Chapter 1 -19 durham

A patient is scheduled for transvaginal ultrasound testing. Which preparation by the nurse is appropriate?

Ascertain whether the patient has a latex or banana allergy.

A nurse is preparing a woman in early labor for an urgent cesarean birth related to breech presentation. Select the best nursing action for reducing the couple's anxiety levels.

Ask the couple to share their concerns. By asking the couple to share their concerns, the nurse can address these concerns.

The nurse is providing support to parents of a premature neonate in NICU. Which actions by the nurse will best provide psychosocial support to the parents? Select all that apply.

Ask the parents how they are coping with the experience. Encourage parents to take photos to share with family and friends. Praise parents for their involvement in the care of their neonate.

The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action does the nurse perform prior to assessing the patient's uterus?

Ask the patient to void.

A client delivered a 2800-gram neonate 4 hours ago by cesarean section with epidural anesthesia. Which of the following interventions should the nurse perform on the mother at this time?

Assess the client's respiratory rate. The client has undergone major abdominal surgery. Her respiratory function should be assessed regularly.

The lactation nurse takes a phone call from a mother who is breastfeeding her 2-month-old infant. The mother reports an area of redness and warmth on the breast and a painful burning sensation when breastfeeding. Which statement by the nurse is correct if mastitis is suspected?

"Continuing to breastfeed will help clear up the condition."

A patient in the second trimester of pregnancy is discussing breastfeeding and other options with the nurse. Which question is most important for the nurses to ask?

"How does your partner feel about you breastfeeding?"

The clinic nurse discusses normal bladder function in pregnancy with a 22-year-old pregnant woman who is now in her 29th gestational week. The nurse explains that at this time in pregnancy, it is normal to experience (select all that apply):

-Urinary frequency -Urinary urgency -Nocturia During pregnancy, the bladder, a pelvic organ, is compressed by the weight of the growing uterus. The added pressure, along with progesterone-induced relaxation of the urethra and sphincter musculature, leads to urinary urgency, frequency, and nocturia. Incontinence of urine is not a normal change during pregnancy.

Interventions for low back pain during pregnancy should include (select all that apply):

-Utilizing proper body mechanics -Applying ice or heat to affected area -Using additional pillows for support during sleep Interventions for back pain during pregnancy include utilizing proper body mechanics, applying heat or ice to the area, using additional pillows during sleep, and not avoiding pelvic rock/tilt, but encouraging pelvic rock/tilt

A nurse who is discussing serving sizes of foods with a new prenatal patient would state that which of the following is equal to 1 (one) serving from the dairy food group?

1 cup low-fat milk

The perinatal nurse explains to the student nurse that __________ is the leading cause of infant death in the United States.

Congenital malformations and chromosomal abnormalities

During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from:

2 to 8 weeks The period of organogenesis lasts from approximately the second until the eighth week of gestation during which time the embryo undergoes rapid growth and differentiation. During organogenesis, the embryo is extremely vulnerable to teratogens such as medications, alcohol, tobacco, caffeine, illegal drugs, radiation, heavy metals, and maternal (TORCH) infections. Structural fetal defects are most likely to occur during this period because exposure to teratogens either before or during a critical period of development of an organ can cause a malformation.

The nurse who is assessing a G2 P1 palpates the fundal height at the location noted on the picture below. The nurse concludes that the fetus is equal to which of the following gestational ages?

20 weeks The fundus at the level of the umbilicus indicates 20 weeks' gestation. In this question, the fact that this patient is a multigravida is not relevant. Uterine growth should be consistent for both primigravidas and multigravidas.

The clinic nurse is aware that the pregnant woman's blood volume increases by:

40% to 45% An increase in maternal blood volume begins during the first trimester and peaks at term. The increase approaches 40% to 45% and is primarily due to an increase in plasma and erythrocyte volume. Additional erythrocytes, needed because of the extra oxygen requirements of the maternal and placental tissue, ensure an adequate supply of oxygen to the fetus. The elevation in erythrocyte volume remains constant during pregnancy.

The nurse is performing an NST along with a biophysical profile scoring (BPP) on a patient at 39 weeks gestation. The nurse determines the fetus has a nonreactive NST. The fetus has trunk or limb movement two times; is noted to be opening and closing hands; has a 45-second breathing episode; and has two 2-cm pockets of amniotic fluid. The nurse should assign a BPP score of ____________________/10.

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A clinic nurse explains to the pregnant woman that the amount of amniotic fluid present at 24 weeks' gestation is approximately:

800 mL Amniotic fluid first appears at about 3 weeks. There are approximately 30 mL of amniotic fluid present at 10 weeks' gestation, and this amount increases to approximately 800 mL at 24 weeks' gestation. After that time, the total fluid volume remains fairly stable until it begins to decrease slightly as the pregnancy reaches term.

Which of the following women is at highest risk for osteoporosis?

A 70-year-old non-Hispanic white woman who has smoked for 50 years Each of the women has a risk factor for osteoporosis, but answer (a) has the additional risk factor of being a non-Hispanic white woman.

The nurse is teaching the mother of a neonate the benefits of kangaroo care. Which action is explained to the mother regarding the procedure?

A bare-chested neonate is held against a bare-chested parent.

The provision of support during labor has demonstrated that women experience a decrease in anxiety and a feeling of being in more control. In clinical situations, this has resulted in:

A decrease in interventions Studies have shown that with a support person, be it a family member, friend, or professional such as a Doula or nurse, the patient experiences a decrease in anxiety and has a feeling of being in more control. This, in turn, results in a decrease in interventions, a significantly lower level of pain, and an enhanced overall maternal satisfaction.

A postpartum patient calls the OB office 8 days following a vaginal delivery. The patient reports concern regarding vaginal bleeding. Which patient-reported symptom causes the nurse concern?

A description of the lochia as being red in color

The nurse is providing pre-amniocentesis teaching for a patient who is at 18 weeks gestation. Which information does the nurse provide? Select all that apply.

A full bladder will assist in ultrasound visualization. Discomfort will be minimized with a local anesthetic.

An ultrasound of a fetus' heart shows that "normal fetal circulation is occurring." Which of the following statements is consistent with the finding?

A right to left shunt is seen between the atria. This is correct. The foramen ovale is a duct between the atria. In fetal circulation, there is a right to left shunt through the duct.

A patient who is 12 hours postpartum after a vaginal delivery continues to have difficulty in initiating urination. The nurse is aware that an integrative method used when a woman is unable to void is peppermint oil. In which manner will the peppermint oil be used?

A saturated cotton ball is placed in a "hat" on the toilet.

The nurse is assisting a newborn's primary care provider with the performance of a circumcision. Which intervention is used to manage the neonate's pain?

A sucrose-dipped pacifier is offered during the nerve block.

The nurse is preparing a talk with new parents about immunity and their newborns. Which factual information will the nurse present? Select all that apply.

A vaccination is an example of acquired immunity. Placental transfer is how newborns get natural passive immunity. Natural passive immunity protects the baby for a few months after birth.

A post-cesarean birth woman has been diagnosed with paralytic ileus. Which of the following symptoms would the nurse expect to see?

Abdominal distension The nurse would expect to see a distended abdomen in a client with a paralytic ileus.

The nurse is providing care to a patient who is diagnosed with dystocia related to hypertonic uterine dysfunction. Which medical intervention does the nurse implement for this patient?

Administer morphine to decrease contractions and promote uterine rest.

A post-cesarean section client has been ordered to receive 500 mL of 5% dextrose in water every 4 hours. The drop factor of the macrodrip tubing is 10 gtt/mL. To what drip rate should the nurse regulate the IV? __________ gtt/min

ANS: 21

The perinatal nurse is preparing a woman for a scheduled cesarean birth. The woman will be receiving spinal anesthesia for the birth. In order to prevent maternal hypotension, the nurse:

Administers a rapid intravenous infusion of 500 mL of normal saline. Complications that may occur with spinal anesthesia block include maternal hypotension, decreased placental perfusion, and an ineffective breathing pattern. Prior to administration, the patient's fluid balance is assessed, and IV fluids are administered to reduce the potential for sympathetic blockade (decreased cardiac output that results from vasodilation with pooling of blood in the lower extremities). Following administration of the anesthetic, the patient's blood pressure, pulse, and respirations and fetal heart rate must be taken and documented every 5 to 10 minutes.

The nurse is providing care to a patient who is in labor. The patient's membranes rupture spontaneously, and the nurse notices meconium-stained amniotic fluid. Which actions does the nurse immediately perform? Select all that apply.

Alert the neonatal team of a possible meconium aspiration neonate. Notify the primary care provider about the presence of meconium.

The nurse is present in the delivery room when a mother is told her neonate was stillborn. The mother begins to wail loudly and pull at her hair. Which action does the nurse take?

Allow the mother to express grief in her own way.

The labor patient you are caring for is ambulating in the hall. Her vaginal exam 1 hour ago indicated she was 4/70/-1 station. She tells you she has fluid running down her leg. Your priority nursing intervention is to:

Assess the fetal heart rate. Assessing the fetal heart rate is the first priority because of the risk of umbilical cord prolapse with rupture of membranes.

The nurse is performing a uterus assessment on a patient who is 20 hours postpartum. The nurse finds the fundus of the uterus to be soft and boggy. In addition, the uterus is displaced to the left and moderate bleeding is noted. If the uterus does not respond to uterine massage, which actions does the nurse implement? Select all that apply.

Assist the patient to the bathroom to void. Reassess to determine response to treatment. Administer oxytocin as prescribed. Make the patient NPO for surgery.

The nurse is assessing a newborn's reflexes. Which response will cause the nurse concern?

Asymmetrical Moro reflex

A patient at 37 weeks' gestation is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be palpated?

At the xiphoid process At 36 weeks' gestation, the fundus should be felt at the xiphoid process.

Sally is in her third trimester and has begun to sing and talk to the fetus. Sally is probably exhibiting signs of:

Attachment Correct, because talking to the fetus is a sign of positive maternal adaptation. All other answers indicate pathology.

The nurse is providing care for a primip patient in active labor. Cervical dilation has progressed 0.5 cm in 2 hours. Intrauterine pressure catheter reading is 20 mm Hg. Which action does the nurse anticipate next?

Augmentation of labor with oxytocin per health care provider's order

Which of the following indicates a Category I fetal heart rate?

Baseline rate of 150 bpm, moderate variability, accelerations to 170 bpm for 20 seconds

A patient at 28 weeks' gestation was last seen in the prenatal clinic at 24 weeks' gestation. Which of the following changes should the nurse bring to the attention of the Certified Nurse Midwife?

Blood pressure change from 110/70 to 140/90 A blood pressure elevation to 140/90 is a sign of mild preeclampsia.

A woman you are caring for in labor requests an epidural for pain relief in labor. Included in your preparation for epidural placement is a baseline set of vital signs. The most common vital sign to change after epidural placement:

Blood pressure, hypotension Blood pressure, hypotension, as up to 40% of women may experience hypotension. Hypotension is defined as systolic BP <100 mm Hg or 20% decrease in BP from preanesthesia levels. Intravenous bolus is typically given to decrease the incidence of hypotension.

A patient arrives at labor and delivery for the induction labor for her first child. The patient tells the nurse, "I can't believe how easy this is just to pick a day, sign a paper, and have a baby." Which action does the nurse take before the induction process?

Call the health care provider to validate patient understanding.

The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient?

Carboprost-tromethamine

The nurse is interviewing a gravid woman during the first prenatal visit. The woman confides to the nurse that she lives with a number of pets. The nurse should advise the woman to be especially careful to refrain from coming in contact with the stool of which of the pets?

Cat The patient should refrain from coming in direct contact with cat feces. Cats often harbor toxoplasmosis, a teratogenic illness.

A patient who is pregnant expresses a desire to attempt a vaginal delivery after a cesarean birth 2 years before. The primary care provider initiates trial of labor after cesarean (TOLAC) and vaginal birth after cesarean (CVAC) screening. The nurse is aware that which patient information will likely disqualify the patient for CVAC?

Cesarean due to pelvic abnormalities

The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room?

Collect blood in calibrated, under-buttocks drapes for vaginal birth.

The nurse is counseling a lesbian couple who have decided to have a child. Which considerations does the nurse present with regard to which partner will become pregnant? Select all that apply.

Consider the age and health of each partner. Evaluate each partner's career goals. Decide which partner has better insurance. Identify which woman desires to be pregnant.

The nurse is providing care for a patient who is 8 hours postpartum after a vaginal delivery. The patient reports severe perineal pain unaffected by pain medication. The nurse notices a 4 cm area of discolo

Contact the primary care provider for further evaluation.

The nurse is aware the greatest source of bleeding during childbirth occurs following detachment of the placenta. Which physiological change takes place immediately after the expulsion of the placenta to decrease the amount of blood loss?

Contractions of the uterine myometrium

Variable decelerations are typically related to:

Cord compression

The nurse is preparing to teach a class on the benefits of breastfeeding for infants. Which benefits will the nurse include in the presentation? Select all that apply.

