type 1 diabetes may become type 2 during pregnancy

It is extremely rare for a woman to die in childbirth; however, it can happen. In the United States, the annual occurrence of maternal death is 12 per 100,000 cases of live birth. What are the leading causes of maternal death? A.) Embolism and preeclampsia B.) Trauma and motor vehicle accidents (MVAs) C.) Hemorrhage and infection D.) Underlying chronic conditions

Maternal nutritional status is an especially significant factor of the many that influence the outcome of pregnancy. Why is this the case? A.) Maternal nutritional status is extremely difficult to adjust because of an individuals ingrained eating habits B.) Adequate nutrition is an important preventive measure for a variety of problems C.) Women love obsessing about their weight and diets D.) A woman's preconception weight becomes irrelevant

Nurses can help their clients by keeping them informed about the distinctive stages of labor. Which description of the phases of the first stage of labor is accurate? A.) Latent: Mild, regular contractions; no dilation; bloody show; duration of 2 to 4 hours B.) Active: Moderate, regular contractions; 4- to 7-cm dilation; duration of 3 to 6 hours C.) Lull: No contractions; dilation stable; duration of 20 to 60 minutes D.) Transition: Very strong but irregular contractions; 8- to 10-cm dilation; duration of 1 to 2 hours

Nurses, certified nurse-midwives, and other advanced practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception. A multidisciplinary approach should ensure that the woman's social, cultural, and interpersonal needs are met. Which action should the nurse first take when meeting with a new client to discuss contraception? A.) Obtain data about the frequency of coitus B.) Determine the woman's level of knowledge concerning contraception and her commitment to any particular method C.) Assess the woman's willingness to touch her genitals and cervical mucus D.) Evaluate the woman's contraceptive life plan

Of which physiologic alteration of the uterus during pregnancy is it important for the nurse to alert the patient? A.) Lightening occurs near the end of the second trimester as the uterus rises into a different position B.) Woman's increased urinary frequency in the first trimester is the result of exaggerated uterine anti-reflexion caused by softening C.) Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise D.) Uterine souffle is the movement of the fetus

Preconception counseling is critical in the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy? A.) Frequent episodes of maternal hypoglycemia B.) Congenital anomalies in the fetus C.) Hydramnios D.) Hyperemesis gravidarum

The client being cared for has severe preeclampsia and is receiving a magnesium sulfate infusion. Which new finding would give the nurse cause for concern? A.) Sleepy, sedated affect B.) Respiratory rate of 10 breaths per minute C.) DTRs of 2 D.) Absent ankle clonus

The client is instructed to place her thumb and forefinger on the areola and gently press inward. What is the purpose of this exercise? A.) To check the sensitivity of the nipples B.) To determine whether the nipple is everted or inverted C.) To calculate the adipose buildup in the abdomen D.) To see whether the fetus has become inactive

The client makes an appointment for preconception counseling. The woman has a known heart condition and is unsure if she should become pregnant. Which is the only cardiac condition that would cause concern? A.) Marfan syndrome B.) Eisenmenger syndrome C.) Heart transplant D.) Ventricular septal defect (VSD)

The condition during which infants are at an increased risk for subgaleal hemorrhage is called what? A.) Infection B.) Jaundice C.) Caput succedaneum D.) Erythema toxicum neonatorum

The health care team is administering naloxone hydrochloride to a pregnant client in labor to counter the adverse effects of opioids. Which teaching regarding Narcan would the nurse provide to the client? A.) "Naloxone will cause a more rapid birth" B.) Naloxone will reverse the pain relief provided by the opioid" C.) "Naloxone is likely to cause nausea and vomiting" D.) "Naloxone may cause prolonged neonatal sedation"

The lactational amenorrhea method (LAM) of birth control is popular in developing countries and has had limited use in the United States. As breastfeeding rates increase, more women may rely upon this method for birth control. Which information is most important to provide to the client interested in using the LAM for contraception? A.) LAM is effective until the infant is 9 months of age B.) This popular method of birth control works best if the mother is exclusively breastfeeding C.) Its typical failure rate is 5% D.) Feeding intervals should be 6 hours during the day

The nurse assuming care of a multiparous client in labor who is complaining of pain that radiates to her abdominal wall, lower back, buttocks and down her thighs. Which term would the nurse use in documenting the client's pain? A.) Visceral B.) Referred C.) Somatic D.) Afterpain

The nurse finds diuresis, weight loss, and muscle atrophy in a pregnant client with mild preeclampsia. Which client condition would the nurse conclude from these findings? A.) The client was mostly on a liquid diet B.) The client was on prolonged bed rest C.) The client has developed HELLP syndrome D.) The client is at risk for placental abruption

The nurse has received a report regarding a client in labor. The woman's last vaginal examination was recorded as 3 cm, 30%, and 2. What is the nurses interpretation of this assessment? A.) Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm above the ischial spines B.) Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines C.) Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm below the ischial spines D.) Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm below the ischial spines

The nurse is caring for a client in the first trimester of pregnancy. The client's laboratory reports indicate a reduction in the levels of pregnancy-associated placental protein (PAPP-A) and an elevation in the levels of human chorionic gonadotropin (hCG) and nuchal translucency (NT). Based on these findings, which condition does the nurse suspect in the fetus? A.) Spina bifida B.) Down syndrome C.) Potter syndrome D.) Fetal cardiac disease

The nurse is caring for a client with rheumatic heart disease (RHD). Which medication would the primary health care provider prescribe to prevent pulmonary edema? A.) Verapamil B.) Furosemide C.) Atenolol D.) Warfarin

The nurse is explaining a Doppler flow analysis screening to a pregnant client. In describing the test, the nurse states at which stage of the pregnancy can the systolic/diastolic ratio be first directed in the fetus? A.) 2nd week of pregnancy B.) 15th week of pregnancy C.) 24th week of pregnancy D.) 32nd week of pregnancy

The nurse is explaining the benefits associated with breastfeeding to a new mother. Which statement by the nurse would provide conflicting information to the client? A.) Women who breastfeed have a decreased risk of breast cancer B.) Breastfeeding is an effective method of birth control C.) Breastfeeding increases bone density D.) Breastfeeding may enhance postpartum weight loss

The nurse is monitoring the client's fetal heart rate (FHR) and notices late decelerations associated with uterine contractions, including a gradual decrease in and return to baseline. To which condition would the nurse attribute this pattern? A.) Fundal pressure B.) Uteroplacental insuffiency C.) Vaginal examination D.) Fetal scalp stimulation

The nurse is providing care during labor for a client with twins and instructs the client to avoid lying flat on the back. Which condition would the nurse aim to prevent in the client during labor? A.) Valsalva maneuver B.) Supine hypotension C.) Respiratory alkalosis D.) Painful uterine contractions

The nurse is providing health education to a pregnant client regarding the cardiovascular system. Which information is correct and important to share? A.) A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia, requires close medical and obstetric observation no matter how healthy she may appear otherwise B.) Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks of gestation to term C.) Palpitations are twice as likely to occur in twin gestations D.) All of the above changes will likely occur

The nurse is reviewing the amniocentesis reports of a client at 20 weeks gestation and notes the presence of high alpha-fetoprotein (AFP) levels. Which should the nurse infer from this information related to the clinical condition of the fetus? A.) Cardiac disorder B.) Neurologic disorder C.) Circulatory disorder D.) Pulmonary disorder

The nurse knows which condition is associated with oligohydramnios? A.) Fetal hydrops B.) Potter syndrome C.) Neural tube defects D.) Fetal gastrointestinal obstruction

The nurse notices that a pregnant client shows signs of fatigue and lethargy, and has glossitis and rough skin. Which condition should the nurse likely suspect? A.) Thalassemia B.) Megaloblastic anemia C.) Iron deficiency anemia D.) Sickle cell hemoglobinopathy

The nurse who elects to work in the specialty of obstetric care must have the ability to distinguish between preterm birth, preterm labor, and low birth weight. Which statement regarding this terminology is correct? A.) Terms preterm birth and low birth weight can be used interchangeably B.) Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation C.) Low birth weight is a newborn who weighs below 3.7 pounds D.) Preterm birth rate in the United States continues to increase

The parents of a newborn ask the nurse how much the newborn can see. The parents specifically want to know what type of visual stimuli they should provide for their newborn. What information provided by the nurse would be most useful to these new parents? A.) Infants can see very little until approximately 3 months of age B.) Infants can track their parents eyes and can distinguish patterns; they prefer complex patterns C.) The infant's eyes must be protected. Infants enjoy looking at brightly colored stripes D.) It's important to shield the newborns eyes. Overhead lights help them see better

The unique muscle fibers that constitute the uterine myometrium make it ideally suited for what? A.) Menstruation B.) Birth process C.) Ovulation D.) Fertilization

Through a vaginal examination, the nurse determines that a woman is 4 cm dilated. The external fetal monitor shows uterine contractions every to 4 minutes. The nurse reports this as what stage of labor? A.) First stage, latent phase B.) First stage, active phase C.) First stage, transition phase D.) Second stage, latent phase

To assist a client in managing the symptoms of PMS, what should the nurse recommend based on current evidence? A.) Diet with more body-building and energy foods, such as carbohydrates B.) Herbal therapies, yoga, and massage C.) Antidepressants for symptom control D.) Discouraging the use of diuretics

What information regarding a fractured clavicle is most important for the nurse to take into consideration when planning the infant's care? A.) Prone positioning facilitates bone alignment B.) No special treatment is necessary C.) Parents should be taught range-of-motion exercises D.) The shoulder should be immobilized with a splint

What information should the nurse understand fully regarding rubella and Rh status? A.) Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus B.) Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination C.) Rh immunoglobulin is safely administered intravenously because it cannot harm a nursing infant D.) Rh immunoglobulin boosts the immune system and thereby enhances the effectiveness of vaccinations

What is the rationale for the administration of an oxytocic (e.g., Pitocin, Methergine) after expulsion of the placenta? A.) To relieve pain B.) To stimulate uterine contraction C.) To prevent infection D.) To facilitate rest and relaxation

What is the rationale for the use of a blood patch after spinal anesthesia? A.) Hypotension B.) Headache C.) Neonatal respiratory depression D.) Loss of movement

When counseling a pregnant client with asthma, the nurse knows that the severity of symptoms usually peak during which time? A.) In the first trimester B.) Between 17 and 24 weeks of gestation C.) During the last 4 weeks of pregnancy D.) Immediately postpartum

When would the nurse expect a client to develop a viremic influenza-like response after being infected with human immunodeficiency virus (HIV)? A.) Immediately after the virus infects the body B.) Within 6 to 12 weeks after the virus infects the body C.) 1 year after initiating antiretroviral therapy D.) Immediately after initiating antiretroviral therapy

Which action is the highest priority for the nurse when educating a pregnant adolescent? A.) Emphasize the need to eliminate common teenage snack foods because they are high in fat and sodium B.) Determine the weight gain needed to meet adolescent growth, and add 35 pounds C.) Suggest that she not eat at fast-food restaurants to avoid foods of poor nutritional value D.) Realize that most adolescents are unwilling to make dietary changes during pregnancy

Which action should the nurse take when measuring the blood pressure of a neonate? A.) Use an oscillometric device to measure blood pressure when the neonate is awake B.) Ensure that the cuff covers 75% of the distance between the axilla and the elbow C.) Report a drop in systolic blood pressure of about 15 mmHg in the first hour of life D.) Report if the systolic pressure is the same in the upper and lower extremities

Which action would the nurse take after finding unequal movement and uneven gluteal skinfolds during the Ortolani maneuver? A.) Tell the parents that one leg may be longer than the other, but they will equal out by the time the infant is walking B.) Alert the provider that the infant may have a dislocated hip C.) Inform the parents and provider that molding has not taken place D.) Suggest that if the condition does not change, surgery to correct vision problems might be needed

Which action would the nurse take when administering erythromycin ophthalmic ointment to a newborn? A.) Instill within 15 minutes of birth for maximum effectiveness B.) Cleanse eyes from the inner to outer canthus before administration if necessary C.) Apply the ointment directly over the cornea D.) Flush the eyes 10 minutes after instillation to reduce irritation

Which action would the nurse take while performing a heelstick for an infant? A.) Puncture the inner aspect of the heel B.) Warm the heel before obtaining the sample C.) Ensure the puncture is no deeper than 1 mm D.) Apply pressure for a minute after the procedure

Which area of concern is appropriate to focus on when providing care to pregnant adolescents? A.) Feelings of isolation B.) Late entry into prenatal care C.) Increased risk for cesarean delivery D.) Risk for chromosomal abnormalities

Which benefit regarding FAMs makes it an appealing choice for some women? A.) Adherence to strict recordkeeping B.) Absence of chemicals and hormones C.) Decreased involvement and intimacy of partner D.) Increased spontaneity of coitus

Which body part both protects the pelvic structures and accommodates the growing fetus during pregnancy? A.) Perineum B.) Bony pelvis C.) Vaginal vestibule D.) Fourchette

Which characteristic correctly matches the type of deceleration with its likely cause? A.) Early deceleration umbilical cord compression B.) Late deceleration uteroplacental insufficiency C.) Variable deceleration head compression D.) Prolonged deceleration unknown cause

Which client complaint would the drinking of cranberry and watermelon juice regularly 10 days before the expected onset of menses address? A.) Back pain caused by menses B.) Peripheral edema before menses C.) Nausea associated with menses D.) Abdominal cramps caused by menses

Which client finding indicates a potential risk for complications during the labor process? A.) Maternal temperature of 99.7 F B.) Persistent dark red vaginal bleeding C.) Intrauterine pressure of 50 mmHg D.) Contractions lasting for 70 seconds

Which client is a probable candidate for the Essure system of transcervical sterilization? A.) A client who has a history of ectopic pregnancy B.) An obese client with abdominal adhesion C.) A client who had a vaginal delivery 1 week ago D.) A client who wants more children

Which description of the phases of the first stage of labor is most accurate? A.) Latent: mild, regular contractions; no dilation; bloody show B.) Active: moderate, regular contractions; 4 to 7 cm dilation C.) Lull: no contractions; dilation stable D.) Transition: very strong but irregular contractions; 8 to 10 cm dilation

Which education would the nurse provide clients about self-care prevention of genital tract infections? A.) Increase dietary sugar and avoid yogurt B.) Limit time spent in damp-exercise clothes and limit exposure to bath salts or bubble bath C.) Choose underwear or hosiery with a nylon crotch D.) Douche frequently

Which fetal heart rate tracing characteristics are considered reassuring or normal (Category I)? A.) Bradycardia not accompanied by baseline variability B.) Early decelerations, either present or absent C.) Sinusoidal pattern, either present or absent D.) Tachycardia not accompanied by baseline variability

Which finding in a urine specimen of a pregnant client indicates that the client has proteinuria? A.) Value greater than or equal to 0.5+ protein in a dipstick testing B.) Value greater than 300 mg/24 hours C.) Concentration greater than or equal to 1 g protein in a 24-hour urine collection D.) Concentration at 10 mg/dL in random urine specimen

Which finding is considered normal for a client in her second trimester? A.) Less audible heart sounds (S1, S2) B.) Increased pulse rate C.) Increased blood pressure D.) Decreased red blood cell (RBC) production

Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand? A.) Stress on the heart is greatest in the first trimester and the last 2 weeks before labor B.) Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms C.) Women with class III cardiac disease should get 8 to 10 hours of sleep every day and limit housework, shopping, and exercise D.) Women with class I cardiac disease need bed rest through most of the pregnancy and face the possibility of hospitalization near term

Which information should the nurse take into consideration when planning care for a postpartum client with cardiac disease? A.) The plan of care for a postpartum client is the same as the plan for any pregnant woman B.) The plan of care includes rest, stool softeners, and monitoring of the effect of activity C.) The plan of care includes frequent ambulating, alternating with active range-of-motion exercises D.) The plan of care includes limiting visits with the infant to once per day

Which is the priority nursing action after administering magnesium sulfate to a pregnant client? A.) Assess the client's weight B.) Assess the serum magnesium level C.) Restrict fluid intake to 250 mL/hour D.) Evaluate fetal movement counts hourly

Which nursing action is the primary step of assessment when meeting with a new client to discuss contraception? A.) Obtain data about the frequency of coitus B.) Determine the woman's level of knowledge about contraception and commitment to any particular method C.) Assess the woman's willingness to touch her genitals and cervical mucus D.) Evaluate the woman's contraceptive life plan

Which nursing action would be taken immediately following the vaginal birth of a healthy term newborn? A.) Placing a hat on the infant before drying the infant B.) Drying the infant on the mother's chest and then placing a hat on the infant C.) Drying the infant in the warmer and then initiating skin-to-skin contact D.) Removing wet blankets from the delivery and placing a hat on the infant

Which nursing explanation is appropriate for a client who is 6 hours postpartum and asks when she will receive a RhoGAM injection? A.) "It is too early to administer the RhoGAM" B.) "The baby's blood type has not come back yet" C.) "You will receive the RhoGAM before discharge" D.) "The RhoGAM will be administered on your first postpartum visit"

Which nursing explanation is appropriate for a client who is estimated to be at 6 weeks of gestation by ultrasonography and states, "I don't understand how I can be pregnant; I just had my period?" A.) The embryo has not reached the uterine lining triggering menses B.) The bleeding was a result of the embryo attaching to the uterine lining C.) The levels of estrogen and progesterone are decreased after conception D.) Some women still experience menses during during the initial period of conception

Which nursing explanation is appropriate to include when preparing a client for a nonstress test? A.) "I will be using stimulation to wake up the baby" B.) "You will recline a bit with a slight tilt to the side' C.) "Push this button when you feel the baby move" D.) "You can lie on your back and get comfortable"

Which nursing information is appropriate to include in an explanation to the parents regarding their 24-hour-old newborn who did not pass his initial hearing screening? A.) A consult with an audiologist will be obtained B.) The screening will be repeated before discharge C.) The screening will be repeated at 2 months of age D.) The screening will be repeated in the health care provider's office on the first visit

Which nursing information is appropriate to include when discussing the storage of breast milk with a client? A.) Store thawed milk for 48 hours B.) Discard unused milk after a feeding within 2 hours C.) Place the containers of stored milk in the door of the freezer D.) Sterilize the containers for milk storage in boiling water

Which nursing information is included when discussing breast care with a pregnant client who would like to breastfeed? A.) Remove nipple jewelry before deliver B.) Avoid the use of soap when washing the nipples C.) Use a pad of synthetic liner on the back to absorb nipple leakage D.) Apply a breast shield a few weeks before delivery

Which nursing information is needed to understand and guide a client through her acceptance of pregnancy? A.) Nonacceptance of the pregnancy very often equates to rejection of the child B.) Mood swings most likely are the result of worries about finances and a changed lifestyle, as well as profound hormonal changes C.) Ambivalent feelings during pregnancy usually are seen only in emotionally immature or very young mothers D.) Conflicts such as not wanting to be pregnant or childrearing and career-related decisions should not be addressed during pregnant because they will resolve themselves naturally after birth

Which physiologic process is affected in the client who has low levels of gonadotropin-releasing hormone (GnRH)? A.) Rate of respiration B.) Development of ovum C.) Gastric acid secretion D.) Muscle contraction

Which physiologic system would be appropriate to evaluate with laboratory testing for a client who is at 37 weeks of gestation and is having itching all over her body? A.) Renal B.) Hepatic C.) Immune D.) Endocrine

Which reason explains how a student nurse measures the blood pressure (BP) of a client as 170/90 mmHg, yet on reassessment the charge nurse finds that the BP is 110/70 mmHg? A.) Using a very large-sized cuff for measuring BP B.) Using a very small-sized cuff for measuring BP C.) Measuring the BP with the client in the lying position D.) Measuring the BP 30 minutes after tobacco consumption

Which renal system adaptation is an anticipated anatomic change of pregnancy? A.) Increased urinary output makes pregnant women less susceptible to urinary infections B.) Increased bladder sensitivity and then compression of the bladder by the enlarging uterus result in the urge to urinate even when the bladder is almost empty C.) Renal (kidney) function is more efficient when the woman assumes a supine position D.) Using diuretic agents during pregnancy can help keep kidney function regular

Which statement best describes the transition period between intrauterine and extrauterine existence for the newborn? A.) Consists of four phases, two reactive and two of decreased responses B.) Lasts from birth to day 28 of life C.) Applies to full-term births only D.) Varies by socioeconomic status and the mothers age

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth? A.) My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter B.) My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles C.) I will not have a menstrual cycle for 6 months after childbirth D.) My first menstrual cycle will be heavier than normal and then will be light for several months after.

Which statement by the student nurse indicates the need for further teaching about the procedure for measuring blood pressure (BP) in pregnant clients? A.) The two readings should be taken at least 1 minute apart B.) The cuff should cover approximately one-half on the upper arm C.) BP should be measured with the woman sitting or in a semi-reclining position D.) If BP is elevated, the woman should rest for at least 10 minutes before I retake her BP

Which statement by the student nurse regarding spermicides indicates effective learning? A.) "They are inserted 3 hours before sexual intercourse" B.) "They would be reapplied for each additional act of intercourse" C.) "Spermicides are added to male condoms to prevent pregnancy" D.) "Spermicides prevent sexually transmitted infections"

Which statement concerning the third stage of labor is correct? A.) The placenta eventually detaches itself from a flaccid uterus B.) An expectant or active approach to managing this stage of labor reduces the risk of complications C.) It is important that the dark, roughened maternal surface of the placenta appears before the shiny fetal surface D.) The major risk for women during the third stage is a rapid heart rate

Which statement correlates with the proliferative phase of the endometrial cycle? A.) The tissue of the endometrium undergoes necrosis B.) Estrogen affects the growth of the lining of the uterus C.) Progesterone is the primary hormone present during this phase D.) The endometrial tissue is sloughed off living the innermost layer intact

Which statement is accurate regarding caring for a client in the third stage of labor? A.) The placenta eventually detaches itself from a flaccid uterus B.) The duration of the third stage may be short and lasts from the birth of the fetus until the placenta is delivered C.) it is important that the dark, roughened materna; surface of the placenta appear before the shiny fetal surface D.) The major risk for women during the third stage of labor is rapid heart rate

Which statement is accurate regarding preeclampsia and eclampsia? A.) Preeclampsia is a condition of the first trimester; eclampsia is a condition of the second and third trimesters B.) Preeclampsia results in decreased function in such organs as the placenta, kidneys, liver and brain C.) The causes of preeclampsia and eclampsia are well documented D.) Severe preeclampsia is defined as preeclampsia plus proteinuria

While assessing an infant, the nurse notes respiratory distress and a murmur. Which recommendation would the nurse make to the parents about infant care? A.) "Switch to exclusive formula feedings" B.) "Additional cardiac evaluation is necessary" C.) "The infant should be wrapped in a thick blanket" D.) "Maintain skin-to-skin contact with the mother"

While assisting the primary health care provider performing an amniotomy, the nurse observes part of the umbilical cord protruding from the client's vagina. The nurse immediately positions the client in the Trendelenburg position and inserts a finger into the client's vagina. Which additional care intervention would the client need to prevent complications? A.) Perform large-bore catheter suction B.) Prepare for an emergency cesarean delivery C.) Administer calcium gluconate intravenously D.) Administer terbutaline subcutaneously

While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the clients recent menstrual cycles. Which statement by the client should prompt the nurse to collect further information? A.) My menstrual flow lasts 5 to 6 days B.) My flow is very heavy C.) I have had a small amount of spotting midway between my periods for the past 2 months D.) The length of my menstrual cycles varies from 26 to 29 days

The nurse is caring for a diabetic client who is pregnant. Which education regarding self care during illness would the nurse provide the client (select all that apply): A.) Avoid insulin if your appetite is less than normal B.) Drink as much fluid as possible C.) Obtain as much rest as possible D.) Check blood glucose levels at regular intervals E.) Seek emergency treatment if your glucose level exceeds 250 mg/dL

B, C, D

In providing teaching to a pregnant client, the nurse knows which are some common maternal and fetal indications for antepartum testing (select all that apply): A.) Gallstones B.) Preeclampsia C.) Previous stillbirth D.) Fetal growth restriction E.) Increased fetal movement F.) Premature rupture of membranes

B, C, D, F

Which interventions would the nurse include in the plan of care for a pregnant client with mild preeclampsia (select all that apply): A.) Ensure prolonged bed rest B.) Provide diversionary activities C.) Encourage intake of adequate fluids D.) Restrict sodium and zinc in the diet E.) Refer to the client to an Internet-based support group

B, C, E

Which statement by the nurse describes the type of questions that help distinguish if a client is experiencing true labor (select all that apply): A.) "Have you noticed any bloody show" B.) "Where are you feeling your contractions" C.) "Have your contractions become closer together" D.) "Do you think you have been leaking amniotic fluid" E.) "Do your contractions feel the same when you are lying down"

B, C, E

Which statements regarding the HPV are accurate (select all that apply): HPV infections: A.) Are thought to be less common in pregnant women than in women who are not pregnant B.) Are thought to be more common in pregnant women than in women who are not pregnant C.) Were previously called genital warts D.) Were previously called herpes E.) May cause cancer

B, C, E

A client reports mild vaginal bleeding, pain and cramping in her lower abdomen at 6 weeks of gestation. On performing a pelvic examination, the nurse finds that the client's cervical os is closed. What is the priority nursing intervention in this case? A.) Administer intravenous fluids to the client B.) Administer carboprost tromethamine to the client C.) Determine the client's human chorionic gonadotropin and progesterone levels D.) Prompt termination of pregnancy in the client by the dilation and curettage method

A mother expresses fear about changing her infants diaper after he is circumcised. What does the client need to be taught to care for her newborn son? A.) Cleanse the penis with prepackaged diaper wipes every 3 to 4 hours B.) Apply constant, firm pressure by squeezing the penis with the fingers for at least 5 minutes if bleeding occurs C.) Gently cleanse the penis with water and apply petroleum jelly around the glans after each diaper change D.) Wash off the yellow exudate that forms on the glans at least once every day to prevent infection

A new mother wants to be sure that she is meeting her daughters needs while feeding the baby commercially prepared infant formula. The nurse should evaluate the mothers knowledge about appropriate infant feeding techniques. Which statement by the client reassures the nurse that correct learning has taken place? A.) Since reaching 2 weeks of age, I add rice cereal to my daughters formula to ensure adequate nutrition B.) I warm the bottle in my microwave oven C.) I burp my daughter during and after the feeding as needed D.) I refrigerate any leftover formula for the next feeding

A nulliparous woman has just begun the latent phase of the second stage of her labor. The nurse should anticipate which behavior? A.) A nulliparous woman will experience a strong urge to bear down B.) Perineal bulging will show C.) A nulliparous woman will remain quiet with her eyes closed between contractions D.) The amount of bright red bloody show will increase

A nurse is assessing a newborn girl who is 2 hours old. Which finding warrants a call to the health care provider? A.) Blood glucose of 45 mg/dl using a Dextrostix screening method B.) Heart rate of 160 beats per minute after vigorously crying C.) Laceration of the cheek D.) Passage of a dark black-green substance from the rectum

A nurse is caring for a client and her partner during the second stage of labor. The client's partner asks the nurse to explain how he will know when crowning occurs. Which of the following responses should the nurse make? A.) "The placenta will protrude from the vagina." B.) "Your partner will report a decrease in the intensity of contractions." C.) "The vaginal area will bulge as the baby's head appears." D.) "Your partner will report less rectal pressure."

A nurse is caring for a client following the administration of an epidural block and is preparing to administer an IV fluid bolus. The client's partner asks about the purpose of the IV fluids. Which of the following is an appropriate response for the nurse to make? A.) "It is needed to promise increased urinary output." B.) "It is needed to counteract respiratory depression." C.) "It is needed to counteract hypotension." D.) "It is needed to prevent oligohydramnios."

A nurse providing care for the antepartum woman should understand that the 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 non-stress test (NST) if the membranes have already been ruptured

A nurse providing care to a client in labor would be aware of which fact about cesarean delivery? A.) It is declining in frequency in the United States B.) It is more likely to be done for the poor in public hospitals who do not get the nurse counseling that wealthier clients do C.) It is performed primarily for the health of the mother and fetus D.) It can be either elected or refused by clients as their absolute legal right

A pregnant client at 14 weeks of gestation is admitted to the hospital with a diagnosis of hyperemesis gravidarum. Which is the primary goal of her treatment at this time? A.) Rest the gastrointestinal tract by restricting all oral intake for 48 hours B.) Reduce emotional distress by encouraging the client to discuss her feelings C.) Reverse fluid, electrolyte and acid-base imbalances D.) Restore the client's ability to take and retain oral fluid and foods

A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of the exercise on the fetus. Which guidance should the nurse provide? A.) You don't need to modify your exercising any time during your pregnancy B.) Stop exercising because it will harm the fetus C.) You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month D.) Jogging is too hard on your joints; switch to walking now

A pregnant woman at term is transported to the emergency department (ED) after a severe vehicular accident. The obstetric nurse responds and rushes to the ED with a fetal monitor. Cardiopulmonary arrest occurs as the obstetric nurse arrives. What is the highest priority for the trauma team? A.) Obtaining IV access, and starting aggressive fluid resuscitation B.) Quickly applying the fetal monitor to determine whether the fetus viability C.) Starting cardiopulmonary resuscitation (CPR) D.) Transferring the woman to the surgical unit for an emergency cesarean delivery in case the fetus is still alive

A primigravida at 40 weeks of gestation is having uterine contractions every to 2 minutes and states that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman's labor? A.) She is exhibiting hypotonic uterine dysfunction B.) She is experiencing a normal latent stage C.) She is exhibiting hypertonic uterine dysfunction D.) She is experiencing precipitous labor

A recently delivered mother and her baby are at the clinic for a 6-week postpartum checkup. Which response by the client alerts the nurse that psychosocial outcomes have not been met? A.) The woman excessively discusses her labor and birth experience B.) The woman feels that her baby is more attractive and clever than any others C.) The woman has not given the baby a name D.) The woman has a partner or family members who react very positively about the baby

A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2015. What is the clients expected date of birth (EDB)? A.) September 17, 2015 B.) November 7, 2015 C.) November 21, 2015 D.) December 17, 2015

