Maternal Exam 4 example Questions

When is a prophylactic cerclage for an incompetent cervix usually placed (in weeks of gestation)? a.12 to 14 b.6 to 8 c.23 to 24 d.After 24

a.12 to 14 (A prophylactic cerclage is usually placed at 12 to 14 weeks of gestation. The cerclage is electively removed when the woman reaches 37 weeks of gestation or when her labor begins.)

In caring for the woman with DIC, which order should the nurse anticipate? a.Administration of blood b.Preparation of the client for invasive hemodynamic monitoring c.Restriction of intravascular fluids d.Administration of steroids

a.Administration of blood

A pregnant woman arrives at the birth unit in labor at term, having had no prenatal care. After birth, her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. Based on her infants physical findings, this woman should be questioned about her use of which substance during pregnancy? a.Alcohol b.Cocaine c.Heroin d.Marijuana

a.Alcohol

Which substance, when abused during pregnancy, is the most significant cause of cognitive impairment and dysfunction in the infant? a.Alcohol b.Tobacco c.Marijuana d.Heroin

a.Alcohol

With regard to hemorrhagic complications that may occur during pregnancy, what information is most accurate? a.An incompetent cervix is usually not diagnosed until the woman has lost one or two pregnancies. b.Incidences of ectopic pregnancy are declining as a result of improved diagnostic techniques. c.One ectopic pregnancy does not affect a womans fertility or her likelihood of having a normal pregnancy the next time. d.Gestational trophoblastic neoplasia (GTN) is one of the persistently incurable gynecologic malignancies.

a.An incompetent cervix is usually not diagnosed until the woman has lost one or two pregnancies.

A 3.8-kg infant was vaginally delivered at 39 weeks after a 30-minute second stage. A nuchal cord was found at delivery. After birth, the infant is noted to have petechiae over the face and upper back. Which information regarding petechiae is most accurate and should be provided to the parents? a.Are benign if they disappear within 48 hours of birth b.Result from increased blood volume c.Should always be further investigated d.Usually occur with a forceps-assisted delivery

a.Are benign if they disappear within 48 hours of birth (Petechiae, or pinpoint hemorrhagic areas, acquired during childbirth may extend over the upper portion of the trunk and face.)

What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy? a.Assessing FHR and maternal vital signs b.Performing a venipuncture for hemoglobin and hematocrit levels c.Placing clean disposable pads to collect any drainage d.Monitoring uterine contractions

a.Assessing FHR and maternal vital signs (Assessment of the FHR and maternal vital signs will assist the nurse in determining the degree of the blood loss and its effect on the mother and fetus.)

Which nursing intervention should be immediately performed after the forceps-assisted birth of an infant? a.Assessing the infant for signs of trauma b.Administering prophylactic antibiotic agents to the infant c.Applying a cold pack to the infants scalp d.Measuring the circumference of the infants head

a.Assessing the infant for signs of trauma

Diabetes refers to a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin action, insulin secretion, or both. Over time, diabetes causes significant changes in the microvascular and macrovascular circulations. What do these complications include? (Select all that apply.) a.Atherosclerosis b.Retinopathy c.Intrauterine fetal death (IUFD) d.Nephropathy e.Neuropathy f.Autonomic neuropathy

a.Atherosclerosis b.Retinopathy d.Nephropathy e.Neuropathy

Which order should the nurse expect for a client admitted with a threatened abortion? a.Bed rest b.Administration of ritodrine IV c.Nothing by mouth (nil per os [NPO]) d.Narcotic analgesia every 3 hours, as needed

a.Bed rest

Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. What are possible causes of early miscarriage? (Select all that apply.) a.Chromosomal abnormalities b.Infections c.Endocrine imbalance d.Systemic disorders e.Varicella

a.Chromosomal abnormalities c.Endocrine imbalance d.Systemic disorders e.Varicella

Which congenital anomalies can occur as a result of the use of antiepileptic drugs (AEDs) in pregnancy? (Select all that apply.) a.Cleft lip b.Congenital heart disease c.Neural tube defects d.Gastroschisis e.Diaphragmatic hernia

a.Cleft lip b.Congenital heart disease c.Neural tube defects

A number of common drugs of abuse may cross into the breast milk of a mother who is currently using these substances, which may result in behavioral effects in the newborn. Which substances are contraindicated if the mother elects to breastfeed her infant? (Select all that apply.) a.Cocaine b.Marijuana c.Nicotine d.Methadone e.Morphine

a.Cocaine b.Marijuana c.Nicotine

In caring for an immediate postpartum client, the nurse notes petechiae and oozing from her intravenous (IV) site. The client would be closely monitored for which clotting disorder? a.DIC b.Amniotic fluid embolism (AFE) c.Hemorrhage d.HELLP syndrome

a.DIC

Which statement concerning the complication of maternal diabetes is the most accurate? a.Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy. b.Hydramnios occurs approximately twice as often in diabetic pregnancies than in nondiabetic pregnancies. c.Infections occur about as often and are considered about as serious in both diabetic and nondiabetic pregnancies. d.Even mild-to-moderate hypoglycemic episodes can have significant effects on fetal well-being.

a.Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy.

Fibrocystic changes in the breast most often appear in women in their 20s and 30s. Although the cause is unknown, an imbalance of estrogen and progesterone may be the cause. The nurse who cares for this client should be aware that treatment modalities are conservative. Which proven modality may offer relief for this condition? a.Diuretic administration b.Daily inclusion of caffeine in the diet c.Increased vitamin C supplementation d.Application of cold packs to the breast as necessary

a.Diuretic administration

Researchers have found a number of common risk factors that increase a womans chance of developing a breast malignancy. It is essential for the nurse who provides care to women of any age to be aware of which risk factors? (Select all that apply.) a.Family history b.Late menarche c.Early menopause d.Race e.Nulliparity or first pregnancy after age 40 years

a.Family history d.Race e.Nulliparity or first pregnancy after age 40 years

In caring for a pregnant woman with sickle cell anemia, the nurse must be aware of the signs and symptoms of a sickle cell crisis. What do these include? (Select all that apply.) a.Fever b.Endometritis c.Abdominal pain d.Joint pain e.Urinary tract infection (UTI)

a.Fever c.Abdominal pain d.Joint pain

A serious but uncommon complication of undiagnosed or partially treated hyperthyroidism is a thyroid storm, which may occur in response to stress such as infection, birth, or surgery. What are the signs and symptoms of this emergency disorder? (Select all that apply.) a.Fever b.Hypothermia c.Restlessness d.Bradycardia e.Hypertension

a.Fever c.Restlessness (Fever, restlessness, tachycardia, vomiting, hypotension, and stupor are symptoms of a thyroid storm)

What is the most important nursing action in preventing neonatal infection? a.Good handwashing b.Isolation of infected infants c.Separate gown technique d.Standard Precautions

a.Good handwashing

Chemotherapy with multiple drug agents is used in the treatment of recurrent and advanced breast cancer with positive results. Which side effects would the nurse anticipate for the client once treatment has begun? (Select all that apply.) a.Hair loss b.Severe constipation c.Anemia d.Leukopenia e.Thrombocytopenia

a.Hair loss c.Anemia d.Leukopenia e.Thrombocytopenia

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

a.Hydralazine (Hydralazine is an antihypertensive medication commonly used to treat hypertension in severe preeclampsia. Typically, it is administered for a systolic BP higher than 160 mm Hg or a diastolic BP higher than 110 mm Hg.)

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

a.Hypertension (Preeclampsia and eclampsia are two noted deadly forms of hypertension)

Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother? a.Hypoglycemia b.Hypercalcemia c.Hypobilirubinemia d.Hypoinsulinemia

a.Hypoglycemia (The neonate is at highest risk for hypoglycemia because fetal insulin production is accelerated during pregnancy to metabolize excessive glucose from the mother.)

During the assessment of a preterm infant, the nurse notices continued respiratory distress even though oxygen and ventilation have been provided. In this situation, which condition should the nurse suspect? a.Hypovolemia and/or shock b.Excessively cool environment c.Central nervous system (CNS) injury d.Pending renal failure

a.Hypovolemia and/or shock (Other symptoms might include hypotension, prolonged capillary refill, and tachycardia, followed by bradycardia. Intervention is necessary.)

Which information regarding to injuries to the infants plexus during labor and birth is most accurate? a.If the nerves are stretched with no avulsion, then they should completely recover in 3 to 6 months. b.Erb palsy is damage to the lower plexus. c.Parents of children with brachial palsy are taught to pick up the child from under the axillae. d.Breastfeeding is not recommended for infants with facial nerve paralysis until the condition resolves.

a.If the nerves are stretched with no avulsion, then they should completely recover in 3 to 6 months.