Decreased incidence of SIDS Fewer cases of necrotizing enterocolitis Decreased risk for developing otitis media

The clinic nurse visits with Wayne, a 32-year-old man whose partner is pregnant for the first time and is at 12 weeks. Wayne describes nausea and vomiting, fatigue, and weight gain. His symptoms are best described as:

Couvade syndrome In preparation for parenthood, the male partner moves through a series of developmental tasks. During the first trimester, the father begins to deal with the reality of the pregnancy and may worry about financial strain and his ability to be a good father. Feelings of confusion and guilt often surface with the recognition that he is not as excited about the pregnancy as his partner, and couvade syndrome, the experience of maternal signs and symptoms, may develop.

Jane's husband Brian has begun to put on weight. What is this a possible sign of?

Couvade syndrome Correct. Couvade syndrome has symptoms that mimic changes of pregnancy.

The nurse is interviewing a pregnant client who states she plans to drink chamomile tea to ensure an effective labor. The nurse knows that this is an example of:

Cultural prescription Correct. Cultural prescription is an expected behavior of the pregnant woman during the childbearing period.

The nurse is assessing a patient at 26 weeks gestation. The patient has chronic hypertension and exhibited hypertension and proteinuria prior to 20 weeks gestation. Previous blood pressure (BP) readings have been in the range of 130 to 140/88 to 90 mm Hg. Due to superimposed preeclampsia, for which additional manifestations will the nurse immediately contact the health care provider? Select all that apply.

Current blood pressure reading of 162/102 mm Hg Evident pulmonary edema noted with auscultation. Subjective report of severe headache and photophobia Lack of response to verbal and tactile stimulation

Information provided by the nurse that addresses the function of the amniotic fluid is that the amniotic fluid helps the fetus to maintain a normal body temperature and also:

Cushions the fetus from mechanical injury Amniotic fluid cushions the fetus from mechanical injury.

The nurse is attending to a patient who just delivered a term fetus who was stillborn. Which nursing interventions will the nurse use to provide emotional support to the couple? Select all that apply.

Cut a lock of the neonate's hair and get foot and hand prints. Allow parents unlimited time to hold and touch the neonate.

Folic acid supplementation during pregnancy is to:

Decrease the incidence of neural tube defects in the fetus Correct. The use of folic acid has decreased the incidence of neural tube defects by 50%.

During the fourth stage of labor, which actions by the nurse will promote parent-newborn attachment? Select all that apply.

Delay administration of eye ointment until parents have held newborn. Initiate skin-to-skin contact with a warm blanket over the neonate and parent. Explain expected neonatal characteristics such as molding, milia, and lanugo.

A patient at 34 weeks gestation is in labor with twins. The primary care provider decides the fetuses need to be delivered by cesarean. Which medical and nursing interventions will be in place for this delivery? Select all that apply.

Delivery is attended by two medical personnel. The placement of a large-bore IV access is ensured. A hospital with a Level II or III nursery is selected.

An adolescent patient who is 15 weeks pregnant refuses to have an alpha-fetoprotein test performed because, "I don't like needles." Which initial approach does the nurse take to achieve the testing?

Explain the testing is important in detecting serious birth defects.

The nurse in a postpartum unit frequently teaches patients regarding breast care. Which teaching is most helpful to the breastfeeding patient?

Express milk by a breast pump or manually.

The Apgar score consists of a rapid assessment of five physiological signs that indicate the physiological status of the newborn and includes:

Heart rate, respiratory rate, muscle tone, reflex irritability, and color The Apgar score includes assessment of heart rate based on auscultation, respiratory rate based on observed movement of chest, muscle tone based on degree of flexion and movement of extremities, reflex irritability based on response to tactile stimulation, and color based on observation.

A diagnostic test commonly used to assess problems of the fallopian tubes is:

Hysterosalpingogram Correct. Hysterosalpingogram provides information on the endocervical canal, uterine cavity, and fallopian tubes.

The nurse is aware of concern about the increasing numbers of severe maternal morbidity (SMM). It is believed to be related to changes in the overall health of the population of women giving birth. Which reasons does the nurse identify as causes of SMM? Select all that apply.

Increases in maternal age Prepregnancy obesity Cesarean deliveries Preexisting chronic medical conditions

Nursing interventions related to late decelerations include all of the following except:

Initiate Pitocin induction

A woman presents for prenatal care at 6 weeks' gestation by LMP. Which of the following findings would the nurse expect to see?

Maternal ambivalence Ambivalence is a common feeling of women during the first trimester.

The nurse is providing support to a mother whose newborn is diagnosed with a life-threatening defect. The mother states, "I just want to go home and never come back." Which reaction by the mother does the nurse recognize?

Maternal emotional distancing

The goal of maternal position changes for a prolonged deceleration is:

Maximizing uterine blood flow

A patient at 36 weeks gestation reports a constant dull backache, regular frequent contractions that are painless, and lower abdominal pressure. Physical examination reveals intact membranes and cervical dilation of 3 cm. Which order by the health care provider is unexpected by the nurse?

Obtain fetal fibronectin levels

The best time to give prophylactic antibiotics to the women undergoing cesarean section is:

One hour before the surgery Administration of narrow-spectrum prophylactic antibiotics should occur within 60 minutes prior to the skin incision.

A mother who is 2 weeks postpartum asks the nurse lactation specialist how she knows if her baby is hungry. Which hunger indicator does the nurse discuss?

Opening the mouth in response to tactile stimulation

The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately?

Peripad weighs 100 g within 15 minutes.

Blood volume expansion during pregnancy leads to:

Physiological anemia of pregnancy Physiological anemia of pregnancy, also referred to as pseudo-anemia of pregnancy, is due to hemodilution. The increase in plasma volume is relatively larger than the increase in RBCs that results in decreased hemoglobin and hematocrit values.

Tanya, a 30-year-old woman, is being prepared for an elective cesarean birth. The perinatal nurse assists the anesthesiologist with the spinal block and then positions Tanya in a supine position. Tanya's blood pressure drops to 90/52, and there is a decrease in the fetal heart rate to 110 bpm. The perinatal nurse's best response is to:

Place a wedge under Tanya's left hip. In the event of severe maternal hypotension, the nurse should place the patient in a lateral position or use a wedge under the hip to displace the uterus, elevate the legs, maintain or increase the IV infusion rate, and administer oxygen by face mask at 10 to 12 L/min, or according to institution protocol.

A patient who is in the third trimester of pregnancy is informed that she will need a cesarean hysterectomy and bladder reconstruction due to a placenta defect. Which medical condition does the nurse explain to the patient?

Placenta percreta

A nurse is teaching a woman about her menstrual cycle. The nurse states that __________ is the most important change that happens during the secretory phase of the menstrual cycle.

Proliferation of the endometrium The proliferation of the endometrium occurs during the secretory phase of the menstrual cycle.

As a result of the previously mentioned research study, the nurses in a postpartum facility will implement which evidence-based change?

Promote strategies to decrease fatigue during both prenatal and postnatal periods.

During a vaginal delivery, the primary care provider notices greenish yellow coloration on the fetal head during crowning. Intrapartum suctioning is performed as soon as the fetus's head is delivered. The nurse understands the aspiration of meconium will have which effects on the neonate's respiratory function? Select all that apply.

Result in airway obstruction Contribute to pulmonary hypertension Result in chemical pneumonitis Cause surfactant dysfunction

A patient who is at 41 weeks gestation is concerned when the primary care provider decides to induce labor. Which reason does the nurse explain as the most important need for this procedure?

Risk for placental dysfunction

The nurse is providing postpartum care for a patient after a vaginal delivery. Which assessment finding causes the nurse to suspect endometritis from beta-hemolytic streptococcus?

Scant amount of odorless lochia

The nurse is presenting information to new parents regarding screening of their newborn. Which information does the nurse identify as being most important to the parents?

Screenings are for infections, genetic diseases, and inherited disorders.

The clinic nurse knows that the part of the endometrial cycle occurring from ovulation to just prior to menses is known as the:

Secretory phase The secretory phases occurs from the time of ovulation to the period just prior to menses, or approximately days 15 to 26. (SEX PRIOR TO MENSES)

The nurse has taken a health history on four multigravida patients at their first prenatal visits. It is high priority that the patient whose first child was diagnosed with which of the following diseases receives nutrition counseling?

Spina bifida The incidence of spina bifida is much higher in women with poor folic acid intakes. It is a priority that this patient receives nutrition counseling.

The nurse is providing care for a patient who is at 42 weeks gestation. The patient's primary care provider is suggesting induction, but the patient is resistant. Which facts can the nurse provide if the patient asks about allowing labor to start spontaneously? Select all that apply.

Stillbirth or newborn death increases in pregnancies beyond 42 weeks. There is a greater chance of developing complications because of larger fetal size. Postmature fetuses have decreased subcutaneous fat and lack vernix and lanugo.

A client is to take Clomiphene Citrate for infertility. Which of the following is the expected action of this medication?

Stimulate release of FSH and LH Clomiphene Citrate stimulates release of FSH and LH.

The nurse is collecting information during a follow-up OB appointment with a patient who delivered 3 months ago. The patient reports her partner has become cynical, irritable, and verbally abusive. The nurse will screen for which risks related to paternal postnatal depression (PPND)? Select all that apply.

The father exhibited depression during the pregnancy. The birth of this fourth child was unexpected and unplanned. The father is recently estranged from his parents and siblings.

A new mother expresses frustration about how to know what her baby wants. The mother states, "I don't know what I expect, but then, the baby doesn't know either." Which situation does the nurse use as an example of neonate communication?

The baby roots for the breast when the cheek is stroked.

The nurse is explaining to a mother that her newborn's blood test indicates a high level of unconjugated bilirubin, which causes jaundice. Which information does the nurse present to the mother? Select all that apply.

The blood test does not indicate a pathological disease. The newborn's liver converts bilirubin to a water-soluble substance. An abundance of RBCs and RBC short life span contributes to the condition. Elevated bilirubin can be excreted in the urine and stool.

The nurse is aware that some parenting skills are acquired through the process of intentional learning. Which activity does the nurse associate with intentional learning?

The couple attends hospital classes addressing newborn and infant care.

A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis?

The couple has established a set schedule for their sexual encounters. Couples who "schedule" intercourse often complain that their sexual relationship is unsatisfying.

A patient who is at 39 weeks gestation is scheduled for amniotomy. The nurse is aware that which criteria must be met before the procedure?

The fetal head is currently engaged in the maternal pelvis.

While performing Leopold's maneuvers on a woman in early labor, the nurse palpates a flat area in the fundal region, a hard round mass on the left side, a soft round mass on the right side, and small parts just above the symphysis. The nurse concludes which of the following?

The fetal presentation is scapular. This is a shoulder presentation.

The nurse is providing care for a patient who is admitted for cervical ripening. The health care provider has prescribed the use of a hygroscopic dilator. Which conclusion is the nurse likely to draw from the prescribed method of cervical ripening?

The method may be indicative of fetal demise.

The nurse in a postpartum unit evaluates new parents for risk factors that can indicate problems with bonding/attachment. Which situations does the nurse recognize as a cause for bonding/attachment problems? Select all that apply.

The mother experienced eclampsia in the third trimester of pregnancy. The neonate is being treated for meconium aspiration syndrome. The mother experienced dystocia in the second phase of labor.

The postpartum nurse is planning a home visit to a mother who delivered her baby 1 week ago. Which finding indicates to the nurse a possible problem with mother-infant bonding?

The mother focuses the visit on her physical recovery and concerns.

A mother of a premature neonate in NICU asks the nurse when her baby will begin getting oral feedings. The nurse is aware that multiple conditions are desired. Which condition is most essential?

The neonate exhibits cardiorespiratory regulation.

The postpartum nurse notices that a new mother has her neonate unwrapped and undressed "to check out the baby." For which reason does the nurse conclude the neonate is at risk for cold stress?

The neonate is moving extremities about.

The nurse works in a postnatal nursery and is required by hospital policy to perform a gestational age assessment on specified neonates. On which neonate is the nurse most likely to perform this assessment?

The neonate with a birth weight of 4,100 g

The nurse is assessing a patient who just received confirmation of pregnancy. While collecting information about the patient's medical history, which information alerts the nurse to biophysical risk factors? Select all that apply.

The patient has been a strict vegetarian for 25 years. The patient is medically treated for rheumatoid arthritis.

The lactation nurse visits the room of a patient who is postpartum and being prepared for discharge. The nurse plans to provide breastfeeding information aimed at assisting the patient to continue breastfeeding her newborn. Which observation by the nurse indicates a possible disruption to the planned teaching?

The patient is excited about taking her baby home.

The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits. Which patient does the nurse identify as having the highest-risk pregnancy?

The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension

The nurse is assessing patients who are postpartum. Which patients does the nurse identify as being at increased risk for respiratory complications? Select all that apply.

The patient who was placed on bedrest for threatened abortion The patient with preeclampsia treated with magnesium sulfate The patient who received large amounts of IV fluid due to blood loss

Which of the following is correct regarding endometriosis?

The physical symptoms of endometriosis can affect the woman's mental health. The physical symptoms can have an effect on the woman's mental health. The woman may experience anger and grief related to loss of fertility. The pain of endometriosis can interfere with social activities, and dyspareunia can have an effect on intimate relationships.

Which statement best exemplifies adaptation to pregnancy in relation to the adolescent?

