2006 Study Cards
A labouring woman's amniotic membranes have just ruptured. What is the immediate action of the nurse? A. Assess the fetal heart rate (FHR) pattern. B. Perform a vaginal examination. C. Inspect the characteristics of the fluid. D. Assess maternal temperature.
A
A pregnant woman is the mother of two children. Her first pregnancy ended in a stillbirth at 32 weeks of gestation, her second pregnancy with the birth of her daughter at 36 weeks, and her third pregnancy with the birth of her son at 41 weeks. Using the GTPAL to describe this woman's current obstetric history, the nurse would record which of the following? A. 4-1-2-0-2 B. 3-1-2-0-2 C. 4-2-1-0-1 D. 3-1-1-1-3
A
A pregnant woman's last menstrual period began on April 8, 2013, and ended on April 13. Using Nägele's rule, what would her estimated date of birth be? A. January 15 B. January 29 C. December 15 D. November 5
A
A woman is giving birth to her third child in a setting that allows her husband and other two children to be actively involved in the process. The nurse caring for the woman must also consider the husband and family as patients and work to meet their needs. What is the term for this type of setting? A. Family-centred Care B. Emergency Care C. Hospice Care D. Individual Care
A
As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman who is one day postpartum. What would be an expected finding? A. Breasts are nontender with presence of colostrum. B. Leakage of true milk C. Breasts are swollen, warm, and tender on palpation. D. A few blisters and a bruise on each areola.
A
During a scheduled ultrasound, a couple notices that their baby's mouth is moving and ask why. What is the appropriate response from the nurse? A. The fetus opens its moth and swallows fluid, and fluid flows into and out of the fetal lungs B. The baby is yawning just like you and I. He must be tired C. You must have been mistake; fetuses do not have the ability to open their mouths in utero D. He must be getting ready to suck his thumb
A
Families in the launching stage of the family life cycle are involved in accomplishing which developmental task? A. Renegotiating the marital status as a dyad B. Establishing financial independence C. Maintaining one's own and couple functioning and interests in the face of physiological decline D. Negotiating tasks related to childrearing and household maintenance
A
Hypertensive disorders of pregnancy should be classified as which of the following? A. Pre-existing and gestational B. Pre-eclampsia and eclampsia C. Essential and pre-existing D. Gestational and HELLP syndrome
A
On completion of a vaginal examination on a labouring woman, the nurse records: 50%, 6 cm, -3. What is a correct interpretation of the data? A. The fetal presenting part is 3 cm above the ischial spines. B. Effacement is 4 cm from completion. C. Dilation is 50% completed. D. The fetus has achieved passage through the ischial spines.
A
Parents can facilitate the adjustment of their other children to a new sibling by doing which of the following? A. Having the children choose or make a gift to give to the new baby on its arrival home B. Emphasizing activities that keep the new baby and other children together C. Having the mother carry the new baby into the home so she can show him or her to the other children D. Reducing stress on other children by limiting their involvement in the care of the new baby
A
The breasts of a bottle-feeding woman are engorged. The nurse should tell her which piece of information? A. Wear a snug, supportive bra. B. Allow warm water to soothe the breasts during a shower. C. Express milk from breasts occasionally to relieve discomfort. D. Place absorbent pads with plastic liners into her bra to absorb leakage.
A
The nurse admits Niral to the labour unit. During the admission procedure, the nurse becomes acquainted with Niral's culture. The nurse is using which part of the nursing process? A. Assessment B. Planning C. Implementation D. Evaluation
A
The nurse should tell a primigravida that the definitive sign indicating that labour has begun would present in which of the following ways? A. Progressive uterine contractions B. Lightening C. Rupture of membranes D. Passage of the mucous plug (operculum)
A
The public health nurse realizes that shortened hospital stays have created the possibility that what life-threatening postpartum event could occur at home? A. Late PPH B. Uterine atony C. Retained placental fragments D. Infection
A
What is the neurological origin of pain and discomfort experienced during labour? A. Visceral and somatic B. Visceral C. Somatic D. Referred and localized
A
What shift must occur to address the factors associated with infant mortality in Canada? A. Focusing on health promotion and preventative care b. Directing attention to decreasing the incidence of congenital abnormalities C. Concentrating on the significant disparities that exist among the diverse populations that make up our country D. Improving perinatal care
A
What would be a warning sign of ineffective adaptation to extrauterine life if noted when assessing a 24-hour-old breastfed newborn before discharge? A. Apical heart rate of 90 beats per minute (bpm), slightly irregular, when awake and active B. Acrocyanosis C. Harlequin colour sign D. Weight loss representing 5% of the newborn's birth weight
A
When performing vaginal examinations on women in labour, the nurse should be guided by what principle? A. Cleanse the vulva and perineum before and after the examination, as needed. B. Wear a clean glove lubricated with tap water to reduce discomfort. C. Perform the examination every hour during the active phase of the first stage of labour. D. Perform immediately if active bleeding is present.
