Maternal Newborn Final
A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal? a. 9 b. 7 c. 3 d. 5
a
A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating: a. transition phase of the first stage of labor. b. active phase of the first stage of labor. c. latent phase of the first stage of labor. d. pelvic phase of the second stage of labor.
a
A client states, "I think my waters broke! I felt this gush of fluid between my legs." The nurse tests the fluid with a Nitrazine swab and confirms membrane rupture if the swab turns: a. blue. b. yellow. c. olive green. d. pink.
a
A nurse is reviewing the fetal heart rate pattern and observes abrupt decreases in FHR below the baseline, appearing as a U-shape. The nurse interprets these changes as reflecting which type of deceleration? a. variable decelerations b. late decelerations c. early decelerations d. prolonged decelerations
a
A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? a. elevated liver enzymes b. elevated platelet count c. disseminated intravascular coagulopathy (DIC) d. hyperglycemia
a
A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which finding would require immediate intervention? a. urine output of 20 mL/hour b. uterine resting tone of 14 mm Hg c. contractions every 2 minutes, lasting 45 seconds d. fetal heart rate of 150 beats/minute
a
A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which effect? a. uterine hyperstimulation b. hypotension c. blurred vision d. headache
a
A client's last menstrual period was April 11. Using Nagele's rule, her estimated date of birth (EDB) would be: a. January 25. b. January 4. c. January 18. d. February 24.
c
A woman in her second trimester comes for a follow-up visit and says to the nurse, "I feel like I'm on an emotional roller-coaster." Which response by the nurse would be most appropriate? a. "Mood swings are completely normal during pregnancy." b. "How often has this been happening to you?" c. "Have you been experiencing any thoughts of harming yourself?" d. "Maybe you need some medication to level things out."
a
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which condition? a. Placental insufficiency b. Fetal gastrointestinal malformations c. Neural tube defects d. Maternal diabetes
a
The nurse is discussing the insulin needs of a primaparous client with diabetes who has been using insulin for the past few years. The nurse informs the client that her insulin needs will increase during pregnancy based on the nurse's understanding that the placenta produces: a. hPL, which deceases the effectiveness of insulin. b. relaxin, which decreases the amount of insulin produced. c. hCG, which increases maternal glucose levels. d. estriol, which interferes with insulin crossing the placenta.
a
When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find? a. ambivalence b. introversion c. acceptance d. emotional lability
a
When planning the care of a low risk woman in the 1st (active) phase of labor, the nurse would anticipate assessing the fetal heart rate at which interval? a. every 30 minutes b. every 4 hours c. every 60 minutes d. every 15 minutes
a
When reviewing the medical record of a client diagnosed with endometriosis, the nurse would identify which finding as a risk factor for this woman? a. menstrual cycles of 24 days b. low fat in the diet c. age of 14 years for menarche d. short menstrual flow
a
When teaching a class of pregnant women about the effects of substance abuse during pregnancy, the nurse would most likely include which effect? a. low-birthweight infants b. longer gestational periods c. excessive weight gain d. higher pain tolerance
a
A nurse is providing care to a pregnant woman in labor. The woman is in the first stage of labor. When describing this stage to the client, which event would the nurse identify as the major change occurring during this stage? a. fetal movement through the birth canal b. placental separation c. cervical dilation d. regular contractions
c
A nurse suspects that a pregnant client may be experiencing abruptio placenta based on assessment of which finding? Select all that apply. a. absent fetal heart tones b. dark red vaginal bleeding c. rigid uterus d. absence of pain e. insidious onset
a, b, c
A nurse is conducting a review course on tocolytic therapy for perinatal nurses. After teaching the group, the nurse determines that the teaching was successful when they identify which drugs as being used for tocolysis? Select all that apply. a. nifedipine b. indomethacin c. misoprostol d. dinoprostone e. magnesium sulfate
a, b, e
A nurse is teaching a woman with mild preeclampsia about important areas that she needs to monitor. The nurse determines that the teaching was successful based on which statement by the woman? Select all that apply. a. "I should check my blood pressure twice a day." b. "I will check my urine for protein four times a day." c. "I will weigh myself once a week." d. "I should complete a fetal kick count each day."