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

a.Induction of labor is likely, as near term as possible.(By 34 weeks of gestation, the risk of continuing the pregnancy may be considered greater than the risks of a preterm birth)

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

a.Intrauterine growth restriction (IUGR) and prematurity

A client who has undergone a D&C for early pregnancy loss is likely to be discharged the same day. The nurse must ensure that her vital signs are stable, that bleeding has been controlled, and that the woman has adequately recovered from the administration of anesthesia. To promote an optimal recovery, what information should discharge teaching include? (Select all that apply.) a.Iron supplementation b.Resumption of intercourse at 6 weeks postprocedure c.Referral to a support group, if necessary d.Expectation of heavy bleeding for at least 2 weeks e.Emphasizing the need for rest

a.Iron supplementation c.Referral to a support group, if necessary e.Emphasizing the need for rest

Which description most accurately describes the augmentation of labor? a.Is part of the active management of labor that is instituted when the labor process is unsatisfactory b.Relies on more invasive methods when oxytocin and amniotomy have failed c.Is a modern management term to cover up the negative connotations of forceps-assisted birth d.Uses vacuum cups

a.Is part of the active management of labor that is instituted when the labor process is unsatisfactory

An infant at 26 weeks of gestation arrives intubated from the delivery room. The nurse weighs the infant, places him under the radiant warmer, and attaches him to the ventilator at the prescribed settings. A pulse oximeter and cardiorespiratory monitor are placed. The pulse oximeter is recording oxygen saturations of 80%. The prescribed saturations are 92%. What is the nurses most appropriate action at this time? a.Listening to breath sounds, and ensuring the patency of the endotracheal tube, increasing oxygen, and notifying a physician b.Continuing to observe and making no changes until the saturations are 75% c.Continuing with the admission process to ensure that a thorough assessment is completed d.Notifying the parents that their infant is not doing well

a.Listening to breath sounds, and ensuring the patency of the endotracheal tube, increasing oxygen, and notifying a physician

Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the client mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. This fetus is at the greatest risk for which condition? a.Macrosomia b.Congenital anomalies of the central nervous system c.Preterm birth d.Low birth weight

a.Macrosomia

What is the correct name describing a benign breast condition that includes dilation and inflammation of the collecting ducts? a.Mammary duct ectasia b.Intraductal papilloma c.Chronic cystic disease d.Fibroadenoma

a.Mammary duct ectasia

A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates. A nonstress test (NST) in the obstetricians office revealed a nonreactive tracing. On artificial rupture of membranes, thick meconium-stained fluid was noted. What should the nurse caring for the infant after birth anticipate? a.Meconium aspiration, hypoglycemia, and dry, cracked skin b.Excessive vernix caseosa covering the skin, lethargy, and RDS c.Golden yellow to green-stained skin and nails, absence of scalp hair, and an increased amount of subcutaneous fat d.Hyperglycemia, hyperthermia, and an alert, wide-eyed appearance

a.Meconium aspiration, hypoglycemia, and dry, cracked skin

A lupus flare-up during pregnancy or early postpartum occurs in 15% to 60% of women with this disorder. Which conditions associated with systemic lupus erythematosus (SLE) are maternal risks? (Select all that apply.) a.Miscarriage b.Intrauterine growth restriction (IUGR) c.Nephritis d.Preeclampsia e.Cesarean birth

a.Miscarriage c.Nephritis d.Preeclampsia e.Cesarean birth

Cellulitis with or without abscess formation is a fairly common condition. The nurse is providing education for a client whose presentation to the emergency department includes an infection of the breast. Which information should the nurse share with this client? (Select all that apply.) a.Nipple piercing may be the cause of a recent infection. b.Treatment for cellulitis will include antibiotics. c.Streptococcus aureus is the most common pathogen. d.Obesity, smoking, and diabetes are risk factors. e.Breast is pale in color and cool to the touch.

a.Nipple piercing may be the cause of a recent infection. b.Treatment for cellulitis will include antibiotics.. d.Obesity, smoking, and diabetes are risk factors.

The reported incidence of ectopic pregnancy has steadily risen over the past 2 decades. Causes include the increase in sexually transmitted infections (STIs) accompanied by tubal infection and damage. The popularity of contraceptive devices such as the IUD has also increased the risk for ectopic pregnancy. The nurse suspects that a client has early signs of ectopic pregnancy. The nurse should be observing the client for which signs or symptoms? (Select all that apply.) a.Pelvic pain b.Abdominal pain c.Unanticipated heavy bleeding d.Vaginal spotting or light bleeding e.Missed period

a.Pelvic pain b.Abdominal pain d.Vaginal spotting or light bleeding e.Missed period

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

a.Placental abruption c.Renal failure e.Maternal and fetal death

A pregnant womans amniotic membranes have ruptured. A prolapsed umbilical cord is suspected. What intervention would be the nurses highest priority? a.Placing the woman in the knee-chest position b.Covering the cord in sterile gauze soaked in saline c.Preparing the woman for a cesarean birth d.Starting oxygen by face mask

a.Placing the woman in the knee-chest position

Which risk factors are associated with NEC? (Select all that apply.) a.Polycythemia b.Anemia c.Congenital heart disease d.Bronchopulmonary dysphasia e.Retinopathy

a.Polycythemia b.Anemia c.Congenital heart disease

What is the correct definition of a spontaneous termination of a pregnancy (abortion)? a.Pregnancy is less than 20 weeks. b.Fetus weighs less than 1000 g. c.Products of conception are passed intact. d.No evidence exists of intrauterine infection.

a.Pregnancy is less than 20 weeks.

Infants born between 34 0/7 and 36 6/7 weeks of gestation are called late-preterm infants because they have many needs similar to those of preterm infants. Because they are more stable than early-preterm infants, they may receive care that is similar to that of a full-term baby. These infants are at increased risk for which conditions? (Select all that apply.) a.Problems with thermoregulation b.Cardiac distress c.Hyperbilirubinemia d.Sepsis e.Hyperglycemia

a.Problems with thermoregulation c.Hyperbilirubinemia d.Sepsis

What are the complications and risks associated with cesarean births? (Select all that apply.) a.Pulmonary edema b.Wound dehiscence c.Hemorrhage d.Urinary tract infections e.Fetal injuries

a.Pulmonary edema b.Wound dehiscence c.Hemorrhage d.Urinary tract infections e.Fetal injuries

The most conservative approach for early breast cancer treatment involves lumpectomy followed by which procedure? a.Radiation b.Adjuvant systemic therapy c.Hormonal therapy d.Chemotherapy

a.Radiation

A client is scheduled for surgery after a recent breast cancer diagnosis. The nurse is discussing the procedure with the client. To allay her fears, which explanation best describes a skin-sparing mastectomy? a.Removal of the breast, nipple, and areola, leaving only the skin b.Removal of the breast, nipple, areola, and axillary node dissection c.Incision on the outside of the breast, leaving the nipple intact d.Removal of both breasts in their entirety

a.Removal of the breast, nipple, and areola, leaving only the skin

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

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

The induction of labor is considered an acceptable obstetric procedure if it is in the best interest to deliver the fetus. The charge nurse on the labor and delivery unit is often asked to schedule clients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction. What are appropriate indications for induction? (Select all that apply?) a.Rupture of membranes at or near term b.Convenience of the woman or her physician c.Chorioamnionitis (inflammation of the amniotic sac) d.Postterm pregnancy e.Fetal death

a.Rupture of membranes at or near term c.Chorioamnionitis (inflammation of the amniotic sac) d.Postterm pregnancy e.Fetal death

A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents? a.Surfactant improves the ability of your babys lungs to exchange oxygen and carbon dioxide. b.The drug keeps your baby from requiring too much sedation. c.Surfactant is used to reduce episodes of periodic apnea. d.Your baby needs this medication to fight a possible respiratory tract infection.

a.Surfactant improves the ability of your babys lungs to exchange oxygen and carbon dioxide.

What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy? a.The blood pressure (BP) cuff should not be applied to the affected arm. b.Venipuncture for blood work should be performed on the affected arm. c.The affected arm should be used for intravenous (IV) therapy. d.The affected arm should be held down close to the womans side.

a.The blood pressure (BP) cuff should not be applied to the affected arm.

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

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

Women who are obese are at risk for several complications during pregnancy and birth. Which of these would the nurse anticipate with an obese client? (Select all that apply.) a.Thromboembolism b.Cesarean birth c.Wound infection d.Breech presentation e.Hypertension

a.Thromboembolism b.Cesarean birth c.Wound infection e.Hypertension

A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM) doses of betamethasone. What is the purpose of this pharmacologic intervention? a.To stimulate fetal surfactant production b.To reduce maternal and fetal tachycardia associated with ritodrine administration c.To suppress uterine contractions d.To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy

a.To stimulate fetal surfactant production

A client at 39 weeks of gestation has been admitted for an external version. Which intervention would the nurse anticipate the provider to order? a.Tocolytic drug b.Contraction stress test (CST) c.Local anesthetic d.Foley catheter

a.Tocolytic drug (A tocolytic drug will relax the uterus before and during the version, thus making manipulation easier.)

Which condition would require prophylaxis to prevent subacute bacterial endocarditis (SBE) both antepartum and intrapartum? a.Valvular heart disease b.Congestive heart disease c.Arrhythmias d.Postmyocardial infarction

a.Valvular heart disease

The exact cause of preterm labor is unknown but believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Which type of infection has not been linked to preterm birth? a.Viral b.Periodontal c.Cervical d.Urinary tract

a.Viral

A client has been prescribed adjuvant tamoxifen therapy. What common side effect might she experience? a.Weight gain, hot flashes, and blood clots b.Vomiting, weight loss, and hair loss c.Nausea, vomiting, and diarrhea d.Hot flashes, weight gain, and headaches

a.Weight gain, hot flashes, and blood clots

During a prenatal examination, a woman reports having two cats at home. The nurse informs her that she should not be cleaning the litter box while she is pregnant. The client questions the nurse as to why. What is the nursesmost appropriate response? a.Your cats could be carrying toxoplasmosis. This is a zoonotic parasite that can infect you and have severe effects on your unborn child. b.You and your baby can be exposed to the HIV in your cats feces. c.Its just gross. You should make your husband clean the litter boxes. d.Cat feces are known to carry Escherichia coli, which can cause a severe infection in you and your baby.

a.Your cats could be carrying toxoplasmosis. This is a zoonotic parasite that can infect you and have severe effects on your unborn child.

Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa. The signs of NEC are nonspecific. What are generalized signs and symptoms of this condition? a.Hypertonia, tachycardia, and metabolic alkalosis b.Abdominal distention, temperature instability, and grossly bloody stools c.Hypertension, absence of apnea, and ruddy skin color d.Scaphoid abdomen, no residual with feedings, and increased urinary output

b.Abdominal distention, temperature instability, and grossly bloody stools

A client is diagnosed with having a stillborn infant. At first, she appears stunned by the news, cries a little, and then asks the nurse to call her mother. What is the proper term for the phase of bereavement that this client is experiencing? a.Anticipatory grief b.Acute distress c.Intense grief d.Reorganization

b.Acute distress

Indications for a primary cesarean birth are often nonrecurring. Therefore, a woman who has had a cesarean birth with a low transverse scar may be a candidate for vaginal birth after cesarean (VBAC). Which clients would beless likely to have a successful VBAC? (Select all that apply.) a.Lengthy interpregnancy interval b.African-American race c.Delivery at a rural hospital d.Estimated fetal weight <4000 g e.Maternal obesity (BMI >30)

b.African-American race c.Delivery at a rural hospital e.Maternal obesity (BMI >30)

Which nursing intervention is paramount when providing care to a client with preterm labor who has received terbutaline? a.Assess deep tendon reflexes (DTRs). b.Assess for dyspnea and crackles. c.Assess for bradycardia. d.Assess for hypoglycemia.

b.Assess for dyspnea and crackles. (Terbutaline is a beta2-adrenergic agonist that affects the mothers cardiopulmonary and metabolic systems. Signs of cardiopulmonary decompensation include adventitious breath sounds and dyspnea.)

NEC is an acute inflammatory disease of the gastrointestinal mucosa that can progress to perforation of the bowel. Approximately 2% to 5% of premature infants succumb to this fatal disease. Care is supportive; however, known interventions may decrease the risk of NEC. Which intervention has the greatest effect on lowering the risk of NEC? a.Early enteral feedings b.Breastfeeding c.Exchange transfusion d.Prophylactic probiotics

b.Breastfeeding

Macromastia, or breast hyperplasia, is a condition in which women have very large and pendulous breasts. Breast hyperplasia can be corrected with a reduction mammoplasty. Which statement regarding this procedure is themost accurate? a.Breast reduction surgery is covered by insurance. b.Breastfeeding might be difficult. c.No sequelae after the procedure is known. d.Pain in the back and shoulders may not be relieved.

b.Breastfeeding might be difficult.

Guidelines for breast cancer screening continue to evolve as new evidence is generated. Which examination or procedure and frequency would be recommended for a 31-year-old asymptomatic client? (Select all that apply.) a.Annual mammography b.Clinical breast examination every 3 years c.Annual MRI d.Breast self-examination e.Mammography every 3 years

b.Clinical breast examination every 3 years d.Breast self-examination

Which maternal condition always necessitates delivery by cesarean birth? a.Marginal placenta previa b.Complete placenta previa c.Ectopic pregnancy d.Eclampsia

b.Complete placenta previa

Preconception counseling is critical in the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy? a.Frequent episodes of maternal hypoglycemia b.Congenital anomalies in the fetus c.Hydramnios d.Hyperemesis gravidarum

b.Congenital anomalies in the fetus

In appraising the growth and development potential of a preterm infant, the nurse should be cognizant of the information that is best described in which statement? a.Tell the parents that their child will not catch up until approximately age 10 years (for girls) to age 12 years (for boys). b.Correct for milestones, such as motor competencies and vocalizations, until the child is approximately 2 years of age. c.Know that the greatest catch-up period is between 9 and 15 months postconceptual age. d.Know that the length and breadth of the trunk is the first part of the infant to experience catch-up growth.

b.Correct for milestones, such as motor competencies and vocalizations, until the child is approximately 2 years of age.

An 18-year-old client who has reached 16 weeks of gestation was recently diagnosed with pregestational diabetes. She attends her centering appointment accompanied by one of her girlfriends. This young woman appears more concerned about how her pregnancy will affect her social life than her recent diagnosis of diabetes. A number of nursing diagnoses are applicable to assist in planning adequate care. What is the most appropriate diagnosis at this time? a.Risk for injury, to the fetus related to birth trauma b.Deficient knowledge, related to diabetic pregnancy management c.Deficient knowledge, related to insulin administration d.Risk for injury, to the mother related to hypoglycemia or hyperglycemia

b.Deficient knowledge, related to diabetic pregnancy management

The client makes an appointment for preconception counseling. The woman has a known heart condition and is unsure if she should become pregnant. Which is the only cardiac condition that would cause concern? a.Marfan syndrome b.Eisenmenger syndrome c.Heart transplant d.Ventricular septal defect (VSD)

b.Eisenmenger syndrome

A premature infant never seems to sleep longer than an hour at a time. Each time a light is turned on, an incubator closes, or people talk near her crib, she wakes up and inconsolably cries until held. What is the correct nursing diagnosis beginning with ineffective coping, related to? a.Severe immaturity b.Environmental stress c.Physiologic distress d.Behavioral responses

b.Environmental stress

A client is concerned because she has been experiencing some milky, sticky breast discharge. Which nonmalignant condition is exhibited with this finding? a.Relative inflammatory lesion b.Galactorrhea c.Mammary duct ectasia d.Breast infection

b.Galactorrhea (Galactorrhea bilaterally exhibits a spontaneous, milky, and sticky discharge and is a normal finding during pregnancy; however, it may also occur as the result of elevated prolactin levels.)

A newborn was admitted to the neonatal intensive care unit (NICU) after being delivered at 29 weeks of gestation to a 28-year-old multiparous, married, Caucasian woman whose pregnancy was uncomplicated until the premature rupture of membranes and preterm birth. The newborns parents arrive for their first visit after the birth. The parents walk toward the bedside but remain approximately 5 feet away from the bed. What is the nurses most appropriate action? a.Wait quietly at the newborns bedside until the parents come closer. b.Go to the parents, introduce him or herself, and gently encourage them to meet their infant. Explain the equipment first, and then focus on the newborn. c.Leave the parents at the bedside while they are visiting so that they have some privacy. d.Tell the parents only about the newborns physical condition and caution them to avoid touching their baby.

b.Go to the parents, introduce him or herself, and gently encourage them to meet their infant. Explain the equipment first, and then focus on the newborn.

A 26-year-old primigravida has come to the clinic for her regular prenatal visit at 12 weeks. She appears thin and somewhat nervous. She reports that she eats a well-balanced diet, although her weight is 5 pounds less than it was at her last visit. The results of laboratory studies confirm that she has a hyperthyroid condition. Based on the available data, the nurse formulates a plan of care. Which nursing diagnosis is most appropriate for the client at this time? a.Deficient fluid volume b.Imbalanced nutrition: less than body requirements c.Imbalanced nutrition: more than body requirements d.Disturbed sleep pattern

b.Imbalanced nutrition: less than body requirements

With regard to infants who are SGA and intrauterine growth restriction (IUGR), the nurse should be aware of which information? a.In the first trimester, diseases or abnormalities result in asymmetric IUGR. b.Infants with asymmetric IUGR have the potential for normal growth and development. c.In asymmetric IUGR, weight is slightly larger than SGA, whereas length and head circumference are somewhat less than SGA. d.Symmetric IUGR occurs in the later stages of pregnancy.

b.Infants with asymmetric IUGR have the potential for normal growth and development. (IUGR is either symmetric or asymmetric. The symmetric form occurs in the first trimester; infants who are SGA have reduced brain capacity. The asymmetric form occurs in the later stages of pregnancy.)

In contrast to placenta previa, what is the most prevalent clinical manifestation of abruptio placentae? a.Bleeding b.Intense abdominal pain c.Uterine activity d.Cramping

b.Intense abdominal pain

The nurse who is caring for a woman hospitalized for hyperemesis gravidarum would expect the initial treatment to involve what? a.Corticosteroids to reduce inflammation b.Intravenous (IV) therapy to correct fluid and electrolyte imbalances c.Antiemetic medication, such as pyridoxine, to control nausea and vomiting d.Enteral nutrition to correct nutritional deficits

b.Intravenous (IV) therapy to correct fluid and electrolyte imbalances

A number of methods can be used for inducing labor. Which cervical ripening method falls under the category of mechanical or physical? a.Prostaglandins are used to soften and thin the cervix. b.Labor can sometimes be induced with balloon catheters or laminaria tents. c.Oxytocin is less expensive and more effective than prostaglandins but creates greater health risks. d.Amniotomy can be used to make the cervix more favorable for labor.

b.Labor can sometimes be induced with balloon catheters or laminaria tents. (Balloon catheters or laminaria tents are mechanical means of ripening the cervix. Ripening the cervix, making it softer and thinner, increases the success rate of induced labor.)