The pregnant adolescent faces the challenge of multiple developmental tasks. Correct. Pregnant adolescents face conflicting and multiple developmental tasks of pregnancy and adolescence at the same time.

The nurse is interviewing a new patient who is in the first trimester of her second pregnancy. The patient shares that her first child was born at 36 weeks gestation. Which information does the patient share that places the patient at risk for a second premature birth?

The premature labor and birth was unexpected and followed a normal pregnancy.

A patient undergoes chorionic villa sampling to rule out the presence of a genetic disorder. Following the procedure, the patient experiences iatrogenic PPROM. Which explanation does the nurse provide to promote patient understanding?

The premature rupture of the membranes is a known risk to the test.

The nurse is reviewing the medical record for a patient who is postpartum. The nurse notices the patient is rubella-nonimmune. Which information does the nurse present to the patient? Select all that apply.

The risks to the fetuses of any future pregnancies. The patient will need to be immunized before discharge. Pregnancy should be avoided for 4 weeks.

The nurse is preparing a postpartum patient for discharge. Which patient teaching is most important for the nurse to provide?

The signs and symptoms of secondary hemorrhage

An Eastern European Jewish couple had two children who died from Tay-Sachs disease. The couple is currently pregnant and have asked for genetic confirmation about this fetus with the intention of early termination if the fetus tests positively. For which reason does the nurse expect chorionic villa sampling to be prescribed?

The test is performed as early as 10 weeks gestation.

A total hysterectomy is the removal of:

The uterus and cervix

The clinic nurse includes screening for domestic violence in the first prenatal visit for all patients. An appropriate question would be:

This is something that we ask everyone. Do you feel safe in your current living environment and relationships? Intimate partner violence is a difficult subject to discuss, and the nurse may fear insulting or psychologically hurting the patient more. A nonthreatening approach is to ask patients directly whether they feel safe going home and whether they have been hurt physically, emotionally, or sexually by a past or present partner.

The nurse is conducting a staff education session about preeclampsia and eclampsia complications. Which statements by the nurse are accurate about HELLP syndrome? Select all that apply.

This syndrome destroys red blood cells. This syndrome impacts the amount of platelets. This syndrome increases liver enzymes.

A primigravida patient is 39 weeks pregnant. Which of the following symptoms would the nurse expect the patient to exhibit?

Urinary frequency Urinary frequency recurs at the end of the third trimester. As the uterus enlarges, it again compresses the bladder causing urinary frequency.

The daughter of an 85-year-old woman informs the doctor that her mother has suddenly become disoriented/confused and that she is dizzy and having difficulty with her balance. She is agitated and has fallen twice in the last 24 hours. The patient's blood pressure and VS are within normal limits. Her medications include Synthroid, Lisinopril, and Crestor. Based on this data, the woman is most likely experiencing:

Urinary tract infection

The premature neonate is more susceptible to skin breakdown than a term neonate. Which skin care interventions will the nurse implement for the premature neonate? Select all that apply.

Use a neutral pH cleanser and sterile water for bathing. Gently apply emollients to avoid unnecessary friction. Use water, air, or gel mattresses.

A postpartum patient states, "I am really in pain." For which sources of pain will the nurse specifically assess the patient? Select all that apply.

Uterine contractions Perineal trauma Breast engorgement Hemorrhoids General soreness

The perinatal nurse providing care to a laboring woman recognizes a category II, fetal heart rate racing. The most appropriate initial action is to:

a. Assist the laboring woman to the left lateral position. -Because Category II fetal heart rate patterns could deteriorate, they constitute a risk indicator for fetal hypoxia, the nurse should change the woman's position to her side to increase oxygen to the baby.

The nurse uses the external electronic fetal heart monitor to evaluate fetal status. The fetal heart tracing shows accelerations. Accelerations in the fetal heart rate are:

a. Associated with fetal well-being and oxygenation. -Accelerations are a sign of fetal well-being.

The nurse knows that a FHR monitor printout indicates a Category III abnormal fetal heart rate pattern when:

a. Baseline variability is minimal or absent with decelerations. -Minimal or absent baseline variability may be an indication of fetal hypoxia.

Which statement correctly describes the nurse's responsibility related to electronic fetal monitoring?

a. Teach the woman and her family about the monitoring equipment and discuss any questions they have. -Teaching is an essential part of the nurse's role. Only an IUPC will measure the intensity of uterine contractions.

After assessing the FHR tracing shown below, which of the following interventions should the nurse perform?

a. Turn the woman on her side. -The woman's position should be changed. The side-lying position is best.

During prenatal class, the childbirth educator describes the two membranes that envelop the fetus. The __________ contains the amniotic fluid, and the __________ is the thick, outer membrane.

amnion; chorion The embryonic membranes (chorion and amnion) are early protective structures that begin to form at the time of implantation. The thick chorion, or outer membrane, forms first. It develops from the trophoblast and encloses the amnion, embryo, and yolk sac. The amnion arises from the ectoderm during early embryonic development. The amnion is a thin, protective structure that contains the amniotic fluid. With embryonic growth, the amnion expands and comes into contact with the chorion. The two fetal membranes are slightly adherent and form the amniotic sac.

The ____________________ in conjunction with NST is a strong indicator of fetal status, as it is accurate in detecting fetal hypoxia.

amniotic fluid index

The perinatal nurse is teaching nursing students about fetal circulation and explains that fetal blood flows through the superior vena cava into the right __________ via the __________.

atrium; foramen ovale Blood flows through the vein from the placenta to the fetus. Most of the blood bypasses the liver and then enters the inferior vena cava by way of the ductus venosus, a vascular channel that connects the umbilical vein to the inferior vena cava. The blood then empties into the right atrium, passes through the foramen ovale (an opening in the septum between the right and left atrium) into the left atrium, and then moves into the right ventricle and on into the aorta. From the aorta, blood travels to the head, upper extremities, and lower extremities.

A nurse is preparing to monitor a patient who is to receive an amnioinfusion. Which of the following actions should the nurse make at this time?

b. Assist in insertion of an internal uterine pressure catheter. -There is a possibility of uterine rupture during an amnioinfusion. An internal pressure transducer, therefore, must be inserted to monitor the patient's intrauterine pressures.

As the nurse explains the purpose of the tocotransducer (Toco), which she places on the abdomen, she states that this monitoring device provides an accurate evaluation of which of the following?

b. Frequency of contractions. -A tocotransducer measures frequency and duration of uterine contractions.

During an initial assessment of the neonate's skin the nurse notices the presence of red marks called ____________________ on the neonate's eyelid and upper lip.

stork bites

The nurse is caring for a woman, G2 P1001, 40 weeks' gestation, in labor. A 12 PM assessment revealed: cervix 4 cm, 80% effaced, -3 station, and fetal heart 124 with moderate variability. 5 PM assessment: cervix 6 cm, 90% effaced, -3 station, and fetal heart 120 with minimal variability. 10 AM assessment: cervix 8 cm, 100% effaced, -3 station, and fetal heart 124 with absent variability. Based on the assessments, which of the following should the nurse conclude?

c. Baby is potentially acidotic. -The variability is decreasing. This is an indication that the fetus is in distress.

Early decelerations are probably cause by:

c. Momentary increase in intracranial pressure due to head compression. -Early decelerations are related to increased intracranial pressure due to head compression.

A patient is threatening spontaneous abortion at 18 weeks gestation. The patient's two previous pregnancies aborted in the same time frame. The patient states, "They want to sew my cervix shut." The nurse shares the terminology for surgical treatment of incompetent cervix, which is ____________________.

cerclage

Premature rupture of membranes is defined as rupture of the ____________________ membranes before the onset of labor but at term.

chorioamniotic

The perinatal nurse knows that the presence of abdominal distension and gas in the post-cesarean birth mother is due to __________.

delayed peristalsis Delayed peristalsis and constipation commonly occur because of slowed peristalsis associated with pregnancy hormones and childbirth anesthesia. In addition, incisional pain may contribute to a decrease in ambulation which contributes to delayed peristalsis.

The perinatal nurse defines a __________ as any substance that adversely affects the growth and development of the embryo/fetus.

teratogen Teratogens (drugs, radiation, and infectious agents that can cause development of abnormal structures in an embryo) and a variety of internal and external developmental events may cause structural and functional defects.

The perinatal nurse explains to the student nurse that the growing embryo is called a __________ beginning at 8 weeks of gestational age.

fetus Major organs are being formed (organogenesis) during the first weeks following fertilization. During this time, the developing organism is called an embryo. By the end of 8 weeks, the embryo has sufficiently developed to be called a fetus.

The nurse in a prenatal unit is providing care for a patient who experienced PPROM at 32 weeks gestation. Which assessment does the nurse consider unnecessary?

heck for cervical dilation

When a patient is diagnosed with preeclampsia, one sign that the fetus is at risk for hypoxia is a change in amniotic fluid called ____________________.

oligohydramnios

After birth, the perinatal nurse explains to the new mother that __________ is the hormone responsible for stimulating milk production.

prolactin Following birth and delivery of the placenta, there is an abrupt decrease in estrogen. This event triggers an increased secretion of prolactin (the hormone that stimulates milk production) by the anterior pituitary gland. The posterior pituitary and hypothalamus play a role in the production and secretion of oxytocin, a hormone that causes release of milk from the alveoli.

The first sign of shoulder dystocia is the ____________________ of the fetal head against the maternal perineum after delivery of the head.

retraction

A multiparous patient reports severe uterine cramps the first day after a vaginal delivery. The nurse is aware the patient is breastfeeding and associates the patient's pain primarily with which occurrence?

An increase in oxytocin release related to the newborn suckling

Menorrhagia may result from (select all that apply):

Anovulatory cycle Metritis

The nurse in NICU is assessing a neonate delivered at 32 weeks gestation. Which pathophysiological manifestation is the nurse's greatest concern?

Apnea 20 seconds or longer

The nurse is collecting information from a parent whose infant has frequent diaper dermatitis. Which comment by the parent indicates a possible cause of the condition? Select all that apply.

"I buy an antibiotic ointment specified for skin rashes."

9. A pregnant client at 20 weeks' gestation comes to the clinic for her prenatal visit. Which of the following client statements would indicate a need for further assessment?

"I hate it when the baby moves." Experiencing quickening as unpleasant may be a sign of maladaptation to pregnancy and needs further assessment by the nurse. b. This is an expected finding in maternal adaptation and development of the maternal role.

The nurse is providing information to a postpartum mother about circumcision of her neonate. The neonate's father states, "We have never done that to any baby boy in my family." Which statement is best for the nurse to make?

"I understand that family culture and beliefs form our way of life."

Which of the following statements by a pregnant woman indicates she needs additional teaching on ways to reduce risks to her unborn child from the potential effects of exposure to toxoplasmosis?

"I will wear a mask when cleaning my cat's litter box." Correct. Pregnant women and women who are attempting pregnancy should avoid contact with cat feces. Exposure occurs when the protozoan parasite found in cat feces and uncooked or rare beef and lamb is ingested. Wearing a mask will not decrease the risk through ingestion of the parasite.

Jenny, a 21-year-old single woman, comes for her first prenatal appointment at 31 weeks' gestation with her first pregnancy. The clinic nurse's most appropriate statement is:

"Jenny, by your information, you are 31 weeks' gestation in this pregnancy. Do you have questions for me before I begin your prenatal history and information sharing?" The initial interview time with the patient should be used to build a positive, nonthreatening relationship and to gain her confidence by respecting her choices and advocating for continued prenatal care. The prenatal nurse's objective is to provide a user-friendly service that is efficient, effective, caring, and patient centered.

When performing a physical assessment on a patient during the initial prenatal visit, the nurse notes spongy gums prone to bleeding during the oral exam. Which comment by the nurse is appropriate?

"Oral bleeding can contribute to anemia."

A patient in the second trimester of pregnancy becomes upset when the health care provider (HCP) schedules several screening tests. The patient voices concern that something is wrong with her baby. Which statement by the nurse will reduce the patient's anxiety?

"Screening tests are primarily to identify those without disease or abnormality."

The postnatal nurse is making a newborn visit to the parents who are from a different country. The nurse finds the newborn swaddled in a heavy blanket and wearing a knitted cap. The newborn has wet hair and is restless with rapid breathing. Which initial comment from the nurse is appropriate?

"Share with me how babies are cared for in your country."

The nurse is collecting information from a new mother who is bottle-feeding her infant. Which comment, if made by the mother, requires the nurse to provide patient teaching?

"Sometimes I will add a little water to the formula if I am running low."

A new mother states, "I don't want anyone around my baby. I need to protect him from getting sick." Which statement by the nurse will help the mother to understand neonatal immunity? Select all that apply.

"The baby has natural passive immunity from you for a few months." "We will give the baby gamma globin for short-term immediate protection."

The clinic nurse talks to a 30-year-old woman at 34 weeks' gestation who complains of having difficulty sleeping. Jayne has noticed that getting back to sleep after she has been up at night is difficult. The nurse's best response is:

"This is normal in pregnancy, particularly during the third trimester when you also feel fetal movement at night; try napping once a day." Pregnancy sleep patterns are characterized by reduced sleep efficiency, fewer hours of night sleep, frequent awakenings, and difficulty going to sleep. Nurses can advise patients that afternoon napping may help alleviate the fatigue associated with the sleep alterations.