a, c, d
A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which finding would the nurse most likely assess? Select all that apply. a. ballottement b. auscultation of a fetal heart beat c. Hegar's sign d. absence of menstruation e. ultrasound visualization of the fetus f. positive pregnancy test
a, c, f
A pregnant woman has a rubella titer drawn on her first prenatal visit. The nurse explains that this test measures: a. Rh status. b. red blood cell count. c. immunity to German measles. d. platelet level.
c
A client who has come to the clinic is diagnosed with endometriosis. What would the nurse expect the primary care provider to prescribe as a first-line treatment? a. progestins b. NSAIDs c. antiestrogens d. gonadotropin-releasing hormone analogues
b
A nurse is conducting a program for pregnant women with gestational diabetes about reducing complications. The nurse determines that the teaching was successful when the group identifies which factor as being most important in helping to reduce complications associated with pregnancy and diabetes? a. control of blood urea nitrogen (BUN) levels for optimal kidney function b. degree of blood glucose control achieved during the pregnancy c. stability of the woman's emotional and psychological status d. reduction in retinopathy risk by frequent ophthalmologic evaluations
b
A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating: a. a multiple gestation pregnancy. b. hemodilution of pregnancy. c. greater-than-expected weight gain. d. iron-deficiency anemia.
b
A pregnant client whose diabetes has been poorly controlled throughout her pregnancy is in labor. The nurse would assess the neonate closely at delivery for which condition? a. hypobilirubinemia b. macrosomia c. low birthweight d. hyperglycemia
b
A woman is at 20 weeks' gestation. The nurse would expect to find the fundus at which area? a. just above the symphysis pubis b. at the level of the umbilicus c. midway between the pubis and umbilicus d. midway between the umbilicus and xiphoid process
b
A woman's amniotic fluid is noted to be cloudy. The nurse interprets this finding as: a. meconium passage. b. possible infection. c. normal. d. transient fetal hypoxia.
b
During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline 2 separate times in 20 minutes. The nurse interprets this as: a. a nonreactive pattern. b. reactive pattern. c. fetal tachycardia. d. variable decelerations.
b
The nurse is reviewing the laboratory test results of a client with abnormal uterine bleeding (AUB). Which finding would be of concern? a. serum cholesterol of 140 mg/dL b. hemoglobin level of 9.1 g/dL c. negative pregnancy test d. prothrombin time of 14 seconds
b
Which action is a priority when caring for a woman during the fourth stage of labor? a. encouraging the woman to void b. assessing the uterine fundus c. offering fluids as indicated d. assisting with perineal care
b
Which information on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy? a. heavy, irregular menses b. recurrent pelvic infections c. use of oral contraceptives for 5 years d. ovarian cyst 2 years ago
b
A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 8 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which possible effect would the nurse include? a. backache b. hemorrhoids c. urinary frequency d. ankle edema
c
A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal tract, what would the nurse expect to find? Select all that apply. a. hyperemic gums b. heartburn c. increased peristalsis d. complaints of bloating
b, c, d
A nurse is developing a teaching plan about nutrition for a group of pregnant women. Which recommendations would the nurse include in the discussion? Select all that apply. a. Keep weight gain to 15 lb. b. Eat three meals with snacking. c. Participate in physical activity. d. Avoid diuretics e. Eat lots of shark
b, c, d
A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which finding would lead the nurse to suspect that the woman is developing an infection? Select all that apply. a. decreased C-reactive protein levels b. abdominal tenderness c. cloudy malodorous fluid d. elevated maternal pulse rate e. fetal bradycardia
b, c, d
Which characteristics about amniotic fluid would alert the prenatal nurse to further investigate? Select all that apply. a. The amount of amniotic fluid fluctuates at each checkup. b. The client has approximately 2 L of amniotic fluid at term. c. Polyhydramnios is noted on assessment. d. Oligohydramnios is noted on assessment. e. The client has approximately 1 L of amniotic fluid at term.
b, c, d
A woman visits the prenatal clinic and is noted to have oligohydramnios. The client asks, "Why is this fluid important anyway?" Which statements would be included in the nurse's response? Select all that apply. a. "The fetus ingests amniotic fluid for its nourishment." b. "It acts like a cushion protecting your baby from trauma that may occur." c. "Too little amniotic fluid is linked with placental problems." d. "Amniotic fluid keeps your baby free from any teratogens." e. "Amniotic fluid helps maintain your baby's body temperature.