A
When planning a diet with a pregnant woman, what would be the nurse's first action? A. Review the woman's current dietary intake. B. Teach the woman about Canada's Food Guide. C. Caution the woman to avoid large doses of vitamins, especially those that are fat-soluble. D. Instruct the woman to limit the intake of fatty foods
A
Which nutrient has been shown to reduce the risk of neural tube defects in infants if consumed by the mother at least one month before conception, throughout her pregnancy, and while nursing? A. Folic acid B. Iron C. Calcium D. Vitamin C
A
Which of the following poses the greatest risk for perinatal patients? A. Language barrier B. Homelessness C. Mental health issues D. Living in remote or rural communities
A
While visiting her obstetrician's office, Farida, in her third trimester of pregnancy, mentions that her abdomen is quite itchy, causing discomfort. How should the nurse respond? A. The itchy feeling you are describing typically precedes noticeable stretch marks. Let me assess your abdomen. B. Did you eat something abnormal or different lately? C. Have you been using any type of cream on your tummy? Maybe you're reacting to that D. Feeling itchy during pregnancy is normal. It is from an increase for circulating estrogen
A
A pregnant woman at seven weeks of gestation complains to her midwife about frequent episodes of nausea during the day with occasional vomiting. She asks what she can do to feel better. The midwife could suggest that the woman do which of the following? A. Drink warm fluids with each of her meals. B. Eat a high-protein snack before going to bed. C. Keep crackers and peanut butter at her bedside to eat in the morning before getting out of bed. D. Schedule three meals and one mid-afternoon snack a day.
B
A pregnant woman with a body mass index of 22 asks the nurse how she should be gaining weight during pregnancy. What would be the nurse's best response about her pattern of weight gain during the pregnancy? A. 453 g (1 lb) a week throughout pregnancy B. 0.9 to 2.26 kg (2 to 5 lbs) during the first trimester, then a pound each week until the end of pregnancy C. 453 g (1 lb) a week during the first two trimesters, then 900 g (2 lbs) per week during the third trimester D. A total of 11.3 to 15.9 kg (25 to 35 lbs)
B
A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment following birth. Recognizing the needs of women during this stage, the nurse should do which of the following? A. Foster an active role in the infant's care. B. Provide time for the mother to reflect on the events of and her behaviour during childbirth. C. Recognize the woman's limited attention span by giving her written materials to read when she gets home rather than doing a teaching session now. D. Promote maternal independence by encouraging her to meet her own hygiene and comfort needs.
B
A woman in labour becomes anxious during the transition phase of the first stage of labour and develops a rapid and deep respiratory pattern. She complains of feeling dizzy and light-headed. The nurse's immediate response would be to do which of the following? 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.
B
A woman is evaluated to be using an effective bearing-down effort if she performs which one of the following actions? A. Begins pushing as soon as she is told that her cervix is fully dilated and effaced B. Takes two deep, cleansing breaths at the onset of a uterine contraction and at the end of the contraction C. Uses the Valsalva manoeuvre by holding her breath and pushing vigorously for a count of 12 D. Continues to push for short periods between uterine contractions throughout the second stage of labour
B
Aguta is in labour in Northern Canada. An anaesthetist is two hours away, because of bad weather, when Aguta asks for an epidural anaesthetic. The nurse recommends nitrous oxide, but Aguta is afraid it will hurt the fetus. How should the nurse reply to diminish Aguta's concerns? A. "Nitrous oxide is a safe alternative when an epidural anaesthetic is not available." B. "The use of nitrous oxide does not appear to cause adverse reactions in the fetus and newborn." C. "Your fetus will be fine; let's get you comfortable." D. "As long as you take nice, deep breaths, everything will be fine."