The nurse is observing a new mother interact with her baby and notices the mother holding the baby close to her body. However, the nurse also notices that the mother does not hold the baby in an enface position. Which question is most appropriate for the nurse to ask?

"What can you tell me about your family's beliefs with new babies?"

Lesbians are at higher risk for breast, cervical, endometrial, and ovarian cancer than heterosexual women due to (select all that apply):

-A higher percentage of lesbians are smokers -Lesbians are less likely to have a Pap test -A higher percentage of lesbians are obese Lesbians have higher rates of smoking, alcohol use, and obesity. They are also less likely to follow the recommended frequency of health screening tests. These behaviors place a woman at higher risk for breast and gynecological cancers. `

The perinatal nurse screens all pregnant women early in pregnancy for maternal attachment risk factors, which include (select all that apply):

-Adolescence -Low educational level -History of depression Maternal attachment to the fetus is an important area to assess and can be useful in identifying families at risk for maladaptive behaviors. The nurse should assess for indicators such as unintended pregnancy, domestic violence, difficulties in the partner relationship, sexually transmitted infections, limited financial resources, substance use, adolescence, poor social support systems, low educational level, the presence of mental conditions, or adolescence that might interfere with the patient's ability to bond with and care for the infant. A strong support system can facilitate the patient's ability to bond with and care for the infant.

The clinic nurse talks with Suzy, a pregnant woman at 9 weeks' gestation who has just learned of her pregnancy. Suzy's nausea and vomiting are most likely caused by (select all that apply):

-An altered carbohydrate metabolism -Increased levels of human chorionic gonadotropin Nausea and vomiting during the first trimester most likely are related to rising levels of human chorionic gonadotropin (hCG) and altered carbohydrate metabolism. Changes in taste and smell, due to alterations in the oral and nasal mucosa, can further aggravate the gastrointestinal discomfort.

The clinic nurse describes the respiratory system changes common to pregnancy to the new nurse. These changes include (select all that apply):

-An increased tidal volume -A decreased airway resistance -An increased chest circumference During pregnancy, a number of changes occur to meet the woman's increased oxygen requirements. The tidal volume (amount of air breathed in each minute) increases 30% to 40%. The enlarging uterus creates an upward pressure that elevates the diaphragm and increases the subcostal angle. The chest circumference may increase by as much as 6 centimeters, and airway resistance decreases. Although the "up and down" capacity of diaphragmatic movement is reduced, lateral movement of the chest and intercostal muscles accommodates for this loss of movement and keeps pulmonary functions stable. There is no increase in airway resistance during pregnancy.

A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients' emotional responses to their infertility. Which of the following responses would the nurse expect to find? (Select all that apply.)

-Anger at others who have babies. -Feelings of failure because they cannot make a baby. -Guilt on the part of one partner because he or she is unable to give the other a baby. a. Infertile couples often feel anger toward couples who have babies. b. Infertile couples often express feelings of personal failure. d. Guilt is often expressed by the couple.

The clinic nurse recognizes that pregnant women who are in particular need of support are those who (select all that apply):

-Are awaiting genetic testing results -Are trying to conceal this pregnancy as long as possible A second pregnancy is not an indication of a woman in need of additional support. A support system may be lacking for women who are trying to conceal a pregnancy or for women who are trying to keep the news of their pregnancy from relatives or friends until results from genetic tests are known. These individuals may need additional support from their nurses and other health-care providers, as they are placed in a powerless situation while awaiting results and face a pregnancy that may be in jeopardy.

Infants whose mothers were obese during pregnancy are at higher risk for which of the following? (Select all that apply.)

-Childhood diabetes -Heart defects -Hypospadias Fetuses and/or infants of women who were obese during pregnancy are at higher risk for spina bifida, health defects, anorectal atresia, hypospadias, intrauterine fetal death, birth injuries related to macrosomia, and childhood obesity and diabetes.

During a health visit, a 23-year-old patient shares with her health-care provider that she has been experiencing a yellowish mucus vaginal discharge, pain during sexual intercourse, and burning on urination. A culture of the cervical epithelial cells is obtained. Based on the patient information, the culture is obtained to assist in the diagnosis of which of the following? (Select all that apply.)

-Chlamydia -Gonorrhea These are symptoms that can be related to either chlamydia or gonorrhea. Syphilis is diagnosed via blood test. Genital herpes has symptoms similar to the flu, and the person usually has an itching or burning sensation in the genital or anal area.

The clinic nurse schedules Tracy for her first prenatal appointment with the certified nurse-midwife (CNM) in the clinic. Tracy has appropriate questions for her potential health-care provider that include (select all that apply):

-Complementary and alternative methods used during labor and birth -An opportunity to meet other providers in the practice -Beliefs and practices concerning an episiotomy and an epidural anesthetic A woman's journey through the pregnancy experience can have long-term effects on her self-perception and self-concept. Therefore, it is especially important that the patient choose a care provider and group with whom she can openly relate and who shares the same philosophical views on the management of pregnancy. At the first prenatal visit, it is not common to explore whether the nurse-midwife will be continually available for support during labor.

A 60-year-old woman is scheduled for a dual-energy X-ray absorptiometry scan (DXA). The woman's health clinic nurse should provide the following information:

-DXA is a diagnostic test for osteoporosis. -DXA measures the bone density of the hip, spine, and forearm. -Osteoporosis can cause a stooped posture. Answers a, b, and d are true statements. A T-score is a comparison of the woman's bone density with that of a woman 30 years of age and the same race.

The clinic nurse encourages all pregnant women to increase their water intake to at least 8 to 10 glasses per day in order to (select all that apply):

-Decrease the risk of constipation -Decrease the risk of bile stasis -Decrease their feelings of fatigue -Decrease the risk of urinary tract infections Patients should be encouraged to drink at least 8 to 10 glasses of water each day and empty their bladders at least every 2 to 3 hours and immediately after intercourse. These measures will help prevent stasis of urine and the bacterial contamination that leads to infection, as well as constipation. Some women experience symptoms of fatigue that can be alleviated by remaining adequately hydrated.

Physical activity can lower a woman's risk for (select all that apply):

-Depression -Colon cancer According to the US Department of Health and Human Services, Office of Women's Health, physical activity can lower a woman's risk for heart disease, type 2 diabetes, colon cancer, breast cancer, falls, and depression.

Physiologic changes that occur in the renal system during pregnancy predispose the pregnant woman to urinary tract infections (UTIs). Symptoms of a UTI include (select all that apply):

-Dysuria -Hematuria -Urgency Urinary tract infection (UTI) symptoms include dysuria, hematuria, and urgency

A woman who is receiving radiation therapy for treatment of stage I cervical cancer is experiencing diarrhea. She contacts the oncology advice nurse. The advice nurse recommends that the woman (select all that apply):

-Eat five or six small meals a day instead of three large meals -Eat cooked vegetables instead of raw vegetables -Use baby wipes instead of toilet paper Radiation damages the cells of the intestines. Interventions are aimed at decreasing stress on the intestines such as eating small, frequent meals and foods low in fiber. Baby wipes help reduce irritation to the anal area. A person should increase fluid intake to compensate for fluid loss caused by the diarrhea.

The clinic nurse describes possible interventions for the pregnant woman who is experiencing pain and numbness in her wrists. The nurse suggests (select all that apply):

-Elevating the arms and wrists at night -Reassessment during the postpartum period -The use of "cock splints" to prevent wrist flexion Edema from vascular permeability can lead to a collection of fluid in the wrist that puts pressure on the median nerve lying beneath the carpal ligament, leading to carpal tunnel syndrome. Elevation of the hands at night may help to reduce the edema. Occasionally, a woman may need to wear a "cock splint" to prevent the wrist from flexing. Reassessment in the postpartum period is indicated because although carpal tunnel syndrome usually subsides after the pregnancy has ended, some women may require surgical treatment if symptoms persist. Massaging the hands and wrists with alcohol does not improve pain and numbness.

Urinary tract infection (UTI) prevention measures during pregnancy include counseling the pregnant woman to (select all that apply):

-Emptying bladder frequently -Wipe from front to back -Urinate after intercourse Anticipatory guidance for urinary tract infection prevention includes emptying bladder frequently, wipe front to back, and maintaining adequate hydration

A woman seeks care at an infertility clinic. Which of the following tests may this woman undergo to determine what, if any, infertility problem she may have? (Select all that apply.)

-Endometrial biopsy -Hysterosalpingogram -Serum FSH analysis b. Endometrial biopsy is performed about 1 week following ovulation to detect the endometrium's response to progesterone. c. Hysterosalpingogram is used to determine if fallopian tubes are patent. d. Serum FSH levels are used to assess ovarian function.

Strategies for culturally responsive care include (select all that apply):

-Examining one's own biases -Learning another language The only actions among the choices that are culturally responsive are examining one's own biases and learning another language. Ethnocentrism and stereotyping are not culturally responsive actions.

A nurse is caring for a woman who is 4 hours post-cesarean birth for arrest of labor. The labor and operative records indicate that she had premature rupture of membranes followed by 36 hours of labor. Her IV fluid intake for the past 24 hours is 2500 mL. The estimated blood loss is 1500 mL. Based on this data, the woman is at risk for which of the following? (Select all that apply.)

-Fluid volume deficit -Infection -Impaired mother-infant attachment -Falls The woman is at risk for fluid volume deficit related to blood loss and risk for postpartum hemorrhage due to risk of uterine atony. She is at risk for infection related to premature and prolonged rupture of membranes. The woman is at risk for impaired mother-infant attachment related to maternal pain and exhaustion. She is at risk for falls related to anesthesia and orthostatic hypotension.

The ovarian cycle includes which of the following phases? (Select all that apply.)

-Follicular phase -Ovulatory phase -Luteal phase Follicular phase, ovulatory phase, and luteal phase are part of the ovarian cycle. Secretory and menstrual phases are part of the endometrial cycle.

A 32-year-old woman now at 32 weeks' gestation is complaining of right-sided sharp abdominal pain. The patient is examined by the clinic nurse and given information about abdominal discomfort in pregnancy. She is also instructed to seek immediate attention if she (select all that apply):

-Has chills or a fever -Feels decreased fetal movements -Has increased abdominal pain Heartburn is a common discomfort throughout pregnancy. Because the appendix is pushed upward and posterior by the gravid uterus, the typical location of pain is not a reliable indicator for a ruptured appendix during pregnancy. The pain should gradually subside, but if it persists or is accompanied by fever, a change in bowel habits, or decreased fetal movement, the patient should promptly contact her medical provider.

The clinic nurse teaches the new nurse about pregnancy-induced blood clotting changes. The nurse explains that a pregnant woman is at risk for venous thrombosis due to (select all that apply):

-Increased fibrinogen volume -Increased blood factor X -Venous stasis Although the platelet cell count does not change significantly during pregnancy, fibrinogen volume has been shown to increase by as much as 50%. This alteration leads to an increase in the sedimentation rate. Blood factors VII, VIII, IX, and X are also increased, and this change causes hypercoagulability. The hypercoagulability state, coupled with venous stasis (poor blood return from the lower extremities) places the pregnant woman at an increased risk for venous thrombosis, embolism, and, when complications are present, disseminated intravascular coagulation (DIC). Blood factor V does not increase.

The perinatal nurse examines the thyroid gland as part of the physical examination of Savannah, a pregnant woman who is now at 16 weeks' gestation. The perinatal nurse informs Savannah that during pregnancy (select all that apply):

-Increased size of the thyroid gland is normal -Increased function of the thyroid gland is normal -The thyroid gland will return to its normal size and function during the postpartal period The thyroid gland changes in size and activity during pregnancy. Enlargement is caused by increased circulation from the progesterone-induced effects on the vessel walls, and by estrogen-induced hyperplasia of the glandular tissue. The thyroid gland increases not decreases in size and activity during pregnancy. The thyroid gland returns to normal size and activity postpartum.

Postoperative nursing care for a woman who had a total hysterectomy includes (select all that apply):

-Informing the woman that she will experience small amounts of vaginal bleeding for several days -Instructing the woman to increase her ambulation to facilitate return of normal intestinal peristalsis

Teera is a 22-year-old woman who is experiencing her third pregnancy. Her obstetrical history includes one first-trimester elective abortion and one first-trimester spontaneous abortion. Teera is a semi-vegetarian who drinks milk and eats yogurt and fish as part of her daily intake. The perinatal nurse discusses Teera's diet with her as she may be deficient in (select all that apply):

-Iron -Zinc Semi-vegetarian diets include fish, poultry, eggs, and dairy products but no beef or pork and have adequate intake of magnesium. Pregnant women who adhere to this diet may consume inadequate amounts of iron and zinc. Because strict vegetarians (vegans) consume only plant products, their diets are deficient in vitamin B12, found only in foods of animal origin

During a routine physical of a 31-year-old non-Hispanic black woman, it was noted that the woman's BMI is 32, her only exercise is taking care of her two children, her last Pap test was 2 years ago, and her last clinical breast exam was 2 years ago. Based on this information the woman (select all that apply):

-Is at risk for type 2 diabetes -Is at risk for depression Recommended screenings for women ages 19 to 39 are clinical breast exams and Pap test every 3 years. Obesity (a BMI of 30 or greater) places the woman at risk for type 2 diabetes; decreased physical activity places the woman at risk of depression.