A woman arrives at the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion? A.) Incomplete B.) Inevitable C.) Threatened D.) Septic

A woman has experienced iron deficiency anemia during her pregnancy. She had been taking iron for 3 months before the birth. The client gave birth by cesarean 2 days earlier and has been having problems with constipation. After assisting her back to bed from the bathroom, the nurse notes that the woman's stools are dark (greenish-black). What should the nurse's initial action be? A.) Perform a guaiac test, and record the results B.) Recognize the finding as abnormal, and report it to the primary health care provider C.) Recognize the finding as a normal result of iron therapy C.) Check the woman's next stool to validate the observation

A woman in labor is breathing into a mouthpiece just before the start of her regular contractions. As she inhales, a valve opens and gas is released. She continues to inhale the gas slowly and deeply until the contraction starts to subside. When the inhalation stops, the valve closes. Which statement regarding this procedure is correct? A.) The application of nitrous oxide gas is not often used anymore B.) An inhalation of gas is likely to be used in the second stage of labor, not during the first stage C.) An application of nitrous oxide gas is administered for pain relief D.) The application of gas is a prelude to a cesarean birth

A woman is in the second stage of labor and has a spinal block in place for pain management. The nurse obtains the woman's blood pressure and notes that it is 20% lower than the baseline level. Which nursing action is appropriate in this case? A.) Encourage the client to empty her bladder B.) Decrease her intravenous (IV) rate to keep-vein-open rate C.) Turn the client to the left lateral position or place a pillow under her hip D.) No action is necessary because a decrease in the woman's blood pressure is expected

A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed? A.) Disseminated intravascular coagulation (DIC); asking for laboratory tests B.) von Willebrand disease (vWD); noting whether bleeding times have been extended C.) Thrombophlebitis; using real-time and color Doppler ultrasound D.) Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis

An infant was born 2 hours ago at 37 weeks of gestation and weighs 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of what condition? A.) Birth injury B.) Hypocalcemia C.) Hypoglycemia D.) Seizures

At a 2-month well-baby examination, it was discovered that an exclusively breastfed infant had only gained 10 ounces in the past 4 weeks. The mother and the nurse develop a feeding plan for the infant to increase his weight gain. Which change in dietary management will assist the client in meeting this goal? A.) Begin solid foods B.) Have a bottle of formula after every feeding C.) Have one extra breastfeeding session every 24 hours D.) Start iron supplements

Dental care during pregnancy is an important component of good prenatal care. Which instruction regarding dental health should the nurse provide? A.) Regular brushing and flossing may not be necessary during early pregnancy because it may stimulate the woman who is already nauseated to vomit. A cleaning is all that is necessary B.) Dental surgery, in particular, is contraindicated during pregnancy and should be delayed until after delivery C.) If dental treatment is necessary, then the woman will be most comfortable with it in the second trimester D.) If a woman has dental anxiety, then dental care may interfere with the expectant mothers need to practice conscious relaxation and to prepare for labor

During the initial visit with a client who is beginning prenatal care, which action should be the highest priority for the nurse? A.) The first interview is a relaxed, get-acquainted affair during which the nurse gathers some general impressions of his or her new client B.) If the nurse observed handicapping conditions, he or she should be sensitive and not inquire about them because the client will do that in her own time C.) The nurse should be alert to the appearance of potential parenting problems, such as depression or lack of family support D.) Because of legal complications, the nurse should not ask about illegal drug use; that is left to the physician

Having a genetic mutation may create an 85% chance of developing breast cancer in a woman's lifetime. Which condition does not increase a client's risk for breast cancer? A.) BRCA1 or BRCA2 gene mutation B.) Li-Fraumeni syndrome C.) Paget disease D.) Cowden syndrome

How many kilocalories per kilogram (kcal/kg) of body weight does a breastfed term infant require each day? A.) 50 to 65 B.) 75 to 90 C.) 95 to 110 D.) 150 to 200

How would the nurse differentiate a meconium stool from a transitional stool in the healthy newborn? A.) Observed at age 3 days B.) Is residue of a milk curd C.) Passes in the first 12 hours of life D.) Is lighter in color and looser in consistency

If a client's normal prepregnancy diet contains 45 g of protein daily, how many more grams of protein should she consume per day during pregnancy? A.) 5 B.) 10 C.) 25 D.) 30

If consistently and correctly used, which of the barrier methods of contraception has the lowest failure rate? A.) Spermicides B.) Female condoms C.) Male condoms D.) Diaphragms

In planning for home care of a woman with preterm labor, which concern should the nurse need to address? A.) Nursing assessments are different from those performed in the hospital setting B.) Restricted activity and medications are necessary to prevent a recurrence of preterm labor C.) Prolonged bed rest may cause negative physiologic effects D.) Home health care providers are necessary

In the acronym BRAIDED, which letter is used to identify the key components of informed consent that the nurse must document? A.) B stands for birth control B.) R stands for reproduction C.) A stands for alternatives D.) I stands for ineffective

In the past, factors to determine whether a woman was likely to develop a high-risk pregnancy were primarily evaluated from a medical point of view. A broader, more comprehensive approach to high-risk pregnancy has been adopted today. Four categories have now been established, based on the threats to the health of the woman and the outcome of pregnancy. Which category should not be included in this group? A.) Biophysical B.) Psychosocial C.) Geographic D.) Environmental

Management of primary dysmenorrhea often requires a multifaceted approach. Which pharmacologic therapy provides optimal pain relief for this condition? A.) Acetaminophen B.) Oral contraceptive pills (OCPs) C.) Nonsteroidal antiinflammatory drugs (NSAIDs) D.) Aspirin

Near the end of the first week of life, an infant who has not been treated for any infection develops a copper-colored maculopapular rash on the palms and around the mouth and anus. The newborn is displaying signs and symptoms of which condition? A.) Gonorrhea B.) Herpes simplex virus (HSV) infection C.) Congenital syphilis D.) HIV

Nurses should be cognizant of what regarding the mechanism of labor? A.) Seven critical movements must progress in a more or less orderly sequence B.) Asynclitism is sometimes achieved by means of the Leopold maneuvers C.) Effects of the forces determining descent are modified by the shape of the woman's pelvis and the size of the fetal head D.) At birth, the baby is said to achieve restitution; that is, a return to the C-shape of the womb

Nurses with an understanding of cultural differences regarding likely reactions to pain may be better able to help their clients. Which clients may initially appear very stoic but then become quite vocal as labor progresses until late in labor, when they become more vocal and request pain relief? A.) Chinese B.) Arab or Middle Eastern C.) Hispanic D.) African-American

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation. What is the primary purpose of prostaglandin administration? A.) To enhance uteroplacental perfusion in an aging placenta B.) To increase amniotic fluid volume C.) To ripen the cervix in preparation for labor induction D.)To stimulate the amniotic membranes to rupture

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem approach. What is the first step in the provision of care for the infant? A.) Pharmacologic treatment B.) Reduction of environmental stimuli C.) Neonatal abstinence syndrome (NAS) scoring D.) Adequate nutrition and maintenance of fluid and electrolyte balance

Some pregnant clients may complain of changes in their voice and impaired hearing. What should the nurse explain to the client concerning these findings? A.) Voice changes are caused by decreased estrogen levels B.) Displacement of the diaphragm results in thoracic breathing C.) Voice changes and impaired hearing are due to the results of congestion and swelling of the upper respiratory tract D.) Increased blood volume causes changes in the voice

The American College of Obstetricians and Gynecologists (ACOG) has developed a comprehensive list of risk factors associated with the development of preeclampsia. Which client exhibits the greatest number of these risk factors? A.) 30-year-old obese Caucasian with her third pregnancy B.) 41-year-old Caucasian primigravida C.) 19-year-old African American who is pregnant with twins D.) 25-year-old Asian American whose pregnancy is the result of donor insemination

The labor and delivery nurse is preparing a client who is severely obese (bariatric) for an elective cesarean birth. Which piece of specialized equipment will not likely be needed when providing care for this pregnant woman? A.) Extra-long surgical instruments B.) Wide surgical table C.) Temporal thermometer D.) Increased diameter blood pressure cuff

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the womans latest laboratory test findings, which reveal a platelet count of 90,000 mm3, an elevated aspartate aminotransaminase (AST) level, and a falling hematocrit. The laboratory results are indicative of which condition? A.) Eclampsia B.) Disseminated intravascular coagulation (DIC) syndrome C.) Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome D.) Idiopathic thrombocytopenia

The labs of a woman in labor are as follows: Blood Type 0+ Hgb 11.2 Hct 33 HIV Positive Platelets 63,000 Her VS are: BP 165/92; P 84; RR 18; T 98.6°F Which of these would contraindicate placement of an epidural? A.) Her positive HIV status B.) Her Vital signs C.) Her Platelet Count D.) Her Hgb & Hct

The management of the pregnant client who has experienced a pregnancy loss depends on the type of miscarriage and the signs and symptoms. While planning care for a client who desires outpatient management after a first-trimester loss, what would the nurse expect the plan to include? A.) Dilation and curettage (D&C) B.) Dilation and evacuation (D&E) C.) Misoprostol D.) Ergot products

The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt? A.) Large doses of vitamin C during pregnancy B.) Prophylactic antibiotics C.) Strict aseptic technique, including hand washing, by all healthcare personnel D.) Limited protein and fat intake

The nurse assisting a laboring client recognizes the Ferguson reflex in a client. Which is the most accurate description of the Ferguson reflex? A.) Release of endogenous oxytocin B.) Involuntary uterine contractions C.) Maternal urge to bear down D.) Mechanical stretching of the cervix

The nurse guides a woman to the examination room and asks her to remove her clothes and put on an examination gown with the front open. The woman replies, I have special undergarments that I do not remove for religious reasons. Which is the most appropriate response from the nurse? A.) You cant have an examination without removing all your clothes B.) I'll ask the physician to modify the examination C.) Tell me about your undergarments. I'll explain the examination procedure, and then we can discuss how you can comfortably have your examination D.) I have no idea how we can accommodate your beliefs

The nurse is assessing a client at 30 weeks of pregnancy with poorly controlled pregestational diabetes. The client has come for the antenatal visit on a Monday. When would the nurse ask the client to come next? A.) The next week on a Monday B.) The next week on a Thursday C.) The same week on a Thursday D.) The week after next week on a Monday

The nurse is assessing a client with hyperemesis gravidarum during the early stages of pregnancy. Which nonpharmacologic measure is appropriate to alleviate the discomforts associated with nausea and vomiting? A.) Having the client cook her favorite foods B.) Allowing frequent visits from friends C.) Providing environment that is free from odors D.) Having the client eat warm, low-fat, soupy foods

The nurse is assessing a pregnant client with a history of atrial septal defect. The nurse knows that the client is at risk for right-sided heart failure because of which factor? A.) Ruptured aorta B.) Stiffened valve leaflets C.) Increased plasma volume D.) Increased pressure in pulmonary veins

The nurse is aware of which factor regarding the conditioning and reconditioning of the urinary system after childbirth? A.) Kidney function returns to normal a few days after birth B.) Diastasis recti abdominis is a common condition that alters the voiding reflex C.) Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium D.) With adequate emptying of the bladder, bladder tone usually is restored 2 to 3 weeks after childbirth

The nurse is caring for a diabetic client who is breastfeeding her infant. Within which time frame after childbirth would the client's insulin requirements return to prepregnancy levels? A.) Immediately after childbirth B.) Seven to ten days after childbirth C.) On completion of weaning D.) During the lactation period

The nurse is preparing to administer methotrexate to the client. This hazardous drug is most often used for which obstetric complication? A.) Complete hydatidiform mole B.) Missed abortion C.) Unruptured ectopic pregnancy D.) Abruptio placentae

The nurse is providing contraceptive instruction to a young couple who are eager to learn. The nurse should be cognizant of which information regarding the natural family planning method? A.) The natural family planning method is the same as coitus interruptus or pulling out B.) This contraception method uses the calendar method to align the woman's cycle with the natural phases of the moon C.) This practice is the only contraceptive method acceptable to the Roman Catholic Church D.) The natural family planning method relies on barrier methods during the fertility phases

The nurse is providing education to a client regarding the normal changes of the breasts during pregnancy. Which statement regarding these changes is correct? A.) The visibility of blood vessels that form an intertwining blue network indicates full function of the Montgomery tubercles and possibly an infection of the tubercles B.) The mammary glands do not develop until 2 weeks before labor C.) Lactation is inhibited until the estrogen level declines after birth D.) Colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding

The nurse is teaching a client with preterm premature rupture of membranes (PPROM) regarding self-care activities. Which activities should the nurse include in her teaching? A.) Report a temperature higher than 40 C B.) Tampons are safe to use to absorb the leaking amniotic fluid C.) Do not engage in sexual activity D.) Taking frequent tub baths is safe

The nurse is teaching new parents about metabolic screening for the newborn. Which statement is most helpful to these clients? A.) All states test for phenylketonuria (PKU), hypothyroidism, cystic fibrosis, and sickle cell diseases B.) Federal law prohibits newborn genetic testing without parental consent C.) If genetic screening is performed before the infant is 24 hours old, then it should be repeated at age 1 to 2 weeks D.) Hearing screening is now mandated by federal law

The nurse observes profuse bleeding in a postpartum client. Which is the priority intervention in this case? A.) Call the client's primary health care provider B.) Administer the standing prescription for an oxytocic C.) Palpate the uterus, and massage it if it is boggy D.) Assess maternal blood pressure and pulse for signs of hypovolemic shock

The nurse providing care for a high-risk laboring woman is alert for late FHR decelerations. Which clinical finding might be the cause for these late decelerations? A.) Altered cerebral blood flow B.) Umbilical cord compression C.) Uteroplacental insufficiency D.) Meconium fluid

The nurse should understand the process by which the HIV infection occurs. Once the virus has entered the body, what is the time frame for seroconversion to HIV positivity? A.) 6 to 10 days B.) 2 to 4 weeks C.) 6 to 12 weeks D.) 6 months

The nurse who provides care to clients in labor must have a thorough understanding of the physiologic processes of maternal hypotension. Which outcome might occur if the interventions for maternal hypotension are inadequate? A.) Early FHR decelerations B.) Fetal arrhythmias C.) Uteroplacental insufficiency D.) Spontaneous rupture of membranes

Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis. Which physiologic alteration is the cause for the diaphoresis and diuresis that this client is experiencing? A.) Elevated temperature caused by postpartum infection B.) Increased basal metabolic rate after giving birth C.) Loss of increased blood volume associated with pregnancy D.) Increased venous pressure in the lower extremities

Under the Newborns and Mothers Health Protection Act, all health plans are required to allow new mothers and newborns to remain in the hospital for a minimum of _____ hours after a normal vaginal birth and for _____ hours after a cesarean birth. What is the correct interpretation of this legislation? A.) 24; 72 B.) 24; 96 C.) 48; 96 D.) 48; 120

What is tandem feeding? A.) Adequate nutritional stores for the mother and infant B.) Using both breasts to nurse the baby C.) Breastfeeding an infant and an older sibling during the same period of time D.) Supplementing breastfeeding with bottle feeding to maintain adequate weight gain