B
During a prenatal class, a primigravida asks the nurse why her friend's babies have "cone heads." How should the nurse respond? A. "This is a normal physiological adaptation of birth." B. "This occurs as a way for the baby's head to fit through the bony pelvis; it is normal." C. "This phenomenon is called sculpting and is completely normal." D. "Cone heads represent an accumulation of blood from trauma during birth."
B
How is the length of pregnancy most accurately measured? A. It is calculated from the first day of the last menstrual period (LMP) B. It is calculated fromt eh first day of the LMP plus 2 weeks C. It is calculated by counting forward 48 weeks based on LMP D. It is calculated counting forward 10 lunar months
B
If exhibited by an expectant father, what would be a warning sign of ineffective adaptation to his partner's first pregnancy? A. He views the pregnancy with pride as a confirmation of his virility. B. He consistently changes the subject when the topic of the fetus or newborn is raised. C. He expresses concern that he might faint at the birth of his baby. D. He experiences nausea and fatigue, along with his partner, during the first trimester.
B
Justine, who is eight weeks pregnant, visits her family doctor's office concerned about the bluish colour of her vagina and wonders if it is normal? What term describes this phenomenon? A. Nagele's rule B. Chadwick's sign C. Hegar's sign D. Goodell's sign
B
Kathy, a homeless woman, is 27 weeks pregnant. The street nurse speaks to Kathy about her life, medical history, and obstetrical history. The street nurse knows that Kathy has a high risk for preterm labour based on recent research linking preterm labour and birth to which factor? A. Low socioeconomic status B. Periodontal infection C. Street violence D. Premature rupture of membranes
B
Masha had her first baby three days ago and is trying to settle in at home with her husband and new baby. Today has been really challenging for Masha because she is very emotional and cannot seem to settle her tears. She wonders if this is normal and calls the public health nurse. How would the nurse respond to Masha? A. "Is your husband not helping you at all, Masha? B. "Your hormone levels are really low right now. Try to get some rest." C. "Tell me about how things are going at home." D. "Hormone levels peak at this time; you're just emotional."
B
Normal uterine involution occurs at the rate of how many units per day? A. 12.7 cm B. 1 to 2 cm C. 0.5 to 1 mm D. 10 cm
B
Tanya, with a body mass index of 30, delivered a healthy infant boy 25 minutes ago via a vaginal forceps delivery. The nurse notices that Tanya suddenly has dyspnea and tachypnea. Which complication is she exhibiting? A. Venous stasis B. Pulmonary embolism C. Hemorrhagic shock D. PPH
B
The nurse examines a woman one hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. What action should the nurse take? A. Place her on a bedpan to empty her bladder. B. Massage her fundus. C. Call the physician. D. Administer an oxytocic medication as per doctor's orders.
B
The nurse helps a breastfeeding mother change the diaper of her 16-hour-old newborn after the first bowel movement. The mother expresses concern, since the large amount of thick, sticky stool is dark green, almost black in colour. She asks the nurse if something is wrong. The nurse should respond to this mother's concern by doing which of the following? A. Telling the mother not to worry, since all breastfed babies have this type of stool. B. Explaining to the mother that the stool is called meconium and is expected of all newborns for the first few bowel movements. C. Asking the mother what she ate at her last meal. D. Suggesting that the mother ask her pediatrician to explain newborn stool patterns to her.
B
The nurse is aware of the signs of cold stress. When caring for a newborn, which of the following signs should alert the nurse? A. Decreased activity level B Increased respiratory rate C. Hyperglycemia D. Shivering
B
The nurse knows a woman with gestational diabetes mellitus (GDM) needs more education surrounding her care when she states which of the following? A. "The aim of the treatment is to control my blood sugar levels." B. "My blood sugars can be maintained with diet, exercise, and oral hypoglycemic agents." C. "Changing my diet is the first line of defense to control GDM." D. "Exercising will help me lower my glucose levels."
