EAQ 1

Which statement is accurate with regard to normal labor? Select all that apply. 1. A single fetus presents by vertex 2. It is completed within 8 hours 3. A regular progression of contractions, effacement, dilation, and descent occurs 4. No complications are involved 5. Mechanisms of labor are involved

1, 3, 4, 5 In normal labor, a single fetus presents by vertex. A regular progression of contractions, effacement, dilation, and descent is the trajectory that the nurse expects for a woman experiencing a normal labor. A normal labor usually has no complications and the movements of the mechanisms of labor are present. Although the amount of time varies with each woman, a normal uncomplicated labor is usually completed within 18 hours.

A client who is 8 weeks pregnant wants to know when she can feel the fetal movements in the womb. What is the best nursing response? 1. "In another 8 to 12 weeks." 2. "In another 6 to 8 weeks." 3. "In another 4 to 6 weeks." 4. "In another 2 to 4 weeks."

1. "In another 8 to 12 weeks." Fetal movements are generally observed between 16 to 20 weeks of gestation. Because the client is in the 8th week of gestation, she will be able to notice fetal movements in another 8 to 12 weeks. By this time the arms and legs of the fetus will be completely developed. All the other options, which are below 16 weeks of gestation, are incorrect, because the arms and legs of the fetus are not well developed. Therefore, the patient cannot feel the fetal movements after 6 to 8 weeks, 4 to 6 weeks, or 2 to 4 weeks from the 8th week.

Ethnocentrism

- A belief that one's own culture's way of doing things is the right way

Which groups of people are considered vulnerable populations?

- African Americans, Hispanic Americans, Native Americans, Pacific Islanders, Asian Americans - Women with health conditions, Adolescent girls, incarcerated women, refugee women, older women, homeless women - Rural peoples

Acculturation

- The process by which people retain some of their own culture while adopting the practices of the dominant society - Changes that occur within one group or among several groups when people from different cultures come in contact with one another - The adoption of cultural traits, such as language, by one group under the influence of another) - Process takes place over the course of generations

The nurse is discussing strategies to decrease maternal mortality in a health care facility that has high maternal mortality rates. What strategies does the nurse suggest during this discussion?

- provide post abortion care - improve family planning services - improve access to skilled attendants at birth - provide adolescents with better reproductive health services

What are the objectives of Healthy People 2020 Maternal, Infant, and Child Health?

- to decrease the incidence of child deaths - to increase the number of women attending pregnancy classes

Which pregnant client is likely to have a cesarean delivery? 1. A client with the fetus in a transverse lie 2. A client with the fetus in a cephalic presentation 3. A client with the fetal biparietal diameter of 9.25 cm at term 4. A client in whom the presenting part is 4 cm below the spines

1. A client with the fetus in a transverse lie A transverse lie indicates that the long axis of the fetus is at a right angle, diagonal to the long axis of the mother. As a result, a vaginal birth is not possible and the client will need a cesarean delivery. A cephalic presentation indicates that the fetal head will lead through the birth canal during labor. This presentation facilitates vaginal delivery. A fetal biparietal diameter of 9.25 cm indicates normal head growth, which can be easily delivered vaginally. If the presenting part is 4 cm below the spines, it indicates that birth is imminent. The part is not an indicator of the type of birth

Which assessment finding in the client increases the risk for a forceps assisted birth? 1. Android pelvis 2. Effacement of the cervix 3. Biparietal diameter of 9.25 cm 4. Involuntary uterine contractions (UCs)

1. Android pelvis An android pelvis has a narrow subpubic arch and the ischial spines have a narrow interspinous diameter. As a result, the client will have difficulty during a vaginal birth and may require a forceps-assisted delivery. Effacement of the cervix takes place at the onset of the labor and indicates that the client is in labor. A biparietal diameter of 9.25 cm indicates normal fetal head growth, which can be delivered vaginally. Involuntary UCs indicate that the client is in labor.

The nurse is caring for a multiparous client. In which stage can the nurse expect the fetal head to be engaged in the pelvic inlet? 1. About 2 weeks before term 2. Before the start of active labor 3. When labor stage I begins 4. After labor is established

4. After labor is established

The nurse is teaching student nurses about changes in blood coagulation and fibrinolytic activity in pregnant women. Which information does the nurse include about coagulation in pregnant women? Select all that apply. 1. Fibrinogen levels increase during pregnancy. 2. Clotting time remains unaffected during pregnancy. 3. Bleeding time remains unaffected during pregnancy. 4. Prothrombin time decreases during pregnancy. 5. Partial thromboplastin time decreases during pregnancy.

1. Fibrinogen levels increase during pregnancy. 4. Prothrombin time decreases during pregnancy. 5. Partial thromboplastin time decreases during pregnancy. Hormonal changes during pregnancy cause alterations in the serum levels of the clotting factors. Therefore, during pregnancy, prothrombin time decreases, fibrinogen levels increase, and partial thromboplastin time decreases. During pregnancy, clotting and bleeding time are unaffected, as there are no appreciable changes in the bone marrow factors.

On completion of a vaginal examination on a laboring woman, the nurse records: 50%, 6 cm, -1. What is a correct interpretation of the data? 1. The fetal presenting part is 1 cm above the ischial spines. 2. Effacement is 4 cm from completion. 3. Dilation is 50% completed. 4. The fetus has achieved passage through the ischial spines.

1. The fetal presenting part is 1 cm above the ischial spines. Station of -1 indicates that the fetal presenting part is above the ischial spines and has not yet passed through the pelvic inlet. Progress of effacement is referred to by percentages, with 100% indicating full effacement and dilation by centimeters, with 10 cm indicating full dilation. Progress of effacement is referred to by percentages, with 100% indicating full effacement and dilation by centimeters, with 10 cm indicating full dilation. Passage through the ischial spines with internal rotation would be indicated by a plus station such as +1.

The nurse examines the blood pressure (BP) of a client and records it as 180/80 mm Hg. What could be the mean arterial pressure of the client? Record your answer using a whole number. ________ mm Hg

113 mmHg The BP of the client is 180/80 mm Hg, which means that the systolic blood pressure is 180 mm Hg and the diastolic blood pressure is 80 mm Hg. The mean arterial pressure of the client is calculated using the formula: systolic blood pressure + 2(diastolic blood pressure)/3. Thus, the mean arterial pressure of the patient would be {180 + 2(80)}/3 = 113 mm Hg.

What is a genogram?

A family tree format depicting relationships of family members over at least three generations

When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that: A. milk, coffee, and tea aid iron absorption if consumed at the same time as iron. B. iron absorption is inhibited by a diet rich in vitamin C. iron supplements are permissible for children in small doses. D. constipation is common with iron supplements.

D. constipation is common with iron supplements. These beverages inhibit iron absorption when consumed at the same time as iron. Vitamin C promotes iron absorption. Children who ingest iron can get very sick and even die. Constipation can be a problem.

The perinatal continuum of care begins with what?

Family planning and preconception care

The nursing instructor asks the students to submit a list of available genetic tests at the next class. To which online tool do the students refer to gather this information?

The Genetic Testing Registry - The Genetic Testing Registry is an online tool that was launched by the National Institute of Health. It has a list of available genetic tests. OMIM is an online catalogue of human genes and disorders; it does not contain a list of genetic tests. "Does It Run in the Family?" and "My Family Health Portrait" are free online tools that help record one's family health history. These tools help identify whether family members are at risk of cardiovascular disorders, diabetes, and other related diseases.

While interacting with a couple, the nurse learns that they are planning to conceive. Which action would be most beneficial in preventing genetic disorders in the newborn? A. Collecting the medical history of the couple and their parents B. Collecting the family history of the couple during the preconception period C. Advising the couple to seek genetic testing during the second trimester D. Advising the couple to take a semen analysis test immediately

The nurse should collect the couple's family history during the preconception period. This will help provide appropriate treatment to reduce the risk of genetic disorders in the newborn. While collecting the family history, the nurse should also obtain the data of three generations to find if the newborn would act as a carrier or be affected by a genetic disorder, so a medical history of the couple and their parents would be incomplete. The nurse should also suggest that the couple undergo genetic testing during the preconception period. Taking the test during the second trimester may not be helpful, because the genetic information would already have been transferred to the fetus. A semen analysis test helps identify fertility in the male partner; it does not help diagnose whether the patient has genetic disorders.

What is an ecomap?

a graphic portrayal of the social and personal relationships of the women and family that may help the nurse understand the social environment of the family and identify support systems available to them

The nurse is teaching nursing students about ethical issues in perinatal nursing and women's health care. Which questions on ethical issues does the nurse include in the teaching?

- Is fetal tissue transplantation safe? - What are the rights of an embryo? - Should cloning of humans be permitted?

What are the expected outcomes of the Patient Protection and Affordable Care Act (ACA)?

- It makes medical insurance affordable and contain costs - It reforms the health care delivery system by reducing waste, fraud, and abuse - It improves the quality of care for all Americans by improving public health and promoting prevention

Assimilation

- Occurs when a cultural group loses its cultural identity and becomes part of the dominant culture - Loss of cultural identity; the group "melts" into the mainstream

Which sign of pregnancy may manifest as an increase of urinary frequency in the client? 1. Hegar sign 2. Goodell sign 3. Ballottement 4. Chadwick sign

1. Hegar sign Hegar sign is characterized by softening and compressibility of the lower uterine segment (uterine isthmus), which is observed at approximately 6 weeks of gestation. The uterine fundus presses on the urinary bladder, causing the woman to have increased urinary frequency. Goodell sign is characterized by softening of the cervical tip. Ballottement is a technique of palpating the fetus by bouncing it gently and feeling the rebound. The deepened violet-bluish color of the vaginal mucosa and cervix is the characteristic feature of Chadwick sign.