What is the primary purpose for magnesium sulfate administration for clients with preeclampsia and eclampsia? A.) To improve patellar reflexes and increase respiratory efficiency B.) To shorten the duration of labor C.) To prevent convulsions D.) To prevent a boggy uterus and lessen lochial flow

What is the primary purpose for the use of tocolytic therapy to suppress uterine activity? A.) Drugs can be efficaciously administered up to the designated beginning of term at 37 weeks gestation B.) Tocolytic therapy has no important maternal (as opposed to fetal) contraindications C.) The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids D.) If the client develops pulmonary edema while receiving tocolytic therapy, then intravenous (IV) fluids should be given

What is the primary rationale for nurses wearing gloves when handling the newborn? A.) To protect the baby from infection B.) As part of the Apgar protocol C.) To protect the nurse from contamination by the newborn D.) Because the nurse has the primary responsibility for the baby during the first 2 hours

What is the primary rationale for the thorough drying of the infant immediately after birth? A.) Stimulates crying and lung expansion B.) Removes maternal blood from the skin surface C.) Reduces heat loss from evaporation D.) Increases blood supply to the hands and feet

What marks on a baby's skin may indicate an underlying problem that requires notification of a physician? A.) Mongolian spots on the back B.) Telangiectatic nevi on the nose or nape of the neck C.) Petechiae scattered over the infant's body D.) Erythema toxicum neonatorum anywhere on the body

What should the nurse be cognizant of concerning the clients reordering of personal relationships during pregnancy? A.) Because of the special motherhood bond, a woman's relationship with her mother is even more important than with the father of the child B.) Nurses need not get involved in any sexual issues the couple has during pregnancy, particularly if they have trouble communicating them to each other C.) Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the father D.) The woman's sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier

When assessing a pregnant client, the nurse is aware of which maternal and neonatal risks associated with gestational diabetes mellitus? A.) Maternal premature rupture of membranes and neonatal sepsis B.) Maternal hyperemesis and neonatal low birth weight C.) Maternal preeclampsia and fetal macrosomia D.) Maternal placenta previa and fetal prematurity

When would a client using the calendar rhythm method for contraception abstain from sexual activity to avoid pregnancy? A.) On day 9 B.) On day 15 C.) From days 10 to 17 D.) From days 2 to 10

Where is the point of maximal intensity (PMI) of the FHR located? A.) Usually directly over the fetal abdomen B.) In a vertex position, heard above the mothers umbilicus C.) Heard lower and closer to the midline of the mother's abdomen as the fetus descends and internally rotates D.) In a breech position, heard below the mothers umbilicus

Which action by the mother will initiate the milk ejection reflex (MER)? A.) Wearing a firm-fitting bra B.) Drinking plenty of fluids C.) Placing the infant to the breast D.) Applying cool packs to her breast

Which action by the pregnant client demonstrates understanding of the nurse's instructions regarding relief of leg cramps? A.) Wiggles and points her toes during the cramp B.) Applies cold compresses to the affected leg C.) Extends her leg and dorsiflexes her foot during the cramp D.) Avoids weight bearing on the affected leg during the cramp

Which action is correct when palpation is used to assess the characteristics and pattern of uterine contractions? A.) Placing the hand on the abdomen below the umbilicus and palpating uterine tone with the fingertips B.) Determining the frequency by timing from the end of one contraction to the end of the next contraction C.) Evaluating the intensity by pressing the fingertips into the uterine fundus D.) Assessing uterine contractions every 30 minutes throughout the first stage of labor

Which adaptation of the maternal-fetal exchange of oxygen occurs in response to uterine contraction? A.) The maternal-fetal exchange of oxygen and waste products continues except when placental functions are reduced B.) This maternal-fetal exchange increases as the blood pressure decreases C.) It diminishes as the spiral arteries are compressed D.) This exchange of oxygen and waste products is not significantly affected by contractions

Which anticipatory guidance would the nurse provide the parents of a newborn? A.) Place the newborn on the abdomen (prone) after feeding and for sleep B.) Avoid the use of pacifiers C.) Use a rear-facing car seat D.) Use a crib with side-rail slats that are no more than 3 inches apart

Which assessment finding indicates a progestin regimen for a client who was prescribed oral contraceptive pills (OCPs) for 6 months for dysfunctional uterine bleeding, experienced condition improvement after 6 months and now wishes to discontinue the OCPs? A.) The client is pregnant B.) The bleeding is scanty C.) Menstruation did not resume D.) The disorder reoccurred

Which assessment finding would the nurse recognize as indicating a problem with latching? A.) The infant's cheeks are rounded while sucking B.) The infant's jaw glides smoothly while sucking C.) The mother reports pain in her nipples while breastfeeding D.) The mother reports that the infant swallows audibly

Which caloric intake is appropriate for the lactating client who gave birth to twins one month earlier? A.) Less than 1800 kcal/day B.) Less than 2200 kcal/day C.) More than 2700 kcal/day D.) 1800 to 2200 kcal/day

Which client behavior is expected during the transition phase of the first stage of labor? A.) Remains calm and silent B.) Doubts her ability to control pain C.) Vomits D.) Attention is directed inward

Which client is most at risk for fibroadenoma of the breast? A.) 38-year-old woman B.) 50-year-old woman C.) 16-year-old girl D.) 27-year-old woman

Which client would be an ideal candidate for injectable progestins such as Depo-Provera (DMPA) as a contraceptive choice? A.) The ideal candidate for DMPA wants menstrual regularity and predictability B.) The client has a history of thrombotic problems or breast cancer C.) The ideal candidate has difficulty remembering to take oral contraceptives daily D.) The client is homeless or mobile and rarely receives health care

Which clinical finding indicates that the client has reached the second stage of labor? A.) Amniotic membranes rupture B.) Cervix cannot be felt during a vaginal examination C.) Woman experiences a strong urge to bear down D.) Presenting part of the fetus is below the ischial spines

Which clinical finding would the nurse attribute to a forceps-assisted birth? A.) Erythematous skin B.) Blotchy or mottled skin C.) Edema and ecchymosis D.) Cyanotic discoloration

Which clinical finding would the nurse expect when examining a 36-week-old newborn male infant immediately after birth? A.) Rugae covering the scrotal sack B.) Desquamation of the epidermis C.) Vernix caseosa covering the body D.) Erythema toxicum

Which clinical significance does a maternal blood Coombs test with a titer of 1:8 and increasing indicate? A.) Fetal lung maturity B.) Significant Rh compatability C.) Significant Rh incompatability D.) Fetus with trisomy 13, 18 or 21

Which condition has the highest possibility of occurrence in a client with endometriosis? A.) Weight gain B.) Mood disorders C.) Impaired fertility D.) Gastrointestinal bleeding

Which condition is associated with a high risk for disseminated intravascular coagulation (DIC)? A.) Eclampsia B.) Placenta previa C.) Placental abruption D.) Gestational hypertension

Which condition is characterized by implantation of fertilized ovum outside the uterine cavity? A.) Placenta previa B.) Molar pregnancy C.) Ectopic pregnancy D.) Cervical insufficiency

Which condition is the most life-threatening virus to the fetus and neonate? A.) Hepatitis A virus (HAV) B.) Herpes simplex virus (HSV) C.) Hepatitis B virus (HBV) D.) Cytomegalovirus (CMV)

Which condition would affect a client at 10 weeks of gestation whose breasts have been leaking colostrum? A.) Elevated prolactin level B.) Hypersecretion of hormones C.) Inaccurate gestational age D.) Decreased human placental lactogen level

Which condition would the nurse suspect when observing mouth breathing in a 4-week infant? A.) Hypoxemia B.) Cardiac disorder C.) Nasal obstruction D.) Laryngeal obstruction

Which conditions are infants of diabetic mothers (IDMs) at a higher risk for developing? A.) Iron deficiency anemia B.) Hyponatremia C.) Respiratory distress syndrome D.) Sepsis

Which consideration is essential for the nurse to understand regarding follow-up prenatal care visits? A.) The interview portions become more intensive as the visits become more frequent over the course of the pregnancy B.) Monthly visits are scheduled for the first trimester, every 2 weeks for the second trimester, and weekly for the third trimester C.) During the abdominal examination, the nurse should be alert for supine hypotension D.) For pregnant women, a systolic BP of 130 mm Hg and a diastolic BP of 80 mm Hg is sufficient to be considered hypertensive

Which description of the phases of the second stage of labor is most accurate? A.) Latent phase: Feeling sleepy; fetal station 2+ to 4+; duration of 30 to 45 minutes B.) Active phase: Overwhelmingly strong contractions; Ferguson reflux activated; duration of 5 to 15 minutes C.) Descent phase: Significant increase in contractions; Ferguson reflux activated; average duration varies D.) Transitional phase: Woman laboring down; fetal station 0; duration of 15 minutes

Which diagnostic test is used to confirm a suspected diagnosis of breast cancer? A.) Mammogram B.) Ultrasound C.) Needle-localization biopsy D.) Magnetic resonance imaging (MRI)

Which dietary finding is the rationale for the nursing instruction to the pregnant client to eat nuts, legumes, cocoa and whole grains during the second trimester? A.) A diet that is low in sinz B.) Low intake of vitamin A C.) Low intake of magnesium D.) Decreased vitamin D intake

Which dietary practice would the nurse expect a Hmong client to follow to enhance milk production? A.) Avoid eating rice B.) Drink seaweed soup C.) Eat boiled chicken D.) Avoid eating hot food

Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process? A.) Moderate bright red lochial flow B.) Breasts firm and tender C.) Fundus below the symphysis and nonpalpable D.) Episiotomy slightly red and puffy

Which explains to the pregnant client the reason for constipation in the second trimester? A.) Progesterone levels decrease gastric acid secretions B.) Progesterone levels increase gastrointestinal (GI) mostly in pregnant women C.) Iron supplements may cause constipation and darkened stool D.) Constipation is caused by inadequate carbohydrate intake

Which information should the nurse provide to a breastfeeding mother regarding optimal self-care? A.) She will need an extra 1000 calories a day to maintain energy and produce milk B.) She can return to prepregnancy consumption patterns of any drinks as long as she gets enough calcium C.) She should avoid trying to lose large amounts of weight D.) She must avoid exercising because it is too fatiguing

Which intervention would be the most beneficial to a pregnant client with cervical Chlamydia trachomatis? A.) Administering doxycycline 100 mg twice a day B.) Administering silver nitrate solution on a regular basis C.) Administering azithromycin 1 g orally once a day D.) Administering human papillomavirus (HPV) vaccine

Which nursing advice is appropriate for a client who is taking combined oral contraceptives (COCs) and complains of increased appetite and post-pill amenorrhea? A.) "Take herbal supplements to prevent these side effects" B.) "Take the pills at the same time each day" C.) "The primary health care provide can prescribe a COC with a low dose of hormone" D.) "These side effects are temporary and will diminish soon"

Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth? A.) Fetal head is felt at 0 station during the vaginal examination B.) Bloody mucous discharge increases C.) Vulva bulges and encircles the fetal head D.) Membranes rupture during a contraction

Which nursing explanation is appropriate for a client who has type 1 diabetes and at 36 weeks of gestation asks why her insulin requirement has increased throughout the pregnancy? A.) The metabolic rate in pregnancy has increased requiring additional insulin B.) The rapid growth of the fetus has resulted in an increased demand for insulin C.) The hormonal levels associated with pregnancy have increased your resistance to insulin D.) The supplementary level of insulin is required to manage the additional intake of carbohydrates

Which nursing information is appropriate for a client who uses the vaginal contraceptive ring, but after feeling discomfort during coitus removed the ring for 1 hour and is now concerned that removal could have increased the chance of pregnancy? A.) "You need to be tested for pregnancy" B.) "The ring will lose efficacy if removed often" C.) "There is no risk if the ring is reinserted in 3 hours" D.) "It may increase the risk of sexually transmitted infection"

Which nursing information is appropriate for a pregnant client at 10 weeks of gestation who jogs three or four times per week and is concerned about the effect of exercise of the fetus? A.) You don't need to modify your exercising any time during your pregnancy B.) Stop exercising because it will harm the fetus C.) You may find that around the seventh month of your pregnancy, you will need to modify your exercise to walking D.) Jogging is too hard on your joints; switch to walking now

Which provider prescription would the nurse expect for a 5-day-old newborn with hypoglycemia and delayed meconium passage? A.) Exclusively breastfeed the newborn B.) Start formula feeding the newborn C.) Give the newborn expressed breast milk D.) Heat the breast milk in a microwave before feeding

Which questionnaire would be best for the nurse to use when screening an adolescent client for an eating disorder? A.) Four Cs B.) Dietary Guidelines for Americans C.) SCOFF screening tool D.) Dual-energy x-ray absorptiometry (DEXA) scan

Which statement accurately describes an appropriate-for-gestational age (AGA) weight assessment? A.) AGA weight assessment falls between the 25th and 75th percentiles for the infants age B.) AGA weight assessment depends on the infants length and the size of the newborn's head C.) AGA weight assessment falls between the 10th and 90th percentiles for the infants age D.) AGA weight assessment is modified to consider intrauterine growth restriction (IUGR)

Which statement by the client will assist the nurse in determining whether she is in true labor as opposed to false labor? A.) I passed some thick, pink mucus when I urinated this morning B.) My bag of waters just broke C.) The contractions in my uterus are getting stronger and closer together D.) My baby dropped, and I have to urinate more frequently now

Which statement by the client with gestational diabetes indicates an understanding of the information provided by the nurse? A.) "I will limit my intake of alcohol" B.) "I will use artificial sweeteners instead of sugar in my coffee" C.) "I will not go more than 4 hours throughout the day without eating" D.) "I will eat a large dinner so I do not become hypoglycemic during the night"

Which statement by the client would lead the nurse to believe that labor has been established? A.) I passed some thick, pink mucus when I urinated this morning B.) My bag of waters just broke C.) The contractions in my uterus are getting stronger and closer together D.) My baby dropped, and I have to urinate more frequently now

Which statement concerning cyclic perimenstrual pain and discomfort (CPPD) is accurate? A.) Premenstrual dysphoric disorder (PMDD) is a milder form of PMS and more common in young women B.) Secondary dysmenorrhea is more intense and more medically significant than primary dysmenorrhea C.) PMS is a complex, poorly understood condition that may include any of a hundred symptoms D.) The causes of PMS have been well established

Which statement describes the recommended weight gain and nutritional goals for the adolescent client who is pregnant? A.) "The caloric intake is increased for adolescents" B.) "Recommended weight goals are different for adolescents" C.) "The nutritional intake for adolescents is the same as for adults" D.) "Recommend the weight gain goal on the upper end of the adolescent BMI chart"

Which statement is not an expected outcome for the client who attends a reputable childbirth preparation program? A.) Childbirth preparation programs increase the woman's sense of control B.) Childbirth preparation programs prepare a support person to help during labor C.) Childbirth preparation programs guarantee a pain-free childbirth D.) Childbirth preparation programs teach distraction techniques

Which statement most accurately describes the HELLP syndrome? A.) Mild form of preeclampsia B.) Diagnosed by a nurse alert to its symptoms C.) Characterized by hemolysis, elevated liver enzymes, and low platelets D.) Associated with preterm labor but not perinatal mortality