B
Vanessa, 33 weeks pregnant with a diagnosis of pre-eclampsia, has been receiving an intravenous infusion of magnesium sulphate for six hours. During an assessment, the nurse notices that Vanessa looks flushed and is slurring her speech. How should the nurse respond? A. The nurse should check Vanessa's temperature, as she is exhibiting a high fever. B. The nurse should give calcium gluconate. C. The nurse should conduct a full neurological assessment. D. The nurse should give atropine.
B
What best describes the pattern of genetic transmission known as autosomal recessive inheritance? A. Disorders in which the abnormal gene for the trait is expressed even when the other member of the pair is normal B. Disorders in which both genes of a pair must be abnormal for the disorder to be expressed C. Disorders in which a single gene controls the particular trait D. Disorders in which the abnormal gene is carried on the X chromosome
B
What factor creates the largest barrier for Aboriginal women to access maternity services in Canada? A. Poverty B. Geography C. Gender D. Lack of Technology
B
When assessing the FHR in a woman at 30 weeks of gestation, the nurse counts a rate of 82 beats/minute (bpm). Initially the nurse should do which of the following? A. Recognize that the rate is within normal limits and record it. B. Assess the woman's radial pulse. C. Notify the physician. D. Allow the woman to hear the heartbeat.
B
Which characteristic is associated with false labour contractions? A. They are painless. B. They decrease in intensity with ambulation. C. A regular pattern of frequency is established. D. They are progressive in terms of intensity and duration.
B
Which core values underpin the provision of culturally competent care, as per the Registered Nurses Association of Ontario? A. Compassion, equity, respect, and valuing differences B. Equity, respect, inclusivity, and a commitment to providing culturally safe nursing care C. Valuing differences and providing culturally safe nursing care and empathy D. Respect, morality, equity, and inclusivity
B
Which method of prenatal screening is considered superior to other screening methods because of an 85% detection rate? A. First-trimester screening B. Integrated prenatal screening (IPS) C. Second-trimester screening D. PAPP-A
B
Which of the following is descriptive of the family systems theory? A. The family is viewed as the sum of individual members B. When the family system is disrupted, change can occur at any point in the system C. Change in one family member cannot create change in other members D. Individual family members are readily identified as the source of the problem
B
Which term is used to define congenital malformations based on environmental substances or maternal exposures that result in functional or structural disability in an embryo and fetus? A. Malnutrition B. Teratogen C. Neural tube defect D. Teratology
B
Which term is used to describe legal and professional responsibility for practices of maternity nurses? A. Evaluation B. Accountability C. Ethics D. Collegiality
B
A 65-year-old woman with an obstetrical history of 6-6-0-0-6 is complaining of increasing stress incontinence and pelvic pressure and fullness. Pelvic examination reveals a bulge in the anterior vaginal wall. This woman is most likely experiencing what issue? A. Uterine prolapse B. Rectocele C. Cystocele D. Vesicovaginal fistula
C
A biophysical profile is scheduled for a woman who is 30 weeks pregnant to evaluate the health of her fetus. Her biophysical profile score is 8. What does this score indicate? A. The fetus should be delivered within 24 hours. B. The patient should repeat the test in 24 hours. C. The fetus is not in distress at this time. D. The patient should repeat the test in one week.
C
A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she does which of the following? 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.
C
A woman is in the second stage of labour 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 action should the nurse take? A. Encourage her to empty her bladder. B. Decrease her intravenous rate to a keep-vein-open rate. C. Turn the woman 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.
C
Akemi has been in active labour for many hours without any cervical change. Her obstetrician and nurse look at the labour graph (partogram) and determine that which complication of labour has occurred? A. Cephalopelvic disproportion B. Malpresentation C. Dystocia D. Malposition
C
An expectant father confides in the nurse that his pregnant wife, at ten weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" What response from the nurse would best support the father? A. "This is normal behaviour and should begin to subside by the second trimester." B. "She may be having difficulty adjusting to pregnancy; I will refer her to a counsellor that I know." C. "This is called emotional lability and is related to hormone 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 behaviour."