Which of the following is a medical indication for a cesarean birth? (Select all that apply.)

-Late deceleration of the fetal heart rate with minimal variability -Complete placenta previa -Arrest of fetal descent A maternal blood pressure of 130/90 may be an indication of mild PHI which is not a medical indication for cesarean birth. Cervical dilation of 1.5 cm/minutes is within normal limits for cervical changes during the active phase. Late decelerations combined with minimal variability in the fetal heart rate reflect fetal intolerance of labor and are an indication for cesarean birth. A complete placenta previa covers the internal os necessitating a cesarean birth. Arrest of fetal descent indicates cephalopelvic disproportion.

Which of the following places a couple at higher risk for conceiving a child with a genetic abnormality? (Select all that apply.)

-Maternal age over 35 years -Partner who has a genetic disorder Fertility decreases after 35 years. A partner contributes half of the chromosomal makeup, and genetic disorders can be inherited. Maternal diabetes can have an effect on the fetus/neonate, such as causing complications such as macrosomia and hypoglycemia, but these are not genetic disorders. Paternal heart disease can place the neonate at risk for heart disease later in life, but this is not referred to as a genetic disorder, such as is trisomy 21 and hemophilia.

Asking the pregnant woman about her use of recreational drugs is an essential component of the prenatal history. Harmful fetal effects that may occur from recreational drugs include (select all that apply):

-Miscarriage/spontaneous abortion -Low birth weight Illegal or recreational drug use can have a number of detrimental effects on maternal and fetal health, including spontaneous abortion, low birth weight, placental abruption, and preterm labor.

Presumptive signs of pregnancy include (select all that apply):

-Nausea -Fatigue -Amenorrhea Nausea and vomiting, fatigue, and amenorrhea are all common during pregnancy and are the presumptive signs of pregnancy. Ballottement is a probably sign, noted during a vaginal exam

The perinatal nurse teaches the student nurse that deep breathing exercises following a cesarean birth are critical to the prevention of (select all that apply):

-Pneumonia -Atelectasis Incisional pain and abdominal distension often cause patients to adopt shallow breathing patterns that can lead to decreased gas exchange and a reduced tidal volume. To facilitate adequate lung functions, patients should be taught how to perform pulmonary exercises. Expectoration of secretions and deep breathing help prevent common complications including atelectasis and pneumonia. Abdominal distension and gas pains are common after abdominal surgery and result from delayed peristalsis.

Secondary amenorrhea results from (select all that apply):

-Polycystic ovary syndrome -Diabetes -Pregnancy

An overweight or obese pre-pregnancy weight increases the risk for which poor maternal outcomes? (Select all that apply.)

-Preeclampsia -Hemorrhage -Difficult delivery Being overweight or obese can substantially increase perinatal risk; however, no data support an increase in vaginal infections for the obese pregnant population.

During the initial antenatal visit, the clinic nurse asks questions about the woman's nutritional intake. Specific questions should include information pertaining to (select all that apply):

-Preferred foods -The presence of cravings -Use of herbal supplements -Aversions to certain foods and odors The nurse should obtain a nutritional history on all pregnant patients and patients of childbearing age to gain specific information related to the pregnancy, including foods that are preferred while pregnant (which may provide information about cultural and environmental dietary factors), special diets (which will assist the nurse in planning for education or interventions for risk factors associated with dietary practices), cravings or aversions to specific foods, and use of herbal supplements

The clinic nurse advocates for smoking cessation during pregnancy. Potential harmful effects of prenatal tobacco use include (select all that apply):

-Preterm birth -Gestational hypertension Nurses can help to improve the fetal environment by educating women about the dangers of direct and passive smoking during pregnancy. Effects of tobacco use during pregnancy are well documented and predispose to premature rupture of the membranes, preterm labor, placental abruption, placenta previa, and infants who are low birth weight or small for gestational age (SGA). Gestational hypertension and diabetes are not associated with smoking during pregnancy.

The clinic nurse is assessing the complete blood count results for Kim-Ly, a 23-year-old pregnant woman. Kim-Ly's hemoglobin is 9.8 g/dL. This laboratory finding places Kim-Ly's pregnancy at risk for (select all that apply):

-Preterm birth -Intrauterine growth restriction True anemia, or iron-deficiency anemia, occurs when the hemoglobin level drops below 10 g/dL. The blood's decreased oxygen-carrying capacity causes a reduction in oxygen transport to the developing fetus. Decreased fetal oxygen transport has been associated with intrauterine growth restriction (IUGR) and preterm birth. There is not a risk factor for abruption or thrombocytopenia

The clinic nurse explains to Margaret, a newly diagnosed pregnant woman at 10 weeks' gestation, that her rubella titer indicates that she is not immune. Margaret should be advised to (select all that apply):

-Receive the rubella vaccine postpartum -Report signs or symptoms of fever, runny nose, and generalized red rash to the health-care provider Testing for rubella (German measles) is not necessary as titers are reliable indicators of immunity. Rubella (German measles) is one of the most commonly recognized viral infections known to cause congenital problems. If a woman contracts rubella during the first 12 weeks of pregnancy, the fetus has a 90% chance of being adversely affected. A maternity patient who is not immune to rubella should be offered the rubella immunization following childbirth, ideally prior to hospital discharge. The patient should report signs or symptoms of rubella during pregnancy to her health-care provider. It is not realistic for a woman to avoid contact with all children

The perinatal nurse teaches the student nurse about the physiological changes in pregnancy that most often contribute to the increased incidence of urinary tract infections. These changes include (select all that apply):

-Relaxation of the smooth muscle of the urinary sphincter -Relaxation of the smooth muscle of the bladder -Inadequate emptying of the bladder -Increased incidence of bacteriuria Ascension of bacteria into the bladder can cause asymptomatic bacteriuria (ASB), or urinary tract infections (UTIs). These infections occur more frequently in pregnancy due to relaxation of the smooth muscle of the bladder and urinary sphincter and inadequate emptying of the bladder, changes that allow bacterial ascent into the bladder

Jorgina is a 24-year-old pregnant woman at 26 weeks' gestation. This is Jorgina's third pregnancy, and her obstetrical history includes one full-term birth, one preterm birth, and two living children. Today Jorgina arrives at the clinic with complaints of fatigue, insomnia, and backache. She reports that she is a nurse on an oncology unit and is worried about continuing with working her 12-hour shifts. The perinatal nurse identifies concerns in Jorgina's history and work environment including (select all that apply):

-Risk of preterm birth -Presence of chemotherapeutic agents -Requirement for heavy lifting Women who are currently experiencing pregnancy complications and those who have a history of pregnancy complications (such as history of preterm birth) or other preexisting health disorders may be required to reduce their hours or stop working. The potential for maternal exposure to toxic substances such as chemotherapeutic agents, lead, and ionizing radiation (found in laboratories and health-care facilities); heavy lifting; and use of heavy machinery and other hazardous equipment should prompt reassignment to a different work area. If reassignment is not possible, Jorgina may need to stop working until the pregnancy has been completed. In this scenario there is no history of diabetes.

The perinatal nurse talks to the prenatal class attendees about guidelines for exercise in pregnancy. Recommended guidelines include (select all that apply):

-Stopping if the woman is tired -Increasing fluid intake throughout the physical activity -Maintaining the ability to walk and talk during exercise Women should adhere to some basic safety guidelines when formulating their exercise program, including monitoring the breathing rate and ensuring that the ability to walk and talk comfortably is maintained during physical activity, stopping exercise when the woman becomes tired, and maintaining adequate fluid intake. Pregnant women should avoid exercises that can cause any degree of trauma to the abdomen or those that include rigorous bouncing, arching of the back, or bending beyond a 45-degree angle.

Excessive drinking places the woman at risk for (select all that apply):

-Suicide -Stroke -Breast cancer Excessive drinking places a woman at risk for alcoholism, elevated blood pressure, obesity, diabetes, stroke, breast cancer, suicide and accidents.

An 18-year-old woman at 23 weeks' gestation tells the nurse that she has fainted two times. The nurse teaches about the warning signs that often precede syncope so that she can sit or lie down to prevent personal injury. Warning signs include (select all that apply):

-Sweating -Nausea -Yawning Sweating is a warning sign that often precedes syncope. Syncope (a trandient loss of consciousness and postural tone with spontaneous recovery) during pregnancy is frequently attributed to orthostatic hypotension or inferior vena cava compression by the gravid uterus. Nausea and yawning are warning signs that often precede syncope. Lightheadedness, sweating, nausea, yawning, and feelings of warmth are warning signs that often precede syncope. Chills are not a warning sign that often precede syncope.

Which of the following statements are true related to teen pregnancies? (Select all that apply.)

-Teen mothers are at higher risk for HIV. -Teen mothers are at higher risk for hypertensive problems. -Infants born to teen mothers are at higher risk for health problems. Health statistics report higher risk for HIV, for hypertensive problems, and for health problems to infants born to teen mothers. Birth rates for teen mothers in all age categories have decreased since 1991.

A couple is undergoing an infertility workup. The semen analysis indicates a decreased number of sperm and immature sperm. Which of the following factors can have a potential effect on sperm maturity? (Select all that apply.)

-The man rides a bike to and from work each day. -The man takes a calcium channel blocker for the treatment of hypertension. The daily riding of a bike can be the cause of prolonged heat exposure to the testicles. Prolonged heat exposure is a gonadotoxin. A number of medications, such as calcium channel blockers, can have an effect on sperm production. Coffee has not been associated with low sperm counts. Prostatitis or other infections within the last 3 months may have an effect on the sperm analysis. This man's episode of prostatitis was 12 months prior.

The woman's health clinic nurse is providing information to a 21-year-old woman who is being scheduled for a pelvic exam and Pap test. This information should include (select all that apply):

-The woman should not use tampons or vaginal medication or engage in sexual intercourse within 48 hours of the exam. -The best time to have a Pap test is 5 days after the menstrual period has ended. The Pap test is a screening versus a diagnostic test. Women should not douche; use tampons; use vaginal creams, spermicide foams, creams, or jellies; use vaginal lubricants or moisturizers; use vaginal medications; or have sexual intercourse for 48 hours prior to the exam. The best time to obtain a Pap test is 5 days after the period ends. Women ages 19 to 39 should have a Pap test every 3 years.

The clinic nurse encourages paternal attachment during pregnancy by including the father in (select all that apply):

-Ultrasound appointments -Prenatal class information -History taking and obtaining prenatal screening information Pregnancy is psychologically stressful for men; some enjoy the role of nurturer, but others feel alienated and begin to stray from the relationship. The nurse can be instrumental in promoting early paternal attachment. Involvement of the father during examinations and tests and prenatal classes, along with thorough explanations of the need for them, can minimize the father's feelings of being left out. A history and prenatal screening should be conducted at the first prenatal visit with the woman alone to ensure confidentiality and an open discussion of any problems or concerns she may have. The history should include information about the current pregnancy; the obstetric and gynecologic history; and a cultural assessment, and a medical, nutritional, social, and family (including the father's) medical history.

Postnatal nurses expressed concern about neonatal pain management during painful interventions. Using evidence-based practice from research performed by Thakkar, Arora, Das, Javadekar, and Panigrahi (2016), which method of pain control will be used for heel sticks?

A combination of stimulated sucking and receiving sucrose orally.

A patient at 30 weeks gestation is exhibiting signs of preterm labor and delivery. The health care provider (HCP) informs the patient that nothing can be done to disrupt this process. The patient is in distress and states, "Why can't something be done to save my baby?" The nurse understands the HCP's decision is likely based on which finding?

A fetal heartbeat could not be obtained.

. The nurse is providing care for a 45-year-old patient who has just learned she is in the second trimester of pregnancy. The patient thought she was experiencing manifestations of menopause until she recognized fetal movement. Which diagnostic test does the nurse expect to be prescribed for this patient?

Amniocentesis

Which of the following foods is highest in calcium?

An 8 oz. container of plain, low-fat yogurt Milk has 293 mg of calcium; cheddar cheese has 307 mg; yogurt has 415; salmon has 181 mg.

Which of the following women is at the highest risk for health disparity?

An Asian, low-income, 30-year-old woman Although age and race contribute to increased risk, income accounts for the largest disparity.

Intimate partner violence (IPV) against women consists of actual or threatened physical or sexual violence and psychological and emotional abuse. Screening for IPV during pregnancy is recommended for:

All pregnant women Correct. AWHONN advocates for universal screening for domestic violence for all pregnant women. Homicide is the most likely cause of death for pregnant or recently pregnant women, and a significant portion of those homicides are committed by their intimate partners. One in six pregnant women reported physical or sexual abuse during pregnancy, seriously impacting maternal and fetal health and infant birth weight.

The nurses in a postnatal unit are aware of the fears of new parents with regard to infant abduction. Which interventions by the nurse will alleviate the concerns of the parents? Select all that apply.

Allow only visitors with identification to enter the unit. Use the hospital abduction alarm systems. Require unit personnel to wear specific name tags. Footprints and a photo of the neonate are taken for identification purposes. Encourage parents to accompany persons transporting the newborn.

