Antepartum/Intrapartum study q

Dilation follows effacement in the primiparous mother. To be fully dilated, the cervix should have a distance of what measurement?

8 to 10 cm

Shoulder dystocia is a true medical emergency that can cause fetal demise because the baby cannot be born. Stuck in the birth canal, the infant cannot take its first breath. Which maneuver is first attempted to deliver an infant with shoulder dystocia? A. McRonald maneuver B. McRoberts maneuver C. McDonald maneuver D. McGeorge maneuver

B. McRoberts maneuver

A woman with Jewish ancestry is pregnant. The nurse is aware that the client may be a carrier for which condition? A. Dupuytren's B. Tay-Sachs disease C. Phenylketonuria D. Krabbe disease

B. Tay-Sachs disease

Which two tests are generally performed on urine at a prenatal visit? A. protein and sodium B. pH and glucose C. occult blood and protein D. protein and glucose

D. Protein and glucose

A woman experiences an amniotic fluid embolism as the placenta is delivered. Your first action would be to a) increase her intravenous fluid infusion rate b) administer oxygen by mask. c) put firm pressure on the fundus of her uterus. d) tell the woman to take short, catchy breaths.

b) administer oxygen by mask.

The skull is the most important factor in relation to the labor and birth process. The fetal skull must be small enough to travel through the bony pelvis. What feature of the fetal skull helps to make this passage possible? a) Vertex presentation b) Caput succedaneum c) Molding d) Cephalohematoma

c) MoldingRationale:The cartilage between the bones allows the bones to overlap during labor, a process called molding that elongates the fetal skull thereby reducing the diameter of the head.

Bupivacaine

local anesthetic-epidural

Misoprostol (Cytotec)

used to help induce labor/contractions

Vitamin K

vitamin-helps stimulate blood clotting function in newborns * some hospitals will not do circumcisions on babies who's parents refuse the administration of vitamin K at birth.

HBIG (hepatitis B immune globulin)

Anti-viral vaccine-one of babies first vaccines-usually given first does before baby leaves the hospital

Why is the first prenatal visit usually the longest prenatal visit? A. Laboratory tests are performed. B. Baseline data is collected. C. A pelvic exam with Papanicolau test is performed. D. Extensive client teaching is done.

B. Baseline data is collected

A nurse working at the local health district clinic assists numerous adolescents who become pregnant. Which factor will the nurse point out to each teen is crucial for a positive pregnancy outcome? A. Cultural sensitivity B. Support network C. Acceptance by peers D. Involvement of the father

B. Support network

A woman is 20 weeks pregnant. The nurse would expect to palpate the fundus at which location? A. symphysis pubis B. between the symphysis and umbilicus C. at the umbilicus D. just below the ensiform cartilage

C. At the umbilicus

Ephedrine

CNS (central nervous system) Stimulants prevents low blood pressure when a patient has a spinal anesthetic

A nurse is caring for a pregnant client at her 34-week checkup. The client has chosen the Lamaze method for her birthing plan but states that her partner does not agree. The client says she will just change her plan. Which response by the nurse would be appropriate to support the female client? A) "Have you and your partner discussed what his / her role will be in the birth?" B) "Just wait until the birth; your partner's mind could change." C) "Preparing for the birth works for some clients, but not for all." D) "Maybe you should choose a different support person."

A) "Have you and your partner discussed what his / her role will be in the birth?" The nurse should explain to the client the different roles the partner can take in the birth process. The nurse should encourage the client to discuss both her feelings and her partner's feelings to better understand the partner's disapproval of Lamaze. This could help improve family communication. The other three answers are not therapeutic because they ignore the client's concern and do not help to prepare the client.

During pregnancy the cardinal rule regarding on taking medications and herbal remedies is that all drugs cross the placenta and have a potential impact on the fetus. What is one disease where treatment must continue during pregnancy? A. asthma B. gout C. cholelithiasis D. gastritis

A. asthma

A nurse is performing a nursing assessment on a new client. The woman estimates that she is approximately 16 weeks pregnant. While assessing her the nurse asks her about what appear to be scratch marks on her hands, and she tells the nurse that she has three cats at home. What screening would be prescribed for this woman? A. toxoplasmosis B. cytomegalovirus C. hepatitis C D. herpes simplex virus

A. toxoplasmosis

During pregnancy, which situation would interfere with mother-child bonding? A. A woman's neighbor is planning an extensive vacation. B. A woman's father has been very ill during the pregnancy. C. A woman's husband was awarded a large year-end bonus. D. A woman's sister recently had a baby boy.

B. A Woman's father has been very ill during the pregnancy

A nurse is caring for a client who has benign prostatic hypertrophy and is taking tamsulosin. The nurse should question the use of the drug if the client also has which of the following? A. A seizure disorder for which he takes carbamazepine B. Erectile dysfuntion for which he take sildenafil C. Diabetes mellitus for which he takes glyburide D. Angle-closure glaucoma for which he take pilocarpine

B. Erectile dysfunction for which he takes sildenafil-Drugs that lower blood pressure, such as sildenafil, can exacerbate hypotension in combination w/ tamsulosin. Clients who take sildenafil should not take tamsulosin

Cystic fibrosis is an example of which type of inheritance? A. autosomal dominant B. autosomal recessive C. X-linked recessive D. multifactorial

B. autosomal recessive

A young patient with a cardiac problem wants to get pregnant and tells the nurse that she is sad that she will never be able to have a baby. What is the best response by the nurse? a) "Women with your problem should never get pregnant, because the risks and dangers are too high for you and the fetus." b) "If you get pregnant, you are likely to face many complications." c) "Because of improved management, more women with cardiac problems can complete pregnancies successfully." d) "Cardiovascular problems are not a concern during pregnancy."

C. "Because of improved management, more women with cardiac problems can complete pregnancies successfully." Explanation:Because of improved management of cardiac disease, women who might never have risked pregnancy in the past can complete pregnancies successfully today.

A nurse is teaching a client about conjugated estrogen and medroxyprogesterone. Which of the following instructions should the nurse include? A. Monitor for rectal bleeding B. Avoid drinking alcoholic beverages C. Have blood pressure checked regularly D. sit up for 30min after taking the drug

C. Have blood pressure checked regularly-Using conjugated estrogen and medroxyprogesterone, a combination of estrogen and progestin for hormone replacement, can cause hypertension. Clients taking the drug combination should have their blood pressure checked regularly and report headache or edema

What is the term that refers to a woman who has never been pregnant? A. gravida B. parity C. nulligravida D. multigravida

C. Nulligravida

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

C. Twin-to-twin transfusion syndrome (TTTS)

A nurse is caring for a client who has a new prescription for conjugated equine estrogen. The nurse should instruct the client to report which of the following indication of a serious adverse reaction? A. Hot flashses B. urinary tract infection C. Vaginal bleeding D. Bone pain

C. Vaginal bleeding-estrogen hormone replacement therapy increases the risk of endometrial cancer. The nurse should instruct clients using the drugs to report recurrent or persistent vaginal bleeding and pelvic pain.