C
During the first trimester, the pregnant woman would be most motivated to learn about which concept? A. Fetal development B. Impact of a new baby on family members C. Measures to reduce nausea and fatigue, so she can feel better D. Location of childbirth
C
Fifty percent of all women have which type of pelvis? A. Anthropoid B. Platypelloid C. Gynecoid D. Android
C
Following rupture of membranes, a prolapse of the cord was noted on vaginal examination. What is the recommended action to prevent cord compression? A. Place woman in a supine position and elevate legs from the hips. B. Insert a Foley catheter to keep the bladder empty. C. Keep the protruding cord moist with warm sterile normal saline compresses. D. Attempt to reinsert the cord.
C
Following the birth of her infant, a woman expresses concern about the weight she gained during pregnancy and how quickly she can lose it now that the infant is born. The nurse, in describing the expected pattern of weight loss, should begin by telling this woman which fact? A. Return to prepregnant weight is usually achieved by the end of the postpartum period. B. Fluid loss from diuresis, diaphoresis, and bleeding accounts for about a 1.3 kg (3-lb) weight loss. C. The expected weight loss immediately after birth averages about 4.9 to 5.9 kg (11 to 13 lbs). D. Lactation will inhibit weight loss, since caloric intake must increase to support milk production.
C
Maternal and neonatal risks associated with gestational diabetes mellitus present in which of the following ways? A. Maternal premature rupture of membranes and neonatal sepsis B. Maternal hyperemesis and neonatal low birth weight C. Maternal pre-eclampsia and fetal macrosomia D. Maternal placenta previa and fetal prematurity
C
Maternity services in Canada are greatly impacted by the social determinants of health (SDOHs). Which of the following SDOHs have the greatest impact on maternal health outcomes? A. Conditions that exist based on geographical location B. The health status of individuals determined by social health C. Health inequalities that result from conditions of vulnerability, such as lack of income D. Inconsistencies in health due to limited education
C
Paramedics were called to deal with a drug overdose. Upon further investigation, the female patient was found to be 26 weeks pregnant and complaining of severe abdominal pain. A white powdered substance was found on the coffee table. When brought to labour and delivery triage, the patient was stabilized and monitored. Her abdomen was tender, vaginal bleeding was present, and the fetal heart tracing was not reassuring. What complication of pregnancy is this woman experiencing? A. Preterm bleeding B. Placenta previa C. Placental abruption D. Uteroplacental insufficiency
C
Shawna and Ed are teen parents. The nurse notices they are having a difficult time transitioning to their new roles as parents. How can the nurse enhance positive parent-infant contact? A. Leave the new couple alone with the infant. B. Encourage the parents to hold the infant while paperwork is finished. C. Go over different sleep and awake states of the newborn. D. Teach Shawna to breastfeed.
C
Tamisha, pregnant with her third baby in her second trimester, comes to the obstetrician's office for a regularly scheduled appointment. Results from routine blood work show that Tamisha has low hemoglobin . What could be the cause of this issue? A. Smoking B. Animal-based protein C. A condition called pica D. Anabolic steroid use
C
The family structure consisting of parents and their dependent children living together is known as which of the following? A. Binuclear family B. Reconstituted family C. Nuclear family D. Extended family
C
The nurse is preparing to discharge a 30-year-old woman who has experienced a miscarriage at ten weeks of gestation. Which statement by the woman would indicate a correct understanding of the discharge instructions? A. "I will not experience mood swings because I was only at ten weeks of gestation." B. "I will avoid sexual intercourse for six weeks and pregnancy for six months." C. "I should eat foods that are high in iron and protein to help my body heal." D. "I should expect the bleeding to be heavy and bright red for at least one week."
C
The nurse knows it is critical to establish venous access when a postpartum hemorrhage (PPH) is occurring. Following doctor's orders, how would the nurse execute this? A. Push oral intake of fluids. B. Start an intravenous (IV) catheter with 5% dextrose in water. C. Start two large-bore IV catheters with Ringer's lactate. D. Give the patient colloids.