The nurse is assessing the fetal heart rate in a pregnant client. The nurse finds asynchronous fetal heartbeats during auscultation. In which condition would this finding be considered normal? 1. Multifetal pregnancy 2. Late pregnancy 3. First pregnancy 4. Surrogate pregnancy

1. Multifetal pregnancy In multifetal pregnancies, the nurse may find asynchronous fetal heartbeats during auscultation. This is because the nurse hears the heartbeats of different fetuses together. Thus, asynchronous fetal heartbeats are considered a normal sign in a client who has multiple fetuses. Asynchronous fetal heartbeats are an abnormal sign during late pregnancy, first pregnancy, and surrogate pregnancy. In these conditions, asynchronous fetal heartbeats indicate cardiac dysfunction in the fetus.

A pregnant client tells the nurse, "I want to know whether or not my family history indicates any risk for genetic disorders in my child." Which cost-effective method does the nurse suggest to the client? 1. My Family Health Portrait 2. The Genetic Testing Registry 3. Genetic testing 4. Gene therapy

1. My Family Health Portrait - My Family Health Portrait is an online tool that is used for organizing the client's medical history. It is a cost-effective method and helps find whether the fetus is at risk of any possible genetic defects. The medical history of both parents is assessed, and a final conclusion is made about possible genetic defects in the fetus. Although My Family Health Portrait detects only the genetic defects that are hereditary, it is primarily used to assess genetic disorders during maternity. The Genetic Testing Registry contains all the possible genetic tests available for various disorders. Genetic testing detects defects in the fetus, but it bears more cost than My Family Health Portrait. Gene therapy is involved in treating genetic disorders but is not involved in the detection of genetic disorders.

The nurse finds low levels of estrogen in a pregnant client. What could be the consequences of low estrogen levels in the client? Select all that apply. 1. Peristalsis increases 2. Pepsin secretion decreases 3. Fat deposition is reduced 4. An epulis develops on the gum line 5. End arterioles branch

1. Peristalsis increases 3. Fat deposition is reduced Estrogen and progesterone should be maintained in the body for healthy pregnancy. Estrogen causes a decrease in peristalsis and gastrointestinal secretions. Estrogen causes an increase in the deposition of fat for the protection of the fetus. Therefore, low estrogen levels would cause increased peristalsis and reduced fat deposition. Estrogen causes a decrease in the release of pepsin and hydrochloric acid. Estrogen may also cause the development of an epulis (gingival granuloma) on the gum line. It also increases the branching of end arterioles for increasing placental perfusion.

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned regarding what this woman consumes during and after tennis matches. Which is the most important? 1. Several glasses of fluid 2. Extra protein sources, such as peanut butter 3. Salty foods to replace lost sodium 4. Easily digested sources of carbohydrate

1. Several glasses of fluid If no medical or obstetric problems contraindicate physical activity, pregnant women should get 30 minutes of moderate physical exercise daily. Liberal amounts of fluid should be consumed before, during, and after exercise, because dehydration can trigger premature labor.

The nurse is teaching a pregnant client who complains of vomiting about the use of dry carbohydrate in the morning. The client asks the nurse, "My husband has similar problems. Will it be useful for my husband as well?" What can the nurse interpret that the husband has? 1. Vena cava syndrome. 2. Couvade syndrome. 3. Carpal tunnel syndrome. 4. Brachial plexus traction syndrome.

2. Couvade syndrome. Intake of dry carbohydrate is recommended in a pregnant client's diet in order to suppress the vomiting observed during early pregnancy. Sometimes pregnancy symptoms are also experienced by the male partner. This is called couvade syndrome. Vena cava syndrome (supine hypotension) and carpal tunnel syndrome are not affected by intake of dry carbohydrate. Brachial plexus traction syndrome is manifested as drooping of the shoulder, which eventually disappears after childbirth. A dry carbohydrate diet has no effect on brachial plexus traction syndrome

What hepatic changes are considered normal during pregnancy? Select all that apply. 1. Increased serum albumin 2. Increased serum alkaline phosphatase 3. Increased serum cholesterol 4. Increased blood urea nitrogen 5. Increased nonprotein nitrogen

1. Increased serum albumin 2. Increased serum alkaline phosphatase 3. Increased serum cholesterol During pregnancy, hepatic changes are observed. Serum albumin increases, serum alkaline phosphatase increases, and serum cholesterol increases. The increase in serum albumin is due to increased synthesis of proteins during pregnancy. Decreased serum creatinine levels are due to increased protein utilization by the fetus. There is increased breakdown of fatty acids during pregnancy, which results in increased serum cholesterol levels. Blood urea nitrogen and nonprotein nitrogen levels decrease in pregnancy

The nurse palpates the fontanels and sutures to determine the fetal presentation. What is the feature of the anterior fontanel? 1. It is diamond-shaped in appearance. 2. It measures about 1 cm by 2 cm. 3. It closes after 6 to 8 weeks of birth. 4. It lies near the occipital bone.

1. It is diamond-shaped in appearance. The anterior fontanel is diamond-shaped and measures about 3 cm by 2 cm. It closes by 18 months after birth. It lies at the junction of the sagittal, coronal, and frontal sutures. The posterior fontanel is triangular in shape and measures about 1 cm by 2 cm. It closes after 6 to 8 weeks of birth. It lies at the junction of the sutures of the two parietal bones and the occipital bone.

A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called what? 1. Primipara. 2. Primigravida. 3. Multipara. 4. Nulligravida

1. Primipara Primipara is a woman who has completed one pregnancy with a viable fetus. Gravida is a pregnant woman; para comes from parity, meaning a viable fetus; primi means first; multi means many; and null means none. A primigravida is a woman pregnant for the first time. A multipara is a woman who has completed two or more pregnancies with a viable fetus. A nulligravida is a woman who has never been pregnant.

Nurses can make a difference in stopping violence against women and preventing further injury. What nursing measures can be implemented for women to discourage their entry into abusive relationships? Select all that apply. 1. Promoting assertiveness 2. Encouraging Pilates classes 3. Encouraging positive self-regard 4. Encouraging support and self-help groups 5. Helping with confidence and empowerment 6. Promoting aggressive behaviors and kickboxing classes

1. Promoting assertiveness 3. Encouraging positive self-regard 4. Encouraging support and self-help groups 5. Helping with confidence and empowerment Nursing measures implemented for women to discourage their entry into abusive relationships include promoting assertiveness, encouraging self-defense (not Pilates) classes, encouraging positive self-regard, encouraging the client's joining support and self-help groups, and helping the client with confidence and empowerment. Promoting aggressive behaviors and kickboxing classes are not nursing measures implemented to discourage women from entering into abusive relationships.

With regard to abnormalities of chromosomes, nurses should be aware that: 1. They occur in approximately 10% of newborns 2. Abnormalities of number are a major cause of pregnancy loss. 3. Down syndrome is a result of an abnormal chromosomal structure. 4. Unbalanced translocation results in a mild abnormality that the child will outgrow.

2. Abnormalities of number are a major cause of pregnancy loss - Aneuploidy is an abnormality of the number of chromosomes; it also is the leading genetic cause of cognitive impairment. Chromosomal abnormalities occur in less than 1% of newborns. Down syndrome is the most common form of trisomal abnormality, an abnormality of chromosome number (47 chromosomes). Unbalanced translocation is an abnormality of chromosome structure that often has serious clinical effects.

The nurse is caring for a pregnant client who drinks alcohol. What adverse fetal effects can the nurse expect to discuss with the client? 1. Postterm delivery 2. Mental retardation 3. Spina bifida 4. Anencephaly

2. Mental Retardation Fetal alcohol syndrome (FAS) is a known consequence of prenatal alcohol intake, and other consequences include increased risk for miscarriage, preterm birth, and sudden infant death syndrome (SIDS). Low birth weight, mental retardation, behavioral problems, learning problems, and physical problems are all symptoms of FAS. Postterm delivery is not typically a problem for pregnant women who use alcohol. Neural tube defects such as spina bifida and anencephaly may be caused by folic acid deficiency in the patient and other factors, but not maternal alcohol consumption.

The nurse is assessing a pregnant client who has undergone bariatric surgery in the past. What will the nurse primarily check in the client's health records? 1. Family history 2. Nutritional status 3. Blood glucose levels 4. Blood pressure

2. Nutritional status Clients who have undergone bariatric surgery are at a high risk of impaired nutrition, so the nurse should regularly monitor the client's nutritional status. The client's family history is considered to rule out the risk of congenital anomalies in the fetus, which is not necessary in this case. Blood glucose levels are monitored if the client is at high risk of developing gestational diabetes during the first or last trimester. Blood pressure levels are usually monitored in the pregnant client during regular visits to assess the risk of gestational hypertension.

The nurse is teaching a woman of childbearing age about the purpose of a pelvic examination. Which statement made by the woman indicates further teaching is needed? 1. "I know the pelvic exam is done to take samples for the Pap test." 2. "I know the health care provider will be palpating my uterus during the pelvic exam." 3. "I know they will be able to feel my fallopian tubes and check them during the pelvic exam." 4. "I know they can collect a sample during the pelvic exam to rule out if I have chlamydia."

3. "I know they will be able to feel my fallopian tubes and check them during the pelvic exam." Feeling the fallopian tubes usually is not possible during a pelvic examination, so the woman needs further teaching if a statement is made that the fallopian tubes will be checked. The pelvic examination is done to take a Pap sample, a chlamydia sample, and the uterus is palpated during the pelvic examination.

