Capstone ob/peds final

3. The patient is a 1-month-old infant with stable supraventricular tachycardia (SVT) at a rate of 250 beats/min. She weighs 6 kg. How much adenosine should be given? a. 0.05 mg rapid IV push b. 0.1 mg rapid IV push c. 0.6 mg rapid IV push d. 0.5 mg rapid IV push

0.6 mg rapid IV push

1. What is the daily fluid requirement for a 60-kg child? a. 2600 mL/m2 per day b. 1500 mL/m2 per day c. 2400 mL/m2 per day d. 3000 mL/m2 per day

1500 mL/m2 per day

13. The American College of Obstetricians and Gynecologists (ACOG) has developed a comprehensive list of risk factors associated with the development of preeclampsia. Which client exhibits the greatest number of these risk factors? a. 30-year-old obese Caucasian with her third pregnancy b. 41-year-old Caucasian primigravida c. 19-year-old African American who is pregnant with twins d. 25-year-old Asian American whose pregnancy is the result of donor insemination

19-year-old African American who is pregnant with twins

13. What is the initial setting on a manual defibrillator for a patient older than 1 year? a. 100 joules b. 360 joules c. 2 joules/kg d. 4 joules/kg

2 joules/kg

10. According to research, what are the minimal viability parameters for an infant? a. 20 to 21 weeks' gestation and fetal weight between 500 and 1000 g. b. 22 to 23 weeks' gestation and fetal weight between 1000 and 15,000 g. c. 23 to 24 weeks' gestation and fetal weight between 500 and 1000 g. d. 24 to 25 weeks' gestation and fetal weight between 500 and 1200 g.

23 to 24 weeks' gestation and fetal weight between 500 and 1000 g.

2. What is the circulating blood volume of a neonate? a. 40 to 60 mL/kg b. 75 to 80 mL/kg c. 80 to 85 mL/kg d. 65 to 70 mL/kg

80 to 85 mL/kg

16. What is the most common obstetric cause of disseminated intravascular coagulopathy (DIC)? a. Preeclampsia b. Abruptio placentae c. Dead fetus syndrome d. Amniotic fluid embolism

Abruptio placentae

5. A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes, dark red vaginal bleeding, and a tense, painful abdomen. Which clinical change does the nurse anticipate? a. Eclamptic seizure b. Rupture of the uterus c. Placenta previa d. Abruptio placentae

Abruptio placentae

6. Which obstetric conditions may precipitate disseminated intravascular coagulation (DIC) in an obstetric patient? (Select all that apply.) a. Abruptio placentae b. Amniotic fluid embolism c. Asthma d. Intracranial hemorrhage e. Bacterial pneumonia f. Dead fetus syndrome

Abruptio placentae Amniotic fluid embolism Dead fetus syndrome

19. A multiparous woman was admitted at 36 weeks' gestation for nausea, vomiting, and severe epigastric pain. The fetal heart rate was normal. Severe preeclampsia was diagnosed. The patient is placed on a magnesium sulfate drip of 3 g/h. After an hour the patient has a seizure. The nurse notifies the practitioner. What order would the nurse anticipate? a. Administer another 2- to 4-g bolus of magnesium sulfate. b. Increase the magnesium drip at a rate of 1 to 2 g/h. c. Prepare the patient for immediate delivery of the baby. d. Prepare for intubation and mechanical ventilatory support.

Administer another 2- to 4-g bolus of magnesium sulfate.

3. A patient has been admitted with severe preeclampsia. The nurse knows that the patient's treatment plan would include which intervention? a. Titrating intravenous fluids to maintain urine output greater than 50 mL/h b. Administering hydralazine to keep the systolic blood pressure less than 120 mm Hg c. Placing the patient on bed rest to decrease the chance of delivery d. Administering magnesium sulfate to maintain serum levels of 4 to 7 mEq/L

Administering hydralazine to keep the systolic blood pressure less than 120 mm Hg

1. What elements help a child cope successfully with a critical care crisis? (Select all that apply.) a. An outside support system b. A resilient personality c. Another child with the same illness d. A supportive family e. A fatalistic practitioner

An outside support system A resilient personality A supportive family

12. A patient is admitted who is pregnant and has Marfan syndrome. The nurse knows that this disorder places the patient at risk for what complication? a. Stroke b. Pulmonary embolism c. Heart failure d. Aortic dissection

