ARCHER REVIEW Maternity
A postpartum client with mastitis in the right breast complains that the breast is too sore for her to breastfeed her infant. Which should the nurse tell the client?
"Breastfeed from the left breast and gently pump the right breast"
The LPN is attending a client who is 20 weeks pregnant and had completed patient education. Which of the client's following statements indicates that she has a good understanding of her baby's development?
"My baby is about 7 1/2 inches long"
The nurse is caring for a woman who has delivered a baby after a pregnancy complicated with placenta previa. Which complication is the client most at risk for developing?
- Postpartum hemorrhage
The LPN assists a mother in labor to the bathroom and notes that the FHR increases from 130 to 190. She sits the mother back down in bed and the FHR remains 190. Which of the following nursing actions would be appropriate? Select all that apply.
- lie the mother down on her left side - administer oxygen
The nurse is providing instructions to a pregnant client with genital herpes about the measures that need to be implemented to protect the fetus. Which instruction should the nurse provide to the client?
A cesarean section will be necessary if vaginal lesions are present at the time of labor.
The nurse is reviewing the treatment plan with the parents of a newborn infant with hypospadias. Which statement by the parents indicates their understanding of the plan?
- "Circumcision has been delayed to save tissue for surgical repair"
The LPN is reinforcing to a pregnant client with DVT in her left lower extremity. The client is at 24 weeks of gestation. The client has been placed on Low Molecular Weight Heparin (LMWH). Which of the following statements by the client indicate(s) that she understands the education regarding LMWH?
- "I hate injections and therefore, I will likely switch to Warfarin after delivery." - "There is an increased risk of fractures w/long term LMWH therapy." - "If I notice blisters followed black red area at the injection site, I will immediately contact the doctor."
The nurse provides explanation to a client prescribed methylergonovine maleate in the immediate postpartum period. Which statement made by the client demonstrates understanding of the rationale for administration?
- "It will help prevent bleeding and control bleeding if it occurs
A client is scheduled to have an elective cesarean delivery. How should the nurse allay the client's feelings of anxiety?
- Encourage the client to discuss her concerns and desires regarding anesthesia options.
The nurse is assisting with caring for a client who has a placenta previa. The nurse understands that a cervical examination should not be performed on the client primarily because it could have which consequence?
- causes hemorrhage
The nurse suspects that the client has a pulmonary embolism when the client exhibits which signs and symptoms?
- dyspnea, tachypnea, and tachycardia
The nurse is reading the primary health care provider's (PHCP) documentation regarding a pregnant client and notes that the PHCP has documented that the client has an android pelvic shape. The nurse understands that which characteristics are included with this pelvic shape? Select all that apply.
- heart shaped - convergent sidewalls - narrow interspinous diameter
A client arrives at the birthing center in active labor. Her membranes are still intact and the nurse-midwife performs an amniotomy. The nurse explains to the client that this procedure will most likely have which effect?
- increased efficiency of contractions
anthropoid pelvic shape
- long, narrow and oval - not the most favorable for vaginal birth
A postpartum client asks the nurse when she may resume sexual activity. Which response should the nurse give to the client?
- sexual activity may be resumed in about 3 weeks when the episiotomy has healed and the lochia has stopped
The nurse caring for a client who is receiving oxytocin for the induction of labor notes a nonreassuring fetal heart rate (FHR) pattern on the fetal monitor. On the basis of this finding, which is the nurse's priority action?
- stop the oxytocin infusion
A client in labor is transported to the delivery room and is prepared for a cesarean delivery. The client is positioned on the delivery room table and the nurse places the client in which position?
- supine with wedge under the right hip
Which should be included in the plan of care for a pregnant teenager to reinforce instructions regarding dental care?
- tell the dental office staff that she is pregnant
A client becomes increasingly more anxious and hyperventilates during the transition phase of labor. The nurse recognizes that the client needs what?
- to regain her breathing pattern
A client is undergoing electronic fetal monitoring (EFM), and the nurse informs the client about the procedure. Which statement indicates to the nurse that the client correctly understands this procedure?
"What an efficient way to record my baby's heart rate."
A G3P3 client in labor asks the LPN, "I would like to breastfeed, but my breasts got so engorged last time. I couldn't take it. Do I have to go through that again?" Which of the following response is most appropriate.