The laboratory reports of a client who is in the 8th week of gestation and reports abdominal cramps and pain, shows an abnormally slow increase in the client's levels of human chorionic gonadotropin (hCG). What risk does this finding indicate? 1. Multiple fetuses 2.. Down syndrome 3. Ectopic pregnancy 4. Gestational trophoblastic disease

3. Ectopic pregnancy The earliest biomarker of pregnancy is hCG. A woman's hCG levels peak after 60 to 70 days of pregnancy and decline to the lowest level at 100 to 130 days of pregnancy. An abnormally slow rise in hCG levels accompanied by abdominal pain and cramping indicates the risk of ectopic pregnancy or miscarriage. hCG levels higher than the normal range indicate the risk for multiple fetuses, Down syndrome, or gestational trophoblastic disease.

A physically disabled client undergoing a pelvic examination is unable to lie comfortably in the lithotomy position. Which is the best nursing intervention to help the client undergo the pelvic examination comfortably? 1. Encourage the client to lie in the V-shaped position. 2. Encourage the client to lie in the M-shaped position. 3. Encourage the client to lie in a comfortable alternative position. 4. Encourage the client to lie in the side-lying position.

3. Encourage the client to lie in a comfortable alternative position. Many women with physical disabilities cannot comfortably lie in the lithotomy position during the pelvic examination. The woman can be asked which position she has previously found most comfortable. If the client has never had a pelvic examination, the nurse can proceed by showing the client pictures of various positions. Then the nurse can ask the client 's preference of the positions. V-shaped, M-shaped, or side-lying positions are the alternate positions to lithotomy. However, the nurse should consider the position that is preferred by the client.

The nurse is assessing a pregnant client and finds that the client has had spinal surgery. What does the nurse interpret from the assessment? 1. The client may have higher chances of preterm delivery. 2. Cesarean birth should be recommended for the client. 3. Epidural anesthesia is contraindicated in the client. 4. The client may have right lower quadrant pain during pregnancy.

3. Epidural anesthesia is contraindicated in the client. From the assessment the nurse determines that the client has a history of spinal surgery, and epidural anesthesia can lead to severe complications in such clients. A history of spinal surgery does not cause preterm delivery or cesarean birth. If the client has had uterine surgery or extensive repair of the pelvic floor, then cesarean birth would be recommended for the client. Unlike appendicitis, spinal surgery does not cause right lower quadrant pain during pregnancy.

In which stage of labor does the nurse expect the placenta to be expelled? 1. First 2. Second 3. Third 4. Fourth

3. Third The placenta is expelled in the third stage of labor. The placenta normally separates with the third or fourth strong uterine contraction after the infant has been born. The first stage of labor lasts from the time dilation begins to the time when the cervix is fully dilated. The second stage of labor lasts from the time of full cervical dilation to the birth of the infant. The fourth stage of labor lasts for the first 2 hours after birth.

The nurse is providing care for a client in labor. What does the nurse instruct the client in the second stage of labor? 1. "Point your toes, to prevent pain." 2. "Avoid fluids until the infant is delivered." 3. "Lie still and avoid movement to prevent fatigue." 4. "Avoid holding your breath or tightening the abdominal muscles."

4. "Avoid holding your breath or tightening the abdominal muscles." The client may hold her breath and tighten the abdominal muscles for pushing during the second stage of labor. This activity is known as the Valsalva maneuver. The activity increases intrathoracic pressure, reducing venous return while increasing venous pressure. Therefore, the nurse instructs the client to avoid the Valsalva maneuver. The client should not point her toes, because it may cause leg cramps. The client should not avoid fluids if thirsty, because it may cause dehydration. The nurse should instruct the client to change positions every few minutes in order to facilitate delivery during the second stage of labor.

Which presumptive sign (felt by woman) or probable sign (observed by the examiner) of pregnancy is matched with another possible cause? Select all that apply. A. Amenorrhea - stress, endocrine problems B. Quickening - gas, peristalsis C. Goodell sign - Cervical polyps D. Chadwick sign - Pelvic congestion E. Urinary frequency - Infection

A, B, D, E Amenorrhea sometimes can be caused by stress, vigorous exercise, early menopause, or endocrine problems. Quickening can be mimicked by gas or peristalsis. Chadwick sign might be the result of pelvic congestion. Urinary frequency can be caused by infection. Goodell sign might be the result of pelvic congestion, not polyps.

In reviewing the history of a woman who wants to become pregnant, which medication profile would indicate a potential concern relative to toxic exposure? Select all that apply. 1 . Tylenol OTC occasionally for a headache twice last week 2. Anticonvulsant for seizure disorder 3. Client being treated for bipolar disorder with lithium 4. Client has been treated with Coumadin for A Fib 5. Taking multivitamins once a day

2. Anticonvulsant for seizure disorder 3. Client being treated for bipolar disorder with lithium 4. Client has been treated with Coumadin for A Fib A client being treated with an anticonvulsant is at risk for toxic effects during pregnancy. A client who is being treated with lithium is at risk for toxic effects during pregnancy. Coumadin can place a clientat risk during pregnancy. Although Tylenol can have toxic effects on the liver, the reported frequency is not a concern at this time. Taking multivitamins is a healthy recommended option.

Which foods does the nurse exclude from the pregnant client's diet plan to ensure good health? Select all that apply. 1. Meats 2. Butter 3. Yogurt 4. Beef fat 5. Stick margarine

2. Butter 4. Beef fat 5. Stick margarine It is advisable to include oils rather than solid fats in the diet plan of a pregnant client. Solid fats are fats that are solid at room temperature and cause increased body weight. This may result in greater BMI and obesity. Therefore, solid fats such as butter, beef fat, and stick margarine should be avoided in the diet plan of a pregnant client. Meat is rich in folate, and yogurt is rich in vitamin D. Therefore, these products are recommended for the diet of a pregnant client.

Which pelvic shape is the most classic female pelvis shape and most conducive to vaginal labor and birth? 1. Android 2. Gynecoid 3. Platypelloid 4. Anthropoid

2. Gynecoid The gynecoid pelvis is round and cylinder shaped, with a wide pubic arch. Prognosis for vaginal birth is good. Only 23% of women have an android-shaped pelvis, which has a poor prognosis for vaginal birth. The platypelloid pelvis is flat, wide, short, and oval. The anthropoid pelvis is a long, narrow oval with a narrow pubic arch. It is more favorable than the android or platypelloid pelvic shape.

Which fetal heart rate indicates that there is normal growth and development? 1. 80 beats/minute 2. 100 beats/minute 3. 150 beats/minute 4. 180 beats/minute

3. 150 beats/minute The normal fetal heart rate is found to be 110 to 160 beats/minute. Usually, the fetal heart rate is higher than normal healthy adults in order to meet the high oxygen demand of the fetus. If the fetal heart rate is 150 beats/minute, it indicates that the fetus is healthy and is receiving sufficient oxygen, as required for fetal growth. If the fetal heart rate is less than 110 beats/minute it indicates an insufficient supply of oxygen to the fetus. If the fetal heart rate is more than 160 beats/minute it indicates that the fetus is at risk of hypertension.

The nurse is caring for a pregnant client in her first trimester with imbalanced nutrition due to nausea and vomiting. What nursing interventions will help maintain appropriate nutrition in the client? Select all that apply. 1. Advise the client to rest as needed. 2. Advise the client to increase fiber in her diet. 3. Advise the client to consume small and frequent meals. 4. Advise the client to eat dry crackers first thing in the morning. 5. Advise the client to contact the primary health care provider if vomiting is severe

3. Advise the client to consume small and frequent meals. 4. Advise the client to eat dry crackers first thing in the morning. 5. Advise the client to contact the primary health care provider if vomiting is severe The pregnant client may eat less than her body requires in the first trimester due to nausea and vomiting. The nurse should advise the client to eat small and frequent meals to avoid nausea. Eating dry crackers first thing in the morning will help decrease the incidence of vomiting. The nurse should advise the client to contact the primary health care provider if severe vomiting occurs. The primary health care provider can help identify possible causes of hyperemesis. Resting reduces fatigue in the client. Encouraging the client to increase fiber in her diet is an intervention to avoid constipation.

A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she does what? 1. Wiggles and points her toes during the cramp 2. Applies cold compresses to the affected leg 3. Extends her leg and dorsiflexes her foot during the cramp 4. Avoids weight bearing on the affected leg during the cramp

3. Extends her leg and dorsiflexes her foot during the cramp Extending the leg and dorsiflexing the foot is the appropriate relief measure for a leg cramp. Pointing toes can aggravate rather than relieve the cramp. Application of heat is recommended. Bearing weight on the affected leg can help relieve the leg cramp, so it should not be avoided.

A primigravida asks the nurse about signs she can look for that indicate that the onset of labor is getting closer. The nurse should describe what? 1. Weight gain of 1 to 3 lbs. 2. Quickening. 3. Fatigue and lethargy. 4. Bloody show

4. Bloody show Passage of the mucus plug (operculum) also termed pink/bloody show occurs as the cervix ripens. Women usually experience a weight loss of 1 to 3 lbs. Quickening is the perception of fetal movement by the mother, which occurs at 16 to 20 weeks of gestation. Women usually experience a burst of energy or the nesting instinct.

The nurse is providing care for a client in the first stage of labor. The client's prenatal documentation indicates that the client has scarring on her cervix due to a past STI. What complication might the nurse predict in the client during labor? 1. Ferguson reflex 2. Slow fetal descent 3. Supine hypotension 4. Slow cervical dilation

4. Slow cervical dilation The cervical dilation is slowed if a previous vaginal infection has caused scarring of the cervix. This is because the dilation occurs by the drawing upward of the musculofibrous components of the cervix. Ferguson reflex refers to the maternal urge to bear down when the stretch receptors in the posterior vagina release endogenous oxytocin. The administration of epidural analgesia may slow the rate of fetal descent. Supine hypotension occurs due to a drop in hydrostatic pressure.