Which statement regarding female sexual response is inaccurate? A.) Women and men are more alike than different in their physiologic response to sexual arousal and orgasm B.) Vasocongestion is the congestion of blood vessels C.) Orgasmic phase is the final state of the sexual response cycle D.) Facial grimaces and spasms of the hands and feet are often part of arousal

Which statement regarding the laboratory test for glycosylated hemoglobin Alc is correct? A.) The laboratory test for glycosylated hemoglobin Alc is performed for all pregnant women, not only those with or likely to have diabetes B.) This laboratory test is a snapshot of glucose control at the moment C.) This laboratory test measures the levels of hemoglobin Alc, which should remain at less than 7% D.) This laboratory test is performed on the woman's urine, not her blood

Which statement regarding the nutrient needs of breastfed infants is correct? A.) Breastfed infants need extra water in hot climates B.) During the first 3 months, breastfed infants consume more energy than formula-fed infants C.) Breastfeeding infants should receive oral vitamin D drops daily during at least the first 2 months D.) Vitamin K injections at birth are not necessary for breastfed infants

Which statement related to cephalopelvic disproportion (CPD) is the least accurate? A.) CPD can be related to either fetal size or fetal position B.) The fetus cannot be born vaginally C.) CPD can be accurately predicted D.) Causes of CPD may have maternal or fetal origins

Which statement, related to the reconditioning of the urinary system after childbirth, should the nurse understand? A.) Kidney function returns to normal a few days after birth B.) Diastasis recti abdominis is a common condition that alters the voiding reflex C.) Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium D.) With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth

Which symptom for a client taking an oral contraceptive pill (OCP) as her birth control method of choice requires immediate health care provider attention? A.) Breast tenderness and swelling B.) Weight gain C.) Swelling and pain in one of her legs D.) Mood swings

Which technique would the nurse use to assess the plantar reflex of an infant? A.) Touch the corner of the infant's mouth with a finger B.) Tap over the bridge of the infant's nose when awake C.) Place a finger at the base of the infant's toes D.) Place a finger in the palm of the infant's hand

Which technique would the nurse use to measure a newborn's physical growth? A.) Place and hold the naked newborn on the scale to obtain weight B.) Allow the caregiver to hold the infant while measuring his or her length C.) Measure the circumference of the head just above the eyebrows D.) Check the plantar reflex by placing a finger in the newborn's palm

Which type of cervical mucus would you expect when the woman is ovulating? A.) Scant B.) Thick, cloudy and sticky C.) Clear, wet, sticky and slippery D.) Cloudy, yellow or white, and sticky

While assessing the integument of a 24-hour-old newborn, the nurse notes a pink papular rash with vesicles superimposed on the thorax, back, and abdomen. What action is the highest priority for the nurse to take at this time? A.) Immediately notify the physician B.) Move the newborn to an isolation nursery C.) Document the finding as erythema toxicum neonatorum D.) Take the newborns temperature, and obtain a culture of one of the vesicles

Why is vitamin K administered to newborns? A.) It reduces bilirubin levels B.) It increases the production of red blood cells C.) It enhances the ability of blood to clot D.) It stimulates the formation of surfactant

With regard to weight gain during pregnancy, the nurse should be aware of which important information? A.) In pregnancy, the woman's height is not a factor in determining her target weight B.) Obese women may have their health concerns, but their risk of giving birth to a child with major congenital defects is the same as with women of normal weight C.) Women with inadequate weight gain have an increased risk of delivering a preterm infant with intrauterine growth restriction (IUGR) D.) Greater than expected weight gain during pregnancy is almost always attributable to old-fashioned overeating

Women with mild gestational hypertension and mild preeclampsia can be safely managed at home with frequent maternal and fetal evaluation. Complete or partial bed rest is still frequently ordered by some providers. Which complication is rarely the result of prolonged bed rest? A.) Thrombophlebitis B.) Psychologic stress C.) Fluid retention D.) Cardiovascular deconditioning

A blind woman has arrived for an examination. Her guide dog assists her to the examination room. She appears nervous and says, "I've never had a pelvic examination." What response from the nurse would be most appropriate? A.) Don't worry. It will be over before you know it B.) Try to relax. I'll be very gentle, and I won't hurt you C.) Your anxiety is common. I was anxious when I first had a pelvic examination D.) I'll let you touch each instrument that I'll use during the examination as I tell you how it will be used

A client is in early labor, and her nurse is discussing the pain relief options she is considering. The client states that she wants an epidural no matter what! What is the nurse's best response? A.) I'll make sure you get your epidural B.) You may only have an epidural if your physician allows it C.) You may only have an epidural if you are going to deliver vaginally D.) The type of analgesia or anesthesia used is determined, in part, by the stage of your labor and the method of birth

A client is using a basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, "My period is due in a few days, and my temperature has not gone up." Which is the most appropriate response? A.) "This probably means you're pregnant" B.) "Don't worry; it's probably nothing" C.) "Have you been ill this month?" D.) "You probably didn't' ovulate during this cycle"

A client who is an intravenous drug (IV) presents with fever and complains of arthritis, nausea, vomiting and mild abdominal pain. Which additional assessment is a priority for this client? A.) Assess if the client consumes alcohol B.) Assess if the client has had any vaccinations C.) Assess for signs of dehydration and malnutrition D.) Assess for hepatitis B surface antigen

A female client tells the nurse that her male partner prefers not to use condoms during intercourse. The client is worried that if she requests that he use a condom, her partner may be offended. Which advice would the nurse provide the client? A.) You will suffer terrible consequences if you don't use a condom B.) You can have unprotected sex once in a while, but use a condom often C.) Carry condoms with you, and demand that your partner use one if he wants to have sex D.) Discuss the importance of using condoms at a time when you are not having sex

A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization, the infant is weighed, and the birth weight is 4550 g (9 lb, 6 oz). What is the nurse's first priority? A.) Leave the infant in the room with the mother B.) Immediately take the infant to the nursery C.) Perform a gestational age assessment to determine whether the infant is large for gestational age D.) Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia

A newly delivered mother who intends to breastfeed tells her nurse, I am so relieved that this pregnancy is over so that I can start smoking again. The nurse encourages the client to refrain from smoking. However, this new mother is insistent that she will resume smoking. How will the nurse adapt her health teaching with this new information? A.) Smoking has little-to-no effect on milk production B.) No relationship exists between smoking and the time of feedings C.) The effects of secondhand smoke on infants are less significant than for adults D.) The mother should always smoke in another room

A nurse in labor and delivery is planning care for a newly admitted client who reports she is in labor and has been having vaginal bleeding for 2 weeks. Which of the following should the nurse include in the plan of care? A.) Inspect the introitus for a prolapsed cord B.) Perform a test to identify the ferning pattern C.) Monitor station of the presenting part D.) Defer vaginal examinations

A nurse in the labor and delivery unit receives a phone call from a client who reports that her contractions started about 2 hours ago, did not go away when she had two glasses of water and rested, and became stronger since she started walking. Her contractions occur every 10 min and last about 30 seconds. She hasn't had any fluid leak from her vagina. However, she saw some blood when she wiped after voiding. Based on this report, which of the following should the nurse recognize that the client is experiencing? A.) Braxton Hicks contractions B.) Rupture of membranes C.) Fetal descent D.) True contractions

A nurse is caring for a client who is in the first stage of labor and is encouraging the client to void every 2 hr. Which of the following statements should the nurse make? A.) "A full bladder increases the risk for fetal trauma." B.) "A full bladder increases the risk for bladder infections." C.) "A distended bladder will be traumatized by frequent pelvic exams." D.) "A distended bladder reduces pelvic space needed for birth."

A nurse is providing education to a support group of women newly diagnosed with breast cancer. It is important for the nurse to discuss which factor related to breast cancer with the group? A.) Genetic mutations account for 50% of women who will develop breast cancer B.) Breast cancer is the leading cause of cancer death in women C.) In the United States, 1 in 10 women will develop breast cancer in her lifetime D.) The exact cause of breast cancer remains unknown

A pregnant client after 20 weeks of gestation reports painless bright red vaginal bleeding. On assessment, the nurse finds that the client vital signs are normal. Which condition would the nurse suspect in the client? A.) Eclampsia B.) Preeclampsia C.) Pyelonephritis D.) Placenta previa

A pregnant client at 28 weeks of gestation has been diagnosed with gestational diabetes. Which nursing action is appropriate when caring for this client? A.) Oral hypoglycemic agents can be used if the client is reluctant to give herself insulin B.) Dietary modifications and insulin are both required for adequate treatment C.) Glucose levels are monitored by testing urine four times a day and at bedtime D.) Dietary management involved disturbing nutrient requirements over three meals and two or three snacks

A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expectant parents class. Which aspect of their birth plan should be considered potentially unrealistic and require further discussion with the nurse? A.) My husband and I have agreed that my sister will be my coach because he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure everything is okay B.) We plan to use the techniques taught in the Lamaze classes to reduce the pain experienced during labor C.) We want the labor and birth to take place in a birthing room. My husband will come in the minute the baby is born D.) Regardless of the circumstances, we do not want the fetal monitor used during labor because it will interfere with movement and doing effleurage

A pregnant woman at 33 weeks of gestation is brought to the birthing unit after a minor automobile accident. The client is experiencing no pain and no vaginal bleeding, her vital signs are stable, and the FHR is 132 beats per minute with variability. What is the nurses highest priority? A.) Monitoring the woman for a ruptured spleen B.) Obtaining a physician's order to discharge her home C.) Monitoring her for 24 hours D.) Using continuous EFM for a minimum of 4 hours

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. The fetal heart rate (FHR) before birth is 180 beats per minute with limited variability. At birth the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic. Based on the maternal history, what is the most likely cause of this newborns distress? A.) Hypoglycemia B.) Phrenic nerve injury C.) Respiratory distress syndrome D.) Sepsis

A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The FHR has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. What disposition would the nurse anticipate? A.) Admitted and prepared for a cesarean birth B.) Admitted for extended observation C.) Discharged home with a sedative D.) Discharged home to await the onset of true labor

A primiparous woman is delighted with her newborn son and wants to begin breastfeeding as soon as possible. How should the client be instructed to position the infant to facilitate correct latch-on? A.) The infant should be positioned with his or her arms folded together over the chest B.) The infant should be curled up in a fetal position C.) The woman should cup the infant's head in her hand D.) The infant's head and body should be in alignment with the mother

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding indicates that preterm labor is occurring? A.) Estriol is not found in maternal saliva B.) Irregular, mild uterine contractions are occurring every 12 to 15 minutes C.) Fetal fibronectin is present in vaginal secretions D.) The cervix is effacing and dilated to 2 cm

A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes, dark red vaginal bleeding, and a tense, painful abdomen. Which clinical change does the nurse anticipate? A.) Eclamptic seizure B.) Rupture of the uterus C.) Placenta previa D.) Abruptio placentae

A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is approximately twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. Which intervention should the nurse immediately initiate? A.) Contact the woman's physician B.) Tell the woman to slow her pace of her breathing C.) Administer oxygen via a mask or nasal cannula D.) Help her breathe into a paper bag

A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she does not know what is happening; one minute she is happy that she is pregnant and the next minute she cries for no reason. Which response by the nurse is most appropriate? A.) Don't worry about it; you'll feel better in a month or so B.) Have you talked to your husband about how you feel? C.) Perhaps you really don't want to be pregnant D.) Hormone changes during pregnancy commonly result in mood swings

A woman who is 16 weeks pregnant has come in for a follow-up visit with her significant other. To reassure the client regarding fetal well-being, which is the highest priority action for the nurse to perform? A.) Assess the fetal heart tones with a Doppler stethoscope B.) Measure the girth of the woman's abdomen C.) Complete an ultrasound examination (sonogram) D.) Offer the woman and her family the opportunity to listen to the fetal heart tones

A woman who is at 36 weeks of gestation is having a nonstress test. Which statement indicates her 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 nauseated" C.) "This test will help to determine if the baby has Down Syndrome or a neural tube defect" D.) "This test observes for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby"

Certain changes stimulate chemoreceptors in the aorta and carotid bodies to prepare the fetus for initiating respirations immediately after birth. Which change in fetal physiologic activity is not part of this process? A.) Fetal lung fluid is cleared from the air passages during labor and vaginal birth B.) Fetal partial pressure of oxygen (PO2) decreases C.) Fetal partial pressure of carbon dioxide in arterial blood (PaCO2) increases D.) Fetal respiratory movements increase during labor

During a prenatal check-up a client who is 7 months pregnant reports that she is able to feel about two kicks in an hour. The nurse refers the client for an ultrasound, and which is the primary reason for this referral? A.) To check for fetal anomalies B.) To check gestational age C.) To check fetal position D.) To check for fetal well-being

During a prenatal evaluation, the nurse notes that the client has a flat pelvis. Which term would the nurse use in documenting the findings? A.) Gynecoid B.) Android C.) Anthropoid D.) Platypelloid

During the vaginal examination of a client in labor, the nurse identifies the presenting part as the scapula. Which fetal presentation would the nurse recognize? A.) Cephalic B.) Frank breech C.) Complete breech D.) Shoulder

Early this morning, an infant boy was circumcised using the PlastiBell method. Based on the nurses evaluation, when will the infant be ready for discharge? A.) When the bleeding completely stops B.) When yellow exudate forms over the glans C.) When the PlastiBell plastic rim (bell) falls off D.) When the infant voids

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, which finding alerts the nurse to possible side effects? A.) Urine output of 160 ml in 4 hours B.) DTRs 2+ and no clonus C.) Respiratory rate (RR) of 16 breaths per minute D.) Serum magnesium level of 10 mg/dl

In her work with pregnant women of different cultures, a nurse practitioner has observed various practices that seemed unfamiliar. The nurse practitioner has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which statement best describes that purpose? A.) To promote family unity B.) To ward off the evil eye C.) To appease the gods of fertility D.) To protect the mother and fetus during pregnancy

In planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the: A.) Mother's age B.) Number of years since diabetes was diagnosed C.) Amount of insulin required prenatally D.) Degree of glycemic control during pregnancy

Many pregnant women have questions regarding work and travel during pregnancy. Which education is a priority for the nurse to provide? A.) Women should sit for as long as possible and cross their legs at the knees from time to time for exercise B.) Women should avoid seat belts and shoulder restraints in the car because they press on the fetus C.) Metal detectors at airport security checkpoints can harm the fetus if the woman passes through them a number of times D.) While working or traveling in a car or on an airplane, women should arrange to walk around at least every hour or so

Maternity nurses often have to answer questions about the many, sometimes unusual, ways people have tried to make the birthing experience more comfortable. Which information regarding nonpharmacologic pain relief is accurate? A.) Music supplied by the support person has to be discouraged because it could disturb others or upset the hospital routine B.) Women in labor can benefit from sitting in a bathtub, but they must limit immersion to no longer than 15 minutes at a time C.) Effleurage is permissible, but counterpressure is almost always counterproductive D.) Electrodes attached to either side of the spine to provide high-intensity electrical impulses facilitate the release of endorphins