"You need to feed your baby as soon as possible. Also, feeding your baby often would prevent breast engorgement."
A pregnant woman visiting a health care clinic for the first prenatal visit hears the primary health care provider discuss the preembryonic period of development with the nurse. The woman asks the nurse what this means. What information should the nurse share related to this stage of development? Select all that apply.
- "The preembryonic period is the first 2 weeks of fetal development following conception." - "The preembryonic period includes initial development of the embryonic membranes and establishment of the primary germ layers."
A client tells the nurse her contractions are getting stronger and that she is getting tired. She appears restless, asks the nurse not to leave her alone, and states, "I can't take it anymore." Based on the client's behavior, the nurse should suspect the client is how far dilated?
- 8 to 10 cm
The nurse is collecting data from a prenatal client. The nurse determines that which situation places the client in the high-risk category for contracting human immunodeficiency virus (HIV)?
- A history of intravenous (IV) drug use in the past year
A woman diagnosed previously with gestational hypertension is returning to the clinic for her scheduled prenatal appointment. During the assessment, the nurse is concerned that she is developing signs/symptoms that indicate that her mild gestational hypertension is progressing. What assessment findings indicate to the nurse that the mild gestational hypertension is progressing? Select all that apply.
- BP 165/120 mmHg - complaints of headache for the last 12 hours
The nurse is collecting data on a client who is 6 hours postpartum following delivery of a full-term healthy newborn. The client tells the nurse that she feels faint and dizzy. Which nursing action is appropriate?
- Instruct the mother to request help when getting out of bed.
The nurse is assisting with caring for a postpartum client who is experiencing uterine hemorrhage. When planning to meet the psychosocial needs of the client, the nurse should plan which action?
- Keep the client and her family members informed of her progress.
The nurse is collecting data from a pregnant client with a history of cardiac disease and is checking the client for venous congestion. The nurse inspects which body areas, knowing that venous congestion is commonly noted in which areas? Select all that apply.
- Legs - Vulva - Rectum
The nurse is monitoring a newborn infant who was circumcised. The nurse notes that the infant has a temperature of 100.6° F and that the dressing at the circumcised area is saturated with a foul-smelling drainage. Which is the priority nursing action?
- Notify the RN
The pregnant client with mitral valve prolapse is receiving anticoagulant therapy during pregnancy. The nurse collects data on the client and expects the client will indicate that which medication is prescribed?
- SUBCUTANEOUS ADMINISTRATION OF HEPARIN SODIUM 5000 UNITS DAILY
A pregnant client in the third trimester of pregnancy with a diagnosis of mild preeclampsia is being monitored at home for progression of the disease process. The home care nurse reinforces teaching the client about the signs that need to be reported to the primary health care provider (PHCP) and tells the client to call the PHCP if which occurs?
- Weight increases by more than 1 pound in a week.
A pregnant client in the second trimester of pregnancy is admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding should the nurse expect to note if this condition is present?
- abdominal pain
The client is informed that she is now in the second stage of labor, the descent phase. Which observations should the nurse make to support this stage of labor? Select all that apply.
- bearing down w/contractions - making expiratory vocalizations - changing body positions frequently
The nurse is assigned to care for a client in the immediate postpartum period who received epidural anesthesia for delivery, and the nurse monitors the client for complications. Which assessment finding most likely indicates a hematoma?
- changes in vital signs
The nurse assists the nurse-midwife in examining the client. The midwife documents the following data: cervix 80% effaced and 3 cm dilated, vertex presentation minus (-) 2 station, membranes ruptured. The nurse anticipates that the midwife will prescribe which activity for the client?
- complete bed rest
The advantages of using spinal anesthesia for delivery of a fetus include which reasons? Select all that apply.
- ease of administration - absence of fetal hypoxia - immediate onset of anesthesia
The nurse is assisting in caring for a newborn with respiratory distress syndrome. Which initial action should the nurse plan to best facilitate bonding between the newborn and parents?
- encourage the parents to touch their newborn
Gynecoid pelvic shape
- rounded w/wide pubic arch - most favorable pelvic shape for vaginal birth
The nurse is providing emergency measures to a pregnant client with a prolapsed cord. The mother becomes anxious and frightened and says to the nurse, "Why are all of these people in here? Is my baby going to be all right?" Which appropriately describes the mother's problem at this time?