During the vaginal examination of a client, the nurse notes that the fetus is in an oblique lie. What does this indicate? 1. The fetus cannot be born by vaginal birth. 2. The long axis of the mother and fetus are parallel. 3. The presentation is either cephalic or breech. 4. The fetal lie will undergo change during labor

4. The fetal lie will undergo change during labor If the fetus is in an oblique lie, it usually converts to a longitudinal or transverse lie during labor. In an oblique lie the long axis of the fetus lies at an angle to the long axis of the mother. Fetal lie is the relation of the long axis (spine) of the fetus to the long axis (spine) of the mother. Vaginal birth cannot occur when the fetus stays in a transverse lie. In the longitudinal lie, the long axis of the fetus is parallel with the long axis of the mother. Longitudinal lies are either cephalic or breech presentations, depending on the fetal structure that first enters the mother's pelvis.

A patient is diagnosed with Type 1 diabetes during pregnancy. The primary health care provider (PHP) finds that the offspring of the patient were born without any malformations. What is the possible reason for the absence of congenital anomaly in the offspring? 1. The patient took vitamin supplements during pregnancy. 2. The patient took calcium supplements during pregnancy. 3. The patient maintained a stable blood pressure during pregnancy. 4. The patient maintained an euglycemic condition during pregnancy.

4. The patient maintained an euglycemic condition during pregnancy. The rate of malformations is reduced if the patient with insulin-dependent diabetes maintains euglycemia (normal blood sugar level) during pregnancy. The euglycemic condition should be maintained until the 56th day of pregnancy, because it is the period of organ development of the fetus. Vitamin supplements are given to pregnant patients to maintain a healthy, nutritional diet. Calcium supplements are prescribed to pregnant patients to prevent problems such as osteoporosis in the fetus. Maintaining a stable blood pressure will help prevent miscarriage during pregnancy.

Cultural Considerations for Native Americans

- Avoid feeding newborn colostrum - Often use cradleboards - Avoid holding the newborn often

Cultural Relativism

- Refers to learning about and applying the standards of another person's culture to activities within that culture - the nurse recognizes that people from different cultural backgrounds comprehend the same objects and situations differently (cultural determines viewpoint)

A pathology report indicates that atypical endometrial cells were detected in a postmenopausal client's vaginal pool specimen. Which test does the nurse expect to be ordered for further evaluation of the client? 1. Biopsy 2. Chlamydia test 3. Sexually transmitted infection test 4. Human immunodeficiency virus (HIV) test

1. Biopsy Endometrial biopsy is suggested for postmenopausal client who are suspected to be at risk of adnexal tumors or cancers. A yearly chlamydia test is recommended for sexually active women under age 25; women aged 25 and older should be tested as needed when sexually active with new or multiple partners. An HIV test is conducted to determine the HIV status of the client. A sexually transmitted infection test doesn't give any information regarding endometrial tumors.

After reviewing a client's genetic test report, the nurse tells the client, "Though you have a mutated gene for sickle cell anemia, you will not acquire the disease in your lifetime." Which test reports enabled the nurse to reach this conclusion? 1. Carrier screening test 2. Presymptomatic test 3. Predispositional test 4. Maternal serum test

1. Carier screening test The carrier screening test helps to identify if the client is a carrier for autosomal recessive genetic disorders such as sickle cell anemia or cystic fibrosis. This helps identify individuals who are asymptomatic in spite of having a mutated gene. The presymptomatic and predispositional tests are types of predictive testing. They help identify genetic mutations whose symptoms appear in the later part of the client's life, such as Huntington disease. The maternal serum test helps screen for certain fetal chromosomal disorders as well as neural tube defects.

A maternity nurse should be aware of which fact about amniotic fluid? 1. It serves as a source of oral fluid and as a repository for waste from the fetus. 2. The volume remains about the same throughout the term of a healthy pregnancy. 3. A volume of less than 300 ml is associated with gastrointestinal malformations. 4. A volume of more than 2 L is associated with fetal renal abnormalities.

1. It serves as a source of oral fluid and as a repository for waste from the fetus Amniotic fluid is a source of oral fluid and a repository for waste from the fetus. It also cushions the fetus and helps maintain a constant body temperature. The volume of amniotic fluid changes constantly. Too little amniotic fluid (oligohydramnios) is associated with renal abnormalities. Too much amniotic fluid (hydramnios) is associated with gastrointestinal and other abnormalities.

The nurse is assessing a client who is 7 months pregnant. The nurse observes that there are increased chest movements and decreased abdominal movements while breathing. How does the nurse interpret this finding? 1. Normal finding during pregnancy. 2. Impaired diaphragm function. 3. Decreased abdominal muscle tone. 4. Presence of obstructive lung disorder.

1. Normal finding during pregnancy. Pregnant women have distended abdomens. This makes it difficult for the diaphragm to descend down during inspiration. Therefore, pregnant women have chest breathing. Thoracic breathing in advanced pregnancy occurs due to the action of the diaphragm. It does not mean that the patient has impaired diaphragm function. Abdominal muscle tone is decreased in pregnant women. The diaphragm is the primary muscle responsible for abdominal movements while breathing. Therefore, chest breathing would not indicate that the client has decreased abdominal muscle tone. Obstructive lung disorder may weaken the diaphragm. Chest breathing does not indicate that the patient has obstructive lung disorder.

Which statement about multifetal pregnancy is accurate? Select all that apply. 1. The expectant mother often develops anemia because the fetuses have a greater demand for iron. 2. Twin pregnancies come to term with the same frequency as single pregnancies. 3. The mother should be counseled to increase her nutritional intake and gain more weight. 4. Backache and varicose veins are often more pronounced. 5. There is always a history of fertility drugs

1. The expectant mother often develops anemia because the fetuses have a greater demand for iron 3. The mother should be counseled to increase her nutritional intake and gain more weight 4. Backache and varicose veins are often more pronounced Twin pregnancies often end prematurely. Serious efforts should be made to bring the pregnancy to term. A woman with a multifetal pregnancy often develops anemia due to the increased demands of two fetuses. This should be monitored closely throughout her pregnancy. The client may need nutrition counseling to ensure that she gains more weight than what is needed for a singleton birth. The considerable uterine distention is likely to cause backache and leg varicosities. Maternal support hose should be recommended. A history of fertility drugs is sometimes, but not always, a cause of multifetal pregnancy.

With regard to the father's acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know what? 1. The father goes through three phases of acceptance of his own. 2. The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after birth. 3. In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home. 4. Typically men remain ambivalent about fatherhood right up to the birth of their child.

1. The father goes through three phases of acceptance of his own A father typically goes through three phases of acceptance: accepting the biologic fact, adjusting to the reality, and focusing on his role. The father-child attachment can be as strong as the mother-child relationship and can begin during pregnancy. In the last 2 months of pregnancy, many expectant fathers work hard to improve the environment of the home for the child. Typically, the expectant father's ambivalence ends by the first trimester, and he progresses to adjusting to the reality of the situation and focusing on his role.

A client in the first trimester of pregnancy reports feelings of ambivalence. How does the nurse react to this finding? 1. The nurse understands it as a normal response during pregnancy. 2. The nurse refers the client to a support group. 3. The nurse understands that it may be due to a psychologic complication. 4. The nurse reports it to the primary health care provider.

1. The nurse understands it as a normal response during pregnancy. Ambivalence is the phenomenon of having conflicting feelings simultaneously. This is a normal response observed in people preparing for a new role, such as parenthood. It is not necessary to refer the client to a support group, because her response is normal. The client's ambivalence is not due to any physiologic complication. This is not a condition that needs immediate medical supervision

A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system? 1) 3-0-1-0-1 2) 3-1-0-1-0 3) 3-1-2-0-1 4) 3-0-2-0-1

2) 3-1-0-1-0 Using the GPTAL system, this woman's gravidity and parity information is calculated as follows: G: Total number of times the woman has been pregnant (she is pregnant for the third time); T: Number of pregnancies carried to term (she has one stillborn); P: Number of pregnancies that resulted in a preterm birth (she has none); A: Abortions or miscarriages before the period of viability (she has had one); L: Number of children born who are currently living (she has no living children)

The nurse is teaching a group of pregnant women about using imagery as a relaxation technique. Which advice should be included to explain passive imagery? 1. "Imagine that you are standing on a hill top." 2. "Imagine a serene sea beach with white sand." 3. "Imagine the feel of river water on your hands." 4. "Imagine that you are cycling through the green countryside."

2. "Imagine a serene sea beach with white sand." Passive imagery and active imagery are techniques of maintaining continuous relaxation. Imagining any passive activity, such as watching a scene or a movie, is a part of passive imagery. Imagining doing an activity is a part of active imagery. Imagining standing on a hill top, or feeling the river water on hands or cycling through the countryside are examples of active imagery.

On assessing the laboratory reports of a client who is 12 weeks pregnant, the nurse observes that the client's level of serum ferritin is low. Which condition does the nurse expect in the client? 1. Tetany 2. Anemia 3. Renal failure 4. Hypertension

2. Anemia Women are at an increased risk for iron deficiency during pregnancy. Iron is needed to allow the transfer of adequate iron to the fetus and for the expansion of the maternal red blood cell (RBC) mass. The serum ferritin level is an indicator of iron content in the body. Poor iron status results in iron-deficiency anemia. Tetany occurs due to calcium deficiency. Renal failure may occur due to an imbalance of electrolytes such as potassium and sodium. Hypertension may occur due to high intake of sodium and potassium.

When does human chorionic gonadotropin (hCG) reach its maximum levels in a pregnant woman? 1. Between 30 to 50 days into the pregnancy 2. Between 50 to 70 days into the pregnancy 3. Between 70 to 90 days into the pregnancy 4. Between 90 to 100 days into the pregnancy

2. Between 50 to 70 days into the pregnancy The protein hormone hCG can be detected in the maternal serum by 8 to 10 days after conception, shortly after implantation. The hCG helps preserve the function of the ovarian corpus luteum and ensures the continued supply of estrogen and progesterone required to maintain pregnancy. The hCG reaches its maximum level at 50 to 70 days and then begins to decrease.The hCG levels are still increasing between 30 to 50 days of pregnancy; hCG levels will decrease at 70 to 90 days of pregnancy or at 90 to 100 days of pregnancy.