What is a maternal indication for the use of vacuum-assisted birth? a.Wide pelvic outlet b.Maternal exhaustion c.History of rapid deliveries d.Failure to progress past station 0

b.Maternal exhaustion

What is the correct terminology for an abortion in which the fetus dies but is retained within the uterus? a.Inevitable abortion b.Missed abortion c.Incomplete abortion d.Threatened abortion

b.Missed abortion

What information regarding a fractured clavicle is most important for the nurse to take into consideration when planning the infants care? a.Prone positioning facilitates bone alignment. b.No special treatment is necessary. c.Parents should be taught range-of-motion exercises. d.The shoulder should be immobilized with a splint.

b.No special treatment is necessary.

During a follow-up home visit, the nurse plans to evaluate whether parents have progressed to the second stage of grieving (phase of intense grief). Which behavior would the nurse not anticipate finding? a.Guilt, particularly in the mother b.Numbness or lack of response c.Bitterness or irritability d.Fear and anxiety, especially about getting pregnant again

b.Numbness or lack of response

Parents have asked the nurse about organ donation after that infants death. Which information regarding organ donation is important for the nurse to understand? a.Federal law requires the medical staff to ask the parents about organ donation and then to contact their states organ procurement organization (OPO) to handle the procedure if the parents agree. b.Organ donation can aid grieving by giving the family an opportunity to see something positive about the experience. c.Most common donation is the infants kidneys. d.Corneas can be donated if the infant was either stillborn or alive as long as the pregnancy went full term.

b.Organ donation can aid grieving by giving the family an opportunity to see something positive about the experience.

A new mother with a thyroid disorder has come for a lactation follow-up appointment. Which thyroid disorder is a contraindication for breastfeeding? a.Hyperthyroidism b.PKU c.Hypothyroidism d.Thyroid storm

b.PKU (PKU is a cause of mental retardation in infants; mothers with PKU pass on phenylalanine and therefore should elect not to breastfeed.)

Which laboratory marker is indicative of DIC? a.Bleeding time of 10 minutes b.Presence of fibrin split products c.Thrombocytopenia d.Hypofibrinogenemia

b.Presence of fibrin split products

The nurse who elects to work in the specialty of obstetric care must have the ability to distinguish between preterm birth, preterm labor, and low birth weight. Which statement regarding this terminology is correct? a.Terms preterm birth and low birth weight can be used interchangeably. b.Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation. c.Low birth weight is a newborn who weighs below 3.7 pounds. d.Preterm birth rate in the United States continues to increase.

b.Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of gestation.

In caring for the preterm infant, what complication is thought to be a result of high arterial blood oxygen level? a.NEC b.ROP c.BPD d.Intraventricular hemorrhage (IVH)

b.ROP

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

b.Respiratory rate of 10 breaths per minute (A respiratory rate of 10 breaths per minute indicates the client is experiencing respiratory depression from magnesium toxicity.)

A clients oncologist has just finished explaining the diagnostic workup results to her, and she still has questions. The woman states, The physician says I have a slow-growing cancer. Very few cells are dividing. How does she know this? What is the name of the test that gave the health care provider this information? a.Tumor ploidy b.S-phase index c.Nuclear grade d.Estrogen-receptor assay

b.S-phase index

Autoimmune disorders often occur during pregnancy because a large percentage of women with an autoimmune disorder are of childbearing age. Which disorders fall into the category of collagen vascular disease? (Select all that apply.) a.Multiple sclerosis b.SLE c.Antiphospholipid syndrome d.Rheumatoid arthritis e.Myasthenia gravis

b.SLE c.Antiphospholipid syndrome d.Rheumatoid arthritis e.Myasthenia gravis

A client with maternal phenylketonuria (PKU) has come to the obstetrical clinic to begin prenatal care. Why would this preexisting condition result in the need for closer monitoring during pregnancy? a.PKU is a recognized cause of preterm labor. b.The fetus may develop neurologic problems. c.A pregnant woman is more likely to die without strict dietary control. d.Women with PKU are usually mentally handicapped and should not reproduce.

b.The fetus may develop neurologic problems. (Children born to women with untreated PKU are more likely to be born with mental retardation, microcephaly, congenital heart disease, and low birth weight)

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

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

Which finding would indicate to the nurse that the grieving parents have progressed to the reorganization phase of grieving? a.The parents say that they feel no pain. b.The parents are discussing sex and a future pregnancy, even if they have not yet sorted out their feelings. c.The parents have abandoned those moments of bittersweet grief. d.The parents questions have progressed from Why? to Why us?

b.The parents are discussing sex and a future pregnancy, even if they have not yet sorted out their feelings.

Which information should the nurse take into consideration when planning care for a postpartum client with cardiac disease? a.The plan of care for a postpartum client is the same as the plan for any pregnant woman. b.The plan of care includes rest, stool softeners, and monitoring of the effect of activity. c.The plan of care includes frequent ambulating, alternating with active range-of-motion exercises. d.The plan of care includes limiting visits with the infant to once per day.

b.The plan of care includes rest, stool softeners, and monitoring of the effect of activity.

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

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

A newborn in the neonatal intensive care unit (NICU) is dying as a result of a massive infection. The parents speak to the neonatologist, who informs them of their sons prognosis. When the father sees his son, he says, He looks just fine to me. I cant understand what all this is about. What is the most appropriate response or reaction by the nurse at this time? a.Didnt the physician tell you about your sons problems? b.This must be a difficult time for you. Tell me how youre doing. c.Quietly stand beside the infants father. d.Youll have to face up to the fact that he is going to die sooner or later.

b.This must be a difficult time for you. Tell me how youre doing.

A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic procedure will the client most likely have performed? a.Amniocentesis for fetal lung maturity b.Transvaginal ultrasound for placental location c.Contraction stress test (CST) d.Internal fetal monitoring

b.Transvaginal ultrasound for placental location (The presence of painless bleeding should always alert the health care team to the possibility of placenta previa, which can be confirmed through ultrasonography.)

It is extremely rare for a woman to die in childbirth; however, it can happen. In the United States, the annual occurrence of maternal death is 12 per 100,000 cases of live birth. What are the leading causes of maternal death? a.Embolism and preeclampsia b.Trauma and motor vehicle accidents (MVAs) c.Hemorrhage and infection d.Underlying chronic conditions

b.Trauma and motor vehicle accidents (MVAs)

In terms of the incidence and classification of diabetes, which information should the nurse keep in mind when evaluating clients during their ongoing prenatal appointments? a.Type 1 diabetes is most common. b.Type 2 diabetes often goes undiagnosed. c.GDM means that the woman will receive insulin treatment until 6 weeks after birth. d.Type 1 diabetes may become type 2 during pregnancy.

b.Type 2 diabetes often goes undiagnosed.

The nurse should be cognizant of which condition related to skeletal injuries sustained by a neonate during labor or childbirth? a.Newborns skull is still forming and fractures fairly easily. b.Unless a blood vessel is involved, linear skull fractures heal without special treatment. c.Clavicle fractures often need to be set with an inserted pin for stability. d.Other than the skull, the most common skeletal injuries are to leg bones.

b.Unless a blood vessel is involved, linear skull fractures heal without special treatment.

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions. What clinical cues alert the nurse that the woman is experiencing uterine hyperstimulation? (Select all that apply.) a.Uterine contractions lasting <90 seconds and occurring >2 minutes in frequency b.Uterine contractions lasting >90 seconds and occurring <2 minutes in frequency c.Uterine tone <20 mm Hg d.Uterine tone >20 mm Hg e.Increased uterine activity accompanied by a nonreassuring FHR and pattern

b.Uterine contractions lasting >90 seconds and occurring <2 minutes in frequency d.Uterine tone >20 mm Hg e.Increased uterine activity accompanied by a nonreassuring FHR and pattern

A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The fluid consists of bright red blood. Her contractions are consistent with her current stage of labor. No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins to decline rapidly after the ROM. The nurse should suspect the possibility of what condition? a.Placenta previa b.Vasa previa c.Severe abruptio placentae d.Disseminated intravascular coagulation (DIC)

b.Vasa previa (Vasa previa is the result of a velamentous insertion of the umbilical cord. The umbilical vessels are not surrounded by Wharton jelly and have no supportive tissue.)

A pregnant woman at 29 weeks of gestation has been diagnosed with preterm labor. Her labor is being controlled with tocolytic medications. She asks when she might be able to go home. Which response by the nurse is mostaccurate? a.After the baby is born. b.When we can stabilize your preterm labor and arrange home health visits. c.Whenever your physician says that it is okay. d.It depends on what kind of insurance coverage you have.

b.When we can stabilize your preterm labor and arrange home health visits.

Bell palsy is an acute idiopathic facial paralysis, the cause for which remains unknown. Which statement regarding this condition is correct? a.Bell palsy is the sudden development of bilateral facial weakness. b.Women with Bell palsy have an increased risk for hypertension. c.Pregnant women are affected twice as often as nonpregnant women. d.Bell palsy occurs most frequently in the first trimester.

b.Women with Bell palsy have an increased risk for hypertension.

Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand? a.Stress on the heart is greatest in the first trimester and the last 2 weeks before labor. b.Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms. c.Women with class III cardiac disease should get 8 to 10 hours of sleep every day and limit housework, shopping, and exercise. d.Women with class I cardiac disease need bed rest through most of the pregnancy and face the possibility of hospitalization near term.

b.Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms. (Class II cardiac disease is symptomatic with ordinary activity. Women in this category need to avoid heavy exertion and limit regular activities as symptoms dictate. Stress is greatest between weeks 28 and 32 of gestation, when hemodynamic changes reach their maximum.)

Which client is most at risk for fibroadenoma of the breast? a.38-year-old woman b.50-year-old woman c.16-year-old girl d.27-year-old woman

c.16-year-old girl

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

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

An infant at 36 weeks of gestation has increasing respirations (80 to 100 breaths per minute with significant substernal retractions). The infant is given oxygen by continuous nasal positive airway pressure (CPAP). What level of partial pressure of arterial oxygen (PaO2) indicates hypoxia? a.67 mm Hg b.89 mm Hg c.45 mm Hg d.73 mm Hg

c.45 mm Hg (The normal range for PaO2 is 60 to 80 mm Hg)

Which statement related to cephalopelvic disproportion (CPD) is the least accurate? a.CPD can be related to either fetal size or fetal position. b.The fetus cannot be born vaginally. c.CPD can be accurately predicted. d.Causes of CPD may have maternal or fetal origins.

c.CPD can be accurately predicted.

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

c.Characterized by hemolysis, elevated liver enzymes, and low platelets

Near the end of the first week of life, an infant who has not been treated for any infection develops a copper-colored maculopapular rash on the palms and around the mouth and anus. The newborn is displaying signs and symptoms of which condition? a.Gonorrhea b.Herpes simplex virus (HSV) infection c.Congenital syphilis d.HIV

c.Congenital syphilis (A copper-colored maculopapular rash is indicative of congenital syphilis with lesions that may extend over the trunk and extremities.)

A woman arrives for evaluation of signs and symptoms that include a missed period, adnexal fullness, tenderness, and dark red vaginal bleeding. On examination, the nurse notices an ecchymotic blueness around the womans umbilicus. What does this finding indicate? a.Normal integumentary changes associated with pregnancy b.Turner sign associated with appendicitis c.Cullen sign associated with a ruptured ectopic pregnancy d.Chadwick sign associated with early pregnancy

c.Cullen sign associated with a ruptured ectopic pregnancy (Cullen sign, the blue ecchymosis observed in the umbilical area, indicates hematoperitoneum associated with an undiagnosed ruptured intraabdominal ectopic pregnancy.)

During a prenatal visit, the nurse is explaining dietary management to a woman with pregestational diabetes. Which statement by the client reassures the nurse that teaching has been effective? a.I will need to eat 600 more calories per day because I am pregnant. b.I can continue with the same diet as before pregnancy as long as it is well balanced. c.Diet and insulin needs change during pregnancy. d.I will plan my diet based on the results of urine glucose testing.

c.Diet and insulin needs change during pregnancy.

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

c.Dipstick value of 3+ for protein in her urine (Proteinuria is defined as a concentration of 1+ or greater via dipstick measurement.)

Breast pain occurs in many women during their perimenopausal years. Which information is a priority for the nurse to share with the client? a.Breast pain is an early indication of cancer. b.Pain is almost always an indication of a solid mass. c.Distinguishing between cyclical and noncyclical pain is important. d.Breast pain is most often treated with narcotics.

c.Distinguishing between cyclical and noncyclical pain is important.

The nurse is teaching a client with preterm premature rupture of membranes (PPROM) regarding self-care activities. Which activities should the nurse include in her teaching? a.Report a temperature higher than 40 C. b.Tampons are safe to use to absorb the leaking amniotic fluid. c.Do not engage in sexual activity. d.Taking frequent tub baths is safe.

c.Do not engage in sexual activity.

A number of metabolic changes occur throughout pregnancy. Which physiologic adaptation of pregnancy will influence the nurses plan of care? a.Insulin crosses the placenta to the fetus only in the first trimester, after which the fetus secretes its own. b.Women with insulin-dependent diabetes are prone to hyperglycemia during the first trimester because they are consuming more sugar. c.During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus. d.Maternal insulin requirements steadily decline during pregnancy.

c.During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus.

To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet? a.Eat six small equal meals per day. b.Reduce the carbohydrates in her diet. c.Eat her meals and snacks on a fixed schedule. d.Increase her consumption of protein.

c.Eat her meals and snacks on a fixed schedule.

When assisting the mother, father, and other family members to actualize the loss of an infant, which action is most helpful? a.Using the words lost or gone rather than dead or died b.Making sure the family understands that naming the baby is important c.Ensuring the baby is clothed or wrapped if the parents choose to visit with the baby d.Setting a firm time for ending the visit with the baby so that the parents know when to let go

c.Ensuring the baby is clothed or wrapped if the parents choose to visit with the baby

Which neurologic condition would require preconception counseling, if at all possible? a.Eclampsia b.Bell palsy c.Epilepsy d.Multiple sclerosis

c.Epilepsy

A primigravida has just delivered a healthy infant girl. The nurse is about to administer erythromycin ointment in the infants eyes when the mother asks, What is that medicine for? How should the nurse respond? a.It is an eye ointment to help your baby see you better. b.It is to protect your baby from contracting herpes from your vaginal tract. c.Erythromycin is prophylactically given to prevent a gonorrheal infection. d.This medicine will protect your babys eyes from drying out over the next few days.

c.Erythromycin is prophylactically given to prevent a gonorrheal infection.

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

c.Fluid retention

Which finding on a prenatal visit at 10 weeks of gestation might suggest a hydatidiform mole? a.Complaint of frequent mild nausea b.Blood pressure of 120/80 mm Hg c.Fundal height measurement of 18 cm d.History of bright red spotting for 1 day, weeks ago

c.Fundal height measurement of 18 cm

What condition indicates concealed hemorrhage when the client experiences abruptio placentae? a.Decrease in abdominal pain b.Bradycardia c.Hard, boardlike abdomen d.Decrease in fundal height

c.Hard, boardlike abdomen (Concealed hemorrhage occurs when the edges of the placenta do not separate. The formation of a hematoma behind the placenta and subsequent infiltration of the blood into the uterine muscle results in a very firm, boardlike abdomen.)

A nurse is providing breast care education to a client after mammography. Which information regarding fibrocystic changes in the breast is important for the nurse to share? a.Fibrocystic breast disease is a disease of the milk ducts and glands in the breasts. b.It is a premalignant disorder characterized by lumps found in the breast tissue. c.Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles. d.Lumpiness is accompanied by tenderness after menses.

c.Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles.

A woman with asthma is experiencing a postpartum hemorrhage. Which drug should be avoided when treating postpartum bleeding to avoid exacerbating asthma? a.Oxytocin (Pitocin) b.Nonsteroidal antiinflammatory drugs (NSAIDs) c.Hemabate d.Fentanyl

c.Hemabate (Prostaglandin derivatives should not be used to treat women with asthma, because they may exacerbate symptoms. Oxytocin is the drug of choice to treat this womans bleeding; it will not exacerbate her asthma)

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

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

An infant was born 2 hours ago at 37 weeks of gestation and weighs 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of what condition? a.Birth injury b.Hypocalcemia c.Hypoglycemia d.Seizures

c.Hypoglycemia (Signs of hypoglycemia include jitteriness, apnea, tachypnea, and cyanosis.)

The nurse is evaluating a neonate who was delivered 3 hours ago by vacuum-assisted delivery. The infant has developed a cephalhematoma. Which statement is most applicable to the care of this neonate? a.Intracranial hemorrhage (ICH) as a result of birth trauma is more likely to occur in the preterm, low-birth-weight infant. b.Subarachnoid hemorrhage (the most common form of ICH) occurs in term infants as a result of hypoxia. c.In many infants, signs of hemorrhage in a full-term infant are absent and diagnosed only through laboratory tests. d.Spinal cord injuries almost always result from vacuum-assisted deliveries.

c.In many infants, signs of hemorrhage in a full-term infant are absent and diagnosed only through laboratory tests.

Which important component of nutritional counseling should the nurse include in health teaching for a pregnant woman who is experiencing cholecystitis? a.Assess the womans dietary history for adequate calories and proteins. b.Teach the woman that the bulk of calories should come from proteins. c.Instruct the woman to eat a low-fat diet and to avoid fried foods. d.Instruct the woman to eat a low-cholesterol, low-salt diet.

c.Instruct the woman to eat a low-fat diet and to avoid fried foods.

A woman has a breast mass that is not well delineated and is nonpalpable, immobile, and nontender. Which condition is this client experiencing? a.Fibroadenoma b.Lipoma c.Intraductal papilloma d.Mammary duct ectasia

c.Intraductal papilloma

Which statement most accurately describes complicated grief? a.Occurs when, in multiple births, one child dies and the other or others live b.Is a state during which the parents are ambivalent, as with an abortion c.Is an extremely intense grief reaction that persists for a long time d.Is felt by the family of adolescent mothers who lose their babies

c.Is an extremely intense grief reaction that persists for a long time

A nurse practicing in the perinatal setting should promote kangaroo care regardless of an infants gestational age. Which statement regarding this intervention is most appropriate? a.Kangaroo care was adopted from classical British nursing traditions. b.This intervention helps infants with motor and CNS impairments. c.Kangaroo care helps infants interact directly with their parents and enhances their temperature regulation. d.This intervention gets infants ready for breastfeeding.

c.Kangaroo care helps infants interact directly with their parents and enhances their temperature regulation.