The nurse at a fertility clinic determines the risk factors for clients using oral contraceptives. Which client would be at highest risk for heart attack or stroke related to use of these contraceptives? A. a 15-year-old with a previous miscarriage B. a 22-year-old woman who drinks alcohol C. a 38-year-old woman who smokes D. a 32-year-old woman who has asthma

C. a 38-year-old woman who smokes

Which type of pelvis has a roomy, round inlet and is most favorable for vaginal birth? A. gynecoid B. platypelloid C. android D. anthropoid

A. Gynecoid

Oxytocin

Oxytocics- A hormone released by the posterior pituitary that stimulates uterine contractions during childbirth and milk ejection during breastfeeding.

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? A. "I've been having bleeding off and on that's irregular and sometimes heavy." B. "I get sharp pain in my lower abdomen usually starting soon after my period comes." C. "I get really irritable and moody about a week before my period." D. "My periods have been unusually long and heavy lately with a lot of bleeding."

A. "I've been having bleeding off and on that's irregular and sometimes heavy."

A pregnant client in her third trimester is diagnosed with supine hypotension syndrome. What would the nurse instruct the client to do? A. Lie laterally, preferably on the left side. B. Sleep on a hard mattress. C. Use a hot water bag. D. Encourage mild exercises.

A. Lie laterally, preferably on the left side.

After an hour of oxytocin therapy, a woman in labor states she feels dizzy and nauseated. The nurse's best action would be to: A. assess the rate of flow of the oxytocin infusion. B. administer oral orange juice for added potassium. C. assess her vaginally for full dilation. D. instruct her to breathe in and out rapidly.

A. assess the rate of flow of the oxytocin infusion.

Simethicone

Antiflatulent

During the physical examination at the first prenatal visit a speculum examination is performed. What sign of pregnancy does the practitioner look for during the speculum examination? A. Hagar's sign B. Chadwick's sign C. Nagel's sign D. Goodell's sign

B. Chadwick's sign

Gynecologic health is an important part of a woman's health history. Which of the following statements best illustrates the way to begin a menstrual history? A. "Discussing menstrual periods can be embarrassing. . ." B. "I'd like to ask you some questions about your menstrual periods." C. "I know you're probably uncomfortable talking about your health. . ." D. "I bet you have pain with menstrual periods."

B. I'd like to ask you some questions about your menstrual periods

When going through the transition phase of labor, women often feel out of control. What do women in the transition phase of labor need the most? A. Their significant other beside them B. Positive reinforcement C. Intense nursing care D. Just to be left alone

B. Positive reinforcement

The nurse in an obstetric clinic is conducting client education with a group of expectant mothers. One young woman asks the nurse to tell the group what labor pain is like. What would be the nurse's best response? A. "It comes in waves." B. "It is best evaluated by talking with visitors in the labor room because they know you best." C. "The pain of labor is unique and multidimensional. It originates from different places depending on what stage of labor you are in." D. "It has been described as the worst pain you will ever feel."

C. "The pain of labor is unique and multidimensional. It originates from different places depending on what stage of labor you are in."

Gestational diabetes occurs around the 24th week of gestation. When should every woman be screened for gestational diabetes? A. between 16 and 20 weeks' gestation B. between 20 and 24 weeks' gestation C. between 24 and 28 weeks' gestation D. between 28 and 32 weeks' gestation

C. Between 24 and 28 weeks' gestation

The nurse is assessing a young couple who desire to get pregnant. The 38-year-old husband and 29-year-old wife report they had used COC; however, they have now been trying unsuccessfully to conceive over the past 4 months. What is the best response for the nurse to make? A. Return in 9 months for further assessment if not pregnant. B. Should seek fertility counseling from a specialist. C. Increase intercourse frequency to four times a week around the time of ovulation. D. Should undergo comprehensive diagnostic testing.

C. Increase intercourse frequency to four times a week around the time of ovulation

A client has asked that an opioid be kept on standby in case she needs it for pain control. As a precaution, the nurse will also have which of medication readily available to reverse the effects of that opioid? A. hydroxyzine B. nalbuphine C. naloxone D. midazolam

C. Naloxone

A 26-year-old primigravida has brought her doula to the birthing center for support during her labor and birth. The doula has been helping her through the past 16 hours of labor. The laboring woman is now 6 cm dilated. She continues to report severe pain in her back with each contraction. The client finds it comforting when her doula uses the ball of her hand to put counterpressure on her lower back. What is the likely cause of the woman's back pain? A. Fetal macrosomia B. Nongynecoid pelvis C. Occiput posterior position D. Breech presentation

C. Occiput posterior position

A nurse is teaching a client who has a new prescription for a testosterone transdermal patch. Which of the following statements made by the client indicates an understanding of the teaching? A. I should have pancreatic function tests obtained while taking this drug B. I should have my white blood cell count checked annually C. I should take off the patch to shower D. I should apply the medication to a different site each time

D. I should apply the medicaiton to a different site each time-The client should rotate the application sites with each application to prevent skin irritation

Why is a Papanicolau test done at the first prenatal visit? A. It predicts whether cervical cancer will occur. B. It helps to date the pregnancy. C. It detects if uterine cancer is present. D. It identifies abnormal cervical cells.

D. It identifies abnormal cervical cells

A client is to be examined for the presence and extent of endometriosis. For which test should the nurse prepare the client? A. tissue biopsy B. hysterosalpingogram C. clomiphene citrate challenge test D. laparoscopy

D. Laparoscopy

A nurse is caring for a client who is taking combination oral contraceptive ethinyl estradiol and drospirenone and is about to begin taking rifampin to treat tuberculosis. Which of the following instructions should the nurse give the client due to a possible drug interaction? A. increase the rifampin dose B. increase the oral contraceptive dose C. wait 2hrs between taking each drug D. use additional birth control methods

D. Use additional birth control methods Rifampin can increase the metabolism of oral contraceptives, reducing the effectiveness. Clients who are taking oral contraceptives and rifampin should use additional contraceptive methods to prevent an unwanted pregnancy. Others drugs that can reduce the effects of oral contraceptives include some antifungal agents and anticonvulsants

A nurse is assisting a client who is in the first stage of labor. Which principle should the nurse keep in mind to help make this client's labor and birth as natural as possible? A. Routine intravenous fluid should be implemented. B. A woman should be allowed to assume a supine position. C. The support person's access to the client should be limited to prevent the client from becoming overwhelmed. D. Women should be able to move about freely throughout labor.

D. Women should be able to move about freely throughout labor

A nurse is caring for a pregnant client with gestational diabetes. Which meal should the nurse recommend for this client? A. pizza, corn, and orange slices B. baked chicken, green beans, and chocolate cake C. steak, baked potato with butter, and ice cream D. baked turkey, brown rice, and strawberries

D. baked turkey, brown rice, and strawberries

A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm/Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next? A. Obtain a voided urine specimen, and determine blood type. B. Palpate the fundus, and check fetal heart rate. C. Measure fundal height. D. Check deep tendon reflexes.