The nurse is caring for an infant who has meconium ileus. For what other condition should the nurse assess the child? 1. Omphalocele 2. Cystic fibrosis 3. Cerebral palsy 4. Renal dysfunction

2. Cystic fibrosis As the fetus nears the birth date, fetal waste products begin to accumulate in the fetal intestines as dark green to black, tarry meconium. Normally this substance is passed through the rectum within 24 hours of birth. An imperforate anus, or meconium ileus, is the condition in which a firm meconium plug blocks the anal passage. This condition is seen in infants with cystic fibrosis. This is not observed in such conditions as omphalocele, cerebral palsy, and renal dysfunction.

The nurse is reviewing the laboratory results of a patient and notes that the patient has low levels of gonadotropin-releasing hormone (GnRH). Which physiologic process would be highly affected in the patient? 1. Rate of respiration 2. Development of ovum 3. Gastric acid secretion 4. Contraction of muscles

2. Development of ovum The hypothalamic-pituitary cycle plays an important role in the development and implantation of the ovum. The hypothalamus secretes gonadotropin, which triggers the secretion of follicle-stimulating hormone (FSH) from the anterior pituitary. FSH stimulates the development of ovarian graafian follicles, as well as the release of estrogen, which play an important role in fertilization and implantation of ova. Therefore, development of the ovum will be greatly affected in a patient with low levels of GnRH. The rate of respiration is controlled by the brain stem. Gastric acid secretion is controlled by the proton pump. Muscle contraction is controlled by acetylcholine (a neurotransmitter). Low levels of GnRH do not affect gastric acid secretion, rate of respiration, or the contraction of muscles.

Which findings can be observed in the individuals with mosaicism on an autosomal gene? 1. Neural tube defect 2. Down syndrome 3. Congenital heart defect 4. Normal intelligence

2. Down Syndrome - Mosaicism is a condition in which the individual may have an extra chromosome in some of the cells. This disorder is usually associated with sex chromosomes. It is found to be present on an autosomal gene and results in Down syndrome in the majority of individuals. Neural tube defects are due to the deficiency of folic acid during pregnancy. Congenital heart defect is a multifactorial inheritance caused due to environmental and chromosomal defects. The child will not be born with normal intelligence.

A pregnant woman experiencing nausea and vomiting should do what? 1. Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning 2. Eat small, frequent meals (every 2 to 3 hours) 3. Increase her intake of high-fat foods to keep the stomach full and coated 4. Limit fluid intake throughout the day

2. Eat small, frequent meals (every 2 to 3 hours) The correct suggestion for a woman experiencing nausea and vomiting is to eat small, frequent meals (every 2 to 3 hours). A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the day or when nauseated. A pregnant woman experiencing nausea and vomiting should reduce her intake of fried foods and other fatty foods. A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the morning or when nauseated but should compensate by drinking fluids at other times.

Which findings could be considered a barrier to a pregnant woman seeking prenatal care? Select all that apply. 1. Client would prefer to be cared for by a midwife instead of a physician. 2. Economic cost of healthcare 3. Client's cultural beliefs do not include prenatal care as being valued. 4. Client speaks several languages. 5. Client had a bad experience the last time she went to a doctor for care.

2. Economic cost of healthcare 3. Client's cultural beliefs do not include prenatal care as being valued 5. Client had a bad experience the last time she went to a doctor for care Economic factors can delay the onset of healthcare treatment. A client's cultural beliefs and values may be a barrier to seeking prenatal care if her culture does not perceive any inherent value in prenatal care. If the client had a bad prior experience with a healthcare provider, this may lead to a barrier in seeking future care. Although the client may prefer to be cared for by a midwife, this fact may not be considered to be a barrier to seeking prenatal care, because it demonstrates a client's choice. The fact that the client is multilingual does not necessarily represent a barrier to seeking prenatal care.

During a health history interview, a woman states that she thinks that she has "bumps" on her labia. She also states that she is not sure how to check herself. The correct response would be to what? 1. Reassure the woman that the examination will not reveal any problems. 2. Explain the process of vulvar self-examination to the woman and reassure her that she will become familiar with normal and abnormal findings during the examination. 3. Reassure the woman that "bumps" can be treated. 4. Reassure her that most women have "bumps" on their labia.

2. Explain the process of vulvar self-examination to the woman and reassure her that she will become familiar with normal and abnormal findings during the examination. During assessment and evaluation the responsibility for self-care, health promotion, and enhancement of wellness is emphasized. The pelvic examination provides a good opportunity for the practitioner to emphasize the need for regular vulvar self-examination. "Reassure the woman that the examination will not reveal any problems" is inappropriate and may be untrue. Because the nurse is unsure of the cause of this client's discomfort, reassuring the woman that the bumps can be treated would be incorrect. Reassuring the woman that most women have bumps on their labia is not accurate and should not be done in this situation.

Which mechanism aids in providing early passive immunity to the fetus? 1. Oogenesis 2. Pinocytosis 3. Hematopoiesis 4. Gametogenesis

2. Pinocytosis Pinocytosis occurs when large molecules, such as albumin and gamma globulins, cross the placental membrane. This mechanism transfers the maternal immunoglobulins, which provide early passive immunity to the fetus. Oogenesis is the process of egg (ovum) formation, which begins during fetal life in the female. Hematopoiesis is the process of blood formation, which occurs in the yolk sac at the beginning of the third week of gestation. Gametogenesisincludes both oogenesis and spermatogenesis. These are the processes involved in the formation of ovum and sperm, respectively.

The nurse is reviewing the diagnostic test results with a pregnant client and informs the client that she is going to have twins. Based on which diagnostic test did the nurse make such a conclusion? 1. Human placental lactogen 2. Ultrasound results 3. Cytogenetic testing 4. Amniotic fluid levels

2. Ultrasound results Ultrasound scan, or fetal ultrasound, is the technique used for visualizing the fetus and the internal structures for prenatal analysis. In this technique, high frequency sound waves produce the image of the fetus without harming the fetal internal organs. Therefore, this technique is used in order to identify the presence of twins in the client's womb. Human placental lactogen changes the metabolism of the mother and supplies energy to the fetus. Cytogenetic testing helps to find genetic abnormalities, which are caused due to changes in the chromosomes. Amniotic fluid protects the fetus from injuries. These tests do not help to determine the presence of twins in the patient's womb.

A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is: 1. a positive pregnancy test 2. fetal movement palpated by the nurse-midwife 3. Braxton Hicks contractions 4. quickening

2. fetal movement palpated by the nurse-midwife Positive signs of pregnancy are those that are attributed to the presence of a fetus, such as hearing the fetal heartbeat or palpating fetal movement. A positive pregnancy test is a probable sign of pregnancy. Braxton Hicks contractions are a probable sign of pregnancy. Quickening is a presumptive sign of pregnancy.

The GTPAL (gravidity, term, preterm, abortions, and living children) of a patient is 3-1-2-1-3. What does the nurse infer about the client's obstetric history from this? 1) 3 pregnancies with 1 miscarriage, 1 preterm birth and 3 living children. 2) 3 pregnancies with 2 miscarriages, 1 preterm birth and 3 living children. 3) 3 pregnancies with 1 miscarriage, 2 preterm birth and 3 living children. 4) 3 pregnancies with no miscarriage, 2 preterm birth and 3 living children.

3) 3 pregnancies with 1 miscarriage, 2 preterm birth and 3 living children. The five-digit system GTPAL provides information on a woman's obstetric history. The GTPAL 3-1-2-1-3 indicates that the client had 3 pregnancies, 1 term birth 1, 2 preterm births, 1 miscarriage, and 3 living children. If the client has 3 pregnancies with 1 miscarriage, 1 preterm birth, and 3 living children, the GTPAL is denoted as 3-1-1-1-3. If the client has 3 pregnancies with 2 miscarriages, 1 preterm birth, and 3 living children, the GTPAL is denoted as 3-1-1-2-3. If the client has 3 children with no miscarriage, 2 preterm births, and 3 living children, the GTPAL is denoted as 3-1-2-0-3.

While assessing the routine diet of a client, the nurse finds that the client takes natural vitamin A supplements in addition to the multivitamin supplements prescribed by the health care provider. The client also eats a lot of carrots and green salads. What instruction should the nurse give to the client? 1. "Limit your intake of green leafy vegetables." 2. "Stop taking the multivitamin supplements." 3. "Avoid taking natural vitamin A supplements." 4. "Drink a lot of water along with the supplements."

3. "Avoid taking natural vitamin A supplements." Excess intake of vitamin A has been associated with spina bifida and cleft palate in the fetus. Therefore, the nurse should ask the client to avoid taking natural vitamin A supplements. The client should not avoid taking recommended multivitamin supplements, because they are required for proper growth and development of the fetus. Green leafy vegetables are good sources of other nutrients such as calcium, iron, and fiber. Thus, the nurse should not ask the client to restrict the intake of green leafy vegetables. Vitamin is a fat-soluble vitamin; thus it would not be excreted in water. Therefore, the nurse need not ask the client to drink a lot of water along with the supplements

What question does the nurse ask when assessing the socioeconomic status of a pregnant client? 1. "What prescription medications do you take?" 2. "Do you have any factories around your house?" 3. "Do you have any medical insurance?" 4. "Are there any diseases that run in your family?"

3. "Do you have any medical insurance?" When the nurse is assessing a client's socioeconomic status, the nurse should determine if the client has health insurance. Lack of health insurance may mean the client does not have a job to pay for insurance nor the income to pay for it privately. This may impact the client's prenatal care if she cannot afford services. When the nurse asks about the family's medical history, this falls under the client's personal history. The nurse asks about the community in which the patient lives when assessing the client's environment. Medications can affect the fetus in a pregnant client. Therefore, the nurse should ask about the medications taken by the client when assessing the patient's health status.