Numerous changes in the integumentary system occur during pregnancy. Which change persists after birth? A.) Epulis B.) Chloasma C.) Telangiectasia D.) Striae gravidarum

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including which items? A.) Chorionic villus sampling (CVS) is becoming more popular because it provides earlier diagnosis B.) Screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for neural tube defects C.) Percutaneous umbilical blood sampling (PUBS) is one of the quad-screen tests for Down Syndrome D.) Maternal serum alpha-fetoprotein (MSAFP) is a screening tool only; it identified candidates for more definitive procedures

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy. Which statement regarding monitoring techniques is the most accurate? A.) Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis B.) MSAFP screening is recommended only for women at risk for NTDs C.) PUBS is one of the triple-marker tests for Down syndrome D.) MSAFP is a screening tool only; it identifies candidates for more definitive diagnostic procedures

Nutrition is an alterable and important preventive measure for a variety of potential problems such as low birth weight and prematurity. While completing the physical assessment of the pregnant client, the nurse is able to evaluate the clients nutritional status by observing a number of physical signs. Which physical sign indicates to the nurse that the client has unmet nutritional needs? A.) Normal heart rate, rhythm, and blood pressure B.) Bright, clear, and shiny eyes C.) Alert and responsive with good endurance D.) Edema, tender calves, and tingling

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. What is the nurses highest priority at this time? A.) Beginning an intravenous (IV) infusion of Ringer's lactate solution B.) Assessing the woman's vital signs C.) Calling the woman's primary health care provider D.) Massaging the woman's fundus

Screening for critical congenital heart disease (CCHD) was added to the uniform screening panel in 2011. The nurse has explained this testing to the new mother. Which action by the nurse related to this test is correct? A.) Screening is performed when the infant is 12 hours of age B.) Testing is performed with an electrocardiogram C.) Oxygen (O2) is measured in both hands and in the right foot D.) A passing result is an O2 saturation of 95%

Since the gene for cystic fibrosis was identified in 1989, data can be collected for the purposes of genetic counseling for couples regarding carrier status. According to the most recent statistics, how often does cystic fibrosis occur in Caucasian live births? A.) 1 in 100 B.) 1 in 1000 C.) 1 in 2000 D.) 1 in 3200

Syphilis is a complex disease that can lead to serious systemic illness and even death if left untreated. Which manifestation differentiates primary syphilis from secondary syphilis? A.) Fever, headache, and malaise B.) Widespread rash C.) Identified by serologic testing D.) Appearance of a chancre 2 months after infection

The brain is vulnerable to nutritional deficiencies and trauma in early infancy. What is the rationale for this physiologic adaptation in the newborn? A.) Incompletely developed neuromuscular system B.) Primitive reflex system C.) Presence of various sleep-wake states D.) Cerebellum growth spurt

The nurse appreciates a murmur when assessing a neonate in resting position. Which additional assessments would the nurse make to identify possible cardiac defects? A.) Measure the circumference of the head B.) Assess movements of the lower extremities C.) Monitor blood pressure (BP) in the upper extremities D.) Assess blood pressure (BP) in all four exremities

The nurse finds that the blood pH of a pregnant client who is diabetic is 6.5. What would the nurse administer to normalize the client's blood pH? A.) Dextrose solution B.) Normal saline solution C.) Sodium citrate solution D.) Sodium bicarbonate solution

The nurse has evaluated a client with preeclampsia by assessing DTRs. The result is a grade of 3+. Which DTR response most accurately describes this score? A.) Sluggish or diminished B.) Brisk, hyperactive, with intermittent or transient clonus C.) Active or expected response D.) More brisk than expected, slightly hyperactive

The nurse is administering glucocorticoids to a pregnant client in preterm labor. When exploring the purpose of this medicine to the client, which response by the nurse is accurate? A.) To prevent fetal cerebral palsy B.) To prevent early birth of the fetus C.) To prevent gestational hypertension D.) To prevent fetal respiratory distress syndrome

The nurse is caring for a client in the first stage of labor and notes that the client has scarring on her cervix as a result of a past STI. Which complication would the nurse predict in the client during labor? A.) Ferguson reflex B.) Slow fetal descent C.) Supine hypotension D.) Slow cervical dilation

The nurse is caring for a client with gestational diabetes. Which education would the nurse provide the client regarding the use of insulin? A.) Store unused vials of insulin in the freezer B.) Shake the prepared syringes well before use C.) Administer long-acting insulin before meals D.) Inject insulin in the abdomen

The nurse is caring for a client with insulin-dependent diabetes mellitus in the first trimester of pregnancy. The client feels dizzy and lethargic and her blood glucose level is 50 mg/dL. What is the priority nursing action in this case? A.) Ask the dietician to recommend a sugar-free diet to the client B.) Assess the client about symptoms of retinopathy and nephropathy C.) Assess serum progesterone and estrogen levels D.) Provide the client a dose of glucose gel or a glucose tablet

The nurse is caring for a client with preeclampsia who is receiving an intravenous (IV) magnesium sulfate infusion. In assessing the client every 20 minutes, which maternal findings would require immediate intervention by the nurse? A.) Deep tendon reflexes of 2+ B.) Urinary output of 30 mL/hour C.) Blood pressure of 130/90 mmHg D.) Respiratory rate of 9 breaths/min

The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge, called lochia. Which statement is the most appropriate? A.) Lochia is similar to a light menstrual period for the first 6 to 12 hours B.) It is usually greater after cesarean births C.) Lochia will usually decrease with ambulation and breastfeeding D.) It should smell like normal menstrual flow unless an infection is present

The nurse is teaching a group of student nurses about fetal oxygenation. The nurse asks a student. "What happens when oxytocin levels are elevated in the client?" Which statement by the student nurse indicates effective learning related to the client's condition? A.) "Hemoglobin levels will decrease" B.) "Blood glucose levels will increase" C.) "There is a lower blood supply to the placenta" D.) "Uterine contractions will increase"

The nurse is using intermittent auscultation (IA) to locate the fetal heartbeat. Which statement regarding this method of surveillance is accurate? A.) The nurse can be expected to cover only two or three clients when IA is the primary method of fetal assessment B.) The best course is to use the descriptive terms associated with EFM when documenting results C.) If the heartbeat cannot be immediately found, then a shift must be made to EFM D.) Ultrasound can be used to find the FHR and to reassure the mother if the initial difficulty is a factor

The nurse is using the CRIES pain scale to determine the pain level is a circumcised infant. What does a score of 1 for "Sleeplessness" indicate? A.) The infant has been constantly awake B.) The infant has been asleep for one hour C.) The infant has awakened only when touched D.) The infant has awakened at frequent intervals

The nurse performs a vaginal examination to assess a client's labor progress. Which action should the nurse take next? A.) Perform an examination at least once every hour during the active phase of labor B.) Perform the examination with the woman in the supine position C.) Wear two clean gloves for each examination D.) Discuss the findings with the woman and her partner

The nursing instructor is teaching nursing students about the daily fetal movement count. Which statement by a student indicates a need for further teaching? A.) "Fetal movements decrease in clients who consume alcohol" B.) "Fetal movements cannot be detected during the fetus sleep cycle C.) "Fetal movements cannot be easily detected in obese clients" D.) "Fetal movements decrease one week before the expected date of delivery"

The obstetric nurse is preparing the client for an emergency cesarean birth, with no time to administer spinal anesthesia. The nurse is aware of and prepared for the greatest risk of administering general anesthesia to the client. What is this risk? A.) Respiratory depression B.) Uterine relaxation C.) Inadequate muscle relaxation D.) Aspiration of stomach contents

Which action is the first priority for the nurse who is assessing the influence of culture on a client's diet? A.) Evaluate the client's weight gain during pregnancy B.) Assess the socioeconomic status of the client C.) Discuss the four food groups with the client D.) Identify the food preferences and methods of food preparation common to the clients culture

Which action would be inappropriate for the nurse to perform before beginning the health history interview? A.) Smile and ask the client whether she has any special concerns B.) Speak in a relaxed manner with an even, nonjudgmental tone C.) Make the client comfortable D.) Tell the client her questions are irrelevant

Which assessment by the client indicates the need for further teaching about palpating the cervix to assess changes that indicate ovulation? A.) "The cervical os becomes slightly dilated during ovulation" B.) "The cervical mucus is watery and clear during ovulation" C.) "The cervix softens and rises in the vagina during ovulation" D.) "The cervical mucus is copious and thick during ovulation"

Which assessment finding is most concerning for a client who is at 38 weeks of gestation and is having difficulty catching her breath, even when sitting? A.) Ansarca B.) Irregular heartbeat C.) Displaced point of maximum impulse (PMI) D.) 5-pound weight gain over the past week

Which assessment finding would the nurse recognize as a sign of possible seizure activity? A.) Tremors are easily elicited by a sound or motion B.) Tremors cease with gentle restraint of the extremity C.) Tremors reduce or stop with passive flexion D.) Tremors are accompanied by ocular changes

Which assessment is least likely to be associated with a breech presentation? A.) Meconium-stained amniotic fluid B.) Fetal heart tones heard at or above the maternal umbilicus C.) Preterm labor and birth D.) Postterm gestation

Which assessment regarding the effects of fear and anxiety during labor would the nurse observe in caring for a client in the last trimester of pregnancy? A.) Increased blood flow B.) Increase in the progression of labor C.) Increased contractions D.) Increase in muscle tension

Which client action might lead to an infant avoiding latching on to the breast? A.) The client breastfeeds the infant at scheduled times only B.) The client gives honey to the infant before breastfeeding C.) The client stopped making skin-to-skin contact with the infant D.) The client has been feeding the infant both formula and breast milk

Which collection of risk factors will most likely result in damaging lacerations, including episiotomies? A.) Dark-skinned woman who has had more than one pregnancy, who is going through prolonged second-stage labor, and who is attended by a midwife B.) Reddish-haired mother of two who is going through a breech birth C.) Dark-skinned first-time mother who is going through a long labor D.) First-time mother with reddish hair whose rapid labor was overseen by an obstetrician

Which complications are increased in pregnant clients with gonococcal infection? A.) Condylomata lata B.) Tuboovarian abscess C.) Chlamydial infection D.) Amniotic infection syndrome

Which condition describes the pregnant client with severe and persistent vomiting who has lost weight, is dehydrated and has electrolyte abnormalities? A.) Tetany B.) Glossitis C.) Hypocalcemia D.) Hyperemesis gravidarum

Which condition is appropriate for the client with dysmenorrhea who has been prescribed nonsteroidal antiinflammatory drugs (NSAIDs) and is passing dark-colored stools 1 week after therapy? A.) Hemorrhoids B.) Allergy to NSAIDs C.) Gastrointestinal infection D.) Gastrointestinal bleeding

Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during the puerperium? A.) Varicosities of the legs B.) Carpal tunnel syndrome C.) Periodic numbness and tingling of the fingers D.) Headaches

Which definition of an acceleration in the fetal heart rate (FHR) is accurate? A.) FHR accelerations are indications of fetal well-being when they are periodic B.) FHR accelerations are greater and longer in preterm gestations C.) FHR accelerations are usually observed with breech presentations when they are episodic D.) An acceleration in the FHR presents a visually apparent and abrupt peak

Which degree of severity is indicated for a client's perineal laceration involving the anterior rectal wall during childbirth? A.) First degree B.) Second degree C.) Third degree D.) Fourth degree

Which device would the nurse use for monitoring the intensity of uterine contractions in a pregnant client? A.) Tocotransducer B.) Spiral electrode C.) Ultrasound transducer D.) Intrauterine pressure catheter (IUPC)

Which drug prevents the risk of cerebral palsy in the fetus? A.) Nifedipine B.) Propranolol C.) Dexamethasone D.) Magnesium sulfate

Which fetal complication is increased by maternal cigarette smoking? A.) Spina bifida B.) Anencephaly C.) Facial deformities D.) Low birth weight

Which fetal impairment is the nurse trying to prevent by recommending the pregnant client avoid fish such as swordfish, tilefish and king mackrel? A.) Bone development B.) Protein metabolism C.) Hemoglobin formation D.) Neurologic development

Which food is a common protein source for a Mexican client who is pregnant? A.) Veal B.) Mussels C.) Dal (lentils) D.) Chorizo (sausage)

Which gastrointestinal alteration of pregnancy is a normal finding? A.) Insufficient salivation (ptyalism) is caused by increases in estrogen B.) Acid indigestion (pyrosis) begins early but declines throughout pregnancy C.) Hyperthyroidism often develops (temporarily) because hormone production increases D.) Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial

Which information can be interpreted from the nurse observing inverted nipples on the breasts of a pregnant client? A.) The client had breast reduction surgery in the past B.) The client applied iodine tincture on the nipples C.) These are normal breast changes during pregnancy D.) The client's baby will probably have difficulty latching

Which interpretation would the nurse have for an Apgar score of 10 at 1 minute after birth? A.) An infant having no difficulty adjusting to extrauterine life and needing no further testing B.) An infant in severe distress who needs ressuscitation C.) A prediction of a future free of neurologic problems D.) An infant having no difficulty adjusting to extrauterine life but who should be assessed again at 5 minutes after birth

Which intervention is appropriate for the professional gymnast client with amenorrhea and low body mass index? A.) Administering aspirin with oral contraceptives to the athlete B.) Administering 200 mg nafarelin by nasal spray to the athlete C.) Administering 1200 mg calcium and 90 mg potassium to the athlete D.) Suggesting a healthful diet and encouraging deep-breathing exercises

Which is a priority nursing action when a pregnant client with severe gestational hypertension is admitted to the health care facility? A.) Prepare the client for cesarean delivery B.) Administer intravenous and oral fluids C.) Provide diversionary activities during bed rest D.) Administer the prescribed magnesium sulfate

Which medication is ideal for the treatment of systemic lupus erythematosus (SLE) in a pregnant client? A.) Aspirin B.) Azathioprine C.) Prednisone D.) Hydroxychloroquine

Which medication is recommended treatment for the prevention of human immunodeficiency virus (HIV) transmission to the fetus during pregnancy? A.) Acyclovir B.) Ofloxacin C.) Podophyllin D.) Zidovudine

Which medication would the primary health care provider ask the nurse to administer to a client who has a history of a myocardial infarction (MI) and is having a vaginal delivery? A.) Oxytocin B.) Diuretics C.) Anticoagulant D.) Epidural analgesia

Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus? A.) Notify the physician of an impending hemorrhage B.) Assess the blood pressure and pulse C.) Evaluate the lochia D.) Assist the client in emptying her bladder

Which nursing advice is appropriate for a 13 year old client who recently began menstruating and has had irregular bleeding since her cycle began? A.) "There may be some underlying disease" B.) "It's likely being caused by a urinary tract infection" C.) "You need to include more calcium in your diet" D.) "Bleeding may be irregular for the first 2 years"

Which nursing advice is appropriate for the 14-week pregnant client asks if it is safe to have a drink with dinner now that her first trimester is complete? A.) "Because you're in your second trimester, there's no problem with having one drink with dinner" B.) "One drink every night is too much. One drink three times a week should be fine" C.) "Because you're in your second trimester, you can drink as much as you like" D.) "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy"