Palpate the fundus and check fetal heart rate. Explanation:The classic signs of abruption placentea are pain, dark red vaginal bleeding, a rigid, board-like abdomen, hypertonic labor, and fetal distress.

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

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

A woman in labor is at risk for abruptio placentae. Which of the following assessments would most likely lead you to suspect that this has happened? a) Sharp fundal pain and discomfort between contractions. b) Painless vaginal bleeding and a fall in blood pressure c) An increased blood pressure and oliguria. d) Pain in a lower quadrant and increased pulse rate.

a) Sharp fundal pain and discomfort between contractions. Rationale:An abruptio placentae refers to premature separation of the placenta from the uterus. As the placenta loosens, it causes sharp pain. Labor begins with a continuing nagging sensation. Painless vaginal bleeding and a fall in blood pressure are indicative of placenta previa. Pain in a lower quadrant and increased pulse rate are indicative of an ectopic pregnancy. Hypertension and oliguria are indicative of preeclampsia.

A young woman presents at the emergency department with complaints of lower abdominal cramping and spotting at 12 weeks' gestation. The physician performs a pelvic examination and finds that the cervix is closed. What does the physician suspect is the cause of the cramps and spotting? a) Cervical insufficiency b) Threatened abortion c) Habitual abortion d) Ectopic pregnancy

b) Threatened abortionRationale:Spontaneous abortion occurs along a continuum: threatened, inevitable, incomplete, complete, missed. The definition of each category is related to whether or not the uterus is emptied, or for how long the products of conception are retained.

A nurse is caring for a pregnant woman in her third trimester. The woman is HIV positive and voices concerns about passing the infection on to her baby. What is the nurse's best response? a. "There is nothing you can do. You will just have to wait and see if your baby is born HIV positive." b. "If you are taking antiretroviral medications and you don't breastfeed your baby, you greatly reduce the risk of perinatal transmission of the disease." c. "Do you have other children? Your baby has a one-in-four chance of having HIV at birth, so if you have three other children who are not HIV positive, then this one will be HIV positive." d. "Perinatal transmission of the virus is a real fear. Would you like to talk to a social worker?"

b. "If you are taking antiretroviral medications and you don't breastfeed your baby, you greatly reduce the risk of perinatal transmission of the disease."

A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which of the following would be the priority for this woman on admission? a) Performing a vaginal examination to assess the extent of bleeding b) Helping the woman remain ambulatory to reduce bleeding c) Assessing fetal heart tones by use of an external monitor d) Assessing uterine contractions by an internal pressure gauge

c) Assessing fetal heart tones by use of an external monitor Rationale:Not disrupting the placenta is a prime responsibility. An internal monitor, a vaginal examination, and remaining ambulatory could all do this and thus are contraindicated.

Hepatitis B

inflammation of the liver caused by the hepatitis B virus (HBV), which is transmitted sexually or by exposure to contaminated blood or body fluids

Erythromycin

macrolide antibiotic-ointment used to put on newborns eyes very shortly after birth.

The nurse tests the pH of fluid found on the vaginal exam and determines that the woman's membranes have ruptured based on which result? A. 6.0 B. 6.5 C. 5.5 D. 5.0

6.5 Explanation:Amniotic fluid is alkaline, so the membranes are probably ruptured if the pH ranges from 6.5 to 7.5

A nurse is assessing a client and suspects that the client may be experiencing premenstrual dysphoric disorder (PMDD). Applying the American Psychiatric Association criteria, the nurse would assess which symptoms? Select all that apply. A. affective lability B. sleep difficulties C. diarrhea D. dysuria E. focused thinking

A, B, C affective lability, sleep difficulties, diarrhea

When measuring the diagonal conjugate of a woman's pelvis, the distance between which anatomic landmarks would be used? A. anterior surface of the sacral prominence and the anterior surface of the symphysis pubis B. medial surface of the ischial tuberosities C. interior surface of the sacral prominence and the posterior surface of the symphysis pubis D. posterior surface of sacrum and the axis of the ischial tuberosities

A. Anterior surface of the sacral prominence and the anterior surface of the symphysis pubis

A 16-year-old girl is brought to the clinic by her mother because she has not had a menstrual period for the past 8 months. Which findings might alert the nurse to the possibility that anorexia nervosa may be contributing to the client's amenorrhea? Select all that apply. A. hyperthermia B. bradycardia C. hypotension D. reduced subcutaneous fat E. evidence of secondary sex characteristics

B, C, D, Bradycardia, Hypotension, reduced subcutaneous fat

A nurse is caring for a male client who has hyperthyroidism and is not responding to treatment. The nurse should identify that hyperthyroidism is a contraindication for which of the following drugs? A. Sildenafil B. Bethanechol C. Tamsulosin D. Finasteride

B. Bethanechol- Bethanechol a cholinergic drug, can cause cardiac dyrshythmias in clients who have hyperthyroidism by triggering the release of norepinephrine. This reaction does not occur in clients who do not have hyperthyroidism.

A nulliparous client at 37 weeks gestation calls the labor and delivery unit to report she thinks she is in labor. The nurse predicts she is in true labor based on which answer to her assessment questions? A. Contractions, irregular, lasting 15 to 20 seconds B. Contraction, regular and lasting longer and stronger C. Scant amount of thick, white vaginal discharge, no odor D. Bloody mucus in the toilet once earlier in the day

B. Contraction, regular and lasting longer and stronger

Which assessment finding in a client reporting uterine contractions would be most consistent as an indicator of approaching labor? A. decrease in duration of contractions B. rupture of amniotic membranes C. decrease in vaginal secretions D. development of a membrane further closing the cervix

B. rupture of amniotic membranes

A nurse is caring for a client who is about to begin clomiphene therapy to treat infertility. The nurse should monitor the client for which of the following adverse effects? A. Breast cancer B. Deep-vein thrombosis C. Ovarian hyperstimulation syndrome D. Restless leg syndrome

C. Ovarian hyperstimulation syndrome-Pelvic pain can indicate ovarian hyerstimulation and can lead to ovarian cyst rupture. The nurse should monitor a client who is taking clomiphene for ovarian enlargement and advise them to seek medical attention immediately for sudden or severe pelvic pain.

the new mother's vital signs every 15 minutes. What sign would indicate impending shock? A. Tachypnea and a widening pulse pressure B. Bradypnea and hypertension C. Tachycardia and a falling blood pressure D. Bradycardia and auscultation of fluid in the base of the lungs

C. Tachycardia and a falling blood pressure Correct Explanation:Monitor the woman's vital signs at least every 15 minutes during the third stage of labor. Tachycardia and a falling blood pressure are signs of impending shock; immediately report these signs.

Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation. A. 3, 2, 1, 2, 1 B. 4, 2, 2, 1, 1 C. 3, 2, 1, 1, 1 D. 4, 1, 1, 1, 1

D. 4, 1,1,1,1

A nurse is counseling women on birth control choices. Which woman is the best candidate for an IUD? A. a woman who has multiple sex partners B. a woman who has a history of PID C. a woman who is in her early twenties and wants children later in life D. a woman who has one partner and three children

D. A woman who has one partner and three children

A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which of the following is a known risk factor for ectopic pregnancy? a) High number of pregnancies b) Multiple gestation pregnancy c) Use of IUD for contraception d) Use of oral contraceptives

c) Use of IUD for contraceptionRationale:Use of an IUD with progesterone has a known increased risk for development of ectopic pregnancies. The nurse needs to complete a full history of the patient to determine if she had any other risk factors for an ectopic pregnancy. Adhesions, scarring, and narrowing of the tubal lumen may block the zygote's progress to the uterus. Any condition or surgical procedure that can injure a fallopian tube increases the risk. Examples include salpingitis, infection of the fallopian tube, endometriosis, history of prior ectopic pregnancy, any type of tubal surgery, congenital malformation of the tube, and multiple elective abortions. Conditions that inhibit peristalsis of the tube can result in tubal pregnancy. Hormonal factors may play a role because tubal pregnancy occurs more frequently in women who take fertility drugs or who use progesterone intrauterine contraceptive devices (IUDs). A high number of pregnancies, multiple gestation pregnancy, and the use of oral contraceptives are not known risk factors for ectopic pregnancy.

Which feature would alert the nurse that the client is in the transition phase of labor? A. beginning urge to bear down B. decrease in the bloody show C. enthusiasm in the client D. reduction of rectal pressure

A. Beginning urge to bear down

A nurse is caring for a pregnant client with rhythmic uterine contractions. Which feature should the nurse identify as associated with true labor? A) increase in frequency of the contractions B) irregularity in the duration of the contractions C) lessening of the contractions with position change D) decrease in the intensity of the contractions

A) increase in frequency of the contractions The nurse should identify that there is an increase in the duration of the contractions associated with true labor. In true labor, the duration, frequency, and intensity of uterine contractions increase. Position change does not reduce the uterine contractions. In false labor, the uterine contractions often disappear with ambulation and sleep. Also, there is no increase in frequency, duration, or intensity of the contractions, and the cervix fails to dilate any further.

A client is ready to push. The nurse instructs her to push vigorously and grunt and breathe out during a pushing effort. What would be important to monitor on the client while she is pushing vigorously? A. blood pressure B. level of consciousness C. fatigue D. temperature

A. Blood pressure

A mother presents to the clinic with her 15-year-old daughter who is reporting amenorrhea. The girl's menarche was at age 12. Which findings might the nurse identify as indicating the cause? Select all that apply. A. extreme rapid weight gain B. pregnancy C. hypothyroidism D. lack of exercise E. emotional distress

A, B, C, E Extreme rapid weight gain, pregnancy, Hypothyroidism, emotional distress

A nurse is working with a couple who is dealing with infertility. Which aspect would be most important for the nurse to consider? A. culture B. insurance restrictions C. family budget D. emotional limits

A. Culture

A nurse is caring for a client who is about to begin taking finasteride to treat benign prostatic hypertrophy. The nurse should explain to the client the need to monitor which of the following laboratory values? A. Prostate-specific antigen (PSA) B. BUN C. Creatine Phosphkinase (CPK) D. ALT

A. Prostate-specific antigen-the nurse should monitor PSA levels at baseline and periodically thereafter. Increases in PSA can indicate prostate cancer. PSA levels should decrease w/ finasteride therapy

A client in her 20th week of gestation expresses concern about her 5-year-old son, who is behaving strangely by not approaching her anymore. He does not seem to be taking the news of a new family member very well. Which strategy can a nurse discuss with the mother to deal with the situation? A. Provide constant reinforcement of love and care to the child. B. Avoid talking to the child about the new arrival. C. Pay less attention to the child to prepare him for the future. D. Consult a child psychologist about the situation.

A. Provide constant reinforcement of love and care to the child.

When assessing a client with symptoms of premenstrual syndrome (PMS), the nurse uses the ACDHO tool. The nurse questions the client about which symptom when addressing the "C" in the tool? A. cravings B. constipation C. crying D. cramping

A. Cravings

A nurse is teaching a client who has a new prescription for transdermal testosterone gel to treat delayed puberty. Which of the following instructions should the nurse include? (select all that apply) A.Apply the gel to the scrotum B. Cover the area of application w/ clothing C. wash your hands after applying the gel D. Do not shower for sever hours after applying the gel E. apply the gel to the gums above an upper incisor

B, C, D Cover the area of application w/ clothing-clothing helps to prevent exposing other to the drug. Clients should let the gel dry before covering the application site w/ a shirt. Wash your hands after applying the gel-Clients should wash their hands after application to prevent exposing others to the drug Do not shower for several hours after applying the gel-clients should not shower or swim for several hours following application of transdermal testosterone gel to avoid washing off the gel

A 30-year-old client tells the nurse that she would like to use a contraceptive sponge but does not know enough about its use and whether it will protect her against sexually transmitted infections (STIs). Which information should the nurse provide the client about using a contraceptive sponge? Select all that apply. A. Keep the sponge in for more than 30 hours to prevent STIs. B. Wet the sponge with water before inserting it. C. Insert the sponge 24 hours before intercourse. D. Leave the sponge in place for at least 6 hours following intercourse. E. Replace sponge every 2 hours for the method to be effective.

B, C, D, Wet the sponge w/ water before inserting it, insert the sponge 24 hrs before intercourse, leave the sponge in place for at least 6 hrs following intercourse

A nurse is assessing a client who has a new prescription of oxybutynin to treat neurogenic bladder. Which of the following assessment findings should the nurse identify as an adverse effect of the drug? (Select all that apply) A. Diaphoresis B. Dilated pupils C. Dizziness D. Distended bladder E. Fever

B, C, D, E Dilated pupils-Oxybutynin can cause mydriasis or dilated pupils, dry eyes, and blurred vision. Clients who take the drug should use lubricating eye drops to help reduce dryness. Dizziness- Oxybutynin can cause dizziness and drowsisness. clients who take the drug should use caution with activities that require alertness until they know how the drug will affect them. Distended bladder-oxybutynin can cause urinary retention and bladder distention Fever-Oxybutynin can cause heat exhaustion and fever. Clients who take the drug should use it with caution in hot weather.

A woman at the infertility clinic for the first time asks, "What could have caused my infertility?" After teaching the woman about possible causes, the nurse determines that the teaching was successful when the woman identifies which condition as a common cause? A. Vaginal pH of 4.2 B. Endometriosis C. History of ovarian tumor D. Pelvic inflammatory disease E. Anovulation

B, D, E Endometriosis, Pelvic inflammatory disease, an ovulation

Labor dystocia is an abnormal progression of labor. It is the most common cause of primary cesarean birth. When is it most common for labor dystocia to occur? A. Third stage of labor B. Second stage of labor C. Fourth stage of labor D. First stage of labor

B. Second stage of labor

A woman of 16 weeks' gestation telephones the nurse because she has passed some "berry-like" blood clots and now has continued dark brown vaginal bleeding. Which action would the nurse instruct the woman to do? A. "Continue normal activity, but take the pulse every hour." B. "Come to the health facility with any vaginal material passed." C. "Maintain bed rest, and count the number of perineal pads used." D. "Come to the health care facility if uterine contractions begin."