A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her: 1. "You don't need to modify your exercising any time during your pregnancy." 2. "Stop exercising, because it will harm the fetus." 3. "You may find that around the seventh month of your pregnancy, you need to modify your exercise to walking." 4. "Jogging is too hard on your joints; switch to walking now."

3. "You may find that around the seventh month of your pregnancy, you need to modify your exercise to walking." Typically, running should be replaced with walking around the seventh month of pregnancy. The nurse should inform the woman that she may need to reduce her exercise level as the pregnancy progresses. Physical activity promotes a feeling of well-being in pregnant women. It improves circulation, promotes relaxation and rest, and counteracts boredom. Simple measures should be initiated to prevent injuries, such as warm-up and stretching exercises to prepare the joints for more strenuous exercise.

Which findings obtained during clinical evaluation of a pregnant client help determine the gestational age of the fetus? Select all that apply. 1. Previous caesarean section 2. Types of contraception used 3. Current fundal height 4. First fetal heart tones heard 5. Current week of gestation

3. Current fundal height 4. First fetal heart tones heard 5. Current week of gestation The current fundal height, first uterine evaluation, first fetal heart tones heard, and current week of gestation help determine the gestational age of the fetus. The fundal height increases as the fetus grows, and the fundal measurement can be used to determine the gestational age. Previous caesarean section may not have a bearing on the current pregnancy and its gestational age. Information on types of contraception used may not help in determining the gestational age.

A pregnant woman has been diagnosed with oligohydramnios. Which presentation would the nurse suspect to find on physical examination? 1. Fetus is in a breech position 2. FHR baseline is within normal range 3. Fetus may have renal problems 4. Increased fundal height

3. Fetus may have renal problems Oligohydramnios reflects a decrease in the amount of amniotic fluid and is associated with renal abnormalities in the fetus and compromised fetal well-being. The position of the fetus is due to gestational age and the maternal uterine environment. FHR may be within normal range. FHR is affected by gestational age and fetal well-being. An increase in fundal height would be associated with polyhydramnios and/or gestational age assessment.

A client is in the 21st week of her third pregnancy. The client's first pregnancy ended in fetal death in the 24th week of pregnancy, and the second one was terminated during the third month of gestation. How does the nurse denote the obstetric history of this patient? 1. Gravida 1 para 1 2. Gravida 2 para 2 3. Gravida 3 para 2 4. Gravida 2 para 1

3. Gravida 3 para 2 Gravidity and parity information is obtained during history-taking interviews. The term gravidity indicates the number of pregnancies. The term parity indicates the number of pregnancies in which the fetus reached 20 weeks of gestation (the fetus may have been alive or stillborn). In this case, the client had a total of three pregnancies, denoted by gravidity 3. Among the three pregnancies, two of them reached 20 weeks of gestation, denoted by para 2. Gravida 1 Para 1 would indicate that the client had one pregnancy, which completed 20 weeks of gestation. Gravida 2 para 2 indicates that the client had two pregnancies, and both fetuses completed 20 weeks of gestation. Gravida 2 Para 1 indicates that the client had two pregnancies, and only one fetus reached 20 weeks of gestation.

After reviewing a client's urine analysis report, the nurse finds that the client is pregnant. Based on the presence of which hormone did the nurse made such conclusion? 1. Estrogen 2. Progesterone 3. Human chorionic gonadotropin 4. Human chorionic somatomammotropin

3. Human chorionic gonadotropin Human chorionic gonadotropin (hCG) is the hormone detected in the maternal serum around 8 to 10 days after conception. Therefore, the presence of human chorionic gonadotropin in the urine sample indicates that the client is pregnant. This hormone helps to maintain the levels of estrogen and progesterone during pregnancy. Estrogen and progesterone are steroid hormones. They are present in females. The levels of progesterone decrease during labor. Human chorionic somatomammotropin is a protein hormone secreted by the placenta. It is secreted only during pregnancy but it is not used to detect pregnancy, because it is not detected in the maternal serum.

The nurse is caring for a preterm infant with low levels of glucuronyl transferase enzyme. What disease risk may be increased in the infant? 1. Spina Bifida 2. Dehydration 3. Hyperbilirubinemia 4. Decreased Immunity

3. Hyperbilirubinemia Glucuronyl transferase enzyme is responsible for the clearance of unconjugated bilirubin. Low levels of glucuronyl transferase enzyme would result in hyperbilirubinemia in the child. Spina bifida is the complication associated with impaired fusion of the vertebrae. Dehydration in the infant may lead to impaired renal function. If the mother chooses to not breastfeed, it may reduce immunity in the infant.

A client visits a prenatal clinic to ask why some couples have conjoined twins. What information should the nurse provide to the client? 1. It happens more often among African-American women than Caucasians. 2. The estimated frequency of having conjoined twins are 4 in 1000 births. 3. The chances of having conjoined twins increases with using fertility drugs. 4. The chances of having conjoined twins increases with the maternal age

3. The chances of having conjoined twins increases with using fertility drugs. The use of fertility drugs increases the chances of having both monozygotic and dizygotic twins. Dizygotic twins are more common in African-American women than in Caucasians. The frequency of having conjoined twins is 1 in 50,000 births, not 4 in 1000 births. The chances of having conjoined twins are independent of maternal age, race, heredity, and parity

A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates what? 1. The fetus is at risk for Down syndrome. 2. The woman is at high risk for developing preterm labor. 3. The lung maturity of the fetus 4. Meconium is present in the amniotic fluid.

3. The lung maturity of the fetus The detection of the presence of pulmonary surfactants, surface-active phospholipids, in amniotic fluid has been used to determine fetal lung maturity, or the ability of the lungs to function after birth. This occurs at approximately 35 weeks of gestation. The presence of surface-active phospholipids is not an indication of Down syndrome. This result reveals that the fetal lungs are mature and in no way indicates risk for preterm labor. Meconium should not be present in the amniotic fluid.

Which behavior exhibited by the nurse while providing care for a client indicates ethnocentrism? 1. The nurse asks a female colleague to examine a fundamentalist Muslim woman 2. The nurse informs the client about telehealth to reduce personal visits 3. The nurse ignores interventions that are culturally relevant to the client 4. The nurse explains the side effects of alternative therapies to the client

3. The nurse ignores interventions that are culturally relevant to the client - Ethnocentrism is a view that one's culture is the best one. If the nurse fails to include culturally relevant interventions in a client's plan of care, it reflects ethnocentric behavior. Asking a female colleague to assess an Asian pregnant patient shows cultural competence, because the client may be comfortable only with a female nurse. Informing the client about telehealth to reduce personal visits is feasible both for the client as well as the nurse. Explaining the side effects of alternative therapies is not ethnocentrism, but is a gesture that may help the client make informed decisions.

What is the likely effect of low prostaglandin levels on the client's menstrual cycle? 1. The endometrium in the uterus fails to form. 2. Peak levels of progesterone are not attained in the luteal phase. 3. The ovum remains entrapped in the graafian follicle. 4. Ovum growth is inhibited in the proliferative phase.

3. The ovum remains entrapped in the graafian follicle. Prostaglandins (PGs) are oxygenated fatty acids and are classified as hormones. PGs may play a key role in ovulation. Hence, low levels of prostaglandins result in entrapment of the ovum within the graafian follicle and interference with ovulation. The levels of progesterone peak during the luteal phase after ovulation. Prostaglandins don't affect the formation of endometrium in the uterus. Prostaglandins influence the release of the ovum but don't have direct influence on the growth of the ovum. The growth of the ovum is facilitated by follicle-stimulating hormone (FSH).

A client reports to the nurse that she had her menses on May 11th and again had some light bleeding on May 26th. The client had her next menses on June 8th. What does the nurse inform the client? 1. "Please come again after your next menses." 2. "Your menstrual cycle has a duration of 15 days." 3. "You may need to undergo an ultrasound of the uterus." 4. "Having bleeding in the middle of your cycle is a normal finding."

4. "Having bleeding in the middle of your cycle is a normal finding." Ovulation usually occurs on the 14th day of the menstrual cycle in a woman who has a 28-day menstrual cycle. After ovulation, there is drop in the estrogen levels, which may result in some light bleeding. This is also referred to as midcycle bleeding. The client had bleeding after 15 days of the first menstrual period, which indicates that the client had midcycle bleeding. Therefore, in this case the nurse should assure the client that it is a normal finding. The client has the first menstrual cycle on May 11th and the next one on June 8th. This indicates that the client has a normal 28-day menstrual cycle. The client is normal and therefore does not need to come for a followup appointment after the next menses. The client's findings do not indicate a uterine pathology; thus, the client need not undergo an ultrasound.

The nurse is teaching a group of pregnant women about safety during pregnancy. Which statement made by a client indicates the need for additional teaching? 1. "We should wear seatbelts in the car." 2. "We should wear gloves while handling chemicals." 3. "We should schedule our daily activities to promote rest and relaxation." 4. "We should avoid travelling to high-altitude regions above 8,000 feet."

4. "We should avoid travelling to high-altitude regions above 8,000 feet." Pregnant women should follow safety steps to avoid complications. Pregnant women should avoid traveling to high-altitude regions above 12,000 feet. Seat belts should be used to ensure safety while traveling. It is necessary for the pregnant women to wear gloves while handling chemicals to avoid the toxic effects of the chemicals. Daily activities should be rescheduled to promote rest and relaxation.