Hypothyroidism occurs in 2 to 3 pregnancies per 1000. Because severe hypothyroidism is associated with infertility and miscarriage, it is not often seen in pregnancy. Regardless of this fact, the nurse should be aware of the characteristic symptoms of hypothyroidism. Which do they include? (Select all that apply.) a.Hot flashes b.Weight loss c.Lethargy d.Decrease in exercise capacity e.Cold intolerance

c.Lethargy d.Decrease in exercise capacity e.Cold intolerance

The management of the pregnant client who has experienced a pregnancy loss depends on the type of miscarriage and the signs and symptoms. While planning care for a client who desires outpatient management after a first-trimester loss, what would the nurse expect the plan to include? a.Dilation and curettage (D&C) b.Dilation and evacuation (D&E) c.Misoprostol d.Ergot products

c.Misoprostol (Outpatient management of a first-trimester loss is safely accomplished by the intravaginal use of misoprostol for up to 2 days.)

By understanding the four mechanisms of heat transfer (convection, conduction, radiation, and evaporation), the nurse can create an environment for the infant that prevents temperature instability. Which significant symptoms will the infant display when experiencing cold stress? a.Decreased respiratory rate b.Bradycardia, followed by an increased heart rate c.Mottled skin with acrocyanosis d.Increased physical activity

c.Mottled skin with acrocyanosis (The infant has minimal-to-no fat stores. During times of cold stress, the skin becomes mottled and acrocyanosis develops, progressing to cyanosis.)

Which diagnostic test is used to confirm a suspected diagnosis of breast cancer? a.Mammogram b.Ultrasound c.Needle-localization biopsy d.Magnetic resonance imaging (MRI)

c.Needle-localization biopsy

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem approach. What is the first step in the provision of care for the infant? a.Pharmacologic treatment b.Reduction of environmental stimuli c.Neonatal abstinence syndrome (NAS) scoring d.Adequate nutrition and maintenance of fluid and electrolyte balance

c.Neonatal abstinence syndrome (NAS) scoring (NAS describes the cohort of symptoms associated with drug withdrawal in the neonate. The NAS system evaluates CNS, metabolic, vasomotor, respiratory, and gastrointestinal (GI) disturbances.)

Having a genetic mutation may create an 85% chance of developing breast cancer in a womans lifetime. Which condition does not increase a clients risk for breast cancer? a.BRCA1 or BRCA2 gene mutation b.Li-Fraumeni syndrome c.Paget disease d.Cowden syndrome

c.Paget disease (Paget disease originates in the nipple and causes nipple carcinoma and exhibits bleeding, oozing, and crusting of the nipple)

With regard to an eventual discharge of the high-risk newborn or the transfer of the newborn to a different facility, which information is essential to provide to the parents? a.Infants stay in the NICU until they are ready to go home. b.Once discharged to go home, the high-risk infant should be treated like any healthy term newborn. c.Parents of high-risk infants need special support and detailed contact information. d.If a high-risk infant and mother need to be transferred to a specialized regional center, then waiting until after the birth and until the infant is stabilized is best.

c.Parents of high-risk infants need special support and detailed contact information.

A woman at 28 weeks of gestation experiences blunt abdominal trauma as the result of a fall. The nurse must closely observe the client for what? a.Alteration in maternal vital signs, especially blood pressure b.Complaints of abdominal pain c.Placental absorption d.Hemorrhage

c.Placental absorption

For clinical purposes, the most accurate definition of preterm and postterm infants is defined as what? a.Preterm: Before 34 weeks of gestation if the infant is appropriate for gestational age (AGA); before 37 weeks if the infant is small for gestational age (SGA) b.Postterm: After 40 weeks of gestation if the infant is large for gestational age (LGA); beyond 42 weeks if the infant is AGA c.Preterm: Before 37 weeks of gestation and postterm beyond 42 weeks of gestation; no matter the size for gestational age at birth d.Preterm: Before 38 to 40 weeks of gestation if the infant is SGA; postterm, beyond 40 to 42 weeks gestation if the infant is LGA

c.Preterm: Before 37 weeks of gestation and postterm beyond 42 weeks of gestation; no matter the size for gestational age at birth

Which preexisting factor is known to increase the risk of GDM? a.Underweight before pregnancy b.Maternal age younger than 25 years c.Previous birth of large infant d.Previous diagnosis of type 2 diabetes mellitus

c.Previous birth of large infant

In planning for home care of a woman with preterm labor, which concern should the nurse need to address? a.Nursing assessments are different from those performed in the hospital setting. b.Restricted activity and medications are necessary to prevent a recurrence of preterm labor. c.Prolonged bed rest may cause negative physiologic effects. d.Home health care providers are necessary.

c.Prolonged bed rest may cause negative physiologic effects.

A woman has experienced iron deficiency anemia during her pregnancy. She had been taking iron for 3 months before the birth. The client gave birth by cesarean 2 days earlier and has been having problems with constipation. After assisting her back to bed from the bathroom, the nurse notes that the womans stools are dark (greenish-black). What should the nurses initial action be? a.Perform a guaiac test, and record the results. b.Recognize the finding as abnormal, and report it to the primary health care provider. c.Recognize the finding as a normal result of iron therapy. d.Check the womans next stool to validate the observation.

c.Recognize the finding as a normal result of iron therapy.

Which conditions are infants of diabetic mothers (IDMs) at a higher risk for developing? a.Iron deficiency anemia b.Hyponatremia c.Respiratory distress syndrome d.Sepsis

c.Respiratory distress syndrome

A woman is having her first child. She has been in labor for 15 hours. A vaginal examination performed 2 hours earlier revealed the cervix to be dilated to 5 cm and 100% effaced, and the presenting part of the fetus was at station 0; however, another vaginal examination performed 5 minutes ago indicated no changes. What abnormal labor pattern is associated with this description? a.Prolonged latent phase b.Protracted active phase c.Secondary arrest d.Protracted descent

c.Secondary arrest (With a secondary arrest of the active phase, the progress of labor has stopped. This client has not had any anticipated cervical change, indicating an arrest of labor.)

A primigravida at 40 weeks of gestation is having uterine contractions every to 2 minutes and states that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this womans labor? a.She is exhibiting hypotonic uterine dysfunction. b.She is experiencing a normal latent stage. c.She is exhibiting hypertonic uterine dysfunction. d.She is experiencing precipitous labor.

c.She is exhibiting hypertonic uterine dysfunction. (The contraction pattern observed in this woman signifies hypertonic uterine activity. Typically, uterine activity in this phase occurs at 4- to 5-minute intervals lasting 30 to 45 seconds.)

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

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

An infant is to receive gastrostomy feedings. Which intervention should the nurse institute to prevent bloating, gastrointestinal reflux into the esophagus, vomiting, and respiratory compromise? a.Rapid bolusing of the entire amount in 15 minutes b.Warm cloths to the abdomen for the first 10 minutes c.Slow, small, warm bolus feedings over 30 minutes d.Cold, medium bolus feedings over 20 minutes

c.Slow, small, warm bolus feedings over 30 minutes

For an infant experiencing symptoms of drug withdrawal, which intervention should be included in the plan of care? a.Administering chloral hydrate for sedation b.Feeding every 4 to 6 hours to allow extra rest between feedings c.Snugly swaddling the infant and tightly holding the baby d.Playing soft music during feeding

c.Snugly swaddling the infant and tightly holding the baby

A woman who is 30 weeks of gestation arrives at the hospital with bleeding. Which differential diagnosis would not be applicable for this client? a.Placenta previa b.Abruptio placentae c.Spontaneous abortion d.Cord insertion

c.Spontaneous abortion

A pregnant woman at term is transported to the emergency department (ED) after a severe vehicular accident. The obstetric nurse responds and rushes to the ED with a fetal monitor. Cardiopulmonary arrest occurs as the obstetric nurse arrives. What is the highest priority for the trauma team? a.Obtaining IV access, and starting aggressive fluid resuscitation b.Quickly applying the fetal monitor to determine whether the fetus viability c.Starting cardiopulmonary resuscitation (CPR) d.Transferring the woman to the surgical unit for an emergency cesarean delivery in case the fetus is still alive

c.Starting cardiopulmonary resuscitation (CPR) (In a situation of severe maternal trauma, the systematic evaluation begins with a primary survey and the initial ABCs (airway, breathing, and circulation) of resuscitation. CPR is initiated first, followed by intravenous (IV) replacement fluid.)

What is the primary purpose for the use of tocolytic therapy to suppress uterine activity? a.Drugs can be efficaciously administered up to the designated beginning of term at 37 weeks gestation. b.Tocolytic therapy has no important maternal (as opposed to fetal) contraindications. c.The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids. d.If the client develops pulmonary edema while receiving tocolytic therapy, then intravenous (IV) fluids should be given.

c.The most important function of tocolytic therapy is to provide the opportunity to administer antenatal glucocorticoids.