B. "Come to the health facility with any vaginal material passed."

A woman's primary care provider has told her he wants to use an episiotomy for birth. She asks the nurse what the purpose of this is. Which answer would be best? A. "It is done primarily for the care provider's benefit." B. "It relieves pressure on the fetal head." C. "It prevents distention of the bladder." D. "It aids contraction of the uterus following birth."

B. "It relieves pressure on the fetal head." An episiotomy widens the vaginal opening, decreasing pressure on the fetal head.

A nurse is assessing a client who has a new prescription for the combination oral contraceptive ethinyl estradiol and drospirenone. Which of the following findings should the nurse identify as a contraindication to use of this medication? A. Drinks a glass of wine each night B. Smokes half a pack of cigarettes a day C. Runs marathons regularly D. Drives a school bus

B. Smokes half a pack of cigarettes a day Smoking increases the risks of thomboemolic events, hypertension, and cardiovacular disease for clients who are taking combination oral contraceptives, especially for those clients who are older than 35yrs. Clients should quit smoking before starting this drug therapy.

Positive signs of pregnancy are diagnostic, meaning nothing else can elicit that sign except pregnancy. What is the earliest positive sign of pregnancy? A. Finding of hCG in the blood B.Visualization of the gestational sac or fetus C.Finding hCG in the urine D.Positive home pregnancy test

B. Visualization of the gestational sac or fetus

A nurse is caring for a young woman who is in her 10th week of gestation. She comes into the clinic reporting vaginal bleeding. Which assessment finding best correlates with a diagnosis of hydatidiform mole? A. Painful uterine contractions and nausea B. Brisk deep tendon reflexes and shoulder pain C. Dark red, "clumpy" vaginal discharge D. Bright red, painless vaginal bleeding

C. Dark red, "clumpy" vaginal discharge

A nurse is caring for a client who received human menopausal gonadotropin (hMG). Which of the following findings should the nurse expect? A. Prolactin secretion B. Estrogen release C. Follicular maturation. D. Oxytocin secretion

C. Follicular maturation Before a client receives human chorionic gonadotropin (hCG) to stimulate ovulation, they must receive a drug that induces follicular maturation, such as hMG, which is a mixture of LH and FSH, c lomiphene, or follitropin. Clients receive hCG 1 day after the last dose of hMG of follitropin or 7-9 days after the last clominphene dose.

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor? A. fetal baseline rate increasing at least 5 mm Hg with contractions B. variable decelerations, too unpredictable to count C. fetal heart rate declining late with contractions and remaining depressed D. a shallow deceleration occurring with the beginning of contractions

C. fetal heart rate declining late with contractions and remaining depressed

After administration of Terbutaline to a client to inhibit preterm labor, the nurse should assess which of the following? A. Peripheral pulses B. Temperature C. Vision D. Heart Rate

C. heart rate- Terbutaline can cause tachycardia, chest pain, and palpitations. The nurse should monitor the clients ECG for tachycardia and other dysrhythmias and monitor fetal heart rate and rhythm

When providing education to a teenage prenatal class, the nurse states that infants born to teenage mothers are more likely to have which outcome? A. lower mortality rates B. postdate birth C. low-birth weight D. genetic problems

C. low-birth weight

A nurse is caring for a client who is about to begin taking cabergoline to treat infertility. The nurse should explain to the client the need to monitor which of the following laboratory values? A. Potassium B. Glucose C. BUN and creatinine D. Prolactin Level

D. Prolactin level Cabergoline inhibits the secretion of prolactin. The provider should monitor prolactin levels to determine the appropriate dosage

Which neonatal assessment is the highest priority if the mother received meperidine during labor? A. Temperature regulation B. Lung sounds C. Time of first meconium D. Respiratory rate

D. Respiratory rate

A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her? A. She is 30 years old. B. She has irregular menstrual cycles. C. She has a history of allergy to foreign protein. D. She has a family history of thromboembolism.

D. She has a family history of thromboembolism

A client makes an appointment with an obstetrician and assessment reveals positive Hegar and Chadwick signs. What should the nurse teach the client about these results? A. The client more likely has a gynecologic disorder rather than pregnancy B. The client is definitively pregnant C. Pregnancy cannot be confirmed D. She is probably pregnant, but this must be confirmed by other means

D. She is probably pregnant, but this must be confirmed by other means

A nurse is caring for a client who has a new prescription for transdermal conjugated estrogen and medroxyprogesterone to treat postmenopausal symptoms. The nurse shoudl explain to the client that this drug combination includes which of the following therapeutic effects? (Select all that apply.) A. Reduces the risk of ovarian cancer B. Relieves hot flashes C. Prevents osteoporosis D. Reduces the risk of breast cancer E. Reduces the risk of thromboembolism

A, B, C, Reduces the risk of ovarian cancer-drug therapy with an estrogen and progesterone combination reduces the risk of ovarian cancer. however, the use of estrogen alone without progesterone can increase the risks of endometrial and ovarian cancer. Relieves hot flashes-drug therapy with an estrogen and progesterone combination or estrogen alone reduces hot flashes and the sweating and sleep disturbances they cause Prevents osteoporosis-drug therapy with an estrogen and progesterone combination or estrogen alone increases bone density and prevents osteoporosis

A provider has prescribed a dinoprostone vaginal insert to promote cervical ripening in a client who is at 40wks of gestation. When administering dinoprostone, which of the following actions should the nurse take? (Select all that apply.) A. Encourage the client to urinate prior to insertion B. Remove the pouch when active labor begins C. Monitor for uterine hyperstimulation D. Encourage the client to walk after insertion E. Monitor the clients temperature

A, B, C, E A-Encourage the client to urinate prior to insertion- the client should urinate prior to the insertion of the dinoprostone pouch. This actions does not specifically relate to the therapeutic effects of the drug, but it promotes comfort and prevents interruption of the administration protocol. B-Remove the pouch when active labor begins-the nurse shoudl remove the pouch when active labor begins or 12hr after the insertion of the dinoprostone, whichever is sooner C-Monitor for uterine hyperstimulation is correct-Uterine stimulation can cause fetal distress. The nurse should monitor uterine activity and fetal heart rate and remove the insert for fetal distress or uterine hyperstimulation D-Encourage the client to walk after insertion is incorrect-the client should lie supine for at least 2hr while the pouch slowly releases the drug E-Monitor the clients temperature- Dinoprostone can cause a fever. The nurse should monitor the client's temperature and report any changes to the provider

A nurse is providing teaching to a client who is taking bethanechol for urinary retention. Which of the following instructions should the nurse include (select all that apply) A. Avoid driving and activities that require alertness B. Increase fluid intake C. take the drug with food D. Stay close to a bathroom after taking the drug E. Increase weight-bearing activities