Aortic dissection

11. A patient is admitted who is pregnant and has a congenital cardiac disorder. The patient is experiencing complications that include dysrhythmias, heart failure, and thromboembolism. The nurse recognizes that these are symptoms of which condition? a. Atrial septal defect b. Ventricular septal defect c. Patent ductus arteriosus d. Mitral stenosis

Atrial septal defect

14. A 4-year-old child is admitted with fever, chills, headache, vomiting, lethargy, photophobia, and nuchal rigidity. Based on these clinical manifestations, what diagnosis would the nurse anticipate? a. Status epilepticus b. Bacterial meningitis c. Head trauma d. Septic shock

Bacterial meningitis

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

Boggy uterus with heavy lochia flow

20. Which statement most accurately describes the HELLP syndrome? a. Mild form of preeclampsia b. Diagnosed by a nurse alert to its symptoms c. Characterized by hemolysis, elevated liver enzymes, and low platelets d. Associated with preterm labor but not perinatal mortality

Characterized by hemolysis, elevated liver enzymes, and low platelets

5. What intrinsic factor can influence fetal development? a. Fungal infections b. Chromosomal abnormalities c. Radiation exposure d. Medication exposure

Chromosomal abnormalities

10. Which statement best describes chronic hypertension? a. Chronic hypertension is defined as hypertension that begins during pregnancy and lasts for the duration of the pregnancy. b. Chronic hypertension is considered severe when the systolic BP is higher than 140 mm Hg or the diastolic BP is higher than 90 mm Hg. c. Chronic hypertension is general hypertension plus proteinuria. d. Chronic hypertension can occur independently of or simultaneously with preeclampsia.

Chronic hypertension can occur independently of or simultaneously with preeclampsia.

11. Central cyanosis is associated with which phenomena? a. Decreased peripheral blood flow b. Desaturation of arterial blood c. Reduced hemoglobin of 15 g/dL d. Permanent cerebral hypoxia

Desaturation of arterial blood

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

Dipstick value of 3+ for protein in her urine

13. The treatment plan for management of an obstetric patient with peripartum cardiomyopathy (PPCM) includes which interventions? a. Oxygen therapy, pain management, and preload enhancement b. Walking exercises, diuretics, and anticoagulants c. Diuretics, digoxin, and anticoagulation d. Fluid resuscitation, beta-blockers, and vasoconstrictors

Diuretics, digoxin, and anticoagulation

14. Women with mild gestational hypertension and mild preeclampsia can be safely managed at home with frequent maternal and fetal evaluation. Complete or partial bed rest is still frequently ordered by some providers. Which complication is rarely the result of prolonged bed rest? a. Thrombophlebitis b. Psychologic stress c. Fluid retention d. Cardiovascular deconditioning

Fluid retention

18. A multiparous woman was admitted at 36 weeks' gestation for nausea, vomiting, and severe epigastric pain. The fetal heart rate was normal. Severe preeclampsia was diagnosed. In addition to her clinical signs and symptoms, the patient's laboratory studies demonstrate hemolysis of red blood cells, elevated liver enzymes, and a low platelet count. What would be anticipated as an additional diagnosis? a. Disseminated intravascular coagulopathy (DIC) b. Dead fetus syndrome c. Amniotic fluid embolism d. HELLP syndrome

HELLP syndrome

2. The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the womans latest laboratory test findings, which reveal a platelet count of 90,000 mm3 , an elevated aspartate aminotransaminase (AST) level, and a falling hematocrit. The laboratory results are indicative of which condition? a. Eclampsia b. Disseminated intravascular coagulation (DIC) syndrome c. Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome d. Idiopathic thrombocytopenia

Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome

15. What is the most common cause of obstetric cardiac arrest in pregnancy? a. Anesthetic complications b. Idiopathic peripartum cardiomyopathy c. Pregnancy-induced hypertension d. Hemorrhage

Hemorrhage

4. What are the causes of status epilepticus in children? (Select all that apply.) a. High fever b. Encephalitis c. Metabolic disorders d. Meningitis e. Gradual weaning of anticonvulsant drugs