C
The student nurse is giving a presentation about milestones in embryonic development. Which information should he or she include? A. At 8 weeks gestation, primary lung and urethral buds appear B. At 12 weeks gestation, the vagina is open or the testes are in position for descent in the scrotum C. At 20 weeks gestation, the vernix caseosa and lanugo appear D. At 24 weeks gestation, the skin is smooth and subcutaneous fat is beginning to collect
C
What is the leading cause of neonatal morbidity and mortality? A. Low birth weight B. Infection C. Preterm and multiple births D. Maternal complications
C
What is the number one indicator of a successful labour and delivery experience for a woman? A. Pain management B. Having family members present C. Support D. A healthy infant
C
When making a visit to the home of a postpartum woman one week after birth, the nurse should recognize that the woman would characteristically do which of the following? A. Express a strong need to review events and her behaviour during the process of labour and birth. B. Exhibit a reduced attention span, limiting readiness to learn. C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn. D. Have re-established her role as a spouse or partner.
C
When palpating the fundus of a woman 18 hours after birth, the nurse notes that it is firm, two finger breadths above the umbilicus, and deviated to the left of midline. How should the nurse respond? A. Massage the fundus. B. Administer an oxytocic medication as per doctor's orders. C. Assist the woman to empty her bladder. D. Recognize this as an expected finding during the first 24 hours following birth.
C
Which hematocrit (HCT) and hemoglobin (HGB) results represent(s) the lowest acceptable values for a woman in the third trimester of pregnancy? A. 0.37-0.47 HCT; 120-160 g/L HGB B. 0.32 HCT; 110 g/L HGB C. >0.32 HCT; >110 g/L HGB D. <0.32 HCT; <110 g/L HGB
C
Which measure would be least effective in preventing postpartum hemorrhage? A. Administer an oxytocic medication as per doctor's orders. B. Encourage the woman to void every two hours. C. Massage the fundus every hour for the first 24 hours following birth. D. Teach the woman the importance of rest and nutrition to enhance healing.
C
Which of the following is true concerning an obese woman and pregnancy? A. Women who are obese are at an increased risk of developing hypotension. B. Women who are obese have an easier time getting pregnant than healthy-weight women. C. Women who are obese have a greater chance of requiring an induced labour or Caesarean section. D. Women who are obese have a higher risk of developing type 1 diabetes during their pregnancy.
C
Which stage is the most critical time in the development of the organ systems and the main external features of the fetus in utero? A. Ovum B. Fetus C. Embryonic D. Chorionic
C
Which term is used to describe changes that occur within one group or among several groups when people are from different cultures? A. Assimilation B. Cultural relativism C. Acculturation D. Ethnocentrism
C
A maternal serum alpha fetoprotein (MSAFP) test is performed at 16 to 18 weeks of gestation. An elevated level of MSAFP is associated with which of the following? A. Down syndrome B. Sickle cell anemia C. Cardiac defects D. Open neural tube defects such as spina bifida
D
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 would be considered unrealistic and require further discussion with the nurse? A. "My husband and I have agreed that my sister will be my coach, since 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 OK." B. "We plan to use the techniques taught in the Lamaze classes to reduce the pain experienced during labour." C. "We want the labour and birth to take place in a birthing room. My husband will come in the minute the baby is born." D. "We do not want the fetal monitor used during labour, since it will interfere with movement and doing effleurage."
D
A pregnant woman at 32 weeks of gestation complains of feeling dizzy and light-headed while her fundal height is being measured. Her skin is pale and moist. What would the nurse's initial response be? A. Assess the woman's blood pressure and pulse. B. Have the woman breathe into a paper bag. C. Raise the woman's legs. D. Turn the woman on her side.
D
A primigravida asks the nurse about signs she can look for that would indicate the approach of the onset of labour. Which information should the nurse provide? A. Weight gain of 453 to 1360 g (1 to 3 lbs) B. Quickening C. Fatigue and lethargy D. Bloody show
D
A woman pregnant for the first time has a long history of type 1 diabetes. She comes to the office concerned about the use of artificial sweeteners in her food. What information should the nurse pass onto the woman? A. "Any sweetener used in moderation is fine during pregnancy and lactation." B. "Sugar in moderation is better than artificial sweeteners, and is safer." C. "Diabetics should be careful about using any type of sweetener during pregnancy." D. "Be careful using products such as stevia."