b, c, e
A client comes to the clinic with abdominal pain. Based on her history the nurse suspects endometriosis. The nurse expects to prepare the client for which evaluatory method to confirm this suspicion? a. hysterosalpingogram b. transvaginal ultrasound c. laparoscopy d. pelvic examination
c
A client with hyperemesis gravidarum is admitted to the facility after being cared for at home without success. What would the nurse expect to include in the client's plan of care? a. total parenteral nutrition b. administration of labetalol c. nothing by mouth d. clear liquid diet
c
A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. Which level would the nurse identify as therapeutic? a. 10.8 mEq/L b. 3.3 mEq/L c. 6.1 mEq/L d. 8.4 mEq/L
c
After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against sexually transmitted infections (STIs)? a. tubal ligation b. intrauterine system c. condoms d. oral contraceptives
c
After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? a. sitting b. side-lying c. knee-chest d. supine
c
After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests? a. Estrogen (estriol) b. Progesterone (progestin) c. Human chorionic gonadotropin (hCG) d. Human placental lactogen (hPL)
c
The nurse is explaining fetal circulation to a pregnant woman during an early prenatal visit. The nurse emphasizes the difference in her baby's circulation from the woman's circulation. The nurse determines that the teaching was successful when the woman describes which reason for the difference? a. Fetal blood is thicker than that of adults and needs different pathways. b. Fetal blood has a higher concentration of oxygen and circulates more slowly. c. Fetal circulation carries rich, oxygenated blood to vital areas first. d. Fetal heart rates are rapid and circulation time is double that of adults.
c
A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which movement would the nurse most likely include? Select all that apply. a. abduction b. pronation c. internal rotation d. flexion e. descent
c, d, e
A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome? a. incompetent cervix b. abruptio placentae c. placenta previa d. congenital anomalies
d
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication? a. urinary output of 20 mL per hour b. respiratory rate of 10 breaths/minute c. difficulty in arousing d. deep tendons reflexes 2+
d
A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, "I've never urinated as often as I have for the past three weeks." Which response would be most appropriate for the nurse to make? a. "Having to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit it." b. "You shouldn't be urinating this frequently now; it usually stops by the time you're eight weeks pregnant. Is there anything else bothering you?" c. "Women having their second child generally don't have frequent urination. Are you experiencing any burning sensations?" d. "By the time you are 12 weeks pregnant, this frequent urination should really decrease, but it is likely to return toward the end of your pregnancy."
d
A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction? a. blood pressure rise from 110/60 mm Hg to 120/74 b. heart rate increase from 76 bpm to 90 bpm c. white blood cell count of 12,000 cells/mm3 d. respiratory rate of 10 breaths/minute
d
A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which symptom? a. contractions noted in the front of abdomen that stop when she walks b. pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds c. increased energy level with alternating strong and weak contractions d. moderately strong contractions every 4 minutes, lasting about 1 minute
d
A woman comes to the clinic because she has been unable to conceive. When reviewing the woman's history, the nurse would least likely identify which factor as a possible risk? a. weight below standard for height and age b. diabetes since age 15 years c. history of smoking d. age of 25 years
d
A woman is to undergo an amnioinfusion. Which statement would be most appropriate to include when teaching the woman about this procedure? a. "After the infusion, you'll be scheduled for a cesarean birth." b. "A suction cup is placed on your baby's head to help bring it out." c. "We'll give you an analgesic to help reduce the pain." d. "You'll need to stay in bed while you're having this procedure."
d
After teaching a group of students about premenstrual syndrome, the instructor determines that additional teaching is needed when the students identify which finding as a prominent assessment finding? a. bloating b. tension c. dysphoria d. weight loss
d
When applying the ultrasound transducers for continuous external electronic fetal monitoring, at which location would the nurse place the transducer to record the FHR, baby is head down? a. over the uterine fundus where contractions are most intense b. above the umbilicus toward the right side of the diaphragm c. between the xiphoid process and umbilicus d. between the umbilicus and the symphysis pubis
d
When assessing cervical effacement of a client in labor, the nurse assesses which characteristic? a. fetal presenting part b. passage of the mucous plug c. extent of opening to its widest diameter d. degree of thinning
d
When assessing several women for possible VBAC, which woman would the nurse identify as being the best candidate? a. one who has undergone a previous myomectomy b. one who has a history of a contracted pelvis c. one who has a vertical incision from a previous cesarean birth d. one who had a previous cesarean birth via a low transverse incision
d