The student nurse asks the clinical coordinator, "When can the gender of the fetus be determined?" Which response given by the clinical coordinator indicates effective teaching? 1. 6th 2. 8th 3. 10th 4. 12th

4. 12th week Rationale: The male and female genitals are completely differentiated by the end of the 12th week of gestation. Therefore, during the 12th week of gestation the gender of the fetus can be determined.

Which testing should the nurse perform to determine if a client is pregnant? 1. Linkage testing 2. Molecular testing 3. Cytogenetic testing 4. Biochemical testing

4. Biochemical testing Rationale: Biochemical testing involves examining proteins and protein products of the genes. A pregnancy confirmation test involves the detection of human chronic gonadotropin (hCG), which is a protein hormone. Biochemical testing for hCG confirms pregnancy within 8 to 10 days of conception. Linkage testing, molecular testing, and cytogenic testing are not helpful in pregnancy testing. Linkage testing is helpful for identifying marker sequences corresponding with the affected gene. Molecular testing is the analysis of nucleic acids. Cytogenetic testing helps in detecting abnormalities in the chromosomes.

Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)? 1. Radioimmunoassay 2. Radioreceptor assay 3. Latex agglutination test 4. Enzyme-linked immunosorbent assay (ELISA).

4. Enzyme-linked immunosorbent assay (ELISA) OTC pregnancy tests use ELISA for its one-step, accurate results. The radioimmunoassay tests for the summit of hCG in serum or urine samples. This test must be performed in the laboratory. The radioreceptor assay is a serum test that measures the ability of a blood sample to inhibit the binding of hCG to receptors. The latex agglutination test in no way determines pregnancy. Rather, it is done to detect specific antigens and antibodies.

If exhibited by a pregnant woman, what represents a positive sign of pregnancy? 1. Morning sickness 2. Quickening 3. Positive pregnancy test 4. Fetal heartbeat auscultated with Doppler/fetoscope

4. Fetal heartbeat auscultated with Doppler/fetoscope Detection of a fetal heartbeat, palpation of fetal movements and parts by an examiner, and detection of an embryo/fetus with sonographic examination are positive signs diagnostic of pregnancy. Morning sickness and quickening, along with amenorrhea and breast tenderness, are presumptive signs of pregnancy; subjective findings are suggestive but not diagnostic of pregnancy. Other probable signs include changes in integument, enlargement of the uterus, and Chadwick sign. A positive pregnancy test is considered to be a probable sign of pregnancy (objective findings are more suggestive but not yet diagnostic of pregnancy) because error can occur in performing the test or, in rare cases, human chorionic gonadotropin (hCG) may be detected in the urine of nonpregnant women. Chances of error are less likely to occur today because pregnancy tests used are easy to perform and are very sensitive to the presence of the hCG associated with pregnancy

A client who is in the second trimester of pregnancy reports dizziness and fatigue. Which laboratory findings indicate that the client is anemic? 1. Hematocrit value of 35% 2. Hematocrit value of 40% 3. Hemoglobin value of 11 g/dl 4. Hemoglobin value of 10 g/dl

4. Hemoglobin value of 10 g/dl Rationale: The decrease in normal hemoglobin values (12 to 16 g/dl blood) and hematocrit values (37% to 47%) due to rapid expansion of plasma is referred to as physiologic anemia. If the hemoglobin value drops to 11 g/dl or less during the first or third trimester, or less than 10.5 g/dl during the second trimester, or if the hematocrit decreases to 32% or less, the woman is considered anemic. A hemoglobin value of 10 g/dl indicates that the patient is anemic. A hematocrit value of 35% does not indicate that the patient is anemic, and 40% is a normal value. In the first or third trimester, a hemoglobin value of 11% indicates that the patient is not anemic. Hemoglobin value of more than 10.5g/dl in the second trimester is not considered anemia.

A dietician has asked a pregnant client to eat 12 ounces of fish every day. The nurse advises the client to avoid fish such as swordfish, tilefish, and king mackerel. Which fetal complication is the nurse trying to prevent by giving this suggestion? 1. Impaired bone development 2. Impaired protein metabolism 3. Impaired hemoglobin formation 4. Impaired neurologic development

4. Impaired neurologic development Swordfish, tilefish, and king mackerel are known to have high mercury content. Consumption of these fish may lead to an increase in serum levels of mercury, which is neurotoxic to the fetus. Impaired bone development may be caused by inadequate calcium and vitamin D intake, but this is unrelated to the consumption of fish. Inadequate consumption of magnesium and vitamin B6 would result in impaired protein metabolism in the fetus, but this is not directly related to fish consumption. Inadequate intake of iron would result in impaired hemoglobin formation in the fetus.

After reviewing the lab reports of a female client, the nurse infers that the client is pregnant. Which lab finding indicates that the female is pregnant? 1. Decreased levels of insulin in the client 2. Increased levels of thyroxine in the client 3. Increased levels of follicle-stimulating hormone (FSH) 4. Increased levels of human chorionic gonadotropin (hCG)

4. Increased levels of human chorionic gonadotropin (hCG) Human chorionic gonadotropin is the earliest biologic marker for pregnancy. The production of the β-subunit of hCG can be detected in the maternal serum or urine within 7 or 8 days after fertilization. Thus, the nurse can confirm the pregnancy status of a female by the increased levels of hCG. Decreased levels of insulin indicate the presence of diabetes. Thyroid abnormalities are confirmed by the increased levels of thyroxine hormone. A follicle-stimulating hormone (FSH) blood test is used in diagnosing abnormal menstrual bleeding and infertility.

The nurse is caring for an underweight patient with singleton pregnancy. After the first trimester, the nurse observes that the patient's weight gain is approximately 0.3 kg per week. Which risk is the fetus exposed to? 1. Hypoglycemia 2. Hypocalcemia 3. Congenital malformations 4. Intrauterine growth restriction (IUGR)

4. Intrauterine growth restriction (IUGR) During the first trimester of singleton pregnancy, the average total weight gain is only 1 to 2 kg. Thereafter, the recommended weight gain increases to approximately 0.5 kg per week for an underweight patient. Therefore, the fetus of a pregnant patient who has gained less than 0.5 kg per week may be at risk for intrauterine growth restriction (IUGR). The fetus is at risk for hypoglycemia if the mother is hypoglycemic. The fetus is at risk for hypocalcemia if the mother has an inadequate amount of calcium in her daily diet during pregnancy. The fetus is at risk for congenital disorders if the mother has impaired nutrition during pregnancy.

The nurse is assisting the primary health care provider during a pelvic examination. What finding would indicate a pelvic infection in the client? 1. Palpable uterus 2. Nonpalpable ovaries 3. Palpable adnexal masses 4. Prominent skene gland openings

4. Prominent skene gland openings Skene glands are located on each side of the urethra and produce mucus, which aids in the lubrication of the vagina. Generally, the openings to the skene glands are not visible, but prominent openings may be seen if the glands are infected. A palpable uterus is a normal finding of the pelvic examination. Palpable adnexal masses are abnormal findings that indicate unwanted growth or tumors. Nonpalpable ovaries are a result of menopause and are not indicative of infection.

The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that: 1. She will have to give birth at home 2. She must see an obstetrician as well as the midwife during pregnancy 3. She will not be able to have epidural analgesia for labor pain 4. She must be having a low risk pregnancy

4. She must be having a low risk pregnancy Midwives usually see low-risk obstetric clients. Care is often noninterventional, with active involvement from the woman and her family. Nurse-midwives must refer clients to physicians for complications. Most nurse-midwife births are managed in hospitals or birth centers; a few may be managed in the home. Nurse-midwives may practice with physicians or independently with an arrangement for physician backup. They must refer clients to physicians for complications. Care in a midwifery model is noninterventional, and the woman and family usually are encouraged to be active participants in the care. This does not imply that medications for pain control are prohibited.

The nurse is teaching a client about contraceptive methods. The nurse suggests that the client use combined oral contraceptives. In which case would this method be the most appropriate? 1 The client already has one child. 2 The client is immunocompromised. 3 The client has pelvic inflammatory disease. 4. The client has a family history of ovarian cancer.

4. The client has a family history of ovarian cancer. Combined hormonal oral contraceptives are known to reduce the development of ovarian and endometrial cancer in women. A woman with a family history of ovarian cancer is susceptible to developing ovarian cancer, and, therefore, the nurse should advise the client to use combined oral contraceptives. Immunocompromised clients are more susceptible to acquiring sexually transmitted infections. This client should use barrier methods of contraception. Already having a child is not a criterion for use of combined oral contraceptives; the contraceptive pill can be used by any woman, regardless of having a child or not. A client with pelvic inflammatory disease should use barrier methods of contraception.

The nurse finds that a 6-month-old breastfed infant is hyperactive and stays awake most of the time. What reason does the nurse suspect is behind this behavior? 1. The mother is on antibiotic therapy. 2. The mother is on anticoagulant therapy. 3. The mother drinks large amounts of alcohol. 4. The mother drinks large amounts of coffee.

4. The mother drinks large amounts of coffee. Caffeine intake can lead to a reduced iron concentration in milk, resulting in anemia. Breastfed infants of mothers who drink large amounts of coffee or caffeine-containing soft drinks can be unusually active and wakeful. If the mother is on a limited dose of antibiotic therapy, it will likely not affect the breastfed infant. However, higher doses cause developmental abnormalities. If the mother is on anticoagulant therapy, it generally does not affect the infant. It is speculated that the mother's use of alcohol may affect the infant's psychomotor development and impair the milk-ejection reflex.