High fever Encephalitis Metabolic disorders Meningitis

17. A woman with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the client and documents the following findings: temperature of 37.1 C, pulse rate of 96 beats per minute, respiratory rate of 24 breaths per minute, BP of 155/112 mm Hg, 3+ DTRs, and no ankle clonus. The nurse calls the provider with an update. The nurse should anticipate an order for which medication? a. Hydralazine b. Magnesium sulfate bolus c. Diazepam d. Calcium gluconate

Hydralazine

19. What is the most common medical complication of pregnancy? a. Hypertension b. Hyperemesis gravidarum c. Hemorrhagic complications d. Infections

Hypertension

2. What is the second leading cause of maternal death in the United States? a. Sepsis b. Hemorrhage c. Hypertensive disease d. Disseminated intravascular coagulation

Hypertensive disease

8. When is the greatest risk for the patient who has had a cesarean section to develop a pulmonary embolism? a. First time patient gets out of bed b. Postoperative day 2 c. During the procedure d. Immediate postpartum period

Immediate postpartum period

10. What is the pathophysiologic characteristic of a left-to-right shunt resulting from a congenital heart defect? a. Decreased pulmonary blood flow b. Mixed lesions with variable clinical symptoms c. Increased pulmonary blood flow d. Obstruction of blood flow to the ventricles

Increased pulmonary blood flow

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

Induction of labor is likely, as near term as possible.

5. A 3-year-old patient is admitted with head trauma as the result of a motor vehicle crash. The nurse knows that the complications of a head injury include which conditions? (Select all that apply.) a. Infection b. Seizures c. Hemorrhage d. Cerebral bleeding e. Brain herniation

Infection Seizures Hemorrhage Cerebral bleeding Brain herniation

15. Which neonatal complications are associated with hypertension in the mother? a. Intrauterine growth restriction (IUGR) and prematurity b. Seizures and cerebral hemorrhage c. Hepatic or renal dysfunction d. Placental abruption and DIC

Intrauterine growth restriction (IUGR) and prematurity

6. A patient is brought to the unit after delivering a very large baby. The patient suddenly becomes extremely agitated and complains of shortness of breath. An amniotic fluid embolism is suspected. The nurse would immediately prepare for which intervention? a. Insertion of a pulmonary artery catheter b. Administration of an ampule of 50% dextrose c. Administration of magnesium sulfate d. Intubation and mechanical ventilation

Intubation and mechanical ventilation

9. A 5-year-old boy has been admitted with severe asthma. His initial PaCO2 was 30 mm Hg. One hour later his PaCO2 is 45 mm Hg, and 1 hour after that, his PaCO2 is 56 mm Hg. Which intervention would the nurse anticipate being ordered by the practitioner? a. High-dose steroids b. Chest percussion and vibration c. Fluid resuscitation with normal saline d. Intubation and mechanical ventilation

Intubation and mechanical ventilation

15. A 4-year-old child is admitted with fever, chills, headache, vomiting, lethargy, photophobia, and nuchal rigidity. Nursing management for this patient would include which intervention? a. Measuring and documenting head circumference. b. Allowing the patient's siblings to visit. c. Isolating the patient during initial antibiotic treatment and for 24 hours thereafter. d. Administering anticonvulsant medications every 6 hours.

Isolating the patient during initial antibiotic treatment and for 24 hours thereafter.

7. Which method can be used to establish an endotracheal tube size for a child younger than 2 years of age? a. Match the endotracheal tube size to the infant's age. b. Take the child's age, add 16, and divide by 4. c. Measure the length of the child's little finger and divide by 2. d. No method is needed, as only one size is available.

Match the endotracheal tube size to the infant's age.

3. What factors must be considered when making clinical decisions regarding critically ill obstetric patients? (Select all that apply.) a. Maternal-fetal mortality b. Parental desires c. Fetal weight d. Parameters of maternal age e. Parameters of gestational age

Maternal-fetal mortality Parental desires Fetal weight Parameters of gestational age

16. A 4-year-old child is admitted to the critical care unit with fever, chills, headache, vomiting, lethargy, photophobia, and nuchal rigidity. The patient has been unable to eat, and tube feedings are to be initiated. What is the preferred method for determining the insertion length of the nasogastric tube? a. Measure from the naris to ear to xiphoid process. b. Measure from the ear to the umbilicus. c. Measure from the naris to the xiphoid to ear. d. Measure from the naris to ear to a point between the xiphoid process and the umbilicus.

Measure from the naris to ear to a point between the xiphoid process and the umbilicus.