- fear about what is happening
The nursing instructor has taught a lecture on the reproductive cycle of the female and asks a nursing student to identify the functions of the vagina. The student correctly responds by identifying which functions? Select all that apply.
- female organ of coitus - discharge of menstrual flow - allows for fetal passage during the process of birth
platypelloid pelvic shape
- flattened w/wide, short oval shape - a unfavorable shape for vaginal birth
The nurse is assisting in administering beractant to a premature infant who has respiratory distress syndrome. The nurse understands that the medication should be administered by which route?
- intratracheal
The nursing student is conducting a clinical conference regarding the hormones that are related to pregnancy, and the instructor asks the student about the function of progesterone. Which response made by the student indicates an understanding of the function of this hormone? Select all that apply.
- it maintains the uterine lining for implantation - it relaxes all smooth muscle, including the uterus
Which action, if noted in the new mother, indicates the need for further data collection by the nurse for signs of postpartum depression?
- mother constantly complains of tiredness and fatigue
The nurse is providing information to a pregnant woman about food items high in folic acid. Which mid-afternoon snack should be recommended to supply folic acid?
- nuts and green, leafy vegetables
The nurse is caring for a client with sickle cell disease who is in labor. The nurse ensures that the client receives appropriate intravenous (IV) fluid intake and oxygen consumption to primarily accomplish which goal?
- prevent dehydration and hypoxemia
A term client is being seen for a final prenatal appointment. The clinic nurse is making arrangements for the client to be admitted to the labor and delivery unit for an oxytocin induction. The nurse reviews the client's chart and should contact the primary health care provider regarding which documented finding to verify the oxytocin induction?
- previous classical vertical uterine incision
The nurse is caring for a client who had a cesarean section to deliver a nonviable fetus as a result of abruptio placentae. The client develops signs of disseminated intravascular coagulopathy (DIC). The spouse asks the nurse what is happening, and the nurse explains the condition. The spouse becomes upset and says to the nurse, "I lost my baby and now my wife! What am I going to do?" Which appropriately describes the situation?
- the spouse lacks hope because of the loss of the baby and illness of his wife
Oxytocin is administered to a client following the delivery of the placenta. The nurse assisting in caring for the client monitors for which effective response from the medication?
- uterine contractions
The nurse has reinforced instructions to a postpartum client who is hepatitis B positive on how to safely bottle-feed her newborn to prevent the transmission of the infection. Which action by the client indicates an understanding of this procedure?
- washes and dries her hands before feeding
A second-day postpartum client diagnosed with a stable cardiac condition has scant lochia with a foul odor and a temperature of 102.2° F. The primary health care provider suspects infection and writes prescriptions to treat the client. Which prescription written by the primary health care provider should the nurse implement first?
- Obtain culture and sensitivity of lochia and urine
A client who has just been told that she is pregnant asks a clinic nurse when the fetus's heart will be developed and beating. The nurse tells the client that the fetal heart is beating at what gestational week?
- Week 5
The nurse in the postpartum unit notes that the result of a rubella titer drawn on a postpartum client during the antepartum period is 1.8. Which should the nurse anticipate to be prescribed by the primary health care provider?
- administration of a SUBCUT rubella virus vaccine
The nurse is assisting in performing Leopold's maneuvers. The client asks the purpose of the procedure. How should the nurse respond to the client? Select all that apply.
- "Leopold's maneuvers are used to determine felt position." - "Leopold's maneuvers assist in determining the degree of descent into pelvis of presenting part." - "Leopold's maneuvers assist in determining the point of maximal intensity of FHR on the maternal abdomen"
The clinic nurse is reviewing the records of the pregnant clients who will be seen in the clinic. Which client profile presents the greatest risk for human immunodeficiency virus (HIV) infection?
- an adolescent w/multiple heterosexual contacts
A perinatal client is at risk for toxoplasmosis. Which instruction should the nurse reinforce with the client to prevent exposure to this disease?
- avoid exposure to litter boxes used by cats
The nurse is asked to assist the primary health care provider in performing Leopold's maneuvers on a client. Which nursing intervention should be implemented before this procedure is performed?
- have the client empty her bladder