Which nursing advice is appropriate for the pregnant client who wants to have a nurse-midwife provide obstetric care? A.) She will have to give birth at home B.) She must see an obstetrician and the midwife during pregnancy C.) She will not be able to have epidural analgesia for labor pain D.) She must be having a low-risk pregnancy

Which nursing information is appropriate for a client who is prescribed a single-rod etonogestrel implant (Implanon) for contraception and believes she can have multiple sexual partners now? A.) "Your partners will have to use a condom lubricated with N-9" B.) "Encourage your partners to use a natural skin condom" C.) "It is better to use a condom, because there may be a risk for pregnancy" D.) "You must avoid multiple sexual partners and use a condom to prevent sexually transmitted infections"

Which nursing information is appropriate for the client who reports having her menses on May 11, some light bleeding on May 26 and her next menses on June 8? A.) "Please come again after your next menses" B.) "Your menstrual cycle has a duration of 15 days' C.) "You may need to undergo an ultrasound examination of the uterus" D.) "Having bleeding in the middle of your cycle is a normal finding"

Which nursing information is appropriate when reassuring and educating the pregnant client about changes in her blood pressure? A.) A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high B.) Shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit C.) The systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant D.) Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the latter stage of term pregnancy

Which nursing report is appropriate for an expectant couple that asks about intercourse during pregnancy and if it is safe for the baby? A.) Intercourse should be avoided if any spotting from the vagina occurs afterward B.) Intercourse is safe until the third trimester C.) Safer-sex practices should be used once the membranes rupture D.) Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present

Which part of the menstrual cycle includes the stimulated release of gonadotropin-releasing hormone (GnRH) and follicle-stimulating hormone (FSH)? A.) Menstrual phase B.) Endometrial cycle C.) Ovarian cycle D.) Hypothalamic-pituitary cycle

Which physiologic alteration of pregnancy most significantly affects glucose metabolism? A.) Pancreatic function in the islets of Langerhans is affected by pregnancy B.) Pregnant women use glucose at a more rapid rate than nonpregnant women C.) Pregnant women significantly increase their dietary intake D.) Placental hormones are antagonistic to insulin, thus resulting in insulin resistance

Which position would the nurse identify as effective in facilitating the rotation of a fetus from a posterior occipital to an anterior occiput presentation? A.) Squatting B.) Ambulation C.) Birthing ball D.) Hands and knees

Which postpartum complication is indicated for the client who has lost 600 mL of blood within 24 hours and has a soft and relaxed uterus? A.) Mastitis B.) Puerperal infectuion C.) Venous thromboembolism D.) Postpartum hemorrhage

Which reason explains the nursing advice of placing a heating pad over the abdomen to reduce dysmenorrhea pain? A.) Blocking pain perception B.) Releasing endogenous opiates C.) Relaxing the paravertebral muscles D.) Increasing vasodilation and minimizing uterine ischemia

Which recommendation would the nurse make to the parents of a newborn about traveling with the infant in a car? A.) Secure and position the infant upright in the car seat B.) Place the infant in a forward-facing car seat after 6 months of age C.) Place the infant seat in the front in the car with front air bags D.) Secure the infant in a rear-facing car seat in the rear of the car

Which relevant drug history is appropriate for the client who had a dark complexion with brownish pigmentation over the cheeks, nose and forehead during pregnancy, which has faded and has recurred? A.) Antibiotics B.) Antipsoriatics C.) Antihistamines D.) Contraceptives

Which risk factor would the nurse recognize as being frequently associated with osteoporosis? A.) African-American race B.) Low protein intake C.) Obesity D.) Cigarette smoking

Which sign or symptom is considered a first-trimester warning sign and should be immediately reported by the pregnant woman to her health care provider? A.) Nausea with occasional vomiting B.) Fatigue C.) Urinary frequency D.) Vaginal bleeding

Which sign would the nurse observe in a client with hydatidiform mole? A.) Clear vaginal discharge B.) A small uterus C.) Decreased fetal heart rate D.) Dark brown vaginal discharge

Which site of examination is appropriate for the client with cervical cancer? A.) Clitoris B.) Fallopian tube C.) Bartholin glands D.) Transformation zone

Which statement best describes chronic hypertension? A.) Chronic hypertension is defined as hypertension that begins during pregnancy and lasts for the duration of the pregnancy B.) Chronic hypertension is considered severe when the systolic BP is higher than 140 mm Hg or the diastolic BP is higher than 90 mm Hg C.) Chronic hypertension is general hypertension plus proteinuria D.) Chronic hypertension can occur independently of or simultaneously with preeclampsia

Which statement by the client indicates the need for further teaching about health promotion and vaccinations? A.) Vaccinating the mother against rubella before pregnancy protects the fetus B.) Vaccination prevents some sexually transmitted infections (STIs) C.) The shingles vaccine is given to women at about 65 years of age D.) The human papillomavirus (HPV) vaccine eliminated the need for the Papanicolaou (Pap) test

Which statement by the student nurse student regarding the management of reduced cervical competence (premature dilation of the cervix) indicates effective learning? A.) "Progesterone supplementation is the only effective treatment" B.) "An abdominal cerclage is performed in the first week of gestation" C.) "Surgical treatment is ineffective in women with an extremely short cervix" D.) "A prophylactic cerclage is used to constrict the internal os of the cervix"

Which statement correctly describes the effects of various pain factors? A.) Higher prostaglandin levels arising from dysmenorrhea can blunt the pain of childbirth B.) Upright positions in labor increase the pain factor because they cause greater fatigue C.) Women who move around trying different positions experience more pain D.) Levels of pain-mitigating beta-endorphins are higher during a spontaneous, natural childbirth

Which statement is accurate regarding primary dysmenorrhea? A.) It is experienced by all women B.) It is not affected by oral contraceptives C.) It occurs in young, multiparous women D.) It may be caused by excessive endometrial prostaglandin

Which statement is the most complete and accurate description of medical abortions? A.) Medical abortions are performed only for maternal health B.) They can be achieved through surgical procedures or with drugs C.) Medical abortions are mostly performed in the second trimester D.) They can be either elective or therapeutic

Which statement mades by the pregnant client indicates that she and her husband are adapting to the pregnancy? A.) "I am still in shock that I am pregnant" B.) "I'm not sure that I'm ready for parenthood" C.) "My husband is unsure of everything and is distant" D.) "I plan to take an extended leave of absence after the birth"

Which statement regarding the care of a client in labor is correct and important to the nurse as he or she formulates the plan of care? A.) The woman's blood pressure will increase during contractions and fall back to prelabor normal levels between contractions B.) The use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxia. C.) Having the woman point her toes will reduce leg cramps D.) Endogenous endorphins released during labor will raise the woman's pain threshold and produce sedation.

Which statement regarding the term contraceptive failure rate is the most accurate? A.) The contraceptive failure rate refers to the percentage of users expected to have an accidental pregnancy over a 5-year span B.) It refers to the minimum rate that must be achieved to receive a government license C.) The contraceptive failure rate increases over time as couples become more careless D.) It varies from couple to couple, depending on the method and the users

Which stool assessment finding would prompt the nurse to evaluate a newborn's breastfeeding effectiveness? A.) Greenish yellow, loose stools on the third day B.) Yellow, soft, and seedy stools on the seventh day C.) Greener, thinner and less sticky stools on the second day D.) Greenish black, thick and sticky meconium stools on the third day

Which strengths and limitations of various biochemical assessments during pregnancy should the nurse be aware of? A.) Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis B.) Screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for neural tube defects C.) Percutaneous umbilical blood sampling (PUBS) is one of the quad-screen tests for Down syndrome D.) MSAFP is a screening tool only; it identifies candidates for more definitive procedures

Which technique would the nurse use to distinguish cutaneous jaundice from the normal skin color of a neonate? A.) Evaluate the size of the nipples B.) Measure the circumference of the head C.) Observe the symmetry of lip movement D.) Apply pressure on the forehead with a finger

Which technology to test for human chorionic gonadotropin (hCG) is used in over-the-counter (OCT) pregnancy tests? A.) Radioimmunoassay B.) Radioreceptor assay C.) Latex agglutination test D.) Enzyme-linked immunosorbent assay (ELISA)

Which term best describes the interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state? A.) Involutionary period because of what happens to the uterus B.) Lochia period because of the nature of the vaginal discharge C.) Mini-tri period because it lasts only 3 to 6 weeks D.) Puerperium, or fourth trimester of pregnancy

Which tool is the most sensitive assessment for the diagnosis of placental abruption after abdominal trauma? A.) Ultrasonography B.) Kleihauer-Betke assay C.) Abdominal palpation D.) External fetal monitoring

Which vitamins or minerals may lead to congenital malformations of the fetus if taken in excess by the mother? A.) Zinc B.) Vitamin D C.) Folic acid D.) Vitamin A

Why does the evaluation of abnormal Papanicolaou (Pap) tests during pregnancy become complicated? A.) The cervix is larger B.) The cervix is more oval in shape C.) The cervix is more soft and velvety D.) The squamocolumnar junction is located away from cervix

Why would the nurse suggest that a client stimulates her baby's lips with her nipple while breastfeeding? A.) To prevent nipple trauma B.) To encourage the baby to swallow the milk C.) To reduce pain while feeding the infant D.) To stimulate the baby to open his or her mouth

A nurse providing couplet care should understand the issue of nipple confusion. In which situation might this condition occur? A.) Breastfeeding babies receive supplementary bottle feedings B.) Baby is too abruptly weaned C.) Pacifiers are used before breastfeeding is established D.) Twins are breastfed together

What is the correct term for a woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability? A.) Primipara B.) Primigravida C.) Multipara D.) Nulligravida

A perimenopausal client has arrived for her annual gynecologic examination. Which preexisting condition would be extremely important for the nurse to identify during a discussion regarding the risks and benefits of hormone therapy? A.) Breast cancer B.) Vaginal and urinary tract atrophy C.) Osteoporosis D.) Arteriosclerosis

A perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the client is experiencing profuse bleeding. What is the most likely cause for this bleeding? A.) Uterine atony B.) Uterine inversion C.) Vaginal hematoma D.) Vaginal laceration

What is the correct term for the cheeselike, white substance that fuses with the epidermis and serves as a protective coating? A.) Vernix caseosa B.) Surfactant C.) Caput succedaneum D.) Acrocyanosis

What is the correct term used to describe the mucous plug that forms in the endocervical canal? A.) Operculum B.) Leukorrhea C.) Funic souffle D.) Ballottement

Which category of weight is appropriate for the client with a calculated body mass index (BMI) of 32? A.) Obesity B.) Appropriate C.) Underweight D.) Overweight

A pregnant client reports abdominal pain in the right lower quadrant, along with nausea and vomiting. The urinalysis report shows an absence of urinary tract infection. A chest x-ray also rules out lower-lobe pneumonia. Which client condition would the nurse suspect? A.) Appendicitis B.) Cholethiasis C.) Placenta previa D.) Uterine rupture

Which client condition would the nurse relate to hypoglycemia in a diabetic client? A.) Clammy skin B.) Rapid breathing C.) Nausea or vomiting D.) Increased urination

A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding? A.) Melasma B.) Linea nigra C.) Striae gravidarum D.) Palmar erythema

A pregnant client who is in preterm labor has been prescribed dexamethasone. The nurse knows the reason for administering this drug would be to facilitate which action? A.) Maturation of fetal lungs B.) Relaxation of smooth muscles C.) Inhibition of uterine contractions D.) Central nervous system (CNS) depresssion

Which client would not be a suitable candidate for internal EFM? A.) Client who still has intact membranes B.) Woman whose fetus is well engaged in the pelvis C.) Pregnant woman who has a comorbidity of obesity D.) Client whose cervix is dilated to 4 to 5 cm

A pregnant woman arrives at the birth unit in labor at term, having had no prenatal care. After birth, her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. Based on her infants physical findings, this woman should be questioned about her use of which substance during pregnancy? A.) Alcohol B.) Cocaine C.) Heroin D.) Marijuana

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. Which recommendation would the nurse make for this particular client after a tennis match? A.) Drink several glasses of fluid B.) Eat extra protein sources such as peanut butter C.) Enjoy salty foods to replace lost sodium D.) Consume easily digested sources of carbohydrate

Which is the most appropriate time to determine the station of the presenting part in a pregnant client? A.) When the labor begins B.) One week before the labor C.) During the fourth stage of labor D.) At the end of the third stage of labor

Fibrocystic changes in the breast most often appear in women in their 20s and 30s. Although the cause is unknown, an imbalance of estrogen and progesterone may be the cause. The nurse who cares for this client should be aware that treatment modalities are conservative. Which proven modality may offer relief for this condition? A.) Diuretic administration B.) Daily inclusion of caffeine in the diet C.) Increased vitamin C supplementation D.) Application of cold packs to the breast as necessary

A pregnant woman wants to breastfeed her infant; however, her husband is not convinced that there are any scientific reasons to do so. The nurse can give the couple printed information comparing breastfeeding and bottle feeding. Which statement regarding bottle feeding using commercially prepared infant formulas might influence their choice? A.) Bottle feeding using a commercially prepared formula increases the risk that the infant will develop allergies B.) Bottle feeding helps the infant sleep through the night C.) Commercially prepared formula ensures that the infant is getting iron in a form that is easily absorbed D.) Bottle feeding requires that multivitamin supplements be given to the infant

For which condition is the client at risk in early pregnancy due to poorly controlled hyperglycemia? A.) Miscarriage B.) Hydramnios C.) Preeclampsia D.) Ketoacidosis

A nurse is discussing the storage of breast milk with a mother whose infant is preterm and in the special care nursery. Which statement indicates that the mother requires additional teaching? A.) I can store my breast milk in the refrigerator for 3 months B.) I can store my breast milk in the freezer for 3 months C.) I can store my breast milk at room temperature for 4 hours D.) I can store my breast milk in the refrigerator for 3 to 5 days

A laboring woman is reclining in the supine position. What is the most appropriate nursing action at this time? A.) Ask her to turn to one side B.) Elevate her feet and legs C.) Take her blood pressure D.) Determine whether fetal tachycardia is present

A lactating client with tuberculosis (TB) has recovered from the infection and completed the TB medication 2 weeks ago. Which recommendation would the nurse provide the client about feeding her 4-month-old baby? A.) "Breastfeed your baby" B.) "Give your baby expressed milk" C.) "Give your baby concentrated formula" D.) "Give your baby fluoride supplements"

A new mother states that her infant must be cold because the baby's hands and feet are blue. This common and temporary condition is called what? A.) Acrocyanosis B.) Erythema toxicum neonatorum C.) Harlequin sign D.) Vernix caseosa

What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy? A.) Assessing FHR and maternal vital signs B.) Performing a venipuncture for hemoglobin and hematocrit levels C.) Placing clean disposable pads to collect any drainage D.) Monitoring uterine contractions

Which is the most commonly used antenatal testing for a client at 39 weeks gestation who requires fetal assessment for decreased fetal movement? A.) Nonstress test B.) Biophysical profile C.) Contraction stress test D.) Vibroacoustic stimulation

Why might it be more difficult to diagnose appendicitis during pregnancy? A.) The appendix is displaced upward and laterally, high and to the right B.) The appendix is displaced upward and laterally, high and to the left C.) The appendix is deep at the McBurneys point D.) The appendix is displaced downward and laterally, low and to the right