A, B, D, Avoid driving and activities that require alertness-Bethanechol, a muscarinic agonist, can cause dizziness and fainting. Clients who take the drug should use caution with activities that require alertness until they know how the drug will affect them. Increase fluid intake-Bethanechol can cause diarrhea and increased salivary and gastric secretions. Clients who take the drug should maintain hydration by increasing their fluid intake Stay close to a bathroom after taking the drug-Bethanechol cause rapid relief of urinary retention or diarrhea, with fecal incontinence. Clients who take the drug should stay near a bathroom or have a bedpan or urinal ready

A nurse is preparing a presentation for a local community women's group about menopause. When describing the body system changes that occur, the nurse would include which changes? Select all that apply. A. hot flashes B. increased abdominal fat C. moist, supple skin D. vaginal dryness E. decreased bone density F. decreased waist size

A, B, D, E Hot flashes, increased abdominal fat, vaginal dryness, decreased bone density

A 14-year-old client and her parents have presented at the obstetrician's office in the second trimester; the teen had been hiding the pregnancy. The nurse is helping them develop a plan of care. What is the best thing the nurse can say to the clearly angry parents? A. "I know you must be very upset and angry about your daughter's pregnancy, but because she's still an adolescent herself, she'll need your guidance in making nutritional and health choices that will be good for the baby and for herself." B. "Anger won't help this situation at all. You'll only push your daughter away, and she'll be less likely to make good choices." C. "I understand your anger, but if you had encouraged your daughter to use condoms she would probably not be in this situation." D. "Your daughter needs to make decisions about this pregnancy for herself."

A. "I know you must be very upset and angry about your daughter's pregnancy, but because she's still an adolescent herself, she'll need your guidance in making nutritional and health choices that will be good for the baby and for herself."

The client presents reporting irregular menstrual cycles, bleeding between periods, mood swings, hot flashes and vaginal tenderness. After an examination, the nurse suspects abnormal uterine bleeding. Which approach would be inappropriate? A. Tell the client to learn to live with it. B. Obtain a prescription for CBC and PT blood test. C. Prepare her for an ultrasound to check internal pelvic structures. D. Obtain a prescription for pregnancy test to rule out ectopic pregnancy.

A. Tell the client to learn to live with it.

Which neonate is at highest risk for developing neonatal herpes following birth? A. A newborn who was a vaginal delivery to a mother who had her initial outbreak during the third trimester of pregnancy and has active lesions B. A newborn who was a vaginal delivery to a mother with no active lesions but a history of herpes C. A newborn who was delivered by cesarean section following prolonged rupture of membranes to a herpes positive mother with no active lesions D. A newborn who was delivered by cesarean section to a mother with genital herpes

A. A newborn who was a vaginal delivery to a mother who had her initial outbreak during the third trimester of pregnancy and has active lesions

A nurse is providing safety education to a client who is scheduled to begin treatment with tamsulosin for benign prostatic hypertrophy (BPH). Which of the following instructions should the nurse include in the teaching? A. Change positions slowly B. Crush the medication C. Take the medication on an empty stomach D. Report increased urinary output immediately

A. Change positions slowly Alphy adrenergic blockers such as tamsulosin are also used to treat hypertension. These drugs can cause the blood pressure to drop, leading to orthostatic hypotension. Therefore, the nurse should instruct the client to change positions slowly to prevent harm.

A priority nursing diagnosis based on Maslow's Hierarchy of Needs for a client with endometriosis would be: A. Chronic Pain related to bleeding and endometrial pelvic implants. B. Deficient Knowledge related to diagnosis and treatment. C. Ineffective Breathing related to pain. D. Anxiety related to effect of endometriosis on fertility.

A. Chronic pain related to bleeding and endometrial pelvic implants

A woman in her 20s explains to the nurse that she would like to eat more healthy foods during her pregnancy but complains about the high cost of food. She confides that she just makes minimum wage at her job and that things are tight for her financially. What would be the most appropriate intervention for the nurse to make? A. Discuss the WIC program with the client. B. Recommend that the client focus on purchasing and eating only fruits and vegetables, to save money. C. Offer some money to the client to help her with her groceries. D. Discuss the school lunch program with the client.

A. Discuss the WIC program with the client

During a spontaneous vaginal birth several things need to occur to the fetus in sequence. As the fetus encounters resistance, what is its usual reaction? A. flexion B. engagement C. internal rotation D. extension

A. Flexion

A client is in active labor. Checking the EFM tracing, the nurse notes variables that are abnormal. What would be the nurse's first nursing intervention? A. Help the woman change positions. B. Obtain assistance to check for a compressed umbilical cord. C. Prepare the woman for an emergency cesarean birth. D. Document the finding.

A. Help the woman change positions.

A nurse should question the use of thinyl estradiol and drospirenone by a client who has renal disease due to the increased risk of thich of the following? A. Hyperkalemia B. Hyponatremia C. Hypoglycemia D. Respiratory alkalosis

A. Hyperkalemia-Ethinyl estradiol and dropirenone can cause potassium retention, so a client who has renal, adrenal, or liver disease should not take the drug combination. The nurse should monitor the serum potassium levels of a client taking the drug and use it with caution w/ other drugs that can increase serum potassium, such as potassium-sparing diuretics

Which factor suggests that a child's disorder is a X-linked inherited one? A. Male children of an affected male are free of the disease. B. Male and female children have the disease equally. C. One of the parents of the child has the disorder. D. The disease will have occurred in a female grandparent.

A. Male children of an affected male are free of the disease.

A group of nursing students are preparing a presentation which will illustrate various components of the birthing process. When presenting the pelvis, the students should point out that it is often referred to as which term? A. Passageway B. Psyche C. Passenger D. Powers

A. Passageway

A nurse is providing teaching to a clent about using leuprolide to treat endometriosis. Which of the following instructions should the nurse include? A. Perform weight-bearing activities B. Wear sunscreen or protective clothing C. Take the drug with food to increase absorption D. Avoid drinking grapefruit

A. Perform weight-bearing activities Leuprolide suppresses estrogen and can cause bone loss. The nurse should instruct the client to perform weigh-bearing activities and increase their intake of calcium and vitamin D.

A client comes to the emergency department reporting strong contractions that have lasted for the past 2 hours. Which assessment will indicate to the nurse that the client is in true labor? A. progressive cervical dilatation and effacement B. 1:5 uterine contractions C. increased fetal activity D. pink show

A. Progressive cervical dilation and effacement

Which of the following would be most appropriate for the woman who experiences dysfunctional labor in the first stage of labor? a) Provide ongoing communication about what is happening. b) Tell her not to feel anxious or discouraged about what is happening. c) Hold all explanations until after the birth to conserve the woman's energy. d) Limit talking to things the woman asks questions about.

A. Provide ongoing communication about what is happening. Explanation:Dysfunctional labor at any point is frustrating to women. Maintaining open lines of communication at least keeps the woman well informed about what is happening.