During the prenatal examination of a pregnant woman, the nurse finds that the client has hemorrhoids. What does the nurse interpret from this finding? 1. The estrogen and progesterone levels are increased in the pregnant client. 2. The fetal blood is coursing through the umbilical cord in the pregnant client. 3. The estrogen and progesterone have caused cervical stimulation in the client. 4. The venous pressure has increased and there is reduced blood flow to the legs

4. The venous pressure has increased and there is reduced blood flow to the legs The causes of hemorrhoids in the pregnant client are increased venous pressure and reduced blood flow to the legs. The enlarged uterus compresses the iliac veins and the inferior vena cava results in increased venous pressure. This increases the blood pressure in the anal vasculature, and predisposes a pregnant woman to have hemorrhoids. Increased levels of estrogen and progesterone cause fullness, heightened sensitivity, tingling, and heaviness of the breasts. The fetal blood coursing through the umbilical cord in the client causes the funic souffle sign of fetal heart rate. Cervical stimulation by estrogen and progesterone results in leucorrhea, which is the white or slightly gray mucoid discharge from the vagina with a faint musty odor.

A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How should the nurse interpret this? 1. This weight gain indicates possible gestational hypertension. 2. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR). 3. This weight gain cannot be evaluated until the woman has been observed for several more weeks 4. The woman's weight gain is appropriate for this stage of pregnancy.

4. The woman's weight gain is appropriate for this stage of pregnancy. This woman's BMI is within the normal range. During the first trimester, the average total weight gain is only 1 to 2.5 kg. The desirable weight gain during pregnancy varies among women. The primary factor to consider in making a weight gain recommendation is the appropriateness of the prepregnancy weight for the woman's height. A commonly used method of evaluating the appropriateness of weight for height is the BMI. This woman has gained the appropriate amount of weight for her size at this point in her pregnancy. Weight gain should take place throughout the pregnancy. The optimal rate of weight gain depends on the stage of the pregnancy.

The nurse reviews the lab reports of a female client and infers that the client has an ectopic pregnancy. What finding would prompt the nurse to consider this clinical diagnosis? 1. Very low levels of insulin 2. Very low levels of anemia 3. Very low levels of thrombocytopenia 4. Very low levels of human chorionic gonadotropin (hCG)

4. Very low levels of human chorionic gonadotropin (hCG) Human chorionic gonadotropin (hCG) is produced by the fertilized ovum. Abnormally low levels of hCG indicate impending miscarriage or ectopic (tubal) pregnancy. Decreased levels of insulin are indicative of diabetes. Lower levels of RBC indicate anemia. Low levels of platelets indicate that the client may have impaired clotting ability. Diabetes, anemia, and thrombocytopenia are not conditions predisposing for ectopic pregnancy

A pregnant client reports an inflamed red tongue. On assessment, the nurse finds that the client also has megaloblastic anemia. Which reason does the nurse suspect is the cause of the client's condition? 1. Sodium deficiency 2. Vitamin D deficiency 3. Vitamin A deficiency 4. Vitamin B12 deficiency

4. Vitamin B12 deficiency Vitamin B12 deficiency can result in megaloblastic anemia, glossitis (inflamed red tongue), and neurologic deficits such as decreased sensation and inability to walk. These clients should be given adequate vitamin B12 supplements. The infants born to affected clients are likely to have megaloblastic anemia and exhibit neurodevelopmental delays. Sodium deficiency may lead to hypotension. Vitamin D deficiency may lead to tetany and hypocalcemia. Vitamin A deficiency in a pregnant client can lead to impairment of cell development, tooth bud formation, and bone growth in the fetus.

A maternity client is being discharged shortly after a vaginal delivery. The nurse provides care instructions for the client's safety and well-being. Which other intervention is a priority before discharge?

Ensuring the client has access to warm lines (telephonic nursing care services that the client can access in case of an emergency, or for discussing any health problems with health care providers, nurses, and specialists)

Which suggestions should the nurse include when teaching about appropriate weight gain in pregnancy? (Select all that apply.) A. Underweight women should gain 12.5 to 18 kg. Correct B. Obese women should gain at least 7 to 11.5 kg. Correct C. Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale. Correct D. In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled. E. Normal weight women should gain 11.5 to 16 kg.

A. Underweight women should gain 12.5 to 18 kg. B. Obese women should gain at least 7 to 11.5 kg. C. Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale. E. Normal weight women should gain 11.5 to 16 kg. Underweight women need to gain the most. Obese women need to gain weight during pregnancy to equal the weight of the products of conception. Adolescents are still growing; therefore, their bodies naturally compete for nutrients with the fetus. Women bearing twins need to gain more weight (usually 16 to 20 kg) but not necessarily twice as much. Normal weight women should gain 11.5 to 16kg.

When planning a diet with a pregnant woman, the nurse's FIRST action would be to: A. review the woman's current dietary intake. B. teach the woman about the food pyramid. C. caution the woman to avoid large doses of vitamins, especially those that are fat-soluble. D. instruct the woman to limit the intake of fatty foods.

A. review the woman's current dietary intake. Reviewing the woman's dietary intake as the first step will help to establish if she has a balanced diet or if changes in the diet are required. These are correct actions on the part of the nurse, but the first action should be to assess the patient's current dietary pattern and practices since instruction should be geared to what she already knows and does.

Most of the genetic tests now offered in clinical practice are tests for: A. single-gene disorders. B. carrier screening. C. predictive values. D. predispositional testing

A. single-gene disorders. Most tests now offered are tests for single-gene disorders in clients with clinical symptoms or who have a family history of a genetic disease. Carrier screening is used to identify individuals who have a gene mutation for a genetic condition but do not display symptoms. Predictive testing is used only to clarify the genetic status of asymptomatic family members. Predispositional testing differs from the other types of genetic screening in that a positive result does not indicate a 100% chance of developing the condition.

What precaution does the nurse take when using an interpreter to understand a client who is ill and unable to converse in English?

Ensuring the interpreter understands health-realted information (this ensures that the nurse is able to effectively understand the client's problems)

A pregnant client is unable to curtail her alcohol abuse. Which nursing intervention could be performed to reduce complications in the fetus? 1 Suggest that the client exercise. 2 Suggest that the client terminate the high-risk pregnancy. 3 Suggest that the client include folic acid in her diet. Correct4 Suggest that the client take a multivitamin supplement

Alcohol use during pregnancy can lead to fetal alcohol spectrum disorder (FASD), which includes fetal alcohol syndrome (FAS), fetal alcohol effects, and alcohol-related neurologic developmental disabilities. Pregnant women who are unable or unwilling to reduce their alcohol intake should take multivitamin supplements to help lessen the effects of prenatal alcohol exposure in the baby. Although this pregnancy is a high-risk one because of the exposure to alcohol, it is inappropriate for the nurse to suggest termination. Folic acid can help reduce the risk of neural tube defects in the fetus. It does not reduce alcohol-related complications. Exercise does not lessen the effects of prenatal alcohol exposure; however, low impact exercise is beneficial to maternal and fetal health.

The primary health care provider recommends genetic screening to a pregnant client to identify the risk of Down syndrome in the fetus. The client requests a noninvasive test. Which test does the nurse expect that the provider will order for the client? A. Amniocentesis B. Urine analysis C. Maternal serum testing D. Chronic villus sampling

C. Maternal serum testing - Maternal serum testing is a blood test that is used to identify whether the fetus of a pregnant client is at risk for Down syndrome. It is a noninvasive technique that requires only the maternal serum sample. Amniocentesis is an invasive technique that is used for testing fetal aneuploidy. Urine analysis is involved in the detection of pregnancy, but is not used to detect chromosomal abnormalities. Chronic villus sampling is also an invasive technique that is used for determining fetal aneuploidy.

While caring for a client with a myocardial infarction, the nurse finds that the primary health care provider has prescribed a lower initial dose of warfarin (Coumadin). What is the reason for this? A. The client is Caucasian. B. The client has variation in the CYP2C9 gene. C. The client has variation in the HER2/neu gene. D. The client has a family history of myocardial infarction.

B. The client has variation in the CYP2C9 gene - Warfarin (Coumadin) is not completely metabolized in client with variation in the CYP2C9 gene. Therefore, to prevent toxic effects of warfarin (Coumadin), an initial low dose should be prescribed to clients with a variation in the CYP2C9 gene. Unlike monoclonal antibodies, warfarin (Coumadin) does not target the HER2/neu gene due to variation in the structure. Therefore, variation in the HER2/neu gene does not require prescribing a low dose of warfarin (Coumadin). Warfarin (Coumadin) metabolism is not impaired in Caucasians or in clientswith a family history of myocardial infarction. Therefore, it is not recommended to prescribe an initial low dose of warfarin (Coumadin) to these clients. (B)

A pregnant woman at 7 weeks of gestation complains to her nurse midwife about frequent episodes of nausea during the day with occasional vomiting. She asks what she can do to feel better. The nurse midwife could suggest that the woman: A. drink warm fluids with each of her meals. B. eat a high-protein snack before going to bed. Correct C. keep crackers and peanut butter at her bedside to eat in the morning before getting out of bed. D. schedule three meals and one midafternoon snack a day

B. eat a high-protein snack before going to bed. Fluids should be taken between (not with) meals to provide for maximum nutrient uptake in the small intestine. A bedtime snack of slowly digested protein is especially important to prevent the occurrence of hypoglycemia during the night that would contribute to nausea. Dry carbohydrates such as plain toast or crackers are recommended before getting out of bed. Eating small, frequent meals (about five or six each day) with snacks helps to avoid a distended or empty stomach, both of which contribute to the development of nausea and vomiting.

What is cultural knowledge?

Beliefs and values about each faucet of life of a women that are passed on from one generation to the next

Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet? A. Fat-soluble vitamins A and D B. Water-soluble vitamins C and B6 C. Iron and folate D. Calcium and zinc

C. Iron and folate Fat-soluble vitamins should be supplemented as a medical prescription, as vitamin D might be for lactose-intolerant women. Water-soluble vitamin C sometimes is consumed in excess naturally; vitamin B6 is prescribed only if the woman has a very poor diet. Iron generally should be supplemented, and folic acid supplements often are needed because folate is so important. Zinc sometimes is supplemented. Most women get enough calcium.