20. Which medication is used for weaning a child with an opioid dependency? a. Morphine b. Fentanyl c. Meperidine d. Methadone

Methadone

17. The nurse is caring for a 6-month-old infant who is having frequent episodes of apparent life- threatening events (ALTEs). The practitioner has ordered a number of treatments for the patient. Which treatment would the nurse question as being inappropriate in this situation? a. Prone positioning b. Moderate sedation c. Nasal continuous positive airway pressure d. Recurrent cutaneous stimulation

Moderate sedation

22. The nurse is caring for a patient with preexisting spinal cord injury (SCI) who is 37 weeks pregnant. The SCI occurred at T4. Which intervention would be added to the plan of care when the patient goes into labor? a. Instruct the patient to let the nurse know when labor starts. b. Administer steroids at the onset of labor. c. Monitor the patient for signs of autonomic dysreflexia. d. Prepare the patient for a cesarean section.

Monitor the patient for signs of autonomic dysreflexia.

16. The nurse has evaluated a client with preeclampsia by assessing DTRs. The result is a grade of 3+. Which DTR response most accurately describes this score? a. Sluggish or diminished b. Brisk, hyperactive, with intermittent or transient clonus c. Active or expected response d. More brisk than expected, slightly hyperactive

More brisk than expected, slightly hyperactive

21. What is the leading cause of maternal trauma? a. Burns b. Motor vehicle accident c. Falls d. Domestic violence

Motor vehicle accident

4. A patient has been admitted with severe preeclampsia. The nurse understands the patient is at risk for hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. What clinical manifestations would indicate the patient is developing this condition? a. Nausea, vomiting, and epigastric pain b. Jaundice, pruritus, and flank pain c. Hypoactive bowel sounds, bleeding at puncture sites, and back pain d. Fever, jugular vein distention, and chest pain

Nausea, vomiting, and epigastric pain

24. Which statement regarding the use of medications or other therapies for advanced cardiac life support (ACLS) in the pregnant patient is accurate? a. No contraindications exist for use of atropine in pregnancy. b. Epinephrine is contraindicated because it decreases uteroplacental perfusion. c. Lidocaine is contraindicated because it crosses the placenta and has adverse fetal effects. d. Electric therapies are contraindicated because of the potential for electrocution of the infant.

No contraindications exist for use of atropine in pregnancy.

4. Which physiologic changes are common in pregnant women? (Select all that apply.) a. Circulating blood volume decreases by 20% as it is diverted to the placenta. b. Oxygen consumption increases to accommodate the fetus's needs. c. Respiratory tidal volumes decrease because of the elevated diaphragm. d. Gastric motility decreases because of displacement of gastrointestinal structures by the enlarged uterus. e. The glomerular filtration rate increases as cardiac output rises.

Oxygen consumption increases to accommodate the fetus's needs. Gastric motility decreases because of displacement of gastrointestinal structures by the enlarged uterus. The glomerular filtration rate increases as cardiac output rises.

14. A patient who is 30-weeks pregnant is admitted with severe asthma. The nurse understands that sufficient fetal oxygenation requires what minimum level of maternal oxygenation? a. PaO2 greater than 100 mm Hg b. PaO2 greater than 70 mm Hg c. Oxygen saturation of 100% d. Oxygen saturation greater than 70%

Oxygen saturation of 100%

12. What is the initial treatment for hypoxia, acidosis, or hypothermia? a. Vasopressin b. Bronchodilators c. Oxygenation and ventilation d. Hydration

Oxygenation and ventilation

19. What is the key to effective pain management in children? a. Behavioral assessment b. Pain assessment c. Physical assessment d. Activity assessment

Pain assessment

6. To establish a patent airway in an infant or child younger than 2 years of age, the nurse would perform which action? a. Initiate the head-tilt/chin-lift maneuver. b. Hyperextend the neck and pull the jaw forward. c. Place a towel under the upper shoulders with the jaw slightly extended into "sniffing" position. d. Place a folded towel under the head to extend the neck.

Place a towel under the upper shoulders with the jaw slightly extended into "sniffing" position.