Which statement regarding the laboratory test for glycosylated hemoglobin Alc is correct? a.The laboratory test for glycosylated hemoglobin Alc is performed for all pregnant women, not only those with or likely to have diabetes. b.This laboratory test is a snapshot of glucose control at the moment. c.This laboratory test measures the levels of hemoglobin Alc, which should remain at less than 7%. d.This laboratory test is performed on the womans urine, not her blood.

c.This laboratory test measures the levels of hemoglobin Alc, which should remain at less than 7%. (Hemoglobin Alc levels greater than 7% indicate an elevated glucose level during the previous 4 to 6 weeks.)

A woman arrives at the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion? a.Incomplete b.Inevitable c.Threatened d.Septic

c.Threatened (A woman with a threatened abortion has spotting, mild cramps, and no cervical dilation)

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

c.To discontinue the magnesium sulfate infusion

During the initial acute distress phase of grieving, parents still must make unexpected and unwanted decisions about funeral arrangements and even naming the baby. What is the nurses role at this time? a.To take over as much as possible to relieve the pressure b.To encourage the grandparents to take over c.To ensure that the parents, themselves, approve the final decisions d.To leave them alone to work things out

c.To ensure that the parents, themselves, approve the final decisions

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

c.To prevent convulsions

Prostaglandin gel has been ordered for a pregnant woman at 43 weeks of gestation. What is the primary purpose of prostaglandin administration? a.To enhance uteroplacental perfusion in an aging placenta b.To increase amniotic fluid volume c.To ripen the cervix in preparation for labor induction d.To stimulate the amniotic membranes to rupture

c.To ripen the cervix in preparation for labor induction (Preparations of prostaglandin E1 and E2 are effective when used before labor induction to ripen (i.e., soften and thin) the cervix.)

The nurse is preparing to administer methotrexate to the client. This hazardous drug is most often used for which obstetric complication? a.Complete hydatidiform mole b.Missed abortion c.Unruptured ectopic pregnancy d.Abruptio placentae

c.Unruptured ectopic pregnancy (Methotrexate is an effective nonsurgical treatment option for a hemodynamically stable woman whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter.)

After a mastectomy, which activity should the client be instructed to avoid? a.Emptying surgical drains twice a day and as needed b.Lifting more than 4.5 kg (10 lb) or reaching above her head until given permission by her surgeon c.Wearing clothing with snug sleeves to support the tissue of the arm on the operative side d.Immediately reporting inflammation that develops at the incision site or in the affected arm

c.Wearing clothing with snug sleeves to support the tissue of the arm on the operative side

Which options for saying good-bye would the nurse want to discuss with a woman who is diagnosed with having a stillborn girl? a.The nurse should not discuss any options at this time; plenty of time will be available after the baby is born. b.Would you like a picture taken of your baby after birth? c.When your baby is born, would you like to see and hold her? d.What funeral home do you want notified after the baby is born?

c.When your baby is born, would you like to see and hold her?

An infant is being discharged from the NICU after 70 days of hospitalization. The infant was born at 30 weeks of gestation with several conditions associated with prematurity, including RDS, mild bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP), requiring surgical treatment. During discharge teaching, the infants mother asks the nurse if her baby will meet developmental milestones on time, as did her son who was born at term. What is the nurses most appropriate response? a.Your baby will develop exactly like your first child. b.Your baby does not appear to have any problems at this time. c.Your baby will need to be corrected for prematurity. d.Your baby will need to be followed very closely.

c.Your baby will need to be corrected for prematurity.

Since the gene for cystic fibrosis was identified in 1989, data can be collected for the purposes of genetic counseling for couples regarding carrier status. According to the most recent statistics, how often does cystic fibrosis occur in Caucasian live births? a.1 in 100 b.1 in 1000 c.1 in 2000 d.1 in 3200

d.1 in 3200

A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. The client shows the nurse her readings for the past few days. Which reading signals the nurse that the client may require an adjustment of insulin or carbohydrates? a.75 mg/dl before lunch. This is low; better eat now. b.115 mg/dl 1 hour after lunch. This is a little high; maybe eat a little less next time. c.115 mg/dl 2 hours after lunch. This is too high; it is time for insulin. d.50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep.

d.50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep. (50 mg/dl after waking from a nap is too low. During hours of sleep, glucose levels should not be less than 60 mg/dl)

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

d.Abruptio placentae (Uterine tenderness in the presence of increasing tone may be the earliest sign of abruptio placentae. Women with preeclampsia are at increased risk for an abruption attributable to decreased placental perfusion.)

The obstetric provider has informed the nurse that she will be performing an amniotomy on the client to induce labor. What is the nurses highest priority intervention after the amniotomy is performed? a.Applying clean linens under the woman b.Taking the clients vital signs c.Performing a vaginal examination d.Assessing the fetal heart rate (FHR)

d.Assessing the fetal heart rate (FHR) (The FHR is assessed before and immediately after the amniotomy to detect any changes that might indicate cord compression or prolapse.)

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

d.Boggy uterus with heavy lochia flow (High serum levels of magnesium can cause a relaxation of smooth muscle such as the uterus. Because of this tocolytic effect, the client will most likely have a boggy uterus with increased amounts of bleeding. All women experience uterine bleeding in the postpartum period, especially those who have received magnesium therapy.)

Which condition might premature infants who exhibit 5 to 10 seconds of respiratory pauses, followed by 10 to 15 seconds of compensatory rapid respiration, be experiencing? a.Suffering from sleep or wakeful apnea b.Experiencing severe swings in blood pressure c.Trying to maintain a neutral thermal environment d.Breathing in a respiratory pattern common to premature infants

d.Breathing in a respiratory pattern common to premature infants (Breathing in a respiratory pattern is called periodic breathing and is common to premature infants.)

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

d.Chronic hypertension can occur independently of or simultaneously with preeclampsia.

Which clinical findings would alert the nurse that the neonate is expressing pain? a.Low-pitched crying; tachycardia; eyelids open wide b.Cry face; flaccid limbs; closed mouth c.High-pitched, shrill cry; withdrawal; change in heart rate d.Cry face; eyes squeezed; increase in blood pressure

d.Cry face; eyes squeezed; increase in blood pressure

The nurse is performing an assessment on a client who thinks she may be experiencing preterm labor. Which information is the most important for the nurse to understand and share with the client? a.Because all women must be considered at risk for preterm labor and prediction is so variable, teaching pregnant women the symptoms of preterm labor probably causes more harm through false alarms. b.Braxton Hicks contractions often signal the onset of preterm labor. c.Because preterm labor is likely to be the start of an extended labor, a woman with symptoms can wait several hours before contacting the primary caregiver. d.Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

d.Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change. (Gestational age of 20 to 37 weeks, uterine contractions, and a cervix that is 80% effaced or dilated 2 cm indicates preterm labor.)

When caring for a pregnant woman with cardiac problems, the nurse must be alert for the signs and symptoms of cardiac decompensation. Which critical findings would the nurse find on assessment of the client experiencing this condition? a.Regular heart rate and hypertension b.Increased urinary output, tachycardia, and dry cough c.Shortness of breath, bradycardia, and hypertension d.Dyspnea, crackles, and an irregular, weak pulse

d.Dyspnea, crackles, and an irregular, weak pulse

Postoperative care of the pregnant woman who requires abdominal surgery for appendicitis includes which additional assessment? a.Intake and output (I&O) and intravenous (IV) site b.Signs and symptoms of infection c.Vital signs and incision d.Fetal heart rate (FHR) and uterine activity

d.Fetal heart rate (FHR) and uterine activity

A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization, the infant is weighed, and the birth weight is 4550 g (9 lb, 6 oz). What is the nurses first priority? a.Leave the infant in the room with the mother. b.Immediately take the infant to the nursery. c.Perform a gestational age assessment to determine whether the infant is large for gestational age. d.Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia.

d.Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia.

A nurse caring for a family during a loss might notice that a family member is experiencing survivor guilt. Which family member is most likely to exhibit this guilt? a.Siblings b.Mother c.Father d.Grandparents

d.Grandparents

When evaluating the preterm infant, the nurse understands that compared with the term infant, what information is important for the nurse to understand? a.Few blood vessels visible through the skin b.More subcutaneous fat c.Well-developed flexor muscles d.Greater surface area in proportion to weight

d.Greater surface area in proportion to weight

What bacterial infection is definitely decreasing because of effective drug treatment? a.Escherichia coli infection b.Tuberculosis c.Candidiasis d.Group B streptococci (GBS) infection

d.Group B streptococci (GBS) infection (Penicillin has significantly decreased the incidence of GBS infection.)

A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Which information assists the nurse in developing the plan of care? a.Bed rest and analgesics are the recommended treatment. b.She will be unable to conceive in the future. c.A D&C will be performed to remove the products of conception. d.Hemorrhage is the primary concern.

d.Hemorrhage is the primary concern.

After giving birth to a stillborn infant, the woman turns to the nurse and says, I just finished painting the babys room. Do you think that caused my baby to die? What is the nurses most appropriate response? a.Thats an old wives tale; lots of women are around paint during pregnancy, and this doesnt happen to them. b.Thats not likely. Paint is associated with elevated pediatric lead levels. c.Silence. d.I can understand your need to find an answer to what caused this. What else are you thinking about?

d.I can understand your need to find an answer to what caused this. What else are you thinking about?