The estrogen content in the contraceptive pill performs which action? A. decreases the permeability of cervical mucus B. increases the level of luteinizing hormone (LH) C. interferes with endometrial proliferation D. suppresses follicle-stimulating hormone (FSH)

D. Suppresses follicle-stimulating hormone (FSH)

A nurse is caring for woman in labor. The woman's membranes just ruptured. The nurse assesses the characteristics of the fluid. Which finding would the nurse identify as normal? A. cloudy B. clear C. malodorous D. green

A. clear Amniotic fluid should be clear when the membranes rupture. During an amniotomy, a disposable plastic hook (an amnihook) is used to perforate the amniotic sac. Cloudy or foul-smelling amniotic fluid indicates infection. Green fluid may indicate that the fetus has passed meconium secondary to transient hypoxia, prolonged pregnancy, cord compression, intrauterine growth restriction (IUGR), maternal hypertension, diabetes, or chorioamnionitis.

During examination of clients, the nurse will question women concerning their LMP. This indicates: A. the first day of their last menstrual period. B. the last day of their last menstrual period. C. the length of their menstrual periods. D. the level of menstrual pain.

A. first day of their last menstrual period

Pregnancy tests (both urine and blood) measure levels of which hormone to validate the existence of pregnancy? A.human chorionic gonadotropin (hCG) B. progesterone C. aldosterone D. estrogen

A. human chorionic gonadotropin (hCG)

Which condition is the most common cause of anemia in pregnancy? A. iron-deficiency anemia B. alpha thalassemia C. beta thalassemia D. sickle cell anemia

A. iron-deficiency anemia

What would be the physiologic basis for a placenta previa? A. low placental implantation B. a placenta with multiple lobes C. a uterus with a midseptum D. a loose placental implantation

A. low placental implantation

The injection of a local anesthetic to block specific nerve pathways is referred to as: A. regional block. B. gas administration. C. amnesic medication. D. natural anesthesia.

A. regional block

A nurse is teaching a client about receiving leuprolide to treat endometriosis. The nurse should instruct the client to expect which of the following side effects? A. Vaginal dryness B. Hypertension C. Blurred vision D. Orthostatic hypotension

A.Vaginal dryness-Leuprolide can cause vaginal dryness. The nurse should suggest that the client use water-based vaginal lubricants to help minimize this effect.

Ampicillin

Antiobacterial- A penicillin that is effective against gram-negative and gram-positive bacteria

The nurse is instructing a client with dysmenorrhea on how to manage her symptoms. Which suggestions should the nurse include in the teaching plan? Select all that apply. A. Increase intake of salty foods. B. Increase water consumption. C. Avoid keeping legs elevated while lying down. D. Use heating pads or take warm baths. E. Increase exercise and physical activity.

B, D, E Increase water consumption, Use heating pads or take warm baths, increase exercise and physical activity

A client at 36 weeks' gestation comes in for her weekly primary care provider visit. She tells the nurse, "I am having contractions, but they are irregular and go away when I rest. Do you think I am going into labor?" The best response by the nurse would be: A. "I think you are going into labor. We may need to give you medications to stop the contractions." B. "These are called Braxton-Hicks contractions and are preparing your body for labor but are not 'true' labor contractions." C. "I think we better send you to the hospital for admission. You could be in labor." D. "It is too early for you too be in labor. Something may be wrong with the pregnancy."

B. "These are called Braxton-Hicks contractions and are preparing your body for labor but are not 'true' labor contractions."

A nurse is providing teaching to a client about sildenafil to treat erectile dysfuntion. Which of the following instructions should the nurse include? A. Take the drug with a glass of grapefruit juice B. Do not take the drug with high-fat foods C. Increase intake of foods rich in vitamin k D. avoid aged cheeses and red wine

B. Do not take the drug with high fat foods high fat foods delay absorption and reduce peak effects of sildenafil. Clients who take the drug should not take it with high fat foods

Some women contract with other women to provide support during pregnancy and birth, to provide emotional support during labor and birth, and to aid in establishing breastfeeding. What is the name of the woman who is contracted? A. partera B. doula C. midwife D. pregnancy aide

B. Doula

The nurse is assessing the health history of a male partner. Which data is most likely to be related to an infertility problem? A. 30 years of age B. employment as a taxi driver C. intercourse approximately every third day D. immunization against mumps as a child

B. Employment as a taxi driver

A nurse is provding care to a pregnant woman in her first trimester who has come to the clinic for a follow up visit. During the visit, the nurse teaches the woman about some of the changes that she will be experiencing during her pregnancy. Which information would the nurse include when describing changes in the breast? A. The areolas becomes lighter in color. B.Montgomery's tubercles become more prominent. C.Prolactin, an anterior pituitary hormone, stimulates the breasts to grow. D. Estrogen causes the breasts to feel nodular.

B. Montgomery's tubercles become more prominent

Amanda's menstrual period is two weeks late. She has been feeling tired and has had bouts of nausea in the morning. What classification of pregnancy symptoms is Amanda experiencing? A. Positive B. Presumptive C. Probable D. No classification

B. Presumptive

The nurse in a primary care clinic and a client have come to see the primary care provider because the client is getting married and wants to have a prenuptial gynecologic examination. After the exam, the nurse asks about the woman's plan to have a family. The woman responds, "Why do I have to plan for a family?" What would be the nurses's best response? A. Families are always best when pregnancies are not planned. B. The couple can control the time between births when they plan their family. C. An unwanted pregnancy can always be aborted. D. The couple can decide on a method of birth control.

B. The couple can control the time between births when they plan their family

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

B. assessing oxygen saturation

The student nurse is preparing to assess the fetal heart rate (FHR). She has determined that the fetal back is located toward the client's left side, the small parts toward the right side, and there is a vertex (occiput) presentation. The nurse should initially begin auscultation of the fetal heart rate in the mother's: A. left upper quadrant. B. left lower quadrant. C. right lower quadrant. D. right upper quadrant.

B. left lower quadrant

A nurse is performing a vaginal examination of a woman in the early stages of labor. The woman has been at 2 cm dilated for the past 2 hours, but effacement has progressed steadily. Which statement by the nurse would best encourage the client regarding her progress? A. Don't mention anything to the client yet; wait for further dilatation to occur. B. "You are still 2 cm dilated, but the cervix is thinning out nicely." C. "There has been no further dilatation; effacement is progressing." D. "You haven't dilated any further, but hang in there; it will happen eventually."

C. "There has been no further dilatation; effacement is progressing."

A nurse is teaching a woman how to use the basal body temperature method of contraception. the nurse determines that the teaching was successful when the woman identifies that she should refrain from having sexual intercourse at which time? A. 4 days after she notices her temperature rise. B. 7 days after noting a slight increase followed by a dip in her temperature. C. 3 days after she records a slight drop in her temperature followed by an increase. D. 14 days after the last day of her menstrual period.

C. 3 days after she records a slight drop in her temperature followed by an increase

A nurse is providing care to a couple who have experienced intrauterine fetal demise. Which action would be least effective in assisting a couple at this time? A. Allow the couple to spend as much time as they want with their stillborn infant. B. Assist the family in making arrangements for their stillborn infant. C. Avoid any discussion of the situation with the couple. D. Give the parents a lock of the infant's hair.