The nurse in the neonate nursery notices a neonate, born 45 minutes ago, is unresponsive to external stimuli, and has a respiratory and heart rate below normal range. Which action does the nurse take?

Allows the neonate to naturally continue deep sleep.

The nurse is researching for evidence-based practice related to a mother's response during the postpartum period. Based on research by Rubin and Mercer, which finding will the nurse be able to easily implement to change the culture of the unit?

Alterations in terminology

What is the most common expected emotional reaction of a woman to the news that she is pregnant?

Ambivalence Ambivalence is a normal expected reaction to the news of pregnancy, whether or not the pregnancy is planned or wanted.

Tobacco use during pregnancy is associated with adverse effects on the unborn infant such as intrauterine growth restriction, preterm births, and respiratory problems. By race, which has the highest percentages of smokers?

American Indian and Alaskan Natives 36% of American Indian and Native American women are cigarette smokers.

The nurse notices that a neonate being treated for hyperbilirubinemia with phototherapy has had a daily increase of total bilirubin serum levels greater than 5 mg/dL for the past 2 days. The neonatal care provider prescribes an exchange transfusion. Which knowledge does the nurse apply to the procedure?

Approximately 85% of the neonate's RBCs are replaced.

A pregnant woman informs the nurse that her last normal menstrual period was on July 6, 2007. Using Naegele's rule, which of the following would the nurse determine to be the patient's estimated date of delivery (EDC)?

April 13, 2008 The EDC is calculated as April 13, 2008. Naegele's rule: subtract 3 months and add 7 days to the first day of the last normal menstrual period.

Lina is an 18-year-old woman at 20 weeks' gestation. This is her first pregnancy. Lina is complaining of fatigue and listlessness. Her vital signs are within a normal range: BP = 118/60, pulse = 70, and respiratory rate 16 breaths per minute. Lina's fundal height is at the umbilicus, and she states that she is beginning to feel fetal movements. Her weight gain is 25 pounds over the prepregnant weight (110 lb), and her height is 5 feet 4 inches. The perinatal nurse's best approach to care at this visit is to:

Ask Lina to keep a 3-day food diary to bring in to her next visit in 1 week. Nutrition and weight management play an essential role in the development of a healthy pregnancy. Not only does the patient need to have an understanding of the essential nutritional elements, she must also be able to assess and modify her diet for the developing fetus and her own nutritional maintenance. To facilitate this process, it is the nurse's responsibility to provide education and counseling concerning dietary intake, weight management, and potentially harmful nutritional practices. To facilitate this process, it is the nurse's responsibility to gather more information on the woman's dietary practices through a food diary.

The perinatal nurse is assessing a woman in triage who is 34 + 3 weeks' gestation in her first pregnancy. She is worried about having her baby "too soon," and she is experiencing uterine contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal examination performed by the health-care provider reveals that the cervix is closed, long, and posterior. The most likely diagnosis would be:

Braxton-Hicks contractions Braxton-Hicks contractions are regular contractions occurring after the third month of pregnancy. They may be mistaken for regular labor, but unlike true labor, the contractions do not grow consistently longer, stronger, and closer together, and the cervix is not dilated. Some patients present with preterm contractions, but only those who demonstrate changes in the cervix are diagnosed with preterm labor.

A breastfeeding mother is planning to return to work 3 months after her baby is born. The mother is planning to use an electric breast pump and freeze some breast milk for use later. Which information does the nurse need to provide?

Breast milk can be kept in a deep freezer for 6 to 12 months.

The NICU nurse encourages the mother of a premature neonate to bring breast milk to the unit for enteral feedings to her baby. For which reason does the nurse make this suggestion?

Breast milk helps prevent necrotizing enterocolitis.

A nurse is reviewing diet with a pregnant woman in her second trimester. Which of the following foods should the nurse advise the patient to avoid consuming during her pregnancy?

Brie cheese Soft cheese may harbor Listeria. The patient should avoid consuming uncooked soft cheese.

____________________ is a chronic lung problem that affects neonates who have been treated with mechanical ventilation and oxygen for problems such as RDS.

Bronchopulmonary dysplasia

A woman is considered in active labor when:

Cervical dilation progresses from 4 to 7 cm with effacement of 40% to 80%, contractions become more intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds. Characteristics of this phase are the cervix dilates, on an average, 1.2 cm/hr for primiparous women and 1.5 cm/hr for multiparous women. Cervical dilation progresses from 4 to 7 cm with effacement of 40% to 80%. Fetal descent continues and contractions become more intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds, and discomfort increases.

The nurse in a labor and delivery department carefully assesses postpartum patients for signs of complications related to hemorrhage. Which factor makes it most difficult to identify the risk of hemorrhage through vital sign evaluation?

Changes in blood pressure may not be an immediate sign.

The nurse is providing care for a new mother during a follow-up visit 6 weeks after a vaginal delivery. The mother begins to cry and reports difficulty with eating and sleeping. The nurse identifies postpartum blues and cites which reason as the most likely cause?

Changes in hormonal levels

A pregnant client asks the nurse why she should attend childbirth classes. The nurse's response would be based on which of the following information?

Childbirth classes will help new families develop skills to meet the challenges of childbirth and parenting. Correct. These are the stated goals of childbirth education (ICEA, Lamaze).

A 26-year-old woman at 29 weeks' gestation experienced epigastric pain following the consumption of a large meal of fried fish and onion rings. The pain resolved a few hours later. The most likely diagnosis for this symptom is:

Cholelithiasis The progesterone-induced prolonged emptying time of bile from the gallbladder, combined with elevated blood cholesterol levels, may predispose the pregnant woman to gallstone formation (cholelithiasis). Pain in the epigastric region following ingestion of a high-fat meal constitutes the major symptom of these conditions. The pain is self-limiting and usually resolves within 2 hours.

The terminology intrauterine inflammation or infection or both or Triple I is now used instead of the term ____________________.

Chorioamnionitis

The postpartum nurse is preparing to present infant care information to a couple who expresses concern about when to bathe their newborn. Which behaviors will the nurse present as general guidelines? Select all that apply.

Daily bathing with soap is not necessary for the newborn. Use a mild preservative-free soap with a neutral pH. Avoid the use of soap on the face of the newborn. Genital and rectal areas should be cleaned at each diaper change.

The nurse is discussing contraception with a couple before discharge following the birth of a first child. The couple are uncertain about the method but are certain about avoiding pregnancy for at least 2 years. Which method does the nurse recommend?

Depo-Provera

The nurse continues to monitor a patient after a vaginal delivery with an estimated blood loss of 1,000 mL. Which assessment finding does the nurse recognize as requiring Stage 3 hemorrhage protocol?

Development of abnormal vital signs.

A patient with pregestational diabetes mellitus delivers a neonate who is diagnosed with macrosomia. The nurse is aware that the neonate is at risk for additional long-term conditions related to maternal diabetes mellitus. Which long-term effects may occur? Select all that apply.

Development of metabolic syndrome Impaired intellectual development Changes in genetic expression Increased risk for chronic illnesses

The nurse is providing support for the parents of a neonate born with anencephaly. The parents repeatedly state, "I don't believe this is happening to us. We were so careful during pregnancy." The nurse associates the parents' comments with which stage of grief?

Disbelief

The nurse is providing care for a neonate during the fourth stage of labor. Which action does the nurse take during this stage?

Dry the neonate immediately.

3. The fetal circulatory structure that connects the pulmonary artery with the descending aorta is known as which of the following?

Ductus arteriosus

The nurse is concerned about the number of infants in the community who die from SIDS even with teaching about "back to sleep" being provided. On which additional preventive measures will the nurse focus? Select all that apply.

During pregnancy, women should not smoke, drink alcohol, or use illegal drugs. Infants need to be dressed to prevent infants from overheating during sleep. Mothers need to be informed that breastfeeding reduces the risk for SIDS. Parents should not smoke or allow smoking around their baby. Parents need to avoid products that claim to reduce the risk of SIDS.

The nurse is teaching a prenatal class. For which reason does the nurse emphasize the importance of managing maternal fear during labor?

Dystocia is associated with extreme fear.

A patient in the third trimester of pregnancy is instructed on how to perform daily fetal movement count. The nurse needs to inform the patient what to do if fetal movement is decreased. Which patient actions are appropriately recommended by the nurse? Select all that apply.

Eat something. Arrange for a period of rest. Focus on movement for 1 hour.

The nurse on a postpartum unit focuses on how to assist the father in identifying his role with the neonate. Which intervention by the nurse is most helpful?

Encourage the couple to identify mutual expectations of the fathering role.

The mechanism of labor known as cardinal movements of labor are the positional changes that the fetus goes through to best navigate the birth process. These cardinal movements are:

Engagement, Descent, Flexion, Internal rotation, Extension, External rotation, Expulsion

Which of the following findings, seen in pregnant women in the third trimester, would the nurse consider to be within normal limits?

Epistaxis Epistaxis is commonly seen in pregnant patients. The bleeding is related to the increased vascularity of the mucous membranes. Unless the blood loss is significant, it is a normal finding.

Fetal heart rate should be assessed in a low-risk woman in active labor:

Every 30 minutes

A patient is in her first trimester of her second pregnancy. The patient's first child was born with a trisomy 21 defect. The patient is requesting testing to determine whether the current fetus has the same defect. Which initial testing does the nurse expect the HCP to prescribe?

Fetal ultrasound

The nurse is providing care to a patient who is at 41 weeks gestation. Which factor about the patient does the nurse consider as an indication of late-term or post-term pregnancy?

Fetus is identified as a male

The clinic nurse uses Leopold maneuvers to determine the fetal lie, presentation, and position. The nurse's hands are placed on the maternal abdomen to gently palpate the fundal region of the uterus. This action is best described as the:

First maneuver Leopold maneuvers are a four-part clinical assessment method used to determine the lie, presentation, and position of the fetus. The first maneuver determines which fetal body part (e.g., head or buttocks) occupies the uterine fundus. The examiner faces the patient's head and places the hands on the abdomen, using the palmar surface of the hands to gently palpate the fundal region of the uterus. The buttocks feel soft, broad, and poorly defined and move with the trunk. The fetal head feels firm and round and moves independently of the trunk.

The nurse is preparing a postpartum patient for discharge. For which reasons does the nurse instruct the patient to call the primary care provider? Select all that apply.

Foul-smelling lochia Hot, red, painful breasts Frequent, painful urination

Increased information provided by assessment of uterine contractions with an intrauterine pressure catheter includes:

Frequency, duration, intensity, and resting tone

A nurse is performing an assessment on a pregnant woman during a prenatal visit. Which of the following findings would lead the nurse to report to the obstetrician that the patient may be experiencing intrauterine growth restriction (IUGR)?

Fundal height measurement: 22 cm at 26 weeks' gestation The fundal height at 26 weeks should be approximately 26 cm. The fundal height, therefore, is below expected. This patient may be experiencing intrauterine growth restriction.

. __________ __________ __________ is when sperm and oocytes are mixed outside the woman's body and then placed into the fallopian tube via laparoscopy.

Gamete intrafallopian transfer Gamete intrafallopian transfer, also referred to as GIFT, is used when there is a history of failed infertility treatment for anovulation, or unexplained infertility, or low sperm count.

The nurse is explaining to the new breastfeeding mother the types of neonatal stools the mother can expect. Which examples does the nurse provide? Select all that apply.

Golden yellow, a pasty consistency, and sour odor is expected. Neonate's first stool is passed within the first 24 to 48 hours.

When providing a psychosocial assessment on a pregnant woman at 21 weeks' gestation, the nurse would expect to observe which of the following signs?

Happiness The nurse would expect the patient to exhibit signs of happiness at this time.

Taboos are cultural restrictions that:

Have serious supernatural consequences Taboos are believed to have serious supernatural consequences. Taboos are not known to have clinical or superstitious consequences and are not functional or neutral practices.

The nurse is assessing a term neonate delivered to a mother with a history of drug and alcohol abuse. Which finding does the nurse relate to the mother's history?

Head circumference is below the 10th percentile of normal for gestational age.

A 65-year-old woman is complaining of jaw pain, nausea, shortness of breath without chest pain, and sweating. These are warning signs of:

Heart attack Warning signs of heart attack in women are uncomfortable pressure, squeezing, fullness, or pain in the center of the chest; pain or discomfort in one or both arms; shortness of breath with or without chest discomfort; nausea; lightheadedness; sweating.

The postpartum nurse-manager wants the unit to become active as a supporter of the Baby-Friendly Hospital Initiative. Which nursing actions will be initiated? Select all that apply.

Help mothers initiate breastfeeding within 1 hour of birth. Teach breastfeeding and promote lactation to mothers separated from infants. Refer mothers to support group resources on discharge.

The nurse is working in a prenatal clinic caring for a patient at 14 weeks' gestation, G2 P1001. Which of the following findings should the nurse highlight for the nurse midwife?

Hematocrit of 29% A hematocrit of 29% indicates that the patient is anemic. The nurse should highlight the finding for the nurse-midwife.

The perinatal nurse listens as Chantal describes her labor and emergency cesarean birth. Providing an opportunity to review this experience may assist Chantal in:

Her role development in the "letting go" stage Administration of narrow-spectrum prophylactic antibiotics should occur within 60 minutes prior to the skin incision.