The nurse who elects to practice in the area of womens health must have a thorough understanding of miscarriage. Which statement regarding this condition is most accurate? a.A miscarriage is a natural pregnancy loss before labor begins. b.It occurs in fewer than 5% of all clinically recognized pregnancies. c.Careless maternal behavior, such as poor nutrition or excessive exercise, can be a factor in causing a miscarriage. d.If a miscarriage occurs before the 12th week of pregnancy, then it may be observed only as moderate discomfort and blood loss.

d.If a miscarriage occurs before the 12th week of pregnancy, then it may be observed only as moderate discomfort and blood loss. (Before the sixth week, the only evidence might be a heavy menstrual flow. After the 12th week, more severe pain, similar to that of labor, is likely.)

Which statement related to the induction of labor is most accurate? a.Can be achieved by external and internal version techniques b.Is also known as a trial of labor (TOL) c.Is almost always performed for medical reasons d.Is rated for viability by a Bishop score

d.Is rated for viability by a Bishop score (Induction of labor is likely to be more successful with a Bishop score of 9 or higher for first-time mothers or 5 or higher for veterans.)

What form of heart disease in women of childbearing years generally has a benign effect on pregnancy? a.Cardiomyopathy b.Rheumatic heart disease c.Congenital heart disease d.Mitral valve prolapse

d.Mitral valve prolapse

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

d.More brisk than expected, slightly hyperactive (DTRs reflect the balance between the cerebral cortex and the spinal cord. They are evaluated at baseline and to detect changes. A slightly hyperactive and brisk response indicates a grade 3+ response.)

Which physiologic alteration of pregnancy most significantly affects glucose metabolism? a.Pancreatic function in the islets of Langerhans is affected by pregnancy. b.Pregnant women use glucose at a more rapid rate than nonpregnant women. c.Pregnant women significantly increase their dietary intake. d.Placental hormones are antagonistic to insulin, thus resulting in insulin resistance.

d.Placental hormones are antagonistic to insulin, thus resulting in insulin resistance.

Which assessment is least likely to be associated with a breech presentation? a.Meconium-stained amniotic fluid b.Fetal heart tones heard at or above the maternal umbilicus c.Preterm labor and birth d.Postterm gestation

d.Postterm gestation

A family is visiting two surviving triplets. The third triplet died 2 days ago. What action indicates that the family has begun to grieve for the dead infant? a.Refers to the two live infants as twins b.Asks about the dead triplets current status c.Brings in play clothes for all three infants d.Refers to the dead infant in the past tense

d.Refers to the dead infant in the past tense

When providing an infant with a gavage feeding, which infant assessment should be documented each time? a.Abdominal circumference after the feeding b.Heart rate and respirations before feeding c.Suck and swallow coordination d.Response to the feeding

d.Response to the feeding (Documentation of a gavage feeding should include the size of the feeding tube, the amount and quality of the residual from the previous feeding, the type and quantity of the fluid instilled, and the infants response to the procedure.)

Because of the premature infants decreased immune functioning, what nursing diagnosis should the nurse include in a plan of care for a premature infant? a.Delayed growth and development b.Ineffective thermoregulation c.Ineffective infant feeding pattern d.Risk for infection

d.Risk for infection

When would an internal version be indicated to manipulate the fetus into a vertex position? a.Fetus from a breech to a cephalic presentation before labor begins b.Fetus from a transverse lie to a longitudinal lie before a cesarean birth c.Second twin from an oblique lie to a transverse lie before labor begins d.Second twin from a transverse lie to a breech presentation during a vaginal birth

d.Second twin from a transverse lie to a breech presentation during a vaginal birth

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. The fetal heart rate (FHR) before birth is 180 beats per minute with limited variability. At birth the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic. Based on the maternal history, what is the most likely cause of this newborns distress? a.Hypoglycemia b.Phrenic nerve injury c.Respiratory distress syndrome d.Sepsis

d.Sepsis (The prolonged rupture of membranes and the tachypnea (before and after birth) suggest sepsis.)

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, which finding alerts the nurse to possible side effects? a.Urine output of 160 ml in 4 hours b.DTRs 2+ and no clonus c.Respiratory rate (RR) of 16 breaths per minute d.Serum magnesium level of 10 mg/dl

d.Serum magnesium level of 10 mg/dl (The therapeutic range for magnesium sulfate management is 4 to 7.5 mg/dl. A serum magnesium level of 10 mg/dl could lead to signs and symptoms of magnesium toxicity, including oliguria and respiratory distress)

A health care provider performs a clinical breast examination on a woman diagnosed with fibroadenoma. How would the nurse explain the defining characteristics of a fibroadenoma? a.Inflammation of the milk ducts and glands behind the nipples b.Thick, sticky discharge from the nipple of the affected breast c.Lumpiness in both breasts that develops 1 week before menstruation d.Single lump in one breast that can be expected to shrink as the woman ages

d.Single lump in one breast that can be expected to shrink as the woman ages

Which client should the nurse refer for further testing? a.Left breast slightly smaller than right breast b.Eversion (elevation) of both nipples c.Faintly visible bilateral symmetry of venous network d.Small dimple located in the upper outer quadrant of the right breast

d.Small dimple located in the upper outer quadrant of the right breast

Parents are often asked if they would like to have an autopsy performed on their infant. Nurses who are assisting parents with this decision should be aware of which information? a.Autopsies are usually covered by insurance. b.Autopsies must be performed within a few hours after the infants death. c.In the current litigious society, more autopsies are performed than in the past. d.Some religions prohibit autopsy.

d.Some religions prohibit autopsy.

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding indicates that preterm labor is occurring? a.Estriol is not found in maternal saliva. b.Irregular, mild uterine contractions are occurring every 12 to 15 minutes. c.Fetal fibronectin is present in vaginal secretions. d.The cervix is effacing and dilated to 2 cm.

d.The cervix is effacing and dilated to 2 cm. (Cervical changes such as shortened endocervical length, effacement, and dilation are predictors of imminent preterm labor.)

A nurse is providing education to a support group of women newly diagnosed with breast cancer. It is important for the nurse to discuss which factor related to breast cancer with the group? a.Genetic mutations account for 50% of women who will develop breast cancer. b.Breast cancer is the leading cause of cancer death in women. c.In the United States, 1 in 10 women will develop breast cancer in her lifetime. d.The exact cause of breast cancer remains unknown.

d.The exact cause of breast cancer remains unknown.

Another common pregnancy-specific condition is pruritic urticarial papules and plaques of pregnancy (PUPPP). A client asks the nurse why she has developed this condition and what can be done. What is the nurses bestresponse? a.PUPPP is associated with decreased maternal weight gain. b.The rate of hypertension decreases with PUPPP. c.This common pregnancy-specific condition is associated with a poor fetal outcome. d.The goal of therapy is to relieve discomfort.

d.The goal of therapy is to relieve discomfort. (PUPPP is associated with increased maternal weight gain, increased rate of twin gestation, and hypertension.)

Human immunodeficiency virus (HIV) may be transmitted perinatally or during the postpartum period. Which statement regarding the method of transmission is most accurate? a.Only in the third trimester from the maternal circulation b.From the use of unsterile instruments c.Only through the ingestion of amniotic fluid d.Through the ingestion of breast milk from an infected mother

d.Through the ingestion of breast milk from an infected mother

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

d.To stay with the client and call for help

A pregnant woman at 33 weeks of gestation is brought to the birthing unit after a minor automobile accident. The client is experiencing no pain and no vaginal bleeding, her vital signs are stable, and the FHR is 132 beats per minute with variability. What is the nurses highest priority? a.Monitoring the woman for a ruptured spleen b.Obtaining a physicians order to discharge her home c.Monitoring her for 24 hours d.Using continuous EFM for a minimum of 4 hours

d.Using continuous EFM for a minimum of 4 hours (Monitoring the external FHR and contractions is recommended after blunt trauma in a viable gestation for a minimum of 4 hours, regardless of injury severity. Fetal monitoring should be initiated as soon as the woman is stable.)

Which statement is the most appropriate for the nurse to make when caring for bereaved parents? a.This happened for the best. b.You have an angel in heaven. c.I know how you feel. d.What can I do for you?

d.What can I do for you?

A healthy 60-year-old African-American woman regularly receives health care at her neighborhood clinic. She is due for a mammogram. At her first visit, her health care provider is concerned about the 3-week wait at the neighborhood clinic and made an appointment for her to have a mammogram at a teaching hospital across town. She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure. What is the most appropriate statement for the nurse to make to this client? a.Do you have transportation to the teaching hospital so that you can get your mammogram? b.Im concerned that you missed your appointment; let me make another one for you. c.Its very dangerous to skip your mammograms; your breasts need to be checked. d.Would you like me to make an appointment for you to have your mammogram here?

d.Would you like me to make an appointment for you to have your mammogram here?

On day 3 of life, a newborn continues to require 100% oxygen by nasal cannula. The parents ask if they may hold their infant during his next gavage feeding. Considering that this newborn is physiologically stable, what response should the nurse provide? a.Parents are not allowed to hold their infants who are dependent on oxygen. b.You may only hold your babys hand during the feeding. c.Feedings cause more physiologic stress; therefore, the baby must be closely monitored. I dont think you should hold the baby. d.You may hold your baby during the feeding.

d.You may hold your baby during the feeding.