1. Which adverse prenatal outcomes are associated with the HELLP syndrome? (Select all that apply.) a. Placental abruption b. Placenta previa c. Renal failure d. Cirrhosis e. Maternal and fetal death

Placental abruption Renal failure Maternal and fetal death

7. Which statement regarding pregnancy and asthma is accurate? a. Progesterone causes smooth muscle relaxation, which can worsen asthma symptoms. b. Poorly controlled asthma has been associated with an increased incidence of spontaneous abortion. c. A decrease in peak expiratory flow rate (PEFR) of more than 20% of the patient's personal best requires a visit to the emergency room. d. It is estimated that approximately two thirds of patients will have worsening of asthma symptoms.

Poorly controlled asthma has been associated with an increased incidence of spontaneous abortion.

20. The mnemonic "tone, tissue, trauma, and thrombosis" refers to potential causes of which disorder? a. Hypoxia b. Abruptio placentae c. Postpartum hemorrhage (PPH) d. Trauma

Postpartum hemorrhage (PPH)

1. What are some of the unique causes of septic shock in pregnant patients? (Select all that apply.) a. Postpartum pyelonephritis b. Ectopic pregnancy c. Chorioamnionitis d. Septic abortion e. Postpartum hemorrhage

Postpartum pyelonephritis Chorioamnionitis Septic abortion

17. A multiparous woman was admitted at 36 weeks' gestation for nausea, vomiting, and severe epigastric pain. The fetal heart rate was normal. Severe preeclampsia was diagnosed. What is the treatment goal for this patient? a. Maintaining maternal blood pressure greater than 140/90 mm Hg b. Delaying delivery of the fetus as long as possible c. Preventing maternal seizures, which may compromise fetal oxygenation d. Limiting fluid intake to avoid postpartum edema.

Preventing maternal seizures, which may compromise fetal oxygenation

5. A patient has been admitted with severe preeclampsia. The nurse knows that the patient's treatment plan would include which goals? (Select all that apply.) a. Prevention of seizures b. Decreasing arterial spasms c. Prompt delivery of the fetus d. Support of hypotension e. Administration of broad-spectrum antibiotics

Prevention of seizures Decreasing arterial spasms Prompt delivery of the fetus

3. Optimal treatment of a pediatric patient with status asthmaticus includes which actions? (Select all that apply.) a. Placing the patient in the knee-chest position b. Extending the neck to promote opening of the airway c. Providing humidified oxygen d. Administering b-adrenergic therapy e. Administering corticosteroids

Providing humidified oxygen Administering b-adrenergic therapy Administering corticosteroids

23. What is the leading cause of cardiac arrest in pregnancy? a. Sepsis b. Pregnancy-induced hypertension c. Hemorrhage d. Pulmonary embolism

Pulmonary embolism

2. What conditions or disorders place the obstetric patient at a 25% to 50% risk of maternal mortality? (Select all that apply.) a. Marfan syndrome with valvular involvement b. Pulmonary hypertension c. Coarctation of aorta with valvular involvement d. Marfan syndrome with aortic involvement e. Mitral stenosis with atrial fibrillation

Pulmonary hypertension Coarctation of aorta with valvular involvement Marfan syndrome with aortic involvement

8. Which process is a pathophysiologic consequence of respiratory syncytial virus (RSV)? a. Replacement of the epithelium with nonciliated tissue resulting in submucosal edema and eventual necrosis b. Necrosis of the alveoli resulting in collapse and destruction c. Inflammation of the diaphragm resulting in alveolar hypoventilation d. Bronchoconstriction resulting in airway inflammation and eventual airflow obstruction

Replacement of the epithelium with nonciliated tissue resulting in submucosal edema and eventual necrosis

18. The client being cared for has severe preeclampsia and is receiving a magnesium sulfate infusion. Which new finding would give the nurse cause for concern? a. Sleepy, sedated affect b. Respiratory rate of 10 breaths per minute c. DTRs of 2 d. Absent ankle clonus

Respiratory rate of 10 breaths per minute

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

Risk for injury to mother and fetus, related to central nervous system (CNS) irritability

18. A 3-month-old infant presents with vomiting and diarrhea. The infant appears to be drowsy; his pulse rate is 180 beats/min; and he has had a dry diaper for the past 3 hours. The nurse suspects the patient has developed which condition? a. Mild dehydration b. Moderate dehydration c. Desiccation d. Severe dehydration

Severe dehydration

6. A woman with worsening preeclampsia is admitted to the hospitals labor and birth unit. The physician explains the plan of care for severe preeclampsia, including the induction of labor, to the woman and her husband. Which statement by the husband leads the nurse to believe that the couple needs further information? a. I will help my wife use the breathing techniques that we learned in our childbirth classes. b. I will give my wife ice chips to eat during labor. c. Since we will be here for a while, I will call my mother so she can bring the two boys2 years and 4 years of ageto visit their mother. d. I will stay with my wife during her labor, just as we planned.