Which nursing interventions are appropriate for a client with a fluid imbalance resulting from postpartum hemorrhage (select all that apply): A.) Weighing peri pads B.) Monitoring vital signs C.) Assessing capillary refill D.) Assessing arterial blood gas E.) Providing oxygen supplementation

A, B

A number of common drugs of abuse may cross into the breastmilk of a mother who is currently using these substances, which may result in behavioral effects in the newborn. Which substances are contraindicated if the mother elects to breastfeed her infant (select all that apply): A.) Cocaine B.) Marijuana C.) Nicotine D.) Methadone E.) Morphine

A, B, C

Dehydration may increase which risk in the client in the ninth month of pregnancy (select all that apply): A.) Cramping B.) Contractions C.) Preterm labor D.) Fetal neurotoxicity E.) Physiologic anemia

A, B, C

The Baby Friendly Hospital Initiative endorsed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) was founded to encourage institutions to offer optimal levels of care for lactating mothers. Which actions are included in the Ten Steps to Successful Breastfeeding for Hospitals (select all that apply): A.) Give newborns no food or drink other than breast milk B.) Have a written breastfeeding policy that is communicated to all staff members C.) Help mothers initiate breastfeeding within hour of childbirth D.) Give artificial teats or pacifiers as necessary E.) Return infants to the nursery at night

A, B, C

Which diet instruction about fish to avoid is appropriate for the pregnant client to prevent the risk of fetal neurotoxicity (select all that apply): A.) Shark B.) Tilefish C.) Catfish D.) Swordfish E.) Pollock

A, B, D

Which nursing interventions are appropriate to relieve symptoms of nausea for the pregnant client in her first trimester of pregnancy (select all that apply): A.) Assessing if the client is well hydrated B.) Assessing the client's weight gain pattern during pregnancy C.) Reviewing the food frequency approach during pregnancy D.) Reviewing measures already taken for the prevention of morning sickness E.) Discussing food cravings that may occur during pregnancy

A, B, D

Which statement about female sexual response is accurate (select all that apply): A.) Women and men are more alike than different in their physiologic response to sexual arousal and orgasm B.) Vasocongestion is the congestion of blood vessels C.) The orgasmic phase is the final state of the sexual response cycle D.) Facial grimaces and spasms of hands and feet are often part of arousal E.) Resolution occurs just before the orgasmic phase

A, B, D

Which dietary changes reduce systemic symptoms associated with dysmenorrhea (select all that apply): A.) Consumption of a low-fat vegetarian diet B.) Increased calcium intake during menses C.) Consumption of asparagus and cranberry juice D.) Decreased salt intake 7 to 10 days before menses E.) Increased sugar intake 7 to 10 days before menses

A, C, D

Which medications are used in the treatment of physical symptoms of premenstrual syndrome (PMS) (select all that apply): A.) Progesterone B.) Estrogen replacement therapy C.) Prostaglandin inhibitors D.) Selective serotonin reuptake inhibitors (SSRIs) E.) Gonadotropin-releasing hormone (GnRH) antagonist therapy

A, C, D

The class of drugs known as opioid analgesics (butorphanol, nalbuphine) is not suitable for administration to women with known opioid dependence. The antagonistic activity could precipitate withdrawal symptoms (abstinence syndrome) in both mothers and newborns. Which signs would indicate opioid or narcotic withdrawal in the mother (select all that apply): A.) Yawning, runny nose B.) Increase in appetite C.) Chills or hot flashes D.) Constipation E.) Irritability, restlessness

A, C, E

Which nursing information is appropriate to include when discussing dietary self-management for a client with hyperemesis (select all that apply): A.) Try to eat more dairy B.) Drink liquids from a cup with a straw C.) Eat a snack that is high with carbohydrates before bed D.) Consume protein after eating a sweet snack E.) Try drinking your water with a slice of lemon

A, D, E

A 3-year-old girls mother is 6 months pregnant. What concern is this child most likely to verbalize? A.) How the baby will get out? B.) How will the baby eat? C.) Will you die having the baby? D.) What color eyes will the baby have?

Which is a danger sign of pregnancy? A.) Constipation B.) Alteration in the pattern of fetal movement C.) Heart palpitations D.) Edema in the ankles and feet at the end of the day

Which is an emergency contraceptive that can be used by a female client after unprotected sex? A.) Oral progestin (minipill) B.) ParaGard Copper T 380A C.) Essure system D.) Etonogestrel implant

A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic procedure will the client most likely have performed? A.) Amniocentesis for fetal lung maturity B.) Transvaginal ultrasound for placental location C.) Contraction stress test (CST) D.) Internal fetal monitoring

A 26-year-old primigravida has come to the clinic for her regular prenatal visit at 12 weeks. She appears thin and somewhat nervous. She reports that she eats a well-balanced diet, although her weight is 5 pounds less than it was at her last visit. The results of laboratory studies confirm that she has a hyperthyroid condition. Based on the available data, the nurse formulates a plan of care. Which nursing diagnosis is most appropriate for the client at this time? A.) Deficient fluid volume B.) Imbalanced nutrition: less than body requirements C.) Imbalanced nutrition: more than body requirements D.) Disturbed sleep pattern

A 25-year-old single woman comes to the gynecologists office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the client has the HPV. The woman asks, What is that? Can you get rid of it? Which is the best response for the nurse to provide? A.) It's just a little lump on your cervix. We can just freeze it off B.) HPV stands for human papillomavirus. It is a sexually transmitted infection that may lead to cervical cancer C.) HPV is a type of early human immunodeficiency virus. You will die from this D.) You probably caught this from your current boyfriend. He should get tested for this

A woman with severe preeclampsia is being treated with an intravenous infusion of magnesium sulfate. When is this treatment considered successful? A.) If blood pressure is reduced to pre-pregnant baseline B.) If seizures do not occur C.) If deep tendon reflexes become hypotonic D.) If diuresis reduces fluid retention

The nurse who is caring for a woman hospitalized for hyperemesis gravidarum would expect the initial treatment to involve what? A.) Corticosteroids to reduce inflammation B.) Intravenous (IV) therapy to correct fluid and electrolyte imbalances C.) Antiemetic medication, such as pyridoxine, to control nausea and vomiting D.) Enteral nutrition to correct nutritional deficits

What three measures should the nurse implement to provide intrauterine resuscitation? A.) Call the provider, reposition the mother, and perform a vaginal examination B.) Turn the client onto her side, provide oxygen (O2) via face mask, and increase intravenous (IV) fluids C.) Administer O2 to the mother, increase IV fluids, and notify the health care provider D.) Perform a vaginal examination, reposition the mother, and provide O2 via face mask

Which pelvic shape is ideal for vaginal birth? A.) Android B.) Gynecoid C.) Platypelloid D.) Anthropoid

Which risk is a fetus subject to if chorionic villus sampling (CVS) is conducted in the 7th week of gestation? A.) Reduced heart rate B.) Limb reduction defects C.) Decreased lung maturity D.) Neural tube defect

Which statement regarding multifetal pregnancy is incorrect? A.) The expectant mother often develops anemia because the fetuses have a greater demand for iron B.) Twin pregnancies come to term with the same frequency as single pregnancies C.) The mother should be counseled to increase her nutritional intake and gain more weight D.) Backache and varicose veins often are more pronounced with a multifetal pregnancy

Which statement regarding the structure and function of the placenta is correct? A.) Produces nutrients for fetal nutrition B.) Secretes both estrogen and progesterone C.) Forms a protective, impenetrable barrier to microorganisms such as bacteria and viruses D.) Excretes prolactin and insulin

Which statement related to fetal positioning during labor is correct and important for the nurse to understand? A.) Position is a measure of the degree of descent of the presenting part of the fetus through the birth canal B.) Birth is imminent when the presenting part is at +4 to +5 cm below the spine C.) The largest transverse diameter of the presenting part is the suboccipitobregmatic diameter D.) Engagement is the term used to describe the beginning of labor

Which clinical finding in a primiparous client at 32 weeks of gestation might be an indication of anemia? A.) Ptyalism B.) Pyrosis C.) Pica D.) Decreased peristalsis

Which recommendations would the nurse provide a postpartum client who intends to breastfeed but is very concerned about returning to her pre-pregnancy weight (select all that apply): A.) "Consider joining Weight Watchers as soon as possible to ensure adequate weight loss" B.) "Even though more calories are needed for lactation, typically women who breastfeed lose weight more rapidly than women who bottle feed in the postpartum period" C.) "Weight-loss diets are not recommended for women who breastfeed" D.) "If breastfeeding, carefully regulate fluid consumption in response to your thirst level" E.) "If you decrease calorie intake by 100 to 200 calories a day, you will lose weight more quickly"

B, C, D

Which nursing information is appropriate to include when conducting a special adolescent program to reduce teenage pregnancy (select all that apply): A.) The advantages of close child spacing B.) Available methods of family planning C.) Adequate financial planning D.) Effective educational programs about sex E.) Effective educational programs about family life

B, D, E

Which nursing information is appropriate when teaching a client about breast self-examination (select all that apply): A.) Perform the examination every other month B.) Completely feel all parts of the breast and chest area C.) The examination should only be done in a lying down position D.) Use the sensitive pads of the middle three fingers to feel for lumps E.) Examine the breasts in a mirror, looking for an unusual shape or dimpling

B, D, E

Which nursing instruction is appropriate when teaching a group of women about home pregnancy tests (select all that apply): A.) Use the last-void evening urine specimen B.) Follow the manufacturer's instructions carefully C.) Contact your primary health care provider for follow-up if the test result is negative D.) Repeat the test (if negative) after 1 week if amenorrhea persists E.) Contact your primary health care provider for follow-up if test result is positive

B, D, E

A breastfeeding woman develops engorged breasts at 3 days postpartum. What action will help this client achieve her goal of reducing the engorgement? A.) Skip feedings to enable her sore breasts to rest B.) Avoid using a breast pump C.) Breastfeed her infant every 2 hours D.) Reduce her fluid intake for 24 hours

A client at 24 weeks of gestation says she has a glass of wine with dinner every evening. Why should the nurse counsel her to eliminate all alcohol intake? A.) Daily consumption of alcohol indicates a risk for alcoholism B.) She is at risk for abusing other substances as well C.) Alcohol places the fetus at risk for altered brain growth D.) Alcohol places the fetus at risk for multiple organ anomalies

A client who has cystic fibrosis (CF) and a normal body mass index (BMI) is pregnant. Which weight-gain recommendation would the nurse give to this client? A.) Amount gained is not as important as maintaining a well-balanced diet B.) Between 30 to 35 pounds C.) Approximately 25 pounds D.) Between 10 and 20 pounds

A pregnant client in the third trimester is advised to undergo an antiphospholipid antibody test. The nurse knows that which is the objective of this test? A.) To diagnose Marfan syndrome B.) To diagnose mitral valve stenosis C.) To diagnose myocardial infarction D.) To diagnose pulmonary hypertension

For which reason is vitamin K administered to newborns? A.) Reduces bilirubin levels B.) Increases the production of red blood cells C.) Enhances the ability of blood to clot D.) Stimulates the formation of surfactant

What condition indicates concealed hemorrhage when the client experiences abruptio placentae? A.) Decrease in abdominal pain B.) Bradycardia C.) Hard, boardlike abdomen D.) Decrease in fundal height

What should the nurses next action be if the clients white blood cell (WBC) count is 25,000/mm3 on her second postpartum day? A.) Immediately inform the physician B.) Have the laboratory draw blood for reanalysis C.) Recognize that this count is an acceptable range at this point postpartum D.) Immediately begin antibiotic therapy

Which phase of the ovarian cycle in characteristic of high progesterone levels? A.) Follicular phase B.) Ovulatory phase C.) Luteal phase D.) Ischemic phase

A postpartum client who had a cesarean delivery reports fever, loss of appetite, pelvic pain and foul-smelling lochia. On assessment, the nurse finds that the client has an increased pulse rate and uterine tenderness. Laboratory reports indicate significant leukocytosis. Which clinical condition would the nurse suspect based on these findings? A.) Cystocele B.) Rectocele C.) Hematoma D.) Endometritis

The nurse is teaching a client how to monitor blood glucose using a glucose meter. Arrange the steps of this procedure into the correct order for the client to perform: A.) Record the results displayed on the meter B.) Select a site on the side of a finger C.) Wash hands with warm water D.) Gently squeeze the finger E.) Pierce the site with a lancelet F.) Let blood be drawn into the test strip

C, B, E, D, F, A

Changes in blood volume after childbirth depend on several factors such as blood loss during childbirth and the amount of extravascular water (physiologic edema) mobilized and excreted. What amount of blood loss does the postpartum nurse anticipate (select all that apply): A.) 100 ml B.) 250 ml or less C.) 300 to 500 ml D.) 500 to 1000 ml E.) 1500 ml or greater

C, D

Which newborn conditions can result from taking vitamin A supplements in higher doses than prescribed (select all that apply): A.) Tetany B.) Anemia C.) Spina bifida D.) Cleft palate E.) Hypocalcemia

C, D

A client is diagnosed with mitral valve stenosis. Because of this diagnosis, the nurse is aware that the client has which increased risks (select all that apply): A.) Hemorrhage B.) Thrombophelbitis C.) Pulmonary edema D.) Pulmonary embolism E.) Right-sided heart failure

C, D, E

The nurse should be cognizant of which important information regarding the gastrointestinal (GI) system of the newborn? A.) The newborns cheeks are full because of normal fluid retention B.) The nipple of the bottle or breast must be placed well inside the baby's mouth because teeth have been developing in utero, and one or more may even be through C.) Regurgitation during the first day or two can be reduced by burping the infant and slightly elevating the baby's head D.) Bacteria are already present in the infants GI tract at birth because they traveled through the placenta

Which hormone is responsible for maturation of mammary gland tissue? A.) Estrogen B.) Testosterone C.) Prolactin D.) Progesterone

A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. What is the nurses highest priority in this situation? A.) Prepare the woman for imminent birth B.) Notify the woman's primary health care provider C.) Document the characteristics of the fluid D.) Assess the fetal heart rate (FHR) and pattern

A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant. Which guidance should she expect to receive? A.) Discontinue all contraception now B.) Lose weight so that you can gain more during pregnancy C.) You may take any medications you have been regularly taking D.) Make sure you include adequate folic acid in your diet

A woman in the 34th week of pregnancy reports that she is very uncomfortable because of heartburn. Which recommendation would be appropriate for this client? A.) Substitute other calcium sources for milk in her diet B.) Lie down after each meal C.) Reduce the amount of fiber she consumes D.) Eat five small meals daily

Which is an early sign of hemorrhagic shock? A.) Hypotension B.) Altered mental status C.) Cool, clammy, pale skin D.) Capillary refill time of 4 seconds

Which are the long-acting reversible contraceptive methods (select all that apply): A.) Condoms B.) Diaphragm C.) Spermicides D.) Contraceptive implants E.) Intrauterine device (IUD)

D, E

Which medications can cause neural tube defects in the fetus (select all that apply): A.) Aspirin B.) Folic acid supplements C.) Pyridoxine supplements D.) Valproic acid E.) Carbamazepine

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