C. Avoid any discussion of the situation with the couple.

Prevention of pregnancy is a major factor in the sex lives of many couples. One method of contraception is the female condom. It is a thin tube made of polyurethane, with flexible rings at both ends. A.What is a disadvantage of the female condom? B. Need an erection to remain in place C. Can slip into the vagina during vigorous intercourse D. Cannot be used by people sensitive to latex E. Decreases stimulation to the clitoris

C. Can slip into the vagina during vigorous intercourse

A nurse is monitoring the FHR of a client in labor using an electronic fetal monitor. The reading shows a late deceleration. Which intervention should the nurse implement? A. Place the client in the lithotomy position. B. Administer exogenous oxytocin. C. Change maternal position to an upright or side lying position. D. Encourage the Valsalva maneuver.

C. Change maternal position to an upright or side lying position.

During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called? A. pseudo pregnancy B. pregnancy syndrome C. couvade syndrome D. cretinism

C. Couvade syndrome

A nurse is caring for a client who missed a dose of her oral contraceptive. Which of the following instructions should the nurse give the client? A. Take a pregnancy test B. Double up on pills for remainder of the pack C. Take the missed dose as soon as possible D Stop the oral contraceptive and use a different contraceptive

C. Take the missed dose as soon as possible. The nurse should tell the client to take the missed dose along with the next dose. Should the client miss two doses, she should take an additional dose each day for the next 2 days and add an additional method of birth control for the remainder of the cycle.

A woman is aware that she is the carrier of a sex-linked recessive disease (hemophilia A); her husband is free of the disease. What frequency of this disease could she expect to see in her children? A. All male children will inherit it. B. All female children will be carriers like she is. C. There is a 50% chance her male children will inherit the disease. D. There is a 50% chance her female children will inherit the disease.

C. There is a 50% chance her male children will inherit the disease.

A nurse is preparing to administer finasteride to a client who has benign prostatic hypertrophy (BPH). Which of the following precautions should the nurse plan to take when administering this drug? A. Refrain from crushing the tablet B. Withhold the medication if the client doesnt eat C. Wear gloves when handling the tablet D. Monitor heart rate prior to administration

C. Wear gloves when handling the tablet-The nurse should avoid touching the drug because it can be absorbed through the skin. For women, this can potentially cause harm if they are pregnant and have a male fetus. Women should also avoid exposure to semen from individuals who are taking finasteride.

The nurse is caring for a child with Down syndrome (trisomy 21). This is an example of which type of inheritance? A. Mendelian recessive B. Mendelian dominant C. chromosome nondisjunction D. phase 2 atrophy

C. chromosome nondisjunction

The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours. Why would the nurse do this? A. Pulmonary hypertension B. Pulmonary emboli C. Pulmonary edema D. Pulmonary atelectasis

C. pulmonary edema In the hospital, monitor blood pressure at least every four hours for mild preeclampsia and more frequently for severe disease. In addition, it is important to auscultate the lungs every two hours. Adventitious sounds may indicate developing pulmonary edema.

To assess the frequency of a woman's labor contractions, the nurse would time: A. how many contractions occur in 5 minutes. B. the end of one contraction to the beginning of the next. C. the beginning of one contraction to the beginning of the next. D. the interval between the acme of two consecutive contractions.

C. the beginning of one contraction to the beginning of the next.

A woman is going to have labor induced with oxytocin. Which statement reflects the induction technique the nurse anticipates the primary care provider will prescribe? A. Administer oxytocin diluted in the main intravenous fluid. B. Administer oxytocin in a 20 cc bolus of saline. C. Administer oxytocin in two divided intramuscular sites. D. Administer oxytocin diluted as a "piggyback" infusion.

D. Administer oxytocin diluted as a "piggyback" infusion.

As a woman enters the second stage of labor, her membranes spontaneously rupture. When this occurs, what would the nurse do next? A. Test a sample of amniotic fluid for protein. B. Ask her to bear down with the next contraction. C. Elevate her hips to prevent cord prolapse. D. Assess fetal heart rate for fetal safety.

D. Assess fetal heart rate for fetal safety.

A nurse should questions the use of conjugated equine estrogen by a client who has a history of which of the following? A. Osteoporosis B. Peptic ulcer disease C. Rheumatoid arthritis D. Blood Clots

D. Blood Clots-Clients who have a history of thromboembolic disease should not use estrogen replacement therapy because of the risks of thrombophlebitis, myocardial infarction, pulmonary embolism, and cerebrovascular accident.

If a woman is 3 months pregnant, which finding related to breast changes would the nurse expect to assess? A. slack, soft breast tissue B. deeply fissured nipples C. enlarged lymph nodes D. darkened breast areolae

D. Darkened breast areolae

About which childhood communicable disease should the nurse question the male client who is seeking information about subfertility? A. measles B. rubella C. chicken pox D. mumps

D. Mumps

A couple has just undergone a semen analysis. The semen sample was visualized under the microscope, and the nurse tells the couple that they must return to do another semen analysis. The man states that he can return later in the week. What is the best answer the nurse can provide? A. The analysis will need to be repeated after 1 or 2 months because spermatogenesis is an ongoing process, and 60 to 90 days are needed for sperm to reach maturity. B. The analysis will need to be repeated after 1 or 2 months because spermatogenesis is an ongoing process, and 30 to 60 days are needed for sperm to reach maturity. C. The analysis will need to be repeated after 2 or 3 months because spermatogenesis is an ongoing process, and 15 to 30 days are needed for sperm to reach maturity. D. The analysis will need to be repeated after 2 or 3 months because spermatogenesis is an ongoing process, and 30 to 60 days are needed for sperm to reach maturity.

D. The analysis will need to be repeated after 2 or 3 months because spermatogenesis is an ongoing process, and 30 to 60 days are needed for sperm to reach maturity.

Hypertonic labor is labor that is characterized by short, irregular contractions without complete relaxation of the uterine wall in between contractions. Hypertonic labor can be caused by an increased sensitivity to oxytocin. What would the nurse do for a client who is in hypertonic labor because of oxytocin augmentation? A. Turn off the methotrexate. B. Increase the methotrexate. C. Increase the oxytocin. D. Turn off the oxytocin.

D. Turn off the oxytocin.

A woman is in the hospital only 15 minutes when she begins to give birth precipitously. The fetal head begins to emerge as the nurse walks into the labor room. The nurse's best action would be to: A. attach a fetal monitor to determine fetal status. B. assess blood pressure and pulse to detect placental bleeding. C. ask her to push with the next contraction so birth is rapid. D. place a hand gently on the fetal head to guide birth.

D. place a hand gently on the fetal head to guide birth.

A pregnant client is excited that she is beginning to feel her baby move within her. The nurse explains that these first fetal movements are known as: A. amenorrhea. B. lactation. C. lordosis. D. quickening.

D. quickening