Since we will be here for a while, I will call my mother so she can bring the two boys 2 years and 4 years of age to visit their mother.

2. One of the most important components of the physical assessment of the pregnant client is the determination of BP. Consistency in measurement techniques must be maintained to ensure that the nuances in the variations of the BP readings are not the result of provider error. Which techniques are important in obtaining accurate BP readings? (Select all that apply.) a. The client should be seated. b. The clients arm should be placed at the level of the heart. c. An electronic BP device should be used. d. The cuff should cover a minimum of 60% of the upper arm. e. The same arm should be used for every reading.

The client should be seated. The clients arm should be placed at the level of the heart. The same arm should be used for every reading.

9. A patient who is 32 weeks pregnant is admitted with a pneumothorax. What must the practitioner consider when placing a chest tube? a. The diaphragm has been displaced 4 cm upward from its original location. b. The diaphragm has been flattened and displaced 2 cm downward. c. The lungs have shrunk to accommodate for the increase in abdominal size. d. The lower lobes are one-half of their original size.

The diaphragm has been displaced 4 cm upward from its original location.

2. Which anatomic and physiologic findings are normal in infants younger than 1 year old? (Select all that apply.) a. The epiglottis is large and floppy. b. The basal metabolic rate is lower than that of an adult. c. The size of the head is smaller compared with the rest of the body. d. The hormonal and metabolic response to pain is the same as that of an adult. e. A positive Babinski reflex is a normal finding.

The epiglottis is large and floppy. The hormonal and metabolic response to pain is the same as that of an adult. A positive Babinski reflex is a normal finding.

5. What is the difference between the upper airway of an infant and that of an adult? a. The infant's epiglottis is located lower than an adult's. b. The infant's tongue is larger than the adult's, and it fills the oral cavity. c. The infant's larynx is more tubular shaped with its narrowest portion at the epiglottis. d. The infant's airway is more rigid than an adult's.

The infant's tongue is larger than the adult's, and it fills the oral cavity.

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

The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor.

2. A perinatal nurse is giving discharge instructions to a woman, status postsuction, and curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. What is the bestresponse by the nurse? a. If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore, if you desire a future pregnancy, it would be better for you to use the most reliable method of contraception available. b. The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, then it would make the diagnosis of this cancer more difficult. c. If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnancy is rare. Therefore, to improve your chance of a successful pregnancy, not getting pregnant at this time is best.

The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, then it would make the diagnosis of this cancer more difficult.

1. A pregnant woman is being discharged from the hospital after the placement of a cervical cerclage because of a history of recurrent pregnancy loss, secondary to an incompetent cervix. Which information regarding postprocedural care should the nurse emphasize in the discharge teaching? a. Any vaginal discharge should be immediately reported to her health care provider. b. The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure should be reported. c. The client will need to make arrangements for care at home, because her activity level will be restricted. d. The client will be scheduled for a cesarean birth.

The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure should be reported.

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

To discontinue the magnesium sulfate infusion

12. What is the primary purpose for magnesium sulfate administration for clients with preeclampsia and eclampsia? a. To improve patellar reflexes and increase respiratory efficiency b. To shorten the duration of labor c. To prevent convulsions d. To prevent a boggy uterus and lessen lochial flow

To prevent convulsions

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

To stay with the client and call for help

3. The nurse is preparing to administer methotrexate to the client. This hazardous drug is most often used for which obstetric complication?

Unruptured ectopic pregnancy

4. What are the normal cerebral perfusion pressure values for a child? a. 30 to 50 mm Hg b. 40 to 60 mm Hg c. Values are unknown d. 60 to 100 mm Hg

Values are unknown

1. A patient has been admitted with preeclampsia. The nurse understands that this disorder is characterized by what widespread physiologic changes? a. Increase in circulating plasma volume b. Vasospasms in the arterial system c. Disseminated intravascular coagulation d. High systemic vascular resistance

Vasospasms in the arterial system