D
A woman who is at 36 weeks of gestation is having a nonstress test. Which statement by the woman would indicate a correct understanding of the test? A. "I will need to have a full bladder for the test to be done accurately." B. "I should have my husband drive me home after the test because I may be nauseous." C. "This test will help to determine if the baby has Down syndrome or a neural tube defect." D. "This test will observe for fetal activity and an acceleration of the fetal heart rate (FHR) to determine the well-being of the baby."
D
An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the fetus. What should the nurse tell this couple? 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 labour are present.
D
Four hours after a difficult labour and birth, a primiparous woman refuses to feed her infant, stating that she is too tired and just wants to sleep. How should the nurse respond? A. Tell the woman she can rest after she feeds her infant. B. Recognize this as a behaviour of the taking-hold stage. C. Record the behaviour as ineffective maternal-newborn attachment. D. Take the infant back to the nursery, reassuring the woman that her rest is a priority at this time.
D
How is evidence-informed practice best described? A. Gathering information of mortality and morbidity in children B. Meeting physical and psychosocial needs of the family in all areas of practice C. using a professional code of ethics of means for professional self-regulation D. Providing care based on evidence gained through research and clinical trials
D
If exhibited by a pregnant woman, what represents a positive sign of pregnancy? A. Morning sickness B. Quickening C. Positive pregnancy test D. Fetal heartbeat auscultated with Doppler/fetoscope
D
Jenny just had her second baby one hour ago. She mentions to the nurse that she is feeling stronger cramping in her tummy than she remembered with her other child. What is this phenomenon called? A. "Pit" pains B. Suckling pains C. Postpartum syndrome D. Afterpains
D
Kama is bleeding heavily after the birth of her fourth child. When the nurse assesses her uterus, it is firm, midline, and 1 cm below her umbilicus. What should the nurse assess next? A. Check Kama's vital signs, starting with her blood pressure and temperature. B. Draw blood so as to check Kama's coagulation status. C. Start an IV line immediately, and give oxytocin, as per doctor's orders. D. Call the primary-care provider to inspect the cervix, vagina, perineum, and rectum for lacerations.
D
Perineal care is an important infection control measure. When evaluating a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman does which of the following? A. Uses soap and warm water to wash the vulva and perineum. B. Washes from symphysis pubis back to episiotomy. C. Changes her perineal pad every two to three hours. D. Uses the peribottle to rinse upward into her vagina.
D
Postpartum women experience an increased risk for urinary tract infection. What prevention measure should the nurse teach the postpartum woman? A. Acidify the urine by drinking three glasses of orange juice each day. B. Maintain a fluid intake of one to two litres per day. C. Empty bladder every four hours throughout the day. D. Perform perineal care on a regular basis.
D
The nurse is planning care for a patient with a different cultural background. What would be an appropriate goal? A. Strive to keep the patient's cultural background from influencing health needs B. Encourage the continuation of cultural practices in the hospital setting C. In a nonjudgemental way, attempt to change the patient's cultural beliefs D. As necessary, adapt the patient's cultural practices to their health needs
D
The nurse should realize that the most common and potentially harmful maternal complication of epidural anaesthesia is which of the following? A. Severe postpartum headache B. Limited perception of bladder fullness C. Increase in respiratory rate D. Hypotension
D
Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. What complication would the nurse suspect? A. Bladder distension B. Uterine atony C. Constipation D. Hematoma formation
D
When weighing a newborn, the nurse would prepare in which way? A. Leave its diaper on for comfort. B. Place a sterile scale 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.
D
Which biochemical marker can help predict which women might experience preterm labour? A. Alpha fetoprotein (AFP) B. Fetal hemoglobin C. Kleihaur-Betke test D. Fetal fibronectin (FFN)
D
Which endogenous opioid is thought to increase during pregnancy and birth, possibly increasing the ability of women in labour to tolerate acute pain and reducing their irritability and anxiety? A. Naloxone B. Nociceptin C. Prostaglandins D. Endorphins
D
Which finding would be a source of concern if noted during the assessment of a woman who is 12 hours postpartum? A. Postural hypotension B. Temperature of 38°C C. Bradycardia—pulse rate of 55 bpm D. Pain in left calf with dorsiflexion of left foot
D
Which maternal position, although not supported by research, is typically used during the birthing process in Canada? A. Squatting B. Semirecumbent C. Hand and knees D. Lithotomy
D