A patient in the first stage of pregnancy is discussing the options for feeding her infant, and asks the nurse, "Which is the most important reason I should consider breastfeeding my baby?" Which is the most significant reason the nurse presents?

Human milk contains multiple antibodies, enzymes, and immune factors.

The nursing staff in a labor and delivery unit has noticed an increase in the number of patients experiencing placental abruption. The nurses begin to review demographics for the patients involved. Which risk factors will the nurses expect? Select all that apply.

Hypertensive disorders Uterine fibroids Cigarette smoking Methamphetamine use Abdominal trauma

The postnatal nurse is providing care for a neonate being treated with phototherapy for hyperbilirubinemia. For which side effects of phototherapy will the nurse contact the neonatal care provider? Select all that apply.

Hyperthermia Hypocalcemia Thrombocytopenia

Which of the following would be a priority for the nurse when caring for a pregnant woman who has recently emigrated from another country?

Identify her support system. Correct, because lack of social support has been correlated with an increased risk of pregnancy complications and difficult adaptation to pregnancy. Pregnant women who are recent immigrants face many challenges in obtaining needed social support, and the nurse should first identify her support system to plan further interventions and referrals.

Cathy is pregnant for the second time. Her son, Steven, has just turned 2 years old. She asks you what she should do to help him get ready for the expected birth. What is the nurse's most appropriate response?

If Steven's sleeping arrangements need to be changed, it should be done well in advance of the birth. Children still sleeping in a crib should be moved to a bed at least 2 months before the baby is due, as this age group is particularly sensitive to disruptions of the physical environment.

The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient?

Immediate hospitalization in a psychiatric unit

The nurse is teaching newborn care to an adolescent mother. When the nurse attempts to teach how to swaddle the newborn, the mother states, "What's the big deal about how to wrap up a baby?" The nurse needs to convey which reason as being most important for proper swaddling?

Improper swaddling can cause hip dysplasia.

The nurse is preparing for the discharge of a premature neonate to home with the parents. The nurse explains the neonate must be able to pass the infant car seat challenge before discharge. For which reason would the neonate be considered unsafe in a car seat?

Inability to maintain adequate oxygenation, heart rate, and respiratory rate during trial

The nurse is providing teaching to a patient who is breastfeeding a newborn. The patient expresses interest in maintaining a healthy nutritional status for both her and her baby. Which information does the nurse present to meet the patient's need? Select all that apply.

Increase caloric intake by 500 to 1,000 per day. Drink 2 to 3 liters of fluid each day.

The perinatal nurse explains to the student nurse that a goal of the Healthy People 2020 report is to:

Increase proportion of infants who are breastfed to 83.9%. A goal of Healthy People 2020 is to increase the proportion of infants who are breastfed from 74% to 81.9%.

The nurse is assessing a patient who is 36 hours postpartum following a cesarean delivery. Which findings cause the nurse to conclude that a wound infection is developing? Select all that apply.

Increased margins of incisional redness Notably warm skin around the incision

The nurse is interested in promoting coparenting because of the high likeability that at some point, both parents will be working outside the home. After reading research by Davis, Schoppe-Sullivan, Mangelsdorf, and Brown (2009), the nurse learns that which factor impacts coparenting the most?

Infant temperament

The nurse is preparing discharge teaching for a postpartum patient who exhibits signs and symptoms of an episiotomy infection and is on oral antibiotic therapy. Which discharge teaching will the nurse provide regarding pain management?

Information applicable to medication therapy

The nurse is providing postpartum care for an adolescent mother and her family. Which factor is most important for the nurse to consider when planning teaching about neonatal care?

Information must be presented on an age-appropriate level.

An ethical dilemma unique to perinatal nursing is the

Innate conflict between maternal and fetal rights A unique aspect of maternity nursing is that the nurse advocates for two individuals: the woman and the fetus.

A patient in labor receives high-level regional anesthesia, which inhibits her ability to push during the second state of labor. The primary care provider will use forceps to aid in the delivery of the fetus. Which fetal complications is the nurse aware of being related to a forceps birth? Select all that apply.

Intracranial hemorrhage Cephalohematoma Nerve injuries Skin lacerations Skull fracture

A woman at 40 weeks' gestation has a diagnosis of oligohydramnios. Which of the following statements related to oligohydramnios is correct?

It indicates that there is a 50% reduction of amniotic fluid. Correct. Oligohydramnios refers to a decreased amount of amniotic fluid of less than 500 mL at term or 50% reduction of normal amounts.

A neonate is born after 37 weeks gestation, and the nurse is concerned about avoiding cold stress after discharge. Which suggestions does the nurse give the mother to keep the baby safe? Select all that apply.

Keep the baby wrapped in a warm blanket. Position the baby away from vents and drafts. Place a stocking cap on the neonate's head. Change wet clothing immediately.

A neonate born at 36 weeks gestation is classified as which of the following?

Late premature Late premature is 34 to 36 completed weeks' gestation.

During a cesarean section, which action by the nurse is done to prevent compression of the descending aorta and vena cava?

Left lateral tilt Positioning of the patient with a left tilt maintains a left uterine displacement to decrease the risk of aortocaval compression related to compression on the aorta and inferior vena cava due to weight of the gravid uterus.

Loutzenhiser, McAuslan, and Sharpe (2015) performed a study regarding maternal and paternal fatigue and factors associated with fatigue across the transition to parenthood. Which evidence-based conclusion is made regarding fatigue and the transitioning parents?

Levels of prenatal and postnatal fatigue are associated.

The nurse is providing prenatal teaching to a group of diverse pregnant women. One woman, who indicates she smokes two to three cigarettes a day, asks about its impact on her pregnancy. The nurse explains that the most significant risk to the fetus is:

Low neonatal birth weight Low neonatal birth weight is the most common complication seen in pregnancies complicated by cigarette smoking.

The nurse is providing care for a neonate born to a mother with preexisting diabetes mellitus. Which neonatal assessment findings do the nurse expect? Select all that apply.

Macrosomia Hypocalcemia Jaundice Dyspnea

The nurse is providing care for a premature neonate in the NICU nursery. The neonate is diagnosed with bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA). Which specific intervention does the nurse expect for this neonate?

Maintain fluid restrictions.

Dayton et al. (2016) performed qualitative research regarding expectant fathers' beliefs and expectations. The nurse identifies which theme as emerging from this research?

Men described fathering as an extremely difficult task.

The labor and delivery nurse understands that some neonates spontaneously take a breath once the head and chest is delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe?

Mild hypoxia and decreased pH stimulates the brain.

You are caring for a woman in labor who is 6 cm dilated with a reassuring FHT pattern and regular strong UCs. The fetal heart rate (FHR) should be:

Monitored every 30 minutes Assessment of fetal heart rate (FHR) during the active phase of labor with a reassuring FHR is indicated every 30 minutes.

The nurse is providing care for a patient in the second phase of labor. After more than 4 hours of pushing, the nurse suspects fetal dystocia. Which is the greatest risk related to the nurse's suspected complication?

Neonatal asphyxia related to prolonged labor

A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient's medical record and associates which risk factors related to a possible urinary tract infection (UTI)? Select all that apply.

Neonatal macrosomia Use of a vacuum extractor Poor oral fluid intake Urinary catheter during labor

A patient who is at 30 weeks gestation is involved in a car crash. The nurse recognizes that which initial testing will be used to assess fetal well-being?

Nonstress testing

The clinic nurse reviews the complete blood count results for a 30-year-old woman who is now 33 weeks' gestation. Tamara's hemoglobin value is 11.2 g/dL, and her hematocrit is 38%. The clinic nurse interprets these findings as:

Normal pregnancy values for the third trimester During pregnancy the woman's hematocrit values may appear low due to the increase in total plasma volume (on average, 50%). Because the plasma volume is greater than the increase in erythrocytes (30%), the hematocrit decreases by about 7%. This alteration is termed "physiologic anemia of pregnancy," or "pseudo-anemia." The hemodilution effect is most apparent at 32 to 34 weeks. The mean acceptable hemoglobin level in pregnancy is 11 to 12 g/dL of blood.

A primary topic for health promotion for a 25-year-old woman with a history of polycystic ovary syndrome is (select the most important topic):

Nutrition Women with PCOS are at higher risk for being obese. Obesity increases the woman's risk for type 2 diabetes. Obesity and type 2 diabetes increase the woman's risk for cardiovascular disease, hypertension, dyslipidemia, and metabolic syndrome. It is also important to talk about self-esteem issues related to hirsutism and the effects of smoking and drinking, but the long-term effects of obesity are a greater risk to a woman with PCOS.

A woman presents to the prenatal clinic at 30 weeks' gestation reporting dysuria, frequency, and urgency with urination. Appropriate nursing actions include:

Obtain clean-catch urine to assess for a possible urinary tract infection. Correct. Dysuria, frequency, and urgency with urination are signs and symptoms of a urinary tract infection, necessitating further assessment and testing.

In an attempt to improve the effectiveness of postpartum teaching, the nurse uses the AWHONN acronym POST BIRTH. Which teaching points require the patient to call for 911 assistance? Select all that apply.

Thoughts of hurting self or baby

The nurses in a NICU are concerned about the appropriate levels of oxygen therapy during the care of premature neonates. The nurses referenced an article by Newman (2014) titled, "Oxygen Saturation Limits and Evidence supporting the Targets." On which evidence-based conclusion will the nurses develop guidelines?

Oxygen saturation limits need to be between 87% to 94%.

The nurse educator is preparing a presentation on preterm labor (PTL) and birth (PTB). Which information does the nurse recognize as being inaccurate?

PTL is defined as regular uterine contractions resulting in cervical changes before 40 weeks gestation.

The nurse is providing care for a premature neonate born at 28 weeks gestation who is experiencing respiratory distress syndrome (RDS). Which assessment finding indicates to the nurse that the neonate's respiratory status is deteriorating?

Pao2 is 48 and Paco2 is 55 mm Hg on 90% oxygen.

A patient in the second trimester of pregnancy is scheduled for a Doppler flow study because the health care provider (HCP) is concerned about an assessment finding during a routine prenatal visit. Which finding of concern does the nurse suspect?

Patient shows no weight gain in 2 weeks.

You are in the process of admitting a multiparous woman to labor and delivery from the triage area. One hour ago her vaginal exam was 4/70/0. While completing your review of her prenatal record and completing the admission questionnaire, she tells you she has an urge to have a bowel movement and feels like pushing. Your priority nursing intervention is to:

Perform a vaginal exam. Perform a vaginal exam to assess the progress of labor. The urge to have a bowel movement and feeling like pushing indicate that birth may be imminent.

The nurse is preparing to perform a visual assessment of the perineum of a postpartum patient. The nurse will use the REEDA acronym. Which specific assessments are covered by REEDA? Select all that apply.

Perineal coloration Suture line appearance Amount of swelling Soft tissue trauma

The color of a person's hair is an example of which of the following?

Phenotype Correct. Phenotype refers to how genes are outwardly expressed, such as eye color, hair color, and height.

A new mother expresses severe frustration with an infant that is exhibiting symptoms of colic. Which suggestions from the nurse are aimed at infant safety? Select all that apply.

Place the baby in a safe place and allow the baby to cry for 10 to 15 minutes. Do simple household chores, such as vacuuming or washing the dishes.

A nurse is admitting a woman for a scheduled cesarean section. Which of the following assessment data should be immediately reported to the physician?

Platelet count of 97,000 Normal range of platelets is 150,000 to 400,000. A low platelet count places the woman at risk for increased bleeding.

The nurse notes each of the following findings in a woman at 10 weeks' gestation. Which of the findings would enable the nurse to tell the woman that she is probably pregnant?

Positive pregnancy test A positive pregnancy test is a probable sign of pregnancy. It is not a positive sign because the hormone tested for—human chorionic gonadatropin (hCG)—may be being produced by, for example, a hydatidiform mole.

A patient who is 8 months postpartum arrives for an OB appointment. The nurse notices that both the patient and the infant appear unkempt. The nurse anticipates a diagnosis of _________________________.

Postpartum depression

In caring for a primiparous woman in labor, one of the factors to evaluate is uterine activity. This is referred to as the __________ of labor.

Powers. Powers refer to the contractions.

The nurse on a postpartum unit is focused on providing care that will assist the mother and father in making the transition to parenthood. For which reason does the nurse review the prenatal and labor records?

Pregnancy and birth experiences, which can either enhance or impede the process of becoming a mother.

The perinatal nurse understands that the purpose of combining an opioid with a local anesthetic agent in an epidural is primarily to:

Preserve a greater amount of maternal motor function Combining an opioid with a local anesthetic agent reduces the total amount of anesthetic required and helps to preserve a greater amount of maternal motor function.

The clinic nurse talks with Kathy about her possible pregnancy. Kathy has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. These symptoms are best described as:

Presumptive signs of pregnancy Presumptive signs of pregnancy include amenorrhea, nausea and vomiting, frequent urination, breast tenderness, perception of fetal movement, skin changes, and fatigue. Probable signs of pregnancy include abdominal enlargement, Piskacek sign, Hegar sign, Goodell sign, Braxton Hicks sign, positive pregnancy test, and ballottement. Positive signs include fetal heartbeat, visualization of the fetus, and fetal movements palpated by the examiner.

The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, "I think that my baby is deformed inside and we have to fix him." Which risk factor is most strongly related to possible postpartum psychosis (PPP)?

Prolonged labor resulting in cesarean

The labor and delivery nurse is present for the delivery of a premature neonate. Which action by the nurse is most important?

Provide a neutral temperature environment.

A patient who is at 20 weeks gestation is being prepared for an MRI after a nonconclusive ultrasound testing for suspected brain abnormality related to possible zika virus exposure. Which nursing actions are appropriate for this patient? Select all that apply.

Provide information regarding the test. Allow patient to express feelings about her high-risk pregnancy. Promote open communication with her primary health care providers. Provide psychological support to the patient and her partner.

A patient just learns that her unborn fetus has a life-threatening condition and is not expected to survive long term. Which does the nurse include in a plan of care to meet psychological needs of the patient and her partner? Select all that apply.

Provide time for the patient to talk about her feelings. Facilitate referrals related to the fetal condition. Ascertain if the patient and partner have previous crisis skills.

When assisting with a vacuum-assisted vaginal delivery, the nurse is aware that adherence to which guidelines for the vacuum device will minimize the nurse's liability in vacuum-assisted vaginal births? Select all that apply.

Pump up the vacuum manually to the pressure indicated on the pump. Recognize that cup detachment (pop off) is a warning sign. Understand that pressure should be released between contractions. The procedure is timed from insertion of the cup into the vagina until the birth.

14. An example of a cultural prescriptive belief during pregnancy is:

Remain active during pregnancy The belief that the patient should remain active during pregnancy is the only example of a cultural prescriptive belief. All of the other answers are examples of cultural restrictive beliefs.

The parents of a newborn male are concerned about providing care for the baby's new circumcision performed with a Plastibell. Which information will the nurse include in the teaching plan for the parents?

Report if penis is red, warm, and swollen and/or there is surgical site drainage.

Evidence-based practice is the integration of the best:

Research evidence, clinical expertise, and patients' values These elements are the accepted definition of evidence-based practice.

The American Nurses Association Code of Ethics for Nurses directs nurses to provide patient care that is

Respectful Respect for the inherent dignity, worth, and uniqueness of every individual is part of the Code of Ethics.

The nurse is collecting the urine of a postpartum patient who is passing large clots. For which reason does the nurse examine the large collected clots?

To determine the presence of tissue

A nurse is caring for a woman 10 hours post-cesarean birth. She received a dose of intrathecal morphine at the time of the birth. Which of the following assessment data would require immediate intervention?

Respiratory rate of 10 breaths/minute Correct. An adverse effect of intrathecal morphine that requires immediate intervention is respiratory distress.

The nurse is preparing for the discharge of a neonate diagnosed with a congenital breathing disorder. Which health team members does the nurse include in discharge planning? Select all that apply.

Respiratory therapist Social worker Home health agency nurse Case manager

The nurse uses research from Greenberg and Morris (1974) as a guideline for identifying the presence of engrossment in a new baby by the father. Which behaviors exhibit paternal-infant bonding related to engrossment? Select all that apply.

Seeing the baby as attractive Perceiving the baby as being perfect Having a desire to touch the baby Indicating an increasing sense of self-esteem Positively commenting about the baby's features

The nurse in a prenatal clinic is assessing a patient who is at 37 weeks gestation for twins. The patient reports increased discomfort and increased lower pelvic pressure. Which action does the nurse take with this patient?

Sends the patient to the hospital to be checked for possible signs of labor

The nurse is providing care to a postpartum patient after an emergency cesarean due to eclampsia. The patient received spinal anesthesia prior to delivery. Magnesium sulfate is infusing 2 g/hr in 100 mL of IV fluid. Which assessment finding will cause the nurse to administer calcium gluconate to the patient via IV push?

Serum magnesium level is 10 mg/dL.

Which of the following information regarding sexual activity would the nurse give a pregnant woman who is 35 weeks' gestation?

Sexual activity may require different positions to accommodate the woman's comfort. Correct. An enlarging abdomen creates feelings of awkwardness and bulkiness and may require couples to modify intercourse positions for the pregnant woman's comfort.

The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of __________.

Sickle cell anemia Sickle cell anemia is an autosomal recessive illness. This client needs to be seen by a genetic counselor.

A nurse working in a prenatal clinic is caring for a woman who asks advice on foods that are high in vitamin C because "I hate oranges." The nurse states that 1 cup of which of the following raw foods will meet the patient's daily vitamin C needs?

Strawberries

Since 1995 there has been a significant decrease in the rate of infant death related to which of the following:

Sudden infant death The rate of infant death related to SIDS has decreased from 87.1 to 47.2. The decrease in rate is partially attributed to placing infants on their backs when sleeping.

At the end of her 32-week prenatal visit, a woman reports discomfort with intercourse and tells you shyly that she wants to maintain a sexual relationship with her partner. The best response is to:

Suggest alternative positions for sexual intercourse and alternative sexual activity to sexual intercourse Although shy to discuss this, she wants to maintain a sexual relationship with her partner. Suggesting alternative positions for sexual intercourse and alternative sexual activity to sexual intercourse provides the woman with information to maintain sexual relations.

The nurse in labor and delivery is preparing to initiate labor induction with the administration of oxytocin. After research about oxytocin, the nurse is aware of which fact about the drug?

Synthetic oxytocin is identical to endogenous oxytocin.

During a routine prenatal visit in the third trimester, a woman reports she is dizzy and lightheaded when she is lying on her back. The most appropriate nursing action would be to:

Teach the woman to avoid lying on her back and to rise slowly because of supine hypotension. Teaching the woman to avoid lying on her back because of occlusion of the vena cava with the gravid uterus causes supine hypotension syndrome.

A major fetal development characteristic at 16 weeks' gestation is:

Teeth begin to form

The labor and delivery unit nurses are adopting methods to reduce the number of women who develop postpartum depression. Research from Dennis and Dowswell (2013) provides evidence-based suggestions regarding beneficial interventions. Which suggestions do the nurses consider? Select all that apply.

Telephone-based peer support Interpersonal psychotherapy Professionally based postpartum home visits

The nurse is assisting the primary care provider with a vacuum-assisted delivery because of a prolonged second stage of labor. The nurse will inform the primary care provider when which guideline of the procedure is met?

The "three-pull rule" has been achieved.

The nurse is palpating a patient's uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis?

To prevent uterine inversion

The nurse is reviewing the purpose of a modified BPP for a patient at 38 weeks gestation. The nurse recognizes which determinations can be made through a modified BPP regarding fetal well-being? Select all that apply.

The NST is an indicator of short-term fetal well-being. The test is considered most predictive for perinatal outcomes. The AFI is an indicator of long-term placental function. An AFI of 5 cm is indicative of fetal asphyxia.

The positive signs of pregnancy are:

The objective signs of pregnancy that can only be attributed to the fetus Correct. Positive signs of pregnancy are the objective signs of pregnancy that can only be attributed to the fetus, such as fetal heart tones.

Which behavior does the nurse identify as a demonstration of unidirectional bonding between a parent and infant?

The parents call the baby by name.

The nurse is assisting a patient who is pregnant to prepare for an MRI scheduled to assess fetal brain development. Which situation causes the nurse to notify the radiology department personnel?

The patient has a permanent body piercing.

A patient at 35 weeks gestation arrives at the prenatal clinic in physical distress. Assessment reveals hypotension, thready pulse, shallow respirations, pallor, cold and clammy skin, and anxiety. The nurse does not find evidence of vaginal bleeding but suspects placental abruption. For which reason does the nurse call for emergency transport to the hospital? Select all that apply.

The patient has all the symptoms of hypovolemia. The absence of blood can indicate a concealed hemorrhage. The patient and fetus are at risk of death from hypovolemic shock. The patient states a sudden onset of severe symptoms.

A couple who has sought infertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur?

The testes are overheated. Spermatogenesis occurs in the testes. High temperatures harm the development of the sperm.

A gravida, G4 P1203, fetal heart rate 150s, is 14 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct?

The woman is experiencing a normal pregnancy.

A mother who is breastfeeding expresses concern about whether her infant is getting enough milk. Which concrete indicator does the nurse provide to the mother?

There are at least eight wet diapers and several stools per day.

Karen, a 26-year-old woman, has come for preconception counseling and asks about caring for her cat as she has heard that she "should not touch the cat during pregnancy." The clinic nurse's best response is:

Toxoplasmosis is a concern during pregnancy, so it is important to have someone else change the cat's litter pan and also to avoid consuming uncooked meat. Women need to be aware that Toxoplasma gondii, a single-celled parasite, is responsible for the infection toxoplasmosis. The majority of individuals who become infected with toxoplasmosis are asymptomatic, although when present, symptoms are described as "flu like" and include glandular pain and enlargement and myalgia. Severe toxoplasmosis infection may cause damage to the fetal brain, eyes, or other organs. Toxoplasmosis is usually acquired by consuming raw or poorly cooked meat that has been contaminated with T. gondii. Toxoplasmosis may also be acquired through close contact with feces from an infected animal (usually cats) or soil that has been contaminated with T. gondii.

True/False: The perinatal nurse explains to the student nurse that in the fetal circulation, the lowest level of oxygen concentration is found in the umbilical arteries.

True The highest oxygen concentration (PO2 = 30-35 mm Hg) is found in the blood returning from the placenta via the umbilical vein; the lowest oxygen concentration occurs in blood shunted to the placenta where reoxygenation takes place. The blood with the highest oxygen content is delivered to the fetal heart, head, neck, and upper limbs, and the blood with the lowest oxygen content is shunted toward the placenta.

When caring for a primiparous woman being evaluated for admission for labor, a key distinction between true versus false labor is:

True labor contractions bring about changes in cervical effacement and dilation, and with false labor there are irregular contractions with little or no cervical changes True labor contractions bring about changes in cervical effacement and dilation, and with false labor there are irregular contractions with little or no cervical changes.

A patient has experienced an uneventful pregnancy but begins to have vaginal spotting at 38 weeks gestation. The health care provider (HCP) suspects placenta previa initiated by cervical thinning. Which testing does the nurse expect the HCP to schedule?

Ultrasonography studies

A woman presents to a prenatal clinic appointment at 10 weeks' gestation, in the first trimester of pregnancy. Which of the following symptoms would be considered a normal finding at this point in pregnancy?

Urinary frequency Urinary frequency is a common complaint of women during their first trimester.

A first-time father is experiencing couvade syndrome. He is likely to exhibit which of the following symptoms or behaviors?

Urinary frequency Urinary frequency is a common symptom of couvade.

Potential causes of late decelerations include:

Uteroplacental insufficiency

Prior to discharge from the birthing center, the nurse informs the patient that she will receive vaccines for rubella, hepatitis B, pertussis, and influenza. For which reason does the nurse explain the need for the vaccinations?

Vaccinating the mother will protect the neonate from serious illnesses.

____________________ stimulation may be effective in eliciting a change in fetal behavior, fetal startle movements, and increased FHR variability.

Vibroacoustic

A patient delivers a term neonate and expresses concern about the reason for giving the neonate an injection. Which information from the nurse is accurate?

Vitamin K is needed to activate clotting factors.

The nurse is providing care to a patient who is postpartum. Using anatomy and physiology knowledge, which expectation does the nurse relate to the cardiovascular system?

WBC laboratory level of 30,000/mm a few hours after delivery

The nurse on a postpartum unit is acutely aware that cultural influences impact the patient's process of "becoming a mother." For which cultural influences does the nurse assess? Select all that apply.

What amount of time the mother spends in each phase Differences in the mother's expectation related to ability to rest Mother's involvement in decision making for the first few months Whether the mother seems interested in how to care for her baby

Which information is important for the nurse to provide to mothers of infants of 3 months of age regardless of the method of infant feeding?

When growth spurts and dietary increases are expected

A patient is scheduled for a contraction stress test (CST) at 36 weeks gestation. The nurse is aware that a successful testing is dependent on which factor?

Whether uterine contractions can be stimulated

The nurse is teaching new parents about the Period of PURPLE Crying Program aimed at the prevention of shaken baby syndrome. At the end of the program, the nurse evaluates the program successful if parents select which fact? Select all that apply.

Your baby may not stop crying no matter what you do. Your baby may cry more in the late afternoon and evening. A crying baby may look to be in pain, even when he or she is not.

The nurse is aware that some ____________________ tests, such as multiple marker screening and ultrasound, are offered to all pregnant women.

screening

After pregnancy and birth, a mother may notice a condition called diastasis recti abdominis, which is a(n) ____________________ of the rectus muscle.

separation

When providing care to a multiparous mother, the nurse needs to assess for the presence of ____________________ between the older children and the new baby.

sibiling rivalry

The Joint Commission Standard states that the __________, __________, and __________ are accurately identified and clearly communicated during the final verification process before the start of any surgical or invasive procedure.

site; procedure; patient To decrease the risk of surgery or invasive procedure being done on the wrong patient or in the wrong site, a "time-out" is called, and active communication to verify correct procedure, site, and patient is done just prior to the beginning of surgery or invasive procedure.